7:30am to 8:30am
REBOA: Trading Scalpels for Balloons
Dr. Louis Alarcon, UPMC Presbyterian
CONED: 1.0 Clinical Patient Care KEYWORD: TRAUMA
We review the importance of decreasing on-scene time and priority EMS transport in the care of a trauma patient in shock. We also discuss the use of a newly-developed balloon device to defeat end-stage shock and cardiac arrest in these patients, both blunt and penetrating trauma.Research Says...
How many times have you heard "a new research study says..."? As EMS matures as a medical subspecialty, more of what we do is being guided by scientific evidence showing what prehospital interventions provide the best outcomes for our patients. We discuss what you need to know about how evidence-based medicine is changing prehospital care and how evidence-based guidelines impact the protocols you use daily. After this session, you will be able to see how prehospital research will impact what you do in the future, what research to pay the most attention to, and what you should be cautious about accepting.Baby on Board: Child Safe Transport
There are many things to consider when transporting a sick or injured child. Safety is a top priority. Through a review of evidence-based safety recommendations, this lecture will review the best practices and equipment for the safe transport of a child in an ambulance.Care and Feeding of Large Gatherings: Principles of Medical Preparedness
This is an overview of how to prepare for providing medical coverage at special events and mass gatherings, from pre-planning and inter-agency collaboration to preparing for the unexpected. Dr. Mosesso discusses the unique challenges and experiences he has encountered at various venues and different types of events.Care of the C-Spine Injured Athlete
Trauma during sports participation is the second leading cause for spinal cord injuries for individuals between the ages of 16-30 years old. EMS agencies frequently provide standbys at sporting events to provide care for the injured athletes. Significant changes to EMS protocols, along with recent updates to the National Athletic Trainer Association (NATA) guidelines for the prehospitlal care of the athlete with a potential cervical spine injury provide a great deal of insight into the research and recommended treatment associated the potentially spinal cord-injured player. The challenge for all is how to incorporate this new information based on the resources available at the time of the injury.
FDNY Deputy Assistant Chief Lillian Bonsignore discusses the qualities of a successful leader, recognizing that rank doesn't necessarily translate to success in leadership. Guidelines and protocols are in place to guide us, but it's important to be able to adapt and overcome difficulties in dynamic situations. She provides insight into unlocking our own abilities, and stresses the importance of recognizing the everyday accomplishments of dedicated members, rather than spending too much time focusing on mistakes. Deputy Chief Bonsignore is the highest ranking uniformed female in FDNY and the second woman to ever reach the rank of Deputy Assistant Chief. Through this, Deputy Chief Bonsignore will explore the personal and professional challenges working as a team. She introduces you to STAND UP, an acronym intended to offer some useful tips and tactics to help women and men successfully navigate the challenges and celebrate the milestones.10:45am to 11:45am
We will discuss ten environmental disasters, including severe hypothermia and heat stroke. Burn injuries, barotrauma and blast injuries are highlighted. High altitude illnesses are covered along with both electrical and lighning injuries. Finally we review snake bites and bee stings.Just Culture for EMS - An Introduction
You probably have read the phrases "Just Culture" or "Highly Reliable Organization". Maybe you already know what these terms mean, but, more than likely, you probably don't. Learn what Just Culture is and isn't and why this may be something you want to talk to your leadership about bringing to your agency. I'll also offer some thoughts on how you might start down the path to becoming a highly reliable organization by adopting the Just Culture approach to the errors and system failings that we all encounter on a daily basis.Prehospital Stroke Care: Taking It To The Next Level
Stroke is the leading cause of disability and the fifth-leading cause of death in the United States. The importance of stroke recognition by EMS and transport to stroke centers has been proved again and again. Now we need to talk about where and when allowing patients access to advanced stroke care can save lives, and the role of EMS in doing so.Transient Loss of Consciousness: Syncope or Seizure
EMS providers often see patients with transient loss of consciousness (TLOC). Syncope and seizures are the most common causes of TLOC. Management of TLOC depends on the underlying cause, but it is often difficult to clinically determine whether a patient suffered a syncope or seizure. Patients with certain seizure types do not have generalized convulsions, and patients with syncope may have brief tonic/clonic movements. About 5 to 15 % of patients thought to have syncope may actually have a seizure disorder. We discuss the clinical clues and tests that are helpful in distinguishing between these two entities. Acute management strategies for both the conditions are addressed.Dealing with Difficult Patients
As EMS providers, we are in the business of helping people. Occasionally we come across patients and families that make that job much more difficult due to a number of factors. We focus on pre-call staff training, communication, interviewing techniques, and de-escalation practices that emergency service personnel can use to help make these situations a little less difficult, and also help to increase the effectiveness of our treatments.
