10th Annual
New Orleans, LA
March 23-27, 2014

Workshop & Educational Session Descriptions

Sunday, March 23, 2014

8:00 am - 11:00 am

Workshop:The "Aye's" Have It - Slit Lamp Skills (OTHER TIME SLOTS OFFERED)
Jason Knight, MD; Kara Geren, MD, MPH 
This workshop will teach you how to do a complete and comprehensive eye examination. We will go over how to use the slit lamp, how to use a tomopen, how to perform visual acuity, testing visual fields, testing extraocular muscles, and how to call excellent ophthalmology consults. We will also spend time on using the ophthalmic burr, removing foreign bodies and looking at visual diagnosis pathology so that you can take excellent care of your eye patients in the emergency department.

Objectives:

  • Review clinically relevant anatomy of the eye and discuss the pathways important for vision.
  • Discuss and demonstrate the ophthalmology procedures essential in emergency medicine: Slit Lamp exam, foreign body removal, visual field testing, Tonopen testing, EOM testing,  Seidel Test, Eye irrigation, ophthalmology ultrasound, lid eversion and pupillary defects.
  • Learn how to choose appropriate eye drops and ointments.
  • Synthesize how to call excellent ophthalmology consults.    
8:00 am - 11:00 am

Workshop: Essentials of Wound Care - Basic Wound Care Techniques
Amy Keim, MS, PA-C ; James Marinucci; Ryan Strauss, PA-C, MPH, MPAS; Andrew Maurano, PA-C 
Proper evaluation and management of wounds is critical to ensuring good patient outcomes. This case-based course is designed to increase the participant's scope-of-practice in managing acute traumatic wounds as they present in the outpatient setting. By exploring common, but potentially problematic, cases from presentation to follow up, participants will learn how to properly assess and manage common wounds including simple lacerations, abrasions, avulsions, bites and puncture wounds.

Objectives:

  • Properly assess wounds in order to determine proper management, referrals and follow-up.
  • Apply understanding of wound preparation, aseptic technique and post-procedure care.
  • Choose appropriate wound management materials and equipment.
  • Apply understanding of anesthetic agent indications and actions in choosing appropriate procedural analgesia. 
  • Determine appropriate suture techniques according to wound and patient characteristics.
  • Demonstrate multiple percutaneous suture techniques.
  • Demonstrate proper intradermal suture technique.
  • Demonstrate alternate methods of acute wound management for non-suturable wounds including skin adhesives.
  • Understand indications for tetanus prophylaxis and rabies prophylaxis.
  • Make appropriate decisions concerning antibiotics in wound management.   
12:00 pm - 4:00 pm

Workshop: Beyond Essentials - Advanced Acute Wound Care Techniques
Amy Keim, MS, PA-C ; James Marinucci; Ryan Strauss, PA-C, MPH, MPAS; Andrew Maurano, PA-C
Many "complex" wounds are referred to specialists either unnecessarily or prematurely - or simply closed improperly. This case-based course is designed to increase the participant's scope-of-practice in managing complicated acute traumatic wounds. By exploring common, but frequently problematic, cases from injury to post-repair follow up, participants will learn specialized repair techniques for some of the most challenging wounds. 

Objectives:

  • Understand general considerations on limitations of complex wound repair.
  • Demonstrate multi-layer cosmetic wound closure techniques.
  • Properly apply general and "Loose Closure" techniques. 
  • Apply methods of proper anatomic border alignment. 
  • Demonstrate appropriate wound excision and debridement techniques.
  • Manage nail/nailbed injuries.
  • Discuss management options for distal fingertip amputations.
  • Demonstrate methods of earlobe and helix repair.
  • Manage complex nasal lacerations. 
  • Demonstrate a 'dog-ear' deformity repair.
  • Utilize excision techniques to decrease tissue contraction related scarring. 
  • Demonstrate management and repair of single and multiple skin flaps. 
  • Demonstrate management and repair of multiple parallel lacerations.   
12:00 pm - 3:00 pm

Workshop:The "Aye's" Have It - Comprehensive Eye Exam and Slit Lamp Workshop II (THIS IS A REPEAT OF THE WORKSHOP GIVEN ON SUNDAY MORNING) 
Jason Knight, MD; Kara Geren, MD, MPH 
This workshop will teach you how to do a complete and comprehensive eye examination. We will go over how to use the slit lamp, how to use a tomopen, how to perform visual acuity, testing visual fields, testing extraocular muscles, and how to call excellent ophthalmology consults. We will also spend time on using the ophthalmic burr, removing foreign bodies and looking at visual diagnosis pathology so that you can take excellent care of your eye patients in the emergency department. 
 

