SAEM 2007 Annual Meeting Program

2007

Annual Meeting Chicago, IL May 16-19

Society for Academic Emergency Medicine

What’s Inside AACEM Activities ________________________________________________________ Page 2 AEM Consensus Conference_______________________________________________ Page 3 Annual Business Meeting ________________________________________________Page 12 Chief Resident Forum ___________________________________________________Page 11 Didactic Session Speakers _______________________________________________Page 32 Grants Preparation Workshop ______________________________________________ Page 4 Innovations in Emergency Medicine Education Exhibits _______________________Page 33 Medical Student Symposium ______________________________________________ Page 5 Registration Form___________________________________________________ Pages 37-38 Schedule of Events __________________________________________________ Pages 6-10

2007 Annual Meeting Program Committee Debra Houry, MD, MPH, Chair Brigitte Baumann, MD Steven L. Bernstein, MD Andra Blomkalns, MD David A. Caro, MD Douglas M. Char, MD Rita K. Cydulka, MD, MS M. Christopher Decker, MD Deborah Diercks, MD Jeffrey Druck, MD Jason S. Haukoos, MD, MS Jolie C. Holschen, MD Eric D. Katz, MD

Terry Kowalenko, MD O. John Ma, MD Antonio E. Muniz, MD Craig Newgard, MD Emanuel Rivers, MD, MPH Marc S. Rosenthal, PhD, DO Christopher Ross, MD John Southall, MD Stewart W. Wright, MD Gary Vilke, MD Mildred Willy, MD John G. Younger, MS, MD Katherine Heilpern, MD, Board Liaison

General Information The SAEM Annual Meeting is the largest forum for the presentation of original research in emergency medicine. The meeting will be held May 16-19 at the Sheraton Chicago Hotel and Towers. Over 1,800 emergency physicians are expected to attend. The Annual Meeting will include 545 original research presentations, as well as 25 Innovations in Emergency Medicine Education (IEME) Exhibits. The oral papers consist of 10 minute presentations followed by five minutes for questions and answers. Selected oral paper sessions will include additional time for discussions. The posters are scheduled in two-hour sessions each day. Most posters will focus on one-on-one discussion between the presenters and the attendees. However, each day 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. In addition to this Annual Meeting brochure, more details regarding the Annual Meeting are posted on the SAEM web site at www.saem.org. The web site is continually updated. A copy of the Abstract Supplement will also be provided to all Annual Meeting attendees in Chicago.

Registration Attendees are strongly urged to pre-register for the Annual Meeting using the online registration form at www.saem. org. Pre-registration ensures shorter registration lines in Chicago and assists staff in preparing name badges that are required for admission into all Annual Meeting sessions. Attendees may also register via fax or mail using the registration form included in this brochure.

Early registration fees are in effect until April 15.

For the cost of the basic registration fee attendees may attend all paper, poster, and didactic sessions, except those sessions that have limited enrollment, require pre-registration, or require an additional registration fee. Some of the limited enrollment sessions may be sold out prior to the Annual Meeting. Therefore, be sure to register early. For those who have pre-registered to attend sessions that require pre-registration, be sure to arrive a few minutes early.

It is the policy of SAEM to comply with the Americans with Disabilities Act. If special arrangements are necessary, please contact SAEM at saem@saem. org or 517-485-5484.

Hotel Accommodations The Annual Meeting will be held at the Sheraton Chicago Hotel and Towers.

Be sure to make hotel reservations by April 14. Reservations received after April 14 will be filled on a space and rate availability only. Call 312-464-1000 for reservations and be sure to mention the SAEM Annual Meeting to receive the discounted room rate of $212 for single or double occupancy.

SAEM has reserved a block of rooms at the Sheraton Chicago based on the

number of rooms used during previous Annual Meetings. The block of rooms will be adequate to allow all attendees to secure a reservation. Unfortunately, reservations are often made before travel plans are finalized, or more rooms are reserved than are expected to be used.

This uses up the block and in some cases requires other SAEM members to secure rooms outside of the block at a higher cost. Please be kind to your colleagues and do not reserve more rooms than you anticipate using. If your plans change, please cancel room reservations at least two weeks in advance to allow others to have an opportunity to make a reservation within the block. It is important to note that SAEM has a commitment to fulfill its block of rooms and pays a penalty if the block is not filled.

The size of the SAEM block is based entirely on the number of rooms that were used during the previous year’s Annual Meeting.

Continuing Medical Education The 2007 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 category 1 credit towards the AMA Physician’s Recognition

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Award. The CPC Competition and the AEM Consensus Conference which are held on the pre-day are also designated for 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 each educational activity.

Annual Business Meeting The Annual Business Meeting will be held on Friday, May 18 from 3:004:00 pm. The election results will be announced, as well as the results of the membership’s ballot regarding any Constitution and Bylaws amendments.

In addition, the Young Investigator Award recipients; the recipients of the Research Training, Institutional Training, EMS Research Fellowship grants; and the recipients of the 2006 Annual Meeting Best Presentation Awards will be presented to the membership.

James W. Hoekstra, MD, will present his Presidential Address to the membership. Incoming President, Judd E. Hollander, MD, will also be introduced.

There may be other reports and presentations to the membership. All SAEM members are urged to attend.

Opening Reception After the poster session on Wednesday, May 16, SAEM will host a brief happy hour reception from 6:30-7:00 pm so that Annual Meeting attendees can have a drink and socialize with other SAEM members. This opening reception will be shorter than prior years because of the later start on this day. However, we will still have great food and a cash bar, so come by!

CPC Competition The Semi-Final CPC Competition will be held on Tuesday, May 15 (the day before the Annual Meeting) from 8:00 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 79 submissions. The CPC Competition 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 six semi-finalists, will be held during the ACEP Scientific Assembly, which will be held in Seattle, WA, October 8-11, 2007.

A Night on the Town Thursday, May 17, is open for you to have a night on the town and enjoy an evening in Chicago. We have obtained group rates for two Chicago venues, a blues club and a comedy club. You can purchase tickets for either event through the online SAEM registration form.

Option A: “The Blues Brothers” Spend a night out on the town discovering what has made Chicago the home for blues music. Located just two miles from the Sheraton, the roomy ‘20s-style club’s lineup is heavy with meat-andpotatoes local bluesmen and women (who are, probably, the house specialty – even featured in a Delmark Records collection entitled The Women of Blue Chicago) like Willie Kent, Eddy Clearwater, Gloria Hardiman, John Primer Band and Big Time Sarah. Bring your dancing shoes, as dancing is definitely encouraged here – and at the sister club Blue Chicago on Clark. There are spacious booths, ample dancing room, and a rocking crowd. Check out the posters on the walls advertising concerts back in the day, as well as John Doyle paintings of the blues scene. Many different blues performers can be seen here, and you’ll seldom pass an evening without hearing Sweet Home Chicago!

The SAEM discounted admission price of $19.50 gets you in to two blues clubs, and two drinks. http://www.blue chicago.com/index.html

Donor Luncheon

Option B: “Cutting it up, Chicago style” (not a trauma lecture)

SAEM will express our thanks to contributors of the Research Fund with a Donor Luncheon on Friday, May 18 at noon.

Chicago has been the starting ground for legendary comedic stars such as John Belushi, Chris Farley, Mike Meyers and Bill Murray. Zanies Comedy Nightclub is located in the heart of Old Town, and is the oldest comedy club in Chicago, around since 1978. Zanies regularly showcases names such as Jay Leno, Jerry Seinfeld, Tim Allen, and Sinbad “before they were famous.”

With its open seating, interactive comedians, smoke-free venue and amazing performances, this will be a night not to miss.

The Council of Emergency Medicine Residency Directors (CORD) will meet on Thursday, May 17 from 8:00 am12:00 noon. The program will include educational sessions, reports, elections, and award presentations. All CORD members are invited to attend. The CORD Board of Directors and CORD committees and task forces will also meet during the Annual Meeting and those meetings will be posted as they are scheduled.

Headlining on May 17 will be James Johann, one of the three stars of The Slackers Tour, the latest national tour from the producers of “The Blue Collar Comedy Tour.” “Born in the midwest during the 70’s era of bell-bottom jeans, wood paneled station wagons and disco music, his childhood upbringing was significantly influenced by country music, countless bad haircuts and heavy doses of Catholic school. His selfdeprecating sense of humor and highenergy style all come together to create a unique onstage persona. James relies more on his brain than the profane; his comedy often hitting upon the universal theme of failure, and providing a truthful and hilarious reflection of life as he sees it.” http://www.chicago.zanies. com/index.php Admission is $22, with a two-drink minimum. Advanced tickets are required as shows sell out quickly.

Fun Run On Friday, May 18, 6-8 am, come run along Lake Michigan! The run will start promptly at 6:15 am and will be a 5K from just south of the hotel to Shedd Aquarium and back. T-shirts, bottled water, and fruit will be provided. You can sign up at the main meeting registration desk for your t-shirt, number, and pins any time before Friday morning. Registration fee is $15 and any profits generated from this event will be donated to the SAEM Research Fund.

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CORD

AACEM The Association of Academic Chairs of Emergency Medicine (AACEM) will meet Tuesday, May 15 from 8:00 am12:00 noon. The AACEM Annual Business Meeting will be held on Tuesday, May 15 from 12:00 noon-1:30 pm. The New/Future Chairs Workshop will be held from 1:30-4:30 pm. AACEM members are invited to attend.

AEM Consensus Conference Knowledge Translation in Emergency Medicine – Tuesday, May 15, 2007 The AEM Consensus Conference will be held on May 15, 2007, at the Sheraton Chicago. The theme of the conference will be “Knowledge Translation in Emergency Medicine: Establishing a Research Agenda and Guide Map for Evidence Update”.

Academic Emergency Medicine, the official journal of SAEM, plans a number of activities at the 2007 Annual Meeting. Again this year, AEM is conducting a consensus conference on the topic of “The Knowledge Translation in Emergency Medicine: Establishing a Research Agenda and Guide Map for Evidence Uptake” on Tuesday, May 15 from 8:00 am until 5:00 pm and will feature many speakers on several topics. Additional details are posted on the SAEM Annual Meeting web site. Registration is open to all Annual Meeting attendees for only $100 and includes lunch.

Registration information is included on the SAEM Annual Meeting online registration form.

A Consensus Conference Sponsored by Academic Emergency Medicine The Official Journal of the Society for Academic Emergency Medicine

Knowledge Translation in Emergency Medicine: Establishing a Research Agenda and Guide Map for Evidence Uptake May 15th, 2007 Chicago Sheraton Chicago, Illinois USA

Conference Co-chairs Barnet Eskin, Peter Wyer, Eddy Lang

Organizational Support Emergency Department SMBD - Jewish General Hospital A McGill University Teaching Hospital

An AEM Reviewers’ Workshop will be held on Thursday, May 17 from noon-1:30 pm. This session is designed for current AEM reviewers and lunch will be provided. All AEM reviewers are invited but must register in advance by sending an email to aemreg@saem.org. Space is limited and registrations will be first-come, first-served.

The AEM Editorial Board will meet during the Annual Meeting. Pre-registration is required through the AEM office at aemreg@saem.org. Please check the online schedule for dates and times.

PROPOSED AGENDA

Plenaries 8 - 8:15am 8:15 - 9am

Welcome, Opening Remarks • Michelle Biros Overview of the Research Practice Gap and Defining Knowledge Translation in the Emergency Medicine Context • Eddy Lang 9 - 9:30am Consensus Process Principles • Barnet Eskin 9:30 - 10am Theme leader presentations Concurrent Breakout Presentations I 10:30 Guideline Implementation Research (Strategies for improving guideline-directed care in the ED setting and how to study their efficacy) • Brian Gibler Decision Support Technology (Cutting edge innovations in technology-assisted evidence implementation: lessons from software development and informatics technology applications) • Brian Holroyd Research Methodology in KT (Unique study design and methodological considerations in planning and conducting KT research) • Donald Yealy Threoretical Underpinnings of KT (Conceptual frameworks for understanding the knowledge to action continuum) • Ian Graham Lunchtime Keynote Address 11:30 - 1pm Opportunities and challenges in closing the research to practice gap: the AHRQ vision for advancing the study of evidence uptake in emergency medicine • Carolyn Clancy Concurrent Breakout Presentations II 1 - 2:00pm Developing Evidence Summaries for Emergency Medicine (Review of ongoing and potentially novel initiatives to appraise and synthesize existing evidence into clinician-friendly and usable content designed for bedside application) • Peter Wyer Implementing Decision Rules in an Emergency Department (Obstacles and facilitators to clinical decision rule uptake in an Emergency Department: studying causes and measuring impact of implementation strategies) • Ian Stiell Funding Opportunities in Knowledge Translation (Review of the AHRQ’s “Translating Research into Practice” initiatives, competing funding agencies and strategies for success) • Jean Slutsky A Model Program in Knowledge Translation Research (Review of CIHR’s multi-faceted and multicentered program in Knowledge Translation Research in Pediatric Emergency Medicine) • Terry Klassen Consensus-building Workshops 2:15 - 4:15pm Consensus process for establishing KT research agenda and key recommendations: Six facilitated groups of participants drawn from the discussion groups involved in the specific preparatory phase will join in this breakout session. Moderated by the designated chairs and aided by the two scribes these six groups will use brainstorming as well as validated consensus techniques to finalize a prepared, comprehensive and prioritized list of KT research opportunities and recommendations for their KT domain.

4:30 - 5:30pm Feedback reporting from workshop groups and large group consensus building exercise

The following stakeholder organizations have issued endorsements and have agreed to be considered among the Consensus Conference supporting agencies • Agency for Healthcare Research and Quality (AHRQ) • American College of Emergency Physicians (ACEP) • Alberta Research Centre for Child Health Evidence (ARCHE) • American Academy of Emergency Medicine (AAEM) • Canadian Agency for Drug and Technology Assessment in Health (CADTH) • Canadian Association of Emergency Physicians (CAEP) • Canadian Association of Emergency Physicians Research Consortium (CAEP RC) • Canadian Institutes for Health Research (CIHR) • Cochrane Prehospital and Emergency Health Field (CPE HF)

• Emergency Multidisciplinary Research Unit (EMRU) • Emergency Medicine Residents Association (EMRA) • Evidence Based Emergency Medicine Interest Group, NY Academy of Medicine • Knowledge Translation Program at the University of Toronto • Ottawa Health Research Institute (OHRI) • Pediatric Emergency Care Applied Research Network (PECARN) • Pediatric Emergency Research Canada (PERC) • Society for Academic Emergency Medicine (SAEM)

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Intensive Grants Preparation Workshop Tuesday, May 15, 2007 Obtaining independent federal research funding is a critical step in achieving a successful academic research career in emergency medicine. Grant Mentorship Workshop sessions offered at past SAEM Annual Meetings have been well received and have assisted past participants in securing subsequent grant funding. This new full-day Grants Preparation Workshop will significantly improve the potential for committed academic emergency physicians to obtain independent research funding by rapidly developing their grant writing skills and providing detailed expert feedback on each participant’s draft grant applications. This expanded format will allow for integration of focused didactics, a newly developed series of writing exercises, and additional time for one-on-one mentoring with the course faculty. Faculty includes highly experienced senior level EM grant writers and reviewers, as well as experts from the NIH. The course is open to SAEM member faculty and fellows registered for the Annual Meeting who can submit a completed grant application draft (near-ready for submission or submitted but not funded) for review 30 days prior to the course. To ensure individual attention, enrollment is limited and there is a $100 course fee in addition to meeting registration fees (please use the online Annual Registration Meeting Form that will is available at www.saem.org). For optimal matching of course faculty with participants and to allow adequate time for expert review of participants’ grant drafts, all draft grant applications (and corresponding “pink sheets”) must be submitted to the SAEM office (via email at www.saem.org by April 15, 2006). Earlier submissions welcomed and encouraged.

A. Didactic Sessions: “Core Content of Grant Writing” 7:30 am Registration and Continental Breakfast 8:00 am

Introduction

8:15 am

Reading and interpreting the Request for Proposals (RFP)

8:45 am

Anatomy of a grant: Common pitfalls and how to avoid them

9:15 am

Strategic planning: Allocating time, personnel and resources for success

9:45 am

Building an “airtight case” for funding

10:15 am Career Development Awards: Jumpstarting a Research Career 10:45 am BREAK B. Interactive Skill Sessions 11:00 am Specific Aims and Hypotheses: Writing a concise and captivating first page 11:45 am Training Grants: Creating a solid career development plan 12:30 pm The Art of the Budget: Tackling FTEs, % effort and indirect costs C. Understanding the Grant Review Process 1:15 pm

LUNCH SESSION Behind Closed Doors: Funding Agencies & Grant Review

2:15 pm

Concurrent Study Section Sessions

3:45 pm

Closing Comments & Course Wrap-Up

D. Individual Grantsmanship Mentoring Program 4:00 pm

Individual Mentoring with Primary Reviewers

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Medical Student Symposium Saturday, May 19, 2007 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 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. To register for the Symposium, use the online Annual Meeting registration form at www.saem.org. The cost is $75.

8:00 – 8:15 am

Introduction, M. Chris Decker, MD, Medical College of Wisconsin

8:15 – 9: 00 am

How to Select the Right Residency for You, Francis Counselman, MD, Eastern Virginia University

9:00 – 9:30 am

Getting Good Advice, Robert Harwood, MD, Christ Hospital

9:30 – 9:45 am

Break

9:45 – 10:30 am

Navigating the Residency Process, Peter DeBlieux, MD, LSU – Charity Hospital

10:30 – 11:15 am

Getting the Most Out of Your Clerkship, Brian Clyne, MD, Brown University

11:15 am – 1:00 pm

Lunch with Program Directors

1:00 – 1:30 pm

The Dean’s Letter, Sheryl Heron, MD, Emory University

1:30 – 2:15 pm

Career Paths and Prospects in Emergency Medicine, Herbert Hern, MD, Highland General Hospital

2:15 – 2:30 pm

Break

2:30 – 3:30 pm

Small Break-Out Groups: Balancing Act, Terry Kowalenko, MD, University of Michigan Financial Planning, David Overton, MD, Michigan State University Optimizing Your Fourth Year, Steve McLaughlin, MD, University of New Mexico Medical Schools Without EM Residencies, Hans House, MD, University of Iowa

3:30 – 3:45 pm

Closing Comments, M. Chris Decker, MD, Medical College of Wisconsin

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Pre-Day, Tuesday, May 15, 2007 8:00 am-12:00 pm AACEM Meeting

8:00 am-5:00 pm Semi-Final CPC Tracks

8:00 am-5:00 pm AEM Consensus Conference

8:00 am-3:00 pm Intensive Grantsmanship Workshop

12:00-1:30 pm AACEM Annual Business Meeting

1:00-4:00 pm SAEM Board of Directors

1:30-4:30 pm AACEM New and Future Chairs Workshop

3:00-5:00 pm Grantsmanship Individual Mentoring

Please check the SAEM Web site, www.saem.org, for the most current schedule.

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Wednesday, May 16, 2007 8:00 am - 12:00 pm SAEM Board of Directors 11:00 am-1:00 pm Board of Directors Orientation with Committee/Task Force Chairs 12:00-12:45 pm Coffee Break 1:00-2:30 pm Plenary Papers 2:30-4:30 pm Oral Papers

2:30-4:30 pm Oral Papers

2:30-4:30 pm The Knowledge Translation Paradigm

2:30-3:30 pm Clinical Research: Getting Started 3:30-4:30 pm State-of-the-Art: Modifiers of Metabolism

4:30-6:30 pm Posters 5:00-6:00 pm Moderated Posters 6:30-7:30 pm Opening Reception

Please check the SAEM Web site, www.saem.org, for the most current schedule.

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Thursday, May 17, 2007 8:00 am-9:45 am Oral Paper Presentations

8:00 am-9:45 am Oral Paper Presentations

8:00 am-9:45 am State-of-the-Art: Evolving Directions in Emergency Cardiac Care

8:00 am-9:30 am Introduction to Statistics

10:00 am-12:00 pm State-of-the-Art: Recent Evidence on the Diagnosis and Management of Bronchiolitis

10:00 am-12:00 pm Communication and Negotiation Skills: The ED, The Hospital, and the Outside

12:15-1:30 pm Abstract Writing Workshop

12:15-1:30 pm Consent Barriers in Emergency Research

12:15-1:30 pm So You Want to be a Residency Director?

3:30-5:00 pm Oral Paper Presentations

3:30-5:00 pm Industry-Sponsored Research Has a Legitimate Role in Emergency Medicine (Debate)

3:30-5:00 pm The Application of Cost Analysis in Emergency Medicine Research and Administration

8:00 am-5:00 pm Chief Resident Forum 8:00 am-12:00 pm CORD Meeting

9:45-10:00 am Coffee Break 10:00 am-12:00 pm Oral Paper Presentations

10:00 am-12:00 pm Oral Paper Presentations

12:00-12:15 pm Break to Pick Up Lunch 12:00-1:30 pm AEM Reviewers Workshop

1:30-3:30 pm Posters 2:30-3:30 pm Moderated Posters 3:30-5:00 pm Oral Paper Presentations

3:00-6:00 pm Faculty Development Workshop 5:00-6:00 pm Opportunities for Emergency Medicine Research Within the NIH Clinical and Translational Science Award (CTSA) Program 5:00-7:00 pm Report from the 2006 Chief Complaint Symposium Evening A Night on the Town Option A: The Blues Brothers Option B: Cutting it up, Chicago Style

Please check the SAEM Web site, www.saem.org, for the most current schedule.

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Friday, May 18, 2007 6:00-8:00 am “FunRun�

8:00 am-9:00 am Oral Paper Presentations

8:00 am-9:00 am Oral Paper Presentations

8:00 am-9:00 am Tour the Poster Session Critiquing the Tables and Figures

8:00 am-9:00 am Planning and Completing a Sabbatical

11:00 am-12:00 pm Oral Paper Presentations

11:00 am-12:00 pm Chart Reviews in EM Research

11:00 am-12:00 pm Letter Writing for Recommendations, Advancements

9:00-11:00 am Posters 10:00-11:00 am Moderated Posters 11:00 am-12:00 pm Oral Paper Presentations

12:00-12:15 pm Break to Pick Up Lunch 12:00-1:30 pm Research Fund Donors Lunch

12:15-1:30 pm Creating Meaningful Tables and Figures

12:15-1:30 pm Spivey Lecture: Academic Mentorship: Seeking Guidance as a Clinician-Educator

12:15-1:30 pm So You Want to be an Editor?

1:30-3:00 pm Oral Paper Presentations

1:30-3:00 pm Oral Paper Presentations

1:30-3:00 pm State-of-the-Art: Therapeutic Hypothermia in Cardiac Arrest

1:30-3:00 pm Adaptive Clinical Trials

3:00-4:00 pm Annual Business Meeting 4:00-5:30 pm IOM Report 5:30-7:00 pm Chicago Blues Reception 7:00-9:00 pm Medical Photography

7:00-9:00 pm EDSTAT-ED Strategies for Teaching

Please check the SAEM Web site, www.saem.org, for the most current schedule.

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Saturday, May 19, 2007 8:00-10:00 am Oral Paper Presentations

8:00-10:00 am Oral Paper Presentations

10:00-11:00 am Oral Paper Presentations

11:00 am-12:00 pm Oral Paper Presentations

8:00-9:30 am Replacing Hindsight with Insight: Understanding Adverse Events

8:00-9:30 am Improving the Quality of Research: Research Methodology

9:30-11:00 am Simulation

9:30-11:00 am ED Information Systems

8:00 am-3:45 pm Medical Student Symposium

11:00-11:15 am Break to Pick Up Lunch 11:15 am-1:00 pm Experience with Early Goal-Directed Therapy for Sepsis

11:15 am-1:00 pm No, Not Another Boring Lecture: Educational Theory

11:15 am-1:00 pm Quality Geriatric Emergency Care

12:00-1:00 pm Lunch with Fellowship Directors

1:00-3:00 pm Posters 4:00-5:30 pm Residency Fair

Please check the SAEM Web site, www.saem.org, for the most current schedule.

