2022 Course Descriptions – Tuesday

As we begin to emerge from the pandemic, there are many lessons we have learned from our preparedness to understanding the disease and what worked and what didn’t. This talk will focus on how the pandemic affected EMS and the lasting changes from preparedness, to treatment, to even education have occurred as a result. There are some parallels to the last big crisis with HIV. Bob will draw these similarities and lessons that could be applied going forward. Objectives: contrast the disease of COVID 19 and HIV and human infection / describe how PPE and precautions prevent disease / describe how education has changed during COVID and what it looks like going forward / describe how better understanding of infectious disease can help us tolerate future occurrences.

Manual ventilation is one of the first skills learned in training. It’s often mentioned as a BLS skill, but no one has ever said it’s an easy skill. This lecture will cover what most take for granted, the importance of proper ventilation including respiratory rate, volume, pressure, flow rates and oxygen percentages. Objectives: describe the importance of pressure, respiratory rates, volume, flow and oxygen percentage / describe new technology to improve manual ventilation / describe the history and manual ventilation and how we got here / understand how/why manual ventilation effects outcome.

The national guidelines for the field triage of injured patients were updated this year. In this presentation, Dr. Kupas will review key changes to the criteria and will discuss the science behind these changes. Important changes include a new structure for the guidelines, the shock index, and changes addressing geriatric trauma care. This session will use case discussions to show practical application of the changes. Objectives: describe the new trauma triage criteria / apply shock index to trauma triage / discuss likelihood ratios for various trauma triage criteria and understand their application to field triage / discuss criteria that reduce under triage of elderly trauma patients.

Using a series of case studies, Dr. Jarvis will discuss the most lethal and most common causes of chest pain. He will discuss what a differential diagnosis is, will shatter the myth that medics “don’t diagnose”, and will present a cognitive framework for approaching the assessment of patients with chest pain. He will also discuss some of the pathophysiology and management of these conditions. The intent of this lecture is to offer the provider an advanced look at a common presentation. Objectives: discuss the importance of forming a differential diagnosis / list several of the most common causes of chest pain / describe the pathophysiology of thoracic aortic dissection, pulmonary embolism and myocardial infarction / describe the historical and exam findings consistent with thoracic aortic dissection, pulmonary embolism and myocardial infarction / describe the management of patients with aortic dissection, pulmonary embolism and myocardial infarction.

As bad as it was, in many ways the public health emergency brought out the best in our people and in ourselves! This session will cover the positive aspect of the pandemic – and discuss the six leadership attributes that emerged as hallmarks of success – attributes that can help sustain us in this post-COVID world of EMS. We’ll use actual quotes from EMS leaders nationwide as to what worked for their organizations. Objectives: list three causes of EMS agency stress during the pandemic / list six qualities of effective leadership in a crisis / discuss the importance of transparency and honesty in communicating with others during a crisis / discuss the leadership lessons learned during the pandemic – what worked and what didn’t work and how these lessons apply to our future existence.

This presentation explores the challenging issues surrounding death in custody and the safe use of ketamine for chemical restraint. Ketamine is effective and generally safe for the restraint of combative patients. But like any potent tool, it can cause harm if misused. Several deaths have been reported in connection with the administration of ketamine to patients restrained by the police. Using expert after-action reports and selected video clips, we’ll examine the pathophysiology of death in custody, the dangers of prone restraint and the safe use of ketamine for chemical sedation. This is one of the most important and relevant conversations in EMS today. We’ll discuss how to protect not only our patients, but also our fellow EMS providers and law enforcement colleagues. Objectives: describe the issues surrounding excited delirium and the pathophysiology of death in custody / explain the risks associated with the use of ketamine to chemically restrain individuals in custody / describe the new training that must be developed to better prepare EMS providers to assess and manage individuals in custody and use ketamine safely / identify how implicit bias affects decision making by EMS providers and law enforcement personnel.

In 2022, there are more methods of pain control than ever. So, why is this still a “thing?” Pain remains the most mismanaged, undertreated ailment even today. Old “reasons” are still being cited in defense of undertreatment, especially when treating abdominal pain. We will explore fears versus facts, excuses versus legitimate concerns, sequelae associated with mistreatment/mismanagement and while reviewing interventions, hopefully clarify some myths associated with certain interventions. Objectives: define pain (the REAL definition) / describe the pain process / discuss the physical sequelae associated with pain / review pharmacologic interventions and “bust some myths”.

