Scientific Assembly 2002: program highlights

8:00-8:55 a.m. Wobbles That Woe: Ataxia and Gait Disturbance and When to Worry (SU-12)
Ataxia and gait disturbances are symptoms of a variety of clinical problems, including acute neurologic diseases, orthopedic diseases, and toxicologic disorders. Dr. Henry will identify the common causes of these symptoms, describe how to make diagnoses, and discuss special considerations for the elderly and children.

Faculty: Gregory L. Henry, MD, FACEP, Clinical Professor, Department of Emergency Medicine, University of Michigan Medical School; Staff Physician, St. Joseph Mercy Hospital; CEO, Medical Practice Risk Assessment, Inc.; Past President, ACEP

12:30-1:25 p.m. Aeromedical Transport: Why Altitude Makes a Difference and How to Prepare for It
(SU-16) High altitudes can cause physiological differences in patients. Dr. Hodgdon will discuss the differences between aeromedical care and standard emergency care, describe treatment plans for patients at high altitudes, and explain the steps an emergency physician must take to prepare a patient for aeromedical transport.

Faculty: Alan K. Hodgdon, MD, FACEP, Medical Director, Emergency Services, Mercy Providence Hospital; Clinical Assistant Professor, Department of Emergency Medicine, University of Pittsburgh School of Medicine, Senior Aviation Medical Examiner, Federal Aviation Administration

12:30-1:25 p.m. Life-Threatening Skin Diseases (SU-20) Life-threatening rashes must be identified and treated rapidly.
Dr. Edwards will focus on early identification and treatment of life-threatening rashes such a erythema multiform, toxic shock syndrome, and necrotizing fascitis (flesh eating bacteria).

Faculty: Libby Edwards, MD, Associate Clinical Professor, Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina; Chief, Dermatology, Carolinas Medical Center, Charlotte, NC

12:30-1:25 p.m. Mistakes You Don't Want to Make in Pediatric Patients (SU-23) Emergency care of children has special challenges.
Dr. Wiebe will discuss "red flags," in pediatric illness and examine some of the most commonly missed pediatric diagnoses, including meningitis, appendicitis, intussuception, and fractures.

Faculty: Robert A. Wiebe, MD, FACEP, The Sarah M. and Charles E. Seay Distinguished Chair in Pediatric Medicine; Professor of Pediatrics; Director, Pediatric Emergency Medicine, University of TX Southwestern Medical Center, Dallas; Director, Emergency Center, Children's Medical Center of Dallas

12:30-1:25 p.m. The Clinical and Practical Challenges of the Drug-Seeking Patient (SU-24)
Patients with chronic pain can become "frequent flyers" in an emergency department, presenting difficult management dilemmas. Dr. Vissers will describe common complaints of people repeatedly seeking pain medications, the terminology that stigmatizes patients in chronic pain, and the ethical and legal issues of treating these patients.

Faculty: Robert J. Vissers, MD, FRCPC, FACEP, Assistant Professor/ Residency Director, Department Emergency Medicine, University of North Carolina, Chapel Hill, NC

12:30-1:25 p.m. Blood and Drugs -- Unexpected Complications of Common Therapies (SU-17)
Dr. Borenstein will discuss the most common and serious side effects of drug therapies on the blood system; review drugs well known to affect bleeding, coagulation, and platelet function; and propose treatment plans.

Faculty: Marc A. Borenstein, MD, FACEP, Chairman and Residency Program Director, Department of Emergency Medicine, Newark Beth Israel Medical Center, Newark, New Jersey; Clinical Associate Professor of Medicine, Columbia University College of Physicians and Surgeons, NY

12:30-2:25 p.m. The Federal "Anti-Dumping" Law: Update on EMTALA and the New CMS Interpretive Guidelines (SU-29)
Ensuring compliance with the Emergency Medical Treatment and Labor Act has become even more difficult with its continued expansion, and penalties for failure to comply are severe. Dr. Bitterman will review new guidelines and government enforcement actions, examine issues related to the hospital's duty to accept patient's in transfer from other facilities, and discuss compliance issues related to on-call physicians.

Faculty: Robert A. Bitterman, MD, JD, FACEP, author of EMTALA: Providing Emergency Care Under Federal Law, and Clinical Assistant Professor, Emergency Medicine, University of North Carolina Medical School, Chapel Hill; Director, Risk Management and Managed Care, Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC

12:30-1:25 p.m. FASTer Than a Speeding Bullet: The Role of Ultrasound in the Trauma Patient (SU-19)
Dr. Lambert will review the literature on the use of ultrasound to evaluate patients with abdominal and penetrating chest trauma, compare it with diagnostic peritoneal lavage and computed tomography, and analyze which clinical situations justify the use of ultrasound alone.

Faculty: Michael J. Lambert, MD, RDMS, FACEP, Clinical Assistant Professor, Department of Emergency Medicine, University of Illinois College of Medicine; Fellowship Director, Emergency Ultrasound, Resurrection Medical Center, Chicago, IL

1:00-2:25 p.m. Child Friendly Emergency Departments (SU-30)
Most community and university emergency departments treat children with a wide variety of complaints and needs. Dr. Gausche-Hill will discuss the rationale of providing family-centric and pediatric friendly care areas. She also will analyze the benefits of pediatric emergency departments and discuss how to establish specific protocols, policies, and procedures.

Faculty: Marianne Gausche-Hill, MD, FACEP, Director, Pediatric Emergency Medicine, Little Company of Mary Hospital; Clinical Professor of Medicine, UCLA School of Medicine, Harbor-UCLA, Department of Emergency Medicine, Torrance, CA ; Past Chair, ACEP's Pediatric Emergency Medicine Committee

1:30-2:25 p.m. Put the Brakes on the Next Drunk Driver! (SU-251)
Dr. Jeff Runge, Administrator for the National Highway Traffic Safety Administration, will review screening exams for identifying at patients at risk for alcohol-related problems. He will outline community referral options and how to establish an intervention program in an emergency department.

