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2024 AAENP National Conference: EmergNP Speakers

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Keynote Speakers

Rethinking the Role of Nursing Education Through an Entrepreneurial Lens 

Sarah Michelle Boes, NP -  Chief Nursing Officer, Blueprint Test Preparation

Sarah Michelle is a nurse educator, entrepreneur, top 100 podcast host, and founder of Sarah Michelle NP Reviews (SMNP) - one of the leading names in nurse practitioner board preparation services. After the acquisition of her company in 2022, she now serves as the Chief Nursing Officer of Blueprint Test Prep.

Sarah Michelle earned her BSN from the University of Kentucky, her MSN in Nursing Education from Western Governors University, and finally her post MSN-FNP from Eastern Kentucky University. Throughout this time, she worked in a variety of healthcare settings from oncology to intensive care, while also simultaneously teaching nursing labs and clinicals at the baccalaureate level. Soon after finishing her post MSN-FNP, she founded SMNP with the goal of helping nurse practitioner students ease their anxiety levels while also boosting their confidence before taking boards and transitioning into practice.

Her relatable, transparent and innovative approach to nursing education has struck a chord with thousands of students worldwide. Sarah’s ultimate passion is to further propel the lifelong learning journey of the nurse while also bringing heightened awareness to the importance of mental health in the entire nursing education space.

 

Abstract

When working in the world of nursing, it can become easy to trap ourselves into the “boxes” of traditional educational trajectories, titles and roles. In Sarah Michelle’s keynote address, she intends to showcase how she has pushed the boundaries of the world of nursing education and the roles we hold as nurse practitioners within the larger medical sphere.  The entrepreneurial landscape for both nurses and nurse practitioners is incredibly vast if you are able to take the opportunity to see it. She will paint this picture through depicting her own journey into lifelong learning in nursing.

 

Learning Objectives
  • Identify at least two challenges or barriers to continued nursing education
  • Recognize the impact of mental health awareness and resources throughout the span of the entire nursing career
  • Differentiate between additional career opportunities available through entrepreneurship

 


AAENP State of the Organization & Awards

Melanie Gibbons Hallman, DNP, CRNP, CNS, FAEN, FAANP, FAAN - Associate Professor, The University of Alabama at Birmingham

Keynote Details Coming Soon.


Breakout Session Speakers

Anaphylaxis

Kevin Letz, DNP, MBA, RN, CNE, FNP-C, ANP-BC, PPCNP-BC, ENP-C, FAANP - Director, AANPCB

Dr. Kevin Letz is a board certified family, adult, pediatric, and emergency nurse practitioner. He has over 20 years of experience in emergency care and allergy, asthma, & immunology. Dr. Letz serves as Director of Certification at American Academy of Nurse Practitioners Certified Board and currently practices as a virtualist.

Abstract

Anaphylaxis is defined as a serious allergic reaction that is rapid in onset and may cause death. The diagnosis of anaphylaxis is clinical and based primarily upon clinical symptoms and signs, as well as a detailed description of the acute episode, including antecedent activities and events.

New diagnostic criteria for anaphylaxis are now available. These criteria were intended to help clinicians recognize the full spectrum of signs and symptoms that comprise anaphylaxis. Anaphylaxis is under-recognized and undertreated. This may partly be due to failure to appreciate anaphylaxis presenting without obvious cutaneous symptoms or overt shock. Anaphylaxis is a much broader syndrome than "anaphylactic shock" however, and the goal of therapy should be early recognition and treatment with epinephrine to prevent progression to life-threatening symptoms, including shock. Recognition of the variable and atypical presentations of anaphylaxis is therefore critical to providing effective therapy in the form of epinephrine, as well as reducing overreliance on less-effective medications, such as antihistamines and glucocorticoids.

Anaphylaxis may be mild and resolve spontaneously or it may be severe and progress within minutes to respiratory or cardiovascular compromise and death. Death from anaphylaxis usually results from asphyxiation due to upper airway edema or respiratory failure due to bronchial obstruction, and less commonly, from cardiovascular collapse. Anaphylaxis is usually characterized by a defined exposure to a potential trigger, followed by rapid onset, evolution, and resolution of symptoms within minutes to hours. This lecture will review early recognition and treatment of anaphylaxis.

Learning Objectives
  • Describe the newest diagnostic criteria for anaphylaxis
  • Identify the most common triggers and mechanism of anaphylaxis
  • Identify the various signs and symptoms of anaphylaxis
  • Be familiar with the treatment strategies for anaphylaxis

Utilizing Bedside Ultrasound to Identify Ocular Emergencies

Kieser Reynaldo, DNP, FNP-C, ENP-C - Emergency Nurse Practitioner, Adjunct Faculty, Arizona State University

Dr. Reynaldo Kieser is a board certified Family and Emergency Nurse Practitioner with over 13 years of emergency clinical experience. After completing his Bachelors of Nursing in 2011 from Baylor University, he furthered his education and obtained his Doctorate of Advanced Nursing Practice at the University of Arizona where he currently resides as adjunct faculty for the Emergency Nurse Practitioner Certification Program.

His full time role is as an Emergency Nurse Practitioner with TeamHealth within the Phoenix Valley where he cares for patients of all acuity in their time of need. His passion is education and advocating for Nurse Practitioners in all areas of Medicine.

Abstract

Bedside ultrasound is a practical and often underutilized tool to quickly identify ocular emergencies by Nurse Practitioners in the Emergency Department/Urgent Care setting. The focus of this presentation is to review techniques for performing an ocular ultrasound and to expose Emergency Nurse Practitioners to normal and abnormal pathologies of the eye as viewed through ocular ultrasound.

This presentation will include PowerPoint slides with media that will cover the approach to using ultrasound, review normal anatomy of the eye on ultrasound, review subjective findings for abnormal pathologies/ocular emergencies, and review abnormal anatomy of the eye on ultrasound.

Learning Objectives
  • Demonstrate the technical approach to performing a bedside ocular ultrasound.
  • Identify normal anatomy of the eye via bedside ocular ultrasound.
  • Identify abnormal anatomy of the eye via bedside ocular ultrasound.
  • Give examples of subjective findings of ocular emergencies in patient presentations.

Pediatric Injury Care: Fusing Case Studies with Procedural Practice

Melinda Johnson, DNP, APRN, FNP-BC, AGACNP-BC, ENP-C - Assistant Professor of Nursing, Vanderbilt University School of Nursing

Dr. Mindy Johnson is board certified as an Emergency, Family, and Adult Gerontology Acute Care Nurse Practitioner. She obtained her Doctor of Nursing Practice and Master of Science in Nursing from Vanderbilt University, where she is now an Assistant Professor in the Emergency Nurse Practitioner Program. Prior to her current practice in the Vanderbilt Walk in Clinics, Dr. Johnson worked in the Pediatric Emergency Department at Monroe Carell Jr. Children's Hospital at Vanderbilt.

She has a passion for teaching, having begun her career with a degree in Secondary Education - Biological Sciences from Pennsylvania State University. Clinically, she has over fifteen years of nursing experience in emergency medicine as well as adult and pediatric intensive care. She is an active member of the American Academy of Emergency Nurse Practitioners, American Academy of Nurse Practitioners, and Sigma Theta Tau. She enjoys spending time outdoors biking and traveling with her husband and children.

