SAEM 2005 Annual Meeting Program

2005 Annual Meeting May 22-25

New York City

Society for Academic Emergency Medicine

Attendees are urged to complete the general Annual Meeting evaluation form, as well as the individual evaluations that are available at each didactic session. Completed evaluation forms should be returned to the SAEM Registration Desk before leaving New York City.

Feedback is critical to the development of future Annual Meetings.

Index Daily Schedules _________________________________________________________ Page 4 Sunday, May 22 Papers/Posters/Didactics __________________________________Page 11 Monday, May 23 Papers/Posters/Didactics __________________________________Page 15 Tuesday, May 24 Papers/Posters/Didactics __________________________________Page 20 Wednesday, May 25 Papers/Posters/Didactics _______________________________Page 25 2005-06 Committee and Task Force Objectives ______________________________Page 44 AEM Consensus Conference _____________________________________________Page 38 Annual Business Meeting ________________________________________________Page 56 Chief Resident Forum ___________________________________________________Page 37 Didactic Session Speakers _______________________________________________Page 42 Innovations in Emergency Medicine Education Exhibits _______________________Page 29 Interest Group Meeting agendas __________________________________________Page 34 Medical Student Symposium ______________________________________________ Page 3 Officer Meetings ________________________________________________________Page 43 Pre-Day (May 21) Activities________________________________________________ Page 2 Photography Display Contributors _________________________________________Page 40 Potential Conflict of Interest Disclosure _____________________________________Page 40 Positions Available Advertisements ________________________________________Page 47 SAEM 2006 Research Grants _____________________________________________Page 33 2006 Call for Didactics __________________________________________________Page 36 2006 Call for Abstracts __________________________________________________Page 28

2005 Annual Meeting Program Committee Brigitte Baumann, MD Andra Blomkalns, MD Richelle Cooper, MD Elizabeth Datner, MD Christopher Decker, MD Deborah Diercks, MD Gregory Garra, DO Robert Gerhardt, MD

Lowell Gerson, PhD Judd Hollander, MD, Debra Houry, MD, MPH John Kelly, DO Terry Kowalenko, MD O. John Ma, MD Craig Newgard, MD Susan Promes, MD

Timothy Reeder, MD Kevin Rodgers, MD Latha Stead, MD Michael Tuturro, MD Terry Vanden Hoek, MD Gary Vilke, MD Mildred Willy, MD

General Information The SAEM Annual Meeting is the largest forum for the presentation of original research in emergency medicine. Over 1,800 emergency physicians are expected to attend. The Annual Meeting will include 502 original research presentations, 20 Innovations in Emergency Medicine (IEME) Exhibits, 33 didactic sessions, the Chief Resident Forum, and the Medical Student Symposium. The oral papers consist of 10 minute presentations followed by 5 minutes for questions and answers. Selected oral paper sessions will include additional time for discussions. The posters are scheduled in 2-hour sessions each day. Most posters will focus on one-on-one discussion between the presenters and the attendees. However, each day two (three on May 22) moderated poster sessions will be assigned to one-hour discussion sessions within the two-hour poster sessions. The moderators will focus discussion on furthering the research in the topic. The IEME Exhibits will be held during the poster sessions with the first group scheduled for May 22 and 23 and the second session on May 24 and 25.

All presented research must be approved by Institutional Review Boards for Human Studies or Animal Care Committees and is so certified by authors upon abstract submission. The abstracts were published in a supplement to the May 2005 issue of Academic Emergency Medicine, the official journal of SAEM. All speakers at the 2005 Annual Meeting have been independently selected by the SAEM Program Committee. All speakers are required to disclose any real or apparent conflict of interest that may be related to the content of their presentation(s). The existence of commercial or financial interests of speakers related to the subject matter of their presentation should not be construed as implying bias or decreasing the value of the presentation(s). However, disclosure should provide information to participants to form their own judgments. A list of disclosed potential conflicts of interest is published in this Program.

The Annual Meeting is always a popular meeting for renewing old acquaintances and making new ones. While sessions are in progress, as a courtesy to the speakers and attendees, please limit conversation to the hallways. Please turn off cell phones while in meeting rooms. Consider bringing a jacket or sweater to sessions since it is often difficult to control the temperature in meeting rooms.

Registration Attendees must register at the SAEM Registration Desk to obtain name badges, which are required for admission into all Annual Meeting sessions. Registrants for limited enrollment sessions (such as lunch sessions and workshops) should arrive a few minutes early to check in. Because of the popularity of such sessions, on-site registration will not be possible if a session has been sold out in advance.

The SAEM Registration Desk will be located on the second floor promenade (outside the Exhibit Hall) and will be open from 7:00 am-7:00 pm on May 21, 22, and 23; from 7:00 am-4:00 pm on May 24 and from 7:00 am-1:00 pm on May 25. An express check-in will be available for those registrants who were mailed a card indicating they had pre-registered and that their registration was complete.

It is the policy of SAEM to comply with the Americans with Disabilities Act. If special arrangements are necessary, please contact the SAEM staff.

Continuing Medical Education The 2005 Annual Meeting has been planned and implemented in accordance with the Essentials Areas and Policies of the Accreditation Council for continuing Medical Education (ACCME) through the joint sponsorship of SAEM and Michigan State University, College of Human Medicine. Michigan State University, College of Human Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Michigan State University, College of Human Medicine designates this educational activity for a maximum of 32 hours

in category 1 credit towards the AMA Physician’s Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity.

Michigan State University, College of Human Medicine designates the CPC Competition and the AEM Consensus Conference for a maximum of 6 hours each in category 1 credit towards the AMA Physician’s Recognition Award.

Annual Business Meeting The Annual Business Meeting will be held on Monday, May 23 from 3:004:00 pm in the Trianon Ballroom on the third floor. The election results will be announced, as well as the results of the membership’s ballot regarding the Constitution and Bylaws amendment. Bill Barsan, MD, and Roger Lewis, MD, PhD, will address the membership as the recipients of the Leadership and Hal Jayne Academic Excellence Awards. In addition, the Young Investigator Award recipients, the recipients of the grants, and the 2004 Annual Meeting Best Presentation Awards will be presented to the membership. A complete agenda is published on pages 56-57.

Photography Exhibit and Visual Diagnosis Contest There were 116 cases and photos submitted to the Program Committee for consideration of presentation at the Annual Meeting. Selected photos and cases will be displayed in two formats.

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Medical students and residents are invited to participate in the Visual Diagnosis Contest. Score sheets may be obtained from the SAEM Registration Desk. Winners in both medical student and resident categories will be awarded a one-year membership in SAEM, including a subscription to Academic Emergency Medicine, a free registration to attend the 2006 SAEM Annual Meeting in San Francisco, a major Emergency Medicine textbook, a subscription to the SAEM Newsletter, and a SAEM coffee mug. Recipients will be announced in the July/August issue of the SAEM Newsletter.

“Clinical Pearls” photos are displayed for the benefit of all attendees. These photos include a case history, as well as the diagnosis and “take home” points. SAEM is proud to display original photos of educational value and gratefully acknowledges the efforts of the individuals who submited photos for consideration (see p. 42).

Banquet and Opening Reception The SAEM Banquet will be held on the evening of Tuesday, May 24 on the Circle Line Cruise around Manhattan. All tickets are $80 and must be purchased by May 7. No refunds can be made after May 7 as SAEM is required to provide a meal count in advance of the event.

SAEM will host an Opening Reception on Sunday, May 22 from 6:00-7:00 pm in the Grand Ballroom. All Annual Meeting registrants are invited to attend at no charge. Hors d’oeuvres will be served and a cash bar will be available.

CPC Competition

Research Fund Donor Reception

The Semi-Final CPC Competition will be held on Saturday, May 21 (the day before the Annual Meeting) from 8:30 am until 5:00 pm. Annual Meeting attendees are encouraged to attend. There is no registration fee to attend the Competition, which showcases emergency medicine residency programs. The CPC consists of the presentation and discussion of the best 60 cases submitted from 77 submissions. The CPC Competition semi-finalists will be announced during a reception held from 5:30-7:00 pm. The CPC Competition is sponsored by ACEP, CORD, EMRA, and SAEM. The CPC Final Competition, consisting of the 6 semi-finalists, will be held during the ACEP Scientific Assembly, which will also be held in Washington, DC in the fall of 2005.

SAEM wants to acknowledge and thank donors to the Research Fund at a special reception at the Annual Meeting. This year the reception will feature a speaker and report on the Fund. Dr. Brian Zink will provide a brief session of the history of academic emergency medicine entitled, “The Strange and Strenous History of Academic Emergency Medicine.” The reception will be on May 23 at 5:00-6:00 pm in the Rotunda Room.

Academic Emergency Medicine Academic Emergency Medicine, the official journal of SAEM, is conducting a consensus conference on the topic of Ethical Conduct of Resuscitation Research on Saturday, May 21 from 8:00 am until 5:00 pm in Concourse A. The keynote speaker is Glenn McGee, PhD. Additional details are published on p. 38-39. Registration is open to all Annual Meeting attendees for $50, which includes lunch.

An AEM Reviewers’ Workshop will be held on Monday, May 23 from noon-1:30 pm in Sutton Center. This session is designed for current AEM reviewers and lunch will be provided. All AEM reviewers are invited but must have registered in advance.

The AEM Editorial Board will meet on Monday, May 23 from 5:00-7:00 pm. All Editorial Board members are urged to attend. The AEM Associate Editors will meet on Tuesday, May 24 from 7:30-9:00 am in the Madison Room. Breakfast will be provided. The AEM Statistical Reviewers will meet on Monday, May 23 at 7:008:00 am in the Harlem Suite. Breakfast will be provided.

AACEM The Association of Academic Chairs of Emergency Medicine (AACEM) will meet Saturday, May 21 from 8:00 am-12:00 noon. The AACEM Annual Business Meeting will be held on Saturday, May 21 from 12:00-1:30 pm. The New and Future Chairs Workshop will be held at 1:305:00 pm. AACEM members are invited to attend.

Scientific Award Candidates An asterisk (*) next to the abstract number denotes a project being considered as a finalist for an SAEM Scientific Award. Awards will be given in the categories of Faculty (Clinical Science and Basic Science), Young Investigator, Fellow, Resident, and Medical Students.

Award selection process: Authors indicated on the abstract submission form whether they wished to be considered for an award. The Program Committee selected award candidates from this group, based on reviewers’ scores and study impact. Candidates were asked to submit a full manuscript by April 30 for review by the awards subcommittee. All finalists submitted a manuscript by April 30 are listed with an asterisk. Final award decisions will be based on both the submitted manuscript and the presentation. Announcements regarding the award recipients will be published in the July/August Newsletter.

CORD The Council of Emergency Medicine Residency Directors (CORD) will meet on Monday, May 23 from 8:00 am-12:00 noon in the Sutton South/Regent Room.

The program will include reports, elections, and award presentations. All CORD members are invited to attend. The CORD Board of Directors, CORD Board/ Past Presidents Lunch, and CORD committees will also meet during the Annual Meeting.

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May 21 Schedule of Events 7:00-8:00 am CPC Committee Breakfast 8:00 am-5:00 pm AEM Consensus Conference: Ethical Conduct of Resuscitation Research, Concourse A 8:00 am-12:00 pm AACEM Meeting, Sutton South 8:30 am-5:00 pm CPC Semi-Final Competitions, Madison, Clinton, Gibson, Nassau A, and Nassau B 9:00 am-4:45 pm Medical Student Symposium, Beekman Parlor/Sutton North 9:45-11:15 am AEM Consensus Conference Breakouts, Concourse B, C, D, E 12:00-1:30 pm AEM Consensus Conference Keynote Speaker/Lunch (registrants only), Concourse G 12:00-1:30 pm AACEM Annual Business Meeting/Lunch (members only), Regent 12:30-2:00 pm Medical Student Symposium Lunch, Sutton Center 1:00-4:00 pm SAEM Board of Directors, Hudson Suite 1:30-3:00 pm AEM Consensus Conference Breakouts, Concourse B, C, D, E 1:30-5:00 pm AACEM New and Future Chairs Workshop, Sutton South 2:00-6:00 pm EMRA Board of Directors, Concourse H 3:45-4:45 pm Medical Student Breakout Sessions, Concourse B, C, D, E 4:30-6:30 pm SAEM Board and Committee/Task Force Orientation, New York Suite 5:00-6:00 pm SAEM Ethics Interest Group, Hudson Suite 5:00-6:30 pm Residency Fair, Americas Hall 1 5:00-6:30 pm EMNet Steering Committee, Concourse F 5:30-7:00 pm CPC Reception, East and West Ballroom 6:00-8:00 pm SAEM 2005 Program Committee, Lincoln Suite

Medical Student Symposium May 21 Beekman/Sutton North (2nd floor) The Medical Student Symposium is intended to help medical students understand the residency and career options that exist in Emergency Medicine, evaluate residency programs, explore research opportunities, and select the right residency.

At the completion of the session, participants will: 1) know the characteristics of good emergency physicians and the “right” reasons to seek a career in this specialty, 2) have a better understanding of the application process with regard to letters of recommendation, personal statement, planning the 4th year, etc., 3) consider factors important in determining the appropriate residency, including geographic locations, patient demographics, length of training, etc., 4) understand the composition of an emergency medicine rotation and what to expect while they are rotating in the ED, 5) discuss the skills needed to get the most out of your educational experience in the ED rotation, 6) Identify the standard sources of information in the field of emergency medicine, 7) have an appreciation of various career paths available in Emergency Medicine, including academics, private practice, and fellowship training, and 8) discover current areas of research in Emergency Medicine.

9:00-9:15 9:15-10:00

10:00-10:30

10:45-11:30

11:30-12:15

12:30-2:00 2:00-2:45

2:45-3:30

3:45-4:45

5:00-6:30

Welcome and Introduction, Kevin Rodgers, MD, Indiana University How to Select the Right Residency for You, Cherri Hobgood, MD, University of North Carolina An overview of EM residency programs will be discussed. Important factors to consider in the selection process including length of training, geographical location, patient demographics, and academic vs. clinical setting will be reviewed. The speaker will also discuss the difference between allopathic and osteopathic programs.

Getting Good Advice, Jamie Collings, MD, Northwestern University One of the keys to any successful career is getting and following good advice. How do you choose the right advisor(s) and use their wisdom to help you succeed? What do you do when your medical school doesn’t have an EM Residency Program? What resources are available to you about the various programs?

Navigating the Residency Application Process, Peter DeBlieux, MD, Charity Hospital - Louisiana State University This presentation will provide students with tips on how to prepare their ERAS application, how and when to successfully interview and how to follow-up with top programs.

Career Paths and Prospects in Emergency Medicine, Carey Chisholm, MD, Indiana University This session will expose students to a variety of career paths including private practice, academics, and dual training (EM-IM / EM-Peds) as well as fellowship training.

Lunch with Program Directors, Sutton Center Getting the Most out of Your EM Clerkship, Gus Garmel, MD, Stanford University This session will provide the student with valuable tips for getting the most from your Emergency Department Clerkship. Specific topics to be discussed will include: 1) appropriate educational goals for an emergency medicine rotation; 2) how to best prepare for your rotation in order to make the most of your ED experience; 3) recommended textbooks and references; and 4) important considerations when deciding when and where to do your emergency medicine rotation.

The Dean’s Letter, Brian Zink, MD, University of Michigan The speaker, an emergency physician and Dean, will review with the students the components of the Dean’s letter. The importance of your input into the contents of the Dean’s letter will be discussed.

Breakout Groups Balancing Act, Concourse B, Susan Promes, MD, Duke University and Elizabeth Datner, MD, University of Pennsylvania This session will discuss how to optimize your career and personal life.

Financial Planning, Concourse C, David Overton, MD, Michigan State University This session will review practical tips on financial issues. The speaker will address such issues as how to put together a budget and what to so with medical student loan debt.

Optimizing Your Fourth Year, Concourse D, Doug Ander, MD, Emory University This session will provide students with recommendations for making the most of their senior year including information about EM and other electives, research experience, and when to take their Board exams.

Medical Schools without EM Residencies, Concourse E, Kevin Rodgers, MD, Indiana University This Q&A session will help guide medical students from medical schools without EM residencies through the complicated maze that leads to a residency and career in EM. It will specifically address how this process differs from those students with a EM residency at their medical school.

Residency Fair and Reception, Americas Hall 1 All osteopathic and allopathic EM residency programs are invited to exhibit. To date, 85 programs have registered, (see p. 41).

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Sunday, May 22 8:00-10:00 am, East Ballroom Plenary Papers: Abstracts 1-5 p. 11 10:00-12:00 pm Oral Papers: Overcrowding (with Discussion) Abstracts 6-11 East Ballroom p. 11

1:30-3:00 pm Oral Papers: Diagnostic Tests Abstracts 20-25 East Ballroom p. 11

3:00-4:00 pm Oral Papers: Challenging Dogma Abstracts 32-35 East Ballroom p. 11

10:00-12:00 pm Oral Papers: Toxicology Abstracts 12-19 West Ballroom

10:00-12:00 pm NIH Roadmap Mercury Ballroom p. 14

12:00-1:30 pm LUNCH SESSION How to be a Moderator Beekman Parlor p. 14

12:00-1:30 pm LUNCH SESSION Closing the Quality Chasm: Research and Educational Initiatives Sutton North p. 14

1:30-3:00 pm Oral Papers: EMS Abstracts 26-31 West Ballroom p. 11

1:30-3:00 pm Registry Data: On Trial Mercury Ballroom p. 14

3:00-4:00 pm Oral Papers: Pediatrics Abstracts 36-39 West Ballroom p. 11

3:00-4:00 pm Top 10 Errors in EM Research Mercury Ballroom p. 15

10:00-11:00 am From Project to Paper Trianon Ballroom p. 14 11:00-12:00 pm Understanding Diagnostic Testing Trianon Ballroom p. 14

1:30-2:30 pm State of the Art: Pain in ED Patients with Serious Illness Trianon Ballroom p. 14 2:30-4:00 pm Introduction to Studying ED Visits Using MEPS, NHAMCS and HCUP Trianon Ballroom p. 14

4:00-6:00 pm, Rhinelander, Gramercy, Murray Hill p. 12 Posters OB-GYN: Abstracts 40-44 ED Administration: Abstracts 45-62 Acute Coronary Syndromes: Abstracts 63-74 Cardiac Markers: Abstracts 75-80 Ultrasound Assisted Procedures: Abstracts 81-89 Sepsis: Abstracts 90-93 Respiratory/ENT: Abstracts 94-97 Pulmonary Embolism: Abstracts 98-105 Public Health: Abstracts 106-113 Intimate Partner Violence: Abstracts 114-118 Innovations in Emergency Medicine Education Exhibits: 1-10 p. 29 Visual Diagnosis and Clinical Pearls: Photos and Cases 5:00-6:00 pm, Rhinelander, Gramercy, Murray Hill p. 13 Moderated Posters Ultrasound for Procedures: Abstracts 119-122 Medical Errors: Abstracts 123-126 Stress Testing in the ED: Running on empty or just uphill? Abstracts 127-130 6:00-7:30 pm Opening Reception, Grand Ballroom

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Sunday, May 22 SAEM and AEM Committee/Task Force/Board Meetings 7:30-8:00 am 10:00-10:30 am 10:00-10:30 am 10:30-12:00 noon 1:00-2:00 pm 2:00-3:00 pm 3:00-5:00 pm 4:30-6:00 pm 8:00-10:00 pm

2005 Program Committee – Morgan Institute of Medicine Task Force – Hudson Suite Constitution and Bylaws Committee – Midtown Suite International Task Force – Hudson Suite Women in Academic Emergency Medicine Task Force – Hudson Suite 2006 Program Committee Subcommittee Chairs – Midtown Suite 2006 Program Committee – Hudson Suite Finance Committee – Midtown Suite Grant Mentorship Sessions (by invitation only) – Hudson Suite

SAEM Interest Group Meetings (agendas on p. 34-36) 12:00-1:00 pm 12:00-1:00 pm 3:00-5:00 pm 4:00-5:00 pm

Public Health Subcommittees – Morgan Toxicology – Gibson Neurological Emergencies – Gibson Medical Student Educators – Morgan

Affiliated Meetings and Satellite Symposia 6:00-8:00 am 10:00-11:30 am 10:00-11:00 am 10:00-12:00 noon 10:30 am-12:00 pm 11:00-1:00 pm 11:30-12:30 pm 12:00-1:30 pm 12:30-2:00 pm 12:30-4:30 pm 1:00-2:00 pm 2:00-3:00 pm 2:00-3:00 pm 2:00-3:30 pm 3:00-4:00 pm 3:00-4:30 pm 3:00-4:00 pm 3:00-4:00 pm 3:00-5:00 pm 4:00-5:00 pm 4:00-5:00 pm 4:00-5:00 pm 5:00-6:00 pm 6:00-7:00 pm

Changing Perceptions: Women and Coronary Artery Disease – Nassau A/B EMRA Board of Directors – Concourse H CORD CPC Committee – Holland Suite ACEP Academic Affairs Committee – Concourse C iSTAT – Madison ACEP Study Guide Meeting (by invitation only) EMRA Leaders Lunch – Concourse B AACEM Executive Committee/Lunch – Hilton Board Room EMRA Representative Council Conference Committee Orientation – Concourse H ACEP Research Forum Task Force – Concourse F CORD Ethical Practice in Residency Recruitment Committee – Clinton EMRA 101: An Orientation to EMRA and Leadership – Concourse D CORD SDOT Task Force – Clinton EARLY ACS – Madison EMRA Medical Student Governing Council – Concourse H CORD Standardized Evaluation Methods Task Force – Clinton EMRA Health Policy Committee – Concourse C EMRA Combined Residency Interest Group – Concourse E EMRA Representative Council Reference Committee – Concourse G EMRA Critical Care Committee – Concourse C EMRA International Committee – Concourse E EMRA Web Site Committee – Concourse B EMRA Awards Reception – Concourse A Headache in the ED: An ED Based Research Network – Concourse D

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Monday, May 23 8:00-10:00 am Oral Papers: Neurology Abstracts 131-138 East Ballroom p. 15

10:00-12:00 pm Oral Papers: Basic Science Abstracts 145-152 East Ballroom p. 15

8:00-9:30 am Oral Papers: Congestive Heart Failure Abstracts 139-144 West Ballroom p. 15

8:00-9:30 am State of the Art: Methods, Markers, and Devices to Diagnose and Risk-Stratify Non-Traumatic Circulatory Shock Mercury Ballroom p. 17

9:30-11:00 am Oral Papers: Substance Abuse Abstracts 153-158 West Ballroom p. 15

9:30-11:00 am Advanced Degrees in the Pursuit of Faculty Advancement and Promotion Beekman Parlor p. 18 11:00-12:00 pm Education Research: Choosing the Educational Research Design Mercury Ballroom p. 18

1:30-3:00 pm Oral Papers: Education Abstracts 159-164 East Ballroom p. 15

12:00-1:30 pm LUNCH SESSION Research Compliance: A Useful Primer Sutton Center p. 18

12:00-1:30 pm LUNCH SESSION Integrating Residency Evaluation Tools and the ACGME Core Competencies Sutton North p. 19

1:30-3:00 pm Oral Papers: Infectious Disease Abstracts 165-170 West Ballroom p. 16

1:30-3:00 pm Knowledge Translation and EM:Bridging the Gap from Evidence to Clinical Practice Mercury Ballroom p. 19

8:00-10:00 am Defining the Research Agenda for ED Crowding and Patient Flow-Lessons from the Robert Wood Johnson Foundation’s Urgent Matters Project Trianon Ballroom p. 18 10:00-12:00 pm The Clinical Research Unit: Achieving Success Through a Variety of Methods Trianon Ballroom p. 18

1:30-3:00 pm Public Health Research: Challenges and Solutions for the Future Beekman Parlor p. 19

3:00-4:00 pm, Trianon Ballroom Annual Business Meeting (see detailed agenda on p. 56) All members urged to attend.

4:00-6:00 pm, Rhinelander, Gramercy, Murray Hill p. 16 Posters Improving Resuscitation: Abstracts 171-183 EMS - Resuscitation/ACLS: Abstracts 184-194 Wounds and Burns: Abstracts 195-199 Abdominal Pain: Abstracts 200-205 Cost Effectiveness and Resource Allocation in the ED: Abstracts 206-212 Ethics: Abstracts 213-215 Family Practice during Resuscitation: Abstracts 216-218 Pain: Abstracts 219-227 Emergency Cardiac Care and Risk Stratification: Abstracts 228-237 Innovations in Emergency Medicine Education Exhibits: 1-10 p. 29 Visual Diagnosis and Clinical Pearls: Photos and Cases 5:00-6:00 pm, Rhinelander, Gramercy, Murray Hill p. 17 Moderated Posters Sports: Caring for Athletes and the Spectators: Abstracts 238-240 Computer Simulation: Abstracts 241-243 6:00-7:00 pm Research Fund Donor Reception Rotunda p. 2

7:00-8:00 pm Acquiring Skills to Interview with the Television Media, Nassau A p. 20

7:00-9:00 pm PowerPoint as a Teaching Tool Nassau B p. 20

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Monday, May 23 SAEM and AEM Committee/Task Force/Board Meetings 7:00-8:00 am 7:30-8:00 am 8:00-10:00 am 9:00-10:00 am 9:30-11:00 am 11:00-12:00 pm 11:00-12:00 pm 12:00-1:00 pm 12:00-1:30 pm 1:00-2:30 pm 2:00-3:00 pm 4:00-5:00 pm 5:00-7:00 pm 6:00-7:00 pm

AEM Statistical Reviewers Breakfast – Harlem Suite 2005 Program Committee – Morgan National Affairs Committee – Hudson Suite Undergraduate Committee – Midtown Suite Development Committee – Harlem Suite Grants Committee – Hudson Suite Board meeting with Dr. Knapp – Lincoln Suite Lunch with Dr. Knapp (by invitation) – New York Suite AEM Reviewers’ Workshop – Sutton Center Ethics Committee – Hudson Suite Industry Task Force – Midtown Suite Graduate Medical Education Committee – Hudson Suite AEM Editorial Board – Morgan Research Fund Donor Reception – Rotunda

SAEM Interest Group Meetings 10:00-11:30 am 10:30-12:00 pm 12:00-1:00 pm 12:00-1:30 pm 12:00-2:00 pm 1:00-3:00 pm 1:30-3:00 pm 2:00-3:00 pm 4:00-6:00 pm 4:00-6:00 pm 5:00-6:00 pm

(agendas on p. 34-36)

Health Services and Outcomes Research – Madison Airway – Clinton Clinical Directors – Morgan Palliative Medicine – Madison Public Health – Clinton Diversity – Morgan Mentoring Women – Gibson CPR/Ischemia/Reperfusion – Madison International – Clinton Research Directors – Gibson Pediatric – Madison

Affiliated Meetings and Satellite Symposia 6:00-8:00 am 8:00-12:00 pm 8:00-11:00 am 8:00-12:00 pm 10:00-12:00 pm 12:00-1:00 pm 12:00-2:00 pm 1:00-5:30 pm 1:30-3:00 pm 4:00-5:00 pm 5:30-7:00 pm 6:00-7:00 pm 6:00-7:30 pm 6:00-8:00 pm 6:00-8:00 pm 7:00-9:30 pm

Advancing the Standard of Care: Cardiovascular and Neurovascular Emergencies – Beekman Parlor CORD Meeting – Sutton South/Regent EMF Board of Trustees – Concourse D EMRA Board of Directors – Concourse H EMRA Reference Committee Work Session – Concourse F ABEM Lunch for Residents – Nassau A/B EMCREG International Steering Committee – Concourse G EMRA Representative Council – Concourse A Accuracy in Applications for EM Residency – Concourse H CORD Efficacy of Training Committee – Midtown Suite ACEP Teaching Fellowship/EMBRS Alumni Reception – Morgan AEMI Meeting – Concourse B EMRA National Journal Club – Beekman Parlor Advances in the Treatment of Patients with Acute Coronary Symptoms – Sutton Center PEMI Site Investigators – Concourse F SUNY Downstate Departmental Welcome and Reception – Nassau A/B

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Tuesday, May 24 Chief Resident Forum: all day (see p. 37) 8:00-9:00 am Oral Papers: CPR Abstracts 244-247 East Ballroom p. 20

7:30-9:00 am Breakfast with the Board New York Suite

8:00-9:00 am Oral Papers: Airway Abstracts 248-251 West Ballroom p. 20

9:00-11:00 am, Rhinelander, Gramercy, Murray Hill p. 20 Posters Hypertension: Abstracts 252-259 CHF: Abstracts 260-268 Research Design: Abstracts 269-271 Large Database Research: Abstracts 272-275 Administration - Interventions and Systems: Abstracts 276-287 Pediatrics: Abstracts 288-298 Psychiatry and Social Issues: Abstracts 299-307 Trauma: Abstracts 308-320 Education: Abstracts 321-333 Learning Ultrasound: Abstracts 334-337 Toxicology: Abstracts 338-347 Innovations in Emergency Medicine Education Exhibits: 11-20 p. 31 Visual Diagnosis and Clinical Pearls: Photos and Cases 10:00-11:00 am, Rhinelander, Gramercy, Murray Hill p. 22 Moderated Posters Syncope: Abstracts 348-350 Contrast Nephropathy: Abstracts 351-353 11:00-12:00 pm Oral Papers: Trauma Abstracts 354-357 East Ballroom p. 22

11:00-12:00 pm Oral Papers: Injury Prevention Abstracts 358-361 West Ballroom p. 22

11:00-12:00 pm Introduction to Statistics Trianon Ballroom p. 23

11:00-12:00 pm Emergencies in Space Mercury Ballroom p. 23

12:00-1:30 pm LUNCH SESSION Full Professorship: Now What?

Nassau A p. 23

12:00-1:30 pm LUNCH SESSION Resident to Rookie Attending: Excelling in Academic EM Regent p. 23

12:00-1:30 pm LUNCH SESSION Getting over the Hump: Assistant to Associate Professor Nassau B p. 24

1:30-3:00 pm Oral Papers: Cardiology Abstracts 362-367 East Ballroom p. 22

1:30-3:00 pm Oral Papers: Geriatrics Abstracts 368-373 West Ballroom p. 23

1:30-3:00 pm Research Fundamentals: Rats and Mice as Models Trianon Ballroom p. 24

1:30-3:00 pm Qualitative Research: How to do it and why Mercury Ballroom p. 24

3:00-4:00 pm Oral Papers: Research Design Abstracts 374-377 East Ballroom p. 23

3:00-4:00 pm Oral Papers: Diagnostic Tests Abstracts 378-381 West Ballroom p. 23

3:00-4:00 pm Successful Strategies to Obtain Federal Funding for Public Health Research Trianon Ballroom p. 24

3:00-4:00 pm Educational Research: Interpreting and Presenting Results Mercury Ballroom p. 25

5:00 pm Banquet – Buses will leave beginning at 5:00 pm. All participants must be on board by 5:20 pm. Buses will leave from the 54th Street entrance. p. 1

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Tuesday, May 24 SAEM and AEM Committee/Task Force/Board Meetings 7:30-9:00 am 7:30-9:00 am 7:30-8:00 am 8:00-9:30 am 9:30-11:00 am 11:00-12:00 pm 1:00-3:00 pm 3:00-4:00 pm 4:00-5:30 pm

Breakfast with the SAEM Board – New York Suite AEM Associate Editors – Madison 2005 Program Committee – Morgan Simulation Task Force – Hudson Suite Research Committee – Midtown Suite Awards Committee – Hudson Suite Faculty Development Committee – Hudson Suite Education Research Subcommittee – Hudson Suite Geriatric Task Force – Midtown Suite

SAEM Interest Group Meetings 9:00-10:00 am 11:00-12:30 pm 12:00-1:00 pm 12:00-1:30 pm 1:00-3:00 pm 1:30-2:30 pm 2:00-4:00 pm 3:00-4:30 pm 4:00-5:30 pm 4:30-5:30 pm

(agendas on p. 34-36)

Disaster Medicine – Gibson Evidence Based Medicine – Clinton Patient Safety – Madison Geriatric – Clinton Simulation – Morgan Trauma – Gibson Ultrasound – Madison Web Educators – Gibson EMS – Morgan Uniformed Services – Madison

Affiliated Meetings and Satellite Symposia 6:00-7:30 am 7:00-8:00 am 8:00-9:00 am 8:00-12:00 pm 8:00 am-5:00 pm 8:30-10:30 am 9:00-10:00 am 10:00-11:00 am 11:00 am-1:00 pm 11:00 am-1:00 pm 11:00 am-6:00 pm 11:30 am-1:00 pm 12:00-1:30 pm 12:00-1:30 pm 1:00-2:00 pm 1:30-3:30 pm 2:00-3:00 pm 3:00-4:00 pm 3:30-6:00 pm 4:00-5:00 pm 4:00-6:00 pm

Acute Coronary Syndromes: Recent Developments in Pathophysiology and Translation of Basic Science to Clinical Science – Beekman Parlor ACEP Research Committee – Concourse E ACEP Scientific Review Committee – Concourse E CORD Board of Directors – Hilton Board Room EMRA Board of Directors – Concourse H ACEP Medical Student Curriculum Task Force – Concourse D AAEM Academic Affairs Committee – Concourse A AAEM Mediterranean Congress Executive Meeting – Concourse A ACEP Smoking Cessation Task Force – Concourse F ACEP Ultrasound Section – Concourse E ABEM Model Review Task Force – Concourse B ACEP Section of Medical Humanities – Concourse C CORD Board and Past Presidents Lunch – East Suite Room Pediatric Emergency Medicine Fellowship Directors – Concourse G AAEM Education Committee – Concourse A National Emergency Airway Registry – Concourse C AAEM ED Overcrowding Committee – Concourse A NET2 Investigators Group – Concourse F Combined Residency Programs – Midtown Suite AAEM EM Practice Committee – Concourse A Academic ED SBIRT Research Collaborative – East Suite Room

9

Wednesday, May 25 8:00-9:00 am Spivey Lecture Developing the Leader within You Sutton North/Center p. 27 9:00-11:00 am Oral Papers: Traumatic Brain Injury Abstracts 382-387 East Ballroom p. 25 11:00-12:00 pm Oral Papers: EMS Abstracts 392-395 East Ballroom p. 25

9:00-10:00 am Oral Papers: Suicidality Abstracts 388-391 West Ballroom p. 25 10:00-12:00 pm Oral Papers: Reactive Airway Disease Abstracts 396-403 West Ballroom p. 25

9:00-10:30 am State-of-the-Art Shift Change Signovers: Importance of Studies of Technical Work Mercury Ballroom p. 27 10:30-12:00 pm Grant Mentorship Mercury Ballroom p. 28

9:00-10:30 am Academic EMS: Research and Beyond Sutton North/Center p. 27 10:30-12:00 pm New Technologies and Environments for Instruction Sutton North/Center p. 28

12:00-2:00 pm, Rhinelander, Gramercy, Murray Hill p. 25 Posters Infectious Disease: Abstracts 404-413 Access and Utilization: Abstracts 414-422 Ischemia: Abstracts 423-431 Anesthesia: Abstracts 432-444 Geriatrics: Abstracts 445-452 EMS: Abstracts 453-470 Neurology: Abstracts 471-487 Diagnostic Tests: Abstracts 488-494 Innovations in Emergency Medicine Education Exhibits: 11-20 p. 31 Visual Diagnosis and Clinical Pearls: Photos and Cases 1:00-2:00 pm, Rhinelander, Gramercy, Murray Hill p. 27 Moderated Posters Aeromed: Abstracts 495-498 CT for Appy: Abstracts 499-502

SAEM and AEM Committee/Task Force/Board Meetings 7:30-8:00 am 9:00-12:00 noon

SAEM 2005 Program Committee – Morgan SAEM Board of Directors – Hilton Board Room

Midwestern Regional SAEM Research Conference Monday, September 12, 2005 The Detroit Institute of Arts The 2005 Midwestern Regional SAEM Research Conference will be sponsored by St. John Hospital and Medical Center in Detroit. The Call for Abstracts will take place in July 2005. For questions or further information, contact Dr. Patricia Nouhan: patricia.nouhan@stjohn.org.

