Course Descriptions

This presentation traces the extraordinary evolution of Emergency Medical Services (EMS) from the visionary pioneers of the 1950s, 60s, and 70s to the modern complexities of the field. The formational years of our modern EMS system were marked by groundbreaking efforts from visionaries like Peter Safar and Nancy Caroline, and significant legislative actions, including Congress’s efforts to establish a unified national EMS system through both the Department of Transportation and the Department of Health, Education, and Welfare. Despite these ambitious beginnings, including the establishment of a federal agency for EMS in the 1970s, the sustaining of these efforts proved challenging, leaving a fragmented system in their wake. By understanding these foundations, we better grasp the realities and challenges of today. The presentation will highlight the power of visionary leadership through the years, from the federal efforts that eventually collapsed to the local leaders who, with extreme passion and tenacity, established EMS services for their communities. We will discuss recent challenges such as the criminal prosecution of EMS practitioners and the impacts of the COVID-19 pandemic as pivot points that underscore the urgent need for innovative leadership. Looking forward, we will explore the opportunities that lie ahead for EMS, focusing on development, sustainability, and career pathways. The keynote will emphasize the role of visionary leadership in navigating the future of EMS, advocating for a system that is not only effective and responsive but also ethical and compassionate. Objectives: be able to identify the key figures and legislative actions that contributed to the formational years of the modern EMS system in the United States and understand their impact on current EMS practices / understand the reasons behind the collapse of federal efforts to sustain a unified EMS system and recognize the impact this had on the development of localized, independent EMS services / be able to describe the recent challenges faced by EMS, including the criminal prosecution of EMS practitioners and the impact of the COVID-19 pandemic, and discuss their implications for policy and practice within the field / recognize the importance of visionary leadership in overcoming the fragmented nature of current EMS systems and explore opportunities for future development and sustainability within the EMS profession.

It’s often said, everything is “Big” in Texas, but caring for the Morbidly Obese Patient is more than caring for a patient referred to as big. Morbidly Obese is a medical condition that creates challenges for EMS & Fire Departments. This session will help Prehospital EMS & Fire Departments better understand how easily morbidly obese patients are injured. We will also look at the challenges that EMS & Fire are faced with while treating and transporting obese patients. We will use a unique power point presentation to show how difficult it is for obese patients to do simple things such as eating and using the toilet. During this session we will look at some of the most common injuries in obese patients and how difficult it is to render care. We will discuss how normal prehospital care equipment just does not work. We discuss the use of bariatric equipment including stretchers and ambulances. We will discuss the treatment for sprains, strains, fractures, and head injuries that are caused by their size and weight. We will also discuss how the obese patient often suffers from multiple medical conditions. We will discuss both BLS and ALS treatment for morbidly obese patients. Objectives: understand the challenges EMS & Fire will face when caring for or transporting the morbidly obese patient / recognize morbidly obese patients as having multi-system medical conditions / realize special equipment is needed to move the morbidly obese patient / have a better understanding of the living condition of the patient.

This age-old question has been a challenge for EMS practitioners for decades as the lines are often blurred as to when our legal obligation to the patient begins and ends. The homicide trial of the two paramedics in the Elijah McClain case emphasized the importance of our “duty to access” the patient as soon as possible, even if the patient is under the control of law enforcement. This thought-provoking session will address the legal and moral “duty to act” issues in the various difficult situations we encounter every day where it is not so clear that we really have a patient in the first place. Objectives: discuss the four elements of negligence in EMS / describe four difficult situations where it is unclear when the patient is actually an EMS patient / discuss the evolving “duty to access the patient” which is an essential part of our professional and legal duty to someone who may need our assistance / discuss the concepts of consent, refusal of care, and informed decision-making in non-transport and other difficult situations / discuss steps to take to ensure that the duty to act on behalf of the patient is met in every situation where EMS is involved.

Hop on and ride along as we explore EMS in the U.S. Fire Administration (USFA). Did you know that over 67% of all fire department responses are EMS incidents? The USFA has statutory responsibility for developing EMS Best Practices for disaster response and related emergency preparedness initiatives, and to provide advanced EMS training courses through the National Fire Academy platforms. Join the discussion on how we collaborate with the National EMS Information System (NEMSIS) for evidence-based, data driven information and journey through USFA EMS Research, Prevention, and Community Risk Reduction programs, coupled with EMS Training and Education at the National Fire Academy. This session will culminate with insight on USFA plans for the Nation’s EMS. Objectives: identify three primary statutory EMS responsibilities of the USFA mission / list three key EMS research projects that have immediate utility to their respective organizations / develop and outline national EMS concerns and discuss resolutions.

More and more evidence supports the negative impact of energy drinks and supplements on the cardiovascular system. Many first responders utilize energy drinks to meet the mental and physical demands of the job. Many more use supplements to augment their personal work out routines. This presentation will cover the science, risks, and negative consequences of these habits. A case presentation will be discussed. Objectives: identify healthy caffeine and supplement consumption / discuss the cardiovascular physiologic effects of energy drinks and supplements / identify the personal risk of energy risk and supplements.

The United States-Mexico border is 1952 miles long. This sprawling demarcation crosses a variety of terrains along southern California, Arizona, New Mexico, and Texas, including several large urban metropolitan centers as well as a vast remote area. While the physical wall may have deterred some, for those who continue to cross the border illegally, it has made the journey increasingly dangerous. This session will review the current state of trauma related to the U.S-Mexico border crossing and discuss the supportive evidence. Objectives: summarize the existing evidence surrounding the different mechanisms on border crossing related trauma / summarize the existing evidence surrounding the morbidity and mortality on border crossing related trauma / summarize the existing evidence surrounding stress Emergency Medical Services (EMS) and Trauma Systems after Multiple Casualty events related to border trauma / summarize the existing evidence surrounding utilization and financial burden on health care centers along the border.

