Podcasts about Pediatric emergency medicine

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.

Is that penicillin or amoxicillin allergy real? Probably not. In this episode, we explore how to assess risk, talk to parents, and refer for delabeling. You'll also learn what happens in the allergy clinic, why the label matters, and how to be a better antimicrobial steward. Learning Objectives Describe the mechanisms and clinical manifestations of immediate and delayed hypersensitivity reactions to penicillin, including diagnostic criteria and risk stratification tools such as the PEN-FAST score. Differentiate between low-, moderate-, and high-risk penicillin allergy histories in pediatric patients and identify appropriate candidates for direct oral challenge or allergy referral based on current evidence and guidelines. Formulate an evidence-based approach for evaluating and counseling families in the Emergency Department about reported penicillin allergies, including when to recommend outpatient referral for formal delabeling. Connect with Brad Sobolewski PEMBlog: PEMBlog.com Blue Sky: @bradsobo X (Twitter): @PEMTweets Instagram: Brad Sobolewski References Khan DA, Banerji A, Blumenthal KG, et al. Drug Allergy: A 2022 Practice Parameter Update. J Allergy Clin Immunol. 2022;150(6):1333-1393. doi:10.1016/j.jaci.2022.08.028 Moral L, Toral T, Muñoz C, et al. Direct Oral Challenge for Immediate and Non-Immediate Beta-Lactam Allergy in Children. Pediatr Allergy Immunol. 2024;35(3):e14096. doi:10.1111/pai.14096 Castells M, Khan DA, Phillips EJ. Penicillin Allergy. N Engl J Med. 2019;381(24):2338-2351. doi:10.1056/NEJMra1807761 Shenoy ES, Macy E, Rowe T, Blumenthal KG. Evaluation and Management of Penicillin Allergy: A Review.JAMA. 2019;321(2):188–199. doi:10.1001/jama.2018.19283 Transcript Note: This transcript was partially completed with the use of the Descript AI and the Chat GPT 5 AI  Welcome to PEM Currents, the Pediatric Emergency Medicine podcast. As always, I'm your host, Brad Sobolewski, and today we are taking on a label that's misleading, persistent. Far too common penicillin allergy, it's often based on incomplete or inaccurate information, and it may end up limiting safe and effective treatment, especially for the kids that we see in the emergency department. I think you've all seen a patient where you're like. I don't think this kid's really allergic to amoxicillin, but what do you do about it? In this episode, we're gonna break down the evidence, walk through what actually happens during de labeling and dedicated allergy clinics. Highlight some validated tools like the pen FAST score, which I'd never heard of before. Preparing for this episode and discuss the current and future role of ED based penicillin allergy testing. Okay, so about 10% of patients carry a penicillin allergy label, but more than 90% are not truly allergic. And this label can be really problematic in kids. It limits first line treatment choices like amoxicillin, otitis media, or penicillin for strep throat, and instead. Kids get prescribed second line agents that are less effective, broader spectrum, maybe more toxic or poorly tolerated and associated with a higher risk of antimicrobial resistance. So it's not just an EMR checkbox, it's a label with some real clinical consequences. And it's one, we have a role in removing. And so let's understand what allergy really means. And most patients with a reported penicillin allergy, especially kids, aren't true allergies in the immunologic sense. Common misinterpretations include a delayed rash, a maculopapular, or viral exum, or benign, delayed hypersensitivity, side effects, nausea, vomiting, and diarrhea. And unverified childhood reactions that are undocumented and nonspecific. Most of these are not true allergies. Only a very small subset of patients actually have IgE mediated hypersensitivity, such as urticaria, angioedema, wheezing, and anaphylaxis. These are super rare, and even then they may resolve over time without treatment. If a parent or sibling has a history of a penicillin allergy, remember that patient might actually not be allergic, and that is certainly not a reason to label a child as allergic just because one of their first degree relatives has an allergy. So right now, in 2025, as I'm recording this episode, there are clinics like the Pats Clinic or the Penicillin Allergy Testing Services at Cincinnati Children's and in a lot of our peer institutions that are at the forefront of modern de labeling. Their approach reflects the standard of care as outlined by the. Quad ai or the American Academy of Allergy, asthma and Immunology and supported by large trials like Palace. And you know, you have a great trial if you have a great acronym. So here's what happens step by step. So first you stratify the risk. How likely is this to be a true allergy? And that's where a tool like the pen fast comes. And so pen fast scores, a decision rule developed to help assess the likelihood of a true penicillin allergy based on the patient's history. The pen in pen fast is whether or not the patient has a self-reported history of penicillin allergy. They get two points if the reaction occurred in the past five years. Two points if the reaction is anaphylaxis or angioedema. One point if the reaction required treatment, and one point if the reaction was not due to testing. And so you can get a total score of. Up to six points. If you have a score of less than three. This is a low risk patient and they can be eligible for direct oral challenge. A score greater than three means they're higher risk and they may require skin testing. First validation studies show that the PEN FFA score of less than three had a negative predictive value of 96.3%. Meaning a very, very low chance of a true allergy. And this tool has been studied more extensively in adults, but pediatric specific adaptations are emerging, and they do inform current allergy clinic protocols. But I would not use this score in the emergency department just to give