課程簡介

The Itaewon disaster was a large-scale disaster that occurred on October 29, 2022. As for human casualties, deaths were 159 people (At the time of accident: 156 people, After the accident: 3 people), and a total of 196 people were injured - (light injuries: 165 people, serious injuries: 31 people) ; property damage. Unknown.

There were many problems with the on-site response system and medical access. In addition, it was an incident that caused a lot of controversy about the transfer of patients and casualties after accident.

Plenary lecture III：Evaluation of Kidney Function at Emergency Department

課程簡介

Acute kidney injury (AKI), chronic kidney disease (CKD), and decreased estimated glomerular filtration rate (eGFR) are all associated with poor clinical outcomes among emergency department (ED) patients. The effects of different types of renal dysfunction and the degree of eGFR reduction on the clinical outcomes in a real-world ED setting is still unclear. We conducted a retrospective observational study that enrolled adult patients with an eGFR lower than 60 mL/min/1.73m2 in our ED, from October 1, 2016, to December 31, 2016. Besides AKI and CKD, patients with unknown baseline renal function before an ED visit were categorized in the undetermined renal dysfunction (URD) category. Among 1495 patients who had eGFR evaluation at ED, this study finally enrolled 441 patients; 22 patients (5.0%) had AKI only, 32 (7.3%) had AKI on CKD, 196 (44.4%) had CKD only, 27 (6.1%) had subclinical kidney injury (those who met neither criteria for AKI nor CKD), and 164 (37.2%) had URD. There was a significant association between eGFR and critical illness defined as the composite outcome of death or intensive care unit (ICU) need, hospitalization, ICU need, death, and renal replacement therapy need. Multivariate logistic regression analysis showed eGFR was an independent predictor of critical illness composite outcome (death or ICU need), hospitalization, and ICU need even after adjustment with AKI or URD. Based on these results, we conclude estimated GFR may be a sufficient predictor of clinical outcomes of ED patients regardless of AKI complication. Considerable ED patients were determined as URD, which might have a significant impact on the ED statistics regarding renal dysfunction.

課程簡介

The world faces increasingly complex challenges, from climate change and global health crises to economic disparities and social inequalities.

Addressing these challenges requires innovative and effective solutions that leverage the expertise and resources of multiple stakeholders, including governments and academia. Collaboration between these two sectors has the potential to generate significant positive impact on society, but it also comes with its own unique set of challenges.

In this talk, we will explore the opportunities and challenges of government-academia partnerships and how they can be leveraged to advance the public good. We will examine successful examples of collaborations between government and academia, highlighting their impact and lessons learned. We will also discuss the potential benefits of such partnerships, including increased access to expertise and resources, enhanced policy development, and improved public trust.

However, such partnerships also come with challenges, such as differences in culture, priorities, and expectations. We will explore these challenges and identify strategies for overcoming them. Key topics will include building trust and communication, defining shared goals and objectives, and navigating ethical and legal considerations.

The talk will conclude with a call to action for stakeholders in government and academia to work together to unlock the full potential of partnerships for the benefit of society. By fostering collaboration and innovation, we can achieve our shared goals of a better, more equitable world.

Symposium 7：急救復甦再升級-理想與實務面挑戰

Update of Resuscitation- Challenges of New Concepts on Interventions

Double sequential shock電擊的最佳治療？

主講人：蘇培易醫師(臺大醫院)

課程簡介

       當病患經過三次去顫電擊與藥物使用後仍呈現心室顫動，即為頑固型心室顫動(refractory ventricular fibrillation)，如果身邊沒有葉克膜等進階維生循環，第一線的我們還有什麼治療選擇?

        本主題將介紹頑固心室顫動之治療，探討不同電擊策略(Standard vs Vector-change vs Double-sequential external defibrillation)之實證與臨床操作注意事項。

ECPR適當的人和時機

主講人：蔡長志醫師(奇美醫院)

課程簡介

       體外心肺復甦術（ECPR）是一種在標準心肺復甦術（ACLS）無法成功恢復自主循環的情況下考慮的治療方法。心跳停止期間啟動體外膜氧合（ECMO），來替代心臟和肺的功能。

       根據美國心臟協會的ALCS指引，目前尚缺乏足夠的證據支持ECPR在心跳停止急救時常規使用。然而，對於適當的患者，如果有經驗豐富的ECMO提供者能夠迅速啟動ECPR，則可以考慮使用ECPR。

