Concurrent Sessions - Tuesday
Tuesday, June 5, 2012 • 10:45 - 12:15
Track 1 - RESEARCH - ORAL
Track Chair: Dr. Paul Atkinson
Track 2 - MODERATED POSTERS
Track Chair: Dr. Paul Atkinson
Track 3 – RESUSCITATION MEDICINE
Track Chair: Dr. Laurie Morrison
Track 3 – RESUSCITATION MEDICINE
Track Chair: Dr. Laurie Morrison
Chest Compressions Save Lives - How to Do it Well in the ED? - Dr. Sheldon Cheskes
The 2010 guidelines have transformed the way we do chest compressions and literature to date highlights the importance of CPR and the strong association with survival to discharge. Sheldon Cheskes has a world-wide reputation for his comprehensive understanding of defibrillation feedback tools and how to get the most out of each compression including avoiding any interruptions, use of “ready charge” technology, “see through CPR”, and working in manual rather than automatic mode. The prehospital care providers have been listening to him for years and their survival has tripled in most services employing high quality CPR. It is time for the ED to optimize the quality of compressions and contribute to the changing epidemiology of cardiac arrest. CPR SAVES LIVES.
Sould We Say No to Drugs in Cardiac Arrest or Give a Few Select Ones Early and Hope for the Best? Dr. Paul Dorian
Recent evidence has suggested that drugs may not be helpful in the immediate treatment of cardiac arrest patients. The recent guidelines have reduced the algorithm to a vasopressor and an antiarrythmic which makes it easy to remember but are we giving the right drugs at the right time? Based on the three phase model of cardiac arrest, the first 4 minutes are electrical and respond well to early defibrillation which can yield survival rates of 75% when given early, whereas the next 10 minutes are the circulatory phase and respond well to high quality CPR and defibrillation with many survivors. Most drugs are given after 20 minutes in arrest, which means they are being given in the final phase of cardiac arrest during the metabolic phase which has a less than 1% chance of survival. Do drugs work or are they harmful? Or perhaps we don’t give them early enough to make a difference?
Post Arrest Care - Cutting Edge Interventions Beyond Return of Circulation - Dr. Steven Brooks
With the paradigm shift to optimizing chest compressions, more patients are regaining circulation and arrive in the ED with a pulse. This means the ED must provide comprehensive and timely post arrest care to optimize survival. Interestingly as the survival rate from out of hospital cardiac arrest is rising, the survival rate to discharge in most hospitals remains flat at 50% despite novel interventions such as controlled oxygenation, use of therapeutic hypothermia, rapid reperfusion post STEMI and improved neuroprognostication. Comprehensive bundling of care in these patients will break this flat line and it needs to begin in the ED to really make a difference.
ECMO Post Arrest in the ED by Emerg Docs: Are Ya’ Nuts? - Dr. Zack Shiner
Many institutions in Europe and Asia are providing this to cardiac arrest patients with dramatic and appealing results. Zack Shiner and his team of ED docs decided to develop a treatment protocol that could be done in the ED at their community hospital far from the ivory tower. They have exciting new data that suggests we have so much more to offer in cardiac arrest than ever before imagined.
Panel Discussion of Cases - Dr. Laurie Morrison
A selection of cases that will allow the panel to think out loud with the audience to address the simple and the complex issues that arise during cardiac arrest resuscitation.
Learning Objectives
• Provide comprehensive post arrest care until the ICU takes over.
• Appreciate how ECMO may be changing our culture of futility to a culture of hope in cardiac arrest patients who are non-responsive to routine care.
Track 4 – ADMINISTRATION
Track Chair: Dr. Samuel Campbell
Overview of Hospital Overcrowding in Canada
This session will review the state of hospital overcrowding in Canada, relative to the rest of the world, with specific examples of approaches to diminish its impact on the provision of emergency care. An examination of the impact of a system wide reaction to the H1N1 pandemic on emergency department flow in a chronically busy Canadian ED will also be discussed.
Learning objectives
• Review the current literature on measurement, causes and the impact of system overcrowding.
ED Overcrowding: Where are we and where do we need to go? - Dr. Jeff Tyberg, Dr. Grant Innes, and Dr. Brian Rowe
This panel discussion will review and discuss the ED overcrowding issue nationally with the purpose of getting emergency departments across the country on the same page.
Learning objectives
• Review the current status of ED overcrowding across the country and develop recommendations on how to help eliminate the problem.
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Track 6 – FORENSIC MEDICINE
Forensic Medicine in the Emergency Department – Where CSI Meets ER
Track Chair: Dr. Dan Cass
The Death Investigation in the Emergency Department - Dr. Dan Cass
The Emergency Department is often a point of intersection between clinical and forensic medicine, or the branch of medicine that deals with the legal implications of health care. In this session, you will gain an understanding of the purpose of the death investigation in the setting of the emergency department, as well as some practical things that you can do to help preserve forensic evidence that may be critical to the criminal justice system.
Learning Objectives
• Understand the role of the coroner / medical examiner in the ED.
