Title: EMc1-Emergency Medicine – Critical Care: Allergies/Anaphylaxis; Shock; Aortic Emergencies

Faculty: Bryant Allen, M.D , Michael E. Winters, M.D., F.A.A.E.M., F.A.C.E.P.

Original Release Date: July 1, 2020  Expiration Date: July 1, 2023

TOPIC 1: Deadly Allergies and Anaphylaxis. Upon completion of this session, the participant should be able to: COMP,EBM

1. Determine the clinical criteria for anaphylaxis using The World Allergy Organization guidelines.
2. Appraise the use of epinephrine in patients with anaphylaxis using evidence-based medicine.
3. Assess the role of second-line medications commonly used in the treatment of anaphylaxis.
4. Specify which patients with anaphylaxis require continued observation or admission.

TOPIC 2: Undifferentiated Shock...Making a Difference. Upon completion of this session, the participant should be able to: COMP, EBM

1. Identify crucial pearls from the history and physical examination that identify patients who may be critically ill.
2. Discuss important initial management steps for the patient with signs of shock according to evidence-based medicine.
3. Implement a systematic approach to quickly identifying the cause of shock in critically ill patients.

TOPIC 3: Aortic Emergencies. Upon completion of this session, the participant should be able to: COMP,EBM

1. Specify the pathophysiology and clinical presentations, and formulate ED management using evidence-based medicine of the following:
a. Abdominal aortic aneurysm,
b. Traumatic aortic disruption,
c. Essentials of aortic dissection.

Title: EMcd-Emergency Medicine - Cardiology: Atrial Fibrillation; Congestive Heart Failure; Carditis

Faculty:Alyson N. Owen, M.D., Gregary Marhefka, M.D

Original Release Date: July 1, 2020  Expiration Date: July 1, 2023

TOPIC 1: Atrial Fibrillation

Upon completion of this session, the participant should be able to: ^{EBM, GL, COMP}

1. Relate the importance of anticoagulation, based upon CHADS₂VASC Risk Scores and the ACC/AHA Guidelines in the management of atrial fibrillation.
2. List various pharmaceutical and non-pharmaceutical methods of normalizing ventricular rate.
3. Compare two possible strategies for cardioversion in atrial fibrillation.
4. Assess the potential benefit and harm of antiarrhythmic therapies.

TOPIC 2: Congestive Heart Failure.

Upon completion of this session, the participant should be able to:  ^{GL, COMP}

1. Recognize the symptoms of congestive heart failure and appropriately Stage as per the ACC/AHA Guidelines.
2. Identify common causes of systolic heart failure.
3. Employ current ACCF/AHA Guidelines and standard-of-care therapies, differentiating between those treatments which reduce mortality and those that improve symptoms.

TOPIC 3: Distinguishing, Diagnosing and Treating Carditis: Pericarditis, Myocarditis and Endocarditis.

Upon completion of this session, the participant should be able to: ^{EBM, GL, COMP}

1. Determine indication and timing of cardiac MRI and/or endomyocardial biopsy to delineate the etiology, prognosis and treatment course in acute myocarditis using evidence-based medicine.
2. Recognize acute myocarditis when treating a new acute heart failure patient.
3. Apply evidence-based medicine treatment strategies in acute pericarditis.
4. Identify and apply ACC/AHA/ASE guideline-directed patient selection for transesophageal echocardiogram in suspected or confirmed acute endocarditis
5. Apply ACC/AHA guidelines in management and timing of operative referral for acute endocarditis

Title: EMed-Emergency Medicine - Emergency Department Challenges: Chest Pain; Head Injury; Nephrolithiasis & Pyelonephritis

Faculty: Kenneth H. Butler, D.O., Andrew D. Perron, M.D., Bryant Allen, M.D.

Original Release Date: July 1, 2020  Expiration Date: July 1, 2023

TOPIC 1:  Chest Pain in The Emergency Department - Value of Heart Score.

Upon completion of this session, the participant should be able to: ^{EBM, GL, COMP}

1. Who should we heart score – Appraise which patients we should heart score in the ED.
2. Do risk factors matter –Identify specific risk factors that are significant and will change your approach to the patient with Chest Pain using the HEART Score of the European Society of Cardiology.

3. What is the incidence of a missed MI – Assess the incidence of a missed MI in patients discharged from the ED.
4. Determine when stress testing is most appropriate - where are we today with a stress test.
5. What about a slightly elevated troponin – Interpret how a slightly elevated troponin will affect your care and a patient’s disposition.

