ACEP Scientific Assembly 2010 wrapup

I was a little concerned about whether I’d like going to the big yearly ACEP meeting, as I went to a couple of the spring conferences and found them lacking in experience, but the last of those was last several years ago.

This time I decided it was the right thing to do, and hoped I’d be able to socialize a bit.

Mandalay Bay was very nice, if laid out Texas-sized.  It was a 10 minute brisk walk (all indoors) to the three story conference center, which was nice and cool despite the reportedly radioactive heat outside.  There were a lot of exhibitors, and they were knowledgeable and professional.

First, the personal highlight, meeting the EM medbloggers!  I got to meet Shadowfax of Movin’ Meat, Nick of Blogborygmi, Graham of Grahamazon (and now The NNT), Symtym, Richard of his epononymously named effort, and WhiteCoat of Whitecoat Rants (who I thought had acromegaly, as opposed to Shadowfaxes’ remembrance of him as a little person…).  (We tried to take his picture but apparently he’s natively pixellated…).  We had individual and group meetups, and except for being remarkably better looking than the other attendees you couldn’t pick us out of a crowd.  Mark and Logan Plaster of EP Monthly were of course very nice (and flattering), and I also got to meet Edwin Leap, but I’m not sure he knew who I was as I didn’t use my pseudonym…

I also enjoyed the Fresno residency get-together, catching up with resident friends and faculty.  There’s something about those friends – hadn’t talked to some in years, and we picked up like we’d last talked 30 minutes before.  It’s probably the shared intense years, but it was remarkable.

Surprisingly, a few people at the meeting had heard of my blog, and one, who was also twittering from the same conference sought me out to have our picture made together!  It was interesting, fun, and humbling.

Speaking  of twitter, I tweeted the meetings I attended (I was tired and bagged the Friday morning meetings), and I guess I went a little tweet-nuts: according to @takeokun I had 281 tweets for the Tuesday, Wed and Thursday meetings.  I tried to post the highlights of the meetings; you can take from that number there were an awful lot of highlights!  For my tweets, which are part of my normal twitter stream look here, and for all 826 tweets from the Scientific Assembly, look for them under their hashtag: #sa10.

I wanted to hone-down the true practice-honing pearls, but there are so many I’ll just throw out the ones that come from the top of the mind:

• single unit blood transfusions are now perfectly fine, the ‘two-unit rule’ is dead
• hip dislocation reduction: use the Captain Morgan technique. Stand beside the bed, fix the pelvis to the bed, put your foot on the bed, put the patient’s affected-limb calf over your leg (right up to the knee), and reduce by flexing your ankle.
• nursemaid’s elbow reduction: hyperpronation, not the supinate-flex manouver.
• to more easily reduce an ankle dislocation, flex the knee first
• in ITP, you can give Rh POS patients rhogam (the antibodies coat the platelets and help prevent splenic sequestration and destruction)
• 90% of pts held in both ED hallway & upstairs hall preferred upstairs. “we think the other 10% liked being able to go smoke”
• “medicine is acting for ugly people” – Greg Henry
• Key clinical picture in thyroid storm is a tachycardia way out of proportion to their fever.
• Lid lag in hyperthyroidism: see the sclera when pt looks down, think hyperthyroidism.
• In thyrotoxicosis can use Li instead of iodine if they’re intolerant, as it has the same mech of action.
• “if the patient sees nothing and the doctor sees nothing, think retrobulbar neuritis”.
• “before you write anxiety as a diagnosis, remember, people get real anxious just before they die”.
• “I don’t understand why you would pay money to have someone rub your back; I understand why you’d pay to rub your front.” Greg Henry.

You get the idea…

I had fun, and will be going next year.  We need to get more attendees twittering the meetings they’re in.  (My iPad was the perfect tool for the job).  EM docs, get ready for next year, and get ready to twitter while you’re there!