13th Annual PEMC - Toronto 2016
Nov
2
to Nov 4

13th Annual PEMC - Toronto 2016

The Hospital for Sick Children's 13th Annual Paediatric Emergency Medicine Conference offers an engaging exchange of knowledge, ideas and innovations with expert faculty and evidence-based clinical applications to direct your practice. I think what makes our conference different is the level of engagement with faculty, the small group learning environment and hands-on practice of critical skills. This year, we are delighted to have three superb keynote speakers:

  • Dr. Damian Roland from University of Leicester in the UK, an international award winning speaker and innovator in use of social media and educational technology in the ED.
  • Dr. Allan de Caen from University of Alberta, Stollery Children's Hospital, an expert in management of critically ill children and a key contributor to the revised 2015 AHA guidelines for paediatric resuscitation.
  • Dr. Deborah Schonfeld from University of Toronto, SickKids leading in early recognition and management of sepsis in the ED.

We are also offering two hands-on pre-conference workshops: the inaugural Advanced Procedural and Resuscitation Skills in PEM, a competency-based workshop offering an opportunity to practice critical skills in paediatric emergency medicine in a simulated environment. As point-of-care ultrasound becomes more integral to emergency medicine, you can enhance your skills by participating in the Paediatric Ultrasound Workshop, which offers both beginner and intermediate training of specific paediatric ultrasound applications.

I look forward to meeting you November 2-4, 2016.

SUZAN SCHNEEWEISS MD, MEd, FRCPC
Chair, PEM Conference


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ACEP - Las Vegas 2016
Oct
16
to Oct 19

ACEP - Las Vegas 2016

Whether you’re a seasoned veteran or a brand new attendee, ACEP16 will be an experience like none other. You will find new ways to learn, new opportunities to network, and new reasons to build a solid foundation for our specialty. But there is one thing you can count on being the same – the best emergency medicine education in the world.
— http://www.acep.org/saContent.aspx?id=90968

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PAS - Baltimore 2016
Apr
30
to May 1

PAS - Baltimore 2016

The Paediatric Academic Societies (PAS) Annual Meeting is the largest international meeting focused on research in child health. We bring together a variety of groups to not only discuss original research, which has been the hallmark of the PAS meeting, but to also discuss how this research can be applied to actual clinical practice in paediatrics.
— https://www.pas-meeting.org/about-pas

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P2|Network - Baltimore 2016
Apr
29
8:00am 8:00am

P2|Network - Baltimore 2016

  • University of Maryland, Shock Trauma Auditorium (map)
  • Google Calendar ICS

All PEM POCUS enthusiasts are welcome!  This is an opportunity for us to share ideas in research, education and administration, and to advance and promote the practice of POCUS in PEM through collaboration and mentoring. This past year our network has grown in number of members and institutions, and our ties have strengthened. Join us this year as we continue towards our ultimate goal of the ubiquitous presence of POCUS in paediatric emergency departments. www.p2network.com


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AIUM Annual Conference - NYC 2016
Mar
17
to Mar 21

AIUM Annual Conference - NYC 2016

  • Los Vegas United States of America (map)
  • Google Calendar ICS
The American Institute of Ultrasound in Medicine is a multidisciplinary medical association of more than 9000 physicians, sonographers, scientists, students, and other health care providers. Established more than 50 years ago, the AIUM is dedicated to advancing the safe and effective use of ultrasound in medicine through professional and public education, research, development of guidelines, and accreditation.
— http://www.aium.org/annualConvention

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JC: Access in EDs, Trauma Training, & Whiteout Lung
Dec
9
10:00am10:00am

JC: Access in EDs, Trauma Training, & Whiteout Lung

This weeks readings:

AlEassa et al.  Point of care ultrasonography use and training among trauma providers across Canada. Can J Surg, 2015

  1. What surprised you about the training experience of surgeons vs. ER physicians?
  2. More ER physicians are certified however than surgeons. Why might there be a difference between training and certification?
  3. How can we reconcile training differences and certification?
  4. Do we need certification?
  5. Come up with your idea of the best and most feasible way for certification?
  6. Which is better? self tracking of accuracy or hospital wide QA?

Sanders et al. Access to and Use of Point-of-Care Ultrasound in the Emergency Department. West J Emerg Med. 2015;16(5):747-752.

  1. Small ED Directors prefer mail over email contact? what assumption would you make on their uptake of POCUS technology?
  2. Do you think the same barriers exist in Canada? in PEM?
  3. How can we overcome the biggest barriers- limited training, expense, limited need?
  4. Only 12% of EPs used PoC US ≥80% of the time to place central venous lines. What concerns you about this finding?
  5. What surprised you about the usage statistics?

