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HKSEMS eNewsletter Issue 012
2020Jan

香港急症醫學會

Hong Kong Society
for Emergency Medicine & Surgery
The council of HKSEMS for the year 2019-2021 has been newly elected. Please click here to know its new council members. 

Congratulations to Dr Ben Kuang-An WAN on being elected as the president of HKSEMS 2019-2021. Click here to read the first message from the president by Dr Wan.

In order to promote knowledge and provide training on pre-hospital basic trauma life support and wilderness related emergencies, HKSEMS ran a series of 4 Basic Trauma Life Support Course for the CAS MSaR attendants. Please click here to see the event.
Message from the President      Dr Ben Kuang-An WAN
It is by all means my honor to be the President of HKSEMS. First of all, I would like to express my gratitude to those who have tirelessly supported HKSEMS. Under the great leadership of successful predecessors, endeavors of councilors and participations of our members, we have witnessed how HKSEMS has become the vanguard of the Emergency Medicine (EM) community in HK, and grown steadily into an internationally recognized professional body since its establishment in 1985.
We are heading towards a new decade, when rapidly evolving technologies such as AI, 5G network, Internet of Things, mixed reality etc. will transform the service of healthcare, and open up endless possibilities. Looking back, in the past 10 years we had several significant achievements. In the era of globalization, collaboration remained a strategic approach for enhancement. We had collaborations with medical counterparts in the Greater China Area. We supported the Greater China Office jointly operated with HKCEM to facilitate exchange activities in the Greater China Region. We launched the A&E Service Oriented Survey in 2012 which addressed the need of healthcare professionals working in local A&Es, and aroused public awareness on the challenges in A&E services. To celebrate our 30th Anniversary in 2015, we published a book “生命邊緣的守護者” and organized the CPR Marathon in 2016. We believed that A&E departments should not be the boundary of EM as a unique specialty. We offered emergency medical training for other healthcare disciplines such as Chinese Medicine practitioners and dentists. We were involved in the public educational programs such as health talks in public libraries, schools and phone-in radio programs. HKSEMS is one of the institutional members of Resuscitation Council of Hong Kong. We are committed to serve the community and we believe that our members think alike.
 
A&E staffs experienced a lot of challenges in the past 10 years. We experienced persistently high demand for A&E services especially during the winter surge. This was not a novel, but a revolving phenomenon, and the situation was deteriorating and worrisome. Non-urgent and semi-urgent attendance remained the greatest proportion of A&E patients. Easy accessibility of A&E Department, inadequate primary healthcare services, and ageing population with higher prevalence of chronic diseases and exacerbations, all contributed to A&E overcrowding and access block. Staff burnout ensued as our professional A&E staffs needed to work for extra hours in adverse working environment to meet the overwhelming service demand. Introduction of new advanced protocols for time-sensitive critical illnesses (such as PPCI for STEMI, Prompt parenteral antibiotics for neutropenic fever or severe sepsis, and emergency CT scan of brain +/- CT angiogram followed by thrombolysis or thrombectomy for ischemic stroke), and the availability of investigations facilitated timely management and improve patient outcome. A&E Department workflow became more sophisticated yet complex. In the face of manpower shortage, it is challenging to maintain the resilient and sustainable development of A&E services to surpass the ever-rising expectations of the general public.
 
HKSEMS aims to look after the interests of our members and the development of EM services. We will continue to address the problems we are facing and the needs of the community on matters related to EM. Let’s work hand in hand to overcome the challenges ahead. Your support and suggestions will also be highly appreciated.
 
Last but not the least, we will co-organize with HKCEM to host the 11th Asian Conference on Emergency Medicine (ACEM) on 17-19 December 2021. The Organizing Committee, formed by EM stakeholders with diverse expertise, is working hard to design a highly educational scientific program, and create a platform where our members are able to meet up high-caliber overseas experts in EM. Save the date and stay tuned!

From the Editors    Dr Chor-man Lo & Dr Sam Siu-ming Yang

Welcome to the new issue of our newsletter.
 
The Annual General Meeting of HKSEMS was successfully held in Oct 2019 and it marked the beginning of the new HKSEMS Council for the term 2019-2021. The new Council is thankful to Dr

Ludwig Tsoi, who has been the President of HKSEMS from 2015-2019, for his valuable contribution to the Society. We believe that the newly elected President, Dr Ben Wan, will take up the lead to promote HKSEMS to be an important icon of Emergency Medicine among the general public and in the regional areas.

As the Asian Conference for Emergency Medicine (ACEM) is going to be held in Hong Kong in 2021, various preparatory works are under way. We sent two teams of delegates, one to ACEM 2019 held in New Delhi in November, and the other to Emirates Society of Emergency Medicine Conference 2019 held in Abu Dhabi in December, to promulgate ACEM 2021 (HK), as well as to gain valuable experience in holding similar events in different localities.

The next issue marks the 3rd anniversary of our Newsletter and we will bring more interesting stuff to our members.

Stay tuned and Happy new year!

