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2022 AAENP National Conference: EmergNP - Speakers

May 5 - 7, 2022 | Virtual Event

Emergency Care in the Future…and It's a Great Future
James Augustine, MD, FACEP - US Acute Care Solutions,

Emergency medicine crosses the boundaries of primary and secondary care, extending from minor injury management to critical care. It has interested and excited health-care professionals, policy makers and the public since its inception almost 50 years ago. While emergency medicine is growing and flourishing around the world the last decade has seen the accumulation of problems, including workforce concerns, rising patient volumes, rising patient acuity, and increased regulation. The landscape of the emergency medicine workforce has changed dramatically over the last few decades. The growth in emergency medicine residency programs, ENP specialty programs, as well as APP emergency medicine post graduate training programs, has significantly increased the number of emergency medicine specialists now staffing emergency departments (EDs) throughout the country. Despite this increase in available providers, rising patient volumes, an aging population, ED overcrowding, and inefficiency, increased regulation, and other factors have resulted in the continued need for additional emergency physicians and APPs. This talk focuses on the current state of emergency medicine, emergency workforce needs, considering the diversity of U.S. emergency departments (EDs), various projections of supply and demand and the future of APPs in Emergency Medicine.

Learning Objectives
  1. Define the current state of Emergency Medical Care in the US and the current issues surrounding the Emergency Care.
  2. Recognize the importance of APPs in Emergency Medical Care and APP roles in the future.
  3. Identify strategies to improve Emergency Care within our departments.

Disclosure: James Augustine, MD, FACEP has nothing to disclose.


Preparing for the Post Pandemic Reality
Jeffrey Doucette, DNP, RN, NEA-BC, FACHE, FAAN

At the height of the pandemic, when nurses were putting themselves in harm’s way day after day, this session’s speaker found ways to keep his nursing teams engaged. Nurses from Thomas Jefferson University Hospital in Philadelphia posted dance videos on social media with a positive message. The videos went viral and were featured on “The Ellen DeGeneres Show.” In this session, Dr. Jeff Doucette, Press Ganey’s chief nursing officer, will discuss the need to refresh, renew and reset when planning for the post-pandemic reality. Equipped with proprietary data sets, Doucette will share the latest trends around nurse and patient engagement, nurse-sensitive quality indicators, and the overall state of the nursing workforce. Doucette will bring his dynamic style to explore innovative solutions to minimize nursing flight risk, reset the focus on evidence-based care and leave you with strategies to address the most challenging workforce dynamics of our time.

Learning Objectives
  1. Identify the national trends in workforce engagement, resilience, and decompression.
  2. Identify the impact on COVID 19 on quality, safety, and reliability
  3. Identify the latest national data in flight risk analytics
  4. Identify strategies for maintaining resilience and strong leadership in times of crisis

Disclosure: Jeffrey Doucette , DNP, RN, NEW-BC, FACHE, FAAN has nothing to disclose.


But They Are Prescribed- Drug-Induced Liver Injury
Nancy Denke, DNP, ACNP-BC, FNP-BC, FAEN, CEN, CCRN - Nurse Practitioner, Toxicology Consultants of Arizona

There are more than 1,000 medications that have been associated with drug-induced liver injury (DILI), but what products are most likely to cause the problem? Many individuals believe that if medications are OTC or even “natural/herbal” supplements, then they are safe. Understanding the causes and outcomes of DILI are poorly understood by clinicians and patients. During this presentation, we will “work through” case studies of common drugs ingested by our patients that can cause drug-induced liver injury without their knowledge and develop some resources that can assist us, as providers, in identifying these injuries early in their course

Learning Objectives
  1. Identify adverse drug reactions that should be considered in patients who develop laboratory criteria for liver injury
  2. Identify prescription, OTC, and alternative medications most responsible for drug-induced liver injury
  3. Apply the physiological concepts of drug-induced liver injury into a treatment plan
  4. Describe how you will counsel patients regarding prescription, OTC, and supplement use in the future

This session includes 1 contact hours of pharmacology credit (self-reported).
Disclosure: Nancy Denke, DNP, ACNP-BC, FNP-BC, FAEN, CEN, CCRN has nothing to disclose.


Fourth time's the charm: A case of missed Steven's Johnson Syndrome and as case for interdisciplinary collaborative care
Benjamin Woodard, DNP, FNP-C, ENP-C, FAWM - Assistant Professor, University of Massachusetts Chan School of Medicine
Rachel Katz MSN, FNP-BC

In this presentation, we will review a case of a woman's 4 separate healthcare contacts before an eventual diagnosis of Steven's Johnson Syndrome. We will review the implications for emergency nurse practitioners, rural providers, and community primary care providers for this rare diagnosis, and review a critical case review of the events leading to her diagnosis, treatment, and recovery from this high risk diagnosis.

Learning Objectives
  1. Review the current evidence on SJS and epidemiology of SJS worldwide and here in the US
  2. Review the pathophysiology and management of SJS
  3. Review the diagnostic criteria, risks, common misdiagnoses, and management and disposition of patient's presenting with this rare and life-threatening process
  4. Review the critical errors in the case, and opportunities for systems improvement and inter-professional collaboration

This session includes 0.5 contact hours of pharmacology credit (self-reported).
Disclosure: Benjamin Woodard, DNP, ENP-C, FNP-C, FAWM disclosures: RedMed, University of Massachusetts, Kyle Kincaid Memorial Scholarship - Paid Faculty, Student.


Social Resources Protocol: Assisting Vulnerable Populations during the COVID pandemic, Case Studies and Conversation
Kathleen Ahn, DNP, FNP-BC - Nures Practitioner, Emergency Department, University of California, Irvine
Amalya D'Altorio, RN, MSN, ACNP-BC - UCI Medical Center, Nurse Practitioner
Mery Oman, NP-C - Nurse Practitioner, UCI
Sheri Jonsson, ACNP-BC, SANE-A - Nurse Practitioner III UCI, Medical Center

The nurse practitioner in the Emergency Department setting provides ambulatory, urgent and emergent care to patients across the lifespan. Emergency Nurse Practitioners (NP) are equipped to provide competent, skillful, evidence-based care to all patients, while modeling exemplary professionalism, in a fast-paced, demanding role. The Emergency Department Observation Unit provides an extension of emergent services, through the utilization of ED Nurse Practitioner implemented observation protocols. The Social Resources protocol was approved in January 2020, just prior to the pandemic. This protocol was designed by the ED faculty to serve patients whose medical conditions require continued care post-acute care hospitalization, and who cannot be discharged safely without case management intervention. The ED Nurse Practitioner coordinates with other team professional partners to assess needs and create an appropriate health care plan for each patient. Examples of essential team partners include home health nursing, physical therapy, occupational therapy, wound care and pain management among others. Patient disposition is facilitated, in conjunction with case manager, either to a home setting, assisted living setting, skilled nursing facility setting, recuperative care, shelter services setting, or other sub-acute environment. Vulnerable populations, often subject to ongoing health inequity, receive targeted care under the social resources protocol. The goal is to decrease morbidy and mortality, to prevent loss to follow up, and promote continued wellness. The NP manages all chronic patient conditions and manages the total care plan until safe disposition can be achieved. Case management, social work, physical therapy, occupational therapy, specialties such as pain management and other teams, form impressions and recommendations for safe discharge or transfer. The NP team competently and compassionately serves this population of at-risk, vulnerable patients with multiple medical needs and complex comorbidities.

