Annual Congress on
Emergency Medicine and Critical Care
Scientific Program
Keynote Session:
Title: A new approach to primary care education to support emergency medicine
Biography:
Stuart Maitland-Knibb is an Ex British military medical officer with extensive experience in primary care & emergency medicine both in hospital and pre-hospital. Specializing in urgent unplanned and remote area health care, he has set up and delivered emergency units delivering care in remote and independent from main hospitals in the UK. He has worked on the Helicopter Emergency Medical Service (HEMS) and pre hospital settings for many years and continues to fly in a consultant position. He is also a responder for the British Association of Immediate Care Scheme (BASICS), Senior Examiner for the Royal College of Surgeons of Edinburgh for the Dip IMC, FIMC and DUMC. He holds a role as medical officer for UK International Search and Rescue (UKISAR) the UK government team operating under INSARAG, is the quick response team for disaster zones that need specialists in search and rescue. Now as the Director of remote and rural medicine at the University of Central Lancashire (UCLAN), he and his team aim to create a national centre of excellence in remote and rural medicine training, delivering education throughout the world where hospital medicine is delivered out of hospital for the benefit of patients and the system that supports them.
Abstract:
The belief is held that a large proportion of the 23 million of people attending emergency departments could also be seen as urgent primary care. (1) With large numbers of patients being age groups that access emergency medicine for convenience or are unsure of their health need. However, we also know that acuity is becoming more complex and admission rates are increasing (1). We know differentiating these patients can also be challenging. We are also aware that remote and rural areas are having noted health inequalities due to the availability of acute care provision. This results in increased burden for travel for patients and ambulance trusts. Increased attendances in emergency departments and health inequalities in the speed of delivery in these settings. In the last two decades primary care training and care delivery has moved away from acute care and to one of chronic disease optimization and within hours care only. This was to meet the governments objectives of quality outcomes in these areas, This lack of investment in training in acute care has led to a situation where primary care is now being asked to deliver more acute medicine both rurally and in emergency settings, whilst willing to deliver it may not necessarily have the confidence or base knowledge to deal with what is being asked. UCLAN have developed a new training program that allows primary care physicians to work confidentially and effectively in acute areas of care. Whether this is front of house in emergency departments or in areas of remote healthcare where clinical support maybe hours away or logistically a challenge. Training in latest techniques and technology innovation allows the physician to feel more able to handle acute care. This not a program designed to make the primary care physician into an emergency physician. This is about making the primary care physician of today as effective as 25 years ago when the vast majority of all acute care was delivered by primary care.
Title: Strengthening Health Care by the Pedagogical Concepts of Mahatma Gandhi andPaulo Freire – Basic Education and Conscientizacao
Biography:
Statement of the Problem: The lack of education means exploitation of children, child labor, population explosion, unsanitary conditions and lower standards of living (Asha; McGuire). The WHO defines health as complex and more as the absence of illness. How is it possible to build up spiritual, personal, social and ecological care? Methodology & Theoretical Orientation: An inter subjective ethnographic study in India using hermeneutic dialogue was utilized during participant observation, in-depth interviews and focus groups. Offers the salutogenesis model of health the chance to integrate different views of the growing of health (Monica-Eriksson) by empathy, self-efficacy, learning resourcefulness, will to meaning, inner strength as well as by the basic education and conscientizacao? Findings: Mahatma Gandhi developed Basic Education in the context of Satyagraha, a-himsa and sarvodaya. Llife-long, social and integral education are complex targets correlated with hygienic behaviour, ability to read and write, maintain the native language and doing craftwork. Paulo Freire elaborated the idea of Conscientizacao, understood as a critical consciousness. Concrete targets are the conflict ability, being historic, creative, dialogic and human-transitive. Basic Education and Conscientizacao should make it possible for people to support inner strength as well as to discuss the problems of their environment. Conclusion & Significance: “Bringing hope through education” (Asha) and strengthen empowerment (A. Sen) will improve the basics of health promotion (Ottawa –Charta 1986).
