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Emergency Medicine CME

 
 
Emergency Medicine: Practicing According to the Evidence

November 30 – December 4, 2009 (8:00am-12:15pm)
Location: Hyatt Regency Sarasota, Florida
20 AMA PRA Category 1 Credits™
20 CME Credits - ACEP AAFP ACOG
Course #SEMLA-2420091130
Price: $645.00 - $795.00

by Michael A. Gibbs, M.D., F.A.C.E.P. - Tufts University School of Medicine; Professor of Emergency Medicine; Chief, Department of Emergency Medicine, Maine Medical Center; Immediate Past President, Maine Chapter of the American College of Emergency Physicians, Portland, ME and Andrew D. Perron, M.D., F.A.C.E.P., F.A.C.S.M. - Tufts University School of Medicine; Professor of Emergency Medicine; Director, Emergency Medicine Residency Program, Maine Medical Center, Portland, ME.

Learning Objectives
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NARRATIVE DESCRIPTION: Following this course, the participant should be able to recognize the epidemiology, demographics and common clinical presentations for the diseases and disorders discussed; construct an appropriate history, physical exam and laboratory evaluation to develop cost-effective and accurate diagnosis; manage as well as employ appropriate follow-up and/or specialty referral for the diseases and disorders presented. This activity is expected to result in increased confidence in making an appropriate diagnosis and providing effective treatment and referral or follow-up care with the overall goal of improving patient outcomes.

The emphasis will be on current guidelines and evidence-based medicine, as indicated within each topic’s specific objectives. Emergency Medicine is a specialty that has a high rate of utilization and change in standards of care. It is often the point of entry for medical care; therefore, this course was designed to be of value to all practitioners at the level of a practicing physician in an effort to keep them abreast of current clinical practices in Emergency Medicine.

Day 1 Mastering Local and Regional Anesthesia. Pitfalls in Orthopedics. Wide-Complex Tachycardias: When is V-Tach Not V-Tach? Pericarditis & Myocarditis: How Can 2 Diseases Sound So Similar & Act So Differently?
Day 2 Subarachnoid Hemorrhage: What’s New in Diagnosis and Management? Low Back Pain in the ED: What We Know, What We Think We Know, and What We Don’t Know. Aortic Disasters. Abdominal Pain Case Studies.
Day 3 Cutting Edge ED Airway Management. Airway Rescue Strategies. ST-Segment Elevation: MI or Not MI. Acute Coronary Syndrome in the ED: So Many Drugs and So Little Time.
Day 4 PE and DVT in the Emergency Department. Thrombolysis for Stroke. Hypertension – Just the Facts! Turning Error into Opportunity.
Day 5 Trauma Case Studies. Essentials of Trauma Imaging. Early Goal Directed Therapy in Sepsis: Why All the Fuss? Community Acquired Methicillin Resistant Staphylococcus aureus (CA-MRSA): A 2009 Update.

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Emergency Medicine: Practicing According to the Evidence
November 30 – December 4, 2009
Location: Hyatt Regency Sarasota, Florida

SPECIFIC OBJECTIVES
Day 1Mastering Local and Regional Anesthesia - Upon completion of this session, the participant should be able to:
1.Describe the pharmacology of local anesthetics.
2.Discuss recent controversies in local anesthetic techniques.
3.Review regional anesthetic techniques appropriate for the ED.
Pitfalls in Orthopedics - Upon completion of this session, the participant should be able to:
1.Outline high-risk scenarios in emergency orthopedics.
2.Discuss severe true orthopedic emergencies.
3.Review commonly missed/mis-managed orthopedic conditions, using a case-based approach.
Wide-Complex Tachycardias: When is V-Tach Not V-Tach? - Upon completion of this session, the participant should be able to:
1.Review the possible etiologies and ECG appearance of wide complex tachycardias.
2.Identify ECG features of these rhythms that will help differentiate between ventricular tachycardia and other more benign etiologies.
3.Discuss evidence-based treatment of these dysrhythmias.
4.Appreciate the clinical significance of the underlying medical conditions that result in these dysrhythmias.
Pericarditis & Myocarditis: How Can 2 Diseases Sound So Similar & Act So Differently? - Upon completion of this session, the participant should be able to:
1.Discuss the pathophysiology and clinical presentation of these two entities.
2.Review the potential pitfalls in the diagnosis and management of these diseases.
3.Discuss the commonalities and differences of these closely related diseases.
4.Describe the evidence-based work-up and treatment options for pericarditis and myocarditis.

Day 2Subarachnoid Hemorrhage: What’s New in Diagnosis and Management? - Upon completion of this session, the participant should be able to:
1.Identify the principles and pathophysiology of SAH.
2.Appreciate new advances in the diagnosis and management of this disease.
3.Describe the evidence-based treatment of SAH based on the latest applicable literature.
4.Recognize the pitfalls in the diagnosis and management of SAH in the ED.
Low Back Pain in the ED: What We Know, What We Think We Know, and What We Don’t Know - Upon completion of this session, the participant should be able to:
1.Discuss the evidence-based approach to the evaluation of non-traumatic back pain.
2.Review the “red flags” that should heighten the suspicion for serious pathology in the evaluation of back pain.
3.Describe both effective as well as disproved therapies in the treatment of back pain.
4.Identify potential pitfalls in the treatment and disposition of low back pain.
Aortic Disasters - Upon completion of this session, the participant should be able to:
1.Review the pathophysiology, clinical presentation, and ED management of the following:
a.Abdominal aortic aneurysm,
b.Traumatic aortic disruption,
c.Essentials of aortic dissection.