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Chief Resident Forum Thursday, May 17, 2007 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.

All chief residents registered to attend the Annual Meeting are invited to register for the special Chief Resident Forum.

Enrollment is limited and the fee is $150, in addition to the basic Annual Meeting registration fee. Use the online Annual Meeting registration form to register for the Annual Meeting and the Chief Resident Forum.

7:30-8:00 AM 8:00-8:10 AM 8:10-9:00 AM

Registration and Continental Breakfast Welcome, Brigitte M. Baumann, MD Leadership and the Management Role, Robert Hockberger, MD, Harbor-UCLA Medical Center This session will discuss how leadership traits and management skills can be learned, developed and used to maximize your effectiveness as a chief resident.

9:00-9:45 AM Time Management, Tom Cook, MD, Palmetto Health Richland Hospital At the end of this session, participants will be able to develop realistic goals given their time constraints, will recognize the importance of “To-Do” lists, and describe effective time management principles.

9:45-10:00 Break 10:00-10:30 AM The Impaired Physician, Terry Kowalenko, MD, University of Michigan Health System Identification of an impaired resident falls within the purview of the chief resident. This discussion will focus on identifying signs of an impaired physician and aiding with the initial intervention.

10:30-11:15 Developing a Schedule, Brigitte Baumann, MD, Cooper University Hospital/UMDNJ-RWJMS at Camden This discussion will review the RRC requirements for scheduling in EM, will outline the principles of scheduling (equity and minimization of the disruption of the circadian rhythm), and will provide mechanisms for dealing with sudden changes and illness.

11:15-12:00 PM Scheduling Panel Session Sheryl Heron, MD, MPH, Emory University Douglas Trocinski, MD, University of North Carolina at Chapel Hill Audience Participation 12:00-1:15 PM Lunch 1:15-2:00 PM Effective Communication, Richard Lanoix, MD, St. Luke’s-Roosevelt Hospital Center Communication is a key element to the success of any leader. During this session, participants will learn how to build effective communication networks, be provided with a communications “skills set” required to manage staff, and receive instruction on how to emerge as a positive intermediary between faculty and residents.

2:00-2:45 PM Professional Growth and Success as a Chief Resident Jill Baren, MD, Hospital of the University of Pennsylvania This session will illustrate strategies for successful career development and maintenance of balance while serving as chief resident.

2:45-3:00 Break 3:00-4:00 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.

4:00-5:00 PM Chief Pearls Teresa Murray Amato, MD, New York Presbyterian Hospital; Mary Gendy, MD, University of South Florida; Nicholas E. Kman, MD, Wake Forest University Baptist Medical Center Anecdotes and words of wisdom from previous chiefs.

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SAEM Annual Business Meeting Friday, May 18, 2007 3:00-4:00 p.m.

All SAEM members are urged to attend 1. SAEM Award and Grant Presentations, James W. Hoekstra, MD, President a. Hal Jayne Academic Excellence Award b. Leadership Award c. Young Investigator Awards d. Research Training Grant e. Institutional Research Training Grant f. EMS Research Fellowship Grant g. Special Recognition Award h. 2006 Annual Meeting Awards: ● Best Faculty Presentation Michael A. Ross, MD Scott Compton, Philip Kilanowski, Patrick Medado, Brian O’Neil: An Emergency Department Diagnostic Protocol for Patients with Transient Ischemic Attack: A Randomized Controlled Trial. ●

Best Young Investigator Presentation Kenneth J. McConnell, PhD Nadia Arab, Christopher F. Richards, Craig D. Newgard, Tina Edlund: The On-call Crisis: A Statewide Assessment of the Costs of Providing On-call Specialist Coverage.

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Best Basic Science Presentation Jing Chen-Roetling, MD Raymond Regan: Resistance of Astrocytes to the Toxicity of Hemoglobin Requires Heme Oxygenase-1.

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Best Resident Presentation Gregory L. Roslund, MD Terri Hepps, Kemedy K. McQuillen: The Emergency Department Role of Oral Ondansetron in the Oral Rehydration of Children with Gastroenteritis-related Vomiting.

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Best Medical Student Presentation Rebecca H. Nerenberg, MD Frances S. Shofer, Jennifer L. Robey, Kara E. Zogby. Aaron M. Brown, Judd Hollander: Impact of a Prior Stress Test on Disposition Decision and 30-day Outcome in Emergency Department Patients with Potential Acute Coronary Syndromes.

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Best Innovations in Emergency Medicine Exhibit (IEME) Presentation Eddy S. Lang, MD Raghu Venugopal, Ken Doyle, Douglas Sinclair, Antoinette Colacone, Xiaoqing Xue: A Multifaceted Workshop for Improving Productivity and Workflow Efficiency Skills in Emergency Medicine Trainees.

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Election Results, James W. Hoekstra, MD, President President Elect Board of Directors Resident Member of the Board Nominating Committee Constitution and Bylaws Committee

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AEM Report and Announcements: Michelle Biros, MD, Editor-in-Chief Bylaws Amendments: James W. Hoekstra, MD President’s Address: James W. Hoekstra, MD Introduction of 2007-2008 President Judd E. Hollander, MD: James W. Hoekstra, 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.

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Wednesday, May 16, 2007 PAPER PRESENTATIONS

POSTER SESSION

Plenary (1:00 – 2:30 pm)

Abdominal/Genitourinary

1.

22.

2.

3.

4.

5.

Can “Non-Emergency” Emergency Department Visits Shed Light on Access to Care? Robert Lowe, MD, Oregon Health & Science University Prospective, Multicenter Validation of the Pulmonary Embolism Rule-Out Criteria, Jeffrey Kline, MD, Carolinas Medical Center Mesenteric Blood Flow During Hemoglobin-Based Oxygen Carrier (HBOC)-201 Fluid Resuscitation In A Swine Model Of Severe Hemorrhagic Shock And Uncontrolled Abdominal Hemorrhage, James Manning, MD, University of North Carolina at Chapel Hill A Double Blind Randomized Controlled Trial Comparing Nebulized Epinephrine And Albuterol In The Emergency Department Treatment Of Bronchiolitis. Paul Walsh, MD, UCLA Kern Medical Center The Ottawa Aggressive Protocol for ED Management of Acute Atrial Fibrillation, Ian Stiell, MD, University of Ottawa

23.

24.

25.

26.

27.

Sepsis (2:30 – 3:30 pm) 6.

7.

8.

9.

Occult Hypo-perfusion Versus Initial Hypotension For Evaluation of Sepsis, Michael Donnino, MD, Beth Israel Medical Center The Microcirculation is Dysfunctional in Patients with Infection, Jeffrey Soderman, MD, Beth Isreal Deaconess Medical Center The Impact Of Time To Antibiotic Initiation On Mortality In ED Patients Treated With Early Goal-Directed Therapy For Severe Sepsis And Septic Shock, David Gaieski, MD, University of Pennsylvania Improved Organ Function At 24 Hours Is Associated With Increased Microcirculatory Flow During The Early Resuscitation Of Patients With Sepsis, Jonathan McCoy, MD, UMDNJ-Robert Wood Johnson Medical School at Camden

11.

12.

13.

28.

29.

30.

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Cardiocerebral Resuscitation Improves Survival From Out-OfHospital Cardiac Arrest, Bentley Bobrow, MD, Mayo Clinic, Arizona Cerebral Oximetry As An Early Predictor of Neurologic Outcome After Out Of Hospital Cardiac Arrest, Patrick Medado, CCRP, William Beaumont Hospital Hypothermia After Cardiac Arrest Does Not Alter Cytokine Release, Clifton Callaway, MD, University of Pittsburgh Changing Cardiovascular Response to Epinephrine with Increasing Duration of Cardiac Arrest, Mark Angelos, The Ohio State University

33.

34.

35.

Disaster Medicine (3:30 – 4:30 pm) 14.

15.

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17.

Does START Triage Work? An Outcomes-Level Assessment Of Use At A Mass Casualty Event, Christopher Kahn, MD, University of California, Irvine Cost-Effectiveness Analysis of Time-Varying Response Strategies to a Large-Scale Bioterrorist Anthrax Attack, Demetrios Kyriacou, MD, Northwestern University Hospital Personnel Response During A Hypothetical Influenza Pandemic--Will They Come To Work? Charlene Irvin, MD, St. John Hospital and Medical Center Patient Perceptions of the Interim Healthcare System After Hurricane Katrina, Natasha Afonso, Medical Student, Tulane University

19.

20.

21.

Safety Of Dismissing Octogenarians From The Emergency Department With Diagnosis Of Undertermined Abdominal Pain, Daniel Cabrera, MD, Mayo Clinic Medical Appropriateness of Geriatric Admissions for Failure to Thrive, Rishi Sikka, MD, Boston University Emergency Department Screening of Abdominal Aortic Aneurysms

by Bedside Ultrasonography, R Holliday, DO, Yale University The Total Lymphocyte Count and Albumin As Measures Of Protein Malnutrition In The Elderly Emergency Department Patient, Sanjey Gupta, MD, New York Hospital Queens Paramedics And Elders At Risk Of Independence Loss (PERIL): Feasibility And Inter-Rater Reliability Of Risk Factors For Adverse Outcomes, Jacques Lee, MD, Division of Emergency Medicine, University of Toronto Validation of Six-Item Screener for Dementia in Elderly Emergency Department Patients, Christopher Carpenter, MD, Washington University in St. Louis Long-term Follow-up of Older Emergency Department Patients with Blunt Injuries, Scott Wilber, MD, Summa Health System / NEOUCOM The Effect Of Age On Emergency Department Length Of Stay: The Elderly At Risk, Peter Smulowitz, MD, Beth Israel Deaconess Medical Center

Wounds 36.

37.

38.

Validation of an Ischemic Comb Burn Model in Swine, Adam Singer, MD, Stony Brook University The Effect of N-Acetyl Cysteine on Burn Progression in Rats, Adam Singer, MD, Stony Brook University A Novel TGF-Beta Antagonist Speeds Reepithelialization and Reduces Scaring of Partial Thickness Porcine Burns, Adam Singer, MD, Stony Brook University

EMS 39.

HIV Testing (3:30 – 4:30 pm) 18.

A Systematic Review of Medical Therapy to Facilitate Passage of Ureteral Calculi, Amandeep Singh, MD, Highland General Hospital National Study of U.S. Emergency Department Visits for Urolithiasis, 1993-2004, Andrea Pelletier, MS, MPH, Massachusetts General Hospital A Double-blind Randomized Clinical Trial Evaluating Ketorolac vs.

Butorphanol for the Treatment of Biliary Colic, Dana Schwarz, MD, University of Chicago Odansetron versus Metoclopramide for Nausea and Vomiting in the Emergency Department, Cynthia Haensel, MD, York Hospital Pretreatment of Patients Requiring Abdominal CT with Oral Contrast with Antiemetics: A RCT, Gregory Garra, DO, Stony Brook University Mortality And Acute Renal Failure After Contrast Enhanced Computed Tomography In Octogenarians Presenting To An Emergency Department With Acute Abdominal Pain, Daniel Cabrera, MD, Mayo Clinic

Geriatrics

Cardiac Arrest (2:30 – 3:30 pm) 10.

(4:30–6:30 pm)

Opt- Out HIV Testing in the Emergency Department: Results From A High Prevalence Setting Following The New CDC Guidelines, Jeremy Brown, MD, The George Washington University Medical Center A Comparison Of The Feasibility And Yield Of Routine Rapid HIV Testing In An Urban Emergency Department And Urgent Care Center, Douglas White, MD, Alameda County Medical Center Factors Predicting Refusal Of Emergency Department Based HIV Testing By At-Risk Patients, Ali Raja, MD, University of Cincinnati Written Consent for HIV Testing: A Significant Barrier for Routine Testing in the Emergency Department Setting, Julianna Jung, MD, Johns Hopkins University

40.

41.

42.

43.

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EMS Helicopter Collision-With-Object Crashes: Types of Objects Struck and Other Circumstantial Factors, Kiernan DeAngelis, MD, Johns Hopkins University A Prehospital Comparison of the King LT to Endotracheal Intubation and the Esophageal-Tracheal Combitube in a Simulated Difficult Airway Patient Encounter, Christopher Russi, DO, University of Iowa Out-of-Hospital Cardiac Arrests occurring in Primary Health Care Facilities in Singapore, Annitha Annathurai, MD, Singapore General Hospital Use of Emergency Medical Services By Patients with ST-Elevation Myocardial Infarction in a Regional Network, Katie Menssen, Minneapolis Heart Institute Foundation Impact Of A Prehospital Bypass Protocol On Time To Primary Percutaneous Coronary Intervention In Acute Myocardial Infarction, Jaelyn Caudle, MD, Queen’s University

Wednesday, May 16, 2007 44.

45.

46.

47.

48.

49.

50.

51.

52.

53.

54.

55.

56.

57.

58.

71.

Inter-observer Agreement about Prehospital Notification of Acute ST Segment Elevation Myocardial Infarction, Nancy Chawla, MD, Boston Medical Center Cardiopulmonary Resuscitation in the Republic of Armenia, Sharon Chekijian, MD, Yale University Prehospital 12-Lead EKG Compliance in the Chest Pain Patient, Mary Vonderschmidt, MPA, MICP, University of Cincinnati A Nationwide Prehospital Stroke Survey: A Reassessment, Laura Levoy, MD, West Virginia University A Diversion Policy Dramatically Reduces Diversion Hours But Increases Drop-Off Times, Osei Kwame Asamoah, MD, University of New Mexico Can Low Priority Emergency Ambulance Calls Be Managed By Telephone Advice? Janette Turner, Ms, University of Sheffield EMS and Managed Care: The Los Angeles Experience, Marc Eckstein, MD, USC University of Southern California Emergency Medical Technician Treatment of Prehospital Hypoglycemia without Transport, Reed Simons, University of Washington A Validation Study Comparing The Glasgow Coma Scale To Its Components And Simplified Alternative Scores In Predicting Trauma Outcomes, Heidi Commins, DO, Milton S. Hershey Medical Center Use Of The Prehospital Record To Identify And Reconcile Home Medications, Zachary Meisel, MD, University of Pennsylvania Development Of A Prediction Rule For Hospital Admission Using Prehospital Data, Zachary Meisel, MD, University of Pennsylvania Safety Of Paramedics With Extended Skills, Suzanne Mason, FCEM, University of Sheffield Intraosseous vs Intravenous Access While Wearing Personal Protective Equipment in a Simulated HazMat Scenario, Christian Knutsen, MD, University of Pittsburgh Outcomes of Out-of-Hospital Cardiac Arrest in Taipei: Does Advanced Life Support Make A Difference? Matthew Ma, MD, National Taiwan University Hosptial Perceptions About Availability, Function, And Access To Emergency Medical Services Between Community And Hospital Based Populations In Calcutta, India, Nova Panebianco, MD, North Shore University Hospital

72.

Neurology 73.

74.

75.

76.

77.

60.

61.

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63.

64.

65.

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External Validation Of The San Francisco Syncope Rule, AnneMaree Kelly, MD, Joseph Epstein Centre for Emergency Medicine Research, Western Health Ultrasound Contrast Agent Increases 120 kHz in-vitro Ultrasound Enhanced Thrombolysis, George Shaw, MD, University of Cincinnati Early Calpain Activity In A Rat Model Of Traumatic Axonal Injury, Marek Ma, MD, University of Pennsylvania Inhibiting Heme Oxygenase-2 Activation Protects Neurons From the Toxicity of Hemoglobin, Jing Chen-Roetling, PhD, Thomas Jefferson University Anion Gap Metabolic Acidosis Predicts Generalized Seizure: A Case-Control Study, Jeffrey Faragher, MD, Denver Health Medical Center

CT 78.

79.

80.

81.

82.

83.

Stroke 59.

Ethnic Differences in Outcomes After Acute Ischemic Stroke: Influence of Hyperglycemia, Nina Gentile, MD, Temple University Adherence to Inpatient JCAHO Prophylaxis Measures After Acute Ischemic Stroke Results In Better Functional Outcome. Ann Hoff, MD, Mayo Clinic

Subsequents Vascular Event Following an Acute Ischemic Stroke, M.Fernanda Bellolio, MD, Mayo Clinic Ischemic Stroke in Young Adults: Etiology and Outcome, M.Fernanda Bellolio, MD, Mayo Clinic Disparities in the Management of Transient Ischemic Attack, Jeffrey Coben, MD, West Virginia University Poor Association Between Hyperglycemia at Arrival and Clinical Outcomes in Acute Stroke Patients Treated with Tissue-type Plasminogen Activator, William Meurer, MD, University of Michigan Ischemic ECG Changes Predict Myocardial Injury In Patients With Intracerebral Hemorrhage, Megan Fix, MD, Massachusetts General Hospital JCAHO Stroke Center Certification as a Strategy for a Statewide System of Acute Stroke Care in North Carolina, Andrew Asimos, MD, Carolinas Medical Center BloodPressure Hemodynamics In Acute Ischemic Stroke: Association With Stroke Severity,Disability And Death, Sailaja Enduri, M.B.B.S, Mayo Clinic Hemoglobin: A Predictor Of Functional Outcome Following An Acute Ischemic Stroke, David Nash, Mayo Clinic Early Clinical Deterioration In Subarachnoid Hemorrhage, John Duldner, MD, Akron General Medical Center Does Initial Emergency Department Hyperglycemia Simply Represent Underlying Undiagnosed Diabetes in Patients Presenting with Acute Ischemic Stroke, Shaily Mishra, MPhil, Mayo Clinic Frequency of Abnormal Lab Values in Patients Presenting to the Emergency Department with Acute Ischemic Stroke, Brian Stettler, MD, University of Cincinnati Diabetes Mellitus And Hyperglycemia Promote Blood Coagulation After Acute Ischemic Stroke, Nina Gentile, MD, Temple Unversity

84.

85.

Marked Increase in Computed Tomography and Magnetic Resonance Imaging Utilization in the Emergency Department, Steven Polevoi, MD, University of California, San Francisco Increasing Utilization of Computed Tomography in the Pediatric Emergency Department, 2000-2006, Joshua Broder, MD, Duke University Medical Center Cost Effectiveness of CT Coronary Angiography Compared to Other Strategies for Evaluating Chest Pain in Patients in the Emergency Department, Rahul Khare, MD, Northwestern University Characteristics Of ED Patients With CT-Proven Small Bowel Obstruction and Discordant Negative Plain Abdominal Radiography, Jeffrey Green, MD, New York Hospital Medical Center of Queens Discrepancies Between Teleradiology and In-house Radiology Interpretations of Emergency Department Computed Tomographic Scans, Timothy Platts-Mills, MD, University of California, San Francisco-Fresno Estimating the cumulative risk of ionizing radiation exposure from diagnostic testing in an Emergency Department Population: What Do We Really Know? Linda Papa, MD, Orlando Regional Medical Center The Eligibility Of ED Low Risk Chest Pain Patients For Multi-Slice CT Coronary Angiography, Amy Romey, MD, William Beaumont Hospital Accuracy Of Radiology Resident Interpretation Of Emergency Department CT Scans, Bruno Petinaux, MD, George Washington University

Diagnostic Technology 86.

87.

88.

89.

90.

91.

92.

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Accuracy of Emergency Physician Interpretation of Xrays - An Analysis of 151693 Radiographs, Bruno Petinaux, MD, George Washington University The Prevalence Of Asymptomatic Abdominal Aorta Aneurysm In An Urban Geriatric Emergency Department Population- A Pilot Study., Monal Patel, MD, Jacobi Medical Center, Albert Einstein College of Medicine Noninvasive Measurement Of Hemoglobin Concentration In Emergency Department Patients Using Fiber Optic Spectral Analysis Of The Tarsal Plate, Justin Racht, MD, Brown University Does Impedance Cardiography Correlate with B-Type Natriuretic Peptide Levels in Acutely Decompensated Heart Failure Patients?

Erika Havelka, MD, Advocate Christ Hospital and Medical Center Infrared Imaging for Detection of Compartment Syndrome, Laurence Katz, MD, University of North Carolina at Chapel Hill Use of Quantitative Broad-Based Polymerase Chain Reaction (PCR) for Detection and Identification of Common Bacterial Pathogens in Cerebrospinal Fluid (CSF), Celeste Cheryll Quianzon, MD, Johns Hopkins University National Survey of Diagnostic Imaging in the Emergency Department: Hospital, Patient, And Geographic Factors Associated with Utilization, Robert Welch, MD, Wayne State University

Wednesday, May 16, 2007 93.

94.

95.

initiative, the AHRQ office of Outcomes and Effectiveness has supported over a dozen research programs in this area. Similarly, KT has been central to the mandate of the CIHR, forging partnerships with researchers and healthcare providers in Canada to ensure that the fruits of the clinical endeavor have an impact on population health. The IOM, healthcare advisor to policymakers and leaders in academic medicine, first raised awareness about the research to practice gap in its seminal “Crossing the Quality Chasm” report; work that has since spawned several followup initiatives. Each speaker will share their views on the challenges and opportunities that Emergency Medicine faces in advancing the KT agenda. This session will provide an opportunity for audience members to obtain a glimpse of this rapidly emerging area from the perspective of these three organizations. After an initial overview of the basic tenets of KT by the moderator, each speaker will give a 20-25 minute presentation followed by a 20 minute panel discussion and question and answer session. At the completion of this session, participants will: 1. Gain an appreciation of the theoretical underpinnings of KT; 2. Have a view to both the challenges and opportunities involved in translating knowledge derived from high quality clinical research into improved quality of care and better patient outcomes; 3. Based upon examples of successful and even failed attempts at disseminating innovation, envision effective evidence implementation opportunities for their own settings; 4. Be able to envision research and/or educational initiatives that would advance KT in Emergency Medicine.

Comparative Study of the Blood Gas and the Acid Base Measurements of Arterial and Venous Blood Samples in Uremia Patients Presenting to the ED, Vineet Gupta, MBBS, All India Institute of Medical Sciences, New Delhi ,India Using Spectroscopy To Assess The Ages Of Bruises, Susan Duffy, MD, Brown University Volume of Infarct on Magnetic Resonance Diffusion Weighted Imaging Is Correlated To Stroke Etiology, Nora Dajani, MD, Mayo Clinic

MODERATED POSTERS

(5:00 – 6:00 pm)

Victims of Partner Violence 96.

97.

98.

99.

Adult Intimate Partner Violence (IPV) Perpetrators are Significantly More Likely to Have Witnessed IPV as a Child (CW) than NonPerpetrators, Jennifer Hall, MD, University of New Mexico Computer Versus Paper Format For Intimate Partner Violence (IPV) Screening, Larry Goldstein, MD, University of New Mexico Are You A Victim Of Domestic Violence? Karin Rhodes, MD, University of Pennsylvania Perpetrators Of Intimate Partner Violence (IPV) Use Significantly More Methamphetamine, Cocaine And Alcohol Than Victims, Elizabeth Hilton, MD, University of New Mexico

MRSA 100. The Local Prevalence Of Nasal Colonization Of Methicillin-Resistant Staphylococcus Aureus In Emergency Department Personnel, Brian Suffoletto, MD, University of Pittsburgh 101. Geographic Variation of Community-Acquired MRSA, Kurt Weber, MD, Orlando Regional Medical Center 102. Low Rate of MRSA Colonization Among Residents, H. Hern, Jr., MD, Alameda County - Highland Hospital 103. Susceptibilities Of Emergency Department Isolates Of CommunityAssociated Methicillin-Resistant Staphylococcus Aureus (CAMRSA) To Non-Beta-Lactam Antimicrobial Agents, Nak Chhiv, MD, University of California, Irvine

State-of-the-Art: Modifiers of Metabolism – New Frontier of Antidotal Therapy (3:30 - 4:30 pm) Theodore Bania MD, St. Luke’s-Roosevelt Hospital Center Jeffrey Suchard MD, University of California, Irvine Medical Center This State of the Art session supports the SAEM mission of promoting research by highlighting novel and experimental ways of treating poisons.