Objectives:

  • Review clinically relevant anatomy of the eye and discuss the pathways important for vision.
  • Discuss and demonstrate the ophthalmology procedures essential in emergency medicine: Slit Lamp exam, foreign body removal, visual field testing, Tonopen testing, EOM testing,  Seidel Test, Eye irrigation, ophthalmology ultrasound, lid eversion and pupillary defects.
  • Learn how to choose appropriate eye drops and ointments.
  • Synthesize how to call excellent ophthalmology consults.    
3:30 pm - 4:30 pm

 Mastering Electrolyte Emergencies
Cory Slovis, MD, FACEP
This course will provide expertise into the immediate management of the most common electrolyte emergencies. Topics covered will include the ECG changes of hyper and hypokalemia, the roles of calcium and bicarbonate in hyperkalemic emergencies, expert use of magnesium in hypokalemia, treatment ofTorsades, how to safely correct symptomatic hyponatremia and when to selectively use hypertonic saline.

Objectives:

  • Learn how to best drive potassium into the cell. nderstand the role of calcium in treating hyperkalemia. 
  • Know the role of magnesium in correcting hypokalemia. 
  • Be able to describe how to use hypertonic saline safely.    
4:30 pm - 5:30 pm

 Sorting out Syncope: Deadly Drop or Frivalous Faint?
Bart Besinger, MD
There are few chief complaints that are more intimidating to the emergency clinician than syncope.  Although syncope patients are at significant risk for morbidity or mortality, the severity of the underlying cause is not always apparent at the time of presentation to the emergency department. This dilemma results in a large number of syncope patients being admitted to the hospital. The emergency clinician’s challenge is to identify patients who have a deadly or potentially deadly cause for their syncope while using resources such as diagnostic testing and hospital admission in a rational way. This session will explore strategies to overcome this challenge.

Objectives:

  • Differentiate the clinical presentation of syncope from that of seizure. 
  • Implement a systematic approach to the patient with syncope. 
  • Elucidate critical information from the syncope patient's history and physical.
  • Understand the limitations of various syncope decision instruments.   
5:30 pm - 6:30 pm

All 'Stressed Out' - How to Prevent Burnout in EM
Jay Kaplan, MD, FACEP
The stressful aspects of emergency medicine are many, subtle, and cumulative. They can lead to job dissatisfaction and burnout. Emergency providers work chaotic hours and may suffer disruption of the sleep-wake cycle. The presenter will identify the stressors in emergency medicine, explain the physiologic effects of those stressors, and provide proactive and real time strategies for dealing with them effectively.

Objectives:

  • Identify the many sources of stress in the practice of emergency medicine.
  • Define the physiology of the stress response so that providers may better understand the effects on their health. 
  • Describe strategies to handle the stress both pro-actively and real-time in order to optimize the enjoyment of practice and avoid burnout.   

Monday, March 24, 2014

8:00 am - 9:00 am

The Wheezing Patient: CHF, Anaphylaxis, COPD or Asthma?
Cory Slovis, MD, FACEP
Wheezing patients are very commonly encountered in the Emergency Department. This talk will discuss the state of the science in the therapy of anaphylaxis, asthma, COPD, heart failure and the short of breath patients. There will be a focus on expert use of IM vs IV epinephrine, non-use of morphine, aggressive use of nitroglycerin and CPAP along with better understanding the limitations of acute diuresis. Five step protocols will be provided for each disease.  

Objectives:

  • Learn the five causes of shortness of breath and the five causes of wheezing. 
  • Know when to use IM vs IV epinephrine in anaphylaxis. 
  • Appreciate the limitations of diuretics in pulmonary edema. 
  • Understand the role of magnesium In acute asthma and COPD.    
9:00 am - 10:00 am

How to Spot the Well-Appearing Patient Who Will Soon be Dead: Avoiding the ER Bounceback
Mike Weinstock, MD
The course helps providers identify the most difficult ED patient: The well appearing patient who has a life-threatening process occurring.
The course has three parts:
1. How to spot (and three unique actions to take when we do)
2. Why we don’t spot (cognitive dispositions to respond and why our normal clinical gestalt may lead us astray)
3. What happens when we don’t spot (legal ramifications). 

Objectives:

  • Use the two-step approach to recognize a well-appearing patient with a life-threatening process.
  • Understand how a 'cognitive disposition to respond' can trick us into discharging patients with life-ending illnesses.
  • Use legal data to improve medical care   
10:30 am - 11:30 am

Top Eye Emergency
Jason Knight, MD
This course will cover various eye emergencies.

