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EMERGENCY
MEDICINE
Saturday, May 4, 2002
12:00pm-3:00pm
Mini Course
4105
Update on Injury Control
Chair: Gary A. Smith,
Children's Hospital, Columbus, OH
The field of injury control
continues to evolve. Over the past decade new sources of
injuries have arisen, new information on old or
overlooked causes has been obtained, and new techniques
for preventing and minimizing the impact of certain
injuries have been developed and evaluated. This session
will review these advances and outline pertinent next
steps for health policy, research and clinical care.
Overview
Gary A. Smith, Columbus Children's Hospital,
Columbus, OH
Firearm Injuries: Just the Facts
M. Denise Dowd, Children's Mercy Hospital,
University of Missouri, Kansas City, MO
Update on Product-Related Injuries
Gary A. Smith, Columbus Children's Hospital,
Columbus, OH
Break
Prevention of Motor Vehicle-Related Injuries
Phyllis F. Agran, Pediatric Injury Prevention
Research Group, Health Policy and Research, University
of California, Irvine, CA
Current Federal Agency Priorities in Childhood Injury
Prevention Research
Richard A. Schieber, Centers for Disease Control and
Prevention, Atlanta, GA
3:15pm-5:15pm
Topic Symposium
4200
Cloning and Embryonic Stem Cells
Chair: Judith Hall,
University of British Columbia, Vancouver, Canada
There is enormous public
interest in cloning and embryonic stem cells. This
symposium will update the pediatric community on recent
developments and raises a variety of policy and ethical
issues.
Overview
Judith G. Hall, University of British Columbia,
Vancouver, Canada
Imprinting and Reprogramming
Arthur L. Beaudet, Baylor College of Medicine,
Houston, TX
Cloning
Brigid Hogan, Vanderbilt University Medical Center
and the Howard Hughes Medical Institute, Nashville, TN
Embryonic Stem Cells
Janet Rossant, Samuel Lunenfeld Research Institute,
Mount Sinai Hospital ON, Canada
3:15pm-5:15pm
Platform Session
4254
Inflicted Trauma/Child Abuse
Chairs: M. Denise Dowd and
John M. Leventhal
5:15pm-7:15pm
Poster Session I (Author Attended)
and Opening Reception
– Emergency Medicine:
Risk Assessment/Diagnosis
Sunday,
May 5, 2002
8:00am-11:00am
Workshops
5106
Reducing Medication Errors – Time To Take Action
Each year there are thousands
of injuries and deaths in U.S. hospitals from medication
errors. These blunders cost millions of dollars and
result in loss of public confidence in our health care
system. Medication errors are the second most frequent
and the second most expensive event causing liability
claims. Errant orders on the inpatient unit and
incorrect prescriptions in the ED and clinics are
common. Physicians, nurses, pharmacists, students,
manufacturers and even caregivers all share
responsibility. Many errors are preventable.
This workshop will focus on common sources of medical
errors and ways to prevent them. Workshop leaders will
discuss specific issues including:
- Root cause analysis looking at systems issues
rather than individuals
- Moving toward non-punitive approaches to reporting
errors
- Developing teaching programs for housestaff and
students
- The role of the pharmacist—how can they help?
- New technology—are computer systems useful? Are
the programs affordable?
- Creating multidisciplinary medication use process
improvement teams
- Approaching the family after a medical error—legal
and ethical implications
Participants will be asked to share their ideas and
experiences. It is hoped that participants will be able
to develop a multidisciplinary program in their own
institutions to reduce and manage medical errors.
S. Selbst, S. Levine, A.I. duPont Hospital for
Children, * Wilmington, DE, and J. Fein, J. Gould, M.
Friedman, C. Mull, Children’s Hospital of
Philadelphia, Philadelphia, PA
8:00am-11:00am
Special Interest Groups
5111
Emergency Medicine
The Pediatric Emergency
Medicine SIG meeting is planning an excellent meeting in
Baltimore this year. Our first topic for discussion will
be the "management of febrile children in the post
pneumococcal vaccine era: Should we change our
practice." Each member of the panel of experts will
give a brief presentation followed by a panel
discussion. In the second part of the meeting we will,
again, have a formal presentation on "teaching
cost-effective medicine in the emergency
department." The presentations and discussion of
each topic will be one hour and fifteen minutes long.
