RESUSCITATOR

WAYNE STATE UNIVERSITY VOLUME 3, ISSUE 2 SCHOOL OF MEDICINE DEPARTMENT OF EMERGENCY MEDICINE

LETTER FROM THE CHAIR

INSIDE THIS ISSUE: Right Where We Should Be lab has not only been re-built, but is flourishing thanks to Jon Sullivan, The preparation of our annual Anthony Lagina, Rita Kumar, RED SHOE 2 Departmental review for the Thomas Sanderson and their University each year renders an DIARIES teams. With the grant performance opportunity to reflect upon where trends seen below, we are clearly we are, where we have been and on track to be one of the top- CLASS OF 2014 4 where we are going. This year, as I ranking Academic Departments of made the presentation to the Dean EM. and Directors at the SOM, I was particularly proud of what we have WSU DEM Grant Performance CLASS OF 2011 5 accomplished. $1,800,000 $1,600,000 GRADUATES A few years ago, as new Chair, I $1,400,000 remember the significant $1,200,000 $1,000,000 challenges that faced our research $800,000 ED CRITICAL 8 team. Three of our four tenured $600,000 CARE $400,000 faculty had retired. Our remaining $200,000 ROTATION senior investigator, Rob Zalenski, $‐ had nobly decided to devote the 2007 2008 2009 2010 Suzanne R. White, MD, ULTRASOUND 10 remained of his career to the Many of our research Chair UPDATES important specialty of palliative advancements have resulted from care. The good news was that we fruitful collaborations with the had a number of shining stars in Center for Molecular Medicine and grow and prosper under the MEDICAL 12 our ranks. Rob Welch, then Genetics, Cardiovascular Research leadership of Cynthia Aaron, STUDIES IN Associate Professor became NIH Institute, Physical Medicine and Susan Smolinske, Matt Hedge, POLAND funded, took on the role of Clinical Rehabilitation, and Physiology. Drs. Lydia Baltarowich and our newer Research Director, and moved to John Flack and Karin Przyklenk faculty members, Bram Dolcourt PALLIATIVE 14 full Professor. He truly put us on the have provided senior level and Keenan Bora. The Poison CARE MEETING map with the NIH Neurologic mentorship at critical points along Center now covers the entire Emergencies Treatment Trials the way. I believe that we are on the state and our fellows are gaining Network Grant Award. We were brink of realizing our vision of national recognition through then able to recruit Brian O’Neil as having our own EM clinical research their research and leadership Associate Chair for Research along network that launches therapeutic activities. Under the leadership with his clinical research team. He investigator initiated trials of Rob Zalenski and Kevin and Rob have taken us to a new prompted by novel discoveries McDonald we saw the field of SPECIAL POINTS high water mark in terms of palliative care achieve ABMS OF INTEREST: made in our own emergency externally funded investigations medicine basic science research recognition, a palliative care and publications; we are now service evolve at SGH, and the laboratory. Emergency Medicine Grand averaging 38 peer-reviewed first palliative care fellowship Rounds, Every Thursday, publications annually. Phil Levy, The growth in our educational program launch at the DMC. Rose Fernandez and Rob Sherwin arena has been equally impressive. Under Gloria Kuhn’s leadership, Detroit Receiving & who were all junior faculty at the The size of our faculty has we continue to offer state of the Sinai-Grace Hospitals time have been instrumental to our increased as have our activities. We art CME courses on subject research success. Recently, Phil continue to offer a superb, highly areas such as EM Wellness, ACEP Scientific Assembly and Rose were both promoted to AAMC-ranked EM fourth year Domestic Violence, Technology in October 15-18, 2011 Associate Professor and Rob was elective; in fact, EM is second only Education, and Critical Care in Reception on October 16th named the Director of Clinical to internal medicine in specialty the ED. Our residency leaders, Research at SGH. As our choice of graduating WSU students. Bob Wahl, Melissa Barton, Kerin at 6:30PM San Francisco, Department’s first Robert Wood Our medical student leadership Jones, Marc-Anthony Velilla, California Johnson Scholar, Phil recently team, Sarkis Kouyoumjian, Trifun Michelle Lall, Scott Derstine, received a $1.9 M NIH grant to Dimitrijevski, Ciara Barclay- Bram Dolcourt, Scott Freeman Midwest Regional SAEM study Vitamin D and hypertensive Buchanan, Jacob Manteuffel, Amy and Erik Olsen continue to Meeting, November 6-7, heart disease. Similarly, Rose was Smark and Elizabeth Bascom, are maintain a pipeline of highly 2011, Toledo, Ohio recently awarded $1 M by the to be commended for their sought-after graduates. AHRQ to utilize simulation to study dedication. Our toxicology patient safety. Our basic science fellowship and service continues to (continued on page 7) DRH/SG Combined Journal Club, December 13, 2011

RESUSCITATOR Page 2

RED SHOE DIARIES

It is hard to believe that as well. It is in the balance don’t know many people, ask another academic year has between the two that the your fellow house officers, come and gone. When my difficulty lies. nurses or attendings for parents used to tell me that It is not as though residency some ideas. It is important time goes by much more is impossible. Hundreds of to decompress. quickly as one ages, I thought thousands have gone before The pressure a resident that they were crazy. Well, you and your residency experiences is tremendous, they were right. (The directors work tirelessly to but not entirely unique. Your physicist wanna-be that I am make sure that not too much attendings have all gone just hopes that my personal is asked of you. Where I through it and other mass has not increased so have observed a change, professions have significant much over the years that I however, is an increasingly stresses as well. It is have warped the space-time prevalent attitude that important to keep your eye continuum enough to actually medicine is a job, not a on the prize. After residency Philip A. Lewalski, M.D. speed my perception of profession. There are no you will embark on one of the Assistant Professor time!) I want to address this clocks in medicine. You are most rewarding and Editor-in-Chief edition’s editorial to the in- serving the needs of the important careers that exists. coming interns. To those of patients and in the ED they It is truly a calling and you that have graduated and do not follow a schedule. vocation. In how many other work in a teaching Admittedly, one of the professions can you touch After residency environment, perhaps you graduating classes did your fellow man and woman, can share this with your present me with the “When I help them and possibly cure you will embark residents. Hopefully the rest was a resident” awards, but I them? This reality is what of you will be reminded fondly will try not to dwell on the keeps us on track and on one of the of those 1,095 days of fact that things are easier in coming back to the hospital residency (1,096 if you were some ways now. (There were in spite of bureaucracies, most rewarding lucky enough to earn another no “caps” on call, no days off politics and long hours. It is and important day of training from a leap- on Surgery and a lot more also important to remember year) where you were forged hours in the ED—288 hours that we, your attendings, are careers that into the strong, competent per month as PGY 1’s.) here for you as well. We are emergency physician that you Conversely, you will have here to educate you, guide exists. It is truly are today. challenges that I did not— you, to push you past your To our wide-eyed, bushy- learning a computer system comfort level and to answer a calling and that takes physicians any questions you may have. tailed new interns I offer the vocation. following bits of wisdom. You increasingly away from the Even if you feel that you can are about to embark on an bedside, Dragon Voice do it alone and we “old- Recognition and time timers” couldn’t possibly awesome journey that is both frightening moments. On the extremely rewarding, yet benchmarks. I acknowledge know what things are like that I cannot fully understand now and what you are going other hand, you will also develop often terrifying. You have friendships that will last a been honored with the ability what it is like to have to learn through, remember Mark these technical applications Twain’s observation. “When I lifetime and have some crazy, and the opportunity to learn fun times as well. I am one of the greatest while working to become a was a boy of 14, my father competent physician. As was so ignorant I could hardly confident that all of you can professions in the world, but succeed as I am sure that Dr. if the thought of that Oscar Wilde wrote, “I am not stand to have the old man young enough to know around. But when I got to be Wahl and Dr. Barton have responsibility doesn’t scare selected residents with the two you at least a little bit, than everything.” 21, I was astonished at how much the old man had most important attributes you are either much braver When your duty is finished necessary to become excellent than I or deluding yourself. and you have done your learned in 7 years.” We do know what you are Emergency Physicians—and the So, how does one survive reading (yes, I said it), then it only things we can’t teach you— three grueling years of is time to use your recreation experiencing and we can help. common sense and a strong residency without breaking time to “re-create” yourself. work ethic. Perhaps Oscar Wilde down physically or It is important to bank some In summary, I would like to understood this when he wrote, emotionally and without sleep, but you also need to welcome you, new residents, “Education is an admirable killing someone? The let loose and have some fun. to a very exclusive club. thing, but it is well to remember unglamorous but truthful This can include time with Many have aspired to it, but a from time to time that nothing answer is to be ready to work families, fellow residents or relative few have attained it. that is worth knowing can be harder than you have ever even time alone—as long as it Be prepared to work hard, taught.” worked before and to is something you enjoy. If absorb a great deal of Philip A. Lewalski, M.D. balance that by playing hard you are in a strange city and knowledge and to have some Editor-in-Chief

