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M

A R C H

4 ~ 5 ,

2 0 1 1

Pittsburgh Marriott City Center

Pittsburgh, Pennsylvania

Eleventh Annual

John M. Templeton Jr.

Pediatric Trauma Symposium

Course Directors:

Christine Campbell, RN, BSN, MS

Barbara A. Gaines, MD, FACS, FAAP

Christine McKenna, MSN, RN, CRNP

Matthew Moront, MD, FACS, FAAP

Michael L. Nance, MD, FACS, FAAP

Marla L. Vanore, RN, MHA

The University of Pittsburgh School of Medicine, Center for Continuing Education in the Health Sciences is the ACCME accredited provider for this activity.

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O

VERVIEW

Trauma is the leading cause of childhood death and disability. However, pediatric trauma care continues

to pose significant and unique challenges. This two-day national symposium will provide the health care

practitioner with up-to-date clinical information for the management of injured children and their families.

Current issues will be addressed across the continuum of trauma care.

O

BJECTIVES

At the conclusion of this course, the participant should be able to:

Describe current treatment and technologic advances that decrease pediatric death and disability.

Discuss how trauma impacts the physical and emotional future of the pediatric patient.

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3

W

HO

S

HOULD

A

TTEND

This national multidisciplinary conference is designed for trauma surgeons who care for injured children, emergency medicine phy-sicians, other phyphy-sicians, physician assistants, nurse practitioners, nurses, pre-hospital providers, injury prevention specialists and other health care professionals involved in the care of injured children.

C

ONTINUING

E

DUCATION

C

REDIT

CME Accreditation ~The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this educational activity for a maximum of12.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Other health care professionals are awarded1.25 continuing education units (CEU’s) which are equal to12.5 contact hours.

Nursing Accreditation ~This continuing nursing education activity has been approved for12.5 contact hours by the UPMC Provider Unit of the PA State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. To receive contact hours, the participant must sign in and will only be accredited for the time attended.

EMS Accreditation ~The Children’s Hospital of Philadelphia is approved as a provider of continuing EMS education by the Pennsylvania Department of Health. An application for Pennsylvania EMS credit has been submitted. This course is for advanced pre-hospital providers.

M

EETING

L

OCATION

The conference will be held at thePittsburgh Marriott City Center, 112 Washington Place, Pittsburgh, PA 15219, (412) 471-4000. The Pittsburgh Marriott City Center is the "Official Hotel of the Pittsburgh Penguins," and is located directly across from the new CONSOL Energy Center and just steps from the heart of the business district. See page 5 for more information about Pittsburgh – a big city that is small-town friendly.

O

VERNIGHT

A

CCOMMODATIONS

The UPMC Center for Continuing Education in the Health Sciences has reserved a block of hotel rooms at discounted rates at thePittsburgh Marriott City Center for our conference attendees. You may make reservations at your own discretion. The room block is limited and only available untilFebruary 11, 2011. Space cannot be guaranteed once the block expires or the block is filled, whichever occurs first. In order to reserve a room at the discounted rate of $105/night plus applicable taxes, please call the hotel at (412) 471-4000 or 1-888-456-6600 and mention you are attending the John M. Templeton Jr. Pediatric Trauma Symposium.

If you experience difficulty arranging your reservations, please call Krystal Moore at (412) 647-8232 or (412) 647-7050.

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The Eleventh Annual John M. Templeton Jr. Pediatric Trauma

Symposium will continue to be green. Access all pre-conference

information at https://ccehs.upmc.com/formalCourses.jsp#2744.

All participants will receive access to course materials following

the conference.

• Injury Prevention • Trauma Outreach

• Evaluation and Management of Pediatric Trauma across the Continuum, including Pre-hospital and Rehabilitation

A

IRPORT

T

RANSPORTATION

Airlines Transportation Company provides shuttle service from the Pittsburgh International Airport to the Pittsburgh Marriott City Center. The cost is $20 one-way. The hotel bell captain can assist you with scheduling for your return to the airport.

P

ARKING

Based on availability, conference attendees may park in the Marriott Garage. The fee for this garage is in the range of $20/daily. Other pay lots are located throughout downtown Pittsburgh. Please note that parking is on your own and not included in the conference registration fee.

At an additional fee, the Pittsburgh Marriott City Center also provides valet parking for overnight guests.