TOPIC 2: Minor Closed Head Injury:  An EvidenceBased Approach. 

Upon completion of this session, the participant should be able to:  ^{GL, COMP}

1. Assess and relate the pathophysiology of minor closed head injury.
2. Appraise the literature as it pertains to minor closed head injury and apply ACEP Guidelines as they relate to minor CHI.
3. Recommend diagnostic algorithms appropriate for the evaluation and management of minor CHI in light of best-evidence available.

TOPIC 3: Nephrolithiasis & Pyelonephritis. Upon completion of this session, the participant should be able to: ^{EBM, GL, COMP}

1. Illustrate the pathophysiology and clinical presentation of these two entities.
2. Specify the best-evidence strategy in both imaging for diagnosis of nephrolithiasis and management of this pathology in the Emergency Department.
3. Discuss the classifications of upper urinary tract infections and pyelonephritis, as current IDSA guidelines for treatment of these classifications.

Title: EMmk-Emergency Medicine - Must Know: High-Risk Abdomen; Post-Arrest Care; Urogenital Emergencies

Faculty: Kenneth H. Butler, D.O., Stephen Winters, M.D., Bryant Allen, M.D.

Original Release Date: July 1, 2020  Expiration Date: July 1, 2023

SPECIFIC OBJECTIVES FOR EACH TOPIC:

TOPIC 1: The High-Risk Abdomen You Cannot Afford To Miss.

Upon completion of this session, the participant should be able to: ^{EBM, GL, COMP}

1. Identify clinical presentations and findings that should alert you to not being fooled by a negative test.
2. Develop clinical strategies that will enable you to think outside the abdominal “black box.”
3. Determine how one simple bedside test can save a life.

TOPIC 2: Post-Arrest Care 

Upon completion of this session, using evidencebased medicine and clinical practice guidelines, to in the AHA CPR and emergency cardiovascular care, the participant should be able to: ^COMP,EBM

1. Develop goals for oxygenation and ventilation in the patient with return of spontaneous circulation following cardiac arrest.
2. Identify the optimal mean arterial blood pressure in post-arrest patients.
3. Employ appropriate use of targeted temperature management in post-arrest patients.
4. Determine which post-arrest patients should be sent for emergent cardiac catheterization.

TOPIC 3: Urogenital Emergencies: Torsion & Priapism.

Upon completion of this session, the participant should be able to: ^{COMP, GL}

1. Describe the anatomy, physiology and epidemiology of priapism and torsion.
2. Discuss the evaluation and potential causes of both high and low flow priapism.
3. Discuss ED management considerations and guidelines for the treatment of priapism.
4. Describe the evaluation and bedside reduction technique for testicular torsion, including recent clinical decision tools and transfer recommendations.

Title: EMtr-Emergency Medicine - Trauma: Airway Trauma; Trauma in Pregnancy; Sick Trauma Patient/Non-Trauma Center

Faculty: Bryant Allen, M.D., Kenneth H. Butler, D.O.

Original Release Date: July 1, 2020  Expiration Date: July 1, 2023

SPECIFIC OBJECTIVES FOR EACH TOPIC:

TOPIC 1 Trauma Airways

Upon completion of this session, using the evidence-based guidelines from the AAP, the participant should be able to: ^{EBM, COMP}

1. Specify and apply critical issues in the evaluation and management of the airway in the critically injured patient using evidence-based medicine.
2. Identify the potential pitfalls in traditional methods of airway management in the critically injured patient.
3. Discuss the potential utility of various pharmacologic agents in obtaining airway access in trauma.
4. Demonstrate an understanding of surgical airway management, both open and percutaneous approaches.

TOPIC 2: Trauma in Pregnancy

Upon completion of this session, the participant should be able to: ^COMP

1. Illustrate the anatomic & physiologic changes of pregnancy that are relevant to traumatic injury.
2. Describe the common injuries associated with trauma in pregnancy, as well as their initial assessment and management.

3. Discuss practice management variation that may be necessary in the evaluation and management of the pregnant traumatized patient.

TOPIC 3: Sick Trauma Patient in the Non-Trauma Center

Upon completion of this session, the participant should be able to: ^COMP

1. Recognize why we no longer follow the hematocrit and understand the utility of serial lactates in the trauma patient.
2. Detect subtle risks and signs in a retroperitoneal bleeding patient.
3. Distinguish who gets permissive hypotension and who should not.
4. Utilize antifibrinolytics in bleeding patients for medical transport.