Spring 2015 E-Newsletter

Spring 2015

Alaska Chapter ACEP

Anne Zink, MD, FACEP, President

Contact us:

Phone: 800.798.1822
Fax: 972.767.0056

From the President
Anne Zink, MD, FACEP

Happy March to everyone!

I feel honored and humbled to be writing this as your newly elected Alaska ACEP President.  I first want to thank Carl Heine, our Past-President.  His guidance, encouragement and leadership these past four years have been tremendous. We are fortunate to have his national ACEP experience, enthusiasm for this state and our profession. He continues to do amazing work lobbing in Juneau fighting for our profession and our patients.

My personal vision for Alaska ACEP these next two years is to provide an avenue where we can learn from and work with each other as emergency providers.  I believe we are stronger together and the "cross polination" that happens with shared experiences will help us grow and weather the continued challenges facing our state and our profession. 

Alaska ACEP Chapter Board
As we move into 2015, I feel honored to work with a great Board that represent many different hospitals and practice styles in the state. They are as follows:

Benjamin Shelton, MD, FACEP President-Elect Providence
Kyland I. Burden, DO Treasurer Central Peninsula
Nancy L. Kragt, DO Secretary Alaska Regional
Danita Koehler, MD Director Bassett Army
Stanley W. Robinson, MD Director Fairbanks
Megan Lea, MD Director Alaska Native
Andrew Elsberg, MD Director Providence

Please feel free to contact any one of us with any questions or concerns. 

Journal Club
In an effort to help connect people and ideas, we had our first Journal Club on Friday, February 27th.  It was a fun and informative night.

Hats off to the JBER clan. Not only were they the motivating force to make it happen, but were the best represented and did the work choosing and presenting the articles. A special thanks to Drs. Coombs and Papacostas for presenting interesting articles. A special congrats is also in order for Dr. Parris. While we had a hard time getting the announcement out about the Journal Club because one of many reasons, the weather in Dallas (please accept my apology for the delay), Dr. Parris completed the Iron Dog and made it out of weathered in Nome to make it in time.  Amazing as always!

Thanks to everyone for taking the time to come.  We had representation from four hospitals and a lively discussion. I know I learned a lot and will change some things in my practice because of the discussion. Feel free to review the articles if you missed it, and keep your eyes open for another survey for another Journal Club in late summer. I hope to see you there.

Please click on the links below to download the articles.

Intranasal Ketamine vs Fentanyl for Analgesia 2015
Nurse Administered Ketamine 2012 (third world environment)
Randomized Trial of Propofol vs Ketofol at 1:1 or 4:1 Mixtures 2014

The Journal Club was timely and helpful, especially with the uncertainly from the state nursing board on the role off nurse administered Ketamine. Thanks to the nurses Sam Jones and Emily Stevens, the case for nurse administered Ketamine in the Emergency Department was brought forward.  After a lengthy conversation, it was decided that based on existing policy statement  nurses can give Ketamine for sedation and intubation as long as there is a licensed provider available.  However, they still have a policy it cannot be given by nurses for pain control, unless it is a post-operative opioid tolerant patient.  This will be our next step to try and clarify this, so our nurses are covered giving a very safe and increasingly used medication.  Please feel free to contact me if you have any questions. 

Drug Data Base and Electronic Medical Records
Another goal of 2015 is to help support the Alaska Drug Data base and improve information between hospitals, specifically to reduced duplicated efforts and better coordinate care for high utilizers of the emergency system.  With the current budget cuts, we have been pushing the state that these efforts will help save the state money, as similar efforts saved Washington's States Medicaid $33.6 million in fiscal year 2013.  We have been working with the State and elected representatives as well as other interested parties such has hospital CEO's, non-profits like the Mat-Su Health Foundation to paint a picture of how this change could not only provide better care, but save the state money.  If you have any interested in helping with this, a political bone in your body or any good contacts that would help move this forward please contact myself or the political mover, Dr. Heine, your Past-President.

The state is also working on a care coordination for frequent ED visitors.  It is called AMCII.  I am just learning about it, but click here to read about it.  They will likely come to our next meeting so we can all learn more.

Upcoming Events
The spring and summer are turning out to be jammed back with emergency medicine fun with lots of events. Three great conferences are coming to the state and one in Seattle is relatively close. 

Seattle, Washington
April 22nd-24th, 2015 
Washington ACEP will hold their Summit to Sound Northwest Emergency Medicine Assembly and involves an inexpensive cadaver lab. Click here for more information.

Anchorage, Alaska
May 21st-23rd, 2015

Mike Levy will hold the 8th Annual Resuscitation and Critical Interventions Conference (RACI).  It is a great event to hear national leaders talk about what is new in resuscitation, talk about challenges in our state and meet other providers. Click here for more information.