Erica May, DNP, APRN, FNP-BC, AGACNP-BC, ENP-C

Speaker Bio Coming Soon.

Rachel Sweeney, DNP, APRN, FNP-BC, AGACNP-BC - Assistant Clinical Professor, Auburn University

Dr. Rachael Sweeney joined the Auburn University College of Nursing Family Nurse Practitioner program as an assistant clinical professor in the spring of 2019. She is the program coordinator for the Primary Care Nurse Practitioner Program with responsibilities in classroom, lab, and clinical settings. She is also the lead faculty for graduate Nurse Practitioner simulations at the College. As an assistant clinical professor, her interests have grown to include the importance and impact of simulation in graduate NP education.

She has over 18 years of emergency medical experience beginning as an EMT, emergency room nurse, flight nurse, and now emergency nurse practitioner. She has, in addition, worked with acute and chronic pediatric homebound patients with significant healthcare needs. She has a passion for teaching in and out of the classroom. She has served as an educator in many roles including as an adjunct clinical instructor for senior nursing students, as well as continuing education courses through the American Heart Association, Emergency Nurses Association, and the National Association of Emergency Medical Technicians.

Abstract

Join us for an interactive session that combines pediatric case studies with hands-on procedural practice. Gain a practical understanding of managing common pediatric injuries using developmentally appropriate approaches. Through case studies, participants will delve into clinical decision-making for common pediatric urgent/emergent complaints, followed by hands-on practice to solidify procedural skills.

Topics covered will include: nurse maid elbow reduction, management of orthopedic injuries, HEENT exam techniques and foreign body removal, and approach to head trauma and lacerations.

Learning Objectives
  • Explore pediatric case-based scenarios to practice common procedural skills.
  • Utilize validated clinical decision-making tools to manage minor pediatric trauma.
  • Learn developmentally appropriate examination techniques for the pediatric patient.
  • Review pediatric anatomic differences and related care implications.

Straight Talk on Wavy Lines - Emergency Electrocardiography Updates

Michael A. Sharma, MPAS, PA-C - Emergency Medicine PA, UT Southwestern Medical Center / Parkland Memorial Hospital; Adjunct Professor of PA Studies, Mercy College of Ohio

Michael A. Sharma, MPAS, PA-C, is a practicing emergency medicine and urgent care PA in the Dallas, TX, area, including Parkland Memorial Hospital, considered by many as the busiest emergency department in the country. He is also an adjunct professor of PA studies and an experienced medical educator who speaks regularly at the national and international levels. Mike co-hosts “The 2 View” podcast, which focuses on the experience of the emergency medicine and urgent care NP and PA. In addition, he is a U.S. Army veteran, including a deployment to Afghanistan as a trauma team leader. He loves translating the latest knowledge from the medical literature into information that the clinician can use at the bedside. Mike can be found on X, Instagram, and Facebook at @michaelsharmapa.

Abstract

With the American College of Cardiology's 2022 update on STEMI equivalents and ischemia equivalents, there is a new emphasis on certain potentially pathologic EKG findings. EKG literature continues to advance and further refines when we should be activating the cath lab or potentially discharging patients despite abnormal EKGs. Go beyond the guidelines to hear the latest from the EKG literature on can't-miss findings and concerning-but-likely-benign waveforms.

Learning Objectives
  • List and be able to recognize the ischemia and STEMI equivalents from the 2022 ACC guidelines for evaluation and diagnosis of chest pain in the emergency department.
  • Utilize Seamens' sign for easier diagnosis of left ventricular hypertrophy.
  • Understand the true specificity of ST elevation in lead aVR with regards to identifying coronary ischemia.
  • Define hyperacute T waves and ways to identify these T waves concerning for early MI.

Everything Hurts: Are Chronic Polyarticular Conditions a Problem for EM?

Michael A. Sharma, MPAS, PA-C - Emergency Medicine PA, UT Southwestern Medical Center / Parkland Memorial Hospital; Adjunct Professor of PA Studies, Mercy College of Ohio

Michael A. Sharma, MPAS, PA-C, is a practicing emergency medicine and urgent care PA in the Dallas, TX, area, including Parkland Memorial Hospital, considered by many as the busiest emergency department in the country. He is also an adjunct professor of PA studies and an experienced medical educator who speaks regularly at the national and international levels. Mike co-hosts “The 2 View” podcast, which focuses on the experience of the emergency medicine and urgent care NP and PA. In addition, he is a U.S. Army veteran, including a deployment to Afghanistan as a trauma team leader. He loves translating the latest knowledge from the medical literature into information that the clinician can use at the bedside. Mike can be found on X, Instagram, and Facebook at @michaelsharmapa.

Abstract

Chronic polyarticular diseases may not sound like the specialty of the emergency medicine or urgent care clinician. However, many chronic polyarticular problems put patients at increased risk for true medical and surgical emergencies. EM & UC practitioners can also be important part of a patient's medical team, starting a workup that will lead to a definitive diagnosis by other clinicians. This lecture will also cover common medications taken by sufferers of these diseases and adverse reactions that may require emergent treatment. In addition, we'll learn a novel mnemonic to remember these diseases.

Learning Objectives
  • Summarize important subjective and objective findings, imaging, and lab testing that are relevant to the diagnosis and treatment of chronic polyarticular disease in the ED/UC.
  • Differentiate between different symmetric and asymmetric polyarthralgias by utilizing the "RAPPEL TARG Et" mnemonic as an initial guide.
  • Select appropriate treatment in the ED/UC setting based on likely diagnosis and describe the adverse effects of other medications often prescribed by outpatient clinicians for chronic polyarticular diseases.
  • Describe which patients with chronic polyarticular problems would benefit from inpatient admission.

Assessment and Management of Ocular Emergencies- Skills-Based Workshop

Dian Evens, PhD, FNP-BC, ENP-C, FAANP, FAAN - Professor Emeritus and ENP, Highland Urgent Care

Dr. Dian Dowling Evans is Professor Emeritus and former Program Director of the Nell Hodgson Woodruff School of Nursing at Emory University. With over 30 years of clinical experience as an emergency nurse practitioner (ENP), Dr. Evans helped to pioneer and advance the ENP role. She was a founding board member and past Chair of the American Academy of Emergency Nurse Practitioners (AAENP). During her tenure she established the AANP Emergency Special Practice Group director and the ENP Special Interest Group for the National Organization of Nurse Practitioner Faculties. Recognized as a leader within the ENP profession, Dr. Evans is actively involved in national ENP policy initiatives, certification exam development, and curricular standards. She currently serves as the Research to Practice Column Editor for the Advanced Emergency Nursing Journal and has extensive publications and national and international presentations on emergency medicine topics, the ENP role, and ENP education. Dr. Evans’ efforts and contributions to the nursing profession have been recognized through induction into the Fellows of the American Association of Nurse Practitioners and the American Academy of Nursing. She currently practices in a family practice/urgent care clinic in Atlanta, GA.

Paula Tucker, DNP, PhD(c), FNP-C, ENP-C, FAANP

Speaker Bio Coming Soon.

