SAEM 1995 Annual Meeting Program by Society for Academic Emergency Medicine

.*,. ,.,t% .n,.,

'1'tt"

:illl:":t

Socieryfor

Academic ..::: EmergCncy Medicine

':"#, . * ,b

WX,*,W t

t . "f { \ \ . .;

fl | ii.l n

:,,":-,,.'k : -{-

1 9 9 May2I-24, 1995 SanAntonie, Texas

'*,.q,,,.,

-Flry-

FLOORPTANS& CAPACITYCHART

W-W'

Jltlun lItilII

1l-1__ GRAND BALLROOTI

T - - l tr - - - U fi r

|I to,o*o|I

tr------

snrona I

1 I I

r t sAlor{cI

ll - r - - - -

- ---!

| t

-l sAloxc

I sl.o*"|

l I

i r ' I

t l ------=

sArorH

I i r oott , i fl

l'"';;l I

o I so,.on

sAror{ J I

sALoil| I

t-1jL-E-Oil-___o_

J STAIRS

,,ffiJ R00it1

::__{

COilFEBEIGE I R00il2

z o F

----{

I I

COI{FEREIIGE RJoltt3 I

;;-,J Roottt 4

-J Pador Room

;r'"4F-,,,,* R00nI

c0ltFtRff{cE . R00M10

ConferenceSuite Rooms 529 and 530 are on the 5th floor.

T-

t-r

F l-r

COiIFEREIICE c0l{FtREilct R00M11

R00M12

CONFERETCE R00r 16

INDEX G e n e r aI n l formation.............. ............,1 Special GuestSpeakers .............,.,.,....3 Schedule of Events(Day-at-a-Glance) ...............4 A A C E MA, C E PC, O R Da n dE M R AM e e t i n g s . . . , . , . , . , . , . . . ; . . . . . , . . . . . . . . . . . . . . . . . , . 8 Fundamentals of Research Series ,.,.,....,....,........9 Careof the ElderPersonCourse .....1i) May 21,Activities D i d a c t iS c essions ...........,..,.,..11 O r a lP a p e r s . . . . . . . . . . . . . .........,.....72 May 22 Activities D i d a c t iS cessions ...................74 O r a lP a p e r s . . . . . . . . . . . . . ......75 Posters..... ..,.,.18 AACEM Agenda .....................27 CORDAgenda ......22 May 23 Activities D i d a c t iS cessions ...................23 O r a lP a p e r s . . . . . . . . . . , . , ...............25 Posters...,. ........,...,,25 AnnualBusiness MeetingAgenda .................29 A w a r dP r e s e n t a t i o n s . . . . . . . . . . . . . . . ,. . ,. . . 3 0 Academic Excellence Award .....,.....31 LeadershipAward Slateof Nominees .,,.,.,....33 Constitutio &nB y l a w s . . . . , . . . . . . . . . ,.,.,.,.,,36 May 24 Activities DidacticSessions ..,...,41, O r a lP a p e r s . . , . , . , . , . . , . .....43 Posters,.,., ..............,44 Exhibitors ............47 Positions Available .,.,.,.,,.,.,..,.,50 CallForAbstracts .............,,..55 MeetingRoomFloorPlans ..,..Inside BackCover Evaluation Form ,.,.,Center 4 Pages

All attendees are urged to complete the evaluation form published in the center of this program. Completed evaluation forms should be returned to the SAEMRegistration deskbefore leaving SanAntonio. Feedback is critical to the development of successfrrl Annual Meetings.

t\ iI I :

r I

GEI\ERAI IMORMAilON

l i r

Registration and Information

Saturday, May 2OzSchedule of Events

All registrantsmust check in at the SAEMRegistrationDesk to pick up name badgeswhich are required for admissioninto all Annual Meeting sessions.The RegistrationDesk will be open during the times listed below:

8:00 am-5:00pm

RegionalCPCCompetitions \festem Region,SalonA Midwest Region,SalonC SouthernRegion,SalonD CentralRegion,ConferenceRooms1 E 2 EastemRegion,ConferenceRooms3 O 4

May 20

11:00am-7:00pm

May 21.

7:00am-12:00noon 1:00-5:00 pm

May 22

7:00am-12:00noon pm 1:00-5:00

2:00-5:00pm

7:00am-12:00noon 1:00-5:00 pm

pm 5:30-6:30

CPCReception,SalonI

5:00-8:00pm

Meetingof the Board and Chairsof Committees.Task Forces.and Interest Groups, ConferenceRooms13 & 14

6:00-8:00pm

GeriatricCourseFacultyMeeting, ConferenceRoom6

May 23 May 24

11:00am-2:00pm AcademicEmergencyMedicineEditonal Board, ConferenceRoom.17

7:00am-12:00noon 1:00-4:00 pm

Continuing Medical Education The 1995SAEMAnnual Meeting will not be accreditedfor Caregory I credit of the PhysiciansRecognitionAward of the American Medical Association.However, the Board of Directors and Program Committee stands behind the meeting and its educational content. Certificatesof attendanceverifying the number of educationalhours at the Annual Meeting will be issuedto each registrant immediately following the conference. The Society will also document the quality and educationalbenefits of the sessions.Many state Boards will accept such verification by an establishedspecialty society for meeting required documentation of CME hours for licensure renewal. This decision was a difficult one and unforhrnately may createa hardship for some attendees.This issuewill be monitored and your commentsand suggestionsare encouraged.

IssuesForum All members are invited to participate in an Issues Forum on Sunday,May 2I from 5:30-6:30pm in Salon C. During this informal session Board members, committee chairs, and others will be availableto discusssome of the major issuesconfronting the Societyand specialty.Theseissuesinclude: 1. SubspecialtyGuidelinesand Development 2. Development of EmergencyMedicine at Academic Medical Centers 3. ResearchDirectionsConference 4. ManpowerTask Force 5. Informed Consent 6. JCAHOLiaisonCommittee Membersare urged to discussthese and any other issuesat this session.

PosterReproductions As was done at last year'sAnnual Meeting, all poster presenters will be provided with reproductions of their poster for distribution to the Annual Meeting attendees.During the day and evening prior to each poster session,posterswill be reproduced, printed, and placed in distribution racks mounted on each poster board. The PosterReproductionCenteris located in the Exhibit Hall and the hours of operation are: May 21, 22, and 23, 7:00 am-9:00pm; and May 24,7:00 am-1.2:00 noon. To ensure that posters will be reproduced and available for distribution in time for the opening of each poster session,presenters should take their postersto the PosterReproductionCenter on the day before their scheduledpresentation. 1995 SAEM Annual Meeting

SAIM Boardof Directors,Conference Rcnm18

Opening Cocktail Reception SAEMis hosting an opening cocktail reception on Sunday,May 2'1.from 6:30-8:00pm in SalonE immediatelyfollowing the Issues Forum. AII Annual Meeting registrantsare invited to attend. Hors d'oeurveswill be servedand a cashbar will be available.

Exhibits Exhibits will be avatlable for viewing on May 22 and 23 in the Exhibit Hall. The poster sessions,Innovations in Emergency Medicine Education exhibits, photography competition, coffee breaks,and the registrationdesk will also be located in the Exhibit Hall. Pleasetake an opportunity ro view the exhibits during the scheduledcoffee breaksand exhibit hours.

Annual BusinessMeeting The Society will hold its Annual BusinessMeeting from 11303:00 pm on Tuesday,May 23 in SalonsB and F. At this meeting David Sklar, MD, will introduce incoming president Lewis Goldfrank, MD. Agenda items for the businessmeeting will include election of officers, Board and committeemembers,presentation of awards, amendmentsto the Constitution and Bylaws, officers' report, and other items of businesspresentedby the membership. All members of the Society are urged to attend,however, only activemembersare eligible to vote.

EMRA Reception Residents,faculty and friends are invited to attend a reception on Monday, May 22 from 7:00-8:00pm in ConferenceRooms17 and 18. The highlight will be the presentationof rhree awards: the L995Jean Hollister Memorial Award for Excellencein EMS and PrehospitalCare,sponsoredby CoastalEmergenryServices; the 1995 Academic ExcellenceAward, sponsored by EmCare; and the EMRADedication Award, sponsored by \i(eatherby Health Care, Inc. EMRA gratefully acknowledgesreception sponsors,California EmergencyPhysiciansMedical Group and Daniel Stem & Associates.

Board of Directors Meeting The SAEMBoard of Directorswill meet on Saturday,May 20 from 2:00-5:00pm in ConferenceRoom 18 and Tuesday,May 23 from 7:00-10:00pm in ConferenceRoom 11. All interestedmembers and others are invited to attend this and all meetinssof the Board.

Recycling Name Badges

Banquet

Annual Meeting attendeesare encouragedto recycle their name badgeswhen they leave the conference.Name badges can be returnedto the SAEMRegistrationDesk and at the Banquet.

The Annual Meeting Banquet will be held on \(ednesday, May 24, in the Marriott Rivercenterin SalonsC, D, and E. Dressis casual.A cocktailreceptionbeginningat 6:30pm until 7:75pm will preceed the banquet. Each attendeewill receive tlvo complimentarydrink ticketsand a cashbar will also be avarlable.

Placement Service A bulletin board with be maintainedon May 21,22,23, and 24 in the Exhibit Hall for persons wishing to post positions and physiciansavailablelistings.Each listing may be no iarger than 8 1./2"x 11". Also, positions availableare published in this onsite program.

MessageBoard A messageboard will be maintained at the RegistrationDesk. Phone messagescan be left at the SAEMRegistrationDesk by calling the Marriott RivercenterHotel at (210) 223-1000and requestingthe SAEMRegistrationDesk.

Photography Competition The photo entriesreceivedfor the photographycompetitionwill be displayedin the ExhibitHall on May 22,23, and 24, Approximately 150 photos were received and awards for the top three photographsin four categories(Clinical, EmergencyMedical Services,A Day in the Life of EmergencyMedicine, and Computer GeneratedResidencyLogo) will be announcedon May 2J.

Financial Support for its finanSAEMis very grateful to Ohmeda Pharmaceuticals cial support which has made the poster reproductionspossible this year. These reproductions greatly enhance the moderated poster sessionsand SAEMis pleased to be able to offer them again this year. In addition,the following companiesprovided educationalgrants which havecontributedto the successof the 1995AnnualMeeting: The Upjohn Company ClinicalCommunications, Inc. \Tilford Hall MedicalCenter OhmedaPharmaceuticals SAEMis also grateful for the financial suppoft of many of the Annual Meeting awards: Physio Control Corporation: PhysioControl/SAEMEMSFellowship MICROMEDEX, Inc.: BestOral ClinicaiSciencePresentation \VeatherbyHealth Care:Best EducationPresentation PediatricEmergency& CriticalCare: BestPediatricEmergencyand CriticalCareAward RonaldReaganInstitute of EmergencyMedicine: BestMedical StudentPresentationAward EmergencyMedicineResidents'Association: BestResident/FellowOral Award Matrx Medical:BestTechnologyAward

Speakers' Ready Room A speakers'ready room (ConferenceRoom 19) will be available for those who wlsh to check their slides in advanceof their presentation.

The evening'sentefiainmentis two-fold. First, last year's Imago ObscuraAward recipient, Dr. Norm Paradis,with the assistance of several previous esteemedaward winners, will presentthis year's nomineesand announce the 1995recipient of the Imago ObscuraAward. Therefore,pleasedo not be alarmedif someof your slides turn up "missing"after your presentation.Past winners of the Imago ObscuraAward "collect entries" throughout the meeting. Slidesare returned by SAEM staff after the Annual Meeting. Act II consistsof the annual Ridiculous Abstract Comoetition. Twenty-sevenabstractswere submitted lrying for the honor of acting silly. Go figure! It was a brain numbing experience,however, the brave reviewers narrowed the field to the following semi-finalists: "PhantomCMECredits,"Leslie\X/olf,MD "Improving Out-of-Hospital CardracArrest Survival in a Major Urban Setting:PhaseI Trial - Early Defibrillation by the Homeless,"Jay LanceKovar, MD "TheRochesterPlanfor AcademicPromotion,"LindaSpillane,MD "Do 'Wedgies'CausePetechiae?," Balentine,DO Jerry "Arming Tactical EmergencyMedicine Services(TEMS)Paramedicswith Semi-AutomaticWeapons:The Impact on an Urban EMSSystem,"S.MarshalIsaacs,MD "As Time Goes By: A Meta-Analysisof ConsultArrival Time by Howard Smithline,MD Subspecialty," By the way, if readingthis has made you say, "To heck with my shift - I'm going to the banquet!",ticketsare $15for active,associate,and internationalmembers;$35 for residentsand medical studentmembersof SAEM;and $45 for non-members.Members are entltled to one ticket at the discountedrate. Therewill be a limited number of tickets availablefor purchaseon-siteand all tickets absolutelymust be purchasedby May 22. Also, if you changeyour mind, unfortunately,there are no refundssince meal countsare required a week in advanceof the banquet.

Senior Olympics in San Antonio From May 17-24the 1995U.S.NationalSeniorSportsClassicV, The SeniorOlympics,will be held in SanAntonio. This eventis expectedto draw 8,000 athletesage 55 + and will feature eighteendifferent sports,including archery,basketball,and golf. The various eventswill take place at Trinity University,Fort Sam Houston, and other sites around San Antonio. The scheduleof events and other pefiinent information will be availableat the SAEMbooth for interestedDersons.

All presented research must be approved by Institutional Review Boards for Human Studies or Animal Care Committees and is so certified by authors upon abstract submission. 1995 SAEM Annual Meeting

SPECIALGIIESTSPEAKERS KENIIEDY TECTURE

KEYNOTESPEAKER "The Emergency Depaf,tment as the Safety Net for Non-Emergency Caf,e RonJ. Anderson, MD

L. Thompson Bowles, MD, PhD L. Thompson Bowles, MD, PhD, is the ideal individual to review the importanceof the JosiahMacyJr. FoundationConference on the Role of Emergency Medicine in the Future of AmericanMedicai Care.His breadth of educationaland administrative experienceis unmatched.Dr. Bowles' early yearswere as a graduateof Duke University Medical School in 1957,a graduate of the generalsurgeryprogram at New York Universityand Beller,r,re Hospital Centerin 1)62, a New York Heart Association Fellow and a CardiovascularFellow atBaylor Medical School.At GeorgeXfashingtonUniversityhe was Professorof Surgeryand Administrative Medicine, Dean for Academic Affairs and Vice Presidentfor MedicalAffairs and ExecutiveDean. Dr. Bowles has held multiple leadershiproles including Chairman aI the NationalBoard of Medical Examiners(NBME),multiple leadershiproles at the Associationof AmericanMedical Coll e g e s ( A A M C ) , C o u n c i l o n G r a d u a t eM e d i c a l E d u c a t i o n (COGME),the National Ltfuary of Medicine and the National Committeeon Foreign Medical Education and Accreditation.L. Thompson Bowles has studied medical education,gerontology, minority education,cardiovascularsurgery and in the past several years the role of emergencymedicine. Dr. Bowles' broad vision of our Society,medicine and human beingsmade him the ideal Chairmanof the Macy FoundationMeetingand the ultimate spokesmanfor the implementationof the conferenceobjectives.

1995 SAEM Annual Meeting

RonJ. Anderson,MD, is Presidentand Chief ExecutiveOfficer of Parkland Memorial Hospital, the general public hospital for Dallas County, Texas and the primary teachinghospital for The University of Texas SouthwesternMedical Center at Dallas. Parkland was the first hospital in Texas to be officially recognized by the Texas Departmentof Health as a Level I Trauma Center and is aiso a major referal center for many specialized medical services.Dr. Anderson became Chief ExecutiveOfficer of Parklandin January,1982.He previously seruedas Parkland's medical director for Ambulatory Care and EmergencyServices. He served concurently as head of the Division of Ambulatory Care which became the Division of General Internal Medicine under his guidance in the Department of Internal Medicine at Southwestern.Dr. Anderson has remained on the faculty of the Medical School as Professorof Internal Medicine and continues to see patientsand teach house staff physiciansat Parkland.He has authored and co-authorednearly 200 articles on medicine, ethics,and healthpolicy issues. Dr. Anderson was the 1988 recipient of the James E. Pear,y Award, the highesthonor bestowedby the TexasPublic Health Association,for contributions to the field of public health, and the 1989McGovernAward, the highest honor bestowedby the Texas School Health Association for his contributions to preventivemedicine,health education,and health promotion, In 1990 he received the Texas Nurses Association(District Four) Award as "Health Care Professionalof the Year." He also received the 1990SafetyNet Award from the NationalAssociation of Public Hospitals for the Communiry Oriented Primary Care Programwhich he initiated at Parkland.This innovative concept in preventive medicine has generatedinternationalinterestand was instrumentalin Parkiand being honored as the 1.994 recipient of the FosterG. McGaw Award for community service. Dr. Anderson received the 7992Earl M. Collier Award for DistinguishedHospital Administration,the highest honor bestowed by the TexasHospital Association;DistinguishedHuman Service Professionalof the Year Award from the Community Council of GreaterDailas;and an honorary Doctor of Public Servicedegree awardedby the University of North Texas. He is also the 1993 recipient of the PrismAward from the Mental Health Association of Greater Dallas. In September,1994,he was honored at the National Primary Care Conferenceas a finalist for the Primary Care AchievementAward given by the Pew Health Professions Commission.In October, 1994,he received another award named after Dr. John P. McGovern.This award for humanitarian medicine was presentedby the Associationof AcademicHealth Centers"for his lifelong commitment to public health, preventive medicine, and carefor poor and underseruedpopulations."

lfr

an, 1 IVI:LYZL E 6

e F

o \

e€

E e1 €

(

€

o O

E-

)

C'"

i.j d ljc

a s

)

ec>

fi@

(

-' .,t*

* .

ffi f$

\-{ N

- l

? I

rwl l-l

z t-{ rh

vt . - l

J p A -

ct) l;"'l'l'lll"''" l,llll

;;i:.ll*i l

ll;ullltlilllll:l ll',1'.

.,,lll:::.

..,,,,r1,',:1':',,tt:t", ]lrlr.,irnilr:ti;;

rrrrrlltV ;:l:::,:iil]llll illlllllrri :lll1i:lll tilllrllrllil':llll,,

rllilriii,:,,,,r,,r,tir rlliittrtrtiiiliilii,rt,r

E G

q G

E d

E 6

E (

o o o o o = P ? F- P oo9 ?co ? o,c ? o - - . =

g d

: =

E o =

E g S

E o ;

c.i

E o

o Li-j

rri

1995 SAEM Annual Meetins

= s a

P F

c o a -

c G o

c d o

s? O

o i

)

E O

;

^iC

Mav 22

)

c? C e T

E O

E a

o K

E O

c? O

)

(

s len

$!|

EEIEE k* lsg l*geEF lsg, l*s$cE gp lau Igt;gs IFEgF l*Hsg gEEES lggglgsxEEf$e l*Hgs lFs lgsssg lEcs l*l EEE k Bsb$'gE$$

N N

H (J

&oo

-.*

-g

E \

S . | ,x=

= v

rtl

E d

- "

E F

8.F

tsr

EEeF*

€

f ?'l

Ft H

E E

t ul E (g

c a(

v, a

? ot a o (9 q,

lrl

Fr l-l

ttl t=

Ict)

t F"'i

art b6a

u, -9

o-F

'L 6

s .X

EFE

.d I

tg q)

6t 6

E -

1.,

F.a

E;-.

lL og q

6 i ,q*

iE E d,

E#d€s

0 $

E gl H

' 6 a,t E

u) *a

u gt

v7 E

\ * _()

[rJ

0 q, a 6 d6

-^-\r

f r\io

_qt

ql-

EH* s

rr,

9..

q r g E

@ rl' 'l.q! 'g q, ot)

E N a

? N

E G g

q? o s?o oo o

1995SAEMAnnual Meetins

E G

a q? o

6 o

c? =

,x,.

i6E,

tJJ !t dr,, l!r' _!t +d o g''

E E g

€

e =

<, cl,

E o

;

-c!

E o

-<i'

Mav r 23 e= I

F F E F E E F F a ? _ s F F FE E E = E = E = E

E E E E F P = = F F = E . FR E E ? E E E E E F lllirr:l.: it:::,,a1/li:':"::1:':l::' tt::::.::aitt:')a:::a '.illlr.,t ,,ii:"' l

i,t,,;iil1a

,)l t:::::1:li tll:rl:,,:llli:il:' :::i.11liLa.:

:.,:lij..!,:::':

i1,:11N""', ,'iiiit 'rllltlll ilut:, . ;lilill::]]::lil )i:lltittt:,1:::,:

$ ,

::lil'

2fi,".

g*el

rr,iiil:'::::;llll

,(^ (

):,ttk::t::1 tltl,:,,rl(

(O N

? l

7v'l Fl

z t.( rh \J

r-l lr

A F

rq l+'l t{ (,

ct) llllr:,,ir',ltr,trtl, lllltlllt,,..'rl '::';l:;):a:a:a:))

uli.llilllrlllrllllri

) l"' .,:l:l,,rrrl.,

,:lt:::,:):l:a) ,:.',a)\t

E $ l

)) \,, 1,,N

iirtl lilltrrri]l! ;",\lll|tt

F F E E F F F E E E = E . E . - a= = . 3 E - IE 3. 3I E3 =3 - = F E E E E 8 -R F -= s E a Io, 3 E a a E E dd N 6 .ij i'i + + H E X X = ; ; cj 5 o, ocj od N r! 1995 SAEM Annual Meeting

Mav 24

G a

o f.-

s E

N Q

:e a

6 a

)

o cD

o o

o cf)

;

cr)

sr)

o o

a o

E o

E a

o o

il@

o el b

-c

o F-

r9$ a

-.s) .n)

lg*

.'l 5

fN*

:O * C

.Cf9 8 p ! O U co6

.dr

oo) E C

=*=

Lc) (t)

.1g pt

I H I z

g'*

.H EE:

.<r

EES

E"Esj

.11 E€ gE$ €E t P". -i- :

t-{ rlt

l*lggg l*lgg*lg lEF, l*lgxg klses lg** l*lggEggEEIE=EEl*l €sFg lu gEEEEIFE l*lsg bg, l*lgggi E E q o

vt .

qfj

s ?ctt s s-\ qa

E ! *

,;fi*

fi s,s

ri 7Y't

Ft E

g ((l l!

*v2

3'c,B

A F{

tl a

H l+l

H' !'

()

e I*J g,

e F

Ict)

=El

=,*

l*ie

E * Eo

lg*.

: c E= t I F E € *

s E o c _ a l e o E t t J cCJ'E\-) lca-<q

IJJ

€

gqt

. i

o g e'E

< o

€ al.

c)=

(g\

^E.= E

E G

E 6

t(f) (tl ,x 4tv

(E an

o:E aA c)

E 6

E G

F F F F F F F E E = f u

1995 SAEMAnnual Meeting

{

E 3 E f i E E E f i E f i E f i D

(

)

T AACEM,ACER CORD andEMRA MEETINGS AssocrnuoNoFAceonurcCrrnns OFEMERGENcY Mnorcnrn AACEM Meeting (seeagenda on page 21)

May 22 8:30-11.:15 am ConferenceRooms13 6 14

Annual Business Meeting and Lunch May 22 11:30am-l:00 pm ConferenceRooms13 6 14

AACEM Banquet May 22 7:00 pm

AunnrcanCourcn or prrysrcrexs EunncnNcy Scientific Reviewpanel May 22 3:00-6:00 pm Conference Room10 EMF/ACEp Teaching Fellowship ^ Wine and CheeseReception May 22 4130-6:00pm Conference Roomg Academic Affairs Commiffee May 24 7z3O-9230 am ConferenceRoom14

Corncn or EurncnNcyMnnrcnrE RnsmnNcy Dnncrons CORDMeeting (seeagendaonpage22)

May ZZ !290_5230 pm SalonB g F

Board of Directors May ZJ t2:00-L:30pm Conference Suite530 Cur:riculum Task Force May 2j 9:00-L0:00am Conference Suite530

EunncnNcyMnorcnrn RnsronNrs' AssocrefioN Board of Directors May 20 7:00pm-12t00midnight Conference Room11 May 2l 5:00-8:00pm ConferenceRoom2

EMRARepresentativeCouncil May2l 12:00-2:00 pm ConferenceRoomlg2

EMRA Reception May 22 7:00-8:00pm ConferenceRoom17 E 1g

1995 SAEM Annual Meetmg

FT]NDAMENTATS OF RESEARCHSERIES

M a y2 2 , 2 3& 2 4 Thesepresentationsare aimedat the novice researcher(particularlyresidentsand junior faculty), and will attempt to identify, define and clarify some basicresearchconcepts.Eachsessionwill concentrateon a particularconcept,and develop it from tire standpointof the new investigator.The approachwill center on "how to" learn, understand,and apply the concept to the researchsetting.Each presenteris an experiencedresearcherin emergencymedicine, and is willing to share "tricks of the trade." Even individuah w[o never intend to do researchmay benefit from knowing how thesebasic conceptsare applied in the researchthat eventuallytouchestheir clinical practice.

Mav 22

Fundamentals of Researth: Getting Started in Research Michelle Biros, MS,MD, Hennepin County Medical Center \(e are all motivated to do researchfor different reasons,and our sources of inspiration for a researchquestion vary. However,researchersall possessa basic desireto learn and to know. This sessionwill discussdefining a researchquestion,translating the question into a project, and taking the first steps to start a researchprojector a researchcareer.

Fundamentals of Research:ResearchDesrgn part 1: The Research Question and Hypotlresis Generation NorrnanA. Parad,is,MD, Columbia Uniuersity The speaker will discusshow to identify an appropriate researchquestion, keeping in mind that an appropriate research question must be important, definable in terms of measurable quantities,and answerablegiven the experienceand resources of the investigator.

May 2J

Fundamentalsof Research:ResearchDesign part 2: SpecificResearchDesigns Edward Panaceh,MD, Uniuersityof Califoruia, Dauis Transforminga specific researchquestion into a researchprotocol requiresa knowledge of the basic types of researchdesign. There are a number of different design types and ways of categorizing them. This lecture will present a standardizedsystem for understandingthe spectrumof researchdesigns.It will also go over each design type and explain its advantages,disadvantages,limitations and ideal applicationto researchquestions. The focus will be on clinical research,though design types applicableto basic researchwill be listed. This sessionis designed to be very practtcaland will illustrateexamplesusing actual emergencymedicine studies.

Fundamentals of Research: Critical Reading of the Medical Literature M, Andrew Leurtt,DO, Higbland GeneralHospital One of the most importantstepsin any researchproject is critical readingof the literature,with the goal of identi$ringweaknesses and omissionsin the work akeadvperformed.The soeakerwill discussspecific characteristicsoh published studiei that may reducethe reliabilityof the conclusions,and how theseproblems may be detected by the discerningreader. This sessionwill discusshow to read critically to obtain the knowledge base to convinceothers of the significanceand novelty of the question you proposeto addresswith original and relevantresearch.

Fundamentals of Research: Basic Statistics RogerJ.Iewis, MD, PhD, Harbor-UCLAMedicalCenrcr Early in the course of planning a project a researcherneeds to make an appraisalof the outcome parametersto be measured, the feasibility of doing the study in a given parient population, the number of patients needed for statisticalcomparison, and 1995 SAEM Annual Meering

the analyticalmeans of addressingthe researchquestion.Early statisticalconsultation can assistwith these questions,but the researchermust provide the information the statisticianneeds for critical and analyrcal review of the proposal. This session will concentrateon those statisticalconceDtsand methods that must be understoodif the investigatoris to be able to communicate with a biostatisticianand productively collaborate in the designand analysisof a clinical study.

Fundamentals of Research: Archival Data Research: How to do a Chart Review SteuenR, Iowenstein, MD, MPH, Uniuersityof Colorado Chart reviews are often used to conduct researchin emergency medicine.However, the reliability of dataabstractedby chart reviews is seldom examined critically. This sessionwill focus on the researchuse of medical record data. Pitfalls and oroblems. such as missing charts,missing or conflicting data,poorly trained abstractors,blinding, bias, and interrateragreementwill be discussed.Published afticles from the emergencymedicine literaturewill be used to illustratemethodologicerrors.This session will then present eight critical strategiesthat can improve the validity and reproducibility of medical record reviews.

Mav 24 Fundamentals of ResearAh: Ethical Considerations in Human Subject Research kffrey W. Runge,MD, Carolinas Medical Center The mechanicsof initiating a researchproject go beyond the developmentof a researchprotocol.It is essentialto obtain research approvalsand consentfrom your institution as well as from individualswho may volunteerto becomeyour researchsubjects.In the enthusiasticquest for knowiedge,researchers may sometimes overlook or forget basic principlesof human rights and welfare. This sessionwill focuson the ethicalaspectsof human research.

Fundamentals of Research: Abstract Thinking: HowtoWrite anAbstract JamesJ.Menegazzi, PhD, Uniuersityof Pittsburgh This sessionwill cover the presentationof researchfindings in al> sffactform. The structuredabstractformat will be emphasized.Eight essentialcomponentsof a successfulabstractwill be presented, along with ten simple rules for writing a good abstract.Examplesof well written abstractsand their counterparts,will be given.

