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Prehospital Management of Pediatric Respiratory Emergencies: Asthma, Bronchiolitis, and Croup

What do you do when when a child can't breath? Pediatric respiratory emergencies can be especially stressful for prehospital providers. This interactive, case based lecture will give ALS and BLS providers the tools they need to recognize different etiologies of pediatric respiratory emergencies and will review the different treatments needed.

  • Review the physical exam findings and prehospital treatment for asthma
  • Learn the physical exam findings and prehospital treatment for croup
  • Discuss the physical exam findings and prehospital treatment for bronchiolitis

Prehospital IV Nitroglycerin for Acute Pulmonary Edema (APE): This Ain’t Monkey Business

Patients experiencing congestive heart failure (CHF) exacerbation with acute pulmonary edema (APE) require rapid preload and afterload reduction. Traditionally, prehospital treatment has been limited to sublingual nitroglycerin at doses that are not able to affect afterload. However, in the hospital setting high dose, bolus intravenous (IV) nitroglycerin has improved patient morbidity and mortality. In this session, Dr. Casey Patrick and Micheal Perlmutter will discuss how Montgomery County Hospital District EMS and North Memorial EMS both implemented a novel prehospital protocol to use bolus dose IV nitroglycerin for patients with APE. The safety, efficacy and impact of this prehospital approach to patients with APE will be discussed.

Death Communication: The Missing Piece of Resuscitation

Research continues to stress the importance of remaining on scene for up to 30 minutes in an effort to improve the outcomes and survivability of cardiac arrest patients. But what happens when even the most successful efforts result in futility and a patient must be pronounced ? Historically, institutions have failed to prepare first responders for this outcome, and "training" for these situations is experiential, at best. As a result, crews continue to default into a “transport for the family," "PR CPR,” or “just for show” mentality that further contributes to the cultural resistance we currently face. We have failed to recognize our unique role in the grieving (healing) process, which begins for the survivors at the moment we determine time of death of the patient. In this class you will learn how to communicate with bystanders effectively and how to identify the process of grief, as well as understand the positive impact first responders can have on survivors when we remain on scene.

A Prehospital Guide to Autism Spectrum Disorders

One of the most difficult situations in prehospital care is the high-risk patient refusal of EMS transport. This topic is far from straightforward for both learners and teachers alike. This session begins with a discussion of capacity vs. competence, then introduces a brand-new mnemonic, FEARS—for 1) full exam, 2) explain the real risks, 3) ask for assistance, 4) record accurately, and 5) supportive attitude—that can help the next time you care for a complex patient who decides hospital transport just isn’t in the cards.

EMS Education 101: Skill Instruction

Skill instructors are the backbone of EMS education and serving as one is a great opportunity for experienced EMS providers to share their talents. Whether you are just getting into education or have been teaching skill labs for years, applying the science of psychomotor knowledge acquisition will lead to increased student success. This session will discuss the principles of skill education and how to leave a legacy with your students.

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Learning Objectives

  • Define psychomotor scaffolding.
  • List the five levels of psychomotor skills development.
  • Distinguish the importance of goal setting in the skills lab.
  • Identify the value of real-time skills tracking.

A Tool for Managing High-Risk Refusals

One of the most difficult situations in prehospital care is the high-risk patient refusal of EMS transport. This topic is far from straightforward for both learners and teachers alike. This session begins with a discussion of capacity vs. competence, then introduces a brand-new mnemonic, FEARS—for 1) full exam, 2) explain the real risks, 3) ask for assistance, 4) record accurately, and 5) supportive attitude—that can help the next time you care for a complex patient who decides hospital transport just isn’t in the cards. 

Objectives

  • Explain the difference between capacity and competence.
  • Understand how to properly document evidence of patient capacity.
  • Know how to use the FEARS mnemonic to have a more organized approach to high-risk EMS transport refusals.

Community Paramedic vs. Advanced-Practice Provider: What's the Right Tool for Your Toolbox?

EMS is uniquely situated to gain a perspective on patients' determinants of health in a way that cannot be achieved in clinics and hospitals, but core training of EMTs and paramedics is heavily focused on providing acute care. As we move into the mobile integrated healthcare space, is it better to train paramedics to work in the disease-management arena, or is it better to train advanced-practice providers (APP) to work in the field environment? Both groups come with advantages and disadvantages, and selecting one over another depends heavily on the mission you hope to achieve.

Objectives

  • Demonstrate understanding of the scope of practice and curriculum limitations of community paramedicine programs.
  • List advantages and disadvantages of utilizing a community paramedic vs. an advanced-practice provider in an MIH program.
  • Demonstrate understanding of the qualifications of APPs to work in the field environment. 
  • Describe innovative and cost-effective ways of incorporating APPs into MIH workflows. 

A Patient Complexity Scale to Evaluate MIH Workloads

MIH cases can vary in complexity and workload.  One community paramedic (CP) can be overwhelmed with four patients while another CP is breezing through ten cases.  Is there a way to score the complexity of a patient's case to help determine the workload their lead CP will face?  The presenters of this course have attempted to address this question by developing a MIH Complexity Scale.  This assessment may also help management monitor and delegate workload.  After discussing the development and research of the complexity scale, the presentation will conclude by discussing the vision for future uses of this scale

After the Airway Is Placed

Once an airway is placed, our job of airway management is far from over. Prehospital providers still need to continuously reassess the airway as well as provide proper breathing management. This presentation introduces best practices for continued airway protection and evaluation, improved breathing and ventilation care, utilization of end-tidal carbon dioxide, and how to plan for the lost airway. Come join in a discussion of how to anticipate and manage what might come up the airway, maximize oxygen administration and carbon dioxide elimination, effectively use a bag-valve mask to prevent increased intrathoracic pressure, and position a patient to make your job easier. 

This session is included in the virtual live stream.

Culture Shock: Welcoming CP Into Fire-Based Cultures

This presentation will take a deep dive into why a divide persists between fire and EMS-based cultures while providing tangible skills and real-world examples to break down such barriers in your own organization.

EMS Finance for 2022 and Beyond

As EMS moves further into alternative delivery and economic models, many EMS agencies struggle with determining the actual cost and value of their service delivery, especially models that have multirole functions, such as EMS-based fire agencies. This session will walk agency leaders through several ways to determine service delivery costs and the development of alternative payment models (APMs) for the services they could provide (community paramedicine, ambulance transport alternatives, etc.).

Objectives:

  • List the five "serial killers" for chest pain and shortness of breath.
  • Describe classic ECG findings in a patient with pericardial effusion.
  • Understand the common clinical presentations associated with thoracic aortic dissection.
  • Know risk factors for pulmonary embolus and deep venous thrombosis.

Deadly Airway Management Errors You Can't Afford to Make

Poor preoxygenation, incorrect medication selection and dosing, incorrect timing of laryngoscopy, bypassing the vocal cords, inadequate minute ventilation—the list of potential rookie mistakes goes on and on. Whether you've intubated one patient or 1,000, you should know these common pitfalls that can have deadly repercussions and how to avoid them.

Working Harder AND Smarter: The Science Behind Learning.

Brain science shows that most students' learning strategies are highly inefficient, ineffective or just plain wrong; and that while all learning requires effort, better learning does not require more effort, but rather effectively aligning how the brain naturally learns with the demands of intellectual work. This presentation will offer straightforward strategies for helping students prepare to learn, engage with course material, and set about improving recall of newly learned material at will.

Winging It: Imposter Syndrome and the Emergency Provider

Learners will discover the definition of imposter syndrome: persistent feelings of inadequacy despite evidence of success.   They will explore the five personalities of emergency providers that are at risk for imposter syndrome: the perfectionist, the superman/superwoman, the rugged individualist, the natural genius, and the expert.   Coping mechanisms to deal with it and the special implications for industry leaders will be discussed.

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Tips and Tricks of Difficult Intubations

This segment will deal specifically with placing an endotracheal tube in the patient that is

“hard to tube.” While we understand other devices are an option, and often a good

 choice, this lecture is designed to review understanding anatomy, positioning as well as

 various techniques and devices to be successful at INTUBATION. Through the 

use of photos, videos, and review of adjunctive intubation devices this program

 will present many variations of the standard technique to obtain success.