This session will focus on the critical questions that need to be answered to translate theoretical and experimental work to clinical practice.

Historically, the cellular mechanism of many toxins remained unclear.

Recent studies suggest that cellular energy utilization may be a common target for many poisons. Altering cellular metabolism during times of insult may prove to be efficacious in cell survival. Prior reports of animal studies using intralipids, amino acids, and insulin all show promising methods of treating serious poisonings. In calcium-channel blocker and bipivucaine overdoses, it has been suggested that these treatments enhance the cardiac cell’s ability to use fatty acid and carbohydrates and thereby increase contractility and function. Although the use of these treatments has been successful in a handful of clinical cases, there have been no large scale, clinical human trials to support these hypotheses.

Given the nature of the relative low incidence of these poisonings, it is unlikely large clinical trials will occur. This session will concentrate: 1. presenting on-going studies to identify other types of poisonings where this approach may be beneficial. 2. determining the necessary research focus to put these novel treatments into clinical practice. 3. laying a groundwork for collaborative clinical toxicologic research to create the ability to collect data on patients who receive these therapies. Describe the current understanding of the theoretical biochemical mechanism and pathways of the toxicities of valproic acid, calcium channel blockers, and local anesthetics. Describe what new studies must be done to support these experimental theories of cell mechanisms of cardiac toxicities.

Identify the traits of other toxins that may cause their effect through mitochondrial metabolic dysfunction. for themselves. Senior participants will gain an understanding of how to develop into a mentor and how to prepare themselves for this key role in academic emergency medicine.

Didactic Sessions Clinical Research: Getting Started (2:30 - 3:30 pm) Edward Panacek MD, UC Davis Problems with clinical research studies often begin at the very beginning, with poorly considered research questions and inadequate study designs.

This session is designed for novice researchers who are just starting to initiate their own research projects. It will focus on the following: How to select and word a proper research question. How to refine questions and decide whether to proceed with the actual research project. How research questions relate to study hypotheses. How null and alternative hypotheses relate to subsequent analyses that attempt to answer the original question. How the questions being asked impact selection of a study design and protocol. A simple lecture format will be used and examples will be extensively drawn from actual EM studies. At the end of this session, participants will: 1. Be able to identify the 4 elements of most properly formatted research questions; 2. Be able to apply the FINER criteria for decisions to move forward with a question; 3. Be able to define null and alternative hypotheses and how they relate to the original research question.

The Knowledge Translation Paradigm: Closing the Research to Practice Gap in Emergency Medicine (2:30 - 4:30 pm) Eddy Lang MD, McGill University Ian Graham PhD, Canadian Institutes for Health Research Carolyn Clancy MD, Agency for Healthcare Research and Quality Arthur Kellerman MD, Robert Wood Johnson Foundation Knowledge Translation (KT) is an emerging conceptual framework and research agenda addressing the process of bringing new knowledge to bear on medical practice and policy making. Research in KT uses scientific methodology to quantify or better understand and enhance this process. The Agency for Healthcare Research and Quality (AHRQ), the Canadian Institutes of Health Research (CIHR) and the Institute of Medicine (IOM), have led the development of the KT agenda in North America. Specifically, through its “Translating Research into Practice”

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Thursday, May 17, 2007 128. Chest Pain Center Accreditation is Associated With Better Performance of Center for Medicare and Medicaid Services Core Measures for Acute Myocardial Infarction, Michael Ross, MD, William Beaumont Hospital 129. Emergency Department Patients with Community Acquired Pneumonia: Effect of a Change in Pneumonia Definition by Centers for Medicare and Medicaid Services on Compliance with Guidelines for Time to Antibiotic Administration, Benjamin Katz, MD, Albany Medical Center

PAPER PRESENTATIONS Clinical Decision Guidelines (8:00 – 9:45 am) 104. Sensitivity and Specificity of the Canadian CT Head Rule and the New Orleans Criteria in a US Trauma Center, Linda Papa, MD, University of Florida/Orlando Regional Healthcare 105. A New Clinical Decision Rule for Predicting Severity of Community Acquired Pneumonia in the Emergency Department, CA Graham, MD, The Chinese University of Hong Kong 106. Reducing Admissions Utilizing the Boston Syncope Criteria, Shamai Grossman, MD, Beth Israel Deaconess Medical Center 107. The Prehospital Validation of the Canadian C-Spine Rule by Paramedics, C. Vaillancourt, MD, University of Ottawa 108. Can ED Triage Nurses Reliably Clear the C-Spine in Minor Trauma?

Ian Stiell, MD, University of Ottawa 109. An Evaluation of the Predictive Value of the Emergency Department Assessment of Patients with Sickle Cell Disease, Aaron Bernard, MD, University of Cincinnati 110. The Acceptability of Clinical Decision Rules: Validation of the Ottawa Acceptability of Decision Rules Scale (OADRS), Jamie Brehaut, PhD, University of Ottawa

Research Design (10:00 am – 12:00 noon) 130. Impact of Regression to the Mean on Studying Interventions to Reduce ED Use, Robert Lowe, MD, Oregon Health & Science University 131. The Agreement Of The Manchester Triage System And The Emergency Severity Index In Terms Of Agreement: A Comparison, Marja Storm-Versloot, MSc, Academic Medical Centre Amsterdam 132. Pre-intervention Physiological Status Trumps Resuscitation Strategy Following Severe Hemorrhagic Shock: Comparison of Survival Analysis Methods, Penny Reynolds, PhD, Virginia Commonwealth University 133. Inappropriate Claims Of Equivalence/Non-Inferiority In Failed Randomized Trials In Emergency Medicine, Suneel Upadhye, MD, McMaster University

Toxicology (8:00 – 9:45 am) 111. Hemodynamic Effects of Intravenous Fat Emulsion plus Standard Therapy in a Model of Severe Verapamil Toxicity, Eric Perez, MD, St. Luke’s-Roosevelt Hospital Center 112. Immediate Apnea Following Acute Chlorine Gas Exposure Is Vagally Mediated, Jason Chu, MD, St. Luke’s-Roosevelt Hospital Center 113. Topical Agent For Post Exposure Prophylaxis Of Rhus-Induced Allergic Contact Dermatitis: A Randomized Controlled Trial, Brian Lovett, MD, St. Luke’s Hospital 114. Methamphetamine Abuse And Emergency Department Utilization, Robert Hendrickson, MD, Oregon Health & Science University 115. Delerium Tremens: An Analysis of Factors Associated With Mortality, Ayesha Khan, MD, Wayne State University/Detroit Receiving Hospital 116. Verapamil Toxicity Induces Dysregulation of the Insulin-Dependent Phosphatidylinositol 3-Kinase Pathway, Laura Bechtel, PhD, University of Virginia 117. The Geiger Counter Versus The Radiation Detection Portal: A Randomized Controlled Trial, Mathew Porter, MD, St. Luke’s Hospital

Analgesia (3:30 – 5:00 pm) 134. Low-Dose Ketamine Versus Fentanyl As Adjunct Analgesic To Procedural Sedation With Propofol: A Randomized, Clinical Trial, David Messenger, MD, Queen’s University 135. Randomized Clinical Trial of Procedural Sedation Using Propofol with and without the Ultra-short Acting Narcotic Alfentanil, James Miner, MD, Hennpin County Medical Center 136. The utility of supplemental oxygen during emergency department procedural sedation and analgesia with propofol - A randomized, controlled, trial, Ken Deitch, DO, Albert Einstein Medical Center, Philadelphia, PA 137. Gender Bias In Opiate Administration For Acute Abdominal Pain, Angela Mills, MD, University of Pennsylvania 138. Development of a Novel Adverse Events Scale for Procedural Sedation in the Emergency Department, Heather Murray, MD, Queen’s University 139. Estimation of Pain Intensity in Emergency Medicine: a Validation Study, Raoul Daoust, MD, Sacré-Coeur Hospital of Montreal

ED Crowding (10:00 am – 12:00 noon)

Trauma (3:30 – 5:00 pm)

118. ED Crowding Is Associated With Delays In Analgesia And NonTreatment For Patients Who Report Severe Pain, Jesse Pines, MD, University of Pennsylvania 119. ED Patient Preferences For Boarding Locations & Wait Times When Hospitals Are At Full Capacity, Chad Garson, MD, University of Pennsylvania 120. The Effect of Inpatient and Outpatient Hospital Census Variables on Emergency Department Length of Stay, Raymond Lucas, MD, George washington University 121. Predicting Emergency Department Overcrowding: A Prospective Validation Study, Nathan Hoot, MS, Vanderbilt University 122. Does Emergency Department Crowding Affect The Quality of Care Provided To Patients With Acute Asthma Exacerbation? Eddy Lang, MD, Sir Mortimer B. Davis-Jewish General Hospital-McGill University 123. The Association of ED Crowding Factors With Quality of Pain Management, Ula Hwang, MD, Mount Sinai 124. Early Treatment Unit Does Not Improve Hospital Length of Stay for ED Boarders, Paul Chen, MD, New York Hospital Queens 125. Leaving Without Being Seen. Boarding, Bored, Or Both? Vincent Torres, MD, Oregon Health & Science University

140. Levels UCH-L1 in Human CSF and Severity of Injury following Severe Traumatic Brain Injury, Linda Papa, MD, Orlando Regional Medical Center 141. Is Hospitalization Necessary in Children with Blunt Abdominal Trauma and a Normal Abdominal CT? James Holmes, MD, University of California, Davis 142. Establishing the Need for Trauma Center Care: Anatomic Injury or Resource Utilization? Craig Newgard, MD, Oregon Health & Science University 143. Comparison Of A New Hemostatic Agent To Current Combat Hemostatic Agents In A Swine Model Of Lethal Extremity Arterial Hemorrhage, Kevin Ward, MD, Virginia Commonwealth University 144. In Patient With Suspected Mild Traumatic Brain Injury Are NonNeurosurgical CT Abnormalities And GCS Score Associated With Cognitive Impairment? Linda Papa, MD, Orlando Regional Medical Center 145. A Clinical Prediction Instrument for the Abdominal Evaluation of Adult Blunt Trauma Patients, James Holmes, MD, University of California, Davis

POSTER PRESENTATIONS

Quality Measures (10:00 am – 12:00 noon)

(1:30 – 3:30 pm)

Disease/Injury Prevention

126. Effect on Time to Antibiotic Administration of a Comprehensive Program for Emergency Department Patients with Community Acquired Pneumonia, Benjamin Katz, MD, Albany Medical Center 127. Chest Pain Center Accreditation Is Associated With Improved Heart Failure Quality Performance Measures, W. Frank Peacock, MD, The Cleveland Clinic

146. ED Medication Lists Are Not Accurate, Selin Calgar, MD, TuftsBaystate Medical Center 147. Use of the 911 System as a Risk Indicator for Intimate Partner Violence in the Emergency Department, Melissa Dichter, MSW, ABD, University of Pennsylvania

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Thursday, May 17, 2007 172. Predicting Moderate Or Severe Migraine Headache Within 24 Hours Of ED Discharge, Peter Greenwald, MD, New York Presbyterian Hospital

148. Physiologic Effects Of Prolonged Conducted Electrical Weapon Discharge On Acidotic Adults, Jeffrey Ho, MD, Hennepin County Medical Center 149. Physiologic Effects Of Prolonged Conducted Electrical Weapon Discharge On Intoxicated Adults, Ronald Moscati, MD, SUNY at Buffalo 150. Inaccuracy, Underreporting of Injury, and Lack of Training in Death Certificates, Marian Betz, MD, MPH, Beth Israel Deaconess Medical Center 151. Estimated Risk for Undiagnosed Diabetes in the Emergency Department: A Multicenter Survey, Adit Ginde, MD, Beth Israel Deaconess Medical Center 152. Rural-urban Differences in Hip Fracture Incidence, Jeffrey Coben, MD, West Virginia University 153. Are Smokers Interested In Smoking Cessation Interventions In The Emergency Department? Ingrid Llovera, MD, North Shore University Hospital 154. Readiness to Quit Smoking and Begin Physical Activity Among A Sample Of Patients Seeking Non-Emergent Care, Talmage Holmes, PhD, University of Arkansas for Medical Sciences 155. Before and After Study of a Smoking Cessation Intervention Among Adult Smokers with An Acute Exacerbation of Asthma, Hyacinth DeGuzman, MD, Lincoln Medical Center 156. Mandated Reporting Of Medically Unfit Drivers: How Reporting and Non-reporting Physicians Differ. Chadd Nesbit, MD, Allegheny General Hospital 157. Screening For Obstructive Sleep Apnea In Emergency Department Patients: Comparison Of Clinical Pre-test Probability With A Previously Validated Prediction Tool, Jacob Eastman, MD, Eastern Virginia Medical School 158. Variables Affecting Illness and Injury Among Long-Distance Hikers, Lee Anderson, MD, Boston Medical Center 159. Victims of Violence: A Survey of Emergency Care Providers Attitudes and Perceptions, Amado Baez, MD, Brigham and Women’s Hospital 160. Osteoporosis Knowledge Lacking Among Patients Seeking Emergency Health Care, Donald Simpson, PhD, University of Arkansas 161. The Attenuation Of Strike Acceleration Through Tae Kwon Do Protective Equipment, Sanjey Gupta, MD, New York Hospital Queens

Computer Technology 173. Process Redesign and Emergency Department Information System Implementation Improve Efficiency, Corey Weiner, MD, Mount Sinai 174. A Randomized Comparison of Two Computerized Lab Result Graphical User Interfaces, Jeffrey Nielson, MD, Summa Health System / NEOUCOM 175. Evaluation of the Validity of a Computerized Version of the Canadian Triage and Acuity Scale in a Pediatric Emergency Department, Jocelyn Gravel, MD, Hôpital Sainte-Justine 176. The Derived Electrocardiogram Eigenvalues as a Marker for Acute Myocardial Infarction, David Schreck, MD, Summit Medical Group 177. Impact of an Electronic Prescription Writer on Emergency Department Narcotic Prescribing Practice, Eric Grafstein, MD, Providence Health Care & St. Paul’s Hospital, Vancouver, BC

Education 178. Confidence, Competence and Leadership: The Role of High Fidelity Simulation Workshops to Improve Emergency Medicine Residents Self Confidence, Technical Competence and Leadership Skills, Margaret Strecker-McGraw, MD, Texas A&M University 179. Heart Rate, Stress and Learning are Independent of Role in High Fidelity Simulation, Jeremy Hall, MD, Advocate Christ Medical Center 180. Chief Complaint Categories For Medical Student Education, Adam Kuykendal, University of North Carolina at Chapel Hill 181. The Perception of Emergency Department Patients Regarding Medical Student Participation in Their Health Care, David Wald, DO, Temple University 182. A Student-Centered Approach To Ethics Education During The EM Clerkship, Amy Kontrick, MD, Northwestern University 183. The Effect Of A Well Being Curriculum On Resident Perception Of Wellness, Lori Weichenthal, MD, University of California San Francisco-Fresno 184. A Longitudinal Study of Emergency Medicine Residents; Malpractice Fear and Defensive Medicine, Robert Rodriguez, MD, University of California, San Francisco 185. Teaching Death Notification Skills to Emergency Medicine Residents: The Role of Feedback, Cherri Hobgood, MD, University of North Carolina Chapel Hill 186. The Impact of Errors Observed by Medical Students on Learning, Cherri Hobgood, MD, University of North Carolina-Chapel Hill 187. SAEM Tests: Revisions Improved Item Validity, Emily Senecal, MD, Massachusetts General Hospital 188. Are USMLE Scores Predictive of ABEM In-Training Exam Scores for Emergency Medicine Residents? Josef Thundiyil, MD, Orlando Regional Medical Center

Motor Vehicle Crash 162. Trends in Young Female Drivers in Alcohol-Related Fatal Crashes over Ten Years, 1995-2004, Virginia Tsai, MD, University of California, Irvine 163. Perceptions of Risk: Health Care Workers, Road Use, and Road Traffic Incidents in Ethiopia. A Pilot Survey. Katherine Douglass, MD, George Washington University 164. Left vs. Right Rollover Crashes: Frequency and Impact on Fatality, Dietrich Jehle, MD, SUNY at Buffalo 165. Prevalence And Correlates Of Self-Reported Safety Belt Non-Use Among US High School Students, William Fernandez, MD, Boston University 166. Predictors Of Seatbelt Use In Native American MVC Trauma Victims, Amy Axberg, MD, Maricopa Medical Center

ED Crowding 189. The Impact of Trauma Care on Non-Trauma Emergency Department Patients, Daniel Smith, MD, The Queens Medical Center 190. Interventions to Decrease ED Visits by Frequent Users, Robert Derlet, MD, University of California, Davis 191. An Estimate Of The United States Emergency Department Boarding Burden, Brendan Carr, MD, University of Pennsylvania 192. Introduction of a Stat Laboratory Reduces ED Length of Stay, Adam Singer, MD, Stony Brook University 193. ED Crowding Is Associated With Perceptions Of Compromised Quality Of Care, Jesse Pines, MD, University of Pennsylvania 194. Emergency Physician Access to Payor Health Information Improves Efficiency of Care, Robert O’Connor, MD, Christiana Care Health System 195. A Comparison Of Hours Length Of Stay And Compliance With 24Hour Patient Length Of Stay Between Emergency And General Internal Medicine/Internal Medicine Subspecialty Observation Services: Implication For ED Crowding At A Tertiary Care Center.

Faiz Khan, MD, Hershey Medical Center/Penn State 196. Is The Emergency Department Only For Emergencies? Public Perceptions of “Appropriate” Emergency Department Use, Elaine Rabin, MD, Mount Sinai

Headache 167. Impact of Oral Dexamethasone After ED Treatment Of Migraine With Phenothiazines On The Rate Of Recurrent Headache, AnneMaree Kelly, MD, Joseph Epstein Centre for Emergency Medicine Research at Western Health 168. A Randomized Trial of Intravenous Dexamethasone For Acute Migraine In The Emegency Department, Theodore C. Bania, MD, MD, St. Lukes-Roosevelt Medical Center 169. Prednisone for Migraine Headaches: An Emergency Department Randomized Double-Blind Placebo-Controlled Trial, Frederick Fiesseler, DO, Morristown Memorial Hospital 170. Olanzapine vs. Droperidol for Primary Headache in the Emergency Department, Chandler Hill, MD, Hennepin County Medical Center 171. Emergency Department And Urgent Care Use By Patients With Primary Headache Disorder, Benjamin Friedman, MD, Albert Einstein College of Medicine

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Thursday, May 17, 2007 221. Characteristics of Children with Headache Two Weeks After a Minor Head Injury, Benoit Bailey, MD, CHU Ste-Justine 222. Safety of the Modification of the Triage Level for Children 6 to 36 Months Old With Fever, Jocelyn Gravel, MD, Hôpital SainteJustine 223. CT Scan with IV Contrast Alone for Evaluation of Pediatric Appendicitis, Madelyn Garcia, MD, University of Rochester 224. Does Respiratory Rate, Height Of Fever, or Oxygen Saturation Predict Pneumonia in Febrile Infants? Leslie Simon, MD, Naval Medical Center San Diego 225. Post-Discharge Adverse Behavioral Events In Children Receiving Fentanyl/Midazolam Versus Ketamine In A Pediatric Emergency Department, Alisa McQueen, MD, Children’s Hospital and Harvard Medical School 226. Clinical Predictors of Lyme Disease Among Pediatric Patients with Acute Monoarticular Arthritis, Amy Thompson, MD, Childrens Hospital Boston 227. What is the Impact of Advanced Life Support on the Management and Outcomes of Out-of-Hospital Seizures in Children? Martin Osmond, MD, University of Ottawa 228. An Assessment of Knowledge, and Beliefs of Pediatric Emergency Nurses towards the use of Metered-Dose Inhaler and Spacer (MDI+S) for the Treatment of Acute Asthma Before and 12 Months After a Practice Change., Martin Osmond, MDCM, University of Ottawa 229. Effect Of Having Children In The Household On Adult Emergency Department Smokers’ Motivation To Quit, Angela Mills, MD, University of Pennsylvania 230. Interobserver Agreement In Assessment Of Clinical Variables In Children With Blunt Head Trauma, Marc Gorelick, MD, Medical College of Wisconsin 231. Blunt Head Trauma in the Pediatric Emergency Care Applied Research Network (PECARN), Nathan Kuppermann, MD, University of California, Davis 232. Bag-Valve-Mask Performance Limitations Due To Improper Setup And Use, James O’Neill, MD, University of Florida at Jacksonville 233. Estimated Measurements of Radiation Exposure to Pediatric Patients During a Trauma Evaluation: A Prospective Study, Joshua Rocker, MD, Schneider Children’s Hospital- Long Island Jewish Medical Center 234. Middle and High School Students Education Regarding the Dangers of Anabolic Steroids, Jean Dymott, MD, State University of New York at Buffalo 235. The Emergency Severity Index (Version 4): Reliability In Pediatric Patients, Yamini Durani, MD, Alfred I. duPont Hospital for Children 236. National Trends in ED Antibiotic Prescribing for Children with Acute Otitis Media 1996-2004, Thomas Fischer, MD, Stony Brook University 237. Effect Of Rapid Assessment Times On Length Of Stay In A Pediatric Emergency Department, Stephen Knazik, DO, Children’s Hospital Of Michigan

197. The Impact Of Emergency Department Paramedic Staffing On Emergency Medical Services Unit Off-load Time, Joanne Sun, MD, Orlando Regional Medical Center 198. Autoregression Models Can Reliably Forecast Emergency Department Occupancy Levels 12 Hours In Advance, Lisa Schweigler, MD, University of Michigan 199. Reduction in Emergency Department Visits by Patients Attending an Anticoagulation Clinic, Peter Whittaker, PhD, University of Massachusetts 200. Inpatient Nurse Staffing to Care for ED Boarders Does Not Relieve Emergency Department Crowding, Theodore Chan, MD, University of California, San Diego 201. Impact of Mandated Nurse-Patient Ratios on Patient Flow in 2 California Emergency Departments, Edward Castillo, PhD, University of California, San Diego 202. Emergency Department Gridlock: Are More Patients Slowing You Down? Lloyd Connelly, MD PhD, Oregon Health & Science University 203. ED Overcrowding Inflation in a Tertiary Care Teaching Hospital, Michael Bullard, MD, University of Alberta 204. Waiting For A Bed: Do Prolonged ED Waits Translate To Adverse Outcomes? Bram Dolcourt, MD, Henry Ford Hosptial 205. The Impact Of Long-Term Care Facility Bed Availability On Emergency Department Overcrowding, Jerome Fan, MD, McMaster University 206. Impact Of An Overcapacity Care Protocol On Emergency Department Overcrowding, Grant Innes, MD, St. Paul’s Hospital

Clinical Decision Guidelines 207. Evaluating the Sensitivity of Visual Inspection of CSF for Xanthrochromia in Patients With Subarachnoid Hemorrhage, Sanjay Arora, MD, University of Southern California 208. Evaluation of the Performance of a Modified Acute Physiology and Chronic Health Evaluation (APACHE II) Scoring System for Critically Ill Patients in Emergency Departments in Hong Kong, TH Rainer, MD, The Chinese University of Hong Kong 209. An International Survey of Emergency Physicians Knowledge, Use, and Attitudes Towards the Canadian CT Head Rule, Ian Stiell, MD, University of Ottawa 210. A Cluster Randomized Knowledge Transfer Trial in 4,457 Minor Head Injury Patients, Ian Stiell, MD, University of Ottawa 211. Communication Barriers In The Emergency Department And Their Impact On Diagnostic Confidence And Ancillary Testing. Hiram Albino, MD, Stony Brook University 212. Perceived Barriers and Facilitators to the Implementation of the Canadian C-Spine Rule By Emergency Department Nurses, Catherine Clement, RN, University of Ottawa 213. Use of Clinical Pharmacists in Academic EDs is Limited, Rollin Fairbanks, MD, University of Rochester 214. Triage Algorithm for Chest Radiography of Community-Acquired Pneumonia in the Emergency Department, Demetrios Kyriacou, MD, Northwestern University 215. Utility of Procalcitonin to Identify Young Febrile Infants at Low Risk of Serious Bacterial Infections, Vincenzo Maniaci, MD, Children’s Hospital Boston