The proposed lecture offers a comprehensive exploration into the pressing issue of occupational hazards faced by both firefighters and non-firefighter EMS personnel, shedding light on the factors contributing to fatalities within these critical professions. Through a meticulous examination, the presentation will identify the key items and circumstances that pose imminent risks to the lives and well-being of these frontline responders. Moreover, it will illuminate a spectrum of prevention strategies, ranging from established protocols to innovative interventions, aimed at mitigating such risks and safeguarding the health and safety of emergency personnel. A particular emphasis will be placed on the pivotal role of pre-employment physicals and ongoing physical assessments in proactively managing occupational hazards and ensuring the longevity of those serving in these indispensable roles. Objectives: identify the occupational hazards faced by firefighters and non-firefighter EMS personnel / analyze the factors contributing to fatalities within the firefighting and EMS professions / evaluate a range of prevention strategies, including established protocols and innovative interventions, to mitigate occupational risks for emergency personnel / highlight the importance of pre-employment physicals and ongoing physical assessments in proactively managing occupational hazards and ensuring the longevity of emergency responders.

Endocrine disorders often lurk beneath the surface, affecting the body’s hormone-producing glands and systems. They can be insidious, silently wreaking havoc on the body with sometimes subtle or confusing signs. Endocrine disorders are scary due to their ability to disrupt the body’s fundamental functions, leading to a range of physical and emotional symptoms, and potential complications. In this session we will explore cases where the endocrine system has gone haywire. Objectives: demonstrate/illustrate how every aspect of our physiology and behavior is directly controlled or modified by hormones using reproduction, growth, development, stress, and metabolism as examples / demonstrate/illustrate how endocrine systems can be disrupted with respect to synthesis, secretion, transport, receptors, mechanisms of action, and metabolism/excretion / recognize signs and symptoms of critical endocrine system malfunction / explain how outside factors can cause endocrine system malfunction.

There are numerous sedation agents used in clinical practice. Some prehospital and critical care transport clinicians routinely encounter only a few of these. However, given the current supply chain challenges, clinicians may encounter other agents that they do not routinely use or may not have learned about during their educational preparation. During this presentation, we will review both common and less common agents, including benzodiazepines, etomidate, ketamine, dexmedetomidine, and propofol. Additionally, we will discuss adjunct medications such as analgesics and neuromuscular blockers. By the conclusion of this session, attendees will reinforce their existing knowledge or gain new insights, ultimately enhancing medication safety in their clinical practice. Objectives: recall pharmacokinetic and pharmacodynamic properties of common sedation agents / identify common side effects associated with the use of sedation agents in critical care transport / recall indications and contraindications for select sedation agents / modify plans of care to incorporate other sedation agents to facilitate patient care.

We all know kids are not just small adults- or are they??? We are all taught that pediatric patients are not just small adults.  For many reasons this is indeed true. However, let’s look at the general responses to trauma in both the Geriatric and Pediatric patient. Their similarities may just surprise you! Objectives: identify two distinct similarities in the pediatric and adult trauma patient / list and discuss two distinct differences in the pediatric and adult trauma patient.

Do you like your science served up with a bit of snark? Perhaps a nice, academic, no-holds-barred debate on the literature guiding our clinical practice? If so, come see a panel of highly opinionated EMS researchers in a wide-ranging discussion of the key topics of the day. Topics are likely to change to assure they are “hot-off-the-presses” current, but are likely to include cardiac arrest management, medications, and airway management. Objectives: describe the main findings of the relevant peer-reviewed papers in airway management / describe the main findings of the relevant peer-reviewed papers for medications in cardiac arrest / describe the main findings of the relevant peer-reviewed papers for sedation of the agitated patient / describe the main findings of the relevant peer-reviewed papers for inequalities in analgesia administration.

Pediatric transport needs more standardization. On average, 900,000 children under age 13 are transported by ambulance annually in the U.S., over 125,000 in Texas. That means 13.9% of children under 13 transported by ambulance in the U.S. are in Texas. The National Highway Traffic Administration (NHTSA) estimates an average of 4,500 ambulance-involved crashes occur annually, 33% of those patients were secured with a lap and shoulder restraint, and 44% were ejected from their cot restraints. Existing child safety seat testing standards cannot be applied to ambulances; therefore, agency policies and protocols are important to support safe pediatric transportation. This presentation will include the Injury Prevention Unit’s EMS Pediatric Transport survey results along with recommendations on what can be done now to improve safety standards. We will highlight NHTSA-funded project updates to develop three test method phases for seated, supine, and neonatal pediatric occupants. The session concludes with recommendations and hands-on practice on child restraint harnessing devices for ambulance transport. Objectives: describe the types of child safety restraints used in ambulances / learn way to be proactive as an agency to reduce injury / learn about pediatric transport survey results in Texas / explain the three-phase project funded by NHTSA.

From your first day on the job as a teen volunteer to decades in the field or hospital, mastering EKG interpretation requires lifelong dedication. In a rapid interactive fashion, we will take you through the basics of cardiac anatomy and physiology all the way through identifying complex 12 lead EKG patterns that go well beyond STEMI. Most EKG lectures focus on pattern recognition. This lecture breaks it down from the beginning: how cardiac anatomy translates into an EKG grid, how physiology determines basic cardiac rhythms, and how rhythm analysis builds into a physical 12 lead EKG. Basic cardiac rhythms are integrated throughout the lecture and in under two hours you will solidify knowledge that you’ve gained over the years to be confident in your EKG interpretation and improve patient outcomes. Objectives: understand how cardiac anatomy translates onto the page as a 12 lead EKG / describe how cardiac physiology creates “rhythm” / explore basic cardiac rhythm analysis / explore fundamentals of 12 lead interpretation beyond STEMI.

