SAEM 2004 Annual Meeting Program

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ANNUAL MEETING May

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-May

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Orlando Society for Academic Emergency Medicine

PAST PRESIDENTS/RESEARCH FUND DONORS RECEPTION SAEM has planned a special Reception for the Society's past presidents and Research Fund donors on Monday, May 17 from 6:00-7:30 pm in the Cambridge Room. SAEM would like to extend an invitation to all past presidents and Research Fund donors to meet with fellow contributors to the Society and the Research Fund, share a glass of wine and conversation with past presidents, and listen to a brief presentation from Dr. John Marx, the SAEM President in 1997-98.

As you are considering attending the Reception, please review the 2005 Call for Grants, which is published below. While SAEM celebrates the 2004 grant recipients at this Annual Meeting, the Society is already preparing for next year's young investigators, and providing them with an opportunity to obtain the funding needed to pursue their careers in academic emergency medicine.

SAEM 2005 Research Grants Emergency Medicine Medical Student Interest Group Grants These grants provide funding of $500 each to help support the educational or research activities of emergency medicine medical student organizations at U.S. medical schools. Established or developing interest groups, clubs, or other medical student organizations are eligible to apply. It is not necessary for the medical school to have an emergency medicine training program for the student group to apply. Deadline: September 9, 2004.

Research Training Grant This grant provides financial support of $75,000 per year for two years of formal, full-time research training for emergency medicine fellows, resident physicians, or junior faculty. The trainee must have a concentrated, mentored program in specific research methods and concepts, and complete a research project. Deadline: November 4, 2004.

Institutional Research Training Grant This grant provides financial support of $75,000 per year for two years for an academic emergency medicine program to train a research fellow. The sponsoring program must demonstrate an excellent research training environment with a qualified mentor and specific area of research emphasis. The training for the fellow may include a formal research education program or advanced degree. It is expected that the fellow who is selected by the applying program will dedicate full time effort to research, and will complete a research project. The goal of this grant is to help establish a departmental culture in emergency medicine programs that will continue to support advanced research training for emergency medicine residency graduates. Deadline: November 4, 2004.

Scholarly Sabbatical Grant This grant provides funding of $10,000 per month for a maximum of six months to help emergency medicine faculty at the level of assistant professor or higher obtain release time to develop skills that will advance their academic careers. The goal of the grant is to increase the number of independent career researchers who may further advance research and education in emergency medicine. The grant may be used to learn unique research or educational methods or procedures which require day-to-day, in-depth training under the direct supervision of a knowledgeable mentor, or to develop a knowledge base that can be shared with the faculty member’s department to further research and education. Deadline: November 4, 2004.

Emergency Medical Services Research Fellowship This grant is sponsored by Medtronic Physio-Control. It provides $60,000 for a one year EMS fellowship for emergency medicine residency graduates at an SAEM approved fellowship training site. The fellow must have an indepth training experience in EMS with an emphasis on research concepts and methods. The grant process involves a review and approval of emergency medicine training sites as well as individual applications from potential fellows. Deadline: November 4, 2004.

Further information and application materials can be obtained via the SAEM website at www.saem.org.

Attendees are urged to complete the general Annual Meeting evaluation form, as well as the individual evaluations that are available at each didactic session. Completed evaluation forms should be returned to the SAEM Registration Desk before leaving Orlando. Feedback is critical to the development of future Annual Meetings.

INDEX General Information..........................................................................................................2 Schedule of Events ..........................................................................................................4 Sunday, May 16 Papers/Posters/Didactics ......................................................................11 Monday, May 17 Papers/Posters/Didactics ......................................................................16 Tuesday, May 18 Papers/Posters/Didactics......................................................................20 Chief Resident Forum ....................................................................................................24 Constitution and Bylaws Amendments ............................................................................25 May 18 Annual Business Meeting Agenda ......................................................................26 Wednesday, May 19 Papers/Posters/Didactics ................................................................28 Innovations in Emergency Medicine Education (IEME) Exhibits ........................................32 Photo Contributors..........................................................................................................35 Didactic Session Speakers..............................................................................................36 Speaker Conflict of Interest ............................................................................................37 2004 Mid-Atlantic Regional Meeting ..............................................................................37 Interest Group Meeting Agendas ....................................................................................38 Committee/Task Force Objectives ..................................................................................41 2004 Midwest Regional Meeting ....................................................................................43 Positions Available..........................................................................................................44

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GENERAL INFORMATION The SAEM Annual Meeting is the largest forum for the presentation of original research in emergency medicine. The meeting will be held on May 16-19 at the Wyndham Palace Resort and Spa in Orlando. Over 1,800 emergency physicians are expected to attend. The Annual Meeting will include 503 original research presentations and 21 Innovations in Emergency Medicine Education (IEME) Exhibits. The oral papers consist of 10 minute presentations followed by 5 minutes for questions and answers. Selected oral paper sessions will include additional time for discussions. The posters are scheduled in 2-hour sessions each day. Most posters will focus on one-on-one discussion between the presenters and the attendees. However, each day two moderated poster sessions will be assigned to one-hour discussion sessions within the two-hour poster sessions. The moderators will focus discussion on furthering the research in the topic. The IEME Exhibits will be held during the poster sessions with the first group scheduled for May 16 and 17 and the second session on May 18 and May 19.

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. The abstracts were published in the May 2004 issue of Academic Emergency Medicine, the official SAEM journal.

All speakers at the 2004 Annual Meeting have been independently selected by the SAEM Program Committee. All speakers are required to disclose any real or apparent conflict of interest they may be related to the content of their presentation(s). The existence of commercial or financial interests of speakers related to the subject matter of their presentation should not be construed as implying bias or decreasing the value of the presentation(s). However, disclosure should provide information to participants to form their own judgments. A list of disclosed potential conflicts of interest is published in this Program.

The Annual Meeting is always a popular meeting for renewing old acquaintances and making new ones. While sessions are in progress, as a courtesy to the speakers and attendees, please limit conversations to the hallways. Also, please turn off cell phones while in meeting rooms.

Research Fellowship grants; and the recipients of the 2003 Annual Meeting Best Presentation Awards will be presented to the membership.

Donald M. Yealy, MD, will present his Presidential Address to the membership. Incoming President, Carey Chisholm, MD, will also be introduced. There may be other reports and presentations to the membership.

Registration Attendees must register at the SAEM Registration Desk to obtain name badges that are required for admission into all Annual Meeting sessions.

Registrants for the limited enrollment sessions (such as lunch sessions and workshops) should arrive a few minutes early to check-in. Because of the popularity of such sessions, on-site registration will not be possible if a session has been sold out in advance.

Scientific Award Candidates An asterisk (*) next to the abstract number denotes a project being considered as a finalist for an SAEM Scientific Award. Awards will be given in the categories of Faculty (Clinical Science and Basic Science), Young Investigator, Fellow, Resident, and Medical Students.

Award selection process: Authors indicated on the abstract submission form whether they wished to be considered for an award. The Program Committee selected award candidates from this group, based on reviewers’ scores and study impact. Candidates were asked to submit a full manuscript by April 30 for review by the awards subcommittee. All finalists who indicated that they will submit a manuscript by April 30 are listed with an asterisk (this program was published prior to April 30, and some manuscripts may not be submitted by April 30). Final award decisions will be based on both the submitted manuscript and the presentation in Orlando.

Announcements regarding the award recipients will be made immediately following the Annual Meeting.

The SAEM Registration Desk will be located in the Great Hall Assembly and will be open from 7:00 am-7:00 pm on May 15, 16 and 17; from 7:00 am4:00 pm on May 18; and from 7:00 am-1:00 pm on May 19.

It is the policy of SAEM to comply with the Americans with Disabilities Act. If special arrangements are necessary, please contact the SAEM staff at the Registration Desk.

Continuing Medical Education The 2004 Annual Meeting has been planned and implemented in accordance with the Essentials Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of SAEM and Michigan State University, College of Human Medicine. Michigan State University, College of Human Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Photography Exhibit and Visual Diagnosis Contest There were 101 cases and photos submitted to the Program Committee for consideration of presentation at the Annual Meeting. Approximately 52 photos/cases were selected and will be displayed in two formats in the Exhibit Hall.

Michigan State University, College of Human Medicine designates this educational activity for a maximum of 30.5 hours in category 1 credit towards the AMA Physician’s Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity. Michigan State University, College of Human Medicine designates the CPC Competition for a maximum of 6 hours in category 1 credit towards the AMA Physician’s Recognition Award.

Medical students and residents will be invited to participate in the Visual Diagnosis Contest. Score sheets may be obtained from the SAEM staff at the Registration Desk. Winners in both medical student and resident categories will be awarded a one-year membership in SAEM, including a subscription to Academic Emergency Medicine, a free registration to attend the 2005 SAEM Annual Meeting in New York City, a major Emergency Medicine textbook, a subscription to the SAEM Newsletter, and a SAEM coffee mug. Recipients will be announced in the July/August issue of the SAEM Newsletter.

Annual Business Meeting The Annual Business Meeting will be held on Tuesday, May 18 from 11:00 am - 12:00 noon in Great Hall West. The election results will be announced, as well as the results of the membership’s ballot regarding the Constitution and Bylaws amendments. Joseph Waeckerle, MD, and Tom Aufderheide, MD, will address the membership as the recipients of the Leadership and Hal Jayne Academic Excellence Awards. In addition, the Young Investigator Award recipients; the recipients of the Research Training, Institutional Training, Scholarly Sabbatical, Neuroscience Research Fellowship, EMS

“Clinical Pearls” photos will also be displayed for the benefit of all attendees. These photos will include a case history, as well as the diagnosis

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and “take home” points. SAEM is proud to display original photos of educational value and gratefully acknowledges the efforts of the individuals who submitted photos for consideration

May 15 (pre-day) Schedule of Events 7:00-8:00 am

Banquet and Opening Reception The SAEM Banquet will be held on the evening of Tuesday, May 18 at Disney's Animal Kingdom. Tickets are $100 and are available at the Registration Desk. Dress is casual.

8:00-12:00 pm 8:00 am-5:00 pm 8:00 am-5:00 pm 8:00 am-5:00 pm 8:30 am-5:00 pm

SAEM will host an Opening Reception on Sunday, May 16 from 6:00-7:30 pm. All Annual Meeting registrants are invited to attend at no charge. Hors d’oeuvres will be served and a cash bar will be available. Dress is casual.

CPC Competition

8:30 am-12 pm

The Semi-Final CPC Competition will be held on Saturday, May 15 (the day before the Annual Meeting) from 8:30 am until 5:00 pm. Annual Meeting attendees are encouraged to attend. There is no registration fee to attend the Competition, which showcases emergency medicine residency programs. The CPC consists of the presentation and discussion of the best 60 cases selected from 85 submissions. The CPC Competition finalists will be announced during a reception held from 6:00-7:00 pm in Great Hall Center. The CPC Competition is sponsored by ACEP, CORD, EMRA, and SAEM. The CPC Final Competition, consisting of the 6 semi-finalists, will be held on October 18, 2004 during the ACEP Scientific Assembly in San Francisco.

8:30 am-5:15 pm

9:00 am-4:30 pm 12:00-1:30 pm 12:30-2:00 pm

Academic Emergency Medicine Academic Emergency Medicine, the official journal of SAEM, plans a number of activities at the 2004 Annual Meeting. Again this year, AEM is conducting a consensus conference. This year the selected topic is “Using Information Technology to Improve ED Patient Care.”

12:00-1:30 pm 1:30-4:30 pm

An AEM Reviewers’ Workshop will be held on May 16 at 12:00-1:30 pm in Scotland B. The topic is “Tips from the Editor (aka – The Editor’s Pet Peeves)”. This session is designed for current AEM reviewers and lunch will be provided. All AEM reviewers are invited but must register in advance by sending an email to aem@saem.org. Space is limited and registrations will be first-come, first-served.

4:00-6:00 pm 5:00-6:00 pm 5:00-6:30 pm 5:00-7:00 pm

The AEM Editorial Board will meet on May 16 at 7:00-9:00 pm in the Oxford Room. All Editorial Board members are urged to attend. The AEM Associate Editors will meet on May 17 at 12:00-1:30 pm in the Sussex Room. The AEM Statistical Reviewers will meet over breakfast on May 18 at 7:00-8:30 am in the Sussex Room.

5:00-8:00 pm

5:30-7:00 pm 6:30 pm 8:00-10:00 pm

CORD The Council of Emergency Medicine Residency Directors (CORD) will meet on May 17 at 2:00-5:00 pm in the England Room. The program will include educational sessions, reports, elections, and award presentations. All CORD members are invited to attend.

CORD CPC Task force Breakfast, Senate/Gallery AACEM Meeting, Great Hall West AAEM Board of Directors, Coventry NHTSA, Crash Outcome Session, Council EMRA Board of Directors, Sussex CPC Semi-Final Competitions, Knave, Scribe, Captain, Yeoman, Cloister North and Cloister South AEM Consensus Conference on Informatics and Technology, Westminster (Breakouts: Emerald, Diamond, Sapphire) Business Aspects of Health System Management: The Emergency Physicians' Role in Health System Leadership, Oxford Medical Student Symposium, Great Hall East (Breakouts: Scotland A, B, and C) AACEM Annual Business Meeting, Senate/Gallery Medical Student Symposium Lunch, Great Hall Center AEM Consensus Conference Lunch, Outback Veranda AACEM New and Future Chairs of Emergency Medicine Workshop, Great Hall West SAEM Public Health Interest Group Subcommittees, Chelsea 2004 Program Committee, Council Residency Fair, Great Hall North Emergency Medicine Network (EMNet), Devon SAEM Board of Directors Orientation Dinner with Committee/Task Force Chairs, Senate/Gallery (Breakouts: Scribe and Knave) CPC Reception, Great Hall Center AACEM Banquet (by invitation only) SAEM Board of Directors, Council

2004 Annual Meeting Program Committee Brigitte M. Baumann, MD Andra L. Blomkalns, MD David C. Cone, MD Richelle Cooper, MD, MSHS Cathy B. Custalow, MD PhD Elizabeth Datner, MD M. Christopher Decker, MD Deborah B. Diercks, MD Brian Euerle, MD

Gregory Garra, DO Bob Gerhardt, MD, MPH Daniel A. Handel, MD, MPH Alan Heins, MD Sean O. Henderson, MD Judd E. Hollander, MD Debra Houry, MD, MPH Alan E. Jones, MD Jack. Kelly, DO, FACEP

Jeffrey A. Kline, MD Terry Kowalenko, MD O. John Ma, MD James C. McClay, MD Antonio E. Muniz, MD Craig D. Newgard, MD Susan B. Promes, MD Kevin G. Rodgers, MD Adam J. Singer, MD

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Terry L. Vanden Hoek, MD Gary M. Vilke, MD Mary Jo Wagner, MD Christopher S. Weaver, MD David W. Wright, MD Stewart W. Wright, MD

SUNDAY, MAY 16, 2004 8:00-9:30 am, Great Hall North President's Welcome and Plenary Papers Abstracts 1-5, pg. 11 9:30-11:00 am, Great Hall North 9:30-11:00 am, Great Hall West Oral Paper Presentations Oral Paper Presentations Pediatrics Best of Basic Science Abstracts 6-11 Abstracts 12-16

9:30-11:00 am, Great Hall East Bedside Teaching in EM - An Interactive Workshop pg. 13

pg. 11

pg. 11

11:00-12:00 pm, Great Hall North Oral Paper Presentations Ethics: Informed Consent Forms/Institutional Review Board Abstracts 17-20

11:00-12:00 pm, Great Hall West Oral Paper Presentations Injury Prevention Abstracts 21-24

11:00-12:00 pm, Great Hall East Educational Research Track: The Current State of Medical Education Research

pg. 11

pg. 14

12:00-1:30 pm, Scotland A LUNCH SESSION: Improving Journal Club through Structured Critical Appraisal, Innovative Educational Formats & Bedside Application, pg. 14 1:30-3:00 pm, Great Hall West Oral Paper Presentations Emerging Applications of Ultrasound Abstracts 31-34

12:00-1:30 pm, Westminster LUNCH SESSION: Parenting & Promotion

9:30-10:30 am, Great Hall Center State-of-the-Art: Ventilatory Management in Resuscitation: Helpful or Harmful?, pg. 13 10:30-12:00 pm, Great Hall Center Exploring & Analyzing Survey Data pg. 14

pg. 11

AEM Reviewers Workshop Scotland B

1:30-3:00 pm, Great Hall North Oral Paper Presentations CT in the ED Abstracts 25-30 pg. 11

pg. 14

12:00-1:30 pm, Scotland C LUNCH SESSION: The Need and Development of a Standardized Disaster Medicine Training Program pg. 14

1:30-2:30 pm, Great Hall East Becoming a Leader in the Medical School Dean's Office

1:30-2:30 pm, Great Hall Center Introduction to Statistics pg. 15

pg. 15

pg. 11

3:00-4:00 pm, Great Hall North Oral Paper Presentations Geriatrics Abstracts 35-38

3:00-4:00 pm, Great Hall West Oral Paper Presentations Clinical Decision Rules Abstracts 39-42

pg. 11

pg. 12

2:30-4:00 pm, Great Hall East Educational Challenges for Training in Pediatric EM pg. 15

2:30-4:00 pm, Great Hall Center Bench to Bedside: How Cutting Edge Molecular Diagnostic Tools are Being Developed for Diagnosis & Management of Infectious Diseases pg. 15

4:00-6:00 pm, Exhibit Hall Posters, pgs. 12-13 Psychiatry in the ED: Abstracts 43-50 Administration/Health Care Policy: Abstracts 51-70 Administration: ED throughput Efficiency and Overcrowding: Abstracts 71-85 Administration: Balancing Supply and Demand: Abstracts 86-89 Research Design/Methodology/Statistics: Abstracts 90-95 Toxicology/Environmental Injury: Abstracts 96-112 Geriatrics: Abstracts 113-120 Geriatrics: Cardiovascular Disease in the Elderly: Abstracts 121-123 Innovations in Emergency Medicine Education Exhibits: 1-6, 8-11 Visual Diagnosis and Clinical Pearls Photos and Cases 5:00-6:00 pm, Exhibit Hall Moderated Posters, pg. 13 Computers and the Web in the ED: Abstracts 124-127 Gastrointestinal Bleeding: Abstracts 128-131 6:00-7:00 pm, Poolside – “Lakeside Deck” Opening Reception all registrants invited to attend, no charge

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SUNDAY, MAY 16, 2004 SAEM and AEM Committee/Task Force/Board Meetings 7:30-8:00 am 9:30-11:00 am 10:30-11:30 am 10:30-11:30 am 11:00-12:30 pm 11:30-12:30 pm 12:00-1:30 pm 1:30-2:00 pm 1:00-2:30 pm 2:00-3:00 pm 2:00-3:30 pm 2:30-4:00 pm 3:00-4:00 pm 4:00-5:00 pm 7:00-9:00 pm

2004 Program Committee - Oxford Undergraduate Committee - Cambridge SAEM/AACEM Officers - Chelsea Critical Care Fellowship Task Force - Oxford Graduate Medical Education Committee - Cambridge SAEM/AAEM Officers - Devon AEM Reviewers Workshop - Scotland B SAEM/NAEMSP Officers - Devon Faculty Development Committee - Cambridge SAEM/ABEM Officers - Devon Healthy People 2010 Task Force - Scribe Membership Survey Task Force - Oxford SAEM/CORD Officers - Sussex Grants Committee - Oxford AEM Editorial Board - Oxford

SAEM Interest Group Meetings 12:00-1:00 pm 12:00-1:00 pm 12:00-2:00 pm 4:00-5:30 pm

Geriatric - Chelsea Patient Safety - Captain Public Health - Cloister Mentoring Women - Captain

Affiliated Meetings and Satellite Symposia 7:00-8:00 am 9:30-11:30 am 9:30-10:30 am 9:30 am-1:30 pm 10:00-11:00 am 10:30 am-3:30 pm 10:30 am-1:30 pm 11:30 am-1:30 pm 12:30-2:00 pm 1:00-2:00 pm 1:00-2:30 pm 2:00-3:00 pm 3:00-4:30 pm 3:00-4:30 pm 3:30-4:30 pm 3:30-4:30 pm 3:30-4:30 pm 4:30-5:30 pm 4:30-5:30 pm 4:30-5:30 pm 5:00-6:00 pm 5:00-6:00 pm 5:00-6:00 pm

AACEM/AAEM Officers (by invitation) - Chelsea EMRA Board of Directors - Council AACEM/ACEP Officers (by invitation) - Chelsea EMCREG-International Steering Committee - Knave CORD CPC Committee - Yeoman New Coordinators Workshop - Windsor EMF Board of Trustees - Cloister North AACEM Executive Committee - Sussex EMRA Conference Committee Orientation - Council CORD/ABEM Officers (by invitation) - Scribe CORD Standardized Direct Observation Assessment Committee - Yeoman EMRA 101 - Senate CORD Standardized Assessment Methods Committee - Yeoman EMRA Reference Committee Hearing - Senate EMRA Critical Care Committee - Gallery EMRA Combined Residency Committee - Devon EMRA Medical Student Governing Council - Chelsea EMRA International Committee - Devon EMRA Program and Activities Committee - Chelsea EMRA Website Committee - Gallery County Program Directors - Senate National Alcohol Screening Day SBIRT Academic EM Research - Scribe EMRA Awards Reception - Scotland 5

MONDAY, MAY 17, 2004 8:00-9:00 am, Great Hall North Oral Paper Presentations Education in EM Abstracts 132-135, pg. 16 9:00-10:00 am, Great Hall North Oral Paper Presentations Professional Development Abstracts 140-143, pg. 16 10:00-11:00 am, Great Hall North Oral Paper Presentations Psychiatric Issues in EM Abstracts 148-151

8:00-9:00 am, Great Hall West Oral Paper Presentations Ischemia and Reperfusion Abstracts 136-139, pg. 16 9:00-10:00 am, Great Hall West Oral Paper Presentations Overcrowding Abstracts 144-147, pg. 16 10:00 am-12:00 pm, Great Hall West Oral Paper Presentations and Discussion Reducing Pain and pg. 16 Discomfort 11:00 am-12:00 pm, Great Hall North Abstracts 156-161 Oral Paper Presentations pg. 16 Neurology Abstracts 152-153, 309 and 155

8:00-9:30 am, Great Hall East Career Development Awards: Indentifying Sources & Developing Successful Applications

8:00-11:00 am, Great Hall Center Responsible Conduct of Research Series: Integrity in Research pg. 18

pg. 18

9:30-10:30 am, Great Hall East So You Want to be a Program Director? pg. 19

10:30 am-12:00 pm, Great Hall East Mid-level Faculty Career Development pg. 19

pg. 16

11:00 am-12:00 pm, Great Hall Center Jump-starting a Successful Research Division pg. 19

12:00-2:00 pm, Exhibit Hall Posters, pgs. 16-18 Renal Colic: Abstracts 162-163 Establishing the Airway: Abstracts 164-170 Procedural Sedation: Abstracts 171-175 Pain Management: Abstracts 176-183 Education/Professional Development: Abstracts 184-195 Cardiovascular Disease: Abstracts 196-198, 154, 199-205 Cardiovascular Disease: Risk Stratification: Abstracts 206-214 Cardiovascular Disease: Gender and the Heart: Abstracts 215-218 Cardiovascular Disease: Back to the Basics: The H&P: Abstracts 219-224 Trauma: Abstracts 225-233 Trauma: Trauma and Head Injury: Abstracts 234-240 Trauma: Trauma and Quality of Life: Abstracts 241-242 Trauma: Trauma and Wounds: Abstracts 243-245 Care of the Critically Ill Patient: Abstracts 246-250 Innovations in Emergency Medicine Education Exhibits: 1-6, 8-11 Visual Diagnosis and Clinical Pearl Photos and Cases

1:00-2:00 pm, Exhibit Hall Moderated Posters, pg. 18 Managing Accelerated Hypertension in the ED: Abstracts 251-254 Updates in Cricothyrotomy: Abstracts 255-258

2:00-5:00 pm, England CORD Meeting 6:00-8:00 pm, Great Hall Center Grant Mentorship Workshop - Part I

6:00-8:00 pm, Great Hall West PowerPoint as a Teaching Tool

pg. 19

pg. 19

(pre-registration required, participants must bring their own computer)

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6:00-7:00 pm, Cambridge Past President/Research Fund Donors Reception

SAEM and AEM Committee/Task Force/Board Meetings 7:00-9:00 am 7:30-8:00 am 8:00-9:30 am 9:00-10:30 am 9:30-11:00 am 10:00-11:30 am 10:30-11:30 am 11:00-12:00 pm 12:00-1:30 pm 1:30-2:30 pm 2:00-3:00 pm 3:30-5:30 pm 6:00-7:30 pm 6:30-8:30 pm

MONDAY, MAY 17, 2004

Ethics Committee - Sussex 2004 Program Committee - Oxford Research Committee - Cambridge Development Committee - Sussex SAEM/CORD Diversity Training Task Force - Oxford National Affairs Committee - Cambridge Finance Committee - Sussex Web Page Task Force - Oxford AEM Associate Editors - Sussex Awards Committee - Windsor SAEM/ACEP Officers - Chelsea Focus Group (by invitation) - Gallery Past President/Research Fund Donor Reception (by invitation) - Cambridge Focus Group Dinner (by invitation) - Sussex

SAEM Interest Group Meetings 10:00-11:30 am 12:00-1:00 pm 1:00-2:00 pm 1:30-3:00 pm 2:00-3:00 pm 2:00-3:30 pm 2:00-3:30 pm 2:00-4:00 pm 2:00-4:00 pm 2:30-4:00 pm 3:00-4:00 pm 3:00-5:00 pm 3:00-5:30 pm 4:00-5:00 pm 4:00-5:30 pm

Disaster Medicine - Yeoman Triage - Yeoman CPR/Ischemia/Reperfusion - Captain Pediatric - Yeoman EMS - Scribe Palliative Care - Devon Goal Directed Therapy Research - Knave Web Educators - Senate Simulation - Council Health Services and Outcomes Research - Captain Clinical Directors - Yeoman Research Directors - Cloister North Medical Student Educators - Cloister South Toxicology - Scribe International - Knave

Affiliated Meetings and Satellite Symposia 6:00-8:00 am 7:00-8:00 am 8:00-10:00 am 8:30-9:30 am 8:30 am-3:30 pm 8:30-9:30 am 9:00-10:30 am 9:00 am-12:00 pm 10:00-12:00 pm 10:00 am-12:00 pm 10:30-11:30 am 11:00 am-12:00 pm 11:30 am-1:00pm 12:00-1:00 pm 12:30-2:00 pm 1:00-2:00 pm 1:00-5:30 pm 2:00-3:00 pm 2:00-3:30 pm 2:00-5:00 pm 2:00-4:00 pm 3:30-4:00 pm 4:00-4:30 pm 4:00-5:00 pm 4:30-6:00 pm 5:00-6:00 pm 5:00-6:00 pm 5:30-7:30 pm 5:30-7:00 pm 6:00-7:30 pm 6:00-7:30 pm

EMCREG Satellite Symposium: Neurovascular Emergencies and Pulmonary Embolism - Scotland C ACEP Scientific Review Committee - Cloister North EMRA Board of Directors - Windsor ACEP Research Committee - Cloister North Residency Coordinators Forum - Ireland B CORD/AAEM Officers (by invitation) - Scribe CORD Ethical Practice in Residency Recruitment Committee - Knave Honesty in Applicants for EM Residency - Devon EMRA Reference Committee - Chelsea Mock Oral Board, Senate CORD Navigating the Academic Waters Planning Committee - Captain CORD International Program Liaison Committee - Knave CORD Past Presidents/Board of Directors Lunch - Gallery ABEM Lunch for Residents - Ireland A PEMI Site Investigator - Oxford CORD/EMARC Leadership Meeting - Knave EMRA Representative Council - Ireland C NET 2 Investigators - Oxford FERNE Satellite Symposium: Management of ED Patients Who Present with Painful Conditions - Scotland A CORD Meeting - England ACEP Academic Affairs Committee - Cambridge FERNE Reception - Scotland A Introduction to FERNE - Scotland A ABEM/ACEP Officers Meeting (by invitation) - Chelsea FERNE Advisory Board Focus Group - Scotland A Harvard ED Safety Study - Yeoman CORD New Program Directors' Workshop Committee - Scribe SUNY Downstate Department Reception - Windsor ACEP Teaching Fellowship/EMBRS Alumni Reception - Oxford EMRA National Journal Club - Captain FERNE Executive Board - Scotland A 7

TUESDAY, MAY 18, 2004 8:00-9:00 am, Great Hall North Oral Paper Presentations EMS Abstracts 259-262, pg. 20 9:00-10:00 am, Great Hall North Oral Paper Presentations OB/GYN Abstracts 267-270 pg. 20

8:00-9:00 am, Great Hall Center Oral Paper Presentations Clinical Cardiovascular I Abstracts 263, 265-266, pg. 20 9:00-10:00 am, Great Hall Center Oral Paper Presentations Toxicology-Basic Abstracts 271-274 & Survival

9:00-10:00 am, Great Hall East Advancement to the Position of Academic Chair: Strategies for Preparation, Negotiation,

9:00-11:00 am, Emerald/Diamond Responsible Conduct of Research Series: Publication Ethics and Issues pg. 22

pg. 20

pg. 22

10:00-11:00 am, Great Hall North Oral Paper Presentations Evaluation of Syncope Abstracts 275-278

10:00-11:00 am, Great Hall Center Oral Paper Presentations Toxicology-Clinical Abstracts 279-282

10:00-11:00 am, Great Hall East Oversight & Monitoring of Ongoing Clinical Research

pg. 20

pg. 20

pg. 22

11:00-12:00 pm, Great Hall West Annual Business Meeting (all SAEM members invited to attend, election results, award presentations, C&B amendments, and President’s Address) 12:00-1:30 pm, Scotland A LUNCH SESSION: Advances in Sepsis

1:30-2:30 pm, Great Hall North Oral Paper Presentations Sepsis/HIV Abstracts 283-286

1:30-2:30 pm, Great Hall Center Oral Paper Presentations Asthma Abstracts 287-290

12:00-1:30 pm, Westminster LUNCH SESSION: Educational Research Track: Defining the Research Question, pg. 23 1:30-2:30 pm, Great Hall East Educational Research Track: Educational Research in EM Examining the Literature

pg. 20

pg. 20

pg. 23

pg. 22

2:30-4:30 pm, Exhibit Hall Posters, pgs. 20-22 Ischemia - Reperfusion: Abstracts 291-299 Neurology: Abstracts 300-305 Neurology: Stroke: Abstracts 306-309 Neurology: Headache: Abstracts 310-312 Neurology: Seizures: Abstracts 313-314 Disease/Injury Prevention: Abstracts 315-328, 330-342 Infectious Disease: Abstracts 343-352 Infectious Disease: Pneumonia: Abstracts 353-355 Respiratory/ENT Disorders: Abstracts 356-361 Innovations in Emergency Medicine Education Exhibits: 12-22 Visual Diagnosis and Clinical Pearl Photos and Cases

3:30-4:30 pm, Exhibit Hall Moderated Posters, pg. 22 Mass Casualty/Bioterrorism: Abstracts 362-365 Violence in the ED: Abstracts 366-369

5:00-9:00 pm Banquet - Animal Kingdom Safari - the bus will depart from the Convention Entrance area on the Lower Level

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12:00-1:30 pm, Sapphire LUNCH SESSION: Public Health Advocacy: The Researcher in Action pg. 23

1:30-2:30 pm, Great Hall West Clinical Research & the HIPAA Privacy Rule pg. 23

TUESDAY, MAY 18, 2004 SAEM and AEM Committee/Task Force/Board Meetings 7:00-8:30 am

AEM Statistical Reviewers Breakfast - Sussex

7:30-8:00 am

2004 Program Committee - Oxford

8:00-9:00 am

Education Subcommittee of the Research Committee - Cambridge

8:30-9:30 am

NIH Roadmap Task Force - Oxford

10:00-10:30 am

Constitution and Bylaws Committee - Chelsea

10:00-11:00 am

CORD/SAEM Model Task Curriculum Task Force - Oxford

11:00-12:00 pm

Annual Business Meeting (all members invited) - Great Hall West

12:30-4:30 pm

Board of Directors - Oxford

3:00-4:30 pm

2005 Program Committee - Cambridge

SAEM Interest Group Meetings 8:00-9:30 am

Ethics - Devon

9:00-11:00 am

Airway - Captain

12:00-1:00 pm

Evidence Based Medicine - Captain

1:30-3:00 pm

Diversity - Sussex

2:00-5:00 pm

Ultrasound - Cloister North

2:30-4:30 pm

Neurologic Emergencies - Cloister South

2:30-3:30 pm

Trauma - Captain

Affiliated Meetings and Satellite Symposia 6:00-8:00 am

EMCREG Satellite Symposium: Cardiovascular Emergencies: Advancing the Standard of Care - Scotland C