Abstract

Ocular emergencies are commonly seen in the ED and are increasing due to a nationwide workforce shortage of ophthalmologists and access to care barriers. As a result, emergency nurse practitioners (ENP)s must be able to recognize emergent eye conditions since improper care can lead to permanent vision loss. This presentation will cover the assessment and management of the most serious and potentially disabling ocular emergencies, including red eye, vision loss, and traumatic injury. Accurate assessment of ocular emergencies requires the ability to correctly perform a slit lamp examination and obtain intraocular pressure measurements using tonometry, core ENP competencies

Learning Objectives
  • Review the assessment and management of red eye emergencies.
  • Identify normal anatomy of the eye via bedside ocular ultrasound.
  • Identify abnormal anatomy of the eye via bedside ocular ultrasound.
  • Give examples of subjective findings of ocular emergencies in patient presentations.

Identifying and managing major depression in the emergency department

Pujeeta Carter, FNP-BC, CNL, RN - Nurse Practitioner, University of Maryland, School of Nursing

Pujeeta Carter is a current doctoral nursing practice (DNP) student at the University of Maryland. She has been working as an Emergency Department nurse practitioner (NP) at University of Maryland Medical Center for over 7 years, where she works in acute care, fast track, urgent care, and tele-triage. Previously, she worked as a Primary Care Provider for 3 years. She worked bedside as a nurse in the pediatric intensive care unit (PICU), surgical acute, and emergency department for over 3 years. Pujeeta completed her bachelor’s at University of Connecticut, with a double major in biology and women’s studies, and then completed her master's education at University of Maryland, where she completed the Clinical Nurse Leader program, then later received a post-masters NP certificate and Global Health certificate. Her global practicum was in Liberia focused on a project to develop an advanced practice program for nurses, specifically in rural, low-resourced areas. In addition to working as a Nurse Practitioner, she is also an adjunct Professor at University of Maryland, teaching the practicum course for final semester master's prepared students. Pujeeta has a passion for addressing the social determinants of health, and factors that lead to health disparities, particularly in patients who present to the ED. She is actively engaged in health disparities education for onboarding nursing staff, NPs, and LPNs at her ED.

Abstract

Major depressive disorder (MDD) is a common and serious medical illness caused by physiological, emotional, and social elements that can be treated and managed. For many adults, the Emergency Department (ED) serves as the safety net for care, reinforcing the importance of addressing MDD when they are present. The ED in Baltimore manages approximately 45,000 patients per year and will serve as the site for the quality improvement project. Currently, there is no existing screening protocol for depression or formal education provided to nursing staff to understand root causes of depression affecting patients presenting to the ED. The purpose of this quality improvement project is to implement the Patient Health Questionnaire (PHQ-9) screening tool within the Emergency Department to better identify patients at risk for MDD and suicide, and thereby align them with mental health, psychiatry, and social work resources. Synthesis of literature demonstrates the PHQ-9 has greater sensitivity for MDD than previous conventional tools, and lower cut-off points for patients presenting with chronic disease. The review of literature was consistent in their recommendation of utilizing the PHQ-9 as a sensitive indicator for MDD demonstrating consistent benefits of implementation in the ED setting. The PHQ-9 will be performed on each patient presenting to the ED with an Emergency Severity Index (ESI) of 2 or greater, via a mandatory screening flowsheet by nursing staff. A chart audit to evaluate staff compliance will be performed weekly, will be used to demonstrate patients screening positive for MDD have been referred to outpatient mental health resources. This initiative will be implemented over a 15-week period in the Fall of 2023, screening potentially 10,000 patients, and providing a more comprehensive assessment of and management of mental health conditions.

Learning Objectives
  • Identify and the historical context of discrimination in Baltimore, affecting mental health
  • Identify symptoms of depression
  • Identify accessible mental health resources in the ED
  • Understand the implications of addressing depression in an emergency department setting

That Bites!: Snakes, Stings, and Other Things!

Ashton Glover, DNP, FNP-C, ENP-C, SANE-A - Assistant Professor, University of North Alabama

Dr. Ashton Glover received her Bachelors of Science in Nursing from the University of North Alabama in Florence, Alabama. She then went on to receive her Masters of Science in Nursing from the University of Alabama at Birmingham and her Doctor of Nursing Practice from Samford University in Birmingham, Alabama. Ashton is board-certified by the American Academy of Nurse Practitioners as a family and emergency nurse practitioner. She is also a certified sexual assault nurse examiner. Ashton currently works as a NP instructor and content author for Blueprint Test Prep. She practices at several rural emergency departments in the Southeastern United States and serves as Assistant Professor at the University of North Alabama. Ashton is a member of the International Association of Forensic Nurses and American Academy of Emergency Nurse Practitioners where she serves on the education committee. Ashton’s scholarly interests include issues related to social determinants of health. emergency care, and forensic nursing. Ashton enjoys spending quality time on her family farm with her husband, two children (Bo Taylor 8 and John Maddax 5), and their animals.

Abstract

Animal bites are a common source of morbidity and mortality worldwide (World Health Organization [WHO], 2018). In the United States, two to five million animal bites occur each year, accounting for approximately 10,000 inpatient admissions (Baddour, 2022). Dog and cat bites are the most prevalent, followed by humans and other animals (i.e. snakes, spiders, raccoons, livestock, etc.). It is estimated that approximately 45,000 snakebites occur in the U.S. each year, with 5,000 envenomations (Ruha, 2023). Bite wounds can range from superficial injuries to causing disfigurement, significant tissue damage, systemic abnormalities, and fatal injuries. Moreover, insect stings have the potential to cause anaphylaxis or serious delayed reactions (Freeman, 2022). Emergency care providers must be able to rapidly recognize and treat any suspicious bite or sting in order to reduce the risk of long-term disability and even death. The purpose of this presentation is to review current evidence-based guidelines regarding the initial evaluation and management of common animal bites and stings presenting to the emergency department.

Learning Objectives
  • Discuss the evaluation of a patient with an animal bite or sting.
  • Describe the presentation of a patient exhibiting signs of venom toxicity.
  • Review management strategies for animal bites and stings.
  • Summarize the emergency care provider’s role as a member of the interprofessional team in enhancing care coordination and facilitating the delivery of timely care to patients experiencing animal bites and stings.

Oh My Broken Heart! A review of Acute Heart Failure Decompensation following the ACEP Clinical Policy

Adam Dobbins, APRN, FNP-C, ENP-C, PhD - Clarinda Regional Medical Center, Nurse Practitioner

I have been working in Emergency Medicine since 2011 with over 10 years of that serving at the level of Nurse Practitioner. I have experience both at large, urban, academic facilities and as single provider rural coverage. I hold FNP and ENP certifications from AANP and hold a PhD in Nursing. In addition to my current work at a small, rural ED, I provide locums to other rural facilities. I serve as adjunct faculty at the University of Central Missouri and have taught at both the undergraduate and graduate level. I am an active member of AAENP and serve as chair of the conference planning committee.

Abstract

Compared to treatment for chronic heart failure, there is a lack of good literature and evidence-based treatments for acute heart failure decompensation. While that remains true, ACEP has recently published a clinical policy to help direct emergency providers in caring for acute heart failure exacerbations. This presentation will use this ACEP body of knowledge as the backdrop to review treatment for acute heart failure in the emergency department. This is a critical and time-sensitive diagnosis and treatment plan that is often overshadowed by other cardiovascular emergencies such as acute coronary disease and arrhythmias.

Learning Objectives
  • Identify the cause and type of heart failure exacerbations.
  • Review the ACEP clinical policy published in June of 2022.
  • Review treatment options tailored to the type of heart failure decompensation.
  • Review some pitfalls that may cause less than optimal patient outcomes in acute heart failure exacerbations.

