REGISTRATION FORM Hawaiian Islands Trauma ......Islands Trauma Symposium; a two-day program of...

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Continuing Education Credit Symposium Information

Hilt

on H

awai

ian

Villa

ge, H

onol

ulu,

Haw

ai‘i

Augu

st 9

& 10

, 201

9

PhysiciansThe Queen’s Medical Center is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Queen’s Medical Center designates this live activity for a maximum of 11.0 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. (August 9 – 5.50 credits; August 10 – 5.50 credits)

Emergency Medicine PhysiciansThis live activity has been approved by the American College of Emergency Physicians for 11.0 hours of ACEP Category I credit.

EMS (EMT/AEMT/Paramedic)The Queen’s Medical Center is an approved provider of continuing education for Emergency Services Personnel - Hawai‘i Provider #005. This symposium has been approved for 11.0 hours. (August 9 – 5.50 credits; August 10 – 5.50 credits)

Nurses and Other Health ProfessionalsA certificate of attendance will be provided to support your needs.

Symposium LocationHilton Hawaiian Village Waikiki Beach ResortCoral Ballroom2005 Kalia Road, Honolulu, Hawai‘i 96815

Self-parking at the hotel will be fully validated. Valet parking will be validated with $5 payment. This excludes participants who are staying at the hotel.

RegistrationThe registration fee covers access to course materials, food and beverage, and validation for parking. Registration will be on space availability basis. Early registration by July 26, 2019 is strongly encouraged. Upon receipt of registration, registrants will receive via email: confirmation, payment receipt, and instructions to access course materials online.

Acknowledgements Special acknowledgement is given to the following for support of this activity: State of Hawai‘i Trauma Special Fund

For more information contact:The Queen’s Medical CenterOffice of Continuing Medical EducationPhone: 808-691-4406Fax: 808-691-5040Email: [email protected]

Hawaiian Islands Trauma Symposium 2019 | REGISTRATION FORM

Name _________________________________________________________________________________

o MD/DO: Specialty: ______________________________________________________________________

o RN o EMS Personnel (EMT/AEMT/Paramedic) o Other: ____________________________________

Mailing Address __________________________________________________________________________

City _________________________________________ State ______________ Zip Code ______________

Daytime Phone ______________________________________ Fax ________________________________

E-mail Address __________________________________________________________________________Note: Confirmation, receipt and access to materials will be sent via email.

Please register me for:o Friday & Saturday, August 9 & 10 o Friday, August 9 (only) o Saturday, August 10 (only)

Registration fee: By July 26, 2019 After July 26, 2019 One Day Two Days One Day Two Days

Physician: QMC $155 $290 $175 $310

Physician: Non-QMC $180 $340 $200 $360

Nurse/Other: QMC $130 $250 $150 $270Nurse/Other: Non-QMC $150 $270 $170 $290EMT (EMT, AEMT, Paramedic) HI: #______________ $110 $210 $130 $230

QMC rates are applicable to medical staff and professional staff of The Queen’s Health Systems.Children at HITS: Due to liability restrictions and concerns, children under 18 may not participate in any part of this symposium.

o Please send me information on pre-ordering Trauma t-shirts.

METHOD OF PAYMENTo Check or money order payable to: The Queen’s Medical Centero VISA o MasterCard o American Express o Discover

Cardholder’s Name ____________________________________________ Total Payment $_______________

Cardholder’s Billing Address ___________________________________________________________________(if different from above)

City ________________________________________ State ______________ Zip Code _______________

Card Number ___________________________________________ Card Security ID Code* ________________ *3 or 4 digits printed on card or security strip

Signature _________________________________________________ Expiration Date ___________________ Please send completed registration form and payment to:The Queen’s Medical CenterOffice of Continuing Medical Education, Harkness 117, 1301 Punchbowl Street, Honolulu, HI 96813Phone: 808-691-4406, Fax: 808-691-5040, Email: [email protected]

Special Needs: The Queen’s Medical Center fully intends to comply with the legal requirements of the Americans with Disabilities Act. If you are in need of accommodation, two weeks’ notice prior to the activity will help us serve you better. Refund: To receive a refund for the registration fee, cancellation must be made in writing. Refunds will be processed less 20% service fee if made by July 26, 2019. No refunds will be made after that date.Cancellation: This activity is subject to cancellation. In the unlikely event that it should be canceled, refund of registration fees will be made in full; however, the sponsor is not responsible for any travel costs incurred.

