2014 ANNUAL NEWSLETTERresearch.med.umkc.edu/docs/em/ED_Annual_Report_2014.pdfand residents to aid them in their research design and statistical analysis. I live near the Plaza in Kansas

2 0 1 4 A N N U A L N E W S L E T T E R

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Big news this year is the expansion of the residency program from 10 to 11 residents per year, starting with this incoming class (of 2017.) We are expanding our providers and some staff physicians are changing their roles. Additionally, by the time your read this, the 5th Annual Great Plains Regional SAEM meeting, hosted by our program, will have come to a wildly successful conclusion!

Throughput continues to be a significant issue as our volume hit 67,000 patients per year this last year. We made the case to TMC that we do not have enough providers and they have agreed to help us hire 2 more advanced practice providers as well as another physician. Two PAs are starting this fall and we are advertising for another physician. We continue as a level I trauma center and a “STEMI” receiving center with 24/7 cardiac catheterization laboratory availability.

The residency program is doing quite well and has 31 residents per year in a 1, 2, 3 format. After many (10+) years of incredible service, Dr Christine Sullivan has stepped down as Program Director. Dr Amy Stubbs stepped into her position on July 1st and we look forward to 10 more years of excellence. Thank Dr Sullivan and say “congrats” to Dr Stubbs next time

you see them. Dr Inboriboon has moved up to Associate PD and Dr Hillman and Dr O’Rourke are the Assistant PDs. Dr O’Rourke starts in October and will be the ED Ultrasound Director. Dr O’Rourke went to Med School at KU, Residency at The Ohio State University and did his US fellowship at New York Methodist Hospital. Dr Hindsley, one of our graduates this year started in July.

Dr Hillman runs our mandatory Student EM Clerkship. It is highly rated and has increased simulation education for our students. This will be the 3rd year the Emergency Medicine Interest Group has fielded a “SimWars” team to compete in the Great Plains Regional SAEM Meeting.

The faculty remains academically productive. We continue to be a site for the Emergency ID Net and just finished up the successful NIH funded study “STOP MRSA” and are one year into the CDC funded “BARDA” Study (looking at influenza testing.) We continue with 3 fully funded study nurses and have a number of other studies underway.

The faculty is busy. Dr Sullivan was just promoted to Associate Dean for Graduate Medical Education and is now Vice Chair of the Residency Review Committee

for Emergency Medicine. Dr Ellison continues as the Associate Dean for Curriculum. Dr Hackman was promoted to Associate Professor (congratulations) and is the Chief Medical Information Officer for TMC. Dr Steele continues as the Chief Medical Officer for TMC and the Executive Medical Director of UPA (the faculty practice management plan.) Drs Algren and Christian still work as toxicology consultants at Children’s Mercy Hospital and at the Kansas Poison Control Center. Dr Inboriboon is the Director for International Emergency Medicine Studies and an Associate PD. Dr Reich continues as the EMS Medical Director for the City of Kansas City and is Chief of the EMS Section.

We continue to appreciate the support of our alumni. We still have several who work clinical shifts as “moonlighters” and several others who help administer the ever popular “mock” oral board examinations. We all thank you for your efforts. We always are looking for moonlighters, so if you are interested, give me a call and let’s see what we can work out. I can almost promise that you will enjoy it and I know that the residents will be appreciative.

Matt Gratton, M.D., FAAEMProfessor and Chair

A MESSAGE FROM THE CHAIRMANMatt Gratton, M.D., FAAEM

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Kansas City since I studied at Kansas University School of Medi-cine over seven years ago. After graduating from KU, I received my residency-training from The Ohio State University and then moved to New York City for an ultrasound fellowship at New York Methodist Hospital. Upon completion of my fellowship, I stayed on as faculty and became an Assistant Program Director. My na-tive New Yorker wife and I decided to relocate to Kansas City to take advantage of the great quality of life and affordability of the Midwest. I am passionate about point-of-care ultrasonography and bedside teaching. I look forward to the new challenges that I will be facing at Truman Medical Center

Kirk Roberts, M.D. (Part Time)I was born and raised in Kansas City and went to Center High School graduating in 1982. I haven’t checked the sports record book there recently but I still may hold the record for tackles in a season (I should mention this was basketball). I then attended the UMKC 6 year program. In 1984, our band (Norm Tailor Proj-ect) debuted. The band still plays occasionally and consists of all Emergency Medicine physicians. After graduating, I did my EM residency here at Truman. After graduation, I practiced EM at St John’s in Springfield MO and was there for 3 years before coming back to town to practice EM and sports medicine. From 1994-2001, I was the team physician for UMKC and helped out with the KC Chiefs. I have practiced at Olathe Med Center since 2001 full time and also work in the Hyperbaric and Wound Care Center.