S

PECIAL

N

EEDS

Participation by all individuals is encouraged. Advance notification of any special needs will help us provide better service. Please notify us of your needs aatt lleeaasstt ttwwoo wweeeekkss in advance of the program by calling (412) 647-7050 or (412) 647-8232.

C

ALL FOR

A

BSTRACTS

The conference organizing committee invites you to submit an abstract for oral or poster presentation at the Eleventh Annual John M. Templeton Jr. Pediatric Trauma Symposium. This is an excellent opportunity to share your best practice initiative or pediatric trauma research project. The oral and poster sessions will focus on topics that are of interest and importance to all clinicians involved in the care of pediatric trauma patients.

Suggested Topics of Interest:

• Clinical Practice • Disaster Management • Development of Standards and Protocols • Quality Assurance / Performance Improvement • Role of Advanced Practice

Nurses and Physician Assistants

Abstracts will only be accepted for review until the submission deadline, December 31, 2010. Please visit

https://ccehs.upmc.com/formalCourses.jsp#2744 for full submission guidelines and to submit your original work. Posters or oral abstracts submitted at other meetings that represent original material not previously published in a peer-reviewed journal will be considered.

Each first author of an abstract that is accepted for oral or poster presentation will receive a $50.00 discount

off the course registration fee.

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5

Big city amenities, small-town friendly. That’s Pittsburgh. With a breathtaking

skyline, sparkling clean rivers, magnificent architecture, and the

LEED-certified Children’s Hospital

of Pittsburgh of UPMC.

Named one of the country’s

best arts cities, conference

attendees can see a wide

variety of art from the

Andy Warhol Museum to

the offerings at the Carnegie Museums of Art and Natural History.

Seven downtown theaters present performances by the world-class

Pittsburgh Symphony Orchestra, Pittsburgh Ballet Theater, Broadway

Series and Pittsburgh Opera, while the city’s jazz legacy is preserved at the

August Wilson Center for

African American Culture.

Downtown restaurants and

shops are easily accessible

on foot or on the “T,” an

underground rail system

that is within the central

business district.

Shopping is convenient and a bargain, as there

is no tax on clothing in Pennsylvania.

Conference attendees can jog along paved,

tree-lined paths along the rivers. Or they can take a

short walk over one of Pittsburgh’s many bridges

as they cross the Monongahela River to visit

Station Square, a riverfront site featuring a

collection of shops and restaurants.

Visitors can experience the city’s

beautiful skyline on board a

river-boat tour or ride the Duquesne

Incline to one of the many

restau-rants overlooking the city at the top

of Mount Washington to experience

firsthand what USA Today Weekend

magazine named as one of the most beautiful views in America.

The conference hotel, The Pittsburgh Marriott City Center, is the “Official Hotel

of the Pittsburgh Penguins,” and is located directly across from the new

CONSOL Energy Center and just steps from the heart of the business district.

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7:00 am Registration, Breakfast and Exhibits 8:00 am Welcome and Introduction

Barbara Gaines, MD, FACS, FAAP and Michael Nance, MD, FACS, FAAP Moderator: Marla Vanore, RN, MHA

8:15 am Models of Trauma Care: A North American Perspective Tarek Razek, MD

9:00 am Controversies in Pediatric Termination of Resuscitation after Out-of-Hospital Traumatic Cardiopulmonary Arrest

Mary Fallat, MD

9:45 am Special Aspects of Pediatrics in Disaster Planning Susan Cox, RN, MS, CPEN, PHN

10:30 am Break

Moderator: Michael Nance, MD, FACS, FAAP

11:00 am Pediatric Trauma Resuscitation: What ATLS Doesn’t Tell You Martin Keller, MD

11:25 am Preventing Injuries Through Education: A Teachable Moment is Needed Michael Gittleman, MD, FAAP

11:50 am Questions and Challenges in the Transport of the Injured Child Kirsten Johnson Moore, RN, MSN

P

ROGRAM

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7

12:15 pm Panel Q&A 12:30 pm Lunch and Exhibits

1:30 pm Concurrent Session A or B (choose one) Concurrent Session A:

Challenging Cases in Pediatric Trauma I

Moderator: Joy Lynn Collins, MD, FAAP 1:30 pm Case 1 Altoona Regional Health System

