Past Congresses

2012: Antalya, Turkey

Antalya, Turkey from 3-6 october 2012

venueEuSEM 2012 took place at the Congress Centre within the Susesi Luxury Resort. The Susesi is a five-star 550-room hotel in Belek with all the services and amenities you could wish for - restaurants, bars, sports and spa facilities.

Antalya is one of the main seaside resorts in Turkey with 300 days of sunshine per year. Created in the 2nd century BC, the city of Antalya has been occupied by many civilisations (Romans, Byzantines ...). The old town (Kaleiçi) is particularly attractive with its lanes, old houses and ramparts. The old town is surrounded by the modern one.

The Susesi Luxury Resort is situated 35 km from the airport. 

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Pre-course: ED Administration

Tuesday 2 October 2012: 8:30 - 17:30

Course Director

  • Philip Anderson (USA)
  • Nathalie Flacke (France)

Faculty

  • Philip Anderson (USA)
  • Stephanie Kayden (USA)
  • Robert Freitas (USA)
  • Nathalie Flacke (France)

Participants

25 physicians maximum. 
The course shall be cancelled if less than 8 participants are registered. 

Course description

Performance and Quality Improvement are among the central administrative challenges facing Emergency Department leaders in all countries. Through a series of lectures and workshops facilitated by experienced faculty, course participants will learn practical approaches for improving performance and quality in their emergency departments.  Participants will work together in small groups on concrete problem solving projects designed to produce concrete tools and strategies that can be implemented in the participants’ home institution.  

This course is being organized by the International Emergency Department Leadership Institute (IEDLI) www.iedli.org 
 

Learning objectives

At the completion of the course, participants will be able: 

• To describe the main theories of change in organizations and discuss strategies for implementing change in Emergency Departments, with a particular focus on implementing quality improvement initiatives
• To define quality as it relates to care delivery in the emergency department and discuss key metrics and performance indicators for measuring quality
• To discuss the difference between practice guidelines and clinical pathways and identify the key elements of clinical pathways that increase likelihood for success
• To describe the key elements of risk management strategies for responding to errors and adverse events in the emergency department.  

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Programme overview

Monday, 1 October 2012 - PRE-COURSES
Room IZMIR 2 Room KASTAMONU      
08:00-18:00
Disaster Medicine
08:30-17:30
Non-Invasive Ventilation
     
         
Room RIZE Room ANTALYA 1 Room ANTALYA 2 Room BIGA Room MARDIN
08:30-17:30
Advanced Pediatric Emergency Care (APEC)
part 1
08:40-17:00
EM Ultrasound - Beginner

part 1
08:30-18:00
EM Ultrasound - Advanced

part 1
08:30-17:00
Simulation

part 1
08:30-17:00
Research

part 1
Tuesday, 2 October 2012 - PRE-COURSES
Room IZMIR 1 Room IZMIR 2      
08:30-17:00
Fluids, Electrolytes and Acid-Base Disorders
08:30-17:00
Administration
     
         
Room RIZE Room ANTALYA 1 Room ANTALYA 2 Room BIGA Room MARDIN
08:30-17:30
Advanced Pediatric Emergency Care (APEC)
part 2
09:00-16:30
EM Ultrasound - Beginner

part 2
08:30-18:00
EM Ultrasound - Advanced

part 2
08:30-17:00
Simulation

part 2
08:30-17:00
Research

part 2
 
Wednesday, 3 October 2012
Room ISTANBUL 1 ISTANBUL 2 IZMIR 1+2 ANTALYA 1 ANTALYA 2 ISTANBUL 3 MARDIN KASTAMONU
TRACK A TRACK B TRACK C TRACK D TRACK E TRACK F TRACK G
  STATE OF THE ART CLINICAL QUESTIONS ORGANISATIONAL ASPECTS EuSEM meets... Track in Turkish  Free papers Free papers
14:00-15:30 A11 - Pre-Hospital EM I B11 - Toxicologic Emergencies II C11 - How to make Protocols? D11 - ...the Simulation Experts E11 - How to treat shock? F11 - Free Papers: Other 1 G11 - Free Papers: Other 2
15:30-17:00

WEINMANN Symposium

ABBOTT Symposium

18:30-20:30 Welcome Ceremony - Herman Delooz Lecture
Tony Redmond: "From Emergency Medicine to Disaster Medicine"
             
 
  Welcome cocktail
» Olympic Pool Ground
             
Thursday, 4 October 2012
Room ISTANBUL 1 ISTANBUL 2 IZMIR 1+2 ANTALYA 1+2  ISTANBUL 3 MARDIN KASTAMONU
TRACK A TRACK B TRACK C TRACK D TRACK E TRACK F TRACK G
  STATE OF THE ART CLINICAL QUESTIONS ORGANISATIONAL ASPECTS EuSEM meets... Track in Turkish Free Papers Free Papers
09:00-10:30 A21 - Toxicologic Emergencies I B21 - Ultrasound in EM C21 - Disaster Medicine I D21 - ...the Young EM Doctors: Proposals for Research Opportunities E21 - Pharmaceutical Side Effects F21 - Free Papers: Life Support 1 G21 - Free Papers: Toxicology
10:40-11:30 Plenary Lecture I
Maareet Castren: "History of Life Support Care in Europe"
             
11:30-12:00 Coffee Break - Visit the Exhibition & the Poster area (Posters with even final numbers. P002, P004...)
12:00-13:30 A22 - Paediatric Emergencies I B22 - Management of Sepsis in the ED C22 - Disaster Medicine II D22 - ...the Society for Academic Emergency Medicine E22 - Regional Toxicological Emergencies F22 - Free Papers: Life Support 2 G22 - Free Papers: Imaging
13:30-14:30 Lunch Break - Visit the Exhibition & the Poster area
14:30-16:00 A23 - The Critical Patient in the ED B23 - Paediatric Emergencies II C23 - Observational EM D23 - ...the European Resuscitation Council E23 - Unrelieved Pain / Abdominal Pain F23 - Free Papers: Disaster Medicine 1 G23 - Free Papers: Infectious Disease/Sepsis
16:00-16:30 Coffee Break - Visit the Exhibition & the Poster area  (Posters with odd final numbers. P001, P003...)
16:30-18:00 A24 - Bleeding and Coagulation B24 - Respiratory Emergencies C24 - Improving Patient Flow in the ED D24 - ...the European Society of Toxicology E24 - ED Management F24 - Free Papers: Disaster Medicine 2 G24 - Free Papers: Traumatology 1
 
19:30-00:30 Congress Dinner
» Susesi Hotel - Football Ground
 
Friday, 5 October 2012
Room ISTANBUL 1 ISTANBUL 2 IZMIR 1+2 ANTALYA 1+2  ISTANBUL 3 MARDIN KASTAMONU
TRACK A TRACK B TRACK C TRACK D TRACK E TRACK F TRACK G
  STATE OF THE ART CLINICAL QUESTIONS ORGANISATIONAL ASPECTS EuSEM meets... Track in Turkish Free Papers Free Papers
09:00-10:30 A31 - Trauma I B31 - Environmental Emergencies C31 - ED & Budgetting D31 - ...Researchers E31 - Infection Emergencies F31 - Free Papers: Administration & Management G31 - Free Papers: Biomarkers 1
10:40-11:30 Plenary Lecture II
Guillaume Alinier: "Simulation is becoming a reality! An overview of high level initiatives from around the world"
             
11:30-12:00 Coffee Break - Visit the Exhibition & the Poster area  (Posters with even final numbers. P498, P500...)
12:00-13:30 A32 - Ethics in EM B32 - Trauma II C32 - Patient Safety in EM D32 - ...the Editors of Emergency Medicine Journals E32 - Key Points in ED Imaging F32 - Free Papers: Cardiovascular 1 G32 - Free Papers: Biomarkers 2
13:30-14:30 Lunch Break - Visit the Exhibition & the Poster area (Posters with odd final numbers. P499, P501...)
14:30-16:00 A33 - Cardiovascular Emergencies I B33 - Pre-hospital EM II C33 - Standards of Quality in EM D33 - ...the Young EM Doctors: Proposals for Training in EM in Europe E33 - Updates on Cardiac Emergencies F33 - Free Papers: Education & Training G33 - Free Papers: Traumatology 2
16:00-16:30 Coffee Break - Visit the Exhibition & the Poster area
16:30-18:00 A34 - Medical Imaging in EM B34 - History of EM C34 - Informatics & Technology in EM D34 - ...the European Master of Disaster Medicine (EMDM) E34 - Updates on Burn Management F34 - Free Papers: Cardiovascular 2 G34 - Free Papers: Management & ED Organisation
Saturday, 6 October 2012
Room ISTANBUL 1 ISTANBUL 2 IZMIR 1+2 ANTALYA 1+2 ISTANBUL 3
TRACK A TRACK B TRACK C TRACK D TRACK E
  STATE OF THE ART CLINICAL QUESTIONS ORGANISATIONAL ASPECTS EuSEM meets... Track in Turkish
09:00-10:30 A41 - Neurologic Emergencies B41 - Cardiovascular Emergencies II C41 - Education & Training in EM D41 - ...the Emergency Medicine National Societies E41 - Neurological Emergencies
10:40-11:30 Best Papers Session & Awards        
11:30-12:00 Coffee Break - Visit the Exhibition
12:00-13:30 A42 - Metabolic Emergencies B42 - Clinical Cases, organised by the YEMD SECTION C42 - Communication in EM D42 - ...the Emergency Medicine National Societies E42 - Earthquake
13:30-14:00 Closing of the meeting            

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Pre-Courses

Administration

1 day

Performance and Quality Improvement are among the central administrative challenges facing Emergency Department leaders in all countries. Through a series of lectures and workshops facilitated by experienced faculty, course participants will learn practical approaches for improving performance and quality in their emergency departments.  

More details

Disaster Medicine

1 day

I SEE RICELAND: A SIMULATION GAME FOR EXTRA AND IN-HOSPITAL PREPAREDNESS AND RESPONSE TO DISASTERS 
In two Phases: Distance learning Course & On site Course 

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Fluids, Electrolytes and Acid-Base Disorders

1 day

The course is based on the basics of applied physiopatology to explain the main acid-base and electrolytes clinical disturbances. The didactic strategy is aimed to actively involve the audience in making diagnosis on a huge number of "real life" clinical cases.

More details

Non-Invasive Ventilation

1 day

The course will give an overview of the pathophysiological basis, rational limits and objectives of the use on Non Invasive Ventilation in the ED. It will present also the different types of NIV, the ventilators and interfaces, and how to treat patients through different clinical scenarios that will be presented in the hands-on part of the course. 

More details

Advanced Pediatric Emergency Care (APEC)

2 days

The objective is to provide physicians participating in the course with both knowledge and advanced skills in recognizing and managing a wide spectrum of paediatric emergencies including trauma, both in the hospital and pre-hospital settings.

More details

Emergency Medicine Ultrasound - Beginner 

2 days

Emergency ultrasound introductory course: lectures, organ-based hands-on practice, problem-oriented ultrasonography. 

More details

Emergency Medicine Ultrasound - Advanced

2 days

Emergency ultrasound advanced course: lectures, organ based hands-on practice, simulated clinical scenarios.

More details

Research

2 days

Following the Pre-Course Program Research fundaments in Emergency Medicine the participant will be involved in all the aspects related to research projects. The program is based on a real case study with the final objective of manuscript generation following step after step all the aspects of a research project, from the design to the final publication strategy. 

More details

Simulation

2 days

Simulation is a technique to replace or amplify real-patient experiences with guided experiences, artificially contrived, that evokes or replicates substantial aspects of the real world in a fully interactive manner. 

More details

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Keynote Speakers

Professor A D Redmond OBE
A.D. Redmond

WEDNESDAY, 3 OCTOBER 2012 18:30 - 20:30 ROOM Istanbul I
PLENARY SESSION WELCOME CEREMONY - HERMAN DELOOZ LECTURE       

From Emergency Medicine to Disaster Medicine

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professor Maaret Castrén

Maaret CastrenTHURSDAY, 4 OCTOBER 2012 10:40 - 11:30 Room Istanbul 1
PLENARY SESSION 

History of Life Support Care in Europe

More info...

PROFESSOR Guillaume Alinier

Guillaume AlinierFRIDAY, 5 OCTOBER 2012 10:40 - 11:30 Room Istanbul 1
PLENARY SESSION

Simulation is becoming a reality! An overview of high level initiatives from around the world

More info...

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Pre-course: Disaster Medicine

Monday 1 October 2012: 8:00 - 18:00

Course Directors

  • Francesco Della Corte, Novara, Italy
  • Steve Photiou, Padova, Italy Faculty
  • Francesco Della Corte, Novara, Italy
  • Ives Hubloue, Brussels, Belgium
  • Kristi Koenig, Irvine, CA, USA
  • PL Ingrassia, Novara, Italy
  • Steve Photiou, Padova, Italy
  • Abdo Khoury, Besançon, France

Participants

 25 physicians maximum.
 The course shall be cancelled if less than 15 participants are registered.

Learning objectives

How to implement a hospital plan to face the contemporary arrival to the Emergency Department of a large number of patients after mass casualties/disasters. Applicants must have basic competence in health care or health management. Practical experience in disaster preparedness or management is welcome.
 

Proposed schedule

The course will be organised in two phases: 

  • distance learning phase on a specific website for 15 days before the course
  • an on-site course of one (and half?) day before the 7th ECEM.

The “I SEE RICELAND” course has an innovative format making use of specific  application of multimedia and interactive simulation tools for prehospital and inhospital preparedness and response in mass casualties incidents and disasters. 

Frontal lectures and Workshops will deal with “Risk analysis” – “Command, control, coordination” – “Pre and In Hospital Triage” – “In Hospital areas definition and treatment pathways” – “Surge Capacity”

Lessons to be read before starting the course

  1. Introduction to Disaster Medicine
  2. Risk analysis
  3. Triage
  4. Expected pathologies in Disasters
  5. Prehospital preparedness
  6. Hospital Disaster Preparedness: general principles
  7. Surge capacity 
  8. Hospital Emergency Incident Command system
  9. Hospital preparedness to nuclear disasters 
  10. Hospital preparedness to bioterrorism
  11.  Hospital preparedness to chemical accidents

 

08:00 Registration of participants.
08:15 General principles of Hospital Preparedness – F. Della Corte
09:00 Risk analysis workshop – PL Ingrassia.
10:00 Principles of prehospital organisation in MCI – A. Khoury
10:45 Coffee break.
11:00 Exercise on triage – S. Photiou.
12:00 Surge capacity: concept and application to MCI emergencies – K. Koenig.
12:30 The chain of command – PL Ingrassia.
13:00 Lunch break.
14:00 Introduction to simulation exercise.
15:00 Simulation exercise : ISEE - Wiljan Van Norel.
17:30 Discussion and Conclusion.
18:00 End of course.

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Pre-course: Fluids, Electrolytes and Acid-Base Disorders

Tuesday 2 October 2018: 8:30 - 17:00

Course Director

  • Fernando SchiraldiItaly

Faculty

  • Fernando SchiraldiItaly
  • Giovanna GuiottoItaly

Participants

The course could be of interest for nephrologists, emergency physicians, intensivists, anestesiologists and nurses in these specialties.

Course description

The course is based on the basics of applied physiopatology to explain the main acid-base and electrolytes clinical disturbances. The didactic strategy is aimed to actively involve the audience in making diagnosis on a huge number of "real life" clinical cases.

A small electronic library will be at the disposal of participants, so that they can copy some of the best papers about the subject on USB keys.

Learning objectives

To provide a simple  diagnostic approach and get the audience confident on the therapeutic priorities.

Proposed schedule

08:30 Introduction
08:45 Applied physiopathology of acid-base disorders: simple & mixed disorders, the expected compensation, diagnostic strategies, gaps vs BE
10:30 Brainstorming on simple disorders
11:00 Coffee Break
11:30 Interactive clinical cases discussion
12:15 The hypoxic patient : diagnostic secrets (P/F ratio, Alveolar-arterial gradients..) and interactive clinical cases discussion
13:15 Lunch Break
14:15 Metabolic microparameters useful in the monitoring of the critically ill patients: ScvO2, OER, PCO2 gradients, lactate trends interpretation
15:00 Therapeutic controversies 
15:30 Acute dyselectrolytemias (Na, K, Mg, Ca) and fluids disorders
16:30 Discussion
16:45 Final Overview & MCQ evaluation test
17:00 MCQ evaluation test

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Pre-course: Basics on Non-Invasive Ventilation

Monday 1 October 2012: 8:30 - 17:30

Course Director

  • Roberta Petrino, Director Emergency Medicine Unit, Ospedale S. Andrea, Vercelli, Italy
    EuSEM Vice-President

Faculty

  • Paolo Groff, Director Emergency Department, San Benedetto del Tronto, Italy
  • Roberto Cosentini, Director Non Invasive Ventilation group, Policlinico Mangiagalli & Regina Elena, Milano  Italy 
  • Roberta Marino, Emergency Medicine Unit, Ospedale S. Andrea, Vercelli,  Italy

Participants

30 physicians maximum. 
The course shall be cancelled if less than 12 participants are registered. 

Course description

 The course will give an overview of the pathophysiological basis, rational limits and objectives of the use on Non Invasive Ventilation in the ED. It will present also the different types of NIV, the ventilators and interfaces, and how to treat patients through different clinical scenarios that will be presented in the hands-on part of the course. 

The format of the course will be: a few frontal lectures with interaction between teacher and audience, and a full afternoon spent on practical exercise on ventilators, interfaces, and clinical simulated scenarios. 

Learning objectives

 Upon completion of this course participants will be able to:

  • understand pathophysiology of  acute hypoxaemic and hypercapnic respiratory failure and the rationale of applying a positive pressure non invasive ventilation as early treatment in the ED
  • know goals, indications and limits of non invasive ventilation 
  • understand mechanism of action of  C-PAP and PEEP and know the principal modalities of ventilation, and their use in several pathological conditions frequently encountered in the emergency setting
  • know how a ventilator is made, it’s function and setting and the different interfaces to the patient

Proposed schedule

08:30 Pathophysiology of respiratory failure - hypoxemia and hypercapnia.
09:15 Pathophisiology of respiratory failure - respiratory mechanics, PEEPi, motion equation,WOB.
10:15 Goals and limits of Non Invasive Mechanical Ventilation.
10:45 Coffee break
11:00 PEEP and C-PAP: Mechanism of action, indications and contra-indications.
11:45 Ventilation modalities and indications.
12:30 Setting the ventilator
13:00 Lunch break
14:00 Monitoring during NIV.
14:30 Interfaces: masks, helmets and accessories.
15:00 Clinical case discussion with practical demonstration – (the students will be divided in 3 groups rotating in 3  40 minutes skill station)  (All faculty)
  • Acute cardiogenic pulmonary oedema
  • COPD exacerbation  
  • Hypoxemic respiratory failure (pneumonia, ARDS)
17:00 Multiple choice questions
17:30 End of course

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Pre-course: Advanced Pediatric Emergency Care (APEC)

Monday 1 October 2012: 08:30 - 17:30

Tuesday 2 October 2012: 08:30 - 17:30

Course Director

  • Yehezkel (Hezi) Waisman, Israel
  • Javier Benito, Spain

Faculty 

  • Patrick Van de Voorde, Belgium
  • Nadeem Qureshi, Saudi Arabia
  • Said H-Idrissi, Belgium

Participants

The course is designed for 30 participants (skill stations and case scenarios will be conducted in small groups).  More specifically, it is designed for PEM Physicians, Paediatricans, and Emergency Physicians who provide care for children in emergencies and who want to refine their knowledge and skills in PEM.  

Course description & learning objectives

Background: The APEC course is a development of the Paediatric Section at EuSEM, and will be conducted by its faculty members. At the end of the course participants will be presented with certificates of course completion by EuSEM.

Objectives: To provide physicians participating in the course with both knowledge and advanced skills in recognizing and managing a wide spectrum of paediatric emergencies including trauma, both in the hospital and pre-hospital settings.

General Outline: A two-day course.  
During the morning hours of both days, lectures will be presented on the management of a wide spectrum of paediatric emergencies (including trauma) with emphasis on evidence-based literature. During the afternoon hours of day 1, students will actively participate (hands-on) in advanced skill stations designed to provide knowledge and skills relevant to paediatric emergency medicine. During the afternoon of day 2, students will participate in small group discussions / cases simulations designed to elicit discussion on the clinical management of common paediatric emergencies including trauma. 

A full course agenda is provided below.  

Schedule

DAY 1    
     
08:30 Introduction to the APEC course Faculty
08:45 Lecture: An Approach to the Seriously Ill Infant and Child Prof. Said Idrissi
09:15 Lecture: Principles of Pediatric Triage Prof. Yehezkel Waisman
09:45 Lecture: Respiratory Emergencies Dr. Patrick Van de Voorde
10:30 Coffee break 
11:00 Lecture: Status Epilepticus (SE) Dr. Nadeem Qureshi
11:45 Lecture: Fluid Resuscitation in Children Prof. Yehezkel Waisman
12:30 Lunch Break 
  Skill Stations (rotations of small groups) 
14:00 Capnography Dr. Nadeem Qureshi
14:45 Cardioversion & Defibrillation  Prof. Said Idrissi
15:30 Advanced Airway Management      Dr. Patrick Van de Voorde
16:15 PALS Algorithms Prof. Yehezkel Waisman
17:00 Day 1 summary  Faculty
17:30 End of day 1 
     
DAY 2    
     
08:30 Introduction to day 2 Faculty
08:45 Lecture: Approach to the Pediatric Multiple Trauma Dr. Patrick Van de Voorde
09:30 Lecture: Cardiovascular Emergencies Prof. Said Idrissi
10:00 Lecture: Diabetic Keto-Acidosis Dr. Nadeem Qureshi
10:30 Coffee break 
11:00 Lecture: Procedural Sedation & Analgesia  Dr. Nadeem Qureshi
11:45 Lecture:  Pediatric Orthopedic Emergencies  Dr. Patrick Van de Voorde
12:30 Lunch Break 
  Case Scenarios (Simulations)  
14:00 Respiratory Cases (2-3)  Dr. Patrick Van de Voorde
14:45 Shock (2-3) Dr. Nadeem Qureshi
15:30 Cardiac Cases & Pediatric Arrhythmias (3)    Prof. Said Idrissi
16:15 Trauma Cases (2-3) Prof. Yehezkel Waisman
17:00 Course Summary Faculty
17:30 End of the pre-course 

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Pre-course: Emergency Medicine Ultrasound - Beginner

Monday 1 October: 08:40 - 17:00

Tuesday 2 October: 09:00 - 16:30

Course Director

  • Director:  Jim Connolly, UK
  • Co-director:  Mike Lambert, USA

Faculty 

  • Harith Al-RawiUAE
  • Zeki AtesliUK
  • Gian A. CibinelItaly
  • Jim ConnollyUK
  • Sadik GirisginTurkey
  • Adela GoleaRomania 
  • Beatrice HoffmanUSA
  • Mike LambertUSA
  • Emmanuel LauritaItaly
  • Chris MuhrSweden
  • Ramon NoguéSpain
  • Vicki NobleUSA
  • Vincent RietveldThe Netherlands
  • Jo WoodUSA

Participants

40 physicians.

Course description

2-days emergency ultrasound introductory course: lectures, organ-based hands-on practice, problem-oriented ultrasonography. 

Learning objectives

  • Recognition of basic images and US artifacts
  • Technique: basic US approach to limbs, chest, heart, abdomen
  • Recognition of basic US syndromes
  • Basic US approach to critical syndromes: cardiac arrest, shock, respiratory failure
  • Recognition of basic images and US artifacts
  • Technique: basic US approach to limbs, chest, heart, abdomen
  • Recognition of basic US syndromes
  • Basic US approach to critical syndromes: cardiac arrest, shock, respiratory failure

Schedule

DAY 1   
   
08:40 Registration and coffee
09:00 Welcome and aims
09:15 Basic Physics
09:30 Knobology / The machine / Physics Practical
10:00 FAST Scanning: lecture of 15 mins followed by 45 min scanning
11:00 Coffee break
11:20 Lung Scanning: 20 mins lecture  plus 30 mins scanning
12:10 Aorta Scanning: 10 mins talk plus 30 mins scanning
12:40 Lunch break
13:20 Scanning the heart: 20 mins lecture plus 30 mins scanning
14:30 Using US for procedures: 20 mins lecture plus 40 mins scanning
15:30 Coffee break
15:45 Scanning  Veins: 15 mins plus 30 mins scanning
16:30 Lecture: Scanning in Shock
   
DAY 2  
   
09:00 Recap of day 1
09:15 Case Discussions
10:00 Scanning Practical – 3 x 30 mins sessions
11:45 Gynae Scanning and case discussions
12:30 Lunch break
13:15 Scenario Scanning – 3 x 30 mins sessions
14:45 Coffee break
15:00 Governance /Training / Accreditation
15:20 What does the future hold?
15:40 Meet the experts
16:30 End of the pre-course

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Pre-course: Emergency Medicine Ultrasound - Advanced

Monday 1 October: 08:30 - 18:00

Tuesday 2 October: 08:30 - 18:00

Course Director

  • Director:  Gian A. Cibinel, Italy
  • Co-director: Sadik Girisgin, Turkey

Faculty 

  • Harith Al-RawiUAE
  • Zeki AtesliUK
  • Gian A. CibinelItaly
  • Jim ConnollyUK
  • Sadik GirisginTurkey
  • Adela GoleaRomania 
  • Beatrice HoffmanUSA
  • Mike LambertUSA
  • Emmanuel LauritaItaly
  • Chris MuhrSweden
  • Ramon NoguéSpain
  • Vicki NobleUSA
  • Vincent RietveldThe Netherlands
  • Jo WoodUSA

Participants

30 physicians in 6 groups.
Requirements: basic US experience and/or previous participation in a basic emergency US course, ALS/ACLS/ATLS certification recommended.

Course description

2-days emergency ultrasound advanced course: lectures, organ based hands-on practice, simulated clinical scenarios.

Learning objectives

  • Technique: advanced US approach to head, neck, limbs, chest, heart, abdomen
  • Recognition of advanced US syndromes
  • US enhanced advanced management of critical syndromes: cardiac arrest, shock, respiratory failure, acute abdomen, coma
  • Technique: advanced US approach to head, neck, limbs, chest, heart, abdomen
  • Recognition of advanced US syndromes
  • US enhanced advanced management of critical syndromes: cardiac arrest, shock, respiratory failure, acute abdomen, coma
 
 

Schedule

DAY 1
 
   
08:30 Greetings and Registration. Introduction
08:45 EuSEM US education in perspective
09:00 ABC US-enhanced assessment of ABCDE
09:45 Coffee break
10:00 STATIONS: morning rotation on stations A to F for the 6 groups
A – Head & neck 
B – Lung (morning and afternoon)
C – Heart
D – Abdomen (morning and afternoon)
E – MSK (morning and afternoon)
F – Procedures 
13:00 Lunch break
14:00 STATIONS: afternoon rotation on stations A to F for the 6 groups
A – Head & neck 
B – Lung 
C – Heart
D – Abdomen
E – MSK
F – Procedures
17:00 Meet the experts
17:30 Faculty meeting
   
DAY 2  
   
08:30 US-enhanced cardiac arrest & periarrest algorithms
09:45 Coffee break
10:00 STATIONS: morning rotation on stations A to F
A – Cardiac arrest
B – B-Failure
C – C-Failure
D – Acute abdomen
E – Trauma
F – Procedures 
13:00 Lunch break
14:00 STATIONS: afternoon rotation on stations A to F
A – Cardiac arrest
B – B-Failure
C – C-Failure
D – Acute abdomen
E – Trauma
F – Procedures 
17:00 Test evaluation & conclusion
17:30 Faculty meeting

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Pre-course: Research

Monday 1 October: 08:30 - 17:00

Tuesday 2 October: 08:30 - 17:00

Course Director

  • Abdelouahab Bellou, France
  • Luis Castrillo, Spain

Faculty

  • Abdelouahab Bellou, France
  • Luis Castrillo, Spain
  • Nathalie Flacke, France
  • Adela Goela, Romania

Course description

Following the Pre-Course Program Research fundaments in Emergency Medicine the participant will be involved in all the aspects related to research projects. The program is based on a real case study with the final objective of manuscript generation following step after step all the aspects of a research project, from the design to the final publication strategy.  The program is orientated to the Emergency Medicine environment with his limitations and opportunities.

The participants will take part in an interactive program focus on the acquisition of basic knowledge and the abilities needed for solving crucial aspects of research projects.
Specifically at the end of the program the participants will the able to:
  • Design research projects.
  • Establish objectives and plan for hypothesis contrast.
  • Prepare a working plan of the crucial project elements.
  • Select variables of interest and prepare a database.
  • Select adequate statistical analysis.
  • Gain abilities in results evaluations and bias, or study limitations.
  • Prepare a manuscript to be sent for publication.
To facilitated objectives acquisition a hands-on program has been planned. Participants will follow from the initial research question, to the publication of the results all the steps needed to produce quality research. Real research question and real data will be the used on the sessions. The obtained results hopefully will be part of a manuscript.

No previous knowledge is needed to follow the program; to come with a personal computer is recommended but not mandatory.

We encourage all emergency medicine professionals (doctors, nurses) with basic o no previous experience on research, to participate on the program that not only facilitates the development of a research program on the institution, but fundamentally creates the needed environment for quality improvement trough the permanent use of scientific methodology. 

Learning objectives

To be announced

Schedule

DAY 1
   
     
08:30 Introduction: Goals and program methodology
09:00 Basic Science concept:
  • a. Scientific method
  • b. Experiments versus clinical research
Abdelouahab Bellou, FR
09:30 Conceptual frame work of any research:
  • a. Objectives
  • b. Design
  • c. Data gathering
  • d. Analysis
 
10:30 Coffee break
11:00 Case Study (Practical session)
  • a. Case presentation
  • b. Background
  • c. Objectives
Case Study(Practical session)
  • a. Design
  • b. Variables
  • c. Gathering information
  • d. Bias
 Luis Castrillo, SP
12:30 Research Plan
  • a. Chronogram
  • b. Economical analysis
 
13:30 Lunch break
14:30 Legal and Ethical Issues.
  • a. Informed consent
  • b. Helsinki regulations
 
15:00 Population and sample size
  • a. Sample concept
  • b. Sample selection
  • c. Sample size
 Luis Castrillo, SP
15:30 Sample size(Practical session)
  • a. Calculations
  • b. Sample Size Effects
 Luis Castrillo, SP
16:30 Wrap-up  
     
DAY 2    
     
08:30 Data gathering strategies
  • a. CRD generation
  • b. Research manual
  • c. Data bases
 
09:30 Data Base (Practical session)
  • a. Data types
  • b. Data bases
Data manipulation (Practical session)
  • a. Secondary variables
 Luis Castrillo, SP
10:30 Coffee break
11:00 Data analysis (Practical session)
  • a. Preliminary analysis
  • b. Descriptive analysis
Inferential analysis (Practical session)
  • a. Inferential analysis
 Luis Castrillo, SP
13:00 Planning for graphical analysis (Practical session)
  • a. Graph  
 
13:30 Lunch break
14:30 Secondary a analysis (Practical session)
  • a. New  analysis
 Luis Castrillo, SP
15:00 Results presentation (Practical session)
  • a. Structure
 
15:30 Discussion (Practical session)
  • a. Main Results
  • b. Comparing with previous publications
  • c. Clinical impact
  • d. Limitations
  • e. New research areas
 
16:30 Publication strategies  
17:00 Program conclusions  

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Pre-course: Simulation

Monday 1 October: 09:00 - 17:00

Tuesday 2 October: 09:00 - 17:00

Course Director

  • Pr Abdelouahab Bellou, France
  • Pr Denis Oriot, France

Faculty

  • Pr Guillaume Alinier, Qatar/UK
  • Pr Abdelouahab Bellou, France
  • Dr Karim Benmiloud, Switzerland
  • Dr François Lecomte, France
  • Dr Ismael Hssain, France
  • Pr Denis Oriot, France
  • Dr G. Ulufer Sivrikaya, Turkey
  • Dr Luis Sanchez, Spain
  • Dr Antonio Iglesias Vazquez, Spain

Participants

15 trainees.

Course description

Simulation is a technique to replace or amplify real-patient experiences with guided experiences, artificially contrived, that evokes or replicates substantial aspects of the real world in a fully interactive manner. As an educational strategy, simulation provides the opportunity for learning that is both immersive and experiential. Thus, to improve education and ultimately enhance patient safety, healthcare professionals are using simulation in many forms including simulated and virtual patients, static and interactive manikin simulators, task trainers, screen-based (computer) simulations and ‘serious’ gaming. Moreover, simulation has the potential to recreate scenarios that are rarely experienced and test professionals in challenging situations, and to carefully replay or examine their actions. It is a powerful learning tool to help the modern healthcare professional achieve higher levels of competence and safer care.

 
These 2 days courses managed by world class experts on simulation will give the opportunity to trainees to get knowledge and how to teach simulation in emergency medicine using high fidelity manikins in a simulation center.

Learning objectives

The global objective of this course is to teach participants how to use Simulation in Emergency Medicine education. At the end of this course, participants will be able: to appreciate the impact of Simulation on the daily practice of Emergency Medicine, to create and run a scenario, to use a simulator (SimMan), to brief and debrief trainees.

  • To learn the basis on medical education, medical error and human factor.
  • To get knowledge on Simulation in Emergency Medicine: definition, tools, scenarios, briefing, debriefing.
  • To learn the concept of Crisis Management (CRM) and team work and multi-disciplinary approach in Simulation.
  • To practice Simulation by producing scenarios and using SimMan in small trainee groups.

Schedule

DAY 1
   
     
09:00 Registration  
09:15
Welcome and Introduction
Objectives: Introduction of participants (instructors and trainees)
 
Pr A. Bellou
09:30
What is simulation education and what can it achieve?
Objectives: Basis in medical education, medical error and human factor; Simulation: definition, introduction to CRM.
Dr I. Hssain
10:10
From standardized patient to high fidelity simulation
Objectives: Description of simulation tools, “simulation is a technique and not a technology”, simulation gadget or pedagogy?
 
Pr G. Alinier
10:30 Coffee break  
10:45 Crisis Resource Management
Objectives: intro to CRM, Why/What? Using Simulation for CRM training, introduction to simulation in team and interdisciplinary simulation.
 
Dr K. Benmiloud
11:15 Preparing and running a simulation and debriefing session: Key principles
Objectives: Preparation, briefing, simulation session, facilitation, debriefing, learning objectives, importance of scenarios
Dr F. Lecomte
11:45 Q&A and discussion  
12:00 Lunch break  
13:00 Presentation of the patient simulator: Laerdal SimMan Dr JAI. Vazquez & Dr L. Sanchez
13:30 Scenario design and preparation as a team Dr JAI. Vazquez & Dr L. Sanchez
  Group split into X teams to design scenarios  
14:15 Coffee break  
14:30 Hands on opportunity: Running and taking part in a scenario in preparation for day 2  
16:45 Q&A and discussion  
     
DAY 2    
     
09:00 Final scenario preparations with workshop participants All the faculties
12:00
Evaluation of a simulation session
Objectives: What is Kirkpatrick’s pyramid? Which practical application for a procedure and for a high-fidelity simulation session?
 
Pr D. Oriot
12:30 Lunch break  
13:30 Welcome and briefing of scenario participants for the simulation session   
14:00 Familiarization of scenario participants with the patient simulator and environment (briefing)
Objectives: Briefing before simulation for scenario participants
 
14:15 Scenarios and debriefings with tea/coffee available in the observation/debriefing room  
16:00 Overview of the adoption of simulation education around the world
Objectives: How to implement simulation in medical and nurse initial and continuous education
 
16:30 Q&A and discussion  

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Keynote Redmond OBE

Anthony (Tony) Redmond qualified in Medicine from the University of Manchester in 1975 where he also completed his postgraduate training. After qualifying in internal medicine and completing an MD research thesis he trained in Emergency Medicine. He was appointed Lecturer in Emergency Medicine at the University of Manchester and subsequently Consultant in Emergency Medicine at the University Hospital of South Manchester. In 1983 he was one of four founding members of the Emergency Medicine Research Society in the UK, which was later absorbed into the new Faculty of Accident and Emergency Medicine. In 1995 he was appointed Foundation Professor of Emergency Medicine at the University of Keele and Emeritus Professor in 1999. He was founding Editor of Archives of Emergency Medicine, which evolved ultimately into the Emergency Medicine Journal in 2000.


His early research interests were in prehospital care and resuscitation. He founded the South Manchester Accident Rescue Team (SMART) in 1987, a BASICS pre hospital medical team, funded by public donation. It continues to provide medical support to the emergency services in South Manchester. In Stockport he established one of the first paramedic training programmes in the UK, expanding it into Greater Manchester to become at one time the largest such programme in the UK.
He is a founder member of the Resuscitation Council (UK) and part of the original working parties that produced the early national resuscitation guidelines and recommendations for Resuscitation Training officers etc.
His interest in disaster management began with the earthquake in Armenia and he has since responded to a range of humanitarian crises including earthquakes, active volcano, refugee camps, plane crashes, conflict and war, and in many countries, including the UK, Kurdistan, Bosnia, Serbia, Macedonia, Montenegro, Cape Verde, Kosovo, Kenya, Iran, Sierra Leone, Pakistan, Uganda, China and Haiti.


In 1994 he established UK-Med www.uk-med.org an NGO that provides international emergency humanitarian medical assistance and which now hosts the UK International Emergency Trauma Register. UKIETR is a national resource funded by the UK government that draws together clinicians to form a national surgical/emergency response to large scale sudden onset natural disasters. It also coordinates and runs national training courses for this work. He is Chair of the Foreign Medical Teams Working Group at WHO Geneva.


He is currently Professor of International Emergency Medicine at the University of Manchester and Lead for Global Health at the Manchester Academic Health Sciences Centre. He co-founded the Humanitarian and Conflict Response Institute at the University of Manchester (www.hcri.ac.uk). This is a joint venture between the Faculties of Medicine and Humanities and researches into the background to and consequence of humanitarian crises. The HCRI runs Masters programmes in humanitarianism and conflict studies, international disaster management and a bachelors programme in global health.


At the Medical School he leads on Global Health education and has established a module in Emergency Humanitarian Assistance as part of a Masters in Public Health and Masters in Humanitarianism and Conflict Studies.
He has published widely in the field of emergency and disaster medicine and is the editor of the ABC of Conflict and Disaster Medicine (BMJ Books).


He was appointed to the Soviet Order for Personal Courage in 1989 for his work in the Armenian earthquake and Officer of the Order of the British Empire for humanitarian assistance to the former Yugoslavia in 1994.
In 2010 he received the Humanitarian Award from the International Federation for Emergency Medicine and in 2011 UK Med received the Excellence in Disaster Management Award from the World Association for Disaster Medicine.

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Keynote Maaret Castren

History of life support care in Europe

Head of Department, Professor in Emergency Medicine, FERC Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
Professor in emergency medicine in Sweden Karolinska Institutet and Finland Turku University
Chair elected for European Resuscitation Council
She has worked in the prehospital setting most of her career. Her research interests are trauma, cardiac arrest, medical education, pain, flows in the emergency department. Professor Castrén has been the founding member of the resuscitation Council in Finland and has been a board member of the Swedish and Finnish Red Cross First Aid Council for years. She is nominated the Co-Chair of ILCOR 2015 and is an active member of the work to develop the Resuscitation Guidelines 2015.

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Keynote Guillaume Alinier

Simulation is becoming a reality! An overview of high level initiatives from around the world

Guillaume Alinier started his career in clinical simulation as a Researcher in 2000 at the University of Hertfordshire, UK. He had a rapid academic career progression that saw him involved in a number of programmesacross the University, ranging from Pharmacy to Electronic Engineering, in the areas of assessment, Objective Structured Clinical Examinations, simulation-based education, and mentoring of fellow faculty. He was instrumental in designing and running a large multiprofessional simulation centre at the University of Hertfordshire which became a hub of knowledge development and collaboration for over 10,000 students, professionals, and visitors coming through its doors annually. He has been the recipient of two prestigious UK Higher Education Academy awards, namely a National Teaching Fellowship in 2006 and a Senior Fellowship in 2009, and received his Chair as Professor of Simulation in Healthcare Education in 2011.
Guillaume has also been a Visiting Fellow of the University of Northumbria since 2009. Last year he joined the Sidra Medical and Research Center (Doha, Qatar) as Simulation Program Manager to help develop a state-ofthe-art simulation training facility and educational programs that will be used to on-board hospital staff and establish Sidra as a world-class academic medical centre. Over the years Guillaume has held national (UK) and international roles in the simulation community, notably with the Society in Europe for Simulation Applied to Medicine, the Association for Simulated Practice in Healthcare, and the international Society for Simulation in Healthcare. He has been involved in several funded research and consultancy projects, conducted simulation education workshops internationally, and contributed to a number of journal publications and book chapters. His areas of interest are training and consultancy for the development of simulation facilitators and new training facilities, and pre- and post-registration interprofessional scenario-based simulation to improve collaborative working and patient safety.

 

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Keynote Speakers

DOCTOR SIMON CONROY (UK)

Simon conroyPlenary Session 1
Sunday, 8 September 2013
13:00 

Simon Conroy is an academic geriatrician based in Leicester, and has a clinical and research on urgent care for older people. He developed vertically integrated urgent care pathways for frail older people in Leicester – Interface Geriatrics.

Lecture: Systems approach to caring for older people

       

PROFESSOR KENT DENMARK (USA)

Kent DenmarkPlenary Session 2
Sunday, 8 September 2013
13:30 

T. Kent Denmark M.D. graduated from Loma Linda University School of Medicine in 1994. After completing a pediatric residency and pediatric emergency medicine fellowship, he joined the faculty at Loma Linda in the Department of Emergency Medicine. He began running medical simulations with the pediatric emergency medicine fellows and pediatric residents shortly thereafter. The initial scenarios consisted of standing around an empty gurney and using a lot of imagination. With the acquisition of Loma Linda’s first medium fidelity simulator, simulation became a tangible reality within the Emergency Department. After acquiring two high-fidelity simulators thanks to generous community donations, Dr Denmark was tasked with developing a campus-wide simulation center at Loma Linda where he now serves as Medical Director.

The Medical Simulation Center (MSC) currently serves students in Medicine, Nursing, Dentistry and Allied Health, as well as practitioners from the Medical Center across disciplines and throughout the continuum of care. After four years using a converted computer lab in Risley Hall, the MSC moved into a new 8000 square foot facility in Centennial Complex in January 2010 designed with physically contiguous simulated care areas to reproduce the continuum of healthcare. There, the group continues to integrate learners from all health-care disciplines and to develop and facilitate inter-professional  teamwork before learners enter the clinical environment. The group has partnered with Graduate Medical Education and Patient Safety and Reliability to use simulation for teaching teamwork and communication skills as well as creating remediation opportunities for healthcare workers after sentinel events. Recently, the MSC participated in validation of the new electronic medical record program prior to it’s deployment within the University Medical Center.

Dr Denmark is a Professor of Emergency Medicine, Pediatrics and Basic Science, is an Associate Editor for MedEdPORTAL, is the former Pediatric Emergency Medicine Fellowship Director, is on the editorial board of Pediatric Emergency Practice, is a reviewer for Respiration, the AAMC Research in Medical Education (RIME) conference, and the Canadian Journal of Emergency Medicine, has provided expert childhood drowning testimony for the Consumer Product Safety Commission, has moderated multiple regional and national simulation skills labs, is the American Academy of Pediatrics Emergency Medicine representative to the Council of Pediatric Subspecialties, has served on the Pediatric Emergency Medicine Fellowship Directors subcommittee on simulation,  and was the recipient of the Loma Linda University Graduate Medical Education Educators award in 2007.

