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American Academy of Emergency Medicine

Public Enemy No. 1 - Obesity Challenges

        

                 

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Public Enemy No. 1: Obesity Challenges in the Management of
Morbidly Obese in the Emergency Department

Wednesday, February 17, 2016
8:00am-3:45pm

Jointly Provided by the California Chapter Division (CAL/AAEM)

Course Description
Course Fee
Credit Designation Statement
Learning Objectives
Course Schedule
Course Director

Course Faculty

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Course Description

According to the American Heart Association, currently, one in three U.S. adults is obese, and another third of Americans are overweight. In numbers, nearly 13 million children and 78 million adults in the United States are affected by the health and emotional effects of obesity on a daily basis.

Not only is there a physical and psychological toll for the obese, there is also a fiscal toll in that the disease costs $190 billion a year in weight-related medical bills.

A Gallup poll based on telephone interviews conducted November. 7-10, 2013, with a random sample of 1,039 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia revealed that, among actual health ailments, obesity ranks first, with 13% naming it.1

Are emergency physicians positioned to face this challenge?

This course is designed to enlighten the emergency physician to the health care issues directly related to the epidemic of obesity in children and adults and to provide an avenue in which to manage these challenges in the emergency department (ED). 

The World Health Organization began sounding the alarm on obesity in the 1990s!2

Key Facts3

  1. Worldwide obesity has more than doubled since 1980.
  2. In 2014, more than 1.9 billion adults, 18 years and older, were overweight. Of these over 600 million were obese.
  3. 39% of adults aged 18 years and over were overweight in 2014, and 13% were obese.
  4. Most of the world's population live in countries where overweight and obesity kills more people than underweight.
  5. 42 million children under the age of five were overweight or obese in 2013.
  6. Obesity is preventable.

References

  1. http://www.gallup.com/poll/165965/americans-say-cost-top-health-problem.aspx
  2. http://www.who.int/nutrition/topics/obesity/en/
  3. http://www.who.int/mediacentre/factsheets/fs311/en/

Course Fee

  • On or before January 25, 2016
    • $300 AAEM member
    • $400 Non-member
       
  • January 26, 2016 and after
    • $350 AAEM member
    • $500 Non-member
       
  • Course fee includes lunch

Credit Designation Statement

The American Academy of Emergency Medicine designates this live activity for a maximum of 4 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Learning Objectives

Obesity Defined

  1. Define obesity.
  2. Differentiate the difference between “overweight” and “obesity”.
  3. Describe bariatrics.

The Obesity “Epidemic”

  1. Describe the magnitude of the obesity dilemma in the United States.
  2. Understand the impact of this “epidemic” on the emergency physician.

Prehospital Challenges

  1. Describe assessment challenges in the prehospital setting.
  2. Discuss transport challenges of the morbidly obese.

ED Structural Challenges

  1. Discuss space/structural challenges and requirements of the morbidly obese in the ED.
  2. Describe patient handling and moving difficulties in the ED due to structural challenges.

Medical Complications of Obesity

  1. Describe medical conditions that have been attributed to obesity.
  2. Describe medical conditions that are correctable by an appropriate program of meal planning and physical activity.

Airway Management

  1. Describe the effect of excess fatty tissue on airway management.
  2. Recognize the importance of position with respect to airway management.
  3. Recognize the importance of preoxygenation.
  4. Describe dosing considerations of agents used to facilitate intubation and airway maintenance.
  5. Discuss optimal approach to airway management in the morbidly obese.

IV Access Issues

  1. Recognize why intravenous (IV) access is challenging in the morbidly obese.
  2. Describe techniques that aid in IV access in the obese patient.
  3. Discuss anatomic sites where IV access may be less of a challenge.

Drug Therapy Challenges

  1. Describe why achieving optimal drug dosing in obese patients can be extremely challenging.
  2. Consider safety profile of the medication when treating the morbidly obese.
  3. Recognize titration strategy of drugs in the obese patient.