7:00-10:00 am

CORD Board of Directors - Knave

8:00-11:00 am

EMRA Board of Directors - Yeoman

8:30 am-3:30 pm

Residency Coordinators Forum - Ireland B

11:30 am-1:00 pm

ACEP Research Forum Task Force (by invitation)- Devon

12:00-5:00 pm

EMRA Board of Directors - Yeoman

1:00-2:30 pm

Residency Coordinators Workshop on Electronic Data Programs - Ireland C

1:30-2:30 pm

CORD/ACEP Officers - Knave

1:30-3:00 pm

CORD Information Resources Committee - Scribe

2:00-3:00 pm

Combined Residency Directors, Cambridge

2:30-4:30 pm

Medical Student Curriculum Task Force - Chelsea

3:00-4:00 pm

ACEP Tactical Medicine Section - Devon

4:00-6:00 pm

National Emergency Airway Registry (NEAR) - Scribe

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WEDNESDAY, MAY 19, 2004 8:00-9:00 am, Great Hall North Oral Paper Presentations Challenging Dogma Abstracts 370-373, pg. 28 9:00-10:00 am, Great Hall North Oral Paper Presentations Diagnostic Lab Tests Abstracts 378-381, pg. 28 10:00 am-12:00 pm, Great Hall North Oral Paper Presentations and Discussions Trauma Abstracts 386-391

8:00-9:00 am, Great Hall Center Oral Paper Presentations CPR Abstracts 374-377, pg. 28 9:00-10:00 am, Great Hall Center Oral Paper Presentations Infectious Disease Abstracts 382-385, pg. 28 10:00 am-12:00 pm, Great Hall Center Oral Paper Presentations and Discussions Clinical Cardiovascular II Abstracts 392-397

pg. 28

pg. 28

12:00-2:00 pm, Exhibit Hall Posters, pgs. 28-30 Clinical Decision Guidelines: Abstracts 398-411 Diagnostic Technologies: Abstracts 412-419 Ultrasound: Abstracts 420-428 Ultrasound: Ultrasound and Vascular Access: Abstracts 429-437 Ultrasound: Imaging of Venous Thromboembolic Disease: Abstracts 438-441 Out-of-Hospital Care: Abstracts 503, 442-456 Out-of-Hospital Care: Airway Control: Abstracts 457-460 Out-of-Hospital Care: Refusals: Abstracts 461-464 Pediatrics: Abstracts 465-470 Pediatrics: Potpourri of Infections and Related Topics: Abstracts 471-477 Cardiac Arrest: Abstracts 478-494 Innovations in Emergency Medicine Education Exhibits: 12-22 Visual Diagnosis and Clinical Pearls Photos and Cases 1:00-2:00 pm Moderated Posters, pg. 30 Safety of First Responders: Abstracts 495-498 Pulmonary Embolism: Abstracts 499-502

Affiliated Meetings and Satellite Symposia 8:30 am-12:30 pm

Residency Coordinators Forum - Ireland B

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8:00-9:30 am, Great Hall West The Identification, Critical Appraisal, & Clinical Application of High-Quality Systematic Reviews

8:00-11:00 am, Great Hall East Responsible Conduct of Research Series: Protecting Humans & Animals in Research

pg. 31

pg. 31

9:30-11:00 am, Scotland A Grant Mentorship Workshop Part 2 pg. 31

11:00 am-12:00 pm, Great Hall West Spivey Lecture The History of Academic Emergency Medicine

11:00 am-12:00 pm, Great Hall East Creating & Developing High Quality Data Collection Instruments

pg. 31

pg. 31

Sunday, May 16, 2004

SCIENTIFIC PAPERS McClure, MD, Oregon Health and Sciences University 20. Need for Training in Informed Consent among Emergency Medicine Residents, Rafael Torres, MD, New York Methodist Hospital

ORAL PAPER PRESENTATIONS Plenary (8:00-9:15 am) Moderator: Michelle Biros, MD, MS, Hennepin County Medical Center 1. Aminophylline in Bradyasystolic Cardiac Arrest: A Randomized Placebocontrolled Trial, Riyad Abu-Laban, MD, MHSc, University of British Columbia ❉ 2. The Sensitivity of Computed Tomography for the Diagnosis of Subarachnoid Hemorrhage in ED Patients with Acute Headache, Jeffrey Perry, MD, MSc, University of Ottawa ❉ 3. Intravenous Dexamethasone to Prevent the Recurrence of Benign Headache Following Discharge from the ED: A Randomized, Placebo Controlled Clinical Trial, Eric Baden, MD, Brooke Army Medical Center 4. Addition of Long-acting Beta-agonists to Corticosteroid Therapy after Discharge for Acute Asthma: A Randomized Controlled Trial, Brian Rowe, MD, MSc, University of Alberta 5. The Terminal Complement Membrane Attack Complex Is Not Required for Survival from CLP Sepsis: An Anti-C5 Antibody Protects from Mortality in Polymicrobial Sepsis, Jon Buras, MD, PhD, Beth Israel Deaconess Medical Center

Injury Prevention (11:00 am-12:00 noon) Moderator: Robert Woolard, MD, Brown Medical School 21. Influence of the Unbelted Rear-seat Passenger on Driver Mortality, Dietrich Jehle, MD, State University of New York at Buffalo 22. Alcohol, Motorcycle Fatalities, and the Arkansas Motorcycle Helmet Law Repeal, Gregory Bledsoe, MD, Johns Hopkins University 23. The Impact of Brief Motivational Intervention and Gender among Injured Drinkers in the ED, P. Allison Minugh, PhD, DATACORP 24. Student Drivers: A Study of Fatal Motor Vehicle Crashes Involving Drivers 16 to 17 Years Old, Steven Lowenstein, MD, MPH, University of Colorado

CT in the ED (1:30-3:00 pm) Moderator: Ian G. Stiell, MD, University of Ottawa 25. Head CT Findings in Patients with New Onset Seizure with and without Associated Head Trauma, David Guss, MD, University of California, San Diego 26. CT Angiography for the Detection of Subarachnoid Hemorrhage: A Pilot Study, Shaun Carstairs, MD, Naval Medical Center San Diego 27. Interobserver Agreement for the Diagnosis of Venous Thromboembolism on CT Chest Angiography and Indirect Venography of the Lower Extremities: An Investigation of Patients Evaluated in the ED, Peter Richman, MD, Mayo Clinic Hospital 28. Accuracy of Emergency Medicine Residents vs “On-call” Radiology Residents in Interpretation of Cranial Computed Tomography (CT) Scans, Todd McGrath, MD, Drexel University 29. The Utility of Computed Tomographic Scanning of the Head to Screen for Facial Fractures, Cameron Crandall, MD, University of New Mexico 30. CT and Shunt Series: Are They Necessary for All Children with VP Shunts and Symptoms Suggesting VP Shunt Abnormality?, Antonio Muniz, MD, Virginia Commonwealth University Health System

Pediatrics (9:30-11:00 am) Moderator: Jill Baren, MD, University of Pennsylvania ❉ 6. What Is the Etiology of Out-of-hospital Pediatric Cardiopulmonary Arrest?, Rick Gerein, MD, University of Ottawa 7. Oral vs Intravenous Rehydration of Moderately Dehydrated Children: A Randomized Clinical Trial, Philip Spandorfer, MD, University of Pennsylvania 8. Predictors of Pneumonia in Young Febrile Infants, Shari Platt, MD, New York Presbyterian Hospital-Weill Cornell Medical Center 9. ED Reliance Is a Marker for Underimmunization, Evaline Alessandrini, MD, MSCE, University of Pennsylvania 10. Pediatric Emergency Airway Management, Yi-Mei Chng, MD, Brigham and Women's Hospital 11. Serum Measurement of Neuron Specific Enolase (NSE), S-100, and Interleukin-6 (IL-6) for the Prediction of Neurologic Outcome in Pediatric Patients with Moderate to Severe Closed Head Injury, Pamela Okada, MD, University of Texas, Southwestern

Emerging Applications of Ultrasound (1:30-3:00 pm) Moderator: Dietrich Jehle, MD, State University of New York at Brooklyn ❉31. Randomized Controlled Trial of Immediate vs Delayed Goal-directed Ultrasound to Identify the Etiology of Nontraumatic Hypotension in ED Patients, Alan Jones, MD, Carolinas Medical Center 32. Use of Ultrasound Bladder Volume Determinations Decreases the Number of Unsuccessful Catheterization Attempts in Pediatric ED Patients, Kathryn McCans, MD, UMDNJ-Robert Wood Johnson Medical School 33. Spectral Doppler Ultrasound Accurately Identifies the Presence, Absence, or Diminished Antegrade Flow in a Ventriculo-peritoneal Shunt Model, Paul Sierzenski, MD, RDMS, Christiana Care Health System 34. Point of Care Limited Ultrasonography for CVC, Truman Milling, MD, New York Methodist Hospital

Best of Basic Science (9:30-11:00 am) Moderator: Brian O’Neil, MD, Wayne State University 12. Insulin Attenuates the Systemic Inflammatory Response in a Rat Model of Acute Myocardial Ischemia and Reperfusion, Zujun Song, MD, Fourth Military Medical University 13. Resuscitation of Combined Traumatic Brain Injury and Hemorrhagic Shock with Racemic vs L-lactated Ringer's, Sue Stern, MD, University of Michigan ❉14. Hyperbaric Oxygen (HBO) Increases Wound Healing In Vivo and Requires Simultaneously Active Nitric Oxide Synthase 2 and 3, Wende Reenstra, MD, PhD, Beth Israel Deaconess Medical Center 15. Mediation of Hypothermia Protection Against Ischemia/Reperfusion Injury: PTEN Phosphorylation and Activation of Nitric Oxide Synthase?, Terry Vanden Hoek, MD, University of Chicago 16. The Value of Emergency Medicine Related Animal Research as Measured by Subsequent Citation, Tracey Reilly, MD, Upstate Medical University

Geriatrics (3:00-4:00 pm) Moderator: Lowell W. Gerson, PhD, Northeastern Ohio Universities 35. Reclining Chairs Reduce Pain from Gurneys in Elder ED Patients: A Randomized, Controlled Trial, Scott Wilber, MD, Summa Health System/Northeastern Ohio Universities 36. Inappropriate Medication Administration to the Acutely-ill Elderly: A Nationwide ED Study, 1992-2000, Jeffrey Caterino, MD, Allegheny General Hospital 37. Does a Simple ED Screening Tool Correlate with Functional Impairments among Older Adults?, Stephen Meldon, MD, MetroHealth Medical Center 38. Emergency Physician Recognition of Adverse Drug Related Events in Elderly Patients Presenting to an ED, Eddy Lang, MD, SMBD Jewish General Hospital

Ethics: Informed Consent Forms/Institutional Review Board (11:00 am-Noon) Moderator: James G. Adams, MD, Northwestern University 17. Time to Infusion Using Proxy Consent: Experience from the Progesterone for Traumatic Brain Injury, Experimental Clinical Treatment (ProTECT) Study, David Wright, MD, Emory University 18. Approval of Minimal Risk Waiver of Informed Consent and Exception to Informed Consent (Final Rule) Studies at IRBs Nationwide, Amy Ernst, MD, University of California, Davis 19. A Qualitative Study of Instututional Review Members Experience with Reviewing Proposals for Exception from Informed Consent in Resuscitation Research, Katie

Clinical Decision Rules (3:00-4:00 pm) Moderator: Roger J. Lewis, MD, PhD, Harbor-UCLA 39. Unstructured Clinician Estimate of Low Clinical Probability for Pulmonary Embolism Is Equivalent to the Canadian Score and the Charlotte Rule, Michael Runyon, MD, Carolinas Medical Center

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Sunday, May 16, 2004 Margarita Jovel, MD, MPH, University of Maryland 69. Adverse Events Identified Following an ED Visit, Alan Forster, MD, MSc, University of Ottawa 70. Improving Patient Satisfaction by Information Delivery: A Controlled Trial of Two Simple, Cost-effective Interventions, Tara Cassidy-Smith, MD, UMDNJCamden/Cooper Hospital

40. Comparison of the Performance of the Components of the Canadian CT Head Rule and the New Orleans Criteria, Ian Stiell, MD, MSc, University of Ottawa 41. Predicting Admission in the Absence of Pneumonia Severity Index Score, Brian Rowe, MD, MSc, University of Alberta 42. A Clinical Decision Rule for the Use of CT Head in Children with Minor Head Injury, Martin Osmond, MD, CM, University of Ottawa

POSTER SESSION

Administration: ED Throughput Efficiency and Overcrowding (4:00-6:00 pm)

71. The Disconfirmation Paradigm: How Throughput Times Impact Patient Satisfaction in the ED, Tara Cassidy-Smith, MD, UMDNJ-Camden/Cooper Hospital 72. Nurse Staffing Levels Affect the Number of ED Patients That Leave Without Treatment, Shkelzen Hoxhaj, MD, Christiana Care Health System 73. Effects of a Fast-track Area on ED Performance: Determinants of Effectiveness and Quality of Care, Miquel Sanchez, MD, PhD, Hospital Clinic 74. The Role of Ambulance Diversion on Time Spent in the ED, K McConnell, PhD, Oregon Health & Science University 75. Impact of Oregon Health Plan Cutbacks on ED Use, Robert Lowe, MD, MPH, Oregon Health & Science University 76. Capacity-related Interfacility Patient Transports: Patients Affected, Waiting Times and Associated Morbidity, Esther Stolte, BSc, Queen's University 77. Daily Patient Care Time Is the Best Predictor of Waiting Time Performance, Drew Richardson, MB, BS, The Canberra Hospital 78. Association of Daily Patient Care Time with Adverse Events in Patients Who Do Not Wait to Be Seen, Drew Richardson, MB, BS, The Canberra Hospital 79. Confirmation of Association Between Overcrowding and Adverse Events in Patients Who Do Not Wait To Be Seen, Drew Richardson, MB, BS, The Canberra Hospital 80. A New Definition of ED Overcrowding Using Point Occupancy, Drew Richardson, MB, BS, The Canberra Hospital 81. Prospective Validation of Point Occupancy Definition of Overcrowding, Drew Richardson, MB, BS, The Canberra Hospital 82. Impact of ED Volume on RN Time at the Bedside, John Villani, MD, PhD, University of North Carolina 83. Reducing Specialty Consultation Times in the ED, Barry Brenner, MD, PhD, University of Arkansas 84. ED Intervention of Key Clinical Procedures Reduces Inpatient Hospital Length of Stay: Policy Implications, Susan Stone, MD, University of Southern California & RAND Corporation 85. The Effect of Physician Triage on Elopement Rates, Throughput, and Patient Satisfaction, Lawrence Lewis, MD, Washington University

Psychiatry in the ED 43. Droperidol, Ziprasidone, and Midazolam for Sedation of Acute Undifferentiated Agitation in the ED: A Randomized, Double-blind Trial, Ann Sterzinger, MD, Hennepin County Medical Center 44. Patient Attitudes Toward ED Physician Attire: A Randomized Trial, Marc Haber, MD, Jacobi Medical Center 45. Depression and Diabetes in the ED - How Often Do They Go Together? Prevalence of Depressive Symptoms among an Inner City Diabetic Population Composed Largely of Hispanics, Marianne Haughey-Barrios, MD, Jacobi Medical Center, Albert Einstein College Of Medicine 46. An ED Screening Tool for Depression and Suicidal Ideation, J Overcash, MD, University of North Carolina 47. Injury and Mental Health: Prevalence and Spectrum of Comorbid Psychopathology in a Cohort of Injured ED Patients, Gregory Larkin, MD, MSPH, University of Texas, Southwestern 48. Spirituality in the ED: The Difference Between Ambulance Patients and Clinicians, Timothy Jang, MD, Washington University 49. Cost Analysis of Pediatric Psychiatric Visits, Prashant Mahajan, MD, MPH, Children's Hospital of Michigan 50. Psychological Effect of SARS on ED Doctors and Nurses, Kum-Ying Tham, MD, Tan Tock Seng Hospital

Administration/Health Care Policy 51. The Impact of a Severe Acute Respiratory Syndrome (SARS) Outbreak on ED Utilization in Toronto, Canada, Michael Schull, MD, MSc, Institute for Clinical Evaluative Sciences 52. ED Overcrowding as Ecologic Problem: A Comparison of Measurement Methods and the Effect on Time to Thrombolysis, Michael Schull, MD, MSc, Institute for Clinical Evaluative Sciences 53. Improving Laboratory Turnaround Time with a QI Project Focusing on Outliers, Gregg Husk, MD, Beth Israel Medical Center 54. Holding Admitted Patients in the ED Is Most Highly Correlated with Longer Patient Throughput Times, Brigitte Baumann, MD, Cooper Health 55. Practice Pattern Variation in Ancillary Diagnostic Testing for Acute Asthma Exacerbations, Rachel Stanley, MD, MHSA, Hurley Medical Center and University of Michigan 56. Current Status of US EDs, Ashley Sullivan, MS, MPH, Massachusetts General Hospital 57. The Effects of a Physician Slow-down on ED Volume, Brian Walsh, MD, MBA, Morristown Memorial Hospital 58. A Comparison of Patient Self-triage to Fast-track with Emergency Medicine Nurses and the Emergency Severity Index, Tara Shapiro, DO, Newark Beth Israel Medical Center â?‰59. Optimizing Triage of High Acuity Patients: Revision of the Emergency Severity Index (ESI) Level 1 and 2 Criteria, Paula Tanabe, PhD, RN, Northwestern University 60. Evaluation of a Program to Address Frequent ED Users, Eric Grafstein, MD, St Paul's Hospital and University of British Columbia 61. Potential Cost Savings of Not Obtaining Routine Gonorrhea and Chlamydia Cultures in ED Patients Presumptively Treated for These Infections, Terrance MacGregor, MD, St. John Hospital 62. Does the Canadian Triage and Acuity Scale Correlate with Admission to the Hospital from the ED?, Julie Spence, MD, St. Michael's Hospital 63. Does ED Activity Level Affect Triage Categorization and Admission to the Hospital?, Julie Spence, MD, St. Michael's Hospital 64. Presenting Chief Complaint: Does Insurance Status Affect ED Evaluation?, Faber White, MD, Strong Memorial Hospital 65. Emergency Physician Time and Motion Study, Steven Friedman, MD, MPH, University Health Network 66. EMTALA: Two Decades Later, Dustin Ballard, MD, University of California, Davis 67. Impact of the San Diego Firestorm on ED Utilization, Brandon Backlund, MD, University of California, San Diego 68. Racial and Ethnic Variations in Hospital Admissions for the State of Maryland,

Administration: Balancing Supply and Demand 86. Reassessment of the Emergency Physician Workforce Demands, Adam Singer, MD, Stony Brook University 87. How Many ED Visits Are There?, Robin Weinick, PhD, Agency for Healthcare Research and Quality 88. Availability of Pediatric Emergency Visit Data from Existing Data Sources, Elizabeth Alpern, MD, Children's Hospital of Philadelphia 89. More Harm than Good? A Sensitivity Analysis to Determine Management of Severe Headache in the ED, Benjamin Friedman, MD, Albert Einstein College of Medicine

Research Design/Methodology/Statistics 90. Reliability of a Method for Measuring Benefit of Emergency Treatment, Jason Haukoos, MD, MS, Denver Health Medical Center 91. Publication Rates of SAEM Abstracts: 1997 and 1999-2001, Tom Umemoto, MD, Jacobi Medical Center 92. Do Randomized Trials Published in the Emergency Medicine Literature Meet a Strict Definition of Randomization, Lawrence Brown, MD, Upstate Medical University 93. Evaluation Methods for the Incident Command System in Disasters, Edbert Hsu, MD, MPH, Johns Hopkins University 94. Reassessing the Methods of Medical Record Review (MRR) Studies in, Ralph Bledsoe, MD, York Hospital 95. Answering Emergency Physicians’ Clinical Questions: Effectiveness of Six Evidence-based Internet Resources, Matthew Emery, MD, Grand Rapids MERC/ Michigan State University

Toxicology/Environmental Injury 96. Early Acetaminophen Toxicity Is Indepenent of NOS3-derived Nitric Oxide, Steven Salhanick, MD, Children's Hospital, Boston 97. Treating the Frostbitten Extremity -- How Often Do I Replace the Water Bath?, Natalie Radford, MD, Cook County Hospital

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Sunday, May 16, 2004 ❉98. Breath Alcohol Concentration, Bispectral Index, and a Standardized Scale as Predictors of Oberservation Time for Intoxicated Patients, Andrea Gaetz, Hennepin County Medical Center 99. Ecstasy’s Effects on In-vitro and Ex-vivo Oxidative Phosphorylation in Rodent Skeletal Muscle, Daniel Rusyniak, MD, Indiana University 100. Myocardial Injury Associated with Carbon Monoxide Poisoning Predicts Long Term Mortality, Christopher Henry, Minneapolis Heart Institute Foundation 101. Are Ambient Spring and Summer Ozone Levels Associated with Daily ED Seizure Visits?, Mark Mycyk, MD, Northwestern Univiversity 102. Use of Vasopressin in a Canine Model of Severe Verapamil Poisoning: A Pilot Study, Matthew Sztajnkrycer, MD, PhD, Mayo Clinic 103. Naloxone Does Not Reverse the Sedative Effects of Gamma-butyrolactone in a Rat Model of Severe Intoxication, Jason Chu, MD, St. Luke’s-Roosevelt Hospital Center/Columbia University 104. Effect of Haloperidol on Gamma-hydroxybutyrate (GHB) Withdrawal in an Animal Model, Theodore Bania, MD, St. Luke's-Roosevelt Hospital/Columbia University 105. Optimal Dosing Regimen to Produce Gamma-hydroxybutyrate (GHB) Withdrawal in an Animal Model, Mellanie O'Neil, MD, St. Luke's-Roosevelt Hospital/Columbia University 106. Gastric Pretreatment with Jimsonweed Does Not Increase Survival in Severe Organophosphate Toxicity, Andrew Stolbach, MD, St. Luke's-Roosevelt Hospital/Columbia University 107. Does Ethanol Intoxication Explain the Acidosis Commonly Seen in Minor Trauma Patients?, Lorenzo Paladino, MD, State University of New York, Downstate Medical Center/Kings County Hospital 108. Osmotic Activity of Ethanol in Plasma and Reconstituted Blood, Jeffrey Suchard, MD, University of California, Irvine 109. Ziprasidone Is Protective in an Animal Model of Acute Cocaine Poisoning, Nathan Cleveland, University of Colorado 110. Accuracy of Medication Histories in ED Patients, Tonya Vining, MD, University of Illinois 111. Concealed Potential Drug-drug Interactions in ED Patients, Matthew McKay, MD, University of Illinois, Peoria 112. Brain Functional MRI after Acute Organophosphate Poisoning, Steven Bird, MD, University of Massachusetts

116. Home Modification to Prevent Falls by Older ED Patients, Lowell Gerson, PhD, Northeastern Ohio Universities 117. EMS Resource Utilization by Elders with DNR or Terminal Status, Teresita Hogan, MD, Resurrection Medical Center 118. Studying the Assessment of Mental Status in Older ED Patients, Samuel Lofgren, MD, Summa Health System 119. Three Screening Tests for Cognitive Impairment in Older ED Patients, Scott Wilber, MD, Summa Health System/Northeastern Ohio Universities 120. The Natural History of Older ED Patients with Non-specific Abdominal Pain, Fredric Hustey, MD, The Cleveland Clinic Foundation

Geriatrics: Cardiovascular Disease in the Elderly 121. What Determines If Older Pateints Are Willing to Participate in Cardiac Arrest Studies?, Paul-Andre Abboud, MD, Denver Health 122. Cardiac Arrests in Skilled Nursing Facilities: Room for Improvement?, Manish Shah, MD, University of Rochester 123. Beta-blocker Use in Elderly ED Patients with AMI, David Vega, MD, York Hospital

MODERATED POSTERS

(5:00-6:00 pm)

Computers and the Web in the ED Moderator: Jonathan A. Handler, MD, Northwestern University 124. Prospective Validation of the MET-AP Clinical Decision Support System for Pediatric ED Triage of Acute Abdominal Pain, Ken Farion, MD, Children's Hospital of Eastern Ontario 125. Web-based Data Collection from ED Patients in Multiple Hospitals in Compliance with the Privacy Rule, Jeffrey Kline, MD, Carolinas Medical Center 126. ED Presence on the Internet, Robert Lavery, MA, MICP, New Jersey Medical School 127. Evaluation of Emergency Medical Text Processor, a System for Cleaning Chief Complaint Textual Data, Debbie Travers, PhD, RN, University of North Carolina

Gastrointestinal Bleeding Moderator: Charles V. Pollack, Jr., MA, MD, University of Pennsylvania 128. A Standardized Conjunctiva Pallor Tool Predicts Anemia, Marisa Stumpf, MD, Beth Israel Deaconess Medical Center 129. Gastrointestinal Bleeding Source Prediction in Patients without Hematemesis, Michael Witting, MD, MS, University of Maryland 130. The Utility of Gastric Lavage in Patients with Suspected Lower Gastrointestinal Bleed, Adam Barkin, MD, Beth Israel Deaconess Medical Center 131. The Evaluation of Gastric Contents in Patients Presenting to the ED with Bright Red Blood Per Rectum or Maroon Stools, Stacie Byers, DO, Albert Einstein Medical Center

Geriatrics 113. Age Has Little Effect on the Predictive Value of the CBC for Bacteremia, Richard Wolfe, MD, Beth Israel Deaconess Medical Center 114. Sentinel Events? Healthcare Utilization by Older Patients Following an Index ED Visit, Joshua Tamayo-Sarver, PhD, Case Western Reserve University 115. Excessive Daytime Sleepiness In Elderly Patients Who Present to the ED, David Barlas, MD, North Shore University Hospital

DIDACTIC SESSIONS process. At the completion of the session, participants will: 1) relate microskills of bedside teaching; 2) relate key elements of effective bedside teaching; 3) elaborate the concept of the learning vector, and its application to bedside teaching; and 4) explain several of the dynamics that occur over the course of a bedside teaching encounter, and options to manage them successfully.

Bedside Teaching in Emergency Medicine – An Interactive Workshop (9:30-11:00 am) Louis Binder, MD, Case Western Reserve University Harold Thomas, MD, Oregon Health & Science University The process of effective bedside teaching is complex, and varies with changes in logistics, available time, content, and expertise of the learner. Mastery of this process is essential to improving one's teaching skill and reputation as an EM educator; however, these skills are uncommonly explicitly identified or demonstrated. The speakers possess an extensive background and successful track record in bedside teaching in the ED setting. This session will focus on the content, framing, and skills necessary to succeed in bedside teaching, and the dynamics of adjusting the approach based on variations in the teaching setting. Course format will utilize a combination of 1) audience questions and input regarding their specific challenges in bedside teaching as the basis for emphasizing basic concepts; 2) use of videotaped bedside teaching encounters as vignettes to demonstrate techniques and stimulate discussion; and 3) present a conceptual framework and techniques for procedural teaching at the bedside. Time and attention will be given to elucidating participants' concerns and challenges in the bedside teaching

State-of-the-Art: Ventilatory Management in Resuscitation: Helpful or Harmful? (9:30-10:30 am) Moderator: Paul Pepe, MD, MPH, University of Texas Southwestern Arthur B. Sanders, MD, University of Arizona Tom Aufderheide, MD, Medical College of Wisconsin Most providers of emergency care, both in-hospital and out-of-hospital, often lack a fundamental understanding of the unique aspects of ventilatory physiology during circulatory arrest and/or compromise. In fact, texts and guidelines for emergency respiratory care traditionally have been somewhat generic, generally avoiding specific discussions of tidal volumes, frequency, and inspiratory times. Instead, most have loosely (and inappropriately) emphasized “hyperventilation”, as a method for “enhancing oxygenation”

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Sunday, May 16, 2004 Lunch Session: Improving Journal Club through Structured Critical Appraisal, Innovative Educational Formats and Bedside Application

and “compensating for metabolic acidosis”. However, recent experimental and clinical research in both cardiac arrest and trauma have increasingly begun to demonstrate the detrimental effects of current ventilatory techniques and have also delineated why these common (but inappropriate) techniques can become a critical confounding variable in resuscitation research. The purpose of this session is to review the physiology of ventilation in the special circumstances of circulatory arrest and/or circulatory compromise and then describe how both basic and advanced ventilatory techniques can be life-saving if used properly), but can also be detrimental when traditional training techniques are followed, and especially if followed too zealously. The speakers will conclude with updated recommendations for the management of both cardiac and trauma resuscitation and will also review priorities for research in this rapidly evolving focus of life-saving investigation (followed by audience discussion and Q and A). At the completion of the session, participants will: 1) understand the differences in ventilatory techniques used during normal hemodynamic conditions versus those required during circulatory arrest/compromise; 2) appreciate the potential detrimental effects of ventilatory techniques commonly used by emergency care providers for cases of cardiac and trauma resuscitation; 3) recognize the rationale and appropriate circumstances for recommended ventilatory strategies/adjuncts, both basic and advanced; 4) learn improved strategies for delivering appropriate ventilatory techniques during cardiac and trauma resuscitation research; and 5) appreciate the immediate and longterm research needs in the field of ventilatory management for Emergency Medicine academicians.

(12:00 Noon-1:30 pm) Eddy Lang, MD, McGill University Barney Eskin, MD, Morristown Memorial Hospital Peter Wyer, MD, New York Presbyterian Medical Center While perceived to be an integral and important component of most if not all residency programs, traditional journal clubs often fail to intersect the domain of clinical decision making during patient care. Journal club sessions are also frequently dominated by a culture of “article bashing”. Thus, journal club sessions often fall short in teaching “critical appraisal” i.e. the skills necessary to discern and apply research evidence that informs and impacts one’s practice. This session will examine the scope of the problem as it pertains to Emergency Medicine journal club, and provide participants with practical strategies related to both content and format that address them. With regard to journal club content, participants will be shown how to: 1) anchor the journal club exercise to a clinical context, as a means of enhancing bedside application of the lessons acquired, thus exemplifying components of “practice-based learning” 2) move from a clinical scenario to formulation of an answerable clinical question, hence providing a problem solving focus for examining articles about therapy, diagnosis, prognosis and/or harm; 3) select best evidence; and 4) select and utilize resources for performing structured critical appraisal. With regard to journal club format, the following will be covered: 1) setting educational objectives for journal club; 2) teaching tips for critical appraisal skills; 3) role playing and other approaches to understanding applicability; and 4) additional strategies for transferring journal club lessons to the bedside. At the completion of the session, participants will be armed with strategies and tips that will enable them to introduce innovative and valuable modifications to journal club in their own programs.

Pre-registration and registration fee required.

Exploring and Analyzing Survey Data (10:30 am - 12:00 noon) Lynne Richardson, MD, Mt. Sinai Medical Center Deborah Fish Ragin, PhD, Montclair State University So much data, so little time! This sentiment is common among researchers who use surveys as their principal data collection tool, especially those new to research. Surveys commonly contain Likert-scale and multiple response questions that may yield large numbers of variables. Even if investigators avoid all of the potential pitfalls in the instrument design phase, they are often faced with an overwhelming volume of data to manage, clean and analyze. A common problem encountered by researchers who have successfully collected a large number of responses is how to select or consolidate variables in order to conduct meaningful data analysis and report useful findings. This session will help researchers to make sense of their data by using data reduction techniques, such as factor analysis and correlational analysis to consolidate variables, thereby building stronger, more robust measures. Participants will learn when to use and how to apply these data reduction techniques as a first step in the data analysis process. The workshop will demonstrate how to test these newly created variables and determine whether they are valid measures of the targeted construct. Finally, the presenters will demonstrate how to apply these techniques in subsequent analyses using examples from the multi-site national database they compiled for a study of emergency department utilization in 28 hospitals in the U.S. At the completion of the session, participants will: 1) know when and how to perform data reduction techniques including factor analysis and correlational analysis; 2) know how to select variables to be consolidated based on the outcomes of the data reduction techniques; 3) know how to assess the validity of the new consolidated variables; and 4) understand how the construction of consolidated variables can yield more robust measures for further analysis.

