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Em. Med. Annual Report 2011 - Hennepin County Medical Center

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Department of<br />

®<br />

<strong>Med</strong>icine<br />

Every Life Matters 24/7<br />

2009–2010


Dear readers,<br />

Contents<br />

This activity report is our attempt to update<br />

you on the remarkable productivity of our<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine. We<br />

believe this document shows the vitality and<br />

passion of our faculty, residents, and ED<br />

staff, as well as their fondness towards and<br />

support of HCMC .<br />

As the editor of this report, I ask that you<br />

please forgive me for any inaccuracies that<br />

may be present in these pages. We have<br />

tried our best to get everything right, but it is<br />

likely that we have misrepresented, forgotten<br />

or ignored at least something. Any mistakes<br />

are likely to be ones of omission, and once I<br />

learn of them, I will include them the next<br />

time around!<br />

Many thanks to the E MED faculty for the<br />

material they contributed to this report and<br />

to the departmental office staff (especially<br />

Nancy Newkumet) for the many many hours<br />

they spent helping get this together and<br />

keeping the staff doctors organized.<br />

We hope you enjoy these pages and we<br />

vow to bring you more in the future!<br />

Keep in touch.<br />

Michelle Biros, MD MS<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine<br />

HCMC<br />

2 Department Overview<br />

Chiefʼs Letter, J. Clinton<br />

Mission Statement<br />

History of Department of<br />

<strong>Em</strong>ergency <strong>Med</strong>icine, E. Ruiz<br />

14 Our Clinical Practice<br />

Overview from the Assistant Chiefs<br />

ED Statistics<br />

Pre-Hospital/Disaster <strong>Med</strong>icine<br />

Hyperbaric <strong>Med</strong>icine<br />

<strong>Em</strong>ergency Ultrasound<br />

International <strong>Em</strong>ergency <strong>Med</strong>icine Outreach<br />

24 The People of the ED<br />

26 The Clinical / Academic Faculty<br />

Faculty Profiles<br />

Our Residents<br />

Our Physician Assistants<br />

32 <strong>Med</strong>ical Education<br />

Teaching the Next Generation<br />

Clinical Curriculum<br />

Simulation and Innovation<br />

Web Based Education<br />

Online Learning<br />

Our Fellows<br />

Students in <strong>Em</strong>ergency <strong>Med</strong>icine<br />

38 Advancing the Science of<br />

<strong>Em</strong>ergency <strong>Med</strong>icine<br />

The Research Associates Program<br />

Scholarly Achievemens<br />

External Grant Awards<br />

Publications | Peer Reviewed<br />

Publications | Abstracts |<br />

Scientific Presentations<br />

64 After Hours<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 1


Overview from<br />

the Chief of <strong>Em</strong>ergency <strong>Med</strong>icine<br />

It has been some time since we have taken the opportunity to tell you about what has been happening in<br />

our active and dynamic Department of <strong>Em</strong>ergency <strong>Med</strong>icine. Our intermittently produced annual reports<br />

in past years have too often been omitted in favor of urgencies of the moment. We hope this activity<br />

report becomes an annual historical milestone of the continuing growth of our academic department.<br />

We continue to strive to deliver the highest quality emergency care to our patients while testing our<br />

existing and emerging practices with disciplined clinical research. Our academic research and<br />

educational activities provide the motivation for continued excellence. Clinical and academic innovations<br />

are constantly occurring in our fine institution. Visit our online conferences and instructional videos on our<br />

nationally acclaimed website at www.hqmeded.com for a flavor of these activities.<br />

You will read in this report on the progress of our <strong>Em</strong>ergency <strong>Med</strong>icine Residency and subspecialty<br />

fellowships. Clinical simulation has become a key component of our clinical education. Our residency has<br />

grown to a total of 13 residents per year (11 EM plus 2 EM/IM). We will soon be graduating the first of our<br />

combined EM/IM residents from their five year program for a combined total of 13 graduates this year.<br />

We have trained a number of fellows in EMS, Hyperbaric <strong>Med</strong>icine, Ultrasound, Research Methodology,<br />

Toxicology and, most recently, in International EM. A required clerkship in <strong>Em</strong>ergency <strong>Med</strong>icine at the<br />

University of Minnesota <strong>Med</strong>ical School has existed for six years, providing a steady stream of medical<br />

students to our clinical setting, in addition to students from around the US traveling to HCMC for their<br />

emergency medicine clinical experience.<br />

We continue to enjoy the experience of <strong>Em</strong>ergency <strong>Med</strong>icine in the uniquely suited environment of<br />

<strong>Hennepin</strong> <strong>County</strong> <strong>Med</strong>ical <strong>Center</strong>. The rich diversity of our patient population and their pathologies<br />

makes each clinical shift a unique and interesting experience. We daily make clinical use of innovative<br />

technologies and management strategies, many of which have been developed and tested by our very<br />

talented faculty.<br />

I hope you enjoy reviewing the 2009-2010 Activity <strong>Report</strong> for the Department of <strong>Em</strong>ergency <strong>Med</strong>icine.<br />

Joseph E. Clinton, M.D.<br />

Chief, <strong>Em</strong>ergency <strong>Med</strong>icine<br />

2 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


Department of <strong>Em</strong>ergency <strong>Med</strong>icine<br />

Mission Statement<br />

We, the faculty of the Department of<br />

<strong>Em</strong>ergency <strong>Med</strong>icine, strive to excel as<br />

leaders in the specialty of <strong>Em</strong>ergency<br />

<strong>Med</strong>icine.We are devoted to providing<br />

excellent care at any time, to any patient<br />

in need of emergency medical services both<br />

in the <strong>Em</strong>ergency Department and in the<br />

greater community.We are determined to<br />

optimize the medical care and well-being<br />

of all patients by working within the<br />

<strong>Med</strong>ical <strong>Center</strong> in a spirit of cooperation.<br />

We are committed to educational excellence<br />

in training physicians, students of medicine,<br />

allied health professionals, and the lay<br />

public in the prevention and management<br />

of acute illness or injury.<br />

We will advance the quality of emergency<br />

care everywhere by contributing new<br />

knowledge and skills obtained through<br />

active biomedical research and innovation<br />

in the practice of <strong>Em</strong>ergency <strong>Med</strong>icine.<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 3


A Thumbnail History of<br />

<strong>Em</strong>ergency <strong>Med</strong>icine in the U.S. and<br />

<strong>Hennepin</strong> <strong>County</strong> <strong>Med</strong>ical <strong>Center</strong><br />

The Start<br />

The National Scene Post WWII by Ernest Ruiz, MD, FACEP<br />

Access to emergency room (ER) care across the<br />

U.S. in the fifties and sixties did not keep up with<br />

the needs of the growing post-war population. The<br />

numbers of practicing physicians had not kept<br />

pace with the growth. Many people began to use<br />

the ER as their primary source of medical care.<br />

Under-staffed, under-funded, and under-equipped,<br />

ERs were serious problems for most hospitals.<br />

Practicing physicians who staffed community<br />

hospitals were pressured by demands for their<br />

time. They were on-call to the ER during their<br />

non-clinic hours. Hospitals and their affected<br />

physician staff became open to ideas that might<br />

ease the situation.<br />

In 1961, an over-burdened practicing physician,<br />

James D. Mills in Alexandria, Va., decided to limit<br />

his practice to ER coverage. He pulled together a<br />

group of like-minded physicians to cover their<br />

community hospital ER around-the-clock. They<br />

would make a modest living at it. They became<br />

"specialists" in emergency care. James Mills<br />

(1920-1989), a respected general practitioner and<br />

proper gentleman, is credited as being the "father<br />

of emergency medicine." The "Alexandria Plan's"<br />

success encouraged physicians elsewhere to get<br />

organized as well. General practitioners John G.<br />

Wiegenstein in Lansing, Mich., Ralston R. Hannas<br />

in Sentinal, Oak., and Harris B. Graves in Omaha,<br />

Neb. joined or formed similar groups and<br />

vigorously carried the message onto the national<br />

stage. They envisioned that emergency care could<br />

be improved across the U.S. if physicians who<br />

4 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010<br />

chose emergency medicine as their livelihood had<br />

their own national organization. Wiegenstein<br />

(1930-2004) and seven others boldly formed a<br />

society called the American College of <strong>Em</strong>ergency<br />

Physicians (ACEP) in 1968. ACEP met in<br />

Colorado the next year and 128 physicians<br />

attended. Hannas (1918-2005) and Harris<br />

(1928-1995) had joined in. ACEP is now widely<br />

accepted as the most effective sounding board for<br />

the practice of emergency medicine while strongly<br />

encouraging scientific progress. It has over 26,000<br />

members. The vision of these few men and<br />

women lives on. They looked forward to the<br />

establishment of residency training for emergency<br />

physicians and the attainment of primary board<br />

status for emergency medicine.<br />

Academia Stumbles Forward<br />

Meanwhile, academic institutions responsible for<br />

the big-city teaching hospitals assigned<br />

responsibility for their ERs to the departments of<br />

Surgery and <strong>Med</strong>icine. Although their residency<br />

training programs provided some medical<br />

manpower, the need for clinical experience in their<br />

specialties did not justify staffing the ER solely with<br />

their residents. The ER was as serious a problem<br />

in the "city hospitals" as it was in community<br />

hospitals. Unfortunately, the inter-departmental<br />

competition for scarce resources common to<br />

teaching hospitals at that time made the common<br />

sense approach used by James Mills impossible.<br />

The obvious solution was to create a residency<br />

program for emergency medicine. This was not an<br />

option because it would have encroached on the


Ernie Ruiz, MD stands before his<br />

portrait, commissioned on the opening<br />

of the Ernie Ruiz <strong>Em</strong>ergency <strong>Med</strong>icine<br />

Residentʼs Library, 2006<br />

privileges and resources provided to the existing<br />

specialties. A crisis was needed to make a change.<br />

The race riots in Cincinnati, Ohio in the late sixties<br />

provided a crisis. The University of Cincinnati's<br />

Cincinnati General Hospital ER was crowded with<br />

patients who perceived their care as poor and<br />

were dissatisfied with long waits. A young internal<br />

medicine staff physician, Herbert Flessa, was<br />

directed by hospital leaders to come up with a<br />

plan. He saw a short and long-term solution if a<br />

residency in emergency medicine could be<br />

established. He was joined by a young<br />

neurosurgeon, H. Paul Lewis, in drawing up a<br />

curriculum and making arrangements for such a<br />

residency. They were unable to find a path to<br />

official recognition but went ahead anyway and<br />

recruited the first resident, Bruce Janiak, in 1970.<br />

This was nine years after James Mills started his<br />

plan. Flessa, Lewis and other staff assigned to the<br />

ER by the hospital were not dedicated to the<br />

practice of emergency medicine and left to<br />

practice their own specialties. The residency<br />

struggled along for a few years and almost<br />

2:00 am


<strong>Em</strong>ergency Department at HCMC in 1971<br />

disappeared but managed to produce leaders in<br />

emergency medicine. Richard Levy, a recent<br />

graduate, became its head in 1977 and<br />

developed a strong education and researchoriented<br />

department while putting community<br />

dissatisfaction to rest. It remains one of the<br />

strongest EM residencies in the U.S.<br />

The news that a residency in <strong>Em</strong>ergency <strong>Med</strong>icine<br />

had begun at the University of Cincinnati was<br />

reported in 1970 in a national news magazine.<br />

Five new residencies in <strong>Em</strong>ergency <strong>Med</strong>icine<br />

began more or less simultaneously in 1971-1972<br />

in these teaching hospitals: Los Angeles <strong>County</strong><br />

General Hospital; <strong>Hennepin</strong> <strong>County</strong> General<br />

Hospital (HCGH); <strong>Med</strong>ical College of<br />

Pennsylvania in Philadelphia; Louisville General<br />

Hospital and the University of Chicago. The ERs<br />

6 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010<br />

were now called <strong>Em</strong>ergency Departments (EDs).<br />

Just 3 years later, 32 EM residencies were<br />

in operation.<br />

EMS Arrives<br />

In 1970, a society called the University Association<br />

for <strong>Em</strong>ergency <strong>Med</strong>ical Services (UA/EMS) was<br />

formed by surgeons interested in pre-hospital and<br />

ED management of trauma as well as in academic<br />

emergency department improvements. Advances<br />

in field management of battle wounds by "medics"<br />

and in helicopter transport to medical facilities<br />

during the Vietnam War offered exciting<br />

possibilities. The new EM residency at Los<br />

Angeles <strong>County</strong>, led by Gail V. Anderson Sr.,<br />

graduated a resident, Ronald Stewart, who taught<br />

one of the first paramedic programs in the country<br />

in 1971. The surgeons realized that EMS


development on the civilian front was a very time<br />

consuming undertaking as was ED management.<br />

Many academic trauma surgeons, already<br />

over-committed to their surgical services, readily<br />

relinquished their positions in the society as<br />

emergency physicians got involved. UA/EMS<br />

became UAEM in 1976 when David Wagner, Chair<br />

of EM at the <strong>Med</strong>ical College of Pennsylvania was<br />

President and the membership was mostly<br />

emergency physicians affiliated with EM<br />

residencies. UAEM, with Ernest Ruiz of HCMC as<br />

President and the Society of Teachers of<br />

<strong>Em</strong>ergency <strong>Med</strong>icine (STEM), with Mary Ann<br />

Cooper of the University of Illinois as President,<br />

joined in 1989 to form the Society for Academic<br />

<strong>Em</strong>ergency <strong>Med</strong>icine (SAEM). SAEM is the<br />

research arm of emergency medicine. SAEM<br />

hosts an annual meeting featuring research<br />

presentations attended by about 1,700 residents,<br />

faculty, students, and others. EMS advances and<br />

EMS research remain vital interests among<br />

SAEM members.<br />

Well Earned Respect<br />

<strong>Em</strong>ergency physicians were considered itinerant<br />

know-nothings by the elite of some specialties in<br />

the sixties. Board status was needed for<br />

emergency medicine. ACEP appointed members<br />

to a committee on board establishment in 1974.<br />

This group worked with the American Board of<br />

<strong>Med</strong>ical Specialties (ABMS) to gain acceptance as<br />

a primary board. Committee member Peter Rosen,<br />

EM Director at the University of Chicago and a<br />

staunch enemy of dishonesty, famously answered<br />

endless wavering from the specialties with blunt<br />

invective. Nevertheless, progress was painfully<br />

slow. The first step was to develop and administer<br />

an oral and written examination designed to certify<br />

an emergency physician capable of making good<br />

decisions in any emergency situation. This test<br />

developed by UAEM and ACEP members was to<br />

be the American Board of <strong>Em</strong>ergency <strong>Med</strong>icine<br />

(ABEM) examination. It was successfully<br />

administered in 1980 and those who passed it<br />

became board certified by an EM "Conjoint<br />

Board." An important step was the publishing by<br />

ACEP in 1979 of <strong>Em</strong>ergency <strong>Med</strong>icine, a<br />

Comprehensive Study Guide, the brainchild of<br />

Judith E. Tintinalli, EM Residency Director at<br />

Wayne State/Detroit Receiving. The test takers<br />

were expected to be knowledgeable of all<br />

emergencies across all specialties and this text<br />

made board preparation a feasible task. Ronald<br />

Krome, Director of EM at Wayne State/Detroit<br />

Receiving and Ruiz were co-editors of the 2nd<br />

edition with Tintinalli. Several HCMC EM, surgery,<br />

neurosurgery, and medicine staff members<br />

contributed chapters. Finally, Primary Board Status<br />

in the ABMS was obtained in 1989, while Joseph<br />

Clinton, then Assistant Chief of EM at HCMC, was<br />

President of ABEM.<br />

Ref: Zink, Brian J: Anyone, anything, anytime: a history of<br />

emergency medicine, Philadelphia, 2006, Mosby, Inc.<br />

Busy <strong>Hennepin</strong> <strong>County</strong> General Hospital <strong>Em</strong>ergency<br />

Department, 1950-1967<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 7


Part 2: A Thumbnail History of<br />

<strong>Em</strong>ergency <strong>Med</strong>icine at<br />

<strong>Hennepin</strong> <strong>County</strong> <strong>Med</strong>ical <strong>Center</strong><br />

by Ernest Ruiz, MD, FACEP<br />

<strong>Hennepin</strong> <strong>County</strong> <strong>Med</strong>ical <strong>Center</strong> (HCMC) evolved<br />

from Minneapolis City Hospital (1887-1901),<br />

Minneapolis General Hospital (1901-1964), and<br />

<strong>Hennepin</strong> <strong>County</strong> General Hospital (1964-1974.)<br />

In 1955, Professor Owen Wangensteen, Chair of<br />

the Department of Surgery at the University of<br />

Minnesota (UM), assigned one of his surgeons,<br />

Claude R. Hitchcock (1920-1994), to the<br />

Minneapolis General Hospital (MGH) to be Chief<br />

of the Department of Surgery. The ER was already<br />

run by a surgery department that consisted of<br />

academically inclined community surgeons who<br />

donated their time to teach and supervise. The ER<br />

was usually staffed by interns and one first year<br />

surgery resident. Hitchcock's arrival enlivened the<br />

hospital with his energy and his love for teaching<br />

and research. Like his mentor, he was a stern<br />

administrator and believed that medicine was a<br />

24/7 occupation. The hospital became well known<br />

for its surgical expertise, especially for trauma and<br />

cancer surgery.<br />

In 1965, hospital and nursing administrations<br />

selected Hildred Prose, RN, an ER staff nurse<br />

since 1951, to become Director of <strong>Em</strong>ergency<br />

Services, answering directly to Hitchcock. The ER<br />

had become very busy, overcrowded, and<br />

understaffed. She was a strong advocate for the<br />

ER patient. She became a thorn in the side of<br />

administration and that of Hitchcock with her<br />

admonitions about staffing and space needs. In<br />

the late sixties, the ER was remodeled and<br />

8 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010<br />

enlarged, expanding into space that had been the<br />

ambulance garage. Hitchcock also encouraged<br />

the ambulance service to train its "drivers" with<br />

basic emergency skills. Interns were no longer<br />

required to ride ambulances. Still, the ER<br />

remained overcrowded. The sixties saw the advent<br />

of Cardio Pulmonary Resuscitation (CPR) that<br />

could be initiated pre-hospital. Ambulance<br />

personnel and fire fighters applied this new skill<br />

enthusiastically. Persons previously pronounced<br />

dead in the community were now rushed, CPR in<br />

progress, to the ER already teeming with patients.<br />

Although attempts were made to resuscitate them<br />

in ER cubicle space, monitoring equipment and<br />

other tools were lacking. Prose wrote long memos<br />

to Hitchcock about problems. He was already<br />

extremely busy leading his department in vital<br />

areas, such as renal transplantation and wound<br />

infection treatment with hyperbaric oxygenation.<br />

In 1971, Hitchcock called Ernest Ruiz, a general<br />

surgeon on his staff, to his office and asked him to<br />

"run the ER." Ruiz was four years out of his<br />

surgery residency. He had experience in trauma<br />

surgery and knew that improvements could be<br />

made. After conferring with his wife about the<br />

consequences of this new assignment, they<br />

agreed that it was the right thing to do. He met<br />

with Hitchcock to accept the offer. Ruiz specified<br />

that it was on condition that the ER was to be<br />

under his control without interference from<br />

Hitchcock or the other departments – it was to be<br />

an <strong>Em</strong>ergency Department (ED) instead of an ER.


Hitchcock nodded his approval. No papers were<br />

signed. Ruiz became Chief of the ED. He<br />

remained on the surgical staff and helped provide<br />

surgical coverage for fifteen more years.<br />

Ruiz found that he had much to learn if he was<br />

going to be an emergency physician as well as a<br />

general surgeon. One never knew what was going<br />

to come through the door next. It was obvious that<br />

residency training in EM was needed. Two second<br />

year surgery residents, G. Patrick Lilja and Robert<br />

S. Long (1938-2005) were drawn to the ED by its<br />

variety and intensity. They had read an article in a<br />

news magazine describing the new residency in<br />

EM at Cincinnati General and called it to Ruiz's<br />

attention. Within days Ruiz put together a<br />

curriculum and sent it off to the fledgling ACEP for<br />

a reaction. No response returned, but the<br />

residency was started anyway in the fall of 1971<br />

with Lilja and Long as the first residents. Hitchcock<br />

allowed the two residents to switch to EM and<br />

even agreed to continue their stipends for the<br />

remainder of their year. The various services<br />

welcomed the additional support from EM<br />

residents. Hitchcock never told Ruiz he approved<br />

of EM, but his support for the residency showed<br />

his willingness to give it a chance.<br />

In 1972, one of Ruiz's first goals was to stop the<br />

practice of rushing critical patients "upstairs." A<br />

well equipped room in the ED should be kept<br />

ready for such patients. Prose was in complete<br />

agreement, having observed the dangers of the<br />

rush-upstairs practice as an ED nursing director.<br />

An ENT exam room could be refurbished as a<br />

"Stabilization Room." Prose successfully recruited<br />

a respected Night Supervisor who was expert in<br />

getting critical care initiated. Audrey Kuhne, RN<br />

(1929-2005) joined the ED nursing staff in 1973<br />

and helped the Stabilization Room effort obtain<br />

hospital-wide credibility<br />

and support. Ruiz and<br />

Kuhne were successful<br />

scavengers of equipment<br />

and supplies from<br />

throughout the hospital.<br />

Some equipment was of<br />

their own design and<br />

G. Patrick Lilja, MD<br />

made from scratch. The<br />

Stabilization Room<br />

contained the equipment necessary to resuscitate<br />

almost any kind of emergency patient to the point<br />

that he or she could be safely moved. Many<br />

innovations were introduced there. For example,<br />

cardiac ultrasound was first used there to<br />

diagnose cardiac tamponade on presentation to<br />

an ED. Not all cases could be "stabilized," but IVs<br />

could be started, airways opened, x-rays and labs<br />

obtained, and life-saving measures taken while an<br />

operating room or intensive care area got ready.<br />

To our knowledge, the Stabilization Room was the<br />

first of its kind in the U.S. It can be stated that it<br />

started a new age in emergency care.<br />

Lilja and Long graduated from the EM residency<br />

in 1972 and became EM staff. They almost<br />

immediately began a first-of-its-kind program of<br />

training pre-hospital personnel in emergency skills<br />

on their own initiative. This included HCMC<br />

ambulance "drivers," police, and firefighters. The<br />

ambulance drivers became <strong>Em</strong>ergency <strong>Med</strong>ical<br />