The stethoscope was invented in 1816. It’s the symbol of the medical professional. It’s used as a patient assessment tool for blood pressures, breath sounds, heart tones and more. But newer technologies such as NIBP and Capnography are now being used. Heart tones are rarely taught or appreciated. So, is the stethoscope still relevant? Recent introduction of digital stethoscopes come with the ability to record and produce waveforms called phonocardiography. Leave it to Stethoscopy instructor Bob Page to be all over it. Come and learn and experience all about this new technology! Objectives: describe the parts of the stethoscope / demonstrate how to use and tune a stethoscope for high and low frequency sounds / describe the advantages of a digital stethoscope in the detection of heart and valvular diseases / using a stethoscope and sounders, recognize normal and abnormal breath sounds / using a digital stethoscope and AI, recognize normal and abnormal heart sounds. (Participants should bring their own stethoscope to fully participate in the lab.)

Opioid overdose rates have been increasing steadily, emergency medical first responders are typically the first to treat these patients. Opioid toxic patients cannot consent to treatment while unconscious and barely breathing, so EMS has to make the choice of best practice. Some will titrate small doses to restore respiratory drive, some will treat with a large dose of naloxone to wake the patient fully. What are the best pre-naloxone interventions? What is the best naloxone strategy? What to do with those patients after EMS disposition. This discussion will delve into the real world of resuscitating those opioid toxic patients. Objectives: discuss the current opioid/overdose crisis that is being experienced in our communities / review current research and clinical best practices across the care continuum on the early recognition and treatment of opioid overdose across the care continuum / provide actionable programs (protocols, education, tools, and support) to assist with the recognition and treatment of opioid overdose across the care continuum in our communities / utilize the case study presented at the beginning to guide the learners through treatment decisions and participate in treatment decision polling during the webinar.

Actual court case studies are a fascinating way to learn from others’ mistakes. In this fast-paced session, national EMS attorney Steve Wirth will review some remarkable EMS legal cases and, more importantly, the practical lessons that your agency can implement organization-wide. There are lessons in these cases that impact billers, EMS practitioners, and agency leaders, and we will present hard cases and practical insights from these EMS court cases where documentation issues were “front and center.” Objectives: discuss the importance of accurate and complete patient care documentation from the clinical, operational, and reimbursement perspectives / discuss key documentation pitfalls from actual legal cases that contributed to the elements of the lawsuit / describe concrete steps to improve patient care documentation based on the results of EMS lawsuits / discuss the importance of documentation training and quality assurance to help reduce liability to your EMS agency.

Have you ever had a call go completely sideways? Ever missed an obvious diagnosis or injury? Why do these things continue to happen to us in EMS? Maybe it is our own mind causing the issues. This session will look at common errors in thinking which prevent us from providing the best care we can. Objectives: understand common cognitive mistakes made and why we never admit to them / understand and be able to discuss the psychology of cognitive dissonance and confirmation bias / understand and discuss Anchoring, Rush-to-solve and overconfidence bias / understand and be able to discuss how to improve these common mistakes.

Responding to a trauma in an industrial setting can be challenging just with the different settings possible in your service area. Welding shops, paint shops, farms/ranches, auto mechanics, and construction sites are just a few examples of what we can respond to. While general trauma care is still utilized, we need to understand specifics with industrial settings. In this presentation, we will address some of the specific injuries we would see in industrial settings. We will go over chemical exposures and decontamination, ocular injuries, high pressure injection injuries, degloving, impaled objects, burns and harness/suspension syndrome to name a few. Objectives: explain what section of the Safety Data Sheets you will find first-aid measures / explain why removing clothing will fix a majority of your decontamination problems / differentiate between simple and complex eye injuries / explain why high-pressure injection injuries are always more destructive under the surface.

When your medical director dies or leaves abruptly, there are a number of things that need to happen rapidly, in a high stress environment. Based on personal experience of losing two medical director colleagues, this presentation will help both medical directors and agencies prepare for these possibilities. Objectives: identify actions that need to happen in the immediate hours after a medical director’s death / list resources available to help navigate this crisis / understand the legal requirements surrounding sudden loss of medical director.

Autism Interactions for First Responders is training aimed at helping first responders understand the differences in caring for those living with Autism Spectrum Disorder (ASD), to include how to interact with family and caregivers. Included are stories from families and first responders on what to do, and not do in emergency situations. Also included are resources for advocacy at the local and national level. We have a responsibility to care for those that are neurodivergent, and this is a glimpse of how to start training for those situations. Objectives: define autism / describe trauma and mortality of people with autism / explore details associated with scene management / discuss opportunities to create training and advocacy in your area.

EMS providers routinely face the challenge of getting the right patient to the right hospital. Worse yet, there’s a lot of misconceptions about what constitutes the right hospital and the right capabilities. In this presentation, we’ll delve into the various hospital designations, what they really mean, and what they mean for you and your patient. Not only will your patient benefit, you’ll be less likely to be awakened for that early morning transfer. Objectives: become familiar with Texas DSHS rules regarding facility designations / learn other accrediting bodies for facility designations / discuss the specialty capabilities of stroke and trauma designated facilities / discuss facility designations not in DSHS rules.

The complexity of hemodynamic principles often presents challenges for transport clinicians in grasping key concepts and applying them effectively in clinical practice. Utilizing case presentations, these concepts will be simplified to insure understanding and ease of application. Objectives: describe the fundamental principles of hemodynamics, including the relationship between pressure, flow, and resistance in the cardiovascular system / identify and differentiate between various hemodynamic parameters such as cardiac output, stroke volume, mean arterial pressure, and systemic vascular resistance / explain the physiological mechanisms underlying alterations in hemodynamics, such as the effects of stress, fluid volume status, and pathological conditions like heart failure or shock / discuss the clinical relevance of hemodynamic monitoring techniques and their application in assessing and managing patients with critical illnesses.