“To promote quality medical care through excellence in clinical services, education and research…”

VOLUME 3, ISSUE 2 Page 3

RESIDENTS: I WANT (NEED) YOU!

I am fortunate to be part of a occupational health (Arnetz On an individual basis, I can collaborative group of and Juratli), cardiovascular make the results of your lab researchers who has recently pathophysiology (Przyklenk) work available to you so that been awarded a Physician and emergency medicine you can see where you stand Investigator Research Award (Lewalski)—an archetype of in regard to stress markers by the Blue Cross Blue Shield multidisciplinary collaboration and cardiovascular risk of Michigan Foundation. Our that exemplifies the mission of factors. For obvious reasons, team, consisting of Karin the Cardiovascular Research this area of study has Przyklenk, PhD of the Institute. The proposal, and become very important to me Cardiovascular Research the fact that we are and I now have a strong Institute, Sham Juratli, MD conducting the study in the desire to understand the and Bengt Arnetz, MD (both emergency department, is mechanisms of job stress of the Family Medicine and especially relevant (and and its relation to work Occupational Medicine personal) to me as a stroke quality and the toll it takes on departments) and I received survivor. Our plan is to use our bodies. We work in a a grant for our project this small seed grant and the unique and highly stressful entitled “Acute data we obtain as the basis for environment, yet the effects Cardiovascular Stress and a larger NIH or AHA of being an “emergency Quality of Patient Care”. The submission in the future which physician”—on our patients, goal of this pilot project is to will include attendings and on our selves—have not been investigate the critical nurses as well. studied. I hope to remedy relationships between acute This is where you, our that. stress, biochemical markers residents, come in! In the If you have any questions of cardiovascular risk and near future I (or another about the study, please quality of patient care among member of the research team) contact me at resident physicians in the will be approaching you to [email protected]. high-stress environment of seek your participation in the I look forward to working with the Emergency Department. study. Being part of the all of you in the near future. As a group, we provide a project will not consume too unique and synergistic much time and will be combination of expertise in Philip A. Lewalski, M.D. relatively painless. (Alas, Editor-in-Chief the psychosocial aspects of blood samples are required.) environmental and

NEW ATTENDING PHYSICIANS AND PHYSICIAN ASSISTANTS

We would like to welcome Jackson Lanphear, M.D. is a Kristin Swor-Wolf, M.D. will be the following physicians and Pediatric Fellow and will be working at S-G, HUH and DSH. physician assistants to the working part-time at DRH. Farah Ubaid, M.D. will be Wayne State University Allison Loynd, D.O. will be working at S-G and HUH. Department of Emergency working at DRH and HUH. Maya Harp, PA-C will be Medicine. We look forward James Paxton, M.D. will be working part-time for MCES. to working with you. working at S-G, DRH and HUH. Nicole Reske, PA-C will be Sherry Hanna, M.D. will be Ryan Phillips, M.D. will be working at S-G. working at DRH, HUH and working at DRH, HUH and HVSH. Sharon Sikkelee, PA-C will be DSH. working for MCES. Brian Kern, M.D. will be Daniel Ridelman, M.D. will be Congratulations on your working at S-G, HUH, and working at S-G, HUH and DSH. DSH. decision to join this Tolu Sonuyi, M.D. will be remarkable team! Robert Klever, M.D. will be working at S-G, DRH and HUH. working at DRH, HUH and DSH.

“We the emergency medicine residents of Sinai-Grace Hospital, stand committed to upholding the core principles of emergency medicine.”

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WELCOME EMERGENCY MEDICINE RESIDENTS CLASS OF 2014

Detroit Receiving Hospital Sinai Grace Hospital St. John Hospital/Medical Ctr William Beaumont Hospital Adam Bartsoff, Wayne State Brendan Byrne, Wayne State Arash Albekord, St. George’s Michael Bagan, University of University University University North Dakota Francesca Civitarese, Lake Marcus Chiodo, Oregon Joseph Donley, Wayne State David Berger, University of Erie College of Osteopathic Health & Science University University Missouri-Kansas City Medicine Nathanael Egger, Wayne State Patrick Frank, Arizona College William Comfort, University Megan Doughertry, Wayne University of Osteopathic Medicine of Colorado State University Brooke Frakes, Oregon Health Christopher Karrumi, Wayne Vi Dang, University of Meredith Hill, University of & Science University State University Maryland Illinois at Chicago Candace Johnson, Wayne Rebecca Mills, Thomas Larissa Dub, Wayne State Jamie Kenney, Ross State University Jefferson University University University Travis MacKenzie, St. Nate Minnick, Virginia College John Everett, University of Andrew Klutman, University George’s University of Osteopathic Medicine Washington of Nebraska Setareh Noori, Des Moines Matthew Nipe, University of Matthew Gerde, University of Vit Kraushaar, Ben-Gurion University South Dakota North Dakota University of the Negev Amit Patel, St. George’s Ryan Saab, American Bryan Gibson, Lincoln Kristi Maso, St. George’s University University of Caribbean Memorial University University Rajesh Patel, St. George’s Christina Schroder, Wayne Pavitra Kotini, Eastern Erin Murphy, Wayne State University State University Virginia Medical School University Joseph Peterson, Wayne State Sameer Sinha, University of Rathi Martinez, University of Arun Rajasekhar, University University Toledo Texas Southwestern Medical of Pittsburgh Julie Rossen, Wayne State Ashley Sullivan, St. George’s Center Adnan Sabic, Wayne State University University Robert McWhirter, Wayne University Erin Shovlin, Wayne State Brett Walters, Rosalind State University Timothy Scott, Lincoln University Franklin University Chicago Linda Okra-Boateng, Loma Memorial University DeBusk Linda University College of Osteopathic Megan Pearce, University of Medicine Iowa Craig Sharkey, St. George’s Ameya Samant, Rosalind University Franklin University Chicago Jessica Simoni, Wayne State University

