Welcome to the Department of Emergency Medicine's Newsletter


From the Chair

State of the Department
June 2006

The Department of Emergency Medicine has continued to flourish in the academic year 2005-2006 and we continue to get bigger and more productive in many ways. I’ll attempt to highlight some of the more significant events.

Clinical
The volume in the University of Michigan Emergency Department continues to grow month after month. This year, we’re projecting to reach almost 75,000 patient visits. Each month has seen a growth in patient visits over the month from prior year. Despite the increasing patient volumes and static patient care space, I think that we have made inroads in patient care and our LBE rate is showing downward trends. There is more hope on the horizon as the hospital has given the OK to convert some space in the Department of Radiology to the Emergency Department. By the end of the next fiscal year, we should have 9-10 additional patient care spaces available to us. We’ve also been busy putting together a long term strategic plan for emergency department space. This will include ultimately absorbing more space from Radiology as well as the current M-Works space and Hospital Dentistry space. Our ultimate emergency department design will include two CT scanners as well as a magnetic resonance imaging scanner. These plans are long term and probably won’t be complete for another 5-7 years. By that time, the Pediatric Emergency Department will also move into their new space in the new women and children’s hospital in 2011. We are continuing process improvement projects in the ED with our Lean projects, as well as working with the hospital to find ways to utilize hospital beds more efficiently in order to impact the overcrowding that we’ve been experiencing recently.

Survival Flight is proceeding with plans to renew the lease on the 3 Bell 430 helicopters we've operated since 1999. The Survival Flight remote base at Livingston Co airport has been very successful in increasing the number of accident scene responses we're called to.

Educational Programs
We are graduating our first pediatric emergency medicine fellow this year, Dr. Amy Shirk. We have three other fellows returning next year with two new fellows starting next month. Michele Nypaver has done an outstanding job in bringing this new program along successfully.

The Emergency Medicine Residency has had another great year in the match. We matched 14 excellent candidates from around the country.

One other educational highlight is that we will be recruiting our first emergency medicine trained stroke fellow beginning in July. William Meurer, MD, is completing his residency at MetroHealth in Cleveland, Ohio and will be joining the University of Michigan for a two-year stroke fellowship and will become part of the BIG (Brain Injury Group) team.

Research
The department has had an extremely successful year in the research arena. Dr. Scott has begun work on his NIH RO1 grant and Dr. Sam McLean was successful in receiving funding on a K23 mentored clinician scientist award.

Rob Silbergleit and I were successful in being funded to run the Clinical Coordinating Center for the Neurologic Emergency Treatment Trials Network (NETT) for NINDS. This will begin in July of this year.

Overall, our NIH research support has reached an all time high and in all likelihood, the Department of Emergency Medicine will become the #1 department in the United States in Emergency Medicine for NIH funding. With our current number of significant grants going into the future, it’s likely that we will retain this position for some time.

Comings and Goings
• Dr. Brian Zink will be leaving the University of Michigan to take the position of Chair of the Department of Emergency Medicine at Brown University and Rhode Island Hospital.
• Dr. Gian Corrado will be leaving the UM and moving to Boston. He will be in charge of Sports Medicine at Northeastern University in Boston.
• Dr. Jeremy Cooke will be taking an academic emergency medicine job at University of California, Davis in Sacramento, California.
• Dr. Bonnie Singal will be retiring from active medical practice and taking a job in research administration at St. Joseph Mercy Hospital.
• Dr. Brad Uren will be starting as a faculty member at the University of Michigan at University Hospital.
• Dr. Amy Shirk will be beginning her career in pediatric emergency medicine at Hurley Medical Center and part-time at University Hospital.
• Dr. Ken VanderHave will be returning to the active emergency medicine faculty at the University of Michigan.

