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SUNDAY ISSUE 3ANDREA MEAD CROSSOCTOBER 16-19, 2016 MANDALAY BAY LAS VEGAS, NVOPENING SESSIONDON’T GIVE UPImportant advice for emergency medicine anddistance swimmingby RICHARD QUINNACEP16 Kickoff Party Takes OverCaesar’s Palace Club, OmniaJEFF KASHGET READY TO PARTY!ACEP has teamed up once againwith ECI Healthcare, a SchumacherClinical Partner, to kick off ACEP167 p.m. to midnight, Sunday, Oct. 16.ACEP16 registrants are invited tospend the night at Omnia, amultilevel venue that encompassesa seductive ultra-lounge, a high-energy main room and mezzanine, and a breathtaking rooftop garden showcasing panoramicviews of the Las Vegas Strip.Best of all, it’s free with ACEP16 registration. All registrants,guests, and exhibitors are invited to attend, badge required foradmittance. Attire is casual.Be sure to bring proper identification with you—you must be21 or older with ID to enter; a passport is required forinternational guests.emCareers.org LIVE is BACK at ACEP16BACK BY POPULAR DEMAND! COME BY ACEP ALLEY INOCEANSIDE FOYER SUNDAY 9:30 A.M.–7 P.M., AND MONDAY ANDTUESDAY 9:30 A.M.–5 P.M. TO ACCESS GREAT CAREER RESOURCES.Be sure to sign up for a free CVconsultation. Receive personal, expertadvice on how to make your CV shine,learn what employers are looking for,and craft a CV that highlights all of your skills and expertise.Visit the official job bank of ACEP and EMRA, emCareers.org, and: Find nearly 1,000 EM openings. Register for job alerts to take control of your job search. Be sure to registeron site for a chance to win one of three 100 American Express Gift Cards. Search career development resources.WWW.ACEP.ORG/ACEP16MOTIVATIONAL SPEAKER DIANA NYAD is sure to inspire as thekeynote speaker of the ACEP16 Opening Session, which will tell herlife story. In the 1970s, she was known for breaking long-distanceswimming records. In 2013, at ageDiana Nyad64, and on her fifth and final try,Sunday, Oct. 16she fulfilled a lifetime dream by8–9:30 a.m.swimming 110 miles from CubaMandalay Bay Ballroom Hto Florida.Her message remains as simple as it strong: Don’t give up. Ever.“I don’t care what business you’re in,” Ms. Nyad said. “I don’t careif you’re a stockbroker wearing a 5,000 suit in Manhattan or you’re anER doctor in Las Vegas, we all have the desire to chase our dreamsand get over our obstacles. And if we just don’t give up, we will get tothat other shore.”RICHARD QUINN is a freelance writer in New Jersey.DON’T BE CAMERASHY—COME ON BY!STUDIO ACEP OPENS SUNDAY AT 9:30A.M. IN ACEP ALLEY, OCEANSIDE FOYER,AND DOESN’T SHUT DOWN UNTIL THECAMERA CALLS IT QUITS AT 5 P.M.Get your picturetaken by a professionalphotographer andwe’ll send you the finished digital headshotafter the convention,absolutely free. Use itfor your LinkedIn page, Facebook profile, orhowever you’d like. While you’re there, pleasehelp ACEP with some promotional images.If you’ve seen some of your colleagues inour advertisements or conference promotions throughout the year, it’s because theystopped by the studio and spent a couple ofminutes with our marketing team.While you’re there, please give us a videotestimonial as well. What’s on your mind?What’s your favorite ACEP member benefit?What do you love about emergency medicine? Say it for the camera. We very muchappreciate the help!

