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

hcmc.org

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

Department of

®

Medicine

Every Life Matters 24/7

2009–2010


Dear readers,

Contents

This activity report is our attempt to update

you on the remarkable productivity of our

Department of Emergency Medicine. We

believe this document shows the vitality and

passion of our faculty, residents, and ED

staff, as well as their fondness towards and

support of HCMC .

As the editor of this report, I ask that you

please forgive me for any inaccuracies that

may be present in these pages. We have

tried our best to get everything right, but it is

likely that we have misrepresented, forgotten

or ignored at least something. Any mistakes

are likely to be ones of omission, and once I

learn of them, I will include them the next

time around!

Many thanks to the E MED faculty for the

material they contributed to this report and

to the departmental office staff (especially

Nancy Newkumet) for the many many hours

they spent helping get this together and

keeping the staff doctors organized.

We hope you enjoy these pages and we

vow to bring you more in the future!

Keep in touch.

Michelle Biros, MD MS

Department of Emergency Medicine

HCMC

2 Department Overview

Chiefʼs Letter, J. Clinton

Mission Statement

History of Department of

Emergency Medicine, E. Ruiz

14 Our Clinical Practice

Overview from the Assistant Chiefs

ED Statistics

Pre-Hospital/Disaster Medicine

Hyperbaric Medicine

Emergency Ultrasound

International Emergency Medicine Outreach

24 The People of the ED

26 The Clinical / Academic Faculty

Faculty Profiles

Our Residents

Our Physician Assistants

32 Medical Education

Teaching the Next Generation

Clinical Curriculum

Simulation and Innovation

Web Based Education

Online Learning

Our Fellows

Students in Emergency Medicine

38 Advancing the Science of

Emergency Medicine

The Research Associates Program

Scholarly Achievemens

External Grant Awards

Publications | Peer Reviewed

Publications | Abstracts |

Scientific Presentations

64 After Hours

Department of Emergency Medicine Activities Report | 2009-2010 | 1


Overview from

the Chief of Emergency Medicine

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

our active and dynamic Department of Emergency Medicine. Our intermittently produced annual reports

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

report becomes an annual historical milestone of the continuing growth of our academic department.

We continue to strive to deliver the highest quality emergency care to our patients while testing our

existing and emerging practices with disciplined clinical research. Our academic research and

educational activities provide the motivation for continued excellence. Clinical and academic innovations

are constantly occurring in our fine institution. Visit our online conferences and instructional videos on our

nationally acclaimed website at www.hqmeded.com for a flavor of these activities.

You will read in this report on the progress of our Emergency Medicine Residency and subspecialty

fellowships. Clinical simulation has become a key component of our clinical education. Our residency has

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

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

We have trained a number of fellows in EMS, Hyperbaric Medicine, Ultrasound, Research Methodology,

Toxicology and, most recently, in International EM. A required clerkship in Emergency Medicine at the

University of Minnesota Medical School has existed for six years, providing a steady stream of medical

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

emergency medicine clinical experience.

We continue to enjoy the experience of Emergency Medicine in the uniquely suited environment of

Hennepin County Medical Center. The rich diversity of our patient population and their pathologies

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

technologies and management strategies, many of which have been developed and tested by our very

talented faculty.

I hope you enjoy reviewing the 2009-2010 Activity Report for the Department of Emergency Medicine.

Joseph E. Clinton, M.D.

Chief, Emergency Medicine

2 | Department of Emergency Medicine Activities Report | 2009-2010


Department of Emergency Medicine

Mission Statement

We, the faculty of the Department of

Emergency Medicine, strive to excel as

leaders in the specialty of Emergency

Medicine.We are devoted to providing

excellent care at any time, to any patient

in need of emergency medical services both

in the Emergency Department and in the

greater community.We are determined to

optimize the medical care and well-being

of all patients by working within the

Medical Center in a spirit of cooperation.

We are committed to educational excellence

in training physicians, students of medicine,

allied health professionals, and the lay

public in the prevention and management

of acute illness or injury.

We will advance the quality of emergency

care everywhere by contributing new

knowledge and skills obtained through

active biomedical research and innovation

in the practice of Emergency Medicine.

Department of Emergency Medicine Activities Report | 2009-2010 | 3


A Thumbnail History of

Emergency Medicine in the U.S. and

Hennepin County Medical Center

The Start

The National Scene Post WWII by Ernest Ruiz, MD, FACEP

Access to emergency room (ER) care across the

U.S. in the fifties and sixties did not keep up with

the needs of the growing post-war population. The

numbers of practicing physicians had not kept

pace with the growth. Many people began to use

the ER as their primary source of medical care.

Under-staffed, under-funded, and under-equipped,

ERs were serious problems for most hospitals.

Practicing physicians who staffed community

hospitals were pressured by demands for their

time. They were on-call to the ER during their

non-clinic hours. Hospitals and their affected

physician staff became open to ideas that might

ease the situation.

In 1961, an over-burdened practicing physician,

James D. Mills in Alexandria, Va., decided to limit

his practice to ER coverage. He pulled together a

group of like-minded physicians to cover their

community hospital ER around-the-clock. They

would make a modest living at it. They became

"specialists" in emergency care. James Mills

(1920-1989), a respected general practitioner and

proper gentleman, is credited as being the "father

of emergency medicine." The "Alexandria Plan's"

success encouraged physicians elsewhere to get

organized as well. General practitioners John G.

Wiegenstein in Lansing, Mich., Ralston R. Hannas

in Sentinal, Oak., and Harris B. Graves in Omaha,

Neb. joined or formed similar groups and

vigorously carried the message onto the national

stage. They envisioned that emergency care could

be improved across the U.S. if physicians who

4 | Department of Emergency Medicine Activities Report | 2009-2010

chose emergency medicine as their livelihood had

their own national organization. Wiegenstein

(1930-2004) and seven others boldly formed a

society called the American College of Emergency

Physicians (ACEP) in 1968. ACEP met in

Colorado the next year and 128 physicians

attended. Hannas (1918-2005) and Harris

(1928-1995) had joined in. ACEP is now widely

accepted as the most effective sounding board for

the practice of emergency medicine while strongly

encouraging scientific progress. It has over 26,000

members. The vision of these few men and

women lives on. They looked forward to the

establishment of residency training for emergency

physicians and the attainment of primary board

status for emergency medicine.

Academia Stumbles Forward

Meanwhile, academic institutions responsible for

the big-city teaching hospitals assigned

responsibility for their ERs to the departments of

Surgery and Medicine. Although their residency

training programs provided some medical

manpower, the need for clinical experience in their

specialties did not justify staffing the ER solely with

their residents. The ER was as serious a problem

in the "city hospitals" as it was in community

hospitals. Unfortunately, the inter-departmental

competition for scarce resources common to

teaching hospitals at that time made the common

sense approach used by James Mills impossible.

The obvious solution was to create a residency

program for emergency medicine. This was not an

option because it would have encroached on the


Ernie Ruiz, MD stands before his

portrait, commissioned on the opening

of the Ernie Ruiz Emergency Medicine

Residentʼs Library, 2006

privileges and resources provided to the existing

specialties. A crisis was needed to make a change.

The race riots in Cincinnati, Ohio in the late sixties

provided a crisis. The University of Cincinnati's

Cincinnati General Hospital ER was crowded with

patients who perceived their care as poor and

were dissatisfied with long waits. A young internal

medicine staff physician, Herbert Flessa, was

directed by hospital leaders to come up with a

plan. He saw a short and long-term solution if a

residency in emergency medicine could be

established. He was joined by a young

neurosurgeon, H. Paul Lewis, in drawing up a

curriculum and making arrangements for such a

residency. They were unable to find a path to

official recognition but went ahead anyway and

recruited the first resident, Bruce Janiak, in 1970.

This was nine years after James Mills started his

plan. Flessa, Lewis and other staff assigned to the

ER by the hospital were not dedicated to the

practice of emergency medicine and left to

practice their own specialties. The residency

struggled along for a few years and almost

2:00 am


Emergency Department at HCMC in 1971

disappeared but managed to produce leaders in

emergency medicine. Richard Levy, a recent

graduate, became its head in 1977 and

developed a strong education and researchoriented

department while putting community

dissatisfaction to rest. It remains one of the

strongest EM residencies in the U.S.

The news that a residency in Emergency Medicine

had begun at the University of Cincinnati was

reported in 1970 in a national news magazine.

Five new residencies in Emergency Medicine

began more or less simultaneously in 1971-1972

in these teaching hospitals: Los Angeles County

General Hospital; Hennepin County General

Hospital (HCGH); Medical College of

Pennsylvania in Philadelphia; Louisville General

Hospital and the University of Chicago. The ERs

6 | Department of Emergency Medicine Activities Report | 2009-2010

were now called Emergency Departments (EDs).

Just 3 years later, 32 EM residencies were

in operation.

EMS Arrives

In 1970, a society called the University Association

for Emergency Medical Services (UA/EMS) was

formed by surgeons interested in pre-hospital and

ED management of trauma as well as in academic

emergency department improvements. Advances

in field management of battle wounds by "medics"

and in helicopter transport to medical facilities

during the Vietnam War offered exciting

possibilities. The new EM residency at Los

Angeles County, led by Gail V. Anderson Sr.,

graduated a resident, Ronald Stewart, who taught

one of the first paramedic programs in the country

in 1971. The surgeons realized that EMS


development on the civilian front was a very time

consuming undertaking as was ED management.

Many academic trauma surgeons, already

over-committed to their surgical services, readily

relinquished their positions in the society as

emergency physicians got involved. UA/EMS

became UAEM in 1976 when David Wagner, Chair

of EM at the Medical College of Pennsylvania was

President and the membership was mostly

emergency physicians affiliated with EM

residencies. UAEM, with Ernest Ruiz of HCMC as

President and the Society of Teachers of

Emergency Medicine (STEM), with Mary Ann

Cooper of the University of Illinois as President,

joined in 1989 to form the Society for Academic

Emergency Medicine (SAEM). SAEM is the

research arm of emergency medicine. SAEM

hosts an annual meeting featuring research

presentations attended by about 1,700 residents,

faculty, students, and others. EMS advances and

EMS research remain vital interests among

SAEM members.

Well Earned Respect

Emergency physicians were considered itinerant

know-nothings by the elite of some specialties in

the sixties. Board status was needed for

emergency medicine. ACEP appointed members

to a committee on board establishment in 1974.

This group worked with the American Board of

Medical Specialties (ABMS) to gain acceptance as

a primary board. Committee member Peter Rosen,

EM Director at the University of Chicago and a

staunch enemy of dishonesty, famously answered

endless wavering from the specialties with blunt

invective. Nevertheless, progress was painfully

slow. The first step was to develop and administer

an oral and written examination designed to certify

an emergency physician capable of making good

decisions in any emergency situation. This test

developed by UAEM and ACEP members was to

be the American Board of Emergency Medicine

(ABEM) examination. It was successfully

administered in 1980 and those who passed it

became board certified by an EM "Conjoint

Board." An important step was the publishing by

ACEP in 1979 of Emergency Medicine, a

Comprehensive Study Guide, the brainchild of

Judith E. Tintinalli, EM Residency Director at

Wayne State/Detroit Receiving. The test takers

were expected to be knowledgeable of all

emergencies across all specialties and this text

made board preparation a feasible task. Ronald

Krome, Director of EM at Wayne State/Detroit

Receiving and Ruiz were co-editors of the 2nd

edition with Tintinalli. Several HCMC EM, surgery,

neurosurgery, and medicine staff members

contributed chapters. Finally, Primary Board Status

in the ABMS was obtained in 1989, while Joseph

Clinton, then Assistant Chief of EM at HCMC, was

President of ABEM.

Ref: Zink, Brian J: Anyone, anything, anytime: a history of

emergency medicine, Philadelphia, 2006, Mosby, Inc.

Busy Hennepin County General Hospital Emergency

Department, 1950-1967

Department of Emergency Medicine Activities Report | 2009-2010 | 7


Part 2: A Thumbnail History of

Emergency Medicine at

Hennepin County Medical Center

by Ernest Ruiz, MD, FACEP

Hennepin County Medical Center (HCMC) evolved

from Minneapolis City Hospital (1887-1901),

Minneapolis General Hospital (1901-1964), and

Hennepin County General Hospital (1964-1974.)

In 1955, Professor Owen Wangensteen, Chair of

the Department of Surgery at the University of

Minnesota (UM), assigned one of his surgeons,

Claude R. Hitchcock (1920-1994), to the

Minneapolis General Hospital (MGH) to be Chief

of the Department of Surgery. The ER was already

run by a surgery department that consisted of

academically inclined community surgeons who

donated their time to teach and supervise. The ER

was usually staffed by interns and one first year

surgery resident. Hitchcock's arrival enlivened the

hospital with his energy and his love for teaching

and research. Like his mentor, he was a stern

administrator and believed that medicine was a

24/7 occupation. The hospital became well known

for its surgical expertise, especially for trauma and

cancer surgery.

In 1965, hospital and nursing administrations

selected Hildred Prose, RN, an ER staff nurse

since 1951, to become Director of Emergency

Services, answering directly to Hitchcock. The ER

had become very busy, overcrowded, and

understaffed. She was a strong advocate for the

ER patient. She became a thorn in the side of

administration and that of Hitchcock with her

admonitions about staffing and space needs. In

the late sixties, the ER was remodeled and

8 | Department of Emergency Medicine Activities Report | 2009-2010

enlarged, expanding into space that had been the

ambulance garage. Hitchcock also encouraged

the ambulance service to train its "drivers" with

basic emergency skills. Interns were no longer

required to ride ambulances. Still, the ER

remained overcrowded. The sixties saw the advent

of Cardio Pulmonary Resuscitation (CPR) that

could be initiated pre-hospital. Ambulance

personnel and fire fighters applied this new skill

enthusiastically. Persons previously pronounced

dead in the community were now rushed, CPR in

progress, to the ER already teeming with patients.

Although attempts were made to resuscitate them

in ER cubicle space, monitoring equipment and

other tools were lacking. Prose wrote long memos

to Hitchcock about problems. He was already

extremely busy leading his department in vital

areas, such as renal transplantation and wound

infection treatment with hyperbaric oxygenation.

In 1971, Hitchcock called Ernest Ruiz, a general

surgeon on his staff, to his office and asked him to

"run the ER." Ruiz was four years out of his

surgery residency. He had experience in trauma

surgery and knew that improvements could be

made. After conferring with his wife about the

consequences of this new assignment, they

agreed that it was the right thing to do. He met

with Hitchcock to accept the offer. Ruiz specified

that it was on condition that the ER was to be

under his control without interference from

Hitchcock or the other departments – it was to be

an Emergency Department (ED) instead of an ER.


Hitchcock nodded his approval. No papers were

signed. Ruiz became Chief of the ED. He

remained on the surgical staff and helped provide

surgical coverage for fifteen more years.

Ruiz found that he had much to learn if he was

going to be an emergency physician as well as a

general surgeon. One never knew what was going

to come through the door next. It was obvious that

residency training in EM was needed. Two second

year surgery residents, G. Patrick Lilja and Robert

S. Long (1938-2005) were drawn to the ED by its

variety and intensity. They had read an article in a

news magazine describing the new residency in

EM at Cincinnati General and called it to Ruiz's

attention. Within days Ruiz put together a

curriculum and sent it off to the fledgling ACEP for

a reaction. No response returned, but the

residency was started anyway in the fall of 1971

with Lilja and Long as the first residents. Hitchcock

allowed the two residents to switch to EM and

even agreed to continue their stipends for the

remainder of their year. The various services

welcomed the additional support from EM

residents. Hitchcock never told Ruiz he approved

of EM, but his support for the residency showed

his willingness to give it a chance.

In 1972, one of Ruiz's first goals was to stop the

practice of rushing critical patients "upstairs." A

well equipped room in the ED should be kept

ready for such patients. Prose was in complete

agreement, having observed the dangers of the

rush-upstairs practice as an ED nursing director.

An ENT exam room could be refurbished as a

"Stabilization Room." Prose successfully recruited

a respected Night Supervisor who was expert in

getting critical care initiated. Audrey Kuhne, RN

(1929-2005) joined the ED nursing staff in 1973

and helped the Stabilization Room effort obtain

hospital-wide credibility

and support. Ruiz and

Kuhne were successful

scavengers of equipment

and supplies from

throughout the hospital.

Some equipment was of

their own design and

G. Patrick Lilja, MD

made from scratch. The

Stabilization Room

contained the equipment necessary to resuscitate

almost any kind of emergency patient to the point

that he or she could be safely moved. Many

innovations were introduced there. For example,

cardiac ultrasound was first used there to

diagnose cardiac tamponade on presentation to

an ED. Not all cases could be "stabilized," but IVs

could be started, airways opened, x-rays and labs

obtained, and life-saving measures taken while an

operating room or intensive care area got ready.

To our knowledge, the Stabilization Room was the

first of its kind in the U.S. It can be stated that it

started a new age in emergency care.

Lilja and Long graduated from the EM residency

in 1972 and became EM staff. They almost

immediately began a first-of-its-kind program of

training pre-hospital personnel in emergency skills

on their own initiative. This included HCMC

ambulance "drivers," police, and firefighters. The

ambulance drivers became Emergency Medical

Technicians (EMT) and Paramedics according to

the skill level they achieved. ED nurses lamented

that Lilja and Long were not always in the ED, but

when patients arrived in better condition, they

appreciated their efforts.

In 1973, Ruiz was in the ED when a call came

from the airport reporting that an airliner was about

to land without its landing gear. The runway was

7:00 am


eing foamed. Ruiz and a resident grabbed

emergency equipment bags and went to the

airport in two ambulances. An ambulance from

another hospital also went to the airport. The plane

skidded in safely and all was well. Ruiz, however,

was disturbed by the lack of coordination and

communication between hospitals and rescue

services made evident by the happenstance

response to the near-disaster. At that time there

was suspicion between hospitals that ambulances

were out to steal patients. Some police and fire

departments were ambivalent about training in

emergency care. Radio communication between

all of the participants was unreliable. Ruiz called a

meeting of police chiefs, fire chiefs, emergency

department directors, ambulance services,

hospital administrators, and Hennepin County

administrators. All agreed that a coordinated

emergency response system for all emergencies

was needed. The group learned that a competition

for a $400,000 Robert Wood Johnson Foundation

grant was being offered to stimulate municipalities

to improve emergency communications and

training. Lilja and Long and others put together the

grant request. It was awarded to Hennepin County

with Lilja as primary investigator. It resulted in a

state-of-the art communications system,

paramedic training and certification, cardiac

defibrillators for pre-hospital use and, ultimately,

the West Metro EMS system.

