Course Schedule 2018

Tuesday – March 13

7:30 AM – 8:00 AM Continental Breakfast

8:00 AM – 8:15 AM Welcome and Introductions

8:15 AM – 9:15 AM
Literature Update 2018
Richard M. Cantor, MD, FACEP, FAAP
It is a real challenge to keep up with the latest literature in pediatric emergency care. The speaker will present the most relevant publications within the past year that will change your practice.

9:15 AM – 10:00 AM
Test Your Skills in Pediatric ECG Interpretation
Timothy A. Horeczko, MD, MSCR, FACEP, FAAP
Interpretation of the pediatric ECG can be a challenge. Early recognition of prolonged QT, ALCAPA, HCM, Brugada, and myocarditis can be life-saving. The speaker will describe key features of the pediatric electrocardiogram that predict serious disease. Presentations of ECGs and presentation of cases will test your knowledge on these features that can improve your interpretative skills and save lives.

10:00 AM – 11:00 AM Break – Visit the Exhibits and Learning Lounge
11:00 AM – 11:45 AM
To Err is Human, but Our Errors Affect Children
Kathy N. Shaw, MD, MSCE
The emergency department is a very challenging environment in which to work. Its complex patients, complex systems, and irregular routine can accentuate cognitive errors and lead to overt medical errors. The presenter will discuss what factors put an emergency clinician at risk for common cognitive errors and will describe strategies to minimize risk for the pediatric population.

11:45 AM – 12:15 PM
The Pressure is Up: Management of Hypertension in Children
Timothy A. Horeczko, MD, MSCR, FACEP, FAAP
In the US approximately 5% of children have hypertension and it is often not recognized or treated. Complications such as renal failure and cardiomyopathy can occur in children as well as adults. The speaker will discuss the causes, definition and treatment of hypertension in children. Recent guidelines from the US, Canada, and Europe will be discussed.

12:30 PM – 1:30 PM Lunch – On Your Own 

1:30 PM – 2:15 PM
Crash and Burn – Preventing Burnout in PEM
Joan Shook, MD, MBA, FACEP, FAAP
Working in the daily chaos of an emergency department takes its toll. The phrase “physician heal thyself” has new meaning when discussing burnout and resilience. This course will focus on strategies to aid in provider resilience and ways to cope with the stress inherent in our profession. The speaker will also discuss the dramatic increase in physician suicide, both young and old alike, and identify methods to not only respond to these events but also help to identify potentially destructive symptoms in ourselves and our colleagues.

2:15 PM – 2:45 PM
What You See May Not be What You Get: Visual Diagnosis in Children
Christopher S. Amato, MD, FACEP, FAAP
Cutaneous findings are important in correctly diagnosing any disease process. Some, however, serve as clues to more serious underlying disorders. This case-based presentation will highlight some of the more common “dangerous” skin findings in infants and children. Diseases addressed will include pediatric lyme disease (the many faces), erythema multiforme, erythema nodosum, and erythema marginatum.

2:45 PM – 3:30 PM Break – Visit the Exhibits and Learning Lounge

3:30 PM – 4:00 PM
High-Risk Handoffs
Joan Shook, MD, MBA, FACEP, FAAP
Flawed handoff in care has been cited as the root cause of nearly a quarter of malpractice claims in emergency medicine and the Accreditation Council of Graduate Medical Education Clinical Learning Environment Review Program (ACGME CLER) has mandated the use of a standardized handoff process for all residents and faculty members at an institution. This session will explore the rationale for utilizing a formal handoff tool (e.g., SBAR (Situation, Background, Assessment, Recommendation), SAFER Sign out and IPASS) in the ED and will present the evidence supporting various options. Tips for implementation formal handoffs in the ED and metrics to follow the success of the implementation will also be presented.

4:00 PM – 4:45 PM
Saving the Baby Before It’s Born: Techniques in the Difficult Emergent Delivery
Marianne Gausche-Hill, MD, FACEP, FAAP, FAEMS
Each year hundreds of deliveries of newborns occur in the US in emergency departments. Complicated deliveries are rare but require knowledge and skills to save the life of the delivering newborn. The speaker will describe complicated delivery scenarios such as breech presentation, nuchal cord, and shoulder dystocia and provide evidence-based techniques to allow for safe delivery of the newborn.