The experience of implementing the Social Resources protocol during a pandemic has had special challenges. Safe and timely disposition of COVID+ patients has been difficult.

The NP team has remained focused on our goals for each client. We would like to share the stories of some of our challenges and successes and provide case details on our creative and comprehensive efforts to ensure safety and continued health among the patients served.

Learning Objectives
  1. Identify the groups of vulnerable populations frequently seeking care in the Emergency Department. Briefly discuss impact of care challenges for these populations on Emergency Department throughput.
  2. Identify chronic or acute conditions among vulnerable populations served which require targeted care post emergency department visit. Discuss the goals of the Social Resources protocol: prevent loss to follow up, provide safe disposition for most vulnera
  3. Describe in detail the elements of NP managed care in the Observation unit. Describe the experience of the ED team environment, and the environment of coordinated care with colleagues on multiple specialty teams.
  4. Identify and discuss the experience of ensuring safe discharge for vulnerable COVID+ patients, the availability of continued care during the pandemic, and populations most frequently at risk of loss to follow

Disclosure:
Kathleen Ahn, DNP, FNP-BC has nothing to disclose.
Sheri Johnson, ACNP-BC, SANE-A has nothing to disclose.


Pediatric Respiratory Emergencies: An Evidence-Based Update
Kathleen Jordan, DNP, RN, FNP-BC, ENP-C, SANE-P - Clinical Associate Professor and Nurse Practitioner, University of North Carolina at Charlotte; B) Mid-Atlantic Emergency Medical Associates

Respiratory disorders are the second most common reason for emergency department use for children, accounting for 20% of all pediatric visits. To meet the challenge of providing high quality, safe and effective care, ED providers must be fully knowledgeable regarding updated evidence to guide the management of pediatric respiratory emergencies. The integration of new scientific, evidence-based therapies, diagnostic tools and clinical practice guidelines must be implemented to support clinical decision-making and achieve optimum patient outcomes. Despite supporting evidence there continues to be widespread use of non-recommended therapies and variation in the use of best practice for therapeutic interventions among ED providers. The focus of this presentation is designed to provide the emergency advanced practice provider with an overview of critical evidence-based information associated with commonly encountered pediatric respiratory conditions. The evidence-based clinical practice guidelines for the following common, yet high-risk pediatric conditions will be presented: 1) bronchiolitis; 2) asthma; 3) croup; 4) pertussis; and 6) community acquired pneumonia. The goal of this presentation is to enhance the knowledge and skill set of the emergency care provider to achieve improvement in healthcare quality and safety, optimize resource utilization, and decrease healthcare costs and unnecessary hospitalization.

Learning Objectives
  1. Identify the importance of an evidence-based approach in the care of the pediatric patient with a respiratory emergency to improve healthcare quality and safety, optimize resource utilization, and decrease healthcare costs and unnecessary hospitalization for safe discharge of a pediatric patient with an acute respiratory disorder.
  2. Identify the impact of evidence-based therapies and diagnostic tools to minimize variability in care and promote best practice in the care of a child with a respiratory emergency. (pharmacology)for safe discharge of a pediatric patient with an acute respiratory disorder.
  3. Apply current evidence as the scientific foundation for the development and application of clinical guidelines in the following pediatric respiratory emergencies: asthma, bronchiolitis; croup, pertussis, and community acquire for safe discharge of a pediatric patient with an acute respiratory disorder.
  4. Identify the critical components in the knowledge and skill set of caregivers that are essential for safe discharge of a pediatric patient with an acute respiratory disorder.

This session includes 0.25 contact hours of pharmacology credit (self-reported).
Disclosure: Kathleen Jordan, DNP, RN, FNP-BC, ENP-C, SANE-P, FAEN, FAANP has nothing to disclose.


MARCH to a New Beat: Stabilization of the Critical Trauma Patient
Jacob Miller, MS, MBA, NP, CNS, NRP - Flight Nurse Practitioner, UC Health Air Care & Mobile Care

We've all been taught the ABCD approach to trauma assessment, but it's time to MARCH to a different mnemonic - and for good reason. Using the MARCH framework, this presentation will discuss priority assessments and evidence-based interventions during the initial stabilization of a critically injured patient.

Learning Objectives
  1. Review evidence-based guidelines and recent literature for initial trauma assessment and resuscitation.
  2. Discuss initial management and resuscitation strategies for critical polytrauma patients.
  3. Identify and discuss limitations and/or opportunities for improvement in the current emergency care arena.
  4. Formulate a treatment plan for a critically injured polytrauma patient.

Disclosure: Jacob Miller, MS, MBA, NP, CNS, NRP has nothing to disclose.


Pediatric Toxidromes: Special Considerations in the ED Management of the Poisoned Child
Kathleen Jordan, DNP, RN, FNP-BC, ENP-C, SANE-P - Clinical Associate Professor and Nurse Practitioner, University of North Carolina at Charlotte; B) Mid-Atlantic Emergency Medical Associates

The focus of this presentation will be on the challenge of accurately diagnosing and treating the pediatric patient with a toxidrome. The advanced practice provider is faced with the challenge of identifying and differentiating those poisonings that are benign from those that have the potential for life-threatening complications. Discussion will include the synthesis of evidence-based knowledge to accurately assess, diagnose, and treat the poisoned child. Discussion will also include a focus on the recognition of the pearls and pitfalls associated with pediatric poisonings. Clinical case studies of the most commonly encountered toxidromes will be included in this presentation to integrate knowledge into clinical practice. To ensure quality of care, evidence-based practice interventions and clinical practice guidelines that promote patient quality and safety in this high-volume, high-risk pediatric clinical condition will be discussed. This presentation will conclude with a discussion of evidence-based recommendations for interventions designed for the prevention of pediatric poisonings.

Learning Objectives
  1. Identify the incidence, prevalence and potential complications of pediatric poisonings.
  2. Describe the critical components of the assessment, clinical decision-making process and interventions/evaluation for pediatric poisonings. (pharmacology)
  3. Differentiate pediatric poisonings in children with low morbidity from those with high morbidity and potential for mortality. (pharmacology)
  4. Discuss the current evidence-based recommendations for the general treatment guidelines for pediatric poisonings. (pharmacology)

This session includes 1 contact hours of pharmacology credit (self-reported).
Disclosure: Kathleen Jordan, DNP, RN, FNP-BC, ENP-C, SANE-P, FAEN, FAANP has nothing to disclose.


Sepsis Updates
Tiffany Andrews, MS, ACNP-BC, ENP-C, CCNS - Emergency Nurse Practitioner, American Academy of Emergency Nurse Practitioners

Sepsis and septic shock present the APP with a difficult management situation. The patients are usually unstable and may rapidly progress to ARDS, MODS, and death. There are evidence-based guidelines available to assist in the diagnosis and treatment of these disorders. This talk outlines some of the current recommendations from the 2021 update, suggestions by the Society of Critical Care Medicine.

