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101/121 - Rapid Cycle Deliberate Practice Simulation for Difficult Airway Management (2 hours)
Date/Time: Thursday, April 20 / 10:20 - 12:30 (2 hours)
Using an actual case of Can’t intubate/Can’t Oxygenate as the basis for discussion, a modified approach to the difficult airway algorithm will be introduced. Using a high-fidelity simulation mannequin and cricothyrotomy task trainers, participants will have the opportunity to participate in Rapid Cycle Deliberate Practice simulation to practice and reinforce the concepts learned. The session will emphasize Crisis Resource Management principles. The session is best suited for participants with some airway experience such as physicians practicing Emergency medicine or anesthesia.
1. Define and communicate a robust airway plan for a patient requiring Rapid Sequence Intubation.
2. Apply Crisis Resource Management skills to recognize the need to progress down the difficult airway algorithm.
3. Execute a front of the neck airway on a cricothyrotomy task trainer.
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129 - Pediatric Status Epilepticus (To be repeated)
Date/Time: Thursday, April 20 / 11:30 - 12:30
Intraosseous placement provides faster access, less complications and a higher success rate.
This workshop provides information regarding intraosseous access, insertion locations, indications, contraindications, and practice of insertion devices to introduce the clinician to the basics of intraosseous access.
1. Describe the anatomy and pathophysiology of intraosseous devices.
2. Identify the advantages of using intraosseous devices.
3. Recognize indications to increase use of intraosseous devices.
4. Interpret the need to elevate the comfort level of healthcare team members utilizing the intraosseous devices.
5. Practice Intraosseous Access.
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148 - Lung PoCUS
Date/Time: Thursday, April 20 / 13:30 - 14:30
Participants will learn an approach to using PoCUS to assess for pulmonary pathology in a patient with dyspnea.
1. Understand the clinical questions that can be answered with lung PoCUS.
2. Describe PoCUS findings of pneumothorax, pleural effusion, and pulmonary edema.
3. Complete hands-on practice on models with PoCUS instructors.
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149 - Pediatric Status Epilepticus (Repeat)
Date/Time: Thursday, April 20 / 13:30 - 14:30
Intraosseous placement provides faster access, less complications and a higher success rate.
This workshop provides information regarding intraosseous access, insertion locations, indications, contraindications, and practice of insertion devices to introduce the clinician to the basics of intraosseous access.
1. Describe the anatomy and pathophysiology of intraosseous devices.
2. Identify the advantages of using intraosseous devices.
3. Recognize indications to increase use of intraosseous devices.
4. Interpret the need to elevate the comfort level of healthcare team members utilizing the intraosseous devices.
5. Practice Intraosseous Access.
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203/223 - Scar Release Workshop (2 hours)
Date/Time: Friday, April 21 / 08:00 - 10:10 (2 hours)
This hands-on workshop reviews the pathophysiology of scars, mechanisms of tissue changes secondary to scar release, patient assessment, treatment technique, patient responses to treatment, and aftercare considerations. A presentation patient will be assessed and treated in real time to illustrate the changes in subjective pain and objective movement.
Participants will learn the myoActivation technique of scar release which can be immediately integrated into clinical practice. In many patients, release of surgical or traumatic scars results in a fundamental change in chronic pain symptoms. Release of pre-existing scars prior to surgery can improve pain, mobility, and balance while releasing scars in the postoperative period can improve postoperative pain and dysfunction. Scar release has effective application in treatment of patients presenting to an emergency department.
Through practice exercises in pairs, participants will experience the sensation of treatment and the changes in range of movement from release of their own scars.
1. Understand the biomechanical effect of scars and consequential effect on persistent pain and mobility restriction.
2. Acquire confidence in safely and effectively altering the physical properties of scars through a dry needling technique.
3. Have fun with needles!
Note: Participants will be required to sign an informed consent to receive scar release treatment and to deliver scar release treatment.
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206 - Advanced Techniques for the Anatomically Difficult Airway: SALAD, Awake, and Fibreoptic Intubation
Date/Time: Friday, April 21 / 08:00 - 09:00
This rotating workshop will allow participants to troubleshoot and gain hands-on experience with difficult anatomic airways. Techniques practiced will include suction-assisted laryngoscopy and airway decontamination (SALAD), awake laryngoscopic intubation, and fibreoptic intubation.
