Edward P. Sloan, MD, MPH EMRA/FERNE ED Clinical Policies Session: Optimizing the Care of ED Patients with Neurological Emergencies

Edward P. Sloan, MD, MPH

EMRA/FERNE EMRA/FERNE ED Clinical Policies Session:ED Clinical Policies Session:

Optimizing the Care of Optimizing the Care of ED Patients with ED Patients with

Neurological EmergenciesNeurological Emergencies

Edward P. Sloan, MD, MPH, FACEP

Optimizing Seizure and Optimizing Seizure and SE Patient Management:SE Patient Management:

Seizure Therapies Seizure Therapies Clinical Policy ReviewClinical Policy Review


Optimizing Optimizing Traumatic Brain Injury Traumatic Brain Injury Patient Management:Patient Management:Clinical Policy ReviewClinical Policy Review


2009 EMRA Meeting at 2009 EMRA Meeting at the SAEM Annual the SAEM Annual

MeetingMeeting

New Orleans, LANew Orleans, LAMay 16, 2009May 16, 2009


Edward P. Sloan, MD, MPH

Professor

Department of Emergency MedicineUniversity of Illinois at Chicago

Chicago, Illinois


Attending PhysicianEmergency Medicine

University of Illinois HospitalSwedish American Belvidere Hospital

Chicago, IL


DisclosuresDisclosuresFERNE Chairman and PresidentFERNE Chairman and PresidentFERNE grants by industryFERNE grants by industry2009 EMRA SAEM Educational activities supported by 2009 EMRA SAEM Educational activities supported by

Genentech, EKR Therapeutics, The Medicines Genentech, EKR Therapeutics, The Medicines Company Company

Participation on industry-sponsored advisory boards Participation on industry-sponsored advisory boards and as lecturer in programs supported by industryand as lecturer in programs supported by industry

ACEP Clinical Policy CommitteeACEP Clinical Policy Committee


Brian J. O’Neil, MD

Professor

Department of Emergency MedicineWayne State University

Detroit, Michigan


www.ferne.orgwww.ferne.org


OverviewOverview

Mission Statement PreambleMission Statement Preamble

The Foundation for the Education and The Foundation for the Education and Research in Neurological Emergencies is Research in Neurological Emergencies is an independent not-for-profit organization an independent not-for-profit organization committed to the following principles:committed to the following principles:


OverviewOverview

Mission Statement PrinciplesMission Statement Principles

• Patients with neurologic emergencies deserve Patients with neurologic emergencies deserve quality emergency care.quality emergency care.

• The emergency care for neurologic emergencies The emergency care for neurologic emergencies can be enhanced through quality scientific can be enhanced through quality scientific research.research.

• Emergency medical care providers can provide Emergency medical care providers can provide optimal medical care for patients with optimal medical care for patients with neurological emergencies through participation neurological emergencies through participation in quality medical education that highlights in quality medical education that highlights state-of-the-art neurologic care.state-of-the-art neurologic care.


AdministrativeAdministrative

Industry Collaborators Industry Collaborators

Abbott LaboratoriesAbbott LaboratoriesAdam Williams InitiativeAdam Williams InitiativeAstraZenecaAstraZenecaBoston ScientificBoston ScientificBristol Myers SquibbBristol Myers SquibbConcentric MedicalConcentric MedicalEisai Inc.Eisai Inc.EB MedicineEB MedicineEKR Therapeutics, Inc.EKR Therapeutics, Inc.EMAEMAGenentechGenentech

GTEGTEJanssen PharmaceuticalJanssen PharmaceuticalNovo Nordisk, Inc.Novo Nordisk, Inc.The Medicines CompanyThe Medicines CompanyOrtho-McNeil Ortho-McNeil

Pharmaceutical, Inc.Pharmaceutical, Inc.Parke-DavisParke-DavisPfizerPfizerRoche PharmaceuticalRoche PharmaceuticalUCB Pharma, Inc.UCB Pharma, Inc.