This session is included in the virtual live stream.

Throw Away Your Backboards!

This lecture will review the evidence that debunks the use of spinal immobilization in trauma patients. After this lecture attendees will understand why the best place for spinal immobilization is in the trash.

This session is included in the virtual live stream.

EMS Serial Killers: The Greatest Dangers Behind Common Chief Complaints

We often start with a diagnosis and teach from there, but getting to the final diagnosis is often a process emergency providers struggle with. To filter from undifferentiated abdominal pain with unstable vitals to an organized differential is often quite challenging.  We’re not going to spend time with nonemergent/chronic diagnoses, just the ones that are deadly when missed—that’s where we as emergency providers must begin. This session focuses on the can’t-miss/"killer" diagnoses associated with four of the most common EMS chief complaints: chest pain, abdominal pain, shortness of breath, and altered mental status.

Objectives:

  • List the five "serial killers" for chest pain and shortness of breath.
  • Describe classic ECG findings in a patient with pericardial effusion.
  • Understand the common clinical presentations associated with thoracic aortic dissection.
  • Know risk factors for pulmonary embolus and deep venous thrombosis.

The Medic Will See You Now: Delivering Care in a Homeless Shelter

San Antonio is home to Texas' largest homeless shelter, which may have more than 2,000 inhabitants on any given night. The shelter is the largest generator of 9-1-1 calls in the city of San Antonio. The UT Health San Antonio Office of the Medical Director and San Antonio Fire Department developed a clinic-style concept staffed by paramedics inside the homeless shelter. This decreases 9-1-1 calls to the campus location and transports to hospitals. While this population suffers from severe health disparities and is at risk for an emergency, they often have needs that could be better addressed by a dedicated overnight clinic. Dr. Miramontes and Dr. C.J. Winckler developed and  taught the paramedics how to perform this unique alternative care through an intensive training program. Quality assurance has proven the program to be successful, and the investment has paid for itself with a reduction in 9-1-1 calls and increased workforce satisfaction.

Field Termination: How to Break the Bad News

Despite our best efforts, many cardiac arrests end in patient death. Field termination is increasingly common, and the EMS practitioner's death notification skill can improve the experience for survivors and prevent pathologic grief. Breaking bad news involves specific communication skills that must be learned and practiced like any other EMS skill. This presentation will discuss various ways in which survivors exhibit grief, examine the aspects of pathologic grief, and describe an approach to breaking bad news during field termination of care. Dr. Kupas will focus on specific actions EMS practitioners should take and avoid and provide operational guidelines for treating our secondary patients: the patient's family members.

Objectives:

  • Understand how various people react to grief.
  • Describe the predispositions and actions that can lead to pathologic grief in survivors.
  • Demonstrate examples of specific phrases to use and to avoid when breaking bad news.
  • Discuss EMS agency operational guidelines that facilitate field termination of resuscitation.

The Fire Department Pharmacy: A New Model of Efficiency For EMS Provider Agencies

Simply stated, no other part of the healthcare system handles prescription pharmaceuticals the way many EMS provider agencies do.  As recent times have demonstrated, pharmaceutical supply chains are vulnerable to drug shortages.  In addition, the requirements around ordering, securing, storing, and documenting controlled drugs can be extremely cumbersome.  In 2017, the Los Angeles County Fire Department launched the first Fire Department-based, federally and state licensed pharmacy.  The department has since realized the benefits of improved supply chains for weathering shortages, pharmacist consultation on medication administration procedures, more efficient distribution processes that have dramatically lowered costs, an automated drug dispensing system for controlled drugs, better compliance with legal requirements for controlled drugs, and reverse distribution contracts that have generated tens of thousands of dollars in refunds.  Best of all, this model is scalable to EMS provider agencies of all sizes.

Hemodynamics Made Simple

Advanced hemodynamic monitoring is widely used in critical care—but its impact across emergency care can be profound. Advanced hemodynamic monitoring (i.e., assessment of preload, afterload, cardiac output, and global systemic perfusion) could help establish goals of resuscitation and oxygenation, which vary depending on diagnosis and disease stage. This session will evaluate each component to assist you in understanding the effects of what we do at bedside.

Objectives:

  • Describe the pathway of basic hemodynamic flow of the cardiac cycle.
  • List the most common advanced hemodynamic values and how they affect decision-making in the management in the different types of shock.
  • Analyze covert and overt data in recognition of specific clinical pathologies.
  • State the three components of oxygen delivery. 

Houston, We Have a Problem: The Breakdown of Bodily Functions

The human body is an interwoven system of systems. For it to work efficiently, all these systems have to be functioning normally. When a system does not function normally, EMS is often called. As an EMT, you have heard that the patient has DKA, but do you really understand what that means? During this session, physiology and pathophysiology will be presented through a series of cases that demonstrates how subtle alterations in these systems can cause major issues. The focus of this presentation won’t be on the specific treatment of the diseases presented; instead it will allow the attendee to understand why or how the disease can be treated.

Objectives:

  • Describe the physiology and pathophysiology of glucose metabolism.
  • Describe the physiology and pathophysiology of ventilation.
  • Describe the physiology and pathophysiology of cardiac muscle respiration.

The Critical Role of EMS in Injury Prevention in a People-Centered System

Over the last decade, the rise of community paramedicine and mobile integrated healthcare programs has reinvigorated efforts to involve EMS in injury prevention programs. Along with a growing recognition that preventing injury and illness reduces costs and improves health, the EMS profession has adopted a more proactive stance toward caring for communities.  But injury prevention is not solely the domain of community paramedics or large EMS systems—and to achieve the people-centered vision described by EMS Agenda 2050, it is time for all EMS organizations to focus on keeping patients safe and healthy before the emergency, not just after.  Two decades ago, the drowning of a toddler inspired paramedics to create EPIC Medics and assume community leadership in injury prevention. In addition, they have presented the Nicholas Rosecrans Award annually to an EMS agency that demonstrates a commitment to population wellness and injury prevention. In this session, you’ll hear from the winners of this year’s award, including how they implemented their program and the lessons learned along the way. You’ll also hear updates about previous years’ winners and engage in a discussion on the integration of EMS and public health in the community.

Psyching Students Up For Success: The Psychology of Motivation and Performance

Everything you do as an educator either contributes to excellence among your students or tears it down.  Do you wish students wanted to work harder?  Wanted to be the best?  You can make them want it!  This session will make sense of the science behind human motivation and show you how that research can be applied to our classrooms.  Many of the techniques behind peak performance are very easy to implement.  Why not give your students a fighting chance at greatness?  After all, each one of them is a reflection of you!

Objectives:

  • Identify classroom behaviors and attitudes that demoralize and detract from success.
  • List at least three activities that promote a student’s drive for excellence in EMS.
  • Appreciate that classroom and school ground attitudes, language, and behavior do directly impact the ability of any student to exceed expectations.

The ABC’s of Geriatrics: A Focus on Fundamentals to Prevent Cardiac Arrest

How can we best care for our oldest and most fragile patients? We put a lot of work into education and practice in the management of cardiac arrest, but what if we focused more on the identification and correction of the factors that may lead to cardiac arrest? When we do this for geriatric patients it can lead to significantly improved outcomes. This program focuses on pre-hospital management of geriatric peri-arrest factors with the goal of avoiding cardiac arrest and, if the worst happens, optimizing BLS and ALS resuscitation care.

State of the Art of Head Up CPR

Description: This session will include presentations from an EMS Fire Chief, an EMS Medical Director, an Emergency Physician/CPR researcher, and a Cardiologist/CPR researcher. All have been involved in the development and deployment of Head Up CPR. The talks will include the underlying science of Head Up CPR, how to implement Head Up CPR, and the latest preclinical and clinical outcomes of this breakthrough in resuscitation science.