The EMS industry has come a long way in advancing safety, but there is still much room for improvement. With the national EMS professional staffing crisis looming, it is imperative that industry leaders make safety a priority within their operations. Throughout this interactive presentation, we will discuss various methods for re-engaging your workforce and re-prioritizing safety beyond “scene safe, BSI!”. Objectives: discuss the challenges of safety versus compliance / review Mike Rowe’s explanation of safety / discuss the 360-degree approach to safety / review safety lessons from the past and apply them to current day.

This presentation provides insight into the world of autoimmune disorders. We will explore different conditions and discuss some triggers. Are these conditions predetermined as DNA? We will discuss how the body creates these conditions to make us more susceptible to a host of illnesses that form the pieces of this complex puzzle. Objectives: recognize a patient presenting with signs/symptoms of an autoimmune disease / communicate possible triggers associated with these conditions / determine best practices in the treatment and transport of patients with autoimmune conditions / create additional differentials when assessing patients with complicated presentations.

Implementing VAN Scoring and LVO Alerts – Experiences From the City of Austin and Travis County EMS

In 2021, leaders from Austin’s office of the chief medical officer, the Travis County division of clinical performance and education, Travis County STAR flight, Austin Travis County EMS, and Lake Travis Fire Rescue implemented a multi-agency approach in Travis County for EMS providers to assess for signs and symptoms of a Large Vessel Occlusion (LVO) using Vision Aphasia Neglect (VAN) scoring. This resulted in modification to existing processes for stroke alerts to create the addition of a LVO alert. Modifications were made to dispatch, and information provided to crews based on the declaration of a stroke or LVO alert and distance to a thrombectomy capable center (comprehensive or primary plus stroke centers) or stroke center. Additional modifications were implemented for auto launching of STAR Flight, a helicopter EMS service for greater Travis County. This session will review the implementation process as well as review of preliminary data and patient cases related to these additions and changes. Objectives: summarize peer-reviewed research supporting use of VAN scoring and LVO alerts in the out of hospital setting / compare the criteria for stroke vs. LVO alerts and selecting the appropriate receiving facility / generate steps for developing system wide LVO alerts and use of VANsScoring / reflect on preliminary data and patient cases following the implementation of LVO alerts and VAN scoring in ATCEMS & Travis County area.

This session is designed to help EMR’s, EMT’s, Paramedics, Firefighters, Nurses & Physicians better understand and manage extreme gunshot wounds. Using a unique power point presentation, we will explore some extreme gunshot wounds and how to properly respond to these dangerous scenes. Each year nearly 40,000 people are killed because of firearms. Medical reports indicate that nearly 550,000 people Dial 911 and use the Emergency Medical Services for extreme gunshot wounds each year. The high incidence of injury and death due to firearms is second only to motor vehicle accidents. This session will use gun violence data collected from U.S. cities including New Orleans “The Big Easy”! Objectives: understand the importance of scene safety, establishing communications and waiting for a Code 4 as the shooter might still be on scene / understand the power of today’s sophisticated weapons / understand the anatomy of the brain, heart, lungs, chest and abdomen when injured by a bullet / understand the golden hour, golden period and platinum 10 minutes while providing basic and advanced life support for gunshot wound victims.

We’ve all heard of Wolff-Parkinson-White Syndrome, but how about Lown-Ganong-Levine or Mahaim Fiber Tachycardia? Ventricular pre-excitation through abnormal accessory pathways has often been covered as an afterthought to cardiology education for EMS providers, with most of the attention devoted to a superficial explanation of WPW. Pre-excitation syndromes, however, often respond differently to conventional EMS treatment aimed at treating far more common AV-nodal reentry tachycardias. If you don’t know a Kent bundle from a James fiber and you’re a cardiology geek at heart, this presentation is for you. Objectives: review epidemiology of ventricular pre-excitation syndromes / discuss the difference in mechanisms between antegrade ventricular activation and retrograde atrial activation through abnormal accessory pathways / discuss pathophysiology of Wolff-Parkinson-White syndrome and conduction through Kent fibers / discuss pathophysiology of Lown-Ganong-Levine syndrome and conduction through James fibers / discuss pathophysiology of ventricular pre-excitation through Mahaim fibers.

