Experience ACEP13. Abdominal Disorders. Abdominal Pain After Bariatric Surgery: What Are the Issues?

Transcription

1 Experience ACEP13 Abdominal Disorders Abdominal Pain After Bariatric Surgery: What Are the Issues? WE-219 / 1 Hour Faculty: Brian Lin, MD Wednesday, October 16 / 12:30 PM - 1:20 PM The percentage of patients who have had bariatric surgery continues to climb, and there are many different procedures. When these patients develop abdominal pain, even long after the immediate post-op period, how does the differential diagnosis change? When is an NG tube contraindicated? Should all of these patients have a surgical consultation? CT scan? How long after their surgery are these steps relevant? The speaker will answer all of these questions and more to give you the knowledge to treat these patients. Abdominal Vascular Emergencies: Detection, Diagnosis, and Decision WE-267 / 1 Hour Faculty: Brian Lin, MD Wednesday, October 16 / 4:30 PM - 5:30 PM The presentation of abdominal vascular emergencies range from dramatic to subtle, and the consequences of missing the diagnosis can be devastating. The range of diagnostic modalities has increased with the advent of limited ultrasound in the ED, improved CT imaging, and increased availability of MRI/MRA. The speaker will present an EM detection strategy to help diagnose aortic dissection, aortic aneurysms, and mesenteric ischemia. The Aging Abdomen: Subtle Case Presentations MO-57 / 1 Hour Faculty: Diane M. Birnbaumer, MD, FACEP Monday, October 14 / 4:30 PM - 5:30 PM Catastrophic disorders present differently in the geriatric population. Identify what signs and symptoms to look for to avert disaster. The speaker will cover select cases in the elderly population that illustrate important clinical presentations of diseases you don t want to miss. CT in Abdominal Pain: Critical Answers to Difficult Questions WE-240 / 1 Hour Faculty: Phillips Perera, MD, RDMS, FACEP Wednesday, October 16 / 1:30 PM - 2:20 PM Emergency physicians increasingly rely on abdominal CT to diagnose patients presenting with abdominal pain. Is contrast necessary? When is abdominal CT not enough in excluding abdominal pathology? Can patients with a normal abdominal CT scan be safely discharged from the ED? The speaker will discuss radiation risk associated with multiple CT exposure, adjustment of scanning protocols to decrease radiation dosage, and alternate studies to avoid exposure.

2 Rapid Fire: GI Foreign Bodies Benign or Bad? TU-160 / 30 Minutes Faculty: Swaminatha Mahadevan, MD, FACEP Tuesday, October 15 / 4:30 PM - 4:55 PM Just about everyone has a story of a patient who presented to the emergency department with a GI foreign body. Some are dangerous and some are not. The speaker will give a quick evidencebased review of the latest thinking in upper and lower GI foreign body management. You haven t seen or heard it all until you ve seen this lecture! Rapid Fire: Getting to the Bottom of Lower GI Bleeding WE-193 / 30 minutes Faculty: Jeremy B. Branzetti, MD Wednesday, October 16 / 9:00 AM - 9:25 AM Melena, BRBPR, black and sticky which are likely lower GI bleeds? What are the current updates in therapy? The speaker will present evidence-based pearls for diagnosis, resuscitation, and definitive management of lower GI bleed. Rapid Fire: Wait! There s a Baby in There Abdominal Imaging of the Pregnant Patient WE-266 / 30 Minutes Faculty: Phillips Perera, MD, RDMS, FACEP Wednesday, October 16 / 4:30 PM - 4:55 PM Everyone dreads the patient who has abdominal pain and also has a positive pregnancy test. The speaker will present the latest evidence-based thinking on the use of abdominal imaging in the pregnant patient. How much radiation is there in a plain film? A CT scan? What if ultrasound doesn t give me the answer that I m looking for? When do we use MRI? You will leave this session feeling more comfortable knowing what the risks are and what to tell the next pregnant patient who you think needs abdominal imaging. Update on Upper GI Bleeding WE-203 / 30 Minutes Faculty: Jeremy B. Branzetti, MD Wednesday, October 16 / 9:30 AM - 9:55 AM Be prepared for the unstable patient with hematemesis by knowing the cutting-edge therapies and reviewing the classic treatments of acute upper GI bleeds. The speaker will discuss the pros and cons of using a Blakemore tube for hemostasis. With new anticoagulants coming to the market in droves, the emergency physician will face a new generation of patients with life-threatening bleeding.