Objectives:

 

  • Learn the key concepts in diagnosing and managing top eye emergencies in the emergency department including conjunctivitis, neonatal conjunctivitis, central retinal artery occlusion,central retinal vein occlusion, vitreous hemorrhage, amarosis fugax, optic neuritis, scleritis, iritis and glaucoma.
  • Learn how to call an exceptional ophthalmology consult including the important information that must be conveyed to your consultant in your history and exam
  • Know when different patients with ophthalmic conditions and pathology need to follow up with a specialist: emergent, 1-2 days, versus delayed follow up.
  • Develop a working knowledge of an afferent pupillary defect, a swinging flashlight test, a red desaturation test, and howto work up amaurosis fugax.  
  • Understand the key management principals ofpost-operative ophthalmic complications

 

12:30 pm - 1:30 pm

Approach to the Poisoned Patient in 2014
Sean Nordt, MD
Interactive discussion of toxidromes.  

Objectives:

  • Become familiar with physical findings of acute poisonings.
  • Be able to differentiate between various toxidromes.
  • Develop an approach to treating the poisoned patient.   
1:30 pm - 2:30 pm

Management of Acute Stroke - Walking the Tightrope Between Patient Benefit and PA Risk
Mike Weinstock, MD
Management of acute stroke syndromes controversy and practices begins with significance of stroke, epidemiology and then exploration of which interventions work and what the recommendations are based upon. Discussion will be framed around a case of patient presenting with stroke symptoms.  

Objectives:

  • Understand the original studies behind the stroke recommendations.
  • Appreciate the benefits of a shared decision making model when deciding on thrombolytics.
  • Recognize the real legal risk of administering and withholding lytics in acute stroke.
  • Management and evaluation of TIAs   
2:30 pm - 3:30 pm

Newer Drugs of Abuse
Sean Nordt, MD
An update on the newer drugs of abuse.  

Objectives:

  • Describe the clinical effects of newer drugs of abuse.
  • List the various street names of these agents.
  • Develop a focused treatment plan of each of these agents.  
3:30 pm - 4:30 pm

Roundtable: The New Recertification Requirements and EM CAQ
Greg Thomas PA, MPH

3:30 pm - 6:30 pm

Workshop: Basic Emergency Ultrasound
Teresa Wu, MD; Haney Mallemat, MD
Emergency bedside ultrasound enhances patient care and improves patient safety. In the basic emergency ultrasound courses, participants will learn how to perform diagnostic and life-saving bedside scans. Nationally renowned faculty will provide informative lectures, followed by small group scanning sessions where participants will have the opportunity to reinforce and augment their skills.

Objectives:

  • Learners will demonstrate understanding of the indications for performing an eFAST exam and will demonstrate the KSA’s required for performing an eFAST exam during a hands-on scanning session.
  • Learners will demonstrate the ability to recognize abnormalities such as intraperitoneal free fluid, pleural fluid/hemothorax, pneumothorax, pericardial effusion, cardiac tamponade, solid organ injury, and bladder rupture on ultrasound. 
  • Learners will demonstrate understanding of the indications for performing an ultrasound guided peripheral and central vascular access and will demonstrate the KSA’s required for performing an ultrasound guided vascular access during a hands-on scanning session.   
3:30 pm - 6:30 pm

Workshop:The "Aye's" Have It - Comprehensive Eye Exam and Slit Lamp Workshop III (THIS IS A REPEAT OF THE WORKSHOP GIVEN ON SUNDAY MORNING)
Jason Knight, MD; Kara Geren, MD, MPH 
This workshop will focus on how to perform a comprehensive eye examination from start to finish. We will teach you at how to use a slit lamp, how to use a tonopen, how to use a panoptic, how to use an ophthalmoscope, how to test visual fields, how to test extra-ocular muscles, and how to call excellent ophthalmology consults. This will be a hands on workshop.  You will learn how to use an ophthalmic burr and how to remove ocular foreign bodies using a real tissue eye model. This will be an interactive case based discussion with visual diagnosis slides and multiple case studies.  
  

Objectives:

  • Review clinically relevant anatomy of the eye and discuss the pathways important for vision.
  • Discuss and demonstrate the ophthalmology procedures essential in emergency medicine: Slit Lamp exam, foreign body removal, visual field testing, Tonopen testing, EOM testing,  Seidel Test, Eye irrigation, ophthalmology ultrasound, lid eversion and pupillary defects.
  • Learn how to choose appropriate eye drops and ointments.
  • Synthesize how to call excellent ophthalmology consults.    
3:30 pm - 6:30 pm

Workshop: Going Beyond Fractures - Diagnosing and Managing Common Orthopedic Injuries
Amy Keim, MS, PA-C ; James Marinucci; Ryan Strauss, PA-C, MPH, MPAS; Andrew Maurano, PA-C
This is a case-based workshop that will work through the diagnosis, management, pearls and pitfalls of common adult orthopedic injuries seen in the emergency department. Participants will learn key procedures in the management of the following common orthopedic injuries: interphalangeal dislocation, AC joint dislocation, glenohumeral joint dislocations, elbow dislocation, hip dislocation, patellar dislocation, arthrocentesis knee, hematoma blocks, digital block and compartments syndromes.

