SAEM 2009 Annual Meeting Program

2009 Annual Meeting

Sheraton New Orleans Hotel

May 14 - 17

Jointly sponsored by the University of California, Irvine School of Medicine

www.saem.org

Join us May 16, 2009 in New Orleans for the Research Foundation Luncheon An educational event you won’t want to miss!

Health Policy, Politics, and Emergency Medicine - Joined at the Hip: A historical perspective on the demand and funding for emergency care.

Presented by: Brian Zink, MD and Joseph Tyndall, MD

Sign-Up at Registration Desk

1000

100 0

Limited seating available!

INDEX General Information.................................................................................................................................................................4 AEM Consensus Conference...................................................................................................................................................6 Leadership Academy...............................................................................................................................................................7 SAEM Business Meeting Schedule..........................................................................................................................................8 CORD Meeting Schedule.........................................................................................................................................................9 Grant Workshop....................................................................................................................................................................10 Daily Schedules.....................................................................................................................................................................11 Thursday, May 14, 2009, Didactics/Paper/Poster...................................................................................................................20 Friday, May 15, 2009, Didactics/Paper/Poster.........................................................................................................................28 Saturday, May 16, 2009, Didactics/Paper/Poster...................................................................................................................35 Sunday, May 17, 2009, Didactics/Paper/Poster.......................................................................................................................42 Late Breakers........................................................................................................................................................................48 Didactic Speaker LIst.............................................................................................................................................................52 Innovations in Emergency Medicine Education Exhibits........................................................................................................54 Residency Fair Participants...................................................................................................................................................56 Photography Exhibit and Visual Diagnosis Contest...............................................................................................................56 Moderator and Reviewer Acknowledgements........................................................................................................................57 Chief Resident Forum............................................................................................................................................................60 Medical Student Symposium.................................................................................................................................................61 2010 Didactic Proposals........................................................................................................................................................62 2010 Abstract Proposals........................................................................................................................................................2 2011 AEM Call for Proposals..................................................................................................................................................63 Exhibitors.......................................................................................................................................64 CME Disclosures...................................................................................................................................................................65 Hotel Maps ...........................................................................................................................................................................70

General Information The SAEM Annual Meeting is the largest forum for the presentation of original research in emergency medicine. The meeting will be held May 14 - May 17 at the Sheraton New Orleans in New Orleans, LA. Over 2,000 emergency physicians are expected to attend. The Annual Meeting will include original research presentations, as well as Innovations in Emergency Medicine Education (IEME) Exhibits. The oral papers consist of 10 minute presentations followed by five minutes for questions and answers. Selected oral paper sessions will include additional time for discussions. The posters are scheduled in two-hour sessions each day. Most posters will focus on one-on-one discussion between the presenters and the attendees. However, each day 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. In addition to this Annual Meeting brochure, more details regarding the Annual Meeting are posted on the SAEM web site at www.saem.org. The web site is continually updated. A copy of the Abstract Supplement will also be provided to all Annual Meeting attendees in New Orleans.

Registration

For the cost of the basic registration fee attendees may attend all paper, poster, and didactic sessions, except those sessions that have limited enrollment, require pre-registration, or require an additional registration fee. Some of the limited enrollment sessions may be sold out prior to the Annual Meeting.

Therefore, be sure to register early. For those who have pre-registered to attend sessions that require pre-registration, be sure to arrive a few minutes early.

Continuing Medical Education Target Audience: This conference has been created for Emergency Medicine physicians who want to expand and update their knowledge of quality instruction in emergency medicine training programs and to improve the quality of emergency medical care.

Overall Program Objectives: • Apply research findings to your emergency medicine practice.

• Apply key statistical indicators in analyzing research results • Utilize acceptable research methods and study design in the development of research projects • Realize the details of the framework for EBM so that intended practice improvements are vetted through this prism.

Accreditation Statement: This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the University of California, Irvine School of Medicine and the Society for Academic Emergency Medicine. The University of California, Irvine School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Designation Statement: The University of California, Irvine School of Medicine designates this educational activity for a maximum of 33.0 AMA PRA Category 1 Credit(s)™.

Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclosure: It is the policy of the University of California, Irvine School of Medicine and the University of California CME Consortium to ensure balance, independence, objectivity

and scientific rigor in all CME activities. Full disclosure of conflict resolution will be made in writing via handout materials or syllabus.

AB1195 Statement: California Assembly Bill 1195 requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency. It is the intent of the bill, which went into effect on July 1, 2006, to encourage physicians and surgeons, CME providers in the state of California, and the Accreditation Council for Continuing Medical Education to meet the cultural and linguistic concerns of a diverse patient population through appropriate professional development. The planners, speakers and authors of this CME activity have been encouraged to address issues relevant in their topic area. In addition, a variety of resources are available that address cultural and linguistic competency, some of which are available at the registration desk.

Additional resources and information about AB1195 can be found on our website at http:// cme.uci.edu.

Annual Business Meeting The Annual Business Meeting will be held on Saturday May 16th from 2:00-2:50 pm. The election results will be announced, as well as the results of the membership’s ballot regarding any Constitution and Bylaws amendments.

In addition, the Young Investigator Award recipients; the recipients of the Research Training, Institutional Training, EMS Research Fellowship grants; and the recipients of the 2008 Annual Meeting Best Presentation Awards will be presented to the membership.

Katherine L. Heilpern MD, will present her Presidential summary address to the membership. Incoming President, Jill M. Baren, MD, will also be introduced and present her preview of the coming year. There may be other reports and presentations to the membership. All SAEM members are urged to attend.

Opening Reception

After the keynote address on Thursday, May 14th, at 5:00 pm SAEM will host an opening reception from 6:00 - 7:30 pm so that Annual Meeting attendees can socialize with other SAEM members.

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CPC Competition The Semi-Final CPC Competition will be held on Wednesday, May 13th (the day before the Annual Meeting) from 8:00 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 72 cases submitted from 100 submissions. The CPC Competition finalists will be announced during a reception held from 6:00 - 8:00 pm. The CPC Competition is sponsored by ACEP, CORD, EMRA, and SAEM. The CPC Final Competition, consisting of the six semi-finalists, will be held during the ACEP Scientific Assembly, which will be held in Boston, October 5-8, 2009.

Fun Run On Saturday, May 16th come run with us. The run will start promptly at 7:00 am and will be a 5K. T-shirts, bottled water, and fruit will be provided. You can sign up at the main meeting registration desk for your t-shirt, number, and pins any time before Saturday morning. Registration fee is $15 and any profits generated from this event will be donated to the SAEM Research Fund.

CORD The Council of Emergency Medicine Residency Directors (CORD) will meet on Friday, May 15th from 8:00am - 12:00pm. The program will include an educational session, reports, election results, and award presentations. All CORD members are invited to attend. The CORD Board of Directors and CORD committees and task forces will also meet during the Annual Meeting and those meetings will be posted as they are scheduled.

Networking Breakfast Breakfast scheduled for Friday, May, 15th, from 7:30 am - 9:30 am. Breakfast buffet. All attendees are welcome.

2009 Annual Meeting Program Committee Jeffrey Druck, MD Susan Fuchs, MD

SAEM Membership Count John Southall, MD Christopher Ross, MD

Joshua Wallenstein, MD

As of April 14, 2009

Maria Glenn, MD Jason Haukoos, MD, MSc Michael Hockberg, MD Craig Newgard, MD - Chair

Sorabh Khandelwal, MD

Deborah Houry, MD - Board Liason

Terry Kowalenko, MD

Chandra Aubin, MD

O. John Ma, MD

Brigitte Baumann, MD

David Milzman, MD

Steven Bird, MD

Antonio Muniz, MD

Andra Blomkalns, MD

James Olson, PhD

Anna Marie Chang, MD

Megan Ranney, MD

Esther Chen, MD

Emanuel Rivers, MD, MPH

Matthew Deibel, MD

Kevin Rodgers, MD

Administrator Track

Marc Rosenthal, PhD, DO

Active

2057

Associate

64

Resident/Fellow

3199

Medical Student

306

International

6

Emeritus/Honorary

35

Total

Didactic Key

5667

Faculty Development Track

Researcher Track

Education/Resident/Student Track

2009 Annual Meeting SAEM Employees Jim Tarrant, CAE - Executive Director

Janet Murray-Bentley - Bookkeeper

Barb Mulder - Associate Executive Director

Sandy Rummel - Executive Assistant

Sandra Arjona - AEM Managing Editor

Kathleen Seal - AEM Technical Editor

Maureen Bruce - Receptionist

Dwight Walker - Membership Assistant

Maryanne Greketis, CMP - Meeting Coordinator

Vene Yates - IT Coordinator

Holly Gouin, MBA - Marketing & Membership Manager Neal Hardin - Network Administrator Jennifer Mastrovito - Customer Service Coordinator

Tuesday, May 12, 2009 SAEM and AEM Committee/Task Force/Board Meetings 5:00 - 9:00 pm

AEM CC Pre Meeting

Southdown Room

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AEM Consensus Conference May 13, 2009, 8:00 - 5:00 p.m Public Health in the Emergency Department - Surveillance, Screening and Intervention Academic Emergency Medicine, the official journal of SAEM, plans a number of activities at the 2009 Annual Meeting. Again this year, AEM is conducting a consensus conference on the topic of Public Health in the Emergency Department on Wednesday, May 13, 2009 from 8:00 am until 5:00 pm and will feature many speakers on several topics. Additional details are posted on the SAEM Annual Meeting web site. Registration is open to all Annual Meeting attendees for only $100 and includes lunch.

Registration information is included on the SAEM Annual Meeting online registration form.

7:30-8:00a - Registration 8:00-8:15a - Welcome, Opening Remarks David Cone, MD Editor-in-Chief, Academic Emergency Medicine 8:15-8:45a The Clinical Impact of Health Behaviors on ED Visits Steven L. Bernstein, MD Yale University 8:45-9:45a Keynote Address - Public Health and Emergency Medicine Arthur L. Kellerman, MD, MPH Emory University 10-11:30a ED-Based Public Health Research Funded by Federal Agencies: Progress and Priorities: A Panel Discussion Gail D’Onofrio, MD, MS (moderator) Yale University Richard Denisco, MD, MPH Services Research Branch, NIDA, NIH Ralph W. Hingson, ScD, MPH Director, Division of Epidemiology and Prevention Research, NIAAA, NIH Amy Goldstein, PhD Program Chief, Child and Adolescent Preventive Intervention Program, NIMH,NIH James Heffelfinger, MD, MPH National Center for HIV, STD and TB Prevention, CDC CONCURRENT BREAKOUT PRESENTATIONS 11:30a-12:30p Alcohol and Substance Use Rebecca Cunningham, MD University of Michigan Frederick C. Blow, PhD University of Michigan Injury Prevention/Intimate Partner Violence Debra Houry, MD, MPH Emory University Stephen W. Hargarten, MD, MPH Medical College of Wisconsin Robin M. Ikeda, MD, MPH Associate Director for Science National Center for Injury Prevention and Control, CDC Sexually Transmitted Infections/HIV Jason Haukoos, MD, MPH Denver Health Richard Rothman, MD, MPH Johns Hopkins

An AEM Reviewers’ Workshop will be held on Friday, May 15 from 12:00 pm -1:30 pm. 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 aemreg@saem.org. Space is limited and registrations will be first-come, first-served.

The AEM Editorial Board will meet during the Annual Meeting. Pre-registration is required through the AEM office at aemreg@saem.org. Please check the online schedule for dates and times.

Using Health Services Databases Jon Mark Hirshon, MD, MPH University of Maryland Margaret Warner, PhD, CDC/NCHS Mental Health Disorders Gregory Luke Larkin, MD, MS Yale University Anthony Spirito, PhD Brown University 12:30-2p LUNCH and PANEL DISCUSSION Controversies in ED Based Public Health Interventions: Screening, Brief Intervention, Referral to Treatment: Has the enthusiasm outpaced the evidence?

Edward Bernstein, MD (moderator) Boston University Jack Stein, MSW, PhD SAMHSA Richard Saitz, MD, MPH Boston University

CONSENSUS-BUILDING WORKSHOPS 2:00-3:30p Conceptual Models of Health Behavior Edwin D. Boudreaux, PhD Univ. of Medicine & Dentistry of New Jersey Rita K. Cydulka, MD, MS MetroHealth/Case Western Study Designs and Evaluation Models for Public Health Interventions Bruce M. Becker, MD Brown University Kerry B. Broderick, MD Denver Health Overcoming Barriers to Implementation and Dissemination Mary Pat McKay, MD, MPH George Washington University Karin V. Rhodes, MD, MS University of Pennsylvania Funding and Sustainability Linda C. Degutis, DrPH Yale University Robert Woolard, MD Texas Tech Univ. Health Sciences Center 3:45-4:30p Workshop Feedback: Defining a Research Agenda 4:30-5p Wrap-Up, Closing Remarks Steven L. Bernstein, MD

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SAEM Leadership Academy May 13, 2009, 8:00 - 5:00 p.m Preparing for the next step in your career How do we make our working lives easier, more productive and ensure our careers are headed in the right direction? We are challenged in this rapidly changing environment to work towards transformational change and prepare ourselves for a different constantly evolving work environment.

Effective leadership begins with an innate ability and talent but it must also be cultivated. The Society for Academic Emergency Medicine has many excellent leaders who developed their leadership traits and managerial skills through a combination of on-the-job training, self-initiated mentorship relationships, self-education through reading, conference attendance and, occasionally, graduate level course work. This inaugural session of the Leadership Academy focuses on two key entities: career choices/advancement and managing people.

This workshop will equip you to engage others, adapt to changing situations, recognize the value of others and lead from an unfamiliar and uncomfortable place. We must recognize and develop the untapped potential in our organizations and ourselves. Bill Adams of Maxcomm Inc. challenges with this statement “ Doing something differently is a natural response to the changing world around us. Becoming something different changes the world by transforming that which is within us.” This conference is a step in that direction.

(LIMITED SEATING) Leadership: What is it? Why do we need it?

Glenn Hamilton, MD Key Note Address: Applying the Principles of Leadership ... Getting Traction ... Getting Action David J. Bachrach, MD Career Paths for the Mid-Career Emergency Physician – What are the Possibilities?

Bernie Lopez, MD, Kate Heilpern, MD, Brian O’Neil, MD The early path for the academic emergency physician typically involves the development of clinical expertise along with the pursuit of an academic niche.

By mid-career, the academic EP has hopefully attained success in both areas.

Academically, they may have taken on a leadership role in one area (residency program director, medical student director, research). What are the career paths that can next be followed?

This session will present a variety of career paths available to the academic emergency physician. A panel of emergency physicians who have pursued careers in areas such as the dean’s office, ED administration, and medical education will present their careers and discuss issues related to their chosen area.

•Gain an exposure to potential career paths •Understand the effects of a specific career choice on one’s personal and professional life •Understand some of the requirements for these positions as well as the necessary steps in pursuing these choices •List some of the paths taken by emergency physicians •Identify the effects of a particular choice on one’s academic advancement •Discuss methods to explore career choice Format: Panel discussion with audience participation

Sustaining a Vision Through Good Times and Bad: How to Make Yours Weatherproof Marc Borenstein, MD This general introductory presentation followed by a small group session will give participants hands-on work and coaching in creating and articulating a vision. At the conclusion of this session the participant should be able to: •Distinguish leadership from management and understand the value of both •Identify the components of an effective vision •Recognize how to use changing circumstances to forward vision •Appreciate what is required to sustain an effective vision over time independent from circumstances Format: Lecture and small group discussion Developing and Managing the Workforce of the Future Tracy Sanson, MD, Bill Barsan, MD Today’s leaders are tasked to motivate, develop, acknowledge and reward, but how do we best accomplish this with our varied workforce? How do we recruit, develop, and retain the best? We must acknowledge that each faculty member

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brings special talents and needs.

This panel will: •Discuss the changing demographics of emergency physicians •Discuss generalizations about leading, coaching, and motivating the various generations in our departments •Discuss family obligations: elder care, pregnancy, and child rearing and their impact on the workplace, workforce, and career advancement •Review options for career and personal life balance enhancing EP wellness and career advancement/longevity Format: Panel presentation Conflict Resolution Rob Strauss, MD, Alan Forstater, MD The issue of conflict resolution is central to developing effective interpersonal and communication skills. It is a common and regular part of our professional and personal lives. This interactive workshop will illustrate and teach effective conflict management skills techniques. Participants will complete a self-assessment tool to detail their usual response to conflict. Participants will become more aware of their own communication style and various approaches of responding to conflict. Cases will be presented and workshop participants will take turns role-playing the scenarios, observing and critiquing each other Discussions will be directed towards teaching effective conflict management through demonstration and actual experience Goals: •Recognize the principles of conflict •Identify methods of conflict management •Develop a basic background on the topic and stimulate further interest in the topic •List the various approaches to dealing with conflict and their outcomes •List effective conflict management techniques •Discuss disruptive behaviors, fact-finding, confrontation, rehabilitation, reentry, and resolution Format: Lecture, small group discussions, role-playing Lessons Identified through trial and error: Panel Discussion Question & Answer Bill Barsan, MD, Bob Hockberger, MD, Kate Heilpern, MD Brent King, MD, Marcus Martin, MD, Tracy Sanson, MD, (Moderator) Discussions with those who have made the career advancement move, their thoughts on sentinel events and lessons identified along the way.

Networking Reception

SAEM Annual Business Meeting

Saturday May 16, 2009 2:00 - 2:50 p.m.

All SAEM members are urged to attend 1.

SAEM Award and Grant Presentations, Katherine L. Heilpern, MD, President a.

Hal Jayne Excellence in Education Award b.

Excellence in Research Award c.

Leadership Award d.

Special Recognition Award e.

Young Investigator Awards f.

SAEM/EMPSF Patient Safety Grant g.

Spadafora Grant h.

Research Training Grant i.

Institutional Research Training Grant j.

EMS Research Fellowship Grant k.

2008 Annual Meeting Awards: ŏ Best Faculty Award Amy Plint, MD

A Multi-Center Randomized Controlled Trial of Nebulized Epinephrine and Dexamethasone in Outpatients with Bronchiolitis

ŏ Best Young Investigator Presentation Lynn Babcock-Cimpello, MD Abnormal Head CT in Children with Mild TBI

ŏ Best Basic Science Award Joseph Piktel, MD

Attenuated Effect of Cooling on Dispersion of Repolarization Underlies Decreased Risk of Arrhythmogenesis in Therapeutic vs. Severe Hypothermia

ŏ Best Resident Award Anna Marie Chang, MD

Left Bundle Branch Block Does Not Increase Risk of Acute Myocardial Infarction in ED Patients with Potential Acute Coronary Syndrome

ŏ Best Fellow Award Erik Hess, MD

Diagnostic Accuracy of Clinical Prediction Rules to Exclude Acute Coronary Syndrome in the Emergency Department Setting: A Systematic Review

ŏ Best Medical Student Award Ms. Maria Nelson

A Geospatial Analysis of Persons Opting-Out from an Exception to Informed Consent Out-of-Hospital Interventional Trial

ŏ Best Innovations in Emergency Medicine Exhibit Award James V. Ritchie, MD, The Contraption: A Low-Cost Participatory Hemodynamic Simulator

ŏ Resident Visual Diagnosis Contest Winner Dustin Mark, MD 2.

Election Results, Katherine L. Heilpern, MD President Elect Board of Directors Constitution and Bylaws Committee Nominating Committee Resident Board Member

3.

4.

5.

6.

7.

8.

AEM Report and Announcements: David Cone, MD, Editor-in-Chief Bylaws Amendments: Katherine L. Heilpern, MD President’s Address: Katherine L. Heilpern, MD Introduction of 2009-2010 President Jill Baren, MD: Katherine L. Heilpern, MD New Business 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.

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CORD MEETINGS Wednesday, 5/13/09 8:00 am - 5:00 pm CORD - CPC Semi Final Competition

4th floor, various rooms

6:00 am - 8:00 pm CPC Awards Reception

Thursday, 5/14/09 8:30 am - 9:30 am PIF Review Committee

Napoleon Ballroom A 1,2,3

10:00 am - 12:00 pm

Remediation Task Force

Salon #828

11:00 am - 12:00 pm

Standardized Evaluation Methods Committee

Coronet Room, 8th floor

12:30 pm - 1:30 pm

Membership Task Force

Coronet Room, 8th floor

1:00 pm - 3:00 pm

EMARC Meeting

Crescent Room

2:00 pm - 3:30 pm

CORD/AACEM/AAEM/ACEP/SAEM Joint Leadership Meeting

Southdown Room

Coronet Room, 8th floor

3:30 pm - 4:30 pm Academy for Scholarship

Friday, 5/15/09 8:00 am - 12:00 pm CORD General Membership Meeting

Coronet Room, 8th floor

12:00 pm - 5:00 pm

CORD Board of Directors Meeting

Coronet Room, 8th floor

1:00 pm - 3:00 pm

Efficacy of Training Committee

Rhythms Ballroom 3

Napoleon Ballroom A 1,2,3

5:30 pm - 6:30 pm Simulation Journal Club

Saturday, 5/16/09 10:30 am - 12:00 pm CORD - 2010 Academic Assembly Planning Committee

1:00 pm - 2:00 pm CORD/EMRA Officers meeting

Coronet Room, 8th floor

3:00 pm - 4:00 pm

Coronet Room, 8th floor

CORD/ABEM Officers meeting

Coronet Room, 8th floor Coronet Room, 8th floor

SAEM Western Regional Research Forum and Medical Student Forum Meeting Announcement and Call for Abstracts Friday, March 19th - Saturday, March 20th, 2010 University of California, Davis, Sonoma, CA

SAEM is pleased to announce the 12th annual meeting of the Western Regional Research Forum. Abstracts must be submitted via the SAEM web site; the submission deadline coincides with national SAEM. When submitting an abstract for the national SAEM meeting, simply check the box indicating your interest in the Western Regional Research Forum and your abstract will be considered for both meetings.

This meeting is an excellent opportunity for medical students, residents, fellows and junior faculty to present their research. Abstracts from senior faculty are also welcome, of course. All accepted abstracts will be presented as mini-oral presentations.

There will also be a half-day Medical Student Forum with discussions on how to select a residency program and make one’s application as competitive as possible. In addition, students will have ample opportunity to speak informally with residency directors from throughout the Western United States.

The venue in Sonoma, California, is 45 miles from the San Francisco airport. The conference will run from noon on Friday through Saturday afternoon, leaving time to enjoy the spring weather, nearby golf & tennis and wine tasting in the Sonoma Valley region.

Questions can be directed to Deborah Diercks, MD, MSc, dbdiercks@ucdavis.edu or Kelsey Cearley cearleyk@ohsu.edu or call (503) 494-1475.

For additional program information please visit our website www.2009wrrf.com

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Pre-Day, Wednesday, May 13, 2009 Intensive Grant Preparation Workshop Please join us on Wednesday, May 13th for the 2009 SAEM Pre-day Intensive Grant Writing Workshop, an ongoing effort by SAEM to bring successful emergency medicine grant writers and new investigators together to discuss this crucial part of career development. The morning session will cover key elements of successful grant writing that include refining scientific questions, common pitfalls in grant submissions, and understanding the review process of both common foundations (including EMF and SAEM) and the federal government. The afternoon session will involve detailed discussion of grants that were not accepted on their first submission but subsequently received extramural support. These grants will be focused in various areas including health service research, clinical research, and basic science research for a broader knowledge of the composition of grants. Specific attention will be given to the process of project development and, importantly, the process of resubmission. Tuition covers meals, course materials, and a textbook on grant writing at the NIH level.

AGENDA 7:30 am Continental Breakfast

11:00 am Career Development Awards Manish Shah, MD University of Rochester

8:00 am Career Timeliness: What to Write and When John Younger, MD University of Michigan

12:30 pm Lunch - The Review Process John Younger, MD University of Michigan

8:30 am The Anatomy of the Science Mark Angelos, MD Ohio State University

1:30 pm Building and Tending Collaborations Basmah Safdar, MD Yale University

9:30 am The Budget and Administrative Shell Richard Rothman, MD Johns Hopkins University

2:30 pm Responding to Reviews and Resubmitting Alan Jones, MD Carolinas Medical Center

10:30 am Break

3:30 pm Wrap-Up Group Discussion

Department Head Regions Hospital in St. Paul, Minnesota, is a nationally recognized Level I trauma/Level I burn center with an annual ED volume of 67,000 and an accredited EM residency. Regions is part of the HealthPartners care system, which includes a multi-specialty medical group, primary and specialty clinics, and health plan.

This highly visible leader provides physician direction to the ED in physician recruitment, program development, quality improvement, budget oversight and academic activities, and in the development and delivery of comprehensive EM services in the Twin Cities and neighboring western Wisconsin communities. The Department Head serves as a member of the core faculty for the Department of EM at the University of Minnesota Medical School.

Qualified candidates must be EM residency trained and ABEM certified. Requires a strong communicator with proven leadership and management skills, a commitment to teaching and research, and eligibility for academic appointment to the U of MN faculty. Current Level I trauma facility work experience preferred. Email CV and cover letter to sandy.j.lachman@healthpartners.com or call (952) 883-5338 or (800) 472-4695 x2 for details. EO Employer

w w w. h e a lt h p a r t n e r s .c o m w w w. r eg io n s h o s p it a l .c o m

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Š 2008 NAS (Media: delete copyright notice)

SAEM Newsletter

Pre-Day, Wednesday, May 13, 2009 SAEM and AEM Committee/Task Force/Board Meetings 8:00 am - 5:00 pm

SAEM Leadership Academy

Maurepas Room

8:00 am - 5:00 pm

SAEM Intensive Grant Writing Workshop

Southdown

5:30 pm - 6:30 pm

SAEM Committee/TF Orientation

Cornet Room

6:30 pm - 8:00 pm

SAEM PC Comm/Sub-Comm Chairs Meeting

Evergreen

6:30 pm - 9:00 pm

SAEM BOD Dinner Meeting

Offsite

Affiliated Meetings/Satellite Symposia 8:00 am - 5:00 pm

SynerMed Satellite Symposia

Armstrong Ballroom

8:00 am - 5:00 pm

AAEM BOD Meeting

Evergreen Room

5:00 pm - 7:00 pm

EMNet Steering Committee

Salon # 801

Wednesday, May 13, 2009 8 am - 5 pm

8 am - 5 pm

8 am - 5 pm

8 am - 5 pm

8 am - 5 pm

Semi-Final

AEM Consensus

SAEM Intensive

SAEM Leadership

SynerMed

CPC Tracks

Conference

Grant Writing

Academy

Satellite

4th Floor

Napoleon C 2-3/3rd Floor

Bayside A Bayside B Bayside C Edgewood A-B Nottoway Oak Alley

Breakouts

Workshop

Napoleon C 2-3 Napoleon C-1 Napoleon B-1 Napoleon B-2 Napoleon B-3

4th Floor Southdown Room

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Symposium

3rd Floor Maurepas Room

8th Floor Armstrong Ballroom

Thursday, May 14, 2009 SAEM and AEM Committee/Task Force/Board Meetings 7:00 am - 8:00 am

SAEM PC Daily Meeting

Poydras

7:00 am - 8:00 am

SAEM Communications Committee

Salon # 824

9:30 am - 11:30 am

SAEM Consultation Services Committee

Salon # 816

10:00 am - 11:30 am

SAEM Regional Task Force

Salon # 817

11:30 am - 12:30 pm

SAEM WEB Editorial Board Committee

Edgewood-A

12:00 pm -1:30 pm

SAEM Membership Committee

Salon # 824

12:30 pm - 2:00 pm

SAEM Grants Committee

Salon # 816

2:00 pm - 3:30 pm

SAEM/ AACEM/CORD/ACEP/AAEM Joint Leadership Meeting Southdown Room

3:00 pm - 4:00 pm

SAEM Education Fund Task Force

Salon # 801

3:00 pm - 4:00 pm

SAEM Academy of Geriatric EM (AGEM)

Bayside B

3:00 pm - 4:30 pm

SAEM Development Committee

Edgewood-A

3:30 pm - 5:00 pm

SAEM Faculty Development Committee

Salon # 816

3:30 pm - 7:00 pm

SAEM Finance Committee

Salon # 817

4:00 pm - 5:00 pm

SAEM Constitution and Bylaws Committee

Salon # 801

4:00 pm - 5:30 pm

SAEM Guidelines Committee

Salon # 824

SAEM Interest Group Meetings 10:00 am - 1:00 pm

SAEM Ultrasound IG

Bayside C

12:00 pm - 1:30 pm

SAEM Sports Medicine IG

Salon # 828

2:00 pm - 3:30 pm

SAEM Public Health IG

Salon # 828

4:00 pm - 5:00 pm

SAEM Disaster Medicine IG

Salon # 829

4:00 pm - 5:30 pm

SAEM Mentoring Women IG

Salon # 828

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

EMCREG Satellite Symposium

Bayside C Room

7:00 am - 5:00 pm

ACEP Meetings

Bayside A Room

8:00 am - 3:00 pm

Emergency Medicine Foundation Board Meeting

Salon # 829

12:00 pm - 5:00 pm

AAEM/RSA BOD Meeting

Oakley Room

1:00 pm - 5:00 pm

NAEMSP Meeting

Salon # 821

1:00 pm - 5:00 pm

EMRA BOD Meeting

Edgewood B

8:00 pm - 10:00 pm

Yealy Study

Salon # 829

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Thursday, May 14, 2009 Thursday, 5/14/2009 8 - 9:30 am

Plenary Papers - Abtracts 1-5

Napoleon B-C 1-2-3 3rd Floor 9:30 - 12:30 pm Didactic

9:30 - 10 am - Coffee Break - Napoleon Corridor C-D/3rd Floor Oral Abstracts 10 - 11:30 am Resuscitation

Oral Abstracts 10 - 11:30 am Cardiovascular

Abstracts 6-11

Abstracts 12-17

Maurepas Room/3rd Floor

Napoleon B 1-2-3/3rd Floor

10 - 11:30 am

10 - 11:30 am

Didactic

Didactic

Big Brother is Watching: ED Crowding and the UK’s “4Hour Rule”

Resident as Teacher and Evaluator

Napoleon C 1-2-3/3rd Floor

Napoleon A 1-2-3/3rd Floor

Maurepas Room/3rd Floor

12:30 - 2 pm Didactic

Southdown Room/4th Floor

Limited: 50

LUNCH 11:30a - 12:30p Oral Abstracts 12:30 - 2 pm Neurology Abstracts 18-23

Perfecting Your Teaching Skills: An Interactive Workshop

12:30 - 2:00 pm Didactic

12:30 - 1:30 pm Didactic

12:30 - 2:30 pm Didactic

Conducting a High Quality Medical Student Career Early Goal-Directed Therapy Randomized Controlled Counseling Workshop - How in Pediatric Septic Shock Clinical Trial: From Design to to Utilize the AAMC Careers State of the Art Harnessing the Power of the Napoleon A 1-2-3/3rd Floor Analysis in Medicine Program Internet for Bedside Teaching

Napoleon B 1-2-3/3rd Floor

Napoleon C 1-2-3/3rd Floor 1:30 - 3 pm Didactic

Oral Abstracts 2 - 3 pm

2 - 3 pm Didactic

Research Methods

Novel Applications for Sonography

Abstracts 24-27

Crowding and the CFO: Is ED Boarding Profitable for Hospitals?

Maurepas Room/3rd Floor

Napoleon B 1-2-3/3rd Floor

Oak Alley/4th Floor

1:30 - 2:30 pm Didactic The Next Step in Closing the Gap in Health DisparitiesIncreasing Diversity Among Emergency Medicine Faculty Through Effective Mentoring

Borgne Room/3rd Floor

Napoleon A 1-2-3/3rd Floor

State of the Art

Posters 3 - 5 pm Neurology - Abstracts 28-38 Diagnostic Technology/Radiology- Abstracts 39-70 Airway/Analgesia - Abstracts 71-80

2:30 - 3:30 pm Didactic

2:30 - 3:30 pm Didactic

Physician Impairment: Development of EvidenceSubstance Use During Based Triage and Altered Standards of Care for Residency and Implications for Disasters Career Development in EM

Education - Abstracts 81 - 158

Napoleon A 1-2-3/3rd Floor

Innovations in Emergency Medicine Exhibits (1-10)

Grand Ballroom/5th Floor Moderated Posters 3:30 - 5:00 pm Synscope - Abstracts 159-164 Infectious Diseases- Abstracts 165-170

Grand Couteau & Grand Chenier Rooms/5th Floor 5:00 pm - CME Sessions End

5 - 6 pm

Keynote Address

Napoleon B-C 1-2-3/3rd Floor 6 - 7:30 pm Opening Reception

Armstrong Ballroom/8th Floor

13

Borgne Room/3rd Floor

Friday, May 15, 2009

SAEM and AEM Committee/Task Force/Board Meetings 7:00 am - 8:00 pm

SAEM Past President’s Breakfast

Bayside A

7:30 am - 4:30 pm

Chief Resident Forum

Armstrong Ballroom

7:30 am - 8:00 am

SAEM PC Daily Meeting

Poydras

8:00 am - 9:00 am

SAEM Residents as Researchers TF

Salon # 801

9:00 am - 10:00 am

SAEM Research Committee

Salon # 816

11:00 am - 12:00 pm

SAEM Strategic Planning TF

Salon # 829

11:00 am - 12:30 pm

SAEM Ethics Committee

Salon # 801

12:00 pm - 1:00 pm

SAEM Industry Relations Committee

Salon # 820

12:00 pm - 2:00 pm

2:00 pm - 3:30 pm

AEM Reviewers lunch/workshop

Bayside A

SAEM GME Sub-Committee/Industry Relations

Salon # 816

3:30 pm - 5:00 pm

SAEM GME Committee

Salon # 828

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

SAEM Uniformed Services IG

Salon # 829

8:00 am - 9:00 am

SAEM Academic Informatics IG

Salon # 816

8:00 am - 9:30 am

SAEM International IG Business Meeting

Gallier Rooms A-B

10:00 am - 12:00 pm

SAEM Research Directors IG

Salon # 828

11:00 am - 12:00 pm

SAEM Airway IG

Salon # 825

11:30 am - 1:30 pm

SAEM Evidence Based Medicine IG

Gallier Rooms A-B

12:00 pm - 1:00 pm

SAEM Patient Safety IG

Salon # 816

12:00 pm - 1:00 pm

SAEM Clinical Directors IG

Salon # 817

1:00 pm - 2:00 pm

SAEM Education Research IG

Salon # 816

1:00 pm - 4:00 pm

SAEM Ethics IG

Salon # 817

2:00 pm - 3:00 pm

SAEM EMS IG

Salon # 801

4:00 pm - 6:00 pm

SAEM International IG Research Forum

Gallier Rooms A-B

4:30 pm - 5:30 pm

4:30 pm - 6:00 pm

SAEM Ischemia-Reperfusion IG

Salon # 821

SAEM Diversity IG

Salon # 816

4:30 pm - 7:30 pm

SAEM Neurological IG

Salon # 817

5:00 pm - 6:00 pm

SAEM ED Crowding IG

Salon # 820

14

Friday, May 15, 2009

Affiliated Meetings/Satellite Symposia 8:00 am - 6:00 pm

ACEP Meetings all day

Southdown

8:30 am - 11:30 am

EMRA BOD Meeting

Evergreen

9:30 am - 11:00 am

ABEM/ACEP Officers Meeting

Salon # 817

12:00 pm - 5:00 pm

CDEM Meeting

Bayside B

1:00 pm - 1:30 pm

EMRA Committee Chair/Vice Chair Orientation

Evergreen

1:00 pm - 2:00 pm

EMRA Regional Representative Committee

Esterwood

1:00 pm - 3:00 pm

EMRA Medical Student Governing Council

Oakley Room

1:00 pm - 4:00 pm

EMRA SIM WARS Competition

Rhythms Ballroom # 1-2

2:30 pm - 3:00 pm

EMRA Rep. Council Conf. Comm. Orientation

Evergreen

3:00 pm - 4:00 pm

ACEP/SAEM Joint Task Force-Continuing

Salon # 801

3:00 pm - 4:00 pm

EMRA Membership Committee

Oakley Room

3:00 pm - 4:00 pm

EMRA Technology Committee

Evergreen

3:00 pm - 4:00 pm

3:00 pm - 4:00 pm

EMRA Representative Council Public Hearing

Wildwood

EMRA Health Policy Committee

Salon # 821

3:00 pm - 4:00 pm

SAEM/ABEM Leadership Meeting

Edgewood A-B Combined

3:00 pm - 4:00 pm

EMRA Rep. Council Public Hearing

Estherwood

4:00 pm - 5:00 pm

EMRA Research Committee

Oakley Room

4:00 pm - 5:00 pm

EMRA Representative Council Reference Committee Work Meeting

Evergreen

4:00 pm - 5:00 pm

EMRA International Committee

Bayside A

4:00 pm - 5:00 pm

EMRA Critical Care Committee

Salon # 820

4:30 pm - 6:00 pm

Denver Health/University for Colorado Alum Fac. & Res. Reception

Salon # 829

5:00 pm - 6:00 pm

EMRA Spring Awards Reception Rhythms

Ballroom # 3

5:00 pm - 7:00 pm

Robert Wood Johnson Foundation Clinical Scholars Program & Physician Faculty Scholars Program Reception Nottoway Room

6:00 pm- 7:30 pm

Brown University Department of Emergency Medicine Reception

15

Edgewood A-B

Friday, May 15, 2009 Friday, 5/15/2009

7:30 - 9:30 am Breakfast and Networking Session

Napoleon B1-C1/3rd Floor

Oral abstracts 9:30 - 11 am Acute Coronary Syndromes Abstracts 171-176

Oral abstracts 9:30 - 11 am Pulmonary Embolism Abstracts 181-186

Maurepas Room/3rd Floor

Borgne/3rd Floor

Oral Abstracts 11 - 12 noon Trauma Abstracts 177-180

Oral Abstracts 11 - 12 noon Pediatrics Abstracts 187-190

Maurepas Room/3rd Floor

Borgne/3rd Floor

8 am - 12 noon

9:30 - 10:30 am 9:30 - 11 am CORD * Didactic Didactic General Membership Meeting Bottlenecks in Patient Novel Approaches to Throughput: Applying Queing Theory to Identify TIA Management in the ED and Manage ED Patient Flow State of the Art Napoleon C 2-3/3rd Floor

Napoleon A 1-2-3 &

10:30 - 12 noon Didactic

Napoleon B 2-3/3rd Floor Common Street Corridor 11 am - 12 noon 3rd Floor

Didactic Leadership From Within – Enhancing Your Natura The Future of Scientific Ability Publication in Emergency Medicine

Napoleon C 2-3/3rd Floor Napoleon B 2-3/3rd Floor 12 - 1 pm - LUNCH BREAK

Posters 1-3 pm Research Methodology - Abstracts 203-208 Geriatrics - Abstracts 209-227 Pediatrics - Abstracts 228-261 Cardiovascular - Abstracts 262-299 Pulmonary Embolism - Abstracts 300-313 Obstertics/Gynecology - Abstracts 314-318 Abdominal/Gastrointestinal/Genitourinary- Abstracts 319-323 Computer Technologies- Abstracts 324-327 Ethics - Abstracts 328-330 Respiratory/ENT - Abstracts 331-335

1:00p-4:00p AHRQ Session Using HCUP Databases for Emergency Medicine Research: Introduction to the Nationwide Emergency Department

Innovations in Emergency Medicine Exhibits (1-10)

Grand Ballroom - 5th Floor Moderated Posters 3:30 - 5:00 pm Ultrasound - Abstracts 336-341 Advancing Education in EM- Abstracts 342-347

Sample (NEDS)

Napoleon A 1-2-3 3rd Floor

Grand Couteau & Grand Chenier Rooms Oral abstracts 3 - 4:30 pm Abdominal Pain Diagnostics Abstracts 191 - 196

Oral abstracts 3 - 4:30 pm Disparities Abstracts 197 - 202

Maurepas Room/3rd Floor

Borgne Room/3rd Floor

3 - 4:30 pm Didactic Faculty Development: Facing the Challenges Identified by the 2007 SAEM Faculty Development Survey