August 9 & 10, 2019Hilton Hawaiian Village, Honolulu, Hawai‘i

LEVEL 1 TRAUMA CENTER

Friday, August 9, 2019 Saturday, August 10, 2019

7:00 am Registration • Continental Breakfast • Exhibits

7:45 am Welcome & Opening Remarks – Michael Hayashi, MD

8:00 am The Current State of Rib Fixation After Blunt Chest Trauma – Michael Lekawa, MD

8:30 am Pediatric Fractures – Kristin Fernandez, MD, MS – Byron Izuka, MD

9:00 am On the R.I.S.E.- Real-Time Improvements in Screening and Examination of Trauma Patients in the ER – Ivan “Kapena” Clute, RN; – Holly Inn, RN; Kelly Yamamoto, RN

9:30 am Break • Exhibits

10:00 am Global Surgery: Understanding Our Role in Improving the Burden of Surgical Disease – Michael Lekawa, MD

10:30 am Are You Prepared for an Active Shooter? – Ed Howard

11:00 am Challenges and Lessons Learned from the 2018 Kaua‘i Floods – Elton Ushio

11:30 am Lunch • Exhibits

12:30 pm MCI - Hospital Notification – Glenn Asaeda, MD

1:00 pm Tactical EMS – What Prehospital Care Brings to the Table – Jonah Thompson, NRP, CP-C

1:30 pm Japanese Visitor Injuries in Hawai‘i – Sho Furuta, MD

2:00 pm Break • Exhibits

2:30 pm World Trade Center Attack – Glenn Asaeda, MD

3:00 pm Mobile Integrated Health and Community Paramedicine - The Pittsburgh Model – Jonah Thompson, NRP, CP-C

3:30 pm Adjourn

Hawaiian Islands TRAUMA SYMPOSIUM 2019 Guest Faculty

Kristina AndersonExecutive DirectorThe Koshka Foundation for Safe SchoolsSeattle, WA

Glenn Asaeda, MD, FACEP, FAAEM, DABEMSChief Medical DirectorFire Department New York (FDNY)Brooklyn, NY

Jeffrey Beeson, DO, FACEP, FAEMSChief Medical DirectorUniversity of North Texas Health Science CenterFort Worth, TX

Deborah A. Kuhls, MD, FACS, FCCMProfessor of SurgeryChief, Section of Surgical Critical CareProgram Director, Surgical Critical Care FellowshipLas Vegas, NV

Michael E. Lekawa, MD, FACSProfessor and Chief, Division of Trauma, Burns, Critical Care and Acute Care SurgeryUniversity of California, Irvine School of MedicineDirector of Trauma Services, University of California, Irvine Medical Center, Orange County, CA

Jonah Thompson, NRP, CP-COperations ManagerMobile Integrated HealthAllegheny Health NetworkPittsburgh, PA

Hawai‘i Faculty

Kari BenesTrauma System Public Health EducatorEMS & Injury Prevention System BranchHawai‘i State Department of Health

Daniel Cheng, MD, MPHAssistant Chief, Emergency MedicineMedical Director, Queen’s Care CoalitionThe Queen’s Medical Center

Ivan “Kapena” Clute, BSN, RN, TCRNRegistered NurseThe Queen’s Medical Center, Punchbowl Campus Emergency Department

Christina “TJ” Donayri, BSN, RN, CEN, TCRNClinical Coordinator Injury Prevention/Outreach and EducationTrauma Services, The Queen’s Medical Center

Kristin K. Fernandez, MD, MSMedical Director of PediatricsLead Physician, After Hours CenterThe Queen’s Medical Center – West O’ahu

Sho Furuta, MD, FACSTrauma and Acute Care SurgeryThe Queen’s Medical Center

Ed HowardVP Corporate Director of Healthcare SecurityAdventist Health/JLL

Holly Inn, RN, CEN, TCRNRegistered NurseThe Queen’s Medical Center, Punchbowl Campus Emergency Department

