CalACEP Emergency Medicine Podcast

Dr. Lori Winston is an emergency medicine physician and Vice President of Medical Education at Kaweah Delta Healthcare in California’s central valley, Director of Academic Affairs for Vituity, and is now the current President of California ACEP. She joins us to discuss her path to emergency medicine, finding success in emergency medicine and her journey to the many different roles that she plays within medicine, and her views on leadership as she begins her term.

Please subscribe and rate the California ACEP podcast on Apple podcasts or wherever you download your podcasts.

Email feedback, questions, comments, or ideas to us at [email protected] and be sure to follow us on Twitter, Instagram, or Facebook.

Links:

Follow Dr. Winston on Twitter at @loriwinstonmd

Dr. Vik Gulati joins us to discuss California ACEP’s 31st Annual Legislative Leadership Conference (LLC), which will be held virtually on April 13th and 15th.

LLC is an opportunity for medical students, residents, and emergency medicine physicians to speak with legislators or their legislative staff and advocate for our patients and for emergency medicine as a specialty.

This is a great way to get experience with health policy and advocacy. You do not have to be an expert on policy or the legislative process, we will lead an introductory session and you will be meeting with legislators as a team and be grouped with folks with advocacy experience. Your experiences within medicine reflect the impact policy has on patient care. Advocacy can be as easy as simply telling a story from your last shift.

Join us for LLC! Register for free here: https://californiaacep.org/event/LLC2021

Please subscribe and rate the California ACEP podcast on Apple podcasts or wherever you download your podcasts.

Email feedback, questions, comments, or ideas to us at [email protected] and be sure to follow us on Twitter, Instagram, or Facebook.

Dr. Vik Gulati is an emergency physician in San Diego and the current President of California ACEP. He joins us to discuss his thoughts on health policy and advocacy, his pathway to joining California ACEP first as a fellow, then being elected to the Board of Directors, and his pathway to becoming President, and his goals for his term.

Please subscribe and rate the California ACEP podcast on Apple podcasts or wherever you download your podcasts.

Email feedback, questions, comments, or ideas to us at [email protected] and be sure to follow us on Twitter, Instagram, or Facebook.

Links:

Follow Dr. Gulati on Twitter at @vikgulati

Teaser Episode: Welcome to the California ACEP podcast!

We’re creating a podcast for California ACEP to bring you up to date information about health policy on both the state and national level and to talk about how these changes will impact your life and your practice. We will also have discussions with California ACEP leaders about who they are and what the organization is doing to address the issues that will affect you.

Please subscribe and rate the California ACEP podcast on Apple podcasts or wherever you download your podcasts.

Email feedback, questions, comments, or ideas to us at [email protected] and be sure to follow us on Twitter, Instagram, or Facebook.

If you want to claim CME credit for listening to this podcast series, you must listen here: https://californiaacep.org/page/CalACEP-MAT-Podcast-Disclosure.

CalACEP MAT Podcast Episode 6: MAT FAQ

In the final episode of this series, our experts answer some of the most frequently asked questions about MAT. You should now have all the tools and information you need to get started with MAT in your ED. See the links below for more resources and reach out to California ACEP with any questions. Remember Kayce’s story and commit to saving a life!

If you enjoyed this podcast let us know! Connect with us on social media at @californiaacep.

Hosts:

Julia Magaña, MD, FAAP. Assistant Professor of Pediatric Emergency Medicine at UC Davis

Sarah Medeiros, MD, MPH, FACEP. Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Aimee Moulin, Associate Professor of Emergency Medicine at UC Davis and Past President of California ACEP

Dr. Hannah Snyder, Assistant Professor of Family Community Medicine and Associate Director of the Addiction Consult Team at UC San Francisco

Dr. Reb Close, Emergency Medicine Physician at Community Hospital of Monterey Peninsula

Resources:

California ACEP Medication Assisted Treatment Resources

California Bridge

“We’re developing hospitals and emergency rooms into primary access points for addiction treatment. This intensive program provides training and technical assistance to acute care providers to encourage patients to enter and remain in treatment.”

Substance Abuse and Mental Health Services Administration (SAMHSA) Medication-Assisted Treatment Resources

“The Game Has Changed”. Featuring Dr. Gail D’Onofrio. EM Pulse Podcast. 2018 March 15.

https://ucdavisem.com/2018/03/15/the-game-has-changed-episode-4/

Apply for your DEA-X Waiver!