Technicians (EMT) and Paramedics according to<br />

the skill level they achieved. ED nurses lamented<br />

that Lilja and Long were not always in the ED, but<br />

when patients arrived in better condition, they<br />

appreciated their efforts.<br />

In 1973, Ruiz was in the ED when a call came<br />

from the airport reporting that an airliner was about<br />

to land without its landing gear. The runway was<br />

7:00 am


eing foamed. Ruiz and a resident grabbed<br />

emergency equipment bags and went to the<br />

airport in two ambulances. An ambulance from<br />

another hospital also went to the airport. The plane<br />

skidded in safely and all was well. Ruiz, however,<br />

was disturbed by the lack of coordination and<br />

communication between hospitals and rescue<br />

services made evident by the happenstance<br />

response to the near-disaster. At that time there<br />

was suspicion between hospitals that ambulances<br />

were out to steal patients. Some police and fire<br />

departments were ambivalent about training in<br />

emergency care. Radio communication between<br />

all of the participants was unreliable. Ruiz called a<br />

meeting of police chiefs, fire chiefs, emergency<br />

department directors, ambulance services,<br />

hospital administrators, and <strong>Hennepin</strong> <strong>County</strong><br />

administrators. All agreed that a coordinated<br />

emergency response system for all emergencies<br />

was needed. The group learned that a competition<br />

for a $400,000 Robert Wood Johnson Foundation<br />

grant was being offered to stimulate municipalities<br />

to improve emergency communications and<br />

training. Lilja and Long and others put together the<br />

grant request. It was awarded to <strong>Hennepin</strong> <strong>County</strong><br />

with Lilja as primary investigator. It resulted in a<br />

state-of-the art communications system,<br />

paramedic training and certification, cardiac<br />

defibrillators for pre-hospital use and, ultimately,<br />

the West Metro EMS system.<br />

<strong>Em</strong>ergency <strong>Med</strong>ical Services (EMS), created and<br />

nurtured under the careful leadership of Lilja and<br />

Long, has grown into one of the premier EMS<br />

systems in the U.S. <strong>Hennepin</strong> <strong>County</strong> is now<br />

served by five ambulance services staffed by<br />

career paramedics. Air medical services are now<br />

provided by LifeLink and North Aircare. Pat Lilja<br />

was a prime mover in establishing helicopter<br />

service in this area. He served as the EM Director<br />

at North Memorial <strong>Med</strong>ical <strong>Center</strong> and <strong>Med</strong>ical<br />

10 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010<br />

Director of North Aircare. In 1985, Brian Mahoney,<br />

HCMC EM staff physician, met with Ed Lord of the<br />

Veterans Administration to start the Twin Cities<br />

chapter of the National Disaster <strong>Med</strong>ical System<br />

(NDMS). <strong>Annual</strong> drills involving 50 organizations<br />

from the East and West Metros are held. When<br />

Grand Forks, N.D. was flooded in 1997, NDMS<br />

evacuated patients from hospitals there to the<br />

Twin Cities using C130 aircraft. Mutual support<br />

also paid off when the 35W bridge fell into the<br />

Mississippi River in 2007. In a little over an hour<br />

all victims were cleared from the scene. EM staff<br />

physician, John Hick, is a respected<br />

spokesperson, teacher and hands-on leader in<br />

Minnesota's Bioterrorism and Disaster<br />

Preparedness efforts. In the 70ʼs, HCMC surgeons<br />

and emergency physicians were leaders in<br />

establishing a regional trauma system. The<br />

<strong>Em</strong>ergency <strong>Med</strong>ical Services Advisory Council of<br />

the State Health Department identified trauma<br />

receiving hospitals throughout the state. They<br />

were designated Level 1, 2, or 3 Trauma <strong>Center</strong>s<br />

according to American College of Surgeons<br />

guidelines. In the 90ʼs, EMS placed Automatic<br />

External Defibrillators (AED) in the hands of first<br />

responder agencies. Many lives have been saved<br />

by fire fighters, police, and sheriffs who<br />

successfully defibrillated patients in cardiac arrest.<br />

Studies found that most of the high quality<br />

neurologic saves were in patients defibrillated<br />

early using an AED. Our Paramedics have been<br />

doing prehospital 12 lead electrocardiograms for<br />

years. They activate the cardiac catheterization lab<br />

from the field for ST elevation myocardial<br />

infarctions. HCMC Interventionalists have the best<br />

door-to-open-vessel time in the country. EMS<br />

education staff train over 2,000 EMTʼs and first<br />

responders a year. EMS has also conducted vital<br />

prehospital research including three National<br />

Institute of Health funded studies: Public Access<br />

Defibrillation; ResQ (enhanced CPR) Trial; and the


Rapid Anti-seizure<br />

<strong>Med</strong>ication Prior to Arrival<br />

Trial (RAMPART). Jeff Ho,<br />

an EM staff physician,<br />

has monitored TASER<br />

use by law enforcement<br />

in our area and offers<br />

scientifically sound<br />

Robert Long, MD<br />

recommendations for its<br />

(1938-2005)<br />

use. Drs. Ho, Hick and<br />

Mahoney provide field supervision of HCMC<br />

ambulance paramedics.<br />

HCMC, including the ED, is on the cutting edge of<br />

the digital documentation revolution. This has<br />

been possible in the ED because both nursing and<br />

physician staff have been led by leaders with<br />

computing skills. Marsha Zimmerman, RN, and<br />

Joseph Clinton, MD have patiently overcome the<br />

difficulties associated with this huge challenge.<br />

Other departments, especially <strong>Med</strong>ical Imaging,<br />

have also contributed.<br />

The Crisis Intervention <strong>Center</strong> (CIC), now called<br />

Acute Psychiatric Services (APS), had its<br />

beginning in Minneapolis General Hospital in the<br />

60's when a telephone on the ER nurse's desk<br />

was dedicated to "suicide calls." In 1967 Zigfrids<br />

Stelmachers (1928-2006), a Ph.D. Psychologist in<br />

the Psychiatry Department, arranged for Mental<br />

Health <strong>Center</strong> staff to relieve ER nursing staff of<br />

this responsibility. In 1968 a small area adjacent to<br />

the ER was added to allow face-to-face interviews<br />

between mentally unstable or depressed patients<br />

presenting to the ER and clinical psychologists.<br />

This unit, under Stelmacher's direction, was the<br />

first hospital based CIC in the country. In the 70's,<br />

the role of the CIC was expanded to help in the<br />

evaluation and disposition of patients being held in<br />

"holding rooms" of the ED. Conversely, EM staff<br />

helped CIC staff evaluate medical problems. This<br />

cooperative arrangement continues between the<br />

ED and APS.<br />

HCMC's Poison Control <strong>Center</strong> (PCC) began in<br />

the middle 70's when the numbers of calls about<br />

possible or real poisoning and drug reactions<br />

caused medical staff to be called away from<br />

patient care. In 1974, Ruiz and Prose interviewed<br />

applicants for a clerical position to assist. Alice<br />

Lang (1914-2004) had no background in similar<br />

services, but she was hired. She proved to be an<br />

angel. She enthusiastically found ways to make<br />

the service efficient and as helpful as possible.<br />

She found ways to keep poison dangers before<br />

the public. She sought expert advice from<br />

botanists and authored a popular book on plant<br />

poisoning. The UM College of Pharmacy saw the<br />

new PCC as a good resource for pharmacy<br />

graduates. Dr. Ed Krenzelok worked with Lang,<br />

EM, and the College to make the PCC among the<br />

best in the country. Enough trained staff were<br />

brought on-board to provide 24 hour coverage. Dr.<br />

Louis Ling, EM staff physician with an interest and<br />

expertise in toxicology replaced Krenzelok when<br />

he became Director of the Pittsburg Childrenʼs<br />

Hospital Poison <strong>Center</strong> in 1984. The Poison Control<br />

<strong>Center</strong> continues as a state-wide public treasure.<br />

Hyperbaric <strong>Med</strong>icine came to HCGH in 1964.<br />

Hitchcock had read articles written by Professor of<br />

Surgery Ite Boerema at the University of<br />

Amsterdam, Holland, regarding the successful<br />

treatment of gas gangrene infections by<br />

administering oxygen to afflicted patients in a high<br />

pressure chamber. Gas gangrene results from<br />

Clostridium infections. Clostridium bacteria are<br />

anaerobes that cannot survive in tissue that is well<br />

oxygenated. This form of infection had a very high<br />

mortality rate and was not uncommon in post<br />

surgical patients and in trauma patients. Hitchcock<br />

used his genius for obtaining financial support to<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 11


The Hyperbaric Chamber in 1964<br />

receive a National<br />

Institutes of Health grant<br />

for a state-of-the-art<br />

multi-place hyperbaric<br />

chamber and its<br />

supporting research<br />

facility located on the<br />

same block as the old<br />

Claude Hitchcock, MD<br />

(1920-1994)<br />

General. A large<br />

contribution from a private<br />

benefactor also helped make it possible. The first<br />

patient was treated in 1964. HCGH became the<br />

Hyperbaric Oxygenation (HBO) center for the<br />

middle of the U.S. Many lives have been saved as<br />

a result. Some of the hoped-for benefits of<br />

hyperbaric oxygenation for certain conditions of<br />

hypoxia did not pass scientific study. Myocardial<br />

ischemia did not respond. However, HBO has<br />

remained life-saving in the treatment of severe<br />

bends, carbon monoxide poisoning, air embolism,<br />

12 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010<br />

and anaerobe infections. It is also beneficial for<br />

several forms of poor healing resulting from poor<br />

tissue oxygenation. Because many cases<br />

presented as emergencies, it was natural that EM<br />

would assume responsibility for the HBO service<br />

when the two surgeons most involved in<br />

hyperbaric medicine, Hitchcock and Dr. John<br />

Haglin (1920-2001), Assistant Chief of Surgery,<br />

retired. Surgery and other departments have<br />

access to the HBO facility through EM. Cheryl<br />

Adkinson, MD, an emergency physician also<br />

board certified in Undersea and Hyperbaric<br />

<strong>Med</strong>icine (UHM), is Director of Hyperbaric<br />

<strong>Med</strong>icine. She directs the HBO Facility and its<br />

certified UHM nursing and engineering personnel.<br />

She is assisted by Robert Collier, MD and Eric<br />

Gross, MD, also EM staff physicians boarded in<br />

UHM. EM has been pleased to collaborate with<br />

Dr. Gaylan Rockswold, Chief of Neurosurgery, and<br />

other surgeons in exploring the uses of HBO.


Thirty-seven years after its beginning, over 260<br />

EM physicians have graduated from the HCMC<br />

residency. Many are practicing in Minnesota. Many<br />

have provided service to their communities and to<br />

the specialty. Two have reached the academic<br />

level of Professor of <strong>Em</strong>ergency <strong>Med</strong>icine. Joseph<br />

Clinton, the current Chief of EM at HCMC and<br />

Professor and Department Head of EM at the<br />

University of Minnesota, is a 1977 graduate. G.<br />

Patrick Lilja, a 1972 graduate, is a Clinical<br />

Professor of <strong>Em</strong>ergency <strong>Med</strong>icine. He supervises<br />

EM residents on rotation at North Memorial<br />

<strong>Med</strong>ical <strong>Center</strong>. Two EM staff members who<br />

trained at other residencies have reached the<br />

professor level. Professor Louis Ling, HCMC<br />

emergency physician, is a graduate of the<br />

University of Chicago EM program. He is Assistant<br />

<strong>Med</strong>ical Director of HCMC, and Associate Dean<br />

for Academic Affairs for the UM <strong>Med</strong>ical School.<br />

Professor Michelle Biros, a Cincinnati EM<br />

Residency graduate and HCMC EM Associate<br />

Research Director, served as SAEM's<br />

Editor-in-Chief of Academic <strong>Em</strong>ergency <strong>Med</strong>icine<br />

from 1998 to 2008. Other staff have held<br />

important national positions. Some have received<br />

distinguished awards. Over 2000 articles have<br />

been published in scientific journals.<br />

a few rooms in the basement of the new hospital<br />

to house a collection of documents, photos,<br />

equipment, and written histories of experiences<br />

she and others had saved. This formally became<br />

the HCMC Historical Museum in 1994. Audrey<br />

Kuhne and Donna Hoover, RN, <strong>Med</strong>icine Service<br />

Supervisor, among many others, helped Prose<br />

upgrade and maintain the exhibits in the museum.<br />

Prose fully retired in 2008 after 60 years of service.<br />

The museum is now open to the public. It is under<br />

the direction of retired Nursing Administrators,<br />

Rondine Mehling and Carol Oeltjenbruns.<br />

Ref: Plummer D, Brunette D, Asinger R, Ruiz E: <strong>Em</strong>ergency<br />

department echocardiography improves outcome in penetrating<br />

cardiac injury. Ann <strong>Em</strong>erg <strong>Med</strong> 21(6):708-12, 1992.<br />

Holtan N: <strong>Hennepin</strong> <strong>County</strong> <strong>Med</strong>ical <strong>Center</strong>'s History Museum.<br />

Metro Doctors: The journal of the East and West Metro <strong>Med</strong>ical<br />

Societies Jan/Feb: 17-19, 2009.<br />

Hildred Prose RN, the<br />

intrepid ED Nursing Director<br />

who instigated so much<br />

progress retired from her<br />

clinical duties in 1965 and<br />

The HCMC Historical Museum<br />

became determined to<br />

preserve the history of "the<br />

General." The move to the<br />

Hillie Prose, RN<br />

new hospital in 1976 could<br />

See http://vimeo.com/7377333<br />

for an interview with Ernie and other<br />

have meant a disastrous loss of historic<br />

leaders in EM about mentorship,<br />

documents and equipment were it not for Prose.<br />

leadership and the development<br />

She convinced hospital administration, with<br />

of our specialty.<br />

support from the HCMC Service League, to devote<br />

12:00 pm


Doug Brunette, MD Bill Heegaard, MD<br />

Our Clinical Practice<br />

Overview from<br />

the Assistant Chiefs of <strong>Em</strong>ergency <strong>Med</strong>icine<br />

Our last “annual” report was produced in 1998. The intervening years have brought many changes to our<br />

department. The numbers of the faculty, residents, physician extenders and mid level providers have<br />

increased along with our annual ED census and the acuity of our patients. We have witnessed increasing<br />

complexity of the practice of emergency medicine and the changing health care environment. Our<br />

patients are sicker, but managed with an ever-increasing desire and need to treat patients on an<br />

observational or outpatient basis.<br />

Significant modifications to the physical plant, as well as infrastructure occurred. Our Urgent Care <strong>Center</strong><br />

was moved immediately adjacent to the main emergency department and renamed <strong>Em</strong>ergency Express<br />

Care. <strong>Em</strong>Stat, the electronic medical record specific for emergency medicine and utilized by our<br />

department for 13 years, was replaced with the hospital wide EPIC system. <strong>Med</strong>ical imaging, electrocardiography<br />

and emergency department ultrasonography entered the digital age.<br />

The health care environment has been dramatically altered, by many factors not the least of which is passage<br />

of the Patient Affordable Care Act of 2010. Terms such as Accountable Care Organizations, Pay for<br />

14 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


Performance, Meaningful Use, Patient and Family <strong>Center</strong>ed Care, Core Measures, and Press Ganey<br />

among many others have become standard medical lexicon.<br />

Our dedicated clinical and support staff has made it easy for us to keep up with the pace of change. In<br />

2010 the ED cared for over 100,000 patients with over 3000 critical care cases. Both time in the<br />

department and time to admission decreased compared to previous years. We have streamlined triage<br />

with the implementation of immediate placement of patients into open <strong>Em</strong>ergency Department and<br />

Express Care beds with excellent responses from patients and staff.<br />

Partnership with our referring hospitals has been a major focus of the HCMC <strong>Em</strong>ergency Department<br />

since its inception. In 2010 we successfully grew our trauma referrals statewide, committed to and<br />

succeeded in achieving both our Adult and Pediatric Level 1 Trauma <strong>Center</strong> certifications with the<br />

American College of Surgeons and continued to provide some of the fastest times from symptom onset to<br />

percutaneous coronary interventions and TIMI III flow in the nation. We have worked with our neurological<br />

and radiological colleagues to build one of the best acute stroke care centers in the Midwest.<br />

The department has excelled in research. Newly developed over the past several years is the Research<br />

Associate program, instrumental in facilitating clinical research in our department. It provides an<br />

outstanding medical experience for college students interested in medicine as a career, as well as<br />

medical students interested in emergency medicine as a specialty of choice.<br />

Educational outreach continues to be a cornerstone of the HCMC <strong>Em</strong>ergency <strong>Med</strong>icine Department. In<br />

2009- 2010, we taught 248 medical students from over 40 schools in their clinical rotations of emergency<br />

medicine. We also taught nursing students, PA students and paramedic students doing clinical rotations.<br />

Over 140 off-service residents did 4-6 week clinical rotations in the ED. In 2010 we provided several<br />

continuing education courses, ranging from paramedic certification classes to eight hour individual<br />

physician procedural teaching laboratories. Under the direction of Dr. Jeff Ho we launched a new<br />

educational venue named the Tactical <strong>Em</strong>ergency <strong>Med</strong>ical Peace Officer or TEMPO © course. Dr. Rob<br />

Reardon continues to teach several ultrasound courses every year to community-based EPs.<br />

This brief listing just scratches the surface of our commitment to life-long medical learning. Heraclitus of<br />

Ephesus (c.535 BC-475 BC) was a Greek philosopher, known for his doctrine of change being central to<br />

the universe. Change is also central to the practice of emergency medicine. We look forward to the<br />

challenges that change in the practice of emergency medicine will inevitably bring. The one thing that has<br />

not changed in these intervening years is our departmental mission. We embrace the triad of state-of-the-art<br />

clinical care, creative and passionate teaching and innovative research. This mission is alive and well in<br />

the HCMC Department of <strong>Em</strong>ergency <strong>Med</strong>icine. We look forward to another exceptional year in <strong>2011</strong> and<br />

we welcome you to our Activity <strong>Report</strong> for 2009-2010.<br />

Warm regards,<br />

Dr. Douglas Brunette<br />

Dr. William Heegaard<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 15


<strong>Em</strong>ergency Department Statistics<br />

Census 2009 2010<br />

TOTAL 101,196 96,068<br />

Main ED 69,847 69,850<br />

Pediatric ED 13,578 (13.4 %) 10,836(11.3 %)<br />

Express Care 17,771 15,382<br />

Stabilization Room 3,508 (36 % trauma) 3,406 (37 % trauma)<br />

Other Characteristics 2009 2010<br />

All Admissions 14,569 (14. 3%) 14,222 (14. 8%)<br />

Inpatient 12,515 11,739<br />

Observation<br />

Time in Department<br />

2,054 2,483<br />

Admissions 5 hr 8 min 4 hr 59 min<br />

Discharged 3 hr 45 min 3 hr 4 min<br />

Clinical Team Work<br />

Trauma Services 2009 2010<br />

Admits 2,769 2,669<br />

From ED and STAB Room 1,725 1,408<br />

Level I Trauma Activations 181 192<br />

Level II Trauma Activations 520 473<br />

Trauma Transfers 888 828<br />

Pediatric Trauma (age 0-14 yrs) 336 343<br />

Cardiology 2009 2010<br />

Pre-hospital Cath Lab Activations for AMI 67 90<br />

Therapeutic Hypothermia NA 94<br />

Neurocritical Care 2009 2010<br />

ED Stroke Codes 167 253<br />

Transfers/Outreach Admissions 120 80 (though 9/10)<br />

Door to tPA in Ischemic CVA 51 min (n=27) 49 (n=40)<br />

16 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


EMS and Disaster <strong>Med</strong>icine<br />

At 6:03 pm on August 1, 2007, the Interstate 35W bridge over<br />

the Mississippi River collapsed, creating a nearly 1 mile long<br />

incident scene. Within minutes, <strong>Hennepin</strong> <strong>Em</strong>ergency <strong>Med</strong>ical<br />

Services (EMS) responded with initial ambulances and<br />

supervisors. Twenty-nine ambulances transported a total of 50<br />

patients to area hospitals. In some cases, pickup trucks were<br />

used to access areas that ambulances could not. Due to a rapid<br />

and coordinated response, all patients were off the scene within<br />

95 minutes after the collapse, despite the significant hazards and<br />

access problems.<br />

<strong>Hennepin</strong> <strong>County</strong> <strong>Med</strong>ical <strong>Center</strong> (HCMC) activated their full disaster plan for the first time in over a<br />

decade, calling in additional staff and mobilizing resources. Twenty-eight rooms in the emergency<br />

department were cleared, and within one hour, ten operating rooms and 22 intensive care beds had been<br />

opened. Twenty-four patients were transported to HCMC, many in critical condition. Eight emergency<br />

surgeries were required including a cesarean section delivering a baby in distress to one of the severely<br />

injured victims. Both mother and baby went on to make a full recovery.<br />

As the closest Level I trauma center, HCMC received all of the critical patients from the incident. Fortunately,<br />

both EMS and the hospital had more than adequate capacity, thanks in part to previous planning and<br />

training for disaster events. This tragedy claimed 13 lives, fortunately none of those deaths occurred after<br />

hospital arrival. Though disaster preparedness played a role, it was the daily familiarity with managing<br />

critical trauma that contributed the most to the successful response: from accurate triage by EMS<br />

personnel, to expedient care in the emergency department, the operating rooms, intensive care, and<br />

attentive rehabilitation. As one of our staff commented to NBC ʻThis is who we are, and this is what we do.ʼ<br />

John Hick, MD<br />

<strong>Med</strong>ical Director for <strong>Em</strong>ergency Preparedness<br />

EMS 2009 2010<br />

TOTAL HCMC service calls 55,000 58,000<br />

(74.5% medical) (75.6% medical)<br />

Transported to HCMC 16,500 16,700


18 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010<br />

35W Bridge Collapse<br />

over Mississippi River


6:03 pm


Hyperbaric <strong>Med</strong>icine<br />

Two thousand ten was a big year for HCMCʼs Hyperbaric <strong>Med</strong>icine Program. First, the program was<br />

re-accredited by the Undersea and Hyperbaric <strong>Med</strong>ical Society (like JCAHO in this role) with distinction.<br />

There are only 60 UHMS certified programs in the U.S. and just a few certified with distinction.<br />

Second, we had our first Accreditation Council for Graduate <strong>Med</strong>ical Education (ACGME) site visit for the<br />

Undersea and Hyperbaric <strong>Med</strong>icine Fellowship. The bad news is the process is the same for a fellowship<br />

with one fellow as it is for an entire EM residency program. The good news is that it went very well. We<br />

received the longest possible re-accreditation of five years. There are currently only 6 ACGME certified<br />

fellowships in hyperbaric medicine. Hopefully this number will grow, as it is now necessary to do an<br />

ACGME fellowship to sit for the Undersea and Hyperbaric <strong>Med</strong>icine subspecialty boards.<br />

Third and most exciting, 2010 was the year that all prior efforts to get a new hyperbaric facility came<br />

together. The Minnesota State legislature allocated $5M for the renovation of hospital space for a new<br />

hyperbaric facility, which, along with some stimulus money, allowed us to move forward with the $5M<br />

previously allocated for the purchase of a new chamber.<br />

HDR architects have worked very closely with our nurse manager, lead technician and myself on details<br />

of the facility design, which went out for bid in April 2010. Unless the design puts us seriously over<br />

budget, this will result in a superb space for patient care and ongoing head trauma research. With respect<br />

to the chambers, likewise, we have had the opportunity to work very closely over the past 2 years with<br />