Ultrasound 238. Caregiver and Healthcare Provider Satisfaction with UltrasoundGuided Pediatric Bladder Catheterization, Brigitte Baumann, MD, UMDNJ-Robert Wood Johnson Medical School at Camden 239. Sonographic Evaluation of Positioning for Lumbar Puncture in Infants, Beth Cadigan, MD, Albany Medical Center 240. Inter-rater Reliability Of Transcutaneous Doppler Ultrasound Measurements Of Cardiac Output And Stroke Volume In The Pediatric Emergency Department, Gail Stewart, DO, Loma Linda University 241. Measurement of Optic Nerve Sheath Diameter Using Ultrasound: Is a specialized probe necessary? Sachita Shah, MD, Massachusetts General Hospital 242. Correlation of Optic Nerve Sheath Diameter with Direct Measurement of Intracranial Pressure, Heidi Kimberly, MD, Massachusetts General Hospital 243. Sonography for the Assessment of Small Bowel Obstruction, Danielle Schindler, MD, University of California, Los Angeles-Olive View

Pediatrics 216. Efficacy of the Shotblocker in Reducing Pain Associated with Intramuscular Injections, Lisa Drago, DO, UMDNJ-Robert Wood Johnson Medical School at Camden 217. Is Parental Weight Estimation More Accurate Than Other Weight Estimation Methods For Children? Anne-Maree Kelly, MD, Joseph Epstein Centre for Emergency Medicine Research at Western Health 218. Accuracy of the Landmark and Palpation Techniques for Pediatric Femoral Vein Identification, James Woodson, MD, Carolinas Medical Center 219. Efficacy and Impact of Intravenous Morphine Before Surgical Consult in Children with Right Lower Quadrant Pain Suggestive of Appendicitis: A Randomized Controlled Trial, Benoit Bailey, MD, CHU Ste-Justine 220. Comparison of Four Pain Scales in Children with Acute Abdominal Pain in a Pediatric Emergency Department, Benoit Bailey, MD, CHU Ste-Justine

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Thursday May 17, 2007 244. Prospective Evaluation of Sonographic Inferior Vena Cava and Internal Jugular Vein Measurements to Estimate Central Venous Pressure, Gregory Snead, MD, Carolinas Medical Center 245. Scanning For Comet Tails: A New Approach In The Differentiation Of Dyspnea Due To Decompensated Heart Failure, Marina Del Rios Rivera, MD, New York Methodist Hospital 246. Comparison Of Infection Rates Among Ultrasound Guided And Blindly Placed Peripheral Intravenous Lines, Srikar Adhikari, MD, University of Nebraska 247. Left ventricular ejection fraction estimation using handheld ultrasonography in critically ill patients, Dustin Mark, MD, University of Pennsylvania 248. Outcome of Radiology-Performed Indeterminate First Trimester Pelvic Ultrasounds, T. Tran, MD, University of Nebraska 249. Utility Of Ultrasound In Developing Countries, Simon Kotlyar, MD, Yale University 250. Sensitivity Of Chest Radiograph For Pleural Effusions Identified By Bedside Ultrasound. James Hwang, MD, Yale University 251. Bedside Ultrasonography Assessment Of Mitral Valve Inflow Velocity And Tissue Doppler Are Similar To Echocardiology Measurements, Geoffrey Hayden, MD, University of Pennsylvania 252. The Right Intercostal Window For Ivc Measurement In Critically Ill Patients Are An Alternative To Subxiphoid Views, Geoffrey Hayden, MD, University of Pennsylvania 253. Abstract Publication Rates As Peer Reviewed Indexed Manuscripts, A Comparison Of Emergency Ultrasound To EMS and Toxicology, Michael Blaivas, MD, Medical College of Georgia 254. Prospective Observational Trial of Point-of-care, Limited Ultrasonography (PLUS) for Lower Extremity Deep Venous Thrombosis in the Emergency Department: The Sonography Outcomes Assessment Program (SOAP)-4 Trial, Lawrence Melniker, MD, New York Methodist Hospital 255. Ultrasound-guided Peripheral Venous Access: A Comparison Of Two Techniques: Locate, Align, Puncture (LAP) Versus Locate, Align, Mark, Puncture (LAMP), Jessica Resnick, MD, MetroHealth Hospital

MODERATED POSTERS

Didactic Sessions State-of-the-Art: Evolving Directions in Emergency Cardiac Care (8:00 - 9:45 am) Judd Hollander MD, University of Pennsylvania Charles Pollack MD, Pennsylvania Hospital James Hoekstra MD, Wake Forest This session will focus on state of the art diagnostic testing, including marker development and imaging technology as well as late breaking or recent clinical trials that will influence practice and future clinical research in the area of emergency cardiac care for patients with potential acute coronary syndromes. Dr. Pollack will discuss cardiac marker development, new markers currently in development not yet available for clinical use and markers recently approved for use but not widely used in the clinical setting. Dr. Hollander will give a historical perspective of risk stratification protocols utilizing imaging, discuss the problems with both development and implementation of technology in the ED and discuss technologies being developed that have promises for future use. Dr. Hoekstra will discuss the latest clinical treatment trials and specifically their impact on emergency cardiac care in the ED and how future research can be better tailored to answer questions relevant to our patient population. Questions and answers and a panel discussion will occur in the last 15-20 minutes. At the completion of this session, participants will be able to: 1. Understand the problems with development of new cardiac markers and determine which studies of markers have emergency medicine applications; 2.Understand the problems with development of new imaging technology and discuss the problems with both development and implementation of technology in the ED; 3.Understand the problems with extrapolating drug treatment results that were not specifically focused on ED issues to the care of our patients so that they can better develop EM relevant clinical trials.

Introduction to Statistics (8:00 - 9:30 am) Roger Lewis MD, Harbor-UCLA Medical Center 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.

Some more advanced concepts, such as subgroup analysis, interim data analysis, and the intention-to-treat principle will be introduced as well.

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. 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.

(2:30 – 3:30 pm)

Tasers 256. Serum Troponin I Measurement Of Subjects Exposed To The Taser X-26, Christian Sloane, MD, University of California, San Diego 257. Does the Taser Cause Electrical Changes in Twelve Lead ECG Monitoring of Human Subjects, Gary Vilke, MD, University of California, San Diego 258. TASER Discharges Capture Cardiac Rhythm in a Swine Model, Andrew Dennis, DO, Stroger Hospital of Cook County 259. Cardiovascular and Metabolic Effects of the Taser on Human Subjects, Gary Vilke, MD, University of California, San Diego

State-of-the-Art: Recent Evidence on the Diagnosis and Management of Bronchiolitis (10:00 am - 12:00 noon)

Disparities

Joseph Zorc, MD, Children’s Hospital of Philadelphia Howard Corneli, MD, Primary Children’s Medical Center Salt Lake City Bronchiolitis is a viral lower respiratory tract infection that is the leading cause of hospitalization among infants. Respiratory syncytial virus (RSV) is the most common etiology of bronchiolitis, occurring predominantly in the winter months. Ninety percent of children are infected with RSV during in the first 2 years of life and 40% of these develop bronchiolitis.

There is substantial variation in methods of diagnosis and treatment for bronchiolitis. Recently the American Academy of Pediatrics (AAP) convened a subcommittee that developed an evidence-based clinical practice guideline (also endorsed by the American Academy of Family Physicians, American College of Chest Physicians, and the American Thoracic Society). In addition, the Pediatric Emergency Care Applied Research Network (PECARN) recently completed a multi-center study of dexamethasone for bronchiolitis. This session will cover current evidence on bronchiolitis, including: epidemiology and pathophysiology, an overview of the recent AAP recommendations presented by a member of the subcommittee, the results of the PECARN study, and implications for clinical practice and future research. At the completion of this session, participants will: 1) discuss the epidemiology of bronchiolitis; 2) understand recent AAP recommendations on the diagnosis and management of bronchiolitis; 3) describe recent PECARN bronchiolitis study results.

260. Gender Bias In Cardiovascular Testing Persists After Adjustment for Presenting Characteristics And Cardiac Risk, Anna Marie Chang, MD, University of Pennsylvania 261. Healthcare Disparities in the Treatment of Acute Chest Pain, Daniel Eiras, MPH, Mount Sinai 262. Outpatient Cardiac Arrest in Hispanic vs. non-Hispanic Patients; Observations from a Statewide Database with Respect to Bystander Performance of CPR, Presenting Rhythm, and Outcome, Michael Darkoh, Mayo Clinic Arizona 263. Gender Bias In Cardiovascular Testing: Is It Due To Patient Preference? Bryn Mumma, MD, University of Pennsylvania

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Thursday, May 17, 2007 animal models. The unfortunate result is that there continues to be no effective clinical therapy for children with severe brain trauma. Dr. King will discuss possible solutions to current obstacles in this area of research, as well as potential future directions. At the end of the session, attendees will be able to: Discuss and implement systematic approach waiver implementation in compliance with the FDA final rule; Discuss potential changes to the waiver of consent process for resuscitation and TBI research, with a potential for understanding how to get more involved in the federal review; Discuss the barriers to pediatric TBI research; Implement new techniques for overcoming these barriers.

Communication and Negotiation Skills: The ED, The Hospital, and The Outside (10:00 am - 12:00 noon) James Adams MD, Northwestern University Robert Strauss MD, Saint Francis The course will be divided into two 30 minute sessions, each followed by a 15 minute small group activity. The first session will focus on improving communication skills by addressing the importance of improved communication skills, identifying styles of communication, and adapting one’s style to meet his/her listener’s needs. The small group activity following the communication skills segment will emphasize the role of communication in conflict resolution, allowing participants to practice learned techniques for responding to conflict scenarios. The second 30 minute session will focus on advancing participants’ negotiation skills by concentrating on using planning, attitude, information, and power to achieve a mutually satisfactory resolution of conflict. The small group activity following the negotiation skills segment will expose participants to negotiation predicaments and the use of false tactics via provided role playing scenarios, then provide brief suggestions for recognizing and responding to such predicaments and tactics. At the completion of this session, participants will be able to more effectively communicate and negotiate inside and outside the hospital.

So, You Want to be a Residency Director (12:15 - 1:30 pm) Samuel Keim MD, University of Arizona Stephen Playe MD, Bay State Medical Center Sarah Stahmer MD, Cooper Hospital - University Medical Center The position of Residency Program Director offers great rewards, but also poses great challenges. The rewards are largely personal ones derived from effective mentorship. The challenges, largely managerial ones, include (1) creating a program that effectively balances educational needs with service requirements, (2) obtaining the buy in and support from faculty and residents necessary to implement programmatic changes, (3) negotiating the resources necessary to deal with ever-expanding RRC requirements, and (4) dealing with “problem” residents. Despite the apparent imbalance of positives and negatives described above, the role of residency program director can be extremely rewarding, both personally and professionally, for individuals who possess (or develop) the skills and traits that are necessary to master the job. A panel of three current and past residency program directors from different practice settings will discuss why they sought the positions in the first place, the personal and professional challenges they have faced, the rewards they have received and, finally, looking back, what they wish they had known before accepting the positions. At the completion of the session, participants will have an understanding of the administrative role of residency program director and an appreciation of the traits and skills necessary to be successful in the role.

Abstract Writing Workshop (12:15 - 1:30 pm) Debra Houry MD, Emory University Judd Hollander MD, University of Pennsylvania This session will focus on tips and techniques to improve abstract writing.

Dr. Hollander will discuss the top 10 reasons why most abstracts are rejected such as lack of methods, low response rate, etc. This will be followed by an interactive session where participants will critique abstracts submitted in the past to different meetings. Dr. Houry will then wrap-up with a summary of tips and techniques to improve the quality of your abstract and the likelihood of acceptance at a national meeting. At the completion of this session, participants will be able to: 1. Understand the reasons abstracts are rejected; Use techniques learned from the session to improve their abstract writing.

Consent Barriers in Emergency Research (12:15 - 1:30 pm)

Industry-Sponsored Research has a Legitimate Role in Emergency Medicine (3:30 - 5:00 pm)

Jill Baren MD, University of Pennsylvania School of Medicine Michelle Biros MD, MS, HCMC and University of Minnesota Christopher King MD, University of Pittsburgh School of Medicine The recent FDA announcement to readdress the issue of exception from informed consent could have tremendous impact for resuscitation research of all types. This is particularly true for neurological emergencies research where patients are usually mentally impaired and cannot provide consent, and the need for timely intervention precludes proxy consent. Pediatrics neurological emergencies add even more complexity to the issue with respect to assent, consent, and other barriers inherent to this population. The study design of resuscitation research, particularly traumatic brain injury (TBI) trials usually require the administration of a test article within a very narrow therapeutic window. Since prospective informed consent is not possible to obtain in this time frame, such trials will likely seek to use the federal regulations for Exception from Informed Consent in Emergency Research. Timing of the IND or IDE application to the FDA, establishing early and frequent IRB communications, choosing and developing cost-effective community consultation and public disclosure materials are all necessary and important steps. Since little is known about operationalizing the Exception from Informed Consent process, there is great opportunity for investigators to design secondary studies which explore these important issues by including specific data elements reflective of the process. Dr. Jill Baren, an expert in the field of emergency ethics will discuss the current state of waiver research, ideas for how to implement the FDA requirements, and options for the future.

She will team with Dr. Biros to discuss the new FDA investigation and how emergency physicians can get involved. Dr. Chris King will address specific ethics and research issues related to the pediatric population.

This is of particular interest to the neurointerest group because brain injury is the most common cause of death and disability in pediatric victims of trauma and despite this, research in pediatric traumatic brain injury (TBI) has been extremely limited. This is due primarily to two significant obstacles: (1) the difficulty of performing clinical research in children, both from an ethical and logistical standpoint, (2) the technical challenges of performing laboratory studies on TBI using immature

Charles Cairns MD, Duke Roger Lewis, MD, PhD, Harbor-UCLA Medical Center John D. Lantos MD, University of Chicago In this point-counterpoint session, leaders in emergency medicine will debate the existence of a potential ethical problem. If profits are a logical expectation of the companies that fund medical discoveries, do investigators from academic institutions have special responsibilities to minimize potential corruption of science? This debate turns on an assumption that the influence of commercial interests on medical science is far-reaching, but to great degree, essential. In some instances, marketing goals of companies may dominate the scientific aspect of the company-funded research. Participants will be asked to defend their position on the ethical legitimacy of the role of industry-sponsored research in emergency medicine. Speakers will place their comments within the wider context of several high-profile research irregularities involving for profit companies, such as the refusal to provide all study data to the study team, interval reporting of trial results designed with longer primary outcome periods, incomplete reporting of serious adverse events, and concealment of clinical trial data showing harm or nonefficacy (referent citations, will be provided). In articulating a position, defending how academia and the public might begin to sort out the honest interests of for-profit companies from the potential corrupting influences of commercial interests will be the emphasis of the session. It is hoped that the participants will challenge the audience to think beyond the check boxes of current faculty disclosure mechanisms, which may fail to unveil the influence of money upon medical science researchers submitting studies for peer-reviewed publication. Understand the evolving complexities and ethical concerns relating to the assessment of legitimacy for industry-sponsored research in medical science. At the completion of this session participants will: be able to list the means by which the integrity of scientific evidence is preserved, (i.e. public speaker/author disclosures of financial relationships and requirements for potential conflict of interest statements in peer review process for publication) in industry-sponsored research; recognize the failure of the

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Thursday May 17, 2007 and vision, its structure, and its relationship to the overall NIH Roadmap initiative. Because involvement in CTSA activities represents a key opportunity for emergency medicine investigators, the presenters will provide suggestions regarding opportunities for investigator involvement and regarding the potential for the development of an emergency medicine-specific subnetwork within funded CTSA institutions. At the completion of this session participants will be able to: 1). understand the CTSA Program including its motivation, structure, and relationship to the NIH Roadmap; and 2). understand the potential value of institutional CTSA programs for providing research training, seed grants, and collaborative research opportunities to emergency medicine investigators.

means to detect relationships does not necessarily equate with absence of sponsored trial validity, but the probability estimate is greater than the odds on a coin-flip; and form an opinion as to whether or not the legitimacy of a sponsor’s role should be credentialed to be trusted.

The Application of Cost Analysis in Emergency Medicine Research and Administration (3:30 - 5:00 pm) Shari Schabowski MD, Cook County Hospital Rebecca Roberts MD, Cook County Hospital Thomas Flottemesch PhD, Health Partners Research John McConnell PhD, Oregon Health Sciences University This session will provide the attendants with a review of the basic principles of cost analysis in research. We will review the difference between cost, cost-effectiveness and cost-benefit analysis and their specific applications. We will review key concepts that are useful in modeling the costs associated with ED care with emphasis on the statistical methods for managing the non-normality present in health care data. Based on their experience, they will provide specific examples of the application of cost analysis in EM related research. Real time operations, current procedures and future planning in ED management are modulated based on by cost. We will review several tools for analyzing ED performance which can aid in decision making in ED management. At the completion of the session, the participants will have a basic understanding of various components of cost analysis and their application to ED research and ED management.

Report from the 2006 Chief Complaint Symposium (5:00 – 7:00 pm) Debbie Travers, MD, University of North Carolina – Chapel Hill Stephanie W. Haas, MD, University of North Carolina – Chapel Hill Judith Tintinalli, MD, University of North Carolina – Chapel Hill The purpose of this SAEM 2007 meeting is to share and gather information about national efforts to standardize ED chief complaint data. In October, 2006, invited experts and stakeholders participated in a national symposium to address improving the quality of the chief complaint data element in the ED patient record. The outcome of the symposium was a set of recommendations regarding the needs and requirements for a controlled vocabulary for CC, which will be published in a forthcoming white paper. This workshop seeks to enlarge the audience for the recommendations by reporting on the symposium results and suggesting ways that stakeholders and other interested parties can get involved.

At the completion of this session participants will be able to: 1) inform people who were not able to attend the symposium about the discussions and recommendations; 2) describe areas in which stakeholders can participate in the effort to establish a controlled vocabulary for CC. Examples include contributing locally-developed CC lists, working on validation studies, or shepherding the resulting vocabulary through the adoption process; and 3) gather feedback and additional input on the symposium recommendations.

Faculty Development Workshop (3:00 - 6:00 pm) Robert Hockberger MD, Harbor-UCLA Medical Center Glenn Hamilton MD, Wright State University William Barsan MD, University of Michigan Gloria Kuhn DO, Wayne State University John Marx, MD, Carolinas Medical Center Course participants will first be given two 30-minute introductory lectures orienting them to the concept of faculty development, including the importance of developing both short-term and long-term career goals that are consistent with one’s interests and skills, identifying annual objectives in pursuit of those goals, and monitoring one’s success in accomplishing those objectives throughout the course of each academic year. Each participant will then be given an individualized 20-minute “mini” faculty development consultation provided by one of the 5 workshop faculty. In order to maximize the benefit of the consultations, course participants will be required to provide the following information in electronic form to the SAEM office (jennifer@saem.org) by April 30, 2007: (1) a copy of their CV, (2) the written requirements for academic advancement in their academic track at their medical school, and (3) two or three specific questions or issues that they would like to discuss with their consultant.

At the completion of the session, participants will (1) understand the importance of establishing career goals based upon their personal interests and professional strengths, and (2) appreciate the necessity of being proactive in developing a strategy for accomplishing those goals within their particular academic environment.

Opportunities for EM Research Within the NIH CTSA Program (5:00 – 6:00 pm) Robert W. Neumar, MD, PhD, University of Pennsylvania Roger J. Lewis, MD, PhD, Harbor-UCLA Medical Center The Clinical and Translational Science Award Program is a major new initiative of the National Institutes of Health (NIH) to accelerate the rate of translational and clinical research in the United States, including the translation of basic and laboratory science to first use in human subjects, and the translation of clinical research to routine clinical practice. The awards, which include both the infusion of new funds and the consolidation of funds previously allocated to General Clinical Research Centers (GCRCs) and institutional training programs, require a fundamental transformation and integration of translational and clinical research at academic institutions. This significant investment, both by institutions and the NIH, will create a research training and clinical research infrastructure which represents a tremendous opportunity for emergency medicine investigators at the institutions who receive these awards. Currently, 12 institutions have received CTSA awards; additional awards are expected to bring the total number of institutions with CTSAs to 60. In this session, the speakers (one from an institution that has received a CTSA and one from an institution that has recently applied) will provide an overview of the CTSA Program including, its motivation

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Friday, May 18, 2007 284. Does The Gender Configuration Of An Aeromedical Crew Play A Roll In The Decision To Administer Analgesics When Transporting Intubated Patients? Gary Bollinger, RN, Christiana Care Health System 285. The Impact Of Patient Gender On Paramedic Pain Management In The Prehospital Setting, Anne-Maree Kelly, MD, Joseph Epstein Centre for Emergency Medicine Research at Western Health 286. Prospective Evaluation of the Safety and Effectiveness of Fentanyl in Pre-hospital Pain Management, Cemal Sozener, MD, University of Michigan 287. Fentanyl Analgesia in the Out-of-Hospital Setting: Variables Associated with Hypotension in 1091 Administrations Among 500 Consecutive Patients, William Krauss, MD, Brigham and Women’s Hospital

PAPER PRESENTATIONS Injury Prevention (8:00 – 9:00 am) 264. SafERTeens: Computerized Screening and Brief Intervention for Teens At-Risk for Youth Violence, Rebecca cunningham, MD, University of Michigan 265. Brief Motivational Intervention To Increase Self-Reported Safety Belt Use Among Emergency Department Patients, William Fernandez, MD, Boston University 266. A Review Of California Police Pursuit Crashes, Injuries, And Fatalities From 1998-2005, Robert Miller, MD, Brigham and Women’s Hospital 267. Stature, Body Weight and Serious Injury from Air Bags Among Adult Drivers and Passengers Involved in Motor Vehicle Crashes, Craig Newgard, MD, Oregon Health & Science University

Heart Failure

Professional Development (8:00 – 9:00 am)

288. Prevalence And Clinical Characteristics Of Patients Reporting Illicit Drug Use In The Acute Decompensated Heart Failure Population: An Acute Decompensated Heart Failure Registry - Emergency Module [ADHERE-EM] Report, W. Frank Peacock, MD, The Cleveland Clinic 289. Peripheral Tissue Oxygen Extraction Abnormalities Persist in Acutely Decompensated Heart Failure After Emergency Department Treatment, Christopher Hogan, MD, Virginia Commonwealth University Reanimation Engineering Shock Center 290. Emergency Physicians’ Risk Attitudes Regarding Low-risk Heart Failure Patients, Julie B. McCausland, MD, University of Pittsburgh

268. Career Satisfaction in Emergency Physicians,1994-2004: The ABEM Longitudinal Study of Emergency Physicians, Rita Cydulka, MD, Case Western Reserve University/MetroHealth Medical Center 269. Comparison Of Resident Productivity Across Post Graduate Years Within An Emergency Medicine Residency Training Program, Daniel Brennan, MD, Orlando Regional Medical Center 270. Factors Associated With Choosing A Residency Program: The ABEM Longitudinal Study Of Residents In Emergency Medicine, Sara Laskey, MD, Case Western Reserve University/MetroHealth Medical Center 271. Performance Of Sexual Assault Evidence Collection By Emergency Physicians. Is It Still Necessary To Train Emergency Medicine Residents? Elizabeth Frost, MD, Beth Israel Deaconess Medical Center

POSTER PRESENTATIONS

Hypertension 291. The Prevalence Of And Risk Factors Associated With Untreated Hypertension In ED Patients, Craig Umscheid, MD, University of Pennsylvania 292. Patient Specific Feedback Increases Referral of Hypertensive Emergency Department Patients: A Randomized Controlled Trial, David Cline, MD, Wake Forest University 293. Test Characteristics Of Six Definitions Of Hypertension In The ED For The Detection Of Hypertension Outside Of The ED, Demian Szyld, MD, University of Pennsylvania 294. Do Patients With Elevated BP In The ED Have Persistently Elevated BP On Home Monitoring? Paula Tanabe, PhD, Northwestern University 295. Elevated Blood Pressures In The ED: Pain, Anxiety, Or Undiagnosed Hypertension, Paula Tanabe, PhD, Northwestern University

(9:00-11:00 am)

Airway 272. The Rusch Viewmax Versus Standard Macintosh Laryngoscopy In Human Cadaver Models: Does The Viewmax Improve Vocal Cord Visualization? Aaron Brillhart, MD, York Hospital 273. Comparison Of Intubation Success Of Videolaryngoscopy Versus Direct Layngoscopy In The Difficult Airway Using High-Fidelity Simulation, Aneesh Narang, MD, Boston Medical Center 274. Achieving Proper Endotracheal Tube Cuff Inflation Pressure: A Cadaveric Study, Marc Levsky, MD, Carl R Darnall Army Medical Center 275. Tracheal Intubation around the Combitube: A Prospective Study on a Cadaveric Model, William Kinkle, RN, University of Pennsylvania 276. Success Rate Of The Gum-Elastic Bougie As A Rescue Airway In The Emergency Department, Brian Kwong, MD, St. Luke’sRoosevelt Hospital Center 277. Comparison Of Survival To Hospital Discharge In Prehospital Trauma Patients Managed With An Endotracheal Tube Compared To Bag-Valve-Mask, Jacob Kesterson, MD, Orlando Regional Medical Center 278. A Comparison Of Rescue Airway Devices Placed By EMS Providers In A Human Patient Simulation Model, Todd Listwa, MD, Brigham and Women’s Hospital

Cardiac Ischemia 296. Derivation of a Rule to Risk Stratify Patients with Chest Pain Using Acute Cardiac Ischemia Time Insensitive Predictive Instrument (ACI-TIPI), Jonathan Ilgen, MD, Harvard Affiliated Emergency Medicine Residency 297. ST2 In Emergency Department Chest Pain Patients With Potential Acute Coronary Syndromes, Aaron Brown, BS, University of Pennsylvania 298. TIMI Risk Score: Does It Work Well In Both Males And Females?