Emergency Medical Services (EMS), created and

nurtured under the careful leadership of Lilja and

Long, has grown into one of the premier EMS

systems in the U.S. Hennepin County is now

served by five ambulance services staffed by

career paramedics. Air medical services are now

provided by LifeLink and North Aircare. Pat Lilja

was a prime mover in establishing helicopter

service in this area. He served as the EM Director

at North Memorial Medical Center and Medical

10 | Department of Emergency Medicine Activities Report | 2009-2010

Director of North Aircare. In 1985, Brian Mahoney,

HCMC EM staff physician, met with Ed Lord of the

Veterans Administration to start the Twin Cities

chapter of the National Disaster Medical System

(NDMS). Annual drills involving 50 organizations

from the East and West Metros are held. When

Grand Forks, N.D. was flooded in 1997, NDMS

evacuated patients from hospitals there to the

Twin Cities using C130 aircraft. Mutual support

also paid off when the 35W bridge fell into the

Mississippi River in 2007. In a little over an hour

all victims were cleared from the scene. EM staff

physician, John Hick, is a respected

spokesperson, teacher and hands-on leader in

Minnesota's Bioterrorism and Disaster

Preparedness efforts. In the 70ʼs, HCMC surgeons

and emergency physicians were leaders in

establishing a regional trauma system. The

Emergency Medical Services Advisory Council of

the State Health Department identified trauma

receiving hospitals throughout the state. They

were designated Level 1, 2, or 3 Trauma Centers

according to American College of Surgeons

guidelines. In the 90ʼs, EMS placed Automatic

External Defibrillators (AED) in the hands of first

responder agencies. Many lives have been saved

by fire fighters, police, and sheriffs who

successfully defibrillated patients in cardiac arrest.

Studies found that most of the high quality

neurologic saves were in patients defibrillated

early using an AED. Our Paramedics have been

doing prehospital 12 lead electrocardiograms for

years. They activate the cardiac catheterization lab

from the field for ST elevation myocardial

infarctions. HCMC Interventionalists have the best

door-to-open-vessel time in the country. EMS

education staff train over 2,000 EMTʼs and first

responders a year. EMS has also conducted vital

prehospital research including three National

Institute of Health funded studies: Public Access

Defibrillation; ResQ (enhanced CPR) Trial; and the


Rapid Anti-seizure

Medication Prior to Arrival

Trial (RAMPART). Jeff Ho,

an EM staff physician,

has monitored TASER

use by law enforcement

in our area and offers

scientifically sound

Robert Long, MD

recommendations for its

(1938-2005)

use. Drs. Ho, Hick and

Mahoney provide field supervision of HCMC

ambulance paramedics.

HCMC, including the ED, is on the cutting edge of

the digital documentation revolution. This has

been possible in the ED because both nursing and

physician staff have been led by leaders with

computing skills. Marsha Zimmerman, RN, and

Joseph Clinton, MD have patiently overcome the

difficulties associated with this huge challenge.

Other departments, especially Medical Imaging,

have also contributed.

The Crisis Intervention Center (CIC), now called

Acute Psychiatric Services (APS), had its

beginning in Minneapolis General Hospital in the

60's when a telephone on the ER nurse's desk

was dedicated to "suicide calls." In 1967 Zigfrids

Stelmachers (1928-2006), a Ph.D. Psychologist in

the Psychiatry Department, arranged for Mental

Health Center staff to relieve ER nursing staff of

this responsibility. In 1968 a small area adjacent to

the ER was added to allow face-to-face interviews

between mentally unstable or depressed patients

presenting to the ER and clinical psychologists.

This unit, under Stelmacher's direction, was the

first hospital based CIC in the country. In the 70's,

the role of the CIC was expanded to help in the

evaluation and disposition of patients being held in

"holding rooms" of the ED. Conversely, EM staff

helped CIC staff evaluate medical problems. This

cooperative arrangement continues between the

ED and APS.

HCMC's Poison Control Center (PCC) began in

the middle 70's when the numbers of calls about

possible or real poisoning and drug reactions

caused medical staff to be called away from

patient care. In 1974, Ruiz and Prose interviewed

applicants for a clerical position to assist. Alice

Lang (1914-2004) had no background in similar

services, but she was hired. She proved to be an

angel. She enthusiastically found ways to make

the service efficient and as helpful as possible.

She found ways to keep poison dangers before

the public. She sought expert advice from

botanists and authored a popular book on plant

poisoning. The UM College of Pharmacy saw the

new PCC as a good resource for pharmacy

graduates. Dr. Ed Krenzelok worked with Lang,

EM, and the College to make the PCC among the

best in the country. Enough trained staff were

brought on-board to provide 24 hour coverage. Dr.

Louis Ling, EM staff physician with an interest and

expertise in toxicology replaced Krenzelok when

he became Director of the Pittsburg Childrenʼs

Hospital Poison Center in 1984. The Poison Control

Center continues as a state-wide public treasure.

Hyperbaric Medicine came to HCGH in 1964.

Hitchcock had read articles written by Professor of

Surgery Ite Boerema at the University of

Amsterdam, Holland, regarding the successful

treatment of gas gangrene infections by

administering oxygen to afflicted patients in a high

pressure chamber. Gas gangrene results from

Clostridium infections. Clostridium bacteria are

anaerobes that cannot survive in tissue that is well

oxygenated. This form of infection had a very high

mortality rate and was not uncommon in post

surgical patients and in trauma patients. Hitchcock

used his genius for obtaining financial support to

Department of Emergency Medicine Activities Report | 2009-2010 | 11


The Hyperbaric Chamber in 1964

receive a National

Institutes of Health grant

for a state-of-the-art

multi-place hyperbaric

chamber and its

supporting research

facility located on the

same block as the old

Claude Hitchcock, MD

(1920-1994)

General. A large

contribution from a private

benefactor also helped make it possible. The first

patient was treated in 1964. HCGH became the

Hyperbaric Oxygenation (HBO) center for the

middle of the U.S. Many lives have been saved as

a result. Some of the hoped-for benefits of

hyperbaric oxygenation for certain conditions of

hypoxia did not pass scientific study. Myocardial

ischemia did not respond. However, HBO has

remained life-saving in the treatment of severe

bends, carbon monoxide poisoning, air embolism,

12 | Department of Emergency Medicine Activities Report | 2009-2010

and anaerobe infections. It is also beneficial for

several forms of poor healing resulting from poor

tissue oxygenation. Because many cases

presented as emergencies, it was natural that EM

would assume responsibility for the HBO service

when the two surgeons most involved in

hyperbaric medicine, Hitchcock and Dr. John

Haglin (1920-2001), Assistant Chief of Surgery,

retired. Surgery and other departments have

access to the HBO facility through EM. Cheryl

Adkinson, MD, an emergency physician also

board certified in Undersea and Hyperbaric

Medicine (UHM), is Director of Hyperbaric

Medicine. She directs the HBO Facility and its

certified UHM nursing and engineering personnel.

She is assisted by Robert Collier, MD and Eric

Gross, MD, also EM staff physicians boarded in

UHM. EM has been pleased to collaborate with

Dr. Gaylan Rockswold, Chief of Neurosurgery, and

other surgeons in exploring the uses of HBO.


Thirty-seven years after its beginning, over 260

EM physicians have graduated from the HCMC

residency. Many are practicing in Minnesota. Many

have provided service to their communities and to

the specialty. Two have reached the academic

level of Professor of Emergency Medicine. Joseph

Clinton, the current Chief of EM at HCMC and

Professor and Department Head of EM at the

University of Minnesota, is a 1977 graduate. G.

Patrick Lilja, a 1972 graduate, is a Clinical

Professor of Emergency Medicine. He supervises

EM residents on rotation at North Memorial

Medical Center. Two EM staff members who

trained at other residencies have reached the

professor level. Professor Louis Ling, HCMC

emergency physician, is a graduate of the

University of Chicago EM program. He is Assistant

Medical Director of HCMC, and Associate Dean

for Academic Affairs for the UM Medical School.

Professor Michelle Biros, a Cincinnati EM

Residency graduate and HCMC EM Associate

Research Director, served as SAEM's

Editor-in-Chief of Academic Emergency Medicine

from 1998 to 2008. Other staff have held

important national positions. Some have received

distinguished awards. Over 2000 articles have

been published in scientific journals.

a few rooms in the basement of the new hospital

to house a collection of documents, photos,

equipment, and written histories of experiences

she and others had saved. This formally became

the HCMC Historical Museum in 1994. Audrey

Kuhne and Donna Hoover, RN, Medicine Service

Supervisor, among many others, helped Prose

upgrade and maintain the exhibits in the museum.

Prose fully retired in 2008 after 60 years of service.

The museum is now open to the public. It is under

the direction of retired Nursing Administrators,

Rondine Mehling and Carol Oeltjenbruns.

Ref: Plummer D, Brunette D, Asinger R, Ruiz E: Emergency

department echocardiography improves outcome in penetrating

cardiac injury. Ann Emerg Med 21(6):708-12, 1992.

Holtan N: Hennepin County Medical Center's History Museum.

Metro Doctors: The journal of the East and West Metro Medical

Societies Jan/Feb: 17-19, 2009.

Hildred Prose RN, the

intrepid ED Nursing Director

who instigated so much

progress retired from her

clinical duties in 1965 and

The HCMC Historical Museum

became determined to

preserve the history of "the

General." The move to the

Hillie Prose, RN

new hospital in 1976 could

See http://vimeo.com/7377333

for an interview with Ernie and other

have meant a disastrous loss of historic

leaders in EM about mentorship,

documents and equipment were it not for Prose.

leadership and the development

She convinced hospital administration, with

of our specialty.

support from the HCMC Service League, to devote

12:00 pm


Doug Brunette, MD Bill Heegaard, MD

Our Clinical Practice

Overview from

the Assistant Chiefs of Emergency Medicine

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

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

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

complexity of the practice of emergency medicine and the changing health care environment. Our

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

observational or outpatient basis.

Significant modifications to the physical plant, as well as infrastructure occurred. Our Urgent Care Center

was moved immediately adjacent to the main emergency department and renamed Emergency Express

Care. EmStat, the electronic medical record specific for emergency medicine and utilized by our

department for 13 years, was replaced with the hospital wide EPIC system. Medical imaging, electrocardiography

and emergency department ultrasonography entered the digital age.

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

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

14 | Department of Emergency Medicine Activities Report | 2009-2010


Performance, Meaningful Use, Patient and Family Centered Care, Core Measures, and Press Ganey

among many others have become standard medical lexicon.

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

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

department and time to admission decreased compared to previous years. We have streamlined triage

with the implementation of immediate placement of patients into open Emergency Department and

Express Care beds with excellent responses from patients and staff.

Partnership with our referring hospitals has been a major focus of the HCMC Emergency Department

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

succeeded in achieving both our Adult and Pediatric Level 1 Trauma Center certifications with the

American College of Surgeons and continued to provide some of the fastest times from symptom onset to

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

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

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

Associate program, instrumental in facilitating clinical research in our department. It provides an

outstanding medical experience for college students interested in medicine as a career, as well as

medical students interested in emergency medicine as a specialty of choice.

Educational outreach continues to be a cornerstone of the HCMC Emergency Medicine Department. In

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

medicine. We also taught nursing students, PA students and paramedic students doing clinical rotations.

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

continuing education courses, ranging from paramedic certification classes to eight hour individual

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

educational venue named the Tactical Emergency Medical Peace Officer or TEMPO © course. Dr. Rob

Reardon continues to teach several ultrasound courses every year to community-based EPs.

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

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

the universe. Change is also central to the practice of emergency medicine. We look forward to the

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

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

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

the HCMC Department of Emergency Medicine. We look forward to another exceptional year in 2011 and

we welcome you to our Activity Report for 2009-2010.

Warm regards,

Dr. Douglas Brunette

Dr. William Heegaard

Department of Emergency Medicine Activities Report | 2009-2010 | 15


Emergency Department Statistics

Census 2009 2010

TOTAL 101,196 96,068

Main ED 69,847 69,850

Pediatric ED 13,578 (13.4 %) 10,836(11.3 %)

Express Care 17,771 15,382

Stabilization Room 3,508 (36 % trauma) 3,406 (37 % trauma)

Other Characteristics 2009 2010

All Admissions 14,569 (14. 3%) 14,222 (14. 8%)

Inpatient 12,515 11,739

Observation

Time in Department

2,054 2,483

Admissions 5 hr 8 min 4 hr 59 min

Discharged 3 hr 45 min 3 hr 4 min

Clinical Team Work

Trauma Services 2009 2010

Admits 2,769 2,669

From ED and STAB Room 1,725 1,408

Level I Trauma Activations 181 192

Level II Trauma Activations 520 473

Trauma Transfers 888 828

Pediatric Trauma (age 0-14 yrs) 336 343

Cardiology 2009 2010

Pre-hospital Cath Lab Activations for AMI 67 90

Therapeutic Hypothermia NA 94

Neurocritical Care 2009 2010

ED Stroke Codes 167 253

Transfers/Outreach Admissions 120 80 (though 9/10)

Door to tPA in Ischemic CVA 51 min (n=27) 49 (n=40)

16 | Department of Emergency Medicine Activities Report | 2009-2010


EMS and Disaster Medicine

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

the Mississippi River collapsed, creating a nearly 1 mile long

incident scene. Within minutes, Hennepin Emergency Medical

Services (EMS) responded with initial ambulances and

supervisors. Twenty-nine ambulances transported a total of 50

patients to area hospitals. In some cases, pickup trucks were

used to access areas that ambulances could not. Due to a rapid

and coordinated response, all patients were off the scene within

95 minutes after the collapse, despite the significant hazards and

access problems.

Hennepin County Medical Center (HCMC) activated their full disaster plan for the first time in over a

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

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

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

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

injured victims. Both mother and baby went on to make a full recovery.

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

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

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

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

critical trauma that contributed the most to the successful response: from accurate triage by EMS

personnel, to expedient care in the emergency department, the operating rooms, intensive care, and

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

John Hick, MD

Medical Director for Emergency Preparedness

EMS 2009 2010

TOTAL HCMC service calls 55,000 58,000

(74.5% medical) (75.6% medical)

Transported to HCMC 16,500 16,700


18 | Department of Emergency Medicine Activities Report | 2009-2010

35W Bridge Collapse

over Mississippi River


6:03 pm


Hyperbaric Medicine

Two thousand ten was a big year for HCMCʼs Hyperbaric Medicine Program. First, the program was

re-accredited by the Undersea and Hyperbaric Medical Society (like JCAHO in this role) with distinction.

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

Second, we had our first Accreditation Council for Graduate Medical Education (ACGME) site visit for the

Undersea and Hyperbaric Medicine Fellowship. The bad news is the process is the same for a fellowship

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

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

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

ACGME fellowship to sit for the Undersea and Hyperbaric Medicine subspecialty boards.

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

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

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

previously allocated for the purchase of a new chamber.

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

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

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

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

Fink Engineering to make the chambers better than any in use around the world.

Groundbreaking on the building renovation, Level I North Block, occured mid-May 2011. The chambers

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

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

facility until the new one is ready. How sweet it is!

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

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

Cher Adkinson, MD

Director, Underseas and Hyperbaric Medicine

HBO 2009 2010

TOTAL treatments 3035 3331

CO poisoning treatments 95 72

Decompression illness 3 5

Life/limb threatening soft tissue infections 32 57

Gas emboli 0 8

20 | Department of Emergency Medicine Activities Report | 2009-2010


Emergency Ultrasound

Our department has been a leader in the field of

emergency ultrasound. We use emergency US on a daily

basis in both clinical practice and research. Residents

learn US with hands-on formal teaching, US workshops

and under direct mentorship while working in the ED.

We currently have twelve ultrasound machines with full

wireless conductivity. Two are permanently mounted in the

Stabilization Room and two are mounted in our pelvic

examination rooms.

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

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

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

performed. Most exams were FAST, Cardiac and OB-GYN ultrasonographic studies.

Our department employs a full time dedicated sonographer who oversees the ultrasound education and

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

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

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

Rob Reardon, MD

Director, Emergency Medicine Ultrasound

The

Hyperbaric

Chamber

Liberty Caroon, an ED Sonographer, assists with an

emergency ultrasound

Department of Emergency Medicine Activities Report | 2009-2010 | 21


International Emergency Medicine Outreach

Our commitment to the delivery of good

emergency care has no geographic boundaries

and the spirit of adventure that makes our practice

so unique has also inspired our faculty and

residents to venture outside our ED walls. Over

the last few years, department members have

volunteered their medical services, administrative

expertise, and teaching talents to hospitals and

clinics in developing areas of the world, including

India, Africa, Central and South America and Haiti,

to name just a few. Often, medical students

accompany us on these medical missions.

These volunteer activities have offered a challenging

and humbling experience, and have underscored

the importance of international outreach.

Estimates by the World Health Organization

suggest that the burden of disease in the

developing world will shift from lower respiratory

disease, diarrheal disease and perinatal

conditions, to diseases that classically predominate

within the developed world. Ischemic heart

disease, unipolar depressive disease and road

traffic accidents are projected to be the top three

contributors to the developing worldʼs disease

burden, comprising greater than 20 percent of the

total by the year 2020. These projections provide a

unique opportunity to take the lessons learned

during the maturation of Emergency Medicine in

the United States and implement both educational

and public health policies that will have an

enormous and efficient impact.

To that end, a Fellowship in International

Emergency Medicine was founded in a joint effort

between HCMC and the University of Minnesota

andl “graduated” itʼs first fellow, Dr. Stephen

Dunlop, in July 2011. During this 2 year fellowship,

22 | Department of Emergency Medicine Activities Report | 2009-2010

Dr. Dunlop completed a Masters in Public Health

focusing on Healthcare in the Developing world, a

Certificate of Knowledge in Clinical Tropical

Medicine and Travelersʼ Health from the American

Society of Tropical Medicine and Hygiene.