Lecture: Non-intuitive applications of simulation in Patient Safety and Human Factors

PROFESSOR JUDD E. HOLLANDER (USA)

Judd E. HollanderPlenary Session 7
Wednesday, 11 September 2013
08:30 

Judd E. Hollander, MD, is Professor and Clinical Research Director in the Department of Emergency Medicine at the University of Pennsylvania.  He graduated from New York University Medical School in 1986, completed an Internal Medicine Residency at Barnes Hospital in 1989, and an Emergency Medicine Residency at Jacobi Hospital in 1992. His research interests include risk stratification and treatment of patients with potential acute coronary syndromes and congestive heart failure; cocaine associated cardiovascular complications; and laceration and wound management. Dr. Hollander has published over 400 peer-reviewed articles, book chapters, and editorials on these and other topics. Dr. Hollander is a past President of the Society for Academic Emergency Medicine, past member of the SAEM Board of Directors (2000-2003, 2006-2009), and past Chair of the SAEM Program Committee. He has been a member of the Emergency Medicine Foundation Scientific Review Committee (1996-2003) and is past Chair of this committee (2000-2002). He is currently a Deputy Editor for the Annals of Emergency Medicine; has served as Associate Editor for Academic Emergency Medicine and as a reviewer for NEJM, JAMA, Circulation, JACC as well as many other EM and Cardiology journals. Dr. Hollander was the awarded the ACEP Award for Outstanding Research in 2001, the Hal Jayne SAEM Academic Excellence Award in 2003 and the SAEM Leadership Award in 2011.

Lecture: Clinical Research for Today & the Future

PROFESSOR BERNARD L. LOPEZ (USA)

lopez2

Plenary Session 3
Monday, 9 September 2013
08:30 

Bernard L. Lopez, MD, MS, is Professor and Vice Chairman of the Department of Emergency Medicine at Jefferson Medical College in Philadelphia, Pennsylvania.  He is also the current Director of Clinical Research. He graduated from Jefferson Medical College in 1986, completed his residency training in Emergency Medicine at Thomas Jefferson University Hospital in 1989.  After completing his training, Dr. Lopez joined the faculty at Jefferson.  The early part of his career was devoted to research.  He spent his early research years in the laboratory where he studied acute cardiac ischemia and reperfusion injury in a rat model.  This was followed by involvement in translational research where he investigated the role of nitric oxide in the acute presentation of sickle cell disease.  During this time, he served as Director of Clinical Research.  Education and faculty development became the focus of the next phase of his career.  From 2001-2013, Dr. Lopez held the position of Associate Dean of Student Affairs and Career Counseling at Jefferson Medical College where he provided academic, personal, and career counseling to medical students.  From 2003-2012, he served as Vice Chair for Academic Affairs in the Department of Emergency Medicine.  In this role, he provided oversight and direction to medical student, resident, and faculty education as well as clinical research and faculty development.  He also served as Residency Program Director in Emergency Medicine from 2006-2010.  In 2012, Dr. Lopez resumed the role of Director of Clinical Research.  In 2013, he was appointed Vice Chairman in the Department of Emergency Medicine where, in addition his academic oversight and guidance, he would provide additional oversight and guidance in clinical operations.

Dr. Lopez’s academic interests are focused on clinical research in emergency medicine, the acute presentation of sickle cell anemia, resident and student education, faculty development, and patient flow in the emergency department.

Lecture: The Future of Emergency Medicine Practice - What Will We Need to Research?

PROFESSOR JEAN-LOUIS VINCENT (BELGIUM)

vincent

Plenary Session 4
Monday, 9 September 2013
14:15 

Dr Vincent is Professor of intensive care at University of Brussels and Head of the Department of Intensive Care at the Erasme University Hospital in Brussels. Specialist in Internal Medicine, he spent two years training at the University of Southern California with Prof. Max Harry Weil.

Dr. Vincent has signed more than 800 original articles, some 300 book chapters and review articles, and 850 original abstracts, and has edited 86 books. He is co-editor of the Textbook of Critical Care (Elsevier Saunders, 5th Edition) and the “Encyclopedia of Intensive Care Medicine” (Springer).

Dr. Vincent is the editor-in-chief of "Critical Care", "Current Opinion in Critical Care", and "ICU Management". He is member of the Editorial Boards of about 30 journals including "Critical Care Medicine" (senior editor), American Journal of Respiratory and Critical Care Medicine (AJRCCM), "PLoS Medicine", "Lancet Infectious Diseases", “Anesthesiology”, "Intensive Care Medicine", "Shock", and "Journal of Critical Care".

Dr. Vincent is presently Secretary General of the World Federation of Societies of Intensive and Critical Care Medicine and President of the Belgian Society of Intensive Care Medicine (SIZ); he is a Past-President of the European Society of Intensive Care Medicine, the European Shock Society, and the International Sepsis Forum.

For 33 years he has organized an International Symposium on Intensive Care and Emergency Medicine which is held every March in Brussels.

He has received the Distinguished Investigator Award of the Society of Critical Care Medicine, the College Medalist Award of the American College of Chest Physicians, was the Recipient of the "Society Medal”(lifetime award) of the European Society of Intensive Care Medicine and has received the prestigious Belgian scientific award of the FRS-FNRS (Prix Scientifique Joseph Maisin-Sciences biomédicales cliniques).

Lecture: Global vision of sepsis management.

DOCTOR DAVID WILLIAMS (UK)

williams

Plenary Session 6
Tuesday, 10 September 2013
14:15 

Dr David Williams is emeritus Consultant in Emergency Medicine to Guy’s & St Thomas’ Hospitals in London. He has been President of the British Association for Emergency Medicine, the UK Faculty (now College) of Emergency Medicine and the European Society for Emergency Medicine, EuSEM. He was Chairman of the UEMS Multidisciplinary Joint Committee (MJC) on Emergency Medicine from 2006-2012 and is currently the first President of the new Section of Emergency Medicine of UEMS, the Union Europeenne des Medecins Specialistes.

Lecture: Development of Emergency Medicine in Europe.

 

 

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Pre-Courses

Ultrasound Beginner 

2 days

This is a course applicable to all from the very beginner to those with some experience.  It is an opportunity to learn and develop basic skills with an internationally renowned faculty. 

More details

Administration 

1 day

Performance and Quality Improvement are among the central administrative challenges facing Emergency Department leaders in all countries. Through a series of lectures and workshops facilitated by experienced faculty, course participants will learn practical approaches for improving performance and quality in their emergency departments. 

More details

Advanced Pediatric Emergency Care (APEC) 

2 days

 The objective is: To provide physicians participating in the course with both knowledge and advanced skills in recognizing and managing a wide spectrum of paediatric emergencies including trauma, both in the hospital and pre-hospital settings.

More details

Disaster Medicine

1 day

A Really Complex Disaster: the Fukushima Event

More details

Non-Invasive Ventilation 

1 days

The course will give an overview of the pathophysiological basis, rational limits and objectives of the use on Non Invasive Ventilation in the ED. It will present also the different types of NIV, the ventilators and interfaces, and how to treat patients through different clinical scenarios that will be presented in the hands-on part of the course. 

More details

Ultrasound Advanced

2 days

2-days emergency ultrasound advanced course: lectures, organ based hands-on practice, simulated clinical scenarios.

More details

Simulation Pre-course: Scenario-based Simulation Facilitator Course

2 days

The global objectives of these workshops which will run concurrently for 2 different groups of participants are to provide a sound overview to participants of two key simulation domains, namely how to develop a simulation centre and/or simulation programme, and the fundamentals of becoming a scenario-based simulation facilitator/educator. 

More details

Simulation Pre-course: Simulation Centre Design and Operations Course

2 days

The global objectives of these workshops which will run concurrently for 2 different groups of participants are to provide a sound overview to participants of two key simulation domains, namely how to develop a simulation centre and/or simulation programme, and the fundamentals of becoming a scenario-based simulation facilitator/educator.

More details

Falck Foundation - Pre Hospital Research

1 days

The pre-conference seminar on prehospital research aims at gathering around the table practitioners seeking to improve pre-hospital emergency health care through Scientific Research.

More details

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Programme overview

Sunday 8 September 2013
 Room Auditorium Endoume
4
Callelongue
1
Callelongue
2
Endoume
1
Endoume
2
Endoume
3
Riou Samena
 Track State of the Art Clinical Questions Administration French Track AAEM-EuSEM Debate MEMC Meeting Place Simulation Oral Abstract Presentation Sessions Oral Abstract Presentation Sessions
13:00
PL1
Plenary Session K. Denmark (USA)
               
13:30
PL2
Plenary Session S. Conroy (UK)
               
14:15
A11
Paediatric Emergencies
B11
Elderly in the ED
C11
Leadership
D11
Urgences vitales I
E11
Prehospital setting
F11
Research
G11
What is simulation?
H11
Airway 1
I11
Biomarkers,
Diagnostic Tech.,
Radiology, and Imaging, Ultrasound, Radiology 1
15:45 Coffee Break - Visit the Exhibition and Scientific Posters
16:15
A12
Elderly in the ED
B12
Paediatric Emergencies
C12
How to define and measure performance?
D12
Urgences vitales II
E12
Observational Medicine
F12
The European Society of Cardiology
G12
Simulation Competition - Opening Session
H12
Airway 2, Ventilation and Simulation
I12
Imaging / Ultrasound 2
18:00
OP1
Opening Ceremony
               
19:00 Opening Reception
Monday 9 September 2013
 Room Auditorium Endoume 
4
Callelongue
1
Callelongue
2
Endoume
1
Endoume 
2
Endoume
3
Riou Samena
 Track State of the Art Clinical Questions Administration French Track AAEM-EuSEM Debate MEMC Meeting Place Simulation Oral Abstract Presentation
Sessions
Oral Abstract Presentation
Sessions
08:30
PL3
Plenary Session B. Lopez (USA)
               
09:15
A21
Psychiatric Emergencies
B21
Pre-hospital Medicine
C21
Cost-
Effectiveness
in the ED
D21
Organisation
E21
Accreditation in EM
F21
Young Doctors Education Session
G21
Simulation as an educational methodology
H21
Shock, and Respiratory
I21
Neurology 1
10:45 Coffee Break - Visit the Exhibition and Scientific Posters
11:15
A22
Pre-hospital Medicine
B22
Symposium Vocera
C22
Patient Safety/ Risk Management
D22
Controverse IOA et délégation de prescription
E22
Disaster Medicine
F22
Research promoted by Societies
G22
Driving Quality Improvement Initiatives...
H22
Infectious Disease/ Sepsis, and Obstetrics
I22
Neurology 2, Geriatrics, Orthopedics, and Endocrine
12:45 Lunch break
13:15-14:15  
WSD2
Lunch Workshop Vygon
   
WSG2
Starting a simulation programme
 
14:15
PL4
Plenary Session JL. Vincent (BE)
               
15:00
A23
Environmental Emergencies
B23
Neurologic Emergencies
C23
Disaster Medicine I
D23
Monitorage
E23
Symposium Novartis
F23
Young Doctors Research Session
G23
Expert Panel Session 1
H23
Management- ED Organisation 1
I23
Education and Training 1
16:30 Coffee Break - Visit the Exhibition and Scientific Posters
17:00
A24
Sepsis
B24
Imaging in the ED
C24
Disaster Medicine II
D24
Urgences en milieu maritime
E24
EM as a specialty
F24
Young Doctors Carrer Planning Session
G24
Simulation Competition - Session 1
H24
Management-ED Organisation 2, and...
I24
Education and Training 2
18:30 End of sessions
20:30 Gala Dinner
Tuesday 10 September 2013
 Room Auditorium Endoume
4
Callelongue
Callelongue
2
Endoume
1
Endoume 
2
Endoume
Riou Samena
 Track State of the Art Clinical Questions Administration French Track AAEM-EuSEM Debate MEMC Meeting Place Simulation Oral Abstract Presentation
Sessions
Oral Abstract Presentation
Sessions
08:30
PL5
Plenary Session L. Moreno-Walton (USA)
               
09:15
A31
Pulmonary Emergencies
B31
Cardio-vascular Emergencies
C31
ED Overcrowding / Flow I
D31
Pédiatrie
E31
Future Challenges for EM
F31
The European Resuscitation Council
G31
Research Studies in Simulation
H31
Pre-Hospital-EMS 1
I31
Trauma
10:45 Coffee Break - Visit the Exhibition and Scientific Posters
11:15
A32
Cardio-vascular Emergencies
B32
Symposium Novartis
C32
ED Overcrowding / Flow II
D32
Gériatrie
E32
Future of an Emergency Physician
F32
The European Association of Poisons Centres and Clinical Toxicologists  
G32
Simulation Competition - Session 2
H32
Pre-Hospital-EMS 2
I32
Pain Management,
Analgesia and
Anesthesia
12:45 Lunch break 
13:15-14:15  
WSC3
Lunch Workshop: ThermoFisher
   
WSF3
Young doctors Pecha-Kucha session!
WSG3
Workshop: Beyond Core Competencies
 
14:15
PL6
Plenary Session D. Williams (UK)
               
15:00
A33
Clinical Toxicology
B33
Trauma
C33
ED Design Issues
D33
Symposium Vygon
E33
EM vs. Primary Care
F33
The European Master in Disaster Medicine
G33
Expert Panel Session 2
H33
Cardio-vascular 1
I33
Disease,
Injury Prevention, and Wound Care
16:30 Coffee Break - Visit the Exhibition and Scientific Posters
17:00
A34
Trauma
B34
Clinical Toxicology
C34
Observational Medicine
D34
Biomarqueurs
E34
The relationship between EM and other specialties
F34
The Society for Academic Emergency Medicine
G34
Simulation & Evaluation
H34
Cardio-vascular 2
I34
Paediatrics
18:30 End of sessions
Wednesday 11 September 2013
 Room Auditorium Endoume
4
Callelongue
Callelongue
2
Endoume 
1
Endoume 
2
Endoume 
3
Riou Samena
Track  State of the Art Clinical Questions Administration French Track AAEM-EuSEM Debate MEMC Meeting Place Simulation Oral Abstract Presentation
Sessions
Oral Abstract Presentation
Sessions
08:30
PL7
Plenary Session J. Hollander (USA)
               
09:15
A41
Biomarkers I
B41
Symposium Abbott
C41
Technology in the ED I
D41
Douleur
E41
International EM
F41
Data Gathering in Emergency Medicine
G41
Simulation Competition - Session 3
H41
Administration/ Health Care Policy
I41
Pre-Hospital-EMS 3, Transportation, and Toxicology
10:45 Coffee Break - Visit the Exhibition and Scientific Posters
11:15
A42
Biomarkers II
B42
Metabolic Disturbances
C42
Technology in the ED II
D42
Filières
E42
Biomarkers in EM
F42
Analysis of Research in Emergency Medicine
G42
Expert Panel Session 3
H42
CPR/ Resuscitation
I42
Disaster Medicine, and Psychiatry
13:00 End of the congress

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2013: Marseille, France

Marseille, FrAnce from 8-11 september 2013

palais1

The VIIth Mediterranean Emergency Medicine Congress took place in Marseille, France, in the 'Palais des Congrès et des Expositions de Marseille'.

The congress was organised on behalf of the European Society for Emergency Medicine (EuSEM), the American Academy for Emergency Medicine (AAEM) and the French Society for Emergency Medicine (SFMU).

2013’s Main theme was ‘Simulation in Emergency Medicine’. A range of activities and sessions have been organised to explore, experience and discuss various applications of simulation, its implementation and its evaluation in our professional domain.

 

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Pre-course: Ultrasound Beginner

Saturday 7 September: 08:00 - 17:30
Sunday 8 September: 08:00 - 12:00

Course Directors

  • James Connolly (UK)
  • Mike Lambert (USA)

Faculty 

  • Rip Gangahar, UK
  • Adela Golea, Romania
  • Robert Jarman, UK
  • Hein Lamprecht, South Africa
  • Jean-François Lanctôt, Canada
  • Christofer Muhr, Sweden
  • Gregor Prosen, Slovenia
  • Vincent Rietveld, The Netherlands
  • Maxime Valois, Canada
  • Joseph P. Wood, USA

Participants

40 physicians.

Course description

This is a course applicable to all from the very beginner to those with some experience.  It is an opportunity to learn and develop basic skills with an internationally renowned faculty. 

Learning objectives

  • Develop basic skills and knowledge Learn how to develop Ultrasound in your institution and personal practice Techniques of  basic US approach to limbs, chest, heart, abdomen
  • Recognition of basic US pathology
  • Basic US approach to cardiac arrest, shock, respiratory failure
  • Recognition of basic images and US artefacts

Schedule

DAY 1   Familiarisation with Ultrasound and the Technology
08:00 Introduction
08:20 Basic Physics
08:40

Practical: Machine familiarisation / Time to get familiar with all machines, settings and artefacts

  ABCDE Sessions
Acute care relevant
Each session will be a short presentation followed by scanning
09:10 Airway and Breathing
Lectures 
10:00 COFFEE BREAK
10:20 Circulatory 1 :  FAST
11:20 Circulatory 2 : Aorta / IVC
12:20 LUNCH BREAK
13:00 Cardiac Images 
Lecture
13:20 Shock Scanning and Cardiac Arrest
Lecture 
14:00 Scanning cardiac
Practical 
15:30 Coffee break
15:50 Assessment of D -  Demonstration in Lecture Room
16:10 Interactive Cases lecture room
16:40 END OF DAY 1
   
DAY 2  
08:00 Procedures
Sort lecture and practice 
09:00 Scanner session
10:30 COFFEE BREAK
10:45

All Faculty wrap up session

Governance

Training

Lessons we have learnt

Round table - Open Questions

12:00 END OF THE PRE-COURSE

 

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PRE-COURSE: ADMINISTRATION

Saturday 7 September: 8:30 - 18:00

Course Director

  • Eric Revue (France)

Faculty

  • Philip Anderson (USA)
  • Rob Freitas (USA)
  • Stephanie Kayden (USA)
  • Eric Revue (France)

Participants

25 participants maximum. 
The course shall be cancelled if less than 8 participants are registered.

Course description

Performance and Quality Improvement are among the central administrative challenges facing Emergency Department leaders in all countries. Through a series of lectures and workshops facilitated by experienced faculty, course participants will learn practical approaches for improving performance and quality in their emergency departments.  Participants will work together in small groups on concrete problem solving projects designed to produce concrete tools and strategies that can be implemented in the participants’ home institution. 

This course is being organized by the International Emergency Department Leadership Institute (IEDLI) www.iedli.org 

Learning objectives

At the completion of the course, participants will be able: .

  • To define quality as it relates to care delivery in the emergency department and discuss key metrics and performance indicators for measuring quality
  • To describe the main theories of overcrowding in emergency departments and discuss strategies for mitigating overcrowding
  • To discuss the difference between practice guidelines and clinical pathways and identify the key elements of clinical pathways that increase likelihood for success
  • To describe the key elements of risk management strategies for responding to errors and adverse events in the emergency department.  

Schedule

08:30 INTRODUCTION
08:45 Lecture 1: Quality Assurance / Improvement Stephanie Kayden (USA)
09:00 Lecture 2: Overcrowding Eric Revue (France)
10:15 COFFEE BREAK
10:30 Lecture 3: Clinical Pathways Stephanie Kayden (USA)
11:15 Lecture 4: Risk Managment Rob Freitas (USA)
12:00 LUNCH BREAK
13:00 Small Group Session 1: Risk Managment Course Faculty
14:30 COFFEE BREAK
14:45 Small Group Session 2: Clinical Pathways Course Faculty
16:15 Small Group Presentations
17:00 Wrap-up - Closing comments
17:15 END OF THE PRE-COURSE

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PRE-COURSE: ADVANCED PEDIATRIC EMERGENCY CARE (APEC)

Saturday 7 September: 08:00 - 17:30
Sunday 8 September: 08:00 - 13:00

Course Directors

  • Yehezkel Waisman (Israel)
  • Javier Benito Fernandez (Spain)

Faculty 

  • Javier Benito Fernandez (Spain)
  • Randy Cordle (USA)
  • Said H-Idrissi (Belgium)
  • Nadeem Qureshi (Saudi Arabia)
  • Yehezkel Waisman (Israel)
 

Participants

The course is designed for 32 participants (skill stations and case scenarios will be conducted in small groups).  More specifically, it is designed for PEM Physicians, Paediatricans, and Emergency Physicians who provide care for children in emergencies and who want to refine their knowledge and skills in PEM.  

Course description & learning objectives

Background: The APEC course is a development of the Paediatric Section at EuSEM, and will be conducted by its faculty members. At the end of the course participants will be presented with certificates of course completion by EuSEM.

Objectives: To provide physicians participating in the course with both knowledge and advanced skills in recognizing and managing a wide spectrum of paediatric emergencies including trauma, both in the hospital and pre-hospital settings.

General Outline: A 1.5-day course.  
During the morning hours of both days, lectures will be presented on the management of a wide spectrum of paediatric emergencies (including trauma) with emphasis on evidence-based literature. During the afternoon hours students will actively participate in small group advanced skill stations, case scenarios and  simulations designed to provide knowledge and skills relevant to paediatric emergency medicine as well as elicit discussion on the clinical management of common paediatric emergencies including trauma. 

A full course agenda is provided below.  

Schedule

DAY 1    
08:00 Buffet
08:30 Introduction to the APEC course Faculty
08:45 Lecture: An Approach to the Seriously Ill Infant and Child Prof. Said Idrissi
09:15 Lecture: Principles of Pediatric Triage Prof. Yehezkel Waisman
09:45 Lecture: Respiratory Emergencies Dr. Javier Benito Fernandez
10:30 Coffee break 
11:00 Lecture: Status Epilepticus (SE) Dr. Nadeem Qureshi
11:45 Lecture: Fluid Resuscitation in Children Prof. Yehezkel Waisman
12:30 Lunch Break 
  Case Scenarios (Simulations) 
14:00 Respiratory Cases (2-3) Dr. Javier Benito Fernandez
14:45 Shock (2-3)  Dr. Nadeem Qureshi
15:30 Cardiac Cases & Pediatric Arrhythmias (3)     Prof. Said Idrissi
16:15 Trauma Cases (2-3) Itai Shavit
17:00 Day 1 summary  Faculty
17:30 End of day 1 
     
DAY 2    
08:00 Buffet
08:30 Introduction to day 2 Faculty
08:45 Lecture: Approach to the Pediatric Multiple Trauma Javier Benito Fernandez
09:30 Lecture: Cardiovascular Emergencies Prof. Said Idrissi
10:00 Lecture: Diabetic Keto-Acidosis Dr. Nadeem Qureshi
10:30 Coffee break 
11:00 Lecture: Procedural Sedation & Analgesia  Javier Benito Fernandez
11:45 Lecture:  Pediatric Orthopedic Emergencies  Randy Cordle
12:30 Course Summary & Certificate Handout Faculty
13:00 End of the pre-course 

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PRE-COURSE: DISASTER MEDICINE

Saturday 7 September: 8:30 - 17:30
A Really Complex Disaster: the Fukushima Event

Course Directors

  • Steve Photiou (Italia)
  • Ziad Kazzi (USA)

Faculty

  • Abdo Khoury (France)
  • Alessandra Revello (Italia)

Participants

25 physicians maximum.

Course description

In March 11, 2011, a 9.0-magnitude earthquake occurred 24 km northeast of the Japanese coastline leading to massive destruction, a secondary tsunami and thousands of deaths and injuries. During the following days, the Fukushima Dai-ichi nuclear power plant suffered significant damage and lost ability to keep the reactors cool. Radioactive materiel were released in the environment and led to the additional displacement of residents living in the surrounding communities. 

Learning objectives

After the completion of this workshop, participants will be able to:
  • Discuss the clinical and public health aspects of earthquakes
  • Discuss the clinical and public health aspects of tsunamis
  • Discuss the clinical and public health aspects of nuclear power plant emergencies
  • Discuss risk communication strategies during an emergency

Schedule

08:00 Introduction
08:10 Clinical and Public Health Consequences of Earthquakes.
09:00 Break
09:15 Clinical and Public Health Consequences of Tsunamis.
10:05 Break
10:20 Clinical and Public Health Consequences of NPP Accident.
11:20 CERC : Crisis and Emergency Risk Communication 
12:05 Lunch break
13:05 Scenario-Based Tabletop Exercise.
16:00 End of course

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PRE-COURSE: NON-INVASIVE VENTILATION

Saturday 7 September: 8:30 - 17:30

Course Director

  • Roberta Petrino (Italia)

Faculty

  • Roberto Cosentini (Italy)
  • Paolo Groff (Italy)
  • Roberta Marino (Italy)
  • Abdo Khoury (France)

Participants

30 physicians maximum. 
The course shall be cancelled if less than 12 participants are registered. 

Course description

The course will give an overview of the pathophysiological basis, rational limits and objectives of the use on Non Invasive Ventilation in the ED. It will present also the different types of NIV, the ventilators and interfaces, and how to treat patients through different clinical scenarios that will be presented in the hands-on part of the course. 

The format of the course will be: a few frontal lectures with interaction between teacher and audience, and a full afternoon spent on practical exercise on ventilators, interfaces, and clinical simulated scenarios.

Learning objectives

Upon completion of this course participants will be able to:

  • understand pathophysiology of  acute hypoxaemic and hypercapnic respiratory failure and the rationale of applying a positive pressure non invasive ventilation as early treatment in the ED
  • know goals, indications and limits of non invasive ventilation 
  • understand mechanism of action of  C-PAP and PEEP and know the principal modalities of ventilation, and their use in several pathological conditions frequently encountered in the emergency setting
  • know how a ventilator is made, it’s function and setting and the different interfaces to the patient

Proposed schedule

08:30 Pathophysiology of respiratory failure - hypoxemia and hypercapnia.
09:15 Pathophisiology of respiratory failure - respiratory mechanics, PEEPi, motion equation,WOB.
10:15 Goals and limits of Non Invasive Mechanical Ventilation.
10:45 Coffee break
11:00 PEEP and C-PAP: Mechanism of action, indications and contra-indications.
11:45 Ventilation modalities and indications.
12:30 Setting the ventilator
13:00 Lunch break
14:00 Monitoring during NIV.
14:30 Interfaces: masks, helmets and accessories.
15:00 Clinical case discussion with practical demonstration – (the students will be divided in 3 groups rotating in 3  40 minutes skill station)  (All faculty)
  • Acute cardiogenic pulmonary oedema
  • COPD exacerbation  
  • Hypoxemic respiratory failure (pneumonia, ARDS)
17:00 Multiple choice questions
17:30 End of course

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PRE-COURSE: ULTRASOUND ADVANCED

Saturday 7 September: 08:30 - 18:00
Sunday 8 September: 08:30 - 12:30

Course Directors

  • Gian Alfonso Cibinel (Italy)
  • James Connolly (UK)
  • Mike Lambert (USA)

Faculty 

  • Rip Gangahar, UK
  • Adela Golea, Romania
  • Robert Jarman, UK
  • Hein Lamprecht, South Africa
  • Jean-François Lanctôt, Canada
  • Christofer Muhr, Sweden
  • Gregor Prosen, Slovenia
  • Vincent Rietveld, The Netherlands
  • Maxime Valois, Canada
  • Joseph P. Wood, USA

Participants

30 physicians in 6 groups.
Requirements: english speaking participants, basic US experience and/or previous participation in a basic emergency US course, ALS/ACLS/ATLS certification recommended.

Course description

2-days emergency ultrasound advanced course: lectures, organ based hands-on practice, simulated clinical scenarios.

Learning objectives

 
  • Technique: advanced US approach to head, neck, limbs, chest, heart, abdomen
  • Recognition of advanced US syndromes
  • US enhanced advanced management of critical syndromes: cardiac arrest, shock, respiratory failure, acute abdomen, coma
  • Technique: advanced US approach to head, neck, limbs, chest, heart, abdomen
  • Recognition of advanced US syndromes
  • US enhanced advanced management of critical syndromes: cardiac arrest, shock, respiratory failure, acute abdomen, coma

Schedule

DAY 1
 
08:30 GREETINGS AND REGISTRATION. INTRODUCTION
08:45 EuSEM US education in perspective
09:00 ABC US-enhanced assessment of ABCDE
09:45 COFFEE BREAK
10:00 STATIONS: morning rotation on stations A to F for the 6 groups
A – Head & neck 
B – Lung
C – Heart
D – Abdomen
E – MSK
F – Procedures 
13:00 LUNCH BREAK
14:00 STATIONS: afternoon rotation on stations A to F for the 6 groups
A – Head & neck 
B – Lung 
C – Heart
D – Abdomen
E – MSK
F – Procedures
17:00 Meet the experts
17:30 Faculty meeting
   
DAY 2  
08:00 US-enhanced cardiac arrest algorithms
08:20 US-enhanced periarrest algorithms
09:00 STATIONS
A – Cardiac arrest
B – Cardiac arrest
C – B-Failure (also in trauma) & procedures
D – B-Failure (also in trauma) & procedures
E – C-Failure (also in trauma) & procedures
F – C-Failure (also in trauma) & procedures
12:00 END OF PRE-COURSE 

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PRE-COURSE: SCENARIO-BASED SIMULATION FACILITATOR COURSE

Saturday 7 September: 08:30 - 17:00
Sunday 8 September: 08:30 - 12:00

Course Directors

  • Director: Pr Guillaume Alinier (Qatar/UK)
  • Co-directors: Pr Denis Oriot (France), Pr Kent Denmark (USA)

Faculty / Facilitators

  • Pr Guillaume Alinier (Qatar/UK)
  • Dr Karim Benmiloud (Switzerland)
  • Pr Kent Denmark (USA)
  • Dr Ismael Hssain (France)
  • Dr François Lecomte (France)
  • Pr Denis Oriot (France)
  • Dr Luis Sanchez (Spain)
  • Dr Antonio Iglesias Vazquez (Spain)

Participants

20 trainees.

Course description

The global objectives of these workshops which will run concurrently for 2 different groups of participants are to provide a sound overview to participants of two key simulation domains, namely how to develop a simulation centre and/or simulation programme, and the fundamentals of becoming a scenario-based simulation facilitator/educator. Although both of these workshops have different themes they will be highly relevant to the daily practice of Emergency Medicine, irrespective of the level of simulation expertise the participants have.

Learning objectives

  • 1. To explore the typology of simulation-based education.
  • 2. To acquire knowledge on scenario development and facilitation, briefing, and debriefing.
  • 3. To discuss aspects of Crisis Resource Management (CRM), teamwork, human factors, and interdisciplinary learning that can be addressed using simulation.
  • 4. To put newly acquired knowledge in practice in small groups by creating and running scenarios making use of a patient simulator, and facilitating a debriefing.

Schedule

DAY 1    
     
08:30 REGISTRATION & COFFEE  
08:45

Welcome and Introduction
Objectives: Introduction of participants (instructors and trainees) and motivations for attending this workshop.

Pr G. Alinier & Pr D. Oriot
09:15

What is simulation education and what can it achieve?
Objectives: Key simulation definitions and concepts, and evidence supporting the use of simulation.

Dr F. Lecomte
09:45

From standardized patient to high fidelity simulation
Objectives: Description of simulation tools, and differentiation between the technology and the technique.

Dr L. Sanchez
10:10 The simulation environment: centre vs in-situ
Objectives: Consider the pros and cons of various potential locations where simulation can be facilitated
Dr I. Hssain
10:30 COFFEE BREAK  
10:45

Identifying key clinical and non-clinical learning objectives that can be addressed using scenario-based simulation training.

Objectives: Discussion of key lessons that can be derived from experience through realistic scenarios.

Pr D. Oriot
11:15

Scenario design and preparation

Objectives: Presentation of how a template can be used for the successful development of educationally sound scenarios.

Dr K. Benmiloud
11:45 Q&A and discussion
12:00 LUNCH BREAK  
13:00

Preparing and running a simulation: Key principles

Objectives: Preparation, briefing, simulation session, facilitation, learning objectives, importance of scenarios.

Dr F. Lecomte 
13:25

Familiarisation with patient simulator and equipment orientation.

Objectives: Gain a basic understanding of the functionalities of a commonly available mid-fidelity patient simulator and equipment available for the workshop scenarios.

Dr JAI. Vazquez
13:55 COFFEE BREAK  
14:10

Exercise; Design of a scenario as part of team of clinical educators.

Objectives: Work as a team to determine learning objectives, design a scenario around them, and determine the role of each faculty for the enactment of the scenario for the other workshop participants.

Pr D. Oriot, Dr I. Hssain, Dr F. Lecomte,Dr L Sanchez
16:20

Simulation: THE excuse for debriefing.

Objectives: Discuss the importance of debriefing, adopting good judgement debriefing practice, and the potentially negative impact.

Pr D. Oriot
16:50 Q&A and discussion
     
DAY 2    
     
08:40

Scenario 1

Objectives: Determined by the team.
Dr F. Lecomte
09:00

Scenario 1

Debriefing Objectives:
- Part 1: Debriefing of scenario by participants
- Part 2: Debriefing of debriefers by faculty

Dr F. Lecomte & Pr D. Oriot 
10:10

Scenario 2

Objectives: Determined by the team.

Dr I. Hssain
10:30

Scenario 2

Debriefing Objectives:
- Part 1: Debriefing of scenario by participants
- Part 2: Debriefing of debriefers by faculty

Dr I. Hssain & Pr D. Oriot 
11:30 Final Q&A and discussion
11:50 Workshop evaluation
12:00 END OF THE PRE-COURSE

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PRE-COURSE: SIMULATION CENTRE DESIGN AND OPERATIONS COURSE

Saturday 7 September: 08:30 - 17:00
Sunday 8 September: 08:30 - 12:00

Course Directors

  • Director: Pr Guillaume Alinier (Qatar/UK)
  • Co-directors: Pr Denis Oriot (France), Pr Kent Denmark (USA)

Faculty / Facilitators

  • Pr Guillaume Alinier (Qatar/UK)
  • Dr Karim Benmiloud (Switzerland)
  • Pr Kent Denmark (USA)
  • Dr Ismael Hssain (France)
  • Dr François Lecomte (France)
  • Pr Denis Oriot (France)
  • Dr Luis Sanchez (Spain)
  • Dr Antonio Iglesias Vazquez (Spain)

Participants

20 trainees.

Course description

The global objectives of these workshops which will run concurrently for 2 different groups of participants are to provide a sound overview to participants of two key simulation domains, namely how to develop a simulation centre and/or simulation programme, and the fundamentals of becoming a scenario-based simulation facilitator/educator. Although both of these workshops have different themes they will be highly relevant to the daily practice of Emergency Medicine, irrespective of the level of simulation expertise the participants have.

Learning objectives

  • 1. To analyse the key stages of designing a simulation centre or preparing a clinical area for in-situ simulation training.
  • 2. To explore solutions commonly adopted in simulation centres worldwide in terms of layout, configuration, storage, technology.
  • 3. To discuss operational aspects of a clinical simulation centre from an equipment point of view.
  • 4. To look at the operational aspects of a clinical simulation centre with regards to staffing and skills mix requirements.
  • 5. To analyse funding and financing of a clinical simulation programme or facility.

Schedule

DAY 1    
     
08:30 REGISTRATION & COFFEE  
09:15

Welcome and Introduction

Objectives: Introduction of participants (instructors and trainees) and motivations for attending this workshop.

Pr G. Alinier & Pr K. Denmark
09:45

What differentiates a simulation centre from a clinical skills training facility?

Objectives: Discussion around clinical skills and simulation training facilities, and simulation programmes.

Pr K. Denmark
10:30 COFFEE BREAK  
10:45

Why and how do we build a simulation centre?

Objectives: Discussion of physical and technological functional requirements and solutions.

Dr F. Lecomte
11:15

Exercise: Given your current circumstances and being realistic, draw the clinical simulation centre you would like to create, the solutions adopted, and its total estimated cost.

Objectives: Put in practice aspects of simulation centre design which have been discussed so far.

Dr JAI. Vazquez
12:00 LUNCH BREAK  
13:00

Review of proposed designs and innovative solutions.

Objectives: Discussion so participants can receive feedback. 

Dr L Sanchez 
13:45

In-situ simulation: Pros and cons of point of care context.

Objectives: Discussion of opportunities afforded by this approach, in the ultimate context from one aspect and not so convenient environment from another perspective.

Dr I. Hssain
14:15 COFFEE BREAK  
14:30

Virtual tour of existing simulation facilities.

Objectives: Allow participants to view the floor plan and pictures of other simulation centres and discuss function and educational aspects.

Pr G. Alinier & Pr K. Denmark
15:45

Operationalising a simulation facility from an equipment perspective.

Objectives: Discussion on the importance of the choice of equipment on the operation of a simulation giving consideration to their ease of use, compatibility, requirements, and likely maintenance schedules 

Dr K. Benmiloud
16:45 Q&A and discussion  
17:00 END OF DAY 1  
     
DAY 2    
     
08:30

Working with architects and building contractors to design and build a simulation centre.

Objectives: Discussion relating to establishing a positive working relationship with external partners for a successful outcome.

Pr G. Alinier
09:00

The simulation centre team: The winning ingredients.

Objectives: Gaining an understanding of what constitutes a successful team.   

Pr K. Denmark 
10:00

Coffee break

10:30

The role and usefulness of simulation centre management software and audio-visual systems.

Objectives: Discussion of the functionalities and pros and cons of investing in a simulation centre management software and AV systems.

Dr JAI. Vazquez, & Pr G. Alinier 
11:30 Final Q&A and discussion All
11:50 Workshop evaluation
12:00 END OF THE PRE-COURSE  

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PRE-COURSE: FALCK FOUNDATION - PRE HOSPITAL RESEARCH

Sunday 8 September: 08:00 - 12:30

Course Directors

  • Rune Andersen, Denmark

Faculty 

  • Olivier Hoogmartens, Belgium
  • V. Anantharaman, Singapore
  • Maaret Castrén, Sweden
  • Joost Bierens, The Netherlands

Participants

100 participants maximum.
The course shall be cancelled if less than 8 participants are registered.

Course description

The pre-conference seminar on prehospital research aims at gathering around the table practitioners seeking to improve pre-hospital emergency health care through Scientific Research.

This seminar will allow clinicians to discuss current literature, its purpose being the critical evaluation of scientific articles that impact upon the practice of pre-hospital emergency care. The aim is to critically appraise selected articles and studies and discuss the relevance and usefulness of the research findings to clinical practice, including answering the question: "Based on the results of scientific studies, should we change our practice?"

Learning objectives

  • How to keep in touch with new publications and Clinical Practice Guidelines;
  • Learn to critique and appraise pre-hospital research;
  • Learn to create a sound prehospital research proposal;
  • Encourage research utilization in prehospital care

Schedule

   Pre‐conference seminar on pre‐hospital Research
08:30 Welcome and short introduction on the Falck
Foundation and the prehospital research seminar
Rune Andersen, Denmark
08:40 Hands on approach to pre‐hospital research. Study Design and Methodology Olivier Hoogmartens, Belgium
09:30 Ethics in Prehospital Research V. Anantharaman, Singapore
10:15 BREAK
10:30 Why is Prehospital Research so Difficult? Maaret Castrén, Sweden
11:15 Rookie Mistakes and Pitfalls in prehospital Research Joost Bierens, The Netherlands
11:45 Prehospital Research Proposal V. Anantharaman, Singapore
12:15 Questions to Faculty Panel All

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Past Congresses

flag of united kingdom

2018: Glasgow, Scotland, United Kingdom

12th  European Congress on Emergency Medicine
flag of greece

2017: Athens, Greece

11th European Congress on Emergency Medicine

2016: Vienna, Austria

10th European Congress on Emergency Medicine

2015: Torino, Italy

9th European Congress on Emergency Medicine in association with SIMEU

2014: Amsterdam, Netherlands

8th European Congress on Emergency Medicine in association with NVSHA

2013: Marseille, France

7th Mediterranean Emergency Medicine Congress in collaboration with AAEM

2012: Antalya, Turkey

7th European Congress on Emergency Medicine in association with EPAT

2011: Kos, Greece

6th Mediterranean Emergency Medicine Congress in collaboration with AAEM

2010: Stockholm, Sweden

6th European Congress on Emergency Medicine in association with SweSEM

2009: Valencia, Spain

5th Mediterranean Emergency Medicine Congress in collaboration with AAEM

2008: Munich, Germany

5th European Congress on Emergency Medicine in association with DGINA

2007: Sorrento, Italy

4th Mediterranean Emergency Medicine Congress in collaboration with AAEM

2006: Crete, Greece

4th European Congress on Emergency Medicine in association with the Anaesthesiology Department of the University of Crete, Greece

2005: Nice, France

3rd Mediterranean Emergency Medicine Congress in collaboration with AAEM

2005: Leuven, Belgium

3rd European Congress on Emergency Medicine in association with the BeSEDiM

2004: Prague, Czech Republic

European Society for Emergency Medicine 10th Anniversary Symposium

2003: Sitges, Spain

2nd Mediterranean Emergency Medicine Congress in collaboration with AAEM

2002: Portoroz, Slovenia

2nd European Congress on Emergency Medicine

2001: Stresa, Italy

1st Mediterranean Emergency Medicine Congress in collaboration with AAEM

2000: Wroclaw, Poland

Eastern European Conference on Emergency Medicine

1998: San Marino

1st European Congress on Emergency Medicine

1996: Mainz, Germany

Working afternoon during WADEM Congress

1994: Inaugural Meeting

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Keynote Speakers

LANCE BECKER 

becker orgSeptember 29, 2014 - 09:00:00 / 09:45:00 - Zuiveringshal West
Keynote Session 1: Going beyond one-size-fits-all ACLS to patient-centered resuscitation

Current ILCOR guidelines suggest a common treatment algorithm that is the same for all patients in cardiac arrest. While these guidelines are useful as a starting point for treatment, an unanswered question remains on whether a patient-centered resuscitation strategy would save more lives. A patient-centered approach to resuscitation would customize the elements of resuscitation like compressions rate, depth, ventilation, and drugs to the physiology of the individual patient. A hierarchy of patient-centered sensors and therapies will be discussed that represent a paradigm shift for resuscitation.

Lance Becker, MD, Professor of Emergency Medicine and Director, Center for Resuscitation Science, has research interests that are translational and extend across the basic science laboratory into animal models of resuscitation and to human therapies. He has been a leader in the field of resuscitation for over 25 years, pioneering advances in improving the quality of CPR, AED use, defining the “three phase” phase model for cardiac arrest care, and therapeutic hypothermia. He has worked closely with the American Heart Association in emphasizing the importance of a “systems of care” approach to improving survival within communities. The systems of care approach represents a major shift in philosophy as it includes bundles of care, multiple interventions, and relies on the measurement of good outcome metrics like the community survival rate to drive the system to better survival rates. He is also an active basic science researcher with a particular interest in the role of mitochondria in “life-versus-death decision making” for cells and tissues exposed to and recovering from ischemia. He founded and directs the Center for Resuscitation Science which bring investigators from diverse fields together for resuscitation research and improved training of young scientists. His cellular studies have helped define reperfusion injury mechanisms, mitochondrial oxidant generation, reactive oxygen and nitrogen species responses to ischemia, apoptotic activation following ischemia, signaling pathways, new cellular cytoprotective strategies and hypothermia protection. Additional new studies are ongoing on development of novel human coolants for rapid induction of hypothermia, inflammatory pathways activated following shock and cardiac arrest, improving the quality of CPR, new defibrillator and cardiopulmonary bypass technologies, epidemiology of sudden death, and novel treatments for cardiac arrest.

 

CAMERON Peter

cameron org

September 29, 2014 - 09:45:00 / 10:15:00 - Zuiveringshal West
Keynote Session 2: When do we know that emergency care is quality care?

