SAEM 1996 Annual Meeting Program

Societyfor Academic EmergencyMedicine

1996Annual Meeting May 5-8, 1996 f)enveri Colorado

INDEX General Information............ .................1 Schedule of Events ...............4 Sunday,May 5 Activities Paper/Poster Presentations......... .................12 Didactics ...................15 Monday,May 6 Activities Paper/Poster Presentations......... .................I7 Didactics ...................20 AACEMAnnualMeeting... .......22 CORDAgenda.... ......23 Tiresday, May 7 Activities Paper/Poster Presentations......... .................24 Didactics ...................27 AnnualBusiness Meeting Agenda .........,...29 AwardPresentations ............. ....,............29 Leadership Award...... ...........30 Academic Excellence Award...... ...........31 Slateof Nominees ................32 Proposed Constitution andBylawsAmendments ...................35 Wednesday, May 8 Activities Paper/Poster Presentations......... .................36 Didactics ...................40 Exhibitors............... ............,42 Positions Available. .............44 MeetingRoomFloorPlans ................52

All attendees are urged to complete the Annual Meeting evaluation form.

Completed evaluation forms should be returned to th9 Registration desk before leaving Denver.

Feedback is critical to the development of successful Annilal Meetings.

tr GENERAL INFORMATION Registrationand Information The SAEM RegistrationDesk will be openduring the times listed below: Saturday,May 4, 12:00noon-7:00pm Sunday,May 5, 7:00 am-12:00noonand 1:00-5:00pm Monday,May 6,7:00 am-12:00noonand 1:00-5:00pm Tuesday,May 7,1:00 am-12:o0noonand 1:00-5:00pm Wednesday, May 8, 7:00 am-12:00noonand 1:00-4:00pm

Residents'NightOut The residentsof the Denver Health and Hospitals Residencyin EmergencyMedicine; the Departmentof EmergencyMedicine, Denver GeneralHospital; and the Division of EmergencyMedicine at the Universityof ColoradoHealth ScienceCenterarehosting a Residents'Night Out for all residentsattendingthe SAEM Annual Meeting.The eventwill be held on Tuesday,May 7 beginning at 8:00 pm at the Bluebird Theater at 3317 East Colfax Avenue in Denver.Music will be provided by Groove Kitchen, which boaststwo residentsas membersof the band.

Saturdap May 4: Scheduleof Events 8:00 am-5:00pm EmergencyCareof the Elder Person: A Coursefor Teachers EmergencyMedicine PhotographyWorkshop RegionalCPC Competition,TerraceLevel 11.:00am-2:00pm Academic Emergency Medicine Editorial Board Meeting, Gold Room 2:00-5:00pm SAEM Board of DirectorsMeetinq. ColoradoRoom 5:30-6:30pm CPC Reception(cashbar), Silver Room 6:00-9:00pm Meeting of the SAEM Board and Chairs of Committeesand TaskForces,DenverRoom pm 8:00-11:00 EMRA Board of Directors.ColoradoRoom

ModeratedPosterSessions The ProgramCommitteeis continuingthe developmentof moderatedposter sessionsto encouragediscussionand feedbackto presenters,as well as to the audience.This year moderated"walkalong" sessions havebeenscheduled.

Thesesessions will be held during the scheduledposter sessionin the Exhibit Hall. The moderatedpostersessionshavebeenstaggeredto begin at two different times and will consistof 7-12 abstractsper session.The namesof the moderatorsarepublishedin this programandthe designatedtime for the moderatedsessionis publishedimmediately following the moderator'sname.Attendeeswishing to participate in the moderatedpostersessionsshouldmeet at the first posterin the topic areaat the designatedtime.

Posterpresentersare askedto put up their postersby 12:00 noon on the day of their poster presentation.The poster sessionsare scheduledfor 2.5 hours in the afternoonand must be taken down at the conclusionof the PosterSession.

ABEM Activities ABEM hasthreeinformationalsessionsplannedfor Annual Meeting participants.A packet of referencematerial for these sessionswill be availableat the SAEM Resistration Desk.

ABEM: Its Mission, May 5, 1:30-2:30pm ABEM directors and staff will provide information on recent Board actions,review current Board activities, and report on the residencyand residentdata gatheredthrough the annual survey of programs. Time will be included for questionsfrom participants.

ABEM Interactions with X'aculty,May 7,3:00-4:00 pm This sessionwill provide an opportunityfor programdirectors and faculty to interactinformally with ABEM directors and staff.

ABEM Interactions with Residents,May 8, 1:30-2:30pm This sessionwill provide an opportunity for residentsto interactinformally with ABEM directorsand staff.

Photography Competition The entriesreceivedfor the 1996PhotographyCompetitiondeveloped by Lany Stack, MD, will be displayedduring the Annual Meeting. Theseentrieswill be judged and awardsfor the top three photographsin four categorieswill be announcedat the conclusion of the Annual Meeting.

Continuing Medical Education Michigan State University, College of Human Medicine, accreditedby the AcreditationCouncil for ContinuingMedical Education, certifies that this program meetsthe criteria for up to 38 hours of CategoryI creditsof the Physician'sRecognitionAward of the AmericanMedical Association.

1996RegionalCPC Competition The 1996RegionalCPC Competitionwill be held on May 4 from 8:00 am-4:30pm on the TerraceLevel. Annual Meeting attendees are encouragedto attendthis important activity which showcases EmergencyMedicine ResidencyPrograms. There is no registration fee to attend.Thecompetitionconsistsof the presentationand discussionof the ten best casessubmittedfrom each of the five geographicalregions. The Best Discussantand Best Presenterrecipientsfrom eachregion will be announcedduring the CPC Receptionin the Silver Room at 5:30-6:30pm. The RegionalCompetition is sponsoredby ACEP,CORD, EMRA, and SAEM.

Medical StudentSession In orderto increasemedicalstudentparticipationandawareness of the opportunitiesfor a careerin emergencymedicine, SAEM is sponsoringa special sessionfor all interestedmedical students.

The sessionwill be held Sunday,May 5 at 7:00-9:00pm in the Silver Room. The programwill featurethe following: "ER - Is it Really Like the Show? A Day in the Life of the Emergency Physician,"Paul Gennis,MD, ResidencyDirector, Jacobi Medical Center "What to Look for in Residency a Program,"David Sklar"MD, Chairman, Deparlment of Emergency Medicine, University of New Mexico "The Application Process," Louis Binder,MD, AssociateDeanfor StudentAffairs, University of Illinois, Chicago A panel discussioncomprisedof the following speakerswill conclude the session:StevenDronen,MD, ResidencyDirector,University of Michigan; Carey Chisholm, MD, ResidencyDirector, Methodist Hospital of Indiana, Inc.; Marcus Martin, MD, Residency Director, Medical College of Pennsylvania./Hahnemann Hospital-Allegheny Campus; and Samina Shahabuddin,MD, Third YearResident,JacobiMedical Center.

Banquet The Annual Meeting Banquetwill be held on the eveningof May 8 and this year will be held at the DenverMuseumof Natural History. Halls of the museumwill be open for viewing before and after dinner. In addition, entertainmentwill be provided by the presentationof the Imago ObscuraAward and the RidiculousAbstractCompetition.

This year's RidiculousAbstractpresentationswill be: "The Valueof EmergencyMedicine:A Placebno ControlledStudy of Economic,Social and Medical Impact," Louis Durkin, MD "The StarbuckSyndrome:Community-WidePre-Conditioningfor SuddenCardiacDeath,"Paul Pepe,MD "Evidencefor GeneticSuppressionof Aversionto NasalMucous," Ron Walls,MD

Evening Meetings and Activities Sunday, May 5 5:00-8:00pm

EMRA Boardof Directors,DenverRoom

6:00-7:30pm

SAEM OpeningReception

7:00-9:00pm

MedicalStudentSession,SilverRoom

Monday May 6 4:00-6:00pm

EMF/ACEPTeachingFellowshipWine and CheeseReception,ColoradoRoom

5:00-6:30pm

Medical Collegeof PennsylvaniaReception, Gold Room

Presentingthis year's Imago ObscuraAward will be the 1995 recipient,ChuckCairns,MD. SAEM membersare entitled to purchaseone ticket at the discountedrate of $15 for active,asiociateand internationalmembers;and $35 for medicalstudentand residentmembers.Tickets for non-members are$45.

Transportationwill be provided to and from the Museum with buses leaving at approximately 6:00 pm and returning around 10:00pm. A cocktailreceptionat the Museumwill proceedthe Banquet.Eachattendeewill receivetwo complimentarydrink tickets and a cashbar will also be available.

5:45-7:00pm

Boston UniversitylBostonCity Hospital ReceptionandBook Signing,DenyerRoont

6:00-7:00pm

EMRA AwardsReception,SilyerRoom

6:00-7:30pm

Forum,GrandBallroomD & E SAEMIssues

Therewill be a limited numberof tickets availablefor purchasein Denverand all ticketsabsolutelymust be purchasedby May 6.

Also, ifyou changeyour mind, unfortunately,thereareno refunds sincemeal countsare requireda week in advanceof the Banquet.

6:00-10:00pm SAEM Banquet,DenverMuseumof Natural History

Speakers'ReadyRoom

Iiresday,May 7 6:00-9:00pm

SAEM Boardof DirectorsMeeting,Century Roctm

Wednesday,May 8

IssuesForum

A speakers'ready room will be availablefor those who wish to checktheir slidesin advanceof their presentation.The speakers' readyroom will be availablestartingMay 4 at 7:00am andwill be locatedin theAspenRoom (MezzanineLevel).

All membersare invited to palticipatein an IssuesForumon Monday,May 6 at 6:00-7:30pm in GrandBallroomD & E. This open forum is an opportunityfor the membershipto exchangeideaswith the Boardandchairsof committeesandtaskforceson the imoortant issuesin academicemergencymedicineandthe Society'sactlvides.

Opening Cocktail Reception

AACEM

SAEM is hostingan openingcocktailreceptionon Sunday,May 5 at 6:00-7:30pm in the South ConventionLobby. A11Annual Meeting registrantsare invited to attend. Hors d'oeurveswill be servedand a cashbar will be available.

The Associationof Academic Chairs of EmergencyMedicine (AACEM) will meeton Monday,May 6 from 8:00am until 12:00 noon. AACEM will conveneits annualbusinessmeetinson Mav 6 from l2:00 noonuntil l:30 om.

Exhibits

The Council of Emergency Medicine Residency Directors (CORD) will meet on Monday,May 6 at 12:30-6:00pm in the Majestic Ballroom. The programwill include educationalsesreports,elections,and awardpresions,roundtablediscussions, sentationsand an agendais publishedin this program.

Exhibits will be availablefor viewing on May 6 and7 in the Exhibit Hall on the Plaza (ground) Level. The poster sessions, Innovations in EmergencyMedicine Education exhibits, coffee breaksand the registrationdeskwill also be locatedin the Exhibit Hall. Pleasetake an opportunity to view the exhibits during the scheduledcoffeebreaksand exhibit hours.

Board of Directors Meetings The SAEM Board of Directors will meet on Saturday,May 4 at 2:00-5:00pm in the ColoradoRoom andTuesday,May 7 at 6:009:00 pm in the CenturyRoom. All interestedmembersand others are invited to attendthesemeetinssof the Board.

Annual Business Meeting/Elections SAEM will conveneits Annual BusinessMeeting on Tuesday, May 7 at 1:30-3:00pm in GrandBallroomD & E. At this meeting Lewis Goldfrank, MD, will introduce incoming president, SteveDronen, MD. Agenda items for the businessmeeting will include election of officers, Board and committeemembers,presentationof awards,amendmentsto the Constitutionand Bylaws, offtcers' reports, and other items of businesspresentedby the membership.A11membersof the Societyareurgedto attend,however,only activemembersare eligible to vote.

CORD

EMRA Awards Reception Residentsandfaculty areinvitedto socializeandto honorthreeresidentsfor outstandingachievement at the EMRA AwardsReception on May 6 from 6:00-7:00pm in the SilverRoom. EMRA thanks CoastalPhysicianServices,Inc. for its co-sponsorship of the Jean Hollister Award, EmCarefor its co-sponsorshipof the Academic ExcellenceAward, and WeatherbyHealth Carefor its co-sponsorship of the EMRA DedicationAward. EMRA gratefullyacknowledges this year's reception sponsors:California Emergency Physiciansand Florida Organizationof IndependentGroups.

MessageBoard Phone messagescan be left at the SAEM RegistrationDesk by callingtheAdamsMark Hotel at 303-893-3333 andrequesting the Desk.

SAEM Registration

IRB Approval A1l presentedresearchmust be approvedby Institutional Review Boardsfor Human Studiesor Animal Care Committeesand is so certifiedbv authorsuoon abstractsubmission.

KEYNOTE SPEAKER

Ricardo Martinez, MD

The Society for Academic Emergency Medicine is pleased to announce that Ricardo Martinez, MD, Administrator of the National Highway Traffrc Safety Administration (NHTSA), will provide the keynote addressat the 1996 Annual Meeting on Sunday,May 5, at 8:00 am. The title of his talk will be "The View From Washington: Opportunities for Emergency Medicine and Health Care Policy."

Dr. Martinez is a board-certified emergencyphysician who has dedicatedhis career to trauma care and automotive injury prevention. He has worked with automotive injury control programs for the past eight years and was chairman of the ACEP Trauma Care and Injury Control Committee and a member of the board of directors of the Association for the Advancement of Automotive Medicine. He has also worked with the Centers for DiseaseControl and the stateof California to develop a plan for trauma systemsand injury prevention.

Dr. Martinez has been active in local and community-basedinjury prevention projects. He has written and developededucational programson motor vehicle injuries for medical providers.

Since 1988 Dr Martinez has been the medical consultantto the National Football Leaguefor the SuperBowl, focusing on emergency services,spectatorcare, and injury prevention.

Prior to his position at NHTSA Dr. Martinez was associatedirector of the Center for Injury Control at the Emory University School of Public Health and associateprofessorof the Division of Emergency Medicine, Department of Surgery at the Emory University School of Medicine. He was also assistantprofessor of Surgery/EmergencyMedicine and associatedirector of Trauma Service at Stanford University Hospital. Dr. Martinez received his undergraduatedegree from Louisiana State University at Baton Rouge and his medical degreefrom Louisiana State University School of Medicine.

KENNEDY LECTURE The Society for Academic Emergency Medicine is honored that Richard D. Lamm has acceptedthe invitation to present the 23rd Annual KennedyLectureshipat the 1996Annual Meeting on Tiresday, May 7 at 1I :00 am. The title of his lecturewill "Infrnite be, Needs,Finite Resources: The New World of Health Care."

Governor Lamm is the chairman of the Pew Health Professions ComRichard D. Lamm mission located at the Center for the Health Professions at the University of California, San Francisco. In November 1995 the third report of the Commission, "Critical Challenges: Revitalizing the Health Professions for the Twenty-First Century," was released.He also servesas the public member for the Accreditation council for GraduateMedical Education (ACGME).

Governor Lamm is the former three-term Governor of Colorado, having served from January 1975 until January 1987. On leaving office, he taught at Dartmouth College in Hanover, New Hampshire, as the Montgomery Fellow.

Since its founding in the Fall of 198'7he has servedas Director of the Center for Public Policy and ContemporaryIssuesat the University of Denver. His researchand teachingfocus has been in the health policy area with special emphasison health care systemsreform and allocation of health care resources.

He was selectedone of Time Magazine's "200 Young Leaders of America" in 1974 and won the Christian Science Monitor "Peace2010" essaycompetitionin 1985. ln 1992he was honored by the Denver Post and Historic Denver,Inc. as one of the "Colorado 100" - people who have made significant contributions to Colorado and made lasting impressionson the state's history. In 1993 he received the "Humanist of the Year" award from the American Humanist Association.

Sunday, May 5

SCHEDULEOF BVENTS

7:00am 7:30 8:00 8:30

Keynote Address RicardoMartinez,MD, NationalHighwayTraffic SafetyAdministration "The View from Washington:Opportunitiesfor EmergencyMedicineandHealthCarePolicy GrandBallroomABC

9:00 9:30 Coffee Break

10:00 10:30 11:00

Clinical Practicel Decision Making (abstracts001-008) Grand Ballroom ABC

Pediatric Emergency Medicine (abstracts009-016) Grand Ballroom DE

Teachingthe Emergency AnalgesiaResearchin EmergencyMedicine UltrasoundCurriculum Vail Room MajesticBallroom Fundamentals of Research: GettingStarted Vail Room

11:30 12:00 12:30 1:00pm

Lunch Session Mentoringin Academic EmergencyMedicine SilverRoom

Lunch Session New Telemedicine: Paradigmin HealthCare DenverRoom

Lunch Session AlternativeFundingof ResidencyPositions Gold Room

1:30 Poster Session,PlazaLevel

2:00 2:30

(abstracts Pediatrics 017-038) EMS (abstracts 039-05l) (abstracts052-070) Cardiovascular Toxicology(abstracts 071-085)

Medical Informatics and Emergency Medicine Majestic Ballroom

3:00 on Ethicsof Procedures the Newly Dead MajesticBallroom

3:30 4:00 4:30 5:00

EMS (abstracts 086-093) GrandBallroomABC

Toxicology/ Environmental (abstracts094-101) Grand Ballroom DE

5:30 6:00 7:00-9:00pm, SilverRoom MedicalStudentSession,

Cardiovascular (abstracts 102-109) Majestic Ballroom

Fundamentalsof Research: ResearchDesign Vail Room

Fundamentals of Research: BasicStatistics Vail Room of Research: Fundamentals EthicalConsiderations Vail Room Fundamentals of Research: Critical Reading Vail Room

SCHEDULEOF EVENTS

Sunday,May 5

SAEM Program Committee ColoradoRoom

7:00am 7230 8:00 8:30 9:00

EMERGENCYID NET Meeting TerraceRoom

EMS SubspecialtyTask Force Capitol Room

SAEM AAMC Liaison Committee Spruce Room

SAEM Political Affairs Committee Snruce Room

EMRA Representative Council Columbine Room

SAEM ManagedCare InterestGroup Colorado Room

Core Content Task Force Terrace Room

9:30 10:00 10:30 11:00 11:30 l2:00 12:30

SAEM Academic Medical CentersTask Force Soruce Room

ABEM: Its Mission Colorado Room

CORD Questionand AnswerBank Task Force CenturyRoom

SAEM ED Categorization Task Force SnruceRoom

SAEM andACEP Officers SAEM UltrasoundInterest SpruceRoom Group ColoradoRoom SAEM and EMRA Officers Spruce Room

California Academicians Colorado Room

SAEM PediatricInterest Group SpruceRoom

SAEM Research DirectorsInterestGroup CenturyRoom

l:00 pm l:30 2:00 2:30 3:00 3:30 4:00 4:30 5:00 5:30 6:00

ACEP ScientificReviewPanel,3:30-6:00pm, CapitolRoom

Monday, Mav 6

SCHEDULEOF EVENTS

7:00am 7:30 8:00 8:30

CPR (abstracts 110-115) GrandBallroomABC

9:00

Injury Prevention/ Interpersonal Violence (abstracts116-12l) Grand Ballroom DE

Teaching Pediatric Emergency Medicine to EM Residents Majestic Ballroom

9:30

EMRA/SAEMResident Leadership Forum: ChiefResidentForum and25 Yearsof AcademicEmergency Medicinein Perspective Vail Room

Coffee Break

10:00 10:30

HealthCareDelivery (abstracts122-129) GrandBallroomABC

11:00

Ischemia/Reperfusion/ Enigmaof PediatricOut-ofHospitalCardiacArrest Shock (abstracts130-137) MajesticBallroom GrandBallroomDE NHLBI-NAEPPAsthma Management Guidelines MaiesticBallroom

11:30 12:00 12230 1:00pm

Lunch Session: in the Controversies Management of Asthma Silver Room

EMRA/SAEMResident Forum: Research Epidemiologic Methodologies in EM Vail Room

1:30 Poster Session,PlazaLevel

2200 2230 3:00 3:30

138-146) CPR (abstracts (abstracts 147-155) Injury Prevention (abstracts 156-163) Ischemia/Reperfusion Shock(abstracts164-17l) EMS (abstracts 172-183) (abstracts 184-195) Respiratory HealthCare Delivery (abstracts196-209)

4:00 4:30 5:00 5:30 6:00

HealthCareDelivery (abstracts 2lO-217) GrandBallroomABC

Respiratory (absrracts 218-225) GrandBallroomDE

Fundamentalsof Research: How to Do a Chart Review Vail Room

WorkforceIssues:Too Many of Us or Too Few? ColumbineRoom

Fundamentals of Research: DataCollectionForms VaiI Room

ResearchDuring the OklahomaDisaster ColumbineRoom

Fundamentalsof Research: Scientific Misconduct VaiI Room

Impact of Managed Care on Academic EmergencyMedicine Columbine Room

Fundamentals of Research: AbstractWriting and Art of PresentationVaiI Room

SCHEDULEOF EVBNTS

Monday, May 6

'7:00 SAEM PhotographyInterest Group CenturyRoom

SAEM OutcomesResearch InterestGroup BiltmoreRoom

SAEM Program Committee ColoradoRoom

SAEM Pediatric Training Task Force Spruce Room

ACEP Academic Affairs Committee Capitol Room

Association of Academic Chairs of Emergency Medicine (AACEM) Meeting Denver Room

SAEM Medical Student Educators Interest Group Century Room

SAEM EMS Committee Spruce Room

CORDResidentSupport Committee CapitolRoom

SAEM AsthmaResearch SAEM Ethics InterestGroup CommitteeSpruceRoom CenturyRoom

CORDCurriculumTask Force CapitolRoom

SAEM Research Committee Spruce Room

7:30 8:00 8:30 9:00 9:30 l0:00 10:30 11:00

CORD ElectronicResidency App Service(ERAS) Demo SavoyRoom AACEM AnnualBusiness Meetingand Lunch Gold Room

SAEM Internet Task Force Colorado Room

CORD Meeting Majestic Ballroom

11:30 SAEM/Physio Control Lunch (by invitation) Centum Room

l2:00 12230 1:00

SAEM Violence Teaching Module Subcommittee Spruce

1:30 2:00 2:30 3:00 3:30

SAEM Rural Emergency Medicine Task Force Spruce Room

SAEM Shock/Trauma InterestGroup CenturyRoom

SAEM Education Committee ColoradoRoom

4:00 4:30 5:00 5:30 6:00

SAEM IssuesForum,6:00-7:30pm, GrandBallroomD & E TaskForce,6:00-7:00pm, SpruceRoom CORD Procedural

7 Tiresday, 1N{I.ay

SCHEDULEOF EVENTS

7:30 8:00 8:30

Geriatrics (abstracrs 226-231) GrandBallroomABC

Administration (abstracts 232-237) GrandBallroomDE

DomesticViolence: Researchand Public Policy Majestic Ballroom

Fundamentalsof Teachins: Determining Goals, Objectives, and Methods Vail Room

PainManagement (abstracts 242-245) GrandBallroomDE

ComputerMethodology (abstracts 246-249) MaiesticBallroom

Fundamentalsof Teaching: Instruction of Procedural Skills Vail Room

9:00 9:30 Coffee Break

10:00 10:30

Ethics (abstracts238-241) GrandBallroomABC

11:00 11:30

Kennedy Lecture: GovernorRichardD. Lamm "InfiniteNeeds,FiniteResources: The New World of HealthCare" GrandBallroomABC

12:00 12:30 1:00pm

Undergraduate Educators Lunch: IntegratingEM into Education Undergraduate DenverRoom

Lunch Session Frontiersin Medical ToxicologyResearch Gold Room

Lunch Session and Advanced Paramedics Life SupportServices SilverRoom

1.:30 2200

SAEM Annual BusinessMeeting GrandBallroomDE

2230 3:00 Poster Session Plaza Level

3:30 4:00 4:30 5:00 5:30 6:00

Clinical Practice (abstracts250-212) Administration (abstracts273 -286) Ethics (abstracts287 -29l) Pain (abstracts 292 -30l) computer Methodology (abstracts302-304) Health Care Delivery (abstracts305-316)

New Horizons in Cerebral Resuscitation Majestic Ballroom

Fundamentalsof Teachins: Effective Lecture Techniques Vail Room

Is the Outcomes Movement Dead?

Majestic Ballroom

Fundamentalsof Teaching: Giving FeedbackThey'lI Listen To VaiI Room

SCHEDULEOF EVENTS

Iiresday, N{{{.ay 7

SAEM Program Committee ColoradoRoom

SAEM National Consensus on Clinical Skills CentumRoom

SAEM International EmergencyMedicine InterestGroup CenturyRoom

SAEM/UAEM/STEM PastPresidents' Breakfast Gold Room

7:00am 7:30 8:00 8:30 9:00

SAEM Constitutionand BylawsCommittee CenturyRoom

SAEM and ABEM Officers SpruceRoom

9:30 10:00 10:30 11:00 11:30 12:00

CORD Boardof Directors CenturyRoom

SAEM PainManagement InterestGroup CapitolRoom

SAEM Boardof Directors Lunch (by invitation) CbloradoRoom

12230 1:00pm 1:30 2:00 2:30 3:00

Organizational Meetingfor SouthernRegionMeeting CapitolRoom

ABEM: Interactionswith Faculty Colorado Room

SAEM Injury Prevention InterestGroup TerraceRoom

SAEM WorkforceTask Force SpruceRoom

3:30 4:00

SAEM CPR/Ischemia/ ReperfusionInterest Group TerraceRoom

4:30 SAEM Academic DevelopmentTask Force SpruceRoom

5:00 5:30 6:00

SAEM Boardof Directors,6:00-9:00pm, CenturyRoom

Wednesday,May 8

SCHEDULEOF EVENTS

7:00am 7:30 8:00 8:30

Injury Prevention (abstracts317-322) GrandBallroomABC

Education (abstracts 323-328) Grand Ballroom DE

ThrombolyticTherapyfor AcuteIschemicStroke Vail Room

BasicNetworkingand InternetAccess Majestic Ballroom

Trauma (abstracts 337-344) Grand Ballroom DE

EmergencyMedicine: and Public Surveillance Health Vail Room

Advanced Internet Lab Majestic Ballroom

9:00 9:30 Coffee Break

l0:00 10:30

Clinical Practice (abstracts329-336) GrandBallroomABC

11:00

FacultyRenewal:From Burnoutto Bonfire Vail Room

11:30 12:00 12:30 1:00

ResearchDirectors' Lunch: WhereShould EM ResearchBe Published?