Dr. Dunlop has just returned from a 6 month

assignment as Director of Outpatient Services at

Arusha Lutheran Medical Centre in Arusha, Tanzania.

We will continue to provide care to

developing countries, not only through our

international fellowship but also though

continued volunteer activities.


�............Mark Danahy, class of 2006,

teaching in Bangelore, India

⊳�................Stephen Dunlop, MD,

International Emergency Medicine

fellow, working in Tanzania

Jamie Karambay, MD, class of 2011,

on medical flight in Tanzania.........�

⊳.............Arleigh Trainor, MD, class

of 2006, teaching in Calcutta

Brian Mahoney, MD,

class 1980, in St, Lucia,

with donated vehicle to

St. Jude Hospital........�

�..Lisa Hayden, MD, class of 2012,

caring for patients in Tanzania

8:00 pm


The People of the ED

�...Emergency Nurses:

are the first line of care for emergency patients. Emergency nurses are well-versed in acute medical

and traumatic conditions, and often initiate assessment and management of ED patients.

24 | Department of Emergency Medicine Activities Report | 2009-2010


�...Interpreters:

assist in taking medical histories of

non-English speaking patients.

⊳...HUCS:

coordinate non-clinical

ED activities and tasks

for the nursing unit, as

well as receptionist and

clerical functions.

�...ED office:

supports the Emergency Services Department.

�...Chaplains/Social Workers:

assist with patientʼs and familyʼs spiritual

and other needs.

�...Health Care Assistants:

perform assigned patient care tasks to support

and assist health care providers.

9:00 pm


People of the ED | Faculty Profiles

Physicianʼs Name Emergency Medicine Residency Program Special Duties

Cher Adkinson HCMC, Emergency Medicine Director of Hyperbaric Medicine, Program

Director for the HBO Fellowship, ENT Liaison

Michelle Biros University of Cincinnati Medical Center, Associate Research Director,

Emergency Medicine Co-Director of Research Associate

Program, Neurology/Neurosurgery/

Psychiatry Departmental Liaison

Douglas Brunette HCMC, Emergency Medicine Assistant Chief of Emergency Medicine

Joseph E. Clinton HCMC, Emergency Medicine HCMC Chief of Emergency Medicine,

Chair of Emergency Medicine, University

of Minnesota Medical School

Robert Collier Kansas City General Hospital, Internal Medicine; Assistant Director of Hyperbaric Medicine

Kansas City General Hospital (Now Truman

Medical Center), Emergency Medicine

Richard Gray University of Pennsylvania, Internal Medicine; Director of Medical Student Education,

Medical College of Pennsylvania, Emergency Medicine Management of ED PAs

Eric Gross George Washington University, Emergency Medicine HBO, Assistant Director of Emergency

Medicine Residency Program

Danielle Hart HCMC, Emergency Medicine Assistant Director of Emergency Medicine

Residency Program, Director of Simulation

William Heegaard HCMC, Emergency Medicine Assistant Chief of Emergency Medicine,

Medical Director for LifeLink III, Director of Critical

Care Airway Lab, Surgery Department Liaison

John Hick HCMC, Emergency Medicine Emergency Preparedness, Assistant

Medical Director for Hennepin EMS

Jeff Ho HCMC, Emergency Medicine EMS Medical Direction for Edina Fire and

Police, TEMPO, Assistant Medical Director

for Hennepin EMS

Scott Joing HCMC, Emergency Medicine Manager of Mediasite hqmeded.com

Christine Kletti HCMC, Emergency Medicine Pediatric Emergency Medicine, SARS,

Assistant Residency Director, APLS,

Ruiz Reading Group

Louis Ling University of Chicago Hospital and Clinics, HCMC Associate Medical Director for

Emergency Medicine Medical Education, UMN Associate

Dean for Graduate Medical Education

Brian Mahoney HCMC, Emergency Medicine EMS Medical Director, Medical Director

for ALS Courses, Medical Director for

Paramedic Education

Marc Martel HCMC, Emergency Medicine Emergency Medicine Residency

Program Director, Co-Director of the

Combined Emergency Medicine/Internal

Medicine Residency Program

John McGill HCMC, Emergency Medicine Ortho ED Rotation Director

Jim Miner HCMC, Emergency Medicine Director of Research, Director of

Research Associate Program, Medical

Director for Quality Assurance

Dave Plummer HCMC, Emergency Medicine IDOCS Schedule Manager

Rob Reardon State University of New York, Buffalo, New York, Ultrasound Fellowship Program Director,

Emergency Medicine Director for Emergency Medicine Ultrasound

Robert Rusnak HCMC, Emergency Medicine and Internal Medicine Dentistry ED Rotation Director

Steve Smith HCMC, Emergency Medicine Cardiology and Laboratory Liasion

Steve Sterner Fairview-St. Mary's Hospitals, Family Medicine HFA Senior Vice President for Medical Affairs

Al Tsai UMN, Pediatric Residency, Valley Medical Center, Director of the Pediatric Emergency

Fresno, CA, Emergency Medicine Department, APLS Course Director

26 | Department of Emergency Medicine Activities Report | 2009-2010


Research Interest Fellowship Start Date at HCMC

Undersea and Hyperbaric Medicine 1984

Exception from Informed Consent, University of Cinncinati Medical Center, 1986

Research Ethics, Head Trauma and Research Fellow,Emergency Medicine

Neurological Emergencies

Hypothermia 1985

Resuscitation 1977

Undersea and Hyperbaric Medicine; 1992

ABEM Exam Editor

Asthma, Sedation 1996

Central Line Emergency Access Registry, George Washington University, Research 2006

Ionizing Radiation in the ED, Infectious Disease and Hyperbaric Medicine

Simulation HCMC, Simulation and Critical Care 2009

HEMS, Ultrasound, Head Trauma and Neurological National Association of Public Hospitals Fellowship, 1994

Emergencies, Conducted Electrical Weapons Emergency Department Flow and Operations

Emergency Preparedness, Disaster Medicine, HCMC, EMS Fellowship 1997

EMS

EMS, Tactical EMS, In-Custody Death; HCMC, EMS Fellowship 1996

Excited Delirium, Conducted Electrical Weapons

Ultrasound, Computer Based Medical Education 2006

Pediatric Emergency Medicine; Sexual Assault, 2000

Simulation, Asthma Education, Toothache

Toxicology 1984

EMS, Resuscitation, Paramedic Education 1980

Educational Research, Psychobehavioral HCMC, Research Fellowship in 2001

Emergencies Emergency Medicine

Airway Management, International 1981

Emergency Medicine

Procedural Sedation, Pain Management, 1999

Conducted Electrical Weapons

Airway Management, Ultrasound, Resuscitation 1985

Ultrasound, Airway Management 1998

Diabetes Mellitus 1980

Acute Coronary Syndromes, GHB HCMC, Clinical Emergency Medicine Fellowship 1991

Urgent Care HCMC, Emergency Medicine 1980

Pediatric EMS, Pediatric Emergency Drug Book 1987


HCMC Faculty Physicians

Emergency Medicine Residents, 2010

28 | Department of Emergency Medicine Activities Report | 2009-2010


Current Emergency Medicine Residents

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

Bischof, Johanna Duke University School of Medicine

Class of 2014 (EM/IM) Not shown: results of 2011 EM match

Driver, Brian University of Colorado School of Medicine

Olives, Travis University of Minnesota Medical School

Class of 2013

Bruen, Charles University of Texas Southwestern Medical School at Dallas (EM/IM)

Boklewski, Jennifer University of Illinois College of Medicine

Gosen, Christine Case Western Reserve University School of Medicine

Hall, Derek University of Wisconsin School of Medicine

Hampton, Rachel Case Western Reserve University School of Medicine

Lee, Jennifer University of Iowa Carver College of Medicine

Ling, Eric Northwestern University Feinberg School of Medicine

Londer, Casey University of Utah School of Medicine

Oakley, Eleanor Washington University in St Louis School of Medicine

Paluchowski, Daniel University of Maryland School of Medicine

Ragaini, Emily University of Connecticut School of Medicine

Scott, Nate University of Minnesota Medical School (EM/IM)

Terrebonne, Megan University of Pittsburg School of Medicine

Class of 2012

Dalton, Tom University of Colorado School of Medicine

Doucette, Eve Indiana University School of Medicine

Hayden, Lisa Creighton University School of Medicine (EM/IM)

Madore, Frank Ohio State University College of Medicine – Public Health

Mayerle, Joe University of Minnesota Medical School

Melson, Taj University of Michigan Medical School

Nystrom, Paul University of Iowa Carver College of Medicine

Peterson, Greg University of Minnesota Medical School

Terwey (Anderson), Karen University of Minnesota Medical School

Thompson, Pete Brody School of Medicine at East Carolina University (EM/IM)

Trussell, Kristi University of Minnesota Medical School

Wilde, Brenden University of Chicago Pritzker School of Medicine

Worrall, Christine University of Pittsburg School of Medicine

Class of 2011

Beeman, William Rosalind Franklin University of Medicine and Science/Chicago Medical School

Beyer, Robert Medical College of Wisconsin

Calvo, Darryl Vanderbilt University School of Medicine

Chang, Richard New York University School of Medicine

Dyer, Justin University of Missouri-Columbia School of Medicine

Fong, Erine University of Minnesota Medical School

Gary, Brandi Temple University School of Medicine (EM/IM)

Jones, Jared St Louis University School of Medicine

Karambay, James Albany Medical College

Kniffin, Colleen University of Minnesota Medical School

Orozco, Benjamin Harvard Medical School

Prekker, Matthew University of Minnesota Medical School (EM/IM)

Romo, Victor University of Illinois College of Medicine

Sherman, Melissa University of Minnesota Medical School

* EM/IM=combined Emergency Medicine/Internal Medicine 5 year program

Department of Emergency Medicine Activities Report | 2009-2010 | 29


Graduate Emergency Medicine Resident Classes

Class of 2010

Bronner, Sarah

Collins, Audrey

Garlich, Fiona

Johnson, Valerie

Moore, Johanna

Roline, Chad

Rosenthal, Eric

Vogel, Emily

Walz, Heidi

Class of 2009

Clark, Michael

Cole, Jon

Delavari, Parissa

Dunlop, Stephen

Gramenz, Paul

Holm, Michelle

Knapp, Ryan

Milkus, Kelly

Olsen, Jeremy

Shinneman, Louis

Stephens, Dana

Stroschein, Amy

Villaume, Frank

Class of 2008

Allegra, Paul

Bahr, Jennifer

Ball, Christian

Gengerke, Todd

Hart, Danielle

Hill, Chandler

Pohland, Jonathan

Ruzanic, Theodore

Westgard, Bjorn

Class of 2007

Bengiamin, Rimon

Budhram, Gavin

Carmody, Sharon

Davarn, Scott

Lapine, Anne

Lewis, Dan

McClain, Carolyn

Skinner, Lisa

Stirling, Kate

Unkefer, Nate

Vogt,Katie

Class of 2006

Baker, Amanda

Becker, Christopher

Bock, Paul

Danahy, Mark

Florence, Andrew

Hartmann, Tracy

Heller, Kimberly

Kingsley, Kyle

Ladmer, David

Lathrop, Lucas

Trainor, Arleigh

Class of 2005

Blonigen, Nancy

Currie, Peter

Herold, Matthew

Huber, Darren

Infante, Jorge

Joing, Scott

Lindgren, Kjell

Sarnov, Olga

Sterzinger, Ann

Torres, Camilo

Tuominen, Kai

Class of 2004

Ansari, Rebecca

Bachman, Andrew

Brueggemann, Marty

Bultman, Laura

Evans, Carly

Kraska, Eric

Lashkowitz, Seth

Leuck Bachman, Katherine

Meyer, Madeleine

Sufka Schaefer, Kristin

Torstenson, Chad

Class of 2003

Fringer, Ryan C.

Haug, Eric

Heining, Travis

Johnson, Christopher

Johnson, Timothy

McCoy, Christopher

Nelson Sims, Jody

Palmer, Christopher

Ross Wyatt, Karen

Thacker Johnson, Jenny

Wyatt, Thomas

Class of 2002

Braksiek, Rob

Danigelis, Matt

Dillman, Brian

Doerffler, Alex

30 | Department of Emergency Medicine Activities Report | 2009-2010

Krieg, Susan

Mertz, John

Moore, J. Alan

Muto-Isolani, Antonio

Peck, Karen Kuo

Thomas, Rob

Class of 2001

Baker, Chris

Block, Jennifer

Craig, Peter

Fish, Sara

Friewald, Scott

Isaacson, Brian

Rhead, Christoper (Kit)

Rooks, Ken

Schrag, Laura

Svenningsen, John

Tibbles, Carrie

Class of 2000

Barrett, Matthew

Benson, Jill

Cochrane, Josh

Hirschman, David

Mapes, Andrew

Martel, Marc

O'Laughlin, Daniel

Palmer, Mitch

Thompson, Rod

Vogel, (Cory) Edward

Class of 1999

Bonanni, Marita Michelin

Chase, Peter

Clark Rue, Casey

Ellmann Black, Cara

Gunn, Scott

Haines, Howard

Huynh, Hung

Kletti, Christine

Miner, Jim

Rodgerson, Jeff

Class of 1998

Abney-Lidahl, Deb

Bilden, Beth

Clarkowski, Brian

DiRe, Danielle

Hsieh, Dan

Kamper, Matthew

Lee, Curtis

McVaney, Kevin

Tewodros, Abel

Topliff, Andrew

Class of 1997

Anderson, Steve

Buccino, Kent

Coomes, Tom

McDaniel, Scott

Patty, Brian

Pogrebra, Kevin

Ramming, Scott

Reed, David

Rock, Michael

Zeitz, Erich

Class of 1996

Beier, Kevin

Epstein, Stephen

Gage, Eric

Hick, John

Joyce, Gail

Lynch, Michael

Sercombe, Clare

Skedros, Anthony

Wu, Mona

Zink, Robert

Class of 1995

Baro, Marte

Battershell, Ty

Christensen, Paul

Friederich, Douglas

Fuller, Robert

Ho, Jeffrey

McEvoy, Larry

McGlothen, Kevin

Peña, Joe

Ross, Harry

Saavedra, Leo

Class of 1994

Bauer, Andrew

Bowdish, Gail

Butts, Michael

Covington, David

Heegaard, Bill

Lueders, Jon

Lynch, Margaret

Matticks, Craig

Mildbrandt, Dave

Pippert, Greg

Sneed, Sara

Zink, Julie


Class of 1993

Arnason, Carol

Dang, Douglas

Dvorak, Dave

Nordness, Bob

Washington, Vindell

Class of 1992

Lofy Larson, Lisa

Nigh, David

Ragen Ide, Lisa

Weiker, Brett

Westwater, Jay

Wingate, Jennifer

Class of 1991

Bradbury, Dorothy

Cohen, Larry

Drill-Mellum, Laurie

Geer, Drew

Gosewisch, Gary

Johansen, R. Bart

Class of 1990

Hagedorn, Dave

Kominsky, John

Lufkin, Kirk

Rothong Erlandson, Carole

Smith, Steve

Stewart, Tom

Ward, Mary

Wilson, Mary

Class of 1989

Bachhuber, Greg

Erickson, Ford

Ng, Angus

Rambow Schmitz, Beth

Class of 1988

Erlandson, Mark

Mlinek, Edward J.

Morton, Sonny

Ripkey, Cathy

Winter, James

Class of 1987

Henrichs, Wade

Woodburn, James

Zarzycki, Mark

Class of 1986

Eisen, Teddi

Gaudio, Frank

Mickelson, Kevin

Wenman, Michael

Class of 1985

Brunette, Douglas

Gravett, Alan

Plummer, David

Roberts, David

Yaron, Michael

Physician Assistants

Class of 2011

Getz, Kaitlin University of Toledo

Schinzel, Mary A. T. Still University

Class of 2010

Anderson, Emily Stonybrook University

Klos, Chelsea University of Wisconsin

Nathan, Laura University of Nebraska

Class of 1984

Brutger, Yvonne

Crimmins, Timothy

Miller, Linda

Romness, David

Class of 1983

Gerdes, Dale

Irwin, Glenn

Mayron, Raymond

Roller, Benedict

Class of 1982

Adkinson, Cheryl

Berg, Mark

Feldshuh, David

Justin, Elliot

Swanson, Jeffrey

Class of 1981

Booth, Samuel

McGill, John

Mirick, Mark

Schwitzer, Kent

Class of 1980

Coon, Gary

Graves, Benjamin

Liebo, Jack

Mahoney, Brian

Nelson, David

Class of 2000

Class of 1979

Dannewitz, Stephen

Evans, Thomas L.

Glauser, Jonathan

LeTourneau, Barbara

Vancura, Ellen

Class of 1978

Greenfeld, Bernard M.

Hill, Martin P.

Rusnak, Robert A.

Thompson, James D.

Class of 1977

Blegen, Carl N.

Clinton, Joseph E.

Condron, Michael J.

Rockswold, Gordon A.

Class of 1976

Larson, James R.

Olson, David G.

Pexa, Charles E.

Timmons, Thomas E.

Class of 1975

Adams, Bruce E.

Tandias, James

Class of 1973

Lilia, G. Patrick

Long, Robert S.

Garfin, Kathy Augsburg College

Class of 1991

Formanek, Timothy University of Iowa

Department of Emergency Medicine Activities Report | 2009-2010 | 31


Marc Martel, MD Eric Gross, MD

Teaching

the next generation of

Emergency Clinicians

Welcome to the 2009-2010 edition of the HCMC Emergency Medicine Activities Report. In recent years

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

the innovations in training, including the following:

� The combined Emergency Medicine/Internal Medicine residency, now graduating its first class. Both

2011 graduates will begin their future academic careers with fellowships, one in International Medicine

and the other in Critical Care.

� The high-fidelity Emergency Medicine simulation program run by Danielle Hart, MD. The new

curriculum has been so successful that Danielle is now Director of the Institutional Interdisciplinary

Simulation and Education Center (ISEC) here at HCMC, scheduled to open in early 2012.

� The ACGME accredited HBO fellowship.

