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SPECIFIC OBJECTIVES - DAY 1 - DISORDERS OF GLUCOSE CONTROL, PARTS I AND II Treatment plan for Diabetic Ketoacidosis (DKA). Compare and contrast DKA and hyperosmolar non-ketotic states (HHNK). Treatment plan for Hypoglycemia and Alcoholic Ketoacidosis. Pitfalls in the treatment and disposition of Hypoglycemia. AS THE WORLD TURNS: PERIPHERAL VERTIGO IN THE ED Common causes of peripheral vertigo. Pathophysiology of benign positional vertigo. How to perform various diagnostic tests in the evaluation of patients with peripheral vertigo. How to perform various therapeutic maneuvers, such as the Epley maneuver, in the treatment of patients with benign positional vertigo. ELECTROLYTES AT PANIC LEVELS Common symptoms and signs that suggest an electrolyte abnormality. Therapies used to treat hyperkalemia. Formulas used to correct disorders in sodium homeostasis. DAY 2 - SUPRAVENTRICULAR TACHYCARDIAS Characteristic EKG findings for atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia, and Wolf-Parkinson-White syndrome. Factors determining the seriousness of any tachycardia. Treatment options for various supraventricular tachycardias. RAPID SEQUENCE INTUBATION: THE BASICS Factors involved in the decision to intubate. The order of rapid sequence intubation (RSI). Indications for using pretreatment medications. Pharmacology of drugs used for induction and paralysis. NEUROMUSCULAR WEAKNESS Upper and lower motor neuron disease. Clinical entities that cause neuromuscular weakness, including Guillain-Barre Syndrome, Myasthenia Gravis, and others. Techniques to be able to discriminate between organic and functional weakness. WRIST INJURIES DONT MISS THAT INJURY! Diagnosis and management of common wrist injuries, including some recent radiologic and orthopedic evidence. Wrist injuries and fractures that could easily be missed. Some pitfalls in management of wrist injuries. DAY 3 - THYROID EMERGENCIES Presentation of life-threatening hyperthyroid states to the Emergency Department. Treatment plan for patient with thyroid storm and thyrotoxicosis. The presentation of myxedema coma. Use of intravenous Synthroid in the potentially hypothyroid patient. SEXUALLY TRANSMITTED DISEASES Latest recommendations by the CDC. Treatment issues in some of the more controversial patients including pregnant and HIV patients. STDs that present with genital ulcers. THE ABNORMAL ECG Approach to the initial ECG and discuss common artifacts and misreads. Subtle presentations of abnormal rhythm and ischemia. Signs of ischemia in patients with underlying bundle branch blocks. Possible non-cardiac causes of abnormal ECG's. APPROACH TO CHEST PAIN, PEARLS AND PITFALLS Warning signs in the typical and atypical presentation of chest pain. Factors in the history and physical which will alter risk stratification, and which interventions will alter outcome. Treatment plan for every patient before obtaining the ECG or lab testing. DAY 4 - CONGESTIVE HEART FAILURE: UPDATES IN DIAGNOSIS AND MANAGEMENT Presenting signs and symptoms of congestive heart failure (or lack thereof). Rapid treatment plan and response to therapy. Non-invasive ventilation in appropriate candidates. Alternative diagnoses in patients who are refractory to treatment. DOES THIS PATIENT HAVE A PE? Algorithm for the diagnosis of pulmonary embolus based on clinical pre-test probability. Use of the D-dimer and define those patients who would benefit from its use. Signs of pulmonary embolus on the screening ECG. Manage the pulmonary embolism patient in a stepwise fashion with anticoagulation or interventions. PSYCHIATRIC EMERGENCIES Early signs of agitation and strategies to resolve them. Complications of commonly used psychiatric medications. Plan for the medical clearance of a psychiatric patient. THE NEW TOXIDROMES Presentation and treatment of intoxication with rave drugs like Ecstasy, ketamine and GHB. Case-based format to discuss some of the newer drugs of abuse. Toxic properties, and the treatments, of some of the most commonly used herbal medicines. DAY 5 - SEPSIS SYNDROMES - THE FEBRILE PATIENT Initial antibiotics based on presenting complaints and indicators of resistance. Special considerations in non-antibiotic therapy of selected infections. Early goal-directed therapy for the septic shock patient. HEADACHE IN THE EMERGENCY DEPARTMENT Common headache syndromes and differentiate them from dangerous pathology. Typical pitfalls of misdiagnosis in the rule out subarachnoid hemorrhage patient. Treatment plan for the unstable patient with severe headache. ABDOMINAL PAIN INTO THE BLACK BOX OF THE BELLY Challenging cases of abdominal pain. Diagnoses of abdominal pain in the absence of abdominal pathology. Utility of various tests, including labs, ultrasound and CT scan in the diagnosis of abdominal pain. FACIAL TRAUMA Rapid screen and thorough evaluation of the patient with facial trauma. Challenges in securing an airway in the patient with facial trauma. Indication for different imaging procedures for facial trauma. Injuries to the soft tissues of the face (lips, tongue, eyelids
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