Weekly Update

April 12, 2020

General Announcements

From Dr. Manish Garg: Primary Survey this Sunday

Dear Residents,
 
We are having our primary survey meeting again at 5pm on Sunday.  We are honored to have 2 very special guests from the departments of psychiatry, Dr. John Barnhill (Cornell) and Dr. Laurel Mayer (Columbia).  They will spend the first half hour interactively navigating us through important issues you have voiced during this pandemic.  I’ve had a chance to communicate with them and I learned quite a bit about myself in the short time we shared.  We will have our normal opportunity to discuss ops/thoughts & feelings immediately following.
 
We have received really great feedback on these sessions, as I think it’s a great outlet for us.  Please make it if you can.  Zoom link below:
 
Zoom Meeting #: 902-383-0868
 

https://weillcornell.zoom.us/j/9023830868

 

From the Chiefs: Residents in the Spotlights

NYP would like to highlight your hard work in the ED and as part of that effort are asking us to submit photos of us in the ED for the NYP twitter feed.  If you’re interested in participating, please text any photos to D. Anne Stewart, the CFO of the Columbia Emergency Department at 347 387 2397.
 

From Dr. Trent She: Sinai Ultrasound Conference

Hey all,
 
Here is our Post-Symposium Survey and a Google Drive containing all the Symposium Lectures + Slides. I split the initial Zoom video recording into separate lectures for ease of access and downloading. The only lecture we are missing is our third poster presentation due to technical difficulties (sorry Christina!). 
 
Please let me know if you have any issues accessing and please feel free to distribute.

Coronavirus Updates

Given the rapidly evolving response to COVID19, it can be challenging to stay current.  Below are the most critical updates from NYP and GME. 

Please see the COVID19 Updates page for additional information and resources. 

UPDATED NYP ED COVID MANAGEMENT ALGORITHM (4/1/2020)

Updated WHS Sick/Exposed/ Quarantined Guidance (4/3/2020)

Interim Testing Guidelines for Admitted Patients (4/4/20)

NYP CPR Guidelines (3/27/20)

Updated Guidelines for Airway Management (3/23/2020)

PPE Guide Visual Aide  (4/4/2020)

NYP COVID19 TRAVEL GUIDANCE AND FAQs

 

Campus Announcements

Dr. Chris Tedeschi: ED Incident Commander

Dear Colleagues:

 
Please utilize the Emergency Medicine Incident Commander  for real-time issues at Columbia. The incident commander (IC) will be on-site 24hrs/day, 7d/week throughout the month of April.
 
The IC will be based at Allen Hospital from midnight to noon, and Milstein/CUIMC from noon to midnight each day. That said, we will work to address issues at both campuses in real time throughout each shift. Responsibilities will include ensuring patient and provider safety, expediting ED logistics and operations, and serving as a primary contact for each command center.
 
The Emergency Medicine Incident Commander can be reached 24/7 at 347-271-0699.
 
We will continue to partner with our charge nurses and nurse managers to establish a unified command in the ED. Please do not hesitate to reach out to the IC as a primary point of contact, or for escalation of any issue related to emergency care.

From Dr. Ken Wong:  Orienting off-service rotators

Senior residents: please ask the rotator if it’s his or her first or second shift, and (if so) give a brief orientation at perhaps 7:45.  This is a shared responsibility with the attending. 
 

Rotators have gotten a welcome email and a handbook; chiefs also gave June in-person orientations.  However, a rotator’s first shift can be any one of about 12 times during a month, and nothing’s as good as on-shift instruction.  Focus your brief pointers on where to find things, the dispo note template, how to bed request after the dispo, and how to PFD and discharge a patient.  Please also go over PPE, early isolation guidance, and guidelines about high risk COVID19 situations.

THIS WILL BE INCREDIBLY IMPORTANT DURING THIS PANDEMIC, AS WE WANT TO KEEP EVERYONE SAFE WHILE IN THE ED.
 

From Dr. Joel Park: Informatics and COVID

The Health Informatics Research Seminar will take place on Thursday, April 16th at 12:00 PM via Zoom. Leo Celi, MD, MPH, will be giving a talk on “Data Sharing in the Era of COVID-19.”

Abstract: The novel coronavirus SARS-CoV-2 continues to test the capacity of world health systems. We have since learned about COVID-19, the infection from SARS-CoV-2, the way medicine always has: clinical presentations, course, and management strategies have been shared by anecdote or small case series. While we use modern technology to communicate, never before has our failure to build robust data-sharing systems in healthcare been more obvious. In the era of the electronic health record, physiologic, laboratory, imaging, decision making, and treatment data are continuously recorded. Inferences drawn from these data can inform epidemiological inquiries and guide treatment protocols where clinical trial data does not exist, or might be too slow to inform a rapidly evolving situation. While trials accrue, live treatment data accumulates, siloed within hospital systems. When considering COVID-19, the insight we could glean from a pooled, publicly available dataset analyzed by researchers in academics, startups, and industry alike, is both invaluable and necessary. Though our world has embraced data monetization, regulatory hurdles, funding apparatuses, and a publish-or-perish academia at the expense of open data sharing, our shortsightedness need not be our undoing. An unprecedented worldwide black-swan event deserves an appropriate response, and this begins with an unprecedented joining of forces – and data – to best understand our foe, and the successes and failures we have found in treatment thus far.