Anyone and everyone who has ever cared for patients with mental health related complaints in the prehospital setting knows that not all need standard hospital emergency department transport. Harris County ESD11 Mobile Healthcare has finally bridged the gap facilitating direct 911 transport from the scene to an inpatient psychiatric hospital. Join the ESD11 clinical leadership as they discuss how the partnership was forged, what criteria the paramedics use to determine direct to mental health patient selection and, most importantly, what their patient and operational data has shown. Objectives: learn the important exclusionary criteria for direct to inpatient psychiatric hospital transports / understand the important communication factors involved in building a bridge from EMS to local psychiatric facilities / list operational and clinical benefits to direct to inpatient psychiatric hospital EMS transports / discuss ways to further create community mental health collaborations.

Have you ever wondered why certain emergency procedures seem easy and others don’t? Have you ever seen the same procedure on the same patient have a completely different outcome? Join us as we illuminate micro skills (that’s the skill within the skill) that have conspired to offer you success or failure for your entire career. These uncompromising micro skills involve your fingertips, dexterity, position, and vision. Most providers don’t realize the critical role anatomy (that’s yours, the patient’s, and the device itself) play between success and failure in a procedural setting. Some experts suggest this knowledge and skill come with experience that must be earned. We happen to know that the “skill within a skill” can be taught at any point in a career! So, join us as we dive deeply into emergent ACCESS and CONTROL from the vantage point of a place you’ve never slowed down enough to actually see. Objectives: define micro skill and its relevance to procedural medicine / outline common mistakes that lend themselves to procedural failure / discuss methods to incorporate micro skills into existing training exercises / offer examples of micro skills use in specific access and control situations.

It is no secret that EMS continues to struggle to fill open positions across the state. From brochures to videos, we will discuss ten recruitment strategies that you should consider adding to your toolbox. In this panel discussion, we will review the effectiveness of a variety of recruitment techniques to increase your application pool. Hear where you can put your chips in and make them count concerning new hire applicant testing, website design, and recruitment visits. This panel will also include tips from Misti Willingham, an experienced Public Information Officer on how you can leverage social media and video production in a cost-effective manner. This á la carte informative discussion will leave you with the confidence to stop gambling with recruitment and implement proven strategies for this high-stakes game. Objectives: understand the most recent national turnover rates in EMS and how that affects recruitment / learn how to use digital and social media to cost-effectively improve recruitment / develop a recruitment plan that meets your organization’s needs / learn how implementing and tracking your recruitment efforts will expand and improve your organization’s reach.

Dr. Stevenson brings years of experience in leadership roles within the military, private business and the Department of State Health Services. His knowledge will support current managers and leaders in an ever-changing leadership challenging environment that is today’s workplace. You will leave this session with helpful tools to navigate and motivate your dedicated workforce. Objectives:

EMS responses increasing involve both bariatric and geriatric patients who present with a number of co-moralities and transport challenges. This interactive session will discuss how obesity combined with aging has created new health care issues for patients and EMS practitioners surrounding the assessment, treatment and packaging of this special patient population. Objectives: identify anatomical and physiological changes in obese and aging individuals / explore the most common health care issues in obesity and elderly and how they are compounded in the elderly obese patient / discuss the assessment and management of select health issues including post weight loss and orthopedic surgeries / discuss wellness practices for packaging and moving patients.

Have you ever cared for a victim of human trafficking? According to research, up to 80% of human trafficking victims accessed healthcare while being trafficked. This means the chances are high that as a healthcare provider or emergency responder you have treated a victim and may have not recognized the signs. Learn how to recognize the signs of human trafficking and what to do should you identify a victim of human trafficking. This lecture includes key take away points from various national and international resources including the International Labour Organization, human trafficking victims, lessons from social services, Allies Against Slavery and more. Objectives: 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 / review common characteristics and/or circumstances to help identify at risk persons / discuss available resources once a potential victim is identified and the legal rights of victims in regard to HIPPA.

This panel discussion will discuss the pathophysiology of opioid addiction and overdose, pharmacological treatments available and ways to partner in your community to provide naloxone harm reduction. The pharmacology of buprenorphine and treatment protocols for use in acute opioid withdrawal will be expanded upon with a tale of two cities approach. We will discuss current programs in Austin and San Antonio. Objectives: understand the basic pathophysiology of opioid intoxication, addiction and withdrawal / appreciate the how opioid antagonists such a naloxone and naltrexone can be used in harm reduction programs / explore buprenorphine protocols for use in opioid withdrawal and gain an understanding of the indications and contra-indications for such therapies / list some of the community benefits obtained from buprenorphine and naltrexone harm reduction initiatives.

