#ICEM2025 May 25th Recap

ICEM 2025 Daily Recap: Sunday, May 25 – A Day of Innovation and Connection

Welcome to our first daily recap from ICEM 2025 in Montréal! Sunday was a dynamic start to the conference, filled with insightful sessions, groundbreaking discussions, and vibrant networking opportunities. Here’s a structured overview of the day’s highlights:

Disclaimer: Much of the content in this post was captured live or based on material shared with us. If any speakers notice inaccuracies, please reach out to the social media team. We also acknowledge that not all of the excellent content from the conference could be included.

🏛️ Opening Ceremony

Opening ICEM2025, a heartfelt tribute was paid to the Kanien’kehá:ka (Mohawk Nation), the traditional custodians of the lands on which the conference is being held. Performed by Ka'nasohon Elder Kevin Deer. Attendees were invited to reflect on the enduring presence and cultural significance of the Kanien’kehá:ka people. This powerful moment served not only as a recognition of the past, but as a commitment to walk together in the spirit of truth, reconciliation, and partnership.

Dr. Aimee Kernick welcomed us to the conference on behalf of the Canadian Association of Emergency Physicians (CAEP) - hosting ICEM for the first time in more than a decade.

🌟 Plenary Session: “Dare to Explore”

Kicking off the conference with inspiration that’s truly out of this world, Dr. David Saint-Jacques joins us live from NASA’s Johnson Space Center in Houston, Texas. A physician, engineer, astrophysicist, and Canadian Space Agency astronaut, Dr. Saint-Jacques brings a unique perspective shaped by years of exploration—both on Earth and beyond. He’s best known for his 204-day mission aboard the International Space Station in 2018–2019, the longest Canadian spaceflight to date. With experience spanning remote Arctic medicine to zero-gravity spacewalks, he opens the conference with a talk aptly titled “Dare to Explore”—challenging us to push boundaries, embrace the unknown, and lead with curiosity.

As he addressed us from the heart of NASA’s operations, Dr. Saint-Jacques reminded us of what’s possible when science, teamwork, and human curiosity align.

A Physician Among the Stars

Dr. Saint-Jacques is no stranger to remote medicine. He described his early career working as the sole physician in a small northern community, managing whatever came through the clinic doors. “Being aboard the ISS can feel very similar,” he noted. “You’re one of a small crew, working together to solve problems, often improvising—McGyver-style.”

He didn’t set out to be an astronaut through medicine, though. That path began much earlier: as a young boy dreaming about the cosmos. “I remember seeing a picture of Earth from the Moon and wondering—who took that? That moment changed my life.” From that seed of curiosity, he pursued engineering, medicine, and ultimately spaceflight, culminating in his 204-day mission aboard the International Space Station.

During his mission, he became the fourth Canadian to perform a spacewalk and the first Canadian to operate the Canadarm2 on the ISS—an iconic symbol of Canadian ingenuity.

Life on the ISS: Medicine, Maintenance, and Perspective

Dr. Saint-Jacques spoke passionately about the ISS as a marvel of technology—“the most complicated machine humans have ever built.” Half of it is essentially a giant life-support machine, sustaining human life in the vacuum of space. The other half? Science experiments and health research - often using the astronauts themselves as study subjects.

“Going to space is cool,” he said with a smile, “but it’s bad for your health.” Weightlessness affects every body system, making astronauts ideal models for studying disease processes in otherwise healthy individuals. Much of that research, he emphasized, is led by Canadian teams.

He also spoke movingly about the collaborative spirit of the ISS, calling it “one of the last bridges humanity wants to keep open at all costs.” Despite conflicts on Earth, nations continue to work together in orbit - proof, he said, that “when we choose to cooperate, we can do incredible things.”

But perhaps most striking was the shift in perspective he experienced while off-world:

“Earth is a life-sustaining machine for billions of us. The ISS keeps a handful of astronauts alive in the deadly vacuum of space—and we’re in awe of that. But the Earth does this at a massive scale. The atmosphere is our helmet.”

It’s a perspective that stays with him still, one that reframes our planet as a shared, fragile spacecraft—one we must protect together.