Napoleon C 2-3/3rd Floor

3 - 4:30 pm Didactic Developing a Research Agenda on ED Crowding and Geriatric Patient Care

Napoleon B 2-3/3rd Floor

4:30 pm CME Sessions End

* Denotes Non-CME Session

16

8 am - 4 pm Chief * Resident Forum

Armstrong Ballroom 8th Floor

Saturday, May 16, 2009

SAEM and AEM Committee/Task Force/Board Meetings 7:30 am -8:00 am

SAEM PC Daily Meeting

Poydras

7:30 am - 12:00 pm

SAEM BOD Meeting

Crescent

8:00 am - 4:00 pm

Medical Student Symposium General Session

Bayside A-B-C

9:00 am - 10:30 am

SAEM Pediatric EM TF

Salon # 824

10:00 am - 11:00 am

SAEM Aging & Generational Issues in Academic EM TF

Salon # 816

10:00 am - 12:00 pm

SAEM 2010 Program Committee Planning Meeting

Salon # 828

11:00 am - 1:00 pm

SAEM Research Fund Luncheon

Oak Alley

12:00 pm - 2:00 pm

AEM Editorial Board Lunch/meeting

Southdown

2:00 pm - 2:50 pm SAEM Awards & Annual Business Meeting

Napoleon Ballroom C 1-2-3

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

SAEM Triage IG

Salon # 801

11:00 am - 12:00 pm

SAEM Patient Safety IG

Salon # 821

11:30 am - 12:30 pm

SAEM Palliative Care and End of Life IG

Salon # 824

12:00 pm - 1:00 pm

SAEM Toxicology IG

Salon # 801

12:00 pm - 1:00 pm

SAEM Trauma IG

Salon # 821

1:30 pm - 2:30 pm

SAEM Health Services & Outcomes Research IG

Salon # 816

7:00 am - 1:30 pm

ABEM EM- Model Review Task Force Meeting

Salon # 817

8:00 am - 9:00 am

Western Regional SAEM Meeting

Salon # 821

8:00 am - 11:00 am

CDEM Executive Committee

Ellendale Room

8:30 am - 9:30 am

EMRA REP Council Welcome Breakfast/Registration

Rhythms Ballroom # 2

9:00 am - 10:00 am

Clinical Science & Translational Award West Coast Consortium

Salon # 821

9:30 am - 12:30 pm

EMRA REP Council Meeting/Town Hall

Rhythms Ballroom # 2

11:00 am - 12:30 pm

AAP Section on EM-Subcommittee on Fellowship

Salon # 816

12:30 pm - 1:30 pm

EMRA Resident's Luncheon

Rhythms Ballroom # 1

1:00 pm - 5:00 pm

Western Journal of Emergency Medicine Editorial Board and Section Editor

Salon # 828

5:00 pm - 6:30 pm

ACEP Reception

Rhythms Ballroom #1

5:30 pm - 7:00 pm

EMRA National EM Jeopardy Contest

Rhythms Ballroom # 2

Affiliated Meetings/Satellite Symposia

17

Saturday, May 16, 2009 Saturday, 5/16/2009 7- 8 am Fun Run Oral abstracts

Oral abstracts

Oral abstracts

8 - 9 am

8:00 - 9:30 am

8 - 9:30 am

8 - 9 am

Didactic

Sepsis

Decision Rules

Imaging and Radiation

Abstracts 348-353

Abstracts 364-369

Maurepas Room/3rd Floor

Borgne Room/3rd Floor

Oral abstracts

8 am - 4 pm * Medical Student

Filling the Holes in EMS Research

Symposium

Napoleon A 1-2-3/3rd Floor Napoleon B 1-2-3/3rd Floor

Bayside A-B-C 4th Floor

Abstracts 380-383

Oral abstracts

9 - 10:30 am

9 - 10:30 am

Didactic Introduction

Didactic State-of-the-Art in Heart

9:30 - 11 am

9:30 - 11 am

to Statistics

Failure Syndromes:

ED Operations

EMS/Out-of-Hospital

of Clinical Trials

Evolving Role of the ED -

Abstracts 354-359

Abstracts 370-375

Current State and a Framework for Future

Maurepas Room/3rd Floor

Borgne Room/3rd Floor

Research

Napoleon A 1-2-3/3rd Floor

Napoleon B 1-2-3/3rd Floor Oral Abstracts 11-12 noon

Oral Abstracts 11 - 12 noon

10:30 - 11:30 am Didactic Academic Career

10:30 - 11:30 am Didactic Case Studies - Conflict

HIV Testing in the ED

Toxicology

Development for

of Interest in Human

Abstracts 360-363

Abstracts 376-379

Clinical Directors

* Research Fund Luncheon 11 am - 1 pm

Subjects Research Where the Rubber Meets

Maurepas Room/3rd Floor

Borgne Room/3rd Floor

the Road

Napoleon A 1-2-3/3rd Floor

Oak Alley Room 4th Floor

Napoleon B 1-2-3/3rd Floor 11:30a - 12:30 pm LUNCH BREAK 12:30 - 2 pm Didactic

12:30 - 2 pm Didactic

12:30 - 2 pm Oral Abstracts

Health Services From Evidence to EMS Integrating Hospice and Practice: Building the Palliative Care Services in Research and Policy National Model the ED: Effects on Abstracts 384-389 Resident and Faculty Education and ED Overcrowding Napoleon A 1-2-3/3rd Floor Napoleon B 1-2-3/3rd Floor Maurepas Room/3rd Floor 2 - 2:50 pm

12:30 - 2 pm Oral Abstracts Airway Management Abstracts 390-395

Borgne Room/3rd Floor

Awards & Annual Business Meeting *

Napoleon Room C 1-2-3/3rd Floor 3 - 4:30 pm ECCC Session Regionalization of Emergency Care: Possibilities and Pitfalls. A National Dialogue

Napoleon Room C 1-2-3/3rd Floor 4:30 - 6:30 pm Wine & Cheese Poster Session Infectious Disease - Abstracts 396-413 Disease/Injury Prevention- Abstracts 414-429 Shock/Critical Care - Abstracts 430-445 Cardiac Arrest - Abstracts 446-453 EMS - Abstracts 454-498 Disaster - Abstracts 499-505 Crowding - Abstracts 506 - 523

Armstrong Ballroom 8th Floor

Innovations in Emergency Medicine Exhibits (11-20)

Grand Ballroom/5th Floor 6:30 pm CME Sessions End

* Denotes Non-CME Session

4 - 5:30 pm * Residency Fair

18

Sunday, May 17, 2009

SAEM and AEM Committee/Task Force/Board Meetings 7:30 am - 8:00 am

SAEM PC Daily Meeting

Poydras

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

Tech in Med. Ed Academy/SAEM Simulation IG Cornet Room

Sunday, 5/17/2009

Oral Abstracts 8 - 9 am Cardiac Arrest Abstracts 524-527

Oral abstracts 8 - 9 am Geriatrics Abstracts 532-535

Napoleon A 1-2-3/3rd Floor

Napoleon B-3 & C-3/3rd Floor

Oral Abstracts 9 - 10 am Post-Cardiac Arrest Abstracts 528-531

Oral Abstracts 9 - 10 am Research Consent Abstracts 536-539

Napoleon A 1-2-3/3rd Floor

Napoleon B-3 & C-3/3rd Floor

Posters 10 am - 12 noon

8 - 10 am Didactic

Publish or Perish: Achieving Opportunities for Academic Scholarship in Your Everyday Emergency Physicians in Teaching and Education Work Undergraduate Medical Education: Looking Beyond Napoleon B-1 & C-1/3rd Floor (and before) the EM Clerkship Didactic 9:30 - 10:30 am

Napoleon B-2 & C-2/3rd Floor Didactic 10 - 11 am

Toxicology - Abstracts 540-567 Trauma - Abstracts 568-594 Wounds/Burns/Orthopedics- Abstracts 595-603 Administration/Health Care Policy- Abstracts 604-656 Decision Rules - Abstracts 657-661 Psychiatry/Social Issues - Abstracts 662-672 Innovations in Emergency Medicine Exhibits (11-20)

Grand Ballroom - 5th Floor

Moderated Posters 10:30 - 12:00 am Preventive Care in the ED - Abstracts 673-678 Triage - Abstracts 679-684

8 - 9:30 am Didactic

Error and Bias in Clinical Research

Napoleon B-2 & C-2/3rd Floor Didactic 11 am - 12 noon “International Academic Experiences: How to Incorporate Them Effectively into Your Career”

Napoleon B-2 & C-2/3rd Floor

Grand Couteau & Grand Chenier/5th Floor 12 noon - Meeting ends

THE POWER OF ONE Don’t forget to stop by registration and make a donation!

Your donation could be the ONE to make the difference in the life of a young researcher and the patients they touch.

19

The Science of Simulation in Healthcare: Followup of the 2008 AEM Consensus Conference

Napoleon B-1 & C-1/3rd Floor Didactic 10:30 am - 12 noon In Situ High Fidelity Simulation for Resident and Prehospital Education

Napoleon B-1 & C-1/3rd Floor

Thursday, May 14, 2009 Perfecting Your Teaching Skills: An Interactive Workshop (9:30 am - 12:30 pm) Diane Birnbaumer, MD, Harbor-UCLA Medical Center Susan Promes, MD, UCSF Mary Jo Wagner, MD, Synergy Medical Education Alliance As medical education moves from primarily didactics to more interactive teaching, emergency physicians are challenged to effectively teach at the bedside and in small groups, and to learn how to give effective feedback. After short didactic sessions to kick off each section of the workshop, participants will engage in role-playing scenarios to practice bedside teaching techniques, leading small groups successfully, and how to give effective feedback.

At the conclusion of this session the participant should be able to: 1.

Discuss the various types of bedside teaching techniques and how to use them. 2. List the components of and challenge to effectively leading a small group session. 3. Explain how to give effective feedback Big Brother is Watching: ED Crowding and the UK’s “4-Hour Rule” (10:00 am - 11:30 am) Brent Asplin, MD, Regions Hospital John Moorhead, MD, Oregon Health and Science University Ellen Weber, MD, University of California, San Francisco Frank Zwemer, MD, McGuire Virginia Medical Center Studying and solving ED crowding requires use of uniform measures of crowding that can be widely applied, as well as establishing clinically relevant, measurable patient outcomes. Many challenges exist in choosing measures of performance, because implementing any given measure may result in unforeseen dysfunctional consequences. In the interest of improving emergency care, the UK National Health Service (NHS) implemented a 4-hour performance target in 2000, with the expectation that no patient presenting to a NHS ED spend more than 4 hours to complete their ED treatment. After apparent lack of progress, in 2003 the program and evaluation were revised, with publicly reported ratings, financial incentives, and the threat of dismissal for senior hospital leaders. Performance improved from 1% (January 2003) to 76% (September 2006). The 4-hour performance target was substantially met, without apparent negative clinical consequences. Potential dysfunctional consequences may have resulted from effort substitution (reducing effort on non-measured performance items) or gaming (making performance appear better than actual).

In the U.S., the National Quality Forum (NQF) recently proposed total ED throughput time as a publicly reported performance measure.

Regulatory policies similar to the 4-hour rule may hold promise as a solution to ED crowding; however, the potential benefits and consequences of such policies require further investigation.

At the conclusion of this session the participant should be able to: 1.

Identify the reported benefits in the UK’s National Health System of establishing a broadly-applied regulatory standard. 2. Identify potential dysfunctional consequences of implementing benchmarks, including effort substitution and gaming. 3. Anticipate challenges with implementing ED-performance standards in the U.S., focusing on the ED throughput time performance measures recently introduced by the National Quality Forum. 4. Outline a research agenda for studying the benefits and adverse consequences of regulatory solutions to ED crowding.

Resident as Teacher and Evaluator (10:00 am - 11:30 am) Amal Mattu, MD, University of Maryland Douglas Ander, MD, Emory University Jennifer Casaletto, MD, Maricopa Medical Center David Howes, MD, University of Chicago Hospitals The course will include an introduction to the importance of residents as teachers, evaluators and role models for medical students, followed by two 20 minute sessions, each followed by a 15 minute small group discussion/activity. The first session will focus on curriculum development strategies by highlighting selected published and unpublished

curricula for resident teacher-training programs to provide participants with learning objectives and an initial structure through which residents’ basic teaching skills could be improved. The small group activity following the teaching skills segment will emphasize the role of EM faculty in preparing residents to teach, allowing participants to practice learned techniques for “teaching” teaching skills. The second 20 minute session will propose effective methods for advancing resident oral and written feedback and evaluation abilities via introduction to a toolbox of helpful feedback and evaluation methods able to be exported to participants’ home department. The small group activity following the evaluation skills segment will expose participants to issues created by poorly executed feedback or evaluation via provided role playing scenarios, then provide brief suggestions for avoiding and responding to such predicaments.

At the conclusion of this session, participants should be able to: Institute teaching and evaluation curricula for EM residents and junior faculty at their home institutions.

Conducting a High Quality Randomized Controlled Clinical Trial: From Design to Analysis (12:30 pm - 2:00 pm) Alan Jones, MD, Carolinas Medical Center Nathan Shapiro, MD, Beth Israel Deaconess MC Steve Trzeciak, MD, Cooper University Hospital A randomized controlled trial (RCT) is an experimental design that produces the most reliable scientific evidence by minimizing spurious causality through elimination of unmeasurable confounding and bias.

It has come to be expected in modern medicine that new treatments will be tested in RCTs in order to determine efficacy and safety.

However, designing and performing a high quality RCT is both time consuming and difficult. Choosing the correct design, techniques (randomization procedure, control group, blinding technique, and concealment), outcome measure, and analysis are of utmost importance. This session begin by providing the scientific rationale as to why RCTs produce the most reliable scientific evidence. The course faculty will then provide an in-depth exploration of the important issues related to conducting a high quality RCT. Two speakers with experience in designing and conducting RCTs will discuss in detail the similarities and differences between the most common RCT designs, non-inferiority and superiority. The final speaker will discuss techniques common to all RCTs that are critical to the integrity of the study, including: randomization, recruitment, control group, blinding, allocation, data collection, outcome measurement, and analysis planning.

At the conclusion of this session participants should be able to: 1.

Identify the basis of RCT experimental design. 2. Have in-depth knowledge of the two most common types of RCTs, non-inferiority and superiority. 3. Identify critical techniques necessary for conducting a high quality RCT. Medical Student Career Counseling Workshop - How to Utilize the AAMC Careers in Medicine Program (12:30 pm - 2:00 pm) Brian Zink, MD, Brown University Jeanette Calli, Association of American Medical Colleges Sorabh Khandelwal, MD, Ohio State University Most emergency medicine faculty members are expected to provide career advising to medical students, but few are trained in how to provide high quality advising services. The AAMC Careers in Medicine (CiM) program was developed to inform and assist medical students in career planning using a four-phase process of self-understanding, career exploration, specialty choice, and getting into residency. The robust CiM web site allows interactive learning and provides extensive career and specialty information.

This workshop will teach faculty how to utilize the AAMC CiM resources and work with CiM liaisons at their medical schools to improve their career counseling skills and expertise. In the first portion Jeanette Calli, MS, the CiM Program Manager and lead trainer will describe the CiM program, introduce and navigate the website, present some important career advising skills and techniques, and par-

20

Thursday, May 14, 2009

ticipate in a question and answer session with medical student educators on aspects of career counseling that are specific to emergency medicine. In the 2nd portion of the workshop common career planning dilemmas encountered by students will be presented and Ms. Calli, Dr. Zink, and Dr. Khandelwal will discuss how to use CiM and other resources to help students make good career choices.

At the conclusion of this session participants should be able to: 1.

Have become familiar with the Careers in Medicine program and structure. 2. Obtained basic skills in advising and working with students in their specialty decisions. 3. Learn about resources that will assist them in their advising role. 4. Discussed common difficult issues that arise when counseling medical students on career choice and residency application.

Early Goal-Directed Therapy in Pediatric Septic Shock (12:30 pm - 1:30 pm) Joseph Carcillo, MD, University of Pittsburg Susan Fuchs, MD, Children’s Memorial Hospital Early Goal-Directed Therapy (EGDT) for shock has been shown to increase survival and many EDs are developing rapid response protocols to rapidly identify and initiate treatment for patients with signs and symptoms of shock. While there is considerable consensus agreement in the treatment of adult septic shock patients, the available literature and current recommendations for the pediatric patient are more limited. This lecture will highlight evidence-based differences in the EGDT pathways for children compared to adults.

At the conclusion of this session, participants should be able to: 1.

Differentiate between pediatric and adult shock treatment algorithms.

2. Be familiar with the current base of evidence supporting recommendations for the treatment of EGDT for pediatric shock.

The Next Step in Closing the Gap in Health Disparities- Increasing Diversity Among Emergency Medicine Faculty Through Effective Mentoring (1:30 pm - 2:30 pm) Alice Mitchell, MD, Carolinas Medical Center Victoria Garrett, MD, Carolinas Medical Center Marcus Martin, MD, University of Virginia Kate Heilpern, MD, Emory University This session will focus on strategies to recruit, retain and promote women and under-represented minority physicians in academic Emergency Medicine, both for department leaders and for faculty members. Ongoing disparities in Emergency Medicine leadership, training and health care delivery have been well-recognized for over several decades. While improving the recruiting of diverse populations into the practice of emergency medicine is essential, specific efforts to improve the representation and success of women and under-represented minorities as academic emergency medicine faculty are also essential.

At the conclusion of this session participants should be able to: 1.

Identify the basic structure and components of the traditional academic promotions system. 2. Create effective mentoring relationships for women and under-represented minorities at various stages of career development. 3. Develop and maintain innovative academic activities by female and under-represented minority physicians. 4. Challenge academic institutions to make specific improvements to recruit, retain and promote women and under-represented minority physicians in academic emergency medicine.

Harnessing the Power of the Internet for Bedside Teaching (12:30 pm - 2:30 pm) Eddy Lang, MD, McGill University Peter Wyer, MD, Columbia University Joel Turner, MD, McGill University David Newman, MD, McGill University Internet access is now widely available in the emergency department setting and holds the potential to empower bedside teaching by showcasing resources that can inform or support clinical reasoning

21

and decision-making. However, many emergency physicians may be unaware of these resources or are unfamiliar with their navigation. This workshop will offer a hands-on and practical experience allowing exploration of a wide range of unique resources. Taking advantage of wireless capabilities offered in the conference hotel, workshop participants will be presented with a series of clinical scenarios / problems which can be resolved through use of unique online electronic resources. Working in small teams and from the laptops that they must bring to the session, participants will be directed to a workshop homepage which will contain an extensive array of links to online resources; some of which will be important for solving the clinical problem they are presented with. They will be given criteria which will enable them to evaluate and select the most appropriate resources for their own purposes. Each small group of 15 participants will work alone initially and then as a team to solve the clinical problem and share their findings with the larger group on a large screen. The course faculty may choose to highlight additional options that were not discovered by the participants. The workshop homepage which will contain over 100 links organized by category, (procedure videos, patient education, EBM resources, clinical calculators, drug interaction detectors etc.) will remain permanently available for participants.

At the conclusion of this session, participants should be able to: 1.

Discover invaluable, pre-appraised and easy to use, online resources that they will integrate in to their teaching (and patient care) repertoire. 2. Practice strategies to rapidly locate high quality evidence and evidence synopses that can address clinical questions that arise during clinical care. 3. Use their own educational institution’s e-classroom to conduct similarly modeled sessions for trainees at all levels and faculty at their institution.

Crowding and the CFO: Is ED Boarding Profitable for Hospitals? (2:00 pm - 3:00 pm) Frank Zwemer, MD, McGuire VA Medical Center Jesse Pines, MD, University of Pennsylvania Daniel Handel, MD, Oregon Health & Science University Brent Asplin, MD, Mayo Clinic Three years after the Institute of Medicine reports on emergency care, and 20 years after it was first described, ED crowding persists. Could there be reasons for this other than inefficiencies in process design?

Might health systems have financial reasons to maintain crowding?

What is the contribution margin for ED patients compared to that of elective admissions? These issues have not been well explored, but a growing body of literature provides important early insights. Two recent papers report conflicting results about the profitability of ED admissions for hospitals.

The goal of this session is to review financial aspects of ED crowding, and to explore whether hospitals have economic incentives to maintain crowding. Some questions to be considered include: What has been proven about the costs of boarding vs. the financial benefits?

What has been shown about variable inpatient space and staffing costs by using the ED as overflow?

Are there measured benefits of limiting boarding and crowding to the ED? In what setting do ED delays and crowding affect the financial performance of any given hospital? Is this an individual market issue, or something broader?

At the conclusion of this session participants should be able to: 1.

Identify the research outcomes in the business models of hospitals with regard to ED boarding and crowding. 2. Describe the tools and competencies that are required to launch a successful research agenda on the financial aspects of ED crowding. 3. Identify the most useful and meaningful common measures of ED crowding and financial performance that will permit broadening the research work on ED crowding.

Thursday, May 14, 2009 Novel Applications in Sonography (1:30 pm - 3:00) Michael Stone, MD, SUNY Downstate Vicki Nobel, MD, Partners HealthCare Arun Nagdev, MD, University of California, San Francisco James Moak, MD, University of Cincinnati This session will consist of three 30-minute segments on novel uses of ultrasound in the emergency department. Each lecture will include a video demonstration, or when feasible a model patient. The first segment, on ultrasound-guided nerve blocks, will focus primarily on identification of the brachial plexus which may be blocked for shoulder dislocations and humeral fractures, thus avoiding the need for procedural sedation. The second discussion will address the potential role of ultrasound in the setting of pulmonary edema. The lecturer will discuss sonographic B-lines and their utility as a diagnostic adjunct to the physical exam, BNP, and chest x-ray. The third lecture will focus on ultrasound-guided lumbar puncture, a technique that has shown promise in patients with challenging anatomy.

At the conclusion of this session participants should be able to: 1. Be familiar with the anatomy and sonographic appearance of the scalene muscles and brachial plexus. 2. They will recognize why sonographic B-lines occur in pulmonary edema and how these lines appear on ultrasound. 3. Realize how ultrasound may be used to visualize spinal landmarks in preparation for lumbar puncture.

Development of Evidence-Based Triage and Altered Standards of Care for Disasters (2:30 pm - 3:30 pm) J Lee Jenkins, MD, Johns Hopkins University Richard Schwartz, MD, Medical College of Georgia Evidence to support the use of one disaster triage algorithm over another is limited, and the development of effective triage protocols is an important research priority. It is recognized that there is a need for a national standard for mass casualty triage, as disasters frequently cross jurisdictional lines involving responders from multiple agencies.

After reviewing all of the existing triage systems a consensus review panel has found that there was insufficient evidence to support one system over the others. The most widely recognized mass-casualty triage algorithms in use today are not evidence-based, and no studies directly address these issues in the mass-casualty setting. This presentation will present the aspects of the existing systems and based on best evidence, the development of SALT triage as a proposed national guideline for all-hazards mass casualty initial triage for all patients.

Recent reports have also highlighted altered standards of care or “reverse triage” as possible tools to be utilized in emergency department overcrowding and surge capacity management. Identification of inpatients for safe early discharge (ie, reverse triage) or identification of certain disease processes in which altered standards of care could be safely utilized could create additional hospital surge capacity. The development of these altered standards or reverse triage algorithms is currently in progress and necessitates an evidence-based approach.

The results of recent publications and the latest state-of-the-art in methodologies to examine this problem will be addressed and discussed.

At the conclusion of this session participants should be able to: 1. Recognize the limited evidence for current triage algorithms, be familiar with the newly developed SALT triage. 2. Be familiar with the use of altered standards of care in disasters. 3. The latest research methodologies being utilized to develop evidence based models.

Physician Impairment: Substance Use During Residency and Implications for Career Development in Emergency Medicine (2:30 pm - 3:30 pm) Brian McBeth, MD, University of California, San Francisco Terry Kowalenko, MD, University of Michigan Felix Ankel, MD, Regions Hospital/University of Minnesota Karl Nibbelink, MD, Temple University

cians impaired by drug and alcohol use. Discussants will include residency directors, researchers and a current resident who has been through treatment for substance abuse. This session will highlight controversies such as options for intervention and treatment, recidivism and confidentiality with implications for employment post-residency. Approaches to prevention and strategies to foster a healthy residency “culture” will be discussed as well.

At the conclusion of this session the participant should be able to: 1. Recognize the symptoms and signs of a physician impaired by substance use in the workplace. 2. Intervene acutely in a manner that protects the safety of patients and maximizes odds of successful treatment of the impaired physician. 3. To recognize current research and treatment options for physician with impairment due substance use.

PAPER PRESENTATIONS Plenary (8:00 – 9:30 am) 1 A Prospective, Blinded, Randomized Controlled Trial to Evaluate Ketamine-Propofol vs. Ketamine Alone for Procedural Sedation in the Pediatric Emergency Department, Amit Shah, MD, The University of Western Ontario 2 Simulation Training for Central Venous Catheter Insertion on a Partial Task Trainer Improves Skills Transfer to the Clinical Setting, Leigh Evans, MD,Yale University School of Medicine 3 Plasma Neutrophil Gelatinase-Associated Lipocalin to Assess the Risk of Developing Renal Dysfunction in Emergency Department Patients with Suspected Sepsis, Nathan Shapiro, MD, Beth Israel Deaconess Medical Center 4 Leaving The ED Without Being Seen and Risk of Subsequent Adverse Events: A Population-Based Study, Michael J. Schull, MD, Institute for Clinical Evaluative Sciences 5 80 Lead ECG Body Surface Mapping Detects More High Risk ECG Abnormalities in ED Patients with Acute Coronary Syndromes: Results from the OCCULT MI Trial, James Hoekstra, MD, Wake Forest University Health Sciences Resuscitation (10:00 – 11:30 am) 6 Whole Blood Redox Potential Correlates with Total Body Oxygen Consumption During Hemorrhagic Shock and Resuscitation, Nathan White, MD, Virginia Commonwealth University (VCURES) 7 Accuracy of Near Infrared Spectroscopy in predicting Central Venous Mixed Oxygenation in the Emergency Department, Anthony Napoli, MD, Brown University Medical School 8 Resuscitation With Balanced Electrolyte Solution Prevents Hyperchloremic Metabolic Acidosis In Patients With Diabetic Ketoacidosis; A Pilot Study, Simon Mahler, MD, Louisiana State University HSC Shreveport 9 Resuscitation With A Hemoglobin Based Oxygen Carrier (HBOC) With And Without L-Arginine In A Swine Model Of Hemorrhagic Shock (HS), Susan Stern, MD, University of Michigan 10 Low Volume Resuscitation and Repayment of Oxygen Debt From Traumatic Shock, Benjamin Leong, MBBS, Virginia Commonwealth University 11 Effect of Continuous Insulin Infusion on Time to Shock Reversal among Patients with High Dose Vasopressor Dependent Septic Shock, Michael Puskarich, MD, Carolinas Medical Center

This round-table discussion will review current epidemiology and challenges associated with identification and treatment of resident physi-

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Thursday, May 14, 2009 Cardiovascular (10:00 – 11:30 am)

POSTER SESSION (3:00 – 5:00 pm)

12 Follow-up of Patients Treated with the Ottawa Aggressive Protocol for Acute Atrial Fibrillation or Flutter, Ian Stiell, MD, University of Ottawa

Neurology 28 Can Intraocular Pressure Measurements Be Used To Screen For Elevated Intracranial Pressure In Emergency Department Patients? Timothy Muchnok, DO, Albert Einstein Medical Center

13 Natriuretic Peptides Fail to Predict Short Term Mortality in Emergency Department Patients with Acute Heart Failure, Richard Nowak, MD, Henry Ford Health System

29 Use of the Emergency Department for Treatment of Musculoskeletal Back Pain, Mikaela Chilstrom, MD, Albert Einstein College of Medicine

14 ED Prediction of Short Term Mortality In Acute Heart Failure: Results Of The International BACH Trial, Frank Peacock, MD, The Cleveland Clinic

30 Do Emergency Department Patients With Vertigo Need Emergent Magnetic Resonance Imaging, Maureen Chase, MD, Beth Israel Deaconess Medical Center

15 One Year Outcomes Of Young Adult Chest Pain Patients, Mark Collin, BS,University of Pennsylvania

31 A Prospective Trial of IV Caffeine vs Placebo for Post-DuralPuncture Headache in the Emergency Department, Mark Kostic, MD, Medical College of Wisconsin

16 Hemodynamic Changes As A Diagnostic Tool for Acute Heart Failure, Justin Benoit, Case Western Reserve University School of Medicine

32 Frequency of Transfer to Tertiary Centers in Emergency Department Patients With Intracerebral Hemorrhage: A Population-based Study, Opeolu Adeoye, MD, University of Cincinnati

17 Factors Affecting Dyspnea Reduction in Emergency Department Patients with Acute Heart Failure Syndromes, Peter Pang, MD, Northwestern University Feinberg

33 Seasonal Variation In Occurrence Of Emergency Department Visits For Cerebrovascular Accidents, David Castillo, DO, Morristown Memorial Residency in Emergency Medicine

Neurology (12:30 – 2:00 pm) 18 Midazolam Versus Diazepam For The Treatment Of Status Epilepticus: A Meta-Analysis, Jason McMullan, MD, University of Cincinnati

34 The Association Between Emergency Department Crowding And Time To Head CT In Patients with Stroke Symptoms, Pia Chatterjee, MD, University of Pennsylvania

19 Stroke Mimickers In The Overdiagnosis Of Acute Stroke And Transient Ischemic Attack By Emergency Physicians, Calvin Huang, MD, Harvard Affiliated Emergency Medicine Residency

35 Predictors of Poor Functional Outcome after Intracerebral Hemorrhage, Adetolu Odufuye, Mayo Medical School

20 The Relative Efficacy Of Phenothiazines For The Treatment Of Acute Migraine: A Meta-analysis, Tracy Walcynski, MD, Joseph Epstein Centre for EM Research

36 Elevated Blood Glucose as a Predictor of 7-day Mortality in Intracerebral Hemorrhage, Adetolu Odufuye, Mayo Medical School

21 Symptoms Of Ischemic Stroke At Presentation To An ED Are Dependent On Sex And Race, William Knight, MD, University of Cincinnati

37 Incidence Of Abnormal Coagulation Parameters In Patients Without Prior Anticoagulation Presenting With Acute Ischemic Stroke, Luis A. Serrano, MD, Mayo Clinic

22 Drive Time Analysis of North Carolina Stroke Deaths to Joint Commission Certified Primary Stroke Centers: Has Access Improved in 2 Years? Andrew Asimos, MD, Carolinas Medical Center

38 Does the Use of Tissue Plasminogen Activator Decrease the Incidence of Dysphagia in ED Patients Presenting with Acute Ischemic Stroke?, Jon Schrock, MD, MetroHealth Medical Center

23 Randomized Controlled Trial for Prevention of Early Recurrent Seizures in the ED, Brittany Copeland, BS, Emory University School of Medicine

Diagnostic Technology/Radiology 39 Discrepancy Between Emergency Physicians And Radiologists in the Radiographic Diagnosis of Pneumonia, Erica Coffin, Tufts University

40 Contrast Induced Nephropathy in the Emergency Department setting: incidence, risk factors and outcomes, Alice Mitchell, MD, Carolinas Medical Center

Research Methods (2:00 – 3:00 pm) 24 Classification and regression tree (CART) analysis: a novel method to derive and validate a pretest probability prediction rule for pulmonary embolism, D. Mark Courtney, MD, Northwestern University 25 Characterizing the Statistical Properties of the Sliding Dichotomy, Robert Silbergleit, MD, University of Michigan

41 Comparison of Advanced Imaging Use in Adult and Pediatric Patients with Appendicitis, Juliana Capatosto, MD, New York Methodist Hospital

26 Nonlinear statistical analysis of bactericidal activity of serum from septic patients using delay differential equations, John Younger, MD, University of Michigan

42 Does A Sample For Peripheral Serum Lactate Need To Be Taken Without A Tourniquet?, Joel Turner, MD, McGill University

27 The efficiency of clinical study assistants in screening for research subjects is affected by patient volume and research activity, Gregory J Fermann, MD, University of Cincinnati

43 Sonographic measurements of IVC correlate with fluid status regardless of blood pressure, Michelle Mendoza, MD, University of Massachusetts

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Thursday, May 14, 2009

44 Abolition of Rectal Temperatures in an Adult ED: Does it Decrease the Recognition of Fever?, Paul Foster, DO, Beth Israel Medical Center 45 Emergency Provider’s Ability to Stratify Risk of Renal Calculi Prior to CT scan Confirmation, Jamine Pierre, MD, New York Hospital Queens 46 Withdrawn 47 Interpretation Errors of CT Scans by Radiology Trainees and Their Clinical Consequences: A Systematic Review, Julien Payrastre, MD, McMaster University 48 The Anion Gap In Patients With Diabetic Ketoacidosis: iSTAT Versus Basic Metabolic Panel, Brian Hohertz, MD, University of Arkansas for Medical Sciences 49 Utility of the Cardiac Component of the FAST Examination in Blunt Trauma, Greg Press, MD, UT Houston 50 Prospective Study of the Use of 2D Uniplanar versus 3D US for Emergency Cardiac Ultrasound, Anthony Weekes, MD, Carolinas Medical Center 51 Emergency Physicians Accurately Identify Regional Wall Motion Abnormalities On Echocardiography, Jennifer Daugharthy, MD, Orlando Regional Medical Center 52 A Prospective Evaluation of Emergency Department Bedside Ultrasound For The Detection Of Cholelithiasis and Acute Cholecystitis, Shane Summers, MD, UCI Medical Center 53 Assessment of echocardiography image acquisition and image interpretation skills in emergency medicine residents, Kimberly Heller, MD, Hennepin County Medical Center 54 Ultrasound Guidance Reduces Adverse Events During Femoral Vein Central Venous Cannulation, Brian Levine, MD, Christiana Care Health System 55 Ultrasound-Guided Peripheral IV Access: Patient Characteristics, Patient Satisfaction, and Admission Rate, Amie Woods, MD, George Washington University Hospital 56 Determining A Reference Standard For Sonographic Measurement Of The Inferior Vena Cava And The Inferior Vena Cava/Aorta Index In Euvolemic Emergency Department Patients, Joseph Novik, MD, Jacobi Medical Center 57 The utility of quantitative beta-hCG to predict patients with ectopic pregnancy after indeterminate bedside pelvic ultrasound in the emergency department, Elizabeth Kwan, MD, University of California, San Francisco 58 Prospective Evaluation of Respirophasic Inferior Vena Cava Variation in the Assessment of Acute Dyspnea, Joseph Miller, MD, Henry Ford Hospital

tion and Practice, Benjamin Goodgame, MD, Christiana Care Health System 62 A Financial Incentive Program Increases Emergency Medicine Faculty Performance of Bedside Ultrasound, Rajesh Geria, MD, Robert Wood Johnson Medical School - UMDNJ 63 Using a novel picture-in-picture video technique to improve the interpretation of bedside ultrasound images performed in the Emergency Department, Ryan Randles, MD, UT Southwestern Medical Center 64 Needle Tip Visualization In Successful Ultrasound-Guided Internal Jugular Vein Cannulation, James H. Moak, MD, University of Cincinnati 65 Patient Positioning And Inferior Vena Caval Indices, Michelle Rockwell, MD, New York Methodist Hospital 66 Incidence of Posterior Vessel Wall Puncture During UltrasoundGuided Catheter Placement, Paradis Uyehara, MD, University of Massachusetts Medical School 67 Expectations And Job Satisfaction Among Current And Former Ultrasound Fellows, James H. Moak, MD, University of Cincinnati 68 A Novel Technique for Ultrasound Guided Supraclavicular Subclavian Venous Cannulation, Michael Mallin, MD, University of Utah 69 The Effect of Hip Abduction and External Rotation on Femoral Vessel Overlap: An Ultrasonographic Study, Francesca Beaudoin, MD, Brown University/Rhode Island Hospital 70 Ultrasound Evaluation of Femoral Vessel Overlap: An Anatomic Study, Francesca Beaudoin, MD, Brown University/ Rhode Island Hospital Airway/Analgesia 71 A Randomized Controlled Trial Comparing A Standardized Titration Protocol Of Hydromorphone Vs. Usual Care In ED Adults With Acute Severe Pain, Andrew Chang, MD, Montefiore Medical Center 72 The Minimum Clinically Significant Difference in Pain in Older ED Patients Decreases Over Time, Polly E. Bijur, PhD, Albert Einstein College of Medicine 73 Sufentanil versus morphine for traumatic severe acute pain in a prehospital setting: A randomized double-blind study, Vincent Bounes, MD, SAMU 31, University Hospital of Toulouse 74 Hot vs. Cold Packs for Back and Neck Strains: A RCT, Breena Taira, MD, Stony Brook University 75 Does non-English speaking status affect opioid administration in the Emergency Department? A retrospective chart review study of nephrolithiasis cases, Nadia Huancahuari, MD, Boston Medical Center

59 Visual Estimation of Inferior Vena Cava Collapse Index Is More Reliable and Accurate than Traditional Measured Values, Jason M. Fields, MD, University of Pennsylvania

76 Does non-English speaking status affect opioid administration in the Emergency Department? A retrospective chart review study of long bone fracture cases, Nadia Huancahuari, MD, Boston Medical Center

60 Implementation of Bedside Transvaginal Ultrasound in an Emergency Medicine Residency Program: Accuracy of Resident Interpretation, Casey Z. MacVane, MD, Maine Medical Center

77 Validation Of The Short-Form McGill Pain Questionnaire In An Emergency Department Setting, Elizabeth Barrall, MD, UMDNJRWJMS at Camden

61 Ultrasound Research Participation Can Alter Physician Percep-

78 A Comparison of the Success Rate and Performance Characteris-

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Thursday, May 14, 2009 ticsof Three Different Versions of the GlideScope Video Laryngoscope in 280 Emergency Department Intubations, Clay Josephy, MD, University of Arizona 79 Comparison of Airway Devices in Standard and Limited Access Intubation Settings, William Hauda, MD, Virginia Commonwealth University 80 Release of Cricoid Pressure Improves Laryngeal View and Success Rates of Intubation, Shawn Radford, MD, Albert Einstein Medical Center Education 81 Medical Knowledge Of Mass Casualty Incident Training Does Not Degrade Using Mixed Simulation Training, Stephanie Stuart, MD, Texas A&M HSC/Scott&White 82 Competency Based Resident Physician Simulation Training on a Central Venous Catheter Partial Task Trainer, Kelly Dodge, MD, Yale University School of Medicine 83 Role of M3 Students in Medical Resuscitation Simulations Does Not Significantly Affect Perceived Effectiveness, Tomer Begaz, MD, Medical College of Wisconsin 84 Emergency Medicine Interns Rate Simulation Sessions as the Most Useful Lecture Type During Orientation Month, Ellie Salinski, MD, Christiana Care Health System 85 Systems Based Practice in an EM Clerkship: Is high-fidelity simulation or self-directed log books a better teaching tool?, Michael Takacs, MD, University of Iowa 86 Perceived Effectiveness of Simulation Compared with Traditional Didactics in an Emergency Medicine Training Program, Thomas P. Noeller, MD, CWRU/MetroHealth 87 Temporary Transvenous Pacing: Simulation Benefits Instruction of Critical but Rare Procedure, Kevin Reed, MD, Georgetown University/ Washington Hospital Center 88 Focused Thoracic Ultrasound Training With Cadaver Simulation: An Assessment Of Emergency Medicine Residents’ Confidence And Comfort Level In Identifying A Pneumothorax, Srikar Adhikari, MD, University of Nebraska Medical Center 89 Pediatric Intern Performance On A Lumbar Puncture Simulator, Carla Pruden, MD, Cincinnati Children’s Hospital Medical Center 90 Drug Information References Used by Emergency Medicine Clinicians to Make Prescribing Decisions in Pregnant Patients, Antonios Likourezos, MA, MPH, Maimonides Medical Center 91 Meeting Accreditation Council for Graduate Medical Education Core Competencies: Development of a Novel Method to Assess Emergency Medicine Residents Systems Based Practice, Ryan Knapp, MD, Hennepin County Medical Center 92 Importance of Spanish Language Skills in Emergency Department Physicians: Survey of Emergency Department Directors in Oregon and Southwestern Washington, Sarah Jump, MD, Oregon Health and Science University 93 Comparison of Peer and Self-assessments for Students in EM Clerkship, Sally Santen, MD, Emory Department of Emergency Medicine 94 Withdrawn