Abstract:
Bernhard Mann is the Professor of Health and Social management (em.) and has his expertise in evaluation the health and wellbeing. His research creates new pathways for improving the healthcare of the youth and the health management of the elderly and the handicaps. His experience in research, evaluation and teaching at several Universities in Germany is focused in Health and Medical Sociology, Health and Social Management and in Public Health. His research was founded by the government of Germany. He was keynote speaker at the World Congress of Public Health in Osaka/Japan 2017.
Title: A dynamic healthcare data ecosystem to support current and future healthcare needs
Biography:
Charles Boicey MS, RN-BC, CPHIMS is the Chief Innovation officer for Clearsense, an outcomes-driven healthcare technology company based in Jacksonville, FL. Previously, he was the enterprise analytics architect for Stony Brook Medicine, where he developed the analytics infrastructure to serve the clinical, operational, quality, and research needs of the organization. In his current role of Assistant Clinical Professor, Stony Brook University Charles developed and teaches the analytics elective concentration. He was a founding member of the team that developed the Health and Human Services award-winning application Now Trending to assist in the early detection of disease outbreaks by utilizing social media feeds. He is a former president of the American Nursing Informatics Association
Abstract:
Healthcare organizations have implemented sophisticated software solutions that collect large amounts of data, but our industry is challenged to understand how to collect, consolidate, analyze, and use that data. Join Charles Boicey, a pioneer in healthcare data science, as he walks through the past, present and future of Applied Data Science in healthcare and learn how you can begin to use the power of Big Data to improve clinical outcomes.
Title: Title: Pulmonary Embolism Diagnosis and Management
Biography:
Badr Alsayed has completed his MBBS at King Abdulaziz University and got his training at King Fahd Armed Forces Hospital in Jeddah where he achieved Saudi Board and Jordanian Board in internal Medicine. He received fellowship training in pulmonary and critical care at Ochsner Health System, New Orleans, USA. He was appointed as Dean of Tabuk Faculty of Medicine, Tabuk, Saudi Arabia for four years and chaired many academic units and committees. He has published many papers in reputed journals and presented his work in regional and international conferences
Abstract:
Pulmonary embolism management is a rapidly evolving field of medicine. It is considered to be the underlaying cause of most preventable in hospital deaths. Diagnosis and management of acute pulmonary embolism in timely manner still major challenge. During my presentation, I will go over fundamentals of diagnostic approach for acute pulmonary embolism based on probability score. As well as, therapeutic options will be discussed. Special attention will be given to intermediate risk group and available update in recently published articles. Lastly, and most importantly, review preventive measures of venous thromboembolism (VTE).
Oral Session 1:
- Emergency Medicine | Nursing Care | Pediatric Emergency Medicine | Anesthesia and Pain Management | Post-accident Primary Care | Neurological Emergencies | Critical Decisions in Emergency Medicine
Title: ABG: Gold standard in ED
Biography:
I completed MD (Medicine) in 1994 from Darbhanga Medical College, Bihar, India. Got times of India achievers award in 2015 and silver certificate of BMJ in 2017. There are 12 publications in different journals, publication of my chapter in two medicine updates and I am engaged in the department of internal medicine and in different research work.
Abstract:
Arterial Blood Gas (ABG) measurements are now widely used in hospitals, particularly in intensive care unit (ICU) where its main use is monitoring of ventilated patients and patients of complex diseases. This is the only test which is indicated in almost all presenting problem of emergency department (ED). The test should be done prior to the start of therapy. Doctors in general and patients, in particular, are not getting the benefit of ABG due to non-availability of the simple and complete method of analysis of the measurement particularly in the complex disease where the mortality is high.
The completely interpreted report helps in diagnosis, management, referral and in some cases indicate about prognosis also. Management of the patient in the background of analyzed ABG report definitely reduces the mortality, particularly in mixed disorder.