Academic CollaborationsAcademic CollaborationsAmerican Academy of Emergency Medicine (AAEM)American Academy of Emergency Medicine (AAEM)American Stroke Association (ASA)American Stroke Association (ASA)American College of Emergency Physicians (ACEP)American College of Emergency Physicians (ACEP)Emergency Medicine Foundation (EMF)Emergency Medicine Foundation (EMF)Emergency Medicine Residents’ Association (EMRA)Emergency Medicine Residents’ Association (EMRA)European Society for Emergency Medicine (EuSEM)European Society for Emergency Medicine (EuSEM)Illinois College of Emergency Physicians (ICEP)Illinois College of Emergency Physicians (ICEP)International Brain Injury Association (IBIA)International Brain Injury Association (IBIA)Mount Sinai School of Medicine, NY (MSSM)Mount Sinai School of Medicine, NY (MSSM)National Institute of Neurological Disorders and Stroke (NINDS)National Institute of Neurological Disorders and Stroke (NINDS)Resuscitative Hypothermia Academic Industry Roundtable (RHAIR) Resuscitative Hypothermia Academic Industry Roundtable (RHAIR) Society for Academic Emergency Medicine Society for Academic Emergency Medicine (SAEM)(SAEM)



Board Chairman and PresidentBoard Chairman and President

Edward P. Sloan, MD, MPH, FACEPEdward P. Sloan, MD, MPH, FACEP ProfessorProfessorDepartment of Emergency Medicine,Department of Emergency Medicine,University of Illinois School of MedicineUniversity of Illinois School of Medicine

Attending PhysicianAttending PhysicianEmergency Medical Services,Emergency Medical Services,University of Illinois Hospital, ChicagoUniversity of Illinois Hospital, ChicagoOur Lady of the Resurrection Hospital, ChicagoOur Lady of the Resurrection Hospital, Chicago


Andy Jagoda, MD, FACEPAndy Jagoda, MD, FACEP - - TreasurerTreasurer

Professor and Vice ChairProfessor and Vice ChairResidency Program Director,Residency Program Director,Department of Emergency Medicine,Department of Emergency Medicine,Mount Sinai School of Medicine, New York, NYMount Sinai School of Medicine, New York, NY

Attending PhysicianAttending PhysicianDepartment of Emergency Medicine,Department of Emergency Medicine,Mount Sinai School of Medicine, New York, NYMount Sinai School of Medicine, New York, NY

J. Steven Huff, MD, FACEPJ. Steven Huff, MD, FACEP - - SecretarySecretary

Associate ProfessorAssociate ProfessorEmergency Medicine and Neurology,Emergency Medicine and Neurology,University of VirginiaUniversity of Virginia

Attending PhysicianAttending PhysicianDepartment of Emergency Medicine,Department of Emergency Medicine,University of VirginiaUniversity of Virginia


Executive Board MembersExecutive Board Members



ExecutiveExecutive Board MembersBoard MembersWilliam G. Barsan, MD, FACEPWilliam G. Barsan, MD, FACEP

Professor and ChairProfessor and ChairDepartment of Emergency MedicineDepartment of Emergency MedicineUniversity of Michigan, Ann ArborUniversity of Michigan, Ann Arbor

Attending PhysicianAttending PhysicianDepartment of Emergency MedicineDepartment of Emergency MedicineUniversity of Michigan, Ann ArborUniversity of Michigan, Ann Arbor

E. Bradshaw Bunney, MD, FACEPE. Bradshaw Bunney, MD, FACEP Associate ProfessorAssociate ProfessorDepartment of Emergency MedicineDepartment of Emergency MedicineUniversity of Illinois School of MedicineUniversity of Illinois School of Medicine