SAMHSA

GetWaivered.com

***

This series is a part of a chapter grant from the American College of Emergency Physicians (ACEP) and is made to compliment the online California ACEP MAT resources.

California ACEP is a wealth of information. Check out our website, californiaacep.org, where you’ll find resources beyond the MAT toolkit, including our mental health toolkit, ED violence prevention resources, human trafficking guidebook, safe prescribing guidelines for opioids, palliative care toolkit, PECARN decisions guides, and much more.

Thank you to Drs. Hannah Snyder, Aimee Moulin, and Reb Close for your expertise.

Also, a big thanks to Kelsey McQuaid for all of your hard work on this project.

EM Pulse is a podcast from the UC Davis Department of Emergency Medicine dedicated to bringing research and expert opinion to the bedside. Check it out and subscribe on iTunes, or wherever you get your podcasts. And follow us on social media @empulsepodcast.

Thanks to OM Audio Productions for audio production services.

References (from Dr. Snyder):

(https://discovery.cdph.ca.gov/CDIC/ODdash/).

Nationally, deaths from the opioid epidemic annually exceed those at the peak of the HIV epidemic. We've had more drug overdose deaths in 2017 than Americans that died in the entire Vietnam war (https://www.economist.com/briefing/2019/02/23/tens-of-thousands-of-americans-die-each-year-from-opioid-overdoses).

Here’s a cool graph that trends ED visits https://www.hcup-us.ahrq.gov/faststats/OpioidUseServlet?radio-3=on&location1=CA&characteristic1=01&setting1=ED&location2=US&characteristic2=01&setting2=ED&expansionInfoState=hide&dataTablesState=hide&definitionsState=hide&exportState=hide

Kashef Z. Starting opioid addiction treatment in the ED is cost-effective, says study. Yale News. August 16, 2017. Health media overview of landmark Yale MAT study and its effectiveness in guiding patients to treatment.

Initiating medication-assisted treatment for patients presenting with opioid withdrawal. ED Management. August 1, 2017. Health media overview of the effectiveness of MAT with a focus on the experiences of a program initiated in Washington state.

Emergency department initiation of medication-assisted treatment for opioid addiction: Strategies for success. California Health Care Foundation. Published August 2016. Report on launching an opioid addiction treatment program with visual guide to setting up an effective MAT program.

Emergency department treatment and follow-up strategies for opioid use disorder. Centers for Medicare & Medicaid Services. December 13, 2017. PowerPoint presentation outlining CMS-sponsored lectures on ED treatment and follow-up planning for patients presenting with opioid use disorder.

Robeznieks A. For patients struggling with opioids, ED visit can mark new start. AMA Wire. November 22, 2017. Brief AMA article outlining MAT therapy in the ED at Washington University Medical Center in St. Louis.

Frazier WT. Medication-assisted treatments and opioid use response to opioid overdose sentinel events. Master essay, University of Pittsburgh. Comprehensive overview of MAT response to opioid overdose to determine treatment utilization before and after nonfatal overdose using a longitudinal retrospective cohort of the Pennsylvania Medicaid population 2008-2013.

Martin A, Kunstler NM. Opinion: We have effective treatments for opioids addiction - why don’t we use them?” ACEPNow. December 12, 2017. Article on some barriers to the widespread adoption of MAT and a call to overcome these barriers for the sake of our patients.

Addressing the opioid crisis - an ACH collaboration. Washington State Hospital Association, Washington State Medical Association. Set of strategies outlined by the Accountable Communities of Health for communities, hospitals, and providers to better combat the opioid epidemic, of which MAT is a main component.

Research

D'Onofrio G, O'Connor PG, Pantalon MV, et al. Emergency department-initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial. JAMA. 2015 Apr 28;313(16):1636-44. “The D’Onofrio Trial,” a randomized clinical trial performed at Yale showing the effectiveness of ED initiated MAT.

Does initiating medication assisted treatment in the emergency room result in better outcome? Recovery Research Institute. An organized breakdown and summary of the D’Onofrio study highlighting the effectiveness of ED initiated MAT.

Protocols

SBIRT and Buprenorphine/Naloxone Administration in the ED for Acute Withdrawal: St Agnes Hospital (PDF).

California ED-Bridge/ Emergency Buprenorphine Treatment Project: Guide for Emergency Buprenorphine Treatment (PDF).

ED Initiation of Buprenorphine in the Emergency Department: Natividad Medical Center (PDF).

