CME Credit Statement
Course Schedule 2015
Invited Faculty 2015
Activities and Events
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Course Schedule 2015

Tuesday – March 24

7:30 AM – 8:00 AM Continental Breakfast
8:00 AM – 8:15 AM Welcome and Introductions

8:15 AM - 9:00 AM

Emerging and Exotic Infections: How New Disease Impacts Children
James M. Callahan, MD, FACEP

We frequently hear that a novel infection has emerged abroad and is likely to come to the United States. There is enterovirus D68, Ebola in Guinea, MERS in Saudia Arabia, Chikungunya and Dengue in the Caribbean. How does the emergency medicine provider keep up with what is happening, reporting requirements and how patients who are suspected of having an unusual infection should be managed? This speaker will discuss the most recent emerging infections globally and how they affect care of children.

9:00 AM - 9:30 AM

Drops, Ointments, Creams, and Patches: Be Careful!
Richard M. Cantor, MD, FACEP, FAAP

Most clinicians are unaware of the potential toxicity of pharmaceutical agents delivered by non-traditional pathways. This presentation will highlight some of the more dangerous products (e.g. drops, salves, onitments, and ptaches) available that have proven toxicity in children.

9:30 AM - 10:30 AM

Reevaluating the "Pan Scan" in Pediatric Trauma Management: Balancing Injury Risk with Risk of Diagnostic Imaging
Sean M. Fox, MD (Moderator); Marianne Gausche-Hill, MD, FACEP, FAAP; Alfred D. Sacchetti, MD, FACEP

Trauma remains the number one cause of mortality in children outside of the first year of life. The appropriate use of advanced imaging including computed tomography (CT) in pediatric trauma continues to evolve. This expert panel will review the science behind CT utilization for pediatric trauma and answer when the “Pan-Scan” is needed, and when we can avoid unnecessary radiation exposure.

10:30 AM – 11:15 AM Break – Visit the Exhibits

11:15 AM - 12:15 PM

Pediatric Literature Update: Could These Articles Change Your Practice?
Richard M. Cantor, MD, FACEP, FAAP

Keeping up with the expanding pediatric emergency medicine literature is quite a challenge for busy emergency physicians. This distinguished expert will review the literature from the past 24 months, focusing on those articles that could affect your practice.

12:15 PM - 12:45 PM

Cough and Fever: The Challenge of Community Acquired Pneumonia
Richard J. Scarfone, MD

When an otherwise well child presents with cough and fever, it is often difficult to decide whether to order a radiograph or simply to treat a likely pneumonia. This session will answer these questions and provide the latest evidence for the emergency medicine provider to guide management including antibiotic therapy. Parameters for how to manage outpatient treatment failures as well as criteria for admission to the hospital will also be discussed.

12:45 PM – 2:15 PM Lunch – On Your Own

2:15 PM - 2:45 PM

Fever and Neutropenia
Joan Shook, MD, FACEP

Children with malignancy who are undergoing chemotherapy frequently develop neutropenia during therapy. When that child (or any child with neutropenia) develops fever in the face of neutropenia, there is concern that the child may have a life-threatening infection. Protocolized care in this population has been shown to streamline care and improve outcomes. This speaker will discuss multidisciplinary protocol development and outcomes from institutions where clinical care protocols are in place.

2:45 PM - 3:30 PM

Appendicitis: Risk Stratification and Making Sense of Scoring Systems
James M. Callahan, MD, FACEP

Appendicitis remains the most common unscheduled abdominal surgery in pediatric patients and a high source of emergency practitioner malpractice cases. This course will review best practices in identifying appendicitis, and compare clinical decision rules including risk stratification schemes, and scoring systems used in emergency care of children.

3:30 PM – 4:30 PM Break – Visit the Exhibits

4:30 PM - 5:00 PM

10 Little Fingers, 10 Little Toes
James Homme, MD

Anyone who has cared for a toddler with a smashed finger or school aged child with an inflamed toe can attest to the fact that these “little” issues can often produce a great degree of distress for provider and patient alike. In this session an expert lecturer will discuss when to repair a nailbed/replace an avulsed nail, treatment of common phalanx fractures, antibiotics (or not) for tuft fractures, subungual hematomas, management options for paronychia, and hair tourniquets, and must not miss diagnoses such as Seymour fractures, Herpetic Whitlow and felons will be discussed with a smattering of the latest “tricks of the trade”.

5:00 PM - 5:45 PM

Distinguishing the Vanilla Faint from a Sudden Death Warning Sign
Michael J. Ackerman, MD, PhD

The child who presents with a history of a syncopal episode is often a source of anxiety for the clinician. What is the appropriate workup? What historical elements make the child more or less likely to have significant underlying cardiac pathology? This expert lecturer will use a case-based approach to discuss rare but important causes of pediatric syncope (e.g. vaso-vagal, orthostatic, cardiac including WPW, ALCAPA, HCM, prolonged QT and Brugada).