Pediatric Emergency Medicine fellows and junior faculty
will have the opportunity to present their research
posters during the break between the two discussion
topics.
Chair: Halim Hennes, hhennes@post.its.mcw.edu
5114
Pain
The Special Interest Group on
Pain in Children focuses each year on an emerging area
in the management of children's pain. Topics at previous
meetings have included long-term consequences of
inadequately treated pain and development of
institutional approaches to promote pain management. The
focus this year will be on minimizing injection pain. It
is particularly relevant given immunization schedules
which cluster multiple injections at the same visit. The
session will attempt to address behavioral and
pharmacological approaches that decrease injection pain
as well as strategies for implementing such approaches
in busy ambulatory settings.
Chair: Neil Schechter, nschecht@stfranciscare.org
1:45pm-2:30pm
State of the Art Plenary
5590
Children as Victims of Bioterrorism: Protecting the
Fragile Host
Chairs: Phyllis Dennery,
Stanford University School of Medicine, Palo Alto, CA
and Tina Lee Cheng, Johns Hopkins University School of
Medicine, Baltimore, MD
With the recent world events
and new threats of biowarfare, what should pediatricians
know? Due to their size and physiology, children are at
higher risk of injury from bioterrorism. This session
will address the biology, clinical manifestations, and
possible preventive strategies for likely biowarfare
agents. The unique vulnerability of the child will be
addressed.
Overview
Phyllis A. Dennery, Stanford University School of
Medicine, Palo Alto, CA
Children as Victims of Bioterrorism: Protecting the
Fragile Host
Ralph D. Feigin, Baylor College of Medicine,
Houston, TX
Discussion
2:00pm-4:00pm
State of the Art Plenary
5701
Children as Research Subjects: Ethical and Regulatory
Issues
Chair: Myron Genel, Yale
University School of Medicine, New Haven, CT
A number of highly publicized
adverse events, including the death of two volunteers
participating in non-therapeutic research, and the
federal shutdown of research at many well-recognized
academic institutions because of inadequate compliance
with regulatory requirements have intensified scrutiny
of the protection afforded to human subjects
participating in research, including children.
Furthermore a Maryland court has recently decreed that
children cannot participate in research without the
potential for direct benefit. As a consequence there has
been increasing media attention and Congressional
concern regarding the adequacy of institutional
oversight and investigator attentiveness to established
standards and regulations. In addition, new regulations
issued under the Health Insurance Portability and
Accountability Act of l996(HIPAA) threaten the capacity
to conduct health services and outcomes research. These
issues will be addressed in the 9th annual Public Policy
Plenary Symposium in an interactive format intended to
stimulate dialogue among the members of the panel and
with the audience.
Overview
Myron Genel, Yale University School of Medicine, New
Haven, CT
Overseeing Research in Children: New Concerns and New
Regulations
Alan R. Fleischman, The New York Academy of
Medicine, New York, NY
International Health Research: Where Bioethics,
Politics and Economics Converge
Eric M. Meslin, Indiana University Center for
Bioethics, Indianapolis, IN
Compliance: What You and Your Institution Need to
Know (and Do)
Pearl O'Rourke, Partners HealthCare System, Inc.,
Boston, MA
HIPAA, Privacy & Confidentiality and Research In
Children?