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95 Resident-Performed Central Venous Cannulation: CLEAR Differences of Opinion as to Occurrence of Procedural Supervision, Peter Mariani, MD, SUNY Upstate Medical University 96 Assessing Training And Comfort Level Of Trauma Care Delivery Among Emergency Care Providers At A Major Academic Teaching Hospital In Ghana, West Africa, Nicholas Testa, MD, University of Southern California 97 The Current State of Pediatric Emergency Medicine (PEM) Fellowship Training and Accreditation Council for Graduate Medical Education (ACGME) Requirements, Minal Amin, MD, Inova Fairfax Hospital 98 Emergency Medicine Interns Rate Lectures Given by Physicians Higher than Lectures Given by Non-Physicians During Orientation Month, Ellie Salinski, MD, Christiana Care Health System 99 The Effect of the Addition of a PGY-1 Anesthesia Rotation on the Endotracheal Intubation Success in the ED During PGY-2, Ted Clark, MD, Indiana University Dept of Emergency Medicine 100 Outcome Measurements for Emergency Medicine Residency Graduates: Correlations of Resident Productivity with National ABEM Scores, Tom Trent, DO, University of Illinois College Medicne at Peoria 101 Assessing Residency Review Committee (RRC) Compliance with an Electronic Survey, Jody Vogel, MD, Denver Health Medical Center 102 Rashes in the Emergency Department: Descriptive Abilities of Emergency Physicians, Kris Whapshare, MD, Resurrection Medical Center 103 Intern Perceptions of Bedside Teaching in the Emergency Department, Craig Schranz, MD, Naval Medical Center San Diego 104 Does the Standard Letter of Recommendation (SLOR) Help Predict Emergency Medicine Intern Performance? Richard D. Shih, MD, Morristown Memorial Hospital 105 Are Good Teachers Always Good Teachers? Sara M. Medendorp, MD, Denver Health Medical Center 106 Evaluating Emergency Medicine Faculty at End-of-Shift, Regina Kovach, MD, Southern Illinois University 107 Etiology and Disposition of Pediatric Consultations Requested

By General Emergency Medicine Physicians, Jeffrey Meyers, MD, Penn State Milton S. Hershey Medical Center 108 Effect of an Integrated Public Health Curriculum in an Emergency Medicine Residency, Marian Betz, MD, Beth Israel Deaconess Medical Center 109 Indian and U.S. Paramedic Students: Comparison of Exam Performance for AHA ACLS Training, Tress Goodwin, MD, Stanford University and Georgetown University 110 Educational Orphans: A Survey of EM Residency Directors on Didactics for Rotating Residents in the ED, Jeremy Branzetti, MD, Northwestern Feinberg 111 Experience And Comfort In Pediatric Emergencies: A Comparison Of Pediatric And Emergency Medicine Residents, Christopher Strother, MD, Mount Sinai

Thursday, May 14, 2009 112 Resident Performance on a July PGY1 Objective Structured Clinical Examination (OSCE) is Predictive of Future Clinical Performance in Postgraduate Training Using the Accreditation Council for Graduate Medical Education (ACGME) Core Competencies, Joshua Wallenstein, MD, Emory University

130 BLINK: Faculty First-Impressions Of Emergency Medicine Residency Applicants Are Not Accurate, David Slattery, MD, University of Nevada School of Medicine

113 Conference Attendance Predicts Clinical Performance for First Year Emergency Medicine Residents, Michael Breyer, MD, Christiana Care Health System

132 The Impact of Attending Physician Schedule on Emergency Physician Burnout, Stress and Job Satisfaction, Megan L Fix, MD, Maine Medical Center

114 Is the Number of Critical Care Medicine Fellowships (CCMFs) Open to Emergency Physicians (EPs) Increasing? Tobias Kummer, MD, Warren Alpert Medical School of Brown University

133 Focused Board Intervention (FBI): Just The Facts, Annette Visconti, MD, New York Methodist Hospital

115 Using Learning Curves to Assess Deliberate Practice of Radiograph Interpretation, Martin Pusic, MD, Columbia University 117 Resident Evaluation - Subjective versus Objective Measures, Daniel Brennan, MD, Orlando Health 118 The Effect of Emergency Department Volume on Resident Workflow and Attending-Resident Teaching Interactions, Sean Geary, MD, Albany Medical Center 119 Resident Education in Emergency Medical Services: Retention of Core Concepts Over Time, Matthew Bitner, MD, Emory University School of Medicine 120 A Mnemonic to Improve Knowledge of the Ottawa Ankle and Foot Rule; a Randomized Controlled Trial, Jocelyn Gravel, MD, CHU Sainte Justine 121 Palliative Care Consultation Initiated in ED is Associated with Significant Reductions in Hospital Length of Stay, Robert Zalenski, MD, Wayne State University 122 Patient Preferences of Emergency Department Physician Attire, Emily Hirsh, MD, Emory University 123 A Comparison Of Medical Student Satisfaction Between An Emergency Medicine Teaching Rotation And A Traditional Emergency Medicine Rotation, Jessica Brooks, MD, Denver Health Medical Center 124 Medical Student Career Choices and Attitudes Toward Emergency Medicine After A Required Emergency Medicine Rotation, Todd Guth, MD, Denver Health Hospital 125 Class Ranking Systems Reported on the Medical Student Performance Evaluations Are Inconsistent or Unavailable, Michael Breyer, MD, Christiana Care Health System 126 Emergency Medicine Residents Cannot Predict Their Scores During a Mock Oral Boards Session with Their Own Faculty Members, Susan Thompson, DO, Christiana Care Health System 127 Resident Perceptions of Palliative Care Training in the Emergency Department, Nicholas Meo, Mount Sinai School of Medicine 128 Adaptation of the Education in Palliative and End-of-Life Care in Emergency Medicine (EPEC™EM) Curriculum in a Residency Program Using Synchronous and Asynchronous Teaching Methodology, Michael Gisondi, MD, Northwestern University 129 The Relationship of National In-Training Exam Scores, Faculty Evaluations and Level of Training of Emergency Medicine Residents, James Ryan, MD, New York Hospital Queens

131 Withdrawn

134 Resident Self-Assessment of Resuscitation Skills Based on Simulated Patient Encounter is Limited, Nathaniel Schlicher, MD, Wright State University 135 What Do You Want To Learn Right Now? Mini-Interviews Of Medical Students On Pediatric Emergency Dept Rotation, Martin Pusic, MD, Columbia University 136 Comparing Resident And Faculty Perceptions Of The Impact Of ED Crowding On Education, Melissa White, MD, Emory University, Department of Emergency Medicine 137 Does Curriculum Change to Address Performance Gaps Improve Emergency Medicine Residents Performance of Communication Skills?, Christine Sullivan, MD, FACEP, Residency Program Director, University of Missouri-Kansas City School of Medicine/ Truman Medical Center 138 The Use And Retention Of SBAR By Emergency Medicine Residents Learning Case Presentation Skills, Matthew Tews, DO, Medical College of Wisconsin 139 New Attendings have Significantly Greater Variance In Hospital Admission Rates Than Experienced Practitioners, John Mottley, MD, Beth Israel Deaconess Medical Center 140 Do Medical Students Benefit From Ultrasound When Learning Peripheral IV Techniques? Scott Osborn, MD, Georgetown Univ.

Hosp./Washington Hosp. Cntr.

141 The Learning Curve and Proficiency Attainment of Pre-clinical Medical Students in FAST Ultrasound Examination: A Prospective Study, Hamid Shokoohi, MD, George Washington University 142 Classification of Education Articles Published in Emergency Medicine Journals, Stacy A Shundry, MD, Summa Health System 143 Reliability Of An In-house Mock In-training Exam, Michael Cabezon, MD, New York Methodist Hospital 144 Evaluating Efficacy of Simulators and Multimedia Teaching Modalities in an International Setting, B. Elizabeth Delasobera, MD, Stanford University and Georgetown University 145 Does Clinical Productivity Affect Assessment of Teaching Effectiveness, Jeff Druck, MD, University of Colorado Denver 146 Emergency Medicine Residents And The Neurological Examination, John Sarko, MD, Maricopa Medical Center 147 Additional Resident Coverage Does Not Impact Emergency Department Attending Productivity, Stephanie Wong, Cedars-Sinai Medical Center

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Thursday, May 14, 2009 148 Residency Education In Fishhook Removal Techniques, Eric Yun, MD, New York Hospital Queens 149 A Prospective Randomized Comparison Of Teaching Techniques For Electrocardiogram Interpretation, Christopher J. Wolcott, MD, LSUHSC Shreveport, LA 150 Do Direct Observation Core-Competency Evaluations of EM Residents Provide Redundant Data Over That Provided by Quarterly Summarative Evaluations? James Ryan, MD, New York Hospital Queens 151 Emergency Medicine Grade, Standardized Letter of Recommendation and Medical School Class Rank Correlate Positively with Placement of an Interviewee on an Emergency Medicine Residency Rank Order List, Michael Breyer, MD,Christiana Care Health System 152 Relative Value Units? RVU Ready? Preparing Emergency Medicine Resident Physicians in Documentation for a Pay for Performance Work Environment., Brian Dawson, MD, East Carolina University 153 The RVU Procedure Poster - Improved Billing and Documentation of Procedures Following the Creation of a Procedure Poster, Brian Dawson, MD, East Carolina University 154 Comparison Of Standardized Patient Versus Faculty Evaluations Of Resident Communication, Torrey Laack, MD, Mayo Clinic Rochester 155 Utility of the Standardized Letter of Recommendation (SLOR) to Predict Matching in an Emergency Medicine Residency, Josef Thundiyil, MD, Orlando Regional Medical Center 156 The Use Of Social Networking Websites And Internet Search Engines In The Residency Applicant Screening Process, Heidi Walz, MD, Hennepin County Medical Center 157 Factors Associated with Research Productivity in Emergency Medicine Residencies, Jonathan Walker, DO, York Hospital Emergency Medicine Residency 158 National Study of Attrition among Physicians with Formal Training or Board Certification in Emergency Medicine, Adit Ginde, MD, University of Colorado Denver School of Medicine MODERATED POSTERS (3:30 – 4:30 pm) Synscope 159 Outcomes of Near Syncope Parallel Syncope Patients in the Emergency Department, Shamai Grossman, MD, Harvard Medical School, Beth Israel Deaconess 160 Refining the Definition of Abnormal Electrocardiogram to Better Predict Short-Term Cardiac Outcomes in Adult Syncope Patients, Venkatesh Thiruganasambandamoorthy, MD, Department of Emergency Medicine, Univ. of Ottawa 161 Knowledge Translation of the American College of Emergency Physicians Clinical Policy on Syncope Using a Computerized Clinical Decision Support System,Edward R. Melnick, MD, North Shore University Hospital 162 Predictors of Cardiac Outcomes in Patients with Syncope, Gelareh Gabayan, MD,West Los Angeles Veterans Affairs Medical Center

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163 Predictors of 30-Day Delayed Cardiac Events in Geriatric Syncope, Benjamin Sun, MD, UCLA/ WLA VA Medical Center 164 Cardiac Evaluation for Structural Abnormalities May Not Be Required in Patients Presenting with Syncope and a Normal Electrocardiogram, Kenton Anderson, MD, Duke University School of Medicine Infectious Disease 165 Does Time to Antibiotics Effect In Hospital Mortality and ICU Length of Stay in Patients With Bacteremia, Maureen Chase, MD, Beth Israel Deaconess Medical Center 166 Bloodstream Infections Associated with Central Venous Catheters Placed in the Emergency Department, Christopher H. LeMaster, MD, Brigham and Women’s Hospital 167 Longitudinal MRSA Colonization Rates in Residents, Jennifer Carnell, MD, Alameda County Medical Center, Highland Hospital 168 How Common Is MRSA In Adult Septic Arthritis?, Chris Fee, MD, University of California San Francisco 169 Rapid Detection Of Bacterial Meningitis Using A Broad Based PCR Assay, Helen Won, Johns Hopkins University 170 A Pilot Study to Evaluate Influenza Viral Loads in the Emergency Department for the Prediction of Inpatient Length of Stay, Kuan-Fu Chen, MD, Johns Hopkins University

Friday, May 15, 2009

Bottlenecks in Patient Throughput: Applying Queuing Theory to Identify and Manage ED Patient Flow (9:30 am - 10:30 am) Jedd Roe, MD, William Beaumont Hospital Jeff Desmond, MD, University of Michigan

How many nurses do I need at triage during a particular time of day?

Defined leadership positions in academic medicine are often achieved later in a physician’s career. If effective future leaders are to be cultivated, leadership development and training must start before a position is sought or achieved. This session will demonstrate how junior faculty, fellows and residents can “lead from within” their departments by developing skills and approaches that enhance their influence and benefit their organization. The session will review the literature on leadership development and present examples of “common sense” early career leadership challenges and opportunities. We will highlight some challenging situations and provide proven leadership solutions addressing the following areas:

How many CT scanners are needed for my ED’s patient volume?

Finding strength zones and identifying your niche

How many beds do I need in the new ED my hospital is building?

Clinical performance leadership

Can I justify adding more physician coverage to my ED?

Overcoming obstacles and the “Energy Drain” demanding hours, complex hierarchies, conformation to systems and protocols

Queuing theory is a set of mathematical tools that allows operations managers to find solutions to problems in matching fixed resources to random demand environments. Bottlenecks of patient flow in the ED are often due to similar random demands, and queuing theory allows analysis that can provide solutions to common questions such as:

At the conclusion of this session participants should be able to: 1 Identify the basics of Queuing Theory and its applications. 2 identify natural vs. artificial variability in patient flow and which queuing models can be applied to common issues faced when managing ED operations. 3 through the use of actual ED case studies, recognize how queuing theory was applied and how these methods may be applied to similar issues in the learner’s ED

Committee involvement – effective participation in meetings – agendas, time management Taking on new tasks Influence and recognition

Novel Approaches to TIA Management in the ED (9:30 am - 11:00 am) Josh Goldstein, MD, PhD, Harvard Medical School Jonathan Edlow, MD, Beth Israel Deaconess Medical Center Michael Ross, MD, Emory University Christopher Lewandowski, MD, Henry Ford Hospital

Communication challenges and their impact – verbal, email, phone, written

Transient neurological events are relatively common complaints in the emergency department, and many of these represent transient ischemic attacks (TIAs). However, there is substantial controversy regarding the necessary workup, and what components of this workup should occur in the ED. The resources available to perform comprehensive workups in the emergency setting vary by community and by hospital, and rapid outpatient followup is not always available. As a result, there is substantial variation in practice.

Drs. Zink and Blomkalns will draw upon their knowledge of and familiarity with several EM leaders – Drs. Deb Diercks, Brian Gibler, Kate Heilpern, Cherri Hobgood, Jim Hoekstra, Art Pancioli, and Charlie Pollack. These individuals (in addition to speakers) will serve to facilitate roundtable discussions for the second portion of the program.

During the initial lecture period, participants may anonymously submit questions via a pre-printed card distributed upon entry to the session. The discussion leaders will use these as starting points for their groups.

Surviving setbacks and fostering improvement Maximizing effectiveness

This session will highlight recent and ongoing studies aimed at improving TIA workup and management in the ED. First, risk stratification schemes that are in various stages of development will be discussed; such schemes can help the emergency physician select which patients are highest risk of stroke in the near term. Second, the indications for and added value of imaging studies such as CT, CT angiography, MRI, MR angiography, carotid doppler studies, and echocardiography will be discussed. Third, current and potentially expanding use of the ED observation unit for TIA management will be explored. Finally, an open-ended panel discussion between speakers and the audience will address current controversies and future areas of research.

At the conclusion of this session participants should be able to: 1.

Possess practical tools of leadership which they can start exercising immediately.

The Future of Scientific Publication in Emergency Medicine (11:00 am - 12:00 pm) David Cone, MD, Yale University School of Medicine James Miner, MD, Hennepin County Medical Center The world of scientific publishing is changing rapidly, primarily due to two driving forces: electronic publishing, and open-access requirements. This session will describe how the medical publishing industry generally, and Academic Emergency Medicine specifically, is evolving and adapting to these and other changes to benefit authors and readers. Dr. Cone, AEM editor-in-chief, will discuss how AEM will evolve in the short- and medium-term to take advantage of these changes, focusing on general industry trends and open-access systems, including AEM’s new “rolling open access” program.

He will also discuss how the journal’s evolution will help broaden its reach internationally. Dr. Miner, who is serving as the journal’s first Senior Associate Editor for Electronic Publishing, will discuss recent advances in the technologies and implementation of electronic medical journalism, and will introduce Academic Emergency Medicine’s plans for electronic platforms. Discussion will include the use of wiki pages, video, and interactive media. Both speakers will discuss how the academic community rewards, or fails to reward, authors who take advantage of these new developments and publication models, and how emergency medicine as an academic specialty can work to advance these issues. There will be a question and answer session

At the conclusion of this session, participants should be able to: 1. Identify current risk stratification schemes for determining which patients with TIA are at highest risk of stroke. 2. Recognize the indications for and appropriate use of different imaging modalities following TIA. 3. Identify the risks and benefits of ED observation unit admission for patients with TIA. Leadership From Within – Enhancing Your Natural Ability (10:30 am - 12:00 pm) Brian Zink, MD, Brown University Andra Blomkalns, MD, University of Cincinnati Deborah Diercks, MD, University of California-Davis W. Brian Gibler, MD, University of Cincinnati Arthur Pancioli, MD, University of Cincinnati Katherine Heilpern, MD, Emory University Cherri Hobgood, MD, University of North Carolina James Hoekstra, MD, Wake Forest University

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Friday, May 15, 2009 discussing the future of scientific publishing.

Help

At the conclusion of the session, participants should be able to: 1.

Be familiar with current and future advances in scientific publishing in general and at Academic Emergency Medicine. 2. Recognize the electronic publication options that can be used to enhance the value of a manuscript or educational offering. 3. Identify the issues that need to be addressed both locally (at home institutions) and specialty-wide regarding the academic value of non-traditional publication venues and methods.

Promoting Faculty Development in the Non-University Setting Picking a Winner: How Department Chairs Select New Faculty Following the presentation of mini-lectures on these topics the panel, along with the audience, will discuss questions presented by the moderator that are derived from the survey results. This session is intended to serve as a stimulus for ongoing dialogue in this important area of academic life in our specialty.

Using HCUP Databases for Emergency Medicine Research: Introduction to the Nationwide Emergency Department Sample (NEDS).

(1:00 pm - 4:00 pm) Ryan Mutter, PhD, Agency for Healthcare Research and Quality Teresa Gibson, PhD, Thomson Reuters

At the conclusion of the session, participants should be able to: 1. Identify the factors related to successful faculty development including techniques and strategies they may employ to actively for their own faculty development. 2. They will recognize the unique aspects of academic emergency medicine in the non-university setting, strategies and methods to achieve and maintain a successfully academic program in this setting including faculty development in such. 3. They will recognize what characteristics and factors a chair find predictive of academic success and the manner and insight with which a chair selects academic faculty. 4. They will have some insight on unique issues relevant to faculty development of women in emergency medicine.

This workshop will provide in-depth exposure to several Healthcare Cost and Utilization Project (HCUP) resources, with a specific focus on the HCUP Emergency Department Databases. HCUP is a family of health care databases, software tools, research publications, and support services created through a Federal-State-Industry partnership and sponsored by the U.S. Department of Health and Human Services (DHHS), Agency for Healthcare Research and Quality (AHRQ). HCUP has the largest collection of publicly available, multi-year, all-payer, encounter-level health care data. Current databases include a mix of national and statewide inpatient, ambulatory surgery, and emergency department data. In early 2009, AHRQ released a national emergency department database, the Nationwide Emergency Department Sample (NEDS), that enables national and regional research on an array of emergency medicine topics.

Developing a Research Agenda on ED Crowding and Geriatric Patient Care (3:00 pm - 4:30 pm) Ula Hwang, MD, Mount Sinai School of Medicine Scott Lynch, PhD, Princeton University Michael Schull, MD, Institute for Clinical Evaluative Sciences Douglas Miller, MD, Indiana University It is projected that the aging of the US population will significantly increase ED visit rates by older adults, almost doubling by 2013 (Hampton, T. JAMA. 2008.,Roberts, et.al. Ann Emerg Med, in press).

While the effects on ED and hospital crowding have been described as potentially “catastrophic,” there remains little to no research demonstrating this nor how ED crowding itself may affect patient care delivery and outcomes for these patients and the general population.

This course is suited for emergency medicine researchers, clinicians, and students. The main objective of this course is to convey how administrative emergency department data can be used to enhance the quality and meaningfulness of clinical and health services research.

Faculty will discuss attendee research ideas and how they could be investigated using HCUP products.

At the conclusion of this session, participants should be able to: 1.

How HCUP resources, specifically the Nationwide Emergency Department Sample (NEDS) database, can be used to enhance the quality of clinical and health services research. 2. How to access HCUP data via HCUPnet – a free on-line data query system – as well as through the HCUP Central Distributor. 3. How to maximize the value of the HCUP databases by applying free software tools that help categorize, transform, and enhance existing HCUP data files.

A research agenda (tasked by the SAEM Board of Directors) has been developed jointly by the Geriatrics and ED crowding Task Forces to address the effects of ED crowding and geriatric patient care.

An expert panel will discuss the current state of the aging US population and its effects on the healthcare system, geriatric quality of care, and ED crowding. The session will present the size and morbidity of the aging US population and its effects on health system utilization and ED crowding. The relationship of quality of care for older persons and acute care needs will be explored, including the relationship of access to care, continuity of care, advance care planning and geriatric care capabilities to ED and hospital utilization and crowding.

The research agenda will be presented and audience participation will allow for the modification what is proposed. By understanding the mutual effects of ED crowding and geriatric patient care this will promote further investigation in areas where the future practice of emergency medicine is and will be significantly affected by these two areas.

Faculty Development: Facing the Challenges Identified by the 2007 SAEM Faculty Development Survey (3:00 pm - 4:30) Gloria Kuhn, DO, PhD, Wayne State University Glenn Hamilton, MD, Wright State University John Marx, MD, Carolinas Medical Center Kathleen Clem, MD, Loma Linda University Medical Center Robert Hoffman, MD, Beth Israel Medical Center While the ongoing professional development of academic faculty members is ultimately their own individual responsibility, academic departments must create environments which foster that development. The SAEM Faculty Development Committee conducted a survey of EM departmental faculty development programs in Emergency Medicine in 2006. The results of the survey were presented in a didactic session at the 2007 SAEM Annual Meeting and published in a 2008 SAEM Newsletter.

At the conclusion of this session the participant should be able to: 1.

Describe how the aging of the US population will affect the healthcare system, including emergency care. 2. Describe what is known about geriatric quality of care and quality indicators. 3. Describe what is known about the effects of ED crowding on patient care. 4. Identify where gaps in geriatric and ED crowding research currently exist and where further investigation is needed; identify potential sources and opportunities of funding for this research.

In this course, a panel of three academic department chairs recognized for their success in fostering the professional development of their faculty will discuss a number of the specific challenges in faculty development identified in the survey. Panel members will provide their perspectives on the following topics:

PAPER PRESENTATIONS Acute Coronary Syndromes (9:30 – 11:00 am) 171 One Year Outcomes Of Patients Following Coronary Computerized Tomographic Angiography In The Emergency Department, Judd

Taking Charge of Your Academic Career: Faculty Development Self-

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188 Predicting C-Spine Injury (CSI) in Children: a Case-Control Analysis, Julie Leonard, MD, Washington University School of Medicine

172 Clinical Assessment Of Ischemia Modified Albumin And HeartFatty Acid Binding Protein In Early Diagnosis Of Non ST Elevation Acute Coronary Syndrome In Emergency Department, Sandrine Charpentier, MD, Purpan University Hospital

189 Scene Motor component of GCS score predicts mortality in pediatric blunt trauma patients comparably to total GCS, Charlene Irvin, MD, St. John Hosptial and MEdical Center

173 Point-of-Care Measurement of Platelet Reactivity in the Emergency Department May Assist in the Early Risk Assessment of Potential Acute Coronary Syndromes, Chad Darling, MD, University of Massachusetts School of Medicine

190 Performance of the Pediatric Glasgow Coma Scale (GCS) Score in the Evaluation of Children with Blunt Head Trauma (BHT), Dominic Borgialli, DO, Univ of Michigan and Hurley Medical Center

174 What is the optimal approach to select patients with Left Bundle Branch Block and Suspected AMI for fibrinolytic therapy?, Jeffrey Tabas, MD, Department of Emergency Medicine, UCSF Med School

Abdominal Pain Diagnostics (3:00 – 4:30 pm) 191Emergency Department CT Scanning For Acute Appendicitis: IV Contrast Only vs. IV And Oral Contrast, Andrew Kepner, MD, York Hospital

175 90 Minute Rule out for Acute Myocardial Infarction Using a Novel Ultrasensitive Troponin I Assay, Donald Schreiber, MD, Stanford University School of Medicine

192 Abdominal CT Limited to the Region of Tenderness Can Accurately Detect Acute Pathology While Substantially Reducing Radiation Exposure: a Prospective Double-Blinded Study, Joshua Broder, MD, Duke University Medical Center

176 Relationship Between TIMI Risk Score And One Year Outcomes In Emergency Department Patients With Potential Acute Coronary Syndromes, Benjamin Weisenthal, University of Pennsylvania

193 A randomized, blinded, controlled clinical trial of 1000 cc versus 500 cc oral contrast in adults undergoing abdominal CT scans, Fiona Azubiuke, MD, Miami Hospital

Trauma (11:00 am – 12:00 noon) 177 Predicting the Need for a Trauma Surgeon in the Emergency Department: External Validation of a Clinical Decision Rule and Implications for Trauma Triage, Richard Byyny, MD, Denver Health Medical Center

194 Decreasing Radiology Turn-around Times in the ED: Does Limiting OralContrast Make a Difference? Zachary Foy, MD, University of Utah

178 Prospective Study on the Indications for Pelvic Imaging and Performance of Plain Pelvic Radiography in Patients with Blunt Trauma, James Holmes, MD, UC Davis School of Medicine

195 S100A8/A9: A Sensitive Diagnostic Blood Marker for Acute Appendicitis, John Bealer, MD, AspenBio Pharma, Inc. 196 Interdisciplinary Initiative to Reduce Radiation Exposure in Children: Evaluation of Appendicitis Using a Staged US and CT Protocol, Naresh Ramarajan, MD, Stanford University School of Medicine

179 Comparison Of Serum GFAP And S100B In Assessing Severity Of Injury In Patients With Mild And Moderate Traumatic Brain Injury, Linda Papa, MD, Orlando Regional Medical Center

Disparities (3:00 – 4:30 pm)

180 Does Mechanism of Injury Predict Trauma Center Need?, E. Brooke Lerner, PhD, Medical College of Wisconsin

197 Increasing Wait Time to See a Physician Among Children Presenting to US Emergency Departments, 1997-2005, Andrew Herring, MD, Alameda County Medical Center

Pulmonary Embolism (9:30 – 11:00 am) 181 Prospective multi-center assessment of interobserver agreement for radiologist interpretation of 64-channel CT angiography for pulmonary embolism, D. Mark Courtney, MD, Northwestern University

198 Black, Poor, and Old: Risk Factors for Decreased Access to Urban and Rural Trauma Centers? A National Analysis of Trauma Centers in the U.S. from 2001-2005, Renee Hsia, MD, MSc, University of California at San Francisco

182 Frequency of Pulmonary Hypertension Six Months After Submassive Acute Pulmonary Embolism, Jeffrey Kline, MD, Carolinas Medical Center

199 Impact Of Gender On Prehospital Management Of Chest Pain, Zachary Meisel, MD, University of Pennsylvania School of Medicine

183 Influence of Gender on the Clinical Presentation of Venous Thromboembolism (VTE) a Prospective, Multi-center, Observational Study of Emergency Department Patients, Peter Richman, MD, Mayo Clinic Arizona

200 Gender-based Disparities in Emergency Department (ED)Analgesia Administration, Heather Farley, MD, Christiana Care Health System 201 Gender Differences in Clinical Presentation and Outcomes in Emergency Department Patients with Nontraumatic Chest Pain, Erik Hess, MD, Mayo Clinic

184 Which Criteria Should We Use To Stratify Admission Disposition Of Patients With Acute Pulmonary Embolism?, Jeffrey Kline, MD, Carolinas Medical Center

202 Racial Disparity In Analgesic Treatment Of Emergency Department Patients With Back And Abdominal Pain, Angela M. Mills, MD, University of Pennsylvania

185 Factors Associated with Positive D-dimer Results in Patients Evaluated for Pulmonary Embolism - A Prospective Multivariate Analysis, Christopher Kabrhel, MD, Massachusetts General Hospital

POSTER SESSION (1:00 – 3:00 pm)

186 Variation in Therapy and Outcomes in Massive Pulmonary Embolism from the Emergency Medicine Pulmonary Embolism in the Real World Registry (EMPEROR), Brian Lin, MD, Stanford University

Research Methodology 203 Computer Facilitated Medical Record Review for Identifying Low Frequency Emergency Department Interventions, Cory Forbach, Univ. of North Carolina at Chapel Hill School of Medicine

Pediatrics (11:00 am – 12:00 noon) 187 Validation and Properties of the Verbal Numeric Scale in Children with Acute Pain, Benoit Bailey, MD, CHU Sainte-Justine

204 Does Knowledge Of Treatment Group Bias Measurement Of

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Friday, May 15, 2009

Time To Seizure In Animal Studies?, Kennon Heard, MD, Rocky Mountain Poison and Drug Center

ma Health System /NEOUCOMP 223 Deriving a Brief Questionaire to Identify Older Emergency Department Patients with Important Functional Deficits, Scott Wilber, MD, Summa Health System / NEOUCOMP

205 The Presence Of Two Sets Of Troponin Cardiac Biomarkers Within 24 Hours Of Emergency Department Registration Is Highly Sensitive And Specific For Initial Identification Of Rule-Out Acute Coronary Syndrome Patient Cohorts In Clinical Research, Jason Shapiro, MD, Mount Sinai Medical Center and Columbia University

224 Multi-faceted Intervention Increases Testing For Osteoporosis In Patients Treated In Emergency Departments For Wrist Fractures, Tracy Walcynski, MD, Joseph Epstein Centre for EM Research

206 Comparison of Prehospital Retrospective Chart Review to Prospectively Obtained Data, Colleen Buono, MD, UCSD

225 Emergency Department Procedural Sedation of Elderly Patients: Is it safe? Robert Bassett, DO, Indiana University School of Medicine

207 Research Perceptions of Patients in the Emergency Department, Loretta Jackson-Williams, MD, University of Mississippi

226 Screening Older Adults in the ED for Depression and Cognitive Impairment: Stability of Symptoms After Two Weeks, Manish Shah, MD, University of Rochester

208 Parametric vs. Non-parametric Statistical Tests: the Length of Stay Example, Jeremiah Schuur, Partners HealthCare System Geriatrics

227 Prehospital Screening for Late Life Depression and Cognitive Impairment: Are Patients At Risk?, Manish Shah, MD, University of Rochester

209 Emergency Department (ED) Patients 60 Years of Age and Older Report Lower Pain Scores, Heather Farley, MD, Christiana Care Health System

Pediatrics

210 Risk of death in senior patients needing emergent intubation in the ED, Marie Irvin, MD, St. John Hospital and Medical Center

228 Age-related differences in risk factors associated with cervical spine injury (CSI) in children, Julie Leonard, MD, Washington University School of Medicine

211 Validity of the Emergency Severity Index for Identifying Elderly Patients Requiring an Immediate Life Saving Intervention, Timothy PlattsMills, MD, UNC Department of Emergency Medicine

229 Can a Centralized Pediatric Transfer Center Impact Pediatric Emergency Department Physician Workload?, Rebecca Floyed, MD, Emory University

212 Using Chief Complaint to Identify a Subset of Elderly Emergency Department Patients with a Very High Admission Rate, Michael Lamantia, MD, UNC Division of Geriatrics

230 The Role of AbdominalX-rays in the Diagnosis of Intussusception When Interpreted by Pediatric Emergency Physicians, Jessica Morrison, MD, CHU Sainte-Justine

213 Potentially Inappropriate Medication Administration During Emergency Department Visits By Geriatric Patients: 2000-2006, William Meurer, MD, University of Michigan

231 Utility of Prone and Left Lateral Decubitus Abdominal X-rays in Diagnosing Intussusception, Kim Askew, MD, Wake Forest University School of Medicine

214 Characteristics of Frequent Geriatric Users of the Emergency Department, Lucille Torres, Mount Sinai School of Medicine

232 Educational Opportunities in a Pediatric Emergency Department Parental Attitude and Perceptions of CPR, Adam Barouh, MD, St. Christopher’s Hospital for Children

215 A descriptive study of emergency department patients subsequently admitted to palliative care, Jason A. Cohen, BA, Mount Sinai School of Medicine

233 Use of Cervical Spine CT in Pediatric Blunt Trauma Patients, Kathleen Adelgais, MD, University of Utah

216 The Use of a Computerized System to Improve Information Transfer during Patient Transition from a Skilled Nursing Facility to the Emergency Department, Fredric Hustey, MD, Cleveland Clinic

234 Bridging the Gap Between Clinical and Community Research: Fracture Rates in Children and Neighborhood Characteristics, Leticia Ryan, MD, Children’s National Medical Center

217 Computer Simulation Enriched Process Re-engineering in Antibiotic Delivery Cycle Time in Community Hospital Pneumonia in Geriatric Patients (> 65 years of age), James Espinosa, MD, UMDNJ-SOM, Kennedy Health System, Stratford, NJ

235 The Impact Of Hospital Policies And Services On The Diagnosis Of Child Abuse In The Emergency Department, Esther K. Choo, MD, Oregon Health & Science University

218 Do Emergency Department Patients Admitted for Pneumonia Experience a Systematic Delay in Time to Antibiotics if They Have an Active Do-Not Resuscitate Order?, Tony Berger, MD, Jacobi Medical Center

236 Association between risk of upper extremity fracture and weight status among children, Leticia Ryan, MD, Children’s National Medical Center 237 Pediatric Ingestions Admitted to the Observation Unit of a Children’s Hospital, Jennifer Plumb, MD, University of Utah, Dept of Pediatrics, PEM Div

219 A Comparison of Two Brief Screening Tools to Detect Cognitive Dysfunction in Older ED Patients, Christopher Carpenter, MD, Washington University in St. Louis

238 The Influence of Insurance Coverage on the Severity of Injuryrelated Emergency Department Visits in California Children., Anna JC Arroyo, BA, Stanford University School of Medicine

220 Single-Center Validation of Two Prognostic Screening Instruments for Older Emergency Department Patients, Christopher Carpenter, MD, Washington University in St. Louis 221 Use Of A Novel Technology To Detect Mild Cognitive Impairment In Elderly Patients, David Wright, MD, Emory University

239 Learning curve of pediatric emergency physicians performing bedside ultrasound for soft tissue infections, Jennifer Marin, MD, Children’s Hospital of Philadelphia

222 Characteristics of Nursing Home Patients Who Visit the ED: An Analysis of the National Nursing Home Survey, Scott Wilber, MD, Sum-

240 Hand Hygiene Evaluation in the Waiting Room: A Novel Approach to Patient Education, Mary Groll, MD, Northwestern Chil-

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Medical Center

241 Prevalence Of Obesity, Hypertension And Risk For Metabolic Syndrome In A Pediatric Emergency Department Based on Body Mass Index and Waist Circumference, Rossana Baracco, MD, Children’s Hospital of Michigan

260 Validation of the Wong Baker Faces Pain Rating Scale in Pediatric ED Patients, Breena Taira, MD, Stony Brook University 261 Is Physician Adjustment Of The Broselow Tape Measurement An Accurate Estimate of Pediatric Patients Weights?, Marcy Rosenberg, MD, Orlando Health

242 The Relationship Between Fever And Pulse Rate In Children Presenting To The Emergency Department, Daniel Yawman, MD, University of Rochester Medical Center

Cardiovascular

243 Use Only as Directed: A survey of opioid pain medication storage and disposal after pediatric fracture, Amanda Hoehler, MD, University of Utah

262 Evaluation of a Strategy to Reduce Door to ECG Times in Patients Presenting with Chest Pain to the Emergency Department in a Chilean Academic Center., M. Fernanda Bellolio, MD, Mayo Clinic

244 Capnometry as a Predictor of Admissions in Bronchiolitis, Rick Place, MD, Inova Fairfax Hospital

263 Emergency Physician Practice and the Acceptable Error Rate in Discharging Patients with Potential Acute Coronary Syndrome, John Nagurney, MD, Masachusetts General Hospital

245 Immediate Impact of Paper to Paperless Documentation on Productivity of Physicians in a Pediatric Emergency Department, Muhammad Waseem, MD, Lincoln Medical & Mental Health Center

264 Clinical Use Of Coronary CT Angiogram In Emergency Department Chest Pain Patients, Carol Clark, MD, William Beaumont Hospital

246 VeinViewer Assisted Intravenous Catheter Placement in Children in a Pediatric Emergency Department, Laura Chapman, MD, Rhode Island Hospital, Alpert Medical School

265 Why Are Some Emergency Department Patients with Acute Atrial Fibrillation Not Treated with the Ottawa Aggressive Protocol for Rapid Rhythm Control? Catherine Clement, RN, Department of Emergency Medicine, Univ. of Ottawa

247 Outcomes Of Children With Intraventricular Hemorrhage (IVH) On CT Scans After Blunt Head Trauma (BHT), Richard Lichenstein, MD, University of Maryland School of Medicine

266 A Pilot Study Evaluating the use of Ultrafiltration in Emergency Department Observation Unit Patients Presenting with Acute Heart Failure, Jon Schrock, MD, MetroHealth Medical Center

248 Withdrawn 249 Surgical Consultation for Laceration Repair in a Recently Established Pediatric Emergency Department in The Country of Georgia:Do initial Education Efforts By US Collaborators Lead to Sustainable Process Improvements?, David Goo, MD, Emory University

267 Cost Effectiveness of Stress MRI for Evaluation of Chest Pain Patients in the Emergency Department Observation Unit, Pawan Suri, MD, VCU Health Systems 268 How Accurate are Emergency Physicians in Predicting the Development of an Adverse Cardiac Event within 30 days?, Erik Hess, MD, Mayo Clinic

250 Viral RNA from nasal washings diluted in universal transport medium -room temperature declines slowly over time., Ty Tran, MD, Kern Medical Center, Bakersfield, CA

269 Is there disparity in Emergency Department STEMI patients needing urgent PTCA, Charlene Irvin, MD, St. John Hosptial and Medical Center

251 Performance of a Rapid Respiratory Syncytial Virus Test in the Emergency Department., Michael Neidens, MD, Kern Medical Center, Bakersfield, California

270 Hypertensive Acute Heart Failure, Frank Peacock, MD, The Cleveland Clinic

252 Withdrawn 253 Ondansetron Use in a Pediatric Emergency Department: Are We Masking Serious Illness?, Adam Schweickert, MD, Emory University Department of Pediatrics

271 Eating High Salt Foods Does Not Increase the Short Term Risk of Presenting to the Emergency Department with Acute Decompensated Heart Failure, Jesse Borke, MD, New York Presbyterian Hospital

254 Inter-observer agreement for clinical findings in children at risk of cervical spine injury, Julie Leonard, MD, MPH, Washington University School of Medicine

272 Comparison Of Three Aspirin Formulations, Sean Nordt, MD, University of California, San Diego

255 Trends in Hospital Utilization for US Children with Respiratory Conditions, 1993-2006., Michelle Macy, MD, University of Michigan

273 Prolonged QTc as a predictor of myocardial infarction and death within a year of Transient Ischemic Attack., Neeraja Yerragondu, MD, Mayo Clinic

256 Vitamin D Insufficiency and Bone Mineral Density in African American Children with Forearm Fractures, Leticia Ryan, MD, Children’s National Medical Center

274 Efficacy and Safety of Electrical Cardioversion of Atrial Fibrillation Following Treatment With Vernakalant Hydrochloride Injection, Scott Harris, MD, Thoracic and Cardiovascular Institute.