       沒有要常規執行下，如何選擇適當的人和時機就成為近年的熱門的議題，不同的研究都試圖去尋找良好的預後指標，然而研究中回溯去找到的指標，如何成為臨床處理病人急救當下的邏輯判定。ECPR的理想與實務面挑戰，嘗試著去尋找出方向。

Symposium 10：疫情後的全球急診感染防治策略：合作與創新

Global Strategies for Infection Prevention and Control in Post-Pandemic Emergency Departments: Collaboration and Innovation

Post-Pandemic ED Infection Control & Technology in Infectious Disease: EU Perspective

主講人：Dr. Lorenzo Porta (ASST Grande Ospedale Metropolitano Niguarda)

課程簡介

       The recent COVID-19 pandemic highlighted the critical need for robust infection control measures and advanced technologies especially in Emergency Department (ED). In fact, the pandemic has exposed the limitations of traditional infection control methods, prompting the exploration of cutting-edge technologies, such as artificial intelligence (AI), Internet of Things (IoT), and telemedicine. AI-powered systems have shown promise in rapid identification and risk assessment of infectious diseases, enabling timely intervention and allocation of resources. IoT-based solutions have facilitated real-time monitoring of patient flows, optimizing ED capacity and minimizing overcrowding. Telemedicine platforms have revolutionized healthcare delivery by enabling remote consultations, reducing patient exposure and ED visits for non-emergent cases.

       The European Union has made significant strides in integrating these technologies into EDs, capitalizing on its robust digital infrastructure and collaborative networks. Collaborative initiatives have fostered the exchange of best practices and the development of standardized infection control protocols across EU member states. The European Centre for Disease Prevention and Control (ECDC) has played a pivotal role in providing evidence-based guidance, facilitating technology adoption, and supporting research in infection control.

臨床預測模式與人工智慧於急診感染症診斷之展望

Clinical prediction model and artificial intelligence in diagnosing infectious disease in emergency medicine

主講人：陳冠甫醫師(基隆長庚醫院)

課程簡介

       在這半小時的時間，講員將把最state-of-the-art的臨床預測模型和人工智慧如何被應用在急診醫學的感染症診斷做介紹，講員也會介紹最新的方向和可以介入的項目給會員參考。

Symposium 12：被人告了怎麼辦？急診醫師應知悉的法律風險與對策

What should one do when facing a legal lawsuit? Legal risks and strategies that emergency physicians should be aware of

主講人：蔣昕佑主持律師(天晴和永國際商務法律事務所)

課程簡介

       在急診醫學領域，風險與挑戰層出不窮，而法律訴訟可能成為急診醫師時常擔憂的問題，本次分享旨在提供急診醫師們應對這些法律風險的知識和對策，以及如果真的遇到糾紛，應用何者心態面對。

       本次分享預計將先分析急診醫師之訴訟案例，透過這些案例，參與者將深入了解可能導致法律紛爭的因素，我們將探討這些案例中的法律細節和判例，以幫助急診醫師預防類似情況的發生。

       再者，本次分享將提供實用的對策，包括如何與律師合作，準備法律文件和相關證據，以及在法庭上的適當行為和陳述。這些對策將有助於急診醫師們在法律挑戰中保持冷靜、應對自如，並確保他們的權益和專業形象得到充分保護。

       通過參加這次演講，急診醫師們將增加對法律風險和對策的認識，並學習如何與專業律師合作，以應對潛在的法律訴訟。

Symposium 13：新世代超音波與科技應用

New Era of Ultrasound and Technology Application

The future of point-of-care ultrasound - how handheld devices, artificial intelligence, and increased adoption will change diagnostic testing over the next 5-10 years.