The Emergency Department is the "front door" of the hospital and results in more complaints, litigation and safety concerns than other departments. Internationally, there has been little consensus on what represents a high quality and safe ED, yet we all hope that we work in one! Developing metrics that show us the state of our EDs is important as we strive for perfection - but what does perfection look like?

Professor Peter Cameron is Chair of Emergency Medicine at Hamad Medical Corporation in Qatar, Immediate Past President of the International Federation for Emergency Medicine and Professor of Emergency Medicine at Monash University and The Alfred Hospital, Melbourne Australia. He has been extensively involved in developing quality metrics in Emergency Medicine at both a national and international level.

Christian Mueller 

chmuellerSeptember 29, 2014 - 10:45:00 / 12:30:00 - Zuiveringshal West
Hot topic session: Ruling out acute myocardial infarction within 1 hour: first results from an international, multi-centre study

Appointed to associated professor at the Department for Clinical Outcome Research Cardiology at the Medical Faculty of the Basel University in 2011, Prof. Christian Mueller is also Chief Practitioner and Department Chief at the University Hospital's Cardiological Clinic. Mueller has been working in this department since 2004. Born in 1968 in Augsburg, Germany, he studied and graduated in Munich. Christian Mueller's main research areas are especially related to the early diagnosis and the initial therapy of acute myocardial infarcts and acute heart failure. He has received various scientific awards in Intensive Care and Cardiology.

 

Sten RUBERTSSON 

rubertsoonSeptember 30, 2014 - 09:00:00 / 09:30:00 - Zuiveringshal West
Hot topic session: Cardiac Arrest - CPR: How to get the patient back

Will summarize the latest knowledge from prehospital to postcardiac arrest care on how to resuscitate the cardiac arrest patient.

MD, PhD, ESICM, EDIC, FERC, Professor in Anaesthesiology & Intensive Care Medicine, Uppsala University. Senior consultant, General ICU, Uppsala University Hospital. Research in Cardiac Arrest with focus on mechanical CPR and postcardiac arrest care.

David HUANG

david huang 1 October 1, 2014 - 09:30 / 11:00 - Zuiveringshal West
Hot topic session: Sepsis - ProCESS - implications for ED sepsis management

This presentation will discuss the background, design, and results of the ProCESS trial, and implications for ED sepsis management.

Dr. Huang trained in Emergency Medicine at Henry Ford Hospital, followed by a CCM Fellowship, NIH Research Fellowship, and MPH at the University of Pittsburgh. He is a Fellow of the American College of Emergency Physicians and the American College of Critical Care Medicine. He is a Core Faculty member of the CRISMA Center, Associate Director of the Abdominal Organ Transplant ICU, and Director of MACRO. His research focuses on organizational safety culture and patient outcome, biomarkers and resuscitation of infection and sepsis, and EM-CCM physician demographics and education. 

Dr Huang was Medical Monitor for the ProCESS trial

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Pre-Courses

Falck Foundation Prehospital Research Workshop

1 day

Participants introduce their own current version of a research proposal by which is then discussed with the researchers, group and in the plenary session. The goal of the interactive workshop is to learn the most important elements that contribute to good quality and successful prehospital research.

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Non-Invasive Ventilation 

1 day

How do you treat hypoxemic and hypercapnic patients.

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Ultrasound Beginner

2 days

This is a course applicable to all from the very beginner to those with some experience. It is an opportunity to learn anddevelop basic skills with an internationally renowned faculty.

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Ultrasound Advanced

2 days

2-days emergency ultrasound advanced course: lectures, organ based hands-on practice, simulated clinical scenarios.

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EMERGENCY DEPARTMENT ADMINISTRATION

1 day

Performance and Quality Improvement are among the central administrative challenges facing Emergency Department leaders in all countries.  Through a series of lectures and workshops facilitated by experienced faculty, course participants will learn practical approaches for improving performance and quality in their emergency departments.

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Advanced Pediatric Emergency Care (APEC)

2 days

The objective is to provide physicians participating in the course with both knowledge and advanced skills in recognizing and managing a wide spectrum of paediatric emergencies including trauma, both in the hospital and pre-hospital settings.

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Airway Management

1 day

Airway Management is a major topic in the Emergency Department. Knowledge of the different devices and techniques is necessary in order to practice safe Airway Management for the patient. 

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EBEEM Preparation Course

2 days

The European Board Examination in Emergency Medicine (EBEEM) is developed and implemented by EMERGE (Emergency Medicine Examination Reference Group in Europe). EMERGE is a joint-committee of EUSEM and the UEMS Section of Emergency Medicine. It is a two-part examination designed to confirm the candidate’s suitability for independent practice as an emergency physician within any country in the European Union.

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Programme overview

Sunday 28 September
Time Zuiveringshal West Transformatorhuis Openbare Verlichting MC Theatre Machinegebouw Ketelhuis Westerliefde
13:00
13:00-14:30
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A11
State of the Art
Pulmonary / Respiratory Emergencies

State of the Art
Pulmonary / Respiratory Emergencies

Moderators: Said LARIBI (PU-PH, chef de service) (Tours, FRANCE), Ulkumen RODOPLU (TURKEY)
13:00 - 13:30 New features for Thrombolysis and D-dimers management in Pulmonary Embolism. Frank VERSCHUREN (BELGIUM)
13:30 - 14:00 The treatment of ARF in pneumonia: Tu_be or not Tu_be? Roberto COSENTINI (Milano, ITALY)
14:00 - 14:30 Acute asthma in the ED. Tim COATS (UK)
13:00-14:30
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B11
The Netherlands Invites
Toxicology

The Netherlands Invites
Toxicology

Moderators: Basar CANDER (TURKEY), Steve HUFF (USA)
13:00 - 13:30 Appropriate Antidote Utilization in Emergency Medicine. Chris HOLSTEGE (Professor) (Charlottesville, USA)
13:30 - 14:00 Updates in Resuscitation of Poisoning Emergencies. Chris HOLSTEGE (Professor) (Charlottesville, USA)
14:00 - 14:30 Play "what did he take?” and win…. Jasper REBEL (THE NETHERLANDS)
13:00-14:30
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C11
Clinical Questions
Psychosocial Emergencies

Clinical Questions
Psychosocial Emergencies

Moderators: Timothy HUDSON RAINER (Cardiff, UK), Kevin MACKWAY-JONES (UK)
13:00 - 13:30 Victims of domestic abuse in the ED. Anna SPITERI (Consultant) (Malta, MALTA)
13:30 - 14:00 Manchester acute self-harm rule. Kevin MACKWAY-JONES (UK)
14:00 - 14:30 Populations on the move - a psychosocial emergency? Michael SPITERI (Clinical Chairperson Emergency Department) (Malta, MALTA)
13:00-14:30
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D11
Administrative Track
Performance in the ED

Administrative Track
Performance in the ED

Moderators: Ulrich BUERGI (SWITZERLAND), John HEYWORTH (UK)
13:00 - 13:30 Appropriate staffing: Key for optimal ED performance. Wilhelm BEHRINGER (Director) (Jena, GERMANY)
13:30 - 14:00 Optimal length of stay in the ED. Thomas BENTER (GERMANY)
14:00 - 14:30 Quality measures in the ED. Ulrich BUERGI (SWITZERLAND)
13:00-14:30
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E11
Research
Pre-hospital Medicine

Research
Pre-hospital Medicine

Moderators: Patrick PLAISANCE (Paris, FRANCE), Marius REHN (NORWAY)
13:00 - 13:30 Are asthma patients managed in the prehospital setting the same than those managed in the ED? Patrick PLAISANCE (Paris, FRANCE)
13:30 - 14:00 Management of multiple trauma patient in physician based prehospital system. Abdo KHOURY (PH) (Besançon, FRANCE)
14:00 - 14:30 Rapid extrication of entrapped victims in motor vehicle wreckage using a Norwegian chain method. Marius REHN (NORWAY)
13:00-14:30
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F11
Free Papers
Imaging, Ultrasound and Diagnostic Technology - Lightning Session

Free Papers
Imaging, Ultrasound and Diagnostic Technology - Lightning Session

Moderators: Tiziana MARGARIA STEFFEN (IRELAND), Luigi TITOMANLIO (Paris, FRANCE)
13:00 - 14:30 #62 - Radiological investigation of acute abdominal symptoms in a uk district general hospital.
Juliet Alletson, Rainer Gerofke, Simon Adams, Amanda Stone (GB)
13:00 - 14:30 #63 - Comparison of results of ultrasonography performed by an emergency physicians and that achieved by radiologists: concordance study.
Mounir HAGUI, Olfa Djebbi, Gofrane Ben Jrad, Imed Bennouri, Lamine Khaled (TN)
13:00 - 14:30 #124 - Time to Computed Tomography (CT) scanning in patients with traumatic intracranial haemorrhage (ICH) seen in the Emergency Department (ED) at a non-neurosurgical centre.
Benedict Broadbent, Neil Roberts, Jeremy Hunter, Ella Daniels, Hannah Lewis, Sophie Marsh, Mark Jadav (GB)
13:00 - 14:30 #257 - Lung ultrasound for the diagnosis of pulmonary edema in the emergency department.
Muhammad Saif Rehman, Muhammad Azam Majeed, Ahmed Al-Hubaishi, Asif Naveed (GB)
13:00 - 14:30 #296 - Ultrasound guidance in the radial arterial puncture: a randomized trial.
Romain GENRE GRANDPIERRE, Xavier BOBBIA, Pierre-Géraud CLARET, Stéphane POMMET, Alexandre MOREAU, Rémi PERRIN BAYARD, Thibaut MASIA, Jean-Emmanuel DE LA COUSSAYE (FR)
13:00 - 14:30 #298 - Interest, importance and limits of standard radiography in chest pain: a study based on 300 patients.
Thibaut MASIA, Romain GENRE GRANDPIERRE, Pierre-Géraud CLARET, Xavier BOBBIA, Alexandre MOREAU, Stéphane POMMET, Nadine HANSEL, Jean-Emmanuel DE LA COUSSAYE (FR)
13:00 - 14:30 #439 - Prevention of contrast induced nephropathy in patient enhanced computed tomography in emergency unit.
Sabine VILLANOVA, Farès MOUSTAFA, Nicolas DUBLANCHET, Daniel PIC, Jeannot SCHMIDT (FR)
13:00 - 14:30 #543 - (DRUFI study) Distal Radial Ultrasound guided Fracture Identification and reduction.
M Azam Majeed, Ahmed Alhubashi, M Saif Rehman (GB)
13:00 - 14:30 #656 - Interest of transthoracic echocardiography by the emergency physician in the management of dyspnea in emergency department resuscitation room.
stéphane pommet, ludivine tendron, andrew stowel, romain genre grandpierre, alexandre moreau, pierre géraud claret, xavier bobbia, jean emmanuel de la coussaye (FR)
13:00 - 14:30 #676 - Analysis of mitral flow in transthoracic ultrasonography in the management of dyspnea in emergency department resuscitation room.
stéphane pommet, romain genre grandpierre, ludivine tendron, alexandre moreau, andrew stowel, xavier bobbia, pierre géraud claret, jean emmanuel de la coussaye (FR)
13:00 - 14:30 #759 - The value of CT angiography in patients with acute severe headache.
Manda Alons, Ido van den Wijngaard, Rolf Verheul, Geert Lycklama à Nijeholt, Marieke Wermer, Ale Algra, Korné Jellema (NL)
13:00 - 14:30 #770 - Bedside ultrasound reliability in locating central Venous catheter and detecting complications.
Mahboub Pouraghaei, Parham Maroufi, Payman Moharamzadeh, Kavous Shahsavari Nia, Alireza Ala, Ali Taghizadieh, mohammadhossein Keyghobadi (IR)
13:00 - 14:30 #773 - Optic nerve sheath diameter measurement with ultrasonography can replace ophthalmoscopy for detecting papilledema in emergency department patients.
Arash Safaie, Ali Mohammadshahi, Peyman Namdar, Ali Omraninava (IR)
13:00 - 14:30 #778 - Serum CXCL12 levels at hospital admission predicts mortality in patients with severe sepsis/septic shock.
Teodoro Marcianò, Cristina Sorlini, Valentina Tinelli, Moreno Tresoldi, Stefano Franchini, Lorenzo Dagna, Maria Grazia Sabbadini (IT)
13:00 - 14:30 #863 - The emergency multiorgan ultrasound for the evaluation of hypotension in non-traumatic shock: RUSH protocol.
Julio Armas Castro, Maikel Ayo Gonzalez, Rafael Esteve Solano, Blas Gimenez Fernandez, Jara Lopez Paterna, Patricia Martin Rodríguez, Juan Carlos Real López (ES)
13:00 - 14:30 #970 - For emergency department patients presenting with bizarre behaviour, what effect did obtaining computerized tomography of the head have on management and length of stay?
Pearlly Ng, Melissa McGowan, Brian Steinhart (CA)
13:00 - 14:30 #1105 - Goal directed ultrasound (US) in emergency department patients with acute dyspnea leads to an earlier transfer in better clinical condition.
Thomas Haendl, Frances Baer, Martin Mueller, Markus Wehler (DE)
13:00 - 14:30 #1180 - What are we missing? A 1-year retrospective survey of missed radiographic abnormalities in an Emergency Department.
Jonathan Lloyd, Cathelijne Lyphout, Rosa McNamara, Ruth Brown (GB)
13:00-14:30
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G11
Free Papers
Geriatric Emergency Medicine

Free Papers
Geriatric Emergency Medicine

Moderators: Gautam BODIWALA (UK), Simon. P. MOOIJAART (LEIDEN, THE NETHERLANDS)
13:00 - 14:30 #39 - Is delirium detection possible in the ED? Testing the feasibility of the modified Confusion Assessment Method for the Emergency Department (mCAM-ED).
Florian Grossmann, Wolfgang Hasemann, Andreas Graber, Chrisitan Nickel (CH)
13:00 - 14:30 #358 - Improving resuscitation decisions in elderly in the emergency department.
H.G. de Rijck van der Gracht, G. van Woerden, E.R.J.T. de Deckere, W.P. Markito (NL)
13:00 - 14:30 #540 - Predicting the chance of hospital admission based on presentation characteristics in older patients acutely presenting to the Emergency Department.
J. Lucke, J. de Gelder, N. Heim, A.J. Fogteloo, C. Heringhaus, G.J. Blauw, S.P. Mooijaart (NL)
13:00 - 14:30 #588 - Manchester triage system in elderly patients in the emergency department.
Floor Derkx-Verhagen, Steffie Brouns, Els Lambooij, Lisette Mignot-Evers, Harm Haak (NL)
13:00 - 14:30 #640 - Profiles of older patients in the emergency department and determinants of post-discharge outcomes : findings from the interRAI multinational emergency department study.
Fredrik Sjostrand (SE)
13:00 - 14:30 #734 - Pattern and outcome of medical admission among elderly people in libya.
FATHIA ZAID, FAKHARI ALHLIFIA (LY)
13:00 - 14:30 #1146 - Modified early warning score (MEWS) and VitalPAC early warning score (VIEWS) in geriatric patients admitted to the emergency department.
Zerrin Defne Dundar, Mehmet Ergin, Mehmet Akif Karamercan, Kursat Ayranci, Tamer Colak, Alpay Tuncar, Basar Cander, Mehmet Gul (TR)
13:00 - 14:30 #1149 - Rapid emergency medicine score (REMS) and HOTEL score in geriatric patients admitted to the emergency department.
Zerrin Defne Dundar, Mehmet Ergin, Mehmet Akif Karamercan, Tamer Colak, Alpay Tuncar, Kursat Ayranci, Basar Cander, Sedat Kocak (TR)
 
15:15
15:15-16:45
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A12
State of the Art
Elderly in the ED

State of the Art
Elderly in the ED

Moderators: Alexandre JELEFF (PARIS, FRANCE), Richard WOLFE (USA)
15:15 - 15:45 The Acutely Presenting Older Adult: Towards Tailored Care Trajectories. Simon. P. MOOIJAART (LEIDEN, THE NETHERLANDS)
15:45 - 16:15 Detection of older people at increased risk of adverse health outcomes after an emergency visit. Jay BANERJEE (Leicester, UK)
16:15 - 16:45 A systematic review of interventions to improve outcomes for elders discharged from the ED. Simon CONROY (Leicester, UK)
15:15-16:45
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B12
The Netherlands Invites
Research / Management

The Netherlands Invites
Research / Management

Moderators: Carine DOGGEN (ENSCHEDE, THE NETHERLANDS), Chris HOLSTEGE (Professor) (Charlottesville, USA)
15:15 - 15:45 Developing a research idea and translating it into practise. Francis MENCL (USA)
15:45 - 16:15 Pulmonary Embolism in 2014: The Critical Updates. Scott SILVERS (USA)
16:15 - 16:45 Leadership and Management in EMS and the Emergency Department. Francis MENCL (USA)
15:15-17:00
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C12
Clinical Questions
Pulmonary / Respiratory Emergencies

Clinical Questions
Pulmonary / Respiratory Emergencies

Moderators: Abdo KHOURY (PH) (Besançon, FRANCE), Adam REUBEN (UK)
15:15 - 15:45 Community acquired pneumonia: which score to use to safely discharge patients from the ED? Roberto COSENTINI (Milano, ITALY)
15:45 - 16:15 Pulmonary Embolism in the ED: Risk stratification and which patients can be discharged from the ED? Adam REUBEN (UK)
16:15 - 16:45 Pneumothorax in the ED: which patients can be discharged? Roberta PETRINO (Head of department) (Italie, ITALY)
15:15-16:45
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D12
Administrative Track
Leadership in EM

Administrative Track
Leadership in EM

Moderators: Gautam BODIWALA (UK), Barbara HOGAN (Past President of the European Society for Emergency Medicine, EuSEM) (HAMBURG, GERMANY)
15:15 - 15:38 International EM and Leadership. Gautam BODIWALA (UK)
15:38 - 16:00 The last frontier: Developing Emergency Medicine in Norway. Lars Petter BJORNSEN (TRONDHEIM, NORWAY)
16:00 - 16:22 Business model innovation as a strategic option for the Emergency Department: Beyond entrenched management wisdoms. Christoph RASCHE (GERMANY)
16:22 - 16:45 Effective leadership within unscheduled care. Darren KILROY (UK)
15:15-16:45
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E12
Research
Clinical Toxicology

Research
Clinical Toxicology

Moderators: Basar CANDER (TURKEY), Santiago MINTEGUI (Barakaldo, SPAIN)
15:15 - 15:45 Calcium channel blocking agents intoxications. Kurt ANSEEUW (Medical doctor) (ANTWERP, BELGIUM)
15:45 - 16:15 Update on Gamma hydroxybutyrate (GHB) and analogs: Are they back on the rise? Deborah ZVOSEC (USA)
16:15 - 16:45 Pesticide poisonings. Polat DURUKAN (TURKEY)
15:15-16:45
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F12
Free Papers
Clinical Decisions Guides and Rules

Free Papers
Clinical Decisions Guides and Rules

Moderators: Michael DUERR SPECHT (GERMANY), Riccardo LETO (Chief of ED) (Overpelt, BELGIUM)
15:15 - 16:45 #209 - Traumatic minor head/brain injury; evaluation of the revised practice guideline.
Victoria van de Craats, Crispijn van den Brand, Annelijn Rambach, Roelie Postma, Femke Verbree, Frank Lengers, Christa Benit, Korne Jellema (NL)
15:15 - 16:45 #284 - Comparison of the Canadian CT Head Rule and the New Orleans Criteria in patients with minor head injury.
cemil kavalci, omer salt, polat durukan, gulsum Kavalci (TR)
15:15 - 16:45 #379 - A prospective comparison of the Glasgow-Blatchford and AIMS65 scoring systems for risk stratification in upper gastrointestinal bleeding in the emergency department.
Elif YAKA, Serkan Y?lmaz, Nurettin Özgür Do?an, Murat Pekdemir (TR)
15:15 - 16:45 #513 - Compliance with the "Infectious Diseases Society of America Guidelines" for emergency management of febrile neutropenia in cancer patients.
Latif Erdem Akal?n, Elif Yaka, SERKAN YILMAZ, Nurettin Özgür Do?an, Nazire Avcu, Murat Pekdemir (TR)
15:15 - 16:45 #523 - Does an acute pain management protocol improve pain management in acute musculoskeletal pain patients?
Jorien G. J. Pierik, Maarten J IJzerman, Sivera A Berben, Menno I Gaakeer, Arie B van Vugt, Fred L van Eenennaam, Carine J. M. Doggen (NL)
15:15 - 16:45 #537 - Children and elderly are at increased risk of undertriage by the Manchester Triage System.
Joany Zachariasse, Nienke Seiger, Pleunie Rood, Peter Patka, Frank Smit, Gert Roukema, Henriëtte Moll (NL)
15:15 - 16:45 #572 - Adherence to guidelines for the initial evaluation of syncope in the emergency department with a focus on orthostatic blood pressure measurements.
Micah Heldeweg, Pedro Freire Jorge, Mark Harms, Jack Ligtenberg, Jan Ter Maaten (NL)
15:15 - 16:45 #709 - Can a single high-sensitivity cardiac Troponin I (hs-cTnI) level taken at a patient’s initial presentation be used to rule out Acute Coronary Syndrome (ACS)?
Shoaib Ahmad, Matthew Gouldstone, Teresa Lee, Andrew Morgan, Katherine Willmer (GB)
15:15 - 16:45 #741 - An audit of patients presenting with “chest pain” to the Emergency Department (ED) following implementation of high-sensitivity cardiac Troponin I testing (hs-cTnI), and a chest pain Accelerated Diagnostic Pathway (ADP).
Shoaib Ahmad, Tamzin Burrows, Matthew Gouldstone, Edward Dunn, Fiona Shelley, Katherine Willmer (GB)
15:15 - 16:45 #1085 - Variation and Predictors of Admission after Emergency Department Visits for Diverticulitis among U.S. Hospitals: 2006-2010.
Margaret Greenwood-Ericksen, Joaquim Havens, Jiemin Ma, Joel Weissman, Jeremiah Schuur (US)
15:15-16:45
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G12
Free Papers
Disaster Medicine - Lightning Session

Free Papers
Disaster Medicine - Lightning Session

Moderators: Francesco DELLA CORTE (ITALY), Erwin DHONDT (BELGIUM)
15:15 - 16:45 #96 - From emergency physician to professional humanitarian: A literature review to identify competencies in disaster relief and emergency humanitarian assistance.
Blair Graham, Amy Hughes, Darren Walter (GB)
15:15 - 16:45 #135 - Medical evacuation center in the plural, a singular choice.
Jean-Philippe Desclefs, Stéphanie Polini, Sandra Gengembre, Roger Kadji, François-Xavier Laborne, David Sapir, Bruno Garrigue, Nicolas Briole (FR)
15:15 - 16:45 #291 - A new medical fitting of the transport aircraft CASA for mass medical evacuation during disasters or armed conflicts. An 8 months evaluation during the war in Mali in 2013.
Laura BAREAU, Emmanuel HORNEZ, George RICHA, Christian Bay, Marie dominique COLAS, Jean-Louis DABAN (FR)
15:15 - 16:45 #402 - High and prolonged demand for ambulance service, particularly in low-mortality areas, until seven weeks after the Great East Japan Earthquake.
Takahisa Kawano, Hiroshi Morita, Osamu Yamamura, Tetsuya Kimura (JP)
15:15 - 16:45 #478 - The brain tissue redox system during crush syndrome.
Natalia Pavliashvili, Natia Gamkrelidze, Vakhtang KIpiani (GE)
15:15 - 16:45 #539 - Hospital Disaster Preparedness in Italy: A nationwide study.
Pier Luigi Ingrassia, Marco Mangini, Massimo Azzaretto, Francesco Della Corte, Ahmadreza Djalali (IT)
15:15 - 16:45 #541 - Integrated Strategy for CBRN Threat Identification and Emergency Response- TIER: A EU-founded project.
Ahmadreza Djalali, Pier Luigi Ingrassia, Francesco Della Corte (IT)
15:15 - 16:45 #671 - Disaster Medicine education in senior Dutch medical students: a real disaster?
luc mortelmans, Stef Bouman, Menno GAAKEER, Greet Dieltiens, kurt anseeuw, marc sabbe (BE)
15:15 - 16:45 #723 - Vascular access without and with chemical biological radiological nuclear suit.
Nathalie GAUBERT, Stéphane DUBOURDIEU, Francis BEGUEC, M LE GUEN, Benoit FRATTINI, Hugues LEFORT, Juile SAULNIER, Daniel JOST, Laurent DOMANSKI, Jean-Pierre TOURTIER (FR)
15:15 - 16:45 #724 - Control of the upper airway without and with chemical biological radiological nuclear suit.
Nathalie GAUBERT, Stéphane DUBOURDIEU, Francis BEGUEC, M LE GUEN, Benoit FRATTINI, Juile SAULNIER, Daniel JOST, Laurent DOMANSKI, Jean-Pierre TOURTIER (FR)
15:15 - 16:45 #782 - CBRN preparedness in Dutch ambulance teams, effect of training.
luc mortelmans, Dirk De Vries, Greet Dieltiens, kurt anseeuw, marc sabbe (BE)
15:15 - 16:45 #784 - Are Belgian, military trained medical officers better prepared for CBRN incidents than civilian emergency physicians?
luc mortelmans, jent lievers, marc sabbe, Greet Dieltiens, kurt anseeuw (BE)
15:15 - 16:45 #786 - CBRN preparedness in Italian emergency department personnel in the Lazio region.
luc mortelmans, Alessandra Revello, steve photiou, Greet Dieltiens, kurt anseeuw, marc sabbe (BE)
15:15 - 16:45 #788 - Fight or flight: will hospital personnel go to work when disaster strikes?
luc mortelmans, pieter van turnhout, gert van springel, Francis Somville, harald de cauwer, Greet Dieltiens, kurt anseeuw, marc sabbe (BE)
15:15 - 16:45 #1054 - The use of Twitter in the acute response phase of two natural disasters in Italy: a comparison of Abruzzo’s (2009) and Emilia Romagna’s (2012) earthquakes.
Pier Luigi Ingrassia, Katuscia Vettoretto, Ester Boniolo, Luca Carenzo, Jeffrey Franc, Luca Ragazzoni, Francesco Della Corte (IT)
15:15 - 16:45 #1059 - Triage decreases the mortality in a simulated road traffic MCI scenario.
Michel Debacker, Christophe Ullrich, Filip Van Utterbeeck, Emilie Dejardin, Erwin Dhondt, Ives Hubloue (BE)
15:15 - 16:45 #1103 - Disaster medical response to Tacloban, Philippines – An epidemiological profile of 3380 patients treated aftermath of Typhoon Haiyan.
Srihari Cattamanchi, Hazem H. Alhazmi, Khaldoon Alkhaldi, Asaad Alsufyani, Ashley L. Greiner, Tyler Howrigan, Selwyn Mahon, Michael Rubin, Gregory Ciottone (US)
 
17:00
17:00-18:30
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A13
State of the Art
Pre-hospital Medicine

State of the Art
Pre-hospital Medicine

Moderators: Carmen Diana CIMPOESU (Prof univ. Head of ED) (IASI, ROMANIA), Jana SEBLOVA (Emergency Physician) (PRAGUE, CZECH REPUBLIC)
17:00 - 17:30 Public and Prehospital interface: between communication, ethics and law. Jana SEBLOVA (Emergency Physician) (PRAGUE, CZECH REPUBLIC)
17:30 - 18:00 Dispatch systems in Europe - time and efficiacy. Carmen Diana CIMPOESU (Prof univ. Head of ED) (IASI, ROMANIA)
18:00 - 18:30 Prehospital patient safety. Stephen SOLLID (NORWAY)
17:00-18:30
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B13
The Netherlands Invites
Aquatic Emergencies

The Netherlands Invites
Aquatic Emergencies

Moderators: Koen MONSIEURS (BELGIUM), Jasper REBEL (THE NETHERLANDS)
17:00 - 17:30 Pathophysiology of drowning and the consequences for optimal resuscitation. Joost BIERENS (Thesis Coordinator EMDM) (Brussels, BELGIUM)
17:30 - 18:00 Drowning: victims and rescuers. Jeroen SEESINK (THE NETHERLANDS)
18:00 - 18:30 How does BEL meet the NATO surgical planning timeline requirements at sea? Erwin DHONDT (BELGIUM)
17:00 - 18:30 Flood Risk Management in the Netherlands. Robert SLOMP
17:00-18:30
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C13
Clinical Questions
Elderly in the ED

Clinical Questions
Elderly in the ED

Moderators: Jay BANERJEE (Leicester, UK), Christian NICKEL (Vice Chair) (Basel, SWITZERLAND)
17:00 - 17:30 Profiles of older patients in the emergency department. Jay BANERJEE (Leicester, UK)
17:30 - 18:00 Screening, detection and management of delirium in the ED. Christian NICKEL (Vice Chair) (Basel, SWITZERLAND)
18:00 - 18:30 Trauma in the older patient: epidemiology and management. Richard WOLFE (USA)
17:00-18:30
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D13
Administrative Track
Cost-effectiveness in the ED

Administrative Track
Cost-effectiveness in the ED

Moderators: Judith BOSMANS (THE NETHERLANDS), Christoph RASCHE (GERMANY)
17:00 - 17:30 Cost-effectiveness in the ED: example temperature management after cardiac arrest. Wilhelm BEHRINGER (Director) (Jena, GERMANY)
17:30 - 18:00 General practitioners in the ED: Cost effective? Judith BOSMANS (THE NETHERLANDS)
18:00 - 18:30 From cost effectiveness to creation of shared value: how EDs can contribute to clinic performance by means of workflow- and network-capabilities. Christoph RASCHE (GERMANY)
17:00-18:30
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E13
Research
Excellence in EM: Global Connections

Research
Excellence in EM: Global Connections

Moderators: Raed ARAFAT (ROMANIA), Ulkumen RODOPLU (TURKEY)
17:00 - 17:15 Women and leadership in Emergency Medicine. Judith TINTINALLI (Chapel hill, USA)
17:15 - 17:30 Visualising the future of data management. Michael DUERR SPECHT (GERMANY)
17:30 - 17:45 How many national societes does Turkey need, and how does this impact EM? Ulkumen RODOPLU (TURKEY)
17:45 - 18:00 What is the future of Emergency Medicine education in India? Tamorish KOLE (INDIA)
18:00 - 18:15 What can pre-hospital emergency medicine do for EuSEM? Raed ARAFAT (ROMANIA)
18:15 - 18:30 Humanitarian crises and the Emergency Physician. Stephanie KAYDEN (USA)
17:00-18:30
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F13
Free Papers
Cardiovascular Emergencies 1

Free Papers
Cardiovascular Emergencies 1

Moderators: Barbra BACKUS (dordrecht, THE NETHERLANDS), Özcan SIR (Doetinchem, THE NETHERLANDS)
17:00 - 18:30 #64 - Ecg quality and documentation audit: in an irish district general hospital.
Brendan Crosbie, Claire Keaveney, Richard Lynch (IE)
17:00 - 18:30 #329 - The diagnostic value of clinical symptoms in women and men presenting with chest pain at the emergency department, a prospective cohort study.
Manon van der Meer, Barbra Backus, Yolanda van der Graaf, Maarten J Cramer, Yolande Appelman, Pieter A Doevendans, A Jacob Six, Hendrik M Nathoe (NL)
17:00 - 18:30 #385 - Continuous Noninvasive Orthostatic Blood Pressure Measurements with syncope patients at the Emergency Department.
Mark Harms, Veera van Wijnen (NL)
17:00 - 18:30 #401 - HOW EFFICIENT ARE EMERGENCY PHYSICIANS AT STRATIFYING RISK WHEN ORDERING STRESS TESTS FROM THE EMERGENCY DEPARTMENT (ED)?
Lisa Moreno-Walton, Nicholas Otts, Benjamin Lee (US)
17:00 - 18:30 #435 - Assessment of reversal prothrombic complex concentrate (PCC) with vitamin K for patients admitted in emergency department for severe bleeding under vitamin K agonist.
Marine PILOT, Farès MOUSTAFA, Nicolas DUBLANCHET, Jennifer SAINT-DENIS, Jeannot SCHMIDT (FR)
17:00 - 18:30 #437 - Retrospective and descriptive study about 73 consecutive patients treated by new oral anticoagulants and admitted to an emergency room.
Guilhem MILHAUD, Farès MOUSTAFA, Nicolas DUBLANCHET, Loic DOPEUX, Jeannot SCHMIDT (FR)
17:00 - 18:30 #519 - The multiplication of the offer in antiplatelet agents increased the number of patients with a ST-segment elevation myocardial infarction receiving a Dual Antiplatelet Therapy.
Julian Moro, Alain Courtiol, Hugues Lefort, Gilles Lenoir, Sophie Bataille, Emmanuelle Chevallier-Portalez, Gaëlle Le Bail, Jean-Yves Letarnec, Mireille Mapouata, Jean-Michel Juliard, Frédéric Lapostolle (FR)
17:00 - 18:30 #526 - ST-segment elevation myocardial infarction (STEMI) in patients under 40 years of age.
Jean-Michel Juliard, Jennifer Culoma, Hugues Lefort, Sophie Bataille, Séverine Cahun-Giraud, Xavier Mouranche, François Dupas, Lionel Lamhaut, Emmanuelle Chevallier-Portalez, Frédéric Lapostolle, Yves Lambert (FR)
17:00 - 18:30 #1043 - Variation and Predictors of Admission after Emergency Department Visits for Atrial Fibrillation and Atrial Flutter among U.S. Hospitals: 2006-2010.
Michelle Lin, Jiemin Ma, Kenneth Bernard, Christopher Baugh, Joel Weissman, Jeremiah Schuur (US)
17:00-18:30
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G13
Free Papers
Critical Care / CPR & Resuscitation

Free Papers
Critical Care / CPR & Resuscitation

Moderators: Juliusz JAKUBASZKO (POLAND), Andrew LOCKEY (Halifax, UK)
17:00 - 18:30 #57 - Availability of cerebral oxygen saturation to predict the futility of resuscitation for out-of-hospital cardiopulmonary arrest patients.
Tatsuma Fukuda, Naoko Ohashi, Masahiro Nishida, Masataka Gunshin, Kent Doi, Takehiro Matsubara, Yoichi Kitsuta, Susumu Nakajima, Naoki Yahagi (JP)
17:00 - 18:30 #120 - Effect of continuous oxygen insufflation during continuous mechanical external cardiopulmonary resuscitation on volume injected in the stomach in a cadaveric model.
Nicolas Segal, Djamila Rerbal, Eric Voiglio, Daniel Jost, Pierre-Yves Dubien, Vincent Lanoe, Marion Dhers, Jean-Pierre Tourtier, Patrick Plaisance, Pierre-Yves Gueugniaud (FR)
17:00 - 18:30 #138 - Reducing mortality after out-of-hospital cardiac arrest : is this possible?
Thierry Schissler, Bart Lesaffre (BE)
17:00 - 18:30 #318 - Continuous positive airway pressure ventilation with bag-valve-mask in the out-of-hospital cardiac arrest management.
Vincent LANOË, Romain MOREAU, Pascal DESNOUES, Daniel JOST, Nicolas SEGAL, Sophie MOLE, Djamila RERBAL, Jean-Pierre TOURTIER, Laurent DOMANSKI (FR)
17:00 - 18:30 #471 - Inaccurate treatment decisions of Automated External Defibrillators: incidence, cause and impact on outcome.
Simon Calle, Paul Calle, Nicolas Mpotos, Koenraad Monsieurs (BE)
17:00 - 18:30 #652 - Cerebral saturation in the pre-hospital cardiac arrest patients, difference between survivors and non-survivors.
Cornelia Genbrugge, Jo Dens, Ingrid Meex, frank Jans, Willem Boer, Cathy de deyne (BE)
17:00 - 18:30 #714 - PROGNOSTIC FACTORS IN PATIENTS HOSPITALISED WITH DIABETIC KETOACIDOSIS.
Sukriti Kumar, Manish Gutch (IN)
17:00 - 18:30 #761 - The comparison of MEWS and SOFA scoring systems in evaluation of patients at critical care units.
Mehmet Ergin, Mustafa Gülpembe, Fatih Emin Visneci, Zerrin Defne Dündar, Abdullah Sad?k Girisgin, Sedat Koçak, Mehmet Gül, Basar Cander (TR)
17:00 - 18:30 #1050 - Evaluation of Developed Complications Following Cardiopulmonary Resuscitation in Emergency Department.
Handan Çiftçi, Hayri Ramadan, Yasemin Y?lmaz Ayd?n, Aylin Erkek, Sevilay Vural, Figen Co?kun (TR)
17:00 - 18:30 #1119 - A simplified lung scoring system to assess lung injury severity in patients with acute respiratory distress syndrome admitted in an intensive care unit.
Carolina Matida Gontijo Coutinho, Thiago Martins Santos, Marcelo Schweller, Marco Antonio Carvalho Filho (BR)
 
18:45
18:45-19:50
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OC
Opening Ceremony
Opening Ceremony

Opening Ceremony
Opening Ceremony

18:45 - 18:55 Welcome and Introduction.
18:55 - 19:15 Looking back on 20 years of EuSEM. Herman DELOOZ (BELGIUM)
19:15 - 19:35 Looking forward. Barbara HOGAN (Past President of the European Society for Emergency Medicine, EuSEM) (HAMBURG, GERMANY)
19:35 - 19:50 Dutch public figure address. Fred KRAPELS (THE NETHERLANDS)
           
Monday 29 September
Time Zuiveringshal West Transformatorhuis Openbare Verlichting MC Theatre Machinegebouw Ketelhuis Westerliefde
 
09:00
09:00-09:45
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KS1
Keynote Session 1

Keynote Session 1

09:15 - 09:45 Goind beyond one-size-fits-all ACLS to patient-centered resuscitation. Lance BECKER (USA)
           
 
09:45
09:45-10:15
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KS2
Keynote Session 2

Keynote Session 2

09:45 - 10:15 When do we know that emergency care is quality care? Peter CAMERON (AUSTRALIA)
           
 
10:45
10:45-12:30
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A21
State of the Art
Cardiovascular Emergencies

State of the Art
Cardiovascular Emergencies

Moderators: Rick BODY (UK), Stephen SMITH (USA)
10:45 - 11:15 HOT TOPIC: Ruling out acute myocardial infarction within 1 hour: first results from an international, multi-centre study. Christian MUELLER (SWITZERLAND)
11:15 - 11:45 Can we safely rule out acute coronary syndromes immediately upon arrival in the Emergency Department?'. Rick BODY (UK)
11:45 - 12:05 Copeptin for the early rule out of acute myocardial infarction. Martin MOECKEL (Berlin, GERMANY)
12:05 - 12:30 The role of CT coronary angiography in the Emergency Department. David BROWN (USA)
10:45-12:15
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B21
The Netherlands Invites
Concentration in Emergency Care

The Netherlands Invites
Concentration in Emergency Care

Moderator: Crispijn VAN DEN BRAND (PHYSICIAN) (den haag, THE NETHERLANDS)
10:45 - 11:15 Emergency Care: Next Level! Frank BOSCH (THE NETHERLANDS)
11:15 - 11:45 How to create optimal value of emergency care for patients and society as a whole? David IKKERSHEIM (THE NETHERLANDS)
11:45 - 12:15 The Quality of Emergency Care; Broadening the Perspective. Teun JERAK-ZUIDERENT (THE NETHERLANDS)
10:45-12:15
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C21
Clinical Questions
Disaster Medicine

Clinical Questions
Disaster Medicine

Moderator: Alessandra REVELLO (ITALY)
10:45 - 11:15 Reverse Triage. Mick MOLLOY (Director of Research) (DUBLIN, IRELAND)
11:45 - 12:15 Preparedness of ED for CBRNE events. Luc MORTELMANS (PHYSICIAN) (Antwerp, BELGIUM)
10:45-12:15
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D21
Administrative Track
Patient Safety / Risk Management

Administrative Track
Patient Safety / Risk Management

Moderators: Ruth BROWN (Speaker) (London, UK), Barbara HOGAN (Past President of the European Society for Emergency Medicine, EuSEM) (HAMBURG, GERMANY)
10:45 - 11:15 How it all goes wrong - common examples of risk and negligence in EM. John HEYWORTH (UK)
11:15 - 11:45 Risk stratification of acute patients – how to find the sick ones. Mikkel BRABRAND (TRAINEES/NURSES/PARAMEDICS) (ESBJERG, DENMARK)
11:45 - 12:15 Cognitive biases in Emergency Medicine. Christian HOHENSTEIN (PHYSICIAN) (JENA, GERMANY)
10:45-12:15
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E21
Research
Elderly in the ED

Research
Elderly in the ED

Moderators: Abdelouahab BELLOU (BOSTON, USA), Simon CONROY (Leicester, UK)
10:45 - 11:15 Prehospital, acute care delivery system to optimize outcomes for older patients with emergency conditions. Alexandre JELEFF (PARIS, FRANCE)
11:15 - 11:45 Pathophysiology of severe sepsis in the elderly: clinical impact and therapeutic considerations. Abdelouahab BELLOU (BOSTON, USA)
11:45 - 12:15 Triage of Elderly ED patients: Common Pitfalls. Christian NICKEL (Vice Chair) (Basel, SWITZERLAND)
10:45-12:15
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F21
Free Papers
Education and Training

Free Papers
Education and Training

Moderators: Luca CARENZO (SIMULATION COMPETITION ONLY) (NOVARA, ITALY), Cornelia HARTEL (Medical Director of the ED, Consultant in EM, Director of Medical Education in EM) (STOCKHOLM, SWEDEN)
10:45 - 12:15 #59 - Comparative Evaluation of Evidence-based Journal Clubs and Conventional Journal Clubs in Teaching Critical Appraisal Skill to Emergency Medicine Residents.
Mostafa Alavi-Moghaddam (IR)
10:45 - 12:15 #348 - Using gaming theory to motivate doctors in training.
Colin Dibble, Nicholas Gili, Daniel Horner (AU)
10:45 - 12:15 #397 - Survey investigation of the attitudes and knowledge of Emergency Department (ED) personnel and patients regarding racial and ethnic healthcare disparities.
Lisa Moreno-Walton, Benjamin Lee, Linus Igbokwe (US)
10:45 - 12:15 #414 - Improvement areas in Pediatric Emergency training detected by high-fidelity simulation.
Borja Gomez, Javier Benito, Beatriz Azkúnaga, María González, Yolanda Ballestero, Santiago Mintegi (ES)
10:45 - 12:15 #590 - Do learners use on scene what they learnt in simulation?
Benoit FRATTINI, Francis BEGUEC, Stéphane DUBOURDIEU, Marilyn FRANCHIN, Sandrine BACQUAERT, Olga MAURIN, Jean Pierre TOURTIER, Laurent DOMANSKI (FR)
10:45 - 12:15 #890 - Assessing the assessment: disadvantages of checklists in emergency care skills assessment.
Frank Baarveld, Karen Stegers-Jager, Jeroen van Merrienboer, Geoff Norman, Frans Rutten, Jan van Saase, Stephanie Schuit, M.E.W. Dankbaar (NL)
10:45 - 12:15 #921 - Residents' experiences of abuse and harassment in emergency departments.
Akram Zolfaghari Sadrabad, Hossein Alimohammadi, Farahnaz Bidarizerehpoosh, Hamidreza Hatamabadi, Reza Farahmand Rad, Hamid Kariman (IR)
10:45 - 12:15 #1138 - Social Media and Medical Education: A European-wide pilot survey.
Luca Carenzo, Angelo D'Ambrosio, Pieter Jan Van Asbroeck, Riccardo Leto, EuSEM EuSEM Young Emergency Medicine Doctors Section (IT)
10:45 - 12:15 #1179 - Scientific research in emergency medicine in relation to the professional development of Emergency Physicians in the Netherlands.
C.J.H. Veldhuyzen, M.I. Gaakeer, C.L. van den Brand, K. Caminada, E. Zwets (NL)
10:45-12:15
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G21
Free Papers
Geriatrics, Orthopedics, Endocrine - Lightning Session

