EM Pulse Podcast™

What happens when a febrile infant presents at 61 days old? Are they suddenly low risk for invasive bacterial infections? In this episode, we explore the gray zone of managing febrile infants aged 61–90 days with the help of two new clinical prediction rules from PECARN. Joining us are two powerhouses in pediatric emergency medicine: Dr. Nate Kuppermann and Dr. Paul Aronson, who walk us through their recent study published in Pediatrics. We discuss why prior research has traditionally stopped at 60 days, what the new data shows about risk in this slightly older age group, and how these rules might help guide clinical decision-making. This study fills a long-standing gap—but should we start using the rules now? Tune in for a nuanced discussion on sensitivity, missed cases, practical application, and the future of risk stratification in young infants with fever. What is your practice in terms of work-up of 2-3 month old febrile infants? Will this change what you do? Hit us up social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guests: Dr. Nate Kuppermann, Executive Vice President and Chief Academic Officer; Director, Children's National Research Institute; Department Chair, Pediatrics, George Washington University School of Medicine and Health Sciences Dr. Paul Aronson, Professor of Pediatrics (Emergency Medicine); Deputy Director, Pediatric Residency Program at Yale University School of Medicine Resources: “Hot” Off the Press: Infant Fever Rule Do I really need to LP a febrile infant with a UTI? Aronson PL, Mahajan P, Meeks HD, Nielsen B, Olsen CS, Casper TC, Grundmeier RW, Kuppermann N; PECARN Registry Working Group. Prediction Rule to Identify Febrile Infants 61-90 Days at Low Risk for Invasive Bacterial Infections. Pediatrics. 2025 Sep 1;156(3):e2025071666. doi: 10.1542/peds.2025-071666. PMID: 40854562; PMCID: PMC12432541. Kuppermann N, Dayan PS, Levine DA, Vitale M, Tzimenatos L, Tunik MG, Saunders M, Ruddy RM, Roosevelt G, Rogers AJ, Powell EC, Nigrovic LE, Muenzer J, Linakis JG, Grisanti K, Jaffe DM, Hoyle JD Jr, Greenberg R, Gattu R, Cruz AT, Crain EF, Cohen DM, Brayer A, Borgialli D, Bonsu B, Browne L, Blumberg S, Bennett JE, Atabaki SM, Anders J, Alpern ER, Miller B, Casper TC, Dean JM, Ramilo O, Mahajan P; Febrile Infant Working Group of the Pediatric Emergency Care Applied Research Network (PECARN). A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections. JAMA Pediatr. 2019 Apr 1;173(4):342-351. doi: 10.1001/jamapediatrics.2018.5501. PMID: 30776077; PMCID: PMC6450281. Pantell RH, Roberts KB, Adams WG, Dreyer BP, Kuppermann N, O'Leary ST, Okechukwu K, Woods CR Jr; SUBCOMMITTEE ON FEBRILE INFANTS. Evaluation and Management of Well-Appearing Febrile Infants 8 to 60 Days Old. Pediatrics. 2021 Aug;148(2):e2021052228. doi: 10.1542/peds.2021-052228. Epub 2021 Jul 19. Erratum in: Pediatrics. 2021 Nov;148(5):e2021054063. doi: 10.1542/peds.2021-054063. PMID: 34281996. **** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

Dive into the second half of our envenomation series! Dr. Jonathan Ford, a UC Davis Medical Toxicologist and Professor of Emergency Medicine, returns to the podcast to tackle scorpions and spiders. We're going beyond the basics to discuss the "why" and "how" of these bites and stings. Learn about the neurotoxic effects of bark scorpion venom and the life-threatening airway risks. Explore the mechanism behind black widow bites that leads to intense pain and spasms, and the crucial role of antivenom in severe cases. Plus, we're setting the record straight on a common myth—the brown recluse—and the proper supportive care for its nasty bite. Join us to discover the latest evidence-based approaches that could change how you manage your next bite or sting. Have you had a patient with a serious or challenging envenomation?  How did you manage it? Share your story with us social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guest: Dr. Jonathan Ford, Professor of Emergency Medicine and Medical Toxicologist at UC Davis Resources: Quan D. North American poisonous bites and stings. Crit Care Clin. 2012 Oct;28(4):633-59. doi: 10.1016/j.ccc.2012.07.010. PMID: 22998994. Levine M, Friedman N. Terrestrial envenomations in pediatric patients: identification and management in the emergency department. Pediatr Emerg Med Pract. 2021 Sep;18(9):1-24. Epub 2021 Sep 2. PMID: 34403224.. ***\ Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

