Society for Academic Emergency Medicine

1996 Annual MeetingMay 5-8, 1996

f)enveri Colorado

INDEX

General Information.. . . . . . . . . . . . . . . . . . . . . . . . . . . .1Schedule of Events ...............4Sunday, May 5 Activities

Paper/Poster Presentations......... .................12Didact ics . . . . . . . . . . . . . . . . . . .15

Monday, May 6 ActivitiesPaper/Poster Presentat ions.. . . . . . . . . . . . . . . . . . . . . . . . . I7Didact ics . . . . . . . . . . . . . . . . . . .20AACEM Annual Meeting... .......22CORD Agenda... . . . . . . .23

Tiresday, May 7 ActivitiesPaper/Poster Presentations......... .................24Didactics . . . . . . . . . . . . . . . . . . .27Annual Business Meeting Agenda .........,...29

Award Presentat ions . . . . . . . . . . . . . . . . . , . . . . . . . . . . . .29Leadership Award...... ...........30Academic Excellence Award...... ...........31Slate of Nominees .. . . . . . . . . . . . . . .32Proposed Constitution and Bylaws Amendments ...................35

Wednesday, May 8 ActivitiesPaper/Poster Presentations......... .................36Didactics . . . . . . . . . . . . . . . . . . .40

Exhib i tors . . . . . . . . . . . . . . . . . . . . . . . . . . . ,42Positions Available. .............44Meeting Room Floor Plans ................52

All attendees are urged to complete the Annual Meeting evaluation form.Completed evaluation forms should be

returned to th9 Registration desk before leaving Denver.Feedback is critical to the development of successful Annilal Meetings.

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GENERAL INFORMATIONRegistration and InformationThe SAEM Registration Desk will be open during the times listedbelow:Saturday, May 4, 12:00 noon-7:00 pmSunday, May 5, 7:00 am-12:00 noon and 1:00-5:00 pmMonday, May 6,7:00 am-12:00 noon and 1:00-5:00 pmTuesday, May 7,1:00 am-12:o0 noon and 1:00-5:00 pmWednesday, May 8, 7:00 am-12:00 noon and 1:00-4:00 pm

Residents'Night OutThe residents of the Denver Health and Hospitals Residency inEmergency Medicine; the Department of Emergency Medicine,Denver General Hospital; and the Division of Emergency Med-icine at the University of Colorado Health Science Center are host-ing a Residents' Night Out for all residents attending the SAEMAnnual Meeting. The event will be held on Tuesday, May 7 begin-ning at 8:00 pm at the Bluebird Theater at 3317 East ColfaxAvenue in Denver. Music will be provided by Groove Kitchen,which boasts two residents as members of the band.

Moderated Poster SessionsThe Program Committee is continuing the development of moder-ated poster sessions to encourage discussion and feedback to pre-senters, as well as to the audience. This year moderated "walk-

along" sessions have been scheduled. These sessions will be heldduring the scheduled poster session in the Exhibit Hall. Themoderated poster sessions have been staggered to begin at two dif-ferent times and will consist of 7-12 abstracts per session. Thenames of the moderators are published in this program and the des-ignated time for the moderated session is published immediatelyfollowing the moderator's name. Attendees wishing to participatein the moderated poster sessions should meet at the first poster inthe topic area at the designated time.

Poster presenters are asked to put up their posters by 12:00 noonon the day of their poster presentation. The poster sessions arescheduled for 2.5 hours in the afternoon and must be taken downat the conclusion of the Poster Session.

ABEM ActivitiesABEM has three informational sessions planned for AnnualMeeting participants. A packet of reference material forthese sessions will be available at the SAEM ResistrationDesk.

ABEM: Its Mission, May 5, 1:30-2:30 pmABEM directors and staff will provide information onrecent Board actions, review current Board activities, andreport on the residency and resident data gathered throughthe annual survey of programs. Time will be included forquestions from participants.

ABEM Interactions with X'aculty, May 7,3:00-4:00 pmThis session will provide an opportunity for program direc-tors and faculty to interact informally with ABEM directorsand staff.

ABEM Interactions with Residents, May 8, 1:30-2:30 pmThis session will provide an opportunity for residents tointeract informally with ABEM directors and staff.

Photography CompetitionThe entries received for the 1996 Photography Competition devel-oped by Lany Stack, MD, will be displayed during the AnnualMeeting. These entries will be judged and awards for the top threephotographs in four categories will be announced at the conclusionof the Annual Meeting.

Saturdap May 4: Schedule of Events8:00 am-5:00 pmEmergency Care of the Elder Person: A Course for TeachersEmergency Medicine Photography WorkshopRegional CPC Competition, Terrace Level

11.:00 am-2:00 pmAcademic Emergency Medicine Editorial Board Meeting,Gold Room

2:00-5:00 pmSAEM Board of Directors Meetinq. Colorado Room

5:30-6:30 pmCPC Reception (cash bar), Silver Room

6:00-9:00 pmMeeting of the SAEM Board and Chairs of Committees andTask Forces, Denver Room

8:00-11:00 pmEMRA Board of Directors. Colorado Room

Continuing Medical EducationMichigan State University, College of Human Medicine, ac-credited by the Acreditation Council for Continuing Medical Edu-cation, certifies that this program meets the criteria for up to 38hours of Category I credits of the Physician's Recognition Awardof the American Medical Association.

1996 Regional CPC CompetitionThe 1996 Regional CPC Competition will be held on May 4 from8:00 am-4:30 pm on the Terrace Level. Annual Meeting attendeesare encouraged to attend this important activity which showcasesEmergency Medicine Residency Programs. There is no registra-tion fee to attend.The competition consists of the presentation anddiscussion of the ten best cases submitted from each of the fivegeographical regions. The Best Discussant and Best Presenter re-cipients from each region will be announced during the CPC Re-ception in the Silver Room at 5:30-6:30 pm. The Regional Com-petition is sponsored by ACEP, CORD, EMRA, and SAEM.

Medical Student SessionIn order to increase medical student participation and awareness ofthe opportunities for a career in emergency medicine, SAEM issponsoring a special session for all interested medical students.The session will be held Sunday, May 5 at 7:00-9:00 pm in theSilver Room. The program will feature the following:"ER - Is it Really Like the Show? A Day in the Life of the Emer-gency Physician," Paul Gennis, MD, Residency Director, JacobiMedical Center"What to Look for in a Residency Program," David Sklar" MD,Chairman, Deparlment of Emergency Medicine, University ofNew Mexico"The Application Process," Louis Binder, MD, Associate Dean forStudent Affairs, University of Illinois, Chicago

A panel discussion comprised of the following speakers will con-clude the session: Steven Dronen, MD, Residency Director, Univ-ersity of Michigan; Carey Chisholm, MD, Residency Director,Methodist Hospital of Indiana, Inc.; Marcus Martin, MD, Resi-dency Director, Medical College of Pennsylvania./HahnemannHospital-Allegheny Campus; and Samina Shahabuddin, MD,Third Year Resident, Jacobi Medical Center.

BanquetThe Annual Meeting Banquet will be held on the evening of May8 and this year will be held at the Denver Museum of Natural His-tory. Halls of the museum will be open for viewing before andafter dinner. In addition, entertainment will be provided by thepresentation of the Imago Obscura Award and the Ridiculous Ab-stract Competition.

This year's Ridiculous Abstract presentations will be:"The Value of Emergency Medicine: A Placebno Controlled Studyof Economic, Social and Medical Impact," Louis Durkin, MD"The Starbuck Syndrome: Community-Wide Pre-Conditioning forSudden Cardiac Death," Paul Pepe, MD"Evidence for Genetic Suppression of Aversion to Nasal Mucous,"Ron Walls, MD

Presenting this year's Imago Obscura Award will be the 1995recipient, Chuck Cairns, MD.

SAEM members are entitled to purchase one ticket at the dis-counted rate of $15 for active, asiociate and international mem-bers; and $35 for medical student and resident members. Ticketsfor non-members are $45.

Transportation will be provided to and from the Museum withbuses leaving at approximately 6:00 pm and returning around10:00 pm. A cocktail reception at the Museum will proceed theBanquet. Each attendee will receive two complimentary drink tick-ets and a cash bar will also be available.

There will be a limited number of tickets available for purchase inDenver and all tickets absolutely must be purchased by May 6.Also, ifyou change your mind, unfortunately, there are no refundssince meal counts are required a week in advance of the Banquet.

Speakers'Ready RoomA speakers' ready room will be available for those who wish tocheck their slides in advance of their presentation. The speakers'ready room will be available starting May 4 at 7:00 am and will belocated in the Aspen Room (Mezzanine Level).

Opening Cocktail ReceptionSAEM is hosting an opening cocktail reception on Sunday, May 5at 6:00-7:30 pm in the South Convention Lobby. A11 AnnualMeeting registrants are invited to attend. Hors d'oeurves will beserved and a cash bar will be available.

ExhibitsExhibits will be available for viewing on May 6 and 7 in the Ex-hibit Hall on the Plaza (ground) Level. The poster sessions,Innovations in Emergency Medicine Education exhibits, coffeebreaks and the registration desk will also be located in the ExhibitHall. Please take an opportunity to view the exhibits during thescheduled coffee breaks and exhibit hours.

Board of Directors MeetingsThe SAEM Board of Directors will meet on Saturday, May 4 at2:00-5:00 pm in the Colorado Room and Tuesday, May 7 at 6:00-9:00 pm in the Century Room. All interested members and othersare invited to attend these meetinss of the Board.

Annual Business Meeting/ElectionsSAEM will convene its Annual Business Meeting on Tuesday,May 7 at 1:30-3:00 pm in Grand Ballroom D & E. At this meet-ing Lewis Goldfrank, MD, will introduce incoming president,Steve Dronen, MD. Agenda items for the business meeting willinclude election of officers, Board and committee members, pre-sentation of awards, amendments to the Constitution and Bylaws,offtcers' reports, and other items of business presented by themembership. A11 members of the Society are urged to attend, how-ever, only active members are eligible to vote.

Evening Meetings and Activities

Sunday, May 55:00-8:00 pm EMRA Board of Directors, Denver Room

6:00-7:30 pm SAEM Opening Reception

7:00-9:00 pm Medical Student Session, Silver Room

Monday May 64:00-6:00 pm EMF/ACEP Teaching Fellowship Wine and

Cheese Reception, Colorado Room

5:00-6:30 pm Medical College of Pennsylvania Recep-tion, Gold Room

5:45-7:00 pm Boston UniversitylBoston City HospitalReception and Book Signing, Denyer Roont

6:00-7:00 pm EMRA Awards Reception, Silyer Room

6:00-7:30 pm SAEMIssues Forum, Grand Ballroom D & E

Iiresday, May 76:00-9:00 pm SAEM Board of Directors Meeting, Century

Roctm

Wednesday, May 86:00-10:00 pm SAEM Banquet, Denver Museum of Natural

History

Issues ForumAll members are invited to palticipate in an Issues Forum on Mon-day, May 6 at 6:00-7:30 pm in Grand Ballroom D & E. This openforum is an opportunity for the membership to exchange ideas withthe Board and chairs of committees and task forces on the imoortantissues in academic emergency medicine and the Society's actlvides.

AACEMThe Association of Academic Chairs of Emergency Medicine(AACEM) will meet on Monday, May 6 from 8:00 am until 12:00noon. AACEM will convene its annual business meetins on Mav6 from l2:00 noon until l:30 om.

CORDThe Council of Emergency Medicine Residency Directors(CORD) will meet on Monday, May 6 at 12:30-6:00 pm in theMajestic Ballroom. The program will include educational ses-sions, roundtable discussions, reports, elections, and award pre-sentations and an agenda is published in this program.

EMRA Awards ReceptionResidents and faculty are invited to socialize and to honor three res-idents for outstanding achievement at the EMRA Awards Receptionon May 6 from 6:00-7:00 pm in the Silver Room. EMRA thanksCoastal Physician Services, Inc. for its co-sponsorship of the JeanHollister Award, EmCare for its co-sponsorship of the AcademicExcellence Award, and Weatherby Health Care for its co-sponsor-ship of the EMRA Dedication Award. EMRA gratefully acknowl-edges this year's reception sponsors: California EmergencyPhysicians and Florida Organization of Independent Groups.

Message BoardPhone messages can be left at the SAEM Registration Desk bycalling the Adams Mark Hotel at 303-893-3333 and requesting theSAEM Registration Desk.

IRB ApprovalA1l presented research must be approved by Institutional ReviewBoards for Human Studies or Animal Care Committees and is socertified bv authors uoon abstract submission.

KEYNOTE SPEAKERThe Society for Academic Emer-gency Medicine is pleased to an-nounce that Ricardo Martinez, MD,Administrator of the National High-way Traffrc Safety Administration(NHTSA), will provide the keynoteaddress at the 1996 Annual Meetingon Sunday, May 5, at 8:00 am. Thetitle of his talk will be "The ViewFrom Washington: Opportunities forEmergency Medicine and HealthCare Policy."

Dr. Martinez is a board-certified emergency physician who hasdedicated his career to trauma care and automotive injury pre-vention. He has worked with automotive injury control pro-grams for the past eight years and was chairman of the ACEPTrauma Care and Injury Control Committee and a member ofthe board of directors of the Association for the Advancementof Automotive Medicine. He has also worked with the Centersfor Disease Control and the state of California to develop a planfor trauma systems and injury prevention.

Dr. Martinez has been active in local and community-based in-jury prevention projects. He has written and developed educa-tional programs on motor vehicle injuries for medical providers.Since 1988 Dr Martinez has been the medical consultant to theNational Football League for the Super Bowl, focusing on emer-gency services, spectator care, and injury prevention.

Prior to his position at NHTSA Dr. Martinez was associate dir-ector of the Center for Injury Control at the Emory UniversitySchool of Public Health and associate professor of the Divisionof Emergency Medicine, Department of Surgery at the EmoryUniversity School of Medicine. He was also assistant profes-sor of Surgery/Emergency Medicine and associate director ofTrauma Service at Stanford University Hospital. Dr. Martinezreceived his undergraduate degree from Louisiana State Uni-versity at Baton Rouge and his medical degree from LouisianaState University School of Medicine.

Ricardo Martinez, MD

KENNEDY LECTUREThe Society for Academic Emer-gency Medicine is honored thatRichard D. Lamm has accepted theinvitation to present the 23rd AnnualKennedy Lectureship at the 1996 An-nual Meeting on Tiresday, May 7 at1 I :00 am. The title of his lecture willbe, "Infrnite Needs, Finite Resources:The New World of Health Care."

Governor Lamm is the chairman ofthe Pew Health Professions Com-mission located at the Center for the

Health Professions at the University of California, SanFrancisco. In November 1995 the third report of theCommission, "Critical Challenges: Revitalizing the HealthProfessions for the Twenty-First Century," was released. Healso serves as the public member for the Accreditation councilfor Graduate Medical Education (ACGME).

Governor Lamm is the former three-term Governor ofColorado, having served from January 1975 until January1987. On leaving office, he taught at Dartmouth College inHanover, New Hampshire, as the Montgomery Fellow.

Since its founding in the Fall of 198'7 he has served as Directorof the Center for Public Policy and Contemporary Issues at theUniversity of Denver. His research and teaching focus has beenin the health policy area with special emphasis on health caresystems reform and allocation of health care resources.

He was selected one of Time Magazine's "200 Young Leadersof America" in 1974 and won the Christian Science Monitor"Peace 2010" essay competition in 1985. ln 1992 he was hon-ored by the Denver Post and Historic Denver, Inc. as one of the"Colorado 100" - people who have made significant contri-butions to Colorado and made lasting impressions on the state'shistory. In 1993 he received the "Humanist of the Year" awardfrom the American Humanist Association.

Richard D. Lamm

Sunday, May 5 SCHEDULE OF BVENTS

7:00 am

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Keynote Address Ricardo Martinez, MD, National Highway Traffic Safety Administration"The View from Washington: Opportunities for Emergency Medicine and Health Care PolicyGrand Ballroom ABC

Coffee Break

Clinical PracticelDecision Making(abstracts 001-008)Grand Ballroom ABC

Pediatric EmergencyMedicine(abstracts 009-016)Grand Ballroom DE

Teaching the EmergencyUltrasound CurriculumMajestic Ballroom

Analgesia Research inEmergency MedicineVail Room

Fundamentals of Research:Getting StartedVail Room

Lunch SessionMentoring in AcademicEmergency MedicineSilver Room

Lunch SessionTelemedicine: NewParadigm in Health CareDenver Room

Lunch SessionAlternative Funding ofResidency PositionsGold Room

Poster Session, Plaza Level

Pediatrics (abstracts 017-038)EMS (abstracts 039-05 l)Cardiovascular (abstracts 052-07 0)Toxicology (abstracts 071-085)

Medical Informatics andEmergency MedicineMajestic Ballroom

Fundamentals of Research:Research DesignVail Room

Fundamentals of Research:Basic StatisticsVail RoomEthics of Procedures on

the Newly DeadMajestic Ballroom Fundamentals of Research:

Ethical ConsiderationsVail RoomEMS

(abstracts 086-093)Grand Ballroom ABC

Toxicology/Environmental(abstracts 094-101)Grand Ballroom DE

Cardiovascular(abstracts 102-109)Majestic Ballroom Fundamentals of Research:

Critical ReadingVail Room

Medical Student Session, 7:00-9:00 pm, Silver Room

SAEM ProgramCommitteeColorado Room

EMERGENCY ID NETMeetingTerrace Room

EMS Subspecialty TaskForceCapitol Room

SAEM AAMC LiaisonCommitteeSpruce Room

SAEM Political AffairsCommitteeSnruce RoomEMRA Representative

CouncilColumbine Room SAEM Managed Care

Interest GroupColorado RoomCore Content Task Force

Terrace Room

SAEM AcademicMedical Centers TaskForce Soruce Room

ABEM: Its MissionColorado Room

SAEM EDCategorization TaskForce Snruce Room

SAEM and ACEPOfficersSpruce RoomCORD Question and

Answer Bank Task ForceCentury Room

SAEM Ultrasound InterestGroupColorado Room SAEM and EMRA

OfficersSpruce Room

SAEM ResearchDirectors Interest GroupCentury RoomCalifornia Academicians

Colorado RoomSAEM Pediatric InterestGroupSpruce Room

ACEP Scientific Review Panel, 3:30-6:00 pm, Capitol Room

SCHEDULE OF EVENTS Sunday, May 5

7:00 am

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Monday, Mav 6

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SCHEDULE OF EVENTS

CPR(abstracts 110-115)Grand Ballroom ABC

Injury Prevention/Interpersonal Violence(abstracts 116-12l)Grand Ballroom DE

Teaching PediatricEmergency Medicine to EMResidentsMajestic Ballroom

EMRA/SAEM ResidentLeadership Forum:Chief Resident Forumand 25 Years ofAcademic EmergencyMedicine in PerspectiveVail Room

Coffee Break

Health Care Delivery(abstracts 122-129)Grand Ballroom ABC

Ischemia/Reperfusion/Shock(abstracts 130-137)Grand Ballroom DE

Enigma of Pediatric Out-of-Hospital Cardiac ArrestMajestic Ballroom

NHLBI-NAEPP AsthmaManagement GuidelinesMaiestic Ballroom

Lunch Session:Controversies in theManagement of AsthmaSilver Room

EMRA/SAEM ResidentResearch Forum:EpidemiologicMethodologies in EMVail Room

Poster Session, Plaza Level

CPR (abstracts 138-146)Injury Prevention (abstracts 147-155)Ischemia/Reperfusion (abstracts 156-163)Shock (abstracts 164-17 l)EMS (abstracts 172-183)Respiratory (abstracts 184-195)Health Care Delivery (abstracts 196-209)

Fundamentals of Research:How to Do a Chart ReviewVail Room

Workforce Issues: TooMany of Us or TooFew? Columbine Room

Fundamentals of Research:Data Collection FormsVaiI Room

Research During theOklahoma DisasterColumbine Room

Fundamentals of Research:Scientific MisconductVaiI Room

Impact of ManagedCare on AcademicEmergency MedicineColumbine Room

Health Care Delivery(abstracts 2lO-217)Grand Ballroom ABC

Respiratory(absrracts 218-225)Grand Ballroom DE Fundamentals of Research:

Abstract Writing and Art ofPresentation VaiI Room

SAEM Photography InterestGroupCentury Room

SAEM Outcomes ResearchInterest GroupBiltmore Room

SAEM ProgramCommitteeColorado Room

SAEM PediatricTraining Task ForceSpruce Room

ACEP Academic AffairsCommitteeCapitol Room

Association of AcademicChairs of EmergencyMedicine (AACEM)MeetingDenver Room

SAEM Medical StudentEducators Interest GroupCentury Room

SAEM EMS CommitteeSpruce Room

CORD Resident SupportCommitteeCapitol Room

SAEM Asthma ResearchInterest GroupCentury Room

SAEM EthicsCommittee Spruce Room

CORD Curriculum TaskForceCapitol Room

SAEM ResearchCommitteeSpruce Room

CORD Electronic ResidencyApp Service (ERAS) DemoSavoy Room SAEM Internet Task

ForceColorado RoomAACEM Annual Business

Meeting and LunchGold Room

SAEM/Physio ControlLunch (by invitation)Centum RoomCORD Meeting

Majestic Ballroom

SAEM ViolenceTeaching ModuleSubcommittee Spruce

SAEM Rural EmergencyMedicine Task ForceSpruce Room

SAEM Shock/TraumaInterest GroupCentury Room

SAEM EducationCommitteeColorado Room

SCHEDULE OF EVBNTS Monday, May 6

'7:00

7:30

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6:00SAEM Issues Forum, 6:00-7:30 pm, Grand Ballroom D & ECORD Procedural Task Force, 6:00-7:00 pm, Spruce Room

Tiresday, 1N{I.ay 7 SCHEDULE OF EVENTS

7:30

8:00

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Geriatrics(abstracrs 226-231)Grand Ballroom ABC

Administration(abstracts 232-237)Grand Ballroom DE

Domestic Violence:Research and PublicPolicyMajestic Ballroom

Fundamentals of Teachins:Determining Goals,Objectives, and MethodsVail Room

Coffee Break

Ethics(abstracts 238-241)Grand Ballroom ABC

Pain Management(abstracts 242-245)Grand Ballroom DE

Computer Methodology(abstracts 246-249)Maiestic Ballroom

Fundamentals of Teaching:Instruction of ProceduralSkills Vail Room

Kennedy Lecture: Governor Richard D. Lamm"Infinite Needs, Finite Resources: The New World of Health Care"Grand Ballroom ABC

UndergraduateEducators Lunch:Integrating EM intoUndergraduate EducationDenver Room

Lunch SessionFrontiers in MedicalToxicology ResearchGold Room

Lunch SessionParamedics and AdvancedLife Support ServicesSilver Room

SAEM Annual Business MeetingGrand Ballroom DE

Poster Session Plaza Level

Clinical Practice (abstracts 250-21 2)Administration (abstracts 27 3 -286)

Ethics (abstr acts 287 -29 l)Pain (abstrac ts 292 -30 l)computer Methodology (abstracts 302-304)Health Care Delivery (abstracts 305-316)

New Horizons inCerebral ResuscitationMajestic Ballroom

Fundamentals of Teachins:Effective LectureTechniques Vail Room

Is the OutcomesMovement Dead?Majestic Ballroom

Fundamentals of Teaching:Giving Feedback They'lIListen To VaiI Room

SAEM ProgramCommitteeColorado Room

SAEM NationalConsensus on ClinicalSkillsCentum Room

SAEM InternationalEmergency MedicineInterest GroupCentury Room

SAEM/UAEM/STEMPast Presidents'BreakfastGold Room

SAEM Constitution andBylaws CommitteeCentury Room

SAEM and ABEMOfficersSpruce Room

CORD Board of DirectorsCentury Room

SAEM Pain Manage-ment Interest GroupCapitol Room

SAEM Board ofDirectors Lunch (byinvitation)Cblorado Room

ABEM: Interactions withFacultyColorado Room

SAEM Injury PreventionInterest GroupTerrace Room

SAEM Workforce TaskForceSpruce RoomOrganizational Meeting for

Southern Region MeetingCapitol Room SAEM CPR/Ischemia/

Reperfusion InterestGroupTerrace Room

SAEM AcademicDevelopment TaskForceSpruce Room

SAEM Board of Directors, 6:00-9:00 pm, Century Room

SCHEDULE OF EVENTS Iiresday, N{{{.ay 7

7:00 am

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Wednesday, May 8 SCHEDULE OF EVENTS

7:00 am

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Injury Prevention(abstracts 317-322)Grand Ballroom ABC

Education(abstracts 323-328)Grand Ballroom DE

Thrombolytic Therapy forAcute Ischemic StrokeVail Room

Basic Networking andInternet AccessMajestic Ballroom

Coffee Break

Clinical Practice(abstracts 329-336)Grand Ballroom ABC

Trauma(abstracts 337-344)Grand Ballroom DE

Emergency Medicine:Surveillance and PublicHealth Vail Room

Advanced Internet LabMajestic Ballroom

Faculty Renewal: FromBurnout to BonfireVail Room

Research Directors'Lunch: Where ShouldEM Research BePublished?Silver Room

Lunch SessionAssessing the Impact ofInternational EMProgramsDenver Room

Lunch SessionImproved Methodologiesfor Measuring PerfusionBeyond Blood PressureGoId Room

Poster Session and IEME Exhibits' Plaza LevelIEME Exhibits (abstracts 345-359)Injury Prevention (abstracts 360-37 2)Education (abstracts 37 3 -385)

Clinical Practice (abstracts 386-409Trauma (abstracts 410-425)Infectious Disease (abstracts 426-434)Neurologic Emergencies (abstracts 435-441)Imaging (abstracts 442-454)

Effective FacultyObservation of Residents'Clinical SkillsSavoy Room

Strategies for UnfundedClinical ResearchMajestic Ballroom

Alcohol Intoxication andInjury ResearchMajestic Ballroom

Applying CQI Metho-dology to EM ClinicalSvstems VaiI Room

Nat'l Info Infrastructure-Health Info NetworkMajestic Ballroom

Neurology(abstracts 455-460)Grand Ballroom ABC

Imaging(abstracts 461-466)Grand Ballroom DE Introduction to Statistical

Software PackagesVaiI Room

SAEM ProgramCommitteeColorado Room SAEM Board and

Interest Group ChairsSpruce Room

SAEM Public Healthand Education TaskForceCentum Room

SAEM GraduateMedical EducationCommitteeSpruce Room

ABEM: Interactions withResidentsColorado Room

SAEM UndergraduateEducation CommitteeSpruce Room

SCHEDULE OF EVENTS

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Wednesday May 8

Sunday, May 5

Scientific Papers: Clinical Practice(10:00 am-12:00 noon)Moderator: Ian G. Stiell, MD, Ottawa Civic Hospital001 Multicenter Comparison of Two Clinical Decision Rules for

Knee Radiographs, David C. Seaberg, MD, University ofFlorida

002 Performance of Two Clinical Decision Rules for Knee Radi-graphy, Peter Richman, MD, State Uniyersity of New York,Stony Brook

003 Follow-Up Evaluation of a Trial to Introduce the OttawaAnkle Rules for Use of Radiography in Acute Ankle In-juries, P. RichardVerbeek, MD, Universitiy of Toronto