SilverRoom

Lunch Session the Impactof Assessing InternationalEM Programs DenverRoom

Lunch Session ImprovedMethodologies for MeasuringPerfusion BeyondBlood Pressure GoIdRoom

1:30 2:00 2:30 3:00 3:30

Poster Sessionand IEME Exhibits' PlazaLevel IEME Exhibits(abstracts345-359) Injury Prevention(abstracts360-372) Education(abstracts373 -385) Clinical Practice(abstracts386-409 Trauma(abstracts410-425) InfectiousDisease(abstracts426-434) (abstracts435-441) NeurologicEmergencies Imaging(abstracts442-454)

4:00 4:30 5:00 5:30 6:00

Neurology (abstracts 455-460) GrandBallroomABC

Imaging (abstracts461-466) Grand Ballroom DE

Effective Faculty Observation of Residents' Clinical Skills Savoy Room

for Unfunded Strategies ClinicalResearch MajesticBallroom Alcohol Intoxicationand Injury Research Majestic Ballroom

Applying CQI Methodologyto EM Clinical Svstems VaiI Room Introductionto Statistical SoftwarePackages VaiI Room

Nat'l Info InfrastructureHealthInfo Network Majestic Ballroom

SCHEDULEOF EVENTS SAEM Program Committee ColoradoRoom

7:00

SAEM Boardand InterestGroupChairs SpruceRoom

7230 8:00 8:30

SAEM PublicHealth and EducationTask Force CentumRoom

9:00 9:30 10:00 10:30 11:00 11:30

SAEM Graduate MedicalEducation Committee SpruceRoom

12:00 12:30 1:00

ABEM: Interactionswith Residents ColoradoRoom

SAEM Undergraduate EducationCommittee SpruceRoom

1:30 2:00 2:30 3:00 3:30 4:00 4:30 5:00 5:30 6:00

Wednesday May 8

Sunday, May 5

PAPER/POSTER PRESENTATIONS ScientificPapers:Clinical Practice (10:00am-12:00noon) Moderator: Ian G. Stiell, MD, Ottawa Civic Hospital 001 MulticenterComparisonof Two Clinical DecisionRulesfor Knee Radiographs,David C. Seaberg,MD, University of Florida 002 Performanceof Two Clinical DecisionRulesfor Knee Radigraphy,Peter Richman,MD, State Uniyersity of New York, StonyBrook 003 Follow-Up Evaluation of a Trial to Introduce the Ottawa Ankle Rules for Use of Radiographyin Acute Ankle Injuries, P. RichardVerbeek,MD, Universitiyof Toronto 004 Examinationof a Mortality Prediction Rule in Nonmortal Outcomes for Patients Presentingwith Community Acquired Pneumonia(CAP), ThomasE. Auble, PhD, University of Pittsburgh 005 Cranial ComputerizedTomographyin the EmergencyEvaluation of Patients Without a Recent History of Head Trauma:ProspectiveAnalysis,Carlton Buchanan,MD, Orlando RegionalMedical Center 006 Role of SerumProgesterone in the EmergencyDeparatment Diagnosisof Ectopic Pregnancy:ProspectiveStludy,Kerry King, MD, Nayal Medical Center,SanDiego 007 Utility of Urine and Blood Culturesin Acute Pyelonephritis, M ark Thanassi,MD, StanfordUniversityIKaiser Permane nte 008 Are Guideline RecommendationsBased on Randomized Trial ResultsAlready Followed by PracticingPhysicians?, Carlos A. Camargo,MD, Massachusetts GeneralHospital

ScientificPapers:Pediatric(10:00am-12:00noon) Moderator: Thomas E. Terndrup, MD, State University of New York,Syracuse 009 Validity and Reliability of Clinical Signsin the Diagnosisof Dehydration,Kathy N. Shaw,MD, Children's Hospital of Philadelphia 010 Detectionof ElectrolyteAbnormalitiesin Children Presenting to the ED: A Multicenter ProspectiveAnalysis, Steven Rudis,MD, Orlando RegionalMedical Center 011 FrozenOral Hydration Therapy(OHT) as an Alternativeto StandardEnteralFIuids,Karen Santucci,MD, RhodeIsland Hospital 012 Parenteralvs Oral Antibiotics in the Preventionof Serious BacterialInfectionsin ChildrenWith S. PneumoniaeOccult Bactermia: A Meta Analysis, Daniel Mcllmail, MD, Orlando RegionalMedical Center 013 CompleteRespiratoryAssessment(CRA) ScoreAccurately PredictsOutcomesin ChildrenWith Acute ReactiveAirway Disease(RAD) Exacerbations,John H . Myers, MD , Baylor Collegeof Medicine 014 ScreeningFor Urinary Tract Infection (UTI) in Young Febrile Children in the EmergencyDepartment:Which Testis Best?,Kathy N. Shaw,MD, MS, Children'sHospital of Philadelphia 015 Chloral HydrateVersusMidazolamfor Sedationof Children During Neuroimaging,JamesD'Agostino, MD, State Universityof NewYork, Syracuse 016 BoomerangBabies: EmergencyDepartmentUtilization by Early DischargeNeonates,Alfred Sacchetti,MD, Our Lady of LourdesMedical Center

(1:30-4:00pm) PosterSession Pediatrics Moderator: Susan Fuchs, MD, University of Pittsburgh (2:003:00 pm) 017 SocietalSavingsBy 'Fast Tracking' Lower Acuity Patients in a Pediatric EmergencyDepartment,Harold K. Simon, MD, EglestonChildren'sHospital 0 1 8 Mechanism of Injury in Pediatric Urban Trauma Patients Does Not Predict SevereOutcomes,Janet H. Friday, MD, Children's H ospital of Philadelphia 0 1 9 Use of PrehospitalInterventionson Children in an Urban Emergency Medical Services (EMS) System, Philip V. Scribano,DO, Children'sHospital of Philadelphia

020 Effect of a Curfew on Pediatric Out-of-Hospital EMS Responses, JohnCouk.MD, LouisianaStateUniversity

021 Can Parentsbe Taught to Read Glass Thermometers?

A ComparisonBetweenGlassandDigital ThermometerReading, Mark C. Clark, MD, Orlando RegionalMedical Center

022 Complianceto Follow-Up in Febrile Children:A Comparison of Four Systems,Sally Santen, MD, Joint Military Medical Centers Cost-Effectivenessof a ComprehensiveVersus Focused ToxicologicalScreenfor SuspectedIngestionsin Children, Martin G. Belson,MD, Emory University Long-Term Cosmetic Outcome of Lacerations Repaired Using a TissueAdhesivein a Children'sEmergencyDepartment,Harold K. Simon,MD, EglestonChildren'sHospital

025 Bayesian Decision Theoretic Interim Analysis of a MulticenterRandomizedClinical Trial of Phenytoinfor the Prophylaxisof Post Traumatic Seizuresin Children,Kelb D.Young,MD, Harbor-UCLAMedicalCenter

026 Spectrumof DiseaseAmong Infants LessThan or Equalto Three Months with Hyperpyrexia,Rachel M. Stanlq, Children's H ospital,Boston

027 What Are Early Predictorsof the Need For Hospitalization of Children With Acute Asthma Exacerbations?, Jill M. Baren,MD, YaleUniversity

Pediatrics Moderalor: Leonard R. Friedland, MD, Universily of Cincinnnti (3:00-4:00pm) 028 Are SubjectiveDeterminationsof Temperaturein Children0 to 36 Months of Age Reliable Predictorsof Fever?,Randy Smith,MD,Wilford Hall Medical Center Value of the PeripheralBlood Smear in Febrile Children Age 0-24 Months With RespiratorySyncytialViral or Occult BacterialIllness,EdwardA.Walton, MD, Universityof Califurnia, SanDiego

030 Usefulnessof ChestRadiographyin FebrileAsthmaticChildren,Kristen Paddon,MD, Medical Collegeof Wisconsin

031 Prevalenceof Urinary TractInfection(UTI) andOccultBacteremia in Febrile Young Children in the EmergencyDepartment (ED), Katlry N. Shaw,MD, MS, The Children's Hospital of Philadelphia

032 Rapid Blood LactateAnalysis Improvesthe Triageof Pedicatric Patientsin the ED, David P. Milzman, MD, Georgetown University

033 Pre-and Post-TreatmentOxygenSaturation(Sp02)inAcute Asthma,GregoryD. Iay, MD, PhD, RhodeIslandHospital

034 PulsusParadoxus(PP):An ObjectiveMeasureof Severityin Crotp, GregoryD. Jay, MD, PhD, RhodeIslandHospital

Sunday, May 5 035 Does EndotrachealIntubation Affect Outcome in Out-ofHospitalPediatricCardiacArrest?,Craig B. Key,MD, Baylor CollegeoJMedicine 036 Accuracy of EpinephrineDosing in Children in Cardiac Anest By PrehospitalProviders,MaureenD. McCollough, MD, Harbor-UCLA Medical Center 037 Bag-Valve-MaskVentilation (BVM) For Children in the PrehospitalSetting,Marianne Gausche,MD , Harbor-UCLA Medical Center 038 Comparisonof IntravenousMidazolam to Pentobarbitalfor Conscious Sedationin the EmergencyDepartmentfor Head ComputedTomographyImaging,Donna M. Moro-Sutherland, MD, TexasChildren's Hospital

EMS Moderator: Paul E. Pepe, MD, Baylor (2:00-3:00 pm) 039 Clinical Significance of the Initial Systolic Blood Pressure of Pre-Hospital Advanced Life Support Patients Without Trauma, Steyen A. Meador, MD, MPH, MS Hershey Medical Center 040

Using Prehospital Trauma Triage Criteria to Identify the Severely Injured: Verification of Accuracy, Robert E. O'Connor, MD, Medical Center of Delaware

041

Emergency Medical Services Transport of Patients Complaining of Headache: Is Mode of Arrival Associated with Emergent Conditions?, Iacqueline A. Nemer, MD, Medical Center of Delaware

042

Aeromedical Scene Evacuation of Non-Traumatically Ill Patients,George H. Lindbeck, MD, University of Vit'ginia

043

Instrument Flight Currency and Safety in Helicopter EMS, Richard C. Wuerz, MD, Hershey Medical Center

044

Prehospital Oral Endotracheal Intubation By Rural Emergency Medical Technicians,.lohn S. Bradley, MD, Methodist Hospital of Indiana

045

Eligibility For Thrombolytic Therapy: Concordanceof Prehospital and Emergency Department Screening, Tadd Delozier, MD, Akron General Medical Center

EMS Moderator: Robert E. O'Connor, MD, Medical Centerof Delaware (3:00-4:00pm) 046 PrehospitalUse of SuccinylcholineBy Paramedics, Steven.

Pace,MD, MadiganArmy MedicalCenter 041 Improved SuccessRate of PrehospitalIntubation With RapidSequence Induction,.leanneM. Alit:andro,MD, State UniversityofNew York,StonyBrook 048 SummertimeStorageTemperatures of PrehospitalMedications in NorthernNew Jersey,VickiLanier,MD, Morristown Memorial Hospital 049 TenYearsof Experiencein Part 121Airline Accidentsas a Model for DisasterPlanning,Lee W. Shockley, MD, Denyer GeneralHospital 050 Emergency MedicalCareRequirement After 1995HanshinAwaji Earthquake:An Overview, Hit'oshi Tanaka, MD, OsakaUniversity 051 EpidemiologicMapping of EMS Drug-RelatedIncidents Using a GeographicalInformationSystemComputerProgram,ChristineFarris, MD , Universityof Arizon,t

054 Evaluationof a New Assay for CardiacTroponin-I versus CK-MB for the Diagnosisof Acute Myocardial Infarction, Gerard X. Brogan, Ir, MD, State University of New York, StonyBrook 055 Serial Use of a Rapid, Multi-Marker Cardiac Panelat the Bedsideof ED PatientsWith ChestPain, Pritvi K. Murthi, H i ghland General H ospital 056 Serum Myoglobin Allows Rapid EmergencyDepartment Rule Out MyocardialInfarctionin PatientswithAcute Chest Pain,RobertJ. Doherty,MD, Universityof Maryland 057 Corelation of ToCPK-MB ElectrophoreticActivity With RelativeIndex By Immunoassay, S. L Wambsgans, MD, Utti vctsity oJ'M i ssissippi 058 Comparisonof CardiacMyosin Light ChainsversusCKMB Identifying Chest Pain Patientsat Risk for Ischemic Complications,Gerard X. Brogan,Jr, MD, StateUniversity oJNewYork, StonyBroolc 059 DiagnosticValueof a RapidDiagnosticProtocolto Exclude Acute Myocardial Infarction and CardiacIschemia,Robert J. Zalenski,MA, MD, Universityof lllinois at Chicago 060 Analysisof anArtificial NeuralNetworkInputtedwith BiochemicalMarkers of AMI as a Predictorof Cardiaclnjury, Emil M. Skobeloff,MD, Medical College of Pennsylvania and HahnemannUniversity 061 ChestPainOnsetandDelayedPresentation, N. Clay Mann, PhD, OregonHealth SciencesUniversity

Cardiovascular Moderator: Daniel J. DeBehnke,MD, Medical College of Wisconsin (3:00-4:00pm) 062 Are ClassicCoronaryRisk FactorsSigniflccntPredictonof AcuteCardiacIschen.ria in theEmergency Department?

A MulticenterTnal, DanielS.Ballin,MD, NewEnglandMedicalCenter 063 UndetectedCardiogenicShock in Chronic Heart Failure PatientsPresenting to the EmergencyDepartment, Michael F. Jaggi, DO, Henry Ford Hospital 064 Continuous,Non-InvasiveCardiac Output Monitoring Desai,MD, QuantifiesSeverityof CHF in the ED, Sangeeta Gcoty,t'Iown Uni vcrsi ry 065 Acute CardiacIschemiain Patientswith CocaineRelated Cornplaints:Resultsof a LargeMulticenterTrial, IamesA. Feldman,MD, BostonCity Hosltital 066 PrimaryAngioplastyfor AcuteMyocardialInfarction:Does Availability Delay Thrornbolysis?,Robert E. O'Connor, MD, Medical CenteroJDelaware 067 EmergencyDepzrtmentUse of GatedSPECTTechnetium99m SestamibiMyocardialImagingFor Risk Stratification of PatientsWith Chest Pain, Eric H. Gilbert, MD NortheasternOhio UniversityCollegeoJ'Medicine 068 Alpha 1 AdrenergicStimulationProtectsAgainst Cardiac Infarctionand Dysfunction,IamesM. Walther,BS,Universitl,of Colorado 069 MonitoredTelemetryBeds:Are They NecessaryFor Patients With NontraumaticChestPainandNormalECG's,SharonM. Valentine,RN,StateUniversityof NewYork,StonyBroolc 010 Direct Evidencethat ExogenousNitric Oxide Decreases BasalNitric Oxide Releasefrom the VascularEndothelium in Rat Aortic Rings,BernardL. Lopez,MD, Thomas.Iefrerson University

Cardiovascular

Toxicology

Moderator:JamesT!Niemann,MD, Harbor-UCLA (2:00-3:00) 052 ImprovedSensitivityin DetectingAcute Myocardial Infarction (AMI) Using Serial CK-MB Sampling:The National CooperativeCK-MB Multicenter Project, W. Brian Gibler, MD, UniversityoJCincinnati 053 BedsideWholeBlood RapidAssayof CardiacTroponin-T: A SensitiveIndicator of Acute Myocardial Infarction, M. StephenBaxter,MD, Universityof Cincinnati

Moderator: James R. Roberts, MD, Mercy Catholic Medical Center (2:00-3:00pm) 071 ProphylacticUse of MagnesiumSulfatein the Preventionof Ventricular Tachyarrhythmiasin Tricyclic Antidepressant Overdose,J . Brent Meyers,BowmanGraySchoolof Medicine 072 Thermal Characteristicsof Neutralization Therapy and WaterDilution For StrongAcid Ingestion,Clark S. Homan, MD, StateUniversityof New York,StonyBrook

Sunday,May 5

0g2 Efficacy and Comfort of Full-Body VacuumSplintsfor CSpine immobilization, Robert S. Hamilton, MD, Denver GeneralHospital to PreventNauseaand 093 ProphylacticUse of Prochlorperazine Vomiting During HelicopterTransport,DeborahL' Schutz, RN,MethodistHosPitalof Indiana

013 Diagnosisof Acute Mountain Sicknessin Pre-verbalChildren,N eil Waldman,MD, Universityof Colorado 074 Comparisonof Routesof FlumazenilAdministrationto Reuets" Midurolam-InducedRespiratoryDepressionin a Dog Model,MelanieS.Heniff,MD, MethodistHospitalof Indiana 075 ElevatedSerumLeadtrvels in EmergencyDepartmentPatients With Retainedtrad Foreign Bodies' SusanE Farrell, MD, Medical Collegeof Pennsylvaniaand HahnemannUniversity

Scientific Papers: Toxicology/Environmental (4:00-6:00pm)

0'..6 Potassium(K+) RepletionFails to InterfereWith Reduction of SerumLithium (Li) ConcentrationsBy SodiumPolystyreneSulfonate(SPS)in Mice,lames G. Linakis,MD, Rhode Island Hospital 0'11 FluorideToxicity TreatmentEffectivenessUsing Red Blood Cell Hemolysisasa Model, WayneJ. Farnsworth,MD ' State (lniversity of NewYork,SYracuse 078 Comparisonof the Efficacy of Single-DoseActivatedCharcoat(SOAC)andMultiple-DoseActivatedCharcoal(MDAC) in ModerateOverdosewith Tylenol Extended-Relief(APAPER) Andls Graudins,MBBS, Universityof Massachusetts

i4oderator: Riihurd C. Dart, MD, PhD, University of Colorado 094 DetrimentalCardiacEffects of CocaineareDue to its Local AnestheticEffects,Edward W. Cetaruk,MD, Universityof Colorado 095 Hemodynamic Effect of Cocaine During Acute Hemorrbage,TheodoreC. Bania, MD, State University of New York,BrooklYn 096 CocaethyleneCausesSignificant Cardiac Toxicity in an Animal Model of Cocaine and Alcohol Abuse,Lance Wilson,MD, Mt. SinaiMedicalCenter 097 Hypothermic CardiacInjury: Role of-Misutilized Oxygen' Bifan A. Agan, MS, IV, UniversityoJColorado Toxicityin 098 Ionic Mechanismsof Cyclic Antidepressant Isolated,Adult Rat Heart Myocytes: Inhibition of Calcium JohnA.Watts,PhD, CarolinasMedicalCenter Transients, 099 lron-Induced Myocardial Dysfunction Develops Independentlyof PerfusedExtracellularHydroxyl Radicalin Isolated Rat Hearts,MarshaD. Ford,MD, CarolinasMedicalCenter

Toxicology

ModeratorlLewis R. Golilfrank, MD, Bellevue Hospital Center (3:00-4:00pm) 079 Treatmentof Extremity Hydrofluoric (HF) Acid Bums: An Comparisonof Topical,Locally in vivo Histopathological Infiltrated, Intraarterial,and RegionalIntravenous,Cynthia K. Aaron,MD, Universityof Massachusetts 080 High SurfaceArea Oral Activated Charcoal Exhibits Supeiior Clinical Properties,James R. Roberts, MD' Mercy CatholicMedicalCenter Effects of Calcium Chloride in a Canine 081 Cardiovascular Model of Acute Propranolol Intoxication, Dan Hanfling' MD, GeorgetownUniversi.tY 082 CardiovascularParametersin Calcium Channel Blocker Toxicity, John J. Cienki, MD, MS HersheyMedical Center (NAC) FollowingAdmin083 BloodLevelsof N-Acetylcysteine istrationvia the RectalRoutein the PorcineModel:A Pilot Study, Sonla R. Stiller, MD, Medical College oJ Pennsylvaniaand HahnemannUniversitY ' ChristinaM 'Yadao' 084 New Populationat Risk For Poisoning MPH, WayneStateUniversitY 085 Primary Heat lllness: The Urban Experience,Kirk R' DuJiy' MD, Cook CountYHosPital

or VerapamilFor 100 Efficacy of ProphylacticDexamethasone in Increase Pressure Intracranial Induced Altitude' Reducing Rabbits,AlanB. Storrow,MD , Joint Military MedicalCenters 101 Histologic Effect of Butyl-2-Cyanoacrylateon Skin Lacerations,John M. Howell, MD, GeorgetownUniversity

pm) ScientificPapers: Cardiovascular(4:0-0-6;p0^

Moderator: Jerr^isR' Hedges,MD, MS, Oregon Health Scicnces University 102 PredictiveValue of a Normal ECG: Is it AffectedBy Duration of Time From Onset of Chest Pain?,Adam J' Singer' MD , StateUniversityof New York,StonyBrook 103 Serial CKMB Resultsare a SensitiveIndicator of AMI in ED PatientsWith Chest Pain but without ECG Changes, Gary P.Young,MD, HighlandGeneralHospital

ScientificPapers:EMS (4:00-6:00PT) ^ -College

Moderator: Vinfent PVerdile, MD, Albany Medical 086 Incremental Benefit of Individual American College of Surgeons(ACS) Trauma Triage Criteria,,Mark C' Henry, MD, StateUniversityof NewYork,StonyBrook A 087 StudyDesignand OutcomesIn Out-of-HospitalResearch: Aial y sis,I aneH' Br ice,MD, University of Pittsburgh Ten-Year 088 High DischargeSurvival from Out-of-HospitalVentricular Fib."rillationwith Rapid Defibrillation by both Police and RogerD.White, MD, Mayo Clinic Paramedics, 089 First ResponderDefibrillation Does Not IncreaseSurvival From SuddenCardiacDeathin a Two-TieredUrban-SuburMD' Medical Center ban EMS System,ThomasA. Sweeney, of Delaware 090 Estimating Effectivenessof Cardiac Arrest Interventions: Logistic {egressionSurvivalModel, TerenceD Valenzuela, MD, MPH, UniversitYof Arizona 091 ProspectivePopulation Based Validation of Receiver Operator Curve (ROC) Derived ResourceBased Trauma Triage Rules,Mark C. Henry' MD' State Universiryof New York,StonyBrook

104 CardiacSerumMarkersMyoglobin and CK-MB areSynergistic in the Very Early Detectionof Acute MyocardialInIarction, W.Brian Gibler,MD, Universityof Cincinnati 105 SerumMyoglobin Levels in Patientswith UnstableAngina and AcutL Myocardial Infarction, Brian J. O'Neil, MD, WayneStateUniversitY 106 Evaluationof Cardiac STAIus CK-MBA4yoglobinDevice Ruling-Out Acute Myocardial Infarction' for Rapidly -Brogar, ir, MD, State [Jniversityof NewYork' Gerard X. StonyBrook lO7 2-DimensionalEchocardiographyis Not UsefulAfter Evaluation of ChestPain Patientsin an EmergencyDepartment' SweeHan Lim, MBBS, SingaporeGeneralHospital 108 Chest Pain Evaluation Registry Study: ComparisonWith Previously Reported Series, loais G. Graff, MD, New Britain GeneralH osPital 109 GenderDifferencesin the Treatmentand Outcomeof ED ChestPainPatients,EdwardP. Sloan,MD, MPH, University of lllinois at ChicaRo I4

Sunday, May 5

DIDACTIC SESSIONS Teachingthe EmergencyUltrasoundCurriculum: When,Why, and How (10:00-12:00 noon) SteveFolstad,MD, BowmanGray Michael Heller, MD, TempleUniversity StephenHoffenberg,MD, RoseMedical Center,Denyer JosephKosnik,MD,Wayne StateUniversity This sessionwill discussimportant issuesinvolved in emergency ultrasoundeducation.We will addressissuespertinentto teachins the emergency ultrasound curriculumin residencytrainingprol grams.Different formats for presentingdidactic material will be discussedas well as methodsfor providing adequatehands-onexperience.Qualityassurance will be addressed througha discussion of the various options availablefor the over reading of resident scans.Recentwork on the "Curriculum for EmergencvMedicine Residency Trainingin Emergency Ultrasonograph-y" beingOeveloped by CORD's Task Force on Curriculum Developmentwill also be presented.Larger issuesconcerningthe training of emergencyphysiciansnot in residencyprogramssuch as emergency medicinedepartment facultywill alsobe discussed.

The resources availablefor alternativemeansof trainins suchas outsidecourses. fellowships. trainingvideos.slidesets.a.-nd insrructional textswill be presented.

The role of researchin emergency ultrasoundasit is todayand how it will relateto the future will be considered.Other issuesthat are important to the developmentof an emergency ultrasoundtrainingprogramsuchasavailableequipment,thepolitical arena,credentialing issues,andfinancialconsiderations for the sponsoring departmentwill alsobe briefly discussed.

This session will be presentedin a panelformat by four faculty membersrepresentingwidely disparategeographicaland practicesettingsand will allow ampletime for questionsfrom the audience.

Analgesia Researchin Emergency Medicine: How Can We Do It Better? (10:00-11:00am) Moderator:Donald M.Yealy,MD, UniversityoJPittsburgh William H. Cordell, MD, MethodistHospital of Indiana JamesDucharme,MD, St.JohnRegionalHospital,NewBrunswick KnoxTodd,MD, Emory University This session will discussspecificareaswhereanalgesia research in emergencymedicinehas sufferedor is in needof attentionincluding: choosingan analgesicregimento study(balanced, syndrome specific,or other options), evaluatingpain relief after discharge from the ED, and clinical versusmathematicsignificancein pain measurements.

In addition,the panelwill solicit questionsfrom the audienceand offer solutionsto commonanalgesictrial quandaries.

Fundamentals of Research: Getting Started in Research(11:00-12:00noon) LanceB. Becker,MD, UniversityoJ Chicago The developmentof nationallyrecognizedresearchprogramshas beenidentifiedasoneof the mostimportantchallengesfacingEmergencyMedicinetoday.Within academicinstitutions,the hallmarkof nationalresearchrecognitionlies with successfulNIH awardsor otherprestigiousfunding.As with any new specialty,thereare few NIH fundedinvestigatorsand even fewer well funded emergency medicineresearchprograms.An additionalchallengefor emergency medicineinvestigatorswho areapplyingto NIH is to avoidthe frequent criticisms of being "overly phenomenalogic"in scientific approach.

Understanding theseissuesis mandatoryfor the developmentof long-termemergencyresearchprograms.

Luncheon: Mentoring in Academic Emergency Medicine (12:00-1:30pm) Moderator: SuzanneM. Shepherd, MD , IJniversity of Pennsylvania Peter Rosen, MD, University of California, San Diego Andy S.Iagoda, MD, Mt. Sinai Medical Center Carol Jack Scott, MD, University of Maryland The initial focus of this session will be on the mentoring process.

Panelists will present mentoring from a historical perspective, mod-

els in current use in business,medicineand academia.The panel will discussthe pros and cons of thesevariousmentoringmodels and the impact of cultural diversity on mentoring.The panel will discussthe spectrumof mentoringcurrently incorporatedby academicprogramsin EmergencyMedicinein both residencyandfaculty development,and how these addresspromotion and tenure issues.The panel will then shift focus to the individual, interpersonalprocessof mentoring.Mentoring will be discussedfrornthe viewpointsof the mentor and mentee.This portion of the session will focus on the processof choosinga single or multiple mentor/menteerelationship,the ongoingdevelopmentof that relationship,and the appropriateterminationof that relationship.

Luncheon: Emergency Telemedicine:A New Paradigm in the Evolution of Health Care (12:00-1:30pm) David Ellis, MD, State Universityof NewYork,Buffalo AndreaPesce,StateUniversityof New York,Buffctlo Daniel Ward,MD, Medical CollegeoJ'Georgia Telemedicineis the provision of health care servicesat remote sites using interactive video conferencesor store-and-forward technologyand the transferof patienthealthinformation via telecommunicationslinkages.It has potential significancefor the practiceof emergencymedicinein academicand community settings.Telemedicine canbe usedto connectoutlyingfacilities,such as communityhospitals,rural clinics,correctionalfacilities,with ref'erralcenters,to connectemergency physicianwith consultants, and to shareeducationalinformation regardingpatientevaluation and management.

This technologymay proveto be part of academic medicine'sresponse to increasinglyscarceandcentralized resources.This luncheonsessionis scheduledto includean introduction to the basicsof telemedicine.a presentation of current capabilitiesand limitations,a demonstration of the US military's portabletelemedicineequipment,and a stagedlive-patientexaminationtransmittedto SAEM from a remotesite.

Luncheon: Alternative Sources for the Funding of Emergency Medicine ResidencyPositions (12:00-1:30 pm) Barry Simon,MD, Highland GeneralHospital VinceMarkoychick,MD, Universityof Colorado GlennHamilton,MD,Wright StateUniversity BensonS. Munger,PhD, ExecutiveDirector, American Board of EmergencyMedicine Federalgovernmentand otherpublic/privatefunding of post-graduatemedicaleducationis threatened.

Hospitalsaredownsizingand closing.Managedcareis producinga decreasein the censusof many emergencydepartments.In order to surviveand thrive, programs/departments must anticipatethe changesand actively pursuealternativetraining sitesand sourcesof funding; i.e., merging programs,addingprivate,universityand/orcounty hospitals,adding fast track and urgent ca.reand other managedcare types of practices.We have put togethera panel of emergencyphysicians who haveexperiencein developingsomeof the more creativeand atypical formats. The goal of this sessionis to learn what has worked and what hasbeentried in varioussettings,to broadenour optionsand to educateus aboutthe problemswe face.

ABEM: Its Mission(1:30-2:30pm) ABEM directors and staff will provide information on recent Board actions,review cuffent Board activities,and report on the residencyand residentdatagatheredthroughthe annualsurveyof programs. Time will be includedfor questionsfrom participants.

