Latest News

  • December 17, 2020 10:02 AM | Sally Winkelman (Administrator)

    One of the most common complaints that I hear from Emergency Physicians around Wisconsin is the difficulty in medically clearing patients for admission to outside psychiatric facilities. Sometimes EM docs are being asked to get serial labs for minute electrolyte abnormalities, or prolonged observation for non-toxic overdoses. This leads to delays in transfer, prolonged ED stays, agitated patients, and exasperated ED staff.

    WACEP has been a part of a joint task force with Wisconsin Psychiatric Association (WPA) to help address issues germane to both our specialties. While emergency physicians struggle on one end of the transfer, every inpatient psychiatrist can share stories of a patient who decompensates shortly after arrival at their facility, so they are appropriately wary.

    At the end of the day, we all want to do what is best for patients. It is imperative that we provide a thorough evaluation and appropriately diagnose and treat any comorbid medical issues in the ED prior to transfer, but what to do when you feel your due diligence has been done and you are getting pushback you feel is inappropriate?

    Often the first screener for admission is a nurse or APP, and many of these requests for additional workup come from a lack of medical understanding and an abundance of caution. The psychiatrists have encouraged us to ask to speak directly to the psychiatrist on-call for a given facility if you feel that further workup is not warranted. In particular, Dr. Pope, Medical Director at Winnebago, endorses this approach.

    WACEP and WPA hope that this will help to alleviate unnecessary delays, and still ensure safe hand-off of patients between EDs and psychiatric facilities.

  • December 17, 2020 9:46 AM | Sally Winkelman (Administrator)

    Caitlin Rublee, MD, MPH

    WACEP has followed in ACEP's lead and joined the Medical Society Consortium on Climate & Health, which represents more than 60% of physicians in the U.S.

    The Wisconsin chapter (Wisconsin Health Professionals for Climate Action or WHPCA), has several working groups and activities planned for the coming year.  WACEP members can get involved here.

    Check out our recent report that highlights the health and economic opportunities of transitioning to clean energy, which would result in $21 billion per year in avoided health damages and would prevent 1,910 early deaths, 650 emergency department visits for respiratory concerns, 34,400 asthma exacerbations, and 650 heart attacks.

    Climate change certainly has several implications for emergency medicine. Heat-related illnesses, acute on chronic disease exacerbations, changing infectious disease burdens (water and vector-borne), and traumatic injuries, even an increase in cold-water drownings from thinner ice. While the current pandemic cannot be ignored, higher mortality rates from COVID-19 were found in U.S. counties with worse air pollution.

    All people are at risk, but specific populations are at increased risk of poor health from climate-related events. Older adults, infants and children, those with other medical problems, outdoor workers, and those with unstable housing or lower incomes are just a few examples. In severe circumstances, shortages in supplies (sterile saline) related to hurricanes and other tropical storms affect health care service delivery even far away from the area of impact. The health sector is also responsible for almost 10% of U.S. greenhouse gas emissions, which continues to fuel further warming.

    December has been a busy month for climate change and health. December 12 marked the 5th Anniversary since the Paris Agreement was signed by 196 parties. The U.S. is expected to re-join in 2021. The 2020 Lancet Countdown on Health and Climate Change U.S. Brief and Appendix were released with recommendations for a just and equitable path forward. The Wisconsin Governor’s Task Force on Climate Change released their report with next steps for action across nine sectors and three policy pathways.

    As we celebrate the New Year, let’s look for opportunities within our healthcare systems and across our great state to support the health of our residents and each other.  

  • November 23, 2020 3:47 PM | Sally Winkelman (Administrator)

    Do you know an EM-bound medical student ready to lead?  Encourage them to apply to the EMRA Medical Student Council to advocate for and offer programming to our medical student members.  Deadline is December 1. These are funded positions to attend the ACEP Scientific Assembly in 2021. 

    EMRA Committee Leadership - From Admin/Ops to Social EM to Wilderness Medicine, EMRA's Committees have a place for student, resident and fellow members.  Applications for Chair Elect and Vice Chair positions are due December 1. These are funded positions to attend the ACEP Scientific Assembly in 2021.

    The EMRA/ACEP Leadership Academy is the perfect place for current and emerging leaders.  This program teaches the soft-skills of leadership through MBA-like courses.  Applications are due December 31

  • November 19, 2020 8:53 AM | Sally Winkelman (Administrator)

    Lisa Maurer, MD, FACEP
    WACEP Past-President & Current Legislative Chair

    “I love it here,” my patient at the Alternate Care Facility (ACF) said, and if I hadn’t been wearing a respirator, my jaw may have dropped.  Since my EM group staffs the ACF, I knew the quality of care would be excellent.  However, I didn’t expect the patients to feel so relaxed and comfortable in the middle of a state fair exposition center. 

    During my recent first shift working at the ACF, I saw patients who were happy to come from overwhelmed hospitals to receive expert care, provided by warmly attentive staff, in a surprisingly relaxing environment.  If open inpatient beds are disappearing and ED holds are growing at your shop, I hope the details of my experience working at the ACF help you to convey the benefits of transfer to the ACF to your next patient with COVID. 