Faculty: Jeffrey W. Runge, MD, FACEP, Administrator, National Highway Traffic Safety Administration (NHTSA), U.S. Department of Transportation, Washington, DC

3:00-4:55 p.m. Pediatric Literature Update: Will These Articles Change Your Practice? (SU-48)
Keeping up with the expanding pediatric emergency medicine literature is challenging for many emergency physicians. Dr. Cantor will review recent literature and identify trends and changes that could affect the way emergency physicians care for children.

Faculty: Richard M, Cantor, MD, FACEP, Associate Professor, Emergency Medicine/Pediatrics, University Hospital, SUNY Health Science Center, Syracuse, New York; Vice Chair, Pediatric Emergency Medicine; Medical Director, Central New York Poison Control Center

3:00-3:55 p.m. Bacterial Resistance: What It Means to Your Emergency Department Practice (SU-39)
In the war against infections, bacteria seem to constantly be developing ways to defeat the best antibiotics. Dr. Stone will describe the mechanisms by which bacteria develop antibiotic resistance and the strategies to reduce it, as well as discuss common scenarios in which resistance is affecting how infections are treated.

Faculty: Susan C. Stone, MD, MPH, Assistant Professor, Keck School of Medicine, university of Southern CA; Associate Residency Director, Emergency Medicine, USC/LAC Medical Center, Los Angeles

3:00-4:55 p.m. Cardiology Exposes: An Interactive Point/Counterpoint Discussion (SU-46)
A panel of experts will discuss the controversies of diagnosing and treating cardiac conditions. Using a point/counterpoint format, they will discuss such topics as atrial fibrillation (to convert or not?), ruling out MI (which protocol?), congestive heart failure (nitrates or BNF?), and the role of Amiodarone and Vasopressin in cardiac arrest. Panelists also will discuss current recommendations for thrombolytic therapy for acute myocardial infarction.

Faculty:
-- Michael J. Bresler, MD, FACEP, Clinical Professor, Surgery, Division of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA
-- Mel L. Herbert, MD, FACEP, MBBS, BMedSci, Assistant Professor, Medicine, UCLA School of Medicine
-- Eric R. Snoey, MD, Associate Clinical Professor, University of California, San Francisco; Residency Director, Department of Emergency Medicine, Alameda County Medical Center, Oakland, CA

3:00-4:55 p.m. Rapid Deployment of Real-Time Surveillance for Chemical-Biological Terrorism Base on Emergency Department Encounter Data (SU-49)
An expert panel will discuss the role of emergency departments in conducting surveillance for biological or other environmental illnesses and review Internet sources for on-line clinical information.

Faculty:
--Kristi L. Koenig, MD, FACEP (Moderator), National Director, Emergency Management Strategic Healthcare Group, Veterans Health Administration, Dept of Veterans Affairs, Washington, DC
-- Jonathan Burstein, MD, FACEP, Director, Disaster Medicine, Beth Israel Deaconess Medical Center; Assistant Professor, Harvard Medical School, Boston, MA
-- Thom A. Mayer, MD, FACEP, Professor, Emergency Medicine and Pediatrics, Georgetown University School of Medicine, George Washington University School of Medicine; Chair, Dept of Emergency Medicine and Medical Director, Flight Services, Inova Fairfax Hospital, Falls Church
-- Stuart B. Weiss, MD, FACEP, Director, Disaster Preparedness; Associate Director, Pre-Hospital Care, Saint Barnabas Health Care System, West Orange, NJ

3:00-3:55 p.m. Providing Medical Care at Mass Gatherings (SU-42)
Dr. Pons will discuss how to plan for providing medical care at mass gatherings and explain the medical and legal issues of providing this kind of care.

Faculty: Peter T. Pons, MD, FACEP, Attending Physician, Emergency Dept, Denver Health Medical Center; Professor, Emergency Medicine, Dept of Surgery, Univer of Colorado Health Sciences Center, Denver

4:00-5:55 p.m. Can Emergency Department Nursing Staff Shortages Be Fixed? (SU-56)
Dr. Lev will discuss appropriate staffing of nurses in emergency departments, as well as recruitment and retention strategies, including how to use allied health providers to provide patient care.

Faculty:
--Roneet Lev, MD, FACEP, Scripps Mercy Hospital, Emergency Department; Clinical Faculty, University of California, San Diego
--Janis Offret, RN, MSN

5:00-5:55 p.m. Recognizing the Top Ten Pediatric and Adult Rashes (SU-65)
Dr. Edwards will discuss how to recognize and treat 10 common and clinically significant rashes in children and how to differentiate among similar presentations.

Faculty: Libby Edwards, MD, Associate Clinical Professor, Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina; Chief, Dermatology, Carolinas Medical Center, Charlotte, NC

5:00-5:55 p.m. Is There a Doctor On Board? Airlines, Defibrillators, and Medical Kits (SU-64)
Dr. Hodgdon will discuss the responsibilities and legal issues of physicians who treat medical emergencies on commercial flights, as well as what medical supplies are available to physicians on these flights.

Faculty: Alan K. Hodgdon, MD, FACEP, Medical Director, Emergency Services, Mercy Providence Hospital; Clinical Assistant Professor, Department of Emergency Medicine, University of Pittsburgh School of Medicine; Senior Aviation Medical Examiner, Federal Aviation Administration

Monday, October 7

8:00-8:55 a.m. Interview With a Vampire: Case Studies in Hematologic Emergencies (MO-73)
Describing a series of patient cases, Dr. Lee will discuss life-threatening hematologic disorders, explaining the coagulation cascade of bleeding patients and the indications for various drugs, factors, and platelet treatments.