Free Papers
Geriatrics, Orthopedics, Endocrine - Lightning Session

Moderators: Erwin DHONDT (BELGIUM), Sandra SCHNEIDER (USA)
10:45 - 12:15 #109 - Is platelet transfusion effective in patients taking anti-platelet agents who suffer an intracranial hemorrhage?
Beng Leong Lim, Kuan Peng David Teng (SG)
10:45 - 12:15 #113 - Increased risk of ischemic stroke in patients with mild traumatic brain injury: a nationwide cohort study.
Yung-Cheng Su (TW)
10:45 - 12:15 #253 - Non-convulsive Seizure And Non-convulsive Status Epilepticus In Emergency Department Patients With Altered Mental Status.
Shahriar Zehtabchi, Richard Sinert, Ahmet Omurtag, Andre Fenton, Samah Abdel Baki (US)
10:45 - 12:15 #392 - Correlation of total serum magnesium level with clinical outcomes in stroke patients.
ali arhami dolatabadi, afshin amini, ali memari, hamid kariman, hamidreza Hatamabadi, reza farahmandrad, farhad Assarzadegan, akram Zolfaghari Sadrabad, ali Dalirrooyfard (IR)
10:45 - 12:15 #654 - Retrospective evaluation of management of 101 consecutive patients affected by ischemic stroke.
Geraldine GIROUD, Farès MOUSTAFA, Nicolas DUBLANCHET, Daniel PIC, Anna FERRIER, Jeannot SCHMIDT (FR)
10:45 - 12:15 #659 - The relationship between NT-proBNP levels and QT changes in acute ischemic stroke.
Ayca Acikalin, Salim Satar, Onur Akpinar, Caglar Emre Cagliyan, Mustafa Sahan, Ferhat Icme, Muge Gulen, Mehmet Yildiz (TR)
10:45 - 12:15 #736 - STROKE MIMICS; A CHALLENGE FOR THE EMERGENCY PHYSICIAN.
Valle Joaquin, Snow David, Lopera Elisa, Lopez Almudena (GB)
10:45 - 12:15 #753 - Gender Influence On I.V. Thrombolysis For Acute Ischemic Stroke.
anne falcou, manuela de michele, svetlana lorenzano, niaz ahmed, nils wahlgren, danilo toni (IT)
10:45 - 12:15 #803 - Acute Stroke Door-to-Needle Time in the Emergency Department.
Massimo Zannoni, Alberto Rigatelli, Manuel Cappellari, Paolo Bovi, Giorgio Ricci (IT)
10:45 - 12:15 #932 - Cerebral venous thrombosis in emergency department: a retrospective single center study of 40 cases.
Lucie Purgertova, Mihaela Mihalcea - Danciu, Claude Geronimus, Claire Kam, Hakim Slimani, Pascal Bilbault (FR)
10:45 - 12:15 #1076 - Availibilty of glial fibrillary acidic protein in differentiation of stroke.
ibrahim KAYITMAZBATIR, BA?AR CANDER, zerrin defne DUNDAR (TR)
10:45 - 12:15 #1079 - Stroke differentiation by heparin binding protein and troponin-?
BA?AR CANDER, zerrin defne DUNDAR, ibrahim KAYITMAZBATIR (TR)
10:45 - 12:15 #1098 - Intracranial hemorrhage in emergency department: one year experience.
Domingo Ribas, Jesús Galvez, Laura Torrente, Francesc Xavier Aviles, Albert Moreno, Carme Boqué (ES)
10:45 - 12:15 #1129 - Cerebral venous thrombosis: diagnostic trap in emergency medicine. An 8-year retrospective study.
Paul Gayol, David Loricourt, Eric Bayle, Fadi Khalil, Manana Potocnik, Ruxandra Cojocaru, Syamak Agababai, Remy Beaujeux, Christian Marescaux, Pascal Bilbault (FR)
 
14:00
14:00-15:30
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A22
State of the Art
Disaster Medicine

State of the Art
Disaster Medicine

Moderators: Raed ARAFAT (ROMANIA), Pinchas HALPERN (PHYSICIAN) (TEL AVIV, ISRAEL)
14:00 - 14:30 ED overcrowding. Alessandra REVELLO (ITALY)
14:30 - 15:00 When a bomb goes off: Management of explosive injury-related MCI. Pinchas HALPERN (PHYSICIAN) (TEL AVIV, ISRAEL)
15:00 - 15:30 Management of Major Incidents in Megacities. Jean-Pierre TOURTIER (Médecin en chef) (Paris, FRANCE)
14:00-15:30
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B22
The Netherlands Invites
Optimal Care for Self Referred Patients

The Netherlands Invites
Optimal Care for Self Referred Patients

Moderator: Crispijn VAN DEN BRAND (PHYSICIAN) (den haag, THE NETHERLANDS)
14:00 - 14:30 Myths and facts about ED visits in the Netherlands. Menno GAAKEER (UTRECHT, THE NETHERLANDS)
14:30 - 15:00 ED Patient Casemix, Lies, Damned Lies and Statistics. Clifford MANN (UK)
15:00 - 15:30 A Bridge Too Far in Basic Emergency Care. Peter DE GROOF (THE NETHERLANDS)
14:00-15:30
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C22
Clinical Questions
EuSEM Meets: European Society of Cardiology

Clinical Questions
EuSEM Meets: European Society of Cardiology

Moderators: Abdelouahab BELLOU (BOSTON, USA), Christian MUELLER (SWITZERLAND)
14:00 - 15:30 Management of Acute Heart Failure in the ED. Christian MUELLER (SWITZERLAND)
14:30 - 15:00 Management of Atrial Fibrillation in the ED. Bulent GORENEK (TURKEY)
15:00 - 15:30 Management of Acute Chest Pain in the ED. Abdelouahab BELLOU (BOSTON, USA)
14:00-15:30
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D22
Administrative Track
Simulation & Experiential Learning

Administrative Track
Simulation & Experiential Learning

Moderators: Natalie MAY (Oxford, UK), Denis ORIOT (POITIERS, FRANCE)
14:00 - 14:30 No evaluation means no simulation. Denis ORIOT (POITIERS, FRANCE)
14:30 - 15:00 Guerilla Sim. Simon CARLEY (Manchester, UK)
15:00 - 15:30 An innovative approach to learning from cases: Steve Smith's ECG blog. Stephen SMITH (USA)
14:00-15:30
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E22
Research
Education and Training in EM

Research
Education and Training in EM

Moderators: Darren KILROY (UK), Suzanne MASON (Professor of Emergency Medicine) (Sheffield, UK)
14:00 - 14:30 EDIT Study: Evaluation of doctors in training. Suzanne MASON (Professor of Emergency Medicine) (Sheffield, UK)
14:30 - 15:00 Effective models of clinical supervision. Darren KILROY (UK)
15:00 - 15:30 Mapping the EM specialty across Europe. Lisa KURLAND (SWEDEN)
14:00-15:30
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F22
Free Papers
Management and ED Organisation 1

Free Papers
Management and ED Organisation 1

Moderators: Cinzia BARLETTA (ITALY), Sandra VERELST (Chef du service des urgences) (Louvain, BELGIUM)
14:00 - 15:30 #287 - Improving patient flow in the emergency department: an observational quality improvement study.
Liza Walet, Brenda Groen, Loes Janssen, Heinrich Janzing, Nathalie Peters, Joost Swaanenburg (NL)
14:00 - 15:30 #336 - ANALYSIS OF APPROPRIATENESS OF ADMISSIONS AND NON ADMISSIONS OF PATIENTS VISITING THE EMERGENCY DEPARTMENT (ED) FOR A MEDICAL COMPLAINT.
AURORE MAHE, DAVID VEILLARD, EMMA BAJEUX, JACQUES BOUGET, Jérémie Bonenfant, Philippe Seguin, ABDELOUAHAB BELLOU (US)
14:00 - 15:30 #368 - Survey of health professionals working in Emergency Department on sexual violence.
Maria Pia Ruggieri, Alessandra Revello, Francesca De Marco, Donatella Livoli, Francesco Rocco Pugliese (IT)
14:00 - 15:30 #375 - Outcomes of emergency department overcrowding: a systematic review.
Ines Weggelaar (NL)
14:00 - 15:30 #443 - Power in predicting hospital admissions: Sepsis Fast Track Triage versus Manchester Triage System.
Micaela Monteiro, Ana Corredoura, Maria Carmo, Maria Bravo (PT)
14:00 - 15:30 #449 - Impact of the implementation of a Mobile Geriatric Team in a Emergency Department for the management of the elderly.
Frederic COCU, Stephanie LEGROS, Marion GUERRIER COUTADEUR, Yann VOISIN, Eric REVUE, Anne FAUDON GIBELIN (FR)
14:00 - 15:30 #480 - Decreasing the Length of Stay in the Emergency Department to 4 hours target : it’s possible !
Stephanie LEGROS, Frederic COCU, Marion GUERRIER COUTADEUR, Eric REVUE (FR)
14:00 - 15:30 #559 - Does a combined front office policy lead to a more appropriate ed population?
Marion de Rooi, Sjoerd Bakker, Danielle de Vries, Martin Heetveld (NL)
14:00 - 15:30 #674 - Lean ED: emergency department service improvement in challenging times.
Kevin Enright, Jane Galloway, Tom McCarthy, Gerrie Adler, Culadeeban Ratneswaran (GB)
14:00 - 15:30 #531 - Fast track medical treatment of elderly patients (?75 years) may be related to lower mortality.
Camilla Strøm, Lars S. Rasmussen, Søren Wistisen Rasmussen, Thomas Andersen Schmidt (DK)
14:00-15:30
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G22
Free Papers
Pre-hospital EM - Lightning Session

Free Papers
Pre-hospital EM - Lightning Session

Moderators: Katarina BOHM (SWEDEN), Stephen SOLLID (NORWAY)
14:00 - 15:30 #36 - Dispatcher recognition of acute stroke using a “key-word” system.
Fabrice Dami, Alexandre Emery (CH)
14:00 - 15:30 #86 - The French pre-hospital trauma triage criteria. Is “pre-hospital resuscitation” criterion of extra value?
Emmanuel HORNEZ, Guillaume Boddaert, Aurélie Mayet, Olga Maurin, Federico Gonzalez, Jean Louis Daban (FR)
14:00 - 15:30 #97 - Pre-hospital blood transfusion: a demonstration of requirement.
John Ferris, Alistair Watts, Adam Chesters (GB)
14:00 - 15:30 #154 - Using EMS telephone triage data to assess the amount of ambulance resources saved through telephone triage.
Tracey Barron, Conrad Fivaz, Jerry Overton (GB)
14:00 - 15:30 #156 - Ability Of a Diabetic Problems Protocol to Predict Patient Severity Indicators Determined by On-Scene EMS Crews.
Jeff Clawson, Greg Scott, Isabel Gardett, Brett Patterson, Tracey Barron, Chris Olola (GB)
14:00 - 15:30 #374 - Ultrasound pre-hospital use for the diagnosis of selective intubation: a feasibility study.
Olga MAURIN, Marilyn FRANCHIN, Guillaume BURLATON, Noémie GALINOU, Romain JOUFFROY, Olivier BON, Daniel JOST, Jean-Pierre TOURTIER (FR)
14:00 - 15:30 #381 - An observational prospective study about the factors that influence direct admissions in stroke unit of the suspect patients of stroke.
Stéphane DUBOURDIEU, Daniel JOST, Laure ALHANATI, Francis BEGUEC, Sophie MOLE, Vincent LANOË, Chritian LE NGOC HUE, Laurent DOMANSKI, Jean-Pierre TOURTIER (FR)
14:00 - 15:30 #406 - Comparison between Emergency Medical Dispatchers and ambulance personnel assessment of patients severity and condition.
Veronica Lindström, Tomas Nilsson, Katarina Bohm, Anders Eriksson (SE)
14:00 - 15:30 #515 - Patients presenting a 2 hours early persistent ST-segment elevation myocardial infarction (STEMI): Can age and localization of myocardial infarcts change the reperfusion time?
Hugues Lefort, Yann-Laurent Violin, Emmanuelle Aaron, Xavier Mouranche, François Laborne, François Dupas, Thévy Boche, Laurent Rebillard, Emmanuelle Chevallier-Portalez, Séverine Cahun-Giraud, Sophie Bataille (FR)
14:00 - 15:30 #524 - Mathematics meets Medicine. Prediction Patterns for pre-hospital emergencies.
Marius Smarandoiu, Ana Maria Acu, Alin Canciu, Denisa Falamas, Monica Sipos, Daniela Taran (RO)
14:00 - 15:30 #528 - Out-of-hospital reperfusion strategy for patients presenting an early 2 h ST segment elevation myocardial infarction (STEMI).
Yves Lambert, Catherine Rivet, Hugues Lefort, Laurent Rebillard, Xavier Mouranche, François Laborne, Jean-Yves Letarnec, François Dupas, Sophie Bataille, Jean-Michel Juliard, Frédéric Lapostolle (FR)
14:00 - 15:30 #567 - Can we Reliably Suspect Pelvic injuries Based on Mechanism.
M Azam Majeed, Graeme Paterson, Asif Naveed, Jitender Monga, Vibhore Gupta, Umesh Salanke (GB)
14:00 - 15:30 #631 - A Multidimensional Approach to Effectively Enhance Dispatcher Assisted Cardiopulmonary Resuscitation.
Hao-Yang Lin, Kah-Meng Chong, Ming-Tai Jeng, Ming-Ju Hsieh, Jiun-Wei Chen, Tsung-Chien Lu, Matthew Huei-Ming Ma, Patrick Chow-In Ko (TW)
14:00 - 15:30 #924 - Analysis of a functioning indicator of the Mobile Intensive Care Unit : “ false alarm”.
Houda Belhaouane, Salim Hamdani, Mylène Ben Hamida, Dorsaf Bellasfar, Mounir Daghfous (TN)
14:00 - 15:30 #950 - Development of a national research agenda for ambulance emergency medical services in the Netherlands, an online Delphi study.
Sivera Berben, Irene Glind van de, Pierre Grunsven van, Henk Poppen, Ina Bolt, Wim Wolde ten, Margreet Hoogeveen, Lilian Vloet (NL)
14:00 - 15:30 #995 - European guidelines: visual patterns overlapping at national scale.
Marius Smarandoiu, Alin Canciu, Denisa Falamas (RO)
14:00 - 15:30 #1000 - Barriers, facilitators, disparities and consequences for people from minority ethnic groups accessing prehospital care: systematic review and narrative synthesis.
Viet-Hai Phung, Karen Windle, Zahid Asghar, Marishona Ortega, Nadya Essam, Mukesh Barot, Joe Kai, Mark Johnson, Aloysius Niroshan Siriwardena (GB)
14:00 - 15:30 #1001 - Dispatching units: with or without an emergency specialist?
Denisa Falamas, Harambas Diana, Smarandoiu Marius, Slavu Paul, Daniela Taran (RO)
14:00 - 15:30 #1037 - How should we measure ambulance service quality and performance?
Joanne Coster, Andy Irving, Janette Turner, Niro Siriwardena, Richard Wilson (GB)
14:00 - 15:30 #1092 - Profile of a traumatized patient: recognizable patterns.
Alin Canciu, Marius Smarandoiu, Oana Bodea, Denisa Falamas, Alexandru Nicula, Sorina Podariu (RO)
14:00 - 15:30 #1118 - Emergency call and the time for contact medical dispatch in North-East Romania.
Diana Cimpoesu, Paul Nedelea (RO)
14:00 - 15:30 #1172 - Developing an universal benchmark tool and common performance reporting standards for European emergency medical dispatch (EMD) centres.
Olivier Hoogmartens, Janette Turner, Alexandra Ziemann, Krafft Thomas, Luis Garcia-Castrillo Riesgo, Freddy Lippert (NL)
14:00 - 15:30 #1178 - Pre-hospital critical ultrasound: utility, indications and limitations.
Mirko Zanatta, Vito Cianci, Piero Benato, Sigilfredo De Battisti (IT)
 
16:15
16:15-17:45
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A23
State of the Art
Head and Neck Trauma

State of the Art
Head and Neck Trauma

Moderators: Marc SABBE (Medical staff member) (Leuven, BELGIUM), Frank VERSCHUREN (BELGIUM)
16:15 - 16:45 Building a better cervical collar: challenges and solutions. Jonathan BENGER (UK)
16:45 - 17:15 Severe traumatic brain injury. Fiona LECKY (Professor of Emergency Medicine) (Sheffield, UK)
17:15 - 17:45 The effect of antiplatelet therapy on head injury. Andrea FABBRI (Chief of Emergency Unit) (Forli, ITALY)
16:15-17:45
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B23
The Netherlands Invites
Education in EM

The Netherlands Invites
Education in EM

Moderators: Francis MENCL (USA), Thomas PLAPPERT (Fulda, GERMANY)
16:15 - 16:45 Teaching: Becoming an Effective Emergency Medicine Teacher. Mike BURG (USA)
16:45 - 17:15 Teaching Lessons. Peter CAMERON (AUSTRALIA)
17:15 - 17:45 The Art of Teaching. George GOLDMAN (USA)
16:15-17:45
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C23
Clinical Questions
EuSEM Meets: European Resuscitation Council

Clinical Questions
EuSEM Meets: European Resuscitation Council

Moderators: Andrew LOCKEY (Halifax, UK), Koen MONSIEURS (BELGIUM)
16:15 - 16:45 Dispatchers - the true lifesavers. Katarina BOHM (SWEDEN)
16:45 - 17:15 Children save lives. Andrew LOCKEY (Halifax, UK)
17:15 - 17:45 Hypothermia. Koen MONSIEURS (BELGIUM)
16:15-17:45
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D23
Administrative Track
Ethics and Philosophy of EM

Administrative Track
Ethics and Philosophy of EM

Moderators: Helen ASKITOPOULOU (Chair Ethics Committee) (Heraklion, GREECE), Bernard FOEX (Manchester, UK)
16:15 - 16:35 Is the Hippocratic oath relevant to modern medicine? Helen ASKITOPOULOU (Chair Ethics Committee) (Heraklion, GREECE)
16:35 - 16:55 Benefit, harm, suffering, compassion and the emergency physician. Rick BODY (UK)
16:55 - 17:15 Delusions of autonomy: decision making in an emergency. Bernard FOEX (Manchester, UK)
17:15 - 17:35 A practical ethics framework for emergency physicians. Tim COATS (UK)
17:35 - 17:45 Panel Discussion.
16:15-17:45
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E23
Research
Disaster Medicine

Research
Disaster Medicine

Moderators: Abdo KHOURY (PH) (Besançon, FRANCE), Luc MORTELMANS (PHYSICIAN) (Antwerp, BELGIUM)
16:45 - 17:15 What education and skills in Disaster Medicine for Emergency Physicians? Raed ARAFAT (ROMANIA)
17:15 - 17:45 Transboundary “teamworking” and common guidelines for disasters. Omer SALT (ASSISTANT PROFESSOR) (EDIRNE, TURKEY)
16:15-17:45
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F23
Free Papers
Admin and Healthcare Policy

Free Papers
Admin and Healthcare Policy

Moderators: Lars Petter BJORNSEN (TRONDHEIM, NORWAY), Thomas BENTER (GERMANY)
16:15 - 17:45 #84 - Norway: The challenges associated with establishing the specialty of Emergency Medicine.
Gayle Galletta, Kåre Løvstakken (NO)
16:15 - 17:45 #101 - Reducing patient placement errors in Emergency Department admissions: Right patient/right bed.
Niels Rathlev, Roger Wu, Christine Bryson, Lynn Garreffi, Haiping Li, Patricia Samra, Bonnie Geld, Paul Visintainer (US)
16:15 - 17:45 #182 - Are bouncebacks and bounceback-admits related to patient care?
Brian Walsh, Paul Porter, Kristen Walsh (US)
16:15 - 17:45 #202 - Characteristics of Ambulance Diversion in Japan.
Bon Ota (JP)
16:15 - 17:45 #312 - Is There a Difference in Efficacy in Care Plans Based on Gender?
Frederick Fiesseler, Ashley flannery, Renee Riggs, David Salo (US)
16:15 - 17:45 #317 - Politics and power in the emergency department: a first sociological international comparative study in emergency medicine.
Anne Schoenmakers, Peter Nugus, Rebekka Veugelers (NL)
16:15 - 17:45 #646 - A Multidisciplinary Approach to Effectively Reduce The Stream of Public EMS Ambulance Abuse.
Jiun-Wei Chen, Ming-Tai Jeng, Tsung-Tai Chen, Hui-Chih Wang, Tsung-Chien Lu, Wen-Chu Chiang, Matthew Huei-Ming Ma, Patrick Chow-In Ko (TW)
16:15 - 17:45 #667 - First results of a Lean Healthcare Principle Implementation at a Tertiary Hospital Emergency Room in Ribeirão Preto, Brazil.
Silvia Fonseca, Paula Luciano, Roberto Chimionato, Larissa Sigaki, Amanda Cohen, Mariana Zanotto, Marcus Antonio Ferez, Maysa Souza, Marcelo Marques, Rodrigo Oliveira (BR)
16:15 - 17:45 #722 - Appropriated hospitalization from the Emergency Department in a second level hospital from Spain.
Grethzel Prado Paz, SORAYA GONZALEZ, FRANCISCA RIVERA CASARES, NURIA CAMPOS, Adriana Chaparro, Ma Angeles Castera, ALEJANDRO PAZ ANAYA (ES)
16:15 - 17:45 #1128 - IMPACT ON SAFETY PATIENT CULTURE OF REORGANIZATION OF EMERGENCY DEPARTMENT CARE.
Sonia Jimenez, Albert Antolin, Ana Garcia, Elisabeth Uria, Motserrat Suarez, Elisabeth Garcia, Maria Asenjo (ES)
16:15-17:45
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G23
Free Papers
Paediatric Emergencies 1

Free Papers
Paediatric Emergencies 1

Moderators: Alain GERVAIX (SWITZERLAND), Rianne OOSTENBRINK (pediatrician) (Rotterdam, THE NETHERLANDS)
16:15 - 17:45 #721 - Audit on care of the febrile child.
Peter Donnelly, Lynne McFetridge (GB)
16:15 - 17:45 #768 - Risk assessment of febrile children with potential serious bacterial infections based on real life videos.
Evelien Kerkhof, Damian Roland, Esther de Bekker-Grob, Rianne Oostenbrink, Monica Lakhanpaul, Henriette Moll (NL)
16:15 - 17:45 #779 - Work-up model for children presenting with headache at the Pediatric Emergency Department.
Kelly Mortelmans, Ives Hubloue, Gerlant van Berlaer (BE)
16:15 - 17:45 #824 - Febrile young infants with altered urinalysis at low risk for invasive bacterial infection. A Spanish Pediatric Emergency Research Network's (RISeuP-SPERG) study.
ROBERTO VELASCO, HELVIA BENITO, REBECA MOZUN, JUAN ENRIQUE TRUJILLO, PEDRO MERINO, . Group for the Study of the Young Febrile Infant of RiSEUP-SPERG Network (ES)
16:15 - 17:45 #831 - Importance of urine dipstick in evaluation of febrile infants with positive urine culture. A Spanish Pediatric Emergency Research Network's (RISeuP-SPERG) study.
ROBERTO VELASCO, HELVIA BENITO, REBECA MOZUN, MERCEDES DE LA TORRE, BORJA GOMEZ, . Group for the Study of the Young Febrile Infant of RiSEUP-SPERG Network, JUAN ENRIQUE TRUJILLO, PEDRO MERINO (ES)
16:15 - 17:45 #839 - Accuracy of urine dipstick to identify febrile infants less than 90 days old with a positive urine culture. A Spanish Pediatric Emergency Research Network’s (RISeuP-SPERG) study.
ROBERTO VELASCO, HELVIA BENITO, REBECA MOZUN, MERCEDES DE LA TORRE, BORJA GOMEZ, . Group for the Study of the Young Febrile Infant of RiSEUP-SPERG Network, JUAN ENRIQUE TRUJILLO, PEDRO MERINO (ES)
16:15 - 17:45 #864 - Patterns of body involvement in severe pediatric injuries according to mechanism of injury and its context.
José Antonio Ruiz-Domínguez, Nieves de Lucas-García, Santos García-García, Juan Vázquez-Estévez, Jorge Parise-Metholo (ES)
16:15 - 17:45 #930 - Diagnostic Accuracy of Three Biomarkers in Identifying Serious Bacterial Infections in Children With Fever Without Source.
Diana Moldovan, Cristian Boeriu, Despina Baghiu (RO)
16:15 - 17:45 #936 - Meeting the target: time to treatment for suspected meningitis in neonates presenting to the emergency department.
Joanna Stanisz, Rahim Valani (CA)
16:15 - 17:45 #1028 - Short-term impact of bronchiolitis severity on the duration of symptoms and recurrence of wheezing.
Natalia Paniagua, Olaia Lopez, Ainhoa Ibarrola, June Udaondo, Raquel Rubio, Lorea Martinez, Javier Benito (ES)
 
18:00
18:00-19:05
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AWC
Awards Ceremony

Awards Ceremony

Moderators: Carine DOGGEN (ENSCHEDE, THE NETHERLANDS), Colin GRAHAM (Hong Kong, HONG KONG)
18:00 - 18:05 Introduction. Barbara HOGAN (Past President of the European Society for Emergency Medicine, EuSEM) (HAMBURG, GERMANY)
18:10 - 18:15 Top Scoring Abstract 1: How should we measure ambulance service quality and performance? Joanne COSTER (Research Fellow) (Sheffield, UK)
18:15 - 18:20 Top Scoring Abstract 2: Adding intranasal ketamine to intravenous morphine sulftate in patients with limb trauma: a double blinded randomized clinical trial. Arash SAFAIE (IRAN, ISLAMIC REPUBLIC)
18:20 - 18:25 Top Scoring Abstract 3: A randomised, double blind, multi-centre, placebo controlled study to evaluate the efficacy and safety of methoxyflurane (Penthrox™) for the treatment of acute pain in patients presenting to an Emergency Department with minor traum. Frank COFFEY (Nottigham, UK)
18:25 - 18:25 Introduction. Rune ANDERSEN (OTHER) (Arhus C, DENMARK)
18:25 - 18:35 Sophus Falck Prize: Using EMS telephone triage data to assess the amount of ambulance resources saved through telephone triage. Tracey BARRON (Bristol, UK)
18:37 - 18:40 EuSEM Best Abstract Prize.
18:40 - 18:45 EuSEM Young Scientist Award.
18:45 - 19:00 EBEEM graduation + Best Exam awards.
18:00 - 19:05 EMDM Graduation ceremony.
19:00 - 19:05 EuSEM Fellowships bestowed.
           
Tuesday 30 September
Time Zuiveringshal West Transformatorhuis Openbare Verlichting MC Theatre Machinegebouw Ketelhuis Westerliefde
 
09:00
09:00-10:30
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A31
State of the Art
Cardiac Arrest

State of the Art
Cardiac Arrest

Moderators: Martin MOECKEL (Berlin, GERMANY), Sten RUBERTSSON (SWEDEN)
09:00 - 09:30 HOT TOPIC: CPR: How to get the patient back. Sten RUBERTSSON (SWEDEN)
09:30 - 10:00 Optimized post-resuscitation care. Lance BECKER (USA)
10:00 - 10:30 Targeted temperature management after cardiac arrest: when and how deep to go. Wilhelm BEHRINGER (Director) (Jena, GERMANY)
09:00-10:30
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B31
The Netherlands Invites
Quality Care

The Netherlands Invites
Quality Care

Moderators: Francesco DELLA CORTE (ITALY), Barbara HOGAN (Past President of the European Society for Emergency Medicine, EuSEM) (HAMBURG, GERMANY)
09:00 - 09:30 Everyday Leadership. Francis MENCL (USA)
09:30 - 10:30 Quality Care. Peter CAMERON (AUSTRALIA)
09:00-10:30
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C31
Clinical Questions
Paediatric Emergencies

Clinical Questions
Paediatric Emergencies

Moderators: Javier BENITO FERNANDEZ (Getxo - Vizcaya, SPAIN), Patrick VAN DE VOORDE (BELGIUM)
09:00 - 09:30 Fluid treatment for the ill child: do's and dont's. Patrick VAN DE VOORDE (BELGIUM)
09:30 - 10:00 Substance abuse in the adolescent: presentation and who needs follow-up? Santiago MINTEGUI (Barakaldo, SPAIN)
10:00 - 10:30 The big five of paediatric emergency care. Henriette MOLL (ROTTERDAM, THE NETHERLANDS)
09:00-10:30
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D31
Administrative Track
Crowding in the ED

Administrative Track
Crowding in the ED

Moderators: Philip D ANDERSON (Boston, USA), Niels RATHLEV (Chair) (Wellesley, USA)
09:00 - 09:30 Emergency Department Crowding in relation to in-hospital adverse medical events. Sandra VERELST (Chef du service des urgences) (Louvain, BELGIUM)
09:30 - 10:00 Emergency Department Crowding as a Healthcare Systems Issue. Philip D ANDERSON (Boston, USA)
10:00 - 10:30 Elective Surgical Admissions and Emergency Department Crowding. Niels RATHLEV (Chair) (Wellesley, USA)
09:00-10:30
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E31
Research
Psychosocial Emergencies

Research
Psychosocial Emergencies

Moderators: Cristian BOERIU (Assoc.Professor) (Targu Mures, ROMANIA), Clifford MANN (UK)
09:23 - 09:46 Improvements for screening child abuse at the emergency department. Henriette MOLL (ROTTERDAM, THE NETHERLANDS)
09:00 - 09:23 Older person mental health. Clifford MANN (UK)
09:46 - 10:09 Deliberate self harm. Katarina BILEN (SWEDEN)
10:09 - 10:30 Paediatric psychiatric emergencies in Belgium. Marc SABBE (Medical staff member) (Leuven, BELGIUM)
09:00-10:30
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F31
Free Papers
ED Management and Clinical Policy - Lightning Session

Free Papers
ED Management and Clinical Policy - Lightning Session

Moderators: Raed ARAFAT (ROMANIA), Dan BRUN PETERSEN (DENMARK)
09:00 - 10:30 #128 - Neurological Observation in Head Injury at the Royal Cornwall Hospital: Can We Do Better?
Jeremy Hunter, Neil Roberts, Ella Daniels, Benedict Broadbent, Hannah Lewis, Sophie Marsh, Mark Jadav (GB)
09:00 - 10:30 #592 - Length of Stay in the Emergency Department is significantly associated with an Increase of In-Hospital Mortality.
Jérémie Bonenfant, Audrey Lavenue, Marc Cuggia, AURORE Mahe, JACQUES BOUGET, Gilles Edan, Philippe Seguin, ABDELOUAHAB BELLOU (FR)
09:00 - 10:30 #619 - Evolution of research production of Emergency Medicine in European Union Countries From 1995 to 2012.
Khaldoon Alkhaldi, ABDELOUAHAB BELLOU (FR)
09:00 - 10:30 #639 - Reproducibility of pediatric triage protocols: the experience of “ospedali riuniti di Pinerolo” emergency department.
alessandra ghione, elena mana, silvia tedeschi, marina civita, emanuela laurita, gian alfonso cibinel (IT)
09:00 - 10:30 #675 - Predictors of long length of stay in a Swedish emergency department.
Therese Djarv, Tobias Perdahl, Per Svensson, Sandra Axelsson (SE)
09:00 - 10:30 #695 - Do emergency department discharge summaries ensure continuity of care?
Naomi Bennett, Tom Coffey, Douglas Hing, Kevin Enright, Jason Fitch, Adele Bevan (GB)
09:00 - 10:30 #713 - Epidemiology, management and outcome of cancer patients admitted in an emergency department.
Laura Thésillat, Grégoire Versmée, Youcef Guechi, Etienne Quoirin, Hugo Basquin, Joana Martine-Singer, Jean-Yves Lardeur, Jean-Marc Tourani (FR)
09:00 - 10:30 #735 - Implementing a General Practitioner post in the hospital: A prospective analysis of patient flow and turnover time at a large urban Emergency Department.
Michiel van Veelen, Christien van der Linden, Resi Reijnen (NL)
09:00 - 10:30 #743 - Identifying domestic elder abuse and neglect in the emergency department in the Netherlands.
Sivera Berben PhD, Marian Adriaansen PhD, RN, Karin Van den Berg MSc, Lilian Vloet PhD, RN (NL)
09:00 - 10:30 #776 - Preliminary diagnosis at admittance and diagnosis at discharge: do they match?
brigitte van de kerkhof-van bon, Lineke van Haarlem, Douwe Rijpsma (NL)
09:00 - 10:30 #804 - Impact of a Clinical Decision Unit on the Emergency Department activity.
Massimo Zannoni, Gianni Turcato, Alberto Rigatelli, Francesco Pratticò, Giorgio Ricci (IT)
09:00 - 10:30 #806 - Skåne emergency department assessment of patient load (SEAL) - a model to estimate crowding based on workload in swedish emergency departments.
Jens Wretborn, Ardavan Khoshnood, Mattias Wieloch, Ulf Ekelund (SE)
09:00 - 10:30 #851 - Superior outcome after out-of-hospital cardiac arrest in a two-tiered emergency medical service: A five-year survey.
Clemens Kill, Elisabeth Bösl, Erich Wranze, Andreas Jerrentrup, Birgit Plöger, Hinnerk Wulf, Wolfgang Dersch (DE)
09:00 - 10:30 #1014 - How to keep patient safe during in-hospital transfer?
Jutta Keränen, Sanna Hoppu, Niku Oksala, Hannu Päivä, Minna Hyvärinen, Janette Saukko, Ari Palomäki, Satu-Liisa Pauniaho (FI)
09:00 - 10:30 #1094 - Three years evolution of patient complaints in a European Emergency Department.
ABDELOUAHAB BELLOU, Margeaux Seitz, François Jérome Kerdiles, JACQUES BOUGET, Jonathan Edlow (FR)
09:00 - 10:30 #1163 - Introducing a senior clinician rapid assessment and treatment pathway in a central london emergency department.
David Shackleton, Alexander Schueler (GB)
09:00 - 10:30 #1171 - Wound Management in the Emergency Department: Quality improvement and cost-effectiveness in Dublin.
Kelly Janssens, Richard Drew (IE)
09:00 - 10:30 #1181 - The application of lean tools in an italian emergency department.
Antonio Voza, Nicholas Mc Innes (IT)
09:00 - 10:30 #1187 - Mortality and chief complaints: Is there a difference between walking-in patients and patients brought by ambulance services? Data from the Charité Chief Complaints Study (CHARITEM).
M. WALSH, M. KOCH, H.-R. ARNTZ, A. ALE-ABAEI, B.A. LEIDEL, J. SEARLE, W. HOPFENMÜLLER, A. SLAGMAN, W. WYRWICH, H. STORCHMANN, J. VOLLERT, S. POLOCZEK, M. MÖECKEL, Rajan SOMASUNDARAM (DE)
09:00 - 10:30 #1188 - “To admit or not to admit”: The management of anti-coagulated patients with head injury a review.
Shwetha Rao, Ian Stell, Charlotte Cockerill (GB)
09:00-10:30
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G31
Free Papers
Trauma 1

Free Papers
Trauma 1

Moderators: Andrea FABBRI (Chief of Emergency Unit) (Forli, ITALY), Fiona LECKY (Professor of Emergency Medicine) (Sheffield, UK)
09:00 - 10:30 #280 - A pilot study for the development of a clinical decision rule for wrist fractures in adult patients with acute wrist injury.
Anne Brants, Michiel IJsseldijk (NL)
09:00 - 10:30 #294 - Domestic Violence - particularities in an Emergency Departament in Romania.
constantin andrei, mihaela Dumea, andrei hancu, diana cimpoesu, paul nedelea (RO)
09:00 - 10:30 #341 - Management of Major Trauma Patients on an Observation Ward in an Emergency Department: a one year experience at St. Mary's Hospital, London, UK.
Ali Zain Naqvi, Sergio B Sawh, Nicola Batrick (GB)
09:00 - 10:30 #390 - Which factors influence the development of Battlefield Advanced Trauma Life Support?
Simone Dierckx, James Ryan (NL)
09:00 - 10:30 #396 - Traumatic brain injury and sepsis in children admitted to hospital following major trauma.
Anjali Pandya, Graham Thompson, Jonathan Guilefoyle, Jessica McKee, Sherry MacGillivray, Ari Joffe, Diane Moser (CA)
09:00 - 10:30 #501 - Use of 'clinician concern' for trauma team activation in a paediatric trauma centre.
Cameron Palmer, Silvia Bressan, Katherine Franklin, Helen Jowett, Sebastian King, Ed Oakley (AU)
09:00 - 10:30 #502 - Comparison of two outcome measures in assessing paediatric trauma team activation appropriateness.
Silvia Bressan, Katherine Franklin, Helen Jowett, Sebastian King, Ed Oakley, Cameron Palmer (AU)
09:00 - 10:30 #614 - The Outcome Relations of Traumatic Out-of-hospital Cardiac Arrest and Ventricular Fibrillation - Implication for the Use of Automated External Defibrillators.
Jiun-Wei Chen, Hao-Yang Lin, Ming-Ju Hsieh, Ming-Tai Jeng, Guan-Cheng Jin, Wen-Chu Chiang, Matthew Huei-Ming Ma, Patrick Chow-In Ko (TW)
09:00 - 10:30 #657 - Predictability of pre-hospital Trauma Triage Tool used for identification of Major Trauma patients.
M Azam Majeed, Shereen Elboray, Ibrahim Hesham, Mohamed Abdelal, David Yeo (GB)
 
11:15
11:15-12:45
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A32
State of the Art
YEMD: The Soft Side of EM

State of the Art
YEMD: The Soft Side of EM

Moderators: Alice HUTIN (PARIS, FRANCE), Senad TABAKOVIC (Zürich, SWITZERLAND)
11:15 - 12:45 Introduction. Alice HUTIN (PARIS, FRANCE)
11:15 - 11:30 Decision making in Emergency Medicine. Senad TABAKOVIC (Zürich, SWITZERLAND)
11:30 - 11:50 Crew/crisis resource management. Rainer GAUPP (SWITZERLAND)
11:50 - 12:10 Dealing with different cultural models of disease. Stefanie VANDERVELDEN (BELGIUM)
12:30 - 12:45 Discussion. Riccardo LETO (Chief of ED) (Overpelt, BELGIUM), Alice HUTIN (PARIS, FRANCE)
11:15-12:45
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B32
The Netherlands Invites
Lights Out: Acute Neurological Emergencies

The Netherlands Invites
Lights Out: Acute Neurological Emergencies

Moderators: Mike BURG (USA), Said HACHIMI IDRISSI (head clinic) (Ghent, BELGIUM)
11:15 - 11:45 Spells - Fit or Faint? Steve HUFF (USA)
11:45 - 12:15 Seizures and the Emergency Physician. Steve HUFF (USA)
12:15 - 12:45 The Fun of Fainting. Suzanne PEETERS (THE NETHERLANDS)
11:15-12:45
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C32
Clinical Questions
Head and Neck Trauma

Clinical Questions
Head and Neck Trauma

Moderators: Erwin DHONDT (BELGIUM), Frank VERSCHUREN (BELGIUM)
11:15 - 11:45 Cervical spine injury: when to immobilise, when to CT. Jonathan BENGER (UK)
11:45 - 12:15 Clinical cases on the management of brain injuries. Fiona LECKY (Professor of Emergency Medicine) (Sheffield, UK)
12:15 - 12:45 The effects of anticoagulants on head injury. Andrea FABBRI (Chief of Emergency Unit) (Forli, ITALY)
11:15-12:45
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D32
Administrative Track
Critical Care

Administrative Track
Critical Care

Moderators: Wilhelm BEHRINGER (Director) (Jena, GERMANY), Christoph DODT (München, GERMANY)
11:15 - 11:45 Do we need resuscitation centers? Michael CHRIST (Director) (Lucerne, SWITZERLAND)
11:45 - 12:15 Screening for severe sepsis in the ED. Luis GARCIA-CASTRILLO (Espagne, SPAIN)
12:15 - 12:45 How much Intensive Care do we need in the ED? Christoph DODT (München, GERMANY)
11:15-12:45
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E32
Research
Paediatric Emergencies

Research
Paediatric Emergencies

Moderators: Santiago MINTEGUI (Barakaldo, SPAIN), Luigi TITOMANLIO (Paris, FRANCE)
11:15 - 11:45 The way to share databases in paediatric international multicenter research. Rianne OOSTENBRINK (pediatrician) (Rotterdam, THE NETHERLANDS)
11:45 - 12:15 Different research models to be developed for PEM. Patrick VAN DE VOORDE (BELGIUM)
12:15 - 12:45 Local to international networks: keep connected. Alain GERVAIX (SWITZERLAND)
11:15-12:45
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F32
Free Papers
Pre-Hospital-EMS II

Free Papers
Pre-Hospital-EMS II

Moderators: Ana NAVIO (SPAIN), Merel WILLEBOER (THE NETHERLANDS)
11:15 - 12:45 #73 - Review of 241 consecutive episodes of acute prostatitis at the emergency department during 1 year.
Ferran Llopis, Carles Ferré, Javier Jacob, Irene Cabello, José Maria Ruiz, Joan Ramon Pérez, Ignasi Bardés (ES)
11:15 - 12:45 #225 - Antibiotic prescriptions in an emergency department.
Julie Grenet, Caroline Guyot, Alain Beauchet, Thomas Tritz, Valérie Sivadon tardy, Sébastien Beaune, Aurélien Dinh (FR)
11:15 - 12:45 #283 - Unnecessary Urine Cultures in the Emergency Department.
Eric Batard, Jarmila Fiers, Stéphane Corvec, Marie-Emmanuelle Juvin, Didier Lepelletier, Gilles Potel, Emmanuel Montassier (FR)
11:15 - 12:45 #338 - A pilot study on predicting outcomes of sepsis in the emergency department: clinical scores, routine markers or specific biomarkers?
Vincent Quinten, Matijs van Meurs, Anna Wolffensperger, Jorinde Witmer, Rianne Jongman, Jan ter Maaten, Jack Ligtenberg (NL)
11:15 - 12:45 #352 - Time to antibacterial therapy of urinary tract infections in the Emergency department.
Emmanuel Grangeon, Emmanuel Montassier, Stéphane Corvec, Didier Lepelletier, Eric Batard (FR)
11:15 - 12:45 #359 - Increasing use of 3rd-generation cephalosporins for pneumonia in the Emergency Department : may some prescriptions be avoided ?
Nicolas Goffinet, Nathalie Lecadet, Marion Cousin, Caroline Peron, Didier Lepelletier, Emmanuel Montassier, Eric Batard (FR)
11:15 - 12:45 #362 - High-sensitivity cardiac Troponin T has the potential to improve effective disposition of ED patients with a suspected infection without acute organ dysfunction.
Gordon Chu, Bas de Groot (NL)
11:15 - 12:45 #394 - 5 years of blood cultures in the Emergency Department-things have changed.
Mike Wilson, Becky Edwards, Pota Kalima (GB)
11:15 - 12:45 #440 - Efficacy of Measuring Procalcitonin Levels in Determination of Prognosis and Early Diagnosis of Bacterial Resistance in Sepsis in an Emergency Department.
Ali Arhami Dolatabadi, Hamid Reza Hatamabadi, Elham Memary (IR)
11:15 - 12:45 #583 - Evidence based semiology and sepsis: the significance of measured fever and heart rate in patients with only one altered vital sign.
Fernanda de Souza Martins, Thiago Martins Santos, Marcelo Schweller, Marco Antônio Carvalho-Filho (BR)
11:15-12:45
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G32
Free Papers
Trauma 2

Free Papers
Trauma 2

Moderators: Bernd BOETTIGER (GERMANY), David HUANG (USA)
11:15 - 12:45 #147 - Injury Severity and Mortality of Adult Zebra Crosswalk and Non-Zebra Crosswalk Road Crossing Accidents: A Cross-sectional Analysis.
Carmen Andrea Pfortmueller, Marti Mariana, Mirco Kunz, Gregor Lindner, Aristomenis Konstantinos Exadaktylos (CH)
11:15 - 12:45 #728 - Short term neurocognitive and symptomatological effects of head injury: a prospective cohort study.
Benjamin Bloom, Rupert Pearse, Kathryn Kinsella, Hiren Patel, Fiona Lecky (GB)
11:15 - 12:45 #794 - Predicting outcomes after blunt chest wall trauma: development and external validation of a new prognostic model.
Ceri Battle, Suresh Pillai, Hayley Hutchings, Simon Lovett, Omar Bouamra, Phillip Evans (GB)
11:15 - 12:45 #853 - Characteristics of injury patients and the care they received at Emergency Trauma Centre, Teaching Hospital Karapitiya, Galle, Sri Lanka.
Arosha Abeywickrama, Vijitha De Silva, Krishantha Jayasekara, Udyoga Edirisinghe, Sudath Priyadarshana, Shelton Perera (LK)
11:15 - 12:45 #892 - Applicability of complementary tests in the diagnosis of the severity of a lateral ankle sprain. Concerning a prospective randomized study of 388 patients.
Jean-Jacques Banihachemi, Jean-Noel Ravey, Christophe Chaussard, Nicolas Gonnet, Enkelejda Hodaj, Jean-Luc Cracowski, Dominique Saragaglia (FR)
11:15 - 12:45 #972 - External and prospective validation of the criteria defining «clinically important brain injury» in patients with mild TBI with the Canadian CT-head rule.
Jean-Marc Chauny, Jean Paquet, Justine Lessard, Jean-François Giguère, Danielle Gilbert, Richard Fleet, Martin Marquis, Raoul Daoust (CA)
11:15 - 12:45 #1029 - Experience of the polish level II field hospital in Afganistan- lessons learned.
przemyslaw wiktor gula (PL)
11:15 - 12:45 #1106 - Does the care of trauma patients in the Emergency Department benefit from implementing Crew Resource Management?
Willemijn Van der Boon, Willemijn Maarleveld, Lonneke Buijteweg (NL)
11:15 - 12:45 #1120 - The effective implementation of emergency FAST-ultrasound in the trauma-algorithm. A simulatorbased approach.
Ulf Martin Schilling, Mazen Majdalani, Per Staffan (SE)
 
13:00    
13:00-14:00
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C-PK
PechaKucha
YEMD Session

PechaKucha
YEMD Session

Moderators: Pieter Jan VAN ASBROECK (Consultant in Emergency Medicine) (Hasselt, BELGIUM), Sabina ZADEL (SLOVENIA)
13:05 - 13:13 Wave after wave - ECG in emergency medicine. Anne PICHORNER (GERMANY)
13:13 - 13:21 The International Student Association of Emergency Medicine (ISAEM). Anh-Nhi THI HUYNH (Aarhus C, DENMARK)
13:21 - 13:29 Emergency Medicine through Google Glass. Luca CARENZO (SIMULATION COMPETITION ONLY) (NOVARA, ITALY)
13:29 - 13:37 Move the doctor - progress of mobility in medicine. Andreas PICHORNER (GERMANY)
13:37 - 13:45 Laying the Foundations: Medical Students & the Professionalisation of Humanitarian Response. Patrick ACHKAR (CANADA)
13:45 - 13:53 Risk or benefit: an APP in the emergency world. Dean DE MEIRSMAN (Emergency medicine resident) (Paal, BELGIUM)
   
13:15-14:15
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F_FAQ
European Board Examination in Emergency Medicine (EBEEM)
Frequently Asked Questions Session – bring your lunch!