Learning Objectives
  1. Describe best practices in early detection and management of sepsis
  2. Identify the changes to the sepsis guidelines in the 2021 update
  3. Identify how to best assess volume status
  4. Identify optimal antibiotic therapy and adjunctive treatments for sepsis

This session includes 0.5 contact hours of pharmacology credit (self-reported).
Disclosure: Tiffany Andrews, MS, ACNP-BC, ENP-C, CCNS has nothing to disclose.

When Beavers Attack: A Curious Case of a Rabid Beaver Attack in an Open-Water Swimmer in Rural Massachusetts
Benjamin Woodard, DNP, FNP-C, ENP-C, FAWM - Assistant Professor, University of Massachusetts Chan School of Medicine

In this case presentation, we review a curious case of a rabid beaver attack on a 73 year old man, the emergency medicine, infectious disease, and public health implications, and consideration for rural and wilderness medicine providers

Learning Objectives
  1. Review the ecology, epidemiology and public health considerations regarding beavers, their habitats and relative risk given human encroachment
  2. Review the most recent evidence regarding rabid aquatic mammal attacks, rabies prophylaxis
  3. Review considerations for management of soft tissue injuries
  4. Identify future implications for rural emergency practice

This session includes 0.25 contact hours of pharmacology credit (self-reported).
Disclosure: Benjamin Woodard, DNP, ENP-C, FNP-C, FAWM disclosures: RedMed, University of Massachusetts, Kyle Kincaid Memorial Scholarship - Paid Faculty, Student.


Recognizing and Integrating Management of Incarcerated Gravid Uterus in the Emergency Department
Jill Ogg-Gress, DNP, APRN, NP-C - Dual Board Certified Family Nurse Practitioner and Emergency Nurse Practitioner; Assistant Professor and Clinical Education Director, FNP Program, Georgetown University

Dr. Jill Ogg-Gress works full-time as an Assistant Professor and the Clinical Education Director for the FNP program at Georgetown University since 2017 and works clinically as an Emergency Nurse Practitioner for a large health organization in Omaha, Nebraska. Dr. Ogg-Gress received her MSN and FNP degree from Clarkson College in 2003 and Doctorate of Nursing Practice degree from the University of Iowa in 2008. She has worked clinically since 2003 in settings including Emergency Medicine, Cardiology and Gastroenterology. Dr. Ogg-Gress received FNP certification from AANP in 2003 and ENP certification from AAENP in 2018. She has published numerous book chapters and articles related to her academic and clinical expertise and has spoken professionally at the local and national levels.

Learning Objectives
  1. Identify and recognize patient symptoms suggestive of incarcerated gravid uterus (IGU)
  2. Describe complications and risks associated with incarcerated gravid uterus (IGU)
  3. Apply diagnostic recommendations and treatment strategies in the emergency department for incarcerated gravid uterus (IGU)
  4. Analyze case studies related to incarcerated gravid uterus (IGU) and integrate knowledge for future practice

Disclosure: Jill Ogg-Gress, DNP, APRN, NP-C has nothing to disclose.


Poster: Lessons Learned: A Case of Intimate Partner Violence During the COVID-19 Pandemic
Hilary Ashton Glover, DNP, FNP-C, ENP-C, SANE-A - Assistant Professor, University of North Alabama
Amanda Hitt, MSN, FNP-C - Family Nurse Practitioner, University of North Alabama

Intimate partner violence (IPV) has been a major public health threat long before COVID-19. However, the pandemic has stripped protective measures from victims, while heightening risk factors associated with IPV. Emergency department providers are often the initial point of contact in the healthcare system for IPV victims; therefore, knowledge of current screening guidelines and IPV management is essential. The purpose of this poster presentation is to present a missed opportunity involving IPV in an emergency department (ED) during the COVID-19 pandemic and to discuss the lessons learned with the aim of educating healthcare providers on the subtle signs of IPV and current screening guidelines.

Learning Objectives
  1. Define intimate partner violence.
  2. Examine the impact of the pandemic on cases of intimate partner violence.
  3. Identify current screening guidelines for intimate partner violence in the emergency setting.
  4. Examine implications for emergency care and potential barriers and solutions.

Disclosure: Hilary Ashton Glover, DNP, FNP-C, ENP-C, SANE-A has nothing to disclose.
Disclosure: Amanda Hitt, MSN, FNP-C has nothing to disclose.


Poster: Special Considerations in Pediatric Orthopedic Injuries
Mindy Johnson, DNP, APRN - Assistant Professor, Vanderbilt University School of Nursing
Erica May, DNP, APRN, FNP-BC, AG-ACNP-BC, ENP-C - Instructor of Nursing, Emergency Nurse Practitioner Program, Vanderbilt University School of Nursing

This ePoster presentation will focus on special considerations for pediatric patients with orthopedic injuries in the Emergency or Urgent Care setting. The unique orthopedic anatomy of the pediatric population, and how it impacts evaluation, diagnosis and management of pediatric orthopedic injuries will be discussed. Attention will be given to injuries unique to the pediatric patient. Topics discussed will include nursemaid's elbow, toddler fractures, occult fracture, supracondylar fracture, Salter-Harris fractures, and considerations for non-accidental trauma. Indications for urgent orthopedic referral will also be included. Procedural content will include reduction of nursemaid's elbow and selection of proper splinting.

Learning Objectives
  1. Review unique pediatric orthopedic anatomy.
  2. Consider the impact of pediatric anatomy on orthopedic injury.
  3. Identify evaluation and management of common pediatric orthopedic injuries in the emergency department and urgent care, including consideration of non-accidental trauma.
  4. Review when emergent orthopedic referral is appropriate

Disclosure:
Mindy Johnson, DNP, APRN, FNP-BC, AG-ACNP-BC, ENP-C has nothing to disclose.
Erica May, DNP, APRN, FNP-BC, AG-ACNP-BC, ENP-C has nothing to disclose.


Poster: Improving the Management of Adults with Mild Traumatic Brain Injury: An Initiative to Reduce Unnecessary Computerized Tomography Scans in the Emergency Department
Rachel Helms, DNP, APRN, AGACNP-BC, FNP-BC - Assistant Clinical Professor, Auburn University

Background and Objective: The overuse of computerized tomography (CT) scans for the evaluation of patients who present to the emergency department (ED) after a mild traumatic brain injury (mTBI) has been well documented. The Canadian CT Head Rule (CCHR) is a validated tool to guide ED providers in determining the need for emergent CT scanning of mTBI patients. The purpose of this project was to reduce radiation exposure and ED length of stay by using the CCHR to decrease unnecessary CT scans in adults with TBI. Cost of care based on avoiding unnecessary scans was estimated as well.

Methods: The CCHR implementation strategy included a targeted education program for MDs, Pas, NPs and RNs. The consistent use of the CCHR was then promoted throughout the intervention period using posted flyers and verbal reinforcement. The outcomes measured were the number of CT scans ordered, ED length of stay in minutes, and the cost of avoidable CT scans. Data were collected through chart reviews completed by the project leader. The data for the pre- and post-implementation periods were evaluated using the independent samples t-test.