Objectives: 

  • Understand classifications and mechanisms associated with common dislocations. Perform appropriate motor/neurological examination for common dislocations. Perform an appropriate vascular examination for common joint dislocations.
  • Recognize common joint dislocations on x-ray. Perform peripheral blocks and hematoma blocks for pain management. Demonstrate methods of joint reductions. 
  • Appropriately diagnose and manage common compartment dyndromes. Know the indications and methods of reduced dislocation immobilization. Understand complication of joint dislocations and reductions. 
  • Perform arthrocentesis of the knee. Make appropriate referrals to specialists consultants.   
3:30 pm - 6:30 pm

Workshop: EKG Patterns You Do Not Want to Miss
George Higgins, III, MD, FACEP
Diagnostic electrocardiography is an essential skill required of clinicians in many specialties. Patients with chest pain, palpitations, syncope, shortness of breath, and mental status change regularly present unexpectedly for evaluation. An ECG is routinely ordered in these situations, and major treatment decisions often are driven off the interpretation of this test. These presentations will familiarize physician assistants with a number of ECG abnormalities that they are likely to encounter during their careers. 

The following conditions which provide ECG clues will be reviewed in Part I:

  • Acute posterior myocardial infarction.
  • Acute right ventricular infarction.
  • Acute myocardial infarction in the presence of LBBB.
  • Recognizing SVT with aberrancy and differentiating it from VT.
  • Wolf –Parkinson-White and Lown-Ganong-Levine Syndromes.
  • ECG changes associated with subarachnoid and intracerebral hemorrhage.
  • ECG changes associated with tricyclic antidepressant toxicity.
  • Heart blocks. 

Objectives:

  • ECG changes associated with acute coronary syndromes and their prognostic implications. Right ventricular infarction. Acute myocardial infarction in the presence of LBBB. Recognizing SVT with aberrancy and differentiating it from VT. 
  • ECG changes associated with subarachnoid hemorrhage. ECG changes associated with tricyclic antidepressant toxicity. Wellen's Syndrome. Brugada Syndrome. 
  • Hypertrophic Cardiomyopathy. ECG changes associated with heart transplantation. Dressler's Syndrome. PAs in several specialties commonly order ECG’s for their patients. Being able to recognize subtle, yet very important, ECG clues at the point-of-care can be literally life saving for the patient and professionally gratifying for the clinician. These presentations will sharpen up their ECH interpretation skills.   

Tuesday, March 25, 2014

8:00 am - 9:00 am

The Best of Pediatric Emergency Literature from 2013-2014 
Richard Cantor, MD, FACEP
The presenter will present a critical review of the most recent research and publications in the field of Pediatric Emergency Medicine.

Objectives:

  • Demonstrate familiarity with the most recent literature in Pediatric Emergency Medicine.
  • Incorporate new in formation in their practice model.   
9:00 am - 10:00 am

Pediatric Abdominal Pain
Brian Kloss, DO, JD 

Objectives:
1) Learn the common causes of pediatric abdominal pain.
2) Learn the subtleties of Intussuception
3) Learn about conditions that mimic appendicitis 
  
10:30 am - 11:30 am

Mistakes You Don't Want to Make With Your Pediatric Patients 
Richard Cantor, MD, FACEP
The speaker will present a series of cases illustrating common mistakes encountered in the management of ediatric Emergency patients. 

Objectives:

  • Understand the many presentations of intussusception. 
  • Be able to appropriately manage the child with fever and torticollis.
12:30 am – 1:30 pm

Geriatric Abdominal Pain "They are not Just big kids"
Brian Kloss, DO, JD
This lecture will review the subtle and not-so-subtle differences in intra-abdominal pathology as it presents in older adults. Pathology including, but not limited to, appendicitis, diverticulitis, nephrolithiasis, cholangitis, bowel obstruction, volvulus, ischemic colitis and ruptured AAA will be presented and discussed in a case presentation format.

Objectives:

  • Understand the subtleties of abdominal pain as a presenting complaint in the elderly patient.
  • Gain an in-depth appreciation of the pathology that occurs more frequently in the elderly population.
  • Develop a sound approach to the work up and management of abdominal pain in the elderly patient.   
1:30 pm - 2:30 pm

Common Emergencies in the First 28 Days of Life
 Richard Cantor, MD, FACEP
Infants less than 30 days of age present the clinician with difficult challenges in diagnosis and proper disposition. This presentation will highlight the most common dermatologic, respiratory, gastrointestinal, and cardiac problems encountered in this population subset. Suggestions for appropriate work up, management, and care of these problems will be provided.