Objectives:

  • understand the shortcomings of conventional CPR in the flat position
  • understand the key physiological effects of Head Up CPR
  • understand how to easily implement Head Up CPR into a BLS protocol

Keep Your Friends Close and Your Enemies Closer: Interpreting Sun Tzu for the EMS Leader

There was no greater leader and strategist than Chinese military general Sun Tzu. His seminal text The Art of War is considered a masterpiece of strategy that presents a philosophy for managing conflicts and winning battles. His book, which details a complete philosophy on how to decisively defeat one’s opponent, was based on a holistic approach to strategy. This approach is especially relevant to today’s marketplace, where EMS is “under attack,” and we need to develop strategy for survival like Sun-Tzu did. The lessons of Sun Tzu have stood the test of time and have taught generations of leaders the fundamentals of being an effective leader in areas such as conflict management, developing organizational strategy and the importance of interpersonal relationships. This session will review these, and other, lessons and assist you in defining expectations of leadership as well as living up to your own personal leadership potential.

  • Describe the threats to your EMS agency, knowing how to reframe your agency and the services it delivers, as well as lead your agency into the future.
  • List the do’s and don’ts of setting organizational goals and objectives.
  • Understand personal power (beyond your positional authority) and how to effectively use it in your leadership role.

Keeping It Clean: The Ryan White Act and Infection Control for EMS

A dirty needle stick or blood splashed in the eye can be a terrifying event to a clinician. In one national study of paramedics, 22 percent of respondents reported at least one blood exposure during the previous year.  Is your agency truly prepared to address the clinical and regulatory challenges of infection control?  Nick, the designated infection control officer for one of the largest county-based ALS first-response agencies in Georgia, and Samantha, an attorney for one of the largest hospital-based EMS systems in the Southeast, translate the legal requirements of infection control for EMS agencies, discuss simple changes to work practices that can greatly reduce the chance of exposure, and explain best practices for handling exposures.

  • Analyze the key components of the Ryan White Act as it relates to infection control practices and notification to emergency response employees who may have been exposed to infectious diseases.
  • Describe the role of the designated infection control officer and describe characteristics of successful programs.
  • Illustrate best practices for setting up infection control oversight at the agency level to enhance provider safety and avoid legal liability.

Kid Talk: Keeping Pediatrics (and Their Families) Calm During Crisis

Learn tips and tricks for keeping your pediatric patients and their families calm and improve communication during prehospital encounters.

  • Review tips on how to examine and treat pediatric patients while keeping them calm.
  • Discuss the importance of body language and tone of voice in communicating with pediatric patients and their families.
  • De-escalate to keep parents and kids calm when the parents are unhappy.

Teaching Students How to Learn

Some students do not know how to learn.  While most have been learning all their life, many students do not know the mechanism by which they acquire and retain information.  Many do not know under what circumstances they learn the best or the most.  You can help!  Current research, theories and trends in educational methods and psychology will be explored.  Strategies will be presented for teaching the same material to different learners.  The emphasis is on saving time and enhancing performance in our EMS classrooms.  Educators will learn how to set students up for academic success.

Stroke Screening for Spanish Speakers

For every second a stroke goes untreated, 30,000 brain cells die.  The most important part of getting timely treatment for a stroke is to know and understand the warning signs described by the FAST acronym. Our team collaborated to create the world's first stroke recognition tool targeting the Hispanic community, which faces elevated stroke risk. This presentation will demonstrate how this simple tool has been used in Polk County, Fla., and integrated with EMS stroke protocols to attack this problem.

Objectives:

  • Name at least 3 stroke symptoms.
  • Recognize diversity in stroke outcomes.
  • Recognize stroke mortality and morbidity in the Hispanic community.
  • Recognize stroke symptoms related to the Spanish language.

Making the Jump from EMS to Physician

The best doctors are paramedics, in our opinion. Have you thought about going back to school? Join this panel of paramedics turned physicians to learn about the pathway to becoming your own medical director. We will share the pearls and pitfalls of making the plunge and applying to medical school, as well as what to expect after you get in. We need more EMS physicians in this world—come learn how you could be the next one!

  • Understand the opportunities that exist for additional education beyond EMS.
  • Understand how to apply to additional educational opportunities and what the requirements are.
  • Describe the difference and comparative benefits of the many different career choices available with additional education.

Secrets of Effective Pipeline Programs

Historically black colleges and universities (HBCUs) are more successful in getting students admitted to medical schools than the Ivy League. What do those schools know that the others do not?  They use learning and motivation science to address what is an opportunity gap, not an achievement gap, and surround learners with the support needed for success while using the teaching strategies proven to make a difference in underrepresented students. Come learn what they are doing—it's good education for all your students!

System of Care Approach for Traumatic Injuries and Acute Illnesses: A Statewide Approach and How it Can Help in Response to Disasters

This will be a panel discussion surrounding a Statewide system of care approach. Discussions will surround what led the state to implement a process and system, the need to gather and evaluate data in an effort  to help identify gaps in definitive care throughout the state.  For Example, knowing we have a gap in a rural area of the state for for definitive care and services with Trauma, Cardiac Cath Labs or Stroke Teams. The system would then help to identify needs and work with the hospitals to train and stand up services to fill gaps throughout the state. Additional discussion surrounds EMS transport decisions and support through a destination call center. This helps ease the process for medics in the field, hospital statuses are monitored by the call center. We will discuss how some urban areas may not use this system on a daily basis but have incorporated the system during disasters and mass casualty events to help distribute patients throughout the region or state. The final topic will be incorporating a specialty such as Burn Care into an already established system and the challenges associated with such an implementation.

  • Upon completion of this discussion, participants will have a better understanding of a how a state-wide system of care for traumatic injuries and acute illness can improve response to disasters.
  • Upon completion of the discussion, participants will understand the challenges associated with implementing such a system.
  • Upon completion of this discussion, participants will have a strong understanding of the LERN systems usage in the state of Louisiana and how it has impacted patient care.

Secretions and Excretions: What Our Bodies Can Tell Us

Grossness and kidding aside, understanding the normal and abnormal fluids that the human body produces can provide valuable clues to underlying conditions.  You’ll never believe how informative the gunk in that tissue can be.

ISS: Meds in Out-of-Hospital Cardiac Arrest: Are They Actually Doing Anything?

We’ve all spent a lot of time learning about (and administering) drugs in cardiac arrest. Does any of it really matter? Epinephrine—Are we saving the heart at the expense of the brain? Amiodarone? Lidocaine? Are they doing anything other than numbing the skin? Does it matter if we give it quickly? How about IV vs. IO? Dr. Jarvis will review the literature on epinephrine and anti-dysrhythmics in cardiac arrest as well as recent work looking at the impact of route of administration. He’ll keep you awake as you learn the latest information that should be shaping your clinical practice.

  • Understand how literature should provide the foundation for clinical practice.
  • Describe the importance of timing with epinephrine use.
  • Describe the impact of epinephrine on outcomes in cardiac arrest.
  • Discuss the difference in outcome between amiodarone, lidocaine, and placebo in cardiac arrest.

RSI for BLS: Make Yourself Part Of The Team

Advanced airway management, especially the use of rapid sequence intubation (RSI), has been commonly held as a procedure that only Advanced Life Support clinicians need to understand and perform. RSI can have significant effects on the patients who are determined to need airway management, both positive and negative. It can be a high-stress, high-acuity, procedure with a narrow therapeutic window.  Frequently ignored in RSI education has been the BLS clinician, who is present for each RSI. The goal of the program is to educate the EMT in the process of advanced airway management, especially RSI, and how they can contribute to the overall success of a procedure that has a significant effect on patient outcomes. We strongly believe it is the EMT that is the "X factor" in successful and consistent RSI outcomes.

Objective

  • Understand the terminology of advanced airway management/RSI, goals of therapy, misconceptions of RSI, its importance in prehospital patient care. State of New Jersey RSI program will be referenced.
  • Describe the procedure of RSI, patient selection, determining difficulty, preparation, medication, securing the airway, and confirmation. EMTs will identify key areas where BLS knowledge and skills are important steps.
  • Identify pitfalls in procedure, such as preoxygentation, suction, and communication; and how the BLS clinician can contribute within their scope of practice to minimize the effects of these problems.
  • Communication between ALS/BLS and human factors will be identified. The BLS clinician will learn to identify areas where they can improve in communication and avoid common errors.