Brian Kamoie, The George Washington University,
Washington, DC
Discussion
Sponsored jointly with the Public Policy Council
of the APS, AMSPDC, SPR and the Public Policy Committee
of the APA
Partially supported by an educational grant from
Columbus Children's Hospital
4:15pm-6:15pm
Platform Session
5904
Emergency Medicine/Infectious Diseases
Chairs: David M. Jaffe and
Kathy N. Shaw
4:15pm-6:15pm
Platform Session
5910
Pain: Opportunities and Outcomes
Chair: Robert M. Kennedy
FEATURED SPEAKER:
Jeffrey L. Blumer
Monday, May 6, 2002
8:00am-10:00am
Platform Session
6056
Injury
Chairs: Katherine Kaufer
Christoffel and Alan D. Woolf
10:15am-12:15pm
Platform Session
6200
Emergency Medicine/Respiratory Disorders
Chairs: Louis M. Bell and
Halim Hennes
10:15am-12:15pm
Platform Session
6201
Emergency Medicine—Psychiatric/General
Chairs: Jane F. Knapp and
Linda Quan
2:45pm-4:45pm
Topic Symposium
6500
Antibiotic Resistance: The Race Is On (PIDS
Symposium)
Chairs: Joseph W. St. Geme
III, Washington University, St. Louis, MO and Richard F.
Jacobs, University of Arkansas, Arkansas Children's
Hospital, Little Rock, AR
In recent years there has been
an explosion in the prevalence of antibiotic resistance.
As a consequence, treatment decisions now are often
complicated, and treatment is more and more commonly
unsuccessful. In this symposium, speakers will review
the epidemiology of antibiotic resistance, the current
state in treating resistant Staphylococcus aureus
and resistant gram-negative bacteria, and new approaches
to antibiotic discovery.
The Evolving Epidemiology of Antibiotic Resistance
Daniel Sahm, Focus Technologies, Inc., Herndon, VA
The Challenge of Antimicrobial Therapy for the
Staphylococci: Our Backs to the Wall
Robert S. Daum, The University of Chicago, Chicago,
IL
Increasing Resistance in Gram-Negative Bacteria: The
Role of Extended Spectrum Beta Lactamases
David L. Paterson, University of Pittsburgh Medical
Center, Pittsburgh, PA
Genomic Approaches to Antibiotic Discovery
Molly B. Schmid, Integrative Proteomics, Inc.,
Toronto, Canada
Sponsored jointly with the Pediatric Infectious
Diseases Society
Tuesday, May 7, 2002
8:00am-10:00am
Platform Session
7057
Injury: Motor Vehicle
Chair: Flaura Koplin
Winston
8:00am-10:00am
Poster Symposium
7058
Modeling To Detect Bioterrorism and Other Threats to
Public Health
Chairs: Stephen M. Downs
and Sarah S. Long
8:45am-11:45am
Mini Course
7090
Controlling Asthma in the New Millennium
Chair: James S. Seidel,
Harbor-UCLA Medical Center, UCLA School of Medicine,
Torrance, CA
Although we have an
understanding of the pathophysiology and treatment of
asthma, the incidence, severity, and mortality from the
disease is increasing. Twice in the past 10 years the
National Heart Lung and Blood Institute has issued
Guidelines for Diagnosis and Management of Asthma. These
have not been widely adopted nor used. This mini course
will explore the management of asthma in the emergency
department and office setting and explore new methods to
form care partnerships between practitioners, families
and children to improve the care of asthma.
The NHLBI Guidelines on the Diagnosis and Management
of Asthma; Why Have We Failed to Use Them. Results of a
National Qualitative Study
James Seidel, Harbor-UCLA Medical Center, UCLA
School of Medicine, Torrance, CA
Management of Acute Asthma in the Emergency
Department
Ellen F. Crain, Albert Einstein College of Medicine,
Bronx, NY
Managing Asthma Over Time: Rescue Medication Versus
Therapeutic Interventions
Shirley A. Murphy, University of New Mexico School
of Medicine, Albuquerque, NM
Forming Care Partnerships with Patients and Families
David Evans, Columbia University College of
Physicians & Surgeons, New York, NY
8:45am-11:45am
Special Interest Group
7111
Pediatric Emergency Medicine Program Directors
The program for Baltimore will
continue the theme of development of programs to mentor
young faculty in their career paths of becoming scholars
and excellent clinical educators. There will be
discussion on goal setting and issues to improve
professional growth. The second part of the program will
discuss the initial data entered in the ED benchmarking
data that is currently being collected with your
assistance. This includes characteristics of PEDs and
descriptions/demographics of our programs and faculty.