Dr. Forsythe will discuss one of the most commonly encountered EMS calls: ground-level falls in the elderly. Injuries from these falls are far more common than we sometimes appreciate, and the severity of those injuries is often dangerous.Prehospital Care in the Wilderness Setting
"The patient is...where?!" Wilderness emergencies are increasingly common, and EMS providers are responsible for caring for patients in these remote environments. We will define the wilderness setting, discuss specific issues and considerations for scene management and patient care, and highlight how prehospital care in the wilderness setting differs from typical street practice. Patient scenarios of traumatic injuries in the wilderness will be discussed.
Allergic reactions including anaphylaxis are relatively common complaints in the out-of-hospital setting. The classic case of rash, throat swelling, and shortness of breath after being stung by a bee is easily recognized as anaphylaxis. However, hypotension without a rash or obvious inciting incident is much more challenging. What is the role of antihistamines and steroids in treating acute anaphylaxis? You might be surprised what the latest research suggests. We review a simple ABC approach to acute anaphylaxis.Top Pitfalls in EMS
When EMS providers make mistakes, it's rarely because of a knowledge deficit. Instead, mistakes occur because of cognitive or thinking errors. Have you ever been led astray by wrong information given to you by dispatch or a bystander? Have you experienced tunnel vision and missed pertinent information hiding in plain sight? Have you been tricked by that weak and nauseous patient who you later found out was experiencing a MI? Have you been in the middle of a bloody intubation only to realize you forgot to hook up the suction? This class will give you the tools necessary to avoid these common pitfalls. We'll discuss actual cases, and we'll do some fun activities to demonstrate how your brain processes information.Let's Chat About PAT: Pediatric Assessment Triangle
Assessing a child is stressful at times. The Pediatric Assessment Triangle (PAT) is a simple yet reliable initial assessment tool that can help determine whether a child is "sick" or "not sick."Deviations, Flags and Special Reports: How To Advance EMS QA/QI
Medical oversight is a critical part of EMS practice. For many EMS agencies, Quality Assurance relates to protocol deviations and documentation issues. The most meaningful QA metrics are those linked with actual patient outcomes. Challenges related to EMS documentation and interface with hospital electronic medical records make it difficult to create a patient centered QA/QI program. Dr. Lawner will discuss high performing agencies and highlight evidence based quality assurance metrics.Almost Missed
Have you ever thought, "I can't believe that patient had..."? This session will discuss prehospital cases with medical conditions that could have been or were missed during emergency care. Real cases will illustrate principles for managing common and not so common medical problems to prevent adverse events and potential liability for EMS providers.
Brad takes a look at the most common relationship problems within the EMS ranks. As in personal relationships, each is acclimated to their own societal needs, but not those of the other. Understanding the needs of both employees and chiefs, you can effectively solve issues regardless of your rank in an organization. We use the basic psychology understanding of relationships and asserts that both the employee and the EMS Administrator can be understood in terms of distinct ways they respond to stress and stressful situations.The Four Horsemen of the Apocalypse" How We Are Hurting Our Shocked Patent--Saline, Intubation, Backboards, and Scene Time
The patient in shock requires critical management. Learn how saline, intubation, backboards and scene time can lead to bad outcomes in the treatment of shock. Also, a look at the importance of hemorrhage control, proper fluid resuscitation, and the use of pressors.Regional Experience with Ketamine: Boon, Bust or a Little of Both?
This presentation will provide and overview of the first year experience with Ketamine in our region. Case examples will highlight successful uses as well as challenges and errors that occurred so that we can all learn how to best use this new medication in our arsenal.Beyond ABCD ACLS BLS: State of the Art Intra Arrest Resuscitation for EMS Providers
Cardiac arrest management continues to evolve. High performing programs which feature bystander CPR and a BLS-centric approach to resuscitation boast high survival rates. In some select areas of the country, VF/VT arrest is considered a survivable disease. Protocols do not account for the wide range of resuscitation scenarios encountered by EMS providers. Integrate the latest evidence and increase your patient's chances for a meaningful neurologic outcome!Public Schools and Public Safety - Key Partnerships to Improve School Safety
Public safety agencies and schools are considered by many to be essential pillars in our communities. Although the underlying mission and purpose of these entities are different, schools' strong desire to keep their students safe creates a natural affinity towards EMS, police and the fire services. In this presentation, we'll explore the importance of close relationships between emergency response agencies and schools and the many ways that they can interact, such as; Comprehensive Prom Promise/Mock Crash pre-prom programs, School Safety Rounds for all Public Safety Personnel, Athletic and Non-Athletic Event Staffing, Professional Development / Training Opportunities, Collaborative Planning with Law Enforcement, Career and Volunteer Recruitment Opportunities. Through each of these initiatives we have found mutual benefit, and most importantly increased safety awareness and preparation for our students and faculty.