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