We are all aware of what the manuals tell us to look for in most medical emergencies but how skewed are they? Is the typical presentation standard across sex? Is sex even relevant to our history-taking? How does the presentation of the patient sway our thought process? We will look at how the typical signs and symptoms we associate with medical emergencies have been by the historic tendency to look at what men experience, what works for them in research. We will look at how these might differ in females. How we can approach sex specific questions in our history taking, in an empathetic way that makes the patient feel safe during their time with us. Objectives: identify presentations where the sex of the patient may make a difference / state how this would affect your history taking / identify the challenges where the sex of your patient is not obvious / explain the importance of creating a safe environment for the patient to be open with you.

Point-of-care ultrasound (POCUS) has gained rapid traction for multiple prehospital applications. One of the most common utilization areas is evaluating ROSC in cardiac arrest. We know manual pulse checks have poor accuracy, so POCUS must be the superior option. At Montgomery County Hospital District EMS, we’ve migrated from cardiac to carotid POCUS for pulse checks in cardiac arrest. Come find out the backstory and hear the honest truth about the unintended consequences of “bright and shiny” new devices in EMS. Objectives: learn the limitations of manual pulse checks in cardiac arrest / introduce the concept of “pseudo-PEA” / review some basic literature behind POCUS use in cardiac arrest / discuss the MCHD experience with prehospital carotid POCUS.

Intubation is challenging in any emergency, but particularly so in EMS. Failure to achieve first pass success is associated with increased mortality in cardiac arrest and increased adverse events, such as hypoxia, hypotension, bradycardia, and death. In this session, we’ll explore how we used the Model for Improvement to improve our system’s performance on the NEMSQA Airway 0-1 measure (Intubation First Pass Success without Hypoxia or Hypotension). We’ll discuss the components of our bundle, how we measure it and how our performance on this measure improved after implementation. We’ll include discussions of lessons learned during this process. Objectives: understand the clinical rationale for the clinical bundle and the outcome measured / explore the sources of data needed to measure the outcome / comprehend the value of each component of the bundle / understand the importance of balancing measures and measuring performance over time / learn to determine if improvement has occurred.

Research shows that more often than not, EMS providers have trouble ventilating patients. In this eye-opening hands-on workshop, Bob shows participants how to ventilate patients by BVM, via Mask, ET tube, and supraglottic airways using state of the art computerized simulators that measure pressures, volumes, and ventilatory rates. You will gain valuable insight, skills and improve your ventilation ability using this valuable feedback and coaching system. This lab features the tools and techniques to introduce to you the concept of high-performance ventilation (HPV). Objectives: describe the three pillars of high-performance ventilation (HPV) / discuss the effect of rate, volume and pressure have on high performance ventilation / describe the benefit of Capnography as an adjunct to monitor and prevent inadvertent hyperventilation and overventilation / using select resources and high-fidelity simulation, demonstrate control of volume, rate and pressure using a BVM device on intubated and non-intubated simulators.

The first newborn resuscitation course specifically for the EMS provider! Join us for a self-contained four-hour course where we will explore cutting edge techniques and information vital for anyone who may resuscitate newborns in the prehostpital environment. Objectives: identify the three pre-arrival prep priorities / discuss the four active labor questions to know prior to delivery / state the three birth assessments to determine if the infant can go to mom’s chest verses being evaluated separately.

Airway management is one of the most critical interventions EMS clinicians perform. Although we like to think our current practice is based on sound evidence, after a structured review of scientific evidence, we often find it is not. Dr. Jeff Jarvis will discuss a recent publication that describes the methods involved with creating a formal Evidence-Based Guideline (EBG) and then review 2024 Airway Managed EBG discussing the recommendations and literature behind them. He’ll also compare and contrast this EBG document with the recent NAEMSP Airway Compendium. Objectives: understand the goal of the Airway EBG process / describe the process for development of the scientifically sound EBGs / review the PICO questions answered by the EBG / discuss the evidence supporting the EBG recommendations / contrast the EBG recommendations with the NAEMSP airway compendium position statements.

Caring for psychogenic non-epileptic seizure (PNES) patients (the condition formerly known as “pseudoseizures”) in the prehospital setting can be exceedingly difficult and frustrating. This is understandable because discerning between true seizure activity and a psychogenic event leads to drastically different treatment pathways. Additionally, PNES patients have high rates of underlying substance use disorders and psychiatric illness, which can further cloud the clinical picture. This is a difficult diagnosis for even hospital neurologists, as demonstrated by the fact that PNES patients account for 25% of EEG unit admissions, and a final diagnosis of PNES takes an average of eight years! If that’s not enough, a significant number of PNES patients also have true epilepsy. Leave this discussion with new knowledge, new empathy, and improved patient care skills. Objectives: update terminology related to the condition formerly known as pseudoseizure / review common mistakes in caring for PNES patients / learn why psychogenic seizures can actually be deadly / discover skills that will allow you to care for PNES patients with greater empathy and compassion.

You’ve heard it a thousand times: “Treat the patient, not the monitor.” And while there is a nugget of wisdom in that advice, all too often it means, “I’m not really sure what to call that wave, but my patient hasn’t crashed yet.” The truth is, sometimes you do treat the monitor, and knowing the significance of subtle waveform morphologies can add a great deal of clarity to the clinical picture, and guide treatment of your patient. Join Kelly Grayson as he shows us how to get the most out of your cardiac monitor and put those squiggly lines to good use. Objectives: understand the basics of waveform capnography interpretation, and how to use the capnograph as an indirect measure of perfusion / discuss how to use capnography to gauge fluid responsiveness / discuss the basic components of a plethysmograph waveform, and how to use it as an indirect measure of central hypovolemia / correlate ECG, plethysmograph, and capnograph findings to patient’s hemodynamic and respiratory status.

