Tag Archives: Emergency Medicine

SOM’s Litzau earns national honor in emergency medicine

Litzau Megan 5x7_5803
Megan Litzau

Megan Litzau, MS 6, has been selected as a winner of the 2015 American College of Emergency Physicians National Outstanding Medical Student Award.

The award recognizes a medical student who intends to pursue emergency medicine careers and has displayed outstanding patient care and involvement in medical organizations and the community. Litzau will continue her training in emergency medicine with a residency at the Indiana University School of Medicine.

Litzau has served as president of the school’s Emergency Medicine Interest Group and organized teams and training sessions for students who participated in the Society for Academic Emergency Medicine’s annual SimWars competition last September. A team from the School of Medicine finished second in the competition by one point.

Litzau has also been an active research participant, working on numerous research projects as a student. She presented two posters at the 2015 UMKC Health Sciences Student Research Summit in April and received the second prize for best student poster.

She has also been selected for a number of School of Medicine Senior Awards given to graduating students including Missouri State Medical Association Honors Graduate; Society for Academic Emergency Medicine Award; Thomas R. Hamilton, M.D., Award for Excellence in Microbiology; Thomas R. Hamilton, M.D., Award for Excellence in Pathology; Vice Chancellor’s Honor Roll Recipient Award and the Women in Medicine Scholarship Achievement Citation.

Litzau will receive her American College of Emergency Physicians award in October at the organization’s annual scientific assembly in Boston.

Responder discusses effort to control Ebola outbreak in Liberia

Thomas Kirsch, M.D., M.P.H.
Thomas Kirsch, M.D., M.P.H.

An expert in disaster management and science who responded to the Ebola outbreak in Liberia said the disease had essentially been eradicated there.

Thomas Kirsch, M.D., M.P.H., director of the Center for Refugee and Disaster Response and an associate professor of emergency medicine at Johns Hopkins University, traveled to Monrovia, the Liberian capital, to work in an emergency operations center during the crisis late last year. He presented the W. Kendall McNabney, M.D., Lecture at the School of Medicine on April 30.

The largest Ebola outbreak ever recorded primarily affected the West African countries of Liberia, Sierra Leone and Guinea. More than 10,000 people died, according to the World Health Organization. “We went from a small, isolated outbreak of a very scary disease, that is a horrible way to die, that has a mortality rate of up to 90 percent, to this massive outbreak, which clearly caught the attention of the world,” Kirsch explained.

When he arrived in Liberia, Kirsch said he expected to find himself in a “zombie apocalypse.” Instead, he found that life in Monrovia was relatively normal. Shops were open, and people were going about their daily lives.

But there were washing stations with bleach solution in front of every building. Also, hand shakes and other forms of touching were forbidden, which Kirsch found disorienting. “Try to go through life like that,” he said. “It’s very odd, it’s very disturbing. But that’s the way people lived there.”

Kirsch was modest and stressed that the focus of his efforts in Liberia was on public health and that he did not provide clinical care. “I was a bureaucrat,” he said.

The United States spent hundreds millions of dollars and deployed troops to Liberia, a historical ally, when estimates suggested failure to act would result in 1 million people in West Africa becoming infected. But the disease was on the wane before the military opened its first treatment center. “Clearly, it was not the Ebola treatment beds that turned this epidemic,” Kirsch said.

What had changed was people’s behavior, Kirsch said. In addition to hand washing stations, isolating the sick and safer burial practices helped to bring the disease under control. “When a first spike occurs in your community, and you watch your neighbors vomiting on the street and dying, you change your behavior,” Kirsch said.

Kirsch said the competence of the political leaders and public health officials in Liberia was key to the social mobilization and education efforts. While there have been no known community transmissions in 80 days, a Liberian woman’s infection was confirmed in March. It is believed she contracted Ebola from unprotected sex with a man who survived the virus. The virus has been found in the semen of some men who have recovered from the infection. “This disease is now endemic in West Africa,” Kirsch said.

Kirsch, however, sounded optimistic that an Ebola vaccine would be developed eventually. “Ebola is a stupid little virus,” he said. “It’s not HIV.”

Gaddis keeps busy teaching, speaking schedule

Gary Gaddis, M.D., Missouri Endowed Chair for Emergency Medicine, spoke to more than 800 physicians at the Pan-Pacific Emergency Medicine Congress in Daejeon, South Korea, on Oct. 15.
Gary Gaddis, M.D., Missouri Endowed Chair for Emergency Medicine, spoke to more than 800 physicians at the Pan-Pacific Emergency Medicine Congress in Daejeon, South Korea, on Oct. 15.