10

Scientific Papers

Sunday, May 22 Diagnostic Tests (1:30 - 3:00 pm), East Ballroom

ORAL PAPER PRESENTATIONS

Moderator: Brian Euerle, MD, University of Maryland 20. Applanation Tonometry: Accuracy of Determinations Through Soft Contact Lenses; Mollie Williams, MD, The Brooklyn Hospital Center 21. Head Computed Tomography Angiography Adds Sensitivity to Non-Contrast Head Computed Tomography Alone in the Diagnosis of Acute Ischemic Stroke; Joshua Resnick, MD, MBA, Massachusetts General Hospital 22. Use of Physical Examination Findings to Identify Patients With Facial Fractures on CT; Rebecca Meyers, MD, Louisiana State University Health Science Center 23. The Use of CT vs X-RAY in Evaluating Patients With Suspected Facial Fractures; Micelle Haydel, MD, Louisiana State University 24. Radiological Diagnoses of Patients Who Received Imaging Despite Negative D-Dimer Tests; Kristen Nordenholz, MD, University of Colorado 25. Limited Role of Genotyping for Thrombophilia in ED Patients With Idiopathic Pulmonary Embolism; Lori Kruse, BS, Carolinas Medical Center

Plenary (8:00-10:00 am), East Ballroom Moderators: Carey Chisholm, MD, Indiana University; Michelle Biros, MS, MD, Hennepin County Medical Center ❋ 1.

OPALS Major Trauma Study: Impact of Advanced Life Support on Survival and Morbidity; Ian Stiell, MD, MSc, FRCPC, University of Ottawa 2.

Evaluation of Georgia’s (GA) Teenage and Adult Driver Responsibility Act (TADRA); Marlena Wald, MLS, MPH, Emory University 3.

Hyperbaric Oxygen (HBO) Increases Growth Factor Receptor (GFR) Expression and Wound Healing In Vivo; Wende Reenstra, MD, PhD, Beth Israel Deaconess Medical Center ❋ 4.

Death Rates of ED Patients with Syncope: Can the San Francisco Syncope Rule (SFSR) Predict Long Term Mortality?; James Quinn, MD, MS, Stanford University ❋ 5.

The Economic Impact of Ambulance Diversions; Kenneth McConnell, PhD, Oregon Health & Science University

Overcrowding (10:00 am -12:00 noon), East Ballroom Moderator: Brent Asplin, MD, Regions Hospital Clinical and Economic Impact of ICU Transfer Delays for Critically Ill ED Patients; Stephen Trzeciak, MD, UMDNJ-Robert Wood Johnson Medical School at Camden 7.

Effect of Low-acuity Patients on ED Waiting Times: Results from the CROWDED Study; Michael Schull, MD, MSc, Institute for Clinical Evaluative Sciences 8.

Validation of the Refined Overcrowding Scale (ROCS): A CaseControl Study; Drew Richardson, MB, BS (Hons), The Canberra Hospital 9.

Comparison of the National ED Overcrowding Scale (NEDOCS) and the ED Work Index (EDWIN) for Quantifying ED Crowding; Steven Weiss, MD, University of New Mexico 10. A Cure for Crowding: The Impact of an ED Observation Unit on Ambulance Diversionary Hours; Robbin Dick, MD, University of Rochester Medical Center 11. Regional Variation in ED Utilization by Oregon Health Plan Enrollees; Robert Lowe, MD, MPH, Oregon Health & Science University

❋ 6.

EMS (1:30 - 3:00 pm), West Ballroom Moderator: Tom Aufderheide, MD, Medical College of Wisconsin Comparison of Termination-of-Resuscitation Guidelines for Basic Life Support-Defibrillator Providers in Out-of-Hospital Cardiac Arrest; Marcus Ong, MD, FRCS(A&E) Ed, University of Ottawa 27. Does Weight Force During Physical Restraint Cause Respiratory Compromise?; Gary Vilke, MD, University of California, San Diego 28. Faster ALS Response Intervals May Improve Cardiac Arrest Survival; Valerie De Maio, MD, MSc, University of North Carolina 29. Reliability and Validity of Retrospective Peer Review of the Quality of Care in Emergency Medical Services; Douglas Andrusiek, BA (Hons), EMA II, University of British Columbia, British Columbia Ambulance Service 30. Influence of Ambulance Arrival on ED Time to Be Seen; Michael Richards, MD, MPA, University of New Mexico 31. OPALS Pediatrics Study: What is the Impact of Advanced Life Support on Out-of-Hospital Cardiac Arrest?; Ian Stiell, MD, MSc, FRCPC, University of Ottawa

❋ 26.

Toxicology (10:00 am -12:00 noon), West Ballroom

Challenging Dogma in Abdominal Pain (3:00 - 4:00 pm), East Ballroom

Moderator: Lewis Goldfrank, MD, New York University 12. Hemodynamic Effect of Aminophylline plus Atropine versus Atropine Alone Verapamil Toxicity; Theodore Bania, MD, St. Luke’sRoosevelt/Columbia University 13. Hyperbaric Oxygen Protects From Acetaminophen Toxicity and Induces Hypoxia-Inducible Factor 1 Alpha; Steven Salhanick, MD, The Childrens Hospital, City?

14. Detecting Acetaminophen: Rapid Qualitative Urine Screen Versus Standard Quantitative Serum Test; James Martin, MD, San Antonio Uniformed Services Health Education Consortium 15. Effect of Intralipid on Organophosphate Toxicity in Mice; Theodore Bania, MD, MS, St. Luke’s-Roosevelt/Columbia University ❋ 16. Temporal Profile of Serum Acetaminophen Concentrations and Aminotransferase Activity in Patients with Hepatotoxicity following Acute Acetaminophen Overdose; Marco Sivilotti, MD, MSc, Queen’s University 17. Benzodiazepine or Tricyclic Antidepressant Use Increases the Risk of Accidental Overdose in Methadone Users: Analysis of Medical Examiner Data; Gar Chan, MD, New York City Poison Control Center 18. Acute Complications of Gamma Hydroxybutyrate Addiction; Deborah Zvosec, PhD, Minneapolis Medical Research Foundation 19. Racial Differences in Treatment of Alcohol Related ED Presentations; Phillip Levy, MD, Wayne State University/Detroit Receiving Hospital

Moderator: E. John Gallagher, MD, Albert Einstein College of Medicine 32. Is Early Analgesia Use Associated With Delayed Diagnosis of Appendicitis?; Steven Frei, MD, Lehigh Valley Hospital and Health Network in Affiliation with Pennsylvania State University 33. Does the Presence of Diarrhea Decrease Rate of Surgical Intervention in Patients With Acute Abdominal Pain?; Angela Mills, MD, University of Pennsylvania 34. Intravenous Morphine In ED Patients With Acute Abdominal Pain Does Not Alter Disposition Decision; David Esses, MD, Albert Einstein College of Medicine 35. Relationship Between Fever and Length of Stay, Antibiotic Use and Need For Operative Intervention in ED Patients With Acute Abdominal Pain; Angela Mills, MD, University of Pennsylvania

Pediatrics (3:00 - 4:00 pm), West Ballroom Moderator: Jill Baren, MD, University of Pennsylvania 36. Wait and See Antibiotic Prescription For the Treatment of Acute Otitis Media: A Randomized, Controlled Trial; David Spiro, MD, Yale University 37. Dexamethasone vs. Ondansetron in Children with Refractory Vomiting from Acute Viral Gastritis; Tracey Reilly, MD, Upstate Medical University 38. A Randomized Clinical Trial Comparing Efficacy and Safety of Etomidate vs. Midazolam for Procedural Sedation Among Children; Benoit Bailey, MD, MSc, FRCPC, St. Justine Hospital

11

Sunday, May 22 39.

Prospective Validation of a Pediatric Appendicitis Score; Ran Goldman, MD, The Research Institute,The Hospital for Sick Children

POSTER SESSION

Acute Coronary Syndromes

â?‹ 63.

64.

(4:00 - 6:00 pm)

OB-GYN 40.

41.

42.

43.

44.

65.

Use of Endovaginal Pelvic US by Emergency Physicians in NonPregnant Women With Right Lower Quadrant Pain; Mark Bullard, MD, Carolinas Medical Center Are Women Able to Fill Their Emergency Contraception Prescription?; Lisa Evans, MD, Thomas Jefferson University Assailants’ Sexual Dysfunction During Rape: Prevalence and Relationship to Genital Trauma in Female Victims; Herald Ostovar, MD, Grand Rapids MERC/ Michigan State University Improving the Care of Sexual Assault Victims Using a Computer Prompted Guideline to Reduce Prescribing Errors in HIV Postexposure Prophylaxis; Carrie Tibbles, MD, Beth Israel Deaconess Clinical Risk Stratification for Ectopic Pregnancy in Symptomatic First Trimester Patients With Low Serum HCG Levels; Errika Walker, MD, Naval Medical Center San Diego

66.

67.

68.

69.

70.

ED Administration 45.

46.

47.

48.

49.

50.

51.

52.

53.

54.

55.

56.

57.

58.

59.

60.

61.

62.

Prospective Validation of the Refined Overcrowding Scale (ROCS); Drew Richardson, MB, BS (Hons), The Canberra Hospital Validation of the Refined Overcrowding Scale (ROCS) in a Different Hospital; Drew Richardson, MB, BS (Hons), The Canberra Hospital Refined Overcrowding Scale (ROCS) Based On Point Occupancy; Drew Richardson, MB, BS (Hons), The Canberra Hospital Creation of Hospital Surge Capacity by the Early Discharge of Inpatients; Chadd Kraus, BA, Johns Hopkins University A Survey of Medical Literacy in Pediatric Caregivers in the ED; Richard Walker, MD, University of Nebraska Medical Center An Evaluation of Emergency Physician Selection of Observation Unit Patients; Michael Lyons, MD, University of Cincinnati How Does Fast-track Affect Quality of Care in the Emergency Depatment?; C Fernandes, MD, McMaster University / Hamilton Health Science Corporation Impact of Triage Classification and Level of Training on ED Patient Flow as Measured by Use of a Web-based Infrared and Radio Frequency Passive-tracking System; L Albert Villarin, MD, Albert Einstein Medical Center Length of Stay in an Emergency Deparment Observation Unit is Not Associated With Patient Satisfaction; Robert Norton, MD, Oregon Health & Science University Dictated Medical Turnover: A New Approach to ED Length of Stay; Marc Stoller, MD, Beth Israel Medical Center Feasibility of Using an Electronic Tracking System to Determine ED Crowding Measures in Real-Time; Sarah Williams, East Carolina University ESI Does Not Reduce Triage Errors; Andrew Sucov, MD, Brown University Patients Per Day and Admission Rate Predict Average Length of Stay in the ED; Mark Moseley, MD, MHA, Christiana Care Health Services Analysis of Inter-Hospital Variability in the Sensitivity of a GI Chief Complaint Syndromic Surveillance Method; Robert Levy, MD, Morristown Memorial Hospital Effect of Triage-Applied Ottawa Ankle Rules on Length of Stay in a Canadian Urgent Care Department: A Randomized Control Trial; Jerome Fan, MD, McMaster University Rural EM: The 2004 West Virginia EM Workforce; Stephen Davis, MPA, MSW, West Virginia University Does CT Imaging of the Head Change Projected Disposition of ED Patients?; Nehal Gatha, MBA, Massachusetts General Hospital The Impact of a Concurrent Trauma Alert Evaluation on Time to Head CT in Patients With Suspected Stroke; Esther Chen, MD, University of Pennsylvania

71.

72.

73.

74.

The Impact of a Trauma Alert Activation on the Care of ED Patients With Potential Acute Coronary Syndromes (ACS); Peter Fishman, BA, University of Pennsylvania The Emergency Evaluation of Chest Pain in the Elderly Population; Jin Han, MD, University of Cincinnati Reaching the Less Than 90 Minute Goal: Changes Associated With Decrease Door to Balloon Time for Patients Presenting to the ED with ST Segment Elevation Myocardial Infarction; Haro Luis, MD, Mayo Clinic Does ED Crowding Prolong Door-to-Balloon Times for Patients with Acute Myocardial Infarction?; Shkelzen Hoxhaj, MD, Christiana Care Health System Diagnostic Testing in Patients With Acute Methamphetamine or; Deborah Diercks, MD, University of California, Davis Role of Reactive Nitrogen and Reactive Oxygen Species in Mechanical Trauma-Induced Cardiomyocyte Apoptosis; Robert Cooney, BS, Thomas Jefferson University Incidence of Abnormal Divalent Ion Levels in Patients Presenting with Chest Pain; Moshe Weizberg, MD, SUNY Downstate Medical Center Limited Utility of the Acute Cardiac Ischemia Time-Insensitive Predictive Instrument (ACI-TIPI) in the Evaluation of Chest Pain Unit Patients; Frederic Jones, MD, Duke University Ischemia Modified Albumin as a Prediction Tool to Rule Out Acute Coronary Syndromes in the ED; W. Frank Peacock, MD, The Cleveland Clinic Use of Acute Cardiac Ischemia Time-Insensitive Predictive Instrument to Predict Outcomes in the ED Chest Pain Unit; Alex Manini, MD, Harvard University Exercise Tolerance as a Risk Factor for Myocardial Infarction in ED Patients With Acute Coronary Syndromes; Kristine Samson, MD, SUNY Downstate Classic Symptoms Do Not Predict Coronary Heart Disease in Pre-Menopausal Women; Andra Blomkalns, MD, University of Cincinnati

Cardiac Markers 75.

76.

77.

78.

79.

80.

Use of the Inflammatory Cardiac Marker Myeloperoxidase to Screen ED Patients in the Chest Pain Unit; Alex Manini, MD, Harvard University The Addition of BNP to Markers of Myocardial Injury Improves Sensitivity for Immediate Detection of 30-Day Adverse Outcomes; Judd Hollander, MD, University of Pennsylvania A Cardiac Multimarker Index Performs Better Than Standard Markers to Diagnose Acute Myocardial Infarction (AMI); Judd Hollander, MD, University of Pennsylvania Role of First-Drawn Indeterminate Troponin I Levels in the ED; Roger Bautista, DO, Brooke Army Medical Center Comparison of Novel Markers of Acute Coronary Syndromes in Low-Risk ED Patients; Alice Mitchell, MD, Carolinas Medical Center Sex-Specific Differences in Presenting Symptoms of Diabetic and Non-diabetic Patients With Acute Myocardial Infarction (AMI) and Their Relationship to In-hospital Mortality; Amber Crowley, MD, Yale University

Ultrasound Assisted Procedures 81.

82.

83.

84.

85.

12

Utilization of Infrared Trans-Illumination as an Aid for Peripheral Arterial Access; Michael Dunn, MD, Allegheny General Hospital Nurse-Performed Ultrasound-Guided Upper Extremity Venous Cannulation in ED Patients With Difficult Venous Access; Brian Chinnock, MD, University of California, San Francisco-Fresno Changes in Jugular Vein Diameter With Valsalva and Trendelenburg Maneuvers as Measured by Ultrasound; Thomas Cook, MD, Palmetto Health Richland Comparison of Single Novice to Novice With Novice and Novice With Expert Ultrasound Guided Vascular Access Techniques; William Weirs, MD, Medical College of Georgia Use of Ultrasound Reduces the Number of Failed Lumbar Punctures and Improves Ease of Performance of Lumbar Puncture in Obese Patients; Jason Nomura, MD, Christiana Care Health System

Sunday, May 22 86.

87.

88.

89.

111. Urban ED Patients’ Diet and Exercise Barriers; Thea James, MD, Boston University 112. Expired Carbon Monoxide Validation of Self-reported Smoking Among ED Patients; Eliezer Mordan, MD, UMDNJ-RWJMS Camden 113. Atmosphere, URI, Inlfuenza, and Sickle Cell Crisis in the ED; Hosseinali Shahidi, MD, MPH, University of Medicine and Dentistry of New Jersey

Venous Ultrasound Testing for Suspected Venous Thrombosis: Incidence of Significant Non-Thrombotic Findings; Mark Sutter, MD, University of California, Davis Clinician-performed Emergency Ultrasound for the Diagnosis of Pneumothorax in the Setting of Trauma; Michael Levinson, MD, University of Pennsylvania Ultrasound Diagnosis of Retrobulbar Hematoma; Kimber Bogush, MD, Drexel University Ultrasound Determination of Chest Wall Thickness: Implications for Needle Thoracostomy; A. McLean, MD, University of New Mexico

Intimate Partner Violence 114. Missed Opportunities for Intervention: ED Visits by ProsecutorIdentified Victims of Intimate Partner Violence; Karin Rhodes, MD, MS, University of Chicago 115. Validating A Screen for IPV Among Male ED Patients; Karin Rhodes, MD, MS, University of Chicago 116. Intimate Partner Violence and ED Screening; Deborah Trautman, PhD, Johns Hopkins University 117. A Comparison Between Male and Female Victims of Domestic Violence Presenting to an ED in Singapore; Chik-Loon Foo, Tan Tock Seng Hospital 118. Intimate Partner Violence In Homeless Patients Presenting to an Urban ED; Kimberly Brayton, University of California, San Francisco

Sepsis 90.

91.

92.

93.

Obesity Exacerbates Sepsis-Mediated Pulmonary Microvascular Injury; Donna Carden, MD, Louisiana State University, Shreveport Granzyme K Levels in Plasma of Septic Patients: A Potential Early Marker in Sepsis; Gregory Jay, MD, PhD, Brown University B-Type Natriuretic Peptide in Severe Sepsis and Septic Shock; Michael Donnino, MD, Henry Ford Hospital Impact of an Early Goal-Directed Therapy Protocol on the Management of ED Patients With Sepsis-Induced Hypotension; Stephen Trzeciak, MD, UMDNJ-Robert Wood Johnson

Respiratory/ENT 94.

95.

96.

97.

Utility of Prescribing Penicillin in the ED for Undifferentiated Toothache; Christine Kletti, MD, Hennepin County Medical Center Antibiotic Prescribing Patterns for Acute Respiratory Tract Infections in Acute Care Settings; Ralph Gonzales, MD, MSPH, University of California, San Francisco Mycoplasma Pneumoniae Increases Human Asthmatic Airway Epithelial Cell MUC5AC Expression; Charles Cairns, MD, Duke University Comparison of a New Short Optical Stylet and the Bougie for Difficult Intubations; William Levin, MD, New York Medical College/Metropolitan Hospital

Pulmonary Embolism 98.

99.

100.

101.

102.

103.

104.

105.

External Validation of the Pulmonary Embolism Rule-out Criteria Rule; Stephen Wolf, MD, Denver Health Medical Center Prevalence of Pulmonary Embolism in Outpatients With Pleuritic Chest Pain; Kerstin Hogg, MBChB, BSc, MD, Manchester Royal Infirmary Is the Current Diagnostic Cutoff for ELISA D-dimer Too Low?; Raymond Jackson, MD, MS, William Beaumont Hospital Effect of Changing From a Latex Agglutination D-Dimer to an ELISA D-Dimer on Emergency Physicians Ordering Imaging Studies Practices to Evaluate for Pulmonary Embolism; Jeffrey Bush, MD, University of California, San Diego Impact of a Clinical Decision Guideline on testing for PE in the ED; Phil Sundberg, MD, Yale University Derivation of a Clinical Decision Rule to Decrease the Rate of False Positive D-dimer Assays in ED Patients Evaluated for Pulmonary Embolism; Michael Runyon, MD, Carolinas Medical Center Equivalence of a 3-test Instrument vs. Echocardiography for the Prediction of Adverse Outcome After Diagnosis of Pulmonary Embolism; Jeffrey Kline, MD, Carolinas Medical Center Measurement of End-tidal pCO2/pO2 Ratio to Diagnose Pulmonary Embolism; Jeffrey Kline, MD, Carolinas Medical Center

MODERATED POSTERS

(5:00 - 6:00 pm)

Ultrasound for Procedures Moderator: O. John Ma, MD, University of Missouri 119. Clinical Guideline for the Use of Point-of-Care, Limited Ultrasonography (PLUS) Assistance for Central Venous Cannulation (CVC); Lawrence Melniker, MD, MS, New York Methodist Hospital 120. Needle Tip Localization During Pericardiocentesis With a “Cardiac Flush” During Real Time Ultrasound; Rajesh Mittal, MD, The Brooklyn Hospital Center 121. Ultrasound Guidance for Difficult Peripheral Intravenous Access: A Randomized Trial; John Stein, MD, University of California, San Francisco ❋ 122. Emergency Physician Performance of Single Parasternal Long Axis View to Visually Estimate Left Ventricular Ejection Fraction; Michael Levinson, MD, University of Pennsylvania

Medical Errors Moderator: Robert Wears, MD, MS, University of Florida 123. Impact of Bar Coding Technology and Computerized Physician Order Entry on Reducing Laboratory Specimen Misidentification Errors in the ED; James Killeen, MD, University of California, San Diego 124. Use of Personal Digital Assistants (PDAs) to Enhance Patient Safety Through Optimization of ED Patient Pass-offs; Kevin Biese, MD, Massachusetts General Hospital 125. Frequency of Adverse Events and Errors Among Patients Boarding in the ED; Shan Liu, MD, Massachusetts General Hospital 126. Predictor Variables of Immediate Adverse Outcomes in Central Venous Line Placement; Robert Bilkovski, MD, Henry Ford Hospital

Stress Testing in the ED: Running on Empty or Just Up Hill?

Moderator: Marc Pollack, MD, PhD, York Hospital 127. Results From a Randomized Trial on Early Stress Nuclear Scan for Patients Presenting to ED With Chest Pain But Non-diagnostic Electrocardiogram; Swee Lim, MD, Singapore General Hospital 128. Resting Magnetocardiography Accurately Excludes Active Cardiac Ischemia in Low-Risk ED Chest Pain Patients Admitted to a Cardiac Evaluation Unit; Peter Hill, MD, Johns Hopkins University 129. The Use of Exercise Treadmill Testing in the Morbidly Obese Chest Pain Patient in the ED; Thomas Behrenbeck, MD, Mayo Clinic 130. Incidence of MI in ED Chest Pain Patients With a Recent Negative Stress Imaging Test; Stephen Smith, MD, Hennepin County Medical Center

Public Health 106. Abandoned Infants: Legal Responsibilities of ED Health Care Providers; Michael Tocco, University of Southern California 107. Self-reported Safety Belt use Among ED Patients in Boston; Tara Coles, MD, Boston University 108. Non-Fatally Injured Motorcyclists: Helmets Save Hospital Days and Hospital Dollars; Mary McKay, MD, MPH, George Washington University 109. Demonstrated Parental Knowledge Related to Household Choking Hazards; Jennifer Adu-Frimpong, MD, Emory University 110. Factors Associated With Obesity and Sufficient Physical Activity Among Urban ED Patients; Thea James, MD, Boston University

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Sunday, May 22 LUNCH SESSION: How to be an Excellent Scientific Meeting Moderator (12:00-1:30 pm), Beekman Parlor

Didactic Sessions

Louis Goldfrank, MD, NYU/Bellevue Hospital Center W. Brian Gibler, MD, University of Cincinnati Moderating a scientific session is an important and prestigious duty.

This task is held out and offered to a select few in any scientific society.

Yet, even this “select group” may fail to lead the session to its highest potential. Furthermore, grooming young experts to take this task and improving the potential for the usually selected moderators is essential.

An excellent moderator takes a scientific session to its highest point of interest and discussion by probing each presenter (to maintain interest and curiosity) while knowing when to stay silent. During this session, the speakers will teach and mold participants into excellent and interesting moderators. Three small-group break-out sessions will give “hands-on” scenarios to challenge the participant. At the end of the session, participants will: 1) Acquire specific strategies to be used as a scientific meeting moderator to create decorum, maintain the rules of the session, and interject important pre-researched questions to trigger discussion and interest; and 2) Identify specific steps a moderator must take before, during, and after a scientific session to guarantee excellence.

The NIH Roadmap: Opportunities for EM Careers of Discovery (10:00-12:00 pm), Mercury Ballroom Lance Becker, MD, University of Chicago Myron Weisfeldt, MD, Johns Hopkins University Roger J. Lewis, MD, PhD, Harbor-UCLA This session will explain the NIH Roadmap and highlight opportunities for residents, fellows and faculty in EM to become involved in NIH Roadmap initiatives and to participate in an integrated vision to deepen our understanding of biology, stimulate interdisciplinary research teams, and reshape clinical research to accelerate medical discovery and improve people’s health. At the end of the session, participants will: 1. Review the three NIH Roadmap themes and initiatives; 2. Identify the potential roles for EM investigators within the NIH Roadmap; 3. Identify means for establishing the people, skill sets, tools and collaborations needed for participation in NIH Roadmap initiatives; 4.

Highlight current interdisciplinary research examples of “big science” involving EM and other medical specialties (e.g. Resuscitation Science; PULSE initiatives).

Registry Data: On Trial (1:30-3:00 pm), Mercury Ballroom

From Project to Paper (10:00-11:00 am), Trianon Ballroom

Edward Panacek, MD, University of California, Davis Jerome Hoffman, MD, University of California, Los Angeles Charles Pollack, MD, Pennsylvania Hospital Ron Walls, MD, Brigham & Women’s Hospital Charles Cairns, MD, Duke University Registry data has been used as a research tool to address clinical questions. Although this has been a common approach in the clinical cardiology arena, its use in other areas is only recently increasing. This methodological approach has some inherent limitations that can lead to criticism of the conclusions provided by such registries. However the use of registries is a cost effective and efficient means of collecting data on a multitude of disease processes or procedures. The objective of this session is to provide an interesting, informative, and entertaining presentation of opposing views of the utility of such registries. This will be done as a courtroom trial format with the audience providing the verdict at the completion of the arguments.

Susan Stern, MD, University of Michigan Michelle Biros, MS, MD, Hennepin County Medical Center This course will be a two part didactic session. The first part will be presented by Dr. Stern, who will tackle “how to write an abstract” and the second part will be presented by Dr. Biros and will focus on “how to turn your abstract into a paper.” At the end of the session, participants will: 1) Learn the nuts and bolts of abstract writing and 2) Obtain practical tips on how to turn an abstract into a paper, including planning and timeline.

Understanding Diagnostic Testing (11:00-12:00 pm), Trianon Ballroom Edward A. Panacek, MD, MPH, University of California, Davis The principles of diagnostic test performance are poorly understood, but critical in the clinical decision making process. Sensitivity and specificity are counter intuitive and often not helpful in clinical care.

Predictive values are unstable and rarely applicable at the bedside.

Likelihood ratios are much more useful, but not understood by most physicians. ROC curves are rarely used clinically, but important in the evaluation and comparison of different diagnostic tests. All of these will be covered, with a particular emphasis on likelihood ratios. At the completion of the session, participants will understand the most common measures of diagnostic test performance and their limitations.

They will be able to apply likelihood ratios at the bedside.

State-of-the-Art: Pain in ED Patients with Serious Illness (1:30-2:30 pm), Trianon Ballroom Robert Zalenski, MD, Wayne State University Knox Todd, MD, MPH, Emory University Sean O’Mahoney, MD, Montefiore Medical Center Preliminary evidence suggests that acute exacerbation of chronic pain in the emergency setting is a major issue. Patients that present with chronic serious illness and pain may be receiving unpredictable treatment in the emergency setting for a variety of factors that include knowledge, skills, attitudes, barriers and lack of emergency setting guidelines. This session will focus on current research topics and opportunities for inquiry in chronic pain research in seriously ill patients with a focus on the EM interface. Funding opportunities and linkages between EM and the larger pain community and palliative care community to stimulate research initiatives for interdisciplinary work will be explored. At the completion of the session, participants will identify key areas for research inquiry in EM and will have a roadmap to funding for these areas.

LUNCH SESSION: Closing the Quality Chasm: Research and Educational Initiatives for Academic EM (12:00-1:30 pm), Sutton North Arthur L. Kellermann, MD, MPH, Emory University Felix K. Ankel, MD, Regions Hospital The speakers will highlight the implications of the IOM report for education and research in EM. Using examples from their department, the speakers will provide specific ideas for incorporating the IOM’s recommendations in EM training programs. Particular attention will be paid to the relationship between the IOM’s goals and the ACGME’s core competencies. The speakers also will discuss the specific steps academic EM must take to develop a translational research agenda for achieving the IOM’s Quality Chasm goals. Extramural funding opportunities, research training programs, and opportunities for collaboration will be identified. At the end of the session, participants will: 1. Identify how the recommendations from the IOM’s Quality Chasm Report apply to EM; 2. Acquire specific ideas for incorporating the IOM’s Quality Chasm recommendations in their educational programs, including an explanation of how the IOM goals can be used to address the ACGME core competencies; 3. Identify specific steps for developing a translational research agenda in EM to achieve the IOM’s Quality Chasm goals, including recommendations for research training, opportunities for collaboration, and funding sources.

A Researcher’s Introduction to Studying Emergency Department Visits Using MEPS, NHAMCS, and HCUP (2:30-4:00 pm), Trianon Ballroom Robin M. Weinick, PhD, Institute for Health Policy Pamela L. Owens, PhD, Agency for Healthcare Research and Quality This session will provide detailed introductions to three large, publiclyavailable data sets sponsored by the U.S. Department of Health and Human Services that can be used for health services research studies of EDs. The Medical Expenditure Panel Survey (MEPS) is a householdbased survey of the civilian, non-institutionalized population of the U.S. designed to provide detailed information on the health care use and expenditures, sources of payment, health insurance, health status, and demographic and economic characteristics. The ED component of the National Hospital Ambulatory Medical Care Survey (NHAMCS) is

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Sunday, May 22

Monday, May 23

a national probability sample survey of visits to hospital EDs. NHAMCS includes data on diagnoses, procedures, and medications, as well as a variety of patient and visit characteristics; additional details on the survey are available. The Healthcare Cost and Utilization Project (HCUP) is a family of hospital discharge-level databases and related software tools and products developed through a Federal-State-Industry partnership. HCUP, which has the largest collection of all-payer, encounter level data, contains data on diagnoses, procedures, expected payer, charges, patient demographics, and hospital characteristics from all hospital inpatient, ED and ambulatory surgery discharges in participating States. This session will describe each data set in detail and provide examples of how each can be used to conduct research on ED utilization. At the completion of the session, participants will be able to describe in detail how 3 major data sets can be used to conduct research on ED visits and to determine which data set is most appropriate for their research project.

Congestive Heart Failure (8:00 - 9:30 am), West Ballroom Moderator: J. Douglas Kirk, University of California, Davis 139. Internal Jugular Ultrasound Is More Accurate than Physical Exam and Chest Radiography in Diagnosing CHF in Patients with Dyspnea; Timothy Jang, MD, Washington University 140. Utility of NT-proBNP for the Diagnosis of Congestive Heart Failure in Patients With Pulmonary Disease; Carlos Camargo, Jr., MD, DrPH, Massachusetts General Hospital 141. Gender and Heart Sounds in Decompensated Heart Failure; W. Frank Peacock, MD, The Cleveland Clinic 142. Routine Laboratory Values as Predictors of Mortality After ED Presentation for Congestive Heart Failure; Chitra Varadachari, MBBS, Mayo Clinic 143. Non-Invasive Ventilation: Friend or Foe of the Failing Heart?; W. Frank Peacock, MD, The Cleveland Clinic 144. Microvascular Tissue Perfusion in Stable vs. Decompensated Heart Failure; Christopher Hogan, MD, Virginia Commonwealth University

The Top 10 Errors in EM Research (3:00-4:00 pm), Mercury Ballroom Riyad B. Abu-Laban, MD, MHSc, Vancouver General Hospital This session will review 10 classic errors frequently found in EM research, and by doing so improve participants’ skills in critical appraisal of the medical literature and research design. While all studies have limitations and methodologic weaknesses, these top 10 errors are easy to recognize and avoidable. The session will utilize a case-based approach, with hypothetical EM studies to highlight each error. This approach will also demonstrate how one error can cascade into another, eventually resulting in a fatally flawed study. The format will be informal and interactive, allowing participants to not only consider issues around each case, but also redirect the discussion if related topics or experiences are raised. This session is primarily aimed at medical students and residents, but would also be of value to junior faculty, particularly those without formal research training or experience. At the completion of the session, participants will have an appreciation and understanding of the most common methodologic errors in EM research. As a result, participants will improve their skills in critical appraisal of the medical literature and research design.

