The Pulse2018-07-05T17:53:52+00:00

Creating a Geriatric-Friendly ED

Dr. Elizabeth Baum is the Medical Director at Bethany Medical Center, a skilled rehab, long-term care, and assisted living facility. She is a Geriatric Consultant at Aultman Hospital where she also serves as Clinical Faculty for the Family Practice and Internal Medicine Residency Programs. Dr. Baum is an Associate Professor of Internal Medicine at Northeast Ohio Medical University where she also attended medical school. She completed a Geriatric Fellowship at the Cleveland Clinic Foundation and is Board certified in both Internal and Geriatric Medicine. By now everyone is familiar with the “Silver Tsunami” that started in 2011 with 10,000 Baby Boomers turning 65 every day in the United States. At the same time, life expectancy for those over age 85 has increased. Currently, nearly one in two older adults will have an ED visit annually. Quality assessment and management of these patients, whether they are admitted to the hospital or discharged, can play a large role in determining [...]

August 6th, 2019|

Confronting Human Trafficking

By Jenny Reyes, DO Chief Resident, Aventura Emergency Medicine Residency Aventura Hospital & Medical Center Only 10% of physicians recognize the signs of human trafficking. Only 3% of emergency physicians receive training in identifying victims of human trafficking. 83% of victims of human trafficking seek medical treatment. Knowledge is a powerful weapon in fighting this horrifying crime. Human trafficking generates an estimated $33.9 billion worldwide and is the 3rd largest source of income for organized crime. According to the 2017 US Department of State Trafficking in Persons Report, there were 100,409 victims identified across the globe in 2017, which has more than doubled since 2014.3 In the United States there were 8,524 confirmed cases of human trafficking in 2017, and the numbers are climbing every year. Despite these growing numbers, it is estimated that less than 1% of victims have been identified due to difficulty obtaining accurate surveillance data. Human trafficking can be further categorized into sex [...]

July 24th, 2019|

Special Needs Children and the ED: What Medical Staff Should Know

by By Karen Ursic, MA The parents of children with special needs can be a wealth of information and valuable perspective. Learn from those with boots-on-the-ground experience in order to provide the best possible care. What are your thoughts? I am a mother of three children, two of whom are on the autism spectrum and one who has type one neurofibromatosis (NF1). Most of what I have learned about their conditions is through lived experience. I also work part-time in the medical field, not as a doctor or nurse, but my job often brings me in contact with patients and has shown me that a little common sense and empathy goes a long way, no matter what my training or education is. It is in this spirit that I hope you find this information helpful, and are prepared to treat special needs children and successfully work with their parents and caregivers. Under no circumstances should you belittle [...]

July 22nd, 2019|

Helping Patients with Autism and Their Families Navigate Emergency Visits

by By Rena Sorensen, PhD and Laura Srivorakiat, PsyD Patients with Autism Spectrum Disorder experience significant challenges when entering the emergency department. It is critical to be prepared and informed in order to proved these patients and their caregivers with quality care. Share with us your experience, perspective, or questions on caring for patients with ASD. Chris’s family traveled more than an hour, with Chris kicking and screaming in the back seat, to make their fourth trip to an emergency department (ED) in as many months. A school provider in their town had told them that by going to this ED, the family might get the help they needed. They felt it was a long shot based on prior experiences but held out some hope. Chris is diagnosed with an autism spectrum disorder (ASD). One of his restricted interests is a love of ambulances, which helped him to calm quickly upon arriving at the ED. In the past [...]

July 19th, 2019|

Check Out the Summer Issue of The Pulse!

Check your mailbox! The summer issue of The Pulse should be arriving any day. This issue explores vulnerable populations—from victims of human trafficking, to geriatric care, to children with special needs. We hear from a variety of experts, explore a patient's perspective, speak with a formerly homeless person, and understand better how ACOEP can help you while you are trying to help others. If you haven’t received your copy yet, you can read online by clicking here. Check back to the ACOEP Newsroom often for the chance to easily share digital versions of the articles, comment on interesting topics, pose questions, and explore expanded content. Thank you to everyone who contributed to this issue. If you are interested in joining our team of writers please contact Erin Sernoffsky at