European Board Examination in Emergency Medicine (EBEEM)
Frequently Asked Questions Session – bring your lunch!

Presenters: Ruth BROWN (Speaker) (London, UK), Serra PITTS (UK), Roberta PETRINO (Head of department) (Italie, ITALY)
This session will provide exam candidates an opportunity to ask any questions they may have about the exam, including how to prepare and form study groups with other candidates. In addition, an OSCE scenario will demonstrated, in an effort to help candidates understand Part B of the EBEEM.
 
 
14:30
14:30-16:00
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A33
State of the Art
Paediatric Emergencies

State of the Art
Paediatric Emergencies

Moderators: Javier BENITO FERNANDEZ (Getxo - Vizcaya, SPAIN), Jean Christophe MERCIER (PARIS, FRANCE)
14:30 - 15:00 Sedation for minor procedures in the emergency department. Itay SHAVIT (ISRAEL)
15:00 - 15:30 Management of urinary tract infection in infants. Roberto VELASCO (Pediatrician) (Laguna de Duero, SPAIN)
15:30 - 16:00 Update on febrile seizure management. Jean Christophe MERCIER (PARIS, FRANCE)
14:30-16:00
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B33
The Netherlands Invites
Trauma

The Netherlands Invites
Trauma

Moderators: Sabine LEMOYNE (Senior Staff Member) (Edegem, BELGIUM), Scott SILVERS (USA)
14:30 - 15:00 mTBI-Concussion for the Emergency Medicine Physician. Steve HUFF (USA)
15:00 - 15:30 Woundcare. George GOLDMAN (USA)
15:30 - 16:00 Reductions - reduced to simplicity: The newest techniques for joint reductions. Mike BURG (USA)
14:30-16:00
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C33
Clinical Questions
YEMD: Education After Graduation

Clinical Questions
YEMD: Education After Graduation

Moderators: Luca CARENZO (SIMULATION COMPETITION ONLY) (NOVARA, ITALY), Anne PICHORNER (GERMANY)
14:30 - 14:50 Beyond see-one, do-one, teach-one: Simulate one! Thomas PLAPPERT (Fulda, GERMANY)
14:50 - 15:10 The European Board Examination in Emergency Medicine (EBEEM). Roberta PETRINO (Head of department) (Italie, ITALY)
15:10 - 15:30 Refresher course experience. Sabina ZADEL (SLOVENIA)
15:30 - 15:45 Debate about social media in education: Pro. Youri YORDANOV (Médecin) (Paris, FRANCE)
15:45 - 16:00 Debate about social media in education: Con. Marc SABBE (Medical staff member) (Leuven, BELGIUM)
14:30-16:00
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D33
Administrative Track
Clinical Decision Units / Observation Medicine

Administrative Track
Clinical Decision Units / Observation Medicine

Moderators: Roland BINGISSER (Basel, SWITZERLAND), Michael CHRIST (Director) (Lucerne, SWITZERLAND)
14:30 - 15:00 The impact of observation on disposition. Roland BINGISSER (Basel, SWITZERLAND)
15:00 - 15:30 Is observational medicine a field of Acute Medicine? Simon CONROY (Leicester, UK)
15:30 - 16:00 What do we want: OUs, CDUs or IMUs? Ulrich BUERGI (SWITZERLAND)
14:30-16:00
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E33
Research
Neurological Emergencies

Research
Neurological Emergencies

Moderators: Jonathan EDLOW (USA), Bettina PFAUSLER (AUSTRIA)
14:30 - 15:00 A new evidence-based approach to the dizzy patient. Jonathan EDLOW (USA)
15:00 - 15:30 From Sydenham to anti-GAD: The "surge" of autoimmune encephalomyelitides. Bettina PFAUSLER (AUSTRIA)
15:30 - 16:00 Status epilepticus. Monica FERLISI (ITALY)
14:30-16:00
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F33
Free Papers
Infectious Disease and Sepsis 2

Free Papers
Infectious Disease and Sepsis 2

Moderators: Mikkel BRABRAND (TRAINEES/NURSES/PARAMEDICS) (ESBJERG, DENMARK), Diederik VAN DE BEEK (THE NETHERLANDS)
14:30 - 16:00 #587 - The relationship among semiological findings and blood culture results in septic patients.
Fernanda de Souza Martins, Thiago Martins Santos, Gisele Guedes, Marcelo Schweller, Marco Antônio Carvalho-Filho (BR)
14:30 - 16:00 #621 - Does the addition of HCV testing to a rapid HIV testing program impact HIV test acceptance? A randomized controlled trial.
Yvette Calderon, Ethan Cowan, Rajesh Verma, Thomas Pereira, Mark Iscoe, Sara Rahman, John Y Rhee, Lisa N Glass, Matthew Barbery, Jason Leider (US)
14:30 - 16:00 #648 - Inflamatory lung edema correlates with increased left ventricle filling pressures in newly admitted septic patients: an ultrasound study.
Thiago Santos, Marcelo Schweller, Daniel Franci, Diego Ribeiro, Carolina Gontijo-Coutinho, José Matos-Souza, Marco Carvalho-Filho (BR)
14:30 - 16:00 #663 - The role of left ventricle tissue Doppler imaging on predicting disease severity and mortality in septic patients newly admitted in an emergency unit.
Thiago Santos, Marcelo Schweller, Daniel Franci, Diego Ribeiro, Carolina Gontijo-Coutinho, José Matos-Souza, Marco Carvalho-Filho (BR)
14:30 - 16:00 #827 - Implementation of an automatic alarms system for early detection of patients with severe sepsis.
JM Ferreras, Gabriel Tirado, Rosa Martinez, Carmen Aspiroz, Torres Sarrat, Paloma Dorado, Ana Ezpeleta, Begoña Gargallo, Teresa Pardo, Rafael Marron, Clara Herranz (ES)
14:30 - 16:00 #982 - Does the presence of an eschar correlate with severity of scrub typhus infection?
Paul Kundavaram (IN)
14:30 - 16:00 #1057 - Effectiveness of the PIRO score in prognostic stratification of patients with sepsis in the Emergency Department.
Elisa Guerrini, Damiano Vignaroli, Eleonora De Villa, Stella Squarciotta, Michele Baioni, Camilla Tozzi, Riccardo Pini, Simone Bianchi, Francesca Innocenti (IT)
14:30 - 16:00 #1111 - Vital sign registration and its use in optimizing disposition of emergency department patients with a suspected infection.
Sanneke van den Brink, Annemieke Ansems, Anne Brouwer, Tanuja Ramsaransing, Douwe Rijpsma, Bas de Groot (NL)
14:30 - 16:00 #1141 - Prognostic factors of complicated acute pyelonephritis in emergency departement.
neila mghaieth, kamel majed, asma chargui, Khadija Zaouche, Mohamed Modhaffar, hamida maghraoui, chokri hamouda, nebiha borsali falfoul (TN)
14:30 - 16:00 #1153 - Skin and soft tissue infection treatment in the emergency department.
Angus Gilchrist, Michael Curry, Kevin Shi (CA)
14:30-16:00
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G33
Free Papers
Cardiovascular Emergencies 2 - Lightning Session

Free Papers
Cardiovascular Emergencies 2 - Lightning Session

Moderators: Bulent GORENEK (TURKEY), Ulkumen RODOPLU (TURKEY)
14:30 - 16:00 #532 - Does the time management of acute coronary syndromes with ST-segment elevation vary depending on the patient's age?
Anne-Claire Michel ep. Mlynski, Hugues Lefort, Olga Maurin, Yann-Laurent Violin, Jennifer Culoma, Alain Courtiol, Catherine Rivet, Amandine Abriat, Cédric Ernouf, Daniel Jost, Jean-Pierre Tourtier, Laurent Domanski (FR)
14:30 - 16:00 #550 - Low risk chest pain patients in the Emergency Department: diagnostic strategy update by the novel exercise high frequency QRS analysis compared to exercise echocardiography.
Andrea Alesi, Alberto Conti, Giovanna Aspesi, Delia Lazzeretti, Simone Bianchi, Alessandro Coppa, Caterina Grifoni, Federica Trausi, Elena Angeli, Margherita Scorpiniti, Francesca Innocenti, Riccardo Pini (IT)
14:30 - 16:00 #551 - Role of long-standing hypertension and atrial fibrillation with troponin elevations about the hidden coronary heart disease.
Elena Angeli, Alberto Conti, Giovanna Aspesi, Andrea Alesi, Niccolò De Bernardis, Chiara Donnini, Delia Lazzeretti, Caterina Grifoni, Alessandro Becucci, Margherita Scorpiniti, Federica Trausi (IT)
14:30 - 16:00 #554 - Value of high-frequency mid-QRS analysis compared to conventional ST-segment analysis in patients with chest pain and normal ECG referred for exercise tolerance test.
Giovanna Aspesi, Alberto Conti, Andrea Alesi, Niccolò De Bernardis, Chiara Donnini, Caterina Grifoni, Delia Lazzeretti, Elena Angeli, Alessandro Becucci, Margherita Scorpiniti, Maurizio Zanobetti, Riccardo Pini (IT)
14:30 - 16:00 #556 - Role of high-frequency mid-QRS analysis compared to exercise tolerance test in the first-line diagnostic workup of patients with low-risk chest pain and high prevalence of long-standing hypertension.
Delia Lazzeretti, Alberto Conti, Giovanna Aspesi, Andrea Alesi, Chiara Donnini, Alessandro Becucci, Caterina Grifoni, Alessandro Coppa, Elena Angeli, Margherita Scorpiniti, Federica Trausi, Riccardo Pini (IT)
14:30 - 16:00 #565 - Chest pain in the Emergency Department- A retrospective analysis of over 5000 patients presenting to a large urban UK Emergency Department with Chest pain.
Sanjay Ramamoorthy, Cheryl Davies (GB)
14:30 - 16:00 #731 - Utility of a validated prediction model for diagnosing acute heart failure - initial results of a prospective trial.
Brian Steinhart, Phil Levy, Gordon Moe, Hilde Vandenberghe, Melissa McGowan, Donna Clark, Gerard Devlin, David Mazer (CA)
14:30 - 16:00 #740 - Comparative study of the management of atrial fibrillation according to clinical practice guidelines in two district hospitals in the UK and Spain.
Valle Joaquin, Snow David, Fonseca Jose Javier, Lopera Elisa, Lopez Almudena, Hernandez Yelda (GB)
14:30 - 16:00 #845 - Prevalence of prolonged qtc interval in patients presenting to an urban irish emergency department.
Nicolas Lim, John Brennan, Ryan Cheng, Paul Webster, Elizabeth Curtin, Geraldine McMahon, Kathleen Bennett, Jacinta O'Brien (IE)
14:30 - 16:00 #859 - Inter-rater reliability of J-point location and the measurement of the magnitude of ST segment elevation at the J-point in ECGs of STEMI patients by emergency department doctors.
Hoon Chin Steven Lim, Edgar Azada Salandanan, Rachel Phillips, Jun Guan Tan, Md Azmi Hezan (SG)
14:30 - 16:00 #992 - Ultra-acute increase in blood glucose during prehospital phase is associated with worse short-term and long-term survival in ST-elevation myocardial infarction.
Hanna Vihonen, Ilkka Tierala, Markku Kuisma, Jyrki Puolakka, Jukka Westerbacka, Jouni Nurmi (FI)
14:30 - 16:00 #1080 - Detecting coronary induced myocardial necrosis by troponin in the over 65 age group (analysed data of 29,062 patients).
Petra Wilke, Wolfgang Langer, Tobias Leipold (DE)
14:30 - 16:00 #1123 - Management of recent-onset atrial fibrillation in Emergency Department: a comparative study upon effectiveness and safety of pharmacological treatment.
Antonio Bonora, Federico Beltrame, Piero Castiglioni, Alberto Rigatelli, Elisa Peron, Silvia Pachera, Elena Franchi, Claudio Pistorelli (IT)
 
16:30
16:30-18:00
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A34
State of the Art
Neurological Emergencies

State of the Art
Neurological Emergencies

Moderators: Thorsten STEINER (GERMANY), Erich SCHMUTZHARD (AUSTRIA)
16:30 - 17:15 Acute ischemic stroke: do current “contraindications” for tPA make sense? Jonathan EDLOW (USA)
17:15 - 17:30 Subarachnoid hemorrhage. Erich SCHMUTZHARD (AUSTRIA)
17:30 - 18:00 Intracerebral hemorrhage. Thorsten STEINER (GERMANY)
16:30-18:00
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B34
The Netherlands Invites
Cardiovascular Emergencies

The Netherlands Invites
Cardiovascular Emergencies

Moderators: Barbra BACKUS (dordrecht, THE NETHERLANDS), George GOLDMAN (USA)
16:30 - 17:00 ECG Manifestations of Pulmonary Embolism You Must Know! George GOLDMAN (USA)
17:00 - 17:30 the Heart of the matter - cardiac ultrasound for Emergency Physicians. Mike BURG (USA)
17:30 - 18:00 Cardiac Resuscitation. Scott SILVERS (USA)
16:30-18:00
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C34
Clinical Questions
EuSEM Meets: ESA

Clinical Questions
EuSEM Meets: ESA

Moderators: Daniela FILIPESCU (ROMANIA), Marc SABBE (Medical staff member) (Leuven, BELGIUM)
16:30 - 17:00 The place of etomidate in emergency medicine: an anaeshesiologist's perspective. Bernd BOETTIGER (GERMANY)
17:00 - 17:30 The anaesthesiologist's role in patient safety in emergency medicine. Edoardo DE ROBERTIS (ITALY)
17:30 - 18:00 Education in resuscitation. Bernd BOETTIGER (GERMANY)
16:30-18:00
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D34
Administrative Track
Development of the Specialty / EM Organisation

Administrative Track
Development of the Specialty / EM Organisation

Moderators: Lisa KURLAND (SWEDEN), David WILLIAMS (UK)
16:30 - 17:00 The changes in acute health care organization in the Netherlands. Menno GAAKEER (UTRECHT, THE NETHERLANDS)
17:00 - 17:30 Danish Emergency Medicine: The ugly duckling - can it become the beautiful swan? Dan BRUN PETERSEN (DENMARK)
17:30 - 18:00 Opportunities, sharing and responding to our own crises. Ruth BROWN (Speaker) (London, UK)
16:30-18:00
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E34
Research
YEMD - Top Scoring Young Doctor Abstract Presentation

Research
YEMD - Top Scoring Young Doctor Abstract Presentation

Moderators: Ibrahim ARZIMAN (EMERGENCY MEDICINE SPECIALIST) (ANKARA, TURKEY), Pieter Jan VAN ASBROECK (Consultant in Emergency Medicine) (Hasselt, BELGIUM)
16:30 - 16:35 Introduction to session. Ibrahim ARZIMAN (EMERGENCY MEDICINE SPECIALIST) (ANKARA, TURKEY)
16:35 - 17:55 Top scoring abstract presentations.
17:55 - 18:00 Award presentation. Pieter Jan VAN ASBROECK (Consultant in Emergency Medicine) (Hasselt, BELGIUM)
16:30 - 18:00 #1022 - Evaluation of an instrument to measure teamwork in Emergency Medicine resident teams.
Elena Angeli, Margherita Scorpiniti, Andrea Alesi, Francesca Innocenti, Riccardo Pini (IT)
16:30 - 18:00 #1041 - Role of the Emergency Department in the prognostic stratification of patients with severe sepsis and septic shock.
Chiara Donnini, Eleonora De Villa, Stella Squarciotta, Michele Baioni, Damiano Vignaroli, Camilla Tozzi, Caterina Grifoni, Francesca Innocenti, Riccardo Pini (IT)
16:30 - 18:00 #1045 - Patients leaving the emergency department against medical advice: A quality indicator?
Julie Mackenhauer, Amal Schnegelsberg, Marie K Jessen, Anders B Møllekær, Jonas Bager-Elsborg, Lars Knudsen, Hans Kirkegaard (DK)
16:30 - 18:00 #1046 - Left ventricular systolic function as main single predictor of mortality in sepsis in the short term: beyond ejection fraction.
Aurelia Guzzo, Elisa Guerrini, Chiara Donnini, Damiano Vignaroli, Vittorio Palmieri, Francesca Innocenti, Riccardo Pini (IT)
16:30 - 18:00 #1112 - The effect of language complexity and health literacy on patient comprehension in the emergency department.
Robert Wiggins, Ian Martin, Darren Dewalt, Robert Lovrich, Michael Hieronymus, Benny Joyner (US)
16:30 - 18:00 #1113 - Perioperative anesthesia care and its correlation with the professionalization of medical teams deployed in the aftermath of natural and man-made disasters: a systematic literature review.
Luca Ragazzoni, Marta Caviglia, Giacomo De Mattei, Alba Ripoll Gallardo, Francesco Della Corte, Pier Luigi Ingrassia (IT)
16:30 - 18:00 #112 - The use of the video laryngoscope compared with a standard laryngoscope for the intubation of children by infrequent users.
Natalie Bee, Thomas Beattie, T.Y.M. Lo, Sarah Mckenzie (GB)
16:30 - 18:00 #1170 - Association between length of stay in the Emergency Department and patient allocation process to emergency physicians.
Alice HUTIN, Bertrand RENAUD, Aline SANTIN (FR)
16:30 - 18:00 #790 - Pre injury antiplatelet therapy in patients with mild head trauma increases the incidence of intracranial hemorrhage.
Gabriele Viviani, Simone Vanni, Sonia Vicidomini, Nazerian Peiman, Giuseppe Pepe, Alberto Conti, Eleonora De Villa, Claudio Poggioni, Federico Bulletti, Giuseppe Giannazzo, Stefano Grifoni (IT)
16:30 - 18:00 #872 - Evaluation of a new triage scale on patient's distribution on a university emergency department.
ANTHONY CHAUVIN, OULED NORA, Cecile DURAND, Nicolas SEGAL, Patrick PLAISANCE (FR)
16:30 - 18:00 #915 - Professionalization of anesthesiologists and critical care specialists in humanitarian action: a nationwide survey among Italian residents in training.
Alba Ripoll Gallardo, Pier Luigi Ingrassia, Luca Ragazzoni, Ahmadreza Djalali, Luca Carenzo, Frederick Burkle, Francesco Della Corte (IT)
16:30 - 18:00 #923 - Low risk chest pain patients in the Emergency Department: clinical scores and cardiac stress test ability in predicting coronary artery disease.
Margherita Luzzi, Chiara Donnini, Barbara Rinaldo, Alberto Conti, Francesca Innocenti, Riccardo Pini (IT)
16:30 - 18:00 #927 - Patients with low risk chest pain in the Emergency Department: clinical scores and stress-echocardiography.
Margherita Luzzi, Chiara Donnini, Barbara Rinaldo, Alberto Conti, Francesca Innocenti, Riccardo Pini (IT)
16:30 - 18:00 #955 - Factors involved in patients death while consulting for an urgent chest pain : claims files analysis 2009-2010.
Anne-Laure Feral-Pierssens, Anne-Laure Feral-Pierssens, Thierry Houselstein, Philippe Juvin, Philippe Juvin (FR)
16:30-18:00
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F34
Free Papers
Pain Management / Analgesia

Free Papers
Pain Management / Analgesia

Moderators: Juliusz JAKUBASZKO (POLAND), Sabine LEMOYNE (Senior Staff Member) (Edegem, BELGIUM)
16:30 - 18:00 #99 - Improved analgesia administration in Emergency Medicine after implementation of revised guidelines.
Geesje van Woerden, Christien van der Linden, Kees den Hartog, Floris Idenburg, Diana Grootendorst, Crispijn van den Brand (NL)
16:30 - 18:00 #423 - Procedural sedation and analgesia by emergency physicians in a large emergency department in the Netherlands; a prospective evaluation.
Nanda Gubbels, Maro Sandel, Gerlande Veldhuis (NL)
16:30 - 18:00 #645 - Pain management of adults in the emergency department, an interventional study.
Emil Verhoofstad, Aniek Schmidt, Rebekka Veugelers (NL)
16:30 - 18:00 #772 - Insight in barriers and facilitators for compliance with a national guideline on pain in the chain of pre-hospital based emergency care.
Sivera Berben PhD, Alvin Westmaas PhD, Pleunie Rood PhD, MD, Carine Doggen PhD, Lisette Schoonhoven PhD, RN (NL)
16:30 - 18:00 #775 - Adding intranasal ketamine to intravenous morphine sulftate in patients with limb trauma: a double blinded randomized clinical trial.
Arash Safaie, Ali Mohammadshahi, Hamed Nikzamir, Seyed Reza Abtahi (IR)
16:30 - 18:00 #832 - Interest of residual neuromuscular blockade and bispectral index mesuarment in the emergency department in prehospital intubated patients.
Guy-Loup Dulière, Xavier Losfeld, Michel Vergnion, Benedicte Schenkelaars (BE)
16:30 - 18:00 #934 - Regional analgesia of face and distal extremities in the emergency department: a prospective analysis of its use, efficacy and complications.
Maro Sandel, Samantha Toet, Victor Jansen (NL)
16:30 - 18:00 #964 - A randomised, double blind, multi-centre, placebo controlled study to evaluate the efficacy and safety of methoxyflurane (Penthrox™) for the treatment of acute pain in patients presenting to an Emergency Department (ED) with minor trauma.
Frank Coffey, Philip Miller (GB)
16:30 - 18:00 #1026 - Adverse events of s-ketamine and propofol for psa in a dutch ed.
Laura Esteve Cuevas, Priscilla Tjon Kon Sang, Martijn van Hooft (NL)
16:30 - 18:00 #1140 - The management of acute pain in the Emergency Department: result of a descriptive study.
Ludovico Gaiottino, Isabella Prisciandaro (IT)
16:30-18:00
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G34
Free Papers
Paediatric Emergencies 2 - Lightning Session

Free Papers
Paediatric Emergencies 2 - Lightning Session

Moderators: Tom BEATTIE (UK), Liviana DA DALT (PHYSICIAN) (PADOVA, ITALY)
16:30 - 18:00 #17 - Effect of pediatric triage Education based on emergency severity index (ESI) on performance of pediatrics nurses and improvement the indices of emergency unit in nemazi hospital of Shiraz Iran , 2014.
mohammad kalantari meibodi, samira esfandyari (IR)
16:30 - 18:00 #42 - Paediatric allergy treatment in A&E and the RCPCH care pathway: An audit.
Toby Flack, Sophie Vaughan (GB)
16:30 - 18:00 #193 - Can the B-natriuretic peptide test be used for diagnosing heart failure in children with congenital heart disease who present to the emergency department with RSV bronchiolitis? A pilot study.
Nir Samuel, Tova Hershkovitz, Itai Shavit (IL)
16:30 - 18:00 #194 - Mechanisms of falls in pediatric minor head injury: A cross sectional analysis.
Nir Samuel, Ron Jacob, Itai Shavit (IL)
16:30 - 18:00 #230 - Predictors of Glasgow Outcome Scale one month after trauma for previously hospitalized children. What happens with youth and other classic predictors?
Nieves de Lucas-García, Santos García-García, José Antonio Ruiz-Domínguez, Juan Vázquez-Estévez, Jorge Parise-Metholo, Julia Martín-Sánchez (ES)
16:30 - 18:00 #234 - Is it ovarian torsion ? A systematic literature review and evaluation of prediction signs.
Celine Rey-Bellet Gasser, Jean-Yves Pauchard, Jean-Marc Joseph, Mario Gehri (CH)
16:30 - 18:00 #263 - Prevalence and predictors of bacterial meningitis among infants under 90 days old with fever without a source.
Borja Gomez, Elena Martínez, Javier Benito, Estibaliz Catediano, Amaia Lopez, Santiago Mintegi (ES)
16:30 - 18:00 #292 - Validation of a sequential approach to identify febrile infants under 90 days old at low risk for invasive bacterial infections – preliminary data.
Borja Gomez, Santiago Mintegi, Javier Benito, Silvia Bressan, Alain Gervaix, Liviana Da Dalt, Isabel Durán, Mercedes de la Torre, Izaskun Olaciregui, Arístides Rivas, Roberto Velasco, Andrés González, Anna Fabregas, Veronica Mardegan, Daniel Blázquez, Laurence Lacroix, Chiara Stefani (ES)
16:30 - 18:00 #302 - Trauma and intracranial hemorrhage in children with idiopathic thrombocytopenic purpra.
Ahmed Alterkait, Roaa Jamjoom, Savithiri Ratnapalan (CA)
16:30 - 18:00 #353 - Outpatient management of pediatric patients at very low risk of bacterial meningitis. Prospective multicenter study.
Silvia Garcia, Mª Jose Martin-Diaz, Javier Benito, Mercedes Sota-Busselo, Eunate Arana-Arri, Santiago Mintegi, Meningitis Study Group Spanish Pediatric Emergency Research Group (ES)
16:30 - 18:00 #400 - IS THE BROSELOW TAPE (BT) AN ACCURATE PREDICTOR OF WEIGHT IN PEDIATRIC PATIENTS STRATIFIED BY RACE?
Lisa Moreno-Walton, Benjamin Lee, Rebecca Hutchings, Alia Fleury (US)
16:30 - 18:00 #569 - Risk of serious bacterial infection in febrile young infants by general appearance and age.
Nieves de Lucas, Mercedes de la Torre, Borja Gomez, . Group for the Study of the Young Febrile Infant (ES)
16:30 - 18:00 #571 - Epidemiological aspects of serious bacterial infections of infants younger than 90 days of age with fever without source.
Nieves de Lucas, Mercedes de la Torre, Borja Gomez, Roberto Velasco, Santiago Mintegi, . Group for the Study of the Young Febrile Infant (ES)
16:30 - 18:00 #578 - Utility of procalcitonin and C-reactive protein for the diagnosis of invasive infections of infants younger than 90 days with fever without source.
Nieves de Lucas, Aristides Rivas, Mercedes de la Torre, Borja Gomez, Roberto Velasco, . Group for the Study of the Young Febrile Infant (ES)
16:30 - 18:00 #575 - Implementation of a written safety netting advice for parents of feverish children at risk for serious infections at the emergency department.
Dorien Geurts, Evelien Kerkhof, Mariska Wiggers, Badies Manai, Monica Lakhanpaul, Henriette Moll, Rianne Oostenbrink (NL)
16:30 - 18:00 #642 - Evaluation of Manchester triage system and pediatric early warning score (PEWS) as triage tools in pediatric emergency care.
Jeroen Veldhuis, Marjolein Van Bekkum, Eric De Groot (NL)
16:30 - 18:00 #1159 - Determining Factors of Recurrence Risk of Seizure in the Observat?on Unit of a Pediatric Emergency Department.
Ozlem Teksam, Ayse Gultekingil Keser (TR)
Wednesday 01 October
Time Zuiveringshal West Transformatorhuis Openbare Verlichting MC Theatre Machinegebouw Ketelhuis Westerliefde
 
09:30
09:30-11:00
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A41
State of the Art
Sepsis

State of the Art
Sepsis

Moderators: Kurt ANSEEUW (Medical doctor) (ANTWERP, BELGIUM), Riccardo PINI (Director, E.D. High Dependency Unit) (Florence, ITALY)
09:30 - 10:00 HOT TOPIC: ProCESS - implications for ED sepsis management. David HUANG (USA)
10:00 - 10:30 Recognition and risk stratification of ED patients with a suspected infection: Towards prevention of severe sepsis? Bas DE GROOT (Amsterdam, THE NETHERLANDS)
10:30 - 11:00 New indices of myocardial dysfunction during severe sepsis and septic shock. Riccardo PINI (Director, E.D. High Dependency Unit) (Florence, ITALY)
09:30-11:00
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B41
The Netherlands Invites
New Stuff

The Netherlands Invites
New Stuff

Moderators: Javier BENITO FERNANDEZ (Getxo - Vizcaya, SPAIN), Michael CHRIST (Director) (Lucerne, SWITZERLAND)
09:30 - 10:00 FOAM: the good bubbles up. The why and how of the internet for learning. Mariska ZWARTSENBURG (THE NETHERLANDS)
10:00 - 10:30 Physician wellness: how to have a lifelong sustainable working career. Klaartje CAMINADA (THE NETHERLANDS)
10:30 - 11:00 ED sepsis care: should we start before we begin? Merel WILLEBOER (THE NETHERLANDS)
09:30-11:00
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C41
Clinical Questions
Neurological Emergencies

Clinical Questions
Neurological Emergencies

Moderators: Monica FERLISI (ITALY), Bettina PFAUSLER (AUSTRIA)
09:30 - 10:00 Viral encephalitis beyond TBE and HSV 1. Monica FERLISI (ITALY)
10:00 - 10:30 Acute bacterial meningitis. Diederik VAN DE BEEK (THE NETHERLANDS)
10:30 - 11:00 Cerebral malaria and other imported infectious encephalopathies. Erich SCHMUTZHARD (AUSTRIA)
09:30-11:00
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D41
Administrative Track
ED Technology and Design

Administrative Track
ED Technology and Design

Moderators: Cinzia BARLETTA (ITALY), Micaela SEEMANN MONTEIRO (LISBON, PORTUGAL)
09:30 - 10:00 Reducing Violence & Aggression in A&E: A project with the UK Design Council. Jonathan BENGER (UK)
10:00 - 10:30 Serious Games: new opportunities to train emergency medicine. Micaela SEEMANN MONTEIRO (LISBON, PORTUGAL)
10:30 - 11:00 Bringing Agility to Technology and Process of Care. Tiziana MARGARIA STEFFEN (IRELAND)
09:30-11:00
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E41
Research
Cardiovascular Emergencies

Research
Cardiovascular Emergencies

Moderators: Barbra BACKUS (dordrecht, THE NETHERLANDS), Alberto CONTI (Toscana, ITALY)
09:30 - 10:00 Troponins and atrial fibrilation. Alberto CONTI (Toscana, ITALY)
10:00 - 10:30 Applicability of the HEART score in Emergency Department patients with chest pain. Barbra BACKUS (dordrecht, THE NETHERLANDS)
10:30 - 11:00 Advances in the ECG Diagnosis of Acute Myocardial Infarction. Stephen SMITH (USA)
09:30-11:00
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F41
International agendas for Emergency Care research

International agendas for Emergency Care research

Moderators: Jim DUCHARME (Mississauga, CANADA), Colin GRAHAM (Hong Kong, HONG KONG)
09:30 - 09:45 What is the research agenda for ED overcrowding? Sandra SCHNEIDER (USA)
09:45 - 10:00 Cardiac output monitoring in the ED: Research questions and needs. Timothy HUDSON RAINER (Cardiff, UK)
10:00 - 10:15 Pain research in EM: What are the next steps? Jim DUCHARME (Mississauga, CANADA)
10:15 - 10:30 Translational research in EM. Lisa MORENO-WALTON (USA)
10:30 - 10:45 What are the important questions for cardiovascular research in EM? Colin GRAHAM (Hong Kong, HONG KONG)
09:30-11:00
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G41
Free Papers
Toxicology an Pharmocology - Lightning Session

Free Papers
Toxicology an Pharmocology - Lightning Session

Moderators: Basar CANDER (TURKEY), Deborah ZVOSEC (USA)
09:30 - 11:00 #65 - ACE mediated angioedema in the Emergency Department - an underrecognised problem.
George Oommen, Alasdair Corfield (GB)
09:30 - 11:00 #172 - Effects of antidotal therapy on testis tissue in organophosphate poisoning.
Umut Gumusay, Ahmet Sebe, Deniz Aka Satar, Mehmet Oguzhan Ay, Mustafa Yilmaz, Ufuk Ozgu Mete (TR)
09:30 - 11:00 #178 - Effects of the global economic crisis on suicide attempts in south of Turkey.
Zikret Koseoglu, Mehmet Oguzhan Ay, Akkan Avci, Nalan Kozaci, Selen Acehan, Sencer Segmen, Ozgur Karcioglu, Salim Satar (TR)
09:30 - 11:00 #199 - Young people's attitudes to novel psychoactive substances.
Kate Buchanan, Maria Finn (GB)
09:30 - 11:00 #206 - Substances the children ingest – a retrospective study regarding involuntary and voluntary poisonings.
Alina Mihaela Busan, Cristiana Geormaneanu (RO)
09:30 - 11:00 #282 - The Incidence of Atropine Induced Psychosis in Organophosphate Intoxication.
Tae Hoon Kim, Hyun Kim, Woo Jin Jung, Yong Sung Cha (KR)
09:30 - 11:00 #347 - Impact of an emergency medicine short stay unit on ED performance of poisoned patients.
Michael Downes, Geoffrey Isbister, Nicole Ritchie, Tracy Muscat (AU)
09:30 - 11:00 #367 - Comparison of ischemia modified albumin levels with total oxidant, total antioxidant status, oxidative stress index in carbon monoxide poisoning.
polat durukan, omer salt, cemil kavalci, gulsum Kavalci (TR)
09:30 - 11:00 #684 - Determining the amount of drug ingestions in adults: accuracy of estimates by healthcare professionals and members of the public.
Dong Hoon Lee, Yoon Hee Choi (KR)
09:30 - 11:00 #715 - The oxidative stress determined through the levels of antioxidant enzymes and the effect of N-acetylcysteine in in aluminium phosphide poisoning.
Manish Gutch, Sukriti Kumar (IN)
09:30 - 11:00 #755 - Anticoagulation reversal at a major urban emergency department.
Diana Sousa Mendes, Ana Corredoura, Micaela Monteiro (PT)
09:30 - 11:00 #805 - Paracetamol overdose – can we rely on history only?
Adeel Akhtar, Colm Gerard O'Kane, John Gray (GB)
09:30 - 11:00 #813 - Alpha-amanitin poisoning: outcome in 242 patients treated with the Pavia mushroom protocol (N-acetylcysteine, forced diuresis and multiple-dose activated charcoal).
Carlo Alessandro Locatelli, Valeria Margherita Petrolini, Andrea Giampreti, Davide Lonati, Sarah Vecchio, Elisa Roda, Emanuela Cortini, Monia Aloise, Francesca Chiara, Teresa Coccini (IT)
09:30 - 11:00 #817 - Prevalence of analytically confirmed intoxications by new psycho-toxic substances in Italy: data from Pavia poison centre and National Early Warning System.
Davide Lonati, Andrea Giampreti, Eleonora Buscaglia, Sarah Vecchio, Valeria Margherita Petrolini, Teresa Coccini, Pietro Papa, Claudia Rimondo, Catia Seri, Teodora Macchia, Giovanni Serpelloni, Carlo Alessandro Locatelli (IT)
09:30 - 11:00 #840 - EFFICIENCY OF THE ANTIVENOM Fab(2) IN THE PATIENTS BITTEN BY CROTALID SNAKES.
Rodolfo Marquez-Martin, Edelmiro Perez-Rodriguez (MX)
09:30 - 11:00 #998 - The correlation between calcium channel blocker overdose and intrapleural/peritoneal free fluid.
Mustafa Yilmaz, Mehmet Oguzhan Ay, Yuksel Gokel, Nalan Kozaci, Gulnihal Samanlioglu, Mesude Atli, Seda Karakucak (TR)
09:30 - 11:00 #1086 - Characteristics of Patients with Major Depressive Disorder Who Were Treated with Drug Intoxication in Emergency Department.
sung wook Kim, jueng taek Park, byung hak So (KR)
09:30 - 11:00 #1125 - Psychoactive substances of abuse - ED experience in Romania.
Mihaela Corlade-Andrei, Diana Cimpoesu, Elena Butnaru (RO)
09:30 - 11:00 #694 - Complaints after cannabis use: safe discharge with standard of care.
Lot Schutte, Mariska Zwartsenburg, Femke Gresnigt (NL)
 
11:45
11:45-13:15
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A42
State of the Art
Education and Training in EM

State of the Art
Education and Training in EM

Moderators: Sabine LEMOYNE (Senior Staff Member) (Edegem, BELGIUM), Anna SPITERI (Consultant) (Malta, MALTA)
11:45 - 12:15 Teaching on the shop floor: Moments of opportunity. Cornelia HARTEL (Medical Director of the ED, Consultant in EM, Director of Medical Education in EM) (STOCKHOLM, SWEDEN)
12:15 - 12:45 Teaching non-technical skills for the ED. Anna SPITERI (Consultant) (Malta, MALTA)
12:45 - 13:15 EBEEM: Outcomes and progress. Roberta PETRINO (Head of department) (Italie, ITALY)
11:45-13:15
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B42
The Netherlands Invites
PSA

The Netherlands Invites
PSA

Moderators: Klaartje CAMINADA (THE NETHERLANDS), Polat DURUKAN (TURKEY)
11:45 - 12:15 Oral and IV analgesia: the best ways to get it right. Gael SMITS (THE NETHERLANDS)
12:15 - 12:45 Say Yes to NO: procedural possibilities of nitrous oxide in the ED. Mariska ZWARTSENBURG (THE NETHERLANDS)
12:45 - 13:15 Intranasal analgesia or sedation: how to please your patient. Gael SMITS (THE NETHERLANDS)
11:45-13:15
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C42
Clinical Questions
Sepsis

Clinical Questions
Sepsis

Moderators: Kurt ANSEEUW (Medical doctor) (ANTWERP, BELGIUM), Ana NAVIO (SPAIN)
11:45 - 12:15 The Golden Hour of Sepsis. Christian HOHENSTEIN (PHYSICIAN) (JENA, GERMANY)
12:15 - 12:45 The role of the High Dependency Unit in the management of severe sepsis and septic shock in the ED. Riccardo PINI (Director, E.D. High Dependency Unit) (Florence, ITALY)
12:45 - 13:15 European Progress in Shock: What we know, what we should know. Ana NAVIO (SPAIN)
11:45-13:15
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D42
Administrative Track
Social Media for the ED

Administrative Track
Social Media for the ED

Moderators: Haldun AKOGLU (Faculty Member) (Istanbul, TURKEY), Simon CARLEY (Manchester, UK)
11:45 - 12:15 St. Emlyn's in Virchester: A virtual hospital on a mission to bring free, open access medical education to all. Simon CARLEY (Manchester, UK)
12:15 - 12:45 Turkey's finest FOAM: Acilci.net. Haldun AKOGLU (Faculty Member) (Istanbul, TURKEY)
12:45 - 13:15 SMACC: The value of an international healthcare conference on social media. Natalie MAY (Oxford, UK)
11:45-13:15
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E42
Research
Hot Off the Press

Research
Hot Off the Press

Moderators: Colin GRAHAM (Hong Kong, HONG KONG), Suzanne MASON (Professor of Emergency Medicine) (Sheffield, UK)
11:45 - 11:55 Introduction. Colin GRAHAM (Hong Kong, HONG KONG)
11:55 - 12:15 Findings from the AHEAD study. Suzanne MASON (Professor of Emergency Medicine) (Sheffield, UK)
12:15 - 12:35 Trends in Death over the last decade:Myocardial Infarction, Heart Failure and Pulmonary Embolism. Said LARIBI (PU-PH, chef de service) (Tours, FRANCE)
12:35 - 12:55 Asthma in the paediatric emergency department. Javier BENITO FERNANDEZ (Getxo - Vizcaya, SPAIN)
11:45-13:15
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F42
Free Papers
Airway, Respiratory and Ventilation

