Tuesday, May 28, 2019 • 13:00 - 14:30
Track 5 - Diagnostic Imaging (2): Beyond the Hocus POCUS
Track Chair: Dr. Lyle Thomas
Room: 106-107

Update in Stroke Imaging - Dr. David Malfair

Description: Imaging continues to be a critical part of acute stroke management, not only for diagnosis but guiding treatment decisions. This talk will review the role of current imaging guidelines and techniques on acute stroke.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Review lessons learned in needle to door times.
  2. Review helpful findings in acute stroke.
  3. Review imaging in TIA.

Dr. David Malfair finished Radiology residency at UBC in 2005. Did a neuroradiology and musculoskeletal radiology fellowship at UCSF from 2005-2007. Worked as attending at Vancouver General Hospital from 2007-2009. Worked in Red Deer as a suburban radiologist since 2009.

Emergency DI Rule Review - Dr. Ryan Henneberry

Description: Review of the common emergency DI decision rules using a case-based approach.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Review the most common ED decision rules.
  2. Review how and when to apply them.
  3. Review cases where the DI rules may ‘fail’.

Pearls

  1. Pearls will be offered highlighting common scenarios where imaging may ‘mislead’ the clinician.

Dr. Ryan Henneberry is a full-time Emergency Medicine specialist and Sports Medicine physician from Halifax.  His primary practice is at the QEII Health Sciences Centre, a tertiary care hospital affiliated with Dalhousie Medical School.  He is the Director of PoCUS at the QEII HSC Emergency Department. Ryan is also the past chair of the CAEP PoCUS Committee and a Speaker on the CAEP EDTU course. 

Myths in Emergency Imaging That Should Change Your Practice - Dr. Daniel Kim

DescriptionThis talk evaluates several common dogmatic practices in emergency imaging to determine if they are supported by the medical literature or are instead myths and misconceptions. Such myths can potentially result in a delay to diagnosis or even fatal misdiagnosis. By the end of this presentation, you should be armed with the tools to avoid these radiology pitfalls!

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Appraise the utility of abdominal x-ray as an initial imaging test in the workup of small bowel obstruction (SBO).
  2. Evaluate the diagnostic yield of computed tomography (CT) scanning of the head for the patient presenting with vertigo.
  3. Clarify the relationship between hypersensitivity reaction to intravenous (IV) radiocontrast media and allergies to shellfish, seafood, and iodine.

Pearls

  1. Abdominal x-ray has poor sensitivity (75%) for SBO and should not be used as an initial imaging test; ultrasound is highly sensitive (92%) and can be quickly and easily performed at the bedside, making it an ideal initial imaging modality.
  2. The diagnostic yield of non-contrast CT head in patients presenting with vertigo is vanishingly low, and negative results may provide false reassurance.
  3. Iodine is not an allergen, and allergies to shellfish and seafood do not increase one’s risk of an allergic reaction to iodinated IV radiocontrast media.

(@dan___kim) Dr. Kim is a Clinical Assistant Professor and the Ultrasound Fellowship Director for the Department of Emergency Medicine at the University of British Columbia. He is also a Staff Emergency Physician at Vancouver General Hospital. His interests include point of care ultrasound, medical education, and strategies to make emergency medicine easier.

Head, Shoulders, Knees & Toes...or Elbows & Feet - Radiologic Pearls for Evaluating Elbow & Foot Fractures in Children - Dr. Kirstin Weerdenburg

Description: Review of radiographic findings associated with pediatric elbow and foot fractures in order to optimally evaluate and treat these injuries.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Appreciate radiographic findings associated with pediatric elbow and foot fractures.
  2. Understand the management associated with the specific pediatric elbow and foot fractures presented.

Pearls

  1. A thorough understanding of elbow and foot anatomy is crucial, especially physes and ossification centres.
  2. Pediatric elbow fractures are associated with a relatively high rate of complications, therefore it’s important to properly recognize and manage these fractures.

Staff Physician and Director of Pediatric Emergency Ultrasound, Research and Quality Assurance at the IWK Health Centre, and Assistant Professor at Dalhousie University in Halifax, Nova Scotia.

Trauma Pan Scan (A One Man Debate) - Dr. Lyle Thomas

Description: Trauma has increasingly become a disease of imaging, but the debate remains on how much is required and for what indications. Outside of Level one trauma centers, there has been some resistance to the frequent use of Whole Body CT scan (WBCT) or Pan scans. This talk hopes to stimulate discussion on both sides of the debate.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Review the available medical evidence for the practice of WBCT in trauma.
  2. Discuss the obstacles faced by emergency physicians in regional/smaller trauma centers to this practice.
  3. Construct a potential “protocol” to WBCT for smaller centers that meet needs of all involved (EM/DI/Surgery).

Lyle is an Emergency Physician at the Red Deer Regional Hospital and the Medical Director of the Central Alberta Trauma Program. He is an Assistant Clinical Professor at both the University of Alberta and the University of Calgary.