Fundamentalsof Research:The Art of the Scientific Presentation Michelle Biros, MS,MD, Hennepin County Medical Center There is an art to the oral or graphic presentationof research findings.\X/hileexperienceis the best teacherand practicemakes perfect,there are some mistakesthat one can leam to avoid from otherswho have made them! This presentationwill focus on the developmentof a good researchpresentation.Basedon one researcher'spersonalmistakes,observations,and contemplation, this sessionwill discusscommon errors and misconceotions about researchpresentations, and how to avoid them. o

THE EMERGENCYCAREOF THE ETDERPERSON: A COURSEFORTEACHERS May 2l &22 MD, uniuersityof Arizona; Edward Bernstein' Anbur B. Sand.ers, of MD, Boston (Jniuersity;Rawden Euans, MD' PhD, {Jniuersity UniSciences Uichtgan; Norm XalbJteiscb,MD, Oregon,Healtb uersiti;JosephLaMaitia, MD, Long kland,Jewish Medical Center; iloien McNamara, MD, Medical Colleg.eof Pennsyluania; Donald witzke, PhD, LlniuersitJtof Kentucky; Robert woolard'' MD, Brown Uniuersity segElder personsrepresenta significantand ra.pidlygrowing paOlder care medical emergency needing patients rrr.nt of the tients, simila; to young chiliren, iu," u unique physiology and diseasepatternsand presentations.The model of emergency medical'care used foi children is different than rhe medical model used for adult patients The SAEMGeriatric Emergency prinMedicineTask Force his worked for two yearsto develop of model new a and ciples of geriatric emergencymedicine didactic eight-hour This persons' elder "rn"rg.n.! care for geri.orr# -iif introduce participantsto the unique issuesof are: atric emergencymedicine.The goals of the course 1. To understandthe changesin anatomy,physiology,pharmacology and psychologythat occur with age' pa2. To learn the overall principles of managingthe geriatric tient in an emergencycareenvironment' the interactionof 3. To learn the concept of functional statusas environment' age, diseaseand of 4. To learn the pathophysiologyancl emergencylreatment n e u r o l o g ic' elderly patients wiifr common medical, psychologicand surgicaldiseases' in The initial course at the SAEMAnnual Meeting is for teachers to the material to willing be will who medicine ...rg.n.y -use at their home institutions Each person attending [^.tt""tnl,* will receive a prepublicationcopy of a textbook of geriatric to "t.rg"n.y med'icineas well as a packet of teachingmaterials environment' home their to course the adapt enabie thlm to use.of The coursewill be lase based and interactive,making eleDidactic overheads,videotapes,and a teaching manual include: material textbook mentscoveredin thb courseand I . \fuy do older patientsrepresenta specialpopulation for emergencymedicine? a. DemograPhics,aging and EMS testsand aging b. nhysiologicchanges/diagnostic aging and c. PharmacologY d. Ethicalissues- advancedirectives,futility, etc' e. Attitudes/ageism I I . Model for emergencycare of the elder patient' T1 Specificinstrumentsfor the emergencydepartment of the elder Patient' assessment a. ED mentai statusexam b. ED functional assessments c. Casefinding

clinical IV. Emergencydepartmentapproachto specificgeriatric issues. a. Altered mental status b. Functionaldecline c. TraumalFalls d. Elder mistreatment e. Acute mYocardialinfarction f. Acute abdomen s. Infections f,. Cerebralvascularaccident i. Dizziness audioThe format for the coursewill include two videotapes,_an will hours eight the of Six tup., Jit."ttions and demonstrations is course The discussions based case to interactive, be cievoted limited to 48 attendees.Pre-registrationis required' CourseObjectives: patients 1. Demonstratea sensitivity to the needs of elderly decisions' and respectfor their ability to make lifestylesof older per2. Recognize "and the diversity in health and of elder personslive maiottty the ihat understand sons active,productive,meaningfullives' (appendicitis, myocatdial. 3. liscuss which commo., diseuses patients with atypical elderly in present infarction, etc.) than the presentations different are that symptoms signsand in youngerPatients 4. Oiscuss-whichlaboratorytests are physiologicallyaltered with aging and which testsare not changed' the ability to do a formal mentalstatusexamfor 5. l"."fitoi" the elderly patient in the emergencydepartmentenvironment' evalu6. o.rnont,iui" the ability to do functional assessments in an patients (ADL) elderly of living ating activitiesof daily setting dePartment emergency 7. DemSnstratethe ability to define and diagnosedementia and delirium in elderlYPatients' in8. D"rnonrtrut" the abiliiy to diagnoseand treat myocardial myool importance the discuss patients; elderly in farction iutiiu,t salvage foi elderiy patients with acute myocardial infarction. of falls in the el9. Discussthe etiologiesand pathophysiology fall victim' elderly the for to care the abiliqr derly; demonstrate 10. Demonstratethe ability to detectand marlageelder mistreatphysicalnement, includingphysicalabuse,sexual-assault, neglect and abuse glect,and psychological and 11. bemonstrate'theability to diagnoseand managetauma discuss patient; acute abdominal emeigenciesin the elderly the differencesin the ipproach to elderly patientswith surgical emergenciescomparedto the non-eldedy' present12. bemonstraie the ability to manageelderly patients acute and ing with altered mental status,functional decline, infections. 13. Demonstratethe ability to addressthe psychosocial.needs of the eldedy being diicharged from the emergencydepartment, demonstrat6the use of community resourcesand multidisciplinary approachto some problems

1995 SAEM Annual Meeting

DIDACTICSESSIONS Performance BasedAssessment of Residents lYrilliamBurdick, MD, Medical Collegeof Pennsyluania Emil Petrusa,PbD, Duke Uniuersity Using videotapesand caseexamples,the panelistswill describe the developmentand implementation of a pedomance based assessment of emergencymedicine residents'clinical skills. Reliability and validity of performancesbased assessmentwill be examinedin the context of the educationtheory that underpins this type of evaluation.

Undergraduate Educatofs' Luncheon: Education Research-What is it? How do you do it? William Burdick, MD, Medical Collegeof Pennsyluania Emil Petrusa,PbD, Duke Uniuersity Educatorsin EmergencyMedicine need to critically examinethe techniquesused to teachgraduatesand undergraduates, and then publish results in peer-reviewedjournals.This luncheon will discussthe basicresearchtools neededfor educationresearch,as well as the forums availablefor presentationof this research.

Luncheon: International Emersency Medicine Opportunities for Education add Practice Moderator:TbomasD, Kirscb,MD, MPH,JobnsHopkinsSchool of Medicine Antbony Good,MBBS,RoyalHospital,Iiuerpool,England 'Western JosepbEpstein,MBBS,Director of EmergencyMedicine, Hospital of Australia SigridJarueklug, Mustamae Hospital, Pallin, Estonia Ramzi S.Musbarafiyyeb, MD, Director, EmergencyUnit, American Uniuersityof Beirut Kaja Pukk, Mustamae Hospital, Pallin, Estonia Nour Sirker,BaptistHospital,Managua, Nicaragua A panel of internationalemergencyphysicianswill discussemergency medicine in their respectivecountries.Specificquestions regardingemergencydepartmentfunction, the prehospital system,physiciantraining,the strengthsand weaknessesof emergency medicine and how SAEMand U.S. emergencyphysicians can assistthem will be addressedto the oanel bv Dr. Kirsch.The audiencewill also be invited ro quesrionihe panel members.

Bedside Observation of Residents - How Often? How Formal? IYtilliamBurdick, MD, Medical Collegeof Pennsyluania Rita K. Cydulka, MD, MetroHealtb Medical Center Kurt Kleinscbmidt, MD, Uniuersityof TexasSoutbwestent IVilliamP. Rennie,MD, Long IslandJewisbMedical Center One method of clinical skill assessmentis direct obseruationat the bedside.The panelistswill discussthe implicarions of the surueyconductedby the National ConsensusGroup on Clinical Skillson the frequencyof residentobservation.Pros and cons of a structuredobservationof residents'bedside interactiveand proceduralskills will be discussedby the panelistsusing their own programsas examples.An overview of the use of direct observationin other specialtieswill also be presented.

Fundamentals of Dealing with News Media in Academic Emergency Medicine - Pafi lz Anatomy, Physiology and Basic Strategies for Interaction Moderator:Roben Scbaferrneyer,MD, Carolinas Medical Center Patti Dracos,NewsProducer,NBCAffiliate KI,|OL-TV,SanAntonict Dauid Glodt, Former ExecutiueProducer, ABC WeekendNews 1995 SAEM Annual Meeting

May 2l

and Tbis lVeekwitb Dauid Brinkley Dauid Goldberg,NewsDirector, CBSAffiliate KHOU-W, Houston Nancy Holland, SeniorReponer,CBSAffiliate KHOLI-W, Houston RebeccaNieto,NewsProducer,ABC ffiliate KABC-ry los Angeles Paul Pepe,MD, Baylor Collegeof Medicine Despite routine interaction with the various news media, few physiciansare famihar with the actual structure,hierarchy and decision-makersin a news organization and their subsequent news production. The purpose of this sessionwiil be to provide a basic insight into those key entities/processes and, accordingly, provide strategiesthat will help academicemergencyphysiciansto: 1) best focus their energiesfor promoting emergency health care information as well as illness/injury prevention; 2) become more proactive with public education through the various media; and 3) learn Ten Golden Rules for achieving better medical communicationand interactionwith the news media.Various expefis from the electronicnews media will provide both didactic and video presentationas well as panel discussionsregardingthe materialpresented.

Fundamentals of Dealing with News Media in Academic Emergency Medicine - Part tr: Communication Objectives and Interview Workshop for the Academic Emergency Physician Moderator: Paul Pepe,MD, Baylor Collegeof Medicine Patti Dracos,NewsProducer,NBCAffiliate KI,IOL-ry SanAntonio Dauid Glodt, Former ExecutiueProducer, ABC \{/eekendNews and This Weekwitb Dauid Brinklejt Dauid Goldberg,NewsDirector, CBSAffiliate KHOU-W, Houston StephenIV, Hargartery MD, MPH, Medical Collegeof Wisconsin Nancy Holland, SeniorReporter,CBSAffiliate KHOU-W, Houston RebeccaNieto,NewsProducer,ABC Affiliate KABC-TV,IosAngeles RobertSchafermeyer,MD, Carolinas Medical Center In this follow-up to Part I, various SAEMmemberswill present some of their own experienceswith the media and, in turn, make specificproposalsfor future communicationobjectivesfor academicemergencyphysicians.An expert panel of media representativesand decision-makerswill react to and discussthose perspectives.The remainderof the sessionwill then be devoted to an interactive(live) interview workshop in which audience members can volunteer to undergo mock interviews by the media experts (using actual emergencymedicine topics). Live taping and playback of interviews will be conducted and interviewees will receive immediate feedback from other audience membersand the panel of experts (attendanceat Pafi I is considereda pre-requisitefor this part of the session).

Faculty Development Environment, Promotion and Tenufe GloriaJ. Kuhn, DO, GraceHospital Jobn C. Moorbead,MD, OregonHealtb Sciences(lniuersity DouglasA. Rund, MD, Obio StateUniuersity NicholasJ. Jouriles, MD, CaseWesternReseruel-lniuersity V. Gail Ray, MD, Uniuersityof Arkansas Faculty developmentis a key component of a maturing specialty. This panel will highlight how academic chairs develop faculty. Topics specificallyaddressedwill include development of new faculty, development of senior faculty, sabbaticalsand how to set up a program at a brand new academicdepafiment. In addition, there will be discussionon how to develop your own skills. From this panel, the learner should learn both the basicsof faculty developmentand severalsuccessfultools. 11

May 2l

ORAI PAPERS

Scientific Papers 1: Plenary (8:0f10:00 am)

016 Comparisonof HyperbaricOxygen and DapsoneTherapy

for LoxescelesInvenomation in a Swine Model, Gregory D. Hobbs,MD, ScottE \VhiteMemorial Hospital

Mod.erator: Michelle H. Biros, MS, MD, Hennepin County Med:ical Center 001 ProspectiveValidation of a Decision Rule for the Use of Radi,cgraphyin Acute Knee Iniuries, Ian G. Stiell,MD, Uniuersityof Onawa

0r7 Direct NoninvasiveAssessmentof the Effect of Hydrox-

002 RelationshipBetween Effectivenessof BystanderCPRand Survivalfrom Cardiac Artest,Paul Gennis,MD' Alben Einstein Collegeof Medicine

018 Prevalenceof the Use of Cocaine in Patientswith Chest Pain, Knox Todd, MD, MPH, LlniuersityMedical Center, StonyBrook

003 Efficacyof IntravenousMagnesiumin Moderateto Severe Asthma in PediatricPatients,Andrew H. Sauer,MD, Haruard Medical Scbool

Man019 A ProspectiveEvaluationof the Electrocardiographic Belleuue MD, Vassallo, Susi Hypothermia, ifestatibns of HosPitalCenter

004 Reliability of PerformanceBased Assessmentof Emergency Medicine Residents,Ix/illiamP' Burdick, MD, Medical Collegeof PennsYluania

020 Cocaine CausesDose Dependent CardiacToxicity in an Animal Model of Cocaine Abuse, Lance D Wilson,MD, Mt. Sinai Med,icalCenter

005 \(orkforce Projectionsfor EmergencyMedicine:How Many EmergencyPhysiciansdo we Need?,C / Holliman, MD, PennsYluaniaStateUniuersitY

Scientific Papers 4z lmaging/Diagnostics (1:3f3:00 Pm)

005 The Sensitivity,Specificityand Accuracyof ED Echocardiography, Daue Plummer, MD, Hennepin County Medical Center 007 24 Hours in the Life of an ED: Ambulatory Patientsat 56 EmergencyDepartments, Gary P. Young,MD, Higbland HosDttal

ocobalaminon CyanideToxicity, Edwqrd C' Cetaruk,MD, Uniuersitvof Colorado

Moderator:Joseph F. Waeckele, MD tlnhtersity of Missouri, Kansas City 021 Sensiiivityof New Generation Computer Tomographyin DetectingSubarachnoidHemorrhage,TbomasA' Sames, MD,IYrilfordHall Medical Center 022 Computed Tomography (CT) in the Dlagnosisof. SubarachnoidHemorrhage:Is Spinal Fluid Analysisalways Needed when the CT is Normal?,RobeftD' Sidman,MD, RbodeIsland HosPital

008 Determining the Correlationof DemographicFactorsand InsuranceStatuswith Patient'sFrequencyof Emergency DepartmentYisits, ValdaR' Crowder,MD, CooperHospital

023 The Reliability of EstimatingintraperitonealFluid Volume

Scientific Papers2; lniury Prevention/Control (10:30-12:00 noon)

024 RadiographicMisreadsas a Function of Level of Training,

Mod.erator: Stepbanie B, Abbuhl, MD, uniaersity of Penn' sybania OOq Can Three Brief QuestionsDetect DomesticViolence in the EmergencyDepartment,Kim M. I;eldbaus,MD, Denuer GeneralHosDital 010 SafetyRestraintLaw ReducesSoft TissueInjuries and ED/ Hospital Charges,Bruce Welkouicb,MD, BostonCity Hospital 011 WeaponsInvolvementin Home InvasionCrimes,Arthttr I. Kellermann,MD, MPH, Emory Uniuersity 012 BehavioralRisks in EmergencyDepartmentPatients:A Multl-Site Study, SteuenR. Iowenstein,MD, MPH, Uniuersity cf Colorado 013 The Effect of LegalizedGaming on Traffic Safetyin Colorado,Jane Koziol-Mclain, kN,MS, Llniuersityof Colorado 014 PersonalSafetyand Ownership of FirearmsAmong Emergency Physicians,Marc Eckstein'MD, IosAngelesCounty/ Uniuersityof SoutbemCalifornia

Scientific Papers 3: Toxicology/Environmental (10:30-12:00Noon)

Mod,erator: Sandra M. Scbneider, MD, Unittersity of Rocbester 01,5 IncreasedGlutathioneand GlutathioneDisulfide in Severe Carbon Monoxide Poisoning,StephenR Thom,MD, PhD, LIniuersity of PennsYluan ia 12

with Ultrasound, Scott'W,Branney, MD, Denuer General Hospital Howard Freed,MD, Albany Medical College

025 The Incidence of Clinically SignificantDiscrepanciesin EmergencyDepartmentRadiographInterpretationwhen EmergencyPhysiciansare Confident, Cra|6 A. Manicks, MD, Hennepin CrtuntyMedical Center

026 High Negative PredictiveValue of Bedside Measurement of'b-aimer for Gram-NegativeBacterenia, Gary Quick, MD, tlniuersityof Oklahoma

Scientific Papers 5: Cardiopulmonary Resuscitation (L :30-3:00 Pm)

Moderator:James T. Niemqnq MD, Harbor-UCI-A Ef027 Validation of Criteria for Termination of Resuscitative lombardi, Gaty forts in Out-of-Hospital Cardiac Atrcsq MD, Albefi EinsteinCollegeof Medicine

028 SelectiveAortic Arch Perfusion(SMP) During CardiacAr-

rest: EnhancedResuscitationUsing SequentialPulsedDiastolic Infusionsof OxygenatedAutologousBlood,JamesE' Manning, MD, Llniuersityof North Carolina at CbapelHill

029 Effectsof GradedDosesof Vasopressinon Median Fibril-

lation Frequencyin a Porcine Model of Cardiopulmonary H.LI,Strobmenger,MD, uniuersityof Um Resuscitation,

030 The Effects of Endothelin-1on ResuscitationHemodynamics During Cardiac Lrtest, Daniel J. DeBebnke'MD, Medical Collegeol lXlisconsin

i995 SAEMAnnual Meeting

May 2l 031 Serum-NeuronEnolaseAs Additional Predictor for CNSFailure in Cardiac Arrest Survivors, Patrick R. Martens, MD, A.Z. St.-IanHospital,Belgiurn

037 The Effect of ManagedCareon the Number of Emergency Department Yisits, StephenK. Epstein, MD, MPP, Hennepin Count! Medical Center

032 Effect of SelectiveAortic Arch Perfusion on Median Frequency and PeakAmplitude of VentricularFibrillation in a Canine Model, Cbristopber W. Barton, MD, tlniuersity of Nortb Carolina at CbapelHill(See erata below)

038 How Much Do \fle SaveFrom One LessEmergencyDepartment Visit?,RobertL. Wears,MD, MS, (Iniuercityof Florida

Scientific Papers6: Health CareDelivery (3:30-5:00pm) Moderator: Teretrce Valenzuela, MD, (Iniuerstty of Arizona, 033 InadequateFunctionalHealth LiteraryAmong Patientsat Two Public Hospitals,Mark V.'Villiams, MD, Emory tlniuersitlt 034 Is the American Collegeof EmergencyPhysicians'(ACEP) CalculatedNumber of PracticingEmergencyphysicians UnderestimatingCurent Needs?,Carolyn E. Haase,MD, IVasbingtonUniuersity,St.Louis

ScientificPapers7: Education(3:3f5:00 pm) Moderq.tor: Mary Ann Cooper, MD, Uruiaersity of lllilnis 039 How Often are EmergencyMedicine ResidentsObserved at the Bedside?, lVilliam P. Burdich, MD, Medical College of Pennsyluania 040 EmergencyMedicine in US Medical Schools,Barbara Barzansky, PbD, AmeNcan Medical Association 041 EM ResidencyTraining as Evaluatedby PracticingResidenry Graduates,Kent N. Hall, MD, tlniuersityof Cincinnati

035 InappropriateEmergencyDepartmentUse:The Eye of the Beholder,Marc J. Sbapiro,MD, RhodeIsland Hospital

042 How Current is the Current EmergencyMedicine Literature?,John E. Gougb,MD, East Carolina tlniuersity 043 Rapid ConsensusDevelopment, Michelle Biros, MD, MS, Hennepin CountyMedical Center

036 Impact of EmergencyMedicine ResidencyTraining on the Evaluationof AtraumaticChestPain in the EmergencyDepartment, Robin Mantootb, MD, Joint Military Medical Centers

044 A Computer Tracking Program for ResidentPatient Encountersto Monitor Clinical Experiencesin Emergency Medicine: Description and PsychometricAssessment, GregoryJ.Mosdossy,MD, Sudbury GeneralHospital

*Thetablein the abstract wasincomect in theMayissueof AEfuI. Thecorectedtable is publishedbelow: (12 min) Pre-SAAP Deffb-l (12.8min) Group MF (Hz) PA(mV) MF (Hz) pA (mV) Control 7.81 1.8 0.38! .1.4 7.3t L.4 0.39t .7i SAAP 7.3t 0.7 0.56t .13 9.6! 0.4* 0]4 r .27*

Defib-2(13.Smin) MF (Hz) pA (mV) 7.Zt 0.Z 0.58t 0.09 7.3r 1.0 1,.03 ! 0.34*

* p < 0.05vs Control.t-test

1995SAEMAnnual Meering

May 22

DIDACTICSESSIONS

Faculty Development: ResearchCareers Michelle Biros, MS, MD, Hennepin County Medical Center Jerris Hedges,MD, MS, OregonHealtb SciencesUniuersity John Marx, MD, Carolinas Medical Center Jobn Younger,MD, Uniuersityof Micbigan This panel will discussthe developmentof researchcareers within EmergencyMedicine. Severalviewpoints will be presented.Dr. John Younger is a current ResearchFellow and will discusswhat conffibuted to his decision to pursue a fellowship instead of directly entering clinical practice. He will also talk about his perceptionsof existingfellowships.Dr. John Marx will present the perspective of a departmental chief on how academic emergencydepartmentscan suppofi the developmentof the researchcareersof academic staff. As a profile researcher and editor of Academic ErnergencyMedicine, Dr. Jerris Hedges is in the unique position to presenta btoad overview of the development of the researchof our specialry,and suggestwhat we can do to further advancethis aspectof our academiclives.

State-of-the-Art: Evolving Concepts in and Management of Hemoffhagic Hypotension William Bickell, MD, Llniuersityof Oklahoma SusanStent,MD, Uniuersityof Michigan Paul Pepe,MD, Baylor Collegeof Medicine ThomasScaleaMD, Kings County Hospital - SUNYBrooklyn This 90-minutecoursewill cover the historicalperspectives,military obseruationsand early laboratory models of hemorrhagic hypotension.Investigatorswill also discussrecent developments in laboratory models of uncontrolled hemorrhageand the controversy regarding appropriate end points of resuscitation. Finally, the resultsof the latest clinical trials assessingthe management of hemorrhagic hypotension and a perspectiveon future clinical researchdirectionson this impofiant topic wili be discussed.

Luncheon: Acute Asthma ResearchState-of-theArt AdvancedStatistics:Multiple Comparisons RogerJ,Iewis, MD, PbD, Harbor-UCU Medical Center Robert Wears,MD, Uniuersityof Florida Eachtime one conductsa statisticaltest,there is a chanceof obtaining a statisticallysignificant tesult, even if there is really no differencebetween the two groups being compared.This risk of a false positive result becomesoverwhelming if many comparisons are made using multiple statisticaltests. In this advanced statisticslecture, the speakerswill review the most common statistical methods for dealing with this problem, including the Bonferroni correction,analysisof variance (ANOVA), and posthoc multiple comparisonstests, and describe the benefits and limitationsof theseprocedures.

Moderator: Emil Skobeloff,MD, Medical Collegeof Pennsyluania E.R.McFadden,Jr, MD, UniuersityHospitalsof Cleueland Ricbard M, Nowak, MD, Henry Ford Hospital Dr. Regis McFadden, an internationally renowned asthma researcherwill be the featured speaker at the Asthma Interest Groups' luncheon. Given his vast experiencein airways research,he will review new advancesin the understandingof the pathophysiologyof acute asthma,with particular emphasis.on bmergencymedicine researchopportunities from a multidisciplinary approach.He will also discusshis overall vision of the role of the emergencyphysicianin the care of the asthmatic patient and how EmergencyMedicine can develop linkages *ith other national organizations.Dr. McFadden'sremarkswill be followed by an open forum, question and answer period. It is anticipated that this lunchtime symposium will be as lively and interactiveas last year's,

EMRA/SAEMResident Leadership Forum

'il/asbington Moderator: Dauid Magid, MD, Uniuersityof Carejt Cbisbolm,MD, Metbodist Hospital of Indiana Marcus Martin MD, Allegbeny General Hospital TeresitaHogan, MD, Uniuersity of lllinois, Chicago Artbur Kellermann,MD, Emory Uniuersity LouisLing, MD, Hennepin Count! Medical Center Carol Scott,MD, [Jniuersityof Maryland JamesScott,MD, GeorgeWasbington Uniuersity RebeccaSmitb- Coggins,MD, Stanford Uniuersity Ahmed Stowers,MD, GeorgeWashington Uniuersity This sessionis open to all residentsbut is designedspecifically for residentswho anticipatean active leadershiprole during the course of their training. The forum will start with a lecture by how to be a good teacherwith particular emphasison how to be an effective teacher in the emergencydepartment.Our second sessionwill be a panel discussionon ethnicity issuesin medicine.This sessionwill addresssensitiveissuesrelated to ethnicity and gender that a resident might encounter.The final sessionwill be a panel discussionthat will focus on a vaiety of topics of importance to chief residentsin an emergencymedicine residencyprogram. Some of the issuesthat the panel will address are building morale, teamwork, motivating residents, conflict resolution, and scheduling hints. Continental breakfast 'XteatberbyHealth Care. complimentsof I4

Luncheon: DisasterMedicine - Impact of Current Researchand Implications for the Future Kristi L, Koenig, MD, Higbland GeneralHospital Paul Rotb, MD, Uniuersityof IVewMexico Carl H. Scbultz, MD, Harbor-UCIA After an overview by the moderator, the panelistswill discuss three important issuesin disastermedicine researchand education. Using eafthquakesas an example,the speakerswill review recent researchdata describingthe problems faced in providing medical care following a catastrophicdisaster.They will further discusshow the Medical DisasterResponse(MDR) protect,as a Dotentialsolution, utilizes this data to constructa directedmedical responseand addressmany of these issues.In addition,panelistswill presentthe rationalefor use of epidemiologicmodeling as a methodology to investigatedisasterrelated injuries,illnesses,and other medicalproblems and describehow the methodology is used to obtain research data. L^stly, speakerswill Dresentwork to date on disaster medicine curriculum recommendations.Also to be discussedis the establishmentof this cuniculum at the undergraduatelevel and the oppofiunity this representsfor emergencymedicine. 1995 SAEM Annual Meeting

May 22 EMRA/SAEMVilliam H. Spivey. MD. Resident Research Forum: Evidenc? Balad ubdical Decision Making GlennHamilton, MD, WrtgbtStateUniuersity Cliniciansregularly confront dilemmaswhen ordering and interpreting diagnostictestsor when making treatrnentdecisionsfor their patients.This sessionwill demonstratean approach to making optimal use of the information that is published in the medical literature.Dr. Hamilton will discusshow to determine whether the results of a study arc valid, how to interpret the results,and whether the infomation will benefit your patients. Ligbt refresbments coruplimentsof Marion Merrell Dow,

Firearm Related Iniuries and Deaths: A State-ofthe-Art Session on Clinical. Research and Public Policy Issues VincentDiMaio, MD, RegionalCrimeLaboratory,County of Bexar, Texas Artbur Kellermann,MD, MPH, Emory Uniuersity Garen \Vintemute,MD, MPH, Uniuersityof Caffirnia, Dauis Firearm-relateddeaths and injuries are continuing to increase, Already firearm-relateddeaths outnllmber motor vehicle crash deathsin severalstates.Firearm-relatedsoinal cord iniuries are emergingas a leadingcauseof permanentdisability.Advances in clinical care,research,and public policy have been limited in academicemergencymedicine. This didactic sessionbrings three national experts together to discussstate-of-the-artissues in the areasof acute care, research,and public policy. This session promisesto be useful for academicemergencyphysicians in the developmentof successfulfirearms-relatedresearchin their institutions.

RegulatoryIssuesUpdate- Issuesof Consentin EmergencyResearch Moderator: Micbelle Biros, MS, MD, Hennepin County Medical Center Cbris Doherty,JD, Fox, Bennett E Turner RogerJ.Iewis, MD, PhD, Harbor-UCU Medical Center Jeffrey W. Runge,MD, Carolinas Medical Center Recent controversy has arisen between the fecierai reguiators and the resuscitationresearchcommunitv over interpretationof

1995 SAEM Annual Meetins

the curent federal regulationsguiding researchstudies involving patientswho are unable to give prospectiveinformed consent. Many studies which attempt to use waiver of consent or exception to informed consenthave been placed on hold or completelystoppedby the Food and Drug Administrationor Office of Protectionfrom Risk Research.I7e will discussthe issues and politics involved in this controversy,and provide an update on the move (spearheadedby SAEM) to develop new regulations that wili allow ethical acute resuscitationand critical care human researchwhen patientsare unable to give consent.

Fractals and Beyond: Chaos and Non-linear Dynamics in Emergency Medicine Research CbarlesG, Brown, MD, Ohio State Uniuersity CharlesB. Caints, MD, Uniuersitl of Colorado This sessionwill addressrecent developmentsin chaos theory and its application to emergencymedicine research.Specific topics to be covered include the use of neural nefworks in the diagnosisof acute myocardial infarction, fractal dynamicsin EKG analysis,and non-equilibrium thermodynamicsin ischemia reperfusionresearch.

Lar ge Databank Research Jerris Hedges,MD, MS, OregonHealtb Sciencestlniuersity Clay Mann, PbD, OregonHealtb Sciences(Iniuersity Andreu Zechnicb,MD, OregonHealth SciencesUniuersity The speakerswill review the basic principles behind designing and implementing large databaseresearch.The discussionwill include the following topics: the advantagesand disadvantages of using large databases in health seryicesresearch,locating and acquiring accessto existing data sources,issuesrelated to the managementand analysisof \arge databases,approachesto technologicalbarriers,common pitfalls of large databaseresearch,and security and ethical issues.Exampleswill be given from the speakers'experiencewith databaseresearchin trials such as Oregon rurai trauma researchand anaiysisof drug interactionsusing Medicaidclaimsdata.