Scientific Papers ORAL PAPER PRESENTATIONS Neurology (8:00-10:00 am), East Ballroom Moderator: William Barsan, MD, University of Michigan 131. A Prospective, Randomized Study to Evaluate the Antipyretic Effect of the Combination of Acetaminophen and Ibuprofen in Neurological ICU Patients; David Jaramillo, MD, Washington University Barnes-Jewish Hospital 132. Time to First Dose of Fresh Frozen Plasma Predicts 24 Hour Anticoagulation Reversal in Acute Intracerebral Hemorrhage; Joshua Goldstein, MD, PhD, Brigham & Women’s Hospital 133. Parenteral Corticosteroids Are No Better Than Placebo for ED Patients With Non-radicular Low Back Pain; Benjamin Friedman, MD, Albert Einstein College of Medicine 134. Cosyntropin vs. Caffeine for Post-Dural Puncture Headaches; Wesley Zeger, DO, University of Nebraska Medical Center 135. Acupressure for the Treatment of Benign Headaches in the ED; Kyle Kingsley, MD, Hennepin County 136. The Use of Hounsfield Units on Initial CT-Scan of the Head to Rule Out a Subarachnoid Hemorrhage; Jeffrey Perry, MD, MSc, University of Ottawa 137. Is a Negative CT Scan of the Head and a Negative Lumbar Puncture Sufficient to Rule Out a Subarachnoid Hemorrhage?; Jeffrey Perry, MD, MSc, University of Ottawa ❋138. Neurovascular Computed Tomography Angiography Is a Sensitive Tool for Localization of Aneurysms in the ED Diagnosis of Acute, Non-Traumatic Subarachnoid Hemorrhage; Joshua Resnick, MD, MBA, Massachusetts General Hospital

Basic Science (10:00 - 12:00 noon), East Ballroom Moderator: Terry VandenHoek, MD, University of Chicago 145. Nitric Oxide Reduces Cardiomyocyte Apoptosis via ERK1/2 Activation; Aihua Hu, MD, PhD, Thomas Jefferson University ❋146. Cellular Mechanisms of Cardioprotection With ‘Postconditioning’: Role of ERK 1/2 Signaling and Mitochondrial KATP Channels; Chad Darling, MD, University of Massachusetts 147. Relationship of Hemodynamic Parameters to Microcirculatory Blood Flow Abnormalities in Patients With Severe Sepsis and Septic Shock; Stephen Trzeciak, MD, UMDNJ-Robert Wood Johnson 148. Age-Associated Differences in Expression of Cardioprotective Signaling Proteins in Old vs. Adult Rabbit Hearts; Karin Przyklenk, PhD, University of Massachusetts Medical School 149. HMGB1 Detection in Patients With Cerebral and Myocardial Ischemia; Richard Goldstein, MD, North Shore/Long Island Jewish Research Institute ❋150. Isoform-Specific Knock-Down of Rat Calpain Expression Using RNA Interference; Michael Amesquita, BAS, University of Pennsylvania 151. Glucose Modulation of the Ischemic Redox State and Reperfusion Oxidant Burst in the Heart; Mark Angelos, MD, The Ohio State University 152. Right Ventricular Dysfunction and Inflammation in Experimental Pulmonary Embolism in Rats; John Watts, PhD, Carolinas Medical Center

Substance Abuse (9:30 - 11:00 am), West Ballroom Moderator: Bruce Becker, MD, Rhode Island Hospital 153. Single Question to Detect At-Risk Drinkers Among College Students; Mary Claire O’Brien, MD, Wake Forest University 154. Emergency Practitioner Performed Brief Interventions for Harmful and Hazardous Drinkers in the ED; Gail D’Onofrio, MD, MS, Yale University 155. The Impact of SBIRT on ED Patients’ Alcohol Use; Robert Aseltine, PhD, University of Connecticut Health Center 156. Smoking Cessation Intervention for Patients Admitted to an Observation Unit for Chest Pain; Robert Partridge, MD, MPH, Brown Medical School 157. Project ASSERT: A 5 year Evaluation of an ED-based Screening, Brief Intervention and Referral to Treatment Program; Gail D’Onofrio, MD, MS, Yale University 158. SBIRT Alcohol Curriculum for Academic ED Providers; Ed Bernstein, MD, Boston University

Education (1:30 - 3:00 pm), East Ballroom Moderator: Lawrence Lewis, MD, Washington University 159. Developing Resident Competence in the Management of Sexual Assault; Steve McLaughlin, MD, University of New Mexico 160. A Web-Based Resident Evaluation System Improves Faculty Compliance and Structured Feedback; Jeffrey Hackman, MD, Truman Medical Center/University of Missouri-Kansas City 161. Inter Rater Agreement on a Standardized Direct Observational Assessment Tool of Resident Performance in the ED; Philip Shayne, MD, Emory University

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Monday, May 23 ❋162. Efficiency, Effectiveness, and Preference for Use of Traditional

185. Inter-rater Reliability and Comfort of Application of a Termination of Resuscitation Decision Rule for Emergency Medical Technicians – Defibrillator; Laurie Morrison, MD, FRCPC, MSc, Sunnybrook & Women’s College 186. Effectiveness of Prehospital Cardiac Arrest Management Enhancements Within a Resort-based Emergency Medical Services System; Michael George, MD, Orlando Regional Medical Center 187. Cardiac Monitoring of Subjects Exposed to the Taser®; Saul Levine, MD, University of California, San Diego 188. Is the Cerebral Performance Category Score a Valid Measure of Functional Outcome After Out-of-Hospital Cardiac Arrest?; Lisa Nesbitt, RRCP, MHA, University of Ottawa 189. Etiology of Pediatric Out-of-Hospital Cardiac Arrest by Coroner’s Diagnosis; Marcus Ong, MD, FRCS (A&E) Ed, University of Ottawa 190. Survival From Out-of-Hospital Cardiac Arrest in New York City: 10 Years Later; Neal Richmond, MD, New York Fire Department 191. Environmental Factors Associated With Intubation Success in Out-of-Hospital Adult Cardiac Arrest Patients; Alex Garza, MD, MPH, Truman Medical Center 192. Evaluation of Response Time Intervals to Defibrillation Using a Single Time Standard; Alex Garza, MD, MPH, University of Missouri-Kansas City 193. External Validation of a Multivariate Logistic Regression Model Predicting Prehospital Pediatric Cardiopulmonary Arrest Survival; Christian McClung, MD, MPhil, Los Angeles County-USC Medical Center 194. Internet-Based CPR/AED Refresher Training; Scott Compton, PhD, Wayne State University

vs. Assessment Oriented Oral Case Presentations in an Academic ED; David Silver, University of Chicago 163. Correlation of a Global Assessment of Student Performance With Clinical Performance; Douglas Ander, MD, Emory University 164. Developing a Valid Evaluation for the General Competency of Interpersonal and Communication Skills; Earl Reisdorff, MD, Michigan State University

Infectious Disease (1:30 - 3:00 pm), West Ballroom Moderator: David Talan, MD, Olive View-UCLA 165. Hyperbaric Oxygen Protects From Sepsis Mortality and Reduces Splenic Bacterial Load; Douglas Holt, MD, Beth Israel Deaconess Medical Center 166. Prevalence of Methicillin-Resistant Staphylococcus Aureus Among ED Patients With Community Acquired Skin and Soft Tissue Infections; Gregory Moran, MD, Olive View-UCLA Medical Center 167. Cost-Effectiveness of Enhanced Screening for Gonorrhea and Chlamydia Compared to Standard Practice in an Urban Pediatric ED; Supriya Mehta, PhD, MHS, Boston University 168. The Utility of the Sepsis Syndromes in Predicting In-Hospital and One Year Mortality; Nathan Shapiro, MD, MPH, Beth Israel Deaconess Medical Center 169. Relative Cost of Performing Rapid HIV Testing in a High Volume Urban ED Setting; Eileen Couture, DO, Stroger Hospital of Cook County 170. A Clinical Decision Rule to Predict Trimethoprim/Sulfamethoxazole Resistance for Urinary Tract Infections Among ED Patients; Robert Norton, MD, Oregon Health & Science University

Wounds and Burns

POSTER SESSION

195. Detection of Ocular Foreign Bodies Using Compact Ultrasound; Stephen Shiver, MD, Medical College of Georgia 196. Ultrasound Detection of Acute and Subacute Wood Soft Tissue Foreign Bodies of Differing Densities; DeAnn Bullock, MD, Medical College of Georgia 197. Dermal Wound Closure Methods Alter Scar Healing; Lillian Rich, MD, University of Massachusetts 198. Assessment of the Efficacy of Suction-Assisted Irrigation of Deep Lacerations Using A Novel Wound Cleansing Model; David Barlas, MD, New York Hospital Queens 199. Effect of a Commercially Available Burn Cooling Blanket on Core Temperatures in Volunteers; Adam Singer, MD, Stony Brook University

(4:00 - 6:00 pm)

Improving Resuscitation 171. Hypothermia Induction in Domestic Swine: Comparison of Cold Intravenous Infusion With a Non-Invasive Approach; William Ohley, PhD, University of Rhode Island 172. Anterior vs. Lateral Needle Decompression of Tension Pneumothorax: Comparison By CT Chest Wall Measurement; Owen Lander, MD, Beth Israel Deaconess Medical Center 173. Shock Frequency With Mono vs. Biphasic AEDs; Sarah Carson, MD, University of Arizona 174. Effect of Bystander-CPR on Successful Defibrillation at Scene During Witnessed Out-of-Hospital Ventricular Fibrillation in Japan; Masaru Suzuki, MD, Keio University 175. Intraosseous Drug Delivery During CPR: Relative Dose Delivery Via the Sternal and Tibial Routes; George Kramer, PhD, University of Texas?

176. Biphasic and Monophasic Defibrillation Produce Equivalent Clinical Outcomes; Kimberly Freeman, MD, University of California, San Francisco Fresno ❋177. Oxygenation of Paralyzed Pigs With High Flow Tracheal Oxygen; William Meggs, MD, PhD, East Carolina University 178. Cardiac Arrest Patients Rarely Receive Chest Compressions Prior to Ambulance Arrival Despite the Availability of Pre-Arrival CPR Instructions; E Brooke Lerner, PhD, University of Rochester 179. Reconsidering the “ABCD” Doctrine: Should Resuscitation Begin With Defibrillation?; Sigrid Hahn, MD, Mount Sinai 180. Mediation of Hypothermia Protection Against Ischemia/Reperfusion Injury: Superoxide Signaling and Later Nitric Oxide Protection?; Wei-Tien Chang, MD, University of Chicago and National Taiwan University Hospital ❋ 181. Cardiac Ultrasound to Monitor Post Cardiac Arrest Myocardial Dysfunction; Ashish Panchal, The Ohio State University 182. Withdrawn 183. Amiodarone is Poorly Effective for the Acute Termination of Ventricular Tachycardia; Keith Marill, MD, Harvard Medical School

Abdominal Pain 200. Computerized Tomography Scan Use in the ED Evaluation of Patients With Non-specific Abdominal Pain is Increasing Despite Decreased Patient Acuity; Jeremy Brown, MD, George Washington University 201. Emergency Ultrasound and Urinalysis in Combination Facilitates Clinical Decision Making in Patients With Suspected Renal Colic; Lisa Preston, DO, Christiana Care Health System 202. Bedside Ultrasound for Appendicitis; Matthew Solley, MD, University of California, Irvine 203. Serum Lipase Level as a Predictor of Gallstones as the Etiology of Acute Pancreatitis; Ali Ghobadi, University of California, San Diego 204. Serum Parameters in Small Bowel Obstruction: Predictors of Mortality?; Laureano Giraldez, BA, University of Puerto Rico 205. Withdrawn

Cost Effectiveness and Resource Allocation in the ED 206. Emergency Physician Echocardiography Reduces Cost of Hospitalization for Patients With Pericardial Effusion; Paul Sierzenski, MD, RDMS, Christiana Care Health System 207. Lack of Utility of Telemetry Monitoring During Transport of LowRisk Chest Pain Patients From the ED; Farid Visram, MD, Stony Brook University 208. Utility of Telemetry Monitoring and Nursing Presence During Transfer of Admitted “Rule Out” Acute Coronary Syndrome Patients To Inpatient Beds; Jesse Pines, MD, MBA, University of Pennsylvania

EMS - Resuscitation/ACLS 184. Prospective Validation of a Termination of Resuscitation Decision Rule for Out-of-hospital Cardiac Arrests Managed by Emergency Medical Technicians – Defibrillator Only; Laurie Morrison, MD, FRCPC, MSc, Sunnybrook & Women’s College

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Monday, May 23 232. Do Temporal and ED Resource Demands Impact Key Intervals to Care in STEMI Patients?; Robert Swor, DO, William Beaumont Hospital 233. Abbreviated Risk TIMI Score (ARTS) Mimics TIMI Risk Score for Low Risk Chest Pain; David Robinson, MD, University of Texas 234. Three Clinical Variables Predict the Need for the Chest Radiograph Among ED Patients With a Possible Acute Coronary Syndrome; Ryan Knapp, BS, Dartmouth Medical School 235. Estimating Pretest Probability of Acute Coronary Syndromes in Low-Risk ED Patients; Alice Mitchell, MD, Carolinas Medical Center 236. Validation of the San Francisco Syncope Rule; Lawrence Kass, MD, Penn State Hershey Medical Center 237. Easily Accessible and Accurate Method to Assess Heart Rate Variability in Humans; David Berkoff, MD, Duke University

209. Reimbursement Rate for EM Ultrasound; Anthony Mazzeo, MD, Drexel University 210. A Clinical Decision Rule for Routine Electrolyte Testing in Diabetic Patients With Moderate Hyperglycemia; David Wallace, MD, MPH, State University of New York, Downstate 211. Emergency Physicians Decrease Hospital Charges by Performing Bedside Ultrasound for Deep Venous Thrombosis; Danniel Morrison, MD, Medical College of Georgia 212. Defining a Set of Criteria to Reduce Blood Redraws in ED Patients With Pseudohyperkalemia; A Lombardi, MD, Ohio State University

Ethics 213. What Determines if Patients are Willing to Participate in Resuscitation Studies Without Providing Informed Consent?; Adel AlMarshal, George Washington University 214. Patient Response to Written Notification During Prehospital Care Trials Using Waiver of Informed Consent; Julia Spence, MD, FRCPC, MSc, St. Michael’s Hospital, University of Toronto 215. Impact of Detailed Informed Consent on Research Subject Participation: A Prospective, Randomized Trial; Catherine Marco, MD, St. Vincent Mercy Medical Center

MODERATED POSTERS

(5:00 - 6:00 pm) Sports: Caring for Athletes and the Spectators Moderator: Frank Peacock, MD, Cleveland Clinic 238. Influence of Environmental Factors on Morbidity at Mass-Gathering Sporting Events; Tomoko Sampson, MPH, University of Iowa 239. Male Patient Visits to the ED Decline During Major Sporting Events; David Jerrard, MD, University of Maryland 240. Certification Requirements for Coaching Staff of Illinois High School Athletic Teams; Adam Schlichting, MPH, University of Illinois

Family Presence during Resuscitation 216. EMS Providers Experiences With Family Presence at Resuscitation; Robert Swor, DO, William Beaumont Hospital 217. Provider Experience and Attitudes Towards Family Presence During Resuscitation Procedures; Kirsten Engel, MD, University of Michigan 218. Family Presence During Critical Resuscitation in the ED: Do Patients and Family Members Agree?; Sara Chakel, MD, University of Michigan

Computer Simulation Moderator: James Gordon, MD, MPH, Harvard 241. Using Simulation as a Cognitive Debiasing Strategy; William Bond, MD, Lehigh Valley Hospital 242. Computer Simulation and Observational Study of the Cardiac Chest Pain Patient in a Variably Overcrowded ED; Aaron Bair, MD, University of California, Davis 243. Interactive Triage Simulator for the Evaluation of ED Triage; Olivier Rutschmann, MD, MPH, Geneva University Hospital

Pain 219. Pain Perception in ED Patients With Headache: Responses to Standardized Painful Stimuli; Catherine Marco, MD, St. Vincent Mercy Medical Center 220. Patient Pain: A Comparison of Observed vs. Documented Physician Assessment and Treatment; Carey Chisholm, MD, Indiana University 221. Two-Thirds of Patients With Acute Severe Pain Obtain Less Than 50% Improvement in Pain 30 Minutes After Receipt of 0.1 mg/kg Intravenous Morphine; Polly Bijur, PhD, Albert Einstein College of Medicine 222. Effect of Temperature on the Pain of Ophthalmic Tetracaine Instillation; Kelly Flannigan, MD, Jacobi Medical Center 223. Addition of Intravenous Ultra Low Dose Naloxone to Morphine Does Not Enhance Analgesia; Michelle Davitt, MD, Albert Einstein College of Medicine 224. Physician Ethnicity Predicts Successful ED Analgesia; Knox Todd, MD, MPH, Beth Israel Medical Center, New York 225. Comparative Study of Efficacy and Safety of Diclofenac and Butorphanol in Acute Musculoskeletal Pain; Vineet Gupta, MBBS, All India Institute of Medical Sciences 226. Sex Differences in Pain Perception and Description; Andra Blomkalns, MD, University of Cincinnati 227. Provider Misperception of Patient Pain Severity Is A Major Reason for Oligoanalgesia; Martha Neighbor, MD, University of California, San Francisco

Didactic Sessions State-of-the-Art: New Methods, Markers, and Devices to Diagnose and Risk-Stratify Non-Traumatic Circulatory Shock (8:00-9:30 am), Mercury Ballroom Jeffrey A. Kline, MD, Carolinas Medical Center Alan E. Jones, MD, Carolinas Medical Center John G. Younger, MD, MS, University of Michigan Nathan Shapiro, MD, Beth Israel Deaconess Non-traumatic circulatory shock is a common clinical entity encountered in the ED that carries a high mortality rate. However, despite decades of research shock remains an elusive diagnosis. An important step in establishing the presence of shock is for the clinician to link the bedside clinical impression to quantitative data of widespread circulatory insufficiency. Recent research has highlighted the potential utility of several new diagnostic options for establishing the presence and etiology of shock in the ED. This session will begin with a brief review of the epidemiology, classification and pathophysiology of shock in the ED. The speakers will then present and critically appraise the latest published evidence on quantitative measurements used to diagnose and risk-stratify shock: 1. The utility of clinical variables such as presenting signs and symptoms and vital signs; 2. Direct and indirect measurements of tissue oxygenation such as lactate and lactate clearance, central venous oxygen saturation, sublingual capnometry, and protein marker measurements (TNF, BNP, and HMGF); 3. Non-invasive methods of determining the etiology of shock such as goal-directed ultrasonography. At the completion of this session participants will: 1. Understand the epidemiology and classification of non-traumatic shock; 2. Learn the value of clinical features and laboratory measurements in establishing the presence of shock; 3. Appreciate the features of emerging non-invasive methods for determining the etiology of nontraumatic shock.

Emergency Cardiac Care and Risk Stratification 228. Multi Detector CT Scan in the Evaluation of ED Chest Pain; Dick Kuo, MD, University of Maryland 229. Is Routine Lipid Testing for Patients Presenting to an ED With Chest Pain Worthwhile?; Debra Kerr, BN, MBL, Joseph Epstein Centre for EM Research 230. Impact of Early Administration of Evidence-Based Antithrombotic and Antiplatelet Therapy in Patients With High-Risk Non-St-Segment Elevation Acute Coronary Syndrome: Experience From the Synergy Study; Charles Pollack, Jr, MA, MD, Pennsylvania Hospital 231. ECG Differentiation of Benign Early Repolarization vs. Acute Myocardial Infarction By Emergency Physicians and Cardiologists; Samuel Turnipseed, MD, University of California, Davis

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Monday, May 23 various advanced degree curricula, including how the degree attainment process might fit into their faculty development plans; 3. Know the costs (both financial and non-financial) involved, and the demands placed on themselves as well as their department during this process; and 4. Be better informed as to whether an additional degree would be of benefit to them and/or their department.

Defining the Research Agenda for ED Crowding and Patient Flow Lessons from the Robert Wood Johnson Foundation’s Urgent Matters Project (8:00-10:00 am), Trianon Ballroom Brent Asplin, MD, MPH, Regions Hospital Leon L. Haley, MD, MHSA, Emory University Niels Rathlev, MD, Boston Medical Center Theodore Chan, MD, University of California, San Diego The Urgent Matters (UM) program was a $4.6 million initiative of the Robert Wood Johnson Foundation to address ED crowding. Ten hospitals, including academic centers, were selected nationwide to participate. Each site conducted research on ED crowding, developed key performance indicators (KPIs) and metrics of ED patient flow, implemented approaches to improve processes, and studied outcome parameters to assess impact. This didactic will focus on the concepts and research tools developed by the UM program and how they were applied at various sites to address ED crowding. These tools include the input/throughput/output conceptual framework of ED flow, measurement of ED process metrics and KPIs, online data tools and reporting, rapid cycle testing, monthly learning network conference calls, and other research strategies for analyzing and assessing impact on ED flow and crowding. An important aspect of this presentation will focus on how EM researchers and ED administrators can implement similar strategies for improving and conducting research on crowding and patient throughput at their sites. To illustrate these strategies for research, case examples will be presented from 3 UM Academic EDs. Each site will discuss various aspects of their approach to ED crowding and flow, as well as present an innovative project developed, implemented and studied: Rapid ED entry and barcoding technology (University of California, San Diego); Elective surgery schedule smoothing and inpatient bed availability (Boston Medical Center) and Augmenting ED clinical decision units with case management (Emory University). At the completion of the session, participants will: 1. Understand the underlying operations management conceptual framework for maximizing patient flow and alleviating ED crowding, including a discussion of the input/ throughput/output model of ED crowding; 2. Acquire new research and measurement tools to assess patient flow, including key performance indicators and other metrics; 3. Develop new ideas for conducting collaborative research to improve patient flow and alleviate ED crowding; 4. Become familiar with implementation strategies such as rapid cycle testing and outcomes assessment for improving patient flow.

The Clinical Research Unit: Achieving Success Through a Variety of Methods (10:00-12:00 pm), Trianon Ballroom Judd Hollander, MD, University of Pennsylvania Ian Stiell, MD, MSc, Ottawa Health Research Institute Lala Dunbar, MD, PhD, Charity Hospital This symposium is a series of 5 conferences designed to teach researchers how to develop their own clinical laboratory. 1. Essential Elements of a Clinical Research Unit (Judd E. Hollander, 15 minutes) 2.

The traditional approach: The government funded approach to clinical research (Ian Stiell, MD, 30 minutes) 3. A university based approach: Integrating students into your clinical research infrastructure (Judd E. Hollander, MD, 30 minutes) 4. Developing your research infrastructure via pharmaceutical trials (Lala Dunbar, 30 minutes) 5. Common Problems with Clinical Research: Avoid the mistakes we have made: Interactive panel discussion with all speakers (45 minutes) Dr. Hollander will discuss the personnel (and their roles) required for successful clinical research. Several strategies to accomplish data collection in an active busy ED will be discussed. Dr. Stiell will discuss the methods he has used to efficiently conduct several different series of studies in a scientifically rigorous yet efficient manner through the use of traditional funding sources. Dr. Hollander will discuss the use of undergraduate students as clinical researchers and describe several currently existing student programs used by EM researchers. This talk will emphasize ways to facilitate EM data collection and integrate education of students into this process. Dr. Dunbar will discuss the methods she has used to conduct pharmaceutical sponsored clinical trials and build her successful research unit. All discussants will then present several problems they have encountered in individual projects and in setting up their research units and discuss ways they have successfully and unsuccessfully managed to deal with these problems. In addition, time will be allotted for questions and audience participation. At the completion of the session, participants will: 1. Understand the essential components of a clinical research unit; 2. Understand the roles of each of the participants; 3. Improve their understanding of expeditious ways to conduct a series of clinical investigations; 4. Be able to establish a clinical research unit in their ED; and 5. Be able to address some of the common problems that occur with clinical research

The Role of Advanced Degrees in the Pursuit of Faculty Advancement and Promotion (9:30-11:00 am), Beekman Parlor

Educational Research Track: Choosing the Educational Research Design (11:00-12:00 pm), Mercury Ballroom

Frank Zwemer, MD, MBA, University of Rochester Arthur L. Kellermann, MD, MPH, Emory University Bernard L. Lopez, MD, MS, Thomas Jefferson University The attainment of an advanced degree such as a Masters of Science, Masters of Public Health, and a Masters of Business Administration requires participation in a formal educational curriculum. They provide the student with didactic, laboratory, and seminar teaching and often involve directed instruction in research. Most academic emergency physicians do not have this formal training. Given the many pressures to succeed, a formal educational tool such as an advanced degree may provide significant benefit both to the individual, as well as to the entire department. This session was developed to inform academic-minded emergency physicians about three advanced degrees that may provide benefit for career advancement. The panel of academic emergency physicians with advanced degrees will describe their particular degree and provide their faculty development plan related to attainment of their degree and its relationship to their field of research or scholarly work. They will describe how and when they carried out their plan and achieved their degree, how the degree has had an impact on their own careers, and how it has affected their department’s academic productivity. They will describe the time requirements, monetary costs, and what is required from the department chair in order to successfully carry out their plan and attain their degree. Finally, the panel discussants will describe ways to actively use this degree to benefit themselves, their department, and the specialty of EM, at local, regional and national levels. At the completion of the session, participants will: 1.

Have an understanding of three advanced degrees and their potential impact on their career development; 2. Have an idea of specifics of the

Boyd Richards, PhD, Baylor College of Medicine Dr. Boyd Richards, the chair of Baylor College of Medicine’s Office of Curriculum and an editorial board member of Teaching and Learning in Medicine, will compare and contrast various educational research design methodologies. Building on the basics addressed in last year’s didactic session, the speaker will focus on more advanced concepts in research design. Practical examples will be provided in a case-based format, focusing on the strengths and weaknesses of each design methodology. This is second module in the second year of the proposed three-year Educational Research Track a longitudinal, comprehensive curriculum designed to provide a foundation for aspiring and established educational researchers in EM in the conduction of medical education (graduate or undergraduate) research. This track will help SAEM members develop a strong theoretical and practical knowledge base in educational research methodologies and advance the state of this type of research within the specialty to meet the highest standard.

At the completion of the session, participants will: 1. Describe different educational research design approaches to answer a research question; 2. Compare and contrast various design methodologies; and 3.

Identify the best methodology design for a particular study question.

LUNCH SESSION: Research Compliance: A Useful Primer (12:00-1:30 pm), Sutton Center Gabor D. Kelen, MD, Johns Hopkins University Judy B. Shahan, RN, MBA, Johns Hopkins University In its 2002 report Integrity in Scientific Research, the Institute of Medicine (IOM) states that it is more important than ever that individual

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Monday, May 23 scientists and their institutions periodically assess the values and professional practices that guide their research, as well as their efforts to perform their work with integrity. As the scope of research in EM continues to advance, it is critical for both young investigators and more experienced scientists to secure the public’s trust in scientific integrity through awareness of and training in the responsible conduct of research. The guidelines, standards, and ethical principles necessary to promote integrity in the conduct of basic and clinical scientific research will be discussed. Topics will include: authorship practices, intellectual property, technology transfer, and scientific misconduct.

Effort reporting is the systematic accounting of salary funds charged to sponsored projects. Researchers will learn how to certify and report sponsored salary funding as a proportion of total professional activity.

Financial and non-financial conflicts of interest are clashes between one’s primary duty and a secondary interest. Included will be an explanation of the primary commitment of the investigator to protect the safety of human subjects and to produce objective results, as well as a discussion of the primary responsibilities of an investigator to his or her academic institution. Information on recognition, reporting and resolution of conflicts of interest will also be presented. At the completion of the session, participants will have: 1. Increased knowledge of and sensitivity to the guidelines, standards, and ethical principles necessary for research integrity; 2. Improved understanding of the concept of sponsored salary support as a proportion of total professional activity; 3. Skills to identify and resolve conflicts of interest; and 4. Knowledge of and appreciation for the difference between conflict of interest and conflict of commitment.

Knowledge Translation and EM: Bridging the Gap from Evidence to Clinical Practice (1:30-3:00 pm), Mercury Jeremy Grimshaw, MD, University of Ottawa Eddy Lang, MD, McGill University Michael Brown, MD, Michigan State University Many patients who receive emergency care fail to receive proven treatments and might be subjected to unnecessary testing and/or harmful therapies. High quality research which supports evidence-based clinical practice exists in journals but often does not get translated into consistent decision-making for patients. Knowledge translation (KT) refers to the exchange, synthesis and ethically-sound application of research evidence into clinical care. Specifically, KT is the application of research which occurs within a complex system of relationships among researchers and knowledge-users i.e. health care providers, patients and administrators. KT is a new area of research that has arisen out of this gap between evidence and practice; it is largely unknown in EM. Other specialties, on the other hand, have addressed KT through published forums (e.g. ACP Journal Club) that offer succinct and useful evidence summaries available to practicing clinicians. Implementation trials that examine the adherence and impact of proven diagnostic aids and treatment protocols are also in the early stages of development in EM. Using the evidence to practice gaps in asthma care as an example, this open session will introduce the conceptual framework underlying KT and provide some practical approaches for engaging in KT activities and research. Emphasis will be placed on: 1. The need for practical syntheses of research that is relevant to EM and presented in a manner that promotes application into practice; and 2. The principles of research methodology for studying the effectiveness of KT initiatives. Specifically, using examples in EM, consider the challenges associated with KT research. At the completion of the session, participants will be introduced to the principles of KT. Furthermore, they will be stimulated to consider opportunities for advancing evidence uptake within their own contexts. This may take the form of specific evidence implementation strategies within their own centers i.e. critical pathways, decision support software, forcing functions. Alternatively, this could also lead to developing evidence summaries with an eye to application in the clinical context or KT research i.e. cluster randomized trials or analyses/comparisons of best practice models.

Outcomes of interest in KT research might include adherence to protocols, cost/efficiency indices or clinical/safety outcomes as the primary measures of interest.

LUNCH SESSION: Integrating Residency Evaluation Tools and the ACGME Core Competencies (12:00-1:30 pm), Sutton North Pamela L. Dyne, MD, University of California, Los Angeles/Olive View Stephen R. Hayden, MD, University of California, San Diego The first phase of the ACGME’s Outcome Project requires that all residency programs and faculty teach and evaluate their residents on the six Core Competencies of Patient Care, Medical Knowledge, Interpersonal Skills and Communication, Practice Based Learning and Improvement, Professionalism, and Systems-Based Practice. Since all faculty members must evaluate residents, it is essential that all faculty members understand not only what the ACGME Core Competencies are, but how they are best evaluated. The ACGME has suggested multiple evaluation tools for use by all specialties in order to accomplish these new requirements. However, Graduate Medical Education is not one-size-fits-all, and which of these are most appropriate for the unique nature of EM training and bedside education? This didactic session will define the six ACGME Core Competencies as they have been refined for EM. The various evaluation tools, such as the global evaluation form, 360 degree evaluations, written examination, direct observation, oral exams, simulations, and porfolios will also be described and evaluated in an evidence-based manner. Potential foci of new educational research on the Competencies, evaluation tools, and the Outcomes Project will be identified. The best evaluation tools will be correlated with the Core Competencies for which they are thought to be most useful. A summary description of how any faculty member or program director may integrate this information to confidently define a resident’s competence in each of the six realms will be presented. At the completion of this session, participants will: be able to understand why all faculty members who work with residents should be evaluating them, be able to state and define the six ACGME Core Competencies, describe the various evaluation tools used to evaluate EM residents, understand which evaluation tools are best for evaluating EM residents for each of the six Core Competencies, and understand how to integrate the various evaluation tools in order to define a resident’s competence in each of the six realms. In addition, participants will be able to identify potential foci of new educational research based on the Core Competencies, evaluation tools, and the Outcomes Project.

Public Health Research: Challenges and Solutions for the Future (1:30-3:00 pm), Beekman Parlor Gail D’Onofrio MD, Yale University Arthur Kellermann, MD, Emory University Linda Degutis, DrPH, Yale University Emergency physicians can and do play major roles throughout the country in public health research and education. EPs have been awarded millions of dollars from federal agencies to identify and describe high risk conditions. For many individuals needing public health interventions, the ED may be the ideal place and sometimes the only place to efficiently identify and intervene. While EM has been successful at identifying the potential for ED based publish health research, ED based interventions pose challenges including the need for additional resources for identification and intervention, and difficulties with adequate follow-up for outcome analysis. Technologies such as the paperless chart and computerized informatics will also have an impact on the future of public health research and surveillance. Using injury prevention as an example, this session will describe challenges in ED based public health research, and pose potential solutions. Additionally, the impact of technology on ED based surveillance and research will be discussed. Our speakers are individuals who have both demonstrated the success and positive impact EP’s can have as public health researchers and advocates. Their experience will highlight the necessary ingredients for success in past, present and future public health research. At the completion of the session, participants will 1. Summarize success of ED public health and injury prevention research; 2.

Use firearm and motor vehicle crash injury prevention as models of ED public health research, describe current challenges and suggested solutions; and 3. Outline the necessary components of successful injury

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Monday, May 23 prevention research including funding, enrollment, intervention, and partnership opportunities for appropriate outcome analysis.