• Recognize when to involve a coroner / medical examiner in deaths in the ED.
• Acquire an understanding of the correct way to express the cause of death on a death certificate.
Preservation and Collection of Forensic Evidence in the Emergency Department - Dr. Elizabeth Shih and Detective Constable Bradley Donais
In this session, you will gain an understanding of the practical things that you can do to help preserve forensic evidence that may be critical to the criminal justice system.
Learning Objectives
• Understand the kinds of forensic evidence that are collected in the ED.
• Understand the clinical information that is critical to the death investigation.
• Identify simple measures that you can take in your ED to ensure that forensic evidence is preserved without compromising the care of the patient.
Tuesday, June 5, 2012 • 13:30 - 15:00
Track 1 - RESEARCH - ORAL
Track Chair: Dr. Paul Atkinson
Track 2 - MODERATED POSTERS
Track Chair: Dr. Paul Atkinson
Track 3 – RESUSCITATION MEDICINE
Track Chair: Dr. Laurie Morrison
Track 3 – RESUSCITATION MEDICINE
Track Chair: Dr. Laurie Morrison
Chest Compressions Save Lives - How to Do it Well in the ED? - Dr. Sheldon Cheskes
The 2010 guidelines have transformed the way we do chest compressions and literature to date highlights the importance of CPR and the strong association with survival to discharge. Sheldon Cheskes has a world-wide reputation for his comprehensive understanding of defibrillation feedback tools and how to get the most out of each compression including avoiding any interruptions, use of “ready charge” technology, “see through CPR”, and working in manual rather than automatic mode. The prehospital care providers have been listening to him for years and their survival has tripled in most services employing high quality CPR. It is time for the ED to optimize the quality of compressions and contribute to the changing epidemiology of cardiac arrest. CPR SAVES LIVES.
Sould We Say No to Drugs in Cardiac Arrest or Give a Few Select Ones Early and Hope for the Best? Dr. Paul Dorian
Recent evidence has suggested that drugs may not be helpful in the immediate treatment of cardiac arrest patients. The recent guidelines have reduced the algorithm to a vasopressor and an antiarrythmic which makes it easy to remember but are we giving the right drugs at the right time? Based on the three phase model of cardiac arrest, the first 4 minutes are electrical and respond well to early defibrillation which can yield survival rates of 75% when given early, whereas the next 10 minutes are the circulatory phase and respond well to high quality CPR and defibrillation with many survivors. Most drugs are given after 20 minutes in arrest, which means they are being given in the final phase of cardiac arrest during the metabolic phase which has a less than 1% chance of survival. Do drugs work or are they harmful? Or perhaps we don’t give them early enough to make a difference?
Post Arrest Care - Cutting Edge Interventions Beyond Return of Circulation - Dr. Steven Brooks
With the paradigm shift to optimizing chest compressions, more patients are regaining circulation and arrive in the ED with a pulse. This means the ED must provide comprehensive and timely post arrest care to optimize survival. Interestingly as the survival rate from out of hospital cardiac arrest is rising, the survival rate to discharge in most hospitals remains flat at 50% despite novel interventions such as controlled oxygenation, use of therapeutic hypothermia, rapid reperfusion post STEMI and improved neuroprognostication. Comprehensive bundling of care in these patients will break this flat line and it needs to begin in the ED to really make a difference.
ECMO Post Arrest in the ED by Emerg Docs: Are Ya’ Nuts? - Dr. Zack Shiner
Many institutions in Europe and Asia are providing this to cardiac arrest patients with dramatic and appealing results. Zack Shiner and his team of ED docs decided to develop a treatment protocol that could be done in the ED at their community hospital far from the ivory tower. They have exciting new data that suggests we have so much more to offer in cardiac arrest than ever before imagined.
Panel Discussion of Cases - Dr. Laurie Morrison
A selection of cases that will allow the panel to think out loud with the audience to address the simple and the complex issues that arise during cardiac arrest resuscitation.
Learning Objectives
• Provide comprehensive post arrest care until the ICU takes over.
• Appreciate how ECMO may be changing our culture of futility to a culture of hope in cardiac arrest patients who are non-responsive to routine care.
Track 4 – ADVOCACY - PHYSICIAN WELLNESS
Track Chair: Dr. Carys Massarella
Dr. Michael Kaufmann
All information for this presentation was unavailable as at time of print. Updates to the preliminary program will be posted on our website at www.caep.ca. Please check regularly for new information.
Physician in Transition - Dr. Carys Massarella
This session will deal with one physician's journey in gender transition in the workplace, highlighting experiences of personal change, the driving need for wellness and ensuring the emergency department as a workplace is prepared and competent to deal with such diversity.
Learning Objectives
• To better understand the dynamics of personal change and wellness as it relates to professional practice.
• How to make a workplace welcoming for diverse populations.
• Learning how to improve cultural competency in the Emergency Department.