Council News
Dear Members of HKSEMS,

Welcome to the 4th issue in 2019. Let’s refresh the activities organized by the council in these 3 months!!
Annual General Meeting(AGM)
 
The AGM 2019 of the HKSEMS was held on 26th October 2019 in the Hong Kong Academy of Medicine Jockey Club Building. It marked the beginning of the 2019-2021 Council.
Election result for the 2019-2021 council was released in the AGM.
The Council expressed their votes of thanks to Dr. Ludwig Tsoi for his amazing leadership in these 4 years, and a warm welcome to Dr. Ben Wan as the new President of the 2019-2021 Council.
Election result
Group photo at HKCEM conferment ceremony
Photo taken after the 2019-2021 first council meeting
The 21st Annual Conference of Society for Emergency Medicine (ACEM 2019)
 
Dr. Ludwig Tsoi, Dr. Axel Siu, Dr. Chau Chi Wai and Dr. Willis Kwok attended the ACEM 2019 in New Delhi, India from 7 November to 10 November. The team promoted to the participants on ACEM 2021 to be co-organized by HKCEM and HKSEMS.
 
.
Emirates Society of Emergency Medicine Scientific Conference (ESEM) 2019

Dr. Axel Siu, Dr. Ben Wan, Dr. Sam Yang and Dr. Wong Kwun Bun attended Emirates Society of Emergency Medicine Scientific Conference 2019 which was held on 11-14 December 2019 in United Arab Emirates.
The team promoted ACEM 2021 to the participants.
Civil Aid Service (CAS) Mountain Search and Rescue (MSaR) Team Mountain Rescue Basic Trauma Life Support (Provider) Course
 
In order to promote knowledge and provide training on pre-hospital basic trauma life support and wilderness related emergencies, Hong Kong Society of Emergency Medicine & Surgery (HKSEMS) ran a series of 4 identical classes for the CAS MSaR attendants. Each class consist of 18 hours of  lectures, skill training and practical sessions, followed by written and practical assessment.
We have just completed the 3rd class!
Training program in trail running (co-organized with HKCEM sports team
 
HKSEMS co-organized this course with the sports team of HKCEM, which comprised of 6 sessions, aiming to gather a group of Trail runners to practice and run together!!

We have successfully completed the 6 sessions. Feedback from the participants was positive. We are now planning for the class of intermediate level. Please stay tune!!
Let’s take a look at the happy moments during the last session in MacLehose trail 7-8 on 21/12/2019.
Welcome new members
 
We welcome the following new member:
 
Dr. Law Ping Keung  (Private Emergency Physician)

Medical Tips

ST Elevation
 
  • The ST Segment represents the interval between ventricular depolarization and repolarization.
  • The most important cause of ST segment abnormality (elevation or depression) is myocardial ischaemia or infarction.
 
Causes:
1. ST elevation myocardial infarction(STEMI)
Acute STEMI may produce ST elevation with either concave, convex or obliquely straight morphology. There is usually reciprocal ST depression in the electrically opposite leads.
Capture beat
2.Pericarditis
Acute Pericarditis causes widespread concave (“saddleback”) ST segment elevation with PR segment depression in multiple leads.
Two fusion beats following a capture beat
 3. Benign Early Repolarization
Benign Early Repolarization causes mild ST elevation with tall T-waves mainly in the precordial leads. It is a normal variant commonly seen in young, healthy patients. There is often notching of the J-point — the “fish-hook” pattern. The ST changes may be more prominent at slower heart rates and disappear in fast heart rate.
Positive concordance

4. Left Bundle Branch Block (LBBB)

In LBBB, the ST segments and T waves show “appropriate discordance” — i.e. they are directed opposite to the main vector of the QRS complex. This produces ST elevation and upright T waves in leads with a negative QRS complex (dominant S wave), and ST depression and T wave inversion in leads with a positive QRS complex (dominant R wave).

5. Left Ventricular Hypertrophy (LVH)

LVH causes a similar pattern of repolarization abnormalities as LBBB, with ST elevation in the leads with deep S-waves (usually V1-3) and ST depression/T-wave inversion in the leads with tall R waves (I, aVL, V5-6).
6. Ventricular Aneurysm
ECG in ventricular aneurysm shows residual ST elevation and deep Q waves seen in patients with previous myocardial infarction. It is associated with extensive myocardial damage and paradoxical movement of the left ventricular wall during systole.

Upcoming Events and Conferences
Certificate course in Mountaineering ( Level 1 )
 
一級山藝訓練證書課程
Only 1 class will be arranged with 3 sessions
Each class consist of one 4-hours Theory class and two 7-hours daylight hiking practical sessions.                  
 
Class
28/4  Theory                 10:30-14:30  
15/5  Daylight Hiking     09:30-16:00
28/5  Daylight Hiking     09:30-16:00
 
 50% sponsorship by HKSEMS for >50% attendance (2 out of 3 attended).
Certificate will be granted with 100% attendance of 2 Daylight Hiking sessions.
 
All HKCEM and HKSEMS members (doctors and nurses) are welcome.
Deadline for application 1 April 2020
 
For enquiry, please contact Ms. Joanne LAU at 2871 8875 email: joanne@hkcem.org.hk.
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