4 SUNDAY ISSUEOCTOBER 16-19, 2016 MANDALAY BAY LAS VEGAS, NVImprove Quality with CEDR and E-QUALAS PART OF ITS ONGOING COMMITMENT TOproviding the highest quality of emergency care,ACEP has developed the Clinical Emergency DataRegistry (CEDR) and the Emergency Quality Network (E-QUAL). These first-of-their-kind networkssupport emergency physicians’ efforts to improvequality and practice in all types of emergency departments, even as practice and payment policieschange over the coming years.CEDRACEP's CEDR has been approved by the Centers for Medicare & Medicaid Services (CMS)as a qualified clinical data registry. CEDR willprovide a unified method for ACEP membersto collect and submit Physician Quality Reporting System (PQRS) data, Maintenance ofCertification (MOC), Ongoing ProfessionalPractice Evaluation (OPPE), and other localand national quality initiatives.Get more information, watchdemonstrations, and sign up on site.Sunday, 7 a.m.–6 p.m.ACEP Alley, Oceanside FoyerE-QUALYou are invited to a Lunch Product Theater Presentationat the American College of Emergency Physicians AnnualScientific Assembly 2016E-QUAL seeks to enroll over 24,000 emergencyclinicians and 2,000 emergency departmentsby 2019 in three focused learning networks designed to transform ED practice and supportthe triple aim of improved health outcomes,better coordination of care, and more efficientspending. E-QUAL will ensure clinicians andemergency departments meet the new CMSMerit-Based Incentive Payment System requirements for clinical practice improvementactivities, receive benchmarking data to guidelocal quality improvement efforts, earn PartIV MOC and CME, and receive free access totoolkits and resources including best practices, sample guidelines, and key talking points.Sign up for E-QUAL on site to participate in ourthree planned learning collaboratives: Improving outcomes for patients withsepsis.THROMBOSIS:DV T/PEAN EXPLORATIONIN RISK REDUCTIONSUNDAY, OCTOBER 16, 201610:30 AM – 11:15 AMMandalay BayGregory Fermann, MD, FACEPMandalay Bay Ballroom ILas Vegas, NevadaProfessor and Executive Vice ChairmanDirector, Clinical Trials CenterDepartment of Emergency MedicineUniversity of Cincinnati College of MedicineCincinnati, Ohio Reducing avoidable imaging in low risk patients through implementation of ACEP’sChoosing Wisely recommendations. Improving the value of ED chest pain evaluation by reducing avoidable admissionsin low-risk patients with chest pain.Get more information on site:Sunday, 7 a.m.–6 p.m.ACEP Alley, Oceanside FoyerPROGRAM DESCRIPTIONThis lecture will discuss treatment options for patients with deep vein thrombosis and pulmonary embolism and how they can reduce therisk of recurrent thrombotic events.In adherence with PhRMA guidelines, spouses or other guests are notpermitted to attend company-sponsored programs.For all attendees, please be advised that information such as your nameand the value and purpose of any educational item, meal, or other itemsof value you receive may be publicly disclosed. If you are licensed in anystate or other jurisdiction, or are an employee or contractor of anyorganization or governmental entity, that limits or prohibits meals frompharmaceutical companies, please identify yourself so that you (and we)are able to comply with such requirements.Please note that the company prohibits the offering of gifts, gratuities,or meals to federal government employees/officials. Thank you foryour cooperation.This promotional educational activity is not accredited. The programcontent is developed by Janssen Pharmaceuticals, Inc. Speakerspresent on behalf of the company and are required to presentinformation in compliance with FDA requirements for communicationsabout its medicines.The personal information you provide may be used to contact you aboutyour request to attend the Janssen Pharmaceuticals, Inc., educationalprogram using your preferred method of communication as indicated byyou. This information may be shared with Janssen Pharmaceuticals, Inc.,its affiliates, and a third party for the sole purpose of completing yourregistration for this program and as required by law.This symposium is not a part of the official Scientific Assembly educational program as planned by ACEP’s Educational Meetings Committee.Supported by Janssen Pharmaceuticals, Inc. Janssen Pharmaceuticals, Inc. 2016August 2016WWW.ACEP.ORG/ACEP16056596-160715Help Make#ACEP16a Trending TopicWhat did @gruntdoc say about thatlecture this morning? What does@jeremyfaust look forward to atinnovatED? How lost did @srrezaieget in the hotel trying to get to theExhibit Hall? What are you up to?ACEP’s social media reach skyrocketed last year—so much so thatACEP’s conference hashtag was oneof Twitter’s most trending topics. Let'smake #ACEP16 even more popular.Follow @ACEPnow, and rememberto check out www.facebook.com/ACEPfan for updates and imagesfrom parties and special sessions.