Faculty: Patricia G. Lee, MD, FACEP, Associate Clinical Professor, University of Illinois at Chicago, Department of Emergency Medicine; Medical Director, Masonic Medical Center, Department of Emergency Medicine, Chicago, IL

8:00-8:55 a.m. After the Blast: From Industrial Accident to Terrorist Bomb (MO-69)
Patients involved in explosions can have several mechanisms of injury that may complicate recognition and treatment of injuries. Dr. Siegel will discuss patterns of explosion injuries and review specific therapies.

Faculty: David A. Siegel, MD

8:00-8:55 a.m. Approach to the Febrile Child: Where Do We Stand? (MO-70)
What should an emergency physician do with a feverish child who "looks great" and has no identifiable source of infection? Dr. Wiebe will discuss guidelines for managing fever in children, as well as epidemiological changes in organisms cause by vaccines, and the role of laboratory tests in evaluating fever in children.

Faculty: Robert A. Wiebe, MD, FACEP, The Sarah M. and Charles E. Seay Distinguished Chair in Pediatric Medicine; Prof of Pediatrics; Dir, Division of Pediatric Emerg Medicine, Univer of Texas Southwestern Medical Center at Dallas; Director, Emergency Center, Children's Medical Center of Dallas

9:00-10:55 a.m. Antibiotic Use in the Emergency Department: What's New? (MO-90)
A wide variety of antibiotics are available for treating emergency patients. Dr. Stone will discuss the adverse effects, the cost-effectiveness of frequently used antibiotics, and features of new antibiotics.

Faculty: Susan C. Stone, MD, MPH, Assistant Professor, Keck School of Medicine, university of Southern California; Associate Residency Dir, Emergency Medicine, USC/LAC Medical Center, Los Angeles, CA

9:00-9:55 a.m. ACLS: Fact or Fiction -- The Experts Debate (MO-83).
Nationally recognized emergency physicians will debate the science and appropriateness of the updated Advanced Cardiac Life Support guidelines.

Faculty:
-- Diane M. Birnbaumer, MD, FACEP, Professor, UCLA School of Medicine; Associate Residency Director, Department of Emergency Medicine, Harbor/UCLA Medical Center, CA
-- Richard O. Cummins, MD, MPH, MSc, Professor of Medicine, University of Washington; Editor, Senior ACLS, Seattle, WA
-- Mel L. Herbert, MD, FACEP, MBBS, BMedSci, Assistant Prof, UCLA School of Med; Asst Prof, Nursing, UCLA School of Nursing, Dept of Emerg Med, Olive View-UCLA Med Cent, Sylmar, CA

9:00-9:55 a.m. EMS and the Law (MO-85)
Dr. Pons will discuss the risks, liability, and responsibility of online control of emergency medicine by radio or phone. He will explore the impact of the latest EMTALA revisions; the potential consequences of new compliance initiatives; as well as patient consent, competence, and refusal.

Faculty: Peter T. Pons, MD, FACEP, Attending Physician, Emergency Department, Denver Health Medical Center; Prof, Emergency Medicine, Dept of Surgery, University of CO Health Sciences Center, Denver

9:00-9:55 a.m. New Cardiac Drugs: How, What, and When to Use Them in the Emergency Department (MO-86)
Dr. Snoey will describe the literature and compare new cardiac drugs, including intravenous ACE inhibitors, B-blockers for congestive heart failure, naturetic peptide, and medication for ventricular tachycardia and atrial fibrillation.

Faculty: Eric R. Snoey, MD, Associate Clinical Professor, University of California, San Francisco; Residency Director, Department of Emergency Medicine, Alameda County Medical Center, Oakland, CA

9:00-9:55 a.m. Dilemmas and Decisions in Emergency Medicine Administration (MO-84)
Panelists will discuss staff physician behavior issues faced by emergency department directors and the associated difficult ethical and economic decisions that must be made.

Faculty:
-- Kelly O'Keefe, MD, FACEP, Medical Director, Adult Emergency Care Center, Tampa General Hospital, Tampa, FL
--Tracy G. Sanson, MD, FACEP, Assistant Medical Director, Department of Emergency Medicine, Brandon Regional Hospital, Brandon, FL

10:00-10:55 a.m. Rules and Regs: When Will It Stop? Dealing with New Regulatory Initiatives (MO-99)
Side rails are a form of restraint, but do they require extreme documentation? Should there be signs in the waiting room when a TV crew is filming? Dr. Smith will discuss recent regulatory initiatives that will directly affect patient care in terms of privacy and confidentiality, as well as the cost and effect of these unfunded mandates.

Faculty: Mason A. Smith, MD, FACEP, President/CEO, Lynx Medical Systems, Inc., Bellevue, Washington; Representative, Carrier Advisory Committee, Washington

12:30-2:25 p.m. When Terrorism Strikes: Will You and Your Hospital/EMS System Be Prepared? (MO-116)
Dr. Burstein will discuss the lessons learned from September 11, the most important issues to consider when developing a plan to handle terrorist attacks, and the most likely weapons used.

Faculty: Jonathan Burstein, MD, FACEP, Director, Disaster Medicine, Beth Israel Deaconess Medical Center; Assistant Professor, Harvard Medical School, Boston, MA

12:30-1:25 p.m. Engineering an Error-Free Environment (MO-105)
Dr. Hobgood will discuss policies and practice patterns to avoid medical errors in an emergency department, illustrate examples of error analyses that led to solutions, and emergency department challenges as error reduction initiatives are undertaken.