Faculty News

Farewell Dr Zink…. As many of you already know, Brian Zink has officially been appointed as the inaugural chair of the Department of Emergency Medicine at Brown Medical School, effective July 1, 2006. Brian will also hold the titles of Emergency Medicine Physician-in-Chief at Rhode Island Hospital and the Miriam Hospital, and will be president of the University Emergency Medicine Foundation. In his new role, Dr. Zink will oversee a department that is home to a faculty of 74 physicians and academic research funding of over $3M. He will also oversee the Medical Simulation Center and the Injury Prevention Center at Rhode Island Hospital. This is an exciting new position for Dr. Zink and a real credit to our department that one of our faculty members will be assuming such a prestigious position. Brian came to the University of Michigan in 1992 after serving as a faculty member at Albany Medical Center for four years. Since coming to the University of Michigan, Dr. Zink has had a profound effect, not only on the department, but on the University of Michigan Medical School as well. He has been a highly successful researcher at Michigan and was successful in being an NIH-funded investigator for his work in alcohol and brain injury. More recently, Brian assumed responsibility in the University of Michigan Dean’s office going from Assistant Dean to Associate Dean for Student Affairs. As much as anyone, Brian Zink helped build the Department of Emergency Medicine at the University of Michigan and he will be sorely missed. We wish him well in his new position at Rhode Island Hospital and Brown University and have no doubt that he will be equally successful in this new undertaking. --William G. Barsan, Chair
Dr. Robert Silbergleit has been promoted from assistant professor to associate professor with tenure by the Board of Regents. Congratulations!	Terry Kowalenko, M.D. has been elected President of Michigan ACEP. There will be a banquet in his honor at the Michigan ACEP meeting on July 11 at the Grand Traverse Resort in Traverse City from 7:30-9:30. All Michigan ACEP members are invited. It would be great to have some UM people in attendance to honor Terry on this accomplishment. .
Ronald Maio, DO to direct University's Human Research Compliance Office read more	Jolie Holschen, MD• received the 2006 AMA Foundation Leadership Award and attended the AMA National Advocacy Conference in Washington, DC in March

Samuel McLean, MD, PI, Development of Chronic Pain After Motor Vehicle Trauma, National Institutes of Health, 7/1/06 – 6/30/09, $384,502

Susan Stern, MD, PI, Development and Evaluation of a New Hemostatic Agent for the Control of Severe Hemorrhage Following Traumatic Injury, Biolife, LLC., 7/1/06 – 2/28/07, $296,786

Susan Stern, MD, PI, Novel Non-Invasive Device for Treatment of Elevated Intracranial Pressures, Advanced Circulatory Systems, Inc., 2/2406 – 1/31/07, $33,000

Lisa Schweigler, MD UM/EM Chief Resident, Class of 2007, has been accepted into the 2007 UM Robert Wood Johnson Scholars Program. RWJ is an intensive two-year training program in health policy and has been an important source of EM investigators in the past few years. Previous RWJ fellows at UM include Jim Pribble, Jim Gordon (UM EM Class of 1996, and currently the director of the Program in Medical Simulation at Massachusetts Genral Hospital), Brent Asplin (currently Chair of Emergency Medicine at Regions Hospital, St. Paul, MN), and Kirsten Greineder (UM EM Class of 2002, and currently at Yale University). Manya Newton (UM EM Class of 2006), will be starting the program in July.

William Meurer, MD, currently Chief Resident in Emergency Medicine at the MetroHealth/Cleveland Clinic/Case Western Reserve University Emergency Medicine Residency, will be joining us this month to begin a two-year Stroke fellowship. The program, which is jointly coordinated through EM and the Department of Neurology, is an intensive clinical exposure to acute stroke care, and will include clinical traiining in neurological emergencies and neurological critical care, neuroradiology, and rehabilitation. This is the first year the fellowship has been offered. For any residents interested in this opportunity in upcoming years, contact Dr. Barsan or Dr. Younger.

A report from the Department of Pathology and co-authored by John Younger that describes a new complement activation pathway appears in this month's issue of Nature Medicine. The authors describe a means of by which thrombin can activate C5 in mice genetically deficient of C3. This is the first report of direct communication between the complement cascade and the coagulation cascade, and has implications for infectious disease, autoimmunity, vascular biology, and acute conditions associated with clotting including myocardial infarction, stroke, and venous thromboembolism.

At long last, the Institute of Medicine in June is releasing its report on the future of emergency care. This is the culmination of more than 2 years of work examining almost every aspect of emergency medicine and will include specific reports on hospital-based emergency care, prehospital services, and pediatric emergency care. The report is expected to generate a roadmap for the further development of emergency care for the next decade, and is likely to be the most influential document related to the specialty since the Macy Report in 1994. Copies of the reports will be available on June 14 and are available, along with downloadable webcasts of the IOM press conference, at www.iom.edu.

Residency News

Congratulations! Class of 2006

Here's where they're headed.........

Dan Benjamin Avstreih, M.D., INOVA Fairfax Hospital, Falls Church, Virginia

Nathaniel Smith Bowler, M.D., Abbot Northwestern Hospital, Minneapolis, Minnesota

Neal Chawla, M.D., INOVA Fairfax Hospital, Falls Church, Virginia

Elke Marksteiner Cooke, M.D.,Kaiser Permanente, Sacramento, California

George Michael Elliott, M.D., St. Joseph Mercy Hospital Emergency Physicians Medical Group, Ann Arbor, Michigan

Marquita Norman Hicks, M.D., Henry Ford Fairlane, Henry Ford Medical Group, Dearborn, Michigan

Matthew K. Hysell, M.D., Lakeland Hospital, St. Joseph, Michigan

Jacques W. Kobersy, M.D., St. Joseph Mercy Hospital Emergency Physicians Medical Group, Ann Arbor, Michigan

Manya Faith Newton, M.D., Robert Wood Johnson Fellowship University of Michigan, Ann Arbor, Michigan

Clifford Wayne Robins, M.D.