主講人：Bret P. Nelson (Icahn School of Medicine at Mount Sinai)

經食道復甦超音波：開創急診醫學的新里程

Resuscitative Transesophageal Echocardiography: Pioneering a New Era in Emergency Medicine

主講人：朱聖恩醫師(亞東醫院)

課程簡介

       給予心搏停止病人施行心肺復甦術（CPR）是急診醫師非常熟悉的急救情境。在CPR中，「胸部按壓」是使病人恢復心跳的關鍵環節。然而現行的CPR指引並未清楚描述何謂「最佳的壓胸位置」。本團隊的最新研究指出，利用經食道復甦超音波（TEE）來精確導引壓胸的位置，可大幅提升心搏停止病人的存活預後！因此，將TEE運用於急救復甦，已日趨重要。

       為使急診醫師更易上手此技能，本團隊根據過去超過百例的實際經驗，成功描繪出急診醫師學習TEE的學習曲線，為未來急診醫師的訓練，提供了實用的學習模式。

       隨著影像科技的飛速進展，我們認為TEE有機會發展成為急診醫師不可或缺的技能，其重要性將可媲美於心臟科和麻醉科的核心地位。期待在未來，TEE能被廣泛應用於急診醫療中，進一步提升病人的生存機會。

       在本次研討中，我們將分享我們最新的研究成果，並探討如何將TEE有效地融入急診醫師的訓練課程。我們希望透過此次分享，能夠讓更多急診從業人員理解到TEE在急診醫療中的重要性，並推動其在未來的急診醫療中得到更廣泛的應用。

人工智慧在臨床超音波中的應用

Artificial Intelligence in Point-of-Care Ultrasound

主講人：邱義閔醫師(高雄長庚醫院)

課程簡介

       本演講專注於人工智慧（AI）在超音波技術中的應用。具體而言，探討了AI在圖像分類、物體檢測、分割和導航方面的應用。還討論了使用深度學習算法指導新手在有限診斷用途中獲得心臟超音波圖像的好處。

       超音波AI是一個快速進步的領域，對改善醫學診斷和治療具有巨大潛力。AI可以協助圖像分類、物體檢測、分割和導引，使臨床醫師能夠更快速、更準確地識別超音波圖像中的結構。分割模型可以根據圖像特徵將圖像分為不同區域，幫助臨床醫生識別異常或有疑慮區域。AI還可以透過即時回饋引導及幫助新手獲得穩定品質的焦點式超音波圖像，以進行診斷用途。超音波AI的這些發展將通過提高準確性和效率，徹底改變醫學診斷和治療。

Symposium 15：國際人道援助的參與及介入-土耳其經驗

Participation and Intervention in International Humanitarian Aid - Insights from Turkey

主講人：黃春源訓練官(APAD亞太災難管理聯盟)

課程簡介

本次演講將由一位在日本國際人道救援NGO工作的旅日台籍人士為大家分享其8年來參與國內外救援行動的經歷與心得。在這期間，講者曾參與過尼泊爾、印尼、東加、斯里蘭卡等國家的救援工作，並親歷了近期土耳其敘利亞大地震的人道救援。

以土耳其為例，講者將回顧救援行動的過程，包括在災難發生後所面臨的挑戰、國際合作機制的運作、以及救援隊伍在不同文化和語言環境中的協同與適應。此外，講者還將分享如何在緊急狀況下確保資源的合理分配、保障受災民眾的基本需求，以及在心理援助方面的探索與實踐經驗。

最後，講者將總結國際人道救援行動的重要性及其在促進國際間互助與友誼中的作用。通過這次分享，希望能引起聽眾對國際人道救援工作的關注和支持，並激發更多人投身於這一充滿挑戰與意義的事業。

Symposium 17：疫後急診教育新進展

New Advances on Emergency Medical Education in the Post-Covid Era

危機處理小組之到院前訓練

Crisis Intervention Team Training in Prehospital Settings

主講人：林皓陽醫師(臺大醫院)

課程簡介

       危機處理小組旨在社區精神危機發生時，讓警、消、衛、社等一線人員可以互相合作，安全地護送病患就醫。到院前危機處理小組的訓練模式，需要跨機關、跨職類的合作。今年台北市及新北市相繼舉辦危機處理小組到院前訓練課程，期望在精神危機的連續性照護中，安全地、有效率地將病患轉送至適當的醫療院所。

建立連結、預防暴力、維護安全：精神病患的降階溝通

Building Connections, Preventing Violence, Ensuring Safety: De-escalation Communication with Psychiatric Patients

主講人：蔡賢龍醫師(振興醫院)

課程簡介

       精神病患的處理不是個容易的議題，藉推廣降階，明確與建立跟精神病患的鏈結與溝通的目的，進而理解與連結到院前的處置，達到一致性，提供病患與家屬恰當的協助。