Faculty: Cherri Hobgood, MD, Assistant Professor, Director of Education, Department of Emergency Medicine, University of NC School of Medicine and The University North Carolina Hospitals, Chapel Hill, NC

12:30-1:25 p.m. Derm and Doom! The Rashes of Common Chemical and Biological Terrorism (MO-104)
Dr. Koenig will describe and discuss how to treat rashes caused by chemical or biological warfare agents, including those caused by small pox, anthrax, bubonic plague, and mustard gas burns.

Faculty: Kristi L. Koenig, MD, FACEP (Moderator), National Director, Emergency Management Strategic Healthcare Group, Veterans Health Administration, Department of Veterans Affairs, Washington, DC

James D. Mills Memorial Lecture
12:30-1:25 p.m. 5,000 Years of Emergency Medicine History: Things Your Mummy Never Told You (MO-106)
The first medical textbook written roughly 5,000 years ago includes many concepts inherent to the practice of emergency medicine. In this humorous and historic look at the work of Imhotep, an ancient Egyptian physician whose works are well preserved and understood, emergency physicians will compare the methodology of physicians from 2900 BC to today.

Faculty: Gregory L. Henry, MD, FACEP, Clinical Prof, Dept of Emergency Medicine, Univer of MI Medical School; Staff Physician, St. Joseph Mercy Hospital; CEO, Med Practice Risk Assessment, Inc.; Vice Pres, Risk Management Emergency Physicians Medical Group, Ann Arbor, MI; Past President, ACEP

12:30-2:25 p.m. Optimizing Patient Flow in the Emergency Department (MO-113)
Dr. Mayor will discuss improving customer service in an emergency department, including identifying the common causes of delays, technologies that can improve patient flow, and how to obtain hospital support for such programs.

Faculty: Thom A. Mayer, MD, FACEP, Professor, Emergency Medicine and Pediatrics, Georgetown University School of Medicine, George Washington University School of Medicine, Washington, DC; Chair, Dept of Emergency Medicine and Medical Director, Flight Services, Inova Fairfax Hospital, Falls Church, VA

3:00-3:55 p.m. HIPAAAchondria: Can You Still Get Medical Records? (MO-127)
The Health Insurance Portability and Accountability Act was passed by Congress to protect the patient's right to confidentiality for their medical illnesses. Dr. Little will analyze how to protect a patient's right to privacy and still provide good medical care. He will review the new rules under HIPAA for patient privacy; discuss the legality of obtaining and releasing medical charts, old ECGs, and prior medical evaluations; and identify with whom and what medical issues can be discussed with family members and others.

Faculty: Neal E. Little, MD, FACEP, Emergency Physicians, McLaren Regional Medical Center; Clinical Assistant Professor, Dept of Emergency Medicine, University of Michigan Medical School, Flint, MI

3:00-3:55 p.m. Doctor, Was This Child Abused? (MO-125)
Emergency physicians often are called on to determine whether an injury to a child was accidental or intentional. Such a request can come from a social service agency, an attorney, a judge, or some other concerned party. Dr. McCollough will discuss the literature on mechanism of injury of the abused child, the subtle differences between intentional and accidental pediatric injuries, and conditions that can mimic child abuse.

Faculty: Maureen D. McCollough, MD, MPH, FACEP, Assistant Professor, Medicine, Dept of Emergency Medicine, Dir of Pediatric Emergency Care, Olive View-UCLA Medical Center, Sylmar, CA

3:00-3:55 p.m. Chest Pain Centers: Marketing or Quality Tool? (MO-124)
With hospitals establishing chest pain centers, the question remains, are chest pain centers really an improvement in patient care or just a marketing tool? The panel will present the data in a point/counter-point format and discuss issues of diagnostic accuracy, patient satisfaction, disease management, outcomes, and cost.

Faculty:
--Michael J. Bresler, MD, FACEP, Clinical Professor, Surgery, Division of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA
-- Mel L. Herbert, MD, FACEP, MBBS, BMedSci, Assistant Professor, Medicine, UCLA School of Medicine; Asst Prof, Nursing, UCLA School of Nursing, Dept of Emerg Med, Olive View-UCLA Med Cent, Sylmar, CA

3:00-3:55 p.m. Ominous Headaches: When Is It an Emergency? (MO-129)
Headache is a common complaint for adults that can present diagnostic dilemmas. Dr. Gerardi will discuss life-threatening causes of headaches, identify common errors in misdiagnosis, and discuss the management of headache causes, including those of immunocompromised patients. He also will review options for patients with longstanding chronic headache pain.

Faculty: Michael J. Gerardi, MD, FACEP, Clinical Assistant Prof of Medicine, Univer of Medicine and Dentistry of New Jersey; Director, Pediatric Emergency Medicine, Children's Medical Center, Atlantic Health System; Vice Chairman, Dept of Emerg Medicine, Morristown Memorial Hospital, Morristown, NJ

3:00-3:55 p.m. My Hand Feels Funny: Peripheral Nerve Problems in the Emergency Department (MO-128)
Acute hand numbness can be daunting to diagnose. Dr. Della-Giustina will discuss clues to the etiology of peripheral motor and sensory defects, identify "red flags" in asymmetrical and symmetrical peripheral neuromuscular problems, and review diagnostic workup and initial treatment for these complaints.

Faculty: David A. Della-Giustina, MD, FACEP, LTC, US Army; Assistant Prof, Medicine, University of WA; Assistant Prof, Dept of Military and Emergency Medicine, Uniformed Services University of the Health Sciences; Program Dir, Madigan University of Washington Emergency Medicine Residency, Tacoma

4:00-4:55 p.m. Who's in Charge? Bioterrorism Meets Bureaucracy (MO-143)
When recent anthrax infections made the threat of bioterrorism real in America, emergency physicians looked for clinical guidelines, public policies, and financial assistance to improve the nation's ability to respond. Dr Koenig will describe and discuss coordination among the state, federal, military, public health, and private institutions involved in biological and chemical response, describe federal assistance for emergency physicians treating patients possibly exposed to a biologic agent, and the resources for supporting local hospital planning.

