Edward P. Sloan, MD, MPH Associate Professor Department of Emergency Medicine University of Illinois College of Medicine Chicago, IL

Attending Physician Emergency Medicine University of Illinois Hospital Our Lady of the Resurrection Hospital Chicago, IL

Overview

Overview Mission Statement The Foundation for the Education and Research in Neurological Emergencies is an independent not-for profit organization committed to the following principles: Patients with neurologic emergencies deserve quality emergency care. The emergency care for neurologic emergencies can be enhanced through quality scientific research. Emergency medical care providers can provide optimal medical care for patients with neurological emergencies through participation in quality medical education that highlights state-of-the-art neurologic care.

Overview Goals Increased access to quality care Improved patient advocacy Improved patient care Enhanced diagnostic skills Optimal acute management Cost-effective Emergency Medicine Enhanced practice of Emergency Medicine

Overview Goals FERNE plans to achieve these goals through: Development of educational curricula Training of Emergency Medicine professionals Development of a network of collaborators Collaboration with Universities Hospitals Clinicians Researchers

Administrative

Administrative Incorporation Initial grant from Parke-Davis Incorporated in Delaware, 1997 Not-for-profit organization (501-C3) Registered to do business in Illinois Registered as non-profit organization in Illinois

Administrative Board of Directors Edward P. Sloan, MD, MPH, FACEP Board Chairman and President Associate Professor Department of Emergency Medicine University of Illinois School of Medicine Attending Physician Emergency Medical Service University of Illinois Hospital, Chicago

Andy Jagoda, MD, FACEP Treasurer Professor Department of Emergency Medicine Mount Sinai School of Medicine Attending Physician Department of Emergency Medicine Mount Sinai School of Medicine, New York, NY Administrative Board of Directors

J. Steven Huff, MD, FACEP Secretary Associate Professor Emergency Medicine and Neurology University of Virginia Attending Physician Department of Emergency Medicine University of Virginia

Administrative Board of Directors William G. Barsan, MD, FACEP Professor and Chair Department of Emergency Medicine University of Michigan, Ann Arbor Attending Physician Department of Emergency Medicine University of Michigan, Ann Arbor

Administrative Board of Directors Michelle Biros, MS, MD, FACEP Associate Professor Department of Emergency Medicine University of Minnesota Senior Associate Physician Department of Emergency Medicine Hennepin County Medical Center, Minneapolis, MN

Administrative Board of Directors E. Bradshaw Bunney, MD, FACEP Associate Professor Department of Emergency Medicine University of Illinois School of Medicine Attending Physician Emergency Medical Service University of Illinois Hospital, Chicago

Administrative Board of Directors Steven C. Dronen, MD, FACEP Associate Head Section of Emergency Medicine Department of Surgery University of Michigan Staff Physician Emergency Department University of Michigan Medical Center, Ann Arbor, MI St. Joseph Mercy Medical Center, Ypsilanti, MI

Administrative Board of Directors James R. Roberts, MD, FACEP Chairman Department of Emergency Medicine Mercy Health Systems, Philadelphia, PA Professor of Emergency Medicine Allegheny University of the Health Sciences Medical College of Pennsylvania/Hahnemann University

Administrative Infrastructure Dell PowerEdge 1400 Server Canon XL1 digital camcorder Adobe Video Editing Software Real-One Video Streaming Software CD-ROM Burners websitewww.FERNE.org Listserve of interested participants

Administrative Brochure

Administrative FERNE Booth

Administrative Newsletter Quarterly Distribution: ACEP, SAEM, NEIG, AAEM, EMRA Future meetings Research updates Collaborations Grants

Administrative Newsletter

Administrative Collaborations American Association of Emergency Medicine (AAEM) American Stroke Association (ASA) American College of Emergency Physicians (ACEP) Emergency Medicine Foundation (EMF) Emergency Medicine Residents’ Association (EMRA) International Brain Injury Association (IBIA) Society for Academic Emergency Medicine (SAEM)

Administrative Future Collaborations National Association of EMS Physicians (NAEMSP) EMedHome.com ePocrates.com

Education

Education Primary Intended Audiences Emergency Medicine practitioners Emergency Medicine residents Emergency Medicine educators

Education Intended Audiences Non-physician providers of emergency care Advocacy Groups Emergency Medicine Organizations Government and Public Health Organizations Industry Sponsors Neurologic Emergency patients and their families