The Battle of the RSI Paralytics: Depolarizing vs. Non-depolarizing

Paralytics are an extremely important, yet potentially dangerous tool in the pre-hospital setting. It is important that pre-hospital providers be up-to-date and aware of the most current literature surrounding these agents to successfully facilitate a safe and effective intubation. Is there a "one-size fits all" when talking about the use of paralytics for rapid sequence intubation (RSI) ? Is there a "preferred" paralytic in specific patient populations? What are the most important side effects and clinical pearls that pre-hospital providers should be aware of? All of the aforementioned questions and more are addressed with the most current evidentiary support.

  • Describe the purpose and utility of paralytics in the pre-hospital setting
  • Describe the specific patient populations for which each paralytic would have the greatest clinical efficacy
  • List the most common side effects associated with both depolarizing and non-depolarizing neuromuscular blockers
  • Understand the pharmacodynamics and pharmacokinetics of neuromuscular blocking agents

Riding the VIPER (Vasopressor Intravenous Push to Enhance Resuscitation) to the Finish Line

We all want to know what push dose pressors we should use for patients, and if we should even implement them. When we look at the data, we find 3 things use in the OR, use in the OB units and sometimes in the ED and we heard it on a podcast. This presentation will go over the identification of when we should consider push dose pressors, what medications should we look at and if there any medications that we can also use outside of the push dose pressor world. VIPER looks at the use of Phenylephrine and Vasopressin as the main arms of medication for the push dose pressor and evaluates the pros and cons to these and other medications for the peri-intubation arrest. By the end of the lecture, the learner will be able to understand the use, and implementation of Push Dose Pressors in the prehospital, peri-intubation arrest setting.

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Implementing the 2020 PALS Guidelines: A Cautionary Tale

U.S.-based healthcare professionals take the advanced life support guidelines at face value and often simply “follow the recommendations” verbatim. If you did this in 2015 you may find yourself reversing course on certain recommendations just five years later. Taking a look under the hood each time the guidelines are updated is a critical exercise for everyone in healthcare, and this year is certainly no different. Join Drs. Peter Antevy and Mark Piehl as they examine the most concerning PALS 2020 recommendations and the evidence base that helped derive them. You may leave this talk with some difficult choices to make.

  • Evaluate the evidence for changes in the recommend ventilation rate during CPR
  • Understand the benefits of push-dose epinephrine for symptomatic bradycardia
  • Recognize the benefits of adequate fluid resuscitation in septic shock
  • Understand the recommendations for blood transfusion in pediatric trauma

Resuscitation: Lead, Follow, or Serve as an Example of What (Not) to Do

The AHA establishes BLS and ALS treatment guidelines based on the strongest evidence available.  Because their guidelines need to be broadly applicable the guideline writing committees take a very conservative approach to changes in response to available literature.  From where does the evidence and literature emerge?  It comes from systems that do not necessarily follow the guidelines.  Many systems violate the AHA guidelines.  This is necessary for the evolution of resuscitation.  This session will describe the approach to the establishment of a resuscitation program custom tailored to fit the needs of a large urban fire based EMS system.  We will discuss the QA/QI requirements, regulatory hurdles, and education need to establish best practices for the local environment.

Response to Psychiatric Emergencies Without Law Enforcement: Is it Safe?

This session will provide attendees with an in depth look at the creation of San Francisco Fire Department's Street Crisis Response Team, the interagency development process, deployment, structure, and abilities of the team, and data showing the safety and efficacy of a trauma informed approach.

This session is included in the virtual live stream.

Three Practical Strategies for Reducing Errors and Building Resilience in EMS

Human and organizational errors can end lives, ruin careers, and capsize hard-earned reputations overnight. Some teams successfully reduce, mitigate, and learn from errors far more effectively than others… How do they do it? More than 30 years of research on “High Reliability Organizations” reveals that the traditional approach of creating more procedures, more rules, and more compliance may cause more problems than it solves. In this presentation, you’ll get an overview of three practical strategies used by medical, military, aviation and other high-hazard industries that you can apply within your EMS team.

Objectives:

  • Describe the three core strategies: (1) Apply Defenses, (2) Improve Processes, (3)  Build Resilience
  • Demonstrate why the single best way to reduce errors is to stop punishing people for making honest mistakes
  • Reveal the fatal flaw of depending only on traditional, person-based error prevention "tools"

Hit the 'Lytes! Case Studies in Electrolyte Imbalances

Electrolyte imbalances are not often at the top of the list of differentials for most EMS providers. Despite this, up to 15% of patients presenting to emergency departments have at least one electrolyte abnormality (Liamis et al., 2013). With such a high possible prevalence of this pathology, it is critical to have a better understanding of the functions of electrolytes and what can happen when something goes wrong. With many EMS services lacking point-of-care testing for electrolytes, EMS providers must use their clinical detective skills to identify and treat these patients. This presentation will walk through four of the most common electrolyte imbalances through real-life case studies. Participants will be asked to interact with the cases to identify the clinical manifestations and appropriately treat each patient, even without the benefit of lab testing.

  • Understand how electrolytes affect the human body.
  • Identify common presentations of electrolyte imbalances in patients.
  • Analyze cases of electrolyte imbalances in order to determine proper treatment for the patient.

Reinventing Recert: an Update on the National Registry Continued Competency Initiative

The National Registry began an initiative to explore new ways to verify continued competency in 2019 with the aim of developing an agenda for the future of recertification.  New ways to verify continued competency could revolutionize the ways in which we renew certification, licensure and local credentials.  Mark will summarize the research and accomplishments of the continued competency initiative.

This session is included in the virtual live stream.

Understanding Social Determinants of Health For EMS: Does this Really Matter?

EMS providers have a front-row seat to many of society’s ills including homelessness, sexual abuse, drug & alcohol use, abuse, and patients who lack access to essential healthcare services.  The umbrella term used this constellation of problems is: Social Determinants of Health, or SDOH. But do social, societal, & economic issues really impact clinical outcomes? As healthcare providers, we believe that clinical care may not solve the patient’s problem if the root cause of the issue lies elsewhere, but what does the evidence say? The COVID-19 pandemic has vividly illustrated some of the weaknesses in the healthcare system, including the inequities related to social determinants, yet SDOH are rarely discussed in the prehospital classroom despite their potent impact on health outcomes. This lecture examines the connection between social determinants and healthcare outcomes. We will look at the various social determinants, how they impact EMS, and lessons learned from initiatives already in place. EMS is well-placed to use our healthcare system role and our expertise to help create systems and practices to address social determinants and improve healthcare outcomes. Join this panel of EMS and public health experts as we look at real-world problems and come up with real-world solutions.

  • Define at least 2 categories of social determinants of health.
  • at the end of this presentation, participants will describe how social determinants of health can contribute to the overuse of EMS systems and exacerbate risk factors for the underserved.
  • Identify strategies to help address social determinants of health within an EMS system.

Realities of EMS: The (Not So) Mundane Complaints, Part 2

Description: This is part 2 of a dynamic lecture series that will explore many of the "mundane" or " routine" medical calls we are called upon to treat. While lacking the excitement of  a trauma resuscitation or airway disaster many of these chief complaints are fraught with danger if not adequately  assessed and treated. In this lecture we will discuss the can't miss signs of abdominal pain. Abdominal pain is the third most common complaint in patients over the age of 65 and the mortality associated with surgical causes of abdominal pain in the elderly are high. Learn the signs and symptoms for some of the most life threatening etiologies of abdominal pain. We will also discuss the red flags of back pain. Key elements of the history and physical exam to risk stratify these patients! Improve your diagnostic acumen and become a better clinician by attending this lecture.