3 Experience ACEP13 Airway, Anesthesia, Analgesia Advanced Airway Techniques Lab TU-76; TU-119; TU-150; WE-182; WE-227; WE-256 / 2 Hours Tuesday Faculty: Michael A. Gibbs, MD, FACEP (Moderator); Calvin A. Brown, III, MD; Michael G. Gonzalez, MD, FACEP; Nathan W. Mick, MD, FACEP; Ali S. Raja, MD, MBA, MPH, FACEP; John C. Sakles, MD, FACEP Wednesday Faculty: Michael R. Baumann, MD, FACEP (Moderator) Tuesday, October 15 / 8:00 AM - 9:50 AM; 12:30 PM 2:20 PM; 3:30 PM 5:30 PM Wednesday, October 16 / 8:00 AM - 9:50 AM; 12:30 PM 2:20 PM; 3:30 PM 5:30 PM Emergency physicians must be experts in airway management. This lab is designed to provide you with hands-on experience in several airway management techniques, including: open and percutaneous cricothyrotomy, intubating LMA, Bougie, Combitube, intubating stylet, and hand-held fiberoptic technology (Glidescope, Shikani Optical Stylet, Levitan Scope, RIFL). (Prior attendance in Unexpected Difficult Airway: How to Avoid It and How to Manage It is required. This lab is limited to 35 participants.) Blocks Unblinded: Ultrasound-Guided Regional Anesthesia MO-43 / 1 Hour Faculty: Michael B. Stone, MD, RDMS Monday, October 14 / 3:30 PM - 4:20 PM Regional anesthesia plays an important role in minor ED procedures, particularly in situations where sedation or parenteral medication is inappropriate; however, the tried and true landmarkbased techniques leave much to be desired. Increasingly, bedside ultrasound is being used as a visual adjunct for nerve blocks, particularly of the extremities. The speaker will offer a wide range of examples where ultrasound can truly guide your regional block, increasing success rates and decreasing dependence on procedural sedation options. (This lecture is a prerequisite to the Ultrasound-Guided Regional Anesthesia Lab.) Delayed Sequence Intubation? Rethinking Convention WE-251 / 1 Hour Faculty: Scott D. Weingart, MD, FACEP Wednesday, October 16 / 3:30 PM - 4:20 PM Conventional teaching is that emergency airway management is typically best accomplished with the use of rapid sequence intubation (RSI); however, patients may experience rapid, and sometimes fatal, decompensation in the peri-intubation period. This presentation will challenge standard dogma by exploring the concept of delayed sequence intubation through a review of pertinent respiratory physiology and the latest medical literature. The speaker will cover practical pearls, as well as avoidable pitfalls, which will be useful for your very next shift. Is DL a Dinosaur? The Role of Video Laryngoscopy in 2013 & Beyond: Point/Counterpoint WE-270 / 1 Hour Faculty: Michael A. Gibbs, MD, FACEP; Robert J. Vissers, MD, FACEP, FRCPC Wednesday, October 16 / 4:30 PM - 5:30 PM The role of video laryngoscopy in EM practice has rapidly evolved over the past decade. The speakers will discuss the current literature comparing video laryngoscopy with standard direct laryngoscopy (DL) in the management of both routine and difficult airways in the ED setting. Further, controversies such as use of video laryngoscopy as the routine first line in airway management versus its use as a helpful airway adjunct (or rescue device) will be discussed.

4 Novel Approaches to Old Problems: Pain Management Pathways WE-212 / 1 Hour Faculty: James Ducharme, MD Wednesday, October 16 / 10:00 AM - 10:50 AM Pain is the number one ED patient complaint. Are you implementing the best approach to alleviate your patient s pain? How does your management differ for the patient with acute versus chronic pain? The speaker will review the most current recommendations for adequately alleviating the ED patient s pain and improving their overall satisfaction. The pros and cons of low-dose ketamine, nasal fentanyl, fentanyl patches, multimodal therapy, patient-controlled analgesia, and more will be discussed. Palliative Care Toolkit: Palliative Care and the Dying Patient TU-116 / 1 Hour Faculty: Mark S. Rosenberg, DO, MBA, FACEP Tuesday, October 15 / 12:30 PM - 1:20 PM As the population ages, we will continue to see more patients suffering from chronic, serious, and life-limiting illnesses which may make it more appropriate to focus on the patient s goals of care and quality of life rather than quantity of life. The team approach to palliative care in the ED focuses on relief of symptom distress and suffering, helping patients and their families understand the prognosis of the underlying condition, and assisting them in choosing between a spectrum of treatment options that neither hasten nor postpone death. Leave this presentation full of tips when caring for your next palliative care patient in the ED. The speaker will review palliative medicine strategies for the actively dying patient and for the patient with hours to weeks to live. Pediatric Airway Panic or Advanced Pediatric Airway Management TU-117 / 1 Hour Faculty: Maureen McCollough, MD Tuesday, October 15 / 12:30 PM - 1:20 PM Do you panic when there is an agitated, semiconscious infant or toddler with a compromised airway in the ED? The ability to manage a child s airway quickly is one of the most important, lifesaving skills an emergency physician can possess. The speaker will address indications for invasive versus non-invasive airway management, RSI, correct drug dosages, unique indications for pharmacologic agents, and tube dimensions for children of various ages. Highlights will include airway management in neonates and other useful airway management tips to provide meaningful quality care for this special population. Procedural Sedation: The Finer Points TU-136 / 1 Hour Faculty: Sanjay Arora, MD Tuesday, October 15 / 1:30 PM - 2:20 PM What are you using for procedural sedation? Ketamine? Propofol? Ketofol? Nitrous Oxide? How important is patient selection and pre-procedure evaluation? Did you know that there are Medicare reimbursement standards for procedural sedation? Using a case-based approach, the speaker will discuss the nuances of common therapeutic agents and the finer points of sedation in the ED setting, including key pearls and avoidable pitfalls.

5 Ultrasound-Guided Regional Anesthesia Lab TU-82; TU-126; TU-156; WE-188; WE-233; WE-262 / 2 Hours Tuesday Faculty: Michael B. Stone, MD, RDMS (Moderator) Wednesday Faculty: Andrew Herring, MD (Moderator) Tuesday, October 15 / 8:00 AM - 9:50 AM; 12:30 PM - 2:20 PM; 3:30 PM - 5:30 PM Wednesday October 16 / 8:00 AM - 9:50 AM; 12:30 PM - 2:20 PM; 3:30 PM - 5:30 PM During this hands-on lab, participants will perform simulations of all the regional anesthesia blocks described in the lecture (distal forearm, brachial plexus, femoral, cluneal, paraspinal, popliteal, etc.). Attendees will employ the use of phantoms, patient models, and their fellow participants as anatomic fodder. A representative sample of currently available ultrasound machines will be used. (Prior attendance in Blocks Unblinded: Ultrasound-Guided Regional Anesthesia is required. This lab is limited to 30 participants.) The Unexpected Difficult Airway: How to Avoid It and How to Manage It MO-52 / 1 Hour Faculty: Michael A. Gibbs, MD, FACEP Monday, October 14 / 3:30 PM - 4:20 PM Nothing is more stressful for the emergency physician than a cannot intubate, cannot ventilate airway scenario. To stay out of trouble, the emergency physician must possess the skills to identify the potentially difficult airway before a management approach is chosen and executed. In addition, a sophisticated understanding of contemporary airway rescue techniques and mastery of these is crucial. (This course is a prerequisite to the Advanced Airway Techniques Lab.)