SUNDAY ISSUE 5OCTOBER 16-19, 2016 MANDALAY BAY LAS VEGAS, NVDon’t Miss ACEP Alley andthe Resource CenterACEP IS BRINGING YOU BIGGER AND BETTER THIS YEAR AT ACEP16!These one-stop-shops for everything ACEP are conveniently located.The Resource Center can be found in the Exhibit Hall, and ACEPAlley is in the Oceanside Exhibit Hall.ACEP GOEarn points, gain notoriety, and compete withyour friends. Right on the ACEP16 Mobile App,play ACEP Go by checking in at designatedlocations marked with the ACEP Go symbol.Earn points and ACEP16 fame while learningmore about what ACEP has to offer you.ACEP AlleyBridging the two Exhibit Halls, here you’ll finda wealth of ACEP-related resources. Stop byemCareers.org LIVE, the Emergency MedicineFoundation Silent Auction, the CEDR/E-QUALInformation Desk, and Studio ACEP—all ofwhich have extended hours.Annals will also host a #FOAMed bar onMonday from 1–2:30 p.m. Discover Annals’ freecontent and ask your #FOAMed and other social media questions. You can find other answers from the leading emergency medicinepeer-reviewed journal in the ACEP ResourceCenter during exhibit hours. At each session,there will be a raffle to give away several 50Amazon gift cards to attendees.ACEP BookstoreCheck out the variety of emergency medicinetitles available for purchase on-site, including the brand-new PEER IX. PEER IX gets you“closest to the boards” with 100 percent newcontent, a brand new user interface, continualupdates, and more. Stop by for more information today. Be sure to participate in our BoothVisitor Program for a chance to win one of fourvaluable prizes. Remember, ACEP membersreceive special pricing on all products.SEMPA AND NEVADAACEP CHAPTERRECEPTION SET FORSUNDAYJoin the Nevada Chapter of ACEP (NV ACEP)and Society of Emergency Medicine PhysicianAssistants (SEMPA) on Sunday, 6–7:30 p.m., atEyecandy Sound Lounge & Bar at the MandalayBay hotel and casino. Past, present, and prospective NV ACEP and SEMPA members arewelcome. Network with colleagues and leadersfrom each organization to learn more aboutwhat they have to offer you. ACEP leaders arealso encouraged to join this event.COME BY AND SPEND SOME TIME WITHNV ACEP AND SEMPA BEFORE THEACEP16 KICKOFF PARTY.ACEP Podcast Recording BoothJEFF KASHNew this year! See some of your favorite podcasters in action as they interview some of thebiggest names in emergency medicine righton the ACEP16 Exhibit Hall floor.Annals of Emergency MedicineAsk the Deputy Editors! Meet and bring yourquestions for Annals Deputy Editors DavidL. Schriger, MD, MPH, and Donald M. Yealy,MD, at the Annals kiosk in the ACEP ResourceCenter. These deputies know the pearls andpitfalls of manuscript submission, and lookforward to answering your questions andproviding tips on manuscript preparation tomaximize acceptance. Dr. Schriger will be atthe Annals kiosk at 2 p.m. Sunday. Dr. Yealywill be at the Annals kiosk at 2 p.m. Tuesday.ACEP Resource CenterThis information-exchange area showcases informationon a wide variety ofACEP benefits andservices, as well as emergency medicine issues. ACEP leaders and staff members will beavailable to answer your questions, discusscollege policy and direction, and provide information on useful and novel products andresources from ACEP.TAKE ADVANTAGE OF THENEMPAC DONOR LOUNGENEMPAC is a critical tool in ACEP’s governmentaffairs strategy to strengthen our influence onmany legislative initiatives affecting the practiceand delivery of emergency medical care. NEMPACactivities at ACEP16 will recognize the support ofour most generous donors and highlight ouragenda for the coming term. Because of ACEPmember support, NEMPAC has become one of thetop medical PACs in the country and is a respectedpolitical voice in Washington, D.C.NEMPAC VIP DONOR LOUNGEJEFF KASHSUNDAYTuesday, 8 a.m.