1.5

May 22

ORALPAPERS

ScientificPapers8: Trauma(8:00-10:00am) Moderator: Tbomas M. Scalea, MD, State Unhtersity of New York, Brooklyn 045 Neurologic Deficit and Cervical Spine Injury in Patients with Gunshot Vounds to the Neck and Face, CbailesJ. Hauel,Jr, MD, Medical Collegeof lVisconsin 046 A New Model of Uncontrolled Intra-Abdominal Hemorrhage Allows Stratificationof Iniury Severity and Direct Correlation of Blood Pressureand Rate of Hemorrhage, Robefi Silberglert,MD, Medical Collegeof Pennsyluania

Scientific Papers10: Pediatrics (10:3H2:00 noon) Mod,erator: Susan Fuchs, MD, IJniaersity of Pittsburgb 051 Effects of Medicaid Managed Care on Infant Emergency DepartmentlJse, EualineA. Alessandrini,MD, Cbild'ren's Hospkal of Phil adelPhia uoz IntramuscularKetamine is Superior to Meperidine, Promethazine and Chlorpromazinefor Pediatric Emergency DepartmentSedation,Emory M. Petrack,MD, MPH, Case 'V/estern ResetaeUniuersity

047 ProspectiveEvaluationsof the American Collegeof Emergency Physicians(ACEP)TruumaTriage Guidelinesin the Rural Setting, William H. Bickell, MD, lYarren Clinic

063 FactorsContributing to PreferentialUse of the ED for

048 NoninvasiveAssessmentof TissueMetabolismin Critically Injured Trawa Patients,CharlesB. Cairns,MD, Uniuersity of Colorado

064 NeonatalFever:Validation of the RochesterCriteriain Deter-

049 The Effect of Prehospital Blood Transfusion on Patient Outcomes in Blunt Tratma, Robert L, Brown, MD, GeisingerMedical Center

065 Do Oral Antibiotics Prevent Meningitis in Children with

050 Use of a Neural Nefwork to Predict Inttactanial Injury in Blunt Head Tratma, Pierre Borczuk, MD, Massachusetts GeneralHospital

056 PediatricDrug Therapy in the EmergencyDepartment:

051 Use of a Dual-LevelTrauma Responsein the Emergency Department to More Rapidly Identify and Treat Patients RequiringAdmission,GlenH. Tinkoff,MD, Medical Center of Delaware

ScientificPapers11:ResPiratory (10:30-12:00 noon)

052 Is Closed DiagnosticPeritonealLavageContraindicatedin Patients with Previous Abdominal Surgery?,Gregory Moore, MD, Metbodist Hospital of Indiana

Nonurgent Pediatric Care, Norman C. Christopber,MD, MetroHeahhMedical Center mining which Neonatesare at Low-Riskfor SeriousBacterial Infections, Peter C, Fercert, MD, Albany Medical College A Meta-Analysis,Steuen Occult PneumococcalBacteremia? Medical Center Regional MD, Oilando Rothrock, G. Does it Meet FDA-ApprovedPrescribingGuidelines?, leffry P.McKinzie, MD, Vanderbilt Uniuersity

Moderator: Cbarlcs L Enxerma'n,MD, MetroHeahb Medical Center 057 A Comparisonof StandardDose Albuterol with High Dose Albuterol for the Treatmentof StatusAsthmaticsin Adult EmergencyCenter Patients,Gail S. Rudnitsky,MD, Medical Collegeof Pennsyluania

068 Estrogen$flithdrawalAlters the BronchodilationResponse

Scientific Papers 9: EMS(8:00-L0:00 am) Mod,erqtor: Vincent P, Verdlle, MD, Albany Medical College 053 ProspectiveValidation of PrehospitalSpinal ClearanceCriteia, RobertM. Domeier,MD, Uniuersityof Michigan 054 Survival Variation in CardiacArrest Occurring After EMS Arival as a Meansof AssessingPersonnelPerformanceIndependent of SystemFactors,E. Jobn Gallagber,MD, Albert Einstein Collegeof Medicine 055 Demographic Correlation of Urban EMS SystemUtihzatron, Tbeodore R, Delbridge, MD, MPH, Uniuersity of Pittsburgb 056 Initial Experienceof an EMT-basedPediatricImmunization OutreachProgram, Cai Glwbak, MD, Uniuersityof Cbicago 057 The Efficacy of Treatment of UnstableAtrioventricular Block and Bradycardiain Patientswith Acute Myocardial Infarction, WilliamJ. Brady, MD, tlniuersityof Virginia PrehospitaiValidationof the Acute CardiacIs058 Retrospective chemia- Time InsensitivePredictiveInstrument(ACI-TIPI), TomP. Aufderbeide,MD, Medical Collegeof Wisconsin

in the AsthmaticRabbit, lVayneA. Satz,MD, Medical Collegeof Pennsyluania Effectsof CombinedIntravenousand Inhaled Steroids The 069 in the EmergencyDepartmentTreatmentof Acute Asthma, Alex Guttman,MD, McGill Uniuersity Impact of Routine Pulse Oximetry Screeningon Medical Management,William R. Mower,MD, UCU

07r A ProspectiveComparisonof Bilevel PositiveAirway Pressure (BIPAP) and CPAP in the ED Treatmentof CHF, ReneA, Hipona, MD, RhodeIsland Hospital 072 Phrenic andLaryngealMotor Nerve Activity During Experimental Cortical Seizuresin Piglets, ThomasE. Terndrup, MD, State Uniuersityof New York, Syracuse

ScientificPapers1.2:Shock(1:3f3:00 pm) Moderator: LI Andrew Leuifi, DO, HighlandGeneralHospital 073 A Comparisonof Two Rapid RewarmingMethodsin a Canine Hypothermia Model, Dauid M. Kam, MD, Butterwortb Hosoital/Michipan State Uniuersity 0/4

UncontrolledHemorrhagicShock in Rats:Limited Fluid ResuscitationUsing Colloid Solutions,Antonio Capone, MD, Uniuersityof Pittsburgb

059 Prehospital Paralysisand EndotrachealIntubation of the PediatricPatient,Ronald F. Sing, DO, Uniuersityof Pennqtluania

075 Comoarisonof the Effect of Bolus versusSlow Infusionof

060 Ambulance Use in the Inner City: The Role of Convenience Issues,Mindy Stimell-Raucb,MD, Albert Einstein Collegeof Medicine

7.5% Hypertonic Saline-Dextranon Blood Flow and Survival in Acute Hemorrhage, Susan A. Stern,MD, Uniuersityof Micbigan

1995 SAEM Annual Meeting

May 22 076 Hypothermic (Hth) Minimal Fluid Resuscitation(FR) Extends the Golden Hour of Uncontrolled Hemonhagic Shock (UHS) in New Ourcome Model in Rats,SeungH, Kim, MD, Uniuersityof Pittsburgb

080 Phase 4 -

077 The Effect of Crystalloid Infusion Rare on Hemorrhage Volume and Mortaliry in a Porcine Model of Splenic Injury, Cail R. Cbudnofsky,MD, [Jniuersityof Michigan

081 ED Visits by PatientsSuspectedof Drug SeekingBehavior,

078 The Use of Diaspirin Cross-Linked Hemoglobin (DCtHb) Solution in the HospitaLManagementof Hemorrhagic Hypovolemic Shock, Edward P. Sloan, MD, MpH, Uniuersity of lllinois at Cbicago

Scientific Papers 13: Clinical Practice (1:30{:00 pm) Modcrator W Brian Grbler,tr[D,Untaersttyof Ctnctnnatt

079 Ruling Out Acute Myocardial Infarction in a Chest pain Center without Hospital Admission: potential Utilirv of a

1995SAEMAnnual Meeting

Protocol Requiring Stat Exercise Testing, RobertJ. Zalenski, MD, Cook County Hospital Implementation of an Outpatient Myocardial Infarction Rule Out Program at a Pilot Hospital, LouiS Graff, MD, New Britain GeneralHoEital

Andrew D. Zechnich,W, OregonHealtb Sciencestlnircrcity

082 Lorazepam Prevents the Recurrenceof Alcohol-Related Seizures,Gail D'Onofrio, MD, Boston City HoEital

083 A Two-Step Model to Identifr Community-Acquired pneumonia Patients at Low Risk for Hospital Mortality, Thomas E. Auble, PhD, Uniuersityof Pinsburgh

084 Evaluation of a Strategyfor Cost Effective Utilization of the CCU for Rule-Out Acute Myocardial Infarction, Gerard X, Brogan,!r, MD, UniuersityMedical Centerat StonyBrook

May 22

POSTERSESSION A

The PosterSessionwill be held in the Exhibit Hall from 3:30-6:00pm. Moderatedposter sessionswill be held from 4:30-5:30pm as listed below:

Topic/Abstracts

Moderator

Meeting Room

DavidA. Talan, MD, UCLA-OllveVlew

ConferenceRoom 1

Resplratory (Abstracts156-1,63)

Rlchard M. Nowak, MD, Henry Ford Hospltal

ConferenceRoom 2

Toxicology/Envlronrnental (Abstracts164-17 5)

IouisJ. Ling, MD, Hennepln County Medical Center

ConferenceRoom 3

Infectious Disease(Abstracts145-1.55)

Computer Methodology/Modeling and Technology(Abstracts 176-180 and 188-193)DietrichJehle, MD, State Unlversity of NewYork, Buffalo

ConferenceRoom 4

Shock(Abstracts 181-187)

Bernard L,l,rlrpez, MD, ThomasJefferson Univ. Hospltal

ConferenceRoom9

Trauma (Abstracts194-204)

John A. Marx, MD, Carolinas Medical Center

ConferenceRoom 12

Education (Absrracrs 205-21.5)

Gloria Kuhn, DO, Wayne State Universlty/Grace Hospital

ConferenceRoom 13

Education (Absrracrs216-226)

Wllllam P. Burdick, MD, Medlcal College of Pennsylvania

ConferenceRoom 14

Infectious Disease

Respiratory

145 Incidenceof PPD Positivityin the EmergencyDepartment, Ricbard D. Sbib, MD, Newark Beth Israel Medical Center

1,56 End Tidal CO2 XflaveformsDetect Bronchospasmand the Responseto B-AgonistTherapy in Adult Ed Patientswith Asthma, Paul Padyk, MD, Uniuersitltof Colorado

146 TuberculosisExposure in the EmergencyDepartment, AmyJ. Bebrman,MD, Uniuersityof Pennsyluania

1.57 The Pathophysiologyof Tension Pneumothoraxin Ventil-

147 Seroprevelenceof Hepatitis B & C in the Urban Emergency Department Population, Brian M. Huettl, MD, Mt. Sinai Medical Center

158 Asthma in the Emergency Department: An Opportunity

1,48 Feasibility of ED-BasedHIV ScreeningProgram Utilizing On-Site Rapid Testing, Michael J. Moore,Jobns Hopkins Uniuersity

1.59 Comparing the Borg Dyspnea Index to PulmonaryFunc-

149 Predictorsof PositiveBlood Culturesin Adult HIV Patients Presentingto the EmergencyDepartment,Simong S. Youmans,MD, Carolinas Medical Center

160 Endotrol Directional-tipEndotrachealTubes for Nasotracheal

150 Incision and Drainage of CutaneousAbscessesis not Associated with Bacteremra,BentleyJ. Bobrow, MD, MaNcopa Medical Center 1,51, A Comparisonof a RecombinantEndotoxin Neutralizing ProteinVersusa RecombinantBactericidal/Permeability IncreasingProteinYaiant for the Treatmentof E. Coli Sepsis in the Rat,Anne M. Stack,MD, Haruard Medical Scbool 1,52 The'BacterialPathogensof CommunityAcquired Pneumonia - Coexistenceof Typical and Atypicals, Iala M. Dunbar, MD, PbD, Louisiana StateUniuersity,New Orleans 153 ExtracranialSitesof Infections in Adult Patientswith Bacterial Meningitis, Kabang Chan, MD, Iong Island Jewisb Medical Center $4

High Prevalenceof Occult SexuallyTransmittedDiseases in'Women UndergoingPelvic Examsand Dischargedwith PresumedIsolated Urinary Tract Infections, Elijah Berg, MD, St.JobnHospitaland Medical Center N-2-Butylcyanoacrylate:Risk of Bacterial Contamination with an Appraisal of its Antimicrobial Effects,Martin H. Osmond,MD, Uniuersityof OUawa

ated Patients:A Swine Model, Erik D. Bafton, MD, MS, Uniuersityof California, San Diego for Education and Intervention, Robert M. McNamara, MD, Medical Collegeof Pennsltluania tion Testing in Patientswith Acute Asthma, RobertA. Siluerman,MD, Iong IslandJewisb Medical Center Intubation, EdmondA. Hooker,MD, Uniuasity of louisuille

r51. Estrogen \flithdrawal Diminishes the Effectivenessof Ipratropium in the AsthmaticRabbit, V(ayneA. Satz,MD, Medical Collegeof Pennsyluania 162 An In-Vitro Analysisof Magnesiumas a Bronchodilatorin Normal, Asthmatic, and Estrogen \Tithdrawal Asthmatic Rabbits, Wayne A. Satz, MD, Medical Collegeof Pennsyluania

163 Prehospital Managementof ReactiveAirway Disease: ComparativeAnalysisof MeteredDose Inhaler and Nebulized Aerosol Treatments, RussFirman, MD. Akron General Medical Center

Toxicology/Environmental 1,64 In-Vitro Cell Culture AssaysMay ReplaceAnimal Studies in Toxin-AntidoteEvaluation,Dauid R. Duncan, MD, Uniuersityof California, Dauis 165 Haloperidol ProducesGreater ElectromechanicalDepression than Lotazepam in Ethanol Perfused Rat Hearts, Ricbard P. Medlin, MD, Carolinas Medical Center 166 Use of Sodium PolystyreneSulfonate(SPS)for Reduction of Chronically ElevatedSerum Lithium Concentrationsin Mice, Daniel I. Sauitt,MD, Brown Uniuersity 1995 SAEM Annual Meeting

May 22 167 Effectsof Cocaethyleneand Cocaine in Isolated Rat Hearts,John P. Riordan,MD, CarolinasMedical Center 168 Verapamil Shock Inhibits Myocardial Fany Acid Uprake, JeffreyA. Kine, MD, Carolinas Medical Center 169 Glucagon and PhenylephrineCombination versus Glucagon Alone in ExperimentalVerapamil Overdose,Stepben H. Tltomas,MD, Uniuersityof Kentucky 170 Naphthalene-Induced Acute Hemolytic Anemia in Chil_ dren with Glucose-5-phosphate Dehydrogenase(G_6_pD) Deficiency- An Overlooked Inner City Toxin, Karen A. Santucci,MD, Brown Llniuersity 171 The Clinical Utility of Toxicologic Screeningin Code III Trauma,Alan B. Stonow,MD, Joint Military Medical Centerc 172 Chlorpromazine,a protectantAgainstCyanideToxicity, In_ hibits the Generationof Endothelium-Derived Nitric Oxide, Dale S.Birenbaum,MD, TbomasJffirson (Jniuersity 173 ThermalEffectsof NeurralizarionTherapy for Acute Alkali Exposurein an In Vivo Canine Modei Clark S. Homan, MD, Slate Uniuersityof New york, StonyBrook 174 Overdosewirh'Extended-ReliefAcetaminophen: Is a New Approach Necessary?, Daniel R. Douglas, MD, Oregon Healtb SciencesUniuersity 175 AssessingYariation in Toxic Self-IngestionsUsing Corres_ gon!9nce Analysis, N. Clay Mann, pbD, MS, Oregon HeaIth Sciencestln iuersity

Computer Methodology/Modeling 176 An Artificial Neural Network in the biagnosis of Ectopic Pregnancy,Andrew T. McAfee, MD, Brigbam and IX/omen's Hospkal,Boston 177 Improved BayesianClinical Trial Design Using a New ComputationalMethod, RogerJ.Iewis, MD, pbD, Harbor_ UCU Medical Center 178 A Criteria BasedExpert Systemto EvaluateChestpain in the EmergencyDepartment,Alan J. Hirsbberg,MD, MpH, Pennsylua n ia Stale Uniuersity 179 ValidatedComputerModel for MeasuringClinical Reason_ ing Proficiency,Strategy,Thoroughnes'sand Efficiency, Dane M. Cbapman, MD, pbD, york Hospital 180 Determinationof the Utility of BiochemicalMarkersin the EarlyDiagnosisof Acute MyocardialInfarctionby Decision Analysis,SteueM. Hudson, MD, tlniuersity of Mississtppi

Shock 181 Blood Pressureis a poor predictor of Oxygen lJtilization Following Brief Hemorrhagic Shock,Jobn G. younger, MD, Uniuersityof Michigan 182 ShockIndex as a Marker for SignificantInjury in Trauma Patients,Randall King, MD, St.VincentMedical Center 183 Elevationof the Shock Index is a Correlateof Global IschemiaDuring the Resuscirationof the Critically Ill in the EmergencyDepartment,Mohamed y. Rady,MD, pbD, CleuelandClinic Foundation 1,84 Extendingthe Golden Hour of Voiume ControlledHemor_ rhagicShock(\tIS) in Awake Ratswith Oxygen (O2) plus Moderare Hypothermia (Hth), S. Wiltiam Stezoski,MD, Uniuersityof Pittsburgb 1995 SAEMAnnual Meerinq

185 In Vivo LongitudinalExpressionof Three Classesof pMN Cell Surface Receptorsas Determined by X(hole Blood Flow Cytometry in University Hospital Trauma patients, TeresaM. Ainswortb, MD, tlniuersity of Rochester 186 High PressureDelivery of ResuscitationFluid Throush Bone Marow, tY/illiamC. IVatson, BS,Uniuersityof Teias Medical Brancb Galueston 187 Effect of Activatedprorein C on Endotoxin Shock in Rab_ bits, Ricbard Saladino,MD, Cbildren,sHospital,Boston

Technology 188 Use of EnzymaticAssay Device for Serum Ethanol Mea_ surement,Mark Keim, MD, Albany Medical College 189 Effect of Skin Pigmentationof pulse Oximeter Accuracy and Function in the EmergencyDepartmefit,Ionatban Ad.ler,MD, Hantard Medical Scbool 1.90 LighrGuided Inrubation for EmergencyAirway Manage_ ment: Clinical Trial of a New Lightwand Devrce, Brace Munay, MD, Butterwortb Hospital I97 PrehospitalUse of a protorype EsophagealDetection De_ vice: A -Wordof Caution!,CbarlesD. Madey, DO, Hanouer GeneralHospital 1,92 Lighted Stylet Im-provesEfficiency of Emergent Direcr Laryngoscopic OrdtrachealInrubation,Ricbard,G. Abood, MD, St.John Hospitaland Medical Center 193 Initial Assessmentof a pC-BasedEmergencyTelemedicine Systemin the Managementof patientsat a Short_Term CorrectionalFacility, Dauid G. Ellis, MD, State Uniuersity of New York,Buffalo

Trauma 194 Comparisonof Poloxamers188 and 407 Treatmenton Burn \Vound Healing, Paul lXt.paustian, DSc,MD, Med._ ical Collegeof Georgia 1.95 A Comparisonof the Tensile Strengthof Lacerations Closedwith CyanoacrylateTissueAdhesiveto Lacerations Closedwith Suture,KeuinA. Bresnaban,MD, Georgetown UniuersitltHospital 196 Both Topical and IntravenousApplicationof LocalAnesthe_ tics Improve Microvascularperfusion Following Burn In_ jury, Bo TomasBrofeldt, MD, uniuersity of Catifoitia, Dauis 1,97 Differencesin HemodynamicData Between Geriatricand Younger Adult Trauma patients, Cbrtsnpber Colwell,MD, DenuerGeneralHospital 198 Diagnosisof SignificantHead Injury in Eldedy parienrs with Blunt Trauma, GregoryI. Almond, MD, Metro7olitan HospitalCenter 199 Incidence and Corelation of Alcohol and Illicit Drus Use in Urban Intentional and Non-IntentionalFatal Iniuries. SconHill, MD, Uniuersityof lllinois 200 Hemodynamic Effects of Etomidate for Rapid Sequence Intubation (RSI) in EmergencyDepaftment (ED) Trauma Patients,Iee L \Voodard,MD, {Jniuersityof pittsburgb 201, Selectionof PatientsRequiringAcute Care Using Hospital Discharge Index, ly'. Clay Mann, pbD, MS, Oregaon Heahb SciencesUniuersity 202 Ultrasoundfor the Detection of IntraperitonealFluid: The Role of Trendelenburgpositioning, Earbara Abrams,MD, State Uniuersityof New york, Buffalo 1.9

May 22 203 Syphilis SerologicScreeningin EmergencyDepartment

)1<

Trauma Patients, Azita A. Toussi,MD, Denuer General Hosprtal Routine Laboratory Testing in Emergency Department Trauma Patientsat Level-I Trauma Centers:A National Survey,Jobn H. Burton, MD, tlniuersity of pittsburgb

ED Intubationsin an EmergencyMedicine Residency:The Selection and Performance of Intubators, CbarlesM. Martinez, MD, Albeft Einstein Collegeof Medicine

216 The Cost of an EmergencyMedicine StudentRotation, Iawrence Kass,MD, Albany Medical College

217 The Value of Self-EstimatedScholasticStandingin Residenry Selection,Dauid P. Sklar,MD, uniuersityof NewMexico

Education 205 Education and Evaluarion of Dearh Notification Skills in an ACLSCourse,Marc Pollack,MD, york Hosprtal

218 The Need for StructuredEM Curriculum and Management of DomesticViolence and SexualAssault,Dauid I. Leuine, MD, Boston Crty Hospital

206 Survivor Notification of SuddenDeath in the EmergencyDepartrnent,Iames L Scoft,MD, GeorgeWasbingtontlniuersity

zrg

207 Do GeneralProblem-SolvingSkills EnhanceClinical Diagnose's of Difficult EmergencyCases?,Rajtwin R. Huang, PbD, lVajtne State UniuersitJ) 208 The Performanceof Non-EmergencyMedicine Residents in an Academic EmergencyDepartment, C. Keitb Stone, MD, Uniuersityof Kentucky 209 Learning Preferencesof EmergencyMedicine Residents: Implication for Educators,Cail M. Ferraro,MD, uniuersity of lllinois 210 Neural Network and Linear RegressionModels in Residency Selectton,StepbenL Pilon, MD, Ilniuersity of New Mexico 21,1, Peopie \Who LeaveAcademic positions:A Comparisonof Three Specialities,Harold Thomas,Jr, MD, OregonHealtb SciencesUniuersitlt 272 Longevity of EmergencyMedicine ResidencyDirectors, Lowell W. Gerson, PbD, Nortbenstern Obio Uniuersities Collegeof Medicine 21,3 Why do StudentsChoosea Careerin EmergencyMedicine?, CbristelM. Zeumer,MD, Harbor-UCIA Medical Center 2I4

Teachingthe Businessof EmergencyMedicinein EM ResidencyPrograms,Kent N. H6ll, MD, Uniuersityof Cincinnati

?<o

Normothermic Intestinal Reperfusionafter Two Hours of IschemiaV/orsensthe Outcome in Rats, Feng Xiao, MD, Louisiana StateUniuersity

A Validity Studyof CognitiveStyleMeasuresfor Identifying who would most Benefit from Problem-BasedLearntng and Computer-AssistedInstruction, Dane M, Cbapman, MD, PhD, YorkHospital

220 A Methodology to Maximize ResidentInput in Improving a Pediatric EmergencyDepartment Rotation, Nicholas Tsarouhas,MD, Cbildren'sHospitalof pbiladelpbia

221 Injury Prevention in Medical Student Education, Deirdre Anglin, MD, IAC/USCMedical Center

222 EmergencyMedicine ResidencyTraining of physicians with Prior Experience:Perspectiveof the ProgramDirectors, Robert M, McNamara, MD, Medical Collegeof pennsyluania

223 CosmeticAppearanceof LacerationsRepairedby EM practitioners with Various Levelsof Training, Adam J. Singer, MD, UniuersityMedical Center,StonyBrook

224 Computer Literacy in EmergencyMedicine Training:A Survey of ResidencyPrograms,Alan J. Sorkey,MS, MD, Malcolm Grow USAFMedical Center ))<

Use of an Instructional SystemsDesign Model to Teach EmergencyMedicine to SecondYear Medical Students, NicbolasJ.Jouriles, MD, MetroHealtb Medical Cenrer

226 Enhancingthe Value of Journal Club: Use of a Structured Review Instrument, Jonatban Burstein, MD, Llniuersity Medical Center,StonyBrook

260 Reperfusionafter 30 Minutes of Intestinal Ischemia does not Influence PlasmaCytokine Levels in Rats,FengXiao, MD, Iouisiana StaleUniuersity

1995SAEMAnnual Meeting

Mav 22

ffiffi

ASSOCIATIONOF ACADEMIC CHAIRS OF EMERGENCY MEDICINE 901 N. washingtonAvenue,Lansing,Michigan 48906-5137 (517) 485-5484 FAX (512)485-0801

AACEMAGENDA ANI\UAI MEETING May 22,1995 Conference Rooms 13 â&#x201A;Ź/ 14 Marriott Rivercenter HoteL San Antonio

AGENDA

8:00-8:30 am

Continental Breakfast

8:30-9:00 am

"Is the Academic Emergency Medicine Department Ready for Capitated and Managed Cate?" Discussionled by BrooksBock,MD, with commentsfrom,tbe membership

am 9:00-1.0:00

*Faculty Appointment, Promotion, and Tenure Requirements in Emergency Medicine" Resultsof a national surueyand discussionled byJobnPrescott,MD, witb com,ments from tbe membership

10:00-10:L5 am

Break

10:1.5-L1:L5 am

"Academic Departments of Emergency Medicine: Where Are We Now and Where Can We Go?" Resultsof a national surueyand discussionled by SteueStapczynski,MD, witb conxments from the membership

L1.:30am-1.:00 pm Annual Business Meeting and Lunch 7:00pm

Annual Banquet at Restaurant BIGA

1995 SAEMAnnual Meeting

May 22

CORDAGENDA Monday,May 22,1995 l2$O-5230pm Salans B e F Marriott Rivercenter Hotel

AGENDA l2:30-2zOOpm

Business Meeting 1. Introductionof New Programs of New President Address/Introduction 2. President's Braen, MD 3. ABEMReport,Ricbard 4. RRCReport, VinceMarkouchick,MD Report,Dauid Kramer,MD 5. Secretary/Treasurer's 5. Committee/TaskForceReports A. Constitution& Bylaws Committee,DebraPedna,MD B. SlideBank TaskForce,KeuinRodgers,MD C. Question andAnswer Bank Task Force,MarcusMartin, MD/GlennHamilton, MD D, CumiculumTaskForce,Dan Sauitt,MD E. AwardsTask Force,Mark Steele,MD F. NominatingCommittee,SteueDronen, MD G. CPCTask Force,SteueDronen, MD 7. DidacticCurriculumSurveyReport, Tim Maclean, MD

2:00-3:30pm

Educational Session Managed Care Its Effects on Graduate Medical Education SamKeim,MD, Uniuersityof Arizona Moderator Keitb \Vrenn,MD, VanderbiltUniuersity Ed Panacek,MD, Uniuersityof California Ricbard Wolfe,MD, Haruard Uniuersity Computers in Medical Education: An Orthopedic Tutorial Diane Hallinen, MD, Uniuersityof Micbigan Emergency Medicine Curriculum, DAn Sauitt,MD, Brown uniuersity

pm 3z3O-3245

Break

3245pm

Elections and Awards Presentations, SteueDronen, MD

4:00-5:30pm

Round Table Discussions A. B, C. D.

PediatricTrainingfor EM Residents,GwenHoffman, MD MD Managingthe ProblemResidents,Bnt'ceThonxpson, ProceduralCompetencyand Credentialing,Ed Panaceh,MD ManagedCare,SamKeim,MD

1995SAEMAnnual Meeting

DIDACTICSESSIONS ACIS: Is the Standard of Consensus Tdy the Art?

State of

Mod,erator: Afibur B. Sanders,MD, (lniuersityof Arizona Iance Becker,MD, Uniuersityof Chicagct JantesT.Niemann,MD, Harbor-UCIAMedical Center NormanA. Paradis,MD, Columbia {Jniuersity There are significant differences between the American Heart Association'sAdvanced Cardiac Life Support (ACLS)course guidelinesand state-of+he-art resuscitationas it is understood and practicedby individual authoritiesin the field. This session will delineateand expose those differences,ask how they evolved, and question whether the ACLSconsensusdocument can ever become state-of-the-art.The panel members will not only discussthese issuesand their significancein clinical management,but also potential mechanismsfor resolvingtheseconflicts. The group will specificallyfocus on potential research effortsthat may achievethis resolution.

The Interface of Managed Carc with Academic Emergency Medicine Moderator: SteuenStapczynski,MD, LlniuersityoJ'Kentucky Jos@hClinton,MD, Hennepin CountyMedical Center Brian Holroyd, MD, Uniuersitjtof Albena Academicemergencymedicine has traditionally respondedto a societalimperativeto provide patient care, education,training, and research.This multiplicity of roles renders the academic arm of our specialty, and that of academicmedical centers in general,relativelynon-competitivein a price-sensitivemanaged care marketplacetargetedat minimizing health care expenditures.Academicemergencymedicine is practiced and taught at the interfacebetween the growing number of managedcare networksand the front door of the teaching hospital. Some of the important issuesthat arise at this interface include prior authorization,retrospectivedenial of reimbursementbasedupon outcomeratherthan presentation,effect on ED volume and case mix, and impact on studenteducationand residencytraining.

Clinical Photography Dan R. Patton, RBP,FBPA, Obio State Uniuersity LawrenceB. Stack,MD, MAJ,MC,Joint Military Medical Centers Alan B. Storrow,MD, CPT,MC,Joint Military Medical Centers Photographyin the emergencydepartmentrequiresan expedient, portable, adaptable,and relatively simple camerasystem to take advantageof fleeting opportunitiesfor recordingvisually educationalmaterial.The prerequisitesare different from those for traditionalmedical photography, for which relatively plentiful time and advancedequipment are routinely available.A1though no single systemor technique is optimal in all these areas,the speakersfind certain componentsand approaches work well. This workshop will provide information to help academic clinicianstake better clinical photographsfor teaching and publicationpurposes.Featuresof this lecture-discussion sessionwill include photographicequipment,film, lighting techniques,radiographs,copy work, close-up photography, lecturing tips, and the newer technologiesof digital imaging and computermanipulation.These topics will be presentedwith emphasison the emergencydepartment and emergencymedicine residencyenvironments.A critique of selectedphotographs from the Clinical PhotographyCompetitionwill provide suggestionsfor improving photographic technique.Awards for the PhotographyCompetitionwill be presenredimmediatelyfollow1995SAEMAnnual Meetins

May 23

ing the workshop. Following the awardspresentation,a meeting for individuals interestedin starting a "photography interest group" will be conducted.

'Inapprop riate' ED Utilization Moderator:Judith C. Brillman, MD, {Jniuersitj.tof NewMexico Robert W. Derlet, MD, Uniuersityof Califoruia, Dauis E.John Gallagher,MD, Bronx Municipal Hospital Barry Wolcott,MD, In"formedAccessSysterns The moderator will review the literature on inappropriate ED visits, including: definitions, quality of numerical estimatesand outcomesstudies.The panel members,all emergencyphysicians, have been chosen to represent different philosophical and experientialperspectiveson whether a population of inappropriate'ED patientscan be defined.The panelmembershaveexperience with proprietary triage systems,managedcare, Medicaid, and public, urban and teachinghospitals.Each panel member will present their perspectiveand will have an opportunity to respondto the others.rVe anticipatea spirited discussion.

Cost Effectiveness Research in Emergency Medicine RobertA, Loute,MD, MPH, Uniuersityof Pennslyuania Dauid Magid, MD, Uniuersityof Wasbington Robefi Wears,MD, MS, Uniuersityof Florida Cosreffectivenessanalysisis becoming increasinglyimportant in developing clinical practice guidelines and in making ED managementdecisions,but many cost-effectiveness studiesare seriously flawed. This sessionwill cover common problemswith current cost-effectiveness studies,basic methodsof analysis,and methods of clbtaininginternal cost information from hospital information systems.

Research Directors'Luncheon: The Pros and Cons of Resident Research Moderator:MichelleBiros,MS,MD, Hennepin CountyMedical Center IVilliam Cordell,MD, MethodistHospitnl of Indiana SteuenC. Dronen, MD, Uniuersityof Micbigan CbarlesPollack, MD, Maricopa Medical Center Dauid P, Sklar, MD, Uniuercityof New Mexico Some residencyprogramsrequire residentsto completea researchproject prior to completing the residency.Other residency programs'stronglyencourage','expect',or 'suggest'that residentsdo research.What is the value of residentresearch? Should it be mandatory?If residentsare not required to do a researchproject, how can researchprinciples be taught in compliance with the RRCrequirements?These issues,as well as many more, will be discussedduring this session.