Free Papers
Airway, Respiratory and Ventilation

Moderators: Roberto COSENTINI (Milano, ITALY), Bas DE GROOT (Amsterdam, THE NETHERLANDS)
11:45 - 13:15 #324 - Gender difference in asthma care and outcomes in emergency departments: Multicenter Observational Study.
Tasuku Matsuyama, Taichi Imamura, Hiroko Watase, Kohei Hasegawa (JP)
11:45 - 13:15 #326 - Lung injury subsequent to resuscitation with mechanical ventilation: Histological findings in Chest Compression Synchronized Ventilation (CCSV) or Intermitted Positive Pressure Ventilation (IPPV) after return of spontaneous circulation in an animal.
Wolfgang Dersch, Elisabeth Bösl, Philipp Hoselmann, Christian Neuhaus, Pascal Wallot, Oliver Hahn, Ulrich Palm, Wilhelm Nimphius, Karl Kesper, Hinnerk Wulf, Clemens Kill (DE)
11:45 - 13:15 #330 - Resuscitation and mechanical positive pressure ventilation: Does the ventilation mode matter?
Wolfgang Dersch, Elisabeth Bösl, Christian Neuhaus, Ulrich Palm, Christopher Sauerbrei, Oliver Hahn, Pascal Wallot, Karl Kesper, Hinnerk Wulf, Clemens Kill (DE)
11:45 - 13:15 #507 - Comparison of nebulized salbutamol plus iv magnesium sulfate to nebulized salbutamol in patients with cancer related dyspnea.
Serkan Yilmaz, Elif Yaka, Melih Yuksel, Nurettin Ozgur Dogan, Murat Pekdemir (TR)
11:45 - 13:15 #605 - Evaluation of videolaryngoscope in emergency medicine.
marion guerrier, stéphanie legros, frédéric cocu, david poubel, eric revue (FR)
11:45 - 13:15 #917 - Awake Intubation: an Atraumatic and Safe Procedure in the Emergency Department.
Gerardo Linares-Mendoza, Luis Arcadio Cortés-Puentes (CO)
11:45 - 13:15 #1012 - Airway management during CPR. Balance between perfusion pressure and operative management: a time saving and free hands choice.
Andrea Leonardi, Marco Bellezza, Gianluca Ugolini, Gianluca Marinello, Patrizio Alocci (CH)
11:45 - 13:15 #1031 - The adherence to the guidelines on acute respiratory failure in Accident and Emergency Units : results of multicenter study.
Isabella Prisciandaro, Luca Panuele, Letizia Barutta (IT)
11:45 - 13:15 #1194 - Age relatied D-dimers - Can you be more specific?
Andrew HAMMOND, Liam O Kane, Sean McGovern (UK)
11:45-13:15
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G42
Free Papers
Research Potpourri: Updates - Lightning Session

Free Papers
Research Potpourri: Updates - Lightning Session

Moderators: Itay SHAVIT (ISRAEL), Roberto VELASCO (Pediatrician) (Laguna de Duero, SPAIN)
11:45 - 13:15 #6 - Diagnostic significance of high sensitivity troponin in diagnosis of blunt cardiac injury.
Carmen Andrea Pfortmueller, Alexander Benedikt Leichtle, Georg-Christian Funk, Gregor Lindner, Aristomenis Konstantinos Exadaktylos (CH)
11:45 - 13:15 #134 - Post-discharge follow-up telephone calls after emergency department visit.
Tirza Huting, Christien Van der Linden, Geesje Van Woerden (NL)
11:45 - 13:15 #278 - The effect of the telephone triage for the patients' usage of ambulance transports to the emergency department.
Yasumitsu Mizobata, Hitoshi Yamamura, Tomonori Yamamoto, Shinichiro Kaga, Takasei Morioka, Naoki Shinyama, Kazuhisa Kaneda, Hiromasa Yamamoto (JP)
11:45 - 13:15 #337 - Knowledge about sirs and sepsis: a survey among emergency department nurses.
Leandra van den Hengel, Pleunie Rood, Stephanie Schuit, Liesbeth Taal, Thijmen Visseren (NL)
11:45 - 13:15 #344 - A military hybrid simulation model for the training of haemorrhage control in proximal extremity bleedings.
Lars Lundberg, Anders Jonsson, Katarina Silverplats (SE)
11:45 - 13:15 #419 - Classification of twitter data from the 2012 Emilia-Romagna earthquake by machine learning: comparison of k-nearest neighbors, kernel support vector machine, and string kernel methods.
Jeffrey Franc, Pier Luigi Ingrassia, Ester Boniolo, Luca Carenzo, Katuscia Vettoretto, Francesco Della Corte (CA)
11:45 - 13:15 #424 - Celox Coated Gauze for the Treatment of Civilian Low Velocity Penetrating Limb Trauma: A Clinical Trial.
Hamid Reza Hatamabadi, Fatemeh Asayesh Zarchi, Ali Tabatabey (IR)
11:45 - 13:15 #426 - Fresh Frozen Plasma Resuscitation Improves Neurological Recovery in Traumatic Brain Injury Combined with Hemorrhagic Shock.
Ihab Halaweish, Durk Linzel, Ted Bambakidis, A Sirinivasan, Hasan Alam (NL)
11:45 - 13:15 #514 - Incidence and predictors of chronic pain after musculoskeletal injury.
Jorien G. J. Pierik, Maarten J IJzerman, Arie B van Vugt, Miriam M R Vollenbroek-Hutten, Menno I Gaakeer, Carine J. M. Doggen (NL)
11:45 - 13:15 #693 - Playing with Sepsis.
Pedro Santos, Claudia Ribeiro, Tiago Antunes, Sofia Corredoura, Micaela Monteiro (PT)
11:45 - 13:15 #809 - The effect of the rapid ultrasound in shock protocol on the diagnostic procedure.
Luuk Schoorlemmer, Mirjam Doff - Holman (NL)
11:45 - 13:15 #922 - Injury patients due to transport accidents, treated at Emergency Trauma Centre, Teaching Hospital Karapitiya, Sri Lanka.
Arosha Abeywickrama, Vijitha De Silva, Krishantha Jayasekara, Udyoga Edirisinghe, Sudath Priyadarshana, Shelton Perera (LK)
11:45 - 13:15 #954 - The rate of transcription of the schedules of the interventions of the Mobile Intensive Care Unit’s team on the fields of regulation of the EMERGENCY MEDICAL SERVICE.
Houda Belhaouane, Mohamed Radhouani, Salim Hamdani, Mylène Ben Hamida, Wafa Limam, Dorsaf Bellasfar, Mounir Daghfous (TN)
11:45 - 13:15 #1006 - UROLOGICAL EMERGENCIES IN A DISTRICT HOSPITAL.
Raquel Sanjuán Domingo, Silvia Castán Ruiz, Maria Peña López Galindo, Maria Luisa Catalán Ladrón, José Enrique Recio Jiménez, Martha Urdaz Hernández, Rocio Sencianes Caro, Marta Alonso Alcañiz, Sergio Muñoz Jacobo, Felicidad Yañez Rodriguez (ES)
11:45 - 13:15 #1039 - The changing role of ambulance services and paramedics in England.
Andy Newton (GB)
11:45 - 13:15 #1048 - Clinical audit on management of patients with psychomotor agitation in Accident & Emergency Unit.
Isabella Prisciandaro, Edem Sandy Takpuie (IT)
11:45 - 13:15 #1107 - Mups showing up at the emergency department, not always funny.
Jelmer Alsma, Jens van de Wouw, Sophie Coffeng, Anne Weiland, van den Brand Crispijn, Stephanie Schuit, Jan van Saase, Korné Jellema (NL)
11:45 - 13:15 #1185 - Improving door-to-needle time for patients with acute ischaemic stroke receiving thrombolysis via the telestroke service.
Yihui Goh, Serene Tan Shi Ying, Camlyn Tan, Rajinder Singh, Jane Marlie, Winnie Soo, Ping Wang, Xiaoyan Jiang, Choon Ming Chong, Ling Tiah (SG)
11:45 - 13:15 #959 - Elderly patients visiting emergency departments: analysis of care pathways and household caregivers.
Anne-Laure Feral-Pierssens, Anne-Laure Feral-Pierssens, Pauline Ecroulant, Philippe Juvin, Philippe Juvin (FR)

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2014: Amsterdam, Netherlands

Amsterdam, Netherlands from 28 September - 1 October 2014

westergasfabriek

Amsterdam has always been open for new ideas and throughout its history has dared to look beyond its borders. It is fitting that EuSEM's congress was taking place in Amsterdam. In this congress we also sought new ideas and sought to move emergency medicine forward internationally.

Amsterdam has a history of creating wealth through global trade. I was reading about how Amsterdam became the richest city in the world in the 1600s: "Amsterdam's wealth was generated by its commerce, which was in turn sustained by the encouragement of entrepreneurs, whatever their origin. In the 1600s, ships from the city sailed to North America, Indonesia, Brazil and Africa and formed the basis of a worldwide trading network for everything from spices and silks to diamonds. Rembrandt painted in the city at the peak of its prosperity. Today the city has a globally active service and knowledge-based economy including banking and finance, transport, freight logistics and trading, while its airport is one of Europe's busiest.

Like Amsterdam, we in emergency medicine must take an international view of our challenges. Emergency medicine is growing rapidly and undergoing major changes across Europe. We have become a key provider of medical treatment, going way beyond the early concepts of accident and urgent care at the evening or weekends when other care providers are absent. In some of the largest European countries, statistics show the number of patients in emergency departments each year reaches a quarter of the population. This huge number of patients demands high quality of treatment. Waiting times in emergency departments are a number one theme in the press and television in some countries. To cope with such challenges emergency medicine needs new ideas. Like the merchants from Amsterdam who made the city rich by reaching out to the world, we must also look beyond our own countries. We must be open to new ideas and seek new knowledge to find new answers.

The Netherlands Society of Emergency Physicians (NSEP) was founded in Amsterdam in 1999. At that time in The Netherlands, emergency medicine as an independent medical specialty was only an idea. In 2014, fifteen years later, over 300 trained emergency physicians are working in 85 out of 93 emergency departments, of which ten are staffed by emergency physicians 24/7. In 28 training hospitals 192 residents are being trained. In a short period emergency medicine has become the future quality standard for emergency care in The Netherlands. As part of these dynamic developments we are proud to have hosted EuSEM 2014 Amsterdam, the 8th European Congress on Emergency Medicine.

2014's main theme was  ‘Connecting for Excellence!’. Traditionally Amsterdam has been a city in connection with the entire world. In 2014, 178 nationalities live together in this capital city… a breeding ground for creative excellence.

The Westergasfabriek, a building in Dutch neo-renaissance style, was originally designed as a coal gas factory complex in 1885. In the course of time the use of the building has changed. Today the area has become a cultural zone which also offers a conference venue in the historical center of Amsterdam, and is an inspiring environment to meet and advance the quality of emergency care together.

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Pre-Course: Falck Foundation Prehospital Research Workshop

Saturday 27 September: 08:30 - 16:30

Course Director

  • Rune Andersen, Denmark

Faculty

  • Maaret Castrén, Sweden
  • Jana Séblova, Czech Republic
  • Joost Bierens, Netherlands
  • V. Anantharaman, Singapore
  • Olivier Hoogmartens, Belgium 

Individual assignement before seminar

  • 1. Create a new prehospital research proposal, or use your current prehospital research proposal
  • 2. During the workshop there will be time available to prepare and/or discuss your prehospital research proposal in group
  • 3. Each attendee will be asked to actively participate in the group discussions

Course description

After 5 introductory presentations by experts with experiences in prehospital research, the participants of the workshop will be separated in distinct groups. Participants introduce their own current version of a research proposal by which is then discussed with the researchers, group and in the plenary session. The goal of the interactive workshop is to learn the most important elements that contribute to good quality and successful prehospital research. The goal is not that the research proposals will be executed, although further initiatives to do so will be applauded.

Learning objectives

Research in the prehospital domain of emergency medicine in scarce. It is well-known that such research is difficult to prepare, execute and publish in high impact journals. It is not uncommon that a young and dedicated researcher has the intention to start an interesting study and discover the hard way that the study cannot be completed successfully. At the same time, such prehospital research is needed to further improve the quality and effectively of current pre-hospital treatments. The pre-conference workshop on prehospital research aims at gathering around the table practitioners seeking to improve their scientific research skills and in this way are able to contribute to improved pre-hospital emergency health care. The learning outcomes when participating in this workshop is: to create a sound prehospital research proposal;

Schedule (tentative)

08.30 Welcome and introduction on the prehospital research workshop
08.45 Prehospital Study Designs and Methodology
09.15 Rookie Mistakes and Pitfalls in prehospital Research
09.45 Coffee break
10.00 Ethics in pre-hospital research
10.30 Why is Prehospital Research so Difficult?
11:00 Prehospital Research Proposal
11.30 Instructions
11.45 Prehospital Research Proposal
12.30 Lunch break
13.15 Prehospital Research Proposal (cnt.)
15.30 Brief presentation of research proposals
16:00 Wrap up and evaluation

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Pre-course: Non-Invasive Ventilation

Saturday 27 September: 9:00 - 17:00

Course Director

  • Roberto Cosentini (Italy)
  • Paolo Groff (Italy)

Faculty

  • Anna Maria Brambilla (Italy)
  • Abdo Khoury (France)
  • Roberta Petrino (Italy)

Proposed schedule

09:00 How I treat hypoxemic patients:
 
Acute Cardiogenic Pulmonary Edema (ACPE):
■ clinical cases
■ pathophysiology & literature
■ How I use CPAP
10:00
Pneumonia:
■ clinical cases
■ pathophysiology & literature
10:45 Coffee break
11:00
■ CPAP hands-on.
12:00 Lunch break.
13:00 How I treat hypercapnic patients:
 
COPD exacerbation:
■ clinical cases
■ pathophysiology & literature
13:45
■ ventilators & ventilation
14:45 Coffee break
15:00
■ NIV hands-on
17:00 End of course

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Pre-course: Ultrasound Beginner

Saturday 27 September: 08:00 - 17:30
Sunday 28 September: 08:00 - 12:00

Course Directors

James Connolly (UK)

Faculty

Nasim Azizi (The Netherlands), Ingvar Berg (The Netherlands), Marco Bijvoet (The Netherlands), Tom Boeije (The Netherlands), James Connolly (UK), Pasha Farooq (Saudi Arabia), Rip Gangahar (UK), Adela Golea (Romania), Beatrice Hoffman (USA), Costas Kaiafas (USA), Christofer Muhr (Sweden), Joseph Osterwalder (Switzerland), Paul van Overbeeke (UK), Vincent Rietveld (The Netherlands), Arthur Rosendaal (The Netherlands), Titus Schonberger (The Netherlands), Prem Sukul (The Netherlands), Maxime Valois (Canada), Gabriele Via (Italy), Joseph Woods (USA)


Participants

 

44 Physicians

Course description

This is a course applicable to all from the very beginner to those with some experience. It is an opportunity to learn anddevelop basic skills with an internationally renowned faculty.

Learning objectives

  • Develop basic skills and knowledge Learn how to develop Ultrasound in your institution and personal practice Techniques of basic US approach to limbs, chest, heart, abdomen
  • Recognition of basic US pathology
  • Basic US approach to cardiac arrest, shock, respiratory failure
  • Recognition of basic images and USartefacts

Educational Objectives

Applicable to all levels of Emergency Practitioner, including paramedical staff High ratio of supervision to ensure maximum hands on Develop basic skills and knowledge Learn how to develop Ultrasound in your institution and personal practice

Schedule

DAY 1    
     
08:00 Introduction James Connolly (UK)
08:20 Basic Physics Rip Gangahar (UK)
08:40 Practical - Machine familiarisation
Time to get familiar with all machines, settings and artefacts
Maxime Valois (Canada)
09:10 Airway and Breathing  
10:00 Coffee break
10:20 Circulatory 1 - FAST Vincent Rietveld (The Netherlands)
11:20 Circulatory 2 Aorta /IVC Adela Golea (Romania)
12:20 Lunch  
13:00 Cardiac Images Gabriele Via (Italy)
13:30 Shock Scanning and Cardiac Arrest James Connolly (UK), Maxime Valois (Canada)
14:00 Practical Scanning Cardiac Session1 Christofer Muhr (Sweden)
14:45 Practical Scanning Cardiac Session2 Christofer Muhr (Sweden)
15:30 Coffee break   
15:50 Assessment of D - Beatrice Hoffman (USA)
16:10 Interactive Cases - Introducing the modality Joseph Wood (USA)
     
DAY 2    
08:00 Scanning Session Nasim Azizi (The Netherlands), Ingvar Berg (The Netherlands), Marco Bijvoet (The Netherlands), Tom Boeije (The Netherlands), Costas Kaiafas (USA), Paul van Overbeeke (UK), Arthur Rosendaal (The Netherlands), Titus Schonberger (The Netherlands), Prem Sukul (The Netherlands)
  Interactive Scenarios  
  Shock Scanning  
  eFast  
10:20 Procedures : Short lecture and practice Pasha Farooq (Saudi Arabia)
10:30 Coffee break
11:00 All Faculty Wrap up Session  
  Governance Zeki Atelsi (UK)
  Training  
  Lessons We Have Learnt Jean Francis Lanctot (Canada)
  Round table Open Questions James Connolly (UK), Maxime Valois (Canada)
12:00 Close  

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Pre-course: Ultrasound Advanced

Saturday 27 September: 08:30 - 18:00
Sunday 28 September: 08:30 - 12:30

Course Directors

Mike Lambert (USA), Hein Lamprecht (South Africa)

Faculty

Zeki Atesli (UK), Raoul Breitkreutz (Germany), Gian Cibinel (Italy), Pasha Farooq (Saudi Arabia), Katarzyna Hampton (USA), Hani Hariri (Saudi Arabia), Beatrice Hoffman (USA), Bob Jarman (UK), Jean Francois Lanctot (Canada), Christofer Muhr (Sweden), Joseph Osterwalder (Switzerland), Maxime Valois (Canada), Gabriele Via (Italy), Joseph Wood (USA)

Participants

60 physicians in 12 groups

Requirements

English speaking participants, basic US experience and/or previous participation in a basic emergency US course, ALS/ACLS/ATLS certification recommended.

Course description

2-days emergency ultrasound advanced course: lectures, organ based hands-on practice, simulated clinical scenarios.

Learning objectives

  • Technique: advanced US approach to head, neck, limbs, chest, heart, abdomen
  • Recognition of advanced US syndromes
  • US enhanced advanced management of critical syndromes: cardiac arrest, shock, respiratory failure, acute abdomen, coma

Schedule

DAY 1    
     
08:00 Introduction Mike Lambert (USA) Gian Cibinel (Italy)
08:20 Basic to Advanced Physics Robert Jarman (UK)
08:50 Practical - Introduction Candidates get to choose 7 sessions from the list below
09:00 Session 1  
09:45 Session 2  
10:30 Coffee  
10:45 Session 3  
11:30 Session 4  
12:15 Lunch  
13:00 Session 5  
13:45 Session 6     
14:30 Coffee  
14:45 Session7  
15:30 Session8  
16:15 Integration in to Serious Illness- Scanarios  
SESSIONS TO CHOOSE FROM
   Advanced Machine/Physics Maxime Valois (Canada), Robert Jarman (UK)
   Lung Ultrasound Robert Jarman (UK)
   Cardiac Basic Joseph Osterwalder (Switzerland), Hani Hariri (Saudi Arabia)
   Cardiac Advanced Raoul Breitkreutz (Germany), Gabriele Via (Italy)
   Shock Scan Jean Francois Lanctot (Canada), Christofer Muhr (Sweden)
   Advanced Abdominal Zeki Atesli (UK)
   MSK Katarzyna Hampton (USA), Beatrice Hoffman (USA)
   DVT Katarzyna Hampton (USA), Joseph Wood (USA)
   eFast Pasha Farooq (Saudi Arabia)
   Small Parts Beatrice Hoffman (USA)
   HepatoBiliary Joseph Wood (USA), Zeki Atesli (UK) 
   Pelvis Mike Lambert (USA)
   FASH - Tb Scanning / HIV Scanning Hein Lamprecht (South Africa)
     
DAY 2    
     
08:00 US in Cardiac Arrest  Raoul Breitkreutz (Germany)
08:30 US in Shock Jean Francois Lanctot (Canada)
09:00 What's New in PoCUS Beatrice Hoffman (USA)
09:30 A Review of What's out there Educationally   
10:00 Coffee
10:20 Interactive Scanning  
   Cardiac Arrest Raoul Breitkreutz (Germany), Joseph Osterwalder (Switzerland)
   Critically Ill Maxime Valois (Canada), Beatrice Hoffman (USA)
   Critically Ill Gian Cibinel (Italy)
12:20 Wrap Up Session  

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PRE-COURSE EMERGENCY DEPARTMENT ADMINISTRATION

Saturday 27 September: 08:00 - 17:30 

Course Director

  • Philip Anderson (USA)
  • Eric Revue (France)

Maximum number of delegates that can be accommodated:  25

Course description & learning objectives

Background

Performance and Quality Improvement are among the central administrative challenges facing Emergency Department leaders in all countries.  Through a series of lectures and workshops facilitated by experienced faculty, course participants will learn practical approaches for improving performance and quality in their emergency departments.  Participants will work together in small groups on concrete problem solving projects designed to produce concrete tools and strategies that can be implemented in the participants’ home institution. 

This course is being organized by the International Emergency Department Leadership Institute (IEDLI) www.iedli.org

 

Learning objectives:  At the completion of the course, participants will be able:

  • To define quality as it relates to care delivery in the emergency department and discuss key metrics and performance indicators for measuring quality
  • To describe the main theories of overcrowding in emergency departments and discuss strategies for mitigating overcrowding
  • To discuss the difference between practice guidelines and clinical pathways and identify the key elements of clinical pathways that increase likelihood for success
  • To describe the key elements of risk management strategies for responding to errors and adverse events in the emergency department. 
 
A full course agenda is provided below.  
 

Schedule

08:30 Introduction  
08:45 Lecture 1 Quality Assurance / Improvement Philip Anderson (USA)
09:30 Lecture 2 Overcrowding Eric Revue (France)
10:15 Coffee break  
10:30 Lecture 3 Clinical Pathways Stephanie Kayden (USA)
11:15 Lecture 4 Risk Management Robert Freitas
12:00 Lunch  
15:15 Small Group Session 1 Risk Management Robert Freitas
15:30 Coffee break  
16:00 Small Group Session 2 Clinical Pathways Stephanie Kayden (USA)
16:30 Small Group Presentations  
17:00  Wrap up - closing comments

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Pre-Course: Advanced Pediatric Emergency Care (APEC)

Saturday 27 September: 08:30 - 17:00 
Sunday 28 September: 08:30 - 13:30

Course Director

  • Yehezkel Waisman, Israel
  • Said Hachimi Idrissi, Belgium

Faculty 

  • Silvia Bressan, Italy
  • Nadeem Quereshi, USA
  • Said Hachimi Idrissi, Belgium
  • Liviana da Dalt, Italy
  • Santiago Mintegui, Spain
  • Tom Beattie, UK
  • Itai Shavit, Israel

Participants

The course is designed for 30 participants (skill stations and case scenarios will be conducted in small groups).  More specifically, it is designed for PEM Physicians, Paediatricans, and Emergency Physicians who provide care for children in emergencies and who want to refine their knowledge and skills in PEM.  

Course description & learning objectives

Background: The APEC course is a development of the Paediatric Section at EuSEM, and will be conducted by its faculty members. At the end of the course participants will be presented with certificates of course completion by EuSEM.

Objectives: To provide physicians participating in the course with both knowledge and advanced skills in recognizing and managing a wide spectrum of paediatric emergencies including trauma, both in the hospital and pre-hospital settings.

General Outline: A two-day course.  
During the morning hours of both days, lectures will be presented on the management of a wide spectrum of paediatric emergencies (including trauma) with emphasis on evidence-based literature. During the afternoon hours of day 1, students will actively participate (hands-on) in advanced skill stations designed to provide knowledge and skills relevant to paediatric emergency medicine. During the afternoon of day 2, students will participate in small group discussions / cases simulations designed to elicit discussion on the clinical management of common paediatric emergencies including trauma. 

A full course agenda is provided below.  
 

Schedule

DAY1    
     
08:30 Registration/Buffet  
09:00 Introduction to the APEC course Faculty
09:15 An Approach to the Seriously Ill Infant and Child Said Hachimi Idrissi, Belgium
09:45 Principles of Pediatric Triage Yehezkel Hezi Waisman, Israel
10:15 Respiratory Emergencies Silvia Bressan, Italy
10:45 Coffee break
11:15 Management of the Febrile Child in the ED Silvia Bressan, Italy
11:45 Status Epilepticus (SE) Nadeem Quereshi, USA
12:15 Abdominal Emergencies Silvia Bressan, Italy
12:45 Common Toxicological Emergencies Santiago Mintegui, Spain
13:15 Lunch Break  
14:00 Case Scenarios (Simulations) Respiratory Cases  Silvia Bressan, Italy
14:45 Shock (2-3) Yehezkel Hezi Waisman, Israel
15:30 Cardiac Cases & Pediatric Arrhythmias (3) Said Hachimi Idrissi, Belgium
16:15 Trauma Cases (2-3) Itai Shavit, Israel
   
DAY 2    
     
08:30 Buffet  
09:00 Introduction to day 2 Faculty
09:15 Approach to the Pediatric Multiple Trauma Patient Tom Beattie, UK
10:00 Cardiovascular Emergencies Said Hachimi Idrissi, Belgium
10:30 Diabetic Keto-Acidosis Nadeem Quereshi, USA
11:00 Coffee break  
11:30 Procedural Sedation & Analgesia
Itai Shavit, Israel
12:15 Pediatric Orthopedic Emergencies Tom Beattie, UK
13:00 Course Summary & Certificate Handout Faculty

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Pre-Course: Airway Management

Sunday 28 September: 08:00 - 12:00

Course Director

  • Sabine Merz (Germany)

Faculty 

  • Christian Hohenstein (Germany)
  • Bernhard Kumle (Germany)

Participants

The course is designed for 30 participants (skill stations and case scenarios will be conducted in small groups).

Course description & learning objectives

Airway Management is a major topic in the Emergency Department. Knowledge of the different devices and techniques is necessary in order to practice safe Airway Management for the patient. The course will give an overview of the frequency and the management of difficult airways in the Emergency Department. Several techniques will be taught by experienced ED physicians and all participants will be able to train the different devices on intubation trainers.

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EBEEM Prep Course

WHO IS THIS COURSE FOR?

  • The course is designed for emergency physicians preparing for Part B of the European Board Examination in Emergency Medicine (EBEEM)
  • This is the only EBEEM preparation course endorsed by The European Board Examination in Emergency Medicine (EBEEM) and the European Society for Emergency Medicine (EUSEM)
  • The purpose is to expose participants to scenarios with the same format as those featured in the Part B exam
  • The course aims to provide test-taking strategies that will improve candidate performance
  • Please note that only those candidates are eligible taking the Priming Course who have been passed the Part A exam and interested in taking the next Part B exam or re-sit candidates of the Part B exam.

CONTENT AND FORMAT

  • This intensive one-day course will feature a total of 14 OSCE (structured clinical examination) stations and 7 VIVA (structured oral examination) stations
  • Each course participant will play the role of the exam candidate during 3 scenarios and participate or observe during the remaining 18 scenarios
  • Focused feedback will be provided after each scenario using structured checklist

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Keynote Speakers

Victoria BRAZIL

victoria brazilMONDAY, 12 OCTOBER 2015 8:30 - 9:00 AUDITORIUM AGNELLI
KEYNOTE SPEAKER

Goal directed medical education - creativity meets discipline.

 

Victoria Brazil is an emergency physician and medical educator.

She is a senior staff specialist in Emergency Medicine at the Gold Coast University Hospital, where she is active in clinical teaching across the continuum of medical learners. She also is the medical director of the Gold Coast Simulation Service - a leader in 'in situ' simulation and in using simulation for quality improvement outcomes.

Victoria was previously the Director of Queensland Medical Education and Training (QMET), within Queensland Health.
Her role at QMET was to connect and support key players in medical education in Queensland, and to provide policy advice to QHealth. During her tenure there, Dr Brazil worked on enhancing the placement capacity of medical education systems, supporting clinical supervisors, encouraging evidence based education, and connecting medical education to healthcare service improvement.

Dr Brazil completed her FACEM in 2001. She undertook further study in medical education at Stanford (International visiting scholar emergency medicine 2003) and at Harvard (Harvard Macy Leaders in Health professional education 2005/6).
Prior to undertaking her role at QMET, Victoria was the Director of the first private company provider of simulation based educational services, and specialised in the provision of 'insitu' and mobile simulation training.

She is a previous Fulbright scholar (2002) and received the ACEM Teaching Excellence award in 2008.

Francesco DELLA CORTE

200x200 Della CorteTUESDAY, 13 OCTOBER 2015 8:30 - 9:00 AUDITORIUM AGNELLI
KEYNOTE SPEAKER

Disasters and Humanitarian crises: different emergencies which demand a professional response.

 

Founder and current director of CRIMEDIMMedical doctor, graduated from Università Cattolica del Sacro Cuore in Rome, Italy (1979) and specialized in Anaesthesiology and Intensive Care (1982). He was the first Associate Professor in Disaster Medicine in Italy and currently is full Professor in Anaesthesia, Critical Care, and Critical Emergency Medicine at the Università del Piemonte Orientale, Novara, Italy. He served as Honorary Secretary to the European Society for Emergency Medicine from 1999 to 2006. He is the co-initiator of the Mediterranean Emergency Medicine Conference (the largest congress in the world of international emergency medicine) and Founder of the European Master in Disaster Medicine (EMDM).  Prof. Della Corte is actively involved in training medical professionals in Disaster and Mass Casualty Incidents management. He is also a Visiting Professor at the Free University of Brussels.

Prof. Della Corte was involved in different projects funded by European Union. He authored more than 130 full papers published on peer-reviewed, impacted journals and was invited as speaker in more than 300 national and international congresses.

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Pre-Courses

Disaster medicine

1 day

Ebola outbreak was a major disaster event these past two years. The severity of the disease, compounded by fear within and beyond the affected countries and population, caused schools, markets, businesses, airline and shipping routes, and borders to close.

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administration

1 day

As the number of interdisciplinary emergency departments grows internationally, where can ED leaders acquire the administrative skills they need to build and sustain successful emergency departments?

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Non-Invasive Ventilation 

1 day

Acute dyspnoea is one of the most common emergencies in the ED, accounting for 3-5% of all admissions. The vast majority of cases are represented by acute heart failure, pneumonia and COPD exacerbation.

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pre-hospital research

1 day

The workshop on pre-hospital research is directed by Falck Foundation, and the aim is to improve the research application skills of the participant. The workshop focuses on pre-hospital research, and the distinctive features that makes this field of research especially difficult.

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airway workshops

1 day

In this course, participants will learn about basic and difficult Airway Management. Furthermore, the technique of anaesthetization will be taught.

All participants will be able to train the different techniques and devices on intubation trainers.

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Ultrasound - Beginner 

2 days

This is a course applicable to all from the very beginner to those with some experience. It is an opportunity to learn and develop basic skills with an internationally renowned faculty.

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Ultrasound - Advanced

2 days

Requirements: basic US experience and/or previous participation in a basic emergency US course, ALS/ACLS/ATLS certification recommended.

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Advanced Paediatric Emergency Care (APEC)

2 days

Objectives: To provide physicians participating in the course with both knowledge and advanced skills in recognizing and managing a wide spectrum of paediatric emergencies including trauma, both in the hospital and pre-hospital settings.

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Acute Pain Management

1 day

We’ll centre our attention on the patient – critical, pediatric, elderly, frail – presenting true and common cases and supplying evidences and suggestions with the aim of optimizing our efficacy on pain.

More details

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Programme overview

Sunday 11 October
Time Auditorium Agnelli Room 500 Room Londra Room Istanbul Room Madrid Room Parigi Room Roma Room Atene Room Dublino Room Lisbona
13:00
13:00-14:30
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A11
State of the Art
Airway Emergencies

State of the Art
Airway Emergencies

Moderators: Rick BODY (UK), Sabine MERZ (senior consultant) (Villingen-Schwenningen, GERMANY)
13:00 - 13:30 Extreme Airways. Rich LEVITAN (USA)
13:30 - 14:00 Preparing for the challenging airway. Chris NICKSON (South Yarra, AUSTRALIA)
14:00 - 14:30 Decision time: Owning the airway in the ED. Reuben STRAYER (USA)
13:00-14:30
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B11
Italy invites
Trauma

Italy invites
Trauma

Moderators: Corrado CASULA (ITALY), Paolo CREMONESI (ITALY)
13:00 - 13:20 I percorsi diagnostico-terapeutici in DEA. Marco BAROZZI (Cesena, ITALY)
13:20 - 13:40 The STOP the bleeding campaign: a che punto siamo? Giuseppe NARDI (Roma, ITALY)
13:40 - 14:00 Il trauma cranico nel paziente in terapia con farmaci anticoagulanti / antipiastrinici. Andrea FABBRI (Chief of Emergency Unit) (Forli, ITALY)
14:00 - 14:20 Il trauma toracico nella prima ora. Elvio DE BLASIO (Salerno, ITALY)
13:00-14:30
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C11
Clinical Questions: Controversies
Pre-hospital EM

Clinical Questions: Controversies
Pre-hospital EM

Moderators: Maaret CASTREN (HELSINKI, FINLAND), Stefan TRENKLER (Košice, SLOVAKIA)
13:00 - 13:30 Use of Point of Care in the prehospital EMS MICU ambulances. Eric REVUE (Head of the ED and prehospital EMS) (Paris, FRANCE)
13:30 - 14:00 All about gasping – from pathophysiology to ethics. Jana SEBLOVA (Emergency Physician) (PRAGUE, CZECH REPUBLIC)
14:00 - 14:30 The DNR order in pre-hospital emergency intervention: possible or impossible. Carmen Diana CIMPOESU (Prof univ. Head of ED) (IASI, ROMANIA)
13:00-14:30
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D11
Administration / Management
Managing Cost Effectiveness

Administration / Management
Managing Cost Effectiveness

Moderators: Wilhelm BEHRINGER (Director) (Jena, GERMANY), Michael DUERR SPECHT (GERMANY)
13:00 - 13:30 The principle of cost effectiveness. Wilhelm BEHRINGER (Director) (Jena, GERMANY)
13:30 - 14:00 National AED programs, are they worth the money? Patrick Stephen MORAN (IRELAND)
14:00 - 14:30 Can cost control and appropriateness get along in today’s emergency medicine? Roberta PETRINO (Head of department) (Italie, ITALY)
13:00-14:30
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E11
Research
Pulmonary Emergencies

Research
Pulmonary Emergencies

Moderators: Luis GARCIA-CASTRILLO (Espagne, SPAIN), Said LARIBI (PU-PH, chef de service) (Tours, FRANCE)
13:00 - 13:30 Observational studies in Emergency Medicine. Luis GARCIA-CASTRILLO (Espagne, SPAIN)
13:30 - 14:00 EuroDEM study: results and perspectives. Said LARIBI (PU-PH, chef de service) (Tours, FRANCE)
14:00 - 14:30 Australian study on dyspnea in Emergency Medicine. Anne-Maree KELLY (PHYSICIAN) (ESSENDON, AUSTRALIA)
13:00-14:30
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F11
YEMD
Sim Session #1

YEMD
Sim Session #1

Moderators: Jennifer TRUCHOT (Paris, FRANCE), Youri YORDANOV (Médecin) (Paris, FRANCE)
13:00 - 13:30 From Zero to Sim. Thomas PLAPPERT (Fulda, GERMANY)
13:30 - 14:00 Engaging Resident Education trough Simulation Competitions. Pier Luigi INGRASSIA (Novara, ITALY)
14:00 - 14:30 SESAM @ EuSEM. Rainer GAUPP (SWITZERLAND)
13:00-14:30
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G11
UK Patient Safety Forum
Making emergency care safe: what is our role?

UK Patient Safety Forum
Making emergency care safe: what is our role?

Moderator: Ruth BROWN (Speaker) (London, UK)
13:00 - 13:30 UK incidents and audience vote on actions. Ruth BROWN (Speaker) (London, UK)
13:00 - 14:00 Second victim. Mary DAWOOD (UK)
14:00 - 14:30 Panel discussion.
13:00-14:30
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OP1-11
Oral Paper 1
Cardiovascular Emergencies I

Oral Paper 1
Cardiovascular Emergencies I

Moderators: Al BEHCET (faculty speaker) (Gaziantep, TURKEY), Cristian BOERIU (Assoc.Professor) (Targu Mures, ROMANIA)
13:00 - 14:30 #1002 - #1002 - Cluster analysis of emergency department acute heart failure patients based on their presenting hemodynamic measurements. Implications for therpay.
#1002 - Cluster analysis of emergency department acute heart failure patients based on their presenting hemodynamic measurements. Implications for therpay.

Background: Hemodynamic (HD) phenotyping of patients with acute heart failure (AHF) using cluster analysis may help to define potential targets for specific therapeutic interventions. Blood pressure (BP) and pulse do not accurately identify the underlying HD profiles of acutely ill patients in general. Objectives: To derive distinct clusters of Emergency Department (ED) patients with AHF based on their presenting noninvasive HD measurements and to identify any potential distinguishing clinical characteristics among patients within each cluster. Methods: Presenting, pre-treatment noninvasive HD parameters (n=23) were compiled using the Nexfin device (Bmeye/Edwards LifeSciences) from 127 ED patients with confirmed AHF. Based on these parameters, k-means clustering was performed to identify a set of variables that provided the greatest level of inter-cluster discrimination and intra-cluster cohesion. The parameter k, representing the number of clusters, was identified iteratively by maximizing the ratio of inter (discrimination) and intra cluster error (cohesion), with smaller values of k being preferred. Principal components analysis validates the choice of small k as appropriate for the data. Our final model included 3 groups with clustering based on the following mean parameters: stroke volume index [(SVI), ml/M²], systemic vascular resistance index [(SVRI), dynes/sec/cm/M²] and finger mean arterial pressure [(fMAP), mmHg]. Group comparisons were then performed. Results: Cluster 1 had normal cardiac function and vascular resistance (SVI 38.7 ± 9.7; SVRI 2065.4 ± 305.7; fMAP 66.7 ± 21.2); cluster 2 slightly low cardiac function (SVI 31.0 ± 6.2) with increased vascular tone (SVRI 3109.4 ± 379.3, fMAP 81.0 ± 20.0); and cluster 3 very decreased cardiac function (SVI 22.4 ± 7.5) with markedly elevated vascular resistance (SVRI 4696.8 ± 795.3, fMAP 89.8 ±26.5). All p values for the cluster HD parameters were <0.0001. Presenting diastolic BP differed among the clusters. However the systolic BP and other baseline variables (including age, gender, heart rate, history of coronary artery disease and creatinine, BNP and recent ejection fraction values) were statistically equivalent. Conclusions: Among ED patients with AHF, distinct clusters can be defined based on presenting non-invasively derived HD measures of cardiac function, systemic vascular resistance and finger mean arterial BP. This approach may help identify distinct patient subtypes that would benefit from target-specific treatment, providing granularity that cannot be achieved using more traditional ED variables.

Richard NOWAK (GROSSE POINTE PARK, MICHIGAN, USA), Brian REED, Salvatore DISOMMA, Prabath NANAYAKKARA, Michele MOYER, Scott MILLIS, Robert SHERWIN, Phil LEVY
13:00 - 14:30 #1215 - #1215 - The utility of a modified heart score in chest pain patients with normal troponins in predicting need for further observation and /or provocative cardiac testing.
#1215 - The utility of a modified heart score in chest pain patients with normal troponins in predicting need for further observation and /or provocative cardiac testing.

Background: The TRAPID-AMI study was a multicenter international trial evaluating the high sensitivity cardiac troponin (hs-cTnT) assay in a rapid "rule-out" acute myocardial infarction (AMI) strategy in the Emergency Department (ED). We evaluated a modified HEART Score (MHS) using historical features (clinical suspicion), ECG, age and cardiac risk factors and a normal hs-cTnT to identify a low-risk patient population that might not require further observation and/or provocative cardiac testing. Each of the elements of the MHS is assigned a 0,1 or 2 with the composite score ranging from 0-8. Methods: There were 1,282 patienst studied in the ED for possible AMI from 10 European, 2 USA and 1 Australian Centers from August 2011 through June 2013. Patients were enrolled if the onset of their chest pain (or equivalent) was less than 6 hours from presentation and hs-cTnT (99%, 14 pg/L) was measured at baseline, 1,2 and 6 hours later. All patients were followed for 30 day adverse events (AEs) which included death and MI. Patients were considered low risk if they had hs-cTnT less than or equal to 14 pg/L at baseline and 6 hours and had a MHS less than or equal to 3. Results: There were 17% (217/1282) of patients that suffered an AE at 30 days overall: 8 deaths (0.6%) and 215 AMIs (17%). There were 40% of patients (514/1282) with normal hs-cTnT values and a MHS less than or equal to 3. The AE (all AMIs) rate in the patients with a MHS less than or equal to 3 was 0.2% (1/514) amd those with a MNS 4 or greater 1.8% (5/285) (p = 0.024) .Conclusions: Serial testing of hs-cTnT along with application of a MHS may identify a very low risk ED chest pain population that might be able to be directly discharged from the ED without further observation and/or provocative testing with outpatient follow up within 30 days. Further prospective trials are needed to verify these results.

Richard NOWAK (GROSSE POINTE PARK, MICHIGAN, USA), James MCCORD, Richard BODY, Evangelos GIANNITSIS, Peter DILBA, Michael CHRIST, Bertil LINDAHL, John FRENCH, Tomas JERNBERG, Christopher DEFILIPPI, Robert CHRISTENSON, Franck VERSCHUREN, Gordon JACOBSEN, Garnet BENDIG, Christian MUELLER
13:00 - 14:30 #1364 - #1364 - Development of a simplified risk score to assess the pre-test probability of acute aortic syndrome in the Emergency Department.
#1364 - Development of a simplified risk score to assess the pre-test probability of acute aortic syndrome in the Emergency Department.

Background. The diagnosis of acute aortic syndromes (AAS) is a challenge for Emergency Physicians due to lack of sensitive and specific signs and symptoms. Patient stratification according to pre-test probability of AAS is suggested to standardize both evaluation and diagnostic decisions on aortic imaging. The Aortic Dissection Detection (ADD) risk score, indicated by the 2010 American Heart Association and 2014 European Society of Cardiology guidelines, can be used to evaluate the pre-test probability of AAS according to the presence/absence of 12 risk factors. Accordingly, three risk categories of patients can be defined: low, medium, and high-risk of AAS. However, the ADD risk score is relatively complex and is not easy to routinely implement in the Emergency Department (ED). Aim of this study was to compare the predictive value of several risk factors for AAS and to develop a simplified score allowing more straightforward risk-stratification for AAS in the ED. 

Methods. Consecutive patients admitted to the ED with a clinical suspicion of AAS were enrolled in two EDs between 2008 and 2013. Patients were included in a registry if the following criteria were satisfied: (1) presence of chest pain, back pain, abdominal pain, syncope or signs/symptoms of perfusion deficit; (2) unclear diagnosis after initial medical evaluation; (3) order of an urgent aortic imaging exam by the attending physician to identify/exclude AAS. Trauma patients were excluded. The final diagnosis was based on computed tomography angiography results. For each patient, we retrospectively reviewed ED charts to calculate both the ADD risk score and a simplified score. Risk factors for the simplified score were identified based on their potential predictability, calculated using the modified Rho2 Spearman’s rank correlation coefficient. We assessed the discriminatory ability of both scores using the c-index.

Results. 1,328 patients with suspected AAS were enrolled in the registry, and 291 (21.9%) had a final diagnosis of AAS. The ADD risk score was 0 (low-risk) in 439 (33.1%) patients, 1 (intermiediate-risk) in 646 (48.6%) patients and >1 (high-risk) in 243 (18.3%) patients. Based on Rho2 coefficient, we identified 5 highly predictive variables for AAS to be used in the simplified score: severe pain, abrupt onset of pain, pulse deficit, hypotension and focal neurologic deficit. Both the ADD risk score and the simplified score had a high c-index (0.73 and 0.72 respectively). Using the 5-variable model, we also built a nomogram for rapid evaluation of AAS risk in the ED. The agreement between expected and predicted scores for the simplified model was assessed by calibration analysis. The performance of the simplified model was similar to that of the ADD risk score, and the simplified score in particular showed a good predictive capacity amongst non-high risk patients.