Opioid Withdrawal Protocol: Zuckerberg San Francisco General Hospital and Trauma Center (PDF includes pocket card).

If you want to claim CME credit for listening to this podcast series, you must listen here: https://californiaacep.org/page/CalACEP-MAT-Podcast-Disclosure.

CalACEP MAT Podcast Episode 5: Implementation

We’ve covered why we should treat opioid use disorder in the ED, how to identify, then approach patients who might benefit from MAT, and lastly how to appropriately use buprenorphine. You’re ready to change your practice, but where do you start? Our experts offer their advice for how to get buy-in from leadership and your colleagues, as well as some specifics on how to start a MAT program in your ED.

If you enjoyed this podcast let us know! Connect with us on social media at @californiaacep.

Hosts:

Julia Magaña, MD, FAAP. Assistant Professor of Pediatric Emergency Medicine at UC Davis

Sarah Medeiros, MD, MPH, FACEP. Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Aimee Moulin, Associate Professor of Emergency Medicine at UC Davis and Past President of California ACEP

Dr. Hannah Snyder, Assistant Professor of Family Community Medicine and Associate Director of the Addiction Consult Team at UC San Francisco

Dr. Reb Close, Emergency Medicine Physician at Community Hospital of Monterey Peninsula

Resources:

California ACEP Medication Assisted Treatment Resources

California Bridge

“We’re developing hospitals and emergency rooms into primary access points for addiction treatment. This intensive program provides training and technical assistance to acute care providers to encourage patients to enter and remain in treatment.”

Substance Abuse and Mental Health Services Administration (SAMHSA) Medication-Assisted Treatment Resources

“The Game Has Changed”. Featuring Dr. Gail D’Onofrio. EM Pulse Podcast. 2018 March 15.

https://ucdavisem.com/2018/03/15/the-game-has-changed-episode-4/

Apply for your DEA-X Waiver!

SAMHSA

GetWaivered.com

***

This series is a part of a chapter grant from the American College of Emergency Physicians (ACEP) and is made to compliment the online California ACEP MAT resources.

California ACEP is a wealth of information. Check out our website, californiaacep.org, where you’ll find resources beyond the MAT toolkit, including our mental health toolkit, ED violence prevention resources, human trafficking guidebook, safe prescribing guidelines for opioids, palliative care toolkit, PECARN decisions guides, and much more.

Thank you to Drs. Hannah Snyder, Aimee Moulin, and Reb Close for your expertise.

Also, a big thanks to Kelsey McQuaid for all of your hard work on this project.

EM Pulse is a podcast from the UC Davis Department of Emergency Medicine dedicated to bringing research and expert opinion to the bedside. Check it out and subscribe on iTunes, or wherever you get your podcasts. And follow us on social media @empulsepodcast.

Thanks to OM Audio Productions for audio production services.

If you want to claim CME credit for listening to this podcast series, you must listen here: https://californiaacep.org/page/CalACEP-MAT-Podcast-Disclosure.

CalACEP MAT Podcast Episode 4: Treating with Buprenorphine

In the fourth episode of our series, we get into the nitty gritty of MAT in the ED. Our experts cover appropriate dosing, potential side effects and contraindications, and so more. See below for links to the California ACEP MAT Toolkit and other resources.

If you enjoyed this podcast let us know! Connect with us on social media at @californiaacep.

Hosts:

Julia Magaña, MD, FAAP. Assistant Professor of Pediatric Emergency Medicine at UC Davis

Sarah Medeiros, MD, MPH, FACEP. Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Aimee Moulin, Associate Professor of Emergency Medicine at UC Davis and Past President of California ACEP

Dr. Hannah Snyder, Assistant Professor of Family Community Medicine and Associate Director of the Addiction Consult Team at UC San Francisco

Dr. Reb Close, Emergency Medicine Physician at Community Hospital of Monterey Peninsula

Resources:

California ACEP Medication Assisted Treatment Resources

California Bridge

“We’re developing hospitals and emergency rooms into primary access points for addiction treatment. This intensive program provides training and technical assistance to acute care providers to encourage patients to enter and remain in treatment.”

Substance Abuse and Mental Health Services Administration (SAMHSA) Medication-Assisted Treatment Resources

“The Game Has Changed”. Featuring Dr. Gail D’Onofrio. EM Pulse Podcast. 2018 March 15.

https://ucdavisem.com/2018/03/15/the-game-has-changed-episode-4/

Apply for your DEA-X Waiver!