257 Topical Anesthetic Creams Promote Spontaneous Skin Abscess Drainage And Decreases Procedural Sedation Rates In Pediatric Emergency Department Patients, Tara Cassidy-Smith, MD, UMDNJRWJMS at Camden

275 Efficacy Of Non-nursing Triage Personnel In the Evaluation Of Acute ST Elevation MI: A Retrospective Review, James Ziadeh, MD, William Beaumont Hospital

258 Sexually Transmitted Diseases in the Emergency Department: Incidence and Trends of Pediatric Data from the NHAMCS, Joseph Konwinski, SUNY Upstate Medical University

276 Detectable Troponin Levels In Low Risk Chronic Kidney Disease Patients Increase Risk For Acute Coronary Syndrome, Alexander Limkakeng, MD, Duke University

259 Single Breath Counting For Evaluation Of Pediatric Asthma: Development Of A Normogram, Uroos Raza, MD, Penn State Hershey

277 The Decline of Emergency Department Intubation Rates for Congestive Heart Failure from 1996 to 2008, Bonnie McGuire Wresch-

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Friday, May 15, 2009 ner, MD, Morristown Memorial Hospital

297 Could Cell Phone Images’ Of Electrocardiograms Be Used To Activate The Cardiac Catheterization Lab?, Marcy Rosenberg, MD, Orlando Health

278 Hyperglycemia On Admission In An Emergency Department As A Predictive Factor For Diagnosis Of Non- ST Elevation Acute Coronary Syndrome, Sandrine Charpentier, MD, Purpan University Hospital

298 Withdrawn

279 Helicopter Transferred ST-Segment Elevation Myocardial Infarction Patients Exceed 90-Minute Medical Contact To Balloon Times and Few Receive Fibrinolytics, Todd Davis, MD, University of Cincinnati

299 Induction of Endothelial Inflammation By The Sphingosine-1-phosphate Receptor-2, Teresa Sanchez, PhD, Beth Israel Deaconess Medical Center

280 Relationship Between Information Available In The ED Regarding Prior Cardiac Catheterization Results And Actual Prior Cardiac Catheterization Results, Kate Lyren-Sondles, MD, University of Pennsylvania

Pulmonary Embolism 300 Prospective Audit Of Real-Time Use Of The Pulmonary Embolism Rule-Out Criteria: Need For More Complete Documentation, Courtney Peterson, Carolinas Medical Center

281 Association Between Emergency Department Triage and Outcomes for Acute Myocardial Infarction Patients, Michael J Schull, MD, Institute for Clinical Evaluative Sciences

301 Heme Oxygenase Activity Is Increased In Rat Liver After Experimental Pulmonary Embolism, Michael Marchick, MD, Carolinas Medical Center

282 The Value of T-wave Inversion In the Diagnosis of An Acute Coronary Syndrome, Deborah Diercks, MD, University of California, Davis Medical Center

302 Diagnostic Utility of MMP9 and MPO in Predicting Severe Outcomes from DVT, Maria Glenn, MD, Carolinas Medical Center

283 Relationship Between Timeliness of Clopidogrel Administration and Patient Outcomes in Acute Myocardial Infarction, Chi Chun-Lin, MD, Taoyuan General Hospital, Taiwan

303 Empiric Systemic Anticoagulation In Patients With Suspected Pulmonary Embolism, Michael Marchick, MD, Carolinas Medical Center

284 Discordance between knowledge and self-care in underserved heart failure population in an inner-city emergency department setting, Douglas S. Ander, MD, Emory University

304 Simultaneous T-wave Inversions in the Anteroseptal and Inferior Leads: A Sign of Pulmonary Embolism, Michael Witting, MD, University of Maryland

285 The Association Between Frontal Plane QRS/T Angle and Shortterm Adverse Events in ED Patients with Chest Pain, John McMullan, MD, Wake Forest University School of Medicine

305 12-Lead Electrocardiogram Findings of Pulmonary Hypertension Occur More Frequently in Emergency Department Patients With Pulmonary Embolism Than In Patients Without Pulmonary Embolism, Michael Marchick, MD, Carolinas Medical Center

286 Prevalence and predictors of preclinical cardiac dysfunction in asymptomatic hypertensive patients in an urban emergency department, Phillip Levy, MD, MPH, Wayne State University

306 Magnitude of D-Dimer Matters for Diagnosing Pulmonary Embolus, Kaushal Shah, MD, St.Luke’s-Roosevelt Hospital

287 New Left Bundle Branch Block in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention., Christopher Solie, MD, Minneapolis Heart Institute Foundation

307 High Frequency Of Repeated Negative Computerized Tomographic Pulmonary Angiography In Emergency Department Patients, Maria Glenn, MD, Carolinas Medical Center

288 Value of High Sensitivity C-Reactive Protein In Low Risk Chest Pain Observation Unit Patients, Deborah Diercks, MD, University of California, Davis Medical Center

308 Right Ventricular Strain on Focused Emergency Physician Echocardiography Predicts Pulmonary Embolism, Eric Goralnick, MD, Yale University

289 The Effect of a Rapid Cardiac Disposition Protocol on Resource Utilization, Jason Puthottile, MD, New York Methodist Hospital

309 Pulmonary infiltrates revealed on CT in patients with negative evaluation for pulmonary embolism, Wesley Self, MD, Northwestern University

290 Function of Electron Transport Chainof Nodose Ganglia Is Impaired in Heart Failure, Paul Tran, MD, University of Nebraska Medical Center

310 Thrombolytic Therapy in Acute PE from the Emergency Medicine Pulmonary Embolism in the Real World Registry (EMPEROR), Beau Alan Briese, Stanford University School of Medicine

291 A novel approach to normalize the blunted baroreflex in diabetes, Paul Tran, MD, University of Nebraska Medical Center

311 Testing Low-Risk Patients For Suspected Pulmonary Embolism: A Decision Analysis, Adam Lessler, University of Pennsylvania

292 Does the Early Administration of Beta-blockers Improve the Outcome of Patients with Acute Coronary Syndrome?, Ethan Brandler, MD, SUNY-Downstate Medical Center

312 Infrequent Use Of Empiric Anticoagulation For Severe Acute Pulmonary Embolism, Jeffrey Kline, MD, Carolinas Medical Center

293 Cost-Effectiveness of Telemetry for Hospitalized Patients with Low-Risk Chest Pain, Michael J. Ward, MD, University of Cincinnati

313 History Of Anxiety Significantly Decreases The Probability Of Pulmonary Embolism In Symptomatic Emergency Department Patients, Jeffrey Kline, MD, Carolinas Medical Center

294 Getting it Right: A Comparison of Diagnostic Standards in Acute Heart Failure, Karen Miller, RN, Vanderbilt University

Obstetrics/Gynecology

295 Exogenous Plasminogen Increases tPA Lytic Efficacy in in-vitro Human Clot, George Shaw, MD, University of Cincinnati

314 Resident Performance In The Setting Of Indeterminate First Trimester Ultrasounds, Jeffrey Lightfoot, MD, Naval Medical Center Portsmouth

296 INO-4885, a Peroxynitrite Decomposition Catalyst, Protects the Heart against Reperfusion Injury in Mice, Rong Li, MD, Thomas Jefferson University

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315 Sexually Transmitted Diseases Do Not Discriminate; First Trimester Vaginal Bleeding Is Not Always A Threatened Abortion, Jeri Rose, DO,

Friday, May 15, 2009 CHRISTUS Spohn Memorial,Texas A&M

To The Emergency Department With Dyspnea, Justin Benoit, Case Western Reserve University School of Medicine

316 A Novel ED-based Sexual Assault Center in Western Kenya: Description of Patients and Analysis of Treatment Patterns, Megan Ranney, MD, Brown University, Department of Emergency Medicine

333 Is a Low-Normal Pulse Oximetry Reading at Triage Really “Normal”? Kevin Maloy, MD, Washington Hospital Center

317 Plan B Availability in Philadelphia Pharmacies, Ralph Riviello, MD, Thomas Jefferson University

334 Factors Associated With Quality Of Life Measures In Patients Presenting To The Emergency Department For Asthma Exacerbation, Theodore Gaeta, DO, New York Methodist Hospital

318 Examining the Impact of a Sexual Assault Response Team (SART) on Delivery of Emergency Department Healthcare to Survivors of Sexual Assault, Lisa Moreno-Walton, MD, Louisiana State University Health Sciences Center – New Orleans

335 Can A Restraint Chair Cause Respiratory Or Ventilatory Compromise?,Gary M. Vilke, MD, University of California, San Diego

Abdominal/Gastronitestinal/Genitourinary

MODERATED POSTERS (3:30 - 4:30 pm)

319 Use Of Computed Tomography In Patients With Prior And No Prior History Of Nephrolithiasis: Does History Matter? Angela M. Mills, MD, University of Pennsylvania

Ultrasound

320 Correlation Between Patient Satisfaction And Physician Management, Esther H. Chen, MD, University of Pennsylvania

336 Patterns of Ultrasound Utilization in US Emergency Departments

by Time of Day and Day of Week: Implications for Emergency Physician Ultrasound, John Stein, MD, University of California, San Francisco

321 Effect of Tamsulosin on Stone Expulsion and Pain Resolution in ED Patients with Ureterolithiasis, Jonathan Walker, DO, York Hospital Emergency Medicine Residency

337 Assessing The Inter-Rater Reliability Of Emergency Physicians Performing Bedside Optic Nerve Sonographic Measurements In Healthy Volunteers, Meghan Lindstrom, MD, Maine Medical Center

322 Urine Neutrophil Gelatinase-Associated Lipocalin Predicts Acute Kidney Injury In A Hypotensive Patient Population, Catherine Forster, MD, Columbia University

338 Tissue Doppler by Emergency Physician Echocardiography Correlates with Preload Reduction During Simulated Hypovolemia in a Lower Body Negative Pressure Model, Edward Tham, MD, SUNYDownstate

323 A Randomized, Double Blind, Placebo-Controlled Trial Comparing Ondansetron, Metoclopramide And Promethazine For Treatment Of Nausea And Vomiting In The Adult Emergency Department, Tyler Barrett, MD, Vanderbilt University Medical Center

339 Ultrasound Guidance Improves Success Of Central Venous Catheterization By Junior Residents, Catherine Lynch, MD, Yale University School of Medicine

Computer Technologies

340 Emergency Physician Compression Ultrasonography For The Detection of Lower Extremity Deep Vein Thrombosis, Cliff Rice, MD, Denver Health Medical Center

324 Emergency Department Patient Evaluation of Internet and Email Access for Healthcare Information, James Killeen, MD, UCSD

341 Focused Musculoskeletal Ultrasound Training:Assessment For Tendon Lacerations, Charles Schmier, MD, University of Nebraska Medical Center

325 Validation Of Data From An Emergency Department Electronic Tracking System, Elaine Rabin, MD, Mount Sinai School of Medicine 326 Maximizing Interpretable Heart Sounds In The Emergency Department Using Digital Auscultation And Computerized Analysis, Brett Donegan, BE,Vanderbilt University School of Medicine

Advancing Education in EM 342 An Educational Intervention Improves Resident Satisfaction with Real-time Feedback in the Emergency Department, Lalena Yarris, MD, Oregon Health & Science University

327 Significantly Reducing Laboratory Specimen Labeling Errors by Implementation of an Electronic Ordering System paired with a Bar Code Specimen Labeling Process, Peter Hill, MD, Johns Hopkins Medical Institutions

343 Does Conference Attendance Correlate With In-Service Exam Scores During EM Residency?, H. Gene Hern, MD, Alameda County Medical Center- Highland

Ethics

344 Remote Instruction Using Videoconferencing Technology Is Equivalent To Live Instruction To Train Novice Users In The FAST Exam, Stephen Leech, MD,Orlando Regional Medical Center

328 Advance Directives In Decompensated Heart Failure Patients, Brian Hiestand, MD, The Ohio State University 329 End Of Life Terminology: Understanding Among Emergency Department Patients, Eric Savory, BS, University of Toledo College of Medicine

345 Implementing Interdisciplinary Teamwork Training: Does The Method Matter? Cherri Hobgood, MD, UNC School of Medicine 346 Faculty Participation and Perceptions in a Novel Human Factors Directed Resident Evaluation Tool, Flavia Nobay, MD, University of Rochester, Department of EM

330 Recognition of Imminent Death in a Cohort of Palliative Care Eligible Patients in the ED, Sangeeta Lamba, MD, UMDNJ, New Jersey Medical School

347 A New Tool to Assess the Clinical Reasoning of Medical Students in the Context of Uncertainty: The Development and Implementation of a Script Concordance Test in an Emergency Medicine Clerkship, Aloysius Humbert, MD, Indiana Universtiy School of Medicine

Respiratory/ENT 331 Treatment Guidelines for Asthma Care Has Lasting Affects for Type of Bronchodilator used but not Treatment Times, Education or Recidivism, Stewart Wright, MD, University of Cincinnati 332 Evaluation Of ST2 For Risk Stratification In Patients Presenting

34

Saturday, May 16, 2009 Filling the Holes in EMS Research (8:00 am - 9:00 am) David Cone, MD, Yale University School of Medicine Jose Cabanas, MD, University of North Carolina

from an established cardiologist and AHFS researcher. Finally, a framework for future research will be presented. The session will close with a question-and-answer panel discussion.

It has been recognized for many years that there is a lack of scientific evidence supporting the efficacy, effectiveness, and even safety of the majority of clinical care delivered in the prehospital setting, and while there have been some recent advances in both the quality and quantity of EMS research, substantial gaps remain. The 2006 Institute of Medicine reports on emergency medicine made a number of concrete recommendations regarding the future of EMS research (7.1: “Federal agencies that fund emergency and trauma care research should target an increased share of research funding at prehospital EMS research, with an emphasis on systems and outcomes research”; 7.3: “The Secretary of the Department of Health and Human Services should conduct a study to examine the research gaps and opportunities in emergency and trauma care research, and recommend a strategy for the optimal organization and funding of the research effort”; and 3.3, involving “developing evidence-based indicators of emergency and trauma care system performance”). What efforts have been made in the nearly three years since the release of this report to begin to advance these objectives? What ethical, economic, and educational challenges may be impeding progress in addressing the IOM recommendations? What existing gaps in EMS research should be prioritized, and how? What funding options are there for academic EMS physicians? This session will explore the current status of EMS research, help identify the major gaps, and examine the IOM recommendations in the context of helping advance the lagging science of prehospital care.

At the conclusion of this session, participants should be able to: 1.

Recognize the complexity and heterogeneity of AHFS management and research. 2. Recognize the need for future ED-based research in this area and the potential pitfalls of extrapolating in-patient research to the ED setting. 3. Describe what new studies need to be performed in this area. 4. Identify the importance of inter-disciplinary collaboration. 5. Identify the proposed framework for future research in AHFS.

At the conclusion of the session, participants should be able to: 1.

Recognize the Institute of Medicine’s 2006 recommendations regarding EMS research. 2. Recognize the existing knowledge gaps in prehospital care, and the priorities for research addressing these gaps. 3.

Be able to identify the current barriers to pursuing quality research in the prehospital setting, and how the IOM recommendations may allow academic EMS physicians routes to overcome these barriers Introduction to Statistics of Clinical Trials (9:00 am - 10:30 am) Roger Lewis, MD, PhD,Harbor-UCLA Medical Center 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. Some more advanced concepts, such as subgroup analysis, interim data analysis, and the intention-to-treat principle will be introduced as well. 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.

State-of-the-Art in Acute Heart Failure Syndromes: Evolving Role of the ED – Current State and a Framework for Future Research (9:00 am - 10:30 am) Alan Storrow, MD, Vanderbilt University Medical Center Sean Collins, MD, University of Cincinnati Peter Pang, MD, Northwestern University This state of the art session will focus on the emerging role of emergency medicine in Acute Heart Failure Syndromes (AHFS), including advances in diagnosis, prognosis, and recent or late-breaking clinical trials that impact the early management and future research directions in AHFS. Despite tremendous advances in cardiovascular care, the post-discharge event rate from AHFS, defined by mortality and re-hospitalization, has not changed in the last decade. Unanswered research questions and novel hypotheses will be presented, covering pathophysiology, biomarkers, risk-stratification, and emerging therapies. Novel clinical trial design and exploratory endpoints for future studies will be discussed.

The importance of collaboration and the role of the ED in the continuum-of-care for AHFS will be emphasized with unique perspectives

35

Academic Career Development for Clinical Directors (10:30 am - 11:30) Niels Rathlev, MD, Baystate Medical Center David Levine, MD, Cook County Stroger Hospital Christopher Beach, MD, Northwestern University The session will examine what skills are necessary for being an effective clinical director in an academic setting. It will also focus on how a clinical director can balance administrative responsibilities and continue to further research and clinical teaching activities. The panelists have balanced running a busy ED and been academically productive. It will emphasize turning operational data into research as well as how to get published and promoted in an academic center.

The session is geared for both aspiring clinical directors as well as current directors trying to advance academically.

At the conclusion of this session participants should be able to: 1.

Identify blending operational skills with research and teaching. 2.

Learn how to take operational data to use for research. 3. Gain insight in opportunities to collaborate in operational research with other facilities. 4. Acquire strategies on how to get promoted academically.

Case Studies: Conflict of Interest in Human Subjects Research Where the Rubber Meets the Road (10:30 am - 11:30 am) Chadwick Miller, MD, Wake Forest University Raquel Schears, MD, St. Mary’s Hospital The 2008 AAMC report on conflict of interest in human subjects research highlights the issue of conflict of interest in research, but these conflicts can be hard to see or define. This case-based session will include four case examples of potential conflict of interest for individuals or institutions, with interactive discussion of the issues at hand and resources to manage these conflicts. Cases will be presented anonymously but will be real-life cases gathered from the general SAEM membership. Specific topics to be covered include consulting relationships, research while developing new technologies, administrative conflicts, and research funding.

At the conclusion of this session, participants: 1. Will be able to recognize situations containing potential individual or institutional conflict of interest in human subjects research. 2. Will have gained navigational tools to manage conflict of interest in emergency medicine research from both a research and ethical perspective.

From Evidence to EMS Practice: Building the National Model (12:30 pm - 2:00 pm) Drew Dawson, National Highway Traffic Safety Administration Eddy Lang, MD, McGill University Daniel Spaite, MD, University of Arizona College of Medicine Jon Krohmer, MD, Department of Homeland Security The session will feature 4 (20 minute) presentations followed by a panel discussion and a QA session.

The need for high quality CPGs in patient care: federal perspectives: Dr. Krohmer will provide the FICEMS and NEMSAC views on the history, rationale, importance and future of the national guideline project.

The state of guidelines in EMS: strengths, challenges and opportunities: Mr. Drew Dawson will provide an overview of the FICEMS/NEM-

Saturday, May 16, 2009

SAC systems approach to developing a national model for out-ofhospital CPGs including rationale and current state of affairs related to pre-hospital care in the US. The challenge of implementation: Dr. Lang will outline issues related to state of clinical practice guidelines as they relate to EMS and both the barriers and potential facilitators that might improve their implementation as identified through the National Model conference.

Short term and long term projects that will complete the objective of the national model. Dr. Spaite will describe the short-term and long-term processes/models that were developed at the National Model conference and which will advance the creation of EMS EBGs that are rigorously developed, implementable and have system-wide stakeholder involvement.

At the conclusion of this session, participants should be able to: 1.

Recognize the basics of guideline development and what criteria can be used to appraise the quality of EBGs. 2. Be aware of the current state of EBGs that have relevance to EMS as viewed from an international perspective. 3. Be able to describe the National Model that was developed at the consensus conference as well as learn about both the short term and long term projects that will complete the conference objective. 4. Consider implementation strategies that will facilitate the uptake of EBGs contextualized for a local EMS context.

Integrating Hospice and Palliative Care Services in the ED: Effects on Resident and Faculty Education and ED Overcrowding (12:30 pm - 2:00 pm) Mark McIntosh, MD, University of Florida Health Science Center Phyllis Hendry, MD, University of Florida Health Science Center Paul Borgman, MD, Community Hospice of Northeast Florida Belena Adkins, RN, Community Hospice of Northeast Florida Most emergency physicians have minimal training in End of Life (EOL) care. ED’s are facing severe overcrowding and admission delays for patients with poor prognoses, limited life expectancies or chronic conditions which require complex decision making skills.

Hospice and palliative care organizations offer a multidisciplinary and family centered care model for patients of all ages with a range of medical conditions including dementia, cancer, renal disease, liver failure, COPD, CHF, AIDS, and degenerative neurological disorders.

These organizations provide non-hospital options for care, pain and symptom management, and bereavement services.

This session will provide didactic information on a new model that integrates a multidisciplinary hospice and palliative care program into a busy academic ED. This model decreases ED admissions and overcrowding, increases patient and family satisfaction, clarifies patient and family goals of care, provides housestaff and faculty education and evaluation including onsite clinical and offsite simulation educational experiences in hospice, palliative and bereavement care.

tive care program. 2. Identify ED patients appropriate for referral to hospice, palliative or bereavement services. 3. Develop an end-of-life educational program for emergency physicians that includes onsite clinical and simulation components. 4. Determine components of an ED model that incorporates hospice concepts and services to decrease futile admissions and offer inpatient alternatives to care.

Regionalization of Emergency Care: Possibilities and Pitfalls.

A National Dialogue (3:00 pm - 4:30 pm) Arthur Kellerman, MD, MPH, Emory University Michael Handrigan, MD, FACEP, Office of the Assistant Secretary for Preparedness and Response Drew Dawson, Director, National Highway Traffic Safety Administration Jon Krohmer, MD, FACEP, Department of Homeland Security Ryan Mutter, PhD, Agency for Healthcare Research and Quality Susan Nedza, MD, MBA, FACEP, American Medical Association In accordance with Homeland Security Presidential Directive (HSPD) #21, the Emergency Care Coordination Center has been established within the Department of Health and Human Services to serve as a focal point for coordination of US Government (USG) efforts to advance day to day emergency care. The ECCC has identified a few high priority issues of national significance to begin its work. One option under consideration is to actively promote and advance the Institute of Medicine’s vision of a “regionalized, coordinated and accountable emergency care system”.

By strengthening the efficient delivery of emergency care on a daily basis, regionalization of emergency care has the potential to enhance our nation’s ability to prepare for and provide services during disasters. This panel of federal and national experts will examine practical benefits and pitfalls of regionalized care, consider how regionalization might influence care delivery, and receive audience suggestions about how the federal government might facilitate regional coordination of emergency care.

At the conclusion of this session participants should be able to: 1.

Establish a shared definition of regionalization to apply to hospitalbased emergency care services. 2. Identify measurable goals for achieving regionalization. 3.Identify benefits and potential unintended consequences of regionalization. 4.Identify necessary enabling factors and potential barriers to implementing regionalization of hospital based emergency care. 5. Describe actionable strategies the federal government might take to promote regionalization of hospital-based emergency care.

PAPER PRESENTATIONS Sepsis (8:00 – 9:30 am)

The content will include:

348 Risk factors for septic shock and death in hemodynamically stable emergency department patients with sepsis, Seth Glickman, MD, University of North Carolina, Chapel Hill

Simulation curriculum for pediatric and adult scenarios on death and dying, breaking bad news, spirituality in the ED, advanced directive decisions, hospice referral and futile admissions.

349 Long-Term Survival Benefit from an Emergency Department Based Early Sepsis Resuscitation Protocol: A Prospective Study, Michael Puskarich, MD, Carolinas Medical Center

Referral guidelines for end-stage diagnoses.

350 Value of Noninvasive Hemodynamic Assessment to predict mortality in Emergency Department patients undergoing Early Goal Directed Therapy for Severe Sepsis, Anthony Napoli, MD, Brown University School of Medicine

Referral process for sudden death and bereavement services.

Implementation model for developing a ED hospice/palliative care program that incorporates a hospice nurse and physician into daily ED operations.

The format will include 3 speakers including a moderator. Sample materials, data and national EOL resources will be provided.

At the conclusion of this session participants should be able to: 1.

Recognize the components of a multidisciplinary hospice and pallia-

351 Multi-Center Randomized Controlled Trial of Lactate Clearance Versus Central Venous Oxygen Saturation as the Endpoint of Early Sepsis Resuscitation, Alan Jones, MD, Carolinas Medical Center 352 Murine sepsis is associated with elevated plasma leptin levels, Kiichiro Yano, PhD, Beth Israel Deaconess Medical Center/Harvard 353 Initial BNP Predicts Adverse Outcome In ED Patients With Sepsis, Anna Marie Chang, MD, University of Pennsylvania

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Saturday, May 16, 2009

ous Outcomes in Emergency DepartmentPatients with Syncope, Venkatesh Thiruganasambandamoorthy, MD, Department of Emergency Medicine, Univ. of Ottawa

ED Operations (9:30 – 11:00 am) 354 Follow-Up Care And Adverse Outcomes In A Population-Based Cohort Of 799,454 Emergency Department Patients Who Left Without Being Seen, Michael J. Schull, MD, Institute for Clinical Evaluative Sciences

EMS/Out-of-Hospital (9:30 – 11:00 am) 370 Prehospital Hypothermia Speeds Time to Goal Temperature in Comatose Patients Resuscitated from Out-Of-Hospital Cardiac Arrest, Jon Rittenberger, MD, University of Pittsburgh

355 ED Super Users: Pain Protocol Implementation Reduces Emergency Department Visits, Brent Passarello, MD, Christiana Care Health System

371 A Trial To End Ambulance Diversion In Boston, Franklin Friedman, MD, Tufts Medical Center

356 Increasing Return Visits to US Emergency Departments, 20012006, Andrew Herring, MD, Alameda County Medical Center

372 Predictors of Survival from Out-of-Hospital Cardiac Arrest do not Change with Age, Jeffry Shellenberger, MD, University of Arizona Dept of Emergency Medicine

357 Emergency Department Overcrowding Is Associated With Reduced Patient Satisfaction Scores, Karis Tekwani, MD, Advocate Christ Medical Center

373 Injury Hospitalization Is A Marker For Increased Emergency Medical Services Utilization And Costs In A Cohort Of Medicare Patients, Ross J. Fleischman, MD, Oregon Health and Science University

358 The Effect Of Emergency Department Crowding On Analgesia Administration In Acute Abdominal Pain Patients, Angela M. Mills, MD, University of Pennsylvania

374 Should the deeply comatose pediatric blunt trauma patient be intubated by EMS?, Charlene Irvin, MD, St. John Hosptial and MEdical Center

359 A Hospital-Wide Approach To Decreasing Emergency Department Congestion: Matching Supply With Demand, Emilie Powell, MD, Northwestern University

375 Injury Adjusted Mortality of Patients Transported by Police Following Penetrating Trauma, Roger Band, MD, Hospital of The University of Pennsylvania

HIV Testing in the ED (11:00 am – 12:00 noon) 360 Clinical Effectiveness of Routine Opt-Out Rapid HIV Screening in the Emergency Department: A Prospective Controlled Clinical Trial, Jason Haukoos, MD, Denver Health Medical Center

Toxicology (11:00 am -12:00 noon)

361 Successful Linkage To Care And Follow-Up For Patients Diagnosed With HIV in the Emergency Department, Beth Kaplan, MD, UCSF/San Francisco General Hospital

376 Hydroxocobalamin And Sodium Thiosulfate Versus Sodium Nitrite And Sodium Thiosulfate In The Treatment Of Acute Cyanide Toxicity In A Swine (Sus Scrofa) Model, Vikhyat Bebarta, MD, Wilford Hall Medical Center

362 Cost Effectiveness of Routine Opt-Out Rapid HIV Screening in the Emergency Department: Results from a Prospective Controlled Clinical Trial, Amy Conroy, MPH, Denver Health Medical Center

377 Pharmacokinetics Of OpdA, An Organophosphorus Hydolyase, In The African Green Monkey, Steven Bird, MD, University of Massachusetts

363 Outcomes and Cost Analysis of Three Operational Models for Rapid HIV Testing Services in an Academic Inner-City Emergency Department, Yu-Hsiang Hsieh, PhD, Johns Hopkins University

378 Derivation of the Prognostic Utility of Lactate for Drug Overdose Fatality, Alex Manini, MD, Mount Sinai School of Medicine 379 Does the Infusion Rate of Intravenous Fat Emulsion in Severe Verapamil Toxicity Affect Survival and Hemodynamic Parameters?, Eric Perez, MD, St. Luke’s/Rossevelt Hospital

Decision Rules (8:00 – 9:30 am) 364 Risk Stratification of Patients with Acute Pulmonary Embolism using the Pulmonary Embolism Severity Index Score from the Emergency Medicine Pulmonary Embolism in the Real World Registry (EMPEROR), Jane Fansler, MD, Stanford/Kaiser Emergency Medicine Residency

Imaging and Radiation (8:00- 9:00 am) 380 Retrospective Review Of Computed Tomography In The Evaluation Of Pediatric Hemophiliacs With Minor Head Trauma, James Winslow, MD, Wake Forest University

365 Early CT Without LP Reliably Excludes Subarachnoid Hemorrhage in Neurologically Intact ED Patients with Acute Headache, Jeffrey J Perry, MD, Department of Emergency Medicine, Univ. of Ottawa

381 Patient Perceptions Of Computed Tomographic Imaging And Their Understanding Of Radiation Risk And Exposure, Brigitte M. Baumann, MD, UMDNJ-RWJMS at Camden

366 Voluntary Use of NEXUS Criteria in an Electronic Emergency Department Information System is Not Associated with Decreased Use of Cervical Spine Imaging, Joshua Broder, MD, Duke University Medical Center

382 Knowledge and Concerns About Radiation Risk from Computed Tomography: An Emergency Department Survey, Kevin Takakuwa, MD, Thomas Jefferson University Hospital

367 Multicenter Prospective Validation of the ABCD2 Rule for Predicting Outcomes of Transient Ischemic Attack Patients in the ED, Jeffrey J Perry, MD, Department of Emergency Medicine, Univ. of Ottawa

383 Charges And Radiation Exposure Associated With Whole Body (PAN) Computed Tomography (CT) Imaging In Low Risk Blunt Trauma Patients, Mary Hughes, DO, MSU-COM Health Services Research and Policy (12:30 – 2:00 pm)

368 A Risk Stratification Rule for Hospitalization among Emergency Department Patients with Acute Asthma: The CHOP Classification Tree, Chu-Lin Tsai, MD, Massachusetts General Hospital

384 Medication Reconciliation in Emergency Department Triage is Limited, Maryann Mazer, MD, University of Pennsylvania

369 Development of an Improved Rule to Predict Short-Term Seri-

385 Reevaluation of the Effect of Mandatory Interpreter Legislation

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on Use of Professional Interpreters for ED Patients with Language Barriers, Adit Ginde, MD, University of Colorado Denver School of Medicine 386 Supply and Demand of Board-certified Emergency Physicians by US State, Carlos Camargo, Jr., MD, Massachusetts General Hospital 387 Impact of Mandated Nurse-Patient Ratios on ED Medication Delivery, Theodore Chan, University of California, San Diego 388 The Effects Of Arrival Intensity, Patient Acuity, ED Boarding, And Hourly ED census On Patient Waiting Times, Mehdi Sattarian, MD, George Washington University Medical Center 389 Quality of Acute Asthma Care Provided by Physician Assistants and Nurse Practitioners in 63 US Emergency Departments, Chu-Lin Tsai, MD, Massachusetts General Hospital

University 403 Analysis of Risk Factors and Effectiveness of Emergency Department (ED) Based Multimedia HIV Testing and Counseling in an Adolescent Cohort, Yvette Calderon, MD, Jacobi Med Ctr & Albert Einstein College of Medicine 404 Emergency Department Staff Satisfaction with Rapid HIV Screening, Aparajita Sohoni, MD, Alameda County Medical Center Highland Hospital 405 CD4 Counts and Viral Loads of HIV Positive Patients Detected Through a Routine Emergency Department HIV Screening Program, Jeremy Brown, MD, The George Washington University Dept of Emergency

Airway Management (12:30 – 2:00 pm)

406 Rapid Opt-Out HIV Screening: Translation into Practice in Pediatric Emergency Medicine, Jon McGreevy, MD, Washington University School of Medicine

390 Does ETCO2 monitoring during ED PSA with propfol lower the rate of hypoxia? A randomized, controlled trial., Ken Deitch, DO, Albert Einstein Medical Center

407 Characteristics of ED Patients Newly Diagnosed with HIV using a Rapid HIV test, Beth Kaplan, MD, UCSF/San Francisco General Hospital

391 Pupillary Response To Light Is Preserved In Patients Undergoing Pharmacologic Neuromuscular Blockade For Rapid Sequence Intubation, Steven Andescavage, DO, University of Florida-Jacksonville

408 Feasability and Acceptance of Routine Screening for HIV in Adolescents in the Emergency Department, James Wilde, MD, Medical College of Georgia

392 Five-Step Cricothyrotomy Technique Using Gum Elastic Bougie is Faster Than Standard Technique in Anesthetized Sheep, Chandler Hill, MD, Hennepin County Medical Center

409 Differences in HIV Testing Among Academic and Non-Academic Emergency Departments in the United States: A National Survey, Jason Haukoos, MD, Denver Health Medical Center

393 Comparison Of The Success And Perceived Ease Of Use Of Bougie-Assisted Endotracheal Intubation (BAI) With Traditional Endotracheal Intubation (ETI) In A Simulated Difficult Airway, Matthew Messa, DO, Geisinger Medical Center

410 The importance of ethnic matching and emotional content in video systems used for HIV prevention education and testing of emergency department patients, Theodore C. Bania, MD, MS, St. Luke’s-Roosevelt/Columbia University

394 Comparison of the RIFL Airway Scope and Levitan FPS scope in simulated difficult tracheal intubation, Ben Sill, MD, University of New Mexico

411 Systematic Assessment Of The Frequency And Reason For Inability To Offer HIV Testing In The Emergency Department Setting, Brian McDonnell, University of Cincinnati College of Medicine

395 The Association of Sub-Clinical Respiratory Depression with Clinical Interventions During Procedural Sedation, Karen Terwey, Hennepin County Medical Center

412 Patients Who Consent for Free Routine Opt-Out Rapid HIV Screening in the Emergency Department Are More Often Uninsured than the General Population, Jeffrey Sankoff, MD, Denver Health Medical Center

POSTER SESSION (4:30 – 6:30 pm) Infectious Disease 396 Barrier Precautions Adherence in the Emergency Department, Rachel Hampton, Case Western Reserve School of Medicine

413 A Validation Study of High Volume, Rapid HIV Testing in a Community Hospital Emergency Department, Melissa Iammatteo, MD Albert Einstein College of Medicine Disease/Injury Prevention

397 Hemodynamic Changes in Patients with Sepsis, Caitlin Hicks, Cleveland Clinic Lerner College of Medicine

414 The Impact of a Brief Educational Intervention on Adolescent Driving Behaviors, Bryan Kane, MD, Lehigh Valley Health Network

398 The Changing Epidemiology of Retropharyngeal Abscesses, Lisa Reedman, MD, Morristown Memorial Hospital

415 The Middle Seat: The Safest Seat in the Vehicle, Dietrich Jehle, MD, SUNY @ Buffalo

399 Management Of Pediatric Skin Abscesses In Academic Versus Community Emergency Departments, Brigitte M. Baumann, MD, UMDNJ-RWJMS at Camden

416 Comparison of Second VS. Third Row Seating for Fatal Injury in Vehicular Collisions, David Milzman, MD, Georgetown University School of Medicine

400 Association Of Time To Antibiotic With Mortality For Emergency Department Patients Entering An Early Goal Directed Treatment PathwayAfter Adjustment For Severity Of Illness, Jacqueline J Mahal, MD, NewYork Presbyterian Emeregcny Medicine Residency

417 Community Assessment and Initial Treatment of Opioid Overdose, Kathryn A. Dong, MD, University of Alberta

401 MRSA Rates and Antibiotic Susceptibilities from Skin and Soft Tissue Cultures in a Suburban ED, Andrei Nazdryn, MD, Stony Brook University 402 Who prefers CDC-recommended streamlined methods for HIV testing?, Michael Waxman, MD, Alpert Medical School of Brown

418 The Correlation Between Self-Reported and Observed Adolescent Driving Behaviors, Bryan Kane, MD, Lehigh Valley Health Network 419 Dependent Smokers Are Interested in Smoking Cessation Interventions in the ED, Ingrid Llovera, MD, North Shore University Hospital

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Saturday, May 16, 2009

420 The Dog Bite Epidemic: An Under-Recognized Prevention Topic, Cinnamon Dixon, DO, Cincinnati Children’s Hospital Medical Center

ing Early Sepsis Resuscitation, Stephen Trzeciak, MD, UMDNJRWJMS at Camden

421 Sweet? HgbA1C Screening In Low Risk Chest Pain Patients Admitted To The Emergency Department Observation Unit, Heather Wiederhold, MD, William Beaumont Hospital

438 Bolus Dose Insulin In The Treatment Of Diabetic Ketoacidosis: A Retrospective Analysis, Joel Kravitz, MD, Albert Einstein Medical Center

422 Infection Control for Influenza: Improving ED Use of Droplet Precautions, Derrick Lung, MD, The George Washington University

439 Ninety-day functional status, living independence, and mortality in older adults seen in the ED with possible sepsis: a prospective case-control study, John Younger, MD, University of Michigan

423 Cognitive function of firefighters following work in thermal protective clothing, Joe Suyama, MD, University of Pittsburgh 424 Brief Emergency Department Intervention About Perpetration Of Intimate Partner Violence: Victims Improved Knowledge Attitudes and Practice More Than Non-Victims, Julie Kanter, MD, University of New Mexico

440 Classical and alternative complement pathway activation in severe sepsis is profound at clinical presentation and does not resolve with early quantitative resuscitation, John Younger, MD, University of Michigan 441 Defect in Serum Bacterial Killing in Severely Septic Patients Identified Using Transgenic Luminescent Bacteria, Christine Nypaver, University of Michigan

425 Persistence Of The Anomaly To The Latino Epidemiologic Paradox, Federico Vaca, MD, University of California, Irvine

442 The Impact Of Prior Statin Use On Clinical Outcomes In Patients With Septic Shock Treated With Early Goal Directed Therapy, Brian Fuller, MD, Cooper University Hospital

426 Using the SF-12 to Assess the Self-Perceived Physical and Mental Health of Emergency Department Patients, Sanjay Arora, MD, UCSF

443 The Significance of Hypotension in Emergency Department Patients with Sepsis, Michael Marchick, MD, Carolinas Medical Center

427 Dating Aggression And Risk Behaviors Among Teenage Girls Seeking Gynecologic Care, Lauren Whiteside, MD, University of Michigan

444 Impact Of Triage ClassificationOn TimeTo TreatmentVariablesIn Patients With Severe Sepsis, Martha Linker, MD, University of Pennsylvania School of Medicine

428 The Impact Of A High Body Mass Index On Injury And Illness In Marathon/Half-Marathon Participants, Tyler Vadeboncoeur, MD, Mayo Clinic Florida

445 Bioreactance Predictors of Hospitalization in Patients with Suspected Sepsis, Caitlin Hicks, Cleveland Clinic Lerner College of Medicine

429 Automobile Safety Restraints Do Not Increase The Chance of Fetal Complications Following Motor Vehicle Collision, Stacie Zelman, MD, Wake Forest University

Cardiac Arrest

Shock/Critical Care

446 Rate of Cardiopulmonary Arrest Before and After Implementing Rapid Response Teams Using Emergency Medicine Residents, John Davis, DO, Saint Luke’s Hospital

430 An Endogenous Molecule, Spermine, Protects Mice against Lethal Sepsis by Enhancing Early but Attenuating Late Cytokine Responses, Shu Zhu, MD, North Shore University Hospital - NYU School of Me

