7:45am to 8:45am
When "Just Hold Your Legs Together" Doesn't Work--Prehospital Management of the Pregnant Patient
Dr. Philip Nawrocki, Allegheny Valley Hospital

CONED: 1.0 Clinical Patient Care KEYWORD: PEDS/OB

We discuss the recognition and management of complications of pregnancy with a focus on complications of the third trimester and trauma in pregnancy. The objectives of this course are for the EMS provider to be able to describe the physiologic changes that take place during pregnancy, accurately recognize complications across all three trimesters, and appropriately manage these complications with a focus on third trimester complications.

Furry and Fluffy Things That Kill
Dr. Jerry Escajeda, University of Pittsburgh School of Medicine

CONED: 1.0 Clinical Patient Care KEYWORD: TRAUMA

A spin-off of a previously delivered EMS Update lecture on animal injuries. A deeper look at mammal-induced injuries. Lions and tigers and fluffy little cats, oh my!

I Feel A Pulse...Now What?
Dr. Lenny Weiss, University of Pittsburgh School of Medicine

CONED: 1.0 Clinical Patient Care KEYWORD: MEDICAL

Much like Trauma Centers and Stroke Centers came to be, we are finding the need for Cardiac Arrest Centers. Such centers are proven to increase survival following cardiac arrest. We discuss the benefits of post-ROSC care at hospitals with exceptional cardiac arrest care and the role of EMS in increasing cardiac arrest survival.

Why So PICC-Y? The Xs and Os of Central Venous Access
Tom Emminger, AHN--LifeFlight

CONED: 1.0 Clinical Patient Care KEYWORD: MEDICAL

What is the big deal about accessing a PICC line? Are dialysis catheters really THAT fragile??? Mid-lines.....Really??? This class will help both BLS and ALS providers navigate the landscape of all the different central lines, catheters and ports commonly seen in today's healthcare environment. Topics will include identification of lines and ports, transport management and emergency access considerations and techniques.

Acute Endovascular Stroke Therapy
Dr. Andrew Ku, Allegheny Health Network

CONED: 1.0 Clinical Patient Care KEYWORD: MEDICAL

Hemorrahagic stroke from brain aneurysms, arterial venous malformations, and fistulas have always resulted in significant morbidity and mortality. Endovascular therapy without craniotomy had revolutionized the treatment of this morbid condition. We review the current therapies available and the methodology for appropriate therapy selection. Latest results, techniques and devices for acute endovascular stroke intervention are discussed. A discussion of future treatments and strategies will be made. Endovascular stroke therapy has advanced greatly since the early days where intra TPA infusion was experimental to the current generation of devices to permit rapid vessel recanalization and restore brain perfusion.

9:00am to 10:00am
Top Ten Tips for the New or Aspiring EMS Manager
Tyler McCardell, Wakefield EMS


Have you just been promoted, or do you want to take on more responsibility as a leader within your organization? If so, this class might just be for you! After Chief McCardell took on his first management position, he had to learn a number of these lessons the hard way. This hour will serve as a "crash course" on leadership and management within an EMS agency, from the perspective of a new EMS manager. Attendees will get pointers on assembling a team and working with a Board of Directors, gain a basic understanding of finance and reimbursement models, discuss personnel oversight, learn strategies to connect with your community, and more.

Brachial Plexus Injuries--Making Sense of It All
Dr. Peter Tang, Drexel University School of Medicine

CONED: 1.0 Clinical Patient Care KEYWORD: TRAUMA

The brachial plexus is the set of nerves that originate from spinal levels C5, 6, 7, 8 and T1 that animate the upper extremity as well as allow for sensation. The most common cause of these injuries are motorcycle accidents. These injuries are high energy and can be particularly devastating and in the worse scenario lead to a total flail arm with no sensation. Nerve transfers are a new technique where uninjured nerves are connected to injured nerves to restore function. We aim to show through clinical videos the significant deficits caused by these injuries. We also review the treatment options that are available to improve patient function. Lastly, we show the outcomes of these treatments through clinical videos.