Byron Izuka, MDChildren’s Orthopaedics of Hawai‘iAssociate Clinical ProfessorUH Division of Orthopaedic Surgery

Theresa PauletteVictim Services SpecialistMADD Hawai‘i

Vanessa Simiola, PsyDResearch AssociateKaiser PermanenteCenter for Integrated Health Care Research

Yvette Suyama, RNTrauma ManagerThe Queen’s Medical Center

Elton UshioEmergency Management AdministratorKauai Emergency Management Agency (formerly Civil Defense)County of Kaua’i, State of Hawai‘i

Kelly Yamamoto, BSN, RN, CENPerformance Improvement CoordinatorThe Queen’s Medical Center, Punchbowl Campus


7:50 am Welcome – Michael Hayashi, MD

8:00 am Lessons Learned from One October Shooting in Las Vegas – Deborah Kuhls, MD

8:30 am Community Paramedicine: Know Before You Go – Jeffrey Beeson, DO

9:00 am The Benefits of Cohorting Trauma Patients and Multidisciplinary Rounds – Yvette Suyama, RN – Michael Hayashi, MD


10:00 am Firearm Injuries: What Every Healthcare Worker Can Do – Deborah Kuhls, MD

10:30 am Provider or Facilitator: Educational Focus for Community Paramedicine – Jeffrey Beeson, DO

11:00 am Understanding, Identifying and Treating Psychological Trauma Following Traumatic Injury – Vanessa Simiola, PsyD


12:30 pm Surviving the Virginia Tech Tragedy, Lessons Learned and the Road to Recovery – Kristina Anderson


2:00 pm BREAKOUT SESSION 1 Recovery from Tragedy and Improving Safety in Our Community (Sea Pearl Suite III-IV) – Kristina Anderson

2:00 pm BREAKOUT SESSION 2-A Mobile Integrated Healthcare: A Texas Tale – Jeffrey Beeson, DO

2:30 pm BREAKOUT SESSION 2-B Impact of Care Navigation for Homeless Trauma Patients – Daniel Cheng, MD, MPH

3:00 pm Impaired Driving, Mandated Reporting and a Personal Perspective – Kari Benes – Christina “TJ” Donayri, RN – Theresa Paulette

3:30 pm Adjourn

SYMPOSIUM CHAIRMichael S. Hayashi, MD, FACSTrauma Medical Director, The Queen’s Medical CenterState Trauma Medical Director Panel, ChairCOT Region 9, State of Hawai‘i ChairFaculty, General Surgery Residency & Surgical Critical Care Fellowship ProgramsAssistant Clinical Professor, Department of SurgeryThe University of Hawai‘i, John A. Burns School of Medicine

SYMPOSIUM CO-CHAIRElizabeth “Libby” Char, MD, FACEP, FAAEMThe Queen’s Medical Center State of Hawai‘i Emergency Medical Services Advisory Committee, ChairEMS and Fire Medical DirectorAssistant Clinical Professor of SurgeryThe University of Hawai‘i, John A. Burns School of Medicine

Educational ObjectivesAfter completing this educational activity, participants should be able to:

• Discuss optimal management of the critically ill and injured patient, with specific consideration in areas of Prehospital Care, Critical Care Medicine, Emergency Medicine, Disaster Management and Response, Pediatric Orthopedic Trauma, Surgical Education and Post-Traumatic Care.• Describe successful system-based practices and strategies in response to the challenges facing the trauma system.• Identify new approaches and challenges to the management of subspecialty trauma issues.• Explore special challenges impacting trauma care.• Discuss specific traumatic events and its effect on the recovery of patients and others involved.• Examine challenges in the prehospital, hospital and community setting.• Explore innovative efforts and initiatives for efficient use of limited resources and improved patient care and systems.• Review guidelines, protocols, research and tools that impact the care of trauma patients.• Explore the benefits and impact of a Community Paramedicine program.