Top 5 Finger Complaints in Emergency Care

Micheal Gooch, DNP, APRN, CCP, ACNP-BC, FNP-BC, ENP-C - Assistant Professor of Nursing; Emergency-Flight NP, Vanderbilt University Medical Center

Dr. Michael D. Gooch is board certified as an acute care, family, and emergency nurse practitioner. He is also board certified as an emergency, flight, transport and trauma nurse. He has over 25 years of emergency and transport medicine experience. He obtained his MSN from Vanderbilt University and his DNP from Loyola University Chicago. He is an Assistant Professor of Nursing with Vanderbilt University School of Nursing, as well as faculty with the Middle Tennessee School of Anesthesia. At Vanderbilt University Medical Center, he practices as a flight and emergency nurse practitioner. He has completed over 1,600 patient transports during his tenure with Vanderbilt’s LifeFlight transport program. He is also employed with TeamHealth and practices as emergency nurse practitioner in a community emergency department.

Michael is a founding member of the American Academy of Emergency Nurse Practitioners and serves as the Southeastern Regional Director. He also serves as an APRN liaison to the board of directors for the Air and Surface Transport Nurses Association.

Michael is a nationally recognized speaker and published author regarding varied emergency and transport medicine topics. He serves on the editorial board as a column editor for the Advanced Emergency Nursing Journal.

Abstract

Using a case based approach, this presentation will review five common finger complaints encountered in emergency care settings: Flexor Tenosynovitis, Felon, Paronychia, Subungal Hematoma, and Herpetic Whitlow. Some of these are minor and some can have significant problems if not managed appropriately. Assessment findings and management options will be reviewed during this presentation.

Learning Objectives
  • Recall key aspects of performing a hand and finger assessment.
  • Identify five common finger complaints encountered in emergency care settings.
  • Recall the classic presentations of select finger emergencies.
  • Describe pharmacologic options for managing select finger emergencies.

Unraveling Delirium: Understanding its Impact Across the Lifespan

Sharon Rainer, Ph.D, APRN, ENP-C, FNP-BC - Assistant Professor, Thomas Jefferson University

Dr. Rainer is an Emergency Nurse Practitioner, educator, and nurse researcher at the College of Nursing, Thomas Jefferson University. Her expertise is in household emergency preparedness, geriatrics, and community-engaged research. She is currently an Assistant Professor and Program Director of the Post-Graduate Emergency Nurse Practitioner Program and a Fellow in the Jefferson Institute for Smart and Health Cities. Dr. Rainer has been a nurse practitioner at Thomas Jefferson Department of Emergency Medicine for 18 years and is a certified family, psychiatric mental health, and emergency nurse practitioner. Her nursing background is in neuro-critical care and trauma. She is lead nursing faculty for Jefferson’s Japan Center working collaborative with Toho University in Tokyo. Dr. Rainer serves as the New Jersey State Representative for the American Association of Emergency Nurse Practitioners.

Abstract

Bedside ultrasound is a practical and often underutilized tool to quickly identify ocular emergencies by Nurse Practitioners in the Emergency Department/Urgent Care setting. The focus of this presentation is to review techniques for performing an ocular ultrasound and to expose Emergency Nurse Practitioners to normal and abnormal pathologies of the eye as viewed through ocular ultrasound.

This presentation will include PowerPoint slides with media that will cover the approach to using ultrasound, review normal anatomy of the eye on ultrasound, review subjective findings for abnormal pathologies/ocular emergencies, and review abnormal anatomy of the eye on ultrasound. If access to ultrasound equipment is available, the presentation may include hands on practice for a few clinicians within the allotted time.

Learning Objectives
  • Demonstrate the technical approach to performing a bedside ocular ultrasound.
  • Identify normal anatomy of the eye via bedside ocular ultrasound.
  • Identify abnormal anatomy of the eye via bedside ocular ultrasound.
  • Give examples of subjective findings of ocular emergencies in patient presentations.

Pearls of documentation (from the lawyer’s kid)

Travis McCall, PhD, AGACNP-BC, FNP-BC, ENP-C, CCP - Assistant Professor/Flight Nurse Practitioner, Vanderbilt School of Nursing/Vanderbilt LifeFlight

Dr. Travis McCall is board-certified as an Emergency, Adult-Gerontologic Acute Care, and Family Nurse Practitioner. He obtained his Master of Science in Nursing from Vanderbilt University with a specialty education in Emergency Care. He earned his Doctor of Philosophy from the University of Tennessee College of Nursing and completed a graduate minor in Epidemiology in the Department of Public Health. He currently serves as an Assistant Professor in the Emergency Nurse Practitioner and Doctor of Nursing Practice programs at Vanderbilt University School of Nursing and practices as a Flight Nurse Practitioner with Vanderbilt LifeFlight.

Abstract

“Pearls of documentation (from the lawyer’s kid)” is a presentation that aims to improve documentation practices to prevent medical malpractice. Content will identify those chief complaints and presentations in emergency medicine that are most commonly associated with litigation. The presentation will also discuss pearls of documentation that support forensic investigation and prosecution in criminal proceedings when emergency department patients are victims of crimes.

Learning Objectives
  • Identify documentation pitfalls associated with medical malpractice in emergency medicine.
  • Describe best practices in documentation to protect against malpractice.
  • Discuss documentation strategies to support forensic investigation and criminal prosecution.

Peripheral vascular injuries

Kelley Scott, DNP, ENP-C, FNP-BC - Assistant Clinical Professor, Drexel University

Registered nurse since 1998, received a Masters of Science in Nursing from the University of Delaware, as a family nurse practitioner in 2007. Doctorate of nursing practice from Drexel University in 2016. Doctoral research focused on improvements in emergency department care and triage.

Adjunct professor at Drexel University since 2016; Full-time assistant professor, assistant track director of the MSN Family Nurse Practitioner Program (Individual Across the Lifespan) since 2018. Emergency track director Emergency Nurse Practitioner Program 2025. Clinical career focus is primarily on family and emergency care for individuals across the lifespan.

Professional career is driven by a passion for health education, preventative healthcare, and caring for patients and their families.

Abstract

Peripheral vascular injuries can be devastating, threatening to life and or limb. These injuries may occur as a result of an accident, from a motor vehicle, a fall, an athletic injury, or from an assault. Individuals with blunt and penetrating trauma are at risk for peripheral vascular injury. Peripheral vascular injuries can present a challenge for healthcare providers. An injury to a vital blood vessel can be subtle and difficult to identify. Delay of diagnosis may lead to complicating hemorrhage, aneurysm formation, arteriovenous fistulization, and gangrene.

Learning Objectives
  • Define Peripheral Vascular Injury
  • Assessment Findings/Presentation
  • Diagnostic Evaluation
  • Criteria for Scoring Peripheral Vascular Injuries

Tick-borne Illnesses

Travis McCall, PhD, AGACNP-BC, FNP-BC, ENP-C, CCP - Assistant Professor/Flight Nurse Practitioner, Vanderbilt School of Nursing/Vanderbilt LifeFlight

Dr. Travis McCall is board-certified as an Emergency, Adult-Gerontologic Acute Care, and Family Nurse Practitioner. He obtained his Master of Science in Nursing from Vanderbilt University with a specialty education in Emergency Care. He earned his Doctor of Philosophy from the University of Tennessee College of Nursing and completed a graduate minor in Epidemiology in the Department of Public Health. He currently serves as an Assistant Professor in the Emergency Nurse Practitioner and Doctor of Nursing Practice programs at Vanderbilt University School of Nursing and practices as a Flight Nurse Practitioner with Vanderbilt LifeFlight.