Bleeding Kills--Toward Zero Preventable Deaths
Dr. Andrew Peitzman , University of Pittsburgh Medical Center

CONED: 1.0 Clinical Patient Care KEYWORD: OPERATIONS

Bleeding kills. This lecture will discuss prehospital bleeding control strategies. Dr. Peitzman will review how Trauma Centers, EMS Agencies, Law Enforcement, and Public Schools are saving lives by making bleeding control education widely available, both in our region and nationally.

What Kind of Overdose is This? Current EMS Toxicology
Dr. Zach Louderback, University of Pittsburgh School of Medicine

CONED: 1.0 Clinical Patient Care KEYWORD: MEDICAL

As drugs of abuse continue to diversify, it is important to have an understanding of how patients will appear under the influence of various common substances. We review various relevant illicit substances and their associated toxidromes as well as treatment pathways.

EMS Technology: The Apps and Tools of the Future
Dr. Lenny Weiss, University of Pittsburgh School of Medicine


Join in on a discussion of how advancing technologies in EMS will be the new wave of the future. We need to get the right help to the right place, faster. The future is ours and we will help design it!

10:45am to 11:45am
Intermediate ALS--The New Kid on the Block
Tyler McCardell, Wakefield EMS


In July 2015, Pennsylvania issued its first protocols for the Advanced EMT provider. As Intermediate ALS gains a foothold in the Commonwealth, it is crucial that providers, managers, and other stakeholders understand both the benefits and challenges associated with this relatively new license. Wakefield EMS was one of the first agencies in South Central PA to obtain an IALS license in July 2017. Attendees at this session will hear from Wakefield's project director about the implementation of an IALS program, the IALS licensure process, technical requirements, outreach strategies, funding considerations, training, and much more. This session will also provide a review of the AEMT scope of practice with patient vignettes to illustrate the utility of IALS care. The target audience of this course is EMTs considering an AEMT course, agency managers considering utilization of IALS providers, and anyone who is curious to see how IALS can benefit our EMS system, patients, and the communities in which we serve.

Hand and Upper Extremity Trauma
Dr. Peter Tang, Drexel University School of Medicine

CONED: 1.0 Clinical Patient Care KEYWORD: TRAUMA

The hand and upper extremity is commonly prone to injury because of the natural reflex to protect the head and face as well as its use in manipulating and exploring our environment. Injuries of the upper extremity can involve multiple tissue structures including: bone, tendon, nerve and vessel. In this course we will review the standard treatments for each of these tissues and we will conclude with amputations that involved injuries of all these structures. The principles of replantation will be reviewed so that the audience gains a better understanding of how a successful replantation can be achieved.

Prehospital Burn Care
Justin Barry, UPMC Mercy

CONED: 1.0 Clinical Patient Care KEYWORD: MEDICAL

A look at prehospital burn management, including treating patients with combined traumatic injuries and burns.

Resuscitating Your Trauma Patient--What and How Much Fluid to Give
Dr. Joshua Brown, University of Pittsburgh School of Medicine

CONED: 1.0 Clinical Patient Care KEYWORD: TRAUMA

Every trauma patient should get 2 liters of fluid.. Or should they? Come explore the latest advancements in prehospital trauma resuscitation. How much fluid should you give? Does blood really make a difference in the field? We will discuss these questions and more including the exciting results from the PAMPer trial done right here in Western Pennsylvania, as well as what's on the horizon for prehospital fluid resuscitation of your trauma patient.

The MISFITS and NEOS Secrets
Brad Dean, Rowan County EMS

CONED: 1.0 Clinical Patient Care KEYWORD: PEDS/OB

You are challenged daily to recognize sick patients, diagnose life-threatening illness, and initiate treatment. Outside the everyday experience of managing sick patients are children and neonates. This is a specific group of patients who often present anxiety-provoking diagnostic challenges. Neonates often present with a nonspecific chief complaint or a history of symptoms that may or may not be benign. In order to recognize which neonates will require life-saving interventions, EMS personnel need to remain current on these life-threatening illnesses and their management. This session offers a clinical review to address the recognition, diagnosis, and management of the more common pediatric and neonatal emergencies. The mnemonic "THE MISFITS" is helpful to quickly recall these critical issues.

