These are without a doubt some of the hidden gems of any boutique conference. At H&R we’ve always had a great time with these, time for instructors to pass on some really actionable, hands-on skills to a small group of really motivated clinicians.
BJJ or Self-Defense for Humans & Health Care Workers – we feel that BJJ is a natural companion to medicine. On all levels the mental and physical benefits far transcend its martial core, and we’re happy to see more and more practitioners in medicine. We always have a lot of fun with it and are fortunate to have some black belts to lead this activity along with a few other aficionados. Even if you have no experience, join us for some basics and learn a few tips to protect yourself and buy time in a few bad scenarios. (Max 30 participants, FREE) – Faculty – SPIEGEL/MILLER/ROLA May 21st
The VExUS Course & Doppler Masterclass – Unbelievable how much VExUS has exploded. This is the original course, given by some of the absolute very best instructors on the plant, including several of its creators. It’s a 3-4 hour hands on course after participants have gone thru the online material. Here we not only show you how to perform it, but more importantly the nuances. Participants will get plenty of Q&A time with the leaders of the field of venous congestion, and will also explore other Doppler techniques which complements the venous side such as VTI, carotid Doppler, splenic Doppler and more. There may be many VExUS courses and workshops going on but this is THE One. Faculty – ARGAIZ/HAYCOCK/SPIEGEL/ROLA/DENAULT/KENNY/ASSAVAPOKEE & more (Half-day, MAX 40 participants) Wednesday May 21st Morning.
ArrestTEE Sim Cases – You’ve done your ResusTEE Course, hopefully a few live cases in your practice. Come and warm up those skills with a series of SIM cases and sharpen up not only your image generation, but also your clinical interpretation skills. Gotta get that muscle memory! FACULTY TBA (Half-day, MAX 12 participants) Wednesday May 21st Afternoon.
The Great Presenter – ED doc and educator extraordinaire Marco Garrone of Italy goes thru the science and skills to up your presentation game! Wednesday May 21 afternoon.
Sauv Life (eCPR) by Paris’ Lionel Lamhaut! – The French experience in prehospital ECPR is unparalleled. Participants will get to tap into these pioneers’ extensive experience and learn the ins and outs of starting an ECPR programme and the required skills! Specific programme TBA! FACULTY: LAMHAUT, TBA, Saturday May 24th Full Day.
SEVA Ventilator Course by The Cleveland Clinic’s Eduardo Mireles-Cabodevila – His social media vent rounds have an immense following on X/MedTwitter, and for good reason! No one breaks it down like Eduardo does. And he’s distilled it into one of the top courses in the world on mechanical ventilation. No matter your level, take your vent curve analysis to a whole other level with this full-day course. FACULTY: MIRELES-CABODEVILA/CHATTERJEE Saturday May 24th Full Day.
Basic Bedside EEG for Intensivists – Technology is rapidly bringing the EEG to the point-of-care realm. With several devices having the ability to provide the raw EEG signal, it is time for the clinicians to have some understanding of brain waves! Half day, May 21. FACULTY: TBA
Resuscitative TEE course by Felipe Teran – May 24th full day, follow resuscitativetee.com/workshop for registration which is opening soon!
Bookmark this page for more info, programs and further additions to the courses!
Here, Sara Crager takes a few minutes to discuss the hemodynamic interfaces with me. Over the next months, I’ll be picking the brains of my co-authors for the fantastic angles they can all bring to our “Trilogy in 4 Parts” (creative title by of course @EMnerd) which we all feel can be a really useful mental model for both learners and veterans and even better for patients!
We are excited to announce this year’s evolution of our H&R conference, the Hospitalist & Resuscitationist VExUS and Doppler Masterclass!
This exclusive event, produced in collaboration with Flosonics Medical, will take place on September 28th, 2024, in Toronto, Ontario, Canada
This masterclass is designed for those who seek a deep dive into the cutting-edge techniques of venous congestion, Doppler ultrasound, and fluid resuscitation. Our curated one-day workshop offers a unique opportunity to learn from world experts in an intimate, hands-on environment with a fantastic faculty-to-participant ratio.
What to Expect: Pre-course Content: Over 5 hours of lectures covering the theory, evidence, and practical tips for venous congestion. Live Content: Hands-on VEXUS course taught by the creators of the VEXUS score, small group discussions on integrating perfusion, fluid responsiveness, and fluid tolerance, and hands-on fluid responsiveness practice using carotid Doppler and cardiac echo-VTI. Bonus Content: Faculty and participant dinner/social event on the evening of September 28th and hotel discounts. Certificate of Attendance: Attendees will receive a certificate of attendance (non-CME) and an optional certificate of VEXUS proficiency for those who complete the online content, in-person workshop, and pass a post-workshop quiz.