004 Examination of a Mortality Prediction Rule in NonmortalOutcomes for Patients Presenting with Community Ac-quired Pneumonia (CAP), Thomas E. Auble, PhD, Univer-sity of Pittsburgh

005 Cranial Computerized Tomography in the Emergency Eval-uation of Patients Without a Recent History of HeadTrauma: Prospective Analysis, Carlton Buchanan, MD, Or-lando Regional Medical Center

006 Role of Serum Progesterone in the Emergency DeparatmentDiagnosis of Ectopic Pregnancy: Prospective Stludy, KerryKing, MD, Nayal Medical Center, San Diego

007 Utility of Urine and Blood Cultures in Acute Pyelonephritis,M ark Thanassi, MD, Stanford U niversity I Kaiser Permane nte

008 Are Guideline Recommendations Based on RandomizedTrial Results Already Followed by Practicing Physicians?,Carlos A. Camargo, MD, Massachusetts General Hospital

Scientific Papers: Pediatric (10:00 am-12:00 noon)Moderator: Thomas E. Terndrup, MD, State University of NewYork, Syracuse009 Validity and Reliability of Clinical Signs in the Diagnosis of

Dehydration, Kathy N. Shaw, MD, Children's Hospital ofPhiladelphia

010 Detection of Electrolyte Abnormalities in Children Present-ing to the ED: A Multicenter Prospective Analysis, StevenRudis, MD, Orlando Regional Medical Center

011 Frozen Oral Hydration Therapy (OHT) as an Alternative toStandard Enteral FIuids, Karen Santucci, MD, Rhode IslandHospital

012 Parenteral vs Oral Antibiotics in the Prevention of SeriousBacterial Infections in Children With S. Pneumoniae OccultBactermia: A Meta Analysis, Daniel Mcllmail, MD,Orlando Regional Medical Center

013 Complete Respiratory Assessment (CRA) Score AccuratelyPredicts Outcomes in Children With Acute Reactive AirwayDisease (RAD) Exacerbations, John H . Myers, MD , BaylorCollege of Medicine

014 Screening For Urinary Tract Infection (UTI) in Young Fe-brile Children in the Emergency Department: Which Test isBest?, Kathy N. Shaw, MD, MS, Children's Hospital of Phil-adelphia

015 Chloral Hydrate Versus Midazolam for Sedation of ChildrenDuring Neuroimaging, James D'Agostino, MD, State Uni-versity of NewYork, Syracuse

016 Boomerang Babies: Emergency Department Utilization byEarly Discharge Neonates, Alfred Sacchetti, MD, Our Ladyof Lourdes Medical Center

Poster Session (1:30-4:00 pm)PediatricsModerator: Susan Fuchs, MD, University of Pittsburgh (2:00-3:00 pm)017 Societal Savings By 'Fast Tracking' Lower Acuity Patients

in a Pediatric Emergency Department, Harold K. Simon,MD, Egleston Children's Hospital

022

Mechanism of Injury in Pediatric Urban Trauma PatientsDoes Not Predict Severe Outcomes, Janet H. Friday, MD,C hildren' s H ospital of P hiladelphia

Use of Prehospital Interventions on Children in an UrbanEmergency Medical Services (EMS) System, Philip V.Scribano, DO, Children's Hospital of Philadelphia

Effect of a Curfew on Pediatric Out-of-Hospital EMSResponses, John Couk. MD, Louisiana State University

Can Parents be Taught to Read Glass Thermometers? AComparison Between Glass and Digital Thermometer Read-ing, Mark C . Clark, MD, Orlando Regional Medical Center

Compliance to Follow-Up in Febrile Children: A Compari-son of Four Systems, Sally Santen, MD, Joint MilitaryMedical Centers

Cost-Effectiveness of a Comprehensive Versus FocusedToxicological Screen for Suspected Ingestions in Children,Martin G. Belson, MD, Emory University

Long-Term Cosmetic Outcome of Lacerations RepairedUsing a Tissue Adhesive in a Children's Emergency Depart-ment, Harold K. Simon, MD, Egleston Children's Hospital

Bayesian Decision Theoretic Interim Analysis of aMulticenter Randomized Clinical Trial of Phenytoin for theProphylaxis of Post Traumatic Seizures in Children, KelbD.Young, MD, Harbor-UCLA Medical Center

Spectrum of Disease Among Infants Less Than or Equal toThree Months with Hyperpyrexia, Rachel M. Stanlq,Children' s H ospital, Boston

What Are Early Predictors of the Need For Hospitalizationof Children With Acute Asthma Exacerbations?, Jill M.Baren, MD, Yale University

PediatricsModeralor: Leonard R. Friedland, MD, Universily of Cincinnnti(3:00-4:00 pm)028 Are Subjective Determinations of Temperature in Children 0

to 36 Months of Age Reliable Predictors of Fever?, RandySmith, MD,Wilford Hall Medical Center

Value of the Peripheral Blood Smear in Febrile ChildrenAge 0-24 Months With Respiratory Syncytial Viral or Oc-cult Bacterial Illness, Edward A.Walton, MD, University ofCalifurnia, San Diego

Usefulness of Chest Radiography in Febrile Asthmatic Chil-dren, Kristen Paddon, MD, Medical College of Wisconsin

Prevalence of Urinary Tract Infection (UTI) and OccultBac-teremia in Febrile Young Children in the Emergency De-partment (ED), Katlry N. Shaw, MD, MS, The Children'sHospital of Philadelphia

Rapid Blood Lactate Analysis Improves the Triage of Pedi-catric Patients in the ED, David P. Milzman, MD, George-town University

Pre- and Post-Treatment Oxygen Saturation (Sp02) inAcuteAsthma, Gregory D. Iay, MD, PhD, Rhode Island Hospital

Pulsus Paradoxus (PP): An Objective Measure of Severity inCrotp, Gregory D. Jay, MD, PhD, Rhode Island Hospital

PAPER/PO S TER PRESENTATIONS

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035 Does Endotracheal Intubation Affect Outcome in Out-of-Hospital Pediatric Cardiac Arrest?, Craig B. Key, MD, Bay-lor College oJ Medicine

036 Accuracy of Epinephrine Dosing in Children in CardiacAnest By Prehospital Providers, Maureen D. McCollough,MD, Harbor-UCLA Medical Center

037 Bag-Valve-Mask Ventilation (BVM) For Children in thePrehospital Setting, Marianne Gausche, MD , Harbor-UCLAMedical Center

038 Comparison of Intravenous Midazolam to Pentobarbital forConscious Sedation in the Emergency Department for HeadComputed Tomography Imaging, Donna M. Moro-Suther-land, MD, Texas Children' s Hospital

EMSModerator: Paul E. Pepe, MD, Baylor (2:00-3:00 pm)039 Clinical Significance of the Initial Systolic Blood Pressure

of Pre-Hospital Advanced Life Support Patients WithoutTrauma, Steyen A. Meador, MD, MPH, MS Hershey MedicalCenter

040 Using Prehospital Trauma Triage Criteria to Identify theSeverely Injured: Verification of Accuracy, Robert E.O'Connor, MD, Medical Center of Delaware

041 Emergency Medical Services Transport of Patients Com-plaining of Headache: Is Mode of Arrival Associated withEmergent Conditions?, Iacqueline A. Nemer, MD, MedicalCenter of Delaware

042 Aeromedical Scene Evacuation of Non-Traumatically IllPatients, George H. Lindbeck, MD, University of Vit'ginia

043 Instrument Flight Currency and Safety in Helicopter EMS,Richard C. Wuerz, MD, Hershey Medical Center

044 Prehospital Oral Endotracheal Intubation By Rural Emer-gency Medical Technicians, .lohn S. Bradley, MD, MethodistHospital of Indiana

045 Eligibility For Thrombolytic Therapy: Concordance of Pre-hospital and Emergency Department Screening, TaddDelozier, MD, Akron General Medical Center

EMSModerator: Robert E. O'Connor, MD, Medical Center of Delaware(3:00-4:00 pm)046 Prehospital Use of Succinylcholine By Paramedics, Steven.

Pace, MD, Madigan Army Medical Center041 Improved Success Rate of Prehospital Intubation With

Rapid Sequence Induction, .leanne M. Alit:andro, MD, StateUniversity ofNew York, Stony Brook

048 Summertime Storage Temperatures of Prehospital Medica-tions in Northern New Jersey, Vicki Lanier, MD, MorristownMemorial Hospital

049 Ten Years of Experience in Part 121 Airline Accidents as aModel for Disaster Planning, Lee W. Shockley, MD, DenyerGeneral Hospital

050 Emergency Medical Care Requirement After 1995 Hanshin-Awaji Earthquake: An Overview, Hit'oshi Tanaka, MD,Osaka University

051 Epidemiologic Mapping of EMS Drug-Related IncidentsUsing a Geographical Information System Computer Pro-gram, Christine Farris, MD , University of Arizon,t

CardiovascularModerator: James T! Niemann, MD, Harbor-UCLA (2:00-3:00)052 Improved Sensitivity in Detecting Acute Myocardial Infarc-

tion (AMI) Using Serial CK-MB Sampling: The NationalCooperative CK-MB Multicenter Project, W. Brian Gibler,MD, University oJ Cincinnati

053 Bedside Whole Blood Rapid Assay of Cardiac Troponin-T:A Sensitive Indicator of Acute Myocardial Infarction, M.Stephen Baxter, MD, University of Cincinnati

Sunday, May 5054 Evaluation of a New Assay for Cardiac Troponin-I versus

CK-MB for the Diagnosis of Acute Myocardial Infarction,Gerard X. Brogan, Ir, MD, State University of New York,Stony Brook

055 Serial Use of a Rapid, Multi-Marker Cardiac Panel at theBedside of ED Patients With Chest Pain, Pritvi K. Murthi,H i ghland G e neral H o spital

056 Serum Myoglobin Allows Rapid Emergency DepartmentRule Out Myocardial Infarction in Patients withAcute ChestPain, Robert J. Doherty, MD, University of Maryland

057 Corelation of ToCPK-MB Electrophoretic Activity WithRelative Index By Immunoassay, S. L Wambsgans, MD,U t t i vct si ty oJ' M i ssi ssippi

058 Comparison of Cardiac Myosin Light Chains versus CK-MB Identifying Chest Pain Patients at Risk for IschemicComplications, Gerard X. Brogan, Jr, MD, State UniversityoJ NewYork, Stony Broolc

059 Diagnostic Value of a Rapid Diagnostic Protocol to ExcludeAcute Myocardial Infarction and Cardiac Ischemia, RobertJ. Zalenski, MA, MD, University of lllinois at Chicago

060 Analysis of an Artificial Neural Network Inputted with Bio-chemical Markers of AMI as a Predictor of Cardiac lnjury,Emil M. Skobeloff, MD, Medical College of Pennsylvaniaand Hahnemann University

061 Chest Pain Onset and Delayed Presentation, N. Clay Mann,PhD, Oregon Health Sciences University

CardiovascularModerator: Daniel J. DeBehnke, MD, Medical College of Wis-consin (3:00-4:00 pm)062 Are Classic Coronary Risk Factors Signiflccnt Predicton of A-

cute Cardiac Ischen.ria in the Emergency Department? A Multi-centerTnal, Daniel S. Ballin, MD, New England Medical Center

063 Undetected Cardiogenic Shock in Chronic Heart FailurePatients Presenting to the Emergency Department, MichaelF. Jaggi, DO, Henry Ford Hospital

064 Continuous, Non-Invasive Cardiac Output MonitoringQuantifies Severity of CHF in the ED, Sangeeta Desai, MD,G cot y,t' I own U n i vc rs i ry

065 Acute Cardiac Ischemia in Patients with Cocaine RelatedCornplaints: Results of a Large Multicenter Trial, Iames A.Feldman, MD, Boston City Hosltital

066 Primary Angioplasty for Acute Myocardial Infarction: DoesAvailability Delay Thrornbolysis?, Robert E. O'Connor,MD, Medical Center oJ Delaware

067 Emergency Depzrtment Use of Gated SPECT Technetium-99m Sestamibi Myocardial Imaging For Risk Stratificationof Patients With Chest Pain, Eric H. Gilbert, MD North-eastern Ohio University College oJ'Medicine

068 Alpha 1 Adrenergic Stimulation Protects Against CardiacInfarction and Dysfunction, Iames M. Walther, BS, Univer-sitl, of Colorado

069 Monitored Telemetry Beds: Are They Necessary For PatientsWith Nontraumatic Chest Pain and Normal ECG's, Sharon M.Valentine, RN, State University of NewYork, Stony Broolc

010 Direct Evidence that Exogenous Nitric Oxide DecreasesBasal Nitric Oxide Release from the Vascular Endotheliumin Rat Aortic Rings, Bernard L. Lopez, MD, Thomas .Iefrer-son University

ToxicologyModerator: James R. Roberts, MD, Mercy Catholic MedicalCenter (2:00-3:00 pm)071 Prophylactic Use of Magnesium Sulfate in the Prevention of

Ventricular Tachyarrhythmias in Tricyclic AntidepressantOverdose, J . Brent Meyers, Bowman Gray School of Medicine

072 Thermal Characteristics of Neutralization Therapy andWater Dilution For Strong Acid Ingestion, Clark S. Homan,MD, State University of New York, Stony Brook

Sunday, May 5013 Diagnosis of Acute Mountain Sickness in Pre-verbal Chil-

dren, N eil Waldman, MD, U niversity of C olorado

074 Comparison of Routes of Flumazenil Administration to Re-uets" Midurolam-Induced Respiratory Depression in a DogModel, Melanie S. Heniff, MD, Methodist Hospital of Indiana

07 5 Elevated Serum Lead trvels in Emergency Department PatientsWith Retained trad Foreign Bodies' Susan E Farrell, MD,Medical College of Pennsylvania and Hahnemann University

0'..6 Potassium (K+) Repletion Fails to Interfere With Reductionof Serum Lithium (Li) Concentrations By Sodium Polysty-rene Sulfonate (SPS) in Mice,lames G. Linakis, MD, RhodeIsland Hospital

0'11 Fluoride Toxicity Treatment Effectiveness Using Red BloodCell Hemolysis as a Model, Wayne J. Farnsworth, MD ' State(lniversity of NewYork, SYracuse

078 Comparison of the Efficacy of Single-Dose Activated Char-coat (SOAC) and Multiple-Dose Activated Charcoal (MDAC)in Moderate Overdose with Tylenol Extended-Relief (APAP-ER) Andls Graudins, MBBS, University of Massachusetts

ToxicologyModeratorlLewis R. Golilfrank, MD, Bellevue Hospital Center(3:00-4:00 pm)079 Treatment of Extremity Hydrofluoric (HF) Acid Bums: An

in vivo Histopathological Comparison of Topical, LocallyInfiltrated, Intraarterial, and Regional Intravenous, C ynthiaK. Aaron, MD, University of Massachusetts

080 High Surface Area Oral Activated Charcoal Exhibits Su-peiior Clinical Properties, James R. Roberts, MD' MercyCatholic Medical C enter

081 Cardiovascular Effects of Calcium Chloride in a CanineModel of Acute Propranolol Intoxication, Dan Hanfling'MD, Georgetown U niversi.tY

082 Cardiovascular Parameters in Calcium Channel BlockerToxicity, John J. Cienki, MD, MS Hershey Medical Center

083 Blood Levels of N-Acetylcysteine (NAC) Following Admin-istration via the Rectal Route in the Porcine Model: A PilotStudy, Sonla R. Stiller, MD, Medical College oJ Pennsyl-vania and Hahnemann UniversitY

084 New Population at Risk For Poisoning ' Christina M 'Yadao'MP H, Wayne State U niversitY

085 Primary Heat lllness: The Urban Experience, Kirk R' DuJiy'MD, Cook CountY HosPital

Scientific Papers: EMS (4:00-6:00 PT) ^ --Moderator: Vinfent PVerdile, MD, Albany Medical College086 Incremental Benefit of Individual American College of

Surgeons (ACS) Trauma Triage Criteria,,Mark C' Henry,MD, State University of NewYork, Stony Brook

087 Study Design and Outcomes In Out-of-Hospital Research: ATen-Year Aial y sis, I ane H' B r ic e, M D, U niv e r s i ty of P itt s bur g h

088 High Discharge Survival from Out-of-Hospital VentricularFib."rillation with Rapid Defibrillation by both Police andParamedics, Roger D.White, MD, Mayo Clinic

089 First Responder Defibrillation Does Not Increase SurvivalFrom Sudden Cardiac Death in a Two-Tiered Urban-Subur-ban EMS System, Thomas A. Sweeney, MD' Medical Centerof Delaware

090 Estimating Effectiveness of Cardiac Arrest Interventions:Logistic {egression Survival Model, Terence D Valenzuela,MD, MPH, UniversitY of Arizona

091 Prospective Population Based Validation of ReceiverOperator Curve (ROC) Derived Resource Based TraumaTriage Rules, Mark C. Henry' MD' State Universiry of NewYork, Stony Brook

0g2 Efficacy and Comfort of Full-Body Vacuum Splints for C-Spine immobilization, Robert S. Hamilton, MD, DenverGeneral Hospital

093 Prophylactic Use of Prochlorperazine to Prevent Nausea andVomiting During Helicopter Transport, Deborah L' Schutz,RN, Methodist HosPital of Indiana

Scientific Papers: Toxicology/Environmental(4:00-6:00 pm)i4oderator: Riihurd C. Dart, MD, PhD, University of Colorado094 Detrimental Cardiac Effects of Cocaine are Due to its Local

Anesthetic Effects, Edward W. Cetaruk, MD, University of

Colorado

095 Hemodynamic Effect of Cocaine During Acute Hemor-rbage, Theodore C. Bania, MD, State University of NewYork, BrooklYn

096 Cocaethylene Causes Significant Cardiac Toxicity in anAnimal Model of Cocaine and Alcohol Abuse, LanceWilson, MD, Mt. Sinai Medical Center

097 Hypothermic Cardiac Injury: Role of-Misutilized Oxygen'Bifan A. Agan, MS, IV, University oJ Colorado

098 Ionic Mechanisms of Cyclic Antidepressant Toxicity inIsolated, Adult Rat Heart Myocytes: Inhibition of CalciumTransients, John A.Watts, PhD, Carolinas Medical Center

099 lron-Induced Myocardial Dysfunction Develops Indepen-dently of Perfused Extracellular Hydroxyl Radical in IsolatedRat Hearts, Marsha D. Ford, MD, Carolinas Medical Center

100 Efficacy of Prophylactic Dexamethasone or Verapamil ForReducing Altitude' Induced Intracranial Pressure Increase inRabbits,Alan B. Storrow, MD , Joint Military Medical Centers

101 Histologic Effect of Butyl-2-Cyanoacrylate on Skin Lacera-tions, John M. Howell, MD, Georgetown University

Scientific Papers : Cardiovascular (4 : 0-0-6;p0^ pm)Moderator: Jerr^is R' Hedges, MD, MS, Oregon Health ScicncesUniversity102 Predictive Value of a Normal ECG: Is it Affected By Dura-

tion of Time From Onset of Chest Pain?, Adam J' Singer'MD , State University of New York, Stony Brook

103 Serial CKMB Results are a Sensitive Indicator of AMI in

ED Patients With Chest Pain but without ECG Changes,Gary P.Young, MD, Highland General Hospital

104 Cardiac Serum Markers Myoglobin and CK-MB are Syner-gistic in the Very Early Detection of Acute Myocardial In-Iarction, W. Brian Gibler, MD, University of Cincinnati

105 Serum Myoglobin Levels in Patients with Unstable Anginaand AcutL Myocardial Infarction, Brian J. O'Neil, MD,

Wayne State UniversitY

106 Evaluation of Cardiac STAIus CK-MBA4yoglobin Devicefor Rapidly Ruling-Out Acute Myocardial Infarction'Gerard X.

-Brogar, ir, MD, State [Jniversity of New York'

Stony Brook

lO7 2-Dimensional Echocardiography is Not Useful After Eval-uation of Chest Pain Patients in an Emergency Department'Swee Han Lim, MBBS, Singapore General Hospital

108 Chest Pain Evaluation Registry Study: Comparison WithPreviously Reported Series, loais G. Graff, MD, NewBritain General H osPital

109 Gender Differences in the Treatment and Outcome of ED

Chest Pain Patients, Edward P. Sloan, MD, MPH, Universityof lllinois at ChicaRo

I4

Sunday, May 5

DIDACTIC SESSIONSTeaching the Emergency Ultrasound Curriculum:When, Why, and How (10:00-12:00 noon)Steve Folstad, MD, Bowman GrayMichael Heller, MD, Temple UniversityStephen Hoffenberg, MD, Rose Medical Center, DenyerJoseph Kosnik, MD,Wayne State UniversityThis session will discuss important issues involved in emergencyultrasound education. We will address issues pertinent to teachinsthe emergency ultrasound curriculum in residency training prolgrams. Different formats for presenting didactic material will bediscussed as well as methods for providing adequate hands-on ex-perience. Quality assurance will be addressed through a discussionof the various options available for the over reading of residentscans. Recent work on the "Curriculum for Emergencv MedicineResidency Training in Emergency Ultrasonograph-y" being Oevel-oped by CORD's Task Force on Curriculum Development willalso be presented. Larger issues concerning the training of emer-gency physicians not in residency programs such as emergencymedicine department faculty will also be discussed. The resourcesavailable for alternative means of trainins such as outside courses.fellowships. training videos. slide sets. a.-nd insrructional texts wil lbe presented. The role of research in emergency ultrasound as it istoday and how it will relate to the future will be considered. Otherissues that are important to the development of an emergencyultrasound training program such as available equipment, the polit-ical arena, credentialing issues, and financial considerations for thesponsoring department will also be briefly discussed. This sessionwill be presented in a panel format by four faculty members repre-senting widely disparate geographical and practice settings andwill allow ample time for questions from the audience.

Analgesia Research in Emergency Medicine:How Can We Do It Better? (10:00-11:00 am)Moderator: Donald M.Yealy, MD, University oJ PittsburghWilliam H. Cordell, MD, Methodist Hospital of IndianaJames Ducharme, MD, St. John Regional Hospital, New BrunswickKnoxTodd, MD, Emory UniversityThis session will discuss specific areas where analgesia research inemergency medicine has suffered or is in need of attention includ-ing: choosing an analgesic regimen to study (balanced, syndromespecific, or other options), evaluating pain relief after dischargefrom the ED, and clinical versus mathematic significance in painmeasurements. In addition, the panel will solicit questions from theaudience and offer solutions to common analgesic trial quandaries.

Fundamentals of Research:Getting Started in Research (11:00-12:00 noon)Lance B. Becker, MD, University oJ ChicagoThe development of nationally recognized research programs hasbeen identified as one of the most important challenges facing Emer-gency Medicine today. Within academic institutions, the hallmark ofnational research recognition lies with successful NIH awards orother prestigious funding. As with any new specialty, there are fewNIH funded investigators and even fewer well funded emergencymedicine research programs. An additional challenge for emergencymedicine investigators who are applying to NIH is to avoid the fre-quent criticisms of being "overly phenomenalogic" in scientificapproach. Understanding these issues is mandatory for the develop-ment of long-term emergency research programs.

Luncheon: Mentoring in Academic EmergencyMedicine (12:00-1:30 pm)Moderator: Suzanne M. Shepherd, MD , IJniversity of PennsylvaniaPeter Rosen, MD, University of California, San DiegoAndy S.Iagoda, MD, Mt. Sinai Medical CenterCarol Jack Scott, MD, University of MarylandThe initial focus of this session will be on the mentoring process.Panelists will present mentoring from a historical perspective, mod-

els in current use in business, medicine and academia. The panelwill discuss the pros and cons of these various mentoring modelsand the impact of cultural diversity on mentoring. The panel willdiscuss the spectrum of mentoring currently incorporated by aca-demic programs in Emergency Medicine in both residency and fac-ulty development, and how these address promotion and tenureissues. The panel will then shift focus to the individual, interper-sonal process of mentoring. Mentoring will be discussed frorntheviewpoints of the mentor and mentee. This portion of the sessionwill focus on the process of choosing a single or multiple men-tor/mentee relationship, the ongoing development of that relation-ship, and the appropriate termination of that relationship.

Luncheon: Emergency Telemedicine: A NewParadigm in the Evolution of Health Care(12:00-1:30 pm)David Ellis, MD, State University of NewYork, BuffaloAndrea Pesce, State University of New York, BuffctloDaniel Ward, MD, Medical College oJ'GeorgiaTelemedicine is the provision of health care services at remotesites using interactive video conferences or store-and-forwardtechnology and the transfer of patient health information via tele-communications linkages. It has potential significance for thepractice of emergency medicine in academic and community set-tings. Telemedicine can be used to connect outlying facilities, suchas community hospitals, rural clinics, correctional facilities, withref'erral centers, to connect emergency physician with consultants,and to share educational information regarding patient evaluationand management. This technology may prove to be part of acade-mic medicine's response to increasingly scarce and centralized re-sources. This luncheon session is scheduled to include an intro-duction to the basics of telemedicine. a presentation of currentcapabilities and limitations, a demonstration of the US military'sportable telemedicine equipment, and a staged live-patient exami-nation transmitted to SAEM from a remote site.

Luncheon: Alternative Sources for the Fundingof Emergency Medicine Residency Positions(12:00-1:30 pm)Barry Simon, MD, Highland General HospitalVince Markoychick, MD, University of ColoradoGlenn Hamilton, MD,Wright State UniversityBenson S. Munger, PhD, Executive Director, American Board ofEmergency MedicineFederal government and other public/private funding of post-grad-uate medical education is threatened. Hospitals are downsizing andclosing. Managed care is producing a decrease in the census ofmany emergency departments. In order to survive and thrive, pro-grams/departments must anticipate the changes and actively pur-sue alternative training sites and sources of funding; i.e., mergingprograms, adding private, university and/or county hospitals, add-ing fast track and urgent ca.re and other managed care types ofpractices. We have put together a panel of emergency physicianswho have experience in developing some of the more creative andatypical formats. The goal of this session is to learn what hasworked and what has been tried in various settings, to broaden ouroptions and to educate us about the problems we face.

ABEM: Its Mission (1:30-2:30 pm)ABEM directors and staff will provide information on recentBoard actions, review cuffent Board activities, and report on theresidency and resident data gathered through the annual survey ofprograms. Time will be included for questions from participants.A packet of reference material for this session will be available allweek at the SAEM registration desk. (See related informal ses-sions: for program directors and faculty, Tuesday, May 7 at 3:00pm; for residents, Wednesday, May 8 at l:30 pm)

Sunday, May 5

Medical Informatics and the AcademicEmergency Physician (1 :30-3:00 pm)GeoffreyW. Rutledge, MD, PhD, Beth Israel Hospital and HarvardMedical SchoolJonathan M. Teich, MD, PhD , Brigham andWomen' s Hospital andHarvard Medical SchoolRobert L.Wears, MD, MS, University of Florida, JacksonvilleMedical informatics includes the cognitive, information process-ing, and communications tasks of medical practice and research,along with the application of computer-based technology to thesetasks. This session will include discussions of research activitiescurrently underway among emergency physicians interested in in-formatics, as well as opportunities for further research and for de-veloping medical decision-making models pertinent to emergencymedicine. The speakers will also specifically address combiningED information systems with hospital-wide systems, the use ofinformation systems to improve the quality of ED care, the back-ground and experience necessary for successful applicationsdevelopment and research and how to obtain it, and potential fund-ing sources to support these activities.