1. Perform Suction Assisted Laryngoscopy & Airway Decontamination (SALAD) to manage the grossly soiled emergency airway.
2. Develop the multiple techniques available for topicalizing the airway in order to facilitate awake intubation.
3. Demonstrate the ability to intubate a simulation task trainer using a bronchoscope/endoscope.
4. Describe the role of video laryngoscopy as a tool in awake intubation.
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207/227 - The Occasional Facial Laceration (2 hours)
Date/Time: Friday, April 21 / 08:00 - 10:10 (2 hours)
The discussion of facial lacerations is important because it considers issues that are common to the management of all laceration as well as some special features related to the face.
In this workshop it will be possible to learn about how to identify suture indications to get the best cosmetic result in suturing facial lacerations.
1. Describe the anatomy and pathophysiology of facial lacerations.
2. Identify the advantages of different types of facial suture.
3. Recognize indications for facial sutures.
4. Interpret the need to raise the comfort level of health team members in facial sutures.
5. Practice facial suturing in occasional facial laceration.
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228 - A POCUS Workshop: Needle Guidance & Foreign Body Identification/Removal (To be repeated)
Date/Time: Friday, April 21 / 9:10 - 10:10
Using POCUS for the location and removal of foreign bodies, as well as US guidance for central and peripheral venous line placement improves both your success rate and patient care. This session is a hands on workshop using models to practice techniques to improve ultrasound guided needle placement and identification of foreign bodies.
In this workshop, participants will have the opportunity to practice locating and extracting foreign bodies embedded in models using POCUS. Participants will also use POCUS to practice needle guidance techniques.
1. Review the use of POCUS in locating foreign bodies in tissue.
2. Demonstrate an understanding of foreign body location using POCUS.
3. Development of skills for foreign body extraction using POCUS.
4. Gain familiarity with low cost models that can be easily replicated for ongoing practice and teaching.
5. Review the use of POCUS in procedures such as IV and central line insertion.
6. Demonstrate an understanding of the using POCUS for visualization in procedures.
7. Develop techniques for needle guidance using ultrasound.
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248 - DVT POCUS
Date/Time: Friday, April 21 / 13:30 - 14:30
Attendees will participate in this combined didactic and hands-on session to develop a practical approach for when, why, and how to perform DVT POCUS in a rural setting. Attendees may be asked to act as models and should have a change of shorts if possible!
1. Learn the technique, pearls and pitfalls of performing Point of Care Ultrasound (POCUS) for lower extremity venous thrombosis.
2. Develop a rural centric workflow for work-up and treatment of lower extremity DVT.
3. Get hands on practice with the technique.
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264 - Difficult Airway Management: A Team-Based Approach
Date/Time: Friday, April 21 / 14:40 - 15:40
This presentation is aimed at multidisciplinary healthcare teams with the goal of improving unanticipated difficult airway management. Similar to standardized training for other life-threatening events (i.e. cardiac arrest), we feel that having common language and a shared mental model will enhance provider confidence, team performance and patient care in the management of a difficult airway.
1. List predictors of a difficult airway and define failure of airway capture.
2. Identify recommended equipment for difficult airway management.
3. Explain the Canadian Airway Focus Group 2021 consensus guidelines for unanticipated difficult airway management.
4. Describe the equipment required and steps involved to perform a scalpel-bougie surgical cricothyroidotomy for emergency front of neck access.
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267/287 - Development, Fabrication & Hands-on Practice on 3D Printed Simulators in the Context of Training for Rural & Remote Practice (2 hours - to be repeated)
Date/Time: Friday, April 21 / 14:40 - 17:00 (2 hours)
Background: Additive manufacturing (AM) is a relatively new technique that is disrupting simulation based education. Three dimensional (3D) printing is the most known form of AM. The benefits of AM include customization of simulators to fit any context and the reduction of costs. The overarching purpose of this workshop will be to allow the attendees to learn about 3D printing and practice psychomotor/technical skills on these simulators.
Format:
The workshop will consist of three parts:
Part 1: 1-hour didactic session that will address objectives 1- 3.
Part 2: 1-hour hands on experience that will address objective 4.
Part 1 will be a mix of didactic and hands-on experiences. It is strongly advised that all participants bring a laptop with internet connection. First, using Tinkercad software, the participants will work on designing and customizing a very simple suture pad. In the reminder of part 1, they will work with silicone solutions and 3D printed models to build a prototype suture pad. In part 2, all participants will be divided into 3 small sub groups and each group will be able to practice skills on three simulators: suturing, IO and perineal repair. They will also be able to explore more complex simulators such as needle decompression, anal sphincter repair, and intravenous insertion skills.