32 | Department of Emergency Medicine Activities Report | 2009-2010


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

“STAB Conference.”

� And finally, our newest event supporting residency endeavors, the Hennepin Health Foundation/

Emergency Medicine Residency Education Councilʼs “Clubs and Scrubs” annual charitable golf

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

research presentations, departmental high-fidelity simulation programs, advanced ultrasound training

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

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

serving emergency patients to their utmost ability – anywhere and anytime. Many begin building their

academic careers at HCMC, with almost one-third choosing fellowships or academic positions upon

graduation. The HCMC legacy still reaches far and wide. Graduates choosing community practice join

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

the top Emergency Physicians in the country. We are excited to have another incredible group graduating

this spring and even more excited to have had a banner recruiting year, receiving more applications to the

HCMC EM programs than ever before. No doubt, the match in March, 2012 will bring yet another

incredible intern class to start in June.

Looking ahead, we plan to continue the move toward small group, interactive teaching sessions

similar to those currently used in simulation and emergency ultrasound, rather than what has historically

been exclusively classroom style didactics. This model truly complements the “hands on” approach we

have always embraced at Hennepin. We hope to increase opportunities for alumni to come back and be

involved in these sessions in their various areas of expertise. We want and need your support.

With this, we hope you enjoy the chance to see “whatʼs new” here at Hennepin. We encourage you to visit

the residency at: www.hcmc.org/education/residency/emresidency/emresprog.htm and look forward to you

coming back soon.

Marc Martel, MD, Residency Program Director

Eric Gross, MD, Associate Program Director

Danielle Hart, MD, Assistant Program Director

Mary Hirschboeck, Residency Program Coordinator


The current

EM residency

curriculum

Simulation and Innovation Education

The Hennepin County Medical Center Interdisciplinary Simulation and Education Center

(HCMC-ISEC) will begin to revolutionize healthcare education and training in the very near

future here at HCMC. From enhancing the development of individual cognitive expertise and

procedural skills, to improving teamwork and communication among the healthcare team and

developing systems expertise within the institution, the utilization of this learning modality is

paramount in improving medical education, patient care, patient safety and patient satisfaction.

Danielle Hart, MD

Simulation has become a term that encompasses many different teaching or learning

modalities. Included are high-fidelity mannequins, procedural task trainers, standardized patients, and virtual reality.

High-fidelity mannequins are computer operated life-sized mannequins that have pulses, respirations, and vital signs,

and are able to converse and interact with the learners or trainees. Procedural task trainers have been designed to

teach technical skills for a wide array of procedures and standardized patients are actors who play the role of a

patient. The HCMC-ISEC will be equipped to offer all of these experiential learning modalities.

We are currently nearing completion of the design phase of the ISEC, which is expected to open in 2012. It will be

located just beneath the EMS classrooms, in the EMS ramp building, adjacent to the contact center on the lower

level. The center will be built in 2 phases, each of which will include approximately 5,000 sq feet of educational

space. The first phase, with a price tag of $2.7 million, will include 3 high fidelity simulation rooms, 3 debriefing rooms

that can also be used as standardized patient rooms, one large procedural skills room, and a conference room. The

funding for this project came from a variety of sources, such as the HCMC master facility plan ($1.5M), state bonding

money ($820K), HRSA grant money ($188K), and discretionary capital from the Office of the Medical Director ($200K).

The state-of-the-art Interdisciplinary Simulation and Education Center (ISEC) here at HCMC will enable us to

continue our longstanding commitment to excellence, both in training the nationʼs future healthcare providers, as well

as providing outstanding patient care on a daily basis.

Danielle Hart, MD, Director, ISEC

34 | Department of Emergency Medicine Activities Report | 2009-2010


Web based education

The HCMC Department of Emergency Medicine began publishing Thursday

morning conferences online for resident and faculty use in 2005. They are

published to a secure, limited access server and allow for live or on-demand

viewing. This allows for more convenient continuing education despite busy

schedules. The program was expanded using grant funding from the Medica

Foundation in 2007 to allow Critical Care Conference access for providers in the

surrounding community and Greater Minnesota.

Hqmeded.com is a HCMC Department of Emergency Medicine website with a focus on publication of

educational content, typically in video format. Much of the content is related to use of ultrasonography at

the bedside, but content related to ECGs and Toxicology can also be found. Over the past year, it has

received 15, 902 visits from 121 countries around the world. New content is added frequently and is

generated from the clinical experience of the residents and faculty of our department.

Scott Joing, MD, EM Media Site Manager

Dr. Smithʼs ECG Blog:

Online learning computers

Steve Smith, MD

Scott Joing, MD

Join us at http://hqmeded-ecg.blogspot.com/

or google “Dr. Smithʼs blog”.

With the help of techno-savvy Scott Joing, Steve Smith developed a learning tool

aimed at ECG interpretation and cardiac disease management. With 1,000 page

views per day and 230 registered followers, Dr. Smithʼs ECG Blog is now one of

the most widely read ECG blog in the world. Beginning at the end of 2008 as a

replacement for Dr. K. Wangʼs “EKG of the Week,” the blog was initially a

departmental and institutional educational tool for residents. It now holds 109 posts

with at least one interesting and educational case per post and up to 10 ECGs per

case. Unlike books, the unlimited space on the internet allows for multiple serial

ECGs to illustrate the evolution of the ECG over time.

Dr. Smithʼs ECG Blog was listed as the 6th best Emergency Medicine web site by EMCrit.org

(http://emcrit.org/podcasts/dirty-dozen-2010/). Scott Weingart calls it a “Ph.D. in EKG:”

(http://emcrit.org/podcasts/phd-in-ekg/). It was highly reviewed and featured in EP Lab Digest

(http://eplabdigest.com/articles/New-Online-Resource-ECG-Interpretation), and by Lifeinthefastlane:

http://lifeinthefastlane.com/2011/01/dr-smiths-ecg-blog/. Because so many sites link to the Blog, it comes

up 1st to 3rd in any Google search for “ECG blog.”

Department of Emergency Medicine Activities Report | 2009-2010 | 35


Our Fellows

EMS Fellows

Jeff Ho 1995

John Hick 1996

Cara Ellman Black 1999

Ryan Fringer 2003

Laura Bultman 2004

Ann Lapine 2008

Jennifer Bahr 2009

Undersea and Hyperbaric

Fellows

Jill Benson 2001

Bjorn Westagard (ACGME Fellow) 2009

Toxicology Fellows

Andrew Topliff 1999-2001

Beth Bilden 1999-2001

Jon Cole 2009-2011

Ultrasound Fellows

Jenny Thacker-Johnson 2004

Kim Heller 2007-2008

Anne Lapine 2008

Gavin Budhram 2008

Rimon Bengiamin 2008

Seth Strote 2010

Christopher Wall 2010

Chad Roline 2011

Jamie Hess 2011

Airway/Critical Care/Simulation

Fellows

Chandler Hill 2009

Danielle Hart 2009

Research Fellows

Marc Martel 2001

Scott Freiwald 2002

Johanna Moore 2010-2011

International Emergency Medicine

Fellow

Stephen Dunlop 2009-2011

(American Society of Tropical Medicine and Hygiene)

Clinical Medicine and Critical Care

Fellow

Stephen Smith 1991

Clinical students at HCMC Department of Emergency Medicine

2009 2010

Total number of medical and PA schools

sending students to HCMC ED 28 27

Number of states represented 20 18

International schools

Medical students

1 3

U of MN Medical School 71 84

Out-of-state medical schools 26 29

DO schools 13 11

Physician Assistants students 5 5

Pharm D students 3 1

TOTAL STUDENTS 118 130

36 | Department of Emergency Medicine Activities Report | 2009-2010


Students

in Emergency Medicine

Both the core and advanced Emergency Medicine rotations at HCMC are essentially four week

sub-internships. Since 2005, Emergency Medicine has been a mandatory core rotation for medical

students at the University of Minnesota. Minnesota medical students participate in this core rotation at

HCMC, Regions, Abbot Northwestern, Fairview, North Memorial Medical Center, St. Johnʼs, St. Josephʼs,

United, St. Maryʼs (Duluth) and St. Lukeʼs (Duluth). In addition, interested students are able to take an

advanced Emergency Medicine rotation at HCMC and Regions. Courses are also available at HCMC for

medical students interested in research and in ultrasound, and at Regions for toxicology.

In addition to University of Minnesota medical students, the Emergency Department at HCMC hosts

medical students and physician assistant (PA) students from across the country who are interested in

emergency medicine.

Along with G1and G2 residents, PAs and students are the primary medical providers (PMPs) of the

emergency department (ED). They evaluate and manage patients in an assigned area in consultation with

the ED supervisors (an ED attending and/or Senior Resident/Pit Boss). This includes conducting the

history and physical examination, performing procedures, interpreting diagnostic tests and determining

diagnoses, therapies, dispositions and follow-up plans on their patients.

We pride ourselves that our students perform professionally and responsibly. Our department is

committed to educating the future generation of providers, and we feel that our environment is very

conducive to their success as future practitioners of medicine.

Richard Gray, MD

Medical Student Course Director.

12:00 pm


Advancing the Science

of Emergency Medicine

The HCMC Department of Emergency Medicine has a long tradition of scientific inquiry and exploration.

From bench work to the bedside, the research we perform has the common goal of advancing the care of

emergency patients. Each year, and at any given time, there are at least 20 active clinical projects being

performed by our faculty and residents. These studies derive from ideas generated during our daily

emergency practice. We try to address the “big” questions, such as the best shock management strategy,

earlier diagnosis and treatment of acute cardiac ischemia, or effective interventions for reducing

secondary injuries in traumatic brain injury. We also take on bread and butter ED issues, such as the best

methods of pain control, the use of emergency ultrasound to guide procedures, or the most effective

methods of procedural sedation. The results of our studies are illustrated in our many publications, grants

received, and scientific presentations given, which are listed later in this report. Several of our faculty

have developed research niches, and are nationally and internationally recognized for their expertise.

Many serve as peer reviewers for prestigious journals. Some are members of federal research review

committees and others develop the evidence used in evidence-based ED practice.

A strong research program also reaps other rewards. By the time our residents complete their training

program they have been exposed to many aspects of research, either by direct initiation of or participation

in a project, or by exposure to research concepts in didactic presentations and journal clubs. They become

excellent critical readers and understand how and when to apply research findings to their patients.

The ability to perform so much research in the setting of a very busy clinical practice is a testimony to our

departmentʻs commitment to advancing the science of our specialty. We appreciate the support our

clinical colleagues have given to our research efforts and the Research Associate program, which has

been key to our successful research endeavors.

Jim Miner, MD

Research Director, Department of Emergency Medicine

Michelle Biros,MD, MS

Associate Research Director, Department of Emergency Medicine

Research Associates

learning monitoring

procedures


The Research Associate Program

In the Fall of 2000, 29 undergraduates and seven medical students arrived at Hennepin County Medical

Centerʼs (HCMC) Emergency Department to begin the Research Associate (RA) Program. The program

was developed by Drs. Jim Miner and Michelle Biros to promote clinical research in our busy Emergency

Department. The students came from many different backgrounds and academic institutions, but shared

one thing in common – an interest in medicine and improving patient care through research. Joseph

Mayerle, a current resident who participated in the program starting in 2004 when he was an

undergraduate at Boston College, described the program as a “one-of-kind thing. I really, really looked

around the country for opportunities, but there is nothing else like this and I am so glad to be a part of this

program.” Today, Mayerle is in his second year of residency in Emergency Medicine at HCMC and will be

one of our Chief Residents next year.

Since 2000, the RA program has grown to 70 volunteers, consisting of medical students and

undergraduate students, who volunteer in four to eight hour shifts to work on clinical studies in the ED. In

addition, Research Associates are trained in subjectsʼ rights and human subjects research prior to

involvement in clinical research. RAs are responsible for approaching patients to tell them about the

study, gain consent, and collect data. Scheduling and communication with the volunteers in the HCMC

Research Associate Program is done through the program website at www.hcmced.org. Many of the RAs

go on to medical school, PA school, or nursing school. Fifteen medical students starting in the University

of Minnesota Medical School Class of 2014 had been part of the RA program. Johanna Moore, a recent

graduate from HCMCʼs Emergency Medicine Residency Program, and our current Research Fellow, was

an RA during all four years of medical school.

The RA program is very competitive, with about 100 applicants a semester. The RAs have the opportunity

to interact one-on-one with patients, shadow doctors, and attend Stab conference and research lectures.

The research associates meet with Dr. Miner to discuss ongoing research projects and for lectures on

general topics in clinical research. The studies that the RAs are involved in range from looking at ways to

manage pain to investigating new treatments for shock. The program has become an important part of both

our Departmentʼs success in research and in exposing future doctors to Emergency Medicine Research.

Becca Nelson

RA Coordinator

Research

Associates,

Summer 2010

Department of Emergency Medicine Activities Report | 2009-2010 | 39


RA graduates speak

I had the good fortune to stumble into the Research Associate (RA) program my first year of medical school. As a

student interested in emergency medicine I thought a summer of research would be a good opportunity to work in the

emergency department and find out what it's really about, while working on research projects at the same time.

Little did I know the decision to work on research for a summer would profoundly change my life.

I stuck with the program, collecting data and becoming more interested about the studies and their purpose, as well

as loving the exposure to the ED. Previously I had done chemistry bench research but was frustrated about its lack of

immediate applications. To this day, I find clinical research fascinating, with the ability to answer practical questions

with results that can be put into practice right away. Dr. Miner encouraged me as a student to apply for a medical

student research grant. He was enthusiastic, I was excited but dubious. We sent off the application and our project

was ultimately funded.

By now, it was official: emergency medicine and emergency medicine clinical research were my career choices. I

contemplated other specialties and other residency programs, but didnʼt want to (and luckily didnʼt have to) leave

HCMC, completing my emergency medicine residency in 2010.

Today, I am in my first year of a two year clinical research fellowship in emergency medicine at HCMC. As part of the

fellowship, I work closely with Drs. Miner, Biros and the RAs on developing and ongoing clinical studies in the ED in

addition to working shifts in the ED. I am also back in the classroom, currently enrolled in the Masters in Clinical

Research program at the University of Minnesota, with the goal of becoming an independent emergency medicine

researcher when I graduate.

Johanna Moore. MD

Class of 2010

EM Research Fellow 2010- 2012.

I have been fortunate to both participate in and benefit from the RA program over my five years of graduate medical

training at HCMC. During my MPH year after medical school graduation and before residency, I trained in as an RA

and learned about informed consent, pain and sedation research, and survey methodology on the "front lines" in the

ED. Later that year, I led my own study on urban injury epidemiology that became my MPH thesis. I watched the RA

program grow bigger and bigger during my combined residency in EM and Internal Medicine. Over the past two

years, the enthusiasm and attention to detail of the current group of RA volunteers has sustained my most recent

project. We were able to screen nearly 3,000 ED patients for HIV with a rapid assay, finding 9 new infections and

getting them linked into care, and paving the way to have rapid HIV testing available 24/7 in our ED.

The RA program is an invaluable resource to our researchers, our academic department, and our hospital. It makes

population-based studies feasible in a busy ED, generating novel data on the prevalence of pain, hunger, literacy, and

other important socioeconomic factors that contribute to our patients' health. Equally important to me and many

others who progressed thru the RA ranks has been the mentorship of our senior research faculty, especially Jim

Miner and Michelle Biros. They are role models in both the research and clinical arenas, and have helped shape my

career path towards academic emergency and critical care medicine. Finally, the peer collaboration over the years

with past and present RA leaders including Dan Hubbard, Erik Rockswold, Roma Patel, and Owen Hanley has been

productive, and I now count them as both friends and colleagues.

Matt Prekker, MD

EM/IM, Class of 2011

40 | Department of Emergency Medicine Activities Report | 2009-2010


Scholarly Achievements

Anthony G. Skedros, MD Memorial

Award

Awarded by the first and second year Emergency

Medicine residents to a graduating Emergency

Medicine resident who exemplified the highest

personal and professional standards, provided and

outstanding role model, and demonstrated

outstanding teaching skills.

1997 Kevin Pogreba, MD

1998 Curtis Lee, MD

1999 Jeff Rodgerson, MD

2000 Cory Vogel, MD

2001 Laura Shrag, MD

2002 Alan Moore, MD

2003 Travis Heining, MD

2004 Chad Torstenson, MD

2005 Darren Huber, MD

2006 Amanda Baker, MD

2007 Nathan Unkefer, MD

2008 Theodore Ruzanic, MD

2009 Paul Gramenz, MD

2010 Chad Roline, MD

Faculty Teaching Award

This award was established by the Emergency

Medicine class of 1991 to honor the Emergency

Medicine faculty who demonstrates outstanding

commitment to the education of resident and the

promotion of Emergency Medicine as a specialty.

1991 David Plummer

1992 Tim Crimmins

1993 Steve Smith

1994 Michelle Biros

1995 Doug Brunette

1996 Al Tsai

1997 Richard Gray

1998 Steve Smith

1999 Bill Heegaard

2000 Rob Reardon

2001 Steve Sterner

2002 Jeff Ho

2003 Jim Miner

2004 Marc Martel

2005 John McGill

2006 David Plummer

2007 Steve Smith

2008 Doug Brunette

2009 Robert Collier

2010 John Hick

Anthony Skedros, MD (1964-1997), class of 1996

James G. Andersen, MD Award

Awarded to the resident demonstrating

exceptional leadership and administrative skills

in Emergency Medicine.

1989 Gregory F. Bachhuber, MD

1990 Thomas R. Stewart, MD

1991 Geoffrey A. Geer, MD

1992 Lisa M. Lofy, MD

1993 Carol Arnason, MD

1994 Greg Pippert, MD

1995 Jeffrey Ho, MD

1996 Clare Sercombe, MD

1997 Ken Buccino, MD

1998 Curtis Lee, MD

1999 Christine Kletti, MD

2000 Daniel OʼLaughlin, MD

2001 Carrie Tibbles, MD

2002 Susan Krieg, MD

2003 Ryan Fringer, MD

Department of Emergency Medicine Activities Report | 2009-2010 | 41


Scholarly Achievements

Emergency Nurse of the Year Award

This award is selected

by the graduating

Emergency Medicine

residency class to honor

the ED nurse that has

provided inspiration and

exceptional assistance in

their clinical growth during

their residency years.

