2025 AAENP National Conference: EmergNP Speakers

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Keynote Session

Cindy Weston, DNP, APRN, FNP-BC, CHSE, FAANP, FAAN - Founding Dean and Professor, College of Nursing | UNT Health Science Center

The Problem Is All In Your Head: Brain and Cranial Nerve Disorders

Michael Sharma, MPAS, PA-C - Emergency Medicine PA; Adjunct Professor, UT Southwestern Medical Center, Dallas, TX

Abstract

Altered mental status, the worst pain of their lives, problems moving their face or extremities... sometimes the presentation of a patient with brain and cranial nerve disorders is as distressing to the patient as it is to the treating clinician. We'll review some common brain and cranial nerve pathology, the emergent work-up required to confirm your working diagnosis, and when a patient needs urgent or emergent treatment to prevent morbidity and mortality

Learning Objectives

• Utilize a novel mnemonic to remember the risk factors of cerebral venous thrombosis and understand how to best diagnose this life-threatening problem.
• Discuss the broad differential diagnosis for a patient with facial palsy and why "Bell's palsy" is probably the incorrect diagnosis at the patient's first presentation with this problem.
• Differentiate between different kinds of hearing loss and know when emergency treatment and consultation is indicated.

Medical Aesthetic Emergencies: Identification and Management in the Emergency Department

Kathleen Richardson, DNP, ARNP, FNP-C, ENP-BC, CEN, FAEN, FAWM, FAAN - Medical Director, Cossmedic Wellness and Aesthetics

Abstract

With the growing popularity of medical aesthetic procedures, emergency departments (EDs) increasingly encounter patients presenting with complications resulting from treatments such as injectable fillers, laser therapies, microneedling, and chemical peels. While most aesthetic procedures are performed safely, adverse events can range from mild allergic reactions to severe vascular occlusions, infections, and life-threatening anaphylaxis. This presentation aims to enhance the knowledge and preparedness of emergency clinicians in recognizing, assessing, and managing these unique medical aesthetic emergencies.

The session will provide an overview of common and uncommon complications arising from medical aesthetic procedures, including their pathophysiology, clinical presentations, and evidence-based management strategies. Key topics will include identifying early signs of filler-related vascular compromise, appropriate use of hyaluronidase in emergent cases, managing laser and chemical-induced burns, addressing infections following microneedling or non-ablative laser treatments, and the immediate treatment of allergic and anaphylactic reactions.

Through case studies and practical examples, participants will learn to differentiate between urgent and non-urgent presentations, prioritize interventions, and understand the role of collaboration with dermatologists and plastic surgeons. This knowledge is vital for reducing morbidity and improving outcomes in patients presenting to the ED with complications from aesthetic procedures.

By the end of this presentation, attendees will be equipped with a comprehensive understanding of medical aesthetic emergencies and gain confidence in delivering prompt and effective care in the emergency setting.

Learning Objectives

• Analyze and Differentiate Aesthetic Emergencies: Attendees will be able to analyze clinical presentations of complications from medical aesthetic procedures and differentiate between urgent and non-urgent cases in the emergency department.
• Apply Evidence-Based Management Protocols: Attendees will be able to apply appropriate evidence-based management protocols for various aesthetic emergencies, including the administration of hyaluronidase, wound care techniques, and emergency management of allergic reactions.
• Collaborate Effectively for Patient Care: Attendees will be able to collaborate effectively with interdisciplinary teams, including dermatologists and plastic surgeons, to develop comprehensive care plans that improve patient outcomes in medical aesthetic emergencies.

Applying a clinical practice guideline for the management of acute nontraumatic dental pain

Erica May, DNP, APRN, AGACNP-BC, FNP-BC, ENP-C - Assistant Professor of Nursing, Vanderbilt University School of Nursing

Abstract

Managing acute dental pain effectively while minimizing opioid use remains a key challenge in clinical practice. Dentists, emergency medicine physicians, and other healthcare providers frequently prescribe medications for pain relief. This presentation will explore the application of a clinical practice guideline developed jointly by the American Dental Association Science and Research Institute, the University of Pittsburgh, the University of Pennsylvania, and McMaster University in managing acute nontraumatic dental pain, emphasizing evidence-based strategies to reduce opioid prescriptions while ensuring adequate pain control. The focus will be on practical approaches for Emergency Nurse Practitioners to recognize and treat acute nontraumatic dental pain, while highlighting the importance of non-opioid alternatives and multidisciplinary collaboration in managing dental pain effectively and safely.

