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Is Moonlighting Right for You? RResidentOfficial ePublication ofsident the Emergency Medicine Residents’ Association February/March 2020 VOL 47 / ISSUE 1 Is Moonlighting Right for You? US-Guided Supracondylar Blocks The Heart of EM: A New Opportunity Pulmonary Hypertension in the ED RICHARD LOGUE, MD, FACEP EMERGENCY MEDICINE Featured Southern Opportunities: ■ Ocala Regional Hospital (Ocala, FL) ■ Ft. Walton Beach Medical Center (Ft. Walton Beach, FL) ■ Brandon Regional Hospital New! Freestanding EDs (Tampa Bay and Lakeland FL) ■ JFK Medical Center (Palm Beach, FL) ■ Parkland Medical Center (Derry, NH) ■ Portsmouth Regional Hospital (Portsmouth, NH) For more information, contact: 877.226.6059 [email protected] I still vividlyThe remember, as a second-year medical student, my attending gushing over EMRA and its resources being a benefit not only to medical students interested in emergency medicine,Heart but also to medical students interested in any specialty.of That EMwas my hook into EM. It started with EMRA. Priyanka Lauber, DO advantage of residents and attendings. up and have made intentional actions, I Editor-in-Chief, EM Resident We need to have the hard conversations: see a positive change that not only benefits Lehigh Valley Health Network let’s talk about an accurate count of duty me, but also effects positive downstream @PriyankaLauber hours, fair and appropriate treatment, improvements unbeknownst to me. appy New Year to my EM and accountability when poor behavior is I have always said personal stories Resident family! The holiday demonstrated by staff/consultants/etc. and the written word are both incredibly Hseason is over. Christmas/ The latest survey by the American powerful. Hanukkah/Kwanzaa/Diwali has passed Medical Association (AMA) demonstrated Thus, I am starting a NEW and most of us have finally recovered that 2 in 5 physicians screen positive series in EM Resident where from our new year’s eve celebrations. for depression. Medical students were residents, medical students, Although many are a little disappointed also noted to be 3 times more likely to and attendings can share their the festivities have ended, there are die of suicide than their counterparts in stories: “Heart of EM.” I want to people out there who are not. Studies the general population. Why is this hear about your struggles, your have demonstrated that the holiday happening? Are we good advocates failures, and your triumphs. season can exacerbate the feelings of for ourselves, attendings, fellow co- Even if you tried and failed, I loneliness some individuals face on a residents, and medical students? welcome it. Please share your daily basis. Medical students, residents, How can we do better? experiences, even if you don’t want and some attendings are no strangers to Over the past several years, like many to share your name (requests feelings of desolation. We are often in of us, I’ve endured instances that positively for anonymity will be honored). a juxtaposition where, although we are and negatively affected my well-being. YOUR stories are humanizing and surrounded by people (hospital staff, Times I felt supported and others not. will help connect all of us globally patients, mid-levels, doctors) all day, we Times I have been quiet, as not to upset through shared experiences and do not encounter meaningful or quality the status quo, and others I have loudly emotional intermediaries. conversations that involve us. spoken up for myself and others. Serendipitously, we already had a When I ran for the EMRA Board, my The times I have been the most submission for this edition that will help speech involved talking about this subject proud, of course, are the times that I have kick-start this new series (“Grab a Shovel” in the context of “mental health.” Better demanded a change and actually witnessed — and your tissues, fair warning). Take mental health and wellness, it seems, and experienced the transformation. a moment to read it. Take a few more to involves increasing grit, utilizing deep Through these experiences, I have realized, add to the conversation. breathing, and incorporating yoga from residents have an innate power in our We are always looking for relevant what most of us have been told repeatedly. hospital systems. We have the combined content, so if you a compelling case you I believe we are missing some foundational support of our co-residents, faculty (core would like to share or a personal story, conversations involving the culture of and not), program directors, designated email me at [email protected]. medical training and organizational institutional officials (DIOs), ACGME, and I am looking forward to making our medicine — a culture that is ripe to take EMRA. I have realized that when I speak specialty feel more connected. ¬ February/March 2020 | EM Resident 1 B:8.75" T:8.5" S:8" B:11.25" S:10.5" T:11" FOR SOME OF OUR MOST ELITE SOLDIERS, THIS IS THE FRONT LINES. As an officer