Summer hikes and backyard play mean we’re bound to see a few snakebites in the ED—and getting the first steps right makes all the difference. In the first half of this 2 part series, Medical Toxicologist Dr. Jonathan Ford joins us to walk through the key steps in caring for patients with snake envenomations. We’ll walk through what to do (and not to do) in terms of pre-hospital care, how to triage and assess patients when they arrive in the ED, and how to decide which patients need antivenom. Dr. Ford reviews dosing strategies, monitoring, and key considerations for children, elderly, and pregnant patients. And we discuss practical guidance on supportive care, from pain control to wound management. By the end of this episode, you’ll be ready to provide effective, evidence-based care for your next snakebite patient. Have you had a patient with a serious or challenging envenomation?  How did you manage it? Share your story with us social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guest: Dr. Jonathan Ford, Professor of Emergency Medicine and Medical Toxicologist at UC Davis Resources: Seifert SA, Armitage JO, Sanchez EE. Snake Envenomation. N Engl J Med. 2022 Jan 6;386(1):68-78. doi: 10.1056/NEJMra2105228. PMID: 34986287; PMCID: PMC9854269. **** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

In the second half of this two part episode, Dr. David Leon unpacks some of the most hotly debated topics in resuscitation—fluids, blood products, ECMO, and post-arrest care. He breaks down the pros and cons of crystalloids (yes, even the “pasta water” debate), explains why lactated Ringer’s is often preferred over normal saline, and dips into the use of albumin and colloids. Dr. Leon also discusses the promise and challenges of extracorporeal life support (ECLS), the evolving role of targeted temperature management (TTM), and even peeks into what advances the future might hold. It’s a thoughtful, forward-looking conversation every resuscitationist should hear. What do you think of Dr. Leon’s tips? Are you using these tools in your practice? We’d love to hear from you. Share them with us on social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guest: Dr. David Leon, Assistant Professor of Emergency Medicine and Anesthesia at UC Davis Resources: American Heart Association (AHA) Algorithms Perman SM, Elmer J, Maciel CB, Uzendu A, May T, Mumma BE, Bartos JA, Rodriguez AJ, Kurz MC, Panchal AR, Rittenberger JC; American Heart Association. 2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2024 Jan 30;149(5):e254-e273. doi: 10.1161/CIR.0000000000001194. Epub 2023 Dec 18. PMID: 38108133. **** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

In this high-yield two part episode, we dive into the evolving world of resuscitation with Dr. David Leon, Assistant Professor of Emergency Medicine and Anesthesia at UC Davis. From the shift in priorities from ABC (Airway-Breathing-Circulation) to CAB (Circulation first) to the practical use of peripheral vasopressors and rapid infusion catheters, this episode breaks down how frontline ED care is adapting to sicker patients, longer ICU boarding times, and limited resources. Tune in for insights on advanced access strategies, pre-hospital blood products, and why old tools, like whole blood and vasopressin, are making a powerful comeback. What do you think of Dr. Leon’s tips? Are you using these tools in your practice? We’d love to hear from you. Share them with us on social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guest: Dr. David Leon, Assistant Professor of Emergency Medicine and Anesthesia at UC Davis Resources: American Heart Association (AHA) Algorithms Perman SM, Elmer J, Maciel CB, Uzendu A, May T, Mumma BE, Bartos JA, Rodriguez AJ, Kurz MC, Panchal AR, Rittenberger JC; American Heart Association. 2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2024 Jan 30;149(5):e254-e273. doi: 10.1161/CIR.0000000000001194. Epub 2023 Dec 18. PMID: 38108133. **** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