a kid a dose of amoxicillin. So. For low risk patients, a pen fast score of less than three or equivalent clinical judgment clinics proceed with direct oral challenge with no skin testing required. The protocol is they administer one dose of oral amoxicillin and they observe for 62 120 minutes monitoring for signs of reaction Urticaria. Respiratory symptoms or GI upset. This approach is safe and effective. There was a trial called Palace back in 2022, which validated this in over 300 children. In adolescents. There were no serious events that occurred. De labeling was successful in greater than 95% of patients. And skin tested added no benefit in low risk patients. So if the child tolerates this dose, then you can remove that allergy immediately from the chart. Parents and primary care doctors will receive a summary letter noting that the challenge was successful and that there's new guidance. Children and families are told they can safely receive all penicillins going forward. And providers are encouraged to document this clearly in the allergy section of the EMR. So you're wondering, can we actually do this in the emergency department? Technically, yes, you can do what you want, but practically we're not quite there yet. So we'd need clearer risk stratification tools like the Pen fast, a safe place for monitoring, post challenge, clinical pathways and documentation support. You know, a clear way to update EMR allergy labels across the board and involvement or allergy or infectious disease oversight. But it's pretty enticing, right? See a kid you diagnose otitis media. You think that their penicillin allergy is wrong, you just give 'em a dose of amox and watch 'em for an hour. That seems like a pretty cool thing that we might be able to do. So some centers, especially in Canada and Australia, do have some protocols for ED or inpatient based de labeling, but they rely on that structured implementation. So until then, our role in the pediatric emergency department is to identify low risk patients, avoid over document. Unconfirmed reactions and refer to allergy ideally to a clinic like the pets. So who should be referred and good candidates Include a child with a rash only, especially one that's remote over a year ago. Isolated GI symptoms. Parents unsure of the details at all. No history of anaphylaxis wheezing her hives, and no recent serious cutaneous reactions. I would avoid referring and presume that this allergy is true. If they've had recent anaphylaxis, they've had something like Stevens Johnson syndrome dress, or toxic epidermolysis necrosis. Fortunately, those are very, very rare with penicillins and there's a need for penicillin during the ED visit without allergy backup. So even though we don't have an ED based protocol yet. De labeling amoxicillin or penicillin allergy can start with good questions in the emergency department. So here's one way to talk to patients and families. You can say, thanks for letting me know about the amoxicillin allergy. Can I ask you a few questions to better understand what happened? This is gonna help us decide the safest and most effective treatment for your child today, and then possibly go through a process to remove a label for this allergy that might not be accurate. You wanna ask good, open-ended questions. What exactly happened when your child took penicillin or amoxicillin? You know, look for rash, hives, swelling, trouble breathing, or anaphylaxis. Many families just say, allergic, when the reaction was just GI upset, diarrhea or vomiting, which is not an allergy. How old was your child when this happened? Reactions that occurred before age of three are more likely to be falsely attributed. How soon after taking the medicine did the reaction start? Less than one hour is an immediate reaction, but one hour to days later is delayed. Usually mild and probably not a true allergy. Did they have a fever, cold or virus at that time? Viral rashes are often misattributed to antibiotics, and we shouldn't be treating viruses with antibiotics anyway, so get good at looking at ears and know what you're seeing. And have they taken similar antibiotics since then? Like. Different penicillins, Augmentin, or cephalexin. So if they said that they were allergic to amoxicillin, but then somehow tolerated Augmentin. They're not allergic. If a patient had rash only, but no hive swelling or difficulty breathing, no reaction within the first hour. It occurred more than five years ago or before the kid was three. And especially if they tolerated beta-lactam antibiotics. Since then, they're a great candidate for de labeling and I would refer that kid to the allergy clinic. Generally, they can get them in pretty darn quick. Alright, we're gonna wrap up this episode. Most kids labeled penicillin allergic or amoxicillin allergic, or not actually allergic to the medication. There are some scores like pen fasts that are validated tools to assess risk and support de labeling. Direct oral challenge for most patients is safe, efficient, and increasingly the standard of care. There are allergy clinics like the Pats at Cincinnati Children's that can dela children in a single visit with oral challenges alone, needing no skin testing, and emergency departments can play a key role in identifying and referring these patients and possibly de labeling ourselves in the future. Well, that's all for this episode on Penicillin Allergy. I hope you learn something new, especially how to assess whether an allergy label is real, how to ask the right questions and when to refer to an allergy testing clinic. If you have feedback, send it my way. Email, comment on the blog, a message on social media. I always appreciate hearing from you all, and if you like this episode, please leave a review on your favorite podcast app. Really helps more people find the show and that's great 'cause I like to teach people stuff. Thanks for listening for PEM Currents, the Pediatric Emergency Medicine podcast. This has been Brad Sobolewski. See you next time.