Lunch Session: Parenting and Promotion (12:00-1:30 pm) Moderator: Latha Stead, MD, Mayo Clinic William G. Barsan, MD, University of Michigan Robert McNamara, MD, Temple University Rita K. Cydulka, MD, MetroHealth Medical Center Each panelist will give an introduction then address one of the following topics: 1) STRATEGIES FOR CHILD/ELDERCARE How do you balance family and parenting with the demands of academic productivity? • What kind of strategies/personal anecdotes have helped you balance both? • Scheduling: ask for same days off as spouse to have some family time or opposite days to maximize parenting coverage? • Timing of family with academic career 2) INVOLVING YOUR FAMILY IN YOUR CAREER • Teaching traffic and helmet safety at your kids’ school • Being the doctor for your kids’ soccer games • Take them to work? 3) DEPARTMENTAL ADMINISTRATION • Review of family leave policies • Does your department have any creative resources for those with small children or special family needs? • As a senior faculty, how do you accommodate your staff’s parenting and family needs? • Can you address the perceptions and realities of parents “falling behind” on the academic ladder? ALL PANELISTS WILL ADDRESS: How has being a parent affected your path to promotion, choice of academic activities, position in the department? At the completion of the session, participants will: 1) Obtain a perspective on the role family issues play in the development of one’s academic career 2) Have positive role models of successful academic emergency physicians who have succeeded in their personal life as well. Pre-registration and registration fee required.

Educational Research Track: The Current State of Medical Education Research (11:00 am - 12:00 noon) Larry Gruppen, PhD, University of Michigan This session will provide an introduction to the current status of medical education research. A brief overview of the history of medical education research and topics that are currently important will be described. The unique characteristics of this type of research will be addressed. This introductory lecture will provide a context for how EM can fit into the realm of educational research in the present and in the future. The Educational Research Track is a three-year, longitudinal, comprehensive curriculum designed to provide a foundation for aspiring and established educational researchers in EM in the conduction of medical education (graduate or undergraduate) research. This track will help SAEM members develop a strong theoretical and practical knowledge base in educational research methodologies and advance the state of this type of research within the specialty to meet the highest standard. At the completion of the session, participants will be able to: 1) describe important historical information about research in medical education; 2) list several topics that are currently important in medical education research; and 3) understand the role of the EM researcher in advancing the state of education research in EM.

Lunch Session: The Need and Development of a Standardized Disaster Medicine Training Program (12:00 Noon-1:30 pm) Richard B. Schwartz, MD, Medical College of Georgia James J. James, MD, DrPH, MHA, The American Medical Association Howard A. Zucker, MD, JD, U.S. Department of Health and Human Services Paul E. Pepe, MD, MPH, University of Texas Southwestern After fall 2001, demands for interoperable all-hazards disaster training courses consistent with public safety, public health, federal and military initiatives dramatically increased. A CDC Specialty Center for Public Health Emergency Preparedness (CLEARMADD) was charged with the assimilation of existing disaster medicine courses into a consensus-based standardized course under a CDC-managed, federal appropriation. A broad consortium of academic, state, and federal organizations, the National Disaster Life Support Education Consortium (NDLSEC), was established to meet this need.

Advanced Disaster Life Support (ADLS) and an evolving family of related basic and core courses have now been developed and piloted. The American Medical Association has taken the lead in developing these courses in collaboration with the U.S. Department of

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Sunday, May 16, 2004 approximately 13% of their total training weeks on pediatric rotations. To complicate matters, critically ill and injured children and the accompanying procedures are infrequently encountered. Studies indicate that retention of knowledge and procedural skill proficiency seems to be enhanced by experience and exposure to real-life encounters.

Thus to be adequately prepared for these encounters, emergency physicians need appropriate educational exposure. To date, this has not been fully elucidated.

Furthermore, means of measuring outcomes is as equally elusive. The panel will discuss the literature available on education in pediatric emergency medicine, suggest minimum competencies for education in pediatric emergency medicine, describe educational modalities and address further research questions. At the end of this session, participants will: 1) comprehend the data on educational experiences and exposure to critically ill or injured children; 2) understand the concept of “commonality of thought process” and how it applies to pediatric emergency medicine exposure; 3) identify the various educational models and standardized pediatric emergency medicine curriculum; and 4) recognize the need for further research in the area of pediatric emergency medicine education.

Health and Human Services (DHHS) along with the U.S. Army and other key federal agencies and professional organizations. SAEM members and national leaders will review the background, scientific basis and methodology for this federally-funded initiative, what it took collaboratively (and politically) to complete the assignment, and then outline its tremendous public service potential. In turn, its value to the reputation and national influence of academic EM will be discussed as will be the limitations, the requirements for modifications, and how SAEM members can and will play a key role in this successful, evolving project. At the completion of the session, participants will: 1) understand the need for nationally-recognized, consensus-based, accredited training courses in order to better prepare primary care providers, public health, public safety and emergency/critical care personnel for all-hazards disaster management, particularly in terms of weapons of mass effect; 2) appreciate the need for a course that has its roots in a consortium of emergency medicine-based academicians as well as other governmentalbased organizations, ranging from the U.S. Military and the U.S. DHHS to the U.S. Departments of Justice, Homeland Security and other related entities; 3) appreciate the scientific basis for the content of the course and the limitations of the literature in disaster medicine; and 4) recognize the steps and methodologies taken (and that still need to be taken) to establish such an undertaking, both collaboratively, as well as politically.

Pre-registration and registration fee required.

Bench to Bedside: How Cutting Edge Molecular Diagnostic Tools are Being Developed for Diagnosis and Management of Infectious Diseases (2:30-4:00 pm)

Becoming a Leader in the Medical School Dean’s Office (1:30-2:30 pm)

Moderator: Richard Rothman, MD, Johns Hopkins University Gregory Moran, MD, UCLA John G. Younger, MD, MS, University of Michigan Gabor D. Kelen, Johns Hopkins University Maulik Majmuder, BS, Northwestern University Significant gaps currently exist between sophisticated advances in biotechnology, and the day-to-day practice of emergency medicine. This session will focus on understanding how ‘translational’ researchers are beginning to bridge this divide by: 1) designing and refining novel molecular diagnostics in the laboratory; and, 2) ‘field’ testing these assays, to both improve understanding of disease pathogenesis/epidemiology, and expedite recognition and management of existing and emerging (e.g. bioterrorist) infectious disease threats. The goals of the session are to provide examples of 1) how a particular molecular tool (platform) is chosen; 2) how different researchers conduct basic experiments to advance the platforms for clinical application and; 3) how the platforms are evaluated in clinical settings. Towards these goals four investigative teams will discuss their research programs, each providing examples and highlights of the strengths and weaknesses of various techniques as well as the successes, failures and visions for bringing them to bear for clinical purposes. Dr. Younger will discuss his work on targeted mutagenesis and transposon mutagenesis for understanding bacterial pathogenesis; Dr. Rothman will describe PCR technologies focusing on technical obstacles and recent advances made for purposes of developing rapid diagnostics; Dr. Moran will describe collaborative investigations using genomic expression systems which rely on mRNA gene expression platforms; lastly, Dr Kelen will highlight how novel diagnostic platforms (which are more developmentally advanced) have been used for epidemiologic surveillance and disease detection; here discussion will focus on institutional and regulatory steps required for evaluating novel diagnostics in ED settings. At the completion of the session, participants will: 1) better understand some of the basic language, techniques and principles associated with evolving molecular techniques for infectious diseases; 2) understand how an EM translational researcher selects a technique or research platform; 3) appreciate some of the recent advances (and their potential applications), which have been made by several translational EM researchers; 4) recognize some common problems encountered in bench-to-bedside research and how to overcome them; and 5) appreciate potential future applications of molecular advances for understanding epidemiology, path physiology, diagnosis and management of infectious diseases in the ED.

Brian Zink, MD, University of Michigan Vincent Verdile, MD, Albany Medical College John Prescott, MD, West Virginia University David Sklar, MD, University of New Mexico Katherine Heilpern, MD, Emory University This will be a panel discussion of six deans presenting on the following areas: 1) maneuvering into a Dean’s position; 2) what the daily work is like; 3) challenges and rewards; and 4) serving in two worlds - Dean’s office and emergency medicine. At the completion of the session, participants will have an improved understanding of the types of opportunities, qualifications, daily work, challenges, and benefits of serving in a Dean position in a medical school. Attendees will be provided time to discuss their interests and direct questions to the Deans.

Introduction to Statistics (1:30-2:30 pm) Roger J. Lewis, MD, PhD, Harbor-UCLA This session will cover introductory statistical topics such as data types, common statistical tests and their application, the meaning of p values and confidence intervals, and simple sample size and power calculations. An investigator with a firm understanding of these concepts is better equipped to plan a sound research study, develop testable hypotheses, choose appropriate analytic methods, and determine the feasibility of performing a study in a given population and setting. Issues surrounding multiple testing, subgroup analysis, and the intention-to-treat principle will also be discussed. At the completion of the session, participants will have a sufficient understanding of statistical concepts and methods to effectively collaborate with more experienced researchers and biostatisticians on the design and analysis of a clinical research study.

Educational Challenges for Training in Pediatric Emergency Medicine (2:30-4:00 pm) Jill Baren, MD, University of Pennsylvania Gregg Garra, MD, State University of New York at Stony Brook Norman Christopher, MD, Children’s Hospital Medical Center/Akron Educational and experiential dilution is a real problem for housestaff requiring exposure to pediatric injury and illness. A previous study determined that EM residents spend

CPC Submission and Acceptance History 2004 85 cases submitted 60 cases accepted

2003 80 cases submitted 50 cases accepted 15

2002 81 cases submitted 50 cases accepted

Monday, May 17, 2004

SCIENTIFIC PAPERS ❉ 152. A Novel Method of Evaluating the Impact of Secondary Brain Insults on Functional Outcomes, Christopher Barton, MD, University of California, San Francisco 153. Missed Diagnosis of Subarachnoid Hemorrhage in the ED: A Population-based Analysis, Michael Schull, MD, MSc, Institute for Clinical Evaluative Sciences ❉ 309. Microscopic Imaging of Recombinant Tissue Plasminogen Activator Thrombolysis with 120 kHz Ultrasound in an In-vitro Human Clot Model, George Shaw, MD, PhD, University of Cincinnati 155. Use of Cell Count and Differential to Identify Patients with Low Risk for Bacterial Meningitis, Melissa Burkhart, MD, Christiana Care Health System

ORAL PAPER PRESENTATIONS Education in EM (8:00-9:00 am) Moderator: Gregory Garra, DO, Stony Brook University 132. Evaluation of a Dedicated Teaching Shift Involving Direct Bedside Observation of Trainees by Attending Staff, Mohammad Alam, MD, SMBD Jewish General Hospital 133. The Development of the Affective Competency Score to Assess Communication in an Standardized Patient Exercise, Tammie Quest, MD, Emory University 134. Reliability of a Visual Analog Scale in Measuring Resident Competency Skills, Marc Haber, MD, Jacobi Medical Center 135. Teaching Medical Students Arterial Blood Gas Sampling Using Ultrasound, Dan Price, MD, Alameda County Medical Center

Reducing Pain and Discomfort (10:00 am-Noon) Moderator: Knox H. Todd, MD, MPH, Emory University ❉ 156. Moderate vs Deep Procedural Sedation for Fracture and Dislocation Reduction in the ED, James Miner, MD, Hennepin County Medical Center ❉ 157. Comparison of Efficacy and Adverse Events of Intravenous Ketorolac and Parenteral Morphine Alone and in Combination in the Treatment of Acute Renal Colic, Basmah Safdar, MD, Yale University 158. A Comparison of Ketamine/Midazolam and Nitrous Oxide/Hematoma Block for Forearm Fracture Reduction in Children, Jan Luhmann, MD, Washington University 159. Does End-tidal Carbon Dioxide Monitoring Improve Standard Practice for Predicting Clinically Important Adverse Respiratory Events During ED Procedural Sedation and Analgesia?, John Burton, MD, Maine Medical Center 160. Demographic Assessment of Pain Relief in the ED, James R. Miner, MD, Hennepin County Medical Center 161. Comparison of Valdecoxib and an Oxycodone Acetaminophen Combination for Acute Musculoskeletal Pain in the ED: A Randomized Controlled Trial, Adam Singer, MD, Stony Brook University

Ischemia-Reperfusion (8:00-9:00 am) Moderator: Robert W. Neumar, MD, PhD, University of Pennsylvania 136. Post-resucitative Hyperoxia Increases Hippocampal Oxidative Injury and Cell Death Following Experimental Cardiac Arrest, Robert Rosenthal, MD, University of Maryland 137. Identification of Novel Biochemical Markers for Ischemic Neurodegeneration, Alexander Pitts-Kiefer, BA, University of Pennsylvania ❉ 138. Oxygen Delivery Modulates Intracellular Hydrogen Peroxide Generation During Initial Reperfusion of the Isolated Ischemic Rat Heart, Jason Stoner, MD, Ohio State University ❉ 139. Combination of Isoflurane and an Extrinsic Caspase Pathway Inhibitor Results in Sustained Neuroprotection in Rats Subject to Focal Cerebral Ischemia, Daniel Davis, MD, University of California, San Diego

Professional Development (9:00-10:00 am) Moderator: Sandra Schneider, MD, University of Rochester 140. Career Satisfaction in Emergency Medicine: The ABEM Longitudinal Study of Emergency Physicians, Rita Cydulka, MD, MS, MetroHealth Medical CenterCase Western Reserve University 141. Effect of Shift Work on Performance in the ED: Relationship Between Time of Day and ED Quality Markers, Robert Silbergleit, MD, University of Michigan 142. Publication Rates in Emergency Medicine: A Comparison among Specialties, Moira Davenport, MD, New York University, Bellevue 143. Attitudes and Opinions of Under-represented Minority Medical Students Regarding Emergency Medicine as a Potential Future Career Choice, Glenn Hamilton, MD, MSM, Wright State University

POSTER SESSION (Noon-2:00 pm) Renal Colic 162. A Double Blind, Randomized Clinical Trial Evaluating the Use of Glycopyrrolate vs Ketorolac for the ED Treatment of Ureteral Colic, L. Albert Villarin, Jr., MD, Albert Einstein Medical Center 163. Does Degree of Initial Visual Analogue Scale (VAS) Scores in Patients with Renal Colic Correlate with Degree of Hydronephrosis or Kidney Stone Size?, Stacy Kesten, MD, North Shore University Hospital

Establishing the Airway

Overcrowding (9:00-10:00 am)

164. Experienced Emergency Physicians Cannot Safely or Accurately Inflate Endotracheal Tube Cuffs or Estimate Endotracheal Tube Cuff Pressure Using Standard Technique, Robert Hoffman, MD, Beth Israel Medical Center 165. National Emergency Airway Registry (NEAR III): An Initial Report of 3,342 ED Intubations, Calvin Brown, MD, Brigham and Women's Hospital 166. Ultrasound as a Tool to Confirm Tracheal Intubation, Alix Rosenstein, MD, MetroHealth Medical Center/Case Western Reserve University 167. Confirming the Location of Previously Placed Tracheal Tubes by Direct Laryngoscopy, William Levin, MD, New York Medical College/Metropolitan Hospital 168. The Use of Field Glasgow Coma Scale to Screen Severely Head-injured Patients to Undergo Paramedic Rapid Sequence Intubation, Daniel Davis, MD, University of California, San Diego ❉ 169. A Randomized Controlled Trial Comparing the Efficacy of Training Paramedic Students Endotracheal Intubation on a Patient Simulator vs Human Subjects, Robert Hall, BSc, MD, University of Calgary 170. Etomidate-based Rapid Sequence Intubation Does Not Change Intracranial Pressure and Brain Tissue Oxygenation: Evolution of a Swine Model, William Bozeman, MD, Wake Forest University

Moderator: David Cone, MD, Yale University ❉ 144. Is This Emergency Department Crowded? A Multicenter Derivation and Evaluation of an ED Crowding Scale (EDCS), Brent Asplin, MD, MPH, Regions Hospital and HealthPartners Research Foundation 145. Development of an ED Workscore to Predict Ambulance Diversion, Stephen Epstein, MD, MPP, Beth Israel Deaconess Medical Center 146. Correllation of Patients Who Leave without Being Seen to the Degree of ED Overcrowding in an Academic Medical Center, Richard King, University of California, Davis 147. Impact of a Rapid ED Entry and an Accelerated Care Initiative on Patient Wait Times and Length of Stay, Theodore Chan, MD, University of California, San Diego

Psychiatric Issues in EM (10:00-11:00 am) Moderator: Michelle Blanda, MD, Summa Health System 148. The Brief Psychiatric Rating Scale Accurately Predicts the Need for In-patient Treatment of Non-suicidal Psychiatric Patients in the ED, Timothy Jang, MD, Washington University 149. Towards Better Written Discharge Information: Health Literacy and the Comprehension of Head Injury Advice Sheets in a New Zealand ED, Kim Yates, MBChB, MMedSc, North Shore Hospital, New Zealand 150. Psychiatric Comorbidity in Victims of Intimate Partner Violence in a Multiethnic ED Population, Gregory Larkin, MD, MSPH, University of Texas, Southwestern 151. Trends in U.S. ED Visits for Mental Health, 1992-2001, Gregory Larkin, MD, MSPH, University of Texas, Southwestern

Procedural Sedation 171. Systemic Bioavailability of Nebulized Ketamine, Robert Hoffman, MD, Beth Israel Medical Center 172. Procedural Sedation of Critically Ill Patients in the ED, James Miner, MD, Hennepin County Medical Center 173. Bispectral Index to Monitor the Depth of ED Sedation with Propofol, William Hauter, MD, Indiana University 174. Ketamine, Adolescents, and the Emergence Phenomenon, Lance Brown, MD, MPH, Loma Linda University and Children's Hospital

Neurology (11:00 am-12:00 noon) Moderator: Arthur M. Pancioli, MD, University of Cincinnati

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Monday, May 17, 2004 201. ACE Inhibitors in Acutely Decompensated Congestive Heart Failure, John Southall, MD, Washington University 202. Cardiac Events in New Jersey after the September 11, 2001 Terrorist Attack, John Allegra, MD, PhD, Morristown Memorial Hospital 203. Optimal Two-hour Cardiac Marker Strategies to Identify Low Risk Patients Not Requiring Chest Pain Unit Evaluation, Grant Innes, MD, St. Paul's Hospital, Vancouver, Canada 204. Point-of-care Testing Reduces Length of Stay in Chest Pain Patients, Joshua Ardise, MD, Stony Brook University 205. ED Multimarker Point-of-care Testing Reduces Time to Cardiac Marker Results without Loss of Diagnostic Accuracy, Alan Storrow, MD, University of Cincinnati

175. A Direct Comparison of Etomidate and Midazolam During Procedural Sedation, Cameron Bobbett, MD, University of Florida Health Science Center/Jacksonville

Pain Management 176. Ultrasound with Topical Anesthetic Rapidly Decreases the Pain of Intravenous Sticks in the ED, Bruce Becker, MD, MPH, Brown University 177. Opiate Analgesia Makes No Difference in the Diagnostic Accuracy of Undifferentiated Acute Abdominal Pain in the ED: A Meta-analysis, Barbara Lock, MD, New York Presbyterian Hospital, Columbia University 178. Self Administered Morphine Algorithm in an ED Observation Unit, Aurelie Brana, MD, Hopital Leon Touhladjian Poissy France 179. Nurse-initiated, Titrated Intravenous Narcotic Analgesia Reduces Time to Analgesia for Selected Painful Conditions, Anne-Maree Kelly, MD, Joseph Epstein Centre for Emergency Medicine Research 180. Factors Effecting Pain Scores During Female Urethral Catheterization, Paula Tanabe, PhD, RN, Northwestern University 181. Administering NSAIDs Before vs After Exercise Offers No Benefit, Jaron Goldberg, MD, St. Luke's Hospital 182. Comparison of Oxycodone and Hydrocodone for Treatment of Acute Pain Associated with Fractures: A Double Blinded Randomized Controlled Trial, Catherine Marco, MD, St. Vincent Mercy Medical Center 183. A Novel Pain Management Protocol Results in More Rapid Analgesia for Trauma Patients, Cecily Reynolds, MS, Dartmouth-Hitchcock Medical Center

Cardiovascular Disease: Risk Stratification 206. Limiting Testing in Low Risk Chest Pain: What Tests Are Necessary to "Rule Out" Acute Ischemia?, Shamai Grossman, MD, MS, Beth Israel Deaconess Medical Center/Harvard Medical School 207. Troponin I: Clinical Effect of an Ambiguous Diagnostic Cutoff, Daniel Waxman, MD, Beth Israel Medical Center, Albert Einstein College of Medicine 208. Physician Evaluation of Risk Factors for Acute Coronary Syndrome and Myocardial Infarction among ED Patients with Chest Pain, Thea James, MD, Boston University 209. Risk Stratification Using Cardiac Troponins: Analysis of Outcomes Derived from the Literature, Mary King, BM, Johns Hopkins University 210. Changes in Serial Cardiac Troponin T Measurements Are Associated with Adverse Cardiac Events in Patients with Chronic Kidney Disease, Jin Han, MD, University of Cincinnati 211. Changes in Cardiac Troponin T Measured Between ED Visits Are Associated with Adverse Cardiac Events in Patients with Chronic Kidney Disease, Jin Han, MD, University of Cincinnati 212. Assessment of the Standardized Reporting Guidelines Electrocardiogram Classification System: The Presenting Electrocardiogram Predicts 30 Day Outcomes, Keara Sease, MAEd, University of Pennsylvania 213. Validation of a Clinical Decision Rule for Young Adult Chest Pain Patients, Robert Marsan, Jr., BS, University of Pennsylvania 214. Validation of the ACI-TIPI Score in Asian Patients with Chest Pain, Chadwick Miller, MD, Wake Forest University

Education/Professional Development 184. Comparison of EM Resident Productivity to Academic Performance on the ABEM In-training Examination, Mark Moseley, MD, MHA, Christiana Care Health System 185. Defining the Position of the Emergency Ultrasound Director: A National Survey of Academic Ultrasound Directors from EM Residency Programs, Paul Sierzenski, MD, RDMS, Christiana Care Health System 186. EM Sub-internship - Does a Standard Clinical Experience Improve Performance Outcomes?, Christopher Lampe, MD, Harbor-UCLA 187. Utilization of Personal Digital Assistants (PDA) by EM and Pediatric Residents, Rajesh Geria, MD, Maimonides Medical Center 188. An EM Elective Course Offered to Pre-clinical Medical Students Is an Effective Adjunct Teaching Method Improving Competence in the Ability to Understand and Integrate Basic Science into the Practice of Clinical Medicine, Dana Stearns, MD, Massachusetts General Hospital 189. Assessing Communication as a Competency Using a Modified Norton Scale, Earl Reisdorff, MD, Michigan State University 190. Academic Success of Women Physicians in EM in Comparison to Other Specialties as Represented by Involvement on Journal Editorial Boards, Beverly Bauman, MD, Oregon Health & Sciences University 191. Oral Board vs High Fidelity Simulation for Competency Assessment: Senior EM Resident Management of an Acute Coronary Syndrome, Deborah Gutman, MD, MPH, Rhode Island Hospital 192. Procedural Observation of Medical Students: Is There a Relationship Between Direct Observation and Procedural Instruction and Assistance ?, David Wald, DO, Temple University 193. Written Documentation of the Chest Pain History by Fourth Year Medical Students Using a Simulated ED Patient Encounter, David Wald, DO, Temple University 194. Differences Between Patient and Staff Expectations for Quality Service: An Opportunity to Improve Professionalism in the ED, C Hamrick, MD, University of North Carolina 195. Honesty in Applicants for EM Residents: Can We Affect Behavior?, Eric Katz, MD, Washington University in St. Louis

Cardiovascular Disease: Gender and the Heart 215. Risk Factors for Acute Myocardial Infarction in Young Women, Leroy Nickles, MD, York Hospital 216. Gender and Age Are Factors in Diagnostic Cardiac Catheterization in Patients Who Present with Acute Coronary Syndrome to the ED, Jean Ayan, RN, North Shore University Hospital 217. Influence of Gender on Cocaine and Methamphetamine Screening in Chest Pain Patients, Deborah Diercks, MD, University of California, Davis 218. Evaluation of a Multifaceted, Community-based Educational Program to Promote Cardiovascular Health in Women, Gail D'Onofrio, MD, MS, Yale University

Cardiovascular Disease: Back to the Basics: The H&P 219. Using the Electrocardiogram and the Fourth Heart Sound to Diagnose Acute MI in the ED, Robert Warner, MD, Inovise Medical, Inc. 220. Prognosis of Patients Discharged from the ED with Asymptomatic Hypertension, Katherine Miao, MD, Jacobi Medical Center 221. Does Accuracy of Patient History Vary with Question Type and What Do Residents Ask?, David Salo, MD, PhD, Newark Beth Israel Medical Center 222. Characterization of Untreated Blood Pressure in the ED, Lawrence Deluca, EdD, University of Miami 223. Elevated Blood Pressure in ED Patients: Characteristics, Management, and Short-term Follow-up, David Karras, MD, Temple University 224. Chest Pain and History of GERD: Not a Low Risk Condition, Jennifer Deyo, BS, University of Pennsylvania

Cardiovascular Disease 196. Is HIV Status a Risk Factor for Intracranial Hemorrhage in Patients Receiving Thrombolytic Therapy for Acute Myocardial Infarction?, Jill Griffin, MD, Baystate Medical Center 197. Pretreatment Magnesium for Ibutilide Induced Ventricular Tachycardia, Scott Corcoran, MD, Baystate Medical Center 198. Adenosine for Wide-complex Tachycardia: Efficacy and Safety, Keith Marill, MD, Harvard Medical School 154. Optical Mapping Reveals Mechanisms of Drug-induced Proarrhythmia in Heart Failure, Lance Wilson, MD, MetroHealth Medical Center 199. A Comparison of the New vs the Traditional Definition of Acute Myocardial Infarction, John Nagurney, MD, MPH, Harvard Medical School 200. Evolving Patterns of Care for Decompensated Heart Failure: Implications from the ADHERE Registry Database, W Peacock, MD, The Cleveland Clinic

Trauma 225. Categorization of Rural Trauma Centers, Melanie Arthur, PhD, Portland State University 226. How Does Obesity Affect Hospital Outcomes of Traumatically Injured Patients?, Philip Salen, MD, St. Lukes Hospital â?‰ 227. The Effect of Non-insulin Dependent Diabetes Mellitus on Uncontrolled Hemorrhage in a Rodent Model, David Finkelstein, MD, State University of New York, Downstate/Kings County Hospital 228. The Operating Characteristics of Vital Signs and Metabolic Parameters in Detecting Major Injury in Trauma Patients, Todd Anderson, MD, State University of New York, Downstate/Kings County Hospital

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Monday, May 17, 2004 Care of the Critically Ill Patient

229. Investigating the Impact of Lowering the Injury Severity Score Cutoff for Major Trauma in Pediatrics, Brian Rowe, MD, University of Alberta 230. Reliabilty of the Abdominal Examination in Blunt Trauma Patients with Minor Head Injury, James Holmes, MD, MPH, University of California, Davis 231. Admission Hypothermia Is Associated with Adverse Outcomes after Trauma, Clifton Callaway, MD, PhD, University of Pittsburgh 232. All Terrain Vehicle Related Traumatic Brain Injuries in the US, Madelyn Garcia, MD, University of Rochester 233. Uterine Trauma Following Motor Vehicle Crashes With Airbag Deployment: A 30case Series, Jean Abbott, MD, University of Colorado

246. The Implementation of a Sepsis Team: A Preliminary Report, Nathan Shapiro, MD, MPH, Beth Israel Medical Center 247. Effects of Esophageal Doppler Measurement of Hemodynamic Parameters on Physician Assessment and Management of Critically Ill ED Patients, Michael Lum Lung, MD, Highland General Hospital 248. Sonographic Measurement of Cross-sectional Area of Right Internal Jugular Vein Distention Comparing Trendelenburg and Valsalva Maneuvers, Gary Quick, MD, Oklahoma Heart Hospital 249. Time to Shock Data among Various Levels of Care at an Urban Trauma Center in Philadelphia, Jonathan McGhee, BS, MAT, Philadelphia College of Osteopathic Medicine 250. Transpulmonary Thermodilution Cardiac Output and Pulse Contour Analysis Continuous Cardiac Output in a Swine Model of Severe Hemorrhagic Shock: Comparison with Pulmonary Artery Cardiac Output, James Manning, MD, University of North Carolina, Chapel Hill

Trauma: Trauma and Head Injury 234. An Analysis of Maximum G Forces and Brain Injury in Automotive Racing Crashes, Christopher Weaver, MD, Indiana University 235. Serum Neuron-specific Enolase as Predictor of Short-term Outcome in Children with Closed Traumatic Brain Injury, Subhankar Bandyopadhyay, MD, Medical College of Wisconsin 236. Comparison of Clinical Suspicion vs. a Decision Rule for Identifying Children with Very Low Likelihood of Brain Injury after Blunt Head Trauma, James Holmes, MD, University of California, Davis 237. Detection of Alpha-II Spectrin and Breakdown Products in Humans after Severe Traumatic Brain Injury, Linda Papa, MD, CM, MSc, University of Florida 238. Predicting Post Concussion Syndrome after Mild Traumatic Brain Injury Using Serum S100b and Cleaved-tau, Jeffrey Bazarian, MD, MPH, University of Rochester 239. Clinical Predictors of Intracranial Injury in Admitted Pediatric Trauma Patients, Matthew Spencer, MD, University of Rochester 240. Use of a Geographic Information System to Identify Clusters of Traumatic Brain Injuries, E. Brooke Lerner, PhD, University of Rochester

MODERATED POSTERS (1:00-2:00 pm) Managing Accelerated Hypertension in the ED Moderator: Arthur B. Sanders, MD, University of Arizona 251. The HyperNet Multi-center Investigation of Elevated Blood Pressure (BP) and Its Association to Barriers to Care (BTC), Marlena Wald, MLS, MPH, Emory University 252. The Natural Course of Blood Pressure Elevation Found in the ED, Maryam Sadeghi, BS, Albany Medical College 253. Missed Referral Opportunities for Emergency Patients with Stage 3 Hypertension (Blood Pressure > 180/110), Adrian Langley, MD, Wake Forest University 254. Headache and Hypertension - Is There an Association?, William Chiang, MD, Bellevue Hospital Center

Trauma: Trauma and Quality of Life 241. What Is the Health-related Quality of Life after Trauma? A Longitudinal Analysis of the OPALS Study, Ella Huszti, MSc, University of Ottawa 242. Functional Profiles of ED Patients Sustaining Minor Injury, Keara Sease, MAEd, University of Pennsylvania

Updates in Cricothyrotomy Moderator: Ron M. Walls, MD, Brigham and Women's Hospital 255. Resident Competency in Cricothyroidotomy Can Be Verified after a Brief Didactic and Laboratory Instruction Emphasizing Critical Actions, Christopher Stromski, MD, St. Luke's Hospital 256. Handheld Ultrasonography for the Localization of the Cricothryoid Membrane, William Levin, MD, New York Medical College/Metropolitan Hospital 257. Comparison of Wire-guided Cricothyrotomy Technique with and without Balloon Cuffed Endotracheal Tubes vs Standard Surgical Cricothyrotomy, Raj Patel, MD, University of California, San Diego 258. Surgical Airways in ED Patients: A Report of 75 Cases from the National Emergency Airway Registry (II), John Collins, MD, Brigham and Women's Hospital

Trauma: Trauma and Wounds 243. Increased Expression of Growth Factor Receptors in Dermal Fibroblasts in Response to Hyperbaric Oxygen (HBO) Is Nitric Oxide (NO) Dependent, Wende Reenstra, MD, PhD, Beth Isreal Deaconess Medical Center 244. Development of a Porcine Incisional Wound Model and Novel Scarring Scales, Adam Singer, MD, Stony Brook University 245. A Prospective Analysis of the Treatment of Friction Blisters with 2-octylcyanoacrylate, Phillip Levy, MD, Wayne State University/Detroit Receiving Hospital

DIDACTIC SESSIONS well as the different sources of funding for such grants; 2) describe the important aspects of career evelopment grants including the applicant’s time commitment and requirements, identifying and working with a mentor(s), and departmental/divisional support; 3) understand the steps by which a federall career development grant application is scored and funded; 4) recognize common pitfalls made in career development grant applications such that they may be avoided; 5) be able to respond to criticisms from the grant reviewers; and 6) be able to resubmit an improved grant to the same or different agency.