About the SymposiumIn Hawai‘i, traumatic injuries are responsible for more deaths of children and young adults, ages one through 40, than all other causes combined. Among residents of all ages, injury is the third leading cause of death, both locally and nationally. On an average week in Hawai‘i, 14 residents die from an injury, another 103 are hospitalized, and nearly 1,640 others are treated in emergency departments. While fatal injuries represent less than 1% of all injuries requiring medical attention; the majority of non-fatal injuries have the greatest public health implications. This includes human suffering, long-term disabilities, productive life years lost, and a staggering financial cost for medical treatment and care. The physical, emotional, economic, and societal burden of trauma is one we all share. In Hawai‘i, our unique trauma system is led by the Emergency Medical Services and Injury Prevention System Branch of the Department of Health to ensure a coordinated approach for providing optimal care of injured patients across our island communities. They also help support our annual Hawaiian Islands Trauma Symposium; a two-day program of cutting-edge, evidence-based presentations and discussions by a multidisciplinary faculty of local and national leaders in the field of Trauma. We hope you will join our annual gathering of pre-hospital providers, physicians, nurses, trauma technicians and program personnel, therapists, and other health care professionals to network and learn together. No matter what setting you care for patients, each of us plays an essential role to support the Hawai’i Trauma System. Collectively we provide a vital resource that serves the people of Hawai’i in their time of greatest need, kama’aina and malihini alike. Welina mai.



7:45 am Welcome & Opening Remarks– Michael Hayashi, MD


8:30 am Pediatric Fractures – Kristin Fernandez, MD, MS– Byron Izuka, MD

9:00 am On the R.I.S.E.- Real-Time Improvements in Screening and Examination of Trauma Patients in the ER– Ivan “Kapena” Clute, RN; – Holly Inn, RN; Kelly Yamamoto, RN







1:00 pm Tactical EMS – What Prehospital Care Brings to the Table– Jonah Thompson, NRP, CP-C



2:30 pm World Trade Center Attack– Glenn Asaeda, MD


3:30 pm Adjourn






Michael E. Lekawa, MD, FACSProfessor and Chief, Division of Trauma, Burns,Critical Care and Acute Care SurgeryUniversity of California, Irvine School of MedicineDirector of Trauma Services, University of California,Irvine Medical Center, Orange County, CA


Hawai‘i Faculty



Ivan “Kapena” Clute, BSN, RN, TCRNRegistered NurseThe Queen’s Medical Center,Punchbowl Campus Emergency Department





Holly Inn, RN, CEN, TCRNRegistered NurseThe Queen’s Medical Center,Punchbowl Campus Emergency Department





Elton UshioEmergency Management AdministratorKauai Emergency Management Agency(formerly Civil Defense)County of Kaua’i, State of Hawai‘i




8:00 am Lessons Learned from One OctoberShooting in Las Vegas– Deborah Kuhls, MD

8:30 am Community Paramedicine:Know Before You Go– Jeffrey Beeson, DO

9:00 am The Benefits of Cohorting TraumaPatients and Multidisciplinary Rounds– Yvette Suyama, RN– Michael Hayashi, MD


10:00 am Firearm Injuries: What Every HealthcareWorker Can Do– Deborah Kuhls, MD

10:30 am Provider or Facilitator: EducationalFocus for Community Paramedicine– Jeffrey Beeson, DO

11:00 am Understanding, Identifying andTreating Psychological TraumaFollowing Traumatic Injury– Vanessa Simiola, PsyD


12:30 pm Surviving the Virginia Tech Tragedy,Lessons Learned and the Road to Recovery– Kristina Anderson


2:00 pm BREAKOUT SESSION 1Recovery from Tragedy and Improving Safety in Our Community(Sea Pearl Suite III-IV)– Kristina Anderson

2:00 pm BREAKOUT SESSION 2-AMobile Integrated Healthcare: A Texas Tale– Jeffrey Beeson, DO

2:30 pm BREAKOUT SESSION 2-BImpact of Care Navigation for HomelessTrauma Patients– Daniel Cheng, MD, MPH

3:00 pm Impaired Driving, Mandated Reportingand a Personal Perspective– Kari Benes– Christina “TJ” Donayri, RN – Theresa Paulette

3:30 pm Adjourn


SYMPOSIUM CO-CHAIRElizabeth “Libby” Char, MD, FACEP, FAAEMThe Queen’s Medical CenterState of Hawai‘i Emergency Medical Services Advisory Committee, ChairEMS and Fire Medical DirectorAssistant Clinical Professor of SurgeryThe University of Hawai‘i, John A. Burns School of Medicine


• Discuss optimal management of the critically ill and injured patient, with specific consideration inareas of Prehospital Care, Critical Care Medicine, Emergency Medicine, Disaster Managementand Response, Pediatric Orthopedic Trauma, Surgical Education and Post-Traumatic Care.