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.

In this week's episode, we explore how creativity, humor, and connection can be powerful tools for mental health and healing.Part 1: When anxiety starts taking over her life, Jude Treder-Wolff signs up for an improv class.Part 2: Counselor Belinda Arriaga and emergency medicine doctor Nancy Ewen join forces to collect scientific evidence of the power of culturally responsive mental health care.Jude Treder-Wolff is a creative arts therapist, writer/performer and trainer with Lifestage, Inc, a company that provides creative personal and professional development workshops and classes. She believes that creativity is a renewable resource that is the energy of change anyone can tap into for healing, change and growth. She hosts (mostly) TRUE THINGS, a game wrapped in a true storytelling show performed once a month in Port Jefferson, NY and brings storytelling workshops to the Sandi Marx Cancer Wellness Program and Seniors Program at the Sid Jacobsen Jewish Community Center and the Alzheimer's Education and Resource Center on Long Island, the National Association of Social Workers in NYS as well as other social service organizations. She has been featured on many shows around the country, including RISK! live show and podcast, Generation Women, Mortified, Story District in Washington D.C., Ex Fabula in Milwaukee WI and PBS Stories From The Stage.Dr. Belinda Hernandez-Arriaga, LCSW, is an educator, advocate, and visionary leader fueled by love and courage. As the Founder and Executive Director of Ayudando Latinos A Soñar (ALAS) in Half Moon Bay, she has transformed the farmworker community, infusing it with cultural pride and unyielding hope. Under her leadership, the Coast's first affordable housing for farmworker elders became a reality, and mental health care for immigrants was reimagined with arts, culture, and community at the center. A beloved mentor and award-winning author of a children's book on family separation, Belinda championed farmworkers' needs during the pandemic and led her community's healing after a mass shooting. From the southern border to the White House, her advocacy has touched countless lives and inspires change rooted in our collective humanity. A passionate educator, Dr. Hernandez-Arriaga teaches at the University of San Francisco, inspiring the next generation of counselors and activists. At ALAS, She has built groundbreaking partnerships with USF and Stanford to lead pioneering research on the power of culturally responsive mental health care. She has helped to publish works like There Is a Monster in My House, Cultura Cura, and Olvidados Entre la Cosecha, which illuminate the emotional experiences of undocumented and mixed-status youth. Belinda has presented ALAS's findings at major conferences such as the American Psychological Association and the Pediatric Academic Societies, resulting in groundbreaking tools including the first-ever Spanish-language instrument to measure immigration trauma. Dr. Belinda's work has positioned ALAS as a national model for community-driven, mental health programs that champion the belief that La Cultura Cura, that culture cures. Belinda also co-founded the Latino Advisory Council in Half Moon Bay, helped launch the Latino Trauma Institute, and actively collaborates with Bay Area Border Relief. A former San Mateo County District 3 Arts Commissioner and inductee of the San Mateo County Women's Hall of Fame, Belinda is an active civic leader. She is also a proud mother of three and holds a Doctor of Education from the University of San Francisco.Dr. N Ewen Wang is a Professor Emerita of Emergency Medicine and Pediatrics. She was Associate Director of Pediatric Emergency Medicine at the Stanford University School of Medicine for more than 20 years. Her career has been committed to serving vulnerable populations and decreasing health disparities locally as well as globally. She founded the Stanford section in Social Emergency Medicine, a field which uses the perspective of the Emergency Department (ED) to identify patient social needs which contribute to disease and to develop solutions to decrease these health disparities. As such, she directed the Social Emergency Medicine fellowship and was medical director for a student-run group which screened ED patients for social needs (Stanford Health Advocates and Research in the ED (SHAR(ED)). She has worked clinically and educated trainees and faculty globally, including at sites in Chiapas, Mexico; Borneo Indonesia and Galapagos, Ecuador. Her current research and advocacy includes investigating disparities in specialty care access and quality, including trauma and mental health. Dr. Wang also works with community organizations to understand best models to provide wraparound social and medical services for unaccompanied immigrant children, for which she has received Stanford Impact Labs, Center for Innovation in Global Health and Office of Community Engagement grants. She presently serves as a medical expert with the Juvenile Care Monitoring team for the U.S. Federal Court overseeing the treatment of migrant children in U.S. detention. In 2023, she was appointed as the inaugural Faculty Director of the Health Equity Education MD/Masters Program at the Stanford School of Medicine. Dr. Wang completed an Emergency Medicine Residency at Stanford and then a Pediatric Emergency Medicine Fellowship between LPCH and Children's Oakland.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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.

The emDOCs.net team is very happy to collaborate with PECARN STELAR (Seattle, Dallas/Texas, and Los Angeles) Node and the Emergency Medical Services for Children Innovation and Improvement Center (EIIC) in presenting high-yield pediatric topics that highlight evidence based medicine with solid research. Dr. Chris Buresh from Seattle Children's Hospital joins us to discuss addressing Substance Use Disorder in children and adolescents and he impactful role of the Emergency Department.To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play

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.

Two deep thinkers and leaders in American healthcare—Dr. Fiona Havers, recently a medical epidemiologist at the U.S. Centers for Disease Control, and Dr. Kenneth Michelson, Associate Professor of Pediatric Emergency Medicine at Lurie Children's—join Meidas Health host Dr. Vin Gupta for a vital discussion on childhood vaccine schedules and the state of pediatric healthcare in the U.S. Learn more about your ad choices. Visit megaphone.fm/adchoices

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.

Dr. Hoffman continues his conversation with Dr. Michelle Perro, a seasoned pediatrician and integrative medicine specialist, about her upcoming book, “Making Our Children Well: A Guidebook Empowering Parents with Nutrition and Homeopathy.” 

