“Symposia Medicus conferences cover high-yield, relevant topics in wonderful locations. What could be better?”
– L. Washington, MD

“Love the destinations and topics! Fun way to get in a vacation while also learning.”
– A. Martin, CPNP

“Always well-organized, educational, and enjoyable.”
– L. Meehan, MD


Our 24th Annual Spring Conference on Pediatric Emergencies focuses on many challenges facing pediatric and emergency physicians, nurse practitioners, PAs, nurses, and other healthcare professionals involved in the clinical care of children. The goal of this conference is to increase the knowledge and enhance the competence of attendees. Emphasis will be placed on practical application of the evidence-based topics presented.

Topics for this year’s conference have been selected based on the educational needs determined from the identified professional practice gaps. The gaps were derived from a variety of sources including evaluations and outcomes data from past participants; clinical expert input; Symposia Medicus’ online survey; and other medical and nursing data.

Conference format will include didactic lectures, smaller group breakout and interactive sessions, case studies, and question and answer sessions.

Smaller group sessions will be held Friday afternoon. These breakout sessions are organized to provide greater participant/faculty interaction, and will give you an opportunity to participate in discussions on subjects relating to your particular area of interest. Please indicate your breakout session topic choices on the conference registration form in this brochure. Space is limited so please reserve early.

An outstanding faculty has been assembled for this conference. Each member was selected based on their individual area of expertise and ability to communicate current, evidence-based, and practical information to participants.

You are sure to enjoy our 24th Annual Spring Conference on Pediatric Emergencies while sharing ideas and experiences with colleagues from across the country in the beautiful setting of Costa Rica.


As a result of participating in this conference, you should have increased knowledge and enhanced competence to…

Explain causes other than sepsis that result in an infant appearing septic

Differentiate the features of life-threatening versus common rashes

Review the new guidelines regarding battery and magnet ingestions

Identify urgent pediatric rheumatologic presentations

Diagnose primary immunodeficiencies in children


At the conclusion of attending this conference, participants are entitled to a certificate of credit which will be available online. Successful completion of this activity is determined by attending the live activity, review of the educational session materials, and submission of the case studies test, surveys, and attendance verification form. Each participant should only claim credit commensurate with the extent of their participation in the activity.


This educational activity was planned and produced in accordance with the ACCME and ANCC Essentials and Standards relating to continuing medical and nursing education.

Symposia Medicus is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Symposia Medicus is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.



Symposia Medicus designates this live activity for a maximum of 18 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This continuing medical education activity has been reviewed by the American Academy of Pediatrics and is acceptable for a maximum of 18 AAP credits. These credits can be applied toward the AAP CME/CPD Award available to Fellows and Candidate Members of the American Academy of Pediatrics.

Approved by the American College of Emergency Physicians for a maximum of 18 hours(s) of ACEP Category I credit.

Application for CME credit has been filed with the American Academy of Family Physicians. Determination of credit is pending. Please check our website for updated credit information.

NCCPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. PAs may receive a maximum of 18 hours of Category 1 credit for completing this program.

Nurse Practitioners/Nurses
The ANCC contact hours awarded for completion of this conference are 18.

Provider is also approved by the California Board of Registered Nursing, Provider #CEP2335, for 21.6 contact hours.

The California Board of Pharmacy accepts as continuing professional education those courses that meet the standard of relevance to pharmacy practice and have been approved for AMA PRA Category 1 Credit™

Pharmacology Content for Prescriptive Authority
A maximum of 4.5 hours in pharmacology content for prescriptive authority may be earned by attending this educational conference. Sessions awarding pharmacology content for prescriptive authority are denoted with an Rx in the schedule. Please contact your state’s Board of Nursing for specific educational requirements as requirements may vary state to state.


Each registrant will have online access to session materials. The session materials will be available for download approximately one week prior to the conference (you’ll receive an email with instructions). If you wish to receive a hard copy of the session materials, please check the box on the registration form in this brochure.

If you are unable to attend this conference, extra copies of the session materials (either paper, flash drive, or digital copy) will be available one week after the conference. The cost is $65 for a hard copy, $30 for a flash drive, and $25 for the digital copy. To place your order,please email publications@symposiamedicus.org.


We have arranged with TAM Travel, our selected tour company in Costa Rica, to provide Symposia Medicus conference attendees with tour options and ground transportation for both airports. For more information and to reserve tours and/or ground transportation, please visit https://www.tamcostarica.com/symposiamedicus-cr/.

Please note: If you are flying to/from the San Jose airport, you will need to overnight there due to the long drive between the airport and the hotel.


