ACOEP The Pulse Winter 2022 by ACOEP

WINTER 2022

A Healthy Outlook For A New Year

FACING CHALLENGES TOGETHER PG 4

WHAT’S ON DECK FOR 2022 PG 6

WOMEN’S COMMITTEE UPDATE PG 8

April 10–13, 2022

Fort Lauderdale Marriott Harbor Beach Resort & Spa Fort Lauderdale, Florida

SS 22

#ACOEP22 acoep.org/2022-Spring-Seminar

The Pulse VOLUME XLX No. 1

EDITORIAL STAFF Timothy Cheslock, DO, FACOEP, Editor Wayne Jones, DO, FACOEP-D, Assistant Editor Tanner Gronowski, DO, Associate Editor John C. Prestosh, DO, FACOEP-D Christine F. Giesa, DO, FACOEP-D Meagan Comerford, Director of Communications EDITORIAL COMMITTEE Timothy Cheslock, DO, FACOEP, Chair Christine Giesa, DO, FACOEP-D

The Pulse is a copyrighted quarterly publication distributed at no cost by ACOEP to its Members, Colleges of Osteopathic Medicine, sponsors, exhibitors, and liaison associations recognized by the national offices of ACOEP. The Pulse and ACOEP accept no responsibility for the statements made by authors, contributors, and/ or advertisers in this publication; nor do they accept responsibility for consequences or response to an advertisement. All articles and artwork remain the property of The Pulse and will not be returned. Display and print advertisements are accepted by the publication through ACOEP, 111 West Jackson Boulevard, Suite 1412, Chicago, IL 60604, (847) 686-2235, or to mcomerford@acoep.org. Please contact ACOEP for the specific rates, due dates, and print specifications.

TABLE OF CONTENTS 4

PRESIDENT’S REPORT G. Joseph Beirne, DO, FACOEP-D

EXECUTIVE DIRECTOR’S DESK Katie Geraghty

THE ON-DECK CIRCLE Timothy Cheslock, DO, FACOEP

WOMEN’S COMMITTEE UPDATE Nicole Vingh, DO, MPH

ACOEP’S NEW BOARD MEMBERS

A SUCCESSFUL SPRING ASSEMBLY

2021 FELLOWS AND LIFE MEMBERS

WHAT WOULD YOU DO? ETHICS IN EMERGENCY MEDICINE Bernard Heilicser, DO, MS, FACEP, FACOEP-D

Deadlines for the submission of articles are as follows: January issue due date is November 15; April issue due date is February 15; July issue due date is May 15; October issue due date is August 15. Advertisement due dates can be found by downloading ACOEP's media kit at www.acoep.org/advertising. ACOEP and the Editorial Board of The Pulse reserve the right to decline advertising and articles for any issue. ©ACOEP 2022 – All rights reserved. Articles may not be reproduced without the expressed, written approval of ACOEP and the author. ACOEP is a registered trademark of the American College of Osteopathic Emergency Physicians.

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PRESIDENT’S REPORT

G. Joseph Beirne, DO, FACOEP-D

FACING CHALLENGES TOGETHER

reetings ACOEP family! I hope the holiday season was a wonderful time for all of you to refresh, spend time with your families, and celebrate the love and memories that make that time of year so special for all of us. This is an exciting time for me, as this is my first official Pulse article as your president. First, I want to thank our staff at Kellen for the fantastic job they did in presenting the scientific assembly. Our CME committee, chaired by Dr. Chris Colbert, Dr. Andy Little and Dr. Molly Estes, once again provided us with a superior CME program. Thank you to all of you for this tremendous effort and success! As we move into 2022, we continue to grapple with COVID19. The new omicron variant may challenge us even more than the delta variant, but in our emergency departments around the country, we continue to provide expert care and service to the public and win the battle each day. Recently, ACOEP was asked to sign onto a statement supported by multiple medical specialty groups, not just emergency medicine, supporting OSHA’s requirement that businesses with greater than 100 employees must have all of their workers vaccinated. The board reviewed this proposal and voted in favor of supporting this statement. It is the only way that we, as the frontline of health care, will be