Luncheon: Managed Care at the StateLevelImpact on Academic Emergency Medicine Moderator: Viuek Tayal, MD, Carolinas Medical Cenler RobertDobefiy,MD, tlniuersityof Matyland John Guisto,MD, Uniuersityof Arizona Patrick O'Brien,MD, Tennessee Cbapter,ACEP Although heaith care reform failed in \Tashington,DC last year the stateshave been reforming Medicaid reimbursementusing managed care mechanisms.Arizona's Medicaid managed care plan has proved relatively successfulwhereasTennessee's Medicaidmanagedcare plan has not. Statelegisiationalso )7

May 2J lmpacts upon the practice of emergencymedicine. Maryland,s emergencyphysicianssuccessfullypassedtheir definition on an emergency.SAEM'sGovernmentalAffairs Committee sponsors this panel discussionto educateacademicemergencyphysicians about the impact of state managed."." upon" the praitice of emergencymedicine becauseall academii emergencyphysi_ ciansdepend upon clinical revenueand statefundiis.

Should EMSbe a Subspecialty? Iouis Ling, MD, Henn@in CountyMedical Center HarueyMeislin,MD, Uniuersityof Arizona PeterPons.MD, DenuerGenera[HosOital RobertSwor,DO, t$/itliamBeaumoni Hospital The issue of subspecializatjonin medicine as a whoie and Emergency.Medicinein particular has generateda greatdeal of interest and controversy.The topic of EMS as a subspecialtvis one arca where no consensushas developedwithin "...g"n.y medicine.The memberson the panel wili addressthe proi and

cons of EMSsubspecializatton, and of subspecializationto emer_ gencymedicine.

Mechanisms of Multicentered Research

Mod.erator:W. Brian Gibler,MD, Uniuersityof Cincinnati Wlliam Bnrsan,MD, Uniuercityof Micbigan" Dauid Talan,MD, Oliue Vieut-UCIA This sessionwill focus on severarissueswhich arise durins the execution of muiticenteredclinicai trials. Topics for discuision include hypothesisgeneration, protoc;l development, communicationbetween the principal investigatorsat eich site, dat"aand safety monitoring, regulatory iompliance, and manuscriptdevelopment.The panelistshave had experience with cardiovascular,neurovascular,and infectious disease multicenteredtrials. This panel will allow participantsto understandthe intricaciesof collaborativemultiientered studies including not only participation in such trials, but also how to coordinatetheseefforls.

1995 SAEM Annual Meering

ORAI PAPERS ScientificPaperst4z PaimManagement (8:00-10:00am) Mod.erator: Robert H. Woolard, MD, Brown Uniaersity 085 A Prospective,Double-Blind Evaluation of prochlorperazine versus Sumatriptanfor the Emergency Depafiment Treatmentof Migraine Headache,MargaretJ. Kantes,DO, Uniuersityof TexasAEM 086 IntramuscularKetorolac versus Oral Ibuorofen in Acute MusculoskeletalPain, Micbael A. Tur"turro,MD, Mercy Hospital of Pittsburgh

1.02 Seroprevalenceof Antibody Levels to Tetanus in Adults Over 65 Yearsof Age,Kumar Ala,gappan,MD, Albert Einstein Collegeof Med,icine

089 Family Member PresenceDuring Pediatric Proceduresin the EmergencyDepartmenr,Richard Licbenstein,MD, Uniuersityof Maryland

103 The GeriatricObstacleCourse.RecognizingStereotypes and MisconceptionsAmong PrehospitalCare Providers, FeliceFleisher,MD, Akron GeneralMedical Center

Scientific Papers L5: Health Care Delivery/Administration (8:0f10:00 am)

105 Age-relatedDifferencesin the ICD-9 Diagnoseswithin an EmergencyDepartment Geriatric Population, A. Ciccone, DO, MorristownMemoNalHospital 106 Plain Abdominal Radiographyin rhe Derecrionof Major Disease in the Elderly, V. Robert Scott,MD, Orlando RegionalMedical Center

Scientific Papers 17: Pediatrics (10:3fl2:0dnoon) Mod.erator: LarryJ. BarafJ, MD, IICUI 1,07 Accuracyof PediatricAssessmentby EMT-Basics,Dauid S. Markenson, MD, AWT-P, BelleuueHospital Center

094 \(hat Happensto ManagedCarePatientswho are Denied Care in the ED?, StephanieB. Abbubl, MD, Uniuersityof Pennsyluania

108 Effectivenessof I.M. Penicillin vs P.O. Amoxicillin in the Early Treatmentof Outpatient Pediatric Pneumonia, Nicbolas Tsaroubas,MD, Cbildren'sHospkal of philadelpbia

095 Nrican Americansin ManagedCare PlansAre Denied ED Care More Often than are \7hites, RobertA. Lowe,MD, MPH, Uniuersityof Pennsyluania

109 Fever and Petechiaeare Associatedwith a Very Low Incidence of Bacteremia,Kenneth D. Mandl, MD, Cbildren's Hospital, Boston

096 An Analysisof FederallyImposed Penaltiesfor COBM Violations,RobertJ.Leuine,MD, Uniuersityof Arizona

110 PredictiveValue of PlasmaCltokines for S. Pneumoniae Bacteremiain Febrile Children 0-3 Years Old: A pilot Study,Ricbard T. Strait,MD, Uniuersityof Cincinnati

098 Can the Use of Continuous Quality Improvement Tools Improve Compliancewith an ED Inter-Hospital Transfer Protocol?, JamesA. Espinosa,MD, OuedookHospital

104 Improvementin the Qualiryof PatientTransfersfrom Skilled Nursing Facilitiesthrough an Audit and Report euality AssuranceProgram,Harry C,Moscouitz, MD, Yaleuniuercity

Moderator: John E McCabe, MD State Ilniuersitlt of New York, Syracuse 093 Triaging Patientswith Abdominal Pain Out of the Emergency Department:Three Month Feasibility Sttdy, Roben W, Derlet, MD, Uniuersityof Califumia, Dauis

097 How Accurateare the \X/aitingTime Estimatesof Patients ln the Emergency Department?,StephenL Adams, MD, Nortbwestern Uniuersity

Scientific Papers 16: Geriatrics (10:3f12:00 noon)

088 ResidentEducationIncreasesthe Frequencyof Discharge AnalgesicPrescribing,William A. IVaIson,PbarmD, LIniuersilyof Missouri, Kansas City

092 IntramuscularKetorolac Comparedto Oral Indomethacin for the Treatmentof Acute Gouty Arthritis, Dauid I. Morgan, MD, Uniuersityof TexasSouthwesterw

100 Patient-SpecificPredictorsof Ambulance tJse,Donald W. Rucker,MD, MS, MBA, Beth Israel Hospital

087 IntravenousKetorolac vs Meperidine vs Both ('Balanced Analgesia')for Renai Colic, William H. Cordell,MD, Metbodist Hospital of Indiana

091. The Clinical Significanceof Reported Changesin pain Severity,KatbleenG. Funk, MD, Emory Uniuersity

099 An ExpandedStatewideProfile of EmergencyDeparrment Uttlization in a Medicaid Population, SteuenM. Cheraow, MD, Uniuersityof Colorado

Moderator: Robert M. McNamara, MD, Med,ical Collcge of Pennsylaania 101 Depressionin Elderly EmergencyDepartmentPatients: Prevalenceand Recognition, StepbenW. Meld,on,MD, MetroHealtbMedical Center

090 The Safetyand Efficacy of Flumazenil in ReversingConscious Sedationin the EmergencyDepartment,Carl R. Chudnofsky,MD, Uniuersitltof Micbigan

May 2J

1995SAEMAnnual Meeting

111 The Cost of Providing Immunizationin an EmergencyDepartment, Sandra J, Cunningbam, MD, Albefi Einstein Collegeof Medicine 1I2

FastTracking Lower Acuity Patientsin the PediatricEmergencyDepartment,Harold.K. Simon,MD, Emory Uniuercity

May2i

POSTERSESSIONB

The PosterSessionwill be held in the Exhibit Hall from 3:30-6:00pm. Moderatedposter sessionswill be held from 4:30-5:30pm as listed below:

Topic/Abstracts

Moderator

Innovations in Emergency Medicine Exhibits (Abstracts227-239)

Meeting Room

Marcus Martin, MD, Medical College of Pennsylvania and Hahnemann University, Allegheny Campus

ConferenceRoom 4

Innovations in Emergency Medicine Exhibits (Abstracts 240-252)

Glenn C. Hamilton, MD, Wright State Universlty

Parior Room

(Absrracrs253-258& 261-262) Norman A. Paradis, MD, Columbia University Pediatrlc Emergency Medicine (Abstracts263-27I) Thomas E. Terndrup, MD, State Unlversity of NewYork, Syracruse Pediatrlc Emergency Medlcine (Abstracrs272-279) Steven G. Rothrock, MD, Odando Regional Medical Center Health Care Delivery/Administration Arthur L. Kellermann, MD, MPH, Emory University (Absrracts280-293) Ischemia/Reperfusion

Health Care Dellvery/Administration (Abstracts 294-308)

E.John Gallagher, MD, Bronx Municipal Hospltal

Innovations in Emâ&#x201A;ŹrgencyMedicine Education Exhibits 227 A RandomizedControlled Trial of the Utilization of Anesthetized Swine for Instructing ParamedicStudentsto Perform Orotracheal Intubation, JamesJ. Menegazzi, PbD, Centerfor EmergencyMedicine of \VesternPennsyluania 228 Teaching Death-TellingSkills to EM Residents,Ronald. Benenson,MD, YorkHospital 229 RecentlyAmputated Lower Extremities:A New Model for Teaching SaphenousVein Cutdowns,Jobn P, McDermott, DO, YorkHospital 230 Direct LaryngoscopyVideo System,Richard M, Ieuitan, MD, New YorkMedical College 231, AssessingClinical Skills and Effectivenessof ProblemBased Learning Curriculum Using Patient Management Computer Simulations,Dane M. Cbapman, MD, PbD, YorkHospital 232 Enhancing ResidentRecruitmentThrough Blinded, Structured Interviews with Critical Incident Scenarios,Dane M, Cbapman, MD, PhD, YorkHospital 233 EvidenceBasedMedicine:A ProposedCurriculumfor an EmergencyMedicine Residency,StephenR. Hayden, MD, Uniuersityof Califoruia, San Diego 234 Innovation in EmergencyMedicine Education:Outreach t o t h e H o m e l e s sP o p u l a t i o n , B r e n d a M e r r i t t , M D , Columbia-PresbyterianMedical Cenler 235 Anatomy Review Course for EmergencyMedicine Residents: An Initiative in Curriculum Design and Interdisciplinary Collaboration, Timothy A. Maclean, DO, Wrigbt StateUniuersity 236 A Novel Method for Teaching ResearchMethodology, LesaD. Fraker, MD, PbD, Uniuersityof Illinois at Cbicago 237 SpeedingTickets:A Model for EmergencyMedicine Resident Evaluationsand Follow-up, Peter Viccellio,MD, State UniuersityofNew York, StonyBrook 238 ResearchOral Exams for EmergencyMedicine Residents, RobenJ. Rydman, PbD, Cook County Hospital 239 An EmergencyMedicine Computer-BasedInteresting Case/RadiographLrbrary,Dauid Seaberg,MD, Mercy Hospital of Pittsburyh 26

ConferenceRoom 9 ConferenceRoom 10 ConferenceRoom 13 ConferenceRoom 14 ConferenceRoom 16

240 Developmentof a ComputerDatabasefor Documentation of ResidentPerformedProcedures,StepbenHecbt,MD, St. VincentMedical Center 241 The Use of Videotape Review in Trauma Resuscitation Chief Training for Senior EmergencyMedicine Residents, Jobn W. Becber,DO, Albert Einstein Medical Center 242 A Palmtop EmergencyMedicine ReferenceDatabase, Mark Rosenbloorn,MD, MBA, Nor"tbwestern tlniuercrty 243 A Novel ComputerizedEvaluationof EM Residentsat Different Levelsof Training, GeorgesR, Ramalanjaona,MD, PbD, Brooklyn Hospital Center 244 A UniversityHospitalED-BasedBicycleHelmet Promotion: B-HIP:The StanfordUniversityBirycle Helmet Intervention Program,Brad,leyZlotnick, MD, Stanford/KaiserHospital 245 Outcome Testing of EmergencyMedicine Instruction for RotatingInterns, ColletteD. V/yte,MD, NorthwesternUniuersi$tMedical school 246 A Preliminary Report of a Unique Four Year Medical School Programto Teach Technical(ManipulativeClinical) Skills Sponsoredby the Departmentof Emergency Medicine, Arlo F. Wehge,MD, Uniuersityof Texas,Houston 247 Trauma and EMS Researchand EducationScholarsProgram for 1st Year Medical Students,BartbolomewJ. Tortella,MD, MTS,FACS,NewJersqt Trauma Center 248 Developmentand Implementationof an EmergencyMedicine Subinternshipas a Required Fourth Year Medical SchoolExperience,Mary C. O'Brien,MD, CooperHospital 249 A MethodologicallySound Form for Evaluationof Medical Studentsand Residents,Mark Hauswald, MD, uniuersity of New Mexico 250 Teamwork Training for EmergencyDepartmentStaff:Application of a BehavioralAircrew Cockpit ResourceManagement Model to EmergencyMedicine Teams, Gregory D Jay, MD, PhD, RbodeIsland Hospital 251. Emergency!An Interactive,Multimedia Patient Simulator, JeffreyM. Hoffman, MD, Children's Mercy Hospital 252 The CareerDevelopmentTrack - A Faculty Development Program for EmergencyMedicine Faculty without SabbaticalOpportunities,RodneyIYt.Smrtb,MD, St.Josepb Mercy Hosbital 1995 SAEM Annual Meetins

May 2J Ischemia/Reperfusion 253 High Dosesof MagnesiumImpah CardiacOxidativeMetabolism,Antbony Ferroggiaro,MD, uniuersity of Colorado 254 SuperoxideDismutaseReversesthe DeleteriousEffectsof Peroxynitritein Myocardial ReperfusionInjury in Crystalloid-PerfusedRat Hearts,Xin-liang Ma, MD, PhD, Thomas Jffirson Uniuersitjt 255 Free Radical ScavengingProtectsAgainst Superoxide-Induced Endothelial Dysfunction, Bernard L. Iopez, MD, TbomasJffi rson Uniuersitlt 256 AntioxidantTreatmentProtectsthe Myocardiumfrom Reperfusion Injury in a HypercholesterolemiaRabbit Model, Bernard L. Lopez,MD, Tltomastffirson Uniuersity 257 ReperfusionAcceleratesCell Death in a Cardiomyocyte Model of Ischemia/Reperfusion,Terry L Vand,enHoek, MD, Uniuersityof Cbicago 258 Oxidative Phosphorylation Maxima and Thermodynamic Efficiencies are Organ Specific, CharlesB. Cairns, MD, Uniuersityof Colorado 26I

Hypoxia/ReoxygenationEnhancesthe VasorelaxationResponse to Peroxynitrite in the Rat Aorta, Constantina Pippis-Nester,MD, TbomasJefferson Uniuersity

262 Distinct Effects of Peroxynitrite on Repefusion Injury in Crystalloid-Perfused vs Blood-PerfusedRat Hearts,XinliangMa, MD, PbD, Tbomastffirson uniuersity

272 A Novel MeasurementTechnique for Pulsus Paradoxus: Utility in Acute Childhood Aithma, Dale Steele,MD, Brown Uniuersity 273 EmergencyDepartment (ED) Based Asthma Educational Interventionto Increasethe Frequencyof Primary Provider (PP) Follow-up Visits (FU),Justin O. Ogbeuoen, MD, '[/ash ington Uniuersity 274 Effectsof ParentalPresenceDuring Children'sVenipuncture, R. IVayne Wolfram, MD, MPH, Eastent Virginia Medical School 275 Temperature(T) Total \fhite Cell (\fBC) and Band Counts as Indicators of S. Pneumoniae(SP) Occult Bacteremia(OB), Dauid M, Jalfe, MD, Vasbington tlniuersity 276 The Changing Bacteriologyof periorbital Cellulitis, Gary Scbwartz,MD, Vanderbilt uniuersity 277 ObservationalVariablesand SubjectiveJudgement:Pediatric Triage in a Non-Children'sHospital ED, Norruan C. Cbristopher,MD, MetroHealthMedical Center 278 Flexion-ExtensionCervicalSpine Radiographyin Pediatric Blunt Trauma, IY/illiamBrady, MD, tlniuersityof Virginia 279 Clinical Impact of Differencesin RadiographInterpretation by PediatricEmergencyPhysiciansand PediatricRadiologists,Harold K. Simon,MD, Emory tJniuersity

NOTE:Abstracts259 and 260will be presentedon May 22.

Health Care Delivery/Administration

Pediatric Emergency Medicine

280 An Analysisof PhysicianDependent CostsBetween Family Practitioners,Internists,and EmergencyPhysicians, WayneA. Satz,MD, Medical Collegeof Pennsyluania

263 LacerationRepair Using a TissueAdhesivein a Children's Emergencyl)epartment, TbomasB. Bruns, MD, Emory Uniuersity 264 Superiority of EMLA Compared wirh TAC for Topical Anesthesiaof Extremity \Tounds in Children, William T. Zempsky,MD, Cbildren\ Hospital of Pittsburgh 265 EmergencyDepartmentPredictorsof Child Abuse: Characteristicsof the ED Yisit, SusanJ.Duffy, MD, Rbod,eIsland Hosprtal 266 A Comparisonof Oral TransmucosalFentanylCitrate and IntramuscularMeperidine,Promethazineand Chlorpromazine for ConsciousSedationof Children, Sara Scbutzman, MD, Cbildren'sHospital,Boston 267 RectallyAdministeredMethohexital for PediatricSedarion in the Emergency Department, Robert M. Bowers, MD, Scott& lVbite Memorial Hospital 268 KetamineUse in a PediatricEmergencyRoom, Donna M. Moro-Sutbeiland,MD, Baylor Collegeof Medicine 269 Effectof DispensingAsthma Medicationsin the Emergency Department (ED) on SubsequenrVisits to Healthcare Providers,Andrew H. Sauer,MD, Haruard Medical Scbool 270 PediatricReactiveAirway DiseaseTreatmentProtocol: Effects on the Efficiency of Patient Care in the Emergency Department,/obn H. Myers,MD, Baylor Collegeof Medicine 271, ClinicalEffect of AerosolizedGlycopyrrolatein \X/heezing Infants, Norman C. Christopber,MD, MetroHealtb Medical Center 1995 SAEMAnnual Meeting

281. Survival and Quality of Life After Cardiac Arcest,Carol Callicot, Uniuersityof ANzona 282 Formal Quality-of-tife Testing of Survivors of OutofHospital CardiacArrest ComelatesPoorly with Commonly UsedNeurologicalOutcomeMeasures, Judy Hsu,BA, UCI.4 283 Effect of Periodic \flaiting Time Announcementson Patient Walk-Outsin a Municipal Hospital ED, Norbert Elsner,MD, Albert Einstein Collegeof Medicine 284 Cost-Effectiveness Analysis of the Ottawa Ankle Rules, I6n G. Stiell, MD, Uniuersityof Onawa 285 MedicaidManagedHealthcare:Compliancewith PrescreenerNotification in the EmergencyDepartment,Kelly Anne Foley, MD, Eastern Virginia Graduate School of Medicine 286 Does Ethnicity andLanguageAffect TriageAgreementand Ability to Predict Admissions,Mario Quintero, MD, Uniuersityof New Mexico 287 Surveyof UndocumentedAliens using the EmergencyDepartment, TheodoreCban, MD, tlniuersity of Califurnia, San Diego 288 Medical Communication:Do our PatientsUnderstand?, Dauid Janicke, MD, PbD, State (lniuersity of New York, Buffalo 289 AbbreviatedHealth StatusIndices Useful for AssessingImpact of Restricted(Managed)Care on Community and Pa, tient Populations,Dane M. Cbapman,MD, PhD, York Hospilal 11

May 23 290 Utilization of Emergency Medical Servicesby Homeless Adults in SanFrancisco:Effectsof SocialDemographicFac_ tors, RussBraun, MD, MpH, Higbland GeneralHospital 291 EmergencyDepafiment HIV Testing and Advocacy pro_ gram, Min Cba, MD, BelleuueHospital Center 292 Persons\7ho Identify the EmergencyDepafiment as Their Usual Sourceof Care, Marc J. Sbapiro,MD, RbodeIsland, HoErtal 293 Patient Understanding of Access to Emergency Care Under TennCare,CarolynM. Socba,Vand.erbiltUniuersity

300 Queuing Theory Predicrsthe porential Benefit to Emer-

gency DepartmentPatientsof Strategiesto provide Altem_ ate Sitesof Care to Patientswith Nonurgent Complaints, Nicbolas Schwartz, yale tJniuersity

301. Patientswho Leave without Being Seen:Do They Know Best?,SarabA. Stabmer,MD, Uniuersityof pennsyluania

302 ED StaffingCharacterisricsin St. Louis and KansasCity -

Does the Presenceof an EM Residencyprogram Make a Difference?,Mark T. Steele,MD, Uniuersity of Missouri, Kansas City

294 A Simple Intervention to Improve Telephone Contact of PatientsDischargefrom an EmergencyDepartment,Hnin Kbine, MD, Children's Hospital of pittsburgb

303 Factors Affecting Patient Throughput Times in an Aca-

295 Emergency Department physician Staffing Needs as a Function of Patient Volume, peter Viccellio, MD. State Uniuersityof New york, StonyBrook 296 EmergencyDepartment'Do Not Resuscitate, Orders:Next of Kin Responseto the EM physician, NarasingaRao,DO, St.BarnabasHospital

304 Continuous Quality Improvement Facilitatespatient Flow

297 The Impact of ManagedCarc Organizationson Emergency Departments, Robert IV. Derlet, MD, []niuersity of-Cali_ fornia, Dauis 298 ProjectASSERT:A Model for EmergencyDepartmentpre_ ventive Intervention, Edward Bernstein, MD, Boston City Hospital 299 Physicians'(MD's) and Nurses'(RN,s)Knowledge of and Attitude Towards Advanced Directives:Experienceand Preference,Bruce M. Becker,MD, Rbod,ehland HosDital

99.]. !*.Fency Medical College

Departmert, Keuin Reilly, MD, Albany

Through the Triage/Fast-Track Areasof an EmergencyDepartment, CbristopberM.B. Fernandes,MD, St.paul's Hospital

305 SustainedEffect of a Simple RequisitionForm in Limiting UnnecessaryOrdering of Lumbo-SacralSpine Films in the ED, Sam Trotzfoi,BA, Albert EinsteinCollegeof Medicine

306 Do Admitted PatientsXfaiting in the ED for Inpatient Beds Have an Impact on the Throughput Time of NonAdmitted Patients?, kffrey I Baza4an, MD, uniuersityof Rocbester

307 Chief Complaint Coding in the EmergencyDepartment, John T. DiPasquale,MD, Carolinas Medical Center 308 Patientswho Leave 'Against Medical Advice, from the EmergencyDepartment,CailosA. Camargo,Jr, MD, MpH, Massacb usettsGeneraI H os2ital

1995 SAEM Annual Meering

May 23

AWARDPRESENT{TIONS

1995 Hal Jayne Academic Excellence Award \filliam G. Barsan,MD, Universityof Michigan 1995 Iradership Award LouisJ. Ling, MD, Hennepin Counfy Medical Center 1995 Physio Control EMS Fellowship PaulaWilloughby, DO Institution:Universityof Illinois This $50,000fellowship is funded by PhysioControl Corporation 1995 SAXM/EMF Innovations in Medical Education Grants "Development and Implementation of an EmergencyMedicine Curriculum on the Wodd \(ide \fleb Utilizing a MOO-Based CollaborativeHypermedia System,"Daniel L. Savitt,MD, Rhode Island Hospital/Brown University "Useof ObjectiveStructuredClinicalExamination(OSCE)to Evaluate PediatricEmergencyMedicineTraining of EmergencyMedicine Residents ," MaryE. Metrou,MD, Universityof Michigan "Teaching Patients Interview Skills in the Emergency Department Using VideotapedFeedbackand AssessmentScores," PatrickBrunett,MD, Oregon Health SciencesUniversity 1995-96 SAEM/EMFMedical Student Research Grants "The Duration of EffectsAfter Inhalation of 500/o Nitrous Oxide: Oxygen for Forty-FiveMinutes" 50%o Medical Student:Craig S. Cohen,BA Preceptor:JamesMenegazzi,PhD Institution:Universityof Pittsburgh "lmproving Pediatric Patient Triage \(ith Admission Lactate Levelsin the EmergencyDepartment" MedicalStudent:Nader Fakhimi Preceptor:David Milzman,MD Institution:GeorgetownUniversity "Evaluationof a PersonalComputer-BasedTelemedicineSystem for RadiographicAssessmentof EmergencyMedicalConditions" MedicalStudent:Gordon Wingard Preceptor:David Ellis, MD Institution:Erie County MedicalCenter

1994 AnlirlualMeetlng Awards Best Oral Cltnical Sclence Presentation "A Comparisonof ImmediateversusDelayed Fluid Resuscitation for HypotensivePatientswith PenetratingTorso Injury," Xflilliam H. Bickell,MD, BayiorCollegeof Medicine "A Multicenter Clinical Trial to Implement the Ottawa Ankle Rules,"Ian Stiell,MD, Universiryof Ottawa Best Oral Basic Sclence Presentation "High Dose Endotoxin NeutralizingProtein Improves Survivalin RabbitsE. Coli Sepsis,"Anne Stack,MD, Haward MedicalSchool Best Poster "Bariers Facing PatientsSeeking Acute Care at a Public HosMD, Emory University pital," Mark V. \X/'illiams, Best Innovations in Ernergency Medicine Education Exhibit "EffectivelyCommunicatingwith Consultants- An Instructional Module," WilliamJ. Frohna,MD, MadiganArmy MedicalCenter Selected to be Presented at the AAMC Annual Meeting "PhysicalExaminationSkills of EmergencyMedicine and Internal Medicine Residents,"SalvatoreMangione,MD, Medical Collegeof Pennsylvania "Can AcademicMedical CentersVhich Do Not Have an Emergency Medicine ResidencyMeet the ResidencyReview Committee's Requirementsto Startan EmergencyMedicine Residency?," C.JamesHolliman,MD, MS,HersheyMedicalCenter Best Education Presentation "PhysicalExaminationSkills of EmergencyMedicine and Internal Medicine Residents,"SalvatoreMangione,MD, Medical Collegeof Pennsylvania Best Oral Resident/Fellow Presentation "Different PreconditioningStimuli ProtectMyocardialMechanical Function after IschemiaReperfusionInjury," Diane C. Barta,MS, MD, Universityof Colorado Best ResidentAellow Poster "EstrogenXfithdrawl Alters the Neutrophil-LymphocyteRatioin Rabbits,"Emil Skobeloff,MD, MedicalCollegeof Pennsylvania Best Pediatric Emergency and Critical Care Presentation "NebulizedDexamethasoneVersus Oral Prednisonein the EmergencyDepartmentTreatment of Acute Asthma in Children,"RichardJ.Scarfone,MD Best Medical Student Presentation "Lower EsophagealSphincterPressureDuring ProlongedCardiac Arrest and Resuscitation,"FrederickP. Bowman, BS,Center for EmergencyMedicineof WesternPennsylvania Best Technology Presentation "Median Frequencyof Ventricular Febrillation ReflectsMyocardial Blood Flow and the Chanceof SuccessfulResuscitation," H.U. Strohmenger,MD, Universityof Ulm

1995SAEMAnnual Meeting

May 2J

HAt JAYNEACADEMICEXCELTENCE AWARD

William G. Barsan, MD Dr. Villiam G. Barsanbeganhis careerin EmergencyMedicinein 1977when he becamea residentat the Universityof Cincinnati. Upon completion of his residencyhe joined the faculty at Cincinnatiat the rank of AssistantProfessorand took the lead in developing one of the specialry'sfirst large animal researchlabs. Early work in this lab included developmentof a canineasphyxial anestmodel and evaluationof drug deliveryduring CPR. In 1981,Dr. Barsanassumedresponsibilityfor directingthe emergencymedicineresidencyat Cincinnati. Under his leadership,this residencydevelopeda reputationas one of the premier academicprogramsin the country. During his tenure, Dr. Barsan recognizedthe challengeof teachingthe entire breadthand depth of emergencymedicinein three years,particularlyif substantial time is committedto a resident'sacademicdevelopment. Consequently,he developedplans for what would ultimatelybecomethe nation'sfirst four-yearemergencymedicineprogram,a model that is now followed at manyother academiccenters. ln 1984,Dr. Barsansteppeddown from the program director position to devote additional time to his interestin the acute treatment of stroke. He becamea founding member of the GreaterCincinnati/NofthernKentucky StrokeTeam, a group that sought to use a multidisciplinary approachto both the clinical managementof stroke and the study of new therapeuticinterventions. This was a difficr"rlttask that involved changingthe pessimisticperceptionsof stroke held by both health professionalsand the lay public. It also involved convincing ftrnding agenciesthat the acute treatmentof stroke was an area deservingadditional investmentof researchdollars. The stroke team was successfulin heightening public awarenessof the need for early intervention and in developing a network of local hospitals committed to rapidly evaluatingand treating these patients. This team was awardednumerous NIH grants that supported investigationof early pharmacologicalinterventionsfor this devastating disorder. An invaluablemember and in many ways the driving force responsiblefor the successof the stroke team, Dr. Barsan was able to demonstrateto these more establishedresearchersthe unique expertise,perspectiveand talent of the emergency physician. He is now a nationally recognizedauthority on the early managementof stroke, a well-funded principal investigator and the author of numerousoriginal researchpublicationson the topic. Dr. Barsan'smost recent achievementwas his appointmentin 1,992as Professorand Head of the Sectionof EmergencyMedicine at the University of Michigan. Michigan is a very traditional medical center and one that many thought would never recognize the need for emergencymedicine. However, Dr. Barsanrapidly won the respectand support of the institution and has established a strong faculty, a productive researchprograni and what will surely become another first class,academically-oriented emergencymedicine residency. Impressivethough these accomplishmentsmay be, Dr. Barsan'sgreatestachievementhas been his ability to share his success with others. He is a warm and generousindividual who possessesa unique blend of enthusiasm,energy and intellectualcuriosity. These traits have attractedcountlessstudents,residentsand junior faculty for whom he has served as a role model, a mentor, and a motivator. Residentswho were trained by Dr. Barsanare currently working in academicpositions al1acrossthe country. Severalare successfulresearcherswho have becomeleadersin the academiccommunity. There is no doubt that many of them would not have accomplishedwhat they have without Dr. Barsanpointing the way. By this accomplishmentmore than any other, Dr. \flilliam G. Barsanhas contributedto both the presentand future strengthof emergencymedicine as an academic discipline. SAEMis proud to recognizehim as this year'srecipient of the HaI JayneAcademicExcellenceaward. SteuenC. Dronen, MD