Limited-Time Offer: Register before August 15th and receive $200 off the registration fee using promo code HR200! Don’t miss this opportunity to secure your spot and benefit from this exclusive discount.
As always, we aim to create an incredibly high-quality and tailored learning experience for all participants, which is why we are capping registrations.
Spots are filling up fast, so act now to secure your place at this unique event.
Register Now For any questions or further information, please feel free to reach out. Looking forward to seeing you there!
HR2025 is about putting it all together. We’ve been talking about the venous side for a long time and it has been fantastic seeing how much it has taken off – at least in the #medtwitter #foamed and PubMed community. There’s enough data out there to show a real clinical utility of consciously examining the venous compartment. This applies to any hospitalized patients, whether in the ED, the wards or the ICU, so that’s why this year, the H and the R will spend the first day together doing all things VExUS and venous congestion, along with the corresponding workshops, again so that participants can leave with some actionable knowledge and skills. Whether you’re a beginner at this or a seasoned veteran, there should be something to learn.
On Day 2, we’ll divide into two tracks. The R side will deep-dive bedside hemodynamics and our 4-interface model of shock management. Of course there will also be some pearls and late-breakers as this is still a year away and there will undoubtedly be some really interesting things cooked up by the crew by then!
Meanwhile on the H side, Katie and Gigi are thrilled to have put together a top-notch lineup of speakers to teach everyone how to become Inpatient Medicine Jedis. We have some big names in attendance this year, including both new and familiar faces – The Clinical Problem Solvers themselves will take us through some challenging cases; Frederik Verbrugge will drop diuretic truth-bombs; the ever-fabulous @NephroPOCUS will discuss a Bedside Approach to AKI; and Allison Bond will share the Top 10 Infectious Disease Mistakes on the ward, among many others! Day 2 Workshops will be focused on high-yield test interpretation: think EKGs, PFTs and sleep studies, urine microscopy, peripheral blood films, and more!
And as always, the ethos of H&R is about putting together physiological clinicians who love to both push the envelope and share their knowledge and experience. The energy that comes out of this is really quite unique, and the sheer number of successful collaborations that have stemmed from it since 2018 is really impressive. The unplanned, unscheduled small group discussions are the true gems of this conference… Many of the usual suspects will be there, and as always some new additions to the H&R family!
Who? I can’t say enough about the H&R crew. Brilliant, open minded, eager to both learn and teach, no large fragile egos here. So expect to learn from and hang with Sara Crager, Korbin Haycock, Rory Spiegel, Matt Siuba, Eduardo Argaiz, Gigi Liu, Ross Prager, Frederic Verbrugge, Vimal Bhardwaj, Glenn Hernandez, Andre Denault, Jon-Emile Kenny, Ashley Miller, Segun Olusanya, Max Hockstein, Ben Daxon, Abhilash Koratala, as well as some new faces to the live event, very much looking forward to meeting Trina Augustin from Mayo as well as another critical care icon, Professor Jan Bakker, and I’m happy to announce the return of the true father of POCUS, Daniel Lichtenstein, and we will even have the amazing opportunity to (virtually) hear from Dr. Geoff Parkin, one of the pillars of hemodynamic physiology! There are a few more to confirm and we promise they will bring the same enthusiasm and unique experience to the event!
So the most important thing for you to do is to mark your calendars and make sure you don’t miss being a part of it! Bookmark this page as the registration link (november 1) will appear as well as developing programme information! Note that registration fees will be in USD given the international nature of the conference.
Montreal, May 21-24. Core conference May 22-23, Pre and Post-courses May 21 and 24.
Pre/Post congress preliminary courses
BJJ or Self-Defense for Humans & Health Care Workers (May 21st pm)
The VExUS Course (May 21st am)
ArrestTEE Sim Cases (May 21st)
The Great Presenter by Marco Garrone (May 21st am)
Sauv Life (eCPR) by Paris’ Lionel Lamhaut! (May 24th)
Bedside EEG for EDCritters? (TBA)
SEVA Ventilator Course by The Cleveland Clinic’s Eduardo Mireles-Cabodevila! (May 24th)
ResuscitativeTEE Workshop by Felipe Teran (May 24)
if there’s a course you want, go ahead and get in touch with us! hospresusconference@gmail.com or via twitter with #HR25 tag.