Hugh Ryan, M.D. (Part Time)Hugh is a graduated from the UMKC School of Medicine in 1994 and is a veteran of the TMC ED program from 1997, where he served as Chief Resident. He has practiced in our community since that time, starting with a staff position at St. Luke’s until he moved onto NKCH where he has been practicing since 2000. In 2008 Hugh took on an additional career path and began working for Cerner Corporation where he is currently the Chief Medical Officer for Population Health Programs where he leads the design of clinical decision support, content and programs. His work with Cerner differs significantly from the ‘real work’ of the ED, but he enjoys the challenges of trying to influence technology with clini-cal acumen. Hugh married Shana Booth (former TMC ED nurse) in 1997 and they cur-rently reside in Lee’s Summit where they are raising two outstanding children: Adam, 14, and Anna, 12…and a new puppy, Bella. Hugh has been heavily engaged in community and youth activities from coaching to music as well as being a 5-time Ironman finisher.

Thomas Hindsley, M.D.Dr Tom Hindsley is an East Coast transplant, having been born at a young age and raised in the Maryland suburbs of Washington, DC. He studied Physiology and American History at the Uni-versity of Maryland in College Park, graduating with an Honors certificate in 2004. He spent the next few years earning a Master’s in Physiology at Georgetown University, but it was his experience as a scribe in a community Emergency Department that sealed his fate. He went to medical school in Norfolk, Virginia, where he had the opportunity to study in a well-regarded academic trauma center and fine Naval and Veterans Administration hospitals. Dr. Hindsley was fortunate enough to match into an excellent Emergency training program at the University of Missouri-Kansas City, and elected to stay on as a member of the fac-ulty upon graduating in 2014. He is currently faculty supervisor for the ACLS course for UMKC students, as well as faculty sponsor for the Wilderness Medicine Interest Group. He currently resides in Kansas City, MO, with his KC-native wife Krista and sons Luke and Jesse. In his spare time, he enjoys backpacking, cycling, and Civil War living history.

Monica Gaddis, PhD I am the Research Director for the UMKC Department of Emer-gency Medicine Residency Program. I also am on the faculty in the Dept. of Biomedical Health and Informatics in the UMKC School of Medicine where I am the course instructor for Biostatis-tics I and II, a student advisor, and serve as a statistics consultant. I received my PhD in Physiology at Indiana University-Blooming-ton and completed a 3 year postdoctoral fellowship in the Dept. of Cellular and Integrative Physiology, Indiana University School of Medicine-Indianapolis. My area of research centered on under-standing the role and control of the capacitance vessels (veins) in the maintenance of cardiovascular homeostasis. As the Research Director I have undertaken the task of reformatting Journal Club. This new format pro-vides a structured process to review medical literature with the intent to improve patient care and to provide a framework for providing experimental design and statistics educa-tion. I have also redesigned the Scholarly Activity requirements of the residency to meet the specifications of the RRC for Emergency Medicine and I consult with fellow faculty and residents to aid them in their research design and statistical analysis. I live near the Plaza in Kansas City Missouri with my husband, Gary Gaddis MD PhD, an EM physician at St. Luke’s and a fellow faculty member at UMKC SOM.

Kevin O’Rourke, M.D.Being born and raised in Kansas City, MO, I am excited for the new career opportunity that I have been given at Truman Medical Center. This will be my first time living in

NEW FACULTY

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CHIEF RESIDENT SNAPSHOTS

Emily Roth, M.D.I was born and raised in Wichita, KS and am a Midwesterner through and through. I went to Wichita State University for undergrad and the University of Kansas for medical school. I had a great rotation at TMC during my 4th year of medical school, and loved the program, residents, and faculty. I’m so glad I got the opportunity to train here at UMKC for residency. My husband, Vince, and I have enjoyed living in Kansas City. I’m excited to be starting my last year of residency and honored to have the opportunity to be one of the chief residents.

Grady Thiems, M.D.My name is Grady Thiems and I am originally from Kingfisher, OK. I attended Oklahoma State University for undergraduate and the University of Oklahoma Health Sciences Center for medical school. My soon-to-be wife, Allison, and I moved to Kansas City together and have been thrilled to be a part of Truman Medical Center (she works as a physical therapist at Lakewood) for the last several years. I feel incredibly honored to be selected as a Chief for this academic year. It’s an exciting time to be an emergency medicine resident at TMC and I look forward to the opportunity to assist in the continued development and strength of our well-established program. In my spare time I enjoy playing/watching sports, trying to achieve some level of physical fitness, and enjoying all of the fruits of Allison’s cooking passion.