1995SAEMAnnual Meetine

May 23

TEADERSHIPAWARD

LouisJ. Ling, MD Dr. Louis Ling is a 1980 graduateof the University of MinnesotaMedical School.Following a flexible intemship at Hennepin County trledical Center,hi completed his training in the emergencymedicine residencyat the Universrryof ChicagoHospitals and Clinic. His careeris marked by steadyachievementand an alwaysincreasingcircle of friends who have had the opportunity to sharein his activities. Organizationswhich have benefited from Dr. Ling's leadershiphave included the American College of EmergencyPhysicians (AaEP),ACEP'sMinnesotaChapter,the ACGME,the Societyfor AcademicEmergencyMedicine (SAEM),the MinnesotaMedical Association,the American Academy of Clinical Toxicology, and, I am happy to add, Hennepin County Medical Center.He has demonstratedimportant leadership in each of these organizations,the scope of which is beyond the space allotted for this tribute. Therefore,some of the high points will be covered. Dr. Ling has always been a leader. He was honored with the Universityof MinnesotaLeadershipAward for his work in student governmentand for serving as Presidentof his class.He continued his leadershipactivitiesas a residentin emergencymedicine inder the late Hal Jayne'sguidance,he becamea founder and chartermember of the EmergencyMedicine Residentsof Illinois. Later,he served as a member of the Board of Directorsof the EmergencyMedicine Residents'Association(EMM)' His activities in EM1]dled him to be recognizedas a worthy representativeto serve in the lone resident position on the ResidencyReview Commirteefor Emergenryl,ledicine (RRC-EM)of the AccreditationCouncil for GraduateMedicalEducation(ACGME).His stellar performanceas a resldentbrought him to the attentionof organizationswho would enlist his talent upon residencygraduation. The ACGMEwasted little time in recalling Dr. Ling to service as a member following his residencygraduation.He returned to the RRCafter a two-year hiatus to serve for six years as a member,including a period as chairman.He began a comprehensive review of the SpeciaiRequirementsfor EmergencyMedicine during his chairmanshipand settledcontroversyover emergingfellowships in emergencymedicine. His easy manner led to speedy resolution of potentially divisive issues.He contributed to SAEMin many ways, on multiple committees,as newslettereditor, on the Board from 1988-94,and by serving as Presidentin 19g2-1993.SAEM experienced rapid growth during his tenure as a Board Member and President.Its meetings became progressivelymore suicessfuland the decisionto publish its own journal, now a reality,was made. Clinical Toxicology is another beneficiaryof Dr. Ling's leadershiplargess.He is the Medical Director of the Hennepin Regional Poison Center in Minneapolis,having served in this capacity since 1986.He has participatedin the activitiesof the American Academyof Clinical Toxiiology since t994. His leadershipof our Poison Centerhas allowed for the steadygrowth and success which seemsto characterizeall the organiztrtionswith which he is involved. and alternatecouncillor. He has Other activitieshave included membershipon the MinnesotaACEPboard as secretary-treasurer ACEP.He was associate for national Education Committee Medical and the Graduate Committee Affairs chaired the Academic editor of PEERIV and servedon the 1990Core ContentTask Force.The list goes on . . . As busy as Dr. Ling has remained,he contributeslocally more so than nationally,He servedas the Director of our Office of Academic Affairs from-I99l.-1993 and is now our AssociateMedical Director for Academic Affairs at Hennepin Country Medical Center. In this capacity,he is heavily involved with the issuesfacing graduatemedicaleducationin our competitiveenvironment. LouisJosephLing, MD, is one of the most affable arrdindustriousleaderswe have the good fortune to include in our specialty Hls logicai mind-allows him to focus on the heart of issuesand bring them to resolutionwithout the tangentialinefficienciesof less tJented leaders.Perhapsthat explains the imbalancebetween the breadth of his accomplishmentsand his relative youth.' The good news is that he continues his contributions at an undiminished pace. !0'e can take comfort that our specialtyand mediiine in generalwill benefit from them for many yearsto come. SAEMis proud to recognizehim as the recipient of its 1995 LeadershipAward. JosepbE. Clinton, MD

1995 SAEM Annual Meeting

SIATE OF NOMII{EES

May 23

The NominatingCommitteeand Board of Directors are pleasedto present this slate of candidatesfor election at the annual business meetingon May 23. The following generalguidelineswere used by the NominatingCommittee. 1. Nominationswere sought from the membershipthrough advertisementsin the Newsletter. 2. All memberswho respondedto the "Call for Nominations"in the Newsletterwere considered. '$flhenever possible,a slate of two or more candidatesis presentedto the membershipfor each position. It is the Board,sopinion that 3. the membershipshould be given choicesof well qualified candidateswhenever possible. 4' The Board believesit is important to have a single ballot for each position undei considerationrather than pairing up nominees.Thus, the most qualifed candidatesfor each position can be selectedby the membership. 5 Eachposition will be open for additionalnominationsfrom the floor at the annui businessmeetrng. 6 Biographicalinformation regardingeach nominee is presentedto the membershipprior to the elections.

PRESIDENT-ELECT Steven C. Dronen, MD, is Associate Professorof EmergencyMedicine and AssociateHead and ResidencyDirector of the Sectionof EmergencyMedicine at the University of Michigan. Dr. Dronen has servedas a memberof the SAEMBoard of Directorssince 1991 and since 1993 as the Secretary/ Treasurer.He is the Presidentof the Council of EmergencyMedicine Residency Directors (7993-95).He has been a member on the SAEMJournal TaskForce,the ResidencyAid Committeeand the CurriculumDevelopmentTask Force. He has served as the coordinatorof the SAEMResidencyConsultingServicefor five years.Dr. Dronen is an Editorial Board member for Academic EmergencyMeclicine and Yearboohof EmergencyMedicine, a Reviewer for Annals oJ' Eruergency Medicine and the American Journal of Emergencl, Medicine,and is an Examinerfor the American Board of EmergencyMedicine.Dr. Dronen graduatedfrom medical school in 1977from the Universityof Illinois and completedan Emergency MedicineResidencyin 1980ar Henry Ford Hospital in Detroit.

Sandra M. Schneider, MD, is Professor and Chair of the Departmentof EmergencyMedicine at the University of Rochester. Since 1993 Dr. Schneiderhas been a member of the SAEM Board of Directors and has seruedas Board Liaison for the Ultrasound Task Force,TechnologyCommittee, DisasterTask Force and the I n t e r n a t i o n a lC o m m i t t e e .S h e h a s been a member of the Technology Committee(1,988-199r,a member of the Constitutionand Bylaws Commitee (j990-g, and Chair of that Committee(1992-9i. Dr. Schneideris a Site Surveyorfor the RRC-EM,as well as an Editorial Board member for theJournal of Prebospitaland DisasterMedicine, EmergencyMedicine Reports,and the Journal of Proceduresin EmergencyMedicine. She is alscra reviewer for Academic EmergenqtMedicine,Annals of EmergencyMedicinq and the AmericanJournal of Medicine. She graduated from the University of pittsburgh Medical School in 1975 and completed an Internal Medicine Residency from the PresbyterianUniversityHospital in 1978.

BOARD OF DIRECTORS Edward Bernstein, MD, is Associate Professorof EmergencyMedicine and Public Health at Boston University School of Medicine and Boston City Hospital. Since 1991 he has seruedas Chair of the SAEMPublic Health and EducationCommittee.He has served on the GeriatricTask Force and Geriatric EducationPanelsince 1991,and is a member of the PatienrPhysician CommunicationTask Force.He is currently P.I. for a US DHH SAMHSACenter of Substance Abuse TreatmentGrant at Boston Citv Hospital. He hasservedas a reviewer for AcademicEmergencyMedicine, Annak of Emergency Med,icine,and SubstanceAbuse,has been a GuestEditor for Health Eclucation euarterly, and is currently editing a case-basedlext: Public Heatth Issuesin Emergency Medicineto be publishedearly in 1995.From 1985-88he developedand directedthe EM Residencyat the Universityof New Mexico.He was the New Mexico ACEp Chapter Officer and servedas Presidentfrom 7982until 1986,and was Chaitpersonof the STEMPublicEducationCommittee(1986-3g).Dr. Bernsteinis a graduateof StanfordUniversitySchoolof Medicine. 1995SAEMAnnual Meeting

Michelle Biros, MS, MD, is SeniorAssociatePhysicianin the Departmentof E m e r g e n c yM e d i c i n e a t H e n n e p i n County Medical Center and Assistant Professorof Neurosurgery al the University of Minnesota.Dr. Biros has been a member of the ResearchCommittee since 1989 and has served as the chair slnce 1992.Since 1992,she has been the Chair of the Research Didactic Task Force,a member of the SAEM/EMFMedical SrudentReview Committee,and a member of the ProgramCommittee(1992-9r. In 7985, Dr. Biros was the recipient of the Best Basic Science Paper,and in1990, the BestOral BasicSciencepaper.Dr. Birosis a memberof the ACEPResearch Sec(ionandan SAEMreoresentative to the EMF Board of Trustees.She is an Ad Hoc Reviewer for Annals of EmergenqtMedicine, and an AssociateEditor for AcademicEmergencyMedicine.Dr. Biros graduatedfrom the University of MinnesotaMedical School in 1982,and completedan EmergencyMedicine Internship/Residencyat the University of Cincinnatiin 1986.She also completedan EmergencyMedicine ResearchFellowshipat the Universityof Cincinnati.

May 2J BOARD OF DIRECTORS (continued) Terri Schmidt, MD, MS, is an Associate Professorin the Deoartment of EmergencyMedicineat OregonHealth SciencesUniversity.Dr. Schmidthas been a member of the SAEMEthics Committeesince 1990 and has been the Chair of that committee since 1993.She is the AssistantDirector at the Centerfor Ethicsin Health Care at OHSU.In 1992,she participatedin the Certificate Program for Health Care Ethicsat the Universityof lfashington, and from 1990-1991,she servedon the NAEMSPEthicsCommittee. Dr. Schmidt graduated from medical school in 1985 from OHSU.comoletedan InternalMedicineInternshiofrom OHSUin 1986,and il i988, completedan EmergencyMedicineResidency from Oregon Health SciencesUniversity.

J. Stephan Stapczynski, MD, is AssociateProfessorand Chairman of the Departmentof EmergencyMedicine at the University of Kentucky Collegeof Medicine.Dr. Stapczynski has served on the SAEMInjury Control Task Force, the AAMC Liaison Committee,and the NominatingCommittee. He has been on the ACEPEducationalMeetingsCommittee(198488) as weli as the ACEPHome Study Task Force (1991-9r. Dr. Stapczynski is the current Presidentof the Associationof AcademicChairsof EmergencyMedicine. In addition, he is a Journal Reviewerfor the American Journal of EmergencyMedicine and Academic EmergencyMedicine as well as a ConsultingEditor for Annals of EmergencyMedicine. Dr. Stapczynskigraduatedfrom medicai school at UCLA in 1976 and completedan Internal Medicine Residencyfrom Harbor UCLA Medical Center in 1979, and in 1979 was Board Certified in Internal Medicine, and Emergency Medicinein 1987.

RESEARCHCOMMITTEECHAIR-ELECT M. Andrew Levltt, DO, is an Assistant Clinical Professorof Medicine in the Division of EmergencyMedicine at the Universityof California,San Franciscoand Director of Researchin the Departmentof EmergencyMedicine at HighlandGeneralHospital.Dr. Levitt has participatedon the SAEM Program Committee (7993-95) and, the ResearchCommittee (1989-1994). He has also participated on the California ACEP Education Committee (I990-9r, was the Co-Chairmanfor the \trinter ScientificSymposium (1990-9J),was Chairman of the CA ACEP Subcommittee on PharmaceuticalFinancialSupport in Medical Education (1991-9r, and the ResearchCommitteesince 1994.Since1991, he has been an instructor for the Center for PrehospitalCare and Research,and from 1988 to 1994,he participatedon the EMF Medical Student Grant Review Committee.Dr. Levitt is a Reviewerfor Academic EmergenqtMedicine,AmericanJournal of EmergencyMedicine, and Annals of EmergencyMedicine. He graduated from the University of OsteopathicMedicine and Health Sciencesmedical school in 1980and completedan Emergency Medicine Residencyin 1984 at the University of Arizona Health ScienceCenter.

RogerJ. Irwls, MD, PhD, is Director of Researchin the Department of EmergencyMedicine,Harbor-UCLA MedicalCenterand AssistantProfessor of Medicine at the UCLA School of Medicine.Dr. Lewishas been a member of the SAEMResearchCommittee (1992-95),and the SAEM National EmergencyMedicine DatabaseTask Force (1991-93).Dr. Lewis is a Consulting Reviewer for Acad,emicEmergencyMedicine,Annals of Emergency Medicine,AmeNcanJournal of EmergencyMedicine,Biometrics, andJAMA. In addition, Dr. Lewis is the Medical Director of the California Chapterof Basic Trauma Life Support, as well as the recipient of the 1.993-94EMF Career Development Award. In 1.987,Dr. Lewis graduatedfrom Stanford University Medical School,receiving both his MD and a PhD in biophysics.He completed an EmergencyMedicine Internship from HarborUCLA Medical Center, and completed an EmergencyMedicine Residencyfrom the same institution in 1990.Dr. Lewis' arcaof researchinterest is the statisticaldesign and analysisof clinical trials.

1995 SAEM Annual Meeting

May 23 NOMINAIING COMMITTEE Carey Chishokn, MD, is the Emergency Medicine ResidencyDirector at Methodist Hospital of Indrana and a Clinical AssociateProfessorof Emergency Medicine at Indiata University School of Medicine.He served on the SAEMEMSCommitteefrom 1986-1991, and on the ResidencyAid Committee from 1989-1995,and since 1992 has seryed as the Chair of the Residency Aid Committee.Since 1988,he has been a special site surveyor for the RRC-EM.Dr. Chisholmis a member of the SAEMProgramComminee(1991-94),a member of the ACEPAcademicAffairs Committee,and since 1991,has servedon the CORDBoard of Directors,and is the President-Elect of CORD.He has been an Editorial reviewerfor Annals of EmergencyMedicine since 1989 and an Editorialreviewer f.or llEtul since 1992 and sjnce 1994a reviewer for AcademicEmergencyMedicine. ln additron,he has served on theIndianaChapterof ACEPBoard of Directorsas well the ACEp ChapterBoard of Directors for Government Services.Dr. Chisholmgraduatedfrom the MedicalCollegeof Virginia in 1980, completeda transitional internship in 1981 and an Emergency MedicineResidencyin 7983from MadiganArmy MedicalCenter. Paul E. Pepe, MD, is a Professorin the Departmentsof Medicine, Surgery and Pediatricsat Baylor Collegeof Medicine and the Ben Taub General Hospital in Houston. He is the Director of the City of Houston EmergencyMedical ServicesSystem and is an AssociateProfessorof Emergency Medicine at the University of Texas Medical School in Houston. He representedSAEMon the AMA Commission for EmergencyMedical Servicesfrom 1985-1.990, servedon the SAEMEMSCommitteefrom 1988-1997,and since 1992 on the Program Committee. Since

1994,Dr. Pepe has been active as an AssociateEditor of Academic EmergencyMedicine. He has previously served as president of the National Associationof EMSPhysiciansand also as a member of the National Advanced CardiacLife Support Subcommittee of the American Heart Association.Among several governmentalappointmentshe has served on the Trauma and EMSAdvisory Committeefor the U.S.Departmentof Health and Human Seruices.Dr. Pepe graduatedfrom the Universityof California, San FranciscoSchool of Medicine in 1976,completedan intemal medicine residencyat the Universityof Xflashington,Seattle, then completed severalClinical and ResearchFellowships including Pulmonary-CriticalCare (1979-81,)and Trauma (198182) at the Departmentsof Medicine and Surgeryat the U\X/and 'Critical then Surgical Care in 1982in the Departmentof Surgery at the Universityof Miami/JacksonMemorialHospital. William A. Robinson, MD, is Professorand Chair of the Departmentof EmergencyMedicine at the University of Missouri-KansasCity School of Medicine/TrumanMedical Center.Dr. Robinson has been a member of the SAEMInternational Committee(199495), and is the SAEMrepresentativeto the Core Content Task Force. He is President-Elect of the Associationof Academic Chairs of EmergencyMedicine and has served as a member of the MissouriChapterof ACEPBoard of Direcrors(1987-1990).In addition, Dr. Robinsonhas been an Editorial Board memberand Section Co-Editor for \Vildernessand EnuironmentalMedicine and is assumingthe role of the editor for this journal. He has also served as a SectionCo-Editor and sonsulting reviewer for Annals of EmergencyMedicine, and as a Consulting Editor for the Journal of EmergencyNursing. He is a Board member of the InternationalMedical Corps (1986-199). Dr, Robinsongraduated from medical school at Tulane Universityin 1975and completed a Residencyin EmergencyMedicine from Truman MedicalCenterin 1978.

CONSTITUTIONAI\D BYTAWSCOMMITTEE Iouis Graff, MD, is AssociateProfessor of ClinicalMedicine,AssistantProfessor of Surgeryat the Universityof Connecticut, and AssociateDirector of Emergency Medicineat New Britain General Hospital. Dr. Graff has served on the SAEMMembership RecruitmentCommittee,PublicHealth& EducationCommittee,and the Research Committee.He served as Chair of the SAEMObservation Medicine Committee (1.989-199L) and Chair of the ResearchDidactics Subcommittee e993-9r. He has also served as a Reviewerfor AcademicEmeryencyMedicine. Dr. Graff is the ACEPObservarion Services SectionChatr,a member of the ACEPPracticeManagementCommittee,and the Board of the ConnecticutChapter of ACEP.Dr. Graff graduatedfrom Haward Medical School in t976, completedan Intemal Medicine Residencyfrom St. Vincent Hospital in Massachusetts in 7979, and a Nephrology Fellowship from theUniversityof Massachusetts MedicalCenterin 1981.

Charles V. PoflackJr, MA, MD, is the ResearchDirector in the Depatment of EmergencyMedicineat MaricopaMedical Centerin Phoenix.Since 1993,Dr. Pollackhas been a memberof the SAIM EducationCommitteeand has servedas a member of the ACEPResearchCommittee (1990-94),as well as the ACEP ScientificReviewPanel.Dr. Pollack is a regular faculqr member for ACEPin Asential Topics,\ffinter Symposium,and ScientificAssembly.He is a Reviewerfor Annab of EmergmcyMedicine and is on the EditorialBoardfor the Journal of EmergencyMedicine. In 1992,Dr. Pollack received rhe EMRAAcademicAchievementAward. In 1984,he graduatedfrom medicalschoolat TulaneUniversitySchoolof Medicine,completeda GeneralSurgeryIntemship from the U.S.Naval Hospital,SanDiego in 1985, and n 1992completedan EmergencyMedicineResidency from the Universityof MississippiMedicalCenter.

May 23

CONSTITUTION

ARTICLEI-NAME The name of this organizationshall be, "The Societyfor Academic EmergencyMedicine," hereinafterreferred to as, "The Association." ARTTCLErr-OBJECTTVES Section1; The objective of this Associationis to improve the care of the acutely ill or injured patient by promoting research, educatinghealth care professionalsand the public, fostering relationshipswith organizationswith a similar purpose, and suppofiing the specializedor multidiscipline care of such patients through researchand education. The Associationwill function as a scientificand educationalorganrzationas defined in Section 501 (c) (3) of the Internal RevenueCode,as amended. Section2: The Associationshall pursue its purpose by: (1) sponsoringforums for the presentationof peer-reviewedscientific and educationalinvestigations,(2) sponsoringand convening educationalprograms for health care professionalsand the lay public, (3) promoting academicdevelopmentand education of its membershipthrough specializedprograms,(4) serving in an academiccapaciryto develop and promote further the most appropriate measuresfor the care of the acutely ill or injured patient, (5) deveioping liaisons with other organizationswith a similar purpose, and (6) publishing researchand educational data in the scientific and educationalliterature and other media availableto the lay public. Section3: A, This corporation is organized exclusivelyfor educationaland scientific purposes,including, for such purposes, the making of distributions to organizationsthat qualify as exempt organizationsunder Section501 (c) (3) of the Internal RevenueCode of 1954(or the coresponding provision of any future United StatesIntemal RevenueLaw). B. No part of the net earningsof the corporation shall inure to the benefit of, or be distributableto its members,Directors,Officers or other private persons,except that the corporation shall be authorizedand empoweredto pay reasonablecompensation for servicesrenderedand to make paymentsand distributionsin furtheranceof the purposesset forth 1n paragraphA hereof. No substantialpart of the activitiesof the corporation shall be the carryingon of propaganda,or otherwiseattemptingtO influence legislation,and the corporation shall not participatein, or intervene in (including the publishing or distribution of statements) any political campaign on behalf of any candidate for public office. Notwithstandingany other provision of these articles,the corporation shall not carry on any other activitiesnot permitted to be carried on (a) by a corporation exempt from FederalIncome tax under Section 501 (c) (3) of the Internal Revenue Code of 7954(or conesponding provision of any future United StatesRevenueLaw) or (b) by a corporation, contributions to which are deductible under Section I70(c) (2) of the Internal RevenueCode of 1954 (or the correspondingprovision of any future United StatesInternal RevenueLaw). ARTICLEIII-MEMBERSHIP Section1: Classificatiors.There shall be seven classesof membership: active,associate,emerifns,resident/fellow,honorary, intemationalactiveand intemationalassociate, and medicalstudent. (1) Section2: Qualifications. Candidatesfor active membership shall be (a) individualswith an advanceddegree(MD, DO, PhD, PharmD, DSc, or equivalent) who hold a medical school or universityfaculty appointmentand who activeiyparticipatein

acute, emergency,or critical care in an administrative,teaching, or researchcapacity,or (b) individuals with similar degreesin activemilitary service(U.S.or abroad)who activelyparticipatein acute, emergency,or critical care in an administrative,teaching, or researchcapacity.Individuals who otherwise meet qualifications for active membershio as defined above but who do not hold a universityfaculty appointmentmay petition the Membership Committeefor considerationfor active membershipstatus. (2) Candidatesfor associatemembershipshall be health professionals,educators,govemmentofficials,membersof lay or civic groups,or membersof the public at large who may have an interestor desireto participatein pursuingthe purposesand objectives of the Association.(3) Candidatesfor emeritusmembership shall be (a) activememberswho seek such statusand who have given 15 continuousyearsof activeserviceto the Associationand have attainedthe age of 65 years or (b) other active members who under special circumstancesare invited for such emeritus status by the Membership Committee.(4) Candidatesfor resident/fellow membership must be residents or fellows in residency programswho have an interest in emergenrymedicine. (5) Candidatesfor honorarymembershipshall be individualswho have made outstandingresearchor educationalcontributionsto the purpose and objectivesof the Association.(5) Candidatesfor intemationalmembershipshall be individualswho resideoutside the U.S. and who meet qualificationsfor active or associate membershipas describedabove. Such candidatesmay apply for active,associate,or other membershipin the Association.(7) Candidatesfor medical student membershio must be medical studentswho have an interestin emergencymedicine. Section3: Mernber Rigbtsand Priuileges,All members may have the privilege of the floor and of servingon the committees of the Association,and serving as committeechairs.Only active and associatemembers may serve on the Board of Directors. Only active membersshall have voting rights and may seffe as officers of the Association. Section4; The Associationshall not discriminate,on the basis of race,sex, creed,religion or national origin. ARTICII N-OFFICERS, BOARD OF DIRECTORS, EXECUTIVE COMMITTEE, E)GCUTIVE DIRECTOR Section7; The officers shall be the President,President-Elect, and Secretary/ Treasurer. Section2: The Board of Directorsshall serveas the goveming body. The Board of Directorsshall consistof the above officers, the ImmediatePastPresident,and six Members-at-Large. SectionJ; The ExecutiveCommitteeshall consistof the President, President-Elect, PastPresidentand Secretary/Treasurer. Section 4: The Executive Director recommends and participates in the formulation of new policies and makes decisions within existing policies as they have been approved by the Board of Directors. ARTICLE V- COMMITTEES The standingcommitteesshall be: (1) NominatingCommittee, (2) MembershipCommittee,(J) ProgramCommittee,(4) Consti tution and Bylaws Committee,(5) EducationCommittee,(6) Research Committee,(7) Liaison Committeeto the Associationof American Medical Colleges,(8) GovernmentalAffairs Committee, and (9) Committee on International Affairs. Additional committees may be created by the Board of Directors and ad hoc committeesand task forcesmay be createdby the President to aid in the Association'seffortsto achieveand further its goals. 1995 SAEM Annual Meeting

May 2J ARTICLE VI - ANNUAL MEETING Section1: There shall be an annual meeting of the Association. This meeting shall consist of an educationaland scientific programand a businesssession.

by at least three membersat least 60 days prior to the meeting at which they are to be considered.The Secretary/Treasurer shall mail the proposed amendmentsto the membershipat least 30 daysprior to that meeting.

Section2: The Board of Directors,by majority vote, may call, upon 30 days notice, a special meeting of the membership or standingcommitteeto conductany businessthat the Boardof Directorsshall place before the membershipor standing committee.

Section-ir The Board of Directorsmay, by resolution,propose amendmentsto the constitutionand bylaws; provided the proposedamendmentsare mailed to the membershipat least30 days prior to the meetingat which they are to be considered.

Section3: A special meeting may be called by the membership upon petition by 100 or more active members stating the shall call reason(s)for the meeting. The Secretary/Treasurer sucha meetingwithin 30 days of receivingthe petition at a time andplacedesignatedby the President.

Section4; Adoption of a constitution and bylaws amendment shall be l>y a maiority vote of the active memberspresent and voting at any annual or specialmeeting.

Section4: The Board of Directors may call and conduct any specialmeetingby mail. For purposesof notice, the meeting dateshall be a date set for the return of mail ballots and it shall be calledthe voting date. Adoption of any proposal, resolution or amendmentby mail ballot sha1lbe achieved by affirmative vote of a majority of voting active members unless otherwise providedby another provision of this constitution. Only those mail ballots received at the businessoffice of the Association within 30 dayssubsequentto the voting date shal1be counted. ARTICLE VII - ADOPTION OF AMENDMENTS Section1; The constitutionand bylaws may be adopted or amendedat any annualor specialmeeting of the membership. Section2; Proposed amendmentsto the constitution and bylawsshall be submitted in writing to the Secretary/Treasurer

ARTICIT YIII - DISSOLUTION Upon the dissolutionof the corporation,the Board of Directors shall, after paying or making provision for the payment of all of the liabilities of the corporation dispose of all of the assetsof the corporation exclusivelyfor the purposesof the corporation i n s u c h m a n n e r , o r t o s u c h o r g a n i z a t i o n so r g a n i z e da n d operated exclusivelyfor charitable,educational,religious or scientificpurposesas shall at the time qualify as an exempt organizationor organ\zationsunder Section 5Ol(c) (3) of the Internal RevenueCode of 1954(or the conespondingprovision of any future United StatesInternal RevenueLaw), as the Board of Directorsshall determine.Any such assetsnot so disposedof shall be disposed by a Court of CompetentJurisdiction in the Council in which the principal office of the corporation is then locatedexclusivelyfor such purposesor to such organizationor organ\zations,as said court shall determine, which are organizedand operatedexclusivelyfor such purposes.