Objectives: 

  • Understand the causes of neonatal cough
  • Adequately perform a workup for the irritable neonate
  • Be familiar with common neonatal abdominal emergencies      
2:30 pm - 3:30 pm

Critical Care Tips and Tricks Every PA Should Know
Haney Mallemat, MD
Sepsis is a critical illness which requires prompt recognition and treatment to improve patient survival. There are several things that the Emergency clinician can do to improve the patients outcomes and many of these are inexpensive and easy to do. This lecture will give you several tips and tricks to improve the morbidity of your patients and save lives. 

Objectives:

  • Understand the three tiers of care for the critically-ill patient
  • Learn the updates to the Surviving Sepsis guidelines and how they apply to the Emergency Department patient. 
  • Learn some tips and tricks to improve the success of your central line placement.  
3:30 pm - 4:30 pm

Roundtable: PA Residencies/Fellowships
Lynn Scherer, PA-C 

3:30 pm - 6:30 pm

Workshop: Advanced Emergency Ultrasound 
Teresa Wu, MD; Haney Mallemat, MD
Emergency bedside ultrasound enhances patient care and improves patient safety. In the advanced emergency ultrasound courses, participants will learn how to perform diagnostic and life-saving bedside scans. Nationally renowned faculty will provide informative lectures, followed by small group scanning sessions where participants will have the opportunity to reinforce and augment their skills.

Objectives:

  • Learners will demonstrate understanding of the indications for performing a bedside ocular ultrasound and will demonstrate the KSA’s required for performing a bedside ocular ultrasound during a hands-on scanning session.
  • Learners will demonstrate the ability to recognize abnormalities such as retinal detachment, vitreous hemorrhage, lens dislocation, retrobulbar hematoma, globe rupture, and dilated optic nerve width.
  • Learners will demonstrate understanding of the indications for performing a bedside musculoskeletal (MSK) ultrasound and will demonstrate the KSA’s required for performing a bedside MSK ultrasound during a hands-on scanning session.
  • Learners will demonstrate the ability to recognize abnormalities such as muscle tears, tendon injuries, ligament rupture, fractures, joint effusions, and joint dislocations.
  • Learners will demonstrate understanding of the indications for performing a bedside emergency cardiac ultrasound and will demonstrate the KSA’s required for performing a bedside emergency cardiac ultrasound during a hands-on scanning session. 
  • Learners will demonstrate the ability to recognize abnormalities such as pericardial effusion, cardiac tamponade, RV dilation, basic wall motion abnormalities, and decreased ejection fraction.  
3:30 pm - 6:30 pm

Workshop: Procedures They Never Taught You that Will Change Your Practice (THIS IS A DIDACTIC WORKSHOP AND NOT HANDS-ON)
George Higgins, III, MD, FACEP
Easily mastered bedside procedures can benefit patients and add professional satisfaction to the life of a physician assistant. Many of these are learned “on the job”. These presentations will review mechanisms of common injuries and discuss in detail maneuvers that will correct them.

The following conditions will be reviewed in Part I:

  • Scalp lacerations
  • Occipital neuralgia
  • Vertigo (Epley Maneuver)
  • Orbital compartment syndrome
  • Peritonsillar abscess
  • Tooth avulsion
  • Temporomandibular joint subluxation
  • Posterior sterno-clavicular dislocation
  • Tension pneumothorax

The following conditions will be reviewed in Part II:

  • Shoulder dislocations
  • Nursemaid’s elbow
  • Transthecal digital blocks
  • Subungual hematoma
  • Hip dislocation
  • Patella dislocation
  • Knee dislocation
  • Ankle dislocation
  • Ankle/brachial Index calculation
  • Sacroliliac joint subluxation

Objectives:

  • PA’s in several specialties commonly encounter patients with acute injuries that can be managed with simple bedside procedures. 
  • These procedures are easily mastered and within the scope of usual PA practice. 
  • These presentations will sharpen up their ability to recognize and manage these injuries.   
3:30 pm - 6:30 pm

Workshop: Wilderness Medicine Skills(OTHER TIME SLOTS OFFERED)
Shana Tarter, WEMT, EMT-I, FAWM
Whether you're an avid outdoorsman or an urban dweller, join us in learning how to adapt and improvise and how these skills can be utilized in the wilderness/disaster setting as well as the Emergency Department. This workshop will introduce you to some of the more commonly used wilderness medicine skills and how to adapt your existing medical knowledge to a new environment. You’ll learn to build improvised splints with limited materials, to manage patients with spinal injuries in remote settings, and to prevent complications from long term care in the wilderness.  We’ll also discuss case studies from NOLS wilderness expeditions focusing on the lessons learned.

