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Rural Medicine

Tuesday June 15

Track Chairs

Aimee Kernick


Sean Moore


Chair of the CAEP Rural, Remote and Small Urban Section, and EM locum in rural British Columbia and the Northwest Territories.


Fast-paced, high yield, just-the-facts style presentations from top presenters in rural EM. We will share some of the latest evidence and cutting edge procedural techniques that can be performed in any ED, even the most remote or rural. Topics include use of TXA for hemoptysis, 5 uses for Turkel Safety needles, use of magnets and alger brushes in ocular FB, occipital nerve blocks for migraine management, and a special 30min power talk with numerous tips, tricks and hacks. Rural and Urban physicians alike have plenty to learn from this engaging session!

Learning Objectives

Learn procedures including: uses for Turkel Safety Needles, Magnets and alger brushes in ocular metallic FB, occipital nerve blocks for migraines.

Review the latest evidence for TXA in hemoptysis.

Learn tips, tricks and hacks for working in a rural (or urban) ED.


Use of Turkel Safety Needles – 5 reasons

Dr Moore will discuss the proper use of the Turkel Safety needle for various uses in emergency situations and present some of the pitfalls and pearls.

Learning Objectives

Be familiar with the proper use of the Turkel Safety needles
Understand the uses and advantages in various procedures


You need to be familiar with the proper grip on the Turkel!
This is an essential piece of equipment in modern emergency medicine.
Need to practice and can put them back together in Sim with simple technique.

Eyes: Magnets and Algar Brushes

In only 10min we will review management of metallic foreign bodies in the eye.

Learning Objectives

review the management of metallic foreign bodies in the eye
discuss the potential use of magnets for metallic foreign bodies
review Alger brush use


magnets might be genius or might not work
eyes are an excuse to update Tetanus
make the Alger brush your friend

Cutting Edge TXA Uses – Hemoptysis

TXA has become the duct tape of emergency medicine when it comes to bleeding. The evidence of its efficacy is mixed. This talk will focus on using TXA for hemoptysis.

Learning Objectives

What is TXA and how does it work
What is it been used for in the emergency department
Does it work for hemoptysis


TXA is not the duct tape of EM
TXA should be given to trauma patients
There is not high-quality evidence to support the routine use of TXA in hemoptysis

Migraine Treatment – Greater Occipital Nerve Blocks in the ED

I will be speaking specifically about occipital nerve blocks for the immediate management of migraines, both acute and chronic, in the emergency department setting. I will be talking about the technique it’s indications and contraindications as well as some other headache presentations which may present themselves to the emergency physicians such as headaches that are focussed over in an area of the head and neck not specifically associated with the occipital nerves which may be amenable to greater occipital nerve blocks.

Learning Objectives
Upon completion of this educational activity the participant should be able to determine which headaches (migraine, cluster, PDPH, occipital neuralgia, cervicogenic headache and more) are likely to benefit from Greater Occipital Nerve (GON) block and offer it accordance with established department / hospital policy for the management of migraine headache.
Upon completion of this educational activity the participant should be able to determine the optimal technique for landmarking and providing a Greater Occipital Nerve block including the local anesthetic used in terms of type, dose and volume.
Upon completion of this educational activity the participant should be able to consider adding Greater Occipital Nerve block to the scope of practice of the ED MD after successful observed education in its application.


Many headaches (migraine, cluster, PDPH, occipital neuralgia, cervicogenic headache and more) are amenable to greater occipital nerve blocks
The treatment effect is variable however greater occipital nerve blocks can provide partial or complete relief for headache patients presenting to the ED so consider it early in your treatment algorithm to provide good service and decrease (potentially) ED LOS
The dose and volume of local anesthetics is often lower in non responders so consider a slightly higher volume to ensure successful block if the technique used is unguided (by US for eg). Steroids are not required.


What are the latest and greatest ER and clinic tips, tricks, and lifehacks? A “lifehack” is a “a strategy or technique adopted in order to manage one’s time and daily activities in a more efficient way.”

Learning Objectives

Apply unique clinical techniques to manage common emergency, hospitalist, and primary care situations.
Describe methods from the published medical literature to improve clinical efficiency using readily-available equipment
List factors that comprise a suitable “lifehack” while maintaining patient safety as a top priority


Tegaderm to protect the eye when applying dermabond.
Hair apposition technique for scalp laceration.
Lubricant and speculum warming with USB warming pad.