Christopher Follansbee, BS, University of Pennsylvania 299. The Influence of Cardiac Risk Factor Burden on Cardiac Stress Testing Outcome, Jon Schrock, MD, MetroHealth Medical Center/ Case Western Reserve University 300. Outcomes Associated With Small Changes In Normal Range Cardiac Markers, Nolan McMullin, MD, Cleveland Clinic 301. The Risk Of Acute Coronary Syndromes Associated With Atrial Fibrillation In Emergency Department Chest Pain Patients. Aaron Brown, BS, University of Pennsylvania 302. Combination of TIMI Risk Score And A Clear Cut Alternative Noncardiac Diagnosis For ED Chest Pain Patient Risk Stratification, Caren Campbell, BS, University of Pennsylvania 303. Performance Of Four Risk Score Models For Patients In The RuleOut Myocardial Infarction Using Coronary Artery Tomography (ROMICAT) Study, Alex Manini, MD, Bellevue Hospital and New York University School of Medicine 304. Stress (Tako-tsubo) Cardiomyopathy Mimicking Acute ST-Segment Elevation Myocardial Infarction, David Larson, MD, Rigdeview Medical Center

Analgesia 279. Chronic Pain In The Emergency Department, Martha Neighbor, MD, University of California, San Francisco 280. Randomized Double-Blind Placebo Controlled Cross-Over Study of Acetaminophen, Ibuprofen, Acetaminophen/Hydrocodone and Placebo for the Relief of Pain From a Standard Painful Stimulus, James Miner, MD, Hennepin County Medical Center 281. No Association between Race/ethnicity and Analgesic Administration to Patients with Long-bone Fractures in a Prospective Study, Polly Bijur, PhD, Albert Einstein College of Medicine 282. ED Prescribing Practices of Hydromorphone vs. Morphine for Acute Pain--Patient and Clinician Factors, Frank Zwemer, MD, University of Rochester 283. Variations in Perceived Pain Measurements Within and Between Subjects Using a Standard Painful Stimulus, James Miner, MD, Hennepin County Medical Center

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Friday, May 18, 2007 305. CT Coronary Angiography For Immediate Disposition Of Emergency Department Patients With Low Risk Chest Pain, Judd Hollander, MD, University of Pennsylvania 306. Physical Fitness Cannot Be Used to Predict the Likelihood of Acute Coronary Syndromes in ED Patients with Chest Pain, Adam Singer, MD, Stony Brook University 307. R-Wave Amplitude Distinguishes Early Repolarization From Subtle Anterior STEMI: Validation Of A Rule, Stephen Smith, MD, Hennepin County Medical Center, University of Minnesota 308. Impact of Multi-Detector Computerized Axial Tomography Scan of the Coronary Arteries on the Decision to Admit Emergency Department Patients with Chest Pain and Inconclusive Emergency Department Evalutations for Acute Coronary Syndrome, John Nagurney, MD, Massachusetts General Hospital 309. Use of 64 Detector Multidetector CT (MDCT) for the Evaluation of Acute Coronary Syndrome (ACS) in Patients presenting to the Emergency Department with Chest Pain, Dick Kuo, MD, University of Maryland 310. Protocolized Evaluation of Low Risk Chest Pain in a Clinical Decision Unit Increases Detection of Significant Coronary Artery Disease, David Gaieski, MD, University of Pennsylvania 311. A Risk Stratification Tool In Patients Presenting With Transient Ischemic Attack For Subsequent Acute Coronary syndrome: The Thrombolysis in Myocardial Infarction Score, M Bellolio, MD, Mayo Clinic

326. Impact Of Cardiac Point-of-Care Testing On ED Door To Disposition Time Is Dependent On Patient Acuity and Hospital Setting, Gregory Fermann, MD, University of Cincinnati 327. Disposition Impacted By Serial Point Of Care Markers In ACS (DISPO-ACS): A Multicenter Randomized Controlled Trial Comparing Central Laboratory And Point-Of-Care Cardiac Marker Testing Strategies, Richard Ryan, MD, University of Cincinnati 328. Incremental Value Of Heart-Type Fatty Acid-Binding Protein, Myoglobin, Troponin T And Electrocardiogram In Rapid Bedside Diagnosis Of Acute Coronary Syndrome In Chest Pain Patients Presenting To The Emergency Department, Shirley Ooi, MD, National University Hospital, Singapore 329. Depression is a Common Coronary Risk Factor in Women Admitted to an ED Chest Pain Center, Basmah Safdar, MD, Yale University 330. Comparison of Novel Hemodynamic Monitoring Methods for Detecting Central Hypovolemia due to Lower Body Negative Pressure, Andrew Reisner, MD, Massachusetts General Hospital

Ethics 331. Treatment Preferences of Patients at the End of Life, Susan Stone, MD, Los Angeles County Medical Center 332. Development Of The Video Assessment of Propensity To Use Emergency Restraints Scale (VAPERS), Darryl Macias, MD, University of New Mexico 333. Paramedics Knowledge Skills and Attitude on End of Life Care, Susan Stone, MD, University of Southern California

Myocardial Infarction

Psychiatry

312. The Use of Cortisol as an Early Marker for Acute Myocardial Infarction in an Emergency Department Setting, John Gough, MD, Brody School of Medicine 313. Corrected QT Interval Distinguishes Early Repolarization From Subtle Anterior STEMI: Derivation Of A Rule, Stephen Smith, MD, Hennepin County Medical Center, University of Minnesota 314. Sources Of Delays in Door-to-Balloon Time In Patients With ST-Elevation Myocardial Infarction Undergoing Percutaneous Intervention: Is An In-house Interventional Cardiology Team Necessary? Bryan McNally, MD, Emory University 315. The Effect of Direct Communication Between Emergency Physicians and Interventional Cardiologists on Door to Balloon Times in STEMI, Kyuseok Kim, MD, Seoul National University 316. Effect Of Workday Vs. After-Hours On Door To Balloon Time With Paramedic Prehospital Catheterization Laboratory Activation For STEMI, David Hildebrandt, NREMT-P, CCEMTP, Hennepin County Medical Center 317. Integrated Systems, Not EMS 12 Lead EKGs Alone, Decrease Time to Reperfusion for ST Segment Myocardial Infarction Patients.

Robert Swor, DO, William Beaumont Hospital 318. Code STEMI Improves Door to Balloon Time, Edward Ullman, MD, BIDMC 319. The Use of Lead aVR to Discriminate between Right and Left Circumflex Coronary Artery Occlusion in Acute Inferior Myocardial Infarction, Michael Kurz, MD, Virginia Commonwealth University Medical Center 320. EMS Patients Receive More Rapid Care Than Ambulatory Patients for STEMI, Dan Naylor, MSII, University of Southern California

334. The Development of Depression Symptoms in Healthcare Providers Involved in the 2005 Hurricanes, Mark Sandoval, MD, Synergy Medical Education Alliance 335. The Development of PTSD Symptoms in Healthcare Providers Involved in the 2005 Hurricanes, Mark Sandoval, MD, Synergy Medical Education Alliance 336. Assessment of Emergency Department (ED) Provider Knowledge about Human Trafficking Victims in the ED, Makini ChisolmStraker, Brown Medical School 337. Prevalence of Posttraumatic Stress Disorder Following Hurricane Katrina, Annelies De Wulf, Medical Student, Tulane University 338. The Association between Hemoglobin A1c and Depression in an Inner City Diabetic Population, Yvette Calderon, MD, Albert Einstein College of Medicine 339. Emergency Severity Index For Psychiatric Triage, Alex Ho, MD, University of North Carolina at Chapel Hill 341. The Psychiatric Emergency Research Collaboration (PERC): A Multicenter Study of Insurance Status, Presentation, Management, and Disposition Among Psychiatric Emergency Patients, Edwin Boudreaux, PhD, UMDNJ-Robert Wood Johnson Medical School at Camden 342. Conceptualizing the Teachable Moment: Intentions to Quit Smoking Following an Emergency Department Visit, Edwin Boudreaux, PhD, UMDNJ-Robert Wood Johnson Medical School at Camden 343. Tracking Inner City Substance Users Longitudinally: How Many Phone Calls (Letters, Home Visits ) Does It Take? Rebecca Cunningham, MD, University of Michigan 344. The Epidemiology of Suicide Post Emergency Department Visit, Eric Grafstein, MD, Providence Health Care & St. Paul’s Hospital, Vancouver, BC 345. The Significance of Laboratory Testing for the Medical Clearance of Psychiatric Patients Presenting to the Emergency Department, Julia Wang, MD, Kern Medical Center

Cardiovascular 321. Is Cardiac Monitoring During Transport Of Selected Chest Pain Patients From The Emergency Department Necessary? AnneMaree Kelly, MD, Joseph Epstein Centre for Emergency Medicine Research 322. Absence of Electrocardiographic Change Following Prolonged Application of a Conducted Electrical Weapon in Physically Exhausted Adults, Jeffrey Ho, MD, Hennepin County Medical Center 323. Serum D-Dimer Is A Sensitive Test For The Detection of Acute Aortic Dissection: A Pooled Meta-Analysis, Keith Marill, MD, Massachusetts General Hospital 324. A Comparison Of Amiodarone And Procainamide For The Termination Of Spontaneous Sustained Ventricular Tachycardia, Keith Marill, MD, Massachusetts General Hospital 325. Gender Differences In Acute Cardiac Care: Where It Is Not, Marna Greenberg, DO, Lehigh Valley Hospital

Trauma 346. Poor Test Characteristics for the Digital Rectal Exam in Trauma Patients, Gil Shlamovitz, MD, University of California, Los Angeles 347. Trend In Shock Index After Injury Predicts Complications, Life Saving Interventions, And Mortality, Brian Eastridge, MD, US Army Institute of Surgical Research 348. Ability of Emergency Physicians To Predict Clinically Significant Traumatic Injury - Physician Assessment Versus Computed Tomography, Craig Berger, MD, Vanderbilt University 349. Comparison of Trauma Mortality between Two Hospitals in Turkey to One Trauma Center in the United States, Emily Squyer, MS III, Pennsylvania State University

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Friday, May 18, 2007 350. The Effect of Insulin Dependent Diabetes on Uncontrolled Hemorrhage in a Rodent Model, Eric Morely, MD, State University of New York - Downstate Medical Center 351. Anterior Cruciate Ligament Injury Is Associated With Lack Of Boundary Lubrication By Lubricin, Gregory Jay, MD, Brown University 352. Prospective Validation of the Surgical Trauma Alert Classification (STAC) Scoring System in Predicting Major Trauma Resuscitation., Victor Coba, MD, St. John Hospital and Medical Center 353. Incidence of Nephropathy after Intravenous Contrast in ED Trauma Patients, Elizabeth Kelly, MD, University of Pittsburgh 354. Repeated Thoracic Discharges From a Stun Device, Daniel Valentino, MD, Stroger Hospital of Cook County 355. Does Tourniquet Time Affect Venous Lactate? Drew Watters, MD, University of Arizona 356. A Simple Scoring System Derived from FAST Findings and Vital Signs Predicts the Need for Urgent Laparotomy in Patients with Blunt Abdominal Trauma, Michael Manka, MD, State University of New York at Buffalo 357. The Association of Coagulopathy and Traumatic Brain Injury, Samara Soghoian, MD, Department of Emergency Medicine, State University of New York, Downstate Medical Center 358. Gender and Outcome after Mild Traumatic Brain Injury, Jeffrey Bazarian, MD, University of Rochester 359. Transfer of Medication Administration Information From Critical Care Transport Teams to Trauma Teams, Kenneth Robinson, MD, Hartford Hospital

375. Measuring Patient Satisfaction In A Public Hospital ED, Helen Straus, MD, Cook County Hospital 376. Impact Of Emergency Department Triage And PreBed Provider Evaluation On Walk-Out Rate, Ambulance Diversion and Patient Satisfaction, Peter Hill, MD, Johns Hopkins University 377. Patient Satisfaction As A Function Of ED Pre-Visit Expectations, Wayne Triner, DO, Albany Medical College 378. Patient Satisfaction Scores Do Not Predict Return Visits to the Emergency Department, Brian Hiestand, MD, The Ohio State University

PAPER PRESENTATIONS Ethics (11:00 am – 12 noon) 379. Bridging the gap: Participation in clinical research amongst minority populations, Seth Glickman, MD, Duke University 380. Estimating The Incidence of Unethical Recruiting Practices and Illegal Questioning By Emergency Medicine Residency Programs In The Resident Recruitment Process, R. Thurman, MD, Vanderbilt University 381. A Brief Educational Intervention Does Not Change Patient Attitudes Towards Research Involving an Emergency Exception From Informed Consent. Joshua Goldstein, MD, Massachusetts General Hospital 382. A Comparison of the Responses to Different Methods of Community Consultation for a Study Using Exception to Informed Consent, Maria Nelson, Oregon Health & Science University

Geriatrics (11:00 am – 12 noon)

Research Design

383. Brief Screen For High Risk Older Adults In An Emergency Department, Kim Yates, MBChB, North Shore Hospital, Auckland, New Zealand 384. Use Of A Novel Technology To Detect Mild Cognitive Impairment In Elderly Patients, David Wright, MD, Emory University 385. Admission Lactate And Base Excess Predict Mortality In Normotensive Elderly Blunt Trauma Patients, David Callaway, MD, Beth Israel Deaconess Medical Center 386. Medication Non-Compliance Among Elderly Emergency Department Patients, Steven Mooth, DO, York Hospital

360. The Utility of an Automated Paging System in Clinical Injury Research Subject Recruitment in the Emergency Department, Jolie Holschen, MD, The University of Michigan 361. Comparison of Abstract Submissions and Oral Presentations at a Regional SAEM, Joshua Schiller, MD, Stony Brook University 362. Emergency Physicians Miss Treatable Symptoms in Active Cancer, Tammie Quest, MD, Emory University 363. Measuring Nausea in the Emergency Department: A Prospective Observational Study Utilizing Factor Analysis to Evaluate an Emergency Department Nausea Profile, Robert Cloutier, MD, Oregon Health & Science University 364. Autoresuscitative Breathing in a Animal Model of Respiratory Failure, Romolo Gaspari, MD, University of Massachusetts 365. Physician vs Self-Reported Measures of Dyspnea in Patients with Acute Decompensated Heart Failure, Selin Caglar, MD, Baystate Medical Center 366. Validity of Patient-Reported Prescription Filling as an Outcome in Emergency Medicine Research, Corinne Hohl, MD, University of British Columbia 367. Logit-Based Risk-Stratification Tools are Generic Predictors of In-Hospital Mortality, Michael Marchick, MD, Carolinas Medical Center 368. Inhospital Mortality Risk for Patients Admitted through Emergency Departments, Guohua Li, MD, Johns Hopkins University

MODERATED POSTERS

Stroke (1:30 – 3:00 pm) 387. Intravenous NGF Reduces Thrombus Burden And Lesion-Size In Experimental Acute Ischemic Stroke. Kama Guluma, MD, University of California, San Diego 388. Role of Statins in Functional Outcome following an Acute Ischemic Stroke, Lekshmi Vaidyanathan, MBBS, Mayo Clinic 389. Dose of Hypertension More Accurately Identifies Patients with Stroke at Risk for Adverse Neurologic Outcome Than AHA guidelines, Christopher Barton, MD, University of California, San Francisco 390. Defining A Threshold For Hyperglycemia-Related Mortality Risk Following Acute Ischemic Stroke, Rachel Gilmore, MD, Mayo Clinic 391. Stroke Severity at Presentation to the Emergency Department Varies by Time of Day: Results of a Population-Based Study, Brian Stettler, MD, University of Cincinnati 392. Comparing The Effectiveness Of Various Methods Of Stroke Education, Yu-Feng Chan, MD, University of Medicine and Dentistry of New Jersey

(10:00 – 11:00 am)

Wounds 369. Prophylactic Antibiotics for Dog Bites: A RCT with Refined Cost Model, James Quinn, MD, Stanford University 370. Tap Water Is Equally Safe And Effective As Sterile Normal Saline for Wound Irrigation; A Double Blind, Randomized, Controlled, Prospective Clinical Trial, Eric Weiss, MD, Stanford University 371. Curcumin Reduces Burn Progression in Rats, Adam Singer, MD, Stony Brook University 372. Effects of a Novel Hemostatic Agent in a Model of Lethal Arterial Injury, Michael Tupper, BS, University of Michigan 373. Modulation Of The Deleterious Effects Of Glucocorticoids On Wound Healing By Immune Regulating Hormones, V. Ramana Feeser, MD, Virginia Commonwealth University Reanimation Engineering Shock Center

Health Care Policy (1:30 – 3:00 pm) 393. What is the Cost of Emergency Department Utilization by Medicaid Enrollees? Daniel Handel, MD, Oregon Health & Science University 394. Which is Better: Adding More Beds to Your ED or Reducing Inpatient Holding Times? Emilie Powell, MD, Northwestern University 395. The Increasing Cost of Maintaining Emergency Department On-Call Coverage, K McConnell, PhD, Oregon Health & Science University 396. Community Characteristics Affecting ED Use by Medicaid Enrollees, Rongwei (Rochelle) Fu, PhD, Oregon Health & Science University 397. Measuring Syncope Care in the ED: Does Choice of Case Definition Bias Outcomes?, Jeremiah Schuur, MD, Yale University 398. Distance to ED and to PCP Office Affects ED Use in Children, Annameika Ludwick, MD, Oregon Health & Science University

Patient Satisfaction 374. Patient Satisfaction And The Risk Of Malpractice Suits, Joshua Tamayo-Sarver, MD, UCLA- Harbor

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Friday, May 18, 2007 Letters of Recommendation for Residency – Communicating Effectively, Efficiently, and Responsibly (11:00 am - 12:00 noon)

Didactic Sessions Touring the Poster Session Critiquing the Tables and Figures (8:00 - 9:00 am)

Andra L. Blomkalns, MD, University of Cincinnati Peter D. Panagos, MD, Brown University H. Gene Hern, MD, Highland General Hospital As emergency medicine becomes an increasingly popular career choice for medical students, clinician educators are often requested to write letters of recommendation. These important documents serve to provide a subjective assessment and communicate an applicant’s strengths and weaknesses. LORs are critical in interview selection and residency ranking. Poorly written or excessively short letters can harm an excellent applicant by understating their abilities and potential. Over-laudatory letters harm the weaker candidates by promoting them to a residency environment where they might not meet expectations. In this course we will cover LOR etiquette, review parts of an effective letter, show examples of good and bad letters, discuss ways to navigate the standard letter of recommendation (SLOR), and suggest phrases by which to convey less than favorable assessments. At the completion of this session, participants will be able to: 1) outline an effective letter addressing medical knowledge, clinical skill, unique strengths, potential weaknesses, and assessment of future emergency medicine success; 2) navigate the “standard letter of recommendation” (SLOR) for emergency medicine; 3) effectively communicate “red flags” in an appropriate fashion; 4) answer questions like, “When can I decline writing a letter?”, “How important is the waiver to see the recommendation and should I use it?”, “Is there a template I can use to write such a letter?”; 5) plan by which the individual course participant can efficiently generate a good LOR.

David Schriger MD, UCLA We will walk through a poster session stopping at posters of interest to critique the quality of the tables and figures. Through a moderated discussion we will consider what works and doesn’t work, in each case sketching out the optimal format for each effort. At the completion of the session, participants will have an enhanced sense of how to use table and figures to communicate science. This session is limited to 25 participants.

Planning and Completing a Sabbatical (8:00 - 9:00 am) Robert Wears MD, University of Florida / Imperial College London Stephanie Abbuhl, MD, University of Pennsylvania Academic sabbaticals are uncommon in emergency medicine, but have great potential for enhancing a faculty member’s research or teaching performance. However, sabbatical time can be difficult to organize, and there are many unrecognized impediments to realizing a successful experience. A sabbatical should be a transformative experience, but transformations are always difficult and can be damaging; conversely, a sabbatical without transformation is merely a long vacation. Because sabbaticals are so rare, practical experience about how to go about them, what benefits to expect, and what trials to endure, is not easily available.

This session will be based on the speakers’ experiences in planning and completing a one year sabbatical aimed at acquiring new research skills, supplemented by discussions with others who have had similar experiences. The goal of the session is to raise the profile of this valuable form of mid-career learning, to encourage other faculty members to take advantage of it, and to provide some practical guidance to assist them in planning and completing a sabbatical, and in integrating that experience back into their careers upon their return. Tt the completion of this session participants will be able to: 1) list advantages and disadvantages of taking “time away from work” to invest in a sabbatical; 2) articulate several common goals for a sabbatical experience; 3) identify critical planning issues for a sabbatical; 4) recognize potential threats to a successful sabbatical experience; and 5) list techniques for managing successful re-entry after the sabbatical is over.

Creating Meaningful Tables and Figures for Analyzing and Presenting your Research (12:15 - 1:30 pm) David Schriger MD, UCLA This course will review the principles of graphical excellence. Through copious examples we will help participants learn to critique tables and figures. This exercise will help them learn to identify problems in graphics of their own making. We will discuss relevant papers on tables and figures and discuss how software can help and hinder the creation of quality graphics. At the completion of the session, participants will have a working knowledge of how to make high quality tables and figures.