working in Emergency Medicine for the U.S. Army health care team, you’ll be on the front lines of medical innovation, practicing in world-renowned hospitals, clinics and health care facilities with access to the most sophisticated medical equipment in the field. With over 90 medical career specialties to choose from, you’ll have the opportunity to participate in humanitarian efforts, learn innovative techniques and make a real difference in the lives of Soldiers and their families. To see the benefi ts of being at the forefront of Army medicine call 800-431-6717 or visit https://www.goarmy.com/amedd.html ©2020. Paid for by the United States Army. All rights reserved. ©2020. Paid for by the United States Army. All rights reserved. For artwork inquiries, contact [email protected] | For print inquiries, contact [email protected] US_Army Mechanical Size Final Output Size Team US Army Corp C. Nieto, M. Holzman, J. Smith Scale 1" = 1" Bleed 8.75" w x 11.25" h Ad # ARMCOR_P5167_Front_Lines_F Trim 8.5" w x 11" h Project # P00005167 WO# 28 Final Output 100% Safety 8" w x 10.5" h Destination(s) Studio PO# 27823 Bleed 8.75" w x 11.25" h EM Resident - Feb/March Issue Print_Magazine, "For some of our most elite soldiers, this is the front lines", Full Page, Trim 8.5" w x 11" h 4/C, Bleed Safety 8" w x 10.5" h File Name ARMCOR_P5167_Front_Lines_F.indd Document Path DDB:US_Army:Active_Work:ARMCOR_US_Army:ARMCOR_P5167_McCann_Ad_resize:Mechanicals:Medical_Corp:ARMCOR_P5167_Front_Lines_F.indd Revision # 0 Links Fonts Inks Creative Date Created 1-9-2020 1:58 PM CNY_MCE-ARMY-HI-2355_V2.tif (CMYK; 377 ppi; 106.05%), ARMYAlrv4cwoTag_Patch_.ai (16.48%) Slug Font Myriad Pro Family Cyan Account Group Saved 1-10-2020 3:04 PM Minion Pro (Regular; OpenType), Magenta Print Producer [email protected] Printed 1-10-2020 3:06 PM Interstate (Regular, Light; OpenType) Yellow Lead Digital Artist matt holzman Print Scale None Black Digital Artist jenny smith InDesign 2020 Retoucher _ Notes MATS Due: 1/10/20 Proofreader B:8.75" T:8.5" S:8" TABLE OF CONTENTS 4 What Can We Do When The Echogenic Kidney EDITORIAL STAFF a Residency Closes? 26 RENAL/NEPHROLOGY EDITOR-IN-CHIEF PRESIDENT’S MESSAGE End the Glow! Priyanka Lauber, DO Emergency Medicine 28 CARDIOLOGY/RADIOLOGY Lehigh Valley Health Network 5 Residents Oppose Pediatric EDITORIAL TEAM the Sale of Graduate 29 Brian Freeman, DO Medical Education Slots Nasopharyngeal Tumor Lakeland Health PEDIATRICS LEADERSHIP REPORT Meghan Gorski, DO Albert Einstein Medical Center How to Fund Your 30 Tactical Medicine: 7 An Evolving EM Whitney Johnson, MD Program’s EMRA UCSF-Fresno Representative Subspecialty Jeremy Lacocque, DO LEADERSHIP REPORT PREHOSPITAL & DISASTER MEDICINE UCSF EMS Fellow 10 Ways You Can Mahesh Polavarapu, MD 9 Help End Trafficking 33 Lessons Learned ChristianaCare LEADERSHIP REPORT the Hard Way on Jason Silberman, MD International Expeditions University of Tennessee How Do You Know 10 INTERNATIONAL Daniel Bral, DO If You’re Ready University of Rochester To Moonlight? 35 Clinical Pathways CAREER TRANSITIONS in the ED MSC Editor B:11.25" S:10.5" T:11" ADMIN/OPS Samuel Southgate Gastric Perforation University of Connecticut 12 after Liquid Nitrogen Demystifying the EM 36 ECG Faculty Editor Ingestion to PEM Journey Jeremy Berberian, MD TOXICOLOGY CAREER TRANSITIONS ChristianaCare Ultrasound Guided 39 Grab a Shovel PEM Faculty Editor 14 Supracondylar Nerve HEART OF EM Yagnaram Ravichandran, MBBS, MD, FAAP Dayton Children’s Hospital Pediatric ED Blocks for Reduction Why EM Should Lead Clinical Asst. Professor of Pediatrics of Distal Radius Fractures 40 the Charge for Wright State University NEURO/ ULTRASOUND Foreign Policy Debate Toxicology Faculty Editor FOR SOME OF OUR MOST ELITE SOLDIERS, Defusing Ectopic OP-ED David J. Vearrier, MD, MPH, FACMT, 17 Pregnancy FAACT, FAAEM THIS IS THE FRONT LINES. EM Leaders of Tomorrow OB/GYN 42 As an officer working in Emergency Medicine for the U.S. Army health care team, you’ll LEADERSHIP REPORT be on the front lines of medical innovation, practicing in world-renowned hospitals, clinics CRASH-3: TXA for TBI EM Resident (ISSN 2377-438X) is the and health care facilities with access to the most sophisticated medical equipment in the 20 News & Notes field. With over 90 medical career specialties to choose from, you’ll have the opportunity CRITICAL CARE 45 bi-monthly magazine of the Emergency to participate in humanitarian efforts, learn innovative techniques and make a real ABEM Announces Advanced Medicine Residents’ Association (EMRA). difference in the lives of Soldiers and their families. Primary Cardiac Synovial Ultrasound Fellowship The opinions herein are those of the authors 22 Program Requirements, To see the benefi ts of being at the forefront of Army medicine call 800-431-6717 Sarcoma Complicated and not of EMRA or any institutions, or visit https://www.goarmy.com/amedd.html Upcoming Events and more organizations, or federal agencies.
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