Hindsight is 20/40: Musings About the Past and Future of EMS

Dr. Douglas Kupas has been an EMS field practitioner for 40 years and a state EMS official for 20 years. In this presentation, he will reflect on the last 40 years of EMS and provide predictions for the future. Over the years, EMS has steadily advanced in patient and provider safety, technology, and patient care. EMS providers are now vital healthcare practitioners who are positioned treat our patients as part of the integrated healthcare system. The U.S. is at a tipping point in EMS reimbursement. The presentation will discuss the future of telehealth by EMS, treat-in-place, and mobile integrated healthcare. Dr. Kupas believes that in the future, all EMS providers will play a role in mobile integrated healthcare and EMS systems will be integrated with health systems to keep patients well at home. He also believes that EMS practitioners can provide significant value in patient care and will be recognized and rewarded for this on par with other healthcare professionals.

  • Describe the history of EMS and characteristics of EMS provider culture that can be detrimental to the future of the profession.
  • Understand how changes in education, scope of practice, and technology have improved patient safety and the quality of care in EMS.
  • Describe the financial factors impacting emergency care and the gap in value and home care that can be filled by EMS.
  • Understand how healthcare payors view EMS and how future reimbursement will depend upon increasing our value to the system and our patients.

Realities of EMS: The (Not So) Mundane Complaints, Part 1

Description: This is part 1 of a dynamic lecture series that will explore many of the "mundane" or " routine" medical calls we are called upon to treat. While lacking the excitement of  a trauma resuscitation or airway disaster, many of these chief complaints are fraught with danger if not adequately  assessed and treated.  In this lecture we will discuss the chief complaints of dizziness/weakness and the red flags associated with it. When should you worry about posterior stroke and how do you risk stratify these patients? Pearls of the neurological exam will be discussed as well as how to structure your history gathering to maximize patient care.  The chief complaint of headache will also be discussed focusing on the high risk signs and symptoms as well as the varied causes of headaches the EMS provider my encounter in the field. Restructure your lexicon of "mundane" to potentially "high risk'" and don't miss these killer patient presentations.

Hidden in Plain Sight: Human Trafficking in America

Human trafficking is the fastest-growing organized crime activity in the United States, averaging over $30 billion per year. Research has revealed that up to 88% of human trafficking victims accessed healthcare while being trafficked. This means that the chances are high that as an emergency responder or healthcare provider, you have treated a victim of human trafficking and may not have recognized it. In this discussion, learn how to recognize the signs of human trafficking, how to identify a potential victim, and what you should do if you identify a victim. This lecture will include key takeaway points compiled from various resources including the human trafficking victim-witness coordinator for Central Texas, a human trafficking victim, Allies Against Slavery, the International Labour Organization, social services and emergency care providers, and the Institute for Family Violence Studies.

  • Understand the scope of human trafficking in the United States.
  • Understand the role of emergency personnel in caring for persons at risk for human trafficking.
  • Identify common characteristics to help identify at-risk persons.
  • Identify resources available once a victim or potential victim has been identified.

When Death Is Not The Enemy

Objectives:

  • Understand public attitudes toward end-of life resuscitation and when it should be withheld
  • Understand the importance of EMS providers understanding issues
  • Describe general best practices for on-scene death notifications.


Project Swaddle: Protecting the Vulnerable During High-Risk Pregnancies Through MIH-CP

Description: Project Swaddle extends the successes of MIH-CP in reducing chronic disease and improving older adult health by providing care for at-risk mothers and their babies. In this program, paramedics make in-home visits with mothers throughout the pregnancy and during the 16 weeks following birth. In addition to providing important prenatal and postpartum care and education, the paramedics develop a trusting relationship with mothers by providing them 24/7 assistance in the form of emergency response, emotional support, and just answering questions mothers might have throughout the process. Following an overview of the need for Project Swaddle in Crawfordsville, IN, the division chief will explain the components of the program and the community paramedic will share his experiences and some successful from the program. The presentation will conclude with an overview from an academic partner about efforts to systematically evaluate the program.

Handling the Heat: Psychological Skills for Better Performance Under Stress

Performing effectively during the resuscitation of a critically ill or injured patient requires more than simply remembering pieces of information and completing individual skills. These situations can be very complicated and require exceptional teamwork, effective communication, and a host of other non-technical skills that fall under the guise of human factors. Many other groups, such as professional athletes, business executives, and elite military special operations teams, have developed comprehensive psychological skills and techniques that allow them to remain calm, think clearly, and stay focused in challenging situations. This lecture draws from the fields of psychology, cognitive science, and human factors to present novel ideas on how to optimize performance in the stressful and dynamic world of EMS.

  • Understand the history and development of psychological skills training.
  • Define the effects of stress on cognitive faculties including memory, decision making, and attention.
  • Outline the potential benefits to using psychological skills in air-medical transport.
  • Comprehend how to use the “BTSF” (breath, talk, see, focus) tool to improve performance during stressful situations. 

Prehospital Ultrasound: Riding the Waves

Description: The utility of ultrasound (US) is ever expanding. Today we have inexpensive, portable devices which makes it hard to justify not having them on every truck or aircraft in the country. In this lecture, we will spend time talking about ultrasounds use in resuscitation and as an adjunct to the performance of procedures.  US can be used to determine if a patient is likely to crash or the reason why a patient is actively crashing. US can also be used to ensure procedures are performed safely and accurately 100% of the time.

Good Enough is Not Good Enough: Demanding More of Yourself and Your Service

Vince Lombardi said, “The quality of a person’s life is in direct proportion to their commitment to excellence.” In our work, the quality of the lives of others is also in direct proportion to our commitment to excellence. So if we've all agreed to work in the service of others in their time of need, why do some people in emergency services only go as far as “good enough”? How do people slide from doing what’s right, to doing what’s “good enough"? And how do we reconnect them to a commitment to excellence? Inspiring and informative, Rom Duckworth shows how easy it can be for organizations and individuals to stray from the path of excellence, and reminds us of the importance of what we do and why—in our unique profession—good enough is simply not good enough.

  • Explain the function of error creep in increasing the risk of personal and organizational errors.
  • Describe the methods to achieve and maintain mastery of core emergency service knowledge, skills, and abilities.
  • Identify your role in the success of your organization and the emergency services profession as a whole.
  • Describe a variety of case studies of organizations and individuals who have exhibited failure, sometimes catastrophic, due to error creep.

Prehospital Telemedicine: A blueprint for Success

Prehospital communication between EMS and hospitals is a challenge, particularly for time-sensitive transfers (STEMI, stroke, trauma). In order to improve communication between EMS, the ED, and inpatient call teams,  we needed an easy-to-use, low-cost method to configure our communications to protocols and to transmit important patient information. The solution? A mobile telemedicine application.  This project was launched by our hospital, Baystate—a large hospital with the only Level 1 Trauma Program and PCI center in its region. EMS travel times reach upwards of 40 minutes and there is limited radio coverage. User accounts, upgrades, and training were offered to all regional EMS agencies included in the chosen program. Telehealth / telemedicine technologies were evaluated and a selection made.  This program grew into a regional application through first intrigue of the ease of success to date.  The user buy-in across all teams was vital and didn’t happen overnight. Each successful team addition or patient save lead to eventual full unity and solution compliance.   We are now exploring further into MIH/CP, additional COVID mitigation and other multi-facility, regional or across state border programs.

Practical Applications to De-stress on the Job

Mindfulness practices such as yoga and meditation are commonly referred to as the number one resource for relieving stress and anxiety. Research is proving that both can have a powerful impact on brain function, nervous system regulation and physical pain relief. But for many of us, the concept of meditation is so elusive that these benefits feel theoretical or unachievable. Some may feel they don’t have the patience to “sit still” and in turn causes more anxiety.  How does one get from a theoretical understanding of mindfulness to practical and consistent application methods that achieve results?  This session will introduce the basics of yoga and meditation with practical applications including how to employ these techniques while on-the-job i.e. in the cab of an ambulance or sitting in a lively office environment. These techniques will be broken down, practiced and yours to keep.

Fun with Physiology: Let's Get Cellular

There is a good chance you were taught cellular physiology in a very academic manner.  This session will address cellular “action potentials” in a manner that is anything but academic.  Interactive case studies will illustrate how cellular action potentials can become an intuitive concept for every level of EMS provider.  More importantly, participants will understand how diseases influences cellular action potentials and outwardly reflect specific signs and symptoms in their patients.