Learning Objectives

• Define non-traumatic acute dental pain.
• Review common patient presentations of acute nontraumatic dental pain in the Emergency Department.
• Discuss the application of an evidence based clinical practice guideline developed by the American Dental Association Science and Research Institute, the University of Pittsburgh, the University of Pennsylvania, and McMaster University for treatment of acute nontraumatic dental pain.

Almost There: Exploring the Hidden Risks of the Late Preterm Infant

LeAnn Baker, DNP, APRN, NNP-BC, C-ONQS - University of Louisville Assitant Professor, Neonatal APP Team Lead, and NNP Track Coordinator, University of Louisville

Toni Dobson, MSN, APRN, ENP-C, FNP-C, RNC-OB - Nurse Practitioner, Pediatric Emergency Medicine Associates

Abstract

Late preterm infants (LPI) may look physically mature, but they are at increased risk for neonatal complications. Jointly presented by a NNP and ENP, we will discuss the 6 most common ED presentations of the LPI. We will review the evidence-based best practices for the management of hyperbilirubinemia, sepsis/infection, hypoglycemia, hypothermia, feeding difficulties, and respiratory distress. We will be discussing the differences between how these patients are managed in the NICU vs the ED and how we as ENPs, can learn from our NNP colleagues. This lecture is a unique opportunity to learn directly from another nursing specialty how to improve our care of neonates in the ED.

Learning Objectives

• Differentiate patients who are late preterm infants and identify common complications of this population.
• Using PediTools, assess your patient’s level of hyperbilirubinemia and develop a treatment plan.
• Develop a management plan for an acutely hypoglycemic late preterm infant.
• Distinguish between non-emergent and emergent feeding difficulties of the late preterm infant.

Navigating Pediatric Dermatological Emergencies: Identification and Management

Bradley Rund, MSN, FNP-BC, NR-P, CEN, CPEN, CFRN, CCP-C, CMLI - Nurse Practitioner, Major Health Partners

Abstract

Pediatric dermatology cases account for 4-5% of annual emergency room visits. Each case can present a different and sometimes limited story that requires unique approaches to identification through history-taking, physical exam, and possibly diagnostic testing. The session will review commonly seen pediatric dermatologic emergencies and presentations. The participants will additionally gain a comprehensive knowledge in the ability to treat, refer, and ensure proper education is provided for these patients.

Learning Objectives

• Recognize commonly seen pediatric dermatology presentations seen in the emergency and urgent care settings
• Outline the methods and tools used for diagnosing dermatological conditions in children.
• Discuss the role of history-taking, physical examination, and when to use diagnostic tests or referrals
• Identify pharmacological treatment options for common dermatology cases

Essential ENT Knowledge for the ED: A Collaborative Perspective

Frederick Barton, MSN ENP FNP, NREMT-P - Emergency Nurse Practitioner, Oregon Emergency Physicians

Aaron Nakano, FNP, MSN RN

Abstract

This lecture will address common ENT issues in the emergency department as well as PEARLS and PITFALLS. Specifically, an ED provider and ENT will share their management techniques for perforated eardrums, epistaxis, and peritonsillar abscesses

• OBJECTIVES

Hitting the Bullseye on Pediatric Lyme Disease

Teresa Dodge, DNP, FNP-C, CEN - Nurse Practitioner, WellNOw

Abstract

Lyme disease is prevalent in the United States, especially in the Northeast. In fact, cases are only increasing and spreading further south. Pediatric patients, specifically those between the ages of five and fourteen, have the highest incidence of infection. Diagnosing and treating Lyme disease in pediatric patients can also be tricky, even for the most experienced nurse practitioners - the classic Lyme rash isn’t always a bullseye, and pediatric Lyme arthritis can mimic many other acute pediatric orthopedic diseases. To make things worse, in 2020, while we were all distracted by COVID, the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN), and the American College of Rheumatology (ACR) released an updated guideline for the management of Lyme disease. These updated guidelines significantly changed the treatment of some Lyme patients. This presentation will review Lyme disease in the pediatric population, its signs and symptoms, how to diagnose it, and how to treat it.

Learning Objectives

• At the conclusion of this presentation, attendees should be able to define Lyme disease.
• At the conclusion of this presentation, attendees should be able to summarize the best testing and screening for Lyme in pediatric patients.
• At the conclusion of this presentation, attendees should be able to summarize the pediatric treatment for Lyme disease and when to initiate prophylaxis.