Empowering Parents with Nutritional and Integrative Health Strategies for Children: Dr. Michelle Perro, a seasoned pediatrician and integrative medicine specialist. discusses her upcoming book, “Making Our Children Well: A Guidebook Empowering Parents with Nutrition and Homeopathy,” which aims to provide parents with practical health strategies. The conversation covers Dr. Perro's extensive experience in various medical fields, the harmful impacts of GMO foods and pesticides, and the benefits of integrative approaches like homeopathy. They delve into controversial topics such as vaccine safety and the need for nutrition education in medical schools, highlighting Robert F. Kennedy Jr.'s initiatives. Dr. Perro shares insights into the ongoing health crises affecting children, including chronic diseases, autism, and the toxic effects of certain medical practices and environmental factors.

The emDOCs.net team is very happy to collaborate with PECARN STELAR (Seattle, Dallas/Texas, and Los Angeles) Node and the Emergency Medical Services for Children Innovation and Improvement Center (EIIC) in presenting high-yield pediatric topics that highlight evidence based medicine with solid research. Dr. Fishe focused on implementation science in EMS care particularly with regards to asthma.To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play

In this episode Jesse Hackell, MD, FAAP, discusses the use of chaperones for pediatric and adolescent encounters. Hosts David Hill, MD, FAAP, and Joanna Parga-Belinkie, MD, FAAP, also speak with Megan Attridge, MD, MS, FAAP, about the development of an advocacy curriculum for pediatric emergency medicine fellows. For resources go to aap.org/podcast.

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.

Newborns are small and examining them the “right way” does not take much and is worth doing, and why it is important (and helpful) to look at Pediatric Emergency Medicine as Simple.

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.

Neck injuries are pretty common in children and may be scary since a significant injury may result in paralysis or loss of sensation. In this episode, we are joined by Pediatric Emergency Medicine specialist Dr. Julia Magaña to discuss common mechanisms of neck injury, how neck injuries are evaluated, when imaging such as x-rays or CT scans are appropriate, and treatment of minor injuries. Don’t let a pain in the neck stop you from listening to this episode! This episode written by Drs. Magaña and Blumberg. We thank Dr. Julia Magaña, Professor of Emergency Medicine at UC Davis Health for joining us for this episode. Additional Resources: Healthy Children Neck Pain or Stiffness Leonard JC et al Lancet article PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study Healthy Children Kids & Sports Injuries: What to Do If Your Young Athlete Gets Hurt Photo courtesy of Active Sport & Spine Therapy Neck injuries are pretty common in children and may be scary since a significant injury may result in paralysis or loss of sensation. In this episode, we are joined by Pediatric Emergency Medicine specialist Dr. Julia Magaña to discuss common mechanisms of neck injury, how neck injuries are evaluated, when imaging such as x-rays or CT scans are appropriate, and treatment of minor injuries. Don’t let a pain in the neck stop you from listening to this episode! This episode written by Drs. Magaña and Blumberg. We thank Dr. Julia Magaña, Professor of Emergency Medicine at UC Davis Health for joining us for this episode. Additional Resources: Healthy Children Neck Pain or Stiffness Leonard JC et al Lancet article PECARN prediction rule for cervical spine imaging of children presenting to the emergency department with blunt trauma: a multicentre prospective observational study Healthy Children Kids & Sports Injuries: What to Do I

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

Glyphosate exposure in kids is a growing concern for parents striving to protect their families from toxins in today's environment. In this episode, pediatrician and GMO expert Dr. Michelle Perro dives into the hot topic of glyphosate—what it is, how it affects children's health, and whether it's a hidden hazard or overhyped concern. Dr. Perro breaks down how glyphosate disrupts gut health, depletes nutrients, and impairs detox pathways, contributing to chronic health issues in children. But don't worry—this conversation is as empowering as it is eye-opening! You'll walk away with practical tips to reduce exposure, detoxify effectively, and make informed choices about organic foods, homeopathy, and natural remedies. From apple cider vinegar as a glyphosate-fighter to detox baths and gut-healing herbs, Dr. Perro shares her best tools to support your child's health. Whether you're a seasoned health-conscious parent or just beginning to clean up your family's diet, this episode is packed with insights to keep your family thriving in a toxic world. Tune in to learn how to turn worry into action and walk away with confidence that you're doing the best for your kids' health—because every mom deserves to feel empowered! Topics Covered In This Episode: Glyphosate impact on kids Organic foods and detoxification Homeopathy for children's health Detox tips for families Reducing exposure to toxins Show Notes: Check out Dr. Perro's website Follow @gmoscience on X Order What's Making our Children Sick? Click here to learn more about Dr. Elana Roumell's Doctor Mom Membership, a membership designed for moms who want to be their child's number one health advocate! Click here to learn more about Steph Greunke, RD's Substack Mindset + Metabolism where women can learn how to nourish their bodies, hit their health and body composition goals, and become the most vibrant version of themselves.  Listen to today's episode on our website Michelle Perro, MD, DHom, is a veteran clinician with over four decades of experience in both pediatrics as well as in integrative medicine, treating both children and their families.  Her career began in Pediatric Emergency Medicine winding its way into integrative medicine over the past 25 years.  She has been director of a Pediatric Emergency Department in NYC and spent over a decade at UCSF Benioff Oakland Children's Hospital Emergency Department.  Dr. Perro has been a tireless advocate regarding the role of GM food and their associated pesticides centered on their affect on children's health.  Dr. Perro has lectured nationally and internationally on the state of our children's health and produced the first Children's Environmental Health Bill of Rights.  She is co-author of the highly acclaimed book, “What's Making our Children Sick?” (https://www.chelseagreen.com/product/whats-making-our-children-sick/).  She is the CEO/co-founder of the website www.gmoscience.org, focused on food as medicine and the regeneration education movement.  Her monthly podcast, The New MDS can be found here.  Her next book, “Making our Children Well” is scheduled to be released in 2025. This Episode's Sponsors  Enjoy the health benefits of PaleoValley's products such as their supplements, superfood bars and meat sticks.  Receive 15% off your purchase by heading to paleovalley.com/doctormom  Discover for yourself why Needed is trusted by women's health practitioners and mamas alike to support optimal pregnancy outcomes. Try their 4 Part Complete Nutrition plan which includes a Prenatal Multi, Omega-3, Collagen Protein, and Pre/Probiotic. To get started, head to thisisneeded.com, and use code DOCTORMOM20 for 20% off Needed's Complete Plan! Active Skin Repair is a must-have for everyone to keep themselves and their families healthy and clean.  Keep a bottle in the car to spray your face after removing your mask, a bottle in your medicine cabinet to replace your toxic first aid products, and one in your outdoor pack for whatever life throws at you.  Use code DOCTORMOM to receive 20% off your order + free shipping (with $35 minimum purchase). Visit BLDGActive.com to order. INTRODUCE YOURSELF to Steph and Dr. Elana on Instagram. They can't wait to meet you! @stephgreunke @drelanaroumell Please remember that the views and ideas presented on this podcast are for informational purposes only.  All information presented on this podcast is for informational purposes and not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a healthcare provider. Consult with your healthcare provider before starting any diet, supplement regimen, or to determine the appropriateness of the information shared on this podcast, or if you have any questions regarding your treatment plan.