Objectives: 

  • Demonstrate construction of an improvised splint for an upper extremity, lower extremity and pelvic injury. 
  • Demonstrate the ability to apply multiple techniques to lift and move a patient with a spinal injury mechanism.
  • Demonstrate wilderness spinal immobilization.
  • Discuss long-term care strategies in a wilderness environment.
  • Learn from wilderness medicine case studies.
  • Discuss common methods of medical decision-making and their potential traps.   
3:30 pm - 7:30 pm

Workshop: Critical Management Skills for Acute Hand Injuries and Infections
Amy Keim, MS, PA-C ; James Marinucci; Ryan Strauss, PA-C, MPH, MPAS; Andrew Maurano, PA-C
More and more, emergency medicine PAs are being entrusted to handle simple to complex hand injuries and infections. Proper assessment and management is essential to ensuring good outcomes for the patient, and the PA. This workshop empowers emergency medicine providers with the critical knowledge and the most essential skills in managing acute hand injuries and infections within the setting of the ER.

Objectives: 

  • Perform a proper hand exam, identify and quantify deficits, and understand the significance of specific abnormal findings. 
  • Identify and manage common hand fractures and dislocations.
  • Choose appropriate methods of immobilizing hand injuries and infections.
  • Properly apply a variety of immobilization materials including plaster, aluminum, pre-formed and fiberglass splinting materials.
  • Identify and manage a variety of hand infections including paronychias, felons and tensosynovitis.
  • Perform proper peripheral anesthesia techniques including digit blocks and wrist level nerve blocks.
  • Manage a variety of acute finger injuries including distal tip amputations, nails plate and nail bed lacerations, and tendon lacerations.
  • Perform a variety of advanced wound repair techniques in the management of hand trauma. 

Wednesday, March 26, 2014

8:00 am - 8:30 am

Pediatric Gastroenteritis: Update on the State of the Art
Sean Fox, MD
Acute gastroenteritis is a common reason for visits to the emergency department, yet significant variation in care exists resulting in sub-optimal outcomes and increased expense to patients. The speaker will briefly review a standardized and evidence-based approach to treating gastroenteritis and dehydration. Evolving treatment evidence including use of oral vs. IV vs. subcutaneous rehydration, indications for effective use of ondansetron, and use of probiotics in the ambulatory setting also will be discussed.

Objectives:

  • Create an evidence-based standard approach to the child with acute gastroenteritis. 
  • Discuss the evidence for the indications and benefits of ondansetron. 
  • Define the indications and benefits for treatment with probiotics in the outpatient setting.  
8:30 am - 9:30 am

EM Literature Review …..Articles to Change Your Practice Part 1
George Higgins, III, MD, FACEP; Robert Dachs, MD
The emergency medicine medical literature continues to be published at an ever increasing rate. It is essential for acute care clinicians to be aware of high quality, evidence-based, and clinically relevant research that can improve the care provided to patients. However, busy clinicians cannot easily conduct comprehensive reviews of recent publications, grade their degree of rigor, and determine if they are influential enough to change practice. This presentation will provide physician assistants with summary reviews of recent high-value publications that should influence management plan decision making. The grade of evidence quality will be identified for each article presented. Several Take Home Points will be provided for each article.

A list of topics will not be provided at this time since publication selection will be made much closer to the conference date in order to ensure that the most recent information possible is presented..

Objectives:

  • Physician assistants benefit in many ways from being updated on high-quality, clinically relevant, and easily adopted Emergency Medicine/Acute Care research, including enhanced professional satisfaction and improved patient care.
  • These presentations will highlight some of this recently published research.  
9:30 am - 10:00 am

Kawasaki Disease: an EM Perspective
Sean Fox, MD
Fever is a very common complaint for the pediatric patient in the Emergency Department. Most often it is due to a relatively benign condition; however, a child with prolonged fever often raises the suspicion for Kawasaki Disease. This presentation will focus on the approach to diagnosing this concerning condition. It will also cover the even more elusive diagnostic strategy for Incomplete Kawasaki Disease.