We’re back with another episode of Push Dose Pearls with ED Clinical Pharacist, Haley Burhans! In this episode, we break down the essentials of managing agitation in the ED—starting with why you should avoid diphenhydramine in the elderly and benzodiazepines in the 3 D’s: drunk, delirium, and dementia. We discuss how to quickly assess the cause, choose the right medication, and decide between IM and IV routes. And Haley offers some key safety tips and considerations for special populations, including kids and the elderly.  Was this episode helpful? What other medications would you like to learn more about? Hit us up on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guests: Haley Burhans, PharmD, Emergency Medicine Clinical Pharmacist at UC Davis Resources: ACEP’s New Clinical Policy on Severe Agitation. By Molly E.W. Thiessen, MD, FACEP | on February 12, 2024 Pediatric Education and Advocacy Kit (PEAK): Agitation Hoffmann JA, Pergjika A, Konicek CE, Reynolds SL. Pharmacologic Management of Acute Agitation in Youth in the Emergency Department. Pediatr Emerg Care. 2021 Aug 1;37(8):417-422. doi: 10.1097/PEC.0000000000002510. PMID: 34397677; PMCID: PMC8383287. Gerson R, Malas N, Feuer V, Silver GH, Prasad R, Mroczkowski MM. Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department: Consensus Statement of the American Association for Emergency Psychiatry. West J Emerg Med. 2019 Mar;20(2):409-418. doi: 10.5811/westjem.2019.1.41344. Epub 2019 Feb 19. Erratum in: West J Emerg Med. 2019 May;20(3):537. doi: 10.5811/westjem.2019.4.43550. Erratum in: West J Emerg Med. 2019 Jul;20(4):688-689. doi: 10.5811/westjem.2019.4.44160. PMID: 30881565; PMCID: PMC6404720.. **** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

In this episode, we welcome back Dr. John Rose as cohost for a conversation with Dr. Gary Tamkin—Emergency Physician and Vice President of Provider Development at US Acute Care Solutions. Together, they explore what it really takes to find happiness and fulfillment in the high-stakes world of emergency medicine. From the trap of the arrival fallacy to the pressure of always chasing the next milestone, Dr. Tamkin shares personal insights and practical strategies tailored to the unique challenges EM clinicians face. You’ll come away with two actionable tools to help build more meaning, balance, and joy—both on shift and off. What are your tips for avoiding burnout and finding balance? Share them with us on social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guest Host: Dr. John Rose, Professor of Emergency Medicine and EMS Medical Director at UC Davis Guest: Dr. Gary Tamkin, Emergency Physician and Vice President of Provider Development and US Acute Care Solutions Resources: Podcast: 10% Happier with Dan Harris Podcast: Hidden Brain with Shankar Vedantam Transitions by William Bridges, PhD with Susan Bridges The Happiness Advantage by Shawn Achor **** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