Acquiring Skills to Interview with the Television Media (7:00-8:00 pm), Nassau A Rishi Sikka, MD, Boston University Emergency physicians may be called upon by television reporters to provide commentary on medical stories and new research. This is an important, public health opportunity for emergency physicians to affect health beliefs and decision making. This workshop will serves as an educational platform to help emergency physicians prepare for this unique and potential, far-reaching moment. This workshop will discuss the process of reporting, interviewing and writing a medical news story from the television reporter’s perspective. Participants will be provided with a series of explicit strategies to help in the preparation of an interview and to assist with answering interview questions. The importance of a prepared agenda and specific messages to be communicated will be stressed. These strategies will be reinforced through a series of roleplaying exercises during the workshop. These interactive exercises will simulate television interviews following mass casualty incidents, public health outbreaks, high profile clinical cases and the publication of new research. At the completion of the session, participants will be able to effectively prepare for and communicate their specific agenda during a television interview.

Tuesday, May 24 245. Factors Associated With Performance of Bystander Cardiopulmonary Resuscitation in a Large Metropolitan Area; Robert Silverman, MD, Long Island Jewish Medical Center ❋ 246. A Randomized Comparison of Manual, Mechanical, and HighImpulse Chest Compression in a Porcine Model of Prolonged Ventricular Fibrillation; Amy Betz, University of Pittsburgh 247. Detrimental Effect of Short Pauses During CPR Following Prolonged Ventricular Fibrillation; Gregory Walcott, MD, University of Alabama at Birmingham

Airway (8:00-9:00 am), West Ballroom Moderator: Ron Walls, MD, Brigham & Women’s Hospital

❋ 248. Confirmation of Endotracheal Tube Placement After Intubation

Using the Sliding Lung Sign; Blake Weaver, DO, Medical College of Georgia ❋ 249. Pressing on the Neck During Laryngoscopy: A Comparison of Cricoid Pressure, Backward Upward Rightward Pressure, and External Laryngeal Manipulation; Richard Levitan, MD, University of Pennyslvania 250. Transtracheal Ultrasound for Detection of Esphageal Intubation; Truman J. Milling Jr., MD, New York Methodist Hospital 251. A Prospective Study Comparing Standard Laryngoscopy to the TrachViewTM Fiberoptic System for Tracheal Visualization Prior to Endotracheal Intubation; Lynn Roppolo, MD, University of Texas Southwestern

PowerPoint as a Teaching Tool (7:00-9:00 pm), Nassau B

POSTER SESSION

Joe Lex, MD, Temple University This hands-on workshop, limited to the first 24 registrants, will give you dozens of hints to enhance your slides and make your presentations unforgettable. You will bring your own laptop with PowerPoint 97 or higher already loaded. We’ll supply the power source, a CD full of useable tools, and a 180-page syllabus full of hundreds of presentation tips. You will leave the workshop with your head full of new ideas for electrifying slideshows. Joe Lex (a.k.a. The Slide Doctor) will show you how to create your own background, import pictures and animations, change the colors of your ClipArt, and edit photos and radiographs without additional expensive software. You will learn how to draw perfect circles, squares, stars, and other shapes, then fill them with your favorite digital photographs. You will discover how to hyperlink from items on your slide to other documents on your hard-drive or, if you have a live Internet connection to a site on the worldwide web. You will see how to animate individual elements in your graphs, and how to revise your graph style by the click of a button. In short, you will gain essential skills needed to turn your slideshows into powerful teaching tools. At the completion of the session, participants will: 1. Recognize at least ten little-known features of PowerPoint - cropping tool, format painter, WordArt, Slide Layout tool, shadows, perfect square and circles, animation as an education tool sticky notes, using a “special picture” as a background, using “watermarks,” converting a slideshow (.pps) into a PowerPoint (.ppt) document, inserting slides from other programs, etc.; 2. Demonstrate the ability to load new Clipart, fonts, and other helpful tools onto your hard drive; 3. Understand how to hyperlink from icons on a PowerPoint slide to other documents, and how to create a “shortcut” to a specific line in a document; 4. Show how to make visual material stand out from the background; 5. Create an appropriate background template from scratch; 6. Comprehend the significance of the “Slide Master” feature; 7. Appreciate how color choices can alter the intent of a presentation; 8. Demonstrate how to successfully use Tables on a slide; 9. understand why the Pack-and-Go feature is so important 10. Show how to work on your speaker’s notes and slides simultaneously.

(9:00 - 11:00 am)

Hypertension 252. Is Elevated ED Blood Pressure Associated With Nonspecific Cardiovascular and Neurologic Symptoms?; Jacob Ufberg, MD, Temple University 253. Hypertension and Epistaxis; William Chiang, MD, Bellevue Hospital 254. Characteristics, Access to Healthcare and Referral of NewlyIdentified Hypertensive ED Patients; Brigitte Baumann, MD, UMDNJ/RWJMS at Camden 255. Limitations of the Triage Blood Pressure in Screening for Hypertension in ED Patients; Brigitte Baumann, MD, UMNDJ/RWJMS at Camden 256. Race and Ethnicity as Determinants of ED Patients’ Knowledge of Hypertension; Brigitte Baumann, MD, UMDNJ/RWJMS at Camden 257. Outcome of Patients Discharged From the ED After an Episode of Severe Hypertension; David Cline, MD, Wake Forest University 258. History of Hypertension Rather Than Elevated ED Blood Pressure Correlates With Patient Morbidity; David Cline, MD, Wake Forest University Health Sciences 259. Impact of Blood Pressure Variability in the First Three Hours of Acute Ischemic Stroke; Latha Stead, MD, Mayo Clinic

Congestive Heart Failure 260. Increases in ED Visits for Congestive Heart Failure During the Christmas and New Year’s Holiday Season; Lisa Reedman, MD, Morristown Memorial Hospital 261. Racial Disparities in Initial Severity of Illness for Patients Hospitalized With Heart Failure; Margaret Hsieh, MD, University of Pittsburgh 262. Length of Stay and Charges are Increased in Patients With Digitally Detected Third Heart Sounds; Alan Storrow, MD, University of Cincinnati 263. Combination of BNP and Automated Heart Sounds Improves Heart Failure Diagnostic Accuracy; Sean Collins, MD, University of Cincinnati 264. Impact of Diabetes on Hospital Admissions, Length of Stay, and Mortality in ED Patients With Acute Decompensated Heart Failure Without Ischemia; Jill Griffin, MD, Baystate Medical Center 265. Morphine for Acute Decompensated Heart Failure: Valuable Adjunct or a Historical Remnant?; W. Frank Peacock, MD, Cleveland Clinic 266. What is the Impact of Testing for NT-proBNP in ED Patients With Dyspnea?; Bruce Cload, PhD, MD, Queen’s University 267. Severely Depressed Left Ventricular Function in Young Patients With New Onset Congestive Heart Failure; Brenna Yursik, Tulane University

Scientific Papers ORAL PAPER PRESENTATIONS CPR (8:00-9:00 am), East Ballroom Moderator: Lance Becker, MD, University of Chicago

❋244. Quality of Defibrillation: Inconsistent Rhythm Identification and

Long Pre-Shock Pauses During Cardiac Arrest; Dana Edelson, MD, University of Chicago

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Tuesday, May 24 292. Evaluation of a Pediatric Sedation Service for Common Diagnostic Procedures; Wendalyn King, MD, MPH, Emory University 293. Ultrasound Assisted Peripheral Intravenous Access in Pediatric ED Patients; Aaron Bair, MD, University of California, Davis 294. Pediatric Pre Hospital Evaluation of New York Cardiorespiratory Survival (PHENYCS): A Large, Prospective Population Based Study of Cardiac and Respiratory Arrest: Analysis of Cardiac Arrests; George Foltin, MD, New York University 295. Pediatric Pre-Hospital Evaluation of New York Cardiorespiratory Survival (PHENYCS): A Large, Prospective Population Based Study of Cardiac and Respiratory Arrest: Analysis of Respiratory Arrests; Michael Tunik, MD, New York University 296. Epidemiology of Pediatric ED Recurrent Visits; Elizabeth Alpern, MD, MSCE, The Children’s Hospital of Philadelphia 297. Should the Centor and McIssac Criteria be Used to Predict the Probability of Group A Streptococcal Pharyngitis in Children Ages 2-12 Years?; Tresa McNeal, MD, Scott & White Hospital/Texas A&M University 298. Discrepancy Rates in Pediatric Teleradiology: General vs. Pediatric In-house Radiologists; Lynn Lawrence, MD, Women and Children’s Hospital of Buffalo

268. Safety and Efficacy of B-Type Natriuretic Peptide as a Bridge to Dialysis in End Stage Renal Failure Patients With Acute Decompensated Heart Failure; Jim Weber, DO, University of Michigan

Research Design 269. Comparing a Single vs. Multi-item Measure of Safety Belt Use for ED-based Survey Research; William Fernandez, MD, MPH, Boston University 270. Learning Algorithms as Applied to a Large Head-Injury Database; Daniel Davis, MD, University of California, San Diego 271. Using Subsequent Citation to Measure the Value of EM Animal Studies: Five vs. Ten Years of Follow-up and Comparisons With the General Surgery Literature; Tracey Reilly, MD, Upstate Medical University

Large Database Research 272. Author Reported Funding in the EM Literature Over the Last Decade; Shawn Van Deusen, MD, New York Methodist Hospital 273. Limitations of ED Claims Data in Detecting Behavioral Health Diagnoses; Robert Lowe, MD, MPH, Oregon Health & Science University 274. Agreement and Validity of Existing and Imputed Prehospital Data in a State Trauma Registry When Compared to Ambulance Data; Craig Newgard, MD, MPH, Oregon Health & Science University 275. Interhospital Trauma Transfer Practices in a Statewide Rural Trauma System; Craig Newgard, MD, MS, Oregon Health & Science University

Psychiatry and Social Issues 299. Mood Disorders and Interest in ED Interventions: A Multicenter Study; Edwin Boudreaux, PhD, UMNDJ-RWJMS Camden 300. ED Management of Acute Undifferentiated Agitation: A Randomized, Double-blind Trial of Droperidol, Lorazepam, and Ziprasidone; Todd Gengerke, MS, Hennepin County Medical Center 301. National Psychiatric and Narcotic Medication Usage Associated With the Terrorist Attacks of the Fall of 2001; Rishi Sikka, MD, Boston University 302. Health Status Among ED Patients Approximately 1 Year After Consecutive Disasters in New York City; William Fernandez, MD, MPH, Boston University 303. Quality of Health Care is Not Adversely Affected for Those Patients Receiving Care From Emergency Physicians of a Gender Opposite to That Which Is Desired; David Jerrard, MD, University of Maryland 304. Withdrawn 305. Reduction of Alcohol Consumption and High Risk Driving Behaviors in Court Mandated Young Drivers; Ted Nirenberg, PhD, Brown University 306. Criminal Correlates of Injury-Related ED Recidivism; Gregory Larkin, MD, University of Texas, Southwestern 307. A Population-Based Case-Cohort Study to Evaluate Prehospital and ED Utilization by Homeless Patients; David Pearson, MD, MS, Denver Health Medical Center

Administration - Intervention and Systems 276. Evaluation of an Algorithm for the Normalization of Chief Complaints; Larry Nathanson, MD, Beth Israel Deaconess Medical Center 277. Faculty Triage is More Efficient Than Resident or Nurse Practitioner Triage; Patricia Frierson, MD, Texas Tech University 278. Effects of Prospectively Screening ED Admissions for Level of Care by a Utilization Management Registered Nurse; Victoria Dickerson, MD, University of Rochester 279. Impact of a Protocolized Approach to Antibiotics in Sepsis; Michael Howell, MD, Beth Israel Deaconess Medical Center 280. A Novel Staffing Approach to Address Patient Satisfaction in the ED; Mary Ward, RN, North Shore University Hospital 281. Patient Satisfaction: Variables Contributing to ED Patient Satisfaction; Catherine Marco, MD, St. Vincent Mercy Medical Center 282. An ED Intake Form Improves Documented Medical History; Lisa Chan, MD, University of Arizona 283. Structured Team Patient Assignment Decreases Variability in Faculty Productivity in an Academic ED; Daniel DeBehnke, MD, Medical College of Wisconsin 284. Validation of a Verbal Assessment Tool of English Proficiency for Use in the Healthcare Setting; Leslie Zun, MD, Mount Sinai Hospital 285. The Impact of an Electronic Medical Record Implementation on ED Work Relative Value Unit Productivity; Abu Khan, MD, MSc., Maimonides Medical Center 286. The Use of an Express Admit Unit to Reduce Overcrowding in the ED and Reduce Hospital Length-of-Stay; Robert O’Connor, MD, MPH, Christiana Care Health System 287. Utility of a Discharge Nurse In Decreasing ED Length of Stay; Gerard Martin, MD, Henry Ford Hospital

Trauma 308. Role of the History in Predicting the Need for CT Scan in Minor Head Injury; Joseph Howton, MD, University of Ottawa 309. Role of Serum Biochemical Markers in Identifying Inflicted Traumatic Brain Injury in Young Infants; Subhankar Bandyopadhyay, MD, Emory University 310. Do Intoxicated Patients With a Mild Traumatic Brain Injury Have Greater Risk of Functional Impairment From Their Injury After Leaving the ED?; Linda Papa, MD, MSc, CCFP, FRCP(C), University of Florida 311. Impact of CPK Correction on the Predictive Value of S-100B After Mild Traumatic Brain Injury; Jeffrey Bazarian, MD, MPH, University of Rochester 312. Clinical Predictors for Pelvic Fracture Following Severe Trauma; Jeffrey Perry, MD, MSc, CCFPEM, University of Ottawa 313. Attitudes of Emergency Physicians Toward the Ottawa Ankle Rules; Ian Stiell, MD, MSc, FRCPC, University of Ottawa 314. The Utility of Boehler’s Angle and the Critical Angle of Gissane in Diagnosing Calcaneus Fractures in the ED; Jason Knight, MD, Maricopa Medical Center 315. How Widely Used is the Canadian C-Spine Rule by Emergency Physicians?; Ian Stiell, MD, MSc, FRCPC, University of Ottawa 316. Comparison of Ibuprofen, Cyclobenzaprine, or Both for Acute Cervical Strain: A RCT; Mustafah Khwaja, DO, Stony Brook University

Pediatrics 288. A Rule Base on Body-Weight for Predicting the Optimum Depth of Sinal Needle Insertion for Lumbar Puncture in Children; David Stocker, MD, Columbus Children’s Hospital 289. Risk Factors for Bloody Lumbar Punctures in a Pediatric ED; Lise Nigrovic, MD, Children’s Hospital 290. Test Characteristics of the Three View Abdominal Radiograph Series in the Diagnosis of Intussusception; Cindy Roskind, MD, Children’s Hospital of New York- Presbyterian 291. The Utilization of a Discharge Facilitator Improves Recall of ED Discharge Instructions; Binita Patel, MD, Baylor College of Medicine

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Tuesday, May 24 344. Plotting Serum Acetaminophen Concentrations Against Simultaneous Aminotransferase Activity: A Novel Instrument to Predict Toxicity Following Acetaminophen Overdose; Thomas Green, MSc, Queen’s University 345. Can the Venom ER Become Venom OBS?; Michelle Goodman, MD, Loma Linda University 346. Recent Changes in the Treatment of Toxic Alcohol Ingestions; Norma Cooney, MD, Texas A&M University 347. Race and Risk for Severe Alcohol Withdrawal Syndrome; Gar Chan, MD, New York University

317. Implementation of a State-wide Trauma System Results in a Reduction in Trauma Deaths; Robert O’Connor, MD, MPH, Christiana Care Health System 318. Characterization and Impact of Pediatric Trauma in the Amish Community; Melissa Vitale, MD, Penn State Children’s Hospital 319. A Test to Detect Chest Tube Kinking; Norberto Adame, MD, Maricopa Medical Center 320. Do Outcome Measures for Trauma Triage Agree?; Sydney Leach, MD, William Beaumont Hospital

Education 321. SAEM 2004/05 Faculty Salary and Benefits Survey; Steven Kristal, MD, William Beaumont Hospital 322. Parental Preference for Error Disclosure. Does Race Have an Impact?; Andrew Elms, UNC-Chapel Hill 323. Comparison of Clinical Performance Assessment Tools in a 4th year EM Clerkship; Douglas Ander, MD, Emory University 324. Evaluating Medical Student Performance in an Observed Structured Clinical Evaluation (OSCE) Using Standardized Patients (SP’s) in a Case of Intimate Partner Violence (IPV); Dahlia Hassani, MD, Emory University 325. Initial Validation of Two Novel Resident Wellness Measures; Samuel Keim, MD, University of Arizona 326. Establishing Inter-rater Reliability for Cognitive Debiasing Simulation Cases; William Bond, MD, Lehigh Valley Hospital 327. Interruptions During Oral Case Presentations in the Academic ED: Benign or Problematic?; David Silver, University of Chicago 328. Actual PDA Use by EM-1 Residents; Christopher Stromski, MD, St. Luke’s Hospital 329. Can Medical Students Have Their EM Knowledge Evaluated Under the Honor Code?; Paul Kolecki, MD, Thomas Jefferson University 330. EM Resident Depression Over an Academic Year; Eric Katz, MD, Washington University 331. Enforcing Accuracy on EM Residency Applications; Eric Katz, MD, Washington University 332. EM Residency Training in Airway Management: Assessing Competency and Expertise; Peter Henry, MD, Resurrection Medical Center 333. Comparing Teachers: The Effect of Ultrasound Technologist vs.

Physician Directed Education for Residents in Ultrasound; Leigh Patterson, MD, University of Florida

MODERATED POSTERS (10:00 - 11:00 am) Syncope Moderator: Paul Gennis, MD, Jacobi Medical Center 348. Use of a New Syncope Pathway to Select ED Patients at Risk for Adverse Outcomes and Clinically Significant Interventions; Shamai Grossman, MD, Beth Israel Deaconess Medical Center 349. Admission of Low Risk Patients With Syncope; James Quinn, MD, MS, Stanford University 350. External Validation of the San Francisco Syncope Rule; Christopher Fischer, MD, Beth Israel Deaconess Medical Center

Contrast Nephropathy Moderator: Allan Wolfson, MD, University of Pittsburgh 351. Use of Creatinine Cut-off of 1.5 mg/dL Does Not Identify Patients at Risk for Contrast Induced Nephropathy; Roger Band, MD, University of Pennsylvania 352. The Risk of Intravenous Contrast Nephropathy in Children, Adolescents and Young Adults Undergoing Emergency Imaging With IV Contrast: Is it Necessary to Check the Serum Creatinine?; James Tsung, MD, NYU/Bellevue Hospital 353. Incidence of Contrast Mediated Nephrotoxicity After ED Intravenous Contrast Exposure; Matthew Kiefaber, MD, The Ohio State University

PAPER PRESENTATIONS Trauma (11:00-12:00 noon), East Ballroom Moderator: John Marx, MD, Carolinas Medical Center 354. Sublingual Capnometry for Rapid Determination of the Severity of Hemorrhagic Shock; Boris Khodorkovsky, MD, Kings County Hospital Center ❋355. Association Between a Positive ED FAST Exam and Need for Laparotomy in Normotensive Trauma Patients; Mark Moylan, MD, Oregon Health & Science University 356. Risk of Thoracolumbar Fractures Doubled in Victims of Motor Vehicle Collisions With Cervical Spine Fractures; James Winslow III, MD, MPH, Wake Forest University 357. Derivation of a Clinical Decision Guideline for Chest Radiography in Blunt Chest Trauma; Gillian Marek, MD, Alameda County Medical Center

Learning Ultrasound 334. Using a Synthetic Model to Train Emergency Physicians for Ultrasound-Guided Peripheral Intravenous Catheterization; Brian George, University of California, San Francisco 335. Grading the Novice FAST Exam: Achieving Interrater Reliability in Among Faculty; Lisa Mills, MD, Louisiana State University 336. How Fast is the FAST Exam Learning Curve? A Comprehensive Analysis of One Residency Class; O John Ma, MD, University of Missouri - Kansas City 337. Do Emergency Physicians Gain Technical Proficiency for FAST, Gallbladder, and Deep Venous Scan After Performing 20 Scans; Daniel Theodoro, MD, RDMS, North Shore University Hospital

Injury Prevention (11:00-12:00 noon), West Ballroom Moderator: Arthur Kellerman, MD, Emory University 358. Effect of a Graduated Driver Licensing System on the Proportion of Crashes and Injuries Involving Drivers Under Age 18; Robert O’Connor, MD, MPH, Christiana Care Health System 359. Subsequent Violent Death Among ED Patients Seen for Firearm Injuries; Cameron Crandall, MD, University of New Mexico ❋360. Do State Motorcycle Helmet Laws Influence Bicycle Helmet Use Among Adolescents?; Timothy Lum, MD, MPP, University of Rochester 361. An Observational Study of Safety Belt Use Among Taxi Drivers in Boston; William Fernandez, MD, MPH, Boston University

Toxicology

❋ 338. Both Endothelial and Inducible Nitric Oxide Synthase Derived

339.

340.

341.

342.

343.

Nitric Oxide Contribute to Acetaminophen Toxicity; Steven Salhanick, MD, The Children’s Hospital Neurons in the Dorsomedial Hypothalamus Mediate Physiologic Effects of MDMA in Anesthetized Rats; Daniel Rusyniak, MD, Indiana University Treatment of Fire Ant Stings With Mitigator™ Sting and Bite Treatment – A Randomized Control Study; Michael Miller, MD, Darnall Army Community Hospital Accuracy of Bedside Testing in Mothball Identification; Peter Tsao, DO, Albert Einstein Medical Center Accuracy and Utility of the Goldfrank Sniffing Bar as a Teaching Tool; Michael Young, DO, Albert Einstein Medical Center Availability, Stability and Sterility of Reformulated Pralidoxime for Mass Casualty Use; Richard Nelson, MD, The Ohio State University

Cardiology (1:30-3:00 pm), East Ballroom Moderator: Brian Gibler, MD, University of Cincinnati 362. Does Practice Make Perfect? The Volume of Acute Myocardial Infarction Patients Seen in EDs and the Risk of Missed Diagnosis; Michael Schull, MD, MSc, Institute for Clinical Evaluative Sciences 363. Evaluation and Management of Patients With Severely Elevated Blood Pressure in Academic EDs: A Multicenter Study; David Karras, MD, Temple University

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Tuesday, May 24 sues surrounding multiple testing, subgroup analysis, and the intention-to-treat principle will also be discussed. At the completion of the session, participants will have a sufficient understanding of statistical concepts and methods to effectively collaborate with more experienced researchers and biostatisticians on the design and analysis of a clinical research study.

364. R Wave Amplitude Distinguishes Early Repolarization From Subtle Anterior STEMI; Stephen Smith, MD, Hennepin County Medical Center 365. Relationship Between A “Clear Cut Alternative Noncardiac Diagnosis” and Cardiac Risk in ED Patients With Chest Pain; Judd Hollander, MD, University of Pennsylvania 366. Prospective Validation of the TIMI Risk Score in the ED Chest Pain Patient Population; Judd Hollander, MD, University of Pennsylvania 367. Single Indeterminate-Range Troponin is Associated With Inpatient Mortality in Patients Presenting to an ED; Daniel A. Waxman, MD, Beth Israel Medical Center, New York

Emergencies in Space (11:00-12:00 pm), Mercury Ballroom Richard Summers, MD, University of Mississippi Manned spaceflight requires significant human risk from both a trauma and medical perspective. Many of the medical problems and resource limitations associated with space travel are also common to EM. This state of the art lecture examines the unique biomedical conditions of microgravity and the common and potential emergencies associated with spaceflight. In this environment, special techniques for diagnosis and treatment are often required in this unusual practice of EM. At the completion of the session, participants will: 1. Provide a brief overview the special physiology of microgravity exposure; 2. Discuss the common emergencies associated with manned spaceflight; 3. Examine the special diagnostic and treatment methods required in this extreme environment; 4. Examine the contrasts and parallels between the earthbound and space-based practices of EM.

Geriatrics (1:30-3:00 pm), West Ballroom Moderator: Robert Woolard, MD, Rhode Island Hospital 368. Assessment of Medication History Accuracy for ED Elderly Patients; Ira Nemeth, MD, Maimonides Medical Center ❋ 369. Predictive Validity of the Triage Risk Screening Tool in a Canadian ED; Jerome Fan, MD, Hamilton Health Science Corporation 370. Application of the Canadian CT-Head Rule in Patients Over 65 Years; Christian Vaillancourt, MD, MSc, University of Toronto 371. A Randomised Controlled Trial to Evaluate the Effectiveness of Community Paramedic Practitioners Managing Older People Calling the Emergency Medical Services With Minor Acute Illness; Suzanne Mason, University of Sheffield 372. Short-term Functional Decline in Older Emergency Patients With Blunt Injuries; Scott Wilber, MD, Summa Health System 373. Relationship Between Age and Diagnostic Testing, Outcomes and Physician Confidence in Diagnosis for Patients With Acute Nontraumatic Abdominal Pain; Esther Chen, MD, University of Pennsylvania

LUNCH SESSION: Full Professorship: Now What?

(12:00-1:30 pm), Nassau A Janet M. Williams, MD, University of Rochester Edward Bernstein, MD, Boston University William Burdick, MD, MSEd, Drexel University The number of full professors of EM is surprisingly large (well over 200) and growing rapidly. Faculty development materials for academic emergency physicians have traditionally focused on attaining promotion, with promotion to professor being an endpoint. Little attention has been paid to career development of professors of EM, with the exception of department chairs or deans. The purpose of this program is to learn from the experience of successful full professors about the goals, activities, and skills necessary for a successful career as a professor of EM who is not a department chair or dean. A panel of successful professors of EM will describe their individual faculty development plans within their fields of research or scholarly work, with an emphasis on their career development, especially as a full professor. An audience interactive session (questions and participant discussion) will follow, enhanced by a luncheon format. The founder/director of several university-based specialty centers and host of a medical call-in television program will discuss how senior emergency physicians’ interactions with other specialties can lead to important coordinating and leadership positions. Another panelist will describe how his research career has greatly expanded since becoming a full professor, leading to a growing national recognition of the importance of ED-based intervention on substance abuse. A noted educator and leader in educational testing will discuss his experiences as academic medicine has evolved.

At the completion of the session, participants will have insight into the goals, activities, and skills necessary for a successful career as a full professor of EM. Participants will be better prepared to advance their own careers as full professors.

Research Design (3:00-4:00 pm), East Ballroom Moderator: Roger Lewis, MD, PhD, Harbor-UCLA 374. Computer-assisted Coding of CT Text Reports for Head Trauma Research; Stephen Wall, MD, MS, Jacobi Medical Center, Albert Einstein College of Medicine ❋ 375. Validation of Probabilistic Linkage for Matching De-Identified Prehospital Records to a State Trauma Registry; Craig Newgard, MD, MPH, Oregon Health & Science University 376. Triage Tool Inter-rater Reliability Using Live Cases vs. Paper Case Scenarios; Arlene Sardo, RN, MSN, ACNP, ENC(C), CNC(C), McMaster University 377. Comparison of Two Models of Attribute Matching to Predict Pretest Probability of Pulmonary Embolism; Daren Beam, MS, Carolinas Medical Center

Diagnostic Tests (3:00-4:00 pm), West Ballroom Moderator: Brian Euerle, MD, University of Maryland 378. The Effect of Hyperventilation on Oral Temperature Measurement; Matt Robinett, MD, Denver Health Medical Center 379. Does Multi Detector CT Scan Correlate With Nuclear Cardiology in the Measurement of Ejection Fraction?; Dick Kuo, MD, University of Maryland 380. Utility of Urgent ED Computerized Tomography and Magnetic Resonance Scanning in the Diagnosis of Acute Stroke; Pierre Borczuk, MD, Massachusetts General Hospital 381. Among Patients With a Cervical Spinal Injury Due to Flexion-Distraction, Plain Radiographs are Not Sufficient to Exclude Associated Cervical Spine Injury; Tyler Barrett, MD, UCLA

LUNCH SESSION: From Resident to Rookie Attending: Excelling in Academic EM (12:00-1:30 pm), Regent Meta Carroll, MD, Northwestern University James G. Adams, MD, Northwestern University Jill M. Baren, MD, University of Pennsylvania Mark Courtney, MD, Northwestern University This session will address the challenges faced by the fresh EM residency graduate embarking on an academic career in EM, and detail strategies for maintaining the momentum of a productive career. Two speakers (Dr. Adams and Dr. Baren) will provide advice concerning time management and learning when to say “no,” balancing clinical and administrative commitments with academic pursuits, finding mentors to achieve short- and long-term goals, accessing opportunities for subspecialty or other advanced degree training, and -- through it all -- staying happy, healthy and sane. Dr. Courtney will provide the recent graduate/junior faculty perspective, as well as insights into launching

Didactic Sessions Introduction to Statistics (11:00-12:00 pm), Trianon Ballroom Roger J. Lewis, MD, PhD, Harbor-UCLA This session will cover introductory statistical topics such as data types, common statistical tests and their application, the meaning of p values and confidence intervals, and simple sample size and power calculations. An investigator with a firm understanding of these concepts is better equipped to plan a sound research study, develop testable hypotheses, choose appropriate analytic methods, and determine the feasibility of performing a study in a given population and setting. Is-

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Tuesday, May 24 a productive research career informed by his personal experience.

This will be followed by an interactive question-and-answer session involving all speakers. At the completion of the session, participants will understand the necessary steps in starting a productive career in academic EM, including identifying mentors; finding a focus within research, education, and/or advocacy work; setting short- and long-term goals; managing time effectively; limiting nonessential administrative tasks that detract from academic productivity; and accessing opportunities for further education and advancement.

Qualitative Research: How to Do it and Why (1:30-3:00 pm), Mercury Ballroom Carl F. Auerbach, PhD, Yeshiva University Stephen P. Wall, MD, MS, Jacobi Medical Center Yvette Calderon, MD, Jacobi Medical Center The traditional approach to research in medicine and the social sciences involves formulating hypotheses and testing them statistically, developing scales and questionnaires, controlling for extraneous variables, and generalizing from a sample to an entire population. More recently, a growing number of researchers have been reevaluating their approach to empirical research, focusing on subjective experience, diversity, and historical context in lieu of traditional quantitative research methods. Qualitative research involves analyzing and interpreting texts and interviews to discover meaningful patterns that describe a particular phenomenon. It is especially useful for exploring topics where little is understood and for hypothesis generation. The aim of this didactic is to familiarize participants with the use of qualitative research. Session participants will be introduced to the qualitative research process, beginning with the basic philosophy of qualitative research and concentrating on the planning and execution of a qualitative research study.

The didactic session will describe the steps in designing a qualitative study, the methods for qualitative data collection, including individual interviews and focus groups, the analysis of qualitative data with grounded theory coding, and the guidelines for publishing qualitative research articles. Dr. Auerbach will begin the session with a formal lecture, after which Dr. Calderon, and Dr. Wall will describe their experiences with qualitative research, providing specific examples from their collaborative research, and answering questions from the audience.

At the completion of the session, participants will be able to 1. Distinguish between hypothesis-testing and hypothesis-generating research.

2. Develop a preliminary design of a qualitative research study. 3. State two basic ideas necessary to design a qualitative research interview. 4.

Identify the three major stages of a qualitative research interview, and provide two basic guidelines for carrying it out. 5. Identify the six stages of coding qualitative data needed to develop theory and 6. State two basic guidelines useful for publishing a qualitative study.

LUNCH SESSION: Demystifying the Promotion Process: Assistant to Associate Professor (12:00-1:30 pm), Nassau B Stephanie Abbuhl, MD, University of Pennsylvania Richard E. Rothman, MD, PhD, The Johns Hopkins University Gabor D. Kelen, MD, The Johns Hopkins University Don Yealy MD, Univeristy of Pittsburgh Faculty at academic institutions require continual career growth and development in clinical, teaching, administrative and scholarly arenas.

One of the most daunting and mysterious steps in an academic career is promotion from the assistant to associate professor level. This session will provide a detailed look at the process of academic promotion by covering the following topics: 1. Historical concept of tenure; tenure vs promotion; 2. Getting the big picture: Understanding your own institution’s promotion requirements and process; these can differ substantially from one institution to another based on the mission and values of each one. Understanding your own strengths and weaknesses; find your passion; 3. Basics of a traditional academic career: find your area of interest; pick a track or path that suits your goals; importance of protected time, publications, funding, evaluations and measures of productivity; 4. Mentoring; expectations of mentor and mentee; the range of possible mentoring arrangements; group mentoring (faculty development sessions); 5. Time management; methods for focusing time and effort to maximize productivity; 6. What to expect at promotion; review the essential elements of a dossier, including CV, letters from referees, teaching evaluations, clinical evaluations, publications and grants; 7. Data will be reviewed showing one institution’s (Penn) outcomes of its COAP committee decisions; distribution of ranks of all faculty, men vs women, and differences between tracks; faculty attrition rate by rank and track; results of faculty development program over 5 years with significant increases in associate professors and decrease in faculty attrition. At the completion of the session, participants will gain greater understanding of the promotion process to Associate Professor including: 1. Differentiating the major paths to promotion (clinical, administrative, teaching, research) and their requirements; 2. Knowing the importance, benefits and responsibilities of engaging in successful mentorship and time management; and 3. Understanding the expectations and dynamics of the institutional promotions committee.

