A Newsletter for the Members of the Hawaii Chapter - Spring 2020

Mark Baker, MD, FACEP

President

Debra Sanders

Executive Secretary

Website

President's Message

Aloha Hawaii ACEP Members,

This “President’s Message” is written during the worst pandemic that the specialty of Emergency Medicine has ever seen. The world has changed so much since January, when I wrote the following while in Japan: “It is great to travel, see different cultures, enjoy a sport (skiing/snowboarding), and eat good food.”

Since that time, our personal and clinical lives have been turned upside down, our jobs are now frightening, and healthcare workers have died from COVID-19. We could get sick, or we could bring COVID-19 home to our families. Volume in Emergency Departments has been reduced to approximately 50% of normal, not just here but nationwide. Our jobs are volume-dependent. I am certain that all of us long for life to return to normal.

Looking on the bright side, we are living in what I believe is the safest state in the country. I’ve heard from more than one person that a number of home projects are finally getting done. If you’re like me, you have had some video calls with friends whom you have not spoken to in some time.

Locally, our chapter supported its first videoconference. Dr. Josh Green, the Lieutenant Governor, gave a great update on the pandemic. Next, we will be hearing from Dr. Sarah Park, the State Department of Health Epidemiologist. National ACEP is a wonderful resource related to COVID-19. If you have not looked at their website you should: https://www.acep.org/corona/COVID-19/.

Dr. Will Scruggs and I would have been in Washington, DC, one week ago lobbying our politicians on topics like balance billing. Instead, we had telephone communication with Representatives Ed Case and Tulsi Gabbard, as well as Senator Mazie Hirono and the staff of Senator Brian Schatz. The topics revolved around PPE, protection from COVID-related liability, hazard pay for emergency physicians, and support that has already been distributed as part of the CARES Act. Representative Case is an advocate for improving Medicare compensation in the State of Hawaii. Related to the CARES Act, there was $132M distributed to over 1,700 healthcare facilities and providers in Hawaii (from a total $30 billion Hospital Provider Relief Fund). CMS will hopefully release information as to which providers and facilities received the reimbursements. I will keep you updated when I know more.

Let’s talk about the future:

We can have a voice in decisions made by the State of Hawaii related to opening back up and travel restrictions. Let me know if you are interested in participating in a task force.
The Annual Meeting at Roy’s Hawaii Kai is postponed.
Bylaws will be voted on when there is an Annual Meeting.
The Bylaws change will allow for more Directors. If you interested, please run; your changes are better than good. The new Bylaws promote integration of members from all counties. So please consider representing yours.

Most important - stay well, physically and mentally. The community is supporting us and cares about us.

Mahalo, Mark Baker, MD, FACEP

President, Hawaii Chapter ACEP

markbaker.hi@gmail.com

Hawaii ACEP Annual Meeting and Dinner – POSTPONED – to be Rescheduled

The annual meeting which was scheduled for May 20th at Roy’s is postponed. A new date will be chosen based on future decisions related to social isolation. At this point, it’s not clear when the meeting will be. As a reminder, this year’s meeting includes ratifying new Bylaws, as well as election of new officers and Board Members. When a date is set, we will be returning to Roy’s Restaurant in Hawaii Kai, 6600 Kalanianaole Highway, Suite 110. Our meeting and dinner will be from 5:00-9:30pm on that date. The restaurant’s beautiful private dining room overlooks Maunalua Bay, and the food and ambiance are excellent. Definitely something to look forward to! For information, contact Debbie Sanders at kepola2014@yahoo.com or Mark Baker at markbaker.hi@gmail.com.

UH JABSOM Emergency Medicine Interest Group (EMIG): by Gregory Suares, MD, FACEP

COVID disrupted medical student education, and JABSOM students were temporarily excluded from all clinical activities. In addition, most of the in-person didactics, lectures, and workshops had to be canceled or postponed for a brief period of time. Most the clinical clerkships have adopted alternative learning activities to provide unique learning opportunities remotely/virtually.