Chart Reviews in Emergency Medicine Research: A Guide to the Methods (11:00 am - 12:00 noon)

Spivey Lecture: Academic Mentorship: Seeking Guidance as a Clinician-Educator (12:15 - 1:30 pm)

Steven Lowenstein MD, University of Colorado Chart reviews are often used to conduct research in emergency medicine. However, the reliability of data abstracted by chart reviews is seldom examined critically. Clinicians often disagree when they obtain, interpret and record information from medical histories, physical examinations and laboratory studies; then, errors and inconsistencies are compounded when information is extracted during a scientific investigation. Dr. Lowenstein will review critical steps that should be taken in conducting a medical chart review to enhance the quality of the data and the reliability and accuracy of the results. During this session he will also explain concepts such as reliability and inter-rater agreement and statistical tests such as kappa. This session will specifically focus on the research use of medical record data and the problems and pitfalls inherent in medical record reviews. At the completion of this session, participants will be able to: 1). recognize problems and pitfalls inherent in medical record reviews, including missing charts, missing or conflicting data, poorly trained abstractors, bias and lack of blinding; 2). list the 8 critical steps that should be taken in conducting a medical chart review to enhance the quality of the data and the reliability and accuracy of the results; 3). explain concepts such as reliability and inter-rater agreement and statistical tests such as Kappa; 4). recognize “numerator nonsense” and other biases and limitations of electronic medical record databases (especially, trauma registries); and 5). critically analyze a published chart review in the emergency medicine literature.

John Marx, MD, Carolinas Medical Center Cherri Hobgood MD, UNC Diane Birnbaumer MD, Harbor UCLA Glenn Hamilton MD, Wright State The researcher/investigator role in emergency medicine is a very traditional one---with specific end-points and responsibilities. For the budding researcher, there are innumerable resources available to provide direction. Academic growth, though, outside of research is one of painstaking starts and stops, with many different avenues open to those who seek it. Mentors are the guides to these avenues. They give advice when needed, comfort when asked, and a voice to the question: How can I accomplish my next goal, whether that goal is the relatively simple like becoming a better teacher or something more complex like seeking a residency directorship. However when is the appropriate time to seek mentorship? And who should be asked? And what exactly is the role of the mentor? Although skilled mentors are able to juggle different personalities all at once, strategies for problem solving and goal-direction are specific to the individual. As such it is vital to both know when mentorship is needed and what to look for in the compatible person. Through a combination of presentations, questions, and audience participation, a panel of four academic emergency physician leaders will discover a solution to these questions. At the completion of the session, junior and mid-level participants will have an understanding of why mentors are critical and essential to the maturity of their clinician-educator careers. Further, they will have gained the knowledge of when is the right time to have a mentor and how to match with the right one for them.

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Friday, May 18, 2007 trials, addressing the issues and concerns that may arise, and defining when such trials are worth the extra design effort. Specific examples of successful adaptive trials will be used to illustrate key concepts. The use of modelling strategies to determine trial characteristics of adaptive designs will be illustrated. At the completion of the session, participants will be able to describe types of adaptive clinical trials, list advantages and disadvantages of adaptive clinical trial designs, and understand the steps required to successfully plan and execute such trials.

So, You Want to be an Editor? (12:15 - 1:30 pm) Michelle Biros MD, MS, Hennepin County Medical Center Brian Rowe MD, University of Alberta John Marx MD, Carolinas Medical Center Deb Houry MD, Emory University This session will focus on the skills and experience necessary to develop and succeed as an editor for an emergency medicine publication. The session will outline the most successful strategies for preparation for a position as an editor, the issues faced at the beginning of one’s career, and the pitfalls to avoid. Dr. Michelle Biros, editor in chief of Academic Emergency Medicine, will discuss the road to becoming a journal editor and the role of serving as a peer reviewer for journals. Dr. John Marx, editor in chief of Rosen’s Emergency Medicine text and deputy editor for Journal Watch Emergency Medicine, will comment on ways to get involved in writing and editing textbooks as well as lessons learned about editing monthly publications such as Journal Watch. Dr. Brian Rowe, editor in chief of Evidence Based Emergency Medicine and international editor for Annals of Emergency Medicine, will talk about developing an idea for a textbook, the challenges of editing a new textbook, and perspectives of being an international editor. This will be followed by a 15-minute open session led by Dr. Deb Houry, former resident editor for Annals of Emergency Medicine and JAMA, to facilitate questions from the audience to the panelists on how to get involved in emergency medicine publications and lessons learned. At the completion of this session, participants will be able to: understand the skills necessary to become an editor for a textbook or journal, understand the issues associated with editing and pitfalls to avoid.

Medical Photography and the Use of Clinical Images in Medical Education (7:00 - 9:00 pm) Larry Stack MD, Vanderbilt University Alan Storrow MD, Vanderbilt University Kevin Knoop MD, Naval Medical Hospital, Portsmouth, VA R. Jason Thurman MD, Vanderbilt University Medical photography is a powerful tool that can be utilized to establish permanence of clinical teaching opportunities. In order to maximize the sharing experience of clinical photographs, the educator must seek to obtain the highest possible quality of medical images. This session shall begin with a lecture addressing a) the essential equipment needed to produce excellent clinical photographs, b) the fundamentals of medical photography including explanations of exposure, lighting, establishment of view, reproduction ratios, and management of distortion, c) the use of clinical images to augment didactic teaching, and d) the use of clinical images in medical research. Following the lecture, the faculty will teach a hands-on workshop so that participants can practice newly learned techniques. During the workshop, the faculty will use digital cameras and projection equipment to demonstrate how proper technique generates high quality images as well as how improper technique may result in poorer quality images. Participants are encouraged to bring their own cameras for use in the practice workshop. At the completion of this session, participants will have gained knowledge of the fundamentals of appropriate medical photography equipment, proper photographic techniques for maximum medical image quality, the use of medical imaging in teaching and research, and hands-on practice in utilizing proper techniques to produce high quality medical images.

State-of-the-Art: Therapeutic Hypothermia after Cardiac Arrest (1:30 - 3:00 pm) Benjamin Abella MD, University of Pennsylvania Robert Neumar MD, University of Pennsylvania Clifton Callaway MD, University of Pittsburgh The use of therapeutic hypothermia after successful resuscitation from cardiac arrest represents a major advance in the field of resuscitation care. This treatment option is a crucial intervention that EM physicians have at their disposal to improve survival and neurologic outcomes in these critically ill patients. The techniques and mechanisms of therapeutic hypothermia are still an area of active research, and investigations from the past few years have greatly expanded our understanding of both how to use hypothermia and how cooling may influence neurologic and myocardial function and survival. In addition, a variety of new technologies have been refined to assist medical teams as they implement cooling protocols in their centers. This didactic course will introduce some of the concepts behind hypothermia and its clinical use, and will present analysis of the body of recent investigation in the field as it pertains to clinical application. After three lectures from research leaders in the field, a group panel discussion will allow participants to explore remaining controversies and practical issues pertaining to therapeutic hypothermia, and speakers will emphasize where the research will evolve over the next few years. At the completion of this session, participants will: 1. Understand the current state of knowledge regarding therapeutic hypothermia after cardiac arrest; 2. become aware of a variety of methods to induce and maintain hypothermia; 3. learn about current research controversies in the use of hypothermia and where future research needs to be focused.

“E.D. S.T.A.T.!”: Emergency Department Strategies for Teaching Any Time (7:00 - 9:00 pm) Glen Bandiera MD, University of Toronto Jason Frank MD, University of Ottawa Constance LeBlanc MD, Dalhousie University Janet Nuth MD, University of Ottawa Danielle Blouin MD, Queen’s University ED teaching is so important, but many find it hard to do well and on the fly. This session will help you. We all agree that effective clinical teaching is essential for the development of the next generation of emergency physicians and the growth of our specialty. Clinical teaching is the cornerstone of modern medical education, and the best teachers can have the greatest effect on learner competence. In addition, future EM leaders will emerge from those medical students and residents who are inspired by the outstanding EM role models they have met in the ED. So what can we do to be better EM teachers? Educational research has identified some core behaviours in outstanding teachers, and these skills can be learned. The ED presents unique challenges to clinical teaching and teaching strategies have been catalogued in recent research (see Bandiera et al, Annals EM 2005). ED STAT! is a faculty development curriculum focused on fostering enhanced clinical teaching skills in emergency medicine teachers. ED STAT is designed with an evidencebased mix of interactive lectures, videos, psychology, laughs, and hands-on teaching practice sessions that makes it unique in EM faculty development. The curriculum can be offered as a 1-hour intro or as a full-day workshop with hands-on practice of skills in breakout groups.

At the completion of the full-day version of ED STAT, participants will be able to: 1. Describe the characteristics of effective and not-so effective clinical teachers 2. Describe the characteristics and challenges of the ED setting for clinical education 3. Use the ED STAT! teaching model in your daily practice 4. Orient a learner in the ED 5. Describe the elements of effective feedback 6. Tailor your teaching to the learner 7. Adapt your teaching to the demands of the ED environment 8. Describe 3 new ways of preparing for teaching 9. Describe 3 techniques to promote active learning on the fly.

Adaptive Clinical Trials (1:30 - 3:00 pm) Roger Lewis MD, Harbor-UCLA Medical Center Ari Lipsky MD, Harbor-UCLA Medical Center Adaptive clinical trials are designed so that key aspects of the trial may be altered during conduct of the trial, based on accumulating data within the trial, to optimize the efficiency of the trial and/or the outcomes of patients within the trial. Trial characteristics that may be adaptively changed include the sample size, the number of treatment groups, dosage levels, and the randomization proportions. The biopharmaceutical industry and the FDA have both recently demonstrated increasing interest in the use of adaptive trials and emergency medicine research is particularly well suited to this approach, given the relatively short interval between treatment and outcome for many emergency condisions. With proper planning, such adaptation does not threaten the validity of the study results, and may allow reliable conclusions to be drawn earlier and with better patient outcomes. Drs. Lewis and Lipsky will provide a qualitative introduction to the issues surrounding the planning and excecution of such

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Saturday, May 19, 2007 421. Evaluation of a Rapid Nucleic Acid Hybridization Test in Detecting Group A Streptococcal Pharyngitis and Comparison to Throat Culture in a Pediatric Emergency Department, Benoit Bailey, MD, CHU Ste-Justine 422. Cosmetic Outcomes of Absorbable Versus Nonabsorbable Sutures in Pediatric Facial Lacerations, Raemma Luck, MD, Temple University Children’s Medical Center

PAPER PRESENTATIONS EMS (8:00 – 10:00 am) 399. A Simple Triage Scoring System Predicting Death and Need for Critical Resources for Use During Epidemics, Nathan Shapiro, MD, Beth Israel Deaconess Medical Center 400. Impact of New Resuscitation Guidelines on Out-of-Hospital Cardiac Arrest Survival, William Fales, MD, Michigan State University Kalamazoo Center for Medical Studies 401. Effect of Emergency Medical Dispatch Systems on First-Responder Run Volume, David Cone, MD, Yale University 402. Simulation-Based Assessment of Paramedic Pediatric Resuscitation Skills, Richard Lammers, MD, Michigan State University/Kalamazoo Center for Medical Studies 403. Emergency Medical Services Utilization By Stroke Patients: A Population-Based Study, Opeolu Adeoye, MD, University of Cincinnati 404. Prospective Evaluation Of A Paramedic Administered EMS Alternative Transport Protocol, Barry Knapp, MD, Eastern Virginia Medical School 405. Can Paramedics Read ST-Elevation Myocardial Infarction on Prehospital ECGs?, Ketan Trivedi, MD, Yale University 406. To Drug or Not to Drug: The Impact of RSI on Mortality in Prehospital Intubation, Michael Cudnik, MD, Oregon Health & Science University

Pulmonary Embolism (11:00 am – 12:00 noon) 423. High Pretest Probability Pulmonary Embolism: Prospective Comparison of the Wells Score vs. Unstructured Physician Estimation, D. Courtney, MD, Northwestern University 424. Biomarkers to Predict Echocardiographic Right Ventricular Hypokinesis from Pulmonary Embolism, Jeffrey Kline, MD, Carolinas Medical Center 425. Use of Cardiac Troponin I for Risk Stratification of Patients with Pulmonary Embolism in Emergency Department, Hamid Shokoohi, MD, George Washington University 426. Prospective Evaluation of a Quantitative D-dimer for Pulmonary Embolism: is Structured Pretest Probability Assessment Necessary?

D. Courtney, MD, Northwestern University

POSTER PRESENTATIONS

(1:00 – 3:00 pm)

Ischemia/Reperfusion 427. Mitochondrial Electron Transport Chain Defects in Acute Murine Hind Limb Ischemia/Reperfusion, T. Paul Tran, MD, University of Nebraska Medical Center 428. Pharmaceutical Metabolic Downregulation By Protein Synthesis Inhibition in Conscious Rats, Penny Reynolds, PhD, Virginia Commonwealth University 429. Acute Stroke in an Urban Matrix of Primary Stroke Centers; Who is Calling 9-1-1? Bentley Bobrow, MD, Mayo Clinic

Antibiotics for Pneumonia (8:00 – 9:00 am) 407. The Association Between ED Crowding and Time To Antibiotics For Pneumonia, Jesse Pines, MD, University of Pennsylvania 408. Early Antibiotic Therapy Does Not Improve Mortality of Community Acquired Pneumonia, Marie Elie, MD, University of Medicine and Dentistry of New Jersey 409. Improving Time To Antibiotics In Pneumonia- Does It Save Lives?

William Frohna, MD, Union Memorial Hospital and the Washington Hospital Center 410. The Effect Of A Chest X-Ray At Triage Protocol On Time To Antibiotics For Admitted Patients With Pneumonia, Julie Cooper, BA, University of Pennsylvania

CPR 430. Independent Validation of a Prehospital Termination of Resuscitation (TOR) Clinical Decision Rule, Peter Richman, MD, Mayo Clinic, Arizona 431. In-Hospital Course of Initial CPR Survivors, Wendi Miller, MS-IV, Wayne State University 432. Fatigue and Quality of CPR by Older Bystanders Using the New 30:2 Chest Compression to Ventilation Guidelines: A Randomized Cross-over Trial, Christian Vaillancourt, MD, University of Ottawa 433. Television Public Service Announcements Improve Bystander CPR Rates, Christian Vaillancourt, MD, University of Ottawa 434. A Comparison Of The Emergency Medicine Physician And The Lay Person Understanding Of Do Not Resuscitate Orders, Kevin Miller, MD, State University of New York at Buffalo 435. Burst Stimulation Improves Hemodynamics Following ROSC After Prolonged Ventricular Fibrillation and Resuscitation, Gregory Walcott, MD, University of Alabama at Birmingham 436. Detecting Cardiac Output Generated by Isolated Atrial Activity During Resuscitation from Ventricular Fibrillation Using a Handsfree, Noninvasive Doppler Device, Todd Larabee, MD, University of Colorado 437. Factors Associated Survival And Neurologic Outcome In PostResuscitated Patients Who Received Therapeutic Hypothermia., Yong Su Lim, MD, Gachon Medical and Science University Gil Medical Center 438. The Effectiveness Of Cardiopulmonary Resuscitation Instruction, Animation Versus Dispatcher Through Cellular Phone: Cluster Randomized Trial, Minhong Choa, MD, Yonsei University, Seoul, Korea 439. Establishing A State-Wide Automated External Defibrillator Database And Educational Network: The Save Hearts In Arizona Registry And Education Experience, Sara Shimmin, MD, Mayo Clinic Arizona 440. Therapeutic Hypothermia for Resuscitated Cardiac Arrest Patients with Anoxic Encephalopathy - Neurologic and Survival Results after the Implementation of an Inter-Disciplinary Protocol, Jon Hokanson, MD, Abbott Northwestern Hospital 441. Beliefs And Attitudes To Family Witnessed Resuscitation Amongst Doctors, Nurses And Paramedics In Emergency Departments: A UK Perspective, Ayan Sen, MD, Hope Hospital, Salford, Manchester, UK

Cardiovascular (9:00 – 11:00 am) 411. Failure to validate the San Francisco Syncope Rule in an independent ED population, Andrew Wollowitz, MD, Albert Einstein College of Medicine 412. The Relationship Between Duration Of Antithrombotic Therapy And Ischemic Outcomes In High-Risk Nste Acs Patients In The Acuity Trial, Charles Pollack, MD, Pennsylvania Hospital 413. Short and Long Term Outcomes With Nesiritide For Acute Decompensated Heart Failure In The Emergency Department Observation Unit, Joseph Styron, BA, Case Western Reserve University 414. Interval Development of Coronary Artery Disease Within Five Years After a Normal Coronary Angiogram, Jason McMullan, MD, University of Cincinnati 415. Heart Failure and Audicor Technology for Rapid Diagnosis and Initial Treatment of ED Patients with Suspected Heart Failure (HEARD-IT), Sean Collins, MD, University of Cincinnati 416. CT Coronary Angiography For Disposition Of Chest Pain Patients From the Clinical Decision (Observation) Unit, Judd Hollander, MD, University of Pennsylvania 417. Myocardial Perfusion PET: A New Tool For Chest Pain Evaluation In The Emergency Department, Brooks Moore, MD, Emory University 418. The Impact Of An Accelerated Clinical Protocol With Outpatient Stress Testing In Chest Pain Patients At Low Risk Of Acute Coronary Syndrome On Admission Rates, Linda Papa, MD, Orlando Regional Medical Center

Pediatrics (10:00 – 11:00 am) 419. Bladder Ultrasound Increases Catheterization Success In Pediatric Patients, Brigitte Baumann, MD, UMDNJ - Robert Wood Johnson Medical School at Camden 420. Multicenter Controlled Clinical Trial to Evaluate the Impact of Advanced Life Support on Children with Out-of-Hospital Respiratory Distress, Martin Osmond, MD, University of Ottawa

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Saturday, May 19, 2007 465. Impact of Patient and Environmental Factors On Capillary Refill Time, Anne-Maree Kelly, MD, Joseph Epstein Centre for Emergency Medicine Research at Western Health 466. Capillary Refill Time In Adults Has Poor Inter-rater Agreement, Anne-Maree Kelly, MD, Joseph Epstein Centre for Emergency Medicine Research at Western Health 467. Hemodynamic Support And Survival Following Severe TraumaHemorrhage In Rodents With Low Volume Cocktail Resuscitation, Robert Barbee, PhD, Virginia Commonwealth University 468. The Relationship of Central Venous Saturation with Mortality in Septic Shock, Nathan Shapiro, MD, Beth Israel Deaconess Medical Center 469. Sensitivity And Specificity Of An Ngram Method For Classifying Emergency Department Visits Into The Respiratory Syndrome In The Turkish Language, Dennis Cochrane, MD, Morristown Memorial Hospital 470. Soluble Flt-1, a Novel Marker in Sepsis, Nathan Shapiro, MD, Beth Israel Deaconess Medical Center 471. In Vitro And In Silico Analysis Of The Utility Of Annexin V Binding To Lymphocytes As A Biomarker In Emergency Department Studies Of Sepsis, Colin Greineder, MD, University of Michigan 472. Determination of the Effect of In-Vitro Time, Temperature and Tourniquet Use on Whole Blood Venous Point-of-Care Lactate Concentrations, Matthew Leonard, MD, Carolinas Medical Center 473. Elevated Lactic Acid Levels Are Common But Not Predictive Of Mortality In Patients With Diabetic Ketoacidosis, Alice Stroe, MD, Henry Ford Hospital 474. Cholinergic Agonists Inhibit LPS Induced Whole Blood TNF Release Ex Vivo In Patients With Severe Sepsis: A Pilot Study, Richard Goldstein, MD, North Shore University 475. A Cardiovascular Chinese Herbal Medicine Rescues Mice from Lethal Sepsis by Selectively Attenuating a Late-acting Proinflammatory Mediator, HMGB1., Wei Li, MD, North Shore University 476. Clinical Effectiveness of Implementing Early Goal Directed Therapy in the Emergency Department Care of Severe Sepsis and Septic Shock: A Prospective Study, Alan Jones, MD, Carolinas Medical Center 477. Impact of Emergency Department Length of Stay on Outcomes of Critically Ill Adult Emergency Department Patients, Alan Jones, MD, Carolinas Medical Center 478. Bacteriology Of Septic Shock In Four Urban Emergency Departments, James Walter, BA, University of Chicago Pritzker 479. Etomidate Use in Severe Sepsis and Septic Shock May Contribute to Relative Adrenal Insufficiency But Not Mortality, Marie Mullen, MD, University of Massachusetts

442. Withdrawn

Cardiovascular Basic Science 443. Neuroprotective Effects of Ceftriaxone Following Excitotoxic Spinal Cord Injury, Kori Brewer, PhD, East Carolina University 444. Prevention of Hippocampal Microglial Activation by OximetryGuided Normoxic Reperfusion after Experimental Cardiac Arrest, Robert Rosenthal, MD, University of Maryland 445. Endothelial Dysfunction in Adiponectin Knockout Mice and Its Mechanisms Involved, Yu Cao, MD, West China Hospital Sichuan University

HIV 446. High Volume, Rapid HIV Testing in an Urban ED, Yvette Calderon, MD, Albert Einstein College of Medicine 447. Is A 9.5 Minute Video An Effective Substitute for An HIV Counselor For Rapid HIV Testing? Roland Merchant, MD, Brown Medical School 448. New CDC Guidelines For HIV Testing: Emergency Medicine Resident Attitudes And Perceptions Before And After An Educational Program and Testing Implementation, Yu-Hsiang Hsieh, PhD, Johns Hopkins University 449. A Simple Method for Estimating the Epidemiology of Undiagnosed HIV Infection Suggests that Existing HIV Prevalence Data are Not Adequate for Site-Specific ED Decision Making, Michael Lyons, MD, University of Cincinnati 450. Initial outcomes of a rapid HIV testing program in an emergency department in western Kenya, Michael Waxman, MD, Brown Medical School 451. Impact Of Prevention Counselor Characteristics On Patient Consent For Emergency Department Based HIV Testing, Ali Raja, MD, University of Cincinnati 452. A Novel Emergency Department Based Prevention Intervention Program for People Living with HIV: Evaluation of Early Experiences, Michael Lyons, MD, University of Cincinnati 453. A Hypothetical Cost Estimation of Implementing Routine Human Immunodeficiency Virus Testing in the Emergency Department, Charlene Irvin, MD, St. John Hospital and Medical Center

Infectious Disease 454. Lyme Disease as a Cause of Aseptic Meningitis in Children in a Lyme-Endemic Region, Maia Rutman, MD, Brown Medical School 455. Neutropenic Staphylococcus epidermidis Bacteremia in a Multicompartment Pharmacokinetic System, Hangyul Chung, University of Michigan 456. Statin Therapy In Patients With Sepsis, Michael Donnino, MD, Beth Israel Medical Center 457. The Use Of Sub-syndromes To Investigate Peaks In A Syndromic Surveillance System, John Allegra, MD, Emergency Medical Associates of New Jersey Research Foundation 458. Video Tool for Increasing Syphilis Knowledge and Testing in the Emergency Department, John Sanchez, MD, Jacobi Medical Center 459. Predicting Need for 24 Hour Admission Among Patients Presenting to the Emergency Department with Soft Tissue Infection, Brett Jensen, MD, Oregon Health & Science University 460. Organ Dysfunction In The Emergency Department Is An Important Predictor Of Mortality In Patients With Suspected Sepsis, Michael Filbin, MD, Massachusetts General Hospital

OB/GYN 480. Fetal Loss In Symptomatic First Trimester Pregnancies With Documented Fetal Cardiac Activity, Michael Juliano, MD, Naval Medical Center Portsmouth 481. Whole Blood Testing For Rapid Detection Of Pregnancy, Christian Fromm, MD, Maimonides Medical Center 482. Factors Associated with Lack of Empiric Antimicrobial Therapy in the ED for Females Testing Positive for Gonorrhea or Chlamydia: A Case Control Study, Satyajit Deshmukh, MD, Lincoln Medical Center

