Residents Corner

Spring Newsletter 2020

This past year Dr. Matthew Earle, PGY-2, created the difficult airway bag. Dr. Earle realized the department needed to have advanced airway equipment consolidated in one easy to access organized location to be better prepared for the inevitable difficult airways in the department.

He worked with Dr. Christian Young, Assistant Program Director, to plan, implement, and teach the department about his project. The bag is designed to supplement the airway equipment that residents take to all floor and ICU intubations that they respond to, where equipment can be difficult to obtain in a timely fashion. Some of the items contained in the bag include Shiley trachs, epistaxis control kits, supraglottic airways, cricothyroidotomy set, trach exchangers, and additional suction equipment. In addition, Dr. Earle worked with nursing and ancillary staff to ensure the organization of the bag is maintained with its continued use and restocking.

Dr. Earle’s difficult airway bag has been used countless times to help provide timely airway management for patients throughout the hospital. Dr. Earle shared his process for planning, developing, and implementing his kit in the emergency department here:

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Dr. Patrick Wallace, PGY-2, and Pauline Terbio, PGY-1, have been busy this past year mentoring and teaching future EM residents at both UNLV School of Medicine and Touru University. Dr. Wallace created and is the resident liaison for the UNLV Emergency Medicine Interest Group, while Dr. Terbio has been serving as the liaison for Tuoro University. He and Dr. Terbio, PGY-1, have lectured medical students at both medical schools on a variety of topics, including interpreting chest x rays, cardioversion, face, and neck injuries, as well as putting on interactive workshops on bedside ultrasound and central line insertion. While the COVID-19 pandemic has halted the hands-on learning and in-person lectures, Dr. Wallace and Dr. Terbio continue to mentor and teach via the internet. Dr. Wallace and Dr. Terbio look forward to guiding the students, as many of them apply for the match process. They look forward to welcoming to the field of emergency medicine on matchday 2021.

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Air Force PGY-2 Resident Physician Jason David, MD, participated in a one month away elective at Mission Control in Houston, TX, during the month of October. He worked on an Internal Jugular Vein Ultrasound Project in Space comparing IJ cross-sectional area in various tilt-table configurations to that of the same subject in space to see if tilt-table exercises a) work as an analog for microgravity and b) is a feasible comparable training model for microgravity. In addition, Dr. David has been assigned to work on a thought/policy paper on Operational Space Medicine.

Congratulations to Dr. David on the great work he’s doing with the Air Force and for representing the UNLV EMR family! We’re proud of you.

Interested in learning more about what Dr. David is up to? Check out his podcast here A discussion about ACLS in space!

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The arrival of COVID-19 to Las Vegas brought new challenges to the UMC Emergency Department. As many emergency physicians across the country have noted, the spectrum of disease burden was astounding, with patients presenting as the “happy hypoxic” to asymptomatic to respiratory failure. The UMC emergency department stepped up and spearheaded the efforts to triage and isolate the influx of patients with COVID-19. The result was a newly built atrium to facilitate a robust triage process that helped separate those who were infected with COVID-19 from the other patients and got them to our isolated COVID-19 unit in a separate wing of the emergency department. From there, patients could receive the interventions, therapies, and counseling they needed. Triage and treatment were just a few of the challenges COVID-19 presented.

Personal protective equipment across the country has been hard to come by, but the efforts of the Las Vegas Chinese/Asian American community helped to keep our UMC safe in the fight with donations of over 30,000 surgical masks and 500 N95 masks. This generosity undoubtedly kept the residents, attendings, nursing, and ancillary staff from bringing COVID home to their loved ones. Dr. Alex Lin, PGY-2, served as a liaison between the Chinese/Asian American community and UMC. Dr. Lin remarked that despite the stigma and discrimination their community has faced, “they can look past that and help contribute.” Even with proper PPE, keeping loved ones safe at home brings its own challenges and frustrations. Many residents and attendings have been isolating themselves in hotels or campers, away from their elderly or vulnerable loved ones. The residency and our patients are all grateful for the risks they’re taking.

The residency and faculty at UMC continue to work with physicians from around the globe in a search for the best way to treat those afflicted with COVID-19. They look forward to meeting the challenges that lie ahead.

Written by, PGY-1 residents at University Medical Center of Southern Nevada