There eventually comes a time when we all leave EMS – sometimes willingly, sometimes unwillingly. Preparation is key in the days leading up to that exit strategy as we transition back into “normal” life and what that entails. As EMS escapees ourselves, we discuss what to expect and ways to prepare yourself or your staff for the day you hang up the radio for the last time. Objectives: describe resources available to transition people out of EMS and into the civilian world / explain the importance of maintaining a mental wellness routine as part of the transition / explore preplanned exit strategies and backups in the event of the unwilling escapee / evaluate common reasons for people to become escapees, from career change to retirement.

Working as a group, escapees will use their emergency and management skills and knowledge to decipher clues and overcome challenges to craft an escape through a fictional scenario with challenging possibility.  This escape room will focus on the first receiver-first responder interface in hospital emergency response team operations for mass casualty incidents. Audience members may be conscripted into escape room play. A hot wash will complete the game. Objectives: solve puzzles while working within a hospital emergency treatment area based on the escape room scenario / incorporate understanding of HERT vocabulary, basics, and function into untangling conundrums / integrate Simple Triage and Rapid Treatment(c) (START) and JumpSTART procedures into problem solving / answer questions and complete tasks and challenges necessary to complete your escape.

This workshop will allow participants to practice functional moves that relate to EMS activities. We’ll identify the most common body parts injured and the most frequent activities that cause them. Whether learning functional moves for the first time or improving existing habits, this workshop is for anyone who wants to reduce their injury risk. Objectives: describe the most common EMS activities that cause injuries / list the four most common body parts injured by EMS providers / demonstrate at least two functional lifting moves / name at least four benefits of improving functional movement.   

The latest in the series of fun, informative interactive game show presentations by Bob Page. This one explores medical emergencies such as endocrine, infectious disease, neurological, sepsis and other special cases. This is great review of common and uncommon medical emergencies that we see in the field, using your phone as a feedback device you can make the call and participate in the assessment and management by answering questions throughout the cases! Objectives: describe the signs and symptoms of various medical emergencies / describe the pathology or various medical emergencies / describe the treatment priorities of various medical emergencies / describe the monitoring strategies of various medical emergencies.

Injuries from crushing forces seem to have become more common place in society. Earthquakes and explosions seem to have become more frequent. The advances made in the technical aspects of confined space rescue have allowed living victims instead of dead bodies to be pulled from rubble. This has created a need to devise and standardize treatments for crush injuries and crush syndrome. However, less glamorous but much more common, will be the immobile patient such as the inebriate or elderly patient. We will talk about crush injuries, compartment syndrome as they relate to actual case presentation. Objectives: discuss the normal pathophysiology of the patient with compartment syndrome and crush injuries / identify the treatment modalities and strategies for case presentations featuring compartment syndrome and /or crush injuries / review controversial treatment modalities / describe assessment strategies for recognition of potential crush injuries and compartment syndrome.

Reality television has popularized hoarding disorder, but what happens before the “Got Junk” people show up? This session will discuss the hoarding disorder, its associated features, and possible co-morbid diseases. Situational awareness and provider safety is of particular concern during these responses; hidden dangers in hoarded environments and appropriate PPE and resources will be examined. Planning and interaction with other agencies, particularly Hoarding Task Forces will be addressed as well. Objectives: define hoarding disorder, its associated features, and co-morbid diseases / explore situational awareness, safety, and interaction with other social services for responders / model interaction with patients and their families related to hoard, extrication, and treatment / recount methods of trauma informed care for communication and interaction with patients and families.