Berant et al. Emergency Point-of-Care Ultrasound Assessment of Whiteout Lung in the Pediatric Emergency Department. Pediatr Emer Care 2015;31: 872–875

  1. Does this case series change how you might practice?
  2. What is the next step in research?

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PEM POCUS ANZ Meetup - Brisbane LCCH
Nov
27
10:00am10:00am

PEM POCUS ANZ Meetup - Brisbane LCCH

  • Lady Cilento Children’s Hospital (map)
  • Google Calendar ICS

Please note, date and time for this event are in Australian Eastern Standard Time (AEST)

This is an invitation to 

  • a Paediatric Emergency Point-of-care Ultrasound ANZ Network,
  • the PEM POCUS Leads Meetup in Brisbane on November 27 2015 (approximately 10-4)
  • a PEM POCUS monthly journal club/image review on the fourth Thursday of the month at 10 am AEST commencing in one month (October 22- linkup details to follow)

Our Mission

To support and further develop practice, training and research in point-of-care ultrasound within Paediatric Emergency Medicine in Australia and New Zealand
Co-chairs (interim) Robyn Brady (CCPU) LCCH Brisbane and Adam O'Brien (DDU forthcoming) RCH Melbourne

Sister organisation: P2Network http://www.p2network.com

The purposes of the November meet-up include: 

  • to form a formal ANZ PEM POCUS Special Interest Group
  • to share with other PEM POCUS leads and EM POCUS fore-runners on a wide range of topics including but not limited to:
  • political and funding battles, 
  • credentialing, audit and governance 
  • ultrasound integrated simulations, phantoms and manikins,
  • training methodology (sonographers, internal/external workshops etc) 
  • emerging ANZ POCUS research
  • and further discussion around the creation and shared supervision of a PEM CCPU module for ASUM.

Tanya Carleton, ASUM Education Manager, will be present to support/advise us on the 27th, and representatives from Sonosite and the Australian Institute of Ultrasound have also expressed an interest in attending/supporting. We are also inviting PEM Fellows and sonographers with a particular interest in point-of-care ultrasound to contribute and attend on the 27th. 
 
We welcome ideas of other ways this group could support PEM POCUS development in Australasia, and look forward to connecting with you through 4th Thursdays and online.

Kind regards,

Robyn Brady
Adam O'Brien


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JC: POCUS in Intraosseous Line Placements & Tropical Infectious Diseases
Nov
18
10:00am10:00am

JC: POCUS in Intraosseous Line Placements & Tropical Infectious Diseases

This weeks readings:

Saul, T. et al. The accuracy of sonographic confirmation of intraosseous line placement vs physical examination and syringe aspiration. http://dx.doi.org/10.1016/j.ajem.2014.12.034 [Attached]

Belard, S. et al. Review Article: Point-of-Care Ultrasound Assessment of Tropical Infectious Diseases—A Review of Applications and Perspectives. American Society of Tropical Medicine and Hygiene. [Attached] Please read only pages 1-12


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JC: POCUS Detecting Papilledema & Evaluating Pyogenic Flexor Tenosynovitis
Nov
11
10:00am10:00am

JC: POCUS Detecting Papilledema & Evaluating Pyogenic Flexor Tenosynovitis

This weeks readings:

Ben-Yakov M, Desjardins M-P, Fischer JWJ. Emergency Point-of-Care Ultrasound Detection of Papilledema in the Pediatric Emergency Department. Pediatr Emerg Care. 2015;31(11):766-770. [Attached]

Questions:

  1. What does the author mean when he states, "POCUS has the potential to aid in difficult diagnostic scenarios by contributing an additional piece of the clinical puzzle at the bedside to confirm a high pretest probability diagnosis and to expedite the appropriate patient care”?
  2. Is the author being too cautious?  Should this technique be used clinically?
 

Cohen SG, Beck SC. Point-of-Care Ultrasound in the Evaluation of Pyogenic Flexor Tenosynovitis. Pediatr Emerg Care. 2015;31(11):805-807. [Attached]

Questions:

  1. How did POCUS impact the care of this child?
  2. What are the limitations of assessing tendons with POCUS?
  3. Why is POCUS for the examination of MSK complaints not readily used in PEM?