A packetof referencematerialfor this sessionwill be availableall week at the SAEM registrationdesk. (Seerelated informal sessions:for program directorsand faculty, Tuesday,May 7 at 3:00 pm; for residents, Wednesday, May 8 at l:30 pm)

Sunday, May 5 Medical Informatics and the Academic Emergency Physician (1:30-3:00 pm)

GeoffreyW.Rutledge,MD, PhD, BethIsrael Hospital and Harvard Medical School s Hospitaland JonathanM. Teich,MD, PhD, BrighamandWomen' Harvard Medical School RobertL.Wears, MD, MS, Universityof Florida, Jacksonville Medical informatics includes the cognitive, information processing, and communicationstasks of medical practiceand research, technologyto these along with the applicationof computer-based of researchactivities tasks.This sessionwill includediscussions currentlyunderwayamongemergencyphysiciansinterestedin informatics,as well as opportunitiesfor further researchand for developing medicaldecision-makingmodelspertinentto emergency medicine.The speakerswill also specificallyaddresscombining ED informationsystemswith hospital-widesystems,the use of information systemsto improve the quality of ED care,the background and experiencenecessaryfor successfulapplications developmentandresearchandhow to obtainit, andpotentialfunding sourcesto supporttheseactivities.

Fundamentals of Research:ResearchDesign (1:30-2:30pm) EdwardA. Panacek,MD, Universityof'California,Davis Transforminga specificresearchquestioninto a researchprotocol requiresa knowledgeof the basictypesof researchdesignsand waysof categorizingthem.This lecturewill presenta standardized the spectrumof researchdesigns.It will systemfor understanding medalsogo overeachdesigntype commonlyusedin emergency limitationsand disadvantages, icine and explain its advantages, The focuswill be on cliniidealapplicationto researchquestions. cal research,althoughdesigntypes applicableto basic research will be listed.This sessionis designedto be very practicalandwill illustrateexamplesusingactualemergencymedicinestudies.

Fundamentalsof Research:BasicStatistics (2:30-3:30 pm) RogerJ. Lewis,MD, PhD, Harbor-UCLA Early in the courseof planninga projecta researcherneedsto make an appraisalof the outcomeparametersto be measured,the feasibility of doing the study in a given patientpopulation,the number of patientsneededfor statisticalcomparison,and the analytical question.Early statisticalconsulthe research meansof addressing tation can assistwith thesequestions,but the researchermust provide the informationthe statisticianneedsfor critical and analytical review of the proposal.This sessionwill concentrateon thosestatistical conceptsand methodsthat must be understoodif the investieator is to be able to communicatewith a biostatisticianand prodictively collaboratein the designand analysisof a clinical study.

Ethics of ProcedurePerformanceon the Newly pm) Dead(3:00-4:00

Moderator: E.Iohn Gallagher,MD, Bronx Municipal Hospital Medical Center RobertK. Knopp, MD, St.Paul-Ramsey and RobertM. McNamara,MD , Medical Collegeof Pennsylttania HahnemannUniversity KennethIserson,MD, MBA, Universityof Arizona Societyexpectsemergencyphysiciansto perform life-savingprocedurescompetently.Someof theseprocedures,suchas cricothyrotomy, are not frequently required,thus making acquisitionand retentionof certaincritical skills difficult. The panel,with thehelp of otherswho chooseto attendthis session,will attemptto examine the ethical issues surroundingthe use of recently deceased cadaversfor educationalpurposesin the ED. Some of the quesinclude:Doesthebasicprincipleofinditionsopenfor discussion vidual autonomysurvive death?Is either the principle of beneficenceor non-maleficenceapplicableto a cadaver?If so,whatethical weight do theseprinciplescarry when consideredin the con' procetext of the next living patientwho may requirea life-saving 'consent' dure?What is thephysician'sethicalobligationto obtain "profrom next of kin, and to what extent do relativespossessa prietary(quasi-property)right" to refusea requestfor petformance of an educationalprocedureon a deceasedfamily member?Is the philoprocedures and'non-invasive' distinctionbetween'invasive' sophicallygroundedin ethicsor aesthetics?

Fundamentalsof Research:Ethical in Human SubjectResearch Considerations (3:30-4:30 pm) W.Runge,MD, CarolinasMedical Center JeJJrey The mechanicsof initiating a clinical researchstudygo beyondthe writing of the protocol. The design must take into accountthe rights and welfare of the patientsor volunteerswho will be the subjectsof the research.Clinical researchis likewisesubjectto will federallaw andmustmeetinstitutionalapproval.This session presentnecessaryethical considerationsin the designandperformanceof research,and will acquaintthe researcherwith the ethical principlesunderlyinginformed consentregulationsand the perspective of the IRB.

Fundamentals of Research: Critical Readingof the Medical Literature (4:30-5:30pm)

SandraM. Schneider,MD , Universityof Rochester One of the most important stepsin any researchprojectis critical readingof the literature,with the goal of identifying weaknesse-s and omissionsin the work alreadyperformed.The speakerwill discuss specific characteristicsof published studies that may and how theseproblems reducethe reliabilityof the conclusions, may be detectedby the discerningreader.This sessionwill discuss how to read critically to obtain the knowledgebaseto convince andnoveltyof the questionyoupropose othersof the significance to addresswith original and relevantresearch.

Monday, May 6

PAPBR/POSTBRPRESENTATIONS ScientificPapers:CPR (8:00-9:30am) Moderator: James I. Menegazzi, PhD, UniversiQ of Pittsburgh 110 Ontario Trial of Active Compression-Decompression Cardiopulmonary Resuscitation for Prehospital Cardiac Arest,JonathanF.Dreyer,MD, UniversityofWesternOntario Resuscitation(CPR) 111 Active Compression-Decompression versus the StandardManual CPR Technique in Out-ofHospital CardiacArrest in a Two-TieredEmergencyMedical Services(EMS) System with Physician-StaffedAmbulancesin the SecondTier, Dietmar Mauer,MD, Johannes GutenbergUniversity Il2 OntarioTrial of Active Comression-Decompression CardiopulmonaryResuscitationFor In HospitalCardiacArrest,1an G. Stiell, MD, Universityof Ottawa 113 Effects of GradedDose EpinephrineTherapy on Hemodynamic and OxygenTransportVariablesin the Post-Resuscitation PeriodAfter Cardiac Anest, Carol KiekhaeJbr,MD, Henry Ford Hospital ll4 Racial Distribution of Pediatric CardiopulmonaryArrest Cases,Paul E. Sirbaugh,DO, Baylor CollegeoJMedicine I l5 Post-ArrestAdministrationof Acetyl-L-CarnitineEnhances the Recoveryof Cardiac MechanicalFunction, CharlesB. Cairns,MD, Universityof Colorado

ScientificPapers:Injury PreventionInterpersonalViolence(8:00-9:30am) Mod,erator:Arthar L. Kellermann,MD, MPH, Emory University 116 ViolenceAgainstWomenRevealedBy RoutineInterviews in the EmergencyDepartment,BruceM. Becker,MD, Rfu;de Island Hospital 111 DomesticViolence:Estimateof Acute Prevalence Using a ValidatedInstrument,Helen Straus,MD, MS, Cook County Hospital 118 DomesticViolenceAmong Men and Womenin an InnerCity EmergencyDepartment,TrevorMills, MD, Louisiana StateUniversity 119 Prospective Analysisof 963 Casesof SexualAssault,Kln M. Feldhaus,MD, DenverGeneralHospital 120 EmergencyDepartmentPatientsWith Assault Injuries: A Case-ControlStudy of PreviousInjuries and Convictions, Harry Moscovitz,MD, YaleUniversity l2l Ethnic Differences in Women's Attitudes Toward Abuse, GretaBell, MD, UniversityoJlllinois at Chicago

Scientific Papers: Health Care Delivery (10:00am-12:00noon) Moderator: E. John Gallagher, MD, Albert Einstein 122 FrequentEmergencyDeparlmentUsers - Can We Intervene?,Linda L. Spillane,MD, Universityof Rochester 123 FactorsAssociatedwith FrequentED Use for Asthmain an UrbanAfrican-AmericanPopulation,LynneD. Richardson, MD, Mt. SinaiMedicalCenter 124 Deflning FactorsAssociatedwith Use of ED for Routine Complaints,Iune Treston,CooperHospitallUniversityMedical Center 125 Influenceof Psycho-SocialDifficulties on EmergencyDepartmentUsage,WilliamR. Mower,MD, Universityof California, Los Angeles 126 Patient Satisfaction with Emergency Department Rapid Treatmentvs Inpatient Care for Acute Asthma, Robert I. Rydman,PhD, Cook CountyHospital 127 Mortality and Morbidity Associated With Welfare Payments, Jim Christenson, MD, St.Paul'sHospital I28 PracticePatternsin an EmergencyDepartment'FastTrack' Setting: Comparisonby Training Background,Edward A. Panacek,MD, Universityof Calfornia, Davis

129 GenderBias in CardiovascularDisease.Iudd E. Hollander, MD, StateUniversityof New York,StonyBrook

Scientific Papers: Ischemia/Reperfusion/Shock (10:00am-12:00noon) Moderator: Mark Angelos, MD, Ohio State University 130 Preconditioning ProtectsAgainstAnomalous Mitochondrial ElectronTransportActivity in IschemicRat Hearts,Charles B. Cairns. MD. Universitvof Colorado l 3 r EndogenousAdenosineMediatedWavefrontsof Protection and Infarction During Regional Cardiac Ischemia, Paul Bender,PhD, Universityof Colorado 132 ReperfusionFollowing MyocardialIschemiaInducesTissue Injury Through Apoptosis, Xin-liang Ma, MD, PhD, Thomas Jffi rson Uni versity 1 3 3 AntioxidantTieatmentAttenuatesMyocardialIschemia-Reperfu sionInjury,BernardL. Lopez,MD,ThomasJeffersonUniversity t34 Adrenal Insufficiencyin High Risk EmergencyDepartment Patients,Heidi C. Blake,MD, Henry Ford Hospital t 3 5 AdenosineReceptorAntagonismas an Adjunct to Standard PharmacotherapyDuring ResuscitationFrom Circulatory Shock:Improvementin Acute HemodynamicFunctionand Survival Following Hemorrhagic Shock, Lawrence de Garavilla.PhD,Albert EinsteinMedicalCenter r36 MyocardialMetabolismDuringTreatmentof Non-Ischemic CardiogenicShockin AwakeCanines,Jffiey A. Kline,MD, CarolinasMedical Center t31 Non Ischemic-Induced MyocardialStunning,Richard M. Ratmond.PhD. RhodeIslandHosoital

CPR

PosterSession(1:30-4:00pm)

Moderator: Norman Paradis,MD, Columbia University(2:00-3:00) 138 Pulsed Diastolic SelectiveAortic Arch PerfusionWith AutologousBlood Resultsin Returnof Spontaneous Circulation in Prolonged Cardiac Arrest,JamesE. Manning, MD, Universityof North Carolina at ChapelHill 139 SystemicBlood Pressureand CoronaryPerfusionPressure DuringClosed-Chest CardiacMassageandMinimally-Invasive Direct CardiacMassagein Pigs, C. Andrew Eynon, TempleUniversity t40 Effect ofVasopressinon CoronaryPerfusionPressureDuring Human CardiopulmonaryResuscitation,Daniel C. Morris, MD, Henry Ford Hospital t41 Adolescent CPR Training: Can Kids Save Lives?, ChristopherMarkus, DO , Universityof Illinois at Chicago t42 Prospective Studyof InjuriesDueto Cardiopulmonary Resuscitationin Children,ColleenM. Bush,MD, ButterworthHospital t43 GastricTraumaand PulmonaryAspiration at AutopsyAfter Cardiopulmonary Resuscitation,William B. Felegi, DO, M orristown M emorial Hospital 144 Impact of Routeand Timing of EpinephrineAdministration on Survival in Out-of-HosDitalCardiac Anest. Keith L. Mausner.MD. MedicatCollbgeofWisconsin \45 13 C NMR Analysisof AcetateOxidationDuring In-\4vo VentricularFibrillation,M ark G.Angelos,MD, Ohio State University 146 Impact of an EndotrachealTube Side Port on The Absorption of Lidocaine,John W. Walthall,NREMT-P,Joint Military Medical Centers

Injury Prevention/Interpersonal Violence Moderator: Ronald F. Maio, DO, University of Michigan (3:004:00 pm) 147 DomesticViolencein the EmergencyDepartment:How Do WomenPreferto DiscloseandDiscussthe Issues?, Stephen R. Hayden,MD, Universiryof California, SanDiego

Monday, May 6 148 Physicaland SexualViolenceAmong Mothersin a Pediatric EmergencyDepartment(PED), SusanJ. Dufu, MD, Rhode Island Hospital 149 PsychologicalComplaints of Women Victims of Violence PresentingInto an EmergencyDepartment,BruceB. Becker, MD, RhodeIsland Hospital 150 Victim-Offender Relationshipsin Intentional Trauma in a SuburbanVersusUrban Trauma Center Population,Carol Irving, MD, Morristown Memorial Hospital 151 Violence Against Women-RiskFactor Identification in the ED and Implicationsfor Resources,Judilh A. Linden, MD, Boston City Hospital 152 Violence Amongst Intimates in an Inner City Emergency DepartmentPopulation,Deirdre Anglin, MD, Universityof SouthernCalifurrua 153 Measuringthe Incidenceof BehaviorsAssociatedWith VioIent Injury Among Adolescents:What Are the Implications for Preventionl,AlanWeiner,MD, Universi4tof Connecticut 154 Weapon-RelatedViolence and Security Measures in the EmergencyDepartment,CynthiaWichelman,MD, Washington University 155 Barriers to Screeningfor Violence Against Women in the Emergency Department, Bruce M. Becker, MD, Rhode Island Hospital

Ischemia./Reperfusion/Shock Moderator: Charles B, Cairns, MD, University of Colorado (2:003:00) 156 ReducedCalcium Accumulationin IsolatedNerve Endinss During Hibernation,Nina T. Gentile,MD , Nationa! Instittie of Health 157 Soluble Complement Receptor-l Mitigates Lung Injury After Intestinal Ischemia/Reperfusionin Rats, Feng Xiao, MD, Louisiana State University 158 Blood-Brain Barrier Sodium PermeabilityFollowing Cardiac Arrest and Resuscitation,JamesE. Olson,PhD,Wright StateUniversity 159 Antioxidant Treatment Preservesthe Aortic Vasorelaxant Responseto Peroxynitritein Hypercholesterolemic Rabbits, Xin-liang Ma, MD, PhD, ThomasJffirson University 160 SplanchnicIschemia-Reperfusion Shockis Attenuatedby LPropionyl Carnitine, an EndogenousEster in Fatty Acid Metabolism,RebeccaStroh,ThomasJeffersonUniversity I 6 1 PotentAntioxidant,SB 211475, AMetaboliteof the New Antihypertensive Agent Carvedilol,ProtectsAgainstSplanchnic Ischemia-Reperfusion-Induced Endothelial Dysfunction, TheodoreA. Christopher,MD, ThomasJffirson University 162 SB 211475is More Protectivein Rat SplanchnicIschemiaReperfusionShockThan its ParentCompoundCarvedilol,A New AntihypertensiveAgent and Free-RadicalScavenger, TheodoreA. Christopher,MD, ThomasJffirson University 163 L-Propionyl Carnitine, an EndogenousEster in Fatty Acid Metabolism, Protects Against Splanchnic IschemiaReperfusion-Induced EndothelialDysfunction,TheodoreA. Christopher,MD, ThomasJeffersonUniversity

Ischemia/Reperfusion/Shock Moderator: Emanael P Rivers, MD, MPH, Henry Ford Hospital 6:00-4:00) 164 Is Urine Output a ReliableIndex of Blood Volumein Hemmorhagic Shock?,Richard H. Sinert, DO, State University of New York,Brooklyn 165 Gastric Tonometryas a Measureof Blood Loss, Bonny J. Baron, MD, StateUniversityof NewYork,Brooklyn 166 Evaluation of Hepatic GluconeogenesisIn ResponseTo Epinephrine During Endotoxic Shock, Clark S. Homan, MD, StateUniversityof New York,StonyBrook 167 Comparisonof BaseDeflcit andLactatein TraumaPatients, C. SeanBlack, MD,Wake ForestUniversity

168 Disassociationof HepaticBlood Flow From OxidativeMetabolism During Hemorrhagic Shock and Resuscitation, ChristopherGnadinger,MS N, Universityof Colorado 169 IL-6 Determinationin ED Patientswith Sepsis,Carol A. Terregino,MD, CooperHospital 170 ChlorpromazineSelectively Inhibits Endothelium-Dependent Vasorelaxatjon,Dale S. Birenbaum,MD , Thomaslefferson University I7l Hydroxyethyl Starchin HypovolemicShock: Pharmakodynamic Comparisonof Intraosseousor IntravenousInfusion, Rainer Kentner,MD, Universityof Mainz

EMS Moderator: Theodore R. Delbridge, MD, MPH, University of Pittsburgh (2:00-3:00 pm) 172 AutomaticExternalDefibrillation and its Effects on Neurologic Outcomein CardiacArrest Patientsin an UrbanTwoTieredEMS System,Jffiey D. Ho, MD, HennepinCounty Medical Center 173 ProjectedImpact of First ResponderAED Use in an Urban ALS Service,JosephStephanStapczynski,MD, University of Kentucky 174 Should Aeromedical Support Be Sent For CardiacArrest Patients?,Carrie Nelson,MD, Universityof Nevada 175 Online Medical Control Does Not Improve SafetyOr Efficacy Of Morphine For Out-of-HospitalPain Control,Sean Carr, OregonHealth SciencesUniversity 176 Online Medical Control Does Not Improve Safety Or Efficacy Of DiazepamFor Out-of-HospitalSeizureControl, Patrick Gregg,OregonHealth SciencesUniversity 177 Rate of Field Pronouncementof Cardiac Arrest Patients After AggressiveTraining of BasePhysicianson Characteristics of CardiacArrest Survival,Eric D. Isaacs,MD, Universityof California, SanFrancisco

EMS Moderator: Ronald Pirrallo, MD, Medical College of Wisconsin (3:00-4:00pm) 178 CrashScenePhotography:Predictorsof Injury in MotorVehicle Trauma?,Craig Newgard,Loyola University 179 Effect of TherapeuticInterventionson the Outcomeof Outof-Hospital Pediatric Cardiopulmonary Arrest, Paul E. Sirbaugh,DO, Baylor Collegeof Medicine 180 GeographicallyBasedAnalysis of ResponseTime Intervals in a Suburban/RuralEMS System, George H. Lindbeck, MD, Universityof Virginia 181 Impact of Use of Lights and Sirens by Ambulanceson ElapsedTravelTimesin an UrbanEMS Setting,llarinder S. Dhindsa,MD, MPH, GeorgetownUniversity 182 Raceis Not a Factor in OHCA Outcomein Two Suburban EMS Systems, KevinChu,MD,William BeaumontHospital 183 ProspectiveTime-Motion Studyof the EMS TurnaroundInterval, David C. Cone, MD, Medical College of Pennsylvania and HahnemannUniversity

Respiratory Moderator: Emil M, SkobeloJf,MD, Medical College of Pennsyl. vaniq qnd Hahnemann University (2:00-3:00pm) 184 Efficacy of IntramuscularDepot vs Oral Steroids in Treatment of Asthmatics Dischargedfrom the EmergencyDepa.rtment,Bruce C. Meneley,MD, Naval Medical Center, SanDiego 185 SecondDerivativeof the End-TidalCO2Waveformis Associated With Admission in Acute Exacerbationof Asthma, Selim Suner,MD, RhodeIsland Hospital 186 Comparisonof Albuterol Administeredby Heliox andOxygen Nebulizationin the Treatmentof Patientswith Exacerbations of Asthma: A Preliminary Report,Jack Horowitz, MD, Medical Centerof Delaware

Monday, May 6 187 Effect of Changes in Acute Asthma Therapy in an EmergencyDepartmentObservationUnit on Improvement in Peak ExpiratoryFlow Rate: 1989 vs. 1994,Daniel G. Murphy, MD, Universityof Illinois at Chicago 188 Surveyof Home Treatmentin PatientsWith Acute Asthma, RobertSilyerman,MD, Long Island.IewishMedicalCenter 189 Adrenal Function and Physiologic Stress During Acute Asthma Exacerbation.Rita K. Cydulka,MD. MetroHealth Medical Center

Respiratory Moderator: Richard M. Nowak,MD, Henry Ford Hospital (3:004:00 pm) 190 Atmosphereand Asthma in New York City: 1989-1995, RonaldB. Low, MD, StateUniversityof New York,Brooklyn 191 Do PatientsUnderstandAsthma?A Surveyof Knowledge and Attitudes in the Emergency DepartmentPopulation, JamesD. Schweigert,MD, ButterworthHospital 192 AssociationBetweenSubstance AbuseandAcuteExacerbation of BronchialAsthma,TheodoreGaeta.DO. St.Barnabas Hospital 193 CaseIdentification

by Administrative ClaimsDataVersusEmergencyDepartmentLogbooks: Experiencewith Acute Asthma, CarlosA. Camargo,MD, Massachusetts Generctl Hospital 194 Comparisonof Rapid SequenceIntubationto Conscious Sedationor Awake Intubation in the EmergencyDepartment,.Iohn P. Fortney,MD,WashingtonUniversity 195 Influenceof Early PostnatalSeizureson RespiratoryControl in WeanlingRats,ThomasE. Terndrup,MD, StateUni, versityof'New York,Syracuse

Health Care Delivery Moderator:Marcus L Maftin, MD, Medical Collegeof Pennsylvania and Hahnemann University,Allegheny Campus(2:00-3:00pm) 196 Compliancewith OutpatientRefenalFrom a LargeUrbanEmergencyDepartment, BruceD. Burstein,MD, BellevueHospital 197 FrequentEmergencyDepartmentUsers:Is It Possibteto Controlthe Cost of Care?,Linda L. Snillane.MD. Llniversityol Rochesttr 198 ComputerizedProtocolsFor DiagnosticTest Ordering:A Double-BlindAssessmentof Inter-raterAgreementWith EmergencyPhysicians,GregoryL. Larkin, MD, University rf Pittsburgh 199 Comparisonof Emergencyand Family PhysicianPractice Patternsfor the Most FrequentPrimary Care Outpatient PediatricProblems,David R. Eitel, MD,York Hospital 200 Profile of PatientsSeenin the EmergencyDepartmentAfier Denialof Authorizationfor Care,JaneneHecker,MD, Medical Collegeof Pennsylvaniaand HahnemannUniversity 201 Cost of RoutineChlamydiaEliza Testingin the Ctinically SymptomaticFemale,Chris Martella, DO, Albert Einstein Medical Center 202 Survey of EmergencyMedicine ResidencyProgramsRegarding Cutbacksin ResidentComplement,Michele B. Wagner,MD, Beth Israel Hospital

Health Care Delivery Moderator: Robert A. Lowe, MD, MPH, University of Pennsylvanin(3:00-4:00pm) 203 Importanceof PatientSelectionin the CostEffectiveness of ED BasedObservation Unit Treatment, RebeccaR. Roberts.

MD, Universityof Illinois at Chicctgo 204 SocioeconomicFactors and Patient Satisfaction Predict EmergencyDepartmentReturn Visits, Robert E. Antosia, MD, MPH, BrighamandWomen'sHospital 205 Women'sHealth:ED Identificationof High Risk Behaviors, Gail D'OnoJrio,MD, BostonCity Hospital 206 Effect of Transferon Outcomein Patientswith Appendicitis, Valer i e C. N orton, M D, Valderbilt [,]niver s ity

207 Effects of Standardizationof the Ratio of Number of EmergencyDepartmentsPerUnit Populationon Emergency HealthCareAccessin the U.S., C. JamesHolliman,MD, MS HersheyMedical Center 208 Is There a Maldistribution of EmergencyPhysiciansFrom Stateto Statein the U.S.?,C. JamesHolliman, MD, MS HersheyMedical Center 209 Comparisonof CaseManagementby PhysicianAssistants VersusEmergencyPhysiciansand Primary CarePhysicians, A. J. Hirshberg,MD, MPH, MS HersheyMedical Center

ScientificPapers:Health Care Delivery (4:00-6:00 pm) Moderator: Robert L Wears,MD, University of Flarfula 210 Impact of EmergencyDepartmentCo-paymenton Delay in SeekingTreatmentfor Patientswith Acute Myocardial Infarction,David J. Magid, MD,UniversityofWashington 211 RandomizedControlledTrial of a Rapid DiagnosticProtocol for ChestPainPatients: CostandPatientSatisfaction Outcomes.

Rebecca R. Roberts,MD , Universityof lllinois at Chicago 212 Decisionof Analytic Cost-Effectiveness Analysis for the Managementof Acute Lower RespiratoryTract Infections, GregoryL. Larkin, MD, Universityof Pittsburgh 213 Comprehensive Metrics Methodologyfor ReducingCosts and Utilization of Resourcesin an AcademicEmergency Department,I. DouglasWhite,MD, MPH, Medical College oJVirginialEmergencyPhysicicans'Medical Group 214 Rationingof ICU Care Basedon EmergencyDepartment Predictionof FutileOutcome,N. EwenWang,MD,StanJord University 215 Removal of a ComputerizedGuideline-Charting System from the ErnergencyDepartment:Effect on the Quality of Care of Health Care Workers Exposedto Body Fluids, David L. Schriser,MD, MPH, UCLA 216 EfTectof StudentsandResidentson ResourceUtilizationin an EmergencyDepartment:Cost of Education,EdwardA. Panacek,MD, UniversityoJ California, Davis 217 Evaluationof Two Strategiesfor Complying with State MandatedLead Screeningin the EmergencyDepartment, ScottOrava,MD, StateUniversityof NewYork,StonyBroolc

ScientificPapers:Respiratory(4:00-6:00pm) Moderator: Charles L. Emerman, MD, Case Western Reserve University 218 Lack of AgreementBetween FEVI an PEFR in Acute Asthma, Robert Silverman, MD, Long Island Jewish MedicalCenter 219 MagnesiumSulfateas an Adjunct to StandardTherapyin Acute SevereAsthma,RobertSilverman,MD, Long Island .IewishMedicalCenter 220 NebulizedGlucagonin the Treatmentof AsthmaticBronchospasm, ScottW.Melanson,MD, St.Luke'sHospital 221 NebulizedIpratropiumas an Adjunct to Albuterol and Prednisonein the Management of theAcuteAsthmatic,David J. Robinson,MD, Universityof Maryland 222 ComparisonBetweenEmergencyDiagnosticandTreatment Unit and Inpatient Care in the Treatment of Asthma, Michael McDermott,MD, Universityof Illinois at Chicago 223 Estrogen-Withdrawal Alters Responseof Asthmatic Rabbit BronchialSmoothMuscle to Calcium,But Not Histamine, Emil M. SkobeloJf,MD, Medical College of Pennsylvania attd Hahneman n Uni versity 224 PulmonaryNeutrophilInfiltration is DecreasedDuring Partial Liquid Ventilation in a Model of Hemonhagic Shock, John G. Younger,MD, Universityof Michigan 225 Use of the Alveolar Dead SpaceFraction and PlasmaDDimer Concentrations to DiagnoseAcute.PulmonaryEmbolism in Ambulatory Patients, Iffiey A. Kline, MD, CarolinasMedical Center

Monday, May 6

DIDACTIC SESSIONS Teaching Pediatric Emergency Medicine to Emergency Medicine Residents: Different Ways to Skin a Cat (8:00-9:30 am) Moderator: Emily Pollack, MD, Maricopa Medical Center Robert Jorden, MD, Maricopa Medical Center Carey Chisholm, MD, Methodist Hospital of Indiana Susan Fuchs, MD , Children' s Hospital, Pittsburgh Pediatric patients comprise a significant portion of ED visits.

Emergency Medicine residents learn about the management of pediairic urgencies and emergencies in a variety of clinical setiings. There is controversy over which of these settings.affords the besl training opportunities. This panel discussion will feature a speaker from each of the three major teaching settings for pediatric^ emergency medicine: a general academic ED that sees patients-of all ages in the same department; an academic ED that divides patients into separateEDs within the same facility based on age; ind a children s hospital ED. Advantages and disadvantagesof each setting will be discussedand debated.