E.D. EXTERNSHIP FOR WSU STUDENTS DEBUTS AT DRH

Thanks to a generous will receive $1,000 each for anticipated that the externs will of Dr. Sarkis Kouyoumjian—and financial commitment from the rotation (entirely donated liaise between the patients and feel that in exchange for us the DMC and strategic by the DMC) and it is felt that in doctors to ensure that the spending some time educating leadership by our academic addition to being a mutually patients understand their these junior students, our faculty, a new, paid externship beneficial arrangement, it will instructions and have all of program will also be enhanced in the Emergency Department serve as a recruiting tool for their questions answered. The by creating a stronger interest at DRH began on June 1, WSU’s best and brightest. students will also receive in a career in Emergency 2011. Open to WSU medical The students will clinically exposure to Emergency Medicine. st students between their 1 and shadow the residents and Medicine sub-specialties by nd 2 years, four positions have attendings in the ED and will having them spend time in been created for a one month have CIS and Logicare access. Toxicology, Hyperbarics and rotation. The number of We will have them print useful Sports Medicine. students vying for a spot was aspects of the patient’s history The WSU Department of Philip A. Lewalski, M.D. tremendous and four that the clinicians may need as Emergency Medicine is looking Editor-in-Chief enthusiastic persons were well as print discharge forward to a very successful finally chosen. The externs instructions. It is also externship—under the direction

“ “We aspire to be competent, trustworthy, and empathetic physicians.”

VOLUME 3, ISSUE 2 Page 5

CONGRATULATIONS EMERGENCY MEDICINE CLASS OF 2011

Detroit Receiving Hospital Sinai Grace Hospital St. John Hospital/Medical Ctr William Beaumont Hospital Michael Fernandes, M.D., Megan Bonanni, M.D., West Nicholas Dyc, M.D., Joel Ascher, M.D., Doctors Carolina Health Specialists, Shore Medical Center, Manistee, Independent Emergency Hospital, Columbus, Ohio Myrtle Beach, South Carolina Michigan, & Season’s Hospice, Physicians, Novi, Michigan Bryan Berry, M.D., Port Fellowship in Palliative Care Richard Gordon, M.D., Anne Messman, M.D., Macquarie Hospital, Australia Emergency Ultrasound Harsheel Desai, M.D., ER One, Emergency Medicine Specialists, Matthew Christ, M.D., Valley Fellowship, Augusta, Georgia Henry Ford Macomb, Clinton Detroit, Michigan Emergency Physicians, Twp., Michigan Brian Kern, M.D., MCES, Jarrod Barker, M.D., Emergency Mishawaka, Indiana Detroit, Michigan David Edwards, M.D., Medicine of Indiana Southwestern Michigan Chip Davenport, M.D., Luthern Robert Klever, M.D., MCES, Emergency Services, Kalamazoo, Fadi Daouk, M.D., Emergency & Good Samaritan Hospitals, Medicine Specialists, Detroit, Detroit, Michigan Michigan Denver, Colorado Michigan Samuel Lee, M.D., Team Health, Joseph Haig, M.D., ER One, Christopher Diaz, M.D., Trinity Franciscan Health Center, Oakwood Southshore Medical Hanna Eadeh, M.D., Memorial Mother Frances Hospital, Regional Hospital, Hollywood, Tacoma & Seattle, Washington Center, Trenton, MIchigan Tyler, Texas Florida; International Red Cross Allison Loynd, D.O., MCES, Lailun Kamal, M.D., Emergency & Red Crescent, Ramallah, West Bradley Dull, M.D., Genesis Healthcare System, Detroit, Michigan Physicians Professional Bank, Palestinian Territories Associates, Goodyear, Arizona Zanesville, Ohio Amy McCroskey, M.D., Cox Wael Hakmeh, D.O., Oakwood Health-Emergency Physicians of JD Langridge, M.D., St. Anthony’s Hospital & Medical Center, Katherine Eckstein, M.D., Springfield, Springfield, McLaren Health System, Flint, Hospital, Chicago, Illinois Dearborn, Michigan Missouri MIchigan Cheryl Larsen, M.D., St. Jude Jessica Kisicki, M.D., Emergency Jeffrey McMenomy , M.D., Medical Center, Fullerton, Medicine Specialists, Madison Brian Felice, M.D., Beaumont Locum Tenens, San Diego, Hospital, Grosse Pointe, California Heights, Michigan California Michigan Cynthia Pfeiffer M.D., Emergency Nicholas Karr, M.D., Questcare, Devon Moore, M.D., University Christian Kolacki, M.D., Medical Associates, Los Angeles, Dallas, Texas Medical Center, Las Vegas, Sparrow Health System, California Nevada Ilya Kott, M.D., Emergency Lansing, Michigan Ramin Raven, M.D., John Medicine Specialists, Macomb Mondeep Narewal, M.D., Kalyan Mantha, M.D., Hopkins Emergency Medical Twp, Michigan Schulich School of Medicine & Beaumont Hospital, Royal Services, Baltimore, Maryland Dentristry-Windsor University of Stuart Lowery, M.D., St. John Oak, Michigan Western Ontario, Windsor, Daniel Ridelman, M.D., MCES, Peacehealth, Longview, Casey Roche, M.D., Kaiser Ontario Detroit, Michigan Washington Permanente Roseville Medical Maria Pak M.D., Georgia Tariq Shihabuddin, M.D., Kaiser Justin Walters, M.D., Practicing Center, Roseville, California Emergency Associates, Permanente, Riverside, in North Dakota Payal Shah, M.D., Beaumont Savannah, Georgia California Hospital, Troy, Michigan Kyle Perry, M.D., The Queen’s Thomas Wolf, M.D., Georgia Medical Center, Honolulu, Emergency Associates, Matthew Zimny, M.D., Medical Center One, Bismarck, Hawaii Savannah, Georgia Maryland Ryan Phillips, M.D., MCES, Detroit, Michigan Rena Salyer, D.O., Metroplex Health System, Killeen & Austin, Texas A CALL FOR YOUR HELP

We at the Resuscitator Sandie Garling for artistic pursuits you would would like your input. We publication in the like to share. Finally, to our would love to hear from both “Ventilator” column. If you core faculty and researchers, our faculty and our have any funny stories or graduates scattered anecdotes, we will try to please send me information throughout the country. If include them in the “Doctor about your on-going or future Philip A. Lewalski, M.D. any of you have any gripes, Aware” column. For the projects. Editor-in-Chief concerns or comments, creative among you, please [email protected] please submit them to me or feel free to send me any [email protected]

“We will relentlessly pursue academic excellence and the advancement of our specialty.”