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JC: POCUS to Measure Spleen + Economic Analysis of POCUS in Internal Medicine
Nov
4
10:00am10:00am

JC: POCUS to Measure Spleen + Economic Analysis of POCUS in Internal Medicine

This weeks readings:

Testa, A. et al. Economic analysis of bedside ultrasonography (US) implementation in an Internal Medicine department. Intern Emerg Med 2015. DOI 10.1007/s11739-015-1320-7

Arishenkoff et al. Spleen Measurement by Residents Using Hand-Carried Ultrasound. J Ultrasound Med 2015; 34:e71–e75. doi:10.7863/ultra.15.02022


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ACEP Scientific Assembly - Boston '15
Oct
26
to Oct 29

ACEP Scientific Assembly - Boston '15

  • Boston Convention & Exhibition Center (map)
  • Google Calendar ICS
Whether you’re a seasoned veteran or a brand new attendee, ACEP15 will be an experience like none other. You will find new ways to learn, new opportunities to network, and new reasons to build a solid foundation for our specialty. But there is one thing you can count on being the same – the best emergency medicine education in the world.
— http://www.acep.org/sa/

Ultrasound Offerings at ACEP15 

 

Monday


Advanced Bedside Echocardiography Lab

MO-6; MO-35 / 3 Hour

Faculty: J. Christian Fox, MD, RDMS, FACEP (Moderator)

Monday, 10/26/2015 / 8:00 AM - 10:50 AM; 12:30 PM - 3:20 PM

Focused cardiac ultrasound is an essential diagnostic test that emergency physicians should be comfortable performing at the bedside. This lab is designed for emergency physicians with a strong fundamental proficiency with EM bedside ultrasound who would like to improve their echocardiography skills. (This lab is limited to 30 participants.)


Critical Care Emergency Ultrasound

MO-22 / 1 Hour

Faculty: Cliff A. Rice, MD

Monday, 10/26/2015 / 12:30 PM - 1:20 PM

The practicing emergency physician needs to be able to utilize ultrasound effectively in the evaluation of the critically ill patient. The speaker will highlight the use of ultrasound to perform an EFAST scan, to dynamically monitor and measure the IVC in the setting of hypovolemic shock, and to detect pericardial effusion and perform ultrasound guided pericardiocentesis. (This course is a prerequisite to the “Critical Care Emergency Ultrasound Lab.”)


Musculoskeletal Ultrasound Scanning Lab

MO-2; MO-31; MO-60 / 2 Hour

Faculty: Charlotte Derr, MD, RDMS, FACEP (Moderator)

Monday, 10/26/2015 / 8:00 AM - 10:00 AM; 12:30 PM - 2:20 PM; 3:30 PM - 5:30 PM

This ultrasound lab will provide an introduction to common emergency department upper and lower extremity musculoskeletal pathologies that can be readily identified with bedside ultrasound. The participant will perform focused ultrasound examinations of the shoulder, hand, knee, hip, ankle and foot. This hands-on lab will provide the training in: foreign body identification, fracture & tendon injury evaluation, joint effusion and abscess identification. This lab will provide the experience participants need to easily integrate these skills into clinical practice. (Course limited to 25 participants)


Procedural Ultrasound

MO-13 / 1 Hour

Faculty: Arun Nagdev, MD

Monday, 10/26/2015 / 11:30 AM - 12:20 PM; 8:00 AM – 9:50 AM; 12:30

The use of ultrasound by emergency physicians to help perform procedures is becoming more frequent. Some of these may soon be considered standard of care and some are useful in selected situations. The speaker will discuss procedural applications for ultrasound that the emergency physician can easily incorporate into daily clinical practice. (This course is a prerequisite to the “Procedural Ultrasound Lab.”)


Saving the Child with Jelly on the Belly!

MO-59 / 1 Hour

Faculty: Russ Horowitz, MD, RDMS

Monday, 10/26/2015 / 3:30 PM - 4:20 PM

Both emergency ultrasound and pediatric emergency ultrasound are rapidly expanding! Multiple easy to learn applications now provide a quick look into the baby’s belly for the busy emergency physician. In this case based interactive review, the speaker will review the evidence behind pediatric emergency abdominal ultrasound applications including pyloric stenosis, intussusception and appendicitis. Additionally, the speaker will provide practical protocols, pearls and pitfalls, needed to put the probe on your pediatric patient pronto!


Venous US in the ED: DVT Skills Lab

MO-4; MO-33; MO-63 / 2 Hour

Faculty: John L. Kendall, MD, FACEP (Moderator)

Monday, 10/26/2015 / 8:00 AM - 10:00 AM; 12:30 PM - 2:20 PM; 3:30 PM - 5:30 PM

During this hands-on lab, participants will practice vascular access and identify the deep venous system in the legs. Compression-decompression ultrasonography will also be performed on healthy models. (This lab is limited to 30 participants.)


Tuesday


Bedside Echocardiography: When Seconds Count

TU-118 / 1 Hour

Faculty: J. Christian Fox, MD, RDMS, FACEP

Tuesday, 10/27/2015 / 10:00 AM - 10:50 AM

The bene­ ts of quick-look echocardiography during resuscitations are numerous and life-saving. Do you start fluids or vasopressors, defibrillate, continue chest compressions, or withhold care? All are options that would be facilitated by this important radiologic procedure. The speaker will present the most recent evidence supporting the use of bedside echocardiography during cardiac resuscitation, emphasizing the ability to distinguish between PEA with and without mechanical activity, and rapid assessment of cardiac output.