447 Assessing Performance in Simulated In-Hospital Ventricular Fibrillation Cardiac Arrest, Jeffrey Siegelman, MD, Brigham and Women’s Hospital

431 The Prevalence and Prognostic Value of Hyperglycemia and APACHE II Scores Among Sepsis Patients in the Emergency Department, Jason D’Amore, MD, North Shore University Hospital

448 CPR Feedback Improves the Quality of Chest Compression Provided by Hospital Healthcare Professionals, Charles N. Pozner, MD, Brigham and Women’s Hospital

432 Correlation of Peripheral and Central Venous Oxygen Saturation, A.J. Hegg, MD, Henry Ford Health System 433 Lactate Measurement As An Independent Predictor Of Death After Adjustment For The Mortality In Emergency Department Sepsis (MEDS) Score In ED Patients With Severe Sepsis And Septic Shock, Jacqueline Mahal, MD, NewYork Presbyterian Emergency Medicine Residency 434 External Validation Of The Mortality In Emergency Department Sepsis (MEDS) Score; Subset Evaluation In Severe Sepsis And Septic Shock, Jacqueline J Mahal, MD, NewYork-Presbyterian Emergency Medicine Residency 435 Referral of Potential Organ Donors from the Emergency Department is Associated with Greater Likelihood of Successful Organ Retrieval, Glen E Michael, MD, University of Virginia, Dept of Emergency Medicine

449 Bridging The Training Gap In Cardiac Arrest: Identification Of Cardiac Arrest Decision-making Deficits In Lay Rescuers, David Slattery, MD, University of Nevada School of Medicine 450 Non-medical Responders Are Not Accurate at Identifying Agonal Respirations?, David Slattery, MD, University of Nevada School of Medicine 451 Depression and Post-Traumatic Stress Disorder Symptoms in Family Members of Cardiac Arrest Victims, Scott Compton, PhD, Wayne State University 452 The Utility of a Novel Portable Computerized EEG Device as an Early Predictor of Neurologic Outcome After Cardiac Arrest, Brian O’Neil, MD, Wayne State University 453 Winessed versus Unwitnessed In-Hospital Cardiorespiratory Arrest: Features and Outcome, William Brady, MD, University of Virignia

436 Perfluorocarbon Emulsion Does Not Impact Coagulation and Platelet Function In Vitro, Nathan White, MD, Virginia Commonwealth University (VCURES) 437 Prospective Multicenter Cohort Study of the Relationship Between Global Tissue Hypoxia and Coagulation Activation Dur-

39

Saturday, May 16, 2009 EMS

Queens

454 The Utility Of Near-Infrared Spectroscopy In The Prehospital Evaluation Of Trauma Patients, Tyler Barrett, MD, Vanderbilt University Medical Center

473 Quality Of Cervical Collar Placement By Pre-hospital Providers, Michael Dailey, MD, Albany Medical College 474 Mode Of Arrival As An Indicator Of Myocardial Infarction In Patients Who Present To The ED With Chest Pain, John Wu, Tufts University School of Medicine

455 Assessment of Trauma/Emergency Care in Public and Private Sectors in Two Districts of Sindh, Pakistan, Junaid Razzak, MD, Aga Khan university 456 Paramedic and Emergency Medical Technician Views on Opportunities and Challenges When Forgoing and Halting Resuscitation in the Field, Corita Grudzen, MD, Mount Sinai School of Medicine 457 Pre-Hospital Medical Clearance of Intoxicated Patients Without Medical Complaints, Angela Bell, MD, University of New Mexico 458 What is the Optimal Strategy for Triaging Field ST Segment Myocardial Infarction Patients, Robert Swor, DO, William Beaumont Hospital 459 The Safety and Efficacy of Prehospital Diltiazem, Brian Walsh, MD, MBA, Morristown Memorial Hospital 460 AirTraq (Optical Laryngoscope) Use in HEMS - A Pilot Trial, Christopher Russi, DO, Mayo Clinic 461 The Availability and Use of Out-of-Hospital Physiologic Information to Identify High-risk Injured Children in a Multisite, PopulationBased Cohort, Craig Newgard, MD, Oregon Health & Science University

475 Cerebral And Somatic Tissue Oxygenation Monitoring In Major Trauma Patients During Aeromedical Transport, Jeremy Brywczynski, MD, Vanderbilt University Medical Center 476 Evaluating the Process of Out-of-Hospital Trauma Triage and Choice of Hospital Destination In A Broad Injury Population, Craig D. Newgard, MD, Oregon Health & Science University 477 Degradation with fragment formation of Prehospital Succinylcholine by Mass Spectrometry, Chris Aquina, Robert Wood Johnson Medical School 478 Implementation of an EMS Screening Tool on Patients Refusing Ambulance Transport and Effects on Requests for On-Line Medical Direction, Juan March, MD, East Carolina University 479 Assessment of the diagnostic and predictive values of thirst perception, plasma arginine vasopressin and angiotensin-2 during initial trauma resuscitation, Brett Shaffer, MD, Brooke Army Medical Center / SAUSHEC Emergency Med 480 Use of midazolam for chemical restraint of agitated patients, Peterson Kari, MD, University of New Mexico

462 Assessment of Inter-rater Reliability for the Recognition of Agonal Breathing and Cardiac Arrest by 9-1-1 Dispatchers, Christian Vaillancourt, MD, Department of Emergency Medicine, Univ. of Ottawa

481 Analysis of Automated External Defibrillator Device Failures Reported to the Food and Drug Administration, Allan C Simpson, University of Arizona

463 Selective Spine Immobilization of the Prehospital Emergency Medical Services Patient: Current Practices and Standards, Luke Day, MD, Albany Medical Center

482 King LT-D Placement Skills are Retained One Year After Initial Training, Jason Biggs, MD, University of Pittsburgh

464 Evaluation of a Modified Sign-Out on Emergency Department Documentation of Medications Administered by Critical Care Transport Teams, Kenneth Robinson, MD, LIFE STAR / Hartford Hospital

483 Use of Geographic Information Systems to Compare the Location of Automated External Defibrillators versus Actual Sudden Cardiac Deaths Sites in one Suburban/Rural North Carolina County, Juan March, MD, East Carolina University

465 When Conducted Energy Weapons Are Combined With Other Force Options: When Does It Happen And Is It Fatal?, Christine Hall, MD, University of Calgary

484 Incidence And Outcomes Of Transcardiac TASER Probe Deployments, Eric Teacher, MD , Wake Forest University Emergency Medicine

466 Prevalence and Presentation of Septic Shock in the Pre-hospital Environment, Satheesh Gunaga, DO, Henry Ford Wyandotte Hospital

485 Ventilator Tidal Volume settings during Air Transport in mechanically ventilated patients, Lekshmi Vaidyanathan, MD, Mayo Clinic

467 Evaluation of Prehospital IV Fluid Warming Techniques, John Lyng, MD, SUNY Upstate Medical University 468 The Role Of Pre-hospital Electrocardiograms In The Recognition Of ST-segment Elevation Myocardial Infarctions And Reperfusion Times, Joshua Eastvold, MD, Advocate Christ Emergency Medicine Program 469 Patterns of pediatric trauma transfers to a level I trauma center in California: 2000-2007, Colleen Acosta, MPH, Stanford University School of Medicine 470 Who gets treatment and transport first in a disaster? Predicting mortality in the “Urgent” triage category, Charlene Irvin, MD, St. John Hosptial and Medical Center

486 EMS use of chemical restraints improves patients agitation, Steven Weiss, MD, University of New Mexico 487 Prehospital Analgesic Protocols in the United States: A National Survey, Luke Day, MD, Albany Medical Center 488 Electronic Transmission Of EKGs Through A Cell Phone: Is It Feasible? Marcy Rosenberg, MD, Orlando Health 489 Utilization Of Emergency Medical Services By Limited English Proficient Parents - Survey At An Inner-City Pediatric Emergency Department, Mydili Subramaniam, MD, Children’s Hospital of Michigan

471 Should Out-of-Hospital EKGs Be Used To Activate the Cardiac Catherization Team, Megan Crider, MD, Orlando Regional Medical Center

490 A Comparison of EMS Provider Assessment of Mechanism of Injury Criteria in a Motor Vehicle Crash with Expert Measurement of Motor Vehicle Damage, E Brooke Lerner, PhD, Medical College of Wisconsin

472 Physicians Are Unaware of Treatments and Procedures Done

by Prehospital Providers, Rachel Waldron, MD, New York Hospital

491Police Use Of Force, Injuries and Death: Prospective Evaluation Of Outcomes For All Police Use of Force/Restraint Including

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Saturday, May 16, 2009

Conducted Energy Weapons In A Large Canadian City., Christine Hall, MD, University of Calgary

University School of Medicine 510 Impact of Prescriptions of Contact Isolation, Supplemental Oxygen and Cardiac-Monitor on Length of Stay in the Emergency Department for Patients Admitted to Hospital Ward, Raoul Daoust, MD, Hopital Sacré-Coeur Université de Montréal

492 Prevalence of methicillin-resistant Staphylococcus aureus colonization in EMS providers, Sara Tsuchitani, MD, Eastern Virginia Medical School 493 Withdrawn

511 Emergency Department Crowding is Associated with Delays in Pain Control in Pediatric Sickle Cell Vaso-occlusive Crises, Rohit Shenoi, MD, Baylor College of Medicine

494 Association Between Ambient Fine Particles and Respiratory EMS Calls in New York City, Robert Silverman, MD, Department of Emergency Medicine NSLIJ

512 Emptying The “Corridors Of Shame” Organisational Chal lenges In Meeting An Imposed Four-Hour Throughput Target For Emergency Departments In The UK, Ellen Weber, MD, University of California, San Francisco

495 Availability of Automated External Defibrillators in Major US Airports, Vincent Mosesso, MD, University of Pittsburgh School of Medicine

513 Equivalent Treatment Times and Patient Satisfaction Seen When Physician in Triage Program Staffed by Junior and Senior Physicians, Nathaniel Schlicher, Wright State University

496 Comparison Of The Philips HeartStart MRx Simplified Acute Myocardial Infarction Classification With The ACI-TIPI Score For STEMI Detection, Mohamud Daya, MD, Oregon Health & Science University

514 Emergency Department Crowding And Analgesia In Patients With Back Pain, Jesse Pines, MD, University of Pennsylvania

497 Effectiveness And Safety Of Fentanyl Versus Morphine For OutOf-Hospital Analgesia, Ross J Fleischman, MD, Oregon Health and Science University

515 The association between ED crowding and delays in time to OR in acute appendicitis, Joshua Isserman, University of Pennsylvania

498 Improved Rates Of Successful Prehospital Intubations With Metal Versus Plastic Laryngoscope Blades, Frank Dos Santos, DO, Robert Wood Johnson Medical School Disaster

516 Predictors of Intensive Care Unit Admissions, Marlaina Norris, MD, Mount Sinai School of Medicine 517 The Emergency Department Frequent User: Case Management As A Method Of Reducing Emergency DepartmentVisits And Radiation Risk From Computed Tomography Scans, Casey Grover, David Geffen School of Medicine at UCLA

499 Comparison of the SALT and Smart Triage Systems Using a Virtual Reality Simulator With Paramedic Students, John Serra, MD, Yale-New Haven Medical Center 500 Disaster Preparedness Perceptions of EMS Providers: Are They Ready?, Sarah Casado, MD, St John Hospital and Medical Center

518 Food, Shelter and Safety Needs Motivating Homeless Persons’ Visits to an Urban Emergency Department, Jonathan Fortman, UCSF School of Medicine-SFGH

501 Pilot Test of the SALT Mass Casualty Triage System, David Cone, MD, Yale University

519 Identification of the Predisposing Factors for Diagnosis Errors in the Emergency Department?, Marc Afilalo, MD, SMBD-Jewish General Hospital

502 The Evaluation of A Telemedicine Model In Acute Wound Management: Phase I of An Alternate Medical Treatment Site (AMTS) Disaster Plan, Christine Van Dillen, MD, Orlando Regional Medical Center 503 How good is the Pediatric ‘JumpSTART’ triage algorithm at predicting patients with high mortality?, Charlene Irvin, MD, St. John Hosptial and Medical Center 504 Randomized Controlled Trial Of High Fidelity Patient Simulators Compared To Actor Patients In A Drill Scenario, David Wallace, MD, Kings County Hospital Center

520 Effect of ED crowding on intervals of care for patients admitted with pneumonia, Christopher Fee, MD, University of California San Francisco 521 Withdrawn 522 Is There An Association Between Occupancy Rates And Rates Of Violence In The Emergency Department?, Dylan Medley, MD, Texas A&M HSC College of Medicine 523 A Multicenter Study Of The Association Between ED Crowding And Laboratory Turnaround Times, Ula Hwang, MD, Mount Sinai School of Medicine

505 Hurricane Ike and the Storm Surge: Changes in Emergency Department Patient Arrival Patterns During Anticipated Natural Disasters, James McCarthy, MD, University of Texas HSC at Houston Crowding 506 A Simulation Methodology for Optimizing Emergency Department Triage Nurse Staffing, Karolina Glowacka, PhD, McGill University 507 Implementation of an emergency department physician in triage system decreases patient wait times and left without being seen rates, Karen Murrell, MD, Kaiser Permanente South Sacramento Medical Center 508 Access Block Occupancy (Boarder Count) As A Measure Of Overcrowding, Drew Richardson, MD, Australian National University 509 Effect of Delayed ICU Transfer and Critical Intervention on Patient Mortality and Length of Stay, Nicole Riordan, MD, Indiana

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Sunday, May 17, 2009

Opportunities for Academic Emergency Physicians in Undergraduate Medical Education: Looking Beyond (and Before) the EM Clerkship (8:00 am - 10:00 am) Kate Heilpern, MD, Emory University Glenn Hamilton, MD, Wright State University James Hoekstra, MD, Wake Forest University Joshua Wallenstein, MD, Emory University

tion scholarship.

Format: Participants will begin with an exercise to assess knowledge and goals. Following a brief lecture discussion of key concepts related to educational effectiveness, excellence, scholarly work, and scholarship, participants will work in small groups to apply the concepts to their own teaching and education activities. Using large group discussion, participants will debrief and explore opportunities for disseminating their original products of teaching and education and examine example peer review processes. Then participants will develop a plan for enhancing their scholarly teaching/education activity and dissemination of scholarship. To conclude, participants will debrief and complete an action plan.

Academic emergency physicians have unique experience and training which make them particularly valuable and effective medical student educators. The 4th year clerkship has traditionally been the focus of undergraduate EM education, but that is only one of many opportunities available to EM faculty in undergraduate medical education.

Emergency physicians have become heavily involved in all facets of medical school education throughout medical school, from smallgroup instruction and lecture-hall presentations during the pre-clinical years to clinical-skills and capstone-course teaching during the clinical years. EM physicians sit on admissions and curriculum committees, and many have obtained significant educational and leadership roles within their institutions, including formal teaching/mentorship positions, clinical-skills and simulation directors, and positions within the Dean’s office. Achievements and accomplishments in undergraduate medical education lead to tangible and personal rewards for the individual faculty member, and advance the prominence of emergency medicine both at an institutional and national level. Faculty development for those wishing to pursue such opportunities is crucial, and must be combined with effective networking and mentorship within and beyond one’s own academic department. While some topics overlap with those relevant to resident educators, there is a unique knowledge base and skill set that medical student educators/mentors need to possess in order to achieve their career goals. This program will consist of a small number of lecture presentations by expert faculty followed by a larger number of focused small group breakout sessions which will detail a variety of opportunities available for both junior and senior faculty.

At the conclusion of this session participants should be able to: 1.

Recognize the distinctions among teaching effectiveness, excellence, and scholarly productivity in their educational activities and 2.

Have an action plan of how to improve his or her scholarship.

The Science of Simulation in Healthcare: Followup of the 2008 AEM Consensus Conference (9:30 am - 10:30 am) James Gordon, MD, Harvard/Massachusetts General John Vozenilek, MD, Northwestern University The 2008 AEM Consensus Conference, The Science of Simulation in Healthcare, focused on the most effective use of simulation-based education and evaluation in medicine. This session is designed as a follow-up panel discussion one year after the consensus event.

Speakers and stakeholders will concentrate on the impact of the special topic-proceedings issue of the Journal, and highlight selected simulation-based initiatives in the field.

At the conclusion of this session, participants should be able to: Discuss the impact of the 2008 AEM Consensus conference on the Science of Simulation in Healthcare.

At the conclusion of this session, participants will should be able to: 1. Identify the vast number of teaching and mentorship opportunities available to faculty in both pre-clinical and clinical undergraduate medical education. 2. Comprehend the organizational and administrative structure of leadership within undergraduate medical education, including the experience and credentials needed to obtain both entry and senior level positions within medical student education. 3. Recognize the key role of networking and mentorship with educators beyond the boundaries of academic departments 4. Develop strategic plans to achieve short and long-term career goals.

Error and Bias in Clinical Research (10:00 am - 11:00 am) Edward Panacek, MD, UC Davis Medical Center Among the most important goals of properly designed and conducted clinical research is to minimize the effects of error and eliminate bias.

However, despite this importance, rarely is this topic taught in didactic conferences or in research methodology articles. This session will cover the different types of error in bias. It will explain the terminology, identify sources and illustrate the effect bias can have on study results and consequent conclusions. Several different types of bias will be covered, including selection bias, spectrum bias, work up bias, etc. Session will also identify steps that can be taken to minimize and ideally eliminate sources of bias in clinical research studies. Examples directly relevant to emergency medicine will be emphasized.

Publish or Perish: Achieving Scholarship in Your Everyday Teaching and Education Work (8:00 am - 9:30 am) Sally Santen, MD, Vanderbilt & Emory University Sheila Chauvin, PhD, Louisiana State University Health Sciences Center Peter DeBlieux, MD, Louisiana State University Health Sciences Center

At the conclusion of this session participants should be able to: 1.

Define the terms “error” and “bias” as they apply to clinical research.

2. List several different types of error and bias. 3. Identify steps that can be taken in study design and performance that can minimize the effects of bias.

Rationale: A recent article in AEM noted that academic emergency medicine could benefit from broadening how scholarship is defined to include teaching, integration and application of knowledge and discovery of new knowledge. Within the past decades, considerable attention and efforts have targeted enhancing faculty members’ scholarly teaching and educational scholarship. There has been increased emphasis given to understanding and enhancing scholarly rigor and recognition of scholarship in teaching/education for academic career advancement. The goal of this workshop is to help participants understand the distinctions among teaching effectiveness, excellence, and scholarly productivity in their educational activities and to promote participants’ scholarship.

International Academic Experiences: How to Incorporate Them Effectively into Your Career” (11:00 am - 12:00 pm) Daniel Keyes, MD, John Peter Smith Health Network and UT Southwestern Ian Martin, MD, Duke University Faculty members of emergency medicine residency programs have become increasingly interested in acquiring visiting professorships and other short-term teaching opportunities overseas. Students and residents also frequently seek faculty assistance with arranging international educational opportunities. One speaker, who was recipient of a faculty Fulbright Scholar award to Israel in 2004, and who established an Emergency Medicine residency in Costa Rica, will discuss the rationales for obtaining such experiences, how to locate opportunities that “fit” an individual’s needs and interests, how to obtain departmental logistical and moral support, suggestions for the

Content: The workshop will introduce a broad definition of scholarship promoted by Boyer (1990) and the characteristics of scholarship (Glassick,1997) that have since been widely adopted by the medical education community. The workshop will also include an array of peer review publication and presentation venues for medical educa-

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Sunday, May 17, 2009 acquisition of funding, and how to make the most of the experience, during and after one’s international exchange. A second speaker will provide additional experience and describe how a faculty member may best facilitate resident and student requests for assistance with international academic exchanges.

The following goals are illustrated in this session: A discussion of rationales for seeking international teaching and learning experiences in the context of faculty development, personal fulfillment, and the increasingly global scientific exchange which exists today will be provided. The impact of such experiences on the participant, on the host country, and at the home institution will be noted.

Session participants will learn strategies for identifying a suitable international teaching opportunity, incorporating key factors such as personal goals, language skills, needs of the target region, and the needs of the teaching environment to which the emergency medicine faculty member will return to and other factors.

Awareness will be raised as to several practical issues which will present themselves, such as sustaining funding during the time of absence from one’s home institution, social, health, academic and other challenges that may be experienced by a traveling faculty member. The potential impact of the experience on any family members that join in the experience will also be addressed.

Recommended modes of interaction with the international host institution will be evaluated, as will strategies for promoting further exchange and understanding between one’s own nation and culture, and that of the host country.

Suggestions should be made relating to how the experience may be used to further one’s own career, and to facilitate the careers of others.

Methods for maintaining the collaborative process after completing the international experience will be discussed.

An exploration of opportunities which exist upon return to one’s own institution will be presented, such as serving to assist other faculty members, residents and students to benefit from an academicallyoriented international experience, or to host a foreign national at one’s home institution.

International educational opportunities for students and residents will be specifically addressed. The session points out how international experience can provide different rewards and benefits at different stages in one’s career.

At the conclusion of this session, participants should be able to: 1.

Recognize the process of incorporating international academic experiences effectively into one’s medical career. 2. Be aware of several resources which exist for international exchange and teaching opportunities which match the individual faculty member, resident or student.

In Situ High Fidelity Simulation for Resident and Prehospital Education (10:30 am - 12:00 pm) JoDee Anderson, MD, Oregon Health and Science University Lalena Yarris, MD, Oregon Health and Science University Robert Cloutier, MD, Oregon Health and Science University Todd Ellingson, MD, Oregon Health and Science University Simulation training has been used to impart both knowledge and practical skills in the management of high-stakes, low-frequency emergencies; it allows for the safe practice of life-saving skills in a lowrisk environment. Crisis Resource Management (CRM) serves as a foundation for high-fidelity simulation and team training. One of the important principles of CRM is situational awareness defined as the understanding of one’s immediate environment during crisis situations. In order to improve the simulated environment, in situ simulation has emerged to allow for a greater degree of exploration of situ-

43

ational awareness.

A multi-disciplinary group of faculty at OHSU has developed in situ simulation techniques to train a diverse set of learners. Emergency Medicine residents are exposed to an in situ curriculum set in the Emergency Department (ED) that often begins with EMS arrival.

Residents in Pediatrics use simulation training in the delivery suites and hospital wards. An in situ curriculum for rural EMTs utilizing wireless simulators allows scenarios to occur along a continuum from extrication to hospital arrival; both the health care providers and health system are evaluated in such scenarios.

By using their own equipment in their own environment, in situ simulation offers participants a higher level of fidelity and improved opportunities for situational awareness training. Our learners have indicated a high degree of satisfaction with this training experience. This workshop will share our experiences developing and implementing in situ simulation curricula including tips, tricks, and lessons learned.

At the conclusion of this session participant should be able to: 1. Appreciate the utility of in situ simulation as an alternative to simulation center based learning. 2. Appreciate the role of situational awareness in teaching CRM via in situ high fidelity simulation.

PAPER PRESENTATIONS Cardiac Arrest (8:00 – 9:00 am) 524 Increased Chest Compression Fraction is Associated with Increased Return of Spontaneous Circulation in Non-Ventricular Fibrillation Out-of-Hospital Cardiac Arrest Victims, Christian Vaillancourt, MD, Department of Emergency Medicine, Univ. of Ottawa 525 A Statewide Network of Cardiac Arrest Centers Significantly Improves Outcomes from Out of Hospital Cardiac Arrest, Brian Geyer, SHARE program, AZ Dept. of Health Services 526 A Geospatial Assessment Of Transport Distance And Survival To Discharge In Out Of Hospital Cardiac Arrest Patients: Implications For Resuscitation Centers, Michael T. Cudnik, MD, The Ohio State University Medical Center 527 Cardiocerebral Resuscitation (CCR) Improves Survival from Out-of-Hospital Cardiac Arrest in the Elderly, Jarrod Mosier, MD, University of Arizona Post-Cardiac Arrest (9:00 – 10:00 am) 528 Therapeutic Hypothermia Following Cardiac Arrest: An Analysis of Protocolized Care on Therapeutic End Points, Mary Whitney, MD, Indiana University 529 Outcome Measures Utilized in Clinical Trials of Interventions for Post-Cardiac Arrest Syndrome: A Systematic Review, Stephen Trzeciak, MD, UMDNJ- RWJMS at Camden 530 The Association between Exposure to Hyperoxia and Mortality after Resuscitation from Cardiac Arrest, J. Hope Kilgannon, MD, UMDNJ/RWJMS at Camden 531 Coronary Artery Disease is Prevalent in Post-Arrest Patients Without Acute ST- elevation Myocardial Infarction, Deborah Vinton, Beth Israel Deaconess Medical Center Geriatrics (8:00 – 9:00 am) 532 Delirium in the Emergency Department is Associated with Six Month Mortality, Jin Ho Han, MD, Vanderbilt University Medical Center 533 The Optimum Period For Assessing Mortality Outcomes In Injured Elders, Ross J. Fleischman, MD, Oregon Health and Science University

Sunday, May 17, 2009

534 Detrimental Effects Of Boarding On Elder Patients, Sandra Schneider, MD, University of Rochester 535 Elderly Patients with Potentially Inappropriate Medications in the Emergency Department, Kou-Wei Chiu, MD, Vanderbilt University Research Consent (9:00 – 10:00 am) 536 Community Attitudes About Research Without Consent, Michelle Biros, MD, University of Minnesota 537 Community VOICES: Developing Educational Modules to Improve Community Consultation for Emergency Research Conducted with an Exception from Informed Consent, Lynne D. Richardson, MD, Mount Sinai School of Medicine 538 Is the Enrollment of Racial and Ethnic Minorities in Research in the Emergency Setting Equitable? Jeremy Sugarman, MD, Johns Hopkins 539 The effect of race and sex on the decision to decline research participation in the Emergency Department, Christopher Lindsell, PhD, University of Cincinnati POSTER PRESENTATIONS (10:00 am – 12:00 noon) Toxicology 540 Duration Of Observation Predictors In Pediatric Overdose, Matthew Hansen, MD, Oregon Health Sciences University 541 High-Dose Insulin Treatment Recommendations by United States Poison Centers, Carson Harris, MD, Regions Hospital 542 Incidence of Methemoglobinemia From Intentional Motor Vehicle Exhaust Exposure, Richard Shih, MD, Morristown Memorial Hospital 543 Is Dental Pain a Risk Factor for Accidental Overdose (OD) of Acetaminophen (APAP)?, Jody Vogel, MD, Denver Health Medical Center 544 The Impact of Fire-Related Air Pollution on ED Admissions, Josef Thundiyil, MD, Orlando Regional Medical Center 545 Coral Snake Bites in the United States: 2000-2007, Dominic Lucia, MD, Scott and White Hospital 546 Recombinant Protein Antidotes for the Treatment of Succinylcholine Apnea and Organophosphate Poisoning, Brian Geyer, Arizona State University 547 The Efficacy Of Nebulized Naloxone In Comparison To Intravenous And Intranasal Formulations, Rachel Haroz, MD, UMDNJ-RWJMS at Camden 548 Is Treatment of Severely Afflicted Pediatric Carbon Monoxide Patients Standardized?, Neeraja Kairam, MD, Morristown Memorial Hospital 549 Impact Of Methamphetamine Use On Emergency Department Recidivism, Deborah Diercks, MD, University of California, Davis Medical Center 550 Two Doses Of Octreotide Is An Effective Treatment For Sulfonylurea-Induced Hypoglycemia, Charles Fasano, DO, Albert Einstein Medical Center 551 Quantitative Insulin, C-peptide and Drug Levels For The Diagnosis of Sulfonylurea-Induced Hypoglycemia, Charles Fasano, DO, Albert Einstein Medical Center 552 Effect of a Conducted Electrical Weapon Exposure on a Methamphetamine Intoxicated Animal Model, Jon Cole, MD, Hennepin County Medical Center

553 Changes in the frequency and lethality of multiple-agent toxic exposure over time, Matthew T. O’Neill, MD, New York Presbyterian Emergency Medicine Residency 554 Apnea from Acute Dichlorvos Poisoning does not involve the Cerebral Hemispheres, Romolo Gaspari, MD, University of Massachusetts 555 A Meta-analysis Of Animal Studies Using Benzodiazepines To Prevent Death From Cocaine Toxicity, Nathan R Cleveland, MD, Denver Health Residency in Emergency Medicine 556 A Novel Circumferential Compression Device Delays On set of Systemic Toxicity after Eastern Diamondback Rattlesnake Envenomation to the Torso of an Animal Model., Jason Hack, MD, Brown University 557 Emergency Physician Recognition of Drug-Related Visits to the Emergency Department, Corinne Michèle Hohl, MD, University of British Columbia 558 Effects of Initiating Short-Term Methadone Detoxification on Electrocardiogram QT Interval, Megan Rishel, MD, Drexel University College of Medicine 559 Prevalence Of Prolonged QTc In Methamphetamine Users Presenting With Chest Pain, Deborah Diercks, MD, University of California, Davis Medical Center 560 Are Patients Aware of Angiotensin Converting Enzyme Inhibitor Associated Side Effects?, Anastasia Khoubaeva, Boston Medical Center, Boston University 561 Female Gender And Obesity Associated With Decreased OddsOf Successful Intramuscular Epinephrine, Craig Mangum, MD, Duke University Medical Center 562 The Effect Of Intravenous Fat Emulsions In Nifedipine Tox icity, Kamal Medlej, MD, St. Luke’s-Roosevelt Hospital Center 563 Performance Of The Rad-57TM Pulse Co-oximeter Compared To Standard Lab Blood Carboxyhemoglobin Measurements, Michael Touger, MD, Jacobi Medical Center 564 Adenosinergic Signaling Limits Acute Acetaminophen Toxicity, Steven D Salhanick, MD, Beth Israel Deaconess Medical Center, Boston 565 Fine Particles and Out-of-Hospital Cardiac Arrest in New York City: The Role of Traffic Exposure, Robert Silverman, MD, NYU Nelson Institute of Environmental Medicine 566 Association of Ambient Fine Particles with Out-of-hospital Cardiac Arrests in New York City, Robert Silverman, MD, Department of Emergency Medicine NSLIJ 567 Venomous and Non-Venomous Snakebites in the United States: 2000-2007, Stephen St. Pierre, MD, Scott and White Memorial Hospital Trauma 568 Spatial-temporal relationships between violence and alcohol outlets in Boston, Robert Lipton, PhD, Emergency Medicine Beth Israel/ Harvard Medical Sch 569 Injuries Associated With Law Enforcement Use Of Conducted Electrical Weapons, Matthew Angelidis, MD, Madigan Army Medical Center 570 Utility of the digital rectal exam in diagnosing injury in pediatric trauma patients, Sara Chidester, MD, New York University

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Sunday, May 17, 2009 571 The Effect Of The 2003 EMTALA Update On Trauma Care, Mitesh Rao, MD, Yale School of Medicine 572 Urinalysis in Blunt Trauma Patients; Is It Relevant Today, Julie Gorchynski, MD, JPS Health Systems, UT Southwest, TX 573 Can computed tomography be excluded in low risk blunt abdominal trauma patients?, Christopher Maples, MD, Eastern Virginia Medical School

590 The Variability In Outcomes Of Injured Patients In Level I Trauma Centers: A Statewide Analysis, Michael T. Cudnik, MD, The Ohio State University Medical Center 591 Plain Pelvic Radiographs Versus Abdominopelvic Computed Tomography Scan In Children With Major Trauma, Antonio MuĂąiz, MD, The University of Texas Health science Center at H 592 Injuries while bicycling under influence of alcohol, Peter De Paepe, MD, Emergency Department, Ghent University Hospital

574 Role Of Computed Tomography Angiogram In Identifying Vascular Injuries Sustained In Lower Extremity Gunshot Wounds: A TwoYear Database Review, Ben Moss, MD, University of Louisville

593 Cytokines Predict Organ Failure In Trauma Patients At Presentation, Brian Nelson, MD, Texas Tech University Health Sciences Center

575 Emergency Department Length Of Stay Is Not Associated With Mortality In Trauma Patients, Michael T. Cudnik, MD, The Ohio State University

594 Validation of Length of Hospital Stay as a Surrogate Measure For Injury Severity and Resource Use Among Injury Survivors, Craig Newgard, MD, Oregon Health & Science University

576 Injuries Associated With Law Enforcement Use Of Force, Erik Verzemnieks, University of Washington

Wounds/Burns/Orthopedics

577 Triage Serum Glucose Levels as a Prognostic Indicator of Major Injury, Darrell Sutijono, MD, SUNY-Downstate Medical Center 578 Non-Invasive Hemodynamic Monitoring in the Acute Phase of Trauma Resuscitation, Christian McClung, MD, Keck School of Medicine/USC 579 Overutilization of Medical Evacuation Helicopters for Trauma, Daniel Nelson, MS-IV, University of Medicine and Dentistry of New Jersey Robert Wood Johnson Medical School 580 Prevalence and Physical Examination Findings in Patients with Occult Pneumothoraces, Selene Castrejon, MD, UC Davis School of Medicine 581 Comparison of Direct Laryngoscopy to GlideScope Video Laryngoscopy in Trauma Intubations at an Academic Level 1 Trauma Center, Laura Dolkas, MD, University of Arizona 582 Impact of Cocaethylene formation on outcome of trauma patients, Darrell Sutijono, MD, SUNY Downstate Medical Center/Kings County Hosp.

583 Comparison Of Early And Late Inhibition Of Tnf-Alphain Restoring Chondroprotection By Lubricin In The Acl Transection Injury Model, Gregory Jay, MD, Rhode Island Hospital 584 Physiologically-Focused Pediatric Trauma Activation Criteria Improve Resource Utilization and Safely Reduce Overtriage, Kaushik Mukherjee, MD, Vanderbilt University Medical Center 585 Emergent Reversal of Anticoagulation and Platelet Dysfunction in Patients with Traumatic Intracranial Hemorrhage, Patrick Carter, MD, University of Michigan/St. Joseph Mercy Hospital 586 The Association Between Levels Of A Novel Serum Biomarker And Severity Of Injury In Patients With Mild And Moderate Traumatic Brain Injury, Linda Papa, MD, Orlando Regional Medical Center 587 Trauma Morbidity And Mortality: The Impact Of An Emergency Medicine Residency, Nicholas Bown, MD, CHRISTUS Spohn Hospital Corpus Christi- Memorial 588 Identification of Predictors of Acute Renal Insufficiency In Trauma Patients., Judy Morris, MD, Hopital du Sacre-Coeur de Montreal 589 Preliminary Evidence for a Direct Effect of Low Volume Hypertonic Saline Resuscitation on Clot Structure and Function During Hemorrhagic Shock., Nathan White, MD, Virginia Commonwealth University (VCURES)

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595 Patterns of Use of Topical Skin Adhesives (TSA) in the ED, Adam Singer, MD, Stony Brook University 596 Hypoxia Induced Effects in Co-Culture of Cutaneous Keratinocytes and Fibroblasts, Giovanni Bonomo, Stony Brook University 597 Superior Performance Of A Novel Non-Adherent Hemostatic Wound Dressing In A Prospective, Randomized Controlled Standardized Human Model of Cutaneous Hemorrhage, Bruce A. Cairns, MD, University of North Carolina-Chapel Hill 598 Emergency Department Burn Resuscitation: Opportunities For Improvement, Marc Burdick, DO, University of Nevada School of Medicine 599 Activated Chlorine Dioxide Solution Can Be Used As A Biocompatible Antiseptic Wound Irrigant, Jonathan Valente, MD, Brown University / Rhode Island Hospital 600 Human Adult Dermal Fibroblasts Die by Necrosis in Response to High Levels of Oxidative Stress, Adam Singer, MD, Stony Brook University 601 The Effects of Diabetes on the Healing of Excisional Wounds in a Porcine Model, Breena Taira, MD, Stony Brook University 602 Does Time of Admission Influence Outcomes in Burn Patients?