BYLAWS ARTICLEI-MEMBERSHIP Section1: Application Process.Membershipapplication forms maybe obtainedfrom the ExecutiveDirector of the Association. TheApplicantmust return the completed application forms and supportinglettersto the ExecutiveDirector. The qualificationsof applicantsfor membership will be reviewed by the Executive Approval of applicantsby the Directorand Secretary/Treasurer. shall constituteelecExecutiveDirector and Secretary/Treasurer tion to one of the membershipcategories,effectiveimmediately. Section2: Dues. Annual dues for active, associate,resident/fellow,medicalstudent,and internationalmemberswill be established by the Board of Directors. Honorary and emeritus memberswill not pay dues. Membershipin the Associationmay be terminatedfor nonpaymentof dues. ARIICI.E tr-BOARD OF DIRECTORS Section1: Mernbers.The Board of Directors shall consist of the President,the President-Elect,the ImmediatePastPresident, EMRA, and six Members-at-Large. the Secretary/Treasurer, AACEM,and CORD may each appoint an ex-officio member to theBoard. Section2: Responsibilities.Members of the Board will meet regularlyto perform the businessof the Association.AII scientific and educationalmeetingsof the Associationare to be approvedby the Board. Membersof the Board may serveon committeesof the Association,but no Board member may serueas a 1995SAEMAnnual Meeting

servcommitteechair, with the exceptionsof the President-Elect ing as Chair of the Nominating Committee and the Secretary/ Treasurerserving as Chair of the MembershipCommittee.The entire Board servesas the MembershipCommittee.Membersof the Board may be appointed to serye as Chairsof ad hoc Committeesand TaskForces. Section3: Electionof Officers.(a) The President-Electshall be elected for a term of one year with automaticsuccessionto Presidentthe following year. During this two-year period, the electedmember will serve as an officer of the Association.Following terms of President-Electand President,this member will automaticallyassumethe position of ImmediatePast President. Election as President-Electshall confer Board of Directorsmembership for a minimum of three years. (b) The Secretary/Treasurer shall be elected to a three year term. An active member may not serve consecutiveterms as Secretary/Treasurer, President,or PastPresident. President-Elect, Members-at-Large Section4: Election of Members-at-Large. shall be elected to three-yeartetms, the terms being staggered. may not serve more than two terms Members-at-Large consecutively. Section5: Nomineesfor Election. Nomineesfor the above offices shall be selectedby the NominatingCommitteeand must have agreed to stand for election prior to their formal nomination for election at the businesssessionof the annual meeting'

May 23 Alternative nominations may be offered from the floor. Such nomineesmust also agreeto stand for election.Electionshall be by majority vote of the active members present and voting at the businesssessionof the annual meeting. Section6: Termsof Office.Terms of office will begin at the conclusion of the annual businessmeeting. The Presidentshall appoint eligible Association members to fill vacancies and unexpired terms on the Board of Directorsand standing and ad hoc committeesuntil the next scheduledelection. Section 7: Meetings.Meetings of the Board of Directors or ExecutiveCommitteewill be convened in accordancewith the Policiesand ProceduresManual. Specialmeetingsmay be convened at the President'sdiscretionor by petition of six members of the Board of Directors. A final notice of time and place of such meetingsshall be sent to all membersof the Board by the Secretary/Treasurer at least7 days before the meeting. Six members of the Board of Directors will constitute a quorum. Any Member of the Associationmay submit agendaitems. Such items must be submitted within 30 days of the meeting date. Meetingsof the Board of Directors are open to all membersof the Associationand to the public. Closedmeetingsof the Board and ExecutiveCommitteeand Executive Director may be convened by order of the President. Section8: Duties of tbe President.The Presidentshall serve as the spokespersonfor the Associationand preside over the educational program and businesssessionof the annual meeting of the Association,and the meetings of the Board of Directors.It shall be the duty of the Presidentto see that the rules of order and decorum are properly enforced in all deliberationsof the Association,to sign the approved minutes of each meeting, and to executeall documentswhich may be required for the Association, unlessthe Board of Directorsshall have expresslyauthorized some other person to perform such execution. The President shall make executive decisionsregarding committee positions, committee tasks, inter-organizationalactivities and Board tasks.The Presidentshall overseeand take ultimate resoonsibility for an annual evaluationof the executivedirector. The President shall serve as Chair of the Board of Directorsand with the Secretary/Treasurer shall set the agendafor the Board meetings and the annual businessmeeting. The Presidentshall serve as an ex-officio member of all committees.The Presidentshali aopoint membersto fill vacanciesand unexpired terms on the Board of Directors and standing and ad hoc Committeesuntil the next scheduledelection.The Presidentshall appoint a Board liaison to each committee. The Presidentmay appoint task forceswith limited specificgoals. Section9: Duties of tbe President-Elect. The President-Elect, in the absenceof the Presidentshall be the spokespersonfor the Associationand supervisethe Board. The PresidenrElectshall serve as Chair of the Nominating Committee and ex-officio member of all committees.The President-Electshall. in coniunction with committeechairs. develoo committee tasks for the presidency year, review committee member performance and make committee membership appointmentsfor the presidency year. The President-Electshall also appoint the Chairs of the non-elected standing committees and develop the long-range planning sessionof the Board during the President-Elect year. Section 10: Duties of tbe Secretary/Treasurer. It shall be the duty of the Secretary/Treasurer to be the spokespersonof the Associationand to preside in the absenceof both the President and President-Elect.The Secretary/Treasurer shall keep a true 38

and correct record of the proceedingsof the annual business meeting and meetingsof the Board of Directors,shall preserve documentsbelonging to the Associationand issue notice of the annual businessmeeting and meetings of the Board of Directors. The Secretary/Treasurer shall keep an accountof the Association with its members and maintlin a current register of memberswith dates of their election to membershipand preferred mailing address.The Secretary/Treasurer shall be responsible for reporting unfinished business requiring action from previous meetingsof the membershipor Board of Directorsand in conjunction with the Presidentshall be responsiblefor the agendaof the annual businessmeeting and meetingsof the Board of Directors.The Secretary/Treasurer shall collect the dues of the Association,make disbursementsof expenses,and overseethe financial accountsand records of the Association. The Secretary/Treasurer shall chair the MembershipCommittee. The financial record will be presentedto the membershipat the annual businessmeeting, biannually to the Board of birectors, and at such times as requestedby the Presidentof the Association.The financial recordsof the Associationshall be reviewed annually by two other members of the Board of Directors appointed by the President,or a certified accountantor financial consultantretainedby the Board of Directors. Section 1 1: Duties of Members-at-Iarge.Members-at-Large shall representthe membershipin conducting the Association's business,abide by the Constitutionand Bylaws of the Association, and representthe Associationin activities related to academic emergencymedicine. Section 12: Duties of tbe Past President.The Past President shall aid the NominatingCommitteein identifying candidatesfor special recognition by the Society.The Past Presidentshall assumewhatever duties are assignedby the President or the PresidenrElectand otherwise serve as a Member of the Board of Directors. Section 13: Absenteeism/terminationof ffice. Absencescan be approved or excusedonly by the President.Two unexcused absencesfrom scheduled Board of Directors meetings, annual businessmeeting, or special meetingsof the Board of Directors during any term as a member of the Board of Directors shall constitutea resignation.Such resignationshail be effectivetwo weeks after notification by the President.Any member of the Board of Directors may voluntarily resign and such resignation will becomeeffectiveimmediately. Section14: Duties of the ExecutiueCommittee:The Executive Committeeshall conduct the businessof the Board of Directors and act in lieu of the Board on routine issues.All actionsby the ExecutiveCommitteeare subjectto review and approval by the full Board of Directorsat their next meeting.

neard liaisen wil

aseirt the eemmit

ien it iens

ARTICLEM-MEETINGS Section1, Annual businessmeeting.A formal businessmeeting of the membershipof the Associationshall be convenedan1995 SAEM Annual Meeting

May 2J nuallyin conjunctionwith the annual scientific and educational meetingof the Association.Businessitems presentedas informationalor for vote by active membersshall include but not be limitedto: (1) a financial report from the Secretary/Treasurer, (2) amendmentsto the Constitutionand Bylaws of the Association, 6) electionof Officers,membersof the Board of Directors,and the Chairsand membersof the appropriatestandingcommittees of the Association,(4) repofis of committeeactivities,(5) transactionof other businesswhich may come before the membership, and (6) a "Stateof the Assoclation"addressby the president.Where dictated by the Constitutionand Bylaws, the Associationshall be governedby a majorityvote of active membersin attendanceat the annual businessmeeting.The presidentof the Associationshali preside over the meeting and the Secretary/Treasurer will circulate agendaitems to the membership 30 days before the annual businessmeetinq.The Chairsof the Constitutionand Bylaws Committee and N6minating Committeewill presideover the respectiveparts of the annual meeting. The annual businessmeeting shall be held at a time and placedeterminedby the Board of Directors of the Association approximatelyone year in advance. Section2r Between annual businessmeetings, within the guidelinesof the Association'sPolicies and ProceduresManual and the Constitutionand Bylaws, the Associationshall be governedby the Board of Directors.Actions of the Board of Directorsshall be determinedby a majority vote of those of its memberspresentat its meeting. SectionJ: Annual scientific ancl educational assembly.The Associationshall sponsor an annual scientific and educational meetingor assemblyto meet its purpose and objectives.Its missionshallbe to foster researchand educationin academicemergencymedicinein accordance with tbe pohcies a.nd procedures mqnual eriginalresearehin the seiereesand edueatienalmethedelety; r the mittees i+ tie+shsiness The researchand educationalprograms of the annualmeeting shall be open to the public and the general membership of the Association.All meetingsof standing and ad hoccommitteesare open to the public and membersof the Association.Programsfor the annual meeting shall be arrangedby the ProgramCommitteeand approved by the Board. A final noticeof the time, place, and program of the annual assembly shallbe sent to all membersof the Associationby the Secretary/ Treasurer at least30 days before the meeting. Section4: Specialmeetingssponsoredor cosponsoredby tbe Association,TheAssociationmay sponsoror cosponsorother scientific or educationalmeetingsof interest to the membership to meet its puposeand objectives.Such meetingsshall be convenedby the President, Boardof Directors,and ProgramCommitteeChair and publicized at least30 daysin advanceby the Secretary/Treasurer. ARTICLEIV-FINANCES Section1: The annual membershipdues for all membersshall be determinedby the Board of Dirictors. The annual membership will be payable within 30 days of request by the SecretarylTreasurer. The Board of Directorsmay establishprocedures andpoliciesregardingnonpaymentof dues and assessments. 1995SAEMAnnual Meeting

--4-

Section2: The Board of Directors shall adopt such membership schedulesas is necessaryto encourageparticipationby the interestedpublic. ARTICLE V - PARLIAMENTARYAI]THORITY Rule of order.Any question of order or procedure not specifically delineated or provided for by these bylaws and subsequent amendmentsshall be determinedby parliamentaryusage as containedin Robert'sRulesof Order (Revised). ARTICLE VI- STANDING COMMITTEES Section1: Dutiesof CommitteeChairs.The Chairs-Electand the appointed Chairs shall assistthe President-Electin determining the committee goals for the coming year. and oaersee tbeir completion mittee me+ ittee member ita riritten semi ^nnual and annurl repert as eutlined in the pelieies preeideat-and*e€r#tiais€ft All Chairs are responsible to the Board and may be removed for cause prior to completion of term of office by majority vote of the Board. yacant positions will be filled by the Presidentfor the remainderof the term. Seetien2: D"#ia ef €enaneitiee {{entbetr, *Iembers sheyld pre pesefoture€&.@e€h€iq-€affy eut assigrmentsgi'r'enb)-

Section3 2 Termsof Office. Terms of office for Commirtee Chairsand memberswill begin at the annual businessmeeting. The Presidentshall appoint eligible Associationmembersto fill vacanciesand unexpired terms on standing and ad hoc committeesuntil the next scheduledelection or appointmentdate. Section4 3 Nominating Committee.The Nominating Commir tee shall consist of the President-Elect,as Chair, the past president, a member of the Board of Directorselected for a one-year term by the Board, and three electedmemberswho may not be membersof the Board of Directors.The latter shall serve staggered two-year terms. It shall be the task of this commlree ro selecta slate of officers to fill the naturally occuring vacancies on the Board of Directorsand electedpositions on the standing committeesof the Associationnot otherwise designatedand provided for by these bylaws. The Nominating Committeewill seek the candidatesapproval for formal nomination and shall place their names in nomination before the membershiofor electionat the businesssessionof the annual meetingThe Nominating Committee will also provide slates for any awards offered by the Board of Directors. Section5 4 MembershipCommittee.The Board of Directors shall constitute the Membership Committee. The Secretary/ Treasurer shall serve as Chair of the Membership Committee. The MembershipCommitteehas rhe responsibilityfor establishing the qualificationsfor each membershipclassification.Applicants reviewed by the Executive Director and Secretary/Treasurer not meeting the qualificationsfor election to a requested classificationof membership shall require presentationto and approval by the majority of the MembershipCommittee,before membershipin that classificationcan be granted.

May 2J Section65 Program Committee.TheprogramCommitteeshall be composedof a Chair,electedby the membershipfor a threeyear teffi, with the first year of the term serued as Chair-Elect; and membersappointed by the presidenr-Electwith input from the Board Liaison and the CommitteeChair for one-yearrerms and who may be reappointedfor subsequentterms.A Research Committeemember and Education Committeemember will be members of the Program Committee. Subcommitteesshall be formed in accordancewith the Policiesand proceduresManual. Tbe committee Chair ma! not serae consecutiae ternts, The duties of the committeeshall be to arrange,in conformity with instructionsfrom the Board of Directors, the program for all meetingsand selectthe formal participants.The duties of the Program Committee Chair shall be in accord,ance witb tbe Policies and, Procedures Manual rr€lud€+{)4alri€fregrafi--€€mnrttee meetin^s; (2\ ieff ffaet st+Lm$ ding emendmentste 5) ever nuat meeting te the

@. The committeemembersshall, under the direction of the program chair and with the assistanceof the Executive Director perforrn duties ln accordance with the policies and, procedures rnanual rag (D legisrie

ireq and @ieies an+lfe€edufes Recommendationsfrom the Program CommitteeChair must be approvedby the Board of Directorsby majority vote. Section16 Constitutionand Bylaws Committee.The Constitution and Bylaws Committeeshall consist of a Chair and rwo other members, elected for staggeredthree-yearterms so that the member with the least remaining tenure shall serve as Chair during their final year on the Committee.This Committeeshall study the potential merits, adverseconsequencesand legal implicationsof all proposed constitutionalamendmentsor changes in the bylaws and report their findings and recommendationsto the Board of Directors prior to formal considerationof the proposed changesby the membership.The membersof the Cbmmittee may suggestappropriate constitutionalamendmentsand bylaws changesto the Board of Directors. Section& 7 Education Commifiee,The Education Committee shall consist of a Chair, elected to a three-yearterm by the membership, with the first year of the term served as ChairElect, and membersappointed by the president-Electwith input from the Board Liaisonand by the committeeChair for one-y-ea,

terms and who may be reappointedfor subsequentterms. The Committee shall foster education in emergency medicrne.The cornmittee Chair may not serl)e consecuthte terms Section9 I ResearcbComnxittee.The ResearchCommittee shall consist of a Chair, elected to a three-yearterm bv the membership, with the first year of the term served as ihairElect, and membersappointed by the president,Electwith input from the Board Liaison and the committee Chair for one-ylat terms and who may be reappointedfor subsequentterms. The Committee shall foster research in emergency medictne.The committee Cbalr may not serae consecutioe tenns Section 44 9 Liaison Committee to tbe Association of American Med.icalColleges(AAMC).The Committeeshall consiit of a Chair,appointed to a one-yearterm by the president-Elect and who may be reappointedfor up to three consecutiveterms, and membersappointed by the President-Electwith input from the Board Liaison and committee chair for one-yearterms and who may be reappointed for subsequentterms. The official emergencymedicine delegatesto the MMC will be membersof this committee.The Committeeshall develop programsfor the Associationto be presentedat the annual meetingof the AAMC. Section14 10 GouentmentalAffairs Committee.The Committee shall consistof a Chair,appointed to a one-yearterm by the President-Electand who may be reappointed for up to three consecutive terms and members appointed by the presidentElectwith input from the Board Liaisonand committeeChair for one-year terms and who may be reappointed for subsequent terms. The Committeeshall foster federal and state support of researchand education in emergencynsediealeare medicine. Section9 11 Committeeon Intemational Affairs. The Committee shall consist of a Chan,appointed to a one-yearterm by the President-Elect and who may be reappointedfor up to three consecutive terms and members appointed by the presidentElectwith input from the Board Liaisonand the committeeChair for one-yearterms and who may be reappointedfor subsequent terms. The Committee shall foster international recognition of educationand researchin emergencytrdi*€re medicine, Section41 12 liaisons to otber organizations.The president may appoint liaison representativesto other organizations.The liaison representativemust be a member of the Associationand be aware of the Association'sorganizationalpositions,missions, policies, and structure.The liaison representativeshall issue at least biannual reports to the Board of Directors on organvational activitiesand issuesrelevantto the Association. ARTICII YII-DISSOLUflON OF THE ASSOCIATION Section1r Dissolutionof this Associationcan only be initiated by a majority vote of all membersof the Board of Directorsand must be approved by two-thirds of the active membership presentand voting at any ar:lrtlralor specialmeeting. Section2: Dissolution shall be achieved in compliancewith Article MII of the constitution.

1995 SAEM Annual Meeting

DIDACTIC SESSIONS The Internet for Academic Emergency physicians R. CarterClementqMD, Higbland GeneralHospital Jobnt. Ellis.MD. Higbland GeneralHospital DauidK. English,MD, Higbtand GeneratHospital JosepbC. Howton, MD, Hightand General Hospital I/hat is the Internet?Vhat can it do for you? How can you use it without a degree in computer science?The Internet is a vast repositoryof medical information. Unfortunatelv. it can be dauntingand incomprehensibleto the averageuser. This ses_ sionis designedto answerali thesequestionJandmore for the busy academicemergency physician. \X/e will cover the basic structureand functions of this hot topic, cover all the major Internetselices, and demonstrateits use online in real time. all in plain languageand in such a way thar makes it as simple as possible.No matter what type of computer you use, you will find useful infomation. Specific areasto be discussedare: The Internetitself, tools for accesslngthe Net (for all computer types),what is availableon the Net and how to get it, how to makethe Net as simpleas possible,and futuredirections.

EMS:Responding to the Forefront of public Health

{oderalor: SteuenJ.Dauidson, MD, Medical ColtegeoJ' Pennsyluania DouglasKey,MedStarEA,ISSystem DauidE. Persse,MD, Baylor Collegeof Medicine JosephL. R1tan,MD, Pinellas County EyS B_qryk Woffi Stateof NewMexico Eureau oJ'primary Careand EMS EMShas been traditionallyviewed as a emergencyresponse/ publicsafetyorganization.In recent years,it hn, i,r..crrn"ap_ parentthat EMSis evolving beyond a focus on single patient en_ countersinto more of a public health seruicemodel. In this era of healthcarereform, EMS,like the emergencydepartment,has beenthe primary gateway into the healttr care systemfor those very persons(the indigent and underinsured)on whom health carereform has been focused. In addition, recent initiatives havebegun to recommendthat paramedicalpersonnel be routinelydelegatedas primary health care providerswho can delivermrny puhlic healthservices. includingscreeningexam_ inationsand widespreadprovision of immr,rnizations. Further_ more,becauseprehospitalcare personnel are in the position tcr gatherimportantepidemiologicaldata, ranging from vehicular damageto sociologicalcircumstancesof a midiial incident. thev havebecomepivotal in the rapidly evolving field of injury and criticalillnesssurveillance.In turn, they have becomeessential to the.injury/illnessprevention movement, a ma1'orcomponenr of bothmanagedcare and health care reform. Tojav, manv EMS medicaldirectorsare obtaining MpH or similar degree, ,.. prrt of theirjob description.The panel will discusstheiigrowing ex_ perience wirh theseevolvingissues.

EvidenceBased Medicine: Applications in EmergencyMedicine S.ChrisPappas,MD, Metbodist Hospital of Indiana Thissessionwill serve to introduce the concepts of eviclence_ basedmedicineand review newer information resourcesand literaturesearchingtechniques relevani to it. The streamlined rulesof evidencefor the critical appraisalof literaturedescribing therapy,diagnosis,prognosis, causation and reviews/meta-_ analyses. will be presented.Emergencymedicine exampleswill be employedand techniquesdescribingthe incorporationof evidence-based medicine into clinical prictice and teachingwill 1995SAEMAnnual Meeting

May 24

be described.At the end of this session,participantswill be able to describethe conceptof an rationalefor evidence-based medi_ cine and be familiar with information resourcesavailable.They will be able to critically appraisean articleon therapy,diagnosis, prognosis,causationor meta-analysis using streamlinedrules of evidence.Paticipants will be able to incorporatetheseconcepts into clinical practice,format rounds and other teachingforums.

lmerggngy Department Iniury Surveillance: State-of-the-ArtStrategies Moderator: StepbenIV. Hargarten, MD, MpH, Medical Coltegeof IVisconsin lelfrey H Coben,MD, Uniuersityctfpinsburgb Daniel A. Pollock,MD, National Centerfor Injury preuention and Control Iance E. Rodewald,MD, MS, Uniuersityof Rochester Emergencydepartment data is now viewed as essentialin the effort to conduct epidemiologicassessments of populationsat risk for injury and to help guide the development and refine_ ment of preventive and therapeuticinterventions.The purpose of this sessionis to provide attendeeswith up-to-dateinforma_ tion on emergencydepar"tmentsurveillancemethods and initia_ tives. Dr Hargartenwill moderatethe sessionand orovide an overview of emergencydepartmentinjury surveiilance.Dr. Rodewald will discussthe local creation of an ED database using existing data sources.Dr. Coben will present his experi_ ence in_developing an alliancewith a public health department to conductpopulation-based ED injury surveillance. Dr. pollack will discussa national initiative to develop a consensuson ED data.At the end of their presenrarions,thi faculty will respond to questionsfrom the audience.

ABEM Synopsis for Faculty Richard Braen, MD, President,ABEII Benson S.Munger, PhD, ExecutiueDirector, ABEM Dr. Braen and Dr. Munger will outline the changesin Board policiesthat have taken place during the pasl 72 months.Many of these changeshave direct application to progrom. and fac_ ulty. EmergencyMedicine program faculty and other interested individualsare urged to attend.The topics which will be ad_ dressedwill include ABEM resear.ch prolects,residenttransfer policies, credit for training in non-EmergencyMedicine programs,the intraining examination,the residenttracking syst.m, and the developmentof additional subspecialties. betailed materialswill be availableand time will be allocatedro resDond to specificquestionsabout theseand other relatedtopics.

Tecfnofogy Luncheon: Updateson New Technologiesthat Have an Impact on the Practiceof ErnergencyMedicine Moderator; Dienich Jehle,MD, Erie County Medical Center CharlesCalrns.MD. Ltniuersityof Cotorado Dauid.Ellis, MD, Erie County Med,ical Center IV.Brian Gibler,MD, tlniuersityof Cincinnati SteuenSeifert,MD, Kinct Hospital This sessionwill be comprisedof four 20 minute presentatlons followed by a 10-minutequestionand answerperioS. Following are the titles and speakersfor eachpresentation.NearInfraredSpec_ troscopy: SheddingNew light on Oxygen Delivery and Metal> olism- Dr. Cairns;TechnologicalAdvancesin the Treatmentof SnakeBites- Dr. Seifert;Inffoducrionto ICD prqection_ Dr. Ellis; and New DiagnosticTestsfor MyocardialIschemia- Dr. Gibler. 4I

May 24 Luncheon: Ischemia and ReperfusionEvolving Conceptsin ResuscitationTechniques Mod.erator:Norman A. Paradis,MD, Columbia Uniuersity JamesManning, MD, (lniuersityof Nortb Carolina JamesJ. Menegazzi, PbD, Uniuersityof PrtBburgh Em.anuelP. Riuers,MD, Henry Ford Hospital Cunent techniques for providing resuscitation efforts for cardiac affest patientsmay very well be too unidimensionalin that, regardlessof arrestinterval and other dynamic aspeclsof card\aariest pathophysiology,most treatment protocols are applied to almost all patients in a relatively uniform manner. This session will: 1) re-visit our current knowledge regarding the dynamic physiology of cardia arrest; 2) examine new, innovative techniquesfor deliveringbasiclife support; 3) disclosesome new developmentsin invasiveand non-invasivetechniquesfor augmenting blood flow during CPR;and 4) demonstratealternativeappr6achesto achievingrestorationof spontaneouscirculationwith pharmacologicalinterventions.The speakerswill also emphasize the need to pay closer attention to more aggressivepost-resuscitativemonitoring and managementof cardiac arest victims.

Teachingand Evaluating Interpersonal Skills in the EmergencyDepafrment

WilliamJ. Frobna, MD, Madigan Army Medical Center ConstanceS. Greene,MD, CookCountyHospital Harold A. Tbornas,Jr, MD, Ponland VAMedical Center Everyone agreesthat effective interpersonalskills are essential to successin emergencymedicine. S(e all recognizepoor inter-

personal skills yet many are unsure how to teach and evaluate good performance.This course will begin with a 20 minute aidacti. presentationon how to teach interpersonalskills. It will be foilo*ed by a review of how the interpersonalrelationships category of part II of the boards has been developed and assessed.A model curiculum (winner of the 1994Innovationsin Medical EducationAward) on how to interact with consultants will be presented.There will be time for audience questions and participation.

Faculty DevelopmentforWomen and Minorities

Moderaior' Juditb C. Brillman, MD, tlniuersity of New Mexico TeresitaHogan, MD, Uniuersityof Illinois, Chicago Norm D. Kalbfleiscb, MD, OregonHealtb SciencesUniuersity MarcusL. Martin, MD, AllegbenyGeneralHospital Sandra M. Scbneider,MD, tlniuersity of Rocbester CarolJ. Scott,MD, MSEd, Uniuersityof Maryland This sessionwill provide a personal account of issues encountered by the panelists in their professionaldevelopment' Each panelist will discussissuesarising from gender, minority statui or sexual orientation which the panelist feels was significantin his/her professionaldevelopment.These issues miy include mentoring, communicationand conflict resolution' The panelistswill then presentthoughts on how they have dealt with these obstaclesand suggestmethods for departmentchairs to deal with these issues. Questions and comments from the audiencewill be encouraged.

1995 SAEM Annual Meeting

ORAI PRESENT{NONS ScientificPapers 18: Clinical practice (8:0f9:30 ain) Moderator: Dougla.s A. Rund MD Ohio State llniuersity 113 High Yield CrireriaBased on presenringChief Complaint to Triage Patienrsfor a Rapid ('5 minute,) ECG, Iouis Graff, MD, Neu B4tain General Hospital 11,4 CervicalCancerScreeningin a public Hospital Emergency Depafimenr,Iinda p. Engektad, MD, Higbland General Hospkal 11,5 PhysicianOrderingof CoagulationSrudiesin the Emergency Center;Impact of Instituting a LaboraIoryRequestForm, Gail S.Rudnitsky,MD, Medical Collegeof pennsytuania 11.6 InterraterAgreementof Palpation Signs in Focal Abdominal Pain, GregoryB. Meador,MD, ScottE rX/hiteMemorial Hosprtal 117 The CBC and ReticulocyteCount in Acute Vasoocclusive SickleCell Crisis - Are they Necessary?, Sbaron Griswold, MD, TltomasJffirson Uniuersity 118 EMRSAbstract: Ultrasound Assessmentof Children,s Ankle Injuries, M.L. Stuart, uniuersityof Mancbester

ScientificPapers L9: Cardiology (8:0f9:30 am)

Moderator: Robert L Wears, MD, Uniaersity of Ftorida 119 EmergencyDepartmentChestPain Evaluationwith DobutamineStressEchocardiography and Telemedicine, James A. T4ppi, MD, Metbodist Hospital of Indiana 120 Usefulnessof Immediate ExerciseStressTesting in the Evaluationof EmergencyDepartmentpatientswith Chest Pain, Daren Heesacker,MD, Buttenaortb Hospital 121 MandatoryStressTesting in Chest pain Center patients, Michael G. Mikbail, MD, Llniuersityof Michigan 122 Isoformsof CK-MB are Sensitiveand Specificfor the Eady Diagnosisof Acute MyocardialInfarctionin the Emergency Department,CbailesB. Caims, MD, Uniuersityof Colorad,o 123 Preferencesof ED Patientsand physiciansfor Management of Chest Pain with Low Risk for Myocardial Infarction, MarkA. Dauis,MD, MS, UCU 124 EmergencyDepartment use of Rapid Lactateto Evaluate Acute Chest Pain Patients, Dauid p, Milzrnan, MD, GeorgetownUniuersity

ScientificPapers 20: Neurology (10:0f11:00 am)

Moderator: Iance B. Becker, MD, Uniaersity of Cbicago Hospitals 125 NeuoprotectiveEffects of Acetyl-L-CarnitineFoilowing FocalCerebralIschemia(Stroke)in Rars,Milena Mi(kouiZ Lolic,MD, MS, GeorgeWasbington Llniuersitlt 126 Effectsof 21-Aminosteroidand/or Hyperbaric Oxygen Treatmentson Functional Recoveryafter Experimental Brain Injury, Micbelle Biros, MD, MS, Hennepin County Medical Center

127 Dextrose Pluslas-ullg4lgr Car-dgg Ar{gsr(CA) Improves cerebralou@ tz, MD, uniuersity of Pittsburgb 1.28 Effectof Ethanol on Brain Lipid peroxidarion in Experimental Traumatic Brain Injury, Brian J. Zink, MD, Uniuersityof Micbigan 1995SAEMAnnual Meering

May 24

Scientific Papers 2L: Ethics (10:0f11:00 am) Moderator: Terri Schmidt, MD, Oregon Heahh Scierrces Uniaersity I29 lWaiverof Informed Consent, Micbael Gerstle,BA, BaystateMedical Center 130 Advance Directives in the Emergency Department, Kristina K. Ishibara, Vanderbilt uniuersitlt 131. GettingAlong with Your IRB: A NationalSurveyof Institutional Review Boards,RobertJ.Faflik, MD, Akron General Medical Center I32 AdvancedCare Directivesin Elderly EmergencyDepartment Patients,DoloresA. Bailey, DO, Nortbeastent.Obio UniuersitiesCollegeof Medicine

Scientific Papers 22zEMS(1:3f3:00 pm) Moderator: Tom Aufderbeide, MD, Medical Collcge of Wisconsin 133 EMS SystemDevelopmenr:Resultsof the StatewideEMS Technical AssessmentProgram, Iill M. Baren, MD, H arbor-UCLAMedi cal Center 134 An Analysis of Ambulance Crashesin Kentucky, ly/iltiam R. Crumbley, MD, tlniuersity of Louisuille 1,35 The Effectof Introducing a !11 TeiephoneNumber ro Re-

:?:ffi m*Tqffi$ffi ,';"ff.#,?'; ::l

MD, Sudbuty GeneralHospital 1.36 Real-TimeVideo Image Transmissionby EmergencyMedical Services,StephenE. Holbrook,MD, Emory tlniuersity L37 Impact of Advanced Life Support Personnelon Outcome of Urban Ourof-Hospital CardiacArrest Victims Treated by First Responderswith Defibrillators, CbristopberD. Madsen,Uniuersitltof Cahfurmia,San Francisco 1.38 Vehicle 'Rollover' Is Not A Predictor of SevereInjury, SusanO'Malley,StateUniuersityof New york at StonyBrook

Scientific Papers 2J: Health Cate Deli-very/Administration (L:30-3:00 pm) Moderator:John C Moorhead,, MD, Oregon Heahh Sciences Uniaersity 139 The Effects of Actual Vairing Time, perceived \X/aiting Time, Information Delivery and Expressiveeuality on PatientSatisfactionin the EmergencyDepartment,Slepben L. Adams,MD, NorthwestetnUniuersitlt 140 Gatekeepers:A Missed Opportunity for SafeTransport, Sandra M. Scbneider,MD, {Iniuersity of Rochester 141 The Impact of InadequateFunctional Health Literacy on Patients'Understandingof Diagnosis,prescribedMedications, and Compliance,Mark V. V/illiams,MD, Emory Uniuersity 142 Comparisonsof CaseManagementand EmergencyDepartment Referralsby Different Specialties- Implications for Health CareReform, C,J. Holliman, MD, pennsyluania Stete Uniuersity r43 Time Factorsin Patients\Who Leave The EmergencyDepartment Vithout Being Seen, Edward. N. Cobill, phD, DO, NaualMedical Center,Portsmoutb 1.44 TreatmentGuidelinesAlter PhysiciansPracticepatternsin EmergencyDepartmentPatients,Kauebllkhanipour, MD, Mercy Hospital of Pittsburgb 45

POSTERSESSIONC

May 24

pm aslisted will be heldfrom4:30-5:30 sessions

poster pm.Moderated The PosterSessionwill be held in the Exhibit Hall from 3:30'6:00 below:

Meeting Room

Topic/Abstracts

CPR (Abstracts309-315)

Moderator M""" gazzi,PhD,Universityof Ptttsburgh F-.-.