When Delirium is the Diagnosis, Not Psychosis: Screening for Delerium in Patients with Serious Mental Illness (SMI) and Dementia

Sharon Rainer, PhD, APRN, ENP-C, FNP-BC, PMHNP-BC - Assistant Professor, Thomas Jefferson University

Abstract

The aim of this presentation is to provide a thorough understanding of how to effectively screen for delirium in patients with serious mental illness (SMI) or dementia in the emergency department (ED). Patients with SMI, such as schizophrenia or bipolar disorder, are at increased risk for delirium, which can complicate their clinical presentation and management. Early detection is crucial for preventing adverse outcomes and ensuring appropriate care. The importance of addressing underlying causes, stabilizing the patient, and employing supportive measures will be discussed. In addition, pharmacologic and non-pharmacologic interventions while considering the impact of these treatments on both delirium and pre-existing psychiatric conditions will be emphasized.

Learning Objectives

• Prepare emergency clinicians to distinguish delirium from psychosis and dementia, focusing on identifying key clinical features and using appropriate screening tools to ensure accurate diagnosis.
• Provide a practical guide for implementing screening protocols for delirium in patients with SMI and dementia, including the use of validated tools.
• Outline strategies for managing patients diagnosed with delirium, including addressing underlying causes, stabilizing symptoms, and coordinating care with multidisciplinary teams.

Recognizing and Management of Incarcerated Gravid Uterus in the Emergency Department: An Update for Treatment

Dr. Jill Ogg-Gress, DNP, APRN, FNP-c ENP-c - Associate Professor, Georgetown University School of Nursing

Abstract

This presentation aims to recognize and manage patients with symptoms suggestive of incarcerated gravid uterus (IGU) who present to the emergency department. It will outline strategies for identifying patients with complaints consistent with IGU, describe complications/risks, provide diagnostic recommendations, and discuss recently published new treatment strategies with minimally invasive ultrasound techniques for management. Case studies will also be provided during the presentation.

Learning Objectives

• Describe common patient complaints consistent with incarcerated gravid uterus
• Identify complications, risks, and diagnostics for incarcerated gravid uterus
• Discuss modalities for treatment of incarcerated gravid uterus including new treatment strategies

Social Determinants of Health for the ED Provider

Travis McCall, PhD, APRN, CCP - Assistant Professor/Flight Nurse Practitioner, Vanderbilt University School of Nursing/Vanderbilt LifeFlight

Abstract

Social determinants of health are non-medical factors that influence the health of individuals, communities, and populations. The Centers for Medicare and Medicaid Services (CMS) has prioritized the need to promote health equity, expand coverage, and improve overall health among patients who benefit from CMS programs. As emergency departments provide access to care for many patients who may be affected by social determinants of health, ENPs are positioned to improve health equity and patient outcomes in the provision of care. This lecture will describe social determinants of health, identify factors that may affect patient health, and discuss the implications of such factors when managing and dispositioning patients in the emergency department.

Learning Objectives

• Describe the influence of social determinants of health outcomes for individuals, communities, and populations.
• Identify factors affecting the health of individuals, communities, and populations within the context of the emergency department.
• Discuss the implications of social determinants of health in the management and disposition of patients in the emergency department.

The Not-So-Sweet Hidden Threat of Diabetic Ketoacidosis

Rachel Helms, DNP, APRN, AGACNP-BC, FNP-BC, ENP-C - Assistant Clinical Professor, Auburn University College of Nursing

Joni Winter, DNP, CRNP, FNP-BC, AGACNP-BC, ENP-C, CVNP-BC - Assistant Clinical Professor, Auburn University College of Nursing

Abstract

Euglycemic diabetic ketoacidosis (EDKA) is an uncommon but life-threatening process identified in patients with type 1 and 2 diabetes. The condition is characterized by normoglycemia in the setting of an anion gap, metabolic ketoacidosis. There are several risk factors for developing EDKA; however, increased risks are linked to SGLT2 inhibitor use, type 1 diabetes, and bariatric surgeries secondary to prolonged perioperative fasting.

EDKA occurs as serum insulin levels decrease and excess counter regulatory hormones develop due to a carbohydrate deficit. The resulting increased glucagon/insulin ratio causes lipolysis, increased free fatty acids, and ketoacidosis.

Unfortunately, the normal glucose level causes the diagnosis of EDKA to be delayed in almost 50% of patients. Therefore, EDKA should be included in the differential list for all patients with the risk factors and symptoms mentioned above.

In order to increase awareness and understanding of EDKA, this presentation will utilize a case study format to illustrate a patient who presents to the emergency department and is ultimately diagnosed with often-missed diagnosis.

Learning Objectives

• Recognize risk factors associated with euglycemic diabetic ketoacidosis (EDKA).
• Discuss the pathophysiology of EDKA.
• Identify the typical presenting symptoms and diagnostic criteria for EDKA.
• Develop an appropriate plan of care for a patient diagnosed with EDKA.