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WE NEED ALL OF OUR MEMBERS INVOLVED AND YOUR FEEDBACK TO CONTINUE MAKING ACOEP BETTER.” able to continue winning the battle against COVID-19. One of my main interests when I assumed the presidency of ACOEP was to create more transparency in the college from the top down. I want our college members to be actively involved in ACOEP. We have restructured some of the committees, as well as created a new “membership and marketing committee,” to increase the number of members in our college. Having you, our members, become involved in the business of the college creates pride in our organization, as well as opportunities for leadership and career advancement. As I said in my presidential address, we need ALL of our members involved and your feedback to continue making ACOEP better. After the scientific assembly, we sent out a survey to members, asking what was most important to them as we move into 2022. The responses

were varied, but one message was very clear — CME and education remain the most important aspect for our members, and we will continue to provide quality CME programs and remain on the cutting edge of emergency medicine. As we progress further into 2022, our specialty will continue to have challenges each day that will test our skills as physicians and leaders in emergency medicine. As we face these challenges, please know that you are not alone. ACOEP is a family and always will be. We will face these challenges together and support each other. I want each of you, our members, to reach out to myself and the other board members with your concerns, questions and ideas. We represent you at the national level and are committed to preserving the integrity and identity of the osteopathic emergency physician. Our mission is success, and together we will succeed. –•–

EXECUTIVE DIRECTOR’S DESK

Katie Geraghty Executive Director

STRENGTHENING OUR COMMITMENT

e are celebrating our one-year anniversary as ACOEP’s management team. Although a few faces have changed, our commitment to serve ACOEP’s mission has remained strong. Alongside the ACOEP Board and committees, we have become more knowledgeable and are excited for the year ahead – with two (planned) in-person meetings in 2022: Spring Assembly April 10-13 in Fort Lauderdale, Florida (registration is open!) and Scientific Seminar October 24-28 in Las Vegas, Nevada. I am proud to work alongside your staff team:

Nakeshia Betsill Membership and Resident and Student Organization Manager

Christine Meehan Meetings Manager Joanne Kubinski Association Manager

Patricia Ferchland-Bingham Education Director

Holly Lundgren Education Project Manager

Meagan Comerford Director of Communications

Josefina Mendez Association Coordinator

We look forward to meeting you in-person this spring. As always, please don’t hesitate to reach out to me with questions. Also, we would love your input on one of our many committees, please visit our website to learn more: https://acoep.org/about-acoep/committees/ Wishing you a healthy and safe 2022, Katie Geraghty

ALONGSIDE THE ACOEP BOARD AND COMMITTEES, WE HAVE BECOME MORE KNOWLEDGEABLE AND ARE EXCITED FOR THE YEAR AHEAD.” WINTER 2022 THE PULSE

THE ON-DECK CIRCLE

Tim Cheslock, DO, FACOEP

WHAT’S ON DECK FOR 2022

t has been a while since I have posted an article for The Pulse. I am humbled and honored to be writing to you all in this column. This would not have been possible without you. I thank you for your support in my re-election to the Board of Directors and I thank the Board for their vote of confidence in voting me to be President Elect of our College. This is a full circle moment for me. I have been a member for many years since my days in medical school. My involvement with the college started like many of yours, at a Scientific Assembly. I can still clearly remember the student chapter events and talks from the then Board Leadership about becoming involved and taking part in all the ACOEP has to offer. As I sat and looked around, it was clear that this college was special. There were so many other students, residents and physicians gathered for the meeting that it was hard to remember everyone, but there was a sense of family and inclusiveness that enveloped me quickly and made me feel a true part of the organization. I returned many times after that first meeting, seeking out more. I attended the student and resident chapter events, became involved in the leadership of the student and resident chapter, all the while becoming more a recognizable face in our college. I sought out mentors and their sage advice. I have met many of you over the years in person at meetings

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AS WE CONTINUE TO DEAL WITH THE NEW NORMAL EMERGING FROM THE PANDEMIC THERE IS MUCH FOR US TO DO.” and other events. Sometimes through email connections and over the last year and a half zoom meetings have been our primary means of socialization. Through it all, your encouragement, support and friendship has brought me along my leadership path in our organization. I am thankful for all of you and resolve to continue to be a representative face of our college that will carry the banner proudly forward. One of my main duties this year is to work with our President, Dr. Beirne to advance our college to the next level. In his opening address, he mentions TEAM. Together Everyone Achieves More. It is my hope that our Team at ACOEP will be successful in this goal. As we continue to deal with the new normal emerging from the pandemic there is much for us to do. We look forward to welcoming you all back to our live meetings for Spring Seminar in Ft. Lauderdale. We look forward to seeing our vibrant organization become active once again in all the college has to offer. Our committees will be taking on new and exciting tasks, our membership will grow, and we will once again be

able to truly enjoy the company of each other and the common bond that makes this organization so resilient and strong! The last 18 months has changed us all in some way. Initially in the fear of the unknown we stood always ready to meet the challenge. Then the true urgency of the situation and the horrible toll on human life that we experienced as EM physicians became painfully evident. The feelings of helplessness that even despite our best efforts, everything we did was often not enough. The devastation of this pandemic I can say has touched us all. We protected ourselves the best we could, we talked to each other, we learned together how to treat and survive this disease. We led our team, our nurses and our departments. We celebrated our victories and mourned our losses. Through it all we were there for each other and that has made us stronger in the end. We have a new perspective on our lives, our careers and our choices. I am thankful for all of you during this pandemic and am excited to continue the journey with you every day, caring for our patients and for each other. –•–