Breena Taira, MD, Stony Brook University 603 Healing of Partial Thickness Burns in a Diabetic Porcine Model, Breena Taira, MD, Stony Brook University Administration/Health Care Policy 604 Impact Of Physician Variability On Emergency Department Patient Flow Part I: Measurement Of Physician Variability, Emily L. Hirsh, MD, Emory University 605 Increasing CT Scan Utilization Rates in an Academic Urban Hospital, Jarone Lee, MD, St. Luke’s Roosevelt Hospital Center 606 The Effect of a Novel Restructuring the Pediatric Emergency Department, Amir Ahmad Syed, MD, Hospital For Sick Children, Toronto 607 Neurosurgical Availability:Neurosurgical Availability: An Analysis Of Requests For Transfer To a Tertiary Care Facility, Timothy Bullard, MD, Orlando Regional Medical Center 608 A web-based standardized, prospective, epidemiologic study of medical emergencies in India: An analysis of the one year pilot phase of Project EMcounter, David Anthony, MD, NewYork-Presbyterian

Sunday, May 17, 2009

Hospital 609 The Changing Profile of Patients Who Used Emergency Department Services in the US: 1996-2005, Brian Nelson, MD, Texas Tech University Health Sciences Center 610 Nurse Administered Propofol for Procedural Sedation in Emergency Departments in the State of Oregon, Denise Langley, RN, Oregon Health and Science University 611 Participation Rates and Emergency Medicine Provider Perceptions of an Error Reporting System With User-Centered Design, Rollin Fairbanks, MD, University of Rochester 612 The Effect of the 2003 EMTALA Rule Change on the Cost of Emergency Care, Esther Choo, MD, Oregon Health & Science University 613 Access to appointments in the District of Columbia based on insurance status, Lara Oyedele, MD, George Washington University 614 A Lean Based Triage Redesign Process Improves Patient Satisfaction in the Emergency Department, Jaime L. Massucci, MD, Christiana Care Health System 615 Impact of Scribes on Performance Indicators in the Emergency Department, Danielle Salovich, BS, UMDNJ-Robert Wood Johnson Medical School 616 Implications of the Consensus SCCM/ACP Definition for Sepsison Proposed Time-based Performance Measures, Arjun Venkatesh, MD, Harvard Affiliated Emerg. Med. Residency-BWH/MGH 617 Malpractice Claims Against Emergency Physicians In Colorado: 2002-2007, Todd Guth, MD, Denver Health Hospital 618 Factors Associated with Community Clinic Follow-up from an ED Internet-based Referral System, Edward Castillo, PhD, UCSD 619 Medical Tourism Revisited-Describing the Frequency and Types of Health Services Received by Patients who Receive Care Across the Border, Michael Menchine, MD, UCI 620 Health Care Disparities: Language and Likelihood Left without Being Seen, Cameron Crandall, MD, University of New Mexico 621 Evaluation Of Hospital Wide Capacity Alert Message On Emergency Department And Hospital Wide Capacity Variables, Samir Haydar, MD, Maine Medical Center 622 Correlation between Emergency Department and Final Discharge Diagnosis of Pneumonia is Poor Despite Use of the “Diagnostic Uncertainty”Documentation, Rishi Sikka, MD, Advocate Christ Medical Center 623 The Shortage Of On-Call Coverage: Understanding The Issue, Mitesh Rao, MD, Yale School of Medicine 624 Differences in Age Distribution May Explain The Majority Of The Discrepancy In Hospital Admission Rates Between Insured And Uninsured Emergency Department Patients, David Griffen, Southern Illinois University School of Medicine 625 Implementation and Evaluation of an Asynchronous Physician Sign-out for ED Admissions, Thom Meredith, MD, Yale Section of Emergency Medicine 626 Financial Implications For Facilities Receiving Higher Level Of Care Transfers, Omar Amr, MD, University of California, Irvine 627 The Effects of a New Psychiatric Institute on Emergency Department Patient Flow, Hessam Afshari, Pennsylvania State University College of Medicine 628 Data From The Emergency Department Observation Unit Bench-

mark Alliance (EDOBA): Characteristics Of High Volume Teaching Hospital Observation Units., John Paul Lemos, MD, Emory University 629 Do age, race, gender, or payor category predict whether discharged Emergency Department patients receive and keep clinic appointments?, Steven H. Saef, MD, Medical University of South Carolina 630 Reviewers Tend To DisagreeOn The Presence Of Errors, Adverse Events And Opportunities For Improvement In72-hour Return Visits To The Emergency Department, Philip Anderson, MD, Beth Israel Deaconess Medical Center 631 The Utilization Of CT Scans In The Emergency Department Based On Physician Experience, Jonathan Kirschner, MD, St. Luke’s Roosevelt Hospital Center 632 Comparing Experiences and Impressions of Routine Health Services Received Abroad With Routine Health Services Received Inside The United States, Michael Menchine, MD, UCI 633 Clinically Significant Changes in Nausea as Measured on a Validated Visual Analog Scale, Barbie Stahlman, MS, York Hospital 634 What Happens to Patients that Leave Without Treatment From Two Busy San Francisco Emergency Departments?, Steven Polevoi, MD, University of California, San Francisco 635 Automated Dispensing Cabinet Alert Improves Compliance With Obtaining Blood Cultures Prior To Antibiotic Administration For Patients Admitted With Pneumonia, Rishi Sikka, MD, Advocate Christ Medical Center 636 Patients With Medicaid Or No Insurance Wait Longer For Emergency Department Care: Findings From The National Hospital Ambulatory Medical Care Survey, Lisa Schweigler, MD, University of Michigan 637 National Trends in Emergency Department Waiting Times for Patients with Sepsis from 1997 to 2006, Ellen Sano, DO, MA, Stony Brook University Health Sciences Center 638 Emergency Department Use by Patients with Asthma or Upper Respiratory Tract Infection After Health Care Reform in Massachusetts, Peter Smulowitz, MD, Beth Israel Deaconess Medical Center 639 The Effect Of Bedside Presentations On Patient Satisfaction In The Emergency Department, Craig Schranz, MD, Naval Medical Center San Diego 640 Patient Satisfaction In The Diagnostic Evaluation By ED Physicians: A Vicious Cycle?, Chris Spewock, University of Pennsylvania 641 The Economic Impact of Recidivism Among Emergency Department Patients Who Abuse Substances, Sundip Patel, MD, UMDNJRobert Wood Johnson - Camden 642 One-Day Hospital Admissions From The ED In Medicare Patients: Unnecessary Admission Or Premature Discharge? Jillian Mongelluzzo, MD, University of Pennsylvania 643 The Effect of Admitting Team Resident Turnover on Emergency Department Patient Flow, Theodore Chan, MD, University of California, San Diego 644 A Comprehensive Approach to Achieving Near 100% Compliance with Joint Commission Core Measures for Pneumonia (PN5c), Mustapha Saheed, MD, Johns Hopkins 645 Discrepancies In Reporting And Payment In The CMS EM PQRI Program In An Academic Medical Center, Abhi Mehrotra, MD, University of North Carolina Dept of Emergency Medince

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Sunday, May 17, 2009 646 Are There Order Surges During Discreet Shift Change Intervals?, Naomi Marks, MD, Alameda County Medical Center - Highland 647 Effects of Manipulating Sleep: Life Enhancement for Emergency Physicians (EMSLEEP), Anne M Daul, MD, Carolinas Medical Center 648 Intervention to Improve Accuracy of Treating Physician Identification for CMS Pneumonia Core Measures, Michael J. Ward, MD, University of Cincinnati 649 Counting Emergency Department Time Toward Hospital Length of Stay, Michelle Macy, MD, University of Michigan 650 Use of Separate Venipunctures for IV Access and Laboratory Studies Decreases Hemolysis Rates and OVerall ED Length of Stay, Shannon Straszewski, MD, Beth Israel Deaconess Medical Center 651 Many Emergency Health Care Workers Do Not Verify Patient Identity Prior to Performing Common Tasks, Philip Henneman, MD, Tufts-Baystate Medical Center 652 Do ED Patients Who Return Satisfaction Surveys Adequately Represent All Discharged ED Patients? Jeffrey Nielson, MD, Summa Health System /NEOUCOMP 653 Financial Review Of A Medical Scribe Program To Improve Emergency Medicine Resident Documentation At An Academic Medical Center: 15 Months After Implementation, Courtney Terry, University of Virginia 654 Eliminating Amylase from the Evaluation of Pancreatitis in the Emergency Department, Kathryn Volz, MD, Beth Israel Deaconess Medical Center 655 Disparities in Triage Assessment: Differences in Triage Acuity Scores Result in Longer Waits for African-Americans, Chet Schrader, MD, Washington University School of Medicine 656 Physician Assistant Productivity in the Emergency Department, Alexandra Chomut, Albany Medical College Decision Rules 657 The REST Study: Rectal Exams Should Be Terminated Prior To Initiating Anticoagulation in the Emergency Department, Joon Choi, MD, Maimonides Medical Center 658 National Survey of Neurologists Regarding the Need and Sensitivity for a Clinical Decision Rule to Predict High Risk TIA Patients, Jeffrey J Perry, MD, Department of Emergency Medicine, Univ. of Ottawa 659 Identifying Emergency Department Patients At Risk Of Clinical Deterioration And ICU Transfer, Maura Kennedy, MD, Beth Israel Deaconess Medical Center 660 Does a Low CURB-65 Score Predict an Uncomplicated Hospital Course for Emergency Department Community-Acquired Pneumonia Patients?, Michelle Law, DO, York Hospital 661 Strong-Ion Gap Compared to Anion Gap in Critically Ill Patients, Leah Bright, DO, SUNY-Downstate Medical Center Psychiatry/Social Issues 662 The Health Literacy of Adults Presenting to an Urban County Emergency Department, Travis Olives, PhD, Hennepin County Medical Center 663 Emergency Department Resource Utilization By Methadone And Heroin Overdose Patients, Brigitte M. Baumann, MD, UMDNJ-

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RWJMS at Camden 664 Epidemiology, Risk Factors, And Outcomes For Patients Who Present To The Emergency Department With Mental Health Concerns: A 6-year Review, Frank Scheuermeyer, MD, St Paul’s Hospital 665 Racial Bias May Increase During Emergency Medicine Residency Training, Andrew Nelson, MD, Advocate Christ Medical Center 666 Effect of maternal mental health on children’s emergency department utilization, William Fernandez, MD, Boston University 667 Are Sexual Assault Victims Presenting To The ED In A Timely Manner?, Lucy Willis, MD, St.Luke’s-Roosevelt Hospital Center 668 Suicidal Behavior Among Older Adults Seeking Non-psy chiatric Emergency Care, Thomas Richardson, PhD, University of Rochester 669 Adolescent Suicide Risk Screening in the Emergency Department, Cheryl King, PhD, University of Michigan 670 Longtitudinal Analysis of the Minnesota Homeless Survey Data: 1991-2006, Bjorn Westgard, MD, Hennepin County Medical Center 671 Does A Brief Intervention Reduce Repeat Visits To The Emergency Department For Suicide Attempts?: A Randomized Controlled Trial, Annette Beautrais, PhD, University of Otago, Christchurch, New Zealand 672 Alcohol Related ED Visits Associated With Collegiate Football Games, Janice Shook, The Ohio State University MODERATED POSTERS (10:30 – 11:30 am) Preventive Care in the ED 673 Computerized Screening And Brief Intervention For Teens AtRisk For Violence, Rebecca Cunningham, MD, University of Michigan 674 As a Brief Intervention, A Computer Based Simulation of Intimate Partner Violence Perpetration Improves Knowledge, Attitudes and Practice Better Than Instruction Alone, Kenlyn Hobley, MD, University of New Mexico 675 The Impact Of Hospital Policies And Services On The Diagnosis Of Intimate Partner Violence In The Emergency Department, Esther K. Choo, MD, Oregon Health & Science University 676 Clean Your Bell: A Quick Method Of Decontaminating Your Stethoscope Of Methicillin Resistant Staphylococcus Aureus (MRSA), Catherine G. Stanescu, MD, UMDNJ-Robert Wood Johnson Medical School 677 A Pilot Study: Predicting Retaliatory Intent And Examining Victimization At The University Hospital Of The West Indies, Khalilah Bullock, MBBS, University Hospital of the West Indies, Mona 678 Smoking Cessation in the Two Weeks after an ED Visit: Testing a New Health Behavior Model, Edwin Boudreaux, PhD, UMDNJRobert Wood Johnson Medical School at Camden Triage 679 Physician in Triage Improves Patient Treatment Times Over Nurse-Initiated Protocols For All Acuity Levels, Nathaniel Schlicher, MD, Wright State University 680 Effect of a Triage Doctor on Length of Stay (LOS) in a Crowded Urban Emergency Department (ED), Peter Crane, MD, University of Rochester

Sunday, May 17, 2009 681 When is a Physician in Triage a Financially Viable Option? Jeff Gerton, MD, University of Maryland SOM-Dept Emerg Medicine 682 Resident Triage - Impact on Patient Satisfaction, Jason Porter, MD, Orlando Regional Medical Center 683 Racial and Ethnic Disparities in Emergency Department Triage, Michael E. Nottidge, MD, Johns Hopkins School of Medicine 684 Multivariate Analysis Demonstrates Persistent Disparities in Triage Assessment, Chet Schrader, MD, Washington University School of Medicine

Late Breaker Abstracts Abdominal CT Limited to the Region of Tenderness Can Accurately Detect Acute Pathology While Substantially Reducing Radiation Exposure: a Prospective Double-Blinded Study Joshua Broder, MD, Erik Paulson, MD, Caroline Hollingsworth, MD, Jennifer Meyer, MD, Duke University Medical Center Background: CT scan is increasingly used for emergency department (ED) patients with abdominal tenderness, occurring in 8% of adult visits. CT-related radiation is implicated in 2% of US cancers. A method to reduce radiation exposure from abdominal CT would improve patient safety. Objectives: Research hypothesis: in the ED patient with nontraumatic abdominal tenderness, the tender region accurately delineates acute pathology. CT restricted to the tender region could be performed, preserving test sensitivity while reducing radiation dose.

Methods: Prospective double-blinded observational trial. The study was approved by the institutional IRB and was registered with ClinicalTrials.gov. Informed consent was obtained prior to subject enrollment.

Convenience sample of ED patients undergoing CT for non-traumatic abdominal tenderness was recruited. Physicians marked the cephalad-caudad extent of the tender abdominal region using skin markers prior to standard abdominal CT. Study personnel blinded to pathology location recorded skin marker positions. Radiologists blinded to the tender region recorded the cephalad and caudad limits of pathology on CT. Sensitivity of the tender region for detecting acute pathology was calculated with 95% confidence intervals. Hypothetical reduction in radiation exposure resulting from a restricted CT was determined.

Results: 102 subjects were enrolled. 93 subjects had complete data for analysis. CT limited to the region of tenderness could have reduced radiation exposure by 69% (95%CI 60-78%) with 96% (95%CI 87-99%) sensitivity. CT beginning at the cephalad marker and scanning the remainder of the caudad abdomen and pelvis would have 98% (95%CI 90-100%) sensitivity and would reduce radiation exposures by 38% (95%CI 29-48%). Conclusions: CT targeted to the region of abdominal tenderness would have high sensitivity for acute pathology while substantially reducing radiation exposure. A larger prospective study is required to confirm these findings.

An Interdisciplinary Initiative to Reduce Radiation Exposure in Children: Evaluation of Appendicitis in the ED: Clinical Assessment supported by a Staged US and CT Protocol Naresh Ramarajan, MD, Rajesh Krishnamoorthi, MD, Peji Ghanouni, MD, Bernard Dannenburg, MD, Beverley Newman, MD, Richard Barth, MD, Ewen Wang, MD, Stanford University Objectives: In the ED a significant proportion of pediatric radiation exposure occurs dueto CT scans performed for the diagnosis of appendicitis5. Children are at increased risk or developing cancer in response to radiation and therefore it is desirable to utilize CT only when appropriate. Ultrasonographic (US) reduces radiation exposure however, the sensitivity of US alone is inferior to CT. We describe an interdisciplinary initiative to use a staged US and CT protocol to preserve diagnostic accuracy while minimizing radiation exposure. Methods: This was a retrospective outcomes analysis of children presenting after-hours for suspected appendicitis at our academic ED over six years. The

protocol established US as the initial imaging modality. Follow up CT was recommended if US was equivocal. Clinical and pathological outcomes were correlated with US and/or CT reads to assess for missed appendicitis, negative appendectomy and potential CT scans avoided. For patients with equivocal US and no follow-up CT, ED diagnosis and disposition, pathology and return visits were recorded.

Results: 680 patients met our study criteria. 407 (60%) patients followed the protocol. 106 (26%) had a positive US for appendicitis; 94 children (23%) had a negative US. These 200/407 (49%) children were managed definitively without CT. 207 children had equivocal US with follow up CT. 144 patients went to the OR; 10 (7 %) patients had negative appendectomies. One case of appendicitis was missed (<0.5%). The sensitivity, specificity, negative predictive value and positive predictive value of our staged US-CT protocol was 98%, 91%, 99% and 85% respectively. 228/680 children had an equivocal ultrasound with no follow-up CT. Of these children 10 (4%) went to the OR with 1 negative appendectomy. 218 children were observed clinically. Conclusions: Use of US as the first imaging modality significantly reduced radiation exposure without missing appendicitis.

Furthermore, when US is equivocal, clinical judgement obviated the need for CT in one third of study patients with no known cases of missed appendicitis. A staged ultrasound and CT protocol to diagnose appendicitis has the potential to yield significant public health benefits without compromising diagnostic accuracy.

Assessment of Trauma/Emergency Care in Public and Private Sectors in Districts of Sindh, Pakistan Junaid Razzak, MD, Uzma Rahim Khan, MD, Muhammad Baqir, MD, Danesh Kumar, MD, Muazzam Nasrullah, MD, Aga Khan University Objective: To identify gaps in the trauma/emergency system in 4 districts of Pakistan. Methods: In this cross sectional survey; a convenience sample of 2 urban and 2 rural districts was selected. These four districts have population of about 5 million. We used stratified random sampling for all public health facilities except for teaching hospitals and decided to take all 3 teaching hospitals due to their importance. Since there was no listing of private health facilities available, we selected a convenience sample of three largest private hospitals in each district. The questionnaires were created with input from guidelines for essential trauma care by WHO. Results: Overall 105 health facilities selected for survey that included different levels of care. The mean number of physicians was 1(SD 0.7) with mean patient influx of 1694(960) in a month in 67 Basic Health Units; similarly, 4(3) physicians with monthly patient influx of 2530(1293) in 14 Rural Health Centers, 19 (25) physicians with 8611(3428) patients in a month in 12 District/taluka or teaching hospitals and 4 (3) physicians with patient visits of 1494(1506) per month in 12 private health facilities. We found 12(11%) designated emergency rooms (ERs) in these health facilities. There were 14(13%) facilities with on call general surgeons and 8(7.6%) facilities with trauma course trained doctors. Private transport was most commonly 63(60%) used for transferring a patient to a health care facility. Dehydration and Diarrhea were most common emergencies for adults 99(29%) and children 99(32%). Road traffic injuries 77(27%) was most common trauma among adults. Oxygen supply/cylinder was available in 67(64%) facilities; but 16(24%) were nonfunctional and was not kept in 1(8%) out of 12 designated ERs. There were 20(19%) facilities with ECG machine but it was unavailable in 6(50%) out of 12 ERs. Essential equipments like blood pressure cuff and thermometer were unavailable in 4(4%) and 3(3%) facilities respectively. Sterile dressing was available in 51(49%) facilities. Epinephrine, Acetylsalicylic acid and tetanus toxoid were available in 41(39%), 59 (56%) and 53(50%) facilities respectively. Laboratory facility for type and cross/group match for transfusion was available in 16(15%) health facilities. Conclusions: Many shortcomings were observed in health facilities with unavailability of essential types of equipment, and this could lead to possible delays in emergency situations.

Characteristics of Frequent Geriatric Users of the Emergency Department Lucille Torres, MD, Ula Hwang, MD, Samuel Yang, MD, Linda DeCherrie, MD, Katherine Ornstein, MPH, Theresa Soriano, MD, Ania Wajnberg, MD,Mount Sinai School of Medicine, Johns Hopkins

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University

Hospital Emergency Medicine Residency

Background: It is projected that ED utilization by older adults will increase in the next two decades, contributing to ED crowding. Older patients are at risk of decreased health-related quality of life after an ED visit. Objective: To determine factors associated with frequent ED utilization by older adults. Methods: This is a prospective telephone survey of older adults with ≥4 visits to an urban, academic, tertiary care ED from 12/07-5/08. Inclusion criteria are ≥65 years of age, non-nursing home resident, English/Spanish speaking, and having a working telephone. All patients are screened for cognitive impairment and if positive, a surrogate is identified to complete the survey. Data gathered include demographics, living situation and support systems, insurance status, self reported health and functional status, and access to primary care providers (PCPs).

Results: Thus far, 207 older adults meet inclusion criteria: 29% have been interviewed, 17% refused, and 49% are to be contacted. Of the 59 interviewed, 68% are female, 47% have Medicare/Medicaid, 36% have education ≤8th grade, 44% live alone. Participants report a history of chronic pain (59%), congestive heart failure (47%), stroke (34%), heart attack (39%), and dementia (24%). The majority (92%) report having a PCP; 41% of these report having seen their PCP ≥10 times in the last year; 36% contacted their PCP before a visit to the ED. Of those who did not contact their PCP, 32 % report it was due to problems accessing their PCP (e.g. at night, did not have number), while 35% report it was an emergency (e.g. no time to wait, called 911). Conclusion: Preliminary results indicate factors associated with frequent ED use are multifaceted. Our initial results are contrary to previous studies that suggest frequent ED users may lack access to primary care. Future studies may include surveying geriatric infrequent ED users and having focus group studies to better understand reasons why geriatric patients use the ED.

Objectives: Use of tamsulosin for stone expulsion has not previously been reported in a placebo-controlled double-blind study. The objective of this study was to compare the efficacy of tamsulosin versus placebo on time to stone expulsion and pain relief in emergency department (ED) patients with symptomatic ureterolithiasis(UL). Methods: This was a two-arm, prospective, randomized, double blind, placebo controlled IRB-approved clinical trial of adult ED patients diagnosed by abdominal/pelvic CT scan with ureterolithiasis of less than or equal to 10mm. Patients were randomized to either placebo or tamsulosin for a maximum of 10 days. Treatment groups remain blinded pending study completion. Patients reported their pain on a 1-10 Likert pain scale and the time of stone expulsion. Results: 53 participants were enrolled and randomized between tamsulosin (n=28) and placebo (n=25) treatment groups. Medians for time to pain relief (described by a pain score of 0 or 1) by the end of the 10-day study period were compared using a Mann-Whitney U test.

40 participants reported pain relief with a median time of 3.0 days (IQR 3). The tamsulosin group had 21 participants report pain relief with a median time of 4.0 days (IQR 4.5), and the placebo group had 19 participants report pain relief with a median time of 3.0 days (IQR 2.0). When comparing the medians, no significance difference between the tamsulosin and placebo groups was found (p=0.138).

An independent two-sample t-test was used to compare the means of time to stone passage in both groups. Of the 53 patients enrolled, 24 participants were able to see and report stone expulsion with a mean time of 3.0 days (95% CI 2.4 to 3.6). In the tamsulosin group, 12 participants reported stone expulsion at mean time of 3.6 days (95% CI 2.7 to 4.5). In the placebo group, 12 participants reported stone expulsion at mean time of 2.4 days (95%CI 1.7 to 3.1). There was a significant difference between groups (p=0.036). Conclusion: There are no significant differences between tamsulosin and placebo when comparing time to pain relief. However, tamsulosin prolonged the time to stone expulsion when compared to placebo.

Does Mechanism of Injury Predict Trauma Center Need?

E. Brooke Lerner, PhD, Manish N. Shah, MD, Jeremy Cushman, MD, Robert Swor, DO, Karen Brasel, MD, Clare Guse, MD, Alan Blatt, MD, Gregory Jurkovich, MD, Medical College of Wisconsin, University of Rochester, CUBRC, Harborview Medical Center Objective: To determine the predictive value of the Mechanism of Injury (MOI) step of the American College of Surgeon’s Field Triage Decision Scheme for determining trauma center need. Methods: EMS providers caring for injured adult patients transported to the regional trauma center in 3 midsized communities were interviewed upon ED arrival over two years. Included was any injured patient, regardless of injury severity. The interview collected patient physiologic condition, apparent anatomic injury, and MOI. Using the 1999 Scheme, patients who met the physiologic or anatomic steps were excluded. Patients were considered to need a trauma center if they had non-orthopedic surgery within 24 hours, ICU admission, or died. Data were analyzed by calculating positive likelihood ratios (+LR) and 95% confidence intervals (CI) for each MOI criteria. Results: 11,870 patients were enrolled. Of those, 333 were excluded because outcome data were not available and 2,320 were excluded because they met the other steps of the Scheme. Of the remaining, 2,333 met one of the MOI criteria and 471 needed a trauma center. Criteria with a +LR >5 were death of another occupant in the same vehicle (7.2; CI:2.9-17.8), fall >20 ft.(5.2; CI:2.4-11.1), and motor vehicle crash (MVC) extrication >20 min.(5.2; CI:3.2-8.4). Criteria with a +LR between 2 and <5 were intrusion >12 in.(4.1; CI:2.9-5.8), ejection(3.5; CI:1.4-8.7), and deformity >20 in.(2.4; CI:1.8-3.1). The criteria with a +LR <2 were MVC speed >40mph(1.9; CI:1.6-2.3), motorcycle crash >20mph(1.2; CI:1.0-1.4), pedestrian/ bicyclist struck >5mph(1.2; CI:1.0-1.5), bicyclist/pedestrian thrown or run over(1.2; CI:0.9-1.6), rider separated from motorcycle(1.0; CI:0.91.1), and MVC rollover(1.0; CI:0.7-1.5). Conclusion: Death of another occupant, fall distance, and extrication time were good predictors of trauma center need when a patient does not meet the anatomic or physiologic conditions. Intrusion, ejection, and vehicle deformity were moderate predictors.

Effect of Tamsulosin on Stone Expulsion and Pain Resolution in ED Patients with Ureterolithiasis Priscilla Shogan, DO, Jonathan Walker, DO, Marc Pollack, MD, York

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Immediate Impact of Paper to Paperless Documentation on Productivity of Physicians in a Pediatric Emergency Department Waseem Muhammad, MD, Orlando Perales, MD, Joan McInerney, MD, Mark Leber, MD, Lincoln Medical & Mental Health Center Background: The use of Relative Value Units (RVU) is considered an important tool to assess physicians’ productivity. It is a value assigned to each CPT code based on the amount of physician work, practice expense and malpractice expense involved in that code. After the implementation of electronic documentation system in the pediatric emergency department, we noted a decrease in RVUs. Loss of funds is not acceptable to any administration. There has been increasing financial pressure on emergency physicians to optimize clinical productivity. We conducted this retrospective study to determine the immediate effect of implementing an electronic medical record system on physicians’ productivity in our Pediatric Emergency Department (PED). Objective: To determine the immediate effect of implementing an electronic documentation system on physicians’ productivity in the pediatric emergency department. Methods: This is a retrospective review of productivity of physicians one year before and after the implementation of an electronic documentation system. Data was collected on pre-electronic documentation performed by eight full time attending physicians in the PED for the period of October 2006 to September 2007, and on post-electronic documentation by the same physicians for the period of October 2007 to September 2008 The total RVUs and the total volume seen by each physician were obtained. RVUs per patient were standardized for each physician using the corresponding volume measurement. A paired-T-test was performed. Results: There was a drop of 26.3% RVUs 26.3%(95%CI 6.0%-46.7%; P=. 018) and 26.0% drop of volume measurements (95%CI ‫־‬.4.6%-56.5%; P=. 09) respectively. Standardized RVUs per patient did not change (P=. 547). Conclusion: Electronic documentation was associated with a decline in total RVUs and total volume.

The RVUs per patient did not change.

Multi-Center Randomized Controlled Trial of Lactate Clearance Versus Central Venous Oxygen Saturation as the Endpoint of

Early Sepsis Resuscitation Alan E. Jones, MD, Nathan I. Shapiro, MD, Stephen Trzeciak, MD, Ryan C. Arnold, MD, Jeffrey A. Kline, MD, Carolinas Medical Center Background: Goal-directed therapy for severe sepsis and septic shock has been reported to reduce mortality when applied in the emergency department (ED). We tested the hypothesis of non-inferiority between lactate clearance and central venous oxygen saturation (ScvO2) as the endpoint of early sepsis resuscitation. Methods: We performed a multicenter randomized, non-inferiority, clinical trial at 3 urban EDs. Inclusion criteria: suspected infection, 2 or more systemic inflammatory response criteria, and either systolic blood pressure <90 mmHg after a fluid bolus or lactate >4 mM. Exclusion criteria: age <18 years, pregnancy, primary diagnosis other than sepsis, no aggressive care desired, CPR prior to enrollment, or need for immediate surgery. Subjects were randomly assigned to one of two groups. Each group received goal-directed therapy in the ED targeting 3 physiological variables: Group 1 - central venous pressure (CVP), mean arterial pressure (MAP) and ScvO2; or Group 2 - CVP, MAP and lactate clearance. The study protocol was continued until all endpoints were achieved or a maximum of 6 hours.

Clinicians who subsequently assumed the care of the patients in the ICU were blinded to the treatment assignment. The primary outcome was in-hospital mortality. The two one sided test was used to evaluate for equivalence of the difference in mortality rates between patients in each group. Intention-to-treat analysis was used and a sample size of 300 was estimated to detect a mortality difference between the groups using 90% confidence intervals and a delta of 10%. Results: 300 subjects were enrolled with an overall in-hospital mortality rate of 19%. In the ScvO2 group 34/150 (23%) had the primary outcome of in-hospital mortality compared with 23/150 (15%) in the Lactate Clearance group.

The 90% confidence interval for the difference between the groups of 8% was 0 to 14%, confirms the primary hypothesis of non-inferiority.

Conclusion: This large randomized trial provides evidence that the use lactate clearance as the final endpoint of early sepsis resuscitation is non-inferior to ScvO2. Lactate clearance can be substituted for ScvO2 in sepsis resuscitation protocols.

dyspnea, < 33% respirophasic IVC variation predicts congestive heart failure (CHF) as the primary cause of dyspnea. Methods: We conducted a prospective observational study at an urban ED with 93,000 annual visits. We enrolled a convenience sample of patients ≥ 55 years with acute dyspnea. Patients were excluded for trauma, portal hypertension, recent abdominal surgery, or mechanical ventilation. After obtaining informed consent and prior to therapeutic interventions, investigators performed sonographic, subxiphoid measurements of the longitudinal IVC in M-mode averaged over 3 respiratory cycles. All treating physicians were blinded to these results. The primary outcomes were the diagnosis of acute CHF or a euvolemic cause of acute dyspnea. Analyses included descriptive statistics and Satterthwaite tests with 95% confidence intervals. Results: 57 patients were enrolled with a mean age of 70±10 years. 49% had a history of CHF and 82% had hypertension. IVC measurements took an average of 4.1±2.7 minutes to complete. The mean respirophasic IVC variation of patients diagnosed with CHF was 26% (95% CI 19-33%) vs. 56% (95% CI 45-67%) in patients diagnosed with a euvolemic cause of dyspnea (p<0.001). The mean expiratory IVC diameter of patients with CHF was 2.1 cm (95% CI 1.9-2.3 cm) vs. 1.5 cm (95% CI 1.3-1.7 cm) for patients without CHF (p<0.001). Respirophasic IVC variation of < 33% was 76% (95% CI 57-99%) sensitive and 79% (95% CI 59-92%) specific for the diagnosis of CHF. Conclusion: In patients with acute dyspnea, < 33% respirophasic IVC variation has moderate correlation with the diagnosis of CHF. Pupillary Response To Light Is Preserved In Patients Undergoing Pharmacologic Neuromuscular Blockade For Rapid Sequence Intubation Steven Andescavage, MD, Dave Caro, MD, Jay Williams, MD, Mohsen Akhlaghi, MD, Colleen Kalynych, MD, University of Florida - Jacksonville

Background: Understanding the epidemiologic spread of methicillinresistant Staphylococcus aureus (MRSA) is an important aspect in limiting the pathogen’s prevalence in a community. As emergency medical service (EMS) personnel are potential portals of infection both into and out of the hospital, knowledge of their MRSA colonization status may have implications on limiting the further spread of this organism.

The prevalence of nasal MRSA colonization in EMS providers is not documented in the current literature. Objectives: We seek to determine the prevalence of MRSA nasal colonization among EMS providers in our community. Methods: We conducted a prospective cohort study on a convenience sample of EMS providers from the City of Norfolk Fire Rescue (single tiered combined Fire/EMS agency; 499 EMS providers; 18,450 annual transports; in Norfolk, Virginia (pop. 234,403).

Participants completed a questionnaire and had nasal culturing. Cultures were grown on Spectra MRSA medium. Data collection took place from April 15, 2008 to December 2, 2008. Results: Of 136 EMS providers enrolled, one (0.7%) tested positive for MRSA colonization.

Conclusion: The prevalence of MRSA nasal colonization among EMS providers in our urban EMS system was exceedingly low.

Background: Neuromuscular blockers are commonly used in the Emergency Department for intubation of critically ill patients via rapid sequence induction (RSI). Neuromuscular blockers work specifically at nicotinic acetylcholine receptors at the neuromuscular endplate of striated muscle. Ciliary muscle activation and pupillary constriction is mediated by muscarinic receptors and therefore neuromuscular blockers should not affect the pupillary response to light. The loss of pupillary response to light is often used for critical clinical decisionmaking, including intracranial pressure and brain death determination.

Objective: To determine if pupillary response to light is affected by pharmacologic neuromuscular blockade during RSI. Methods: IRBapproved prospective, observational study in an urban level 1 trauma center, with convenience sampling from February 2008 to February 2009. Inclusion criteria were patients >18 years of age whose pupils displayed a brisk reaction (<1 second and >1mm constriction) to light challenge prior to RSI. After RSI, pupil reactivity was reassessed for a brisk reaction. Two physicians independently reviewed pupillary activity pre and post RSI. Results: 96 patients met inclusion criteria. Of these, 92 patients had pupillary activity after RSI, 2 had no response to light, and 2 instances where physicians disagreed on reactivity post RSI. Gross agreement of pupil reactivity of the observers was 98% (CI = 93% - 100%) with an intraclass correlation of 0.90.

A liberal definition of reactivity (at least one physician judges as reactive) yields a proportion remaining reactive of 98% (CI = 93% - 100%) whereas conservative definition (requiring both physicians to agree) yields 96% (CI = 90% - 99%). Conclusions: Neuromuscular blocking agents do not appear to inhibit pupillary reactivity in the vast majority of patients whose pupils are reactive prior to RSI.

Prospective Evaluation of Respirophasic Inferior Vena Cava Variation in the Assessment of Acute Dyspnea Joseph Miller, MD, Seth Strote, MD, AJ Hegg, MD, Dusan Barisic, MD, Adam Schlichting, MD, Sarah Farris, MD, Ajeet Dube, MD, Usamah Mossallam, MD, Henry Ford Hospital

Release of Cricoid Pressure Improves Laryngeal View and Success Rates of Intubation Richard Levitan, MD, Shawn Radford, MD, Gerald O’Malley, MD, Patricia Giraldo, MD, Sorin Cadar, MD, Manisha Verma, MD, Albert Einstein Medical Center

Background: Respirophasic inferior vena cava (IVC) variation can evaluate volume status in hypovolemic and dialysis patients. The utility of these sonographic measurements in patients with undifferentiated, acute dyspnea is undefined. Objectives: We tested the hypothesis that in patients presenting to the Emergency Department (ED) with acute

Background: Cricoid pressure has been advocated as an adjunct to direct laryngoscopy and to prevent aspiration during intubation. Recent studies have called into question the benefit of this practice.

Objectives: To determine the effect of cricoid pressure on laryngeal view and intubation success rate. Method: IRB approved, random-

Prevalence of Methicillin-Resistant Staphylococcus Aureus Colonization in EMS Providers.

Barry Knapp, MD, Sara Tsuchitani, MD, Nicole Watring, MD, Eastern Virginia Medical School

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ized, controlled prospective study involving all non-trauma related intubations in an urban, academic ED with an annual patient volume of 85,000. Only patients without muscular tone were included (RSI or cardiac arrest). Patients with laryngeal masses, angioedema, preexisting tracheostomy, and bowel obstruction were excluded. A standardized airway algorithm was employed. Second year emergency medicine residents were designated as the primary laryngoscopist. If no PGY2 was available a senior resident or attending performed intubation. All operators received standardized training. Intubations were randomized to an initial intervention of cricoid or no cricoid pressure.

With each laryngoscopy, the percentage of glottic opening (POGO), a validated scoring system was reported in real time by the operator, and recorded by a research assistant who witnessed the intubation, along with success or failure of intubation. A POGO score of 0% = no view of the glottic opening; POGO 100% = complete view of the glottic opening. Cricoid pressure was released in patients who had an unsuccessful intubation with cricoid pressure. The effect of release of cricoid pressure on POGO score and intubation success was compared using the same operator during the same laryngoscopy. Results: CP was released in 31out of 99 intubations. Using a paired sample t-test the mean POGO scores improved by a difference of 20.3% (95% CI 3.18-37.45) with release of cricoid pressure. 11/31 got intubated after cricoid pressure was released. Conclusion: Release of cricoid pressure improved laryngeal view and intubation success rates.

Single Breath Counting For Evaluation Of Pediatric Asthma: Development Of A Normogram Uroos Raza, MD, Kristy Putnam, MPh, Lawrence Kass, MD, Penn State Hershey Medical Center Background: Peak Expiratory Flow Rate (PEFR) is the conventional measurement of asthma severity, but is difficult to perform in children.

Our previous work has demonstrated that a novel technique, Single Breath Counting (SBC) correlates well with standard measures of pulmonary function in children. However, no normal reference values for SBC exist. Objective: To create a graph of normal values (“normogram”) for SBC in children. Methods: Using a convenience sample study design, healthy children were recruited from the pediatrics and family medicine clinics of the Penn State Hershey Medical Center. The inclusion criteria were 1) age 4-14 yrs, 2) ability to understand and follow instructions, 3) absence of known underlying cardiopulmonary disease, and 4) not previously enrolled in this study. Recorded demographics were age, gender, height and weight. Each child was asked to take a deep breath and count along with a metronome clicking at 2 beats per second in a single breath (SBC). Three such attempts as well as any difficulties in performance were recorded. Highest value (best effort) was used for analysis. Data for males and females were analyzed separately. Correlation coefficients (r) were calculated for SBC with age, height and weight. Stepwise multiple regression analysis with calculation of coefficient of determination (R2) was performed to create a normogram. Results: 69 children were enrolled. 1 was excluded because of inability to count. The remaining 68 were analyzed. 29 (45%) were male. Median age was 11 yrs. In both males and females, SBC correlates with age (r= 0.572, r= 0.722, respectively), weight (r=0.495, R= 0.532), and height (r=0.555, r= 0.707) with p<0.006 for all comparisons. Multiple regression analysis reveals a best linear fit with age as the sole independent variable (R2=0.327 for males, R2=0.521 for females) with p<0.001 for both genders. Conclusions: A normogram for SBC in children has been demonstrated.

This was an essential step before embarking on our next phase…the evaluation of SBC as a tool to measure asthma severity and response to treatment in emergency department patients.

The Effect of the Addition of a PGY-1 Anesthesia Rotation on the Endotracheal Intubation Success in the ED During PGY-2.

Ted R. Clark, MD, MPP, Kevin G Rodgers, MD, Edward J. Brizendine, MS, Indiana University Objectives: The objective of the study is to determine the effect the recent addition of a PGY-1 Anesthesia rotation has had on ETI success during PGY-2. Methods: Design-We conducted a retrospective comparative observational study. Study Group-The study group is made up of PGY-2 residents in the class of 2010, all of which have

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completed a PGY-1 anesthesia rotation (AR). The comparison group is the previous PGY-2 class (class of 2009), which did not have a PGY-1 anesthesia rotation (No-AR). The study period is the first 6 months of each PGY-2 class. Data Collection-An Airway Card is filled out by a faculty member for each ED ETI performed by a resident; data recorded include date, level of training, first- and second-attempt success, rescue devices used, minor and major adverse events, and intubation scenario. Statistical Analysis- A Pearson Chi-square test was used to compare first-attempt success, overall success (<=2 attempts), and adverse events rates between the two groups.

Results: We recorded 116 ETI attempts for the AR group and 145 attempts for the No-AR group. First-attempt success- NoAR Group=83.5% (121/145). AR Group=78.5% (91/116). Percent change=-5% (-14.6%, 4.6%) (p=0.304). Overall success- No-AR Group = 94.5% (137/145); AR Group=95.7% (111/116). Percent change=1.2% (-4.0%, 6.5%) (p=0.656). Adverse Events (Major and Minor)- No-AR Group=24.8% (36/145). AR Group=19.0% (22/116).

Percent change=-5.9% (-15.9%, 4.2%) (p=0.258). Conclusions: The results of our observational study indicate the addition of an anesthesia rotation to the PGY-1 curriculum has not had a significant effect on ETI intubation success in the first 6 months of PGY-2. The results also show no difference in the rate of adverse events between the groups. First-attempt, overall success, and adverse events of our PGY-2 study group were consistent with previously published studies. Limitations include an unknown number of unreported intubations (reporting bias) and small study numbers.

The Shortage of On-Call Coverage: A National Survey of ED Directors Mitesh B. Rao, MD, Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, New Haven, CT; VA Medical Center, West Haven, CT, Catherine Lerro, MD, Yale University School of Public Health, New Haven, CT, Cary Gross, MD, Robert Wood Johnson Clinical Scholars Program, Yale University School of Medicine, New Haven, CT Objective: To report the experiences of a national sample of ED Directors regarding: the degree of difficulty in providing specialist coverage, the impact of coverage shortages on patient care, and current/future approaches to providing on-call coverage. Methods: We conducted a cross-sectional self-administered survey of a national random sample of ED Directors distributed proportionally across all 50 states. 14 multi-level quantitative questions directed at each of our primary and sub-domains constituted the bulk of our instrument.

The instrument was designed and piloted with the help of the Yale University EM Department. A five-wave method of administration was used to maximize response rate. Data was analyzed using SAS 9.1 Statistical Software, with responses compared by hospital (trauma level, ownership) and geographic variables. Results: We received 442 responses (overall response rate of 62%); 72% of our respondents reported having problems with inadequate on-call coverage by specialist physicians. Of teaching hospitals, 66% reported problems with inadequate on-call coverage versus 76% of non-teaching hospitals (p=0.025). Approximately 60% of respondents reported that their institution has lost the ability to provide 24/7 coverage for a specialty in the past four years. Of our respondents, 23% reported that specialist on-call participation had negatively affected their hospital’s trauma level designation, and 22% reported increases in the number of patients leaving their ED after completion of initial evaluation but before being seen by a medically needed specialist during the past year. Regarding transfer rates, 25% of respondents reported increases in the number of transfers to their ED, and 49% reported increases in the number of transfers from their ED over the past year.

Teaching hospitals were more likely to report an increase in incoming transfers (42% vs. 17%, p<0.001), while non-teaching hospitals were more likely to report an increase in outgoing transfers (57% vs.