12:15pm to 1:15pm
Coffee and Cool Cases
Dr. Brendan Mulcahy, Allegheny General Hospital

CONED: 1.0 Clinical Patient Care KEYWORD: TRAUMA

Sit down. Relax. Bring a cup of coffee. We will spend the next hour discussing some of the cool cases EMS has brought through the emergency department doors over the past year. Patient follow-up provides a valuable and unique vehicle for learning. We will review cases in an interactive atmosphere and find out what happened to these interesting patients.

BLS Pharmacology
Andrew Basile, UPMC Prehospital Care

CONED: 1.0 Clinical Patient Care KEYWORD: MEDICAL

A review of BLS pharmacology and medication administration.

1:30pm to 2:30pm
Traffick Control: The Role of EMS in Human Trafficking
Kerry McCans


Human trafficking is a pervasive and global crime that effects every race, age, society, country, and socioeconomic status. However, law enforcement, government, and medical personnel are decades behind this criminal industry. Awareness of this crime is the first step in freeing its millions of victims. How common is human trafficking- and is it prevalent in the communities we serve? What puts victims at risk and how are they manipulated in becoming modern slaves? Lastly, what can one EMS provider do to eradicate this international criminal industry? To understand this issue, we will explore statistics, research studies, and survivor's stories.

Stigma Reduction
Ashley Potts, Allegheny Health Network

CONED: 1.0 Clinical Patient Care KEYWORD: MEDICAL

How to reduce the stigma associated with substance use disorders. We provide a general understanding of addiction and addiction services. Ashley was featured at EMS Update 2018 at the Opening Session and continues her discussion.

Thoracic Trauma
Dr. Matthew Noorbakhsh, Allegheny General Hospital

CONED: 1.0 Clinical Patient Care KEYWORD: TRAUMA

Multiple challenges exist in the care of patients with thoracic trauma, and specifically in the prehospital and emergency department settings. We discuss: prehospital management of blunt and/or penetrating thoracic trauma. Controversies and approaches to prehospital chest decompression are reviewed through cases of interesting thoracic trauma, with a focus on optimal pre-hospital management.

Crucial Tactics for Successful 12-Lead Interpretation
Dr. Jeffrey Nusbaum, UPMC Prehospital Care

CONED: 1.0 Clinical Patient Care KEYWORD: MEDICAL

A review of 12-Lead EKG principles and crucial tactics for successful interpretation.

Hypothermia--All the Cool Kids are Getting It
Dr. Philip Nawrocki, Allegheny Valley Hospital

CONED: 1.0 Clinical Patient Care KEYWORD: MEDICAL

A case-based discussion of the prehospital recognition and management of accidental hypothermia and cold related injury. It will focus on the physiologic changes the body undergoes when exposed to cold environments, discuss risk factors for the development of hypothermia, and provide a discussion of the diagnostic and clinical findings in the hypothermic patient. In the second half of this course we will focus on specific prehospital management considerations for hypothermic patients including PA state protocol, and how cardiopulmonary resuscitation and destination decisions may differ in comparison to a normothermic patient.

2:45pm to 3:45pm
Do It For Drew
Bradley Dean

CONED: 1.5 Clinical Patient Care KEYWORD: MEDICAL

Drew was in a skateboarding accident, but that wasn't what killed him. He died after his brain was starved for oxygen by an ET tube, improperly inserted and not checked in the ambulance during an interfacility transport, as his oxygen saturation level crashed. It's a heartbreaking story, and in our closing keynote, we will hear from Drew's father about the Do It for Drew Foundation he and his wife started to educate medical professionals in the hopes that similar situations of medical-care errors can be avoided. Bradley Dean, one of your favorite Update speakers, is back to discuss this tragic case and what EMS professionals can learn from this call. They will discuss appropriate crew resource management, post-intubation management and monitoring, use of and interpretation of capnography waveforms and how to deal with the death of your patient.