Successful Strategies to Obtain Federal Funding for Public Health Research in the ED (3:00-4:00 pm), Trianon Ballroom Margaret Murray, MSW, National Institute of Alcohol and Alcohol Abuse Donald Vereen Jr, MD, National Institute of Drug Abuse Substance abuse problems are increasingly prevalent in the ED setting. It is estimated that as many as 4-27% of ED patients are in need of alcohol and other drug referral and treatment. From 1992-2002, substance abuse visits increased by 58%. Because of the rising incidence of these public health problems and the uniqueness of our clinical setting, emergency physicians have been awarded millions of dollars from the National Institutes of Health (NIH) over the last five years to test clinical interventions. What accounts for our recent success in obtaining NIH extramural funding, and what does NIH find promising about EM? In the proposed didactic session, a distinguished panel of NIAAA and NIDA representatives will have 20 minutes each to discuss funding opportunities, techniques for writing competitive grants, strategies for developing a collaborative research agenda that includes EM and federal partners. Margaret Murray, MSW, Branch Chief for Health Sciences and Education at NIAAA, will describe the evolution of the current trial of screening and brief intervention for high risk and dependent drinkers in 14 ED sites around the country. During the 30 minute discussion period, EM colleagues who have received NIH funding will be invited from the audience to comment about what they have learned, and potential investigators will be able obtain assistance with perceived barriers to writing a successful proposal. The session will also permit networking of successful grantees and NIH staff with prospective EM researchers during the last 15 minutes. The means of building collaborative networks within EM that can then be leveraged at the Federal level will give participants an opportunity for action. At the completion of the session, participants will: 1. Identify funding opportunities for studying alcohol, other drug and mental health problems in the ED; 2. Discuss important components of a competitive grant application; 3. Discuss factors that contribute to a successful

Research Fundamentals: Rats and Mice as Models in EM (1:30-3:00 pm), Trianon Ballroom John Younger, MD, University of Michigan Mark Angelos, MD, Ohio State University John Watts, PhD, Carolinas Medical Center Although large animal studies continue to be performed by EM researchers, rodent models have become the preeminent platform for studying basic problems related to EM. Rodent models offer much to the EM investigator, including compact size, relatively low cost, narrow genetic variability, and, particuarly in mice, a wealth of genetically modified animals with which to study mechanisms of illness. However, rodent models have important limitations, many of which may not be recognized by novice investigators. This session will draw from the expertise of small animal investigators in EM to address a number of central issues relevant to rodent work. These include 1) key species differences between rodents, large animals, and humans, 2) techniques for evaluating hemodynamic performance in small animals, and 3) how to rationally apply genetically engineered animals in an EM research program. Lectures will include useful advice for getting started as well as identify common pitfalls to avoid when initiating rodent work. At the completion of the session, participants will understand the research niche filled by mice and rats in EM, fundamentals of evaluating cardiovascular performance in small animals, and the role of genetic engineering in the development of small animal models.

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Wednesday, May 25 395. Clinical Reliability and Validity of the Canadian Triage Acuity Scale Among Paramedics; Douglas Adrusiek, BA, University of British Columbia

collaborative research program; 4. Identify successful researchers and mentors in EM in these areas; 5. Identify the means of building collaborative networks within EM that can then be leveraged at the federal level will give participants an opportunity for action.

Reactive Airway Disease (10:00-12:00 noon), West Ballroom

Educational Research Track: Interpreting and Presenting Results (3:00-4:00 pm), Mercury Ballroom

Moderator: Rita Cydulka, MD, MS, Case Western Reserve University 396. Salmeterol Use and Risk of Admission Among ED Patients With Acute Asthma; Carlos Camargo, Jr., MD, DrPH, Massachusetts General Hospital 397. Association of Ambient Ozone With ED Asthma Visits and Age; Lori Stevenson, MPH, Mt Sinai 398. Respiratory Viruses as Causes of COPD Exacerbations Requiring Emergency Care; Sunday Clark, MPH, Massachusetts General Hospital 399. Impact of Diabetes on Hospital Admission, Length of Stay and Mortality of ED Patients With Asthma and COPD; Ben Osborne, MD, Baystate Medical Center 400. Montelukast Improves Lung Function in the Proximal and Distal Lung; Charles Cairns, MD, Duke University 401. Ionized Magnesium Levels and the Ratio of Ionized Calcium to Magnesium in Asthma Patients Before and After Treatment With Magnesium; Andrew Gorlin, MD, SUNY-Downstate 402. Survival Among ED Patients With COPD Exacerbation; Sunghye Kim, MD, MMSc, Massachusetts General Hospital 403. A Randomized, Double-Blind Investigation of Two Days of Dexamethasone vs. Five Days of Prednisone in the Treatment of Acute Asthma; Joel Kravitz, MD, Albert Einstein Medical Center

Michael Whitcomb, MD, Association of American Medical Colleges In this session, Dr. Michael Whitcomb, the current editor-in-chief for Academic Medicine, will provide his unique insight as the editor of an educational research journal. The speaker will discuss his views on medical educational research with a focus on how to draw appropriate conclusions from the data and how to present the results. The EM researcher will learn of common pitfalls in data interpretation and presentation, which often may lead to obstacles in publication. This is the third module in the second year of our proposed three-year Educational Research Track a longitudinal, comprehensive curriculum designed to provide a foundation for aspiring and established educational researchers in EM in the conduction of medical education (graduate or undergraduate) research. At the completion of the session, participants will: 1. Identify common errors made in the interpretation of results in educational research. 2. Understand common mistakes made in presenting data for publication submissions

Wednesday, May 25 ORAL PAPER PRESENTATIONS Traumatic Brain Injury (9:00-11:00 am), East Ballroom

POSTER SESSION

Moderator: David Wright, MD, Emory University 382. OPALS Major Trauma Study: Does the Addition of ALS to a Multicentre BLS System Affect Traumatic Brain Injury Outcomes?; Ian Stiell, MD, MSc, FRCPC, University of Ottawa 383. Impact of Hyper-and Hypoventilation on Outcome in Traumatic Brain Injury; Daniel Davis, MD, University of California, San Diego 384. Serum Neuron-specific Enolase and S100b as Predictors of Outcome in Infants With Inflicted Traumatic Brain Injury; Subhankar Bandyopadhyay, MD, Emory University 385. Use of ED Sonographic Measurement of Optic Nerve Sheath Diameter to Detect CT Findings of Increased ICP in Adult Head Injury Patients; Matthew Neulander, MD, Carolinas Medical Center 386. Levels of Alpha-II Spectrin Breakdown Products in Human Cerebrospinal Fluid and Outcome After Severe Traumatic Brain Injury; Linda Papa, MD, MSc, CCFP, FRCP(C), University of Florida 387. What are the Key Features of Minor Head Injury Patients Who Present With GCS Score 15 But Go on to Require Neurological Intervention?; Catherine Clement, RN, University of Ottawa

404. Smallpox: Healthcare Providers’ Knowledge, Self-Efficacy, and Fear; A Prospective Interventional Survey in the ED; Rachel Waltenburg, MPH, Emory University 405. Error Rate in Males and Females Presumptively Treated for STD’s in the ED; Gjon Dushaj, St. John Hospital and Medical Center 406. The Diagnostic Accuracy of Urine Analysis and Clinical Diagnosis for Detecting Urinary Tract Infection Among ED Patients; Heather Brooks, BS, Oregon Health & Science University 407. A Lethal Model of Francisella Pneumonia Using CDC Exempt Francisella Tularensis; Eric Dickson, MD, University of Iowa 408. Rapid Diagnosis of Pneumococcal Pneumonia in Adult ED Patients Using Quantitative Sputum PCR; Samuel Yang, MD, Johns Hopkins University 409. Blood Cultures in Hospitalized Patients With Community Acquired Pneumonia - Useful and Cost-Effective?; Prasanthi Ramanujam, MD, Boston Medical Center 410. Reasons for the Admission of Low Risk and the Discharge of Higher Risk Pneumonia Patients from the ED; Julie McCausland, MD, University of Pittsburgh 411. Clinical Predictors of Early and Late Mortality for Community-onset Bloodstream Infection; Chien-Chang Lee, MD, MSc, National Taiwan University Hospital 412. Risk Factors for Acquiring Waterborne Bacteria Infections in Wilderness Environments; Robert Derlet, MD, University of California, Davis 413. Acute Bacterial Meningitis: Presentation and Management Within the Past 10 Years; Anthony Pizon, MD, Banner Good Samaritan Medical Center

Suicidality (9:00-10:00 am), West Ballroom Moderator: Lynne Richardson, MD, Mt. Sinai School of Medicine

❋ 388. Subsequent Suicide Mortality Among ED Patients Seen for Sui-

cidal Behavior; Cameron Crandall, MD, University of New Mexico 389. Mental Health Symptoms and Intimate Partner Violence; Debra Houry, MD, MPH, Emory University 390. Suicide Rates Strongly Correlate With Altitude; David Cheng, MD, University of Arkansas 391. Differences in Ecological Predictors of Firearm and Non-firearm Suicide Deaths: What We Miss by Focusing on Overall Rates; Amy Ernst, MD, University of New Mexico

Access and Utilization 414. Which Medical Conditions Account for the Majority of Spending on ED Services?; Kenneth McConnell, PhD, Oregon Health & Science University 415. National Study of the Relation of Primary Care Shortages to ED Utilization; Ilana Richman, Massachusetts General Hospital 416. Linear Regression Analysis to Assess the Impact of System Factors on Length of Stay, Wait Time, and Treatment Time in a Large Urban ED; Phillip Asaro, MD, Washington University 417. Can ED Utilization Be Predicted?; Nathalie Soucy, PhD, SMBD Jewish General Hospital 418. Medicaid, Access to Primary Care and ED Utilization: Variations Across States; Elaine Rabin, MD, Mount Sinai

EMS (11:00-12:00 noon), East Ballroom Moderator: Ian Stiell, MD, MSc, Ottawa Health Research Institute 392. ‘Vertical Response Time’: The Hidden Component of Ambulance Response Time; Robert Silverman, MD, Long Island Jewish Medical Center 393. An Optimal Solution for Enhancing Ambulance Safety: Implementing a Driver Performance Feedback and Monitoring Device in Ground Ambulances; Nadine Levick, MD, MPH, Maimonides Medical Center 394. Patient Willingness to Consider Alternatives to Ambulance Transport to an ED; Lalena Yarris, MD, Oregon Health & Science University

(12:00 - 2:00 pm)

Infectious Disease

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Wednesday, May 25 Geriatrics

419. Increased Primary Care Access: Can It Reduce ED Overcrowding?; Gerald Banet, MPH, Washington University 420. Percentage of Patients Who Leave Before Treatment is Complete is Related to the Average Length of Stay and Patients Seen Per Day; Heather Farley, MD, Christiana Care Health Services 421. Correlation Between the Number of Patients Emergency Physicians See On a Shift and the Percentage of Patients Who Leave Without Being Seen; Riyad Abu-Laban, MD, MHSc, Vancouver General Hospital 422. Logistic Regression Analysis of the Determinants of Renege Likelihood in a Large Urban ED; Phillip Asaro, MD, Washington University

445. Does Functional Decline Prompt ED Visits and Admission in Older Patients?; Scott Wilber, MD, Summa Health System 446. Early Detection of Dying Trajectories; Robert Zalenski, MD, Wayne State University 447. Impact of Pre-existing Medical Condtions on Disposition of Elderly Trauma Patients; Heidi Holland, DO, York Hospital 448. Nursing Home Placement From the ED: Do Case Managers Improve Success and Reduce Costs?; Agarwahl Subhashish, MD, University of Illinois 449. Treatment and Outcome of Elderly Patients Who Present With Acute Abdominal Pain; David Lee, MD, North Shore University Hospital 450. Withdrawn 451. Relationship of Psychological, Social and Health Factors and Continuity of Primary Care to ED Use Among Seniors; Thomas Flottemesch, PhD, Regions Hospital 452. Effect of a Short Screen for Alcoholism on the Care of Older ED Patients; Fredric Hustey, MD, The Cleveland Clinic Foundation

Ischemia

❋423. Thioredoxin Reduces Post-Ischemic Myocardial Apoptosis by

424.

425.

426.

427.

428.

429. ❋ 430.

431.

Blocking Peroxynitrite-Induced Protein Nitration; Christian Coletti, BS, Thomas Jefferson University Decreased Nitric Oxide Levels in the Face of Adequate L-arginine in Sickle Cell Vasoocclusive Crisis May Be Due to Increased Arginase Activity; Bernard Lopez, MD, MS, Jefferson Medical College Effect of Enkephalins on Myocardial Ischemic Tolerance; Eric Dickson, MD, University of Iowa Endogenous Fibrinolysis of an Autologous Clot Pulmonary Embolism Does Not Induce a Severe Lung Inflammatory Response; Michael Runyon, MD, Carolinas Medical Center Transient and Partial Mitochondrial Inhibition for the Treatment of Post-resuscitation Injury: Getting it Just Right; Travis Anderson, MD, University of Chicago Controlled Myocardial Reperfusion With Antioxidants in the Perfused Rat Heart; Carlos Torres, MD, MPH, MSc., The Ohio State University Cutaneous Oxygen Saturation in Sickle Cell Vasoocclusive Crisis; Imoigele Aisiku, MD, MSCR, Virginia Commonwealth University Inhibition of Matrix Metaloproteinases During Ishcemia and Reperfusion in the Perfused Rat Heart Attenautes Infarction Size; Paul Klawitter, MD, PhD, Upstate Medical University Preconditioning With Asphyxia Enhances Recovery After Cardiac Arrest; Peter Whittaker, PhD, University of Massachusetts

EMS 453. Combat Trauma Airway Management: Combitube vs. the King Laryngeal Tracheal Device by Army Combat Medic Students; John McManus, MD, US Army Institute of Surgical Research 454. Combitube Dual Lumen Esophageal Airway Device Retention Skills in Deployed Army Combat Medics; John McManus, MD, US Army Institute of Surgical Research 455. The Search for the Correlation Between Malpositioned Endotracheal Tubes; Kelly Klein, MD, Wayne State University 456. Is There Added Benefit to Prehospital Intubation Over Non-invasive Airway Maneuvers?; Daniel Davis, MD, University of California, San Diego 457. Identification of Cardiac Arrest by Emergency Dispatch; Raina Merchant, MD, University of Chicago Hospitals 458. Relationship Between Organizational Policy and EMT Seat Belt Use; Jon Studnek, BS, NREMT-P, National Registry of Emergency Medical Technicians 459. Do EMS Personnel Identify and Disclose Medical Errors?; Josie Bowen, MD, UNC-Chapel Hill 460. Validation of Low Acuity Emergency Medical Services Dispatch Codes; Karl Sporer, MD, University of California, San Francisco 461. EMS-Initiated Refusal of Transport: The Current State of Affairs; Brian Kerns, MD, Eastern Virginia Medical School 462. Pediatric EMS Refusals to Transport; Nirupama Kannikeswaran, MD, Children’s Hospital of Michigan 463. WITHDRAWN 464. Pre-Hospital Seizure Management in Pediatric Patients; John Alexander, MD, Maine Medical Center 465. ED Offload Study: The Subjective Impressions of Patients Awaiting EMS Offload in the ED; Steven Friedman, MD, MPH, University Health Network 466. System Impact of the 2003 Blackout on New York City EMD; John Freese, MD, New York City Fire Department 467. EMS Service Staffed By Incarcerated Felons; Edmond Hooker, MD, University of Louisville 468. Intranasal vs. Intravenous Naloxone for Prehospital Narcotic Overdose; Tania Robertson, MD, University of San Fransciso, Fresno 469. The Effectiveness of Parenterally Administered Promethazine in Relieving Nausea and Vomiting in the Pre-hospital Setting; Mark Moseley, MD, MHA, Christiana Care Health System 470. Does START Triage Correspond to ED Acuity?; Laura Bultman, MD, Hennepin County Medical Center 471. Apoptosis is Present in Severe But Not in Mild Traumatic Brain Injury; Lawrence Lewis, MD, Washington University

Anesthesia 432. Laser Assisted Anesthesia Prior to Intravenous Cannulation in Volunteers: A RCT; Ran Regev, MD, Stony Brook University 433. Use of a Laser Device to Enhance Anesthesia Prior to IV Cannulation in ED Patients; Robert Weeks, MD, Stony Brook University 434. Is Procedural Sedation Safe in the Community ED?; Alfred Sacchetti, MD, Our Lady of Lourdes Medical Center 435. ED Patients Misuse Over-The-Counter Analgesics; Kennon Heard, MD, University of Colorado 436. Brief Focal Ultrasound and Topical Anesthetic Decreases Pain of IV Placement in Children; Bruce Becker, MD, MPH, Brown Medical School 437. Single Fascia Iliaca Compartment Block for Post-Hip Fracture Pain Relief; Kenneth Iserson, MD, MBA, University of Arizona 438. Treatment of Acute Orofacial Pain With Lower Cervical Intramuscular Bupivacaine Injections: A One Year Retrospective Review of 113 Patients; Larry Mellick, MS, MD, Medical College of Georgia 439. The Effect of Morphine Dosing Strategy on Pain Relief; Ralph Powell, Hennepin County Medical Center 440. Disparities in ED Pain Management; Alan Heins, MD, University of South Alabama 441. Patient Satisfaction in the ED Management of Acute Sickle Cell Pain; Philpott Sheila, MD, Virginia Commonwealth University 442. Relationship Between Intensity and Relief in Patients With Acute, Severe Pain; Steven Bernstein, MD, Albert Einstein College of Medicine 443. ED Triage Nurse Initiated Pain Management; Hsin Kai Goh, MBBS, Tan Tock Seng Hospital 444. Outside Regulatory Investigation is Associated With Reduced Opiate Administration; Amy Young, MD, Albany Medical College

Neurology 472. Optic Nerve Sheath Ultrasonography: A Novel Way to Assess Intracranial Pressure in Acute Mountain Sickness; Dan Price, MD, Highland General Hospital 473. Lake Louise Scoring System Underestimates Symptoms of Acute Mountain Sickness in 4-11 Year Old Children; Andrew Southard, University of Colorado

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Wednesday, May 25 474. Emergency Physicians’ Opinions of tPA Use in Acute Ischemic Stroke: Treat Thy Patient as Thy Self?; Heidi Ladner, MD, St. Luke’s Roosevelt Hospital Center 475. Gender-Specific Differences in Stroke Treatment and Outcome; Nina Gentile, MD, Temple University 476. Serum Troponin as a Predictor of Mortality after Acute Ischemic Stroke; Rachel Gilmore, MBBCh, MRCPI, Mayo Clinic 477. Relationship Between Respiratory Illness and Environmental Factors and the Incidence of Ischemic Stroke in a Large Urban Population; David Stuhlmiller, MD, University of Medicine & Dentistry of New Jersey - New Jersey Medical School 478. Physician Prediction of ED Head CT Scan Results; Clifford Swap, MD, MS, Massachusetts General Hospital 479. Accuracy of CT Interpretations by Emergency Physicians; John Johnson, DO, TTUHSC 480. Factors Associated With Significant Computed Tomography Abnormalities in an Undifferentiated ED Population; Joshua Resnick, MD, MBA, Massachusetts General Hospital 481. Seizures in Hyperglycemia; James Kolb, MD, University of Mississippi 482. Physicians and Patients Cannot Accurately Predict Anticonvulsant Levels; Douglas White, MD, Alameda County Medical Center - Highland Hospital 483. Emergent Conditions Among Neuro-Imaged Seizure Patients Presenting to US EDs; Nara Shin, MD, Olive View- UCLA Medical Center 484. Feasibility of Acquiring and Transmitting Real-Time Wireless Electroencephalograms in the ED; Patrick Medado, BS, Troy Beaumont Hospital 485. Relationship of International Headache Society Classification and Headache Treatment in the ED; James Miner, MD, Hennepin County Medical Center 486. Headache Relief Following Lower Cervical Injections With Bupivacaine: A One Year Retrospective Review of 412 Patients; Larry Mellick, MS, MD, Medical College of Georgia 487. Should Spectrophotometry be Used to Diagnose Xanthochromia in the Cerebrospinal Fluid of Alert Patients Suspected of Having Subarachnoid Hemorrhage?; Jeffrey Perry, MD, University of Ottawa 488. Can ED Personnel Accurately Estimate the Weight of Adult Patients?; Christopher Kahn, MD, University of California, Irvine

498. What Happens to SpO2 During Air Medical Crew Intubations?; Tami Tiamfook, MD, Harvard

CT for Appendicitis Moderator: Nathan Shapiro, MD, Beth Israel Deaconess ❋ 499. CT Scan With IV Contrast Only (CT IV) for Pediatric Appendicitis;

Madelyn Garcia, MD, University of Rochester 500. Effect of Increased CT Scan Usage on Appendicitis Outcomes; Steven Frei, MD, Lehigh Valley Hospital 501. Impact of Helical CT on the Rate of Negative Appendicitis; Robyn Heister, MD, University of California, San Diego 502. Withdrawn

Didactic Sessions Spivey Lecture: Developing the Leader within You (8:00-9:00 am), Sutton North/Center James G. Adams, MD, Northwestern University Andy Jagoda MD, Mt. Sinai School of Medicine Cynthia Ambres MD, MS, Kaleida Health Everything rises and falls on leadership. We often discuss the issue but very few truly understand it. However, leadership can be taught. This panel of distinguished leaders in EM will review the key components of dynamic leadership. The session will address the importance of a vision and setting priorities, how to develop the right attitude, the need for integrity and creating positive change, and how to become a person of influence and investing in those around us. The speakers will also discuss the importance of different types of degree programs, as a tool to prepare one for leadership. The session will include 30 minutes for audience participation.

Shift Change Signovers as a Double-edged Sword: The Importance of Studies of Technical Work in EM (9:00-10:30 am), Mercury Ballroom Robert L. Wears, MD, MS, University of Florida Emily Patterson, PhD, Ohio State University Emilie Roth, PhD, Roth Cognitive Engineering Shawna Perry, MD, University of Florida Shift changes are commonly viewed as hazardous times in EDs, but have seldom been directly studied, and their procedures are not specifically taught. In addition, methods for effectively studying shift changes are not well-known in health care. The objectives of this session are to: 1) Challenge some long held ideas about shift changes, based on research observations; 2) Present what is has been learned about effective shift change behaviors in other hazardous domains; 3) Introduce participants to methods for studying shift changes effectively; and 4) Summarize the current state of the art regarding what is involved in shift changes. The format will be as follows: 1. Shift Changes: Best of Times, Worst of Times (Dr Wears, 20 minutes). Introduces the problem and the speakers. 2. Shift Changes in Hazardous Work (Dr Patterson, 40 minutes). Describes strategies observed in a variety of hazardous domains to make shift changes safer and more effective. 3. How to Study Hard-To-See Things (Dr Roth, 40 minutes). Introduces methodologies for observational studies of behavior in complex environments, since traditional medical research methods are not well suited to these problems. 4. What Goes On At Shift Change. (Dr Wears, 20 minutes) Proposes a framework for studying and understanding shift change activities based on recent research. At the completion of the session, participants will: 1. Be familiar with methods of ethnographic observational research useful in studying shift changes; 2. Be familiar with methods for analyzing such data; 3. Be able to identify benefits as well as risks in shift changes; and 4. Be able to list several common strategies for more effective shift changes.

Diagnostic Tests 489. How Accurate is Weight Estimation in the ED?; Anne-Maree Kelly, MD FACEM, Joseph Epstein Centre for EM Research 490. Agreement Between Arterial and Venous Values for pH, Bicarbonate, Base Excess and Lactate; Anne-Maree Kelly, MD FACEM, Joseph Epstein Centre for EM Research 491. HbA1c Levels Among Non-Diabetic ED Patients; Robert Silverman, MD, Long Island Jewish Medical Center 492. HIV Testing in the ED: An Alternative Way to Increase Rates of Testing When Counselors Are Not Available; Yvette Calderon, MD, Albert Einstein College of Medicine 493. Utility of Thrombocytopenia as a Marker for Heparin Allergy in Adult ED Patients; Matthew Howell, MD, University of Connecticut 494. ED Adherence to American College of Chest Physicians Guidelines for Management of Elevated International Normalized Ratio Levels in Patients taking Warfarin; Michael Liao, MD, Long Island Jewish Medical Center

MODERATED POSTERS

(1:00 - 2:00 pm)

Aeromed Moderator: Daniel Davis, MD, University of California, San Diego 495. The Impact of Aircraft Type, Temperature and Turbulence on Airsickness in Air Medical Transport; Darren Braude, MD, MPH, EMT-P, University of New Mexico 496. Estimation of Total Body Weight Based on Anthropometric Measurements for Use in Air Medical Transport; Stephanie Gardner, MD, University of New Mexico 497. Prospective Study of the Impact of Multiple Patient Transports on Patient Care During Helicopter Emergency Transport; Dorian Drigalla, MD, University of Louisville

Academic EMS: Research and Beyond (9:00-10:30 am), Beekman Parlor Henry E. Wang, MD, MPH, University of Pittsburgh Tom Aufderheide, MD, Medical College of Wisconsin David C. Cone, MD, Yale University As EMS has become increasingly sophisticated and complex, the need for academic physician leadership has increased. EMS research is a particularly important component of academic EMS, and as noted in

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Wednesday, May 25 the NHTSA EMS Outcomes Project, EMS research is only beginning to come into its own. This session will explore the field of academic EMS and guide academic EMS physicians to pathways for success by examining the careers of three academic EMS physicians and their roles in research, publishing, and service to specialty societies. Dr. Wang will speak on the challenges in performing EMS research and obtaining funding. He will highlight the experiences and challenges that affected his career path and outline strategies for achieving a successful career in EMS research. Dr. Aufderheide will speak on the Research Outcomes Consortium for cardiac arrest and trauma, and his role in promoting and performing extramurally funded, high quality EMS research. Dr. Cone will speak on scientific writing, editing, and publishing in EMS, and on service to national organizations and specialty societies, with an emphasis on how these activities promote not only high quality education and research, but also help enhance the academic nature of EMS. By the end of this session, the participant will: 1. Identify and describe the means for pursuing a career in academic EMS; 2.

Discuss the status of EMS research and list current efforts to improve the quality of that research; and 3. List groups and organizations that support the mission of the academic EMS physician.

ing an opportunity for a broader dialogue concerning the knowledge and skills needed to create a succesful grant application. A new addition to the open session this year will be a brief follow-up report in which previous program participants will describe the impact of the grant mentorship program on their subsequent career development.

At the completion of the session, participants will: 1. Gain insight into the common errors in grant writing; 2. Understand the thought process of a grant reviewer and how to ‘spin’ a grant application based on the goals of the agency and study section. 3. Understand the role of senior mentorship in the grant application process

New Technologies and Environments for Instruction (10:30-12:00 pm), Sutton North/Center Gloria Kuhn, DO, PhD, Wayne State University Martin Reznek, MD, Emory University Steve McLaughlin, MD, University of New Mexico William Bond, MD, Lehigh Valley Hospital Virtual reality and simulation technologies facilitate realistic, easily standardized instruction in safe environments. Increasingly, EM educators are becoming aware of their potential and are eager to use them.

This course will introduce educational principles and techniques that are necessary to optimally teach and assess students and residents using simulation technology. The course will be divided into four thirtyminute sections: 1. Foundations and Theory of Instruction in Simulated Environments, Dr Kuhn will discuss the general theory of instruction pertaining to simulated learning environments and how new technologies can be used to increase transfer of learning from the classroom to the workplace. 2. Developing Simulation Scenarios from Learning Objectives, Dr. McLaughlin will demonstrate how to effectively realize preset learning objectives via well designed simulation scenarios and debriefing sessions. The advantages of using learning objectives to design simulation scenarios and common pitfalls will be discussed. 3.

Specifics of Simulation, Dr. Bond will give examples of how simulators can be used in instruction, emphasizing when simulation is the most efficient and effective educational modality. Examples using simulation training in airway, bioterrorism, cognitive forcing strategies, teamwork, and patient safety will be given. 4. Potential Applications of Virtual Reality, Dr. Reznek will discuss the available technology and how it can enhance instruction in EM. He will also discuss how other high stakes professions have created effective training in safe environments using this technology. At the completion of the session, participants will: 1. Understand the educational theory which enables virtual/simulated environments to function as effective instructional modalities; and 2.

Provide examples of how simulators/virtual reality can be used for effective resident/student instruction in EM.

Grant Mentorship Workshop (10:30-12:00 pm), Mercury Gary Green, The Johns Hopkins University Richard E. Rothman, MD, PhD, The Johns Hopkins University James Olson, PhD, Wright State University Mark Angelos, MD, Ohio State University This well-received and rapidly expanding program organized by the research committee is now in its fourth year. This year, the program will once again include two components, a closed Individual Grant Review Session and an Open Interactive ‘Lessons Learned’ Panel Discussion. The Individual Grant Review session provides junior and midlevel grant writers with an opportunity to submit unsuccessful or draft grant applications for review by volunteer senior researcher-reviewers who will then offer private one-on-one in-depth mentorship and specific feedback on how to improve their applications. The Individual Grant review sessions will be held during the Annual Meeting. During this Open ‘Lessons Learned’ session, selected grant writers and expert reviewers will serve as panelists and will use excerpts from the reviewed applications to highlight common grant writing pitfalls. Reviewers will attempt to focus discussion on specific aspects of the grant which were not covered in detail in the last SAEM Annual Meeting. The bulk of the time during this session will then be dedicated to spontaneous interactive discussion between the panelists and the audience, provid-

Call for Abstracts - 2006 Annual Meeting May 18-21 • San Francisco, CA The Program Committee is accepting abstracts for review for oral and poster presentation at the 2006 SAEM Annual Meeting.

Authors are invited to submit original research in all aspects of Emergency Medicine including, but not limited to: abdominal/ gastrointestinal/genitourinary pathology, administrative/health care policy, airway/anesthesia/analgesia, CPR, cardiovascular (nonCPR), clinical decision guidelines, computer technologies, diagnostic technologies/radiology, disease/injury prevention, education/ professional development, EMS/out-of-hospital, ethics, geriatrics, infectious disease, IEME exhibit, ischemia/reperfusion, neurology, obstetrics/gynecology, pediatrics, psychiatry/social issues, research design/methodology/statistics, respiratory/ENT disorders, shock/critical care, toxicology/environmental injury, trauma, and wounds/burns/orthopedics.

The deadline for submission of abstracts is Tuesday, January 10, 2006 at 5:00 pm Eastern Time and will be strictly enforced.

Only electronic submissions via the SAEM online abstract submission form will be accepted. The abstract submission form and instructions will be available on the SAEM website at www.saem.org in November. For further information or questions, contact SAEM at saem@saem.org or 517-485-5484 or via fax at 517-485-0801.

Only reports of original research may be submitted. The data must not have been published in manuscript or abstract form or presented at a national medical scientific meeting prior to the 2006 SAEM Annual Meeting. Original abstracts presented at national meetings in April or May 2006 will be considered.

Abstracts accepted for presentation will be published in the May issue of Academic Emergency Medicine, the official journal of the Society for Academic Emergency Medicine. SAEM strongly encourages authors to submit their manuscripts to AEM. AEM will notify authors of a decision regarding publication within 60 days of receipt of a manuscript.

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Innovations in Emergency Medicine Education Exhibits IEME Exhibits 1-10 will be presented on May 22 and May 23.

Exhibits 11-20 will be presented May 24 and 25.

1 The Feasibility of Training Emergency Physicians to Obtain Cardiac Output Measurements Using Transthoracic Ultrasonography

3 Construction of Simple, Inexpensive Models for the Training of Invasive Procedures in Emergency Medicine Residents

Rebecca Bloch, MD, William Owens, MD, John Saucier, MD, Dennis Atherton; Maine Medical Center Background: The measurement of cardiac output (CO) can greatly affect the management of critical patients by providing information regarding the adequacy of cardiac function and organ perfusion. The traditional method for determining CO involves pulmonary artery catheterization, and is both time consuming and invasive. Ultrasound is fast, non-invasive, and readily available in most EDs. Objective: Our objective was to determine the ability of EPs to be trained to obtain an accurate measurement of CO using standard transthoracic ultrasonography techniques following a standardized teaching program.

Additionally, we sought to quantify the amount of training necessary for an EP to learn to measure CO using this technique. Learners: Emergency medicine resident and attending physicians. Intervention: This project employed a prospective, observational design in which EPs worked with an echocardiographer to learn a standard technique for measuring CO and practiced methods individually. Training hours were recorded. The method for obtaining CO measurement involves obtaining two values; first the left ventricular outflow tract (LVOT) using the parasternal long view, and the velocity-time integral (VTI) in the apical five-chamber view. After heart rate is obtained, software built into the ultrasound machine (Sonosite Titan) calculates CO and reports it along with the measured parameters. Relevance: In this pilot project, we determined that interested EPs can effectively learn a standardized technique for obtaining CO measurements via ultrasound in the ED following approximately two hours of teaching with an echocardiographer and five hours of independent practice. A future project will compare measurements obtained by trained EPs and ultrasonographers.

Aaron Smith, MD, Mary Wagner; Synergy Medical Education Alliance Training residents and students to perform invasive procedures is a critical part of the medical education process. The old adage of “see one, do one, teach one” is recognized as less than ideal. It has been demonstrated that complications following bedside invasive procedures occur more often during the first few months of a resident’s first postgraduate year in part because of lack of preparation. There are many techniques for teaching these skill sets including use of simulation models, animal labs, and cadaver labs, as well as directly observed performance on actual patients. Repetitive deliberate practice has been shown to improve the expertise of a learner, including with procedural skills. The availability of models for repetition and the development of proficiency are often limited by many factors especially monetary resources. We have designed several simple, inexpensive procedural models for use in simulation of invasive procedures. We have used easily obtainable materials so that they could be effortlessly replaced for repetitive use in a cost-effective manner. For example, the model for arterial catheriterization consists primarily of a drinking straw, foam hair curlers and a sock. Other procedures that we have built simulation models for include diagnostic peritoneal lavage, lumbar puncture and thoracotomy. The thoracotomy model is unique as practice of this procedure cannot be done with any currently available commercial models or even costly simulators. Our experience and a survey of residents have shown that these models are valuable teaching aids and could be useful for residencies with limited resources.

4 Withdrawn 5 Evidence Detectives: Integration Research Methodology, Searching, and Critical Appraisal Curricula into a Dynamic Monthly Exercise.