Faculty: Kristi L. Koenig, MD, FACEP (Moderator), National Director, Emergency Management Strategic Healthcare Group, Veterans Health Administration, Dept of Veterans Affairs, Washington, DC

5:00-5:55 p.m. International Emergency Medicine (MO-153)
Diversity is a fundamental aspect of emergency medicine. Dr. Rooyen will describe the way emergency medicine is practiced around the world, comparing the systems strengths and weaknesses and various methods of EMS delivery.

Faculty: Michael J. Van Rooyen, MD, MPH, FACEP, Vice Chairman, Johns Hopkins Dept of Emergency Medicine; Director, Johns Hopkins Center for International Emergency, Disaster, and Refugee Studies; Associate Professor, Dept of Emergency Medicine, Johns Hopkins Univer School of Med, Baltimore

5:00-5:55 p.m. HAZMAT: Are Your ED, Hospital, and Pre-Hospital Personnel Prepared for Contaminated Patients? (MO-152)
Are emergency physicians prepared to treat patients with unknown chemical exposures? Dr. Weiss will describe levels of personal protection, equipment, and patient decontamination systems; discuss OSHA and other federal regulations concerning HAZMAT responses; and review the educational requirements.

Faculty: Stuart B. Weiss, MD, FACEP, Director, Disaster Preparedness; Associate Director, Pre-Hospital Care, Saint Barnabas Health Care System, West Orange, NJ

5:00-5:55 p.m. When a Rash is More Than Just a Rash (MO-157)
Many serious systemic illnesses, such as meningococemis and endocarditis, can cause skin rashes. Dr. Beddingfield will review the rashes associated with such diseases as rheumatic fever, inflammatory bowel disease, and Kawasaki's disease.

Faculty: Frederick C. Beddingfield, III, MD, Division of Dermatology, UCLA School of Med, Los Angeles, CA

5:00-5:55 p.m. Anaphylaxis and Allergies: State of the Art (MO-148)
Understanding the pathophysiology and presentation of allergy and anaphylaxis can help emergency physicians more effectively manage these disorders. Dr. O'Brien will describe the syndromes of acute urticaria, pruritus, angioedema, and anaphylaxis; explain treatment options for each; and discuss a reasonable and cost-effective evaluation for patients with symptoms.

Faculty: John F. O'Brien, MD, FACEP, Clinical Assoc Prof of Med, University of Florida College of Medicine; Assistant Residency Dir, Dept of Emergency Medicine, Orlando Regional Medical Center, Orlando, FL

5:00-5:55 p.m. Do You Really Need an X-Ray? (MO-151)
Millions of x-rays are performed on emergency patients with a "positive" rate less than 10 percent for many film types. Dr. Hendey will describe the criteria for ordering x-rays; compare and contrast competing rules for c-spine and knee radiographs; and review the evidence questioning the need for x-rays in patients with cough, abdominal pain, back pain, and joint dislocations.

Faculty: Gregory W. Hendey, MD, FACEP, Research Dir, UCSF-Fresno Emergency Medicine Residency Program, University Medical Center; Associate Clinical Prof, UCSF School of Medicine, Fresno, CA

Tuesday, October 8

8:00-8:55 a.m. Acute Coronary Syndromes: Tailoring Treatment Based on Risk Stratification (TU-158)
Emergency physicians are improving the outcomes of patients with acute coronary syndrome through risk stratification. Dr. Diercks will discuss the guidelines of the American Heart Association and the American College of Cardiology for the diagnosis and risk stratification of acute coronary syndromes, as well as treatment recommendations based on risk stratification. Faculty: Deborah B. Diercks, MD, FACEP, Assistant Professor, Emergency Medicine, University of California, Davis Medical Center, Sacramento, CA

8:00-9:55 a.m. Bioterrorism: The Risk and the Treatment (TU-166)
What is the difference between the symptoms of anthrax exposure and a common upper respiratory infection? Dr. Burstein will discuss the threat of bioterrorism and the most likely agents to be used in an attack, such as anthrax, plague, smallpox, tularemia, and Ebola. He also will describe the signs, symptoms, and treatments, of biological agent exposure.

Faculty: Jonathan L. Burstein, MD, FACEP, Director, Disaster Medicine, Beth Israel Deaconess Medical Center; Assistant Professor, Harvard Medical School, Boston, MA

8:00-9:55 a.m. Heroic Procedures You Should Know (TU-170)
Emergency thoracotomy is a life-saving procedure, but not without significant risk to the patient and even health care workers. Other heroic procedures are done infrequently, but will save lives. Dr. Bartlett will demonstrate proper techniques for specific emergency heroic procedures and describe the benefits, risks, and limitations of each.

Faculty: Robert L. Bartlett, MD, FACEP, Chief Executive Officer, Carolina Care, PA; President, Carolina Care Foundation for Emergency Medicine; Attending, Dept of Emergency Medicine, Richland Memorial; Medical Dir, Hyperbaric Medicine, Richland Memorial Hospital; Associate Prof, Pharmacy, College of Pharmacy, University of SC; Associate Prof, Surgery, Medical University of SC, Charleston, SC

8:00-8:55 a.m. Mental Health Emergencies in Children: A Growing Crisis (TU-165)
Emergency physicians treat a growing population of children with mental health emergencies. Dr. Gerardi will review common pediatric mental health emergencies, medications for treating them, and what community resources area available to help. He also will address the medical-legal aspects of physical restraint, voluntary and involuntary commitment, and methods for suicide risk assessment in children.