Introduction of “rkdas Indian 2017 method of ABG interpretation”, which also interprets accuracy of measurements and is simple, step wise, true, systematic and a combination of different methodology. ABG has now become most accurate test possible without restriction in emergency department.
After taking out the arterial blood according to the protocol, the ABG measurement is taken from the machine and analyzed in the following steps:-
1. Accuracy of ABG
2. Gas analysis
3. Electrolyte analysis
4. Acid-base analysis
5. Complete diagnosis
In my opinion if ABG machine is provided in peripheral hospitals world-wide, after a short training of the doctors posted there, it will change the scene of diagnosis, management, referral and mortality of the patients with high level of confidence among treating doctors.
Title: Pediatric Sepsis
Biography:
Nazeema Khan-Assad has completed her MD from State University of New York- at Brooklyn-School of Medicine. She is the Director of Pediatric Emergency Department at Al Jalila Children’s Specialty Hospital
Abstract:
Sepsis is a leading cause of morbidity and mortality in both the adult and pediatric population due to failure to recognize and poor resuscitation measures. We have to educate regarding the key presenting signs and symptoms, pathology and resuscitation. My discussion will focus on the definition of pediatric sepsis based on Pediatric Critical Care Committee review. The manifestation of sepsis in the pediatric population is key to recognition and early treatment. We will review treatment in both pediatric and neonatal sepsis, and the establishment of clinical pathways to improve care recognition and care delivered. We will also review how to monitor adherence to standard clinical practice for pediatric sepsis patients to improve outcomes.
Title: Pediatric C-spine injuries : Current evidence
Biography:
Ahmad completed his Boards in Pediatric in Saudi Arabia then joined Hospital for Sick Children (SickKids) in Toronto, Canada where he achieved Pediatric Emergency Medicine fellowship, Pediatric Trauma Fellowship and an advanced training in Pediatric Point of Care Ultrasound (POCUS). Currently, he is a Consultant Pediatric Emergency and Trauma in Riyadh. He is the Director of Pediatric POCUS training in Kingdom of Saudi Arabia. He is an international speaker in the field of Pediatric Emergency and Trauma with a major research interest in the field of Pediatric POCUS
Abstract:
Pediatric cervical spine injuries (CSIs) are rare and differ from adult CSIs. It has been a major dilemma in the Emergency Department due to the nature of the patient, age variation and lack of strong evidence. Many research networks in Europe, Australia and North America worked to establish guiding protocols that determine which patients require imaging (CT vs. X-ray) or clinical clearance. Emergency radiologic evaluation of the pediatric cervical spine can be challenging because of the confusing appearance of synchondroses, normal anatomic variants, and injuries that are unique to children. Cervical spine injuries in children are usually seen in the upper cervical region owing to the unique biomechanics and anatomy of the pediatric cervical spine. Familiarity with anatomic variants is also important for correct image interpretation. These variants include pseudosubluxation, absence of cervical lordosis, wedging of the C3 vertebra, widening of the predental space, prevertebral soft-tissue widening, intervertebral widening, and “pseudo–Jefferson fracture.” In addition, familiarity with mechanisms of injury and appropriate imaging modalities will aid in the correct interpretation of radiologic images of the pediatric cervical spine.
Keynote Session:
Title: ECG leads misplacement, artefact and other technical errors
Biography:
Richard Lynch is a consultant in Emergency Medicine. He is a self-confessed ECG enthusiast and has a particular interest in ECG lead misplacement. In 2013 he wrote a very popular ECG interpretation book, ECG interpretation: it’s easier when you know how. He is currently working on his second book “ECG lead misplacement, artefact and other technical errors”. He has around 100 numbers of both publications and conference presentations in his account.