1. Demonstrate proficiency at the use of hardware, software and selection of manufacturing materials available and the operations of 3D printers.
2. Modify a simple 3D model for printing.
3. Create silicone solutions to construct soft tissues.
Hands on practice
4. Understand the difference between AM created models vs commercially available ones by testing both for:
a. Suturing
b. Intraosseous (IO) Insertion
c. Perineal repair
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284 - Tools and Techniques for Difficult Airway Management
Date/Time: Friday, April 21 / 16:00 - 17:00
The aim of this workshop is to discuss techniques and tools that can assist with management of both the anticipated and unanticipated difficult airway. We recognize that individual rural and remote communities will have different levels of practitioner experience and tools available for difficult airway management. Therefore, we will present a variety of airway adjuncts and techniques to help participants develop skills that are relevant to their community and area of practice.
1. Review recommended equipment for difficult airway management.
2. Demonstrate and practice scalpel-bougie surgical cricothyroidotomy for emergency front of neck access, including the use of ultrasound for anatomic landmarking.
3. Demonstrate and practice intubation via laryngeal mask airway.
4. Review recommendations for difficult airway carts/boxes.
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300 - Airway Management in Trauma
Date/Time: Saturday, April 22 / 08:00 - 09:00
This will be a practical update on what's new in airway management in trauma, in addition to some practical tips and trick. I will be focusing on:
1) BVM as the 1st crucial skill in resuscitation. How to do it well…it’s much harder than it looks to do properly.
2) SGA like the LMA or iGel
3) Cricothyroidotomy - the simple scalpel, finger, bougie technique.
Understand the current state of literature for best practices in airway management in trauma including:
-'C' before 'A' or resuscitate before you intubate.
- Management of the soiled airway.
- Airway checklist and algorithms - why are they worth the time.
- CICO emergencies and how to train for the surgically inevitable airway.
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303/323 - Basic Suturing Workshop (To be repeated) (2 hours)
Date/Time: Saturday, April 22 / 08:00 - 10:10 (2 hours)
Two instructors, using video and slide material, will describe the equipment required for suturing, common suture material, and demonstrate frequently used suture techniques. Participants will have the opportunity to perform these techniques on pigskin under supervision.
1. Learn equipment and basic suturing techniques for lacerations and minor surgery.
2. Learn appropriate application of the various techniques.
3. Have an opportunity to practice techniques under supervision.
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304/324 - PRACTISS Rural Simulations (2 hours)
Date/Time: Saturday, April 22 / 08:00 - 10:10 (2 hours)
This workshop is meant to help novice or inexperienced practitioners become comfortable facilitating effective medical simulations using PRACTISS (Peer-Run Applied Cases for Teaching Interdisciplinary Simulations and Scenarios)--a FOAMED online platform we developed to help those in rural and remote areas deliver simulation education to their peers or learners. Participants are encouraged to bring their own tablets or laptops, though this is not required.
The workshop will begin with a brief presentation outlining the importance of simulations in rural environments, and the barriers impeding its implementation in the rural and remote context. We will then introduce how the PRACTISS platform helps overcome those barriers, and briefly describe the platform's main features - its database of scenarios, prebrief and debrief scripts, facilitator supports, and live feedback tools.
The attendees will then be broken into small groups of 3-4, and given tablets if they did not bring their own devices. In groups, the attendees will each get the chance to facilitate fun non-medical simulation scenarios using the PRACTISS platform. Doing so, attendees will become familiar with using PRACTISS’ tools to run effective simulation experiences as novice facilitators–from the prebriefing of the simulation to the debriefing and the collection of feedback. A presenter will help coach each group through the activity.
Groups will be brought together at the end for a final debriefing discussion and question period.
1. Recognize the importance of effective medical simulation activities in rural environments and how PRACTISS helps overcome barriers to their implementation.
2. Identify, explore, and perform the key components of effective medical simulation activities using PRACTISS–including the prebrief, the simulation itself, the debrief, and the collection of feedback.