Disaster Medicine

Shock/Critical Care

483. Healthcare Worker Response to Disaster Conditions, David Karras, MD, Temple University 484. Who’s Publishing Disaster Medicine? Evaluation of Disaster Publications Pre and Post 9/11, Lauren Sauer, BA, Johns Hopkins University 485. Implications Of Hospital Evacuation After Hurricane Rita, Carl Schultz, MD, University of California, Irvine 486. Does Wireless Technology Improve Patient Tracking in Mass Casualty Incidents? Colleen Buono, MD, University of California, San Diego 487. Professional Consensus on Altered Standards of Hospital Care in Disaster Surges, Robert Kanter, MD, SUNY Upstate Medical University

461. A Central Venous Pressure Threshold Of 8 Mmhg Or Greater Does Not Exclude Preload-Dependent Increases In Cardiac Output During Early Hemodynamic Support Of Septic Shock, Nicole Abate, MD, Albert Einstein Medical Center 462. A Novel Method for Measuring Central Venous Pressure to Facilitate Early Goal Directed Therapy in the Emergency Department, Amish Shah, MD, Lincoln Medical and Mental Health Center 463. Noninvasive Measurement Of Central Venous Pressure, Kevin Ward, MD, Virginia Commonwealth University Reanimation Engineering Shock Center 464. Inhibition of Margination and Diapedesis of Neutrophils by Protein Synthesis Blockade, Kevin Ward, MD, Virginia Commonwealth University Reanimation Engineering Shock Center

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Saturday, May 19, 2007 488. Disparities In Prolonged Indirect Health Effects of Disasters, Robert Kanter, MD, SUNY Upstate Medical University 489. Pediatric Hospital Mortality Reduction Strategies In Disasters, Robert Kanter, MD, SUNY Upstate Medical University

Health Care Policy 514. Drug Related Problems (Drps) In The Emergency Department (ED): Clinical Pharmacists Improve Detection Of Medication NonAdherence. Maria Rudis, PhD, University of Southern California 515. Medical and Nursing Staff Highly Value Clinical Pharmacists in the ED, Rollin Fairbanks, MD, University of Rochester 516. Effect Of An Expedited Referral System On Follow-up Rate Of Emergency Department Patients To A Federally Funded Health Clinic System, Tara Scherer, Washington University 517. Perception of Language as a Barrier to Care Among Non English Speaking Patients, Steven Shuchat, MD, New York Hospital Medical Center of Queens 518. Frequent Emergency Department Utilizers: A One Year Review, Michael Baumann, MD, Maine Medical Center 519. Effect Of Follow-Up To A Federally Funded Health Clinic System On Repeat Emergency Department Visits, Rachel Jones, MD, Washington University 520. The Effect Of Mandatory Nursing Ratios On Quality Of Patient Care At A California Urban Emergency Department, Lori Weichenthal, MD, University of California San Francisco-Fresno 521. Sleep Duration and Quality in Emergency Department Staff Working Sequential Night Shifts, Karen Hansen, MD, University of Maryland 522. Development of a standardized diagnosis list for use in Canadian Emergency Departments, Bernard Unger, MD, SMBD Jewish General Hospital 523. Reduction of Physical Restraint Use In Emergency Behavioral Health Patients After Logistic Modification of Infrastructure and Implementation of Evidence-Based Care Guidelines, Thomas Yeich, MD, Henry Ford Hospital 524. On Call Physician Availability in California Emergency Departments - 2006, Michael Menchine, MD, University of California, Irvine 525. Improving Patient Flow: The Effect Of A Staggered Resident Staffing Pattern, Eric Lowe, MD, Maine Medical Center 526. Geography And Travel Distance Impact ED Visits, Philip Henneman, MD, Tufts-Baystate Medical Center 527. The Drive Toward Quality: Do CMS Quality-Process Measures Improve Quality Of Care In The Emergency Department? Reena Duseja, MD, University of Pennsylvania 528. Malpractice Claims on Emergency Physicians: Time and Money, Darien Cohen, MD, Resurrection Medical Center 529. Transitioning Patients from the ED to the Hospital: Observations of Handoff Communication, Christopher Beach, MD, Northwestern University 530. Predictors Of Emergency Physician Workload. Jonathan Dreyer, MD, The University of Western Ontario 531. Variability Of Emergency Physician Time By Triage Category.

Jonathan Dreyer, MD, The University of Western Ontario 532. Comparing Two Strategies to Estimate Emergency Department Flow, Neil Hadpawat, MD, New York Methodist Hospital 533. Do Patients Present for Sexual Assault Nurse Examiner (SANE) Evaluations More Often During Nights, Weekends, or Summertime?

A Five-Year Analysis of Presentation Trends, Danielle Peress, BS, North Shore University 534. Effect of Peer to Peer Education on Emergency Physician Critical Care Documentation Practices, Jennifer Wiler, MD, Drexel University 535. The Effect of Medical Students on Patient Flow in a Low Acuity Area of an Academic Emergency Department, Jason Frank, MD, University of Ottawa 536. Are Physicians Good At Turning Out To Vote? Jennifer Lee, MD, Johns Hopkins 537. Characteristics and Short-Term Recidivism Rates Of Patients Who Leave The Emergency Department Against Medical Advice, Ru Ding, MS, Johns Hopkins University 538. Determination of factors most associated with patients leaving the Emergency Department without being seen with data from the National Hospital Ambulatory Care Survey, Douglas Brosnan, MD, University of California, Irvine 539. A Mid-Level Provider After Triage to Reduce Patients Who Left Without Being Seen, Benjamin Sigal, MD, MPH, Saint Joseph Mercy Hospital

Pulmonary 490. The Impact of the Taser Weapon on Respiratory and Ventilatory Function in Human Subjects? Theodore Chan, MD, University of California, San Diego 491. Volumetric Capnography Derived Indices for Prediction of Noninvasive Ventilation in the Emergency Department, Ronny Otero, MD, Henry Ford Hospital 492. Spacer Device Ownership and Utilization by Emergency Department Patients, Ilona Barash, PhD, University of California at San Diego 493. Evaluation of 50 Potential Markers of Pulmonary Embolism for Use in the Emergency Department, Alice Mitchell, MD, Carolinas Medical Center 494. Mycoplasma pneumoniae increases airway mucin production in asthmatics, Charles Cairns, MD, Duke University 495. Volumetric Capnography as Predictor of Respiratory Outcomes in Triage, Ronny Otero, MD, Henry Ford Hospital 496. Quantified Changes in End-tidal Carbon Dioxide During Procedural Sedation are Associated with Specific Clinical Signs of Respiratory Depression, Joseph Mayerle, MS, Hennepin County Medical Center

Toxicology 497. Patient-Reported Adverse Drug Related Events from Emergency Department Discharge Prescriptions, Corinne Hohl, MD, University of British Columbia 498. Non-Adherence With Emergency Discharge Prescriptions, Corinne Hohl, MD, University of British Columbia 499. Toxicokinetics of Paraquat in Rat Model, Yu Jin Kim, MD, Seoul National University College of Medicine 500. High Dose Insulin Reverses Calcium Channel Blocker Inhibition Of Glucose Uptake In An Adipocyte Model, Laura Bechtel, PhD, University of Virginia 501. Treatment Of The Poison Ivy Rash With a Topical Over-The-Counter Agent: A Randomized Controlled Trial, David Rios, MD, St. Luke’s Hospital 502. Six Years Of Acute Unintentional Epinephrine Digital Injections: Lack Of Ischemia Or Significant Systemic Effects, Andrew Muck, MD, Wilford Hall Medical Center 503. The Role Of Cardiac Free Fatty Acid Metabolism In Verapamil Toxicity Treated With Intravenous Fat Emulsions, Tony Lyon, St. Luke’s-Roosevelt 504. Slower Infusion of Metoclopramide Reduces Akathisia, Linda Regan, MD, NYU -Bellevue Hospital Center 506. Multiplying the Serum Acetaminophen by the Aminotransferase to Risk-stratify Patients Following Acetaminophen Overdose, Marco Sivilotti, MD, Queen’s University 507. Hospital Admission Is Common After Intentional Zolpidem Ingestion, Amy Zosel, MD, Northwestern University

Observation Units 508. Evaluation of an Emergency Department Inpatient Observational Unit, Thomas Richardson, MBA, University of Rochester 509. Prevalence of Non-Diagnostic Stress Tests in Observation Unit Patients: Potential Implications for CT Coronary Angiography, Emilie Powell, MD, Northwestern University 510. ED Predictors Of Observation Unit Heart Failure Treatment Outcomes, Preeti Jois-Bilowich, MD, Cleveland Clinic 511. Heart Failure: Predictors of Treatment Failure in an ED based Observation Unit, Rick Spurlock, MD, Emory University 512. Impact Of Stress Test Selection On Chest Pain Observation Unit Length Of Stay, Abhinav Chandra, MD, Duke University Medical CEnter 513. Evaluation and Validation the Use of Modified Early Warning Score (MEWS) in Emergency Department Observation Ward, CA Graham, MD, The Chinese University of Hong Kong

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Saturday, May 19, 2007 540. Pre-formatted Structured Charts Versus Open Charts: A Comparison Of Documentation And Adherence To Consensus Guidelines, Laura Sehnert, MD, Denver Health 541. Follow-up of patients discharged from the emergency department: Why do we have the wrong phone number? Erik Almeida, DO, Advocate Christ Medical Center 542. CTAS Reliability Across Provincial Health Regions, Eric Grafstein, MD, Providence Health Care & St. Paul’s Hospital 543. Do Emergency Physicians and Nurses Differently Perceive Safetyrelated Factors? The National ED Safety Study, Ashley Sullivan, MS, MPH, Massachusetts General Hospital 544. A New Classification System for Emergency Departments: Massachusetts, 2005, Carlos Camargo, Jr., MD, DrPH, Massachusetts General Hospital 545. Effect of Night Work on C-Reactive Protein in Emergency Department Staff, Karen Hansen, MD, University of Maryland

Simulation as a Training Tool: Where are the Metrics?

(9:30 - 11:00 am) Andy Godwin, MD, University of Florida College of Medicine/ Jacksonville James Gordon, MD, MPA, Massachusetts General Hospital Marc Shapiro, MD, Brown University Simulation training has become a favored method of training in emergency medicine, so much so that the Residency Review Committee for Emergency Medicine (RRC-EM) considers procedural training performed on simulators to count towards the procedural requirements that are documented for residents to graduate. Simulation also has the benefit of placing participants in high-stakes clinical scenarios and allowing the participants to follow the course of the “patient’s” disease state, interact and intervene in the “patient’s” clinical course, and observe the outcome of their critical decision making in these circumstances.

While other industries (aviation, military) have embraced simulation as inherently useful, medical simulation experiences more rigorous scrutiny and questioning as the metrics used to verify performance remain to be validated. This course will highlight the current development of medical simulation, including the various types of simulation centers that exist, the degree to which simulation has been validated, and the simulation metrics that need to be further defined and validated. At the completion of this session participants will be able to: 1). discuss medical simulation and its application to emergency medicine; 2) identify how leaders in simulation are integrating simulation into training, advancement, and ultimately board certification and maintenance; and 3) identify metrics that simulation leaders expect will be useful in the future, and illustrate how these metrics are currently being validated.

Didactic Sessions Replacing Hindsight with Insight: Understanding Adverse Events (8:00 - 9:30 am) Richard Cook MD, University of Chicago Christopher Nemeth PhD, University of Chicago Robert Wears MD, University of Florida Jacksonville Research in patient safety (“medical error”) often involves close examination and analysis of critical incidents or adverse events for the purposes of learning from them. However, these analyses are often unable to meet those goals because they do not take into account the insidious and powerful effects of hindsight and outcome biases. This panel discussion will be divided into three sections. Dr Cook will present evidence for the effects of hindsight and outcome bias on retrospective analyses of incidents and accidents. This section will include lessons learned as Principal Investigator for the Medical Events Data Collection and Analysis Service (MEDCAS) project. Dr Nemeth will then present methods developed in other fields to create a scientific basis to understand clinical care, which can minimize or reduce the effects of hindsight and outcome biases. This session will educate participants about the effects of hindsight and outcome bias, and present recent experience in applying these methods to the analyses of accidents and incidents in the MEDCAS project. The final section, led by Dr Wears, will engage the audience and the panelists in a discussion of what can be learned from historical analyses of events relevant to emergency medicine, and how to use this information to improve patient safety research. Dr. Wears will serve as the panel expert on patient safety in emergency medicine, and as a practicing EM clinician and safety researcher, he will use case examples to close the gap between the theory of safety science and the realities of clinical research. After attending this session, members of the audience will: 1. Articulate how socio-political influences prevent understanding the context and factors that contribute to adverse events; 2. Explain how behavioral influences such as hindsight bias impede researchers’ understanding of adverse events in clinical care; 3. List several research approaches to collecting and analyzing qualitative and quantitative data on human performance

Making an ED Information System Work For Operations, Monitoring Education, Research, and Disease Surveillance (9:30 - 11:00 am) Ludi Jagminas MD, Brown University, Rhode Island Hospital Bala Hota MD, Rush University, Cook County Hospital David Levine MD, Cook County Hospital, Rush Medical College Tracking systems and the Electronic Medical Record (EMR) have made vast amounts of Emergency Department data more available. There is also a continual push to make the Emergency Department more efficient and maximize Emergency Department output. It is critical to find a balance in limiting the amount of data entry for efficiency while maximizing data acquisition for research and disease surveillance. The goal of an Emergency Department director is to maximize physician time with direct patient care and minimize clinician time in front of a computer screen.

Proper and maximal data is important for surveillance, research, and tracking of resident and attending physician performance benchmarks.

For a Residency Director, it would be ideal to capture all procedures done by a resident and a summary of patient types and encounters.

For surveillance and research purposes specific diagnosis codes and other demographics may be necessary. This session will focus on how busy Emergency Departments have balanced efficiency with successful surveillance and research agendas. How to best collect data from a research, educational and operational standpoint will be emphasized.

What should be expected in standard reports and what should be asked to be customized will be discussed. Panels will discuss how they have managed to balance the data and how they have obtained the best data for surveillance, educational, operational and research purposes.

Panelists have a background in running busy emergency departments, working with emergency medicine residents, and managing large data for surveillance and research. At the completion of this session participants will: 1). identify key data elements necessary to collect for national and local disease surveillance, research, and monitoring of resident education; 2). learn how to balance data collection with the efficient running of an ED that maximizes time of clinicians with patients; 3) collect relevant data for tracking education, research, or surveillance from the Electronic Medical Record or ED tracking system; and 4). recognize essential items that must be included in ED reports for operations, research, educational monitoring, and disease surveillanceOver-laudatory letters harm the weaker candidates by promoting them to a residency environment where they might not meet expectations. In this course we will cover LOR etiquette, review parts of an effective letter, show examples of good and bad letters, discuss ways to navigate the standard letter of recommendation (SLOR), and suggest phrases by which to convey

A Consideration of the Purpose of the Medical Literature, The Goals of Peer Review, and Practical Tips For Improving Papers (8:00 - 9:30 am) David Schriger, MD, UCLA We will begin with a consideration of what Kuhn, Ziman, Medawar, Broad and Wade tell us about the scientific process, the role of scientific publication, and the role of peer review. From these principles we develop practical ways of improving the completeness and transparency and hence the quality of scientific papers. Topics to be considered include: the role of reporting guidelines (e.g. CONSORT, QUOROM, STAR-D..), the merits of estimation versus hypothesis testing, the merits of stating assumptions versus stating limitations, ways of accounting for random error and bias, using graphics to show the data, and posting protocols and datasets to the web. This session should be of interest to both novice and experienced researchers and authors. At the completion of the session, participants will have gained an understanding of the theoretical rationale and practical methods for improving the quality of their manuscripts.

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Saturday, May 19, 2007 to select and employ new tools specific to their teaching environment as well as gain an understanding of some of the foundations of cognitive adult learning theory.

less than favorable assessments. At the completion of this session, participants will be able to: 1) outline an effective letter addressing medical knowledge, clinical skill, unique strengths, potential weaknesses, and assessment of future emergency medicine success; 2) navigate the “standard letter of recommendation” (SLOR) for emergency medicine; 3) effectively communicate “red flags” in an appropriate fashion; 4) answer questions like, “When can I decline writing a letter?”, “How important is the waiver to see the recommendation and should I use it?”, “Is there a template I can use to write such a letter?”; 5) plan by which the individual course participant can efficiently generate a good LOR.

Quality Geriatric Emergency Care: Preparing for the Future (11:15 am - 1:00 pm) Neil Wenger MD, University of California Los Angeles Fred Hustey MD, Cleveland Clinic Foundation Kevin Terrell DO, Indiana University Tammie Quest MD, Emory University This session will provide attendees with information and skills to create consensus about quality indicators for emergency care with emphasis on older patients. There are three reasons for the emphasis on older patients. Demographic shifts show they are becoming the largest proportion of ED patients (26% by 2035). Older patients present diagnostic and management challenges so quality care for them may serve as a global quality indicator. Government agencies, such as the CMS focus on older patients. They and other third party payers are developing quality indicators which may be inappropriate for emergency medicine. It is critical that we proactively establish our own quality indicators. Neil Wenger will highlight information on importance of quality indicators, how to measure them, and why older patients are of interest.

Presentations reporting three focus areas of quality; pain (and palliative care), cognitive assessment, and transitions of care will follow. Speakers conducted comprehensive literature reviews prior to the session and identified potential quality indicators focusing on processes care. These were reviewed by members of the Geriatric Task Force and the Geriatric and Pain and Palliative Care Interest Groups using a modification of the RAND ACOVE project methodology. Speakers will present potential indicators along with the rationale for that indicator. Audience discussion will lead to consensus on whether to accept, modify, or delete the indicator(s). The session is scheduled for 2 hours. Dr. Wenger’s will talk for 30 minutes. Each presenter will talk for 20 minutes allowing 30 minutes for discussion. At the end of the session attendees will be able to: 1) describe an approach to developing and measuring quality indicators in emergency department care; 2) participate in a discussion to identify important quality indicators and their measurement for three specific issues: pain (and palliative care), cognitive assessment, and transitions of care; 3) list quality indicators and measurement techniques as agreed upon by the audience for three specific issues.

Translating Research into Clinical Practice: Experiences and Observations from Implementing Early Goal-Directed Therapy for Sepsis in the ED (11:15 am - 1:00 pm) Alan Jones MD, Carolinas Medical Center Nathan Shapiro MD, Beth Israel Deaconess Med Center Stephen Trzeciak MD, Cooper University Hospital Michael Roshon MD, Colorado Springs In recent years consensus recommendations for the management of severe sepsis and septic shock have included the use of an early quantitative resuscitation protocol, Early Goal-Directed Therapy (EGDT), immediately upon recognition of the condition. Given that at least one half of in-patients with sepsis are admitted through the ED, the potential of benefit from this intervention is often reliant upon emergency physicians and their resources. The original study of EGDT relied upon a “research team” to implement and execute the protocol. This gives rise to numerous questions about the generalizability and feasibility of the protocol to other ED settings. This state-of-the-art session will begin by reviewing the history of and scientific basis for quantitative resuscitation. The course faculty will then discuss experiences, observations, and potential barriers that one may encounter during the process of implementation of a quantitative, protocol based resuscitation strategy in the ED. The course faculties were not part of the original study; however, all have successfully implemented EGDT based sepsis protocols at their respective hospitals, representing a variety of ED, hospital and ICU models. There experience will therefore give attendees a “real world”, clinical perspective on the topic. The speakers will present and discuss various models to consider when implementing EGDT: 1) Community vs. university based EDs, 2) Teaching vs. non-teaching practice settings; 2) Open vs. closed intensive care unit models; 3) Team vs. no-team approaches to executing the protocol. At the completion of this session participants will: 1) Understand the history, evidence and recommendations supporting ED based quantitative resuscitation; 2) Learn from experiences of investigators that have successfully implemented EGDT in a variety of clinical care, nonresearch settings.

Lunch With Fellowship Directors (12:00 - 1:00 pm) Various Fellowship Directors Residents and medical students often consider careers in academic emergency medicine but are uncertain if this pathway is right for them. This session is designed to provide participants with direct access to various emergency medicine fellowship directors who will provide information and answer questions about fellowship training in emergency medicine. The format will consist of multiple interactive roundtable discussion groups with the tables arranged by fellowship specialty. At the completion of the session, participants will be able to: 1) understand training requirements of various emergency medicine fellowship programs, 2) gain insight into the benefits of fellowship training, and 3) begin the initial steps to prepare for emergency medicine fellowship application.

“No! Not Another Boring Lecture”: Using Educational Theory as Basis for Alternative Methods of Teaching (11:15 am - 1:00 pm) Philip Shane MD, Emory University Sally Santen MD, Vanderbilt University Robin Hemphill MD, Vanderbilt University Katherine Heilpern MD, Emory University Bransford (2000) wrote that effective learning should be centered in 4 spheres: learner, knowledge, assessment, and community. Lectures usually focus on transmitting the knowledge component with less consideration of the other frames, at times, blunting the effectiveness for adult learners. However, use of the other spheres may allow for unique and dynamic opportunities for the teacher to engage the learner.