Fink Engineering to make the chambers better than any in use around the world.<br />

Groundbreaking on the building renovation, Level I North Block, occured mid-May <strong>2011</strong>. The chambers<br />

will arrive on campus the first week of November 2012. The new facility will open for patient care in April<br />

2012. There will be minimal disruption in patient care, as patients will continue to be treated in our current<br />

facility until the new one is ready. How sweet it is!<br />

With all of this going on in 2010, we maintained our clinical activity during a bad economic year with 3,131<br />

treatments, including 142 emergency treatments (130 in 2009), 128 consultations, and 62 TCO2 procedures.<br />

Cher Adkinson, MD<br />

Director, Underseas and Hyperbaric <strong>Med</strong>icine<br />

HBO 2009 2010<br />

TOTAL treatments 3035 3331<br />

CO poisoning treatments 95 72<br />

Decompression illness 3 5<br />

Life/limb threatening soft tissue infections 32 57<br />

Gas emboli 0 8<br />

20 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


<strong>Em</strong>ergency Ultrasound<br />

Our department has been a leader in the field of<br />

emergency ultrasound. We use emergency US on a daily<br />

basis in both clinical practice and research. Residents<br />

learn US with hands-on formal teaching, US workshops<br />

and under direct mentorship while working in the ED.<br />

We currently have twelve ultrasound machines with full<br />

wireless conductivity. Two are permanently mounted in the<br />

Stabilization Room and two are mounted in our pelvic<br />

examination rooms.<br />

We perform a variety of bedside ultrasound exams including procedures, gallbladder, renal, OB-GYN,<br />

FAST, thoracic cardiac/echo, aorta, fluid status/IVC, DVT, ocular, musculoskeletal and fracture reductions.<br />

In 2009, we performed and recorded 9,488 exams of all types. In 2010, a total of 10,909 exams were<br />

performed. Most exams were FAST, Cardiac and OB-GYN ultrasonographic studies.<br />

Our department employs a full time dedicated sonographer who oversees the ultrasound education and<br />

explores opportunities for growth within our residency program. We use the OsiriX system, which is a<br />

DICOM PACS workstation for imaging. This allows us to monitor ultrasound exams in real time. It also<br />

allows us to have an extensive digital library of ED ultrasound images for educational purposes.<br />

Rob Reardon, MD<br />

Director, <strong>Em</strong>ergency <strong>Med</strong>icine Ultrasound<br />

The<br />

Hyperbaric<br />

Chamber<br />

Liberty Caroon, an ED Sonographer, assists with an<br />

emergency ultrasound<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 21


International <strong>Em</strong>ergency <strong>Med</strong>icine Outreach<br />

Our commitment to the delivery of good<br />

emergency care has no geographic boundaries<br />

and the spirit of adventure that makes our practice<br />

so unique has also inspired our faculty and<br />

residents to venture outside our ED walls. Over<br />

the last few years, department members have<br />

volunteered their medical services, administrative<br />

expertise, and teaching talents to hospitals and<br />

clinics in developing areas of the world, including<br />

India, Africa, Central and South America and Haiti,<br />

to name just a few. Often, medical students<br />

accompany us on these medical missions.<br />

These volunteer activities have offered a challenging<br />

and humbling experience, and have underscored<br />

the importance of international outreach.<br />

Estimates by the World Health Organization<br />

suggest that the burden of disease in the<br />

developing world will shift from lower respiratory<br />

disease, diarrheal disease and perinatal<br />

conditions, to diseases that classically predominate<br />

within the developed world. Ischemic heart<br />

disease, unipolar depressive disease and road<br />

traffic accidents are projected to be the top three<br />

contributors to the developing worldʼs disease<br />

burden, comprising greater than 20 percent of the<br />

total by the year 2020. These projections provide a<br />

unique opportunity to take the lessons learned<br />

during the maturation of <strong>Em</strong>ergency <strong>Med</strong>icine in<br />

the United States and implement both educational<br />

and public health policies that will have an<br />

enormous and efficient impact.<br />

To that end, a Fellowship in International<br />

<strong>Em</strong>ergency <strong>Med</strong>icine was founded in a joint effort<br />

between HCMC and the University of Minnesota<br />

andl “graduated” itʼs first fellow, Dr. Stephen<br />

Dunlop, in July <strong>2011</strong>. During this 2 year fellowship,<br />

22 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010<br />

Dr. Dunlop completed a Masters in Public Health<br />

focusing on Healthcare in the Developing world, a<br />

Certificate of Knowledge in Clinical Tropical<br />

<strong>Med</strong>icine and Travelersʼ Health from the American<br />

Society of Tropical <strong>Med</strong>icine and Hygiene.<br />

Dr. Dunlop has just returned from a 6 month<br />

assignment as Director of Outpatient Services at<br />

Arusha Lutheran <strong>Med</strong>ical Centre in Arusha, Tanzania.<br />

We will continue to provide care to<br />

developing countries, not only through our<br />

international fellowship but also though<br />

continued volunteer activities.


�............Mark Danahy, class of 2006,<br />

teaching in Bangelore, India<br />

⊳�................Stephen Dunlop, MD,<br />

International <strong>Em</strong>ergency <strong>Med</strong>icine<br />

fellow, working in Tanzania<br />

Jamie Karambay, MD, class of <strong>2011</strong>,<br />

on medical flight in Tanzania.........�<br />

⊳.............Arleigh Trainor, MD, class<br />

of 2006, teaching in Calcutta<br />

Brian Mahoney, MD,<br />

class 1980, in St, Lucia,<br />

with donated vehicle to<br />

St. Jude Hospital........�<br />

�..Lisa Hayden, MD, class of 2012,<br />

caring for patients in Tanzania<br />

8:00 pm


The People of the ED<br />

�...<strong>Em</strong>ergency Nurses:<br />

are the first line of care for emergency patients. <strong>Em</strong>ergency nurses are well-versed in acute medical<br />

and traumatic conditions, and often initiate assessment and management of ED patients.<br />

24 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


�...Interpreters:<br />

assist in taking medical histories of<br />

non-English speaking patients.<br />

⊳...HUCS:<br />

coordinate non-clinical<br />

ED activities and tasks<br />

for the nursing unit, as<br />

well as receptionist and<br />

clerical functions.<br />

�...ED office:<br />

supports the <strong>Em</strong>ergency Services Department.<br />

�...Chaplains/Social Workers:<br />

assist with patientʼs and familyʼs spiritual<br />

and other needs.<br />

�...Health Care Assistants:<br />

perform assigned patient care tasks to support<br />

and assist health care providers.<br />

9:00 pm


People of the ED | Faculty Profiles<br />

Physicianʼs Name <strong>Em</strong>ergency <strong>Med</strong>icine Residency Program Special Duties<br />

Cher Adkinson HCMC, <strong>Em</strong>ergency <strong>Med</strong>icine Director of Hyperbaric <strong>Med</strong>icine, Program<br />

Director for the HBO Fellowship, ENT Liaison<br />

Michelle Biros University of Cincinnati <strong>Med</strong>ical <strong>Center</strong>, Associate Research Director,<br />

<strong>Em</strong>ergency <strong>Med</strong>icine Co-Director of Research Associate<br />

Program, Neurology/Neurosurgery/<br />

Psychiatry Departmental Liaison<br />

Douglas Brunette HCMC, <strong>Em</strong>ergency <strong>Med</strong>icine Assistant Chief of <strong>Em</strong>ergency <strong>Med</strong>icine<br />

Joseph E. Clinton HCMC, <strong>Em</strong>ergency <strong>Med</strong>icine HCMC Chief of <strong>Em</strong>ergency <strong>Med</strong>icine,<br />

Chair of <strong>Em</strong>ergency <strong>Med</strong>icine, University<br />

of Minnesota <strong>Med</strong>ical School<br />

Robert Collier Kansas City General Hospital, Internal <strong>Med</strong>icine; Assistant Director of Hyperbaric <strong>Med</strong>icine<br />

Kansas City General Hospital (Now Truman<br />

<strong>Med</strong>ical <strong>Center</strong>), <strong>Em</strong>ergency <strong>Med</strong>icine<br />

Richard Gray University of Pennsylvania, Internal <strong>Med</strong>icine; Director of <strong>Med</strong>ical Student Education,<br />

<strong>Med</strong>ical College of Pennsylvania, <strong>Em</strong>ergency <strong>Med</strong>icine Management of ED PAs<br />

Eric Gross George Washington University, <strong>Em</strong>ergency <strong>Med</strong>icine HBO, Assistant Director of <strong>Em</strong>ergency<br />

<strong>Med</strong>icine Residency Program<br />

Danielle Hart HCMC, <strong>Em</strong>ergency <strong>Med</strong>icine Assistant Director of <strong>Em</strong>ergency <strong>Med</strong>icine<br />

Residency Program, Director of Simulation<br />

William Heegaard HCMC, <strong>Em</strong>ergency <strong>Med</strong>icine Assistant Chief of <strong>Em</strong>ergency <strong>Med</strong>icine,<br />

<strong>Med</strong>ical Director for LifeLink III, Director of Critical<br />

Care Airway Lab, Surgery Department Liaison<br />

John Hick HCMC, <strong>Em</strong>ergency <strong>Med</strong>icine <strong>Em</strong>ergency Preparedness, Assistant<br />

<strong>Med</strong>ical Director for <strong>Hennepin</strong> EMS<br />

Jeff Ho HCMC, <strong>Em</strong>ergency <strong>Med</strong>icine EMS <strong>Med</strong>ical Direction for Edina Fire and<br />

Police, TEMPO, Assistant <strong>Med</strong>ical Director<br />

for <strong>Hennepin</strong> EMS<br />

Scott Joing HCMC, <strong>Em</strong>ergency <strong>Med</strong>icine Manager of <strong>Med</strong>iasite hqmeded.com<br />

Christine Kletti HCMC, <strong>Em</strong>ergency <strong>Med</strong>icine Pediatric <strong>Em</strong>ergency <strong>Med</strong>icine, SARS,<br />

Assistant Residency Director, APLS,<br />

Ruiz Reading Group<br />

Louis Ling University of Chicago Hospital and Clinics, HCMC Associate <strong>Med</strong>ical Director for<br />

<strong>Em</strong>ergency <strong>Med</strong>icine <strong>Med</strong>ical Education, UMN Associate<br />

Dean for Graduate <strong>Med</strong>ical Education<br />

Brian Mahoney HCMC, <strong>Em</strong>ergency <strong>Med</strong>icine EMS <strong>Med</strong>ical Director, <strong>Med</strong>ical Director<br />

for ALS Courses, <strong>Med</strong>ical Director for<br />

Paramedic Education<br />

Marc Martel HCMC, <strong>Em</strong>ergency <strong>Med</strong>icine <strong>Em</strong>ergency <strong>Med</strong>icine Residency<br />

Program Director, Co-Director of the<br />

Combined <strong>Em</strong>ergency <strong>Med</strong>icine/Internal<br />

<strong>Med</strong>icine Residency Program<br />

John McGill HCMC, <strong>Em</strong>ergency <strong>Med</strong>icine Ortho ED Rotation Director<br />

Jim Miner HCMC, <strong>Em</strong>ergency <strong>Med</strong>icine Director of Research, Director of<br />

Research Associate Program, <strong>Med</strong>ical<br />

Director for Quality Assurance<br />

Dave Plummer HCMC, <strong>Em</strong>ergency <strong>Med</strong>icine IDOCS Schedule Manager<br />

Rob Reardon State University of New York, Buffalo, New York, Ultrasound Fellowship Program Director,<br />

<strong>Em</strong>ergency <strong>Med</strong>icine Director for <strong>Em</strong>ergency <strong>Med</strong>icine Ultrasound<br />

Robert Rusnak HCMC, <strong>Em</strong>ergency <strong>Med</strong>icine and Internal <strong>Med</strong>icine Dentistry ED Rotation Director<br />

Steve Smith HCMC, <strong>Em</strong>ergency <strong>Med</strong>icine Cardiology and Laboratory Liasion<br />

Steve Sterner Fairview-St. Mary's Hospitals, Family <strong>Med</strong>icine HFA Senior Vice President for <strong>Med</strong>ical Affairs<br />

Al Tsai UMN, Pediatric Residency, Valley <strong>Med</strong>ical <strong>Center</strong>, Director of the Pediatric <strong>Em</strong>ergency<br />

Fresno, CA, <strong>Em</strong>ergency <strong>Med</strong>icine Department, APLS Course Director<br />

26 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


Research Interest Fellowship Start Date at HCMC<br />

Undersea and Hyperbaric <strong>Med</strong>icine 1984<br />

Exception from Informed Consent, University of Cinncinati <strong>Med</strong>ical <strong>Center</strong>, 1986<br />

Research Ethics, Head Trauma and Research Fellow,<strong>Em</strong>ergency <strong>Med</strong>icine<br />

Neurological <strong>Em</strong>ergencies<br />

Hypothermia 1985<br />

Resuscitation 1977<br />

Undersea and Hyperbaric <strong>Med</strong>icine; 1992<br />

ABEM Exam Editor<br />

Asthma, Sedation 1996<br />

Central Line <strong>Em</strong>ergency Access Registry, George Washington University, Research 2006<br />

Ionizing Radiation in the ED, Infectious Disease and Hyperbaric <strong>Med</strong>icine<br />

Simulation HCMC, Simulation and Critical Care 2009<br />

HEMS, Ultrasound, Head Trauma and Neurological National Association of Public Hospitals Fellowship, 1994<br />

<strong>Em</strong>ergencies, Conducted Electrical Weapons <strong>Em</strong>ergency Department Flow and Operations<br />

<strong>Em</strong>ergency Preparedness, Disaster <strong>Med</strong>icine, HCMC, EMS Fellowship 1997<br />

EMS<br />

EMS, Tactical EMS, In-Custody Death; HCMC, EMS Fellowship 1996<br />

Excited Delirium, Conducted Electrical Weapons<br />

Ultrasound, Computer Based <strong>Med</strong>ical Education 2006<br />

Pediatric <strong>Em</strong>ergency <strong>Med</strong>icine; Sexual Assault, 2000<br />

Simulation, Asthma Education, Toothache<br />

Toxicology 1984<br />

EMS, Resuscitation, Paramedic Education 1980<br />

Educational Research, Psychobehavioral HCMC, Research Fellowship in 2001<br />

<strong>Em</strong>ergencies <strong>Em</strong>ergency <strong>Med</strong>icine<br />

Airway Management, International 1981<br />

<strong>Em</strong>ergency <strong>Med</strong>icine<br />

Procedural Sedation, Pain Management, 1999<br />

Conducted Electrical Weapons<br />

Airway Management, Ultrasound, Resuscitation 1985<br />

Ultrasound, Airway Management 1998<br />

Diabetes Mellitus 1980<br />

Acute Coronary Syndromes, GHB HCMC, Clinical <strong>Em</strong>ergency <strong>Med</strong>icine Fellowship 1991<br />

Urgent Care HCMC, <strong>Em</strong>ergency <strong>Med</strong>icine 1980<br />

Pediatric EMS, Pediatric <strong>Em</strong>ergency Drug Book 1987


HCMC Faculty Physicians<br />

<strong>Em</strong>ergency <strong>Med</strong>icine Residents, 2010<br />

28 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


Current <strong>Em</strong>ergency <strong>Med</strong>icine Residents<br />

Class of 2015 (EM/IM) Not shown: results of 2012 EM match<br />

Bischof, Johanna Duke University School of <strong>Med</strong>icine<br />

Class of 2014 (EM/IM) Not shown: results of <strong>2011</strong> EM match<br />

Driver, Brian University of Colorado School of <strong>Med</strong>icine<br />

Olives, Travis University of Minnesota <strong>Med</strong>ical School<br />

Class of 2013<br />

Bruen, Charles University of Texas Southwestern <strong>Med</strong>ical School at Dallas (EM/IM)<br />

Boklewski, Jennifer University of Illinois College of <strong>Med</strong>icine<br />

Gosen, Christine Case Western Reserve University School of <strong>Med</strong>icine<br />

Hall, Derek University of Wisconsin School of <strong>Med</strong>icine<br />

Hampton, Rachel Case Western Reserve University School of <strong>Med</strong>icine<br />

Lee, Jennifer University of Iowa Carver College of <strong>Med</strong>icine<br />

Ling, Eric Northwestern University Feinberg School of <strong>Med</strong>icine<br />

Londer, Casey University of Utah School of <strong>Med</strong>icine<br />

Oakley, Eleanor Washington University in St Louis School of <strong>Med</strong>icine<br />

Paluchowski, Daniel University of Maryland School of <strong>Med</strong>icine<br />

Ragaini, <strong>Em</strong>ily University of Connecticut School of <strong>Med</strong>icine<br />

Scott, Nate University of Minnesota <strong>Med</strong>ical School (EM/IM)<br />

Terrebonne, Megan University of Pittsburg School of <strong>Med</strong>icine<br />

Class of 2012<br />

Dalton, Tom University of Colorado School of <strong>Med</strong>icine<br />

Doucette, Eve Indiana University School of <strong>Med</strong>icine<br />

Hayden, Lisa Creighton University School of <strong>Med</strong>icine (EM/IM)<br />

Madore, Frank Ohio State University College of <strong>Med</strong>icine – Public Health<br />

Mayerle, Joe University of Minnesota <strong>Med</strong>ical School<br />

Melson, Taj University of Michigan <strong>Med</strong>ical School<br />

Nystrom, Paul University of Iowa Carver College of <strong>Med</strong>icine<br />

Peterson, Greg University of Minnesota <strong>Med</strong>ical School<br />

Terwey (Anderson), Karen University of Minnesota <strong>Med</strong>ical School<br />

Thompson, Pete Brody School of <strong>Med</strong>icine at East Carolina University (EM/IM)<br />

Trussell, Kristi University of Minnesota <strong>Med</strong>ical School<br />

Wilde, Brenden University of Chicago Pritzker School of <strong>Med</strong>icine<br />

Worrall, Christine University of Pittsburg School of <strong>Med</strong>icine<br />

Class of <strong>2011</strong><br />

Beeman, William Rosalind Franklin University of <strong>Med</strong>icine and Science/Chicago <strong>Med</strong>ical School<br />

Beyer, Robert <strong>Med</strong>ical College of Wisconsin<br />

Calvo, Darryl Vanderbilt University School of <strong>Med</strong>icine<br />

Chang, Richard New York University School of <strong>Med</strong>icine<br />

Dyer, Justin University of Missouri-Columbia School of <strong>Med</strong>icine<br />

Fong, Erine University of Minnesota <strong>Med</strong>ical School<br />

Gary, Brandi Temple University School of <strong>Med</strong>icine (EM/IM)<br />

Jones, Jared St Louis University School of <strong>Med</strong>icine<br />

Karambay, James Albany <strong>Med</strong>ical College<br />

Kniffin, Colleen University of Minnesota <strong>Med</strong>ical School<br />

Orozco, Benjamin Harvard <strong>Med</strong>ical School<br />

Prekker, Matthew University of Minnesota <strong>Med</strong>ical School (EM/IM)<br />

Romo, Victor University of Illinois College of <strong>Med</strong>icine<br />

Sherman, Melissa University of Minnesota <strong>Med</strong>ical School<br />

* EM/IM=combined <strong>Em</strong>ergency <strong>Med</strong>icine/Internal <strong>Med</strong>icine 5 year program<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 29


Graduate <strong>Em</strong>ergency <strong>Med</strong>icine Resident Classes<br />

