Concurrent Sessions: Research; Échographie à l’urgence; Neurology; Creativity; Critical Care; Respiratory Disease

June 5, 2016

10:00  –  11:30
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Track 1

Track 1 – RESEARCH

Track Chair: Dr. Jeff Perry

Lightning Orals

ID Number Title Presenter
* Resident Abstract Award Winner
LO001 The Prevalence of Low Back Pain in the Emergency Department: A Systematic Review and Primary Study in the Charles V. Keating Emergency and Trauma Centre, Halifax, Nova Scotia, Canada. Jordan Edwards
LO002 Improving safety of patients in respiratory distress: Identifying preventable adverse events related to care provided in the emergency department Shannon Pretty
LO003 Outpatient Referrals from the Emergency Department - A Retrospective Review Nicholas Prudhomme
LO004 Short-Term Risk of Arrhythmias among Syncope Patients Presenting with Atrial Fibrillation/Flutter to Canadian Emergency Departments Cristian Toarta*
LO005 Association between emergency department chest pain volume and outcomes among patients presenting with chest pain Neil Dattani*
LO006 Interarm Blood Pressure Differential as a Clinical Marker for Acute Aortic Dissection in the Emergency Department Sung Um
LO007 Pragmatic Randomized And Controlled Evaluation Of Nurse-Initiated Protocols Matthew Douma
LO008 Assessment of the Need for Diagnostic Imaging in Extremity Injuries by Advanced Care Paramedics Patrick Froese
LO009 Impact of physician navigators on measures of emergency department efficiency Alexander Leung

Track 2

Track 2 – ÉCHOGRAPHIE À L’URGENCE

Track Chair: Dr Claude Topping

Comment l’échographie a changé ma pratique?
Dr Marc Charles Parent

Conférence sur la façon d’intégrer l’échographie ciblée à l’urgence. Comment l’échographie ciblée à l’urgence va changer la pratique à l’urgence.

Objectifs d’apprentissage

  • Identifier les échographies ciblées à l’urgence pouvant changer ma pratique
  • Comprendre comment l’échographie à l’urgence peut changer la pratique à l’urgence

Pourquoi l'échographie ciblée est-elle importante en choc?
Dr Maxime Valois, Dr Jean-François Lanctôt

L’échographie ciblée prend une place de plus en plus grande en médecine d’urgence. Nous réviserons comment et pourquoi son utilisation peut influencer la prise en charge et possiblement le devenir des patients en choc. De la tamponnade à l’embolie pulmonaire en passant par le choc cardiogénique et les sepsis, la sémiologie échographique du choc et les préceptes physiologiques sous-jacents seront abordés. Nous verrons comment les applications de base et plus avancées peuvent s’intégrer aux soins usuels.

Objectifs d’apprentissage

  • Connaitre la sémiologie échographique du choc et les préceptes physiologiques sous-jacents
  • Intégrer l’échociblée 2D dans la gestion quotidienne des patients en choc
  • Connaître les modalités plus avancées et leur pertinence dans la gestion du choc

Le Combo Trauma
Dr Claude Topping

À la fin de la séance, le participant pourra connaître une séquence ordonnée de balayage ÉDU compris dans l’ABC d’un polytraumatisé. Deux professionnels Å“uvrant dans un département d’urgence et fous de bandes dessinées ont eu un projet en tête. La vie et le travail dans un département d’urgence est loin d’être monotone, mais comment rendre accessible en bande dessinée ce climat particulier où se côtoient drame humain et situations loufoques? Nous croyons avoir réussi par le moyen d’une BD. Nous travaillons présentement avec l’équipe des Studios Frima dans la création d’une version animée pour la télévision.

Objectifs d’apprentissage

  • Connaître une séquence ordonnée de balayage ÉDU compris dans l’ABC d’un polytraumatisé
  • Identifier les résultats recherchés lors de cette séquence et les diagnostics associés
  • Adapter l’investigation secondaire en conséquence

Track 3

Track 3 – NEUROLOGY FOR DUMMIES

Track Chair: Dr. Jeff Perry

Acute Ischemic Stroke and TIA Management in the ED: What You Must Know and Do
Dr. Andrew Demchuk

Dr. Demchuk will review the new evidence for endovascular treatment in acute ischemic stroke. He will also discuss the crucial tests and process for timely decision making to ensure all eligible patients for endovascular treatment receive the therapy across all jurisdictions in Canada as well as the approach, investigations and management of minor stroke and TIA. The emphasis is on the importance of vascular imaging with CTA which is now the minimum standard with non-contrast CT to evaluate patients with major stroke symptoms. CTA is also very useful to triage high risk TIAs for hospital admission versus discharge from the ED.