Faculty: Michael J. Gerardi, MD, FACEP, Clinical Assistant Professor of Medicine, University of Medicine and Dentistry of NJ; Director, Pediatric Emergency Medicine, Children's Medical Center, Atlantic Health System; Vice Chairman, Dept of Emergency Medicine, Morristown Memorial Hospital, NJ

8:00-8:55 a.m. The Emergency Department of the Future (TU-163)
This special 10-year anniversary presentation will review the technological developments in emergency medicine over the past decade and discuss future technologies.

Faculty: Robert Blankenship, MD, Assistant Program Director, Darnall Army Community Hospital, Emergency Medicine Residency Program, Ft. Hood, TX

9:00-9:55 a.m. Cold Turkey and Other Leftovers: Withdrawal Syndromes (TU-173)
Withdrawal from the chronic use of psychoactive or recreational drugs can lead to vexing clinical problems, including seizures and death (from ethanol and benzodiazepine). Dr. Aks will describe the pathophysiology of various drug withdrawal syndromes, review classic and cutting-edge research, and outline treatment strategies.

Faculty: Steven A. Aks, DO, FACEP, Fellowship Director, The Toxikon Sonsortium/Cook County Hospital; Clinical Associate Professor of Emergency Medicine, University of Illinois; Attending Physician, Department of Emergency Medicine, Mercy Hospital and Medical Center, Chicago, IL

9:00-9:55 a.m. New Parts, New Challenges: The Transplant Patient in the Emergency Department (TU-175)
Organ transplant recipients increasingly are coming to emergency departments. The nature of their diseases and complex medication regimens can make treatment challenging. Dr. Playe will discuss the disease processes associated with transplantation and he immunology therapy used after transplantation.

Faculty: Stephen J. Playe, MD, FACEP, Assistant Professor, Emergency Medicine, Tufts University School of Medicine; Residency Program Director, Department of Emergency Medicine, Baystate Medical Center, Western Campus of Tufts University School of Medicine, Springfield, MA

10:00-10:55 a.m. Open Your Eyes and See the Danger: Plain Film Diagnoses You Can't Afford to Miss (TU-189)
Advances in radiographic techniques contribute to an ever-decreasing role in the use of plain film radiography. However, emergency physicians continue to order these studies frequently. Dr. Sachs will review five dangerous radiographic diagnoses that must not be missed..

Faculty: Carolyn J. Sachs, MD, MPH, FACEP, Assistant Professor, Medicine, Division of Emergency Med, Dept of Medicine, University of California Los Angeles School of Medicine, Los Angeles, CA

12:30-1:25 p.m. Dog, Cat, and Human Bites: Preventing and Treating Infections (TU-194)
Bacteria transmitted through dog and cat bites can cause life-threatening infections. Dr. Eilberg will review the diseases that can be transmitted through these bites and review the literature, which includes recommendations for antimicrobial prophylaxis, wound care, tetanus immunization, and the risk of HIV and hepatitis C transmission.

Faculty: Wesley P. Eilberg, MD, FACEP, Clinical Associate Professor, Department of Emergency Medicine, University of Illinois College of Medicine; Director of Undergraduate Education, Department of Emergency Medicine, Mercy Hospital and Medical Center, Chicago, IL

12:30-2:25 p.m. Lurking Liabilities: Delayed Presentations of Trauma Patients (TU-200)
The immediate ABC [airway, breathing, circulation] resuscitation of acutely traumatized patients is rote for emergency physicians. Dr. Lucchesi will review the most frequently missed traumatic injuries and the hidden complications of patients with prior traumas, such as symptoms of delayed splenic rupture and diaphragmatic injuries.

Faculty: Michael P. Lucchesi, MD, FACEP, Associate Professor, SUNY-Downstate/Kings County Hospital, Brooklyn, NY

12:30-2:25 p.m. Tackling Emergency Department "Over" Crowding -- From the Inside Out (TU-205)
An expert panel will discuss successful strategies for reducing the adverse effects of overcrowding, using examples from their departments and national advocacy activities.

Faculty:
-- Brent Asplin, MD, MPH, Director of Policy Research, Regions Hospital, St. Paul, MN
-- Jay A. Kaplan, MD, FACEP, Assistant Clinical Professor, Emergency Medicine, Mount Sinai School of Medicine; Vice President, Regional Emergency Services, Banner Health System, Phoenix, AZ
-- Thom A. Mayer, MD, FACEP, Prof, Emergency Medicine and Pediatrics, Georgetown Univer School of Med, George Washington Univer School of Med, Washington, DC; Chair, Dept of Emergency Medicine and Medical Dir, Flight Services, Inova Fairfax Hospital, Falls Church, VA
-- Todd B. Taylor, MD, FACEP, Affiliate Assistant Professor, Arizona College of Osteopathic Medicine; emergency physician, Good Samaritan Regional Medical Center, Phoenix

3:00-3:55 p.m. Mars Men, Venus Women -- Is There An Earthly Difference in Heart Disease? (TU-214)
Being male has been a risk factor for cardiovascular disease for ages, but what about women? Is estrogen really protective? The speaker will discuss data concerning women and cardiovascular disease and highlight the latest research in this area.

Faculty: Deborah B. Diercks, MD, FACEP, Assistant Professor, Emergency Medicine, University of California, Davis Medical Center, Sacramento, CA

3:00-3:55 p.m. The Shocking Truth: Lightning and Electrical Injuries (TU-216)
Electrical injuries caused by natural and manmade resources can be challenging to diagnose and treat. Significant differences exist in the pathophysiology and treatment of high-voltage electrical versus lightning injuries. Dr. Della-Giustina will review the types of electrical injuries, differences in injury pattern and treatment, and admission and discharge criteria.