Wednesday – March 25

7:30 AM – 8:00 AM Continental Breakfast

8:00 AM - 8:45 AM

When You Hear Hoof Beats, It Might Actually Be a Zebra: Challenging Cases In Pediatric Emergency Medicine
Jeffrey R. Avner, MD

Most of the time, a cold is just a cold and vomiting and diarrhea is just gastroenteritis. However, sometimes the more common chief complaints can harbor a more significant underlying etiology than anticipated. As an emergency medicine provider, one must be aware of not just the common diagnoses but also the more uncommon diagnoses that may have high morbidity and mortality. In this lecture, a potpourri of clinical findings will be presented in a case-based format such that participants can test themselves on various diagnostic and management issues. This speaker will provide an effective guide to recognizing and dealing with some challenging pediatric conditions that you may encounter in the ED.

8:45 AM - 9:15 AM

To Fast or Not to Fast: That is the Question
Baruch Krauss, MD, EDM, FACEP

Children often present with injury requiring sedation after eating. The issue of need for fasting has been controversial for some time. There is much disagreement between anesthesiologists and emergency physicians about need for fasting prior to sedation for emergency procedures. This expert lecturer will provide pros and cons for fasting prior to sedation and outline the latest evidence based guidelines.

9:15 AM - 9:45 AM

Look Into My Eyes: Practical Tips to Measuring Intraocular Pressure and Using the Slit Lamp Exam in Children
Gil Binenbaum, MD

The ophthalmologic exam in young children can be challenge in the ED. Measuring pressures and using the slit lamp are critical skills yet are difficult to perform in the uncooperative child. This expert lecturer will provide advanced tips and techniques for use of devices to measure ocular pressure and to complete a slit lamp exam.

9:45 AM – 10:45 AM Break- Visit the Exhibits

10:45 AM - 11:30 AM

The Eyes Have It: Ocular Signs of Systemic Disease
Gil Binenbaum, MD

There are many diseases that have pathognomonic ocular findings. This expert lecturer using illustrative cases will demonstrate the most critical eye findings indicating systemic disease in children that you do not want to miss.

11:30 AM - 12:15 PM

ABCD: How Point of Care Ultrasound Can Save Lives
Stephanie Doniger, MD, FACEP

A new approach to teaching point-of-care ultrasound and incorporating ultrasound into daily practice is by utilizing the “ABCD approach”. Point-of-care ultrasound can be utilized in each step of the assessment and management of the most critically ill of patients: A (airway), B (breathing), C (circulation), D (Disability), E (exposure, everything else). This approach was introduced by the organization, Winfocus (World Interactive Network Focused on Critical Ultrasound), and has become adopted worldwide. This expert lecturer will present through real-life cases how the ABCD approach is utilized to rapidly assess and manage critical pediatric patients.

12:15 PM – 1:45 PM Lunch – On Your Own

1:45 PM - 2:15 PM

Applying Sinusitis Guidelines in Pediatric Emergency Care
Jeffrey R. Avner, MD

An upper respiratory infection is a common presenting complaint in the ED. While most causes of URIs are of viral etiology, a small percentage of these cases develop into acute bacterial sinusitis. Nevertheless, many cases of URIs are treated with antibiotics and URI is one of the more common reasons for inappropriate antibiotic use. How can the clinician determine when a URI is complicated by sinusitis? What antibiotics should be used for empiric treatment? What defines a “worsening course” of illness? In 2013, the AAP issued updated clinical practice guidelines for the diagnosis and management of acute bacterial sinusitis in children aged 1 to 18 years. This session will review the characteristics of acute bacterial sinusitis in children and how the updated guidelines should be applied in the ED.

2:15 PM - 3:00 PM

PECARN Update on Head Injury: Translating Research into Usable Care Strategies
Nate Kuppermann, MD, FACEP

The Pediatric Emergency Care Applied Research Network (PECARN) has developed a cadre of literature surrounding the identification of patients at low risk for traumatic brain injury. This work is expansive in informing the diagnosis and management of special subpopulations of children with head trauma or isolated risk factors associated with clinically significant head injuries. This expert lecturer will describe the PECARN clinical decision rule, provide updates on its application, and describe new translational studies to assist us in putting the rule into practice in our EDs.