July 18th, 2019|

Mass Casualty Incidents – Preparing to prepare

Duane D. Siberski, D.O., FACOEP-D, FACEP, PHP Media coverage of the latest mass casualty incident [MCI] has decreased.  Parkland High School is in the record book.  Remembrances of previous MCI events tribute the victims ceremoniously.  The Academy of Country Music awards show dedicated to the Route 91 victims, #RunBoston spelled out the city’s name with a course route along the city streets, a Massachusetts’s moment of silence at 2:49 PM occurred five years after the bombing, the National Park located at a plane crash site in Pennsylvania, the corollary New York City memorial and museum with a $44 admission ticket price, an empty field devoid of the removed Amish one room schoolhouse all stand as reminders to previous MCI events. American public sentiment and awareness ebbs and flows after MCIs occur. The need for an integrated system with well-trained providers responding to mass casualty incidents truly exists.  Critiques of MCIs bring to light shortcomings; communication failure, remote staging of [...]

July 5th, 2018|

Ethics in Emergency Medicine: What Would You Do?

Bernard Heilicser, D.O., M.S., FACEP, FACOEP-D In this issue of The Pulse we will review the dilemma presented in the April 2018 issue, referred to us by a frustrated paramedic. The situation involved a 70-year-old female patient being transferred from an urgent aid to an affiliated hospital emergency department. The patient had sustained a fall injury and struck her head.  She was on anticoagulant medication. The EMS crew noted the patient to be “a little restless …complaining of a headache”.  Although, initially alert with normal vital signs, she became disoriented.  The paramedic asked the physician if he would consider transferring the patient to a Trauma Center, concerned for a possible intracranial bleed.  The physician told him to run it by the accepting ED for medical control.  Diversion was denied. En route, the patient became nonverbal and responsive only to pain.  Diversion was again denied. The same crew was later called to transfer the patient to a different trauma center [...]

July 5th, 2018|

Emergency Decontamination: What You Need to Know

Bernard Heilicser, DO, MS, FACEP, FACOEP-D Medical Director & Medical Manager, IL-TFI USAR We often talk about decontamination as something accomplished prior to a patient arriving at our emergency department.  Fortunately, this is usually what occurs.  However, in our chaotic and disturbing world, we cannot always rely on this to have been adequately or fully performed, nor the probability of self-presenting patients from the scene.  Additionally, to be best, and safely, prepared, we truly need to know what is happening in the field, or our driveway, before we see the patient. With the multitude of dangerous chemicals traversing our highways and train tracks on a daily basis, the potential for hazardous material and other contaminants becoming clinical events cannot be overlooked.  The easy availability of these new weapons, by terrorists, adds to our concerns. Here is a brief overview of decontamination as practiced by trained responders at an operational level. If we define decontamination as the process of removing [...]

July 5th, 2018|

The Las Vegas Mass Casualty Incident

Michael P. Allswede DO “That music is going to keep me up all night.” Without realizing the irony of my words, I went to bed at 2100 on October 1st.  My phone started ringing around midnight with the words “every available physician report to Sunrise for a mass casualty event.”  I responded to Sunrise Hospital & Medical Center in Las Vegas for duty at 0020 and walked into one of the largest mass shooting events in our country.  My most enduring memory of that night was the strong smell of blood that permeated the ambulance entrance and throughout the emergency department. The Las Vegas mass casualty incident (MCI) began a bit after 2200 on October 1 at the Harvest Festival Concert.   The terrorist had planned his assault by reserving a room on the 32nd floor of a high-rise hotel with a view of the concert venue.  The terrorist had assembled an arsenal of 27 weapons with hundreds of rounds [...]

July 5th, 2018|

Physician Wellness: A Bill of Rights

Janice Wachtler, BAE, CBA About 25 years ago, a television show premiered that focused on the daily activities of a group of physicians, nurses, and nurse’s aids in one emergency room in Chicago.  ER was a great hit for nearly 10 years and in one episode it chronicled one attending physician’s encounter with a patient’s family who accosted him and left him broken and bleeding. Recently, a nurse at a hospital in Chicago was shot and wounded by a patient’s family member who felt she did not provide that patient appropriate care.  The article in the Chicago Tribune called the emergency department a war zone, in which emergency department workers were often spat upon, accosted, and verbally or physically abused.  The wounding of this nurse was just the tip of the iceberg at this hospital. So, is it time for all the emergency medicine associations to come together and insist that emergency department personal be better protected?  Should we [...]

July 5th, 2018|