Class of 2010<br />

Bronner, Sarah<br />

Collins, Audrey<br />

Garlich, Fiona<br />

Johnson, Valerie<br />

Moore, Johanna<br />

Roline, Chad<br />

Rosenthal, Eric<br />

Vogel, <strong>Em</strong>ily<br />

Walz, Heidi<br />

Class of 2009<br />

Clark, Michael<br />

Cole, Jon<br />

Delavari, Parissa<br />

Dunlop, Stephen<br />

Gramenz, Paul<br />

Holm, Michelle<br />

Knapp, Ryan<br />

Milkus, Kelly<br />

Olsen, Jeremy<br />

Shinneman, Louis<br />

Stephens, Dana<br />

Stroschein, Amy<br />

Villaume, Frank<br />

Class of 2008<br />

Allegra, Paul<br />

Bahr, Jennifer<br />

Ball, Christian<br />

Gengerke, Todd<br />

Hart, Danielle<br />

Hill, Chandler<br />

Pohland, Jonathan<br />

Ruzanic, Theodore<br />

Westgard, Bjorn<br />

Class of 2007<br />

Bengiamin, Rimon<br />

Budhram, Gavin<br />

Carmody, Sharon<br />

Davarn, Scott<br />

Lapine, Anne<br />

Lewis, Dan<br />

McClain, Carolyn<br />

Skinner, Lisa<br />

Stirling, Kate<br />

Unkefer, Nate<br />

Vogt,Katie<br />

Class of 2006<br />

Baker, Amanda<br />

Becker, Christopher<br />

Bock, Paul<br />

Danahy, Mark<br />

Florence, Andrew<br />

Hartmann, Tracy<br />

Heller, Kimberly<br />

Kingsley, Kyle<br />

Ladmer, David<br />

Lathrop, Lucas<br />

Trainor, Arleigh<br />

Class of 2005<br />

Blonigen, Nancy<br />

Currie, Peter<br />

Herold, Matthew<br />

Huber, Darren<br />

Infante, Jorge<br />

Joing, Scott<br />

Lindgren, Kjell<br />

Sarnov, Olga<br />

Sterzinger, Ann<br />

Torres, Camilo<br />

Tuominen, Kai<br />

Class of 2004<br />

Ansari, Rebecca<br />

Bachman, Andrew<br />

Brueggemann, Marty<br />

Bultman, Laura<br />

Evans, Carly<br />

Kraska, Eric<br />

Lashkowitz, Seth<br />

Leuck Bachman, Katherine<br />

Meyer, Madeleine<br />

Sufka Schaefer, Kristin<br />

Torstenson, Chad<br />

Class of 2003<br />

Fringer, Ryan C.<br />

Haug, Eric<br />

Heining, Travis<br />

Johnson, Christopher<br />

Johnson, Timothy<br />

McCoy, Christopher<br />

Nelson Sims, Jody<br />

Palmer, Christopher<br />

Ross Wyatt, Karen<br />

Thacker Johnson, Jenny<br />

Wyatt, Thomas<br />

Class of 2002<br />

Braksiek, Rob<br />

Danigelis, Matt<br />

Dillman, Brian<br />

Doerffler, Alex<br />

30 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010<br />

Krieg, Susan<br />

Mertz, John<br />

Moore, J. Alan<br />

Muto-Isolani, Antonio<br />

Peck, Karen Kuo<br />

Thomas, Rob<br />

Class of 2001<br />

Baker, Chris<br />

Block, Jennifer<br />

Craig, Peter<br />

Fish, Sara<br />

Friewald, Scott<br />

Isaacson, Brian<br />

Rhead, Christoper (Kit)<br />

Rooks, Ken<br />

Schrag, Laura<br />

Svenningsen, John<br />

Tibbles, Carrie<br />

Class of 2000<br />

Barrett, Matthew<br />

Benson, Jill<br />

Cochrane, Josh<br />

Hirschman, David<br />

Mapes, Andrew<br />

Martel, Marc<br />

O'Laughlin, Daniel<br />

Palmer, Mitch<br />

Thompson, Rod<br />

Vogel, (Cory) Edward<br />

Class of 1999<br />

Bonanni, Marita Michelin<br />

Chase, Peter<br />

Clark Rue, Casey<br />

Ellmann Black, Cara<br />

Gunn, Scott<br />

Haines, Howard<br />

Huynh, Hung<br />

Kletti, Christine<br />

Miner, Jim<br />

Rodgerson, Jeff<br />

Class of 1998<br />

Abney-Lidahl, Deb<br />

Bilden, Beth<br />

Clarkowski, Brian<br />

DiRe, Danielle<br />

Hsieh, Dan<br />

Kamper, Matthew<br />

Lee, Curtis<br />

McVaney, Kevin<br />

Tewodros, Abel<br />

Topliff, Andrew<br />

Class of 1997<br />

Anderson, Steve<br />

Buccino, Kent<br />

Coomes, Tom<br />

McDaniel, Scott<br />

Patty, Brian<br />

Pogrebra, Kevin<br />

Ramming, Scott<br />

Reed, David<br />

Rock, Michael<br />

Zeitz, Erich<br />

Class of 1996<br />

Beier, Kevin<br />

Epstein, Stephen<br />

Gage, Eric<br />

Hick, John<br />

Joyce, Gail<br />

Lynch, Michael<br />

Sercombe, Clare<br />

Skedros, Anthony<br />

Wu, Mona<br />

Zink, Robert<br />

Class of 1995<br />

Baro, Marte<br />

Battershell, Ty<br />

Christensen, Paul<br />

Friederich, Douglas<br />

Fuller, Robert<br />

Ho, Jeffrey<br />

McEvoy, Larry<br />

McGlothen, Kevin<br />

Peña, Joe<br />

Ross, Harry<br />

Saavedra, Leo<br />

Class of 1994<br />

Bauer, Andrew<br />

Bowdish, Gail<br />

Butts, Michael<br />

Covington, David<br />

Heegaard, Bill<br />

Lueders, Jon<br />

Lynch, Margaret<br />

Matticks, Craig<br />

Mildbrandt, Dave<br />

Pippert, Greg<br />

Sneed, Sara<br />

Zink, Julie


Class of 1993<br />

Arnason, Carol<br />

Dang, Douglas<br />

Dvorak, Dave<br />

Nordness, Bob<br />

Washington, Vindell<br />

Class of 1992<br />

Lofy Larson, Lisa<br />

Nigh, David<br />

Ragen Ide, Lisa<br />

Weiker, Brett<br />

Westwater, Jay<br />

Wingate, Jennifer<br />

Class of 1991<br />

Bradbury, Dorothy<br />

Cohen, Larry<br />

Drill-Mellum, Laurie<br />

Geer, Drew<br />

Gosewisch, Gary<br />

Johansen, R. Bart<br />

Class of 1990<br />

Hagedorn, Dave<br />

Kominsky, John<br />

Lufkin, Kirk<br />

Rothong Erlandson, Carole<br />

Smith, Steve<br />

Stewart, Tom<br />

Ward, Mary<br />

Wilson, Mary<br />

Class of 1989<br />

Bachhuber, Greg<br />

Erickson, Ford<br />

Ng, Angus<br />

Rambow Schmitz, Beth<br />

Class of 1988<br />

Erlandson, Mark<br />

Mlinek, Edward J.<br />

Morton, Sonny<br />

Ripkey, Cathy<br />

Winter, James<br />

Class of 1987<br />

Henrichs, Wade<br />

Woodburn, James<br />

Zarzycki, Mark<br />

Class of 1986<br />

Eisen, Teddi<br />

Gaudio, Frank<br />

Mickelson, Kevin<br />

Wenman, Michael<br />

Class of 1985<br />

Brunette, Douglas<br />

Gravett, Alan<br />

Plummer, David<br />

Roberts, David<br />

Yaron, Michael<br />

Physician Assistants<br />

Class of <strong>2011</strong><br />

Getz, Kaitlin University of Toledo<br />

Schinzel, Mary A. T. Still University<br />

Class of 2010<br />

Anderson, <strong>Em</strong>ily Stonybrook University<br />

Klos, Chelsea University of Wisconsin<br />

Nathan, Laura University of Nebraska<br />

Class of 1984<br />

Brutger, Yvonne<br />

Crimmins, Timothy<br />

Miller, Linda<br />

Romness, David<br />

Class of 1983<br />

Gerdes, Dale<br />

Irwin, Glenn<br />

Mayron, Raymond<br />

Roller, Benedict<br />

Class of 1982<br />

Adkinson, Cheryl<br />

Berg, Mark<br />

Feldshuh, David<br />

Justin, Elliot<br />

Swanson, Jeffrey<br />

Class of 1981<br />

Booth, Samuel<br />

McGill, John<br />

Mirick, Mark<br />

Schwitzer, Kent<br />

Class of 1980<br />

Coon, Gary<br />

Graves, Benjamin<br />

Liebo, Jack<br />

Mahoney, Brian<br />

Nelson, David<br />

Class of 2000<br />

Class of 1979<br />

Dannewitz, Stephen<br />

Evans, Thomas L.<br />

Glauser, Jonathan<br />

LeTourneau, Barbara<br />

Vancura, Ellen<br />

Class of 1978<br />

Greenfeld, Bernard M.<br />

Hill, Martin P.<br />

Rusnak, Robert A.<br />

Thompson, James D.<br />

Class of 1977<br />

Blegen, Carl N.<br />

Clinton, Joseph E.<br />

Condron, Michael J.<br />

Rockswold, Gordon A.<br />

Class of 1976<br />

Larson, James R.<br />

Olson, David G.<br />

Pexa, Charles E.<br />

Timmons, Thomas E.<br />

Class of 1975<br />

Adams, Bruce E.<br />

Tandias, James<br />

Class of 1973<br />

Lilia, G. Patrick<br />

Long, Robert S.<br />

Garfin, Kathy Augsburg College<br />

Class of 1991<br />

Formanek, Timothy University of Iowa<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 31


Marc Martel, MD Eric Gross, MD<br />

Teaching<br />

the next generation of<br />

<strong>Em</strong>ergency Clinicians<br />

Welcome to the 2009-2010 edition of the HCMC <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong>. In recent years<br />

we have tried to keep you abreast of developments in our residency. You may have heard about many of<br />

the innovations in training, including the following:<br />

� The combined <strong>Em</strong>ergency <strong>Med</strong>icine/Internal <strong>Med</strong>icine residency, now graduating its first class. Both<br />

<strong>2011</strong> graduates will begin their future academic careers with fellowships, one in International <strong>Med</strong>icine<br />

and the other in Critical Care.<br />

� The high-fidelity <strong>Em</strong>ergency <strong>Med</strong>icine simulation program run by Danielle Hart, MD. The new<br />

curriculum has been so successful that Danielle is now Director of the Institutional Interdisciplinary<br />

Simulation and Education <strong>Center</strong> (ISEC) here at HCMC, scheduled to open in early 2012.<br />

� The ACGME accredited HBO fellowship.<br />

32 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


� The nationally acclaimed educational website www.hqmeded.com with on-line CME for<br />

“STAB Conference.”<br />

� And finally, our newest event supporting residency endeavors, the <strong>Hennepin</strong> Health Foundation/<br />

<strong>Em</strong>ergency <strong>Med</strong>icine Residency Education Councilʼs “Clubs and Scrubs” annual charitable golf<br />

tournament. This event directly supports EM and EM/IM residency activities including national<br />

research presentations, departmental high-fidelity simulation programs, advanced ultrasound training<br />

and resident wellness. Keep an eye out for information about the event planned for August, 2012.<br />

Giving back to EM as a whole is still a driving tenet of the residency. Residents and graduates focus on<br />

serving emergency patients to their utmost ability – anywhere and anytime. Many begin building their<br />

academic careers at HCMC, with almost one-third choosing fellowships or academic positions upon<br />

graduation. The HCMC legacy still reaches far and wide. Graduates choosing community practice join<br />

groups throughout the US. Results from our first employer survey support that HCMC graduates some of<br />

the top <strong>Em</strong>ergency Physicians in the country. We are excited to have another incredible group graduating<br />

this spring and even more excited to have had a banner recruiting year, receiving more applications to the<br />

HCMC EM programs than ever before. No doubt, the match in March, 2012 will bring yet another<br />

incredible intern class to start in June.<br />

Looking ahead, we plan to continue the move toward small group, interactive teaching sessions<br />

similar to those currently used in simulation and emergency ultrasound, rather than what has historically<br />

been exclusively classroom style didactics. This model truly complements the “hands on” approach we<br />

have always embraced at <strong>Hennepin</strong>. We hope to increase opportunities for alumni to come back and be<br />

involved in these sessions in their various areas of expertise. We want and need your support.<br />

With this, we hope you enjoy the chance to see “whatʼs new” here at <strong>Hennepin</strong>. We encourage you to visit<br />

the residency at: www.hcmc.org/education/residency/emresidency/emresprog.htm and look forward to you<br />

coming back soon.<br />

Marc Martel, MD, Residency Program Director<br />

Eric Gross, MD, Associate Program Director<br />

Danielle Hart, MD, Assistant Program Director<br />

Mary Hirschboeck, Residency Program Coordinator


The current<br />

EM residency<br />

curriculum<br />

Simulation and Innovation Education<br />

The <strong>Hennepin</strong> <strong>County</strong> <strong>Med</strong>ical <strong>Center</strong> Interdisciplinary Simulation and Education <strong>Center</strong><br />

(HCMC-ISEC) will begin to revolutionize healthcare education and training in the very near<br />

future here at HCMC. From enhancing the development of individual cognitive expertise and<br />

procedural skills, to improving teamwork and communication among the healthcare team and<br />

developing systems expertise within the institution, the utilization of this learning modality is<br />

paramount in improving medical education, patient care, patient safety and patient satisfaction.<br />

Danielle Hart, MD<br />

Simulation has become a term that encompasses many different teaching or learning<br />

modalities. Included are high-fidelity mannequins, procedural task trainers, standardized patients, and virtual reality.<br />

High-fidelity mannequins are computer operated life-sized mannequins that have pulses, respirations, and vital signs,<br />

and are able to converse and interact with the learners or trainees. Procedural task trainers have been designed to<br />

teach technical skills for a wide array of procedures and standardized patients are actors who play the role of a<br />

patient. The HCMC-ISEC will be equipped to offer all of these experiential learning modalities.<br />

We are currently nearing completion of the design phase of the ISEC, which is expected to open in 2012. It will be<br />

located just beneath the EMS classrooms, in the EMS ramp building, adjacent to the contact center on the lower<br />

level. The center will be built in 2 phases, each of which will include approximately 5,000 sq feet of educational<br />

space. The first phase, with a price tag of $2.7 million, will include 3 high fidelity simulation rooms, 3 debriefing rooms<br />

that can also be used as standardized patient rooms, one large procedural skills room, and a conference room. The<br />

funding for this project came from a variety of sources, such as the HCMC master facility plan ($1.5M), state bonding<br />

money ($820K), HRSA grant money ($188K), and discretionary capital from the Office of the <strong>Med</strong>ical Director ($200K).<br />

The state-of-the-art Interdisciplinary Simulation and Education <strong>Center</strong> (ISEC) here at HCMC will enable us to<br />

continue our longstanding commitment to excellence, both in training the nationʼs future healthcare providers, as well<br />

as providing outstanding patient care on a daily basis.<br />

Danielle Hart, MD, Director, ISEC<br />

34 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


Web based education<br />

The HCMC Department of <strong>Em</strong>ergency <strong>Med</strong>icine began publishing Thursday<br />

morning conferences online for resident and faculty use in 2005. They are<br />

published to a secure, limited access server and allow for live or on-demand<br />

viewing. This allows for more convenient continuing education despite busy<br />

schedules. The program was expanded using grant funding from the <strong>Med</strong>ica<br />

Foundation in 2007 to allow Critical Care Conference access for providers in the<br />

surrounding community and Greater Minnesota.<br />

Hqmeded.com is a HCMC Department of <strong>Em</strong>ergency <strong>Med</strong>icine website with a focus on publication of<br />

educational content, typically in video format. Much of the content is related to use of ultrasonography at<br />

the bedside, but content related to ECGs and Toxicology can also be found. Over the past year, it has<br />

received 15, 902 visits from 121 countries around the world. New content is added frequently and is<br />

generated from the clinical experience of the residents and faculty of our department.<br />

Scott Joing, MD, EM <strong>Med</strong>ia Site Manager<br />

Dr. Smithʼs ECG Blog:<br />

Online learning computers<br />

Steve Smith, MD<br />

Scott Joing, MD<br />

Join us at http://hqmeded-ecg.blogspot.com/<br />

or google “Dr. Smithʼs blog”.<br />

With the help of techno-savvy Scott Joing, Steve Smith developed a learning tool<br />

aimed at ECG interpretation and cardiac disease management. With 1,000 page<br />

views per day and 230 registered followers, Dr. Smithʼs ECG Blog is now one of<br />

the most widely read ECG blog in the world. Beginning at the end of 2008 as a<br />

replacement for Dr. K. Wangʼs “EKG of the Week,” the blog was initially a<br />

departmental and institutional educational tool for residents. It now holds 109 posts<br />

with at least one interesting and educational case per post and up to 10 ECGs per<br />

case. Unlike books, the unlimited space on the internet allows for multiple serial<br />

ECGs to illustrate the evolution of the ECG over time.<br />

Dr. Smithʼs ECG Blog was listed as the 6th best <strong>Em</strong>ergency <strong>Med</strong>icine web site by EMCrit.org<br />

(http://emcrit.org/podcasts/dirty-dozen-2010/). Scott Weingart calls it a “Ph.D. in EKG:”<br />

(http://emcrit.org/podcasts/phd-in-ekg/). It was highly reviewed and featured in EP Lab Digest<br />

(http://eplabdigest.com/articles/New-Online-Resource-ECG-Interpretation), and by Lifeinthefastlane:<br />

http://lifeinthefastlane.com/<strong>2011</strong>/01/dr-smiths-ecg-blog/. Because so many sites link to the Blog, it comes<br />

up 1st to 3rd in any Google search for “ECG blog.”<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 35


Our Fellows<br />

EMS Fellows<br />

Jeff Ho 1995<br />

John Hick 1996<br />

Cara Ellman Black 1999<br />

Ryan Fringer 2003<br />

Laura Bultman 2004<br />

Ann Lapine 2008<br />

Jennifer Bahr 2009<br />

Undersea and Hyperbaric<br />

Fellows<br />

Jill Benson 2001<br />

Bjorn Westagard (ACGME Fellow) 2009<br />

Toxicology Fellows<br />

Andrew Topliff 1999-2001<br />

Beth Bilden 1999-2001<br />

Jon Cole 2009-<strong>2011</strong><br />

Ultrasound Fellows<br />

Jenny Thacker-Johnson 2004<br />

Kim Heller 2007-2008<br />

Anne Lapine 2008<br />

Gavin Budhram 2008<br />

Rimon Bengiamin 2008<br />

Seth Strote 2010<br />

Christopher Wall 2010<br />

Chad Roline <strong>2011</strong><br />

Jamie Hess <strong>2011</strong><br />

Airway/Critical Care/Simulation<br />

Fellows<br />

Chandler Hill 2009<br />

Danielle Hart 2009<br />

Research Fellows<br />

Marc Martel 2001<br />

Scott Freiwald 2002<br />

Johanna Moore 2010-<strong>2011</strong><br />

International <strong>Em</strong>ergency <strong>Med</strong>icine<br />

Fellow<br />

Stephen Dunlop 2009-<strong>2011</strong><br />

(American Society of Tropical <strong>Med</strong>icine and Hygiene)<br />

Clinical <strong>Med</strong>icine and Critical Care<br />

Fellow<br />

Stephen Smith 1991<br />

Clinical students at HCMC Department of <strong>Em</strong>ergency <strong>Med</strong>icine<br />

2009 2010<br />

Total number of medical and PA schools<br />

sending students to HCMC ED 28 27<br />

Number of states represented 20 18<br />

International schools<br />

<strong>Med</strong>ical students<br />

1 3<br />

U of MN <strong>Med</strong>ical School 71 84<br />

Out-of-state medical schools 26 29<br />

DO schools 13 11<br />

Physician Assistants students 5 5<br />

Pharm D students 3 1<br />

TOTAL STUDENTS 118 130<br />

36 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


Students<br />

in <strong>Em</strong>ergency <strong>Med</strong>icine<br />

Both the core and advanced <strong>Em</strong>ergency <strong>Med</strong>icine rotations at HCMC are essentially four week<br />

sub-internships. Since 2005, <strong>Em</strong>ergency <strong>Med</strong>icine has been a mandatory core rotation for medical<br />

students at the University of Minnesota. Minnesota medical students participate in this core rotation at<br />

HCMC, Regions, Abbot Northwestern, Fairview, North Memorial <strong>Med</strong>ical <strong>Center</strong>, St. Johnʼs, St. Josephʼs,<br />

United, St. Maryʼs (Duluth) and St. Lukeʼs (Duluth). In addition, interested students are able to take an<br />

advanced <strong>Em</strong>ergency <strong>Med</strong>icine rotation at HCMC and Regions. Courses are also available at HCMC for<br />

medical students interested in research and in ultrasound, and at Regions for toxicology.<br />

In addition to University of Minnesota medical students, the <strong>Em</strong>ergency Department at HCMC hosts<br />

medical students and physician assistant (PA) students from across the country who are interested in<br />

emergency medicine.<br />

Along with G1and G2 residents, PAs and students are the primary medical providers (PMPs) of the<br />

emergency department (ED). They evaluate and manage patients in an assigned area in consultation with<br />

the ED supervisors (an ED attending and/or Senior Resident/Pit Boss). This includes conducting the<br />

history and physical examination, performing procedures, interpreting diagnostic tests and determining<br />

diagnoses, therapies, dispositions and follow-up plans on their patients.<br />

We pride ourselves that our students perform professionally and responsibly. Our department is<br />

committed to educating the future generation of providers, and we feel that our environment is very<br />

conducive to their success as future practitioners of medicine.<br />

Richard Gray, MD<br />

<strong>Med</strong>ical Student Course Director.<br />

12:00 pm


Advancing the Science<br />

of <strong>Em</strong>ergency <strong>Med</strong>icine<br />

The HCMC Department of <strong>Em</strong>ergency <strong>Med</strong>icine has a long tradition of scientific inquiry and exploration.<br />

From bench work to the bedside, the research we perform has the common goal of advancing the care of<br />

emergency patients. Each year, and at any given time, there are at least 20 active clinical projects being<br />

performed by our faculty and residents. These studies derive from ideas generated during our daily<br />

emergency practice. We try to address the “big” questions, such as the best shock management strategy,<br />

earlier diagnosis and treatment of acute cardiac ischemia, or effective interventions for reducing<br />

secondary injuries in traumatic brain injury. We also take on bread and butter ED issues, such as the best<br />

methods of pain control, the use of emergency ultrasound to guide procedures, or the most effective<br />

methods of procedural sedation. The results of our studies are illustrated in our many publications, grants<br />

received, and scientific presentations given, which are listed later in this report. Several of our faculty<br />

have developed research niches, and are nationally and internationally recognized for their expertise.<br />

Many serve as peer reviewers for prestigious journals. Some are members of federal research review<br />

committees and others develop the evidence used in evidence-based ED practice.<br />

A strong research program also reaps other rewards. By the time our residents complete their training<br />

program they have been exposed to many aspects of research, either by direct initiation of or participation<br />

in a project, or by exposure to research concepts in didactic presentations and journal clubs. They become<br />

excellent critical readers and understand how and when to apply research findings to their patients.<br />

The ability to perform so much research in the setting of a very busy clinical practice is a testimony to our<br />

departmentʻs commitment to advancing the science of our specialty. We appreciate the support our<br />

clinical colleagues have given to our research efforts and the Research Associate program, which has<br />

been key to our successful research endeavors.<br />

Jim Miner, MD<br />

Research Director, Department of <strong>Em</strong>ergency <strong>Med</strong>icine<br />

Michelle Biros,MD, MS<br />

Associate Research Director, Department of <strong>Em</strong>ergency <strong>Med</strong>icine<br />

Research Associates<br />

learning monitoring<br />

procedures


The Research Associate Program<br />

In the Fall of 2000, 29 undergraduates and seven medical students arrived at <strong>Hennepin</strong> <strong>County</strong> <strong>Med</strong>ical<br />

<strong>Center</strong>ʼs (HCMC) <strong>Em</strong>ergency Department to begin the Research Associate (RA) Program. The program<br />

was developed by Drs. Jim Miner and Michelle Biros to promote clinical research in our busy <strong>Em</strong>ergency<br />

Department. The students came from many different backgrounds and academic institutions, but shared<br />

one thing in common – an interest in medicine and improving patient care through research. Joseph<br />

Mayerle, a current resident who participated in the program starting in 2004 when he was an<br />

undergraduate at Boston College, described the program as a “one-of-kind thing. I really, really looked<br />

around the country for opportunities, but there is nothing else like this and I am so glad to be a part of this<br />

program.” Today, Mayerle is in his second year of residency in <strong>Em</strong>ergency <strong>Med</strong>icine at HCMC and will be<br />

one of our Chief Residents next year.<br />

Since 2000, the RA program has grown to 70 volunteers, consisting of medical students and<br />

undergraduate students, who volunteer in four to eight hour shifts to work on clinical studies in the ED. In<br />

addition, Research Associates are trained in subjectsʼ rights and human subjects research prior to<br />

involvement in clinical research. RAs are responsible for approaching patients to tell them about the<br />

study, gain consent, and collect data. Scheduling and communication with the volunteers in the HCMC<br />

Research Associate Program is done through the program website at www.hcmced.org. Many of the RAs<br />

go on to medical school, PA school, or nursing school. Fifteen medical students starting in the University<br />

of Minnesota <strong>Med</strong>ical School Class of 2014 had been part of the RA program. Johanna Moore, a recent<br />

graduate from HCMCʼs <strong>Em</strong>ergency <strong>Med</strong>icine Residency Program, and our current Research Fellow, was<br />

an RA during all four years of medical school.<br />

The RA program is very competitive, with about 100 applicants a semester. The RAs have the opportunity<br />

to interact one-on-one with patients, shadow doctors, and attend Stab conference and research lectures.<br />

The research associates meet with Dr. Miner to discuss ongoing research projects and for lectures on<br />

general topics in clinical research. The studies that the RAs are involved in range from looking at ways to<br />

manage pain to investigating new treatments for shock. The program has become an important part of both<br />

our Departmentʼs success in research and in exposing future doctors to <strong>Em</strong>ergency <strong>Med</strong>icine Research.<br />