Traumatic brain injury (TBI) is a major cause of death and disability following trauma. Actions taken by the EMS provider—regardless of level of training—have a direct impact on patient outcomes. This presentation is geared towards all levels of EMS provider. It begins with a discussion of cerebral perfusion, the normal physiologic processes the body employs to maintain it, and how the body responds to increased intracranial pressure—knowledge that is crucial to understanding why some prehospital interventions are performed and why others are (and should be) avoided. The potentially disastrous effects of secondary brain injury, and how to minimize or avoid it, are discussed in detail. Specific injuries discussed include subdural and epidural hemorrhage (focal injuries), axonal injury (diffuse injury), and intracerebral hemorrhage; this includes clinical presentations, critical assessment parameters, and key emergency care procedures and interventions. We will also review the latest scientific literature regarding the use of TXA for the TBI patient, as well as the effects of hard cervical collars on intracranial pressure. Objectives: discuss cerebral perfusion and what is required to maintain it / describe the various types of traumatic brain injury / discuss signs and symptoms of various traumatic brain injuries / discuss the prehospital treatment (BLS and ALS) for the TBI patient / review recent scientific literature regarding specific care of the TBI patient.

The negative effects of burnout in EMS stretch well-beyond the individual with consequences for entire organizations as well as the patients served. Nevertheless, most interventions aimed to reduce burnout focus on the individual and fail to address the underlying systematic causes. In this session, Dr. Remle Crowe will discuss the latest research and present organizational-level strategies to meaningfully reduce and prevent burnout at your EMS agency. Objectives: recognize signs and symptoms of burnout / describe how burnout negatively affects individuals and organizations / discuss why burnout requires intervention at an organizational level / list three job resources associated with reduced burnout.

People routinely say that volunteer EMS (or fire) is a dying trend. Agencies routinely talk about a volunteer crisis, yet rarely address why they’re having a volunteer crisis. If they don’t outright ignore the issues plaguing their volunteer program, they double down on the activities and behaviors that drive away prospective and/or current volunteers. This presentation is intended to identify some of those activities and behaviors and offer constructive alternatives that have shown to make a volunteer program actually work, especially in a combination paid/volunteer department. Objectives: explore outreach strategies to attract volunteers / describe onboarding and orienting new volunteers / discuss organizational behaviors which drive away new volunteers / explain ways in which volunteers can coexist with paid staff.

The EMS industry is a prime target for hackers, but what many don’t realize is that not adequately protecting patient data can have a negative impact on patient outcomes. In this presentation, we will review the five major threats against all healthcare entities, mobile or stationary, and the ten practices designed to protect against these threats. Objectives: discuss how EMS and cyber security are aligned / describe the five cyber threats against all healthcare entities / review case studies and the impact on patient outcomes / list ten practices designed to protect against these threats.

Paramedics traditionally reach for IV analgesia, however, there are other options! This presentation explores what is used around the world, including Entonox and Penthrox. Can we make proper analgesia a proper BLS skill? Objectives: define inhaled analgesia / describe the legislative basis of inhaled analgesia / describe the indications, contraindications, and action of Entonox / describe the indications, contraindications and action of Penthrox.

Traumatic Brain Injury (TBI) exacts huge costs on patients, families, and society due to death and disability. What can we in EMS do to improve outcomes? The old advice to “avoid hypotension & hypoxia” is still true, but there’s much more to it nowadays. This presentation reviews updates to the Glasgow Coma Scale (GCS) as well as major findings of the EPIC TBI initiative and other, recent, evidence-based EMS TBI assessment and care practices. Finally, it discusses new and emerging technologies that may improve patient care and outcomes for moderate-severe TBI. Objectives: describe key pathophysiologic features of traumatic brain injury (TBI) / describe recent refinements in the Glasgow Coma Scale (GCS) / identify the “H-Bombs” of prehospital care of moderate-severe TBI / identify new and emerging technologies that may improve TBI care.

This unique and slideshow free lecture focuses on the way respiration, oxygenation and circulation isn’t taught to EMT’s, paramedics, and critical care providers. Join Bryan Walker for this one of a kind walk through the physics of the human body and how air really goes in and out, while blood goes round and round. The creative drawings, in person demonstrations, and class participation make this learning environment one of a kind. Objectives: explore the history of EMS education while disclosing the short falls of the EMS education system / describe the physics of the air we breathe / illustrate the importance of Pao2 vs SPO2 / compare and contrast negative vs positive pressure ventilation, and considerations before DSI/PAI.

This presentation focuses on a community’s long-term recovery to a mass casualty incident. First responders are very well versed on responding to mass casualty situations. However, the impacts of a mass casualty incident can last for years. By understanding the roles that first responders play in preparedness and recovery, first responders can better provide for their community’s healing from such traumatic incidents. Objectives: understand the scope of work required by jurisdictions and first responders after the shooting has ended / understand the necessity of a robust crisis communications plan / understand the requirement to manage volunteers and donations and the impact if not addressed / understand the need for a wide array of mental needs for victims, first responders and the community.