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 lieu of a traditional episode this holiday season I wanted to share a reading of the Pediatric Emergency Medicine version of a famous Christmas poem. Transcript ‘Twas the night before Christmas, and I'm working a shift,The symptoms were varied, the pace was quite swift.The screens glowed with orders, the rooms filled with care,In hopes […]

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 are joined by the renowned Dr. Michelle Perro, a pediatrician with over 40 years of experience and a dedicated advocate for children's health. Together, Dr. Jill Carnahan and Dr. Michelle Perro dive deep into the critical issues affecting the wellness and health of the next generation. This conversation covers a wide array of topics essential for parents, educators, and health practitioners alike. Key Points ✅ How the massive exposure to Roundup and glyphosate is affecting our children's health and microbiome ✅ The surprising sources of Toxic metals in children's diet, especially school lunches ✅ What you can do that is accessible and affordable as a parent to help your children detox

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.

In this episode, we dive into the rising threat of cyberattacks on healthcare systems and their profound impact on emergency medicine. With 386 attacks reported in 2024 alone (as of October 7th), the likelihood of your hospital being targeted is increasing. But why are these attacks happening, and what can we do to mitigate their effects? To explore this critical topic, we're joined by Dr. In Kim, Executive Vice Chair of Pediatrics at the University of Louisville School of Medicine and a leader in advancing his university's cyber capabilities. From real-world examples of devastating attacks to actionable steps for hospitals, departments, and individual physicians, we'll break down what you need to know to protect your patients, your practice, and yourself. Don't miss this essential discussion for every emergency medicine provider! Has your health system been the victim of a cyber attack? Tell us your story and 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. In K. Kim, Executive Vice Chair and Professor of Pediatrics, Executive Medical Director, Norton Children's Medical Group, and Director of the Center for Health Process Innovation at the University of Louisville Schools of Medicine and Business Resources: American Hospital Association: A Look at 2024's Health Care Cybersecurity Challenges  By John Riggi, National Advisor for Cybersecurity and Risk, AHA U.S. Department of Health and Human Services Office for Civil Rights Breach Portal *** 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.

It seems like kids are playing competitive sports younger and younger these days. Is playing one sport year round ok? When is it safe for kids to start running? Lifting weights? How can you tell growing pains from something that needs to be check out?Join us on this episode with our guest Dr. Julia Rawlings, MD. Dr. Rawlings is trained in Pediatric Emergency Medicine with additional fellowship training in Primary Care Sports Medicine.  She is the team physician for the USA climbing team!What is sports specialization? How to recognize burnout and overuse injuries. Join us for this intro to sports! 

On this "Outside Hospitalist" episode of Talking Pediatrics, Dr. Gabi Hester chats with Children's Minnesota Sports Medicine and Pediatric Emergency Medicine physician Dr. Laura Nilan, and Tria Orthopedics Certified Athletic Trainer, Micaela Kelso-Otieno, about keeping young athletes healthy. 