Fundamentals of Research: Research Design(1:30-2:30 pm)Edward A. Panacek, MD, University of'California, DavisTransforming a specific research question into a research protocolrequires a knowledge of the basic types of research designs andways of categorizing them. This lecture will present a standardizedsystem for understanding the spectrum of research designs. It willalso go over each design type commonly used in emergency med-icine and explain its advantages, disadvantages, limitations andideal application to research questions. The focus will be on clini-cal research, although design types applicable to basic researchwill be listed. This session is designed to be very practical and willillustrate examples using actual emergency medicine studies.

Fundamentals of Research: Basic Statistics(2:30-3:30 pm)Roger J. Lewis, MD, PhD, Harbor-UCLAEarly in the course of planning a project a researcher needs to makean appraisal of the outcome parameters to be measured, the feasi-bility of doing the study in a given patient population, the numberof patients needed for statistical comparison, and the analyticalmeans of addressing the research question. Early statistical consul-tation can assist with these questions, but the researcher must pro-vide the information the statistician needs for critical and analyticalreview of the proposal. This session will concentrate on those sta-tistical concepts and methods that must be understood if the inves-tieator is to be able to communicate with a biostatistician and pro-dictively collaborate in the design and analysis of a clinical study.

Ethics of Procedure Performance on the NewlyDead (3:00-4:00 pm)Moderator: E.Iohn Gallagher, MD, Bronx Municipal HospitalRobert K. Knopp, MD, St. Paul-Ramsey Medical CenterRobert M. McNamara, MD , Medical College of Pennsylttania andHahnemann UniversityKenneth Iserson, MD, MBA, University of ArizonaSociety expects emergency physicians to perform life-saving pro-cedures competently. Some of these procedures, such as cricothy-rotomy, are not frequently required, thus making acquisition andretention of certain critical skills difficult. The panel, with the helpof others who choose to attend this session, will attempt to exam-ine the ethical issues surrounding the use of recently deceasedcadavers for educational purposes in the ED. Some of the ques-tions open for discussion include: Does the basic principle ofindi-vidual autonomy survive death? Is either the principle of benefi-cence or non-maleficence applicable to a cadaver? If so, what eth-ical weight do these principles carry when considered in the con'text of the next living patient who may require a life-saving proce-dure? What is the physician's ethical obligation to obtain 'consent'

from next of kin, and to what extent do relatives possess a "pro-

prietary (quasi-property) right" to refuse a request for petformanceof an educational procedure on a deceased family member? Is thedistinction between'invasive' and'non-invasive' procedures philo-sophically grounded in ethics or aesthetics?

Fundamentals of Research: EthicalConsiderations in Human Subject Research(3:30-4:30 pm)JeJJrey W. Runge, MD, Carolinas Medical CenterThe mechanics of initiating a clinical research study go beyond thewriting of the protocol. The design must take into account therights and welfare of the patients or volunteers who will be thesubjects of the research. Clinical research is likewise subject tofederal law and must meet institutional approval. This session willpresent necessary ethical considerations in the design and perfor-mance of research, and will acquaint the researcher with the ethi-cal principles underlying informed consent regulations and theperspective of the IRB.

Fundamentals of Research: Critical Reading ofthe Medical Literature (4:30-5:30 pm)Sandra M. Schneider, MD , University of RochesterOne of the most important steps in any research project is criticalreading of the literature, with the goal of identifying weaknesse-sand omissions in the work already performed. The speaker willdiscuss specific characteristics of published studies that mayreduce the reliability of the conclusions, and how these problemsmay be detected by the discerning reader. This session will discusshow to read critically to obtain the knowledge base to convinceothers of the significance and novelty of the question you proposeto address with original and relevant research.

PAPBR/POSTBR PRESENTATIONSScientific Papers: CPR (8:00-9:30 am)Moderator: James I. Menegazzi, PhD, UniversiQ of Pittsburgh110 Ontario Trial of Active Compression-Decompression

Cardiopulmonary Resuscitation for Prehospital CardiacArest, Jonathan F. Dreyer, MD, University ofWestern Ontario

111 Active Compression-Decompression Resuscitation (CPR)versus the Standard Manual CPR Technique in Out-of-Hospital Cardiac Arrest in a Two-Tiered Emergency Med-ical Services (EMS) System with Physician-Staffed Am-bulances in the Second Tier, Dietmar Mauer, MD, JohannesGutenberg University

Il2 Ontario Trial of Active Comression-Decompression Cardio-pulmonary Resuscitation For In Hospital Cardiac Arrest, 1anG. Stiell, MD, University of Ottawa

113 Effects of Graded Dose Epinephrine Therapy on Hemody-namic and Oxygen Transport Variables in the Post-Resusci-tation Period After Cardiac Anest, Carol KiekhaeJbr, MD,Henry Ford Hospital

ll4 Racial Distribution of Pediatric Cardiopulmonary ArrestCases, Paul E. Sirbaugh, DO, Baylor College oJ Medicine

I l5 Post-Arrest Administration of Acetyl-L-Carnitine Enhancesthe Recovery of Cardiac Mechanical Function, Charles B.Cairns, MD, University of Colorado

Scientific Papers: Injury Prevention -Interpersonal Violence (8:00-9:30 am)Mod,erator: Arthar L. Kellermann, MD, MPH, Emory University116 Violence Against Women Revealed By Routine Interviews

in the Emergency Department, Bruce M. Becker, MD, Rfu;deIsland Hospital

111 Domestic Violence: Estimate of Acute Prevalence Using aValidated Instrument, Helen Straus, MD, MS, Cook CountyHospital

118 Domestic Violence Among Men and Women in an Inner-City Emergency Department, Trevor Mills, MD, LouisianaState University

119 Prospective Analysis of 963 Cases of Sexual Assault, KlnM. Feldhaus, MD, Denver General Hospital

120 Emergency Department Patients With Assault Injuries: ACase-Control Study of Previous Injuries and Convictions,Harry Moscovitz, MD, Yale University

l2l Ethnic Differences in Women's Attitudes Toward Abuse,Greta Bell, MD, University oJ lllinois at Chicago

Scientific Papers: Health Care Delivery(10:00 am-12:00 noon)Moderator: E. John Gallagher, MD, Albert Einstein122 Frequent Emergency Deparlment Users - Can We Inter-

vene?, Linda L. Spillane, MD, University of Rochester123 Factors Associated with Frequent ED Use for Asthma in an

Urban African-American Population, Lynne D. Richardson,MD, Mt. Sinai Medical Center

124 Deflning Factors Associated with Use of ED for RoutineComplaints, Iune Treston, Cooper Hospitall University Med-ical Center

125 Influence of Psycho-Social Difficulties on Emergency De-partment Usage,William R. Mower, MD, University of Cali-fornia, Los Angeles

126 Patient Satisfaction with Emergency Department RapidTreatment vs Inpatient Care for Acute Asthma, Robert I.Rydman, PhD, Cook County Hospital

127 Mortality and Morbidity Associated With WelfarePayments, Jim Christenson, MD, St. Paul's Hospital

I28 Practice Patterns in an Emergency Department 'Fast Track'Setting: Comparison by Training Background, Edward A.Panacek, MD, University of Calfornia, Davis

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129 Gender Bias in Cardiovascular Disease. Iudd E. Hollander,MD, State University of New York, Stony Brook

Scientific Papers: Ischemia/Reperfusion/Shock(10:00 am-12:00 noon)Moderator: Mark Angelos, MD, Ohio State University130 Preconditioning Protects AgainstAnomalous Mitochondrial

Electron Transport Activity in Ischemic Rat Hearts, CharlesB. Cairns. MD. Universitv of ColoradoEndogenous Adenosine Mediated Wavefronts of Protectionand Infarction During Regional Cardiac Ischemia, PaulBender, PhD, University of ColoradoReperfusion Following Myocardial Ischemia Induces TissueInjury Through Apoptosis, Xin-liang Ma, MD, PhD,T homa s Jffi rson U n i ve rsi tyAntioxidant Tieatment Attenuates Myocardial Ischemia-Reperfu -sion Injury, Bernard L. Lopez, MD,Thomas Jefferson UniversityAdrenal Insufficiency in High Risk Emergency DepartmentPatients, Heidi C. Blake, MD, Henry Ford HospitalAdenosine Receptor Antagonism as an Adjunct to StandardPharmacotherapy During Resuscitation From CirculatoryShock: Improvement in Acute Hemodynamic Function andSurvival Following Hemorrhagic Shock, Lawrence deGaravilla. PhD, Albert Einstein Medical CenterMyocardial Metabolism During Treatment of Non-IschemicCardiogenic Shock in Awake Canines, Jffiey A. Kline, MD,Carolinas Medical C enterNon Ischemic-Induced Myocardial Stunning, Richard M.Ratmond. PhD. Rhode Island Hosoital

Poster Session (1:30-4:00 pm)CPRModerator: Norman Paradis, MD, Columbia University (2 :00-3 :00)138 Pulsed Diastolic Selective Aortic Arch Perfusion With

Autologous Blood Results in Return of Spontaneous Cir-culation in Prolonged Cardiac Arrest, James E. Manning,MD, University of North Carolina at Chapel HillSystemic Blood Pressure and Coronary Perfusion PressureDuring Closed-Chest Cardiac Massage and Minimally-Inva-sive Direct Cardiac Massage in Pigs, C. Andrew Eynon,Temple UniversityEffect ofVasopressin on Coronary Perfusion Pressure Dur-ing Human Cardiopulmonary Resuscitation, Daniel C.Morris, MD, Henry Ford HospitalAdolescent CPR Training: Can Kids Save Lives?,Christopher Markus, DO , University of Illinois at ChicagoProspective Study of Injuries Due to Cardiopulmonary Resusci-tation in Children, Colleen M. Bush, MD, Butterworth HospitalGastric Trauma and Pulmonary Aspiration at Autopsy AfterCardiopulmonary Resuscitation, William B. Felegi, DO,M orristown M emorial HospitalImpact of Route and Timing of Epinephrine Administrationon Survival in Out-of-HosDital Cardiac Anest. Keith L.Mausner. MD. Medicat Collbge ofWisconsin13 C NMR Analysis of Acetate Oxidation During In-\4vo Ven-tricular Fibrillati on, M ar k G. An ge lo s, M D, O hi o S tat e U niv e r s ityImpact of an Endotracheal Tube Side Port on The Absorp-tion of Lidocaine, John W. Walthall, NREMT-P, Joint Mili-tary Medical Centers

Injury Prevention/Interpersonal ViolenceModerator: Ronald F. Maio, DO, University of Michigan (3:00-4:00 pm)147 Domestic Violence in the Emergency Department: How Do

Women Prefer to Disclose and Discuss the Issues?, StephenR. Hayden, MD, Universiry of California, San Diego

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Monday, May 6148 Physical and Sexual Violence Among Mothers in a Pediatric

Emergency Department (PED), Susan J. Dufu, MD, RhodeIsland Hospital

149 Psychological Complaints of Women Victims of ViolencePresenting Into an Emergency Department, Bruce B. Becker,MD, Rhode Island Hospital

150 Victim-Offender Relationships in Intentional Trauma in aSuburban Versus Urban Trauma Center Population, CarolIrving, MD, Morristown Memorial Hospital

151 Violence Against Women-Risk Factor Identification in theED and Implications for Resources, Judilh A. Linden, MD,Boston City Hospital

152 Violence Amongst Intimates in an Inner City EmergencyDepartment Population, Deirdre Anglin, MD, University ofSouthern Califurrua

153 Measuring the Incidence of Behaviors Associated With Vio-Ient Injury Among Adolescents: What Are the Implicationsfor Preventionl, AlanWeiner, MD, Universi4t of Connecticut

154 Weapon-Related Violence and Security Measures in theEmergency Department, Cynthia Wichelman, MD, Washing-ton University

155 Barriers to Screening for Violence Against Women in theEmergency Department, Bruce M. Becker, MD, RhodeIsland Hospital

Ischemia./Reperfusion/ShockModerator: Charles B, Cairns, MD, University of Colorado (2:00-3:00)156 Reduced Calcium Accumulation in Isolated Nerve Endinss

During Hibernation, Nina T. Gentile, MD , Nationa! Instittieof Health

157 Soluble Complement Receptor-l Mitigates Lung InjuryAfter Intestinal Ischemia/Reperfusion in Rats, Feng Xiao,MD, Louisiana State University

158 Blood-Brain Barrier Sodium Permeability Following Car-diac Arrest and Resuscitation, James E. Olson, PhD,WrightState University

159 Antioxidant Treatment Preserves the Aortic VasorelaxantResponse to Peroxynitrite in Hypercholesterolemic Rabbits,Xin-liang Ma, MD, PhD, Thomas Jffirson University

160 Splanchnic Ischemia-Reperfusion Shock is Attenuated by L-Propionyl Carnitine, an Endogenous Ester in Fatty AcidMetabolism, Rebecca Stroh, Thomas Jefferson University

I 6 1 Potent Antioxidant, SB 21 147 5, AMetabolite of the New An-tihypertensive Agent Carvedilol, Protects Against SplanchnicIschemia-Reperfusion-Induced Endothelial Dysfunction,Theodore A. Christopher, MD, Thomas Jffirson University

162 SB 211475 is More Protective in Rat Splanchnic Ischemia-Reperfusion Shock Than its Parent Compound Carvedilol, ANew Antihypertensive Agent and Free-Radical Scavenger,Theodore A. Christopher, MD, Thomas Jffirson University

163 L-Propionyl Carnitine, an Endogenous Ester in Fatty AcidMetabolism, Protects Against Splanchnic Ischemia-Reperfusion-Induced Endothelial Dysfunction, Theodore A.C hristopher, MD, Thomas Jefferson U niversity

Ischemia/Reperfusion/ShockModerator: Emanael P Rivers, MD, MPH, Henry Ford Hospital6:00-4:00)164 Is Urine Output a Reliable Index of Blood Volume in Hem-

morhagic Shock?, Richard H. Sinert, DO, State Universityof New York, Brooklyn

165 Gastric Tonometry as a Measure of Blood Loss, Bonny J.Baron, MD, State University of NewYork, Brooklyn

166 Evaluation of Hepatic Gluconeogenesis In Response ToEpinephrine During Endotoxic Shock, Clark S. Homan,MD, State University of New York, Stony Brook

167 Comparison of Base Deflcit and Lactate in Trauma Patients,C. Sean Black, MD,Wake Forest University

168 Disassociation of Hepatic Blood Flow From Oxidative Me-tabolism During Hemorrhagic Shock and Resuscitation,Christopher Gnadinger, MS N, University of Colorado

169 IL-6 Determination in ED Patients with Sepsis, Carol A.Terregino, MD, Cooper Hospital

170 Chlorpromazine Selectively Inhibits Endothelium-Depen-dent Vasorelaxatjon, Dale S. Birenbaum, MD , Thomas lef-ferson University

I7l Hydroxyethyl Starch in Hypovolemic Shock: Pharmakody-namic Comparison of Intraosseous or Intravenous Infusion,Rainer Kentner, MD, University of Mainz

EMSModerator: Theodore R. Delbridge, MD, MPH, University ofPittsburgh (2 :00-3 :00 pm)172 Automatic External Defibrillation and its Effects on Neuro-

logic Outcome in Cardiac Arrest Patients in an Urban Two-Tiered EMS System, Jffiey D. Ho, MD, Hennepin CountyMedical Center

173 Projected Impact of First Responder AED Use in an UrbanALS Service, Joseph Stephan Stapczynski, MD, Universityof Kentucky

174 Should Aeromedical Support Be Sent For Cardiac ArrestPatients?, Carrie Nelson, MD, University of Nevada

175 Online Medical Control Does Not Improve Safety Or Effi-cacy Of Morphine For Out-of-Hospital Pain Control, SeanCarr, Oregon Health Sciences University

176 Online Medical Control Does Not Improve Safety OrEfficacy Of Diazepam For Out-of-Hospital Seizure Control,Patrick Gregg, Oregon Health Sciences University

177 Rate of Field Pronouncement of Cardiac Arrest PatientsAfter Aggressive Training of Base Physicians on Character-istics of Cardiac Arrest Survival, Eric D. Isaacs, MD, Uni-versity of California, San Francisco

EMSModerator: Ronald Pirrallo, MD, Medical College of Wisconsin(3:00-4:00 pm)178 Crash Scene Photography: Predictors of Injury in MotorVe-

hicle Trauma?, Craig Newgard, Loyola University179 Effect of Therapeutic Interventions on the Outcome of Out-

of-Hospital Pediatric Cardiopulmonary Arrest, Paul E.Sirbaugh, DO, Baylor College of Medicine

180 Geographically Based Analysis of Response Time Intervalsin a Suburban/Rural EMS System, George H. Lindbeck,MD, University of Virginia

181 Impact of Use of Lights and Sirens by Ambulances onElapsed Travel Times in an Urban EMS Setting, llarinder S.Dhindsa, MD, MPH, Georgetown University

182 Race is Not a Factor in OHCA Outcome in Two SuburbanEMS Systems, Kevin Chu, MD,William Beaumont Hospital

183 Prospective Time-Motion Study of the EMS Turnaround In-terval, David C. Cone, MD, Medical College of Pennsyl-vania and Hahnemann University

RespiratoryModerator: Emil M, SkobeloJf, MD, Medical College of Pennsyl.vaniq qnd Hahnemann University (2:00-3:00 pm)184 Efficacy of Intramuscular Depot vs Oral Steroids in Treat-

ment of Asthmatics Discharged from the Emergency De-pa.rtment, Bruce C. Meneley, MD, Naval Medical Center,San Diego

185 Second Derivative of the End-Tidal CO2 Waveform is Asso-ciated With Admission in Acute Exacerbation of Asthma,Selim Suner, MD, Rhode Island Hospital

186 Comparison of Albuterol Administered by Heliox and Oxy-gen Nebulization in the Treatment of Patients with Exacer-bations of Asthma: A Preliminary Report, Jack Horowitz,MD, Medical Center of Delaware

187 Effect of Changes in Acute Asthma Therapy in anEmergency Department Observation Unit on Improvementin Peak Expiratory Flow Rate: 1989 vs. 1994, Daniel G.Murphy, MD, University of Illinois at Chicago

188 Survey of Home Treatment in Patients With Acute Asthma,Robert Silyerman, MD, Long Island.Iewish Medical Center

189 Adrenal Function and Physiologic Stress During AcuteAsthma Exacerbation. Rita K. Cydulka, MD. MetroHealthMedical Center

RespiratoryModerator: Richard M. Nowak, MD, Henry Ford Hospital (3:00-4:00 pm)190 Atmosphere and Asthma in New York City: 1989-1995,

Ronald B. Low, MD, State University of New York, Brooklyn191 Do Patients Understand Asthma? A Survey of Knowledge

and Attitudes in the Emergency Department Population,James D. Schweigert, MD, Butterworth Hospital

192 Association Between Substance Abuse and Acute Exacerba-tion of Bronchial Asthma, Theodore Gaeta. DO. St. Barna-bas Hospital

193 Case Identification by Administrative Claims Data Versus Emer-gency Department Logbooks: Experience with Acute Asthma,Carlos A. Camargo, MD, Massachusetts Generctl Hospital

194 Comparison of Rapid Sequence Intubation to ConsciousSedation or Awake Intubation in the Emergency Depart-ment, .Iohn P. Fortney, MD,Washington University

195 Influence of Early Postnatal Seizures on Respiratory Con-trol in Weanling Rats, Thomas E. Terndrup, MD, State Uni,versity of'New York, Syracuse

Health Care DeliveryModerator: Marcus L Maftin, MD, Medical College of Pennsylvaniaand Hahnemann University, Allegheny Campus (2:00-3:00 pm)196 Compliance with Outpatient Refenal From a Large Urban Emer-

gency Department, Bruce D. Burstein, MD, Bellevue Hospital197 Frequent Emergency Department Users: Is It Possibte to

Control the Cost of Care?, Linda L. Snillane. MD. Llniver-sity ol Rochesttr

198 Computerized Protocols For Diagnostic Test Ordering: ADouble-Blind Assessment of Inter-rater Agreement WithEmergency Physicians, Gregory L. Larkin, MD, Universityrf Pittsburgh

199 Comparison of Emergency and Family Physician PracticePatterns for the Most Frequent Primary Care OutpatientPediatric Problems, David R. Eitel, MD,York Hospital

200 Profile of Patients Seen in the Emergency Department AfierDenial of Authorization for Care, Janene Hecker, MD, Medi-cal College of Pennsylvania and Hahnemann University

201 Cost of Routine Chlamydia Eliza Testing in the CtinicallySymptomatic Female, Chris Martella, DO, Albert EinsteinMedical Center

202 Survey of Emergency Medicine Residency Programs Re-garding Cutbacks in Resident Complement, Michele B.Wagner, MD, Beth Israel Hospital

Health Care DeliveryModerator: Robert A. Lowe, MD, MPH, University of Pennsyl-vanin (3:00-4:00 pm)203 Importance of Patient Selection in the Cost Effectiveness of

ED Based Observation Unit Treatment, Rebecca R. Roberts.MD, University of Illinois at Chicctgo

204 Socioeconomic Factors and Patient Satisfaction PredictEmergency Department Return Visits, Robert E. Antosia,MD, MPH, Brigham andWomen's Hospital

205 Women's Health: ED Identification of High Risk Behaviors,Gail D'OnoJrio, MD, Boston City Hospital

206 Effect of Transfer on Outcome in Patients with Appendicitis,Val e r i e C . N ort o n, M D, Valde rbilt [,] niv e r s ity

Monday, May 6207 Effects of Standardization of the Ratio of Number of

Emergency Departments Per Unit Population on EmergencyHealth Care Access in the U.S., C. James Holliman, MD,MS Hershey Medical Center

208 Is There a Maldistribution of Emergency Physicians FromState to State in the U.S.?, C. James Holliman, MD, MSHershey Medical Center

209 Comparison of Case Management by Physician AssistantsVersus Emergency Physicians and Primary Care Physicians,A. J. Hirshberg, MD, MPH, MS Hershey Medical Center

Scientific Papers: Health Care Delivery(4:00-6:00 pm)Moderator: Robert L Wears, MD, University of Flarfula210 Impact of Emergency Department Co-payment on Delay in

Seeking Treatment for Patients with Acute Myocardial In-farction, David J. Magid, MD,University ofWashington

211 Randomized Controlled Trial of a Rapid Diagnostic Protocolfor Chest Pain Patients: Cost and Patient Satisfaction Outcomes.Rebecca R. Roberts, MD , University of lllinois at Chicago

212 Decision of Analytic Cost-Effectiveness Analysis for theManagement of Acute Lower Respiratory Tract Infections,Gregory L. Larkin, MD, University of Pittsburgh

213 Comprehensive Metrics Methodology for Reducing Costsand Utilization of Resources in an Academic EmergencyDepartment, I. DouglasWhite, MD, MPH, Medical CollegeoJ Virginial Emergency P hysicicans' Medical Group

214 Rationing of ICU Care Based on Emergency DepartmentPrediction of Futile Outcome, N. EwenWang, MD,StanJordUnive rsity

215 Removal of a Computerized Guideline-Charting Systemfrom the Ernergency Department: Effect on the Quality ofCare of Health Care Workers Exposed to Body Fluids,David L. Schriser, MD, MPH, UCLA

216 EfTect of Students and Residents on Resource Utilization inan Emergency Department: Cost of Education, Edward A.Panacek, MD, University oJ California, Davis

217 Evaluation of Two Strategies for Complying with StateMandated Lead Screening in the Emergency Department,Scott Orava, MD, State University of New York, Stony Broolc

Scientific Papers: Respiratory (4:00-6:00 pm)Moderator: Charles L. Emerman, MD, Case Western ReserveUniversity218 Lack of Agreement Between FEVI an PEFR in Acute

Asthma, Robert Silverman, MD, Long Island JewishMedical Center

219 Magnesium Sulfate as an Adjunct to Standard Therapy inAcute Severe Asthma, Robert Silverman, MD, Long Island.Iewish Medical Center

220 Nebulized Glucagon in the Treatment of Asthmatic Bron-chospasm, ScottW. Melanson, MD, St. Luke's Hospital

221 Nebulized Ipratropium as an Adjunct to Albuterol and Pred-nisone in the Management of the Acute Asthmatic, David J.Robinson, MD, University of Maryland

222 Comparison Between Emergency Diagnostic and TreatmentUnit and Inpatient Care in the Treatment of Asthma,Michael McDermott, MD, University of Illinois at Chicago

223 Estrogen-Withdrawal Alters Response of Asthmatic RabbitBronchial Smooth Muscle to Calcium, But Not Histamine,Emil M. SkobeloJf, MD, Medical College of Pennsylvaniaa ttd Hahneman n U ni versi ty

224 Pulmonary Neutrophil Infiltration is Decreased During Par-tial Liquid Ventilation in a Model of Hemonhagic Shock,John G. Younger, MD, University of Michigan

225 Use of the Alveolar Dead Space Fraction and Plasma D-Dimer Concentrations to Diagnose Acute. Pulmonary Em-bolism in Ambulatory Patients, Iffiey A. Kline, MD,C arolinas Medical C enter

Monday, May 6

DIDACTIC SESSIONSTeaching Pediatric Emergency Medicine toEmergency Medicine Residents: Different Waysto Skin a Cat (8:00-9:30 am)Moderator: Emily Pollack, MD, Maricopa Medical CenterRobert Jorden, MD, Maricopa Medical CenterCarey Chisholm, MD, Methodist Hospital of IndianaSusan Fuchs, MD , Children' s Hospital, PittsburghPediatric patients comprise a significant portion of ED visits.

Emergency Medicine residents learn about the management of

pediairic urgencies and emergencies in a variety of clinical set-

iings. There is controversy over which of these settings. affords the

besl training opportunities. This panel discussion will feature a

speaker from each of the three major teaching settings for pediatric^

emergency medicine: a general academic ED that sees patients-of

all ages in the same department; an academic ED that divides

patients into separate EDs within the same facility based on age;

ind a children s hospital ED. Advantages and disadvantages of

each setting will be discussed and debated.

EMRA/SAEM LeadershiP Forum1) Chief Residents'Forum (8:00-12:00 noon)Rita Cydulka, MD, Metrohealth Medical CenterDavid Fosnocht, MD, Unitersity of PittsburghRobin Hemphill, MD, Joint Military Medical CentersThis forum, an annual presentation organized by EMRA' is an

effort to help future chief residents deal with commonly encoun-

tered problems and concerns. Each panelist will address an aspect

of leadership in emergency medicine, and a question and answer

period will ensue. A11 residents, especially future chief residents,

are encouraged to attend. Weatherby Health Care will sponsor a

refreshment break between these two sessions'

2) ZlYears of Academic Emergency Medicine inPerspectiveMorJeiator: John Marx, MD, Carolinas Medit'al CenterRobert Knopp, MD, St. Paul-Ramsey Medical CenterLewis Goldt'rank, MD, New York U niversityPeter Rosen, MD, University oJ California, San DiegoDavidWacner, MD, Medical College of'Pennsylvania and Hahna-mann UniversityHistorical reflections on the origins of academic emergency medicine'commentary on what we have accomplished, an assessment of thecurrent national status of academic emergency medicine and recom-mendations for future directions for academic programs. To be dis-cussed by recognized, experienced academic leaders in the specialty'

The Enigma of Pediatric Out-of-HospitalCardiac Arrest: Are Current ResuscitationMethods Really Worthwhile? (10:00-11:00 am).Ioan E. Shook, MD-, Texas Children' s Hospital Emergency CenterLinda Quan, MD, Children's Hospital and Medical Center, SeattleA recent population-based cohort study (n=210) has confirmedthat, despiie aggressive use of advanced resuscitative efforts (with-in an EMS system with excellent adult survival rates), outcomesremain bleak for those children found pulseless and apneic byEMS personnel. Using this recent study and review of the litera-ture. the faculty wil l challenge our present techniques for resusci-tating children and call to question very interesting considerationsregaiding the etiology, epidemiology, demography and manage-ment of pediatric out-of-hospital cardiac arrest. Specifically,^cansubgroups of patients be identified for whom resuscitation effortsstroutO Ue teminated on-scene or even waived altogether? Canstudies with such small populations, statistically speaking, be usedto determine "zero chance of survival." When is a zero numeratorreally zero? Should we change our current regimens for out-of-hospital pediatric resuscitation or simply concentrate on etiologicand prevention issues? In this session, the speakers will compre-hensively present and then itemize future research challenges.