Simon Lampard, MD, FACS Case 2 McGill University Health Centre

Tarek Razek, MD

Case 3 St. Louis Children’s Hospital Martin Keller, MD and Diana Kraus, RN, BSN

3:00 pm Break and Exhibits Friday, March 4th

continued

Friday Schedule continues

Concurrent Session B:

Moderator: Mary Jo Pedicino, RN, MSN 1:30 pm Management of Orthopedic Injuries

in the Emergency Department James Roach, MD

1:55 pm Best Practices in the Care of Complex Wounds Paula Erwin-Toth, MSN, RN, CWOCN, CNS 2:20 pm Critical Considerations in Emergent Laparotomies

Matthew Moront, MD, FACS, FAAP 2:45 pm Panel Q&A

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3:30 pm Concurrent Session C or D (choose one) Concurrent Session C:

Oral Abstracts

Moderator: Barbara Gaines, MD, FACS, FAAP

See page 4 for information regarding Abstract Submission.

5:00 pm Friday Adjournment

5:00 pm Welcome Reception and Poster Session – Please join us immediately following the end of today’s conference session for refreshments and poster viewing. Friday, March 4th

continued Concurrent Session D:

Moderator: Michael Gittelman, MD, FAAP 3:30 pm Dog Bites to Children: A Behavioral

Perspective

Ilana Reisner, DVM, PhD, DACVB 3:55 pm A Strategic Approach to Trauma

Procedures in the ED Mary Fallat, MD

4:20 pm Dental Trauma: Restoration of a Child’s Smile Brian Martin, DMD 4:45 pm Panel Q&A

(9)

9

7:00 am Registration, Breakfast and Exhibits 8:00 am Welcome and Introduction

Barbara Gaines, MD, FACS, FAAP and Matthew Moront, MD, FACS, FAAP Moderator: John M. Templeton Jr., MD

8:15 am Getting Beyond the Mainstream: Reaching High-Risk Kids on the Nation’s Roads and Highways Alexander W. (Sandy) Sinclair

9:00 am Families: Integral Team Members or “Just Visiting”? Kathryn Roberts, RN, MSN, CRNP, CCRN, CCNS 9:45 am Approaches to the Management of Pediatric Shock

David W. Tuggle, MD, FACS, FAAP, FCCM 10:30 am Break and Exhibits

11:00 am Concurrent Session E or F (choose one) Concurrent Session E:

Moderator: Robert Cilley, MD

11:00 am Trauma: The Ultimate Team Event Susan Cox, RN, MS, CPEN, PHN 11:25 am Rural Trauma

David Tuggle, FACS. FAAP, FCCM

11:50 am Uncovering the Truth Regarding Radiation in Children Archana Malik, MD

12:15 pm Panel Q&A

P

ROGRAM

Saturday, March 5th

Saturday Schedule continues

Concurrent Session F:

Simulation and Team Roles

Moderator: Marianne Miller, RN, BSN Joy Lynn Collins, MD, FAAP;

Melinda F. Hamilton, MD, MSc; Brett McAninch, MD;

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12:30pm Lunch & Exhibits

1:30 pm Concurrent Session G or H (choose one) Concurrent Session G:

Challenging Cases in Pediatric Trauma II

Moderator: Monica A. Liebman, RN, MSN, PHRN Case 1 Lehigh Valley Hospital Medical Center

Donna Grather, RN, BSN, CEN, PHRN and William D. Hardin Jr., MD

Case 2 Penn State Milton S. Hershey Medical Center Susan E. Rzucidlo, MSN, RN and Robert E. Cilley, MD Case 3 St. Christopher’s Hospital for Children

Brooke Burkey, MD and Susan Cannon RN, MSN, CPN

3:00 pm Conference Adjournment Saturday, March 5th

continued

Concurrent Session H:

Advances in Pediatric Neurotrauma Care

Moderator: Matthew Moront, MD, FACS, FAAP 1:30 pm New Frontiers in Pediatric Neuro

Critical Care Michael Bell, MD

2:05 pm Nursing Management of the Pediatric TBI Patient: the PICU Perspective Kathryn Roberts, MSN, RN, CRNP, CCRN, CCNS

2:30 pm The Management of Post-Concussion Syndrome

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11

C

OURSE

D

IRECTORS

Christine Campbell, RN, BSN, MS Trauma Program Manager

St. Christopher’s Hospital for Children Philadelphia, PA

Barbara A. Gaines, MD, FACS, FAAP Associate Professor of Pediatric Surgery University of Pittsburgh School of Medicine Director, Benedum Pediatric Trauma Program Children’s Hospital of Pittsburgh of UPMC Pittsburgh, PA

