Weekly Update

August 3, 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 Dr. Adria Simon:  Asynchronous Learning

Hi team!

I wanted to update you on some changes to asynchronous learning going forward.   We are going to transition to using the ALiEM AIR and AIR Pro series to compliment each conference module.  The material has been vetted extensively by the ALiEM team and has a nice mix of podcasts and blog posts to offer some flexibility across different learning styles. We are excited to incorporate this and see how it goes.  As we make this transition, please don’t hesitate to offer feedback on your experience – you are the biggest stakeholders here and I want to ensure that you’re finding the material accessible, engaging and on target. 

You’ll need to take a few simple steps to get set up:

  • Go to https://www.aliemu.com/  and create an account.
  • Once logged in, go to My Profile and click the Groups tab.  
  • Add me as a coach using this email (as6150@cumc.columbia.edu ).  Completing this step allows me to track your progress and ensure you get appropriate conference credit for completion.   
  • For PGY2/3/4, you may have already created an account during the COVID pandemic. If so, use that login informatinon, but be sure to add Adria as a coach as well

Once your profile is created, you can navigate to Catalog in the upper right hand corner to find the course material.  To finish out this month’s assignments, you’ll be completing the AIR Pro– Critical Care Part 1 module which should dovetail nicely with our core day material on POCUS and resuscitation. You will see some posts listed as “AIR Pro” and some listed as “honorable mention.”  Honorable mentions are not required to get credit but are there if they pique your interest.  Completing the associated assessments is required in order to get credit. 

In the spirit of transparency, I am not logging into this every single month to ensure you complete this on time.  My philosophy about embracing adult learning includes embracing the freedom to choose how and when you learn.  I understand that different rotations pose different demands on your time and while you are encouraged to complete asynchronous in a timely fashion to enhance your module-specific learning, I understand it may not always be feasible and I want us to maintain a flexible approach. However, including asynchronous learning as part of your conference content ensures that in person/zoom conference can be 4 hours long and that you don’t have to wake up for 7 AM conference every Wednesday. Completion is clutch for both your learning and your beauty rest.  You will see some modules are longer than others; rest assured that these will often be balanced out by shorter ones in other conference blocks and will even out across the year. 

TLDR:

  • Set up an ALiEMU account and make me your coach to get conference credit for asynchronous learning
  • This month’s assignment is the AIR Pro- Critical Care Part 1 module

Hit me up with any questions and let me know how it’s going!

 

From Dr. Oz Sayan: Professional Developement

Dear Colleagues,

As part of our Professional Development program, I will be meeting with each one of you twice a year.  It will allow me the opportunity to interact with you all one-on-one and to help you grow throughout residency.    In preparation for our meeting, I would ask that you complete the questions asked in my email from Sunday, July 29.  These are some of the topics we will touch on.  Having you spend some time before our conversation will allow you provide the best answers.  I will be spreading these out over the semester.  

Some questions are for specific classes only.

The question above Scholarly Work can be skipped for now as I just collected this info about one month ago.  It will be asked next semester as a way to update info.

I will likely meet with interns later in the semester when they have had more time as interns.

I really look forward to spending some time with all of you.

Oz

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 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

Campus Announcements

From Dr. Angela Mills: Buprenorphine X-Waiver

Dear colleagues,

In a few weeks, our Department will join many Emergency Departments across the nation in an effort to end the opioid epidemic. We will be rolling out an exciting initiative to help our patients who suffer from substance use disorders. One key aspect will be our ability to prescribe buprenorphine in the ED.
 
Buprenorphine has been shown to be an important medication in treating patients with substance use disorders. It has a good safety profile and is easy to administer. Patients can be started on buprenorphine while in the ED. Buprenorphine can be prescribed by all clinicians. To prescribe it, you will need to obtain the data 2000 waiver (called an “X-waiver”)  in order to prescribe buprenorphine for these patients.The process has been streamlined, requiring watching an online program and then filling an updated form to the DEA (no fees).
 
I strongly recommend that you obtain the waiver, if you haven’t done so. It can be done for free (and with CME credit) online at your convenience. I have included below some options for you. When complete, please send a copy of your X-waiver to:  Lily Abrukin (attendings) and Nathan Todd (APPs), who are currently keeping the lists of our X-waiver providers.  
 
Thank you for all your help in treating this vulnerable patient population! 
Angela
 
 
Please see TWO links below for the training:
 
 

Zoom EM-Focused MAT Waiver Training : Get Your DEA DATA-2000 X Waiver

  • Date/Time: August 25th 2020 9am-5:30pm CT.
  • Eligibility: MD, DO (including residents), NP/PAs (including NP/PA in training and medical students)
  • Prerequisites/prior learning: None
  • Cost: None (free)
  • CME: provided

Register Now

OUD & the Emergency Department Experience During the COVID-19 Pandemic

From Jimmy Truong: EMRA PEM FUNDAMENTALS
 

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!
 
 

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

August 5, 2020 - Cardiology

Time

Topic

Speaker

  • 08:00 - 09:00
  • EKG Workshop
NYPEM EKG Team
  • 09:00 - 09:30
  • Sudden Pediatric Cardiac Death
Dr. Zoe Grabinski

CHONY PEM Fellow

  • 09:30 - 10:00
  • Calcium and Beta Blocker Toxicity
Dr. Jason Chu

CUIMC Emergency Attending

  • 10:00 - 10:30
  • Dysrhythmias
Dr. Ross McCormack

CUIMC Emergency Attending

  • 10:30 - 12:00
  • GRAND ROUNDS:
  • Aortic Dissection / How to Give a Talk
Dr. Anand Swaminathan

Assistant Professor Emergency Medicine, St. Joseph's Regional Medical Center

ASYNCHRONOUS LEARNING
Calcium channel antagonist and beta-blocker overdose: antidotes and adjunct therapies (Br J Clin Pharmacol., 2015) Attached.
Tintinalli’s Emergency Medicine 9th Ed – Chapters 75, 76, 131 (WCM Library for residents)
 
CONFERENCE ATTENDANCE AND EVALUATION LINK
 
ZOOM
Vineet Sharma

Shout out to all the residents who have been incredible representatives of our program during recruitment events: Matt, Ryan, Michael, Mary Kate, Cam, Liza, David, Jess, Ahmed, Rana, Jamie (and her fiance)!

And special thanks to Vineet Sharma, who has put countless hours into our recruitment efforts and has been a driving force in promoting our residency. We are truly grateful for the love and commitment to our family!!!

Upcoming Residency Events

  • August 19 – PGY2 Retreat!!

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

Chris Reisig
Chris Reisig, 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.