Hypoglycemia can be subtle—or dangerously obvious—and knowing when and how to treat it is critical. In her first episode as our new Push Dose Pearls expert, Emergency Medicine Clinical Pharmacist, Haley Burhans, joins us to break it down. We discuss glucose thresholds by age, when to draw critical labs, and how to choose the right treatment—whether it’s oral glucose, IV dextrose, or IM or intranasal glucagon. From neonates to older adults, Haley delivers practical, evidence-based pearls to help you manage low blood sugar safely and effectively in the ED. Was this episode helpful? What other medications would you like to learn more about? Hit us up on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guests: Haley Burhans, PharmD, Emergency Medicine Clinical Pharmacist at UC Davis Resources: Gandhi K. Approach to hypoglycemia in infants and children. Transl Pediatr. 2017 Oct;6(4):408-420. doi: 10.21037/tp.2017.10.05. PMID: 29184821; PMCID: PMC5682370. Rickels MR, Ruedy KJ, Foster NC, Piché CA, Dulude H, Sherr JL, Tamborlane WV, Bethin KE, DiMeglio LA, Wadwa RP, Ahmann AJ, Haller MJ, Nathan BM, Marcovina SM, Rampakakis E, Meng L, Beck RW; T1D Exchange Intranasal Glucagon Investigators. Intranasal Glucagon for Treatment of Insulin-Induced Hypoglycemia in Adults With Type 1 Diabetes: A Randomized Crossover Noninferiority Study. Diabetes Care. 2016 Feb;39(2):264-70. doi: 10.2337/dc15-1498. Epub 2015 Dec 17. PMID: 26681725; PMCID: PMC4722945.. MD Calc GIR (Glucose Infusion Rate) Calculator **** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

Summer travel is in full swing and, for physicians, that means more than just packing swimsuits and sunscreen. In this episode of EM Pulse, we sit down with wilderness medicine expert, Dr. Mary Bing, to unpack the real-world essentials of travel medical kits. From duct tape and whistles to epinephrine and steroids, you’ll learn what to bring, how to tailor your supplies based on destination and group, and why your role as a physician—formal or not—comes with extra responsibilities. Whether you’re headed to the Alps or the backyard, this episode is your go-to guide for staying medically prepared on the move. Don’t just travel light—travel smart. What’s in your first aid kit? Hit us op on on social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guests: Dr. Mary Bing, Professor of Emergency Medicine and Assistant EM Residency Program Director at UC Davis Resources: Surviving a Wilderness Emergency by Peter Kummerfeldt ACEP: First Aid Kit U.S. Customs and Border Protection: Traveling with medication ***  Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

In this follow-up to our artificial intelligence in EM series, we’re diving into how AI can enhance your professional life outside of clinical shifts. Joined by Dr. Jaymin Patel—Assistant Residency Program Director and tech-savvy educator—we explore three practical AI tools that can streamline teaching, content creation, communication, and even how you consume literature on your commute. From ChatGPT to DALL·E to NotebookLM, we break down what each tool does, how to use it effectively, what pitfalls to avoid, and how even non-educators can leverage them. Tune in to learn how to use AI intentionally, efficiently, and ethically in your day-to-day professional life.  Are you using AI in your professional life? What’s your favorite tool? Share your experience with us on social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guests: Dr. Jaymin Patel, Assistant Professor of Emergency Medicine and Assistant EM Residency Program Director at UC Davis Resources: Nivritti Gajanan Patil, Nga Lok Kou, Daniel T. Baptista-Hon, Olivia Monteiro. Artificial Intelligence in Medical Education: A Practical Guide for Educators. MedComm – Future MedicineVolume 4, Issue 2 e70018. First published: 02 April 2025 https://doi.org/10.1002/mef2.70018 ChatGPT DALL•E NotebookLM **** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

In this episode of EM Pulse, Dr. Daniel Hernandez, an emergency medicine and addiction specialist at UC Davis, joins the team to spotlight methadone—one of the original and still powerful tools for treating opioid use disorder (OUD). While newer medications like buprenorphine often steal the spotlight, methadone remains a critical option, especially in the era of fentanyl. Tune in for a practical conversation on when and how to initiate methadone in the ED, navigating regulatory barriers, arranging follow-up at opioid treatment programs, and managing pain in patients already on methadone. Whether you’re new to methadone or looking to sharpen your approach, this episode offers real-world insights and actionable pearls  Have you started methadone from the ED? Share your experience with us on social media @empulsepodcast or connect with us on ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guests: Dr. Daniel Hernandez, Assistant Professor of Emergency Medicine and Assistant Director of the Addiction Medicine Fellowship at UC Davis Resources: CA Bridge ACEP/CA Bridge - Methadone Hospital Quick Start Liberate Methadone: An Introduction for the Emergency Medicine Physician By Terence M. Hughes, MD; Joan Chen, MD; and Utsha G. Khatri, MD, MSHP | on April 14, 2025 *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