A Pre-Publication Analysis of the NHLBI-NAEPPAsthma Management Guidelines from anEmergency Medicine Perspective (L1:ffi-12:00 noon)Moderitor: Richard M. Nowak, MD, MBA, Henry Ford HospitalEmit Skobetoff, MD, Medical College of Pennsylvania andHahnemann UniversitYCharles Emermctn, MD, Case Western ReserveCharles Cairns, MD , University of ColoradoRobert Silverman, MD, Long Island Jewish Medical CenterMichael McDermott, MD, Cook County HospitalJanice Zimmerman, MD, BaYlorThe National lnstitutes of Health's Expert Panel on Asthma Man-agement is currently in the process of updating its previously^pub-liihed asthma management guidelines. Draft documents of thisreport will be analyzed with an opportunity for input from them-embership. Selected members will critically discuss the emer-gency care aspects of the guidelines and provide scientific infor-mation as to why there should be changes suggested. Those attend-ing this meeting will also review these draft guidelines and canuo'i". ony scientific concerns. Dr. Nowak will take back to the NIHthe results of the deliberations. This session should provide interes!ing dialogue concerning asthma management emergency careguldelineJwith an opportunity to affect national recommendations'

EMRA/SAEM William H. Spivey, MD' ResidentResearch Forum (12:00-1:30 Pm)Robert A. Lowe, MD, MPH, University of PennsylvaniaEpidemiologic techniques are powerful tools for clinical research'Wnite traOitionally associated with public health issues, thesemethods are equally suited for addressing clinical investigationsand health poliiy questions. The purpose of this session is to giveresidents and young faculty investigators an introduction to thetechniques of itinicat epidemiology as applied to emergency med-icine research. The speaker will illustrate the advantages and pit-falls of these methods with examples from the literature as well asfrom his own research.

Luncheon: Controversies in the AcuteManagement of Asthma (L2:00-1:10 p*)Moderalor: Emil M. SkobeloJJ, MD, Medical College of PennsylvaniaRichard Martin, MD, National .Iewish CenterSally Wcnzel, MD, National Jewish CenterRichard M. Nowak, MD, Henry Ford HospitalMichael McDermott, MD, Cook County HospitalNoted researchers from the National Jewish Center for Immun-ology and Respiratory Medicine in Denver and emergency physi-ciani will discuss their views on current interventions and futuredirections in the care and disposition of patients presenting to theEmergency Department with an acute exacerbation of asthma'Diveriity of opinion and a disinclination to agreement will beencouraged on the part of panelists and attendees alike. Activeaudience participation will be encouraged'

Fundamentals of Research: How to do a ChartReview (1:30-2:30 pm)Steven R. Lowenstein, Mb, MPH, University of ColoradoChart reviews are often used to conduct research in emergencymedicine. However, the reliability of data abstracted by chart isseldom examined critically. This session will focus on the researchuse of medical record and trauma registry data. Pitfalls and prob-lems, such as missing charts, missing or conflicting data, poorlytrained abstractors, Uiinding, bias, and inter-rater agreement willbe discussed. "Numerator nonsense"' a flaw found in manyresearch studies based on trauma registries, will also be discussed'Published articles from the emergency medicine literature will beused to illustrate methodologic errors. This session will then pre-sent eight critical strategies that can improve the validity andreproducibility of medical record reviews.

Workforce Issues Affecting Emergency Medicine- Are There Too Many of Us or Too Few?(1:30-2:30 pm)Moderator: C.Iames Holliman, MD, MS Hershey Medical CenterRichardWuerz, MD, MS Hershey Medical CenterWilliam Dalsey, MD, Albert Einstein, PhiladelphiaLouis Ling, MD, Hennepin County Medical CenterSandra Schneider, MD, University of RochesterThis session will present data accumulated by the SAEM Work-force Task Force regarding workforce issues; present computermodel projections of the need for EM physicians in the futureunder different workforce conditions; discuss the recent Pew Com-mission and Institute of Medicine Reporls as these relate to emer-gency medicine; and answer questions from the membership aboutworkforce data and issues.

Fundamentals of Research: Data, DataEverywhere . . . Data Collection Forms and DataManagement (2:30-3:30 pm)Susan S. Fish, PharmD, MPH, Boston UniversityThe art of data collection form development is central to anyresearch project. It sounds easy, but it's not. Examples of winnersand losers, many from the speaker's own er-periences, will be usedto illustrate how to avoid headaches from data collection. Once theform is developed, then what? How to manage the data is depen-dent on the type of data as well as the funding available. Data man-agement for an unfunded, or poorly funded, project will bestressed. Examples from emergency medicine projects will be usedto show how to keep control of the immense amount of data thathas been collected.

Research Development During a Major Disaster:The Oklahoma Bxperience (2:30-3:30 pm)KevinYeskey, MD, UniJbrmed Services, University of the HealthSciences, BethesdaDavid Hogan, MD, University of' OklahctmaRichard Aghababian, MD, University of MarylandM. Andrew Levitt, DO, University of Califbrnia, San FranciscoThe focus ofthis session will be how to fund and conduct researchduring a major disaster. Specifically, it will be discussed how toobtain manpower and funding from the federal government, themilitary, and the department of public health. Additionally, the var-ious difficLrlties and methodologies that occur in setting up aresearch base during a disaster will be reviewed. It will be dis-cussed how to set up and implement an injury registry to collectdata in an ongoing basis during both the acute phase and the daysfollowing the disaster.

Fundamentals of Research: Scientific Misconductand Fraud (3:30-4:30 pm)Michelle Biros, MS, MD, Hennepin County Medical CenterOver the last several years the issue of scientific misconduct hascome to public view by increased media attention to allegations ofdata fabrication, falsification, and plagiarism. The definition of

Monday, May 6

scientific misconduct is extremely broad and open to intelpreta-tion. As the research base of emergency medicine grows, thepotential for intentional or unintentional scientific misconduct andfraud increases. It is the responsibility of the emergency medicineresearch community to police itself and prevent abuse and misuseof research. This discussion will attempt to classify the major cat-egories of misconduct and illustrate the impact of fraudulentresearch on the scientific literature. Suggestions regarding identi-fication and subsequent actions aimed at reversing consequencesof misconduct and fraud will be discussed.

The Current and Future Impact of ManagedCare on Academic Emergency Medicine (3:30-5:00 pm)Moderator: E. John Gallagher, MD, Bronx Municipal HospitalJohn C. Moorhead, MD, Oregon Health Sciences UniversityDavid P. Sklar, MD, University of New MexicoGary P.Young, MD, Highland General HospitalLeslie S. Zun, MD, Mt. Sinai, ChicagoSome of the many questions to be discussed by the panel and theparticipants attending this session include the following: How willcare for the indigent be provided, particularly those who cannotqualify for Medicaid? Academic medical centers have traditional-ly provided uncompensated care for as long as they have been inexistence; how will ED's that are part of academic medical centerssurvive and maintain their long-standing covenant with society ifthey are not reimbursed for this in some fashion? If the focus ofmanaged care is directed away from teaching and research - inlarge measure because these entities represent long-term invest-ments rather than short-term profits - how will the next genera-tion of physicians be trained and how will medical knowledgeadvance? What will be the likely programmatic and educationalimpact on EM residency programs, particularly if ED censusdeclines and patient mix becomes increasingly homogeneous?Will there be a place for EM faculty who wish to develop careersin clinical investigation if they are unable to support themselvesthrough increasingly competitive grant acquisition or via patientcare revenues? How will EM faculty advance academically if theyare required to cover large numbers of clinical shifts, thus makingresearch and writing even more problematic? What sorts of 'value-

added' strategies should academic ED's consider, e.g., chest painobservation units, short-stay units, augmented fast-track, criticalpathways? Are there other strategies that academic EM mightdevelop to weather the 'managed care story'?

Fundamentals of Research: Writing the Abstractand the Art of the Scientific Presentation (4:30-5:30 pm).Iantes J. Menegazzi, PhD, University of PinsburghThe research is done and now the word needs to get out to clinicians.This session will cover the presentation of research findings as anabstract, a poster, and a platform presentation. The eight essentialcomponents ofa successful abstract will be presented along with tensimple rules for writing a good abstract. Examples of well written,and not-so-well written, abstracts will be used to illustrate the how-to. The art of oral or graphic presentations is complex, but there aresome easy rules to help the young investigator with these profes-sional presentations. Helpful hints will be provided.

Monday, MaY 6

8:00 - 8:30 am

8:30 - 9:L5

9:L5 - L0:00

10:00 - 10:30

L0:30 - 1L:L5

1,1:L5 - L2:00 pm

12:00 - 1:30

7:00 pm

ASSOCIATION OF ACADEMIC CHAIRSOF EMERGENCY MEDICINE

g01 N. Washington Avenue, Lansing, Michigan 48906-5137 (517) 485-5484 FAX (517) 485-0801

AACEM Annual Meeting

MondaYo MaY 6,1996Denver Room

Adam's Mark HotelDenver, Colorado

Continental Breakfast

o,Managing Change - Chair to Dean During Hgalth ftf:-tliipaul Roth, MD, Dean, iii:,rrrrtty of New Meico School of Medicine andformer Chair,

Department of EmergencY Medicine

"Academic Chairs: Who Are We?"

Results of a national survey and discussion led by sandra schneider, MD

Break

'oClinical Activity in an Academic Emergency Department"

Discussion led by Steve Stapczynski, MD

"Endowed Chairs: What Are They and How Do I Get One?"

Panel discussion with comments from membership

Moderator: Bill Robinson, MDExperts: Brooks norlt ,- ttn, Jack Allison, MD, Earl schwartz, MD, Brian Gibler, MD

Annual Business Meeting and Lunch, Gol'd' Room

1. President's Report, Bill Robinson, MD

2. Treasurer's Report, Sandra Schneider, MD

3. Election of Offrcers fot 1996-97, John Prescott' MD

4. New Business5. Updates:

a. ABEM, Doug Rund, MDb. Developmen, oi n-"tg"ncy Medicine at Academic Medical Centers Task Force'

John Gallagher, MDc. HCFA ruletl_zlzRegarding Teaching physicians, Nicholas Benson, MD

Annual Banquet

Monday, May 6

[6n1;couN'#,9,il"1%,"S,1*T:',K?'cINEMonday, May 6r 1996

Majestic BallroomAdam's Mark Hotel

Denver. Colorado

AGENDA

Note: Lunch will not be provided

12:30 - 1:30 pm Call to Order and Business Meeting[. Introduction of New Programs, Carey Chisholm, MD2. President's Address, Carey Chisholm, MD3. Secretary/Treasurer's Report, Sam Keim, MD4. ABEM Report

i. ffi i,;#"ffit"""T. member- at- r arge7. Presentation of the CORD Awards:

Resident Academic Achievement Award: Theodore C. Chan, MD, and Gary M.Vilke,MD, University of California, San DiegoFaculty Teaching Award: Charles V. Pollack, MD, Maricopa Medical Center

1:30-2:30 ooPanel Discussion on Faculty Development"Richard Braen, MD, John McCabe, MD, Corey Slovis, MD, and DavidWagner, MD

2230-2:45 Break

2:45-3:45 "Principles of Resident Evaluation"Stephen Abrahamson, PhD, D.Sc., Professor Emeritus of Medical Education, Universityof Southern Calfornia

3:45-4:45 "Medicare Reimbursement for Faculty Supervision"Terrence Kay, Director, Division of Physician Services, Health Care FinanceAdministration

4:45-5:00 Break

5:00-6:00 Round Table Discussions1. Evaluation of Emergency Medicine Residents2. RRC-EM Accreditation Issues3. Procedural Competency Task Force

Tlresday, May 7

Scientific Papers: Geriatric (8:00-9:30 am)Moderator: Arthur B. Sanders, MD, University of Arizona226 Clinical and Test Parameters in Geriatric Patients with Acute

Cholecystitis, L. Joseph Parker, Mayo Clinic227 Effectiveness of an Organized Follow-up System for Elderly

Patients Discharged From the Emergency Department,Michael S.Young, MD Butterworth Hospital

228 Validation of a Brief Screening Instrument to Detect De-pression in Elderly Emergency Department Patients,StephenW. Meldon, MD, MetroHealth Medical Center

229 Identification of Factors Which May Predict Adverse Out-comes in Elderly Patients: Prevalence Study ofPatient Func-tional and Cognitive Impairment and Care Giver Burden,Norm Kalbfleisch, MD, Oregon Health Sciences University

230 Geriatric Emergency Department Nutritional Screening:Feasibility, Yield, and Needs Assessment,.Iustin L. Kaplan,MD, Albert Einstein Medical Center

231 Immunologic Response to Tetanus Toxoid in the Elderly,Kumar Alagappan, MD, Long Island Jewish Medical Center

Scientific Papers: Administration (8:00-9:30 am)Moderator: David C. Seaberg, MD, University of Florida232 Effect of an Asthma Practice Guideline on Documentation

and Patient Outcome in an Urban Emergency Department,Kent Hall, MD, University of Cincinnati

233 Asthma Clinical Pathway: Reduction in ED TreatmentTimes, Sarah A. Stahmer, MD, University of Pennsylvania

234 Survey of Clinical and Non-Clinical Time Requirements ofEmergency Department Attendings in an Academic Setting,Marc R. Salzberg, MD, Baystate Medical Center

235 Predictive Validity of the Emergency Physician Job Satisfac-tion (EPJS) and Global Job Satisfaction (GJS) Instruments,Stephen Lloyd, MD, MSc, McMaster University

236 Tenure Track in Emergency Medicine, SethW.Wright, MD,Vanderbilt University

237 Assessing the Scientific Contribution of Two Decades ofEmergency Medicine Literature: An Alternative to the Sci-ence Citation Index Impact Factor, Douglas P. Barnaby,Albert Einstein C ollege of Medicine

Scientific Papers: Ethics (10:00-11:00 am)Moderator: James G. Adams, MD, Harvard238 Readability Analysis of Informed Consents Used to Enroll

Patients in Emergency Medicine Research, Timothy J.Mader, MD, Baystate Medical Center

239 How Informed is Informed Consent?, Tom Perera, MD,Albert Einstein College of Medicine

240 Should Postmortem Procedures Be Practiced on RecentlyDeceased Patients?, Kristen M. Ward. MD. MethodistHospital of Indiana

241 Distinct Criteria for the Termination of Resuscitation Ef-forts for Cardiopulmonary Arrest in Children, Paul E. Pepe,MD, MPH, Baylor College of Medicine

Scientific Papers: Pain Management(10:00-11:00 am)Moderator: Seth Wright, MD, Vanderbilt University242 Pain Documentation and Emergency Department Analgesic

Practice, Megan Leapley, MS V, University of Missouri,Kansas City

243 Visual Analog Pain Scale: Lack of Reactivity in the AcuteSetting, Diane Rimple, MD, Emory University

244 Effect of Age and Gender on Physician Estimates of PainSeverity in Patients With Extremity Trauma, NicholasVanD e e le n, MD, Butterworth H o spital

245 Nitrous Oxide for the Treatment of Migraine Headache,Wayne R. Triner, DO, Albany Medical Center

Scientific Papers: ComputerMethodology/Modelling (L0:00-11 :00 am)Moderator: David Schriger, MD, MPH, University of Caffirnia,Los Angeles246 Dynamic Decision Network for Modeling Time-Critical De-

cisions, GeffieyW. Rutledge, MD, PhD, Beth Israel Hospi-tal, Boston

241 Factor Analysis of the Standard Electrocardiogram, DavidM. Schreck, MD, MS, Muhlenberg Regional Medical Center

248 Genetic Algorithm Identifies Predictor Variables Used by aHead Injury Artificial Neural Network, Pierre Borczuk, MD,Mas sachusetts General H ospital

249 Model to Discriminate Bacterial vs Viral Meningitis, JosephGarber, MD, Long Island Jewish Medical Center

Poster Session (3:00-5:30 pm)Clinical PracticeModerator: Jeffrey W. Runge, MD, Carolinas Medical Center(3:30-4:30 pm)250 Violence and Threats of Molence Against Practicing Emer-

gency Physicians, Joseph C. Munafo, MD, Medical Collegeof Pennsylvania and Hahneman University

251 Confirmation of the Pulse Oximetry Gap in Carbon MonoxidePoisoning, William P. Bozeman, MD, University of Maryland

252 Systemic Inflammatory Response Syndrome (SIRS) at Tri-age: Prevalence and Association with Hospital Admissions,Alan P.Tuttle, MD, Henry Ford Hospital

253 Prevalence of Lactic Acidosis on Emergency DepartmentPresentation and Association with Hospitalization Rates,Mary Grzybowski, PhD. Henry Ford Hospital

254 Physician Ordering of Coagulation Studies in the EmergencyCenter - Impact of lnstituting a Laboratory Request Form,Continuation and Follow-Through, Gail S. Rudnitsky, MD,Medical College of Pennsylvania and Hahnemann University

255 Who Should Make the Thrombolysis Decision in a TeachingHospital?, Ron M.Walls, MD, Brigham andWomen's Hospital

256 Large Diameter Suction Tubing Significantly ImprovesSimulated Vomitus Evacuation Times, James T. Vandenberg,MD, Madigan Army Medical Center

257 Clinical Features Predictive of Coagulopathy in ChronicAlcoholics. Azita A. Toussi. MD. Carolinas Medical Center

258 In Vitro Assessment of the Boundary Lubricating Ability ofHealon as a Synovial Fluid Replacement for OutpatientManagement of Osteoarthritis, Gregory D. Iay, MD, PhD,Rhode Island Hospital

259 Characteristics of Depression in the Elderly, Stephen W.Meldon. MD. MetroHealth Medical Center

260 Prevalence of Low Thiamine Levels in Elderly NursingHome Patients Admitted Through the Emergency Depart-ment, Dayid C. Lee, MD, Medical College of Pennsylvaniaand Hahnemann Universiry

261 Serologic Prevalance of Anti-Diphtheria Antibodies (ADA)in the Elderly, Kumar Alagappan, MD, Long Island JewishMedical Center

Clinical PracticeModerator: Charles V Pollack, Jr., MD, Maricopa MedicalCenter (4:30-5:30 pm)262 Reliability of Dipstick Urinalysis in Adult Patients With

Suspected Infection or Hematuria, William W. Jou, MD,University of C onnecticut

PAPER/PO S TER PRESENTATIONS

263 Blood Cultures in Outpatient Pyelonephritis: Necessity orHabit, Richard B. Schwartz, MD, Madisan Army MedicalCenter

264 Efficacy of a Clinical Pathway for Suspected Renal Colic inReducing Intravenous Pyelogram Utilization, Dayid F.M.Brown, MD, Massachusetts General Hospital

265 How Useful are History and Physical Exam in IdentifyingEctopic Pregnancy in Patients with First Trimester Painand/or Bleeding?, Robert Dart, MD, Boston City Hospital

266 Orthostatic Vital Signs: Determining the Durarion of InitialSupine Positioning, Richard A. Harrigan, MD, TempleUniversity

261 Triage Classification Correlates With Final Disposition ofED Patients, Andrew T. McAJ'ee, MD, Brigham andWomen'sHospital

268 Heparin Anticoagulation in Patients Who Are Hemoccult Pos-itive, Ilya Chern, MD, Long Island Jewish Medical Center

269 Correlation of Blood Pressure With Peripheral Pulses,Richard A. Crayen, MD, EasternVirginia Medical School

270 Comparison of Systolic Blood Pressures Measured by PulseOximetry, Manual and Dinamap Methods in Children LessThan Two Years Old, Thomas J. Abramo, MD, University oJ'Texas Southwesterrt

27 | Blood Pressure: Assessment of Intera"rm Differences, Judd E.Hollander, MD, State University of NewYork, Stony Brook

212 Circadian Pattern Found in Pulmonary Edema, MelissaWeintraub, MD, The Brooklyn Hosoital Center

AdministrationModerator: Edward Bernstein, MD, Boston City Hospital (3:30-4:30 pm)273 Academic Emergency Departments in the Year 2000: Are

They Prepared or Willing to Change?, Harold K. Simon,MD, Egleston Children's Hospital

274 Canadian Association of Emergency Physicians (CAEP)Manpower Survey: Part I - Emergency Department Chiefs,Stephen R. Lloyd, MD, MSc, McMaster University

275 Increasing Compliance With RRC Requirements forFollow-up of Emergency Department Patients: Results ofthe 1996 National Emergency Medicine Residency TrainingPrograms Follow-up Survey, Harold Osborn, MD, LincolnMedical and Mental Health Center

276 Residency Training Site is Important in EM ResidentChoice of Practice Location, Mark T. Steele, MD , Universityof Missouri - Kansas City

277 Resident Physician Staffing Levels Do Not Alter AttendingPhysician Productivity at Five Large Academic EmergencyDepartments, James C. McClay, MS, MD, St. Joseph MercyHospital

2'78 What is the Support for Clinical Research in EmergencyMedicine?, Linda L. Spillane, MD, University of Rochester

279 Writing a Scientific Abstract: Survey of Authors, David C.Cone, MD, Medical College of Pennsylvania and Hahne-mann University

AdministrationModerator: J. Stephan Stapczynski, MD, (Jniversity of Kentucky(4:30-5:30 pm)280 Effect of PhysicianAttire on Patient Satisfaction, Anthony L.

Fisher, MD, Baystate Medical Center281 Does Wearing A Neck Tie Influence Patient Perceptions of

Emergency Department Care?, David Pronchik, MD, St.Luke's Hospital

282 Reducing Length of Stay Decreases the Number of Emer-gency Department Patients who Leave Without Seeing aPhysician, Christopher M.B. Fernandes, MD, St. Paul'sHospital, Vancouver

Thesday, May 7283 Analysis of Patient Care Complaints in the Emergency De-

partment Based on Level of Acuity, Length of Stay, and In-surance Type, Robert O'Connor, MD, Medical Center ofDelaware

284 Procedures for Completion of Incomplete Abortion in theEmergency Department: Under Whose Control?, Susan S.Fish, PharmD, MPH, Boston City Hospital

285 Variability in Blood Hemolysis Rates with Different BloodDrawing Techniques, Luis Alvernez, MS, MPH, Boston CityHospital

286 Undiagnosed Myocardial Infarction: Liability Before andAfter Thrombolytic Therapy, Virginia Burke, ID, WayneState University

EthicsModerator: Norm D. Kalbfleisch, MD, Oregon Health SciencesUniversity (3:30-4:30 pm)287 Ethical Issues of Cardiopulmonary Resuscitation: A Survey

Of Emergency Physicians, Catherine A. Marco, MD, lohnsHopkins

288 Oregon Emergency Physicians' Experiences, Attitudes andConcerns About Physician Assisted Suicide, Terri A.Schmidt, MD, Oregon Health Sciences Universiry

289 Measuring the Community Standard Regarding Waiver ofInformed Consent in Emergency Research Trial, John P.Anic etti, MD Harbor-UCLA

290 Academic Honesty: The Ethical Reference Point of Trainees,Robert M. McNamara, MD, Medical College of Pennsyl-yania and Hahnemann University

291 Impact of Patient Acuity on Patient Preference for MedicalDecision Making Autonomy and Information, Mark A.Davis, MD, MS, Beth Israel Hosoital

PainModerator: Knox H. Tbdd, MD, Emory University (4:30-5:30 pm)292 Use of Transcutaneous Electrical Nerve Stimulation to

Decrease the Pain Associated with Subcutaneous Injections,Michael Harrigan, MD, Carolinas Medical Center

293 Intravenous Ketorolac vs. Meperidine With Promethazine inthe Treatment of Renal Colic in the Emergency Department,William S. Korey, MD, Orlando Regional Medical Center

294 Prospective, Randomized Study Evaluating the Efficacy ofSublingual Hyoscyamine Sulfate and Intravenous KetorolacTromethamine in the Relief of Renal Colic, James B. Iones,MD, PharmD, Geisinger Medical Center

295 Effect of Temperature and pH Adjustment of BupivacaineFor Intradermal Analgesia, Christina Plzak, MD, Butter-worth Hospital

296 Pain Reduction in Local Anesthetic Administration ThroushBuffering and Warming, Kenneth B. Colaric, MD. MichiginState UniversitylKalamazoo Center for Medical Studies

297 Prilocaine-Phenylephrine and Bupivacaine-PhenylephrineTopical Anesthetics Compared to TAC During Repair ofLacerations, Thomas W, Barrett, Ohio State University

298 Benzyl Alcohol With Epinephrine as an Alternative LocalAnesthetic, Steven Martin, MD, Mt. Sinai Medical Center

299 PhysiciansAttitudesTowards NarcoticAnalgesic UseinAcuteAbdominal Pun, Jacques S. Lee, MD, University of Ottawa

300 Do Quantitative Changes in Pain Intensity Correlate withPain Relief and Satisfaction?, Sarah A. Stahmer, MD,Hospital of the University of Pennsylvania

301 Evaluation of Dermal Injury Threshold and SubcutaneousTemperature Change Associated with IontophoreticDelivery of Lidocaine with Epinephrine, Clark S. Homan,MD, State University of New York, Stony Brook

Ttresday, N{4ay 7C_omputer MethodologyModerator: Robert J. Schiartz, MD, MpH, University ofPittsburgh (3 : 30-4:30 pm)302 Chaotic Dynamics Model of patient Volume Flow In A

Major Urban Emergency Department, Raywin R. Huang,PhD, Wayne State University

303 Non-linear Time-varying Chaotic Attractor UnderlyingIschemic Cardiac Arrhythmias, Kyong foo, phD, Universi[,of Colorado

304 Linking Multiple Large Databases to Determine patientOutcomes, Sohail A. Waien, MD, Sunnybrook Health Sci_ence Centre

Health Care DeliveryModerutor: Sandra M. Schneider, MD, University of Rochester(4:30-5:30 pm)305 Medicaid HMO Participants' Compliance with ,Gatekeep-

rJrg' Guidelines for Emergency Department Utilization,Daniel S. Crough, State (Jniyersity of New york, Syracuse

306 lgrvey of Patients Denied Emergency Department Care ByTheir Managed Care plan, Theodore Chai, ptO. Universiivof Califurnia, San Diego

307 G^ate [eeping: A Limited Impact on Non-Urgent Urilizationof the Pediatric Emergency Department During Office Hours,Richard T. Strait, MD, Children's Hospital of Wisconsin

Does Access to Primary Care Offices Decrease ED Use?,Robert A. Lowe, MD, MPH, University of pennsylvania

Do Emergency Medicine Physicians Agree with primaryCare Physicians on Who is Appropriati for Care in the!ryergency Department?, Marc J. Shapiro, MD, RhodeIsland HospitalAre There liases in Triaging ED patients as Urgent vs Non_urgent? A National Multicenter Study Comparing 3143 tJr-gent Patients wirh3044 Nonurgent patients, Gary p.young,MD, Highland General HospitalAmbulatory Visits to 56 Hospital EDs Nationwide: AreThere Difference Between Nonurgent patients Who AreHospitalized Versus Those Who Are Denied Care?. Gam p.Young, MD, Highland General HospitalS,uccess-of a Triage Out Program in a Large public Teachingflgspitgl, Kevin S. Merigian, MD, University of Tennessee,Memphis

lmgrgency Department: Who is Really Nonurgent?, RobertW. Derlet, MD, University of Catifornia, DaviiDemand Management and Its Effect on Emergencv Care.Eric D. Salk, MD. UCLAEmergency Deparffnent Managed Care Denials: Do patientsPay Their Bills?, Claudia M . Beck, MD, Universitv of louisvilleWITHDRAWN

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DIDACTIC SESSIONSDomestic Violence: Research and Public Policy(8:00-9:30 am)Moderator: Jean Abbott, MD, University of ColoradoCapt. Miriam Reed, Denver City Police Department, DomesticViolence Task ForceSteve Lowenstein, MD, MPH, University of ColoradoLenora M. Olson, Director, Center for Injury Prevention Researchand Education, University of New MexicoThis session will review the status of research in domestic violencein 1996, as well as the unanswered questions regarding diagnosisand intervention. We will start with a critical appraisal of the liter-ature, a review of the epidemology of domestic violence in emer-gency medicine, and follow with a debate among the panelistsabout the utility and effectiveness ofthe legal approach to domes-tic violence - i.e. treating domestic violence as a crime and uti-lizing law enforcement officials to provide intervention.