Navigating the Storm: Mastering Acute Alcohol Withdrawal in the Emergency Department

Sharon Rainer, PhD, APRN, ENP-BC, FNP-BC, PMHNP-BC - Assistant Professor, Thomas Jefferson University College of Nursing

Abstract

Acute alcohol withdrawal is a potentially life-threatening condition that requires prompt recognition and management to prevent severe complications such as seizures, delirium tremens (DTs), and cardiovascular instability. Effective management of acute alcohol withdrawal in the ED involves prompt identification, appropriate use of pharmacological and supportive treatments, and careful monitoring. Early intervention and proper follow-up are crucial for reducing complications and improving patient outcomes.

Learning Objectives

• Prepare emergency clinicians to accurately identify and assess the severity of acute alcohol withdrawal using clinical tools and symptom evaluation to ensure timely and effective intervention.
• Provide a detailed overview of current best practices for managing acute alcohol withdrawal, including pharmacological therapies and supportive care, to mitigate withdrawal symptoms and prevent complications.
• Develop strategies for effective patient disposition, including risk stratification and planning for appropriate next level of care.

I Only Turned My Back for One Second!! Most Common Pediatric Toxicological Emergencies Seen Today

Michael Schill III, DNP, FNP-BC, ENP-C, CEN, CFRN, MICN - Lead Advanced Practice Clinician, Apollo MD

Abstract

Each day, we are unaware of some dangers around the house. It only takes a moment for a pediatric patient to get into something potentially harmful. We have all heard the phrase from a parent: "I only turned my back for one second." This presentation will provide a review of the most common harmful household items and common medications. Whether you work in the Emergency Department or Urgent Care, this will help to review common signs and symptoms and up-to-date treatment. This interactive case scenario-based presentation will review and discuss pharmacological and non-pharmacological treatment modalities.

Learning Objectives

• Discuss the epidemiology of household ingestions in the pediatric population
• Describe evaluation and management of potentially fatal ingestion of a single prescription medication
• Identify common non-toxic toys that can still be toxic to the pediatric population

Rapid Fire: Critical Care Pharmacology Review

David Warren, FNP, ACNP, ENP, (CRNA, expected Dec 2024) - Nurse Practitioner, Integrative Emergency Services, David Warren NP PLLC

Abstract

This session delivers a fast-paced, comprehensive review of critical care pharmacology tailored for Emergency Nurse Practitioners. Attendees will delve into common essential drugs used in emergency and critical care settings, focusing on mechanism of action, dosing, expected effects, and indictions/contraindications. The session includes interactive case studies and real-world scenarios to enhance understanding and application. Topics covered will include vasoactive agents, sedatives/hypnotics, analgesics, and neuromuscular blockers/reversals. The goal is to equip participants with the knowledge to make swift, evidence-based decisions in critical care situations.

Learning Objectives

• Optimize drug administration: Understand the pharmacokinetics and pharmacodynamics of critical care drugs to optimize administration and dosing in emergency settings.
• Identify and manage side effects: Develop skills to identify and manage common drug side effects/adverse effects in critical care patients, and how to manage them.
• Enhance rapid decision-making: Apply current evidence to make rapid, informed pharmacological decisions in high-stakes situations.
• Implement Best Practices: Utilize case studies to implement best practices in the use of vasoactive agents, sedatives/hypnotics, analgesics, and neuromuscular blockers/reversals.

Taming the Toxins: Solutions for Ingestions and Exposures

Michael Gooch, DNP, APRN, CCP, FAASTN, FAANP, FAEN - Assistant Professor and Emergency-Flight NP, Vanderbilt University

Abstract

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 unique treatment plans. During this presentation, the typical toxidromes as well as a range of toxins, medications, and substances will be discussed. Newer agents of abuse such as xylazine and new strategies including high dose insulin and intralipid therapy administration will be reviewed.

Learning Objectives

• Identify applicable reversal agents in select toxic ingestions and exposures.
• Recall indications for high dose insulin and intralipid therapy in select toxic emergencies.
• Discuss appropriate ordering, monitoring, and risk assessment associated with reversal agents.

Little people, Big Emotions: Management of Pediatric Mental Health Emergencies

Bradley Rund, MSN, FNP-BC, NR-P, CEN, CPEN, CFRN, CCP-C, CMLI - Nurse Practitioner, Major Health Partners

Abstract

The number of pediatric mental health visits are continuing to rise in addition to the number of children with a pediatric mental health diagnosis. This presentation will examine the common pediatric mental health disorders and what acute behavioral episodes will look like in an emergency setting. It will explore considerations for the rule out of medical causes for behavioral disturbances. In addition to a review of non-pharmacological and pharmacological interventions to consider. This presentation will prepare you to feel more comfortable in evaluating and treating pediatric mental health visits.