  • Participants will be able to identify the basic elements of cellular action potentials.
  • Participants will be able to describe why understanding cellular action potentials relates to all EMS providers.
  • Participants will be able to integrate the “School House Theory” into their understanding of normal and abnormal human physiology.

Pediatric Bereavement: Caring for All of the Patients

There are 7,000 pediatric out-of-hospital cardiac arrests each year in the U.S. and only 11% of those children survive to hospital discharge.  This means that 89% of children die either on scene or in the emergency department, yet EMS education does not focus on how to best care for the "other patients" - the family members on scene. Join Dr. Peter Antevy and Amy Richardson to learn why this skill is so important for long term healing, and how to walk through these chaotic, emotionally charged scenes with proficiency. These dynamic speakers will discuss best practices for speaking with caregivers, focusing on how to incorporate them into the code with the ultimate goal of getting them to closure.  We know that a heartfelt on-scene interaction with family members can change the grief trajectory for everyone involved and it’s a skill that may save your career.

Not Your Grandfather’s DKA: Recent Changes in Diabetes Care

Diabetic ketoacidosis (DKA) is one of the most serious complications of diabetes and is often associated with significant hyperglycemia.  Increasingly, patients with Type II diabetes are developing DKA, even in the absence of abnormally elevated glucose levels.  What many of these patients have in common is the use of one group of medications recently approved by the FDA for the treatment of diabetes.  Euglycemic DKA can easily mislead EMS personnel resulting in delays in appropriate management strategies.  This case-based presentation will review the associated pathophysiology of patients presenting with euglycemic DKA and discuss the approach to diagnosis and management of such patients.

This session is included in the virtual live stream.

Diagnosis and Treatment of LVO Strokes

This presentation will review the trials that led us to endovascular therapy, issues with the trials, how to identify large vessel occlusion strokes, and finally how to put it all together into one concise workflow.

  • Understand the evidence supporting endovascular therapy in large vessel occlusion strokes.
  • Understand the limitations of the supporting evidence for endovascular therapy in large vessel occlusion strokes.
  • Be able to identify a large vessel occlusion stroke clinically using the VAN tool. 

Not Imposters: How Women an EMS Can Break the Glass Ceiling

The emergency services are a male-dominated field, and nowhere is that more apparent than at the upper levels of management. Whether fire-based, municipal, private, or state, the female presence is thin at the top. For women who are in leadership roles or aspiring to attain them, there is not much information available that can be practically applied to gender challenges. This presentation will take an honest and objective approach to the social and generational influences that shape the industry. It will offer advice on how to improve professional and personal communication and help you learn to spot pitfalls and instances where "imposter syndrome" and social conditioning may be holding you back. 

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Next Level Public Relations

You are confidently responding to media inquiries to your agency, you’ve successfully pitched some stories and your digital media presence is growing. That’s it, right? Not even close. During this pre-conference session, participants will dig deep into public relations, audience engagement, writing, planning, tools for execution and how to evaluate. Participants will leave this session with hands-on experience creating a successful PR campaign, developing a media plan and calendar including how to identify opportunities and how to create messaging. In addition, they will learn how to generate interest and connect with audiences by revisiting (and practicing) the fundamentals of writing pieces like press releases, social medial posts, blog posts and media pitches. Information will be useful for new/occasional PIOs as well as for more seasoned professionals.

From the Frontlines: EMS and the Opioid Crisis

Opioid overdoses, and the long-term issues surrounding addiction, present significant challenges to communities across the country and EMS providers are on the front lines of this crisis. From naloxone-leave-behind programs to pre-hospital treatment with suboxone, EMS has shifted from an emergency response role to becoming a key driver in developing a comprehensive approach to helping our patients who are victims of this long-term epidemic.  This presentation will highlight innovative, evidence-based initiatives led by EMS providers serving on those front lines combating the opioid crisis and saving lives. Attendees will gain an increased awareness of direct strategies and how to form necessary partnerships essential to be effective in addressing opioid issues in their communities.  Join this experienced panel of EMS and public health experts as we look at some of the cutting-edge solutions that EMS systems have developed as they respond every day to this public health crisis. 

  • Understand  the pharmacology of different opiod substances 
  • Understand recommended treatment options for Narcotic overdose treatment 
  • Understand the use of Buprenorphine for opiod withdrawal treatment

New Treat-at-Home Partnership Opportunities for EMS

By forging a new partnership between EMS providers, insurers, and emergency physicians, UCM brings emergency medicine triage directly to the location of the patient.  With telehealth communication that includes responding EMS crews, a patient can be assessed, diagnosed, referred, and treated in place. The Virtual ER reduces unnecessary hospital ER visits, freeing up EMS resources and time for patients with true emergencies.  Through health insurance partnerships, the Virtual ER pays EMS agencies for treat-at-home visits.

UCM's EMS partnerships have rapidly expanded during 2020, securing EMS payment opportunities for treat-at-home for Medicaid Managed Care, Medicare Advantage, and commercial insurance patients across a growing swath of Upstate NY.  A growing body of evidence is being collected that shows a high percentage of patients calling 911 for non-emergent conditions can be successfully treated at home, rather than in the emergency room.  This has added extra value during the COVID-19 pandemic.

Demonstrated savings has expanded health insurer participation, making this a viable innovation pathway for a growing number of for-profit, fire-based, and not-for-profit EMS agencies.  After the short introduction to the concept at the 2020 Virtual EMS World, this presentation will examine data and key performance indicators that drive the success of EMS treat-at-home.

Embracing a Mental Health-Focused Culture

Agencies' attempts to address mental health issues often fall short of intended goals. Rarely do they do anything to correct underlying challenges. Instead, embracing and owning a culture of supporting mental health takes intentionality, purposeful steps, and dedication. Embracing mental health has to be threaded throughout the organizational structure and a core part of agency identity. This presentation will review common cultural barriers and look at simple steps agencies can take to shift their department culture in the right direction.

Objectives:

  • Recognize common barriers to embracing a mental health culture.
  • Describe the steps necessary to create avenues to open conversations about mental health in your agency.
  • Locate appropriate resources for agencies to utilize to provide education on mental health and the EMS responder.

Everyone Is Watching: Addressing Unprofessional Conduct and Managing Liability Risk

Salacious videos and social media posts can show providers at their absolute worst: arguing, physically assaulting patients, criticizing and fighting with their public safety partners. Unprofessional interactions have plaintiffs’ lawyers seeing dollar signs—instead of focusing on care, lawyers can focus on how providers act and sway juries toward big verdicts.  This session explores how public safety agencies can support a culture of professionalism, manage the difficult conversations, and address interpersonal and interagency issues before the next big lawsuit.

  • Illustrate and discuss examples of unprofessional interactions among EMS providers, law enforcement, fire departments, and hospital personnel.
  • Examine the effect of unprofessional interactions on legal liability for providers and their agencies.
  • Describe best practices for leaders to support a professional culture and address interpersonal and interagency conflicts.

Moving Past EMS Staffing as Usual in a Post Covid World

EMS was hit hard by COVID-19 — but the implications for workforce planning are long lasting.  In this fast paced engaging seminar, Fitch will outline how leaders and team members can better use resources to improve customer service and caregiver satisfaction.

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EMS and Public Health: Connecting the Dots

For far too long EMS has been relegated to “you call, we haul.” As we all struggle with funding challenges, it is time to look at ourselves differently. With recent events such as active shooters, the opioid epidemic, MIH, the COVID-19 pandemic, civil unrest, and more, the role of EMS has changed forever. This session will connect the dots between EMS, MIH, and public health. EMS has never been properly assimilated into public health, but when we as EMS take one step back, we are at the epicenter of it. No other entity nationally or internationally has the routine and trusted access to the public we do! Join us to see how to change the narrative and trajectory of EMS.

Objectives:

  • Understand the concept of EMS providers functioning as a part of public health.
  • Have a greater understanding of how quality data drives funding, which drives staffing and legislation.
  • Understand that the EMS provider is perfectly poised to assist with issues concerning public health.