    After being propped up by the U.S. Army Corps of Engineers in the Spring, the ACF was activated on October 16th to serve as an overflow facility for Wisconsin.  Check out this 15-second time lapse video showing the process of turning an Expo Center into a facility with the capacity to care for hundreds of patients. “Cubicle” type rooms are surprisingly quiet and have hospital beds.  It’s not uncommon to see a patient’s room featuring a blanket or keepsake from home.  Catered food is available three times daily, and on game day, the patients might be found in the common area by the big screen.  There are pods of bathrooms and showers for those who feel up to it.  Patients told me that they were getting more rest there than they were ever able to get in the hospital or even at home. 

    From a medical standpoint, almost 300 of the cubicles have in-line oxygen with capabilities for nasal cannula, high flow, or opti-flow up to 50L at 50% FiO2.  They can receive IV fluids and medications, including remdesivir.  As of the time of this article’s publication, there were 18 patients at the ACF with 6:1 nursing ratio and two providers.  The onsite pharmacist is top notch, and many of the nurses and RTs are “travelers” who are more than comfortable caring for patients with COVID given their vast experience.  In the case where a patient needs respiratory support or other medical care than surpasses what’s readily available, the onsite EMS unit transfers them to a nearby hospital at the discretion of the onsite emergency physician.

    In response to feedback from around the state, the intake form has once again been revised and simplified.  If you have a patient in your ED that meets the eligibility criteria as per the Reference Guide, fill out pages 4-5 of the guide and email to the address listed.  The information will be reviewed by the CMO or designee, who is another fellow emergency physician.  They review patients for transfer daily from 9a-5p, and patients may now arrive until 6:30p, updated from a previous 5p arrival deadline. 

    Everyone involved wishes we didn’t need an ACF.  However, if you’re like me, I’m so grateful to have it as an option, especially now that I know it has proven to be a good experience for patients.  I would expect nothing less than the EM physicians of Wisconsin to lead the effort in managing patient flow around our state as we continue to fight this pandemic. 

    Editor’s Note: this article was written for informational purposes only and does not constitute any endorsement of care. The author, the author’s independent group practice/employer, and Wisconsin ACEP do not benefit in any manner from the transfer of patients or their care at the Alternate Care Facility in Milwaukee, WI.  

  • November 17, 2020 9:31 AM | Sally Winkelman (Administrator)

    WACEP President Message, November 2020
    Ryan Thompson, MD, FACEP

    Remember back in March when it seemed you couldn’t go through a shift without your department receiving pizza, cupcakes, or some other treat from well-wishers? Emergency physicians, nurses, and other staff were being hailed as heroes despite our mostly empty departments.

    These days, that sort of praise and support feels a distant memory. As we enter this new phase of the pandemic where Emergency Departments are being asked to treat more and more COVID patients in addition to the myriad of health conditions brought on by delayed treatments, limited access to specialists, and prolonged social isolation, it seems we have fallen out of the public eye.  

    To be honest, I was never comfortable with all the hero talk. Emergency Physicians were working in the trenches before this pandemic began and we’ll keep on trucking right through it and beyond. We don’t do it for the plaudits. We do it because we have the skill, we have the drive, and most of all, because we care about our patients, and we care about our communities.

    So, while we may not be front and center in the minds of our communities anymore, we will keep giving back. To that end, I wanted to share a few of my favorite charities in case you were looking for even more ways to give back to your community.

    Child’s Play: This charity gives games and toys to hospitalized children to make their stay in the hospital less daunting. You can either given monetarily or order directly off of the Amazon Wish lists curated by Child Life Specialists at your Children’s Hospital of Choice. http://childsplaycharity.org/

    Wisconsin Youth Symphony Orchestra: Supporting musically-inclined children and teens from across the state, this group provides opportunities to perform and high-quality lessons (even remotely during COVID) to diverse and low-resource aspiring young musicians. https://wysomusic.org/

    Alzheimer’s & Dementia Alliance of Wisconsin: Every emergency physicians recognizes the stress and difficulty that dementia can put on a family. This group offers support, education, and advocacy for patients and their families. https://www.alzwisc.org/

    By no means are these the only worthwhile charities in our communities – I encourage you to find something near and dear to your heart. This year has been hard on all of us, and I can’t think of a better way to continue to support the communities we serve. So thank you all for the dedicated work you have put in over the course of this year, and thank you for continuing to give to support those who need it most during these difficult times.

  • November 12, 2020 3:38 PM | Sally Winkelman (Administrator)

    This Thanksgiving, the American College of Emergency Physicians (ACEP) recommends that holiday hosts and guests prioritize efforts to prevent the spread of COVID-19 and take steps to protect the health and safety of friends and family.

    “If you are planning to get together on Thanksgiving, it is a good idea to reduce the risks that invite COVID-19 into your home,” said Mark Rosenberg, DO, MBA, FACEP, president of the American College of Emergency Physicians (ACEP). “Even a small gathering of family or close friends can still contribute to the spread of the virus.”