Becca Nelson<br />

RA Coordinator<br />

Research<br />

Associates,<br />

Summer 2010<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 39


RA graduates speak<br />

I had the good fortune to stumble into the Research Associate (RA) program my first year of medical school. As a<br />

student interested in emergency medicine I thought a summer of research would be a good opportunity to work in the<br />

emergency department and find out what it's really about, while working on research projects at the same time.<br />

Little did I know the decision to work on research for a summer would profoundly change my life.<br />

I stuck with the program, collecting data and becoming more interested about the studies and their purpose, as well<br />

as loving the exposure to the ED. Previously I had done chemistry bench research but was frustrated about its lack of<br />

immediate applications. To this day, I find clinical research fascinating, with the ability to answer practical questions<br />

with results that can be put into practice right away. Dr. Miner encouraged me as a student to apply for a medical<br />

student research grant. He was enthusiastic, I was excited but dubious. We sent off the application and our project<br />

was ultimately funded.<br />

By now, it was official: emergency medicine and emergency medicine clinical research were my career choices. I<br />

contemplated other specialties and other residency programs, but didnʼt want to (and luckily didnʼt have to) leave<br />

HCMC, completing my emergency medicine residency in 2010.<br />

Today, I am in my first year of a two year clinical research fellowship in emergency medicine at HCMC. As part of the<br />

fellowship, I work closely with Drs. Miner, Biros and the RAs on developing and ongoing clinical studies in the ED in<br />

addition to working shifts in the ED. I am also back in the classroom, currently enrolled in the Masters in Clinical<br />

Research program at the University of Minnesota, with the goal of becoming an independent emergency medicine<br />

researcher when I graduate.<br />

Johanna Moore. MD<br />

Class of 2010<br />

EM Research Fellow 2010- 2012.<br />

I have been fortunate to both participate in and benefit from the RA program over my five years of graduate medical<br />

training at HCMC. During my MPH year after medical school graduation and before residency, I trained in as an RA<br />

and learned about informed consent, pain and sedation research, and survey methodology on the "front lines" in the<br />

ED. Later that year, I led my own study on urban injury epidemiology that became my MPH thesis. I watched the RA<br />

program grow bigger and bigger during my combined residency in EM and Internal <strong>Med</strong>icine. Over the past two<br />

years, the enthusiasm and attention to detail of the current group of RA volunteers has sustained my most recent<br />

project. We were able to screen nearly 3,000 ED patients for HIV with a rapid assay, finding 9 new infections and<br />

getting them linked into care, and paving the way to have rapid HIV testing available 24/7 in our ED.<br />

The RA program is an invaluable resource to our researchers, our academic department, and our hospital. It makes<br />

population-based studies feasible in a busy ED, generating novel data on the prevalence of pain, hunger, literacy, and<br />

other important socioeconomic factors that contribute to our patients' health. Equally important to me and many<br />

others who progressed thru the RA ranks has been the mentorship of our senior research faculty, especially Jim<br />

Miner and Michelle Biros. They are role models in both the research and clinical arenas, and have helped shape my<br />

career path towards academic emergency and critical care medicine. Finally, the peer collaboration over the years<br />

with past and present RA leaders including Dan Hubbard, Erik Rockswold, Roma Patel, and Owen Hanley has been<br />

productive, and I now count them as both friends and colleagues.<br />

Matt Prekker, MD<br />

EM/IM, Class of <strong>2011</strong><br />

40 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


Scholarly Achievements<br />

Anthony G. Skedros, MD Memorial<br />

Award<br />

Awarded by the first and second year <strong>Em</strong>ergency<br />

<strong>Med</strong>icine residents to a graduating <strong>Em</strong>ergency<br />

<strong>Med</strong>icine resident who exemplified the highest<br />

personal and professional standards, provided and<br />

outstanding role model, and demonstrated<br />

outstanding teaching skills.<br />

1997 Kevin Pogreba, MD<br />

1998 Curtis Lee, MD<br />

1999 Jeff Rodgerson, MD<br />

2000 Cory Vogel, MD<br />

2001 Laura Shrag, MD<br />

2002 Alan Moore, MD<br />

2003 Travis Heining, MD<br />

2004 Chad Torstenson, MD<br />

2005 Darren Huber, MD<br />

2006 Amanda Baker, MD<br />

2007 Nathan Unkefer, MD<br />

2008 Theodore Ruzanic, MD<br />

2009 Paul Gramenz, MD<br />

2010 Chad Roline, MD<br />

Faculty Teaching Award<br />

This award was established by the <strong>Em</strong>ergency<br />

<strong>Med</strong>icine class of 1991 to honor the <strong>Em</strong>ergency<br />

<strong>Med</strong>icine faculty who demonstrates outstanding<br />

commitment to the education of resident and the<br />

promotion of <strong>Em</strong>ergency <strong>Med</strong>icine as a specialty.<br />

1991 David Plummer<br />

1992 Tim Crimmins<br />

1993 Steve Smith<br />

1994 Michelle Biros<br />

1995 Doug Brunette<br />

1996 Al Tsai<br />

1997 Richard Gray<br />

1998 Steve Smith<br />

1999 Bill Heegaard<br />

2000 Rob Reardon<br />

2001 Steve Sterner<br />

2002 Jeff Ho<br />

2003 Jim Miner<br />

2004 Marc Martel<br />

2005 John McGill<br />

2006 David Plummer<br />

2007 Steve Smith<br />

2008 Doug Brunette<br />

2009 Robert Collier<br />

2010 John Hick<br />

Anthony Skedros, MD (1964-1997), class of 1996<br />

James G. Andersen, MD Award<br />

Awarded to the resident demonstrating<br />

exceptional leadership and administrative skills<br />

in <strong>Em</strong>ergency <strong>Med</strong>icine.<br />

1989 Gregory F. Bachhuber, MD<br />

1990 Thomas R. Stewart, MD<br />

1991 Geoffrey A. Geer, MD<br />

1992 Lisa M. Lofy, MD<br />

1993 Carol Arnason, MD<br />

1994 Greg Pippert, MD<br />

1995 Jeffrey Ho, MD<br />

1996 Clare Sercombe, MD<br />

1997 Ken Buccino, MD<br />

1998 Curtis Lee, MD<br />

1999 Christine Kletti, MD<br />

2000 Daniel OʼLaughlin, MD<br />

2001 Carrie Tibbles, MD<br />

2002 Susan Krieg, MD<br />

2003 Ryan Fringer, MD<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 41


Scholarly Achievements<br />

<strong>Em</strong>ergency Nurse of the Year Award<br />

This award is selected<br />

by the graduating<br />

<strong>Em</strong>ergency <strong>Med</strong>icine<br />

residency class to honor<br />

the ED nurse that has<br />

provided inspiration and<br />

exceptional assistance in<br />

their clinical growth during<br />

their residency years.<br />

1996 Florence Johnson<br />

1997 Paul Finney<br />

1998 Diana Bly-Gale<br />

1999 Dan Levie<br />

2000 Sharon Roy<br />

2001 Steve Pederson<br />

2002 Kristi Pender<br />

2003 Ian Johnson<br />

2004 Jean Tersteeg<br />

2005 Corey Zeig<br />

2006 Mark Allard<br />

2007 Florence Johnson<br />

2008 John Conrad<br />

2009 Paul Finney<br />

2010 Janine Landes<br />

Magnet Award Illegetimi non Carborundum<br />

Given by the emergency<br />

medicine residents to<br />

identify the emergency<br />

department member who<br />

seems to have had an<br />

especially tough year.<br />

Dave Plummer<br />

Lifetime Member<br />

1988 Mark Erlandson<br />

1989 Steve Sterner<br />

1990 Laurie Drill Mellum<br />

1991 Ernie Ruiz<br />

1992 Joe Clinton<br />

1993 Steve Sterner<br />

1994 Willie Braziel<br />

1995 Bill Heegaard<br />

1996 Beth Bilden<br />

1997 Liz Bonin<br />

1998 Michelle Biros<br />

1999 Peter Chase<br />

2000 Matt Barrett<br />

2001 Tina Eatmon<br />

42 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010<br />

2002 Peter Craig<br />

2003 Chris Johnson<br />

2004 Andy Bachmann<br />

2005 FMD<br />

2006 Arleigh Trainor<br />

2007 Doug Brunette/EPIC<br />

2008 Todd Gengerke<br />

2009 Mary Hirschboeck<br />

2010 Cher Adkinson<br />

Ernest Ruiz Award<br />

Established in 2004<br />

and given annually to a<br />

graduating <strong>Em</strong>ergency<br />

<strong>Med</strong>icine resident who<br />

has made significant<br />

contributions to the<br />

Department of <strong>Em</strong>ergency<br />

<strong>Med</strong>icine and the Residency<br />

Program. The award is<br />

named after Ernest Ruiz,<br />

M.D., Chief of Service<br />

from 1972-1992, whose<br />

contributions to the<br />

department exemplify the<br />

meaning of this honor.<br />

2004 Kristin Sufka<br />

2005 Scott Joing<br />

2006 Chris Becker<br />

2007 Scott Davarn<br />

2008 Danielle Hart<br />

2009 Jon Cole<br />

2010 Heidi Walz<br />

North Memorial <strong>Med</strong>ical <strong>Center</strong><br />

Faculty Teaching Award<br />

Awarded by the graduating residents to the North Memorial<br />

<strong>Med</strong>ical <strong>Center</strong> emergency medicine faculty<br />

member who demonstrates outstanding commitment<br />

to the education of the HCMC residents.<br />

2008 Laura Schrag<br />

2009 Ann Sterzinger<br />

2010 Adina Connelly


Other Notable Achievements 2009-2010<br />

Michelle Biros, MD<br />

Elected to the Institute of <strong>Med</strong>icine of the National<br />

Academie, 2009<br />

SAEM Leadership Award 2009<br />

Top Doctor for Women Award from<br />

Minnesota Monthly Magazine, 2009, 2010<br />

Jon Cole, MD<br />

Boarded in <strong>Em</strong>ergency <strong>Med</strong>icine, 2010<br />

Boarded in Toxicology, 2010<br />

Stephen Dunlop, MD (Class of 2009)<br />

Boarded in Tropical <strong>Med</strong>icine, 2010<br />

Boarded in <strong>Em</strong>ergency <strong>Med</strong>icine, 2010<br />

Danielle Hart, MD<br />

Boarded in <strong>Em</strong>ergency <strong>Med</strong>icine, 2009<br />

Bill Heegaard, MD<br />

Selected National Association of Public Hospitals<br />

Fellowship, 2009<br />

Minnesota Monthly “Top Doctors for Women”<br />

Recognition for 2009<br />

John Hick, MD<br />

Minneapolis / St. Paul Magazine ʻTop Docʼ<br />

Recognition, 2009<br />

<strong>Med</strong>ica / Twin Cities Business “Physician Health Care<br />

Hero”, 2009<br />

Radiation Injury Treatment Network Certificate of<br />

Appreciation, April, 2009<br />

MN Dept. of Health Certificate of Appreciation – Red<br />

River Floods, June, 2009<br />

Jeff Ho, MD<br />

IACP/Sprint Law<br />

Enforcement Research<br />

Award, August, 2010<br />

International Association<br />

of Chiefs of Police, Orlando,<br />

FL. *Awarded for project<br />

leadership of research of<br />

international importance<br />

to the law enforcement<br />

profession.<br />

Pistol Expert Award, November, 2007-2010<br />

Meeker <strong>County</strong> Sheriffʼs Office, Litchfield, Minnesota<br />

*Awarded for mastery and marksmanship during<br />

firearm qualification.<br />

Kjell Lindgren, MD (Class of 2005)<br />

Selected as a member of the 20th NASA Astronaut<br />

Class, 2009<br />

Louis Ling, MD<br />

University of Minnesota Distinguished Alumni Award,<br />

2009<br />

Travis Olives, MD (Class of 2014)<br />

Spadafora Award, 2010<br />

Matt Prekker, MD (Class of <strong>2011</strong>)<br />

Year 4 <strong>Med</strong>ical Resident Distinguished Teaching<br />

Award from the University of Minnesota <strong>Med</strong>ical<br />

School, 2010-<strong>2011</strong><br />

Steve Smith, MD<br />

E M Critʼs Best EM Web Sites of 2010<br />

(Dr. Smithʼs ECG Blog, #6)<br />

Top Consultant, Annals of <strong>Em</strong>ergency <strong>Med</strong>icine, 2010<br />

Bjorn Westgard, MD (Class of 2008)<br />

Boarded in Undersea and Hyperbaric <strong>Med</strong>icine, 2009<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 43


External Grant Awards 2009-2010<br />

Project Title: Clinical Evaluation of High Sensitivity Troponin T Assay in Diagnostic and Risk Stratification in<br />

Patients with Symptoms of Acute Coronary Syndromes.<br />

Principal Investigator: Apple F<br />

Co-Investigator: Smith S<br />

Funding Source: Roche<br />

Project Title: Comparison of Siemens Immulite and ADVIA Centaur D Dimer Immunoassays with VIDAS<br />

D-Dimer Exclusion Assay<br />

Principal Investigator: Apple F<br />

Co-Investigator: Smith S<br />

Funding Source: Siemens<br />

Project Title: Finding ACS with Serial Troponin Testing for Rapid Assessment of Cardiac Ischemic Symptoms<br />

(FAST-TRAC)<br />

Principal Investigator: Apple F<br />

Co-Investigator: Smith S<br />

Funding Source: Nanosphere, Inc.<br />

Project Title: Neurological <strong>Em</strong>ergencies Treatment Trials (NETT) Network<br />

Principal Investigator: Biros M<br />

Co-Investigators: Anderson D<br />

Funding Source: National Institute of Neurological Disorders and Stroke<br />

Project Title: Community Attitudes about <strong>Em</strong>ergency Exception from Informed Consent (EFIC) and the<br />

ProTECT Head Injury Research Trial<br />

Principal Investigator: Biros M<br />

Co-Investigators: Miller K, Sargent C<br />

Funding: National Institute of Neurological Disorders and Stroke<br />

Project Title: Rapid Anti-seizure <strong>Med</strong>ication Prior to Arrival<br />

Co-Principal Investigators: Biros M, Mahoney B<br />

Funding Source: National Institute of Neurological Disorders and Stroke<br />

Project Title: Albumin in Acute Ischemic Stroke<br />

Principal Investigator: Ezzeddine M<br />

Co-Investigators: Biros M, Heegaard W<br />

Funding Source: National Institute of Neurological Disorders and Stroke<br />

Project Title: Progesterone for the treatment of TBI<br />

Principal Investigator: Rockswold<br />

Co-Investigator: Biros M<br />

Funding Source: National Institute of Neurological Disorders and Stroke<br />

Project Title: CRISIS-1 Study, Cyanide's Role in Smoke Inhalation Study<br />

Principal Investigator: Gray R<br />

Funding: <strong>Center</strong>s for Disease Control<br />

Project Title: <strong>Med</strong>iciNova IV beta 2 agonist study in acute asthma<br />

Principal Investigator: Gray R<br />

Co-Investigators: Miner J, Smith S, Plummer D, Cole J, Biros M, Ho J, Heegaard W<br />

Funding: <strong>Med</strong>iciNova<br />

Project Title: Multi-center, investigator-blinded, randomized, comparative study to evaluate the efficacy and<br />

safety of oral NXL-103 versus oral linezolid in the treatment of acute bacterial skin and skin structure<br />

infections<br />

Principal Investigator: Gross E<br />

Funding: Novexel, Inc.<br />

44 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


Project Title: Prevalence and Risk Factors for Community Associated MRSA Pneumonia<br />

Principal Investigator: Gross E<br />

Co-Investigator: Clinton J<br />

Funding Source: <strong>Center</strong>s for Disease Control (CDC) <strong>Em</strong>ergency ID Net<br />

Project Title: Micropathology of Blood Cultures<br />

Principal Investigator: Gross E<br />

Co-Investigator: Clinton J<br />

Funding Source: <strong>Center</strong>s for Disease Control (CDC) <strong>Em</strong>ergency ID Net<br />

Project Title: Utilization of <strong>Em</strong>ergency Departments for Possible Exposures to Biological Weapons<br />

Principal Investigator: Gross E<br />

Co-Investigators: Clinton J, Joni Kopitzke, R.N.<br />

Funding Source: <strong>Center</strong>s for Disease Control (CDC) <strong>Em</strong>ergency ID Net<br />

Project Title: Bacteriology of Acute Cutaneous Cellulitis with Drainage Using Conventional Culture and<br />

Molecular Identification of Skin Biopsy Specimens (MSRA Cellulitis Etiology and Diagnosis)<br />

Principal Investigator: Gross E<br />

Co-Investigator: Joni Kopitzke, R.N.<br />

Funding: <strong>Center</strong>s for Disease Control and Prevention<br />

Project Title: Use of Prehospital Focused Abdominal Sonography (PFAST) and Aortic Ultrasound in Trauma<br />

and Aortic Aneurysms<br />

Principal Investigator: Heegaard W<br />

Co-Investigator: Hildebrandt D<br />

Funding: Sonosite<br />

Project Title: Developing a National Standard for HEMS Quality Assurance Thresholds<br />

Co-Principal Investigators: Heegaard W, Frascone R<br />

Funding: LifeLink III and FARE Grant<br />

Project Title: Use of the King Airway in the Helicopter<br />

Co-Principal Investigators: Heegaard W, Frascone R<br />

Funding: FARE Grant<br />

Project Title: Ability to Handcuff Subjects During TASER Device Application<br />

Principal Investigator: Ho J<br />

Co-Investigators: Miner J, Dawes D<br />

Funding: TASER International, Inc.<br />

Project Title: Passive Observation of Human Effects of the TASER Xtended Range Electronic Projectile During<br />

Civil Unrest<br />

Principal Investigator: Ho J<br />

Co-Investigator: Miner J<br />

Funding Source: TASER International, Inc.<br />

Project Title: Descriptors of TASER Device Application Gathered from Training Human Volunteers<br />

Principal Investigator: Ho J<br />

Co-Investigator: Miner J<br />

Funding Source: TASER International, Inc.<br />

Project Title: Tactical <strong>Em</strong>ergency <strong>Med</strong>ical Peace Officer (TEMPO) Course<br />

Principal Investigator: Ho J<br />

Co-Investigator: Snyder R<br />

Funding Source: <strong>Hennepin</strong> Health Foundation<br />

Project Title: Impedance Threshold Valve for Improving Standard CPR<br />

Co-Principal Investigators: Mahoney B, Lurie K<br />

Funding: National Heart, Lung, and Blood Institute<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 45


Project Title: ResQ Trial<br />

Co-Principal Investigators: Mahoney B, Frascone R<br />

Funding: Food and Drug Administration Investigational Device Exemption<br />

Project Title: A randomized, double-blind, Placebo and Oxycodone Controlled Study of Tapentadol HCL for<br />

the Treatment of Acute Pain Caused by Vertebral Compression Fractures Associated with Osteoporosis<br />

Principal Investigator: Miner J<br />

Co-Investigators; Gray R, Martel M<br />

Funding Source: Ortho-McNeil<br />

Project Title: Observation of Field Deployment Effects of a Projectile Electronic Control Device on<br />

Rioting Subjects<br />

Principal Investigator: Miner J<br />

Co-Investigator: Ho J<br />

Funding Source: TASER International, Inc.<br />

Project Title: Comparison of Circuit Type, Probe Position, and Duration of TASER Exposure<br />

Principal Investigator: Miner J<br />

Co-Investigator: Ho J<br />

Funding Source: TASER International, Inc.<br />

Project Title: Factors Associated with Sudden Law Enforcement Custodial Deaths<br />

Principal Investigator: Miner J<br />

Co-Investigator: Ho J<br />

Funding: TASER International, Inc.<br />

Project Title: Use of Axon Technology in the <strong>Em</strong>ergency Department<br />

Principal Investigator: Ho J<br />

Co-Investigators: Heegaard W, Miner J, Clinton J, Hart D<br />

Funding: TASER International, Inc.<br />

Project Title: Assessing the Cardiac Effects of TASER Conducted Electrical Weapon Device Application in the<br />

Presence of Methamphetamine Intoxication<br />

Principal Investigator: Miner J<br />

Co-Investigators: Ho J, Cole J<br />

Funding Source: Taser International, Inc.<br />

Project Title: Comparison of Circuit Type, Probe Position, and Duration of TASER Exposure<br />

Principal Investigator: Miner J<br />

Co-Investigator: Ho J<br />

Funding Source: Taser International, Inc.<br />

Project Title: Evaluation of Stress Markers in Humans Undergoing Law Enforcement Officer Training<br />

Exercises or Intoxication<br />

Principal Investigator: Miner J<br />

Co-Investigator: Ho J<br />

Funding Source: TASER International, Inc.<br />

Project Title: Assessing the Physiologic and Cardiac Effects of TASER 40mm Circuit<br />

Principal Investigator: Miner J<br />

Co-Investigator: Ho J<br />

Funding Source: Department of Defense<br />

Project Title: Cardiac Safety and Muscle Stimulation Effects of the TASER 40mm Projectile Circuit<br />

Principal Investigator: Miner J<br />

Funding: US Department of Defense<br />

Project Title: Time Series Analysis of Critical Procedures in the <strong>Em</strong>ergency Department<br />

Principal Investigator: Miner J<br />

Co-Investigator: Biros M<br />

Funding Source: Minneapolis <strong>Med</strong>ical Research Foundation<br />

46 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


Project Title: Time Series Analysis of Critical Procedures in the <strong>Em</strong>ergency Department<br />

Principal Investigator: Miner J<br />

Co-Investigator: Biros M<br />

Funding Source: Minneapolis <strong>Med</strong>ical Research Foundation<br />

Project Title: Prospective Evaluation of the fluID Rapid Influenza Test<br />

Principal Investigator: Miner J<br />

Funding Source: Meso Scale`<br />

Project Title: The Assessment of Pain Management Practice and the Prevalence, Risk Factors, and the Natural<br />

History of Substance Use and Trauma in the <strong>Em</strong>ergency Department<br />

Principal Investigator: Miner J<br />

Co-Investigator: Biros M<br />

Funding Source: Minneapolis <strong>Med</strong>ical Research Foundation<br />

Project Title: Biomarkers Associated with Psychosocial Stress and Pain<br />

Principal Investigator: Miner J<br />

Co-Investigator: Moore J<br />

Funding Source: Minneapolis <strong>Med</strong>ical Research Foundation currently, NIH grant in revision 2<br />

Project Title: Beriplex, a Prothrombin Complex Concentrate, for the Reversal of Coumadin Anticoagulation in<br />