Schedule
Day 1 – May 22
Time
Talk/Workshops
Faculty
0800-0815
The Concept of Fluid Tolerance
Rory Spiegel
0815-0845
Bedside Cheat Code – Femoral Doppler
Vimal Bhardwaj and Andre Denault
0845-0915
An update on the Hepatic Vein
Eduardo Kattan
0915-0945
Understanding Portal Vein Doppler
William Beaubien-Souligny
0945-1015
Coffee Break
1015-1045
Renal Venous Doppler – RVSI and VExUS
Eduardo Argaiz (virtual)
1045-1115
eCPR and Organ Donation
Lionel Lamhaut
1115-1215
Workshops:Mastering the IVC assessment
Hepatic and Portal vein assessments
Intrarenal hemodynamics
Femoral vein
How I assess congestion at the bedside (Virtual workshop)
Rory Spiegel, Juliana Kan and Audrey Lacasse Eduardo Kattan and William Beaubien-Souligny Abhilash Koratala and Korbin Haycock Vimal Bhardwaj and Andre Denault Ross Prager
1215-1300
Lunch
1300-1330
Keynote Lecture – The Evolution of Venous Congestion Assessment
Andre Denault
1330-1400
Pulmonary congestion: Mastering lung US
Daniel Lichtenstein
1400-1430
Practical Diastology: Will my Pt get Pulmonary Edema?
Frederik Verbrugge
1430-1530
Workshops:Diastology, E/e’ and LA size
CVP using Jugular POCUS (Virtual and in person workshop)
Lung US
RV assessment (TAPSE, S’, RVH, PASP)
Beside Cerebral Oximetry in congestion
Frederik Verbrugge and Max Hockstein
Jon Emilie Kenny and Korbin Haycock
Daniel Lichtenstein and Marco Garrone Matt Siuba, Andre Denault, Juliana Kan and Audrey Lacasse Phil Rola and Masimo
1530-1545
Coffee break
1545-1615
Fluid Tolerance in the ED – Is It Pertinent?
Marco Garrone
1615-1645
Minute Ventilation: Physical Exam Hack?
Rory Spiegel
1645-1715
Clinical Cases: Congestion
Abhilash Koratala
Day 2 – May 23
Time
H side talks
Faculty
R side talks
Faculty
0800-0830
Clinical Problem Solvers: Challenging Cases
Reza Manesh and Rabih Geha
Intro to the circuit & interfaces
Sara Crager
0830-0900
Clinical Problem Solvers: Challenging Cases
Reza Manesh and Rabih Geha
0830-0850: What is Coupling?
Jon Emilie Kenny
0900-0930
Immune Checkpoint Inhibitor Toxicity
0930-0940: Buffer
Laura Cappelli
0850-0910: Understanding MSFP
0910-0940: Resurrecting Blood Pressure. Curious Cases of B12 for Vasoplegia
Ashley Miller and Korbin Haycock
Ben Daxon
0940-1040
Workshops:Approach to acid-base problems (Virtual and in person workshop)
Rory Spiegel
Workshops:LVOT VTI
Capillary refill time
POCUS AMA
Hemodynamic Pearls Part 1
Sara Crager, Trina Augustin and Jeff Scott Glenn Hernandez and Eduardo Kattan
Jay Chatterjee, Jon Emilie Kenny and Marco Garrone Ashley Miller
1040-1110
Coffee break
1110-1140
Oncologic Emergencies
Aditi Singh
Interface 1: LV-VA coupling & How I Measure it
Max Hockstein
1140-1210
Bedside Approach to AKI
Abhilash Koratala
Interface 2: Macro-Micro
Glenn Hernandez
1210-1300
Lunch
1300-1330
Keynote Lecture – “Fill him up to his eyeballs.”
Jan Bakker
1330-1400
Acute decompensated heart failure
Frederik Verbrugge
Interface 3: Capillary-Venular
Eduardo Kattan
1400-1430
High output heart failure
Eduardo Argaiz – (virtual)
Interface 4: RV to PA
Matt Siuba
1430-1530
Workshops: Urine electrolytes and microscopy POCUS AMA
Abhilash Koratala
Daniel Lichtenstein and Sara Crager
Workshops: POCUS RV-PA coupling PA catheter (3 simulators)
Hemodynamic Pearls Part 2 (Virtual and in person workshop)
Matt Siuba and Korbin Haycock Katrina Augustin, Jeff Scott and Andre Denault Ashley Miller
1530-1545
Coffee break
1545-1615
Management of Non-Insulin medications in the hospitalized patient
Elias Spanakis
Can Starling and Guyton Collaborate at the Bedside?