Objectives:

  • Define the criteria to make the diagnosis of Kawasaki Disease.
  • Define the method to make the diagnosis of Incomplete Kawasaki Disease.
  • Discuss the management strategy for patients who you are concerned have Kawasaki Disease.  
10:30 am - 11:30 am

EM Literature Review …..Articles to Change Your Practice Part II
George Higgins, III, MD, FACEP; Robert Dachs, MD
The emergency medicine medical literature continues to be published at an ever increasing rate. It is essential for acute care clinicians to be aware of high quality, evidence-based, and clinically relevant research that can improve the care provided to patients. However, busy clinicians cannot easily conduct comprehensive reviews of recent publications, grade their degree of rigor, and determine if they are influential enough to change practice. This presentation will provide physician assistants with summary reviews of recent high-value publications that should influence management plan decision making. The grade of evidence quality will be identified for each article presented. Several Take Home Points will be provided for each article.

A list of topics will not be provided at this time since publication selection will be made much closer to the conference date in order to ensure that the most recent information possible is presented.

Objectives:

  • Physician assistants benefit in many ways from being updated on high-quality, clinically relevant, and easily adopted Emergency Medicine/Acute Care research, including enhanced professional satisfaction and improved patient care.
  • These presentations will highlight some of this recently published research.   
11:30 am - 12:30 pm Town Hall Meeting: SEMPA Update and Membership Meeting
SEMPA Board of Directors
12:30 pm - 1:30 pm

 10 Fatal Imaging Myths That Should Change Your Practice 
Joshua Broder, MD, FACEP 
Diagnostic imaging is vital to the evaluation of many patients in the emergency setting.  Misconceptions around imaging can delay or prevent correct diagnosis, resulting in morbidity and mortality.  The speaker will dispel common myths and explain the adverse consequences of medical misinformation.

Objectives:

 

  • describe common misconceptions around x-ray, ultrasound, and CT
  • explain the adverse consequences of these myths
  • provide accurate information to optimize imaging and patient care

 

1:30 pm - 2:00 pm

  Pediatric Management Myths: Is What You Were Taught Wrong?
Sean Fox, MD
Throughout the course of medical education, numerous beliefs are passed on as if they are facts.  This is particularly true regarding several commonly held beliefs pertaining to the care of children in the ED. During this session, the difference between myth and reality in the pediatric ED will be discussed, including myths about resuscitation techniques and medications as well as simple procedures.

Objectives:

  • Discriminate between myth and reality for several commonly held beliefs of pediatric management.
  • Discuss the evidence that supports the use of cuffed endotracheal tubes for some pediatric patients.
  • Judge the merits and safety of using epinephrine for digital blocks.
  • Judge the merits of the common belief that atropine needs to be used for premedication during RSI.
  • Discuss the optimal positioning for performing a lumbar puncture successfully.  
2:00 pm - 2:30 pm

 The Ouchless ED: Tips for Minimizing Pain and Anxiety in the Pediatric Patient 
Maureen McCollough, MD, FACEP
A visit to the ED is fraught with fearful and sometimes painful procedures for young children. This lecture will review ways that your ED can aim to be an "ouchless ED" through a variety of tools, medications, and protocols. 

Objectives:

  • Review some of the most painful or fearful procedures that children must face in the ED.
  • Review some of the variety of ways that can be used to lessen the pain and fear a child experiences including medications and devices.  
2:30 pm - 3:30 pm

Reading a Head CT: What Every PA Needs to Know 
Joshua Broder, MD, FACEP

3:30 pm - 6:30 pm

Workshop: Advanced Airway
Ken Butler, DO 
This workshop provides an in-depth look at effective airway management techniques that you will actually use in your next emergency airway. Instruction on skills and strategies for adult and pediatric intubation that promote patient safety and increase provider confidence.

Topics covered include: 

  • Orotracheal Intubation
  • Laryngoscopy
  • Surgical Airways (cricothyrotomy, tracheotomy)
  • Video Laryngoscopy
  • Fiberoptic Intubation
  • Nasotracheal Intubation
  • Pediatric Intubation
  • Rescue Ventilation devices such as the Laryngeal Mask Airway   
3:30 pm - 6:30 pm

Workshop: Wilderness Medicine Skills (THIS IS A REPEAT OF THE WORKSHOP GIVEN ON TUESDAY)
Shana Tarter, WEMT, EMT-I, FAWM 
Whether you're an avid outdoorsman or an urban dweller, join us in learning how to adapt and improvise and how these skills can be utilized in the wilderness/disaster setting as well as the Emergency Department. This workshop will introduce you to some of the more commonly used wilderness medicine skills and how to adapt your existing medical knowledge to a new environment. You’ll learn to build improvised splints with limited materials, to manage patients with spinal injuries in remote settings, and to prevent complications from long term care in the wilderness.  We’ll also discuss case studies from NOLS wilderness expeditions focusing on the lessons learned.