EMRA/SAEM LeadershiPForum

(8:00-12:00 noon) 1) ChiefResidents'Forum

Rita Cydulka, MD, Metrohealth Medical Center David Fosnocht,MD, Unitersity of Pittsburgh Robin Hemphill, MD, Joint Military Medical Centers This forum, an annual presentation organized by EMRA' is an effort to help future chief residents deal with commonly encountered problems and concerns.Each panelist will addressan aspect of leadership in emergency medicine, and a question and answer period will ensue.A11residents, especially future chief residents, are encouraged to attend. Weatherby Health Care will sponsor a refreshmentbreak betweenthesetwo sessions'

2) ZlYears of Academic Emergency Medicine in Perspective

MorJeiator:John Marx, MD, CarolinasMedit'al Center MedicalCenter RobertKnopp,MD, St.Paul-Ramsey Lewis Goldt'rank,MD, New York University PeterRosen,MD, UniversityoJCalifornia,SanDiego and HahnaDavidWacner,MD, MedicalCollegeof'Pennsylvania mannUniversity medicine' Historicalreflectionson theoriginsof academicemergency of the an assessment commentaryon what we have accomplished, currentnationalstatusof academicemergencymedicineandrecommendationsfor future directionsfor academicprograms.To be disacademicleadersin the specialty' experienced cussedby recognized,

The Enigma of Pediatric Out-of-Hospital Cardiac Arrest: Are Current Resuscitation Methods Really Worthwhile? (10:00-11:00am)

.IoanE. Shook,MD-,TexasChildren's Hospital EmergencyCenter Linda Quan,MD, Children'sHospitaland MedicalCenter,Seattle cohort study (n=210)has confirmed A recentpopulation-based that,despiieaggressiveuseof advancedresuscitativeefforts(within an EMS systemwith excellentadult survivalrates),outcomes remain bleak for those children found pulselessand apneic by EMS personnel.Using this recentstudyand reviewof the literafor resusciour presenttechniques ture.the facultywill challenge tating children and call to questionvery interestingconsiderations regaiding the etiology, epidemiology,demographyand management of pediatric out-of-hospitalcardiac arrest.Specifically,^can subgroupsof patientsbe identified for whom resuscitationefforts stroutOUe teminated on-sceneor even waived altogether?Can studieswith suchsmall populations,statisticallyspeaking,be used "zero chanceof survival."When is a zero numerator to determine really zero? Should we changeour current regimensfor out-ofhospitalpediatricresuscitationor simply concentrateon etiologic and preventionissues?In this session,the speakerswill comprehensivelypresentand then itemize future researchchallenges.

A Pre-Publication Analysis of the NHLBI-NAEPP Asthma Management Guidelines from an Emergency Medicine Perspective(L1:ffi-12:00 noon)

Moderitor: RichardM. Nowak,MD, MBA, Henry Ford Hospital Emit Skobetoff,MD, Medical College of Pennsylvaniaand HahnemannUniversitY CharlesEmermctn,MD, CaseWesternReserve CharlesCairns,MD , Universityof Colorado RobertSilverman,MD, Long IslandJewishMedicalCenter Michael McDermott,MD, Cook CountyHospital JaniceZimmerman,MD, BaYlor The National lnstitutesof Health's Expert Panelon AsthmaManagementis currentlyin the processof updatingits previously^publiihed asthmamanagementguidelines.Draft documentsof this report will be analyzedwith an opportunity for input from the Selectedmemberswill critically discussthe emerm-embership. gency care aspectsof the guidelinesand provide scientificinforThoseattendmationas to why thereshouldbe changessuggested. ing this meeting will also review these draft guidelinesand can uo'i". ony scientificconcerns.Dr. Nowak will takebackto theNIH This sessionshouldprovideinteres! theresultsof the deliberations. ing dialogue concerning asthma managementemergencycare guldelineJwithan opportunityto affectnationalrecommendations'

EMRA/SAEM William H. Spivey,MD' Resident Forum (12:00-1:30 Research Pm)

RobertA. Lowe,MD, MPH, Universityof Pennsylvania arepowerfultoolsfor clinicalresearch' Epidemiologictechniques Wnite traOitionallyassociatedwith public health issues,these methodsare equally suitedfor addressingclinical investigations The purposeof this sessionis to give andhealthpoliiy questions. residentsand young faculty investigatorsan introduction to the medof itinicat epidemiologyas appliedto emergency techniques andpitThe speakerwill illustratethe advantages icine research. falls of thesemethodswith examplesfrom the literatureaswell as from his own research.

Luncheon: Controversiesin the Acute Managementof Asthma (L2:00-1:10p*)

MD, MedicalCollegeof Pennsylvania Moderalor:Emil M. SkobeloJJ, RichardMartin, MD, National.IewishCenter SallyWcnzel,MD, NationalJewishCenter RichardM. Nowak,MD, Henry FordHospital MichaelMcDermott,MD, CookCountyHospital Noted researchersfrom the National Jewish Center for Immunphysiology and RespiratoryMedicinein Denverand emergency ciani will discusstheir views on current interventionsand future directionsin the careand dispositionof patientspresentingto the EmergencyDepartmentwith an acute exacerbationof asthma' Diveriity of opinion and a disinclinationto agreementwill be encouragedon the part of panelistsand attendeesalike. Active audienceparticipationwill be encouraged'

Fundamentals of Research:How to do a Chart Review (1:30-2:30pm)

Mb, MPH, Universityof Colorado StevenR. Lowenstein, Chart reviews are often used to conduct researchin emergency medicine. However,the reliability of data abstractedby chartis seldomexaminedcritically. This sessionwill focuson theresearch use of medicalrecord and traumaregistry data.Pitfalls andproblems, such as missing charts,missing or conflicting data,poorly will trained abstractors,Uiinding,bias, and inter-rateragreement "Numerator nonsense"'a flaw found in many be discussed. researchstudiesbasedon traumaregistries,will alsobe discussed' Publishedarticlesfrom the emergencymedicineliteraturewill be usedto illustrate methodologicerrors.This sessionwill thenpresent eight critical strategiesthat can improve the validity and reproducibilityof medicalrecordreviews.

Monday, May 6

WorkforceIssuesAffecting EmergencyMedicine - Are There Too Many of Us or Too Few? (1:30-2:30 pm) Moderator: C.Iames Holliman, MD, MS Hershey Medical Center RichardWuerz, MD, MS Hershey Medical Center William Dalsey, MD, Albert Einstein, Philadelphia Louis Ling, MD, Hennepin County Medical Center Sandra Schneider,MD, University of Rochester This session will present data accumulated by the SAEM Workforce Task Force regarding workforce issues; present computer model projections of the need for EM physicians in the future under different workforce conditions; discuss the recent Pew Commission and Institute of Medicine Reporls as these relate to emergency medicine; and answer questions from the membership about workforcedata and issues.

Fundamentalsof Research:Data, Data Everywhere . . . Data Collection Forms and Data Management (2:30-3:30pm) SusanS. Fish, PharmD, MPH, Boston University The art of data collection form development is central to any researchproject. It sounds easy,but it's not. Examples of winners and losers,many from the speaker'sown er-periences,will be used to illustrate how to avoid headaches from data collection. Once the form is developed, then what? How to manage the data is dependent on the type of data as well as the funding available.Data management for an unfunded, or poorly funded, project will be stressed.Examples from emergency medicine projects will be used to show how to keep control of the immense amount of data that has been collected.

ResearchDevelopment During a Major Disaster: The Oklahoma Bxperience (2:30-3:30pm) MD, UniJbrmedServices,Universityof the Health KevinYeskey, Bethesda Sciences, David Hogan,MD, Universityof' Oklahctma RichardAghababian,MD, Universityof Maryland M. AndrewLevitt,DO, Universityof Califbrnia,SanFrancisco Thefocusofthis sessionwill be how to fund andconductresearch duringa major disaster.Specifically,it will be discussedhow to obtain manpowerand funding from the federal government,the of publichealth.Additionally,thevarmilitary,andthedepartment ious difficLrltiesand methodologiesthat occur in setting up a researchbaseduring a disasterwill be reviewed.It will be discussedhow to set up and implementan injury registryto collect datain an ongoingbasisduringboth the acutephaseandthe days followingthe disaster.

Fundamentalsof Research:Scientific Misconduct and Fraud (3:30-4:30pm) Michelle Biros, MS, MD, Hennepin County Medical Center Over the last several years the issue of scientific misconduct has come to public view by increased media attention to allegations of data fabrication, falsification, and plagiarism. The definition of

scientific misconductis extremelybroad and open to intelpretation. As the researchbase of emergencymedicine grows, the potentialfor intentionalor unintentionalscientificmisconductand fraud increases.It is the responsibilityof the emergencymedicine researchcommunityto police itself and preventabuseand misuse of research.This discussionwill attemptto classifythe major categories of misconduct and illustrate the impact of fraudulent researchon the scientific literature.Suggestionsregardingidentification and subsequentactionsaimed at reversingconsequences of misconductandfraudwill be discussed.

The Current and Future Impact of Managed Care on AcademicEmergencyMedicine(3:305:00pm)

Moderator: E. John Gallagher,MD, Bronx Municipal Hospital John C. Moorhead,MD, OregonHealth SciencesUniversity David P. Sklar,MD, Universityof New Mexico Gary P.Young,MD, HighlandGeneralHospital LeslieS. Zun,MD, Mt. Sinai,Chicago Someof the many questionsto be discussedby the panel and the participants attendingthis sessionincludethe following:How will care for the indigent be provided, particularly those who cannot qualify for Medicaid?Academicmedical centershavetraditionalcarefor as long as they havebeenin ly provideduncompensated existence;how will ED's that arepart of academicmedicalcenters covenantwith societyif surviveand maintaintheir long-standing they are not reimbursedfor this in some fashion?If the focus of managedcare is directedaway from teachingand research- in large measurebecausetheseentitiesrepresentlong-term investmentsratherthan short-termprofits - how will the next generation of physiciansbe trainedand how will medicalknowledge advance?What will be the likely programmaticand educational impact on EM residencyprograms,particularlyif ED census declinesand patient mix becomesincreasinglyhomogeneous?

Will therebe a place for EM faculty who wish to developcareers in clinical investigationif they are unableto supportthemselves throughincreasinglycompetitivegrant acquisitionor via patient if they How will EM facultyadvanceacademically carerevenues? arerequiredto coverlargenumbersof clinicalshifts,thusmaking What sortsof 'valueresearch andwriting evenmoreproblematic? e.g.,chestpain ED's consider, should academic added'strategies observationunits, short-stayunits, augmentedfast-track,critical pathways?Are there other strategiesthat academicEM might 'managedcarestory'? developto weatherthe

Fundamentalsof Research:Writing the Abstract and the Art of the ScientificPresentation(4:305:30pm) .Iantes J. Menegazzi, PhD, University of Pinsburgh The researchis done and now the word needs to get out to clinicians.

This session will cover the presentation of research findings as an abstract, a poster, and a platform presentation. The eight essential components ofa successful abstract will be presentedalong with ten simple rules for writing a good abstract. Examples of well written, and not-so-well written, abstractswill be used to illustrate the howto. The art of oral or graphic presentationsis complex, but there are some easy rules to help the young investigator with these professional presentations.Helpful hints will be provided.

Monday, MaY 6

ASSOCIATIONOF ACADEMIC CHAIRS OF EMERGENCY MEDICINE (517)485-0801 g01N. Washington Avenue,Lansing,Michigan 48906-5137(517)485-5484 FAX

AACEM Annual Meeting MaY 6,1996 MondaYo DenverRoom Adam's Mark Hotel Denver,Colorado 8:00- 8:30am

Continental Breakfast

8:30- 9:L5

o,Managing Change - Chair to Dean During Hgalth ftf:-tlii paul Roth, MD, Dean, iii:,rrrrtty of NewMeico Schoolof Medicine andformer Chair, Departmentof EmergencYMedicine

9:L5- L0:00

"Academic Chairs: Who Are We?" schneider,MD Resultsof a nationalsurveyand discussionled by sandra

10:00- 10:30

Break

L0:30- 1L:L5

'oClinical Activity in an Academic Emergency Department" MD Discussionled by SteveStapczynski,

- L2:00pm 1,1:L5

"Endowed Chairs: What Are They and How Do I Get One?" Paneldiscussionwith commentsfrom membership Moderator: Bill Robinson,MD MD, Brian Gibler, MD Experts:Brooksnorlt ,-ttn, Jack Allison, MD, Earl schwartz,

12:00- 1:30

Annual Business Meeting and Lunch, Gol'd'Room 1. President'sReport,Bill Robinson,MD 2. Treasurer'sReport,SandraSchneider,MD 3. Election of Offrcers fot 1996-97, John Prescott' MD 4. New Business 5. Updates: a. ABEM, Doug Rund,MD Medical CentersTask Force' b. Developmen,oi n-"tg"ncy Medicine at Academic John Gallagher,MD physicians,NicholasBenson,MD c. HCFA ruletl_zlzRegarding Teaching

7:00pm

Annual Banquet

Monday, May 6

[6n1;couN'#,9,il"1%,"S,1*T: Monday, May 6r 1996 Majestic Ballroom Adam's Mark Hotel Denver. Colorado

AGENDA Note: Lunch will not be provided 12:30 - 1:30 pm

Call to Order and BusinessMeeting [. Introductionof New Programs,CareyChisholm,MD 2. President'sAddress,CareyChisholm,MD 3. Secretary/Treasurer's Report,SamKeim, MD 4. ABEM Report

i. ffii,;#"ffit"""T. memberatrarge 7. Presentationof the CORD Awards: ResidentAcademicAchievementAward: TheodoreC. Chan,MD, andGary M.Vilke, MD, Universityof California, SanDiego Faculty TeachingAward: Charles V. Pollack, MD, Maricopa Medical Center 1:30-2:30

ooPanel Discussionon Faculty Development" Richard Braen, MD, John McCabe,MD, Corey Slovis,MD, and DavidWagner,MD

2230-2:45

Break

2:45-3:45

"Principles of Resident Evaluation" StephenAbrahamson,PhD, D.Sc.,ProfessorEmeritusof Medical Education,University of SouthernCalfornia

3:45-4:45

"Medicare Reimbursement for Faculty Supervision" TerrenceKay, Director, Division of PhysicianServices,Health Care Finance Administration

4:45-5:00

Break

5:00-6:00

Round Table Discussions 1. Evaluationof EmergencyMedicine Residents 2. RRC-EM AccreditationIssues 3. ProceduralCompetencyTask Force

Tlresday,May 7

PAPER/POSTER PRESENTATIONS Scientific Papers: Geriatric (8:00-9:30 am) Moderator: Arthur B. Sanders,MD, University of Arizona 226 Clinical andTestParameters in GeriatricPatientswith Acute Cholecystitis,L. JosephParker,Mayo Clinic 227 Effectivenessof an OrganizedFollow-up Systemfor Elderly Patients Discharged From the Emergency Department, MichaelS.Young,MD ButterworthHospital 228 Validation of a Brief ScreeningInstrumentto Detect Depression in Elderly Emergency Department Patients, StephenW.Meldon, MD, MetroHealthMedical Center 229 Identification of FactorsWhich May Predict AdverseOutcomesin Elderly Patients:PrevalenceStudyofPatient Functional and Cognitive Impairment and Care Giver Burden, Norm Kalbfleisch,MD, OregonHealth SciencesUniversity 230 Geriatric Emergency Department Nutritional Screening: Feasibility,Yield, and NeedsAssessment,.Iustin L. Kaplan, MD, Albert EinsteinMedicalCenter 231 Immunologic Responseto TetanusToxoid in the Elderly, KumarAlagappan,MD, Long Island JewishMedical Center

245 Nitrous Oxide for the Treatmentof Migraine Headache, WayneR. Triner,DO, Albany Medical Center

ScientificPapers:Computer (L0:00-11 Methodology/Modelling :00 am) Moderator: David Schriger, MD, MPH, University of Caffirnia, Los Angeles 246 Dynamic DecisionNetwork for Modeling Time-CriticalDecisions,GeffieyW. Rutledge,MD, PhD, BethIsraelHospital, Boston 241 FactorAnalysis of the StandardElectrocardiogram,David M. Schreck,MD, MS, MuhlenbergRegionalMedical Center 248 GeneticAlgorithm Identifies PredictorVariablesUsedby a HeadInjury Artificial NeuralNetwork,Pierre Borczuk,MD, MassachusettsGeneralH ospital 249 Model to DiscriminateBacterialvs Viral Meningitis,Joseph Garber,MD, Long Island JewishMedical Center

(3:00-5:30pm) PosterSession

Scientific Papers: Administration (8:00-9:30 am)

Clinical Practice

Moderator: David C. Seaberg,MD, University of Florida 232 Effect of an AsthmaPracticeGuidelineon Documentation and PatientOutcomein an Urban EmergencyDepartment, Kent Hall, MD, Universityof Cincinnati 233 Asthma Clinical Pathway: Reduction in ED Treatment Times,SarahA. Stahmer,MD, Universityof Pennsylvania 234 Surveyof Clinical and Non-ClinicalTime Requirements of EmergencyDepartment Attendingsin an AcademicSetting, Marc R. Salzberg,MD, BaystateMedical Center 235 PredictiveValidityof theEmergencyPhysicianJobSatisfac(GJS)Instruments, tion (EPJS)and GlobalJob Satisfaction StephenLloyd, MD, MSc, McMaster University 236 TenureTrack in EmergencyMedicine,SethW.Wright,MD, VanderbiltUniversity 237 Assessingthe ScientificContributionof Two Decadesof EmergencyMedicineLiterature:An Alternativeto the Science Citation Index Impact Factor, Douglas P. Barnaby, Albert Einstein Collegeof Medicine

Moderator: Jeffrey W. Runge, MD, Carolinas Medical Center (3:30-4:30pm) 250 ViolenceandThreatsof MolenceAgainst PracticingEmergencyPhysicians,JosephC. Munafo, MD, Medical College of Pennsylvaniaand HahnemanUniversity 251 Confirmationof thePulseOximetryGapin CarbonMonoxide Poisoning,WilliamP.Bozeman,MD, Universityof Maryland 252 SystemicInflammatoryResponse Syndrome(SIRS)at Triage:Prevalence andAssociationwith HospitalAdmissions, Alan P.Tuttle,MD, HenryFordHospital 253 Prevalenceof Lactic Acidosis on EmergencyDepartment Presentationand Associationwith HospitalizationRates, Mary Grzybowski,PhD. Henry Ford Hospital 254 PhysicianOrderingof CoagulationStudiesin the Emergency Center- Impact of lnstituting a LaboratoryRequestForm, Continuationand Follow-Through,Gail S. Rudnitsky,MD, Medical Collegeof Pennsylvania and HahnemannUniversity 255 Who ShouldMake the ThrombolysisDecisionin a Teaching Hospital?,RonM.Walls,MD, BrighamandWomen's Hospital 256 Large Diameter Suction Tubing Significantly Improves SimulatedVomitusEvacuationTimes,JamesT. Vandenberg, MD, Madigan Army Medical Center 257 Clinical FeaturesPredictive of Coagulopathyin Chronic Alcoholics.Azita A. Toussi.MD. CarolinasMedical Center 258 In Vitro Assessmentof the BoundaryLubricatingAbility of Healon as a Synovial Fluid Replacementfor Outpatient Managementof Osteoarthritis,Gregory D. Iay, MD, PhD, RhodeIsland Hospital 259 Characteristicsof Depressionin the Elderly, StephenW. Meldon. MD. MetroHealthMedical Center 260 Prevalenceof Low Thiamine Levels in Elderly Nursing Home PatientsAdmitted Through the EmergencyDepartment,Dayid C. Lee, MD, Medical Collegeof Pennsylvania and HahnemannUniversiry 261 SerologicPrevalanceof Anti-DiphtheriaAntibodies(ADA) in the Elderly, Kumar Alagappan,MD, Long Island Jewish Medical Center

ScientificPapers:Ethics(10:00-11:00 am) Moderator: James G. Adams, MD, Harvard 238 ReadabilityAnalysisof InformedConsentsUsedto Enroll Patientsin EmergencyMedicine Research,Timothy J. Mader,MD, BaystateMedical Center 239 How Informed is Informed Consent?,Tom Perera, MD, Albert EinsteinCollegeof Medicine 240 Should PostmortemProceduresBe Practicedon Recently DeceasedPatients?,Kristen M. Ward. MD. Methodist Hospital of Indiana 241 Distinct Criteria for the Terminationof ResuscitationEfforts for CardiopulmonaryArrest in Children,Paul E. Pepe, MD, MPH, Baylor Collegeof Medicine

Scientific Papers: Pain Management (10:00-11:00 am) Moderator: Seth Wright, MD, Vanderbilt University 242 Pain Documentationand EmergencyDepartmentAnalgesic Practice, Megan Leapley, MS V, University of Missouri, KansasCity 243 VisualAnalog Pain Scale: Lack of Reactivityin the Acute Setting,Diane Rimple,MD, Emory University 244 Effect of Age and Genderon PhysicianEstimatesof Pain Severity in Patients With Extremity Trauma, Nicholas VanDeelen, MD, ButterworthH ospital

Clinical Practice Moderator: Charles V Pollack, Jr., MD, Maricopa Medical Center (4:30-5:30pm) 262 Reliability of Dipstick Urinalysis in Adult PatientsWith SuspectedInfection or Hematuria, William W. Jou, MD, Universityof Connecticut

Thesday, May 7 263 Blood Cultures in OutpatientPyelonephritis:Necessityor Habit, Richard B. Schwartz,MD, Madisan Army Medical Center 264 Efficacyof a Clinical Pathwayfor SuspectedRenalColic in ReducingIntravenousPyelogram Utilization, Dayid F.M. Brown,MD, Massachusetts GeneralHospital 265 How Useful are History and PhysicalExam in Identifying Ectopic Pregnancyin Patients with First Trimester Pain and/orBleeding?,Robert Dart, MD, BostonCity Hospital 266 OrthostaticVital Signs:Determiningthe Durarion of Initial Supine Positioning, Richard A. Harrigan, MD, Temple University 261 Triage ClassificationCorrelatesWith Final Disposition of ED Patients,AndrewT. McAJ'ee, MD, Brigham andWomen's Hospital 268 HeparinAnticoagulationin PatientsWho Are HemoccultPositive,Ilya Chern,MD, Long IslandJewishMedical Center 269 Correlation of Blood PressureWith Peripheral Pulses, RichardA. Crayen,MD, EasternVirginiaMedicalSchool 270 Comparison of SystolicBlood Pressures Measuredby Pulse Oximetry,Manual and DinamapMethods in Children Less ThanTwo YearsOld, ThomasJ. Abramo,MD, UniversityoJ' TexasSouthwesterrt 27| Blood Pressure: Assessment of Intera"rmDifferences,JuddE. Hollander,MD, StateUniversityof NewYork,StonyBrook 212 Circadian Pattern Found in Pulmonary Edema, Melissa Weintraub,MD, The Brooklyn Hosoital Center

Administration Moderator: Edward Bernstein,MD, Boston City Hospital (3:304:30pm) 273 Academic EmergencyDepartmentsin the Year 2000: Are They Preparedor Willing to Change?,Harold K. Simon, MD, EglestonChildren'sHospital 274 CanadianAssociationof EmergencyPhysicians(CAEP) ManpowerSurvey:Part I - EmergencyDepartmentChiefs, StephenR. Lloyd, MD, MSc, McMaster University 275 Increasing Compliance With RRC Requirementsfor Follow-up of EmergencyDepartmentPatients:Results of the 1996National EmergencyMedicine ResidencyTraining ProgramsFollow-up Survey,Harold Osborn,MD, Lincoln Medical and Mental Health Center 276 ResidencyTraining Site is Important in EM Resident Choiceof PracticeLocation,Mark T. Steele,MD , University of Missouri - KansasCity 277 ResidentPhysicianStaffing Levels Do Not Alter Attending PhysicianProductivity at Five Large AcademicEmergency Departments, JamesC. McClay, MS, MD, St.JosephMercy Hospital 2'78 What is the Support for Clinical Researchin Emergency Medicine?,Linda L. Spillane,MD, Universityof Rochester 279 Writing a ScientificAbstract: Survey of Authors, David C. Cone,MD, Medical College of Pennsylvaniaand Hahnemann University

Administration

Moderator:J. StephanStapczynski, MD, (Jniversityof Kentucky (4:30-5:30 pm) 280 Effectof PhysicianAttireon PatientSatisfaction,AnthonyL. Fisher,MD, BaystateMedical Center 281 DoesWearingA Neck Tie Influence PatientPerceptionsof EmergencyDepartment Care?,David Pronchik, MD, St. Luke'sHospital 282 ReducingLength of Stay Decreasesthe Number of Emergency DepartmentPatientswho Leave Without Seeing a Physician,ChristopherM.B. Fernandes,MD, St. Paul's Hospital,Vancouver

283 Analysis of PatientCareComplaintsin the EmergencyDepartmentBasedon Level of Acuity, Length of Stay,and InsuranceType, Robert O'Connor, MD, Medical Center of Delaware 284 Proceduresfor Completion of IncompleteAbortion in the EmergencyDepartment:Under Whose Control?,SusanS. Fish, PharmD, MPH, BostonCity Hospital 285 Variability in Blood HemolysisRateswith Different Blood Drawing Techniques,Luis Alvernez,MS, MPH, BostonCity Hospital 286 UndiagnosedMyocardial Infarction: Liability Before and After Thrombolytic Therapy, Virginia Burke, ID, Wayne StateUniversity

Ethics Moderator: Norm D. Kalbfleisch, MD, Oregon Health Sciences University(3:30-4:30pm) 287 Ethical Issuesof CardiopulmonaryResuscitation:A Survey Of EmergencyPhysicians,CatherineA. Marco, MD, lohns Hopkins 288 OregonEmergencyPhysicians'Experiences,Attitudes and ConcernsAbout Physician Assisted Suicide, Terri A. Schmidt,MD, OregonHealth SciencesUniversiry 289 Measuringthe Community StandardRegardingWaiver of Informed Consent in EmergencyResearchTrial, John P. Anicetti, MD Harbor-UCLA 290 AcademicHonesty:The EthicalReferencePointof Trainees, Robert M. McNamara, MD, Medical College of Pennsylyania and HahnemannUniversity 291 Impact of PatientAcuity on PatientPreferencefor Medical Decision Making Autonomy and Information, Mark A. Davis, MD, MS, Beth Israel Hosoital

Pain Moderator: Knox H. Tbdd,MD, Emory University (4:30-5:30pm) 292 Use of TranscutaneousElectrical Nerve Stimulation to Decreasethe PainAssociatedwith Subcutaneous Injections, Michael Harrigan, MD, CarolinasMedical Center 293 IntravenousKetorolacvs. MeperidineWith Promethazinein the Treatmentof RenalColic in the EmergencyDepartment, William S. Korey,MD, Orlando RegionalMedical Center 294 Prospective,RandomizedStudy Evaluatingthe Efficacy of SublingualHyoscyamineSulfateand IntravenousKetorolac Tromethaminein the Relief of RenalColic, JamesB. Iones, MD, PharmD, GeisingerMedical Center 295 Effect of Temperatureand pH Adjustment of Bupivacaine For IntradermalAnalgesia, Christina Plzak, MD, Butterworth Hospital 296 PainReductionin Local AnestheticAdministrationThroush Buffering andWarming,KennethB. Colaric, MD. Michigin StateUniversitylKalamazooCenterfor Medical Studies 297 Prilocaine-Phenylephrineand Bupivacaine-Phenylephrine Topical AnestheticsComparedto TAC During Repair of Lacerations,ThomasW,Barrett, Ohio StateUniversity 298 Benzyl Alcohol With Epinephrineas an Alternative Local Anesthetic,StevenMartin, MD, Mt. Sinai Medical Center 299 PhysiciansAttitudesTowards NarcoticAnalgesic UseinAcute AbdominalPun, JacquesS.Lee,MD, Universityof Ottawa 300 Do QuantitativeChangesin Pain Intensity Correlatewith Pain Relief and Satisfaction?,Sarah A. Stahmer,MD, Hospital of the Universityof Pennsylvania 301 Evaluationof Dermal Injury Thresholdand Subcutaneous Temperature Change Associated with Iontophoretic Delivery of Lidocaine with Epinephrine,Clark S. Homan, MD, StateUniversityof New York,StonyBrook

Ttresday,N{4ay7 C_omputer Methodology Moderator: Robert J. Schiartz, MD, MpH, University of Pittsburgh (3: 30-4:30 pm) 302 Chaotic Dynamics Model of patient Volume Flow In A Major Urban EmergencyDepartment,Raywin R. Huang, PhD, WayneState University 303 Non-linear Time-varying Chaotic Attractor Underlying IschemicCardiacArrhythmias,Kyongfoo, phD, Universi[, of Colorado 304 Linking Multiple Large Databasesto Determine patient Outcomes,Sohail A. Waien,MD, SunnybrookHealth Sci_ enceCentre

Health Care Delivery Moderutor: Sandra M. Schneider, MD, University of Rochester (4:30-5:30pm) 305 Medicaid HMO Participants'Compliancewith ,GatekeeprJrg' Guidelines for Emergency Department Utilization, Daniel S. Crough,State(Jniyersityof New york, Syracuse 306 lgrvey of PatientsDenied EmergencyDepartmentCareBy Their ManagedCareplan, TheodoreChai, ptO. Universiiv of Califurnia, SanDiego 307 G^ate [eeping: A Limited Impact on Non-UrgentUrilization of the PediatricEmergencyDepartmentDuring OfficeHours, RichardT. Strait,MD, Children'sHospital of Wisconsin

308 Does Accessto Primary Care Offices DecreaseED Use?, RobertA. Lowe,MD, MPH, Universityof pennsylvania

309 Do EmergencyMedicine PhysiciansAgree with primary

Care Physicianson Who is Appropriati for Care in the !ryergency Department?,Marc J. Shapiro, MD, Rhode Island Hospital 3 1 0 Are Thereliases in Triaging ED patientsas Urgentvs Non_ urgent?A National Multicenter Study Comparing3143tJrgent Patientswirh3044 Nonurgentpatients,Gary p.young, MD, Highland GeneralHospital 3 1 r Ambulatory Visits to 56 Hospital EDs Nationwide: Are There Difference Between Nonurgent patients Who Are HospitalizedVersusThoseWho Are Denied Care?.Gam p.