Bleeding Patients<br />

Principal Investigator: Miner J<br />

Co-Investigators: Clinton J, Reardon R, Smith S<br />

Funding Source: CSL Behring<br />

Project Title: An Open Label, randomized multicenter Phase IIIb Study to assess the efficacy, safety and<br />

tolerance of Beriplex P/N compared with plasma for rapid reversal of coagulopathy induced by coumarin<br />

derivatives in subjects with acute major bleeding<br />

Principal Investigator: Miner J<br />

Co-Investigators: Gorlin J, Richardson C<br />

Funding Source: CSL Behring<br />

Project Title: EKG Changes in Acute Coronary Syndromes<br />

Principal Investigator: Miner J, Smith S<br />

Funding: NewCardio<br />

Project Title: A Two-Arm Study Comparing the Analgesic Efficacy and Safety of Acetram Contramid BID<br />

versus Placebo for the Treatment of Acute Low Back Pain<br />

Principal Investigator: Miner J<br />

Co-Investigator: Gorlin J<br />

Funding: CSL Behring GMBH<br />

Project Title: Reversal of Anticoagulation of Patients on Coumadin with GI Bleeding<br />

Principal Investigators: Miner J, Gorlin J<br />

Funding: HemCom<br />

Project Title: Capnogram as a Measure of Perfusion in Patients with Hypotension<br />

Principal Investigator: Miner J<br />

Co-Investigators: Moore J, Mayerle J<br />

Funding Source: <strong>Em</strong>ergency <strong>Med</strong>icine Foundation<br />

Project Title: Capnogram as a Measure of Hypoventilation During Procedural Sedation<br />

Principal Investigator: Miner J<br />

Funding Source: Physio-Control<br />

Project Title: RCT of Tissue Oxygenation Monitoring During the Resuscitation of Shock in the ED<br />

Principal Investigator: Miner J<br />

Co-investigators: Clinton J, Reardon R, Smith S, Moore J<br />

Funding Source: Hutchinson Technology<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 47


Project Title: Near Infrared Spectroscopy as a Measure of Perfusion and Undifferentiated Shock<br />

Principal Investigator: Miner J<br />

Funding: Hutchinson Technology<br />

Project Title: StO2 Monitoring of Patients Presenting to the <strong>Em</strong>ergency Department Triage<br />

Principal Investigator: Miner J<br />

Funding Source: Hutchinson Technology<br />

Project Title: The Effect of Tissue Perfusion Monitoring on Patients Undergoing Treatment for Shock<br />

Principal Investigator: Miner J<br />

Co-Investigators: Hayden L, Smith S, Clinton J, Biros M<br />

Funding Source: Hutchison Technology<br />

Project Title: Safety of Implantable Neuro-Stimulator in Patients Undergoing Treatment for Severe Asthma<br />

Principal Investigator: Miner J<br />

Co-Investigators: Gray R, Smith S, Reardon R<br />

Funding Source: ElectroCore<br />

Project Title: Standard Treatment Protocol for the Relief of Shortness of Breath Associated with an Acute<br />

Exacerbation of Chronic Obstructive Pulmonary Disease<br />

Principal Investigator: Miner J<br />

Funding: ElectroCore<br />

Project Title: Standard of Care Therapy for COPD in the ED<br />

Principal Investigator: Miner J<br />

Funding: ElectroCore<br />

Project Title: ED Patient Rapid HIV Testing Practices<br />

Principal Investigator: Prekker M<br />

Funding: <strong>Center</strong>s for Disease Control<br />

Project Title: The Assessment of Endotracheal Tube Placement Using Ultrasound<br />

Principal Investigator: Reardon R<br />

Co-Investigator: Miner J<br />

Funding Source: Plisiatek<br />

Project Title: Patient and Physician Satisfaction and Impressions of Workflow Efficiency of Wall-Mounted<br />

Ultrasound Machines in Pelvic Exam Rooms of a Busy <strong>Em</strong>ergency Department<br />

Principal Investigator: Reardon R<br />

Co-Investigators: Miner J, Strote S, Wall C, Caroon L<br />

Funding: Sonosite<br />

Project Title: Comparison of the P21/Cardiac and C60/Abdominal Probes for Image Quality in Focused<br />

Assessment with Sonography in Trauma<br />

Principal Investigator: Reardon R<br />

Co-Investigators: Miner J, Strote S, Wall C, Moore J<br />

Funding: Sonosite<br />

Project Title: Comparison of the Sonosite P21 Probe Settings for Image Quality in the Focused Assessment<br />

with Sonography in Trauma Scan<br />

Principal Investigator: Reardon R<br />

Co-Investigators: Miner J, Strote S, Wall C, Collins A, Caroon L<br />

Funding: Sonosite<br />

Project Title: Use of Ultrasound in HEMS for Detection of Pneumothorax<br />

Principal Investigator: Roline C<br />

Co-Investigators: Heegaard W, Frascone R<br />

Funding: Sonosite<br />

48 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


Project Title: Evaluation of an Inspiratory Impedance Threshold Device (ITD) in the <strong>Em</strong>ergency Department for<br />

the Treatment of Hypotension<br />

Principal Investigator: Smith S<br />

Funding: US Department of Defense<br />

Project Title: Electronic Asthma Action Plan<br />

Principal Investigator: Smith S<br />

Funding: Agency for Health Research and Quality<br />

Project Title: A Phase 3b, Randomized, Double-Blind, Placebo-Controlled Multi-<strong>Center</strong> Study to Assess the<br />

Safety and Efficacy of Conivaptan in Symptomatic Acute Decompensated Heart Failure (ADHF).<br />

Co-Principal Investigators: Smith S, Goldsmith S<br />

Funding Source: Astellas<br />

Project Title: A multi-center, randomized, double-blind, parallel group, phase 2b study assessing the safety<br />

and efficacy of early dosing of intravenous CD-NP versus placebo in the treatment of subjects with acute<br />

decompensated heart failure (CONDITION HF)<br />

Co-Principal Investigators: Smith S, Goldsmith S<br />

Funding Source: Niles<br />

Project Title: Combat Casualty Training Consortium<br />

Principal Investigator: UMN Simportal<br />

Co-Investigators: Clinton J, Biros M<br />

Funding: US Department of Defense<br />

Project Title: The Safety-Net Role of the <strong>Em</strong>ergency Department in the Care of the Homeless and<br />

Disadvantaged: Determining Factors Associated with ED Use at the Department, <strong>County</strong>, and State Levels<br />

Principal Investigator: Westgard B<br />

Co-Investigators: Biros M, Miner J<br />

Funding: <strong>Em</strong>ergency <strong>Med</strong>icine Foundation Research Fellowship<br />

Project Title: Minnesota <strong>Em</strong>ergency Research for Children Sedation Study<br />

Principal Investigator: Miner J<br />

Co-Investigators: University of Minnesota and Minneapolis Childrenʼs Hospital<br />

Funding: Various sources<br />

Project Title: Minnesota <strong>Em</strong>ergency Research for Children Appendicitis Study<br />

Principal Investigator: Miner J<br />

Co-Investigators: University of Minnesota and Minneapolis Childrenʼs Hospital<br />

Funding: Various sources


HCMC Department of <strong>Em</strong>ergency <strong>Med</strong>icine 2009-2010<br />

Publications | Peer reviewed<br />

Apple FS, Smith SW, Pearce LA, Murakami MM. Assessment of the Multiple-Biomarker Approach for Diagnosis of<br />

Myocardial Infarction in Patients Presenting with Symptoms Suggestive of Acute Coronary Syndrome. Clinical<br />

Chemistry January 2009; 55(1):93-100.<br />

Apple FS, Pearce LA, Smith SW, Kaczmarek JM, Murakami MM. Role of monitoring changes in sensitive cardiac<br />

troponin I assay results for early diagnosis of myocardial infarction and prediction of risk of adverse events. Clinical<br />

Chemistry 2009; 55 (5): 930-937.<br />

Bahr J, Lapine A, Ho J. The utility of point-of-care carbon monoximetry in fireground emergency medical services<br />

rehabilitation operations. Prehosp <strong>Em</strong>erg Care, 2010;14 (Suppl 1): 98.<br />

Balls A, LoVecchio F, Stapczynski J, Gross EA, et al. CLEAR: Central Line <strong>Em</strong>ergency Access Registry: The CLEAR<br />

project protocol methods paper. Am J <strong>Em</strong>erg <strong>Med</strong>.2009;27(1):119-122. (Correspondence)<br />

Balls A, LoVecchio F, Kroeger A, Stapczynski JS, Mulrow M, Drachman D For the CLEAR Investigators (Gross EA) .<br />

Ultrasound guidance for central venous catheter placement: Results from the Central Line <strong>Em</strong>ergency Access<br />

Registry Database. American Journal of <strong>Em</strong>ergency <strong>Med</strong>icine. 2010; 28: 561-567<br />

Biros M, Mann J, Hanson R, Cen Y. Unsuspected or Unacknowledged Depressive Symptoms in Young Adult ED<br />

Patients. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. April 2009; 16 (4): 288-294<br />

Biros MH, Baren JM. Commentary. The Ethics of Observation. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. September 2009; 16<br />

(9): 908-910.<br />

Biros M, Sargent C, Miller K. Community Attitudes towards <strong>Em</strong>ergency Research and Exception from Informed<br />

Consent. Resuscitation 2009; 80: 1382-1387.<br />

Biros M. The People Speak: Community Consultation in <strong>Em</strong>ergency Research. Annals of <strong>Em</strong>ergency <strong>Med</strong>icine.<br />

2010; DOI: 10.1016/j.annemergmed.2010.08.028.<br />

Biros MH, McNeil MA, Ankel F, Gordon B, Lindgren KN, Joing S. Interviews with Leaders in <strong>Em</strong>ergency <strong>Med</strong>icine.<br />

Academic <strong>Em</strong>ergency <strong>Med</strong>icine. 2010; 17 (9): e87. DOI: 10.111/j1553-2712.2010.00822<br />

Brunette DD, Roline C. Heterotopic pregnancy resulting from in vitro fertilization. The American Journal of<br />

<strong>Em</strong>ergency <strong>Med</strong>icine. 2010; [epub ahead of print] DOI: 10.1016/j.ajem.2010.07.028<br />

Chase PB, Hansen KL, Rothers J, Biros MH, Cartwright CP. Nucleic-acid amplification testing of urine vs. patient<br />

complaint-driven evaluation. Journal of <strong>Em</strong>ergency <strong>Med</strong>icine. 2010; 38 (5):572-577.<br />

Christian MD, Joynt GM, Hick JL, Colvin J, Danis M, Sprung CL. Chapter 7. Critical care triage. Intensive Care<br />

<strong>Med</strong>icine. 2010; 36 (Suppl 1): S55-S64.<br />

Cole JB, Sattiraju S, Bilden EF, Asinger RW, Bertog SC. Isolated Tramadol Overdose Associated with Brugada ECG<br />

Pattern. Pacing and Clinical Electrophysiology. 2010; [epub ahead of print] DOI: 10.1111/j.1540-8159.2010.02924.x<br />

Dawes D, Ho J. Letter to the Editor, “Fortuitous therapeutic effect of TASER shock” misleading (On Richards<br />

#2008-267). Ann <strong>Em</strong>erg <strong>Med</strong>, 2009;53:286-287.<br />

Dawes D, Ho J, Miner J. The neuroendocrine effects of the TASER X26: A brief report. Forensic Sci Int,<br />

2009;183:14-19.<br />

50 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


Dawes D, Ho J, Reardon R, Miner J. Echocardiographic evaluation of TASER X26 probe deployment into the chests<br />

of human volunteers. The American Journal of <strong>Em</strong>ergency <strong>Med</strong>icine 2009; 28(1): 49-55.<br />

Dawes D, Ho J, Reardon R, Miner J. The Physiologic Effects of Multiple Simultaneous Electronic Control Device<br />

Discharges. The Journal of <strong>Em</strong>ergency <strong>Med</strong>icine, 2009; 37(2): 209-210.<br />

Dawes DM, Ho JD, Reardon RF, Miner JR. The Cardiovascular, Respiratory, and Metabolic Effects of a Long<br />

Duration Electronic Control Device Exposure in Human Volunteers. Forensic Science and <strong>Med</strong>ical Pathology. 2010;<br />

6: 268-274.<br />

Dawes D, Ho J, Kroll M, Miner J. Electrical characteristics of an electronic control device under a physiologic load: a<br />

brief report. Pacing and Clinical Electrophysiology. March 2010;33 (3): 330-336.<br />

Dawes DM, Ho JD, Cole JB, Reardon RF, Lundin EJ, Terwey KS, Falvey DG, Miner JR Effect of an Electronic<br />

Control Device Exposure on a Methamphetamine-intoxicated Animal Model. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. April<br />

2010; 17 (4): 436-443.<br />

Dawes DM, Ho JD, Reardon RF, Sweeny JD, Miner JR, The Physiologic Effects of Multiple Simultaneous Electronic<br />

Control Device Discharges. Western Journal of <strong>Em</strong>ergency <strong>Med</strong>icine. February 2010; 11 (1) 49-56.<br />

Dawes DM, Ho JD, Orozco B, Vogel E, Nelson R, Miner JR. Human creatine kinase effect from conducted electrical<br />

weapons. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. 2010;17:S77.<br />

Dawes DM, Ho JD, Orozco B, Vogel E, Nelson R, Miner JR. The respiratory, metabolic and neuroendocrine effects<br />

of a new generation electronic control device. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. 2010;17:S155.<br />

Deitch K, Miner JR, Chudnofsky CR, Dominici P, Latta D Does End Tidal CO2 Monitoring During <strong>Em</strong>ergency<br />

Department Procedural Sedation and Analgesia With Propofol Decrease the Incidence of Hypoxic Events? A<br />

Randomized Controlled Trial. Annals of <strong>Em</strong>ergency <strong>Med</strong>icine, 2010; 55 (3): 258-264.<br />

Dries DJ, Frascone RJ, Hick JL, Salzman J. <strong>Med</strong>ical Preparation for the 2008 Republican National Convention: A<br />

Practical Guide (September 1-4, 2008, St. Paul, Minnesota). The Journal of Trauma: Injury, Infection, and Critical<br />

Care. Accepted for publication August 2010.<br />

Flannagan CE, Daramola OO, Maisel RH, Adkinson C, Odland RM. Surgical Debridement and Adjunctive<br />

Hyperbaric Oxygen in Cervical Necrotizing Fasciitis. Otolaryngology-Head and Neck Surgery, 2009; 140(5): 730-734.<br />

Gossett WA, Rockswold GL, Rockswold SB, Adkinson CD, Bergman, Quickel RR. The safe treatment, monitoring<br />

and management of severe traumatic brain injury patients in a monoplace chamber. Undersea and Hyperbaric<br />

<strong>Med</strong>icine. 2010; 37 (1): 35-45.<br />

Gostin LO, Hanfling D, Hodge, Jr. JG, Hick JL, Peterson CA. Standard of Care – In Sickness and in Health and in<br />

<strong>Em</strong>ergencies. The New England Journal of <strong>Med</strong>icine. 2010; 363(14): 1378-1379.<br />

Gramenz P, Roberts D, Shrag L. Intra-arterial self-injection of methadone tablets in the femoral artery. Journal of<br />

<strong>Em</strong>ergency <strong>Med</strong>icine. 2010; 39 (3): e125-e127.<br />

Gross EA, Bruen C. Anorectal emergencies. EM <strong>Report</strong>s.2009; 30 (26):1-12.<br />

Gross EA. Computed tomographic screening for thoracic and lumbar fractures: is spine reformatting necessary?<br />

American Journal of <strong>Em</strong>ergency <strong>Med</strong>icine. January 2010; 28 (1): 73-75.<br />

Hanfling D, Hick JL. Hospitals and the Novel H1N1 Outbreak: The Mouse that Roared? Disaster <strong>Med</strong> Public Health<br />

Preparedness, 2009: 3(Supp 2); S100-S106.<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 51


Hanley O, Miner J, Rockswold E, Biros M. The relationship between chronic illness, chronic pain, and<br />

socioeconomic factors in the ED. American Journal of <strong>Em</strong>ergency <strong>Med</strong>icine. April 2010. [Epub ahead of print]DOI:<br />

10.1016/j.ajem.2009.10.002<br />

Heegaard W, Hildebrandt D, Reardon R, Plummer D, Clinton J, Ho J. Prehospital Ultrasound Diagnosis of<br />

Traumatic Pericardial Effusion. Academic <strong>Em</strong>ergency <strong>Med</strong>icine 2009; 16 (4): 364.<br />

Heegaard W, Fringer R, Frascone RJ, Pippert, G, Miner J. Bispectral Index Monitoring Indicates Patients Are<br />

Adequately Sedated. Prehospital <strong>Em</strong>ergency Care 2009; 13 (2): 193-197.<br />

Heegaard W, Hildebrandt D, Spear D, Chason K, Nelson B, Ho J. Prehospital Ultrasound by Paramedics: Results of<br />

Field Trial. Academic <strong>Em</strong>ergency <strong>Med</strong>icine 2010; 17(6): 624-630<br />

Hick JL, Barbera JA, Kelen GB. Refining Surge Capacity: Conventional, Contingency, and Crisis Capacity. Disaster<br />

<strong>Med</strong> and Public Health Preparedness. 2009; 3 (Suppl 1): s59-s67. (e-published ahead of print April 6, 2009 as<br />

doi:10.1097/DMP.0b013e31819f1ae2, print June 2009).<br />

Hick JL, Frascone RJ, Grimm K, Hillman M, Griffith J, Hogan M, Trotsky-Sirr R, Braun J. Health and <strong>Med</strong>ical<br />

Preparedness and Response to the 2008 Republican National Convention. Disaster <strong>Med</strong> Public Health<br />

Preparedness, 2009; 3: 224–232.<br />

Hick JL, Christian MD, Sprung CL. Chapter 2. Surge capacity and infrastructure considerations for mass critical care.<br />

Intensive Care <strong>Med</strong>icine. 2010; 36 (Suppl 1): S11-S20.<br />

Hill C, Reardon R, Joing S, Falvey D, Miner JR, Cricothyroidotomy Technique Using Gum Elastic Bougie Is Faster<br />

than Standard Technique: A Study of <strong>Em</strong>ergency <strong>Med</strong>icine Residents and <strong>Med</strong>ical Students in an Animal Lab<br />

Academic <strong>Em</strong>ergency <strong>Med</strong>icine. June 2010; 17 (6): 666-669.<br />

Ho J, Dawes D, Heegaard W, Miner J. Human Research Review of the Taser Electronic Control Device. Conf Proc<br />

IEEE Eng <strong>Med</strong> Biol Soc, 2009; 1: 3181-3183.<br />

Ho J. Human Cardiorespiratory and acid/base effect of a civilian-conducted electrical weapon. Prehosp <strong>Em</strong>erg Care,<br />

2009;13:94-95.<br />

Ho J, Dawes D, Cole J, Hottinger J, Overton K, Miner J. Lactate and pH Evaluation in Exhausted Humans with<br />

Prolonged TASER X26 Exposure or Continued Exertion. Forensic Sci Int, 2009; 190: 80-86.<br />

Ho J. Can There Be Truth About TASERs? (Commentary) Academic <strong>Em</strong>ergency <strong>Med</strong>icine, 2009:16:771-773.<br />

Ho J, Dawes D, Heegaard W, Calkins H, Moscoti R, Miner, J. Absence of Electrocardiographic Change After<br />

Prolonged Application of a Conducted Electrical Weapon in Physically Exhausted Adults. Journal of <strong>Em</strong>ergency<br />

<strong>Med</strong>icine 2009; May 12 epub.<br />

Ho J, Heegaard W, Dawes D, Natarajan S, Reardon R, Miner J. Unexpected Arrest Related Deaths in America: 12<br />

Months of Open Source Surveillance. Western Journal of <strong>Em</strong>ergency <strong>Med</strong>icine 2009; 10(2): 68-73.<br />

Ho JD, Dawes DM, Nelson RS, Lundin EJ, Frank JR Overton KG, Zeiders AJ, Miner JR. Acidosis and<br />

Catecholamine Evaluation Following Simulated Law Enforcement “Use of Force” Encounters. Academic <strong>Em</strong>ergency<br />

<strong>Med</strong>icine. July 2010; 17(7): e60-e68.<br />

Ho J, Clinton J, Lappe M, Heegaard W, Williams M, Miner J. Introduction of the conducted electrical weapon into a<br />

hospital setting. Journal of <strong>Em</strong>ergency <strong>Med</strong>icine. 2010; [epub ahead of print] DOI: 10.1016/j.jemermed.2009.09.031<br />

Ho J, Dawes D, Cole J, Hottinger J, Overton K, Miner J. Corrigendum to “Lactate and pH evaluation in exhausted<br />

humans with prolonged TASER X26 exposure or continued exertion”. Forensic Sci Int, 2010;195:169.<br />

52 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


Ho JD, Dawes DM, Reardon RF, Strote SR, Kunz SN, Nelson RS, Lundin EJ, Orozco BS, Miner JR. Human<br />

cardiovascular effects of a new generation conducted electrical weapon. Forensic Science International. 2010; Doi:<br />

10.1016/j.forsciint.2010.05.003<br />

Ho JD, Dawes DM, Nelson RS, Lundin EJ, Ryan FJ, et al. Human acidosis and catecholamine evaluation following<br />

simulated law enforcement “use of force” encounters. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. 2010; 17 (7): e60-e68.<br />

Ho JD, Dawes D, Johnson V, Karambay J, Kniffin, C, Nelson R, Miner J. Do conducted electrical weapon probes<br />

carry bacteria? Academic <strong>Em</strong>ergency <strong>Med</strong>icine. 2010;17:S134.<br />

Lewis RJ, Duber HC, Biros MH, Cone DC, International Regulatory Status of <strong>Em</strong>ergency Exception to Informed<br />

Consent Study Group: International resuscitation research, exception from informed consent, and the European<br />

Union Directive 2001/20/EC. European Journal of <strong>Em</strong>ergency <strong>Med</strong>icine. October 2009; 16 (5): 234-41.<br />

McBeth B, McNamara R, Ankel F, Mason EJ, Ling LJ, Flottemensch TJ, Asplin BR. Modafinil and zolpidem use by<br />

emergency medicine residents. Ann <strong>Em</strong>erg <strong>Med</strong> 48 (4), 32 – 33, 2008 and Academic <strong>Em</strong>ergency <strong>Med</strong>icine<br />

16(12):1311-1317, December 2009.<br />

Miner JR, Gray RO, Stephens D, Biros MH. Randomized Clinical Trial of Propofol With and Without Alfentanil for<br />

Deep Procedural Sedation in the <strong>Em</strong>ergency Department. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. September 2009; 16 (9):<br />

825-834.<br />

Miner JR. Randomized Double-blind Placebo Controlled Crossover Study of Acetaminophen, Ibuprofen,<br />

Acetaminophen/Hydrocodone, and Placebo for the Relief of Pain From a Standard Painful Stimulus. Academic<br />

<strong>Em</strong>ergency <strong>Med</strong>icine, September 2009; 16 ( 9): 911-914.<br />

Miner JR, Gray R, Delavari P, Patel S, Patel R, Plummer D. Alfentanil for Procedural Sedation in the <strong>Em</strong>ergency<br />

Department. Annals of <strong>Em</strong>ergency <strong>Med</strong>icine. 2010; 57(2):117-121.<br />

