Weekly Update

July 27, 2020

General Announcements

Choose your Academic Practice Track!

The ACADEMIC PRACTICE TRACKS represent various areas of sub-specialization under the umbrella of Emergency Medicine. 

The 16 APTs that we have thus far identified are as follows: 

  • Academic/International Medicine/Global Health
  • Critical Care 
  • Disaster/Wilderness/Space/Austere Medicine 
  • Geriatrics 
  • Humanities 
  • Innovation/Telemedicine 
  • Medical Education 
  • Operations 
  • Pediatrics 
  • Prehospital/EMS/Transport/Tactical 
  • Quality & Patient Safety 
  • Research 
  • Simulation 
  • Sports Medicine 
  • Toxicology 
  • Ultrasound/PEM Ultrasound 

We would ask that you CHOOSE AN APT to join. We are limiting the residents to one APT (two with Dr. Garg’s permission).  You can explore at the beginning but hope that residents will focus on one APT by PGY3 year.

Email Oz Sayan (ors1@cumc.columbia.edu) with your APT choice.

2020 Annual Hospital Training (AHT 2020)

Get ready to complete your mandatory annual hospital training!

Access the 2020 Annual Hospital Training (AHT20) in the NYP Learning Center. This year’s launch is earlier than in prior years to allow more time for completing the training and learning the critical competencies. Completion of AHT20 is required by all graduate staff. Compliance is mandatory for you to work and for NYP to meet regulatory requirements. Failure to complete this in a timely manner will lead to your CWID account being disabled.

The deadline for completing AHT20 is Friday, December 4, 2020.

Instructions for completion can be found here. 

From Leadership: Daily COVID Screening App

As part of an NYP-level initiative, please be aware that residents must log into the COVID PASS app on Mobile Heart Beat  on a daily basis before arriving at work.  

If you answer “no symptoms,” you should receive a green pass as indicated above.  While it does not appear that security is checking these for NYP employees, this is a critical compliance issue and residents should log a pass daily when working clinically.  

From the Munira Persad: BLS/ACLS Recertifications

Please see the attached documents regarding BLS/ACLS (Re)Certification. 

Residency Leadership guidance will be coming shortly to answer questions residents have about certifying or recertifying.

AHA COVID Interim Guidance

BLS/ACLS NYP Sign-Up Information

From the Program Evaluation Committee: Evaluations

Hi all! 

We need your help to make the residency better! 

One of the most important ways we make improvements is through our ED and off-service evaluations.  Please fill these out in MedHub for each block you complete.  The more data we have, the more we know what’s working and what’s not.  Evaluations are also our evidence whenever we want to affect a change, so please let your voice be heard! If you have any questions or concerns, feel free to contact leadership, the chiefs, or any member of the PEC (Taylor, Chris, Alex, Ryan, Mary Kate, and Billy).

From Dr. Kaushal Shah:  SAEM Pulse Articles

SAEM Pulse is looking for writers to author non-research articles that address any and all matters related to racism as a public health crisis to be included in an upcoming issue of SAEM Pulse.

Topic suggestions/examples:

  • Discrimination and health
  • Institutional, cultural, and/or intersectional racism and health
  • Racism across the life course
  • Residential segregation and other neighborhood factors and health
  • Approaches and strategies to addressing racism and achieving health equity
  • Educational strategies to teach about racism and its health impact
  • Diversity and racism issues with regard to residency recruitment, retention, and pipeline building; faculty development and advancement, etc.

Papers should focus on emergency medicine, academic emergency medicine and/or issues relevant to either/both. Paper formats can be essays, narratives, profiles, interviews, op-ed pieces, human interest stories, “think” pieces, or informational/how-to articles. Length: 400-700 words. Direct inquiries to Stacey Roseen, senior editor, publications and communications at sroseen@saem.org

Upcoming Deadlines 
August 1, 2020 for the September/October Issue (Extended to August 7!)
October 1, 2020 for the November/December Issue
December 1, 2020 for the January/February 2021 issue

From Dr. Trudi Cloyd: Our New Conference Format!