This is the next episode of our Push Dose Pearls miniseries with ED Clinical Pharmacist, Chris Adams. In this ongoing series we’ll dig into some of the questions we all have about medications we commonly see and use in the ED. In this epsidoe, we unpack the complexities of anticoagulation reversal in the emergency department - It’s not just about vitamin K anymore! Tune in as we explore the key reversal agents, when and why to use them, how fast they work, and the risks that come with turning off anticoagulation. From bleeding emergencies to stroke prevention, this quick dive offers practical pearls for navigating the coagulation cascade in real time. Have you had a bad GI bleed or intracranial hemorrhage in a patient on thinners?. Share your story with us on social media or at ucdavisem.com. Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guests: Christopher Adams, PharmD, Emergency Department Senior Clinical Pharmacist and former Assistant Professor at UC Davis Resources: Baugh CW, Levine M, Cornutt D, et al. Anticoagulant Reversal Strategies in the Emergency Department Setting: Recommendations of a Multidisciplinary Expert Panel. Ann Emerg Med. 2020 Oct;76(4):470-485. doi: 10.1016/j.annemergmed.2019.09.001. Epub 2019 Nov 13. PMID: 31732375; PMCID: PMC7393606. ACEP Point of Care Tools: Anticoagulation Reversal. **** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

Big news for emergency medicine residencies! The ACGME is proposing several major changes to EM program requirements. To comply with these new requirements, programs would need to be 4 years long. This is a hotly debated topic at the moment as most EM residencies in the U.S. currently are 3 year programs. So what are the proposed changes? How would they affect the curriculum and training for future EM physicians? To answer these questions, we sit down with UC Davis EM Program Director and medical education specialist, Dr. Aaron Danielson.  What do you think of these proposed changes? We’d love to hear from you. We’re on social media @empulsepodcast or connect with us on ucdavisem.com Host: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Guest: Dr. Aaron Danielson, Associate Professor of Emergency Medicine and Emergency Medicine Residency Program Director at UC Davis Resources: Share your comments with the ACGME ACEP: ACGME Releases Proposed Changes to EM Program Requirements UC Davis Emergency Medicine Residency Program *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services. Disclaimer

In the fourth and final episode of our advocacy mini series with guest host, Dr. Anna Yap, we dive into a powerful story of advocacy led by a mother-daughter duo. Pediatric nurse practitioner Robyn Lao and her 9-year-old daughter, Addie, who has severe food allergies, turned their personal challenges into a statewide movement by co-authoring California Senate Bill 68—the Allergen Disclosure for Dining Experiences (ADDE) Act. Together, they share their journey from navigating daily food allergy struggles to pushing for legislative change, proving that anyone, at any age, can make a difference. Tune in to hear how their determination is shaping a safer future for millions. Have you been involved in health care related legislation? Share your story with us on social media @empulsepodcast or at ucdavisem.com Host: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest Host: Dr. Anna Yap, Assistant Professor of Emergency Medicine and Director and Health Policy & Administration Fellowship Director at UC Davis Guest: Robyn Lao, D.N.P., C.P.N.P.-A.C., Pediatric Surgery Nurse Practitioner at UC Davis  Addie Lao, 9-year-old Food Allergy Advocate Resources: Addie’s website: Addie Tells All Addie’s Video and YouTube Channel California SB 68: The Allergen Disclosure for Dining Experiences (ADDE) Act ACEP: Tools for Effective State Advocacy **** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services. Disclaimer