37%, p<0.001). Conclusions: Shortages in specialty on-call care are a pervasive problem for Emergency Departments at the national level. The effects of these shortages range from loss or suspension of trauma capabilities to increasing numbers of patients leaving before receiving appropriate care. Furthermore, outgoing transfers have increased for non-teaching hospitals (who are more likely to report oncall coverage inadequacies), and incoming transfers have increased

Didactic Speakers Belena Adkins, RN Community Hospice of Northeast Flordia

Susan Fuchs, MD Children's Memorial Hospital

David Levine, MD Cook County Stroger Hospital

Douglas Ander, MD Emory University

Victoria Garrett, MD Carolinas Medical Center

Christopher Lewandowski, MD Henry Ford Hospital

JoDee Anderson, MD Oregon Health and Science University

W. Brian Gibler, MD University of Cincinnati

Roger Lewis, MD, PhD Harbor - UCLA Medical Center

Mark Angelos, MD Ohio State University

Teresa Gibson, PhD Thomas Reuters

Scott Lynch, PhD Princeton University

Felix Ankel, MD Regions Hospital/University of Minnesota

Joshua Goldstein, MD, PhD Partners Healthcare

Ian Martin, MD Duke University

Brent Asplin, MD Mayo Clinic

James Gordon, MD Harvard Mass General

Marcus Martin, MD University of Virginia

Christopher Beach, MD Northwestern, University

Glenn Hamilton, MD Wright State University

John Marx, MD Carolinas Medical Center

Diane Birnbaumer, MD Harbor-UCLA Medical Center

Daniel Handel, MD Oregon Health & Science University

Amal Mattu, MD University of Maryland

Andra Blomkalns, MD University of Cincinnati

Michael Handrigan, MD Emergency Care Coordinators Center

Brian McBeth, MD University of California, San Francisco

Paul Borgman, DO Communicty Hospice of Northeast Florida

Katherine Heilpern, MD Emory University

Mark McIntosh, MD University of Florida Health Science Center

Jose Cabanas, MD University of North Carolina

Phyllis Hendry, MD University of Florida Health Science Center

Chadwick Miller, MD Wake Forest Universtiy

Jeanette Calli Association of American Medical Colleges

Cherri Hobgood, MD University of North Carolina at Chapel Hill

Douglas Miller, MD Indiana University

Joseph Carcillo, MD University of Pittsburg

James Hoekstra, MD Wake Forest University

James Miner, MD Hennepin County Medical Center

Jennifer Casaletto, MD Maricopa Medical Center

Robert Hoffman, MD Beth Israel Medical Center

Alice Mitchell, MD Carolinas Medical Center

Sheila Chauvin, PhD Louisiana State University Health Sciences Center

David Howes, MD University of Chicago Hospitals

James Moak, MD, RDMS University of Cincinnati

Kathleen Clem, MD Loma Linda University Medical Center

Ula Hwang, MD Mount Sinai School of Medicine

John Moorhead, MD Oregon Health and Science University

Robert Cloutier, MD Oregon Health and Science University

J Lee Jenkins, MD Johns Hopkins University

Ryan Mutter, PhD Coordinator Emergency Dept. Research Activities

Sean Collins, MD University of Cincinnati

Alan Jones, MD Carolinas Medical Center

Arun Nagdev, MD University of California, San Francisco

David Cone, MD Yale University School of Medicine

Arthur Kellermann, MD Emory School of Medicine

Susan Nedza, MD, MBA American Medical Association

Drew Dawson National Highway Traffic Safety Administration

Daniel Keyes, MD John Peter Smith Health Network

David Newman, MD McGill University

Peter DeBlieux, MD Louisiana State University Health Sciences Center

Sorabh Khandelwal, MD Ohio State University

Karl Nibbelink, MD Temple University

Jeff Desmond, MD University of Michigan Health System

Terry Kowalenko, MD University of Michigan

Vicki Nobel, MD, Partners HealthCare

Deborah Diercks, MD University of California-Davis

Jon Krohmer, MD Department of Homeland Security

Edward Panacek, MD UC Davis Medical Center

Jonathan Edlow, MD Beth Israel Deaconess Medical Center

Gloria Kuhn, DO, PhD Wayne State University School of Medicine

Arthur Pancioli, MD University of Cincinnati

Todd Ellingson, MD Oregon Health and Science University

Eddy Lang, MD McGill University

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Peter Pang, MD Northwestern University

Didactic Speakers Cont.

Jesse Pines, MD University of Pennsylvania

Richard Schwartz, MD Medical College of Georgia

Ellen Weber, MD University of California - San Francisco

Charles Pollack, MD University of Pennsylvania

Manish Shah, MD University of Rochester

Peter Wyer, MD Columbia University

Susan Promes, MD University of California - San Francisco

Nathan Shapiro, MD Beth Israel Deaconess MC

Lalena Yarris, MD Oregon Health and Science University

Niels Rathlev, MD Boston Beaumont Hospital

Daniel Spaite, MD University of Arizona College of Medicine

John Younger, MD, MS University of Michigan

Jedd Roe, MD William Beaumont Hospital

Michael Stone, MD, RDMS SUNY Downstate

Brian Zink, MD Brown University

Michael Ross, MD Emory University

Alan Storrow, MD Vanderbilt University Medical Center

Frank Zwemer, MD University of Rochester

Richard Rothman, MD, PhD Johns Hopkins University

Steve Trzeciak, MD Cooper University Hospital

Basmah Safdar, MD Yale University

Joel Turner, MD McGill University

Sally Santen, MD Vanderbilt & Emory University

John Vozenilek, MD Northwestern University

Raquel Schears, MD St. Mary's Hospital

Joshua Wallenstein, MD Emory University

Michael Schull, MD Institute for Clinical Evaluative Sciences

Mary Jo Wagner, MD Synergy Medical Edication Alliance

The University of California, Irvine School of Medicine, Department of Emergency Medicine

The University of California, Irvine is recruiting three new full-time faculty members, either in the Health Sciences Clinical Series or Clinical Scholar (Clinical X) Series at the Assistant or Associate Professor level. The HS Clinical Series includes substantial patient care, medical student and resident teaching, and optional clinical research. Candidates for the Clinical Scholar Series will develop an independent research program, and already have or develop a track record in scholarly activity. Board preparation or certification in EM required. Fellowship or advanced degree, or both, strongly desired. Appropriate Rank and Series commensurate with qualifications.

UC Irvine Medical Center is a 472-bed tertiary care hospital with all residencies. The ED is a progressive 35-bed Level I Trauma Center with 38,000 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, UC Irvine Medical Center, Route 128, 101 City Drive, Orange, CA 92868, or at mark.langdorf@uci.edu, or apply online at https://recruit.ap.uci.edu UCI is an equal opportunity employer committed to excellence through diversity.

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Innovations In Emergency Medicine Education Exhibits Presenting on Thursday & Friday, May 14 & 15, 2009 1.A Novel Approach to Teaching Periocardiocentesis, Mara Aloi, MD, Allegheny General Hospital 2. Receiving: The Use of Web 2.0 to Create a Dynamic Learning Forum to Enrich Resident Education Adam J. Rosh, MD, Wayne State University 3. A Model for Ultrasound-Assisted lumbar Puncture Mara Aloi, MD, Allegheny General Hospital

4. "Sim Wars": A New Edge to Academic Residency Competitions Richard Westenbarger,MD, University of Florida â&#x20AC;&#x201C; Jacksonville 5. Use of Simulation Technology in Forensic Medical Education Heather V. Rozzi, MD, York Hospital

6. The Thanksgiving Turkey Tap: A New and Simple Model for Teaching Ultrasound-Guided Thoracentesis Derek Kuhl Richardson, MD, New York-Presbyterian

7. Geriatric Emergency Medicine Educational Module: Abdominal pain in the Older Adult Eve Losman, MD, University of Michigan

8. The Emergency Informatics Transition Course: A Flexible, On-Line Course in Health Informatics for Emergency Medicine Clinicians and Trainees James McClay, MD, University of Nebraska Medical Center

9. The ER of the Future: an Interdisciplinary Graduate Course in Healthcare Design Jeremy Ackerman, MD, PhD, Emory University

10. Teamwork Training for Interdisciplinary Applications Cherri Hobgood, MD, University of North Carolina

Presenting on Saturday & Sunday, May 16 & 17, 2009 11. Skin Abscess Model for Incision and Drainage Myto Duong, MD, Southern Illinois University

12. Model for Ultrasound Assisted Lumbar Puncture Training Jason Nomura, MD, Christiana Care Health System 13. Geriatric Emergency Medicine With Integrated Simulation Curriculum Brian Gillett, MD, State University of New York Downstate 14. An Inexpensive, Easily Constructed, Reusable Task Trainer for Simulating Ultrasound-Guided Pericardiocentesis Herb Zerth, MD, Advocate Christ 15. Multimedia Emergency Bedside Ultrasound Quality Assurance Feedback Stephen Leech, MD, Orlando Regional Medical Center 16. The E.R. Game Kevin Ferguson, MD, University of Florida

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Innovations In Emergency Medicine Education Exhibits Cont.

Presenting on Saturday & Sunday, May 16 & 17, 2009 17. Regional Medicine-Public Health Education Center: Integrating Population Health, Public Pealth, and Prevention into the Residency Curriculum Jonathan Fisher, MPH, Harvard University 18. Basic Emergency Medicine Skills Workshop as the Introduction to the Medical School Clinical Skills Curriculum Jeremy Sperling, MD, New York Presbyterian Hospital / Weill Cornell Medical Center 19. Use of Embalming Machine to Create Central Venous Access Model in Human Cadavers Lee Wilbur, MD, Indiana University 20. Competency Testing Using a Novel Eye Tracking Device Gregory Christiansen, DO, Virginia Commonwealth University

Vice-Chair-Research , Department of Emergency Medicine The Emergency Department of William Beaumont Hospital in Royal Oak, Michigan is seeking an exceptional Academic Emergency physician for a Vice-Chair for Research / Research Director position. The ideal candidate will be board-certified in emergency medicine and have an established record of production in terms of extramural funding and published research. In addition, it is important that the candidate demonstrate an ongoing commitment to medical education and excellence in patient care.

William Beaumont Hospital is a 1,066-bed suburban teaching hospital and Level 1 Trauma Center whose emergency department serves approximately 117,000 patients, with approximately 25,000 pediatric patients annually. The department of emergency medicine will also be a full academic department in the new Oakland University William Beaumont School of Medicine. It is a tertiary referral center for patients with cardiovascular disease, neurologic conditions, and pediatric illness and injury. The department has a well-established emergency medicine residency program, a state of the art emergency center and accredited observation unit, and an active research division.

Competitive salary and benefits are available for qualified candidates.

Interested candidates should submit curriculum vitae and letter of interest to Jedd Roe, MD, MBA, FACEP Chair, Department of Emergency Medicine William Beaumont Hospital 3601 W. 13 Mile Road Royal Oak, Michigan 48073-6769 Phone: (248) 898-1969 Fax: (248) 898-2017 Jedd.Roe@beaumont.edu

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Residency Fair Participants Saturday, May 16, 2009 4:00 - 5:30 pm Advocate Christ Medical Center

Maimonides Medical Center Maine Medical Center

University of Chicago

Newark Beth Israel Medical Center

University of Cincinnati

New York Presbyterian Hospital

University of Kentucky

North Shore University Hospital

University of Massachusetts

Oregon Health & Science University

University of Michigan

Orlando Regional Medical Center

University of Mississippi

Regions Hospital

University of North Carolina

St. Luke’s-Roosevelt

University of Nevada

SUNY Downstate/Kings County Hospital

University of New Mexico

SUNY Upstate Medical University

University of South Florida

Synergy Medical Education Alliance

University of Texas – Houston

Texas A&M/Scott & White Memorial Hospital

West Virginia University

Lehigh Valley Health Network

University of California San Francisco – Fresno

William Beaumont Hospital

Louisiana State University – Shreveport

University of California San Francisco – SFGH

Albany Medical Center Albert Einstein Medical Center (PA) Baystate Medical Center Beth Israel Medical Center Corpus Christi Denver Health Medical Center East Carolina University East Carolina University EM/IM Geisinger Health System Georgetown University Hospital Grand Rapids MERC/MSU Henry Ford Hospital

Wright State University Yale-New Haven Medical Center

University of Arizona

Photography Exhibit and Visual Diagnosis Contest There were 102 cases and photos submitted to the Program Committee for consideration of presentation at the Annual Meeting. Selected photos and cases will be displayed in two formats.

Medical students and residents will be invited to participate in the Visual Diagnosis Contest. Score sheets may be obtained in the exhibit hall next to the photo display. 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 2010 SAEM Annual Meeting in Phoenix, AZ, a major Emergency Medicine textbook, and a subscription to the SAEM Newsletter. Recipients will be announced in the July/August issue of the SAEM Newsletter.

“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 and “take home” points. SAEM is proud to display original photos of educational value and gratefully acknowledges the efforts of the 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 posters and Innovations in Emergency Medicine Exhibits.

Gallane Abraham, MD Steve C. Christos, DO, MS Jillian Corbett, MD Jamie Edelstein, MD Jennifer Jackson, MD Brian Kloss, DO, JD, PA-C John Misdary, MD Ali Osman, MD M.L. Ridderikhof Mark Silverberg, MD Henry Truong, MD Andrew Wong, MD

Maya Arii, MD David Conner, MD Rui Domingues, DC, MD Jessica A Gedraitis , MD Rebecca Jeanmonod, MD Lanny F. Littlejohn, MD Caroline Molins Ananda Pandurangadu, MD Dana Sajed, MD Jessica L. Smith, MD Jody Vogel, MD Phil Wynn, MD

Joshua G. Briscoe, MD Norma L. Cooney, MD Suzanne Dooley-Hash, MD Phil Goebel Starner Jones, MD Anyka McClain, MD Andrew Nyce, MD Nilesh Patel, MD Shellyann Sharpe, MD Edward Tham, MD Jessica Wang, MD

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Moderator & Reviewer Acknowledgement Significant efforts, time, and resources are devoted to reviewing and moderating the many excellent abstracts submitted to SAEM every year. We thank all the reviewers and moderators for their time and efforts for making our annual meeting a success. The continued achievement of these important academic exercises depends on their unrelenting enthusiasm to support with their highest standards.

Gratefully,

Andra L. Blomkalns, MD Chair, Scientific Subcommittee on behalf of Program Committee SAEM Annual Meeting 2009

Moderator List Brent Asplin, MD Steve Godwin, MD Mayo Clinic University of Florida - Jacksonville

Jill Baren, MD Gary Green, MD, MPH MBA University of Pennsylvania NYU Bellevue

Steven Bernstein, MD Jason Haukoos, MD, MSc Yale University Harbor - UCLA Medical Center

Wallace Carter, MD Kennon Heard, MD New York Presbyterian University of Colorado Hospital

Katherine Heilpern, MD David Cone, MD Emory University Yale University

Michael Hochberg, MD Rita Cydulka, MD, MS University of Massachusetts MetroHealth

James Hoekstra, MD Deborah Diercks, MD Wake Forest University University of California - Davis

David Karras, MD Stephen Epstein, MD Temple University Harvard University

Arthur Kellermann, MD, MPH Rollin Fairbanks, MD, MS Emory University University of Rochester Medical Center Roger Lewis, MD, PhD

Harbor - UCLA Medical Center Walter Gibler, MD University of Cincinnati Michael Lyons, MD

University of Cincinnati

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James Miner, MD Hennepin County Medical Center William Mower, MD, PhD UCLA Medical Center Tiffany Osborn, MD University of Virginia William Peacock, MD Cleveland Clinic Lynne Richardson, MD Mount Sinai Medical Center Adam Singer, MD SUNY - Stonybrook Jeffrey Tabas, MD San Francisco General Hospital Vivek Tayal, MD Carolinas Medical Center Don Yealy, MD University of Pittsburgh John Younger, MD MS University of Michigan

Reviewer List Jean Abbott, MD University of Colorado

Ryan Arnold, MD Cooper Health System

Dominik Aronsky, MD, PhD Vanderbilt University

Chandra Aubin, MD Washington University

Joel Bartfield, MD Albany Medical Center

Brigitte Baumann, MD UMDNJ-RWJMS at Camden

Louis Binder, MD MetroHealth Medical Center

Steven Bird, MD University of Massachusetts

Robert Birkhahn, MD New York Methodist Hospital

Michael Blaivas, MD Medical College of Georgia

Michelle Blanda, MD Summa Health System

Andra Blomkalns, MD University of Cincinnati Medical Center

William Brady, MD University of Virginia

Kris Brickman, MD University of Toledo Medical Center

Gerard Brogan, MD North Shore University

Lance Brown, MD, MPH Loma Linda University Medical Center

Christine Butts, MD Louisiana State University

Wallace Carter, MD New York Presbyterian

Francis Counselman, MD Eastern Virginia Medical School

Leon Haley, Jr., MD Emory University

Paul Dargan, MD Guy's and St. Thomas' Poison Units, London

Daniel Handel, MD, MPH Oregon Health and Science University

Matthew Deibel, MD Synergy Medical Education Alliance

Jason Haukoos, MD Denver Health Medical Center

Nicole Deiorio, MD Oregon Health and Science University

E. Parker Hays, Jr., MD Carolinas Medical Center

Valerie DeMaio, MD University of North Carolina

Kennon Heard, MD University of Colorado

Barry Diner, MD Emory University

Jerris Hedges, MD University of Hawaii

Jeffrey Druck, MD University of Colorado

Sean Henderson, MD University of Southern California

Amy Ernst, MD University of New Mexico

Michael Hochberg, MD Albert Einstein College of Medicine

Brian Euerle, MD University of Maryland

Judd Hollander, MD University of Pennsylvania

William Fernandez, MD Boston Medical Center

James Holliman, MD National Naval Medical Center

Susan Fish, MD Boston University

James Holmes, MD University of Califo rnia, Davis

Stephen Freedman, MD, MSc The Hospital for Sick Children

Jeffrey Hom, MD SUNY - Downstate

Susan Fuchs, MD Children's Memorial Hospital

Alexander Isakov, MD Emory University

E. John Gallagher, MD Albert Einstein College of Medicine

Raymond Jackson, MD Wayne State University

Gregory Garra, MD SUNY - Stonybrook

John Jesus, MD Beth Israel Deaconess Medical Center

Alex Garza, MD University of Missouri

Jeff Jones, MD Spectrum Health-Butterworth Campus

Marianne Gausche-Hill, MD Harbor UCLA Medical Center

David Karras, MD Temple University

Paul Gennis, MD Jacobi Medical Center

Anne-Maree Kelly, MD Joseph Epstein Centre for EM

AnnaMarie Chang, MD University of Pennsylvania

Esther Chen, MD University of Pennsylvania

Carey Chisholm, MD Indiana University

Gregory Conners, MD, MPH, MBA University of Rochester

Lowell Gerson, PhD Northeastern Ohio Universities

Sorabh Khandelwal, MD Ohio State University

Maria Glenn, MD Carolinas Medical Center

Jeffrey Kline, MD Carolinas Medical Center

Lewis Goldfrank, MD Bellevue Hospital Center

Terry Kowalenko, MD University of Michigan

William Grant, MD SUNY Upstate Medical University

E. Brooke Lerner, PhD Medical College of Wisconsin

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Reviewer List Cont.

Roger Lewis, MD, PhD Harbor - UCLA Medical Center

Bernard Lopez, MD, MS Thomas Jefferson University

Robert Lowe, MD, MPH Oregon Health and Science University

Steven Lowenstein, MD, MPH University of Colorado Health Sciences Center

Xin Ma, MD, PhD Thomas Jefferson University

Keith Marill, MD Massachusetts General Hospital

Marc Martel, MD Hennepin County Medical Center

Andrew McAfee, MD Harvard Business School

Kenneth McConnell, PhD Oregon Health and Science University

Jason McMullan, MD University of Cincinnati

William Meggs, MD East Carolina University

Larry Melniker, MD, MS New York Methodist Hospital

Glen Michael, MD University of Virginia

Chris Moore, MD Yale University

Lisa Moreno-Walton, MD Louisiana State University

Michael Mullins, MD Washington University

Antonio Muniz, MD University of Texas, Houston

Mark Mycyk, MD Northwestern University

Richard Nowak, MD Henry Ford Hospital

David Seaberg, MD University of Tennessee

Robert O'Connor, MD, MPH University of Virginia

Rawle Seupaul, MD Indiana School of Medicine

James Olson, PhD Wright State University

Nathan Shapiro, MD Beth Israel Deaconess Medical Center

Peter Panagos, MD Rhode Island Hospital

Suzanne Shepherd, MD University of Pennsylvania

Robert Partridge, MD, MPH Rhode Island Hospital

Robert Silbergleit, MD University of Michigan

Megan Ranney, MD Brown University

Adam Singer, MD SUNY - Stonybrook

Timothy Reeder, MD, MPH East Carolina University

Susan Stern, MD University of Michigan

Daniel Rodgers, MD Milton S. Hershey Medical Center

Ian Stiell, MD, MSc The Ottawa Hospital

Kevin Rodgers, MD Indiana University

Arvind Venkat, MD Alleghany General Hospital

Marc Rosenthal, DO, PhD Yale University

Joshua Wallenstein, MD Emory University

Chris Ross, MD Cook County Hospital

John Watts, PhD Carolinas Medical Center

Brian Rowe, MD, MSc University of Alberta

Chris Weaver, MD Indiana University

Michael Runyon, MD Carolinas Medical Center

Steven Weiss, MD University of New Mexico

Philip Salen, MD St. Luke's Hospital

Janet Williams, MD University of Rochester

Art Sanders, MD University of Arizona

Stewart Wright, MD University of Cincinnati

Terri Schmidt, MD Oregon Health and Science University

Donald Yealy, MD University of Pittsburgh

Sandra Schneider, MD University of Rochester

Wesley Zeger, DO University of Nebraska

Michael Schull, MD, MSc Institute for Clinical Evaluative Sciences

Heinz Zimmerman, MD University Hospital of Bern

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Chief Resident Forum Friday, May 15, 2009 8:00 - 5:00 pm Chief residency is a demanding and highly responsible position, however little formal and structure preparation is available prior to becoming a chief resident. New chief residents typically have not had the benefit of training in essential administrative, academic, and leadership skills. This one-day course will include a variety of sessions covering administrative and academic topics relevant to new chief residents. Talks and small group discussions will be led by experienced program directors and past chief residents. All sessions will include ample time for questions. In addition, a lunch session and coffee breaks will provide opportunities for chiefs from different programs to meet and exchange ideas. The small group discussion sessions will also allow for interaction with workshop faculty and former chief residents.

At the conclusion of this session, participants should be able to: 1. Identify basic characteristics of good leadership, management techniques, administration and problem solving concepts. 2. Learn successful scheduling and back-up techniques. 3. Become aware of common pitfalls faced by chief residents. 4. Learn effective communication techniques. 5. Have the opportunity to discuss potential ethical dilemmas that may arise during the chief resident year; and learn time management techniques.

All chief residents registered to attend the Annual Meeting are invited to register for the special Chief Resident Forum. Enrollment is limited and the fee is $175, in addition to the basic Annual Meeting registration fee.

2009 Chief Resident Forum Schedule 7:30-8:00 am Continental Breakfast 8:00-8:10 am Welcome Jeff Druck, MD, University of Colorado

3:00- 4:00 pm Problem Resolution From Former Chief Residents - Panel Discussion of Former Chief Residents 4:00-5:00 pm Networking Time

8:10-9:00 am Leadership Management Role Carey Chisholm, MD, Indiana University This session will discuss how leadership traits and management skills can be learned, developed, and used to maximize your effectiveness as chief resident 9:00-10:00 am Communication as a Key to Leadership Success Jim Adams, MD, Northwestern University Communication is a key element of success in any leadership role.

Participants will be provided with concrete examples of a “communication skill set” that will enable them to improve in their role as intermediary between faculty and residents.

10:00-10:15 am Break 10:15-11 am Work Life Balance Sheryl Heron, MD, Emory University The participant will be able to discuss how other elements of life affect work function and ways to weigh competing interests.

11:00-12:00 pm How to Enter Academic Emergency Medicine Gail D’Onofrio, MD, Yale University 12:00-1:15 pm Lunch with Program Directors 1:15-2:45 pm Solving Problems as Chief- An Interactive Workshop Diane Birnbaumer, MD, UCLA Harborview Susan Promes, MD, UCSF Mary Jo Wagner, MD, Synergy Medical Education Alliance 2:45-3:00 pm Break

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Medical Student Symposium Saturday, May 16, 2009 8:00 - 4:00 pm The Medical Student Symposium is intended to help medical students understand the residency and career options that exist in Emergency Medicine, evaluate residency opportunities, and select the right residency. At the conclusion of the session, participants should be able to: 1. Know the characteristics of good emergency physicians and the “right” reasons to seek a career in this specialty. 2. Have better comprehension of the application process. 3. Consider factors important in determining the appropriate residency, including geographic locations, patient demographics, length of training, etc. 4. Realize the composition of an emergency medicine rotation and what to expect while they are rotating in the ED. 5. Discuss the skills needed to get the most out of the educational experience in the ED rotation. 6. Identify the standard sources of information in the field of emergency medicine 7. Have an appreciation of various career paths available in Emergency Medicine, including academics, private practice, and fellowship training. 8.

Discover current areas of research in Emergency Medicine.

8:00-8:10 am 11:45 am-1:15 pm Lunch with Program Directors Introduction Terry Kowalenko, MD University of Michigan 1:15-1:45 pm 8:10-8:50 am Career Paths and Prospects in Emergency Medicine Is Emergency Medicine the Right Specialty for Me? H. Gene Hern Jr., MD, Highland Hospital Joshua Wallenstein, MD, Emory University This session will expose students to a variety of career paths including private The speaker will discuss the attributes and personality traits of a successful practice, academics, and dual training (EM-IM/EM-PEDS/FP) as well as fellowship Emergency Physician. What should students expect in residency and be- training. The speaker will touch upon elective/career opportunities such as reyond? What are the positives and negatives of the specialty? Students will search, EMS, Wilderness Medicine, Rural EM, International Medicine, among othhave a better idea if Emergency Medicine is the right specialty for them. ers.

8:50-9:30 am Getting the Most of Your Clerkship Gus Garmel, MD, Stanford University/Kaiser Permanente This session will provide students with valuable tips for getting the most from an Emergency Department Clerkship. Specific topics to be discussed will include: 1) appropriate educational goals for an emergency medicine rotation; 2) how to best prepare for your rotation in order to make the most of your ED experience; 3) recommended textbooks and references; and 4) important considerations when and where to do your emergency medicine rotation.

1:45-2:15 pm Assessing Your Competitiveness as an Emergency Medicine Applicant and the Competitiveness of Programs, Chris Ghaemmaghami, MD, University of Virginia This session will help applicants better understand what PD’s are looking for so that they can assess their own competitiveness when applying for EM residency programs. How important are USMLE scores? Do I need to be AOA or have “Honors” on my EM rotations? These and other potential predictors of success as a resident will be discussed. The speaker will also give some insight into how applicants can find out how competitive they are for individual programs. What should you be asking?

9:30-10:00 am How to Select the Right Residency for You Annie Sadosty, MD, Mayo Clinic An overview of EM residency programs will be discussed. Important factors to consider in the selection process including length of training (3 vs. 4 years), geographic location, patient demographics, urban vs. suburban, allopathic vs. osteopathic and academic vs. clinical will be reviewed. How does a candidate gauge the reputation of a program?

2:15-2:30 pm Break

10:00-10:15 am Break 10:15- 10:45 am The Medical Student Performance Evaluation (MSPE) “The Dean Letter” David Seaberg, MD, University of Tennessee The speaker, an Emergency Medicine physician and Dean, will review the components of the MSPE. Medical school deans adapt the MSPE template to prepare your Dean’s letter. What is MSPE? What is the role of the MSPE in the residency process? How can you take a proactive role in your MSPE?

2:30-3:30 pm Small Group Break-Out Sessions •Balancing Act - Charlene Irvin, MD, St. Johns Hospital This session will discuss how to optimize your career and personal life.

•Financial Planning - Dave Overton, MD, Michigan State University - Kalamazoo This session will review practical tips on financial issues for students and residents.

The speaker will address issues such as insurance coverage, loans, college expense planning, goal-setting and retirement.

•Optimizing your 4th Year - Douglas Ander, MD, Emory University This session will provide students with recommendations for making the most of their senior year including information about EM and other electives, research experience, and when to take their Board exams.

•Medical Schools without Residencies - Patricia Lanter, MD, Dartmouth University This Q&A session will help guide medical students from medical schools without EM residencies through the complicated maze that leads to a residency and career in EM. It will specifically address how this process differs from those students with an EM residency at their medical school.

•Osteopathic Students and Programs - Greg Garra, DO, Stony Brook University This session will be geared toward the Osteopathic medical student. The speaker will discuss the differences between Osteopathic and allopathic programs. There will be plenty of time for questions.

10:45-11:15 am Navigating the Residency Application Process Micelle Haydel, MD, Louisiana State University This presentation will provide students with tips on how to prepare their ERAS application. How many letters of recommendation and from whom?

What volunteer and work experience should appear on the application? Tips 3:30-4:00 pm Resident Panel for the Personal Statement and more. The candidate will have a much better This will be a Q & A session for students to ask residents from different programs idea of what a well written application should look like. and levels questions regarding residency and the application process.

11:15-11:45am The Interview 4:00-4:15 pm Closing Comments - Terry Kowalenko, MD University of Michigan Jamie Collings, MD, Northwestern University The speaker will explain the importance of the interview. How should a student prepare; what should he/she wear; what are appropriate questions to 4:30-6:30 pm Residency Fair ask programs, etc? What are some questions the candidate should be prepared to answer? What should the candidate do after the interview? How do you follow up with your top programs? Students should have a better idea of how to prepare and what to expect at an interview.

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Call for Didactic Proposals - 2010 Annual Meeting June 3-6, 2010 • Phoenix, AZ

The Program Committee is inviting proposals for didactic sessions for the 2010 Annual Meeting. 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 or teaching 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 topics that have important implications for further investigation or the future practice of emergency medicine; note that State-of-the-Art sessions are not a review of the literature or a summary of clinical practice) Health Care Policy and National Affairs affecting emergency medicine

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.

Call for Abstracts - 2010 Annual Meeting June 3-6, 2010 • Phoenix, AZ

The Program Committee is accepting abstracts for review for oral and poster presentation at the 2010 SAEM Annual Meeting. Authors are invited to submit original emergency medicine research in the following categories: • • • • • • • • • • • • •

abdominal/gastrointestinal/genitourinary pathology administrative/health care policy airway/anesthesia/analgesia CPR cardiovascular (non-CPR) clinical decision guidelines computer technologies diagnostic technologies/radiology disaster medicine disease/injury prevention education/professional development EMS/out-of-hospital Ethics

• • • • • • • • • • • • •

geriatrics infectious disease ischemia/reperfusion neurology obstetrics/gynecology pediatrics psychiatry/social issues research design/methodology/statistics respiratory/ENT disorders shock/critical care toxicology/environmental injury trauma wounds/burns/orthopedics

Abstracts detailing innovations in emergency medicine exhibits (IEME) are also being requested. 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 2010. 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 2010 SAEM Annual Meeting. Original abstracts presented at regional meetings in April or May 2010 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.

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Call for Proposals 2011 AEM Consensus Conference Deadline: April 15, 2010

The editors of Academic Emergency Medicine are accepting proposals for the 2011 AEM Consensus Conference, which will be held on May 31, 2011, the day before the SAEM Annual Meeting, in Boston.

Proposals must advance a topic relevant to emergency medicine that is conducive to the development of a research agenda and be spearheaded by thought leaders from within the specialty of emergency medicine. The goals of the AEM consensus conferences are to heighten awareness related to the topic, discuss the current state of knowledge about the topic, identify knowledge gaps, propose needed research, and issue a call to action to allow future progress.

Previous topics have included errors in emergency medicine, the unraveling safety net, quality/best practices in emergency care, information technology in emergency medicine, disparities in emergency care, emergency research without informed consent, the science of surge, and knowledge translation.

Developed proposals will be reviewed on a competitive basis by the AEM Editorial Board. The topic chosen for the 2011 AEM Consensus Conference will be announced at the SAEM Business Meeting during the 2010 Annual Meeting in Phoenix. Proceedings of the meeting and original contributions related to the topic will be published exclusively by AEM in its Special Topic Issue in November 2011.

Submitters are strongly advised to review the Special Topic issues of previous AEM Consensus Conferences (see November issues of AEM) to guide the development of their proposals. Proposals must include the following: 1. Introduction of the topic

• brief statement of relevance

• justification for this topic choice 2. Proposed conference chairs and sponsoring groups (i.e., SAEM interest groups, committees) 3. Proposed conference agenda and proposed presenters

• Plenary lectures

• Panels

• Breakout topics and questions for discussion

• Anticipated audience

• Stakeholder groups/organizations

• Federal regulators

• National researchers and educators

• Others 4. Anticipated budget 5. Potential funding sources and strategies for securing conference funding Proposals must be submitted electronically to the AEM office at aem@saem.org no later than April 15, 2010 at 5:00 PM Eastern Time.

Future SAEM Annual Meetings June 3-6, 2010, Phoenix, AZ June 1-5, 2011, Boston, MA May 9-13, 2012, Chicago, IL 63

19th Annual SAEM Midwest Regional Meeting Meeting Announcement & Call for Abstracts Monday, September 21, 2009 Michigan League Ann Arbor, Michigan

The Department of Emergency Medicine at University of Michigan is pleased to announce that abstracts are now being accepted for the 2009 SAEM Midwest Regional Meeting.

The meeting location is the Michigan League, 911 N. University Avenue, Ann Arbor, MI. The deadline for abstract submission is FRIDAY, August 21, 2009 at 5:00 p.m. Eastern Standard Time. Only electronic submissions via the SAEM online abstract submission form at www.saem.org will be accepted.

Acceptance notifications will be sent by email.

Questions concerning the meeting can be directed to the Program Chair, John G. Younger, MD, MS at jyounger@umich.edu.

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UCI OCME requires that the content of the CME activities and related materials provide balance, independence, objectivity, and scientific rigor. Planning must be free of the influence or control of a commercial entity, and promote improvements or quality in healthcare. It is the policy of the UCI Office of Continuing Medical Education to insure balance, independence, objectivity, and scientific rigor in all its educational activities. All faculty participatin in UCI OCME sponsored CME programs are expected to disclose to the activity participants any real or apparent conflict(s) of interest that may have a direct bearing on the subject matter of the continuing education activity. This pertains to relationships with parmaceutical companies, biomedical device manufacturers, or other corporations whose products or services are related to the course content. The intent of this policy is identifying potential conflicts of interest so participants can form their own judgements with full disclosure of the facts. It remains for the participants to determine whether the speaker’s outside interest reflect a possible bias in either the exposition or the conclusions presented.

The views and opinions expressed in this activity are those of the faculty and do not necessarily reflect the views of the UCI or SAEM. The following speakers have

relevant financial relationships to disclose within abstracts: John

Bealer

Justin

Benoit

Michael T.

Cudnik

Brittany

Copeland

Mohamud

MD

AspenBio Pharma, Inc.

Aspen Bio Pharma, Inc.

Case Western Reserve University School of Medicine

Cheetah Medical, Inc.

MD

The Ohio State University Medical Center

American Heart Assn

BS

Emory University

UCB Pharma

Daya

MD

Oregon Health & Science University

Philips Medical Systems

Deborah

Diercks

MD

University of California, Davis Medical Center

Heartscape

Michael

Gisondi

MD

Northwestern University

The EPEC-EM Project

James

Hoekstra

MD

Wake Forest University Health Sciences

Heartscape

Caitlin

Hicks

Cleveland Clinic Lerner College of Medicine

Cheetah Medical, Inc., Cleveland Clinic Fdn

Judd

Hollander

MD

University of Pennsylvania

Biosite, Inc., Inverness

Jeffrey

Kline

MD

Carolinas Medical Center

CP Diagnostics, US Patents

Phillip

Levy

MD, MPH

Wayne State University

BCBS of MI Fdn, RWJ Fdn Physician Scholars Program, Cardiodynamics, Inc,

Jennifer

Marin

MD

Children's Hospital of Philadelphia

Sonosite, Inc. Mt. Sinai Skills and Simulation Ctr

BioSite, Inc. Thomas P.

Noeller

MD

CWRU/MetroHealth

Richard

Nowak

MD

Henry Ford Health System

Brahms, Germany

John

Nagurney

MD

Masachusetts General Hospital

Biosite, Inc.

Brian

O'Neil

MD

Wayne State University

Brainscope, Inc.

Linda

Papa

MD

Orlando Regional Medical Center

Banyan Biomarkers, Inc.