Abstract

With observed changes in the climate, the prevalence of ticks and the diseases they carry and transmit to humans is increasing. This rapid-fire lecture will review diseases such as Lyme disease, Rocky Mountain Spotted Fever, anaplasmosis, ehrlichiosis, babesiosis, Powassan virus, and Borrelia miyamotoi. Distribution, diagnosis, and treatment of these tick-borne illnesses will be discussed. The prevalence, pathology, and recognition of alpha-gal syndrome will also be discussed.

Learning Objectives
  • Describe the prevalence and distribution of tick-borne illnesses in North America.
  • Identify symptoms and evidence-based treatment of tick-borne illnesses in the emergency department.
  • Discuss the pathology, recognition, and appropriate treatment of patients with alpha-gal syndrome.

The Emergency NP’s Role in Reducing Maternal Mortality

Toni Dobson, APRN, MSN, ENP-C, FNP-C, RNC-OB - Nurse Practitioner, AAENP/ACOG

oni Dobson, originally from New Orleans, LA, is a nurse practitioner in Chattanooga, TN. She is double-boarded by the American Academy of Nurse Practitioners (AANP) as a Family and Emergency Nurse Practitioner. She works for Pediatric Emergency Medical Associates (PEMA) and Regional Obstetric Consultants (ROC) in the children’s and obstetric emergency departments at Erlanger Medical Center.

Before entering nursing, she worked as a paramedic for 911 in New Orleans, LA, and Huntsville, AL. After graduating from nursing school in 2001, she worked as an emergency department nurse before discovering her passion for women’s health and transferring to labor and delivery (L&D). She worked for over ten years as a L&D nurse before completing her master’s degree at Frontier Nursing University in 2014. That year, she was part of the opening team of Erlanger’s Obstetric Emergency Department (OBED), one of the first in the area.

In 2018, she completed a post-master’s certificate program at Vanderbilt University and began working in Erlanger's level I trauma center and community emergency departments. She was recruited by PEMA in 2021 and transferred to Erlanger’s Children’s Emergency Department. She remains full-time at children's and works intermittently in the OBED.

Toni is a member of several professional organizations, including AANP, AAENP, and ACOG.

Toni has been serving as a representative of AAENP on ACOG’s initiative to provide education and resources to non-obstetric providers about obstetric emergencies since 2023.

She lives in Chattanooga with her spouse, 17-year-old son, and four fur babies. She also has a 21-year-old son who lives in Huntsville, AL. Outside of medicine, she enjoys painting, beekeeping, traveling, and music.

Abstract

More than half of pregnancy-related deaths in the United States (U.S.) happen up to one year after delivery.  Emergency Nurse Practitioners (NP) are critical in reducing U.S. maternal mortality by providing early recognition, stabilization, and treatment of pregnancy-related emergencies.  The American College of Obstetrics and Gynecology (ACOG) has partnered with the American Academy of Emergency Nurse Practitioners (AAENP) and other non-obstetric provider groups to increase awareness of these emergencies and provide guidelines for diagnosis and treatment.  Recognition of these emergencies is a critical factor in successful patient outcomes.  Asking any woman of childbearing age, “Are you pregnant now or have you been pregnant in the last year?” quickly identifies this at-risk population and helps the emergency NP to broaden their differential to include pregnancy-related and postpartum emergencies.  

Focus areas of this initiative include cardiovascular disease, hypertension, and maternal mental health.  Cardiovascular disease (CVD) is now the leading cause of pregnancy-related death.  Careful consideration of risk factors, symptoms, physical exam findings, and diagnostic testing is necessary to provide life-saving early identification and management of cardiovascular emergencies.  New guidelines are available to emergency providers to guide in diagnosis and management.  

Gestational hypertension is managed aggressively in acute care to avoid the adverse sequelae of pregnancy and postpartum hypertension. Safe blood pressure parameters are significantly lower in this population, and emergency interventions are indicated when readings are 160/110 or greater.  ACOG now provides management algorithms to guide non-obstetric providers in caring for hypertensive pregnant or postpartum women. 

Mental health conditions are rising nationally, affecting one in five pregnant and postpartum women.  New mothers are at increased risk of suicide during the first year postpartum.  Emergency NPs can ensure the safety of both mother and infant by providing emergency pharmacotherapies and urgent psychiatric assessments.  

As a whole, the role of the emergency NP is vital in the early recognition, diagnosis, and management of obstetric emergencies.  With this awareness and information, NPs can affect change in their workplace by spreading this message to other first-line medical providers, ultimately reducing the overall U.S. maternal mortality rate.  

Learning Objectives
  • Develop a method to identify this at-risk population.
  • Explain how to differentiate between normal pregnancy symptoms and acute pregnancy-related cardiovascular emergencies.
  • Define mild and severe range blood pressure and identify what requires urgent management. 
  • Discuss emergency interventions for patients experiencing a postpartum mental health crisis.

Common Orthopaedic Conditions in the Emergency Department - Lower Extremity

Tiffany Reabold, CRNP - Senior Clinical Practice Manager/Senior Nurse Practitioner, University of Maryland Medical Center

Tiffany Reabold is a Family Nurse Practitioner with nearly 20 years of NP experience. She joined the Adult Emergency Department at the University of Maryland Medical Center in Baltimore, Maryland in 2019, and currently is the lead NP for the nurse practitioners in the adult emergency department and urgent care. Prior to joining the ED, she worked for nearly 15 years in outpatient orthopaedics in an NP role. Tiffany has a special interest in the education and mentoring of new nurse practitioners and students and is currently pursuing her DNP degree to be completed in April 2024.

Abstract

This course will provide an overview of common emergency department complaints of the lower extremity. Content to include history and physical examination components as well as overview of management of common fractures and other musculoskeletal pathologies.

Learning Objectives
  • Gain confidence in performing orthopedic history and physical examination for lower extremity complaints.
  • Identify appropriate imaging indications and modalities.
  • Identify appropriate treatment strategies for common fractures and musculoskeletal complaints.
  • Discuss indications for orthopaedic consultation versus outpatient follow-up.

Shining a Light on Pediatric Non-accidental Trauma

Kathy Schall, MD - Pediatric Surgeon, Children's Nebraska

I was born and raised in rural Nebraska in a town of 280 people, called Litchfield. I went to undergraduate school at the University of Nebraska Omaha and then to medical school at the University of Nebraska Medical Center. I then did my General Surgery Residency at the University of Utah and my Short Bowel Syndrome Research Fellowship at Children's Hospital Los Angeles before heading to my Pediatric Surgery Fellowship at Phoenix Childrens Hospital.