Miner JR, Gray RO, Bahr J, Patel R, McGill JW. Randomized Clinical Trial of Propofol vs. Ketamine for Procedural<br />

Sedation in the <strong>Em</strong>ergency Department. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. June 2010; 17 (6): 604-611.<br />

Moore JA, Gross EA. Update on emerging infections: news from the <strong>Center</strong>s for Disease Control and Prevention.<br />

Surveillance for Foodborne Disease Outbreaks—United States, 2006. Annals of <strong>Em</strong>ergency <strong>Med</strong>icine. 2010; 55 (1):<br />

49-50.<br />

Moscati R, Ho JD, Dawes DM, Miner JR. Physiologic effects of prolonged conducted electrical weapon discharge in<br />

ethanol-intoxicated adults. American Journal of <strong>Em</strong>ergency <strong>Med</strong>icine, 2010; 28: 582-587.<br />

Mulder M, Smith SW, Bart BA. Faster, Cooler, Better? A Comparison of Two Methods for Instituting Mild Therapeutic<br />

Hypothermia in Comatose Out of Hospital Cardiac Arrest Patients. Journal of the American College of Cardiology<br />

March 9, 2010; 55 (10A): E1038-E1040.<br />

Olives T, Patel R, Patel S, Hottinger J, Miner JR. Health literacy of adults presenting to an urban ED. American<br />

Journal of <strong>Em</strong>ergency <strong>Med</strong>icine. July 2010; [Epub ahead of print] DOI: 10.1016./j.ajem.2010.03.031<br />

Parsons D, Convertino V, Idris A, Smith SW, Lindstrom D, Parquette B, Aufderheide TP. The ResQGARD®: a<br />

New Device for Combat Casualty Care to Augment Circulation and Blood Pressure in Hypotensive Spontaneously<br />

Breathing War Fighters. Journal of Special Operations <strong>Med</strong>icine Spring 2009; 9(2): 49-52.<br />

Patel R, Miner JR, Miner SL. The need for dental care among adults presenting to an urban ED. American Journal of<br />

<strong>Em</strong>ergency <strong>Med</strong>icine. October 2010; [Epub ahead of print] DOI: 10.1016./j.ajem.2010.09.011<br />

Prekker ME, Miner JR, Rockswold EG, Biros MH. The Prevalence of Injury of Any Type in an Urban <strong>Em</strong>ergency<br />

Department Population. The Journal of Trauma-Injury, Infection, and Critical Care. June 2009; 66 (6): pp. 1688-1695.<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 53


Prekker ME, Chang R, Cole JB, Reardon R. Rapid Confirmation of Central Venous Catheter Placement Using an<br />

Ultrasonographic “Bubble Test.” Academic <strong>Em</strong>ergency <strong>Med</strong>icine. 2010; 17 (7); e85-e86.<br />

Reardon R. “ACEP <strong>Em</strong>ergency Ultrasound Guidelines - American College of <strong>Em</strong>ergency Physicians Policy<br />

Statement on the use of US by EP's. (www.acep.org/workarea/downloadasset.aspx?id=32878)<br />

Rokos IC., French WJ., Koenig WJ., Stratton SJ., Nighswonger B., Strunk B., Jewell J., Mahmud E., Dunford JV.,<br />

Hokanson J., Smith SW., Baran KW., Swor R., Berman A., Wilson BH., Aluko AO., Gross BW., Rostykus PS.,<br />

Salvucci A., Dev V., McNally B., Manoukian SV., King III SB. Integration of Pre-Hospital Electro-cardiograms and<br />

ST-Segment Elevation Myocardial Infarction Receiving <strong>Center</strong> Networks: Impact on Door-to-Balloon Times Across 10<br />

Independent Regions. Journal of the American College of Cardiology: Cardiovascular Interventions. April 2009; 2 (4):<br />

339-346.<br />

Rubinson L, Knebel A, Hick JL. MSOFA: An Important Step Forward, but Are We Spending Too Much Time on the<br />

SOFA? Editorial. Disaster <strong>Med</strong>icine and Public Health Preparedness. 2010; 4 (4): 271-272.<br />

Safdar B, Heins A, Homel P, Miner JR, Neighbor M, DeSandre P, Todd K. Impact of Physician and Patient Gender on<br />

Pain Management in the <strong>Em</strong>ergency Department. Pain <strong>Med</strong>icine, March 2009; 109 (2): 364-372.<br />

Simonian SM, Lotfipour S, Wall C, Langdorf MI. “Challenging the Superiority of Amiodarone for Rate Control in<br />

Wolff-Parkinson-White and Atrial Fibrillation.” International <strong>Em</strong>erg <strong>Med</strong>. 2010:5 (5);421-426.<br />

Smith SW, Parquette B, Lindstrom D, Metzger AK, Kopitzke J, Clinton J. An Impedance Threshold Device<br />

Increases Blood Pressure in Hypotensive Patients. The Journal of <strong>Em</strong>ergency <strong>Med</strong>icine. May 2010; on line;<br />

10.1016/j.jemermed.2010.05.013<br />

Smith SW, Clark M, Nelson J, Heegaard W, Lufkin KC, Ruiz E. <strong>Em</strong>ergency Department Skull Trephination for<br />

Epidural Hematoma in Patients Who Are Awake but Deteriorate Rapidly. Journal of <strong>Em</strong>ergency <strong>Med</strong>icine. 2010; 39<br />

(3):377-383.<br />

Smith SW. Book Review of: The Textbook of <strong>Em</strong>ergency Cardiovascular Care and CPR, John M. Field,<br />

Editor-in-Chief. Annals of <strong>Em</strong>ergency <strong>Med</strong>icine 2009;54 (4);643-644.<br />

Smith SW. Letter to the Editor. Electrocardiographic Research on Left Bundle Branch Block Must Use Angiographic<br />

Outcomes and Proportionality if it is to Guide Reperfusion Therapy. Annals of <strong>Em</strong>ergency <strong>Med</strong>icine. 2009;53(5):<br />

691-692.<br />

Sprung CL, Zimmerman JL, Christian MD, Joynt GM, Hick JL, Taylor B, Richards GA, Sandrock C, Cohen R, Adini B.<br />

Recommendations for intensive care unit and hospital preparations for an influenza epidemic or mass disaster:<br />

Summary report of the European Society of Intensive Care <strong>Med</strong>icineʼs Task Force for intensive care unit triage during<br />

an influenza epidemic or mass disaster. Intensive Care <strong>Med</strong>icine. 2010: 36 (3): 428-443.<br />

Stellpflug SJ, Harris CR, Engebretsen KM, Cole JB, Holger JS. Intentional overdose with cardiac arrest treated with<br />

intravenous fat emulsion and high-dose insulin. Clinical Toxicology. March 2010; 48 (3): 227-229.<br />

Stellpflug SJ, Cole JB, Harris CR. I shouldnʼt have had dessert…A moonflower seed ingestion. Western Journal of<br />

<strong>Em</strong>ergency <strong>Med</strong>icine. May 2010; 11 (2): 213.<br />

Stellpflug SJ, Fritzlar SJ, Cole JB, Engebretsen KM, Holger JS. Cardiotoxic Overdose Treated with Intravenous Fat<br />

<strong>Em</strong>ulsion and High-Dose Insulin in the Setting of Hypertrophic Cardiomyopathy. December 2010; DOI<br />

10.1007/s13181-010-0133-3.<br />

Thumbigere-Math V, Sabino MC, Gopalakrishnan R, Huckabay S, Dudek AZ, Basu S, Hughes PJ, Michalowicz BS,<br />

Leach JW, Swenson KK, Swift JQ, Adkinson C, Basi DL. Bisphosphonate-Associated Osteonecrosis of the Jaw:<br />

Clinical features, Risk Factors, Management and Treatment Outcomes of 26 patients. J Oral and Maxillofac Surg,<br />

2009; 67: 1904-1913.<br />

54 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


Wagner MJ, Wolf S, Promes S, McGee D, Hobgood C, Doty C, McErlean MA, Janssen A, Smith-Coggins R, Ling L.<br />

Mattu A, Tantama S, Beeson M, Brabson T, Christiansen G, King B, Luerssen E, Muelleman R. Duty hours in<br />

<strong>Em</strong>ergency <strong>Med</strong>icine: Balancing patient safety, resident wellness, and the resident training experience: A consensus<br />

response to the 2008 Institute of <strong>Med</strong>icine resident duty hours recommendation. Academic <strong>Em</strong>ergency <strong>Med</strong>icine.<br />

2010; 17 (9): 1004-1011.<br />

Wagner MJ, Wolf S, Promes S, McGee D, Hobgood C, Doty C, McErlean MA, Janssen A, Smith-Coggins R, Ling L.<br />

Mattu A, Tantama S, Beeson M, Brabson T, Christiansen G, King B, Luerssen E, Muelleman R. Duty hours in<br />

<strong>Em</strong>ergency <strong>Med</strong>icine: Balancing patient safety, resident wellness, and the resident training experience: A consensus<br />

response to the 2008 Institute of <strong>Med</strong>icine resident duty hours recommendation. Journal of <strong>Em</strong>ergency <strong>Med</strong>icine.<br />

September 2010; 39 (3): 348-355.<br />

Westgard BC, Adkinson C. “Power in studies of mortality and necrotizing soft tissue infections”. Letter to Editor,<br />

Surgical Infections, in regard to George, et al, Hyperbaric Oxygen does not improve outcome in patients with<br />

necrotizing soft tissue infection” in Surgical Infections, 2010;11 (4); 403-404.<br />

Yannopoulos D, Matsuura T, McKnite S, Goodman N, Idris A, Tang W, Aufderheide TP, Lurie KG. No assisted<br />

ventilation cardiopulmonary resuscitation and 24-hour neurological outcomes in a porcine model of cardiac arrest.<br />

Critical Care <strong>Med</strong>icine. January 2010; 38 (1): 254-260.<br />

Zvosec DL, Smith SW, Hall BJ. Three Deaths Associated with Use of Xyrem ® . Sleep <strong>Med</strong>icine. April<br />

2009;10(4):490-493.<br />

Zvosec DL. Smith SW. Response to Letter to the Editor regarding “Three Deaths Associated with Use of Xyrem®.<br />

Sleep <strong>Med</strong>icine. April 2009;10(4):490-493.” Sleep <strong>Med</strong>icine 2009. http://dx.doi.org/10.1016/j.sleep.2009.08.006<br />

Zvosec DL. Smith SW. Response to “Cognitive, psychomotor and subjective effects of sodium oxybate and<br />

triazolam in healthy volunteers. Psychopharmacology Sep 24 2009; 206(1):141-154.”<br />

Zvosec DL. Smith SW. Commentary on: [Akins BE, Miranda E, Lacy M, Logan BK. A multi-drug intoxication fatality<br />

involving Xyrem_ (GHB). J Forensic Sci 2009;54(2):495-6]. J Forensic Sci, September 2009 54(5):1203-4; author<br />

reply 1205.<br />

Zvosec DL, Smith SW, Porrata T, Strobl AQ, Dyer JE. Case series of 226 Gamma-hydroxybutyrate-associated<br />

deaths: lethal toxicity and trauma. The American Journal of <strong>Em</strong>ergency <strong>Med</strong>icine. April 2010; Article in press,<br />

corrected proof online. DOI: 10.1016/j.ajem.2009.11.008.<br />

Zvosec DL, Smith SW. Significant underreporting of GHB deaths. Clinical Therapeutics April 2010; 32(4): 780-785.<br />

Zvosec DL. Smith SW. Response to Letter to the Editor, “Xyrem® (sodium oxybate) Postmarketing Adverse Event<br />

<strong>Report</strong>ing System,” by Dr. Wang. Sleep <strong>Med</strong>icine June 2010; 11 (6): 595-596.<br />

Zvosec DL. Smith SW. Response to Editorial: “Xyrem safety: The debate continues.” Sleep <strong>Med</strong>icine 2010;<br />

11:105-109.<br />

Zvosec DL. Smith SW. Response from the authors to Letter to the Editor regarding “Three Deaths Associated with<br />

Xyrem.” Sleep <strong>Med</strong>icine 2010; 11:106-108.<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 55


HCMC Department of <strong>Em</strong>ergency <strong>Med</strong>icine 2009-2010<br />

Publications | Abstracts | Scientific Presentations<br />

Biros MH, Sargent C, Miller K. Community Attitudes About Research Without Consent. Academic <strong>Em</strong>ergency<br />

<strong>Med</strong>icine. April 2009; 16 (4, Suppl 1): S216. Presented at the SAEM 2009 <strong>Annual</strong> Meeting, New Orleans, LA, May<br />

2009.<br />

Breyer M, Sadosty AT, Biros MH. EM Grades, SLOR, and <strong>Med</strong>ical School Rank Correlate Positively with Placement<br />

of Interviewee on EM Rank List. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. April 2009; 16 (4, Suppl 1): S63-S64. Presented at<br />

the SAEM 2009 <strong>Annual</strong> Meeting, New Orleans, LA, May 2009.<br />

Breyer M, Sadosty AT, Biros MH. Class Ranking Systems <strong>Report</strong>ed on <strong>Med</strong>ical Student Performance Evaluations<br />

Are Inconsistent or Unavailable. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. April 2009; 16 (4, Suppl 1): S53-S54. Presented at<br />

the SAEM 2009 <strong>Annual</strong> Meeting, New Orleans, LA, May 2009.<br />

Cole JB, Sattiraju S, Pace SL, Bertog SC, Asinger RW. Isolated Tramadol Overdose Associated with Brugada<br />

Pattern EKG Changes. Clin Toxicol 2009; 47(7):757. Poster Presentation at the North American Congress of Clinical<br />

Toxicology, September 26, 2009, San Antonio, TX<br />

Cole JB, Stellpflug SJ, Karpas A, Roberts DJ. Ingestion of One Lead Fishing Sinker Resulting in Toxic Lead Levels<br />

Within Hours. Clin Toxicol 2010; 48(6):622. Poster Presentation at the North American Congress of Clinical<br />

Toxicology, October 10, 2010, Denver, CO.<br />

Cole JB, Stellpflug SJ, Moquist KL, Setzer SC, Bilden EF. Massive Hydroxyurea Overdose in a Child Treated with<br />

Gastric Lavage and Activated Charcoal. Clin Toxicol 2010;48(6):655-656. Poster Presentation at the North American<br />

Congress of Clinical Toxicology, October 12, 2010, Denver, CO.<br />

Cole JB, Stellpflug SJ, Gross EA, Smith SW. Wide Complex Tachycardia in a Pediatric Diphenhydramine Overdose<br />

Treated with Sodium Bicarbonate. Clin Toxicol 2010; 48(6):655. Poster Presentation at the North American Congress<br />

of Clinical Toxicology, October 12, 2010, Denver, CO<br />

Cole JB, Stellpflug SJ, Massive Venlafaxine Overdose Resulting in Abdominal Compartment Syndrome. Clin Toxicol<br />

2010; 48(6):644-645. Poster Presentation at the North American Congress of Clinical Toxicology, October 11, 2010,<br />

Denver, CO<br />

Dawes D, Ho J, Reardon R, Miner J. The Physiologic Effects of Multiple Simultaneous Electronic Control Device<br />

Discharges. J <strong>Em</strong>erg <strong>Med</strong>, 2009; 37 (2): 209-210. Presented at the First Caribbean <strong>Em</strong>ergency <strong>Med</strong>icine Congress,<br />

Bridgetown, Barbados, January 2009.<br />

Dawes D, Ho J, Miner J. The Neuro-Endocrine Effects of the TASER X26 Conducted Electrical Weapon. J <strong>Em</strong>erg<br />

<strong>Med</strong>, 2009; 37 (2): 210. Presented at the First Caribbean <strong>Em</strong>ergency <strong>Med</strong>icine Congress, Bridgetown, Barbados,<br />

January 2009.<br />

Dawes DM, Ho JD, Orozco B, Vogel E, Nelson R. Miner J. Human Creatine Kinase Effect From Conducted<br />

Electrical Weapons. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. May 2010; 17(5, Suppl 1): S77. Presented at the SAEM 2010<br />

<strong>Annual</strong> Meeting, Phoenix, AZ, June 2010.<br />

Dawes DM. Ho JD, Orozco B, Vogel E, Nelson R, Miner JR. The Respiratory, Metabolic, and Neuroendocrine<br />

Effects of a New Generation Electronic Control Device. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. May 2010; 17(5, Suppl 1):<br />

S155. Presented at the SAEM 2010 <strong>Annual</strong> Meeting, Phoenix, AZ, June 2010.<br />

Deitch K, Miner J, Chudnofsky C, Dominici P, Latta D, Giraldo P. Does ETCO2 Monitoring during ED PSA with<br />

Propofol Lower the Rate of Hypoxia? A Randomized Clinical Trial. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. April 2009; 16 (4,<br />

Suppl 1): S159. Presented at the SAEM 2009 <strong>Annual</strong> Meeting, New Orleans, LA, May 2009.<br />

56 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


Hart DH, Reardon RF, Miner JR, Ward C, Nelson G. Assessment of Face-Mask Ventilation Using an Airway<br />

Simulation Model, Phase 2. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. May 2010; 17(5, Suppl 1): S155. Presented at the<br />

SAEM 2010 <strong>Annual</strong> Meeting, Phoenix, AZ, June 2010.<br />

Heegaard W, Hildebrandt DA, Ho J. The Prehospital Ultrasound Study: Results of the First Six Months. Prehospital<br />

<strong>Em</strong>ergency Care 2009: 13 (1): 139. Presented at the 2009 NAEMSP Scientific Assembly, Jacksonville, FL, January<br />

2009.<br />

Heller, K, Budhram G, Lapine A, Reardon R. Assessment of Echocardiography Image Acquisition and Image<br />

Interpretation Skills in <strong>Em</strong>ergency <strong>Med</strong>icine Residents. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. April 2009; 16 (4, Suppl 1):<br />

S26. Presented at the SAEM 2009 <strong>Annual</strong> Meeting, New Orleans, LA, May 2009.<br />

Hill C, Reardon R, Miner J, Falvey DG. Five-Step Cricothyrotomy Technique Using Gum Elastic Bougie is Faster<br />

than Standard Technique in Anesthetized Sheep. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. April 2009; 16 (4, Suppl 1): S159.<br />

Presented at the SAEM 2009 <strong>Annual</strong> Meeting, New Orleans, LA, May 2009.<br />

Hill CH, McGill JW, Reardon RF, Falvey D. Intubator Recall of Hypoxia and Number of Attempts is Often Inaccurate<br />

Compared to Video Review. Annals of <strong>Em</strong>ergency <strong>Med</strong>icine. September 2009; 54 (3, Suppl. 1), S21. Presented at<br />

the ACEP Research Forum, Boston, MA, October 2006.<br />

Hill CH, Falvey D, Reardon RF. Effects of <strong>Em</strong>ergent Intubation on Pulse Rate Using Three Different <strong>Med</strong>ication<br />

Regimens for Rapid Sequence Intubation: A Retrospective Video Review. Annals of <strong>Em</strong>ergency <strong>Med</strong>icine. September<br />

2009; 54 (3, Suppl. 1), S138-S139. Presented at the ACEP 2009 Research Forum, Boston, MA, October 2009.<br />

Ho JD, Dawes DM, Miner JR. Human Cardiorespiratory and Acid/Base Effect of a Civilian Conducted Electrical<br />

Weapon. Pre-Hospital <strong>Em</strong>ergency Care, 2009; 13: 94-95. Presented at the 2009 NAEMSP Scientific Assembly,<br />

Jacksonville, FL, January 2009.<br />

Ho J, Dawes D: “Research Update on the TASER Electronic Control Device.” 5th European Symposium on<br />

Non-Lethal Weapons. Fraunhofer Institut Chemische Technologie. Karlsruhe: DWS Werbeagentur und Verlag GmbH,<br />

2009.<br />

Ho JD, Heegaard W, Miner J, Dawes D. Introduction of a Conducted Electrical Weapon in a Hospital Setting: The<br />

First 8 Months of Use. J <strong>Em</strong>erg <strong>Med</strong>, 2009; 37 (2): 210. Presented at the First Caribbean <strong>Em</strong>ergency <strong>Med</strong>icine<br />

Congress, Bridgetown, Barbados, January 2009.<br />

Ho J, Clinton J, Lappe, M, Heegaard W, Williams M, Miner J. Introduction of the Conducted Electrical Weapon into<br />

a Hospital Setting. Journal of <strong>Em</strong>ergency <strong>Med</strong>icine 2009; 37: 209.<br />

Ho J, Dawes D, Cole J, Reardon R, Hottinger J, Terwey K, Miner J. Effect of a conducted electrical weapon<br />

exposure on a methamphetamine intoxicated animal model. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. April 2009; 16 (4, Suppl<br />

1): S222. Presented at the SAEM 2009 <strong>Annual</strong> Meeting, New Orleans, LA, May 2009.<br />

Ho J, Dawes D, Lundin E, Miner J. Comparison of Acidosis Markers Associated with Law Enforcement Applications<br />

of Force. Annals of <strong>Em</strong>ergency <strong>Med</strong>icine, 2009; 54 (3, Suppl 1): S40. Presented at the ACEP 2009 Research Forum,<br />

Boston, MA, October 2009.<br />

Ho JD, Dawes D, Johnson V, Karambay J, Kniffin C, Nelson R, Miner J. Do Conducted Electrical Weapon Probes<br />

Carry Bacteria? Academic <strong>Em</strong>ergency <strong>Med</strong>icine. May 2010; 17(5, Suppl 1): S134. Presented at the SAEM 2010<br />

<strong>Annual</strong> Meeting, Phoenix, AZ, June 2010.<br />

Holger, JS, Engebretsen KM, Stellpflug SJ, Cole JB, Harris CR. High Dose Insulin: A Consecutive Case Series. Clin<br />

Toxicol 2010; 48(6):613-614. Poster Presentation at the North American Congress of Clinical Toxicology, October 9,<br />

2010, Denver, CO<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 57


Holm M, Caroon L, Reardon RF. Impact of Image Processing on the Pleural Sliding Sign. Annals of <strong>Em</strong>ergency<br />

<strong>Med</strong>icine. September 2009; 54 (3, Suppl. 1), S88. Presented at the ACEP 2009 Research Forum, Boston, MA,<br />

October 2009.<br />

Knapp R, Martel ML, Miner J. Meeting Accreditation Council for Graduate <strong>Med</strong>ical Education Core Competencies:<br />

Development of a Novel Method to Assess <strong>Em</strong>ergency <strong>Med</strong>icine Residents Systems Based Practice. Academic<br />

<strong>Em</strong>ergency <strong>Med</strong>icine. April 2009; 16 (4, Suppl 1): S41. Presented at the SAEM 2009 <strong>Annual</strong> Meeting, New Orleans,<br />

LA, May 2009.<br />

Kwon SK, Lintner CP, Brandt R, Cole JB, Stellpflug SJ. Parachuting of Water-Extracted Dextromethorphan. Clin<br />

Toxicol 2010; 48(6):617. Poster Presentation at the North American Congress of Clinical Toxicology, October 9, 2010,<br />