Dear family, 
 
A reminder that you can find conference details (as well as asynchronous content) by toggling the “Conference Details” section below each conference schedule.  This content is part of a larger revamp of our educational structure, including:
 
  • Module curriculum – expect a month long deep dive into core topics with Cardiology, Resuscitation, GI and more.
  • Foundations Curriculum – small group breakout sessions with deeper dive into diagnosis and management of assorted ED presentations.
  • Rosh Review – 30 question assigned quiz at end of module to consolidate learning of the month (residents).
  • Tintinalli chapters – assigned weekly core-content reading accessible via WCM e-Library (residents).
  • Morbidity & Mortality – Cornell and Columbia specific sessions, typically on the first and second Wednesday of the month, respectively.
  • Journal Club – quick fire statistics lecture before breaking out into small groups for further discussion of the study’s design and results.
  • CPC Competition – one day, all CPC cases. Vote for the best faculty and resident to nominate for CORD’s CPC competition!
  • Theme & Core Days – resident-driven educational days designed by PGY3s and PGY4s, respectively.
  • Attendance is via Google Feedback form (below). Don’t forget to mark yourself present!
Please continue to  use our google feedback form for conference evaluation and attendance.
 
We hope you include some valuable comments so that we can continue to improve our education efforts!

Campus Announcements

From Jimmy Truong:
 

For residents interested in PEM:

Many of you are aware of the current EMRA EM Fundamentals, which is an adult EM based on shift resource for emergency providers. The goal of PEM fundamentals is to create a pediatric emergency medicine on shift resource for EM providers. This publication is being headed up by the faculty and fellows at Harbor-UCLA and EMRA.
 
There are currently several chapters remaining that need primary authors. The chapters are relatively short (1-3 pages, 300 words per page), and like EM fundamentals or WikEM should be brief, succinct, and info-packed. 
  
All chapters will have a section editor at Harbor-UCLA who will oversee the chapter authors’ work. Cindy Chang, Patricia Padlipsky, and Kelly Young at Harbor-UCLA are the overall editors. They will provide you with chapter outlines and have allotted page counts to each chapter. They will have clear author guidelines and will be available for guidance along the way, as will your section editor. 
 
Current Timeline:
August 15, 2020 – Draft #1 due for chapter authors to section editors (This is a tight turn around, it may be pushed back to Aug 21st)
October 15, 2020 – Revision feedback from section editors to chapter authors due
November 16, 2020 – Revision #2 from chapter authors to section editors due
December 15, 2020 – Section editors give to Cindy, Kelly, Patricia for final review
March, 2021 – the book will go to press!
 
Signing up:
 
Residents/Fellows
 
Please send me the following information if you are interested in authoring a chapter:
-Your name
-email address 
-your position (PGY_ in EM/Peds residency/fellowship at _ institution)
-several topics from the below list you would be interested in writing (including if you are open to writing anything available or not).
-How many chapters you would be interested in writing (one is fine)
-If you would be interested in being paired with an EMRA medical student as a co-author (and their name if you have a person in mind)
 
Depending on interests and the number of potential authors, I will divide the available chapters. Given the limited list of chapters, it will be on a first come, first served basis.
 
Section | Chapter Title | Pages Allotted
Neurology | Ataxia & Paralysis | 2
Orthopedics | Back Pain & Discitis | 1
Psychiatry | Autistic Child in the ED | 1
Psychiatry | Behavior | 1
Trauma | Extremity Trauma | 3
Trauma | Thoracic Trauma | 2
Trauma | Spinal Trauma | 1.5
 
Email Jimmy Truong (jt2979@cumc.columbia.edu) if interested..
 
From the Columbia EPIC team: Documentation Workflow
 
A reminder to all residents that when completing your primary provider note in Epic, you must click the box requiring a co-signature. 
 