2 Developing Competence in the Management of Sexual Assault in the Emergency Department Steve McLaughlin, MD, Cameron Crandall, MD, Constance Monahan, MPH, David Doezema, MD; University of New Mexico The recent emergence of Sexual Assault Nurse Examiner (SANE) programs has dramatically improved the quality of care for sexual assault (SA) victims. A side effect of these programs is the reduced resident clinical exposure to victims of SA. EM residents training in an urban center with an active SANE program may require additional focused training in the management of SA. This is an 8 hour educational intervention that develops competence in the management of victims of SA. The learning objectives were developed from established SANE provider performance criteria. The education intervention includes lecture, role play exercises, and a lab to develop skills at evidence collection. The course also includes a comprehensive assessment of competence using a written knowledge test, simulation based assessment of evidence collection and standardized patient assessment of communications skills. This demonstration includes examples of lecture materials, handouts and written assessments, video taped examples of role play exercises and skills labs, and examples of pre and post intervention resident performance on the evidence collection simulation and standardized patient assessment of communication skills.

This is the first course developed that uses a multimodal education and assessment model to develop competence in the management of victims of SA. This innovative approach also allows the development and demonstration of resident competence in several important areas of the ACGME core competencies including patient care, interpersonal and communication skills and systems based practice.

Barbara Lock, MD, Peter Wyer, MD, Peter Greenwald, MD; New YorkPresbyterian Hospital/Columbia University Objectives: To create and implement a novel method for teaching research methodology, search strategy and critical literature appraisal to EM residents and attendings, entitled “Evidence Detectives”. Background: EM residents currently learn EBM skills, research methodology, and literature analysis from Journal Club, Research Grand Rounds, bedside teaching, and through the performance of their scholarly project. This model may fragment the educational experience. Prior model: Research and EBM sessions were didactic in nature. Journal Club was interactive, but was article-driven. Question generation and searching skills were largely ignored. Attendings were passive participants. Goals for New Model: We planned 2-hour team-driven, interactive sessions in which both residents and attendings would hone EBM skills to do live searching for, and analysis of, relevant articles. Results: We created 20 hours of “Evidence Detectives,” reduced research and EBM lectures, and eliminated traditional Journal Club. The 20 hours are divided into 10 2-hour sessions, each run by a rotating resident-attending team, and supervised by one of five additional attendings with specific EBM or research experience. Components of each session: case presentation; unformatted question generation; PICO exercise (patients, interventions/exposures, co-interventions/exposures, outcomes); live online searching with research librarians; article selection and review in groups; “ad lib” methodology or statistics discussion; return to the case. 7 sessions have been successfully run. Video was recorded. Conclusions: Research methodology, search strategy, and

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critical literature appraisal can be taught both to EM residents and to attendings using an integrated 2-hour model that emphasizes clinical applicability, and employment of real-time online skills.

8 Augmenting EM Student Clerkship Teaching Via Dedicated EM Resident Teaching Shifts Jason Mansour, MD, Lynn Dezelon, MD, Louis Binder, MD; MetroHealth Medical Center, Case Western Reserve University School of Medicine Ensuring high quality teaching for medical students while maintaining patient flow during busy ED shifts can be challenging. In response to this challenge, we developed and implemented an educational model that provides dedicated EM resident teaching shifts for students, and evaluated its effectiveness in augmenting medical student supervision and instruction. Description: Beginning in August 2002, with funds provided by Case School of Medicine, dedicated paid teaching shifts of 5-6 hours duration were offered to EM2 and EM3 residents. Residents were paid hourly to precept senior medical students as they evaluated and managed ED patients during their EM elective. Each student was assigned to 2-3 teaching shifts during the month in addition to their standard ED shifts. The ratio of residents to students was 1:2. The students were permitted to choose any patient that was waiting to be seen, or the resident could select a patient that provided a specific educational opportunity. Emphasis was placed on residents’ presence at the bedside to both observe and teach proper history and exam skills. Many procedures were performed by the students with the direct observation/assistance by the resident. In addition, some students elected to use portions of these shifts to practice ultrasound skills, be the team leader of a mock trauma, or practice procedures on models. All patient care was ultimately supervised by an ED attending physician. Our primary objectives were to improve medical students’ educational experience by providing more time for detailed discussion of each patient encounter, and to improve procedural skills by providing focused and immediate feedback during one-to-one observations. Findings: Feedback from senior medical students who have experienced dedicated teaching shifts was overwhelmingly positive.

Surveys distributed after the students’ ED month repeatedly reported that these shifts were helpful as an adjunct to the clerkship. For the months of July through September, 2004, the students (n=18) evaluated the overall educational experience of the teaching shifts as 4.5 on a 5-point scale (1=Poor, 5=Excellent). Most students requested more of these shifts during their ED clerkship. Funds were allocated from the CWRU annual budget allotted to our Department of EM. Cost to fund each resident was $240 per teaching shift (6 hours at $40/hr). In fiscal year July 2003-June 2004, cost to fund these shifts was $7840.

On a 6 hour teaching shift, the resident would precept an average of 6-8 patients. At an average of $378 collected per patient in the ED at our institution, each teaching shift generated an average of $1100$1500 in revenue for the department. Summary: Our program of dedicated resident teaching shifts is an innovative and cost-effective way to augment senior medical students’ educational experience in EM, with overwhelmingly positive feedback from the students. In addition, the performance of clinical procedures by the resident/student team for the EM faculty on shift helps to free them for other patients and responsibilities.

6 Development of Web-based Question Bank for Emergency Medicine Students David Nicolaou, MD, MS, Emily Senecal, MD, Joshua Sai-Hung, BA, Michelle Mowad, MD, Stephen Thomas, MD, MPH; Johns Hopkins University, Massachusetts General Hospital/Brigham and Women’s; UCLA; NYU School of Medicine The majority of required clinical rotations for medical students employ a standardized “Shelf” exam to evaluate medical student performance. The discipline of Emergency Medicine lacks such an evaluation tool. The reasons for this are numerous and include the fact that standardizing core content for a medical student Emergency Medicine rotation is a challenging task. As a subcommittee of the SAEM Undergraduate Education Committee, we have developed a question bank available through the SAEM website to all Emergency Medicine clerkship directors to facilitate the evaluation of medical students during their rotation in Emergency Medicine. The question bank contains over 500 multiple choice questions covering a broad range of topics within Emergency Medicine. Images (ECGs, radiographic studies, photographs) accompany approximately one-quarter of the questions.

Answers include brief explanations of the correct answer, as well as text or literature references for further reading. Thanks to support from SAEM, the question bank is currently being made available on the SAEM website. Clerkship directors can select a 50-question test from the question bank to administer to their students. Only after students have been registered by their clerkship directors on the website are they eligible to take the test. The students’ scores and individual answers are automatically reported to the Clerkship Directors by email.

Although not yet the equivalent of a standardized “Shelf” exam, we believe this tool helps fill a gap in the educational needs of students of Emergency Medicine.

7 A Virtual Learning Environment for Team Training in Trauma Management Patricia Youngblood, PhD, Phillip Harter, MD, Sakti Srivastava, MD, Wm Heinrichs, MD, PhD, Parvati Dev, PhD; Stanford University Medical Media and Information Introduction: An important component of all EM residency programs is managing trauma effectively as a team member, but practice on live patients is often impractical and mannequin-based simulations are expensive and logistically restrictive. Therefore, we developed and trialed a web-based, virtual learning environment that provides repeated practice opportunities with life-threatening trauma cases. The Virtual Learning Environment Geographically dispersed trainees use the Internet to access the virtual ED via desktop or laptop computers, take the role of a member of the ED team, and select actions from a menu to assess and manage trauma cases. Deteriorating physiological signs change according to ED team actions. Twelve senior medical students and four beginning EM interns trialed the virtual ED. All reviewed basic trauma management and EMCRM team leadership skills prior to initial orientation to the simulation system. Pairs of trainees were teamed with two standardized team players: an emergency physician and nurse. Each team managed six cases, including a pre and post assessment case, with trainees alternating the leadership role. An ED faculty member led the debriefing sessions after each training case. Formative Evaluation: Faculty members rated each trainee’s performance on pre and post assessment cases using an objective, structured rating scale, and trainees completed a survey of their perceptions of the experience. Results show that subjects improved their team leadership performance and reported feeling immersed (presence), increasing confidence, and satisfaction with this learning approach. Conclusions: The Virtual ED affords a valid and cost effective method for training ED teams. Reznek M, Smith-Coggins R, Howard S, Kiran K, Harter P, Sowb Y, Gaba D, Krummel T. (2003). Emergency medicine crisis resource management (EMCRM): Pilot study of a simulation-based crisis management course for emergency medicine.

Academic Emergency Medicine, 10: 386-389.

9 A Second Chance to Make a Bad Impression Yasuharu Okuda, MD, Joshua Quinones, MD; Mount Sinai School of Medicine In an academic setting, adverse outcomes are currently reviewed in a conference/lecture setting. This format has recently fallen into question as an effective training modality. We used a human patient simulator to recreate a real case which would have normally been presented in Morbidity and Mortality conference. This allowed participants to actively engage in the case, and care for a simulated patient. We observed repetition of errors, which were discussed immediately after the case in a debriefing session. Residents not participating in the simulation viewed the case to completion, and were included in the debriefing session. We found this approach to Morbidity and Mortality was well received by the residents, and focused the educational experience to clinical improvement and error evaluation rather

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By closing the loop, the system can provide ongoing, timely feedback to residents about their radiographic interpretations allowing them to maximize learning by identifying errors. The system can also enable the residency as a whole to assess the adequacy of training and weakness. Finally, from a patient safety standpoint, discrepant interpretations between EM and radiology can be highlighted for rapid review.

10 EDwin: Emergency Department Web-based Information Network Albert Villarin, MD; Albert Einstein Medical Center EDwin maintains all AEMC-ED clinical protocols and procedures, resident and attending schedules, evidence-based medicine resources, admissions criteria & order-sets. Rapid passive informational pages as well as active data collection for lab culture results, outpatient physician call-ins and incident reports are available. These active server pages allow users to input bedside data for use ‘real-time’ by clinicians in the ED and department administrators. 24/7 evidenced medicine bedside resident/clinician education, internet resources and patient education (text and video) is supported via computer terminal, mobile laptops, and Palm. EDwin integrates ongoing ED activities with bioterrorism alerts, response protocols and city wide ED status posted for immediate dissemination. Online research protocols, consent forms and data are collected at the bedside with mobile computers. EDwin is the single portal for all resident education, clinician data collection and retrieval, key ED mission critical information and patient educational resources.

13 The FBI (Focused Board Intervention): Evolution of a Remediation Program Annette Visconti, MD, Chris Garrett, Michael Cabezon, Theodore Gaeta; New York Methodist Hospital The In-service examination has been a marker for successfully passing the Emergency Medicine Board Examination. It has been noted in the past that residents who score passing grades on their National Inservice exam (NIE) should be in a good position to pass their National Board Exam as well. Each year there is a small group of residents whose score on the National In-service fall outside of two standard deviations of the national average, a risk for not passing the National Boards when they graduate. Issues identified were poor study planning and lack of motivation; hence, this prompted the formation of an intervention to assist these residents improve there in-service scores and pass the boards. After a few trials of scheduled meetings, and group review sessions, the FBI was formed. Our current approach, utilizes a program of audio review with mandatory fill in exams. The exams help us to ensure that the resident learns certain basic facts from each tape. Weaknesses identified on our own mock in-service exam &/or the NIE are noted and reviewed with the audiotapes. All topics must be completed prior to the residents’ next semi-annual evaluation or in-service exam. The FBI has met with our best success in terms of participation and elevation of scores. It is our hope that this remediation program will optimize our residents’ ability to pass their boards.

11 Web Based Tutorial for Training in Ultrasound Guided Central Venous Cannulation John Rose, MD, Arturo Soria, Aaron Bair, MD; UC Davis The role of ultrasound assistance in central venous cannulation has been increasing over the past several years. Both research and health policy have advocated the use of ultrasound to improve patient safety.

This is an interactive web-based tutorial that introduces a step-by-step approach to ultrasound guided internal jugular vein cannulation. Using a Macromedia Flash-based format, Quicktime video and Maya enhanced 3-D rendering, this tutorial is geared towards students and residents to introduce the principles of ultrasound guided central line placement. Emphasis is on practical tips and easy navigation. The tutorial introduces to the learner relevant basics of ultrasound and practical tips on how to assure patient safety with the use of ultrasound.

The tutorial then focuses on the 4 P’s of ultrasound guided central venous cannulation: prescan, preparation, poke, and path. Tricks and pitfalls are covered for each of the areas. Video and 3-D animations are used to illustrate important components and common pitfalls. For example, the user is able to participate in a simulation of the internal jugular central venous cannulation by controlling a virtual ultrasound transducer and needle. The final section covers common problems encountered in ultrasound guided line placement and effective solutions. The navigation system allows for learners to select focused areas of interest or complete the tutorial sequentially. Both a pre and post test are included within the tutorial to assess understanding of key areas.

14 Virtual Reality Simulation Model for Emergency Airway Management Training Jeffrey Myers, DO, James Mayrose, PhD, David Ellis, MD, Ajay Anand, BS, T. Kesavadas, PhD; State University of New York at Buffalo Virtual Reality simulation has been identified as an emerging educational tool with significant potential to enhance teaching of residents and students in emergency clinical encounters and procedures. Tracheal intubation represents a critical procedure for emergency care providers including physicians, residents, mid-level providers and EMTs. Current methods of training include working with cadavers and mannequins, which have limitations in their representation of reality, ethical concerns, and overall availability with access, cost and location of models. This exhibit will present a human airway simulation model designed for tracheal intubation based on the Virtual Human dataset. For intubation simulation to be effective, objects in the simulated environment should respond to the user’s actions dynamically, in real-time, with accurate visual representations in regards to changes in geometry and appearance. Development of an effective virtual environment requires real-time interactivity coupled with realistic visualization. Interactivity includes the ability to manipulate objects, perform physics-based interaction and deformation of objects, incorporate force feedback for haptics, and allow immersive stereo visual output.

The user’s actions are not predictable, especially when laryngoscope blade use, tube placement and deformation are involved. In addition, it is also necessary to consider how the model geometry will change in response to user interaction. To add additional realism to this intubation simulator, texture mapping has been applied to achieve photorealistic visualization. This work provides a solid foundation for future versions of the intubation simulator, which will incorporate two haptic devices for laryngoscope blade use and tracheal tube insertion.

12 Real-time Web-based System to Monitor Radiographic Interpretation Proficiency Fawaz Ahmad, MS, Rohit Gupta, Christopher Straus; University of Chicago Radiographic tests are a frequently utilized diagnostic modality by emergency physicians. Previous studies have demonstrated that EPs commonly provide the initial interpretation of emergency radiographs.

Often occurring hours or days before radiologist over-read, the initial reading guides diagnostic, therapeutic, and disposition decisions. Traditionally, EM residents have been trained in radiographic interpretation through didactic lectures, elective rotations, and “on-the-job” training.

Though vital to patient safety, little has been reported regarding systems to monitor resident proficiency in reading films over the course of their education. We developed a real-time, web-based, electronic tracking tool to capture radiographic wet reads by radiology and EM. The tool records each radiographic film ordered in the ED, the initial ED reading, the time of reading, the resident performing the read, and the radiology over-read. The tool provides flags to highlight discordant readings by severity. The system automatically tracks the number and type of films read by each resident and the percentage of discrepant reads. Discrepancies and overall performance can automatically be provided to each resident on an ongoing basis. Our application provides multiple benefits in both medical education and patient care.

15 A Novel Methodology for Teaching Direct Laryngoscopy Richard Levitan, MD; Albert Einstein Medical Center, Philadelphia Laryngoscopy training traditionally involves mannequin practice and intubation opportunities in the operating room. In live patients, clinical restrictions limit educational instruction and visualization of critical structures to only a few seconds, even in elective anesthesia settings.

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Due to the visual restrictions inherent to laryngoscopy, it is difficult to create a standardized visual experience for trainees in the OR, or even with a mannequin. It is optically challenging to provide targeted feedback and supervision, and very difficult for an experienced supervisor to impart acquired insights about the procedure to novices. Most educators are resigned to the belief that skill competence requires a large number of attempts and failures before competence can be achieved.

A best practice approach to performing or teaching laryngoscopy has never been defined. This exhibit displays a novel methodology for hands-on laryngoscopy training. It is comprised of five components: 1) visual acuity testing at target distances and with visual restrictions typical of laryngoscopy; 2) a new intubation trainer modeled from CT 3D imaging which has very realistic anatomic landmarks and mechanical properties; 3) a defined, pre-planned strategy for first pass success, featuring an epiglottis first approach, bimanual laryngoscopy, recognition of posterior laryngeal structures, and straight-to-cuff stylet shaping; 4) a selection of equipment to facilitate first-pass success including recommended laryngoscope blade designs, tracheal tube introducers, and optical stylets; and 5) a series of essential instructional insights demonstrated with photo-documentation on the intubation trainer (and actual patients) using the direct laryngoscopy imaging system (i.e. from the laryngoscopist’s perspective).

care spectrum. The recently developed Clinical Skills Education and Assessment Center provides a physical space, support staff, and an inroad into the medical school curriculum. Modular training sessions are provided with syllabi, multimedia presentations, didactics, supervised scanning, and review of clinically obtained images. This change in ultrasound education transforms the onus of learning ultrasound and focuses efforts toward dissemination of knowledge and assigning metrics. All academy participants establish basic ultrasound competency, then with each specialty focusing on intermediate and advanced competencies in order to meet their clinical needs. Successes to date include: support from multiple specialties; incorporating ultrasound into the medical student anatomy lab; training senior medical students in ultrasound guided central line placement; training surgery residents in the standardized FAST exam; and hosting a CME event for emergency medicine faculty. This paradigm combines multispecialty support and preclinical educators, establishing the groundwork for basic training and assessment, collaborative research, and expanding the role of ultrasound in medicine.

16 Educating Diverse Learners with a Single CD-ROM: A Flexible and Efficient Multimedia Education Tool

Leo Kobayashi, MD, Marc Shapiro, MD, Andrew Sucov, MD, Robert Woolard, MD, Gregory Jay, MD; Brown Medical School / Rhode Island Hospital Transition of an active Emergency Department (ED) to a new physical plant presents tremendous challenges. Staff unfamiliarity with the new environment, emergence of systems incompatibilities, and discrepancies between expected and actual practice parameters create potentially hazardous conditions for patients. Efforts to mitigate unexpected problems are imperative to ensure effective healthcare delivery and patient safety during the transition period. Actively employed in various settings, enhanced medical simulation (SIM) has become sufficiently sophisticated to assist evaluative and familiarization efforts for new clinical practice environments. With the “portabilization” of life-sized computerized manikins that exhibit real-time responses to participant interventions, SIM now permits analysis and performance of patient care activities in situ. Intended to realize complex events of high-risk and low-frequency, SIM may also enable assessment of actual patient care areas’ capacity for emergent resuscitative processes.

Operational readiness testing and preliminary orientation to Rhode Island Hospital’s new ED have been arranged through a Transportable Enhanced Simulation Technologies for Pre-Implementation Limited Operations Testing (TESTPILOT) program. Designed by simulation experts and ED administrators, the program consists of cardiac arrest, multi-trauma, uroseptic shock, and pediatric toxicology SIM scenarios.

Precisely scripted cases require assorted on-site interventions along the continuum of emergent patient care to elicit the dynamics of reallife ED activities and functions. Critical action checklists, surveys and debriefings have been designed to identify deficiencies and participant concerns requiring attention prior to opening day. Continuing the flight simulator analogy of SIM’s role in healthcare provider education, TESTPILOT may serve as a trouble-shooting “wind tunnel” for new clinical environments.

18 Transportable Enhanced Simulation Technologies for Pre-Implementation Limited Operations Testing (TESTPILOT) Program in New Emergency Departments

Scott Votey, MD; UCLA Medical Center, David Geffen School of Medicine Multimedia education products allow dissemination of knowledge to large and dispersed learner groups. Delivery of a uniform content ensures all learners share a common knowledge base. Yet teaching diverse learner groups from a single source can be problematic. Beginners may be overwhelmed when exposed to materials that advanced learners find basic. This challenge must be overcome, however, as creating multiple products is expensive and time consuming. I created a multimedia tutorial on the management of Chemical, Biological, Radiation, Nuclear, and Explosives (CBRNE) emergencies for hospital personnel. Links to text and images are synchronized to movies that deliver the core content. Four levels of learners (Basic: non-medical personnel, Intermediate: nurses, Advanced: physicians, and Executive: administrators) were identified; each has specific learning objectives, content, and competency assessment. Basic learners are only required to watch the movies. Intermediate, Advanced, and Executive learners select links matching their learner level. The tutorial may be used independently or in a classroom setting. Movies and links may be viewed in any order, repeated, or skipped. In the classroom the tutorial can be played passively, used interactively by a group of learners, or used by an instructor in a lecture or interactive seminar.

The advantage of a group setting is the creation of a community of learning. This educational tool has several advantages over standard multimedia teaching products. Diverse learners share basic content, allowing them to work together more effectively, while learners with differing roles are provided content corresponding to their responsibilities. Depending on the learner level, the tutorial provides 1 to 6 hours of instruction. With this single CD-ROM all hospital personnel can be educated on CBRNE.

19 A Novel Educational Curriculum: Using Risk-management Principles to Improve Resident Documentation

17 The Ultrasound Academy: A New Paradigm for Ultrasound Education David Bahner, MD, RDMS, Richard Limperos, MD, James Schneider, RDMS, Douglas Rund, MD; The Ohio State University Many physicians within the house of medicine incorporate ultrasound in clinical practice, yet training requirements, assessment of competency, and standard learning opportunities vary across specialties.

The Ultrasound Academy was developed in response to the competency issues raised surrounding ultrasound education and provides an enterprise wide solution for training and assessment. The construct of the facility is based on a simple learning curve from novice to basic, intermediate, and advanced practitioner specific to each specialty.

Training is designed to facilitate end users including prehospital providers, medical students, residents, and faculty from across the health

Michael Woodruff, MD, Carrie Tibbles; Beth Israel Deaconess Medical Center Harvard Affiliate Inadequate documentation in the medical record has been identified as one of the leading legal and financial liabilities for healthcare providers, and has significant implications for patient safety. Despite the acknowledged importance of good documentation, residents have traditionally received little or no formalized training in this aspect of emergency medicine. We designed an interactive seminar covering documentation, communication, and risk management in the emergency department. The seminar includes: - Prior to the seminar, a brief online activity introducing the importance of good documenta-

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tion in the care of emergency department patients - A scripted mock clinical encounter during which the residents practice documenting in the ED chart - A didactic presentation on the essentials of good documentation and its role in communication between providers - Two mock malpractice trials based on real malpractice cases: residents play the roles of plaintiff’s attorney, physician, and jury, reviewing each piece of the case and focusing on the documentation in the ED chart - The course concludes by revisiting and expanding upon the original clinical encounter; residents again practice and discuss documentation techniques To evaluate the effects of the seminar created an objective scale to provide numerical scores for documentation of differential diagnosis, medical decisionmaking / treatment rationale, and completeness of discharge instructions. A group of 100 charts from the residents who participated in the seminar is being compared to a control group of residents from the previous year. Initial analysis suggests that the seminar is effective in improving resident documentation of differential diagnosis.

20 BAAM, ENDOTROL, and FINGERS for ENDOTRACHEAL INTUBATION-no Drugs or Laryngoscope Needed Richard Cook Jr., MD, MPH; St. Christopher’s Hospital for Children; Drexel University While paralytic medications allow for ease of completion of endotracheal intubation, tragically, in some cases, the patient’s loss of the ability to maintain at least some ventilation, coupled with unsuccessful intubation and inadequate BVM ventilation, leads to needless brain damage and/or death. Broken teeth are a bane of intubators and patients (though a boon for malpractice attorneys). This exhibit presents an opportunity for EM practitioners to learn about and perfect their skills at nontraditional, nonlaryngoscopic techniques, successfully used in varied clinical situations and published in the literature that can be used “in a pinch,” or even instead of RSI. Using various commercial and improvised teaching aids, participants have the opportunity to become aware of and skillful in performing: - digital (tactile) intubation in the right hands, an extremely useful technique. We can make yours the right hands, with practice and specific tips. - blind nasal intubation- once a commonly used, prime emergency physician/paramedic skill envied by others, many residents haven’t learned this due to RSI, but it still has its role, especially if one knows how to minimize damage. - blind oral intubation (“Hershey” technique)- this unique approach employs the general technique of blind nasal intubation, but the oral route eliminates most of the disadvantages, while maintaining the patient’s ability to breathe. Teaching will include simple devices for facilitating the techniques, including the BAAM, and the Endotrol tube. Come and add these nontraditional but simple, practical, successful approaches to your airway control armamentarium. Impress coworkers and colleagues, save a few more lives.

SAEM 2006 Research Grants Emergency Medicine Medical Student Interest Group Grants These grants provide funding of $500 each to help support the educational or research activities of emergency medicine medical student organizations at U.S. medical schools. Established or developing interest groups, clubs, or other medical student organizations are eligible to apply. It is not necessary for the medical school to have an emergency medicine training program for the student group to apply. Deadline: September 8, 2005.

Research Training Grant This grant provides financial support of $75,000 per year for two years of formal, full-time research training for emergency medicine fellows, resident physicians, or junior faculty. The trainee must have a concentrated, mentored program in specific research methods and concepts, and complete a research project. Deadline: November 3, 2005.

Institutional Research Training Grant This grant provides financial support of $75,000 per year for two years for an academic emergency medicine program to train a research fellow. The sponsoring program must demonstrate an excellent research training environment with a qualified mentor and specific area of research emphasis. The training for the fellow may include a formal research education program or advanced degree. It is expected that the fellow who is selected by the applying program will dedicate full time effort to research, and will complete a research project. The goal of this grant is to help establish a departmental culture in emergency medicine programs that will continue to support advanced research training for emergency medicine residency graduates. Deadline: November 3, 2005.

Scholarly Sabbatical Grant This grant provides funding of $10,000 per month for a maximum of six months to help emergency medicine faculty at the level of assistant professor or higher obtain release time to develop skills that will advance their academic careers. The goal of the grant is to increase the number of independent career researchers who may further advance research and education in emergency medicine. The grant may be used to learn unique research or educational methods or procedures which require day-to-day, in-depth training under the direct supervision of a knowledgeable mentor, or to develop a knowledge base that can be shared with the faculty member’s department to further research and education. Deadline: November 3, 2005.

Emergency Medical Services Research Fellowship This grant is sponsored by Medtronic Physio-Control. It provides $60,000 for a one year EMS fellowship for emergency medicine residency graduates at an SAEM approved fellowship training site. The fellow must have an in-depth training experience in EMS with an emphasis on research concepts and methods. The grant process involves a review and approval of emergency medicine training sites as well as individual applications from potential fellows. Deadline: November 3, 2005.

Further information and application materials can be obtained via the SAEM website at www.saem.org.

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Interest Group Meeting Agendas Airway 1.

2.

3.

4.

5.

6.

7.

8.

Welcoming remarks and orientation to the committee and structure Thoughts about restructuring the committee, direction, presentations, collaborations, research ideas Report of Research Subcommittee, Barry Diner, MD Report of Education Subcommittee, Michael Radeos, MD Report of Program Subcommittee, Adrian Tyndall, MD Presentation of potential collaborations.

Presentation of research ideas Election of New Chairman

Clinical Directors The Clinical Directors Interest Group will be meeting on May 23 at 12:00-1:00 pm in the Morgan Room during the Annual Meeting.

Key issues will be to determine leadership for the coming year, and to make decisions about on-going activities, including the Clinical Directors’ survey. The agenda will include: Review activities of the last year; election of new Chair/Co-Chair; Clinical Directors’ survey – next step; other academic activities; and other activities.

Diversity The Diversity Interest Group (DIG) will hold its meeting on Monday May 23, from 1:00-3:00 pm. The DIG will be continuing work from last year including a follow up report on the Focus Group data from last year, developing a diversity consult service, and assisting the Diversity in Curriculum Task Force in their efforts. There are two items of new business. There was a request to revise the position statement written mostly by the DIG several years ago, and the DIG is scheduled to elect new officers this year. There will also be time preserved for member items of business so please everyone bring your ideas for the new officers to begin their work.

Geriatric The Geriatric Interest Group will meet on Tuesday, May 24, from 12:00-1:30 pm in the Clinton Room. The geriatric oral abstract presentations are scheduled to follow this meeting. Our speaker is going to Dr. Sean Morrison from Mt. Sinai. Dr. Morrison is a nationally recognized leader and researcher in geriatrics and palliative care, with a particular interest in detecting and managing pain in acute care hospitals and pain and symptom management in high risk and medically underserved populations. He has received many awards for his research and is an excellent speaker. His talk will address pain management in the older adult patient.

1. Welcome and Introductions (5 min) 2. Chair’s report (5 min) 3. Discussion and Progress on 2004-2004 Objectives (5 min) 4. Speaker (45 min) R. Sean Morrison, MD Hermann Merkin Professor of Palliative Care Professor of Geriatrics and Medicine Vice-Chair for Research Brookdale Department of Geriatrics and Adult Development Mount Sinai School of Medicine 5. Objectives and plans for 2005-2006 (20 min) Suggested: New interest group objectives Prepare a didactic session to be presented at the 2006 annual meeting.

Plan to have a speaker present at the 2006 interest group meeting.

Update on abdominal pain multicenter study.

Discussion on Geriatric Task Force

International The International Interest Group will meet on Monday, May 23 from 4:00-6:00 pm in the Clinton Room. Annual meeting and elections 4:00-5:20 pm; educational session from 5:20-6:00 pm.

Active Items 1.

List-serv update – optimizing use Discuss ongoing international projects Enlist volunteers for short international assessment and teaching trips Collaborate on international research 2.

International faculty mentorship program 3.

Primer for international EM resident rotations 4.

Fellowship list-servs – Fellowship Director listserv Fellows Listserv 5.

Scholarships for international faculty

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New Items 1.

Upcoming international meetings 2.

New York Symposium Update 3.

New Fellowship programs 4.

Proposals for didactic sessions 2006 5.

SAEM Task Force 6.

Additional items 7.

Elections: chair, vice-chair, secretary 8.

Items for SAEM meeting at ACEP (Washington, DC) Educational Session – Challenges in establishing EM residencies abroad

Mentoring Women On Monday, May 23 the Mentoring Women Interest Group will meet from 1:30 – 3:00 pm. The interest group is delighted to have Dr. William Barsan, Chair of Emergency Medicine at the University of Michigan Health System will address the group with a presentation entitled “Women in Academic Medicine.” The interest group will then discuss plans for the upcoming year and elect officers to continue the mission of mentoring women in academic emergency medicine.

Palliative Medicine Are you or your residents troubled by the lack of core training and research in pain management, end-of-life communication skills, or the management of ‘suffering’ in the emergency department? Do patients that present to the ED with a variety of physical and non-physical complaints related to dementia, cancer, heart failure or pulmonary disease frustrate residents and faculty? Are you concerned about teaching your residents how to discuss end-of-life issues or disclose the death of a loved one to a family? If so, you should consider checking out the Palliative Medicine Interest Group. This group is principally concerned with defining educational and research objectives for emergency medicine in the area of palliative medicine. Palliative Medicine is the study and treatment of patients living with life-threatening or severe advanced illness expected to progress toward dying and where care is particularly focused on alleviating suffering and promoting quality of life. Major components are pain and symptom management, information sharing, advance care planning, and coordination of care, including psychosocial and spiritual support for patients and their families. Save the date and time for Monday May 23 at 12:00-1:30 pm in the Madison Room.

1. Introduction to Palliative Care 2. Creation of a Strategic Plan for the Palliative Care in Emergency Medicine Interest Group 3. Website Development for Palliative Medicine in Emergency Medicine 4. Project Plan for 2004-5 a. Research b. Education c. Administrative 5. Election of Interest Group Chair

Research Directors 1. Welcome 2. Review of minutes of October 2004 meeting 3. Election of new interest group chair 4. Research Directors’ Survey Task Force Report 5. Review and assessment of group objectives, 2004 – 2005 a. Web-based research directors’ resource (Dr. Munger) b. Research curriculum/education resource (Drs. Green and Rothman) c. Enhancing communication between group members (Dr. Karras) d. Mentorship program (Dr. Karras) 6. Development of objectives for 2005 – 2006 7. Regional presentation: New York State Research Directors (Dr. Bania) 8. New business/open discussion 9. Adjourn

Uniformed Services The Uniformed Services Interest Group will conduct a business meeting on Tuesday, May 24 at 4:30 pm. The agenda will include introductions, elections, and initial planning for the launch of the Military Emergency Medicine Research Collaboration (MEMREC).

First formed in 2004, the USIG strives to provide a forum for both military and other uniformed services academic emergency

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physicians within the SAEM organization, as well as to promote cooperation among military EM training and research programs.

USIG also endeavors to recruit and involve military EM physicians into the academic environment, and promote SAEM membership within this unique community. Non-military EM physicians and other interested parties are welcome to attend and participate in USIG activities.

Ultrasound 1.

2.

3.

4.

5.

6.

Opening Remarks Interest Group Update • US Image Bank • Research Consultation Service • World Congress The State of PLUS • Evidence-based Medicine applied to PLUS: 2000-2005 Didactics Sessions • PLUS in Medical Resuscitation • User Friendly Digital Archiving and Record Keeping • New Procedural Applications Interest Group Awards • Excellence in Education • Excellence in Research New Business • Introduction of Chair 2005-6: Chris Moore • Election of Chair-elect for 2006-7 • Open floor for other new business

Call for Didactic Proposals 2006 Annual Meeting May 18-21 • San Francisco, CA The Program Committee is inviting proposals for didactic sessions for the 2006 Annual Meeting. This year the ProgramCommittee would like to emphasize proposals on educational research methodology and leadership development (including advancement within academic departments, medical schools and national organizations). Didactic proposals may be aimed at medical students, residents, junior faculty and/or senior faculty. The format may be a lecture, panel discussion, or workshop. The Program Committee will also consider proposals for pre- or post-day workshops or multiple sessions during the Annual Meeting aimed at in-depth instruction in a specific discipline.