Conference Co-Chair

Professor of Emergency Medicine & Pediatrics
Vice Chair, Department of Emergency Medicine
Loma Linda University Medical Center
Loma Linda University Children’s Hospital
Loma Linda, California

Caitlin Sgarlat Deluca, DO, MSc
Assistant Professor of Pediatrics
Division Head, Pediatric Rheumatology & Integrative Medicine
Upstate Medical University
Golisano Children’s Hospital
Syracuse, New York

Niraj Patel, MD, MS
Associate Professor of Pediatrics
Chief, Pediatric Infectious Disease & Immunology
Director, Charlotte Immunodeficiency Center
Levine Children’s Hospital
Charlotte, North Carolina

Michelle Pietzak, MD
Assistant Professor of Clinical Pediatrics
University of Southern California
Keck School of Medicine
Attending, Gastroenterology
Children’s Hospital Los Angeles & Los Angeles County + University of Southern California
Los Angeles, California

Ghazala Q. Sharieff, MD, MBA
Conference Co-Chair

Clinical Professor
University of California, San Diego
Corporate Vice President
Chief Experience Officer
Scripps Health
San Diego, California

Consistent with ACCME and ANCC guidelines, it is the policy of Symposia Medicus to ensure balance, independence, objectivity, and scientific rigor in all educational activities. Prior to the planning of this educational activity, all individuals in a position to influence and/or control the content of continuing education activities have been asked to disclose all relevant financial relationships within the past 12 months. Beyond disclosure of relevant financial relationships, faculty are required to disclose when they plan to discuss pharmaceuticals and/or medical devices that are not approved by the FDA and/or medical or surgical procedures that involve an unapproved or “off-label” use of an approved device or pharmaceutical. Symposia Medicus is committed to providing learners with commercially unbiased continuing education activities. This information is intended to assist learners in forming their own judgments about the content presented. Disclosure information will be included in the session materials for this activity, and speakers will provide a slide disclosure for each presentation, and will also verbally disclose on-site.



Wednesday, April 1

7:00am Registration & Check-in
8:00 Welcome & Introduction
Lance Brown, MD, MPH & Ghazala Q. Sharieff, MD, MBA
8:15 Pediatric Respiratory Emergencies
(Rx = 30 minutes)
Ghazala Q. Sharieff, MD, MBA
9:00 Environmental Health in Pediatrics: A Primer on Keeping Our Children Safe
Caitlin Sgarlat Deluca, DO, MSc
9:45 Questions & Answers
Group Discussion

Faculty Panel & Audience
10:15 Break
10:30 The Growing Problem of Pediatric Food Allergies: Prevalence & Prevention (Rx = 20 minutes)
Michelle Pietzak, MD
11:15 Pediatric Emergency Medicine Literature Update
(Rx = 15 minutes)
Lance Brown, MD, MPH
Noon Sick Again?! – When to Suspect an Immunodeficiency (Rx = 5 minutes)
Niraj Patel, MD, MS
12:45pm Questions & Answers
Group Discussion

Faculty Panel & Audience
1:30 Adjourn for the Day
5:30-7:00 Group Reception
(Faculty, Participants, and Guests)

Thursday, April 2

8:00am Foreign Bodies in the GI Tract (Rx = 45 minutes)
Michelle Pietzak, MD
8:45 Sedating Children in the Emergency Department
(Rx = 35 minutes)
Lance Brown, MD, MPH
9:30 Questions & Answers
Group Discussion

Faculty Panel & Audience
10:00 Break
10:15 Name That Rash: Dermatology Dilemmas in Pediatrics (Rx = 15 minutes)
Ghazala Q. Sharieff, MD, MBA
11:00 Pediatric Trauma: Little People, Big Problems
(Rx = 5 minutes)
Lance Brown, MD, MPH
11:45 Is It Inflammatory Bowel Disease or Infection?
(Rx = 45 minutes)
Michelle Pietzak, MD
12:30pm Questions & Answers
Group Discussion

Faculty Panel & Audience
1:15 Adjourn for the Day

Friday, April 3

3:00pm Smaller Group Breakouts – Session One
. How to Perform a Quick & Complete Musculoskeletal Exam
Caitlin Sgarlat Deluca, DO, MSc
. Improving Patient Experience Scores
Ghazala Q. Sharieff, MD, MBA
. The ABCs of TORCH: Diagnosis & Management of Congenital Infections
Niraj Patel, MD, MS
. The Use of Probiotics in Pediatrics
Michelle Pietzak, MD
4:30 Break
4:45 Smaller Group Breakouts – Session Two
(Session One Topics Repeated)
6:15 Adjourn for the Day