Results: A total of 600 charts were reviewed. There was a significant difference between adherence to the CCHR before provider education (M=64.6%) and after provider education (M=74.3%); t(595)=-2.55, p = 0.01. The percentage of CT scans that could have been avoided using the CCHR significantly decreased from baseline (M=0.63) after provider education on the use of the CCHR (M=0.46); t(1)=7.89, p = 0.04. Length of stay for mTBI patients who were managed based on the CCHR (M=184.9) was significantly less than the length of stay for those who were not managed based on the CCHR (M=260.1); t(6)=-3.63, p = 0.01. The CCHR was 100% sensitive in identifying significant injury.

Conclusions: By increasing awareness of the CCHR and promoting its use, the total number of head CTs ordered, the cost of care, and the ED length of stay for patients who present to the ED after mTBI can be significantly improved.

Learning Objectives
  1. Summarize CT overuse for mTBI patients in the ED and how it negatively impacts cost of care and ED throughput
  2. Evaluate the efficacy of the CCHR in identifying mTBI patients who require CT imaging
  3. To identify barriers of the consistent use of decision-making tools such as the CCHR how to address them
  4. To recognize the importance of and how to implement targeted education for ED providers and staff to promote the consistent use of the CCHR

Disclosure: Rachel Helms, DNP, APRN, AGACNP-BC, FNP-BC has nothing to disclose.


High-Yield Laceration Management
Patrick O'Malley, MD - Board Certified Emergency Physician, The Laceration Course

This lecture will cover common myths and bad practice habits in laceration management, tips and pearls with evidence based recommendations to provide better care and improve efficiency.

Learning Objectives
  1. Identify bad practice habits/myths in laceration management with evidence to support them
  2. Discuss helpful tools, products, devices to improve patient care
  3. Apply advanced techniques to improve your practice and patient care
  4. Discuss medico-legal topics relating to laceration management

This session includes 1 contact hours of procedural credit (self-reported).
Disclosure: Patrick O'Malley, MD has the following to disclose: Medline - Royalty; The Laceration Course - Course sales revenue; Rescue Essentials - Royalty.


Resiliency in Emergency Management
Christopher Ziebell, MD - Director of Behavioral Health, US Acute Care Solutions

In this session, Dr. Ziebell will review real-life crisis situations and well-being strategies for clinicians.

Learning Objectives
  1. Recognize the urgency of clinician resilience
  2. Describe emotional real-life scenarios to exemplify why clinicians are in crisis in 2022 and will be at risk for years
  3. Identify techniques of consciously addressing issues for maximum resilience
  4. Understand why the aftereffects will continue even after the pandemic recedes, reinforcing that these initiatives must be viewed as longitudinal

Disclosure: Christopher Ziebell, MD has nothing to disclose.


When the Heat is On: Hyperthermic Emergencies
Michael Gooch, DNP, APRN, CCP, ACNP-BC, FNP-BC, ENP-C - Assistant Professor of Nursing; Emergency Nurse Practitioner, Vanderbilt University

A patient presents with altered mental status and an elevated core temperature. As the emergency care provider, how will you manage this patient? What are your differentials, is it a fever, environmental, or perhaps a medication reaction? These are some of the aspects which will be covered as we review the differentials and prehospital and hospital management options for the hyperthermic patient in the emergency care setting.

Learning Objectives
  1. Formulate differentials for the hyperthermic patient.
  2. Identify those at risk for hyperthermic emergencies.
  3. Describe non-pharmacologic and pharmacologic options for reducing the core temperature.
  4. Describe the indications, contraindications, benefits, and risks of cooling techniques.

This session includes 0.25 contact hours of pharmacology credit (self-reported).
Disclosure: Michael Gooch, DNP, APRN, CCP, ACNP-BC, FNP-BC, ENP-C has nothing to disclose.


Implementing an Advanced Practice Transition-to-Practice Program:
Foundations & Implications

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

Learning Objectives
  1. Review key facilitators, barriers, and outcomes of Advanced Practice Post-Graduate Training
  2. Identify various implementation frameworks for post-graduate training programs

Disclosure: Andrew Rotjan, RN, FNP-BC, ENP, CPEN, EMT-P has nothing to disclose.


Using Telemedicine in Rural EDs to Complete Examinations on Sexual Assault Patients
Janice Ceccucci, DNP, FNP-BC, ENP-C, SANE-A, SANE-P, NYSAFE - Nurse Practitioner, St. Peter's Health Partners, Utica College
Nancy Harris, ANP-C, SANE-A, SANE-P, NYSAFE - Nurse Practitioner, St. Peter's Health Partners

The use of telemedicine has exploded over the past 10 years with the last two years showing the highest growth due to the impact of the COVID-19 pandemic (Rossano, et al., 2022). Rural emergency departments have the highest benefit of telemedicine as they may lack trained specialists and the ability to access a specific specialty on an as needed basis would increase quality of care while keeping costs down (Miyamoto, et al., 2014). Many advanced practice providers working in rural emergency departments may not be trained specifically in the care of the sexual assault patient and may only see these patients on occasion. Therefore, having access to a trained and certified sexual assault nurse examiner would be beneficial to both the patient and the provider.

This presentation will explore the use of telemedicine in sexual assault patients. The current literature surrounding this will be discussed. The benefits and pitfalls of the use of technology will be described. Sample patient scenarios will be examined. Resources will be provided for those looking to utilize this technology in their state or area will be provided.

Learning Objectives
  1. Describe the benefit to sexual assault patients of using synchronous telemedicine.
  2. Describe the benefit to advanced practice providers of using synchronous telemedicine.
  3. Identify the potential pitfalls of using telemedicine in rural emergency departments to aid in sexual assault examinations.
  4. Evaluate individual scenarios for the potential benefit that telemedicine could have for the patient discussed.

Disclosure:
Janice Ceccucci, DNP, FNP-BC, ENP-C, SANE-A, SANE-P, NYSAFE has nothing to disclose.
Nancy Harris, ANP-C, SANE-A, SANE-P, NYSAFE has nothing to disclose.


ENP Fellowship
Lisa Avery, MSN, FNP-C, FNP-BC - Emergency Medicine Nurse Practitioner Fellow, Northwell Health
Hadassah Lampert, DNP, FNP-BC, ENP-C - Emergency Medicine Nurse Practitioner Fellow, Northwell Health

First-hand account from two current emergency medicine nurse practitioner fellows with opportunity to questions.

Learning Objectives
  1. Describe ENP Fellowships.
  2. Determine the need for APP fellowship programs.
  3. Recognize an FNP stands to gain from a fellowship experience.
  4. Recognize what a DNP, FNP, ENP stands to gain from a fellowship experience.

Disclosure:
Lisa Avery, MSN, FNP-C, FNP-BC has nothing to disclose.
Hadassah Lampert, DNP, FNP-BC, ENP-C has nothing to disclose.