Critical Care Emergency Ultrasound Lab

TU-91; TU-140; TU-173 / 2 Hour

Faculty: Cliff A. Rice, MD (Moderator)

Tuesday, 10/27/2015 / 8:00 AM - 9:50 AM; 12:30 PM - 2:20 PM; 3:30 PM - 5:30 PM

The practicing emergency physician needs to be able to utilize ultrasound effectively in the evaluation of the critically ill patient. This hands-on practical lab will highlight the use of ultrasound to perform a EFAST scan, to dynamically monitor and measure the IVC in the setting of hypovolemic shock, and to detect pericardial effusion and perform ultrasound-guided pericardiocentesis. (Prior attendance in “Critical Care Emergency Ultrasound” is required. This lab is limited to 30 participants.)


Go With the Flow! Adding Doppler to Your Ultrasound Skill Set

TU-184 / 1 Hour

Faculty: David C. Pigott, MD, RDMS, FACEP

Tuesday, 10/27/2015 / 4:30 PM - 5:30 PM

Using Doppler in the ED can take your practice to the next level. The speaker will introduce participants to the various Doppler modes including color Doppler, power Doppler and spectral Doppler. Indications, limitations, and pearls will be highlighted. The course will also review the uses of Doppler ultrasound in the assessment of valvular function & diastolic heart failure, as well as biliary, gynecologic and testicular conditions. The speaker will incorporate case presentations where bedside ultrasound using Doppler imaging resulted in significant changes in clinical management or emergent interventions.


Wednesday


Advanced Pediatric Ultrasound Lab: Kids are Not Just Small Adults… Or Are They?

WE-204; WE-252; WE-283 / 2 Hour

Faculty: Stephanie J. Doniger, MD, RDMS, FAAP, FACEP (Moderator)

Wednesday, 10/28/2015 / 8:00 AM - 9:50 AM; 12:30 PM – 2:20 PM; 3:30 PM – 5:30 PM

General emergency medicine providers care for the majority of children in the United States in community hospitals. Point-of-care ultrasound has become the standard of care for adult emergency patients, but is only beginning to emerge in the care of pediatric patients. This lab will provide a hands-on experience that will provide the participants with an excellent foundation to perform pediatric ultrasound in their clinical practice.


Pelvic Ultrasound in the ED: Make the Diagnosis!

WE-282 / 1 Hour

Faculty: David C. Pigott, MD, RDMS, FACEP

Wednesday, 10/28/2015 / 3:30 PM - 4:20 PM

Bedside pelvic ultrasound has been shown to expedite patient care, reduce ED length of stay and improve patient satisfaction. This course will provide an introduction to pelvic ultrasound in the setting of first-trimester pregnancy as well as in the non-pregnant patient. The course will also review the basic techniques for performing transvaginal ultrasound, including the basics of probe orientation, pelvic anatomy and common pitfalls. The course will incorporate case presentations where bedside pelvic ultrasound resulted in significant changes in clinical management or emergent interventions in both pregnant and non-pregnant patients.


Procedural Ultrasound Lab

WE-207; WE-254; WE-285 / 2 Hour

Faculty: Arun Nagdev, MD (Moderator)

Wednesday, 10/28/2015 / 8:00 AM - 9:50 AM; 12:30 PM - 2:20 PM; 3:30 PM - 5:30 PM

The use of ultrasound by emergency physicians to help perform procedures is becoming more frequent. Some of these may soon be considered standard of care and some are useful in selected situations. This procedural lab will provide hands-on experience with practical EM ultrasound applications. (Prior attendance in “Procedural Ultrasound” is required. This lab is limited to 30 participants.)


Thursday


HOCUS POCUS: Ultrasound Cases that Will Open Your Eyes, Broaden Your Differentials, and Improve Your Practice

TH-340 / 1 Hour

Faculty: Tarina Lee Kang, MD, FACEP

Thursday, 10/29/2015 / 11:00 AM - 11:50 AM

Point-of-Care Ultrasound (POCUS) in EM is now a necessary component of our everyday practice, and its implications stretch far beyond knowing whether a FAST is positive. Using real case scenarios, learners will understand how to incorporate ultrasound into the workup of common patient complaints to confirm or change a presumed diagnosis, broaden differential diagnoses, streamline patient workup, and provide safer more effective care for patients in the ED. The learner will learn the technique for each study performed for each case with pearls on how to obtain optimal imaging quality.