Nothing, however, can replace bedside teaching and learning. I'm happy to report that, starting in May, some area hospitals (such as The Queen’s Medical Center) will resume allowing 4th year JABSOM students back in the Emergency Departments to fulfill this graduation requirement. Castle has okayed student return on April 30. HPH will be starting students back on May 4. Kaiser and Kuakini are still undecided.

The future is obviously unknown, but we all hope that our educational community is well prepared for the challenges to come.

Please feel free to visit the EMIG Website.

Mahalo, Gregory Suares, MD, FACEP

Director, Hawaii Chapter ACEP

gregorysuares@gmail.com

Ph: 808-586-8236; Cell: 808-388-9934

Wellness Hawaii: Self-Care During the COVID-19 Pandemic

by Grace Chen O’Neil, MD, FACEP

Secretary-Treasurer, Hawaii Chapter ACEP

Since COVID-19 has hit Hawaii, we want make sure to stay healthy by taking care of ourselves. In this article, I am going to talk about some practices which will help boost immunity and prevent illness.

First, I will talk about the more obvious aspects of self-care. We have to take care of ourselves first before we can take care of others! We should make sure to get adequate sleep, exercise, and minimize stress. This of course includes avoiding smoking and drugs, and minimizing alcohol intake. We also need to maintain good practices such as hand-washing and wearing masks to prevent infection.

What else can we do? It appears that diet is a significant modulator of immunity. Certain micronutrients play an important role in immune function. There is evidence that micronutrient deficiencies in zinc, selenium, iron, copper, folic acid, and vitamins A, B6, C, and E may alter immune responses of animals (in vitro). A diet with a variety of vegetables, fruits, legumes, grains, nuts, and seeds can help in obtaining these micronutrients. Unfortunately, three-fourths of Americans have a diet low in vegetables and fruits, but exceed the USDA's recommendations for added sugars, sodium, and saturated fats. The CDC has found more than 10% of the population is deficient in vitamins C, D, and B6, with lower percentages deficient in iron. It is important to make sure you are not deficient in any of these vitamins.

In conclusion, a combination of a good diet, getting adequate sleep, and exercise will hopefully help keep us all healthy and keep COVID-19 at bay. Please let me know if you have other suggestions for improving immunity! If you have other contributions to the newsletter, please email me at chengr7@gmail.com.

Hawaii ACEP Board Meetings

The Hawaii ACEP Board meetings are held every other month. Hawaii ACEP members are welcome to attend the Board meetings – please contact us in advance if you are interested. For more information on the meetings, contact Debbie at kepola2014@yahoo.com. Upcoming Board meetings will be held on the following dates: Wednesday, May 20, 2020; Wednesday, July 22, 2020; Septermber 2020 (date to be advised); Wednesday, November 18, 2020.

Visit our Hawaii ACEP website where you can view or download past issues of our Hawaii ACEP e-newsletter.

2020 Hawaii ACEP Emergency Department Leadership Summit

The 7th annual Hawaii ACEP Emergency Department Leadership Summit will be held in September 2020 (date to be advised). This is a forum to discuss critical issues impacting Emergency Physicians, ED Nurse Leadership, Trauma Coordinators, and Emergency Departments state-wide. Our goal is to make this summit interactive, allowing participants to discuss challenges and potential solutions for all counties. We are hopeful that there will be an opportunity to meet with some of our legislators, either during or after the conference. We are all leaders, and you are all invited. Contact Debbie Sanders at kepola2014@yahoo.com or Will Scruggs at wscruggs@hepa.net for more information.

Welcome New Members!

Kathryn B Cherefko, DO

Ramsey F Hasan, MD, FACEP

Jai Singh Kahlon

Patrick Leaf, MD

Jaymes Allen Jeremiah Lonzanida

Kersten Milligan, MD

Michael Mouri, MD, MPH, DDS

Hima K Rao, MD, FACEP

Jolene Yehl, MD

FROM NATIONAL ACEP

We are updating our COVID-19 Clinical Alert repository daily to assist you with patient care, stay up-to-date with ACEP's efforts and resources and acces free & discounted offers to healthcare workers. The site is organized by topic and also includes links to trusted external sources.