Learning Objectives

• Recognize acute behavioral disorders in the presence of pediatric mental health disorders
• Apply non-pharmacological interventions to de-escalate pediatric acute behavioral cases
• Identify appropriate pharmacological options in collaboration with non-pharmacological interventions

Down on the Farm: Agriculture Illnesses and Injuries

Travis McCall, PhD, APRN, CCP - Assistant Professor/Flight Nurse Practitioner, Vanderbilt University School of Nursing/Vanderbilt LifeFlight

Abstract

“Down on the Farm: Agricultural Illnesses and Injuries” will describe illnesses and injuries among farm workers who may present to the emergency department. Content will include the incidence, diagnosis, and management of environmental exposures, vector-borne illnesses, toxicologic poisoning, and mechanical injuries that may occur among farm workers. Social determinants of health that may affect the care and health of farm workers will also be discussed.

Learning Objectives

• Describe the epidemiology of illnesses and injuries among farm workers.
• Understand the illnesses and injuries that may result from environmental, toxicologic, and mechanical exposures.
• Discuss evidence-based care and treatment of patients who suffer farm-related illnesses or injuries.

Autonomic Disorders Demystified: Collaborative Protocols for NPs in the ER

June Bryant, DNP, APRN, CPNP-PC - Assistant Professor/Medical Ambassador, University of Tampa, The Dysautonomia Project

Abstract

This presentation offers a deep dive into the recognition, assessment, and management of autonomic disorders—conditions that are often misunderstood and misdiagnosed in the fast-paced emergency environment.

Participants will gain a comprehensive understanding of autonomic dysfunction, including key symptoms, differential diagnoses, and the significant impact these disorders can have on patient outcomes. The course will introduce an evidence-based protocol specifically tailored for emergency departments, aimed at ensuring patients with autonomic dysfunction receive appropriate care and are not dismissed or mismanaged.

Additionally, the presentation emphasizes the importance of interdisciplinary collaboration, equipping nurse practitioners with the knowledge and tools necessary to work effectively alongside neurologists, cardiologists, and other healthcare providers. Through real-world examples and practical strategies, this session will empower NPs to lead the charge in improving care for patients with autonomic disorders, ultimately enhancing patient outcomes and reducing the frequency of emergency department revisits.

Learning Objectives

• Apply knowledge of autonomic disorders by identifying and differentiating key symptoms, understanding common misdiagnoses, and recognizing the impact on patient quality of life in emergency settings.
• Develop and implement an evidence-based protocol designed to systematically assess, manage, and refer patients presenting with symptoms of autonomic dysfunction.
• Evaluate current practices and enhance interdisciplinary collaboration by identifying roles and responsibilities of various healthcare providers, including emergency nurse practitioners, neurologists, cardiologists, and primary care providers, to create a coordinated care pathway that improves patient outcomes.

Buzz, Bite, and Battle: Vector-Borne Diseases in the ER

Elizabeth (Libby) Carger, DNP, FNP-BC, CNE - Nurse Practitioner, Duke Employee Occupational Health and Travel Clinic

Mustapha Debboun, PhD, BCE Fellow ESA - Consultant, Independent

Abstract

This evidence-based presentation addresses vectors and disease transmission to humans, including symptom assessment and guidance for best treatment practices. The speakers will explain the risks of encountering mosquito, tick and emerging vectors in the U.S. and endemic areas abroad. The presentation will include pathogens of greatest concern, emphasizing common and unusual symptoms. It includes guidance on when immediate treatment is essential. The speakers will address Alpha Gal syndrome, a sometimes serious food allergy that is conveyed by the lone star tick. Finally, they will discuss personal protection practices for bite avoidance, with tips for counseling patients, colleagues and the community-at-large.

Learning Objectives

• Identify vector-borne disease symptoms based on age-related presentation differences
• Recognize when and why prompt medical intervention can be crucial
• Evaluate patient risks based on where they live and travel
• Describe key vector behaviors and bite avoidance strategies for patients, colleagues and other stakeholders

New STEMI Equivalents

Jennifer Carlquist, PAC- C, ER CAQ - Physician Assistant, Cardiology Made Easy Inc.

Abstract

This will cover the new stemi quivalents outlined in the JACC article on how to manage chest pain in the ED that was published nov 15, 2022.