Young,MD, Highland GeneralHospital 312 S,uccess-of a TriageOut Programin a Largepublic Teaching flgspitgl, Kevin S. Merigian, MD, University of Tennessee, Memphis 313 lmgrgency Department:Who is Really Nonurgent?,Robert W.Derlet, MD, Universityof Catifornia,Davii 314 Demand Managementand Its Effect on EmergencvCare.

Eric D. Salk,MD. UCLA Jl) EmergencyDeparffnentManagedCare Denials: Do patients PayTheir Bills?, ClaudiaM . Beck,MD, Universitvof louisville 316 WITHDRAWN

Tlresday llN{.I.ay 7

DIDACTIC SESSIONS

I I'

DomesticViolence:Researchand Public Policy (8:00-9:30 am)

Luncheon:Frontiers in Medical Toxicology pm) Research(12:00-1:30

Moderator: Jean Abbott, MD, University of Colorado Capt. Miriam Reed, Denver City Police Department, Domestic Violence Task Force SteveLowenstein, MD, MPH, University of Colorado Lenora M. Olson, Director, Center for Injury Prevention Research and Education, University of New Mexico This sessionwill review the statusof researchin domestic violence in 1996, as well as the unansweredquestions regarding diagnosis and intervention. We will start with a critical appraisal of the literature, a review of the epidemology of domestic violence in emergency medicine, and follow with a debate among the panelists about the utility and effectiveness ofthe legal approach to domestic violence - i.e. treating domestic violence as a crime and utilizing law enforcement officials to provide intervention.

Moderator: Richard C. Dart. MD, PhD, Universitvof Colorado Judd Hollander,M D, SrateL/niversityof New Yori, itony Brook Martin Smilkstein,MD, OregonHealth SciencesUniversity During this session,recentresea.rch advancesin areasof acutetoxicologywill be explored.The topicsto be coveredinclude:l) cocaine in the emergencydepartment;2) acetaminophen overdose;and 3) the therapeuticuse of antibodies.Recentresearchindicatesthat a reassessment of cocaine induced heart diseasein needed.Dr. Hollanderwill revealthe mostrecentissuesproducedfrom his multicenter studies on cocaine-inducedmyocardialischemia.Dr. Smilksteinwill addressrecentresearchquestionsregardingthediagnosisand treatmentissuesof acetaminophen toxicity relatedto the recentintroductionof new longer-actingacetaminophen products.

Finally, Dr. Dart will presentthe latestfindings from clinical trials on a new generationofpolyclonal antibodyproductsfor diseases as diverseasrattlesnakebitesand tricyclic antidepressant poisoning.

Fundamentalsof Teaching: Teaching'sToughest Part: Determining Goals, Objectives, and Methods (8:00-9:30am)

Luncheon: Paramedics and Advanced Life Support Services:Do We Really Need Them?

(12:00-1:30 pm)

Kurt C. Kleinschmidt,MD, Universityof Texas,Southwestern Wehaveall beenon the "receivingend" of suboptimaleducational experiences.

Theseoften resultfrom poor planningand development.Whetheran item to be taughthas a small or extensive focus,the sameprinciplesguidecuriculum development and the teachingmethodsused.This presentation focuseson thebasicconceptsof curiculum developmentand how to establishgoalsand objectives.The different teachingmethods,and the typesof material for which eachis bestused,will alsobe discussed.

The material can bestbe usedby residentsand faculty.

Fundamentals of Teaching: The Hands-On Instruction of Procedural Skills (10:00-11:00am) MichaelP.Wainscott, MD, Universityof Texas,Southwestern Teachinga proceduralskill is a challengerequiringan unique approach.While the actual practice of teachinga procedurecan not be done, the presentationdescribeshow to best teachprocedures.The material differentiatesbetweenthe parts of the proceduresbesttaughtin the classroomversuswith hands-on.Topics includethe roles of the orientation,demonstration, observatlon, feedback,andthe performancechecklist.The materialcanbe used by residentsand faculty.

Luncheon: Integrating Emergency Medicine Into Undergraduate Medical Education (12:00-1:30pm) n

i

i

Moderator: Nick Jouriles,MD, CaseWesternReserveUniversity WilliamBurdick,MD, Medical Collegeof Pennsylvania Gail D'Onofrio,MD, BostonUniversity KarenRestifo,MD,Yale University JohnMahoney,MD, Universityof Pittsburgh LawrenceKass,MD, Albany Medical Center RichardKrugman,MD, Dean, Universityof Colorado This panel discussionwill review the undergraduate(medical school)teachingof emergencymedicine.It is designedfor those educators without an academicdepartment.It will describehow to incorporateemergencymedicineinto undergraduate teaching,with an emphasison how emergencymedicinefits into the teachingof all medicalschoolgraduates,especiallythe 'generalist.'Thelearner will learn about what to include, educationalstructure and administrativehurdles.The goal is to provide each leamer with ideassothathelshecan establishemersencvmedicineeducationat his/hermedicalschool.

Iac:kP. Campbell,MD, UniversityoJMissouri, KansasCity Jerry Overton,Medical Collegeof Virginia Paul E. Pepe,MD, MPH, Baylor Collegeof Medicine Edward M . Racht,MD , City of AustinlTravisCountyEMS Daniel Spaite,MD , Universityof Arizona Brian S. Zachariah,MD , Universityof TexasSouthwestern Recentpublications,in both the scientificand lay press,havebegun to questiontheproveneffrcacyof out-of-hospital advancelife support interventions.

In this eraofhealthcarereformandsovemmental budgetarybelt-tightening,suchpublicationshavenori begunto capture the attentionof governmentofficials,rangingfrom U.S. municipalities, Canadianprovincesand even national-leveldebatesin some venues(e.g.,United Kingdom).Particularlywith the adventof technology suchas automatedexternaldefibrillators,computerized12leadECG algorithmsandaltemativeairwaydevices,the actualvalue and cost-effectiveness of paramedics(EMIP) services,as well as any conesponding ALS training,andnow comingunderincreasingly seriousscrutiny.This luncheonsessionwill review the pros and consof paramedicand out-of-hospitalALS carefrom both a scientific andfiscalperspective, andthenattemptto resolvetheissueusing a mock city councilforum from a modelcommunitywhich is in the processof examiningan EMS work needsanalysis.

Fundamentals of Teaching: Providing Lip Service: Effective Lecture Techniques(3:00-4:00pm) William P. Burdick, MD, Medical College of Pennsylvaniaand HahnemannUniversity Would you like to avoid being the lecturer that nobodywants to hear?This session,intendedfor faculty andresidents,offerstips to making lectures more useful and effective for your audience.

Issuesto be addressedinclude content, organization,body language,and settingup the learningenvironment.

New Horizonsin CerebralResuscitation (3:00-4:00 pm) Moderator: Norman Paradis,MD, Columbia University RobertW.Neumar,MD,WayneStateUniversity Michelle H. Biros, MS, MD, HennepinCountyMedical Center JewellL. Osterholm,MD This stimulating showcasesessionwill provide attendeeswith a view of the future as dramaticallynew approachesto brain resuscitation are discussed.Dr. Biros will discussthe role antioxidants and free radical scavengersin cerebralresuscitation.Dr. Neumar will examinepost-resuscitation strategiesto minimize injury and interventionsto induce repair mechanismactivity. Dr. Osterholm will presentventriculo-subarachnoid perfusionwith a hypothermic oxygencarryingnutrientemulsion.

Thesday,May 7 Fundamentalsof Teaching:Praiseand Criticism: Giving FeedbackThey'll Listen To (4:00-5:00pm) Kurt C. Kleinschmidt,MD , Universityof Texas, Southwestern One of the most important educational tools that any clinical "feedback." Unfortunately, this is not an easy teacherhas is giving nor naturally acquired skill. Some trainees already know it all, have an excusefor everything, or are simply not nice to be around.

Teacherscharacteristicscan also affect the ability to give feedback' This presentationclarifies some of the barriers that prevent effective feedbackand how to overcomethem. The material can be used by residentsand faculty.

ABEM Activities: ABEM Interactions with Faculty(3:00-4:00pm)

This sessionwill provide an opportunityfor EmergencyMedicine program directors and faculty to interact with ABEM directors and

staff. A packet of referencematerial for this sessionwill be available all week at the SAEM registration desk.

Is the OutcomesMovementDead?(4:00-5:00pm)

Moderator: RonaldMaio, DO, MS, Universityof Michigan Jane Scott,PhD, Universityof Maryland In recentyears,the medical professionhas begunaggressivelypursuing outcomesresearch.The primary funding sourcefor this type of researchhas been the AHCPR. U:tfortunately, this organization experienceda 75Vobudget cut last year' Politicians and scientists have questioned whether outcomes researchis legitimate and/or worthwhile. During this session,Dr. Jane Scott will speakon the future of outcomesresearchin regardsto its scientific credibility and its funding potential.Dr. Scott waspreviously a Health ScientistAdminisffator and a Team I-eaderof the Methods and OutcomeMeasurementteam for the AHCPR. She is currently working for The CharlesMcC. Mathias, Jr. National Center for EMS Studiesbased at the University of Maryland School of Medicine. Dr. Ron Maio, a rauma careoutcomesresearcher,will moderatethe discussion.

Thesday May 7

ANNUAL BUSINESSMEETING AGENDA 1. Elections, Lewis Goldfrank, MD , President The slate of nominees and biographical information on each candidateis published on pages32-35.

2. Amendments to the Constitution and Bylaws, John Marx, MD, SecretarllTreasurer The full Constitution and Bylaws and proposed amendmentsare published on pages 24-27 of the 1995-96 Annual Report. The Constitution and Bylaws Committee proposedamendmentsare published on page 35. They are: a. changeProgram Committee chair from electedto appointedposition b. changeEducation Committee chair from electedto appointedposition c. changeResearchCommittee chair from elected to appointedposition d. changeassociatemembershipstatus 3. Awards Presentations, DonYealy, MD and Lewis Goldfrank, MD 4. Secretary/Treasurerts Report, J ohn M arx, M D, SecretarylTreasurer A review of SAEM membership and finances is published on pages 12 and 13 of the 1995-96 Annual Report.

5. President's Address, Lewis Goldfrank, MD 6. Introduction of 1996-97 President: Steve Dronen, MD 7. New Business 8. Adjournment Note:Awardrecipientsandnewly electedmembersshouldmeetat the podiumat the conclusionof theAnnualBusiness Meetingfor a brief photosession.Photoswill be publishedin upcomingissuesof the Newsletter.

Award Presentations Hal JayneAcademic ExcellenceAward CoreySlovis,MD, VanderbiltUniversity LeadershipAward JudithE. Tintinalli, MD, University of North Carolina PhysioControl EMS Fellowship OwenT. Traynor,MD Institution:University of Pittsburgh This $50,000fellowship is fundedby PhysioControl Corporation 1995Annual Meeting Awards Best Oral Clinical SciencePresentation Arthur L. Kellermann,MD, MPH, Emory University BestOral Basic SciencePresentation MichelleBiros,MS, MD, HennepinCountyMedicalCenter BestPoster Amy J. Behrman,MD, University of Pennsylvania JudyHsu, BA, University of Califomia, Loi Angeles BestInnovations in Emergency Medicine Education Exhibit JohnW. Becher,DO. Albert EinsteinMedical Center

Selectedto be Presentedat the AAMC Annual Meeting C. JamesHolliman,MD, Pennsylvania StateUniversity William P.Burdick,MD, MedicalCollegeof Pennsylvania and HahnemannUniversity Best Education Presentation William P. Burdick, MD, Medical Collegeof Pennsylvaniaand HahnemannUniversity Best Oral Resident/FellowPresentation Robeft Silbergleit,MD, Medical Collegeof Pennsylvaniaand HahnemannUniversity Best Resident/FellowPoster WayneSatz,MD, Medical Collegeof Pennsylvaniaand HahnemannUniversity Best Pediatric Emergency and Critical Care Presentation David M. Jaffe,MD, WashingtonUniversity Best Medical Student Presentation Kristina K. Ishihara,VanderbiltUniversity Best TechnologyPresentation CharlesB. Cairns,MD, University of Colorado

Tlresday, May 7

1996LEADERSHIP AWARD

Judith Ellen Tintinalli. MD A graduateof the University of Michigan Medical School, and a graduate of internal medicine residency,Dr. Tintinalli found her love and her niche in her professional career in emergencymedicine. She graduated her residency in the days when emergency medicine residencieswere just a birthing, and there r"re non" in Michigan, her home state.

Dr' Tintinalli had an all consuming love for Detroit and Michigan. She was a single parent during much of her professionalcareer, when her children were growing into and past adolescence.Di. Tintinalli *unugJd ti ^""t rr". parentalresponsibilitieseven when her professionalduties were demanding. And her passionateself only continuid into her professional career.

She was demandingof her students,her residents,and her colleagues. She expectedall of us to meet her high standards,but especially her studentsand residents. Dr. Tintinalli brought an air of"collegiality fo her residentsand students,frequently engagingin social activities with them. She expectedall of us to act as compassionatephysicians, not technical doctors. or un trr" things she accomplishedfor the specialty,I believe her desireto associatewith others who r"." equally compassionate,equally responsible, and equally passionateabout life and learning, is perhapsher most outstanding single contiibution to the field.

Dr' Tintinalli's contributions include being associatedwith, and developing, three residenciesin emergencymedicine - wayne State University, william Beaumont Hospital, and now University of Nortli carolina. She servedas a chairpersonof the Liaison ResidencyEndorsement^c^ommittee, the precursorof the RRC-EM, continuing a legacy oi Ji poricing for all of us. Dr Tintinalli was the first president of coRD. she has servedas presidentof the Americui so#a or n-Ltgin"y Medicine. She servedas the Program chairman for the uA/EM Annual Meeting. in all of her service, shebrought ttr" ,u-"?i-passion and passionand desire to succeed.

Her enduring legacy may.always_bethe Study Gu.ide,first developedby her, then nurtured by her, and then, matured by her. When we worked with her as editors of the study Guide, we knew who was'the "boss."

This besi selling textbook in emergencymedicine is published in German, Spanish,and French. It has made her internationally known, and respected.

In 1981' she was chosen Michiganian of the Year- She is the recipient of ACEp's major awards for contributions to emergency medicine and to the college, having received both the Mills Award and the weigenstein Award. Dr. Tintinalli servedall organizations the same,with passion to contribute and to make a positive contribution to the field.

As I look at the list of award winners that SAEM.has electedfor this particular award, I am overwhelmed with the distinguished group shejoins' But I cannot help but think of all her luster adds to tire shine and the prestige or tfr" Award.

Ronald L. Krome, MD

TiresdayoN[ay 7

1996HAL JAYNE ACADEMIC EXCBLLENCB AWARD

Corey Slovis, MD After an admittedly checkeredcollege career typical of the late 60's, Corey Slovis went on to medical school at the New Jersey College of Medicine. After graduation, he came south and quickly establishedhimself as one of the brightest Internal Medicine residentsat Emory University. He was on the fast track to a careerin Infectious Diseasesuntil he was eiposed to the lights and sirenson the ambulanceramp at Grady Memorial Hospital. He was hooked. Immediately upon finishing his IfrtedicinerJsidency and againstalmost everyone's advice, he signed up for an EmergencyMedicine residency ai E-o.y.

It was a marriage made in heaven. Corey found he thrived on chaosand Grady Hospital is one of those places where chaosis the rule. Immediately after finishing his secondresidency,he took the position as Direitor of the Medical EmergencyClinic (MEC) at Grady. There weren't many Emergency"Departments" in those days. As the only faculty member ln the nlpC, he established a daily morning conference and made regular "lightning" rounds at other times. It was here that he began to hone his natural teachingskills and soon had become something of a legend at Grady. To truly appreciatethe impact he hid, you should read the chapterabout Dr. Mal Goodson in the book on Becoming a Doctor by Melvin Konner.

With accessto large numbers of the sickest,most neglectedpatients in Atlanta, he had at his fingertips a veritable cornucopia of clinical experience. It provided not only grist for his teaching, but also an opportunity for cliniial rbsearch. He began to write and to develop a faculty of teachersdedicatedto EmergencyMedicine, hard to do in an environment where EmergenJyMedicine was considereda stepchild to the more powerful departmentsof Medicine and Surgery.

He beganto get his first teaching awards at Grady. He becameinvolved with EMS and further expandedhis reservoir of experience. He also got state-of-the-artlights and sirens put on his own car, as well as a regulation set of fireman's gear.

After 15 years at Grady, he decided to take on the challenge of starting up EmergencyMedicine at the University of Rochester.

Over the next few years, despite consistentand vigorous resistance,he set the stagefor the eventual achievemeniof a residency and departmentalstatus. He turned a money-hemonhaging areainto a profit center and attracteda faculty worthy of a residency.

In threeyears,he won the graduatingclass' Award for TeachingExcellenceevery year and was honored with Alpha OmegaAlpha Faculty Member Selection. In the meantime, he had become a speaker of national reputation and won th; 1990-91 ACEp OutstandingSpeakerof the Year award.

Before achievinghis goals at the University of Rochester,he longed to return to the South where he had adoptedroots. Vanderbilt University provided that opportunity. Since his arrival in Nashville in 1992,he has attainedthe academicrank of Professor,a residencyprogram has gotten off the ground, departmentalstatushas been achieved,another money-losing venture has been turned around,he has tripled the size of the faculty, and he has won two major teaching awards. All this occurr"d while he maintained his rigorous national speaking schedule.

Corey has demonstratedall of the academic attributes of scholarship,researchand service required to even be consideredfor an honor such as the Hal JayneAcademic Excellence award. His CV contains 120 articles, book chaptersand monographs. He is a memberof the Editorial Board of EmergencyMedicine Reports and is a reviewer for the Annals o7E*ergrnry Uiaicine and the AmericanJournal of EmergencyMedicine.

But if you askedhim how he'd like to be remembered,it would be as a teacher. To be a "good" teacher,you have to combine intelligenceand experience. To be a "great" teacher,you have to have enormousenergy and really care about what you do. More importantly,you have to be willing to give something of yourself to your students.Corey has given his unique blena of wisdom, honor and humor to countlessstudents,residentsand young faculty members.

KeithWrenn,MD

Tiresday, May 7

1996Slate of Nominees The NominatingCommitteeand Board of Directorsarepleasedto presentthis slateof candidates.

The following generalguidelineswereused. l. Nominationswere soughtfrom the membershipthroughadveriisements in the Newsletter.

"Call 2. All memberswho respondedto the for nbminations" in the Newsletterwere considered.

3' wheneverpossible,a slateof two or more cand-idates presentedto the membership-for eachposition.It is the committbe,sopinion that .are . the membershipshouldbe given choicesof well qualified candidateswheneverpossitle.

4' The Board of Directorsbelievesit is important to havea single ballot for eachposition underconsiderationratherthan pairing up nominees.Thus, the most qualified candidateifor each.positioncin be selectedby thi membership.

5' Each position will be openfor additionalnominationsfrom the floor at the annualbusiness meeting.

6' Biographicalinformation regardingeachnomineeis presentedto the membershipprior to the elections.

President-Elect

JohnMarx, MD

Secretary/T[easurer (one3-yearposition)

MarcusMartin, MD

Board of Directors (two 3-yearpositionsand one l-year position)

EdwardBernstein,MD William Dalsey,MD, MBA JamesHolliman,MD SandraSchneider,MD ScottSyverud,MD Brian Zink, MD Education Committee chair-elect GlennHamilton,MD (one year as chair-elect, two yearsas chair)

Program Committee chair-elect (oneyear as chair-elect, two yearsas chair)

CharlesCairns,MD Andrew Levitt, DO

Nominating Committee Member (.one2-yearposition)

E. JohnGallagher,MD Paul Pepe,MD

Constitutionand Bylaws CommitteeMember (one3-yearposition)

RobertMuelleman,MD ThomasO. Stair,MD

President-Elect John A. Marx, MD is Chair of the Departmentof EmergencyMedicine at CarolinasMedical Center and Clinical Professor in the Dep^artTent Emergency tvtediiine at the University of North Carolinas, chapel 9f Hill. He graduatedfrom StanfordMedical Schoolin 1977and completedan Emergency MedicineResidency from Denver General Hospital in 1980. Dr. Marx has served on tire SAEM Board of Directors since 1992 and this pastyearhas servedas Secretary/Treasurer.

He hasparticipatedon the publicationsCommitteesince 1992 and as a member of the Job Negotiation Monograpir Task Force. He is on the Editorial Boards of Emergency Medicine, Journal oJ'Emergnrry Medicine andEmergencyMedicine: \:,1d.emic Conceptsand Clinical Practice' He cofoundedCase Studiesin Emirgency Medicine and"Emirgindex.Dr. Marx was the recipientof the 1991Hal JayneAcademicExcellenceAward.

Secretary/TFeasurer Marcus L. Martin, MD is an Associate Professor and Interim Chair of the Department of Emergency Medicine at the Medical College of Pennsylvania,Allegheny Campus.He graduatedfrom EasternVirginia Medical Schoolin 1916and completedan Internshipfrom uSpgs Hospital,-Staten Island,New york, as well as an FmergencyMedicine Residencyin 1981from the Universityof Cincinnati.He has servedon the SAEM -Constitution Board of Directors since 1992.He was a memberof the SAEM and Bylaws Committee(19g992) andservedas chair (1991-92).He has servedas a consultantfor the ResidencyConsultation Service.Dr. Martin has been a member of the CORD Board of Directorsand is the CORD president-Elect.

He has participated as an ABEM Oral Examiner, an ACEP Councillor, ACEP GME, Academic Affairs, and Steering Committees, the PennsylvaniaACEP Board of Directors. He has also served as a Reviewer/Consultant fbr Annals of EmergencyMedicine from 1985-92.

Board of Directors Edward Bernstein, MD is AssociateProfessorof EmergencyMedicine and public Health and Vice Chair for Academic Affairs at Boston University School of Medicine and Boston City Hospital.

He graduatedfrom Stanford University School of Medicine. He has servedon the SAEM Board of l]irectors s]nce 1995,and from 1993-95servedas Chair of the SAEM Public Health and EducationCommittee.

He has servedon the GeriatricTaskForce since l99l and the SAEM Patient-PhysicianCommunicationTask Force (1994-96).He has served as a Reviewer^forAcademic EmergencyMediiine and,Annals of Emergency Mediiine. He was the New Mexico ACEP Chapterofficer and servedas Presidenr(1982-86);and fr6m isso-ss he servedas Chairman of the STEM Public Education Committee.

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Ttresday,N{.I.ay 7 Board of Directors (Continued) William Dalsey, MD, MBA is Chair of the Department of EmergencyMedicine at Albert Einstein Medical Center and Associate Professor of Medicine at Temple University Medical School. Dr. Dalsey graduated from the Medical College of Pennsylvaniamedical schoolin 1981 and completedan EmergencyMedicine residency at the University of Cincinnati in 1989. He has served a consultant for the SAEM-Residency ConsultingServiceand was a memberof the TechnologyCommittee(1989-93).Since 1992he has been a member of the SAEM Residency Committee. Dr. Dalsey is the chair of the CORD Bylaws Committee and the CORD Curriculum Task Force and is a reviewer for Academic Emergency Midicine and Annals of EmergencyMedicine.

C. James Holliman, MD is an Associate Professorof Surgery and Emergency Medicine at Pennsylvania State University, and Director, Center for International Emergency Medicine. He graduated from medical schoolin 1979from WashingtonUniversityin St. Louis, andcompleteda Bum ResearchFellowshipin 1982, as well as a GeneralSurgeryResidencyin 1983from the Universityof Utah. Dr. Holliman has servedas the Chair of the SAEM Workforce Task Force (1995-96), and as a member of the International Committee (1993-96). Since 1994, he has served as an ACEP Councillor, and Chair of the ACEP publications Committee and Education Committee. He is a Reviewer for Academic EmergencyMedicine andprehospital and Disaster Medicine and is International Editor of the Hong Kong Journal of EmergencyMeelicine. Dr. Holliman was a recipientof the 1995CPC Best Faculty DiscussantAward.

Sandra Schneider,MD is Professorand Chair of the Departmentof EmergencyMedicine at the University of Rochester.She graduatedfrom the University of PittsburghMedical School in 1915 and completedan Internal Medicine Residencyin 1978 from the PresbyterianUniversity Hospital.Dr. Schneiderservedas a member of the SAEM Board of Directors from 1993-95.She chaired the SAEM Fellowship Task Force 1995-96and will chair the ResidencyConsultingServicestarting July 1996.She has been a memberof the SAEM TechnologyCommittee(1988-93),a memberof the Constitutionand Bylaws Committee(1990-93) and Chair of that committee (1992-93). Dr. Schneider is an Editorial Board member for the Journal of Prehospital and Disaster Medicine, Emergency Medicine Reports, and the Journal of procedures in EmergencyMedicine. She is also a Reviewer for AcademicEmergencyMedicine, Annals oJ'Emergency Medicine, and the AmericanJournal of Medicine.

Scott Syverud, MD is AssociateProfessorand Interim Chair of the Departmentof EmergencyMedicine at the Universityof Virginia. He graduatedfrom medicalschoolin 1981from the StateUniveisityof Newyork, Syracuseand completedan EmergencyMedicineResidencyin 1985at the Universityof Cincinnati.He completeda ResearchFellowshiptherein 1984and servedas chief residentin 1985.He has servedon the SAEM Board of Directors since 1994 serveson the Financial Oversight Committee. He was the EMRA representative to the UAEM ExecutiveCouncil and the STEM Board of Directors(1984-85),a memberof the UAEM GovernmentalAffairs Committee(1986-87),the chief residentsprogram organizerin 1990and a memberof the SAEM Program Committee (1988-93). He has been a Reviewer for AcademicEmergencyMedicine, Annals of EmergencyMedicine, the American Journal of EmergencyMedicine, andJAMA.

Brian Zink, MD is AssistantProfessorin the Section of EmergencyMedicine, Departmentof Surgery at the University of Michigan Medical Center.He graduatedfrom medical school at the University of Rochesterin 1984 and completed an Emergency Medicine Residencyfrom the University of Cincinnati Medical Center in 1988.Dr. Zink has beena memberof the SAEM ResearchCommitteefrom 1989-1993and a memberof the Constitutionand Bylaws Committeefrom 1993-96and during this past year has servedas chair of that committee. He has been the coordinator for the SAEM ResearchConsulting service since 1993. Dr. zink is a reviewer for Academic EmergencyMedicine.

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TiresdayMay 7 EducationCommitteeChair-Elect Glenn Hamilton, MD is professor and chair of the Department of Emergency Medicine at Wright State University School of Medicine. He graduatedfrom the University of Michigan medical school in I9l3 and completed his emergencymedicine residency at Denver GeneraVSt.Anthony's Medical Center tn 1979. Dr. Hamilton servedon the SAEM Board of Directors(1988-90),was chair of the AAMC Liaison Committee (1990-94), and servedas a representativeto the Council of Academic Societiesfor many years.Dr. Hamilton currently servesas a member of the Fellowship Thsk Force. In 1991, Dn Hamilton was the recipient of the SAEM Academic LeadershipAward.