In this episode, we address the growing concern over political violence in the United States as the presidential election draws near. Political violence, defined as the intentional use of power and force to achieve political ends, is a significant public health issue. Violence researcher and emergency physician, Dr. Garen Wintemute, joins us to provide a clear, evidence-based perspective on the topic. We explore recent data and expert insights to better understand the threat of political violence, its potential impact in emergency departments, and what we can do about it. *Please note: Views and opinions expressed in this episode are the speaker's own and do not represent those of UC Davis or the University of California.*  Are you concerned about political violence related to the upcoming election? How are you and your ED preparing? 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. Garen Wintemute, Distinguished Professor of Emergency Medicine and Director of the Violence Prevention Research Program at UC Davis Resources: Opinion: Don't underestimate threats of violence from Proud Boys and other right-wing groups. By Dr. Garen Wintemute. Los Angeles Times, September 20, 2024.  Opinion: Too many Americans support political violence.  It's up to the rest of us to dissuade them. By Dr. Garen Wintemute. Los Angeles Times, July 18, 2024. Wintemute GJ. Guns, violence, politics: the gyre widens. Inj Epidemiol. 2021 Nov 2;8(1):64. doi: 10.1186/s40621-021-00357-3. Wintemute GJ, Robinson SL, Crawford A, Tancredi D, Schleimer JP, Tomsich EA, Reeping PM, Shev AB, Pear VA. Views of democracy and society and support for political violence in the USA: findings from a nationally representative survey. Injury Epidemiology. 2023;10(1):45. FACT SHEET Wintemute GJ, Robinson SL, Tomsich EA, Tancredi DJ. MAGA Republicans' views of American democracy and society and support for political violence in the United States: a nationwide population-representative survey. PLOS ONE. 2024;19(1):e029574

As emergency physicians, we are very familiar with giving naloxone to patients with concern for opioid overdose. Our EMS colleagues give naloxone all the time in the prehospital setting. We know it works well for patients who are obtained due to opioids, but what about for patients who have an out-of-hospital cardiac arrest? Our expert on todays episode, Dr. David Dillon, set out to find out.  Were you surprised by the findings in Dr. Dillon's study? Does it change your practice? 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, Associate Professor of Emergency Medicine at UC Davis Guests: David Dillon, M.D., M.Phil., Ph.D, Assistant Professor of Emergency Medicine at UC Davis Resources: Dillon DG, Montoy JCC, Nishijima DK, Niederberger S, Menegazzi JJ, Lacocque J, Rodriguez RM, Wang RC. Naloxone and Patient Outcomes in Out-of-Hospital Cardiac Arrests in California. JAMA Netw Open. 2024 Aug 1;7(8):e2429154. *** 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.

Kids get cuts and scrapes all the time. Have you ever wondered, should I go to the Emergency Room (ER) for this? Does it need stitches? In this episode of Real Talk With Kid Docs we are joined by Dr. Stephanie Spanos, Pediatric Emergency Medicine physician and Associate Professor of Pediatrics at the University of Utah. We focus our discussion on wounds and lacerations (the fancy word for cuts). Wounds are all unique and whether or not intervention is required depends on a number of variables including location, size, depth, and mechanism of injury.   As with any injury, if you are worried, this is always a reason to seek medical attention. If you have any thought that it might need stitches (the wound is wide open, the edges do not come together well and/or the edges cannot stay together), the sooner you get to medical attention, they better the outcome. Washing it out and addressing it as soon as you can helps prevent infection and increase the likelihood of a good cosmetic outcome.  Home care includes cleaning the wound with lots of water and applying pressure while in transit. Be aware that some areas of the body like the mouth and scalp bleed a LOT. Avoid putting anything else in the wound including soap, hydrogen peroxide, rubbing alcohol, etc. If there is a foreign body stuck on the wound, leave it in place. It is holding pressure on the wound. We hope you enjoy Dr. Spanos as much as we did and that you take away lots of practical tips.

Acetaminophen overdose is one of the most common medication concerns we see in the ED. It is important to know when to be concerned and when to treat as true overdoses can cause liver failure and death. UC Davis medical toxicologist, Dr. Hoan Nguyen, joins us in this episode to discuss a new consensus statement published in JAMA Network Open in August 2023: Managing of Acetaminophen Poisoning in the US and Canada. We discuss the updated approach and walk through as hypothetical case. At the end of this episode, you'll be able to identify high risk patients, know what labs to draw, when to start NAC, transfer, and call your local toxicologist. Do these updated guidelines change your practice? 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, Associate Professor of Emergency Medicine at UC Davis Guests: Dr. HoanVu Nguyen, Military Emergency Physician and Medical Toxicologist at UC Davis.  Resources: Dart RC, Mullins ME, Matoushek T, et al. Management of Acetaminophen Poisoning in the US and Canada: A Consensus Statement. JAMA Netw Open. 2023 Aug 1;6(8):e2327739. doi: 10.1001/jamanetworkopen.2023.27739. Erratum in: JAMA Netw Open. 2023 Sep 5;6(9):e2337926. doi: 10.1001/jamanetworkopen.2023.37926. PMID: 37552484. ***** 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. This episode focuses on naloxone. Naloxone is a staple in every ED docs toolbox but it can save more lives if it's immediately available in the community. We'll discuss ED based naloxone programs, why they are important, how to get funding, and which patients could benefit.  Do you give out naloxone in your ED? Is it readily available in your community? We'd love to hear your experience. 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, Associate Professor of Emergency Medicine at UC Davis Guests: Christopher Adams, PharmD, Emergency Department Senior Clinical Pharmacist and former Assistant Professor at UC Davis Resources: Kids Considered Podcast - Naloxone and Opioid Overdose Sindhwani MK, Friedman A, O'Donnell M, Stader D, Weiner SG. Naloxone distribution programs in the emergency department: A scoping review of the literature. J Am Coll Emerg Physicians Open. 2024 May 8;5(3):e13180. doi: 10.1002/emp2.13180. PMID: 38726467; PMCID: PMC11079430. Jacka BP, Ziobrowski HN, Lawrence A, Baird J, Wentz AE, Marshall BDL, Wightman RS, Mello MJ, Beaudoin FL, Samuels EA. Implementation and maintenance of an emergency department naloxone distribution and peer recovery specialist program. Acad Emerg Med. 2022 Mar;29(3):294-307. doi: 10.1111/acem.14409. Epub 2021 Nov 23. PMID: 34738277.. *** 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 special episode, we celebrate the incredible 19-year tenure of Dr. Nate Kuppermann as Chair of the UC Davis Emergency Department. As he transitions to his new role as Executive Vice President, Chief Academic Officer, and Chair of Pediatrics at Children's National Hospital in Washington, D.C., Dr. Kuppermann reflects on the growth and evolution of the department since he started in 2006. He shares insights on the challenges and accomplishments throughout his career, offers advice for aspiring department chairs, and discusses the importance of social media in building a department's presence. Join us as we bid farewell and thank Dr. Kuppermann for his remarkable contributions. What would you like to hear more of on EM Pulse? Hit up on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Guests: Dr. Nate Kuppermann, Professor of Pediatric Emergency Medicine and outgoing Chair of the Department of Emergency Medicine at UC Davis, now Executive Vice President, Chief Academic Officer and Chair of Pediatrics at Children's National Hospital in Washington, DC ***** 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.