We look forward to a strong contingent at the meeting.
For information contact Richard Ruddy, MD Cincinnati,
Ohio 513-636-7973 or richard.ruddy@chmcc.org
Chair: Richard Ruddy, richard.ruddy@chmcc.org
10:00am-11:45am
State of the Art Plenary
7200
Pediatric Pain
Chairs: K. J. S. Anand,
Arkansas Children's Hospital, Little Rock, AR and R.
Whit Hall, University of Arkansas for Medical Sciences,
Little Rock, AR
Critical periods for early
brain development are associated with neurogenesis,
neuronal migration, exuberant synaptogenesis, and
developmental regulation of cell differentiation and
apoptosis. Exposure to repetitive or prolonged pain
during critical windows in development can permanently
alter the neural substrates associated with pain
processing as well as other behavioral domains. This
symposium will describe age related changes in pain
processing, recent advances in analgesic pharmacology
for pediatric patients, and the long-term effects of
neonatal pain on subsequent cognition and behavior.
Translational research applied to pain processing and
analgesic management will be emphasized, to provide the
practicing pediatrician with the scientific rationale
for current clinical practice.
Introduction and an Overview of Pediatric Pain
Research
K. J. S. Anand, Arkansas Children's Hospital and
University of Arkansas for Medical Science, Little Rock,
AR
R. Whit Hall, University of Arkansas for Medical
Sciences, Little Rock, AR
Repetitive Neonatal Pain: Long-Term Effects in Human
Infants?
Ruth Eckstein Grunau, University of British
Columbia, Vancouver, Canada
Advances in Pediatric Analgesic Pharmacology for the
Management of Acute and Chronic Pain
Charles Berde, Children's Hopsital, Boston, MA
Managing the Pain of Emergency Procedures: Sedation,
Schizophrenia and Senility
David M. Jaffe, Washington University School of
Medicine, St. Louis Children's Hospital, St. Louis, MO
Pain, Plasticity, and Preterm Birth: Findings From
the Bench and Bedside
K. J. S. Anand, Arkansas Children's Hospital and
University of Arkansas for Medical Science, Little Rock,
AR
Conclusions
R. Whit Hall, University of Arkansas for Medical
Sciences, Little Rock, AR
1:45pm-3:45pm
Hot Topic
7702
Disaster Preparedness: Beyond 9/11
Chairs: Tina L. Cheng,
Johns Hopkins University School of Medicine, Baltimore,
MD; Danelle Laraque, Mount Sinai School of Medicine, New
York, NY; and Benard Dreyer, New York, NY
The impact of 9/11 and the
public health aftermath have affected us personally and
professionally. This session will address what the child
health professional needs to know regarding disaster
planning and preparedness. Speakers will review and
provide updates on national and regional systems for
emergency management and how those systems interact with
local public health agencies, the pediatrician's role in
the community's preparedness including what the school
system, the pediatric office and the patient should be
doing to prepare and respond, recognition and management
of chemical and biologic agents of terrorism, and the
psychological reactions to disaster and stress.
Disaster Planning and Preparedness for Child Health
Professionals
George L. Foltin, New York University School of
Medicine and Bellevue Hospital Center, New York, NY
Biologic Agents of Terrorism
Anne Fine, New York City Department of Health, New
York, NY
Chemical Agents of Terrorism
Fred Henretig, University of Pennsylvania School of
Medicine and Children's Hospital of Philadelphia,
Philadelphia, PA
Helping Children Cope with Terrorism and Disasters
David J. Schonfeld, Yale University School of
Medicine, New Haven, CT
Discussion
1:45pm-3:45pm
Platform Session
7800
Asthma
Chairs: Ellen F. Crain and
Richard M. Ruddy
Includes Ludwig–Seidel
Award:
Does End-Tidal Capnography Predict the Need for
Hospitalization in Acute Childhood Asthma?
Sergey Kunkov
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