CONGRATULATIONS TO THE RECIPIENTS OF THE 2021 ACOEP AWARDS! Bruce D. Horton, D.O., FACOEP Lifetime Achievement Award

George J. Miller, III, DO, FACOEP Advocate South Suburban Hospital –•–

Robert D. Aranosian, DO, FACOEP Excellence in Emergency Medical Service Award

Matthew J. Letizia, DO, FACOEP Trinitas Regional Medical Center –•–

Benjamin A. Field, DO, FACOEP Mentor of the Year Award

Nikolai Butki, DO, MPH, FACOEP McLaren-Oakland –•–

Willoughby Leadership Award

Karen Greenberg, DO, FACOEP Global Neurosciences Institute

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WOMEN’S COMMITTEE UPDATE By Nicole Vigh DO, MPH

A GET INVOLVED ACOEP’s Committee for Women in Emergency Medicine is seeking a medical student and a resident representative. To learn more and get into “the room where it happens,” email Association Manager, Joanne Kubinski at JKubinski@acoep.org.

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lthough we were hoping for an in-person conference, with such a quick transition to a virtual platform, the Women’s Committee was thrilled to have such a great turnout for the virtual ACOEP Scientific Assembly this year! As always, our women’s track lectures were exceptional! Dr. Erica Howe, a board-certified Hospitalist and a nationally known educator, wife and mother, gave her talk entitled “Gaining Clarity in Your Clinical Career and Beyond”. Dr. Howe is an advocate for wellness in medicine, and she has given many talks on topics like conflict management and boundary setting. In 2018, she founded the Women Physicians Wellness Conference as a way of bringing female physicians together to share their struggles and their strategies for success. She discussed an issue which many of us are guilty of, that is, saying yes to every opportunity that comes our way in order to improve our CV. However, in doing this many of us are left feeling overwhelmed and unsure of the direction we want to take our careers. Dr. Howe’s lecture discussed ways to maintain control in our work and home environment, set boundaries and how to say no to commitments that put a

strain on our lives and replacing that with commitments that inspire us both in our work and home lives. We were also delighted to be joined by Dr. Shana Ross, an Associate Program Director and the Director of Simulation, Curriculum and Conferences for the University of Illinois, Chicago. Dr. Ross has expertise in medical education and is currently completing a Masters in Health Professional Education. She is passionate about improving resident education through innovation and simulation. Her talk entitled “Building a Board of Mentors” discussed changing the way mentorship is traditionally viewed in medicine. She discussed the advantages of having a board of advisors, with each board member serving a different purpose, as well as returning the favor and being on someone else’s board of advisors. Dr. Howe and Dr. Ross left us all feeling inspired and optimistic for our future careers! In honor of breast cancer awareness month in October, we had a panel of speakers who discussed how breast cancer had affected their lives. Our panelists included Dr. Patricia Robinson, an associate professor at the Loyola University

…THE WOMEN’S COMMITTEE WAS THRILLED TO HAVE SUCH A GREAT TURNOUT FOR THE VIRTUAL ACOEP SCIENTIFIC ASSEMBLY THIS YEAR!”

Stritch School of Medicine and a breast oncologist and director of the Loyola University Medical Center cancer survivorship program. Dr. Robinson has had numerous publications and has served as the principal investigator on numerous breast oncology clinical trials. Dr. Jennifer Himmel Salch is a full time nocturnist at Riverside Regional Medical and Trauma Center in Newport News, Virginia. Dr. Himmel Salch is the physician liaison for the emergency management team at her health system and is the Vice Chair of philanthropy for the ACOEP Women’s Committee. Dr. Himmel Salch discussed her experience as a breast cancer survivor! Dr. Kathy Neacy is an emergency physician at Loyola University Medical Center in Maywood, Illinois. Dr. Neacy is also a breast cancer survivor who was treated in 2009-2010! Lastly, Dr. Christina Long, who is an emergency medicine physician and clinical assistant professor with Loyola University and Stritch School of Medicine, discussed her experience when her mother was diagnosed with breast cancer while she was in medical school. It was very interesting to hear how breast cancer has