Education Curriculum Development Standardize training of EM residents SAEM’s Neurologic Interest Group ACEP Clinical Policies Committee

Education Educational Meetings Residents’ Case-based Courses Teach-the-Teachers’ Courses Practitioners’ Courses

Education Branded Product Uniform case-based content –Cases –Introductions –Case outcomes –References –Annotated bibliography –Questions and answers to test knowledge

Education Course Handouts Binders – Cases, introductions, case outcomes, references, annotated bibliographies –PowerPoint presentation handouts –Course evaluation forms CD-ROM – Power Point presentations

Education Branded Product: Binder

Education CD-ROMs Material from educational courses Annotated PowerPoint slides Stroke materials, Spring 2002 Seizure materials, Spring 2003 TBI materials, Spring 2004

Education Branded Product: CD-Rom

Education FERNE Courses Fit into the larger meeting’s agenda minute presentations Presentations on the latest guidelines Rational use of resources Optimize patient outcomes

Education International EM Meetings Mediterranean EM Congress, Stresa, 2001 ACEP Clinical Policies, Amsterdam, 2002 UIC EM, Havana, 2003 Mediterranean EM Congress, Barcelona, 2003

Education National EM Meetings American Academy of Emergency Medicine (AAEM) American College of Emergency Physicians (ACEP) National Association of EMS Physicians (NAEMSP) Society for Academic Emergency Medicine (SAEM)

Education CME Web-based CME pending CME at national educational meetings CME at state and local meetings CME: University of Illinois at Chicago

Education Web-based Learning Case-of-the-Month Videostreaming course materials Downloadable slide-based lectures Abstract search vehicle

Education Case-of-the-Month Neurological emergency case-of-the-month. PowerPoint presentation Cases, introduction, case outcomes, references, annotated bibliography, and question and answer section Interactive Grant money available eMedhome.com: 250,000 hits/month

Education 2002 FERNE Courses TBI & Stroke Lectures, AAEM, March 2002, SF, CA CPC & EBM Course, ACEP, April 2002, Amsterdam Seizure Symposium, SAEM, May 2002, St. Louis, MO Pediatric Case Course, SAEM, May 2002, St. Louis, MO Stroke Palm Course, SAEM, May 2002, St. Louis, MO Case Studies Course, ACEP, Oct 2002, Seattle, WA Seizure Symposium, ACEP, Oct 2002, Seattle, WA

Education 2001 FERNE Courses Stroke Course, ACEP, October 2001, Chicago, IL Residents' Course, ACEP, October 2001, Chicago, IL Seizure Symposium, ACEP, October 2001, Chicago, IL Case Studies Course at the First Mediterranean Emergency Medicine Congress, September 2001, Stresa, Italy Stroke Symposium, SAEM, May 2001, Atlanta, GA Residents' Course, SAEM, May 2001, Atlanta, GA

Education FERNE Courses Stroke Symposium, ACEP, October 2000, Philadelphia, PA Residents' Course, ACEP, October 2000, Philadelphia, PA Residents' Course, SAEM, May 2000, San Francisco, CA Residents’ Course, ACEP, May 1999, Boston, MA Residents’ Course, ACEP, October 1999, Las Vegas, NV

Education FERNE Supported Lectures Blood Can Be Very Bad, Part I: Head CT Interpretations for Emergency Physicians Jeff Kline, MD, Carolinas Healthcare System, Charlotte, North Carolina Blood Can Be Very Bad, Part II: Head CT Interpretations for Emergency Physicians Andrew Perron, MD, University of Virginia Health System, Charlottesville, Virginia Use of AEDs in Seizure & Migraine Disorders ACEP, Philadelphia, PA, October 2000 Brain Injury Symposium at the World International Brain Injury Congress Turin, Italy, May 2001

Education FERNE Courses EMRA/FERNE Resident’s Course ACEP, October 2001, Chicago, IL The Neurologic Exam in ED Patients With Suspected TIA/CVA Edward Sloan, MD, MPH, FACEP A Case of Sudden Severe Headache Andy Jagoda, MD, FACEP A Case of Eye Pain and Confusion Daniel Murphy, MD, FACEP A Case of Dizziness William Barsan, MD, FACEP