Developing less passive teaching methods may provide opportunities to that can be more effective than the standard lecture. This interactive session will incorporate the Bransford model of how people learn and other cognitive theories as a basis for the introduction to alternative and innovative methods of teaching. During the session participants will participate in experiences or demonstrations using other methods of teaching including readiness assessment testing, modified teambased and problem-based learning, jig-saw small groups, diad and triad reflection grouping, assessment centered learning, and “Jeopardy-”based assessment. At the completion of the session, participants will be able to select and employ new tools specific to their teaching environment as well as gain an understanding of some of the foundations of cognitive adult learning theory. At the completion of the session, participants will be able

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Didactic Session Speakers Stephanie Abbuhl, MD University of Pennsylvania

Gary Green, MD Johns Hopkins University

Kevin Knoop, MD Naval Medical Hospital, Portsmouth

Brian Rowe, MD University of Alberta

Benjamin Abella, MD University of Pennsylvania

James Gordon, MD, MPA Massachusetts General Hospital

Gloria Kuhn, DO Wayne State University

Sally Santen, MD Vanderbilt University

James Adams, MD Northwestern University

Jeremy Grimshaw, MD Otttawa Health Research Institute

Eddy Lang, MD McGill University

Shari Schabowski, MD Cook County Hospital

Mark Angelos, MD Ohio State University

Glenn Hamilton, MD Wright State University

John D. Lantos, MD University of Chicago

David Schriger, MD University of California, Los Angeles

Glen Bandiera, MD University of Toronto

Jerris Hedges, MD Oregon Health & Sciences University

Constance LeBlanc, MD Dalhousie University

Judy Shahan, RN Johns Hopkins University

Theodore Bania, MD St. Luke’s-Roosevelt Hospital

Katherine Heilpern, MD Emory University

David Levine, MD Cook County Hospital

Philip Shane, MD Emory University

Jill Baren, MD University of Pennsylvania

Robin Hemphill, MD Vanderbilt University

Roger Lewis, MD Harbor-UCLA Medical Center

Marc Shapiro, MD Brown University

William Barsan, MD University of Michigan

H. Gene Hern, MD Highland General Hospital

Ari Lipsky, MD Harbor-UCLA Medical Center

Nathan Shapiro, MD Beth Israel Deaconess Medical Center

Diane Birnbaumer, MD Harbor-UCLA Medical Center

Cherri Hobgood, MD University of North Carolina

Steven Lowenstein, MD University of Colorado

Jean Slutsky, P.A., M.S.P.H AHRQ

Michelle Biros MD, MS Hennepin County Medial Center

Robert Hockberger, MD Harbor-UCLA Medical Center

John Marx, MD Carolinas Medical Center

Larry Stack, MD Vanderbilt University

Andra L. Blomkalns, MD University of Cincinnati

James Hoekstra, MD Wake Forest University

John McConnell, PhD Oregon Health & Sciences University

Sarah Stahmer, MD Cooper Hospital

Danielle Blouin, MD Queen’s University

Judd Hollander, MD University of Pennsylvania

Christopher Nemeth, PhD University of Chicago

Ian Stiell, MD, MSc University of Ottawa

Charles Cairns, MD Duke University

Brian Holroyd, MD University of Alberta

Robert Neumar, MD University of Pennsylvania

Alan Storrow, MD Vanderbilt University

Clifton Callaway, MD University of Pittsburgh

Bala Hota, MD Cook County Hospital

Janet Nuth, MD University of Ottawa

Robert Strauss, MD Saint Francis

Richard Cook, MD University of Chicago

Deborah Houry, MD Emory University

James Olson, PhD Wright State University

Jeffrey Suchard, MD University of California, Irvine

Howard Corneli, MD Primary Children’s Medical Center Salt Lake City

Susan Huckson, RN National Institute of Clinical Studies

Edward Panacek, MD University of California, Davis

Kevin Terrell, DO Indiana University

Fred Hustey, MD Cleveland Clinic Foundation

Peter D. Panagos, MD Brown University

R. Jason Thurman, MD Vanderbilt University

Ludi Jagminas, MD Brown University

Stephen Playe, MD Bay State Medical Center

Stephen Trzeciak, MD Cooper University Hospital

Alan Jones, MD Carolinas Medical Center

Charles Pollack, MD Pennsylvania Hospital

Robert Wears, MD University of Florida

Samuel Keim, MD University of Arizona

Tammie Quest, MD Emory University

Neil Wenger, MD University of California, Los Angeles

Gabor Kelen, MD Johns Hopkins University

Rebecca Roberts, MD Cook County Hospital

John Younger, MD University of Michigan

Christopher King, MD University of Pittsburgh

Michael Roshon, MD Colorado Springs

Joseph Zorc, MD Children’s Hospital of Philadelphia

Terry Klassen, MD University of Alberta

Richard Rothman, MD Johns Hopkins University

V. Ramana Feeser, MD Virginia Commonwealth University Thomas Flottemesch, PhD Health Partners Research Jason Frank, MD University of Ottawa Robert Freishtat, MD Children’s National Medical Center W. Brian Gibler, MD University of Cincinnati Andy Godwin, MD University of Florida, Jacksonville Ian Graham, PhD Canadian Institutes for Health Research

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Innovations In Emergency Medicine Education Exhibits May 16-17, 2007 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

Employing Fail-Safe Methodology for Risk Management and Medical Education, Paul Kivela, MD Best Evidence Topics (BETs) - An Evidence Based Problem Based Learning Tool, Shweta Gidwani, Whiston Hospital Breaking Barriers To Communication: A Spanish-English Communication Tool For The English Speaking Provider, Michelle Tomassi, MD, Albany Medical College Beyond “Good Job�: A Novel, Multimedia Training Module on Effective Feedback Strategies, Esther K. Choo, MD, San Francisco General Hospital Longitudinal Educational Tracks in an Emergency Medicine Residency Curriculum, Chris Ghaemmaghami, MD, University of Virginia Using Human Models with Known Pathology for Resident Ultrasound Examination Skills Development, Daniel Rodgers, MD, Northwestern University Morbidity and Mortality Conference: Revisited, Reframed, Renamed, Tracy Sanson, MD, University of South Florida Paperless End-of-Shift Evaluation of EM Residents Using a Three Point Scale, Brian Donahue, MD, Resurrection Medical Center Emergency Department Based Critical Care Electives: A Growing Educational Opportunity, Robert Sherwin, MD, Henry Ford Hospital An Evidence Based Medicine Immersion for Emergency Medicine Residents, Rawle Seupaul, MD, Indiana University Use of an Advanced Skills OSCE to Evaluate Core Competencies in an Emergency Medicine Clerkship, Joshua Wallenstein, MD, Emory University A Low Technology, Low Cost Simulation Model For Performance of Lumbar Puncture, Sally Santen, MD, Vanderbilt University The Healing Power of the Written Word: A Workshop Exploring Medical Literature, Sarah Andrus, MD, Oregon Health & Sciences University

May 18-19, 2007 14. Online ED Orientation for Rotating House Staff and Medical Students, Jonathan Davis, MD, Georgetown University/Washington Hospital Center 15. High-Fidelity Medical Simulation for Geriatric Emergency Medicine Training, Luna Ragsdale, MPH, Brown University 16. Teaching Module for using Point-of-Care Limited Bedside Ultrasound (PLUS) to Detect Lower Extremity DVT, Amy Sedgwick, MD, Maine Medical Center 17. Changing Residents Understanding of System Resources by Visiting a Nursing Home, Jail, and Homeless Shelter, Krista Jahnke, MD, Emory University 18. Optimizing Communication in Emergency Medicine: An Innovative Training Primer, Caesar Djavaherian, MD, New York-Presbyterian Weill Cornell Medical Center 19. A Residency Ethics Workshop, Louis Binder, MD, Case Western Reserve University 20. Venous Cutdown Lab: An Inexpensive Yet Realistic Model For Teaching The Clinical Procedure, Dean Straff, MD, New York-Presbyterian 21. Coding and Documentation Education for EM Residents, Emily Hirsh, MD, Emory University 22. Changes in Perceived Managerial Styles of Senior Emergency Medicine Residents, Nicole Franks, MD, Emory University 23. The Journal Club Blog: An Accessible, Searchable Reference to Enhance Evidence-Based Medical Training, Nicholas Genes, PhD, The Mount Sinai Hospital, Elmhurst Hospital 24. An Ultrasound Simulator for Emergency Medicine Resident Education, Tim Heilenbach, MD, Evanston Northwestern Healthcare 25. Simulation of Tele-Trauma Resuscitations for Rural Emergency Physicians and Emergency Medicine Residents, David Ellis, MD, University at Buffalo (SUNY)

33

Call for Proposals 2008 AEM Consensus Conference Deadline: April 2, 2007 The editors of Academic Emergency Medicine are accepting proposals for the 2008 AEM Consensus Conference, which will be held on May 28, 2008, the day before the SAEM Annual Meeting, in Washington, DC. Proposals must advance a topic relevant to emergency medicine that is conducive to the development of a research agenda and be spearheaded by thought leaders from within the specialty of emergency medicine. The goals of the AEM consensus conferences are to heighten awareness related to the topic, discuss the current state of knowledge about the topic, identify knowledge gaps, propose needed research, and issue a call to action to allow future progress. Previous topics have included errors in emergency medicine, the unraveling safety net, quality/best practices in emergency care, information technology in emergency medicine, disparities in emergency care, emergency research without informed consent, the science of surge, and knowledge translation.

Developed proposals will be reviewed on a competitive basis by the AEM Editorial Board. The topic chosen for the 2008 AEM Consensus Conference will be announced at the SAEM Business Meeting during the 2007 Annual Meeting in Chicago.

Proceedings of the meeting and original contributions related to the topic will be published exclusively by AEM in its Special Topic Issue in November 2008.

Submitters are strongly advised to review the Special Topic issues of previous AEM Consensus Conferences (see November issues of AEM) to guide the development of their proposals. Proposals must include the following: 1. Introduction of the topic • brief statement of relevance • justification for this topic choice 2. Proposed conference chairs and sponsoring groups (i.e., SAEM interest groups, committees) 3. Proposed conference agenda and proposed presenters • Plenary lectures • Panels • Breakout topics and questions for discussion • Anticipated audience • Stakeholder groups/organizations • Federal regulators • National researchers and educators • Others 4. Anticipated budget 5. Potential funding sources and strategies for securing conference funding Proposals must be submitted electronically to the AEM office at aem@saem.org no later than April 2, 2007 at 5:00 PM Eastern Time.

34

Future SAEM Annual Meetings May 29-June 1, 2008, Washington, DC May 14-17, 2009, New Orleans June 3-6, 2010, Phoenix, AZ

SAEM Regional Meetings Western Regional Meeting, March 16-17, 2007, Portland, Oregon. Contact Robert A. Lowe, MD, MPH, lowero@ohsu.edu with questions.

Southeastern Regional Meeting, March 23-24, 2007, Wilmington, North Carolina. Contact Kori Brewer, Ph.D., brewerk@ecu.edu; or Tim Reeder, MD, reedert@ecu.edu with questions.

New York Regional Meeting, March 28, 2007, New York, New York. Contact Christine Ryan, (631) 444-2094 to register; or Adam Singer, MD, asinger@notes.cc.sunysb.edu with questions.

New England Regional Meeting, April 18, 2007, Shrewsbury, Massachusetts. Contact Jonathon Fisher, MD, jfisher2@bidmc.harvard.edu with questions.

Advertising Positions Available at Annual Meeting SAEM is again offering an opportunity to advertise in the on-site program. The Annual Meeting will be held May 16 – May 19 in Chicago and will attract approximately 1,800 academic emergency physicians.

A limited amount of space is being set aside for the position available section and only academic positions available will be accepted. The deadline for receipt of ads at the SAEM office is April 1, 2007.

The following ad requirements and prices are available for the on-site program: Classified line ads (100 words maximum): $120 (contact SAEM member) or $145 (non-SAEM member) Quarter page ads: 31⁄2" wide x 43⁄4" deep $350 Half page ads: 71⁄2" wide x 43⁄4" deep or 31⁄2" wide x 93⁄4" deep $425 Full page ads: 71⁄2" wide x 93⁄4" deep

$525

A typesetting fee ($25-$50) will be charged if the quarter, half, or full page ads are not camera-ready.

35

Registration Form 2007 Annual Meeting Sheraton Chicago Hotel and Towers May 16-19, 2007

Online registrants receive an immediate email confirmation.

The Annual Meeting brochure is also on the SAEM website and is updated continuously.

To Contact SAEM: Email: jennifer@saem.org Fax: (517) 485-0801 Phone: (517) 485-5484 Address: 901 N. Washington Ave. Lansing, MI 48906

Do not use this form if you have registered online. Do not submit duplicate registration forms.

PLEASE PRINT OR TYPE Send this form and appropriate fees to SAEM by fax, email, or mail. No phone registrations. This form may be photocopied.

Name and title for badge: MD, DO, PhD, etc. _______________________________________________ Institution _____________________________________________________________________________ Address _______________________________________________________________________________ ______________________________________________________________________________________ City, State, Zip _________________________________________________________________________ Telephone ( ______ )_______________________

Fax ( ______ )_______________________

Email _________________________________________________________________________________ ❒ I am a faculty member of this didactic or lunch session ____________________________________ ❒ I will present abstract(s) # ____________________________________________________________ BASIC FEE SCHEDULE Contact SAEM if you are unsure of your membership status. Non-members who wish to join SAEM and receive the discounted member registration rate must submit a completed membership application (including payment of dues) by May 1, 2007.

Early Registration Received by April 15, 2007

Registration Received after April 15, 2007

SAEM Members Active or Associate Resident or Fellow Medical Student One-Day Registration (Date:______________)

❒ $435 ❒ $145 ❒ $45 ❒ $220

❒ $485 ❒ $190 ❒ $80 ❒ $250

Non-Members Physician Resident or Fellow Nurse, EMT, PA, Other Non-Physician Medical Student or Undergraduate One-Day Registration (Date:_______________)

❒ $835 ❒ $285 ❒ $285 ❒ $160 ❒ $325

❒ $895 ❒ $320 ❒ $320 ❒ $195 ❒ $355 continued on next page

37

A NIGHT ON THE TOWN ❒ Option A: The Blues Brothers Spend a night on the town on Thursday, May 17 discovering what has made Chicago the home for blues music. The SAEM discounted price of $19.50 gets you in to two blues clubs, and two drinks.

No. of tickets _____ x $19.50 = $ _______ ❒ Option B: Cutting it up, Chicago Style Zanies Comedy Nightclub is located in the heart of Old Town, and is the oldest comedy club in Chicago. Headlining on May 17 will be Janes Johann, one of the three stars of the Slackers Tour, the latest national tour from the producers of “The Blue Collar Comedy Tour.” Admission is $22, with a two-drink minimum. Advanced tickets are required as shows sell out quickly.

No. of tickets _____ x $22.00 = $ _______ FUN RUN ❒ Run along Lake Michigan on Friday, May 18. The 5K run will start promptly at 6:15 a.m. The registration fee is $15 and includes a t-shirt, bottled water, and fruit. $15.00 WORKSHOPS AND SPECIAL SESSIONS Tuesday, May 15, 2007 (Day before the Annual Meeting)

❒ Intensive Grantsmanship Workshop

$100.00

(Limited enrollment; includes continental breakfast and lunch)

❒ AEM Consensus Conference

$100.00

(Includes lunch)

Thursday, May 17, 2007 ❒ Chief Resident Forum

$150.00

(Limited to 200 participants; must also register for the Annual Meeting; includes continental breakfast & lunch)

❒ Faculty Development Workshop

$0.00

(Registrations for consultation/small groups limited to first 25 participants who register and submit required material; no fee to attend; registration for lectures at the beginning of workshop not required)

Friday, May 18, 2007 ❒ E.D.S.T.A.T.!: ED Strategies for Teaching Evening Session

$0.00

(Limited to 50 participants; no fee to attend)

Saturday, May 19, 2007 ❒ Medical Student Symposium

$75.00

(Includes lunch with program directors and Residency Fair; Medical Students may attend only the Symposium without registering for the Annual Meeting)

Payment can be made by check (payable to SAEM in US Funds) or by credit card.

❒ CHECK ENCLOSED OR

CREDIT CARD INFORMATION ❒ MasterCard

❒ VISA

Amount $__________________ Card Number___________________________________ Exp. Date _______________ Name as it appears on card__________________________________ Signature________________________________ Credit Card Billing Zip _______________________________________________________________________________ Full refund of fees will be made if cancellation is received by April 20, 2007.

No refunds after May 3, 2007.

38

Chicago Guide (approximate distances from the Sheraton Hotel) Wyndham Downtown- 633 N. St. Clair (4 blocks) Fairfield Inn and Suites- 216 E. Ontario St. (4 blocks)

Banks Bank One- 605 N. Michigan Ave. (5 blocks) Citibank- 539 N. Michigan Ave. (4 blocks) Beauty Salons and Spas Mario Tricocci- 211 E. Ontario St. (5 blocks) Spa Mondial- 355 E. Grand Ave. (3 blocks)

Movie Theaters AMC River East 21- 322 E. Illinois St. (1 block) Pharmacies Walgreen’s- 342 E. Illinois Ave. (2 blocks) Walgreen’s (24 hour) 757 N. Michigan Ave. (3 miles)

Bowling Alley Lucky Strike Bowling Alley- 322 E. Illinois (1 block) Community Points of Interest Hancock Observatory- 875 N. Michigan Ave. (7 blocks) Museum of Contemporary Art220 E. Chicago St. (6 blocks) Navy Pier- 600 E. Grand Ave. (3 blocks)

Post Office/UPS Post office- 200 E. Ontario St. (5 blocks) UPS- 207 E. Ohio St. (4 blocks) Theaters Chicago Shakespeare Theater800 Grand Ave. (3 blocks) Lyric Opera of Chicago- 20 N. Wacker Dr. (4 blocks) HOT TIX- half price day of performance tickets (www.hotix.org)

Copy Center Kinko’s- 540 N. Michigan Ave. (inside Marriot Hotel) (3 blocks) Kwik Kopy- 500 N. Michigan Ave. (3 blocks) Family Fun Adler Planetarium - Best views in the city (2.2 miles) Art Institute of Chicago (5 blocks) Chicago Architecture Foundation River Cruise (5 blocks) Field Museum (2 miles) Mueseum of Science and Industry (7 miles) Shedd Aquarium (2 miles)

Wine and Liquor Store Uncork It! 393 E. Illinois Ave. (2 blocks) Restaurants http://chicago.menupages.com/restaurants. asp?neighborhoodid=107 Quick Lunch in the Neighborhood Chipotle- 291 E. Ontario St. Healthy eats Mexican food. $ (5 blocks) Ed DeBevic’s - 640 N. Wells St. (312-664-1707) Waitresses/waiters politely insult you and they like it if you can insult them back. It is set up like an oldfashioned downstate Illinois roadside diner. $ Gene and Georgetti’s Steak House - 500 N Franklin St (312- 527-3718) Chicago’s oldest Italian steakhouse. $$$$ Maggianos Little Italy (the original) - 516 N. Clark St. (E. Grand Ave.) (312-644-7700) $$ Nacional 27 - 325 West Huron (312-664-2727) Ceviche and tapas restaurant with live music and salsa dancing on weekends. $$ Pocket’s- 205 E. Ohio St. Lunch place with salads and sandwiches. $ (4 blocks)

Grocery Dominick’s- Full service grocery store with Starbucks inside. 255 E. Grand Ave. (1 block) Fox and Obel- Organic and natural food store. 401 E. Illinois St. (2 blocks) White Hen Pantry (convenience store)600 N. McClurg Court (4 blocks) Hotels Holiday Inn City Center- 300 E. Ohio St. (2 blocks) Embassy Suites Lakefront511 N. Columbus Dr. (2 blocks) W Hotel- 644 N. Lakeshore Dr. (6 blocks) Sheraton Chicago- 301 E. North Water Ct.

39

Potbelly Sandwich- 277 E. Ontario St. Quick lunch place with delicious sandwiches. $ (5 blocks) Tutto Pronto- 401 E. Ontario St. Great Italian deli. $ (4 blocks) West Egg Café- 620 N. Fairbanks Ct. Brunch place with excellent food. Duck into the bar area to avoid the lines) $$ (2 blocks)

Bars in the Neighborhood Timothy O’Tooles- 622 N. Fairbanks Whiskey Sky Lounge- 644 N. Lake Shore Dr. (bottom of W Hotel) Pops for Champagne- 601 N. State St. McFadden’s Restaurant & Saloon1206 N. State Pkwy. Irish pub with DJ and dancing on the weekends.

P.J. Clarke’s Restaurant and Bar- 302 E. Illinois

Dinner Chicago-Style Benihana- 166 E. Superior St. (312-664-9634) Japanese steakhouse with live grillmasters and family style seating. $$$ Bistro 110- 111 E. Pearson St. (312-266-3110) Loud, colorful French Bistro. $$$ Blue Agave- 1050 N. State St. (312-335-8900) Mexican food and fabulous margaritas and tequila bar. $$ Ditka’s- 100 E. Chestnut (312-587-8989)Da Coach’s place! Go bears!

Emilio’s Tapas- 215 E.Ohio (312-467-7177) Spanish tapas restaurant with great wine list. $$$ Gibson’s Steakhouse- 1028 N. Rush (312-266-8999)- Where athletes, politicians, and the who’s who of Chicago go to eat steak and talk “business.” $$$$ Hugo’s Frogbar- 1024 N. Rush (312-640-0999)- Sister restaurant to Gibson’s. Seafood and the scene. $$$$ India Garden- 247 E. Ontario (312-280-4910) Craving good Indian food close by, the place to go. $$$ Kamehachi- 240 E. Ontario (312-587-0600)- Japanese sushi, seafood and steak. One of the best in the city. $$$ Pizzeria Uno and Due- 29 E. Ohio St. (312-321-1000) Chicago style pizza originated here in the early 1900’s. $$ Reza’s Restaurant- 432 W. Ontario St. (312-664-4500) Amazing Middle Eastern food. $$ Shula’s Steakhouse (bottom floor of Sheraton) 301 E. North Water St. (312-670-0788) $$$$ Star of Siam- 11 E. Illinois Ave. (312-670-0100) Great Thai food for cheap! $ The Signature Room- 875 N. Michigan Ave (top of the John Hancock-888-2DINE-95)- Spectacular views of the city. Drinks are better than the food. $$$

Bar Specials: (subject to change) WednesdayDuffys- 420 W. Diversey Pkwy. (Lincoln Park) $1 Bud light bottles. Band playing 80’s/90’s music with dancing. No cover.

Durkin’s- 810 W. Diversey Pkwy. (Lincoln Park) 15 cent wings, $4 jagerbomb shots, $10 domestic buckets. Flippy cup tournament at 9pm. No cover.

Glascott’s- 2158 N. Halsted. (Lincoln Park) $2.50 Guiness, Harp and Bass.

Kincaide’s- 950 W. Armitage (Lincoln Park) $1 select bottles. Karaoke at 9pm.

ThursdayBar Celona- 3474 N. Clark (Wrigleyville) $2 sangrias, $2 Miller lite bottles, $3 cosmos Barleycorn- 2142 N. Clyborn (Lincoln Park) $2 Guiness, Jameson shots and domestic bottles Kerryman Irish Pub- 661 N. Clark (River West) $2 drafts. DJ and dancing.

McGee’s- 950 W. Webster (Lincoln Park) $1 domestic beers, $3 import beers. Live music and dancing.

Tin Lizzie- 2483 N. Clark St. (Lincoln Park) $2 domestic bottles.

Friday- (Cubs vs. White Sox @ Wrigley Field) Kendall’s- 2263 N. Lincoln (Lincoln Park) $2.50 bottles McFadden’s- 1206 N. State Pkwy. (Old Town) 5-7 pm happy hour. $10 all you can drink beer and wine. DJ and dancing.

Sedgewick’s- 1935 W. Sedgewick (Old Town) $3.50 Long Island 16 oz. Teas.

Timothy O’Tooles- 622 N. Fairbanks (Streeterville) $15 Sam Adams Lite buckets

Special thanks to Gary Gaddis, Chris Ross, and Comilla Sasson for their suggestions on this page.

40

SAEM Interest Group Meetings Wednesday, May 17, 2006 3:00-6:00 pm

Medical Student Educators, David Wald, DO, waldda@tuhs.temple.edu

Thursday, May 18, 2006 12:15-1:30 pm

Trauma, Bonny Baron, MD, bonny.baron@verizon.net

2:00-4:00 pm

Research Directors, Ed Panacek, MD, eapanacek@ucdavis.edu

3:00-4:30 pm

Mentoring Women, Susan Promes, MD, susan.promes@duke.edu

3:00-4:30 pm

Uniformed Services, Robert Gerhardt, MD, robert.gerhardt@us.army.mil

3:00-5:00 pm

Education Research, Chadwick Miller, MD, cmiller@wfubmc.edu

3:00-5:00 pm

International, Kris Arnold, MD, karnold@bu.edu

3:00-5:00 pm

Public Health, Steven Bernstein, MD, sbernste@montefiore.org

3:30-4:30 pm

Patient Safety, Karen Cosby, MD, kcosby@ccbh.org

Friday, May 19, 2006 8:00-10:00 am

Academic Informatics, L. Albert Villarin, MD, villaria@einstein.edu

8:30-10:00 am

Disaster, John McManus, MD, john.mcmanus@amedd.army.mil

12:00-1:15 pm

Geriatric, Manish Shah, MD, manish.shah@rochester.edu

12:00-1:30 am

Simulation, John Vozenilek, MD, simjockey@gmail.com

12:00-1:30 pm

Ethics, Rocky Schears, MD, MPH, schears.rocky@mayo.edu

12:15-1:30 pm

Clinical Directors, David Levine, MD, dlevine@ccbh.org

1:45-2:30 pm

Health Services and Outcomes Research, Shari Schabowski, MD, sschabowski@ccbh.org

2:00-4:00 pm

Ultrasound, Chris Moore, MD, cris.moore@yale.edu

Saturday, May 20, 2006 9:00-10:00 am

Toxicology, Bryan Judge, MD, bryan.judge@spectrum-health.org

5:30-6:30 pm

EMS, Christopher Kahn, MD, ckahn@uci.edu

S A E M

Society for Academic Emergency Medicine 901 N. Washington Ave. Lansing, MI 48906-5137 517-485-5484 517-485-0801 fax

PRSRT STD US POSTAGE PAID GRAND RAPIDS MI PERMIT # 1