4:45 PM – 5:15 PM - Visit the Exhibit Hall and Learning Lounge

Wednesday – March 14

7:15 AM – 8:00 AM Continental Breakfast - Visit the Exhibits and Learning Lounge

8:00 AM – 9:00 AM
Common and Critical Cases: Real Cases Covered by Real Docs
Marianne Gausche-Hill, MD, FACEP, FAAP, FAEMS (Mod); Richard M. Cantor, MD, FACEP, FAAP; Sean M. Fox, MD, FACEP, FAAP; Emily C. MacNeill, MD
Our patients teach us a lot and we can all benefit from discussing the critical thinking in problem solving difficult cases. This unique presentation will take case-based presentations to a new level by having pediatric emergency medicine experts manage each other’s patient cases. These cases will help to highlight and review the concepts in the management of critical pediatric emergency cases.

9:00 AM – 9:45 AM
Toxins That are Not Pills: Patches, Salves, Drops...You Name It
Richard M. Cantor, MD, FACEP, FAAP
Toxic exposures come in many forms and flavors, especially for the inquisitive pediatric patient. Almost all asynchronous gastrointestinal delivery systems (drops, patches, ointments) have the potential to impart dramatically toxic events. The presenter will describe through case presentations the various non-pill form of medications that are toxic and their management.

9:45 AM – 10:45 AM Break - Visit the Exhibits and Learning Lounge

10:45 AM – 11:15 AM
Damage Control Resuscitation: Considerations for the Severely Traumatized Child
Sean M. Fox, MD, FACEP, FAAP
Traumatic injuries are still a leading cause of morbidity in children. The concept of “damage control resuscitation” for the adult trauma patient has become popularized and focuses on acute coagulopathy of trauma, permissive hypotension, and hemostatic resuscitation with massive transfusion protocols. How do these concepts impact the care of the pediatric trauma patient? The presenter will discuss the latest science of managing the critically traumatized child.

11:15 AM – 11:45 AM
Bugs and Drugs: Antibiotic Stewardship in the Pediatric ED
Michael Bolaris, MD
In this day of increasing antibiotic resistance, the onus of appropriately prescribed antibiotics is becoming increasingly important to the emergency clinician and their patients. What are the medical conditions in which a “wait-and-see” approach can be safely implemented? What are the most recent guidelines pertaining to conditions that do not necessarily require prescribed antibiotics? The speaker will discuss the advanced practices in stewardship during a time when we need to choose wisely.

11:45 AM – 1:30 PM Lunch – On Your Own

1:30 PM – 2:00 PM
Rapid Testing for Infectious Disease: Does This Change the Fever Workup?
Michael Bolaris, MD
New polymerase chain reaction panels are available and are highly accurate. How do we incorporate these into our algorithms for management of infants and children with fever? This Speaker will describe the rapid testing that is now available to detect a whole host of viral and bacterial agents. Can we use these in the ED to “rule-out” infections? Use of these new rapid diagnostic tests will alter the landscape of the fever work-up in the ED.

2:00 PM – 2:30 PM
Is That BLOOD in My Child’s Diaper? What To Do With Red #2
James (Jim) L. Homme, MD
Of the rainbow of colors that can be found in the diaper of an infant or young child, none engenders more fear and anxiety than the color RED. Generally the first order of business for the emergency clinician is to determine if this represents blood or some other rubicund imposter. After confirmation of heme positivity, the source and etiology of the nappy invader comes next in the diagnostic pathway. During this lecture you will be provided with the differential diagnosis and an evidence-based approach to the workup and management of heme positive diapers as well as common mimics.

2:30 PM – 3:15 PM
Clots in Kids: Identifying Children With DVT and PE
Mimi Lu, MD, MS
Pleuritic chest pain, shortness of breath and tachycardia – what is the top of your differential diagnosis? The emergency clinician thinks pneumonia, asthma, pneumothorax or possibly pulmonary embolism. Which pediatric patient is truly at risk for deep venous thrombosis or pulmonary embolism? Are the risk factors, signs and symptoms similar between children, adolescents and adults? Can clinical decision rules (Wells, Geneva, or PERC) assist the emergency clinician in risk stratification of the pediatric patient? What role, if any, does a d-dimer, venous ultrasonography or CT angiography play in the evaluation? All these questions will be addressed in this lecture to help the front line emergency clinician to identify children with DVT and PE.