Education FERNE Courses EMRA/FERNE/ASA Stroke Symposium ACEP, October 2001, Chicago, IL Transient Ischemic Attacks Rodney Smith, MD Ischemic Anterior Circulation Stroke Edward Jauch, MD, MS Ischemic Posterior Circulation Stroke Christopher Lewandowski, MD Hemorrhagic Stroke Andrew Asimos, MD Subarachnoid Hemorrhage Nina Gentile, MD Clinical Use of tPA With Stroke Edward Sloan, MD, MPH

Education FERNE Courses FERNE Seizure Symposium ACEP, October 2001, Chicago, IL Developing Clinical Guidelines Andy Jagoda, MD Seizure Recognition/EEG Use in the ED J. Stephen Huff, MD New Onset Seizures Andy Jagoda, MD Managing Sub-therapeutic AED Levels: Oral Versus IV Loading Edwin Kuffner, MD First-line Therapy in Acute Seizure Management William Dalsey, MD Status Epilepticus: Medication Alternatives Edward Sloan, MD, MPH

Education FERNE Courses FERNE Case Studies Course September 2001, Stresa, Italy The Neurologic Examination for the Emergency Physician Andy Jagoda, MD New Onset Headache: Diagnosis and Management Michelle H. Biros, MD, MS Spontaneous Vertebral Artery Dissection William Barsan, MD Status Epilepticus (SE): Diagnosis and Management Edward P. Sloan, MD, MPH

Education FERNE Courses Brain Injury Symposium May 2001, Turin, Italy Epidemiology of Traumatic and Ischemic Brain Injuries G. Citerio, MD Guidelines for the Management of Minor Head Injuries in Adults Ivo Casagranda, MD Management of Moderate and Severe Head Injuries Ignacio Previgliano, MD Acute Stroke Identification and Treatment: ‘Time is Brain’ Andy Jagoda, MD Pathophysiology of Brain Injury F. Della Corte, MD Traumatic Brain Injury Case Scenario Workshop Maurizio Berardino, MD

Education FERNE Courses EMRA/FERNE Residents’ Course May 2001, Atlanta, GA The Focused Neurologic Exam Arjun Chanmugam, MD Pediatric Seizure Edward Sloan, MD, MPH Low Back Pain E. Bradshaw Bunney, MD Amnesia Allan Wolfson, MD Violent Patients Scot Hill, MD

Education FERNE Courses ASA/FERNE Stroke Symposium May 2001, Atlanta, GA Epidemiology of Stroke Dexter L. Morris, MD, PhD Pathophysiology of Stroke Sid Shah, MD The Focused Neurologic Exam in Stroke Arjun Chanmugam, MD Transient Ischemic Attacks Rodney Smith, MD Ischemic Anterior Circulation Stroke Edward Jauch, MD, MS Ischemic Posterior Circulation Stroke Christopher Lewandowski, MD Hemorrhagic Stroke Andrew Asimos, MD

Education FERNE Courses ASA/FERNE Stroke Symposium May 2001, Atlanta, GA Subarachnoid Hemorrhage Nina Gentile, MD Systems in Acute Stroke Care Andy Jagoda, MD Pre-hospital Care in Stroke Todd Crocco, MD Neuroimaging of Stroke Andrew Perron, MD Clinical Use of tPA With Stroke Edward Sloan, MD, MPH Research Horizons/Future Therapies E. Bradshaw Bunney, MD

Education FERNE Courses EMRA/FERNE Residents’ Course ACEP, October 2000, Philadelphia, PA The Neurologic Exam Andy Jagoda, MD The Case of the Comatose Prisoner James Roberts, MD Hemiparesis: The Emerging Role of the Emergency Physician in Stroke Management Edward Sloan, MD, MPH Double Vision: Differentiating Emergent from Non-emergent Processes J. Stephen Huff, MD Mild Traumatic Brain Injury: Diagnosis and Management Andy Jagoda, MD

Education FERNE Courses FERNE Stroke Symposium ACEP, October 2000, Philadelphia, PA The Focused Neurologic Exam in Stroke Arjun Chanmugam, MD Transient Ischemic Attacks Rodney Smith, MD Ischemic Anterior Circulation Stroke Edward Jauch, MD, MS Hemorrhagic Stroke Andrew Asimos, MD Ischemic Posterior Circulation Stroke Christopher Lewandowski, MD Subarachnoid Hemorrhage Nina Gentile, MD