Author, Reviewer, or Editorial Board Member: Which One is For You?
Wesley Davis, DNP, ENP-C, FNP-C, AGACNP-BC, CEN, FAANP, FAEN - President, American Academy of Emergency Nurse Practitioners
Karen "Sue" Hoyt, PhD, RN, FNP-BC, ENP-BC, FAEN. FAANP, FAAN
Nicole Martinez, PhD, RN, FNP-BC, ENP-C, PHN - DNP Program Director, ENP, Advanced Emergency Nursing Journal, University of California, Irvine

Three seasoned panelists will describe the roles and responsibilities of authors and reviewers for peer-reviewed journals. Participants will learn about the top 10 mistakes to avoid when submitting a manuscript and other tips for submission. Participants will also be given successful strategies "to provide constructive feedback to help the authors develop their work, and feedback that provides sound guidance for the editor in making the decision related to publication".

Qualifications for each of these roles will be reviewed. An editor-in-chief will also discuss the application process for serving on an editorial advisory board.

Learning Objectives
  1. Identify the process for manuscript submission to a peer reviewed journal
  2. Develop the necessary strategies for becoming a manuscript reviewer for a peer reviewed journal
  3. Summarize assistive information for serving on an editorial board
  4. Identify the minimum qualifications for each of these roles/responsibilities

Disclosure:
Wesley Davis, DNP, ENP-C, FNP-C, AGACNP-BC, CEN, FAANP, FAEN has nothing to disclose.
Karen "Sue" Hoyt, PhD, RN, FNP-BC, ENP-BC, FAEN. FAANP, FAAN has nothing to disclose.
Nicole Martinez, PhD, RN, FNP-BC, ENP-C, PHN has nothing to disclose.


The RAST-NP Pilot: Preparing New Nurse Practitioners for Emergent Procedures in Remote Settings Using a Novel Training Program
Benjamin Woodard, DNP, FNP-C, ENP-C, FAWM - Assistant Professor, University of Massachusetts Chan School of Medicine

This presentation will review the results of the RAST-NP pilot at Yale School of Nursing, and explore the literature and practice implications for training remotely practicing primary care providers in emergency procedures, and the implications of self-efficacy on learning these skills.

We will explore what the field of ENP specialty has to offer rural and remote NPs, and review the intersection of these skill sets.

Learning Objectives
  1. Review the current literature on rural emergency NP practice and emergency procedural skills
  2. Review the results of the diverse expert panel regarding prioritized emergency procedural skills
  3. Review the results of the pilot training program
  4. Identify the future implications for ENP contributions to rural primary care emergency skills trainings

Disclosure: Benjamin Woodard, DNP, ENP-C, FNP-C, FAWM has nothing to disclose.


It Will Make Your Head Spin: Utilizing the ATTEST Method in the Evaluation of the Dizzy Patient
Alexander Wrynn, DNP, FNP-C - Nurse Practitioner, Allegheny Health Network

Dizziness is a common chief complaint in emergency departments, urgent care centers, and primary care offices. It can be a distressing complaint for providers, as it carries a broad differential of both benign and serious causes. Furthermore, it is often difficult to distinguish what the patient is experiencing when they say they are dizzy. Classic approaches to the dizzy patient often involve providers trying to fit patients in different categories of dizziness. This approach often leads to misdiagnosis and potential adverse outcomes for patients. Utilizing the ATTEST method (A-associated symptoms, TT-timing/triggers, ES-exam signs, and T-testing) nurse practitioners can successfully narrow the dizziness differential and become more precise with their diagnosis. Once learned, the ATTEST method is simple and applicable to everyday practice.

Learning Objectives
  1. Compare utilization of the ATTEST evaluation in comparison to traditional approach to the chief complaint of dizziness.
  2. Formulate a differential diagnoses of dizziness based on ATTEST evaluation findings.
  3. Summarize patient disposition based on ATTEST evaluation.
  4. Apply the ATTEST evaluation in their everyday practice

Disclosure: Alexander Wrynn, DNP, FNP-C has nothing to disclose.


Saving Minutes, Saving Beds, Saving Lives -- Improving ED Throughput in Resource-Constrained Times
Michael Sharma, PA-C - Emergency Medicine

Especially during the COVID-19 pandemic, EM clinicians have been called upon to do more, to do it faster, to do it in hallways and waiting rooms, and with less staff and less beds. This presentation will cover multiple common potentially time-consuming but ultimately mostly benign chief complaints, and how we can still perform excellent evidence-based patient care while saving beds and space for patients who need them the most. This presenting clinician applied these strategies during the pandemic and went from being borderline on his throughput metrics to meeting/exceeding them, even during multiple COVID-19 variant waves, with average lengths-of-stay ~30 minutes shorter than many similar clinicians.

Learning Objectives
  1. Demonstrate the utility of strep throat pre-test probability scores in clinically ruling out the condition without testing and the downsides of treating strep throat with antibiotics.
  2. Compare the sensitivity for a self-obtained vaginal swab to a provider-performed endocervical swab for the diagnosis of gonorrhea and chlamydia.
  3. Define the typical course of acute cystitis in the uncomplicated female patient and how that can guide better testing and choosing between immediate and deferred treatment.
  4. Review the importance of passing an oral challenge prior to discharging the vomiting pediatric patient.

Disclosure: Michael Sharma, PA-C has nothing to disclose.


The Thing About Drug Dealers is You Can’t Trust Them: Fillers and Killers of Common Street Drugs
Nancy Denke, DNP, ACNP-BC, FNP-BC, FAEN, CEN, CCRN - Nurse Practitioner, Toxicology Consultants of Arizona

When you use street drugs, you’re taking a lot of risks. Remember drug dealers are attempting to make sure that their "product" can spread as thin as they can get it. There’s no way to know how strong they are or what else may have been added to them. This presentation will provide a limited review of the neuroscience and biochemical changes that affect your patient. We will also discuss some concerns and findings with marijuana, new street drugs, and abuse of prescription drugs

Learning Objectives
  1. Identify potentially harmful adulterants utilized as fillers in common street drugs
  2. Describe how the route of administration of illicit drugs affects each of the body systems
  3. Describe the potentially harmful adverse effects that may occur due to fillers in common street drugs
  4. Summarize the added risk of these illicit substances that have been altered with these potentially harmful fillers

This session includes 0.75 contact hours of pharmacology credit (self-reported).
Disclosure: Nancy Denke, DNP, ACNP-BC, FNP-BC, FAEN, CEN, CCRN has nothing to disclose.


LGBTQI Care in the Emergency Department
Rick Ramirez, DNP, APRN, AG-ACNP-BC, FNP-BC, ENP-C, CEN, CPEN - DNP Program Director and Assistant Professor, AAENP/ University of Hawaii at Manoa

LGBTQ individuals are subject to implicit and explicit biases in our society, ranging from antagonistic legislation and microaggressions to overt harassment. A disproportionate number of LGBTQ+ patients utilize emergency medicine as primary care. The National Academy of Medicine identified the transgender adult population as an at-risk group because these individuals face both an increased disease burden and reduced access to health care services. Transgender individuals have a high prevalence of HIV/STIs, victimization, mental health issues, and suicide. Initiation of PrEP and on-dmand PrEP may be initiated in the Emergency Department. By increasing knowledge of care, ED providers can increase access to care and provide care to the LGBTQ population.