Coming Home, and Looking Forward

Returning to Earth wasn’t gentle. “You crash land, then are pulled from the capsule by a rescue team. Gravity hits hard.” After weeks of rehab, he slowly regained his balance and strength. “I felt useless at first… but eventually I was ready to be an Earthling again.”

Despite the trials, it’s clear his time in space brought him closer to his loved ones. “It’s like a long business trip. I cherished every FaceTime I got with my family.”

As for the future, Saint-Jacques shared his excitement for Artemis II, the upcoming crewed mission to orbit the Moon, which will include Canadian astronaut Jeremy Hansen. Looking ahead to Mars, he highlighted how medical autonomy - especially for long-duration missions - will be a crucial challenge. Physicians, he emphasized, will continue to play a central role in space exploration.

A Final Glimpse from Above

Dr. Saint-Jacques closed with a series of breathtaking images of Earth taken from the cupola of the ISS—reminders of both our smallness and our shared home.

“When you zoom out, you realize how much we’re in the middle of nowhere, floating together. It makes you want to protect your family—and this planet.”

🔍 Morning Concurrent Tracks

Digital EM and Tech Innovation: Sessions explored the integration of digital tools in emergency settings, highlighting advancements in telemedicine, electronic health records, and AI-driven diagnostics.

Dr. Kendall Ho on Implementing Medical Technology in the Emergency Department

• AI scribes are being developed to detect diagnostic errors from emergency physicians and request changes to management plans or investigations

• AI diagnostic technologies are booming and are now able to estimate a pro-BNP through a stethoscope-like probe

• Are we allowing AI to take over the emergency provider's job?

Dr. Erik Blutinger on the Cost and Value of AI in Emergency Medicine

The rapid rise of telemedicine has significantly reduced the burden on emergency departments, decreasing the number of patients requiring in-person care. While this shift offers clear benefits for system efficiency and accessibility, it also presents challenges for emergency medicine stakeholders who are now seeing a decline in patient volumes. However, the promise of virtual care is not universal — limited broadband access in some regions continues to restrict equitable use of telehealth services. Additionally, growing concerns around artificial intelligence are emerging among healthcare providers, including fears about erosion of clinical autonomy, the role of private tech companies in handling sensitive patient data, and the potential for political interference in clinical decision-making.

Dr. Tom Hughes and Dr. Ben Bloom on Value-Based Emergency Healthcare

The world is changing — with fewer trauma cases and evolving models of care, we must ask ourselves: what value do emergency physicians bring, and what will our role be in 50 or even 500 years? One significant shift is the sharp decline in patients referred directly to the emergency department by primary care providers, altering the traditional pathways of acute care. At the same time, emergency physicians often manage patients who present with undifferentiated symptoms that do not lead to a definitive diagnosis — a common and acceptable outcome in our field. This raises an important question: how do we demonstrate the value of emergency medicine when our work is focused on risk stratification, stabilization, and ruling out life-threatening illness rather than providing a final answer?

Dr. Goksu Bozdereli Berikol on hyperprecision in Emergency Medicine:

• The current focus in emergency medicine is shifting away from generalized, population-level early warning systems and clinical decision rules (CDRs) toward a highly personalized, patient-specific approach.

• Emerging technologies, including AI, aim to deliver dynamic and precise recommendations tailored to the individual, rather than relying solely on static protocols.

• For example, current guidelines on the use of P2Y12 inhibitors in acute coronary syndrome (ACS) do not account for genetic or individual variability in patient response to these medications.

• AI has the potential to assess data in real time and generate personalized management recommendations at the bedside, enhancing precision and safety in emergency care.

Drugs and Doses: Toxicology and Addiction: Experts discussed current trends in substance use, overdose management, and the role of emergency departments in addressing addiction.

EMS: Presentations focused on pre-hospital care innovations, including community paramedicine programs and strategies for improving response times.

Geriatric Emergency Medicine: Attendees examined best practices for managing the complex needs of older adults in emergency settings.

Hard Core EM: Just the Facts: Rapid-fire sessions delivered concise, evidence-based updates on critical emergency medicine topics.