RESUSCITATOR Page 6

TRIP SITTERS

It’s All Just a Little Bit of had a god named Tenenet others. History Repeating who was the goddess of beer. People are even shopping for There is evidence that Or drugs like this online. marijuana was used prior to Prescription drugs have been th Everything Old is New Again the 20 century BCE in available for years. Now, with China. In terms of regulation, Or the onset of darknets like the tobacco use was penalized Silk Road, illegal drugs can That Which I Know, I See by death in Germany in the be delivered to your home. Recently, we had the Detroit late 1600s. Most currently, What the history of drugs has Electronic Music Festival. In illegal drugs, such as shown is that law is often the world of Medical cocaine, morphine and well behind what is actually Toxicology this is referred to heroin, started as happening and that as The Most Interesting therapeutics. Once abuse technology outpaces Weekend of the Year. Some behavior started or the regulation. of the more entertaining government thought to tax them to increase revenue, Where does this leave us? stories come from this Keenan M. Bora, M.D. then laws were enacted to Education. We must educate weekend. Illegal substances ourselves on which drugs are Clinical Assistant Professor usually fuel these stories. control them or make them illegal. available, from where, with One of the more interesting which affects/complications. ways that people have been More recently, we have seen The great thing is that we are obtaining drugs lately has recreational use of research ED physicians. We excel at been through an chemicals. This trend started pattern recognition. I 1 underground trade . This in the 1960s with the encourage everybody to keep website, Silk Road, allows discovery of LSD and reading about the latest This website, you to trade online services substituted amphetamine trends in drug abuse and for a virtual currency and compounds. As these look for patterns in patients. Silk Road, then trade that currency for compounds are discovered, We at the Poison Control drugs. There is even a laws restricting their use are Center receive calls from the allows you to ratings system. usually enacted several years whole state and can help What this website has later. A recent synthetic drug identify clusters and notify trade online underscored for me is the of abuse is the class of local physicians but again, pervasiveness of drugs and compounds related to JWH- this is only possible through services for a the history of law 018. “JWH” stands for John your help. enforcement’s efforts to W. Huffman, a PhD chemist virtual currency from Clemson who studies 1. http://www.wired.com/ control them. There have threatlevel/2011/06/ and then trade been substances altering the drugs that act at the cannabinoid receptors. These silkroad/ human mind for millennia. that currency for The Sumerians named the drugs were made illegal in opium poppy Michigan in 2010 and were Keenan M. Bora, M.D. drugs. “Gil” (happiness). Egyptians marketed as Spice, K2 and

Trying che, imagine esta, my fist i hear the words flunk out of my mouth chulo, mirame tu corazon, sigues? now watch my fingers but i watch your eyes trace no tienes para tanto dilate, this is your heart and retrace each finger articulated into no lo corras corazon unclenching this fist.

as it struggle to squeeze you are 14, and i’d aome of your muscle runs ragged rather use emoticons, as distressed as fibers of your tee Shradha P. Shah, MD back out September 14, 2010 from explaining: Class of 2008

VOLUME 3, ISSUE 2 Page 7

LETTER FROM THE CHAIR… (CONTINUED FROM PAGE 1)

voice recognition. Further, scholarship such that we 2006: 21 core faculty, 90 we have successfully linked significantly advance the voluntary faculty our advancement of ED science and practice of our 2011: 35 core faculty, 165 bedside Ultrasound EMR specialty. Today, we are voluntary faculty processes to Part IV of clearly realizing that vision, Maintenance of ABRM thanks to each of you. Today, Clinically at the DMC, we Certification. I am excited we are exactly where I hoped continue to see increasing ED that we will soon begin we would be on this journey. volumes while maintaining exploring ED throughput LWBS rates and throughput robotics management Suzanne R. White, MD times that are unachievable systems. Dayanandan Professor & Chair in other academic centers. Despite the Under Pat Sweeny, Bill Berk, DMC ED Patient Volumes 300,000 Chris Heberer, Mark tremendous Brautigan, Crystal Arthur, and 250,000 clinical Ali Hassan’s direction, we are 200,000 DRH a model department in terms HUH of quality care, efficiency, 150,000 HVSH pressures we SGH and peer review 100,000 DMC Surgery TOTAL face each day, performance. Despite the 50,000 tremendous clinical 0 we have not pressures we face each day, 2005 2006 2007 2008 2009 2010 we have not shied away from shied away from technology. In fact, we have Five years ago, we embraced it, adopting CPOE announced our vision to technology. nearly seven years ago, and become the preeminent now performing 30% of our Department for emergency EM documentation using medical care, education, and

CONGRATULATIONS!

Tamar and Bram Dolcourt are 2011 SERVICE AWARDS Congratulations! Nabil (Bill) the proud parents of a baby 10 YEARS Bahu, M.D. is the first girl, Ester Mariam, born on Melissa Barton, M.D., emergency medicine April 29th. Matthew Compton, M.D. and physician to complete his Lorette Haddad, M.D. (APP) Assessment of Martina and Kevin Sprague Practice, Bedside Ultrasound. are the proud parents of a 15 YEARS Lydia Baltarowich, M.D., APP is intended to address baby girl, Charlotte Mae, born the competencies of patient on June 28th. Demetris Haritos, M.D. and Kerin Jones, M.D. care, interpersonal/ Jennifer Newby and Leonard communication skills, Bunting are the proud 20 YEARS professionalism, and parents of a baby boy, Jacek Brudzewski, M.D. and practice-based learning. Samuel Anthony, born July Pamela Claps, M.D. Marc Rosenthal, D.O. and 12th. 30 YEARS Phillip Levy, M.D. have also Amirta and Binesh Patel are Kalavathy Srinivasan, M.D. completed their APP. the proud parents of a baby and Sudershan Grover, M.D. girl, Simreen Kaur, born on July 17th.

Lauren and Thomas Nabil Bahu, M.D. Sanderson are the proud Clinical Assistant Professor parents of a baby boy, Conor Hudson, born on July 31st.

“We aspire to practice excellence and lead by example.”

RESUSCITATOR Page 8

ED CRITICAL CARE ROTATION CRITICAL FOR RESIDENT’S EDUCATION

The Emergency Department- (#91309) at all times. Their perform medication review, Critical Care (ED-CC) rotation clinical responsibilities are review ventilator orders (in began in July of 2006 as an primarily focused on addition to airway elective and continued as a participating in the care of pressures) and sepsis required rotation for all WSU critically ill or potentially guideline adherence where