Fundamentals of Teaching: Teaching's ToughestPart: Determining Goals, Objectives, andMethods (8:00-9:30 am)Kurt C. Kleinschmidt, MD, University of Texas, SouthwesternWe have all been on the "receiving end" of suboptimal education-al experiences. These often result from poor planning and devel-opment. Whether an item to be taught has a small or extensivefocus, the same principles guide curiculum development and theteaching methods used. This presentation focuses on the basic con-cepts of curiculum development and how to establish goals andobjectives. The different teaching methods, and the types of mate-rial for which each is best used, will also be discussed. The mate-rial can best be used by residents and faculty.

Fundamentals of Teaching: The Hands-OnInstruction of Procedural Skills (10:00-11:00 am)Michael P.Wainscott, MD, University of Texas, SouthwesternTeaching a procedural skill is a challenge requiring an uniqueapproach. While the actual practice of teaching a procedure cannot be done, the presentation describes how to best teach proce-dures. The material differentiates between the parts of the proce-dures best taught in the classroom versus with hands-on. Topicsinclude the roles of the orientation, demonstration, observatlon,feedback, and the performance checklist. The material can be usedby residents and faculty.

Luncheon: Integrating Emergency MedicineInto Undergraduate Medical Education(12:00-1:30 pm)Moderator : Nick Jouriles, MD, Case Western Reserve UniversityWilliam Burdick, MD, Medical College of PennsylvaniaGail D'Onofrio, MD, Boston UniversityKaren Restifo, MD,Yale UniversityJohn Mahoney, MD, University of PittsburghLawrence Kass, MD, Albany Medical CenterRichard Krugman, MD, Dean, University of ColoradoThis panel discussion will review the undergraduate (medicalschool) teaching of emergency medicine. It is designed for thoseeducators without an academic department. It will describe how toincorporate emergency medicine into undergraduate teaching, withan emphasis on how emergency medicine fits into the teaching ofall medical school graduates, especially the 'generalist.'The learn-er will learn about what to include, educational structure andadministrative hurdles. The goal is to provide each leamer withideas so that helshe can establish emersencv medicine education athis/her medical school.

Tlresday llN{.I.ay 7

Luncheon: Frontiers in Medical ToxicologyResearch (12:00-1:30 pm)Moderator: Richard C. Dart. MD, PhD, Universitv of ColoradoJudd Hollander, M D, Srate L/niversity of New Yori, itony BrookMartin Smilkstein, MD, Oregon Health Sciences UniversityDuring this session, recent resea.rch advances in areas of acute toxi-cology will be explored. The topics to be covered include: l) cocainein the emergency department; 2) acetaminophen overdose; and 3)the therapeutic use of antibodies. Recent research indicates that areassessment of cocaine induced heart disease in needed. Dr.Hollander will reveal the most recent issues produced from his mul-ticenter studies on cocaine-induced myocardial ischemia. Dr.Smilkstein will address recent research questions regarding the diag-nosis and treatment issues of acetaminophen toxicity related to therecent introduction of new longer-acting acetaminophen products.Finally, Dr. Dart will present the latest findings from clinical trialson a new generation ofpolyclonal antibody products for diseases asdiverse as rattlesnake bites and tricyclic antidepressant poisoning.

Luncheon: Paramedics and Advanced LifeSupport Services: Do We Really Need Them?(12:00-1:30 pm)Iac:k P. Campbell, MD, University oJ Missouri, Kansas CityJerry Overton, Medical College of VirginiaPaul E. Pepe, MD, MPH, Baylor College of MedicineEdward M . Racht, MD , City of AustinlTravis County EMSDaniel Spaite, MD , University of ArizonaBrian S. Zachariah, MD , University of Texas SouthwesternRecent publications, in both the scientific and lay press, have begunto question the proven effrcacy of out-of-hospital advance life supportinterventions. In this era ofhealth care reform and sovemmental bud-getary belt-tightening, such publications have nori begun to capturethe attention of government officials, ranging from U.S. municipali-ties, Canadian provinces and even national-level debates in somevenues (e.g., United Kingdom). Particularly with the advent of tech-nology such as automated external defibrillators, computerized 12-lead ECG algorithms and altemative airway devices, the actual valueand cost-effectiveness of paramedics (EMIP) services, as well asany conesponding ALS training, and now coming under increasing-ly serious scrutiny. This luncheon session will review the pros andcons of paramedic and out-of-hospital ALS care from both a scien-tific and fiscal perspective, and then attempt to resolve the issue usinga mock city council forum from a model community which is in theprocess of examining an EMS work needs analysis.

Fundamentals of Teaching: Providing Lip Service:Effective Lecture Techniques (3:00-4:00 pm)William P. Burdick, MD, Medical College of Pennsylvania andHahnemann UniversityWould you like to avoid being the lecturer that nobody wants tohear? This session, intended for faculty and residents, offers tips tomaking lectures more useful and effective for your audience.Issues to be addressed include content, organization, body lan-guage, and setting up the learning environment.

New Horizons in Cerebral Resuscitation(3:00-4:00 pm)Moderator: Norman Paradis, MD, Columbia UniversityRobertW. Neumar, MD,Wayne State UniversityMichelle H. Biros, MS, MD, Hennepin County Medical CenterJewell L. Osterholm, MDThis stimulating showcase session will provide attendees with aview of the future as dramatically new approaches to brain resus-citation are discussed. Dr. Biros will discuss the role antioxidantsand free radical scavengers in cerebral resuscitation. Dr. Neumarwill examine post-resuscitation strategies to minimize injury andinterventions to induce repair mechanism activity. Dr. Osterholmwill present ventriculo-subarachnoid perfusion with a hypothermicoxygen carrying nutrient emulsion.

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Thesday, May 7

Fundamentals of Teaching: Praise andCriticism: Giving Feedback They'll Listen To(4:00-5:00 pm)Kurt C . Kleinschmidt, MD , University of Texas , SouthwesternOne of the most important educational tools that any clinicalteacher has is giving "feedback." Unfortunately, this is not an easynor naturally acquired skill. Some trainees already know it all,have an excuse for everything, or are simply not nice to be around.Teachers characteristics can also affect the ability to give feedback'This presentation clarifies some of the barriers that prevent effec-tive feedback and how to overcome them. The material can be usedby residents and faculty.

ABEM Activities: ABEM Interactions withFaculty (3:00-4:00 pm)This session will provide an opportunity for Emergency Medicineprogram directors and faculty to interact with ABEM directors and

staff. A packet of reference material for this session will be avail-able all week at the SAEM registration desk.

Is the Outcomes Movement Dead? (4:00-5:00 pm)Moderator: Ronald Maio, DO, MS, University of MichiganJane Scott, PhD, University of MarylandIn recent years, the medical profession has begun aggressively pur-suing outcomes research. The primary funding source for this typeof research has been the AHCPR. U:tfortunately, this organizationexperienced a 75Vo budget cut last year' Politicians and scientistshave questioned whether outcomes research is legitimate and/orworthwhile. During this session, Dr. Jane Scott will speak on thefuture of outcomes research in regards to its scientific credibility andits funding potential. Dr. Scott was previously a Health ScientistAd-minisffator and a Team I-eader of the Methods and Outcome Mea-surement team for the AHCPR. She is currently working for TheCharles McC. Mathias, Jr. National Center for EMS Studies basedat the University of Maryland School of Medicine. Dr. Ron Maio, arauma care outcomes researcher, will moderate the discussion.

Thesday May 7

ANNUAL BUSINESS MEETING AGENDA1 . Elections, Lewis Goldfrank, MD , President

The slate of nominees and biographical information on each candidate is published on pages 32-35.

2. Amendments to the Constitution and Bylaws, John Marx, MD, SecretarllTreasurerThe full Constitution and Bylaws and proposed amendments are published on pages 24-27 of the 1995-96 AnnualReport. The Constitution and Bylaws Committee proposed amendments are published on page 35. They are:a. change Program Committee chair from elected to appointed positionb. change Education Committee chair from elected to appointed positionc. change Research Committee chair from elected to appointed positiond. change associate membership status

3. Awards Presentations, DonYealy, MD and Lewis Goldfrank, MD

4. Secretary/Treasurerts Report, J ohn M arx, M D, S e cretary lTreasurerA review of SAEM membership and finances is published on pages 12 and 13 of the 1995-96 Annual Report.

5. President's Address, Lewis Goldfrank, MD

6. Introduction of 1996-97 President: Steve Dronen, MD

7. New Business

8. Adjournment

Note: Award recipients and newly elected members should meet at the podium at the conclusion of the Annual BusinessMeeting for a brief photo session. Photos will be published in upcoming issues of the Newsletter.

Award PresentationsHal Jayne Academic Excellence AwardCorey Slovis, MD, Vanderbilt University

Leadership AwardJudith E. Tintinalli, MD, University of North Carolina

Physio Control EMS FellowshipOwen T. Traynor, MDInstitution: University of PittsburghThis $50,000 fellowship is funded by Physio Control Corporation

1995 Annual Meeting AwardsBest Oral Clinical Science PresentationArthur L. Kellermann, MD, MPH, Emory University

Best Oral Basic Science PresentationMichelle Biros, MS, MD, Hennepin County Medical Center

Best PosterAmy J. Behrman, MD, University of PennsylvaniaJudy Hsu, BA, University of Califomia, Loi Angeles

Best Innovations in Emergency Medicine Education ExhibitJohn W. Becher, DO. Albert Einstein Medical Center

Selected to be Presented at the AAMC Annual MeetingC. James Holliman, MD, Pennsylvania State UniversityWilliam P. Burdick, MD, Medical College of Pennsylvania andHahnemann University

Best Education PresentationWilliam P. Burdick, MD, Medical College of Pennsylvania andHahnemann University

Best Oral Resident/Fellow PresentationRobeft Silbergleit, MD, Medical College of Pennsylvania andHahnemann University

Best Resident/Fellow PosterWayne Satz, MD, Medical College of Pennsylvania andHahnemann University

Best Pediatric Emergency and Critical Care PresentationDavid M. Jaffe, MD, Washington University

Best Medical Student PresentationKristina K. Ishihara, Vanderbilt University

Best Technology PresentationCharles B. Cairns, MD, University of Colorado

Tlresday, May 7

1996 LEADERSHIP AWARD

Judith Ellen Tintinalli. MD

A graduate of the University of Michigan Medical School, and a graduate of internal medicine residency, Dr. Tintinalli found herlove and her niche in her professional career in emergency medicine. She graduated her residency in the days when emergencymedicine residencies were just a birthing, and there r"re non" in Michigan, her home state.

Dr' Tintinalli had an all consuming love for Detroit and Michigan. She was a single parent during much of her professional career,when her children were growing into and past adolescence. Di. Tintinalli *unugJd ti ^""t rr". parental responsibilities even whenher professional duties were demanding. And her passionate self only continuid into her professional career.

She was demanding of her students, her residents, and her colleagues. She expected all of us to meet her high standards, but espe-cially her students and residents. Dr. Tintinalli brought an air of"collegiality fo her residents and students, frequently engaging insocial activities with them. She expected all of us to act as compassionate physicians, not technical doctors. or un trr" things sheaccomplished for the specialty, I believe her desire to associate with others who r"." equally compassionate, equally responsible,and equally passionate about life and learning, is perhaps her most outstanding single contiibution to the field.

Dr' Tintinalli's contributions include being associated with, and developing, three residencies in emergency medicine - wayneState University, william Beaumont Hospital, and now University of Nortli carolina. She served as a chairperson of the LiaisonResidency Endorsement^c^ommittee, the precursor of the RRC-EM, continuing a legacy oi Ji poricing for all of us. Dr Tintinalliwas the first president of coRD. she has served as president of the Americui so#a or n-Ltgin"y Medicine. She served as theProgram chairman for the uA/EM Annual Meeting. in all of her service, she brought ttr" ,u-"?i-passion and passion and desireto succeed.

Her enduring legacy may.always_be the Study Gu.ide,first developed by her, then nurtured by her, and then, matured by her. Whenwe worked with her as editors of the study Guide, we knew who was'the "boss." This besi selling textbook in emergency medi-cine is published in German, Spanish, and French. It has made her internationally known, and respected.

In 1981' she was chosen Michiganian of the Year- She is the recipient of ACEp's major awards for contributions to emergencymedicine and to the college, having received both the Mills Award and the weigenstein Award. Dr. Tintinalli served all organi-zations the same, with passion to contribute and to make a positive contribution to the field.

As I look at the list of award winners that SAEM.has elected for this particular award, I am overwhelmed with the distinguishedgroup she joins' But I cannot help but think of all her luster adds to tire shine and the prestige or tfr" Award.

Ronald L. Krome, MD

Tiresdayo N[ay 7

1996 HAL JAYNE ACADEMIC EXCBLLENCB AWARD

After an admittedly checkered college career typical of the late 60's, Corey Slovis went on to medical school at the New JerseyCollege of Medicine. After graduation, he came south and quickly established himself as one of the brightest Internal Medicineresidents at Emory University. He was on the fast track to a career in Infectious Diseases until he was eiposed to the lights andsirens on the ambulance ramp at Grady Memorial Hospital. He was hooked. Immediately upon finishing his Ifrtedicine rJsidencyand against almost everyone's advice, he signed up for an Emergency Medicine residency ai E-o.y.

It was a marriage made in heaven. Corey found he thrived on chaos and Grady Hospital is one of those places where chaos is therule. Immediately after finishing his second residency, he took the position as Direitor of the Medical Emergency Clinic (MEC)at Grady. There weren't many Emergency "Departments" in those days. As the only faculty member ln the nlpC, he establisheda daily morning conference and made regular "lightning" rounds at other times. It was here that he began to hone his naturalteaching skills and soon had become something of a legend at Grady. To truly appreciate the impact he hid, you should read thechapter about Dr. Mal Goodson in the book on Becoming a Doctor by Melvin Konner.

With access to large numbers of the sickest, most neglected patients in Atlanta, he had at his fingertips a veritable cornucopia ofclinical experience. It provided not only grist for his teaching, but also an opportunity for cliniial rbsearch. He began to writeand to develop a faculty of teachers dedicated to Emergency Medicine, hard to do in an environment where EmergenJy Medicinewas considered a stepchild to the more powerful departments of Medicine and Surgery.

He began to get his first teaching awards at Grady. He became involved with EMS and further expanded his reservoir of experi-ence. He also got state-of-the-art lights and sirens put on his own car, as well as a regulation set of fireman's gear.

After 15 years at Grady, he decided to take on the challenge of starting up Emergency Medicine at the University of Rochester.Over the next few years, despite consistent and vigorous resistance, he set the stage for the eventual achievemeni of a residencyand departmental status. He turned a money-hemonhaging area into a profit center and attracted a faculty worthy of a residency.In three years, he won the graduating class' Award for Teaching Excellence every year and was honored with Alpha Omega AlphaFaculty Member Selection. In the meantime, he had become a speaker of national reputation and won th; 1990-91 ACEpOutstanding Speaker of the Year award.

Before achieving his goals at the University of Rochester, he longed to return to the South where he had adopted roots. VanderbiltUniversity provided that opportunity. Since his arrival in Nashville in 1992, he has attained the academic rank of Professor, a res-idency program has gotten off the ground, departmental status has been achieved, another money-losing venture has been turnedaround, he has tripled the size of the faculty, and he has won two major teaching awards. All this occurr"d while he maintainedhis rigorous national speaking schedule.

Corey has demonstrated all of the academic attributes of scholarship, research and service required to even be considered for anhonor such as the Hal Jayne Academic Excellence award. His CV contains 120 articles, book chapters and monographs. He is amember of the Editorial Board of Emergency Medicine Reports and is a reviewer for the Annals o7 E*ergrnry Uiaicine and theAmerican Journal of Emergency Medicine.

But if you asked him how he'd like to be remembered, it would be as a teacher. To be a "good" teacher, you have to combineintelligence and experience. To be a "great" teacher, you have to have enormous energy and really care about what you do. Moreimportantly, you have to be willing to give something of yourself to your students. Corey has given his unique blena of wisdom,honor and humor to countless students, residents and young faculty members.

Keith Wrenn, MD

Corey Slovis, MD

Tiresday, May 7

1996 Slate of NomineesThe Nominating Committee and Board of Directors are pleased to present this slate of candidates. The following general guidelines were used.l. Nominations were sought from the membership through adveriisements in the Newsletter.2. All members who responded to the "Call for nbminations" in the Newsletter were considered.3 ' whenever possible, a slate of two or more cand-idates .are presented to the membership-for each position. It is the committbe,s opinion that. the membership should be given choices of well qualified candidates whenever possitle.4' The Board of Directors believes it is important to have a single ballot for each position under consideration rather than pairing up nomi-nees. Thus, the most qualified candidatei for each.position cin be selected by thi membership.5' Each position will be open for additional nominations from the floor at the annual business meeting.6' Biographical information regarding each nominee is presented to the membership prior to the elections.

President-Elect

Secretary/T[easurer(one 3-year position)

Board of Directors(two 3-year positions andone l-year position)

Education Committee chair-elect(one year as chair-elect,two years as chair)

President-Elect

John Marx, MD

Marcus Martin, MD

Edward Bernstein, MDWilliam Dalsey, MD, MBAJames Holliman, MDSandra Schneider, MDScott Syverud, MDBrian Zink, MD

Glenn Hamilton, MD

Program Committee chair-elect(one year as chair-elect,two years as chair)

Nominating CommitteeMember(.one 2-year position)

Constitution and BylawsCommittee Member(one 3-year position)

Charles Cairns, MDAndrew Levitt, DO

E. John Gallagher, MDPaul Pepe, MD

Robert Muelleman, MDThomas O. Stair, MD

John A. Marx, MD is Chair of the Department of Emergency Medicine at Carolinas Medical Center andClinical Professor in the Dep^artTent

9f Emergency tvtediiine at the University of North Carolinas, chapelHill. He graduated from Stanford Medical School in 1977 and completed an Emergency Medicine Residencyfrom Denver General Hospital in 1980. Dr. Marx has served on tire SAEM Board of Directors since 1992and this past year has served as Secretary/Treasurer. He has participated on the publications Committee since1992 and as a member of the Job Negotiation Monograpir Task Force. He is on the Editorial Boards of\:,1d.emic Emergency Medicine, Journal oJ'Emergnrry Medicine and Emergency Medicine: Concepts andClinical Practice' He cofounded Case Studies in Emirgency Medicine and"Emirgindex.Dr. Marx was therecipient of the 1991 Hal Jayne Academic Excellence Award.

Edward Bernstein, MD is Associate Professor of Emergency Medicine and public Health and Vice Chair forAcademic Affairs at Boston University School of Medicine and Boston City Hospital. He graduated fromStanford University School of Medicine. He has served on the SAEM Board of l]irectors s]nce 1995, andfrom 1993-95 served as Chair of the SAEM Public Health and Education Committee. He has served on theGeriatric Task Force since l99l and the SAEM Patient-Physician Communication Task Force (1994-96).Hehas served as a Reviewer^for Academic Emergency Mediiine and, Annals of Emergency Mediiine. He wasthe New Mexico ACEP Chapter officer and served as Presidenr (1982-86); and fr6m isso-ss he served asChairman of the STEM Public Education Committee.

Marcus L. Martin, MD is an Associate Professor and Interim Chair of the Department of EmergencyMedicine at the Medical College of Pennsylvania, Allegheny Campus. He graduated from Eastern VirginiaMedical School in 1916 and completed an Internship from uSpgs Hospital,-Staten Island, New york, as wellas an Fmergency Medicine Residency in 1981 from the University of Cincinnati. He has served on the SAEMBoard of Directors since 1992. He was a member of the SAEM

-Constitution and Bylaws Committee (19g9-

92) and served as chair (1991-92). He has served as a consultant for the Residency Consultation Service. Dr.Martin has been a member of the CORD Board of Directors and is the CORD president-Elect. He has par-ticipated as an ABEM Oral Examiner, an ACEP Councillor, ACEP GME, Academic Affairs, and SteeringCommittees, the Pennsylvania ACEP Board of Directors. He has also served as a Reviewer/Consultant fbrAnnals of Emergency Medicine from 1985-92.

Secretary/TFeasurer

Board of Directors

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Ttresday, N{.I.ay 7Board of Directors (Continued)

William Dalsey, MD, MBA is Chair of the Department of Emergency Medicine at Albert Einstein MedicalCenter and Associate Professor of Medicine at Temple University Medical School. Dr. Dalsey graduatedfrom the Medical College of Pennsylvania medical school in 1981 and completed an Emergency Medicineresidency at the University of Cincinnati in 1989. He has served a consultant for the SAEM-ResidencyConsulting Service and was a member of the Technology Committee (1989-93). Since 1992he has been amember of the SAEM Residency Committee. Dr. Dalsey is the chair of the CORD Bylaws Committee andthe CORD Curriculum Task Force and is a reviewer for Academic Emergency Midicine and Annals ofEmergency Medicine.

C. James Holliman, MD is an Associate Professor of Surgery and Emergency Medicine at PennsylvaniaState University, and Director, Center for International Emergency Medicine. He graduated from medicalschool in 1979 from Washington University in St. Louis, and completed a Bum Research Fellowship in 1982,as well as a General Surgery Residency in 1983 from the University of Utah. Dr. Holliman has served as theChair of the SAEM Workforce Task Force (1995-96), and as a member of the International Committee(1993-96). Since 1994, he has served as an ACEP Councillor, and Chair of the ACEP publicationsCommittee and Education Committee. He is a Reviewer for Academic Emergency Medicine and prehospitaland Disaster Medicine and is International Editor of the Hong Kong Journal of Emergency Meelicine. Dr.Holliman was a recipient of the 1995 CPC Best Faculty Discussant Award.

Sandra Schneider, MD is Professor and Chair of the Department of Emergency Medicine at the Universityof Rochester. She graduated from the University of Pittsburgh Medical School in 1915 and completed anInternal Medicine Residency in 1978 from the Presbyterian University Hospital. Dr. Schneider served as amember of the SAEM Board of Directors from 1993-95. She chaired the SAEM Fellowship Task Force1995-96 and will chair the Residency Consulting Service starting July 1996. She has been a member of theSAEM Technology Committee (1988-93), a member of the Constitution and Bylaws Committee (1990-93)and Chair of that committee (1992-93). Dr. Schneider is an Editorial Board member for the Journal ofPrehospital and Disaster Medicine, Emergency Medicine Reports, and the Journal of procedures inEmergency Medicine. She is also a Reviewer for Academic Emergency Medicine, Annals oJ' EmergencyMedicine, and the American Journal of Medicine.

Scott Syverud, MD is Associate Professor and Interim Chair of the Department of Emergency Medicine atthe University of Virginia. He graduated from medical school in 1981 from the State Univeisityof Newyork,Syracuse and completed an Emergency Medicine Residency in 1985 at the University of Cincinnati. He com-pleted a Research Fellowship there in 1984 and served as chief resident in 1985. He has served on the SAEMBoard of Directors since 1994 serves on the Financial Oversight Committee. He was the EMRA representa-tive to the UAEM Executive Council and the STEM Board of Directors (1984-85), a member of the UAEMGovernmental Affairs Committee (1986-87), the chief residents program organizer in 1990 and a member ofthe SAEM Program Committee (1988-93). He has been a Reviewer for Academic Emergency Medicine,Annals of Emergency Medicine, the American Journal of Emergency Medicine, and JAMA.

Brian Zink, MD is Assistant Professor in the Section of Emergency Medicine, Department of Surgery at theUniversity of Michigan Medical Center. He graduated from medical school at the University of Rochester in1984 and completed an Emergency Medicine Residency from the University of Cincinnati Medical Centerin 1988. Dr. Zink has been a member of the SAEM Research Committee from 1989-1993 and a member ofthe Constitution and Bylaws Committee from 1993-96 and during this past year has served as chair of thatcommittee. He has been the coordinator for the SAEM Research Consulting service since 1993. Dr. zinkis a reviewer for Academic Emergency Medicine.

--

Tiresday May 7

Education Committee Chair-Elect

Program Committee Chair-Elect

Glenn Hamilton, MD is professor and chair of the Department of Emergency Medicine at Wright StateUniversity School of Medicine. He graduated from the University of Michigan medical school in I9l3 andcompleted his emergency medicine residency at Denver GeneraVSt. Anthony's Medical Center tn 1979. Dr.Hamilton served on the SAEM Board of Directors (1988-90), was chair of the AAMC Liaison Committee(1990-94), and served as a representative to the Council of Academic Societies for many years. Dr. Hamiltoncurrently serves as a member of the Fellowship Thsk Force. In 1991, Dn Hamilton was the recipient of theSAEM Academic Leadership Award.

Nominating Committee

Charles B. Cairns, MD is Assistant Professor at the University of Colorado and the Director of the ColoradoEmergency Medicine Research Center. He graduated from medical school at the University of NorthCarolina in 1986 and completed an Emergency Medicine Internship and Residency in 1989 and a ResearchFellowship in 1990 from Harbor-UCLA Medical Center. Dr. Cairns has served on the SAEM ResearchCommittee (1991-95) and the Program Committee (1995-96). Since 1993, he has been a member of theAsthma Interest Group; since 1994 a member of theACEP Scientific Review Committee; since 1995, hasacted as Secretary/Treasurer of the ACEP Section on Research; and since 1993, has been the Chair of theAnnual Rocky Mountain Research Forum. He is a manuscript consultant for Academic Emergency Medicineand Annals of Emergency Medicine, and is consulting editor for Emergindex.