ED in the System: Healthcare Delivery and Wellness: Discussions addressed systemic challenges in emergency care delivery and strategies for clinician wellness.

🔍 Afternoon Concurrent Tracks 1

Drugs and Doses: Toxicology and Addiction: Experts discussed current trends in substance use, overdose management, and the role of emergency departments in addressing addiction.

Dr. Craig Berlinger on Managing Organophosphate Poisoning

In Johannesburg, up to 80% of non-fatal suicide attempts involve organophosphates — and over half of these patients require intubation or ICU-level care.

💡 Key Takeaways:

1️⃣ Recognize & treat the toxidrome early

 • Muscarinic symptoms (SLUDGE, killer B’s) → respond to aggressive atropine (rapid doubling)

2️⃣ Nicotinic toxicity? Consider IV magnesium

3️⃣ Gastric lavage may have a role in select cases

4️⃣ FFP might help — evidence is limited

5️⃣ Hemoperfusion has shown promise in some settings

🧠 Remember: These aren’t just agricultural toxins — they’re increasingly part of urban overdose patterns.

Dr. Venkat Kotamraju on the Brady Bunch: Cardiotoxic Overdoses

Bradycardia from cardiotoxic overdoses? Think BBs, CCBs, Digoxin, Clonidine — and look for the clinical clues that differentiate them.

🩺 Key Pearls:

• Beta-blockers

 • Propranolol = Na⁺ channel blocker → mimics TCA on ECG

 • Sotalol → watch for Torsades

 • BBs = ↓ glucose & ↓ LOC

• Calcium channel blockers

 • CCBs = ↑ glucose & normal LOC

 • Amlodipine = “pipe” issue, Verapamil = “pump” failure

 • Insulin resistance is a key feature

💉 Hyperinsulinemia Euglycemic Therapy

 • 1U/kg bolus + 1U/kg/hr insulin infusion

 • Monitor glucose & potassium

🧪 Other options: Intralipid, ECMO, pacing, methylene blue

💊 Digoxin → look for GI or neuro symptoms, biventricular VT → treat with Digibind

🧠 Clonidine → opioid mimic, may reverse with naloxone

Dr. Sophie Gosselin on GI Decontamination in 2025

GI decontamination isn’t dead — it’s just evolved. The key is balancing risk vs benefit in the modern tox landscape.

🧠 Clinical Pearls:

• Ask: Is the toxin absorbable? Is it lethal? Are there risks of aspiration/seizure?

• Toxin gastroparesis: Large ingestions may delay gastric emptying

• Pharmacobezoars: May benefit from decontamination

• Activated Charcoal (AC): Still useful >1 hr post-ingestion in select cases

 – SR drugs, ongoing absorption, slowed GI motility

• NG tube caution: Avoid AC via NG if no ET tube (aspiration risk)

 – Consider only in severe toxicity where benefits outweigh risks

📌 AC indications: Early/life-threatening ingestions, pharmacobezoars, toxic gastroparesis

📌 Gastric lavage: Very early & lethal ingestions only

Disaster Emergency Medicine: This track explores the evolving challenges of mass casualty response, resource-limited care, and health system resilience during large-scale emergencies.

Geriatric Emergency Medicine: Attendees examined best practices for managing the complex needs of older adults in emergency settings.

Hard Core EM: Just the Facts: Rapid-fire sessions delivered concise, evidence-based updates on critical emergency medicine topics.

ED in the System: Healthcare Delivery and Wellness: Discussions addressed systemic challenges in emergency care delivery and strategies for clinician wellness.

Dr. Louise Rang on Wellness, What Works:

In the current climate of emergency medicine, wellness initiatives can feel impossible to implement — but they’re more essential than ever. This session highlighted that effective programs share three key principles:

• Ground-up needs assessment

• Shared ownership of the future

• Fostering real human connection

Here are three inspiring wellness initiatives to help guide your next steps.

1. Clinical Adaptation Policies for Senior Physicians

Dr. Riyad Abu-Laban – University of British Columbia

Emergency medicine is a demanding career, and we must support longevity in our colleagues.