Hemorrhagic shock can be caused by trauma, GI disease, or even a nosebleed. Some traditional prehospital programs are suboptimal. When a patient bleeds, they lose whole blood. What would be the ideal replacement fluid for blood loss? The objective of this discussion to provide insight into a prehospital whole blood program based on the experience in San Antonio. The systematic deployment of prehospital whole blood, the clinical factors, and supply issues will be addressed. The discussion will also include regulatory issues, patient outcomes, lessons learned, and best practices regarding FDA and American Association of Blood Banks regulatory requirements. Objectives: discuss advantages and disadvantages of low-titer O-positive whole blood / discuss logistical consideration of a whole blood program / discuss legal considerations of a whole blood program / discuss clinical consideration of a whole blood program.

Seizures are a common medical emergency. Most are brief and self-limited – typically stopping on their own in less than a few minutes and present a low risk of patient harm. There are many types of seizures, which range in severity, and vary by where and how they begin in the brain. Astute recognition and aggressive treatment of seizures and related complications is the foundation of prehospital care. This presentation provides an overview of seizure types, origins, causes, and up to date management practices for EMS professionals. Objectives: differentiate between seizure and status epilepticus / discuss various complications related to seizures / name three types of seizures / list three causes of a seizure.

Although they are not directly life-threatening, eye injuries can result in devastating temporary or permanent vision loss. Prompt recognition, appropriate EMS assessment and treatment, and rapid transport for specialist evaluation may prevent this adverse outcome. When and how should we assess visual acuity? When and how should we irrigate? When and how should we “shield and ship”? What about treating the pain? This presentation reviews blunt, penetrating, chemical, and thermal eye injuries; prehospital patient assessment principles; and fundamentals of BLS and ALS care. Objectives: identify blunt and penetrating eye injuries, including globe rupture, impaled object/TASER and blast / identify chemical eye injuries, including acid, alkali, and riot-control agents / identify thermal and laser eye injuries / describe principles of BLS and ALS EMS care and triage of eye injuries.

Our industry’s frontline leaders are directly responsible for our organization’s’ most valuable assets, our people. Performing one of the most important jobs in EMS, they often burn out shortly after receiving this great honor, due to senior leadership not understanding, or valuing, the role. In this presentation, we will review, and discuss, five ways we can unintentionally ruin our frontline leaders and ways to avoid it. Objectives: review the roles of frontline leaders / recognize front line leader burnout / review methods to prevent front line leader burnout / discuss retention methods for front line leaders.

We’ve all done them before, and many of us love them, rodeo standby. These are what I like to refer to as a trauma rich environment. Have you ever stopped to consider some of the common injuries that we see from rodeo accidents? Even more importantly, we will discuss the multi-faceted aspect of team safety in the rodeo environment. Be ready for some great pictures, videos and discussion about the wild world of rodeo trauma. Objectives: understand the many scene safety issues which may be present at the scene of a rodeo trauma / identify common mechanisms of injury in rodeo trauma / anticipate common underlying injuries in the setting of rodeo trauma.

The skill in attending a party is knowing when it’s time to leave. “No one ever wants to consider the possible necessity of leaving the party. How will I pay bills? I don’t want to screw my co-workers. Will I be thought of as a wimp? Am I burning a bridge?” These are some of the thoughts running through our heads when we realize that we just can’t do this anymore. If you don’t care for you, you cannot effectively care for others. Leaving the party may not the always the best option, but sometimes it’s a necessary option. We will talk about the why and the most obvious indications that let us know “IT’S TIME.” Objectives: define burnout / list the five stages of burnout / discuss at least three concerns when faced with the decision to “leave the party” / identify at least three healthy solutions/alternatives to combatting burnout.

We use the primary assessment to systematically determine and rapidly, prioritize and correct immediate life threats. Whether you just finished your EMR or EMT course or have been in the field for years and just want to brush up on your skills, this crowdsourcing session is designed to up our skills. Together, we can create something special. Join, and bring some ideas! Objectives: describe the purpose of the primary assessment / identify five additional resources that can be used if needed / discuss the merits of the CAB vs the ABC approach / identify the five steps of the primary assessment / determine potential life-threats.

