Wednesday, May 30, 2018 • 12:45 - 14:15
Track 2 - HOW TO
Track Chair: Dr. Nadder Sharif
Room: TELUS 104-5-6

ET CO2 - Dr. Joe Nemeth

Description: The talk will highlight the vital role of End-Tidal CO2 in managing the ill patient, guiding resuscitation of the arrest patient and monitoring during procedural sedation.

Learning Objectives:

  1. Will learn basic concepts of application and interpretation of ETCO2
  2. Will learn how to use the information from ETCO2 to guide resuscitation.
  3. Will learn limitations of ETCO2 interpretation

Pearls:

  1. Although not exact equal to pCO2, trends are important
  2. Watch for trends during cardiac rescusitation
  3. Use of ETCO2 during PSA is especailly important if using medication which depress respiratory drive

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.

Dental Anesthesia and Other Strategies to Properly Manage Dental Emergencies - Dr. Tobias Meiszinger, Dr. Heidi Rabie

Description: Dental anesthesia made easy! Come and learn how to identify anatomical landmarks inside the mouth to help you quickly alleviate oral pain via nerve blocks. What’s next after relieving the acute pain? We will also discuss what resources and advice you can provide to stop the revolving door.

Learning Objectives:

  1. Learn how to deliver dental nerve blocks with confidence
  2. Learn how to advocate for your patients to receive necessary dental care outside the ED
  3. Your role in clinical pathway creation for dental infections

Pearls:

  1. Dental nerve blocks are easy to deliver if you know what landmarks to look for inside the mouth
  2. Relieving acute pain is a good start but patients without access to private dental care will need you to advocate for them to receive the dental care they need outside the ER
  3. Public/community resources for basic urgent dental care are available ex. Public Health Dental Clinics coupon referral program

Biography – Dr. Tobias Meiszinger:  I grew up in small town Ontario and graduated from McGill dental school in 2014. I then moved to Calgary to complete a one year hospital residency. Since finishing residency I have enjoyed practicing dentistry in Calgary in both private and public settings allowing me to treat a diverse demographic of patients. I have a passion for improving access to dental care for Canada’s vulnerable populations.

Biography: Dr. Heidi Rabie is Chief Dentist of the Alberta Health Services’ Public Health Dental Clinics (PHDC) in Calgary, Alberta. The clinics target population low income and Albertans without dental insurance  and provide emergency relief and basic dental care.  PHDC became the referral pathway for low income dental infection patients in Calgary area ER’s and Urgent Cares through a referral/ free coupon project collaboration with the departments of Infectious Diseases and Emergency Medicine. Dr. Rabie graduated from the Faculty of Dentistry of the University of Montreal in 1998 and practiced in private practice for 10 years before joining AHS in 2008. Addressing dental inequity is her greatest passion.

Bloody Nose: Co-creating a Framework Together in 10 Mins - Dr. Khurram Jahangir

Description: An opportunity to co-develop a framework together within 10mins – strategizing how to stop both the common and the more obstinate causes of nose bleeds, as well as preventive measures to avoid recurrences.

Learning Objectives:

  1. Describe the common causes of nose bleeds seen in an ER setting
  2. Discuss strategies to stop nose bleeds
  3. Discuss preventive measures and patient education resources to avoid recurrences of nose bleeds

Pearls:

  1. Using design-thinking in medicine to create frameworks encompassing common understanding
  2. Using enabling technology to co-create experiences that address the needs of the users in a way that brings them joy and delight
  3. In re-designing systems and services in health, the most important experts – ordinary practitioners and patients – managing their own learning and wellbeing must not be left out of the equation

Biography: Emergency Physician, Edmonton | Former Associate Dean Lifelong Learning | Clinical Professor Emergency Medicine and Family Medicine, Faculty of Medicine & Dentistry, University of Alberta.

Shoulder Relocation with No Drugs and No Pulling - Dr. James Thompson

Description: We can give safer, faster, better care to most shoulder reduction patients with less use of resources by using medication free positioning rather than sedate and manipulate.

Learning Objectives:

  1. Know when to use different types of reduction techniques.
  2. Most shoulder relocations can be done with positioning and without force
  3. The majority of reductions can be done comfortably without medication.

Pearls:

  1. Being patient and knowing that a bit time is needed.
  2. Convice the patient that yes, this will work if they work with you.
  3. Some cases do need medication, and then positioning, not force.

Biography: Staff ER physician trained and practicing in the Edmonton zone.

How to Set up a Ventilator (for Smart People Who Never Do This) - Dr. Sara Gray

Description: We will review the basics of setting up and adjusting a ventilator, in ten quick minutes!  Come get the refresher you need.

Learning Objectives:

  1. Review initial vent settings for the ED
  2. Discuss how to adjust those initial settings based on patient factors
  3. Discuss how to adjust the vent to solve hypoxia and hypercarbia

Pearls:

  1. The initial settings matter a lot less than how you adjust the vent based on your patient’s responses
  2. PEEP is your friend
  3. Tidal volumes should (almost) never exceed 8cc/kg

Biography: Dr Gray is cross trained in Emergency Medicine and Critical Care and works in both areas at St. Michael’s Hospital.  Her academic interests include patient safety and physician wellness.

The CT Head - When All You Have Is a Few Minutes - Dr. Hareishun Shanmuganathan

Description: A quick primer of the key areas to focus on when reading a CT Head. This won’t be a replacement for a “formal” read, but should help you to catch the most common, and serious, pathologies.

Learning Objectives:

  1. Basic CT Head Anatomy
  2. Common Areas of Missed ICH
  3. When to Wait for a Formal Report

Pearls:

  1. Put to the “Read” in context of the patient’s clinical status
  2. Use an appropriately calibrated viewscreen
  3. Pay extra attention to the bone/brain parenchyma imaging margins

Biography: Avid Reader, Voracious Traveller, Amateur Naturalist, Enthusiastic Physician!