Anchorage, Alaska
May 22nd at 6:00 pm

Is the tentative date and for the next Alaska ACEP Chapter Meeting. More details to follow. Save the date!

Girdwood, Alaska
June 8th-12th, 2015
34th Annual Series Emergency Medicine & Acute Care
or better know as the Rick and Jerry show is coming back to Alaska. Rick Bukata and Jerry Hoffman are bringing some of the top educators in emergency medicine to the state. Click here for more information.

Hospital Updates
I am hoping to expand this section, so every group can post an update here including what's new, maybe if they are looking for doctors, changes in service lines and so forth.  Here is a quick update for now and feel free to send me your hospitals updates for the next e-newsletter.

Providence Anchorage
Officially certified as a trauma 2 center marking a milestone change in trauma care in the state. Congratulations!

Re-certified as a trauma 2 center and building a helicopter pad.

Mat-Su Regional
March 17th will go live with a transfer center that will coordinate all transports in and out of the hospital.

Well, that's all I have for this quarter.  Hope everyone is well.  Thanks for all you do. Please let me know if there is anything you would like to see in the next e-newsletter.

2015 Legislative Advocacy Conference and Leadership Summit

Don’t miss ACEP’s Legislative Advocacy Conference and Leadership Summit.
The 2014 elections brought dramatic changes to the 114th US Congress. Now more than ever it is crucial for Congress to hear from emergency physicians. Your voice needs to be heard.
Join ACEP and 500 of your colleagues for the annual Legislative Advocacy Conference and Leadership Summit , May 3-6 in Washington, D.C. 
Revamped based on feedback from past attendees, this year’s conference offers an exciting new schedule and format, a new venue, and new opportunities to connect with the movers and shakers in DC, as well as in EM.
Start on Sunday, May 3 with the Chapter Executives Forum, Committee Meetings and the Leadership and Advocacy Essentials, presented by EMRA and the ACEP Young Physicians Section. Feel confident heading into the week after gaining this core knowledge and developing a focused action plan.
Then, get up-to-speed on the key issues and hone your media skills on Monday, May 4 with a deeper policy dive into the current health landscape. Even if you have never visited with a lawmaker, this day of courses will arm you with the key facts and the ability to articulate ACEP’s advocacy positions. 
Tuesday, May 5 delivers a full day on Capitol Hill. In the morning, learn about current legislative issues then spend the afternoon meeting with your members of Congress and their staff members to share your messages about the issues facing emergency medicine and your patients. 
The last day of the conference is the ALL NEW Leadership Summit. Expand your leadership skills to become more effective in your hospital and state while earning CME credit. Influential emergency medicine leaders will discuss relevant topics to make you stand out as a leader.
Looking for more time to engage with legislators and peers? New this year - small-group Dine Arounds allow you to network with EM leaders and Members of Congress in some of the city’s best restaurants.
Have a voice - don't just sit back and watch change occur. Step into a leadership role and join us at the Legislative Advocacy Conference and Leadership Summit, May 3-6 in Washington, DC. 

ACEP Committee Interest 2015-16

Committee interest for 2015-16 is now open! 
Members interested in serving on a committee, and who are not currently serving on a national committee, must submit a completed committee interest form and curriculum vitae by May 18, 2015
The online application form is found here
The CV and any letters of support from the chapter can be emailed to Mary Ellen Fletcher or mailed to the ACEP headquarters.  
After completion of the form, you should receive an acknowledgement that your committee interest form has been submitted.  If you do not receive this message, please contact Mary Ellen by email or phone at 800-798-1822 Ext. 3145.
The committee selection process will occur in mid-June and applicants will be notified by the end of July. 

Clinical News

Mouthguard Technology May Help Evaluate and Treat Traumatic Brain Injury in Sports
A new athletic mouthguard under development by a partnership involving Louisiana State University (LSU) could have a future impact emergency medicine’s treatment of traumatic brain injuries caused by sports.
Measles Outbreak Highlights the Need for Infectious Disease Containment Protocols in the Emergency Department
Emergency physicians and emergency department leaders are challenged to develop a rational and consistent approach to patients with potential infectious diseases. The Centers for Disease Control and Prevention (CDC) posted a nationwide health advisory in an effort to educate clinicians about a widespread outbreak of the measles.
CME Article
Laceration or Incised Wound: Know the Difference
The Case: A 24-year-old male presents to the emergency department sustaining the wound shown in Figure 1 from a broken beer bottle. He states that someone broke the bottle and cut him with it. What is the correct discharge diagnosis for the chart?