1996 Florence Johnson

1997 Paul Finney

1998 Diana Bly-Gale

1999 Dan Levie

2000 Sharon Roy

2001 Steve Pederson

2002 Kristi Pender

2003 Ian Johnson

2004 Jean Tersteeg

2005 Corey Zeig

2006 Mark Allard

2007 Florence Johnson

2008 John Conrad

2009 Paul Finney

2010 Janine Landes

Magnet Award Illegetimi non Carborundum

Given by the emergency

medicine residents to

identify the emergency

department member who

seems to have had an

especially tough year.

Dave Plummer

Lifetime Member

1988 Mark Erlandson

1989 Steve Sterner

1990 Laurie Drill Mellum

1991 Ernie Ruiz

1992 Joe Clinton

1993 Steve Sterner

1994 Willie Braziel

1995 Bill Heegaard

1996 Beth Bilden

1997 Liz Bonin

1998 Michelle Biros

1999 Peter Chase

2000 Matt Barrett

2001 Tina Eatmon

42 | Department of Emergency Medicine Activities Report | 2009-2010

2002 Peter Craig

2003 Chris Johnson

2004 Andy Bachmann

2005 FMD

2006 Arleigh Trainor

2007 Doug Brunette/EPIC

2008 Todd Gengerke

2009 Mary Hirschboeck

2010 Cher Adkinson

Ernest Ruiz Award

Established in 2004

and given annually to a

graduating Emergency

Medicine resident who

has made significant

contributions to the

Department of Emergency

Medicine and the Residency

Program. The award is

named after Ernest Ruiz,

M.D., Chief of Service

from 1972-1992, whose

contributions to the

department exemplify the

meaning of this honor.

2004 Kristin Sufka

2005 Scott Joing

2006 Chris Becker

2007 Scott Davarn

2008 Danielle Hart

2009 Jon Cole

2010 Heidi Walz

North Memorial Medical Center

Faculty Teaching Award

Awarded by the graduating residents to the North Memorial

Medical Center emergency medicine faculty

member who demonstrates outstanding commitment

to the education of the HCMC residents.

2008 Laura Schrag

2009 Ann Sterzinger

2010 Adina Connelly


Other Notable Achievements 2009-2010

Michelle Biros, MD

Elected to the Institute of Medicine of the National

Academie, 2009

SAEM Leadership Award 2009

Top Doctor for Women Award from

Minnesota Monthly Magazine, 2009, 2010

Jon Cole, MD

Boarded in Emergency Medicine, 2010

Boarded in Toxicology, 2010

Stephen Dunlop, MD (Class of 2009)

Boarded in Tropical Medicine, 2010

Boarded in Emergency Medicine, 2010

Danielle Hart, MD

Boarded in Emergency Medicine, 2009

Bill Heegaard, MD

Selected National Association of Public Hospitals

Fellowship, 2009

Minnesota Monthly “Top Doctors for Women”

Recognition for 2009

John Hick, MD

Minneapolis / St. Paul Magazine ʻTop Docʼ

Recognition, 2009

Medica / Twin Cities Business “Physician Health Care

Hero”, 2009

Radiation Injury Treatment Network Certificate of

Appreciation, April, 2009

MN Dept. of Health Certificate of Appreciation – Red

River Floods, June, 2009

Jeff Ho, MD

IACP/Sprint Law

Enforcement Research

Award, August, 2010

International Association

of Chiefs of Police, Orlando,

FL. *Awarded for project

leadership of research of

international importance

to the law enforcement

profession.

Pistol Expert Award, November, 2007-2010

Meeker County Sheriffʼs Office, Litchfield, Minnesota

*Awarded for mastery and marksmanship during

firearm qualification.

Kjell Lindgren, MD (Class of 2005)

Selected as a member of the 20th NASA Astronaut

Class, 2009

Louis Ling, MD

University of Minnesota Distinguished Alumni Award,

2009

Travis Olives, MD (Class of 2014)

Spadafora Award, 2010

Matt Prekker, MD (Class of 2011)

Year 4 Medical Resident Distinguished Teaching

Award from the University of Minnesota Medical

School, 2010-2011

Steve Smith, MD

E M Critʼs Best EM Web Sites of 2010

(Dr. Smithʼs ECG Blog, #6)

Top Consultant, Annals of Emergency Medicine, 2010

Bjorn Westgard, MD (Class of 2008)

Boarded in Undersea and Hyperbaric Medicine, 2009

Department of Emergency Medicine Activities Report | 2009-2010 | 43


External Grant Awards 2009-2010

Project Title: Clinical Evaluation of High Sensitivity Troponin T Assay in Diagnostic and Risk Stratification in

Patients with Symptoms of Acute Coronary Syndromes.

Principal Investigator: Apple F

Co-Investigator: Smith S

Funding Source: Roche

Project Title: Comparison of Siemens Immulite and ADVIA Centaur D Dimer Immunoassays with VIDAS

D-Dimer Exclusion Assay

Principal Investigator: Apple F

Co-Investigator: Smith S

Funding Source: Siemens

Project Title: Finding ACS with Serial Troponin Testing for Rapid Assessment of Cardiac Ischemic Symptoms

(FAST-TRAC)

Principal Investigator: Apple F

Co-Investigator: Smith S

Funding Source: Nanosphere, Inc.

Project Title: Neurological Emergencies Treatment Trials (NETT) Network

Principal Investigator: Biros M

Co-Investigators: Anderson D

Funding Source: National Institute of Neurological Disorders and Stroke

Project Title: Community Attitudes about Emergency Exception from Informed Consent (EFIC) and the

ProTECT Head Injury Research Trial

Principal Investigator: Biros M

Co-Investigators: Miller K, Sargent C

Funding: National Institute of Neurological Disorders and Stroke

Project Title: Rapid Anti-seizure Medication Prior to Arrival

Co-Principal Investigators: Biros M, Mahoney B

Funding Source: National Institute of Neurological Disorders and Stroke

Project Title: Albumin in Acute Ischemic Stroke

Principal Investigator: Ezzeddine M

Co-Investigators: Biros M, Heegaard W

Funding Source: National Institute of Neurological Disorders and Stroke

Project Title: Progesterone for the treatment of TBI

Principal Investigator: Rockswold

Co-Investigator: Biros M

Funding Source: National Institute of Neurological Disorders and Stroke

Project Title: CRISIS-1 Study, Cyanide's Role in Smoke Inhalation Study

Principal Investigator: Gray R

Funding: Centers for Disease Control

Project Title: MediciNova IV beta 2 agonist study in acute asthma

Principal Investigator: Gray R

Co-Investigators: Miner J, Smith S, Plummer D, Cole J, Biros M, Ho J, Heegaard W

Funding: MediciNova

Project Title: Multi-center, investigator-blinded, randomized, comparative study to evaluate the efficacy and

safety of oral NXL-103 versus oral linezolid in the treatment of acute bacterial skin and skin structure

infections

Principal Investigator: Gross E

Funding: Novexel, Inc.

44 | Department of Emergency Medicine Activities Report | 2009-2010


Project Title: Prevalence and Risk Factors for Community Associated MRSA Pneumonia

Principal Investigator: Gross E

Co-Investigator: Clinton J

Funding Source: Centers for Disease Control (CDC) Emergency ID Net

Project Title: Micropathology of Blood Cultures

Principal Investigator: Gross E

Co-Investigator: Clinton J

Funding Source: Centers for Disease Control (CDC) Emergency ID Net

Project Title: Utilization of Emergency Departments for Possible Exposures to Biological Weapons

Principal Investigator: Gross E

Co-Investigators: Clinton J, Joni Kopitzke, R.N.

Funding Source: Centers for Disease Control (CDC) Emergency ID Net

Project Title: Bacteriology of Acute Cutaneous Cellulitis with Drainage Using Conventional Culture and

Molecular Identification of Skin Biopsy Specimens (MSRA Cellulitis Etiology and Diagnosis)

Principal Investigator: Gross E

Co-Investigator: Joni Kopitzke, R.N.

Funding: Centers for Disease Control and Prevention

Project Title: Use of Prehospital Focused Abdominal Sonography (PFAST) and Aortic Ultrasound in Trauma

and Aortic Aneurysms

Principal Investigator: Heegaard W

Co-Investigator: Hildebrandt D

Funding: Sonosite

Project Title: Developing a National Standard for HEMS Quality Assurance Thresholds

Co-Principal Investigators: Heegaard W, Frascone R

Funding: LifeLink III and FARE Grant

Project Title: Use of the King Airway in the Helicopter

Co-Principal Investigators: Heegaard W, Frascone R

Funding: FARE Grant

Project Title: Ability to Handcuff Subjects During TASER Device Application

Principal Investigator: Ho J

Co-Investigators: Miner J, Dawes D

Funding: TASER International, Inc.

Project Title: Passive Observation of Human Effects of the TASER Xtended Range Electronic Projectile During

Civil Unrest

Principal Investigator: Ho J

Co-Investigator: Miner J

Funding Source: TASER International, Inc.

Project Title: Descriptors of TASER Device Application Gathered from Training Human Volunteers

Principal Investigator: Ho J

Co-Investigator: Miner J

Funding Source: TASER International, Inc.

Project Title: Tactical Emergency Medical Peace Officer (TEMPO) Course

Principal Investigator: Ho J

Co-Investigator: Snyder R

Funding Source: Hennepin Health Foundation

Project Title: Impedance Threshold Valve for Improving Standard CPR

Co-Principal Investigators: Mahoney B, Lurie K

Funding: National Heart, Lung, and Blood Institute

Department of Emergency Medicine Activities Report | 2009-2010 | 45


Project Title: ResQ Trial

Co-Principal Investigators: Mahoney B, Frascone R

Funding: Food and Drug Administration Investigational Device Exemption

Project Title: A randomized, double-blind, Placebo and Oxycodone Controlled Study of Tapentadol HCL for

the Treatment of Acute Pain Caused by Vertebral Compression Fractures Associated with Osteoporosis

Principal Investigator: Miner J

Co-Investigators; Gray R, Martel M

Funding Source: Ortho-McNeil

Project Title: Observation of Field Deployment Effects of a Projectile Electronic Control Device on

Rioting Subjects

Principal Investigator: Miner J

Co-Investigator: Ho J

Funding Source: TASER International, Inc.

Project Title: Comparison of Circuit Type, Probe Position, and Duration of TASER Exposure

Principal Investigator: Miner J

Co-Investigator: Ho J

Funding Source: TASER International, Inc.

Project Title: Factors Associated with Sudden Law Enforcement Custodial Deaths

Principal Investigator: Miner J

Co-Investigator: Ho J

Funding: TASER International, Inc.

Project Title: Use of Axon Technology in the Emergency Department

Principal Investigator: Ho J

Co-Investigators: Heegaard W, Miner J, Clinton J, Hart D

Funding: TASER International, Inc.

Project Title: Assessing the Cardiac Effects of TASER Conducted Electrical Weapon Device Application in the

Presence of Methamphetamine Intoxication

Principal Investigator: Miner J

Co-Investigators: Ho J, Cole J

Funding Source: Taser International, Inc.

Project Title: Comparison of Circuit Type, Probe Position, and Duration of TASER Exposure

Principal Investigator: Miner J

Co-Investigator: Ho J

Funding Source: Taser International, Inc.

Project Title: Evaluation of Stress Markers in Humans Undergoing Law Enforcement Officer Training

Exercises or Intoxication

Principal Investigator: Miner J

Co-Investigator: Ho J

Funding Source: TASER International, Inc.

Project Title: Assessing the Physiologic and Cardiac Effects of TASER 40mm Circuit

Principal Investigator: Miner J

Co-Investigator: Ho J

Funding Source: Department of Defense

Project Title: Cardiac Safety and Muscle Stimulation Effects of the TASER 40mm Projectile Circuit

Principal Investigator: Miner J

Funding: US Department of Defense

Project Title: Time Series Analysis of Critical Procedures in the Emergency Department

Principal Investigator: Miner J

Co-Investigator: Biros M

Funding Source: Minneapolis Medical Research Foundation

46 | Department of Emergency Medicine Activities Report | 2009-2010


Project Title: Time Series Analysis of Critical Procedures in the Emergency Department

Principal Investigator: Miner J

Co-Investigator: Biros M

Funding Source: Minneapolis Medical Research Foundation

Project Title: Prospective Evaluation of the fluID Rapid Influenza Test

Principal Investigator: Miner J

Funding Source: Meso Scale`

Project Title: The Assessment of Pain Management Practice and the Prevalence, Risk Factors, and the Natural

History of Substance Use and Trauma in the Emergency Department

Principal Investigator: Miner J

Co-Investigator: Biros M

Funding Source: Minneapolis Medical Research Foundation

Project Title: Biomarkers Associated with Psychosocial Stress and Pain

Principal Investigator: Miner J

Co-Investigator: Moore J

Funding Source: Minneapolis Medical Research Foundation currently, NIH grant in revision 2

Project Title: Beriplex, a Prothrombin Complex Concentrate, for the Reversal of Coumadin Anticoagulation in

Bleeding Patients

Principal Investigator: Miner J

Co-Investigators: Clinton J, Reardon R, Smith S

Funding Source: CSL Behring

Project Title: An Open Label, randomized multicenter Phase IIIb Study to assess the efficacy, safety and

tolerance of Beriplex P/N compared with plasma for rapid reversal of coagulopathy induced by coumarin

derivatives in subjects with acute major bleeding

Principal Investigator: Miner J

Co-Investigators: Gorlin J, Richardson C

Funding Source: CSL Behring

Project Title: EKG Changes in Acute Coronary Syndromes

Principal Investigator: Miner J, Smith S

Funding: NewCardio

Project Title: A Two-Arm Study Comparing the Analgesic Efficacy and Safety of Acetram Contramid BID

versus Placebo for the Treatment of Acute Low Back Pain

Principal Investigator: Miner J

Co-Investigator: Gorlin J

Funding: CSL Behring GMBH

Project Title: Reversal of Anticoagulation of Patients on Coumadin with GI Bleeding

Principal Investigators: Miner J, Gorlin J

Funding: HemCom

Project Title: Capnogram as a Measure of Perfusion in Patients with Hypotension

Principal Investigator: Miner J

Co-Investigators: Moore J, Mayerle J

Funding Source: Emergency Medicine Foundation

Project Title: Capnogram as a Measure of Hypoventilation During Procedural Sedation

Principal Investigator: Miner J

Funding Source: Physio-Control

Project Title: RCT of Tissue Oxygenation Monitoring During the Resuscitation of Shock in the ED

Principal Investigator: Miner J

Co-investigators: Clinton J, Reardon R, Smith S, Moore J

Funding Source: Hutchinson Technology

Department of Emergency Medicine Activities Report | 2009-2010 | 47


Project Title: Near Infrared Spectroscopy as a Measure of Perfusion and Undifferentiated Shock

Principal Investigator: Miner J

Funding: Hutchinson Technology

Project Title: StO2 Monitoring of Patients Presenting to the Emergency Department Triage

Principal Investigator: Miner J

Funding Source: Hutchinson Technology

Project Title: The Effect of Tissue Perfusion Monitoring on Patients Undergoing Treatment for Shock

Principal Investigator: Miner J

Co-Investigators: Hayden L, Smith S, Clinton J, Biros M

Funding Source: Hutchison Technology

Project Title: Safety of Implantable Neuro-Stimulator in Patients Undergoing Treatment for Severe Asthma

Principal Investigator: Miner J

Co-Investigators: Gray R, Smith S, Reardon R

Funding Source: ElectroCore

Project Title: Standard Treatment Protocol for the Relief of Shortness of Breath Associated with an Acute

Exacerbation of Chronic Obstructive Pulmonary Disease

Principal Investigator: Miner J

Funding: ElectroCore

Project Title: Standard of Care Therapy for COPD in the ED

Principal Investigator: Miner J

Funding: ElectroCore

Project Title: ED Patient Rapid HIV Testing Practices

Principal Investigator: Prekker M

Funding: Centers for Disease Control

Project Title: The Assessment of Endotracheal Tube Placement Using Ultrasound

Principal Investigator: Reardon R

Co-Investigator: Miner J

Funding Source: Plisiatek

Project Title: Patient and Physician Satisfaction and Impressions of Workflow Efficiency of Wall-Mounted

Ultrasound Machines in Pelvic Exam Rooms of a Busy Emergency Department

Principal Investigator: Reardon R

Co-Investigators: Miner J, Strote S, Wall C, Caroon L

Funding: Sonosite

Project Title: Comparison of the P21/Cardiac and C60/Abdominal Probes for Image Quality in Focused

Assessment with Sonography in Trauma

Principal Investigator: Reardon R

Co-Investigators: Miner J, Strote S, Wall C, Moore J

Funding: Sonosite

Project Title: Comparison of the Sonosite P21 Probe Settings for Image Quality in the Focused Assessment

with Sonography in Trauma Scan

Principal Investigator: Reardon R

Co-Investigators: Miner J, Strote S, Wall C, Collins A, Caroon L

Funding: Sonosite

Project Title: Use of Ultrasound in HEMS for Detection of Pneumothorax

Principal Investigator: Roline C

Co-Investigators: Heegaard W, Frascone R

Funding: Sonosite

48 | Department of Emergency Medicine Activities Report | 2009-2010


Project Title: Evaluation of an Inspiratory Impedance Threshold Device (ITD) in the Emergency Department for

the Treatment of Hypotension

Principal Investigator: Smith S

Funding: US Department of Defense

Project Title: Electronic Asthma Action Plan

Principal Investigator: Smith S

Funding: Agency for Health Research and Quality

Project Title: A Phase 3b, Randomized, Double-Blind, Placebo-Controlled Multi-Center Study to Assess the

Safety and Efficacy of Conivaptan in Symptomatic Acute Decompensated Heart Failure (ADHF).

