Principles of Critical Care Medicine for Non-Intensive Care Specialists

SIXTH ANNUAL Principles of Critical Care Medicine for Non-Intensive Care Specialists Sept. 26-29, 2018 SEAPORT HOTEL, BOSTON, MASSACHUSETTS CARL J. SHAPIRO SIMULATION AND SKILLS CENTER (SASC) AT BETH ISRAEL DEACONESS MEDICAL CENTER FEATURING ADVANCED SIMULATION AND PROCEDURAL TRAINING WORKSHOPS FOR PHYSICIANS, NPs, PAs AND APNs INTERACTIVE CASE-BASED LECTURES HANDS-ON PROCEDURAL TRAINING LIVE PATIENT DEMONSTRATIONS Hands-on skills practice ultrasound-guided vascular access and IO placement Current management strategies for pulmonary embolism Principles of mechanical ventilation Differential diagnosis of shock and best practices for vasopressor use Best practices for critical care nutrition Evidenced-based management of arrhythmias Updates in the management of ARDS in 2018 Approaches to common toxicology challenges Best practices for management of alcohol withdrawal Tangible strategies for managing delirium in your ICU Individualized thoracic ultrasound and echocardiography training on live patient models (advanced training) Updates in diagnosis and management of the critically ill cardiac patient in 2018 (advanced training) Integrated high-fidelity simulation cases and procedural training in our state-of-the-art simulation center at BIDMC (advanced training) EARN UP TO: 32.00 AMA PRA Category 1 Credits 7.25 Risk Management Credits

Course Overview Keeping pace with the rapid changes in evidence-based critical care medicine is a challenge for specialty-trained intensivists; for non-intensivists, the challenge of staying up to date may be overwhelming. This cutting-edge CME course is intended to provide core clinical critical-care skills to health care providers who are not trained as intensivists but whose clinical duties involve taking care of critically ill patients. The focus of this course will be to highlight recent important evidence-based advances in the practice of modern critical care medicine. Our outstanding faculty, recognized as experts in the field, will use diverse teaching methodologies including: didactic sessions, interactive case-based discussions, Q&As and procedural, clinical management and hands-on simulation practice sessions. These sessions will assess your reasoning and strategies for incorporating, synthesizing and applying core critical knowledge. Master the skills you need to practice modern critical care medicine by customizing your learning experience Choose from a variety of specific-population workshops that are included in your tuition, or take advantage of the hands-on and advanced training sessions to enhance your medical and procedural skills. The following intensive care problems and techniques will be addressed in this comprehensive course: Mechanical ventilation Ultrasound End-of-life care in the ICU Shock and vasopressors Toxicology Bleeding and transfusions Sedation Delirium ARDS Infections and antimicrobials Who Should Attend? All health care professionals who are not trained as intensivists but whose clinical duties involve the care of critically ill patients, including: Emergency medicine physicians Hospitalists and nocturnists Family practitioners Cardiologists Critical care physicians Obstetriciansgynecologists Surgeons Anesthesiologists PAs Nurse practitioners Other health care professionals who are commonly involved in the care of critically ill patients in intensive care settings Learning Objectives 1. Review the basic principles of mechanical ventilation and describe indications for noninvasive and invasive ventilation. 2. Identify specific causes of delirium in critically ill patients, interpret signs of delirium in the critically ill and characterize appropriate sedation goals to prevent delirium. 3. Describe evidenced-based utilization of blood transfusions in the ICU. 4. Categorize different types of shock, describe the pathophysiologic mechanism behind each and formulate appropriate treatment strategies. 5. Rapidly assess causes and determine appropriate initial treatment for patients in cardiopulmonary arrest and identify best practices for post-arrest treatment. 6. Identify appropriate steps for ultrasound-guided cannulation of the internal jugular vein. 7. Demonstrate increased understanding of contemporary evidence-based practice in critical care. 8. Integrate point-of-care ultrasound in the ICU. 9. Describe treatment options for critically ill patients with pulmonary emboli. 10. Diagnose and treat commonly encountered electrolyte abnormalities.