Steven Patrick Schmidt, M.D., St. Joseph’s Hospital, Tampa, Florida

Nathan Ashley Siegel, M.D., Rhode Island Hospital, The Miriam Hospital, Brown University, Providence, Rhode Island

Richard Gerald Taylor, M.D., Dartmouth-Hitchcock Medical Center Dartmouth Medical School, Lebanon, New Hampshire

Brad J. Uren, M.D. University of Michigan, Ann Arbor, Michigan

Ellen Walkling White, M.D, Eastern Maine Medical Center, Bangor, Maine

Peds Fellowship News

The Peds Fellowship matched their top two picks for July 1 start date, both from pediatric residencies; Desiree Seeyave, MD will be coming from SUNY in New York (Med school Trinidad and Tobago) and Marisa Louie from the University of Michigan.

This year the Fellowship Program had it's very first graduation.
Amy Shirk, MD graduated June 3rd. Dr. Shirk will be working at Hurley Medical Center and part-time at University Hospital.

Medical Student News

Alumni News

One of our own serving in Iraq

Paul DeFlorio, class of 2005 has been deployed to Iraq. Below he shares this email...

I leave for Iraq today. I will be working in the largest in-theater hospital for the next four to six months. While no one likes to go off to war, it turns out I have the best job in the whole affair--trying to save lives.
It's what I signed up for way back in 1997, and I'm happy to go and serve.

Having said that, it will be hellishly hot, there will be mortars landing on my base daily, and from what I hear and imagine, mail from home will be worth its very weight in gold.

Please include me in your thoughts and prayers, and address any mail to me at:

Capt Paul DeFlorio
332 EMDG
APO AE 09315-9997

Note that it takes two or three weeks to arrive, and baked goods are unlikely to survive the trip in an edible form.

Yours,
Paul

Recent Publications

Pribble JM, Goldstein KM, Majersik JJ, Barsan WG, Brown DL, Morgenstern LB. Stroke information reported on local television news: a national perspective. Stroke. 2006 Jun;37(6):1556-7. Epub 2006 May 4.

Blow FC, Barry KL, Walton MA, Maio RF, Chermack ST, Bingham CR, Ignacio RV, Strecher VJ. The efficacy of two brief intervention strategies among injured, at-risk drinkers in the emergency department: impact of tailored messaging and brief advice. J Stud Alcohol. 2006 Jul;67(4):568-78.

Lerner EB, Maio RF, Garrison HG, Spaite DW, Nichol G. Economic value of out-of-hospital emergency care: a structured literature review. Ann Emerg Med. 2006 Jun;47(6):515-24. Epub 2006 Mar 24.

Pribble JM, Goldstein KM, Fowler EF, Greenberg MJ, Noel SK, Howell JD. Medical news for the public to use? What's on local TV news. Am J Manag Care. 2006 Mar;12(3):170-6.

Scott PA. For rich and poor, the message is still "dial 9-1-1": but is it getting through? Stroke. 2006 Jun;37(6):1354-5. Epub 2006 May 11.

Silbergleit R, Watters D, Sayre MR. What treatments are "satisfactory?" divining regulatory intent and an ethical basis for exception to informed consent for emergency research. Am J Bioeth. 2006 May-Jun;6(3):24-6; discussion W49-50.

Karras DJ, Kruus LK, Baumann BM, Cienki JJ, Blanda M, Stern SA, Panacek EA. Emergency medicine research directors and research programs: characteristics and factors associated with productivity. Acad Emerg Med. 2006 Jun;13(6):637-44. Epub 2006 Apr 24.

Yang S, Nakamura T, Hua Y, Keep RF, Younger JG, Hoff JT, Xi G. Intracerebral hemorrhage in complement C3-deficient mice. Acta Neurochir Suppl. 2006;96:227-31.

Huber-Lang M, Sarma JV, Zetoune FS, Rittirsch D, Neff TA, McGuire SR, Lambris JD, Warner RL, Flierl MA, Hoesel LM, Gebhard F, Younger JG, Drouin SM, Wetsel RA, Ward PA. Generation of C5a in the absence of C3: a new complement activation pathway. Nat Med. 2006 Jun;12(6):682-7. Epub 2006 May 21.

Anyone wishing to submit information for the July/Aug issue, please email Lisa Garnes at liswil@umich.edu.