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Dr. Justina Truong named the ACOEP/RSO resident of the year!

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It is a great honor to announce that Dr. Justina Truong was named the ACOEP/RSO resident of the year. This award recognizes an emergency medicine resident who has gone above and beyond their duties as a resident, leader, mentor, and academician. This award is the highest national award bestowed to an osteopathic emergency medicine resident each year. Way to go Dr. Truong!

Sepsis in the Emergency Department

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How Sepsis has Changed ED Protocols

How Sepsis Has Changed Emergency Department Protocols

By Laura Edgerley-Gibb, MD, FACEP, Medical Director, SLV Health Emergency Department, and Chief Medical Officer, Innova Emergency Medical Associates.

Sepsis affects nearly 1.7 million Americans per year and results in 270,000 deaths. It can affect patients at any age, from our tiniest neonates to our elderly patients. There is rarely a shift in the Emergency Department where we do not treat a patient with sepsis. In the past, “sepsis care” was ill-defined and there was inadequate data to show how we should best treat sepsis. Sepsis was not even formally defined in the medical community until 2001.

Through the years, there have been many iterations of sepsis treatments, but today we know that there are three main tenants of sepsis care:
1. Identifying Sepsis – with advances in lab testing (lactate levels, procalcitonin levels, and rapid panels for common bacteria/viruses) we are much better at identifying sepsis.
2. Providing broad-spectrum antibiotics – antibiotic recommendations from the IDSA and other sources are better studied and more robust.
3. Treating poor perfusion – a hallmark of sepsis is poor perfusion to the organs. Prompt treatment with IV fluids and blood pressure support is needed.

We now know that early identification of sepsis and appropriate treatment can save lives.

gibbs and deraet

Pictured in the SLV Health Regional Medical Center are Hospitalist Director Olivier de Raet, MD (L), and Innova CMO Laura Edgerley-Gibb, MD (R).

 

https://www.sanluisvalleyhealth.org/news/2020/september/how-sepsis-has-changed-ed-protocols/?fbclid=IwAR1fGMofF831Lc1RGdfaqOxSTQgte1HSmAAWFavkNBNx7Bbbu6EhhSWs_cA

 

Innova included on prestigious Inc. 5000 list

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Inc. magazine announced yesterday that Innova Emergency Medical Associates was included on its annual Inc. 5000 list, a prestigious ranking of the nation’s fastest-growing private companies. This list represents a unique look at the most successful companies within the American economy’s most dynamic segment – it’s independent small businesses. Intuit, Zappos, Under Armor, Microsoft, and many other well-known names gained their first national exposure as honorees on the Inc. 5000. We are proud to be among their ranks and are filled with immense gratitude, as we could not have done this without our incredible crew. So thank you to each and every team member for making Innova the best it can be day in and day out.

A Reflection On Distance by Dr. John Tveten

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Our computer stations are only six feet apart but I can’t recall if we’ve ever touched. Was there an accidental bump while negotiating the ER labyrinth? Now my hand rests on your shoulder. Through double gloves, part of a body covered in synthetic armor, it is meant to be a touch of reassurance. My voice muffled by two masks, tries to project the accompanying words. “We’ll get you through this”. Words I mean. Words I believe. But I can’t help my thoughts from drifting towards Nieci.

Just an hour ago I was told she had died. Just a week ago it was she in this very bed. Like you, she was an integral part of our hospital. Performing a task that I came to see while I was a resident as the heart of the department: the quartermaster who plots the course and steers the ship.

Neici was a powerful woman of color. I’ve heard her called “big mamma”, in the most respectful light. Played out in real time she was bigger than big. Grand is more like it, singular. Brazen in her determination to provide, with arms that could hug two city blocks. It was impossible to get in her way.

While you have the same effect, your way is different. In your tradition you are the silent pillar. A cornerstone in a foundation that has absorbed the weight of generations of massacre from disease in all its forms. Providing the strength needed to nurture community and sustain culture. From six feet away I have seen you calmly handle the next crisis that your cell phone delivers even as you steer me through the next crisis that comes through the ambulance bay doors. Now it is you who is in need of support. When I tell you that we need to admit you, are you anxious? With you it is hard to tell.

I walk the roughly sixty meters to the medical floor reflecting on distance. Six feet, the distance from middle fingertip to middle fingertip of the average English sailor’s outstretched arms, aka a fathom. Six feet, the distance declared to bury victims during the plague of 1665 to prevent further spread, hence the euphemism ‘six feet under’. Six feet, the standard unit of social distance… based on what? A sneeze can propel droplets to speeds of 100 miles per hour. According to an MIT study, these droplets can travel eight meters and remain suspended in the air for ten minutes. A cough is not far behind traveling up to six meters. Why six feet? The answer is no different in 2020 then it was 355 years previously, it seems about right.

Whether I measure by seven sneezes, ten coughs, or thirty-three social distance units I arrive at the Covid ward. I walk past the void left where Nieci. used to sit. It is fathoms deep. I can’t see where it ends. Three days have passed since I last saw you and a quick glance tells me your oxygen requirement has gone up. Your anxiety is now plain to see. Can you see mine?

This disease is like nothing I’ve encountered in my twenty-five years of practice. For most it is goes unnoticed or is a quickly passing storm. But some get walked to the canyon rim, are allowed a moment to take in the view and then without warning are cast into free-fall. I wish I could tell you that someone couldn’t be you.

Double masked and gloved, armor in place, I sit on your bed and hold your hand. It is the best medicine I can offer. There is no distance. I remain hopeful. You remain strong. We make a pact to hug.

John Tveten is an ER doctor at Little Colorado Medical Center in Winslow, AZ., which provides emergency care for northeast Arizona including the southern Navajo Reservation. The Navajo reservation has been particularly affected by Covid-19 and has suffered the third highest per capita cases in the country.

https://medium.com/@johntveten/a-reflection-on-distance-41f62a066b7f