Dr. Abu-Laban described a structured process to develop a local policy for clinical adaptation for advanced-career physicians:

• Literature review and national surveys to understand current practices

• Values-based consultations with faculty

• Tailored solutions like:

  
  

  • Exclusion from night or resus shifts

  • Max 7-hour shift pick-ups

  • Split-shift pools for flexibility

🔑 Wellness isn’t just about yoga mats — it’s about policy that respects lived experience.

2. Simulation for Collective Efficacy

Dr. Eve Purdy – Gold Coast University Hospital, Australia

When her team transitioned into a new ED, Dr. Purdy used simulation not just for clinical prep, but for team resilience.

Sim was used to:

• Map out and improve workflows

• Explore how team members interact under pressure

• Build connection and confidence ahead of major change

• Test how the system reacts to common and uncommon scenarios

🔑 Sim isn’t just about skills — it’s about building collective confidence in your team.

3. TMTL: There’s More to Life Than Medicine

Dr. Louise Rang – Queen’s University

In an annual November event, residents and staff come together to share 10-minute talks about anything but medicine.

• Hosted at a local restaurant

• 10–12 talks, with food, drinks, and laughter

• Themed versions (e.g., “Family,” or “It seemed like a good idea at the time”) add fun structure

• Smaller spin-offs:

  
  

  • “Question of the week” whiteboards

  • ED photo boards with “Talk to me about…” prompts

🔑 Connection doesn’t require a program — it can start with a story, a smile, or a shared meal.

Wellness in emergency medicine can’t be a side project.

It must be rooted in what your people need, built on mutual respect, and sustained through human connection.

Whether it’s policy, simulation, or storytelling, wellness that works is wellness that belongs to everyone.

Francophone Track: High yield pearls, presented in French and disseminated in French and English!

🔍 Afternoon Concurrent Tracks 2

Drugs and Doses: Toxicology and Addiction: Experts discussed current trends in substance use, overdose management, and the role of emergency departments in addressing addiction.

Dr. Ingrid Berling on QTc in Overdose:

Torsade de Pointes (TdP) is rare — but QT interval assessment in overdose is a daily challenge. Here’s what to keep in mind:

🧠 Clinical Pearls:

• QT prolongation depends on genetics, bradycardia, and electrolytes — not just the drug

• TdP often self-resolves → patient reverts to prolonged QTi

• Never rely on the ECG machine to calculate the QT — often inaccurate

• QT must be assessed in context of HR: slower HR = longer QTi

• Bicarb can prolong QT by inducing hypokalemia

⚠️ Always confirm the QT manually and correct contributing factors — especially potassium.

Disaster Emergency Medicine: This track explores the evolving challenges of mass casualty response, resource-limited care, and health system resilience during large-scale emergencies.

Geriatric Emergency Medicine: Attendees examined best practices for managing the complex needs of older adults in emergency settings.

Hard Core EM: Just the Facts: Rapid-fire sessions delivered concise, evidence-based updates on critical emergency medicine topics.

Francophone Track: High yield pearls, presented in French and disseminated in French and English!

🏁 PoCUS Competition Final: Skill, Speed and Creatitivity Collide

The PoCUS Competition Final saw “Echo Location” (McGill University) face off against “Jelics Angels” (University of Manitoba) in a thrilling conclusion to this annual event.

In the final challenge, teams had to locate a hidden key within an ultrasound model and skillfully extract it using only rounded forceps — a test of both image interpretation and fine motor control.

Next came the macromodel round, where competitors used props to physically recreate ultrasound concepts, prompting judges to guess the topic based on visual clues — like ureteric jets cleverly represented on stage.

In the end, Echo Location from McGill came out victorious!

Thank you to all the participants — the team names, creativity, and costumes continue to impress us year after year!

🎭 Evening Improv Session

The day concluded with an engaging improv session, offering attendees a chance to unwind and connect through humor and creativity. The session emphasized the value of adaptability and communication—key skills in emergency medicine.

Stay tuned for tomorrow’s recap as we continue to explore the innovations and collaborations shaping the future of emergency medicine at ICEM 2025, presented to you by the #ICEM2025 Social Media team!