–5 p.m., Surf B(NEMPAC VIP access pass required)ACEP Wellness CenterACEP members are invited to visit the ACEP Wellness Center and assess their level of well-being.The Wellness Center offers services to ACEP members including blood pressure checks, bloodchemistry (including HgbA1C), body composition screening, flu vaccine, wellness-related resource materials, and a burnout questionnaire with personalized feedback. This is a 160 valuebut is only 50 for ACEP members. Admission tickets to the Wellness Center may be purchasedat the ACEP16 registration area or at the nearby ACEP Bookstore.NEMPAC’s highest donors ( 600 and above, 60for residents in 2016) are invited to stop by and relaxin the NEMPAC VIP Lounge. Donors will receiveaccess to complimentary breakfast, lunch, laptop/printer usage, and professional neck and shouldermassages. Give-A-Shift donors will receive aspecial thank-you gift from the NEMPAC Board.Supported in part by HBI–Hagan Barron Intermediaries.WWW.ACEP.ORG/ACEP16

6 SUNDAY ISSUEOCTOBER 16-19, 2016 MANDALAY BAY LAS VEGAS, NVHot SessionsLearn to Spot ThreeCritical ECG Findingsby RICHARD QUINNQwaves and atrioventricular (AV)issues and cor pulmonale, oh my.All three can be pitfalls whilereading the findings of electrocardiography (ECG), yet emergency physiciansare expected to not misread them asprecursors to serious pathology. However,veteran emergency physician Jerry Jones,MD, FACEP, said a lack of training canlead to misdiagnoses.“It’s really not difficult to understandwhat causes problems in interpretingthe ECG in terms of properly evaluatingwhat’s happening in Lead III, understanding AV dissociation, or recognizing acutecor pulmonale,” said Dr. Jones, founder ofMedicus of Houston. “It’s a matter of looking for abnormalities when you’re perhapsexpecting an abnormality to jump out atyou from the ECG. They aren’t going todo that! You need to look for them andyou need to understand exactly whatyou’re looking for. They’re not hard to find,you just need to be able to recognizethem when you do see them.”“It’s a very importantarea that needs to beunderstood by thephysician so that areally unfortunate mistake doesn’t occur.”—Dr. JonesDr. Jones will discuss the issue during a rapid-fire session, “Mastering ThreeProblems that Can Kill in EmergencyElectrocardiography: An AdvancedApproach.” He will focus on Q wavesand negative complexes in Lead III; recognizing the difference between AV dissociation and third-degree AV block; andthe manifestations of acute and chroniccor pulmonale.“It’s a very important area that needsto be understood by the physician sothat a really unfortunate mistake doesn’toccur,” he said.RICHARD QUINN is a freelance writerin New Jersey.Boost Your Abilityto Diagnose andTreat OphthalmicEmergenciesby VANESSA CACERESBoost your comfort level withophthalmology during today's session “Essential OphthalmologicProcedures and Examinations,” led byGil Binenbaum, MD, MSCE, attendingsurgeon in the division of ophthalmology atThe Children’s Hospital of Philadelphia.The session will cover a wide range ofeye problems presenting to the emergencydepartment. Many of these problems arevision threatening and can have significantshort- and long-term morbidity. One area offocus during Dr. Binenbaum’s talk will bethe slit lamp microscope and how emergency physicians can build their comfortlevel with this commonly used instrument inophthalmology. Proper use of the slit lamphelps to diagnose conditions that may otherwise be difficult to identify, ranging fromcorneal ulcers and foreign bodies, to uveitis, dry eye, and open globe injury. “Thereare many subtle but important findings thatare much easier to see, or in some casesonly possible to see, with the magnificationand capabilities of the slit lamp,” he said.Dr. Binenbaum also will talk about howand when to measure intraocular pressure, highlighting congenital glaucoma,hyphema, and retrobulbar hemorrhage.When retrobulbar hemorrhage results inorbital compartment syndrome, the emergency physician may need to act quickly,so the session will include instruction onhow to perform a canthotomy and cantholysis. “If they can diagnose the problem, thenemergency physicians can do canthotomyand cantholysis. The