Career Development Awards: Identifying Sources and Developing Successful Applications (8:00-9:30 am) Moderator: James Holmes Jr., MD, University of California, Davis Kay Anderson, PhD, Agency for Healthcare Research and Quality Sandra Hatch, MD, National Heart, Lunc, and Blood Institute, Colombine James Quinn, MD, Stanford University Terry Vanden Hoek, MD, University of Chicago Obtaining protected time for the development of techniques and skills to foster a research career is a goal for many clinicians beginning their academic careers. With the current financial stress on many medical institutions, protected time for research career development is more difficult to obtain. The introduction of career development awards has provided young clinicians a method of garnering funding and protected time to develop skills necessary for a successful research career. Now both federal and private agencies provide career development type grants that may be applicable to emergency physicians wishing to start a research career. This didactic session will provide information on the multiple agencies that fund career development grants. All facets of the process for applying for a career development grant will be detailed in the session. The course will provide insight on identifying a mentor(s) and how the mentor can help or hurt the proposal. Finally, the course will provide the audience with a personal experiences on how a career development grant has helped their research career. At the completion of the session, participants will: 1) describe the different types of career development grants as

Responsible Conduct of Research Series: Integrity in Research (8:00-11:00 am) Drummond Rennie, MD, University of California, San Francisco Jill Baren, MD, University of Pennsylvania Roger J. Lewis, MD, PhD, Harbor-UCLA Conflict of interest: Conflict of interest in scientific research and publishing exists in several forms: financial, non-financial, institutional and professional/personal, with financial conflict of interest in the form of a funding source or personal investment being the most widely examined. This session will describe the various forms of conflict of interest that exist, evidence of the bias that results from conflict of interest, how researchers can try to avoid bias as a result of a conflict of interest and disclosures that should be required. Suggested guidelines for peer review journals with regard to handling conflict

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Monday, May 17, 2004 challenges creating the necessary research infrastructure, obtaining start-up funding, motivating faculty and residents, and creating an environment conducive to research.

The insight of other research directors is invaluable in planning, problem-solving, and negotiating for vital resources which may help jump-start development of a successful research program. This session is intended for EM faculty attempting to create or enhance a research program. The goal is to present and discuss successful approaches to developing high-quality, self-sustaining emergency medicine research divisions. This session includes three speakers who have developed successful research programs and bring different perspectives to the panel. Dr. Karras will discuss development of a research infrastructure, including research coordinators, secretarial support, space, academic associates, institutional support, sources of start-up funds, and the role of industry-initiated trials. Dr. Panacek will discuss identifying sources of expertise, including research directors’ skills, consultants, extra-departmental collaboration, and assistance with project development and grant-writing. Dr. Olson will discuss creation of a research culture, including motivating faculty and residents, mentorship, inclusion of nonresearch-oriented faculty, and the role of the chair. The speakers will include examples of specific problems they have encountered and discuss alternative solutions. At the completion of the session participants will: 1) understand the challenges faced in developing successful research programs; 2) learn alternative solutions to commonly encountered problems; and 3) be able to negotiate with institutional leaders for necessary resources.

of interest disclosures will be made. Scientific Misconduct: What is It, and How to Avoid It - This session will begin with definitions of scientific misconduct, and examples to illustrate application of the definitions to real-life situations. The ramifications (scientific, financial, ethical) of misconduct will be discussed. The presentation will include how these situations might have been avoided, and what to do if you find yourself in a similar situation. Federal guidelines for institutional processes to address alleged misconduct will be provided. Use and Abuse of Statistics in this session, the speaker, a nationally recognized expert in research design and statistics, will discuss ways in which data can be analyzed or interpreted to support one conclusion or another. This session will explain ‘data torturing’, namely, how statistical methodology can be used inappropriately to arrive at an incorrect conclusion. While statistical support is necessary for publication, inappropriate use of statistics can be harmful; incorrect conclusions can lead to patient harm, unnecessary research, or wasted time and money. D). Mentoring in Research: It’s More than Teaching Them Methodology! Most successful researchers begin or advance their careers with the aid of a mentor. There has been suggestion that a primary approach to assure integrity in research is gave a strong mentor who educates trainees in the written and unwritten “rules” of ethical research. This session will discuss the responsibilities of a mentor, particularly with regard to teaching the principles of responsible research and integrity in publication. In addition, the responsibilities of the trainee will be presented. The first two topics will be presented for 90 minutes. Use and Abuse of Statistics will be 60 minutes. Mentoring will be 30 minutes. At the completion of the session, participants will; 1) identify conflict of interest in its various forms; 2) describe the possible impact of conflict of interest on research results, interpretation, publication and ultimately patient care; 3) suggest methods to eliminate, reduce, and manage various conflicts of interest; 4) understand how statistics can be used inappropriately to support incorrect conclusions; 5) describe various types of scientific misconduct; 6) develop steps to avoid or address misconduct; and 7) list responsibilities of both mentor and trainee in an effective mentor-trainee relationship.

Grant Mentorship Workshop: Part I (6:00-8:00 pm) Moderator: Gary Green, MD, MPH, Johns Hopkins University Richard Rothman, MD, PhD, Johns Hopkins University James Olson, PhD, Wright State University Mark Angelos, MD, Ohio State University This is a continuation of the highly successful grant mentorship service being developed by the Research Committee. Although continuing to include two components (Individual Grant Review and Open Interactive Session), the following improvements have been made based on prior experience from similar sessions, and feedback from membership, prior participants and the research committee. Part I: Individual Grant Review: Recognizing the demand for one-on-one in-depth mentorship of junior and midlevel grant writers, we will further expand the service being offered matching experienced researchers with unsuccessful grant writers and giving specific feedback on how to improve their grant applications. Part II: Open Interactive Session: Following the individual reviews, 2 grant applications will be selected from among those reviewed to be presented and discussed in an open forum. During this session each grant writer will give a brief summary of the application and each of two expert reviewers will then explain their constructive feedback. The bulk of the time during this session will then be dedicated to spontaneous interactive discussion between the panelists and the audience in order to extrapolate specific comments raised during the reviews to general principles of grantsmanship. At the completion of the session, participants will: 1) gain insight into the common errors in grant writing; 2) understand the thought process of a grant reviewer; and 3) know how to ‘spin’ a grant application based on the mission and goals of the agency and study section.

So You Want to Be a Program Director (9:30-10:30 am) Moderator: Peter DeBlieux, MD, Louisiana State University Carey Chisholm, MD, Indiana University Mary Jo Wagner, MD, Synergy Medical Education Alliance/Michigan State University Stephen Hayden, MD, University of California, San Diego Program directors have the important task of establishing quality emergency medicine training programs. Although, many have successfully navigated the various challenges of such a career path through on-the-job training, many have not. Therefore, at the completion of this session, participants will be cognizant of the skills and experience necessary to develop, succeed and enjoy career longevity as a program director. The session will outline the most successful strategies for preparation for a position as program director, the issues faced at the beginning of one’s career and the pitfalls to avoid. Time management, an important component of the skills set needed to be an effective program director will be addressed, as well as highlight the annual cycle of activities. The challenges faced by program directors to achieve academic promotion will also be discussed. This will be followed by a 15-minute open session, to facilitate questions from the audience. At the completion of this session, participants will be cognizant of the skills and experience necessary to develop, succeed and enjoy career longevity as a program director.

PowerPoint as a Teaching Tool (6:00-8:00 pm) Joe Lex, MD, Temple University Hospital This hands-on workshop will provide dozens of hints to enhance your slides and make your presentations unforgettable. You will bring your own laptop with PowerPoint 97 or higher already loaded. SAEM will supply the power source, a CD full of useable tools, and a 180-page syllabus full of hundreds of presentation tips. You will leave the workshop with your head full of new ideas for electrifying slideshows. Joe Lex will show you how to create your own background, import pictures and animations, change the colors of your ClipArt, and edit photos and radiographs without additional expensive software. In short, you will gain essential skills needed to turn your slideshows into powerful teaching tools. At the completion of the session, you will: 1) recognize at least ten little-known features of PowerPoint - cropping tool, format painter, WordArt, Slide Layout tool, shadows, perfect square and circles, animation as an education tool (and not just to show off), sticky notes, using a “special picture” as a background, using “watermarks,” converting a slideshow (.pps) into a PowerPoint (.ppt) document, inserting slides from other programs, etc.; 2) demonstrate the ability to load new Clipart, fonts, and other helpful tools onto your hard drive; 3) understand how to hyperlink from icons on a PowerPoint slide to other documents, and how to create a “shortcut” to a specific line in a document; 4) show how to make visual material stand out from the background; 5) create an appropriate background template from scratch; 6) comprehend the significance of the “Slide Master” feature; 7) appreciate how color choices can alter the intent of a presentation; 8) demonstrate how to successfully use Tables on a slide; 9) understand why the Packand-Go feature is so important; and 10) show how to work on your speaker’s notes and slides simultaneously.

Mid-level Faculty Career Development (10:30 am-12 Noon) John Gallagher, MD, Albert Einstein College of Medicine Debra Perina, MD, University of Virginia William Barsan, MD, University of Michigan Sandra Schneider, MD, University of Rochester This seminar will focus on academic advancement for mid-level career faculty. Panelists will offer the following information: 1) Inter-institutional variation in the balance of academic requirements for advancement, including research productivity, educational contributions, clinical expertise, and administrative strengths; 2) Discussion of various routes individuals can pursue within their department to advance their careers, such as clinical director, vice-chair, or director of undergraduate medical education; and 3) Insights into barriers and struggles commonly faced when developing promotional strategies. At the end of the session, participants will be able to formulate strategies for successful career development appropriate to their institution, describe various intradepartmental routes to advancement, and recognize some of the challenges and barriers to promotion.

Jump-starting a Successful Research Division (11:00 am-12 Noon) David J. Karras, MD, Temple University Edward A. Panacek, MD, University of California, Davis James Olson, PhD, Wright State University Developing a successful research division is a daunting task. Nascent programs face

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Tuesday, May 18, 2004

SCIENTIFIC PAPERS ORAL PAPER PRESENTATIONS

280. The Prophylactic Use of Ondansetron in Toxic Ingestions, Kurt Isenberger, MD, Regions Hospital ❉ 281. Can Physicians Detect Fluorescence in Children's Urine?, Tania Parsa, MD, Jacobi Medical Center 282. Effect of Delayed Activated Charcoal after Acute Ingestion of Acetaminophen and Oxycodone, Michael Mullins, MD, Washington University

EMS (8:00-9:00 am) Moderator: Tom P. Aufderheide, MD, Medical College of Wisconsin 259. A Controlled Study of the Cost-effectiveness of Emergency Medical Services for Out of Hospital Cardiac Arrest: An Economic Evaluation of the OPALS Study, Graham Nichol, MD, University of Ottawa 260. Near-continuous, Noninvasive Blood Pressure Monitoring in the Out-of-hospital Setting, Stephen Thomas, MD, MPH, Harvard Medical School 261. A Statewide Emergency Medical Services Spine Assessment Protocol: Review and Outcomes from 16,000 Trauma Encounters, John Burton, MD, Maine Medical Center 262. Are Any ALS Treatments Associated with Better Survival in Out-of-hospital Cardiac Arrest?, Ian Stiell, MD, MSc, University of Ottawa

Sepsis/HIV (1:30-2:30 pm) Moderator: Emanual P. Rivers, MD, MPH, Henry Ford Hospital ❉ 283. Charlson Comorbidity Index Predicts 1-year Mortality in ED Patients at Risk for Sepsis, Scott Murray, MD, Beth Israel Deaconess Medical Center 284. A Liver-derived Acute Phase Protein, Fetuin, Protects Against Lethal Endotoxemia Partly Through Inhibiting HMGB1 Release, Haichao Wang, PhD, North Shore University Hospital 285. HIV Screening in the ED: An Ongoing Counseling and Testing Program in a Low Prevalence Setting, Holly Walerius, MD, University of Cincinnati 286. The Evaluation of an Educational Video Program for HIV Testing: A Comparative Analysis, Yvette Calderon, MD, Jacobi Medical Center

Clinical Cardiovascular I (8:00-9:00 am) Moderator: W. Brian Gibler, MD, University of Cincinnati 263. Missed Diagnosis of Acute Myocardial Infarction in the ED Varies by Region and Hospital Size, Michael Schull, MD, MSc, Institute for Clinical Evaluative Sciences 264. Withdrawn 265. PPARgamma-activator Rosiglitazone Improves the Insulin-induced Inotropic Effect of Cardiomyocytes in Spontaneously Hypertensive Rats, Feng Gao, MD, PhD, Fourth Military Medical University 266. Effective Smoking Cessation Intervention for ED Patients with Chest Pain, Robert Partridge, MD, MPH, Brown Medical School

Asthma (1:30-2:30 pm) Moderator: Richard M. Nowak, MD, Henry Ford Hospital 287. Use of Asthma Services by Pediatric Asthma Patients after ED Treatment of an Exacerbation, Jill Baren, MD, University of Pennsylvania 288. Attenuation of Inflammatory-induced Oxidative Burst in Human Neutrophils by Albuterol Is Enantiomer Specific, Richard Kubista, MD, University of Colorado Health Sciences Center 289. The Beneficial Effect of Warmed Humidified Oxygen in Pediatric Asthmatic Patients Having Acute Exacerbation During Winter Months, Kumara Nibhanipudi, MD, Metropolitan Hospital Center 290. Burden of Asthma Persists One Month after ED Discharge: Results from the Illinois ED Asthma Collaborative (IEDAC), James Walter, MD, University of Chicago Hospitals

Obstetrics/Gynecology (9:00-10:00 am) Moderator: Judith Tintinalli, MD, MS, University of North Carolina at Chapel Hill 267. Outcome of Patients with Indeterminate First-trimester ED Pelvic Ultrasound, Hillary Cohen, MD, Carolinas Medical Center 268. Vaginal pH as a Predictor of Gonorrhea and Chlamydia DNA Probe Results, Paul Glisson, DO, Medical College of Georgia 269. D-dimer Concentrations in Normal Pregnancy, Jackeline Hernandez, MD, Carolinas Medical Center 270. Randomized Pilot Study Comparing a Rubber Ring Catheter to the World Catheter in the Treatment of Bartholin Abscesses, Jennifer Provataris, MD, Jacobi Medical Center

POSTER SESSION (2:30-4:30 pm) Ischemia-Reperfusion 291. Streptozotocin-induced Diabetes Does Not Induce Markers of Microvascular Dysfunction and Does Not Affect Myocardial Infarction Size, Jon Buras, MD, PhD, Beth Israel Deaconess Medical Center 292. Cell Column Chromatography: A Tool to Quantify Cerebral Cell Volume Changes Following Chemically-induced Anoxia/Re-oxygenation, Feng Xiao, MD, Louisiana State University, Shreveport 293. Exacerbation of Cardiac Troponin I Degradation with Antioxidants During Global Ischemia, Brian Palmer, PhD, The Ohio State University 294. Substrate Supplementation During Low Flow Reperfusion of the Globally Ischemic Heart, Carlos Torres, MD, MPH, MSc., The Ohio State University 295. Isoflurane and Caspase Inhibition Reduce Cerebral Injury in Rats Subject to Focal Cerebral Ischemia, Daniel Davis, MD, University of California, San Diego 296. Temporal Effects of Regional Ischemia on the Peak Frequency (PF) of VF in an Isolated Swine Heart Model, Christopher Barton, MD, University of California, San Francisco ❉ 297. 'Post-conditioning' Via Stuttering Reperfusion Limits Myocardial Infarct Size in Rabbit Heart, Chad Darling, MD, University of Massachusetts 298. Intercellular Communication Via Gap Junctions Does Not Contribute to Preconditioning-induced Cardioprotection in Rabbit Heart, Karin Przyklenk, PhD, University of Massachusetts 299. Morris Water Maze Performance and Correlation with Neuronal Counts after Graded Neuronal Ischemia, Geoffrey Wiss, MD, Wayne State University

Toxicology - Basic (9:00-10:00 am) Moderator: Richard C. Dart, MD, PhD, Denver Health ❉ 271. Crotalidae Polyvalent Immune Fab Antivenom Is Effective for the Treatment of South American Viperidae Envenomations in a Murine Model, William Richardson, MD, University of California, San Diego 272. Amiodarone Improves Survival in a Murine Model of Fluoride Toxicity, Amar Shah, MD, St. Luke's-Roosevelt Hospital Center/Columbia University 273. Evaluation of Mixed Venous Oxygen Saturation (MVO2) as a Marker of Calcium Channel Antagonist Toxicity, Eric Perez, MD, St. Luke's-Roosevelt Hospital/Columbia University 274. Physostigmine Does Not Increase Arousal but Produces Toxicity in an Animal Model of Severe Gamma-hydroxybutyrate (GHB) Intoxication, Theodore Bania, MD, MS, St. Luke's-Roosevelt Hospital/Columbia University

Evaluation of Syncope (10:00-11:00 am) Moderator: James Quinn, MD, MS, Stanford University 275. Inconsistent Electrocardiogram Testing for Syncope in U.S. EDs, 1992-2000, Benjamin Sun, MD, MPP, Massachusetts General Hospital 276. Evaluation of Syncope in an Observation Unit, Deborah Diercks, MD, University of California, Davis 277. Usefulness of a Diagnostic Protocol for Patients with Syncope Remaining Unexplained after Emergency Assessment, Francois Sarasin, MD, MSc, Hopital Cantonal Universitaire, Geneva, Switzerland 278. Prospective Validation of the San Francisco Syncope Rule (SFSR) to Predict Patients with Serious Outcomes, James Quinn, MD, MS, Stanford University

Neurology 300. Spectrum of Cranial Neuropathy in Bell's Palsy, Jonathan Edlow, MD, Beth Israel Deaconess Medical Center 301. Determination of Physiological Variables to Assess Changes in Neuronal Function Following Injury to Near-by Neurons, Selim Suner, MD, MS, Brown University ❉ 302. Defining Long-term Signal Reliability for a 100-electrode Chronically Implanted Array to Develop a Primate Model for Studying the Effect of Near-by Injury on Individual Neurons in Primary Motor Cortex (M1), Selim Suner, MD, MS, Brown University

Toxicology - Clinical (10:00-11:00 am) Moderator: Lewis R. Goldfrank, MD, New York University ❉ 279. A Rapid Qualitative Test for Suspected Ethylene Glycol Poisoning, Heather Long, MD, New York University/NorthShore University Hospital

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Tuesday, May 18, 2004 334. Multicenter Study of Smoking, Nicotine Dependence, and Intention to Quit among ED Patients and Visitors, Edwin Boudreaux, PhD, UMDNJCamden/Cooper Hospital 335. Breast Cancer Education and Screening in the ED: An Effective Means of Targeting Women at Risk, Christy Robinson, MD, University of Arkansas 336. Patients with Severe Hyperlipidemia Do Not Get Appropriate Treatment at Follow-up, Andra Blomkalns, MD, University of Cincinnati 337. ED Education Improves Patient Knowledge of Cardiac Risk Factors but Not the Accuracy of Their Own Risk Perception, Annette Williams, MD, University of Cincinnati 338. Examining ED Use and Arrest Histories to Identify Patients at Risk for Serious Violence: A Case Control Study, Cameron Crandall, MD, University of New Mexico 339. Opportunities for Intervention: Epidemiology of Urban Alcohol Involved Pedestrian Crashes in Albuquerque, New Mexico, Jonathon LaValley, University of New Mexico 340. All-terrain Vehicle Injuries in New Mexico - Children Beware, Elizabeth Janello, University of New Mexico 341. Recidivism after ED Screening for Domestic Violence, Brendan Carr, MD, University of Pennsylvania 342. Prevalence and Characteristics of ED Patients with Harmful and Hazardous Drinking, Gail D'Onofrio, MD, MS, Yale University

303. Steady State Serum Concentration of Intravenous Progesterone in Moderate to Severe Traumatic Brain Injury Patients, David Wright, MD, Emory University â?‰ 304. Increasing Expression of Endogenous Heme Oxygenase-1 Protects Astrocytes from Heme-mediated Oxidative Injury, Jing Chen, PhD, Thomas Jefferson University â?‰ 305. The Neurotoxic Effect of Sickle Cell Hemoglobin, Garig Vanderveldt, Thomas Jefferson University

Neurology: Stroke 306. Compliance and Impact of Including the Los Angeles Prehospital Stroke Screen into a Paramedic Protocol, Andrew Asimos, MD, Carolinas Medical Center 307. Does ED Blood Pressure Determine Survival Following Acute Ischemic Stroke?, Latha Stead, MD, Mayo Clinic 308. Procoagulant Effects of Hyperglycemia after Acute Stroke, Nina Gentile, MD, Temple University

Neurology: Headache 310. Do Patients with Recurrent Headaches Attempt Abortive Therapy Prior to Their ED Visit?, Frederick Fiesseler, DO, Morristown Memorial Hospital 311. Overuse of Narcotic Analgesics in the Treatment of Acute Migraine Headache, Brian Rowe, MD, MSc, University of Alberta 312. Sumatriptan for the Treatment of Benign Headaches in the ED, James Miner, MD, Hennepin County Medical Center

Infectious Disease

Neurology: Seizures

343. The Incidence of MRSA in Patients Attending a Central London ED, Fey Probst, MBBS, Charing Cross Hospital, England 344. High Prevalence of Methicillin-resistant Staphylococcus Aureus (MRSA) in ED Skin and Soft Tissue Infections, Bradley Frazee, MD, Alameda County Medical Center - Highland Campus 345. Hyperbaric Oxygen Reduces Lung Injury Priming and Enhances Interleukin-23 p40 Production During Sepsis, Jon Buras, MD, PhD, Beth Israel Deaconess Medical Center 346. Mortality in ED Sepsis (MEDS) Score: A Predictor of One Year Mortality, Nathan Shapiro, MD, MPH, Beth Israel Deaconess Medical Center 347. Do Patient Perceptions Influence Compliance with Outpatient HIV Testing Referrals from the ED? An Application of the Health Belief Model, Jason Haukoos, MD, MS, Denver Health Medical Center 348. Modulation of Cytokines Production by Intravenous Immunoglobulin in Patient with Pulmonary Edema Caused by Enterovirus 71, Shih-Min Wang, MD, National Cheng Kung University Hospital, Taiwan 349. Seroprevalence and Health Care Worker Exposure to HIV-1 in Resuscitated ED Patients: 15 Years Later, Anthony Cruz, MD, Henry Ford Hospital 350. Rapid Serum Procalcitonin Testing for the Diagnosis of Infection in the ED, Nicolas Simon, MD, Hopital Leon Touhladjian Poissy, France 351. Polymerase Chain Reaction (PCR) Diagnosed Enteroviral Meningitis in Adults with Aseptic Meningitis, Alla Trubetskoy, MD, PhD, Long Island Jewish Medical Center 352. Evaluation of Antibiotic Resistance Patterns in ED Patients with Urinary Tract Infections, Robert Norton, MD, Oregon Health & Science University

313. First Time Febrile Seizures Presenting to the ED, Jennifer Sato, BA, Mayo Clinic 314. Single Dose Oral Phenytoin vs Intramuscular Fosphenytoin Loading in the ED: A Comparison of Tolerability and Outcomes, Larissa Velez, MD, University of Texas Southwestern

Disease/Injury Prevention 315. Hospitalization for Motorcycle-related Injuries in the United States, 2001, Jeffrey Coben, MD, Allegheny General Hospital 316. A Telephone Intervention for Alcohol Use in ED MVC Patients, Michael Mello, MD, MPH, Brown University 317. Brief Motivational Interventions with Motor Vehicle Crash Patients, Michael Mello, MD, MPH, Brown University 318. A Seven-year Study of Bicycle Helmet Use on Mackinac Island, Michigan, Mary Hughes, DO, Michigan State University 319. Childhood Soccer Injuries: Estimates from the 2000 National Electronic Injury Surveillance System All Injury Program, Annette Adams, MA, MPH, Oregon Health & Science University 320. The Role of Alcohol in Traffic Collisions Involving Older Drivers in Orange County, California, Cris Jivcu, University of California, Irvine 321. Relationship Between Traumatic Injury, Alcohol Consumption, and Previous ED Visits: Opportunity for Early Screening and Intervention?, Jeffrey Cukor, MD, University of Massachusetts 322. Rural Motor Vehicle Crash Mortality Rates Are Higher Even When Controlling for Injury Severity, Robert Muelleman, MD, University of Nebraska 323. Availability of Emergency Contraception in Massachusetts EDs, Elizabeth Temin, MD, Boston Medical Center 324. A Randomized Trial to Determine the Contribution of ED Influenza Immunization on End of Season Immunization Rate, Wayne Triner, DO, MPH, Albany Medical College 325. Lack of Prior Cessation Screening and Advice for ED Patients Who Smoke, Steven Bernstein, MD, Albert Einstein College of Medicine 326. Weight Estimation by ED Personnel, Leon Sanchez, MD, MPH, Beth Israel Deaconess Medical Center 327. Alcohol Assessment Validity and Reliability of (SIP-ER) Short Index of Problems, Robert Woolard, MD, Brown Medical School 328. Alcohol Screening and Intervention for Injured ED Patients, Robert Woolard, MD, Brown Medical School 329. Withdrawn 330. Errors in ED Prescriptions Resulting in Pharmacy Call Backs, John Abdelshehid, MD, Loma Linda University 331. Moderate Ambient Temperatures Cause Significant Temperature Rise in Enclosed Vehicles, Catherine McLaren, MD, Stanford University-Kaiser 332. Serum Ionized Magnesium Levels and Ionized Calcium to Magnesium Ratios in Adult Patients with Sickle Cell Anemia, Betty Chang, MD, State University of New York, Downstate/Kings County Hospital 333. Pre-race Screening Does Not Predict Medical Complications During Extreme Endurance Events, Claude Lyle, MD, University of Arkansas

Infectious Disease: Pneumonia 353. What Are the Effects of Timing of Antibiotic Administration Less than and Greater than 4 Hours in Pneumonia Patients?, Dennis Bishop, MD, St. John Hospital and Medical Center 354. Determination of Patient Recovery Time from Community Acquired Pneumonia (CAP) According to Initial Pneumonia Outcomes Research Team Classification, A Lombardi, MD, The Ohio State University 355. How Good Is the Agreement Between Prospectively and Retrospectively Collected Data Comprising the Pneumonia Severity Index?, Donald Yealy, MD, University of Pittsburgh

Respiratory/ENT Disorders 356. Automated Pulsus Paradoxus: A Noninvasive Index of Work of Breathing that Predicts Admission in ED Patients with Respiratory Complaints, James Rayner, MD, Brown University 357. Impact of Blood Levels of (S)-albuterol (S-AL) on Response to Levalbuterol (LEV) and Racemic Albuterol (RAC) in the ED Setting, Richard Nowak, MD, Henry Ford Health System 358. Serum Thymus and Activation-regulated Chemokine (TARC) Levels in Acute Asthma, Robert Silverman, MD, Long Island Jewish Medical Center 359. Evaluation of a New Nasal Tampon for Epistaxis: A RCT, Kerry Cronin, MD, Stony Brook University

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Tuesday, May 18, 2004 Violence in the ED

360. Comparison of Two Methods of Measuring Quality of Life in Acute Asthma, Brian Rowe, MD, MSc, University of Alberta 361. A Comparison of the Electrocardiographic Findings in ED Patients Who Rule-in vs Rule-out for Pulmonary Embolism, Peter Richman, MD, Mayo Clinic

Moderator: Debra Houry, MD, MPH, Emory University 366. How Do ED Providers Respond When Women Disclose Domestic Violence?, Karin Rhodes, MD, University of Chicago 367. Intimate Partner Violence in a Diverse Population of Women and Men Presenting to an Urban ED, Beth Kaplan, MD, San Francisco General Hospital, University of California, San Francisco 368. Injured Youth: Rates of Compliance with Follow Up, Theodore Corbin, MD, Thomas Jefferson University 369. A Review of Intimate Partner Homicide Followed by Suicide and the Use of Firearms, Cameron Crandall, MD, University of New Mexico

MODERATED POSTERS (3:30-4:30 pm) Mass Casualty/Bioterrorism Moderator: Joseph Waeckerle, MD, Acute Care & Emergency Specialists, PC 362. Intra-hospital Variability in the Sensitivity of a Biosurveillance Method Using Patient’s Chief Complaint, Dennis Cochrane, MD, Morristown Hospital 363. Need for Improved Hospital Preparedness for a Cyanide Terrorism Event as Demonstrated by an Unannounced Large Multi-hospital Drill, Edward Jasper, MD, Thomas Jefferson University 364. Discriminating Bioterrorism-Related Inhalational Anthrax from Communityacquired Pneumonia and Influenza-like Illness, Demetrios N. Kyriacou, MD, PhD, Northwestern University-Feinberg 365. EMS Preparedness for Mass Casualty Events Involving Children, Rhonda Dick, MD, University of Arkansas

DIDACTIC SESSIONS jects. This lecture will discuss the evidence for and against publication bias in submission of manuscripts and publication decisions and determine the impact of this bias on the scientific endeavor as well as on the translation of research findings to clinical practice. Errors in Published Data? How should concerns about potential errors in the data be reported, and to whom? What are the reasons studies should be retracted? What types of investigation should ensue when fraud is discovered. How are retracted studies noted in the literature and in databases? At the completion of the session, participants will: 1) understand the “rules” and responsibilities of authorship; 2) delineate issues of misconduct in publication of scientific research, and discuss methods to avoid or address these; 3) describe perspectives on data ownership and related contract issue, and understand how data ownership impacts on the ability to publish research results; 4) use published data to support or refute the charge of publication bias; and 5) identify methods to address publication if errors are found in data once published.

Advancement to the Position of Academic Chair: Strategies for Preparation, Negotiation, and Survival (9:00-10:00 am) Moderator: E. John Gallagher, MD, Albert Einstein College of Medicine James Hoekstra, MD, Wake Forest University Stephen Hargarten, MD, MPH, Medical College of Wisconsin Glenn C. Hamilton, MD, Wright State University This leadership development panel will provide practical information targeted at those faculty considering seeking a position as academic chair at some future point in their career. The panel members are all currently active academic chairs, with tenure in their position ranging from 1-20+ years. Panelists will focus on one of the three main strategies chosen for discussion: 1) How to prepare and position oneself for the job of chair, including development of the necessary credentials. This process will vary considerably as a function of the mission of the medical school and whether one is an “inside” or an “outside” candidate. 2) How to negotiate for the resources needed to accomplish one’s personal goals and those of the institution. This will require development of both shortand long-term strategies, with careful attention to detail and meticulous clarification of institutional expectations. 3) How to survive as chair. In dealing with the sometimes conflicting needs of our patients, faculty, fellows, residents, students, and the administration, a chair must frequently revisit the academic triad of care, research, and teaching, in order to avoid losing perspective on the overarching departmental mission. At the completion of the session, participants will understand how to: 1) Prepare oneself for a position as academic chair; 2) Negotiate for the necessary resources to do the job once offered it; and 3) Survive as a viable and productive chair over time.

Oversight and Monitoring of Ongoing Clinical Research (10:00-11:00 am) Roger J. Lewis, MD, PhD, Harbor-UCLA The speaker will review the rationale for ongoing oversight and monitoring of clinical studies to ensure scientific validity and protect patient safety. The session will focus on the monitoring of investigator initiated clinical research, rather than multicenter commercially sponsored clinical studies. Safety monitoring, focusing on the identification of unexpected patterns in adverse events, will be contrasted with data monitoring, which focuses on the early identification of treatment effects. Ongoing monitoring of clinical studies is now required for all federally funded phase III trials, and is increasingly required by individual institutions. This session will provide the information necessary so that individual clinical investigators can develop and implement practical and effective data safety and monitoring plans to ensure the success and safety of their clinical research. At the completion of the session, participants will: 1) define the objectives of data and safety monitoring, and contrast those objectives with the objectives of clinical trial design (pre-enrollment) and analysis (post-enrollment); 2) describe the rationale for the monitoring of adverse events, define such events, and define severity and attribution; 3) describe the goals of data monitoring, including the early identification of treatment effects, and the tracking of study progress; and 4) develop and implement a practical and effective data safety and monitoring plan to ensure the success and safety of their clinical research.