The emDOCs.net team is very happy to collaborate with PECARN STELAR (Seattle, Dallas/Texas, and Los Angeles) Node and the Emergency Medical Services for Children Innovation and Improvement Center (EIIC) in presenting high-yield pediatric topics that highlight evidence based medicine with solid research. Today on we have our two renowned experts, Dr. Ilene Claudius and Dr. Danica Liberman, discussing the case for food insecurity and how it impacts the health of our children. To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play

Many of our ED patients come in because they were told to. Whether it's by an advice nurse, primary care provider, urgent care, call center, specialty coordinator, etc., it often feels to us like the default is “go to the ED”. But, of course, that's not the case. There are myriad reasons why patients may be sent to the ED. In this episode, we talk with two of our favorite outpatient physicians - a Pediatrician and an Internist - about when and why they refer patients to the ED, as well as what they do to try to keep them out of the ED!  Did you learn something new? Please share this podcast with your colleagues! 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, Associate Professor of Emergency Medicine at UC Davis Guests: Dr. Olivia Campa, Assistant Clinical Professor of Internal Medicine at UC Davis Dr. Lena van der List , General Pediatrician at UC Davis, Host of Kids Considered Podcast Resources: Should you go to the emergency room (ER), urgent care or doctor's office? UC Davis Health resource  I'm Sending You a Patient… by Keri Gardner, MD, MPH, FACEP. EP Monthly, April 30, 2018 When Urgent Care Center Refers Patient to ED, Reasons Might Be Unclear. ED Legal Letter, May 1, 2021. *** 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.

Oncologic Emergencies: Part 2 In this two-part series, we dive into the world of oncological emergencies with guest expert, Dr. Monica Wattana. In part 1, we covered everything from making new cancer diagnoses in the ED, to hypercalcemia, febrile neutropenia, and tumor lysis syndrome. We also discussed some of the tricky complications that often accompany cancer treatments, like mucositis, vomiting and diarrhea, anemia, and neuropathic pain. In part 2, we tackle pain management, palliative care, and some tough ethical dilemmas. The goal is to make sure we're all equipped to provide the best care possible for our patients with cancer.  Did you learn something new that changed your practice? We'd love to hear about it. 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, Associate Professor of Emergency Medicine at UC Davis Guests: Dr. Monica Wattana, Associate Professor and Education Director for the Department of Emergency Medicine at The University of Texas MD Anderson Cancer Center in Houston, Texas Resources: Pocket Guide to Oncologic Emergencies, by Dr. Monica Kathleen Wattana  Gould Rothberg BE, Quest TE, Yeung SJ, et al. Oncologic emergencies and urgencies: A comprehensive review. CA Cancer J Clin. 2022 Nov;72(6):570-593. doi: 10.3322/caac.21727. Epub 2022 Jun 2. PMID: 35653456. Multinational Association of Supportive Care in Cancer (MASCC) Guidelines SPIKES: A Strategy for Delivering Bad News, by Dr. Claire Ciarkowski **** 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.

After six years of medical school in Romania, Mioara Manole, MD, came to the U.S. and discovered her passion for pediatric emergency medicine and the unique challenges it can bring. In addition to seeing patients in our emergency department, she is also the director of Basic and Translational Research in the Division of Pediatric Emergency Medicine. Learn about Dr. Manole's journey to emergency medicine and how her research translates to her clinical work, including the creation of the FLO2 NeuroCap, a noninvasive device that measures brain oxygenation and neuronal activity in children after cardiac arrest or other brain injuries.