Ten Fatal Imaging Myths That Should Change Your Practice

TH-310 / 1 Hour

Faculty: Andrew D. Perron, MD, FACEP

Thursday, 10/29/2015 / 8:00 AM - 8:50 AM

Diagnostic imaging is critical to many emergency department patients, but myths and misconceptions can result in potentially fatal misdiagnosis or delay. Does a chest x-ray really rule out free air, obstruction, or aortic dissection? Can a normal ovarian ultrasound rule out ovarian torsion? Using a case-based approach with audience participation, the speaker debunks these urban legends, teaching axioms, and myths. By the end of the lecture, you will be armed with the tools to change your practice and be better able to avoid these radiology pitfalls!


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American Academy of Pediatrics National Conference
Oct
24
to Oct 27

American Academy of Pediatrics National Conference

  • Walter E. Washington Convention Center (map)
  • Google Calendar ICS
The American Academy of Pediatrics (AAP) invites you to take part in a monumental experience October 24–27 in Washington, DC. Experience over 350 educational sessions including practical hands-on learning and networking in addition to the largest pediatric technical exhibit of its kind.
— http://www.aapexperience.org/

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WINFOCUS 2015
Oct
22
to Oct 25

WINFOCUS 2015

  • The Joseph B. Martin Conference Center (map)
  • Google Calendar ICS
We invite you to join us at the 11th WINFOCUS World Congress on Ultrasound in Emergency and Critical Care Conference that will be held in Boston, MA on October 22 - 25, 2015. World Interactive Network Focused On Critical Ultrasound (WINFOCUS) is the world’s leading scientific organization committed to developing point of care ultrasound practice, research, education, technology, and addressing the needs of patients, institutions, services, and communities in“critical” scenarios.
— http://www.winfocus2015.com/

Our doctors will be teaching and lecturing at WINFOCUS. Be sure to drop in. See the full list of presentations here.


Charisse Kwan

Research on Software to Measure Learning Curves


Mark Tessaro

Lung and Airway Assessment

Physics and Knobology:  How to Work the Machines


Jason W. Fischer

Decision Support Software and Emerging Technologies

Shock Assessment

Interactive "ABCD" Cases

Building Your POCUS Program


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JC: Accuracy of POCUS Thrombosis & Fluid Resuscitation Using IVC and Lung US
Oct
21
10:00am10:00am

JC: Accuracy of POCUS Thrombosis & Fluid Resuscitation Using IVC and Lung US

This weeks readings:

Lee CWC, et al, Development of a fluid resuscitation protocol using inferior vena cava and lung ultrasound, J Crit Care (2015), http://dx.doi.org/10.1016/j.jcrc.2015.09.016 

Li, S. et al. Diagnostic accuracy of point-of-care ultrasound for catheter-related thrombosis in children. Pediatr Radiol (2015) DOI 10.1007/s00247-015-3467-9


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JC: POCUS Learning Curve & Intestinal Foreign Bodies
Oct
14
10:00am10:00am

JC: POCUS Learning Curve & Intestinal Foreign Bodies

This weeks readings:

Chenkin et al. Defining the learning curve of point‑of‑care ultrasound for confirming endotracheal tube placement by emergency physicians. Crit Ultrasound J (2015) 7:14 DOI 10.1186/s13089-015-0031-7 [Attached]

Questions

  1. Describe the process of learning that is laid out in the article. What learning theory does this fall into.
  2. Does 10 correct interpretations mean that someone is proficient in image interpretation of Intubation placement ultrasounds? 
    • How would we this apply to other applications?
    • What would be the ideal method of determining this threshold number?
  3. How would a larger sample /threshold for proficiency have yielded different results (as mentioned in the discussion?)

Leibovich, S. and Doniger, S. The Use of Point-of-Care Ultrasound to Evaluate for Intestinal Foreign Bodies in the Pediatric Emergency Department. Pediatr Emer Care 2015;31: 731–734 [Attached]

Questions

  1. How were these cases influenced by the use of POCUS?
  2. How might we use POCUS to help us in the FB ingestion?
  3. What is the value of recognizing normal bowel?

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JC: Abdomen Trauma & PEEPS
Oct
7
10:00am10:00am

JC: Abdomen Trauma & PEEPS

This weeks readings:

O’Dochartaigh D, Douma M. Prehospital ultrasound of the abdomen and thorax changes trauma patient management: A systematic review. Injury (2015), http://dx.doi.org/10.1016/j.injury.2015.07.007  

Sundeep et al Prehospital Evaluation of Effusion, Pneumothorax, and Standstill (PEEPS): Point-of-care Ultrasound in Emergency Medical Services. West J Emerg Med. 2015;16(4):503-509


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HSC 12th Annual Paediatric Emergency Medicine Conference
Oct
1
to Oct 2

HSC 12th Annual Paediatric Emergency Medicine Conference

  • Peter Gilgan Centre for Research and Learning (map)
  • Google Calendar ICS

CONFERENCE HIGHLIGHTS 

Conference topics include: 