Didactic proposals must support the mission of SAEM (to improve patient care by advancing research and education in emergency medicine) and should fall into one of the following categories: • Education (educational research methodology, education methodology, improving the quality of education, enhancing teaching skills) • Research (research methodology, improving the quality of research) • Career Development • State-of-the-Art (presentation of cutting-edge basic science or clinical research that has important implications for further investigation or the future practice of emergency medicine, not a review of the literature or a summary of clinical practice) • Health Care Policy and National Affairs The deadline for submission is Thursday, September 8, 2005 at 5:00 pm Eastern Daylight Time. Only online submissions will be accepted. To submit a proposal, complete the online Didactic Submission Form at www.saem.org. For additional questions or information, contact SAEM at saem@saem.org or call 517485-5484 or send a fax to 517-485-0801.

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Chief Resident Forum May 24 Beekman Parlor/Sutton North (2nd floor) Chief residency is a demanding and highly responsible position, however little formal and structure preparation is available prior to becoming a chief resident. New chief residents typically have not had the benefit of training in essential administrative, academic, and leadership skills. This one-day course will include a variety of sessions covering administrative and academic topics relevant to new chief residents. Talks and small group discussions will be led by experienced program directors and past chief residents. All sessions will include ample time for questions. In addition, a lunch session and coffee breaks will provide opportunities for chiefs from different programs to meet and exchange ideas. The small group discussion sessions will also allow for interaction with workshop faculty and former chief residents.

At the completion of this course, participants will be able to understand basic characteristics of good leadership, management techniques, administration and problem solving concepts; have learned successful scheduling and back-up techniques; become aware of common pitfalls faced by chief residents; learned effective communication techniques; had the opportunity to discuss potential ethical dilemmas that may arise during the chief resident year; and learned time management techniques.

7:30-8:00 am

Registration and Continental Breakfast

8:00-8:45 am

So You’re Chief Resident. What Does that Mean?, Stephen Playe, MD, Baystate Medical Center This session will explain the various roles and requirements of chief residents.

8:45-9:45 am

Leadership and the Management Role, Robert Hockberger, MD, Harbor-UCLA Medical Center This session will describe the scope of authority and responsibility in your role and explain leadership theories focusing particularly on action-centered leadership.

9:45-10:00 am

Break

10:00-11:00 am

Effective Communication, Marc Borenstein, MD, Newark Beth Israel Medical Center Communication is a key element to the success of any leader. At the end of this discussion, participants will understand how to build effective communication networks, identify the key communication skills required to manage staff, explain formal and informal communication networks, facilitative questioning, active listening, and describe the principles of giving and receiving feedback.

11:00-12:00 noon

Developing a Schedule, Kevin Rodgers, MD, University of Indiana (moderator), Clint Evans, MD, University of Arkansas; Corita Grudzen, MD, New York University/Bellevue Hospital Center; Orlando Heredia, MD, MPH, Washington University The emergency department schedule is a central element of any chief resident’s responsibility. This discussion will outline the RRC requirements for scheduling in EM, suggest tips for managing the complexities of an ED work schedule and explain mechanisms for dealing with sudden changes.

12:00-1:30 pm

Lunch - Question and answer session, Sutton Center/South

1:30-2:15 pm

Professional Growth, Sandra Schneider, MD, University of Rochester This session will illustrate strategies for successful career development, describe various routes to advancement and describe the challenges and barriers to promotion.

2:15-3:00 pm

Ethics and Professionalism, James Adams, MD, Northwestern University As chief resident, you may confront a new series of ethical dilemmas. This session will highlight ethical and confidential issues that involve other residents and describe how to set professional examples for others.

3:00-3:45 pm

Time Management, Susan Promes, MD, Duke University At the end of this session, participants will understand what you can realistically achieve with your time, recognize the importance of prioritizing To-Do lists and describe time management principles that can help you in your role as chief resident.

3:45-5:00 pm

Lessons Learned, Staci Kristen, MD, Oregon Health and Sciences University; Risa Moriarity, MD, University of Mississippi; David Vega, MD, York Hospital Panel discussion of former chief residents

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AEM Consensus Conference Ethical Conduct of Resuscitation Research Saturday, May 21 Concourse A (one level below lobby) 8:00-8:45 am

Opening Remarks: A Historical Perspective on the Final Rule for Conducting Reseach using Exception from Informed Consent, Concourse A, Michelle Biros, MD, MS This session will also include an electronic survey of the participants.

8:45-9:30 am

Panel: Update of Existing Research about the Rules, Concourse A, Lynne Richardson, MD, Terri Schmidt, MD, Roger Lewis, MD, PhD This session will provide an overview of research that has been published on the effectiveness of the current rules.

9:45-11:15 am

Breakout Sessions: Protecting Subjects Communicating with communities, Concourse B, Topic Leaders: Lynne Richardson, MD, Tammie Quest, MD ● What constitutes effective community consultation and public disclosure? ● How is this measured? ● What is known about the best methods of community consultation and notification? ● How should community consultation and public disclosure address language barriers, ethnic minorities and cultural diversity? ● What are the future research directions that should be taken to further study the regulations?

Communicating with subjects, Concourse C, Topic Leaders: Ilene Wilets, PhD, Raquel Schears, MD, MPH ● What is known about whether or not emergency department patients can ever give informed consent? ● Who can/should consent for subjects? (Patient, surrogate?) ● Can research assistants adequately consent subjects? ● What is known about readability and subject understanding of consent documents? ● What are the future research directions that should be taken to further study the regulations?

Research without consent with subjects with diminished capacity, Concourse D, Topic Leaders: Jill Baren, MD, Richard Bradley, MD ● What if any, special safeguards should apply before enrolling children into studies using exception to informed consent? ● Can prisoners ever be enrolled? ● What special safeguards are needed for other special groups (elderly people, persons with mental illness)? ● What are the future research directions that should be taken to further study the regulations?

Determining how well the rules are currently protecting subjects, Concourse E, Topic Leaders: Nicole DeIorio, MD, Katie McClure, MD ● What is empirically known about whether or not the current rules provide adequate protection of subjects in resuscitation research? ● What is known about the best methods of community consultation and notification? ● What are the future research directions that should be taken to further study the regulations?

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11:15-12:00 pm Reports of Breakout Sessions, Concourse A 12:00-1:30 pm

Lunch and Keynote Address, Traumatic Consent: Ethics and Emergency Medical Research, Concourse G, Glenn McGee, PhD, The John A. Balint Professor of Medical Ethics, Director of the Center for Medical Ethics, Albany Medical Center, Editor, The American Journal of Bioethics

1:30-3:00 pm

Breakout Sessions: Impact on Research Using the regulations in research, Concourse B, Topic Leaders: Vince Mosesso, MD, Dave Cone, MD ● What evidence exists that research is hindered by these regulations? ● What evidence exists that research has successfully used these regulations? ● What are the future research directions that should be taken to further study the regulations?

Researchers understanding of the guidelines, Concourse C, Topic Leaders: Art Sanders, MD, John Duldner, Jr., MD ● What is known about the direction that has been provided to researchers about how and when to use exception to consult? ● What more is needed to interpret the guidelines? ● What are the future research directions that should be taken to further study the regulations?

Research conditions that qualify for exception to consent, Concourse D, Topic Leaders: Mike Sayre, MD, Drew Watters, MD ● What is the definition of life-threatening condition? ● How is equipoise determined? ● What level of evidence is required before an intervention can be tested? ● What is empirically known about whether or not the current rules create undue barriers to performing important resuscitation research? ● What are the future research directions that should be taken to further study the regulations?

Issues related to IRBs Review, Concourse E, Topic Leaders: Amy Ernst, MD, Sue Fish, PharmD, MPH ● How do IRBs balance the risk to subjects in the proposed research with the potential benefit? ● What criteria should IRBs use in evaluating the community consultation and public disclosure plan for a study? ● What are the future research directions that should be taken to further study the regulations?

3:15-4:00 pm

Reports of Breakout Sessions, Concourse A

4:00-4:30 pm

Electronic Survey of Participants, Concourse A

4:30-5:00 pm

Closing and Consensus Process, Concourse A

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Photography Display Contributors SAEM would like to thank the following individuals who contributed to this year’s Clinical Pearls and Visual Diagnosis Contest entries. It is a significant commitment of time and intellect to develop the ever-popular Photo Display, which once again will be presented at the SAEM Annual Meeting in the Exhibit Hall, along with the posters and Innovations in Emergency Medicine Education Exhibits.

Allon Amitai MD David Bahner MD Shawn Baichoo MD Nikki Barnes MD Jason Bernad MD Christina Bloem BA Sean Bryant MD Kirsten Busse MD Alison Celis MD Nancy Chawla MD Jerrica Chen MD Thomas Cruz MD Chad Crystal MD Mike Dalley MD Ayim Darkeh MD Rolando Diaz MD

David Farcy MD Peter Fontana MD Michael Gibbs MD Joseph Gibson MD Jessica Goldstein MD Diane Gorgas MD Nicely Guzman PA Barry Hahn MD Terri Hepps MD Antonia Hipp MD Jason Hoppe MD Carl Hsu DO Daniela Iacona EM2 Randy Johnson MD Kerin Jones MD Jamie Juntunen MD

John Kendall MD Kristen Kent MD Richard Kubista MD Yung Lee MD Yiju Theresa Liu MD Jyh-I Lu MD Eric Lubliner MD Bryan MacWilliams MD Lucas Mailander MD Oliver Mayorga MD Vincent Meol MD Edward Michelson MD John Munyak MD Allison Murphy MD Arian N MD Kumara Nibanipudi MD

Ramon Nunez MD Maria O’Rourke MD Leslie Oyama MD Gregory Roslund MD Mary Ryan MD Lekha Shah MD Angela Shen MD Mark Silverberg MD Ronald Sing MD Erin Smith MD L. Troy Sullivan MD Muhammad Waseem MD Daniel Waxman MD Jack Wu BA Robert Yates MD

Potential Conflict of Interest Disclosure As an accredited provider of continuing medical education Michigan State University, College of Medicine is required to ask speakers to disclose any real or apparent conflict of interest they may have as related to the content of their presentation(s). The existence of the commercial or financial interests speakers related to the subject matter of their presentation should not be construed as implying bias or decreasing the value of their presentation(s).

However, disclosure should provide information to participants to form their own judgements. All speakers were independently selected by the SAEM Program Committee. Those speakers (of both didactics and abstracts presentations) who disclosed affiliations or any potential conflicts are listed below.

Nicole Abate, MD Douglas Adrusiek, BA Amy Betz Charles Cairns, MD Carlos Camargo, MD Sunday Clark, MPH Catherine Clement, RN Sean Collins, MD Scott Compton, MD Dana Edelson, MD Richard Goldstein, MD Kennon Heard, MD Judd Hollander, MD Michael Howell

David Karras, MD Edwards Life Sciences, LLC Jeffrey Kline, MD CIHR, CHFRS, AFHR Michigan Instruments, Inc. Dick Kuo, MD Merck & Co. Inc. Angela Mills, MD Roche Diagnostics, Inc., GSK, Lisa Nesbitt Boehringer, Ingelheim Aventis Pasteur Marcus Ong, MD CIHR W. Frank Peacock, MD Inovise Medical Inc. Medtronic Physio-Control Jeff Perry, MD Laerdal Michael Runyon, MD NIGMS Nathan Shapiro, MD McNeil Consumer Products Jacob Ufberg, MD Biosite Gregory Walcott, MD Edwards Life Sciences, LLC

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Pfizer, Inc. Breath Quant Medical Systems, Inc. Philips Medical Systems Biosite, Inc MOHLTC EHS Branch, CIHR NIL SCIOS, Ischemia Technologies, Audicor NIL Agen, Inc. Edwards Life Sciences Pfizer Medtronic

Residency Fair Participants SAEM would like to thank the following 85 EM residency programs who have registered (as of May 1) to participate in the Residency Fair, which will be held immediately following the Medical Student Symposium. The Residency Fair provides a unique and economical opportunity for medical students interested in a career in emergency medicine.

Advocate Christ Medical Center Akron General Medical Center Albany Medical Center Albert Einstein / Beth Israel Medical Center Albert Einstein / Jacobi Medical Center / Montefiore Baystate Medical Center Beth Israel Deaconess Medical Center - Harvard Boston Medical Center Brown University Carolinas Medical Center Christiana Care Health System Cooper University Hospital Denver Health Duke University Emory University Geisinger Medical Center Georgetown University/Washington Hospital Grand Rapids MERC Hennepin County Medical Center Henry Ford Hospital Indiana University Lincoln Medical and Mental Health Center Loma Linda University Long Island Jewish Medical Center Louisiana State University - Baton Rouge Louisiana State University - Shreveport Madigan/University of Washington Maimonides Medical Center Maine Medical Center Mayo Clinic Medical College of Georgia Medical College of Virginia Metropolitan Hospital Morristown Memorial Hospital Mount Sinai New York Hospital of Queens New York Methodist Hospital New York Presbyterian Columbia / Cornell Newark Beth Israel Medical Center North Shore University Northwestern University New York University/Bellevue Hospital Center Oregon Health and Science University

Orlando Regional Medical Center Palmetto Health Richland Memorial Hospital Penn State/Hershey Medical Center Regions Hospital Resurrection Medical Center St. Luke’s Hospital Stanford University/Kaiser Permanente State University of New York at Buffalo State University of New York at Stony Brook State University of New York Downstate State University of New York Upstate Summa Health System/Northeastern Ohio Universities Synergy Medical Education Alliance Texas A&M / Scott & White Memorial Hospital Thomas Jefferson University UMDNJ of New Jersey University of Alabama, Birmingham University of Arizona University of California, Davis University of California, Irvine University of California San Francisco-Fresno University of Chicago University of Cincinnati University of Florida / Jacksonville University of Iowa University of Louisville University of Massachusetts University of Michigan / St. Joseph Mercy Hospital University of Mississippi University of New Mexico University of Pennsylvania University of Pittsburgh University of Rochester University of South Florida University of Texas at Houston University of Utah University of Virginia Wake Forest University Baptist Medical Center Washington University, St. Louis Wayne State University/Sinai-Grace Hospital Wright State University York Hospital

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Didactic Session Speakers Stephanie Abbuhl, MD p. 14 University of Pennsylvania Riyad Abu-Laban MD p. 14 Vancover General Hospital

Marc Borenstein MD p. 37 Newark Beth Israel Medical Center Michael Brown MD p. 19 Michigan State University

James Adams MD p. 23, 27, 37

William Burdick MD, MS Ed

Northwestern University

p. 23

Doug Ander MD p. 3 Emory University

Yvette Calderon MD p. 24 Jacobi Medical Center

Mark Angelos MD p. 24, 28 Ohio State University

Meta Carroll MD p. 23 Northwestern University Theodore Chan MD p. 18 University of California, San Diego

Felix Ankel MD p. 14 Regions Hospital Brent Asplin MD, MPH Regions Hospital Carl Auerbach PhD Yeshiva University

Carey Chisholm MD Indiana University

p. 14

Harbor-UCLA

Jeremy Grimshaw PhD University of Ottawa

p. 19

Joseph Lex MD p. 20 Temple University

Leon Haley MD, MHSA Emory University

p. 18

Robert Hockberger MD Harbor-UCLA Jerome Hoffman MD UCLA

Mark Courtney MD p. 23 Northwestern University

Lance Becker, MD p. 14 University of Chicago

Elizabeth Datner MD p. 3 University of Pennsylvania

Ed Bernstein MD Boston University

Peter DeBlieux MD Charity Hospital

Gail D’Onofrio MD Yale University

p. 14, 23

Bernard Lopez MD, MS p. 18

Steve McLaughlin MD p. 28 University of New Mexico

Alan Jones MD p. 17 Carolinas Medical Center

Sean O’Mahoney MD p. 14 Montefiore Medical Center David Overton MD p. 3 Michigan State University Pamela Owens PhD p. 15 Agency for Healthcare Research and Quality Edward Panacek MD, MPH p. 14

p. 19

Lala Dunbar MD, PhD Charity Hospital

James Olson PhD p. 28 Wright State University

p. 14

Andy Jagoda MD p. 27 Mount Sinai School of Medicine

p. 19

Margaret Murray MSW p. 24 Office of Research Translation and Communication

p. 37

Judd Hollander MD p. 18 University of Pennsylvania

p. 3

Linda Degutis DrPH Yale University

SMBD Jewish General Hospital

Gary Green MD, MPH p. 28 John Hopkins University

p. 27

Jill Baren MD p. 23 University of Pennsylvania

William Bond MD p. 28 Lehigh Valley Hospital

p. 19

Cheri Hobgood MD p. 3 University of North Carolina

p. 27

Michelle Biros MD p. 14 Hennepin County Medical Center

Eddy Lang MDCM, CCFP

p. 3

Jamie Collings MD p. 3 Northwestern University

p. 23

Brian Gibler MD p. 14 University of Cincinnati

Thomas Jefferson University

p. 18

David Cone MD Yale University

Gloria Kuhn DO, PhD p. 28 Wayne State University

Stephen Hayden MD p. 19 University of California, San Diego

p. 24

Tom Aufderheide MD Medical College of Wisconsin

Gus Garmel MD p. 3 Stanford University

Roger Lewis MD, PhD

Charles Cairns p. 14 Duke University

Kaleida Health

Jeffrey Kline MD p. 17 Carolinas Medical Center

p. 19

Lewis Goldfrank MD Bellevue Hospital

Drexel University Cynthia Ambres MD, MS p. 27

Pamela Dyne MD UCLA/Olive View

p. 18

Gabor Kelen MD p. 18, 24 John Hopkins University

University of California, Davis

Arthur Kellerman MD, MPH

Emily Patterson PhD Ohio State University

p. 14, 18, 19

p. 27

Emory University

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Shawna Perry MD p. 27 University of Florida

Emilie Roth PhD p. 27 Roth Cognitive Engineering

Richard Summers MD p. 23 University of Mississippi

Myron Weisfeldt, MD p. 14 John Hopkins University

Stephen Playe MD p. 37 Baystate Medical Center

Richard Rothman MD, PhD

Knox Todd MD, MPH Emory University

Michael Whitcomb MD p. 25 Association of American Medical Colleges

p. 24, 28

p. 14

John Hopkins University Charles Pollack MD p. 14 Pennsylvania Hospital Susan Promes MD Duke University

Judy Shahan RN, MBA p. 18 Stephen Wall MD p. 24 Jacobi Medical Center John Hopkins University

Donald Yealy MD p. 24 University of Pittsburg

Ron Walls MD p. 14 Brigham & Women’s

Nathan Shapiro MD p. 17 Beth Israel Deaconess

John Younger MS, MD p. 17, 24

University of Michigan

p. 28

Boyd Richards PhD p. 18 Baylor College of Medicine Kevin Rodgers MD Indiana University

Janet Williams MD p. 23 University of Rochester

p. 3, 37

Niels Rathlev MD p. 18 Boston Medical Center Martin Reznek PhD Emory University

Donald Vereen MD p. 24 NIH / National Institute of Drug Abuse

Sandra Schneider MD p. 37 University of Rochester

Rishi Sikka MD p. 20 Boston University

Henry Wang MD, MPH University of Pittsburgh

Susan Stern MD p. 14 University of Michigan

John Watts PhD p. 24 Carolinas Medical Center

Ian Stiell MD, MSc p. 18 Ottawa Health Research Institute

Robert Wears MD, MS University of Florida

p. 27

Robert Zalenski MD Wayne State

p. 3, 37

p. 14

Brian Zink MD p. 3 University of Michigan

p. 27

Frank Zwemer MD, MBA p. 18

Robin Weinick PhD p. 15 Agency for Healthcare Research and Quality

University of Rochester

Organizational Officers’ Meetings Many of the emergency medicine organizations meet annually to update each other on current activities and discuss areas of mutual interest. Most often these meetings are accomplished by “officers’ meetings” in which the officers of the organizations meet once or twice a year. In order to accomplish a long agenda in a short amount of time, these meetings are “by invitation only” and only the officers of the organizations are invited to attend.

SUNDAY, MAY 22 AACEM/CORD Officers, 10:30-11:30 am, Green Room CORD/ABEM Officers, 1:00-2:00 pm, Holland Suite AACEM/AAEM Officers, 2:00-3:00 pm, Green Room SAEM/ABEM Officers, 2:00-3:00 pm, Holland Suite ACEP Executive Committee, 2:00-4:00 pm, East Suite Room AACEM/SAEM Officers, 3:00-4:00 pm, Green Room AACEM/ACEP Officers, 4:00-5:00 pm, Green Room AACEM/ABEM Officers, 5:00-6:00 pm, Green Room MONDAY, MAY 23 SAEM/EMRA Officers, 8:00-9:00 am, Holland Suite AACEM/EMRA Officers, 9:00-10:00 am, Green Room ACEP/American College of Emergency Psychiatrists Officers, 1:00-3:00 pm, Concourse D ABEM/ACEP Officers, 4:00-5:00 pm, Concourse F SAEM/AAEM Officers, 4:30-5:30 pm, Holland Suite

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TUESDAY, MAY 24 CORD/ACEP Officers, 1:30-2:30 pm, Green Room CORD/EMRA Officers, 2:30-3:00 pm, Green Room SAEM/ACEP Officers, 2:30-3:30 pm, Holland Suite CORD/AAEM Officers, 3:00-4:00 pm, Green Room SAEM/CORD Officers, 4:00-5:00 pm, Holland Suite

2005-06 SAEM Task Force Objectives how to relate to international EM as a Society. As the requests for SAEM’s involvement in international EM activities will continue for the foreseeable future, it is essential for the Society to chart its own course, one that will benefit international EM and allow the Society to maintain its mission.

1. Survey the range of international activities being offered by US based EM organizations currently. Due: October 1, 2005.

2. Make specific report to the Board on pros and cons of potential activity in international relations that are consistent with the Society’s mission. Due: December 1, 2006.

3. After Board review and response on objective #2, draft a position statement for Board review describing the potential perspective roles of SAEM in advancing international academic emergency medicine. Due: April 1, 2006.

4. Draft article discussing objectives #1-3 for the SAEM Newsletter, Due: April 1, 2006

Geriatrics Task Force: Chair, Lowell Gerson, MD, lgerson@neoucom.edu Rationale: The aging population will be a significant responsibility of emergency medicine in the foreseeable future. Research and educational programs in geriatric emergency medicine are very important for the Society to foster.

1. Develop the SAEM/ACEP consensus conference for 2006 on geriatrics, including development of research agenda. Due: October 15, 2005 2. Draft a proposal for a foundation interested in geriatrics to support new resources for educational curriculum and training materials regarding the emergency care of the elder person. Due: December 1, 2005 3. Develop new resources for educational curriculum and training materials on the emergency care of the elder person. Due: February 1, 2006 4. Develop one article on this ongoing work for the SAEM Newsletter.

Due: April 1, 2006

Technology in Medical Education – Simulators Task Force: Chair, James Gordon, MD, jgordon3@partners.org

Industry Relations Task Force:

Rationale: The incorporation of medical simulator devices, especially human mannequins, has rapidly accelerated in the last few years as a viable alternative for teaching and evaluating competencies in our specialty. There are literally dozens of simulator centers being developed at academic medical centers. It is important for SAEM to take an active role in this unique tool for medical education, both for the benefit of its membership and to establish emergency medicine as an important contributor to the development and use of this unique training tool.

1. To list the equipment necessary to establish a sample basic entrylevel turnkey simulator laboratory, including costs, for an emergency medicine site. This would include the potential teaching activities such a laboratory would support, and a timetable for implementing such a laboratory, Due: October 1, 2005 2. To develop basic elements and criteria for a consultation service in the development and/or enhancement of a simulation laboratory for emergency medicine training programs. This service may be web-based, and would focus on equipment assessment, educational programs, maintenance expectations, and their associated costs. Due: December 1, 2005.

3. To develop two documents for Board review and potential publication. One summarizes the educational research supporting this teaching technique, and the settings in which it may be used.

The other outlines potential directions for a research agenda in emergency medical education utilizing the simulator. Due February 1, 2006.

4. Write an introductory article for the Newsletter referenced to the literature outlining how simulators are being used to enhance undergraduate and graduate medical education with an emphasis in emergency medicine. Due: March 1, 2006.

5. The development of a simulator case library to be made available to the members who are developing their own simulator cases.

An anticipated number of 50-80 cases will be assembled and made available for distribution. Due: May 1, 2006.

Chair, Debra Diercks, MD, dbdiercks@ucdavis.edu Rationale: Currently, SAEM has a relatively limited engagement with industry, eg. there are no industry-related exhibitors at the Annual Meeting. To assure the Society is maximizing the potential for research and education support for its members, the Board has supported creating this Task Force.

1. Prepare a report for the Board thoroughly discussing the pros and cons of SAEM having a potential relationship with industry. The report (due December 1, 2005) should include: a. a historical perspective as to why SAEM’s current position exists b. a status review of industry relationships with other specialties c. identified arenas in which SAEM may engage with industry d. categories of industry (eg. pharmaceutical, medical devices, simulators) with which SAEM may engage. e. Practical recommendation as to how this engagement may be accomplished. These may be linked for obj. 1c and 1d above.

2. Review the current policies of the Society specific to SAEM’s relationship with industry and make recommendations with regard to continuing or changing the policy. Due February 1, 2006

Institute of Medicine IOM Report Task Force: Chair, Carey Chisholm, MD, cchisholm@clarian.org Rationale: The primary purpose of this task force will be to assist the Board in anticipating and assisting in Institute of Medicine (IOM) activities in advance of the IOM report and to guide the Society’s response to the report through recommendations to the Board of Directors. Their report is anticipated for release in early 2006.

1. To participate in a briefing by one or two of the current IOM EM Committee members at the 2005 Annual Meeting.

2. To serve as alternates for Board members in terms of attendance at important IOM functions related to this committee. Due: as necessary 3. To serve as reviewers of any preliminary documents circulated by the IOM that would be made available to the Society. Timeliness and shared commentary with the Board is essential. Due: as requested 4. To assist the Board in strategizing about the best ways to respond and utilize pertinent content items of the IOM Report for the benefit of academic emergency medicine. Due: January 1, 2006, and when report released.

Women in Academic Emergency Medicine Task Force: Chair, Kathleen Clem, MD, clem0002@mc.duke.edu Rationale: Higher percentages of women are graduating from medical school than ever in the past. The numbers of women going into emergency medicine or academic emergency medicine have not kept the same pace. As part of our continued diversity effort, the recruitment and retention needs of women in academic emergency medicine should be explored.

1. Write an article for the Newsletter on faculty development opportunities in academic medicine with a unique focus on women. Due: October 1, 2005 2. Create a document for the Board that defines and describes the unique recruitment, retention, and advancement needs for women in academic emergency medicine. This includes exploring

International Task Force: Chair, Kumar Alagappan, MD, kalagapp@lij.edu Rationale: International emergency medicine continues to grow in scope and activity. One of the significant short-comings in international EM development is academic development, including education and research. SAEM currently does not have a strategy and plan for

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a variety of services for background information to define these needs, e.g. ELAM, AAMC, Due: December 1, 2006 3. Make recommendations to the Board based on the information in Objective #1 as to how SAEM may encourage and support women in their academic careers. Due: December 1, 2006

4. Prepare a presentation on objectives #2 and 3 above to be submitted to the Program Committee as a potential didactic presentation at the Annual Meeting. A request will be made of the AACEM leadership to present separately to their annual meeting. Due: February 1, 2006

2005-06 SAEM Committee Objectives Awards Committee:

Faculty Development Committee:

Chair, William Barsan, MD, wbarsan@umich.edu 1. Develop recommendations for the Board on a standardized means of identifying and nominating Awards Committee members. Due: September 1, 2005 2. Identify two new potential academic award themes for the Society to recognize; one individual, one programmatic. Make recommendations for the Board consideration, including theme, criteria for award, and nature of recognition. Due: November 1, 2005 3. Request and review nominations for the Young Investigator Award and recommend recipients to the Board. Due: February 1, 2006 4. Request and review nominations for the Academic Excellence and Leadership Awards and recommend recipients to the Board.

Due: February 1, 2006

Chair, Theodore Christopher, MD, NChristopher@chmca.org 1. Develop a series of didactic proposals on academic skills development for submission to the 2006 Annual Meeting. At least one session should target each of senior, mid-career, junior level development needs. Due: September 1, 2005 2. Work with the Consultation Service to develop a proposal to the Board for a Faculty Development consultation. Due: November 1, 2005 3. Develop a proposal to the Board for creating an Academic Leadership Skills Course to be sponsored by SAEM, and potentially 1 or 2 other organizations. This is to be a Senior level course directed at individuals interested in moving from a Mid-Career level to Chair/Dean’s office/EM leadership position. Due: December 1, 2005 4. Take “Skill sets for Clinician-Teachers”, developed in 2004-05 objectives by GME Committee, and create an educational tool to assist faculty in learning and developing them. This may be a paper, presentation, or other mechanism. Due: February 1, 2006 5. Create a recommended text based library with an annotated bibliography for Faculty Development to assist in training faculty in specific academic and administrative skills. Due: April 1, 2006

Constitution and Bylaws Committee: Chair, Craig Newgard, MD, newgardc@ohsu.edu 1. Review the Constitution and Bylaws to ensure consistency with Society’s activities and internal functions. Propose amendments to the Board for review and approval. Due: January 1, 2006 2. Respond to specific requests from the Board regarding potential changes in the Constitution and Bylaws over the course of the year.

Finance Committee:

Development Committee:

Chair, Frank Zwemer, MD, frank_zwemer@urmc.rochester.edu 1. Respond to the findings of the external audit process with recommendations to the Board. Due: September 1, 2005 2. Initiate the annual SAEM budget planning with the Executive Director and Secretary-Treasurer in anticipation of an end-of-calendar year presentation to the Board. Due: October 1, 2005 3. Review the structure and reporting mechanisms of SAEM’s investment and non-operational funds, and make recommendations as necessary. Due: December 1, 2005 4. Review the current financial goals of investment funds and make recommendations for the next 5-year goals. Due: February 1, 2006

Chair, Brian Zink, MD, bzink@umich.edu 1. Evaluate 2004-05 fundraising activities with regard to success rates (perceived and actual) of current efforts. To include donor recognition event at Annual Meeting, silent auction, mail solicitations, and others. Due: September 1, 2005 2. Identify current and potentially new areas for revenue enhancement for the Society for Board review. This process will include a survey of Past-Presidents, Committee, and Task Force Chairs, IG Chairs for their ideas. Due: November 1, 2005 3. Identify specific potential donors for “keystone” level gifts, and work with the Board to identify specific academic programs or themes they would consider funding. Due: November 1, 2005 4. Identify potential sponsors and donors within industry, foundations, and other non-member sources for Board review. Due: January 1, 2006

GME Committee: Chair, Douglas McGee, DO, mcgeed@einstein.edu 1. Continue to coordinate the Resident Section of the SAEM Newsletter, including soliciting, selecting, and editing of quality articles in a timely manner. Ensure 2-3 articles throughout year oriented toward important resident issues/topics. Due: September 1, December 1, 2005 and March 1, 2006 2. Plan and organize the authorship and writing schedule for a document to assist residents seeking a career in academic emergency medicine. Due: October 1, 2005 Complete initial draft, February 1, 2006; Final draft, May 1, 2006 3. Create a presentation referenced to Objective #2 on seeking a career in academic emergency medicine for residents. This will be distributed to residency programs and Regional meetings. Due: March 1, 2006

Ethics Committee: Chair, Raquel Schears, MD, schears.rocky@mayo.edu 1. Develop recommendations for the Board on means to effectively distribute the “Ethics Teaching Resources for EM Residencies”, when completed. These are avenues and approaches beyond potential publication in AEM. Due: September 1, 2005 2. Assist the Board in developing mechanisms to distribute the findings of the 2005 AEM consensus conference on Research Integrity. This includes implementation as appropriate. Due: November 1, 2005 3. Revise the three SAEM Policies regarding relationships with Industry into a comprehensive single policy. Share with the Industrial Relations Task Force for review and the Board for approval.

Due: February 1, 2006 4. Complete documents for Board review on specific ethics topics: “Publication ethics and issues”, Teacher-learner relationships”, “Academic dishonesty issues”. Due: April 1, 2006

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4. Hold conference call between Program Committee leadership, Board liaison, and 2005-06 Regional meeting directors to discuss relationship options, including the regional meeting orientation session. Due: October 1, 2005 5. Make recommendations to the Board as to whether a distinct Awards Ceremony should be established and held at the Annual Meeting, beginning 2006. Due: November 1, 2005.

6. Incorporate planned media-oriented publicity as part of Annual Meeting development. Due: March 1, 2006 7. Review and update the Annual Meeting operating manual created in 2005. Due: April 1, 2006

Grants Committee: Chair, Clifton Callaway, MD, callawaycw@upmc.edu 1. Coordinate the grant application reviews with the assistance of expert reviewers within the Society. Recommend a prioritized recipient list to the Board for the following grants and fellowship: Research Training, Institutional Research Training, Scholarly Sabbatical, EMS Research Fellowship, Medical Student Interest Group, and EMF/SAEM Medical Student Research. Due: Varies by grant program 2. Review the criteria and application process for the EMS project grants. Due: September 1, 2005 3. Establish resource for frequently asked grant-related questions and grant-writing tips on the website. Due: November 1, 2005 4. Work with Research Committee to determine criteria and assess impact of SAEM grant program for 1999 to 2003 recipients. Due: December 1, 2005 5. Review the mechanism and timeline of the current Grant Review procedure. Develop a status report for the Board with recommendations for improvement. February 1, 2006

Research Committee: Chair, James Olson, PhD, james.olson@wright.edu 1. Develop recommendations and a content outline for establishing both a Research and Scholarly Work development consultation program for emergency medicine programs. These will be reviewed by the Board prior to any notice of availability. Due: January 1, 2005 2. Maintain and update the website for listing emergency medicine researchers with federal grant funding, foundations or large-scale industry support. Define criteria for inclusion on this listing. Due: November 1, 2005 3. Develop 1 day Applied Grantsmanship and Grant Review Course for consideration as 2006 Annual Meeting Pre-meeting course.