EMS in the Electronic Era: The San Diego Experience

Remember the days of old, when the doctor would be handed the handwritten EMS patent care report, when EM physician trainees were taught to always read the EMS report? That was 10 years ago! We have generations of emergency physicians not understanding the importance of reading EMS notes. What was the blood pressure on that trauma patient? When was the last dose of inhaled epinephrine given to that child with croup? When was the IM epinephrine given to the patient with anaphylaxis? EMS care is critical to both the patient and the team receiving them. This presentation discusses the history of EMS going electronic and how San Diego is getting both the EMS report to the hospital and the hospital outcomes back to the agency.

  • Describe how EMS went from paper to electronic records.
  • Describe the importance of the emergency department receiving timely EMS records.
  • Describe the importance of EMS receiving hospital outcomes.

Mass vaccination clinic: Mobilizing your EMS agency

If anything, the COVID-19 response has inspired some outside the box thinking for EMS agencies. This includes staffing, deployment models and major protocol change. Some agencies have even stepped deeper into the public health role as a result. Albert Einstein said "In the middle of difficulty, lies opportunity". This presentation highlights the opportunity that EMS has been afforded during this difficult time. An opportunity to bolster the efforts of public health and further impact the communities they serve. Learn how Indianapolis EMS and the Indiana Department of Homeland Security partnered with state and local health assets to stand up Indiana's first EMS lead mass vaccination clinic.

Manikins, Students and Scenarios: Simulation Essentials

This session will go over the different types of simulation, simulation objectives, simulation resources and how to select the best type of simulation for your objectives. Simulation in medical and nursing education is formalized and requires additional education and certifications. EMS has been doing simulation for years, but not necessarily in a formal way. Learn how to approach simulation effectively and professionally. NAEMT’s integrated testing scenario uses simulation as a summative assessment. What can you use simulation for? Learning objectives, formative and summative assessments, and just about anything else. If you are a new instructor or have been doing EMS education for years you can learn something or get some new ideas.

Crew Resource Management: Can It Work on the Ground?

Crew Resource Management (CRM) is a proven and accepted process that has reduced errors, omissions, incidents, and accidents in the aviation community. But while it works and is here to stay as part of aviation culture, CRM is not yet well understood or accepted in prehospital and hospital care. Should it also be a standard in the medical community? 

Objectives:

  • Identify the importance of CRM to the aviation community.
  • Identify where and how CRM can apply in EMS.
  • Describe how to engage in CRM with supervisors and coworkers.
  • Appreciate that use of CRM techniques will reduce errors and injuries.

EMS Education via Netflix

Have you ever wanted to watch a movie or TV show instead of reading or studying? Now you can do both at the same time! This session uses movies, clips, TV shows, and pop culture to cover concepts in EMS.

  • List examples of medical TV shows and movies that can be used for case studies.
  • Use technology to add audiovisual materials to slide shows and lectures.
  • Create lesson plans and assignments that utilize popular culture. 

Global Roundup 2021

Returning with his highly-rated and entertaining review of EMS around the planet, U.S.-based Rob Lawrence will be joined by international EMS leaders to discuss the delivery of prehospital care in their own countries. 2020 was a year in which EMS across the planet was—and continues to be—on the front line. By the time this conference is delivered, the session's leaders will have battled, possibly lost, and definitely overcome the challenges of COVID and the normal delivery of EMS in their respective nations. Expect to hear from leaders based in Europe, Israel and Australia.

  • Understand how EMS agencies have coped with 2020.
  • Extract best practices from the international EMS world in both clinical and operational arenas.
  • Understand how issues identified and solved in other EMS nations can be applied in your own EMS system.

How Do I Reach These Kids? Student Engagement in the 21st Century EMS Classroom

In a world filled with distraction, how do EMS educators and leaders engage students? Whether you teach in a traditional classroom, a "flipped" classroom, an entirely hybrid program, or clinically as a preceptor, it is incumbent on us to ensure our students get the most out of their educational experience. In this presentation we will build from an understanding of student engagement theory through the literature, and apply key points to the EMS classroom. Through a discussion facilitated by case studies, we will better understand what we must do as educators to reach our students in an engaging and meaningful way.

  • Discuss evidence-based adult education and student engagement theories.
  • Apply evidence-based adult education and student engagement theory to the EMS classroom.
  • Analyze case studies and apply new and existing knowledge to enhance student learning and engagement outcomes

ISS: Airway Options in Cardiac Arrest: What Does the Evidence Say?

While endotracheal intubation has long been a key procedure in the management of cardiac arrest, it is often done while focusing solely on getting the tube in the right hole. All too often paramedics (and physicians) pay insufficient attention to what is happening to the patient while they are intubated. This is a fast-moving review of the literature on the topic, including two large landmark trials comparing intubation to supraglottic airways. Dr. Jarvis will also cover several additional studies investigating possible mechanisms that might explain the results of these trials. 

  • Describe the methods and findings of two large RCTs of intubation vs. supraglottic airways in out-of-hospital cardiac arrest.
  • Describe the strengths and weakness of these two trials.
  • Describe the potential mechanisms to explain these results.
  • Describe the important takeaway points medics can use to improve their practice.

ISS: Oral Abstracts Session 1

The first session in the International Scientific Symposium is a fast-paced blend of presentations. David Page, Heather Davis, and Katie O’Connor will moderate the session, leading off with “must-know” project summaries and blending in original projects during which the primary investigator will have 15 minutes to describe their research. After each abstract the audience will have the opportunity to make comments and ask probing questions.

  • Defend the importance of evidence-based decisions in prehospital care education and clinical practice.
  • Respectfully challenge the conclusions drawn by authors regarding their research.
  • Recognize the ease with which prehospital providers can become involved in research.

ISS: Oral Abstracts Session 2

Description: This second session in the International Scientific Symposium is a fast-paced blend of presentations. Heather Davis, David Page and Katie O’Connor will moderate the session, leading off with “must-know” project summaries and blending in original projects during which the primary investigator will have 15 minutes to describe their research. After each abstract the audience will have the opportunity to make comments and ask probing questions.

  • Recognize the ease with which prehospital providers can become involved in research.
  • Defend the importance of evidence-based decisions in prehospital care education and clinical practice.
  • Challenge respectfully the conclusions drawn by authors regarding their research.

ISS: Oral Abstracts Session 3

This third session in the International Scientific Symposium is a fast-paced blend of presentations. David Page, Heather Davis, and Katie O’Connor will moderate the session, leading off with “must-know” project summaries and blending in original projects during which the primary investigator will have 15 minutes to describe their research. After each abstract the audience will have the opportunity to make comments and ask probing questions.

  • Defend the importance of evidence-based decisions in prehospital care education and clinical practice.
  • Respectfully challenge the conclusions drawn by authors regarding their research.
  • Recognize the ease with which prehospital providers can become involved in research.

ISS: The Idiot's Guide to Interpreting Research and Incorporating it into Practice

Reading a peer-reviewed research article can sometimes feel like trying to decipher code: Odds ratios. P-values. Confounders. Yet it's vitally important that EMS leaders and practitioners understand how a study was designed, what the results mean, and whether or not it should impact our clinical practice or daily operations. Using examples from recent EMS research, you'll learn a simple six-step method to use any time you read a research study—how to interpret the results, and whether or not the research should impact your practice.

  • Define common terms used in scientific research.
  • Develop a system to critically review medical literature.
  • Describe the different types of research studies and the benefits and drawbacks of each.

Embracing Diversity and Confronting Bias in EMS

Participants in this panel discussion will receive the tools they need to embrace diversity and acknowledge biases in their own agencies. We will will review the steps each speaker has taken at their own agency and discuss lessons learned.

ISS: The Year's Best International EMS Research

This session will showcase the top winning research abstracts from scientific conferences outside the United States. Rapid 10-to-15-minute presentations will highlight the best of the best of 2020's international research projects.

  • Defend the importance of evidence-based decisions in prehospital care education and clinical practice.
  • Appreciate the differences in prehospital care system priorities internationally compared to the United States.
  • Determine at least three differences in methods, participation, value, distribution or decision-making for international prehospital care research compared to US-based projects.