Detroit Receiving Hospital PGY- critically ill patients in the DRH appropriate. Discrepancies Trauma 2 EM residents in July 2007. ED (defined as all medical are brought to the attention 19% CV Since 2006, over 50 EM codes, trauma codes, ICU of the ED attending and 27% residents have participated in consults or patients that an mitigated at their TOX this extremely successful ED attending deems as discretion. 6% rotation with ongoing “sick”). The residents are to In addition to their clinical GI supervision, direction and assist in the evaluation of duties, the ED-CC residents 4% didactic support from Dr. these patients and to “dot all have several “downtime” Metabolic Pulm 8% 12% Robert Sherwin. Additionally, the I’s and cross all the T’s”. activities that include over a dozen WSU 4th year The function of the resident is completing a required Sepsis medical students have Neuro as an adjunct or “floating” reading list, viewing of 14% 10% participated in a parallel WSU resident in the emergency several online critical care School of Medicine EM-CC department. They are under lectures, obtaining online NIH- medical student elective over the clinical supervision of Stroke Scale certification, Figure 1: Break down of the last four years. The goals whichever EP is primarily completing required patients by subtype seen and objectives of the ED-CC caring for the patient. The ED- administrative duties, and by the ED-CC resident. rotation focus on optimizing the CC resident is specifically assisting with QI projects education and experience of instructed to perform only related to ICU boarders and these residents (and medical those procedures or initiate sepsis. The residents can also students) with respect to the orders under the direct perform necessary procedures diagnosis, resuscitation and supervision and knowledge of on critically ill patients and management of the wide range the EP of record. Dr. Sherwin place ultrasound guided of critically ill patients that serves solely as an education peripheral intravenous lines present to the DRH ED. A support. on all patients when they are common adage shared by Dr The ED-CC residents are needed. Dr. Sherwin provides Sherwin is that, “Critical Care required to round with the regular one-on-one didactic practice in the ED is similar but overnight/day ED teams sessions throughout the unique from that practiced in during morning sign-out on all month on topics such as Critical care the ICU.” Practice in the ED critically ill patients. During sepsis, oxygen delivery, demands simultaneous their duty hours, the ED-CC mechanical ventilation, skills are execution of diagnostic, resident is required to round cardiac arrest and other valuable assets procedural and management with the MICU team when they general critical care topics. skills. Patients present to the come down to round on ICU Furthermore, Dr. Sherwin and for graduating ED un-diagnosed, un-accessed patients being boarded in the the resident round by phone or and un-resuscitated and it is ED. It is a standing agreement by in-person bed-side rounds EM residents the charge of the EP to “un” all between the DRH ED and the on a daily basis. the “uns”. Critical Care skills MICU that the MICU call the A recent descriptive analysis of who are hired to are valuable assets for ED-CC phone prior to their graduating EM residents who a two year sample of the ED- staff EDs with arrival in the ED. This function CC rotation experience was are hired to staff EDs with dually allows the ED-CC increasing acuity and volume. presented at SAEM 2010. increasing acuity resident to function as a Compared to a resident on a The rotation primarily focuses hybrid resident and to benefit on highly valuable resident routine ED rotation, the ED-CC and volume. from ICU rounds taking place resident participated in the educational experiences to in the ED. Additionally, this these ends. care of an average of 92.8 ± function augments ED-ICU 10.3 versus 42.3 ± 6.5 The 4-week ED-CC resident communication and improves critically ill patients each schedule is Monday through patient care. For all ICU month (p <0.0001). The Friday, 7:00 am to 7:00 pm patients with ED lengths of residents see a wide spectrum and the residents are expected stay greater than four hours, a of critically ill patients (Figure to attend at least four hours of checklist is completed by the 1). The subtypes of trauma grand rounds weekly. They ED-CC resident which requires carry a dedicated Spectra-link them to re-check I/O status, (continued on page 9) phone (966-3693) and pager labs, outstanding orders,

“We will relentlessly pursue academic excellence and the advancement of our specialty.”

VOLUME 3, ISSUE 2 Page 9

ED CRITICAL CARE ROTATION CRITICAL... (CONTINUED FROM PAGE 8)

that were seen included blunt for a spot each year. Many patients. It is a highly unique (81%), penetrating (13%) and residents have confessed a opportunity that is often a topic burns (6%). In a survey of the deep appreciation of being of conversation with respect to ED nurses, residents and able to observe a wide the WSU DRH program on the physician staff (60% response spectrum of clinical practices residency trail. The ED-CC rate), 98.5% of the respondents in resuscitations by attendings rotation at DRH is one of five agreed that the presence of the and PGY-3 EM residents from rotations among accredited ED-CC resident improved the which they can assimilate U.S. EM residency programs care of critically ill ED patients desirable practices and avoid focused on critical care while 96% agreed that the undesirable ones. The education with respect to ED Robert L. Sherwin, M.D. presence of the ED-CC resident rotation further allows them a patients, and was the first to Assistant Professor improved their work efficiency. chance to read up on “good” establish a fixed, required Assistant Residency Director Common feedback from the EM cases in real-time - a practice rotation for all of its residents. residents is that the ED-CC which is highly encouraged by Its ongoing success, however, rotation is their favorite and Dr. Sherwin. This gives them is indebted to the physicians While in no way most valuable rotation of their the invaluable and all too rare and nurses of the DRH ED who residency. Several EM PGY-3 opportunity to “anchor” their contribute to the ED-CC shirking his own acquired knowledge to a flesh resident’s education and thirst have even used elective time in responsibility, year three to participate as a and blood patient at the for excellence on a daily basis. bedside. senior ED-CC resident. The Christensen medical student rotation, which The ED-CC rotation provides allows only one student per the DRH EM residents with Robert L. Sherwin, M.D. showed how his month, is equally popular and significantly more critical care often results in a waiting list for education and valuable colleagues, both EM residency candidates vying exposure to critically ill ED superiors and WELLNESS CONFERENCE WELL DONE subordinates, “enabled” his On May 12th, the Wayne State an addiction expert—gave a preventing burnout in the ED. University Department of fascinating and deeply He gave examples on making addictions... Emergency Medicine hosted a personal presentation on Dr. the workplace a more efficient, Wellness Seminar at the Christensen’s own experiences productive as well as more Richard J. Mazurek, M.D. with drug and alcohol enjoyable environment. Dr. The Wellness Seminar was Medical Education Commons, addiction. While in no way Kaplan also presented an ACEP well attended and well with speakers from around the shirking his own responsibility, Update on improving quality received and left the country presenting on such Christensen showed how his and service to our patients. attendees with much food varied topics as stress colleagues, both superiors and Dr. Wayne Wolfram from the for thought as to how to management, drug subordinates, “enabled” his Ohio University College of deal with one of the most dependence, coping with death addictions with interesting real- Osteopathic Medicine lectured stressful careers in and career maturation. The life examples. He was able to on coping with the death of a medicine. Dr. Kuhn, Sandie seminar was organized by Dr. demonstrate how easy it is to pediatric patient. Using Garling and Gloria Daniel Gloria Kuhn and was give a co-worker the benefit of personal examples, Dr. deserve special recognition sponsored by DMC, ACEP and the doubt and overlook the Wolfram was able to poignantly for their hard work in the WSU Department of warning signs of substance demonstrate how to deal with presenting this conference. Emergency Medicine. abuse despite what we are all tragedy in the Emergency Dr. Kirk Mills led off with an taught to do (e.g. compliance Department—something The Department of introductory talk on wellness hotlines). Dr. Gehrke shared ubiquitous in our job. Emergency Medicine that defined some of the information about the Health Finally, Dr. Greg Henry of the welcomes Gloria Kuhn principles and vocabulary of Professional Recovery Program University of Michigan back after her time away Wellness, which set the stage which serves Michigan’s health Department of Emergency from us. You were missed! for the speakers that followed. professionals with addiction. Phone: 800-453-3784, Medicine, was able to present Dr. Carl Christensen from the www.hprp.org. in his own unique and WSU Department of OB/GYN entertaining way, a lecture and Psychiatry, with the Dr. Jay Kaplan, a member of focusing on the maturation of assistance of Dr. Charles the ACEP Board of Directors, emergency physician’s careers Philip A. Lewalski, M.D. Gehrke of Brighton Hospital— presented his recipe for and how to evolve as one ages. Editor-in-Chief