Abstract

Pediatric trauma is the leading cause of death for children in the United States. The majority of pediatric trauma is preventable, however, not all trauma is as obvious as a motor vehicle accident. Non-accidental trauma (NAT) can be subtle and requires a high level of suspicion to identify. Our stand-alone tertiary pediatric Level II trauma center typically gets 23 NAT patients on average per year over the last 5 years. Recently, we have noticed an increase in the number of NAT patients, getting 21 patients in the last 7 months. In addition, there have been 4 missed NAT patients that have died over the last few months. This is troubling and has prompted us to investigate how to identify NAT in a more objective manner and enabling any team member to speak if up if they question the possibility of an NAT. There are many red flags to look for, including pattern of injury, delay in seeking treatment, inconsistent stories to different team members, changing stories as time goes on, caregivers with inappropriate affect, child with history of injuries and a pattern of injury that does not match what the caregivers said happened. Occasionally, it can be obvious but more often, these are subtle and if not picked up, could result in further abuse and possible death.

Learning Objectives
  • What is Non-Accidental Trauma?
  • What are the presentations of Non-Accidental Trauma?
  • What is the work-up of NAT?
  • Who is responsible for reporting possible NAT?

Common Orthopaedic Conditions in the Emergency Department - Upper Extremity

Tiffany Reabold, CRNP - Senior Clinical Practice Manager/Senior Nurse Practitioner, University of Maryland Medical Center

Tiffany Reabold is a Family Nurse Practitioner with nearly 20 years of NP experience. She joined the Adult Emergency Department at the University of Maryland Medical Center in Baltimore, Maryland in 2019, and currently is the lead NP for the nurse practitioners in the adult emergency department and urgent care. Prior to joining the ED, she worked for nearly 15 years in outpatient orthopaedics in an NP role. Tiffany has a special interest in the education and mentoring of new nurse practitioners and students and is currently pursuing her DNP degree to be completed in April 2024.

Abstract

This course will provide an overview of common emergency department complaints of the upper extremity. Content to include history and physical examination components as well as overview of management of common fractures and other musculoskeletal pathologies.

Learning Objectives
  • Gain confidence in performing orthopedic history and physical examination for upper extremity complaints.
  • Identify appropriate imaging indications and modalities.
  • Identify appropriate treatment strategies for common fractures and musculoskeletal complaints.
  • Discuss indications for orthopaedic consultation versus outpatient follow-up.

Navigating the Enhanced Beers Criteria: Applying the Latest Guidelines in the Emergency Department

Sharon Rainer, Ph.D, APRN, ENP-C, FNP-BC - Assistant Professor, Thomas Jefferson University

Dr. Rainer is an Emergency Nurse Practitioner, educator, and nurse researcher at the College of Nursing, Thomas Jefferson University. Her expertise is in household emergency preparedness, geriatrics, and community-engaged research. She is currently an Assistant Professor and Program Director of the Post-Graduate Emergency Nurse Practitioner Program and a Fellow in the Jefferson Institute for Smart and Health Cities. Dr. Rainer has been a nurse practitioner at Thomas Jefferson Department of Emergency Medicine for 18 years and is a certified family, psychiatric mental health, and emergency nurse practitioner. Her nursing background is in neuro-critical care and trauma. She is lead nursing faculty for Jefferson’s Japan Center working collaborative with Toho University in Tokyo. Dr. Rainer serves as the New Jersey State Representative for the American Association of Emergency Nurse Practitioners.

Abstract

Healthcare professionals in the emergency department (ED) will discover how to effectively navigate the updated Beers Criteria and apply the latest guidelines to enhance patient care for older adults. The Beers Criteria, established by the American Geriatrics Society, offers essential recommendations for safer medication use in older adults across all health care settings.

Attendees will gain insights into the updated criteria, highlighting recent developments and best practices for managing medication-related issues in older adults presenting to the Emergency Department. The presentation will cover key topics such as identifying high-risk medications, minimizing adverse drug events, and improving patient outcomes.

Through case studies, practical examples, and evidence-based strategies, participants will learn how to integrate the Beers Criteria into their daily practice. This presentation aims to empower ED clinicians with the knowledge and tools necessary to provide safer, more effective care to older adults, ultimately reducing hospital readmissions and improving the overall quality of care for older adults in the emergency department.

Learning Objectives
  • Participants will describe the latest changes to the Beers Criteria and articulate the relevance of the criteria to emergency care of older adults.
  • Participants will apply the updated Beers Criteria to effectively screen and review mediations for older adults in the emergency department.
  • Participants will evaluate the Beers Criteria as a tool to improve older adult care in the emergency department and foster patient-centered care.
  • Participants will identify critical pearls and pitfalls associated with utilizing the Beers Criteria to improve outcomes for older adults in emergency care.

Recognizing and managing thyroid emergencies: Puzzlers not to miss

Dian Evens, PhD, FNP-BC, ENP-C, FAANP, FAAN - Professor Emeritus and ENP, Highland Urgent Care

Dr. Dian Dowling Evans is Professor Emeritus and former Program Director of the Nell Hodgson Woodruff School of Nursing at Emory University. With over 30 years of clinical experience as an emergency nurse practitioner (ENP), Dr. Evans helped to pioneer and advance the ENP role. She was a founding board member and past Chair of the American Academy of Emergency Nurse Practitioners (AAENP). During her tenure she established the AANP Emergency Special Practice Group director and the ENP Special Interest Group for the National Organization of Nurse Practitioner Faculties. Recognized as a leader within the ENP profession, Dr. Evans is actively involved in national ENP policy initiatives, certification exam development, and curricular standards. She currently serves as the Research to Practice Column Editor for the Advanced Emergency Nursing Journal and has extensive publications and national and international presentations on emergency medicine topics, the ENP role, and ENP education. Dr. Evans’ efforts and contributions to the nursing profession have been recognized through induction into the Fellows of the American Association of Nurse Practitioners and the American Academy of Nursing. She currently practices in a family practice/urgent care clinic in Atlanta, GA.

Abstract

Thyroid illness is the second most common endocrine disorder. Thyroid disorders affects an estimated 20 million individuals within the US, and among those affected approximately 60% are unaware of their condition. Thyroid illnesses affects all genders and ages and if undiagnosed can lead to the onset of other chronic illnesses and even death. This presentation will discuss how to recognize and manage potentially life-threatening thyroid emergencies.

Learning Objectives
  • Analyze a patient's symptoms and physical findings to diagnose and treat thyroid emergencies using a case based approach.
  • Discuss the evaluation and management of thyroid emergencies.
  • Review the pathophysiology of hypo- and hyper-thyroid conditions.
  • Discuss pharmacologic interventions in managing thyroid emergencies.

Seriously? You're here for that??

Elda Ramirez

Breakout Session Details Coming Soon.


Bugs and Drugs: An Antibiotic Update

Micheal Gooch, DNP, APRN, CCP, ACNP-BC, FNP-BC, ENP-C - Assistant Professor of Nursing; Emergency-Flight NP, Vanderbilt University Medical Center

Dr. Michael D. Gooch is board certified as an acute care, family, and emergency nurse practitioner. He is also board certified as an emergency, flight, transport and trauma nurse. He has over 25 years of emergency and transport medicine experience. He obtained his MSN from Vanderbilt University and his DNP from Loyola University Chicago. He is an Assistant Professor of Nursing with Vanderbilt University School of Nursing, as well as faculty with the Middle Tennessee School of Anesthesia. At Vanderbilt University Medical Center, he practices as a flight and emergency nurse practitioner. He has completed over 1,600 patient transports during his tenure with Vanderbilt’s LifeFlight transport program. He is also employed with TeamHealth and practices as emergency nurse practitioner in a community emergency department.