Learning Objectives

  • Understand the randomized clinical trial evidence for endovascular treatment of ischemic stroke
  • Risk stratify neurologic spells to identify those who are high risk TIAs requiring urgent evaluation
  • Understand the value of vascular imaging in the assessment of stroke

Abstracts

ID Number Title Presenter
LO010 Clinical Assessment of Transient Ischemic Attack Patients for Symptomatic Carotid Disease in the Emergency Department Nickan Motamedi
LO011 Identification of mild Acute Cerebrovascular Syndrome (ACVS) in the Emergency Department: Validation of an ACVS clinical classifier to help distinguish mimics. Kristine Votova
LO012 High-Risk Investigation Findings for Symptomatic Carotid Disease in ED TIA Patients Nickan Motamedi

Hemorrhagic Stroke
Dr. Dariush Dowlatshahi

Hemorrhagic stroke, or intracerebral hemorrhage (ICH), is the most lethal form of stroke. Untreated, mortality is as high as 40 percent in the first three months and 80 percent of survivors are disabled. Despite the nihilism that has surrounded ICH for many years, recent breakthroughs in diagnostic technologies and treatment targets offer new management strategies in the emergency department. In this session, Dr. Dowlatshahi will review the use of CT imaging to predict early hematoma expansion, and emerging hemostatic, hemodynamic and surgical therapies.

Learning Objectives

  • Use CT and CT-angiography to identify patients at highest risk of deterioration
  • Initiate early hemodynamic therapy to improve clinical outcome
  • Initiate hemostatic therapy in appropriate patients

Track 4

Track 4 – CREATIVITY

Track Chairs: Mr. Patrice Aubertin, Mr. Bernard Petiot

Creativity, the He(art) of Medical Schools
Dr. Julien Poitras

Creativity is “the use of the imagination or original ideas, especially in the production of an artistic work.” Medicine has been qualified as a mix of science and art, although in the last decade science has been said to have taken the lead over other aspects of the profession. On the other hand, creativity is at the heart of scientific progress and research. In this presentation, Dr. Poitras will explore how medical schools can nurture creativity in their operations/mission to foster scientific/research careers and in the professionals they train to provide care to patients.

Learning Objectives

  • Describe three benefits of creativity in professional practice
  • Name three initiatives that medical schools can foster to nurture creativity in students
  • Initiate a change to teach creativity in the clinical setting

ED Creativity: From ED to Comics
Dr. François Paquet

Dr. Paquet and other professionals working in an emergency department, crazy about comics, have an idea: How can the trauma of human life, and the working climate of an ED, translate into a comic strip? They believe they’ve succeeded with Statcomics and are currently working with a team at Frima Studios in the creation of an animated version of “Stat” for television.

Learning Objectives

  • Recognize that emergency physicians can develop a good work-life balance
  • Understand how physicians can develop hobbies in a stressful known emergency environment
  • Recognize that humour offers a healthy means of coping with life stress
  • Recognize the positive aspects experienced by emergency workers with the use of humour
  • Recognize that humour is an excellent tool in the relationship between patient and physician, sometimes in very difficult situations

Creativity Lost. The Downstream Impact of a “Paint By Numbers“ Culture
Dr. Dean Kreillaars

In this session, Dr. Kreillars will discuss some of the societal factors responsible for inhibition of creativity, and the downstream effects on meaningful participation in society and innovation. Highlighting recent research on creativity, he will reveal a new creativity assessment tool. The session will finish with sector-based recommendations for creativity enhancement.

Learning Objectives

  • Understand the neurophysiology of creativity
  • Identify societal barriers to creativity
  • Articulate the downstream negative effects of creative inhibition

The Quality Function Deployment (QFD): A Structured Approach that Fosters Creativity
Dr. Eric Wagnac

Creativity is essential to the design of innovative and good quality products. To be of good quality, it is imperative that new products satisfy customer needs. Quality Function Deployment (QFD) is a method for developing products to satisfy consumers by transferring their demands into design targets and specifications. It was proven that for people to be creative and innovative there must be a work environment that supports QFD implementation. By using a number of real life case studies, in this presentation Dr. Wagnac will show that QFD inspires commitment and creativity in product delivery.