6 Experience ACEP13 Cardiovascular Disorders ACLS Guidelines 2013: What the Emergency Physician Has to Know WE-215 / 30 Minutes Faculty: Michael E. Winters, MD, FACEP Wednesday, October 16 / 10:30 AM - 10:55 AM The last decade has seen many changes occur to the ACLS algorithms. Are these changes evidence-based and really the best science has to offer? The presenters will discuss the latest in recommendations from the American Heart Association and use what is in the literature to back up these new guidelines. Are we really doing what is best for our patients based on the latest literature? You be the judge! Acute Decompensated Heart Failure: Cutting-Edge Therapies to Benefit Now and Later TH-276 / 1 Hour Faculty: Matthew Strehlow, MD Thursday, October 17 / 8:00 AM - 8:50 AM The treatment of congestive heart failure (CHF) has remained relatively static for years. Not anymore! Utilization of cardiac biomarkers assists in both the diagnosis and treatment of CHF. The presenter will focus on cutting-edge therapies for decompensated CHF such as controversial nesiritide, high-dose nitroglycerin, ACE inhibitors, and noninvasive ventilation. Using aggressive management protocols not only reduces morbidity and mortality in the short-term but also in the long-term in the form of reduced re-admission rates. Advanced Electrocardiography Workshop Part I: Myocardial Ischemia and Its Mimics MO-15 / 2 Hours Faculty: Amal Mattu, MD, FACEP Monday, October 14 / 11:30 AM - 1:20 PM One of the first priorities in ECG analysis is to look for patterns of injury. Myocardial ischemia can be subtle on an ECG and can be mimicked by several pathological processes. The speaker will focus on a diagnostic approach to the recognition of myocardial ischemia. Differentiation from other diseases and normal variants also will be reviewed. By the time you are finished, you won t be fooled by mimickers of ischemia, and recognition of acute coronary syndromes on ECG will be second nature. Advanced Electrocardiography Workshop Part II: Dysrhythmias and Syncope TU-151 / 2 Hours Faculty: Amal Mattu, MD, FACEP Tuesday, October 15 / 3:30 PM - 5:30 PM The ECG is an essential tool not only for arrhythmia detection and analysis but can also risk stratify for disorders like syncope. Having the tools to diagnose a dysrhythmia is essential for the emergency physician with implications of not only treatment but disposition as well. Using a case-based approach, the speaker will review advanced dysrhythmia analysis.

7 Advanced Recognition and Treatment of Bradycardias and Blocks WE-268 / 1 Hour Faculty: Preeti Jois, MD, FACEP Wednesday, October 16 / 4:30 PM - 5:30 PM During this course, the speaker will present a brief overview of the practical anatomy and physiology relevant to bradyarrhythmias. This will be followed by a review of identification, management, and disposition of patients with bradyarrhythmias, conduction blocks, and drug electrolyte-induced cases. An interactive session of clinical cases and ECGs also will be included. Particular emphasis will be placed on accepted management modalities, and comments will be made on therapeutic controversies. Advanced Recognition and Treatment of Tachycardias TH-297 / 1 Hour Faculty: Preeti Jois, MD, FACEP Thursday, October 17 / 10:00 AM - 10:50 AM Through an interactive session of clinical cases and ECGs, the speaker will review identification, management, and disposition of patients with atrial and ventricular tachycardias. Particular emphasis will be placed on accepted management modalities and comments will be made on therapeutic controversies. Aortic Dissection WE-237 / 30 Minutes Faculty: Kevin C. Reed, MD, FACEP Wednesday, October 16 / 1:30 PM - 1:55 PM Thoracic aortic dissection is an uncommon but extremely lethal condition of which emergency physicians should be keenly aware. Aortic dissection has a high mortality rate and is commonly missed for a number of reasons. This presentation will highlight why the diagnosis is missed and what emergency physicians can do to decrease their miss rates. Cardiac CTA TU-112 / 1 Hour Faculty: David F. M. Brown, MD, FACEP; Benjamin Lawner, DO Tuesday, October 15 / 12:30 PM - 1:20 PM Evaluation of chest pain patients is common place in emergency departments. A key issue for emergency physicians relates to the disposition of the lower risk chest pain patient. CT coronary angiography has been touted as a diagnostic strategy to help risk stratify patients who present to the ED with chest pain. What chest pain patients, if any, should get a coronary CT scan? What types of findings predict good outcomes? What dose of radiation is imparted with CT coronary angiography? Should we even be ordering this test in the emergency department? Chest Pain in the ED: Is One Troponin Enough? TH-310 / 1 Hour Faculty: David H. Newman, MD, FACEP Thursday, October 17 / 11:00 AM - 11:50 AM Chest pain is a constant challenge for emergency physicians, and the literature on how best to handle potential coronary chest pain patients continues to emerge. Unfortunately, guidelines have failed us while the pressure to find safe, efficient solutions to the problem is mounting. The speaker will review the most recent literature on the topic, and will generate a portable, reasonable, safe approach to chest pain that can be individualized to patients and settings. Familiarity with the emerging literature and the most current risk data is the best way to ensure your patients benefit.