Michael is a founding member of the American Academy of Emergency Nurse Practitioners and serves as the Southeastern Regional Director. He also serves as an APRN liaison to the board of directors for the Air and Surface Transport Nurses Association.

Michael is a nationally recognized speaker and published author regarding varied emergency and transport medicine topics. He serves on the editorial board as a column editor for the Advanced Emergency Nursing Journal.

Abstract

This presentation will provide a review and update on empiric "bugs and drugs" commonly encountered in emergency care settings. A brief review of microbiology and the classes of medications and their common side effects and interactions will be reviewed. Using a body system approach, the current recommendations for appropriate empiric agents will be reviewed including ENT, CAP, SSSTI, STI, UTI, viral infections, exposure prophylaxis, and systemic problems such as sepsis. Lastly, the importance of patient education and antibiotic stewardship will be addressed.

Learning Objectives
  • Identify the mechanisms of action of the main categories of antibiotic therapies.
  • Describe common adverse drug reactions associated with antimicrobial agents.
  • Recall which antimicrobial agents have the risk for cross-reactivity.
  • Modify plans of care to incorporate the appropriate empiric agent based on the presumed site or source of infection.

See one, Read one! An Intro to Chest Xray Interpretation

Andrew S. Rotjan, DNP, FNP-BC, AGACNP-BC, ENP-C, EMT-P, CHSE - Director -- ACP Clinical Training and Education / ACP Fellowships; Advanced Clinical Providers Administration, Northwell Health

Speaker Bio Coming Soon.

Abstract

Session Details Coming Soon.


Naked & Alone

Alica Le Pard, PhD, MBA, ACNP-BC, ENP-C, FNP-BC, GNP-BC, FAANP - Doctor, High Desert Healthcare

Alicia Le Pard is a professional student, entrepreneur, emergency provider who has served roles in healthcare as a CNA, to now a fully independent rural family, geriatric, acute care and emergency nurse practitioner for a variety of healthcare environments including as a federal disaster responder, critical access solo ER/Hospitalist provider, critical care intensivist, and family care provider.

Abstract

Can you practice alone, without backup, only one or two nursing staff present? Deliver a baby? Full trauma? multi-casualty event? Cardiac? DKA? Explore the skill sets needed in rural and frontier healthcare where you are the only provider for a facility and your nearest backup is only a phone or video call away! How can you set up for success as a full practice provider for roles in the emergency department AND hospital to take safe care of all patients? We will discuss the skills, emotions, and systems used in various Mountain West facilities to make such systems a critical part of the health care of rural America.

Learning Objectives
  • Explore the ancillary training beyond the nurse practitioner and the emergency nurse practitioner level to be prepared for rural healthcare emergency medicine.
  • Identify strategies to maximize the mental fortitude to practice confidently as a independent, full practice rural practitioner
  • Learn art of patient presentation for effective transfers of patients to other facilities, complications of transport and Plan B when they can't leave your facility
  • Develop strategies for accepting the limitations of your environment - practicing with a healthy level of fear, know your nurses and your nursing skill, your facility, your equipment and How to MacGyver
General Sessions

Trauma Triage in a Warzone

Frederick Barton, ENP FNP MSN RN NREMT-P - Emergency Nurse Practitioner, Sound Physicians

Frederick Barton, MSN, FNP-C, ENP-C, NREMT-P has been practicing emergency medicine for over a decade. He worked as a firefighter, paramedic, rescue swimmer and recovery diver in Virginia before returning to school to further his education. He has a Master’s of Science in Nursing from Columbia University as well as from Emory University and completed a fellowship in emergency medicine from the Carilion Clinic. He has since dedicated his career to providing emergency care in critical access facilities and has worked in both Central America and on the front lines of Ukraine. He is passionate about Emergency Nurse Practitioners working to the full extent of their scope to provide evidence-based, quality medicine.

Abstract

In the United States, emergency departments manage over 3 million traumas annually . We have developed a highly effective algorithm for managing these patients which is in place in most hospitals nationwide and consists of a step-by-step, easy to follow set of guidelines which can be utilized in most settings. Emergency medicine providers nationwide are able to work together to manage these patients without any preplanning or discussions as we are all trained to operate using the same rules. Does this system work outside of the civilian world, though, and what is its utility in a setting where the entire team is not well versed in ATLS, FAST exams, and algorithmic trauma? In July of 2022, I spent a month volunteering at a front line medical center in Ukraine, providing emergency medical care and stabilization to soldiers brought from the field. My team consisted of myself, a general surgeon, and a special forces medic. While there, we learned that the treatment and management algorithm being utilized is very different from what we are used to in the States. We were able to observe and directly compare our training and system for trauma management to their own.

This presentation will explore the trauma system employed by Ukrainian healthcare workers on injured soldiers presenting from the front lines. It will discuss the algorithms they use, the typical injuries they see, and the diagnostic and interventional equipment at their disposal. It emphasizes the importance of the physical examination and point of care ultrasound and illustrates the clear benefit of ATLS and standardized patient management. The lecture will conclude with pearls and pitfalls which may be relevant to practice in the United States.

Learning Objectives
  • An improved understanding of how triage and trauma assessments are performed by Ukrainian physicians operating in a warzone
  • Reinforce the advantage of an algorithmic approach to trauma and ability to look beyond distracting injuries
  • Illustrate the imporance of the provider assessment and point of care diagnositcs in decision making and stabalization
  • ase the time to identify and treat life threatening injuries in trauma

Don't CRASH your patient! Mitigating the physiologically difficult airway

Jacob Miller, DNP, MBA, ACNP, ENP-C, CNS, NRP - Clinical Educator, UC Health Air Care & Mobile Care

Jacob Miller is a Nurse Practitioner, Clinical Nurse Specialist, and Paramedic with background in flight, critical care transport, and emergency nursing. Jacob received his Master of Science in acute care from the University of Maryland, post-master’s certificate in advanced transport nursing from Case Western Reserve University, and his Doctorate in Nursing Practice from the University of Cincinnati.

Jacob is on the Air & Surface Transport Nurses Association Board of Directors, chairs the Emergency Nurses Association’s advanced practice advisory council, and co-chairs AAENP’s EMS Special Interest Group. Jacob is a Fellow of the Academy of Emergency Nursing for his contributions to the field of critical care transport medicine.

Abstract

Nearly all airway courses focus on the physical task of intubation. Similarly, most "difficult airway" courses cover psychomotor and procedural challenges encountered in airway management. Here, we focus on the physiologic difficulties that can lead to clinical deterioration during the peri-intubation period and how to mitigate them. Next time you have to perform airway management, don't allow your patient to CRASH -- make sure their physiology has been optimized first!

Learning Objectives
  • Differentiate anatomic from physiologic airway management difficulties
  • Identify risk factors predicting physiologic difficulty using the CRASH and HOp mnemonics
  • Formulate a treatment plan to prevent peri-intubation arrest in the physiologically challenging patient
  • Compare and contrast airway management strategies in the medical versus trauma patient

Code Red: Managing Hemorrhage following Spontaneous Abortion in the ER

Amanda Hitt, DNP, ENP-C, FNP-C - ACONHP

Amanda Hitt is dually prepared as an emergency and family nurse practitioner. She has spent the past 20 years in the emergency department as both an RN and NP. She is a published author and peer reviewer in her field. Dr. Hitt began teaching at UNA in 2020 where she shares her passions for emergency care, women's health, and pediatrics.