Join us for a vital session aimed at EMTs and paramedics that offers an insider’s view on the regulatory aspects of EMS, presented by a speaker with extensive experience both as a frontline paramedic and a regulatory official. This presentation will deepen your understanding of how complaints, investigations, and enforcement actions are handled within the EMS system, emphasizing the importance of professional accountability in partnership with regulatory bodies. The highlight of this talk is a “Top 10” list of recommendations that will not only help you reduce the likelihood of facing enforcement actions but also guide you through navigating these challenges should they arise. These insights are drawn from a rich career that merges practical EMS experience with regulatory expertise, providing actionable strategies for maintaining professional standards and enhancing service quality. This session is designed to instill confidence in the regulatory process, helping you appreciate its role in professional accountability and the ongoing partnership between practitioners and regulators. Learn how to navigate the EMS regulatory landscape confidently and understand your critical role in upholding the high standards of EMS practice. Objectives: identify the key components of EMS regulatory processes, including how complaints are received, investigated, and resolved to uphold public safety and professional standards / understand the various enforcement mechanisms used by regulatory bodies, and how these are applied to ensure compliance and accountability within the EMS profession / learn how to apply the “Top 10” recommendations to their daily EMS practices to prevent regulatory issues and effectively manage potential enforcement actions / recognize the importance of professional accountability in EMS practice and how it is maintained through cooperation with regulatory bodies, enhancing their confidence in and respect for the regulatory system.

This interactive presentation discusses the unique health challenges the homeless population faces and outlines best practices for Emergency Medical Services (EMS) care. It highlights the need for culturally competent care, partnerships with community resources, and strategies to overcome barriers to healthcare access. Objectives: understand the health challenges and disparities facing the homeless population, including mental health issues, substance abuse, and chronic conditions / learn best practices for providing culturally competent EMS care to homeless individuals, demonstrating empathy and respect / identify outreach programs, peer support networks, and integrated care clinics in accessing preventive services and overcoming healthcare barriers / recognize the need for focused training and education for EMS providers to address the healthcare needs of homeless individuals effectively.

EMS has always “owned” cardiac arrest resuscitation. But – for many decades – outcomes were dismal and discouraging. We’ve all been there, seen that. In 2024, however, we now have a much better idea of the critical components of successful resuscitation with good outcomes. Whether you prefer a “pas de deux” or a “pit crew” approach, choreography is key. And, fortunately for us and for our patients, science clearly favors the importance of Basic/Intermediate Life Support interventions. Come learn about ten key components of prehospital resuscitation targeted towards the best possible outcome. Objectives: list the two most important factors in good outcome from out-of-hospital cardiac arrest / describe key features of effective chest compressions during cardiac arrest resuscitation / describe the importance of the “pre-shock pause” in cardiac arrest resuscitation / list four reasons why over-ventilation is harmful in cardiac arrest resuscitation.

In our upcoming session, ‘Rural Health Deserts: Navigating the Challenges Beyond Urban Edges,’ we delve deep into the escalating crisis facing rural healthcare systems. This comprehensive lecture, workshop, and pre-conference class aims to shed light on the unique challenges rural communities encounter, including limited access to medical facilities, scarcity of healthcare professionals, and the growing burden of chronic diseases. We will explore innovative strategies to bridge these gaps, from leveraging telehealth and mobile health clinics to enhancing local health education and training programs. Participants will gain insights into the multifaceted nature of rural health disparities, the impact of these challenges on patient outcomes, and the critical role of interprofessional collaboration in driving sustainable improvements. Through interactive discussions, case studies, and solution-oriented workshops, attendees will be equipped with the tools and knowledge to make a tangible difference in the lives of those living in the shadows of our healthcare system Objectives: gain a thorough understanding of the specific barriers facing rural healthcare delivery, including geographic isolation, workforce shortages, and limited access to specialty care / learn about the various health disparities that disproportionately affect rural populations, such as higher rates of chronic diseases, mortality, and lower life expectancies, and the social determinants that contribute to these disparities / provide knowledge on how telehealth and other innovative healthcare delivery models can be utilized to improve access to care in rural areas, including case studies of successful implementations / understand the importance of interprofessional collaboration in addressing rural health care crises and learn strategies for effective teamwork among healthcare providers, community organizations, and policymakers to improve health outcomes in rural communities.

This session will discuss the intricate management of patients with pulmonary hypertension (PH) and right-sided heart failure. With a focus on acute decompensation, this session will explore the underlying pathophysiology driving the rapid deterioration often observed in these patients. Ventilation tactics tailored to the unique needs of PH and right-sided heart failure patients will be discussed, equipping attendees with practical strategies to optimize respiratory support and alleviate hemodynamic stress. Additionally, this will highlight specific medications proven to benefit these patients, offering insights into their mechanisms of action and appropriate utilization in acute settings. This session will provide attendees with key strategies to implement in everyday clinical practice. From early recognition of signs of decompensation to proactive intervention strategies, participants will leave with actionable insights to enhance patient outcomes and improve overall quality of care. Objectives: gain understanding of how decompensated pulmonary hypertension can occur and its signs / recognize and address potential complications in hemodynamics using key strategies from presentation / improve knowledge in selecting appropriate pharmacological agents in this patient population / provide knowledge in selecting appropriate ventilator strategies and reasons why you would use them.