8 Coming to an ED Near You: The LVAD Patient! MO-55 / 30 Minutes Faculty: J. Scott Wieters, MD Monday, October 14 / 4:00 PM - 4:25 PM End-stage congestive heart failure and other severe cardiac conditions are increasingly being treated with the use of left ventricular assist devices (LVAD). Patients with complications related to these devices will obviously seek medical attention in the emergency department, so it is crucial for emergency physicians to be aware of the complications associated with LVAD use. Armed with some basic, yet very important information, the emergency physician will be in a position to provide cutting-edge care to our most complicated cardiac patients. The Crashing Patient: Clinical Pearls for Pre- or Post-Cardiac Arrest WE-206 / 1 Hour Faculty: Matthew Strehlow, MD Wednesday, October 16 / 10:00 AM - 10:50 AM Most patients in cardiac arrest have a dismal prognosis regardless of their management. On the other hand, it is the patient in the peri-arrest period the crashing patient in whom a significant improvement in outcome can be achieved. The speaker will discuss some critical considerations and interventions for patients who are in the peri-arrest period that can result in the difference between life and death. Cruising the Literature: Cardiology 2013 WE-250 / 1 Hour Faculty: Corey M. Slovis, MD, FACEP Wednesday, October 16 / 3:30 PM - 4:20 PM Medical journals abound with cardiology articles, and numerous multi-center trials have recently been published. New drugs are being introduced, existing medications have changing indications, and diagnostic and management strategies are being evaluated. Which of these articles should you integrate into your practice? The speaker will review the most important cardiology articles from the past year s literature that will directly impact your patients. From Paper to Patient: Recent Advances in Emergency Electrocardiography That Will Save a Life MO-63 / 1 Hour Faculty: Amal Mattu, MD, FACEP Monday, October 14 / 4:30 PM - 5:30 PM Tremendous advances have been made in the field of electrocardiography in the past several years. We are now able to detect subtleties which may literally mean either detection of disease and/or changing management that can save lives. Join this expert in finding and utilizing electrocardiographic pearls buried in years of bench studies. Once you have finished this review, you will not only have skills in new and improved methods of ECG analysis, but you will have the literature to back you up. Hypertensive Emergencies: Drugs, Drips, and Drops WE-177 / 1 Hour Faculty: Michael E. Winters, MD, FACEP Wednesday, October 16 / 8:00 AM - 8:50 AM Hypertension is an extremely common condition that is treated by emergency physicians on a daily basis. Several hypertensive emergencies necessitate the use of antihypertensive drip medications. The speaker will highlight common hypertensive emergencies and what antihypertensive drip medications to use. Useful pearls and pitfalls when dealing with the hypertensive patient will also be discussed.

9 I m Clear You re Clear, We re All Clear! Continuous CPR During Defibrillation MO-42 / 30 Minutes Faculty: J. Scott Wieters, MD Monday, October 14 / 3:30 PM - 3:55 PM We were all taught that we will get shocked if we are even close to a patient being defibrillated, but there is no data supporting this belief. We know that stopping compressions for any reason can reduce the possibility of return of spontaneous circulation and patient recovery. Learn why you may not need to stop CPR for any procedures, including defibrillation. New Cardiac Drugs: How, What, and When to Use Them in the ED WE-275 / 30 Minutes Faculty: David F. M. Brown, MD, FACEP Wednesday, October 16 / 5:00 PM - 5:30 PM Each year new medications are developed to assist us in our management of cardiac disease. These include anticoagulants, antiplatelet agents, and anti-hypertensives. The speaker will present a literature review of these new drugs and compare the medications to those currently available. A discussion of case presentations to reinforce concepts also will be included. Pacemakers and AICDs: Short Circuit of the Electronic Heart TU-92 / 1 Hour Faculty: Tarlan Hedayati, MD, FACEP Tuesday, October 15 / 9:00 AM - 9:50 AM The expanding use of technology for acute and chronic electrical therapy of dysrhythmias is complex. Emergency physicians must have an understanding of the various devices that utilize electrical therapy for either rate-related control or cardioversion/defibrillation for malignant dysrhythmias. Using a case-based approach, the presenter will review the identification and management of normal and abnormal function of implantable electronic devices. Syncope with a Lethal Twist TU-168 / 1 Hour Faculty: Benjamin Lawner, DO Tuesday, October 15 / 4:30 PM - 5:30 PM Life-threatening conditions can present as fainting or syncope in children and young adults. Patients often present to the ED with no complaints after a syncopal episode. If not identified appropriately, these conditions can result in morbidity and death. Using a case-based approach, the speaker will discuss how to identify these rare but important syndromes including Brugada syndrome, subarachnoid hemorrhage, subaortic stenosis, long QT syndrome, congenital heart disease, pulmonary embolus, and aortic dissection. Therapy STEMI: Update 2013 WE-218 / 30 Minutes Faculty: Tarlan Hedayati, MD, FACEP Wednesday, October 16 / 12:30 PM - 12:55 PM Outcomes in patients with ST elevation myocardial infarction (STEMI) have improved significantly over the past decade. Each year new therapies are developed and existing therapies modified to improve outcomes in these patients. The speaker will review the support for the use of therapies specific to STEMI, such as reperfusion strategies, antiplatelet agents, anticoagulation medications, and antithrombin therapies.

10 Therapy for Non-ST Elevation ACS: Update 2013 WE-247 / 30 Minutes Faculty: Tarlan Hedayati, MD, FACEP Wednesday, October 16 / 2:00 PM - 2:25 PM A number of established and new therapies exist in the management of patients with non- ST elevation myocardial infarction and unstable angina. Every year, however, these therapies are updated or changed completely. The speaker will review the most recent literature on risk stratification and treatment of NSTEMI. Therapies, such as heparin, nitrates, antiplatelet agents, antithrombins, and percutaneous coronary interventions will be reviewed, using the latest literature and guidelines. Updates in the Management of Acute Atrial Fibrillation MO-30 / 30 Minutes Faculty: Benjamin Lawner, DO Monday, October 14 / 1:30 PM - 1:55 PM Management of atrial fibrillation can be extremely challenging. How does the emergency physician most effectively manage these patients? By providing rate control or conversion to sinus rhythm? More importantly, how does the emergency physician decrease the risk of stroke, and what approach should be used in anticoagulation? Other issues for this increasingly common condition, such as indications for admission and commonly encountered pitfalls, will be discussed.