Christine McKenna, MSN, RN, CRNP Manager, Trauma Clinical Services Benedum Pediatric Trauma Program Children’s Hospital of Pittsburgh of UPMC Pittsburgh, PA

Matthew Moront, MD, FACS, FAAP Assistant Professor of Surgery Drexel University College of Medicine Director of Trauma Services St. Christopher’s Hospital for Children Philadelphia, PA

Michael L. Nance, MD, FACS, FAAP Professor of Pediatric Surgery

University of Pennsylvania School of Medicine Director, Pediatric Trauma Program

Josephine J. and John M. Templeton Jr. Endowed Chair in Pediatric Trauma The Children’s Hospital of Philadelphia Philadelphia, PA

Marla Vanore, RN, MHA

Manager, Trauma and Injury Prevention Programs The Children’s Hospital of Philadelphia

Philadelphia, PA

P

LANNING

C

OMMITTEE

Monica Liebman, RN, MSN, PHRN

Coordinator, Emergency Medical Services (EMS) Emergency Transport Team

The Children’s Hospital of Philadelphia Philadelphia, PA

Marianne Miller, RN, BSN

Trauma Performance Improvement Coordinator Benedum Pediatric Trauma Program

Children’s Hospital of Pittsburgh of UPMC Pittsburgh, PA

Mary Jo Pedicino, RN, MSN Trauma Education Coordinator The Children’s Hospital of Philadelphia Philadelphia, PA

C

OURSE

F

ACULTY

Michael Bell, MD

Associate Professor of Critical Care Medicine, Pediatrics and Neurological Surgery Associate Director, Safar Center for

Resuscitation Research

University of Pittsburgh School of Medicine Director, Pediatric Neurotrauma Center Director, Pediatric Neurocritical Care Children’s Hospital of Pittsburgh of UPMC Pittsburgh, PA

Brooke Burkey, MD Attending Surgeon

Section of Plastic and Reconstructive Surgery St. Christopher’s Hospital for Children Assistant Professor of Surgery and Pediatrics Drexel University College of Medicine Philadelphia, PA

Susan Cannon, RN, MSN, CPN Nurse Manager SCU/BC

St. Christopher’s Hospital for Children Philadelphia, PA

Robert E. Cilley, MD

Chief, Division of Pediatric Surgery Pediatric Trauma Program Medical Director Professor of Surgery and Pediatrics Milton S. Hershey Medical Center Penn State College of Medicine Hershey, PA

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Joy Lynn Collins, MD, FAAP Assistant Professor of Surgery

University of Pennsylvania School of Medicine Attending Surgeon, Division of Pediatric

General, Thoracic and Fetal Surgery The Children’s Hospital of Philadelphia Philadelphia, PA

Susan A. Cox, RN, MS, CPEN, PHN President, Society of Trauma Nurses Director, Trauma and Volunteer Services Rady Children’s Hospital

San Diego, CA

Paula Erwin-Toth, MSN, RN, CWOCN, CNS Director, WOC Nursing Education

Cleveland Clinic Foundation Cleveland, OH

Mary E. Fallat, MD

Hirikati S. Nagaraj Professor and Division Director, Pediatric Surgery

University of Louisville Chief of Surgery Kosair Children’s Hospital Louisville, KY

Michael Gittelman, MD, FAAP Associate Professor of Clinical Pediatrics Division of Emergency Medicine Cincinnati Children’s Hospital Cincinnati, OH

Amy Goldstein, MD Assistant Professor of Pediatrics

University of Pittsburgh School of Medicine Division of Child Neurology

Children’s Hospital of Pittsburgh of UPMC Pittsburgh, PA

Donna Grather, RN, BSN, CEN, PHRN Pediatric Trauma Coordinator Lehigh Valley Health Network Allentown, PA

Melinda F. Hamilton, MD, MSc

Assistant Professor of Critical Care Medicine & Pediatrics Department of Critical Care Medicine