VOLUME 3, ISSUE 2 Page 10

ULTRASOUND UPDATES

I can’t believe it’s been almost the skill clinically by the start of practice improvement piece viewable in ECare under the a year since I took over the their second year. focuses on the lack of formal ‘Clin Docs’ tab. ultrasound director position at Second and Third Years: The documentation for ED WSU. Thank you to everyone for second and third years attend ultrasounds. Most major I have used and developed welcoming me back and teaching sessions on Fridays. trauma cases have FAST exams several recording schemes supporting the program. I They are required to attend at performed as part of the for bedside ultrasound and I thought it would be a good time least four half-day courses per secondary survey, but until am pleased to say that the to update everyone on what year, but there are recently none were recorded new process is by far the we’ve been doing and what the opportunities for more. and documented adequately. most efficient and robust I Practitioners using ultrasound have seen. I hope you find it plans are for the coming These sessions cover one study academic year. for their APP requirement will fits easily into your workflow, in detail and give me the identify 10 cases in which and look forward to showing Resident Endeavors opportunity to evaluate how bedside exams were it to each of you. When I took over the each resident is doing. Although performed, but not properly It has been a wonderful year responsibility for ultrasound they get an additional 32 hours documented. After learning the of training their last two years, it new recording mechanism (see and I appreciate the education I thought a paradigm opportunity to continue to shift was in order. My previous is critically important that they below), 10 cases are then practice during shift work to recorded properly. work with all of you. Please teaching experience taught me let me know if you have any that residents who took the hone their skills and make ultra -sounding more efficient. Roughly, 15 attendings have suggestions – I want the ultrasound elective were quite gone through the program thus program to be the best it can good, but the ones who did not Even though it’s still in its far. We are starting with those be. take the elective graduated infancy, the response from the whose requirements come up without mastering the skill. As residents has been great. One first and proceeding down the ultrasound is a required skill of my goals for the coming year list. Although participation in and residents need a dedicated is to develop a recording this program is voluntary, we month to master the skill, can method for educational studies, strive to make it the most Leonard Bunting, M.D. we really call the additional so I can review the resident’s straight forward solution to the training 'elective'? work. I also plan on creating an APP burden. online resource for posting and Therefore, with the support of New Recording Scheme the academic committee, discussing interesting cases. additional ultrasound Attending Endeavors Potentially, the most exciting development over the previous experience was worked into the Our immediate focus is on resident schedule. Although a year for us was the helping attendings fulfill their implementation of a new dedicated month was a viable Assessment of Practice option, I’ve also learned that recording mechanism. It is Performance (APP) requirement important both professionally residents tend to forget what for ABEM recertification. This they are not regularly exposed and legally to have a system in addition to board recertification place to document our bedside to. With this and their already requires practitioners to full schedules in mind, the ultrasounds. After countless periodically identify an area hours of work from numerous added ultrasound training was needing improvement in their integrated throughout their departments, we finally have a clinical practice. They then viable solution. three years to ensure regular sample 10 patients, institute reviews and updates. The some change in their practice The process begins with structure is as follows: and then sample 10 additional entering an order in ECare, First Year: During their patients. All APP programs must which places the patient orientation month, interns be signed off by your Chair and information on a work list attend a crash course in 10% will be audited by ABEM to server. The ultrasound machine ultrasound. This two day, 16 ensure compliance. Visit can then wirelessly download hour event exposes them to all ABEM’s website the order information, saving the core ED ultrasound studies (www.abem.org) for further the tedious step of typing in and includes plenty of hands details and to see your patient information. After completing the exam, the on experience. Apart from this, schedule. Leonard Bunting, M.D., images are wirelessly uploaded they also have time dedicated FACEP, RDMS The requirement is involved, to the same PACS system to scan in the ED and four Assistant Professor and not something any of us radiology uses. The procedure sessions with my co-educator, look forward to. However, Dr. Director of Ultrasound Nancy Heberer. These 32+ note is generated from a pre- White had the idea for a completed note using EMR. hours of ultrasound training are painless solution using meant to prepare them to use With a few clicks of the mouse, ultrasound. In short, the the bedside ultrasound report is

VOLUME 3, ISSUE 2 Page 11

VENTILATOR

Isn’t That Interesting “Mr. Jones, how do you intestines. I push my fingers shave?” I asked. “Well, it is into his right upper quadrant “Mr. Jones, where do you get interesting that you should where the liver and gall food to eat?” I ask? “Well, it ask,” he says. “Throughout bladder sit. This does not is interesting that you should the day I look for change in elicit pain. I pull down the ask,” he says. “There is a telephone booths, once in a sheet to expose the rest of Donut Shop near where I while I’ll find a couple his body. I look at his skin, sleep and at night they come quarters. I’ll take this money which is strikingly a shade of out of the back of the store and buy a disposable razor.” yellow; somewhere between and bring me the extra donuts “And then where do you go to mustard and a banana peel. and usually a hot coffee. shave?” I asked. “I shave in “Mr. Jones, when did your Sometimes, though, I have to the bathroom at a casino skin turn so yellow?,” I ask. Adam J. Rosh, M.D. go through the garbage and around the corner from where “It’s been like this for about 2 Assistant Professor look for food. You know, I’ll I sleep. There is a very nice months.” “We call this find half eaten sandwiches in bathroom there and the jaundice,” I tell him. It is there.” workers don’t seem to mind.” caused from high levels of Mr. Jones is a 53 year-old Mr. Jones came to the hospital bilirubin in the blood. “Mr. man. He is an accountant by today because he was weak, Jones, I think we need to get training. Now he lives on the just hasn’t felt right for the you a CT scan tonight to look street and earns his money by last month. He tells me he is into your abdomen to see collecting recyclable bottles. more tired than usual and has what is causing you to feel so He was once married to a no appetite. “Food doesn’t weak and changing the color woman, Alice, for more than appeal to me anymore,” he of your skin.” I tell him. 20 years but just a few years says. I start my examination I am worried for what we will ago she got sick with of Mr. Jones simply by find. He lost his job metastatic breast cancer. He observing him. A sheet is Mr. Jones returns from the CT started to take longer and pulled up to his neck, yet I and soon the longer absences from work to scanner and is back in the notice that his eyes are treatment room. I access his care for his dying wife. Her sunken, his temporal muscles money ran out. medical bills started to pile scan on the computer and are wasting, I can make out start to scroll through it. Just Alice died. He up. They liquidated all of their every curve of the bones that assets to help pay for the life- as I feared, there is a mass in make up his face, which is his pancreas that is causing lost his prolonging medications. He tanned from the recent sunny lost his job and soon the an obstruction leading to days and gives him the look of elevated bilirubin in his blood apartment. money ran out. Alice died. He a healthy man. His silver hair lost his apartment. – the cause of his yellow is neatly combed to the left. skin. “Mr. Jones, where do you get His teeth are unusually white your haircut?” I asked. “Well, for a homeless man. I listen “Mr. Jones, I have to tell you it is interesting that you to his beating heart, no signs something, we’ve found the should ask,” he says. “There of an abnormality. I place my cause of your weakness, poor is a woman in the stethoscope on his back and appetite and yellow skin.” neighborhood that walks by ask him to take a deep breath; “Yes,” he says. “You have me once in a while and I hear the whoosh of air filling pancreatic cancer,” I say. instead of handing me money, his lungs. I listen to his bowel “Well, isn’t that interesting,” she takes me to the local sounds by placing my he says quietly. barber shop and pays for a stethoscope softly on his haircut; she is a very nice sunken abdomen. I hear the woman.” usual gurgling of the Adam J. Rosh, M.D.

