Little Big Med

Violent injury, particularly related to firearms, has been at the forefront of national discussion recently. Pediatric victims and survivors have begun to enter into the public discussion via a strong social media presence, and as clinicians who treat these patients’ injuries, we are also obligated to participate in prevention. This is the first in a series of episodes to address what we know about firearm violence, what interventions have been tried, and how we can reframe the discussion to focus less on political beliefs and more on harm reduction. Host Jason Woods MD gathered national firearm violence experts Megan Ranney MD MPH, Patrick Carter MD, and Stephen Hargarten MD MPH to introduce where the research, policy, and political climate sits currently and to give some ideas on how to think and speak about this issue with patients and families. Guests Megan Ranney MD MPH- Associate Professor of Emergency Medicine at Brown University, violence prevention researcher, past chair of ACEP Trauma and Injury Prevention Section Stephen Hargarten MD MPH – Professor and chair of Emergency Medicine of Medical College of Wiscone, Director of MCW Comprehensive Injury Center Patrick Carter MD – Assistant Professor of Emergency medicine, and Assistant Director of the Injury Prevention Center at the University of Michigan Resources Videos from University of Michigan  “Open Michigan” site on how to talk to patients and families about firearms Articles * McCourt AD, Vernick JS, Betz ME, Brandspigel S, Runyan CW. Temporary Transfer of Firearms From the Home to Prevent Suicide. JAMA Intern Med 2017;177(1):96–6. * Wintemute GJ, Betz ME, Ranney ML. Yes, You Can: Physicians, Patients, and Firearms. Ann Intern Med 2016;165(3):205–10. * MPH MLRM, MD JF, MPH HAM, et al. A Consensus-Driven Agenda for Emergency Medicine Firearm Injury Prevention Research. YMEM 2017;69(2):227–40. * Parikh K, Silver A, Patel SJ, Iqbal SF, Goyal M. Pediatric Firearm-Related Injuries in the United States. Hospital Pediatrics 2017;:hpeds.2016–0146–12. * Hargarten S. Firearm Injury in the United States: Effective Management Must Address Biophysical and Biopsychosocial Factors. Ann Intern Med 2016;165(12):882–2. * Carter PM, Cook LJ, Macy ML, et al. Individual and Neighborhood Characteristics of Children Seeking Emergency Department Care for Firearm Injuries Within the PECARN Network. Acad Emerg Med 2017;24(7):803–13. * Goldstick JE, Carter PM, Walton MA, et al. Development of the SaFETy Score: A Clinical Screening Tool for Predicting Future Firearm Violence Risk. Ann Intern Med 2017;166(10):707–15. * Carter PM, Walton MA, Goldstick J, et al. Violent firearm-related conflicts among high-risk youth: An event-level and daily calendar analysis. Preventive Medicine 2017;102(C):112–9.

Host Jason Woods MD chats with Dan Lindberg MD, national expert in Child Abuse evaluation, on what role the ED plays in the evaluation of child abuse, and addresses the things that scare the ED doc the most. How do I avoid going to court? What and how should I document? What can I do so that I don’t screw up the case for the lawyers?

Host Jason Woods MD chats with Brad Sobolewski MD, on how he established his own brand as a medical educator, with advice for new medical educators just starting on this path.

Host Jason Woods MD chats with Joe Grubenhoff MD, on what role the ED plays in concussion evaluation, the updated concussion guidelines, and where the pendulum will come to rest on rest versus activity in the post-concussion time period.

Host Jason Woods MD talks with Lalit Bajaj MD on the use of home oxygen dispensed from the emergency room in the treatment of bronchiolitis. Dr. Bajaj is an emergency medicine physician at the University of Colorado and Children’s Hospital Colorado and was one of the early participants in their home oxygen protocol initiation and evaluation.

Hot on the heels of our previous recording, new guidelines were published on the care of pediatric sepsis by the American College of Critical Care Medicine/Society of Critical Care Medicine. Host Jason Woods MD and Halden Scott MD evaluate how these new guidelines change our previous discussion on the use of lactate measurement in the treatment of pediatric sepsis in the emergency department.

Host Jason Woods MD sits down with Halden Scott MD to discuss the state of pediatric sepsis, and specifically the use of lactate measurements in the Emergency Department. Dr. Scott is a leading expert in pediatric sepsis in the Emergency Department, with multiple articles published on the topic of the use of lactate measurement in the treatment of pediatric sepsis.

The inaugural episode of Little Big Med: Little Patients, Big Medicine! Host Jason Woods MD sits down with Sam Wang MD (pediatric emergency medicine physician and toxicologist) and Matt Zuckerman MD (emergency medicine physician, toxicologist, and host of the ToxNow podcast) to discuss the pediatric medical issues surrounding marijuana legalization.