University of Pittsburgh Medical Center Director, Pediatric Simulation

Peter M. Winter Institute for Simulation, Education, and Research (WISER) and

Children’s Hospital of Pittsburgh of UPMC Simulation Center

Pittsburgh, PA

William D. Hardin Jr., MD

Medical Director, Pediatric Trauma Program Lehigh Valley Health Network

Allentown, PA Martin S. Keller, MD

Associate Professor of Pediatric Surgery Washington University

Director of Trauma St. Louis Children’s Hospital St. Louis, MO

Diana J. Kraus, RN, BSN Manager, Trauma Services St. Louis Children’s Hospital St. Louis, MO

Simon Lampard, MD, FACS Medical Director

Trauma and Critical Care Services Altoona Regional Health System Altoona, PA

Archana Malik, MD Attending Radiologist

St. Christopher’s Hospital for Children Assistant Professor, Pediatric Radiology Drexel University College of Medicine Philadelphia, PA

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13

Brian Martin, DMD

Chief, Division of Pediatric Dentistry Children’s Hospital of Pittsburgh of UPMC Pittsburgh, PA

Brett McAninch, MD Assistant Professor of Pediatrics

University of Pittsburgh School of Medicine Pediatric Emergency Medicine

Children’s Hospital of Pittsburgh of UPMC Pittsburgh, PA

Kirsten Johnson Moore, RN, MSN Director, Emergency Nursing Services &

Respiratory Care

St. Christopher’s Hospital for Children Philadelphia, PA

Tarek S. Razek, MD Trauma Program Director McGill University Health Centre Montreal, Canada

Ilana R. Reisner, DVM, PhD, DACVB Assistant Professor of Behavioral Medicine Director, Behavior Clinic

Ryan Veterinary Hospital School of Veterinary Medicine University of Pennsylvania

Philadelphia, PA

James Roach, MD

President, Pediatric Orthopedic Society of North America

Professor of Surgery, University of Pittsburgh School of Medicine

Professor of Surgery, University of Utah School of Medicine

Children’s Hospital of Pittsburgh of UPMC Pittsburgh, PA

Kathryn Roberts, MSN, RN, CRNP, CCRN, CCNS Clinical Nurse Specialist

Pediatric Intensive Care Unit The Children’s Hospital of Philadelphia Philadelphia, PA

Roni Robinson, RN, MSN, CRNP Pediatric Trauma Nurse Practitioner The Children’s Hospital of Philadelphia Philadelphia, PA

Susan E. Rzucidlo, MSN, RN Pediatric Trauma and Injury Prevention

Program Manager

Coordinator, Safe Kids Dauphin County Penn State Hershey Children’s Hospital Milton S. Hershey Medical Center Hershey, PA

Alexander W. (Sandy) Sinclair Highway Safety Specialist

U.S. Department of Transportation/NHTSA Washington, DC

John M. Templeton Jr., MD Adjunct Professor of Surgery

University of Pennsylvania School of Medicine President, Pennsylvania Division,

American Trauma Society Philadelphia, PA

David Tuggle, MD, FACS, FAAP, FCCM Professor, Department of Surgery Chief, Section of Pediatric Surgery Children’s Hospital at Oklahoma

University Medical Center Oklahoma City, OK

In accordance with Accreditation Council for Continuing Medical Education requirements on disclosure, information about relationships of presenters with commercial interests (if any) will be included in materials distributed at the time of the conference.

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R

EGISTRATION

I

NFORMATION Pre-register

Early registrations are due by February 2, 2011. After February 2, 2011, late registrations will be accepted until February 20, 2011 at an additional fee and we cannot guarantee space in the program or any program inclusions for those registrations received after this date.

Online Registrations (due by February 2, 2011)

Registering online is the quickest and easiest way to reserve your space at CCEHS conferences.

1. Visit our on-line registration site at

https://ccehs.upmc.com/formalCourses.jsp#2744

2. Click the Registration button and enter all the requested information (including an e-mail address) and follow the prompts to submit your registration after entering your payment information.

3. If you register online, you will receive an immediate e-mail confirmation message. Print the automatic electronic registration confirmation e-mail sent to the e-mail address you provided us when you registered. If you do not receive this confirmation, please contact us at (412) 647-8232.

Paper Registration

A confirmation letter will be faxed or mailed if registration is completed through the mail or fax.

Please note: Registration is not complete until you receive this confirmation. If you do not receive this letter within 5-7 days of registration, please contact us at (412) 647-8232 or (412) 647-7050.

