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AAEM Chapter Division Updates: California Chapter Division Update: CAL/AAEM Golden State Symposium
Here are some of the highlights and important take home pearls from the day:
• The COVID-19 pandemic has disproportionally impacted our country’s most vulnerable populations in incidence, complications, and death rate. • Rocuronium may be preferred in a hemodynamically compromised patient. • Earlier return to activity may be beneficial in concussion. • Increasing the d-dimer threshold (to 1000 ng/mL) in low risk patients may decrease imaging without increasing risk. • Review your professionalism contract clause with your medical group and hospital and how it applies to your social media presence. • AAEM advocates for fair and equitable practice environments for the emergency physician including physician ownership and the right to due process. • Clinical symptoms of a large vessel occlusion in acute stroke include: aphasia, gaze deviation, or neglect. These symptoms are potentially an indication for mechanical thrombectomy. • A STEMI is a complete vessel occlusion while a NONSTEMI is an incomplete occlusion. The clinical picture should significantly impact your decision to activate the cath lab or administer thrombolytics. • deWinters T waves and post-arrest are two clinical indications for a
Code STEMI. • Mental visualization of procedures and resuscitations can improve performance. • Less than 1% of children with acute SARS-CoV2 infection require ICU admission. • MIS-C is a rare but serious post-infectious sequelae that presents with fever, abdominal pain, and with two general phenotypes: 1) Kawasakilike or 2) multi-organ involvement commonly with cardiac involvement.
Treatment is extrapolated from KD treatment. Cardiac function typically improves with treatment but long term outcomes are unknown. • Communication is a critical skill which enhances the patient care experience, improves outcomes, and reduces risk management events.
Excellent communication requires practice, intentionality, and feedback. Effective communication is vital when disclosing medical errors, delivering bad news, during handoffs, and with conflicts. • In his classic book Nonverbal Communication (1972), Mehrabian described the 7-38-55% rule in which 7% of personal communication involves spoken words, 38% is voice and tone, and 55% is through body language. Communicating empathy is an important skill that can be learned and body language is part of that communication. • Hyperkalemia is the deadliest of all electrolyte emergencies.
Nebulized albuterol, IV calcium (if QRS is wide) and IV insulin/dextrose “buy time” by shifting K+. 5 units of insulin is effective and safer than 10 units (particularly in renal failure). Hemodialysis or working kidneys are the only way to really solve the problem of hyperkalemia by removing potassium from the circulation. Sodium polystyrene and patiromer (Kayexalate and Veltassa) prevent GI absorption of K+ and are not effective in emergencies.
These great pearls and more were discussed during this high yield symposium. Check it out for some CME credit!
SUNDAY, JUNE 20, 2021
• Opening Reception | 5:45pm-6:45pm • DEI Reception at BBs Jazz, Blues, and Soups | 8:30pm-9:30pm
MONDAY, JUNE 21, 2021
• Early Risers Yoga | 6:30am-7:30am • AAEM/RSA & YPS Social | 6:00pm-7:00pm • Airway at AAEM Storytelling | 7:00pm-9:30pm
TUESDAY, JUNE 22, 2021
• Wellness Fun Run/Walk | 6:30am-7:55am • Women in EM Networking Lunch | 12:05pm-1:30pm • Chapter Divisions & Sections Social | 7:00pm-8:30pm
WEDNESDAY, JUNE 23, 2021
• Women in EM Coffee Meet-Up | 7:00am • Scott Joplin Historic Site Tour | 12:30pm-3:00pm
ONGOING
• African American Outreach Program • Wellness Room • AAEM21 Wellness Puzzle • F3 Wellness Meals - Food, Friendship, and Fun