• Describe successful system-based practices and strategies in response to the challengesfacing the trauma system.

• Identify new approaches and challenges to the management of subspecialty trauma issues.• Explore special challenges impacting trauma care.• Discuss specific traumatic events and its effect on the recovery of patients and others involved.• Examine challenges in the prehospital, hospital and community setting.• Explore innovative efforts and initiatives for efficient use of limited resources and improved

patient care and systems.• Review guidelines, protocols, research and tools that impact the care of trauma patients.• Explore the benefits and impact of a Community Paramedicine program.

About the SymposiumIn Hawai‘i, traumatic injuries are responsible for more deaths of children and young adults, ages onethrough 40, than all other causes combined. Among residents of all ages, injury is the third leadingcause of death, both locally and nationally. On an average week in Hawai‘i, 14 residents die from aninjury, another 103 are hospitalized, and nearly 1,640 others are treated in emergency departments.

While fatal injuries represent less than 1% of all injuries requiring medical attention; the majorityof non-fatal injuries have the greatest public health implications. This includes human suffering,long-term disabilities, productive life years lost, and a staggering financial cost for medical treatmentand care. The physical, emotional, economic, and societal burden of trauma is one we all share.

In Hawai‘i, our unique trauma system is led by the Emergency Medical Services and Injury PreventionSystem Branch of the Department of Health to ensure a coordinated approach for providing optimalcare of injured patients across our island communities. They also help support our annual HawaiianIslands Trauma Symposium; a two-day program of cutting-edge, evidence-based presentations anddiscussions by a multidisciplinary faculty of local and national leaders in the field of Trauma.

We hope you will join our annual gathering of pre-hospital providers, physicians, nurses, traumatechnicians and program personnel, therapists, and other health care professionals to network andlearn together. No matter what setting you care for patients, each of us plays an essential role tosupport the Hawai’i Trauma System. Collectively we provide a vital resource that serves the peopleof Hawai’i in their time of greatest need, kama’aina and malihini alike. Welina mai.



7:45 am Welcome & Opening Remarks – Michael Hayashi, MD


8:30 am Pediatric Fractures – Kristin Fernandez, MD, MS – Byron Izuka, MD

9:00 am On the R.I.S.E.- Real-Time Improvements in Screening and Examination of Trauma Patients in the ER – Ivan “Kapena” Clute, RN; – Holly Inn, RN; Kelly Yamamoto, RN







1:00 pm Tactical EMS – What Prehospital Care Brings to the Table – Jonah Thompson, NRP, CP-C



2:30 pm World Trade Center Attack – Glenn Asaeda, MD


3:30 pm Adjourn






Michael E. Lekawa, MD, FACSProfessor and Chief, Division of Trauma, Burns, Critical Care and Acute Care SurgeryUniversity of California, Irvine School of MedicineDirector of Trauma Services, University of California, Irvine Medical Center, Orange County, CA


Hawai‘i Faculty



Ivan “Kapena” Clute, BSN, RN, TCRNRegistered NurseThe Queen’s Medical Center, Punchbowl Campus Emergency Department





Holly Inn, RN, CEN, TCRNRegistered NurseThe Queen’s Medical Center, Punchbowl Campus Emergency Department





Elton UshioEmergency Management AdministratorKauai Emergency Management Agency (formerly Civil Defense)County of Kaua’i, State of Hawai‘i




8:00 am Lessons Learned from One October Shooting in Las Vegas – Deborah Kuhls, MD

8:30 am Community Paramedicine: Know Before You Go – Jeffrey Beeson, DO

9:00 am The Benefits of Cohorting Trauma Patients and Multidisciplinary Rounds – Yvette Suyama, RN – Michael Hayashi, MD


10:00 am Firearm Injuries: What Every Healthcare Worker Can Do – Deborah Kuhls, MD