Denver, CO.<br />

Lintner CP, Kwon SK, Stellpflug SJ, Cole JB. Heating Pad Ingestion with Significant Iron Level Elevation. Clin Toxicol<br />

2010; 48(6):623. Poster Presentation at the North American Congress of Clinical Toxicology, October 10, 2010,<br />

Denver, CO<br />

Lundin E, Dawes D, Ho J, Ryan F, Miner J. Catecholamines in Simulated Arrest Scenarios. Annals of <strong>Em</strong>ergency<br />

<strong>Med</strong>icine, 2009; 54 (3, Suppl 1): S98-S99. Presented at the ACEP 2009 Research Forum, Boston, MA, October<br />

2009.<br />

Miner JR., Westgard BC., Gray RC., Smith SW. The Effect of Access to Health Care and Socio-Economic Status on<br />

the Availability and Effectiveness of <strong>Med</strong>ical Treatment for Asthma and Hypertension Among Patients Presenting to<br />

the <strong>Em</strong>ergency Department. (This was erroneously cited with incorrect authors in the publication.) Annals of<br />

<strong>Em</strong>ergency <strong>Med</strong>icine 2009; 54(3 Suppl 1): S46. Presented at the ACEP 2009 Research Forum, Boston, MA, October<br />

2009.<br />

Miner JR, Nelson R, Lukavsky, Patel R, Hayden L, Smith SW. Vascular Occlusion Testing as a Predictor of Future<br />

Need for Intensive Care Unit Treatment in Patients Admitted to the Hospital From the <strong>Em</strong>ergency Department.<br />

Academic <strong>Em</strong>ergency <strong>Med</strong>icine. May 2010; 17(5, Suppl 1): S107. Presented at the SAEM 2010 <strong>Annual</strong> Meeting,<br />

Phoenix, AZ, June 2010.<br />

Miner JR, Gray RO, Patel R, Plummer D. Randomized Clinical Trial of Alfentanil versus Propofol for Procedural<br />

Sedation in the <strong>Em</strong>ergency Department. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. May 2010; 17(5, Suppl 1): S142. Presented<br />

at the SAEM 2010 <strong>Annual</strong> Meeting, Phoenix, AZ, June 2010.<br />

Miner JR, Patel S, Patel R, Nelson R, Plummer D. Physiologic Stress from Unperceived Pain:<br />

The Change in Serum Catecholamines in Patients Undergoing Procedural Sedation in the <strong>Em</strong>ergency Department<br />

with Propofol with and without Supplemental Alfentanil. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. May 2010; 17(5, Suppl 1):<br />

S156-S157. Presented at the SAEM 2010 <strong>Annual</strong> Meeting, Phoenix, AZ, June 2010.<br />

Miner JR, Mason B, OʼConnor A, Patel R. Anderson L, Miner S. Correlation Between the Results of Oral Health<br />

Screening Exams Done on Patients in the <strong>Em</strong>ergency Department by <strong>Em</strong>ergency Physicians and a Dental Hygienist.<br />

Academic <strong>Em</strong>ergency <strong>Med</strong>icine. May 2010; 17(5, Suppl 1): S163-S164. Presented at the SAEM 2010 <strong>Annual</strong><br />

Meeting, Phoenix, AZ, June 2010.<br />

Miner JR, Westgard BC, Patel R, Olives T, Biros MH. Increasing Rate of Patients Who Are Homeless or Have<br />

Unstable Living Situations Presenting to the <strong>Em</strong>ergency Department at an Urban <strong>County</strong> Hospital between 2007 and<br />

2009. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. May 2010; 17(5, Suppl 1): S168. Presented at the SAEM 2010 <strong>Annual</strong><br />

Meeting, Phoenix, AZ, June 2010.<br />

Miner JR, Westgard BC, Patel R, Olives T, Biros MH. The Increasing Rate of the Experience of Hunger Among<br />

Patients Presenting to the <strong>Em</strong>ergency Department of an Urban, <strong>County</strong> <strong>Med</strong>ical <strong>Center</strong>. Academic <strong>Em</strong>ergency<br />

<strong>Med</strong>icine. May 2010; 17(5, Suppl 1): S175-S176. Presented at the SAEM 2010 <strong>Annual</strong> Meeting, Phoenix, AZ, June<br />

2010.<br />

58 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


Miner JR. Screening of <strong>Em</strong>ergency Department Triage Patients Using Near Infrared Spectroscopy. Annals of<br />

<strong>Em</strong>ergency <strong>Med</strong>icine September 2010; 15 (3): A6. Presented at the ACEP 2010 Research Forum, Las Vegas, NV,<br />

September 2010<br />

Miner JR. “Point of View” Video Documentation in the <strong>Em</strong>ergency Department: Feasibility and Patient/Provider<br />

Perception. Annals of <strong>Em</strong>ergency <strong>Med</strong>icine September 2010; 15 (3): A6. Presented at the ACEP 2010 Research<br />

Forum, Las Vegas, NV, September 2010<br />

Roline CE, Ho JD, Bahr JM. 9-1-1 Lift Assistance After a Minor Fall: Pilot Study of Patient Outcomes With Police<br />

Officer First Responders. Academic <strong>Em</strong>ergency <strong>Med</strong>icine. May 2010; 17(5, Suppl 1): S171. Presented at the SAEM<br />

2010 <strong>Annual</strong> Meeting, Phoenix, AZ, June 2010.<br />

Scott NL, Mulder M, Bart B, Smith SW. Correlation of STEMI in Resuscitated, Non-traumatic Out-of-hospital<br />

Cardiopulmonary Arrest Patients with Initial Rhythm and Cardiac Catheterization Findings. Academic <strong>Em</strong>ergency<br />

<strong>Med</strong>icine. May 2010; 17(5, Suppl 1): S194-S195. Presented at the SAEM 2010 <strong>Annual</strong> Meeting, Phoenix, AZ, June<br />

2010.<br />

Smith SW. Degree of ST Segment Upward Concavity is Only Slightly Greater in Benign Early Repolarization than in<br />

Electrocardiographically Subtle Acute Anterior ST- Elevation Myocardial Infarction. Annals of <strong>Em</strong>ergency <strong>Med</strong>icine<br />

September 2010; 15 (3): A6. Presented at the ACEP 2010 Research Forum, Las Vegas, NV, September 2010<br />

Smith SW. Derivation of a Rule for Diagnosis of Hypokalemia on the Electrocardiogram. Annals of <strong>Em</strong>ergency<br />

<strong>Med</strong>icine September 2010; 15 (3): A6. Presented at the ACEP 2010 Research Forum, Las Vegas, NV, September<br />

2010<br />

Stellpflug SJ, Cole JB, Fritzlar SJ, Engebretsen KM, Holger JS. Overdose of Diltiazem, Metoprolol, and Amiodarone<br />

Treated Successfully with Intravenous Fat <strong>Em</strong>ulsion and High Dose Insulin in an Awake Patient. Clin Toxicol 2010;<br />

48(6):612. Poster Presentation at the North American Congress of Clinical Toxicology, October 9, 2010, Denver, CO.<br />

Stellpflug SJ, Cole JB, Dolan JA, Setzer SC, Moser KL, Harris CR. Life-Threatening Flecainide Overdose Treated<br />

with Intravenous Fat <strong>Em</strong>ulsion. Clin Toxicol 2010; 48(6):612-613. Poster Presentation at the North American<br />

Congress of Clinical Toxicology, October 9, 2010, Denver, CO.<br />

Stellpflug SJ, Cole JB, Lintner CP, Kwon SK, Roberts DJ. Diethylene Glycol: A Poison <strong>Center</strong> Review Of 10 Years Of<br />

Pediatric Exposures. Clin Toxicol 2010; 48(6):606. Poster Presentation at the North American Congress of Clinical<br />

Toxicology, October 9, 2010, Denver, CO.<br />

Stellpflug SJ, Cole JB, Bangh SA, Roberts DJ. Potentially Lethal Ingestion of DMT and Syrian Rue. Clin Toxicol<br />

2010; 48(6):630. Poster Presentation at the North American Congress of Clinical Toxicology, October 10, 2010,<br />

Denver, CO<br />

Wall C. Workflow and Quality Improvements Using Wall Mounted Ultrasonography Machines in Pelvic Exam Rooms<br />

of a Busy <strong>Em</strong>ergency Department. Annals of <strong>Em</strong>ergency <strong>Med</strong>icine September 2010; 15 (3): A6. Presented at the<br />

ACEP 2010 Research Forum, Las Vegas, NV, September 2010<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 59


HCMC Department of <strong>Em</strong>ergency <strong>Med</strong>icine 2009-2010<br />

Publications | Books and Book Chapters<br />

Asken M, Nystrom P. Code Calm; Mental Toughness Skills for <strong>Med</strong>ical <strong>Em</strong>ergencies.<br />

www.mindsighting.com, 2009.<br />

Bahr JM. Deep sutures: When, why, and why not? In Avoiding Common Errors in the <strong>Em</strong>ergency Department. Mattu<br />

A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters Kluwer. Lippincott,<br />

Williams, and Wilkins. 2010.<br />

Bertog C. Smith SW. What ECG Changes Might Myocardial Ischemia Cause Other Than ST Segment Elevation or<br />

Q Waves, and What are the Differential Diagnoses of These Changes? In Critical Decisions in <strong>Em</strong>ergency and Acute<br />

Care Electrocardiography. William Brady and JD Truwit, Editors. Blackwell Publishing 2009.<br />

Biros M, Heegaard W. Head Trauma. In Rosenʼs <strong>Em</strong>ergency <strong>Med</strong>icine: Concepts and Clinical Practice. Seventh<br />

Edition. Editors Marx, Hockberger, Walls. Mosby -Elsevier, St. Louis, 2010.<br />

Brady WJ. Burt D. Ghaemmagnhami C. OʼConnor R. Smith SW. What are the ECG Indications for Acute Reperfusion<br />

Therapy (Fibrinolysis and PCI)? In Critical Decisions in <strong>Em</strong>ergency and Acute Care Electrocardiography. William<br />

Brady and JD Truwit, Editors. Blackwell Publishing 2009.<br />

Bruen CA. Be certain to perform a neurologic examination of the hand prior to anesthetizing a laceration. In Avoiding<br />

Common Errors in the <strong>Em</strong>ergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP<br />

(Editors). Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Calvo DV. Remember to consider peripartum cardiomyopathy in pregnant patients with shortness of breath. In<br />

Avoiding Common Errors in the <strong>Em</strong>ergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD,<br />

Woolridge DP (Editors). Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Chang RJ. Keep it clean: Pitfalls in traumatic wound irrigation. In Avoiding Common Errors in the <strong>Em</strong>ergency<br />

Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters<br />

Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Cole JB. Be wary of Drug-drug interactions when treating cocaine-intoxicated patients. In Avoiding Common Errors in<br />

the <strong>Em</strong>ergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors).<br />

Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Collier RE, Gough JE, Clement PA: Diarrhea. In Marx, Hockberger, Walls, et al, eds. Rosenʼs <strong>Em</strong>ergency <strong>Med</strong>icine:<br />

Concepts and Clinical Practice, 7th Edition, St. Louis, Elsevier, 2010<br />

Connelly MD. Holger JS. Smith SW. What is a Hyperacute T Wave? In Critical Decisions in <strong>Em</strong>ergency and Acute<br />

Care Electrocardiography. William Brady and JD Truwit, Editors. Blackwell Publishing 2009.<br />

Connelly MD. Holger JS. Bertog C. Smith SW. What Further Diagnostic Adjuncts to the Standard 12-lead ECG May<br />

Help to Diagnose Acute Coronary Syndrome? In Critical Decisions in <strong>Em</strong>ergency and Acute Care<br />

Electrocardiography. William Brady and JD Truwit, Editors. Blackwell Publishing 2009.<br />

Dunlop SJ. Prophylactic antibiotic use for simple, nonbite wounds is not necessary. In Avoiding Common Errors in<br />

the <strong>Em</strong>ergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors).<br />

Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Fong EOM. Know the complications of infertility treatment. In Avoiding Common Errors in the <strong>Em</strong>ergency<br />

Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters<br />

Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

60 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


Garlich FM. Do not rely upon the presence of an anion gap acidosis or an elevated osmol gap to diagnose toxic<br />

alcohol ingestion. In Avoiding Common Errors in the <strong>Em</strong>ergency Department. Mattu A. Chanmugam AS, Swadron SP,<br />

Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Gross EA, Martel ML. Multiple Trauma. In: Marx R, Hockberger R, Walls R, et al (eds): Rosenʼs <strong>Em</strong>ergency<br />

<strong>Med</strong>icine. 7th ed. China: Mosby; 2009; 243-51<br />

Hart D, Brunette D. Hypothermia. In Wolfson AB: Harwood-Nussʼ Clinical Practice of <strong>Em</strong>ergency <strong>Med</strong>icine, 5th<br />

Edition, Lippincott, Williams, and Wilkins, Philadelphia, 2010.<br />

Hayden LM. Explore wounds properly prior to repair. In Avoiding Common Errors in the <strong>Em</strong>ergency Department.<br />

Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters Kluwer. Lippincott,<br />

Williams, and Wilkins. 2010.<br />

Hill CH. Beware of postpartum headaches. In Avoiding Common Errors in the <strong>Em</strong>ergency Department. Mattu A.<br />

Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters Kluwer. Lippincott,<br />

Williams, and Wilkins. 2010.<br />

Heegaard WH, Biros MH. Skull Fractures. Up to Date. 2009.<br />

Ho JD. “Electrocardiographic Effects of the CEW. In TASER Conducted Electrical Weapons: Physiology, Pathology,<br />

and Law. Ed. MW Kroll and JD Ho. New York: Springer Science <strong>Med</strong>ia, 2009.<br />

Ho JD. Serum and Skin Effects of CEW Application. In TASER Conducted Electrical Weapons: Physiology,<br />

Pathology, and Law. Ed. MW Kroll and JD Ho. New York: Springer Science <strong>Med</strong>ia, 2009.<br />

Kniffin CC. Do not forget to consider nonobstetric causes of abdominal symptoms in a pregnant patient. In Avoiding<br />

Common Errors in the <strong>Em</strong>ergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP<br />

(Editors). Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Kroll MW, Ho JD (Eds). TASER Electronic Control Devices: Physiology, Pathology, and Law. New York: Springer<br />

Science <strong>Med</strong>ia, 2009.<br />

Kulig K, Ling L. General Management of Poisonings. In Marx, Hockberger, Walls, et al, eds. Rosenʼs <strong>Em</strong>ergency<br />

<strong>Med</strong>icine: Concepts and Clinical Practice, 7th Edition, St. Louis, Elsevier, 2010<br />

Ling, LJ. Ethanol, methanol, ethylene glycol and isopropyl alcohol. In Markovchick, Pons, Bates eds. Secrets of<br />

<strong>Em</strong>ergency <strong>Med</strong>icine. 5th Edition, Philadelphia: Elsevier, 2010.<br />

Martel M, Biros MH. Psychotropic Drugs. In Tintinalli, et al. (Eds). <strong>Em</strong>ergency <strong>Med</strong>icine: A Comprehensive Study<br />

Guide. 7th Edition. New York, McGraw-Hill, 2009.<br />

Milkus KM. Ovarian torsion: Tips to make this tough diagnosis. In Avoiding Common Errors in the <strong>Em</strong>ergency<br />

Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters<br />

Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Miner JR. Procedural Sedation and Analgesia. In Tintinalli, et al. (Eds). <strong>Em</strong>ergency <strong>Med</strong>icine: A Comprehensive<br />

Study Guide. 7th Edition. New York, McGraw-Hill, 2009.<br />

Miner JR, Paris P, Yealy DM. Pain Management. In Rosenʼs <strong>Em</strong>ergency <strong>Med</strong>icine: Concepts and Clinical Practice,<br />

Marx, Hockberger, Walls (Eds.) Mosby, anticipated 2009<br />

Moore JC. Remember that eclampsia can occur in postpartum and in women with no prior diagnosis of<br />

preeclampsia. In Avoiding Common Errors in the <strong>Em</strong>ergency Department. Mattu A. Chanmugam AS, Swadron SP,<br />

Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 61


Moscati R and JD Ho. Alcohol and the CEW. In TASER Conducted Electrical Weapons: Physiology, Pathology, and<br />

Law. Ed. MW Kroll and JD Ho. New York: Springer Science <strong>Med</strong>ia, 2009.<br />

Olsen J, Gullett J. Do not forego a pelvic ultrasound in patients with a clinical suspicion for ectopic pregnancy but a<br />

low β-hCG. In Avoiding Common Errors in the <strong>Em</strong>ergency Department. Mattu A. Chanmugam AS, Swadron SP,<br />

Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Orozco BS. Do not cause further tissue injury during the management of frostbite. In Avoiding Common Errors in the<br />

<strong>Em</strong>ergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia:<br />

Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Reardon RF. Ultrasound in Trauma – The FAST Exam in Ultrasound Guide for <strong>Em</strong>ergency Physicians. Eds:<br />

Hoffmann (2009-2010) www.sonoguide.com/FAST.html<br />

Reardon RF. Echocardiographic Effects of Conducted Electronic Weapons. In TASER Conducted Electrical<br />

Weapons: Physiology, Pathology, and Law. Ed. MW Kroll and JD Ho. New York: Springer Science <strong>Med</strong>ia, 2009.<br />

Reardon RF. Mateer J, Ma OJ Editors; <strong>Em</strong>ergency Ultrasound Pocket Atlas - Eds:, (2010) McGraw Hill <strong>Med</strong>ical,<br />

New York<br />

Reardon RF. Basic Airway Management and Decision-Making in Clinical Procedures in <strong>Em</strong>ergency <strong>Med</strong>icine – Eds:<br />

Roberts J, Hedges J, et al (2010)<br />

Reardon RF. Tracheal Intubation in Clinical Procedures in <strong>Em</strong>ergency <strong>Med</strong>icine – Eds: Roberts J, Hedges J, et al<br />

(2010)<br />

Reardon RF. Focused Echocardiography and Volume Assessment in <strong>Em</strong>ergency Ultrasound Made Easy - Eds:<br />

Bowra J, McLaughlin R (2010)<br />

Reardon RF. <strong>Em</strong>ergency Ultrasound in <strong>Em</strong>ergency <strong>Med</strong>icine Study Guide - Eds: Tintinalli J, Ma OJ, et al (2010)<br />

Roline CE, Wang S. Be aware of the high risk associated with “fight bites”. In Avoiding Common Errors in the<br />

<strong>Em</strong>ergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia:<br />

Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Scott NL. Consider pulmonary embolism in pregnancy and the postpartum period. In Avoiding Common Errors in the<br />

<strong>Em</strong>ergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia:<br />

Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Sherman ML. Do not misinterpret vital signs in the pregnant patient. In Avoiding Common Errors in the <strong>Em</strong>ergency<br />

Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters<br />

Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Smith SW. Larson DM. What Pseudoinfarction Patterns Mimic ST elevation Myocardial Infarction? In Critical<br />

Decisions in <strong>Em</strong>ergency and Acute Care Electrocardiography. William Brady and JD Truwit, Editors. Blackwell<br />

Publishing 2009.<br />

Smith SW. Larson DM. What QRS Complex Abnormalities Result in ST Segment Elevation That May Mimic or<br />

Obscure AMI? In Critical Decisions in <strong>Em</strong>ergency and Acute Care Electrocardiography. William Brady and JD Truwit,<br />

Editors. Blackwell Publishing 2009.<br />

Stellpflug SJ. Holger JS. Smith SW. What is the Role of the ECG in the Patient with Suspected Acute Coronary<br />

Syndrome? In Critical Decisions in <strong>Em</strong>ergency and Acute Care Electrocardiography. William Brady and JD Truwit,<br />

Editors. Blackwell Publishing 2009.<br />

62 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010


Stellpflug SJ. Holger JS. Smith SW. What are the Electrocardiographically Silent Areas of the Heart? In Critical<br />

Decisions in <strong>Em</strong>ergency and Acute Care Electrocardiography. William Brady and JD Truwit, Editors. Blackwell<br />

Publishing 2009.<br />

Todd K, Miner JR Acute Pain Management in the <strong>Em</strong>ergency Department. In Acute Pain Management, Sinatra,<br />

Leon-Casasola, Ginsberg, Viscusi (Eds) Cambridge University Press, 2009<br />

Villaume IV FE. Always monitor third-trimester pregnant patients after they have sustained trauma of any severity. In<br />

Avoiding Common Errors in the <strong>Em</strong>ergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD,<br />

Woolridge DP (Editors). Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Vogel EE. Be prepared to manage postpartum hemorrhage at every delivery. In Avoiding Common Errors in the<br />

<strong>Em</strong>ergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia:<br />

Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Walz HF. Pelvic inflammatory disease is a difficult diagnosis to make: Know the CDC recommendations. In Avoiding<br />

Common Errors in the <strong>Em</strong>ergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP<br />

(Editors). Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Westgard BC. Know the basics of rewarming and resuscitation of hypothermic patients. In Avoiding Common Errors<br />

in the <strong>Em</strong>ergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors).<br />

Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.<br />

Whitwam W, Smith SW. Does Localization of the Anatomic Segment/Identification of the Infarct-Related Artery<br />

Affect Early Care? In Critical Decisions in <strong>Em</strong>ergency and Acute Care Electrocardiography. William Brady and JD<br />

Truwit, Editors. Blackwell Publishing 2009.<br />

Zvosec DL, Smith SW. Gamma hydroxybutyrate and Analogues. In: <strong>Em</strong>ergency Management of Drugs of Abuse.<br />

Harris C and Stellpflug S., eds. McGraw Hill. In Press.<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010 | 63


Clubs and Scrubs.....�<br />

<strong>Annual</strong> fundraising golf event<br />

BEAT THE BOSS.....��<br />

Resident vs. Faculty golf event<br />

After hours<br />

SAEM......�<br />

Interns, residents and staff attend the annual meeting of “The Society for<br />

Academic <strong>Em</strong>ergency <strong>Med</strong>icine”.<br />

64 | Department of <strong>Em</strong>ergency <strong>Med</strong>icine Activities <strong>Report</strong> | 2009-2010<br />

Resident Bowling<br />

League????............�


�......PreSeason Physical<br />

Cross country ski race, proceeds benefit the RA Program.<br />

�.......Golden Chest Tube<br />

Football game between <strong>Em</strong>ergency <strong>Med</strong>icine<br />

and Surgery residents<br />

Holiday<br />

Party....�<br />

Drs. Rearden, Miner,<br />

Heegaard, Sterner,<br />

Liberty Caroon and<br />

Dave Hildebrandt<br />

Bronz Foley.................�<br />

Broomball competition with Surgery<br />

�........ALOHA<br />

Party<br />

Welcome to our new<br />

residents & goodbye<br />

to our graduating<br />

residents<br />

�......Ultrasound Technology at the Zoo


®<br />

Department of <strong>Em</strong>ergency <strong>Med</strong>icine<br />

701 Park Avenue | Minneapolis, MN 55415<br />

www.hcmc.org

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