Co-Principal Investigators: Smith S, Goldsmith S

Funding Source: Astellas

Project Title: A multi-center, randomized, double-blind, parallel group, phase 2b study assessing the safety

and efficacy of early dosing of intravenous CD-NP versus placebo in the treatment of subjects with acute

decompensated heart failure (CONDITION HF)

Co-Principal Investigators: Smith S, Goldsmith S

Funding Source: Niles

Project Title: Combat Casualty Training Consortium

Principal Investigator: UMN Simportal

Co-Investigators: Clinton J, Biros M

Funding: US Department of Defense

Project Title: The Safety-Net Role of the Emergency Department in the Care of the Homeless and

Disadvantaged: Determining Factors Associated with ED Use at the Department, County, and State Levels

Principal Investigator: Westgard B

Co-Investigators: Biros M, Miner J

Funding: Emergency Medicine Foundation Research Fellowship

Project Title: Minnesota Emergency Research for Children Sedation Study

Principal Investigator: Miner J

Co-Investigators: University of Minnesota and Minneapolis Childrenʼs Hospital

Funding: Various sources

Project Title: Minnesota Emergency Research for Children Appendicitis Study

Principal Investigator: Miner J

Co-Investigators: University of Minnesota and Minneapolis Childrenʼs Hospital

Funding: Various sources


HCMC Department of Emergency Medicine 2009-2010

Publications | Peer reviewed

Apple FS, Smith SW, Pearce LA, Murakami MM. Assessment of the Multiple-Biomarker Approach for Diagnosis of

Myocardial Infarction in Patients Presenting with Symptoms Suggestive of Acute Coronary Syndrome. Clinical

Chemistry January 2009; 55(1):93-100.

Apple FS, Pearce LA, Smith SW, Kaczmarek JM, Murakami MM. Role of monitoring changes in sensitive cardiac

troponin I assay results for early diagnosis of myocardial infarction and prediction of risk of adverse events. Clinical

Chemistry 2009; 55 (5): 930-937.

Bahr J, Lapine A, Ho J. The utility of point-of-care carbon monoximetry in fireground emergency medical services

rehabilitation operations. Prehosp Emerg Care, 2010;14 (Suppl 1): 98.

Balls A, LoVecchio F, Stapczynski J, Gross EA, et al. CLEAR: Central Line Emergency Access Registry: The CLEAR

project protocol methods paper. Am J Emerg Med.2009;27(1):119-122. (Correspondence)

Balls A, LoVecchio F, Kroeger A, Stapczynski JS, Mulrow M, Drachman D For the CLEAR Investigators (Gross EA) .

Ultrasound guidance for central venous catheter placement: Results from the Central Line Emergency Access

Registry Database. American Journal of Emergency Medicine. 2010; 28: 561-567

Biros M, Mann J, Hanson R, Cen Y. Unsuspected or Unacknowledged Depressive Symptoms in Young Adult ED

Patients. Academic Emergency Medicine. April 2009; 16 (4): 288-294

Biros MH, Baren JM. Commentary. The Ethics of Observation. Academic Emergency Medicine. September 2009; 16

(9): 908-910.

Biros M, Sargent C, Miller K. Community Attitudes towards Emergency Research and Exception from Informed

Consent. Resuscitation 2009; 80: 1382-1387.

Biros M. The People Speak: Community Consultation in Emergency Research. Annals of Emergency Medicine.

2010; DOI: 10.1016/j.annemergmed.2010.08.028.

Biros MH, McNeil MA, Ankel F, Gordon B, Lindgren KN, Joing S. Interviews with Leaders in Emergency Medicine.

Academic Emergency Medicine. 2010; 17 (9): e87. DOI: 10.111/j1553-2712.2010.00822

Brunette DD, Roline C. Heterotopic pregnancy resulting from in vitro fertilization. The American Journal of

Emergency Medicine. 2010; [epub ahead of print] DOI: 10.1016/j.ajem.2010.07.028

Chase PB, Hansen KL, Rothers J, Biros MH, Cartwright CP. Nucleic-acid amplification testing of urine vs. patient

complaint-driven evaluation. Journal of Emergency Medicine. 2010; 38 (5):572-577.

Christian MD, Joynt GM, Hick JL, Colvin J, Danis M, Sprung CL. Chapter 7. Critical care triage. Intensive Care

Medicine. 2010; 36 (Suppl 1): S55-S64.

Cole JB, Sattiraju S, Bilden EF, Asinger RW, Bertog SC. Isolated Tramadol Overdose Associated with Brugada ECG

Pattern. Pacing and Clinical Electrophysiology. 2010; [epub ahead of print] DOI: 10.1111/j.1540-8159.2010.02924.x

Dawes D, Ho J. Letter to the Editor, “Fortuitous therapeutic effect of TASER shock” misleading (On Richards

#2008-267). Ann Emerg Med, 2009;53:286-287.

Dawes D, Ho J, Miner J. The neuroendocrine effects of the TASER X26: A brief report. Forensic Sci Int,

2009;183:14-19.

50 | Department of Emergency Medicine Activities Report | 2009-2010


Dawes D, Ho J, Reardon R, Miner J. Echocardiographic evaluation of TASER X26 probe deployment into the chests

of human volunteers. The American Journal of Emergency Medicine 2009; 28(1): 49-55.

Dawes D, Ho J, Reardon R, Miner J. The Physiologic Effects of Multiple Simultaneous Electronic Control Device

Discharges. The Journal of Emergency Medicine, 2009; 37(2): 209-210.

Dawes DM, Ho JD, Reardon RF, Miner JR. The Cardiovascular, Respiratory, and Metabolic Effects of a Long

Duration Electronic Control Device Exposure in Human Volunteers. Forensic Science and Medical Pathology. 2010;

6: 268-274.

Dawes D, Ho J, Kroll M, Miner J. Electrical characteristics of an electronic control device under a physiologic load: a

brief report. Pacing and Clinical Electrophysiology. March 2010;33 (3): 330-336.

Dawes DM, Ho JD, Cole JB, Reardon RF, Lundin EJ, Terwey KS, Falvey DG, Miner JR Effect of an Electronic

Control Device Exposure on a Methamphetamine-intoxicated Animal Model. Academic Emergency Medicine. April

2010; 17 (4): 436-443.

Dawes DM, Ho JD, Reardon RF, Sweeny JD, Miner JR, The Physiologic Effects of Multiple Simultaneous Electronic

Control Device Discharges. Western Journal of Emergency Medicine. February 2010; 11 (1) 49-56.

Dawes DM, Ho JD, Orozco B, Vogel E, Nelson R, Miner JR. Human creatine kinase effect from conducted electrical

weapons. Academic Emergency Medicine. 2010;17:S77.

Dawes DM, Ho JD, Orozco B, Vogel E, Nelson R, Miner JR. The respiratory, metabolic and neuroendocrine effects

of a new generation electronic control device. Academic Emergency Medicine. 2010;17:S155.

Deitch K, Miner JR, Chudnofsky CR, Dominici P, Latta D Does End Tidal CO2 Monitoring During Emergency

Department Procedural Sedation and Analgesia With Propofol Decrease the Incidence of Hypoxic Events? A

Randomized Controlled Trial. Annals of Emergency Medicine, 2010; 55 (3): 258-264.

Dries DJ, Frascone RJ, Hick JL, Salzman J. Medical Preparation for the 2008 Republican National Convention: A

Practical Guide (September 1-4, 2008, St. Paul, Minnesota). The Journal of Trauma: Injury, Infection, and Critical

Care. Accepted for publication August 2010.

Flannagan CE, Daramola OO, Maisel RH, Adkinson C, Odland RM. Surgical Debridement and Adjunctive

Hyperbaric Oxygen in Cervical Necrotizing Fasciitis. Otolaryngology-Head and Neck Surgery, 2009; 140(5): 730-734.

Gossett WA, Rockswold GL, Rockswold SB, Adkinson CD, Bergman, Quickel RR. The safe treatment, monitoring

and management of severe traumatic brain injury patients in a monoplace chamber. Undersea and Hyperbaric

Medicine. 2010; 37 (1): 35-45.

Gostin LO, Hanfling D, Hodge, Jr. JG, Hick JL, Peterson CA. Standard of Care – In Sickness and in Health and in

Emergencies. The New England Journal of Medicine. 2010; 363(14): 1378-1379.

Gramenz P, Roberts D, Shrag L. Intra-arterial self-injection of methadone tablets in the femoral artery. Journal of

Emergency Medicine. 2010; 39 (3): e125-e127.

Gross EA, Bruen C. Anorectal emergencies. EM Reports.2009; 30 (26):1-12.

Gross EA. Computed tomographic screening for thoracic and lumbar fractures: is spine reformatting necessary?

American Journal of Emergency Medicine. January 2010; 28 (1): 73-75.

Hanfling D, Hick JL. Hospitals and the Novel H1N1 Outbreak: The Mouse that Roared? Disaster Med Public Health

Preparedness, 2009: 3(Supp 2); S100-S106.

Department of Emergency Medicine Activities Report | 2009-2010 | 51


Hanley O, Miner J, Rockswold E, Biros M. The relationship between chronic illness, chronic pain, and

socioeconomic factors in the ED. American Journal of Emergency Medicine. April 2010. [Epub ahead of print]DOI:

10.1016/j.ajem.2009.10.002

Heegaard W, Hildebrandt D, Reardon R, Plummer D, Clinton J, Ho J. Prehospital Ultrasound Diagnosis of

Traumatic Pericardial Effusion. Academic Emergency Medicine 2009; 16 (4): 364.

Heegaard W, Fringer R, Frascone RJ, Pippert, G, Miner J. Bispectral Index Monitoring Indicates Patients Are

Adequately Sedated. Prehospital Emergency Care 2009; 13 (2): 193-197.

Heegaard W, Hildebrandt D, Spear D, Chason K, Nelson B, Ho J. Prehospital Ultrasound by Paramedics: Results of

Field Trial. Academic Emergency Medicine 2010; 17(6): 624-630

Hick JL, Barbera JA, Kelen GB. Refining Surge Capacity: Conventional, Contingency, and Crisis Capacity. Disaster

Med and Public Health Preparedness. 2009; 3 (Suppl 1): s59-s67. (e-published ahead of print April 6, 2009 as

doi:10.1097/DMP.0b013e31819f1ae2, print June 2009).

Hick JL, Frascone RJ, Grimm K, Hillman M, Griffith J, Hogan M, Trotsky-Sirr R, Braun J. Health and Medical

Preparedness and Response to the 2008 Republican National Convention. Disaster Med Public Health

Preparedness, 2009; 3: 224–232.

Hick JL, Christian MD, Sprung CL. Chapter 2. Surge capacity and infrastructure considerations for mass critical care.

Intensive Care Medicine. 2010; 36 (Suppl 1): S11-S20.

Hill C, Reardon R, Joing S, Falvey D, Miner JR, Cricothyroidotomy Technique Using Gum Elastic Bougie Is Faster

than Standard Technique: A Study of Emergency Medicine Residents and Medical Students in an Animal Lab

Academic Emergency Medicine. June 2010; 17 (6): 666-669.

Ho J, Dawes D, Heegaard W, Miner J. Human Research Review of the Taser Electronic Control Device. Conf Proc

IEEE Eng Med Biol Soc, 2009; 1: 3181-3183.

Ho J. Human Cardiorespiratory and acid/base effect of a civilian-conducted electrical weapon. Prehosp Emerg Care,

2009;13:94-95.

Ho J, Dawes D, Cole J, Hottinger J, Overton K, Miner J. Lactate and pH Evaluation in Exhausted Humans with

Prolonged TASER X26 Exposure or Continued Exertion. Forensic Sci Int, 2009; 190: 80-86.

Ho J. Can There Be Truth About TASERs? (Commentary) Academic Emergency Medicine, 2009:16:771-773.

Ho J, Dawes D, Heegaard W, Calkins H, Moscoti R, Miner, J. Absence of Electrocardiographic Change After

Prolonged Application of a Conducted Electrical Weapon in Physically Exhausted Adults. Journal of Emergency

Medicine 2009; May 12 epub.

Ho J, Heegaard W, Dawes D, Natarajan S, Reardon R, Miner J. Unexpected Arrest Related Deaths in America: 12

Months of Open Source Surveillance. Western Journal of Emergency Medicine 2009; 10(2): 68-73.

Ho JD, Dawes DM, Nelson RS, Lundin EJ, Frank JR Overton KG, Zeiders AJ, Miner JR. Acidosis and

Catecholamine Evaluation Following Simulated Law Enforcement “Use of Force” Encounters. Academic Emergency

Medicine. July 2010; 17(7): e60-e68.

Ho J, Clinton J, Lappe M, Heegaard W, Williams M, Miner J. Introduction of the conducted electrical weapon into a

hospital setting. Journal of Emergency Medicine. 2010; [epub ahead of print] DOI: 10.1016/j.jemermed.2009.09.031

Ho J, Dawes D, Cole J, Hottinger J, Overton K, Miner J. Corrigendum to “Lactate and pH evaluation in exhausted

humans with prolonged TASER X26 exposure or continued exertion”. Forensic Sci Int, 2010;195:169.

52 | Department of Emergency Medicine Activities Report | 2009-2010


Ho JD, Dawes DM, Reardon RF, Strote SR, Kunz SN, Nelson RS, Lundin EJ, Orozco BS, Miner JR. Human

cardiovascular effects of a new generation conducted electrical weapon. Forensic Science International. 2010; Doi:

10.1016/j.forsciint.2010.05.003

Ho JD, Dawes DM, Nelson RS, Lundin EJ, Ryan FJ, et al. Human acidosis and catecholamine evaluation following

simulated law enforcement “use of force” encounters. Academic Emergency Medicine. 2010; 17 (7): e60-e68.

Ho JD, Dawes D, Johnson V, Karambay J, Kniffin, C, Nelson R, Miner J. Do conducted electrical weapon probes

carry bacteria? Academic Emergency Medicine. 2010;17:S134.

Lewis RJ, Duber HC, Biros MH, Cone DC, International Regulatory Status of Emergency Exception to Informed

Consent Study Group: International resuscitation research, exception from informed consent, and the European

Union Directive 2001/20/EC. European Journal of Emergency Medicine. October 2009; 16 (5): 234-41.

McBeth B, McNamara R, Ankel F, Mason EJ, Ling LJ, Flottemensch TJ, Asplin BR. Modafinil and zolpidem use by

emergency medicine residents. Ann Emerg Med 48 (4), 32 – 33, 2008 and Academic Emergency Medicine

16(12):1311-1317, December 2009.

Miner JR, Gray RO, Stephens D, Biros MH. Randomized Clinical Trial of Propofol With and Without Alfentanil for

Deep Procedural Sedation in the Emergency Department. Academic Emergency Medicine. September 2009; 16 (9):

825-834.

Miner JR. Randomized Double-blind Placebo Controlled Crossover Study of Acetaminophen, Ibuprofen,

Acetaminophen/Hydrocodone, and Placebo for the Relief of Pain From a Standard Painful Stimulus. Academic

Emergency Medicine, September 2009; 16 ( 9): 911-914.

Miner JR, Gray R, Delavari P, Patel S, Patel R, Plummer D. Alfentanil for Procedural Sedation in the Emergency

Department. Annals of Emergency Medicine. 2010; 57(2):117-121.

Miner JR, Gray RO, Bahr J, Patel R, McGill JW. Randomized Clinical Trial of Propofol vs. Ketamine for Procedural

Sedation in the Emergency Department. Academic Emergency Medicine. June 2010; 17 (6): 604-611.

Moore JA, Gross EA. Update on emerging infections: news from the Centers for Disease Control and Prevention.

Surveillance for Foodborne Disease Outbreaks—United States, 2006. Annals of Emergency Medicine. 2010; 55 (1):

49-50.

Moscati R, Ho JD, Dawes DM, Miner JR. Physiologic effects of prolonged conducted electrical weapon discharge in

ethanol-intoxicated adults. American Journal of Emergency Medicine, 2010; 28: 582-587.

Mulder M, Smith SW, Bart BA. Faster, Cooler, Better? A Comparison of Two Methods for Instituting Mild Therapeutic

Hypothermia in Comatose Out of Hospital Cardiac Arrest Patients. Journal of the American College of Cardiology

March 9, 2010; 55 (10A): E1038-E1040.

Olives T, Patel R, Patel S, Hottinger J, Miner JR. Health literacy of adults presenting to an urban ED. American

Journal of Emergency Medicine. July 2010; [Epub ahead of print] DOI: 10.1016./j.ajem.2010.03.031

Parsons D, Convertino V, Idris A, Smith SW, Lindstrom D, Parquette B, Aufderheide TP. The ResQGARD®: a

New Device for Combat Casualty Care to Augment Circulation and Blood Pressure in Hypotensive Spontaneously

Breathing War Fighters. Journal of Special Operations Medicine Spring 2009; 9(2): 49-52.

Patel R, Miner JR, Miner SL. The need for dental care among adults presenting to an urban ED. American Journal of

Emergency Medicine. October 2010; [Epub ahead of print] DOI: 10.1016./j.ajem.2010.09.011

Prekker ME, Miner JR, Rockswold EG, Biros MH. The Prevalence of Injury of Any Type in an Urban Emergency

Department Population. The Journal of Trauma-Injury, Infection, and Critical Care. June 2009; 66 (6): pp. 1688-1695.

Department of Emergency Medicine Activities Report | 2009-2010 | 53


Prekker ME, Chang R, Cole JB, Reardon R. Rapid Confirmation of Central Venous Catheter Placement Using an

Ultrasonographic “Bubble Test.” Academic Emergency Medicine. 2010; 17 (7); e85-e86.

Reardon R. “ACEP Emergency Ultrasound Guidelines - American College of Emergency Physicians Policy

Statement on the use of US by EP's. (www.acep.org/workarea/downloadasset.aspx?id=32878)

Rokos IC., French WJ., Koenig WJ., Stratton SJ., Nighswonger B., Strunk B., Jewell J., Mahmud E., Dunford JV.,

Hokanson J., Smith SW., Baran KW., Swor R., Berman A., Wilson BH., Aluko AO., Gross BW., Rostykus PS.,

Salvucci A., Dev V., McNally B., Manoukian SV., King III SB. Integration of Pre-Hospital Electro-cardiograms and

ST-Segment Elevation Myocardial Infarction Receiving Center Networks: Impact on Door-to-Balloon Times Across 10

Independent Regions. Journal of the American College of Cardiology: Cardiovascular Interventions. April 2009; 2 (4):

339-346.