Objectives: 

  • Demonstrate construction of an improvised splint for an upper extremity, lower extremity and pelvic injury. 
  • Demonstrate the ability to apply multiple techniques to lift and move a patient with a spinal injury mechanism.
  • Demonstrate wilderness spinal immobilization.
  • Discuss long-term care strategies in a wilderness environment.
  • Learn from wilderness medicine case studies.
  • Discuss common methods of medical decision-making and their potential traps.    
3:30 pm - 6:30 pm

Workshop: Dental Procedures and Blocks for the Non-Dentist
Denise Ramponi, DNP, ENP-BC, FAEN, FAANP; Joseph Mattis, CRNP; Mary Jo Cerepani, DNP, FNP-BC, CEN
This interactive skill workshop will review the most common dental emergencies which frequently present to the emergency department, clinic, or urgent care center. Dental pain and caries, dental fractures, loose and avulsed teeth, as well as dry sockets, post-extraction bleeding and loose appliances (caps, crowns, filling) will be discussed. Dental and facial regional anesthesia will be reviewed utilizing case presentations and video. Simulation of the dental injections with capped syringes will be approximated on partners. Dental medicaments, glues and pastes will be mixed and applied to dental models. 

Objectives:

  • The clinician will acquire the confidence and skill set required to diagnose and treat the most common presenting dental emergencies. This includes a detailed understanding of dental and facial anatomy. 
  • The clinician will gain a better understanding of dental anesthetics and dental anesthetic equipment, along with the techniques necessary to perform supraperiosteal injections and infraorbital, inferior alveolar and mental nerve blocks. 
  • The clinician will gain experience n using common dental materials to cover tooth fractures, seal dental caries and splint loosened (subluxed, luxated) teeth. Loosened fillings, crowns and caps will also be discussed.  

Thursday, March 27, 2013

8:00 am - 9:00 am

Pediatric Neuro Complaints .. Giving you a Headache?
Maureen McCollough, MD, FACEP
This course will review a variety of pediatric neurological complaints from the more serious such as status epilepticus, to more common complaints such as headache. An algorithm for handling a child in status epilepticus will be presented. 

Objectives:

  • Review more common and usually less serious complaints such as headache in the pediatric patient.  
  • Review status epilepticus and understand a step-by-step approach to the child who is actively seizing.  
9:00 am - 10:00 am

Drinking from the Fire Hose: Making Sense of On-Line Resources and Free Open Access Meducation
Joseph Lex, Jr., MD, FACEP, FAAEM, MAAEM
If you want to know how we practiced medicine 5 years ago, read a textbook.  If you want to know how we practiced medicine two years ago, read a journal article.  If you want to know how we practice medicine now, go to a good conference like this one.  But if you want to know how we will practice medicine in the future, listen in the hallways and use FOAM – Free Open Access Meducation.  We have entered an era when self-education is king, and the tools for self-education are available on the web – blogs, podcasts, tweets, and personal exchanges – at no charge.  Self-directed asynchronous learning acknowledges that adults learn best by being self-directed, problem-orientated and by relating new knowledge to past experiences.  Learn how to take responsibility for your own learning and develop the skills you will need for differentiate pedagogy from androgogy and heutagogy and explain why the latter two are more important for adult learners. 

Objectives:

  • Describe an efficient way to keep up with emergency and critical care blogs and podcasts.
  • Explain why Twitter can be a valuable teaching and learning tool.
  • Clarify how crowd sourcing can be a more valuable tool than peer review.   
10:30 am - 11:30 am

The Crashing Airway
Ken Butler, DO 
This session will answer the question of "Which patients have the potential to develop a crash airway?". Clinical scenarios will be discussed in depth to teach the provider how to rescue the airway. These conditions include suspected high intracranial pressure (eg, TBI, intracranial hemorrhage ), severe asthma or COPD, hypovolemic shock, aortic emergencies, and pediatric emergencies.

We will answer these questions in airway management: 

  • Is RSI  indicated in a patient who are unconscious and apneic? 
  • Which clinical scenarios call for pretreatment medications prior to induction/paralysis to optimize physiologic parameters for intubation.  
11:30 am - 12:30 pm

High-Risk Orthopedics: Training Your Eye to See the Injury
Joseph Lex, Jr., MD, FACEP, FAAEM, MAAEM
Missed fractures are still a common cause of litigation in the emergency department. This session will cover the most commonly missed adult and pediatric orthopedic injuries that can lead to a bad outcome. You will learn decision points to determine who is at risk and train your eye to find the injury. 

Objectives:

  • Explain why a missed Salter V fracture can be so devastating.
  • Discuss a common-sense approach to ruling out a compartment syndrome.  
  • Describe the significance of a Segond fracture.   

 

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