Learning Objectives

• Define dewinters t waves
• Define stemi equivalents
• Review wellens warning

Angioedema in the Emergency Department

Elizabeth Gilley, APRN, FNP-BC, RN - APP Fellow, Department of Emergency Medicine, UT Southwestern Department of Emergency Medicine

Abstract

This will be an evidence-based overview of Angioedema as it is encountered in the Emergency Department. It will include a review of (1) Angioedema Pathophysiology, (2) Assessment and Workup of Undifferentiated Angioedema, (3) Management of Angioedema, and (4) Disposition for patients presenting with Angioedema. See below for subsections within each topic as outlined above. The presentation will include case examples for further discussion and understanding.

Learning Objectives

• Pathophysiology of Angioedema: histamine-mediated, bradykinin-mediated, hereditary, acquired, ACEI-induced, Tissue Plasminogen Activator-Induced, idiopathic.
• Assessment and Workup of Undifferentiated Angioedema: differential diagnoses to consider, physical exam, diagnostic studies.
• Management of Angioedema: initial stabilization/management, pharmacologic management (epinephrine, antihistamines, corticosteroids, C1 Esterase Inhibitor Replacement Therapy, Recombinant C1 Esterase Inhibitor, Non–C1 Esterase Inhibitor Concentrate Therapy, Fresh Frozen Plasma, tranexamic acid, prophylactic medications).
• Disposition: general recommendations and considerations

Beyond the "Ds": Posterior Circulation Vascular Emergencies

Katherine Kruger, MSN, ENP, FNP, ACNP, CEN - Emergency Nurse Practitioner, University of Michigan

Abstract

Course will be a rapid fire overview of key typical and atypical presentations of posterior vascular emergencies- to include strokes, vertebral artery dissections, as well as sentinel aneurysms. We'll also discuss essential pathophysiology, history, and physical exam findings, as well as the current state of the evidence. Much of this will be presented in a case study format based off of a de-identified case.

Learning Objectives

• Identify essential history and PE findings to accurately suspect posterior strokes
• Identify necessary diagnostic and treatment pathways for suspected posterior circulation vascular emergencies
• Identify common pitfalls leading to failure to suspect a posterior vascular emergency.

Three Diagnoses You Should Never Make In the ED: GERD, PUD, and Gastritis

Michael Sharma, MPAS, PA-C - Emergency Medicine PA; Adjunct Professor, UT Southwestern Medical Center, Dallas, TX

Abstract

Abdominal pain is the most common emergency department chief complaint in adult patients. Ultimately, as many as 1 in 4 patients are discharged with no clear etiology to their pain. Although many discharged patients likely have nonemergent conditions like gastroesophageal reflux, peptic ulcer disease, and gastritis, it's important that we recognize the significance of these diagnoses when we use them for patients with new abdominal pain in the ED. We'll talk about common treatment for these conditions as well as dangerous mimics not to miss.

Learning Objectives

• Describe the diagnostic standards for GERD, PUD, and gastritis.
• List treatments for GERD, PUD, and gastritis as well as diagnostic testing needed to rule out emergent complications.
• Compare and contrast emergent conditions that can mimic GERD, PUD, and gastritis.

The Agony & Ecstasy of Sex Injuries

LaMon Norton, NP - Nurse Practioner

Abstract

Both consensual and nonconsensual sexual contact can have seriously negative health consequences. From the mild severity of "carpet burn" to the sequelae of a cerebrovascular event in a 30 year old, emergency care providers must have differential diagnosis thinking that focuses on appreciating risk for patients. This topic can be difficult for patients to discuss with candor, so the practitioner must apply both the art and science of medicine.

Learning Objectives

• Describe common sexual contact related injuries.
• Detect atypical contributing causes of episodic care visits.
• Evaluate all sexual assault presentations for choking injuries.

Talk Smart, Code Fast, Next Patient: Medical Decision Making in EM Documentation

Michael Sharma, MPAS, PA-C - Emergency Medicine PA; Adjunct Professor, UT Southwestern Medical Center, Dallas, TX

Abstract

Especially since 2023, the "medical decision making" section is by far the most important part of your emergency medicine documentation. We'll talk about different strategies for MDM charting, including what to make sure you document and also what to toss. In addition, we'll review updates to the 2023 American Medical Association emergency medicine coding and billing changes and ways to capture the heavy cognitive load involved in even a quick emergency department visit.

Learning Objectives

• Describe the purpose of the medical decision making section of your documentation and its relation to other parts of your documentation.
• List the three elements of coding and discuss how they interact to determine your level of coding and billing for emergency department visits.
• Utilize a point-of-care application to streamline your coding decisions in the emergency department.