SAMHSA

GetWaivered.com

***

This series is a part of a chapter grant from the American College of Emergency Physicians (ACEP) and is made to compliment the online California ACEP MAT resources.

California ACEP is a wealth of information. Check out our website, californiaacep.org, where you’ll find resources beyond the MAT toolkit, including our mental health toolkit, ED violence prevention resources, human trafficking guidebook, safe prescribing guidelines for opioids, palliative care toolkit, PECARN decisions guides, and much more.

Thank you to Drs. Hannah Snyder, Aimee Moulin, and Reb Close for your expertise.

Also, a big thanks to Kelsey McQuaid for all of your hard work on this project.

EM Pulse is a podcast from the UC Davis Department of Emergency Medicine dedicated to bringing research and expert opinion to the bedside. Check it out and subscribe on iTunes, or wherever you get your podcasts. And follow us on social media @empulsepodcast.

Thanks to OM Audio Productions for audio production services.

If you want to claim CME credit for listening to this podcast series, you must listen here: https://californiaacep.org/page/CalACEP-MAT-Podcast-Disclosure.

CalACEP MAT Podcast Episode 3: Treatment Options

In this episode, our experts discuss various treatment options available for opioid use disorder. What do you need to know? How do you approach a patient? What do you need from the patient? Turns out all you need from them is to be willing!

If you enjoyed this podcast let us know! Connect with us on social media at @californiaacep.

Hosts:

Julia Magaña, MD, FAAP. Assistant Professor of Pediatric Emergency Medicine at UC Davis

Sarah Medeiros, MD, MPH, FACEP. Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Aimee Moulin, Associate Professor of Emergency Medicine at UC Davis and Past President of California ACEP

Dr. Hannah Snyder, Assistant Professor of Family Community Medicine and Associate Director of the Addiction Consult Team at UC San Francisco

Dr. Reb Close, Emergency Medicine Physician at Community Hospital of Monterey Peninsula

Resources:

California ACEP Medication Assisted Treatment Resources

California Bridge

“We’re developing hospitals and emergency rooms into primary access points for addiction treatment. This intensive program provides training and technical assistance to acute care providers to encourage patients to enter and remain in treatment.”

Substance Abuse and Mental Health Services Administration (SAMHSA) Medication-Assisted Treatment Resources

“The Game Has Changed”. Featuring Dr. Gail D’Onofrio. EM Pulse Podcast. 2018 March 15.

https://ucdavisem.com/2018/03/15/the-game-has-changed-episode-4/

Apply for your DEA-X Waiver!

SAMHSA

GetWaivered.com

***

This series is a part of a chapter grant from the American College of Emergency Physicians (ACEP) and is made to compliment the online California ACEP MAT resources.

California ACEP is a wealth of information. Check out our website, californiaacep.org, where you’ll find resources beyond the MAT toolkit, including our mental health toolkit, ED violence prevention resources, human trafficking guidebook, safe prescribing guidelines for opioids, palliative care toolkit, PECARN decisions guides, and much more.

Thank you to Drs. Hannah Snyder, Aimee Moulin, and Reb Close for your expertise.

Also, a big thanks to Kelsey McQuaid for all of your hard work on this project.

EM Pulse is a podcast from the UC Davis Department of Emergency Medicine dedicated to bringing research and expert opinion to the bedside. Check it out and subscribe on iTunes, or wherever you get your podcasts. And follow us on social media @empulsepodcast.

Thanks to OM Audio Productions for audio production services.

If you want to claim CME credit for listening to this podcast series, you must listen here: https://californiaacep.org/page/CalACEP-MAT-Podcast-Disclosure.

CalACEP MAT Podcast Episode 2: Opioid Overview

In this episode we explore what the opioid crisis is, who it impacts, and why we care as emergency medicine providers. We discuss the options that are out there and what our experts believe is the best for the ED setting.

If you enjoyed this podcast let us know! Connect with us on social media at @californiaacep.

