Monday, May 28, 2018 • 10:45 - 12:15
Track 6 - CARDIOVASCULAR
Track Chair: Dr. David Carr
Room: Marriott Kensington B/C.D

Endocarditis Will #!@%& You UP - Dr. David Carr

Description: Endocarditis has been on the back burner for a while now.  It is a disease that is evolving as new risk groups emerge and microbiology change.    This talk will provide you with the framework to identify the disease and avoid the pitfalls in preventing you to nail down this diagnosis.    After this talk you will neither be bored nor afraid of abnormal blood cultures and you will realized you don’t need to fulfill SIRS criteria to be sexy.

Learning Objectives:

  1. Framework to identify the disease and avoid the pitfalls in preventing you to nail down this diagnosis.
  2. Appreciation and approach to abnormal blood cultures
  3. Develop an Endocarditis Hx and Px in the new millennium

Pearls:

  1. Coag neg staph + Valve = IE until proven otherwise
  2. Keep IE on the radar of every febrile pt
  3. Remember the Fever plus One approach to IE

Biography: Associate Professor in the Division of Emergency Medicine at the University of Toronto.  He serves as the Assistant Director of Risk Management and Faculty Development at the University Health Network in Toronto. In 2015, he co- authored a chapter on Occlusive Arterial Disease in the 8th Edition of Tintinalli’s Emergency Medicine.

Full Contact Cardiology - Dr. Chris Hicks

Description: Hard hitting lessons and controversies in emergency cardiology, from arrest to resuscitation to post-arrest care and beyond.

Learning Objectives:

  1. Electrical storm: What changes should you make when the first line fails?
  2. Priorities in the immediate post-arrest period
  3. A simplified approach to cardiogenic shock

Pearls:

  1. Electrical storm requires sympatholysis — Step 1: Stop all the Epi
  2. A higher post-arrest MAP target is associated with survival
  3. You need one pressor for cardiogenic shock: Norepi

Biography: I am an emergency physician and trauma team leader at St. Michael’s Hospital, as well as a Clinician-Educator in the Department of Medicine at the University of Toronto.  I use high fidelity human patient simulation to help make teams work better and more safely.

Stop the Bleeding!...in the Anticoagulated Patient - Dr. Anil Chopra

Description: The DOACs are increasingly being used to manage venous thromboembolism and stroke risk in patients with atrial fibrillation. ED clinicians end up treating the bleeding complications of these newer agents. We will discuss the latest strategies to stop the bleeding including reversal agents.

Learning Objectives:

  1. Identify the commonest bleeding complications related to DOACs.
  2. Identify the critical patient related factors which guide management of bleeding.
  3. Discuss the role of ‘antidotes’ and other strategies to manage life-threatening bleeding.

Pearls:

  1. Routine coagulation tests are generally not useful in guiding ED treatment of bleeding in patients taking DOACs.
  2. Most bleeding complications related to DOACs are not serious and can be managed without any aggressive measures or reversal agents.
  3. The use of antifibrinolytic medications, reversal agents and dialysis may be considered in patients with uncontrolled or life-threatening bleeding.

Biography: Chief of Emergency Department, University Health Network in Toronto. Division Director, Emergency Medicine, University of Toronto. Executive Member, Thrombosis Canada.