Responsible Conduct of Research Series: Publication Ethics and Issues (9:00-11:00 am) Michelle Biros, MD, Hennepin County Medical Center Jim Adams, MD, Northwestern University Ellen Weber, MD, University of California, San Francisco Authorship of peer-reviewed articles is extremely important for academic advancement for scientists and physicians. At the same time, pharmaceutical companies and biotechnology companies may wish to involve well-known authors to add credibility to their manuscripts. This session will cover established guidelines for authorship, responsibilities of authors, and various ways of presenting authorship in journals. Misconduct in authorship, including plagiarism, ghost authorship, duplicate publications and data-splitting, will also be discussed. Publication rights and data ownership: Who “owns” the data?

Can the data be shared? What are the rights of the institution, investigator or source of financial support with regard to preventing publication, and copyright. This issue is of particular interest to young investigators who may overlook this detail, and then find that they are unable to publish their research findings. Publication Bias: Does publication bias exist, or is it a figment of our imagination? Publication bias is the tendency to publish only studies with significant findings, while not publishing studies without significant results.

If publication bias exists, it is likely to result in duplicative research efforts, erroneous conclusions in meta-analyses, and faulty clinical practice. Failure to submit or publish research with negative findings may also be considered scientific misconduct in that it witholds important information often gained through the cooperation of research sub-

Lunch Session: Advances in Sepsis (12 Noon-1:30 pm) Moderator: Edward Panacek, MD, University of California, Davis Emanuel Rivers, MD, MPH, Henry Ford Hospital Stephen Trzeciak, MD, Cooper University Hospital H. Bryant Nguyen, MD, MS, Loma Linda University This session will focus specifically on “cutting edge” research in the pathogenesis and treatment of severe sepsis. In this Bench to Bedside approach, the speakers will examine the recent landmark studies in sepsis that pertain to ED management. This symposium will cover: Recent data on epidemiology of severe sepsis; New research in pathophysiology of severe sepsis; New evidence-based strategies for the treatment of sepsis

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Tuesday, May 18, 2004 Clinical Research and the HIPAA Privacy Rule (1:30-2:30 pm)

(including activated protein C; steroids for relative adrenal insufficiency, and early goaldirected therapy); applying clinical research to clinical practice: Implementing evidencebased strategies for septic shock in the ED and a cost analysis of ED interventions in sepsis; and future directions in sepsis research for emergency medicine. At the completion of the session participants will: 1) understand recent advances in the pathophysiology of severe sepsis; 2) new evidence-based strategies for treating sepsis and septic shock in the ED; and 3) the cost-benefit of providing early ED interventions for sepsis.

Carlos Camargo, MD, DrPH, Massachusetts General Hospital Gabor Kelen, MD, Johns Hopkins University The Health Insurance Portability and Accountability Act (HIPAA) of 1996 contained a requirement for a “privacy rule” that protects certain patient health information. This Privacy Rule was created in an attempt to balance the protection of identifiable health information of individuals with certain social benefits of disclosure, including clinical health care research. This didactic session will discuss the Rule and its accompanying guidance, the NIH publication “Protecting Personal Health Information in Research: Understanding the HIPAA Privacy Rule”. The session will provide clinical researchers with an understanding of the Privacy Rule and how it impacts health care research. The session will begin with a brief focus on what entities are regulated and what protected health information (PHI) is covered by the Privacy Rule. The focus will then turn to methods researchers can use to comply and cope with the Privacy Rule and incorporate PHI into their clinical research activities, such as: de-identification of PHI, obtaining authorization or waiver of authorization, use of limited data sets, understanding preparatory research activities and how to use decedents’ PHI. The session will end by addressing several important frequently asked questions and by addressing special situations in clinical research such as multicenter trials and collaborative databases. At the completion of the session, participants will: 1) have an understanding of HIPAA and its Privacy Rule, particularly as it relates to clinical research; 2) know what patient information is protected by the Privacy Rule; 3) discuss methods to comply and cope with the Privacy Rule as it relates to clinical research; and 4) understand how the Privacy Rule affects patient rights, collaborative research and ongoing research undertaken prior to implementation of the Privacy Rule.

Lunch Session: Educational Research Track: Defining the Research Question (12:00 Noon-1:30 pm) Michelle Biros, MD, Hennepin County Medical Center This session will define the characteristics of well-designed research studies in medical education. Included in the discussion will be the choice of a research topic, the generation of an appropriately-bounded research hypothesis, and the rigorous standards that must be met to prepare a publishable manuscript. At the completion of the session, participants will be able to: 1) understand the principles needed to write an appropriatelybounded research question; 2) define the characteristics of educational research, including study populations, typical study designs, methods of evaluating data related to this modality; and 3) identify the standards that an educational research study must meet in order to get published. Pre-registration and registration fee required.

Lunch Session: Public Health Advocacy: The Researcher in Action (12:00 Noon-1:30 pm) Moderator: Susan Fuchs, MD, Northwestern University Flaura Koplin Winston, MD, PhD, The Children’s Hospital of Philadelphia Joseph L. Wright, MD, MPH, Children’s National Medical Center Mary Pat McKay, MD, MPH, Harvard Medical School A career focus in public health advocacy, work intended to reduce death or disability in a population, broadens the scope of an emergency physician’s clinical, educational, and/or research endeavors beyond the clinical setting or individual academic institution.

This session provides new and specific information about careers in public health advocacy. Using the real-world experiences of the expert panelists, the academic emergency physician or EP-in-training will see how each speaker’s clinical practice fueled research interests and hypotheses, then their data was put into action through public health advocacy. Each speaker will discuss his/her area of research and career transition to advocacy work—work that relies on problem identification, data collection, strategy development, education of policy makers and others, process/outcomes evaluation, among other components. This session provides each speaker an opportunity to discuss the process and specifics of his/her own public health advocacy work, with the final 30 minutes reserved for audience questions. At the completion of the session, participants will: 1) understand the specific objectives of the public health advocate; 2) understand the value of clinical exposure and data collection to the physician/advocate; 3) understand the multidisciplinary process required for successful public health advocacy; and 4) gain new insight into a career path that broadens the clinical/educational/research scope of the academic emergency physician. Pre-registration and registration fee required.

Future SAEM Annual Meetings 2005

May 22-25 New York Hilton, NY

2006

May 18-21 San Francisco Marriott, CA

2007

May 16-19 Sheraton Hotel, Chicago, IL

2008

May 29-June 1 Marriott Wardman Park Hotel, Washington DC

Educational Research Track: Educational Research in EM – Examining the Literature (1:30-2:30 pm) Gloria Kuhn, MD, Wayne State University Wendy Coates, MD, Harbor-UCLA The speakers will focus on medical education in Emergency Medicine and lead the audience through an analysis of selected studies to highlight specific strengths and pitfalls in study design and implementation. This will provide them with a critical appreciation of how to read the medical education literature. Instruction on how to report on educational innovations (e.g., evaluating a new curriculum) will be presented. A strategy for searching education databases, such as ERIC, will be introduced by leading the audience through a prepared practical example. At the completion of the session, participants will be able to: 1) describe the current progress of educational research in EM; 2) give examples of strengths and weaknesses in designing and implementing an educational research study; and 3) perform a basic search using Educational Resources Information Center (ERIC) education research publications database.

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Tuesday, May 18, 2004

CHIEF RESIDENT FORUM England Room 8:00-8:30 am

Registration and Continental Breakfast

8:30-9:00 am

Welcome and Opening Remarks; Characteristics of Good Leaders – Deb Houry, MD, MPH, Emory University.

This session will discuss general aspects of being a chief resident as well as the qualities of a good leader (organizational skills, honesty, communication, consistency).

9:00-9:45 am

Chief Resident as Teacher – Richard Shih, MD, Morristown Memorial Hospital This session will focus on innovative approaches to journal club, morbidity and mortality conferences, and lectures (including finding speakers, resident involvement, and format).

9:45-10:00 am

Break

10:00-11:30 am

Case studies: Major problems chief residents deal with – Peter DeBlieux, MD, Charity Hospital, Pam Dyne, MD, UCLA-Olive View, Robert McNamara, MD, Temple University, Kevin Rodgers, MD, Methodist Hospital This session will cover cases studies of problems chief residents may encounter (scheduling problems, resident in crisis, inappropriate residents)

11:30 am-1:00 pm Lunch/ Small Group Discussion Section – Developing Your Chief Resident Skill Set, Scotland A & B Each of the small groups will be led by a faculty member and/or chief resident. Topics to be discussed will include various situations that may arise during the year and possible solutions. Emphasis will be placed on the skills that are necessary to have a successful year as chief resident.

1:15-1:45 pm

Life and relationship issues in medicine – Rita Cydulka, MD, MetroHealth Medical Center This session will cover personal issues faced by residents including pregnancy issues, family, and sexual harassment.

1:45-2:30 pm

Tips for a successful year/ Q&A Session – Chief residents – Rahul Khare, MD, University of Michigan and Amy Lazarides, MD, New York Methodist Hospital; Moderators- Richard Shih MD, Morristown Memorial Hospital; Debra Houry, MD, MPH, Emory University This session will involve discussion of questions that are solicited from participants prior to the date of the conference. Topics are anticipated to involve various EM residency issues.

2:30-3:15 pm

Ethics and Professionalism – Jim Adams, MD, Northwestern University This session will discuss ethical and confidential issues that involve other residents, how to set professional examples for others, and how to represent your department in the hospital setting.

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Tuesday, May 18, 2004

CONSTITUTION PROPOSED AMENDMENTS

Bylaws: Article VI, Section 3: The Nominating Committee will also provide recommendations to the Board of Directors for Society awards.

Clarifying the Annual Business Meeting: The C&B Committee recommends wording changes that clarifies the Annual Business Meeting.

2.

Bylaws: Article III, Section 1: Business items presented as informational or for vote by active members shall include, but not be limited to: transaction of other business which may come before the membership, and a "State of the Society" address by the President and announcement of the results of the election of officers and committee members and any amendments. Where dictated by the Constitution and Bylaws. Where dictated by the Constitution and Bylaws, the Society shall be governed by a plurality of eligible members voting. The President of the Society shall preside over the meeting and the Secretary-Treasurer will circulate agenda items to the membership 30 days or more before the annual business meeting. The chairs of the Constitution and Bylaws Committee and Nominating Committee will preside over the respective parts of the Annual Meeting.

Clarifying the Role of the Nominating Committee: Traditionally the Board has approved the slate of nominees proposed by the Nominating Committee, however the C&B does not require this action. The C&B Committee recommends that the following sentence be added to the Bylaws: 3.

Bylaws: Article VI, Section 3: The slate of nominees selected by the Nominating Committee shall be approved by the Board of Directors prior to distribution to the membership for consideration.

Clarifying the Role of the Secretary-Treasurer: The C&B Committee recommends a number of amendments that would clarify the role of the SecretaryTreasurer, specifically those functions that are assigned to the Secretary-Treasurer, but are more appropriately handled by the SAEM Executive Director.

4.

Bylaws: Article II, Section 11: The SecretaryTreasurer in conjunction with the President shall be responsible keep a true complete and correct record of for the agenda proceedings of the annual business meeting and meetings of the Board of Directors. The SecretaryTreasurer shall oversee the financial accounts and records of the Society. The Executive Director shall keep a true, complete and correct record of meetings of the Board of Directors and preserve documents belonging to the Society, and issue notice of the annual business meeting and meetings of the

BYLAWS AMENDMENTS

Board of Directors. The administrative staff of the Society shall keep an account of the Society with its members and maintain a current register of members with dates of their election to membership and preferred mailing address. The Secretary-Treasurer shall be responsible for reporting unfinished business requiring action from previous meetings of the membership or Board of Directors and in conjunction with the President shall be responsible for the agenda of the annual business meeting and meetings of the Board of Directors. The administrative staff of the Society shall collect the dues keep an account of the Society with its members and maintain a current register of members with dates of their election to membership and preferred mailing address. The administrative staff of the Society shall collect the dues of the Society. The Secretary-Treasurer shall make disbursements of expenses, and oversee the financial accounts and records of the Society.

Establishment of an Awards Committee: The C&B Committee proposes that an Awards Committee be established. Currently the C&B requires that the Nominating Committee develop the slate of candidates for the elected positions, as well as select the recipients of the SAEM awards (Academic Excellence, Leadership, and Young Investigator). To establish an Awards Committee the following amendment is proposed: 1.

AND

5.

Constitution: Article VII, Section 2: The SecretaryTreasurer Executive Director shall mail the proposed amendments to the membership at least 30 days prior to that meeting.

6.

Bylaws: Article II, Section 8: A final notice of time and place of such meetings shall be sent to all members of the Board by the SecretaryTreasurer at least via the Executive Director at least 7 days before the meeting. Six members of the Board of Directors will constitute a quorum.

Agenda items for Board meetings may originate from any member of the Society and are submitted for review to either the Secretary-Treasurer or the Executive Director no fewer than 30 days before the meeting date.

7.

Bylaws: Article III, Section 3: A final notice of the time, place, and program of the annual assembly meeting shall be sent to all members of the Society by the Secretary-Treasurer Executive Director at least 30 days before the meeting.

8.

Bylaws: Article III, Section 4: Such meetings shall be convened by the President, Board of Directors, and Program Committee Chair and publicized at least 30 days in advance by the Secretary-Treasurer Executive Director.

Amending Wording Regarding Resident/Fellow and Medical Student Membership: The C&B Committee recommends deleting some of the wording regarding the definition of resident/fellow and medical student membership. The proposed changes have no effect on the criteria or status of these members.

9.

Constitution: Article III, Section 2: (3) Candidates for resident/fellow membership must be residents or fellows in good standing. This category of membership shall apply only to residents or fellows currently enrolled in a training program. and an individual's membership in this category expires on the last day of the calendar year of his or her enrollment in the program. The individual may then be eligible for membership in another category. (4) Candidates for medical student membership must be medical students who have an interest in emergency medicine. Medical student membership expires on the last day of the calendar year in which the member is no

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longer enrolled as a medical student. The individual may then be eligible for membership in another category.

Deleting the Requirement that the President-Elect Serve on All Committees: The C&B Committee recommends that the C&B be amended to no longer require that the President-Elect serve as an ex-officio member of all committees.

10. Bylaws: Article II, Section 10: The President-Elect shall serve as chair of the Nominating Committee. and ex-officio member of all committees.

Minor Wording Changes: The C&B Committee has proposed a number of minor wording changes for consideration by the membership.

11. Constitution: Article II, Section 2: (4) serving in an academic capacity to develop and promote further the most appropriate improved measures for the of care of for the acutely ill or injured patient, 12. Constitution: Article III, Section 3: All members may have the privilege of the floor and of serving on the standing and ad hoc committees, task forces, and interest groups of the Society.

13. Bylaws: Article II, Section 9: The President may appoint task forces with specified goals. The President shall appoint a Board liaison to each committee, task force, and interest group. The President may appoint task forces with specified goals.

14. Bylaws: Article III, Section 3: The Society shall sponsor an annual scientific and educational meeting or assembly to meet its purpose and objectives.

15. Bylaws: Article VI, Section 3: It shall be the task of this committee to select candidates a slate of officers to fill the naturally occurring vacancies on the Board of Directors and elected positions on the standing committees of the Society not otherwise designated and provided for by these Bylaws.

16. Bylaws: Article II, Section 9: It shall be the duty of the President to see that the rules of order and decorum are properly enforced in all deliberations of the Society, to set the agenda for each Board meeting, and to sign the approved minutes of each meeting, and to execute all documents which may be required for the Society, unless the Board of Directors shall have expressly authorized some other person to perform such execution.

17. Bylaws: Article I, Section 1: Application Process.

Aapplications for membership forms may be obtained from the Society Headquarters. The Applicant must return the completed application forms and supporting letters to the Executive Director. The qualifications of applicants for membership will be reviewed by the Executive Director and Secretary-Treasurer Approval of applicants by the Executive Director and Secretary-Treasurer shall constitute election to one of the membership categories, effective immediately.

Tuesday, May 18, 2004

SAEM ANNUAL BUSINESS MEETING 11:00-12:00 noon All SAEM members are encouraged to attend.

1. SAEM Award and Grant Presentations, Don Yealy, MD, President 2004 Hal Jayne Academic Excellence Award: Thomas P. Aufderheide, MD, Medical College of Wisconsin 2004 Leadership Award: Joseph F. Waeckerle, MD, Acute Care & Emergency Specialists, PC Young Investigator Awards: Debra Houry, MD, Emory University Craig Newgard, MD, Oregon Health & Science University Michael Schull, MD, Sunnybrook & Women's College Health Sciences Centre Resident Research Year Grant: Brian Blyth, MD, University of Rochester Institutional Research Training Grant: Richard Rothman, MD, PhD, Johns Hopkins University Scholarly Sabbatical Grant: Robert Wears, MD, University of Florida EMS Research Fellowship Grant: Jonnathan Busko, MD, MPH, EMT-P, Carolinas Medical Center Neuroscience Research Training Grant: Daniel Rusyniak, MD, Indiana University 2003 Annual Meeting Awards: Faculty Clinical Science Presentation Ian G. Stiell, MD, MSc, FRCPC, University of Ottawa: OPALS Study Phase III: What is the Impact of Advanced Life Support on Out-of-Hospital Cardiac Arrest.

Faculty Basic Science Presentation Lawrence D. Sherman, MD, University of Pittsburgh: Angular Velocity: A New Method to Predict Ventricular Fibrillation Duration.

Young Investigator Clinical Presentation Nathan I. Shapiro, MD, MPH, Beth Israel Deaconess Medical Center: Who Needs a Blood Culture? A Prospectively Derived and Validated Clinical Prediction Rule.

Young Investigator Basic Presentation Daniel P. Davis, MD, University of California, San Diego: Decoy Molecules May Contribute to Neuronal Ischemic Preconditioning.

Clinical Science Fellow Presentation Christian Vaillancourt, MD, MSc, FRCPC, University of Ottawa: Mathematical Model Predicting the Potential Impact of Various Community Bystander CPR Rates on Overall Survival from Cardiac Arrest.

Clinical Science Resident Presentation Christopher Kabrhel, MD, Massachusetts General Hospital: Prospective Evaluation of the Canadian Pulmonary Embolism Score in an Undifferentiated Emergency Department Population.

Clinical Science Medical Student Presentation Jason McMullan, University of South Carolina: Emergency Department Volume and Patient Acuity as Factors in Patients Leaving Without Treatment.

Basic Science Medical Student Presentation Cedric Lefebvre, BS, Wake Forest University: Anti-Apoptotic Effects and Its Mechanisms of a Peroxisome Proliferator-Activated Recetor-g Agonist in Hypercholesterolemic Rabbits Subjected to Myocardial Ischemia and Reperfusion.

Innovations in Emergency Medicine Exhibits (IEME) Presentation Michael Gisondi, MD, Stanford University: Emergency Department Orientation Utilizing Web-Based Streaming Video.

2.

Election Results, Don Yealy, MD, President The following slate of nominees was presented to the membership for vote by mail ballot: President-elect: Glenn Hamilton, MD, Wright State University Susan Stern, MD, University of Michigan Secretary/Treasurer: Katherine Heilpern, MD, Emory University James Hoekstra, MD, Wake Forest University Board of Directors: Mark Angelos, MD, Ohio State University Jeffrey Kline, MD, Carolinas Medical Center Robert Neumar, MD, PhD, University of Pennsylvania

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Tuesday, May 18, 2004 Robert Schafermeyer, MD, Carolinas Medical Center Terri Schmidt, MD, Oregon Health & Sciences University Ellen Weber, MD, University of California, San Francisco Resident Member of the Board: Maria Raven, MD, New York University, Bellevue Jon Rittenberger, MD, University of Pittsburgh Joel Schofer, MD, University of California, Irvine Nominating Committee: Wendy Coates, MD, Harbor - UCLA Frank Counselman, MD, Eastern Virginia Medical Schoo Constitution and Bylaws Committee: Michael Beeson, MD, Summa Health System James Holmes Jr., MD, University of California, Davis Charlene Irvin, MD, Wayne State University 3. AEM Report and Announcements, Michelle Biros, MD, Editor-in-Chief 4. Constitution and Bylaws Amendments, Don Yealy, MD 5. President’s Address, Don Yealy, MD 6. Introduction of 2004-2005 President Carey Chisholm: Don Yealy, MD 7. New Business 8. Adjournment NOTE: Award and grant recipients, newly elected members of the Board and Nominating and Constitution and Bylaws Committee are asked to remain after the Annual Business Meeting to participate in a brief photo session. Photos will be published in upcoming issues of the SAEM Newsletter.

Leadership Award

Academic Excellence Award

Joseph Waeckerle, MD

Tom P. Aufderheide, MD

Young Investigator Awards

Debra Houry

Craig D. Newgard, MD, MPH

Michael Schull, MD, MSc

Grant Recipients

Brian Blyth, MD

Jonnathan M. Busko, MD, MPH, EMT-P

Richard E. Rothman, MD, PhD

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Daniel Rusyniak, MD

Robert Wears, MD

Wednesday, May 19, 2004

SCIENTIFIC PAPERS ORAL PAPER PRESENTATIONS

390. The Accuracy of Mild Traumatic Brain Injury Surveillance Using Retrospective Case Ascertainment by ICD-9 Codes, Jeffrey Bazarian, MD, MPH, University of Rochester 391. Cost Analysis of Point-of-care, Limited Ultrasonography (PLUS) in Trauma Patients: The Sonography Outcomes Assessment Program (SOAP)-1Trial, M Sharma, DO, New York Methodist Hospital

Challenging Dogma (8:00-9:00 am) Moderator: Judd E. Hollander, MD, University of Pennsylvania ❉ 370. A Randomized Controlled Trial of Removable Splinting vs Casting in the Management of Wrist Buckle Fractures, Amy Plint, MD, Children's Hospital of Eastern Ontario 371. Is Simulation a Valuable Teaching Tool or a Waste of Time?, Linda Spillane, MD, University of Rochester 372. Single vs Double Layer Closure for Facial Lacerations, Adam Singer, MD, Stony Brook University 373. Value of an Unannounced Drill in Preparing Hospitals for a Terrorism Attack or Other Mass Casualty Event, Edward Jasper, MD, Thomas Jefferson University

Clinical Cardiovascular II (10:00 am-Noon) Moderator: James Hoekstra, MD, Wake Forest University 392. Rapid Transfer of ST Elevation Myocardial Infarction Patients for Primary Angioplasty Is Feasible in the United States, David Larson, MD, Ridgeview Medical Center 393. Prognostic Value of a Novel Qualitative Analysis for Heart-type Fatty Acid-binding Protein in Patients with Acute Coronary Syndrome in the ED, Masaru Suzuki, MD, Saiseikai Utsunomiya Hospital, Japan ❉ 394. Does a Negative Inpatient Stress Test or Catheterization Prevent Return Cardiac Visits in the Following Year?, Kyle Shaver, BS, University of Pennsylvania 395. Vein-to-brain Time: An ED Quality of Care Marker for Non-ST-segment Elevation Acute Coronary Syndromes, William Peacock, MD, The Cleveland Clinic Foundation 396. Relationship Between Time to ED Cardiac Marker Results and Adverse Cardiac Events, Alan Storrow, MD, University of Cincinnati 397. ED Observation of Heart Failure is Safe and Cost-effective, Alan Storrow, MD, University of Cincinnati

CPR (8:00-9:00 am) Moderator: Lance B. Becker, MD, University of Chicago 374. Incomplete Chest Wall Decompression during CPR, Tom Aufderheide, MD, Medical College of Wisconsin ❉ 375. A Comparison of Traditional Dispatcher Assisted CPR to Compressions-only Dispatcher Assisted CPR, Jefferson Williams, BS, University of North Carolina, Chapel Hill 376. Clinical Factors Have Time-dependent Influences on Death Rate after Cardiac Arrest, Alice Min, BS, University of Pittsburgh 377. Geographic Variability of Out of Hospital Cardiac Arrest after Controlling for Population Density, E. Brooke Lerner, PhD, University of Rochester

POSTER SESSION (Noon-2:00 pm)

Diagnostic Lab Tests (9:00-10:00 am)

Clinical Decision Guidelines

Moderator: Brian Euerle, MD, University of Maryland 378. Lack of Utility in Obtaining Routine Serum Coagulation Studies Prior to Intravenous Heparin Anti-coagulation in the ED, Aaron Jones, MD, York Hospital 379. Does the Presence of Crystal Disease (Gout/Pseudogout) Rule Out Septic Arthritis?, Kaushal Shah, MD, St.Luke's-Roosevelt/Columbia University 380. Comparison of Laboratory Values Obtained by Phlebotomy vs Saline Lock Devices, Jill Corbo, MD, Jacobi Medical Center, Albert Einstein College of Medicine 381. Warfarin Patients in the ED: Prevalence of Dangerous INR and the Need for Laboratory Testing, David Newman, MD, St. Luke's/Roosevelt Hospital, Columbia University

398. Anion Gap as a Screening Tool for Elevated Lactate in Patients with an Increased Risk of Developing Sepsis in the ED, Matthew Berkman, MD, Beth Israel Deaconess 399. Lactate Predicts Death in ED Patients with Infection, Nathan Shapiro, MD, MPH, Beth Israel Deaconess Medical Center 400. The Role of the Mental Status Examination in Assessment of Minor Head Injury, Ian Stiell, MD, MSc, University of Ottawa 401. Interobserver Agreement in the Assessment of Children with Minor Head Injury, Martin Osmond, MD, CM, University of Ottawa 402. How Important Is the 'Age 65' Criterion in the Canadian C-spine Rule?, Ian Stiell, MD, MSc, University of Ottawa 403. Can Nurses Apply the Canadian C-spine Rule?: A Pilot Study, Anne-Maree Kelly, MD, Joseph Epstein Centre for Emergency Medicine Research, Australia 404. Concordance of Disposition for Hypothetical Medical Patients in the ED, Jason Hack, MD, East Carolina University 405. A Decision Rule for Terminating Search and Rescue Missions Based on Maximum Survivor Benefit in a Rural State, Annette Adams, MA, MPH, Oregon Health & Science University 406. Implementation of Acute MI Guidelines in Community Hospitals without Cardiac Catheterization Labs. Are We There Yet?, David Larson, MD, Ridgeview Medical Center 407. Development of a Prediction Rule for the Early Discharge of Patients with Chest Discomfort, Jim Christenson, MD, St. Paul's Hospital, University of British Columbia 408. Is Routine Electrolyte Testing Necessary for Diabetic Patients with Moderate Hyperglycemia?, Mamie Caton, MD, State University of New York, Downstate/Kings County Hospital 409. Selective Radiography in Anterior Shoulder Dislocation: Prospective Validation of a Clinical Decision Rule, Gregory Hendey, MD, University of California, San Francisco- Fresno 410. The Role of Clinical Factors, Wood's Lamp Exam, and Slit Lamp Exam in the Diagnosis of Eye Disease in the ED, Steven Go, MD, University of Missouri, Kansas City 411. Prediction of Progressive Renal Insufficiency in Patients with Acute Rhabdomyolysis, Rais Vohra, MD, University of Texas Southwestern

Infectious Disease (9:00-10:00 am) Moderator: Gregory Moran, MD, Olive View-UCLA 382. The Short and Long Term Effect of an Educational Intervention on the Contamination Rate of Physicians’ Stethoscopes, Scott Melanson, MD, St. Luke's Hospital 383. Do Clumped Leukocytes on Standard Urinalysis Predict Urinary Tract Infection in Children?, Christopher Russo, MD, Drexel University 384. Performance Characteristics of Clinical Diagnosis and a Rapid Influenza Test in the Detection of Influenza Infection in a Community Sample of Adults, John Stein, Jr, MD, University of California, San Francisco 385. Tap Water Irrigation of Sutured Wounds, Aaron Pfalzer, MD, State University of New York, Buffalo

Trauma (10:00 am-Noon) Moderator: E. John Gallagher, MD, Albert Einstein College of Medicine ❉ 386. Effects of Cocaine in an Experimental Model of Traumatic Brain Injury, Brian McBeth, MD, University of Michigan 387. Motor Vehicle Collision Characteristics Associated with Brain Injury in Mild Head Injury Patients, Majid Al-Salamah, MBBS, University of Ottawa 388. Level One Trauma Centers with Emergency Medicine Residency Programs Are Associated with Improved Trauma Patient Outcome, Shawn Taylor, MD, Brooke Army Medical Center 389. The Error Rate and Image Quality of Emergency Medicine Residents Performing Focused Abdominal Sonography for Trauma: Is There a Learning Curve?, Timothy Jang, MD, Washington University

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Wednesday, May 19, 2004 Diagnostic Technologies Ultrasound: Imaging of Venous Thromboembolic Disease

412. Factors Influencing the Distance that Oral Contrast Travels in Patients with Blunt Abdominal Trauma as Determined by Abdominal CT Scan, John Broderick, MD, Albany Medical Center 413. Evaluation of Acute Contrast Induced Nephropathy in Acute Ischemic Stroke Patients Undergoing Routine CT Angiography Using Nonionic Contrast, Andrew Asimos, MD, Carolinas Medical Center 414. Does Potassium Concentration Measured on Blood Gas Analysis Agree with Serum Potassium in Patients with Diabetic Ketoacidosis?, Anne-Maree Kelly, MD, MclinEd, Joseph Epstein Centre for Emergency Medicine Research, Australia 415. Ketone Measurements in the ED, Elizabeth Hilton, MD, University of New Mexico 416. Aluminum Foreign Bodies: Do They Show Up on Standard Radiographs?, Jonathan Valente, MD, Rhode Island Hospital, Brown University 417. Reliability of Radiology Resident Radiograph Interpretations in a Tertiary Care Center, Sangeeta Lamba, MD, University of Medicine and Dentistry, New Jersey 418. Reliability of ED Head CT Scan Interpretation, Michael Bullard, MD, University of Alberta 419. Electrocardiographic ST Segment Depression: Predictive Association with Acute Coronary Syndromes, Trey Dobson, MD, University of Virginia

438. Value of Pulmonary Contusion Score (PCS) by Chest CT Scan, Hyuk Jun Yang, MD, Gil Medical Center, Gachon Medical School 439. Can EM Residents Detect Acute DVT with a Limited, Two-site Ultrasound Exam?, Jeanne Jacoby, MD, St. Luke's Hospital 440. Accuracy of Resident-performed Limited Compression Ultrasonography for the Diagnosis of Lower Extremity Deep Vein Thrombosis, Anthony Dean, MD, University of Pennsylvania 441. Emergency Physician Performed Ultrasound Accurately Identifies Upper Extremity Deep Venous Thrombosis, Stephen Leech, MD, Christiana Care Health System

Out-of-Hospital Care 503. The Epidemiology of Cardiac Arrest In Schools: Limited Potential For PAD In a Low Risk Setting, Valerie De Maio, MD, MSc, University of North Carolina 442. Predictors of Survival for Out-of-hospital Chest Pain Patients in the OPALS Study, Marcus Ong, MD, FRCS, University of Ottawa, Canada 443. Prehospital Presentation of SIDS and Patient Survival, Matthew Smith, MD, Harbor-UCLA 444. Validation of Bispectral Index Monitoring in Aeromedical Transport, Ryan Fringer, MD, Hennepin County Medical Center 445. A Retrospective Case Series Describing the Injury Pattern of the Advanced M26 TASER in Multnomah County Oregon, John McManus, MD, Oregon Health & Science University 446. Improvement in First Shock Time in Areas of Mass Gathering by Use of Quick Response ALS Teams, Salvatore Silvestri, MD, Orlando Regional Medical Center 447. Outcome of an Educational Intervention on Pre-hospital Pain Management, Shu B. Chan, MD, MS, Resurrection Medical Center 448. Triage Behavior of First Responders, Kenneth Williams, MD, Rhode Island Hospital 449. A Randomized Controlled Feasibility Trial Comparing Safety and Effectiveness of Prehospital Pacing vs Conventional Treatment: ‘PrePACE’, Laurie Morrison, MD, Women's College Health Sciences Centre 450. Derivation of a Termination-of-resuscitation Guideline for Emergency Medical Technician-paramedics and Comparison with a Published Emergency Medical Technician-defibrillator Guideline, Laurie Morrison, MD, Sunnybrook & Women's College Health Sciences Centre 451. Location of Out of Hospital Cardiac Arrests to Determine Placement of AED, Elhussein Khalid, MD, University of Medicine and Dentistry, New Jersey 452. Learning Curve for Paramedics Administering a Reconstituted Study Drug Infusion during Cardiac Arrest Resuscitation in a Randomized Controlled Trial, Riyad Abu-Laban, MD, MHSc, University of British Columbia 453. Recognition of ALTE by Prehospital Providers after the Institution of a Countywide Protocol, Christopher Fee, MD, University of California, San Francisco 454. The Impact of an Active EMS Medical Control to Manage Scarce Health Care Resources, James McCubbin, MD, University of Rochester 455. Socioeconomic Status and Survival after Prehospital Cardiac Arrest, Christopher Denny, MD, University of Toronto 456. Neither EMS Personnel nor Lay Observers Estimate Heights Accurately, Jennifer Axelband, DO, St. Luke's Hospital