11 Experience ACEP13 Critical Care Beyond EM: Emergent Interventions in the Developing World TH-309 / 1 Hour Faculty: Ravi S. Morchi, MD Thursday, October 17 / 11:00 AM - 11:50 AM Many emergency physicians spend a significant portion of their practice volunteering and working on the international front. A wide range of medical environments exist - from urban centers with specialists and modern EDs to rural settings in villages without organized EM. What can the EP learn from these practice environments and what skills can be brought back to improve care in the US? The speaker will discuss the bedside diagnosis and treatment of critical surgical emergencies in resource-poor, rural settings and share lessons learned about the impact abroad and the potential impact at home. Critical Care: An Interactive Experience TU-152 / 2 Hours Faculty: Evie G. Marcolini, MD, FACEP; Tiffany M. Osborn, MD, FACEP Tuesday, October 15 / 3:30 PM - 5:30 PM ED management of critically ill patients has been shown to benefit patients in decreasing morbidity, mortality, and length of hospital stay. With the development of non-invasive technologies for hemodynamic assessment, it is reasonable to predict that future emergency physicians may be expected to obtain, interpret, and act upon these measures. During this workshop, the speakers will use a case-based format to walk participants through developing a differential diagnosis and choosing a diagnostic and therapeutic strategy. (This course is limited to 50 participants.) From Ordinary to Extraordinary: Critical Care Medicine in the ED WE-195 / 1 Hour Faculty: David Pearson, MD, FACEP Wednesday, October 16 / 9:00 AM - 9:50 AM Whether you have mastered early goal-directed therapy or are just beginning to manage critical patients in the ED, there are a multitude of management options for extraordinary critical care. Bolus dose pressors, high frequency oscillatory ventilation, and delayed sequence intubation may sound out of the ordinary, but if they happen to be used in your ED you want to be prepared. The ICU Is Not Ready For Your Critical Patient, Are You? TU-148 / 1 Hour Faculty: Michael E. Winters, MD Tuesday, October 15 / 3:30 PM - 4:20 PM So you ve intubated, ventilated, and fluid resuscitated your critically ill patient. The ICU is not ready or there are no beds. Now what? What else should you be thinking about? How can you involve the ICU in the care of the patient before the patient is transferred? This case-based presentation will review the most common post-resuscitation issues in critically ill patients. After this lecture, you will be better equipped to anticipate and manage these issues in your ICU-bound patient before they become major problems!

12 Just the Pearls: Bedside Tips and Tricks for the Critically Ill Patient TH-288 / 1 Hour Faculty: Scott D. Weingart, MD, FACEP Thursday, October 17 / 9:00 AM - 9:50 AM A critically ill patient in the ED can utilize a substantial amount of resources and time. The speaker will cover 20 topics, distilling it all down to just the pearls. This is the ultimate lecture for the ADHD emergency physician. The speaker will also present strategies and skills to enable rapid assessment and treatment of the critically ill patient. Neuro-Critical Care: What Every Physician Needs to Know TU-101 / 1 Hour Faculty: Evie G. Marcolini, MD, FACEP Tuesday, October 15 / 10:00 AM - 10:50 AM Whether you are in a big city trauma center or what seems like a rural medical outpost, there are time-critical actions that every emergency physician must know when caring for the neurologically injured patient. Who gets a hole in their head? Who get intubated? Who gets osmotic therapies? The speaker will focus on fundamental care of the critically ill patient with neurological injury complexes. From monitoring these patients to controversies surrounding some of the most common neurological illnesses, this course is not to be missed. Protect that Airway! The Perils of Intubating and Sedating a Critically Ill Patient WE-265 / 30 Minutes Faculty: Tarlan Hedayati, MD, FACEP Wednesday, October 16 / 4:30 PM - 4:55 PM The decision to intubate a critically ill patient is often multifaceted. Careful consideration of the pharmacotherapy used in these patients needs to be addressed before, during, and after intubation. Does it make a difference which agents are used to perform the intubation of a patient with sepsis due to pneumonia? What medications can be administered to the hypotensive trauma patient who is in pain? What is the safest method of sedating the uncooperative, combative patient? You will learn the answers to these difficult problems during this case-based presentation. Rapid Fire: Push Dose Pressors TU-96 / 30 Minutes Faculty: Tiffany M. Osborn, MD, FACEP Tuesday, October 15 / 9:30 AM - 9:55 AM Your patient is diaphoretic, ashen, and has a BP of 55/P. Push dose pressors have been advocated as an effective temporizing therapy for the severely hypotensive patient. Which patients would benefit? What are your choices? How should they be dosed? What is the evidence? The speaker will use a case-based format to illustrate how to best use epinephrine, phenylephrine, and other agents to help you manage critical hypotension. You don t want to miss the high-yield pearls in this 30 minute session! Rapid Fire Critical Care: Speed Em Up, Slow Em Down TU-130 / 30 Minutes Faculty: Jeffrey Sankoff, MD, FACEP Tuesday, October 15 / 1:30 PM - 1:55 PM Arrhythmias are common and more life-threatening to the critically ill patient. This rapid fire session will quickly review the most common arrhythmias associated with critical care patients, review therapeutic interventions, and discuss considerations specific to the critical care patient.