On Sept 15, 2021, Jill, a flight paramedic, was flying a stroke patient to the medical center. Her phone was vibrating incessantly, so she answered it in flight, only to hear that her 18-month-old grand-daughter’s head had been run over by a truck and that she was flown to the Pediatric trauma center right next to where Jill was delivering her patient. This case study will chronicle the accident and discuss Kaydance’s course from the initial accident to recovery. We will review the incidence, initial and on-going management of pediatric head trauma. This case study is sure to grab the group’s attention and incite them to review and maybe even change their practice! Objectives: review of sequelae and management of pediatric head injury / discuss logistical needs and concerns in transporting the pediatric trauma patient / list possible complications resulting from head and preventative efforts / cite importance of addressing mental health/self-care needs.

Texas experienced the hottest meteorological summer on record in 2023, resulting in a record number of heat-related EMS calls, and amplifying the need for effective strategies to save lives. Despite being one of the deadliest conditions that a pre-hospital provider can encounter, the tools provided to the EMS professional for managing exertional hyperthermia often fall far short of what is needed in the field. Treatment protocols have remained vague and ineffective, and often emphasize ALS procedures that have little to no impact on patient outcome. Even where appropriate treatment protocols have been adopted, operational realities have prevented the most effective treatments from being available in the field, where they are needed the most. In this lecture we will outline the sometimes controversial, evidence-based treatment strategy for managing heat stroke in the pre-hospital environment. We will also present a case study that showcases this strategic approach in action and discuss how the adoption of operational plans between STAR Flight, EMS, and Central Texas Fire Departments continues to save lives. Objectives: recognize the important difference between heat stroke and other heat related injuries / understand the essential treatment approach to reducing core temperature for a patient in the field / understand the clinical consequence of failing to recognize and treat heat stroke in the pre-hospital environment / review regional operational strategies that make this treatment possible.

The role of EMS continues to dramatically evolve. Healthcare systems and payers have new agendas – delving even more into the value-based payment arena. Agencies and practitioners are implementing new services that enhance the value EMS brings to patients, payers, hospitals, ACOs, CMOs, and Hospital in the Home providers. MedStar has recently implemented new partnerships with commercial and public payers and other stakeholders who are paying for preventive and patient navigation services, including commercial insurance payments using CPT codes, in addition to HCPCS codes. This session will provide an overview of the programs implemented over the past year and the ways they are generating value to their key stakeholders. Objectives: understand the ways the role of EMS continues to evolve / learn five new programs that have been implemented over the past year / understand the ways value is being determined for these new programs / learn how to partner with others to change the environment to facilitate transformation.

Even experienced clinicians can be stumped when a patient presents with multiple signs and symptoms. Diagnosis and treatment are often delayed as a result, especially when these signs and symptoms don’t jive with the patient’s chief complaint. Interestingly, there is a subset of medical terminology known as an eponym – which is any word related to medicine, whose name is derived from a person, usually a physician. Observing these unique “signs” and understanding what they represent can help an EMS professional efficiently, differentially diagnose, guide patient management, and make appropriate transport decisions. Objectives: define what is an eponym / describe the physical presentation of three unique patient signs / discuss the underlying pathophysiology of three unique signs / discuss the management of a patient with three unique signs.

This session is certainly NOT for the faint of heart. This session does not cater to everyone’s tastes. We will be looking at various (many are blunt and gruesome) trauma pictures/scenarios and attempting to figure out what type of mechanism of injury may have caused patient presentation. Let’s see how well you think outside the box! Objectives: identify plausible causes of injuries presented / create solutions for stabilizing injuries / create differential diagnoses / anticipate actions that may put the patient at further risk.

Based on the best-selling leadership book by Simon Sinek, “Start with WHY,” this session applies these principles to the EMS world. We’ll discuss why some people and EMS organizations are more innovative, more influential, and yes, more profitable than others. You will leave this session with proven strategies to help inspire everyone in your organization. This will help you get all your leadership team working within the same “Golden Circle,” so they are all on the “same page” to better think, act, and communicate effectively and efficiently. Objectives: discuss key communication skills needed for effectively communicating with team members / describe the importance of staff member understanding of “why” a course of action is being followed / discuss steps to encourage staff member engagement and participation / discuss the difference between directing others vs. inspiring others to meet common goals and objectives.

Over a third of EMS patients are over the age of 65, yet little specialized training is devoted to this amazing demographic. This lecture focuses on the unique pathophysiology and socioeconomic challenges in this population, which often has a much higher complication rate and mortality risk than younger patients. We will exam how a “normal” exam often underestimates the true scope of injuries, how mechanisms of injury and “pre-quels” are critically important in assessment, and management strategies including utilizing trauma triage protocols. Objectives: review unique geriatric pathophysiology / examine how injury “pre-quels” and mechanisms of injury are critically important in assessment and management strategies including trauma triage / discuss the role of polypharmacy in contributing to injuries and mortality / understand of the unique assessment and management strategies to a unique population in which there is minimal formal specialized training.

This presentation delves into the critical yet often overlooked aspect of disaster management: effective communication. By examining a series of catastrophic events, including the grounding of the Ever Forward ship, the crashes of Air Florida Flight 90 and Avianca Flight 52, alongside other lesser-known local disasters, we aim to uncover the communication lapses that played a pivotal role in these incidents.

Each case study presents a unique narrative of failure and lessons learned. The grounding of the Ever Forward highlights the complexities of maritime communication and coordination. Air Florida Flight 90’s tragic end on a frozen Potomac River serves as a stark reminder of the consequences of miscommunication in adverse weather conditions. The Avianca Flight 52 disaster, culminating from a fuel emergency, underscores the critical need for clear and assertive communication in aviation.