Public Poll: Emergency Care Concerns Amidst COVID-19

There is a worrisome trend across ERs of people who are avoiding getting the medical care they need. While it’s important to stay home and follow social distancing guidelines, it’s critical to always know when to go to the emergency department. Read more.

COVID-19 Physician Wellness Webinars & Crisis Support

ACEP collaborated with the American Association of Emergency Psychiatry on a webinar and podcast related to physician wellness and mental health during COVID-19. In this webinar, Dr. Jack Rozel, Medical Director at resolve Crisis Services and president of AAEP, and Dr. L. Anthony Cirillo, ACEP Board Member, share insights on why we are experiencing fear and grief, how to cope with different types of stress, and how to help yourself and your team through this difficult time. View the webinar and listen to the podcast.

ACEP Member Benefit: Free Counseling and Support

Receive exclusive access to 3 free counseling sessions through ACEP’s new Wellness & Assistance Program. Support is available 24/7, & you can conduct your sessions over the phone, face-to-face, via text message or through online chat. Learn more.

COVID-19 Field Guide: New Updates

Our most popular COVID-19 resource, the Field Guide to COVID-19 Care in the ED, continues to be updated with the latest information. This week, the following sections were updated: isolation, PPE, risk factors, and evaluation/management of COVID-19. View the guide.

Another Week, Another Bundle of COVID-19 Regulatory Changes

Regs and Eggs Blog - May 7, 2020

Last week, we mentioned that the Centers for Medicare & Medicaid Services (CMS) was planning on releasing a COVID-19 regulation any day—and in fact the reg came out later that same day, Thursday, April 30th. This is the second major reg CMS has released in response to the COVID-19 pandemic. While the first reg that CMS issued at the end of March had huge implications for emergency physicians, the reg released last Thursday won’t have as much of a direct impact on emergency medicine. Read more on ACEP’s regulatory blog.

COVID-19 Financial Survival Guide: What You Need to Know

ACEP is standing up for our members who, despite serving on the frontlines of the COVID-19 pandemic, are having their livelihoods threatened. Cutting benefits, reducing shifts or canceling contracts in today’s environment is akin to signing a ‘Do Not Resuscitate’ order for many emergency departments and the physicians who care for patients, especially those in rural or underserved areas. Access the guide.

Member Benefits: COVID-19 No Cost, Discount & Other Offers

You are risking your lives to care for patients from this unprecedented pandemic, and we all appreciate the additional stress on you and your families. We want to help. And, so do a lot of companies out there. So, thanks to you and thanks to the companies willing to support our healthcare heroes. View the benefits.

Get Waiver Training on Zoom

Given the unprecedented crisis that COVID 19 poses to patients with opioid addiction Get Waivered, ED Bridge, and ACEP are providing the first ever seamless Zoom version of the traditional waiver training on May 20 at 10 a.m. EST. Register here.

COVID-19 Special Edition of Critical Decisions in EM

Our newest CDEM features lifesaving lessons focused on the ED evaluation and management of COVID-19, including timely information on risk factors, common examination findings, valuable diagnostic tests, and the safe use of pharmacological treatments. The issue also takes a deep dive into PPE, the provision of respiratory support, and what interventions should be avoided when managing these vulnerable patients. Learn more.

Call for Research Forum Abstracts

Submit your abstracts to ACEP’s Research Forum 2020 by June 11. Abstracts will be peer reviewed for presentation at the 2020 Research Forum during ACEP’s Scientific Assembly. See abstract requirements.

Be Accredited to Provide Pain & Addiction Care in the ED

Show your community that your ED is part of the solution. ACEP is now accepting applications for the Pain & Addiction Care in the ED (PACED) Accreditation Program, developed for EM physicians by EM physicians.

PACED, the nation’s only specialty-specific accreditation program, will provide the education, tools & resources you need to provide better care for patients in pain & those with substance misuse.

Elevate the quality of patient care with innovative treatments, alternative modalities, and impactful risk reduction strategies in a collaborative team setting, resulting in positive outcomes for your patients, families, providers, and communities. Learn more at www.acep.org/PACED or contact us at paced@acep.org

Hawaii Chapter ACEP

3215 -A Pawale Place

Honolulu, HI

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