M. Andrew Levitt, DO is Assistant Clinical Professor of Medicine in the Division of Emergency Medicineat the University of California, San Francisco and Director of Research in the Department of EmergencyMedicine at Highland General Hospital. He graduated from medical school in 1980 from the University ofOsteopathic Medicine and Health Sciences Medical School and completed an Emergency MedicineResidency in 1984 from the University of Arizona Health Science Center. Dr. Levitt has participated on theSAEM Program Committee (1993-96) and the Research Committee (1989-94). He has also participated onthe California ACEP Education Committee (1990-95), was the Co-Chairman for the Winter ScientificSymposium ( 1990-93), was Chairman of the CA ACEP Subcommittee on Pharmaceutical Financial Supportin Medical Education (199 l-93), and the Research Committee since 1994. Dr. Levitt is a Reviewer forAcad.emic Emergency Medicine, American Journal ofEmergency Medicine, and Annals of EmergencyMedicine.

E. John Gallagher, MD is the Unified Chair and Professor of Emergency Medicine of the Department ofEmergency Medicine at the Albert Einstein College of Medicine. He graduated from medical school in 1972from the University of Pennsylvania and completed an internship and residency at the Bronx MunicipalHospital Center, Albert Einstein College of Medicine in 1915. From 1990-91 he was a Robert Wood JohnsonClinical Scholar at Yale University School of Medicine. Dr. Gallagher has served on the ResidencyConsulting Service since 1992 and has served as chair of the Development of Academic Centers from I 991-93 and from 1995-96. Since 1995 he has been a member of the Program Committee. Since 1983 he hasserved as an oral examiner for ABEM, and has been a member of the ABEM Board of Directors since 1995.Dr. Gallagher has been a reviewer/consultant for Academic Emergency Medicine, Annals of EmergencyMedicine, JAMA, and Journal of Emergency Medicine. He is an associate editor of Academic EmergencyMedicine and serves on the editorial board of Annals of Emergency Medicine.

Paul E. Pepe, MD, MPH is a Professor in the Departments of Medicine, Surgery and Pediatrics at BaylorCollege of Medicine and the Ben Taub General Hospital in Houston. He is the Director of the City ofHouston Emergency Medical Services System and is an Associate Professor of Emergency Medicine andSurgery at the University of Texas Medical School in Houston. He graduated from the University ofCalifornia, San Francisco School of Medicine in 1916, completed an Internal Medicine Residency at theUniversity of Washington, Seattle, then completed several Clinical and Research Fellowships includingPulmonary-Critical Care (1978-81) and Trauma (1981-82) at the Departments of Medicine and Surgery atthe University of Washington and then Surgical Critical Care in 1982 in the Department of Surgery at theUniversity of Miami/Jackson Memorial Hospital. He represented SAEM on the AMA Commission forEmergency Medical Services from 1985-1990, served on the SAEM EMS Committee from 1988-1991, andon the Program Committee (1992-96). Dr. Pepe is an associate editor of Academic Emergency Medicine.

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Tlresday, May 7

Constitution and Bylaws CommitteeRobert L. Muelleman, MD is Associate Professor and Co-Director of Research at Truman Medical Centerin Kansas City, Missouri. He graduated from the University of Nebraska College of Medicine in 1984 andcompleted an Emergency Medicine Residency in 1987 as well as a Research Fellowship from TrumanMedical Center in 1988. Dr. Muelleman has served on the SAEM Public Health and Education Committee(1993-96) and chaired that committee in 1995-96. He also served on the Membership RecruitmentCommittee from l99l-92 and served as chair of that committee from 1993-94: and since 1992.he has beena member of the Injury Control Interest Group. Dr. Muelleman has served on the ACEP Public PolicyCommittee since 1991 and from 1988-1993 was a councillor.

Tom Stair, MD is Professor of Emergency Medicine at the University of Maryland. He graduated from fromHarvard Medical School in 1975 and completed a General Surgery Residency in 1977 from New EnglandDeaconess, as well as an Emergency Medicine Residency in 1979 from Georgetown University. Dr. Stair hasserved on the SAEM Technology Committee (1989-95) and the National ED Database Task Force (1993-95). He also served on the STEM Board of Directors from 1982-88 and was President in 1986-87. From1985-88 he was the UAEM Representative to the AAMC CAS and from 1980-81 he served as theWashington, DC ACEP Chapter President. Dr. Stair has also served as an ACEP councillor.

PROPOSED CONSTITUTION AND BYLAWS AMENDMENTS

The old language is crossed out and the proposed new lan-guage is in bold face.

Article VI - Standing CommitteesSection 5: Program Committee. The Program Committeeshall be composed of a Chair, @

ehh*ir+lee$, appointed by the President-Elect, and membersappointed by the President-Elect with input from the BoardLiaison and the Committee Chair for one-year terms and whomay be reappointed for subsequent terms. A Research Com-mittee member and Education Committee member will bemembers of the Program Committee. Subcommittees shall beformed in accordance with the Policies and ProceduresManual. The committee Chair may not serve for more thanthree consecutive lerm* years.

The duties of the committee shall be to arrange, in conformi-ty with instructions from the Board of Directors, the programfor all meetings and select the formal participants. The dutiesof the Program Committee Chair shall be in accordance withthe Policies and Procedures Manual.

The committee members shall, under the direction of the pro-gram chair and with the assistance of the Executive Directorperform duties in accordance with the Policies andProcedures manual. Recommendations from the ProgramCommittee Chair must be approved by the Board of Directorsby majority vote.

Section 7: Education Committee. The Education Committeeshall consist of a Chair, @

iF@ appointed by the Presi.dent-Elect, and members ap-pointed by the President-Elect with input from the BoardLiaison and by the committee Chair for one-year terms andwho may be reappointed for subsequent terms. TheCommittee shall foster education in emergency medicine. Thecommittee Chair may not servelfor more than three consec-utive te+m* years.

Section 8: Research Committee. The Research Committee shallconsist of a Chair,

appointed by the President-Elect, and members appointed bythe President-Elect with input from the Board Liaison and thecommittee Chair for one-year terms and who may be reap-pointed for subsequent terms. The Committee shall fosterresearch in emergency medicine. The committee Chair may notsewefor more than three consectttive tem*yecrs.

Article III - MembershipSection 3: Member Rights and Privileges. All members mayhave the privilege of the floor and of serving on the commit-tees of the Association, and serving as committee chairs. Onlyactive affd{s€€€iate members may serve on the Board ofDirectors. Only active members shall have voting rights. flnd

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Wednesday, May 8

Scientific Papers: Injury Prevention(8:00-9:30 am)ifioderator: Herbert G. Garrison, MD, MPH, East CarolinaUniversity311 Fir-earm-Related Injuries in Three Cities, Arthur L'

Kellermann, MD, MPH, Emory University

318 Do Wrist Guards Prevent Fractures?, Lawrence M. Lewis,M D, Washington U niv ersitY

319 Comparison of Compliance with Traffic Laws Among Hel-meted and Nonhelmeted Bicyclists, Christine Farris, MD,Unitersity of Arizona

320 Window Cord Strangulations in the United States, 1985-1995'N . Clay Mann, PhD, Oregon Health Sciences University

321 Missouri's Emergency Department E-Code Data Reporting:New Level of Data Resource for Injury Control, Robert L'Muelleman, MD, tlniversity of Missouri, Kansas City

322 Utilizing the Emergency Department & Trauma Service ForAccident Prevention: New Strategy For Managed Care,Herbert N.Wigder, MD, Lutheran General Hospital

Scientific Papers: Education (8:00-9:30 am)Moderator: Nicholas J. Jouriles, MD, Case Western ReserveUniversity323 Construct Validity of Performance Based Assessment of

Emergency Mediiine Residents, William Burdick, MD, Med-ical College of Pennsylvania and Hahnemann University

324 Retiability of Faculty Clinical Evaluation of Students andNon-EM Residents During Emergency DepartmentRotations, James G. Ryan, MD, North Shore University

325 Addition of Emergency Medicine Residents Alone DoesNot Increase the Utilization or Cost of Ancillary Testing,Joseph D. Sexton, MD, St. Luke's Hospital

326 Negative Advice Regarding Emergency Medicine TrainingFrom Non-Emergency Physicians, Howard A. Blumstein,MD, Medical College of Pennsylvania and HahnemannUniversity

321 Comparison of Classroom and Distance Learning Tech-niques for Rural EMT-I Instruction, Gregory D. Hobbs, MD'Texas A & M

328 Evaluation of the Peer Reviewer: Performance of Reviewerson a Factitious Submission, Michael Callaham, MD' Annalsof Emergency Medicine

Scientific Papers: Clinical Practice(10:00 am-I2:00 noon)ifioderator: Scott A. Syverud, MD, University of Virginia329 Patient Perception of Illness Severity Predicts Emergency

Department Outcome, Kathleen A. Raftery, MD, BrighamandWomen's Hospital

330 Improving the Detection Rate of Victims of Domestic Vio-lenie Using Direct Questioning in the Emergency Depart-ment, Laurie J. Morrison, MD, University of Toronto

331 ED Rapid Sequence vs. Conventional Sputum Collection forAFB Smear Microscopy and Culture Inoculation to Diag-nose Pulmonary Tuberculosis, Daniel G. Murphy' MD'Cook County HosPital

332 Occult Depression in Emergency Department Patients,M ichael B urry, Vande rbilt U niv e r s ity M e di c al C e nt e r

333 Appendectomy: Acute and Long Term Complications,Christy McCowan, University of Utah

334 Prospective Randomized Comparison of a New TissueAdhesive Versus Sutures in the Management of TraumaticLacerations, JimV. Quinn, MD, University of Ottawa

335 Topical Tetracaine Attenuates the Pain Of Infiltration OfBuffered Lidocaine, Fayzel S. Lee' MD, Albany MedicalCenter

336 Comparison of Arterial and Venous Blood Gases in the In-itial

^Emergency Department Evaluation of Patients with

Diabetic Ketoacidosis, Mark A. Brandenburg, MD' Univer-sity of Oklahoma

Scientifi c Papers : Ttauma (10:00 am-1,2:00 rtoon)Moderator: Steien C. Dronen, MD, University of Michigan331 Use of an Eye Oximeter to Monitor Blood Loss in a Swine

Model, Kurt R. Denninghoff, MD' [Jniversity of Alabama,Birmingham

338 Immediate Fluid Resuscitation Increases Rate and Durationof Bleeding in a Sheep Model of Uncontrolled PulmonaryArtery Hemorrhage, iohn C' Sakles, MD, University ofCalifornia, Davis

33g Bacterial Counts and Infection Rates in Experimental Con-taminated, Crush Wounds Irrigated With Various Concen-trations of Cefazolin and Penicillin, Christopher Henry,MD, Michigan State University Kalamazoo Center for Med-ical Studies

340 Wound Irrigation With Tap Water? Faster! Cheaper! Be-tter?,Robert Reirdon, MD State University of NewYork, Buffalo

341 Geriatric Trauma Patients Have More Complications ThanYounger Adult Patients Despite Similar HemodynamicPresentations in the Emergency Department, Christopher B'Colwell, MD, UniversitY of Colorado

342 Comparison of Staples Versus Sutures in Penetrating C-ar-diac Wounds, James Mayrose, MS, State University of NewYork, Buffalo

343 Reduction of Head CT Scanning in Minor Head TraumaPatients Utilizing Simple Clinical Rules: Is it Safe?, ErilcC'Milter, MD, University of California, Davis

344 Rural Hospital Transfer Patterns After Implementation of aStatewide Trauma System, N. Clay Mann, PhD, OregonH ealth Science s UniversitY

Poster Session (L:30-4:00 Pm)Innovations in Emergency Medicine EducationExhibitsMoilerator: Inuis S. Bind'er MD, (lniversity of Illinois (2:00-3:00pm)345 Four Week Course to Teach Rotating Residents Emergency

Medicine (EM) Procedural Skills Using the InstructionalSystems Design Model, Felix K. Ankel, MD, St. Paul-Ramsey Medical Center

346 Emergency Medicine Multimedia Computer Tutorial andReferince- in Orthopedic Splinting Techniques, PhillipScott, MD, UniversitY of Michigan

341 Use of Digital Photography to Record Emergency MedicineResidency Experience, Anna Bradham, MD, VanderbiltUniversity

348 Structured Curriculum in Domestic Violence And ChildAbuse For Emergency Medicine Residents, Gary M' Vilke,MD, University of Calfornia, San Diego

349 Implementation of a Hypertext Curriculum for EmergencyMedicine on the World Wide Web, Daniel L. Savitt, MD,Rhode Island HosPital

350 Emergency Department Administration: A Residency Cur-riculnm, David C. Seaberg, MD ' Universiry of Florida

351 Paper-Less File Cabinet: Establishing a Digital Emergelgytr,ledicine Filing System, Steven J. White, MD,VanderbiltUniversitY

PAPER/POSTBR PRBSENTATIONS

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r '352 Multimedia Authoring for Emergency Physicians: Introduc-

tion to a Novel Educational Modality, Iohn S. Rose, MD,University of California, Davis

353 Customized Database for Tracking Residency Applications,Mark Mandell, MD, Morristown Memorial Hospital

354 Increasing the Inteffater Reliability and Predictive Validityof Critical Incident Interviewing, Ronald S. Benenson, MD,York Hospital

355 Multi-Media Educational Model to Prepare EM Residents toProvide Pre-Hospital Medical Controi, Margaret Harling,MD, Boston City Hospital

356 MEDSIMM c 2.1 - A Pediatric Advanced Life SupporlSimulation Program, Richard Lichenstein, MD, Universityof Maryland

357 Value of a Digital Radiology System in EmergencyMedicine Education, Brian D. Euerle, MD, BaltimoreVeterans Afr'airs Medical Center

358 World Wide Web: New Concepts in International Emer-gency Toxicology Education, Mark D. Crockett, MD, Uni-versity of Illinois at Chicago

359 EMS Database of State Rules and Laws, Steyen J. Weiss,MD, Louisiana State University

Injury PreventionModerator: David P, Sklar, MD, University of New Mexico (3:00-4:00 pm)360 Patterns of Burn Injuries Among Children in an Urban

Emergency Department, J. Piene, MD, Lincoln Medicaland Mental Health Center

36I WITHDRAWN362 WITHDRAWN363 Preventing Window Falls In The Inner City: Results of a

Follow Up Study, N. Narra, Lincoln Medical, and MentalHealth Center

364 Survey of Adolescents' Knowledge Regarding Over- the-Counter Medication Toxicity, Michael A. Huott, MD,IointMilitary Medical C enters

365 WITHDRAWN366 Increased Frequency of Alcohol Related Driving Convic-

tions in Drivers Who Injure Pedestrians, Charles M.Callahan, MD, MPH, University of Rochester

367 Impact of Injury on the ED and Predictors of Injury Patterns,Henry E.Wang, Cooper HospitallUniversity Medical Center

368 Factors Associated with the Intent of Firearm-Related Iniurvin Pediatric Trauma Patients, Guohua Li, MD, Johns Hop-kins Hospital

369 Population-Based Study of Fatal and Nonfatal FirearmInjuries, Jffiey H . Coben, MD, University of Pittsburgh

370 Domestic Violence Prevalence in Patients with InflictedTrauma, Arthur Davies, MD, Metropolilan Hospital Center

371 Use of Protective Gear in Children Presenting to the Emer-gency Department With Skating Injuries, ThomasKwiatkowski, MD, Long Island Jewish Medical Center

372 Injury as a Predictor of Problem Drinking in an Urban ED,Manley Clodfelter, MD, Emory University

EducationModerator: William P. Burdick, MD, Medical College ofPennsylvania and Hahnemann University (2:00-3:00 pm)373 Successful Model For An Integrated Emergency Medicine/

Trauma Service, .I. Hartm(tnn, MD, University oJ Connecticut374 Effectiveness of an Interactive Multimedia Comouter Pro-

gram in Teaching Airway Management to Medicai Students,John C. Sakles, MD, University of Calfornia, Davis

375 Integration of Clinical Anatomy Into an EmergencyMedicine Residency Curriculum, Michael S. Beeson, MD,Summa Health System

Wednesday, May 8376 Teaching the Laryngeal Mask Airway to Inexperienced,

Infrequent Airway Managers in an ACLS Course, MichaelA. Silverman, MD, Johns Hopkins Hospital

377 Clinical Duties of Faculty and Residency Directors in Ac-credited EM Training Programs: Clinical Hours Worked,Number of Patients Primarily Managed and Supervised,Ionathan Glauser, MD, Mt. Sinai Medical Center

378 Are Residents Performing Quality Research in EmergencyMedicine?, M . Andrew Lev itt, D O, H i g hl and G ene ral H o sp ital

319 Threat of Funding Cuts For Graduate Medical Education:Survey of Decision Makers, Richard J. Kozak, MD, Univer-sity of Calfornia, Iryine

380 Longevity and Promotion of Former Emergency MedicineResidency Directors, Lowell W. Gerson, PhD, NortheasternOhio Universities College of Medicine

381 Process for Assessing Communication Skills of EmergencyMedicine Residents, Steven Rosenzweig, MD,Thomas JeJ-ferson University

382 Predictive Value of Letters of Recommendation Versus Pre-printed Questionnaire for Emergency Medicine ResidentPerformance, Ieffrey Schaider, MD, Cook County Hospilal

383 Structured vs. Nonstructured Abstracts for Transmission ofMedical Information, Michael Heller, MD, St. Luke's Hospital

384 Personal Exposure of Physicians and Physicians-In- Train-ing to Family Molence, Elizabeth A. deLahunta, MD, Uni-versit! of Rochester

385 Disaster Medicine Fellowship Curricula: Can We Form anAcademic Foundation?, Clark A. Morres, MD, MadisanArmy Medical Center

Clinical PracticeModerator: Steven R. Lowenstein, MD, MPH, University ofColorado (3:00-4:00 pm)386 Derivation of a Decision Rule to Predict Delayed Functional

Recovery After Acute Knee Injury, Ian G. Stiell, MD, Uni-versity of Ottawa

387 Physicians' Predictions and Clinical Course of Patients WithAcute Soft Tissue Injuries of the Knee, George A. Wells,PhD, University of Ottawa

388 Derivation of a Clinical Decision Rule for the EmergencyDepartment Diagnosis of Ectopic Pregnancy, RobertBuckley, MD, Naval Medical Center, San Diego

389 Time Analysis of Consult Service Emergency Depafiment Ad-mission Process Compared to Emergency Medicine ServiceAdmission Process, Gary Quick, MD , University of Oklahoma

390 Retrospective Review of X-Ray Interpretations in a Com-munity Hospital, Ronald F. Sing, DO, Carolinas MedicalCenter

391 Emergency Department Utilization of Head CT in HIV-Positive Patients, Richard Rothman, MD, Johns HopkinsHospital

392 Limited Utility of Serum hCG in rhe Expectant Manage-ment of Suspected Ectopic Pregnancy, Norbert Elsner, MD,Albert Einstein College of Medicine

393 Urine Pregnancy Testing in the Emergency Department:Does Urine Specific Gravity Influence Results?, Tamara M.Ardans. MD. Carolinas Medical CenterhCG Values > 3,000 mlU/ml and/or Mentrual Dates > 38Days Exclude a Normal Intrauterine Pregnancy in Patientswith Pain or Bleeding and No Intrauterine Sac by Trans-vaginal Sonography, Robert Dart, MD, Boston City HospitalUtility of a Single Beta HCG Measurement To Evaluate ForEtopic Pregnancy, Keith A. Marill, MD, Texas TechUniversity, El PasoDoes Exogenous Melatonin Improve Day Sleep or NightAlert-ness in Emergency Physicians Working Night Shifts?, K.Michael Jorgensen, MD, University of Maryland

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Wednesday, May 8

EMRS Best Paper461 Reduced Quality of In-Vitro Clot Formation with Gelatin

Based Plasma Substitutes, Fiona M. Sanders, MD, NorthStaffordshire Trauma Centre (see abstract on page 5 I )

Clinical PracticeModerator: Joseph F. Waeckerle, MD, University of Missouri'Kansas City (2:00-3:00 pm)397 Medical Clearance and Screening of Emergency Depart-

ment Psychiatric Patients, Ionathan S. Olshaker, MD,Unirersity of Maryland

398 Biphasic Anaphylactic Reactions: An Uncommon Event,William Brady, MD, University of Virginia

399 Predicting Optimal Depth of Nasotracheal Intubation Priorto Chest X-Ray, David B. Reed, MD, Hennepin CountyMedical Center

400 Safety of Droperidol for Sedating Out-of-Control Emer-gency Department Patients , Scott W. Branney, MD, DenverGeneral Hospital

401 Safety of Etomidate ForRapid Sequence Intubation, Erik G.Laurin, University of California, Davis

402 Does Combined Serum Amylase and Lipase Testing Im-prove Diagnostic Accuracy in Pancreatitis?, James D.Cameron, MD, Jersey Shore Medical Center

403 Nitric Oxide Levels in ED Patients Presenting with AcuteVasocclusive Sickle Cell Crisis, Jordan Barnett, MD,Thomas J ffi rs on U niv ersity

404 Do Patients with Mild Head Injury and Positive Cranial CTScan Require Admission?, Pierre Borczuk, MD, Massachu-setts General Hospital

405 Rapid Sequence Intubation at an EM Residency: SuccessRate and Complications Encountered During a Two-YearPeriod, RussellW. Riggs, MD, Carolinas Medical Center

406 Diagnostic Profile of Alcohol Intoxicated Patients Seen in aUniversity Facilitated County Hospital Emergency Depart-ment, Robert Rusnak, MD, Hennepin Counry Medical Center

407 Influence of an Emergency Medicine Residency Program onInternal Medicine Admissions, Thomas Wilkins, MD, EarlK. Long Medical Center

408 Psychologic Effect of a 4 Week EM Rotation for Residentsin Training, Kumar Alagappan, MD, Long Island JewishMedical Center

409 In-line Skate Injuries: An Emergency Depaftment Perspec-tive, Robert Vander Leest, MD, University of Colorado

T[aumaModerator: Thomas M. Scalea, MD, State University of NewYork, Brooklyn (3:00-4:00 pm)410 Head Trauma: Do all Patients with a GCS=14 Require Head

CT Scanning? , f ames F. Holmes, Ir, MD , University of Cali-fornia, Davis

4ll Value of Cardiac Screening in the Trauma Patient: An Out-comes Assessment, David P. Milzman, MD, GeorgetownUniversity

412 Can Serial Hematocrits Reliably Detect Occult Blood Loss?A Prospective Cross-Over Study of the Effect of Phlebot-omy and Intravenous Crystalloid on Hematocrit, Irene Y.Tien, BS, Albany Medical Center

413 Injuries Distracting From Severe Intraabdominal InjuriesAfter Blunt Trauma, Peter C . Fenera, MD, Albany MedicalCollege

414 Blunt Traumatic Arest: The Usefulness of ProceduresOther Than Thoracotomy, Heatherlee Bailey, MD, MedicalCollege of Pennsyvania and Hahnemann Unit,ersity

415 Use of a Venous Tourniquet Does Not Increase Venous Lac-tate Levels, Bartholomew Tortella, MD, New fersey TraumaCenter

TFaumaModerator: Susan A. Stern, MD, University of Michigan (2:00-3:00 pm)418 Efficacy of Semi-Rigid Cervical Collars For Whiplash Injury

Raymond lannaccone, MD, Alben Einstein College of Medicine

Inter-rater Reliability of Cervical Spine Injury Criteria,William Goldberg, MD, University of California, Los Angeles

Incremental Analysis of Diagnostic Peritoneal Lavage Fluidin Adult Abdominal Trauma, DanTandberg, MD, Universityof New Mexico

Impact of Statewide Trauma System on Rural ED TraumaPatient Assessment Documentation, N. Clay Mann, PhD,Oregon Health Sciences Unit:ersity

Influence of an Emergency Medicine Residency on the Role ofCricothyroidotomy, Robert S. Chang, MD, Bellevue Hospital

Increased Morbidity and Mortality in Hospitalized, IvanRamirez, MD, Meffopolitan Hospital Center

Retrospective Descriptive Epidemiologic Study of the Okla-homa City Terrorist Bombing: Emergency Department Im-pact, April 19, 1995, David E. Hogan, DO, University ofOklahomaRetrospective Descriptive Epidemiologic Study of the Okla-homa City Terrorist Bombing, Impact on Surgical Services,April I 9, 1995, Daniel J. Dire, M D, U niversity of O klahoma

Infectious Disease (3:00-4:00 pm)Moderator:426 Development of a Decision Rule for the Emergency Depart-

ment Triage of HlV-Infected Patients, Christel M. Zeumer,MD. Harhor-UCLA Medical Center

Lactate Identifles Major Trauma Better Than a Standard TriageCriteria, David Livingston, MD, Nau Jersey Trauma Center

Significance of Abnormal Glascow Coma Score in AcutelyIntoxicated Patients Following Minor Closed Head Injury,Azita A. Toussi. MD, Carolinas Medical Center

Delayed Hospital Arrival in Patients with Acute Stroke,Thomas Kwiatkowski, MD, Long Island Jewish Medical Center

Stroke Victims: Clueless, Edward C. Iauch, MD, UnittersityoJ'CincinnatiDelay in Seeking Care For Stroke - Demographic Deter-minants: Delay in Accessing Stroke Healthcare (DASH)Study, Dexter L. Morris, PhD, MD, Unittersity of NorthCarolina, Chapel Hill

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Absolute Lymphocyte Count as a Predictor of Absolute CD4Count, Nathan L Shapiro, BS , Temple University

Rapid HIV Testing in the Emergency Department, Gabor D.Kelen, MD,The lohns Hopkins Hospital

Bacteriology of Infected Dog and Cat Bite Wounds, DavidA. Talan. MD. Olive View-UCLA

Antimicrobial Effects of a New Tissue Adhesive, Jim V.Quinn, MD, Universiry of Ottawa

Chlamydia Pneumoniae Infection in Patients With PersistentCough, Seth Wright, MD, Vanderbilt U niversity

Viral URI's ('Colds') and Cold Weather, Ronald B. Low,MD, State University of New York, Brooklyn

New Optical lmmunoassay For the Dectection of Strep Throatin the ED, David C. Seaberg, MD, U niversity of F lorida

Validation of a Protocol for Respiratory Isolation of PatientsWith Pulmonary Tuberculosis in an Inner City Hospital,Jerry Balentine, DO, St. Barnabas Hospital

Neurologic EmeNeurologic lrmergenclesModerator: Willi.am G. Barsan, MD, University of Michigan(2:00-3:00 pm)435 Alcohol and Time to Death in Motor Vehicle Crash Victims,

Brian I. Zink, MD, University of Michigan

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439 Effects of In Vitro Ischemia on Human Brain Slices, KeltftK. Burkhart, MD, MS Hershey Medical Center

440 Effect ofHyperbaric Oxygen Therapy on Cerebral OxygenUtilization After Global Cerebral Ischemia, RobertSilb e r gle it, M D, G e orge Was hington U niv ersity

441 Protection From Hemoglobin Mediated Cortical Cell Injuryby the Intracellular Iron Chelator Dexrazoxane, Raymond F.Regan, M D, T homas f ffirs on U niv ersity