Education FERNE Courses FERNE Residents’ Course SAEM, May 2000, San Francisco, CA The Focused Neurologic Exam Andy Jagoda, MD Hemiparesis: The Emerging Role of the Emergency Physician in Stroke Management Edward Sloan, MD, MPH Double Vision: Differentiating Emergent from Non-emergent Processes J. Stephen Huff, MD Thunderclap Headache: A Challenge in Clinical Decision Making Michael Gerardi, MD Weakness: Using a Systematic Approach to Localizing Pathology Peter Shearer, MD

Education FERNE Courses FERNE Stroke Symposium SAEM, May 2000, San Francisco, CA Hemiparesis: The Emerging Role of the Emergency Physician in Stroke Management Edward Sloan, MD, MPH Double Vision: Differentiating Emergent from Non-emergent Processes J. Stephen Huff, MD Thunderclap Headache: A Challenge in Clinical Decision Making Michael Gerardi, MD Weakness: Using a Systematic Approach to Localizing Pathology Peter Shearer, MD

Education FERNE Courses FERNE Residents’ Course SAEM, May 1999, Boston, MA Acute Dizziness and Vertigo: Diagnosis, Assessment, and Management Gregory Bergey, MD Altered Mental Status/Confusion J. Stephen Huff, MD Mild Traumatic Brain Injury Andy Jagoda, MD Status Epilepticus (SE): Diagnosis and Management Edward Sloan, MD, MPH The Case of the Comatose Prisoner James Roberts, MD The Neurologic Screening for the Non-Neurologist Andy Jagoda, MD

Education FERNE.org All lectures videostreamed All PowerPoint slide shows Possibility for web-based CME Planned collaboration with EMedHome.com

Education FERNE Website Content Download with PDF ssoftware Enhanced printing capabilities PowerPoint shows allow easy viewing Redistribution at your own institutions Greater number of physician learners

Education Stroke Series American Stroke Association (ASA) France Foundation

Education AEM Supplement Material from educational courses Michelle Biros-Editor of AEM Stroke materials, Spring 2002 Seizure materials, ??Spring 2003 Pain materials, ??Spring 2004

Education Handheld Technology Use of tPA NIH Stroke Scale Written by a team at Mount Sinai, New York –Funded by a FERNE grant Planned collaboration with ePocrates.com: 250,000 visits/month

Education Stroke Card EMRA NIH Stroke Scale

Research

Research Grant Opportunities Research support is provided by FERNE via three mechanisms: FERNE/EMF $50,000 Directed Neurologic Emergencies Research Grant FERNE RFP's Seed grants for unsolicited proposals

Research Directed Neurological Emergencies Research Grant recipient:Edward Jauch, MD, MS University of Cincinnati Cincinnati, OH Functional Proteomics Identification of Serum Proteins Associated with Intracerebral Hemorrhage Following Thrombolytic Therapy for Acute Ischemic Stroke

Research Directed Neurological Emergencies Research Grant recipient:John E. Duldner, Jr., MD Akron General Medical Center Akron, OH Spontaneous Intracerebral Hemorrhage: Compliance, Hyperacute Management, and Mortality After Published Guidelines

Research Directed Neurological Emergencies Research Grant recipient: Kevin M. Curtis, MD, Hospital of the University of PA Philadelphia, PA Characterizing and quantifying the delayed mitochondrial calcium overload in the hippocampus after trauma and after global ischemia.

Research Unsolicited Proposals John Duldner, MD, received a $5,000 seed grant from FERNE for his research on Subarachnoid Hemorrhage (SAH) Johns Hopkins University: Emergency Evaluation of the ED Dizzy Patient, $5,000 pending Mt. Sinai Hospital, $5,000 for palm stroke application development

Research Seed Grants Up to $5,000 grants Promote new research Help secure future funding

Opportunities With the SAEM NEIG and WEIG

SAEM NEIG Opportunities Grant writing and participation New participation in education New content areas Operational support Administrative oversight Grant support

SAEM WEIG Opportunities Teaching others how to use web Develop new web content Live transmission of events Administrative oversight for projects Grant writing and support

Conclusions Largest Challenges Ongoing funding New participants in the teaching process More learners Better technology More time

Conclusions FERNE Good educational materials Use of new technologies Opportunity to support research Opportunity to participate

Questions?