Once the note has been assigned to the attending, sign your note (unless specifically asked not to by the attending. This workflow ensures that notes can be signed in a timely manner by attending. 
 
If you have questions, please feel free to reach out to the chiefs!
 
 

NEXUS Access

Cornell leadership wants to make sure we can all access to https://nexus.weill.cornell.edu/. Please try to login with your usual information, if you have difficulty, please email the Chiefs (nypemchiefs@gmail.com).  

From Cornell Leadership

Please fill out the Emergency Department COVID-19 Survey. Please remember that this survey is anonymous, and results will be used for internal use only.
 
WCM Racial Diversity Survey: Racial Diversity at WCM Survey
 

From Dr. Amos Shemesh: ED Disaster Committee

For those residents interested, the WCMC ED Disaster Committee is looking for new membership.
 
Dave and Dayna are our nursing leaders who run the Committee and are currently obtaining masters degrees in disaster preparedness. This would be a new opportunity for residents to join nursing, APPs, and physician leadership on the committee. 
 
It’s typically a monthly meeting with various activities around disaster prep/protocols, operations, mass casualty prep, tabletops, drills, ideas, and most pressingly the epic cutover downtime.
 
Contact Dave (dvm9033@nyp.org) and Dayna (rae9017@nyp.org) if interested! 

From Dr. Brenna Farmer: Cornell Bed Requests Update

 Please note the following regarding 

-ED Staff will NOT submit Bed Request orders until all disposition-determining ED tests* and consultations are complete. (*Staff should not rely exclusively on EPOC results)
-ED Staff will make every effort to complete the new Bed Request order with optimal fidelity
-Always choose the correct service, including surgical sub-services (Colorectal, trauma, vascular, etc.)
-Choosing the correct level of care eg: floor vs step-down vs ICU (nursing needs may dictate higher level of care eg: trach, drips, etc). Please confirm with consulting team if unclear.
-Only selecting Hallway Bed Eligible if special conditions from the drop-down list do not apply (Exceptions to hallways include: trachs,  face-mask O2, PEG/J, etc)
-Work to identify the Admitting Attending, if pt is admitted to medical service,  including  all voluntary physicians and their level of involvement.
-Include in the Comments section information regarding special conditions:   transplant,  immunosuppression, renal, geriatrics, onc (solid/liquid), 1:1, isolation)
-Include in the Comments section information regarding the clinical case to augment the diagnosis (eg:  chest pain – ROMI, AMS – neuro work up negative, suspect UTI)
–Include in the Comments section information on recent travel: state no travel or list the state/country where a patient has recently been

From Dr. Julie Zhao: First Responder Course for Med Students

Hi all,

We are about 1 months away from the annual First Responder Course for first year medical students, scheduled for the morning of Thursday, August 27, 2020. 

It is a 3 hour Lecture, Workshop, and Sim/Standardized Patient based course aimed to teach students in their early clinical years to become confident and capable first responders in the pre-hospital setting. It has been a fun and educational hands-on experience with excellent feedback.

Unfortunately due to Covid, the course will be run in a Zoom format this year.

We are brainstorming different ideas for running virtual sims for the four case scenarios (anaphylaxis, chest pain, seizure, overdose) and two sessions (splinting and airway).

Each session will be about 20 min long. If you are interested in helping to run one or more of these sessions, please reply at juz9013@med.cornell.edu.

If so, please also remember to request Aug 27 off on the next schedule requests.

Thanks very much!

From Dr. Alexis Halpern: EM Palliative Care Study

Dear colleagues,

We are launching a multi-center study entitled Emergency Medicine Palliative Care Access (EMPallA). This is a PCORI (Patient Centered Outcomes Research Institute) sponsored trial in collaboration with the NYU Emergency Department. The study will compare outpatient and telephonic delivery of palliative care for adults over 50 who are identified and enrolled through the ED. Outpatient appointments are currently being conducted via telemedicine.