affected and shaped the lives of these strong, female physicians in so many different ways. At our luncheon, we also announced our Willoughby Award winner, Dr. Karen Greenberg! The Willoughby award is presented to women physicians by the Women in Emergency Medicine Committee to recognize the role they play in the profession. The award was established in 2016 in honor of the first female President of the College, Dr. Paula Willoughby DeJesus. According to Dr. DeJesus, “To me the award recognizes a woman for her leadership that has sustaining impact… To me it is the person who leaves a lasting footprint and inspires others to pick up the torch and lead as well.” Dr. Karen Greenberg is the director of the first and only dedicated Neurologic Emergency Department in the country, at Crozer Chester Medical Center in Upland, Pennsylvania. The Neuro ED that she directs has received the Gold Plus Target: Stroke Elite Plus/Target Advanced Therapy Award, which is the highest level of recognition by the American Heart Association. In 2015 Dr. Greenberg was awarded the prestigious Practice Innovation Award by the ACOEP to recognize

her innovations to improve critical treatment to patients experiencing acute ischemic stroke. Dr. Greenberg has lectured at emergency medicine and neuroscience conferences locally, regionally and nationally. She is also an Assistant Professor at four different medical schools, as well as serves as an American Stroke Life Support Instructor educating EMTs, nurses and physicians. She has published research and has presented multiple abstracts at the International Stroke Conference. Dr. Greenberg embodies what the Willoughby award was designed to recognize, a woman for her leadership that has sustaining impact. Congratulations Dr. Karen Greenberg! We thank all those who participated in the virtual ACOEP Scientific Assembly; we are so excited to have had such a great turnout! Please remember to check out our Facebook page for future details regarding purchasing ACOEP merchandise as well as to stay informed regarding future events. We look forward to seeing you all (hopefully in person!) at the ACOEP Spring Scientific Assembly, April 10-13 in Fort Lauderdale, Florida! –•–

WINTER 2022 THE PULSE

Michael Chapman, DO, FACOEP

Italo Subbarao, DO, MBA

WELCOME TO OUR NEWEST ACOEP BOARD MEMBERS ACOEP’s new board members began their terms at the Scientific Assembly held October 11-15. We welcome Michael Chapman, DO, FACOEP (Genesys Regional Medical Center); Italo Subbarao, DO, MBA (William Carey University College of Osteopathic Medicine); ACOEP Resident and Student Organization (RSO) President Melinda Kizziah, DO, PGY1 (Ohio State); and RSO Director of Student Affairs Coral Byrns, OMS III (Edward Via College of Osteopathic Medicine). Congratulations to our new board President, Gregory J. (Joe) Beirne, DO, FACOEP-D, FACEP, Des Peres Fire and EMS/Respond Right EMS Academy/ Washington University School of Medicine; and President-Elect Timothy Cheslock, DO, FACOEP, Brevard Physician Associates.

Melinda Kizziah, DO, PGY1

They join continuing board members: Robert E. Suter, DO, MHA, FACOEP-D, Immediate Past President; Brandon Lewis, DO, FACOEP, Secretary; Jennifer Axelband, DO, FACOEP, Treasurer; John Dery, DO, FACOEP, FACEP, FAWM, EC Member-at-Large; Patrick Cody, DO, MPH, FACOEP; Benjamin Godfrey, DO; Ameet Parikh, DO, FACOEP; Victoria Selley, DO, FACOEP; Duane Siberski, DO, FACOEP-D, FACEP, and Michael Allswede, DO, FOEM Liaison. We also share our gratitude to those who have completed their terms: Chris Giesa, DO, FACOEP-D; John W. Graneto, DO, MEd, FACOEP-D; Kaya Smith, DO, (former RSO President); and Mehgan Lazenby, CRNP, OMS III, (former RSO Director of Student Affairs).

Coral Byrns, OMS III

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ANOTHER SUCCESSFUL SCIENTIFIC ASSEMBLY Thank you to our attendees, speakers and presenters for making the 2021 Virtual Scientific Assembly such a success! Though we were disappointed not to be able to meet in person, event Chair Christopher Colbert and Vice Chair Andy Little and the Continuing Medical Education Committee were ready with a contingency plan and quickly adapted for another virtual event . More than 600 registrants logged in to sharpen their skills during 51 lectures, 2 keynote sessions, 3 EM Over Easy podcasts, 4 FOEM competitions and 7 hours of dedicated content for students and residents. We are all hoping we can meet in person for the 2022 Spring Seminar, April 10-13 in Fort Lauderdale, Florida. Registration is open now at acoep.org/2022-Spring-Seminar.

WE ARE ALL HOPING WE CAN MEET IN PERSON FOR THE 2022 SPRING SEMINAR...”