Hosts:

Julia Magaña, MD, FAAP. Assistant Professor of Pediatric Emergency Medicine at UC Davis

Sarah Medeiros, MD, MPH, FACEP. Assistant Professor of Emergency Medicine at UC Davis

Guests:

Dr. Aimee Moulin, Associate Professor of Emergency Medicine at UC Davis and Past President of California ACEP

Dr. Hannah Snyder, Assistant Professor of Family Community Medicine and Associate Director of the Addiction Consult Team at UC San Francisco

Dr. Reb Close, Emergency Medicine Physician at Community Hospital of Monterey Peninsula

Resources:

California ACEP Medication Assisted Treatment Resources

California Bridge

“We’re developing hospitals and emergency rooms into primary access points for addiction treatment. This intensive program provides training and technical assistance to acute care providers to encourage patients to enter and remain in treatment.”

Substance Abuse and Mental Health Services Administration (SAMHSA) Medication-Assisted Treatment Resources

Apply for your DEA-X Waiver!

SAMHSA

GetWaivered.com

***

This series is a part of a chapter grant from the American College of Emergency Physicians (ACEP) and is made to compliment the online California ACEP MAT resources.

California ACEP is a wealth of information. Check out our website, californiaacep.org, where you’ll find resources beyond the MAT toolkit, including our mental health toolkit, ED violence prevention resources, human trafficking guidebook, safe prescribing guidelines for opioids, palliative care toolkit, PECARN decisions guides, and much more.

Thank you to Drs. Hannah Snyder, Aimee Moulin, and Reb Close for your expertise.

Also, a big thanks to Kelsey McQuaid for all of your hard work on this project.

EM Pulse is a podcast from the UC Davis Department of Emergency Medicine dedicated to bringing research and expert opinion to the bedside. Check it out and subscribe on iTunes, or wherever you get your podcasts. And follow us on social media @empulsepodcast.

Thanks to OM Audio Productions for audio production services.

If you want to claim CME credit for listening to this podcast series, you must listen here: https://californiaacep.org/page/CalACEP-MAT-Podcast-Disclosure.

Episode 1: Kayce was my daughter

The opioid crisis is a reality for all of us. In this series, we go in-depth on what YOU can do about it in your emergency department (ED). This is the first of six episodes brought to you by California ACEP on medication assisted treatment or MAT. Dr. Steve Anderson, an experienced emergency physician, tells his own compelling story of why he is leading the charge in his ED to combat opioid addiction.

If you enjoyed this podcast let us know! Connect with us on social media at @californiaacep.

Hosts:

Julia Magaña, MD, FAAP. Assistant Professor of Pediatric Emergency Medicine at UC Davis

Sarah Medeiros, MD, MPH, FACEP. Assistant Professor of Emergency Medicine at UC Davis

Guest:

Stephen H. Anderson, MD, FACEP. Emergency Medicine Physician, and Chair of the National ACEP Board of Directors.

Resources:

California ACEP Medication Assisted Treatment Resources

California Bridge

“We’re developing hospitals and emergency rooms into primary access points for addiction treatment. This intensive program provides training and technical assistance to acute care providers to encourage patients to enter and remain in treatment.”

“Steve’s Story: Fighting for Kayce” Real Talk Podcast. Recorded Apr 4th 2019 at the Washington ACEP “Summit to Sound” Conference in Seattle. Speaker: Steve Anderson, MD, FACEP with Alicia Kurtz, MD. https://www.vituity.com/realtalk

Substance Abuse and Mental Health Services Administration (SAMHSA) Medication-Assisted Treatment Resources

Apply for your DEA-X Waiver!

SAMHSA

GetWaivered.com

***

Thank you to Dr. Alicia Kurtz and Marco Gonzalez from Real Talk Podcast for facilitating this recording. Real Talk is a space for doctors and other healthcare professionals to share their real, human experiences from working in medicine.

Thank you to Dr. Steve Anderson for sharing his personal story.

This series is a part of a chapter grant from the American College of Emergency Physicians (ACEP) and is made to compliment the online California ACEP MAT resources.

California ACEP is a wealth of information. Check out our website, californiaacep.org, where you’ll find resources beyond the MAT toolkit, including our mental health toolkit, ED violence prevention resources, human trafficking guidebook, safe prescribing guidelines for opioids, palliative care toolkit, PECARN decisions guides, and much more.

Thank you to Drs. Hannah Snyder, Aimee Moulin, and Reb Close for your expertise.

Also, a big thanks to Kelsey McQuaid for all of your hard work on this project.

EM Pulse is a podcast from the UC Davis Department of Emergency Medicine dedicated to bringing research and expert opinion to the bedside. Check it out and subscribe on iTunes, or wherever you get your podcasts. And follow us on social media @empulsepodcast.

Thanks to OM Audio Productions for audio production services.