  • Dermatology, child abuse, paediatric septic shock, ECGs, difficult paediatric airway, toxicology, pain management and more!
  • Best papers in PEM
  • Quick hit sessions

Keynote speakers: 

  • Dr. James Holmes, UC Davis School of Medicine 
  • Dr. Garth Meckler, BC Children's Hospital
  • Dr. Suzanne Beno, The Hospital for Sick Children

PRECONFERENCE COURSES: 

  • Advanced Paediatric Procedural Sedation Course
  • Paediatric Emergency Ultrasound Workshop Novice 
  • Paediatric Emergency Ultrasound Workshop Intermediate

CONFERENCE LOCATION

Peter Gilgan Centre for Research and Learning
686 Bay Street, Toronto

Early Bird pricing ends September 14th! Be sure to register early as space is limited

For more information, contact Maggie Stevanovic at info.pem@sickkids.ca  


Welcome to the SickKids 12th Annual Paediatric Emergency Medicine Conference.
This year we are offering a variety of learning formats to meet your individual learning needs. From short quick hit lectures highlighting new and innovative practices to case-based breakouts and hands-on workshops, all our sessions are designed to bring you evidence-based practical information that you can apply in your own practice setting.
We are delighted to have three superb keynote speakers; Dr James Holmes from UC Davis Children’s Hospital in California, Dr. Garth Meckler from Vancouver Children’s Hospital in British Columbia and our very own Dr. Suzanne Beno from SickKids in Toronto.
We are also offering three hands-on preconference courses including the all new Advanced Paediatric Procedural Sedation Course highlighting key issues and best practices with hi-fidelity simulation cases to practice skills. In addition, as ultrasound becomes a key component of emergency medicine practice, we have added new hands-on beginner ultrasound course to address this need in the paediatric emergency setting. We will also be offering the intermediate level ultrasound course for those who are interested in increasing their paediatric ultrasound skills.
Finally our conference offers an engaging community with faculty who are always ready to answer your questions and international colleagues to develop networks.
I look forward to meeting you in October.

Suzan Schneeweiss MD, MEd, FRCPC


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Paediatric Emergency Ultrasound Workshop
Sep
30
8:00am 8:00am

Paediatric Emergency Ultrasound Workshop

  • Peter Gilgan Centre for Research and Learning (map)
  • Google Calendar ICS

Novice and Intermediate sessions

Maximum 24 participants each session

Location: Peter Gilgan Centre for Research and Learning

This innovative one day course offers novice and intermediate point-of-care ultrasound users the unique opportunity to learn PEM-specific applications from leading experts in the field. A novel case-based curriculum will provide practical, hands-on instruction designed to enhance patient care and maximize workflow in your ED.

Novice

  • Novice attendees will be introduced to knobology, soft tissue and PEM-specific applications such as soft tissue, skull, ocular, lung and hydration status. 

Intermediate

  • Intermediate attendees will be immersed in clinical scenarios which highlight PEM-specific applications such as optic nerve sheath, forearm nerve block, E-FAST, focused abdomen (intussusception, appendicitis, pyloric stenosis), and resuscitation.

Small group teaching and open-interactive sessions will deliver unparalleled access to international expertise during this state-of-the-art educational experience.

Course Directors:  Dr. Charisse Kwan and Dr. Mark Tessaro 

Breakfast is served at 8:00AM!


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JC: Femoral Osteomyelitis & U/S Training of Medical Students
Sep
23
10:00am10:00am

JC: Femoral Osteomyelitis & U/S Training of Medical Students

This weeks readings:

Hayden, G. E., Upshaw, J. E., Bailey, S., & Park, D. B. (2015). Ultrasound-Guided Diagnosis of Femoral Osteomyelitis and Abscess. Pediatric Emergency Care, 31(9), 670–673.  [Attached]

Questions

  1. How does the presence or absence of an effusion affect the likely diagnosis of a septic joint?
  2. If the subperiosteal collection was absent (which can be the case in osteomyelitis), how do you think POCUS would have affected this case?

Dinh, V. A., Dukes, W. S., Prigge, J., & Avila, M. (2015). Ultrasound Integration in Undergraduate Medical Education: Comparison of Ultrasound Proficiency Between Trained and Untrained Medical Students. Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine. [Attached]

Questions

  1. The year 3 and year 4 medical students were asked to participate voluntarily. How does this impact the results of this study?
  2. What do you think of the goal of the study?
  3. Does this make for meaningful medical educationresearch?
  4. What do you think of the conclusions they make?
  5. Do they prove the “importance of implementing this skill early on during a student’s medical education”?