10:30 am Provider or Facilitator: Educational Focus for Community Paramedicine – Jeffrey Beeson, DO

11:00 am Understanding, Identifying and Treating Psychological Trauma Following Traumatic Injury – Vanessa Simiola, PsyD


12:30 pm Surviving the Virginia Tech Tragedy, Lessons Learned and the Road to Recovery – Kristina Anderson


2:00 pm BREAKOUT SESSION 1 Recovery from Tragedy and Improving Safety in Our Community (Sea Pearl Suite III-IV) – Kristina Anderson

2:00 pm BREAKOUT SESSION 2-A Mobile Integrated Healthcare: A Texas Tale – Jeffrey Beeson, DO

2:30 pm BREAKOUT SESSION 2-B Impact of Care Navigation for Homeless Trauma Patients – Daniel Cheng, MD, MPH

3:00 pm Impaired Driving, Mandated Reporting and a Personal Perspective – Kari Benes – Christina “TJ” Donayri, RN – Theresa Paulette

3:30 pm Adjourn


SYMPOSIUM CO-CHAIRElizabeth “Libby” Char, MD, FACEP, FAAEMThe Queen’s Medical Center State of Hawai‘i Emergency Medical Services Advisory Committee, ChairEMS and Fire Medical DirectorAssistant Clinical Professor of SurgeryThe University of Hawai‘i, John A. Burns School of Medicine


• Discuss optimal management of the critically ill and injured patient, with specific consideration in areas of Prehospital Care, Critical Care Medicine, Emergency Medicine, Disaster Management and Response, Pediatric Orthopedic Trauma, Surgical Education and Post-Traumatic Care.• Describe successful system-based practices and strategies in response to the challenges facing the trauma system.• Identify new approaches and challenges to the management of subspecialty trauma issues.• Explore special challenges impacting trauma care.• Discuss specific traumatic events and its effect on the recovery of patients and others involved.• Examine challenges in the prehospital, hospital and community setting.• Explore innovative efforts and initiatives for efficient use of limited resources and improved patient care and systems.• Review guidelines, protocols, research and tools that impact the care of trauma patients.• Explore the benefits and impact of a Community Paramedicine program.

About the SymposiumIn Hawai‘i, traumatic injuries are responsible for more deaths of children and young adults, ages one through 40, than all other causes combined. Among residents of all ages, injury is the third leading cause of death, both locally and nationally. On an average week in Hawai‘i, 14 residents die from an injury, another 103 are hospitalized, and nearly 1,640 others are treated in emergency departments. While fatal injuries represent less than 1% of all injuries requiring medical attention; the majority of non-fatal injuries have the greatest public health implications. This includes human suffering, long-term disabilities, productive life years lost, and a staggering financial cost for medical treatment and care. The physical, emotional, economic, and societal burden of trauma is one we all share. In Hawai‘i, our unique trauma system is led by the Emergency Medical Services and Injury Prevention System Branch of the Department of Health to ensure a coordinated approach for providing optimal care of injured patients across our island communities. They also help support our annual Hawaiian Islands Trauma Symposium; a two-day program of cutting-edge, evidence-based presentations and discussions by a multidisciplinary faculty of local and national leaders in the field of Trauma. We hope you will join our annual gathering of pre-hospital providers, physicians, nurses, trauma technicians and program personnel, therapists, and other health care professionals to network and learn together. No matter what setting you care for patients, each of us plays an essential role to support the Hawai’i Trauma System. Collectively we provide a vital resource that serves the people of Hawai’i in their time of greatest need, kama’aina and malihini alike. Welina mai.

The

Que

en’s

Med

ical

Cen

ter

Offi

ce o

f Con

tinui

ng M

edic

al E

duca

tion

1301

Pun

chbo

wl S

treet

Hon

olul

u, H

awai

‘i 96

813

Continuing Education Credit Symposium Information

Hilt

on H

awai

ian

Villa

ge, H

onol

ulu,

Haw

ai‘i

Augu

st 9

& 10

, 201

9

PhysiciansThe Queen’s Medical Center is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Queen’s Medical Center designates this live activity for a maximum of 11.0 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. (August 9 – 5.50 credits; August 10 – 5.50 credits)

Emergency Medicine PhysiciansThis live activity has been approved by the American College of Emergency Physicians for 11.0 hours of ACEP Category I credit.