important thing is toknow what the indications are for doingit,” he said. Other procedures, such ascorneal foreign body removal and eyelideversion will also be covered. Some visually-threatening problems require urgentevaluation by an ophthalmologist, and Dr.Binenbaum will highlight important redflags for consulting ophthalmology. Foreven more ophthalmology, Dr. Binenbaumwill be giving a second talk on Sundaycalled “Visual Diagnosis in EmergencyMedicine: Eye Can See the Problem.”That talk will focus broadly on the red eyeand vision loss.Discover the Ins andOuts of Pressor Agentsin the Critically Illby VANESSA CACERESOne tricky area of emergencymanagement is the use of pressoragents for severe hypotension. Inhis presentation “Under Pressor! UtilizingIV Pressors in the ED,” Peter M. DeBlieux,MD, FACEP, professor of clinical medicine and chief medical officer at UniversityMedical Center at New Orleans, will helpclear up some confusion.Dr. DeBlieux will review the basics ofblood pressure support with IV pressoragents and give take-home tips onhow to manage patients with severelylow blood pressure.One specific area he will address issepsis management of blood pressureusing both norepinephrine to improveblood pressure and the inotropic agentdobutamine to improve cardiac performance. He also will cover utilization of thesame two agents in the setting of cardiogenic shock as a bridge to more invasiveapproaches, which can include intra-aorticpump, left ventricular assist devices, coronary artery stenting, and coronary arterybypass grafting.The presentation also will cover: Systolic blood pressure The use of mean arterial blood pressure as a goal of therapy rather thansystolic blood pressure. “Mean arterial blood pressure measures moreclosely approximate organ perfusionpressures and are more physiologic,”Dr. DeBlieux said. The use of dobutamine as avasoactive agent and not a truevasopressor Pulse dosing of vasopressorsExpect some take-home tips fromDr. DeBlieux, such as the importanceof ultrasound with this patient group.“Bedside utilization of ultrasound shouldbe used in close concert with vasopressor therapy to develop a treatment planand to assess for response,” he said.VANESSA CACERES is a freelancemedical writer based in Florida.Should You BeUsing Ketamine andTransaxenemic Acid forTrauma Patients?by RICHARD QUINNThe dangers of ketamine and transaxenemic acid (TXA) have beengreatly exaggerated, according to apharmacist who hopes to get emergencyphysicians talking about using the oftenoverlooked medications at this year’sannual meeting.“People seem to be hesitant to usethem based on old data and what I wantto present to them is newer data thatshould help convince them that they aresafe to use in a trauma patient,” said BryanHayes, PharmD, FAACT, an emergencymedicine pharmacist and toxicologist atMassachusetts General Hospital in Boston.Dr. Hayes will present a rapid-fire session titled, “Traumacology: Drugs for theTrauma Bay.” His goal is to get peopletalking about the efficacy of ketamine andTXA, both shown in recent data to beuseful after years of data that cast doubtson their usefulness.Attend this session tofind out why ketamineand TXA are due for achange.He plans to suggest that physicianswho don’t have access to the medicationsask for them to be added to their formularies. He’ll try to fight misperceptions,including that ketamine causes worseningintracranial pressure increases in traumapatients.“We’ve had so many times in medicine where we’ve been practicing a certain way based on what we thought wasgood data for many years,” he said. “All ofa sudden one, or two, or three new trialscome out that show s

Mandalay Bay Ballroom H ACEP16 Kickoff Party Takes Over Diana Nyad Caesar's Palace Club, Omnia GET READY TO PARTY! ACEP has teamed up once again with ECI Healthcare, a Schumacher Clinical Partner, to kick off ACEP16 7 p.m. to midnight, Sunday, Oct. 16. ACEP16 registrants are invited to spend the night at Omnia, a multilevel venue that encompasses