“We will conduct ourselves in a professional manner while holding ourselves to the utmost ethical standards in our practice.”

RESUSCITATOR Page 12

MEDICAL STUDIES IN POLAND

Wroclaw Medical University studies in Poland begin after obstetrics and gynecology, completion of high school one year of neurology, two An increased number of and last for six years. Their years of surgery, and one physician hopefuls are system allows for graduation year of family medicine. expanding their horizons and two years earlier than These courses were held one completing their medical the American norm. Poland day a week for the entire degrees abroad. I graduated has 12 medical schools, all school year. For example, from the Medical Academy of of which offer medical Monday would be surgery, Wroclaw (Poland), now studies in English for either Tuesday, internal medicine, known as Wroclaw Medical four (with B.S. or equivalent and Wednesday obstetrics University (WMU). Recently, degree) or six years duration. and gynecology. Besides the my daughter Diana These programs were core curriculum, students completed a six year program established to provide must elect to participate in a The Medical Academy of Wroclaw there as well. Poland is one medical studies for number of subspecialty was opened in 1702. of many countries that offer international students mostly courses such as clinical an opportunity for American from the European Union microbiology, dermatology students to study medicine. countries (i.e. Norway, with elements of plastic The Medical Academy of Sweden, Germany and surgery and wilderness Wroclaw was opened in others), as well as, students medicine, etc. In addition, 1702. Wroclaw was a from North America. At the students are required to German city known as end, students graduate with complete one month Breslau at that time. World a degree equivalent to a apprenticeships in their War II redefined the borders medical degree in N.A. and home country during summer of many European countries, the E.U. break. The final year of especially Germany and The first two years of school school in Poland was divided Poland. Breslau and the focus strictly on basic into short blocks of sub- surrounding lands were medical sciences including specialties, sometimes split annexed to Poland as Anatomy, Histology, up between semesters. For restitution for most of Physiology, Pathology and example, ophthalmology was eastern Poland taken away Biochemistry. Years three two weeks in the first by the Soviet Union. The through six encompass semester and two weeks in Wroclaw Medical University faculties of Lwow and Wilno hospital and academic the second semester. (WMU) Medical Academies moved to work. Students spend 5-6 Orthopedics and Wroclaw from eastern days a week in local hospitals traumatology was a two week Poland. The Medical from 8am-noon. There they course held in the first Academy of Wroclaw began are exposed to short semester. Otolaryngology was to function as one of the first seminars and practical a two week course held in the post-war medical schools in work. Afternoons are second semester. successful and fulfilling Poland in 1945. Many occupied by formal lectures. There are of course careers. Diana is beginning a famous physicians and additional benefits to The course load differs from preliminary residency year in scientists were associated studying in Europe. Once with the Wroclaw Academy. North American schools. general surgery July 1st. Poland follows the European there, one can travel and Some of the most well-known I recommend studying in system, which focuses more enjoy various countries, include: Alzheimer, Wernicke Europe to all who are on medical education as a exploring their geography, and Mikulicz. interested in not only whole, rather than history, languages, and local expanding their knowledge, In 2003, WMU established functioning as a “pre-intern” customs. Many who study in but also in gaining an an English Division in the in U.S. hospitals. The Europe develop life long invaluable cultural experience Faculty of Medicine. In American schools have their friendships with their and life long memories. 2008, a new university students rotate through colleagues. Studying abroad

hospital was opened in various specialties in one to enhances one’s educational Wroclaw. It is the largest two month blocks. For experiences by exposure to center for the specialized instance, two months of other cultures. treatment of patients in internal medicine, two Physicians who graduated Jacek (Jack) Brudzewski, M.D. South Western Poland. This months of surgery, and one with myself in Poland, and Diana Brudzewski, M.D. facility is equipped with state- month of family medicine. In then settled in the U.S. have of-the-art diagnostic and Poland, we had three years of not had any problems in http://www.am.wroc.pl/en/ therapeutic equipment, and internal medicine, four years completing various residency research facilities. Medical of pediatrics, two years of programs, and embarking on

VOLUME 3, ISSUE 2 Page 13

WSU AFFILIATE NEWS

July starts a new academic in the ED such as chest pain, with their patients and the year and the beginning of abdominal pain, and patients’ families. Students rotations for 4th year Wayne shortness of breath. The learn the communication State medical students students gain experience skills that make EM looking to match into EM for with laceration repairs, physicians professional, residency. At Henry Ford, we incision and drainage, compassionate, efficient and are adding ultrasound to the peripheral IVs and Foley effective communicators all curriculum for the 2011-12 catheters. Formal student in the same breath. academic year. Students will level didactic sessions occur Professionalism and begin the month in the each Thursday of the month interpersonal communication simulation center learning with some of this time spent skills are a significant aspect EM applications of in the simulation center for in the determination of the ultrasound, including FAST more hands on experience. students’ grade. exams, ultrasound-guided The highlights of the rotation The first three to four months central and peripheral lines. for many students at Henry of the academic year are very This session will be led by the Ford are the Category 1 important for both students Jacob Manteuffel, M.D. ultrasound fellow. Students shifts, particularly in the as well as for our EM Clinical Assistant Professor will also spend one shift afternoons. Patients on residency as prospective Medical Student Coordinator working one-on-one with the these shifts typically come in residents rotate through the ultrasound fellow scanning high volume with high acuity. department before interview patients in the ED. On these shifts, students season starts in November. In general, the rotation is gain experience in the These “audition” rotations designed to introduce management of critically ill allow the students, residents students to the field of patients. The concepts of and EM staff to see how they Emergency Medicine. early-goal directed therapy fit into our residency are introduced in the program. Students gain a Students assume primary Students care for ED patients under resuscitation of patients in great amount of clinical the supervision of residents septic shock. Students have experience on this rotation, assume primary and attending staff. The the opportunity to gain and regardless of which students perform the initial experience in more advanced program or specialty a care for ED history and physical exam, procedures as well including, student chooses, their develop and discuss a endotracheal intubation, feedback indicates their EM patients under diagnostic and therapeutic central line and arterial line month makes them feel well plan and perform any placement, and lumbar prepared for residency. the supervision puncture. Overall, the EM student procedures needed to of residents and implement these plans. By In addition to the analytical rotation allows students to understand what it means to the end of the rotation, the and technical aspects of attending staff. goal is to have the students emergency medicine, be an EM physician and gives have a good approach to, students learn to develop the EM physicians the differential diagnosis for, and interpersonal communication opportunity to recruit and diagnostic/treatment plan for skills with their interactions train the future leaders of our common presentations seen with the ED team as well as specialty. Jacob Manteuffel, M.D. 2011 RESIDENT AWARDS