Josh Honeyman, D.O.I am a current third year resident and one of the new chief residents. I was born and raised in the flat plains of North Dakota, where my family still resides. I attended A.T. Still Osteopathic Medical School. While in attendance, I was given the opportunity to train in both urban and rural environments near Phoenix, AZ and Cincinnati, OH. After visiting several programs I chose to train at UMKC because of the excellent reputation of the program and the exceptional faculty. Looking back over the past two years it is incredible the amount I have learned while here because of the quality of the teaching and the diversity of the patient population. As a new chief resident I have enjoyed being more involved in the process of improving the residency and sharing my knowledge with medical students. Following this year I will be moving back to Fargo, ND to settle in and begin my career. I look forward to an exciting and challenging final year of residency.

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2014 GREAT PLAINS REGIONAL SAEM MEETINGTMC DEPARTMENT OF EMERGENCY MEDICINE FACULTYAdam Algren MDAngela Bogle MDMichael Christian MDStefanie R Ellison MDSteven Go MDMatthew C Gratton MD, ChairJeffrey L Hackman MDEmily Hillman MDThomas Hindsley MDP Charles Inboriboon MDHeather Isom MDNicole Kibbee MDKevin O’Rourke MDJay Reich MDMark T Steele MDAmy Stubbs MDSrikala Subramanian MDChristine Sullivan MD

PART-TIME FACULTYJordana Kaban, MDSajid Khan, MDRyan Jacobsen, MDRobert McCullough, MDKirk Roberts, MDJacob Ruthstrom, MDHugh Ryan, MDTed Sibley, MD

ADVANCED PRACTICE PROVIDERSAdam Dobbins, APRNAmy Siebes, APRNAngie Hunter, PAGeorge Varghese, PA

STAFFJayna Ross, Education CoordinatorKaren Manley, Administrator

CLASS OF 2017Ryan Bachman DO University of North Texas, Ft Worth, Texas

William Beeler MD University of Illinois, Chicago, Illinois

Blake Buchanan MD University of South Florida, Tampa, Florida

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The Department of Emergency Medicine at the University of Missouri-Kansas City School of Medicine and Truman Medical Center was honored to host the 2014 Society for Academic Emergency Medicine Great Plains Regional Meeting at the Westin Crown Center hotel on September 6, 2014. An enjoyable and engaging social was held on the evening of September 5th at the World War I museum. The private museum showing and trips to the top of Liberty Memorial were a hit with attendees.

An entertaining keynote address, “Mass Disasters- Past, Present, Future”, was delivered by Alex Garza, MD, MPH. He serves as Associate Dean for Public Health Practice and Professor in Epidemiology at the Saint Louis University College of Public Health and Social Justice. In addition he is an Associate Professor of Emergency Medicine at St. Louis University. Dr. Garza provided a unique perspective on disaster management and preparedness given his previous position as Chief Medical Officer for the Department of Homeland Security. The morning session also including a lively EMS panel discussion that addressed various aspects of EMS disaster preparedness and response. Over lunch, Mark Courtney, MD, SAEM Board of Directors member and Associate Professor of Emergency Medicine at Northwestern School of Medicine shared thoughts about mentorship and career development.

The highlight of the afternoon was the conclusion of the Annual Medical Student SimWars. Seven teams of medical students from schools from around the region battled each other though cases of snakebite and alcohol withdrawal amongst others. The final matchup pitted the University of Missouri-Kansas City team 1 against Washington University team 1. Ultimately, Washington University prevailed by a narrow margin and was crowned

champion. The medical student forum that followed included a panel discussion of several EM residency program directors regarding the residency application and interview process.

Various research projects were presented in poster format with eight selected to provide detailed oral presentations. Two projects received special recognition with research awards. Angela Lin and colleagues of Washington University were voted “Best Poster” for their project, “Predicting One-Month ED Returns in Undifferentiated Geriatric Patients: Derivation of a Clinical Decision Rule”. Daniel Theodoro and colleagues of Washington University were awarded the “Best Oral Presentation” for their project entitled “Emergency Department Central Line Associated Blood Stream Infections (CLABSI) Incidence in the Era of High Prevention”. Congratulations to Washington University for a clean sweep of all the awards this year!

Thank you to everyone for attending and making this a successful meeting. The baton has officially passed to Regions Hospital in St. Paul, Minnesota who will host next year’s meeting.

Adam Algren, MD and Mike Christian, MDCo-Chairs, 2014 SAEM Great Plains Regional Meeting

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OperationsJeff Hackman, ED Operations Director

Like many Emergency Departments around the country, throughput has been our primary focus in the clinical operations area. A year ago we lost our faculty triple coverage, but we were able to add a resident each weekday to focus on throughput and education. Based on the positive results of those pilot projects we have partnered with Truman to increase our staffing. Truman is financially supporting the increase in the size of our new PGY1 resident class, allowing us to expand clinical coverage by residents starting next year. Truman and UPA are also partnering to hire two physician assistants, an emergency physician, and associated support staff. The PAs have been hired and start in September and October. They will be seeing patients in the current Fast Track area, in triage, and in the main ED, depending on the needs of the department.