CORE COURSE REGISTER ON OR BEFORE JUNE 1 REGISTER AFTER JUNE 1 Physicians and Allied Health Professionals $845 $945 Residents and Fellows in Training $545 $645 ADVANCED TRAINING LIMITED AVAILABILITY Hands-on Vascular Access (offered 7 times) $100 each Utilizing Point-of-Care Ultrasound in the ICU: A Hands-on Workshop for Ultrasound Novices $475 Care of the Critically Ill Cardiac Patient $350 Simulation and Skills Lab Workshop at BIDMC (transportation provided) $525 Fees are shown in USD. Your tuition includes daily breakfast and morning and afternoon refreshment breaks. All course participants will receive a comprehensive digital syllabus and complimentary Internet access. General Information REGISTRATION, PAYMENT, CONFIRMATION AND REFUND POLICY You may register by credit card (Visa, MasterCard or American Express) or check using s secure online registration system. A processing fee of $5 (USD) will be assessed per transaction. Upon receipt of your paid registration, an email confirmation from the HMS-GCE office will be sent to you. Be sure to include an email address that you check frequently. Your email address is used for critical information, including registration confirmation, evaluation and certificate. Refunds, less an administrative fee of $150, will be issued for all cancellations received two weeks before the start of the course. Refund requests must be received by postal mail, email or fax. No refunds will be issued should cancellation occur less than two weeks before. No shows are subject to the full course fee, and no refunds will be issued once the conference has started. ACCREDITATION The is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The designates this live activity for a maximum of 32.00 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity. NEW! ABIM MAINTENANCE OF CERTIFICATION Successful completion of this CME activity enables the participant to earn up to 32.00 MOC points in the American Board of Internal Medicine s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC points. NURSE PRACTITIONERS AND REGISTERED NURSES For the purpose of recertification, the American Academy of Nurse Practitioners Certification Board and American Nurses Credentialing Center accept AMA PRA Category 1 Credit issued by organizations accredited by the ACCME (Accreditation Council for Continuing Medical Education). We would also suggest that learners check with their state licensing board to ensure they accept reciprocity with AMA PRA Category 1 Credit for relicensure. PHYSICIAN ASSISTANTS The National Commission on Certification of Physician Assistants (NCCPA) states that AMA PRA Category 1 Credits are acceptable for continuing medical education requirements for recertification. We would also suggest that learners check with their state licensing board to ensure they accept reciprocity with AMA PRA Category 1 Credit for relicensure. RISK MANAGEMENT This activity meets the criteria of the Massachusetts Board of Registration in Medicine for 7.25 credits of Risk Management Study. This includes.75 Credit of Opioid Education and Pain Management Training and 1.0 Credit of End-of-Life Care Studies. Please check with your individual state licensing board requirements before claiming Risk Management Credits. EUROPEAN ACCREDITATION Through an agreement between the American Medical Association and the European Union of Medical Specialists, physicians may convert AMA PRA Category 1 Credits to an equivalent number of European CME Credits (ECMECs ). Information on the process of converting AMA PRA Category 1 Credits to ECMECs can be found at www.eaccme.eu. CANADIAN ACCREDITATION The Royal College of Physicians and Surgeons of Canada recognizes conferences and workshops held outside of Canada that are developed by a university, academy, hospital, specialty society or college as accredited group learning activities.

COURSE DIRECTORS Margaret Molly Hayes, MD DIRECTOR Assistant Professor of Medicine Associate Program Director, Internal Medicine Residency Director, Medical Critical Care Education Director, Intensive Care Medicine Clerkship Peter F. Clardy, MD Assistant Professor of Medicine Chair, Department of Medical Education Intensivist, Medical and Surgical Intensive Care Units Mount Auburn Hospital COURSE LOCATION All sessions for this activity will be held at: The Seaport Hotel One Seaport Lane Boston, MA 02210 Tel: 617-385-4000 www.seaportboston.com ACCOMMODATIONS AND TRAVEL A limited number of rooms have been reserved until Sept. 4 at the Seaport Hotel. Please call 617-385-4000 or 1-877-SEAPORT and specify that you are attending the HMS Critical Care Medicine course to take advantage of the reduced group rate of $329 single/ double. Discounted rooms may sell out before the expiration date. Early reservations are encouraged. Please do not make nonrefundable airline reservations until you have received an email from the HMS-GCE office confirming your paid registration. INQUIRIES By phone at 617-384-8600, Monday-Friday, 9:00am - 5:00pm (ET), or by email at ceprograms@hms.harvard.edu. CME activities accredited by are offered solely for educational purposes and do not constitute any form of certification of competency. Practitioners should always consult additional sources of information and exercise their best professional judgment before making clinical decisions of any kind. Jakob I. McSparron, MD Assistant Professor of Medicine Associate Director of the Critical Care Medicine Unit Associate Program Director for the Pulmonary and Critical Care Medicine Fellowship University of Michigan J. Woodrow Weiss, MD Professor of Medicine Chief, Division of Pulmonary, Critical Care and Sleep Medicine Morgan I. Soffler, MD Instructor in Medicine Michael C. Gavin, MD, MPH, FACC ADVANCED CARDIOLOGY TRAINING DIRECTOR ADVANCED TRAINING: CARE OF THE CRITICALLY ILL CARDIAC PATIENT Instructor in Medicine Director, Cardiac Direct Access Unit Director, General Cardiology Inpatient Service Duane S. Pinto, MD, MPH ADVANCED CARDIOLOGY TRAINING DIRECTOR ADVANCED TRAINING: CARE OF THE CRITICALLY ILL CARDIAC PATIENT Associate Professor of Medicine Director, Intensive Care Unit Associate Director, Interventional Section