Peter

Pang

MD

Northwestern University Feinberg School of Medicin

Astellas, Bayer, Otsuka , Nile, PDL BioPharma, PeriCor Therapeutics,

Frank

Peacock

MD

The Cleveland Clinic

Abbott, BAS, Beckman-Coulter, Biosite, Brahms, Heartscape, Inovise,

Paul

Tran

MD

University of Nebraska Medical Center

Pfizer, Merck

Jonathan

Valente

MD

Brown University/Rhode Island Hospital

Frontier Pharmaceutical

David

Wright

MD

Emory University

Zenda Technologies

Anthony

Weekes

MD

Carolinas Medical Center

Philips US

Solvay Pharmaceuticals Inverness, Ortho Clinical Diagnostics, EKR, The Medicines Co., Vital Sensors

The following speakers have no relevant financial relationships to disclose within abstracts: Colleen Kathleen Opeolu Srikar Marc Hessam Minal Omar Douglas S. Kenton Philip Steven Matthew Annitha David Christopher Sanjay Anna JC Andrew Kim Fiona Benoit Roger Theodore Adam Elizabeth Tyler Fermin Robert Brigitte M. Francesca Annette Vikhyat Tomer Angela M. Fernanda Justin Tony Marian Jason Polly E. Steven Robert Michelle Matthew Giovanni Dominic Jesse Edwin Vincent Nicholas William William Ethan Jeremy Daniel Michael Beau Alan

Acosta Adelgais Adeoye Adhikari Afilalo Afshari Amin Amr Ander Anderson Anderson Andescavage Angelidis Annathurai Anthony Aquina Arora Arroyo Asimos Askew Azubiuke Bailey Band Bania Barouh Barrall Barrett Barrueto Bassett Baumann Beaudoin Beautrais Bebarta Begaz Bell Bellolio Benoit Berger Betz Biggs Bijur Bird Birkhahn Biros Bitner Bonomo Borgialli Borke Boudreaux Bounes Bown Bozeman Brady Brandler Branzetti Brennan Breyer Briese

MPH MD MD MD MD MD MD MD MD MD DO MD MD MD MD MD MD MD MD MD MD MD MD MD MD DO MD MD PhD MD MD MD MD, MS MD MD MD PhD MD MD MD MD DO MD PhD MD MD MD MD MD MD MD MD

Stanford University School of Medicine University of Utah University of Cincinnati University of Nebraska Medical Center SMBD-Jewish General Hospital Pennsylvania State University College of Medicine Inova Fairfax Hospital University of California, Irvine Emory University Duke University School of Medicine Beth Israel Deaconess Medical Center University of Florida-Jacksonville Madigan Army Medical Center Emory University Hospital NewYork-Presbyterian Hospital Robert Wood Johnson Medical School UCSF Stanford University School of Medicine Carolinas Medical Center Wake Forest University School of Medicine Miami Hospital CHU Sainte-Justine Hospital of The University of Pennsylvania St. Luke's-Roosevelt/Columbia University St. Christopher's Hospital for Children UMDNJ-RWJMS at Camden Vanderbilt University Medical Center University of Maryland SOM-Dept Emerg Medicine Indiana University School of Medicine UMDNJ-RWJMS at Camden Brown University/ Rhode Island Hospital University of Otago, Christchurch, New Zealand Wilford Hall Medical Center Medical College of Wisconsin University of New Mexico Mayo Clinic Case Western Reserve University School of Medicine Jacobi Medical Center Beth Israel Deaconess Medical Center University of Pittsburgh Albert Einstein College of Medicine University of Massachusetts New York Methodist Hospital University of Minnesota Emory University School of Medicine Stony Brook University Univ of Mich and Hurley Medical Center New York Presbyterian Hospital UMDNJ-Robert Wood Johnson Medical School at Camden SAMU 31, University Hospital of Toulouse CHRISTUS Spohn Hospital Wake Forest University Emergency Medicine University of Virignia SUNY-Downstate Medical Center Northwestern Feinberg School of Medicine Orlando Health Christiana Care Health System Stanford University School of Medicine

Joshua Jessica Jeremy Jeremy Timothy Khalilah Colleen Marc John Richard Michael Bruce A. Carlos Juliana Jennifer Christopher Patrick Sarah Tara David Edward Selene Theodore Andrew Anna Marie Laura Sandrine Maureen Pia Jean-Marc Kuan-Fu Sara Mikaela Robert Kou-Wei Joon Alexandra Esther K. Chi Carol Ted Catherine Nathan R Jason A. Jon Mark Scott David Amy D. Mark Peter Megan Michael T. Rebecca Michael Jason Chad Joshua

Broder Brooks Brown Brywczynski Bullard Bullock Buono Burdick Burton Byyny Cabezon Cairns Camargo, Jr. Capatosto Carnell Carpenter Carter Casado Cassidy-Smith Castillo Castillo Castrejon Chan Chang Chang Chapman Charpentier Chase Chatterjee Chauny Chen Chidester Chilstrom Chin Chiu Choi Chomut Choo Chun-Lin Clark Clark Clement Cleveland Cohen Cole Collin Compton Cone Conroy Courtney Crane Crider Cudnik Cunningham Dailey D'Amore Darling Broder

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MD MD MD MD MD MBBS MD DO MD MD MD MD MD MD MD MD MD MD MD DO PhD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD RN MD MD PhD MD MD MD MD MD MD MD MD MD MD MD

Duke University Medical Center Denver Health Medical Center The George Washington University Dept of Emergency Vanderbilt University Medical Center Orlando Regional Medical Center University Hospital of the West Indies, Mona UCSD University of Nevada School of Medicine Albany Medical Center Denver Health Medical Center New York Methodist Hospital University of North Carolina-Chapel Hill Massachusetts General Hospital New York Methodist Hospital Alameda County Medical Center, Highland Hospital Washington University in St. Louis University of Michigan/St. Joseph Mercy Hospital St John hospital and Medical Center UMDNJ-RWJMS at Camden Morristown Memorial Residency in Emergency Medicin UCSD UC Davis School of Medicine University of California, San Diego Montefiore Medical Center University of Pennsylvania Rhode Island Hospital, Alpert Medical School Purpan University Hospital Beth Israel Deaconess Medical Center University of Pennsylvania Hopital Sacré-Coeur Université de Montréal Johns Hopkins University New York University Albert Einstein College of Medicine Jacobi Med Ctr & Albert Einstein College of Med Vanderbilt University Maimonides Medical Center Albany Medical College Oregon Health & Science University Taoyuan General Hospital, Taiwan William Beaumont Hospital Indiana University Dept of Emergency Medicine Department of Emergency Medicine, Univ. of Ottawa Denver Health Residency in Emergency Medicine Mount Sinai School of Medicine Hennepin County Medical Center University of Pennsylvania Wayne State University Yale University Denver Health Medical Center Northwestern University Unviersity of Rochester Orlando Regional Medical Center The Ohio State University Medical Center University of Michigan Albany Medical College North Shore University Hospital University of Massachusetts School of Medicine Duke University Medical Center

The following speakers have no relevant financial relationships to disclose within abstracts cont.:

Jessica Jeremy Jeremy Timothy Khalilah Colleen Marc John Richard Michael Bruce A. Carlos Juliana Jennifer Christopher Patrick Sarah Tara David Edward Selene Theodore Andrew Anna Marie Laura Sandrine Maureen Pia Jean-Marc Kuan-Fu Sara Mikaela Robert Kou-Wei Joon Alexandra Esther K. Chi Carol Ted Catherine Nathan R Jason A. Jon Mark Scott David Amy D. Mark Peter Megan Michael T. Rebecca Michael Jason Chad Anne M John

Brooks Brown Brywczynski Bullard Bullock Buono Burdick Burton Byyny Cabezon Cairns Camargo, Jr. Capatosto Carnell Carpenter Carter Casado Cassidy-Smith Castillo Castillo Castrejon Chan Chang Chang Chapman Charpentier Chase Chatterjee Chauny Chen Chidester Chilstrom Chin Chiu Choi Chomut Choo Chun-Lin Clark Clark Clement Cleveland Cohen Cole Collin Compton Cone Conroy Courtney Crane Crider Cudnik Cunningham Dailey D'Amore Darling Daul Davis

Sanjey Todd Jason Christine Rachel Jin Ho Matthew Rachel Carson Scott William Jason Samir Kennon Andrew A.J. Kimberly Philip H. Gene Andrew Erik Caitlin Brian Chandler Peter Emily Cherri Amanda Brian Corinne Michèle James Renee Yu-Hsiang Nadia Calvin Mary Aloysius Fredric Ula Charlene Ajit Loretta Gregory Dietrich Alan Clay Sarah Christopher Neeraja Bryan Beth Maura Andrew Anastasia J. Hope James Mira Cheryl

Gupta Guth Hack Hall Hampton Han Hansen Haroz Harris Harris Hauda Haukoos Haydar Heard Herring Hegg Heller Henneman Hern Herring Hess Hicks Hiestand Hill Hill Hirsh Hobgood Hoehler Hohertz Hohl Holmes Hsia Hsieh Huancahuari Huang Hughes Humbert Hustey Hwang Irvin Itty Jackson-Williams Jay Jehle Jones Josephy Jump Kabrhel Kairam Kane Kaplan Kennedy Kepner Khoubaeva Kilgannon Killeen Kinariwala King

MD MD MD MD MBBS MD DO MD MD MD MD MD MD MD MD MD MD MD DO PhD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD RN MD MD PhD MD MD MD MD MD MD MD MD MD MD MD DO

MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD PhD MD MD DO MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD PhD

Denver Health Medical Center The George Washington University Dept of Emergency Vanderbilt University Medical Center Orlando Regional Medical Center University Hospital of the West Indies, Mona UCSD University of Nevada School of Medicine Albany Medical Center Denver Health Medical Center New York Methodist Hospital University of North Carolina-Chapel Hill Massachusetts General Hospital New York Methodist Hospital Alameda County Medical Center, Highland Hospital Washington University in St. Louis University of Michigan/St. Joseph Mercy Hospital St John hospital and Medical Center UMDNJ-RWJMS at Camden Morristown Memorial Residency in Emergency Medicin UCSD UC Davis School of Medicine University of California, San Diego Montefiore Medical Center University of Pennsylvania Rhode Island Hospital, Alpert Medical School Purpan University Hospital Beth Israel Deaconess Medical Center University of Pennsylvania Hopital Sacré-Coeur Université de Montréal Johns Hopkins University New York University Albert Einstein College of Medicine Jacobi Med Ctr & Albert Einstein College of Med Vanderbilt University Maimonides Medical Center Albany Medical College Oregon Health & Science University Taoyuan General Hospital, Taiwan William Beaumont Hospital Indiana University Dept of Emergency Medicine Department of Emergency Medicine, Univ. of Ottawa Denver Health Residency in Emergency Medicine Mount Sinai School of Medicine Hennepin County Medical Center University of Pennsylvania Wayne State University Yale University Denver Health Medical Center Northwestern University Unviersity of Rochester Orlando Regional Medical Center The Ohio State University Medical Center University of Michigan Albany Medical College North Shore University Hospital University of Massachusetts School of Medicine Carolinas Medical Center Saint Luke's Hospital

Brian Peter Ken B. Elizabeth Deborah Cinnamon Kelly Brett Kathryn A. Frank Jeff Joshua Amy James Leigh Rollin Jane Heather Charles Christopher Gregory J William Jason M. Megan L Ross J. James Rebecca Cory Catherine Jonathan Paul Zachary Franklin Brian Gelareh Theodore Romolo Sean Robert Rajesh Brian Adit Maria Seth Karolina David Benjamin Tress Eric Julie Eric Jocelyn David Mary Shamai Casey Corita Satheesh

Dawson De Paepe Deitch Delasobera Diercks Dixon Dodge Donegan Dong Dos Santos Druck Eastvold Ernst Espinosa Evans Fairbanks Fansler Farley Fasano Fee Fermann Fernandez Fields Fix Fleischman Fleming Floyed Forbach Forster Fortman Foster Foy Friedman Fuller Gabayan Gaeta Gaspari Geary Gerhardt Geria Geyer Ginde Glenn Glickman Glowacka Goo Goodgame Goodwin Goralnick Gorchynski Grafstein Gravel Griffen Groll Grossman Grover Grudzen Gunaga

New York Hospital Queens Denver Health Hospital Brown University University of Calgary Case Western Reserve School of Medicine Vanderbilt University Medical Center Oregon Health Sciences University UMDNJ-RWJMS at Camden Regions Hospital Thoracic and Cardiovascular Institute Virginia Commonwealth University Denver Health Medical Center Maine Medical Center Rocky Mountain Poison and Drug Center Alameda County Medical Center Henry Ford Health System Hennepin County Medical Center Tufts-Baystate Medical Center Alameda County Medical Center- Highland Alameda County Medical Center Mayo Clinic Cleveland Clinic Lerner College of Medicine The Ohio State University Hennepin County Medical Center Johns Hopkins Medical Institutions Emory University UNC School of Medicine University of Utah University of Arkansas for Medical Sciences University of British Columbia UC Davis School of Medicine University of California, San Francisco Johns Hopkins University Boston Medical Center Harvard Affiliated Emergency Medicine Residency MSU-COM Indiana Universtiy School of Medicine Cleveland Clinic Mount Sinai School of Medicine St. John Hosptial and Medical Center University of Arizona University of Mississippi Rhode Island Hospital, Dept of Emergency Medicine SUNY @ Buffalo Carolinas Medical Center University of Arizona Oregon Health and Science University Massachusetts General Hospital Morristown Memorial Hospital Lehigh Valley Health Network UCSF/San Francisco General Hospital Beth Israel Deaconess Medical Center York Hospital Boston Medical Center, Boston University UMDNJ/RWJMS at Camden UCSD Stony Brook University University of Michigan

Jonathan Ryan William Alicia Joseph Mark Regina Joel Tobias Torrey Michael Sangeeta Denise Taher Michelle Luan Jarone Stephen Christopher H. Julie Benjamin E Brooke Adam Brian Rong Richard Jeffrey Antonios Alexander Brian Christopher Meghan Martha Robert Ingrid Dominic Derrick Catherine John Kate Casey Z. Michelle Jacqueline J Simon Michael Kevin Craig Alex Christopher Juan Michael Peter Naomi Julie Jaime L. Maryann James Christian

Kirschner Knapp Knight Knowles Konwinski Kostic Kovach Kravitz Kummer Laack Lamantia Lamba Langley Lashkeri Law Lawson Lee Leech LeMaster Leonard Leong Lerner Lessler Levine Li Lichenstein Lightfoot Likourezos Limkakeng Lin Lindsell Lindstrom Linker Lipton Llovera Lucia Lung Lynch Lyng Lyren-Sondles MacVane Macy Mahal Mahler Mallin Maloy Mangum Manini Maples March Marchick Mariani Marks Marmon Massucci Mazer McCarthy McClung

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MD MD DO MD MD DO MD MD DO MD MD MD MD MD MD MD MD DO MD MD MD MD MD MD MD MD

DO MD MD MD DO MD MD MD MD MD MD PhD MD MD MD MD MD MD MD MD MD MD DO

MD MD MD MD MD MD MD MD MD MD MD MD RN MD DO MD MD MD MD MD

East Carolina University Emergency Department, Ghent University Hospital Albert Einstein Medical Center Stanford University and Georgetown University University of California, Davis Medical Center Cincinnati Children's Hospital Medical Center Yale University School of Medicine Vanderbilt University University of Alberta Robert Wood Johnson Medical School University of Colorado Denver Advocate Christ Emergency Medicine Program University of New Mexico UMDNJ-SOM, Kennedy Health System, Stratford, NJ Yale University School of Medicine University of Rochester Stanford/Kaiser Emergency Medicine Residency Christiana Care Health System Albert Einstein Medical Center University of California San Francisco University of Cincinnati Boston University University of Pennsylvania Maine Medical Center Oregon Health and Science University University of New Mexico Emory University Univ. of North Carolina at Chapel Hill Columbia University UCSF School of Medicine Beth Israel Medical Center University of Utah Tufts Medical Center Cooper University Hospital West Los Angeles Veterans Affairs Medical Center New York Methodist Hospital University of Massachusetts Albany Medical Center Brooke Army Medical Center / SAUSHEC Emergency Med Robert Wood Johnson Medical School - UMDNJ SHARE program, AZ Dept. of Health Services University of Colorado Denver School of Medicine Carolinas Medical Center University of North Carolina, Chapel Hill McGill University Emory University Christiana Care Health System Stanford University and Georgetown University Yale University CHRISTUS Spohn Memorial,Texas A&M St Paul's Hospital CHU Sainte-Justine Southern Illinois University School of Medicine Northwestern Children's Memorial Hospital Harvard Medical School, Beth Israel Deaconess David Geffen School of Medicine at UCLA Mount Sinai School of Medicine Henry Ford Wyandotte Hospital

St. Luke's Roosevelt Hospital Center Hennepin County Medical Center University of Cincinnati Jacobi Medical Center SUNY Upstate Medical University Medical College of Wisconsin Southern Illinois University School of Medicine Albert Einstein Medical Center Warren Alpert Medical School of Brown University Mayo Clinic Rochester UNC Division of Geriatrics UMDNJ, New Jersey Medical School Oregon Health and Science University Inova Fairfax hospital York Hospital East Carolina University St. Luke's Roosevelt Hospital Center Orlando Regional Medical Center Brigham and Women's Hospital Washington University School of Medicine Virginia Commonwealth University PhD Medical College of Wisconsin MD, MBAUniversity of Pennsylvania MD Christiana Care Health System MD Thomas Jefferson University MD University of Maryland School of Medicine MD Naval Medical Center Portsmouth MA, MPHMaimonides Medical Center MD Duke University MD Stanford University School of Medicine PhD University of Cincinnati MD Maine Medical Center MD University of Pennsylvania School of Medicine PhD Emergency Medicine Beth Israel/Harvard Medical Sch MD North Shore University Hospital MD Scott and White Hospital MD The George Washington University MD Yale University School of Medicine MD SUNY Upstate Medical University MD University of Pennsylvania MD Maine Medical Center MD University of Michigan MD NewYork-Presbyterian Emergency Medicine Residency MD Louisiana State University HSC Shreveport MD University of Utah MD Washington Hospital Center MD Duke University Medical Center MD Mount Sinai School of Medicine MD Eastern Virginia Medical School MD East Carolina University MD Carolinas Medical Center MD SUNY Upstate Medical University MD Alameda County Medical Center - Highland MD University of California, San Diego MD Christiana Care Health System MD University of Pennsylvania MD University of Texas HSC at Houston MD Keck School of Medicine/USC

Brian Jon Bonnie Jason John Sara M. Kamal Dylan Abhi Zachary Edward R. Michael Nicholas Thom Matthew William Jeffrey Glen E Joseph Karen Angela M. David Alice James H. Lisa Judy Vincent Ben John Timothy Kaushik Antonio Karen Anthony Andrei Andrew Brian Daniel Craig Jeffrey Flavia Sean Marlaina Michael E. Christine Adetolu Travis Matthew T. Scott Lara Lorenzo Linda Brent Sundip Julien Frank Eric Jeffrey J

McDonnell McGreevy McGuire Wreschner McMullan McMullan Medendorp Medlej Medley Mehrotra Meisel Melnick Menchine Meo Meredith Messa Meurer Meyers Michael Miller Miller Mills Milzman Mitchell Moak Moreno-Walton Morris Mosesso Moss Mottley Muchnok Mukherjee Mu単iz Murrell Napoli Nazdryn Nelson Nelson Nelson Newgard Nielson Nobay Nordt Norris Nottidge Nypaver Odufuye Olives O'Neill Osborn Oyedele Paladino Papa Passarello Patel Payrastre Peacock Perez Perry

Michael Jeremiah Adam Lisa Eli Wesley Luis A. Usha Amit Kaushal Manish Jason Nathan George Jeffry Rohit Richard Priscilla Hamid Janice Stacy A Jeffrey Rishi Robert Ben Robert Allan C Richard Adam David Arthur Peter Christopher Chris Stephen Barbie Catherine John Susan Ian Shannon Jared Christopher Stephanie Mydili Jeremy Christine Shane Benjamin Pawan Joe Robert Amir Ahmad Jeffrey Breena Michael Kevin Karis

Schull Schuur Schweickert Schweigler Segal Self Serrano Sethuraman Shah Shah Shah Shapiro Shapiro Shaw Shellenberger Shenoi Shih Shogan Shokoohi Shook Shundry Siegelman Sikka Silbergleit Sill Silverman Simpson Sinert Singer Slattery Smolensky Smulowitz Solie Spewock St. Pierre Stahlman Stanescu Stein Stern Stiell Straszewski Strote Strother Stuart Subramaniam Sugarman Sullivan Summers Sun Suri Suyama Swor Syed Tabas Taira Takacs Takakuwa Tekwani

Michael Christopher J. Helen Stephanie Sangeeta Stewart Kiichiro Lalena Daniel Neeraja John Stacie Shu James

Witting Wolcott Won Wong Wood Wright Yano Yarris Yawman Yerragondu Younger Zelman Zhu Ziadeh

MD MD MD MD MD MD MD MD MD MD MD DO MD MD MD MD RN MD MD MD MD MD MD MD MD MD DO MD MD MD MD MD MD MD MD MD MD MD MD MD

PhD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD DO MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD DO MD MD MD MD MD MD MD MD

MD MD MD MD MD MD MD MD

University of Cincinnati College of Medicine Washington University School of Medicine Morristown Memorial Hospital University of Cincinnati Wake Forest University School of Medicine Denver Health Medical Center St. Luke's-Roosevelt Hospital Center Texas A&M HSC College of Medicine University of North Carolina Dept of Emergency Med University of Pennsylvania School of Medicine North Shore University Hospital UCI Mount Sinai School of Medicine Yale Section of Emergency Medicine Geisinger Medical Center University of Michigan Penn State Milton S. Hershey Medical Center University of Virginia, Dept of Emergency Medicine Henry Ford Hospital Vanderbilt University University of Pennsylvania Georgetown U School of Medicine Carolinas Medical Center University of Cincinnati LSU - New Orleans Hopital du Sacre-Coeur de Montreal University of Pittsburgh School of Medicine University of Louisville Beth Israel Deaconess Medical Center Albert Einstein Medical Center Vanderbilt University Medical Center The University of Texas Health science Center at H Kaiser Permanente South Sacramento Medical Center Brown University School of Medicine Stony Brook University Advocate Christ Medical Center Texas Tech University Health Sciences Center Robert Wood Johnson Medical School Oregon Health & Science University Summa Health System/NEOUCOMP University of Rochester, Department of EM University of California, San Diego Mount Sinai School of Medicine Johns Hopkins School of Medicine University of Michigan Mayo Medical School Hennepin County Medical Center New York Presbyterian Emergency Medicine Residency Georgetown Univ. Hosp./Washington Hosp. Cntr.

George Washington University SUNY-Downstate Medical Center Orlando Regional Medical Center Christiana Care Health System UMDNJ-Robert Wood Johnson - Camden McMaster University The Cleveland Clinic St. Luke's/Rossevelt Hospital Department of Emergency Medicine, Univ. of Ottawa

Courtney Kari Jasmine Jesse Timothy Jennifer Steven Jason Emilie Charles N. Greg Carla Martin Michael Elaine Shawn Naresh Ryan Megan Mitesh Uroos Junaid Lisa Cliff Drew Lynn Thomas Peter Nicole Megan Jon Ralph Kenneth Michelle Marcy Christopher James Leticia Steven H. Mustapha Steven D Ellie Danielle Teresa Jeffrey Ellen Sally John Mehdi Eric Nathaniel Charles Sandra Elizabeth Chet Craig Donald Jon

Institute for Clinical Evaluative Sciences Harvard Medical School Emory University Department of Pediatrics University of Michigan SMBD-Jewish General Hospital Northwestern University Mayo Clinic Children's Hospital of Michigan The University of Western Ontario St.Luke's-Roosevelt Hospital University of Rochester Mount Sinai Medical Center and Columbia University Beth Israel Deaconess Medical Center University of Cincinnati University of Arizona Dept of Emergency Medicine Baylor College of Medicine Morristown Memorial Hospital York Hospital Emergency Medicine Residency George Washington University The Ohio State University Summa Health System Brigham and Women's Hospital Advocate Christ Medical Center Medical University of South Carolina University of New Mexico Department of Emergency Medicine NSLIJ University of Arizona SUNY-Downstate Medical Center Stony Brook University University of Nevada School of Medicine University of Arizona Beth Israel Deaconess Medical Center Minneapolis Heart Institute Foundation University of Pennsylvania Scott and White Memorial Hospital York Hospital Elmhurst Hospital Center University of California, San Francisco University of Michigan Department of Emergency Medicine, Univ. of Ottawa Beth Israel Deaconess Medical Center University of Washington Mount Sinai School of Medicine Texas A&M HSC/Scott&White Children's Hospital of Michigan Johns Hopkins University of Missouri-Kansas City SOM UCI Medical Center UCLA/ WLA VA Medical Center VCU Health Systems University of Pittsburgh William Beaumont Hospital Hospital For Sick Children, Toronto Department of Emergency Medicine, UCSF Med School Stony Brook University University of Iowa Thomas Jefferson University Hospital Advocate Christ Medical Center

Courtney Karen Nicholas Matthew Edward R. Venkatesh Susan Josef Lucille Michael Paul Tom Stephen Chu-Lin Sara Paradis Federico Tyler Lekshmi Christian Christine Arjun Gary Deborah Annette Jody Kathryn Tracy Rachel Jonathan David Joshua Brian Paul Heidi Michael J. Muhammad Denise Susan Michael Ellen Scott Benjamin Steven Bjorn Kris Douglas Melissa Nathan Lauren Mary Heather Sage Michael Scott Christopher J. Scott Helen James Stephanie Lucy Sangeeta Stewart James

University of Maryland LSUHSC Shreveport, LA Johns Hopkins University Cedars-Sinai Medical Center Georgetown University/Washington Hospital Center University of Cincinnati Beth Israel Deaconess Medical Center/Harvard Oregon Health & Science University University of Rochester Medical Center Mayo Clinic University of Michigan Wake Forest University North Shore University Hospital - NYU School of Me William Beaumont Hospital

Kiichiro Lalena Daniel Neeraja John Stacie Shu James

67

Peterson Peterson Pierre Pines Platts-Mills Plumb Polevoi Porter Powell Pozner Press Pruden Pusic Puskarich Rabin Radford Ramarajan Randles Ranney Rao Raza Razzak Reedman Rice Richardson Richardson Richardson Richman Riordan Rishel Rittenberger Riviello Robinson Rockwell Rosenberg Russi Ryan Ryan Saef Saheed Salhanick Salinski Salovich Sanchez Sankoff Sano Santen Sarko Sattarian Savory Schlicher Schmier Schneider Schoenfeld Schrader Schranz Schreiber Schrock

Carolinas Medical Center University of New Mexico New York Hospital Queens University of Pennsylvania UNC Department of Emergency Medicine University of Utah, Dept of Pediatrics, PEM Div University of California, San Francisco Orlando Regional Medical Center Northwestern University Brigham and Women's Hospital UT Houston Cincinnati Children's Hospital Medical Center Columbia University Carolinas Medical Center Mount Sinai School of Medicine Albert Einstein Medical Center Stanford University School of Medicine MD UT Southwestern Medical Center MD Brown University, Department of Emergency Medicine MD Yale School of Medicine MD Penn State Hershey Medical Center MD Aga Khan university MD Morristown Memorial Hospital MD Denver Health Medical Center MD Australian National University MD Mt. Siani Medical Center PhD University of Rochester MD Mayo Clinic Arizona MD Indiana University School of Medicine MD Drexel University College of Medicine MD University of Pittsburgh MD, MS Thomas Jefferson University MD LIFE STAR / Hartford Hospital MD New York Methodist Hospital MD Orlando Health DO Mayo Clinic MD New York Hospital Queens MD Children's National Medical Center MD Medical University of South Carolina MD Johns Hopkins MD Beth Israel Deaconess Medical Center, Boston MD Christiana Care Health System UMDNJ-Robert Wood Johnson Medical School PhD Beth Israel Deaconess Medical Center MD Denver Health Medical Center DO Stony Brook University MD Emory Department of Emergency Medicine MD Maricopa Medical Center MD George Washington University Medical Center BS University of Toledo College of Medicine MD Wright State University MD University of Nebraska Medical Center MD University of Rochester MD George Washington University Hospital MD Washington University School of Medicine MD Naval Medical Center San Diego MD Stanford University School of Medicine MD MetroHealth Medical Center MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD

Terry University of Virginia Terwey Hennepin County Medical Center Testa MD University of Southern California Tews DO Medical College of Wisconsin Tham MD Yale University School of Medicine Department of Emergency Medicine, Univ. of Ottawa ThiruganasambandMD Thompson DO Christiana Care Health System Thundiyil MD Orlando Regional Medical Center Torres Mount Sinai School of Medicine Touger MD Jacobi Medical Center Tran MD University of Nebraska Medical Center Trent DO University of Illinois College Medicne at Peoria Trzeciak MD UMDNJ-RWJMS at Camden Tsai MD Massachusetts General Hospital Tsuchitani MD Eastern Virginia Medical School Uyehara MD University of Massachusetts Medical School Vaca MD University of California, Irvine Vadeboncoeur MD Mayo Clinic Florida Vaidyanathan MD Mayo Clinic Vaillancourt MD Department of Emergency Medicine, Univ. of Ottawa Van Dillen MD Orlando Regional Medical Center Venkatesh MD Harvard Affiliated Emerg. Med. Residency-BWH/MGH Vilke MD University of California, San Diego Vinton Beth Israel Deaconess Medical Center Visconti MD New York Methodist Hospital Vogel MD Denver Health Medical Center Volz MD Beth Israel Deaconess Medical Center Walcynski MD Joseph Epstein Centre for EM Research Waldron MD New York Hospital Queens Walker DO York Hospital Emergency Medicine Residency Wallace MD Kings County Hospital Center Wallenstein MD Emory University Walsh MD, MBAMorristown Memorial Hospital Walsh MD Kern Medical Center, Bakersfield, California Walz MD Hennepin County Medical Center Ward MD University of Cincinnati Waseem MD Lincoln Medical & Mental Health Center Waselewsky MD Wayne State University Watts MD, PhD Texas Tech University Health Sciences Center Alpert Medical School of Brown University Waxman MD Weber MD University of California, San Francisco Weiner MD, MPHTufts University School of Medicine Weisenthal University of Pennsylvania Weiss MD University of New Mexico Westgard MD Hennepin County Medical Center Whapshare MD Resurrection Medical Center, Chicago, Illinois Alameda County Medical Center - Highland Hospital White MD White MD Emory University, Department of Emergency Medicine White MD Virginia Commonwealth University (VCURES) Whiteside MD University of Michigan Whitney MD Indiana University Wiederhold MD William Beaumont Hospital Wiener MD SUNY Downstate Medical Center/Kings County Hosp.

Witting MD University of Maryland Wiener MD Tufts University School of Medicine Wolcott MD LSUHSC Shreveport, LA Wilber MD Summa Health / NEOUCOMP Won Johns System Hopkins University Wilde MD Medical College of Georgia Wong Cedars-Sinai Medical Center Willis MD St.Luke's-Roosevelt Center Wood MD GeorgetownHospital University/Washington Hospital Center Wright MD University of Cincinnati Winslow MD Wake Forest University Yano Yarris Yawman Yerragondu Younger Zelman Zhu Ziadeh

MD

MD MD MD MD MD

Beth Israel Deaconess Medical Center/Harvard Oregon Health & Science University University of Rochester Medical Center Mayo Clinic University of Michigan Wake Forest University North Shore University Hospital - NYU School of Me William Beaumont Hospital

UCI OCME requires that the content of the CME activities and related materials provide balance, independence, objectivity, and scientific rigor. Planning must be free of the influence or control of a commercial entity, and promote improvements or quality in healthcare. It is the policy of the UCI Office of Continuing Medical Education to insure balance, independence, objectivity, and scientific rigor in all its educational activities. All faculty participatin in UCI OCME sponsored CME programs are expected to disclose to the activity participants any real or apparent conflict(s) of interest that may have a direct bearing on the subject matter of the continuing education activity. This pertains to relationships with parmaceutical companies, biomedical device manufacturers, or other corporations whose products or services are related to the course content. The intent of this policy is identifying potential conflicts of interest so participants can form their own judgements with full disclosure of the facts. It remains for the participants to determine whether the speakerâ&#x20AC;&#x2122;s outside interest reflect a possible bias in either the exposition or the conclusions presented.

The views and opinions expressed in this activity are those of the faculty and do not necessarily reflect the views of the UCI or SAEM. The following speakers have

relevant financial relationships to disclose within didactics: Sean Peter

Collins Pang

MD MD

University of Cincinnati Northwestern University

Arthur Ryan Vicki

Kellermann Mutter Nobel

MD, MPH PhD MD, FACEP

Emory School of Medicine Coordinator, Emergency Dept, Research Activities Partners Healthcare

Abbott, Astellas, Otsuka, Corthera, Inova Medical Inc. Astellas, Bayer, Otsuka, Nile, PDL BioPharma, PeriCor Therapeutics, Solvay Pharmaceuticals, Biogen Idec, Corthera, EKR Therapeutics, Palatin Technologies, Merck, Medicines Company HHS OASPR, Bisan Pharmaceuticals, US Patent Agency for Healthcare Research and Quality Siemens, Sonosite

The following speakers have no relevant financial relationships to disclose within didactics: Belena Douglas JoDee Mark Felix Shellie Brent Jill Christopher Diane Andra Paul Jose Jeanette Joseph Jennifer Sheila Kathleen Robert David Drew Peter Jeff Deborah Jonathan Todd Susan Victoria W. Brian Teresa Joshua James Glenn Daniel Michael Kate Phyllis Cherri James Robert David Ula J Lee Alan Daniel Sorabh Terry Jon Gloria Eddy David Christopher Roger Scott Ian Marcus John Amal Brian Mark Chadwick Douglas James Alice

Adkins Ander Anderson Angelos Ankel Asher Asplin Baren Beach Birnbaumer Blomkalns Borgman Cabanas Calli Carcillo Casaletto Chauvin Clem Cloutier Cone Dawson DeBlieux Desmond Diercks Edlow Ellingson Fuchs Garrett Gibler Gibson Goldstein Gordon Hamilton Handel Handrigan Heilpern Hendry Hobgood Hoekstra Hoffman Howes Hwang Jenkins Jones Keyes Khandelwal Kowalenko Krohmer Kuhn Lang Levine Lewandowski Lewis Lynch Martin Martin Marx Mattu McBeth McIntosh Miller Miller Miner Mitchell

RN, CHPN MD MD MD MD MD MD MD, MBE MD MD MD DO MD MS MD MD PhD MD MD MD Director MD MD MD MD MD MD MD MD PhD MD, PhD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD DO MD MD MD MD PhD MD MD MD MD MD MD MD MD MD MD

Community Hospice of Northeast Florida Emory University Oregon Health and Science University Ohio State University Regions Hospital/University of Minnesota Albany Medical College Mayo Clinic Hospital of the University of Pennsylvania Northwestern Harbor-UCLA Medical Center University of Cincinnati Community Hospice of Northeast Florida University of North Carolina Association of American Medical Colleges, Careers University of Pittsburgh Maricopa Medical Center Louisiana State University Health Sciences Center Loma Linda University Medical Center Oregon Health and Science University Yale University School of Medicine Office of Emergency Medical Services, National Highway Traffic Safety Administration Louisiana State University Health Sciences Center University of Michigan Health System University of California-Davis Beth Israel Deaconess Medical Center Oregon Health and Science University Children's Memorial Hospital, Chicago Carolinas Medical Center University of Cincinnati Director, Health Outcomes Partners Healthcare Harvard/Mass General Wright State University Oregon Health and Science University Emergency Care Coordination Center Emory University University of Florida Health Science Center/Jackso University of North Carolina at Chapel Hill Wake Forest University Beth Israel Medical Center University of Chicago Hospitals Mount Sinai School of Medicine Johns Hopkins University Carolinas Medical Center John Peter Smith Health Network and UT Southwester Ohio State University University of Michigan Department of Homeland Security Wayne State University School of Medicine McGill University Cook County Stroger Hospital Henry Ford Hospital Harbor-UCLA Medical Center Office of Population Research, Princeton Universit Duke University University of Virginia Carolinas Medical Center University of Maryland Unversity of California, San Francisco University of Florida Health Science Center/Jackso Wake Forest University Indiana University Hennepin County Medical Center Carolinas Medical Center

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James John Arun Susan David Karl Arthur Edward Jesse Charles Susan Niels Jedd Michael Rich Basmah Sally Raquel Michael Richard Manish Nathan Daniel Michael Alan Steve Joel John Mary Jo Joshua Ellen Peter Lalena John Brian Frank

Moak Moorhead Nagdev Nedza Newman Nibbelink Pancioli Panacek Pines Pollack Promes Rathlev Roe Ross Rothman Safdar Santen Schears Schull Schwartz Shah Shapiro Spaite Stone Storrow Trzeciak Turner Vozenilek Wagner Wallenstein Weber Wyer Yarris Younger Zink Zwemer

MD, RDMS MD MD MD, MBA MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD MD, RDMS MD MD MD MD MD MD MD MD MD MD MD MD

University of Cincinnati Oregon Health and Science University Rhode Island Hospital Vice President for Clinical Quality and Patient Safety, AMA McGill University Temple University University of Cincinnati UC Davis Medical Center University of Pennsylvania University of Pennsylvania University of California - San Francisco Boston Medical Center William Beaumont Hospital Emory University School of Medicine Johns Hopkins University Yale University Vanderbilt & Emory Dept of Emergency Medicine St. Mary's Hospital Sunnybrook Health Sciences Center Medical College of Georgia University of Rochester Beth Israel Deaconess MC University of Arizona College of Medicine SUNY - Downstate Vanderbilt University Medical Center Cooper University Hospital McGill University Northwestern Saginaw Cooperative Hospitals Emory University University of California - San Francisco Columbia University Oregon Health and Science University University of Michigan Alpert Medical School of Brown University McGuire VA Medical Center

UCI OCME requires that the content of the CME activities and related materials provide balance, independence, objectivity, and scientific rigor. Planning must be free of the influence or control of a commercial entity, and promote improvements or quality in healthcare. It is the policy of the UCI Office of Continuing Medical Education to insure balance, independence, objectivity, and scientific rigor in all its educational activities. All faculty participatin in UCI OCME sponsored CME programs are expected to disclose to the activity participants any real or apparent conflict(s) of interest that may have a direct bearing on the subject matter of the continuing education activity. This pertains to relationships with parmaceutical companies, biomedical device manufacturers, or other corporations whose products or services are related to the course content. The intent of this policy is identifying potential conflicts of interest so participants can form their own judgements with full disclosure of the facts. It remains for the participants to determine whether the speakerâ&#x20AC;&#x2122;s outside interest reflect a possible bias in either the exposition or the conclusions presented.

The views and opinions expressed in this activity are those of the faculty and do not necessarily reflect the views of the UCI or SAEM. The following speaker has

relevant financial relationships to disclose within AEM CC:

Steve Bernstein, MD Albert Einstein College of Medicine Arthur Kellerman, MD Emory Universiy

Expert Witness for Plaintiff:Class action lawsuit against tobacco Companies, State of MissouriOASPR, US Dept of HHS, Senior Public Health Advisor, RWJ Foundation Health Policy Fellow, Kaiser Commission on Medicaid and Uninsured, Member

The following speakers have no relevant financial relationships to disclose within AEM CC: Gail D'Onofrio, MD Bruce M. Becker, MD Edward Bernstein, MD Edwin D. Boudreaux, PhD Kerry B. Broderick, MD Rebecca Cunningham, MD Rita K. Cydulka, MD Stephen W. Hargarten, MD Jason Haukoos, MD Jon Mark Hirshon, MD Debra E. Houry, MD Gregory L. Larkin, MD Karin V. Rhodes, MD Anthony Spirito, PhD Robert Woolard, MD

Yale University Brown University Boston University U of Medicine and Dentistry of NJ University of Colarado University of Michigan MetroHealth Medical Center Medical College of Wisconsin Denver Health Medical Center University of Maryland Emory Universiy Yale University University of Penn Brown University Univerty of Texas

The following speakers have no relevant financial relationships to disclose within IEME: Adam J. Rosh, MD Brian Gillett, MD Derek Kuhl Richardson, MD Cherri Hobgood, MD Eve Losman, MD, Gregory Christiansen, DO Heather V. Rozzi, MD Herb Zerth, MD James McClay, MD Jason Nomura, MD Jeremy Ackerman, MD, PhD Jeremy Sperling, MD Jonathan Fisher, MPH Kevin Ferguson, MD, Mara Aloi, MD, Myto Duong, MD, Richard Westenbarger, MD Stephen Leech, MD

Wayne State University State University of New York Downstate New York Presbyterian Hospital University of North Carolina University of Michigan Virginia Commonwealth University York Hospital Advocate Christ University of Nebraska Medical Center Christiana Care Health System Emory University New York Presbyterian Hospital Harvard University University of Florida Allegheny General Hospital Southern Illinois University University of Florida - Jacksonville Orlando Regional Medical Center

The following speaker has relevant financial relationships to disclose within Leadership Academy: Tracy Sanson, MD

University of South Flordia-Tampa

TeamHealth - Speakers Bureau, ACEP Speakers Bureau

The following speakers have no relevant financial relationships to disclose within Leadership Academy: Alan Forstater, MD Bernie Lopez, MD Bill Barsan, MD Bob Hockberger, MD Brent King, MD Brian O'Neil, MD David J. Bachrach, MD Glenn Hamilton, MD Gloria Kuhn, MD Kate Heilpern, MD Marc Borenstein, MD Marcus Martin, MD

Thomas Jefferson University Thomas Jefferson University University of Michigan Harbor-UCLA Medical Center University of Texas Houston Wayne State University The Physician Executiveâ&#x20AC;&#x2122;s Coach, Inc. Wright State University Wayne State University Emory University Newark Beth Israel Medical Center University of Virginia

**Although some physicians may have pharmaceutical or device relationships, it has been perceived that no bias will be singled out during presentations.

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Sheraton New Orleans, Second Floor

70

Sheraton New Orleans, Third & Fourth Floors

A3

A2

A1

B3

B2

B1

C3

C2

C1

D3

D2

D1

71

Service Elevators

Sheraton New Orleans, Fifth & Eighth Floors

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SAEM Welcomes New Exhibitors BIONETCK Corporation El Monte, CA Bionetek offers a novel non-invasive CCG (crebro cardiography) system that is much more sensitive in myocardial ischemia detection than the ECG. This proprietary early cardiac diagnostic system can detect CAD with 94% accuracy and differentiate various heart dysfunctions with average 90% accuracy. For more information, visit our website at www.bionetek.com Challenger Corporation Memphis, TN Elsevier-Procedures Consult Philadelphia, PA Health Care Facilities Partnership of South Central Pennsylvania Hershey, PA

Medviks Telehealth, LP Pearland, TX Virtual medical scribe services for the emergency room doctor for virtual completion of the patient medical record, under the supervision of the doctor. The transmission is through secure video conferencing.

Physio-Control Redmond, WA LIFEPAK defibrillator/monitors and automated external defibrillators from Physio-Control set the standard for quality and reliability and are used by more physicians, hospitals and emergency medical services than any other brand. Physio-Control continues to lead the industry through innovation and advanced technology. For more information, visit our website at www.physio-control.com.

Taser International Scottsdale, AZ

Revolutionizing Cardiac Diagnostics CARDx ECD (12-Lead CCG & ECG)

Interested in Exhibiting?

Contact SAEM To Reserve Your Premium Booth

Sensitive: Quantum CCG analysis more sensitive & quantifiable than ECG ST analysis

In Phoenix, June 3-6, 2010

Accurate: CAD detection ~ 94% Heart dysfunctions differentiation ~ 90% (e.g. ACS) Fast: 10-minute stress free test (includes generating easy-to-read reports) Non-Invasive: Performed at any point-of-care setting Photo submitted by Johnson Kwong

www.bionetek.com

saem@saem.org

Notes

Millions of records, thousands of hospitals, hundreds of clinical and non-clinical data elements make the Healthcare Cost and Utilization Project (HCUP) a powerful data source.

Learn about HCUPâ&#x20AC;&#x2122;s newest database: The Nationwide Emergency Department Sample (NEDS) Friday, May 15th from 1P to 4P

CARDIOVASCULAR AND NEUROVASCULAR EMERGENCIES