Ultrasound 420. Detection of Soft Tissue Foreign Bodies by Ultrasound in the Presence of Soft Tissue Gas, Matthew Lyon, MD, RDMS, Medical College of Georgia 421. Intra-oral Ultrasound in the Diagnosis and Real Time Guided Drainage of Peritonsillar Abscesses, Michael Blaivas, MD, RDMS, Medical College of Georgia 422. A Prospective Comparison of Supine Chest X-ray and Bedside Ultrasound for Diagnosis of Traumatic Pneumothorax, Sandeep Duggal, MD, RDMS, Medical College of Georgia 423. Bedside Ultrasound for the Diagnosis of Pneumothorax: A Teaching Module for Emergency Physicians, Christine Irish, MD, Maine Medical Center 424. Accuracy of Ultrasound in Major Pelvic Injury, Amie Nielsen, MD, Carolinas Medical Center 425. Emergency Physician Ultrasound Decreases Time to Diagnosis, Time to CT Scan, and Time to Operative Repair in Patients with Ruptured Abdominal Aortic Aneurysm, Eitan Dickman, MD, Christiana Care Health System 426. Emergency Physician Ultrasound Decreases Physician Times to Diagnosis, Beta-blocker Therapy and Operative Repair in Patients with Acute Aortic Dissection, Paul Sierzenski, MD, RDMS, Christiana Care Health System 427. Opioid Analgesia Does Not Affect the Assessment of the Sonographic Murphy's Sign, Bret Nelson, MD, Massachusetts General Hospital 428. Accuracy of FAST Exam Interpretation as Influenced by Anechoic Stripe Size and Physician Experience Level, O. John Ma, MD, Truman Medical Center

Ultrasound: Ultrasound and Vascular Access 429. Ultrasound-guided Peripheral Intravenous Cannulation in ED Patients with Difficult IV Access, Wendy Cole, MD, Alameda County Medical Center 430. Anatomic Survey of External Landmark Method for Placement of Internal Jugular Catheters with Ultrasound, Ralph Wang, MD, Alameda County Medical Center, Highland Campus 431. The Effect of Head Rotation on Vascular Anatomic Relationships in the Neck: An Ultrasound Study, Ralph Wang, MD, Alameda County Medical Center, Highland Campus 432. Ultrasound Guided IV Placement Superior to Traditional Approaches at Establishing Peripheral Intravenous Access in Difficult Patients, Aman Parikh, MD, Drexel University 433. The Effect of Hip Abduction and External Rotation on Femoral Vein Accessibility for Cannulation, Sandra Werner, MD, MetroHealth Medical Center, Case Western Reserve University 434. Ultrasound-guided vs the Blinded Landmark Technique for the Placement of Percutaneous Suprapubic Cystostomy Catheter Placement in the ED, Jeffrey Chan, MD, Martin Luther King Jr./Drew Medical Center 435. Emergency Nurses Utilization of Ultrasound Guidance for Placement of Peripheral Intravenous Lines in Difficult Access Patients, Larry Brannam, MD, RDMS, Medical College of Georgia ❉ 436. The Effect of Needle Entry Angle and Needle Type on Needle Tip and Shaft Visualization During Ultrasound-guided Vascular Access, Robert Jones, DO, MetroHealth Medical Center 437. Use of Real-time, Single-operator, Dynamic-guidance Ultrasonography (DPLUS) for Central Venous Cannulation (CVC), Truman Milling, MD, New York Methodist Hospital

Out-of-Hospital Care: Airway Control 457. Thiopental vs Etomidate for RSI in Aeromedicine, Jennifer Axelband, DO, St. Luke's Hospital 458. Rate and Outcomes of Unrecognized Esophageal Placement of Endotracheal Tubes by Paramedics in an Urban ED, Christine Ortiz, MD, St. Luke's/Roosevelt Hospital, Columbia University 459. An Automatic Transport Ventilator (ATV) vs Bag Valve Mask (BVM) for Ventilation During EMS Transport, Steven Weiss, MD, UC Davis Medical Center 460. Succinylcholine Use by General Duty Paramedics in the Prehospital Setting: A Comparison of Intubation Success Utilizing an RSI Protocol vs Historical Control in an Urban Canadian ALS System, Christine Hall, MSc, MD, University of Calgary

Out-of-Hospital Care: Refusals 461. Patient Refusal of Out-of-hospital Medical Treatment and/or Transport: Do We Really Determine Medical Decision-making Capacity and Obtain Informed Refusals?, Michael T. Cudnik, MD, MetroHealth Medical Center

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Wednesday, May 19, 2004 483. Asphyxial Cardiac Arrest Increases Brain N-methyl-D-aspartate Receptor 1 Expression in Rats, Feng Xiao, MD, Louisiana State University, Shreveport 484. Ifenprodil, an N-methyl-D-aspartate Receptor Polyamine Site Antagonist, Decreases Brain Aquaporin 4 Expression Following Cardiac Arrest in Rats, Feng Xiao, MD, Louisiana State University, Shreveport 485. A Comparison of Anti-arrhythmic Medications in the Treatment of Hypothermic Ventricular Fibrillation in a Pig (Sus Scrofa) Model, Shannon Faber, MD, Wilford Hall Medical Center 486. Vasopressin Alone or with Epinephrine May Be Superior to Epinephrine in a Clinically Relevant Porcine Model of PEA Cardiac Arrest, Mia Marietta, MS, University of Colorado 487. Uninterrupted Chest Compression CPR Is Easier to Perform and Remember than Standard CPR, Joseph Heidenreich, University of Arizona 488. A Comparison of Methodologic Approaches to Quantify Return of Spontaneous Circulation (ROSC) in Cardiac Arrest Research Including ROSC Survival Analysis, Riyad Abu-Laban, MD, MHSc, University of British Columbia 489. Validation of the Gothenburg Futility Criteria For Out-of-hospital Cardiac Arrest Presenting with Pulseless Electrical Activity, Riyad Abu-Laban, MD, MHSc, University of British Columbia 490. Relationship Between Rapidity of Fibrinolytic Administration and Probability of Pulse Return in Patients Given Tissue Plasminogen Activator During Pulseless Electrical Activity Cardiac Arrest, Riyad Abu-Laban, MD, MHSc, University of British Columbia 491. Chest Compression Rates during CPR Are Sub-optimal: A Prospective Study during In-hospital Cardiac Arrest, Benjamin Abella, MD, MPhil, University of Chicago 492. BLS Performance Decreases with Increasing Resuscitation Complexity, Jon Rittenberger, MD, University of Pittsburgh 493. Combination Pharmacotherapy vs Standard Advanced Cardiac Life Support for the Treatment of Ventricular Fibrillation, Todd Larabee, MD, Washington Hospital Center 494. The Three-phase Model of Cardiac Arrest as Applied to Ventricular Fibrillation in a Large, Urban EMS System, Daniel Davis, MD, University of California, San Diego

462. Safety of Pre-hospital Medical Clearance of Psychiatric Patients without Medical Complaints, Tiffany Haddock, MD, University of New Mexico Health Sciences Center 463. Short-term Outcome of Air Travelers Who Refuse Transport after EMS Evaluation at an International Airport, Robert Marsan, BS, University of Pennsylvania 464. What Are the Characteristics and Outcomes of Non-transported Pediatric Patients?, Martin Osmond, MD, CM, University of Ottawa

Pediatrics 465. Where Do Acutely Injured Children Receive Care? Health Service Utilization for Acute Pediatric Trauma: An Expansion of the Canadian Hospitals Injury Reporting Prevention Program (CHIRPP), Martin Osmond, MD, CM, University of Ottawa 466. Child Abuse Fatalities: Are We Missing Opportunities for Intervention?, Wendalyn King, MD, MPH, Emory University 467. Do Family Members Disrupt Care When Present During Invasive Procedures in Children?, Alfred Sacchetti, MD, Our Lady of Lourdes Medical Center 468. The Effect of Picture Archiving and Communications Systems on the Diagnostic Performance of Pediatric Emergency Physicians, Serge Gouin, MDCM, SteJustine Hospital 469. The PECARN Core Data Project: Epidemiology of a Pediatric Emergency Medicine Research Network, Elizabeth Alpern, MD, MSCE, The Children's Hospital of Philadelphia 470. Evaluation of Adverse Effects after ED Sedation, Jan Luhmann, MD, Washington University

Pediatrics: Potpourri of Infections and Related Topics 471. A Randomized, Controlled Trial of Sucrose Analgesia for Children Less than 90 Days of Age Undergoing Bladder Catheterization in the Pediatric ED, Alexander Rogers, MD, Emory University and Childrens Healthcare of Atlanta 472. Bacteremia in Febrile Infants Presenting to the ED after the Introduction of Heptavalent Pneumococcal Vaccine, Keri Carstairs, MD, Naval Medical Center, San Diego 473. Prevalence of Tubo-ovarian Abscess in Adolescents Diagnosed with Pelvic Inflammatory Disease in a Pediatric ED, Cynthia Mollen, MD, MSCE, The Children's Hospital of Philadelphia 474. Diagnostic Utility of C-reactive Protein in Children with Suspected Appendicitis, Linda Brown, MD, The Children's Hospital of Philadelphia 475. Performance of Lumbar Puncture in Young Children with Febrile Seizures, Bryan Ngo, University of Califonia, Davis 476. Adult Uropathogen Resistant Trends Do Not Predict Pediatric Resistant Trends, Romolo J. Gaspari, MD, MSc, University of Massachusetts 477. Utility of Bedside Bladder Ultrasound Prior to Urethral Catheterization in Infants, Lei Chen, MD, Yale New Haven Children's Hospital

MODERATED POSTERS (1:00-2:00 pm) Safety of First Responders Moderator: Jane Brice, MD, University of North Carolina, Chapel Hill 495. Do First Responders Enter Unsafe Environments?, Kenneth Williams, MD, Rhode Island Hospital 496. The Effect of Night Vision Goggles on Performance of ALS Skills by Physicians and Paramedics, Savoy Brummer, MD, Hospital of the University of Pennsylvania 497. Effect of Personal Protective Equipment (PPE) on Rapid Patient Assessment and Treatment During a Simulated Chemical Weapons of Mass Destruction (WMD) Attack, Selim Suner, MD, MS, Brown University ❉ 498. Using DC Oximetry to Detect Exhaustion in Working Firefighters, Carin Van Gelder, MD, Yale University

Cardiac Arrest 478. Does End-tidal CO2 Indicate the Mechanism of Cardiac Arrest with Pulseless Electrical Activity, Stefek Grmec, MD, PhD, Center for Emergency Medicine, Maribor, Slovenia 479. Performing Procedures on the Newly Deceased: Survey of a Rural Community, Melanie Brown, MD, Oregon Health and Science University 480. The Rate of Survival to Discharge with Intact Neurologic Status Following Cardiac Arrest in the Hospital, Robert O'Connor, MD, MPH, Christiana Care Health System 481. The Effectiveness of Cardioversion Using Automated External Defibrillators (AED’s) Deployed to Treat Victims of Cardiac Arrest at Horse Race Tracks, Robert O'Connor, MD, MPH, Christiana Care Health System ❉ 482. Epinephrine in the Treatment of Hypothermic Ventricular Fibrillation in a Canine Model, Kenneth Margolis, MD, Henry Ford Hospital

Pulmonary Embolism Moderator: Jeffrey A. Kline, MD, Carolinas Medical Center 499. Reduction of Pretest Probability Below the Test Threshold Using Clinical Criteria Alone, Alice Mitchell, MD, Carolinas Medical Center 500. An ED Guideline for the Diagnosis of Pulmonary Embolism: An Outcome Study, Steven Vance, MD, Grand Rapids MERC/Michigan State University 501. Inter-rater Agreement in Screening for Pulmonary Embolism, Nils Naviaux, MD, University of Colorado 502. Bed Rest as a Predictor of VTE in Hospitalized Patients Admitted from the ED, Susan Sheehy, MSN, MS, RN, Beth Israel Deaconess Medical Center

Abstract Submission and Acceptance History 2004 997 submissions 503 accepted

2003 939 submissions 451 accepted 30

2002 934 submissions 497 accepted

Wednesday, May 19, 2004

DIDACTIC SESSIONS Responsible Conduct of Research Series: Protecting Humans and Animals in Research (8:00-11:00 am)

Grant Review and Open Interactive Session), the following improvements have been made based on prior experience from similar sessions, and feedback from membership, prior participants and the research committee. Individual Grant Review Part I: Recognizing the demand for one-on-one in-depth mentorship of junior and midlevel grant writers, we will further expand the service being offered matching experienced researchers with unsuccessful grant writers and giving specific feedback on how to improve their grant applications. Open Interactive Session Part II: Following the individual reviews, two grant applications will be selected from among those reviewed to be presented and discussed in an open forum. During this session each grant writer will give a brief summary of the application and each of two expert reviewers will then explain their constructive feedback. The bulk of the time during this session will then be dedicated to spontaneous interactive discussion between the panelists and the audience in order to extrapolate specific comments raised during the reviews to general principles of grantsmanship. At the completion of the session, participants will: 1) gain insight into the common errors in grant writing; 2) understand the thought process of a grant reviewer; and 3) know how to ‘spin’ a grant application based on the mission and goals of the agency and study section.

Jill Baren, MD, University of Pennsylvania Leonard Friedland, MD, Temple University Lynne Richardson, MD, Mt. Sinai Medical Center Susan Stern, MD, University of Michigan This lecture will begin with a discussion of the system for protection of human subjects, including the institutional review board, its development and its implementation. The differences between exempt studies, expedited review of studies and full board review will be described, using examples of each. Topics of particular interest to research in emergency medicine will be emphasized, such as various risks to human subjects involved in research, including adverse events and loss of confidentiality. Requirements for the protection of human subjects in the design and conduct of studies will be reviewed.

Defining, assessing, and reporting of adverse events will be discussed. A major portion of this presentation will be devoted to a variety of informed consent issues, such as consent for cognitively impaired patients and waiver of informed consent, using case studies as examples. In discussion of the Waiver of Consent/Exception from Consent for Emergency Research, the criteria to qualify for these regulations will be reviewed. Care and Use of Animals in Research (1 hr): This session will review the history of animal research, the development of laboratory animal medicine, and animal research regulations. Advances that have been made through, and value of animal research will also be discussed and indications for animal research and biological models will be reviewed.

Appropriate alternatives to animal research will be offered. Current animal use guidelines will be discussed including the 3 R’s of Animal Research: replacement, reduction, and refinement. Criteria for a good animal model system will be given. At the completion of the session, participants will: 1) be familiar with ethical principles and federal regulations relating to protection of human subjects of research; 2) identify ethical and regulatory perspectives that may be unique to research in the emergency setting; 3) have experience applying these principles and regulations to actual cases; 4) be familiar with ethical principles and federal regulations relating to research in animals; and 5) be able to address general issues of concern to IRBs and IACUCs.

WILLIAM SPIVEY LECTURE: The History of Academic Emergency Medicine (11:00 am-12:00 Noon) Brian Zink, MD, University of Michigan This lecture will focus on the early history of academic emergency medicine up to the formation of SAEM in 1989. It will trace the origins of academic emergency medicine from the junior academic surgeons (UAEMS) who were charged with running university hospital emergency rooms in the 1960’s, through the formation of ACEP and early educational efforts for practicing emergency physicians, to the first residency training programs, to the creation of a certifying board in emergency medicine, and finally the establishment of a full-fledged academic discipline in the 1980’s and 1990’s with the rapid advancement of academic emergency medicine training and research. The factors that encouraged and impeded the growth of academic emergency medicine will be explored.

The lecture will demonstrate how the struggles and triumphs of these early years provide lessons on how academic emergency medicine can meet its challenges today. The presentation will include historical images, and excerpts from the oral history interviews.

At the completion of the session, participants will have an improved awareness and understanding of the history of the academic emergency medicine, and how their careers compare with the early leaders.

The Identification, Critical Appraisal, and Clinical Application of High-Quality Systematic Reviews (8:00-9:30 am) Michael D. Brown, MD, Grand Rapids MERC/Michigan State University Brian Rowe, MD, University of Alberta For questions regarding both therapy and diagnosis, systematic reviews (SRs) are often placed at the pinnacle of the hierarchy of evidence. Like any research endeavor, however, obtaining high quality in SRs can be achieved only by a sound knowledge of the methodological principles and rigorous, systematic conduct of the review. In order to judge the quality of a systematic review, the clinician must understand some basic principles of systematic reviews. The goals of this course are: 1) review the methodology in conducting a systematic review; 2) interactively analyze a systematic review. The session will be presented in 3 parts. Part I: Standard methods for systematic review including a clear statement of the objectives, the search strategies, study selection and study assessment. Part II: Critical appraisal of a systematic review. Part III: Advanced concepts related to systematic review such as publication bias, assessment of methodological quality using scores vs. sensitivity analysis, summary estimates of effect for therapeutic interventions and diagnostic tests (‘meta-analysis), and how to explore and test for heterogeneity. At the completion of the session, participants will: 1) understand the definitions of “systematic review,” “overview,” and “meta-analysis”; 2) critically appraise the quality of a systematic review; 3) understand the concepts of publication bias, selection bias, and methodological quality; 4) understand the concepts of statistical pooling, heterogeneity and subgroup/sensitivity analyses; 5) apply and teach the application of systematic reviews to emergency medicine clinical practice; and 6) discuss the strengths and weaknesses of systematic reviews vs. large randomized, controlled clinical trials.

Creating and Developing High-Quality Data Collection Instruments (11:00 am-12:00 Noon) Demetrios N. Kyriacou, MD, PhD, Northwestern University Clinical scientists use data collection instruments to measure exposure, intervention, predictor, and outcome variables to assess postulated cause and effect relationships.

Since the validity of a study’s findings depends on the quality of the collected data, it is imperative that clinical scientists use instruments that accurately measure and classify the study variables. This lecture will present the fundamental principles of creating and developing high-quality data collection instruments. It will discuss the importance of constructing valid and reliable questions to measure demographic, behavioral, and clinical characteristics – emphasizing clarity, simplicity, and neutrality. The advantages and disadvantages of using various types of questions and scales will be reviewed, including the use of existing pre-validated versus newly-created questions. Steps in assembling the data collection instrument will also be presented, including: 1) selecting the study variables; 2) composing a draft of the instrument; 3) formatting the questions within the instrument; 4) pilot testing the draft instrument; and 5) revising and shortening the instrument as necessary. The importance of proper methods of administering the instrument will also be presented. Several examples of question construction and instrument implementation will be demonstrated. At the completion of the session, participants will understand: 1) the basic principles for creating and developing high-quality data collection instruments for clinical research; 2) the advantages and disadvantages of different types of questions; and 3) proper methods of administering the data collection instrument.

Grant Mentorship Workshop - Part II (9:30-11:00 am) Moderator: Gary Green, MD, MPH, Johns Hopkins University Richard Rothman, MD, PhD, Johns Hopkins University James Olson, PhD, Wright State University Mark Angelos, MD, Ohio State University This is a continuation of the highly successful grant mentorship service being developed by the Research Committee. Although continuing to include two components (Individual

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INNOVATIONS IN EMERGENCY MEDICINE EDUCATION EXHIBITS 1 Use of an Online Virtual Library as an ED Bedside Teaching Adjunct and Learning Resource Christopher Russi, James Brown, Richard Harover; Wright State University This exhibit will be the demonstration of an online virtual library for use in the ED as an adjunct to bedside teaching and medical education. Rapid information exchange in the ED is pivotal for learning, bedside teaching and patient care. We wish to demonstrate that the creation of such a web page using a simple program such as Microsoft Word, or more advanced using Dreamweaver, can be easily and efficiently done. Creating such a page allows attendings and residents to rapidly access documents or tools to aid in bedside teaching and patient care, rather than using traditional search strategies on the internet which can be both time consuming and difficult at the point at which information is needed.

4 Digital Photography as a Follow-up Tool for Laceration Repairs Sylvia Kim, Leon Sanchez, Jason Imperato; Beth Israel Deaconess Medical Center/Harvard Affiliate The goal of using digital photography as a follow-up tool in the ED is to improve cosmesis on laceration repairs. We conducted a survey of 100% of our residents which showed that 68% received any comments on laceration repairs and 72% received constructive comments beyond "looks good" on their repairs. The survey also found that 83% have seen five or less suture repairs in follow-up for suture removal and even less for long term results. In our exhibit, we will show the results of our resident survey prior to the initiation of this study which shows the small percentage of residents receiving faculty input. We will also include a sample of the actual survey form. We will display numerous photographs of laceration repairs performed by EM residents before and after suture repair. In our ED, we have a digital camera with macroscopic lens available to the residents. Residents obtain consent from the patient and then take photographs before and after suture repair. Photographs are emailed to multiple members of faculty with a standardized evaluation form, which will also be included in the exhibit. Comments to improve cosmesis address the repair of simple lacerations, deep wounds, and wounds with free flaps. The review includes actual techniques used, tension on wound, number of sutures used and the potential application of deep sutures. Through the use of digital photography, EM residents will be able to see the results of their laceration repairs and receive consistent and detailed faculty comments.

2 Creating a MESS (Multiple Encounter Simulation Scenario) for Medical Error Reduction and Enhanced Medical Education Leo Kobayashi, Marc Shapiro, Anthony Hill, Selim Suner, Gregory Jay; Rhode Island Hospital; Brown Medical School High-fidelity medical simulation (SIM) has the potential to effect change in the culture and practice of medicine, specifically through error reduction and enhancement of patient safety. One role for advanced SIM exists in the ED, an environment where cognitive biases, deficiencies in communication and teamwork, task overload and system flaws make practice prone to error. In order to promote safe delivery of excellent care in such multi-tasking, time-limited and interrupt-driven settings, specific clinical abilities and teamwork functions must be fostered. Distinct from single manikin implementations, a training exercise utilizing multiple SIM manikins which cross-influence each other is necessary. Complex interactions between numerous “patients” and caregivers create chaotic dysfunction and adverse events reflective of the work situation being addressed. Learners are required to handle dynamic and competing cognitive and temporal demands. This Multiple Encounter Simulation Scenario (MESS) instills error-reducing strategies and mental worksets in staff members to assist in managing concurrent high-acuity patients without lapsing into error. The Rhode Island Hospital Medical Simulation Center has successfully implemented nine-victim “dirty bomb” scenarios and Emergency Medicine residency dual-manikin courses focusing on dynamic interactivity.

Deliberately scripted errors such as EKG mislabeling and incorrect medication dosing bring to attention workload assessment, task assignment and enhanced communication.

Participant effectiveness at process prioritization, situational awareness and rapid identification with recovery from critical errors are cultivated. Efficient decision-making and teamwork behavior, as well as rapid initiation of critical interventions are rewarded.

MESS provides opportunities with which to initiate a dialog in the systematic reduction of medical error.

5 A Simple Porcine Model for Teaching Ultrasound-guided Vascular Access Dale McNinch, Jeffrey Jones; Grand Rapids MERC/ Michigan State University Objectives: Although vascular access is a fundamental skill of EM, it may occasionally be challenging to even the most seasoned emergency physician. A laboratory-based curriculum using a quarter round ham was developed to teach emergency physicians the proper technique for ultrasound (US)-guided vascular access and to provide them with hands-on training. Methods: A quarter round ham was used to provide an inexpensive but realistic soft tissue echo image similar to the texture of the human arm or leg. Latex and plastic tubing, filled with red fluid, were used simulate veins and arteries respectively. The tubing was placed at approximately 1.5 cm in depth to simulate a deeper peripheral artery or, potentially, a central vein. Participants were EM residents (PGY 1-3) and practicing physicians attending an US training course during 2003. After a 30-minute tutorial on US-guided vascular access, physicians performed arterial and venous cannulation using a Sonosite 180 Plus® portable ultrasound system. Results: During a one year period, 30 EM residents and 62 practicing physicians were trained using this model.

The mean time to vascular cannulation was 2.4 minutes, depending upon the approach used. The model itself was relatively simple, requiring easily obtainable ingredients from a grocery and hardware store. A post-laboratory survey demonstrated a high subjective level of comfort with this procedure. Conclusions: A quarter round ham model is an effective method to teach emergency physicians with limited training and experience to use ultrasound as an adjunct for arterial and venous access.

3 Bedside Ultrasound for the Diagnosis of Pneumothorax: A Teaching Module for Emergency Medicine Physicians Christine Irish, William Owens, Michael Gibbs; Maine Medical Center Study Objective: The technique for identifying pneumothorax (PNMTX) via thoracic ultrasound (US) may have important clinical implications. This study evaluated the ability of emergency medicine (EM) providers to diagnose PNMTX by thoracic US after completing an investigator-designed, educational intervention. Methods: A prospective, observational methodology was used. Study participants consisted of medical providers at three EM residency-training programs. The study intervention reviewed the principles and technique for thoracic US with incorporation of digitized US images. The intervention was presented in didactic lecture format at each program site. The EM provider’s ability to identify PNMTX was assessed immediately after the intervention, using a case-based format consisting of thoracic US images distinguished by presence or absence of PNMTX. The EM provider assessments were collated and data were analyzed using descriptive statistics. Results: Eighty-six EM providers were enrolled: 19 attending physicians, 54 resident physicians and 13 other providers. Following the study intervention, providers were able to correctly identify PNMTX in 92% (95% CI: 90% to 93%) of reviewed images. Mean post-intervention assessment scores demonstrated no difference between EM provider groups: attending, resident, and other providers with PNMTX group identification accuracy of 92% (95% CI: 89% to 95%), 91% (95% CI: 89% to 93%), and 93% (95% CI: 89% to 96%), respectively. Conclusion: After completing this education intervention, EM providers were able to reliably diagnose PNMTX during review of thoracic US images. Clinical application of this procedure, including the ability to reliably diagnose PNMTX at the bedside, is currently the focus of further investigation.

6 V-Lectures: A Standardized, Multimedia Curriculum for Medical Student Education in Emergency Medicine Michelle Lin, Wendy Coates; University of California, San Francisco, Harbor-UCLA Medical school graduates must be proficient in managing emergencies in their practices.

The EM clerkship can provide this training and typically is composed of didactic and clinical educational components. Currently, there is no standardized undergraduate curriculum for EM, so didactic programs vary in quality and quantity by institution. To develop a virtual, web-based, multimedia standardized EM curriculum for use by medical student educators. The “V-Lectures” core content is based on the SAEM undergraduate curriculum (1998). “V-Lecture” modules are created using Macromedia Studio’s Flash MX. Nationally recognized EM educators work with the V-Lectures group to design interactive, evidence-based educational modules. Each module consists of text, supplemented with audio, animation, movies, still images, and interactive click-buttons. Each module also has assessment tools to solidify the user’s knowledge by giving immediate feedback on answer selection. There are global and individual benefits to the “V-Lecture” system.

Medical students receive a standardized, high-quality education in EM, regardless of their training institution or availability of on-site EM educators. On an individual level, “VLecture” modules enable students to repeat complex concepts until they are mastered.

Each module can be watched at the student’s leisure, repeating certain slides or entire sections, if desired. Educators can individualize this curriculum to match their needs and utilize the evaluation tools for education or evaluation. “V-Lectures” could be part of a nationwide medical student curriculum for EM and potentially serve as a prototype model for other medical specialties.

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development. Table of Contents 1. Curriculum Development a. Description of a Clerkship b. Designing a curriculum c. Revising a pre-existing curriculum 2. How to Run a Medical Student Clerkship a. Different clerkship environments b. Teaching techniques (1) Clinical settings (2) Didactic c. Information technology d. Evaluation of student performance (1) Clinical setting (2) Objective testing e. Effective feedback f.

Difficult medical student g. Mentoring non LCME students 3. Opportunities for student education in EM a. Additional EM courses b. Integrating into first and second year didactics c. Medical student research opportunities 4. Faculty and residents a. Faculty involvement b. Faculty development c. Residents 5. Administration issues a. Budget issues b. Documentation issues c. Administrative skills 6. Appendix a. Additional resources b. Evidenced-based medicine

7 Withdrawn 8 Emergency Ultrasound Digital Documentation Utilizing a Handheld Pocket PC Brett Ohlfs, Fawaz Ahmad, Rohit Gupta; University of Chicago We previously presented methods for digital documentation of ultrasound images. Our previous systems had significant limitations to widespread deployment. With the advent of newer technologies we have developed a system which is both easily deployable and affordable. With our new system a clinician can record ultrasound examinations on a pocket pc and upload them to a server for quick retrieval at a later time. Our system utilizes a pocket pc (Compaq Ipaq), specialized software and commercially available hardware. Our application records ultrasound images onto a secure digital card on a pocket pc and then transmits the examination to a server using encrypted wireless technology.

The physician has the ability to document the findings and print reports for billing and chart documentation as well as store the images into a digital library for educational purposes. The system provides a HIPAA compliant means of remotely over reading exams utilizing the internet. Future implications of this application will allow us to provide patient images electronically to other departments, as well as incorporate the ability to record motion video. Our system is a cost-effective simple solution for the management of ultrasound images.

12 Inexpensive Intravenous Catheterization Training Model Susan Stroud, Cox Brady; University of Utah Health Sciences Center Teaching medical students and interns venipuncture and IV catheterization skills has traditionally relied on expensive phlebotomy models that simulate human tissue and veins.

These commercially available models generally range in cost from $95 - $395. They are often bulky and difficult to transport and store. We developed an inexpensive, easy to make, disposable venipuncture and intravenous catheter model for use in an emergency medicine interest group training clinic for medical students. The model is small, lightweight and easily transported. The model can be varied to have both superficial and deep veins and provides a reliable flash upon entering the vein. Superficial veins may be palpated through the medium, providing a simulated tactile experience in identifying appropriate vessels in live patients. The model may also be varied in color and translucency making students more or less reliant on feel alone to find a vessel. The vein can be refilled, and the model may be repunctured multiple times before failure. The model is made from gelatin, psyllium, penrose drains, food coloring, salt and water. Each model cost us less than fifty cents to make, and can easily be produced in small or large quantities. The models may be stored in a refrigerator up to several weeks, or at room temperature for several days. A copy of the recipe and demonstration of the production and use of this model will be available at the exhibit.

9 Augmentation of the Medical Student Rotation with High Fidelity Simulation: Learning by the Numbers John Vozenilek, Jonathan Handler, Amy Kontrick; Evanston Northwestern Healthcare, Northwestern Universit The “best� teaching cases present rarely and to a select few fortunate enough to be working that shift. Management of the most critical patients usually requires that medical students step aside, often relegated to observe patiently, waiting to be told what just happened. Some diseases, such as croup and influenza, are seasonal. The clinical experience of medical students rotating through the ED is often shaped by the season, the patient mix, and fortune. Using a real-time patient-tracking tool allows our high fidelity simulation center to modify the case scenarios presented to our medical students. Each month medical students log the real patients they are exposed to during their rotation.

These data are then used to craft a curriculum designed to fill in the gaps.

Medical students ending their EM rotation are commonly asked: How many times did you take a history and physical? Our program asks: How many times did you primarily manage a Level I trauma, or a patient with cardiogenic shock? The Exhibit will demonstrate the database and its application to high fidelity simulation scenario creation.