ImagingModerqtor: David Olson, MD, University of Texas, Houston(3:00-4:00 pm)442 Trauma Ultrasonography Versus Chest Radiograph For the

Diagnosis of Hemothorax, O. John Ma, MD, University oJNorth Carolina, Chapel Hill

443 Ultrasound Assisted Central Vein Catheterization in theEmergency Department, Paul Hrics, MD, Summa HealthSystem

444 Ultrasonography by Emergency Physicians in DetectingHydronephrosis in Patients with Suspected Renal Colic,Carlo L. Rosen, MD, Massachusetts General Hospital

445 Ultrasonography by Emergency Physicians in the Diagnosisof Cholelithiasis, Carlo L. Rosen, MD, Massachusetts Gen-eral Hospital

446 Transthoracic Echocardiographic Diagnosis of PulmonaryEmbolism, Raymond R. Rudoni, MD, William BeaumontHospital

447 Radiographic Detection of Gravel Foreign Bodies in SoftTissue Wounds, Christopher O. Wood, Methodist Hospitalof Indiana

448 Correlation Between Clinical, Laboratory, andHepatobiliary Scanning Findings in Patients with SuspectedAcute Cholecystitis, Mark C. Henry, MD, State Universityof NewYork, Stony Brook

ImagingModerator: Ronald Moscati, MD, State University of New York,Buffalo (2:00-3:00 pm)449 Probability of Detecting C-Spine Fractures With CT Scans

Using the Visible Human TM Database, A. K. Singh, MD,U niver si ty of M i ssi s si ppi

450 Utility of the Routine Swimmers View Cervical Radiographin Addition to the Cross Table Lateral Cervical Radiographin Detecting Cervical Injury in Critical Trauma Patients,Jeffrey D. Ho, MD, Hennepin County Medical Center

451 Evaluation of Clinical Criteria for Emersent Abdominal Ra-diography, Mary F. Saterly, MD, Joiir Mititary MedicalCenters

452 Accuracy of Spiral CT Scanning in Making the Diagnosis ofNephrolithiasis: Is it a New Gold Standard?, Lisa A.Bennett, MD. Medical Center of Delaware

Wednesday, May 8453 Effects of the Trendelenburg Position on the Sonographic

Detection of Intraperitoneal Fluid, Nils P. Albert, DenverGeneral Hospital

454 Contrast-Enhanced Brain CT Scans Are Not Indicated in theEvaluation of Most Non-Trauma Patients in the EmergencyDepartment, Gregory J. Fermann, MD, Maricopa MedicalCenter

Scientific Papers: Neurology (4:00-5:30 pm)Moderator: Michelle H. Biros, MS, MD, Hennepin CountyMedical Center455 Depletion of Cerebral Antioxidant Activity After Asphyxial

Cardiac Anest, Clifton W. Callaway, MD, PhD, Universityof Pittsburgh

456 Effect of Oxygenated Ultra-Purifled Bovine Hemoglobin onNeuro-Injury After Cardiac Arrest and Resuscitation withAClS-Selective Aortic Occlusion and Infusion, Norman A.Paradis, MD, Columbia University

457 Neurotoxic Effect of Brain-Derived Neurotrophic Factor(BDNF) in Cortical Cell Culture, Raymond F. Regan, MD,Thomas f ffi rson U niversity

458 Effect of Hemonhagic Hypotension on the Early Hemody-namic and Cerebrovascular Response in a New CombinedTraumatic Brain Injury/Hemorhage Model, Susan A. Stern,MD, University of Michigan

459 Effects of Ethanol in an Experimental Model of CombinedTraumatic Brain Injury and Hemorrhagic Shock, Brian LZink, MD University of Michigan

460 Autonomic Regulation of Gastric Ulcerogenesis AfterCervical Cord Transection in the Rat, Nicft Leonard, MD,Earl K. Long Medical Center

Scientific Papers: Imaging (4:00-5:30 pm)Moderator: Dietrich Jehle, MD, State University of New York,Buffalo461 Incidence of Abnormalities in Postreduction Radiographs

of Anterior Shoulder Dislocation, W. Knox Kinlaw, MD,Valley Medical Center

462 Rate of Clinically Significant Discrepancies in Plain Radiog-raph Interpretation in an Emergency Medicine Residency Pro-gram, Leonard A. Nitowski, MD, Medical Center of Delaware

463 Cost Effectiveness of Non-contrast Helical Comouterized To-mography Compared to IVP in the Initial Evaluation of Ftankin the Emergency Department, Lane Duvall,Yale University

464 Hand-Held Doppler Ultrasound in the Emergency Depart-ment for the Diagnosis of DVI Catherine Jones, MD, Uni-versity of Massachusetts

465 Limited Transabdominal Pelvic Ultrasonography by Emer-gency Physicians in Patients at Risk for Ectopic Pregnancy,Wayne A. Chin, MD, Boston City Hospital

466 Influence of 24-Hour Ultrasound Availability on EmergencyDepartment Practice, Gerard Farris, MD, Earl K. LongMedical Center

DIDACTIC SESSIONSThrombolytic Therapy for Acute Ischemic Stroke:Should We or Shouldn't We? (8:00'9:30 am)Moderator: William G. Barsan, MD, University of MichiganRashmi U . Kothari, MD , University oJ' CincinnatiChris Lewandowski, MD, Henry Ford HospitalJoseph Broderick, MD, University of CincinnatiThomas Kwiatkowski, MD, Long Island lewish Medical CenterThis panel discussion will consist of emergency physicians andneurologists who have been intimately involved with the use ofthrombolytic therapy in acute ischemic stroke. During this session,recent advances in the use of thrombolytic therapy in stroke will bereviewed. Discussants will then critique some of the recent studiesthat have been published, including recently completed EuropeanCooperative Acute Stroke Study and the NINDS rt-PA StrokeStudy. They will discuss the strength and weaknesses of these stud-ies as well as the pros and cons of using thrombolytic therapy instroke. Furthermore, the future role of emergency medicine strokeresearch will be discussed. In particular, current ongoing trials aswell as questions that still remain to be answered. The session willconclude with a 20-minute question and answer session that willaddress some of the culrent concems of emergency physicians.

Basic Networking and Internet Access forEmergency Physicians (8:00-10:00 am) _David K. English, MD, Ilniversity of Califurnia, San FranciscoJohn L Etlis, MD, tJniversity of Calfurnia, San FranciscoR. Carter Clements, MD, University of California, San FranciscoThis session will review the basics of computer networking, includ-ing the benefits and burdens of various options. Implementation ona Jlim budget will be discussed. Interconnection ofvaried platforms-will be emphasized. The Internet will be introduced and a variety ofaccess methods will be presented. A selection of the EmergencyMedicine resources on the Internet will be demonstrated.

Advanced Internet Lab for EmergencyPhysicians (10:00-12:00 noon)John L Ellis, MD, University of Califurnia, San FranciscoDavid K. English, MD, University of California, San FranciscoR. Carter Clements, MD, University of Califurnia, San FranciscoThe Internet plays an increasingly prominent role in health care.This session will review the underlying concepts of internetwork-ing and the Intemet. Various methods of access to the Intemet willbe presented for the individual physician, group, and department.Development of hosts and presentation of resources on the Internetwill be demonstrated and practiced. This session presumes somefamiliarity with computers and data communication.

Emergency Medicine: Role of Surveillance andPublic Health (10:00-11:00 am)M oderator : D avid Talan, M D, O live View -UC LAArthur Kellermann, MD, MPH, Emory UniversiryDan Pollock, MD, Centers for Disease ControlWilliam Mower, MD, MA, UCLAThe role of emergency medicine in surveillance and public healthresearch is rapidly expanding. Cooperative efforts with the Centersfor Disease Control and Prevention on surveillance of injuries andemerging infections are already underway. The focus of emer-gency department efforts will be acute illness affecting at-risk pop-ulations not easily studied in other venues. Medical informaticsknow-how is also key to implementing these projects. An expertfaculty will discuss recent experience in national emergency de-partment surveillance progralns.

Wednesday, May 8

Faculty Renewal: From Burnout to Bonfire(11:00-12:00 noon)Marc Borenstein, MD, University of ConnecticutHal Thomas, MD, Oregon Health Sciences UniversityThe stresses on medicine in general and academic medicine in par-ticular have never been greater. Many faculty are feeling over-whelmed by factors seemingly beyond their control. This coursewill explore factors associated with bumout and career longevityin academic emergency medicine. The interactive session willinclude exercises designed to maximize satisfaction and perfor-mance by identifying a personal mission statement and aligningactivities with core values.

Research Directors' Luncheon: Where ShouldEmergency Medicine Research Be Published?(12:00-L:30 pm)Judd Hollander,-MD, State University of New York, Stony BrookJerris R. Hedges, MD, Editor-in Chief, AEMPhil Fontanarosa. MD, Senior Editor, JAMANorman Paradis, MD, Columbia UniversityThe speakers will discuss the advantages and disadvantages topublishing in Emergency Medicine versus Non-EmergencyMedicine journals. Jerris Hedges, MD, Editor-in-Chief of AEM,will represent Emergency Medicine journals; Phil Fontanarosa'MD, Senior Editor of JAMA, will represent broad interest medicaliournals. Norman Paradis, MD, wilt discuss the pros and cons ofpublishing in various journals from the viewpoint of a senior sci-entist, while Judd Hollander, MD, will introduce the hurdles ayoung investigator must overcome to publish in the non-emer-gency medicine journals. In addition, panel members will givetheir-personal insight into the promotion and tenure issues of pub-lishing and suggestions for manuscript publication.

Luncheon: Assessing the Impact of InternationalEmergency Medicine ProjectsModeraior: C. James Holliman, MD, MS Hershey Medical CenterWilliam Robinson, MD, University of Missouri, Kansas CityGary Green, MD, MPH, Johns Hopkins UniversityAlan Hodgdon, MD, Mercy Hospital PittsburghDr. Holliman will introduce structured ways to assess the feasibil-ity and utility of potential international emergency medicine pro-

.|ects. R panel of speakers will then present information on severaldifferent international emergency medicine projects focusing onproject intent, methods, expected outcomes, actual outcomes,overall success and ways of improving similar projects in the fu-ture. Dr. Robinson will discuss, "Developing Emergency Medicinein a War-torn Country: The International Medical Corps BosniaProject". Dr. Green will discuss, "Catalyzing the Development ofEm-ergency Medicine in Guatemala: A Longitudinal Grass-rootsApproacht'. Dr. Hodgdon will discuss, "Emergency MedicineTialning in Turkey - The Mercy Hospital Experience." Finally,the moderator will direct an interactive session between the paneland the audience focusing on issues involved in these assessments.Visiting emergency physicians from other countries (including Dr.Wang Yitang, president of the Chinese Association of EmergencyMedicine) will be introduced to the audience and their commentson program evaluation elicited.

Luncheon: Epilogue for an Analog: ImprovedMethodologies for Measured Perfusion BeyondBlood Pressure (12:00-1:30 Pm)Moderator: Paul E. Pepe, MD, Baylor College of MedicineWilliam Bickell, MD, St. Francis Hospital,TulsaEmanuel P. Rivers, MD, MPH, Henry Ford HospitalCharles B. Cairns, MD, University of ColoradoDuring this luncheon session, the technology, ischemia-reperfu-sion, EMS and shock trauma interest groups will gather together to:1) re-examine the basic principles of shock and oxygen utilization;

2) explore new measuring tools and therapeutic devices for shockmanagement; and 3) display this physiologic matinee performance incomputer-generated formats. Specifically, the session is intended toprovide an introduction of what will evenfually be the standard ap-proach to scientific paper presentations (using disks instead of slidetlays). The session will cover basic concepts of Oz utilization andthen review new technology for measuring shock, titrating therapyand also introduce new technology for delivering oxygen to the tis-sues (e.g., artificial bloods and metabolic therapies). Traditional ana-1og concepts such as slide trays. transfusions and titration of systemicblood pressure will be de-emphasized, ifnot discarded altogether!

ABEM Activities: ABEM Interactions withResidents (1:30-2:30 pm)This session will provide an opportunity for Emergency Medicineresidents to interact informally with ABEM directors and staff. Apacket of reference material for this session will be available allweek at the SAEM registration desk.

Effective Faculty Observation of Residents'Clinical Skills (1:30-3:30 pm)Joseph LaMantia, MD, North Shore University HospitalRita Cydulka, MD, MetroHealth Medical CenterLinda Spillane, MD, University of RochesterWilliam Rennie, MD, Lons Island Jewish Medical CenterThis session will demonstrate the difficulty of evaluating residentson the basis of presentation skills only and discuss the use of per-formance criteria as a means to more reliable observation of resi-dents. We will demonstrate and practice the use of the performancecriteria developed by the SAEM National Consensus on ClinicalSkills Task Force to grade videotaped resident-patient interactions.Finally, we will discuss and demonstrate other techniques foreffective observation. By the completion of the session, the partic-ipants will be able to: l) use the observation system that the taskforce has developed or be able to develop an observation systemfor their own residency programs; and 2) effectively observe, cri-tique, and give formative feedback to residents.

Strategies to Accomplish High Quality UnfundedClinical Research (1:30-2:30 pm)Judd E. Hollander, MD, State University oJ'NewYorlc, Stony BrookSharon M.Valentine,RN, BSN, State (Jniversitv of'Newyork. StonvBrookThe development of a successful unfunded clinical research pro-grams helps to pave the way for competitive funding at a later time.This session will present concrete inexpensive methods to lay thegroundwork for a clinical research program. Since one of the moredifficult aspects of clinical research is fostering practitioner compli-ance with study protocols and data collection, this course will em-phasize proven methods to facilitate project completion. This ses-sion will also discuss successful methods to recruit ED staff (facul-ty, resident, nursing, and ancillary staff), generate enthusiasm andparticipation in project development and implementation, methodsto enhance likelihood ofstudy subject identification, ways to attractvolunteer (free) research assistants to staff the ED as data collectors,design of easy to complete yet detailed case report forms for realtime use in the ED, strategic locations to distribute and collect datasheets, and efficient and inexpensive methods to perform data entrysuch as structured charts and automated data entry. These issues willbe discussed predominantly from the point of view of ED clinicalresearch. Some discussion of these principles as they pertain to theprehospital and follow-up settings will also be discussed. Additionalcomments regarding the development of multicenter networks, with-out investment of money, will be incorporated.

One For The Road: Current Concepts andControversies in Alcohol Intoxication and InjuryResearch (2:30-3:30 pm)Moderator: Bruce Becker, MD, MPH, Brown UniversityRonald F. Maio, DO, MS, University of MichiganRichard Longabaugh, EdD, Center for Alcohol and AddictionStudies. Brown U niy e r sitv

Wednesdayo May 8This session will focus on research in iniurv related to alcoholintoxication. The speakers will discuss cornpetence and consent,identification of the patient at risk and intervention, longitudinalpatient tracking and follow-up, and a variety of difficult and excit-ing issues that sumound these important investigations. It's likelythat there will be debate about the unique procedural, ethical, andlegal barriers that have traditionally hindered research with thispatient population. The speakers will propose solutions and willundoubtedly elicit heated audience interjection.

Applying CQI Methodology to EmergencyMedicine Clinical Systems and OutcomesResearch: A Case Study Using the Chest PainModel (3:30-4:30 pm)George L. Higgins,lll , MD, Maine Medical CenterCQI Techniques, when applied as the true operational philosophyof the ED, are ideal for analyzing and improving clinical systemsof care. By capitalizing on the creative talents and energies of allinterested contributors to the system, many opportunities forimprovement can be identified and realized. Working relationshipsamong various disciplines, clinical departments, and support ser-vices also improve naturally. An actual CQI project, dealing withthe processing of adult patients presenting to the ED with non-traumatic chest pain, will be presented to emphasize the followingaspects ofthis process: the importance ofaccurate baseline data asthe basis for effective decision making; the value of "inclusivity"versus "exclusivity" in team membership; the need to invite hon-est input from all invested contributors to the system no matterhow threatening the message; the power of the anecdote in moti-vating "buy-in" and influencing behavior; the importance of time-ly and personalized feedback in order to effect lasting improve-ment in individual practices; the ability of successful CQI activi-ties to elevate the ED's stature in its institution and communitv.

The National Information Infrastructure-HealthEducation Network (NIIHIN): A DemonstrationProject (3:30-4:30 pm)Robert .1. Schwartz, MD, MPH, University of PittsburghGlen Reece, PhD, ISX Corporation, Marietta, GeorgiaBelinda Hoshstrasser, ISX C orporation, Marietta, GeorgiaThe NIIHIN is a public-private partnership that is developing tech-nology towards the goal of a national health information infra-structure network. The Minimum Emergency Medicine Data Set(MEDS), which is part of NIIHIN, is being developed as an infor-mation system for collecting, integrating, analyzing, and dissemi-nating information on emergency care episodes and their out-comes. Ultimately, there will be 24-hours-per-day access to theMEDS system from anywhere in the nation. The faculty will de-scribe the system engineering process, its intended use, and the im-plications of such a national database for the practice of emergencymedicine. Access to and use of MEDS will be demonstrated.

An Introduction to Statistical Software Packages(4:30-5:30 pm)Roger J. Lewis, MD, PhD, Harbor-UCLARobert L. Wears, MD , MS , University of Florida, lacksonvilleSophisticated and relatively easy-to-use statistical software pack-ages for personal computers are now available and reasonablypriced. These packages allow investigators to perform virtually allstatistical analyses commonly reported in the medical literature. Inthis session, the speakers will compare several of the most popularpackages, comparing their capability and ease of use, as well asshowing actual procedures and results. This session wilt give theinformation necessary to make an informed decision on the selec-tion of a statistical package for your own use.

BXHIBITORSAircast, Inc.92 River RoadSummit, NJ 07901

(800) 526-8785

Innovative orthopaedic devices that promote functional management.

American Academyof Emergency MedicineP.O. Box 1968Santa Fe, NM 87504

(800) 884-2236

The American Academy of Emergency Medicine is the professional,democratic organization for the specialist in Emergency Medicine.

Annals of Emergency MedicineP.O. Box 6199llDallas, TX 75261

(214) 550-0911

Annals of Emergency Medicine is the official journal of theAmerican College of Emergency Physicians and the specialty'sleading clinical and scientific journal. Annals publishes the latestin research, clinical studies, case reports, and issues in emergencymedicine. Annals staff will be available to answer questions anddiscuss journal policies and procedures.

BRC Health Care3705 North Lamar, Ste 207Austin, TX 78705

(stD 4s2-7261

BRC Health Care provides the "Total Solution" for emergencydepartment automation including patient tracking, triage, nursecharting, orders and interventions, results reporting, charge cap-ture, physician charting, prescriptions, and discharge instructions.Our advanced 3-tier client/server architecture using UNIX, Oracleand Windows integrates easily with other hospital systems andprovides tremendous fl exibility.

Cook Critical Care925 South Curry PikeP.O. Box 489Bloomington,lN 47402

(812\ 339-2235

Cook Critical Care will be displaying: Products for the DiffrcultAir-way; Emergency Cricothyrotomy Catheter Sets, Retrograde Intuba-tion Sets, Airway Exchange Catheters, and Intraosseous Needles.

Emergency Medical Systems, LP651 W. Mt. Pleasant AvenueLivingston, NJ 07039

(201\ 740-241s

Emergency Medical Systems, LP provides professional transcriptionservices, electronic cha"rting and information/patient managementsystems, charting component utilizes over 175 diagnostic based tem-plates to facilitate production. Real time patient tracking system pro-vides clinicians and administrators with the ability to produce dis-charge notes, prescriptions, triage notes, lab orders, statistical QAreports and the overall management of patient care information.

Emergency MedicineResidents'Association (800) 798-18221125Exttutilc CirtlrIrving, TX 75038The EMRA booth will feature membership materials and informa-tion about this exciting 4,000 member organization for residentsand medical students interested in emersencv medicine.

Emergency Physician Associates, P.A.307 South Evergreen Ave., Ste 201Woodbury, NJ 08096

(609) 848-3817

Emergency Physician Associated, P.A. is a multihospital, interstategroup practice of Emergency Medicine physicians founded in 1978.EPA provides management services and staffs its client hospitalswith experienced Emergency Department Directors and physicians,

as well as qualified physician assistants and nurse practitioners.EPA s practice settings range from rural to urban, academic to com-munity, and urgent care to trauma to suit a wide variety of need.

Emergency Practice Associates (319) 236-3858P.O. Box 1260Waterloo, IA 50704Emergency Practice Associates is a Midwest based emergency physi-cian staffing organization. Founded and operated by physicians since1914. We are cumently staffrng emergency departments in Iowa andMinnesota. Excellent director and staffpositions with generous com-pensation packages available in a wide variety oflocations.

EMF/ACEP Teaching Fellowship (214) 550-09111L25 Executive CircleIrving, TX 75038The Teaching Fellowship Program consists of two ten-day ses-sions. The first session in October focuses on curriculum develoo-ment and instruction, teaching methods, and evaluation. The sec-ond session in June focuses on academic survival skills, as well asadministration and management. For additional information, stopby the EMF/ACEP Teaching Fellowship booth.

Fischer Imaging Corporation (303) 4s2-680012300 N. Grant StreetDenver, CO 80241Fischer Imaging, the oldest domestic X-ray manufacturer, designs,produces, and markets X-ray imaging systems for radiology, mam-mography, and cardiology. Fischer's Digital Traumex providesunique capabilities, and performs all standard radiographic viewsof both ambulatory and traumatized patients.

FluoroScan Imaging Systems. Inc. (847) 564-5400650 B. Anthony TlailNorthbrook, IL 60062FluoroScan is a world leader in the design and manufacture ofmini surgical c-arm fluoroscopic imaging systems. FluoroScan isspecially designed for extremity imaging in orthopaedics and canbe used in the operating room, surgicenter, or in the office. TheFluoroScan with its superior image quality, incorporates many ofthe features of a standard c-arm.

Glaxo Wellcome Inc. (60D 494-496011209 N. Tatum Blvd., #120Phoenix, AZ 85028You are cordially invited to visit the Glaxo Wellcome Inc, exhibitwhere our sales representatives will be available to answer yourquestions and discuss the latest clinical information on: Ceftin@,Imitrex@, Valtrexo, Zofran@, Iniection and Zoftan' Tablets.

Iloechst Marion RousselP.O.Box9627Kansas City, MO 64134

International Medical Corps12233West Olympic Blvd.o #280

(816) 966-33Ur

(310) 826-7800

Los Angeles, CA 90035Recruitment for International Medical Corps (IMC) which is a pri-vate, Nonsectarian, nonpolitical, nonprofit organization estab-lished in 1984 by volunteer United States physicians and nurses.Its mission is to save lives, relieve suffering, and improve the qual-ity of life through health interventions and related activities thatbuild local caoacitv in areas worldwide.

t ' -

Jones and Bartlett Publishers, Inc.40 Tall Pine DriveSudbury, MA 01776

(508) 443-s000

Publisher of a series of medical titles including "Case Studies inEmergency Medicine" authored by a group of dedicated contribu-tors and edited by Edward and Judith Bernstein.

Laerdal Medical Corporation167 Myers Corners RoadWappingers Falls, NY 12590

(800) 648-18sr

The following will be displayed: Resusci'Anne Family of CPRTraining Aids and Manikins, Heartstart@ Automated ExtemalDefibrillators and Early Defibrillation Training System, ALSTrainers, Heartsim@ 2000 Cardiac Rhythm Simulatorsru, AirwayManagement products including: Laerdal' Silicone Resuscitators,V-Vacrr',r Manual Suction System, Pocket Maskrla, First ResponderAirway Management Kitsrv, Spinal Motion Restriction productsincluding: Stifneck Extrication Collars, HeadBedru II CIDs,"Issues in Spinal Care" Training Curriculum.

Lexi-Comp, Inc.1100 Terex RoadHudson. OH 44236

(216) 6s0-6s06

Lexi-Comp provides clinical information in print and electronicformats including pharmacology (pediatric, adult, and geriatricdosing), infectious diseases, poisoning and toxicology, and labora-tory/diagnostic tests. The Clinical Reference Library on CD-ROMintegrates ten datasets, Stedman's Medical Dictionary, Drug Iden-tification (with color images) and Symptoms Analysis Module.

MICROMEDEX.Inc.6200 S. Syracuse Way, Ste. 300Englewood, CO 80111

(303) 486-6400

The MICROMEDEX Healthcare Series, designed for all healthcareprofessionals, provides comprehensive, peer-reviewed knowledgebases containing referenced information on toxicology (clinical andindustrial), drug therapy, emergency medicine, patient instructions,and dosing programs. Delivery method options include CD-ROMfor PCs, LANs and tapes for mainframe applications.

Mosby, Williams-Wilkins9693 Desert Paintbrush CourtParken CO 80134

(303) 841-8297

Purveyors of the finest in emergency medicine texts, journals, andmulti-media products.

National Highway TlafficSafety AdministrationNTS-22

(202) 366-2727

400 7th Street SWWashington, DC 20590Publications and audio-visual materials dealing with all aspects ofhighway safety through the process of injury control toward safecommunities.

Ohmeda PharmaceuticalProducts Division110 Allen RoadLiberty Corner, NJ 07938

Physio Control Corporation11811Willows Rd NERedmond. WA 98052LIFEPAK 11@ diagnostic cardiac monitor and LIFEPAK 11 de-fibrillator/pacemaker; LIFEPAK 9P. 10 defibrillator/monitor/pacemakers; LIFEPAK 300 automatic advisory defibrillator;FIRSTMEDICTv 5 I 0, 7 1 0 semi-automatic defibrillators, QUICK-COMBOTu pacing/defibrillation/ECG electrode system.

Requa, Inc.I Seneca PlaceP.O. Box 4008Greenwich. CT 06830

(203) 869-244s

CharcoAid 2000 superActivated Charcoal products. Clinical stud-ies show two to four times more absorption of drugs and sig-nificantly lower blood levels compared to other charcoal products.

Spectral Diagnostics Inc.135-2 The West MallToronto. CANADA M9C 1C2

(416) 62G3233

Cardiac STAIusrv CK-MB/I\4yoglobin Test Kit - simultaneous,qualitative results from whole blood at the point of care. This easyto use panel test provides STAI results in less than twenty minutesand is ideally suited for the emergency department or point of caresituations where an early rule-out of myocardial infarction cansave lives and avoid unnecessary expenditures.

U.S. Army Medical Recruiting14470F. Sixth AvenueAurora, CO 80011

Weatherby Health Care25 Van Zant StreetNorwalk, CT 06855

(303) 360-9378

(203\ 866-1144

Weatherby Health Care is the country's pre-eminent physiciansearch firm. We are the proud sponsors of the Weatherby HealthCare Resuscitation Fellowship at Henry Ford Hospital,SAEM/EMRA Leadership Forum and SAEM Best EducationPresentation Award.

Wilderness Medical SocietyP.O. Box 2463Indianapolis, IN 46206

(317\ 631-1745

The goal of the Wilderness Medical Society is to provide a profes-sional and scientific forum for wilderness related medical interestsand to encourage both basic science and clinical research that willresult in the development of the scientific basis for the health of theindividual in the wildemess settine.

Zoll Medical Corporation32 Second AvenueBurlington, MA 01803

(800) 348-9011

Cardiac Resuscitation equipment will be displayed.