Our group of full-time faculty is already expanding by two: Tom Hindsley, a 2014 graduate of our program, started in July; Kevin O’Rourke, fellowship trained in Ultrasound, is starting in October. We’re also happy to have grown our group of part-time physicians to a total of 11 people who work elsewhere in the community or around the country most of the time, and contribute their valuable experience to our ED, residents, and patients a few times each month.

We’re still looking for another full-time physician. Give me a call if you’re interested!

Another productive and eventful year for our residency program! We recently celebrated the graduating Class of 2014 with a dinner party for faculty, residents, and their families at Brio on the Plaza. The Class of 2017 has now begun and everyone is getting used to their new roles. I am looking forward to another outstanding class of residents. Thanks to the support of Truman Medical Center, we were able to establish funding for an additional residency position, allowing us to match 11 residents for the 2017 class. Over the next three years this will bring our total resident complement to 33 which will afford us more flexibility in scheduling and ultimately better care for our patients.

An additional recent event was the promotion of our former Residency Program Director, Dr. Christine Sullivan, to Associate Dean for Graduate Medical Education for the UMKC School of Medicine. Dr. Sullivan served as the Residency Program Director for 10 years with unparalleled enthusiasm and dedication. I am both nervous and excited to follow her and feel so honored to take on this new role at the residency where I had the good fortune to train. I am also extremely grateful to have Dr. Charlie Inboriboon, previously our Assistant Program Director, Dr. Emily Hillman, current Student Clerkship director and Dr. Kevin O’Rourke, our Ultrasound Director, on board as well. We are all indebted to Dr. Sullivan for her innovations and further elevation of our program; we will continue to rely on her advice and expertise. I would be remiss to not mention the outstanding support our program receives from Dr. Gratton, Ms. Jayna Ross, and our entire group of remarkably dedicated faculty. It truly “takes a village.”

We continue to adapt our curriculum according to ACGME requirements while also incorporating resident feedback. Some recent additions/changes include the advent of an EMS “Field Day” for the new PGY-1s, increased simulation experiences, and the incorporation of more case-based and small group time into our didactics. We are also very excited about the additions of Dr. Monica Gaddis as our Research Director and Dr. Kevin O’Rourke as our Ultrasound Director and a second Assistant PD.

Our residents continue to receive outstanding clinical training at our three teaching sites, with the majority of their time still being spent at TMC. They also have numerous teaching opportunities through ACLS, the EMS training program, and our highly rated student clerkship. And though residency remains a very busy time, our residents continue to be a social group and manage to enjoy the occasional Chiefs game, concert at the Sprint Center, or the proverbial post-shift beer(s).

As always, our residents really appreciate and enjoy getting to know some of our alumni who have helped out with didactics, mock oral boards, and clinical shifts. Our faculty really enjoys catching up with you too. Thanks so much to all of you!

I am really proud of where our program is and look forward to another excellent year!

Residency ProgramAmy Stubbs MD, Program DirectorP. Charles Inboriboon MD, Associate Program Director

Emily Hillman MD, Assistant Program DirectorKevin O’Rourke, MD, Assistant Program Director

UPDATES

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UPDATESCLASS OF 2017 (continued) Brandon Elder MD University of Missouri-Kansas City, Kansas City, Missouri

Brian Freeman DO Kansas City University of Medicine and Biosciences, Kansas City, Missouri

Craig Hirsch MD University of Virginia, Charlottesville, Virginia

Melissa Howard MD University of Mississippi, Jackson, Mississippi

Linda Schwartz DO A.T. Still University, Kirksville, Missouri

Adam Stuppy MD University of Missouri-Columbia

Katie Willet MD University of Nebraska, Omaha, Nebraska

Paul Williams DO Kansas City University of Medicine and Biosciences, Kansas City, Missouri

CLASS OF 2014 PRACTICE LOCATIONS Beau Butherus MD – St Joseph Medical Center, Kansas City, Missouri

Eric Canaday DO – St Francis Hospital, Tulsa, Oklahoma

Erica Carney MD – EMS Fellowship, Washington University, St. Louis, Missouri

Allen Davied MD – Providence Medical Center, Kansas City, Kansas

James Hall MD – Critical Care Fellowship, Washington University, St. Louis, Missouri

Thomas Hindsley MD – Truman Medical Center, University of Missouri-Kansas City, Kansas City, Missouri

Stephanie Lewis MD – Flowers Hospital, Dothan, Alabama

Robert McCullough MD – Saint Luke’s Hospital, Kansas City, Missouri

Aaron Stinton MD – Sanford USD Medical Center, Sioux Falls, South Dakota

David Tarullo MD – Wyoming Medical Center, Casper, Wyoming

Ryan White MD – Park Plaza Hospital and Houston Methodist, Houston, Texas

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The Emergency Medicine Clerkship is currently preparing for its biennial review. It is exciting to review the progress our clerkship has made since the last review in 2012. This will be our second year using the NBME ACE examination. We continue to increase the number of simulation workshops given as part of the curriculum. Many of our faculty members

continue to contribute to monthly lectures and simulation labs and the students appreciate the faculty commitment. For the next academic year we are working to increase our involvement with other EMS agencies. Additionally, we are gearing up to implement more e-learning with the hopes of increasing student knowledge gains and satisfaction.