Through these analyses, this session seeks to provide insights into how miscommunication can escalate into a disaster. We will explore the human factors, organizational culture, and systemic issues that contribute to communication breakdowns. Furthermore, we will discuss strategies to enhance communication effectiveness in high-pressure environments, drawing from interdisciplinary approaches and best practices. By learning from past mistakes, we aim to foster a culture of proactive and clear communication, ultimately enhancing safety and efficiency in managing disasters Objectives: identify key communication lapses and their roles in the escalation of these events / learn about the human factors, organizational culture, and systemic issues that contribute to communication failures / enhance communication effectiveness in disaster management and emergency response contexts / foster a culture of proactive, clear, and assertive communication within their organizations.

A discussion and look at farming hazards present in both urban and rural communities. We will discuss mechanical and chemical hazards that can be dangerous to the responder and are often unknown. Objectives: discuss machinery present in these facilities and the dangers they pose to responders / discuss the importance of replanning these events and conducting site visits to learn of the chemicals, machinery and safety plans in place / discuss how some agricultural chemicals do not follow the normal rules for responding to hazardous materials incidents / stress the importance of knowing your territory and continually evaluating ways to enhance your response to community based hazards.

This presentation will cover the differences with pediatric sepsis compared to the adult population. The signs and symptoms of a pediatric patient becoming septic can mimic several other common pediatric conditions, making it difficult to recognize in the first place. Recognizing pediatric sepsis is critical to early interventions and a reduction in overall mortality rates. We will explore the development of a sepsis alert, Pediatric sepsis scoring tool, and treatment pathway all supported by evidence-based literature and best practices. This presentation will also identify communication barriers in hand-off reports throughout the healthcare system which may contribute to adverse events or negative patient outcomes with patients that are septic. Objectives: identify the signs and symptoms of sepsis in the pediatric patient / discuss the components of a sepsis scoring tool using the PIRO model / describe priority interventions within the sepsis treatment pathway / discuss specific treatment goals after a sepsis protocol is initiated in a pediatric septic patient / identify the importance of a multidisciplinary approach and communication while caring for septic patients in order to decrease mortality rates.

The story of Freedom House EMS is generally well known, but the same developments were happening almost independently in Europe. This presentation compares and contrasts the development of EMS in America, the UK and other countries. The same but very different… Objectives: describe the history of EMS in the USA / describe the history of EMS in the UK / state the similarities and differences in the evolution of the two systems/ state how other systems around the world developed.

Join Dr. Remle Crowe for an overview of a recent evaluation of disparities in out-of-hospital analgesic administration while accounting for the influence of clinical characteristics and community socioeconomic resources among a national cohort of patients with confirmed long bone fractures on ED diagnosis. Learn concrete strategies to leverage EMS data to identify inequities in care and apply improvement science driven approaches to close these gaps. Objectives: identify at least three clinical areas with evidence of racial and ethnic disparities in prehospital care / discuss at least three reasons for racial and ethnic disparities in prehospital pain management / discuss the IHI Model for Improvement and how it can be applied to reduce inequities in prehospital analgesics / describe at least one category of interventions to reduce disparities in prehospital care delivery.

This session is designed to help Prehospital Care Practitioners, Emergency Nurses & Physicians, Respiratory, X-ray and Lab Technicians better understand and manage injuries sustained at the rodeo. After a long cattle drive in West Texas, Cowboy’s would often demonstrate their riding and roping skills in what came to be known as a Rodeo. Records indicate that the first formal rodeo was held in 1872 in Cheyenne, Wyoming, and has continued to be one of the competitive sports in the United States where athletes compete for a cash prize. During this session we will explain the different types of injuries sustained in the six (6) main rodeo events. We will explain the common injuries that occur while riding saddle and bareback broncos, bull riding, steer wrestling, calf roping and team roping. During this session you will learn and have a better understanding of the size and weight of the livestock, mechanism of injuries, safety equipment and accidents that happen before, during and after a rodeo. This session will use a unique slide show and video to show how Cowboys become broken! We will discuss both Basic & Advanced Life Support. Objectives: understand the EMS Role at a rodeo / understand the size and weight of rodeo injuries / recognize rodeo injuries / review both Basic and Advance EMS care of rodeo injuries.

When to place a definitive prehospital airway is a question with infinite variables. This discussion will focus on the foundational reasons why EMS intubation may be both urgent and emergent. Specific focus will be placed on the differentiation between loss of airway patency and airway protection. Recent teaching has (rightfully) called into question the appropriateness of “GCS less than 8, intubate.”  But, before we scrap “GCS<8” altogether, it’s worth considering some potential value in recognizing altered mental status as an obvious tenuous airway risk factor. Objectives: learn the difference between airway patency loss versus protection loss / recognize the five “S’s” of airway patency loss / know the supporting literature against “GCS<8, intubate” as a singular rule / review specific situations where EMS airway management is emergency versus urgent.

Bipolar disorders inhabit an area of the DSM-5 between depression and psychosis. Historically, it was described as manic depression. EMS calls for patients suffering from bipolar disorders are common. Many of these patients also suffer from poor physical health. The effects of bipolar disorders, both mental and physical, can be a source of frustration for EMS providers. In this talk, I will highlight the signs and symptoms of bipolar disorder. We will also discuss why these patients are sometimes inconsistent with medication. Our goal will be to increase provider understanding and empathy for those suffering from bipolar disorder. Objectives: differentiate between bipolar I and II disorders based on signs and symptoms / discuss common co-morbid mental and physical ailments / discuss treatments, prognoses, reasons for repeat EMS usage, and ideas for improving care.