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JC: Renal Colic & Urolithiasis
Sep
16
10:00am10:00am

JC: Renal Colic & Urolithiasis

This weeks readings:

Chandra A, et al, Point-of-care ultrasound in pediatric urolithiasis: an ED case series, Am J Emerg Med (2015), http://dx.doi.org/10.1016/j.ajem.2015.05.048 

C. Ng and J. W. Tsung AVOIDING COMPUTED TOMOGRAPHY SCANS BY USING POINT-OF-CARE ULTRASOUND WHEN EVALUATING SUSPECTED PEDIATRIC RENAL COLIC The Journal of Emergency Medicine, Vol. 49, No. 2, pp. 165–171, 2015

Questions:

  1. Would you feel comfortable using POCUS as the only imaging test if it revealed hydronephrosis on the side of pain? Why or why not?
  2. Is probe orientation in the transverse view an essential component of this scan? Why or why not?
  3. Are you surprised that the 3 year old with a 1cm stone received no further imaging? Why or why not?
  4. In one of the papers, CT was avoided in all patients. In the other, it was obtained in all patients. Why the difference?
  5. Bonus question: Why are patients with IBD predisposed to urolithiasis?
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JC: VTU & RUSH + M-Mode
Sep
9
10:00am10:00am

JC: VTU & RUSH + M-Mode

This weeks readings:

Blanco et al. Rapid Ultrasound in Shock Velocity-Time Integral. J Ultrasound Med 2015; 34:1691–1700

Questions:

  1. What clinical advantage do the authors suggest is gained by adding VTI to the RUSH protocol?  Are you convinced?
  2. What technical challenges must the operator overcome to insure accuracy of the VTI measurement?
  3. Do you believe this technique could be modified for use in pediatric patients presenting with shock?

 

Saul, T et al. M-MODE ULTRASOUND APPLICATIONS FOR THE EMERGENCY MEDICINE PHYSICIAN. J of Emerg Med 2015; 1-7

Questions:

  1. Did you know M-mode could be so “icepick” cool?
  2. Should EPSS replace our qualitative assessment of LV function as the best way to determine and report LV disfunction?
  3. Describe how M-mode is used to determine cardiac tamponade.
  4. Should M-mode be used routinely by EM providers in the assessment of pediatric patients with possible HCM?

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2nd City-Wide Multidisciplinary Acute Care Ultrasound Rounds
Sep
8
5:00pm 5:00pm

2nd City-Wide Multidisciplinary Acute Care Ultrasound Rounds

After an extremely successful first meeting, we are getting together again! - Anesthesiologists, Emergency Physicians, Intensivists, Internists, and Pediatricians who apply point-of-care ultrasound in the diagnosis and treatment of patients in the acute care setting. This meeting uses a case-based format to facilitate multidisciplinary discussions on the utility of ultrasound in acute care medicine and offers attendees unique exposure to new techniques and applications used by colleagues in other specialties.  Plus, we get to share cool cases and amazing images!  Join us for a great evening of  interdisciplinary discussion and collaboration.   All are welcome!

17:00 - Welcome
17:05 - St. Mike's EM
17:20 - Sunnybrook Internal Medicine
17:35 - UHN EM
17:50 - Intermission
18:00 - UHN Critical Care
18:15 - Sunnybrook EM
18:30 - UHN Anesthesia
18:45 - SickKids PEM
19:00 Post-meeting social


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JC: POCUS & The Intracranial
Sep
2
10:00am10:00am

JC: POCUS & The Intracranial

This weeks readings:

McCormick et al. Point-of-Care Ultrasound for the Detection of Traumatic Intracranial Hemorrhage in Infants A Pilot Study Pediatr Emer Care 2015;00: 00–00

Questions:

  1. What problems are posed by separating the acquisition of POCUS images from their interpretation? Does this also occur with radiology department imaging?
  2. Would you feel comfortable using this test to rule-out ICH? To rule-in ICH? How would you see yourself improving patient care with this POCUS application in practice?
  3. How would you design the next study on this topic? How would you make it both accurate and feasible?

 

Choi et al. Optic nerve sheath diameter in hydrocephalus surgery. Anaesthesia 2015. doi:10.1111/anae.13180

Questions:

  1. I’m an emergency doctor, not a neurosurgeon! How does this study affect me?
  2. What do you think of the image quality and measurements illustrated in the figures?
  3. What do you think of the decision not to analyze data from children whose operations failed?
  4. Are you satisfied with the data being presented as a mean?
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JC: Predicting Outcomes + Resuscitation
Aug
26
10:00am10:00am

JC: Predicting Outcomes + Resuscitation

This weeks readings:

Inaba K, Chouliaras K, Zakaluzny S, et al. FAST Ultrasound Examination as a Predictor of Outcomes After Resuscitative Thoracotomy. Annals of Surgery 2015;262(3):512–8. 