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CONGRATULATIONS TO THE WINNERS OF THE 2021 FOUNDATION FOR OSTEOPATHIC EMERGENCY MEDICINE (FOEM) COMPETITIONS! Clinical Pathological Case Competition 1st Place – Live or Let Bleed Resident: Rebecca Kreston, MD, MSPH, University of Illinois Chicago, IL Faculty Discussant: Shawn M Quinn, DO, FACOEP, FACEP, Lehigh Valley Health Network, PA 2nd Place – Weak in the Knees Resident: Brandon Somwaru, DO, St. Joseph’s University Medical Center, NJ Faculty Discussant: John Downing, DO, FACOEP, Midwestern University/Franciscan Health, IL 3rd Place – The Febrile Altered Patient Resident: Katie VanNatta, DO, MBA, MS, Midwestern University/Franciscan Health, IL Faculty Discussant: Stacey Barnes, DO, St. Joseph’s University Medical Center, NJ

Research Study Poster Competition 1st Place: James Katsilometes, MPH, OMS-II, Kingman Regional Medical Center, AZ A Multisite Cross-sectional Assessment of Emergency Medicine Resident Knowledge of Evidence-based Medicine as Measured by the Fresno Test of Evidence-based Medicine 2nd Place: Alex Dolan, OMS-IV, Kingman Regional Medical Center, AZ Real World Utilization of Dalbavancin at a Rural Community Emergency Department 3rd Place: Jenna Wonsowicz, DO, Ascension Macomb-Oakland Hospital, MI A Study of the Incidence of COVID-19 Thrombotic Sequelae in a Metropolitan Hospital System

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Research Paper Competition 1st Place: Dhimitri A Nikolla, DO, AHN Saint Vincent Hospital, PA Comparing Post-induction Hypoxemia Between Ramped and Supine Position Endotracheal Intubations with Apneic Oxygenation in the Emergency Department 2nd Place: Bailey Hasenbalg, DO, Kingman Regional Medical Center, AZ Sex-specific Differences in Upper and Lower Extremity Deep Vein Thromboses at a Rural Community Hospital

Oral Abstract Competition 1st Place: Carlos Rondon-Clavo, MD, Kingman Regional Medical Center, AZ The Comparative Efficacy of High and Low Titer COVID-19 Convalescent Plasma in the Community Setting 2nd Place: James Katsilometes, MPH, OMS-II, Kingman Regional Medical Center, AZ A Multisite Cross-sectional Study of Emergency Medicine Resident’s Learning Styles using the VARK Questionnaire 3rd Place: Jordan Memmott, OMS-IV, Kingman Regional Medical Center, AZ A Community Experience with REGEN-COV to Delay COVID-19 Disease Progression in the Outpatient Setting

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CONGRATULATIONS TO THE 2021 CLASS OF ACOEP FELLOWS AND LIFE MEMBERS ACOEP is built upon a foundation of connection and community. Congratulations to the 2021 ACOEP Fellows, Distinguished Fellows and Life Members. Your commitment to our organization is instrumental to our success.

ACOEP 2021 FELLOWS Andrea Allman, DO, FACOEP Kimberly Benham, DO, FACOEP David Heath, DO, MS, ATC, FAAEM, FACOEP Matthew Olmstead, DO, FACOEP Ameet Parikh, DO, FACOEP

ACOEP 2021 LIFE MEMBERS Steven Perry, DO Elaine Lombardi Wilk, DO, FACOEP Jennifer B. Wilson, DO, FACOEP

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Bernard Heilicser, DO, MS, FACEP, FACOEP-D

What Would You Do? Ethics in Emergency Medicine

In this issue of The Pulse, we present a case submitted by George Miller, DO (recipient of the Bruce D. Horton DO, FACOEP Lifetime Achievement Award). The patient is a 16-year-old male who was brought to the ED by EMS accompanied by his mother. The patient was in respiratory distress, tachycardia, tachypneic and hypotensive. The mucous membranes were pale. He was conversive and demonstrated decision-making capacity. Work-up revealed a Hgb of 1.5. When informed he needed a transfusion, he refused, stating his religious beliefs forbade it. When questioned what religion, he stated it was his Church and he was the Pastor, and his was the only congregation. The patient’s mother stated he is the Man of the House (the father left them when the patient was an infant). The patient did agree to be intubated. Should we honor the patient’s wishes? Or, should we transfuse, and if so, under what premise?

WHAT WOULD YOU DO? Visit www.acoep.org/newsroom and share your thoughts on this case.

If you have any cases that you would like to present or be reviewed in The Pulse, email them to us at mcomerford@acoep.org.

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