Day 1: Wednesday, Sept 26 OPTIONAL SESSION 7:00am - 8:15am HANDS-ON VASCULAR ACCESS 1 (pre-registration required breakfast provided) 7:15am - 8:15am General Registration and Continental Breakfast 8:15am - 8:20am Transition 8:20am - 8:25am Introduction and Overview 8:25am - 9:15am Principles of Mechanical Ventilation: What You Must Know to Care for Vented Patients A Didactic and Take-Home Self-Assessment 9:15am - 10:00am Critical Care Toxicology: What You Must Know in the Era of the Opioid Crisis 10:00am - 10:20am 10:20am - 11:05am The Tricks of Tracheostomy: Who, When, How and What to Do with Complications 11:05am - 12:00pm Update in Management of Refractory Hypoxemia in 2018 12:00pm - 1:45pm Lunch Break (on your own) 12:30pm - 1:45pm HANDS-ON VASCULAR ACCESS 2 12:45pm - 1:45pm Workshop 1: Small Adults? Critical Care of the Pediatric Patient 12:45pm - 1:45pm Workshop 2: Practicing Critical Care in Resource- Poor Settings Lessons Learned from the International Experience 1:45pm - 1:50pm Transition 1:50pm - 2:20pm Test Your Knowledge: A Case-Based Review Ripped from the BIDMC Case Files 2:20pm - 3:10pm Are You a Restrictive or Liberal Transfusionist? Best Practices for Blood Transfusions in 2018 3:10pm - 4:10pm Diagnosis and Management of Commonly Encountered Infections in the ICU 4:10pm - 4:30pm 4:30pm - 5:30pm Consolidating Your Knowledge: A Live Ventilator Demonstration to Move Your Knowledge from Plateau to Peak 5:30pm - 5:35pm End-of-Day Wrap-up 5:35pm - 5:45pm Transition to Optional Sessions 5:45pm - 7:00pm HANDS-ON VASCULAR ACCESS 3 5:45pm - 6:45pm Workshop 3: ECMO 101 HANDS-ON VASCULAR ACCESS SESSIONS During this workshop, you will receive individualized instruction in ultrasound basics and central venous catheterization for internal jugular, subclavian and femoral venous access, as well as ultrasound-guided peripheral IV insertion. You will have the opportunity to practice these skills, with supervision and feedback from our experts, on our ultrasound-compatible, highfidelity task trainers. This workshop includes multiple stations for each skill to maximize instructor-to-learner ratios and allows learners to choose and move to the various stations at their own pace/skill level. Learners of all levels are welcome, as individual instruction is tailored to the needs of the learner. Day 2: Thursday, Sept 27 OPTIONAL SESSION 6:45am - 8:00am HANDS-ON VASCULAR ACCESS 4 (pre-registration required breakfast provided) 7:00am - 8:00am Continental Breakfast 8:00am - 8:05am Break 8:05am - 8:20am Consolidating Your Knowledge: Mechanical Ventilation Self-Assessment Review 8:20am - 9:10am Diagnosis and Management of Shock 9:10am - 9:45am Fire Fast, Pace Slow: Management of Common Arrythmias 9:45am - 10:05am 10:05am - 10:45am Deconstructing Oxygen Delivery A Show-and-Tell Session