13 Informed Consent Guidelines: A Tool for Emergency Medicine Residents Rafael Torres, Theodore Gaeta, Michael Guttenberg; New York Methodist Hospital Earlier this year we performed a cross-sectional study of EM residents to determine knowledge and practices of obtaining informed consent in the ED. The survey covered topics related to training, comfort levels and current practices. We found that the majority of EM residents have never received formal training in obtaining informed consent, and only 19% have been trained on the issue during residency. More than half of the residents surveyed have felt uncomfortable obtaining consent and only a third are very confident that they disclose all pertinent risks, benefits and alternatives to patients. Twothirds of all EM residents believe formal training is necessary and half were interested in receiving training. Finally, almost all of the responders (95%) thought a detailed reference source would be useful. We developed a pocket manual for commonly performed ED procedures designed for use by house officers who are required to obtain informed consent. We cover the standards for determining which procedures need consent and provide information about the legal ramifications of obtaining or deferring informed consent. Each procedure has a comprehensive listing of risks, benefits, and alternatives that need to be conveyed to the patient. This handbook can serve as a template for other institutions and specialties that are interested in providing an educational tool for their house staff and students. This manual has the potential to improve communication, minimize misinformation and maximize the patient’s ability to make an informed decision regarding procedures.

10 Integration of High Fidelity Simulation into a Systems-based Modular Curriculum for Emergency Medicine Residents John Vozenilek, Jamie Collings, Ernest Wang; Evanston Northwestern Healthcare, Northwestern University The degree of exposure EM residents have to the powerful tool of high fidelity simulation varies greatly from residency to residency. A variety of factors including; dedicated faculty time to prepare simulation experiences, the variety of case scenarios available, and ancillary resources, are rate-limiters to this valuable teaching modality. In particular, balancing the standard curriculum that typically utilizes a large resident to faculty ratio (conference time) with the less efficient, but probably more individually impact-full simulation sessions, is quite difficult. We have developed a systems-based modular curriculum that is presented over a two-year span, encompassing all aspects of emergency care. By introducing individual and large group simulation sessions directly within this curriculum residents obtain the valuable exposure to high fidelity training. By utilizing digital reproduction and simulcast of sessions during conference time the residents at large experience these cases. Their understanding of the pathophysiology and presentation of acute illness within the systems-based module is augmented by the novel incorporation of high-fidelity simulation to conference time. A particularly valuable experience is the high fidelity augmented morbidity and mortality conference. During this session, the entire residency class may see the historical, physical and laboratory data unfold in a true-totime sequence, managed by resident teams using the simulator. Example video and sample curricula will be available at the exhibit.

14 Web-based Errors Reporting: Capturing More Educational Opportunities Rahul Khare, Brad Uren, Colin Greineder; University of Michigan We present an innovation currently being implemented for the purpose of increasing the reporting of medical errors and using these errors for educational purposes. Our prior research has indicated that while errors occur in the ED, many physicians find there is no effective and confidential channel to address these errors. We have begun to implement a Web-based anonymous reporting form. The report may be left by anyone working in the ED (physicians, nurses, technicians, transporters, etc), as well as any service receiving patients from the ED. Any perceived adverse event is encouraged to be reported. The Web-based form is simple and the required data field includes: patient name, medical record number, admission date, and a description of the event. The optional data field includes: reporter's name and email address. Anonymity is assured, however if the reporter does want feedback of how this was addressed or if they would like to talk about the incident, this can be done. These perceived errors which occur in the ED are reviewed by a member of the CQI committee. The reports are treated as part of an internal CQI/Quality Control project and therefore any educational value attained by these reports are addressed in our monthly Morbidity and Mortality conference. It is our hope that this means of reporting events will allow us to capture more errors and quickly identify and make systems changes to reduce these errors. Also, this system has an extraordinary

11 Medical Student Educator's Handbook David Manthey, Wendy Coates, Douglas Ander; Wake Forest University Baptist Medical Center, Harbor-UCLA, Emory University Faculty in the role of Medical Student Director should have guidance and mentorship as they try to design or assume administrative and teaching roles for medical students.

While the Association of American Medical Colleges has published a general guide for all clerkship directors, this material and advice does not encompass the specific needs that apply to EM. Under the auspices of SAEM, the Undergraduate Medical Education Committee and the Medical Student Educators Interest Group have developed this guide for the EM Medical Student Educators and Clerkship Directors. This text is intended to assist educators who wish to design and implement a new elective or clerkship, improve an existing curriculum, and become aware of resources that can aid in personal career

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18 Wireless Ultrasound: The Wave of the Future?

David Bahner, Timothy Corvino, Greg Telles, Kathy Tunstal; Ohio State University Ultrasound in the ED is a powerful diagnostic tool. Most departments seeking to provide ultrasound services find quality assurance (QA), credentialing and education as core areas central to implementation. Wireless technology in the 802.11 a/b/g bandwidths has been utilized to improve care in registration and other key areas in the emergency department. This technology was recently activated in our department and has facilitated efficient sonographic services. Preceding wireless, thermal printed ultrasound images were used to communicate with consultants, teach remotely from the bedside (conferences), QA, and credential. It was extremely difficult to track acquired images, bind them to the medical record, or use the images as teaching aids. Most importantly, it was impossible for remote consultants to visualize urgent findings from the bedside. This wireless PACS (Picture Archiving and Communication System) ultrasound model bolsters informatics provided to consultants across the academic spectrum. Patients in clinical trauma bays are registered and tracked from a hospital radiology information system (RIS), which populates demographics into a portable ultrasound machine equipped with a wireless PCMCIA network card. Standard obtained images are transmitted wirelessly to an access point connected to a system network PACS. Images can be viewed remotely at any viewing station within the clinical enterprise. The benefits of digitally networking emergency department images are multiple and include clinical interpretation of images at multiple sites, cases for education across disciplines, quality assurance, credentialing, billing, and tracking ultrasound scans for research. Wireless networked imaging is a feasible method to provide emergency ultrasound services.

amount of educational value. Ideally, this could improve the level of care in our ED. 1.

Schenkel S, Khare RK, Rosenthal MM: Residents Perceptions of Medical Mishaps in the Emergency Department: An Interview Based Case Series of Resident Experiences, Academic Emergency Medicine 2003 10: 1318-1324.

15 Technology Requirements for Internet-based EM Education Edward Sloan, J. Huff; University of Illinois at Chciago, University of Virginia The Foundation for the Education and Research in Neurological Emergencies (FERNE) is a non-profit foundation dedicated to improving the emergency care of patients who present with acute neurological emergencies by breaking down the barriers of place and time in Emergency Medicine education. The cornerstone of FERNE’s education efforts is www.FERNE.org, which enables offsite learning and asynchronous, case-based educational content developed by over 60 emergency care providers. Since 1998, FERNE has hosted over 30 conferences and posted over 200 case-based lectures on neurological emergencies to its website, including a stroke meeting presented by the NINDS. Each patient case is accompanied by a discussion of the patient, ED diagnosis and management, an annotated bibliography, and questions and answers. In addition to these PDF materials, there are also MS PowerPoint presentations that may be downloaded for individual use. Using REAL technology, streaming media recordings of these clinical case presentations are also available. Streaming video allows the user to begin viewing the presentation as subsequent portions of the file are being downloaded, and it requires a server that supports the streaming process. One key feature of these video presentations is the ability to listen to the audio associated with an individual slide of interest, making the learning process more efficient. These presentations can also be provided as Windows Media video files and MP3 audio files, which further enhances the accessibility of these clinical cases. This exhibit will demonstrate the www.FERNE.org content and specify the hardware and software necessary to host similar internet-based educational content.

19 Personal Digital Assistant (PDA) Database with Actual Signature of the Supervising Physician - An Innovative Procedure Logbook for the Residents Abu Khan, Steven Davidson; Maimonides Medical Center As a requirement for credentialing, a residency program requires residents to maintain a log of procedures encountered in the ED. Although, there are a few electronic procedure logbooks available, most of them are self-reporting system and does not include the evaluation and signature of the supervising physician. Because of this limitation, many residency programs continued to use the standard paper procedure logbook. We created a Pocket PC® operating system PDA database (with password protection) for recording the procedure evaluation. Interface design was based on standard paper logbook. We focused on rapid data entry with minimum requirement for text, and field-level automation with a scribble control field for recording the actual signature of the supervisor. Once the data is submitted by the supervising physician, it becomes locked, no further editing option is available for the user. The database easily synchronizes with a desktop application. Residents could view each individual procedure evaluation and easily print a report sheet with all procedures and the actual image of the supervisors’ signature. An institutional version of the application could be available to synchronize multiple residents’ PDAs with one desktop database for the program director’s record. This is a noncommercial application, free for personal use. This application is simple to operate and allows easy tracking of procedures including the supervisors’ signatures. In addition, this is less likely to be lost than a paper logbook and maintains a higher degree of patient confidentiality. It could be a great alternative to the conventional procedure evaluation logbook.

16 Live Webcasting of Educational Conferences Brett Ohlfs, Fawaz Ahmad, Marc Bellazini; University of Chicago, University of Wisconsin Educational conferences are an important aspect of resident education and continuing education. Conference attendance at our institution has been affected by the geographic distances between our hospital sites. We initially addressed the issue by developing electronic recordings of lectures which were made available over the internet. While this improves the educational experience for those unable to attend, it eliminates a crucial experience of grand rounds, the interaction between the attending and residents in order to convey relevant experiences. In order to capture this component of education, we have developed a method to broadcast our lectures live on the internet utilizing Microsoft Power Point streaming technology. Residents, attending, and alumni are able to access our secure server from any location and view both streaming video and power point presentations as they occur. In addition, they have the ability to interact with the audience via an integrated chat room in order to provide feedback as well as ask questions and generate discussions. Our system has provided results of near 100% resident attendance, as well as an increasing number of attending and alumni attendance.

17 Use of Single Operator, Real-Time, Dynamic-Guidance Ultrasonography for Central Venous Cannulation Theodore Gaeta, Lawrence Melniker, Truman Milling Jr.; New York Methodist Hospital Use of real-time, dynamic-guidance ultrasonography (D-PLUS) for central venous cannulation (CVC) generally requires two operators, one to hold the transducer and the other to guide the needle. We performed a pilot study evaluating a single-operator technique (D1-PLUS) for the placement of internal jugular (IJ) catheters. All patients requiring central venous access were eligible and were assigned to the D1-PLUS or D2-PLUS technique. Pre-randomization assessment included: demographic characteristics; the clarity of anatomical landmarks (CAL), using a Likert Scale, ranging from 1 for clear visualization to 5 for no visible landmarks; and static determination of IJ diameter. Ultrasound users were novice emergency medicine residents who completed a one-hour training session. Outcomes included first attempt success, number of attempts until success, time to placement of CVC and early complications. In our sample of 18 patients, the percentage first attempt success, average number of attempts and average time to placement for the D1-PLUS group were 62% (27, 99%), 1.6 (1, 2.2) and 64 sec (35, 93 sec), and the D2-PLUS group were 62% (27, 99%), 2.5 (0.3, 4.7) and 84 sec (19, 149 sec).

There was one arterial stick in the D2-PLUS group and no morbidity in the D1-PLUS group. Our data suggests our single operator technique may be equivalent to the traditional dual operator technique regarding first attempt success, average number of attempts and average time to placement. This exhibit describes the content of our brief training session, and, through video, we demonstrate the single-operator technique.

20 Advanced Bioterrorism Triage Algorithm: Handling the Critical First Encounter with Victims of Terror Attacks Italo Subbarao, Christopher Johnson, William Bond; Lehigh Valley Hospital History shows biological and chemical agents, radiation dispersal devices, and suicide bombings have been effective weapons and a continued threat. Numerous courses exist to increase awareness of individual agents and their treatments. However, no material currently exists that focuses on the crucial first encounter with victims of an attack. Until now. We created a new triage algorithm and developed an Advanced Bioterrorism Triage Card and Course to guide emergency physicians, medical command, triage nurses, and EMS response teams to handle the critical first minutes of a bioterrorism attack by using initial symptoms to triage victims into isolation, decontamination, or dirty resuscitation areas. The goals are threefold: to maximize recognition of victims of terror agents and triage appropriately minimizing secondary contamination, maximize recognition of agents and their antidotes, and educate principles of dirty resuscitation. Our Triage Algorithm is directed towards known and unknown, stable and unstable, victims of terror attacks. Using this Algorithm, a take-home pocket card and a day-long course were designed, including testing. The course includes a lecture covering Fundamentals of Bioterrorism followed by 6 small group stations: biological, chemical, cyanide vs. nerve agents, dirty resuscitation, radiation dispersal devices and suicide bombings, and decontamination. Groups at each station use either high fidelity simulation or video vignettes with brief lectures to reinforce the card algorithms. Our Advanced Bioterrorism Triage Card and Course is an effective and essential means of educating those who are the first to interact with terror casualties. Our exhibit will display the Triage Card and algorithms, illustrate scenarios in written form, demonstrate the training video vignettes, and display test results.

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22 Redefining the Scholarly Project: Emergency Medicine Residents Gain Critical Skills Via Scholarly Tracks Brigitte Baumann, Deborah Pierce, Thomas Rebbecchi, Sarah Stahmer,Stephen Trzeciak; UMDNJ/RWJMS at Camden, Einstein Medical Center The goals of the scholarly project are to cultivate residents’ skills in scientific inquiry, promote problem-solving skills and to expose residents to research. As per the Residency Review Committee, these goals can be fulfilled in various ways, from the writing of a case report to the completion of an original research project. Yet, an isolated project generally does not prepare a resident for the demands of an academic career. At our institution, a 2.5 year scholarly track system evolved to help standardize scholarly project requirements as well as to promote the development of an area of expertise by participating residents. Five tracks were developed: Medical Student Educator, ACLS, Ultrasound, Critical Care, and the Administrative Track. Interested residents begin their tracks during the second half of their PGY1 year. This early start enables residents to submit their written projects (i.e. the formal write up of a research project, a literature review or a practice guideline) for presentation/publication well in advance of their search for faculty positions. Tracks also require at least 3 additional skills objectives: administrative, mentorship/teaching, performance improvement, specialized certification (i.e. ACLS instructor, ultrasound credentialing, Fundamental Critical Care Support certification), lecture/presentation skills, and/or the writing of letters of recommendation/student evaluations. At the end of the PGY3 year, participating residents graduate with a portfolio of teaching cases, lectures, PI projects and their written project. This portfolio has been very well received by future employers and serves as the foundation for the development of a niche/area of expertise by our newly graduated residents.

21 Teaching Professionalism: A Case-based Module for Medical Student Educators Charissa Pacella, Ernest Wang, David Wald, Susan Farrell,Wendy Coates; University of Pittsburgh, Northwestern University, Temple University, Brigham and Women's Hospital, Harvard Medical School, Harbor-UCLA Traditional Western medical education has emphasized medical science over the artful practice of medicine. Professional attributes such as responsibility, integrity, compassion and ethical practice, have historically received little formal teaching. In a recent paradigm shift, the ACGME has identified “professionalism” as one of six areas of core competency for resident education, and the LCME Accreditation Standards for medical schools has mandated inclusion of a number of related topics into undergraduate medical education. This has left faculty educators searching for new ways to teach professionalism. The majority of medical schools responding to an AMA survey identified a need for teaching materials or “model programs” to assist in teaching professionalism.

To help fulfill this need, we have designed a case-based teaching module with an accompanying introduction for medical student educators. The format is a downloadable PowerPoint (Microsoft) presentation intended for modification by presenters to suit their individual needs. An enhanced version of the module includes video footage of simulated patient encounters to stimulate further discussion. Issues raised by the cases span professionalism content areas described in the ACGME core competency requirements.

This product is designed primarily for use in the small group discussion setting, which we feel to be most conducive to learning about professionalism. The presentation will be readily available on the internet at <http://saem.org> without any associated fee or restrictions on its use for educational purposes. We anticipate that this module will be a great resource for medical student educators charged with the formal teaching of professionalism.

IEME Submission and Acceptance History 2004 60 submissions 22 accepted

2003 52 submissions 25 accepted

2002 62 submissions 39 accepted

PHOTOGRAPHY DISPLAY CONTRIBUTORS SAEM would like to thank the following individuals who contributed to this year's Clinical Pearls and Visual Diagnosis Contest entries. It is a significant commitment of time and intellect to develop the ever-popular Photo Display, which once again will be presented at the SAEM Annual Meeting in the Exhibit Hall, along with the poster and Innovations in Emergency Medicine Education Exhibits.

Opeolu Adeoye Alexander Baer,MD Kismet Baldwin Keith Bricking, MD David Bryant, DO Susie Chiang, DO Greg Christiansen, DO Richelle Cooper MD, MSHS Adam Corrado, MD Libby Crenshaw, MD Nahla Darkazally, MD Nikhil Goyal Raj Guharoy, MD Barry Hahn, MD Kenneth Heng, MD Jennifer Hess, MD Carl Hsu, MD Andy Hsu, MD

Yanick Isaac, MD Leslie Iverson, ARNP-MPH Kerin Jones, MD Kevin Joseph Chien-Chang Lee, MD Tiffany McCalla Michael Menchine Edward Michelson, MD Rakesh Mistry, MD Risa Moriarity, MD Robert Moskowitz, MD Sergey Motov, MD Charles Muntan Ira Nemeth Floriano Putigna, DO Martin Reznek, MD Christopher Russi, DO Mary Ryan, MD

Michael Schmidt, MD Scott Sherman, MD Carl Skinner, MD Stephen Small, MD Amy Stromwall, MD Jonathan Valente, MD David Vega Muhammas Waseem, MD Evan Alpert, MD Nathan R. Andrew, MD Tom Ashar, MD Alexander B. Baer, MD Robert Blankenship, MD Brian Boesiger, MD William Browder, MD Gar Chan, MD Justin C. Chang, MD Gregory Christiansen, DO

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Troy P. Coon, MD Chad S. Crystal, MD G. Patrick Daubert, MD Dan R. Dockham, MD Amy Drendel, DO Mary Eberhardt, MD Jason W. Edsall, MD Brian Euerle, MD Jason Gardner, MD Gus M. Garmel, MD Diane Gorgas, MD Kadeer M. Halimi, DO Alan Heins, MD David C. Hindle, MD Thea James, MD Abu N.G.A. Khan, MD Kevin J. Knoop, MD David C. Lee, MD

Valerie R. Lint, CO Paris Lovett, MD Anuradha Luke, MD Billy J. Miller, MD D. Scott Moore, DO Jamie M. Patel, MD Laurie Pemberton, DO Lloyd Pena, MD Erin Doherty-Phrampus, MD Floriano Putigna, DO David G. Reiley, MD Michael Reit, MD Jacob A. Roberts, DO Mary Ryan, MD Steven A. Seifert, MD Chu Lin Tsai, MD Brian Wexler, MD George P. Whitehead, MD

DIDACTIC SESSION SPEAKERS James Adams, MD (pg. 22, 24) Northwestern University

Leonard Friedland, MD (pg. 31) Temple University

Roger Lewis, MD, PhD (pg. 45, 18, 23) UCLA-Harbor

Arthur Sanders, MD (pg. 13) University of Arizona

Doug Ander, MD (MSS) Emory University

Susan Fuchs, MD (pg. 23) Northwestern University

Joe Lex, MD (pg. 19) Temple University Hospital

Sandra Schneider, MD (pg. 19) University of Rochester

Kay Anderson, PhD (pg. 18) AHRQ

E. John Gallagher, MD (pg. 19, 22) Montefiore Medical Center

Mary Pat McKay, MD, MPH (pg. 23) Harvard Medical School

Richard Schwartz, MD (pg. 14) Medical College of Georgia

Mark Angelos, MD (pg. 19, 31) Ohio State University

Gregg Garra, MD (pg. 15) Stony Brook University

Robert McNamara, MD (pg. 14, 24) Temple University Hospital

Richard Shih, MD (pg. 24) Morristown Memorial Hospital

Tom Aufderheide, MD (pg. 13) Medical College of Wisconsin

Gary Green, MD, MPH (pg. 19, 31) Johns Hopkins University

Maulik Majmuder, BS (pg. 15) Northwestern University

David Sklar, MD (pg. 15) University of New Mexico

Jill Baren, MD (pg. 15, 18, 31) University of Pennsylvania

Larry Gruppen, PhD (pg. 14) University of Michigan

Gregory Moran, MD (pg. 15) UCLA - Olive View

Latha Stead, MD (pg. 14) Mayo Clinic

William Barsan, MD (pg. 14, 19) University of Michigan

Glenn Hamilton, MD (pg. 22) Wright State University

Bryant Nguyen, MD (pg. 22) Loma Linda University

Susan Stern, MD (pg. 31, MSS) University of Michigan

Louis Binder, MD (pg. 13) Case Western Reserve University

Stephen Hargarten, MD (pg. 22) Medical College of Wisconsin

James Olson, MD (pg. 19, 31) Wright State University

Harold Thomas, MD (pg. 13) Oregon Health & Science University

Michelle Biros, MD (pg. 22, 23) Hennepin County Medical Center

Sandra Hatch, MD (pg. 18) Columbini National Heart, Lung, and Blood Institute

David Overton (MSS) Michigan State University/KCMS

Steve Trzeciak, MD (pg. 22) Cooper Hospital

Edward Panacek, MD (pg. 19, 22) University of California, Davis

Terry Vanden Hoek, MD (pg. 18) University of Chicago

Paul Pepe, MD, MPH (pg. 13, 14) University of Texas, Southwestern

Vincent Verdile, MD (pg. 15) Albany Medical College

Debra Perina, MD (pg. 19) University of Virginia

Mary Jo Wagner, MD (pg. 19) Synergy Medical Education Alliance

John Prescott, MD (pg. 15) West Virginia University

Ellen Weber, MD (pg. 22) University of California, San Francisco

Michael Brown, MD (pg. 31) Grand Rapids MERC/Michigan State University

Stephen Hayden, MD (pg. 19) UCSD Medical Center

Carlos Camargo, MD, DrPH (pg. 23) Massachusetts General Hospital

Katherine Heilpern, MD (pg. 15) Emory University

Carey Chisholm, MD (pg. 19) Indiana University

Cherri Hobgood, MD (MSS) University of North Carolina

Norman Christopher, MD (pg. 15) Children's Hospital Medical Center/Akron

James Hoekstra, MD (pg. 22) Wake Forest University

Wendy Coates, MD (pg. 23, MSS) Harbor-UCLA Frank Counselman, MD (MSS) Eastern Virginia Medical School Rita Cydulka, MD (pg. 14, 24) MetroHealth Medical Center Elizabeth Datner, MD (MSS) University of Pennsylvania Peter DeBlieux, MD (pg. 19, 24, MSS) Charity Hospital Pam Dyne, MD (pg. 24) UCLA - Olive View Barnet Eskin, MD, PhD (pg. 14) Morristown Memorial Hospital Deborah Fish Ragin, PhD (pg. 14) Montclair State University

James Holmes Jr., MD (pg. 18) University of California, Davis Debra Houry, MD, MPH (pg. 24) Emory University

Susan Promes, MD (MSS) Duke University James Quinn, MD (pg. 18) Stanford University

James James, MD, DrPH, MHA (pg. 14) The American Medical Association

Drummond Rennie, MD (pg. 18) University of California, San Francisco

David Karras, MD (pg. 19) Temple University

Lynne Richardson, MD (pg. 14, 31) Mt. Sinai Medical Center

Gabor Kelen, MD (pg. 15, 25) Johns Hopkins University

Emanuel Rivers, MD (pg. 22) Henry Ford Hospital

Gloria Kuhn, MD (pg. 23) Wayne State University

Kevin Rodgers, MD (pg. 24) Methodist Hospital

Demetrious Kyriacou, MD, PhD (pg. 31) Northwestern University

Richard Rothman, MD, PhD (pg. 15, 19, 31) Johns Hopkins University

Eddy Lang, MD (pg. 14) SMBD Jewish General Hospital

Brian Rowe, MD (pg. 31) University of Alberta

MSS = Speaker at the Medical Student Symposium

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Flaura Winston, MD (pg. 23) The Children's Hospital of Philadelphia Joseph Wright, MD (pg. 23) Childrenâ&#x20AC;&#x2122;s National Medical Center Peter Wyer, MD (pg. 14) New York Presbyterian Medical Center John Younger, MD (pg. 15) University of Michigan Brian Zink, MD (pg. 15, 31, MSS) University of Michigan Howard Zucker, MD (pg. 14) US Dept. of Health and Huma Services

POTENTIAL CONFLICT

OF INTEREST

DISCLOSURE

As an accredited provider of continuing medical education Michigan State University, College of Medicine is required to ask speakers to disclose any real or apparent conflict of interest they may have as related to the content of their presentation(s). The existence of the commercial or financial interests speakers related to the subject matter of their presentation should not be construed as implying bias or decreasing the value of their presentation(s). However, disclosure should provide information to participants to form their own judgements.

All speakers were independently selected by the SAEM Program Committee. Those speakers (of both didactics and abstracts presentations) who disclosed affiliations or any potential conflicts are listed below.

Andra Blomkalns, MD Cameron Crandall, MD Kerry Cronin, MD Daniel Davis, MD Gail D'onofrio, MD, MS Ken Farion, MD Steven Friedman, MD, MPH Robert Hall, MD Ella Huszti, MSc David Karras, MD O. John Ma, MD Chadwick Miller, MD James Miner, MD Graham Nichol, MD Richard Nowak, MD W. Frank Peacock, MD William Richardson, MD Brian Rowe, MD, MSc Daniel Rusyniak, MD Basmah Safdar, MD Susan Sheely, MSN, MS, RN Selim Suner, MD, MS Ian Stiell, MD, MSc Alan Storrow, MD Stephen Thomas, MD

Merck & Co. VAWA Applied Therapeutics Patel, PI Astra Zeneca, Bayer, Lilly, SBC SNET, VHA, SNET Yellow NSERC NIL Medical Education Technologies, Inc Medtronics Physio-Control Corp., CIHR Pfizer Pharmaceuticals KC FPF Millenium Pharmaceuticals Glaxco Smith Kline Medtronics Physio-Control Corp.

Sepracor Millenium Pharmaceuticals, SCIOS Altana Inc., Protherics Inc. Glaxco Smith Kline Clarian Value Funds CCEP Aventis Pharmaceuticals ONR, Cyberkinetics Inc., DARPA CIHR, Medtronics Physio-Control Corp.

Roche Diagnostics, Inc. Medwave

Call for Abstracts 7th Annual Mid Atlantic Regional SAEM Meeting

The SAEM Newsletter is mailed every other month to approximately 6000 SAEM members.

Advertising is limited to fellowship and academic faculty positions.

The deadline for the July/August issue is June 1, 2004. All ads are posted on the SAEM website at no additional charge.

October 1, 2004 Washington Hospital Center Georgetown University Medical Center/ Marriot Conference Center Washington, DC

Advertising Rates: Classified ad (100 words or less) Contact in ad is SAEM member Contact in ad non-SAEM member Quarter page ad (camera ready) 3.5â&#x20AC;? wide x 4.75â&#x20AC;? high

The Program Committee is now accepting abstracts for review for oral and interactive poster presentations. The meeting will take place Friday October 1, 2004; 8 am to 4 pm The deadline for abstract submission is Monday August 2, 2004, by 3:00 pm EDT. Only electronic submissions via the SAEM online abstract submission form at www.saem.org will be accepted. Acceptance notifications will be sent in late August. All registration and Hotel Information will be published in the next newletter and available on line at SAEM website by May 15, 2004. The same successful format of all presentation in oral format with plenary paper allowed 15 minute presentations and standard acceptances allowed 5 minutes for presention. All presentations will be made in powerpoint. there will be teaching, research and a large medical student residency application session. All medical students from the Mid-Atlantic Region within a days drive are enouraged to attend.

$100 $125 $300

To place an advertisement, email the ad, along with contact person for future correspondence, telephone and fax numbers, billing address, ad size and Newsletter issues in which the ad is to appear to: Carrie Barber at carrie@saem.org

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INTEREST GROUP MEETING AGENDAS AIRWAY

DIVERSITY

May 18, 2004, 9:00-11:00 am, Captain Room The Airway Interest Group meeting will be divided into two parts. The first part will be both educational and an effort to present cutting edge research or ideas for the purpose of group collaboration on future studies. All individuals with an interest in airway research are invited to attend.

May 18, 2004, 1:30-3:00 pm, Devon Room

EMS 1.

2.

3.

4.

5.

6.

Part 1: This year as part of our Program Subcommittee we will present "Asthma Education in the ED," the results of an international consensus conference (30 minutes). It will cover the content of asthma education, feasibility of doing this in an ED setting, and research and future directions. We will then have the presentation of four preliminary studies for possible group collaboration. Each of these will last 6-7 minutes with a brief question and answer session. These presentations will be submitted and selected by the Research Subcommittee.

Due to time consideration, there will be only four presentations. The other projects would be handed out to the attendees at the meeting.

ETHICS 1.

2.

3.

4.

Part 2: Reports from the subcommittees: a. Research: Barry Diner, MD, will present one "easy" project for collaboration not requiring much, if any, funding and the other more elaborate, long range requiring funding. b. Education: Michael Radeos, MD, MPH, will present areas to collaborate in asthma education, both research and promulgating best practices for emergency medicine. c. Program: Adrian Tyndall, MD, will present concepts to present next year at the SAEM Annual Meeting, both to the SAEM membership at large, as well as to the Airway Interest Group.

CLINICAL DIRECTORS May 17, 2004, 3:00-4:00 pm, Yeoman Room

CPR REPERFUSION 1.

2.

3.

4.

5.

6.

7.

May 18, 2004, 8:00-9:30 am, Devon Room Introductions Old Business: Follow up on EM intra-professional dating survey New Business: Where do we go from here?

Discussions on major topic areas: a. Research: The Ethics Research Agenda for Emergency Medicine 1. Provider/researcher foci 2. Resident/student foci 3. Patient/consumer foci 4. Systemic/policy foci b. Education/Teaching 1. Ethics and Humanities: Teaching Ethics using literature, film, and developing a resource for EM teachers (Mike Burg, MD) 2. The Core Competencies: What are we doing to evaluate professionalism, cultural competency and ethics in EM learners?

3. Submitting proposals for the 2005 SAEM Annual Meeting 4. Election of new Interest Group Chair 5. Adjourn

EVIDENCE-BASED MEDICINE

May 17, 2004, 1:00-2:00 pm, Captain Room Introduction, Norman Paradis MD Activities and Projects â&#x20AC;&#x201C; Old Business - Review of previous initiatives.

- PULSE Initiative and status of consortium Hot topics and State-of-the-Art discussion New Business - Proposals for upcoming sessions - Other new projects

May 18, 2004, 12:00-1:00 pm, Captain Room Business 1. Announcement of chair for 2004-05, Michael Brown, MD 2. Membership report, Peter Wyer, MD 3. List-serv and SAEM website transition, Dr. Yeh Activities and Projects (Old Business) 4. Evidence-Based Medicine Journal Club Luncheon, Eddy Lang, MD 5. SAEM online course, Charlene Irvin, MD 6. Rational clinical examination project, Dr. Newman 7. Consultancy for EM programs (survey results), Michael Brown, MD Forward Plans, Meetings and Perspectives (New Business) 8. Undergraduate EBM Proposal (SAEM 2005), Dr. Ismach 9. Practice-based learning proposal (SAEM 2005), Dr. Brown for Dr. Gerhardt 10. Other new projects

DISASTER MEDICINE 1.

2.

3.

4.

May 17, 2004, 2:00-3:00 pm, Scribe Room Introductions Define interest group goals Elect chair for coming year Discuss EMS fellowship curricula development Review NAEMSP Research Agenda Open forum

May 17, 2004, 10:00-11:30 am, Yeoman Room Welcome Review of prior minutes Educational sessions Integration of Disaster Medicine Training into EM Residency and Medical School Curricula-Sharing of ideas Use of list service Open forum Adjournment

GERIATRIC May 16, 2004, 12:00-1:00 pm, Chelsea Room 1. Introduction 2. Interest Group chair's report 3. Program: Adam Golden, MD, a geriatrician from Orlando Regional 38

MENTORING WOMEN

Healthcare, who has interests in EM geriatric education curriculum and geriatric medication issues is the invited speaker and will present a short program.

4. Objectives for the coming year a. Discussion of possible collaborative research projects among Interest Group members b. Submission of a didactic session proposal for the 2005 SAEM Annual Meeting c. Discussion of an update and possible autumn presentation of the Emergency Care of the Elder Person course d. Discussion regarding the use of the AGS/Hartford Foundation/EMF resident research funds.

1.

2.

3.

4.

5.