Gary Gaddis, M.D., Missouri Endowed Chair for Emergency Medicine, gave two lectures at the Fifth World Congress of Emergency Medicine conducted Nov. 19-22 in Guadalajara, Jalisco, Mexico. He also traveled to Daejeon, South Korea, where he gave two talks on Oct. 15 at the Pan-Pacific Emergency Medicine Congress. He then spent Nov. 7 and 8 in Irving, Texas., presenting 14 hours of instruction in biostatistics at the American College of Emergency Physicians Emergency Medicine Basic Research Skills course.

In Mexico, Gaddis spoke on how to recognize and treat drug related problems in the emergency room and gave another talk on the muscle disease Rhabdomyolysis and its adverse consequences. He presented his topics to more than 300 Mexican emergency medicine physicians and nurses with the help of Saint Luke’s medical interpreter Carlos Rodriguez who aided in translating the presentations into Spanish.

His presentations in South Korea included a keynote/plenary presentation “Medication Related Problems in the Emergency Department: How to Recognize Them and What Do About Them,” and a research methods presentation, “Testing for Non-Inferiority: An Overview.”

Gaddis said the official recognition of the emergency medicine specialty in South Korea and the existence of emergency medicine residency training programs has a much shorter history in Korea than in the United States. Many of the struggles of the specialty in Korea are the same struggles that the specialty of emergency medicine underwent in the United States 20 to 30 years ago, Gaddis said.

The American Academy of Emergency Medicine partnered with the Korean Society of Emergency Medicine to present the congress to foster education and the development of the specialty. The American academy has partnered with a  number of emergency medicine societies around the world to foster development of the specialty.

Gaddis said his keynote talk on medication-related problems covered a common, yet poorly recognized issue by emergency physicians.

“In Korea, as in the United States, patients may not fill all of their prescriptions with one pharmacy,” Gaddis said. “They may not understand their medications. They may be taking problem-prone medications and their medication regimens may be confounded by extreme poly-pharmacy.”

Gaddis made practical suggestions to make the audience more aware of medication-related problems so that physicians might be able to recognize them more frequently and act upon them more appropriately.

His second presentation explored how most clinical studies are concerned with demonstrating a hypothesized difference between groups being studied. A “non-inferiority” study design should be utilized when a new treatment might or might not be similarly effective as the current treatment, and when that new treatment constitutes less burden to the patient or to the medical team delivering it, he said. The main question when evaluating for “non-inferiority” is how much difference between the new, less burdensome treatment and the standard treatment can be tolerated to permit the conclusion that the two treatments are so similar that the difference between them is too small to matter.

Gaddis used a highly animated presentation to demonstrate that these studies are not as complex or as difficult to understand as most physicians believe. The key to understanding non-inferiority designs is to understand how to set the “cutoff” for the margin of difference between treatments and to understand the use of the confidence intervals for the amount of difference between treatments to determine whether or not the two treatments are sufficiently similar that “non-inferiority” can be concluded.

More than 800 physicians attended the joint effort between the Korean Society of Emergency Medicine and the American Academy of Emergency Medicine. The event promotes the exchange of academic advancements in emergency medicine through three days of workshops and lectures from renowned scholars and experts. This year’s event also celebrated the 25th anniversary of the Korean emergency medicine society.

The emergency physicians’ November research course offered at the American College of Emergency Physicians’ national headquarters is a mini research fellowship for early-career emergency physicians who are beginning their research careers. During a 10-day period in November, younger physicians receive help in preparing an initial research project that they will implement at their home institution. They receive mentoring throughout the period between the initial classes in November and a presentation of their results in April.

Faculty, including Gaddis, who is mentoring three attendees from Lithuania, provide their research experience to mentor younger physicians to plan and execute their own research projects.


EMS Field Day provides new experience for emergency medicine residents

School of Medicine residents from the Emergency Medicine Residency program teammed up with emergency medical services personnel from the Grandview Fire Department on July 21 for EMS Field Day, a joint training session in out-of-hospital emergency and trauyma services.
School of Medicine residents from the Emergency Medicine Residency program teammed up with emergency medical services personnel from the Grandview Fire Department on July 21 for EMS Field Day, a joint training session in out-of-hospital emergency and trauma services.