It's OK to Not Be OK: Building Wellness Within Your Agency

EMS leaders often tell their employees they are their greatest asset, but are they showing it? In this discussion the presenter will review the grim statistics surrounding EMS health and well-being. The presenter will discuss how they used trying times within their agency as an opportunity to build systems of support. The presenter will then outline steps leaders can take to build emotionally safe work environments and encourage resiliency among their providers.

  • Recognize the risk of burnout among EMS providers and describe its impact on patient care and operations management.
  • Differentiate compassion fatigue from secondary traumatization, burnout, and compassion satisfaction. 
  • Discuss the role of critical incident stress debriefing, including its purpose and timing.
  • Create a plan for building resilience and increasing support within one's EMS agency.

Lessons Learned: ET3 Model Implementation

Didn’t apply for the CMS/CMMI ET3 Model in round one?  Thinking about applying if the window opens again in the future, but still unsure if it’s a fit for your organization?  In this session, hear from EMS agencies who implemented the ET3 model in round one about their experiences and insights.  What were the challenges?  What have been the early lessons learned?  What are the keys to implementation?  This will be a very dynamic and interactive session with ample opportunity for participant engagement.

  • Understand the essential components of the ET3 model.
  • Learn the key partnerships necessary for successful implementation of an ET3 model.
  • Understand the financial modeling to evaluate the impact of ET3 model implementation.
  • Learn the myths and realities for a successful ET3 model implementation.

Modern Day Vent Management: Force the Non-compliant Lung into Submission

This course will focus on the ventilator management of non-compliant lungs. These can be difficult to handle from pre-intubation through the 10th ventilator setting change. The student will be guided through 3 actual cases. Problems will be identified and solutions discussed. A student polling system will be used to engage the students of the activity.

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Prehospital Management of Pediatric Seizures

This interactive, case based lecture will give ALS and BLS providers the tools they need to evaluate and treat pediatric seizures and will review the  treatment and interventions needed.  It will review the importance of looking for subtle signs of trauma in evaluating the pediatric seizure patient to look for signs of child abuse.

Special Delivery: Pregnant Patients and Liability Risks

Are pregnant patients your riskiest population?  Recent jury verdicts and settlements suggest the answer is “yes.”  Nick, an EMS Division Chief for one of the largest county-based ALS first response agencies in Georgia, and Samantha, an attorney for one of the largest hospital-based EMS systems in the Southeast, examine the legal and clinical risks that providers must keep in mind when caring for pregnant patients.  Using actual incidents and reported legal cases, Nick and Samantha offer tips and tricks for responders to enhance patient care while protecting themselves and their services from legal liability.

Taking to the Streets: Mobile Outreach in the Face of COVID-19

This presentation recalls the efforts by Gainesville Fire Rescue as they navigate the COVID-19 pandemic.GFR took a proactive approach to ensure that the public had resources and adequate knowledge to keep themselves safe. The approach used included the Respond, Educate, Treat, and Prevent method that included mobilizing and repurposing the CP Program to do intensive outreach missions.

Teamwork: How to Make the Dream Work on Your Ambulance

Teamwork is often an underappreciated part of EMS care despite its proven link to patient outcomes. This presentation will review the literature emphasizing its importance in providing optimal care and ensuring patient safety. The presenter will highlight broad topics of "The Big Five" and crew resource management, but will focus on the EMT teamwork survey developed by Patterson et al in 2012. Through utilization of this survey, the presenter will discuss how one agency was able to better identify teamwork deficits and work toward a nine-factor solution of partner dynamics. The presenter will demonstrate how to develop a teamwork training program in your agency, measure provider performance, and improve outcomes beyond hands-on patient care.

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The 2021 Revised EMS Education Standards: Putting Them to Work

The 2010 National EMS Education Standards for Emergency Medical Responder, EMT, AEMT and Paramedic were revised and updated for 2021. In this session, the presenters will discuss the discuss the history of the Education Standards, and explain the rationale for the changes made to the Standards that will affect EMS educators across the nation. The presenters will also provide insight in how to implement the changes into curricula and the classroom.

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This session is included in the virtual live stream.

The Basics of Burns and Beyond

This will be a lecture surrounding burns. It will begin with an overview of the types of burns seen in the field along with illustrations from recent events. We will discuss the care from a prehospital perspective and the need to get these patients to definitive care. We will discuss the importance of fluid resuscitation and basic care for the patients enroute, especially in transport time is a challenge. Following an to burn center care, Dr. Carter will discuss the specifics of care beyond the EMS transfer. We will discuss and illustrate escharotomies, hydrotherapy and laser therapy, We will reiterate the need for basic care, like keeping the patient warm due to volume loss, as well as the importance of fluid resuscitation. We will then discuss outcomes, both good as a result of definitive care and the and less favorable from a lack of definitive care. This will include illustrations fo video of actual patients. Finally, we will close with a Good, Better, Best practice for prehospital providers and what they can do with given resources or simple changes.

The Dark Humor of Emergency Care: Unprofessional Behavior or Therapeutic Coping Mechanism?

Description: Healthcare providers, particularly critical care and emergency healthcare providers, are infamous for having a dark sense of humor.  This session will explore what qualifies as dark humor, why we practice it, and most importantly, when it is therapeutic and where the line is that crosses over to unprofessional behavior.

This session is included in the virtual live stream.

The Value of EMS: Your Skills Don’t Matter

Prehospital Care professionals are personally invested in caring for people on their worst day. We assume that the value of what we do is obvious, yet as an industry we are struggling to match compensation, agency and individual, to the work we do and the resources expended. This talk will explore some of the silos we have created and how the experience of Mobile Integrated Health programs has helped expose the gap between what we think is important and what large stakeholders in healthcare value. 2020 and the additional roles healthcare systems and EMS agencies were pressed into assuming further highlighted areas where opportunity exists, it’s up to forward thinking leaders to capitalize on that momentum.

Will They Escape? A How-To Session on Developing a Custom Escape Room

Attention educators! Do you find that your providers are unenthusiastic in their current learning environment? Are you looking for new ways to engage your personnel in training? Join us as we uncover the secrets to plan, develop, and successfully execute an EMS Escape Room! This content is designed for educators looking to tap into their creative side and deploy a different learning model. This model provides an interactive experience for your providers to apply skills and knowledge in a fun and engaging atmosphere. 

Education Track Sponsored By:

Comms Help in Crisis: Meet the FirstNet Response Group

From a pandemic that has claimed hundreds of thousands of lives to hurricanes, wildfires, tornadoes, and manmade emergencies, the dedicated mobile broadband network has been there for public safety. FirstNet recognizes the value of supporting medical facilities and quarantine and mobile testing sites and providing needed connectivity following devastating events. Learn how the FirstNet Response Operations Group has answered more than 450 calls for help from agencies across the country and streamlined the process for deploying satellite cellular assets across states and territories.

Objectives:

  • Understand how the FirstNet Response Operations Group supports emergency response and recovery as well as planned events.
  • Describe different incident request and deployable support types.
  • Understand how to request deployable support. 

When interviewing a patient with a medical emergency the EMTS using the technique of summary when she says?

hospitals can better prepare for the arrival of a patient. When interviewing a patient with a medical​ emergency, the EMT is using the technique of summary when she​ says: "So the nausea and vomiting started two days ago."

What is therapeutic communication quizlet EMT?

Therapeutic communications. refers to your interaction with the patient and ability to obtain clinical information. Interpersonal communications. ability to send and receive information between at least two people.

What is therapeutic communication paramedic quizlet?

THERAPEUTIC COMMUNICATION. T or F: A professional demeanor and skilled communication techniques are key components of a successful patient-paramedic interaction. TRUE. A collection of radio equipment consisting, at minimum, of a transmitter, receiver, and antenna. BASE STATION.

Which one of the following is the most effective way to improve communication with most patients?

7 Ways to Improve Communication with Patients.
Assess your body language. ... .
Make your interactions easier for them. ... .
Show them the proper respect. ... .
Have patience. ... .
Monitor your mechanics. ... .
Provide simple written instructions when necessary; use graphics where possible. ... .
Give your patients ample time to respond or ask questions..