Abdominal Pain Case Studies - Upon completion of this session, the participant should be able to:
1.Outline an evidence-based approach to evaluation of the ED patient with abdominal pain.
2.Identify common pitfalls in the assessment of patients with abdominal pain.
3.Describe high-risk scenarios related to patients with abdominal pain.

Day 3Cutting Edge ED Airway Management - Upon completion of this session, the participant should be able to:
1.Discuss essentials of airway pharmacology.
2.Discuss a fundamental approach to airway assessment.
3.Describe the technique of rapid sequence intubation.
Airway Rescue Strategies. - Upon completion of this session, the participant should be able to:
1.Describe the epidemiology and risk factors associated with the failed airway in the ED.
2.Discuss contemporary airway rescue techniques.
3.Present an algorithm for management of the failed airway.
ST-Segment Elevation: MI or Not MI - Upon completion of this session, the participant should be able to:
1.Appreciate the wide variety of clinical conditions that can result in ST elevation on the ECG.
2.Describe ECG findings that can aid the clinician in determining the significance of ST-elevation on an ECG.
3.Discuss the possible adjuncts a clinician can use to further define the significance of ST-elevation on an ECG.
Acute Coronary Syndrome in the ED: So Many Drugs and So Little Time - Upon completion of this session, the participant should be able to:
1.Identify the scope of the problem of ACS in the ED.
2.Review the evidence-based treatment of ACS based on the latest applicable literature.
3.Appreciate the areas of controversy in the treatment of this disease entity.
4.Recognize emerging therapies that may prove useful for the treatment of ACS in the ED.
5.Identify and integrate the updated ACC/AHA guidelines for the management of patients with unstable angina and non ST-segment elevation myocardial infarction.

Day 4PE and DVT in the Emergency Department - Upon completion of this session, the participant should be able to:
1.Identify the scope of the problem of thromboembolic disease in the ED.
2.Discuss the latest diagnostic algorithms and adjuncts available to aid the clinician in the diagnosis of thromboembolic disease.
3.Review the evidence-based treatment of thromboembolic disease based on the latest applicable literature.
4.Recognize the limitations of current diagnostic modalities for these diseases.
Thrombolysis for Stroke - Upon completion of this session, the participant should be able to:
1.Identify the principles and pathophysiology of stroke and stroke treatment.
2.Appreciate the applicable medical literature that is available to the clinician.
3.Review the performance of thrombolysis for stroke to this point in time.
4.Describe the controversy regarding this therapy.
5.Recognize emerging technologies and therapies useful for the treatment of stroke in the ED.
Hypertension – Just the Facts! - Upon completion of this session, the participant should be able to:
1.Review the emergency department "essentials" for the assessment of the patient with hypertension.
2.Provide a rational framework for the ED treatment of acute hypertension.
3.Review highlights of the current guidelines: "Prevention, detection, evaluation, and treatment of high blood pressure.
Turning Error into Opportunity - Upon completion of this session, the participant should be able to:
1.Describe the elements of the emergency care environment that predisposes the clinician to decision-making errors.
2.Describe cognitive strategies that reduce the likelihood of error.
3.Illustrate effective methods for reviewing, discussing and addressing medical errors.

Day 5Trauma Case Studies - Upon completion of this session, the participant should be able to:
1.Identify critical issues in the evaluation and management of the injured patient using a case-based format.
2.Describe the management imperatives of:
a.Blunt and penetrating traumatic arrest,
b.Shock in the injured patient,
c.Severe traumatic brain injury,
d.Spinal trauma,
e.Pelvic ring trauma,
f.Aortic trauma.
3.Discuss common pitfalls in the evaluation of the injured patient.
Essentials of Trauma Imaging - Upon completion of this session, the participant should be able to:
1.Identify which patients need imaging following trauma.
2.List which imaging studies are most effective in diagnosing injury.
Evidence-based guidelines will be provided for:
a.Imaging of the cervical spine,
b.Thoracic imaging,
c.Imaging in blunt aortic injury
d.Interpretation of pelvic radiology,
e.Indications and strengths/weaknesses of abdominal CT,
f.Indications for CT imaging in minor brain injury.
Early Goal Directed Therapy in Sepsis: Why All the Fuss? - Upon completion of this session, the participant should be able to:
1.Describe the pathophysiology of sepsis and the sepsis syndrome.
2.Appreciate the scope of the problem regarding effective management of sepsis in the ED.
3.Review the principles of early goal-directed therapy in the treatment of sepsis.
4.Appreciate the potential gains that can be realized, as well as the pitfalls to avoid, in the management of sepsis utilizing early goal directed therapy.
Community Acquired Methicillin Resistant Staphylococcus aureus (CA-MRSA): A 2009 Update - Upon completion of this session, the participant should be able to:
1.Identify risk factors for CA-MRSA infection.
2.Recognize the management of skin and soft tissue infections in the era of drug resistance.
3.Discuss both pharmacologic and non-pharmacologic management strategies for this disease entity.
4.Demonstrate familiarity with the latest treatment guidelines for CA-MRSA.

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