NEUROLOGIC EMERGENCIES May 18, 2004, 2:30-4:30 pm, Cloister South Room 1. Business meeting - election 2. FERNE update 3. Stroke Centers Designation and the Impact on Emergency Medicine: What is the impact of developing stroke centers on the practice of emergency medicine? a. Introduction and overview, Andy Jagoda, MD b. American Stroke Association, Ellen Magnes, PhD • What they know?

• What they want and why? c. JCAHO (Joint Commission), TBA • What are the guidelines?

• How are they derived?

• Why were they derived? d. SAEM, Jim Adams, MD • What is the perspective of academic emergency physicians e. National Association of EMS Physicians, Robert O'Conner, MD • What would a protocol look like?

• Triage? f. ACEP, Brian Hancock, MD • What is the College's view/position?

• What activities has the College undertaken? g. Questions and Answers

GOAL DIRECTED THERAPY RESEARCH May 17, 2004, 2:00-3:30 pm, Knave Room

HEALTH SERVICES AND OUTCOMES RESEARCH May 17, 2004, 2:30-4:00 pm, Captain Room 1. Development of didactic proposals for the 2005 SAEM Annual Meeting a. The role of Emergency Medicine in health services research b. Common pitfalls in outcomes research in Emergency Medicine c. Resources for outcomes and health services research training and education for the emergency physician 2. Development of a consultation service for outcome and health services research protocol and grant application reviews.

3. Election of Interest Group chair

INTERNATIONAL 1.

2.

3.

4.

May 16, 2004, 4:00-5:30 pm, Captain Room Reaffirm interest group objectives Mentorship form Elect chair for coming year Plans for the future Open forum

April 17, 2004, 4:00-5:30 pm, Knave Room Active Items a. List-serv update optimizing use b. International faculty mentorship program New Items a. Upcoming international meetings b. New Fellowship programs c. Fellowship Directors list-serv d. Proposals for didactic sessions 2005 e. Scholarships for international faculty Additional items Elections

PALLIATIVE CARE 1.

2.

3.

MEDICAL STUDENT EDUCATORS May 17, 2004, 3:00-5:30 pm, Cloister South Room In an effort to better support medical student educators in their endeavor to develop the best Emergency Medicine education, the interest group will offer a 2.5 hour session. This session will consist of an educational component (topic to be announced). It will be followed by an annual business meeting. Previous members and anyone interested in medical student education are invited.

1. Educational component (1.5 hours): topic to be announced 2. Business Meeting (1 hour) a. Review of last year's activities b. Election of new officers c. Growth of group d. Ideas for next year's educational program.

4.

May 17, 2004, 2:00-3:30 pm, Devon Room Introduction to Palliative Care Creation of a Strategic Plan for the Palliative Care in Emergency Medicine Interest Group Project plan for 2004-2005 a. Research b. Education c. Administrative Election of Interest Group chair

PATIENT SAFETY May 16, 2004, 12:00-1:00 pm, Captain Room 1. Identification of interest group members a. Dues b. Contact information, updating membership list 2. Governance - election of chair 3. Development of objectives for 2004-05 a. Prepare a Newsletter article on research opportunities related to patient safety? b. Collaborate with other professional societies and disciplines on patient safety as needed. c. Develop didactic session proposal for 2005 Annual Meeting d. Refine curriculum and teaching materials 39

Phrampus) (15 minutes with 15 minutes for discussion) 4. Update on interactions with other simulation organizations (10 minutes) • Society for Medical Simulation (J. Gordon) • Simdot (W. Bond) 5. Future directions (roundtable)(30 minutes) • Use of the website / library to facilitate multi-center research • How to incorporate more VR into the group • Other simulation technology developments 6. Election of new officers. (15 minutes)

e. Other?

4. General discussion/current research efforts 5. Assignments and adjournment

PEDIATRIC EMERGENCY MEDICINE 1.

2.

3.

4.

5.

May 17, 2004, 1:30-3:00 pm, Yeoman Room Welcome and Introduction Business Meeting a. Review and development of annual objectives b. Governance, leadership c. Election of chair Didactic proposal discussion Brief presentation: The Ethical Conduct of Research Involving Children, Norm Christopher, MD Announcements

TOXICOLOGY May 17, 2004, 4:00-5:00 pm, Scribe Room

TRAUMA

PUBLIC HEALTH

3.

4.

5.

6.

May 16, 2004, 12:00-2:00 pm, Cloister South Room Welcome, introduction Review of first year a. Membership b. Votes (decisions, insurance) c. Public health database d. NHTSA/SAEM course e. Committees Healthy People 2010, Steps Development of annual objectives Governance, election of chair(s) Other business, announcements

1.

2.

3.

4.

May 17, 2004, 3:00-4:00 pm, Cloister North Room Report of the research directors’ survey working group Development of an EM research resource website Other tools for enhancing communication and pooling resources Discussion of future goals and objectives

1.

2.

May 18, 2004, 2:30-3:30 pm

TRIAGE 1.

2.

3.

4.

May 17, 2004, 12:00-1:00 pm, Yeoman Room Election of chair Triage Research Projects Didactic Session for 2005 Other business

ULTRASOUND 1.

2.

RESEARCH DIRECTORS

3.

4.

5.

SIMULATION May 17, 2004, 2:00-4:00 pm, Council Room The Simulation Interest Group was created to promote the use of simulation of all types for education in Emergency Medicine. The group also fosters collaboration in educational research and provides a forum for discussion of issues of clinical competency assessment. This year the meeting will include an educational update from Paul Phrampus, MD, of the University of Pittsburgh regarding the use of simulation for difficult airway instruction and competency assessment. The Interest Group will review its progress on the editorial process for the simulation scenario library. Elections will be held for the offices of chair.

Nominations are open until May 10. To nominate someone please email the name of the nominee to william.bond@lvh.com. The Interest Group meeting is open to all SAEM members.

1. Membership update / introduction of new members. (10 minutes) 2. Progress report on the simulation scenario library. (Vozenilek, Bond, McLaughlin) (30 minutes) • Review of the template for scenarios • Review of the scenario scoring rubric • Review of the editorial process 3. Educational update: Clinical Competency Assessment. (P.

6.

7.

8.

May 18, 2004, 2:00-5:00 pm, Cloister North Room Introduction and Year in Review Educational Presentations on novel uses of Ultrasound in Emergency Medicine a. Christine Irish: Pneumothorax b. Paul Sierzenski: Hand and Tendon US c. Anthony Dean: CHF and wet lung d. Mike Blaivas: Ocular US Pitfalls with Ultrasound Manuscripts (Mike Blavis) Community Ultrasound Survey Results (Chris Moore) Development of didactic proposals for the 2005 SAEM Annual Meeting (Larry Melniker) Sonographic Outcome Asseesment Protocol Report (Larry Melniker) Election of Interest Group chair ACEP Ultrasound Section meeting (John Kendall)

WEB EDUCATORS May 17, 2004, 2:00-4:00 pm, Senate Room

40

2004-2005 SAEM COMMITTEE/TASK FORCE OBJECTIVES Listed below are the 2004-05 committee and task force objectives (SAEM’s year runs from May to May to coincide with the Annual Meeting). While SAEM’s mission “to improve patient care by advancing research and education in emergency medicine” gives direction to SAEM’s activities, and the Five-Year goals and objectives (http://www.saem.org/newsltr/hd5yrpla.htm) lay the foundation, it is the extensive and detailed work of each committee and task force towards the fulfillment of their specific goals and objectives, which really advance the academic specialty.

Although the committee and task force objectives are developed and approved by the Board of Directors, they are based on SAEM’s Five Year Goals and Objectives and on the suggestions of prior committee and task force chairs and members, and from individual SAEM members. The Board strives to ensure that the objectives assigned to each committee and task force are well-defined, achievable, and directly related to SAEM’s core mission. The Board appreciates feedback regarding these objectives from the membership, and most importantly, invites suggestions for future objectives.

Awards Committee: Chair, Louis Ling, MD 1. Review announcements for all awards to assure consistency and clarity of qualifications and criteria. Deadline: August 1, 2004.

2. Develop a standardized application format/CV for the Young Investigators, Hal Jayne Academic Excellence and Leadership Awards. Deadline: September 1, 2004.

3. Solicit and review nominations for the Academic Excellence and Leadership Awards and recommend recipients to the Board. Deadline: January 15, 2005 4. Solicit and review nominations for the Young Investigator Award and recommend recipients to the Board. Deadline: January 15, 2005

CORD/SAEM Diversity Training Task Force: SAEM Co-Chair, Sheryl Heron, MD 1. Develop learning modules and resources (using previously developed guides by SAEM Graduate Medical Education Committee) to incorporate diversity awareness and skills to residency training programs. This will be done jointly with the CORD. 2. Finalize Web site product based on objective #1 and submit to SAEM and CORD Boards for their consideration. Deadline: April 15, 2005.

Ethics Committee: Chair, Terri Schmidt, MD 1. Assist in the development of the 2005 AEM Consensus Conference on Research Integrity in EM. Serve as peer reviewer resources for manuscript submissions.

2. Revise and update the “Ethics Curriculum for EM Residencies” web based site. Rename “Ethics Teaching Resource for EM Residencies”. Deadline: March 1, 2005.

3. With the Research Committee, develop a document built on issues discussed in the “Clinical Research and the HIPAA Privacy Rule” session at the 2004 Annual Meeting. Deadline: November 1, 2004.

4. Prepare three documents on the following ethics-related subjects: “Publication ethics and issues” and “Teacher-learner relationships” and “Issues surrounding the response to a dishonest faculty member” (fabrication of CV/data/authorship). Deadlines: September 15, 2004, February 15, 2005 and May 1, 2005. Include these subjects in the web based teaching resource.

Faculty Development Committee: Chair, Frank Counselman, MD 1. Develop 2004 Annual Meeting sessions on “Becoming a leader in the medical school’s Dean’s office, ” “Advancement to the position of academic chair, ” and “Career development awards” into Newsletter submissions and web-based resources. Deadlines: September 15, 2004, February 15, 2005 and May 1, 2005.

2. Review and revise the Faculty Development web site. Deadline: November 1, 2004.

3. Develop a series of didactic proposals about general leadership skills for the Program Committee’s consideration of presentation at the 2005 Annual Meeting. At least one of these sessions should target senior level leadership needs, and one should target mid-career level needs. Deadline: September 1, 2004.

4. Develop a resource about junior committee member leadership development, timeline management, and task delegation for use by committee and task force chairs. This resource should also include recommendations about effective committee management and how to maximize the productivity of a working group that are targeted to the actual committee chair.

Deadline: March 1, 2005.

5. Conduct the bi-annual Faculty Salary Survey and prepare a manuscript for submission to the Board and to AEM for consideration of publication.

Deadline: February 15, 2005.

Constitution and Bylaws Committee: Chair, Catherine Marco, MD 1. Review the Constitution and Bylaws to ensure accuracy relative to the Society’s activities and internal functions. Propose needed amendments to the Board for approval. Deadline: January 1, 2005.

2. Develop “minimum criteria” for candidates to Board, Secretary-Treasurer, President-elect, Constitution and Bylaws Committee, Nominating Committee and committee and task force chair positions. Deadline: December 1, 2004.

Critical Care Fellowship Task Force: Chair, Stephen Trzeciak, MD 1. Explore the feasibility for training opportunities (not certification options) for EM graduates interested in pursuing critical care fellowship training through the Anesthesiology/Surgery pathway and report to the Board.

Deadline: February 1, 2005.

2. Develop a database of existing EM physicians either in the active practice of Critical Care Medicine or trained in Critical Care Medicine. Deadline: November 1, 2004.

Development Committee: Chair, Brian Zink, MD 1. Make recommendations to the Board for mechanisms to expand the Research Fund through collaborative undertakings with industry, philanthropic organizations, non-members and members. Deadline: October 1, 2004.

2. Develop oral presentations, web-based material and publications targeted at each of these groups (in objective 1). Deadline: November 15, 2004 (members and industry), February 15, 2005 (philanthropic organizations and non-members).

3. With the Board and the Program Committee, develop a mechanism to recognize contributors at the Annual Meeting. Deadline: November 15, 2004.

4. Investigate the development of a multi-year campaign for members targeting a total amount and/or percentage participation and report to the Board.

Deadline: October 1, 2004.

Finance Committee: Chair, Steve Dronen, MD 1. Provide oversight for the investment and accounting of SAEM’s non-operational funds. Provide quarterly written performance reports to the Board and annually undertake a review by a professional funds manager.

2. Annually review the SAEM budget with the Secretary – Treasurer. Provide recommendations for operational finances or non-salary capital expenses.

Graduate Medical Education Committee: Chair, Douglas McGee, DO 1. Coordinate the Resident Section of the SAEM Newsletter, including the solicitation, selection, and editing of articles, with strict attention to focus, quality, and timely completion to meet publication. Ensure at least one submission per issue from the Committee or others devoted to resident issues/concerns. One topic should be written by one or more fellowship graduates discussing the value of their training on their academic career.

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2.

3.

4.

5.

6.

7.

8.

9.

Another topic should evaluate the pros and cons of doing a fellowship at the same institution that one does their EM residency. Deadlines: August 1, October 1 and December 1, 2004 and February 1,April 1 and June 1, 2005.

Maintain and complete the revision of the Resident Section of the Web site.

This includes all posted articles in the current residency section. Deadline: November 1, 2004.

Distribute and integrate the ‘Fellowship Catalog’ being developed by Fellowship Task Force into current GME venues including the Web site.

Deadline: October 1, 2004.

Develop resources (implementation guides and assessment tools) for the “Systems-Based Practice Core Competency” and post on the Web site.

Deadline: November 1, 2004.

Working with the Undergraduate Educators Committee, revise the Residency Catalog data fields. Prepare a Newsletter announcement describing the changes. Deadline: July 1, 2004.

With the Web Page Task Force, write a Newsletter article describing the new ability of program directors to directly access their Residency Catalog database, and the expectation that they will maintain their own program data.

Deadline: August 1, 2004.

Working with the EMS Interest Group and the National Association of EMS Physicians, revise and update the EMS fellowship curriculum document and post on the web. Deadline: March 1, 2005.

Develop and administer a survey instrument to assess whether academic chairs value additional training in their hiring practices, and whether their hiring practices for new faculty have changed over the past 3-5 years.

Prepare a document discussing the survey results for the Board. Deadline: May 1, 2005.

Develop a list of skill sets required by clinician teachers and possible mechanisms to develop those skills. Deadline: May 1, 2005.

Membership Survey Task Force: Chair, Wendy Coates, MD 1. Develop and complete a comprehensive survey of the SAEM membership to ascertain services that are most valued and areas of greatest need.

Areas to investigate may include the concept of creating limited access areas on the web page, the AEM journal and editorial review process, election process, whether or not minimum criteria for appointment as a chair or to stand for election is necessary, issues surrounding the Annual Meeting activities (no-industry policy, banquet or not, social events from dues or meeting registration, extracurricular events), regional meetings, need for a “professors section” and the development of position statements that cross into clinical practice or specialties (e.g. stroke, care of pediatric emergencies). Wherever possible, an explanation of the rationale for the way SAEM currently addresses an area should accompany specific questions. A written report should be presented to the Board. Deadline: February 1, 2005.

CORD/SAEM Model Curriculum Task Force: SAEM Co-Chair, Sam Keim, MD 1. Continue the collaborative development of a model curriculum revision based upon the ABEM Model of the Clinical Practice of Emergency Medicine.

National Affairs Committee: Chair, Robert Schafermeyer, MD 1. Develop a draft program for the fall AAMC Annual Meeting. Deadline: March 1, 2005.

2. Submit reports on interactions with the AAMC for publication in the January/February and May/June issues of the SAEM Newsletter.

Deadlines: December 1, 2004 and April 1, 2005.

3. Implement an advocacy network plan. Prepare an accompanying Newsletter article discussing the network. Deadline: July 1, 2004.

4. Monitor legislative and regulatory issues pertinent to academic emergency medicine.

5. Develop policy statement on Principles for Measuring Quality and Reporting of Medical Errors and submit to the Board. Deadline: January 1, 2005.

6. Submit a didactic proposal to the Program Committee for consideration of presentation at the 2005 Annual Meeting. Deadline: September 1, 2004.

Grants Committee: Chair, Clifton Callaway, MD 1. Coordinate the grant application reviews (working with expert reviewers from committees, task forces and interest groups) and recommend recipients to the Board for the following grants: Research Training, Institutional Research Training , Scholarly Sabbatical, Medical Student Interest Group, EMS Research Fellowship, Neuroscience Research Fellowship, and EMF/SAEM Medical Student Research. Deadline: varies by grant program.

2. Develop a plan for offering a one-year medical student research training fellowship and prepare a report to the Board. Deadline: January 1, 2005.

3. Review all grant applications for clarity and consistency, offer a report summarizing any changes to Board and incorporate any proposed changes before next grant cycle. Specifically evaluate and offer advice on electronic-only (Web-based) applications and creation of common on-line form mirroring NIH format for all submissions. Deadline: September 1, 2004.

4. Working with the Research Committee, explore the feasibility of developing and maintaining a grant database for emergency physicians and report to the Board. Deadline: January 1, 2005.

5. Develop and implement a mechanism to assess outcomes of prior SAEM grants recipients and report to the Board. Deadline: March 1, 2005.

6. Working with the Research Committee, explore the feasibility of implementing a “virtual advisor” grants mentoring process. Establish a mechanism to track outcomes and report to the Board. Deadline: December 1, 2004.

NIH Roadmap Task Force: Chair, Roger Lewis, MD, PhD 1. Using the information outlined in NIH’s new policy shift (Roadmap), make specific recommendations to the Board about actions SAEM can take to increase EM’s interaction with the NIH. Deadline: February 1, 2005.

Nominating Committee: Chair, President-elect 1. Develop a slate of nominees for the elected positions on the Board of Directors, Nominating Committee, and Constitution and Bylaws Committee and submit to the Board for approval. Deadline: March 1, 2005 2. Prepare recommendations for the Board about a standardized mechanism for identification and selection of nominees to the Nominating Committee.

Deadline: November 1, 2004.

3. Develop a standardized “mini-bio” for potential candidates to elected positions. This should emphasize elements of prior service and performance in leadership capacities within SAEM. Deadline: January 1, 2005.

4. Working with the web editor, develop an on-line tool for use by committee and task force chairs to evaluate their members. Establish a databank of the electronic committee and task force evaluation reports for use in candidate selection. Deadline: November 1, 2004.

5. Create a Web-based evaluation tool for members of committees and task forces to assess their chairs. Data should be accessible for the use by the Board on an annual basis. Develop a databank of these evaluations for use in candidate selection. Deadline: February 1, 2005.

6. Develop a tool for the Board to perform and maintain an annual committee and task force chair assessment. Deadline: February 1, 2005.

7. Develop and maintain a database of potential candidates for elected offices, as well as those who have served in elected offices in the past. Deadline: February 1, 2005.

Healthy People 2010 Task Force: Chair, Charlene Irvin, MD 1. Implement activities with the Department of Health and Human Services (DHHS) in the following areas: 1) Access to Quality Health Services, 2) Injury and Violence Prevention, and 3) Substance Abuse. Each working group should submit a written report to Board detailing specific progress.

Deadline: November 1, 2004.

2. Submit at least one Annual Meeting didactic proposal from each working group for consideration of presentation by the Program Committee for presentation at the 2005 Annual Meeting. Deadline: September 1, 2004.

3. Working with the National Affairs Advocacy program, inform SAEM members of Healthy People 2010 issues of interest to the membership. Deadline: December 1, 2004.

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Program Committee: Chair, Judd Hollander, MD 1. Plan 2005 Annual Meeting, and deliver quarterly reports to Board on progress, successes, limits and opportunities.

2. Create an operating manual describing timelines, protocols and prior problem areas. Update annually. Deadline: May 1, 2005.

3. Submit a preliminary budget for the 2005 Annual Meeting to the Board.

Deadline: November 1, 2004.

4. Evaluate success and offer suggestions to enhance participation/attendance at SAEM meetings by non-members, particularly other academic physicians. Submit a report to Board. Deadline: December 1, 2004.

5. Conduct a review of the 2004 Annual Meeting feedback and submit a report to the Board. Deadline: July 1, 2004.

6. Develop a regional meeting orientation session targeting Regional Meeting coordinators to be delivered in October 2004 (in conjunction with the SAEM committee and task force sessions during the ACEP Scientific Assembly or via conference call). Deadline: October 1, 2004.

7. Make a recommendation to the Board about whether or not contributors to educational sessions at the annual meeting (non-commercial) should be acknowledged in the annual meeting brochure (e.g. “The following contributed proposals or ideas that have been incorporated into the 2005 Annual Meeting: Ethics committee,AACEM, NIH Task Force, etc.”). Deadline: November 1, 2004

tion at the 2005 Annual Meeting. Deadline: September 1, 2004.

5. Develop an article directed towards medical students about how to get the most out of the Annual Meeting and post on the web site. Deadline: March 1, 2005.

6. Develop an article for the September/October Newsletter outlining the importance of attending the AAMC meeting, and highlight sessions that would be of particular interest to medical student coordinators. Deadline: August 1, 2004.

7. Examine how LCME requirements are affecting EM rotations and make recommendations regarding potential methods to address these requirements. Deadline: March 1, 2005.

8. Develop an educational module for “the resident as a teacher” and post on the Web site. Deadline: May 1, 2005.

9. Develop a resource for use by a faculty member who is developing or managing a Medical Student Interest Group and post on the web site. Deadline: May 1, 2005.

10. Finalize the implementation of the medical student question bank, evaluate the product and establish a mechanism for upkeep. Deadline: July 1, 2004.

Web Page Development Task Force: Chair, Felix Ankel, MD 1. Evaluate the need for an assistant Web developer and recommend candidates to the Board. Deadline: August 1, 2004.

2. Review current Web policy and make recommendations to the Board about areas that require clarification of the development of a new policy.

Deadline: August 1, 2004.

3. Develop a plan for ultimate “housing” of the web page. Deadline: May 1, 2005.

4. Develop an editorial board structure for the web page and present to the Board. Deadline: May 1, 2005.

5. Establish the plan with logistical priorities and timeline for the ultimate Web page and present to the Board. Deadline: May 1, 2005.

Research Committee: Chair, Jim Olson, PhD 1. Identify and highlight emergency medicine researchers who attain new federal grant funding or large scale industry funding, and any new or underrecognized funding sources and publish in the Newsletter. Deadline: October 1, 2004.

2. In conjunction with the Grants Committee, develop and implement a grants mentorship process for SAEM members. Develop an accompanying Newsletter article describing this service. Establish a mechanism to track outcomes. Deadline: August 1, 2004.

3. Working with the Grants Committee, explore the feasibility of developing and maintaining a grant database of emergency physicians and report to the Board. Deadline: January 1, 2005.

4. Assist the Ethics Committee and AEM in planning the 2005 AEM Consensus Conference on “Integrity in Research”. Deadline: September 1, 2004.

5. With the Ethics Committee, develop a manuscript for submission to AEM for consideration of publication on issues discussed in the “Clinical Research and the HIPAA Privacy Rule” session at the 2004 Annual Meeting. Deadline: November 1, 2004.

6. Develop a list of needed skills and possible methods to attain those skills for an EM educational researcher. Prepare a Newsletter article and post of the web. Deadline: February 1, 2005.

7. Establish a research agenda for EM educational research and report to the Board. Deadline: January 1, 2005.

8. Examine the ACGME core competencies, including procedural competency and maintenance, for specific research needs and report to the Board.

Deadline: February 1, 2005.

9. Working with the Undergraduate Education and Graduate Medical Education Committees, continue the development of the three-year curriculum in educational research. Submit to the Program Committee for consideration of presentation at the 2005 Annual Meeting. Deadline: September 1, 2004.

Call for Abstracts 14th Annual Midwest Regional SAEM Meeting September 9-10, 2004 The Wyndham Milwaukee Center Hotel Milwaukee, Wisconsin The Program Committee is now accepting abstracts for review for oral and interactive poster presentations.

The meeting will take place Thursday, September 9, 2004, 6:30-8:30 pm, and Friday, September 10, 2004, 8:00 am-4:00 pm at the Wyndham Milwaukee Center Hotel, 139 East Kilbourn Avenue, Milwaukee, WI 53202.

The deadline for abstract submission is Friday, July 9, 2004, by 3:00 pm EDT. Only electronic submissions via the SAEM online abstract submission form at www.saem.org will be accepted. Acceptance notifications will be sent in late July.

Registration forms are available from Dawn Kawa, Department of Emergency Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, FEH Room 1870, Milwaukee, WI 53226 or dkawa@mcw.edu.

Registration Fees: Faculty--$75; Other health care professionals--$40; Fellows/residents/students--No Charge. Late fee after Wednesday, September 1, 2004: add $10. For questions or additional information, call 414-805-6452.

Undergraduate Education Committee: Chair, Cherri Hobgood, MD 1. Working with the Web Editor, update and revise the Medical student Section of the home page. Deadline: June 1, 2004.

2. Working with the Graduate Medical Education Committee, revise the Residency Catalog. Deadline: July 1, 2004.

3. Working with the Research Committee, develop a resource available to education researchers outlining federal or foundation funding sources specifically for education research. Deadline: January 1, 2005.

4. Working with the Research and Graduate Medical Education Committees, continue the development of the three-year curriculum in educational research. Submit to the Program Committee for consideration of presenta-

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Positions Available

Non-Contributory 15%Of Salary Pension Plan, Paid Family Health, $6,000 To Cover Cme And Other Business Expenses. Call Kathy Valentino 315-4485481, Email Kathleen.Valentino@Sjhsyr.Org Or Fax To 315-448-5467.

OHIO: Director of Clinical Operations - University Hospitals of Cleveland, a premier NE Ohio healthcare provider seeks a dynamic BC academic EP. UHC is the primary teaching hospital of Case Western Reserve University. In this role, you will be responsible for leading the team in the UHC ED, which serves 78k patients/year. We seek candidates with proven interpersonal and leadership skills in a teaching ED. Competitive salary and benefits package along with academic appointment in the Case Dept. of EM is offered.

Interested candidates should send a CV and cover letter to: Edward Michelson, MD, Chairman, Department of Emergency Medicine; edward.michelson@uhhs.com. Ph: 216-844-8956. Page: 800-429-2989 during SAEM. EOE M/F/D/V OHIO: Residency Program Director - University Hospitals of Cleveland, a premier NE Ohio healthcare provider, seeks a proven BC/EM educator to help prepare for and launch a new EM residency program. UHC is the primary teaching hospital of Case Western Reserve University Medical School.

Successful candidate will have proven excellent resident teaching and administrative experience. Competitive salary and benefits package along with academic appointment in the Case Dept. of EM is offered. Interested candidates should send a CV and cover letter to: Edward Michelson, MD, Chairman, Department of Emergency Medicine; edward.michelson@uhhs.com. Ph: 216-844-8956. Page: 800-429-2989 during SAEM. EOE M/F/D/V Maricopa Medical Center, Phoenix, Arizona: We are seeking qualified applicants with an interest in academic Emergency Medicine. Serious applicants must be BC/BP in emergency medicine with a strong interest in clinical teaching. All entry levels will be considered. Applicants with ultrasonography certification and/or research experience are encouraged to apply. Maricopa Medical Center is a Level One Trauma Center with 50,000 adult patients/year and 30,000/year in the Pediatric ED. The Regional Burn Center is the only Level One Center in the Southwest. Send C.V. to Norberto Adame, Jr., MD, 2601 E. Roosevelt, Phoenix, Arizona, 85008. Telephone 602344-5418. E-mail nadamejr@cox.net.

University of California, Irvine is recruiting for a Research Director.

Appointment as Associate or Professor in Clinical Scholar series anticipated.

Substantial protected time. Board certification in EM required. MPH, PhD or research fellowship/training strongly desired. UCI Medical Center is a 472-bed tertiary care hospital with all residencies. The ED is a progressive 33-bed Level I Trauma Center with 46,000 patients, in urban Orange County. Collegial relationships with all services. Excellent salary and benefits with incentive plan. Send CV to Mark Langdorf, MD, MHPE, FACEP, UCI Medical Center, Route 128. 101 City Drive, Orange, CA 92868, or contact me at this meeting beeper (714) 506-6111. UCI is an equal opportunity employer committed to excellence through diversity.

Kentucky: The Department of Emergency Medicine at the University of Kentucky is recruiting full-time faculty members at the assistant or associate professor level. The desired individual must be BE/BC in emergency medicine.

Academic tenure track and non-tenure track positions available. The EM residency has full accreditation. The Emergency Department at UK Hospital is a Level I trauma center, regional referral center, with 40,000 annual visits. The department has nine full-time faculty and provides medical direction to Air Medical and Hyperbaric Oxygen Programs. Contact: Roger Humphries, MD, Interim Chair, Department of Emergency Medicine, University of Kentucky Medical Center, 800 Rose St., Room M-53, Lexington, KY 40536-0298: phone 859-323-5908; fax 859-323-8056; or E-mail rlhump0@uky.edu We are an EOAAE. Syracuse, New York. Emergency Physician â&#x20AC;&#x201C; Immediate Opening. Join A Collegial, Democratic Group Of 10 Bc/Be Emergency Physicians. Community Portion Of An Emergency Medicine Residency With 50,000 Patient Visits, Utilizing Double Attending Coverage And Double Pa Coverage. Looking For Abem Certified Or Board Eligible. Very Competitive Salary, Benefits Include

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Call for Didactic Proposals 2005 Annual Meeting May 22-25, 2005 New York, New York The Program Committee is inviting proposals for didactic sessions for the 2005 Annual Meeting. This year the Program Committee would like to emphasize proposals on educational research methodology and leadership development (including advancement within academic departments, medical schools and national organizations). Didactic proposals may be aimed at medical students, residents, junior faculty and/or senior faculty. The format may be a lecture, panel discussion, or workshop. The Program Committee will also consider proposals for pre- or post-day workshops or multiple sessions during the Annual Meeting aimed at in-depth instruction in a specific discipline.

Didactic proposals must support the mission of SAEM (to improve patient care by advancing research and education in emergency medicine) and should fall into one of the following categories: • Education (educational research methodology, education methodology, improving the quality of education, enhancing teaching skills) • Research (research methodology, improving the quality of research) • Career Development • State-of-the-Art (presentation of cutting-edge basic science or clinical research that has important implications for further investigation or the future practice of emergency medicine, not a review of the literature or a summary of clinical practice) • Health Care Policy and National Affairs The deadline for submission is Thursday, September 9, 2004 at 5:00 pm Eastern Daylight Time. Only online submissions will be accepted. To submit a proposal, complete the online Didactic Submission Form at www.saem.org. For additional questions or information, contact SAEM at saem@saem.org or call 517-485-5484 or send a fax to 517-4850801.

Call for Abstracts 2005 Annual Meeting May 22-25, 2005 New York, New York Deadline: January 5, 2005 The Program Committee is accepting abstracts for review for oral and poster presentation at the 2005 SAEM Annual Meeting. Authors are invited to submit original research in all aspects of Emergency Medicine including, but not limited to: abdominal/gastrointestinal/genitourinary pathology, administrative/health care policy, airway/anesthesia/analgesia, CPR, cardiovascular (non-CPR), clinical decision guidelines, computer technologies, diagnostic technologies/radiology, disease/injury prevention, education/professional development, EMS/out-of-hospital, ethics, geriatrics, infectious disease, IEME exhibit, ischemia/reperfusion, neurology, obstetrics/gynecology, pediatrics, psychiatry/social issues, research design/methodology/statistics, respiratory/ENT disorders, shock/critical care, toxicology/environmental injury, trauma, and wounds/burns/orthopedics.

The deadline for submission of abstracts is Wednesday, January 5, 2005 at 5:00 pm Eastern Time and will be strictly enforced. Only electronic submissions via the SAEM online abstract submission form will be accepted. The abstract submission form and instructions will be available on the SAEM website at www.saem.org in November. For further information or questions, contact SAEM at saem@saem.org or 517-485-5484 or via fax at 517-485-0801.

Only reports of original research may be submitted. The data must not have been published in manuscript or abstract form or presented at a national medical scientific meeting prior to the 2005 SAEM Annual Meeting. Original abstracts presented at national meetings in April or May 2005 will be considered.

Abstracts accepted for presentation will be published in the May issue of Academic Emergency Medicine, the official journal of the Society for Academic Emergency Medicine. SAEM strongly encourages authors to submit their manuscripts to AEM. AEM will notify authors of a decision regarding publication within 60 days of receipt of a manuscript.