EMS (Abstracts 3L6-327)

Brian S. Zachatiah, MD, Baylor University

Iniury Prevention (Abstracts 328-340) Cardiology (Abstracts34| - 351)

Chades B. Cairns, Denver General Hospital

ConferenceRoom 8

Kalamazoo David T. Overton, MD, Michigan State Unlversity'

ConferenceRoom 9

Donald M. Yealy, MD, University of Pittsburgh

ConferenceRoom 10

Imaging/Diagnostics (Abstracts 352-363)

and Neurology

Pain Management (Abstracts 364-374) Clinical Practice (Abstracts 375-384) Clinical Practice (Abstracts 385-394)

ConferenceRoom 4 ConferenceRoom 5 ConferenceRoom 7

Scott Syverud, MD, Unlversity of Virginia C. James Holliman, MD, Hershey Medical Center

CPR to Guide 309 Pre-HospitalInvasive HemodynamicMonitoring of

CardiopulmonaryResuscitation:PreliminaryExperience a lhysician ResponseSystem,.lo*n: -E:,Manning'MD' Ilniuersityof woih Carolina at ChapelHill During 3 1 0 Ootimal Dutv CVclesand Abdominal Compression Purdue PbD, cin,'chartes F' Babbs, MD, nii.t""f UniuersitY Remodeling,a Novel MeEffect of Post-Compression The 3r1 Rechanlcal CompressionTechnique in Cardiopulmonary Resuscitation' Cardiac and suscitation,on Hemodynamics tilisconsin Gary L. Swart,MD, Medical Collegeof (SMP) During Cardiactu312 SelectiveAortic Arch Perfusion ContinuousFollowed Using Infusions Serial of nff"o r.t* ty nut"a Diastolic Infusion of OxygenatedPerflubron nmulsion in Combination with Aortic Arch Epinephrineof Administration,James E' Manning, MD' uniuersity Hill Cba7el at Carolina' Nortb with Out-of313 End-Tidal Co2 Measurementin Patients Compression-DecompresActive Arrest: Cardiac Hospital CPR sion Resuscitation(CPR)Versusthe StandardManual Gutenberg MD, Jobannes iechniq,re, Dietmar Mauer, Uniuersitat 414 Pediatric Injuries Due to CardiopulmonaryResuscitation' ColleenM. busb, MD, Butterwortb Hospital 315 Analysis of PrehospitalAsystole, Mi9lta.el R'^Gunderson' nWtf p, PinellasC;unry ErnergencyMedical Seraices

EMS Aeromedical 317 Intubation SuccessRatesImprove for an

O' Prog.u* with Use of NeuromuscularBlocking Agents' Hill Cbapel at Carolina Nortb of Uniuercity MD, lobi ua, Setting' 318 The Efficacy of Droperidol in the Prehospital Hospital General Denver Carlo L. Rosen,MD, Access 31.6 The Effect of Population Density on the Patient Missouri' of Uniuersity MD, Interval, Jack P. Campbell, Kansas CitY a 1 q SecondaryPSAPCall ProcessingInterval:An U*nmearsured Comoonent of the Total 911 interval, Jack P' Campbell' MD, (Jniuersityof Missouri, Kansas City

ConferenceRoom 15 ConferenceRoom 16

SystolicBlood 320 The Effect of Sublingual Nitroglycerin-on Other Causes from Pressurein the Diffeientiation of CHF B' Scbwind' Dauid Setting, "iOVtp^", in the Prehospital Hospital Memorial l,tS,l,tiCp, Morristown Vehiclesin Motor 32I The Usefulnessof Photographsof Crash tlniuersity of MD, Orsay, M' nlizabeth Vehicle Trauma, Illinois at Cbicago RobertA' 322 Optimal Positioningfor CervicalImmobilization' Delorenzo, MD, Wrigbt State Uniuersity thâ&#x201A;Ź Performanceot 323 The Effect of RefresherTraining on MD' -ricothyrotomy by Paramedics,Dauid R' Johnson' UniuersitYof New Mexico A' PrehospitalTreatment of Heroin Overdoses'Kad The 324 Francisco San Sporer,MD, Uniuersityof California, Intubation can be Effectively Performed-in Endotracheal 325 RN' u.t f.t-ftigttt EMS Helicoptet' Timotby H' Harrison' BostonMedFligbt Mortality in the Pre326 Failure of the Shock Index to Predict of Miami Uniuersity MD, Saef, H' hospitalSetting,Steuen Intravenous Safety of 327 Effectivenessand Acceptance Catheter Use tn Prehospital Cate, Edward A' Stapleton' EMT-P, UniuersityMedical Center,StonyBrook

Iniurv Prevention Needand Berween #1"rn";ricViolence, DiurnalMismatch 329

330

33t 332

333

Availability of Service,Rama B' Rao, MD, Albert Einstein Collegeof Medicine Domestic Violence Among Inner-City \(-omen Presenting MPH' to the EmergencyDepartment,SberylL' Ileron' MD' Center Medical Drew Martin LutberKing/Cbailes Safe at Home? Domestic Violence and Other Homicides Uniamong Women in New Mexico, Mike Howard' MD' Mexico New uersilYof Effectof StatewideTraumaSystemon-PediatricOutcomes' Mary E. McCaskill, MD, OregonHealth SciencesUniuersity in The Impact of a New StateLaw on Bicycle Heimet Use of uniuersity State MD, Connors' M Katbleen Children, New York, SYracuse The Effect of Ethanol on the Outcome of the Iniured Ddver, Daniel L' Beskind,MD, Uniuersityof A4zona 1995 SAEM Annual Meeting

May 24 334 Effect of the Legal Sysremon rhe Recidivism Rare in Traumapatientswho Drive rJflhileIntoxicated, VirginiaM. Ribeiro,MD, Uniuersityof Massacbusetts 335 The Effectof Time of Day and Durarion into Shift on Hazardous Exposures.toBiological Fluids, iarryl J. Macias, MD, Uniuersityof NewMexiio 336 ReportedSafetyRestraintUtilization Does Not Corelate with Actual Utilization Among Drivers S[ho Visit a pedi_ atric EmergencyDepartment, Vicki Ray, RN,Rhode J. Island Hospitat 337 Alcohol Abuse/Dependencein Motor Vehicle Crash Vic_ tims?resentingto the EmergencyDepartment:prevalence and PatientCharacteristics, Ronald F.'Maio, DO, MS, Uni_ uersityof Michigan 338 ProspectiveEvaluation of Seat Belt Efficacy , Marle C. Henry, MD, UniuersityMedical Center,StonyBrook 339 AdolescentSuicide: The Lack of Emergerrcy Depafiment Intervention, Bonnie L. McManus, frD, Cook^County Hosprtal 340 Relationshipof Cigarette Smoking to Saf.ety Restraint Utilization, VickiJ. Ray, RN,Rbodeljand iospitat

Cardiology 341 Tr91tmelt SeekingBehaviorin Chestpain parients:poren_ nal lor_UommunityIntervention, SusanMatbias, W, BSN, MercyHospital of pittsburyb 342 Reducingthe Time to Thrombolltic Therapy in rhe Emer_ gency Deparlment using a Continuous quufity Improve_ ment Program, Scott p. Krall, UD, Me-dicai Ceiter o1 Delaware 343 The Time to Thrombolytic Therapy in the Emergency De_ partmentis Reducedif the Decision to Treat is made with_ ont Telephone Consultation,RobertE. O,Connor, MD, Medical Centerof Delaware 344 An Assessmentof Time Delays from Chest pain onset to HospitalArrival in Acute MyocardialInfarction patients, TomP, Aufderbeide, MD, Medicat Coltegeoliiiiorri, 345 Reducingthe Time to Thrombolytic Therapy in the Emer_ C..:.LD.,p.lr..-T a ThrombolyricCode Team,Saru trlng r. Jurhertand.MD. Medical Centerof Delaware 346 ST,Monitoring and the Early Diagnosis of Myocardial Ischemia/Infarcrion in rhe Low Risktnes pnln pi tient, Jill Henzendo$ MD, RiuersideMetbodist HosDitals 347 ProspectiveStudy of Variance Cardiographyin the ED Evaluationof Chest pain parients, lamis C. ;ie;er, Mich_ igan State Uniuersi ty-Saginaw 348 goroyry Artery Disease in patients with Cocaine Asso_ ciatedMyocardialInfarction, Judd E. Hollander, MD, State UniuersityctfNew york at StonyBrook 349 ElevatedED Serial CK-MB in patienrswirhour Acute MyocardialInfarction (AMI): Evidencefor Cardiac Enzyme Releasein Unstable Angina, JosephJ. ioeltman, MD, Uniuersity of Ci n cinn a ti 350 Antioxidanr Therapy Auenuates Endothelial Dysfunction in Hypercholesterolemia,TlteodoreA. Cbristopher, MD, ThomasJffirson tlniuersity 351 Pharmacological Interactionsof Glucagon and B_Blockers in.Rat Lung Tissue, Darryl Hoskins,MD, Nottheastern ' ObioUniuersitiesCollegeof Urdirfn, 1995SAEMAnnual Meerinq

Imaging/Diagnostics 352 EmergencyMedicine ResidentInrerpretation pediatric of Radiographs,J. Eric Brunswick, llb, Uercjt Aospitii i1 pittsburgh 353 An AbbreviatedEducationalSessionImproves Cranial CT Scan_ Interpr.ru,ig:r_1.n. the Departmenr, RogelioDawkins, MS, Highland_Emergency Genelat Hospitit 354 Interobserveryariability in the Interpretation of Sono_ qi?ry. Images of Morison,s pouch, Scott lV. Branney, MD, Denuer GeneralHospital 355 Color Doppler Ultrasound by Emergencyphysicians for the Diagnosis of Acute Deep Venius thrombosis, g. Tilman Jolly, MD, George\Vashington (Iniuersity Intrasound 356 Vibration Tesring in Acute Ankle Injuries, Raymond Otto,MD, St.Vincen Medical C:enter 357 Portable Fluoroscopyfor the Evaiuation of Extremity In_ juries in the Emerg-ency Department, Ronald Moscatf,'Ui, StareUniuersityof New VorE,Auffalo 358 Cervicai prevertebralSoft-TissueMeasurements in Intub_ ated Trauma patienrswithout Cervical Injury, KipJenifer, MD, St.VincentMedical Center

Neurology 359 Is Admission Necessaryfor all Head Injury patients with Cerehral Contusion?,Erik Milter, MD, tlniuersity of Cali_ .fomia, Dauis 360 Multiple Minor Head Traumain Intoxicatedpatients, Michelle Biros, MD, MS, Hennepin County Medical Center 361, HemoglobinNeurotoxicityin CorticalCell Culture is Atten_ uated by the Sodium/CalciumExchangeInhibitor Benza_ mil, RaymondF. Regan,MD, ThomasJelferson Lrniuersity 362 Ferritin protects Cortical Astrocytesfrom Heme_Mediated Oxidative Injury in Vitto, Nidbi Kumar, Ihomaslrff;;;;; Uniuersity 363 Acute Spinal Cord Injury: Altered Methyiprednisolone (MP) Pli2ll26okinetics may Explain EquivocalRestoration of Useful Moror Function,Brian f Uaitby, MD, uniuersity of California, haine

Pain Management 364 The Use of propofol for ConsciousSedationin the Emer_ gency Department,Eric R. Swanson,MD, Mercy Hospital of Pittsburgb 365 Propofol in the ED, Hany Ross,MD, Hennepin County Medical Center 366 A Comparisonof Four Injectable Anestheticsfbr Lacera_ tion Repair,Amy A. Ernst,MD, Louisiana State {Jniuersity, lVewOrleans 367 Buffering of Diphenhydraminedoes not Reduce the pain of Infiltration. Adan J. Singer.MD, Uniuersity Medical Center,StonyBrook 368 RegionalAnesthesiaDuration of Lidocainewith Epinephrine, with and without Buffering, Dan G. Snow, MD, St. John Hospitaland,MedicalCentel 369 njTe;t of^tnlectionSpeedon pain of LidocaineInfiltration, Ricbard S.Krawe, MD, StateUniuersi,tltof Uew Voik, BulJitto 370 A Double-Blind, Single Dose Comparisonof Intravenous KetorolacTromethamineand Mepeiidine in the Treatment on Renal Colic,Jelfrey Gibbons,MD, york HosOitat

May 24 in Ethanol Intoxicated Patients' 371 Two Point Discrimination of NewMexico uniuersity MD, Pamela V' Cutler, Difference in Physician Important 372 The Minimum Clinically Emory uniuersity MD' Funk' P' Pain Assessmem, Josepib Comparisonot Dose Single 373 A Prospective,Double-blind, KetoroiacTromethamineasComparedwithMeperidine in the HyJio.f,fotid" uttJ iyatoxyzine Hydrochloride Christ MD' Stump' L Treatmentof Acute RenalCoiic' Jack Center HosPitatand Medical Butorphanol and A ProspectiveComparisonof Transnasal L ' J374 MusculoskelAcute of Relief the rot coa"i'nt ivi"t"ivr-n Uniuersity' State Michigan MD' pain, lY/ol,ford', Robert eial Saginaw

Clinical Practice

for of Pantomographyto Mandibular Series ;7;"a;^;;rison theDetectionotMandibleF'utntttt'MarcD'Taub'MD' uniuersityof California, San Diego Protocol for the Sequential-Useof 376 EmergencyUepartment out Ectopic Prog""rt.ron.,HCG, and UltrasoundI?.Rule Centersan Medical Naual MD' Buckley' Robert i';d;;;.y' Diego does not Exclude the Need for 377 B-hCG> 75,000mlU/ml Pain andlor Sonographyit' patitnts with First Trimester Hospital City Bleed"ing,i<obenG' Dart, MD' Boston as Monotherapyfor Near t v Ineffectivenessof Alkalinization J378 Dog' Non-Nephrectomized i"iiiuL uyp"tkalemia in the jiiri" t iapltn, MD, AtbertEinsteinMedical Center During IntraPain ald f1s11ess 379 Women's Perceptionof terrzation' Mini-Cathe Urethral venous Catheteitzationand Mexico New of Uniuersity MD, tinda C. Kelley, Index: Compartson*withTra380 OrthostaticChangein Shock lvitting, MD, uniuerMicbael befin\Iions, ditional Tilt Test sitYof MarYland Short Term and Long Term 381 fact< of CorrelationBetween JwL Barbara of"iacerations Repaired in the ED' Ap;;;; Brook Stony at York New Blasko, aS,Stati ii'uersity of

Controlled Trial Compartng 382 A RandomizedDouble Blind Lidocaine for Digital

noorn f"*p"rature Versus Heated of Onawa N.-" gfo.it , JamesV' Quinn, MD' Uniuersity Cricothyrotomy'Dauid R' 383 EndotrachealTube Size and of New Mexic Jobnson,MD, UniuersitY Levels from PeripheralVen384 Prediction of Arterial Lactate Einstein College ""t gl""a, Keuin Rod'riguez,MD, Atbert of Medicine Ratesof Tube Thoracostomy'Lisa Chan' Complication 385 MD,'AlbanYMedical College of PatientsEscorted EmergencyDepartmentManagement

386

ffi;il;,'tp

Medicalcenter ien H. croucb,i4D,carolinas

Comparison9{ Cryotherapy 387 In Vivo Tissue Temperature Dauid Barlas' MD'

with 'stitn and without External Pressure' iniunrtlty of New Yoile,StonyBrook of Admitted.CardiacPatients 388 The Effect of Length of Stay and Adverse held in the ED on Length of Hospitalization. Hosptmt Events,CarolA' Tenegino'MD' Cooper A ProspectiveStudy of Dis389 Follow-Up \flithin 48 Hours: puti"nt, at Risk for Clinical Deterioration' .n"tg"a bD

ii)Tt"nit 390

of NewYork' "rtki, RN,NP-C,Stateuniuersity

StonyBrooh with ChestPain The ChestRadiographin Young Adults TbomasJffirson fr^i i.."*u.y?,"Alan T' Forstater'MD'

UniuersitY Emergency Evaluationof ScrotalPain in a Pediatric The 391 uniuersity Haruard MD' Perron' o' iotberine irp^ni"ir, Transillumination using 392 Comparisonof Inflight Intubation Henderson' RN'East , RickyA' versusDirect Laryngoscopy Carolina UniuersitY and-Presentation' Adnexal Torsion: Clinical Features 393 -itiiitrn Uniuersities T' Suminski,MD, Nortbeasternohio Collegeof Medicine Suturing for SecuringCen394 Comparisonof StaPIesversus MD, EasI tral Venous Catheters,Dauid,P. Higbtower, Carolina UniuersitY

1995 SAEM Annual Meeting 40

HGIIBITORS (708)735-rr7o Academic Pharmaceuticals, Inc. 11-21North Skokie Valley Highway Suite21-G3 Iake Bluff, n-60044 AcademicPharmaceuticals,Inc. (API) is a new pharmaceutical firm dedicatedto innovative researchand the develooment of cardiovascular drug products for their use in emergincy and cardiovascular medicine. Representatives from API will be availableto discusstheir researchand to speak with interestedclinicalinvestigators. (800)526-8785 Alrcast, Inc. 92 Rlver Road Summit,NJ 07901 Innovativeorthopaedicdevicesthat promotefunctionalmanagement. Anerican Academy of (8oo) 884-AAEM Emergency Medicine P.O.Box 1968 SantaFe, NM 87504 Thetrue democraticspecialty organizationof EmergenryMedicine

(2r4) 55o-o971 Annqk of Emergenqt Medicine P.O.Box 619911 Dallas,T){7526l Annalsof EmergencyMedicineis the official joumal of the American College of EmergencyPhysiciansand the specialty'sleadingclinical andscientificjournal. Annals publishesthe latest in research, clinicalstudies,caserepofts,and issuesin emergencymedicine. Boehringer Ingelheim Pharmaceuticals, Inc. P.O.Box 368 Ridgeffeld, CT 06877

(zoD798-4047

CerenexPharmaceuticals. Division of Glaxo, Inc. orD248-2468 FiveMoore Drive ResearchTdangle Park, NC 27709 You are cordially invited to visit the CerenexPharmaceuticalsexhibitwhere our representatives will be availableto answer your questions and discussthe latestclinical informationon our products.

ChallengerCorporation 5530SummerAvenue Memphis,TI\ 38134

(901)385-1840

Challenger Corporationis the publisher of Med-ChallengerComprehensive for Acute Care & EmergencyMedicine & Med-Challengerfor PediatricAcute & EmergentCare.The productsare clinicalreference& educationaltools for physicians.Come see us at ourboothfor the demonsffationof our new illustratedversion3.0.

(66512) Clinical Resource Systems, Inc. 452-726r 3701North lamat Boulevard Suite207 Austin, TX 78750 Progressive hospitals rely on CRS'sEmSTATcomprehensive Emergency DepartmentInformation System.EmSTATboosts tevenue,provides support for medicai teaching, improves patientsatisfaction,helps busy EDs marrageeffectively, and integrateswith existing systems.This OMCLE/UNIX client-server application is modular, and includes patient and event tracking, clinicaldocumentation,logs, statistics,and more. 1995SAEMAnnual Meeting

(703D917-6600 Cybermedix, Inc. 8230 Old Courthouse Road Suite 300 Vienna, YA22182-3853 The Cliniplex systemis a comprehensivedepartmentalautomation solution for clinicians focused on increasingproductivity, reducing costs,minimizing risk and maximizingquality. Seeour high-performanceclinical decision suppofi system running on MicrosoftWindows NT, featuringwireless,pen-baseddata entry. Learn how this knowledge based expefi systemeasily complements your existing hospital information systemsenvironment and suppoftsthe increasinggrowth of managedcare.

(8oo)438-2476 Daniel Stern and Associates The Medical Center East 211 North Whitfield Street Pittsburgh, PA152A6 Daniel Stern and Associatesprovides physicianand physician extender recruitment selices, EM consulting and medical staff development/analysisnationwide. The EM division has successfully provided serviceswithin this specialtyfor the last 25 years. National Salary Survey Information and information about EM opportunitiesis availableat our Booth+35. DatascopeCorporation 580Winters Avenue Paramus,NJ07653

(800)288-2121

DatascopeCorp. will display its complete line of physiological monitoring systems. Emergency Medicine (800)798-1822 Residents' Association 1125 Executive Circle Irving, TX 75038 T h e E M R A b o o t h w i l l f e a t u r e m e m b e r s h i pm a t e r i a l sa n d information about this exciting 3,500 member organizationfor residentsand medicalstudentsinterestedin emerqencymedicine. EMF/ACEP Teaching Fellowship P.O. Box 619911 Dallas, TX7526l

(800)798-1822

(312) 347 -7095 Encyclopaedla Bfitannkca-North America 310 South Michigan Avenue Chicago,[L60604 Publisher of the NEXflEncyclopaediaBritannica, The Great Books of the W'estern\World, Scienceand The Future Library; plus a completeline of educationalaccessories including the latestBritannicaon CD-ROM.

611382-1457 T0WeilWay Wilmington, OH 45177 We are pleasedto display the new Vivalink AED which we believe more closelyaddressesthe recommendationsof the AmericanHeart Associationthan any other product. It is light weight, maintainsitself and caniesa list price of $2800.This AED is worth seeing!

(7o8) 564-5400 FluoroScan Imaging Systems, Inc. 650 B Anthony Trail Northbrook, IL 60062 FluoroScanis a miniature SurgicalC-arm specially designedfor use in the operating room, surgicenter,or in the office. It features a very low intensity x-ray beam that is tightly focused on the image detector.The result is safety.

Glaxo Inc. 5 Moore Drive Research Triangle Park, NC 27709 You are cordially invited to visit the Glaxo, Inc. exhibit where will be availableto answeryour quesour SalesRepresentatives tions and discussthe latest clinical information on the following products,including but not limited to, Ceftin, Flonase,Serevent, Imitrex, and Zantac,

Hanley & Belfus, Inc. 210South13th Street Philadebhfa, PA 19107

(2rr) 546-0313

Hanley & Belfus, Inc. is the publisher of Academic Emergency Medicine, the official journal of the Societyfor AcademicEmergency Medicine. Stop by the booth to meet some of the people who make this journal possible.

(3,oD443-4600 Informed Access Systems 4888 Pearl East Circle, #300W Boulder, CO 80301 FirstHelprMis a systemdesignedto safely provide the first level of care over the telephone by having experiencedregistered nurses use risk assessmentalgorithms to assistthe member in finding the appropriate level, type and timing of care needed. The result is a reduction in medically unnecessaryand inappropriatecare, better matching of patient needswith provider services,enhancedmember satisfactionand lower overall costs. International Medical Corps 12233Olympic Boulevard Suite280

(310)826-7800

Los Angeles, CA 90064 The InternationalMedical Corps is a private,non-sectarian,nonpolitical, non-profit organizationthat provides emergencyrelief and training in regions devastatedby war. It seeks individuals with strong teaching skills who are interestedin sharing their expertisewith medical professionalswho are rebuilding health care systemsin countriesexperiencingcivil strife.

J.B. tippincott Company 227 East\/ aslrington Square Philadelphia,PA 19106

(2r) 238-4200

J.B. Lippincott publishes a variety of referencesfor your information needs, including EmergencyMedicine News, The News Magazine-forthe EmergencyCare Professional.Stop by to pick up your Iree copy. Klek Specialty Systems 1625 Cresent Cfucle,#225 Carrollton, TX 75006

(2r4) 245-1600

I^aerdal Medical Corp. 1 Labriola Court Armonk, NY 10504

(8oo)431-1055

(816) 966-3313 Marion Merrell Dow, Inc. 9300 Ward Parkway Kansas Citv.MO 64114 Marion Merrell Dow Inc. invites you to visit our booth, where our representativeswill be happy to discuss,Cardizem@Injectable(diltiazemhydroctrloride),Cardizem@CD (diltiazem hydrochloride). 48

(4r4)362-2410

MarquetteElectronics 8200WestTower Avenue Milwaukee,W153223

On display will be the Marquette@ResponderrM7250and 1500 defibrillator systems.TheMarquetteResponder1250systemis an AED which featurescontinuousanalysisand solid staterecorder of all ECG and event data. The MarquetteResponder1500systems features an AED mode, external pacing and 1,2SIMULECG TANEOUSLEAD ACQUISTIONwith a field proven 1ZSLrM analysisprogram.

Gor 486-6400

MICROMEDEX,Inc. 6200 South SyracuseWay Suite300 Englewood,CO S01l1.-47 40

The CCIS@ComputerizedClinical Information Systemcontains information on drug therapy, emergency medicine, and toxicology. CCISis used by physicians,pharmacists,nurses,and allied health professionals.Available in a variety of computerized delivery methods.

(2ro) 653-8755

Mosby,Willlams & Wllkins 402 Crestwind SanAntonio , TX78239

A completecollectionof the best books, journals,videos and new CD-ROMSin emergencymedicine. Ohmeda Pharmaceutical Products Division (908) 604-7674 110 Allen Road Liberty Corner, NJ 07938 Ohmeda PharmaceuticalProducts Division is pleased to introduce REWXr' (nalmefene,hydrochlorideinjection). Physicians for a Violence-Free Soclety P.O.Box 35528 Dallas, Tx75235-0528

(214) 590-8807

(206) 867-4569 Physlo-Control Corp. 11811 Willows Road, Northeast Redmond, WA 98052 LIFEPAK@11 diagnostic cardiacmonitor; LIFEPAK10,qP defibrillatorlmonitor/pacemaker;LIFEPAK300 Automatic externai defibrillator;ShockAdvisory SystemrM, RLIS,Inc. 1.6Ancient Bend SanAntonio , TX78248

(2ro) 230-5239

SafeVare,Inc. 3633 136PLace,Southeast Suite200 Bellevue,WA 98006 no summarylisted

(206) 644-6128

Society for Academic Emergency Medicine (577) 485-5484 901 North Washington Avenue Lansing, MI 48906 Stop by the SAEM booth to preview the various educational materialsdescribedon the back cover of this publication.In addition, SAEM membership information and publicationswill be available. 1995 SAEM Annual Meeting

TangentMedical,Inc. l4Juniper Avenue Westerville,OH 43081

(61,4)891.-3398

Discharge! is a \(indows-based patient dischargesystemfor the ED. \fith its mouse interface, Discharge!is fast and intuitive. Graphicbuttonsprovide accessto dischargeinstructions,scripts, physicianfollowup, industrial injury instructions and school/ work excuses.The results are personalized and professional, evenprintedwith your hospital logo. University of Texas, Houston Department of Emergency Mediclne

(7rr792-4969

643rrannin M585.232 Houston,TX 77030 Thiswill be a demonstration of a new Emergency Medicine t$(ebSite. Intemet W.B.SaundersCompany l3z2OakPath SanAntonio,TX78258

(2r0) 497-3198

Visitour displayof medicalbooks and periodicals.

1995SAEMAnnual Meeting

WeatherbyHealth Care (20r 866-1144 25YanZantStreet Norwalk, CT 06855 \(eatherby Health Care'sEmergenryMedicineDMsion housesthe nation's most effective staff of consultantsdedicated solely to the placement of emergencymedicine physicians.\fleatherby is your resourcefor investigatingand securing the perfect practice opportunity. Stop by our booth to pick-up your free copy of \(zeatherbyHealth Care'sBestFripnd's Guide to Finding an EmergencyMedicinePractice and other important industry information.

Wellsoft Corp. J6Johnson Road Somerset,NJ 08873

(800) 597-9909

Integrated Clinical ManagementSystem-Modulesinclude Electronic Patient Record, Patient Tracking, Physicianand Nursing Documentation, Prescriptions,Staff Directory, CustomizedReport Generation, ICD-9 Coding, HomeEasyDischarge Instructions included (nearly 2,000illnesses,drugs, surgeries,and tests including Spanishsheets). Patient demographicsautomatically downloaded.Turnkey available(hardwareand softwareinstallation if desired).fuily networkable.User Friendly.