Attending PhysicianAttending PhysicianEmergency Medical ServiceEmergency Medical ServiceUniversity of Illinois HospitalUniversity of Illinois HospitalOur Lady of the Resurrection Hospital, Our Lady of the Resurrection Hospital, ChicagoChicago



ExecutiveExecutive Board MembersBoard Members

Scott M. Silvers, MD, FACEPScott M. Silvers, MD, FACEP

Assistant Professor of MedicineAssistant Professor of MedicineMayo Medical SchoolMayo Medical SchoolRochester, Minnesota Rochester, Minnesota

ConsultantConsultantChair, Emergency Medicine EducationChair, Emergency Medicine EducationDivision of Emergency MedicineDivision of Emergency MedicineMayo Clinic, JacksonvilleMayo Clinic, Jacksonville

Sydney Starkman, MD, FACEPSydney Starkman, MD, FACEP

Professor of Emergency Medicine and Professor of Emergency Medicine and NeurologyNeurologyDirector, Emergency Stroke ProgramDirector, Emergency Stroke ProgramUniversity of California Los AngelesUniversity of California Los AngelesLos Angeles California Los Angeles California



ExecutiveExecutive Board MembersBoard Members

Heather Prendergast, MDHeather Prendergast, MD

Associate Professor of Emergency MedicineAssociate Professor of Emergency MedicineUniversity of IllinoisUniversity of IllinoisChicago, ILChicago, IL

Jonathan Edlow, MDJonathan Edlow, MD

Associate Professor of Emergency MedicineAssociate Professor of Emergency MedicineBeth Israel HospitalBeth Israel HospitalBoston, MA Boston, MA


30 Members30 MembersEmergency Medicine PhysiciansEmergency Medicine PhysiciansProvides input regarding needs and Provides input regarding needs and

future directionsfuture directionsAdvisory board last convened May Advisory board last convened May

20042004Insights into FERNE priorities and Insights into FERNE priorities and

educational needseducational needs


Extended AdvisoryExtended Advisory BoardBoard


EducationEducation

Case-based LearningCase-based Learning

Uniform contentUniform contentCase presentationCase presentationKey Learning PointsKey Learning PointsIntroduction, discussion of the clinical disease Introduction, discussion of the clinical disease

statestateOptimal ED management strategiesOptimal ED management strategiesPatient outcomePatient outcomeReferencesReferencesAnnotated bibliographyAnnotated bibliographyQuestions and answersQuestions and answers


EducationEducation

CMECME

CME available through the CME available through the University of Illinois College of MedicineUniversity of Illinois College of MedicineAvailable for all FERNE educational Available for all FERNE educational

meetingsmeetingsFree for all course attendeesFree for all course attendeesICH CME on lineICH CME on line

Future plans Future plans Interactive, web-based CMEInteractive, web-based CMEAvailable following cases provided on Available following cases provided on

websitewebsite


EducationEducation

Other Educational MaterialsOther Educational Materials

Acute Stroke MaterialsAcute Stroke Materials

Developed a Handbook and Developed a Handbook and Companion CD RomCompanion CD Rom

Published Spring 2004Published Spring 2004

Collaboration included Collaboration included American Stroke American Stroke

Association and France Association and France FoundationFoundation


EducationEducation

SupplementsSupplements

Planned Seizure PublicationPlanned Seizure Publication

Emergency Medicine ClinicsEmergency Medicine Clinics

20102010

Comprehensive state-of-the-art Seizure DataComprehensive state-of-the-art Seizure Data

15 Manuscripts total15 Manuscripts total


EducationEducation

Meeting Attendance and EvaluationsMeeting Attendance and Evaluations

79 FERNE meetings79 FERNE meetings

~450 Educational Lectures, 14 Research Lectures~450 Educational Lectures, 14 Research Lectures

186 Speakers186 Speakers

More than 5630 physicians in attendanceMore than 5630 physicians in attendance

10,670 contact hours10,670 contact hours

Evaluated as excellent or good by 97% of learnersEvaluated as excellent or good by 97% of learners