Billie Johnsson will be leading subject enrollment. I am writing to request your assistance with this process, in two ways:

1) Inform Billie via MHB with the patient’s name and MRN if you are seeing a patient with end stage CHF, COPD, renal failure, or solid tumor cancer or,

2) Inform Billie via MHB with the patient’s name and MRN if you are placing orders on a patient and the pop-up informing you that the patient qualifies under the Palliative Care Act comes up on your screen.

Billie may not answer you right away, and as such you can send her messages 24/7. We have permission to conduct remote enrollment, and have 24 hours post-discharge to reach out to the patients or their caregivers.

Please reach out to me or Billie (bin9004@med.cornell.edu)  with any questions regarding the study, or these requests.
Thank you in advance for your assistance.

Best,
Alexis

MCB Message of the Month

Conference This Week

July 29, 2020 - Resuscitation

CORE DAY - ROSC

Time

Topic

Speaker

  • 08:00 - 08:35
  • The Case for Cardiac US in Cardiac Arrest
Dr. Thomas Bennett

NYPEM Resident

  • 08:35 - 09:00
  • Pitfalls of Cardiac US in Cardiac Arrest
Dr. Neil Patel

NYPEM Resident

  • 09:15 - 10:35
  • ACLS Flipped Classroom
Drs. Thomas Bennett, Neil Patel, Paula Marin, Cameron Callipari, Di Coneybeare & Nick Avitabile

ROSC CORE DAY TEAM

  • 10:40 - 12:00
  • Incorporating Cardiac US in Cardiac Arrest
Drs. Thomas Bennett, Neil Patel, Paula Marin, Cameron Callipari, Di Coneybeare & Nick Avitabile

ROSC CORE DAY TEAM

Dear EM family,
 
Next week’s conference will be a Core Day on Cardiac Arrest. This is an educational day led by our residents Thomas Bennett, Neil Patel, Paula Marín Acevedo, and Cameron Callipari. Mentorship for the day was provided by Di Coneybeare and Nick Avitable. Thank you everyone for your hard work, and we look forward to the day!
 
Please review the flipped classroom resources before conference to prepare for the small group activities.
CONFERENCE SCHEDULE
8:00 AM     Introduction
8:10 AM     Point-Counterpoint: Ultrasound in Cardiac Arrest
9:00 AM     Point-Counterpoint: Q&A
9:15 AM     ACLS Flipped Classroom (small groups)
10:40 AM   Incorporating US into cardiac arrest care (small groups)
 
FOR FLIPPED CLASSROOM
CASA protocol (see email for attachment)
Guiding CPR with focused echo (see email for attachment)
 
ASYNCHRONOUS LEARNING (required)
Tintinalli’s Emergency Medicine 9th Ed – Chapters 24-27 (WCM Library for residents)

 
CONFERENCE ATTENDANCE AND EVALUATION LINK
Please note the new attendance system for CUIMC faculty** The attached linked form allows you to mark your hours present for attendance purposes. We will no longer be manually collecting attendance and will rely on self-reporting.Thank you for your compliance with this new system.

ZOOM

Shout out, Columbia Anesthesia Resident, Dr. Sharon Sun

She diagnosed an aortic dissection on a busy Columbia shift expeditiously after having a high suspicion, alerting the senior and nursing to get the patient quickly and safely to CT and managing the patient thoroughly to admission. Way to go, Dr. Sun!

Upcoming Residency Events

To Dos

ALL

PGY4s

  • The first year of attending starts now!  Please touch base with leadership and your CCC member as you start the process of the job search and career development.
  • Complete all of your procedures via MedHub by the end of December!

PGY3s

PGY2s

  • Time to start dominating the board.  
  • 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

  • Ask questions constantly! Everyone is here to help!

Chief on Call

Phong
Phong Huynh, 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.