Geoff Parkin and Segun Olusanya (virtual)
1615-1645
Next level BiPAP and CPAP
Segun Olysanya (virtual)
Impella in Cardiogenic Shock – What Every ER and ICU Doc oughtta know!
There will be a number of different registration options so please select carefully. Please note that for online-only registrants, we will follow a fee scale using the World Bank country classification system, so click the link below if you’re not sure what applies to you (this applies to where you live/work, not your country of origin).
Scientific Committee – Dr. Philippe St-Arnaud (Santa Cabrini Hospital, Montreal), Dr. Benjamin Daxon (Mayo Clinic, Minnesota), Dr. Rory Spiegel (Medstar Health, Washington, DC), Dr. Katie Wiskar, (University of British Columbia).
Cancellation policy: Cancellations until April 15th will be accepted and refunded minus a 5% administrative fee. Cancellations until May 1st st will receive 50% refund, and after that date no cancellations will be possible.
Hotel Information: as the hospital is in a residential area there really isn’t very much around. We suggest finding a hotel on the east side of downtown Montreal (east of University ave) or in Old Montreal, for the enjoyment of the city after the conference, especially if travelling with companions. We have found that better deals can be had using websites rather than for us to secure a conference rate (usually +30%). Priceline/expedia/booking.com are fairly reasonable. The hospital is about 20 minutes by uber/cab from these areas.
An awesome track by my intensivist friend and co-educator, Segun Olusanya, where he probes the mind of a seriously next-level physiologist, particularly about the formula he devised to estimate Pmsf. Not to be missed by bedside physiologists of all levels!
Had the honour of being invited to give grand rounds by Dr. Paul Mayo and share some thoughts on fluid tolerance and venous congestion. Starts around the 17min mark – sorry I have no editing capabilities!
Due to the tremendous amount of work required to put together a large live event, we’ve decided to skip 2024 in terms of a full-fledged H&R, but HR23’s Inpatient Medicine section, put together by none else than Katie Wiskar, was a real firecracker, and we felt that the spark to bring high level bedside physiology to the clinician on the wards should not be allowed to fizzle. So, while waiting for HR25 (May 2025), Katie once again worked her magic to put together a one-day webinar that packs a academic and clinical punch.
Preliminary Schedule:
H&R 2024 Outline: Acute Inpatient Medicine – Next Level!
Date: June 15 10am-4:30pm EST (7am-1:30pm PST)
Format:
one-day, 6.5 hours, online only
Pre-recorded lectures
Live Q&A
The Day
10am-10:15am: Intro and welcome (15min)
Track 1 (90min) – POCUS et al
10:15am-10:35am: POCUS for shock – Ross Prager
10:35am-10:55am: VEXUS tips and tricks – Abhilash Koratala
10:55am-11:15am: Ventilators 101 – Segun Olusanya
11:15am-11:35am: Q&A
Track 2 (90 min) – Fluids and physiology
11:35am-11:55am: Dysnatremias in cirrhosis – Eduardo Argaiz
11:55am-12:15pm: Top 10 diuretic mistakes – Frederik Verbrugge
12:15pm-12:35pm: Physiology of the shock patient – Ashley Miller
12:35-12:55pm: Q&A
12:55pm-1:30pm: Break (35min)
Track 3 – The decompensating ward patient
1:30pm-1:50pm: The sick aortic stenosis patient – Trina Augustin
1:50pm-2:10pm: The sick pulmonary HTN patient – Matt Siuba
2:10pm-2:30pm: The seizing ward patient – Casey Albin
2:30pm-2:50pm: Q&A
Track 4 – Practical pearls
2:50pm-3:10pm: Palliative Medicine pointers – Brittany Rance
3:10pm-3:30pm: Top 5 Geriatric Pearls on the ward – Gurmeet Sohi
3:30pm-3:50pm: Sepsis: what we should be doing – Sara Crager
3:50pm-4:10pm: Q&A
4:10-4:30pm: Concluding remarks (20min)
Also some online-only BONUS lectures – How-To VExUS by Dr. Taweevat Assavapokee!