Sylvia Owusu-Ansah MD, MPH, FAAP is a board-certified pediatrician, pediatric emergency medicine, and emergency medical services (EMS) physician who is currently an attending at UPMC Children's Hospital of Pittsburgh and Director of Pre-hospital and EMS. Dr. Owusu-Ansah has been extremely involved in pediatric advocacy and education of EMS providers at all levels, locally, regionally and nationally. She currently sits on the Pediatric Emergency Medicine Advocacy and EMS Committees with the American Academy of Pediatrics, and additional regional and national committees related to her work. One of the contributions she is most proud of is advocating for pediatric health on Capitol Hill in Washington D.C. office on federal, state, and community pediatric advocacy issues including the School Access to Emergency Epinephrine Act, signed into law by President Barack Obama in 2013. She is proud mother of two girls and wife a transitioning paramedic.

In this two-part series, we dive into the world of oncological emergencies. Our guest expert, Dr. Monica Watana, an emergency physician specializing in this area. In part 1, we cover everything from making new cancer diagnoses in the ED, to hypercalcemia, febrile neutropenia, and tumor lysis syndrome. We also talk about some of the tricky complications that often accompany cancer treatments, like mucositis, vomiting and diarrhea, anemia, and neuropathic pain. The goal is to make sure we're all equipped to provide the best care possible for our patients with cancer. Stay tuned for part two, when we'll tackle pain management, palliative care, and some tough ethical dilemmas.  Did you learn something new that changed your practice? We'd love to hear about it. Hit us up on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Guests: Dr. Monica Wattana, Associate Professor and Education Director for the Department of Emergency Medicine at The University of Texas MD Anderson Cancer Center in Houston, Texas Resources: Pocket Guide to Oncologic Emergencies, by Dr. Monica Kathleen Wattana  Gould Rothberg BE, Quest TE, Yeung SJ, et al. Oncologic emergencies and urgencies: A comprehensive review. CA Cancer J Clin. 2022 Nov;72(6):570-593. doi: 10.3322/caac.21727. Epub 2022 Jun 2. PMID: 35653456. Multinational Association of Supportive Care in Cancer (MASCC) Guidelines SPIKES: A Strategy for Delivering Bad News, by Dr. Claire Ciarkowski ***** 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, Dr. Stacy Reynolds, Chief of Pediatric Emergency Medicine at Atrium Health shares her background, discusses current pediatric trends, and highlights initiatives aimed at improving pediatric emergency care across Atrium Health's extensive network.

Syphilis has gone by many nicknames over the years including “The Great Pretender” and “The Great Imitator.” Emily Labudde, MD, a Pediatric Emergency Medicine fellow at Children's Healthcare of Atlanta and recent pediatric residency graduate from Cincinnati Children's discusses the various manifestations of this sexually transmitted infection, and how we can't miss this very treatable, […]

The emDOCs.net team is very happy to collaborate with PECARN STELAR (Seattle, Dallas/Texas, and Los Angeles) Node and the Emergency Medical Services for Children Innovation and Improvement Center (EIIC) in presenting high-yield pediatric topics that highlight evidence based medicine with solid research.  Today on we have our two renowned experts, Dr. Ilene Claudius and Dr. Danica Liberman, discussing the case for food insecurity and how it impacts the health of our children. To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play

In this episode of Push Dose Pearls, we delve into the use of push dose pressors in emergency medicine. Dr. Chris Adams talks about their use, potential side effects, and the importance of a clear plan for the administration of push dose pressors. Did this episode change your practice? Let us know on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Guests: Christopher Adams, PharmD, Emergency Department Senior Clinical Pharmacist and Assistant Professor at UC Davis *** 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.

Managing pregnant patients in the ED can be stressful - especially because you have (at least) two patients to think about! Emergency physicians are generally comfortable managing first trimester emergencies but are less familiar with complications in the later stages of pregnancy. It is these complications that contribute in part to the maternal health crisis in the US. In this episode, we delve into the realm of obstetric emergencies in the ED with Dr. Jenna White, an EM physician with a special interest in OB. She introduces us to resources developed by the American College of Obstetrics and Gynecology (ACOG) to help ED providers identify common pathologies and navigate high-stakes scenarios, including screening for cardiovascular disorders, managing hypertension, and tackling the dreaded eclampsia. How does your ED manage OB emergencies? Have you implemented the ACOG algorithms? Share your experience with us on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Guests: Dr. Jenna White, Associate Professor of Emergency Medicine at the University of New Mexico and chair of an Obstetrics Working Group jointly convened by ACOG and the CDC Resources: Identifying and Managing Obstetric Emergencies in Nonobstetric Settings, ACOG resources for Emergency providers.   Pregnancy-Related Deaths: Data From Maternal Mortality Review Committees in 36 U.S. States, 2017–2019 Wolf LA, Delao AM, Evanovich Zavotsky K, Baker KM. Triage Decisions Involving Pregnancy-Capable Patients: Educational Deficits and Emergency Nurses' Perceptions of Risk. J Contin Educ Nurs. 2021 Jan 1;52(1):21-29. doi: 10.3928/00220124-20201215-07. PMID: 33373003. *********************************************************************************************** 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 our ongoing miniseries "Push Dose Pearls," we discuss the use of intranasal medications in the emergency department with Chris Adams, an ED clinical pharmacist at UC Davis. We talk about the benefits of intranasal administration, intranasal medications, and advantages for pediatric patients. Did this episode change your practice? Let us know on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis Guests: Christopher Adams, PharmD, Emergency Department Senior Clinical Pharmacist and Assistant Professor at UC Davis *** 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.