Learning Objectives
  1. Recognize Bias in Healthcare
  2. Review Concepts of Sexual and Gender Minority (SGM) healthcare
  3. Review Trans-affirmative Medications and Procedures
  4. Review Initiation of PEP and PrEP in the ED

This session includes 0.25 contact hours of pharmacology credit (self-reported).
Disclosure: Rick Ramirez, DNP, APRN, AG-ACNP-BC, FNP-BC, ENP-C, CEN, CPEN has nothing to disclose.


(Don't) HOp to it: Intubating the physiologically difficult airway
Jacob Miller, MS, MBA, NP, CNS, NRP - Flight Nurse Practitioner, UC Health Air Care & Mobile Care

Many airway courses teach us about 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 just "HOp to it," make sure your patient's physiology has been optimized first!

Learning Objectives
  1. Differentiate anatomic from physiologic difficulties
  2. Identify risk factors for physiologic difficulty
  3. Describe methods to mitigate physiologic difficulties in airway management
  4. Formulate a treatment plan to prevent peri-intubation arrest

This session includes 0.5 contact hours of pharmacology credit (self-reported).
This session includes 1 contact hours of procedural credit (self-reported).
Disclosure: Jacob Miller, MS, MBA, NP, CNS, NRP has nothing to disclose.


Five Can’t Miss EKGs
Jen Carlquist, PA-C,ER CAQ - PA-C at Central Coast Cardiology, Conquering Cardiology

This lecture is designed to get providers ready to spot 5 High Risk EKG Findings some of which the machine software may miss!

Learning Objectives
  1. Review how to spot Brugadas on the EKG
  2. Review a case of palpitations that causes young people to die and that we need to be looking for in sports physicals
  3. Identify Red Flags in the history that should cue you to do an EKG in a young patient
  4. Review why widespread attacks depression on the EKG should not be dismissed and should be worked up and not discharged

This session includes 0.5 contact hours of procedural credit (self-reported).
Disclosure: Jennifer Carlquist, PA-C,ER CAQ has nothing to disclose.


Oh Snap: Carpal, Radial, and Ulnar Fractures in the ED
Emilee Engelhaupt, MSM, MMS, PA-C - Emergency Medicine APP Fellow, UT Southwestern
Prayag Mehta, MD - Assistant Professor, Program Director of APP EM Postgraduate Program, UTSW
Zea Navazio, MSN, APRN, FNP-C, ENP-C

Musculoskeletal or Orthopedic conditions are among the most common complaints seen in the acute care setting. Approximately 20% of all Emergency Department (ED) visits are musculoskeletal in nature. Of that hand, foot, and ankle complaints are responsible for 75% of those visits. However, these conditions are among the most commonly missed, misdiagnosed, and inaccurately consulted on. A study of how orthopedic conditions are diagnosed and managed by ER personnel at a Level 1 trauma center found that a significant number of them are misdiagnosed and ineffectively managed. In order to combat this issue, a solution to increase Orthopedic training across schooling, residencies, and departments was proposed. This is why I am here in front of you all today. I am here to that bring you hopefully the very beginning of that education, a taste if you will, by covering common and cannot miss hand and wrist fractures in the ED. We will cover mainly carpal, radial, and ulnar fractures along with clinical pearls on fracture reduction and splinting techniques. With this presentation I hope to educate, discuss, and ignite each of your personal passions on the learning objectives listed below. These learning objectives are to achieve our common and united goal as medical providers, which is to improve patient care and outcomes with accurate diagnoses and treatment in the ED.

Learning Objectives
  1. Review current and clinical information for the treatment of hand and wrist injuries/fractures in ED.
  2. Review high yield clinical pearls for common Orthopedic Emergencies involving the wrist and hand.
  3. Review fracture reduction and splinting techniques in ED.
  4. Describe optimal patient outcome and identify misdiagnoses and inaccurate consults on Orthopedic complaints/conditions in ED.

This session includes 0.5 contact hours of procedural credit (self-reported).
Disclosure:
Emilee Engelhaupt, MSM, MMS, PA-C disclosure: UT Southwestern Medical Center - Salary.
Prayag Mehta, MD has nothing to disclose.


Fundamentals of CXR Interpretation (Emphasis on Lines and ETT Placement)
Ronald Ray, DNAP, CRNA, FNP-C, ENP-C - Doctor of Nursing Practice (Nurse Anesthesiologist, Family Nurse Practitioner, Emergency Nurse Practitioner), Logan Health - Conrad

Interpreting CXRs is an essential skill for all providers. A fundamental review of reading CXRs. The lecture starts with the basics and moves on to diagnosing pneumonia, heart failure, pneumothorax, abdominal free air, pneumomediastinum and more. An emphasis is placed on proper positioning of central lines and ETT placement. The lecture teaches a method that makes reading a CXR easy.

Learning Objectives
  1. Describe the ABCDE method of reading a CXR
  2. Define how to verify ETT placement after intubation
  3. Summarize how to verify central line placement after placing a CVL
  4. Interpret a pneumothorax on a CXR

This session includes 1 contact hours of procedural credit (self-reported).
Disclosure: Ronald Ray, DNAP, CRNA, FNP-C, ENP-C has nothing to disclose.


Peripheral Nerve Blocks in the ED: Don't Let Your Patients Suffer
Ronald Ray, DNAP, CRNA, FNP-C, ENP-C - Doctor of Nursing Practice (Nurse Anesthesiologist, Family Nurse Practitioner, Emergency Nurse Practitioner), Logan Health - Conrad

Are you still doing sedation for fractures and dislocations? Opioids for analgesia? Learn about the various ultrasound guided peripheral nerve blocks that are easily performed in the ED and are a huge benefit for patients.

Learning Objectives
  1. Demonstrate knowledge and competence in performing ultrasound guided peripheral nerve blocks in the ED
  2. Review the indications for performing US guided regional nerve blocks in the ED
  3. Describe the benefits of US guided PNB vs sedation for fractures and dislocations in the ED
  4. Identify which local anesthetics to use

This session includes 0.5 contact hours of pharmacology credit (self-reported).
This session includes 0.5 contact hours of procedural credit (self-reported).
Disclosure: Ronald Ray, DNAP, CRNA, FNP-C, ENP-C has nothing to disclose.


The Use of Ocular Ultrasound for Common EYE-mergency Complaints
Ashley Davenport, PA-C - Emergency Medicine Physician Assistant Fellow, UT Southwestern Medical Center
Prayag Mehta, MD
Zea Navazio, MSN, APRN, FNP-C, ENP-C

Disorders of the eye are common reasons for patients to present to the emergency department for higher level of care. The spectrum of patient presentations can vary from vision loss to eye pain to an ocular foreign body. With the combined use of history, physical exam and bedside ocular ultrasound, the astute provider can ensure no eye complaint goes unseen. Using realistic cases and ultrasound imaging, this presentation will provide a brief overview of how to diagnose and manage common eye problems using point-of-care ultrasound.