3:00 PM - 3:45 PM

"In Search Of…" An Evidence-Based, Commonsense Approach to Evaluation for Pediatric Cervical Spine Injuries
Julie C R Leonard, MD, MPH

Pediatric cervical spine injuries are accompanied by significant likelihood of morbidity and mortality. Emergency medical personnel trying to follow mandates towards spinal precautions and clinicians trying to determine clinical clearance versus imaging of potentially spinal injured children often rely on decision rules. Providers at all levels are faced with tough questions such as: “Should I tackle the toddler to immobilize their neck?” “Is there a pediatric specific decision rule I can apply?” “When imaging is indicated do I order plain x-rays (with or without odontoid view), flexion and extension films, computed tomography (CT) or magnetic resonance imaging?” “Who needs to stay in a collar?” “Does SCIWORA even exist anymore and how is it truly defined?” This expert lecturer will integrate available evidence for spinal immobilization with need for diagnostic imaging and by what modality to outline a practical approach to c-spine evaluation and management in the ED.

3:45 PM – 4:00 PM Break

4:00 PM - 4:45 PM

Concepts and Myths in the Emergency Treatment of DKA in Children
Nate Kuppermann, MD, FACEP

Treatment of DKA in children has undergone considerable modification for the last 5 years. There are many myths in the treatment of children and there has been a great emphasis in withholding fluids for children in order to prevent life threatening complications such as cerebral edema. This expert lecturer will describe the latest evidence on the emergency treatment of children with DKA and will outline a protocol for emergency management using illustrative cases.

4:45 PM - 5:15 PM

Best Practice UTI
Kathy Shaw, MD, FACEP

The 2011 guidelines that were published in Pediatrics recommended many changes in our approach to the child with a first febrile UTI. No longer are prophylactic antibiotics routinely recommended nor is admission to the hospital routine. The emergency medicine provider is now often responsible for orchestrating outpatient follow-up of these children. The AAP guidelines will be reviewed with particular emphasis on how emergency care including parental education is impacted.

Thursday – March 26

7:30 AM – 8:00 AM Continental Breakfast

8:00 AM - 8:45 AM

Medical Decision Making in Pediatric Emergency Care: How You Reason Reduces Errors
Kathy Shaw, MD, FACEP

Medical decision-making is a complicated process, that requires knowledge of the cognitive process, inherent biases, and knowledge of disease prevalence and risk by which a clinician sorts through a variety of information in order to arrive at the best evidence-based decision. For the emergency medicine provider, this decision-making process is applied to triage, stabilization, diagnosis, management and disposition. These decisions are often more difficult in the unique setting of the ED where historical information is often incomplete or unreliable, privacy is variable, time is limited, multiple decisions need to be made concurrently and interruptions of the thought process are frequent. This expert speaker will focus on the various factors that go into medical decision making in the ED setting and how deficiencies in medical decision making can lead to diagnostic errors.

8:45 AM - 9:15 AM

Bronchiolitis: What’s New and What Not to Do
Marianne Gausche-Hill, MD, FACEP, FAAP

Bronchiolitis is a respiratory disease in infants and in children that is typically diagnosed by clinical findings. Recommendations for diagnosis and management have been previously promulgated by the American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis. These guidelines have been updated. This expert lecturer will discuss controversies in care management (e.g. Levels to define hypoxemia) and risk factors of the patient with bronchiolitis (e.g. an ED visit the week prior, maternal smoking, etc…) and evidence-based guidelines for admission.

9:15 AM - 10:00 AM

Evidence-Based Guidelines: Mandating Care or Improving Quality?
Charles Macias, MD, FACEP

Payors, the public and government are increasingly demanding structured improvements in the patient experience, population health and the reduction of per capita cost of care. This means that hospitals and EDs must change their practice environments to systematize evidence-based practice through guidelines of care and demonstrate improvement in outcomes for children. In a changing landscape of healthcare, the emergency medicine provider must understand the extent to which evidence-based practice is regulated, linked to payer or delivery system reform, and linked to outcomes of care.
10:00 AM – 10:15 AM Break

10:15 AM - 11:00 AM

Practical Tips and Tools: Removing Foreign Bodies in the Ears, Nose and Throat
Timothy Horeczko, MD, FACEP

Pediatric patients are subspecialists in obtaining or placing foreign bodies in odd places, commonly within the ears and nose. As emergency practitioners, we will be faced with identifying and removing these objects. This course will describe the evolution of foreign body types and update practitioners regarding newer modalities to identify and remove challenging foreign bodies.

11:00 AM - 11:45 AM

Best Practices in the ED Management of Status Asthmaticus
Charles Macias, MD, FACEP

The management of status asthmaticus in the pediatric population can be challenged by controversies in the choice of novel therapies to treat severe asthma. In this session, the optimal management of status asthmaticus will be discussed for which evidence suggests best practices. Additionally, research in the comparative effectiveness of other therapies will be discussed.

©  2014 American College of Emergency Physicians