    Emergency physicians recommend everyone heed the Centers for Disease Control and Prevention (CDC)’s holiday safety recommendations this year.

    Remember anyone can get or spread COVID-19. Close friends and family with whom you don’t live with can still contract and spread the virus to you the same way a stranger could.

    Trim the guest list. Rather than a specified “safe” number of guests, public health experts suggest that hosts determine the size of a gathering by how many guests from different households can remain at least six feet apart. Note that a “household” is made of people who live in the same house every day. Family members who are close but don’t live at home, such as college students visiting for the holiday, are considered a separate household in public health terms.     

    Cover your face and maintain your distance. It may be difficult but try to avoid hugs and handshakes. People should also cover their face when they are not eating or drinking.

    Stay outside and stay safer. If it is possible, hosting a small event outside instead of inside is preferable.

    Encourage good hygiene. Hosts should make sure that bathrooms have plenty of soap so guests can frequently wash their hands and single-use towels.

    While there are precautions you can take this holiday season, the safest option for some will be to stay home. Do not attend an in-person gathering if you or anyone in your household has been diagnosed with COVID-19 and has not met the CDC’s criteria for when it is safe to be around others. Stay home if you show symptoms, if you are waiting for COVID-19 test results, or if you have been exposed to somebody with COVID-19 in the last 14 days.

    “Unfortunately, the safest option for older individuals or people with weakened immune systems is to skip in-person gatherings this year,” said Dr. Rosenberg. “It may be disappointing to adjust traditions or modify plans in the short-term, but these decisions can save lives.”

    Remember, emergency physicians work 24/7, even on holidays. Do not ignore your symptoms if you think you are having a medical emergency—if something is wrong call 911 or visit your closest emergency department. Emergency departments across the country are taking extensive precautions to adapt and protect patients. If holiday plans go awry, emergency departments are safe and ready for anything or anyone that comes their way.  

    Read more about COVID-19 and Thanksgiving safety at www.emergencyphysicians.org.

  • November 10, 2020 9:07 AM | Sally Winkelman (Administrator)

    Join WACEP at 12:00 noon on Friday, December 11 for a lunch & learn webinar on the management of pediatric trauma and burns, during which we will focus on these challenging presentations in rural and low-resource departments.

    Hear from experts Dr. Jennifer Roberts, Trauma Surgeon at Marshfield Clinic Health System, and Mark Johnston, RN, BSN, Manager of the Burn Program at Regions Hospital in St. Paul, on the best approach to these children and the best ways to prepare these patients for transport to pediatric care centers.

    After the presentations, there will be time for questions and discussion on these important topics. We hope to see you there! Register Here.

  • October 28, 2020 3:58 PM | Sally Winkelman (Administrator)

    Savannah Vogel, a 2020 graduate of the University of Wisconsin School of Medicine and Public Health, was recognized by the American College of Emergency Physicians (ACEP) for her excellence in compassionate care of patients, professional behavior and service to the community and/or specialty. 

    Vogel was a recipient of the National Medical Student Professionalism and Service Award, and was officially announced as part of the 2020 Awards Ceremony during ACEP20.

  • October 28, 2020 2:33 PM | Sally Winkelman (Administrator)

    Established almost 40 years ago, the designation of Fellow of the American College of Emergency Physician (FACEP) is earned by those committed to the preservation and growth of emergency medicine.

    The Wisconsin Chapter, ACEP congratulates five members who have achieved FACEP status and were recognized during ACEP20:

    • Bradley Burmeister, MD, FACEP
    • Abigail Dahlberg, MD, FACEP
    • Andrew Fischer Dean, MD, FACEP
    • Theodore F Elsaesser, MD, FACEP
    • Joshua C. Timpe, MD, FACEP

    WACEP is proud to honor these five members who now join 190 other emergency physicians in Wisconsin who hold this distinction, point of pride and badge of honor.  Congratulations.

  • October 21, 2020 3:52 PM | Sally Winkelman (Administrator)

    The University of Wisconsin School of Medicine and Public Health (SMPH) is one of four sites awarded a total of $7.5 million from the National Institutes of Health (NIH) to conduct research that could lead to improved care in emergency departments for people with dementia.

    The effort aims to leverage expertise in emergency medicine, geriatrics and Alzheimer’s disease and related dementias to identify gaps in emergency care for people with dementia and address those gaps, according to Manish Shah, MD, MPH, professor of emergency medicine and co-principal investigator.

    For example, many commonly used medications are problematic for people with dementia.  Better understanding which medications are safest for this vulnerable population would help clinicians better care for them, he said.

    “The emergency department is not an ideal care setting for people with dementia,” Shah said. “What we want to do is find better ways to care for one of our most vulnerable populations, namely older adults with cognitive impairment.”

    The funds will support Geriatric Emergency Care Applied Research Network 2.0 – Advancing Dementia Care (GEAR 2.0 ADC), which is a collaboration between SMPH, Yale School of Medicine, Feinberg School of Medicine at Northwestern University and Washington University School of Medicine in St. Louis. All four institutions are home to an NIH-National Institute on Aging-designated Alzheimer’s Disease Research Center.