Learning Objectives
  1. Apply ocular ultrasound techniques
  2. Interpret ocular ultrasound images in real time
  3. Recognize the contraindications to performing an ocular ultrasound
  4. Apply the appropriate treatment plan and disposition based on ultrasound findings

This session includes 0.5 contact hours of procedural credit (self-reported).
Disclosure:
Ashley Davenport, PA-C has nothing to disclose.
Prayag Mehta, MD has nothing to disclose.


Addressing the Gap in Caring for Sexual Assault Patients Presenting to the Emergency Department
Jessica Landry, DNP, FNP-BC - Assistant professor and nurse practitioner, University of Louisiana at Lafayette
Christy Lenahan, DNP, FNP-BC, ENP-C, CNE - Doctor, University of Louisiana at Lafayette

Sexual assault occurs at a rate of once every 73 seconds in the United States, including once every nine minutes in pediatric victims. Approximately 90% of all sexual assault victims present to the emergency department for forensic examinations and evidence collection (Ladd & Seda, 2021). Clinicians who are trained to perform sexual assault exams demonstrate a significant difference in attitude towards sexual assault victims versus those who are not trained (Nielson, Strong, & Stewart, 2015). Additionally, trained clinicians can improve patient throughput for those patients presenting with complaints of sexual assault. In one study, implementation of a training program for emergency department clinicians resulted in decreased door to provider times, 32.5 minutes versus 20 minutes (Sampsel et al., 2009).

Further, trained clinicians demonstrate improved evidence collection techniques when compared to clinicians who are not trained. Sexual assault kits that are performed and collected by trained clinicians are more likely to be sealed correctly (91% trained vs. 75% not trained), to include the appropriate number of swabs (88% vs. 71%), to include the proper number of blood tubes (95% vs. 80%), and to maintain a completed chain of custody (92% vs. 81%) (Sievers, Murphy, & Miller, 2003). Effective evidence collection and proper chain of custody for sexual assault kits results in decreased challenges to persons prosecuting alleged sexual assault offenders (National Sexual Assault Resource Center, 2018).

Despite a large body of evidence that demonstrates improved psychological, physical, and legal outcomes when sexual assault victims are examined by trained clinicians, there remains a significant need for sexual assault examiners. In an evaluation of six randomized states, the U.S. Government Accountability Office found that "the number of examiners available in each state did not meet the need for exams, especially in rural areas" (Clowers, 2018). Factors contributing to this gap included limited availability of training, lack of stakeholder support for sexual assault examiners, and low sexual assault examiner retention rates (Clowers, 2018).

Emergency department clinicians are positioned to be clinical and legal advocates for sexual assault victims. Opportunities to train, support, and retain sexual assault examiners do exist, but may require creative strategies such as simulation and use of standardized patients (Landry, 2021), compensation to support long work hours and on-call shifts, and a strong support system to avoid burnout (Clowers, 2018).

Learning Objectives
  1. Identify current gaps in caring for sexual assault patients presenting to emergency department.
  2. Describe evidence based strategies to improve outcomes in patients suffering from sexual assault.
  3. Review legal implications of proper and improper evidence collection during a sexual assault exam.
  4. Review opportunities to improve psychological, physical, and legal outcomes in sexual assault exams.

This session includes 1 contact hours of procedural credit (self-reported).
Disclosure:
Jessica Landry, DNP, FNP-BC has nothing to disclose.
Christy Lenahan, DNP, FNP-BC, ENP-C, CNE has nothing to disclose.


On-Demand Sessions

Acute Pancreatitis Updates - Everything You Thought You Knew Is Wrong (Almost)
Michael Sharma, PA-C - Emergency Medicine PA

We know how to take care of acute pancreatitis -- don't we? The state-of-the-art treatment for pancreatitis has come a long way since the advent of Ranson's criteria. We'll review the basics and then dive into the newest evidence-based risk management and treatment, including 1) selection of IV fluids, 2) imaging, 3) risk stratifying to determine need for admission, and 4) the importance (or not) of "bowel rest.

Learning Objectives
  1. Identify the pathophysiology of acute pancreatitis, including common risk factors / triggers.
  2. Utilize the IV fluid and dosing strategy associated with best outcomes in acute pancreatitis.
  3. Describe the different imaging modalities in acute pancreatitis, including ultrasound and CT.
  4. Recognize modern methods of risk stratification for acute pancreatitis, like BISAP, and whether SIRS criteria is adequate for risk stratification.

This session includes 0.25 contact hours of pharmacology credit (self-reported).
Disclosure: Michael Sharma, PA-C has nothing to disclose.


Back Pain and Spinal Epidural Abscess
Tiffany Andrews, MS, ACNP-BC, ENP-C, CCNS - Emergency Nurse Practitioner, American Academy of Emergency Nurse Practitioners

Spinal epidural abscess (SEA) is still an uncommon but devastating infection of the spine. In recent years, a number of reported cases have risen. The most important prognostic factor for a favorable outcome is early diagnosis and appropriate treatment. However, a diagnosis of SEA is often delayed, particularly in the early stages of the disease before patients present with neurological symptoms. The knowledge of risk factors, clinical features, and appropriate diagnostic procedures, it may be possible to reduce diagnostic delay in the early stages of the disease. This talk focuses on early diagnosis of SEA based on risk factors, presenting symptoms, diagnostic workup, and appropriate treatment.

Learning Objectives
  1. Utilize a detailed history, including past infectious, surgical, procedural and social history to evaluate for risk factors for epidural abscess.
  2. Describe clinical signs and symptoms of spinal epidural abscesses and understand that initial clinical presentations can be variable.
  3. Review how to perform a focused neurological exam including evaluation of motor, sensory, reflexes, and rectal tone.
  4. Utilize appropriate laboratory testing and imaging modalities for spinal epidural abscess diagnosis.

This session includes 0.25 contact hours of pharmacology credit (self-reported).
Disclosure: Tiffany Andrews, MS, ACNP-BC, ENP-C, CCNS has nothing to disclose.


GU Complaints: Discharge to Stones and More
Michael Gooch, DNP, APRN, CCP, ACNP-BC, FNP-BC, ENP-C - Assistant Professor of Nursing; Emergency Nurse Practitioner, Vanderbilt University

Genitourinary (GU) complaints are commonly seen in all age groups in emergency care settings. Patients may present complaining of pain or various other symptoms. With proper knowledge, the NP can assess, order the appropriate diagnostics, and manage these patients using evidence based guidelines.

Learning Objectives
  1. Recognize the primary anatomical structures of the genitourinary tract and their physiological functions.
  2. Identify the clinical manifestations associated with five common genitourinary tract disorders.
  3. Formulate a plan of care to manage a patient presenting with a genitourinary complaint.
  4. Describe appropriate ordering, monitoring, and risk assessment associated with pharmacologic interventions.

This session includes 0.5 contact hours of pharmacology credit (self-reported).
Disclosure: Michael Gooch, DNP, APRN, CCP, ACNP-BC, FNP-BC, ENP-C has nothing to disclose.