Program Committee Chair-Elect Charles B. Cairns, MD is AssistantProfessorat the Universityof Coloradoand the Director of the Colorado Emergency Medicine Research Center. He graduated from medical school at the University of North Carolinain 1986 and completedan EmergencyMedicine Internshipand Residencyin 1989and a Research Fellowship in 1990 from Harbor-UCLA Medical Center.Dr. Cairns has servedon the SAEM Research Committee (1991-95) and the Program Committee (1995-96).Since 1993, he has been a member of the Asthma InterestGroup; since 1994 a member of theACEP Scientific Review Committee;since 1995,has of the ACEP Sectionon Research;and since 1993,has been the Chair of the acted as Secretary/Treasurer Annual Rocky Mountain ResearchForum. He is a manuscriptconsultantfor AcademicEmergencyMedicine andAnnals of EmergencyMedicine,and is consultingeditor for Emergindex.

M. Andrew Levitt, DO is AssistantClinical Professorof Medicine in the Division of EmergencyMedicine at the University of California, San Franciscoand Director of Researchin the Departmentof Emergency Medicine at Highland GeneralHospital. He graduatedfrom medical school in 1980 from the University of OsteopathicMedicine and Health SciencesMedical School and completed an Emergency Medicine Residencyin 1984from the Universityof Arizona Health ScienceCenter.Dr. Levitt has participatedon the SAEM ProgramCommittee(1993-96)and the ResearchCommittee(1989-94).He has also participatedon the California ACEP Education Committee (1990-95), was the Co-Chairmanfor the Winter Scientific FinancialSupport Symposium( 1990-93),was Chairmanof the CA ACEP Subcommitteeon Pharmaceutical in Medical Education (199l-93), and the ResearchCommittee since 1994. Dr. Levitt is a Reviewer for Acad.emicEmergencyMedicine, American Journal ofEmergency Medicine, and Annals of Emergency Medicine.

NominatingCommittee E. John Gallagher, MD is the Unified Chair and Professorof EmergencyMedicine of the Departmentof EmergencyMedicine at the Albert EinsteinCollegeof Medicine.He graduatedfrom medicalschoolin 1972 from the University of Pennsylvaniaand completedan internship and residencyat the Bronx Municipal HospitalCenter,Albert EinsteinCollegeof Medicine in 1915.From 1990-91he was a RobertWood Johnson Clinical Scholar at Yale University School of Medicine. Dr. Gallagher has served on the Residency ConsultingServicesince 1992and has servedas chair of the Developmentof AcademicCentersfrom I 99193 and from 1995-96.Since 1995 he has been a member of the Program Committee.Since 1983 he has servedas an oral examinerfor ABEM, and hasbeena memberof the ABEM Board of Directorssince 1995.

Dr. Gallagher has been a reviewer/consultant for Academic Emergency Medicine, Annals of Emergency Medicine, JAMA, and Journal of EmergencyMedicine. He is an associateeditor of AcademicEmergency Medicine and serveson the editorial board of Annals of EmergencyMedicine.

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I Paul E. Pepe, MD, MPH is a Professorin the Departmentsof Medicine, Surgery and Pediatrics at Baylor College of Medicine and the Ben Taub General Hospital in Houston. He is the Director of the City of Houston EmergencyMedical ServicesSystemand is an AssociateProfessorof EmergencyMedicine and Surgery at the University of Texas Medical School in Houston. He graduated from the University of California, San Francisco School of Medicine in 1916, completed an Internal Medicine Residency at the University of Washington,Seattle,then completed severalClinical and ResearchFellowships including Pulmonary-CriticalCare (1978-81)and Trauma (1981-82)at the Departmentsof Medicine and Surgeryat the University of Washington and then Surgical Critical Care in 1982 in the Department of Surgery at the University of Miami/Jackson Memorial Hospital. He representedSAEM on the AMA Commission for EmergencyMedical Servicesfrom 1985-1990,servedon the SAEM EMS Committeefrom 1988-1991,and on the Program Committee (1992-96). Dr. Pepe is an associateeditor of Academic EmergencyMedicine.

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Constitutionand Bylaws Committee Robert L. Muelleman, MD is Associate Professorand Co-Director of Researchat Truman Medical Center in Kansas City, Missouri. He graduatedfrom the University of Nebraska College of Medicine in 1984 and completed an Emergency Medicine Residency in 1987 as well as a Research Fellowship from Truman Medical Center in 1988. Dr. Muelleman has served on the SAEM Public Health and Education Committee (1993-96) and chaired that committee in 1995-96. He also served on the Membership Recruitment Committee from l99l-92 and servedas chair of that committee from 1993-94:and since 1992.he has been a member of the Injury Control Interest Group. Dr. Muelleman has served on the ACEP Public Policy Committeesince 1991 and from 1988-1993was a councillor.

Tom Stair, MD is Professorof EmergencyMedicine at the University of Maryland. He graduatedfrom from Harvard Medical School in 1975 and completed a General Surgery Residency in 1977 from New England Deaconess,as well as an EmergencyMedicine Residencyin 1979from GeorgetownUniversity. Dr. Stair has served on the SAEM Technology Committee (1989-95) and the National ED DatabaseTask Force (199395). He also servedon the STEM Board of Directors from 1982-88and was Presidentin 1986-87.From 1985-88 he was the UAEM Representativeto the AAMC CAS and from 1980-81 he served as the Washington, DC ACEP Chapter President.Dr. Stair has also servedas an ACEP councillor.

PROPOSEDCONSTITUTIONAND BYLAWSAMENDMENTS The old languageis crossedout and the proposednew languageis in bold face.

Article VI - Standing Committees Section 5: Program Committee. The Program Committee shall be composedof a Chair, @ ehh*ir+lee$, appointed by the President-Elect, and members appointedby the President-Elect with input from the Board Liaison and the Committee Chair for one-yearterms and who may be reappointedfor subsequentterms. A ResearchCommittee member and Education Committee member will be membersof the Program Committee. Subcommitteesshall be formed in accordance with the Policies and Procedures Manual. The committee Chair may not servefor more than three consecutive lerm* years.

The duties of the committee shall be to arrange,in conformity with instructions from the Board of Directors, the program for all meetingsand select the formal participants.The duties of the Program Committee Chair shall be in accordancewith the Policies and ProceduresManual.

The committeemembersshall, under the direction of the program chair and with the assistanceof the Executive Director perform duties in accordance with the Policies and Proceduresmanual. Recommendations from the Program CommitteeChair must be approvedby the Board of Directors by majority vote.

Section 7: Education Committee. The Education Committee shall consist of a Chair, @ iF appointed by the Presi.dent-Elect, and members ap@ pointed by the President-Elect with input from the Board Liaison and by the committee Chair for one-year terms and who may be reappointed for subsequent terms. The Committee shall foster educationin emergencymedicine.The committee Chair may not servelfor more than three consecutive te+m* years.

Section8: ResearchCommittee.The ResearchCommitteeshall consist of a Chair, appointed by the President-Elect, and members appointed by the President-Electwith input from the Board Liaison and the committee Chair for one-year terms and who may be reappointed for subsequentterms. The Committee shall foster researchin emergencymedicine.The committeeChair may not sewefor more than three consectttivetem*yecrs.

Article III - Membership Section 3: Member Rights and Privileges. All members may have the privilege of the floor and of serving on the committeesof the Association, and serving as committee chairs. Only active affd{s€€€iate members may serve on the Board of Directors. Only active members shall have voting rights. flnd i€ft

_r Wednesday,May 8

PAPER/POSTBRPRBSENTATIONS 335 Topical TetracaineAttenuatesthe Pain Of Infiltration Of Buffered Lidocaine, Fayzel S. Lee' MD, Albany Medical Center of Arterial and VenousBlood Gasesin the In336 Comparison ^Emergency DepartmentEvaluation of Patients with itial Diabetic Ketoacidosis,Mark A. Brandenburg,MD' Universityof Oklahoma

ScientificPapers:Injury Prevention (8:00-9:30 am)

ifioderator: Herbert G. Garrison, MD, MPH, East Carolina University 311 Fir-earm-RelatedInjuries in Three Cities, Arthur L' Kellermann,MD, MPH, Emory University LawrenceM. Lewis, 318 Do Wrist GuardsPreventFractures?, M D, WashingtonUniversitY 319 Comparisonof Compliancewith Traffic Laws Among Helmeted and NonhelmetedBicyclists, Christine Farris, MD, Unitersity of Arizona in the UnitedStates,1985-1995' 320 Window Cord Strangulations N . Clay Mann,PhD, OregonHealth SciencesUniversity 321 Missouri's EmergencyDepartmentE-CodeData Reporting: New Level of Data Resourcefor Injury Control, Robert L' Muelleman,MD, tlniversity of Missouri, KansasCity 322 Utilizing the EmergencyDepartment& TraumaServiceFor Accident Prevention: New Strategy For Managed Care, HerbertN.Wigder,MD, LutheranGeneralHospital

rtoon) Scientific Papers: Ttauma (10:00am-1,2:00

Moderator: Steien C. Dronen, MD, University of Michigan 331 Use of an Eye Oximeterto Monitor Blood Loss in a Swine Model, Kurt R. Denninghoff,MD' [Jniversityof Alabama, Birmingham 338 ImmediateFluid ResuscitationIncreasesRate and Duration of Bleeding in a SheepModel of UncontrolledPulmonary Artery Hemorrhage,iohn C' Sakles, MD, University of California,Davis 33g BacterialCountsand Infection Ratesin ExperimentalContaminated,Crush Wounds Irrigated With Various Concentrations of Cefazolin and Penicillin, Christopher Henry, MD, Michigan StateUniversityKalamazooCenterfor Medical Studies 340 WoundIrrigationWith TapWater?Faster!Cheaper!Be-tter?, RobertReirdon, MD StateUniversityof NewYork,Buffalo 341 Geriatric TraumaPatientsHave More ComplicationsThan Younger Adult PatientsDespite Similar Hemodynamic in the EmergencyDepartment,ChristopherB' Presentations Colwell, MD, UniversitYof Colorado 342 Comparisonof StaplesVersusSuturesin PenetratingC-ardiac Wounds,JamesMayrose,MS, State Universityof New York,Buffalo 343 Reduction of Head CT Scanningin Minor Head Trauma PatientsUtilizing SimpleClinicalRules:Is it Safe?,ErilcC' Milter, MD, Universityof California, Davis 344 Rural HospitalTransferPatternsAfter Implementationof a StatewideTrauma System,N. Clay Mann, PhD, Oregon s UniversitY H ealthScience

ScientificPapers:Education(8:00-9:30am)

Moderator: Nicholas J. Jouriles, MD, Case Western Reserve University 323 ConstructValidity of PerformanceBased Assessmentof EmergencyMediiine Residents,William Burdick,MD, Medical Collegeof Pennsylvaniaand HahnemannUniversity 324 Retiability of Faculty Clinical Evaluationof Studentsand Non-EM Residents During Emergency Department Rotations,JamesG. Ryan,MD, North ShoreUniversity 325 Addition of EmergencyMedicine Residents Alone Does Not Increasethe Utilization or Cost of Ancillary Testing, JosephD. Sexton,MD, St.Luke'sHospital 326 NegativeAdvice RegardingEmergencyMedicine Training From Non-EmergencyPhysicians,Howard A. Blumstein, MD, Medical College of Pennsylvaniaand Hahnemann University 321 Comparison of Classroom and Distance Learning Techniquesfor Rural EMT-I Instruction,GregoryD. Hobbs,MD' TexasA & M 328 Evaluationof the PeerReviewer:Performanceof Reviewers MichaelCallaham,MD' Annals on a FactitiousSubmission, of EmergencyMedicine

(L:30-4:00Pm) PosterSession

Innovationsin EmergencyMedicine Education Exhibits

Moilerator: Inuis S. Bind'er MD, (lniversity of Illinois (2:00-3:00 pm) 345 Four Week Courseto TeachRotating ResidentsEmergency Medicine (EM) ProceduralSkills Using the Instructional SystemsDesign Model, Felix K. Ankel, MD, St. PaulRamseyMedical Center 346 EmergencyMedicine Multimedia Computer Tutorial and Referince- in Orthopedic Splinting Techniques,Phillip Scott,MD, UniversitYof Michigan 341 Use of Digital Photographyto RecordEmergencyMedicine ResidencyExperience,Anna Bradham, MD, Vanderbilt University 348 Structured Curriculum in Domestic Violence And Child Abuse For EmergencyMedicine Residents,Gary M' Vilke, MD, Universityof Calfornia, SanDiego 349 Implementationof a Hypertext Curriculum for Emergency Medicine on the World Wide Web, Daniel L. Savitt, MD, RhodeIsland HosPital 350 EmergencyDepartmentAdministration:A ResidencyCurriculnm, David C. Seaberg,MD ' Universiryof Florida 351 Paper-LessFile Cabinet:Establishinga Digital Emergelgy tr,ledicineFiling System,StevenJ. White,MD,Vanderbilt UniversitY

Scientific Papers: Clinical Practice (10:00am-I2:00 noon)

ifioderator: Scott A. Syverud, MD, University of Virginia 329 Patient Perceptionof Illness Severity PredictsEmergency DepartmentOutcome,KathleenA. Raftery, MD, Brigham andWomen'sHospital 330 Improving the DetectionRate of Victims of DomesticViolenie Using Direct Questioningin the EmergencyDepartment,Laurie J. Morrison, MD, Universityof Toronto 331 ED Rapid Sequencevs. ConventionalSputumCollectionfor AFB SmearMicroscopy and Culture Inoculation to Diagnose Pulmonary Tuberculosis,Daniel G. Murphy' MD' Cook CountyHosPital 332 Occult Depression in Emergency Department Patients, M ichaelBurry, Vanderbilt Univer s ity M edical Center 333 Appendectomy:Acute and Long Term Complications, Christy McCowan, Universityof Utah 334 ProspectiveRandomized Comparison of a New Tissue AdhesiveVersusSuturesin the Managementof Traumatic Lacerations,JimV. Quinn, MD, Universityof Ottawa

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Wednesday,May 8 352 MultimediaAuthoring for EmergencyPhysicians:Introduction to a Novel EducationalModality, Iohn S. Rose,MD, Universityof California, Davis 353 CustomizedDatabasefor Tracking ResidencyApplications, Mark Mandell, MD, Morristown Memorial Hospital 354 Increasingthe InteffaterReliability and PredictiveValidity of Critical Incident Interviewing,Ronald S. Benenson,MD, YorkHospital 355 Multi-MediaEducationalModel to PrepareEM Residentsto ProvidePre-HospitalMedical Controi, Margaret Harling, MD, BostonCity Hospital 356 MEDSIMM c 2.1 - A Pediatric Advanced Life Supporl SimulationProgram,Richard Lichenstein,MD, University of Maryland 357 Value of a Digital Radiology System in Emergency Medicine Education,Brian D. Euerle, MD, Baltimore Veterans Afr'airsMedical Center 358 World Wide Web: New Conceptsin International EmergencyToxicologyEducation,Mark D. Crockett,MD, Universityof Illinois at Chicago 359 EMS Databaseof State Rules and Laws, SteyenJ. Weiss, MD, LouisianaStateUniversity

Injury Prevention Moderator: David P, Sklar, MD, University of New Mexico (3:004:00pm) 360 Patternsof Burn Injuries Among Children in an Urban EmergencyDepartment,J. Piene, MD, Lincoln Medical andMental Health Center 36I WITHDRAWN 362 WITHDRAWN 363 PreventingWindow Falls In The Inner City: Resultsof a Follow Up Study,N. Narra, Lincoln Medical, and Mental Health Center 364 Survey of Adolescents'Knowledge RegardingOver- theCounterMedicationToxicity,MichaelA. Huott, MD,Ioint Military Medical Centers 365 WITHDRAWN 366 IncreasedFrequencyof Alcohol RelatedDriving Convictions in Drivers Who Injure Pedestrians,Charles M. Callahan,MD, MPH, Universityof Rochester 367 Impactof Injury on the ED andPredictorsof Injury Patterns, HenryE.Wang,CooperHospitallUniversityMedical Center 368 FactorsAssociatedwith the Intent of Firearm-RelatedIniurv in PediatricTraumaPatients,GuohuaLi, MD, JohnsHopkinsHospital 369 Population-BasedStudy of Fatal and Nonfatal Firearm Injuries,Jffiey H . Coben,MD, Universityof Pittsburgh 370 Domestic Violence Prevalencein Patients with Inflicted Trauma,Arthur Davies,MD, Metropolilan Hospital Center 371 Use of ProtectiveGear in Children Presentingto the Emergency Department With Skating Injuries, Thomas Kwiatkowski,MD, Long Island JewishMedical Center 372 Injury as a Predictorof ProblemDrinking in an Urban ED, ManleyClodfelter,MD, Emory University

Education Moderator: William P. Burdick, MD, Medical College of Pennsylvania and Hahnemann University (2:00-3:00pm) 373 SuccessfulModel For An IntegratedEmergencyMedicine/ TraumaService,.I. Hartm(tnn,MD, UniversityoJConnecticut 374 Effectivenessof an InteractiveMultimedia ComouterProgramin TeachingAirway Managementto Medicai Students, JohnC. Sakles,MD, Universityof Calfornia, Davis 375 Integration of Clinical Anatomy Into an Emergency MedicineResidencyCurriculum, Michael S. Beeson,MD, SummaHealth System

376 Teachingthe Laryngeal Mask Airway to Inexperienced, InfrequentAirway Managersin an ACLS Course,Michael A. Silverman,MD, JohnsHopkinsHospital 377 Clinical Duties of Faculty and ResidencyDirectors in Accredited EM Training Programs:Clinical Hours Worked, Number of Patients Primarily Managed and Supervised, Ionathan Glauser,MD, Mt. Sinai Medical Center 378 Are ResidentsPerforming Quality Researchin Emergency Medicine?,M . AndrewLevitt, D O, H ighland General H ospital 319 Threat of Funding Cuts For GraduateMedical Education: Surveyof DecisionMakers,RichardJ. Kozak,MD, Universityof Calfornia, Iryine 380 Longevity and Promotion of Former EmergencyMedicine ResidencyDirectors,Lowell W. Gerson,PhD, Northeastern Ohio UniversitiesCollegeof Medicine 381 Processfor AssessingCommunicationSkills of Emergency MedicineResidents,StevenRosenzweig, MD,ThomasJeJferson University 382 PredictiveValueof Lettersof Recommendation VersusPreprinted Questionnairefor Emergency Medicine Resident Performance,Ieffrey Schaider,MD, Cook CountyHospilal 383 Structuredvs. NonstructuredAbstractsfor Transmissionof MedicalInformation,MichaelHeller,MD, St.Luke'sHospital 384 PersonalExposureof Physiciansand Physicians-In-Training to FamilyMolence,ElizabethA. deLahunta,MD, Universit! of Rochester 385 DisasterMedicineFellowshipCurricula:Can We Form an Academic Foundation?,Clark A. Morres, MD, Madisan Army Medical Center

Clinical Practice Moderator: Steven R. Lowenstein, MD, MPH, University of Colorado (3:00-4:00pm) 386 Derivationof a DecisionRuleto PredictDelayedFunctional RecoveryAfter Acute Knee Injury, Ian G. Stiell, MD, Universityof Ottawa 387 Physicians'PredictionsandClinical Courseof PatientsWith Acute Soft Tissue Injuries of the Knee, GeorgeA. Wells, PhD, Universityof Ottawa 388 Derivation of a Clinical Decision Rule for the Emergency DepartmentDiagnosis of Ectopic Pregnancy,Robert Buckley,MD, Naval Medical Center,SanDiego 389 TimeAnalysisof ConsultServiceEmergencyDepafimentAdmissionProcessComparedto EmergencyMedicine Service AdmissionProcess, Gary Quick,MD , Universityof Oklahoma 390 RetrospectiveReview of X-Ray Interpretationsin a Community Hospital, Ronald F. Sing, DO, Carolinas Medical Center 391 EmergencyDepartmentUtilization of Head CT in HIVPositive Patients,Richard Rothman, MD, Johns Hopkins Hospital 392 Limited Utility of Serum hCG in rhe ExpectantManagement of SuspectedEctopic Pregnancy,Norbert Elsner,MD, Albert EinsteinCollegeof Medicine 393 Urine PregnancyTesting in the EmergencyDepartment: DoesUrine SpecificGravity InfluenceResults?,TamaraM. Ardans.MD. CarolinasMedical Center 394 hCG Values> 3,000 mlU/ml and/or Mentrual Dates > 38 Days Exclude a Normal IntrauterinePregnancyin Patients with Pain or Bleeding and No IntrauterineSac by TransvaginalSonography, RobertDart, MD, BostonCity Hospital 395 Utility of a SingleBeta HCG MeasurementTo EvaluateFor Etopic Pregnancy,Keith A. Marill, MD, Texas Tech University,El Paso 396 DoesExogenousMelatoninImproveDay Sleepor NightAlertness in Emergency PhysiciansWorking Night Shifts?, K. MichaelJorgensen, MD, Universityof Maryland

Wednesday,May 8 EMRS BestPaper

416 LactateIdentiflesMajor TraumaBetterThan a StandardTriage Criteria,David Livingston,MD, Nau JerseyTraumaCenter 411 Significanceof Abnormal GlascowComa Scorein Acutely IntoxicatedPatientsFollowing Minor Closed Head Injury, Azita A. Toussi.MD, CarolinasMedical Center

461 ReducedQuality of In-Vitro Clot Formation with Gelatin Based Plasma Substitutes,Fiona M. Sanders,MD, North StaffordshireTraumaCentre(seeabstracton page 5I )

Clinical Practice

TFauma

Moderator: Joseph F. Waeckerle, MD, University of Missouri' KansasCity (2:00-3:00pm) 397 Medical Clearanceand Screeningof EmergencyDepartment Psychiatric Patients, Ionathan S. Olshaker, MD, Unirersity of Maryland 398 Biphasic Anaphylactic Reactions:An Uncommon Event, William Brady, MD, Universityof Virginia 399 PredictingOptimal Depth of NasotrachealIntubation Prior to Chest X-Ray, David B. Reed,MD, HennepinCounty MedicalCenter 400 Safety of Droperidol for Sedating Out-of-Control Emergency DepartmentPatients, Scott W. Branney,MD, Denver GeneralHospital Intubation,Erik G. 401 Safetyof EtomidateForRapidSequence Laurin, Universityof California, Davis 402 Does Combined Serum Amylase and Lipase Testing Improve Diagnostic Accuracy in Pancreatitis?,James D. Cameron,MD, JerseyShoreMedical Center 403 Nitric Oxide Levels in ED PatientsPresentingwith Acute VasocclusiveSickle Cell Crisis, Jordan Barnett, MD, ThomasJffi rson University 404 Do Patientswith Mild Head Injury and PositiveCranial CT ScanRequireAdmission?,Pierre Borczuk,MD, MassachusettsGeneralHospital 405 Rapid SequenceIntubationat an EM Residency:Success Rate and ComplicationsEncounteredDuring a Two-Year Period,RussellW.Riggs,MD, CarolinasMedicalCenter 406 DiagnosticProfile of Alcohol IntoxicatedPatientsSeenin a University FacilitatedCounty Hospital EmergencyDepartment,RobertRusnak,MD, HennepinCounryMedical Center 407 Influenceof an EmergencyMedicineResidencyProgramon Internal Medicine Admissions,ThomasWilkins, MD, Earl K. Long Medical Center 408 PsychologicEffect of a 4 Week EM Rotation for Residents in Training, Kumar Alagappan, MD, Long Island Jewish Medical Center 409 In-line SkateInjuries: An EmergencyDepaftmentPerspective,Robert VanderLeest,MD, Universityof Colorado

Moderator:SusanA. Stern,MD, Universityof Michigan(2:003:00pm) Injury CervicalCollarsForWhiplash 418 Efficacyof Semi-Rigid 419 420

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MD, AlbenEinsteinCollegeof Medicine Raymondlannaccone, Inter-rater Reliability of Cervical Spine Injury Criteria, William Goldberg,MD, Universityof California,Los Angeles IncrementalAnalysis of DiagnosticPeritonealLavageFluid in Adult AbdominalTrauma,DanTandberg,MD, University of New Mexico Impact of StatewideTrauma Systemon Rural ED Trauma PatientAssessmentDocumentation,N. Clay Mann, PhD, OregonHealth SciencesUnit:ersity Influenceof anEmergencyMedicineResidencyon theRoleof RobertS. Chang,MD, BellevueHospital Cricothyroidotomy, IncreasedMorbidity and Mortality in Hospitalized,Ivan Ramirez,MD, MeffopolitanHospital Center RetrospectiveDescriptiveEpidemiologicStudyof the Oklahoma City TerroristBombing: EmergencyDepartmentImpact,April 19, 1995,David E. Hogan,DO, Universityof Oklahoma RetrospectiveDescriptiveEpidemiologicStudyof the Oklahoma City TerroristBombing, Impact on SurgicalServices, April I 9, 1995,Daniel J. Dire, M D, Universityof Oklahoma

InfectiousDisease(3:00-4:00pm) Moderator: 426 Developmentof a DecisionRule for the EmergencyDepartment Triage of HlV-Infected Patients,Christel M. Zeumer, MD. Harhor-UCLA Medical Center 427 AbsoluteLymphocyteCountasa Predictorof AbsoluteCD4 Count,NathanL Shapiro,BS, TempleUniversity 428 RapidHIV Testingin the EmergencyDepartment,GaborD. Kelen,MD,The lohns HopkinsHospital 429 Bacteriologyof InfectedDog and Cat Bite Wounds,David A. Talan.MD. OliveView-UCLA 430 Antimicrobial Effects of a New Tissue Adhesive,Jim V. Quinn, MD, Universiryof Ottawa 431 ChlamydiaPneumoniaeInfection in PatientsWith Persistent Cough,SethWright, MD, VanderbiltUniversity 432 Viral URI's ('Colds') and Cold Weather,Ronald B. Low, MD, StateUniversityof New York,Brooklyn 433 New Optical lmmunoassayFor the Dectectionof StrepThroat in the ED, David C. Seaberg,MD, Universityof F lorida 434 Validationof a Protocolfor RespiratoryIsolationof Patients With Pulmonary Tuberculosisin an Inner City Hospital, Jerry Balentine,DO, St.BarnabasHospital

T[auma Moderator: Thomas M. Scalea, MD, State University of New York,Brooklyn (3:00-4:00pm) 410 HeadTrauma:Do all Patientswith a GCS=14RequireHead CT Scanning? , f amesF. Holmes,Ir, MD , Universityof CaliDavis fornia, 4ll Value of CardiacScreeningin the TraumaPatient:An Outcomes Assessment,David P. Milzman, MD, Georgetown University 412 Can SerialHematocritsReliably DetectOccult Blood Loss?