Scholarly Achievement Medical Student Resident Norman Rosenberg, D.O. Awards Teaching Awards Award—Amy McCroskey 1st Year—Aaron Brody and Richard Gordon and Harsheel ARC Dayanandan Resident Cameron Kyle-Sidell Desai Award—Samuel Lee 2nd Year—Jack (John) Hicks DRH Resident of the Year— and Ayse Avcioglu Samuel Lee 3rd Year—Cheryl Larson and SGH Resident of the Year— Richard Gordon Harsheel Desai

“Our vision is to become this country’s premier Department for emergency medical care, education, and scholarship…”

VOLUME 3, ISSUE 2 Page 14

PALLIATIVE CARE MEETING A SOOTHING SUCCESS

The Fourth Annual Regional conference was entitled settings, Mary described how Palliative Care Collaborative “What is a ‘good death’ in a caring for families whose brought together Sudden Death Event?” loved ones have just died approximately 300 Mary Mitsch, a nurse should be viewed as a practitioners, educators, and educator, presented this ritualized activity, so that the researchers from across the topic from the perspectives death will bring meaning to state and region to discuss of a bereaved parent and a the grieving process and important basic and WSU researcher in subsequent memory work in innovations in palliative care anthropology. Her quest was the course of bereavement. to improve outcomes for to focus on how a death in What happens in the ED lays patients. The conference the ED can be good, even the foundation for everything was sponsored by when sudden and that follows. This lecture is CAPEWAYNE, The Center to unexpected. Mary had case-study based, explaining Advance Palliative-Care posed this question as she how healthcare providers can Excellence, led by Rob pursued a doctoral degree in give quality care to parents Zalenski, and by 10 other medical anthropology, initially and families of sudden, sponsoring organizations in as a way of enriching her traumatic death. Mary Eleanor Mitsch, R.N., PhDc. the field of hospice and nursing scholarship, teaching Her doctoral research work Associate Professor palliative care. The and practice. has led her to study Faculty Mentor, College of conference was held on Though already planning to professional staff and the Nursing and Health Friday, October 29, 2010 at do her doctoral dissertation affected familes of patients Madonna University the Dearborn Inn. on this subject, life events with sudden and traumatic The conference covered the focused her direction in a death in the ED. Working in subjects of pain and way she never imagined. a very busy urban ED in symptom management, During her final doctoral southeast Michigan, the delirium, organ donation, and coursework, her 24 year old ideas for a “good death” in futility. The outcomes of the daughter was killed in a car hospice are examined and Family Witnessed accident in southeast contrasted with sudden Resuscitation, conducted at Michigan. She died in the ED. death events in the ED. Mary DRH and SGH, were This traumatic experience is exploring numerous ideas presented by Rob Zalenski. greatly affected her future that could be incorporated In a nutshell, the results of professional vocation. into protocols in the ED to the quasi experimental study Blending anthropological and improve care for bereaved were that there were no short nursing perspectives with family members. As her term reductions in anxiety or searing personal experience, dissertation research comes depression in the closest Mary developed a to fruition, we look forward to bereaved relative when she/ presentation on sudden learning much from Mary about providing quality care he was brought into the death--its personal and Robert J. Zalenski, M.D. for sudden death in the ED. resuscitation process cultural meaning--through the Professor compared to control subjects. lens of a bereaved parent. Director, Division of Robert J. Zalenski, M.D. The closing plenary of the To her colleagues in Palliative Care academic and healthcare Mary E. Mitsch, R.N., PhDc

ATTENDINGS GET BURNED AT ROAST

On Saturday June 11th, my onto a seamless, the annual roast returned 2011 has set the bar high for wife Mimi and I had the professional quality DVD that with a bang. No one was future graduates and we pleasure of once again allowed everyone present to sacred in this bawdy attendings can’t wait to learn hosting the annual attending sit down and watch, and re- production and from start to more about ourselves next roast, performed by our watch the show in comfort.) finish the impressions were year. In the meantime, I will graduating residents. I am As with the “Jack Ass” movies hilarious and spot-on. Some pour myself a Gator-Aid and pleased to report that it was that part of the roast was of the skits were a little cheap beer and wait in just as crude, rude, modeled after, it became harsher than others, but all Cougar Town for the next distasteful—and funny—as funnier with each “pop” the of them were presented with installment. years past, with the addition viewers drank. respect and love—well most of top-notch video After a one year hiatus (either of them anyway! Philip A. Lewalski, M.D. production. (Ryan Phillips out of respect to me or an The DRH Emergency Editor-in-Chief mastered the entire roast unmotivated residency class) Medicine Resident Class of

Website: www.med.wayne.edu/em

WSUSOM EDITORIAL BOARD Department of Emergency Medicine University Health Center Editor-in-Chief: Philip A. Lewalski, M.D. 4201 St. Antoine, 6G Assistant Professor

Managing Editor:

Sandra L. Garling Phone: 313 745-3030 Emergency Medicine Coordinator Fax: 313 966-7569 Photographer: E-mail: [email protected] Kerin A. Jones, M.D. Assistant Professor

“ WE ARE COMMITTED TO BEING THE LEADERS..”

KUDOS

Congratulations to the following faculty members: Trifun Dimitrijevski, M.D., has joined the WSUSOM Academic and Student Programs as lead faculty member for Clinical Simulation Programs. Scott Freeman, M.D. and Erik Olsen, M.D., are the new Assistant Program Directors for the DRH Residency Program. Robert Sherwin, M.D., was appointed EM Clinical Research Director at Sinai-Grace Hospital. Rob has directed the Emergency Medicine Research Associate Program and has been Co-director of Resident Research at Detroit Receiving Hospital. Phillip Levy, M.D., MPH, on receiving a $1.9 million National Institutes of Health Grant to study the role of vitamin D in halting and reducing subclinical cardiac damage in African-Americans suffering from high blood pressure. Brian O’Neil, M.D., co-wrote the new CPR guidelines, which incorporate a radical change from CPR rules previously taught. Mark Brautigan, M.D., received the 2011 Michigan College of Emergency Physicians, Emergency Physician of the Year Award. Prashant Mahajan, M.D., was selected to co-guest edit the Critical Pediatric Medicine Journal on Improving Quality Pediatric Emergency Medicine. Anthony Southall, M.D., received the Lifetime Achievement Award from the Michigan Chapter of the American College of Physicians. On June 30, 2011 Lawrence Schwartz, M.D., retired from WSU. He has been with the department for 19 years and distinguished himself as a medical education scholar. Chitlada Paopairochanakorn Limjindaporn, M.D., has been appointed Chair of the Department of Emergency Medicine at Thammasat University, Klongluang, Pathumthani Thailand.