Emergency Medicine Interest Group/SimWars UpdateWe have a very active emergency medicine interest group at UMKC. The interest group hosts monthly meetings with faculty and resident guest lecturers. In September Lifeflight Eagle personnel presented on emergency and critical care transport. Our interest group also received a grant from SAEM to host a medical student procedural skills conference. We are currently in the planning phase for this conference, which will be held in February 2015. Lastly, EMIG competed in our 3rd SimWars Competition

at the SAEM Great Plains Regional Meeting. The SimWars competition is a judged event where students are presented with a simulated case and are expected to demonstrate proper management as well as skills in teamwork and communication. A total of 11 students are part of our two simulation teams and trained at least once or twice weekly until competition day. Most faculty members and residents helped train the students. After tough competition we did well, placing second!

Emily Hillman, M.D., Clerkship Director

Emergency Medicine Student Clerkship Update

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“Advancing the health of our community.” That’s the mission of the UMKC School of Medicine. For many years, the School has interpreted that this mission goes beyond educating physicians and providers in the clinical setting, but includes the education of providers in the field, where the patients are found. For this

reason, the School of Medicine initiated the Emergency Medical Services (EMS) education program, and in 2012 placed administrative

oversight in the newly developed EMS section of the Department of Emergency Medicine.

In 2014, the program is in the process of educating its third class of Paramedic students, and is preparing to admit the 2015 class. The program is also in the process of educating its eighth Emergency Medical Technician class. Part of the educational process for these EMT and Paramedic students is interaction with students of the School of Medicine who attend lectures during their EMS elective, and Emergency Medicine residents who provide instructional assistance and guidance to the program’s students during skills lab sessions. All of this takes place in the School of Medicine’s new Clinical Training Facility, an approximately 5000 square foot skills and simulation center located on the Hospital Hill campus.

During EMS Week in May, the EMS Education program sponsored a screening of the documentary Freedom House

– Street Saviors. The film is the story of a social experiment that trained the first paramedics in the United States and provided some of the nation’s most advanced prehospital care in Pittsburgh, Pennsylvania in the late 1960’s. Appearing with the documentary was George McCary III, one of the Freedom House paramedics. After the showing, graduates of the UMKC EMS programs were awarded program challenge coins by Mr. McCary.

New in 2014, the EMS Education program in cooperation with the Grandview Fire Department and Life Flight Eagle conducted the first EMS Field Day for the incoming Emergency Medicine residents. This experience, held at two locations in the City of Grandview, included skill stations, a search and rescue scenario where the residents donned protective gear and searched a simulated burning structure, an opportunity to climb an aerial ladder, and observation of a vehicle extrication. In addition, Life Flight Eagle provided an orientation to air-medical transportation and an opportunity to observe a real-time simulated scene response with a live aircraft.

Coming in the future, the Paramedic program is working to complete its national accreditation process, moving to full accreditation from the Letter of Review status currently in place. A paramedic program satellite in cooperation with the Lex La-Ray Technical Center will offer its first program this January in Lexington, Missouri. Finally, as healthcare changes, so does prehospital care. The EMS Education program is working to develop a program to meet the demand for mobile integrated healthcare paramedics (aka Community Paramedics). Look for the first classes to form in late 2015 or early 2.

UPDATESEMS Education ProgramJay Reich, M.D., EMS Section Chief, EMS Medical Director, KCMO

Paul Ganss, MS, NRP, NCEE, CHSE, Director, EMS Education

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2014 TMC DEPARTMENT OF EMERGENCY MEDICINE AWARDSRobert M Elenbaas PharmD Research Award (chosen by EM faculty): David Tarullo MD and Ryan White MD, April 2014.

Resident of the Year (chosen by EM faculty): David Tarullo MD, Truman Medical Center, Department of Emergency Medicine

Resident Teaching Award (chosen by medical students rotating in department and rotating residents): Jim Hall MD

Highest In-Training Exam Scores by PGY class: Eric Canaday DO, Dustin Keffer DO and Elliott Fried MD.