3. Become comfortable facilitating a rural medical simulation with minimal experience, resources, and preparation.
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307/327 - Development, Fabrication & Hands-on Practice on 3D Printed Simulators in the Context of Training for Rural & Remote Practice (2 hours) (Repeat)
Date/Time: Saturday, April 22 / 08:00 - 10:10 (2 hours)
Background: Additive manufacturing (AM) is a relatively new technique that is disrupting simulation based education. Three dimensional (3D) printing is the most known form of AM. The benefits of AM include customization of simulators to fit any context and the reduction of costs. The overarching purpose of this workshop will be to allow the attendees to learn about 3D printing and practice psychomotor/technical skills on these simulators.
Format:
The workshop will consist of three parts:
Part 1: 1-hour didactic session that will address objectives 1- 3.
Part 2: 1-hour hands on experience that will address objective 4.
Part 1 will be a mix of didactic and hands-on experiences. It is strongly advised that all participants bring a laptop with internet connection. First, using Tinkercad software, the participants will work on designing and customizing a very simple suture pad. In the reminder of part 1, they will work with silicone solutions and 3D printed models to build a prototype suture pad. In part 2, all participants will be divided into 3 small sub groups and each group will be able to practice skills on three simulators: suturing, IO and perineal repair. They will also be able to explore more complex simulators such as needle decompression, anal sphincter repair, and intravenous insertion skills.
1. Demonstrate proficiency at the use of hardware, software and selection of manufacturing materials available and the operations of 3D printers.
2. Modify a simple 3D model for printing.
3. Create silicone solutions to construct soft tissues.
Hands on practice
4. Understand the difference between AM created models vs commercially available ones by testing both for:
a. Suturing
b. Intraosseous (IO) Insertion
c. Perineal repair
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328 - Using Ultrasound to Assess Volume Status in the Office
Date/Time: Saturday, April 22 / 09:10 - 10:10
Ultrasound can be very helpful in the assessment of fluid status in patients with CHF. Quick views of the heart, IVC, and lungs can contribute significantly to your physical exam to help guide therapeutic management and avoid adverse side effects. In this workshop we will briefly review all three exams and offer the opportunity to practice any one of these exams or do all three in a "putting it all together" exercise.
1. Review Parasternal Long Axis of the heart to assess for ejection fraction.
2. Review IVC to assess for volume status.
3. Review views above the diaphragm to assess for "B" lines.
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341/361 - Physical Examination of the Ear, Nose, Oral Cavity, Oropharynx, and Neck (2 hours)
Date/Time: Saturday, April 22 / 13:30 - 15:40 (2 hours)
RELEVANCE. Knowledge and competencies in the examination of the ENT-Neck are essential in generalist practice. However, several publications in the UK, US, and Canada have underscored the inadequate focus on the ENT-neck in undergraduate and postgraduate medical education. Moreover, the shift to online education and virtual patient care during the pandemic has decreased the opportunities for hands-on practice of physical examination techniques.
WORKSHOP DESCRIPTION. We developed a workshop focused on learning physical examination techniques of the ENT-neck. The workshop will consist of the following: (a) a 45-minute lecture and live demonstration of PE techniques and relevant findings; (b) a 75-minute hands-on practice. Regular otoscopes and video-otoscopes will be available for practice. The participants will be divided into groups; the workshop facilitators will assist and provide feedback.
LEARNING STRATEGIES. The workshop is designed with several strategies for learning. Relevance is established by using only topics listed in CFPC's Assessment Objectives for Certification in Family Medicine (2020). Handouts with photos of examination techniques and anatomical areas will be provided. Immediate feedback on examination techniques and findings will be provided.
At the end of the workshop, the participants will have achieved the following:
1. Reviewed the techniques of and common findings in physical examination (PE) of the ear, nose, oral cavity, throat (oropharynx only), and neck (ENT-Neck).
2. Watched a live demonstration of the PE of the ENT-Neck.
3. Practiced techniques of PE of the ENT-Neck on another participant. To provide immediate feedback of PE techniques, the participants will use a video-otoscope attached to a laptop. To teach the depth and pressure of palpation, the presenters will palpate consenting participants.
Note: PE of the ENT-Neck will need the consent of the person being examined. It is recommended that participants register in pairs or register with a partner in mind.
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343/363 - Basic Suturing Workshop (Repeat) (2 hours)
Date/Time: Saturday, April 22 / 13:30 - 15:40 (2 hours)
Two instructors, using video and slide material, will describe the equipment required for suturing, common suture material, and demonstrate frequently used suture techniques. Participants will have the opportunity to perform these techniques on pigskin under supervision.