10:45am - 11:20am Best Practices for Management of Alcohol Withdrawal in the ICU 11:20am - 12:15pm To Lyse or Not to Lyse: Is That Really the Question? Controversies in the Management of Pulmonary Embolism An Interactive Panel with Audience Participation 12:15pm - 2:00pm Lunch Break (on your own) 12:45pm - 2:00pm HANDS-ON VASCULAR ACCESS 5 1:00pm - 2:00pm Workshop 4: The Other Machine in the Room: Breaking Down CRRT 1:00pm - 2:00pm Workshop 5: Critical Thinking in Critical Care: Mitigating Cognitive Errors to Improve Patient Care 2:00pm - 2:05pm Transition 2:05pm - 2:45pm Salt and Water: Caring for Patients with Common Electrolyte Abnormalities 2:45pm - 3:45pm When Leukocytosis Is Not Sepsis: Evaluation, Management and Triage of Benign and Malignant Hematologic Emergencies 3:45pm - 4:00pm 4:00pm - 4:45pm Updates in Neurocritical Care for the General Intensivist 4:45pm - 5:30pm Beyond the Guidelines: Diagnosis and Management of Sepsis in 2018 5:30pm - 5:35pm End-of-Day Wrap-up 5:35pm - 5:45pm Transition to Optional Sessions 5:45pm - 7:00pm HANDS-ON VASCULAR ACCESS 6 5:45pm - 6:45pm Workshop 6: Creating a Culture of Dignity at the End of Life in Your ICU Day 3: Friday, Sept 28 OPTIONAL SESSION 6:45am - 8:00am HANDS-ON VASCULAR ACCESS 7 (pre-registration required breakfast provided) 7:00am - 8:00am Continental Breakfast 8:00am - 8:05am Break 8:05am - 9:05am Happy? Grumpy? Sleepy? Best Practices for Managing Delirium in Your ICU 9:05am - 9:40am Starving to Life: Nutrition in Critical Illness 9:40am - 10:25am To Scope or Not to Scope: Management of GI Bleeding in the ICU 10:25am - 10:45am 10:45am - 11:15am Beyond the NAC Drip: Diagnosis and Management of Liver Failure 11:15am - 12:00pm Top Ten Pearls for Appropriate Use of Noninvasive Ventilation in Your ICU 12:00pm - 12:30pm Quality over Quantity: Important QI Changes to Make in Your ICU 12:30pm - 12:35pm Closing Remarks ADVANCED TRAINING Utilizing Point-of-Care Ultrasound in the ICU: A Hands-on Workshop for Ultrasound Novices This course will provide ultrasound novices with tips, tricks and skills to evaluate decompensating patients in the ICU. Groups are small to facilitate one-on-one attention from faculty as you practice ultrasounding live models. You will practice basic cardiac echo for point-of-care evaluation to determine cardiac function, right heart strain, tamponade and volume assessments, as well as basic pleural ultrasound skills to detect a pneumothorax, pleural effusion and pulmonary edema. You will walk away with improved comfort and confidence to start using the ultrasound in the ICU. This course is designed for those with little to no ultrasound experience. 1:00pm - 6:00pm The Use of Ultrasound to Aid in Diagnosis Small-Group Rotations (live patient models) Parasternal Long and Short Subcostal and IVC Apical 4 Chamber The Basics of Pleural Ultrasound

ADVANCED TRAINING Care of the Critically Ill Cardiac Patient This workshop is designed for those who take care of patients in cardiac care units and cardiovascular intensive care units. This is intended for learners of all levels, including cardiologists who care for these patients. Taught by Harvard Medical School cardiologists, this advanced training will provide practitioners in CCUs and CVICUs with tangible strategies and novel ways to improve the care of critically ill cardiac patients, including: Up-to-date evidence and advice on choosing the best mechanical circulatory-support devices Tips for managing challenging heart-failure patients Strategies to effectively care for post-tavr patients This workshop is a MUST for those who manage critically ill cardiac patients. Early registration is encouraged due to limited space. 2:00pm - 2:30pm Myocardial Infarction in the ICU: Considerations for Complex Medical and Surgical Patients 2:30pm - 3:15pm Tricks of the Trade: Advanced Management of Decompensated Systolic CHF 3:15pm - 3:45pm Severe AS in the ICU: Management Before and After Percutaneous Intervention 3:45pm - 4:00pm Refreshment Break 4:00pm - 4:45pm Circulatory-Assist Devices in the ICU 4:45pm - 4:50pm Transition to Simulation Sessions 4:50pm - 7:00pm Live Demonstration and Hands-on Impella Simulation Day 4: Saturday, Sept 29 ADVANCED TRAINING Simulation and Skills Lab Workshop at BIDMC Join us in our state-of-the-art simulation center to test out the skills you learned in the course during a highly interactive and hands-on workshop. During this session, learners will participate in a high-fidelity critical care simulation, practice airway management skills from a respiratory therapist and an anesthesiologist and learn how to place chest tubes, dialysis lines and more! Our multidisciplinary group of trained educators will bring you a high-yield and interactive educational experience that you must not miss. Register early, as space is limited! 8:00am Bus departs from the Seaport Hotel to the Carl J. Shapiro Simulation and Skills Center (SASC) at BIDMC 8:30am - 8:45am Welcome and Simulation Center Overview 8:45am - 12:45pm Small-Group Rotations Integrative High-Fidelity Critical Care Simulations: Put Your New Skills into Practice Hands-on Deliberate Practice: Thoracenteses and Chest Tubes Taught by an Interventional Pulmonary Expert Airway Management: Training from Masking to Intubating and Everything in Between Advanced Vascular Access: Hands-on Practice Placing Large Bore Lines and Confirming Venous Placement 12:45pm - 1:00pm Closing Remarks 1:10pm Bus returns to the Seaport Hotel