13 Rapid Fire Critical Care: Critical Asthma Management WE-236 / 30 Minutes Faculty: David Pearson, MD, FACEP Wednesday, October 16 / 1:00 PM - 1:25 PM Preventing intubation is one of the most important things you can do to help the critical asthmatic. What do you need to do and consider when your asthmatic is failing nebs and steroids? What new therapies and alternatives are available to the emergency physician? If you have to intubate an asthmatic, how can you minimize morbidity associated with ventilation? This short, rapid fire lecture will provide the most up-to-date approach to the critical asthmatic. Rapid Fire Critical Care: Warm Em Up, Cool Em Down WE-264 / 30 Minutes Faculty: David Pearson, MD, FACEP Wednesday, October 16 / 4:00 PM - 4:25 PM Therapeutic hypothermia and core rewarming have become staples in the management toolbox of emergency physicians. The speaker will present the latest issues, guidelines, and management recommendations. Come listen to this quick-hit, just-the-facts session, and leave with the latest pearls. Trends in Critical Care for the Busy Emergency Physician TU-137 / 1 Hour Faculty: Peter M. DeBlieux, MD, FACEP Tuesday, October 15 / 1:30 PM - 2:20 PM Wouldn t it be great if you could pull a critical care expert out of your pocket to manage the sickest of the sick? During this interative session, the speaker will discuss the latest trends in ED critical care management that will make a real difference and help you safely land the crashing patient. Determine the best strategies for stabilizing the patient with rapidly dropping saturation, undifferentiated shock, coagulopathy, sepsis, and the brain injured patient with progressively deteriorating neurological status. Undifferentiated Shock: Making a Difference WE-254 / 1 Hour Faculty: Matthew Strehlow, MD Wednesday, October 16 / 3:30 PM - 4:20 PM Emergency physicians can easily identify patients suffering from uncompensated shock the patient s vital signs are grossly abnormal and they look ill. The challenge lies in identifying patients with early, compensated shock. Using a case-based approach, the speaker will discuss novel approaches to identifying, treating, and monitoring patients suffering from shock. Audience participation will be encouraged.

14 Experience ACEP13 Critical ED Management Applying the Principles of Lean Management to Healthcare MO-58 / 1 Hour Faculty: Thom A. Mayer, MD, FACEP Monday, October 14 / 4:30 PM - 5:30 PM Improving ED operations and processes is one of our biggest challenges. Many past modalities have attempted to attain improvements, including total quality management, Six Sigma, rapid cycle testing, and patient satisfaction initiatives. Lean management, developed by Toyota as part of its Toyota Production System (TPS), is a methodology to accelerate the pace of improvement in healthcare. Through the use of case studies, the speaker will discuss how lean management principles can be applied in the ED. Benchmarking Your Way To Success TH-317 / 1 Hour Faculty: Robert J. Vissers, MD, FACEP, FRCPC Thursday, October 17 / 12:00 PM - 1:00 PM ED benchmarking standards provide the tools required to optimize how your department functions. Practical solutions and management techniques will be explored to optimize financial performance, patient satisfaction, throughput, and quality scores. Define the ED benchmarks you need to ensure your department is viewed as a winner by your hospital administration, the hospital board, and your medical staff colleagues. Harness this information to enhance patient flow and departmental revenue. Challenges From Behind the Medical Director s Closed Doors MO-18 / 1 Hour Faculty: Michael Silverman, MD, FACEP Monday, October 14 / 12:30 PM - 1:20 PM Based on his popular column The Director s Corner, the speaker will use a case-based format to present and review several dilemmas and complex administrative decisions made by medical directors. The medical director faces challenges throughout the hospital - whether it s addressing the clinically adept, but interpersonally incompetent physician or the intensivist trying to sabotage your leadership. How do you ensure that patients receive great care, that emergency physicians and staff members work in an unfettered environment, and that you address hospital administration s strategic goals and fiscal responsibility? Even experienced medical directors require a road map sometimes to get through the day. Everyday Leadership: Secrets From Great Minds Through the Ages TU-71 / 1 Hour Faculty: Amal Mattu, MD, FACEP Tuesday, October 15 / 8:00 AM - 8:50 AM Individuals want to follow successful leaders. This definition implies nothing about titles, money, or delegated power. History is rife with examples of ordinary people becoming great leaders as well as figureheads who were not great leaders. The difference was often simple behaviors and attitudes. The speaker will discuss qualities and characteristics of truly successful leaders. Participants will acquire new leadership skills and translate these skills for success in all walks of life, whether as a national leader, emergency physician, spouse, and/or parent.

15 Hospital-Wide Patient Flow: Cracking the Code WE-242 / 1 Hour Faculty: Kirk B. Jensen, MD, MBA, FACEP Wednesday, October 16 / 1:30 PM - 2:20 PM Are excessive waits, delays, and boarders in your ED inevitable? It seems that way if your attempts to improve flow only focus on the ED. Improving patient flow is a campaign for the entire healthcare system. The speaker will teach you how to identify and effectively deal with the constraints and bottlenecks that backup patient flow within your hospital. Methods of moving patients out the back door of the ED in order to aid you in opening up the front door will also be discussed. Negotiating for Success TU-120 / 2 Hours Faculty: Robert W. Strauss, Jr., MD, FACEP Tuesday, October 15 / 12:30 PM - 2:20 PM Like it or not, every time you interact with somebody to accomplish what doesn t already exist, you are negotiating. Sharpen your survival skills with this highly interactive presentation covering the fundamental principles central to negotiating. Whether trying to hammer out the details of a complex negotiation or a simple every day family discussion, meeting the needs of both parties can be tricky. This presentation will help you to comprehend the principles of negotiation, improve your skills, and help you and the other person get what you each want. (This course is limited to 40 participants). Number Needed to Treat: Pinpointing ED Interventions that Matter Most WE-198 / 1 Hour Faculty: David H. Newman, MD, FACEP Wednesday, October 16 / 9:00 AM - 9:50 AM Emergency physicians deal with both individual patient care and the economies of care. On any given shift, EPs often simultaneously manage patients experiencing MIs, sepsis, hemorrhoids, rashes, ankle sprains, cardiac arrest, back pains, and more. Stress can result from being unsure of where, in this grab bag of diagnoses and in the variety of measures available, we should be spending our greatest effort. The speaker will discuss the definition of and an in-depth understanding of the number needed to treat (NNT). The speaker will discuss common complaints and diagnoses and how they stack up in terms of the NNT. The speaker also will identify how to derive the most benefit for patients when time and resources are a challenge. Oh No, Not Another Meeting! Conducting Effective Meetings WE-273 / 1 Hour Faculty: Robert W. Strauss, Jr., MD, FACEP Wednesday, October 16 / 4:30 PM - 5:30 PM Oh no! Not another meeting! The speaker will review when and when not to have a meeting and how to make the most effective and rewarding meetings possible. Appraise how to guide the overbearing, the sarcastic, the bashful, and the detractor. Discover effective methods for opening and closing discussions.