You must bring this confirmation letter with you to the conference. Cancellation

All cancellations must be in writing and sent to us via U.S. mail, e-mail or fax. Tuition for cancellations postmarked or date stamped before February 13, 2011 will be completely refunded. After February 13, 2011 a $35 administrative fee will be assessed. No refunds will be made after February 20, 2011. Cancellation requests must be made in writing to:

Krystal Moore, Coordination Specialist

UPMC Center for Continuing Education in the Health Sciences 200 Lothrop Street • Iroquois Building, Suite 302

Pittsburgh, PA 15213-2536

Telephone: (412) 647-8232 or (412) 647-7050 • Fax: (412) 647-8222 E-mail: moorekl2@upmc.edu

The UPMC Center for Continuing Education in the Health Sciences reserves the right to cancel this program if sufficient registrations are not received. In the case of cancellation, the department will fully refund registration fees.

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15

Early

Late

Onsite

Due: February 2, 2011 Due: February 20, 2011 Register onsite if you are unable to pre-register by February 20, 2011 Physicians

Full Conference $425 One Day $250 Nurses and Other

Health Care Professionals Full Conference $325 One Day $200 Residents, Trainees and Students Full Conference $150 One Day $ 75 Physicians Full Conference $450 One Day $275 Nurses and Other

Health Care Professionals Full Conference $350 One Day $225 Residents, Trainees and Students Full Conference $150 One Day $ 75 Physicians Full Conference $475 One Day $300 Nurses and Other

Health Care Professionals Full Conference $375 One Day $250 Residents, Trainees and Students Full Conference $175 One Day $ 75

R

EGISTRATION

F

EES

Registration fee includes:

• Continuing education credit

• Continental breakfast, refreshments and lunch • Welcome reception

• Access to all online course materials

Each first author of an abstract that is accepted for oral or poster presentation will receive a $50.00 discount off the course registration fee.

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REGISTRATIONFORM (FOR USE ONLY IF NOT REGISTERING ON-LINE)

Eleventh Annual John M. Templeton Jr.

Pediatric Trauma Symposium

M

ARCH

4-5, 2011 • C

OURSE

#2744

See Registration Information section on page 14.

Please complete pages 16, 17 and 18 of this registration form. Please type or print. Photocopy all pages of the registration form

for additional registrants.

NO REGISTRATION WILL BE ACCEPTED WITHOUT PAYMENT.

Last FIVE digits of your Social Security Number #___ – ___ ___ ___ ___* Prefix ❏ Mr. ❏ Mrs. ❏ Dr. ❏ Ms. ❏ Other __________ (please indicate) First Name Last Name Suffix (Jr., Sr., etc.) Company/Institutional Affiliation Specialty E-mail Address

Degree* (List only one.) ❏MD ❏ DO ❏ PhD ❏ MPH ❏ RN

Other (please indicate) ______________________ Address

City

Work Telephone (_____) Fax (_____)

How did you hear about this conference?

I require vegetarian lunch. ❏ I require kosher lunch. ❏I have no special dietary requirements.

*Required

}

This is how your

name will appear on your name badge.

State _____ ZIP Code

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17 1:30 pm Concurrent Session A or B

(Friday – choose one)

❏Concurrent Session A: Challenging Cases in Pediatric Trauma I or ❏Concurrent Session B 3:30 pm Concurrent Session C or D

(Friday – choose one)

❏Concurrent Session C:

Oral Abstracts or

❏Concurrent Session D

11:00 am Concurrent Session E or F

(Saturday – choose one)

❏Concurrent Session E:

or

❏Concurrent Session F:

Simulation and Team Roles

1:30 pm Concurrent Session G or H

(Saturday – choose one)

❏Concurrent Session G: Challenging Cases in Pediatric Trauma II or ❏Concurrent Session H: Advances in Pediatric Neurotrauma Care

Total Registration fee enclosed $________________

Each first author of an abstract that is accepted for oral or poster presentation will receive a $50.00 discount off the course registration fee. NEW THIS YEAR...the opportunity to present your oral abstract...see page 4 for details.