Conclusion. This is first attempt to simplify a published scoring system for suspected AAS. Our 5-variable simplified risk score showed a discrimination power similar to the 12-variable ADD risk score. External validation of the simplified score is needed, and a new prospective study is currently recruiting.

Emanuele PIVETTA (Torino, ITALY), Peiman NAZERIAN, Francesca GIACHINO, Simone VANNI, Corrado MOIRAGHI, Matteo CASTELLI, Milena MAULE, Stefano GRIFONI, Enrico LUPIA, Fulvio MORELLO
13:00 - 14:30 #1429 - #1429 - Hypothesis of correlation between hemoconcentration and paroxysms of supraventricular arrhythmias: prospective study in emergency department.
#1429 - Hypothesis of correlation between hemoconcentration and paroxysms of supraventricular arrhythmias: prospective study in emergency department.

Background. During a previous study performed in our emergency department (ED), about comparison between electrical and pharmacological cardioversion of paroxysmal Atrial Fibrillation (AF), higher values of hematocrit were observed in patients with AF. A positive correlation between higher hematocrit and incidences of paroxysmal AF have already been reported in a small number of patients and in some studies of the 90s - early 2000s. It is still to be clarified if hemoconcentration itself is the cause of the arrhythmia, or, alternatively, is caused by Atrial Natriuretic Peptide (ANP) hypersecretion during the paroxysms of AF.

Objectives. The aim of our study was to investigate the possible proarrhythmic role, mostly for the AF, of the hemorheological abnormalities due to increased hematocrit.

Materials and methods. Between December 2014 and March 2015, a control case-control study was carried out on patients presenting to the ED complaining of “palpitations”. For all these patients, we asked all physicians of our ED to fill in a form reporting: medical history, medications, vital signs and ultrasound measurement of dynamic changes of inferior cava vein (IVC) diameter.

The patients with paroxysms of AF or supraventricular tachycardia (SVT) were reviewed after a month, in order to complete the same form, perform the ECG, and collect the same blood samples.

 

Results. We enrolled 167 patients: 98 patients were analyzed, 59 had sinus rhythm and 39 had supraventricular arrythmia (33 AF and 6 SVT); 69 patients were excluded. Incidence of recent profuse sweating (p=0.085) and polyuria (p=0.083), and assumption of antiarrhythmic agents (p=0.0003) or drugs that induce a decrease of hematocrit (p=0.015) were higher in patients with arrythmia. Mean + standard deviation values of hemoglobin (Hb) [151.20+12.55 vs 141.42+13.23 g/L (p=0.0004)], red blood cells (RBC) [8.29+1.97 vs 7.34+2.40 x10.12/L (p=0.01)] and white blood cell count (WBC) [5.14+0.46 vs 4.88+0.57 x10.9/L (p=0.01)], hematocrit (HCT) [0.465+0.034 vs 0.433+0.039 (p<0.0001)], urea [6.34+2.32 vs 5.22+1.55 mmol/L (p=0.003)], creatinine [88.71+21.53 vs 79.10+5.99 umol/L (p=0.007)], sodium [140.48+1.81 vs 139.72+1.73 mmol/L (p=0.04)], osmolality [292.05+4.48 vs 285.88+5.14 mOsm/Kg (p<0.0001)], Prohormone Brain Natriuretic Peptide (NT-proBNP) [604.56+1143.45 vs 87.45+160.41 ng/L (p<0.0001)] and Erythropoietin (EPO) [13.11+7.36 vs 10.53+5.51 IU/L (p=0.015)], were higher among patients with arrhythmia. No difference was found between the two groups regarding platelets count, MCV, calcium, magnesium, TSH levels, blood pressure values and IVC diameter changes.

After 1 month, patients with arrythmia showed lower values of WBC (p<0.0001), RBC (p<0.0001), Hb (p<0.0001), HCT (p<0.0001) urea (p=0.02), creatinine (p=0.002), osmolality (p<0.0001) and NT-pro BNP (p=0.0009), while EPO slightly decreased (p=0.036) and IVC values did not change.

No difference were found between the lab values of the group with sinus rhythm and with supraventricular arrhythmias after 1 month, except lower values in calcium, potassium, osmolality, TSH and NT-proBNP.

 

Conclusion. Our study shows that hemoconcentration is common in patients presenting with paroxysms of supraventricular arrhythmias. These patients shows chronically higher EPO and NT-proBNP values. The hemorheological abnormalities in combination with fluid loss, apparently only in part induced by BNP hypersecretion on an atrium already mechanically stressed, can promote the occurrence of arrhythmias.

 

 

Sara GREGORI (PADOVA, ITALY), Chiara SANDONA', Roberta VOLPIN, Samuela BARTOLACCI, Monica MION, Francesco BORRELLI, Gianna VETTORE, Martina ZANINOTTO, Franco TOSATO, Mario PLEBANI
13:00 - 14:30 #1525 - #1525 - Patients with NSTEMI treated with non invasive procedures in an emergency department: a review of a case study.
#1525 - Patients with NSTEMI treated with non invasive procedures in an emergency department: a review of a case study.

Introduction                 

The use of invasive therapeutic treatments is still controversial and under debate for selective elderly patients presenting with  UA/NSTEMI. Age and several comorbidities lead to a difficult management of this kind of patients.

Objectives

Elderly patients are often underrepresented in clinical trials. The aim of this study is to analyze the treatment protocol, the mortality risk factors, the one-year mortality rate and the recurrence rate of MI in elderly patients presenting with  UA/NSTEMI and treated in our Unit.

Methods

This is a review of case study. From  2013 to  2014, 137 patients have been  admitted in the Department of Medicina Interna Area Critica of Policlinico in Modena for the management of acute myocardial infarction. For each patient we analyzed clinical presentation, past medical history (focusing on previous cardiac diseases, renal failure, advance tumour), therapeutic approach and outcomes (one year mortality, recurrence of myocardial infarction). We proceded with a univariated and multivariated analysis of the mortality risk factors and of the one-year overall survival, assessed with Cox regression analysis.

Results

The mean age was 84.2 ± 10.3 y.o. The therapeutic approach was conservative in 117 patients (85%) and invasive (PCI) in 20 patients (15%). The average follow up was 292 days. The overall mortality rate was 43.1% (59 patients). 21 of them (3.6%) died during hospitalization: they were considered “critical patients” since admission.
The population was divided in two groups: patients dead at the time of the analysis and patients still alive. We compared the two groups considering all the data collected. Concerning the survival, the univariated analysis pointed out as prognostic factors: age (p=0.001), urea (p=0.001), creatinine (p=0.003), glycemic decompensation (p=0.029), troponine risen (p=0.048), symptomatic heart failure (p=0.048), conservative approach indication (p=0.020), acute administration of Ace-inhibitors/Sartans (p=0.004), Statins (p=0.004), B-blockers (p=0.012) e Aspirin (p=0.039).
The multivariated analysis showed as independent mortality risk factors: age (Hazard Ratio 1.055, Confidence Interval at 95% 1.014-1.098, p=0.009), troponine risen (HR 1.026, CI95% 1.011-1.043, p=0.001), urea (HR 1.012, CI 95% 1.004-1.020, p=0.004), symptomatic heart failure (HR 1.76, CI 95% 1.01-3.06, p=0.046), glycemic decompensation (HR 1.004, CI 95% 1-1.007, p=0.054), acute administration of Statins (HR 0.43, CI 95%, p=0.015) and Aspirin (HR 0.43, CI 95% 0.22-0.85, p=0.015).

Conclusions

Elderly patients with MI are high mortality risk patients.
One-year mortality is higher in patients conservatively treated, compared to those receiving reperfusion therapies.  The mortality is higher in patients presenting with risen troponine, renal failure, heart failure and glycemic decompensation.
In patients not suitable for invasive treatments, acute administration of selected medications (Aspirin, Statin, Ace-inhibitor/Sartan and B-blocker) is the therapeutic approach to reduce mortality risk at one year

 

 

 

 

 

 

Brugioni LUCIO (Modena, ITALY), Gozzi CRISTINA, Vivoli DANIELA, Cameli ANNAMARIA, Rossi ROSARIO
13:00 - 14:30 #1531 - #1531 - Anticoagulation therapy for patients with non valvular atrial fibrillation: evaluation of the oral anticoagulants prescription by emergency physicians.
#1531 - Anticoagulation therapy for patients with non valvular atrial fibrillation: evaluation of the oral anticoagulants prescription by emergency physicians.

Background: Atrial fibrillation (AF) is the most frequently arrhythmia represented in Emergency department (ED). The risk of thromboembolic events is five times higher in patients with AF than those in sinus rhythm. The vitamin K antagonists (VKAs) are currently the most effective therapeutic class for the prevention of these events.

Objectives: To study the epidemiology of non-valvular AF (NVAF) in ED, assess VKAs prescription in eligible patients and to determine criteria associated with an under-prescription of this therapy.

Methods: Prospective, observational, over two years study. Inclusion criteria: age> 18 years, patients with NVAF eligible for anticoagulation. Non-inclusion criteria: AF treated by VKAs, contra-indications to VKAs. Collection of epidemiological and clinical parameters, classification of NVAF, calculation of ischemic risk (CHADS2 [Congestive heart failure (CHF), Hypertension (HTA), Age75 years, Diabetes(D), Stroke (S)] or CHA2DS2-VASc [CHF, HTA, Age75 years, DM, Stroke, Vascular disease, Age 65 -74 years, Sex category] and bleeding risk (HAS-BLED [HTA ,Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile INR, Elderly, Drugs/alcohol concomitantly]) scores. Patients divided into two groups:  VKAs+ Group: patients received VKAs and VKAs- Group. An analytic study was done in order to know the parameters significantly and independently associated with under prescription of the VKAs.

Results: During study, 176 patients were enrolled. Mean age: 67±13 years. Sex-ratio=0.5. Cardiovascular comorbidities were present in 68% cases. FA classification: paroxysmal n=114, permanent n=47 and persistent n=15. The mean CHADS2 score was 1.5 ± 1.2, the mean CHA2DS2VASc score was 2.88 ± 1.55 and the mean HASBLED score was 1.52 ± 1.05. VKA prescription rate was 36%. In multivariate analysis, age >70 years (OR=1.59, 95%CI[1.11-2,21];p<0.001), creatinine level ≥110 µmol/l(OR=2,54;95%CI[1,20–5,37];p=0,01) and aspirine use (OR =1,7;95%CI[1,08-2,67];p=0,02) were independently associated with non-prescription VKAs. The main causes of VKAs underuse reported by the emergency physicians were: factors related to patient characteristics n=38, factors related to emergency physician n=62, factors related to the patient environment n=20 and factors related to the drug n=22.

Conclusions:  The prescription rate of VKAs was 36%. To optimize this rate, the prescription of VKAs must be in a socio-medical perspective taking account the socio-economic conditions of each patient. The goal is to aim for appropriate and rational management to improve the prognosis of this disease.

Hanen GHAZALI, Jihen ESSID (TUNISIE), Houssem AOUNI, Anware YAHMADI , Moez MOUGAIDA, Mahbouba CHKIR, Mohamed MGUIDICH, Sami SOUISSI
13:00 - 14:30 #837 - #837 - CLINICAL AND LABORATORY CHARACTERISTICS OF PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH HYPERTENSIVE URGENCY.
#837 - CLINICAL AND LABORATORY CHARACTERISTICS OF PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH HYPERTENSIVE URGENCY.

Background:  Clinical and laboratory characteristics of individuals presenting to the emergency department (ED) with hypertensive urgency (HU) are not well characterized. 

Methods:  In a retrospective chart review study, 150 consecutive patients admitted to a tertiary care center ED with HU (systolic blood pressure values >180 mmHg or diastolic blood pressure values > 110 mmHg without evidence of end organ involvement) were compared with 150 patients with normal blood pressure evaluated in the surgical ward of the same emergency room.  Demographic variables, co-morbidities and laboratory values were compared between the two groups. 

Results: HU patients were older (66±16.1 years vs. 61.7±19 years, p=0.04), had a greater prevalence of hypertension 90% vs. 64%, p=0.001), were treated with more anti-hypertensive medications (1.9±1.4 vs. 1±1.3, p=0.001) and had a higher prevalence of chronic kidney disease (10.6% vs. 4% p=0.044). Laboratory findings were similar in HU and normotensive individuals.

Conclusions:  HU in an ED setting is more prevalent among elderly, hypertensive individuals, particularly among those with chronic kidney disease  

 

Shachaf SHIBER (tel aviv, ISRAEL), Alon GROSSMAN
13:00-14:30
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OP2-11
Oral Paper 2
Geriatric Emergencies

Oral Paper 2
Geriatric Emergencies

Moderators: Gautam BODIWALA (UK), Mehmet Akif KARAMERCAN (ANKARA, TURKEY)
13:00 - 14:30 #1161 - #1161 - Treatment of acutely admitted elderly patients in a short stay unit vs. standard care. A randomised trial.
#1161 - Treatment of acutely admitted elderly patients in a short stay unit vs. standard care. A randomised trial.

Background: Short stay units (SSU) in conjunction to emergency departments (ED) are increasingly being implemented to provide accelerated care and shorter hospitalisation. However, it is not well studied, whether short stay hospitalisation is appropriate for elderly medical patients. In an audit, we have found that treatment of elderly patients in our SSU vs. standard treatment in a department of internal medicine (DIM) was associated with lower mortality (7 vs. 22 %, p=0.05), shorter length of stay (2.8 ± 2.0 days vs. 7.7 ± 7.5, p<0.001), fewer adverse events (5 % vs. 19 %, p=0.04), and lower re-admission rate (2 % vs. 23 %, p=0.001)[1]. These findings are promising, but we have now decided to conduct a randomised trial to examine this more rigorously. 

Methods: The ELDER trial is a randomised trial with 1:1 allocation between hospitalisation in a SSU (intervention) vs. a DIM (standard care). The study is conducted at Holbaek Hospital, a regional hospital and part of University of Copenhagen. Eligible participants are patients with age ≥ 75 years; in need of in-hospital treatment of an acute internal medical condition; which are stable on admission indicated by green tag triage in the ED. Patients are randomised by computer-generated block sequence with varying block size. Blinding participants or services to the allocation is not possible, but all outcome measures will be blinded for investigators until analyses are complete. The primary outcome is 90-day all cause mortality. Secondary outcomes are: length of stay in-hospital, the incidence of complications during hospitalisation, in-hospital mortality, number of ward transfers during hospitalisation, rate of readmission, change in instrumental activities of daily living, and change of living facility after hospitalisation.  We aim at recruiting 430 patients. All outcome measures will be assessed in an intention-to-treat analysis.

Results: Recruitment started in January 5th, 2015. An interim analysis will be performed after inclusion of 215 patients. By April 17th 2015, we have enrolled 78 patients (average inclusion rate: 0.76 participants/day). Therefore, we expect to complete inclusion by July 2016.

Conclusion: In the present study, we explore benefits and harms related to treatment in a short stay unit for elderly medical patients compared to standard hospitalisation.



[1] Strøm C, Rasmussen LS, Rasmussen SR, Schmidt TA. Fast track medical treatment of elderly patients (≥75 years) may be related to lower mortality. Abstract. Eusem 2014.

Camilla STRØM (Copenhagen S, DENMARK), Lars Simon RASMUSSEN, Thomas Andersen SCHMIDT
13:00 - 14:30 #1513 - #1513 - The Identification of seniors at risk (ISAR) score to predict frequent returns in elderly discharged from emergency department.
#1513 - The Identification of seniors at risk (ISAR) score to predict frequent returns in elderly discharged from emergency department.

Introduction: At the emergency department (ED), tools are required to identify older people at high-risk of frequent returns so that appropriate services can be directed towards them. The Identification of Seniors at Risk (ISAR) score is a short self-report questionnaire that can quickly identify older patients in the ED at increased risk of several adverse health outcomes and those with current disability during the 6 months after the ED visit.

Objective: In this study, we investigated whether the ISAR tool can also predict frequent returns to ED in patients aged more than 65 years old.

Methods: Prospective and observational study.  Inclusion of all patients aged more than 65 years who were discharged from the ED on the index consultation (IC) from October 1st to October 31st. ISAR score calculation. Follow-up of 3 months. Frequent returns were defined as patients who consulted at any ED more than 2 times during the 90 days after the IC. The cut-off value of the ISAR score was determined by using the receiver-operator curve analysis to compare baseline ISAR to frequent returns at 90 days.

Results: Inclusion of 137 patients. Mean age 76 ± 7 years. Sex-: 0, 92. Co-morbidities: Hypertension 65%, Diabetes 37%, Coronaropathy 21%. Mean ISAR score: 2,66±1, 5. Frequent returns was observed in 29% (n=41) of patients. A score≥ 2 on the ISAR tool predicted frequent returns to the ED (area under the curve (AUC) = 0, 65, p=0, 02; 95% IC [0,46-0,59]). The sensitivity, specificity, PPV and NPV of this cut-off were   84%, 32%, 44% and 86% respectively.

Conclusion: In elderly, frequent returns to the ED are common. The ISAR score, a simple tool, has a good predictive value to determine senior at high-need of care.

 

 

 

 

 

 

 

 

 

Ines CHERMITI, Hanen GHAZALI, Najla EL HENI , Sami SOUISSI, Rania JABRI (Ben Arous, TUNISIA), Mohamed MGUIDICH, Anware YAHMADI , Sami KOOLI
13:00 - 14:30 #1530 - #1530 - Comparison of emergency risk scoring systems in geriatric ED patients: results of a national study-TEDGES.
#1530 - Comparison of emergency risk scoring systems in geriatric ED patients: results of a national study-TEDGES.

 

Objective: We aimed to evaluate the prognostic value of the Modified Early Warning Score (MEWS), VitalPac Early Warning Score (VIEWS), and Rapid Emergency Medicine Score (REMS) score in predicting hospitalization and in-hospital mortality in geriatric emergency department (ED) patients.

Methods: This prospective, multi-centered observational study was conducted over one week at the EDs of 13 hospitals in patients 65 years old and older presented to ED. The following vital parameters of the patients measured on admission to ED were recorded. The scores were calculated using the recorded physiological parameters of the patients. Hospitalization and in-hospital mortality were used as the primary outcomes.

Results: A total of 1299 patients was included in this study.The mean age of the patients was 74.8±7.3 years and 619 (47.7%) were male. While 877 patients (67.5%) had been discharged from ED and 140 (10.8%) were admitted to intensive care unit. Overall in-hospital mortality rate was 5.8%. The MEWS is effective for discriminating patient groups that have been discharged from ED, admitted to a ward and admitted to ICU (1[1-2] vs. 2[1-3] vs. 2[1-4], respectively, p<0.001). The VIEWS is also effective for discriminating patient groups that have been discharged from ED, admitted to a ward and admitted to ICU (2[1-3] vs. 3[1-5] vs. 6[2-9], respectively, p<0.001). The REMS is also effective for discriminating patient groups that have been discharged from ED, admitted to a ward and admitted to ICU (6[5-8] vs. 7[6-9] vs. 8[7-11], respectively, p<0.001). The median MEWS of the non-survivors were statistically significantly higher than those of the survivors (3[2-5] vs. 1[1-2], p<0.001). The median VIEWS of the non-survivors were statistically significantly higher than those of the survivors (6[4-10] vs. 2[1-4], p<0.001). The median REMS of the non-survivors were statistically significantly higher than those of the survivors (8[6-11] vs. 6[5-8], p<0.001).The AUCs of MEWS, VIEWS, and REMS were 0.656, 0.668, and 0.627 in predicting hospitalization, respectively. The AUCs of MEWS, VIEWS, and REMS were 0.797, 0.802, and 0.711 in predicting in-hospital mortality, respectively.

Conclusions: The MEWS, VIEWS, and REMS are easy-to-use and less time consuming for predicting the hospitalization and in-hospital mortality of geriatric ED patients.

Zerrin Defne DUNDAR, Mehmet ERGIN, Mehmet AYRANCI, Yucel YAVUZ, Ozcan YAVASI, Mustafa SERINKEN, Tarik ACAR, Mucahit AVCIL, Behcet AL, Atif BAYRAMOGLU, Hasan Mansur DURGUN, Yalcin GOLCUK, Ibrahim ARZIMAN, Mehmet Akif KARAMERCAN (ANKARA, TURKEY)
13:00 - 14:30 #1565 - #1565 - Validation of the Identification Seniors at Risk tool (ISAR) in acutely presenting older adults; the APOP study.
#1565 - Validation of the Identification Seniors at Risk tool (ISAR) in acutely presenting older adults; the APOP study.

Introduction: Acute medical illness in older adults is a major contributor to deterioration. Even a minor medical problem can result in a permanent change in daily life. Early identification of high-risk patients could be the first step to decrease adverse health outcomes. The Identification of Seniors At Risk (ISAR) tool has specifically been developed for older Emergency Department patients to predict negative outcomes. However, clinical usefulness is debated because of lack of accuracy and efficiency. In the present study we externally validated the ISAR tool with regard to mortality and functional decline.

Methods: We initiated the prospective Acutely Presenting Older Patient (APOP) study, in which we included all consecutive patients aged 70 and over 24h/7d presenting to the Emergency Department of an university teaching hospital (LUMC) in the Netherlands. The traditionally used ISAR cut-off score of 2 or higher (range 0-6) was used to analyse predictive performance for 90 day mortality and 90 day functional decline, which was defined as a 1 point increase in Katz ADL score and/or new institutionalisation.

Results: 757 patients were included from September 2014 until November 2014 with a mean age of 78.7 years. During the ninety day follow-up 72 patients (9.5%) deceased and 163 patients (21.5%) declined in functional status. A ISAR score of 2 or higher had a hazard ratio of 3.38 (95% CI 1.82-6.29) on mortality and an odds ratio of 4.18 (2.83-6.18) on functional decline. Predictive performance on mortality showed a sensitivity of 0.83, a specificity of 0.41, a positive predicting value (PPV) of 0.13, a negative predicting value (NPV) of 0.96 and an area under receiver operating curve (AUROC) of 0.67 (95% CI 0.61-0.73) and on functional decline a sensitivity of 0.79, a specificity of 0.48, a PPV of 0.35 , NPV of 0.87 and an AUROC of 0.68 (95% CI 0.63-0.72).

Conclusion: In our study, the ISAR was able to stratify patients at risk for adverse outcomes with moderate accuracy. Positive predictive value was low, whereas negative predictive value was high, suggesting that ISAR more accurately identifies patients NOT at risk for negative outcomes. 

J. DE GELDER (LEIDEN, THE NETHERLANDS), J.a. LUCKE, B. DE GROOT, C. HERINGHAUS, A.j. FOGTELOO, G.j. BLAUW, S.p. MOOIJAART
13:00 - 14:30 #1595 - #1595 - Independent predictors of hospital admission in emergency department patients younger and older than 70 years of age.
#1595 - Independent predictors of hospital admission in emergency department patients younger and older than 70 years of age.

Background: Independent predictors of hospital admission have been investigated in patients on the Emergency Department, but it hasn’t been researched whether these predictors are different for patients above and below 70 years old. Therefore, the aim of the present study was to compare readily available patient characteristics between patients younger and older than 70 years and to investigate if independent predictors of hospital admission are different in ED patients younger and older than 70 years of age.

Material and methods: In this retrospective cohort study all ED visits in a tertiary hospital in 2012 were stratified in ED patients younger and older than 70 years of age. Readily available patient characteristics at ED presentation including way of arrival, presenting complaint and urgency of the complaint were analysed. Multivariable logistic regression was used to identify independent predictors of hospital admission. Discriminative performance of the models was quantified by receiver operator characteristics with area under the curve (AUC) analysis. Goodness of fit was tested with the Hosmer and Lemeshow test.

Results: 4255 patients older than 70 years and 17319 patients younger than 70 years of age were included. 45 % of the older patients were hospitalized as opposed to 25% of the younger patients. In the patients younger and older than 70 years of age exactly the same independent predictors were found, most of them reflecting illness severity. Only gender was not an independent predictor in the model of patients above 70 years. However the fit of the model was different in both groups. The prediction model for hospitalisation had had a higher discriminative performance in the young patients with an AUC of 0.85 (0.84-0.85), whereas the AUC of the prediction model in old patients had an AUC of 0.76 (0.75-0.78) with both models having good predicting capabilities.

Conclusion: Independent predictors of hospital admission are similar in patients younger and older than 70 years of age. However the discriminative performance of the prediction model for hospitalisation was higher in the younger patients, indicating that besides patient characteristics reflecting illness severity, other factors, such as cognitive and functional status, multimorbidity and polypharmacy, may play role in prediction of hospitalisation in older patients. In future studies these factors should be investigated.

Jacinta LUCKE (LEIDEN, THE NETHERLANDS), Jelle DE GELDER, Fleur CLARIJS, Bas DE GROOT, Christian HERINGHAUS, Jaap FOGTELOO, Gerard-Jan BLAUW, Simon MOOIJAART
13:00 - 14:30 #1624 - #1624 - Early recognition of cognitive impairment in the ED.
#1624 - Early recognition of cognitive impairment in the ED.

Introduction:

Cognitive Impairment (CI) is present in up to 40% of older adults who use the services of the Emergency Department (ED), with acute delirium comprising a significant proportion of the spectrum of CI seen in the ED. Despite reports that acute delirium confers the same mortality rates as acute coronary syndromes, is still missed in up to 80% of cases by emergency physicians. Two main reasons for this have been hypothesized; a lack of adequate training for Emergency physicians and of validated screening tools which can be completed quickly and with minimal training in the ED. Failing to diagnose delirium delays diagnosis and timely management of underlying, potentially life-threatening conditions.  In previous audit at our trust, we found that only 54% of adults over 75 had cognitive screening and we sought a means to improve rate of screening across and to introduce a more simple screening tool to our department.

 

Methods:

We performed a prospective, point prevalence study of cognitive impairment in the ED of a London major trauma center.  All patients over the age of 16 were eligible for inclusion over a 24 period in the department. Screening was completed by all present emergency nurses, trainees and consultants, supported by allocated dementia nurses, using the 4AT screening tool. If an AMT10 had already been completed, this was accepted instead of the 4AT. We included all patients including those with a history of severe dementia or substance abuse.  Patients either too ill to be interrogated or unable to speak a language for which we had a reliable interpreter were excluded.

 

Results:

Of the 147 patients who visited our ED during the 24 hour study period who were eligible for inclusion 62(43%) had a cognitive assessment. The male/female ratio was 65/82 and the average age was 56.6 years. Out of the 51 patients who were assessed with the 4AT, 7 (14%) had cognitive impairment (cutoff ≥1). Of the 11 patients who had a AMT10 done 9(81.8%) had CI (cutoff <8). Overall we found that 16/147 (10.8%) patients who visited our department during the audit had signs of cognitive impairment in the first screening while only 6/147 (4%) had known previous dementia.

 

Conclusion:

Although adding Cognitive screening to usual clinical assessment in the ED may be seen as an additional burden to the assessment process in the ED, we found it to be a ‘high yield’ step with 10% of all those screened found to have impairment.  Our main purpose in conducting this study was to raise awareness about the prevalence of CI within our ED and encourage screening prior to our next audit cycle.

 

Acute cognitive impairment is a medical emergency and should have protocolled risk stratification and management, as is the case with other diseases with similar mortality rates, such as acute coronary syndrome and sepsis.

Serena ROVIDA (London, UK), Sarah DARCIS, Jonathan RITSON, Hannah DUNLOP, Rosa MCNAMARA
13:00 - 14:30 #1738 - #1738 - Population ageing in Verona district and its impacts on the Emergency and Hospital activities.
#1738 - Population ageing in Verona district and its impacts on the Emergency and Hospital activities.

Objective and Methods: We report presentation and outcome patterns of aged patients treated at the Accident and Emergency Department (AED) of Verona (Italy) during the period Jan 2002 - Dec 2014. Data are discussed in the framework of population demographics in the District of Verona and NHS acute hospital bed stocks trends. RESULTS: In the study period total of AED presentations decreased from 82,797 (2002) to 69,568 (2014) patients/year but aged patients admissions increased from 20,274 to 24,368. When dividing the patients in different groups of age the increase is more evident in the elder group: +74.1% with a mean yearly increase of 4.83% in the >85 years old population and +27.33% (2.08% of mean yearly increase) in the 76-85 years old group. Over two thirds of patients self-presented to AED without medical consultation (66-75 years old: 82.9% (Q1: 82%; Q2: 84%; IQ range: 2%); 76-85 years old: 79.4% (Q1: 78%; Q2: 82%; IQ range: 4%); >85 years old; 74.9% (Q1: 72%; Q2: 77%; IQ range: 5%). According to our triage criteria, we observed an increase of patients tagged at higher disease acuity: 66-75 years old: from 21.7% to 31.6%; 76-85 years old: from 27.1% to 32.3%; >85 years old: from 36% to 48.4%). Ward admissions dramatically increased in the eldest group (>85 years old: +48.57%) with a slight decrease in the 66-75 years old (-7.72%) and in the 76-85 years old (-2.99%) groups. Verona District demographics in the study period showed an increase of general population (from 827,328 to 921,717 inhabitants) and aged people in terms of figures (66-75 years old: +17.58% (mean year increase: 1.37%); 76-85 years old: +34.69% (mean year increase: 2.54); >85 years old: +49.03% (mean year increase: 3.48%) and of indexes (ageing index: +5.54%; old aged dependency ratio: +18.74%). Despite those figures mean bed stock availability in our hospital decreased from 899 in 2006 to765 in 2014 (medical department: -27.2%; surgery: -20.5%). On the other hand the ratio urgent/planned admissions increased from 0.5 to 1.52 (medical department: +327%; surgery:+176%). DISCUSSION: Accident and Emergency departments  overcrowding have been widely reported. One of the causes of patients' long staying in the emergency departments seems to be related to a lack of available beds in the hospital wards. In this study we report the impact of Verona District population ageing on AED activity during the last years. There has been an increase of aged AED and ward admissions. On the other hand Healthcare policy imposes reduction of bed stocks in NHS acute hospitals. First consequence is the heavy impact on planned hospital admissions to be delayed. Therefore an accurate gate control in terms of better targeted admissions is required to the emergency physician in order to avoid the risk of AED but also hospital paralysis.

Massimo ZANNONI (VERONA, ITALY), Lucia ANTOLINI, Laura CRESTANI, Giulia BISOFFI, Giorgio RICCI
 
 
15:00
15:00-16:30
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A12
State of the Art
Cardiovascular Emergencies

State of the Art
Cardiovascular Emergencies

Moderators: Rick BODY (UK), Louise CULLEN (Brisbane, AUSTRALIA)
15:00 - 15:30 The burden of chest pain assessment: Is it time for change? Louise CULLEN (Brisbane, AUSTRALIA)
15:30 - 16:00 Six years of the HEART score. Barbra BACKUS (dordrecht, THE NETHERLANDS)
16:00 - 16:30 Coronary CTA: Who, What and When? Judd HOLLANDER (USA)
15:00-16:30
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B12
Italy invites
Malattie infettive e BPCO

Italy invites
Malattie infettive e BPCO

Moderators: Giorgio CARBONE (ITALY), Paolo GROFF (ITALY)
15:00 - 15:25 Vecchi batteri e nuove resistenze. La terapia empirica più appropriata. Silvio BORRE (Vercelli, ITALY)
15:25 - 15:50 Tubercolosi e micobatteri atipici. Guido CALLERI (TORINO, ITALY)
15:50 - 16:15 BPCO: nuovi farmaci, vecchi pazienti? Rodolfo FERRARI (Bologna, ITALY)
16:15 - 16:30 Polmoniti: guida ragionata alla diagnosi e terapia in PS. Giovanni PINELLI (Modena, ITALY)
15:00-16:30
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C12
Clinical Questions: Controversies
Hot Controversies in EM

Clinical Questions: Controversies
Hot Controversies in EM

Moderators: Janos BAOMBE (manchester, UK), Mehmet Akif KARAMERCAN (ANKARA, TURKEY)
15:00 - 16:30 Unstable pelvic trauma: contemporary management. Marco BAROZZI (Cesena, ITALY)
15:30 - 16:00 How To Use Ketamine Fearlessly, For All Its Indications. Reuben STRAYER (USA)
16:00 - 16:30 High flow oxygen in hypoxemic lung failure. To difficult to apply in the Emergency Department? Abdo KHOURY (PH) (Besançon, FRANCE)
15:00-16:30
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D12
Clinical Questions: Controversies
Thrombosis

Clinical Questions: Controversies
Thrombosis

Moderators: Luis GARCIA-CASTRILLO (Espagne, SPAIN), Anne-Maree KELLY (PHYSICIAN) (ESSENDON, AUSTRALIA)
15:00 - 15:30 Should patients with superficial vein thrombosis receive anticoagulation? Giuseppe CAMPORESE (ITALY)
15:30 - 16:00 Is warfarin an outdated treatment? Jecko THACHIL (UK)
16:00 - 16:30 Should we give thrombolysis to patients with submassive pulmonary embolism? Franck VERSCHUREN (Bruxelles, BELGIUM)
15:00-16:30
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E12
Research
Pre-hospital EM

Research
Pre-hospital EM

Moderators: Patrick PLAISANCE (Paris, FRANCE), Gregor PROSEN (MARIBOR, SLOVENIA)
15:00 - 15:30 Rescuer fatigue and energy expenditure during basic life support. Roman SKULEC (KLADNO, CZECH REPUBLIC)
15:30 - 16:00 Helium in acute asthma patients. Patrick PLAISANCE (Paris, FRANCE)
16:00 - 16:30 Cerebral saturation pre-hospital during cardiac arrest. Cathy DE DEYNE (BELGIUM)
15:00-16:30
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F12
YEMD
Joining the FOAM-party

YEMD
Joining the FOAM-party

Moderators: Riccardo LETO (Chief of ED) (Overpelt, BELGIUM), Chris NICKSON (South Yarra, AUSTRALIA)
15:00 - 15:30 Social Media For Today's Learners: Medical Education on Steroids. Rob ROGERS (USA)
15:30 - 16:00 Social Media changed my life! Natalie MAY (Oxford, UK)
16:00 - 16:30 Data science for health: social media analytics, surveillance and interventions. Ciro CATTUTO (ITALY)
15:00-16:30
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G12
UK Patient Safety Forum
Making emergency care safe: what is our role?

UK Patient Safety Forum
Making emergency care safe: what is our role?

Moderator: Ruth BROWN (Speaker) (London, UK)
15:00 - 15:30 Crowding and exit block. Sally-Anne WILSON (LEEDS, UK)
15:30 - 16:00 Designing departments for safety. Susan ROBINSON (Doctor) (Cambridge, UK)
16:00 - 16:30 Panel discussion.
15:00-16:30
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OP1-12
Oral Paper 1
Paediatric Emergencies I

Oral Paper 1
Paediatric Emergencies I

Moderators: Nikolas SBYRAKIS (GREECE), Itay SHAVIT (ISRAEL)
15:00 - 16:30 #1005 - #1005 - Development of a risk map in a pediatric emergency department of a teaching hospital.
#1005 - Development of a risk map in a pediatric emergency department of a teaching hospital.

BACKGROUND

Patient safety is an topic of particular concern in pediatrics. Developing a risk map in a Pediatric Emergency Department (PED) using proactive strategies (PS) and reactive strategies (RS) can help to identify risks and promote an improvement of health quality. However, to the best of our knowledge, no risk map has been developed in the Emergency setting combining these two strategies.

OBJECTIVE

To develop a risk map in a PED of a tertiary teaching hospital combining PS and RS.

METHODS

PS: After several meetings, a document identifying several risks was written and reviewed by external consultants.

RS: the incidents reported by professionals and caregivers of the children admitted in the PED from Nov´04-Dec´13 were analyzed.

Results obtained from both strategies were classified using the International Classification for Patient Safety from the World Health Organization and the degree of the risks was classified according to the official classification system of the Spanish Ministry of Health.

Finally, the map was created combining both strategies.

RESULTS

PS: 49 failures, 60 effects and 252 causes were identified. Most common failures were related with the discharge of the patient (mainly identification of the patient and delay of the process). Most common effects were related with complaints of the caregivers, prolonged length of stay in the PED, delay in diagnosis/treatment and unnecessary treatment. Most frequent causes were due to: not including the family in the process, shift change, incorrect identification of the patient and computer error.

RS: 1795 incidents were notified by nurses (33%), caregivers (25%), PED pediatricians (14%), director of the ED (13%), quality manager (9%) and others (6%). Most of them were related with medical equipment (38%), resources/organization of staff (17%), clinical process (15%), facilities (12%) and medication errors (5%).

PS identified risks in several phases of the clinical process: complementary tests, treatment and discharge. RS added risks about prehospitalary transportation, triage, medical care, complementary tests, treatment and discharge.

CONCLUSSION

The combination of PS and RS improves the quality of the risk map in a PED. The involvement of different professionals and caregivers enables the risk map to accurately reflect the real situation of the PED.

Elisa MOJICA, Estibaliz IZARZUGAZA, Maria GONZALEZ, Eider ASTOBIZA, Javier BENITO, Santiago MINTEGI (Barakaldo, SPAIN)
15:00 - 16:30 #1189 - #1189 - Non-inferiority monocentric retrospective observational study about the efficacy of paracetamol in different pharmaceutical forms in reducing pain in children belonging to the Regina Margherita Children's Hospital Emergency Department.
#1189 - Non-inferiority monocentric retrospective observational study about the efficacy of paracetamol in different pharmaceutical forms in reducing pain in children belonging to the Regina Margherita Children's Hospital Emergency Department.

Background: Pain is a physical and psychological negative experience, often linked to suffering. It is therefore important to alleviate it as soon as possible using the most appropriate and pleasant medication for the patient.

Objective: To test the non-inferiority in terms of efficacy of buccal paracetamolvs syrup or tablet paracetamol in reducing pain in pediatric patients referred to the Emergency Department for headache, earache, nonspecific abdominal pain (NSAP).

Materials and Methods: we conducted a non-inferiority monocentric retrospective observational studyon children between 3 and 14 years, in which pain was assessed by Wong-Baker scale at entrance and 60 minutes after administration of analgesic therapy in triage. The data were collected using special data collection and processed by statistical analysis.

Results: We analyzed 200 patients (70 buccal vs 130 tablet or syrup), with mean entrance pain level of 4.77/10. Buccal paracetamol was found to be more effective to reduce pain (mean reduction: 2.37/10) vs tablet or syrup paracetamol(mean reduction: 1.95/10) (p<0.05), in particular for earache (2.32/10 vs 1.90/10, p<0.05) and NSAP (2.43/10 vs 1.93/10, p<0.05). In addition, there were statistically significant differences (p<0.05) depending on the intensity of pain, age, gender and nationality.

Conclusions: Buccal paracetamol was found to be more effective in reducing pain in certain conditions. It is therefore a specific pediatric nurse task to take into account the peculiarities of each patient in administration of paracetamol. Further similar studies are desirable on other painkillers.

Marta Lucia Celestina GOGLIO (Rivarolo Canavese (TO), ITALY), Pierpaolo CHIALVO, Liliana VAGLIANO, Emanuele CASTAGNO, Fulvio RICCERI, Fulvio RICCERI, Antonio Francesco URBINO
15:00 - 16:30 #1355 - #1355 - Feverkidstool to reduce prescription of antibiotics in children suspected of community-acquired-pneumonia.
#1355 - Feverkidstool to reduce prescription of antibiotics in children suspected of community-acquired-pneumonia.

Background

Community acquired Pneumonia (CAP) is the most frequent serious infection among children with fever. The rate of antibiotic prescribing amongst children suspected of CAP is high, contributing to antibiotic resistance in the community. Diagnostic tools for guiding antibiotic prescribing in children with fever are needed.

Aim: To evaluate the diagnostic value of the Feverkidstool, a  validated decision rule using clinical features and CRP,  to safely identify children suspected of CAP who do not need antibiotics.

Methods

Patients: previously healthy children aged 1 – 60 months, with fever and cough  at risk of CAP, visiting the emergency department of ErasmusMC in 2013.

Outcome: children suspected of CAP recovering without antibiotics.

Prospective observational study with standardised data collection. Risk of CAP was calculated using the Feverkidstool, a validated prediction model for febrile children (www.erasmusmc.nl/feverkidstool).

Results:

In a population of 248 children (median age 14 mo (IQR 7-27), 51 children received  antibiotic treatment (21%), of whom 53% received amoxicillin; 55 (22%) were hospitalized. For both the frequency of antibiotic prescription and the predicted risk for CAP by the Feverkidstool, we observed a high association with the doctors decision to perform chest radiographs, but not for the result of the chest radiograph. The risk for CAP predicted by the Feverkidstool was significantly associated with increased antibiotic prescription, even after correcting for age, gender and performing a chest radiograph. The discriminative value of the Feverkidstool was 0.67 (0.60-0.74)  to identify children suspected of CAP not needing antibiotics. In a population with low antibiotic prescription rate, the Feverkidstool cutoff of 10% had specificity of 73% to correct identify children suspected of CAP not needing antibiotics; specificity increased to 89% using a 20% cutoff.  In children with predicted risks below these thresholds, a follow-up strategy to detect deterioration and to start delayed antibiotic treatment if necessary, was safe.

Conclusion:

The Feverkidstool safely identifies children suspected of CAP who do not need antibiotics. This adds to reducing unnecessary antibiotic prescription in febrile children. 

Michelle HORSTEN, Ruud NIJMAN, Yvonne VERGOUWE, Rianne OOSTENBRINK (rotterdam, THE NETHERLANDS)
15:00 - 16:30 #1500 - #1500 - Management of febrile young infants with altered urine dipstick. A Spanish Pediatric Emergency Research Network’s (RISeuP-SPERG) substudy.
#1500 - Management of febrile young infants with altered urine dipstick. A Spanish Pediatric Emergency Research Network’s (RISeuP-SPERG) substudy.

Background

Urinary tract infection (UTI) is the most common serious bacterial infection (SBI) in febrile infants. A primary diagnosis can be made in the emergency department if an altered urine dipstick test is obtained. Spanish guidelines recommend inpatient treatment in patients less than 90 days old with UTI suspected.

Objective

To describe the management of febrile young infants with in a urine disptick and analyze factors associated with an outpatient management.

Patients and methods

Subanalysis of a prospective multicentric study developed in 19 Spanish Pediatric Emergency Departments (PED) included in the Spanish Pediatric Emergency Research Network (RISEUP-SPERG), including febrile infants less or equal than 90 days old with fever without source (FWS) attended at the PED between October-2011 and September-2013.

An urine dipstick was considered altered whien either a leukocyte esterase test or nitrite test were positive.

Results

A total of 3,401 infants were included. Of them, 765 (22.5%) had an altered urine dipstick and 72 (9.4%) were managed as outpatient, 30 after an observation period shorter than 24 hours. After a multivariate analysis, variables that remained as independent factors for an outpatient management were: being well-appearing, being older than 60 days old and presenting a C-reactive protein (CRP) less than 20 mg/L and a procalcitonin (PCT) less than 0.5 ng/mL.

Among the 72 patients managed as outpatients, 51 received antibiotic treatment (70.8%; via oral in 27 and parenteral in 24). Overall, urine culture grew >50,000 cfu/ml in 36 (50%) of them, and 10000-50000 cfu/ml in other 3 (4.2%). None of them was admitted after receiving the results of the urine culture. Two patients had bacteremia, both of them received one dose of parenteral antibiotic in the emergency department prior to discharge. Both patients were afebrile when blood culture result was received.

 

Conclusions

A significant proportion of febrile young infants with a suspected UTI are managed as outpatients. Well appearing patients older than 60 days old with normal CRP and PCT values are more frequently managed as outpatients.