1. Learn equipment and basic suturing techniques for lacerations and minor surgery.
2. Learn appropriate application of the various techniques.
3. Have an opportunity to practice techniques under supervision.
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347 - Advanced Wound Assessment and Suturing Workshop (To Be Repeated)
Date/Time: Saturday, April 22 / 13:30 - 14:30
This workshop will look at more complex wound types (traumatic or surgical) and help with developing an approach to closure. We will discuss surgical planning for excisional biopsies, undermining, subcutaneous wound closure to reduce tension at the wound site and different flap repairs / considerations. Corner stitch and stellate wound repairs will also be reviewed.
1. Surgical wound planning and closure.
2. Traumatic wound assessment and closure of complex wounds.
3. Undermining wound edges and subcutaneous suturing technique to reduce tension and other considerations for the best cosmetic results.
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348 - A POCUS Workshop: Needle Guidance & Foreign Body Identification/Removal (Repeat)
Date/Time: Saturday, April 22 / 13:30 - 14:30
Using POCUS for the location and removal of foreign bodies, as well as US guidance for central and peripheral venous line placement improves both your success rate and patient care. This session is a hands on workshop using models to practice techniques to improve ultrasound guided needle placement and identification of foreign bodies.
In this workshop, participants will have the opportunity to practice locating and extracting foreign bodies embedded in models using POCUS. Participants will also use POCUS to practice needle guidance techniques.
1. Review the use of POCUS in locating foreign bodies in tissue.
2. Demonstrate an understanding of foreign body location using POCUS.
3. Development of skills for foreign body extraction using POCUS.
4. Gain familiarity with low cost models that can be easily replicated for ongoing practice and teaching.
5. Review the use of POCUS in procedures such as IV and central line insertion.
6. Demonstrate an understanding of the using POCUS for visualization in procedures.
7. Develop techniques for needle guidance using ultrasound.
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349 - Chest Tubes (To be repeated)
Date/Time: Saturday, April 22 / 13:30 - 14:30
We will discuss the indications for chest tube drainage, the rationale for using small diameter tubes and those inserted via Seldinger technique. We will spend a significant amount of time inserting chest tubes in models and review the mechanics of chest tube drainage.
1. To understand the indications and contraindications for chest tubes.
2. To understand the pros and cons of small diameter tubes and those inserted via Seldinger technique.
3. To practice the insertion of Seldinger technique chest tubes in relatively realistic models.
4. To discuss various aspects of the mechanics of chest drainage.
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367 - Advanced Wound Assessment and Suturing Workshop (Repeat)
Date/Time: Saturday, April 22 / 14:40 - 15:40
This workshop will look at more complex wound types (traumatic or surgical) and help with developing an approach to closure. We will discuss surgical planning for excisional biopsies, undermining, subcutaneous wound closure to reduce tension at the wound site and different flap repairs / considerations. Corner stitch and stellate wound repairs will also be reviewed.
1. Surgical wound planning and closure.
2. Traumatic wound assessment and closure of complex wounds.
3. Undermining wound edges and subcutaneous suturing technique to reduce tension and other considerations for the best cosmetic results.
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368 - Perineal Repair (To be repeated)
Date/Time: Saturday, April 22 / 14:40 - 15:40
After a short review of what evidence there is for practice in this area, we’ll have a chance to do perineal repairs on a model. This will be geared to the medical learner or those in early / resuming practice.
1. Be familiar with evidence-based practice in this area.
2. Practice perineal repair.
3. Learn pearls from other participants.
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369 - Chest Tubes (Repeat)
Date/Time: Saturday, April 22 / 14:40 - 15:40
We will discuss the indications for chest tube drainage, the rationale for using small diameter tubes and those inserted via Seldinger technique. We will spend a significant amount of time inserting chest tubes in models and review the mechanics of chest tube drainage.
1. To understand the indications and contraindications for chest tubes.
2. To understand the pros and cons of small diameter tubes and those inserted via Seldinger technique.
3. To practice the insertion of Seldinger technique chest tubes in relatively realistic models.
4. To discuss various aspects of the mechanics of chest drainage.
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388 - Perineal Repair (Repeat)
Date/Time: Saturday, April 22 / 16:00 - 17:00
After a short review of what evidence there is for practice in this area, we’ll have a chance to do perineal repairs on a model. This will be geared to the medical learner or those in early / resuming practice.
1. Be familiar with evidence-based practice in this area.
2. Practice perineal repair.
3. Learn pearls from other participants.
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