EducationEducation

Web-based Learning: WebsiteWeb-based Learning: Website



EducationEducation

Web-based Learning: EMedHome.comWeb-based Learning: EMedHome.com


• FERNE generated contentFERNE generated content

• CME can be obtained via EMedHome websiteCME can be obtained via EMedHome website• Slides and audioSlides and audio


EducationEducation

Web-based Learning: Video SlideshowsWeb-based Learning: Video Slideshows

• Audio, video and slide contentAudio, video and slide content• Able to access individual slides, specific contentAble to access individual slides, specific content• MS Producer, viewable with Windows Media PlayerMS Producer, viewable with Windows Media Player


EducationEducation

Web-based Learning: Slide LecturesWeb-based Learning: Slide Lectures

Download or view online


EducationEducation

Handheld Software: HandiStroke RxHandheld Software: HandiStroke Rx

HANDi Stroke Rx Available freefrom www.ferne.org

• Written at Mount Sinai, New York• Funded by a FERNE grant• NIH Stroke Scale• tPA Inclusion/Exclusion criteria• tPA dosage calculator• Continuation of care orders


EducationEducation

Handheld Software: Handheld Software: SeizureStat©

SeizureStat© Available freefrom www.ferne.org

• Written at University of Illinois, Chicago

• Funded by FERNE • Written materials• Urgent SE protocol• Information on 10 urgent meds


ResearchResearch

Directed Neurological Emergencies Research GrantDirected Neurological Emergencies Research Grant

• Up to $ 50,000 per Grant• $300,000 awarded with EMF support• Promotes new knowledge relating to the

diagnosis and management of neurological emergencies in the medical community

• Directed to researchers in established emergency medicine research program

• One directed research grant per institution, per cycle, is awarded


ResearchResearch


•Christopher Barton, MD•UCSF

•Emergency Department Assessment of Secondary Brain Insults in ICH

•Jane Brice, MD, MPH•UCSF

•Stat 911: Stroke Assessment Tool for 911


ResearchResearch


•Andrew W. Asimos, MD•Carolinas Medical Center•A Prospective Validation Study of the ABCD Score and Kaiser Criteria for Short-term Stroke Risk after ED Diagnosis of TIA

•Michael Ross, MD•William Beaumont Hospital Research Institute•The Emergency Department Transient Ischemic Attack Accelerated Diagnostic Protocol


ResearchResearch

Seed Grants / Unsolicited ProposalsSeed Grants / Unsolicited Proposals

• Up to $5,000 grants, $25,000 total

• Promote new research

• Help secure future funding

• Identify the support source

• Specific area of interest

• Available for all EM practitioners


Opportunities For InvolvementOpportunities For Involvement

How You Can Become InvolvedHow You Can Become Involved

• Development of new cases• Become a speaker• Tell us about your preferred:

• Symposia, content, venues• Learning methods • Research grants

• Develop technology based applications

• Contact us: [email protected]

www.ferne.orgwww.ferne.orgCheck It Out !Check It Out !


Today’s MeetingToday’s Meeting• Grants by Genentech, EKR Therapeutics, Grants by Genentech, EKR Therapeutics,

the Medicines companythe Medicines company• Content developed independentlyContent developed independently• CME via EB MedicineCME via EB Medicine• Please comment Re: format, contentPlease comment Re: format, content• Thank you to Carla, Michele, Leah, EB Thank you to Carla, Michele, Leah, EB

Medicine, the EMRA Board and its Medicine, the EMRA Board and its members, and all of you!members, and all of you!


Questions?Questions?

www.FERNE.org

[email protected] 312 413 7490

ferne_emra_saem_2009_sloan_intro_051609_final04/18/23 12:55

Documents

Edward P. Sloan, MD, MPH EMRA/FERNE ED Clinical Policies Session: Optimizing the Care of ED Patients with Neurological Emergencies