(908) 604:7614

(206) 8674s69

l

POSITIONS AVAILABLEClassified ads (100 words or less) are published at a charge of $75for SAEM members, $125 for non-members per classified ad, perissue. Quarter page ads are $250, plus a $25 typesetting fee if notcamera-ready. Ads must be received by the 25th of the precedingmonth in which you would like it published.

FELLOWSHIP POSITIONSPENN STATE UNMRSITY: Accepting applications for a Fellow-ship in prehospital care/EMS. Candidate will develop knowledge andcompetency in administrative, teaching, clinical and research. In-cludes ground and air services, dispatch, medical control, QA, specialevent medicine and disaster planning. Observe local, regional, andstate policy development, administrative organization, and dynamicinteractive relationships between providers. The cumiculum has beenapproved by the SAEM EMS Committee. Candidates should beboard-certified/prepared in emergency medicine. Send CV to StevenA. Meador, MD, MPH, Hershey Medical Center, PO Box 850, Her-shey, PA 17033-0850. We are anAA./EOE and encourage minority andfemale applicants to apply.

PENNSYLVANIA STATE UNMRSITY: Pennsylvania State Uni-versity Medical Toxicology available. Fellows will develop expertisethrough an established program that includes: Busy inpatient service,regional poison centeg toxicology referral clinic, weekly educationalconf'erences, and animal/clinical research. For your health, HersheyMedical Center is a smoke-free campus. Those interested in career de-velopment via toxicology please contact Keith K. Burkhart, MD, Fel-lowship Director, Division of Emergency Medicine, The Milton S.Hershey Medical Center, PO Box 850, Hershey PA 17033-0850. Weare an affirmative action/equal opportunity employer and encourageminority and female applicants to apply.

UNMRSITY OF CALIFORNIA' SAN DIEGO: The Division ofMedical Toxicology offers a 2-year fellowship in Medical Toxicologybeginning 711197. Fellowship fulfills guidelines established by theACMT. Experience includes the San Diego Regional Poison Center,inpatient admitting and consult services at several area hospitals, out-patient referral clinic, and ongoing clinical and bench research. Hyper-baric medicine service also under Department of Emergency Medi-cine. Fellows will meet criteria necessary for eligibility for the ABEMsubspecialty board examination in toxicology. Interested individualsshould contact Richard F. Clark, MD, Department of Emergency Med-icine, UCSD Medical Center, 200 W Arbor Dr., #8676, San Diego,CA 92103-867 6, or call 619-543-7341.

UNIVERSITY OF MASSACHUSETTS MEDICAL CENTER: FEI-lowship in Prehospital and Disaster Medicine. Two-year program offersclinical, research, and teaching. Disaster preparedness and planning,disaster management, drills and simulations, plus training with disasterresponders and Disaster Medical Assistance Team are included. Prehos-pital experience with UMASS EMS, a paramedicJevel ambulance ser-vice. UMASS Life Flight, an airmedical transpolt service with physi-cian-nurse crew, plus local and regional EMS services includes medicaldirection, training/education, and total quality management. Opportuni-ties for intemational experience with EMS and disaster management areavailable. UMMC is a tertiary care Level 1 Trauma Center, with a BumCenter, the only PICU in Central Massachusetts, plus an EM Residency.Salary commensurate with PGY 415level. Contact Lucy Gans, MD, De-partment of Emergency Medicine, University of Massachusetts MedicalCenter 55 Lake Avenue North, Worcester, MA 01655-0228 or call (508)

856-4101; (508) 856-6902 FAx.

UNIVERSITY OF MASSACHUSETTS MEDICAL CENTER:Fellowship in Medical Toxicology. Two-year training program offersclinical research and teaching experience. Toxicology Service providesadult/pediatric in/out patient toxicology consultations at Worcester hos-pitals (150,000 combined ED visits) and is staffed by three ABMT/ABEM diplomates. UMMC is a tertiary care Level I Trauma Center,Toxicology Treatment Center, Bum Center, Renal Dialysis Center, and

has a Comprehensive Toxicology Laboratory and the only PICU in

Central Massachusetts. Salary commensurate with PGY 4/5 level.Contact Bob Ferm, MD, Dept. of Emergency Medicine, UMMC, 55

Lake Ave. North, Worcester, MA 01655-0228 or call (508) 856-4101

UNrvrRslrv or PlrrssuRcHCENTER FOR INIURY RESEARCH & CONTROI-

INf URY CONTROL FELLOWSHIP

The University of Pit tsburgh Department of Emergency Med-icine and the Center for Iniury Research and Control are of-fe r ing a Fe l lowsh ip in In ju ry Cont ro l . Cand ida tes fo r the Fe l -lowship should be residency trained and board cert i f ied/el i-g ib le in Emergency Med ic ine . The focus o f the fe l lowsh ip i sthe development of expert ise in injury control methods in-c lud ing surve i l lance, research , in te rvent iona l p rograms, andpolicy. Fel lows develop these ski l ls through coursework inthe Craduate School of Public Health ( leading to the MPHdegree), and involvement in the ongoing programs of theCenter for Injury Research and Control (CIRCL). CIRCL wasestabl ished in 1992 and is an interdiscipl inary programhoused within the Department of Emergency Medicine. InSeptember 1995 i t become one of ten centers in the countryto receive off icial designation as an Injury Control ResearchCenter by the US Centers for Disease Control and Preven-t ion. In addit ion to CIRCL, the Department of EmergencyMedicine houses programs in Medical Toxicology, EMS, andHyperbar ic Med ic ine . Fe l lows w i l l assume l im i ted c l in ica lresponsibi l i t ies in the University of Pit tsburgh Medical Cen-ter Emergency Department and aff i l iated inst i tut ions. An ap-pointment of Instructor of Emergency Medicine with Univer-sity benefi ts and CME al lowance is provided. Contact JeffreyH. Coben, MD, Director, Center for Injury Research and

Control, 230 McKee Place, Suite 400, Pittsburgh, PA 15213.The University o{ Pittsburgh is an A{iirmative Action, Equa\Opportunity Employer.

NAIRT)ilX HOSPITALPediatric Emergency Medicine

Fellowship Applicants

The Pediatric Section of the Department of EmergencyMedicine at Fairfax Hospital in conjunction with theGeorge Washington Emergency Medicine Residency i.qrecruiting applicants for a two-year fellowship in pedi-atric emergency medicine beginning in July 1997.This fellowship is designed for physicians who haveprimary training in emergency medicine and whowish to receive additional training in pediatric emer-gency medicine and be eligible to sit for the subspe-cialty boards in pediatric emergency medicine.

In addition to training in the Pediatric EmergencyDepartment, the fellow will experience rotations inbasic pediatrics, pediatric intensive care, pediatricanesthesiology, neonatal intensive care, pediatrictrauma, as well as in various other areas of pediatricemergency care as it relates to emergency medicalservices. There will be sufficient time and resourcesin the fellowship to pursue research interest.

Faculty appointments (to GW/GT)will be made avail-able to the fellows. A commensurate salary and bene-fit package is being offered. Interested applicantsshould write to either Julian B, Orenstein, MD, FAAPor Ronald M. Salik, MD at Fairfax Hospital, Depart-ment of Emergency Medicine, 3300 Gallows Road,Falls Church , VA 22046, or call (703) 698-3195. Thedeadline for applications will be October 1, 1996'

44

t - -

FACULTY POSITIONSBASSETT HEALTHCARE, COOPERSTOWN, NY: The Depart-ment of Emergency and Trauma Services at Bassett Healthcare, a 200-bed Columbia University affiliated teaching hospital in a predomin-ately rural region of upstate New York, has an opening for an emer-gency physician. The new state-of-the-art ED facility has a volume of15,800 visits/year with 26Vo admission rate. Full departmental status.BE/BC, EM, FP, IM preferred. Bassett offers a rich aiademic environ-ment, excellent medical staff, and competitive salary/benefits in abeautiful lakeside village. Contact: August Leinhart, MD, Chief, De-partment of Emergency and Trauma Services, Bassett Healthcare, OneAtwell Road, Cooperstown, NY 13326. 6071547-3981

MARYLAND, HAGERSTOWN: Seeking Assistant Medical Directorfor this family-oriented community surrounded by the Allegheny andBlue Ridge Mountains. Hospital serves as a regional trauma center with50,000 volume, triple physician coverage and full specialty back-up.Qualified candidate needs to be BC/BP EM with aptitude for EMS. Ex-cellent compensation and benefit package. Contact: Jennifer Hymes,EMSA, 1-800-422-3672, extension 7260, or fax to (305) 424-3270.

MICHIGAN STATE UNIYERSITY-Saginaw Campus: Director ofResearch sought for expanding community-based Emergency Medi-cine Program. Responsible for teaching/supervising residents and med-ical students, research, and clinical patient care. Application for Emer-gency Medicine Residency is pending. Family-oriented community of-fers wide-ranging entertainment and educational activities. Competi-tive remunerations, excellent benefits package and protected time fbrresearch. For further information, contact Robert Wolford, MD, Direc-tor, Dept. of Emergency Medicine, Saginaw Cooperative Hospitals,Inc., 1000 Houghton Ave., Saginaw, MI 48602 or call (517) 771-6817.

NEW ENGLAND MEDICAL CENTER: Board-Certified/Board-Prepared emergency physician faculty opportunity (full/part-time) foracademic Department of Emergency Medicine at New England Med-ical Center, Medicine. Housestaff supervision, teaching, and adminis-trative responsibilities, with excellent research opportunities. Applica-tion for Emergency Medicine Residency in process. New facilityopened July l 995 with fast track, acute care, observation and pediatricemergency services included. Academic appointment within the De-partment of Emergency Medicine at TUSM. Competitive salary andbenefits. Contact Charlotte S. Yeh, MD, FACEP, Physician-in-Chief,Department of Emergency Medicine, New England Medical Center,750 Washington Street, NEMC Box 311, Boston, MA 02111, Tel:(611) 636-4720 or FAX: (617) 636-4723.

NEWARK BETH ISRAEL MEDICAL CENTER: Due to the re-cent expansion of our Emergency Medicine Residency Program, weare recruiting qualified candidates to join our young, progressive fac-ulty, effective immediately. NBIMC is a large tertiary-care majorteaching medical center with numerous residencies and fellowships inall major specialties. The Emergency Department is closely affiliatedwith the NJ Poison Center and with the New Jersey Institute forMedical Research for Emergency Medicine. The positions availableincluce those of Research Director, Associate Research Director, Asst.Residency Director, as well as junior and senior faculty positions.Multiple administrative and research possibilities exist. Compensationis highly competitive with incentive bonus plan. Please forward a copyof your CV to NBIMC, Dept. of Emergency Medicine, Attn: Dr.Joseph Calabro, 201 Lyons Ave., Newark, NJ 071 12. (201) 926-2620.

RESURRECTION-MICHAEL REESE, Integrated EmergencyMedicine Residency Program, Chicago: was approved on January16,1996 and is scheduled to begin July, 1996. Michael Reese is ex-panding their faculty and seeking qualified candidates to help developthe new program. Physicians must be BC/EM and practice experiencein an academic environment. Excellent comoensation and benefitspackage, including paid liability insurance. Contact: Dr. ThomasKirsch in care of Jennifer Hymes, l-800-422-3672, ext.7260 or faxyour CV to (305) 424-3270. EOE/AA/M/F

0ssistonUflssociot@ Profossor lnstructorThc Univcrsitg of Texos HeolthSciencc Ccnter ot Son flntonio,Deoortment of Suroeru. Division of€m'crgencg Mccf icific s'sl.oltr,gFul l - t ima junror crnd s@nior tocul tg to lo in thanr.l .n oF arar|>.rnirallt t arie,olrz.el €mrz,rorz, , , ! v , , , y - , , - , : / - n C VA/ladicino phgsicicrns to stcrff tha UnivorsitrTHospitcrl €margoncq (antor. Ihe 552-tcedhosoifol hos o larral I Trcrumcr Contor crnd tsthe primcrrg tocrching hospitcrl For thoUniversitu oF Taxos Hocrlth Scionco Contar crtSon l lntonio. Dutios In( ude duocr provisionoF oofrenf cora oncj srrnan/ision oF macjiccrlstudants and rosidon[s trom vorious sp@ciol-fias Comrlansot-ion crnd crccrdemic rcrnkbosad on oriol i t icottons. Proforrad condr-dcr[os uuil l bo €morgancg Madicina rcidoncltroinad, bocrrd c@rtifi@d or aroaar@d. Sendcurriculurn vito@ [o Chorlas B. Bcruor, MD,Mediccrl Diractor, Univarsitu Hosoitcrl(morgoncrl Conlor, 4502 M\ediccrl Driva, ScrnFntonio, IX 1 8229 -4493, fobphono: (2 I 0)6 ) 6 2 0 1 8 , F l l X : ( 2 1 0 ) 6 1 6 1 9 1 2

The UTHSCSF s on oquol omploqmentopporLu^ rq/crrf ,ncrivo crcl on onploqar.

@Cook County Hospital

Chicago, Illinois

Director, Research Division. Experienced investigator withtrack record of publications and/or extramural funding to directresearch division of major public hospital. The research divi-sion has seven full-time faculty, including a PhD co-director,grants/data coordinator and nurse epidemiologist. Major divi-sion research interests include cost/medical effectiveness ofdiagnostic/treatment protocols for asthma, chest pain, diabetes,tuberculosis, primary needs assessments, and violence detec-tion/prevention. The Department of Emergency Medicine has26 full-time faculty, a residency program with 54 residents,170,000 visits for adult/pediatrics, and a separate l2-bed Ob-servation Unit. The department is affiliated with Rush Univer-sity Medical College. The candidate must be emergency medi-cine BC/BE, have sufficient academic credentials to qualify atthe rank of associate professor, and capable of providing acad-emic/administrative leadership to the Division.

Send CV to Robert Simon, MD, Chairman and Professor, De-partment of Emergency Medicine, 10th F1oor, 1900 W. Polk St.,Chicago, ll 60612.

Cook County Hospital, Chicago, Illinois is an Equal Opportun,ity/Affirmative Action Employer. Women and minorities areencouraged to apply.

STATE UNMRSITY OF NEW YORK AT BROOKLYN: NewYork City - Faculty Position - seeking Emergency Medicine Resi-dency Trained or Board Certified faculty for our fully accredited emer-gency medicine residency. 24-30 hours/week of clinical responsibility,most of it at Kings County Hospital, one of the busiest trauma centersin the country. We support both clinical and animal research. We areaffiliated with an accredited pediatric emergency medicine fellowship.Contact Ronald Low, MD (719) 245-2974, fax CV to (718) 245-4799or send e-mail to Low@medlib.hscbklvn.edu

UNMRSITY OF SOUTHALABAMA: Department of EmergencyMedicine seeking physicians residency trained or board certified inEmergency Medicine. 50,000 patients in USA Hospital system. Sub-specialty backup all disciplines. USAMC is a 400-bed Level I TraumaCenter with helicopter program. Mobile is located on the Gulf Coastwith warm climate, outstanding beaches, and low cost of living. USAhas committed to the development of Emergency Medicine ResidencyProgram. Clinical research opportunities. Compensation and fringebenefits are competitive. Contact Frank S. Pettyjohn, MD, Departmentof Emergency Medicine, University of SouthAlabama,245l FillingimSt., Mobile, AL 36617 0r call (205) 470-1649.

UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CEN-TERAT DALLAS: Unique academic opportuniry in emergency med-icine. EM faculty will have opportunity to be involved in the estab-lishment of a first rate EM division committed to excellence in patientcare, education, and clinical research, Openings are for full-time andpart-time BC/BP faculty for the University of Texas AffiliatedEmergency Medicine Training program comprised of ParklandHospital and Children's Medical Center. THE UNIVERSITY IS ANEQUAL OPPORTUNITY EMPLOYER. Please respond in full confi-dence to James E. Hayes, MD, Chairman, Division of EmergencyMedicine, UT Southwestern Medical Center at Dallas, 5323 HanyHines Blvd., Dallas, TX 75335-8579, (214) 648-3916.

NEW YORK MEDICAL COTLEGEEMERGENCY MEDICINE PHYSICIANSACAD EM IClRESEARCH/AD M I N ISTRATIVE

YORK HEALTH SYSTEM: Regional patient care and medical edu-cation resource seeks Director EM Education for 588-bed tertiary cen-ter, serves 400,000 south-central Pennsylvanians. Seven fully-accred-ited programs, 108 residents (EM=10/10/10). University-quality edu-cation complex at York plus full medical school integration with PennState - Hershey. ED=10,000-sq. ft., 42-bed,54,000 visits (20qopeds), computerized tracking, 13 FT EM-boarded faculty, Level IItrauma center. Scholarly activity stressed. Get details here at Denvermeeting from Ron Benenson, MD, or from our representative, BillGregory MedQuest, Inc., MAIL=PO Box MQ, Devault, PA 19432-0160; FAX=6101640-4392; E-MAIL=72253.2751@compu-serve.com; CALL (800) 220-6331 (9am-9pm East).

Fully accredited academic Department of Emergency Medicine at New YorkMedical College is seeking qualified BC/BP EM physicians to join ener-getic, lulll ime faculty in an Emergency Medicine ResidencyTraining pr0gram and Pediatric Emergency Medicine Fellowship,Conveniently located in New York Cily, Lincoln Hospital in the Bronx,offers laculty appoinlmenl and provides a competitirle salary, facultypractice, and benefits package in the worlds most exciting city.Individuals with a strong interest in teaching, research, 0r administrati0nare urged to apply. Responsibilities include supervision 0f EmergencyMedicine Residents, Physician Assistants and Medical Students, in addi-tion to the provision 0l direct care. Protected time is provided lor teach-ing and research, Leadership positrons are available.Lincoln Medical Center is a Level I Trauma Center and has over160,000 ED visits a yearThese opportunities will allow the right candidates an opportunity for per-sonal growth in an academic department while being affiliated with a re-s0ected medical school.Please send your Curriculum Vitae, indicating positi0n 0l interest, to:

Harold H. Osbom, MD, FACER FACE ACMTGhairman, Depanment 0l Emetgency Medicine

Telephone: (718) 579-48S5FAX: (718) 575-4822

NEW YORK MEDICAI. COLIEGELINCOTN MEDICAT AND MENTAT HEALTH CENTER

R00M 1-81 . 234 EAST 149TH STREETBRONX, NEW YORK 10459

NORTH SHOREHEALTH SYSTEM EMERGENCY MEDICINE

North Shore University Hospital at Manhasset, a 700 plus bedtertiary care teaching hospital and its affiliated communityteaching hospitals seeks board prepared/certified, residencytrained career Emergency Physicians to augment its staff. Wehave a new residency program in Emergency Medicine at theManhasset site which started July 1.,1995 and as a result we areseeking faculty with interest in academic and scholarly activity.A wide range of clinical, teaching and research opportunities aieavailable. The development of our affiliated Emergency Depart-ments has created an opportunity for joint positions among in-stitutions. Several positions are available at this time.

We have particular interest in academic faculty with EmergencyMedicine Board Certification and additional fellowship trainingin Pediahic Emergency Medicine or Toxicology. Excellent salaryin association with an outstanding benefit package with poten-tial for growth.

Please forward resumes and inquiries toAndrew Sama, MD, Chairman

Department of Emergency MedicineNorth Shore UniversiW Hospital

300 Community Drive, Manhasset NY 11030(516) 562-3090 Phone o (516) 562-3580 FAX

AII EOUAL OPPORTUIIIIY EMPLOYEN

46

EMERGENCY MEDICINE PHYSICIANSAca demic/Clinical/Administ rative

Medical College of Virginia/VC0 Hospitals

7 NNewly established academic Department of Emergency Medicine at Medical College ofVirginiais seeking highly qualified and results-oriented BC/BP EM Physicians ro join the full-time faculty.

In addition to staff positions we are looking for the following:Researcb Direcktr

Medical Educatictn DirectorPrebospital Medical Director

Hmergency Medicine Neurolctgist

The Department has a special recruitment eflbrt to attract emergency physicianswith additi<lnal training,/experience in neurology and/<>r infectious clisease.

MCV Hospital is a distinguished 81l-bed, Level I Trauma Center with over 100,000 visits peryeag and is a regional coronary, critical care, pediatrics, and toxicology center. The EmergencyDepartment has a renewed commitment to the highest quality of patient care and teachingenvironment.The ED faculty positions offer unusually attractive career opportunities in anacademic environment of patient care, teaching, research, and aclministration.

All positions carry appointment to the faculty at the Meclical College of Virginia ancl provide ahighly competitive salary and benefits package.

For consideration for these opportunities, sencl your current curriculum vitae indicating theposition of interest to:J. Douglas'White, MD, MPH, FACEP;Office of the Chair, Department ofEmergency Medicine;Medical College of Virginia/VCU Hospitals;4Ol North 12th Street;Richmond,vA23298-0510 or call Martha Elle or'ftrnyvianna at t-8oo-424-37554.

Dr. White will be discussing this exciting re-engineering proiect at the SAAM AnnualMeeting in Denver on May 6, t996 at 4;45 p.n.

Medical College of Virg iniaN Cu Hospitals401 North l2th Street, Richmond,VA 23298-O5lO

7 NMCV/VCU is an EEO/AA employer

worten, minorities, and persons with disabilities a.re encouraged to apply.

41

Chief of Emeryency MedicineSt Paul-Itamsey Medical Center

HealthPartners, one of the largest healthcare organizations in Minnesota with

over 600,000 members, is currently seeking a Chief of Emergency Medicine for

the St. Paul-Ramsey Medical Center. Our newly remodeled state-of-the-art,30

room - 15,000 sq. ft. Emergency Department has an annual census of 56,000

and an 1,8Vo admission rate. St. Paul-Ramsey Medical Center is a Level I

trauma center, a Level I burn center, a regional poison center and serves as

medical control for urban, suburban and rural EMS systems.

Your role will be to provide physician leadership and direction in the devel-

opment and delivery of comprehensive emergency medicine services. You will

also provide leadership in expanding operations to serve the community and

oversee our Emergency Medicine residency and research program. You should

be trained and board certified in emergency medicine.

Knowledge and experience in a managed care environment and strong

communication skills are required. Your career and clinical experience should

demonstrate both leadership and management skills. A commitment to teach-

ing and research, and eligibility for academic appointment to the faculty of the

University of Minnesota is required. Experience working in a Level I trauma

facility is preferred.

HealthPartners offers a competitive salary and comprehensive benefits

package. For consideration, please send your CV to: HealthPartners Ramsey,

Physician Services, Attn: Sandy Lachman, 640 ]ackson Street, St. Paul, MN

55101. Or for more information call (672) 221'-1'840. You may fax your CV to(612) 221.-8571,.8O/ AA Employer.

lrl lr!5 , ! ' -

ttm HealthPartnersSt. Paul-Ramsey Medical Center

NonrH SuonE UNrveRsrry Hosprr] @ C O M M U N I T Y D R I V E , M A N H A S S F I N E W Y O R K I I O . l O .

NORT}ISHORE

HEALT1ISYSTEM

Eunncnxcy MnorcrwnRnsnencH DrnnctonNorth Shore University Hospital at Manhasset is avoluntary, not-for-profit tefti^ry care, 700-bed academicmedical center affliated with New York UniversitySchool of Medicine. It is located in a beautiful suburbansetting on Long Island less than 15 miles from midtownManhattan.\fith a newly accredited Emergency Medi-cine residency program we are seeking a ResearchDirector with special interest and accomplishment inclinical and/or basic science research and other aca-demic and scholady activities.We would welcomeapplicants who are board eligible/certified EmergencyMedicine Physicians with additional expertise in ascientific fleld of interest. A wide range of clinical andbasic science research resollrces and opportunities areavailable. Our research program is active and diverseand would be enhanced by an individual with excep-tional leadership, motivational and development skills,MD, MD/PhD or PhD candidates would be considered.Excellent salary in association with an outstanding ben-efit package arc available with potential for growth.

Please forward resumes and inquiries toAndrew E. Sama, MD, ChairmanDepartment of Emergency MedicineNorth Shore University Hospital300 Community Drive, Manhasset, NY 11030(515> 562-3090 Phone (5t6) 562-3680 FAX

Department of Emergency Medicine

Open Rank: The University of Cincinnati Depart-ment of Emergency Medicine has a full-time aca-demic position available with research, teaching,and patient care responsibilities. Significant re-search experience in cardiovascular, neurovascular,or toxicologic emergencies preferred. Candidatemust be residency trained in emergency medicinewith board certification/preparation. Salary, rank,and track commensurate with accomplishmentsand experience.

The University of Cincinnati Department of Emer-gency Medicine established the first residency train-ing program in Emergency Medicine in 1970. TheCenter for Emergency Care evaluates and treats66,000 patients per year and has 40 residents in-volved in a 4-year curriculum. Our department hasa long history of academic productivity, with out-standing institutional support.Please send Curriculum Vitae to W Brian Gibler,MD, Chairman of Emergency Medicine, Universityof Cincinnati Medical Center, 231 Bethesda Avenue,Cincinnati, OH 45267 -0769.

Missouri, St. Louis: Barnes-Jewish Hospital at Washington University hascareer opportunities for energetic individuals. Two full-time faculty positionsfor qualified Emergency Medicine Residency-trained BCIBP individuals arebeing offered. An application has been submitted for an emergency medicineresidency program to begin in July 1,997. We are curently seeking anexperienced individual to become a Research Director. We are also seeking afull time junior faculty physician to complete our compliment of core faculty.We are a lcvel 1 ffauma center wittr over 60,000 annual visits and a busyEMS-base station. These are excellent career offerings which include clinical,teaching, and research opportunities. A competitive salary with acomprehensive benefits package is offered, as well as options fortenure/clinical ffact university appointment. Contact Larry Lewis, M.D.,Chiel Emergency Medicine Division, Washington University School ofMedicine, 660 S. Euclid Ave., Box 8072, St. Louis, MO. 63110; 3141362-4362, Fax 314-362-2495 or contact through the message board at theconference. E-mail : llewi s @ imgate. wustl. edu.

NOTES

50

This abstract will be presented during the May 8poster session, following poster 396.

467Reduced Quality of In-Vitro ClotFormationwith Gelatin Based Plasma SubstitutesSN Mardel, FM Saunders, U Allen et al, NorthStaffordshire Trauma Centre, Stoke On Trent, UnitedKingdomWe investigated the properties of blood clot formed in-vitro when fresh blood was diluted with gelatin basedcolloid solutions compared with crystalloid controls overa wide range of dilutions. Both of the colloid solutionstested were found to produce clots that had reducedweight and reduced shear modulus (using thromboelas-tography) compared with controls. These differenceswere statistically significant (p<0.01 for 47o succinylatedgelatin ("Gelofusine") and p<0.001 for 3.5Vo polygeline("Haemaccel"). No changes were found in the haemato-logical composition ofthese clots suggesting that the gel-ative based colloid solutions may alter their physicalstructure. This theory is supported by finding normalconsumption of fibrinogen with no evidence of fibrindegradation. Scanning electron microscopy showed thatfibrin formed a less extensive mesh in the presence of thegelatin based colloids.

Conventional screening of coagulation times only detectchanges up to the formation of a coagulum, and do notassess clot quality. While many workers have document-ed reduction in clot quality with the various dextran andhydroxy ethyl starch infusions, we have found no similarstudies on gelatin based colloids. Further work is beingconducted to ascertain if this occurs in-vivo as thesesolutions are frequently used in patients who require fullhaemogatic competence.

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