Smoke billowed from the door of a small Grandview, Mo., structure on July 21 as a group of UMKC School of Medicine Emergency Medicine Residents dressed in fire fighting gear ventured inside to rescue a victim. A short time later, they watched from nearby as an emergency medical crew from the Grandview Fire Department worked to extract an accident victim from a crushed vehicle.

Fortunately, the victims were mannequins and the emergencies mere simulations. But for 11 members of the Emergency Medicine Residency program, the School’s first EMS Field Day provided a first-hand look at what takes place with trauma victims outside the hospital setting before they reach the emergency room.

“Emergency medicine is a specialty field that needs to be involved with out-of-hospital patient care,” said Matt Gratton, M.D., professor and chair of emergency medicine. “This field day is a wonderful up-close-and-personal way to show residents this.”

Before the day was over, residents had climbed to the top of the extension ladder on a Grandview fire truck and been introduced to Life Flight Eagle, an air-ambulance helicopter.

The day-long program, including both classroom and hands-on simulations, was a joint training session bringing together Grandview EMS personnel and the resident emergency medicine physicians from UMKC coordinated by the School’s Department of Emergency Medicine, its Emergency Medical Services Program, the Grandview Fire Department and Life Flight Eagle.

“This is kind of an introduction for emergency medicine residents to what takes place out in the field,” said Paul Ganss, M.S., NRP, NCEE, CHSE, the EMS education director and manager of the School’s Clinical Training Facility. “They get to meet some of the out-of-hospital care providers and experience what happens in the field. In the past, emergency medicine physicians might wonder why they didn’t get a piece of information or why wasn’t something done before the patient got to the emergency room. This gives them an idea of some of the things that happen in the field.”

Ganss said the event provided residents with an eye-opening experience.

“They got the opportunity to pick up some background and knowledge,” he said. “We’re looking at doing this again in the future, refining it and making it even better.”


Noted emergency medicine physician delivers 2014 McNabney Lecture

Jerome Hoffman, M.D., professor emeritus of medicine and emergency medicine at the UCLA School of Medicine, delivered the annual McNabney Lectureship on May 22.
Jerome Hoffman, M.D., professor emeritus of medicine and emergency medicine at the UCLA School of Medicine, delivered the annual McNabney Lectureship on May 22.

Jerome R. Hoffman, M.D., M.A., professor emeritus of medicine and emergency medicine at the UCLA David Geffen School of Medicine delivered the annual McNabney Lecture at the UMKC School of Medicine on May 22.

Hoffman spoke on what he calls a modern epidemic of over-diagnosis in medicine.

The lectureship honors Kendall McNabney, M.D., who founded the Department of Emergency Medicine at Truman Medical Center and the UMKC School of Medicine in 1973. McNabney was the first and longest serving chair of emergency medicine at the School and served as the head of trauma services for many years.

Hoffman served as director of the UCLA emergency medicine residency program and the school’s doctoring program and taught for more than 30 years in the UCLA School of Medicine and the Robert Woods Johnson Clinical Scholars Program.

He was a consultant toxicologist for the Los Angeles Regional Poison Control Center for more than a decade and served as a reviewer, editorial board member and editor for a number of medical journals throughout his career.

Much of his research has focused on health services and clinical decision making, as well as medical education.

Dr. Go selected to National Board of Medical Examiners

Steven Go, M.D.
Steven Go, M.D.

Steven Go, M.D., associate professor of emergency medicine, was selected as a member of the board of the National Board of Medical Examiners at the organization’s 100th annual meeting on April 3-4 in Washington, D.C.

Go has actively served on the NBME since 1998, working in various capacities on the development of the organization’s computerized case simulation exam. He has served on various Test Development Committees, Task Forces, Item Review Boards for the USMLE Step 3 and Computerized Case Simulations group.

As a Board Member, Go is part of the 80-member constituency of the NBME that serves a strategic role to create ideas and policy towards advancing the mission of the NBME. In addition, the membership has the key fiduciary roles of revising the corporate bylaws and articles of incorporation and electing, from among the Membership, the board of directors (Executive Board).

Go has been a faculty member in the Department of Emergency Medicine at the School of Medicine for the last 20 years. He was appointed assistant dean for medical education in 2004 and was awarded a dual appointment to the Office of Medical Education and Research in 2006.  In this role, he spearheaded the integration of the ACGME competencies in the UMKC/TMC graduate medical education residencies and fellowships, which was completed in 2008.  In July 2009, he accepted a position at Children’s Mercy Hospital to assist their efforts to integrate the ACGME competencies in their graduate medical education programs.