Thursday – March 15

7:30 AM – 8:00 AM Continental Breakfast

8:00 AM – 8:30 AM
The Unvaccinated Patient: Work-Up, Treat, or Discharge
Jeffrey R. Avner, MD
Unvaccinated children who present with a possible vaccine preventable illness can be a source of frustration or concern for the emergency clinician. Clinical decision making can be difficult when a child is unvaccinated. The reasons for parental refusal of vaccines are diverse and emergency clinician strategies that can improve vaccine acceptance will be discussed. The speaker will outline the risks of serious underlying infection of the unvaccinated child and how to impact future vaccination of children for families that do not currently embrace vaccination practices.

8:30 AM – 9:00 AM
Suicide Screening Tool for the ED: Is Anyone Low Risk?
Emily C. MacNeill, MD
Psychiatric disorders are prevalent in our EDs and affect people of all races and socioeconomic groups. Suicide is still a leading cause of death in adolescents and young adults in the USA. While these conditions warrant considerable concern and caution, many children will, fortunately, not be in imminent danger. Determining which patient is truly at low risk however, can be challenging to the emergency clinician. The presenter will review this critical topic in pediatric emergency practice and discuss some of the recommended available screening tools that can be appropriately used in the ED.

9:00 AM – 9:30 AM
ILI Oh My! Complications From Influenza Infections
Jeffrey R. Avner, MD
A 2-year-old presents to the ED with a influenza-like illness (ILI) with fever, body aches and complaint of general weakness. What complication of flu must be considered and which patients are at risk? What are the diagnostic and management strategies for these patients? The speaker will describe early detection, and strategies for treatment for these complications of influenza in the ED.

9:30 AM – 9:45 AM Break

9:45 AM – 10:30 AM
Angioedema: Not all That Swells is Anaphylaxis
Mimi Lu, MD, MS
Pediatric patients frequently present to the ED with swelling of the lips, eyelids, or other parts of the body with or without an associated itchy red rash. Treatment for anaphylaxis ensues yet all that swells is not anaphylaxis and some forms of angioedema or edema. During this lecture you will be provided with up-to-date information on the underlying mechanisms of urticaria, angioedema, and edema as well as a rationale diagnostic and therapeutic approach to these clinically similar but distinct entities.

10:30 AM – 11:00 AM
Vitamin K for Pain Control: Ketamine for Kids
James (Jim) L. Homme, MD
Patients with acute or chronic pain presenting to the ED have largely been managed with non-steroidal, opiates and other non-narcotic analgesics. Ketamine (“Vitamin K”) has long been known to provide potent analgesic and when given at low doses (otherwise known as sub-dissociative or sub-anesthetic) can be an excellent single or adjuvant treatment for acute or chronic pain. Prehospital and palliative settings utilize ketamine for analgesia due to the unparalleled safety profile and opioid sparing or potentiating properties. Is it time to add “Vitamin K” for sedation but also a key tool in the toolbox for pain management?

11:00 AM – 11:45 AM
Pitfalls in the Care of the Critical Newborn: Resuscitation and Beyond
Marianne Gausche-Hill, MD, FACEP, FAAP, FAEMS
Newborn deliveries are infrequent in the ED but when they do occur, the emergency clinician must know the critical steps in the resuscitation of these high-risk newborns. The speaker will outline new changes in newborn resuscitation including stimulation of the baby, use of oxygen, suctioning, timing of cutting the cord, timing of positive pressure ventilation and warming of the newborn will be described. The optimal equipment and supplies for the care of the newly born will also be discussed.

11:45 AM – 12:15 PM
Sticks and Stones Can Break a Bone: When to Consult Orthopedist and When to Refer
Christopher S. Amato, MD, FACEP, FAAP
Orthopedic injuries in children vary based on age of patient and mechanism of injury. How much angulation is acceptable for immobilization with discharge and outpatient follow-up versus a call for closed reduction in the ED today? Does that fracture/dislocation even need orthopedic follow up? From ankle to the apex, the presenter will discuss the diagnosis and management of the more complex orthopedic injuries.