Rubinson L, Knebel A, Hick JL. MSOFA: An Important Step Forward, but Are We Spending Too Much Time on the

SOFA? Editorial. Disaster Medicine and Public Health Preparedness. 2010; 4 (4): 271-272.

Safdar B, Heins A, Homel P, Miner JR, Neighbor M, DeSandre P, Todd K. Impact of Physician and Patient Gender on

Pain Management in the Emergency Department. Pain Medicine, March 2009; 109 (2): 364-372.

Simonian SM, Lotfipour S, Wall C, Langdorf MI. “Challenging the Superiority of Amiodarone for Rate Control in

Wolff-Parkinson-White and Atrial Fibrillation.” International Emerg Med. 2010:5 (5);421-426.

Smith SW, Parquette B, Lindstrom D, Metzger AK, Kopitzke J, Clinton J. An Impedance Threshold Device

Increases Blood Pressure in Hypotensive Patients. The Journal of Emergency Medicine. May 2010; on line;

10.1016/j.jemermed.2010.05.013

Smith SW, Clark M, Nelson J, Heegaard W, Lufkin KC, Ruiz E. Emergency Department Skull Trephination for

Epidural Hematoma in Patients Who Are Awake but Deteriorate Rapidly. Journal of Emergency Medicine. 2010; 39

(3):377-383.

Smith SW. Book Review of: The Textbook of Emergency Cardiovascular Care and CPR, John M. Field,

Editor-in-Chief. Annals of Emergency Medicine 2009;54 (4);643-644.

Smith SW. Letter to the Editor. Electrocardiographic Research on Left Bundle Branch Block Must Use Angiographic

Outcomes and Proportionality if it is to Guide Reperfusion Therapy. Annals of Emergency Medicine. 2009;53(5):

691-692.

Sprung CL, Zimmerman JL, Christian MD, Joynt GM, Hick JL, Taylor B, Richards GA, Sandrock C, Cohen R, Adini B.

Recommendations for intensive care unit and hospital preparations for an influenza epidemic or mass disaster:

Summary report of the European Society of Intensive Care Medicineʼs Task Force for intensive care unit triage during

an influenza epidemic or mass disaster. Intensive Care Medicine. 2010: 36 (3): 428-443.

Stellpflug SJ, Harris CR, Engebretsen KM, Cole JB, Holger JS. Intentional overdose with cardiac arrest treated with

intravenous fat emulsion and high-dose insulin. Clinical Toxicology. March 2010; 48 (3): 227-229.

Stellpflug SJ, Cole JB, Harris CR. I shouldnʼt have had dessert…A moonflower seed ingestion. Western Journal of

Emergency Medicine. May 2010; 11 (2): 213.

Stellpflug SJ, Fritzlar SJ, Cole JB, Engebretsen KM, Holger JS. Cardiotoxic Overdose Treated with Intravenous Fat

Emulsion and High-Dose Insulin in the Setting of Hypertrophic Cardiomyopathy. December 2010; DOI

10.1007/s13181-010-0133-3.

Thumbigere-Math V, Sabino MC, Gopalakrishnan R, Huckabay S, Dudek AZ, Basu S, Hughes PJ, Michalowicz BS,

Leach JW, Swenson KK, Swift JQ, Adkinson C, Basi DL. Bisphosphonate-Associated Osteonecrosis of the Jaw:

Clinical features, Risk Factors, Management and Treatment Outcomes of 26 patients. J Oral and Maxillofac Surg,

2009; 67: 1904-1913.

54 | Department of Emergency Medicine Activities Report | 2009-2010


Wagner MJ, Wolf S, Promes S, McGee D, Hobgood C, Doty C, McErlean MA, Janssen A, Smith-Coggins R, Ling L.

Mattu A, Tantama S, Beeson M, Brabson T, Christiansen G, King B, Luerssen E, Muelleman R. Duty hours in

Emergency Medicine: Balancing patient safety, resident wellness, and the resident training experience: A consensus

response to the 2008 Institute of Medicine resident duty hours recommendation. Academic Emergency Medicine.

2010; 17 (9): 1004-1011.

Wagner MJ, Wolf S, Promes S, McGee D, Hobgood C, Doty C, McErlean MA, Janssen A, Smith-Coggins R, Ling L.

Mattu A, Tantama S, Beeson M, Brabson T, Christiansen G, King B, Luerssen E, Muelleman R. Duty hours in

Emergency Medicine: Balancing patient safety, resident wellness, and the resident training experience: A consensus

response to the 2008 Institute of Medicine resident duty hours recommendation. Journal of Emergency Medicine.

September 2010; 39 (3): 348-355.

Westgard BC, Adkinson C. “Power in studies of mortality and necrotizing soft tissue infections”. Letter to Editor,

Surgical Infections, in regard to George, et al, Hyperbaric Oxygen does not improve outcome in patients with

necrotizing soft tissue infection” in Surgical Infections, 2010;11 (4); 403-404.

Yannopoulos D, Matsuura T, McKnite S, Goodman N, Idris A, Tang W, Aufderheide TP, Lurie KG. No assisted

ventilation cardiopulmonary resuscitation and 24-hour neurological outcomes in a porcine model of cardiac arrest.

Critical Care Medicine. January 2010; 38 (1): 254-260.

Zvosec DL, Smith SW, Hall BJ. Three Deaths Associated with Use of Xyrem ® . Sleep Medicine. April

2009;10(4):490-493.

Zvosec DL. Smith SW. Response to Letter to the Editor regarding “Three Deaths Associated with Use of Xyrem®.

Sleep Medicine. April 2009;10(4):490-493.” Sleep Medicine 2009. http://dx.doi.org/10.1016/j.sleep.2009.08.006

Zvosec DL. Smith SW. Response to “Cognitive, psychomotor and subjective effects of sodium oxybate and

triazolam in healthy volunteers. Psychopharmacology Sep 24 2009; 206(1):141-154.”

Zvosec DL. Smith SW. Commentary on: [Akins BE, Miranda E, Lacy M, Logan BK. A multi-drug intoxication fatality

involving Xyrem_ (GHB). J Forensic Sci 2009;54(2):495-6]. J Forensic Sci, September 2009 54(5):1203-4; author

reply 1205.

Zvosec DL, Smith SW, Porrata T, Strobl AQ, Dyer JE. Case series of 226 Gamma-hydroxybutyrate-associated

deaths: lethal toxicity and trauma. The American Journal of Emergency Medicine. April 2010; Article in press,

corrected proof online. DOI: 10.1016/j.ajem.2009.11.008.

Zvosec DL, Smith SW. Significant underreporting of GHB deaths. Clinical Therapeutics April 2010; 32(4): 780-785.

Zvosec DL. Smith SW. Response to Letter to the Editor, “Xyrem® (sodium oxybate) Postmarketing Adverse Event

Reporting System,” by Dr. Wang. Sleep Medicine June 2010; 11 (6): 595-596.

Zvosec DL. Smith SW. Response to Editorial: “Xyrem safety: The debate continues.” Sleep Medicine 2010;

11:105-109.

Zvosec DL. Smith SW. Response from the authors to Letter to the Editor regarding “Three Deaths Associated with

Xyrem.” Sleep Medicine 2010; 11:106-108.

Department of Emergency Medicine Activities Report | 2009-2010 | 55


HCMC Department of Emergency Medicine 2009-2010

Publications | Abstracts | Scientific Presentations

Biros MH, Sargent C, Miller K. Community Attitudes About Research Without Consent. Academic Emergency

Medicine. April 2009; 16 (4, Suppl 1): S216. Presented at the SAEM 2009 Annual Meeting, New Orleans, LA, May

2009.

Breyer M, Sadosty AT, Biros MH. EM Grades, SLOR, and Medical School Rank Correlate Positively with Placement

of Interviewee on EM Rank List. Academic Emergency Medicine. April 2009; 16 (4, Suppl 1): S63-S64. Presented at

the SAEM 2009 Annual Meeting, New Orleans, LA, May 2009.

Breyer M, Sadosty AT, Biros MH. Class Ranking Systems Reported on Medical Student Performance Evaluations

Are Inconsistent or Unavailable. Academic Emergency Medicine. April 2009; 16 (4, Suppl 1): S53-S54. Presented at

the SAEM 2009 Annual Meeting, New Orleans, LA, May 2009.

Cole JB, Sattiraju S, Pace SL, Bertog SC, Asinger RW. Isolated Tramadol Overdose Associated with Brugada

Pattern EKG Changes. Clin Toxicol 2009; 47(7):757. Poster Presentation at the North American Congress of Clinical

Toxicology, September 26, 2009, San Antonio, TX

Cole JB, Stellpflug SJ, Karpas A, Roberts DJ. Ingestion of One Lead Fishing Sinker Resulting in Toxic Lead Levels

Within Hours. Clin Toxicol 2010; 48(6):622. Poster Presentation at the North American Congress of Clinical

Toxicology, October 10, 2010, Denver, CO.

Cole JB, Stellpflug SJ, Moquist KL, Setzer SC, Bilden EF. Massive Hydroxyurea Overdose in a Child Treated with

Gastric Lavage and Activated Charcoal. Clin Toxicol 2010;48(6):655-656. Poster Presentation at the North American

Congress of Clinical Toxicology, October 12, 2010, Denver, CO.

Cole JB, Stellpflug SJ, Gross EA, Smith SW. Wide Complex Tachycardia in a Pediatric Diphenhydramine Overdose

Treated with Sodium Bicarbonate. Clin Toxicol 2010; 48(6):655. Poster Presentation at the North American Congress

of Clinical Toxicology, October 12, 2010, Denver, CO

Cole JB, Stellpflug SJ, Massive Venlafaxine Overdose Resulting in Abdominal Compartment Syndrome. Clin Toxicol

2010; 48(6):644-645. Poster Presentation at the North American Congress of Clinical Toxicology, October 11, 2010,

Denver, CO

Dawes D, Ho J, Reardon R, Miner J. The Physiologic Effects of Multiple Simultaneous Electronic Control Device

Discharges. J Emerg Med, 2009; 37 (2): 209-210. Presented at the First Caribbean Emergency Medicine Congress,

Bridgetown, Barbados, January 2009.

Dawes D, Ho J, Miner J. The Neuro-Endocrine Effects of the TASER X26 Conducted Electrical Weapon. J Emerg

Med, 2009; 37 (2): 210. Presented at the First Caribbean Emergency Medicine Congress, Bridgetown, Barbados,

January 2009.

Dawes DM, Ho JD, Orozco B, Vogel E, Nelson R. Miner J. Human Creatine Kinase Effect From Conducted

Electrical Weapons. Academic Emergency Medicine. May 2010; 17(5, Suppl 1): S77. Presented at the SAEM 2010

Annual Meeting, Phoenix, AZ, June 2010.

Dawes DM. Ho JD, Orozco B, Vogel E, Nelson R, Miner JR. The Respiratory, Metabolic, and Neuroendocrine

Effects of a New Generation Electronic Control Device. Academic Emergency Medicine. May 2010; 17(5, Suppl 1):

S155. Presented at the SAEM 2010 Annual Meeting, Phoenix, AZ, June 2010.

Deitch K, Miner J, Chudnofsky C, Dominici P, Latta D, Giraldo P. Does ETCO2 Monitoring during ED PSA with

Propofol Lower the Rate of Hypoxia? A Randomized Clinical Trial. Academic Emergency Medicine. April 2009; 16 (4,

Suppl 1): S159. Presented at the SAEM 2009 Annual Meeting, New Orleans, LA, May 2009.

56 | Department of Emergency Medicine Activities Report | 2009-2010


Hart DH, Reardon RF, Miner JR, Ward C, Nelson G. Assessment of Face-Mask Ventilation Using an Airway

Simulation Model, Phase 2. Academic Emergency Medicine. May 2010; 17(5, Suppl 1): S155. Presented at the

SAEM 2010 Annual Meeting, Phoenix, AZ, June 2010.

Heegaard W, Hildebrandt DA, Ho J. The Prehospital Ultrasound Study: Results of the First Six Months. Prehospital

Emergency Care 2009: 13 (1): 139. Presented at the 2009 NAEMSP Scientific Assembly, Jacksonville, FL, January

2009.

Heller, K, Budhram G, Lapine A, Reardon R. Assessment of Echocardiography Image Acquisition and Image

Interpretation Skills in Emergency Medicine Residents. Academic Emergency Medicine. April 2009; 16 (4, Suppl 1):

S26. Presented at the SAEM 2009 Annual Meeting, New Orleans, LA, May 2009.

Hill C, Reardon R, Miner J, Falvey DG. Five-Step Cricothyrotomy Technique Using Gum Elastic Bougie is Faster

than Standard Technique in Anesthetized Sheep. Academic Emergency Medicine. April 2009; 16 (4, Suppl 1): S159.

Presented at the SAEM 2009 Annual Meeting, New Orleans, LA, May 2009.

Hill CH, McGill JW, Reardon RF, Falvey D. Intubator Recall of Hypoxia and Number of Attempts is Often Inaccurate

Compared to Video Review. Annals of Emergency Medicine. September 2009; 54 (3, Suppl. 1), S21. Presented at

the ACEP Research Forum, Boston, MA, October 2006.

Hill CH, Falvey D, Reardon RF. Effects of Emergent Intubation on Pulse Rate Using Three Different Medication

Regimens for Rapid Sequence Intubation: A Retrospective Video Review. Annals of Emergency Medicine. September

2009; 54 (3, Suppl. 1), S138-S139. Presented at the ACEP 2009 Research Forum, Boston, MA, October 2009.

Ho JD, Dawes DM, Miner JR. Human Cardiorespiratory and Acid/Base Effect of a Civilian Conducted Electrical

Weapon. Pre-Hospital Emergency Care, 2009; 13: 94-95. Presented at the 2009 NAEMSP Scientific Assembly,

Jacksonville, FL, January 2009.

Ho J, Dawes D: “Research Update on the TASER Electronic Control Device.” 5th European Symposium on

Non-Lethal Weapons. Fraunhofer Institut Chemische Technologie. Karlsruhe: DWS Werbeagentur und Verlag GmbH,

2009.

Ho JD, Heegaard W, Miner J, Dawes D. Introduction of a Conducted Electrical Weapon in a Hospital Setting: The

First 8 Months of Use. J Emerg Med, 2009; 37 (2): 210. Presented at the First Caribbean Emergency Medicine

Congress, Bridgetown, Barbados, January 2009.

Ho J, Clinton J, Lappe, M, Heegaard W, Williams M, Miner J. Introduction of the Conducted Electrical Weapon into

a Hospital Setting. Journal of Emergency Medicine 2009; 37: 209.

Ho J, Dawes D, Cole J, Reardon R, Hottinger J, Terwey K, Miner J. Effect of a conducted electrical weapon

exposure on a methamphetamine intoxicated animal model. Academic Emergency Medicine. April 2009; 16 (4, Suppl

1): S222. Presented at the SAEM 2009 Annual Meeting, New Orleans, LA, May 2009.

Ho J, Dawes D, Lundin E, Miner J. Comparison of Acidosis Markers Associated with Law Enforcement Applications

of Force. Annals of Emergency Medicine, 2009; 54 (3, Suppl 1): S40. Presented at the ACEP 2009 Research Forum,

Boston, MA, October 2009.

Ho JD, Dawes D, Johnson V, Karambay J, Kniffin C, Nelson R, Miner J. Do Conducted Electrical Weapon Probes

Carry Bacteria? Academic Emergency Medicine. May 2010; 17(5, Suppl 1): S134. Presented at the SAEM 2010

Annual Meeting, Phoenix, AZ, June 2010.

Holger, JS, Engebretsen KM, Stellpflug SJ, Cole JB, Harris CR. High Dose Insulin: A Consecutive Case Series. Clin

Toxicol 2010; 48(6):613-614. Poster Presentation at the North American Congress of Clinical Toxicology, October 9,

2010, Denver, CO

Department of Emergency Medicine Activities Report | 2009-2010 | 57


Holm M, Caroon L, Reardon RF. Impact of Image Processing on the Pleural Sliding Sign. Annals of Emergency

Medicine. September 2009; 54 (3, Suppl. 1), S88. Presented at the ACEP 2009 Research Forum, Boston, MA,

October 2009.

Knapp R, Martel ML, Miner J. Meeting Accreditation Council for Graduate Medical Education Core Competencies:

Development of a Novel Method to Assess Emergency Medicine Residents Systems Based Practice. Academic

Emergency Medicine. April 2009; 16 (4, Suppl 1): S41. Presented at the SAEM 2009 Annual Meeting, New Orleans,

LA, May 2009.

Kwon SK, Lintner CP, Brandt R, Cole JB, Stellpflug SJ. Parachuting of Water-Extracted Dextromethorphan. Clin

Toxicol 2010; 48(6):617. Poster Presentation at the North American Congress of Clinical Toxicology, October 9, 2010,

Denver, CO.

Lintner CP, Kwon SK, Stellpflug SJ, Cole JB. Heating Pad Ingestion with Significant Iron Level Elevation. Clin Toxicol

2010; 48(6):623. Poster Presentation at the North American Congress of Clinical Toxicology, October 10, 2010,

Denver, CO

Lundin E, Dawes D, Ho J, Ryan F, Miner J. Catecholamines in Simulated Arrest Scenarios. Annals of Emergency

Medicine, 2009; 54 (3, Suppl 1): S98-S99. Presented at the ACEP 2009 Research Forum, Boston, MA, October

2009.

Miner JR., Westgard BC., Gray RC., Smith SW. The Effect of Access to Health Care and Socio-Economic Status on

the Availability and Effectiveness of Medical Treatment for Asthma and Hypertension Among Patients Presenting to

the Emergency Department. (This was erroneously cited with incorrect authors in the publication.) Annals of

Emergency Medicine 2009; 54(3 Suppl 1): S46. Presented at the ACEP 2009 Research Forum, Boston, MA, October

2009.

Miner JR, Nelson R, Lukavsky, Patel R, Hayden L, Smith SW. Vascular Occlusion Testing as a Predictor of Future

Need for Intensive Care Unit Treatment in Patients Admitted to the Hospital From the Emergency Department.

Academic Emergency Medicine. May 2010; 17(5, Suppl 1): S107. Presented at the SAEM 2010 Annual Meeting,

Phoenix, AZ, June 2010.