Hard Truths, Soft Landings: Delivering Bad New with Compassion

Rachel Helms, DNP, APRN, AGACNP-BC, FNP-BC, ENP-C - Assistant Clinical Professor, Auburn University

Abstract

Emergency department providers frequently face the difficult responsibility of delivering bad news to patients and their families. Although this is always a challenging task, the fast-paced and high-pressure environment of the ED adds unique complexities that can intensify the difficulty. This presentation will equip providers with a thoughtful, compassionate approach to handling these tough conversations.

Learning Objectives

• Identify the unique challenges of delivering bad news in the emergency department.
• Understand the importance of an intentional approach to delivering bad news.
• Apply key communication techniques to deliver bad news in a compassionate and clear manner.

Advanced Airway Management in Emergency Care Settings

Michael Gooch, DNP, APRN, CCP, FAASTN, FAANP, FAEN - Assistant Professor and Emergency-Flight NP, Vanderbilt University

Abstract

Advanced airway management is the most common life saving intervention performed in emergency care settings. Unfortunately, this intervention does not come without risks. This presentation will review current recommended practices to improve success and reduce complications, especially hypoxia and hypotension. Airway assessment, preparation and planning, medication selection, and a brief overview of ventilator management will be included. At the conclusion of this presentation, emergency nurse practitioners will be better prepared to manage airways, reduce complications, and improve outcomes.

Learning Objectives

• Explain the priorities of airway management.
• Recall pharmacotherapeutic properties of medications used with advanced airway management.
• Plan appropriate interventions for patients with impaired airway and ventilations.
• Evaluate the effectiveness of interventions for patients with impaired airway and ventilation.

Mind the Gap: A Look at Toxic Alcohols

Nancy Denke, DNP, ACNP-BC, FNP-BC, FAEN, CEN, CCRN - Nurse Practitioner, Toxicology Consultants of Arizona

Abstract

When we consider alcohol toxicity as a diagnosis in the altered patient, the first thing that comes to mind is ethyl alcohol intoxication. However, it is important to understand that any alcohol, when consumed in sufficient quantity, can be toxic. Other “toxic alcohols” we frequently overlook include methanol, ethylene glycol, propylene glycol, and isopropanol (isopropyl alcohol). In this presentation, we examine 3 different scenarios: an intentional overdose, an agitated patient who will not give you a history, and an inebriated individual with numerous medical and psychiatric histories that you have “no clue what is going on with them.”. And lastly, the simple “very drunk.”. We will touch on propylene glycol, which is seen mainly in an inpatient setting with IV infusions that contain propylene glycol as an additive but must be “considered” in any patient. It is our job as providers to identify, treat, and manage the “rare” toxic alcohols that have potentially life-threatening diagnoses. And that is not so easy!

Learning Objectives

• Identify the clinical and laboratory clues to recognizing toxic alcohol poisonings
• Describe the goals of management and treatment in toxic alcohol poisoning
• Examine the time-sensitive management actions for these poisonings

Mitigating Malpractice Risks in the Emergency Department: Strategies for Emergency Nurse Practitioners

David Warren, FNP, ACNP, ENP, (CRNA, expected Dec 2024) - Nurse Practitioner, Integrative Emergency Services, David Warren NP PLLC

Abstract

This session will focus on practical strategies and best practices for Emergency Nurse Practitioners to minimize malpractice risks in the Emergency Department (ED). Attendees will explore the concept of “standard of care”, the anatomy of a malpractice claim, common sources of malpractice claims, learn risk management techniques, and understand the importance of thorough documentation and communication. The session will include case studies, legal insights, and interactive discussions to equip Nurse Practitioners with the tools needed to reduce liability and enhance patient safety. By the end of the presentation, participants will be able to apply these strategies in their daily practice, fostering a safer and legally sound clinical environment.

Learning Objectives

• Understand Legal Standards of Care and the anatomy of a malpractice claim: Explain the legal standards of care applicable to Nurse Practitioners in the Emergency Department and how adherence to these standards can prevent malpractice claims.
• Identify common malpractice risks: Recognize and understand the common sources of malpractice claims in the ED.
• Implement risk management strategies: Apply effective risk management techniques, including thorough documentation and clear communication, to minimize liability in emergency care.
• Develop effective communication skills: Strengthen communication skills with patients, families, and interdisciplinary teams to improve patient outcomes and reduce misunderstandings that can result in legal action.
• Implement proactive patient education: Design and implement patient education strategies that inform patients about their care plans, potential risks, and follow-up instructions, thereby reducing the risk of dissatisfaction and potential malpractice claims.