Historically, in medicine, what we know, and how we practice has mostly been led by men. Due to normal human bias, this has led to a very male-centric model of medicine. Did you know most medical research does not involve female participants, particularly including new drugs? Come learn how these biases have led to missed diagnoses and inappropriate treatment and how to avoid them while treating your next female patient. Objectives: discuss why much of traditional medical practice is too male-centric and how it effects women / discuss the misdiagnosis and treatment of acute coronary events in women and how to avoid these issues / discuss the differences in stroke presentation, assessment, and care for women / discuss implicit bias and how it can negatively affect female patients.

Delve into critical topics such as withholding or withdrawing resuscitative efforts, balancing patient autonomy with beneficence, and addressing cultural considerations in patient care. Through engaging discussions and practical case studies, attendees gain a deeper understanding of the ethical principles guiding prehospital care decisions and learn strategies for making ethically sound choices in challenging situations. This class empowers EMS providers to uphold ethical standards while delivering compassionate and patient-centered care, ultimately enhancing the quality of care provided in the dynamic and demanding prehospital environment. Objectives: understand the ethical considerations involved in withholding or withdrawing resuscitative efforts in patients with critical illness or injuries, including factors such as prognosis, quality of life, and patient preferences / explain the tension between respecting patient autonomy and acting in the patient’s best interest, particularly in scenarios where patients refuse recommended treatments or interventions / recognize the influence of cultural beliefs, values, and practices on patient care decisions in the prehospital setting, and identify strategies for providing culturally competent care and overcoming language barriers / demonstrate an understanding of the ethical principles guiding prehospital care decisions, including beneficence, nonmaleficence, autonomy, and justice, and apply these principles to analyze and resolve ethical dilemmas encountered in EMS practice.

Join us for a comprehensive session designed to equip EMS and prehospital care providers with the latest knowledge and skills in concussion management. This engaging lecture delves into the complexities of identifying, assessing, and managing concussions sustained in prehospital settings. Through a blend of expert-led discussions and interactive case studies participants will learn to recognize the subtle signs of concussion, implement immediate care strategies, and make critical decisions about transport and referral. We’ll explore the latest guidelines and research in concussion care, emphasizing the importance of a nuanced approach to patient assessment and the role of EMS professionals in mitigating long-term impact. Whether you’re a seasoned paramedic, an EMT, or a nurse involved in prehospital care, ‘Collision Course’ will enhance your competence and confidence in handling these potentially life-altering injuries, ensuring you’re prepared to act decisively in the golden hour.” Objectives: equip participants with the ability to accurately identify the signs and symptoms of concussion, emphasizing the variety of presentations and the importance of early detection in the prehospital setting / discuss essential initial management strategies for concussions, including on-scene assessment protocols, stabilization techniques, and when to administer immediate interventions to prevent worsening of the condition / provide a comprehensive overview of the pathophysiology behind concussions, helping participants grasp the biological impact of traumatic brain injuries and the rationale behind specific treatment approaches / explore decisions regarding the need for further medical evaluation, including criteria for immediate transport to healthcare facilities and recommendations for follow-up care, ensuring continuity and quality of patient care. 

This class is designed to provide new and experienced EMTs, as well as beginner ALS providers with a crash course on how to perform a more in-depth assessment, as well as how to avoid some biases, basic knowledge of Capnography and how to apply it to regular practice. Objectives: identify biases and how to avoid them / recognize common Capnography waveforms including sepsis and acidosis recognition / create a detailed history and form differential diagnoses that dynamically change and apply those to a patient / recognize commonly used medications and be able to form a basic medical history from a list of medications.

Beta Blockers and Calcium Channel Blockers are common medications used to treat cardiovascular diseases such as hypertension. Unfortunately, when taken in excess, they can cause havoc. These toxic substances can cause severe bradycardia and hypotension to the point of cardiovascular collapse. Correctly managing these cases requires very aggressive management that can easily overwhelm an emergency department or a critical care unit. With limited resources, a critical care transport crew must use a systematic approach and apply aggressive management to tend to these cases appropriately. Objectives: identify the beta blocker or calcium channel blocker overdose by its presenting signs and symptoms / interpret various objective lab data and vital signs to suspect a beta blocker or calcium channel blocker overdose / understand the emergency and critical care management of the beta blocker or calcium channel blocker overdose / implement a systematic approach to aggressively managing a beta blocker or calcium channel blocker toxicity in transport.

This will be a fast-paced series of selected speakers that submitted the five best abstracts for the Texas EMS Conference Research Forum. You will hear directly from the investigators that are at the forefront of EMS Innovation. You will see the latest science, and maybe get an idea to bring back to your organization. Objectives: gain insight into current research projects being conducted by Texas EMS researchers / learn how current research projects are designed to ask questions / demystify EMS research / build relationships for the responsible conduct of Texas EMS research.

This fast-moving lecture will give you a broad overview of how to develop a mobile integrated health program from the ground up. We’ll address how to get your local government buy-in and support, what protocols are unique to a program like this, KPIs to monitor, funding sources, legal implications, and future vision. This lecture will cover our unique opiate use disorder program, alcohol use disorder care, and ways to manage more than 80% of your mental health patients without needing to involve law enforcement. You’ll leave well-equipped with a host of new ideas, specific resources, and next steps to create or further your own program. Objectives: explore ways to create transformation throughout the local healthcare system, from clinics to emergency departments / create a multidisciplinary team to provide excellent patient care while minimizing use of the 911 system and emergency departments / identify the greatest strains on their system resources / identify key needs in your community and possible ways to address them.

Dogma is a set of principles promoted by an authority that is held to be true. Despite proof of the falseness of these “truths” they are often passed along from clinician to clinician as still being true. Dogma runs rampant through most medical professions including EMS. This session will explore common EMS dogma and what the actual science says about these embedded beliefs. Objectives: define and understand dogma / recognize how dogma is established / recognize some of the more common EMS dogma / discuss the literature that has dispelled some of the more common EMS dogma.