Joe Nemeth

Monday, May 28, 2018 • 10:45 - 12:15
Track 1 - HOW TO
Track Chair: Dr. Joe Nemeth

Bier (IV Regional Anesthetic) Block in the ED Management of Wrist Fractures - Dr. Bruce Mohr

Description: Provide a short history of the BB technique and describe the equipment and method used to provide safe effective analgesia for a variety of patients requiring orthopedic closed manipulation of distal forearm trauma.

Learning Objectives:

  1. To be introduced to a short history of the origins and uses of the technique
  2. To become aware of the equipment and methods used in performing the technique safely and effectively
  3. To be shown how the technique is appreciated by a wide variety of patients and the physician, nursing, and resident staff who use it

Biography: Staff Physician Emergency Whistler Health Care Centre Clinical Instructor University of British Columbia Department of Emergency Medicine Whistler Blackcomb Ski Patrol Physician and Canadian Alpine Ski Team Physician

The ABCs of Pediatric POCUS - Dr. Charisse Kwan

Description: Rapid-fire clinical cases to illustrate the potential of Point of Care Ultrasound in pediatric resuscitation.

Learning Objectives:

  1. Illustrate how POCUS can be integrated into your practice
  2. Understand the limitation of these Pediatric POCUS applications

Pearls:

  1. POCUS can help you make quick decision in resuscitation
  2. POCUS can reduce cognitive bias and errors
  3. POCUS can decrease your cognitive load

Biography: Charisse Kwan is Director of the Paediatric Emergency Medicine Point of Care Ultrasound Program and Fellowship at The Hospital for Sick Children in Toronto, Canada. She is also an Assistant Professor in the Department of Paediatrics at the University of Toronto and works as a PEM physician at the The Hospital for Sick Children.

POCUS for the Pediatric Abdomen - Dr. Charisee Kwan

Description: “Awake” intubations are gaining momentum in the emergency department world. Airway management has evolved from a task-focused procedure to a physiology-focused procedure. During this session we will discuss both the general indications for intubation and the types of patients that may benefit from an awake (topicalization only) approach. Finally, the topicalization approach adopted by STARS may be demonstrated.

Learning Objectives:

  1. an increased depth of understanding around the indications for intubation
  2. an increased understanding of the types of patients who may benefit from an awake approach to intubation
  3. increased confidence with how to adequately topicalize an airway, thus allowing laryngoscopy and intubation

Pearls:

  1. POCUS can help reduce cognitive bias and errors
  2. POCUS can help decrease coginitive load
  3. Clinical Context matters!

Biography: Charisse Kwan is Director of the Paediatric Emergency Medicine Point of Care Ultrasound Program and Fellowship at The Hospital for Sick Children in Toronto, Canada. She is also an Assistant Professor in the Department of Paediatrics at the University of Toronto and works as a PEM physician at the The Hospital for Sick Children.

Rapidly Establishing Goals of Care in the Older Critically Ill Patient - Dr. Jacques Lee

Description: A critically ill older patient is brought to your resuscitation room from home. He is in respiratory distress and may need endotracheal intubation    Your initial assessment and review of medications suggests that this patient has multiple comorbidities and Alzheimer’s dementia.    There is no DNR available. What do you do?

Learning Objectives:

  1. Help develop a structured approach to establishing goals of care in critically ill patients
  2. Better understand how to start this difficult conversation
  3. Better understand medicolegal and ethical framework

Pearls

  1. Need to rehearse this like any resuscitation technique
  2. Simultaneous non-invasive resuscitation while establishing goals of care
  3. Focus on the patient’s needs and wishes

Biography: Dr. Jacques Lee is a clinician scientist at Sunnybrook. As such, he spends 50% of his time on the ED floor and the other 75% committed to research to improve the ED care of older persons through knowledge creation, knowledge translation, and advocacy.  He was recently awarded a University of Toronto Merit salary award and is the Principal Investigator of 3 national randomized clinical trials funded by the CIHR and the Canadian Center for Aging Brain Health Innovation (CC-ABHI).

How to Kill Someone With RSI - Mr. Reuben Strayer

Description: We commonly see patients arrest during or immediately after RSI. We will describe how this happens and how to prevent it.

Learning Objectives:

  1. After this presentation, the participant will be able to predict the anatomically difficult airway and develop a strategy for its successful management.
  2. After this presentation, the participant will be able to recognize patients who are at risk for physiologic decompensation during or immediately after RSI and employ measures to prevent this.
  3. After this presentation, the participant will be able to describe the conditions under which regurgitation during RSI is likely, reduce its likelihood, and successfully manage this dangerous scenario should it occur.

Pearls:

  1. You cannot predict the anatomically difficulty airway so have a plan for can’t intubate, and also for can’t intubate/can’t ventilate, every time.
  2. Delay RSI to optimize perfusion in physiologically frail patients requiring intubation.
  3. If significant regurgitation occurs in the midst of laryngoscopy, intubate the esophagus and inflate the balloon, so as to divert the emesis.

Biography: Reuben Strayer, author of emupdates.com, is an emergency physician based in New York City.  His clinical areas of interest include airway management, analgesia, procedural sedation, agitation, decision-making and error. His extra-clinical areas of interest include sweeping generalizations and jalapeño peppers. He lures himself out of bed with chocolate dipped in peanut butter before heading to Maimonides Medical Center, in Brooklyn, where he is happily employed.

How to Prepare for a Sick Pediatric Trauma Coming In - Dr. Joe Nemeth

Description: The management of the critically injured pediatric patient is a ubiquitous challenge to any emergency medicine physician. Proper preparation of oneself, the team and the room is of paramount importance for good care.

Learning Objectives:

  1. Will be able to identify strategies to prepare oneself for managing the injured child
  2. Will be able to highlight key elements in leading the team in preparing mentally for the imminent arrival of the injured child
  3. Will be able to identify key logistical and equipment related issues to address prior to arrival of the injured child

Pearls:

  1. physiologic (mind and body) preparation of oneself
  2. walk through the worst case scenario with team members prior to arrival
  3. know your trauma bay inside out

Biography: I have been at the McGill University Health Center since 2001, working as staff physician and trauma team leader in pediatric and adult emergency medicine. I also was the director of the dept. of emergency medicine at the Montreal General Hospital  for 8 of those years.