Faculty Teaching Award 2014 (chosen by EM residents): Michael Christian MD

2014 ORAL BOARD EXAMWe want to thank our 2014 examiners for sacrificing their free time to help with the Mock Oral Board practice.Aaron Barksdale MD (2009)Denny Chinnock MD (2006)Tim Elliott MD (2002)Alex Garza MD (1999)Jeff Hackman MD (2004)Joe McDonnell MD (2004)Tom Millard MD (2007)Hugh Ryan MD (1997)Christine Sullivan MD (1988)The date for the 2015 exam is Thursday, March 12, 2015. Sign up now and avoid the rush! Contact Jayna Ross ([email protected]).

NURSING NEWSLynette M. Wheeler MSN, RN, FAAMA, FACCA, FABC is our Chief Nursing Officer.

Gina Rosser RN BSN is our Emergency Department Director.

Our Nursing Education Coordinators are Hannah Olson RN and Christina Fenwick RN.

Our current Clinical Team Managers are Marisa Laing RN, Nicole Gums RN, Pam Hinrichs RN, Kara Richmond RN, and Deborah Corder RN.

Jen Green RN is our SANE Coordinator and Marian Hardin is our Unit Clerk Supervisor.

WEEKLY CONFERENCESAll alumni are invited to attend our weekly conferences and socialize! Conferences are held every Thursday. For specific details or to be added to the conference schedule distribution list, please contact Jayna Ross ([email protected]).

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Research2013-14 was another productive year for faculty and resident research. Recent presentations and publications from faculty and residents range from ED operations, resident and student education, EMS, Toxicology, and infectious disease. Several of our faculty had abstracts accepted at our recent SAEM Great Plains meeting.

Faculty and residents recently had the opportunity to participate in a multi-center, NIH funded trial, STOP MRSA, designed to determine the best treatment for MRSA related skin and soft tissue infections. Enrollment goals were successfully met and active enrollment concluded in April 2013. We look forward to contributing to forthcoming publications from the information obtained in this large study.

Currently the department is involved in the Biomedical Advanced Research and Development Authority (BARDA) Influenza study, a multi-center trial funded by DHHS to determine the best testing and treatment strategies for Influenza. Multiple teams have worked together to prepare for this complex study including ED Research, Nursing, Laboratory and IT. It has given us the opportunity to use a new, rapid, highly accurate Influenza test that will improve patient care and real time disease surveillance.

We have recently had the good fortune to add a research director to our faculty, Dr. Monica Gaddis PhD. Dr. Gaddis has experience in the areas of clinical research, teaching, and statistical analysis. We look forward to her contributions to our ongoing projects and appreciate the improvements she has already made to our Journal Club.

Our eighth annual McNabney Professorship lecture was held on May 22, 2014. We were pleased to welcome Dr. Jerry Hoffman as the keynote speaker. Dr. Hoffman is Professor Emeritus of Medicine / Emergency Medicine at UCLA and is a world-renowned expert on Health Services Research and Clinical Decision Making, as well as in areas related to Medical Education. Dr. Hoffman gave a superb presentation entitled “Over-Diagnosis: A Modern Epidemic”, where he led the audience through the details of a pervasive problem that has the potential to negatively impact emergency medicine long into the future. He also proposed several practical solutions that we can each enact to combat this phenomenon in our own individual practice.

The attendees were very enthusiastic in their response and many felt this was one of the best speakers we have ever had for this event. During his stay here, Dr. Hoffman also gave grand rounds to the department where he discussed pitfalls in medical decision making. He also had an informal luncheon session with our residents. We will continue to offer the McNabney lecture series free of charge to our alumni, and hope that many of you will make

W Kendall McNabney MD Professorship Lecture

UPDATES

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SCHOLARLY ACTIIVITYGrants as of August 2014

• Strategies using Off Patient Antibiotics for Methicillin Resistant S. aureus (“STOP MRSA”) – a multi-center, phase III, randomized, double-blind clinical trial. National Institutes of Health (NIH) / National Institute of Allergy and Infectious Diseases (NIAID) / Division of Microbiology and Infectious Diseases (DMID). $1,563,576.78 funded 2007-2014. Principal site investigator, Mark Steele, MD

• Continuation of an “Emergency Department Emerging Infections Sentinel Network” Center for Disease Control and Prevention and the Olive View – UCLA Medical Center. $19,000 funded 2013/2014. Principal site investigator, Mark Steele, M.D.

o Surveillance and risk factor analysis of community-associated uropathogen antimicrobial resistance among emergency department patients with acute pyelonephritis in the United States

o Prevalence of Pathogen in cerebrospinal fluid obtained from emergency department patients

• Influenza diagnosis, treatment and surveillance with Xpert Flu Jan 2013 to Jan 2016. John Hopkins University with Biomedical Advanced Research and Development Authority (BARDA). Total award $600,000 over 3 years; year I $154,000. Principal site investigator, Mark Steele, MD

• Smoking Intervention with Trauma Patients. Grant with MetroHealth System from Pfizer, Inc. to The American College of Emergency Physicians. $8500. Principle site investigator, Mark Steele, MD

2014 Peer-Reviewed Publications Gratton MC, Shariq S, McCrary J, Wayne L, Bogart DB. Electrocardiographic Findings Resulting in Inappropriate Cardiac Catheterization laboratory Activation for ST-Elevation Myocardial Infarction. Cardiovasc Diagn Ther 2014; 4(3): 215-223.