In the third episode of our advocacy mini series with Dr. Anna Yap, we explore the evolving challenges faced by transgender patients and medical professionals in today’s political climate. We’re joined by Charlie Adams, a fourth-year medical student and dedicated advocate, who shares his powerful journey fighting for transgender rights and health equity. Together, we discuss the importance of gender-affirming care, the real-world impact of restrictive laws, and how we can improve emergency department care for transgender patients. Tune in for an insightful conversation on advocacy, inclusivity, and the role we all play in creating a more supportive healthcare system. How have your patients and your practice environment been affected by legal and political changes in transgender rights? Share your story with us on social media @empulsepodcast or at ucdavisem.com Host: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest Host: Dr. Anna Yap, Assistant Professor of Emergency Medicine and Director and Health Policy & Administration Fellowship Director at UC Davis Guest: Charlie Adams, Medical Student, Future Emergency Physician, and Transgender Health Advocate  Resources: Charlie Adams’ Instagram: @transproudmed ACEP: Caring for Transgender and Gender Diverse Patients in the Emergency Department Clarifying Misconceptions About Youth Gender-Affirming Care. By Center for Health Journalism Fellow, Sophie Putka. May 22, 2024 Trans adults on edge as legislatures broaden focus beyond children. Washington Post, February 15, 2024 Gender-affirming care is life-saving, research says. Why is it so controversial? by David Oliver, USA Today, Nov 1, 2023 *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services. Disclaimer

In the second episode of our advocacy mini series with Dr. Anna Yap, we dive into the critical intersection of emergency medicine and immigration health. As emergency physicians, we frequently care for undocumented patients, asylum seekers, and refugees—individuals who face significant barriers to medical care, including fear, cost concerns, and language obstacles. Dr. Ellen Shank, a UC Davis health policy fellow and expert in migrant healthcare, joins us to explore the legal and ethical responsibilities of emergency providers, including how to navigate interactions with immigration enforcement, protect patient rights, and provide trauma-informed care. We’ll discuss practical ways physicians can advocate for these vulnerable populations, from facilitating asylum medical exams to supporting protective hospital policies. Tune in for an essential discussion on how emergency physicians can go beyond medical treatment to become informed advocates for their patients in an evolving immigration landscape. Has ICE come to your ED? Share your story with us on social media @empulsepodcast or at ucdavisem.com Host: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest Host: Dr. Anna Yap, Assistant Professor of Emergency Medicine and Director and Health Policy & Administration Fellowship Director at UC Davis Guest: Dr. Ellen Shank, Emergency Physician and Health Policy Fellow at UC Davis.  Resources: ACEP: Navigating Immigration Enforcement in the Emergency Department Red Cards/Tarjetas Rojas (download and print in multiple languages) Q&A on Immigration Enforcement for Hospitals (Greater New York Hospital Association) “Know Your Rights” video for patients in several languages (Immigration Institute of the Bay Area) *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services. Disclaimer

When corporate interests threaten patient care, who speaks up for doctors and their patients? This episode kicks off a special EM Pulse mini-series with guest host, Dr. Anna Yap, in which we explore the power of advocacy in medicine. In our first episode, Dr. Michelle Wiener shares how she and her colleagues took on a private equity-backed staffing group, formed a union, and fought for safer working conditions—proving that real change starts from within. Whether you’re new to advocacy or already involved, this series will inspire you to take action. Have you or you colleagues considered collective bargaining to address concerns in your ED?  We’d love to hear from you on social media @empulsepodcast or at ucdavisem.com Host: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest Host: Dr. Anna Yap, Assistant Professor of Emergency Medicine and Director and Health Policy & Administration Fellowship Director at UC Davis Guest: Dr. Michelle Wiener, Emergency Physician and Clinical Faculty at Henry Ford Health in Detroit, MI. mrsdrwiener@gmail.com Resources: ACEP: Unionization Unionization. An Information Paper This information paper was created by members of the ACEP Medical-Legal Committee June 2024  AMA Advocacy Resource Center ***** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services. Disclaimer