Abstract

Annually in the United States, there are approximately 1,952,000 ER visits for pregnancy complications (CDC, 2021). Obstetrical emergencies managed by emergency department providers can be a complex and challenging occurrence. The reason is multifactorial. Most emergency department providers are not specialized in obstetrics and may not have frequent patient encounters with obstetric cases (Raoust, et al., 2022). Resources and access to care are also problematic. This is especially true in rural areas where smaller hospitals are closing their obstetrical units and pregnant patients must either travel great distances to seek OB care or present to small, rural emergency departments (Tuttle, et al., 2020). This can lead to potentially life-threatening situations for both the mother and the baby. Some of the problems that can occur include delayed diagnosis, inadequate monitoring, and inappropriate management of obstetric emergencies. These issues can be further compounded by factors such as the patient's medical history, gestational age, and availability of obstetrical consultation. It is crucial to address these challenges and ensure that emergency department providers are trained and equipped to manage obstetrical emergencies effectively. Throughout this presentation, we will follow a case study of a patient suffering from hemorrhage following spontaneous abortion at 12 weeks gestation and discuss best practices as well as treatment options.

Learning Objectives

Learning Objectives

  • Discuss current treatment guidelines for selected OB emergencies during first trimester.
  • Discuss current treatment guidelines for selected OB emergencies during the second trimester.
  • Verbalize pathophysiology of common causes of hemorrhage following spontaneous abortion.
  • Identify pharmacological treatments and surgical options for hemorrhage following spontaneous abortion in the first trimester.

Approach to the Alcoholic Patient in Emergency Settings.

Jessica Stadler

Speaker Bio Coming Soon.

Louis Stadler, RN - Brookhaven Hospital - Tulsa

My name is Louis Stadler. I am married, have 3 adult children and a dog; I live in Broken Arrow, OK. Broken Arrow is adjacent to Tulsa.

I began working in the medical field at age 19 as a Combat Medic in the U.S. Army National Guard. I then worked in the hospital setting in a variety of roles while I completed by degree in nursing from Southwest Baptist University in Missouri. I have been an RN for more than 14 years. I worked as an ICU nurse for most of my career with the 1st 7 years in a Burn ICU. I then worked as a travel nurse for about 2 years. Most of my assignments were in an ICU or ICU stepdown role. I have also worked in the E.D. setting, outpatient clinic, LTC/SNF and I currently work for a traumatic brain injury hospital in Tulsa, OK.

Abstract

This presentation will cover the alcoholic patient who presents to the emergency department. During the presentation we will learn more about the DSM criteria for alcoholic use disorder (AUD), including the classification of drinker as defined by the DSM-5. Then, we will move on to workup of alcoholic patient in the ER, including red flag signs/symptoms, diagnostic considerations and pitfalls. Next, we will speak to possible inpatient interventions to be aware of when admitting, and outpatient interventions/treatment including medication therapy for the alcoholic. Finally, we will speak to resources that are available for the family of the alcoholic as well as the alcoholic him/herself.

Both speakers have personal experience with a loved one who is plagued by alcoholism. We hope to present a topic that will help not only ourselves, but other providers aid the patients we encounter that suffer from this terrible disease.

Learning Objectives
  • Identifying and classifying the alcoholic
  • History, diagnosis, and workup of the alcoholic in the ED
  • Inpatient and outpatient interventions/treatment for alcoholics- Pharmacology content
  • Family and patient resources

Priapism Management in a Rural ED

Corey Sizelove, DNP, APRN, FNP-C, ENP-C, NHDP-BC - Associate Professor and Co-Director of Clinical Education, Rocky Mountain University of Health Professions

Dr. Corey Sizelove, DNP is a highly accomplished and dedicated healthcare professional with a diverse range of expertise and experience. With over 9 years of experience in the emergency room (ER), Dr. Sizelove is a board-certified emergency nurse practitioner and family nurse practitioner whose commitment to providing exceptional care to patients in critical situations has earned him a reputation as a trusted and skilled healthcare provider.

Throughout his career, Dr. Sizelove has demonstrated a passion for education and has made significant contributions to the field. He has served as a faculty member at various educational institutions, teaching at the baccalaureate, master's, and doctoral levels. Corey's ability to effectively communicate complex medical concepts and his dedication to mentoring and guiding future healthcare professionals have made him a respected and sought-after educator.

Currently, Dr. Sizelove works at a critical access level 3 trauma center in the ER. In this role, he is responsible for providing comprehensive and compassionate care to patients in emergency situations. Dr. Sizelove’s extensive experience in emergency medicine allows him to quickly assess and manage a wide range of medical conditions, ensuring that patients receive the appropriate treatment and interventions.

In addition to his clinical work, Dr. Sizelove also serves as the co-director of clinical education at Rocky Mountain University of Health Professions. In this role, he plays a vital role in shaping the education and training of future healthcare professionals. Dr. Sizelove’s expertise and experience in emergency medicine and disaster management make him a valuable asset in developing and implementing educational programs that prepare students for the challenges of the healthcare field.

Dr. Sizelove’s dedication to his profession extends beyond his clinical and educational roles. He is also a national healthcare disaster professional, demonstrating his commitment to emergency preparedness and response. Dr. Sizelove’s expertise in disaster management allows him to effectively coordinate and lead healthcare teams during times of crisis, ensuring that patients receive the necessary care in challenging and high-stress situations.

Throughout his career, Dr. Sizelove has consistently demonstrated a strong work ethic, a commitment to excellence, and a genuine passion for providing exceptional care to his patients. His extensive experience in emergency medicine, combined with his dedication to education and disaster management, make him a well-rounded and highly skilled healthcare professional.

Abstract

Priapism is a urological emergency characterized by a prolonged and painful erection that persists beyond four hours without sexual stimulation. Prompt management in the emergency department (ED) is crucial to prevent long-term complications. This abstract provides an overview of the management strategies for priapism in the ED.

The initial step in managing priapism involves a thorough history and physical examination to determine the type of priapism along with any special patient considerations which will need to be accounted for. In the ED, the primary goal is to relieve the patient's pain and prevent complications. Conservative measures such as ice packs, analgesics, and hydration can be initiated while further interventions are planned. Aspiration and irrigation of the corpora cavernosa with normal saline or sympathomimetic agents like phenylephrine are effective interventions for ischemic priapism. However, these procedures require expertise and specialized equipment that may not be readily available in all EDs.

In cases where immediate intervention is not possible, close monitoring and further investigation are necessary to identify and address the underlying cause of non-ischemic priapism, often caused by trauma or underlying medical conditions. Collaboration with urologists and transfer to a specialized center should be considered for cases that require more advanced interventions or expertise. Timely transfer is crucial to ensure optimal outcomes for patients.

In conclusion, prompt, and appropriate management of priapism in the ED involves identifying the priapism type, relieving pain, preventing complications, and determining the underlying cause. Collaboration with urologists and transfer to specialized centers may be necessary for cases that require advanced interventions.

Learning Objectives
  • Differentiate between the various types of priapism and their underlying causes.
  • Identify potential complications associated with priapism.
  • Discuss the step-by-step approach to the management of a priapism in a rural ED.
  • Recognize the limitations of managing a priapism in the ED.