A ProspectiveCross-OverStudy of the Effect of Phlebotomy and IntravenousCrystalloid on Hematocrit, Irene Y. Tien,BS,AlbanyMedical Center 413 Injuries Distracting From Severe IntraabdominalInjuries After Blunt Trauma,Peter C. Fenera, MD, Albany Medical College 414 Blunt Traumatic Arest: The Usefulnessof Procedures Other Than Thoracotomy,HeatherleeBailey,MD, Medical Collegeof Pennsyvaniaand HahnemannUnit,ersity 415 Use of a VenousTourniquetDoesNot IncreaseVenousLactate Levels,BartholomewTortella,MD, New fersey Trauma Center

Eme Neurologic lrmergencles Moderator: Willi.am G. Barsan, MD, University of Michigan

(2:00-3:00 pm) 435 AlcoholandTimeto Deathin MotorVehicleCrashVictims, BrianI. Zink,MD, Universityof Michigan 436 Delayed Hospital Arrival in Patients with Acute Stroke, ThomasKwiatkowski,MD, Long IslandJewishMedical Center 431 StrokeVictims: Clueless,Edward C. Iauch, MD, Unittersity oJ'Cincinnati 438 Delay in SeekingCare For Stroke- DemographicDeterminants: Delay in Accessing Stroke Healthcare(DASH) Study,Dexter L. Morris, PhD, MD, Unittersity of North Carolina, ChapelHill

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Wednesday,May 8 439 Effectsof In Vitro Ischemiaon Human Brain Slices,Keltft K. Burkhart,MD, MS HersheyMedical Center 440 Effect ofHyperbaric OxygenTherapyon CerebralOxygen Utilization After Global Cerebral Ischemia, Robert Silbergleit, MD, George Washington University 441 ProtectionFrom HemoglobinMediatedCortical Cell Injury by the IntracellularIron ChelatorDexrazoxane,RaymondF. Regan,MD, Thomasf ffirs on University

Imaging Moderqtor: David Olson, MD, University of Texas, Houston (3:00-4:00pm) 442 TraumaUltrasonographyVersusChestRadiographFor the Diagnosisof Hemothorax,O. John Ma, MD, University oJ North Carolina,ChapelHill 443 UltrasoundAssisted Central Vein Catheterizationin the EmergencyDepartment,Paul Hrics, MD, SummaHealth System 444 Ultrasonographyby Emergency Physicians in Detecting Hydronephrosisin Patients with SuspectedRenal Colic, Carlo L. Rosen,MD, Massachusetts GeneralHospital 445 Ultrasonography

by EmergencyPhysiciansin the Diagnosis of Cholelithiasis,Carlo L. Rosen,MD, Massachusetts General Hospital 446 TransthoracicEchocardiographicDiagnosis of Pulmonary Embolism, Raymond R. Rudoni, MD, William Beaumont Hospital 447 RadiographicDetection of Gravel Foreign Bodies in Soft TissueWounds,Christopher O. Wood,Methodist Hospital of Indiana 448 Correlation Between Clinical, Laboratory, and HepatobiliaryScanningFindingsin Patientswith Suspected Acute Cholecystitis,Mark C. Henry, MD, State University of NewYork,StonyBrook

Imaging Moderator: Ronald Moscati, MD, State University of New York, Buffalo (2:00-3:00pm) 449 Probabilityof DetectingC-SpineFracturesWith CT Scans Usingthe Visible HumanTM Database, A. K. Singh,MD, University of M i ssissippi 450 Utility of the RoutineSwimmersView Cervical Radiograph in Addition to the CrossTableLateral Cervical Radiograph in Detecting Cervical Injury in Critical Trauma Patients, JeffreyD. Ho, MD, HennepinCountyMedical Center 451 Evaluationof Clinical Criteria for EmersentAbdominal Radiography,Mary F. Saterly, MD, Joiir Mititary Medical Centers 452 Accuracyof Spiral CT Scanningin Making the Diagnosisof Nephrolithiasis:Is it a New Gold Standard?,Lisa A. Bennett,MD. Medical Centerof Delaware

453 Effects of the TrendelenburgPosition on the Sonographic Detection of IntraperitonealFluid, Nils P. Albert, Denver GeneralHospital 454 Contrast-Enhanced Brain CT ScansAre Not Indicatedin the Evaluationof Most Non-TraumaPatientsin the Emergency Department,GregoryJ. Fermann,MD, Maricopa Medical Center

ScientificPapers:Neurology(4:00-5:30pm) Moderator: Michelle H. Biros, MS, MD, Hennepin County Medical Center 455 Depletionof CerebralAntioxidant Activity After Asphyxial Cardiac Anest, Clifton W. Callaway,MD, PhD, University of Pittsburgh 456 Effect of OxygenatedUltra-PurifledBovine Hemoglobinon Neuro-Injury After Cardiac Arrest and Resuscitationwith AClS-Selective Aortic Occlusionand Infusion,NormanA. Paradis,MD, Columbia University 457 Neurotoxic Effect of Brain-Derived Neurotrophic Factor (BDNF) in Cortical Cell Culture,RaymondF. Regan,MD, Thomasf ffi rson University 458 Effect of HemonhagicHypotensionon the Early Hemodynamic and Cerebrovascular Responsein a New Combined TraumaticBrain Injury/HemorhageModel, SusanA. Stern, MD, Universityof Michigan 459 Effects of Ethanolin an ExperimentalModel of Combined Traumatic Brain Injury and HemorrhagicShock, Brian L Zink, MD Universityof Michigan 460 Autonomic Regulation of Gastric UlcerogenesisAfter Cervical Cord Transectionin the Rat, Nicft Leonard, MD, Earl K. Long Medical Center

ScientificPapers:Imaging (4:00-5:30pm) Moderator: Dietrich Jehle, MD, State University of New York, Buffalo 461 Incidenceof Abnormalitiesin Postreduction Radiographs of Anterior Shoulder Dislocation, W. Knox Kinlaw, MD, ValleyMedical Center 462 Rateof Clinically SignificantDiscrepancies in Plain Radiograph Interpretationin an EmergencyMedicine ResidencyProgram,LeonardA. Nitowski,MD, MedicalCenterof Delaware 463 CostEffectiveness of Non-contrastHelical ComouterizedTomographyComparedto IVP in the Initial Evaluationof Ftank in the EmergencyDepartment,Lane Duvall,Yale University 464 Hand-HeldDoppler Ultrasoundin the EmergencyDepartment for the Diagnosisof DVI CatherineJones,MD, Universityof Massachusetts 465 Limited TransabdominalPelvic Ultrasonographyby EmergencyPhysiciansin Patientsat Risk for Ectopic Pregnancy, WayneA. Chin, MD, BostonCity Hospital 466 Influenceof 24-HourUltrasoundAvailability on Emergency DepartmentPractice, Gerard Farris, MD, Earl K. Long Medical Center

Wednesday,May 8

DIDACTIC SESSIONS ThrombolyticTherapyfor Acute IschemicStroke: ShouldWe or Shouldn'tWe?(8:00'9:30am)

Moderator: William G. Barsan,MD, Universityof Michigan RashmiU. Kothari, MD , UniversityoJ'Cincinnati Chris Lewandowski,MD, Henry Ford Hospital JosephBroderick,MD, Universityof Cincinnati ThomasKwiatkowski,MD, Long Island lewish Medical Center This panel discussionwill consist of emergencyphysiciansand neurologistswho have been intimately involved with the use of thrombolytictherapyin acuteischemicstroke.During this session, recentadvancesin the useof thrombolytictherapyin strokewill be reviewed.Discussantswill then critique someof the recentstudies that have been published,including recentlycompletedEuropean CooperativeAcute Stroke Study and the NINDS rt-PA Stroke of thesestudStudy.They will discussthe strengthandweaknesses ies as well as the pros and cons of using thrombolytic therapyin stroke.Furthermore,the future role of emergencymedicinestroke researchwill be discussed.In particular,current ongoing trials as well as questionsthat still remainto be answered.The sessionwill concludewith a 20-minutequestionand answersessionthat will addresssomeof the culrent concemsof emergencyphysicians.

Basic Networking and Internet Access for Emergency Physicians (8:00-10:00am) _

David K. English,MD, Ilniversityof Califurnia,SanFrancisco John L Etlis, MD, tJniversityof Calfurnia, SanFrancisco R. Carter Clements,MD, Universityof California, SanFrancisco This sessionwill reviewthe basicsof computernetworking,including the benefitsand burdensof variousoptions.Implementationon Interconnectionofvaried platformsa Jlim budgetwill be discussed.

The Internetwill be introducedanda varietyof will be emphasized. accessmethodswill be presented.A selectionof the Emergency Medicineresourceson the Internetwill be demonstrated.

Advanced Internet Lab for Emergency Physicians(10:00-12:00noon)

John L Ellis, MD, Universityof Califurnia, San Francisco David K. English,MD, Universityof California, SanFrancisco R. Carter Clements,MD, Universityof Califurnia, SanFrancisco The Internet plays an increasinglyprominent role in health care.

This sessionwill review the underlyingconceptsof internetworking and the Intemet.Variousmethodsof accessto the Intemetwill be presentedfor the individual physician,group, and department.

Developmentof hostsandpresentationof resourceson the Internet will be demonstratedand practiced.This sessionpresumessome familiarity with computersand datacommunication.

Emergency Medicine: Role of Surveillance and Public Health (10:00-11:00am)

M oderator: D avid Talan,MD, Olive View-UCLA Arthur Kellermann,MD, MPH, Emory Universiry Dan Pollock,MD, Centersfor DiseaseControl William Mower,MD, MA, UCLA The role of emergencymedicinein surveillanceand public health researchis rapidly expanding.Cooperativeeffortswith the Centers for DiseaseControl and Preventionon surveillanceof injuries and emerging infections are already underway.The focus of emergencydepartmenteffortswill be acuteillnessaffectingat-riskpopulations not easily studied in other venues.Medical informatics know-how is also key to implementingtheseprojects.An expert faculty will discussrecent experiencein national emergencydepartmentsurveillanceprogralns.

Faculty Renewal:From Burnout to Bonfire (11:00-12:00 noon) Marc Borenstein,MD, Universityof Connecticut Hal Thomas,MD, OregonHealth SciencesUniversity The stresseson medicinein generalandacademicmedicinein particular have never been greater.Many faculty are feeling overwhelmedby factors seeminglybeyond their control. This course will explorefactors associatedwith bumout and careerlongevity in academicemergencymedicine. The interactive sessionwill include exercisesdesignedto maximize satisfactionand performanceby identifying a personalmission statementand aligning activitieswith core values.

Research Directors' Luncheon: Where Should Emergency Medicine Research Be Published?

(12:00-L:30pm) Judd Hollander,-MD,StateUniversityof New York,StonyBrook Jerris R. Hedges,MD, Editor-in Chief,AEM Phil Fontanarosa.MD, SeniorEditor, JAMA Norman Paradis,MD, Columbia University The speakerswill discussthe advantagesand disadvantagesto publishing in Emergency Medicine versus Non-Emergency Medicine journals. Jerris Hedges,MD, Editor-in-Chief of AEM, will representEmergencyMedicine journals; Phil Fontanarosa' MD, SeniorEditor of JAMA, will representbroadinterestmedical iournals.Norman Paradis,MD, wilt discussthe pros and cons of publishingin variousjournals from the viewpoint of a seniorscientist, while Judd Hollander, MD, will introduce the hurdles a young investigatormust overcometo publish in the non-emergency medicinejournals. In addition, panel memberswill give their-personalinsight into the promotionand tenureissuesof publishing and suggestionsfor manuscriptpublication.

the Impact of International Luncheon:Assessing EmergencyMedicine Projects

Moderaior: C. JamesHolliman, MD, MS HersheyMedical Center William Robinson,MD, Universityof Missouri, KansasCity Gary Green,MD, MPH, JohnsHopkins University Alan Hodgdon,MD, Mercy Hospital Pittsburgh Dr. Holliman will introducestructuredways to assessthe feasibility and utility of potential internationalemergencymedicinepro.|ects.R panelof speakerswill then presentinformationon several different internationalemergencymedicine projects focusing on project intent, methods, expected outcomes, actual outcomes, overall successand ways of improving similar projectsin the fu"DevelopingEmergencyMedicine ture.Dr. Robinsonwill discuss, in a War-torn Country: The InternationalMedical Corps Bosnia "Catalyzingthe Developmentof Project". Dr. Greenwill discuss, Grass-roots Em-ergencyMedicine in Guatemala:A Longitudinal "Emergency Medicine Approacht'. Dr. Hodgdon will discuss, Tialning in Turkey - The Mercy Hospital Experience."Finally, the moderatorwill direct an interactivesessionbetweenthe panel and the audiencefocusingon issuesinvolvedin theseassessments.

Visiting emergencyphysiciansfrom othercountries(includingDr. WangYitang, presidentof the ChineseAssociationof Emergency Medicine) will be introducedto the audienceand their comments on programevaluationelicited.

Luncheon: Epilogue for an Analog: Improved Methodologies for Measured Perfusion Beyond Blood Pressure(12:00-1:30Pm)

Moderator: Paul E. Pepe,MD, Baylor Collegeof Medicine WilliamBickell,MD, St.FrancisHospital,Tulsa EmanuelP. Rivers,MD, MPH, Henry Ford Hospital CharlesB. Cairns,MD, Universityof Colorado During this luncheon session,the technology,ischemia-reperfusion,EMS andshocktraumainterestgroupswill gathertogetherto: 1) re-examinethe basicprinciplesof shockand oxygenutilization;

WednesdayoMay 8 2) explorenew measuringtools and therapeuticdevicesfor shock management; and3) displaythisphysiologicmatineeperformance in computer-generated formats.Specifically,the sessionis intendedto providean introduction of what will evenfuallybe the standardapproachto scientificpaperpresentations (usingdisksinsteadof slide tlays).The sessionwill cover basic conceptsof Oz utilization and thenreviewnew technologyfor measuringshock,titrating therapy andalsointroducenew technologyfor deliveringoxygento the tissues(e.g.,artificialbloodsandmetabolictherapies).

Traditionalana1ogconcepts suchasslidetrays.transfusions andtitrationof systemic bloodpressure will be de-emphasized, ifnot discardedaltogether!

ABEM Activities:ABEM Interactions with (1:30-2:30 Residents pm) This sessionwill provide an opportunityfor EmergencyMedicine residentsto interactinformally with ABEM directorsand staff.A packetof referencematerial for this sessionwill be availableall weekat the SAEM registrationdesk.

Effective Faculty Observation of Residents' Clinical Skills (1:30-3:30pm) JosephLaMantia,MD, North ShoreUniversityHospital Rita Cydulka,MD, MetroHealthMedical Center Linda Spillane,MD, Universityof Rochester WilliamRennie,MD, Lons Island JewishMedical Center This sessionwill demonstratethe difficulty of evaluatingresidents on thebasisof presentation skills only and discussthe useof performancecriteria as a meansto more reliable observationof residents.We will demonstrateandpracticethe useof the performance criteriadeveloped by the SAEM NationalConsensus on Clinical SkillsTaskForceto gradevideotaped resident-patient interactions.

Finally,we will discussand demonstrateother techniquesfor effectiveobservation.

By the completionof the session,theparticipantswill be ableto: l) usethe observationsystemthat the task forcehasdevelopedor be able to developan observationsystem for their own residencyprograms;and 2) effectively observe,critique,andgive formativefeedbackto residents.

Strategiesto AccomplishHigh Quality Unfunded ClinicalResearch(1:30-2:30pm) JuddE. Hollander,MD, StateUniversityoJ'NewYorlc, StonyBrook SharonM.Valentine,RN, BSN,State(Jniversitvof'Newyork.Stonv Brook The developmentof a successfulunfundedclinical researchprogramshelpsto pavethe way for competitivefunding at a latertime.

This sessionwill presentconcreteinexpensivemethodsto lay the groundworkfor a clinical researchprogram.Sinceone of the more difficultaspectsof clinical researchis fosteringpractitionercompliancewith studyprotocolsand datacollection,this coursewill emphasizeprovenmethodsto facilitateproject completion.This sessionwill alsodiscusssuccessfulmethodsto recruitED staff (faculty, resident,nursing,and ancillary staff), generateenthusiasmand participation in project developmentand implementation,methods to enhance likelihoodofstudy subjectidentification,waysto attract volunteer(free)researchassistants to staffthe ED asdatacollectors, designof easyto completeyet detailedcasereport forms for real timeusein the ED, strategiclocationsto distributeand collectdata sheets, andefficientand inexpensivemethodsto performdataentry suchasstructured chartsandautomateddataentry.Theseissueswill be discussed predominantlyfrom the point of view of ED clinical research.

Somediscussionof theseprinciplesas they pertainto the prehospital andfollow-up settingswill alsobe discussed.

Additional comments regardingthedevelopmentof multicenternetworks,withoutinvestment of money,will be incorporated.

OneFor The Road: Current Concepts and Controversiesin Alcohol Intoxication and Injury Research(2:30-3:30pm) Moderator:BruceBecker,MD, MPH, Brown University RonaldF. Maio, DO, MS, Universityof Michigan RichardLongabaugh,EdD, Center for Alcohol and Addiction Studies.

Brown Uniyer sitv

This sessionwill focus on researchin iniurv related to alcohol intoxication. The speakerswill discusscornpetenceand consent, identification of the patient at risk and intervention,longitudinal patienttrackingand follow-up, and a variety of difficult and exciting issuesthat sumoundtheseimportant investigations.It's likely that therewill be debateaboutthe uniqueprocedural,ethical,and legal barriers that have traditionally hinderedresearchwith this patient population.The speakerswill proposesolutionsand will undoubtedlyelicit heatedaudienceinterjection.

Applying CQI Methodology to Emergency Medicine Clinical Systemsand Outcomes Research:A Case Study Using the Chest Pain Model (3:30-4:30pm) GeorgeL. Higgins,lll , MD, Maine MedicalCenter CQI Techniques,when appliedas the true operationalphilosophy of the ED, are ideal for analyzingand improving clinical systems of care.By capitalizingon the creativetalentsand energiesof all interested contributors to the system, many opportunities for improvementcanbe identifiedandrealized.Working relationships among variousdisciplines,clinical departments,and supportservices also improve naturally.An actualCQI project, dealingwith the processingof adult patientspresentingto the ED with nontraumaticchestpain, will be presentedto emphasizethe following aspects ofthis process:the importanceofaccuratebaselinedataas the basisfor effectivedecisionmaking; the value of "inclusivity" versus"exclusivity"in teammembership; the needto invite honest input from all investedcontributorsto the systemno matter how threateningthe message;the power of the anecdotein motivating "buy-in" and influencingbehavior;the importanceof timely and personalizedfeedbackin order to effect lasting improvement in individualpractices;the ability of successful CQI activities to elevatethe ED's staturein its institutionandcommunitv.

The NationalInformation Infrastructure-Health EducationNetwork (NIIHIN): A Demonstration Project(3:30-4:30pm) Robert.1.Schwartz,MD, MPH, Universityof Pittsburgh GlenReece,PhD, ISXCorporation,Marietta,Georgia Belinda Hoshstrasser,ISX Corporation,Marietta, Georgia The NIIHIN is a public-privatepartnershipthat is developingtechnology towards the goal of a national health information infrastructurenetwork. The Minimum EmergencyMedicine Data Set (MEDS),which is part of NIIHIN, is beingdevelopedas an information systemfor collecting,integrating,analyzing,and disseminating information on emergencycare episodesand their outcomes.Ultimately,there will be 24-hours-per-day accessto the MEDS systemfrom anywherein the nation. The faculty will describethesystemengineering process,its intendeduse,andtheimplicationsof sucha nationaldatabasefor the practiceof emergency medicine.Accessto anduseof MEDS will be demonstrated.

An Introduction to StatisticalSoftwarePackages (4:30-5:30 pm) RogerJ. Lewis,MD, PhD, Harbor-UCLA RobertL. Wears,MD , MS, Universityof Florida, lacksonville Sophisticatedand relatively easy-to-usestatisticalsoftwarepackages for personal computersare now available and reasonably priced.Thesepackagesallow investigatorsto perform virtually all statisticalanalysescommonlyreportedin the medicalliterature.In this session,the speakerswill compareseveralof the mostpopular packages,comparingtheir capability and easeof use, as well as showing actualproceduresand results.This sessionwilt give the informationnecessaryto make an informed decisionon the selection of a statisticalpackagefor your own use.

BXHIBITORS Aircast, Inc. 92 River Road Summit, NJ 07901

(800) 526-8785

as well as qualified physician assistantsand nurse practitioners.

EPAs practicesettingsrangefrom rural to urban,academicto community,andurgentcareto traumato suit a wide varietyof need.

Innovative orthopaedic devices that promote functional management.

American Academy (800)884-2236 of Emergency Medicine P.O.Box 1968 Santa Fe, NM 87504 TheAmericanAcademyof EmergencyMedicineis theprofessional, democraticorganizationfor the specialistin EmergencyMedicine.

(214)550-0911 Annals of Emergency Medicine P.O. Box 6199ll Dallas, TX 75261 Annals of EmergencyMedicine is the official journal of the American College of EmergencyPhysiciansand the specialty's leadingclinical and scientificjournal.Annalspublishesthe latest in research, clinicalstudies,casereports,andissuesin emergency medicine.Annalsstaff will be availableto answerquestionsand discussjournalpoliciesandprocedures.

(stD 4s2-7261 BRC Health Care 3705 North Lamar, Ste 207 Austin, TX 78705 BRC Health Care provides the "Total Solution" for emergency departmentautomation including patient tracking, triage, nurse charting,ordersand interventions, resultsreporting,chargecapture,physiciancharting,prescriptions, and dischargeinstructions.

Our advanced3-tierclient/server architecture usingUNIX, Oracle and Windows integrateseasily with other hospitalsystemsand providestremendousfl exibility.

(812\ 339-2235 Cook Critical Care 925 South Curry Pike P.O.Box 489 Bloomington,lN 47402 CookCriticalCarewill be displaying:Productsfor the DiffrcultAirway; EmergencyCricothyrotomyCatheterSets,RetrogradeIntubation Sets,Airway ExchangeCatheters,andIntraosseous Needles.

(201\740-241s Emergency Medical Systems,LP 651 W. Mt. PleasantAvenue Livingston, NJ 07039 EmergencyMedicalSystems,LP providesprofessionaltranscription services,electroniccha"rtingand information/patientmanagement systems,chartingcomponentutilizesover 175diagnosticbasedtemplatesto facilitateproduction.Realtime patienttrackingsystemprovides cliniciansand administratorswith the ability to producedischargenotes,prescriptions,triage notes,lab orders,statisticalQA reportsandthe overallmanagement of patientcareinformation.

Emergency MedicineResidents'Association (800) 798-1822 1125Exttutilc Cirtlr Irving, TX 75038 The EMRA booth will featuremembershipmaterialsandinformation about this exciting 4,000 member organizationfor residents and medicalstudentsinterestedin emersencvmedicine.

(609)848-3817 Emergency Physician Associates,P.A. 307 South EvergreenAve., Ste 201 Woodbury, NJ 08096 EmergencyPhysicianAssociated,P.A. is a multihospital,interstate grouppracticeof EmergencyMedicinephysiciansfoundedin 1978.

EPA providesmanagementservicesand staffs its client hospitals with experiencedEmergencyDepartmentDirectorsandphysicians,

(319)236-3858 Emergency Practice Associates P.O.Box 1260 Waterloo, IA 50704 physiEmergencyPracticeAssociates is a Midwestbasedemergency cian staffingorganization.

Foundedandoperatedby physicianssince 1914. We are cumentlystaffrngemergencydepartmentsin Iowa and Minnesota.Excellentdirectorandstaffpositionswith generous compensationpackagesavailablein a wide varietyoflocations.

(214)550-0911 EMF/ACEP TeachingFellowship 1L25Executive Circle Irving, TX 75038 The TeachingFellowshipProgramconsistsof two ten-daysessions.The first sessionin Octoberfocuseson curriculumdevelooment and instruction,teachingmethods,and evaluation. The second sessionin Junefocuseson academicsurvivalskills,aswell as administrationand management.For additionalinformation,stop by the EMF/ACEP TeachingFellowshipbooth.

(303)4s2-6800 Fischer Imaging Corporation 12300N. Grant Street Denver,CO 80241 FischerImaging,the oldestdomesticX-ray manufacturer, designs, produces,andmarketsX-ray imaging systemsfor radiology,mammography,and cardiology. Fischer's Digital Traumex provides unique capabilities,and performsall standardradiographicviews of both ambulatoryand traumatizedpatients.

(847)564-5400 FluoroScanImaging Systems.Inc. 650 B. Anthony Tlail Northbrook, IL 60062 FluoroScanis a world leaderin the designand manufactureof mini surgicalc-armfluoroscopicimagingsystems.FluoroScanis speciallydesignedfor extremity imaging in orthopaedicsand can be usedin the operatingroom, surgicenter,or in the office. The FluoroScanwith its superiorimage quality, incorporatesmany of the featuresof a standardc-arm.

(60D 494-4960 Glaxo Wellcome Inc. 11209N. Tatum Blvd., #120 Phoenix,AZ 85028 You are cordially invited to visit the Glaxo WellcomeInc, exhibit where our salesrepresentatives will be availableto answeryour questionsand discussthe latest clinical information on: Ceftin@, Imitrex@, Valtrexo,Zofran@, Iniection andZoftan' Tablets.

Iloechst Marion Roussel P.O.Box9627 Kansas City, MO 64134

(816)966-33Ur

(310)826-7800 International Medical Corps 12233West Olympic Blvd.o#280 Los Angeles,CA 90035 Recruitmentfor InternationalMedical Corps(IMC) which is a private, Nonsectarian,nonpolitical, nonprofit organization establishedin 1984by volunteerUnited Statesphysiciansand nurses.

Its missionis to savelives,relievesuffering,andimprovethe quality of life through health interventionsand related activities that build local caoacitvin areasworldwide.

t'(508)443-s000 Jonesand Bartlett Publishers, Inc. 40 Tall Pine Drive Sudbury,MA 01776 Publisherof a seriesof medical titles including "Case Studiesin Emergency Medicine" authoredby a group of dedicatedcontributorsandeditedby Edwardand Judith Bernstein.

(800)648-18sr Laerdal Medical Corporation 167Myers Corners Road WappingersFalls, NY 12590 The following will be displayed: Resusci'Anne Family of CPR Training Aids and Manikins, Heartstart@ Automated Extemal Defibrillators and Early Defibrillation Training System, ALS Trainers,Heartsim@ 2000 CardiacRhythm Simulatorsru,Airway productsincluding: Laerdal' Silicone Resuscitators, Management V-Vacrr',r ManualSuctionSystem,PocketMaskrla,First Responder Airway ManagementKitsrv, Spinal Motion Restrictionproducts including: Stifneck Extrication Collars, HeadBedru II CIDs, "Issuesin SpinalCare" Training Curriculum.

(216)6s0-6s06 Lexi-Comp, Inc. 1100Terex Road Hudson.OH 44236 Lexi-Compprovides clinical information in print and electronic formatsincluding pharmacology(pediatric, adult, and geriatric dosing),infectiousdiseases,poisoningand toxicology,and laboratory/diagnostic tests.The Clinical ReferenceLibrary on CD-ROM integrates ten datasets,Stedman'sMedical Dictionary,Drug Identification(with color images)and SymptomsAnalysis Module.

MICROMEDEX.Inc. 6200S.Syracuse Way,Ste.300 Englewood, CO 80111

(303)486-6400

TheMICROMEDEXHealthcareSeries,designedfor all healthcare professionals, providescomprehensive,peer-reviewedknowledge bases containingreferencedinformationon toxicology(clinical and industrial),drugtherapy,emergencymedicine,patientinstructions, anddosingprograms.Delivery methodoptionsinclude CD-ROM for PCs,LANs and tapesfor mainframeapplications.

Mosby,Williams-Wilkins 9693DesertPaintbrushCourt ParkenCO 80134

(303)841-8297

Ohmeda Pharmaceutical Products Division 110 Allen Road Liberty Corner, NJ 07938

(908)604:7614

(206)8674s69 Physio Control Corporation 11811WillowsRd NE Redmond. WA 98052 LIFEPAK 11@diagnosticcardiac monitor and LIFEPAK 11 defibrillator/pacemaker; LIFEPAK 9P. 10 defibrillator/monitor/ pacemakers;LIFEPAK 300 automatic advisory defibrillator; FIRSTMEDICTv 5 I 0, 7 10 semi-automaticdefibrillators,QUICKCOMBOTupacing/defibrillation/ECGelectrodesystem.

(203)869-244s Requa, Inc. I SenecaPlace P.O. Box 4008 Greenwich. CT 06830 CharcoAid2000 superActivatedCharcoalproducts.Clinical studies show two to four times more absorptionof drugs and significantly lower blood levelscomparedto other charcoalproducts.

(416)62G3233 Spectral DiagnosticsInc. 135-2 The West Mall Toronto. CANADA M9C 1C2 CardiacSTAIusrv CK-MB/I\4yoglobinTest Kit - simultaneous, qualitativeresultsfrom whole blood at the point of care. This easy to usepaneltestprovidesSTAI resultsin lessthan twenty minutes andis ideally suitedfor the emergencydepartmentor point of care situationswhere an early rule-out of myocardial infarction can expenditures. savelives and avoid unnecessary U.S.Army Medical Recruiting 14470F. Sixth Avenue Aurora, CO 80011

(303)360-9378

(203\866-1144 Weatherby Health Care 25 Van Zant Street Norwalk, CT 06855 WeatherbyHealth Care is the country's pre-eminentphysician searchfirm. We are the proud sponsorsof the WeatherbyHealth Care Resuscitation Fellowship at Henry Ford Hospital, SAEM/EMRA Leadership Forum and SAEM Best Education PresentationAward.

(317\ 631-1745

Purveyors of the finest in emergencymedicinetexts,journals, and multi-mediaproducts.