Develop appropriate advertising for the course. Due: December 1, 2005 4. Serve as a resource for the IOM Task Force. This activity may include reviews, recommendations, and written materials, as requested. Due: Dependent on IOM timetable 5. Continue guidance and relationship with Educational Research Subcommittee.

National Affairs Committee: Chair, Michael Baumann, MD, baumam@mmc.org 1. Review the recently approved AAMC initiative plan with the AAMC representatives, and make recommendations to the Board on mechanisms for implementing it. Due: September 1, 2005 2. Monitor legislative and regulatory issues pertinent to academic emergency medicine. Write 1-2 articles on select topics for the Newsletter. Due: October 1, 2005, February 1, 2006 3. Generate a list of options for the Board regarding targeted advocacy roles (i.e. issues, opportunities, actions) in specific national institutions important to academic emergency medicine. These institutions include the AHRQ, NIH, CDC, DHHS and others. Due: November 1, 2005 4. Work with the AAMC representatives to develop a draft program for the AAMC Annual Fall Meeting 2006. Submit summaries of these events to the Newsletter. Due: 1 month post-meeting 5. Serve as a resource for the IOM Task Force. This activity may include reviews, recommendations, and written materials, as requested. Due: Dependent on IOM timetable

Educational Research Subcommittee: Chair, Gloria Kuhn, DO, PhD, gkuhn@med.wayne.edu 1. Determine the feasibility of a Researcher in Education Interest Group within the Society. Due: November 1, 2005 2. Design and develop a curriculum for educating academic emergency physicians in conducting educational research. Plan to submit as an IEME proposal for the 2006 Annual Meeting. Due: February 1, 2006 3. Develop a listing of educational resources for the subject of educational research for posting on the Societies’ web site. Due: January 1, 2006 4. Develop criteria and a guide to assist in writing a grant request in the field of educational research. Plan to share with membership through SAEM Newsletter. Due: May 1, 2006

Nominating Committee: Chair, President-elect 1. Review and assess the efficacy of the new “mini-bio” approach for the Nominating Committee review, and voter information. Make recommendations to the Board for continued improvements, as necessary. Due: September 1, 2005 2. Review and assess the success of the three new committee/task force evaluation forms instituted in early 2005. Make recommendations to the Board for continued improvements, as necessary.

Due: November 1, 2005 3. Develop a slate of recommended nominees for the following elected positions in 2006: Board officers, Board of Directors, Nominating Committee, and Constitution and Bylaws Committee. To be submitted to the Board for approval. Due: March 1, 2006

Undergraduate Education Committee: Chair, Cherri Hobgood, MD, hobgood@med.unc.edu 1. Facilitate ideas for the Board as to how SAEM can propagate and implement the recently complete MS4 curriculum document, including work with other EM organizations. Due: September 1, 2005 2. Work with the Program Committee on assessing and improving the Medical Student Pre-Day at the Annual Meeting. Due: November 1, 2005 3. Develop a proposal for evaluating the effectiveness and impact of the Virtual Advisor Program. Due: November 1, 2005 4. Development of informational materials on ‘Emergency Medicine as a Potential Career Choice’ for medical students. Develop a potential distribution plan to under-represented minority medical students, traditionally African-American Medical schools, and EM undergraduate educators in medical schools. Due: December 1, 2005 5. Monitor continued development and implementation of Undergraduate Question Databank by subcommittee. Due: over course of year

Program Committee: Chair, Deborah Houry, MD, dhoury@emory.edu 1. Review the feedback from the 2005 Annual Meeting, and present the report to the Board with recommendations for improvement and change. Due: July 1, 2005 2. Plan 2006 Annual Meeting. This includes presenting budget (Nov. 1, 2005) and quarterly progress reports by the Chair to the Board. Due: July, September, November 2005 and March, 2006 3. As part of quarterly reports, the Chair will be updated by the Board on current academe-related themes of interest to the Society. These themes may be considered for incorporation into Annual Meeting activities. Due: Dates as Objective #2

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means of continuing to improve their quality as well as impact.

Due: January 1, 2006 3. Work with the Faculty Development and Research Committees on developing new consultations in both these areas, as requested.

Due: over course of year1. Write an article for the Newsletter on faculty development opportunities in academic medicine with a unique focus on women. Due: October 1, 2005

Consultation Service: Chair, Wallace Carter, MD, wac9010@nyp.org 1. Review the current structure and function of the SAEM Consultation Committee, and make recommendations to the Board to improve its visibility. Due: November 1, 2005 2. Review the satisfaction with current consultations services. Make recommendations to the Board for additional consultations and

Positions Available NEW YORK: Albany Medical Center – The Department of Emergency Medicine, in Albany, NY, is currently recruiting for a full-time clinical faculty position to join our 15 board certified EM faculty team. We are seeking individuals with excellent clinical skills, a strong interest in teaching residents and medical students, and a willingness to contribute to research. We are a Level One Trauma Center with an integrated Pediatric ED. We see over 65,000 patients annually. Residency training, certification/ preparation in Emergency Medicine is required. Academic rank is dependent upon qualification. Apply to Mary Wilkes (wilkesm@mail.amc.edu) or Mara McErlean, MD (Mcerlem@mail.amc.edu), Fax (518) 262-3236. AMC is an EEO/AA Employer.

SEEKING TWO EMERGENCY MEDICINE PHYSICIANS PENNSYLVANIA We are recruiting two additional Emergency Medicine Residency-trained physicians to join our group of 38 board certified physicians and 11 PAs. Our team evaluates over 100,000 patients at the three sites of 750-bed Lehigh Valley Hospital (LVH). Educational and research opportunities continue to grow in tandem with our Emergency Medicine Residency Program. We are a collegial group with a good mix of experience, and our physician retention rate is extraordinary. We are employed by Lehigh Valley Physician Group, the multi-specialty physician practice of LVH. We have an active Emergency Medicine Institute that provides a number of educational programs, including a paramedic school. EMI trained over 11,000 healthcare providers last year.

LVH is now the largest hospital in Pennsylvania by number of admissions, with a Level I trauma program with three helicopters, Regional Burn Center, kidney and pancreas transplantation, 900 open hearts, 3,200 births, etc. The Hospital has 13 freestanding, fully-accredited residency programs, including one in Emergency Medicine, and about 700 medical student rotations annually. You would be eligible for faculty appointment at Penn State/Hershey. And you would be working with excellent nurses; we are very proud that in 2002 LVH received the highest honor in nursing, which is MAGNET designation.

LVH was recently voted one of the top 100 “wired” hospitals in the U.S., so you will enjoy working with state-of-the-art ER-based radiology, as well as electronic medical records, physician order entry and documentation. Our hospital also uses bar coding for patients’ medications.

You’ll receive a competitive salary with bonus, and benefits including: healthcare for you and your family with no employee contribution, life insurance of two-times salary, three forms of pension, five weeks of paid time off plus one week of CME with $4,500 annually, long term disability of 75% of salary, etc. AND, our hospital was just voted the second best large company at which to work in Pennsylvania.

LVH is located in the beautiful Lehigh Valley, with 700,000 people, excellent suburban public schools, safe neighborhoods, a moderate cost of living, 10 colleges and universities and many cultural and recreational organizations. And it’s close – but not too close – to two great cities; Philadelphia is 60 miles south and NYC is 80 miles east. If you would like to learn more, please email your CV to Michael Weinstock, MD, Chair of Emergency Medicine, at carol.voorhees@LVH.com. Phone (610) 402-7008. Hope to hear from you!

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ACADEMIC EMERGENCY MEDICINE FACULTY POSITION

LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER SHREVEPORT, LOUISIANA

Due to an expansion of the faculty, the University of Florida, Department of Emergency Medicine is seeking a full-time Assistant/Associate Professor to join our faculty practicing at Shands Teaching Hospital Emergency Department. The Department emphasizes active involvement with emergency medicine residents and medical students. Qualified applicants will be board certified/eligible in emergency medicine and ability to develop a funded research program is preferred. Faculty will provide clinical guidance and supervision of treatment delivered in the ED. Shands at UF is the hub of a multi-hospital network. Emergency Medicine medically directs county EMS and hospital transport including the ShandsCair helicopter and NASA Medical Support. Excellent compensation, great benefits package, great city! Join a progressive, democratic, superb, 13 person faculty group of team players with emphasis on quality emergency care with dedicated customer service. Anticipated Start date is July 2005. Application deadline is April 30, 2005.

Please send personal statement and CV to : David C. Seaberg, MD, FACEP, Professor & Associate Chair, Department of Emergency Medicine, University of Florida, P O Box 100186, Gainesville, FL 32610-0392.

Women and minorities are encouraged to apply.

University of Florida is an Equal Opportunity Employer.

Faculty / Open Rank The Department of Emergency Medicine at Louisiana State University Health Sciences Center has recently started a Residency Training Program in Emergency Medicine and is seeking full-time faculty to complete the complement of core faculty necessary to achieve excellence. LSUHSC is the tertiary referral center for the entire region with an annual selected volume of 65,000 and serves as the only Level I Trauma Center in the area. The department faculty is involved in all levels of graduate medical education and operates in a progressive environment with total digital radiography, computerized charting and a stat lab located within the ED. Clinical and basic science research opportunities are available with proven investigators along with protected time and educational benefits provided.

Several opportunities are available for energetic applicants with residency training and ABMS board status. Rank and position commensurate with experience and qualifications. LSUHSC is an Equal Opportunity/Affirmative Action employer.

Interested applicants are encouraged to contact: Thomas C. Arnold, M.D. Chairman, Department of Emergency Medicine LSUHSC-Shreveport 1501 Kings Highway P.O. Box 33932 Shreveport, LA 71130-3932 (318) 675-6885 or fax (318) 675-6878 tarnol@lsuhsc.edu

St. Vincent始s Mercy Medical Center in Toledo, Ohio is currently seeking candidates for the position of Clinician/Faculty within the Department of Emergency Medicine. Candidates must be residency trained in Emergency Medicine and board certified. The Emergency Medicine residency program was established in 1974 and is a fully accredited three-year program with 12 positions per year. Providing an excellent experience for residents, the ED is a high-acuity facility with 59,000 visits per year; this hospital is a Level I trauma center with special recognition as a pediatric trauma center. The program is also recognized for training within the LifeFlight program, the region始s first emergency aeromedical service. A highly appealing package is offered which includes competitive remuneration, excellent benefits, and equity ownership eligibility within an established, democratic group.

For additional information please contact: Amy Spegal Premier Health Care Services (800) 726-3627, ext. 3682 aspegal@phcsday.com fax: (937) 312-3683

48

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49

CHIEF PEDIATRIC EMERGENCY MEDICINE

Brigham and Womenʼs Hospital Harvard Medical School

The Department of Pediatrics at Womenʼs & Childrenʼs Hospital in Buffalo, NY, seeks a Chief of Pediatric Emergency Medicine who can lead a strong pediatric emergency medicine program in areas of clinical medicine, medical education and research. This position will lead both the Pediatric Emergency Medicine Division and the Hospitalʼs Emergency Medicine Department.

The Hospital is a private, not for profit, 313 bed full service pediatric and womenʼs hospital (majority of beds are pediatric with about 60 designated for women) and is a Level I regional, pediatric trauma center. The Emergency Department has 30 beds and had 42,000 visits in 2003. The Division has 12 full time faculty, and an ACGME fellowship program. Qualifications: MD, BC in Pediatric Emergency Medicine, demonstrated track record in leading and managing, committed to teaching and research. For additional information, contact: Diane Alston (602)234-3890 dalston@FaheyAssociates.com

Full-time academic faculty position. Includes excellent academic support, appointment at Harvard Medical School, unparalleled research opportunities, competitive salary, and an outstanding comprehensive benefit package.

Brigham and Womenʼs Hospital is a major Harvard affiliated teaching hospital, level I trauma center, and the base hospital for the four year ACGME accredited Brigham and Womenʼs Hospital/Massachusetts General Hospital Harvard Affiliated Emergency Medicine Residency Program. The Department of Emergency Medicine cares for over 54,000 ED patients per year, and the 43 bed ED includes a 10 bed ED Observation Unit, a 5 bed rapid assessment cardio/neuro unit and an advanced informatics system. The department is also home to STRATUS, a comprehensive medical simulation training center. The department has a robust International Emergency Medicine Program and offers international EM fellowships.

The successful candidate must have successfully completed a four year residency training program in emergency medicine or a three year program followed by a fellowship, and be board prepared or board certified in emergency medicine. Interest and proven ability in Emergency Medicine research and teaching are essential. Please send inquiries and CV to Ron M. Walls, MD, FACEP, Chairman Department of Emergency Medicine Brigham and Womenʼs Hospital 75 Francis Street, Neville House Boston, Massachusetts 02115. E-mail rwalls@partners.org BWH is an Equal Opportunity/Affirmative Action Employer

50

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Section of Emergency Medicine Yale University School of Medicine Associate Section Chief

/REGON (EALTH 3CIENCE 5NIVERSITY /(35 $OERNBECHER #HILDREN S (OSPITAL IS RECRUITING A 0EDIATRIC %MERGENCY 0HYSICIAN 2ANK WILL BE COMMENSURATE WITH EXPERIENCE

The Section of Emergency Medicine at Yale University School of Medicine is seeking to fill the position of Associate Section Chief at the Associate Professor level. The candidate should be an experienced clinician with demonstrated excellence in administrative and interpersonal skills. In conjunction with the Chief, he/she will assist with the overall mission of the Section, to excel in clinical practice, education, and research. Responsibilities will include oversight and direction of clinical operations, in conjunction with the Medical Director of the Emergency Department, specifically the development and monitoring of quality measures.

/(35 IS A ,EVEL 4RAUMA #ENTER WITH A CENSUS OF ABOUT

OF WHICH APPROXIMATELY IS PEDIATRIC /UR DEDICATED PEDIATRIC EMERGENCY DEPARTMENT IS CURRENTLY OPEN HOURS A DAY #LINICAL RESEARCH ASSISTANTS ARE AVAILABLE IN THE %$ HOURS A DAY

Candidates must be board certified in Emergency Medicine, obtain licensure in Connecticut, have a minimum of 7 years of experience with significant administrative responsibility within a Section or Department of Emergency Medicine in an academic setting. The successful candidate will also have significant administrative experience, as well as demonstrated leadership skills and a strong commitment to medical education and clinical excellence.

4HERE IS OPPORTUNITY FOR A JOINT APPOINTMENT WITH THE $EPARTMENT OF 0EDIATRICS 7E ARE SEARCHING FOR AN OUTGOING PHYSICIAN WITH SKILLS AND INTEREST IN PROVIDING OUTREACH TO LOCAL REFERRING PROVIDERS AND BUILDING RELATIONS WITH PEDIATRIC SUBSPECIALISTS AND PRIMARY CARE PROVIDERS

Yale New Haven Hospital is the primary practice site. It is a level I trauma center with approximately 70,000 adult ED visits per year. In addition, a satellite ED on the Connecticut shoreline with an annual census of approximately 10,000 adult and pediatric patients per year.

0LEASE SUBMIT A LETTER OF INTEREST AND #6 TO

Rank and salary will be commensurate with education, training and experience. For more information, contact Dr. Gail D’Onofrio at (203) 785-4404 or gail. donofrio@yale.edu. To apply, please forward your CV and cover letter via fax at (203) 785-4480, email jamie.petrone@yale.edu, or mail at Yale University School of Medicine, Department of Surgery, Section of Emergency Medicine, 464 Congress Ave, P.O. Box 208062, New Haven, CT 06519-1315.

"EVERLY "AUMAN -$ )NTERIM #HIEF 0EDS %MERGENCY 3ERVICES /(35 $EPARTMENT OF %MERGENCY -EDICINE 37 3AM *ACKSON 0ARK 2OAD #$7 %0ORTLAND /2 BAUMANB OHSU EDU

Yale University is an affirmative action, equal opportunity employer and women and members of minority groups are encouraged to apply.

/(35 IS AN %QUAL /PPORTUNITY %MPLOYER

The Texas Tech University Health Sciences Center El Paso School of Medicine invites applications for a Full-Time Assistant Professor Faculty position in the Department of Emergency Medicine. Qualified candidates must have graduated from an accredited medical school, with the completion of the required period of postgraduate training in the specialty of Emergency Medicine. The Department is located in El Paso, TX, is over twenty years old, fully accredited and has twenty-four residents at present. The main Emergency Department is located at our affiliate hospital, Thomason Hospital and is a Level I Trauma Center with a 6- bed Observation Unit. Our Department has a long history of clinical excellence, both in teaching and patient care, with outstanding institutional support.

Interested candidates must apply on line at http://jobs.texastech.edu. Four letters of reference, a curriculum vitae and a brief description of research interests should be attached on the on-line application or can be sent to: Matthew J. Walsh, MD Associate Professor and Chairman Texas Tech University Health Sciences Center 4801 Alberta Ave. El Paso, TX 79905 The Texas Tech University Health Sciences Center is an Equal Opportunity/Affirmative Action Employer.

51

/REGON (EALTH 3CIENCE 5NIVERSITY

&ELLOWSHIP /PPORTUNITIES

%MERGENCY -EDICINE %-3 &ELLOWSHIP 4HE $EPARTMENT OF %MERGENCY -EDICINE $%- OFFERS ONE YEAR OR TWO YEAR FELLOWSHIPS IN %MERGENCY -EDICAL 3ERVICES %-3 /(35 IS A ,EVEL ) TRAUMA CENTER AND BASE STATION HOSPITAL WHOSE FACULTY IS ACTIVELY INVOLVED IN GROUND AND AIR MEDICAL %-3 IN THE THREE COUNTIES SURROUNDING 0ORTLAND /REGON /(35 IS A QUALIlED HOST FOR THE 3!%- -EDTRONIC 0HYSIO #ONTROL &ELLOWSHIP IN %-3 ! FORMAL DIDACTIC CURRICULUM THROUGH THE /(35 3CHOOL OF 0UBLIC (EALTH OFFERS INDIVIDUALS THE OPPORTUNITY TO EARN AN -0( DEGREE DURING THE TWO YEAR FELLOWSHIP /PPORTUNITIES ALSO EXIST TO COMBINE THE CLINICAL AND ADMINISTRATIVE FELLOWSHIP EXPERIENCE WITH DEGREE OR DIPLOMA PROGRAMS IN CLINICAL RESEARCH HEALTHY POLICY

EPIDEMIOLOGY INFORMATICS OR BUSINESS ADMINISTRATION 0LEASE CONTACT -OHAMUD $AYA -$ -3 %-3 &ELLOWSHIP $IRECTOR /(35 -AIL #ODE #$7 % 37 3AM *ACKSON 0ARK 2OAD 0ORTLAND /2 0HONE % EMAIL DAYAM OHSU EDU

%MERGENCY -EDICINE 2ESEARCH &ELLOWSHIP /(35 S #ENTER FOR 0OLICY 2ESEARCH IN %MERGENCY -EDICINE #02 %- HAS OPENINGS IN ITS YEAR RESEARCH FELLOWSHIP &ELLOWS SELECT RESEARCH PROJECTS TAILORED TO THEIR INDIVIDUAL INTERESTS WITH A FOCUS ON ACCESS TO CARE QUALITY OR COST OF CARE AND EMERGENCY RESUSCITATION OF TRAUMA OR CARDIAC ARREST &ELLOWS MAY PARTICIPATE IN AN .)( SPONSORED MULTI CENTER RESUSCITATION OUTCOMES CONSORTIUM A 2OBERT 7OOD *OHNSON &OUNDATION SPONSORED STATEWIDE PROJECT ON %$ USE AND ACCESS TO CARE AND MULTIPLE OTHER PROJECTS 4HEY ALSO COMPLETE A -ASTER S COURSE OF STUDY INCLUDING RESEARCH METHODS AND GRANTSMANSHIP !LL FELLOWS WILL GAIN EXPERIENCE AS A CLINICAL FACULTY MEMBER &ULL BENElTS A COMPETITIVE SALARY TRAVEL FUNDS AND TUITION SUPPORT ARE INCLUDED #ANDIDATES MUST BE BOARD PREPARED OR BOARD CERTIlED IN EMERGENCY MEDICINE 4HEY SHOULD HAVE A DEMONSTRATED INTEREST IN HEALTH SERVICES RESEARCH OR CLINICAL RESEARCH AND A COMMITMENT TO A CAREER IN ACADEMIC EMERGENCY MEDICINE 0LEASE ADDRESS QUESTIONS TO 2OBERT ! ,OWE -$ -0( $IRECTOR #02 %/(35 -AIL #ODE #2 37 3AM *ACKSON 0ARK 2OAD 0ORTLAND /2 % MAIL LOWERO OHSU EDU

52

4OXICOLOGY &ELLOWSHIP /(35 OFFERS A TWO YEAR 4OXICOLOGY &ELLOWSHIP &ELLOWSHIP SITE INCLUDES %- RESIDENCY PROGRAM %- OBSERVATION UNIT TO ADMIT 4OXICOLOGY PATIENTS WEEKLY 4OXICOLOGY DIDACTIC CONFERENCES 4OXICOKINETICS COURSE

0EDIATRIC %- AND 0%$S 4OXICOLOGY 7E ALSO HAVE LINKAGES WITH %-3

(!:-!4 !(,3 COURSE CERTIlCATE PROGRAM OR -0( IN RESEARCH AND PESTICIDE SURVEILLANCE PROGRAM 4HE /REGON 0OISON #ENTER SERVES /REGON .EVADA 'UAM AND !LASKA

AND RECEIVES CALLS PER YEAR &OR A FULL DESCRIPTION SEE OUR WEBSITE HTTP WWW OHSU EDU SOM %MERG-ED FELLOWSHIP TOX INDEX HTM &OR AN APPLICATION PLEASE CONTACT :ANE (OROWITZ -$ /(35 -AIL #ODE #" 37 3AM *ACKSON 0ARK 2OAD 0ORTLAND /2 0HONE % MAIL HOROWIZA OHSU EDU

University of Nebraska Faculty Openings The University of Nebraska Medical Center, Section of Emergency Medicine is recruiting 1-2 additional faculty members committed to developing an academic career.

Adequate protected time is provided and start-up funding is available. Preference is given to individuals with fellowship training or research experience. With an accredited residency which began in July 2004, this is a great opportunity to help shape the future of emergency medicine in this region. Candidates who have toxicology training will also have the opportunity to work with the Nebraska Regional Poison Center. The new Center for Clinical Excellence, which will house the Emergency Department and provide services for 45,000 annual visits, will open in November 2005.

Respond in confidence to: Robert Muelleman, M.D., Professor, Chief of Emergency Medicine, University of Nebraska Medical Center, 981150 Nebraska Medical Center, Omaha, NE 68198-1150. (402559-6705) The University of Nebraska is an affirmative action/equal opportunity employer. Minorities and women are encouraged to apply.

Stony Brook University Department of Emergency Medicine Position: Full Time BC/BE Emergency Medicine Physicians and Assistant Professors Job Description: This is an exciting opportunity to join a strong clinical and academic program with teaching opportunities for medical students and emergency medicine residents at Stony Brook University Hospital and Central Suffolk Hospital, a new member of the University Hospital Alliance located in Riverhead, Long Island. Combined, the two hospitals see approximately 100,000 patients annually. Physicians will be faculty in the Department of Emergency Medicine at Stony Brook with privileges at both Central Suffolk and Stony Brook University Hospital, a 504 bed tertiary care hospital and Level I trauma center. These academic positions are tenure track eligible with The Stony Brook University School of Medicine in a department with a proven track record and nationally recognized research program. Excellent salary and outstanding benefits are offered.

Job Requirements: Candidate must be residency trained in Emergency Medicine with board certification/preparation.

Contact: Mark Henry, M.D., FACEP, Chair, Department of Emergency Medicine, Stony Brook University Stony Brook New York, 11794-8350. Phone (631) 444-2829.

Stony Brook University is an equal opportunity employer.

53

Future SAEM Annual Meetings

Emergency Medicine Academic University Physician Associates, the faculty practice plan for the University of Missouri-Kansas City School of Medicine, is recruiting for faculty physicians in the Department of Emergency Medicine.

Opportunities exist at the Assistant or Associate Professor level for residency-trained and board-eligible or board-certified emergency physicians to join a growing department. A fully-accredited EM residency was established in 1973 and currently accepts 9 residents per year. Truman Medical Center, the primary clinical site, is undergoing an extensive ED renovation that will nearly double its capacity and create a modern, state-of-the-art facility. Research areas of focus and/or need include EMS, medical simulation, asthma, cardiovascular disease, and ultrasound.

University Physician Associates offers competitive salary and benefits. Contact: Robert A. Schwab, MD, Professor and Chair, Department of Emergency Medicine, 2301 Holmes Street, Kansas City, Missouri 64108. Robert.Schwab@tmcmed.org.

An Equal Opportunity Employer

2006

May 18-21 San Francisco Marriott, CA

2007

May 16-19 Sheraton Hotel, Chicago, IL

2008

May 29-June 1 Marriott Wardman Park Hotel, Washington DC

University of California San Diego

University of California San Diego Emergency Medicine Hyperbaric Medical Director

Emergency Department Faculty Member

The University of California San Diego Department of Emergency Medicine is recruiting for the position of Medical Director of the Division of Hyperbaric Medicine. The division is UHMS accredited and conducts 2500 treatments per year at the main teaching hospital site and about 1500 treatments at a second community hospital site. The division is comprised of 7 full time and 2 part time emergency physicians and has had an active fellowship training program for 6 years. Suitable candidates should be board certified in Emergency Medicine and Hyperbaric and Undersea Medicine with a minimum of 5 years experience in both fields. California medical license or eligibility is required. The Medical Director is expected to be active clinically in the emergency department and the hyperbaric program with administrative oversight of hyperbaric treatment sites, the fellowship training program, and research activities. Appointment level is expected to be at the Associate or Professor level commensurate with experience and qualifications. In addition to the Hyperbaric Division, the UCSD Department of Emergency Medicine is comprised of two emergency departments with a combined census of 58,000 patients, a clinical toxicology division, and an EMS division. There is a PGY 2-4 residency, in place since 1990, and there are fellowship programs in Toxicology, EMS and Hyperbaric Medicine.

Salary is based upon established UCSD salary scale. Interested candidates should reply in confidence by 7/31/05 to David Guss, M.D., Director, Department of Emergency Medicine, UCSD Medical Center, 200 West Arbor Drive, San Diego, CA 92103-8676; (619) 543-6217, email dguss@ucsd. edu. AA/EOE.

The University of California San Diego Department of Emergency Medicine is recruiting for fulltime faculty members for the academic

year commencing July 2006. The UCSD Department of Emergency Medicine is comprised of a Comprehensive Emergency Department (census 37,000) and a Basic Emergency Department (census 21,000). In addition, the department has an active Hyperbaric Medicine Program, Clinical Toxicology Service, Pre-Hospital EMS program, operates a busy base hospital and provides medical oversight for a branch of the California Poison System, an air medical service, and the regional Disaster Medical Assistance Team. A PGY 2-4 residency in Emergency Medicine has been in place since 1990, and there are fellowship programs in Toxicology, EMS and Hyperbaric Medicine. California medical license or eligibility to apply required. Appointment level in the academic series will be commensurate with experience and qualifications, with salary based upon established UCSD salary scale. Reply in confidence by 7/31/05 to David Guss, M.D., Director, Department of Emergency Medicine, UCSD Medical Center, 200 West Arbor Drive, San Diego, CA 921038676; (619) 543-6217, email dguss@ucsd.edu. AA/EOE.

54

Notes

55

Annual Business Meeting May 23 3:00-4:00 pm Trianon Ballroom (3rd floor) All SAEM members are urged to attend.

1. SAEM Award and Grant Presentations, Carey Chisholm, MD, President a. b. c. d. e. f. g. h.

Hal Jayne Academic Excellence Award: Roger Lewis, MD, PhD Leadership Award: Bill Barsan, MD Young Investigator Awards: Alan Jones, MD; Jeff Perry, MD, MSc; Henry Wang, MD Research Training Grant: Michelle Charfen, MD Institutional Research Training Grant: Robert Lowe, MD, MPH Scholarly Sabbatical Grant: Timothy Mader, MD EMS Research Fellowship Grant: Francis Guyette, MD 2004 Annual Meeting Awards: • Faculty Clinical Science Presentation Amy C. Plint, MD, Children’s Hospital of Eastern Ontario Jeff Perry, Isabelle Gaboury, Rhonda Correll, Louis Lawton: A Randomized Controlled Trial of Removable Splinting vs. Casting in the Management of Wrist Buckle Fractures.

• Faculty Basic Science Presentation Selim Suner, MD, MS, Brown University Matthew R Fellows, Carlos Vargas-Irwin, John P Donoghue: Defining Long-term Signal Reliability for a 100-electrode Chronically Implanted Array to Develop a Primate Model for Studying the Effect of Nearby Injury on Individual Neurons in Primary Motor Cortex (M1).

• Young Investigator Clinical Presentation Alan E. Jones, MD, Carolinas Medical Center Vivek S. Tayal, D. Matthew Sullivan, Jeffrey A. Kline: Randomized Controlled Trial of Immediate vs. Delayed Goal-directed Ultrasound to Identify the Etiology of Nontraumatic Hypotension in Emergency Department Patients.

• Young Investigator Basic Presentation Daniel P. Davis, MD, University of California, San Diego Satoki Inoue, John C. Drummond, Paul J. Kelly, Daniel J. Cole, Piyush M. Patel: Combination of Isoflurane and an Extrinsic Caspase Pathway Inhibitor Results in Sustained Neuroprotection in Rats Subject to Focal Cerebral Ischemia.

• Clinical Science Fellow Presentation Rick Gerein, MD, University of Ottawa Martin Osmond, Ian G. Stiell, Lisa Nesbitt, Starla Campbell: What Is the Etiology of Out-of-Hospital Pediatric Cardiopulmonary Arrest.

• Basic Science Fellow Presentation Jing Chen, MD, Thomas Jefferson University Luna Benvenisti-Zarom, Raymond F. Regan: Increasing Expression of Endogenous Heme Oxygenase-1 Protects Astrocytes from Heme-mediated Oxidative Injury.

• Clinical Science Resident Presentation Basmah Safdar, MD, Yale New Haven Hospital Linda C. Degutis, Keala Yamamoto, Harry C. Moscovitz, Swarupa R. Vedere, Gail D’Onofrio: Comparison of Efficacy and Adverse Events of Intravenous Ketorolac and Parenteral Morphine Alone and in Combination in the Treatment of Acute Renal Colic.

continued on next page

56

• Basic Science Resident Presentation Brian McBeth, MD, University of Michigan Susan A. Stern, Xu Wang, Michelle Mertz, Brian J. Zink: Effects of Cocaine in an Experimental Model of Traumatic Brain Injury.

• Clinical Science Medical Student Presentation Kyle Shaver, University of Pennsylvania Robert J. Marsan, Keara L. Sease, Frank D. Sites, Frances S. Shofer, Judd E. Hollander: Does a Negative Inpatient Stress Test or Catheterization Prevent Return Cardiac Visits in the Following Year?

• Basic Science Medical Student Presentation Garig M. Vanderveldt, Thomas Jefferson University Raymond F. Regan: The Neurotoxic Effect of Sickle Cell Hemoglobin.

• Innovations in Emergency Medicine Exhibit (IEME) Presentation Italo Subbarao, DO, MBA, Lehigh Valley Hospital Christopher Johnson, William Bond: Advanced Bioterrorism Triage Algorithm: Handling the Critical First Encounter with Victims of Terror Attacks.

• Visual Diagnosis Contest Winners: • Resident Winner - Dan Lindberg, MD, University Hospital - Cincinnati Medical Student Winner - Laurie DuBois, SUNY Downstate

2. Election Results, Carey Chisholm, MD, President President Elect Board of Directors Resident Member of the Board Nominating Committee Constitution and Bylaws Committee

3.

4.

5.

6.

7.

8.

AEM Report and Announcements: Michelle Biros, MD, Editor-in-Chief Constitution and Bylaws Amendment: Carey Chisholm, MD President’s Address: Carey Chisholm, MD Introduction of 2005-2006 President Glenn Hamilton: Carey Chisholm, MD New Business Adjournment

NOTE: Award and grant recipients, newly elected members of the Board and Nominating and Constitution and Bylaws Committee are asked to remain after the Annual Business Meeting to participate in a brief photo session. Photos will be published in upcoming issues of the SAEM Newsletter.

57

Hilton New York Floor Plan Second Floor Escalator

SAEM Registration

Escalators

Beekman Parlor

Escalators

Elevators Restrooms Women Men

Rhinelander Gallery

Bryant Suite

Restrooms Men Women

Morgan Suite

Business Madison Clinton Center Suite Suite

Gibson Suite

Posters Gramercy

Nassau Suite

Murray Hill

A

IEME Exhibits & Moderated Posters

B

Sutton Parlor North Sutton Parlor Center Sutton Parlor South Regent Parlor

Photo Display

Third Floor k To Americas Halls

Escalator to Rhinelander

Escalators

Escalators

Rendezvous Trianon

Elevators

West Ballroom

Rotunda

Petit Trianon

Mercury Ballroom

Trianon Ballroom

East Ballroom

The Concourse rooms are one level below the lobby.

The following rooms are on the 4th floor: East Suite Hilton Board Room Lincoln Suite

Green Room Holland Suite Midtown Suite

Harlem Suite Hudson Suite New York Suite