POSITIONS FELLOWSHIP EM resiE A S TC A R O L I N AU N I V E R S I T YS: e e k i n ga c c r e d i t e d instrucof fellowship',Rank 4"".V gr"A""tefor one or two-year compoIndividualized stipend' competitive EM, tor in ilinical teachingskills, research, statistical n"nir',r.1' as benchresearch, or traumatology' toxicology, administration, aeromedicine, EMS, ED attendingphvsiurri*i." i"alviJualizedprogram/half-time I Regional cian. ED at Pitt CountyMemorialHospitalis Level service' helicopter active annually; iruu.u Center;50,000visits of EmerDepartment Professor, MD, 6unron, Nichoias C;;i"a Schoolof Medicine' e".l;-M"ai.ine, EastCaiolinaUniversity b r e e n v i l l eN, C 2 7 8 5 8 - 4 3 5o4r c a l l ( 9 1 9 )8 16 - 4 7 5 7' Health Care ResuscitaHENRYFORD HOSPITAL-Weatherby a v a i l a b l e7 / 9 5 ' T h i s w e l l P o s i t i o n iion i"t"it.h Fellowship: sponreceived.permanent has program fellowship established center activities Research Care' Health i"tinio from Weatheiby i"tut.itution of criticallyill patientsincludingcard.iac.aril;i pathophysioliestvictims.Clinicalstudiesinvolveevaluationof . ; ; ; i s h o c ka n d n e w t h e r a p e u t i ci n t e r v e n t i o n sL'a b o r a t o r y to r.ihi"i i;";l;" useof MR technologyand molecularbiology Fellow studvcerebralresponsein the critiially ill and injured' as stafffacultyin tertiarycare nur fption for clinicalexperience excellent tO *itn residencyprogram.Competitivesalarywith of EmerDepartment MD, Nowak, ["."iiit. Contact'Richird

w' CrandBlvd'' ro1! !91oitll127s9 g"..v M"ai.ine,Henrv. betroit, Ml 48202or call (313) 876-1909'

two-year An established STATEUNIVERSITY: PENNSYTVANIA emergency feilowshipin medicaltoxicologyaffiliatedwith the expertise medicineresidencyprogram'The fellow will develop certifiedfaculty:A busy througha programrun 5y ABEM/ABMT poisoncenter' a inoati""ntadmittingservice,a certifiedregional ano toxicologvreferralclinic, weekly educationalconterences' development in career interested Those research. ..it"ilii.i-i Fellowship uiu to*i.otogypleasecontactKeithK' Burkhart'MD' Medical Hershey S' Milton The Medicine, Director,Emergency , A '1 7 0 3 3o r c a l l 1 - 8 0 0 - 5 2 1 C e n t " r , ' P OB o . "8x6 0 , H e r s h e y P Women oii o. nfitrnutive action/equalopportunityemployer' to apply' encouraged and minorities

RocKYMoUNTA|NPoIsoNCENTER:Two-yearfe||owship'in for activeclinicalinMedicalToxicologyprovidesconsultations in toxo"ii"niS"rui." "ni'it committedto teachingand research Poicertified for medical-back-up provide i-i"gv. i"ti"*i ulto Affiliaannually. cases 120,000 over handles which sonCenter Hospiiionr-in.tra" Level1 TraumaCentersat DenverCeneral Adi u l ; n ; U n i v e r s i t yo f C o l o r a d oH e a l t hS c i e n c e sC e n t e r ' interfor available are MPH, PhD,, eg, ;;";;; giuJuat"degrees; to equal op;;i"J;t? q;alified"fellowtlucusc is committed C' Dart' Richard to CV Send action' and affirmative ;;il"it; Street' [rro, Ff'b, RockyMountainPoisonCenter,645 Bannock Denver,CO 80204. D i v i s i o no f U N I V E R S I TO YF C A L I F O R N I AS, A N D I E G O :T h e in V"Ji*f Toxicologyat UCSD offersa two-yearfellowship guidelines fulfills Program 711/96' V"Ji.ut Toxicologyavailable Toxicology "it"Ofirn"a by tnJ'ncur. The Divisionof Medical ToxiMedical Center' Poison Regional Diego includesthe 3an at two ;"I;gy admitting,"rii."t for both childrenand adults out"i""?tftpit"ft an"dconsultingservicesat two otherhospitals' and ongoingclinical ouii"ni ,.ui"rrulclinic for toiic exposures, . y p e r b a r i cM e d i c i n es e r v i c ea l s o u n d e r ; ; l - b ; " . h - , " s e a r c hH Medicine'ContactRichardF' Clark' Departmentof Emergency 200 W' A1b91Dr'' #8676' San Center, tvtedicaT ffi, USCD Diego,CA 92103'8676or call (619)543-6463'

FellowMEDICAICENTER: OF MASSACHUSETTS UNIVERSITY p r o g r a mo f f e r s t r a i n i n S T w o y e a r T o x i c o l o g y ' +io in Medical Service .li,ii."f researchand teachingexperience..Toxicology at in/outpatienttoxicologyconsultations rrouiautadulVpediatric is staffed Yv;;;;"; h;tiiiurt irso,o00 combinedED visits)and UMMC is a tertiarycareLevel r""thr*lgMiTnBEM diplomates' i ' T ; ; r ; , C " n i " r , T o x i c o l o g yT r e a t m e nCt e n t e r 'B u r n . C e n t e r ' Toxicology.LaRenalDialysisCenter,and liasa Comprehensive Salarv t';;;i";t ;; the oniv PICU in CentralMassachusetts' MD' DeFerm' Bob Contact level' 4/5 PbY with .orr"ltutute y e d i c i n e ,U Y M - C : ^ | l L a k eA v e n u e p"iit".t of EmergencM ' or call (508)856-4101 OIOsS-ozzA f1A frottn,Wot."ster, Emergency UNIVERSITO Y F P I T T S B U R G HT:h e D i v i s i o no f Toxicology. Medical in fellowship Medicineoffersa two-year an EmerbunaiJ","t should have an MD/DO and completed considered)' (equivalent experience i""iv-l,r"iliin" n"tiJun.v stream'Salary: in Medicine;non-tenure ippointm"ntto Instructor and occupapediatric' adult, include ebV+ salary.Experiences opportunresearch tional toxicology,(inpatientand outpatient), year' each 1 of Starting July Center' Poison iti"r-una Pittsb"urgh u pon completion ;i ;l bli it ioi tr''uft "a i.al Toxicologv Sub-board, MD, IellowshipDirector' olin" i"[to*tnip. ContactJohnBenitez, MUH University NE-583, Room, Program, Treatment io*i.ofogy Pittsburgh'PA Street' Lothrop 200 .ipl-rfrr.i'tf,r MedicalCenler, is an Pittsburgh of University The (a1 648-6800' 2) lall or isZti ployer' Em ity n Opportu AffirmativeAction,Equal UN|VERS|TYoFPITTSBURGH:TheUniversityofPittsburgh in basic fifiuiuJn"tia"ncy offersone-yearfellowshipsin EMSand each to tailored be can Fellowships Research. EM i"a u"J "ppf in experience incorporate can goals, and t"ril*tJ individualcareer ContactAllan care' clinical of aspects aii and lJulution ;;;;i Med-icine'230 McKee S.-Wotfton,MD, Centerof Emergency (412)s78-3180' call or 15213 PA eittsburgh, SbO, Fiu.u,St". 1995 SAEM Annual Meeting

FACUTTY POSITIONS EASTCAROLINAUNIVERSITY: Facultyposition- Department oI Emergency Medicine.Full-time positions for academically qualified,boardcertifiedand/orboardpreparedemergencyphyiicians at the levelof the instructor,assistant pitt and associjteorofessor. CountyMemorialHospitalis a LevelI TraumaCenterwith 50,000 visitsannuallyand an activehelicopterservice.Craduateteachins programhas30 EM residents. SendCV to NicholasBenson.MDI Professor, Departmentof EmergencyMedicine, EastCarolina University Schoolof Medicine,Creenville, NC 2ZB5S-43 54;(919\ 8 1 6 - 4 7 5 7F;A X( 9 1 9 )8 1 6 - 5 0 1 4E . asC t a r o l i n aU n i v e r s i t iys a n AffirmativeAction/Equal Opportunity Employer. ERIECOUNTYMEDICATCENTER: With thE SUNY At BUffAIO, Department of EM is seekingfull-timeEMfaculty.EM Residencv, protected academictime, Adult Level I Trauma/BurnCenterfor WesternNY, ongoingactive researchprogram,competitivesalary,CME,benefits, 42,00OED visits/year, excellentcommunitv. schools and recreational opportunities. Attendingstaffpositions available. ContactDietrichJehle,MD or C. RichardBraen,MD at (716)B9B-4430or send CV to Departmentof Emergency Medicine, 462 CriderStreet,Buffalo,Ny .l4215.AA/EOE H E N N E P IC NO U N T YM E D I C A LC E N T E Ri :s s e e k i n gf u l l _ t i m e c l i n i c atle a c h i n gf a c u l t y .R e s i d e n ctyr a i n e dE m e r g e i c yp h y s i ciansinterested in teachingareencouraged to apply.,qgeMcertification attainedor in processrequired.Currentlythe departmentsees98,000visitsper year.lt is a Level1 traumacenter, andhasa well established Emergency Medicineresidency. Facultyarescheduled in boththe Main Emergency Department with occasiorral coveragein the UrgentCare division of the department.Competitive salaryand practiceplan with benefitspack_ agethat includesbusiness expenses, retirementplan, maipractice,health,disability,and dental insuranceis offered.piease sendcurriculumvitaeto JosephE. Clinton,MD, Chiefof Emer_

gencyMedicine,HennepinCountyMedical Center,7Ol park A v e n u e ,M i n n e a p o l i sM , i n n e s o t a5, 5 4 j 5 . T e l e p h o n en u m b e r (612)347-s683;FAX(612)337-7447. l[LlNOlS/ Chicago:Associate Residency Directorpositionavaila b l e a t M i c h a e l R e e s eM e d i c a l C e n t e r .R e q u i r e sr e s i d e n c v trainedin EMwith BoardCertification and academicexperience. This Levelll, 34,OOO volumefacilityis qualifyingto becomean accredited emergency residency programin the fall of 1995.Exc e l l e n tc o m p e n s a t i o a n n d b e n e f i tp a c k a g eC . o n t a c tJ e n n i f e r Hymes,EMSA,1200 Southpine lsland,Suite600, Ft. Lauder_ d a l e , F L 3 3 3 2 4 - 4 4 6 01; - 8 0 0 - 4 2 2 - 3 6 7 2e,x t .Z Z 6 0 ;F a x( 3 0 5 ) 424-3270.EOE/AA/MIF profesMEDICAI COttECE OF GEORGIA:Assistant/Associate sor,Sectionof Emergency Medicinehasopeningsfor academic faculty.Mustbe boardcertified,or preparedin emergency medicine. Level1 TraumaCenter.An established Emergency Medicine Residency program,now approvedfor B residents per year. Active researchprogramswith good extramuralsupport.Spac i o u s ,n e w , u l t r a m o d e r E n D f a c i l i t i e sT. h e c o m p e n s a t i oann d b e n e f i t sa r e e x c e l l e nat n d h i g h l yc o m p e t i t i v eE. x c e l l e nvt e a r round outdooractivitiesand pleasantenvironment.Interested candidates shouldsubmitCV or contactElginHobbs,MD, Sectiol of Emergency Medicine,MedicalCollegeof Ceorgia,1120 15th Street,Augusta,Ceorgia 309'12-4407 or call (Z-06)Z2l3 3 3 2o r f a x( 7 0 6 )7 2 1 - 7 7 1 8 . MICHIGAN:Exceptional positionas medicaldirectorwith wellestablished emergencymedicinegroup locatedin southeastern M i c h i g a nT . h i s c h a l l e n g i nogp p o r t u n i t cy o m b i n e sc l i n i c a la n d administrative functionsin a 62,000-visit department. Adminis_ trativeexperience, excellentclinicalskills,and stronginterpersonalskillsrequired.Competitive compensation pacKage (commensurate with experience) includesa strongmonthlyadminis_ trativestipend,malpracticecoverage,flexiblescheduling,relo_

FIEAnHCARE I\ ORmNDoREGIoNAL SYSEM

EesrERN VrncrNrA MeprcAL ScrroorTheDepartmentof EmergencyMedicineof EasternVirginia MedicalSchooland Emergency Physlcians of Tidewaterare seekingapplicirions for a facultyposirion.Wb are an esiablished academlcdeparrmenrwith a 14 year-old,fully accreditedPGY-IIthrough PGY-IVemergency me_dicine residencyprogram. We are seekingan individualwith significanrresearchexperience. / QualificationsincIude boardcerti[icatr,on preparationin emergencymedicine,interestrn teaching,and demonstratedsuccessin basic scienceand/orciinical research.Ample protected time, outs[andingcompensationand benefits offered.Beautifuiareaof the country with moderateclimateand beachesand mountains nearbySubmit CV to FrancisCounselman,MD, Departmenrof EmergencyMedicine,Room 206, RaleighBuilding, 600 GreshamDr., Norfolk, VA 23507,or call 804/668-3397.

1995SAEMAnnual Meerins

OrlandoRegionalMedicalCenter Departmentof EmergencyMedicine Orlando.Florida EMERGENCY MEDICINE FACULTYPOSITION AvailableJune.1995 Due to expansionof services,one or morefull-time facultypositionsat ORMCwill be avaitablein June, 1995.Candidatesmust be residencytrainedand boardcertifiedin EmergencyMedicinb.Candidates with severalyearsof practicein an academicenvironmentwith a trackrecordof scholarlyactivityand eligibilityfor.clinrcalappointmentat the associbteprofe!sor levelatthe University of Floridaare preferr6d. Our groupprovidesemergencyservicesfor the entire, growing,OllandoRegionalHealthcareSystem.Our fully accre-dited EmergencyMedicineResidencyprogramhas30 residents and a fellow. Inquires shouldbe directedto: Dr.TimothyB. Bullard,Chairman (407) 841-s111 ext. 6279 or Dr. Jay L. Falk,ProgramDirector(407)297-6929

EmergencY NewAcademic Program Illedistne ilount SlnalSshoolof tledislne NewYorhClty . 9+ sites.I trauma centers . Emergencymedicineresidencycurrently at one site r Seehinâ&#x201A;Źentry levelfaculty,residencysitedirectors,reand emergencymedicinesubspecialists searchassociates . Highly competitivesalaryand benefitspachage . Supportiveapproachto faculty developmentand interdisciplinarYactivities Pleasesendor fax your CV to' SheldonJacobson,MD Chairman,Dept.of EmergencyMedicine or BarbaraRichardson'MD Director,EmergencYDepartment Mount SinaiMedicalCenter- Box 1149 One GustaveL. LevYPlace New Yorh, NY 10029 FAX,(912)423-tO23 StuartKessler,MD Director,EmergencYDepartment ElmhurstHosPital 79-01Broadway Elmhurst,NY 11373 (718)354-301s

and much more. lf you are CME allowances, cationassistance, interestedin this careeropportunity,contact EmergencyPhysiat'l -800Department Resources ciansMedicalCroup,Physician CV to (313)995-2913. 466-3764or FAXvour confidential KALAMAZOOCENTERFOR MICHICAN STATEUNIVERSITY physicianto serveas qualified a Seeking STUDIES: MEDICAI Directorof PediatricEmergencyMedicine,and to serveas acaResiMedicineand Pediatrics demicfacultyfor our Emergency dency programs.Candidatesshould be BC/BPin emergency or pediatricemergency medicine,as well as BCIBPin pediatrics commedicine.This excitingopportunityinvolvesoutstanding pensationand benefits,ample protectedtime,.anda delightful universitycommunityin which to live and work. Pleasecontact MD, MichiganState DavidOverton,MD or DonaldCreydanus, 1000Oakland Centerfor MedicalStudies, UniversitvKalamazoo (616) 337-6600. 49008, Michigan Kalamazoo, Drive, Campus:Director of MICHICAN STATEUNIVERSITY-Saginaw Emergency Researchsoughtfor expandingcommunity-based resifor teaching/supervising Responsible Program. Medicine and clinicalpatientcare' research, dentsand medicalstudents, MedicineResidencyhas been subApplicationfor Emergency community mittedand site visit is completed.Family-oriented activities' educational and entertainment wide-ranging offers excellentbenefitspackageand proCompetitivererrurnerations, tectedtime for research.For further information,contactRobert Wolford, MD, Director,Departmentof EmergencyMedicine, lnc., 1000 HoughtonAve', SagHospitals, SaginawCooperative 7) 771-6817. inaw,Mf 48602or call (5.1 Full-timepositionsavailNEW ENGTANDMEDICAI CENTER: physiciansas facultyfor able for Board-Certified/Board-Prepared Medicine expansionof new academicDepaftment.ofEmergency at New EnglandMedicalCenter,a 521-bedtertiarycare{acility and majorleachinghospitalfor TuftsUniversitySchoolof Medi<)

MEDICINE EMERGENCY ACADEMIC ATIANTA,GA EMORYUNIVERSITY:The expanding Divi' sion of EmergencyMedicine at Emory Uni' versity Schoolof Medicine is activelyrecruiting faculty to pursue academic Emergency Medicine in a maior university system. In addition to patient care, activities include teachingand supervisionin the principle af' filiate hospitals of the Schoolof Medicine ( i n c l u d i n ga L e v e l I T r a u m aC e n t e r ) 'r e ' search,and active involvementin the Emer' gencyMedicine ResidencyProgram.Exper' tise in Toxicology,Iniury Control,and clinical researchare of particular interest. Candi' dates should be board certified or prepared i n E m e r g e n c yM e d i c i n e . P l e a s ec o n t a c t William E. Davis,MD, FACEBDirector'Divi' sion of EmergencyMedicine, Departmentof Surgery,Emory UniversitySchoolof Medi' cine,69 Butler Street,SE,Atlanta'GA 30303. E m o r qt J n i v e r s i t iys a n E q u a l O p p o r t u n i t y Employer.

Chairperson, of I)epartment Emengency Medieine The Hospitalof Saint Raphael,locatedalongthe Con' necticutseaboard,is a major affiliateof the Yale Uni' versitySchoolof Medicine The Deoartmentsees 45,000 patientsannually and is involvedin trainingresidentsin InternalMedicine, GeneralSurgeryand Pediatrics.The successful candidatewill be trainedand BoardCertifiedin EmeF gencyMedicineand havea minimumof five yearsexperience in EmergencyMedicinepractice.Experiencein an academicsettingwith departmentaladministration will be highlyvalued.opportunitiesfor participationin EmergencyMedicinetrainingmay also exist. Competitivesalaryand benefitsincludingmal' practice,life and health insurance.The successfulcandidatewill qualiryfor facultyappointmentin the Yale Schoolof Medicine. University Send CVand letter of interestto PeterN. ChairHerbert,M.D.;Chair,E.D.SearchCommittee; man, Departmentof Medicine;Hospitalof Saint Raohael;1450 ChapelStreet; New Haven'cT 06511' Inqukles and appllcatlonsmust be tecelvedby June 30,1995. Equalopportunityemployer,M/F/D/Y. We are a smokefree facility.

of $=Hospital =ffiz Saint Raphael Healthcare System oftheSaintBaphael A member

1995 SAEM Annual Meeting

cine.Housestaff supervision, teaching,and administrative respon_ sibilities, with excellentresearch opportunities. Applicationfor Emergency MedicineResidency submitted.New EmergencyDe_ partment facilityscheduled for completionearly1995.Excellent institutional supportand resources. Academicappointmentwith comp_etitive salaryand benefits.ContactCharlotieS. yeh, MD, FACEP, Physician-in-Chief, Departmentof EmergencvMedicine. NewEngland MedicalCenter,250 Washington Street,Box 311. Boston, MA 02111.(617)636-4720or FAX(Oln o%_qzzl. NORTHWESTERN MEMORTAL HOSptTAt:Full-timeacademicpo_ sitionavailablein EM at Northwestern UniversityMedicalSchool (NUMS)and Northwestern MemorialHospital(NMH). NMH sees approximately 50,000visitsperyear,and is a LevelI traumacenter. A fullyaccredited EM residencyis in place.Completionof an EM r e s i d e n coyr E M b o a r dc e r t i f i c a t i o ni s r e q u i r e d M . alpractice insurance on an occurrencebasisand competitivecompensation package basedupon experienceare provided.ContactJames Mathews, MD, Chief,Emergency Medicine,216 E.SuperiorSt.,1st F l o o rC, h i c a g o , l L6 0 6 1 j o r c a l l ( 3 j 2 ) 9 0 S - 5 1 2 9N. o r t h w e s t e r n University is an AffirmativeAction/EqualOpportunityEmployer. Hiringiscontingent uponeligibilityto work in the UnitedStaies. PRESBYTERIAN MEDICA|_ CENTER OF pHil_ADEtpHtA:Assistant Professor/lnstructor. Stablefacultygroup seekingexperienced, Emergency Physicianwith strongintere-st in teaching. lgiri: 300-bed urbanteachinghospitalwith EDannualcensus of 23,00"0 adults. Resource facilityfor international medicalemergencies. P r o t e c t etdi m e a n d f a c u l t y a p p o i n t m e n ta t U n i v e i s i t yo f Pennsylvania available.Excellent facultycoverageand dictaiion service provided.PleasesendCV or contactLaurence J. Cavin, MD, FACEP, Presbyterian MedicalCenterof philadelphia,39th & pA 19104or call (215) 662-9350. Market Streets, Philadelphia, UNIVERSITY OF KENTUCKy:Lexington,Departmentof EmergencyMedicinerecruitingfull+imefacultyat Assistant professor level.Fullacademicdepartment within the Collegeof Medicine.

Board-Certifiedrange$128,000-$152,000, commensuratewith experience . Blue CrossHealth Insurance . Dental Program . Life Insurance irrllf,lx . Disabilityplans """11: . RetirementPlans Four weekspaidvacation Eight paidpersonaldays(unlimitedaccrual) Ten paidholidavs Expensespaid up to $2.500peryearwith commensurate time off''

, O..ur..n.. ralpracticepaid by hospital SendC.V. to Niels Rathlev,M.D., Departmentof EmergencyMed.icine, CameyHospitai.2l 00 Dorchester Avenue,Boston,MA 02124 Phone:(617)296-4000, ext.4445

carnâ&#x201A;ŹD/Hos'ital

UNIVERSITY OF VIRGINIA HEALTH SCIENCESCENTER EMERGENCY MEDICINE CHAIR, DEPARTMENT OF EMERGENCY MEDICINE The University of Virginia Schoolof Medicine invitesapplications for the positionof chair of the new Departmentof EmergencyMedicine. The university of Virginia Health sciencescenter is a tertiary care and level I trauma center located at the foot of the Blue RidgeMountains in Charlottesville,virginia. The ED ""rrru, is 59,000 including 14,000children. The departmentincludes active air and ground transport programs and a poison control center. There are currently l l full-time faculty in the department'The University of Virginia EM training program will start its first group of g residents this June. Candidatesmust possessthe administrativeand leadershipskills necessaryto foster the growth and developmentof the new department'Residencytraining in EmergencyMedicine und ,trorrg credentials in the traditional three missionsof an academic institution--teaching,research, and clinical practice--are essential. Due to the changes in the health environment, an understanding of managedcare and integratedhealth care delivery systemsis desirable. The University of virginia is an affirmative action, equal opportunity employer. women, minorities, disabled persons,and veteransare encouraged to apply. Inquiriesand curriculum vitae should be directed to the Search Committee for Emergency Medicine, oflice of the Dean, University of Virginia School of Medicine, Box 395, McKim Hall, Charlottesville, V.l iZsoA.

1995SAEMAnnual Meerins

activities. l ,n d r e s e a r c h D e p a r t m e nht a s c l i n i c a l ,e d u c a t i o n a a emergencydepartmentin the University Up-to-datefull-service application Hospitalwith an annualcensusof 36,000.Residency beingconsidered by RRCin August.Desirecandidatefor administrativeand educationalactivitiesas medicaldirectorof EMS EducationCenterand stateBTLSsteeringcommittee.PleaseconMD, Chair, Departmentof Emergency tact SteveStapczynski, Medicine,UKMC RoomM-53, B00 RoseStreet,Lexington,KY 40536-0084or call (606)323-5908.EOE MediUNIVERSITY OF MICHICAN:The Sectionof Emergency cine is seekinga physicianfor a full-timeacademicpositionin E m e r g e n cM y e d i c i n e .R e s p o n s i b i l i t i ei ns c l u d e h o u s eo f f i c e r and direct patientcare in a settingproviding training,research, both primaryand tertiarycare experience.Protectedtime for researchand educationwill be provided.UMMC is an American levelone adultand pediatrictraumacenter. Collegeof Surgeons trainingand/orboardcertificaApplicantsshouldhaveresidency Medicine.Excellentfringe benefitpackage. tion in Emergency and Sendcurriculumvitaeto: William C. Barsan,MD, Professor Medicine,UMMC, 1500 E. Medical SectionHead, Emergency CenterDr.,Ann Arbor,Ml 48109-0014. MediUNIVERSITY OF MICHIGAN:The Sectionof Emergency for full-timeclinicalpositionsin Emercine is seekingphysicians gencyMedicine.Academicrankwill be determinedby credenwill includepatientcareactivityat tials.Clinicalresponsibilities H u r l e yH o s p i t a il n F l i n t .R e s p o n s i b i l i t iiensc l u d eh o u s eo f f i c e r trainingand providingdirect patientcare in a settingproviding both primaryand tertiarycare experience.Applicantsshould haveresidencytrainingand/orboardcertificationin Emergency please Medicine.Excellentfringebenefitpackage.lf interested, and sendcurriculumvitaeto: William C. Barsan,MD, Professor Medicine,UMMC, 1500 E. Medical SectionHead, Emergency C e n t e rD r i v e ,A n n A r b o r , M l 4 8 1 0 9 - 0 0 1 4T. h e U n i v e r s i t yo f ActlonEmployer. Michiganis an EqualOpportunityAffirmative

rHecrev'o'4ilR"?ir,['s ffi

Academic Theway It SbouldBe Practiced In a new, state-of-tbe-art

emergency

department.

Emergency medicine residency to be established,within a newly createdAcademic Department of Emergency Medicine . Excâ&#x201A;Źllent compensation package with protected academic time. We are seeking board-certified/board-eligible Attending Physicians at all academic levels Please send CV to: M.D., Chairman Nofman S. Abramson, Department of Emergency Medicine The Cleveland Cllnlc Foundation, Elp 950o Euclld Avenue Cleveland, Ohlo 44195 Fax;216/445-4552 The Clevelancl Clinic Founclation.

a 1,008 becl multispecialty

medical center' isfecognizeda6 a Naff;iliixf,lf;il:,1,L:'

WO*E EMERGENCYPHYSICIANS,PA

Exceptionaltwenty-onemembergroup seeking double- boar dedem er gen c ym edi cine/pediatric emergencymedicine physician to assumea combinedacademicand clinical position. Affiliation with newly forming EmergencyMedicine Residency through University of North Carolina, Chapel Hill. Exciting practice/good quality life-style in centralNC, easily accessibleto mountains and coast.Competitive salary andbenefitpackage. For more information during the conference, contactDavid Cline, MD, ResidencyDirector, at the Marriott River Center.After the conferencesend CV to Frantz Melio, MD, President,Wake EmergencyPhysicians,PA, 3000New BornAvenue,RaleigbNC 27610.

Associate ResiMEDICALCENTER: UNIVERSITY OF ROCHESTER dency Director- lmmediateopeningfor academicphysicianinresiterestedin associateresidencydirectorposition.Established dencyprogram, pediatricemergencymedicinefellowshipprogram.Annualvolume60,000.Level1 traumacenter,aeromedical transpoft,EMSdirection,toxicology.ContactSandraM. Schneider, r ,Y M D , F A C E P6, 0 1 E l m w o o dA v e n u e ,B o x 6 5 5 , R o c h e s t e N 14642or call(716)275-9490.EqualOpportunityEmployer. of Emergency UNIVERSITY OF SOUTHALABAMA:Department residency trainedor boardcertified Medicineseekingphysicians Medicine.50,000 patientsin USA Hospitalsysin Emergency USAMCis a 400-bed backupall disciplines. tem. Subspecialty LevelI TraumaCenterwith helicopterprogram.Mobile is loc a t e d o n t h e C u l f C o a s tw i t h w a r m c l i m a t e ,o u t s t a n d i n g and low costof living.USA hascommittedto the debeaches, Program. Clinical MedicineResidency velopmentof Emergency and fringe benefitsare researchopportunities.Compensation competitive.ContactFrankS. Pettyjohn,MD, Departmentof Emergency Medicine,Universityof SouthAlabama,2451 Fillingim st.,Mobile,AL 36617or call(205)470-1649. HOSPITAI:is activelv WASHINGTONUNIVERSITY-BARNES seekinga residencydirectorto developand implementa resiinclude dency programin emergencymedicine.Qualifications residencytraining/boardcertificationin emergencymedicine with at leasttwo yearsexperienceas a residencydirectoror associateresidencydirectorin a currentlyapprovedemergency medicineresidencyprogram.Qualifiedapplicantsare eligible track. on the tenuredor non-tenured for academicadvancement A m p l e p r o t e c t e dt i m e , s u p p o r ts p a c e ,a n d p e r s o n n e al r e Conavailablealongwith excellentsalaryand benefitspackage. t a c t L a w r e n c eM . L e w i s ,M D , C h i e f ,D i v i s i o no f E m e r g e n c y MedicineW , a s h i n g t o nU n i v e r s i t yS c h o o lo f M e d i c i n eo r c a l l (314)362-4362;(314\362-2495FAx. 1995 SAEM Annual Meeting

CALL FORABSTRACTS 1996Annual Meeting May 6-9 AdamsMark Hotel Denver, Colorado The Program Committee is accepting abstractsfor review for oral and poster presentation. Authors are urged to submit original work in all aspectsof EmergencyMedicine including cerebral resuscitation,pediatrics,cardiopul-onuty resusciiation,medical toxicology,administration,trauma,EMS, shock,basic science,injury prevention,health policy reseatch,education,infectiousdisease,neurologictrauma,unO-.tfrodo1ogy. Abstract submissionforms arc avallableupon requestto the SAEM office and will be publishedin the November 1995 issueof the SAEM newsletter.Abstractsnot submitted on the official abstractform or not conforming to the instructions wilt not be considered. Call (5l7) 485-5484to requestan abstractform or obtain further information. Abstractssubmittedor the resultantmanuscriptsmust not appearin a refereedjournal prior to publication of the Annual Meeting abstractsin the Vtay 1996issueof Academic EmergencyMedicine. Abstractspresentedat other national meetingswithin 30 days of the 1996SAEM Annual Meeting will be consideredfor presentation] IAEM strongly recommendsthat authors submit their manuscriptsto Academic EmergencyMedicine. Academic EmergencyMedicine will notify authorsof a decision regardingpublicationwithin 60 daysof receipt. All abstracts must be submitted on the official abstract form, and must be received no later than January 10, 1996.Abstractsand correspondence shouldbe sentto: SAEM Annual Meeting Abstracts 901 North WashingtonAvenue Lansing,MI48906 Awards w_illbe given for the best abstractsin the following categories:Clinical Oral (Human Subjects),Basic ScienceOral, Education, Resident/Flllow Oral, poster, Innovation in Medical Education Exhibit, Resident/FellowPoster,Medical Student, Technology,and Pediatric Emergency & Critical Care. Awards wiil 6e presentedat the 1997Annual Meetins.

1995SAEMAnnual Meeting

NOTtrS

1995 SAEMAnnual Meeting

STOP BY TIIE SAEM BOOTH TO PREVMW - Careof theElderPerson TtsXTBOOK From the SAEM GeriatricEmergencyMedicineTask Force,Arthur B. Sanders,MD, Editor A comprehensive core textbookfocusingon the multi-disciplinarytearn'sneedsfor providingprehospital,ED, and follow-up emergencycarebasedon the specialneedsof the elderpopulation.The sourcefor all health care professionalsto read and to use as a reference. .

Publicationis the resultof the work of the SAEM GeriatricEmergencyMedicineTask Force, with the generoussupportof the John A. Hartford Foundationof New york.

Developedby the collaborativeeffortsof an interdisciplinary group of emergencyphysicians, geriatriciens,emergencynurses,and paramedics.

Cotrsidersthe uniquephysiology,atypicaldiseasepresentations, and psychosocial needsof elder persons.

Introducesa new modeland principlesfor emergencycareof the elderpatient.

Includesproveninstrumentsfor assessing elderpersonsin the emergencycareenvironment.

Presentspracticalinformationonhow to approachspecificclinicalissuesin older patientssuchas trauma,infections,myocardialinfarction,alteredmentalstatus,elderabuse,functionaldecline. abdominalpun, dizzinessand cerebrovascularaccidents.

INSTRUCTOR'S MANUAL - EmergencyCare of the Elder Person Designedto be usedby facultyto presentan 8 hour trainingcoursein geriatricemergencycare.It is to be usedin conjunctionwith the text, EmerencyCareof the Elder Person. o

Providesinstructorswith the tools for usingproblem-based learningfor teachingemergencycare of elderpeople.

Encourages activelearningthroughthe useof 6 casestudiesreflectingcornmonclinicalproblems.

Eachcasecorresponds to one or more chaptersin the textbookand is accompanied by transparencies.

Eachcasereinforcesthe new modelof careand principlesof geriatricemergencymedicine.

VIDEOTAPE - The Recognitionof Delirium in the ED Developedby DouglasK. Miller, MD, assistant professorof geriatricmedicine,SaintLouis University Schoolof Medicinein codunctionwith the SAEM GeriatricEmergencyMedicineTask Force. .

30 Minute runningtime.

Demonstrates strategiesfor detecting,evaluating,and managingdeliriumin the elderemergency deparbnentpatient.

Emphasizes the significanceof mortalityand morbidityassociated with misseddiagnosis.

Demonstrates the useof assessment instruments currentlyavailablefor differentiatingdelirium (acuteconfusionalstate)ftom dementia(chronicconfusionalstate).