In the last couple of years VExUS has seemingly sparked a number of clinicians to focus on right-sided or venous congestion and its deleterious consequences. Many of us feel there is sufficient associative evidence and physiological basis to use VExUS to manage patients on a daily basis and do so routinely. Currently, several studies we know of (and probably many we don’t!) are on track to show that a VExUS-based approach is likely to be superior to a highly variable traditional approach. In teaching it at the bedside, however, we emphasize the fact that this tool should not be used in a brain-bypass, monosynaptic fashion – all elevated VExUS scores should NOT blindly be diuresed… These ways on how to integrate VExUS in clinical decision-making is what we will emphasize in this part of the Mini-Fellowship.
So due to demand, we have added this specific skill to our Mini-Fellowships which have been going strong for over a decade. The idea (just like in resuscitation!) is to tailor these days to what you need the most. Whether you want to focus on advanced POCUS, looking at coupling parameters and TDI or whether you want to learn to integrate these findings into a resuscitation approach, we will do our best to fill the gaps you may have.
We’ve been organizing mini-fellowships now for over a decade (obviously slowed by the whole pandemic business), because while learning the technical aspect of scanning is one thing, the translation into clinical application and decision-making is altogether another step that, for many, is achieved more readily by witnessing live clinical management.
This year, for the first time, we are adding a specific VExUS element. Participants will be able to pre-emptively watch the online VExUS Course, and then follow a senior instructor for 2-5 days of clinical practice (avg 4-6h/day) where they will be able to observe live scanning and management of real patients both in outpatient, inpatient, ED and ICU settings.
Tuition – Montreal Mini-Fellowships: 600$ CAN / 500$ USD per day for 1 physician, 400$ CAN / 350$ USD per person per day for additional days, and 400$ CAN / 350$ USD per person per day for a 2 to maximum 3 physician group. For physicians who are not from high income countries, do let us know, we will try to help get some industry sponsorship to make it possible.
CME : For Canadians, from the Royal College of Physicians standpoint, the Mini-Fellowships qualify for 25 Section 2 credits (regardless of the length) and 3 hours of Section 3 credits (per day of fellowship). For you Americans:
Through an agreement between the Royal College of Physicians and Surgeons of Canada and the American Medical Association, physicians may convert Royal College MOC credits to AMA PRA Category 1 Credits™.
Advanced airway skills are a key element of the resuscitationist’s arsenal. In this workshop, participants will be able to tailor their experience and spend as much or as little time as they want in each station to maximize their learning. We will cover basic direct and video laryngoscopy and intubation with and without the use of the bougie as well as bronchoscopic assistance. Emergency surgical airways – both percutaneous and scalper-finger-bougie techniques – will be reviewed and practiced until participants can perform both rapidly and adequately.
Basic Upper Airway Endoscopy
Endoscopy for basic diagnostic and procedural purposes will be reviewed for obstructive and airway toilet. This will include rhino-pharyngo-laryngoscopy for foreign body/lesion assessment and stridor management in the ER.
Critical Care Endoscopy
Basic bronchoscopy for rapid diagnosis and airway toilet will be covered. This will pertain to most critical care cases where removal of mucus plugs and broncho-alveolar lavage is the bread and butter. Following instruction, each participant will be asked to demonstrate the ability to identify basic anatomy and be able to orient themselves successfully.
Bedside Percutaneous Tracheostomy Course
Participants will spend the last 90 minutes in a separate track focused on the technique and will be asked to perform 5 unassisted techniques to obtain a certificate of adequate completion. {Note that, since this is not an emergency life-saving procedure, this does not qualify the participant to perform the technique independently in clinical practice and will require supervision by an experienced colleague until sufficient experience is attained.}
Participants & Registration
There will be 15 complimentary trainee registration slots and 20 spots for practicing physicians (249$/199$ for CEMTL MDs) and 5 spots including the percutaneous tracheostomy course (349$). Participants will receive a link to pre-course material to watch prior to the workshops. Lunch will be included. There is no formal CME accreditation for this event.
The Faculty: Dr. Joe Nemeth (ER), Dr. Philippe St-Arnaud – (ER/Critical Care) Dr. Lawrence Leroux (ER/Anaesthesia), Dr. Andy Nguyen (Respirology), Dr. Olivier Abboud (Otolaryngology), Dr. Ian Ajmo (Critical Care), Dr. Philippe Rola (Critical Care).
thinking critical care 