Questions:

  1. "All were penetrating thoracic injuries with a pericardial effusion on FAST and all were emergently brought to the operating room for a planned sternotomy and were ,therefore, excluded from the study." How do you think this affected the primary outcome?
  2. The authors conclude that identification of pericardial fluid can prevent unnecessary thoracotomies, saving resources and potential risks to the practitioners.
  3. What is the actual resource burden and risk to the practitioner
  4. Can you think of any benefits to performing thoracotamies despite the low survival rate of the patient?
  5. How might this apply to the paediatric population?

Adedipe, A. A., Fly, D. L., Schwitz, S. D., Jorgenson, D. B., Duric, H., Sayre, M. R., & Nichol, G. (2015). Resuscitation. Resuscitation, 1–5. http://doi.org/10.1016/j.resuscitation.2015.07.024  

Questions:

  1. Why do you think they chose to record only for 5 mins?
  2. Is there value in checking carotid flow for longer? or for other parts of the CPR cycle?
  3. The authors describe some patient populations where carotid flow might not be feasible.
  4. What limitations might there be in traumatic arrests?
  5. What about the paediatric arrests?
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JC: Pediatric Shock + Detecting Cancer
Aug
19
10:00am10:00am

JC: Pediatric Shock + Detecting Cancer

This weeks readings:

Park DB, Presley BC, Cook T, Hayden GE. Point-of-Care Ultrasound for Pediatric Shock. Pediatr Emerg Care. 2015;31(8):591-598. 

Questions:

  1. Does this article meet its CME objectives?
  2. Did this article just make POCUS a “standard of care” for PEM providers managing a patient in shock? Why or why not?    

 

Jamjoom RS, Etoom Y, Solano T, Desjardins M-P, Fischer JW. Emergency Point-of-Care Ultrasound Detection of Cancer in the Pediatric Emergency Department. Pediatr Emerg Care. 2015;31(8):602-604.  

Questions:

  1. Does more nuanced, less conventional POCUS practice make you nervous or excited?
  2. How do you respond to this critique: “These patients would have received their gold-standard tests regardless of the POCUS”?
  3. Are these authors from the future?
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JC: Pneumomediastinum + Coronal Axis Measurement of ONSD
Aug
12
10:00am10:00am

JC: Pneumomediastinum + Coronal Axis Measurement of ONSD

This weeks readings:

Saracino, C. and Tessaro M., Pneumomediastinum as a Sonographic Mimic of Pneumothorax. J Ultrasound Med 2015; 34:1515–1522 

Questions to Consider:

  1. Would you feel comfortable discharging a stable pneumomediastinum patient home after ultrasound diagnosis? What about if the clinical exam alone suggested pneumomediastinum?
  2. What patients would this exam be difficult on?
  3. What other body parts might show sonographic evidence of pneumomediastinum?
  4. What scenarios can mimic pneumomediastinum on x-ray? It’s kind of a trick question….

Amini et al—Coronal Axis Measurement of the Optic Nerve Sheath Diameter. Ultrasound Med 2015; 34:1607–1612 

Questions to Consider:

  1. What is the "cylinder tangent effect" as it pertains to ultrasound? Discuss how the visual axis approach and the infraorbital approach differ in their ability to ensure the cylinder of the optic nerve is in plane with the ultrasound beam.
  2. In this healthy volunteer study, the infraorbital approach produced measurements in agreement with the visual axis approach. Do you think this would also be true in patients with increased ONSD?
  3. What issues could arise in EM clinical practice regarding the head and eye positioning described for the infraorbital approach?
  4. What problem could exist in using the infraorbital technique serially (eg to assess response to therapy, or worsening ICP from baseline)?
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JC: The Phantom Menace + POCUS in Rural Nicaragua
Jul
29
10:00am10:00am

JC: The Phantom Menace + POCUS in Rural Nicaragua

This weeks readings:

Soucy ZP, Mills L, Rose JS, Kelley K, Ramirez F, Kuppermann N. Creation of a High-fidelity, Low-cost Pediatric Skull Fracture Ultrasound Phantom. J Ultrasound Med. 2015;34(8):1473-1478. doi:10.7863/ultra.34.8.1473. [Attached]

Questions to Consider:

  1. What are the essential elements of a good POCUS phantom?
  2. Are "Do-It-Yourself” phantoms really low-cost?
  3. How much impact do you think this skull fracture phantom will have on operator performance? 
  4. What other applications would benefit from a phantom to improve hands-on learning?
 

Kolbe N, Killu K, Coba V, et al. Point of care ultrasound (POCUS) telemedicine project in rural Nicaragua and its impact on patient management. Journal of Ultrasound …. April 2015:1-7. doi:10.1007/s40477-014-0126-1. [Attached]

Questions to Consider:

  1. Is this a feasible model for POCUS deployment in resource-limited settings?
  2. Are there hidden costs to this model?
  3. How would you improve this model?
  4. Are you impressed with the clinical impact of POCUS in this study?
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