Trauma Management

  1. Describe the injury patterns in the obese trauma patient.
  2. Discuss diagnostic dilemma.
  3. Comprehend the challenges of resuscitation.
  4. Develop skills needed in the resuscitation of the obese trauma patient.

The Obese Child

  1. Understand the complex disorder of childhood obesity.
  2. Describe medical complications associated with childhood obesity.
  3. Discuss ways and means in which the emergency physician may aid in the “battle” against childhood obesity.
  4. Describe the association of obesity and certain injury patterns.

Complications of Bariatric Surgery

  1. Understand risks associated with bariatric surgery.
  2. Describe the potential complications of bariatric surgery.
  3. Discuss the assessment and management of the bariatric surgery patient in the ED.

Gynecologic and Obstetric Complications 

  1. Describe the adverse effects of obesity on the reproductive system.
  2. Discuss pregnancy complications associated with overweight and obese women.
  3. Recognize fetal complications associated with pregnancy in obese women.

Imaging Challenges

  1. Understand the limited ability of currently designed imaging technology to accommodate the morbidly obese.
  2. Describe image quality challenges in the obese patient.
  3. Consider the best technique to image the morbidly obese for a given indication.

Course Schedule

Wednesday, February 17, 2016
8:00am-3:45pm

  8:00am
 

  Welcome & Introduction
  Joanne Williams, MD FAAEM

  8:10am
 

  Obesity Defined
  Erick Eiting, MD MPH MMM FAAEM

  8:25am
 

  The Obesity “Epidemic”
  Erick Eiting, MD MPH MMM FAAEM

  8:40am
 

  Prehospital Challenges
  Heather M. Prendergast, MD

  9:10am
 

  ED Structural Challenges
  Cynthia Price, MD

  9:40am

  Break

  9:50am     
 

  Medical Complications of Obesity              
 
Cynthia Price, MD

  10:30am
 

  Airway Management
  Joanne Williams, MD FAAEM

  11:00am
 

   IV Access Issues
   Kristin Berona, MD

  11:30am
 

   Drug Therapy Challenges
   Kathryn R. Challoner, MD MPH DTMH FACEP

  12:00am

 

   Lunch
   Trauma Management
   Joanne Williams, MD FAAEM

  1:15pm

   The Obese Child
   Emily A. Rose, MD FAAP FAAEM

  2:00pm
 

   Complications of Bariatric Surgery
   Alessandra Conforto, MD FAAEM

  2:30pm
 

   Gynecologic & Obstetric Complications
   
Sophie Terp, MD

  3:00pm
 

   Imaging Challenges
   Tarina Lee Kang, MD

  3:30pm
 

   Roundtable Discussion/Q&A
   All Faculty & Attendees

  3:45pm

   Adjourn

 


Course Director

Joanne Williams, MD FAAEM
Associate Professor of Clinical Emergency Medicine, Charles R. Drew University of Medicine & Science, Keck School of Medicine of USC, Los Angeles, CA


Course Faculty

Kristin Berona, MD
University of Southern California, Los Angeles, CA

Kathryn R. Challoner, MD MPH DTMH FACEP
Manhattan Beach, CA

Alessandra Conforto, MD FAAEM
LAC & USC Medical Center, Long Beach, CA

Erick Eiting, MD MPH MMM FAAEM
Los Angeles, CA

Tarina Lee Kang, MD
Director of Emergency Ultrasound, Assistant Professor of Emergency Medicine, Department of Emergency Medicine, Los Angeles County Medical Center and The University of Southern California, Los Angeles, CA

Heather M. Prendergast, MD
University Of Illinois, Chicago, IL

Cynthia Price, MD
Hartford Hospital, Division of Emergency Medicine, West Hartford, CT

Emily A. Rose, MD FAAP FAAEM
Los Angeles County - USC Medical Center, Arcadia, CA

Sophie Terp, MD
USC Keck School of Medicine, Santa Monica, CA              

Joanne Williams, MD FAAEM
Associate Professor of Clinical Emergency Medicine, Charles R. Drew University of Medicine & Science, Keck School of Medicine of USC, Los Angeles, CA

 

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