S

ESSION

R

EGISTRATION

(Please choose your session)

continued on page 18

Early

Late

Due: February 2, 2011 Due: February 20, 2011 ❏ Physicians

Full Conference $425 One Day: $250

❏ Friday ❏ Saturday ❏ Nurses and Other

Health Care Professionals Full Conference $325 One Day: $200

❏ Friday ❏ Saturday ❏ Residents, Trainees and

Students Full Conference $150 One Day: $ 75 ❏ Friday ❏ Saturday ❏ Physicians Full Conference $450 One Day: $275 ❏ Friday ❏ Saturday ❏ Nurses and Other

Health Care Professionals Full Conference $350 One Day: $225

❏ Friday ❏ Saturday ❏ Residents, Trainees and

Students

Full Conference $150 One Day: $ 75

(18)

continued from page 17

M

ETHOD OF

P

AYMENT

The following methods of payment are acceptable for the registration fee: ■Checks, personal or employer Credit Card UPMC Journal Entry Transfers

Checks. Make payable to UPMC Presbyterian Shadyside.

❏ Employer check included ❏ Personal check included

❏ Employer or Personal check to arrive under separate cover.

If your employer or personal check is arriving under separate cover, you may send or fax in your completed registration form now, but you must complete the Credit Card Payments section below with valid credit card information in order to hold your reservation. If the check payment is not received by four weeks post course, we will charge the registration fee to the credit card number provided.

There is a $25.00 returned check fee.

Credit Card Payments

Visa ❏ MasterCard ❏ American Express ❏ Discover Credit Card No.

Expiration Date (Month/Year) Signature

UPMC Journal Entry Transfer. If you are a UPMC employee and your department will be responsible for payment, we can charge your department directly. DO NOT SUBMIT a disbursement to UPMC Accounts Payable. Complete the following:

Business unit Account number Department ID number Authorized department signature Telephone number

NO REGISTRATION WILL BE ACCEPTED WITHOUT PAYMENT.

Mail payment, accompanied by the registration form to: UPMC Center for Continuing Education in the Health Sciences 200 Lothrop Street

Iroquois Building, Suite 302 Pittsburgh, PA 15213-2536

For additional information, contact: Krystal Moore, Coordination Specialist Telephone: (412) 647-8232 or (412) 647-7050 Fax: (412) 647-8222

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19

F

OR ADDITIONAL INFORMATION

,

CONTACT

:

Krystal Moore, Coordination Specialist Telephone: (412) 647-8232 or (412) 647-7050 Fax: (412) 647-8222

E-mail: moorekl2@upmc.edu

V

ISIT THE

C

ENTER FOR

C

ONTINUING

E

DUCATION IN THE

H

EALTH

S

CIENCES

W

EB

S

ITE

Our Internet address is: https://ccehs.upmc.com

The UPMC Center for Continuing Education in the Health Sciences invites you to visit our web location. Receive information on CME programs, earn CME credits on the Internet, and access information about our formal courses and much more. Discover who we are and how you can contact us. Please visit our web location often to get updated information on upcoming programs.

The University of Pittsburgh, as an educational institution and as an employer, values equality of opportunity, human dignity, and racial/ethnic and cultural diversity. Accordingly, the University prohibits and will not engage in discrimination or harassment on the basis of race, color, religion, national origin, ancestry, sex, age, marital status, familial status, sexual orientation, disability, or status as a disabled veteran or a veteran of the Vietnam era. Further, the University will continue to take affirmative steps to support and advance these values consistent with the University’s mission. This policy applies to admissions, employment, access to and treatment in University programs and activities. This is a commitment made by the University and is in accordance with federal, state, and/or local laws and regulations. For information on University equal opportunity and affirmative action programs and complaint/grievance procedures, please contact: William A. Savage, Assistant to the Chancellor and Director of Affirmative Action (and Title IX and 504 Coordinator), Office of Affirmative Action, 901 William Pitt Union, University of Pittsburgh, Pittsburgh, PA 15260, (412) 648-7860.

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Center for Continuing Education in the Health Sciences 200 Lothrop Street • Iroquois Building, Suite 302 Pittsburgh, PA 15213-2536 Nonprofit Org. U.S. Postage PAID Pittsburgh, PA Permit No. 2110

M

A R C H

4 ~ 5 , 2 0 1 1

Eleventh Annual

John M. Templeton Jr.

Pediatric Trauma Symposium

Pittsburgh Marriott City Center

Pittsburgh, Pennsylvania

Children’s Hospital of Pittsburgh of UPMC The Children’s Hospital of Philadelphia

St. Christopher’s Hospital for Children University of Pittsburgh, Center for Continuing

Education in the Health Sciences

Visit us online at

References

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