 

 

Roberto VELASCO (Laguna de Duero, SPAIN), Helvia BENITO, Rebeca MOZUN, Borja GOMEZ, Mercedes DE LA TORRE, Santiago MINTEGI, Of The Riseup-Sperg Network GROUP FOR THE STUDY OF THE FEBRILE INFANT
15:00 - 16:30 #1806 - #1806 - Presentation and investigation of paediatric bone and joint infections in the paediatric emergency department.
#1806 - Presentation and investigation of paediatric bone and joint infections in the paediatric emergency department.

Bone and joint infections present a major diagnostic challenge in the paediatric emergency department (PED). The presenting features of osteomyelitis and septic arthritis in children can vary greatly and can be difficult to distinguish from other conditions.

 

Method

We performed a retrospective review of the medical notes and electronic patient records of children diagnosed with osteoarticular infections over a 12-year period at a Paediatric Emergency Department (PED) serving a diverse urban population. We compared the presenting features and investigations to the literature and current trends in practice.

 

Results

A total of 88 cases of osteomyelitis and/or septic arthritis presented to the PED and were managed at the same hospital during the study period. Fever, pain, impaired function and localised changes were commonly reported at presentation but overall there was inconsistency in the incidence of these features among patients with osteoarticular infections.

 

Inflammatory makers were sensitive tools in identifying bone and joint infections, particularly when used in combination. When CRP, total white cell count and ESR were all abnormal, 98% of bone and joint infections were identified.

 

A positive microbiological diagnosis was only obtained in 38% of cases, the largest proportion being from cultures of synovial fluid and bone tissue. Streptococcal organisms were significantly more likely to be isolated in children under 5 years than in children over 5 years (p = <0.001). Conversely staphylococcal organisms were significantly more likely to be isolated in children over 5 years than in children under 5 years (p = <0.001).

 

It is of concern that virulent organisms such as PVL staphylococcus aureus and MRSA were identified in some of our cases. This should prompt review of antibiotic choices and broaden diagnostic techniques.

 

Overall, children under 5 years of age were significantly more likely to be diagnosed with septic arthritis than osteomyelitis (p = 0.006). Children over 12 years of age were significantly more likely to be diagnosed with osteomyelitis than septic arthritis (p = 0.019).

 

Conclusion

Our experience highlights the difficulty of differentiating osteoarticular infections from other conditions using clinical features alone. Diagnosis of bone and joint infections requires a combination of clinical suspicion and investigations. However, the differences we identified between the incidence of osteomyelitis and septic arthritis and the variation of causative organisms across age groups may be useful to consider at presentation and in cases of diagnostic uncertainty.

 

Olugbenga AKINKUGBE (London, UK), Charles STEWART, Caoimhe MCKENNA
15:00 - 16:30 #1963 - #1963 - Are healthcare professionals comfortable with parental presence during paediatric resuscitation?
#1963 - Are healthcare professionals comfortable with parental presence during paediatric resuscitation?

Introduction

 

The practice of family centred care within paediatric hospitals has continuously evolved over the past number of decades, with parents now considered essential participants in their child’s care. Parents are now routinely present during situations where they previously would have been asked to leave e.g. intravenous cannulation, lumbar puncture and cardiopulmonary resuscitation (CPR). However controversy remains around the presence of parents in the paediatric resuscitation room. There is a paucity of evidence to support the practice, few policies/guidelines and few established programmes which provide specific training.

 

 

Outcome Measures

 

 

The primary outcome measure was to identify healthcare professionals’ attitudes towards parental presence in the resuscitation room during paediatric resuscitation. Secondary outcome measures included:

1. Identification of barriers towards parental presence during paediatric resuscitation

2. Identification of methods to facilitate parental presence

3. Identification of methods of training suitable for clinicians involved

 

 

Methods

 

An anonymous questionnaire was created and distributed among healthcare professionals involved in paediatric resuscitation. The purpose of the audit was to gain perspective into the thoughts of the healthcare professionals involved in paediatric CPR and discover their views on what the best methods of training in dealing with parental presence are.

 

 

Results

 

There were 36 respondents to the questionnaire: 24 doctors and 12 nurses. Of the doctors, 12 were emergency physicians, 10 were paediatricians and 2 were anaesthetists. The majority of respondents (n=22, 61%) stated they were happy for parents to remain during a procedure/resuscitation. The majority of respondents (n=26, 72%) felt that parents/family members should be present in the resuscitation room during the resuscitation process. However they did not feel that they had adequate training in how to deal with family members during paediatric resuscitation (n=32, 89%). The majority of participants did not agree that their training had prepared them for any difficulties that could arise with having parents/family members present in the room during a resuscitation (n=29, 81%). Respondents were asked if their APLS or NRP training had dealt with the situation where relatives are present in the room during paediatric resuscitation. Of the 27 participants who were eligible to answer this question, the majority did not agree (n=19, 70%). All of the respondents said that they would welcome additional training in running a resuscitation with relatives present.

When asked to rank types of training a lecture followed by simulation of distressed relatives was the most popular method with 22 (61%) participants ranking it highest. The second most popular was training with simulation alone (n=14, 39%). No other method of training was given a highest ranking. The least popular method of training was a booklet with 26 respondents (72%) ranking it lowest. It was followed by computer/e-learning with 6 participants (17%) ranking it lowest.

 

 

Conclusions

 

Parental presence during paediatric resuscitation is increasing and guidelines should be developed to facilitate it. This small audit demonstrates that clinicians welcome relatives being present, but would welcome education in on how to facilitate parental presence during paediatric resuscitation. Simulated scenarios together wih formal instruction would be the preferred ecucation methods.

Nuala QUINN, Eimhear QUINN, Gavin STONE (Cork, IRELAND), Paula MIDGLEY, Tom BEATTIE
15:00 - 16:30 #982 - #982 - PILOT CLINICAL TRIAL OF THE USE OF OXYGEN AT HIGH FLOW IN CHILDREN WITH ASTHMA IN THE PEDIATRIC EMERGENCY DEPARTMENT.
#982 - PILOT CLINICAL TRIAL OF THE USE OF OXYGEN AT HIGH FLOW IN CHILDREN WITH ASTHMA IN THE PEDIATRIC EMERGENCY DEPARTMENT.

Background:

High-flow oxygen (HFO) therapy has been shown to be efficacious and safe treatment in pediatric populations with acute respiratory processes. There are, however a lack of studies about its application in the ED.

 

Objective:

The aim of our study is to assess the feasibility of HFO treatment and assess its efficacy and safety given to children with asthma and moderate respiratory failure attended in the emergency department (ED).

 

Patients and method:

This was a prospective randomized trial of children (1 – 16 years) who presented to the ED with acute asthma. Patients with a Pulmonary Score (PS) ³ 6 or oxygen saturation < 90% with FiO2 40, despite initial treatment with nebulized salbutamol every 20 minutes during the first hour (at least 3 doses) were randomly assigned to one of two treatment groups. The experimental group received HFO therapy and the control group conventional oxygen therapy. Along with oxygen therapy the pharmacological treatment of acute asthma was left to the discretion of the attending physician.   

The PS, oxygen saturation, respiratory rate and heart rate were recorded at 30 minutes, 1 hour 2 hours and then every 2 hours after initiation of therapy.

At the end of the study a satisfaction questionnaire was distributed among the PED staff.

 

Results: Duringa period of 24 months (Oct 2012 – Oct 2014), 52 patients met the inclusion criteria and 36 patients were studied (18 in each study group). Characteristics of patients at baseline did not showed differences except in the mean PS that was higher in HFO group (6.5 (1.29) in the HFO group vs. 6.05 (0.23) in control group; p<0.001). At two hours after initiation of therapy Pulmonary Score decreased more than 2 points in 11 patients (61.1%) in HFO group vs. 5 (27.8%) in control group (mean PS scores 4.77 (1.16) and 5.05 (1.05) respectively); p<0.05). No differences were found in oxygen saturation mean values at this time, 95.77 (1.76) and 97.81 (2.04) respectively. Eleven patients (51.1%) in HFO group were finally admitted in ward versus 7 (38.9%) in control group. The satisfaction questionnaire was answered by 42 professionals and 36 (85%) considered HFO treatment as a positive experience. No adverse effects were reported.   

 

Conclusions: HFO treatment is feasible and safe when given in the ED. HFO improves the overall respiratory status of children with acute asthma and moderate respiratory failure. Further studies are needed to prove its overall effectiveness in the management of patients with asthma and respiratory failure in the emergency department.

Yolanda BALLESTERO, Jimena DE PEDRO, Otilia MARTINEZ-MUJICA, Elisa MOJICA, Eunate ARANA, Javier BENITO (Getxo - Vizcaya, SPAIN)
15:00-16:30
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OP2-12
Oral Paper 2
Disasters and Psychosocial emergencies

Oral Paper 2
Disasters and Psychosocial emergencies

Moderators: Anna SPITERI (Consultant) (Malta, MALTA), Robert WUNDERLICH (Scientific Assistant) (Tübingen, GERMANY)
15:00 - 16:30 #1018 - #1018 - Demographic Characteristics of the Patients Suffering from Mushroom Poisoning in Bolu.
#1018 - Demographic Characteristics of the Patients Suffering from Mushroom Poisoning in Bolu.

OBJECTIVE: City of Bolu has a lot of greenery places and it gets frequent rains. This frequent rains give rise to an increase in the diversity of mushrooms in a year. It can not be neglegted that this diversity is essential commercially. In this study, we aimed to evaluate the demographic characteristics of poisoning cases due to highly preferred mushrooms.
MATERIALS-METHODS: We evaluated the patients who had admitted to Bolu Abant Izzet Baysal University Izzet Baysal Research and Education Hospital Emergency Department in the time period of 01/01/2007-31/12/2014. Patient characteristics such as age, gender, length of stay in hospital and the way of discharge from hospital were evaluated statistically.
RESULTS: There was 648 patients who were applied to Bolu AIBU Izzet Baysal Research and Education Hospital Emergency Department in the time period of 01/01/2007-31/12/2014 with mushroom poisoning. 257 (39.7%) of the patients were male (mean age 41,32 ± 19,44), and 391 (60.3%) of them were female (mean age 39,6854 ± 18,7). Most of the patients are in the age range below 40 (351 patients, 53.4%). The most common application complaint was abdominal pain (288 patients, 44.4%), and the remaining ones are diarrhea (198 patients, 30.6%), nausea (60 patients, 9.3%), lack of apetite (60 patients, 9.3%), severe vomiting (36 patients, 5.6%) and weakness (6 patients, 0.9%) respectively. Most common applications were in the evening hours (16-24 time interveal: 53.7%) and in the months of November (15.6%) and June (14.8%). In the season of autumn (51.4%) and in the years of 2014 (29.3%) and 2010 (25.3%), registrations in the emergency department are higher than the remaining time periods. Most discharges were from the observation room of emergency department (64%), and the remaining part from the intensive care units (51 patients, 7.9%) and inpatient clinics (182 patients, 28.1%). 26 of the patients in intensive care units were sent to other medical centers. 
CONCLUSION: It is obviously seen that poisoning from the mushrooms are increasing in the seasons of high mushroom growing. Most of the patients require hospitalization. If the intensive care unit observation is not enough and there is a necessity of liver transplantation, patients are sent to other medical centers.

Arif DURAN, Mansur Kürşad ERKURAN, Bülent YILMAZ (Bolu, TURKEY), Tarık OCAK, Musab Medeni ZORLU
15:00 - 16:30 #1029 - #1029 - Impact of 2012 Olympic and Paralympic games on a Large Central London Emergency Department.
#1029 - Impact of 2012 Olympic and Paralympic games on a Large Central London Emergency Department.

Background

 

In 2012, London hosted the International Olympic and Paralympic games. To date, there has been minimal research on the impact of the games on local hospitals. 

 

Methodology:

 

This was a retrospective analysis comparing Emergency Department (ED) attendances during the Olympic (OG) and Paralympic Games (POG) to a corresponding period in the previous year.  

 

Results:

Over the Olympic and Paralympic period, there was no significant change in attendances, gender or age. 

(Attendances: OG:2012=6069 2011=6558. POG 2012=4716 2011=4710)

(Females: OG:2012=46.5%,2011=53.5%.p=0.114. POG:2012=50.6%,2011=49.4%p=0.146) 

(Age: OG: (I.Q.R):2012=36.04,(23-49),2011=36.59,(22-50),p=0.149. POG: (I.Q.R):2012=34,(23-51),2011=33,(23-49),p=0.065). 

There were reduced numbers of patients from our catchment area with slight increase in patients from London/UK. There was no significant change in number of British nationals compared to overseas patients.

(Catchment area: OG: 2012=83.08%, 2011=84.96% p=0.001. POG 2012=59.2% 2011=69.5% p=0.001)

(Non EU; OG: 2012=2.59%, 2011=2.82%, p=0.407. POG: 2012=1.3%, 2011=0.9% p=0.112) 

Admission rates were similar between both years.

(Admissions: OG: 2012=25.97%, 2011=28.07, p=0.008%. POG: 2012=29.3%, 2011=29.3%, p=0.982)

Despite minor differences in patient demographics, there were changes in presentations. During the games, there were increases in chest, respiratory, and abdominal problems. 

(OG p=0.001, POG p=0.016; OG p=0.093, POG p=0.003; OG p=0.020, POG p=0.029)

There were fewer presentations of alcohol intoxication, assault and trauma. 

(OG p=0.863 POG p=0.042, OG p=0.172 POG p=0.795, OG p=0.321 POG p=0.671)

 

Conclusion:

In our study more people presented with chest, respiratory, and abdominal problems. This conflicts other studies which suggest there may not be a difference in pathology during sporting events.  However; these studies reviewed a definitive diagnosis (ie acute myocardial infarction) rather than a patients’ presenting complaint (ie. chest pain). Our study population is large (22,053 patients) and despite our results showing there is no increase in admissions, there may need to be extra provision for outpatient investigations. Furthermore, the data shows a decrease in the number of patients presenting with alcohol intoxication, assault and trauma. 

This project has shown there were minimal changes in the number of attendances and patient demographics. In addition; the rates of hospital admission were not affected. Such information is exceptionally useful for future workforce and event planning. It is the first of its kind to solely review a large tertiary non-designated hospital for two major international sporting events. Furthermore, by reviewing patients’ presentations rather than diagnosis, it gives a focus for where future service provision may need to be directed. 

Sarah EL-SHEIKHA, Sarah EL-SHEIKHA (Liverpool, UK), Tony BOLTON, Joseph EL-SHEIKHA, Rebecca SAMUELS, Yusuf BEEBEEJAUN, Francesca GARNHAM
15:00 - 16:30 #1166 - #1166 - Homeless patients in the emergency department: a multicenter case-control prospective study in France.
#1166 - Homeless patients in the emergency department: a multicenter case-control prospective study in France.

Study objectives

Homeless people represent a vulnerable population. Their access to health care is limited and they have a higher mortality rate. Public hospitals and their emergency departments (EDs) are known to be used frequently by these patients. They can be seen as difficult to treat, and have an increased incidence of substance abuse and risk of violence in the ED. We tested the hypothesis that homeless patients experience suboptimal care by the provision of fewer healthcare resources.

 Methods: We conducted a prospective multicenter case-control study in 31 EDs in France. Our Institutional Review Board authorized the study without the need for signed informed consent. We defined a homeless patient as a patient that currently lives on the street or in a shelter. During 72 hours from March 3th 2015, all homeless patients that visited the participating EDs were included in the study. One control patient was prospectively recruited after each case was included: the next patient that visited the ED with similar severity triage level (on a one to four scale), similar age (+/- ten years) and same sex.  The primary outcome measures were length of stay, number of investigations per patient and treatment in the ED.

Results:

A total of 212 homeless patients and 212 control patients were included in the study. Mean age was 44 (standard deviation SD 13) years in both groups, and 87% were male. Homeless patients were more likely to have visited the ED in the past 28 days than other patients (47% vs 10%, p<0.001). They presented with similar rates and types of comorbidities than control patients, except for a more frequent history of substance abuse.

Heart rate, blood pressure, temperature, capillary blood glucose and Glasgow Coma Scale score were similar in both groups.  Chief complaint was “housing demand” for 30 (14%) homeless patients. After excluding them, we found no difference in the type of chief complaint except for alcohol abuse, more frequent in homeless patients (20% vs 4%, p<0.001). We found a similar median waiting time to physician assessment in the two groups (58 min for both), although mean length of stay was longer for homeless patients than for control patients (6.2 vs 3.9 hours, p<0.001). We found no significant difference in the rate of radiological or biological investigations between the two groups. Similarly, we found no significant difference for the rate of oral or parenteral treatment administration, and admission rate was similar in the two groups (9% vs 7%, p=0.6)

Amongst the 182 analyzed homeless patients that visit the ED beside a housing demand, 53 (29%) were uninsured.

Conclusion:

We did not find a difference in the level of medical care delivered in French ED to homeless patients when compared to matched control. Resource consumption was similar for both groups, as was the admission rate. Nevertheless, homeless patients visit ED more often for an alcohol related complaint, are often uninsured and have higher rates of return visit.

Anne-Laure FERAL (, ), Adeline AUBRY, Jennifer TRUCHOT, Pierre-Alexis RAYNAL, Alice HUTIN, Geraud DEBRUYNE, Luc-Marie JOLY, Juvin PHILIPPE, Agathe LELEU, Bruno RIOU, Yonathan FREUND
15:00 - 16:30 #1196 - #1196 - Weapon related injuries in cairo during a turn of civilian violence in 2013: an overview.
#1196 - Weapon related injuries in cairo during a turn of civilian violence in 2013: an overview.

 Background: Violence in Egypt during the recent years of political turmoil has involved civilians. The use of armed weapons among opposing groups (armed demonstrators, extremists and security forces) has resulted in extensive injuries causing pain, disabilities and when severe, death. 

  Methods: During an episode of civilian violence (3 months in 2013) a total of 841 hospital files of firearm - wounded victims were analyzed. The hospitals were near Tahrir Square and Cairo City Center where chaos was at a maximum. Some of the victims were clinically examined. Emphasis on medical neutrality, the rights of the wounded and the need for social and psychiatric support to the victims is implied.

  Results: Seventy two percent of the wounded victims were young males (mean age 30.54 ± 10.22 years). Wounds were mostly inflicted by locally made crude arms having low-energy clout and involved the lower extremity in 29.8 %, upper extremity in 22.6%, eye zone in 19.0% and trunk in 4.4%. All shootings were from a short distance, but a minority , probably by snipers, were from a long distance. In some cases of gunshot wounds (13.08%) affected more than one anatomical region of the body:  4 regions in 2.38%, 3 in 3.92 % and 2 in 6.78%.

Conclusion: Handguns were the most common weapons inflicting civilian injuries in Cairo during armed demonstrations. Young males were injured the most, having wounds distributed randomly over their body, but significantly focused on the extremities causing severe morbidity. Social and psychotraumatic support to the injured were inadequate, but positive steps are being taken and improvement is anticipated.

Gamal SAIED (Cairo, EGYPT), Karim MOUSTAFA
15:00 - 16:30 #1395 - #1395 - Effects of large public outdoor events on attendances in an Emergency Department.
#1395 - Effects of large public outdoor events on attendances in an Emergency Department.

Introduction:

Brighton & Hove is a large cosmopolitan city with a population of nearly 300,000. It is the most populous sea side resort in England. Its economy has a strong emphasis on creative, electronic and digital technology. There are two large universities in the city (University of Brighton and Sussex University) with over 35,000 students in total. Brighton & Hove is unusual in that large proportion of its population (42%) is aged between 20-44.

Emergency Department at Royal Sussex County Hospital is the only department in the 14 mile radius and is a Level 1 trauma centre. It has annual attendances in excess of 110,000. There is a separate Children's Emergency Department with an annual attendance of 36,000. As Brighton & Hove is a seaside resort, there is also a large transit population of tourist coming on holidays, who would not necessarily have knowledge of how to access primary care services in the city.

There are several large outdoor public events that take place in the city (all take places on a Sunday). These include:

•Half Marathon

•Brighton Marathon

•London to Brighton Bike Ride

•Pride

•Shakedown

•5th November Bonfire Night

•Ney year’s Eve

We wanted to see whether these events increase number of attendances to our Emergency Department.

 

Methods:

Data from Emergency Department (Symphony) was used. Attendances for Sunday one week prior and one week post event were used to compare to those on the day of the event. Both Adults and Children Emergency Department attendances were included.

Results:

Out of all events mentioned above, the only two that clearly impacted on the Emergency Department were the Pride (August) and New Year’s Eve (December). Both increased attendances by 10-14% when compared to the attendances same day a week before and a week after.

Other events mentioned have a well-established medical management team which organises and runs prehospital support for the participants and the audience. The medical team consists of Emergency Medicine Consultants, Emergency Medicine Nurses and other advanced health care practitioners. They are able to treat multitude of presentations on scene thereby preventing unnecessary attendances in the Emergency Department. They operate to clear clinical protocols and have an open line of communication with the Department in relation to the patients they feel need transfer to the hospital.

Conclusion:

Emergency Departments should be aware of the large events that take place in the region and which can increase their attendances. Staffing should be increased to allow for a busy department. Also, there should be a real drive to have medical cover of these events prehospitally as it has been shown that having a medical team at events decreases attendances.

Natasza LENTNER, Maria FINN (Hove, UK)
15:00 - 16:30 #1978 - #1978 - Emergency Department physician’s perceptions of difficulties during the treatment of psychological/psychiatric emergencies: a pilot study.
#1978 - Emergency Department physician’s perceptions of difficulties during the treatment of psychological/psychiatric emergencies: a pilot study.

Background: Psychological andpsychiatric diseases in acute phases largely access to the hospital emergency department (ED). Knowledge about ED physician’s perceptions of difficulties during the treatment of psychological/psychiatric emergencies is limited. A pilot study was used to assess factors associated to the perception of difficulties of medical staff working in two EDs.

Methods: Two EDs (Santa Croce and Carle Hospital in Cuneo and Regina Montis Regalis Hospital in Mondovì in Northwestern Italy), approximately 80,000 and 30,000 patients per year respectively, were selected as convenience samples.  A semi-structured questionnaire was conducted with closed and open-ended questions. The survey was conducted using questionnaire having: (i) background and demographic data of the physicians; (ii) physician’s perception of difficulties in the treatment of psychological/psychiatric patients was evaluated by a 10-point numerical rating scale (0 = no difficulties, 10 = extreme difficulties). A cut-off ≥ 7 was used to determine a high level of difficulty. (iii) Personal satisfaction in treating psychological/psychiatric emergencies with respect to other types emergencies; (iv) prescribing behaviour; (v) physicians’ emotions mostly associated to psychological/psychiatric patients (considering positive feelings like empathy and wonder, anxious emotions like anxiety, alarm, concern, discomfort, or depressive emotions like boredom, impotence, anger, frustration; (vi) physicians’ perception about the principal causes of difficulties with psychological/psychiatric patients; (vii) physicians’ perception about factors that could ameliorate the treatment of psychological/psychiatric emergencies.

Descriptive statistics of percentages, means, standard deviations and correlations were used to analyse the data.

Results: Forty-eight out of fifty-four eligible emergency doctors (89%) gave their consent to participate. Twenty-eight males and twenty women had completed the questionnaires. Participants’ mean age was 40,3 years (SD = 8,5). Psychological/psychiatric emergencies showed physicians’ lower degree of preference with respect to other hospital emergencies (like cardiovascular, neurological, respiratory, toxicological, trauma, infectious, hematologic and gastroenterology emergencies). Physicians’ perception of difficulties with psychological/psychiatric patients had a mean level of 6,5 (SD = 1,8). Thirty-one physicians evaluated their difficulties with a numerical rate ≥ 7.

Univariate analysis indicated that the lack of specific psychological/psychiatric training (84.3% vs 15,7%, OR=5,7 CI 95% 1,3-23,9; p=0.01) was significantly associated with physicians’ perceived difficulties with those patients. Physicians’ difficulties resulted not significantly associated with a specific emotional cluster (positive, anxious or depressive cluster), but a trend was noticed between difficulty perception and anxious emotions.

Conclusions: Several factors potentially involved in the physicians’ perception of difficulties in the treatment of psychological/psychiatric patients have been analysed, but the sole significant values were associated to the lack of specific psychological/psychiatric training for the ED medical staff. Data collection was arduous and a larger study will require strategies to improve recruitment. On the whole this pilot study indicated that a deeper knowledge of physicians’ perceptions and emotions is useful both to identify and act on the principal causes of their difficulties with psychological/psychiatric patients, in order to ameliorate assessment procedures and clinical treatment.

Attilio ALLIONE, Ketty LETO (Cuneo, ITALY), Bartolomeo LORENZATI, Emanuele BERNARDI, Letizia BARUTTA, Elisa PIZZOLATO, Elena MAGGIO, Luca DUTTO, Giuseppe LAURIA, Bruno Maria TARTAGLINO
15:00 - 16:30 #2010 - #2010 - INTERCONNECTION BETWEEN HOSPITAL EMERGENCY DEPARTMENT AND HOME CARE IN THE UNIVERSITY HOSPITAL MARQUÉS DE VALDECILLA.
#2010 - INTERCONNECTION BETWEEN HOSPITAL EMERGENCY DEPARTMENT AND HOME CARE IN THE UNIVERSITY HOSPITAL MARQUÉS DE VALDECILLA.

Introduction: Hospital emergency departments (ED) are overwhelmed by the high workload and the inability of the hospital to reduce waiting times for the transfer of patients already hospitalized from the emergency to inpatient facilities. An alternative to conventional hospitalization is the Hospitalization at Home (HaH), in which patients would enter under some criteria, thus avoiding hospitalization and reducing the collapse of emergency departments.

Objective: To evaluate the healthcare model of HaH, on the basis of cost-effectiveness in patients with infectious diseases who are admitted from the emergency room.

Patients-Methods: A descriptive study of 654 incidents of patients receiving OPAT (Outpatient Parenteral Antibiotic Therapy) between April 2013 and April 2014, sent from the ED. Each patient was diagnosed in the emergency department before being included in the HaH programme. Demographic details, comorbidity, location of infection, isolated microorganisms and HIAT duration were recorded. The effectiveness through cure / recovery rate, deaths and readmissions (during OPAT and within 30 days). We evaluate the cost of stay in the HaH and in conventional hospital and the average stay in both.

Results: Average age: 66.39 years. Women: 49%. Average Charlson index: 2.21. Most frequent types of infection: respiratory (42%), urinary (34%), skin and soft tissue (11%). Causal microorganism known in 30% of cases. Most frequent germs: Escherichia Coli: 35%, Pseudomonas aeruginosa: 17%, Klebsiella spp: 9%, Staphylococcus spp: 7%. OPAT average duration: 8.3 days. Cure / recovery rate: 94%. Deaths: 1%. Readmissions during OPAT: 5%. Readmissions within 30 days: 7%. The estimated cost per HaH stay was €166 per day, and the average cost in hospital was €630 per day.

Discussion: Thanks to the use of this healthcare model, some serious infections have been treated at the patient’s home, thus avoiding hospital admission and the consequent vacancy of boxes in the ED. Comparing the cost of staying one day in the HaH (166 euros) and in hospital (630 euros), we can state that this model is linked to significant cost savings to the National Health Service.

Giusi SGARAMELLA (santander, SPAIN), Maria LARA, Zuany SONEIRA, Maria ANDRES, Ana AGUILERA, Luis Gerardo GARCIA-CASTRILLO, Emilio PARIENTE, Pedro SANROMA
15:00 - 16:30 #2068 - #2068 - The demographics and clinical data for domestic violence patients in the emergency department.
#2068 - The demographics and clinical data for domestic violence patients in the emergency department.

Introduction:

Victims of domestic violence (DV) appeal to the health care system through emergency room visits for injuries related to violent episodes. Health professionals must acknowledge DV as a possible cause of injuries and other health disorders in emergency patients. Knowing the demographics, epidemiological and clinical data of DV patients can enhance the quality of care for these victims.

 

Objective:

To identify demographic, epidemiological and clinical characteristics of victims of DV in emergency department and to deduce the possible deleterious consequences of DV.

Methods:  

A prospective observational study was conducted over one year. Patients were eligible for inclusion if they reported being a victim of DV. A domestic violence questionnaire was used. The demographics, co-morbidities, clinical data and in-hospital procedures were collected. Gravity was estimated according to the clinical classification of patients in emergency department (CCMU, Rea Urg 1994)

 

Results:

Inclusion of 169 patients. 2 men and 167 women. The average age of abused women was 35 +/ - 9 years and the average age of the abuser was 40 + - 9 years. The emergency visit was the same day (64%) and the second day (25%). The frequency of DV was daily in 60% cases. Women have filed a complaint in 45% of cases and sanctioned partner became more aggressive in 33% of cases. The topics of quarrel were (%): money and leisure (74%), alcohol (48%), children's education (47%), jealousy and infidelity (40%), family relationship (38%), sex (15% ) Friends relationship (11%),  related to work (8%). The nature of the abuse was physical in 100% cases, psychological (99%), economic (65%) and sexual (29%). The abusers had a history of alcohol use in 48% of cases, 47% had completed primary education and 64% were unemployed.

The damage was generally mild, class 1 of CCMU classification was found in 75% of cases. One hundred forty eight patients were discharged home, 21 victims of VC were addressed to a specialized service: 7 cases in orthopedics, 2 in ophthalmology, 2 in neurology and 10 in gynecology.

Conclusion:

Domestic violence affects female victims and has the characteristics of a gender-based violence. It is occurring at an alarming rate, is under-reported, and often not recognized by physicians and nurses. Screening of DV in emergency department can enhance the quality of care for these victims.

Rania JEBRI (Ben Arous, TUNISIA), Sami SOUISSI, Najla HENI, Mohamed MGUIDICH, Wifek BEN HMIDA, Soumaya MAHDHAOUI , Wided BOUSSLIMI, Hanane GHAZALI
15:00 - 16:30 #2082 - #2082 - How does countertransference (CT) affect medical decision-making? A resident survey.
#2082 - How does countertransference (CT) affect medical decision-making? A resident survey.

Background: Medical decision-making is not an objective process, despite the presence of medical algorithms for work-up and diagnosis of most conditions. Bias in medical decision making can cause costly mistakes in treatment, and has been linked to race, gender, socio-economic status. However, the real reasons for bias are not well understood, nor are the mechanisms by which bias affects decision-making. Countertransference, the psychodynamic concept representing feelings of providers towards patients, has been reported anecdotally to affect decision-making, but never formally studied in this setting. Modern countertransference representations have operationalized those feelings into eight dimensions: overwhelmed/disorganized, helpless/inadequate, positive, special/overinvolved, sexualized, disengaged, parental/protective, and criticized/mistreated. In this study, we explore how countertransference affects medical decision making in typical patient encounters, with the overarching hypothesis that CT feelings impact decision-making in everyday patient encounters, not exclusively in psychiatric settings.

Methods: Five patient encounters eliciting one to two CT dimensions each were filmed. The vignettes were as follows: 1- a likeable nurse presenting with chest pain, 2- young man with a history of drug addiction and chest pain, inability to walk more than a few steps, patient is covered win tattoos and marginally cooperative 3- young woman with borderline, histrionic personality c/o chest pain and palpitations (has pulmonary embolism), 4-Entitled patient with acute cholecystitis who repeatedly belittles, refuses to talk to housestaff  & 5- young man presenting with sleepiness- has an overbearing, overly controlling mother- patient has a knife in his belt buckle; presents very differently when interviewed with his mother versus alone.

  Residents in emergency medicine were shown the vignettes, asked what workup they would order for the patient, their top three differential diagnoses, then asked to fill out the therapist response questionnaire, a countertransference questionnaire. Participants were given 5-6 minutes per questionnaire, aiming at instinctive, rapid answers.

Results: Twenty-eight residents in emergency medicine participated in the survey. CT Feelings elicited by patient vignettes were similar across levels of training, and consistent with projected hypotheses. CT influenced medical decision making in cases combining psychiatric and medical components.  Two kinds of effects were detected: patients eliciting positive CT were less likely to get tested for drug use, whereas patients eliciting negative CT were more likely to be dismissed with minimal workup, more likely to get tested for drug use (even when drug use is reported in already available history) and be subject to a higher suspicion of malingering.

Conclusions: To our knowledge, this is the first study linking countertransference to how resident providers in emergency medicine made decisions to order tests: CT seems to affect adherence to ACEP-recommended algorithms. The effect is most prominent when the criticized/mistreated, helpless/inadequate dimensions are activated. The effect is less pronounced when a diagnostic dilemma is absent, as in the case of the patient with gastrointestinal symptoms.  When providers had positive CT for a patient, less testing for substance use was performed. Lack of awareness of one’s own feelings towards patients could cause significant changes in treatment, potentially missing serious conditions.

Nidal MOUKADDAM (Houston, USA), Asim SHAH, Larry LAUFMAN, Jim LOMAX, Veronica TUCCI
 
 
16:40
16:40-18:10
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A13
State of the Art
Pre-hospital EM

State of the Art
Pre-hospital EM

Moderators: Eric REVUE (Head of the ED and prehospital EMS) (Paris, FRANCE), Jana SEBLOVA (Emergency Physician) (PRAGUE, CZECH REPUBLIC)
16:40 - 17:10 Difficult airways in prehospital care – up-to-date. Stefan TRENKLER (Košice, SLOVAKIA)
17:10 - 17:40 Sonography during cardiac arrest – state of the art and new opportunities. Roman SKULEC (KLADNO, CZECH REPUBLIC)
17:40 - 18:10 LEAN way of thinking in the process of acute care. Maaret CASTREN (HELSINKI, FINLAND)
16:40-18:10
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B13
Italy invites
Organizzazione dei Dipartimenti d'Emergenza

Italy invites
Organizzazione dei Dipartimenti d'Emergenza

Moderators: Salvatore MANCA (ITALY), Francesco PUGLIESE (Rome, ITALY)
16:40 - 17:00 L'architettura ideale per una buona organizzazione. Annamaria FERRARI (Reggio Emilia, ITALY)
17:00 - 17:20 Gestione delle risorse e percorsi appropriati per garantire il diritto alle 6 ore. Bruno TARTAGLINO (Cuneo, ITALY)
17:20 - 17:40 Responsabilità nelle disfunzioni organizzative in area d'emergenza. Michele ZAGRA (Messina, ITALY)
17:40 - 18:00 Il punto di vista del cittadino sulle strategie organizzative. Alessio TERZI (ITALY)
16:40-18:10
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C13
Clinical Questions: Controversies
Cardiovascular Emergencies

Clinical Questions: Controversies
Cardiovascular Emergencies

Moderators: Rick BODY (UK), Polat DURUKAN (TURKEY)
16:40 - 17:10 High sensitivity troponin: friend or foe? Louise CULLEN (Brisbane, AUSTRALIA), Rick BODY (UK)
17:10 - 17:40 Is there any point in taking a history from a patient with chest pain? Edd CARLTON (UK), Barbra BACKUS (dordrecht, THE NETHERLANDS)
17:40 - 18:10 Ruling out ACS: Getting It Done. Judd HOLLANDER (USA)
16:40-18:10
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D13
Administration / Management
Patient Safety & Risk Management

Administration / Management
Patient Safety & Risk Management

Moderators: Janos BAOMBE (manchester, UK), Christian HOHENSTEIN (PHYSICIAN) (JENA, GERMANY)
16:40 - 17:10 You can't fix what you don't measure: Improving care in the ED and beyond. Susan ROBINSON (Doctor) (Cambridge, UK)
17:10 - 17:40 Pitfalls in behaviour that can take you to court - soft skills that satisfy patients and make them your friend. Christian HOHENSTEIN (PHYSICIAN) (JENA, GERMANY)
17:40 - 18:10 The IFEM Quality and Safety Framework for Emergency Medicine. Fiona LECKY (Professor of Emergency Medicine) (Sheffield, UK)
16:40-18:10
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E13
Research
Education

Research
Education

Moderators: Katrin HRUSKA (Farsta, SWEDEN), Cem OKTAY (FACULTY) (ANTALYA, TURKEY)
16:40 - 17:10 The iTeachEM approach to medical education. Rob ROGERS (USA)
17:10 - 17:40 The European Board Examination in Emergency Medicine (EBEEM). Cornelia HARTEL (Consultant in Emergency Medicine/ Director of Medical Education in Emergency Medicine) (Stockholm, SWEDEN)
17:40 - 18:10 Medical Education in 2015: the Swedish perspective. Katrin HRUSKA (Farsta, SWEDEN)
16:40-18:10
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F13
YEMD
Sim Session #2

YEMD
Sim Session #2

Moderators: Luca CARENZO (SIMULATION COMPETITION ONLY) (NOVARA, ITALY), Roberta PETRINO (Head of department) (Italie, ITALY)
16:40 - 17:10 Simulation Clinical Case 1. Luca CARENZO (SIMULATION COMPETITION ONLY) (NOVARA, ITALY), Roberto COSENTINI (Milano, ITALY)
17:10 - 17:40 Simulation Clinical Case 2. Chris NICKSON (South Yarra, AUSTRALIA)
17:40 - 18:10 Simulation Clinical Case 3. Riccardo LETO (Chief of ED) (Overpelt, BELGIUM), Mikkel MALBY SCHOOS (Copenhagen, DENMARK)
16:40-18:10
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G13
EuSEM meets
China

EuSEM meets
China

Moderators: Giorgio CARBONE (ITALY), Gian CIBINEL (Torino, ITALY)
16:40 - 17:10 The Developing Trend of Chinese Emergency Medicine. Zhong Qiu LU (CHINA)
17:10 - 17:40 The Professional Quality Control Indicator of Chinese Emergency Medicine. Wei JIE (CHINA)
17:40 - 18:10 The Standardized Training of Emergency Medicine Residency in China. Wei JIE (CHINA)
16:40-18:10
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OP1-13
Oral Paper 1
Imaging and Ultrasound I

Oral Paper 1
Imaging and Ultrasound I

Moderators: Ammar ALANI (UK), Paolo PRINETTO (ITALY)
16:40 - 18:10 #1033 - #1033 - REAL-TIME ULTRASOUND-GUIDED THORACENTESIS USING A LONGITUDINAL AXIS APPROACH IN THE EMERGENCY DEPARTMENT.
#1033 - REAL-TIME ULTRASOUND-GUIDED THORACENTESIS USING A LONGITUDINAL AXIS APPROACH IN THE EMERGENCY DEPARTMENT.

BACKGROUND: Real-time ultrasound guidance has demonstrated to improve the success and to reduce the incidence of adverse events during medical procedures. Ultrasound-guidance during thoracentesis has decreased the likelihood of pneumothorax by 19% --thereby improving the overall outcomes. Since the needle orientation in a longitudinal axis provides better precision and decreases the rate of adverse events during ultrasound-guided vascular access, we hypothesized that ultrasound-guided thoracentesis performed with a longitudinal axis approach could also have better outcomes. To our knowledge, this technique and its potential benefits have not been yet reported in the literature. We aimed to describe the real-time ultrasound-guided thoracentesis using longitudinal axis approach.

OBJECTIVE: To describe the outcomes of ultrasound-guided thoracentesis using a longitudinal axis approach in an Emergency Department in Bogotá-Colombia.

METHODOLOGY: We described two different techniques of ultrasound-guided thoracentesis: 1) the conventional (out of plane) and 2) the longitudinal axis (in-plane), in the Emergency Department of Fundación Cardioinfantil - Instituto de Cardiología, from October 1, 2013 to September 10, 2014. The measured variables were: difference between pleural effusion depth at the puncture site, success rate in pleural fluid removal, and adverse events.

RESULTS:  We performed 47 ultrasound-guided thoracentesis using the conventional approach and 26 ultrasound-guided thoracentesis using the longitudinal axis approach. Pleural effusion depth median  at the puncture site was 32.5 mm in the longitudinal axis group, compared to 47 mm in the conventional technique group (p = 0.0225), with a lowest pleural effusion depth of 15 mm and 20 mm respectively. Success rate in fluid removal was 100% in thoracentesis performed with longitudinal axis approach, compared to 93% (44 out of 47 procedures) with the conventional approach. One pneumothorax occurred in the conventional technique group. Thoracentesis was performed in the first attempt in all cases when longitudinal axis was used. Six thoracentesis required more than one attempt of puncture in the conventional technique group.

CONCLUSION: Longitudinal axis approach during ultrasound-guided thoracentesis is a feasible and safe technique that could potentially improve the success rate in pleural fluid removal while reducing the likelihood of adverse events. Additional clinical studies are needed to support our findings.

Luis Arcadio CORTES-PUENTES (BOGOTA, COLOMBIA), Gustavo Andres CORTES-PUENTES, Gerardo LINARES-MENDOZA
16:40 - 18:10 #1209 - #1209 - THROMBUS (THROMbosis detection by Bedside UltraSound). A prospective, multicentre study: Diagnostic concordance of emergency doctor-performed bedside US vs radiologist echo-doppler US in the diagnosis of deep venous thrombosis of lower limbs.
#1209 - THROMBUS (THROMbosis detection by Bedside UltraSound). A prospective, multicentre study: Diagnostic concordance of emergency doctor-performed bedside US vs radiologist echo-doppler US in the diagnosis of deep venous thrombosis of lower limbs.

INTRODUCTION:

Deep venous thrombosis (DVT) is an increasing major cause of mortality and morbidity. There is a need for quick, easy, inexpensive, convenient, and reliable diagnostic tools.

 

OBJECTIVES:

To ascertain the diagnostic concordance of emergency doctor-performed ultrasound (EDUS) of the lower extremities with specialist doctor-performed echo doppler (SDED) in the diagnosis of DVT.

 

METHODS:

In this prospective, multicenter study, adult patients (>18 years old) with clinical suspicion of DVT, with high or moderate risk (on Wells scoring) or low risk with increased D-dimer levels, were eligible.

From September 2013 to September 2014, 328 patients were enrolled. Fifty-one investigators from seven hospitals performed the EDUS. Each patient had the EDUS and SDED both in femoral and popliteal areas.

The final result was considered non-concordant if one or both of the EDUS did not match with the SDED. For inter-rater agreement analysis, we used the Kappa statistic,12 and confidence intervals (CIs) of 95% were computed using a jack-knife re-sampling procedure.

 

RESULTS:

Of 328 pairs of US studies, 37 were non-concordant between EDUS and SDED. Two EDUS were incomplete; therefore, the concordance analysis was performed with 326 ultrasound studies, with 35 discordant.

The percentage of agreement between EDUS and SDED was 89%. The kappa index was 0.76 (95% CI = 0.69–0.84), which means a “substantial agreement.”

 

CONCLUSIONS:

There is substantial agreement between the EDUS and SDED in the diagnosis of DVT in routine clinical practice.

 

WHAT THIS STUDY ADDS:

What is already known on this subject

           Current available evidence suggest that emergency doctors can perform bedside ultrasonography to diagnose or to rule out DVT, in a quick, inexpensive, and accurate way in comparison with “gold standard” studies by the Radiology department.

           Nonetheless, important concerns have been raised about the interpretation of the data: small sample sizes and methodological issues (very different experience of the emergency doctors performing bedside ultrasound, lack of details involving patient enrollment)

 

Section 2: What this study adds

           There is a “substantial agreement” between bedside ultrasound performed by a homogeneous sample of novice in bedside ultrasound management emergency doctors, and Doppler ultrasound performed by the Registrar radiologist in the diagnosis of DVT of lower limbs.

           The diagnostic concordance will escalate from 89% to 95% if the emergency doctor is shadowed in the first five performances, when the most mistakes are made.

Roberto PENEDO ALONSO, Mario SÁNCHEZ PEREZ, Fernando ROLDAN MOLL, Domingo LY-PEN (Westcliff on Sea, UK), Miguel ZAMORANO SERRANO, Luis DÍAZ VIDAL, Soledad JUSTO