Miner JR, Gray RO, Patel R, Plummer D. Randomized Clinical Trial of Alfentanil versus Propofol for Procedural

Sedation in the Emergency Department. Academic Emergency Medicine. May 2010; 17(5, Suppl 1): S142. Presented

at the SAEM 2010 Annual Meeting, Phoenix, AZ, June 2010.

Miner JR, Patel S, Patel R, Nelson R, Plummer D. Physiologic Stress from Unperceived Pain:

The Change in Serum Catecholamines in Patients Undergoing Procedural Sedation in the Emergency Department

with Propofol with and without Supplemental Alfentanil. Academic Emergency Medicine. May 2010; 17(5, Suppl 1):

S156-S157. Presented at the SAEM 2010 Annual Meeting, Phoenix, AZ, June 2010.

Miner JR, Mason B, OʼConnor A, Patel R. Anderson L, Miner S. Correlation Between the Results of Oral Health

Screening Exams Done on Patients in the Emergency Department by Emergency Physicians and a Dental Hygienist.

Academic Emergency Medicine. May 2010; 17(5, Suppl 1): S163-S164. Presented at the SAEM 2010 Annual

Meeting, Phoenix, AZ, June 2010.

Miner JR, Westgard BC, Patel R, Olives T, Biros MH. Increasing Rate of Patients Who Are Homeless or Have

Unstable Living Situations Presenting to the Emergency Department at an Urban County Hospital between 2007 and

2009. Academic Emergency Medicine. May 2010; 17(5, Suppl 1): S168. Presented at the SAEM 2010 Annual

Meeting, Phoenix, AZ, June 2010.

Miner JR, Westgard BC, Patel R, Olives T, Biros MH. The Increasing Rate of the Experience of Hunger Among

Patients Presenting to the Emergency Department of an Urban, County Medical Center. Academic Emergency

Medicine. May 2010; 17(5, Suppl 1): S175-S176. Presented at the SAEM 2010 Annual Meeting, Phoenix, AZ, June

2010.

58 | Department of Emergency Medicine Activities Report | 2009-2010


Miner JR. Screening of Emergency Department Triage Patients Using Near Infrared Spectroscopy. Annals of

Emergency Medicine September 2010; 15 (3): A6. Presented at the ACEP 2010 Research Forum, Las Vegas, NV,

September 2010

Miner JR. “Point of View” Video Documentation in the Emergency Department: Feasibility and Patient/Provider

Perception. Annals of Emergency Medicine September 2010; 15 (3): A6. Presented at the ACEP 2010 Research

Forum, Las Vegas, NV, September 2010

Roline CE, Ho JD, Bahr JM. 9-1-1 Lift Assistance After a Minor Fall: Pilot Study of Patient Outcomes With Police

Officer First Responders. Academic Emergency Medicine. May 2010; 17(5, Suppl 1): S171. Presented at the SAEM

2010 Annual Meeting, Phoenix, AZ, June 2010.

Scott NL, Mulder M, Bart B, Smith SW. Correlation of STEMI in Resuscitated, Non-traumatic Out-of-hospital

Cardiopulmonary Arrest Patients with Initial Rhythm and Cardiac Catheterization Findings. Academic Emergency

Medicine. May 2010; 17(5, Suppl 1): S194-S195. Presented at the SAEM 2010 Annual Meeting, Phoenix, AZ, June

2010.

Smith SW. Degree of ST Segment Upward Concavity is Only Slightly Greater in Benign Early Repolarization than in

Electrocardiographically Subtle Acute Anterior ST- Elevation Myocardial Infarction. Annals of Emergency Medicine

September 2010; 15 (3): A6. Presented at the ACEP 2010 Research Forum, Las Vegas, NV, September 2010

Smith SW. Derivation of a Rule for Diagnosis of Hypokalemia on the Electrocardiogram. Annals of Emergency

Medicine September 2010; 15 (3): A6. Presented at the ACEP 2010 Research Forum, Las Vegas, NV, September

2010

Stellpflug SJ, Cole JB, Fritzlar SJ, Engebretsen KM, Holger JS. Overdose of Diltiazem, Metoprolol, and Amiodarone

Treated Successfully with Intravenous Fat Emulsion and High Dose Insulin in an Awake Patient. Clin Toxicol 2010;

48(6):612. Poster Presentation at the North American Congress of Clinical Toxicology, October 9, 2010, Denver, CO.

Stellpflug SJ, Cole JB, Dolan JA, Setzer SC, Moser KL, Harris CR. Life-Threatening Flecainide Overdose Treated

with Intravenous Fat Emulsion. Clin Toxicol 2010; 48(6):612-613. Poster Presentation at the North American

Congress of Clinical Toxicology, October 9, 2010, Denver, CO.

Stellpflug SJ, Cole JB, Lintner CP, Kwon SK, Roberts DJ. Diethylene Glycol: A Poison Center Review Of 10 Years Of

Pediatric Exposures. Clin Toxicol 2010; 48(6):606. Poster Presentation at the North American Congress of Clinical

Toxicology, October 9, 2010, Denver, CO.

Stellpflug SJ, Cole JB, Bangh SA, Roberts DJ. Potentially Lethal Ingestion of DMT and Syrian Rue. Clin Toxicol

2010; 48(6):630. Poster Presentation at the North American Congress of Clinical Toxicology, October 10, 2010,

Denver, CO

Wall C. Workflow and Quality Improvements Using Wall Mounted Ultrasonography Machines in Pelvic Exam Rooms

of a Busy Emergency Department. Annals of Emergency Medicine September 2010; 15 (3): A6. Presented at the

ACEP 2010 Research Forum, Las Vegas, NV, September 2010

Department of Emergency Medicine Activities Report | 2009-2010 | 59


HCMC Department of Emergency Medicine 2009-2010

Publications | Books and Book Chapters

Asken M, Nystrom P. Code Calm; Mental Toughness Skills for Medical Emergencies.

www.mindsighting.com, 2009.

Bahr JM. Deep sutures: When, why, and why not? In Avoiding Common Errors in the Emergency Department. Mattu

A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters Kluwer. Lippincott,

Williams, and Wilkins. 2010.

Bertog C. Smith SW. What ECG Changes Might Myocardial Ischemia Cause Other Than ST Segment Elevation or

Q Waves, and What are the Differential Diagnoses of These Changes? In Critical Decisions in Emergency and Acute

Care Electrocardiography. William Brady and JD Truwit, Editors. Blackwell Publishing 2009.

Biros M, Heegaard W. Head Trauma. In Rosenʼs Emergency Medicine: Concepts and Clinical Practice. Seventh

Edition. Editors Marx, Hockberger, Walls. Mosby -Elsevier, St. Louis, 2010.

Brady WJ. Burt D. Ghaemmagnhami C. OʼConnor R. Smith SW. What are the ECG Indications for Acute Reperfusion

Therapy (Fibrinolysis and PCI)? In Critical Decisions in Emergency and Acute Care Electrocardiography. William

Brady and JD Truwit, Editors. Blackwell Publishing 2009.

Bruen CA. Be certain to perform a neurologic examination of the hand prior to anesthetizing a laceration. In Avoiding

Common Errors in the Emergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP

(Editors). Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.

Calvo DV. Remember to consider peripartum cardiomyopathy in pregnant patients with shortness of breath. In

Avoiding Common Errors in the Emergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD,

Woolridge DP (Editors). Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.

Chang RJ. Keep it clean: Pitfalls in traumatic wound irrigation. In Avoiding Common Errors in the Emergency

Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters

Kluwer. Lippincott, Williams, and Wilkins. 2010.

Cole JB. Be wary of Drug-drug interactions when treating cocaine-intoxicated patients. In Avoiding Common Errors in

the Emergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors).

Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.

Collier RE, Gough JE, Clement PA: Diarrhea. In Marx, Hockberger, Walls, et al, eds. Rosenʼs Emergency Medicine:

Concepts and Clinical Practice, 7th Edition, St. Louis, Elsevier, 2010

Connelly MD. Holger JS. Smith SW. What is a Hyperacute T Wave? In Critical Decisions in Emergency and Acute

Care Electrocardiography. William Brady and JD Truwit, Editors. Blackwell Publishing 2009.

Connelly MD. Holger JS. Bertog C. Smith SW. What Further Diagnostic Adjuncts to the Standard 12-lead ECG May

Help to Diagnose Acute Coronary Syndrome? In Critical Decisions in Emergency and Acute Care

Electrocardiography. William Brady and JD Truwit, Editors. Blackwell Publishing 2009.

Dunlop SJ. Prophylactic antibiotic use for simple, nonbite wounds is not necessary. In Avoiding Common Errors in

the Emergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors).

Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.

Fong EOM. Know the complications of infertility treatment. In Avoiding Common Errors in the Emergency

Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters

Kluwer. Lippincott, Williams, and Wilkins. 2010.

60 | Department of Emergency Medicine Activities Report | 2009-2010


Garlich FM. Do not rely upon the presence of an anion gap acidosis or an elevated osmol gap to diagnose toxic

alcohol ingestion. In Avoiding Common Errors in the Emergency Department. Mattu A. Chanmugam AS, Swadron SP,

Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.

Gross EA, Martel ML. Multiple Trauma. In: Marx R, Hockberger R, Walls R, et al (eds): Rosenʼs Emergency

Medicine. 7th ed. China: Mosby; 2009; 243-51

Hart D, Brunette D. Hypothermia. In Wolfson AB: Harwood-Nussʼ Clinical Practice of Emergency Medicine, 5th

Edition, Lippincott, Williams, and Wilkins, Philadelphia, 2010.

Hayden LM. Explore wounds properly prior to repair. In Avoiding Common Errors in the Emergency Department.

Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters Kluwer. Lippincott,

Williams, and Wilkins. 2010.

Hill CH. Beware of postpartum headaches. In Avoiding Common Errors in the Emergency Department. Mattu A.

Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters Kluwer. Lippincott,

Williams, and Wilkins. 2010.

Heegaard WH, Biros MH. Skull Fractures. Up to Date. 2009.

Ho JD. “Electrocardiographic Effects of the CEW. In TASER Conducted Electrical Weapons: Physiology, Pathology,

and Law. Ed. MW Kroll and JD Ho. New York: Springer Science Media, 2009.

Ho JD. Serum and Skin Effects of CEW Application. In TASER Conducted Electrical Weapons: Physiology,

Pathology, and Law. Ed. MW Kroll and JD Ho. New York: Springer Science Media, 2009.

Kniffin CC. Do not forget to consider nonobstetric causes of abdominal symptoms in a pregnant patient. In Avoiding

Common Errors in the Emergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP

(Editors). Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.

Kroll MW, Ho JD (Eds). TASER Electronic Control Devices: Physiology, Pathology, and Law. New York: Springer

Science Media, 2009.

Kulig K, Ling L. General Management of Poisonings. In Marx, Hockberger, Walls, et al, eds. Rosenʼs Emergency

Medicine: Concepts and Clinical Practice, 7th Edition, St. Louis, Elsevier, 2010

Ling, LJ. Ethanol, methanol, ethylene glycol and isopropyl alcohol. In Markovchick, Pons, Bates eds. Secrets of

Emergency Medicine. 5th Edition, Philadelphia: Elsevier, 2010.

Martel M, Biros MH. Psychotropic Drugs. In Tintinalli, et al. (Eds). Emergency Medicine: A Comprehensive Study

Guide. 7th Edition. New York, McGraw-Hill, 2009.

Milkus KM. Ovarian torsion: Tips to make this tough diagnosis. In Avoiding Common Errors in the Emergency

Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters

Kluwer. Lippincott, Williams, and Wilkins. 2010.

Miner JR. Procedural Sedation and Analgesia. In Tintinalli, et al. (Eds). Emergency Medicine: A Comprehensive

Study Guide. 7th Edition. New York, McGraw-Hill, 2009.

Miner JR, Paris P, Yealy DM. Pain Management. In Rosenʼs Emergency Medicine: Concepts and Clinical Practice,

Marx, Hockberger, Walls (Eds.) Mosby, anticipated 2009

Moore JC. Remember that eclampsia can occur in postpartum and in women with no prior diagnosis of

preeclampsia. In Avoiding Common Errors in the Emergency Department. Mattu A. Chanmugam AS, Swadron SP,

Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.

Department of Emergency Medicine Activities Report | 2009-2010 | 61


Moscati R and JD Ho. Alcohol and the CEW. In TASER Conducted Electrical Weapons: Physiology, Pathology, and

Law. Ed. MW Kroll and JD Ho. New York: Springer Science Media, 2009.

Olsen J, Gullett J. Do not forego a pelvic ultrasound in patients with a clinical suspicion for ectopic pregnancy but a

low β-hCG. In Avoiding Common Errors in the Emergency Department. Mattu A. Chanmugam AS, Swadron SP,

Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.

Orozco BS. Do not cause further tissue injury during the management of frostbite. In Avoiding Common Errors in the

Emergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia:

Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.

Reardon RF. Ultrasound in Trauma – The FAST Exam in Ultrasound Guide for Emergency Physicians. Eds:

Hoffmann (2009-2010) www.sonoguide.com/FAST.html

Reardon RF. Echocardiographic Effects of Conducted Electronic Weapons. In TASER Conducted Electrical

Weapons: Physiology, Pathology, and Law. Ed. MW Kroll and JD Ho. New York: Springer Science Media, 2009.

Reardon RF. Mateer J, Ma OJ Editors; Emergency Ultrasound Pocket Atlas - Eds:, (2010) McGraw Hill Medical,

New York

Reardon RF. Basic Airway Management and Decision-Making in Clinical Procedures in Emergency Medicine – Eds:

Roberts J, Hedges J, et al (2010)

Reardon RF. Tracheal Intubation in Clinical Procedures in Emergency Medicine – Eds: Roberts J, Hedges J, et al

(2010)

Reardon RF. Focused Echocardiography and Volume Assessment in Emergency Ultrasound Made Easy - Eds:

Bowra J, McLaughlin R (2010)

Reardon RF. Emergency Ultrasound in Emergency Medicine Study Guide - Eds: Tintinalli J, Ma OJ, et al (2010)

Roline CE, Wang S. Be aware of the high risk associated with “fight bites”. In Avoiding Common Errors in the

Emergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia:

Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.

Scott NL. Consider pulmonary embolism in pregnancy and the postpartum period. In Avoiding Common Errors in the

Emergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia:

Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.

Sherman ML. Do not misinterpret vital signs in the pregnant patient. In Avoiding Common Errors in the Emergency

Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia: Wolters

Kluwer. Lippincott, Williams, and Wilkins. 2010.

Smith SW. Larson DM. What Pseudoinfarction Patterns Mimic ST elevation Myocardial Infarction? In Critical

Decisions in Emergency and Acute Care Electrocardiography. William Brady and JD Truwit, Editors. Blackwell

Publishing 2009.

Smith SW. Larson DM. What QRS Complex Abnormalities Result in ST Segment Elevation That May Mimic or

Obscure AMI? In Critical Decisions in Emergency and Acute Care Electrocardiography. William Brady and JD Truwit,

Editors. Blackwell Publishing 2009.

Stellpflug SJ. Holger JS. Smith SW. What is the Role of the ECG in the Patient with Suspected Acute Coronary

Syndrome? In Critical Decisions in Emergency and Acute Care Electrocardiography. William Brady and JD Truwit,

Editors. Blackwell Publishing 2009.

62 | Department of Emergency Medicine Activities Report | 2009-2010


Stellpflug SJ. Holger JS. Smith SW. What are the Electrocardiographically Silent Areas of the Heart? In Critical

Decisions in Emergency and Acute Care Electrocardiography. William Brady and JD Truwit, Editors. Blackwell

Publishing 2009.

Todd K, Miner JR Acute Pain Management in the Emergency Department. In Acute Pain Management, Sinatra,

Leon-Casasola, Ginsberg, Viscusi (Eds) Cambridge University Press, 2009

Villaume IV FE. Always monitor third-trimester pregnant patients after they have sustained trauma of any severity. In

Avoiding Common Errors in the Emergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD,

Woolridge DP (Editors). Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.

Vogel EE. Be prepared to manage postpartum hemorrhage at every delivery. In Avoiding Common Errors in the

Emergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors). Philadelphia:

Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.

Walz HF. Pelvic inflammatory disease is a difficult diagnosis to make: Know the CDC recommendations. In Avoiding

Common Errors in the Emergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP

(Editors). Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.

Westgard BC. Know the basics of rewarming and resuscitation of hypothermic patients. In Avoiding Common Errors

in the Emergency Department. Mattu A. Chanmugam AS, Swadron SP, Tibbles CD, Woolridge DP (Editors).

Philadelphia: Wolters Kluwer. Lippincott, Williams, and Wilkins. 2010.

Whitwam W, Smith SW. Does Localization of the Anatomic Segment/Identification of the Infarct-Related Artery

Affect Early Care? In Critical Decisions in Emergency and Acute Care Electrocardiography. William Brady and JD

Truwit, Editors. Blackwell Publishing 2009.

Zvosec DL, Smith SW. Gamma hydroxybutyrate and Analogues. In: Emergency Management of Drugs of Abuse.

Harris C and Stellpflug S., eds. McGraw Hill. In Press.

Department of Emergency Medicine Activities Report | 2009-2010 | 63


Clubs and Scrubs.....�

Annual fundraising golf event

BEAT THE BOSS.....��

Resident vs. Faculty golf event

After hours

SAEM......�

Interns, residents and staff attend the annual meeting of “The Society for

Academic Emergency Medicine”.

64 | Department of Emergency Medicine Activities Report | 2009-2010

Resident Bowling

League????............�


�......PreSeason Physical

Cross country ski race, proceeds benefit the RA Program.

�.......Golden Chest Tube

Football game between Emergency Medicine

and Surgery residents

Holiday

Party....�

Drs. Rearden, Miner,

Heegaard, Sterner,

Liberty Caroon and

Dave Hildebrandt

Bronz Foley.................�

Broomball competition with Surgery

�........ALOHA

Party

Welcome to our new

residents & goodbye

to our graduating

residents

�......Ultrasound Technology at the Zoo


®

Department of Emergency Medicine

701 Park Avenue | Minneapolis, MN 55415

www.hcmc.org

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