Abstract:
The electrocardiogram (ECG) is an essential diagnostic tool in the assessment and management of acutely unwell patients. Lead misplacement rates between 0.4% and 4% have been reported. Bond et al reported that, in the presence of lead misplacement or artefact, there is a 17-24% chance that the ECG diagnosis will be different. Despite this, few ECG textbooks adequately address this topic. When errors occur, it is important that they are recognised and corrected to avoid spurious diagnosis and unnecessary, potentially harmful, treatment. The most commonly encountered ECG lead misplacements, in clinical practice, are demonstrated and clues to their presence are emphasised. Training is required for recognition of lead misplacement; otherwise, the eyes will not see what the mind does not know.
Title: Title: Role of Simulation based Training in improvement of quality Nursing care in emergency department
Biography:
Devendra Richhariya is practicing emergency medicine since last 15 years, Trained in Emergency Medicine, critical care, and working as emergency Intensivist. He is a Member and faculty of Society of Emergency medicine in India, society of critical care medicine, International trauma care society. He is the Head and Associate Director of emergency department, Simulation Lab, training program of basic & advanced life support program in the hospital. He has Implemented, road & air evacuation services in the institution and advisor & faculty for emergency medical services. He has special interest in emergency department administration and quality improvement. He has published numerous papers in national & International journals. He is the Editor in Chief “Textbook of emergency and trauma care” first edition 2018 Jaypee Medical Publishers New Delhi.
Abstract:
Simulation has been recently adopted as a training and assessment tool in nursing medical education in Emergency. Conventional teaching methods may be inadequate to properly train healthcare providers for rare but potentially lethal events in Nursing such as managing polytrauma, Acute Brain stroke, acute coronary syndrome and cardio-respiratory arrest in adults and paediatrics, birthing simulation in 3rd trimester of pregnancy. We have observed that Simulation based training, by enhancing provider skills, can subsequently decrease medical errors and increase patient safety. This will eventually lead to transfer of skills into real world settings and have an impact on patient safety, and hence improve patient outcomes.
Title: Anti-cancer preparation NSC 631570 (Ukraine) and its efficacy in the treatment of breast cancer
Biography:
Wassil Nowicky is the Director of “Nowicky Pharma” and President of the Ukrainian Anti-Cancer Institute (Vienna, Austria). He has finished his study at the Radiotechnical Faculty of the Technical University of Lviv (Ukraine) with the end of 1955 with graduation to “Diplomingeniueur” in 1960 which title was nostrificated in Austria in 1975. He is the Inventor of the anticancer preparation on basis of celandine alkaloids “NSC-631570”. He has been the author of over 300 scientific articles dedicated to cancer research. He is a real member of the New York Academy of Sciences, member of the European Union for applied immunology and of the American Association for scientific progress, honorary doctor of the Janka Kupala University in Hrodno, doctor “honoris causa” of the Open international university on complex medicine in Colombo, honorary member of the Austrian Society of a name od Albert Schweizer. He has received the award for merits of National guild of pharmacists of America, the award of Austrian Society of sanitary, hygiene and public health services and others.