Learning Objectives

  • Define and explain QFD in a design process
  • Understand the relationship between QFD and creativity
  • Organize a creativity session around QFD

Cirque du Monde: A Journey Behind the Scenes
Ms. Julie Théberge

Social circus is an intervention tool like no other.  Social circus makes people move – it makes people connect with themselves and with each other. Cirque du Monde cultivates confidence and celebrates differences. Circus arts call for teamwork and a combination of strengths and talents; elements that can help young people develop a sense of belonging. They allow for freedom and creativity while demanding perseverance and discipline. The workshops offer young people a space to open up, to express themselves and to create, while helping them make new bonds with a society that has often excluded them. The aim of the workshops is to transform circus skills into life skills.  More a tale than the results of scientific research, Ms. Théberge’s presentation will focus on the human experience of preparing for CAEP.

Learning Objectives

  • Understand the social circus approach
  • Discover the process behind the creation of a circus presentation
  • Apply the lessons of circus skills to life skills

Track 5

Track 5 – CRITICAL CARE

Track Chair: Dr. Francis Bernard

The Crashing Trauma Patient
Dr. Jean-François Shields

One of the most challenging situations emergency physicians face is the dying trauma patient. In this presentation, Dr. Shields will provide resources to help you manage your next critically-ill trauma patient. He will also talk about selecting which patient who arrests might benefit from a full resuscitation.

Learning Objectives

  • Understand better use of vasopressors in trauma
  • Understand the latest evidence on fluid resuscitation of the trauma patients
  • Identify and treat the blunt cardiac arrest patient

Mechanical Ventilation 101 in the Emergency Department
Dr. Yannick Poulin

In this presentation, Dr. Poulin will discuss what doctors should know when starting mechanical ventilation in the emergency department. He will also provide tips to help in the management of difficult cases.

Learning Objective                                                                                

  • Differentiate between mechanical ventilation modes to start the right mode for the right patient use the PEEP

Initial Management of Brain Injured Patients: Golden Hour
Dr. Francis Bernard

In this session, Dr. Bernard will review the management of moderate and severe brain injured patients in the emergency department. He will focus on the role of the emergency physician in the patient outcome. Dr. Bernard will review the critical issues related to brain homeostasis: cerebral perfusion pressure, ventilator management (PaO2 and PCO2), sedation, osmotic therapy and temperature management. He will highlight these concepts and the underlying physiology with the help of advanced cerebral monitoring: transcranial doppler, cerebral oxygenation (Licox) and cerebral saturation (NIRS).

Learning Objectives

  • Name the critical physiological parameters to address in the ED while managing a moderate/severe brain injured patient
  • Understand appropriate use of osmotic therapies and temperature management
  • Learn the determinants of oxygen delivery to the brain

Track 6

Track 6 – RESPIRATORY DISEASE FROM 0 TO 99 YEARS OLD

Track Chair: Dr. Serge Gouin

Difficult Airways, Tips and Pearls to Survive Intubation
Dr. Raoul Daoust

In this presentation, Dr. Daoust will provide tips and pearls that will enable you to expertly perform intubations in difficult situations.

Learning Objective

  • Describe techniques for optimal intubation conditions

SOB! That’s Not Pneumonia...Interesting Chest X-Rays and Respiratory Cases in the ED
Dr. Aaron Assedou

In this presentation, Dr. Assedou will give you a better understanding of laboured-breathing presentations that could easily be mistaken for pneumonia. Although rare, these are interesting cases and diagnoses to consider, and not to miss, in the ED.

Learning Objectives

  • Recognize red flags in the evaluation of a patient with dyspnea
  • Include less frequent causes of dyspnea to a differential, when appropriate
  • Evaluate the need for additional testing

Management of Status Asthmaticus: Pediatric and Adult Considerations
Dr. Matthieu Vincent

The management of status asthmaticus can be challenging and time sensitive. There are several therapeutic options, each with varying levels of efficacy and supporting evidence. Dr. Vincent will discuss treatments such as corticosteroids, IV and continuous nebulized B2-agonists, ipratropium, magnesium sulfate, heliox, epinephrine, ketamine and others. He will also discuss the role of non-invasive ventilation and the challenges associated with mechanical ventilation. This session will include both adult and pediatric considerations.

Learning Objectives

  • Classify the severity of the bronchospasm
  • Tailor the therapeutic regimen according to severity and progression of status asthmaticus
  • Initiate mechanical ventilation and adjust settings

Bronchiolitis: Are We Doing Too Much?
Dr. Serge Gouin

Bronchiolitis is a common disease that confronts all Canadian emergency physicians during the winter. The burden of this disease is significant for families and resource utilization. Could we help them and reduce the impact on the health care system? Dr. Gouin will present new studies that address these issues.

Learning Objectives

  • Review the observation, discharge, admission and transfer criteria for patients with bronchiolitis
  • Review current ideal proposed therapeutic modalities for bronchiolitis
  • Review the importance of a standardized management approach for bronchiolitis