Emergency Nurse Practitioners

Kathleen Ahn, DNP, FNP-BC - Nurse Practitioner in Emergency Medicine, Volunteer Assistant Clinical Professor, UCI Sue & Bill Gross School of Nursing, Univeristy of California, Irvine Medical Center

Tonya Santiago, DNP, FNP-BC - Nurse Practitioner in Emergency Medicine, Volunteer Assistant Clinical Professor, UCI Sue & Bill Gross School of Nursing, Univeristy of California, Irvine Medical Center

Abstract

Nurse Practitioners employed in Emergency Medicine within an academic system have daily interactions with multiple specialty services. From Trauma Surgery to neurology, Ophthalmology to Rheumatology, Interventional Radiology to Colorectal Surgery, Hematology-Oncology and more, the breadth of academic medicine is represented within the system. ED NPs must be prepared to advocate for their patients by identifying a need for consult, formulating an appropriate consultation question, ordering preliminary lab or radiology testing in preparation for a potential consult, and then mastering an effective presentation to the consulting team so that a clinical need or question can be addressed. A case presentation to a specialist must be clear, concise, and tie together all pertinent information. The initial presentation to a consulting team can either forward the case expediently, or create a potential delay in care. When imposter syndrome affects NP practice, these interactions can be challenging.

Learning Objectives

• Name 7 skills the NP practicing in the Emergency Department of an Academic Medical Center must develop to facilitate meaningful interactions with a breath of specialty services.
• Discuss at least 5 elements of an effective case presentation to a specialty service within academic medicine.
• What are 3 common feelings of a professional who faces the challenges of Imposter syndrome
• Detail 5 affirmations and/or effective interventions for an NP who is addressing imposter syndrome, or feelings of anxiety and intellectual self-doubt, within the work environment
• Discuss a challenging case presentation you experienced that either succeeded, or did not succeed. Discuss any feelings of intellectual self doubt that may have influenced your clinical discussion, and your opinion of any effect on patient outcome.

Don’t Ask, Don’t Tell! Pregnancy-Related, Hypertensive Emergencies That Are Easy to Miss

Toni Dobson, MSN, APRN, ENP-C, FNP-C, RNC-OB - Nurse Practitioner, Pediatric Emergency Medicine Associates

Abstract

In this interactive, case-based presentation, we will cover a variety of ED presentations of pregnancy-related HTN, including pregnant and postpartum examples and some that were near-misses. Cases will be linked to the 2024 ACOG guidelines published to help non-obstetric providers manage pregnancy-related emergencies. We will discuss how to diagnose gestational hypertension, Pre-eclampsia, and Pre-eclampsia with severe features. Then, we will decide together how to treat each patient and determine who gets admitted and who goes home.

Learning Objectives

• Develop a method to consistently identify this at-risk population of women.
• Define mild and severe range blood pressure and identify what requires urgent management.
• Diagnose gestational hypertension, pre-eclampsia, and pre-eclampsia with severe features.

Advancing Pain Management in Emergency Medicine: Innovative Approaches to Regional Anesthesia

David Warren, FNP, ACNP, ENP, (CRNA, expected Dec 2024) - Nurse Practitioner, Integrative Emergency Services, David Warren NP PLLC

Abstract

This session will focus on innovative approaches and advancements in the use of regional anesthesia within the Emergency Department to control acute and chronic pain. Emergency Nurse Practitioners will gain insights into indications/contraindications to regional anesthesia, local anesthetic pharmacology, and basic/advanced regional anesthetic techniques that can be employed in the emergency department setting. Attendees will engage in case studies, and practice identifying anatomy on ultrasound images to understand how these advancements can enhance pain management and improve patient outcomes.

Learning Objectives

• Explore basic and advanced regional anesthesia techniques: Learn about the latest advancements in regional anesthesia, including ultrasound-guided nerve blocks, local anesthetic pharmacology, and their applications in the ED setting.
• Implement innovative pain management strategies: Develop the ability to apply new techniques and tools for regional anesthesia to improve pain management and patient outcomes in the emergency department.
• Optimize efficiency and safety: Analyze how advanced regional anesthesia techniques can reduce the need for systemic opioids and enhance overall efficiency and safety in patient care in the emergency department. Discuss local anesthetic systemic toxicity (LAST) and it’s treatment.
• Address and mitigate contraindications to regional anesthesia: Identify and address specific contraindications to regional anesthesia.
• Specific regional anesthetic blocks: Utilize evidence-based approaches to compare and contrast different regional anesthetic techniques that can be utilized in emergency medicine, including upper extremity blocks, lower extremity blocks, and truncal blocks.