EMS (EMT/AEMT/Paramedic)The Queen’s Medical Center is an approved provider of continuing education for Emergency Services Personnel - Hawai‘i Provider #005. This symposium has been approved for 11.0 hours. (August 9 – 5.50 credits; August 10 – 5.50 credits)

Nurses and Other Health ProfessionalsA certificate of attendance will be provided to support your needs.

Symposium LocationHilton Hawaiian Village Waikiki Beach ResortCoral Ballroom2005 Kalia Road, Honolulu, Hawai‘i 96815

Self-parking at the hotel will be fully validated. Valet parking will be validated with $5 payment. This excludes participants who are staying at the hotel.

RegistrationThe registration fee covers access to course materials, food and beverage, and validation for parking. Registration will be on space availability basis. Early registration by July 26, 2019 is strongly encouraged. Upon receipt of registration, registrants will receive via email: confirmation, payment receipt, and instructions to access course materials online.

Acknowledgements Special acknowledgement is given to the following for support of this activity: State of Hawai‘i Trauma Special Fund

For more information contact:The Queen’s Medical CenterOffice of Continuing Medical EducationPhone: 808-691-4406Fax: 808-691-5040Email: [email protected]

Hawaiian Islands Trauma Symposium 2019 | REGISTRATION FORM

Name _________________________________________________________________________________

o MD/DO: Specialty: ______________________________________________________________________

o RN o EMS Personnel (EMT/AEMT/Paramedic) o Other: ____________________________________

Mailing Address __________________________________________________________________________

City _________________________________________ State ______________ Zip Code ______________

Daytime Phone ______________________________________ Fax ________________________________

E-mail Address __________________________________________________________________________Note: Confirmation, receipt and access to materials will be sent via email.

Please register me for:o Friday & Saturday, August 9 & 10 o Friday, August 9 (only) o Saturday, August 10 (only)

Registration fee: By July 26, 2019 After July 26, 2019 One Day Two Days One Day Two Days

Physician: QMC $155 $290 $175 $310

Physician: Non-QMC $180 $340 $200 $360

Nurse/Other: QMC $130 $250 $150 $270Nurse/Other: Non-QMC $150 $270 $170 $290EMT (EMT, AEMT, Paramedic) HI: #______________ $110 $210 $130 $230

QMC rates are applicable to medical staff and professional staff of The Queen’s Health Systems.Children at HITS: Due to liability restrictions and concerns, children under 18 may not participate in any part of this symposium.

o Please send me information on pre-ordering Trauma t-shirts.

METHOD OF PAYMENTo Check or money order payable to: The Queen’s Medical Centero VISA o MasterCard o American Express o Discover

Cardholder’s Name ____________________________________________ Total Payment $_______________

Cardholder’s Billing Address ___________________________________________________________________(if different from above)

City ________________________________________ State ______________ Zip Code _______________

Card Number ___________________________________________ Card Security ID Code* ________________ *3 or 4 digits printed on card or security strip

Signature _________________________________________________ Expiration Date ___________________ Please send completed registration form and payment to:The Queen’s Medical CenterOffice of Continuing Medical Education, Harkness 117, 1301 Punchbowl Street, Honolulu, HI 96813Phone: 808-691-4406, Fax: 808-691-5040, Email: [email protected]

Special Needs: The Queen’s Medical Center fully intends to comply with the legal requirements of the Americans with Disabilities Act. If you are in need of accommodation, two weeks’ notice prior to the activity will help us serve you better. Refund: To receive a refund for the registration fee, cancellation must be made in writing. Refunds will be processed less 20% service fee if made by July 26, 2019. No refunds will be made after that date.Cancellation: This activity is subject to cancellation. In the unlikely event that it should be canceled, refund of registration fees will be made in full; however, the sponsor is not responsible for any travel costs incurred.

August 9 & 10, 2019Hilton Hawaiian Village, Honolulu, Hawai‘i

LEVEL 1 TRAUMA CENTER

REGISTRATION FORM Hawaiian Islands Trauma ......Islands Trauma Symposium; a two-day program of...

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