WildernessMedicalSociety P.O.Box2463 Indianapolis,IN 46206

NationalHighway Tlaffic (202)366-2727 SafetyAdministration NTS-22 4007th Street SW Washington,DC 20590 Publications andaudio-visualmaterialsdealingwith all aspectsof highwaysafetythroughthe processof injury control toward safe communities.

(800)348-9011 Zoll Medical Corporation 32 SecondAvenue Burlington, MA 01803 CardiacResuscitationequipmentwill be displayed.

The goal of theWildernessMedical Societyis to providea professionaland scientificforum for wildernessrelatedmedicalinterests and to encourageboth basic scienceand clinical researchthat will resultin the developmentof the scientificbasisfor the healthof the individual in the wildemesssettine.

POSITIONSAVAILABLE

NAIRT)ilX HOSPITAL

Classifiedads(100wordsor less)arepublishedat a chargeof $75 for SAEM members,$125 for non-membersper classifiedad, per issue.Quarterpageads are $250, plus a $25 typesettingfee if not Ads must be receivedby the 25th of the preceding camera-ready. month in which you would like it published.

Pediatric Emergency Medicine Fellowship Applicants The Pediatric Section of the Department of Emergency Medicine at Fairfax Hospital in conjunction with the George Washington Emergency Medicine Residency i.q recruiting applicants for a two-year fellowship in pediatric emergency medicine beginning in July 1997.

This fellowship is designed for physicians who have primary training in emergency medicine and who wish to receive additional training in pediatric emergency medicine and be eligible to sit for the subspecialty boards in pediatric emergency medicine.

In addition to training in the Pediatric Emergency Department, the fellow will experience rotations in basic pediatrics, pediatric intensive care, pediatric anesthesiology, neonatal intensive care, pediatric trauma, as well as in various other areas of pediatric emergency care as it relates to emergency medical services. There will be sufficient time and resources in the fellowship to pursue research interest.

Faculty appointments (to GW/GT)will be made available to the fellows. A commensurate salary and benefit package is being offered. Interested applicants should write to either Julian B, Orenstein, MD, FAAP or Ronald M. Salik, MD at Fairfax Hospital, Department of Emergency Medicine, 3300 Gallows Road, Falls Church , VA 22046, or call (703) 698-3195. The deadline for applications will be October 1, 1996'

FELLOWSHIP POSITIONS

l

Accepting applications for a FellowPENN STATE UNMRSITY: ship in prehospital care/EMS. Candidate will develop knowledge and competency in administrative, teaching, clinical and research. Includes ground and air services,dispatch, medical control, QA, special event medicine and disaster planning. Observe local, regional, and state policy development, administrative organization, and dynamic interactive relationships between providers. The cumiculum has been approved by the SAEM EMS Committee. Candidates should be board-certified/preparedin emergency medicine. Send CV to Steven A. Meador, MD, MPH, Hershey Medical Center, PO Box 850, Hershey,PA 17033-0850.We are anAA./EOE and encourageminority and female applicants to apply.

Pennsylvania State UniPENNSYLVANIA STATE UNMRSITY: versity Medical Toxicology available. Fellows will develop expertise through an establishedprogram that includes: Busy inpatient service, regional poison centeg toxicology referral clinic, weekly educational conf'erences,and animal/clinical research. For your health, Hershey Medical Center is a smoke-freecampus.Those interestedin careerdevelopmentvia toxicology pleasecontactKeith K. Burkhart,MD, Fellowship Director, Division of EmergencyMedicine, The Milton S. HersheyMedical Center,PO Box 850, HersheyPA 17033-0850.We are an affirmative action/equal opportunity employer and encourage minority and female applicants to apply.

OF CALIFORNIA' SAN DIEGO: The Division of UNMRSITY Medical Toxicology offers a 2-yearfellowship in Medical Toxicology beginning 711197.Fellowship fulfills guidelines establishedby the ACMT. Experienceincludes the San Diego Regional Poison Center, inpatient admitting and consult servicesat several area hospitals, outpatient referral clinic, and ongoing clinical and bench research.Hyperbaric medicine service also under Department of Emergency Medicine. Fellows will meet criteria necessaryfor eligibility for the ABEM subspecialtyboard examinationin toxicology. Interestedindividuals should contact Richard F. Clark, MD, Department of EmergencyMedicine, UCSD Medical Center,200 W Arbor Dr., #8676, San Diego, CA 92103-8676, or call 619-543-7341.

UNIVERSITY OF MASSACHUSETTS MEDICAL CENTER: FEIlowship in Prehospitaland DisasterMedicine. Two-year program offers clinical, research, and teaching. Disaster preparednessand planning, disastermanagement,drills and simulations,plus training with disaster respondersand DisasterMedical AssistanceTeam are included. Prehospital experiencewith UMASS EMS, a paramedicJevelambulanceservice. UMASS Life Flight, an airmedical transpolt service with physician-nursecrew, plus local and regional EMS servicesincludes medical direction, training/education,and total quality management.Opportunities for intemational experiencewith EMS and disastermanagementare available.UMMC is a tertiary care Level 1 Trauma Center,with a Bum Center,the only PICU in Central Massachusetts,plus an EM Residency.

Salarycommensuratewith PGY 415level.ContactLucy Gans,MD, Departmentof EmergencyMedicine, University of MassachusettsMedical Center 55 Lake AvenueNorth, Worcester,MA 01655-0228or call (508) 856-4101;(508) 856-6902FAx. UNIVERSITY OF MASSACHUSETTS MEDICAL CENTER: Fellowship in Medical Toxicology. Two-year training program offers clinical researchand teaching experience.Toxicology Service provides adult/pediatricin/out patient toxicology consultationsat Worcesterhospitals (150,000 combined ED visits) and is staffed by three ABMT/ ABEM diplomates. UMMC is a tertiary care Level I Trauma Center, Toxicology Treatment Center, Bum Center, Renal Dialysis Center, and has a ComprehensiveToxicology Laboratory and the only PICU in Central Massachusetts.Salary commensurate with PGY 4/5 level.

Contact Bob Ferm, MD, Dept. of Emergency Medicine, UMMC, 55 Lake Ave. North, Worcester,MA 01655-0228or call (508) 856-4101

or PlrrssuRcH UNrvrRslrv & CONTROIFORINIURYRESEARCH CENTER

INfURYCONTROLFELLOWSHIP The Universityof PittsburghDepartmentof EmergencyMedicine and the Center for Iniury Researchand Control are off e r i n ga F e l l o w s h i pi n I n j u r yC o n t r o l .C a n d i d a t e sf o r t h e F e l lowship should be residencytrained and board certified/elig i b l e i n E m e r g e n c yM e d i c i n e .T h e f o c u s o f t h e f e l l o w s h i pi s the development of expertisein injury control methods in, nd c l u d i n g s u r v e i l l a n c er,e s e a r c hi,n t e r v e n t i o n apl r o g r a m s a policy. Fellows develop these skills through coursework in the Craduate School of Public Health (leading to the MPH degree),and involvement in the ongoing programs of the Center for Injury Researchand Control (CIRCL). CIRCLwas established in 1992 and is an interdisciplinary program housed within the Department of EmergencyMedicine. In September1995 it become one of ten centersin the country to receiveofficial designationas an Injury Control Research Center by the US Centersfor DiseaseControl and Prevention. In addition to CIRCL, the Department of Emergency Medicine housesprogramsin Medical Toxicology,EMS,and H y p e r b a r i cM e d i c i n e . F e l l o w sw i l l a s s u m el i m i t e d c l i n i c a l responsibilitiesin the Universityof PittsburghMedical Center EmergencyDepartmentand affiliatedinstitutions.An appointment of Instructorof EmergencyMedicine with University benefitsand CME allowance is provided.Contact Jeffrey H. Coben, MD, Director, Center for Injury Researchand

PA15213.

Control,230McKeePlace,Suite400,Pittsburgh, The University o{ Pittsburgh is an A{iirmative Action, Equa\ Opportunity Employer.

44

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FACULTYPOSITIONS BASSETT HEALTHCARE, COOPERSTOWN, NY: The Departmentof Emergencyand Trauma Servicesat BassettHealthcare,a 200bed Columbia University affiliated teaching hospital in a predominately rural region of upstate New York, has an opening for an emergencyphysician.The new state-of-the-artED facility has a volume of 15,800visits/year with 26Voadmission rate. Full departmentalstatus.

BE/BC, EM, FP,IM preferred. Bassettoffers a rich aiademic environment, excellent medical staff, and competitive salary/benefits in a beautifullakesidevillage. Contact: August Leinhart, MD, Chief, Departmentof Emergencyand Trauma Services,BassettHealthcare,One Atwell Road,Cooperstown,NY 13326. 6071547-3981 MARYLAND, HAGERSTOWN: SeekingAssistantMedical Director for this family-oriented community surroundedby the Allegheny and Blue RidgeMountains.Hospital servesas a regional trauma center with 50,000volume, triple physician coverage and full specialty back-up.

Qualifiedcandidateneedsto be BC/BP EM with aptitudefor EMS. Excellentcompensationand benefit package. Contact: Jennifer Hymes, EMSA, 1-800-422-3672, extension7260,or fax to (305) 424-3270.

MICHIGAN STATE UNIYERSITY-Saginaw Campus: Director of Researchsought for expanding community-based Emergency MedicineProgram.Responsiblefor teaching/supervisingresidentsand medical students,research,and clinical patient care.Application for EmergencyMedicine Residencyis pending. Family-oriented community offers wide-ranging entertainment and educational activities. Competitive remunerations,excellent benefits package and protected time fbr research.

For further information, contact Robert Wolford, MD, Director, Dept. of Emergency Medicine, Saginaw Cooperative Hospitals, Inc., 1000HoughtonAve., Saginaw,MI 48602 or call (517) 771-6817.

NEW ENGLAND MEDICAL CENTER: Board-Certified/BoardPreparedemergencyphysician faculty opportunity (full/part-time) for academicDepartmentof Emergency Medicine at New England Medical Center,Medicine.Housestaffsupervision,teaching,and administrativeresponsibilities, with excellentresearchopportunities.Application for Emergency Medicine Residency in process. New facility openedJuly l 995 with fast track, acute care, observationand pediatric emergencyservicesincluded.Academic appointmentwithin the Departmentof Emergency Medicine at TUSM. Competitive salary and benefits.Contact Charlotte S. Yeh, MD, FACEP, Physician-in-Chief, Departmentof Emergency Medicine, New England Medical Center, 750 WashingtonStreet,NEMC Box 311, Boston,MA 02111,Tel: (611)636-4720or FAX: (617) 636-4723.

NEWARK BETH ISRAEL MEDICAL CENTER: Due to the recent expansionof our Emergency Medicine Residency Program, we arerecruiting qualified candidatesto join our young, progressivefaculty, effective immediately. NBIMC is a large tertiary-care major teachingmedical center with numerous residenciesand fellowships in all major specialties.The Emergency Department is closely affiliated with the NJ Poison Center and with the New Jersey Institute for Medical Researchfor Emergency Medicine. The positions available inclucethoseof ResearchDirector, Associate ResearchDirector, Asst.

ResidencyDirector, as well as junior and senior faculty positions.

Multiple administrativeand researchpossibilities exist. Compensation is highly competitivewith incentive bonus plan. Pleaseforward a copy of your CV to NBIMC, Dept. of Emergency Medicine, Attn: Dr. JosephCalabro,201 Lyons Ave., Newark, NJ 071 12. (201) 926-2620.

RESURRECTION-MICHAEL REESE, Integrated Emergency Medicine Residency Program, Chicago: was approved on January 16,1996and is scheduledto begin July, 1996. Michael Reeseis expandingtheir faculty and seeking qualified candidatesto help develop the new program.Physiciansmust be BC/EM and practice experience in an academic environment. Excellent comoensation and benefits package,including paid liability insurance. Contact: Dr. Thomas Kirsch in care of Jennifer Hymes, l-800-422-3672, ext.7260 or fax your CV to (305) 424-3270. EOE/AA/M/F

@

Cook County Hospital Chicago,Illinois Director, Research Division. Experienced investigator with track record of publications and/or extramural funding to direct research division of major public hospital. The research division has seven full-time faculty, including a PhD co-director, grants/datacoordinator and nurse epidemiologist. Major division research interests include cost/medical effectiveness of diagnostic/treatmentprotocols for asthma,chest pain, diabetes, tuberculosis, primary needs assessments,and violence detection/prevention. The Department of Emergency Medicine has 26 full-time faculty, a residency program with 54 residents, 170,000 visits for adult/pediatrics, and a separate l2-bed Observation Unit. The department is affiliated with Rush University Medical College. The candidate must be emergencymedicine BC/BE, have sufficient academic credentials to qualify at the rank of associateprofessor, and capable of providing academic/administrativeleadership to the Division.

Send CV to Robert Simon, MD, Chairman and Professor,Department of EmergencyMedicine, 10th F1oor,1900W. Polk St., Chicago,ll 60612.

Cook County Hospital, Chicago, Illinois is an Equal Opportun, ity/Affirmative Action Employer. Women and minorities are encouragedto apply.

0ssistonUflssociot@ Profossorlnstructor

Thc Univcrsitg of TexosHeolth ScienccCcnterot Sonflntonio, Deoortmentof Suroeru.Divisionof €m'crgencg Mccficific s'sl.oltr,g F u l l - t i mj uan r o rc r n ds @ n i ot ro c u l t gt o l o i n t h a nr.l .n oF arar|>.rnirallt , , , ! v , , ,t yarie,olrz.el €mrz,rorz -, ,-, :/-nCV

phgsicicrns A/ladicino to stcrfftha UnivorsitrT (antor.Ihe 552-tced Hospitcrl €margoncq hosoifolhos o larral I Trcrumcr Contorcrndts the primcrrg tocrching hospitcrlFortho Universitu oFTaxosHocrlth ScioncoContarcrt Son llntonio.DutiosIn( ude duocrprovision oFmacjiccrl oFoofrenfcoraoncjsrrnan/ision studantsand rosidon[stromvorioussp@ciolfias Comrlansot-ion crndcrccrdemic rcrnk bosad on orioliticottons.

Proforrad condr€morgancg dcr[osuuillbo Madicinarcidoncl troinad,bocrrdc@rtifi@d or aroaar@d.

Send curriculurn vito@[o ChorlasB. Bcruor, MD, MediccrlDiractor, Univarsitu Hosoitcrl (morgoncrlConlor,4502 M\ediccrl Driva,Scrn Fntonio,IX 1 8229-4493, fobphono: (2 I 0) 6 ) 6 2 0 1 8 ,F l l X :( 2 1 0 )6 16 1 9 1 2 The UTHSCSFs on oquol omploqment opporLu^rq/crrf,ncrivo crclon onploqar.

STATE UNMRSITY OF NEW YORK AT BROOKLYN: New York City - FacultyPosition- seekingEmergencyMedicineResidencyTrainedor BoardCertifiedfacultyfor our fully accredited emergencymedicineresidency.

24-30hours/weekof clinicalresponsibility, mostof it at Kings CountyHospital,oneof thebusiesttraumacenters in the country.We supportboth clinical and animalresearch.

We are affiliatedwith an accredited pediatricemergency medicinefellowship.

ContactRonaldLow, MD (719)245-2974,fax CV to (718) 245-4799 or sende-mailto Low@medlib.hscbklvn.edu UNMRSITY OF SOUTHALABAMA: Department of Emergency Medicineseekingphysiciansresidencytrainedor boardcertifiedin EmergencyMedicine.50,000patientsin USA Hospitalsystem.Subspecialtybackupall disciplines.USAMC is a 400-bedLevelI Trauma Centerwith helicopterprogram.Mobile is locatedon the Gulf Coast with warmclimate,outstanding beaches, andlow costof living. USA hascommittedto thedevelopment of EmergencyMedicineResidency Program.Clinical researchopportunities.Compensation and fringe benefitsarecompetitive.ContactFrankS.Pettyjohn,MD, Department of Emergency Medicine,Universityof SouthAlabama,245lFillingim St.,Mobile,AL 366170r call (205) 470-1649.

NORTH SHORE HEALTH

SYSTEM EMERGENCY

MEDICINE North ShoreUniversity Hospital at Manhasset,a 700plus bed tertiary care teaching hospital and its affiliated community teachinghospitalsseeksboard prepared/certified,residency trained careerEmergencyPhysiciansto augmentits staff. We have a new residencyprogram in EmergencyMedicine at the Manhasset sitewhich startedJuly 1.,1995andasa resultwe are seekingfaculty with interestin academicand scholarlyactivity.

A wide rangeof clinical,teachingand researchopportunitiesaie available.Thedevelopment of our affiliatedEmergency Departmentshascreatedan opportunityfor joint positionsamonginstitutions.Severalpositionsareavailableat this time.

Wehaveparticularinterestin academic facultywith Emergency MedicineBoardCertificationandadditionalfellowshiptraining in PediahicEmergency Medicineor Toxicology.

Excellentsalary in association with an outstandingbenefitpackagewith potential for growth.

Pleaseforwardresumesand inquiriesto Andrew Sama,MD, Chairman Departmentof EmergencyMedicine North ShoreUniversiWHospital 300CommunityDrive,ManhassetNY 11030 (516)562-3090 Phone o (516)562-3580 FAX

UNIVERSITY OF TEXAS SOUTHWESTERNMEDICAL CENTERAT DALLAS: Uniqueacademicopportuniryin emergency medicine. EM faculty will haveopportunityto be involvedin the establishmentof a first rateEM divisioncommittedto excellence in patient care,education,andclinical research,Openingsarefor full-time and part-time BC/BP faculty for the University of Texas Affiliated EmergencyMedicine Training program comprised of Parkland Hospitaland Children'sMedicalCenter.THE UNIVERSITYIS AN EQUAL OPPORTUNITYEMPLOYER.Pleaserespondin full confidenceto JamesE. Hayes,MD, Chairman,Division of Emergency Medicine,UT Southwestern Medical Centerat Dallas,5323 Hany (214) 648-3916.

HinesBlvd., Dallas,TX 75335-8579,

NEWYORKMEDICALCOTLEGE

YORK HEALTH SYSTEM: RegionalpatientcareandmedicaleducationresourceseeksDirectorEM Educationfor 588-bedtertiarycenter, serves400,000south-central Pennsylvanians.

Sevenfully-accredited programs,108residents(EM=10/10/10).

University-quality educationcomplexatYorkplus full medicalschoolintegrationwith Penn State- Hershey.ED=10,000-sq. ft., 42-bed,54,000visits (20qo peds),computerizedtracking, 13 FT EM-boardedfaculty,Level II traumacenter.Scholarlyactivity stressed.

Get detailshereat Denver meetingfrom Ron Benenson,MD, or from our representative, Bill Gregory MedQuest,Inc., MAIL=PO Box MQ, Devault,PA 194320160; FAX=6101640-4392; E-MAIL=72253.2751@compuserve.com; CALL (800)220-6331(9am-9pmEast).

EMERGENCY MEDICINE PHYSICIANS ACADEMIClRESEARCH/AD MINISTRATIVE Fully accredited academic Department ofEmergency Medicine atNew York qualified Medical College isseeking BC/BP EMphysicians tojoinenergetic, lulllime faculty in anEmergency Medicine Residency pr0gram Training andPediatric Emergency Medicine Fellowship, Conveniently located in NewYorkCily,Lincoln Hospital intheBronx, offers lacultyappoinlmenl andprovides a competitirle salary, faculty practice, package andbenefits intheworlds most exciting city.

Individuals withastrong interest inteaching, research, 0radministrati0n areurged to apply.

Responsibilities include supervision 0f Emergency Medicine Residents, Physician Assistants andMedical Students, inadditiontotheprovision 0ldirect care.

Protected timeisprovided lorteachpositrons ingandresearch, Leadership areavailable.

Lincoln Medical Center is a LevelI Trauma Center andhasover 160,000 EDvisits ayear These opportunities willallow therightcandidates anopportunity forpergrowth sonal inanacademic department whilebeing affiliated witha res0ected medical school. yourCurriculum Please positi0n send Vitae, indicating 0linterest, to: Harold H.Osbom, MD,FACER FACE ACMT Ghairman, Depanment 0l Emetgency Medicine (718)579-48S5 Telephone: (718)575-4822 FAX: NEWYORKMEDICAI.COLIEGE LINCOTNMEDICATAND MENTATHEALTH CENTER R00M1-81. 234EAST 149TH STREET BRONX, NEW YORK 10459 AIIEOUAL OPPORTUIIIIY EMPLOYEN

46

EMERGENCY MEDICINEPHYSICIANS Academic/Clinical/Administ rative MedicalCollegeof Virginia/VC0 Hospitals

7N Newly established academic Department of Emergency Medicine at Medical College ofVirginia is seeking highly qualified and results-oriented BC/BP EM Physicians ro join the full-time faculty.

In addition to staff positions we are looking for the following: Researcb Direcktr Medical Educatictn Director Prebospital Medical Director Hmergency Medicine Neurolctgist The Department has a special recruitment eflbrt to attract emergency physicians with additi<lnal training,/experience in neurology and/<>rinfectious clisease.

MCV Hospital is a distinguished 81l-bed, Level I Trauma Center with over 100,000 visits per yeagand is a regional coronary,critical care,pediatrics, and toxicology center. The Emergency Department has a renewed commitment to the highest quality of patient care and teaching environment.The ED faculty positions offer unusually attractive career opportunities in an academicenvironment of patient care,teaching,research,and aclministration.

All positions carry appointment to the faculty at the Meclical College of Virginia ancl provide a highly competitive salary and benefits package.

For consideration for these opportunities, senclyour current curriculum vitae indicating the position of interest to:J. Douglas'White,MD, MPH, FACEP;Officeof the Chair,Department of EmergencyMedicine;Medical College of Virginia/VCU Hospitals;4Ol North 12th Street; Richmond,vA23298-0510 or call Martha Elle or'ftrnyvianna at t-8oo-424-37554.

Dr. White will be discussing this exciting re-engineering Meeting in Denver on May 6, t996 at 4;45 p.n.

proiect at the SAAM Annual

Medical College of Virg iniaN Cu Hospitals 401 North l2th Street,Richmond,VA23298-O5lO

7N MCV/VCU is an EEO/AA employer worten, minorities, and persons with disabilities a.re encouraged to apply.

41

Medicine Chiefof Emeryency MedicalCenter St Paul-Itamsey HealthPartners,one of the largest healthcareorganizations in Minnesota with over 600,000members,is currently seekinga Chief of EmergencyMedicine for the St. Paul-RamseyMedical Center.Our newly remodeledstate-of-the-art,30 room - 15,000sq. ft. EmergencyDepartment has an annual censusof 56,000 and an 1,8Voadmission rate. St. Paul-RamseyMedical Center is a Level I trauma center, a Level I burn center, a regional poison center and serves as medical control for urban, suburbanand rural EMS systems.

Your role will be to provide physician leadership and direction in the development and delivery of comprehensiveemergencymedicineservices.You will also provide leadership in expanding operations to serve the community and overseeour EmergencyMedicineresidencyand researchprogram.You should be trained and board certified in emergencymedicine.

Knowledge and experience in a managed care environment and strong communication skills are required. Your careerand clinical experienceshould demonstrateboth leadershipand managementskills. A commitment to teaching and research,and eligibility for academicappointment to the faculty of the University of Minnesota is required. Experienceworking in a Level I trauma facility is preferred.

HealthPartners offers a competitive salary and comprehensive benefits package.For consideration,pleasesend your CV to: HealthPartnersRamsey, Physician Services,Attn: Sandy Lachman, 640 ]ackson Street, St. Paul, MN You may fax your CV to 55101.Or for more information call (672)221'-1'840.

(612)221.-8571,.8O/ AA Employer.

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HealthPartners St.Paul-RamseyMedical Center

NORT}I SHORE HEALT1I SYSTEM

NonrH SuonEUNrveRsrryHosprr ] @ C O M M U N I T Y D R I V E , M A N H A S S F I N E W Y O R KI I O . l O .

Eunncnxcy Mnorcrwn RnsnencHDrnncton North Shore University Hospital at Manhasset is a voluntary, not-for-profit tefti^ry care, 700-bed academic medical center affliated with New York University School of Medicine. It is located in a beautiful suburban setting on Long Island less than 15 miles from midtown Manhattan.\fith a newly accredited Emergency Medicine residency program we are seeking a Research Director with special interest and accomplishment in clinical and/or basic science research and other academic and scholady activities.We would welcome applicants who are board eligible/certified Emergency Medicine Physicians with additional expertise in a scientific fleld of interest. A wide range of clinical and basic science research resollrces and opportunities are available.Our research program is active and diverse and would be enhanced by an individual with exceptional leadership, motivational and development skills, MD, MD/PhD or PhD candidates would be considered.

Excellent salary in association with an outstanding benefit package arc available with potential for growth.

Pleaseforward resumes and inquiries to Andrew E. Sama,MD, Chairman Department of Emergency Medicine North Shore University Hospital 300 Community Drive, Manhasset,NY 11030 (515> 562-3090 Phone (5t6) 562-3680 FAX

Departmentof EmergencyMedicine Open Rank: The University of Cincinnati Department of EmergencyMedicinehas a full-time academic position available with research,teaching, and patient care responsibilities.Significant researchexperiencein cardiovascular, neurovascular, or toxicologic emergencies preferred. Candidate must be residencytrained in emergencymedicine with board certification/preparation.Salary, rank, and track commensurate with accomplishments and experience.

The Universityof CincinnatiDepartmentof EmergencyMedicineestablishedthe first residencytraining programin EmergencyMedicinein 1970.The Center for Emergency Care evaluates and treats 66,000 patientsper year and has 40 residentsinvolvedin a 4-yearcurriculum.Our departmenthas a long history of academic productivity,with outstandinginstitutionalsupport.

Pleasesend Curriculum Vitae to W Brian Gibler, MD, Chairman of EmergencyMedicine,University of CincinnatiMedicalCenter,231 BethesdaAvenue, Cincinnati,OH 45267-0769.

Missouri, St. Louis: Barnes-JewishHospital at WashingtonUniversity has careeropportunitiesfor energeticindividuals. Two full-time faculty positions BCIBP individuals are for qualified EmergencyMedicine Residency-trained being offered. An applicationhas been submittedfor an emergencymedicine residencyprogram to begin in July 1,997.We are curently seekingan experiencedindividual to becomea ResearchDirector. We are also seekinga full time junior faculty physician to completeour compliment of core faculty.

We are a lcvel 1 ffauma centerwittr over 60,000 annual visits and a busy EMS-basestation.Theseare excellentcareerofferingswhich include clinical, teaching,and researchopportunities.A competitivesalarywith a comprehensive benefitspackageis offered,as well as optionsfor tenure/clinicalffact university appointment.ContactLarry Lewis, M.D., Chiel EmergencyMedicine Division, WashingtonUniversity Schoolof Medicine,660 S. EuclidAve., Box 8072,St. Louis,MO. 63110;31413624362,Fax 314-362-2495or contactthroughthe messageboard at the conference.E-mail: llewi s@imgate.wustl.edu.

NOTES

50

This abstract will be presentedduring the May 8 postersession,following poster396.

467 ReducedQuality of In-Vitro ClotFormation with Gelatin BasedPlasmaSubstitutes SN Mardel, FM Saunders, U Allen et al, North StaffordshireTrauma Centre, Stoke On Trent, United Kingdom We investigatedthe propertiesof blood clot formed invitro when fresh blood was diluted with gelatin based colloid solutionscomparedwith crystalloidcontrolsover a wide range of dilutions. Both of the colloid solutions tested were found to produce clots that had reduced weight and reducedshearmodulus (using thromboelastography) compared with controls. These differences were statisticallysignificant(p<0.01for 47osuccinylated gelatin ("Gelofusine") and p<0.001 for 3.5Vopolygeline ("Haemaccel").No changeswere found in the haematological compositionofthese clots suggestingthat the gelative based colloid solutions may alter their physical structure.This theory is supportedby finding normal consumptionof fibrinogen with no evidenceof fibrin degradation.Scanningelectronmicroscopyshowedthat fibrin formed a lessextensivemeshin the presenceof the gelatinbasedcolloids.

Conventionalscreeningof coagulationtimes only detect changesup to the formation of a coagulum,and do not assessclot quality.While many workershavedocumented reductionin clot quality with the variousdextranand hydroxy ethyl starchinfusions,we havefound no similar studieson gelatin basedcolloids. Further work is being conductedto ascertainif this occurs in-vivo as these solutionsare frequentlyusedin patientswho requirefull haemogaticcompetence.

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