Faculty: David A. Della-Giustina, MD, FACEP, LTC, US Army; Assistant Professor, Medicine, University of Washington; Assistant Prof, Dept of Military and Emergency Medicine, Uniformed Services University of the Health Sciences; Program Dir, Madigan University of WA Emerg Med Residency, Tacoma, WA

3:00-3:55 p.m. Otitis Media, Sinusitis, and Pharyngitis in Children: Does Our Practice Follow the Medical Evidence? (TU-215)
Medical treatment can vary for pediatric patients with otitis media, sinusitis, and pharyngitis -- the most common diagnoses in children. Dr. King will discuss the criteria for making a diagnosis, the current antibiotic prescribing practices for these diseases, and a cost-effective approach to diagnosing and treating streptococcal pharyngitis.

Faculty: Brent R. King, MD, FACEP, Associate Professor, Emergency Medicine/Pediatrics; Chairman, Dept of Emergency Medicine, The University of Texas, Houston Medical School, Houston, TX

4:00-4:55 p.m. What Every Physician Should Know About Interpersonal Violence. (TU-231)
Domestic violence crosses all social and ethnic boundaries. Despite efforts to increase awareness among emergency personnel, the problem continues to escape detection in emergency patients. Dr. Feldhaus will discuss the language of partner violence and recommend methods of assessing, documenting, and reporting suspicions and findings. She also will describe how to assess patient safety and the ethical issues involved in patient care.

Faculty: Kim Feldhaus, MD, FACEP, Attending Physician, Department of Emergency Medicine, Denver Health Medical Center Residency in Emergency Medicine; Associate Professor, Division of Emergency Medicine, Dept of Surgery, University of Colorado Health Sciences Center, Denver, CO

4:00-5:55 p.m. Challenging Cases: How the Experts Practice Emergency Medicine (TU-233)
In a fast-paced, interactive format, a panel of experts will describe current emergency care controversies for three clinical disorders, list two alternative diagnostic tests for three clinical disorders, and identify important clinical clues.

Faculty:
-- Rita K. Cydulka, MD, MS, FACEP, Associate Professor, Case Western Reserve University School of Medicine; Emergency Medicine Residency Program, Case Western Reserve University, MetroHealth Medical Cntr; Consultant, Cleveland Clinic Foundation, Cleveland, OH
-- Carl M. Ferraro, MD, FACEP, Clinical Associate Professor, Emergency Medicine, University of Illinois College of Medicine; Program Director, Department of Emergency Medicine, Mercy Hospital and Medical Center, Chicago, IL
-- Douglas L. McGee, DO, FACEP, Assistant Professor, Thomas Jefferson University and Philadelphia College of Osteopathic Medicine; Director, Emergency Medicine Residency Program, Albert Einstein Medical Center; Philadelphia, PA
-- Barry C. Simon, MD, Associate Clinical Prof, Medicine, University of CA, San Francisco; Chairman, Dept of Emergency Med, Alameda County Medical Center, Highland General Hospital, Oakland, CA

5:00-5:55 p.m. Master Clinician Series: Examination of the Extremities-Knee and Shoulder (TU-241)
The team physician of the Chicago Cubs will discuss the common problems of knee and shoulder injuries and the examination methods used by experts. Dr. Adams also will demonstrate techniques to more precisely distinguish pathologic findings and achieve a precise evaluation.

Faculty: Stephen L. Adams, MD, FACEP, Prof of Med; Chief, Div of Sports Med, Dept of Med, Northwestern University Medical School; Team Physician, Chicago Cubs National League Baseball Club, Chicago

5:00-5:55 p.m. Evidence-Based Health Policy: An Oxymoron? (TU-239)
Efforts to control the costs of health care by limiting access have failed. A recent report from the Institute of Medicine argues for redefining health care based on quality. An expert panel will examine the forces of clinical policies and outcome measurements, discuss the recent literature on controlling costs and reducing errors, and describe steps to logically evaluate suggestions for changes in practice.

Faculty:
-- Roneet Lev, MD, FACEP, Scripps Mercy Hospital, Emergency Department; Clinical Faculty, University of California, San Diego
-- Susan M. Nedza, MD, MBA, FACEP, Staff Physician, Elmhurst Memorial Hospital, Elmhurst, Illinois; Clinical Instructor, Department of Emergency Medicine, Northwestern Memorial Hospital; EMS Medical Consultant, Division of EMS, Department of Public Health, IL

Wednesday, October 9

8:00-8:55 a.m. PALS: Updates and Controversies (WE-250)
The American Heart Association has developed new PALS (Pediatric Advanced Life Support) guidelines. Dr. Quan will discuss the changes to the guidelines and course content, as well as the scientific evidence supporting these changes. She also will discuss areas of controversy related to resuscitating children.

Faculty: Linda Quan, MD, FACEP, Chief, Emergency Service, Children's Hospital and Regional Medical Center; Professor, Department of Pediatrics, University of Washington, Seattle, WA

9:00-9:55 a.m. One Pill Can Kill: Pediatric Poisonings (WE-261)
Regardless of how well medicines and hazardous materials are locked up, toddlers still manage to get them. Dr. Singer will discuss the most common medications and ingestions that could kill a child with one dose, discuss treatment issues unique to managing life-threatening toxicity in children, and describe the signs and symptoms of children and how they differ from adults.

Faculty: Jonathan I. Singer, MD, FACEP, Prof, Emergency Medicine/Pediatrics, Wright State University; Vice Chair/Assoc Program Dir, Dept of Emerg Med; Staff Physician, Children's Medical Center, Dayton, OH

9:00-9:55 a.m. Against Medical Advice: When Should You Take "No" For an Answer? (WE-256)
One of the highest risk patients in an emergency department is the one who leaves before being evaluated and treated. Dr. Marco will discuss what information a patient should receive prior to leaving against medical advice. She will describe the ethical and legal foundations of informed consent and refusal and under what circumstances an emergency physician should forcible treat a patient not actively suicidal or homicidal.