Saturday, April 4

8:00am Urgent Pediatric Rheumatologic Mishaps - Part I
Caitlin Sgarlat Deluca, DO, MSc
8:45 Facing Adversity: Managing Adverse Drug Reactions (Rx = 45 minutes)
Niraj Patel, MD, MS
9:30 Questions & Answers
Group Discussion

Faculty Panel & Audience
10:00 Break (hotel check-out, if applicable)
10:15 Urgent Pediatric Rheumatologic Mishaps - Part II
Caitlin Sgarlat Deluca, DO, MSc
11:00 Hot Blooded! Fever of Unknown Origin, A Case-Based Approach (Rx = 5 minutes)
Niraj Patel, MD, MS
11:45 The Septic-Appearing Infant (Rx = 5 minutes)
Lance Brown, MD, MPH
12:30pm Questions & Answers
Group Discussion

Faculty Panel & Audience
1:15 Conference Adjourns

Rx = Pharmacology Content for Prescriptive Authority
will be granted for these sessions



Beautiful Costa Rica (bordered by the Caribbean to the east, the Pacific Ocean to the west, and Panama to the south) is a democratic country where peace is the most precious possession of its people. Costa Rica is known for its white sand beaches, beautiful sunsets, mountainous plains, numerous national parks, tropical forests, and wildlife reserves, all protected through renowned conservation efforts. It is a country with modern goods and services, combined with exotic charm.

Our conference resort, the JW Marriott Guanacaste Resort & Spa, is within driving distance to tourist attractions such as Arenal Volcano National Park (80 miles northwest of San Jose) and Monteverde Cloud Forest Reserve (110 miles north of San Jose).

Located on Mansita Beach in Hacienda Pinilla, the JW Marriott Guanacaste Resort & Spa is on the northwest coast of Costa Rica in the province of Guanacaste. With five beaches, a championship golf course, an equestrian center, world-class spa and more, your experience will be unforgettable.

During conference breaks, you can also venture out of the resort and experience various activities such as horseback riding, fishing, national park tours, river floating, canoeing, snorkeling, ATV tours, scuba diving, or a zip line canopy excursion through the rain forest.

Costa Rica is truly a paradise for those who are in search of a combination of beauty, history, culture, and both land and water sports. Costa Rica’s exotic setting, combined with our 24th Annual Spring Conference on Pediatric Emergencies, make this an opportunity you won’t want to miss.


Enrollment for this conference is limited in order to provide the best possible learning environment.
Early registration is advised.

You can register and receive conference lodging group rates by reserving the following ways:

On-line at our website, www.symposiamedicus.org; OR

Call Monday-Friday, 8:30am-5:00pm (Pacific Time), (925) 969-1789 with Visa, MasterCard, American Express, or Discover; OR

By mail, make check payable to Symposia Medicus and send with registration form to 399 Taylor Blvd., Suite 201, Pleasant Hill, CA 94523-2287.

Visit www.symposiamedicus.org or call (925) 969-1789 for additional questions or information.


If postmarked by
January 22, 2020
If postmarked after
January 22, 2020
Physicians $695 $795
Residents, Nurses, PAs, & All Others $595 $695

Discounts are available for retired healthcare providers, active U.S. military, and groups of three or more. For more information, please contact Symposia Medicus prior to registering.

Tuition includes continuing education, online access to session materials, and break refreshments for conference registrants. Tuition also includes group reception for faculty, registrants, and their guests.

Conference registration will be confirmed via email


Conference group rates have been arranged at the JW Marriott Guanacaste Resort & Spa. Rooms at our group rates are limited and on a first come, first served basis. PLEASE RESERVE EARLY as rooms may sell out and/or room rates may increase. If you wish to extend your stay, group rates may be available three days before and three days after the conference.

Two nights’ deposit (room rate only) must accompany your reservation. The balance of your lodging, hotel fees as stated below, and all incidental charges are due to the hotel. The hotel accepts most major credit cards.


Room Type/View Group Rates
Garden View


(Limited number of rooms available at this rate. Once sold, rate will increase to $320/night.)

All rooms are 556 sq. ft. and have either a king or two double beds. Each room offers a closet, flat screen TV, iPod docking station, Marriott’s luxury bedding, mini bar, iron & ironing board, in-room safe, work desk, hair dryer, coffee maker, and terrace or balcony. Rooms only differ by the view and floor they are on within the hotel.
Ocean View $370/night
Ocean Front $410/night
By booking your lodging with Symposia Medicus, you will receive the following on a complimentary basis: in-room and resort-wide internet access, self and valet parking, use of the fitness center, nightly turn down service, complimentary access to beach soccer, Dynamic Exercise, aquatic aerobics, volleyball, and giant chess.
The resort has added a daily resort fee and its items are excluded for our group. Upon check-in, you may pay the resort fee to receive the additional resort amenities (subject to change). For more information regarding the resort fee, please contact the hotel.