Khan S, Arshad M. A Lesser Known Side Effect of Sildenafil. EM Resident. 2013 Oct/Nov; 40 (5): 36.

Khan S, Hall J. A Temporal Problem: Diagnosing and Treating Viral Encephalitis in the ED. EM Resident. 2014 Apr/May; 40 (8): 43-44.

O’Donnell, S., Adler, D. H., Inboriboon, P. C., Alvarado, H., Acosta, R., & Godoy-Monzon, D. Perspectives of South American physicians hosting foreign rotators in emergency medicine. International Journal of Emergency Medicine. 2014 7(1), 24

Sullivan C, Regan L, Nazario S, Visconti A, Hexom B, Shah S, Pazderka P. A council of residency directors-emergency medicine (CORD-EM) taskforce report on remediation of interpersonal and

communication skills and professionalism Milestones. Western Journal of Emergency Medicine, August 2014; 15(66): 535

Stubbs AM, Steele MT. Infectious Disease/CDC Update. Update on emerging infections: news from the Centers for Disease Control and Prevention. Comment on MMWR Notes from the Field: Heartland Virus United States 2012-2013. Ann Emerg Med 2014 (in press.)

Ellison SE, Sullivan C, McCullough R. No longer waiting for an accident to happen: simulation in emergency medicine. Missouri Med. 2013; 110(2):133-138

Abstracts Barksdale A, Hackman J, Williams K, Gratton MC. Emergency Department Triage Pain Protocol Reduces Time to Receiving Analgesics in Patients with Painful Conditions. Academic Emergency Medicine 2014; 21(5) Suppl. 1 S217.

Book Chapters Algren A, Wasserman, Lowry. Chapter 12, Bites in Ashraft’s Pedicatic Surgery, 6th Edition, 2014, Saunders Elsevier.

Ellison S. Sudden Death in Adolescents, Primary Care Clinics, 42:1

Inboriboon C and Pim J. Diffuse Idiopathic Skeletal Hyperostosis. In 5 Miniute Clinical Consults. 2014, Lipincott Williams and Wilkins.

Steele M, Stubbs A. Hip and Femur Injuries, In Tintinalli’s Emergency Medicine, 2014, McGraw-Hill

Go S, Worman DA. Stroke Syndrome. In Tintinalli, J, Stapczynski JS Cline D, Ma OJ, Cydulka RK, editors. Tintinalli’s Emergency Medicine, 8th Edition, McGraw-Hill Medical; in press.

Online Khan S. Quantia MD. Use of Patient Chaperones. June, 2014.

Khan S. Quantia MD. Spread of Infection from Clinicians’ Clothing. June, 2014.

Khan S. Quantia MD. Unsolicited Medical Advice to Strangers. April, 2014.

Khan S. Quantia MD. Acute Otitis Media Revisited. March, 2014.

Khan S. Quantia MD. 45 yo male with Shoulder Pain Post Fall. February, 2014.

Khan S. Quantia MD. December 2013 General Medicine Challenge (Heterotopic Ossification). November, 2013.

Khan S. Quantia MD. Patellar Tendon Rupture. September 2013.

Khan S and Quantia MD. Good Samaritan Laws: An Introduction. September, 2013.

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Khan S. Quantia MD. Good Samaritan Laws: Is There a Doctor on Board? September, 2013.

Khan S. Quantia MD. August 2013 General Medicine Challenge (Perilunate Dislocation). August, 2013.

Khan S. Films and Scans Look Again: Sternal Fracture. Emergency Physicians Monthly. 2013 August.

KhanS. Quantia MD. Are Mandatory Influenza Vaccinations Legal? July, 2013.

Khan S. Quantia MD. Medical Ethics: Therapeutic Privilege. July, 2013.

Khan S. Quantia MD. Good Samaritan Laws: When Are You Covered? September, 2013.

Letters Algren DA. Christian MR. Phenytoin Toxicity Unlikely to Result in Arrhythmias. JAMA Internal Medicine. 2014 Jan; 174:167.

2013 Peer-Reviewed Publications

Algren DA and Monteilh CP, Punja M, Schier JG, Belson M, Hepler BR, Schmidt CJ, Miller CE, Patel M, Paulozzi LJ, Straetemans M, Rubin C. Fentanyl-associated Fatalities Among Illicit Drug Users in Wayne County, Michigan (July 2005-May 2006), Journal of Medical Toxicology, Vol. 9, pp. 106-15, 2013.