In this final installment of our three-part series on artificial intelligence in emergency medicine, we explore the rapid expansion of AI and its implications for clinical practice. In previous episodes, we explored how AI is revolutionizing tasks like diagnosis, treatment planning, and patient monitoring. In this final chapter, guest expert, Dr. Brian Patterson, joins us to discuss how to safely integrate AI into clinical practice. We recap insights from previous episodes, including AI’s transformative potential and real-world applications, while diving into the challenges and regulatory efforts shaping this exploding field. Whether you’re an AI skeptic or an early adopter, this episode unpacks what you need to know about integrating AI safely and effectively into emergency medicine. How are you using AI in your ED? What are your concerns and hopes for the future of AI in medicine? Keep the discussion going on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest: Dr. Brian Patterson, Associate Professor Emergency Medicine and Physician Administrative Director of Clinical AI at the University of Wisconsin.  Resources: Liao F, Adelaine S, Afshar M, Patterson BW. Governance of Clinical AI applications to facilitate safe and equitable deployment in a large health system: Key elements and early successes. Front Digit Health. 2022 Aug 24;4:931439. doi: 10.3389/fdgth.2022.931439. PMID: 36093386; PMCID: PMC9448877. Mello MM, Guha N. Understanding Liability Risk from Using Health Care Artificial Intelligence Tools. N Engl J Med. 2024 Jan 18;390(3):271-278. doi: 10.1056/NEJMhle2308901. PMID: 38231630. OpenEvidence.com *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

In the second episode our three part series, we dive deeper into the practical impact of artificial intelligence on emergency medicine with expert, Dr. Gabriel Wardi. Building on our previous discussion about AI’s role in healthcare, we explore clinical decision support systems (CDS)—how they aim to improve diagnostic accuracy but can sometimes miss the mark. Dr. Wardi shares insights from his own experience implementing AI-driven CDS, highlighting both its successes and challenges, including bias, reliability, and the importance of high-quality data. We discuss how AI can address traditional pitfalls of CDS, improve outcomes like sepsis care, and offer a glimpse into the future of AI in emergency settings. Plus, we look ahead to the critical conversation of AI governance and regulation in EM. Tune in as we break down what’s working, what’s next, and how frontline EM physicians can stay ahead of the curve. How are you using AI in your ED? What are your concerns and hopes for the future of AI in medicine? Keep the discussion going on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest: Dr. Gabriel Wardi, Associate Professor & Chief of the Division of Critical Care in the Department of Emergency Medicine at UC San Diego Resources: Boussina A, Shashikumar SP, Malhotra A, Owens RL, El-Kareh R, Longhurst CA, Quintero K, Donahue A, Chan TC, Nemati S, Wardi G. Impact of a deep learning sepsis prediction model on quality of care and survival. NPJ Digit Med. 2024 Jan 23;7(1):14. doi: 10.1038/s41746-023-00986-6. Erratum in: NPJ Digit Med. 2024 Jun 12;7(1):153. doi: 10.1038/s41746-024-01149-x. PMID: 38263386; PMCID: PMC10805720. *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

In this episode, we dive into how AI is changing emergency medicine with Dr. Peter Steel, an expert in AI and EM at Cornell. We break down the basics of AI, machine learning, and deep learning, explore real-world applications like improving triage and clinical decision-making, and tackle challenges like bias and integration in high-pressure settings. Dr. Steel shares insights on generative AI, large language models, and the exciting future of AI in EM. If you’re curious about how AI can transform patient care and what’s next for the field, this episode is for you! How are you using AI in your ED? What are your concerns and hopes for the future of AI in medicine? Keep the discussion going on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Guest: Dr. Peter Steel, Associate Professor of Clinical Emergency Medicine and Vice Chair of Clinical Services at Weill Cornell Medical College Resources: Challen R, Denny J, Pitt M, Gompels L, Edwards T, Tsaneva-Atanasova K. Artificial intelligence, bias and clinical safety. BMJ Qual Saf. 2019 Mar;28(3):231-237. doi: 10.1136/bmjqs-2018-008370. Epub 2019 Jan 12. PMID: 30636200; PMCID: PMC6560460. *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.