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Track 5 – ADVOCACY – INJURY PREVENTION
Track Chair: Dr. Carolyn Snider
Time for ER Docs to Get Serious about Injury Control! - Dr. Louis Francescutti
Dr. Francescutti will speak on the national initiative to develop goals and actions to reduce injury in Canada. He has spearheaded a collaboration of key stakeholders in the injury prevention field (including CAEP) in Canada to come together to develop goals and actions for the reduction of injury.
Learning Objectives
• Review the true burden of injuries in Canada.
• Share strategies for becoming a more effective injury advocate.
• Introduce "Injury Action Forums" - a new national wide injury initiative.
Re-framing Violence as Preventable - Dr. Carolyn Snider
Injury caused by violence is a common presentation to most emergency departments. Unlike many injuries, violent injuries are rarely perceived as preventable. This session will aim to re-frame the way we look at violence and suggest roles of the emergency department in the prevention of future violent injury.
Learning Objectives
• Describe why violence should be treated as a public health issue.
• Describe the role of the emergency physician in prevention of violent injury.
Tuesday, June 5, 2012 • 15:30 - 17:00
Track 1 - RESEARCH - ORAL
Track Chair: Dr. Paul Atkinson
Track 2 - MODERATED POSTERS
Track Chair: Dr. Paul Atkinson
Track 3 – INFORMATICS/NEW TECHNOLOGY
Track Chair: Dr. Michael Feldman
Development and Implementation of a Push-alert System for Critical Notifications for Emergency Physicans - Dr. Michael Feldman
The description and learning objectives for this session were unavailable as at time of print. Updates to the preliminary program will be posted on our website at www.caep.ca. Please check regularly for new information.
Lessons and Insights on An Introduction of a Tool for Delivery of Clinical Decision Support at the Point of Care - Dr. Michael Bullard
The description and learning objectives for this session were unavailable as at time of print. Updates to the preliminary program will be posted on our website at www.caep.ca. Please check regularly for new information.
Panel Discussion: Perspectives on Challenges, Lessons, Innovations, and Insights in Information Technology Projects in the Emergency Department - Dr. Michael Feldman, Dr. Michael Bullard, TBC
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Track 4 – ADVOCACY – PATIENT SAFETY
Track Chair: Dr. David Ouellette
Critical Thinking and Patient Safety in the ED - Dr. Pat Croskerry
When faced with over 100 possible cognitive errors, how do we successfully make decisions in the unique environment of the ED, known for its constant interruptions, compulsory multi-tasking, ability to intensify fatigue and cognitive overload, and significant uncertainty? How does this ultimately influence patient safety? This session explores the components of rational and critical thinking, the vulnerability of the physician to flawed decision-making, and promotes increased awareness and healthy skepticism of our decision-making process in the ED.
Learning Objectives
• Recognize the importance of decision-making to patient safety and healthcare.
• Understand the origins and components of rational and critical thinking.
• Recognize how both systems and individuals are vulnerable to flawed decision-making.
• Use process analysis to critically evaluate particularly vulnerable environments in healthcare, such as the Emergency Department.
• Incorporate new awareness and vigilance around decision-making.
• Develop a healthy skepticism of the decision-making process.
Patient Safety in Emergency Medicine - Dr. David Ouellette
Patient safety is a discipline in healthcare aimed at reducing and preventing medical error. Both patient safety and medical errors are driven by human factors, medical complexity, and systems operation and failure. This session discusses the current state of patient safety and its role in emergency medicine. It explores the contributions of the individual and system to a safe ED environment, and outlines the importance of ED human factor engineering in patient safety.
Learning Objectives
• Acquire a brief overview of the history of patient safety and the common terms used in patient safety.
• Consider the contribution of the individual and the system to patient safety.
• Understand Human Factors and Human Factor Engineering in the Emergency Department.
• Appreciate the role of patient safety in the emergency department.
• Learn about the future of patient safety in the emergency department.
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Track 5 – EMS
Track Chair: Dr. Michelle Welsford
EMS STEMI Care Panel Department - Dr. Andrew Travers, Dr. Sheldon Cheskes, and Dr. John Tallon
Come and learn about some innovative STEMI programs in Canada. Bring your questions and be part of a discussion with the experts on the role and scope of EMS in recognizing, triaging and managing these patients as part of their continuum of care.
Learning Objectives
• Review some of the innovative EMS STEMI programs in Canada.
• Explore whether these programs should be standardized.
• Discuss the role of the ED in STEMI management if EMS takes STEMI patients directly to the cath lab.
Capnography in Cardiac Resuscitation - Dr. Michelle Welsford
Capnography use in cardiac resuscitation is a key recommendation in the new 2010 ILCOR/AHA guidelines. Come learn about the practical use, experience, and evidence in this modality to monitor and manage your cardiac arrest patients both in the emergency department and by paramedics in the community.
Learning Objectives
• Explore the 5 reasons to use waveform capnography in cardiac resuscitation.
• Review the 2010 AHA/HSFC recommendations for capnography use.
• Review the evidence for capnography use as prognostication in cardiac resuscitation.