Faculty: Catherine A. Marco, MD, FACEP, Associate Professor, Medical College of Ohio; Attending Physician, St. Vincent Mercy Medical Center, Toledo, Ohio; Chair, ACEP's Ethics Committee

10:00-10:55 a.m. Chemical Warfare Agents: What You Really Need to Know (WE-268)
Emergency physician must be prepared for chemical warfare exposures. Expert panelists will review the most likely agents to be used in future attacks, including nerve gases and blistering agents. They also will discuss the symptoms and treatments of such exposures and how to create a plan for personal protection as well as decontamination.

Faculty: Jeffrey R. Suchard, MD, Assistant Clinical Professor; Director of Medical Toxicology, Department of Emergency Medicine, University of California Irvine Medical Center, Orange, CA

10:00-10:55 a.m. Cardiac Arrest: What Lessons Learned from 25 Years of Research Tell Us Today -- Tomorrow. (WE-267)
Two internationally famous researchers on cardiac arrest will discuss current controversies in cardiac care, one of the defining features in emergency medicine. They will describe research they and others have performed in the past 25 years and foreshadow questions about resuscitation in the future.

Faculty:
-- Richard O. Cummins, MD, MPH, MSc, Professor of Medicine, University of Washington; Editor, Senior ACLS, Seattle, WA
-- Mickey S. Eisenberg, MD, PhD. Professor, Medicine, Director of the Emergency Medicine Service, University of Washington Medical Center, Seattle; Co-Director, Center for Evaluation of Emergency Medical Services, King County EMS Division, Dept of Health, Seattle, WA

10:00-11:55 a.m. Treating Sports Injuries in the Emergency Department (WE-276)
The team physician for the Chicago Cubs will discuss common sports injuries in athletes of all ages, including the evaluation and management of the head injured athlete and the evaluation of groin pulls.

Faculty: Stephen L. Adams, MD, FACEP, Professor of Medicine; Chief, Division of Sports Medicine, Department of Medicine, Northwestern University Medical School; Team Physician, Chicago Cubs National League Baseball Club, Chicago, IL

11:00-11:55 a.m. Stroke Mimics (WE-284)
Correct identification of acute stroke is even more important today because of thrombolytic therapy. Not all acute neurologic deficits are from strokes, and not all strokes present in a typical manner. Dr. Huff will review the differential diagnosis of stroke and stroke subtypes, list common stroke mimics and diagnostic procedures for misdiagnosing strokes, and review unusual presentations of acute stroke.

Faculty: J. Stephen Huff, MD, Associate Professor, Emergency Medicine and Neurology, Department of Emergency Medicine, University of Virginia Health System, Charlottesville, VA

11:00-11:55 a.m. Is It � Influenza? (WE-279)
With fears of anthrax and bioterrorism, the annual influenza onslaught of patients can be stressful in emergency departments. The problem is complicated by lethal diseases that just "start as the flu." Dr. Birnbaumer will review the epidemiology of influenza, vaccination protocols, and treatment options. She also will discuss new treatment options for influenza and their mechanism of actions, as well as the diseases that mimic influenza.

Faculty: Diane M. Birnbaumer, MD, FACEP, Professor, UCLA School of Medicine; Associate Residency Director, Department of Emergency Medicine, Harbor/UCLA Medical Center, CA

12:00-12:55 p.m. What's New on the Street? Drugs of Abuse (WE-297)
Recreational drug users are getting more creative all the time, and they often seek care in the emergency department when their recreation goes awry. Dr. Perrone will identify the current trends in drugs of abuse, including heroin, cocaine, methamphetamines, and GHB. She also will discuss how to recognize and treat patients who use these drugs.

Faculty: Jeanmarie Perrone, MD, FACEP, Director, Division of Toxicology; Assistant Professor, Emergency Medicine, Pediatrics and Laboratory Medicine, Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA

12:00-12:55 p.m. Hot Topics in Emergency Radiology (WE-290)
Should all emergency departments have fluoroscopy? Should MRIs be ordered in the emergency department to rule out navicular fractures and hip fractures? Should a CT or VQ scan be ordered to rule out a pulmonary embolism? Dr. Schwartz will present data supporting the emergency use of these different modalities and challenge the practice of emergency medicine.

Faculty: David T. Schwartz, MD, FACEP, Associate Professor of Emergency Medicine, New York University School of Medicine; Attending Physician, Bellevue Hospital, New York; co-editor of textbook: Emergency Radiology.

12:00-12:55 p.m. Trauma Conundrums: When Minor Trauma Causes Major Injury (WE-295)
Patient symptoms can hide major injuries. Reviewing patient cases, Dr. Legome will describe how airbag deployment can result in significant and unique injuries, explain how falls in the elderly can result in occult injuries, discuss instances in which "minor" head injuries may not be benign, and explain how trauma in a pregnant patient may be more serious than is apparent on first glance.

Faculty: Eric L. Legome, MD, FACEP, Program Dir, NYU/Bellevue Emergency Medicine Residency, NY, NY

12:00-12:55 p.m. What Do You Mean There Is No Dentist in the ED? Treating Dental Complaints at 4 AM (WE-296)
Dental pain is a common complaint in an emergency department, but relieving it can be challenging. Dr. Benko will review dental problems ranging from abscesses to trauma to TMJ and discuss evaluation and treatment plans for each. He also will review essential diagnoses that must not be missed and how to recognize and classify dental fractures and tooth trauma. In addition, he will discuss nerve block techniques for oral and dental complaints and treatment of TMJ and criteria for immediate and delayed referral of dental emergencies.

Faculty: Kip R. Benko, MD, FACEP, Clinical Instructor, Emergency Medicine, University of Pittsburgh School of Medicine; Attending Physician, Mercy Hospital of Pittsburgh