Thanks to the efforts of Dr. Mark Lyttle (@mdlyttle) APEM 2012 proved to be a resounding success. Here is a selection of some of the hot topics, mainly via the superb tweets of Dr. Natalie May (@_nmay) to fill those in who weren’t there and prompt further discussion and debate. A more detailed twitter feed can be found on my Storify site for Day One and Two and all the presentations will shortly be available via apem.me.uk. The links within the tweets should all work (let me know if not!)
1. Dr. Nick Sargent “Anaphylaxis – an evidence based update”
Not something I had really considered and wonder if I have ever missed this. It does appear studies on adrenaline versus salbutamol for acute asthma have taken place fairly recently http://www.ncbi.nlm.nih.gov/pubmed/16490653
Useful to consider how your local allergy/anaphlaxis pathways ensure suitable follow up?
2. Dr. Anne Frampton “PEM Training Update”
Although not directly related to the theme of the talk this is causing a lot of concerned conversations
Has your unit fully implemented toxbase guidance (sorry can’t link as password protected) that children should have bloods at 75mg/kg cut off? This technically means the calpol bottle glugger may need investigations when previously they could have gone home. It’s not entirely clear what consultation occurred before this change but consensus was this will result in unnecessary tests.
3. Dr. Mike Clancy “The future of Emergency Medicine”
Mike Clancy emphasised the need for departments to take the bull by the horns in engaging with the new world of commissioning, especially with LETBs . The workforce crisis has been taken on board by the DOH but solutions will not happen overnight.
4. Prof. Ronan O’Sullivan “Paediatric Procedural Sedation – an evidence based approach”
Ronan O’Sullivan has sent up an extensive curriculum around paediatric procedural sedation, in which consent must be obtained even for Nitrous Oxide. The reason being that the mindset created around consenting ensures the proper respect is shown to the procedure. It was great to see some anecdote being supported by other APEM delegates
5. Prof. Adam Finn “The impact of new vaccines in Paediatric Emergency Medicine”
So a number of vaccines will shortly be available in the UK – rotavirus from next year and a flu vaccine. The effects on Paediatric Emergency Departments potentially may be profound. Add in the addition of Men B (potentially) and you are left wondering what we all might be doing in a decade! Some food for thought…
6. Dr. Natalie May and Dr. Damian Roland “This house believes paediatric Emergency Medicine in the UK would benefit from more doctors in the UK being active on mainstream Social Media”
The against argument is available here
7. Dr. Lisa Munro Davies “Is there a role for ultrasound in Paediatric Emergency Medicine?”
Utilising Ultrasound in Paediatric Emergency Medicine is an inevitable progression as technology advances but the true overall utility has yet to be defined. There was much discussion about the best methods of gaining, developing and maintaining skills. What was clear is the Paediatric Emergency Medicine community would like to be masters of their own destiny in this regard.
8. Dr. Anne Kerr ” Should we use Tranexamic Acid in Paediatric Trauma”
TXA has a good safety profile in paediatric surgery but despite the large amount of patients in CRASH-2 we don’t have the paediatric data to know when and in which category of patient to most effectively give it. The RCPCH guidance should promote its use.
9. Dr. Catherine Bevan “Paediatric Cervical Spine Injuries – a pain in the neck?”
An interesting conundrum – true C-Spine injury astonishingly rare but consequences of missing potentially catastrophic. A sharp mind ad flexible thinking required.
10. Dr. Ffion Davies “Paediatric Trauma Networks: the national picture”
It was noticed that whatever national system is put in place there remains not an insignificant number of patients who present with high trauma scores who are brought directly to Emergency Departments by their parents….
11. Dr. Simon Chapman “Simulation in Practice”
Simulation continues to expand but the traditional APLS model is increasingly becoming replaced by more immersive scenarios. Key message was importance of debrief and need for role credibility to be maintained i.e. play the role you actually are!
Thanks for reading!