Monday, May 28, 2018 • 10:45 - 12:15
Track 2 - NEURO EMERGENCIES
Track Chair: Dr. Devin Harris
Room: TELUS 104-5-6

Stroke 2018 - A New Era in Emergency Medicine - Dr. Devin Harris

Description: The emergent treatment of stroke and transient ischemic attack is in rapid evolution.  With the advent of literature to support endovascular therapy (EVT) for stroke, the requirement for advanced imaging, and the impact on pre-hospital transport and emergency departments, the paradigm for stroke treatment has changed.  This session will inform and engage attendees in these transformational changes.

Learning Objectives:

  1. To review EMS initiatives necessary for best stroke care
  2. To review evidence for advanced imaging for stroke
  3. To review endovascular therapy literature and apply to future systems

Pearls:

  1. Organized stroke systems of care will provide the largest impact for better stroke care in the future
  2. Advanced imaging for stroke is now standard of care
  3. Endovascular therapy will transform how stroke care is delivered

Biography: Dr. Devin Harris is Chief of Staff, Kelowna General Hospital, and Associate Scientific Director of Research, Interior Health, B.C.  He is a Clinical Associate Professor, Department of Emergency Medicine, UBC.  He has been involved in numerous quality improvement and research initiatives in stroke, both provincially and nationally.

Is this Patient’s Headache from a Subarachnoid Hemorrhage? - Dr. Jeffrey Perry

Description: Dr. Perry is an emergency physician clinician scientist who has conducted several large prospective studies of ED patients at risk for subarachnoid hemorrhage (SAH).  This session introduces the Ottawa SAH Rule, if a lumbar puncture is required following CT, and how to interpret abnormal cerebrospinal fluid.

Learning Objectives:

  1. Understand how to stratify headache patients as high or low risk for subarachnoid hemorrhage using the Validated Ottawa SAH Rule
  2. Learn how to investigate efficiently and safely to exclude subarachnoid hemorrhage
  3. Understand how to interpret a slightly abnormal cerebrospinal fluid result

Pearls:

  1. Use the Ottawa SAH Rule to identify headache patients at risk for SAH
  2. For most patients, CT performed <6 hours from headache onset is sensitive enough to rule out SAH
  3. CSF results with <2000 x 106 and no xanthochromia is a low risk LP

Biography: Dr. Perry is a Professor with the Department of Emergency Medicine, University of Ottawa, and a Senior Scientist with the Ottawa Hospital Research Institute and Research Chair, Emergency Neurological Research, University of Ottawa. He is a peer reviewer for several granting agencies and journals. Dr. Perry’s major research studies have been in the area of neurological emergencies. He has lead several large multicentre prospective clinical decision rule studies to improve care for patients with headache, subarachnoid hemorrhage (SAH), elderly patients with minor injuries at risk for subsequent functional decline and transient ischemic attack (TIA).  He is the Chair of Research for the Canadian Association of Emergency Physicians (CAEP), Vice Chair of the Academic Section of CAEP and is Chair of the Canadian Network of Emergency Research (NCER).

Treatment of Pediatric Seizures and Preventing Status Epilepticus - Dr. Angelo Mikrogianakis

Description: Review and discuss the Southern Alberta Treatment of Seizures in Infants and Children Clinical Algorithm

Learning Objectives:

  1. Review the treatment of pediatric generalized seizures
  2. Discuss the best medications and the optimal route of administration
  3. Understand the treatment approach used to standardize care and approach

Pearls:

  1. Use the intranasal route for early benzodiazepines
  2. There are non-IV options for treatment
  3. Know your first line, second line and tertiary agents

Biography: Section Chief and Medical Director, Pediatric Emergency Medicine

Co-Director, Pediatric Critical Care Transport

Alberta Children’s Hospital