16 Open the Back Door of the ED! Working Effectively with Hospitalists MO-12 / 1 Hour Faculty: Thom A. Mayer, MD, FACEP Monday, October 14 / 11:30 AM - 12:20 PM The emergence of hospital medicine has dramatically changed the way in which EM interacts with the medical staff. Like emergency medicine 30 years ago, it is a new specialty and evolving on a daily basis. The advent of hospitalists has met the needs of primary care and specialty physicians much more than emergency medicine. Emergency physicians must take an active role in shaping the way in which hospitalists meet the needs of emergency department patients. This course presents a series of strategies to improve this relationship. Optimizing the Patient Flow in the Emergency Department WE-253 / 1 Hour Faculty: Kirk B. Jensen, MD, MBA, FACEP Wednesday, October 16 / 3:30 PM - 4:20 PM Improving patient flow in your ED is a deeply important issue. Even the most talented and compassionate healthcare providers are only as good as their surroundings allow them to be. When patients flow smoothly through your ED it improves patient care, access to services, and the wellbeing of your team. The speaker will identify and discuss barriers to efficient patient flow, review strategies to improve workflow patterns, identify methods to build effective relationships and change ED culture, and discuss structural redesign. Psychology of Waiting TH-299 / 1 Hour Faculty: Kirk B. Jensen, MD, MBA, FACEP Thursday, October 17 / 10:00 AM - 10:50 AM Federal Express has noted that waiting is frustrating, demoralizing, agonizing, aggravating, annoying, time consuming, and incredibly expensive. We intuitively know this from our own experience as well as from our patients. Much has been written in the business literature about managing the waiting experience. The speaker will familiarize you with the current literature and give practical tips to improve your patients ED experience. Satisfied Physicians Have Satisfied Patients: Improving the Emergency Physician Experience by Improving the Patient Experience WE-224 / 1 Hour Faculty: Robert W. Strauss, Jr., MD, FACEP Wednesday, October 16 / 12:30 PM - 1:20 PM Callousness, anger, frustration, and tantrums are commonplace in the stressful ED environment. Many of our customers are in crisis. Everyone emergency caregivers, private practitioners, patients and administrators have needs that must be met. Explore what causes communication breakdown. Participants will discuss the origin of common ED conflicts and successful resolution methods.

17 When To Say When!: Managing Patients Demands! WE-181 / 1 Hour Faculty: Kevin M. Klauer, DO, EJD, FACEP Wednesday, October 16 / 8:00 AM - 8:50 AM Every physician encounters patients with unreasonable demands. Some deal with specific diagnostic studies, others unwarranted therapies, and still others the involvement of physicians with obviously greater expertise than an ER doctor. Through the use of specific clinical scenarios, the speaker will present practical approaches to the management of these patients, their family members, and their private referring physicians. Recognizing that no one approach will fit every ED, the speaker will emphasize flexible solutions that can be adapted to a variety of practice environments. Win-Win: How Improving the Patient Experience Improves Your Job Security TH-306 / 1 Hour Faculty: Douglas C. Finefrock, DO Thursday, October 17 / 10:00 AM - 10:50 AM The patient experience has emerged as an important factor in our reimbursement and job security. It has become critical to implement best practices in your patient care. Using both video and case examples, the speaker will introduce both a patient satisfaction checklist and a novel systematic approach to patient encounters. Women in Emergency Medicine (James D. Mills, Jr. Memorial Lecture) TU-83 / 2 Hours Faculty: Diane M. Birnbaumer, MD, FACEP (Moderator); Sheryl Heron, MD, MPH, FACEP; Gillian Schmitz, MD, FACEP; Ghazala Q. Sharieff, MD, MBA, FACEP; Mary Jo Wagner, MD, FACEP Tuesday, October 15 / 8:00 AM - 9:50 AM Fifty-five percent of current medical students are women; thirty-five percent plus of EM residents are female. How does this demographic s change impact our practice? Why is a specialty, so often characterized as lifestyle-friendly, not more equal in terms of gender distribution. The speakers will briefly review the legacy of women physicians in medicine, including EM, and prognosticate the future of female emergency physicians. The panel will identify practical tips on effective mentoring and identify leadership strategy themes that guide practice. The panel also will explore methods to close the gender gap both in the general distribution of EPs and positions of leadership.

18 Experience ACEP13 Dermatologic Disorders Approach to the Unknown Rash WE-221 / 1 Hour Faculty: Carl M. Ferraro, MD, FACEP Wednesday, October 16 / 12:30 PM - 1:20 PM How do you approach the unknown rash? Knowing how to identify and classify a skin lesion is an essential component in developing a systematic and organized approach to any lesion. The speaker will present guidelines for the proper diagnosis of various dermatologic conditions using case presentations to illustrate these concepts. Classic Pediatric Rashes TU-145 / 1 Hour Faculty: Elizabeth Weinstein, MD, FACEP Tuesday, October 15 / 3:30 PM - 4:20 PM Do children with rashes still stump you? The speaker will review pediatric rashes, from classic childhood exanthemas to unusual and life-threatening cutaneous disorders. Using a case-based format, measles, varicella, roseola, Kawasaki s disease, impetigo, and staphylococcal scalded skin syndrome will be discussed. Cocktail Party Conversations: Hey Doc, What s This? WE-263 / 30 Minutes Faculty: Carl M. Ferraro, MD, FACEP Wednesday, October 16 / 4:00 PM - 4:25 PM Ever been at a party and get asked to identify that unknown lesion or rash someone s had for days, months, or years? What you learn during this case-based presentation will make you the star of the party! The speaker will describe how to recognize ten common and clinically significant rashes as well as look-alike rashes. The appropriate management and disposition of each rash will be discussed. In addition, pearls for distinguishing look-alike rashes will be presented. Cutaneous Abscesses: Have Matters Come to a Head? WE-248 / 30 Minutes Faculty: Catherine A. Marco, MD, FACEP Wednesday, October 16 / 3:30 PM - 3:55 PM Oh no, not another spider bite! MRSA skin infections are becoming more common in the ED what is the best treatment for them? What are the indications for packing? Should you give antibiotics? Which antibiotic is best? How can the epidemic be stopped? Join the speaker in a discussion of the newest treatments for MRSA and help bust the pus! The Death Rash: Lethal Rashes You Can t Miss WE-207 / 1 Hour Faculty: Heather M. Murphy-Lavoie, MD Wednesday, October 16 / 10:00 AM - 10:50 AM Many patients who present to the ED with the complaint of a rash are not in immediate danger. A concerning minority, however, have life-threatening disorders that require immediate recognition and treatment if they are to have any chance of survival. From autoimmune to infectious disorders, the speaker will identify rashes you cannot miss!