Toxicology Pearls in Emergency Care
Michael Gooch, DNP, APRN, CCP, ACNP-BC, FNP-BC, ENP-C - Assistant Professor of Nursing; Emergency Nurse Practitioner, Vanderbilt University

Emergency nurse practitioners often manage patients with a variety of exposures and ingestions. These can be accidental or intentional overdoses, resulting in challenging and sometimes treatment plans. During this presentation, a wide range of toxins and medications, including some of the newer street drugs will be discussed. Lastly, the management of cardiotoxic patients will be addressed, including newer strategies of high dose insulin and intralipid therapy administration.

Learning Objectives
  1. Identify applicable reversal agents in select toxic emergencies.
  2. Identify indications for high dose naloxone.
  3. Recognize indications for high dose insulin and intralipid therapy in select toxic emergencies.
  4. Discuss appropriate ordering, monitoring, and risk assessment associated with reversal agents.

This session includes 1 contact hours of pharmacology credit (self-reported).
Disclosure: Michael Gooch, DNP, APRN, CCP, ACNP-BC, FNP-BC, ENP-C has nothing to disclose.


Adolescent Substance Abuse: A Focus on Novel Drugs
Kathleen Jordan, DNP, RN, FNP-BC, ENP-C, SANE-P, FAEN, FAANP - Clinical Associate Professor and Nurse Practitioner, University of North Carolina at Charlotte and Mid-Atlantic Emergency Medical Associates

The use of novel drugs in the adolescent population is increasing at an unprecedented rate. Novel drugs are readily available in a variety of forms and can be more potent, difficult to identify and detect, and result in more significant and unpredictable medical consequences. This discussion will include an overview of screening adolescents for illicit drug use, the most common novel drugs used to include pathophysiology, symptoms and treatment, and a discussion of clinical strategies for the prevention and treatment of illicit substance use and abuse in adolescents.

Learning Objectives
  1. Describe the incidence and prevalence of illicit substance use and abuse in the adolescent population. (pharmacology)
  2. Identify the unique challenges associated with the use of novel drugs among adolescents. (pharmacology)
  3. Describe the pathophysiology, symptoms and treatment for common novel drugs of abuse. (pharmacology)
  4. Identify evidence-based clinical strategies for the identification, intervention and referral to treatment among adolescents who are at-risk for a substance-abuse disorder.

This session includes 1 contact hours of pharmacology credit (self-reported).
Disclosure: Kathleen Jordan, DNP, RN, FNP-BC, ENP-C, SANE-P, FAEN, FAANP has nothing to disclose.


Medication for Addiction and Treatment (MAT) in the Emergency Department
K. Chenin Kenig, RN, MSN, FNP-C - Nurse Practitioner Special Advisor, CA Bridge
John Bressan, MS, RN, NP-BC - NP Special Advisor/Nurse Practitioner, Emergency Medicine, CA Bridge

Over 21 million people in the United States require substance use disorder (SUD) treatment however less than 4 million people receive treatment. The crisis of deaths due to opioid overdose requires aggressive public health interventions. This presentation will describe the role of the hospital emergency department (ED), not simply in emergency treatment of overdose, but as a provider of care for underlying addiction and as a catalyst for change in our approach to drug use as a society.

It has been found that EDs and hospitals serve as an important point for initiating treatment for substance use disorders. It is important to provide equitable access to care. In the recent article published in Drug and Alcohol Dependence titled “Voting with their feet: Social factors linked with treatment for opioid use disorder using same-day buprenorphine delivered in California hospitals”, the ED served as an important access point for those with socio-economic disadvantages. In this course we will discuss MAT for opioid use disorder, specifically buprenorphine. We will also discuss how and why to initiate treatment in the emergency department. We will walk through the steps required to obtain one’s x-waiver. Finally, we will cover billing for MAT induction in the ED. The course content will be highlighted with case studies.

Learning Objectives
  1. Describe the Pharmacokinetics of buprenorphine
  2. Review initial dosing, induction of buprenorphine in the ED
  3. Identify billing criteria for MAT in the ED, G2213
  4. Identify ways to obtain X-waiver

This session includes 1 contact hours of pharmacology credit (self-reported).
Disclosure: K. Chenin Kenig, RN, MSN, FNP-C has nothing to disclose.


My What Big Teeth You Have: The Assessment and Current Pharmacologic Treatment of North American Crotalid Snakebite
Gordon Worley, MSN, RN, FNP-C, ENP-C, FAWM

This presentation will discuss the characteristics and identification of various species of pit vipers native to North America. The pathophysiology and toxicology of crotalid snakebite and the current evidence-based recommendations for assessment and treatment of snakebite will be discussed. We will review the pharmacology and current recommendations for the use of both established and recently introduced antivenoms. We will also explore (and de-bunk) a variety of common myths and misunderstandings about snake behavior and the treatment of snakebites.

Learning Objectives
  1. Recognize and describe the identifying characteristics of venomous snakes native to North America.
  2. Describe prehospital and emergency department evaluation and treatment of crotalid snakebite.
  3. Review antivenom treatment of crotalid envenomation. (Pharm content ~ 0.3 hours)
  4. Identify common misconceptions about snake behavior and snakebite treatment.

This session includes 0.75 contact hours of pharmacology credit (self-reported). Disclosure: Gordon Worley, MSN, RN, FNP-C, ENP-C, FAWM has nothing to disclose.


Bugs and Drugs
Michael Gooch, DNP, APRN, CCP, ACNP-BC, FNP-BC, ENP-C - Assistant Professor of Nursing; Emergency Nurse Practitioner, Vanderbilt University

This presentation will provide a review and update on empiric "bugs and drugs" commonly encountered in emergency care. A brief review of 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 CAP, SSSTI, STI, and systemic problems such as sepsis. Lastly, the importance of antibiotic stewardship will be addressed.

Learning Objectives
  1. Identify the mechanisms of actions of the five main categories of antimicrobial therapies.
  2. Describe common adverse drug reactions associated with antimicrobial agents.
  3. Modify the plan of care to incorporate the appropriate empiric agent based on presumed site or source of infection.
  4. Identify appropriate ordering, monitoring, and risk assessment associated with antimicrobial, antifungal and antiviral medications.

This session includes 1 contact hours of pharmacology credit (self-reported).
Disclosure: Michael Gooch, DNP, APRN, CCP, ACNP-BC, FNP-BC, ENP-C has nothing to disclose.


Joint Accreditation Statement:

Joint Accreditation Logo

In support of improving patient care, this activity has been planned and implemented by Northwell Health and American Academy of Emergency Nurse Practitioners (AAENP). Northwell Health is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE) and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

Disclosure Policy:

Northwell Health adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CME-CE activity, including faculty, planners, reviewers, or others are required to disclose all relevant financial relationships with ineligible companies. All relevant financial relationships have been mitigated prior to the commencement of the activity.

Planner and Speaker's Disclosures:

Course Director:
Tiffany S Andrews, NP has nothing to disclose.

Planners:
Bradley Goettl, DNP has nothing to disclose.
Andrew Rotjan, NP has nothing to disclose.
Adam B. Dobbins, PhD has nothing to disclose.
Cindy Kumar, NP has nothing to disclose.
Warren E. Shaulis, NP has nothing to disclose.
Jolene Traum, NP has nothing to disclose.
Megan Wider, PA has nothing to disclose.

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