As clinical research director and principal research scientist at the MIT Laboratory for Computational Physiology (LCP), and as a practicing intensive care unit (ICU) physician at the Beth Israel Deaconess Medical Center (BIDMC), Leo brings together clinicians and data scientists to support research using data routinely collected in the process of care. His group built and maintains the publicly-available Medical Information Mart for Intensive Care (MIMIC) database and the Philips-MIT eICU Collaborative Research Database, with more than 12,000 users from around the world. MIMIC-III has been cited more than 500 times since 2016. In addition, Leo is one of the course directors for HST.936 – global health informatics to improve quality of care, and HST.953 – collaborative data science in medicine, both at MIT. He is an editor of the textbook for each course, both released under an open access license. “Secondary Analysis of Electronic Health Records” has been downloaded more than 500,000 times, and has been translated to Mandarin. Finally, Leo has spoken in more than 35 countries across 6 continents about the value of data and learning in health systems.

All are welcome to attend.

Join Zoom Meeting
https://weillcornell.zoom.us/j/140502099

Meeting ID: 140 502 099

 

From Dr. Lynn Jiang: Wellness

I hope this finds you doing well and staying safe!
 
I had an idea for a wellness related project and wanted to see if you’d be interested in helping me do this or participate.
Many healthcare providers are using the arts (drawing, photography, writing) to help process and meditate during this time. A lot of our colleagues are also sharing these works with others, which creates a stronger community with our colleagues and allows those outside the healthcare field a unique “insider’s perspective.” 
 
My idea is to essentially compile together everyone’s individual work. It can be any type of media as long as it is original work — think the photos we’re already posting or the work Cleavon’s shared. People can continue to share them on their own accounts, but the ultimate goal is to share it to a larger group too — at least via a joint email group, but also (if people are ok with it) by social media so that anyone can participate. Will definitely share a full compiled product at the end of all of this but if we have enough submissions, possibly a weekly update. Hopefully both the creation of pieces (and their viewing) will be helpful for those involved.
 
If you’re interested, please contact Lynn at lgj7001@med.cornell.edu.
 

MCB Message of the Month

Conference This Week


Shouts once again to everyone in our EM family. Thank you all for coming to work each day and doing what you do.

You were made for this moment.

Upcoming Residency Events

 
  • May 27th – 8 hr Theme and PGY4 Research Day
  • May 28th – Residency Retreat 
  • June 3rd – Graduation at the Central Park Boathouse 

To Dos

ALL

  • WEAR YOUR PPE ON SHIFT! Keep yourself safe always!
  • MedHub hours must be logged! 
  • Please fill-in your resident profile on nypem.net. It’s a great way to highlight your interests and things you’ve done during residency. https://nypem.net/meet-our-residents/
  • Remember– Away Electives require an application submitted 112 days in advance, while NYP electives are a minimum of 56 days. Instructions located here. 
  • Check out this career guide from the Academy for Women in Academic Emergency Medicine  https://issuu.com/saemonline/docs/saem_awaem_toolkit
  • Please be wise on social media use and don’t risk patients’ trust in the medical profession.  
  • Give time and action-specific instructions in the discharge papers.  “See your primary doctor soon” is much less informative than “See your primary doctor in the next four days, but return to the E.R. if your abdominal pain worsens or persists.”  

PGY4s

  • Get disability insurance before graduating residency.  Here’s one resource to start.
  • Educate yourself on potential job contract issues.  Here’s one article and another EM specific book.   
  • If a job requires your residency malpractice insurance history, email nog9010@nyp.org & mam9160@nyp.org to obtain the relevant documents.  
  • Remember to complete your EMS ride-alongs! You need 10 4-hour sessions to graduate!

PGY3s

PGY2s

  • Time to start leading notifications!  Rely on your fellow residents, constantly communicate with your team, and learn as much as you can! You can do this.
  • If you have money to save after NYC costs and student loan repayment, consider putting it into NYP’s 403(b) or an IRA.  The “Roth” option is likely better when you’re a resident.  

PGY1s

  • Scroll down to 3. Publications and Educational Initiatives for some good EM resources!  Or check out this centralization of other EM resources including podcasts, books, apps and Qbanks.
  • We’re at that point in the year when it’s time to start becoming the PGY2 you always knew you could be. Stretch yourself on shift both in terms of volume and patient complexity.   

Chief on Call

Liza Hartofilis, M.D. 
EM Chiefs’ Cell:  917-410-1056
  • Please call and do not text/ email so we can address issues promptly.
  • If you do not hear back within 10 minutes, then call any of the other chiefs.