Hotel Policies

Above conference group rates are per room, per night and do not include the following (subject to change):
- 13% sales tax
- $7.00 mandatory housekeeping fee

Maximum guestroom occupancy is four, regardless of age (no exceptions)

Mandatory additional occupant charge (13 years and over) is $45.00 per person, per night (includes daily buffet breakfast and taxes)

Children 12 years and under are complimentary (includes daily buffet breakfast and taxes)

Rollaways & Cribs: Rollaway beds and cribs are both complimentary (based on availability and subject to change)

Check-in time is 3:00pm and check-out time is noon. A late check-out can only be confirmed on the date of departure by the front desk. Late check-outs are based on availability and additional charges may apply.

Credit/Debit Card Policy: Upon check-in, the hotel requires a credit card or debit card to ensure that funds are available. Holds are placed on your account for your entire stay, plus $50/day for incidental charges; however, the amount may be immediately deducted from your account. The length of time for which these holds remain on your credit or debit account varies from bank to bank.

Parking: Valet and self-parking are complimentary when booking with Symposia Medicus

Cancellation Policies

Conference cancellations must be made in writing (via email or mail) to Symposia Medicus and a refund, less a 10% processing fee, will be given. No refunds will be made if cancellation is received after February 26, 2020; however, tuition, less 10% processing fee, may be applied to a future Symposia Medicus conference.

Per our hotel contract, hotel reservation cancellations must be made in writing to Symposia Medicus and you will receive a full refund if emailed/postmarked by January 29, 2020. Between January 30, 2020 and February 26, 2020, one night’s deposit is forfeited. After February 26, 2020, no hotel refunds can be made.

All cancellations must be emailed to registrar@symposiamedicus.org OR mailed to Symposia Medicus. If mailed, it must be postmarked by the dates stated above.

In the unlikely event of conference cancellation by Symposia Medicus, full tuition and, if reservation was made with Symposia Medicus, hotel deposit refunds will be made. Symposia Medicus will not be responsible for refunding travel or any other expenses.


The JW Marriott Guanacaste Resort & Spa is located in Guanacaste, in the northwest area of Costa Rica. You can fly into Daniel Oduber Quirós International Airport (LIR - known as Liberia International Airport), which is an approximate 1¼ hour drive to the hotel; however, lower fares can often be found by flying into Juan Santamaria International Airport (SJO), located in Costa Rica’s capital city of San Jose, which is an approximate 4-5 hour drive to the hotel.

Symposia Medicus has arranged for discount fares with Alaska, Delta, and United airlines for this conference. Reservations can be made either through your travel agency or through the airlines website or Convention Desk numbers listed below.

Airlines that fly into Daniel Oduber Quirós International Airport (LIR - Guanacaste) and Juan Santamaria International Airport (SJO - San Jose):

Alaska Airlines For discounts on Alaska Airlines flights, please book online at www.alaskaair.com and click on the link “Use Discount Code,” located at the bottom of the “Book Flights” box. Once you click on this link, another page will appear. On this page, you will need to insert ECMC615 in the “Discount Code” box, located at the right hand side of the page.
Please note discount has blackout dates of March 27-29, 2020 and April 3-5, 2020; discount will only apply to flights before or after these dates.
Delta Airlines For discounts on Delta Airlines, please visit www.delta.com, enter in your travel plans and then click on the “Advanced Search” link located below the “Passenger” box. Once you click on this link, a panel will appear and you will need to insert NMT7R in the “Meeting Code” box.
For questions, please call the Delta Airlines Convention Desk at (800) 328-1111.
United Airlines For discounts on United Airlines, please visit www.united.com and click on Advanced Search, located on the bottom left corner of the "Book Travel" box. Once you click on this link, another page will appear. At the bottom of this page, you will insert ZH4W711859 in the "Promotions and Certificates" box at the end of the page. For questions, please call the United Airlines Convention Desk at (800) 426-1122.

Another airline that flies into Daniel Oduber Quirós International Airport (Guanacaste) and Juan Santamaria International Airport (San Jose) - No conference discounts available:

American Airlines (800) 433-7300 www.aa.com


Transportation is available for either airport through TAM Travel. For more information, please visit https://www.tamcostarica.com/symposiamedicus-cr/.
Please note: If you are flying to/from the San Jose airport, you will need to overnight there due to the long drive between the airport and the hotel.