Abstract:
The researchers who conducted studies with the anticancer preparation NSC 631570 concluded: “The anticancer drug NSC 631570 exerts its cytotoxic effects on both mouse and human breast cancer cell lines in a dose and time dependent manner. Weeks following NSC 631570 treatment, cells maintained a reduced capacity to proliferate.” In a controlled clinical study conducted at the University Grodno (Grodno, Belarus), after the therapy with NSC-631570 the hardening of the tumor, a slight increase in the tumor size (5-10%) and proliferation of connective tissues were observed. The tumours appeared harder and slightly enlarged after NSC-631570 therapy, and were easier to detect by ultrasound or radiological examination. Metastatic lymph nodes were also hardened and sclerotic (fibrous). Tumours and metastatic lymph nodes were clearly demarcated from healthy tissue and therefore easier to remove. Complications such as prolonged lymphorrhoea (leakage of lymph onto the skin surface), skin necrosis (death of skin tissue), suppuration of the wound, and pneumonia, all occurred in patients from the two NSC-631570 groups at only half the rate that they appeared in patients from the control group. Based on the results of this study the scientists from Grodno recommended the use of NSC-631570, at the higher dosage, in all breast cancer operations. Other parameters were also evaluated, e.g. hormones (T3, T4, cortisol, progesterone, estradiol, prolactin), immune values (lymphocytes, immune globulins, complement, phagocytic activity, morphologic and cytochemical changes), amino acids and their derivates in plasma and in the tumor tissue. The effect of the NSC-631570 on the various parameters in breast cancer patients has been studied. Best results were achieved with higher dosage of NSC-631570. Almost every patient noted the improvement of the general well-being, sleep and appetite. During the surgery, the tumors as well as involved lymph nodes were presented sclerotic and well demarcated from the surrounding tissue. This alleviated the surgical removal of the tumor considerably. In the tumor tissue, increased concentration of the amino acid proline was revealed indicating augmented production of connective tissue that demarcates the tumor from surrounding tissue. NSC-631570 improved also the amino acid balance of patients. NSC 631570 is the very first proton anticancer preparation and due to this after administration it accumulates in tumors very fast that can be seen under the UV-light thanks to its the autofluorescence. Besides, this preparation can regenerate the immune system and works as an immune modulating agent. The selective effect of the NSC 631570 has been confirmed by 120 universities and research centers in the world. Until now this preparation has been tested on over 100 cancer cell lines and on 12 normal cell lines.
Oral Session 1:
- Health Care | Cardiac Emergency Medicine | Emergency Medicine: Procedures and Perfection | Oncology Nursing | Neonatal Care and Midwifery
Title: When ACLS fails: Double sequential defibrillation- A case report and review of the literature
Biography:
Shafeek Kiblawi received his Doctorate of Medicine in 2012 from the American University of Beirut. He is currently in his final year of Residency in Emergency Medicine at the American University of Beirut Medical Center. Shafeek previously worked in EMS as a Paramedic in the United States and has experience in Firefighting and Disaster Medicine.
Abstract:
Using two defibrillators at the same time on a patient may seem unusual to those unfamiliar with the concept. This procedure, deemed double sequential defibrillation, is being used for refractory or recurrent ventricular fibrillation when standard Advanced Cardiac Life Support (ACLS) fails. Although not fully understood, mounting evidence exists as to the efficacy of double sequential defibrillation and multiple theories about its mechanism of action can be found in the literature. We report a case of an elderly male with massive gastrointestinal bleeding who developed refractory ventricular fibrillation in the Emergency Department and was successfully resuscitated using double sequential defibrillation. We subsequently review the literature and describe the current evidence and understanding regarding double sequential defibrillation.
Title: Chronic traumatic stress disorder: Fact or fictional
Biography:
Miranda Wessels is a MBChB student at the university of South Africa. She has completed her Diploma in Architecture at the Tshwane university of Technology in 2015. She completed her BAA qualification in 2015. She is part of the training network of the CPR – AED initiative. She is currently busy developing a conference which focus awareness on mental health amongst health faculty students.Miranda is still operational in the pre-hospital environment working for Netcare 911, as well as working in-hospital for Vermaak and Partners Pathologist.
Abstract:
Chronic traumatic stress disorder is a mental health problem that develop in certain people due to chronic exposure to stress, high pressured expectations and high cognitive demands. It is important to look at factors causing CTSD in Emergency medical personal. Causing factors that is mostly seen in emergency medical personal includes extended working hours, high pressure working environments and excessive emotional demands. Focus is necessary on how to overcome these factors and how to prevent future relapse. Physicians need to be aware of behavioural symptoms like hostility, social isolation, agitation etc. Physiological symptoms such as fear, severe anxiety and insomnia can also be experienced. CTSD is treatable and methods for better awareness should be established.
