Jonathan Guilfoyle

Tuesday, May 29, 2018 • 13:00 - 14:30
Track 1 - HOW TO MANAGE PEDIATRIC TRAUMA
Track Chair: Dr. Jonathan Guilfoyle

'How to' Manage Pediatric Traumatic Shock… Your Patient May Be in Shock but You Don't Have to Be - Dr. Andrea Boone

Description: Having an approach to pediatric traumatic shock will help you identify and successfully manage the most common forms of shock in the pediatric patient – hemorrhagic, hemorrhagic and hemorrhagic shock. Join us for a review of the subtle in’s and out’s of the pediatric traumatic shock patient.

Learning Objectives:

  1. Learn to be a sleuth and detect compensated shock before it’s too late.
  2. Learn to look for less likely causes for hemorrhagic shock in pediatrics.
  3. Review indications for fluid and blood product management in the pediatric shock patient and how it may differ from the adult trauma resuscitation.

Pearls:

  1. Key skills in detecting compensated shock will allow for early and aggressive resuscitation of the pediatric trauma patient.
  2. The vast majority of pediatric trauma patients are stabilized with good ED resuscitation obviating the need for trauma laparotomy or angio-embolization.
  3. TXA is a go – use it in your MTP pediatric patients!

Biography: Dr. Andrea Boone is an emergency physician in Calgary, Alberta. She divides her practice between the Foothills Medical Centre and Alberta Children’s Hospital, as well as working as a transport physician for STARS. Her interests include medical simulation education, global health and wellness in emergency medicine.

'How to' Decompress the Thoracic Cavity… Relieving the Pressure for Everyone - Dr. Jonathan Guilfoyle

Description: Relieving a tension pneumothorax is one of the most important, immediately life-saving interventions you are likely to perform. Join us as we review the indications, techniques and pitfalls of decompression of the thoracic cavity.

Learning Objectives:

  1. Know the indication for decompression of the thoracic cavity
  2. Understand the techniques for thoracic decompression
  3. Be aware of common pitfalls when decompressing the thoracic cavity

Pearls:

  1. Address the pneumothorax before it develops into a tension in CT or on transport
  2. Simple ‘finger’ thoracostomy is easy and effective
  3. Needle decompression has a high failure rate

Biography: I was once told “do what scares you”, so after finishing my Pediatric Emergency Medicine fellowship at BC Children’s Hospital, I packed up the family and went to the city of brotherly love to do an extra year of training in trauma and critical care at the Children’s Hospital of Philadelphia. A decade later I am very fortunate to still be doing what I love (and still scares me a little), working at the Alberta Children’s Hospital and serving as the Medical Director of Trauma.

'How to' Incorporate Ultrasound in Pediatric Trauma… It's Not Always Black and White - Dr. Mark Bromley

Description: Although images are relatively easy to acquire and interpret in the paediatric population, sensitivity is low in hemodynamically stable patients. Test characteristics improve significantly in the unstable patient.

Learning Objectives:

  1. Understand the characteristics of FAST in stable paediatric patients
  2. Understand the characteristics of FAST in unstable paediatric patients

Biography: Emergency medicine physician. Cross appointed to the departments of emergency medicine and paediatrics. Ultrasound director Alberta Children’s Hospital Section of Emergency Medicine

'How to' Manage Severe TBI in Pediatric Trauma… Let's Keep It Simple but Not a 'No-Brainer' - Dr. Andrea Boone

Description: Join us for a discussion around best practices in managing the head injured pediatric trauma patient. The principles of managing the pediatric head injury patient are really no different than that of the adult head injury patient, but the devil is in the details.

Learning Objectives:

  1. Review of the core principles of management of the head injured pediatric patient.
  2. Arm yourself with the knowledge of subtle pediatric physiologic and anatomic differences that will guide and alter your resuscitation
  3. Review of management of increased ICP and hemodynamics in the head injured patient.

Pearls:

  1. The basic principles apply in managing the pediatric head injury patient – avoidance of hypotension, hypoxia, hypoglycemia and hyperthermia.
  2. Hypertonic saline is the osmotic agent of choice in pediatric ICP management.
  3. What you do matters – appropriate initial resuscitation in the head injured pediatric saves neurons and lives!

Description: Join us for a discussion around best practices in managing the head injured pediatric trauma patient. The principles of managing the pediatric head injury patient are really no different than that of the adult head injury patient, but the devil is in the details.

'How to' Use a Pediatric Trauma Checklist… Making a List and Checking It Twice - Dr. Russell Lam

Description: When you receive a patch call about a polytrauma patient arriving in your ED, do you have a system to prepare your team for everything that might happen? After stabilizing your patient, before they leave your ED for the CT/OR/Chopper, do you have a way to ensure all the critical procedures are performed? Join us as we explore the exciting world of checklists in medicine.

Learning Objectives:

  1. Review the evidence for checklist use in medicine and their role as a memory aid and as a CRM tool.
  2. Review the generation, creation, and validation of the ACH Trauma Checklist.
  3. Review common pitfalls in managing polytraumatized patients at the ACH and how a checklist can address them.

Pearls:

  1. Use a checklist for your sickest patients. Verbally repeat items on the checklist to get your best CRM benefit.
  2. Don’t forget to decompress the chest!
  3. Make sure you have clear handover once your patient leaves the ED.

Biography: Russell Lam did his pediatric training at Queen’s University and finished his emergency fellowship at the University of Calgary. His interests are in trauma, resuscitation, and medical education.

'How to' Run a Pediatric Traumatic Arrest… Without Soiling Yourself - Dr. Jonathan Guilfoyle

Description: When your trauma resuscitation goes from bad to worse, do you have a plan? Join us as we review the most sphincter tightening of our pediatric trauma topics, the traumatic cardiac arrest.

Learning Objectives:

  1. Simplify and organize your approach to pediatric traumatic arrest
  2. Know how to recognize and treat reversible causes of traumatic arrest
  3. Understand when it is reasonable to terminate the resuscitation

Pearls:

  1. The PALS algorithm does not work for traumatic arrest
  2. CPR and epinephrine will not save your patient
  3. Treat the 2Hs (hypovolemia/hypoxia) and 2Ts (tension/tamponade)

Description: When your trauma resuscitation goes from bad to worse, do you have a plan? Join us as we review the most sphincter tightening of our pediatric trauma topics, the traumatic cardiac arrest.