19 Dermatology Jeopardy WE-175 / 1 Hour Faculty: Catherine A. Marco, MD, FACEP Wednesday, October 16 / 8:00 AM - 8:50 AM How well do you know your emergency dermatology? In this fast-paced, competitive, game setting you can test your knowledge against colleagues and review dermatologic presentations and therapies. Dermatology Update 2013: New Treatments, Classic Conditions WE-241 / 1 Hour Faculty: Heather M. Murphy-Lavoie, MD Wednesday, October 16 / 1:30 PM - 2:20 PM Plant-based dermatitis, eczema, psoriasis, fungal skin infections, and more! Is that expensive new cream or pill really better? Some common rashes are easy to identify but the treatment options can be daunting. During this session the speaker will guide you through the options for treating these classic rashes with a focus on novel therapies and the evidence for their use. No Immunizations? No problem! Recognition of Reemerging Rashes WE-235 / 30 Minutes Faculty: Rose M. Chasm, MD, FACEP Wednesday, October 16 / 1:00 PM - 1:25 PM Old diseases have begun to return, as some patients do not receive recommended immunizations. As emergency physicians, we are on the front lines and must be ready to recognize and treat these potentially deadly conditions and protect the public from harm. Learn strategies to recognize common reemerging rashes and educate your patients to help stop preventable disease. Popping, Shooting, Snorting, and Huffing: Dermatologic Clues to Drug Abuse WE-192 / 30 Minutes Faculty: William K. Mallon, MD, FACEP Wednesday, October 16 / 9:00 AM - 9:25 AM Suspect that a patient might be hiding drug abuse? By a careful examination of the skin you might uncover the hidden signs of illicit substance use it doesn t lie! During this session the speaker will review the common dermatologic manifestations of drug abuse and how changes in the skin can reflect the frequency and type of drug use. Recognizing the Top Ten Pediatric and Adult Rashes TH-300 / 1 Hour Faculty: Heather M. Murphy-Lavoie, MD Thursday, October 17 / 10:00 AM - 10:50 AM What is it, and what can I do about it? This is what emergency physicians really want to know when faced with a patient who has a rash. The speaker will describe how to recognize ten common and clinically significant rashes as well as look-alike rashes. The appropriate management and disposition of each rash will be discussed. In addition, pearls for distinguishing look-alike rashes will be presented.

20 Experience ACEP13 Emergency Imaging Advanced Bedside Echocardiography Lab MO-04; MO-41 / 3 Hours Faculty: J. Christian Fox, MD, RDMS, FACEP (Moderator) Monday, October 14 / 8:00 AM - 11:00 AM; 3:00 PM - 6:00 PM Focused cardiac ultrasound is an essential diagnostic test that emergency physicians should be comfortable performing at the bedside. This lab is designed for emergency physicians with a strong fundamental proficiency with EM bedside ultrasound who would like to improve their echocardiography skills. (This lab is limited to 25 participants.) Avoiding Unnecessary X-Rays: Evidence-Based Rules for Radiography MO-39 / 30 Minutes Faculty: Robert J. Tubbs, MD Monday, October 14 / 2:00 PM - 2:25 PM Does your patient have a healthy glow after his or her trip to the radiology suite? Have you been as prudent and thoughtful with your radiologic study and plain film requests? The speaker will summarize the strongest evidence to help clinicians appraise the high and low-risk criteria for ordering plain radiographs. Case study examples will incorporate rules for ankle/foot, knee, chest, pelvis, skull, and abdominal radiographs. Bedside Echocardiography: When Seconds Count TU-99 / 1 Hour Faculty: J. Christian Fox, MD, RDMS, FACEP Tuesday, October 15 / 10:00 AM - 10:50 AM The benefits of quick-look echocardiography during resuscitations are numerous and life-saving. Do you start fluids or vasopressors, defibrillate, continue chest compressions, or withhold care? All are options that would be facilitated by this important radiologic procedure. The speaker will present the most recent evidence supporting the use of bedside echocardiography during cardiac resuscitation, emphasizing the ability to distinguish between PEA with and without mechanical activity, and rapid assessment of cardiac output. Critical Care Emergency Ultrasound TU-113 / 1 Hour Faculty: Cliff A. Rice, MD Tuesday, October 15 / 12:30 PM - 1:20 PM In 2013, the practicing emergency physician needs to be able to utilize ultrasound effectively in the evaluation of the critically ill patient. The speaker will highlight the use of ultrasound to perform a FAST scan, to dynamically monitor and measure the IVC in the setting of hypovolemic shock, and to detect pericardial effusion and perform ultrasound guided pericardiocentesis. (This course is a prerequisite to the Critical Care Emergency Ultrasound Lab. )