Tarullo DB and Jacobsen RC, Algren DA. Two Successive Necrotic Lesions Secondary to Presumed Loxosceles Envenomation, Wilderness and Environmental Medicine, Vol. 24, pp. 132-35, 2013.

Saoraya J, Inboriboon PC, Pulmonary Vein Thrombosis Associated with a Large Hiatal Hernia, The Journal of Emergency Medicine, Volume 44, Issue 3, March 2013, Pages e299-e301

Inboriboon PC, Lumlertgul S, A Cadaveric Model for Pericardiocentesis Training, The Journal of Emergency Medicine, Volume 44, Issue 3, March 2013, Pages 661-662

Khan, S. Films and Scans Look Again: Sternal Fracture. Emergency Physicians Monthly. 2013 August; 20(8).

O’Laughlin, K, Hoffman, J, Go S, Gabayan G, Eqbal E, Merchant G, Lopez-Freeman R, Zucker M, Hoffman J, Mower WR. “Non-Concordance between Clinical and Head CT Findings- the Specter of Overdiagnosis” Emergency Medicine International, vol. 2013, Article ID 314948, 7 pages, 2013. doi:10.1155/2013/314948

Abstracts Barksdale A, Hackman J, Bonham A, Gratton M. Diagnosis and Disposition Are Changed When Board Certified Emergency Physicians Use CT for Non-Traumatic Abdominal Pain. Ann Emerg Med 2012; 60(4) Suppl. 61

Jacobsen, Ryan and Watts J, Abdel-Rahman S, Doyle S, O’Malley D, Hefner T, Dowd D. Novel

Pediatric Weight Estimation Tool for EMS Providers, Prehospital Emergency Care, Vol. 17, pp. 131, 2013.

Christian MR, Pallash EM, Wahl M, Mycyk MB. Lipid Rescue 911: Are poison centers recommending intravenous fat emulsion therapy for severe poisoning? Journal of Medical Toxicology (September 2013): Epub ahead of print 10 May 2013.

Inboriboon, Pholophat C., Saoraya, J. What Brings You to Here Today? A Qualitative Study Exploring Patients Perceptions and Reasons for Presenting to the Emergency Department with Non-Urgent Complaints. Prehospital and Disaster Medicine 2013, Vol. 28, Suppl. 1, s36.

Inboriboon, Pholophat C., Saoraya, J. Xanthogranulomatous Pyelonephritis: Not Your Usual Pyelonephritis. What Every Emergency Physicians Should Know When Encountering This Diagnosis? Prehospital and Disaster Medicine 2013, Vol. 28, Suppl. 1, s36.

Inboriboon, Pholophat C., Saoraya, J., Williams, K. Please Don’t Go: Factors Associated with High Acuity Patient Leaving without Being Seen at an Urban VA Emergency Department, Prehospital and Disaster Medicine 2013, Vol. 28, Suppl. 1, s95.

Inboriboon, Pholophat C., Lumlertgul, S., Saoraya, J., Williams, K. Emergency Medicine in Thailand: A Survey of Residency Program Graduates, Prehospital and Disaster Medicine 2013, Vol. 28, Suppl. 1, s95.

Book Chapters Hackman, Nelson, Ma. Spontaneous Subarachnoid and Intracerebral Hemorrhage. In Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8th edition, 2013

Algren, Adam. Cardiac Medications. In Tintinalli’s Emergency Medicine: Just the Facts 3rd Edition, 2013, McGraw-Hill

Gratton, Matt: Gratton MC: Peptic Ulcer Disease and Gastritis. In Cline DC, Ma OJ (eds): Just the Facts, 3e, McGraw-Hill, 2013, Chapter 43, 157-159

Gratton, Matt: Genitourinary Injuries. In Cline DC, Ma OJ (eds): Just the Facts, 3e, McGraw-Hill, 2013, Chapter

Algren, Adam. Metals and Metaloids. In Tintinalli’s Emergency Medicine: Just the Facts 3rd Edition, 2013, McGraw-Hill

Inboriboon, Pholaphat C. Video-Assisted Orotracheal Intubation Devices. In Emergency Medicine Procedures, pp. 1271 2013. McGraw Hill, Ed. Reichman, Eric

Go S. Priapism Management. In: Reichman E (editor) Emergency Medicine Procedures, 2nd ed.

McGraw-Hill; 2013: 984-989.

Go S. Testicular (Manual) Detorsion. In: Reichman E (editor) Emergency Medicine Procedures, 2nd ed.

McGraw-Hill; 2013: 1001-1004.

©2014 Truman Medical Centers #4380 ED Annual Report 10-2014