By E. Lea Walters ’94, Interim Chair, Department of Emergency Medicine, LLUSM
No doubt, this year will be one for the record books. In reflecting back on the last several months, I am reminded of the quote by JFK, “In a crisis be aware of the danger, but recognize the opportunity.” While on the front lines of responding to the SARS-CoV-2 pandemic, the emergency department (ED) has found many opportunities for leadership, innovation, education, and research.
The early days of SARS-CoV-2 were admittedly chaotic, with information and recommendations constantly changing. Under the guidance of Lance Brown, MD, and Jim Moynihan, DO, the department was able to be both proactive and reactive to the current expert information. Their collaboration with nursing, acute and critical care inpatient units, laboratory, and radiology services kept the ED running smoothly and safely. Their constant presence in the ED provided much needed calm and continuity during those early weeks. They continue to provide ongoing support for which I have received many grateful comments from staff, both within and outside the department.
Intubation of patients during this pandemic is a high-risk procedure for all involved. Darcy Mainville ’15, in partnership with our critical care colleagues, addressed this challenge through the development of the “Copperhead Intubation Hood.” This device provides an additional layer of protection for the intubating team. Dustin Smith, MD, medical director of the Medical Simulation Center and professor of emergency medicine, offered extensive team training on use of the apparatus throughout the hospital. With these scenarios, physicians, nurses, and respiratory therapists were able to plan and practice these potentially dangerous procedures, resulting in better patient care and staff safety.
The emergency medicine residency continues to be a highly competitive and sought after program. Michael J. Kiemeney ’09, program director, was awarded a CalMedForce Grant, which has allowed expansion to 18 incoming residents this year. Under the direction of Timothy P. Young ’04, the pediatric emergency medicine division continues to create, collaborate, and publish valuable educational content through the online platform “The Gurney Room” (www.thegurneyroom.com). Follow on Instagram to keep up with the latest educational innovations.
Clinical research is thriving in the department, with over 30 current or recently completed projects and grants of over $500,000. Research topics range from understanding local emergency departments’ response to the San Bernardino terrorist attacks, how treatment of snake bites in children compares with adults, several COVID-related studies, and medical education innovations and best practices. Dustin Smith, MD, P. Brian Savino ’11, Lance Brown, MD, and Ellen Reibling, PhD, continue to lead the education group for the newly formed Western Regional Alliance for Pediatric Emergency Management (www.wrap-em.org). Funded by a grant through the U.S. Department of Health and Human Services (DHHS), WRAP-EM is one of two Pediatric Disaster Care Centers of Excellence in the country and coordinates multiple health organizations from Washington, Oregon, California, Nevada, and Arizona in preparation for pediatric disasters.
In these chaotic times, physician wellness is more important than ever. The emergency department is fortunate to have as faculty one of the leaders in this area, Vi Dinh, MD. Dr. Dinh was recently promoted to professor and holds clinical appointments in emergency medicine and critical care medicine. Take a look at the fruits of just some of his efforts at www.zenproductivity.com or his point-of-care ultrasound tips at www.pocus101.com.
Finally, this update would be incomplete without mentioning the appointment of Tamara L. Thomas ’87, professor of emergency medicine, as dean of the School of Medicine. During her three years as department chair, she led the recruitment of faculty with experience and skill sets that complemented and built upon an already impressive foundation. I am particularly proud of continuing her efforts to build a culture of inclusion. The diverse backgrounds and perspectives of our faculty and trainees have improved our care, expanded the lens for our research, and broadened the educational experience for our students, residents, and fellows. Her leadership and vision have set our path toward a successful future, regardless of the challenges ahead.
Recently, we initiated a strategic plan that sets the course for our next round of improvement and growth, as we try to anticipate how things such as changing patient care venues, new treatment modalities, and a planned new hospital and emergency department will change what we do. The challenges will keep coming, but with them are opportunities that we can only now imagine.
Dr. Walters is a graduate of LLUSM and EM residency. Her area of interest is in disaster medicine. When not at work, she enjoys hikes with her husband and dogs near their home in Forest Falls.
EMERGENCY MEDICINE FACULTY SPOTLIGHTS:
Mindi J. Guptill ’06
After medical school, Dr. Mindi Guptill completed her emergency medicine training, also at LLU. She has a passion for global health, and in medical school and residency, she participated in mission trips to China, Cameroon, Taiwan, Peru, and Malawi. These trips inspired in her a desire for a longer commitment, and shortly after completing her residency, she and her husband spent one year in the Republic of Niger. Here she was the medical director of a remote 140-bed district hospital in Maine Soroa.
Returning from Niger, Dr. Guptill became the emergency medicine (EM) associate residency director, which kindled another passion: medical education. Her experience in the residency gave her a unique perspective on the skills needed to build, maintain, and grow an EM residency. Combining her two interests, Dr. Guptill, her husband, and now three young children, moved to Rwanda to help start the country’s first EM residency. She continues to mentor her Rwandan residents in their careers, research projects, and in their own opportunities for mentoring.
Dr. Guptill’s research interests are primarily centered on global health, medical education, and women in medicine, including projects exploring intergenerational communication in the ED, intimate partner violence among physician mothers, and various emergency medical issues with unique presentations in Rwanda. She continues to be involved in global health for the department as associate global health fellowship director and in leading resident trips, most recently to Rwanda and an upcoming trip to Ghana.
While she states that the fictional character she most identifies with is Lucy Ricardo, Dr. Guptill is nothing if not organized, but in a way that appears effortless. She spends her off time hiking and camping with her family in the local mountains and regaling you with stories about their adventures. She is a member of the medical honor society Alpha Omega Alpha and the recipient of multiple awards in the ED, including two Healing Hands awards through the Grateful Patient Program and five Gold Stars for Service Excellence.
P. Brian Savino ’11
Dr. Brian Savino joined the emergency department (ED) in 2016. After medical school, residency took him to Kalamazoo, Michigan. With an interest in prehospital and disaster emergency services, Dr. Savino went on to complete a fellowship in Emergency Medical Services (EMS) at University of California, San Francisco, while simultaneously earning his MPH from University of California, Berkeley.
Dr. Savino’s expertise has been well-utilized here at LLUH. In addition to his clinical work in the ED, he serves as the director of prehospital care, acting as a liaison between LLUMC and the county EMS agency. In this role, he sits on multiple county committees focused on the improvement of EMS care in our region. In our own institution, Dr. Savino is the ED representative to our STEMI and trauma programs, assisting with both programs’ successful achievement of national accreditation.
Dr. Savino has been very involved with the School of Medicine, participating in the medical student Life Communities program. He is also the director for the annual Critical Event Response course, an interprofessional disaster medicine training program for the schools of medicine, nursing, pharmacy, and dentistry. The course serves as a capstone for the graduating students in these programs with a focus on working together as a team in disaster scenarios. Over 450 students participate in the course annually. Recently, he has joined other ED faculty in a regional pediatric disaster grant for the creation of a Pediatric Disaster Center of Excellence, where he is completing an associated Community Regional Response to COVID-19 Interim Report, and is the leader in planning a multistate disaster drill.
Out of the hospital, Dr. Savino enjoys playing, writing, and recording music, genealogy research, and reading, although his favorite pastime is spending time with his wife, Miljoy, and their two children, Lucca and Concetta.
Dr. Savino’s clinical expertise, sense of humor, and calm demeanor are his greatest assets in the department and earned him the ED Nursing Leadership “Attending of the Year” award.