Setting up a QA/QI program at your EMS agency can feel like a daunting task. Will we review only a percentage of patient care reports and all specialty charts like cardiac arrests or traumas? Or do we have the capability to perform 100% chart review and gather all the information from our patient care reports? The short answer is – neither of these. In this discussion, we’ll apply best practices for meaningful quality improvement using the Model for Improvement framework. Objectives: Describe the Model for Improvement framework / understand the value of displaying data over time for improvement / differentiate between common cause variation and special cause variation.

First responders work hard to protect their communities, but vaccine preventable diseases (VPDs) are a real threat during disasters and emergencies. If left unprotected, first responders are at risk from not only contracting VPDs, but also spreading them to the community members they serve on the job and their loved ones. Examples such as seasonal influenza demonstrate that infectious disease outbreaks can threaten the safety of first responders and the communities, they serve every day. To safeguard the health of the communities in Texas, first responder immunizations must continue to be a high priority. The Texas Department of State Health Services (DSHS) Immunization Section is committed to preparing for an emergency or disaster by improving and sustaining vaccination rates for first responders, their communities, and their families. DSHS works to develop and strengthen partnerships with local health departments and first responder organizations to expand first responders’ knowledge of the Texas Immunization Registry (ImmTrac2) and adult immunizations recommended by the Advisory Committee on Immunization Practices (ACIP) and Centers for Disease Control and Prevention (CDC). During this session, participants will be provided with information about the important role immunizations play in the daily activities of first responders. They will also be provided with information and strategies from the Texas First Responder Immunization Toolkit to help increase vaccination rates within first responder organizations by recommending adult immunizations to their staff, increasing the utilization of ImmTrac2 to record immunizations for consented adults, and raising awareness of the importance of adult immunizations among first responders. Objectives: increase knowledge and awareness of the importance of adult immunizations among first responders and their families / increase the number of first responder organizations who recommend adult immunizations to their staff, including the annual influenza vaccine / increase the utilization of ImmTrac2 to gain consent and record immunizations for first responders / provide resources for ongoing education and training on adult immunizations for first responders.

The procedural side of emergency medicine can be challenging, rewarding, and even impossible all at the same time (just ask the person next to you)! As an example, airway access and ventilation management are unquestionably vital to patient care yet published problems with our ability “somehow” appear debatable. Unfortunately (for all of us), we continue to ask the same questions before, during, and after a clinical problem yet just keep repeating the same skills introductions, training routines, and practice sessions with the expectation of a different outcome. This talk—which offers concrete evidence and examples – targets solutions (rather than just illumination). Let us help you reframe our procedural issues and highlight what’s needed in EMS to effect quantifiable change. Objectives: compare and contrast algorithm usage for education and training – vs – emergent applications / highlight education, training, and the experience needed to for quantifiable change in airway access and ventilation management outcomes / define the origins of flexibility in the face of “complex” airway challenges.

In the early phases of illness, epiglottitis and croup share many clinical characteristics. Although both cause respiratory distress in children, one isn’t generally serious while the other is potentially life-threatening. Early differentiation between these two types of infections is vital to avoid misdiagnosis and life-threatening acute airway obstruction and peripheral circulatory failure. This case-based session will provide a framework for EMS crews to differentiate between epiglottitis and croup along with current evidence-based treatment recommendations. Objectives: recall the components of the pediatric assessment triangle / differentiate between croup and epiglottitis / list the most common cause of epiglottitis / formulate a treatment plan for the field management of a child suffering from epiglottitis.

This lecture will discuss the pharmacokinetics and pharmacodynamics of illicit street drugs assigned to seven different drug categories and their effect on the human body. We will discuss simple and reliable exams involving pupillary response, pupillary convergence, nystagmus, Romberg test, and others to help make a differential diagnosis in the altered patient suspected of drug impairment. These exams have been used by narcotics law enforcement officers all over the country, however, are rarely taught to EMS. EMS is behind the curve with these patients because a “Tox screen” for us is not available in the prehospital setting. Utilizing these quick assessments EMS will be able to quickly rule in / rule out illicit substance impairment with high accuracy when our patients are well…less than forthcoming with information. Objectives: identify the seven main drug categories of illicit substances and their commonly found forms in the United States / relate illicit substance pharmacokinetics and pharmacodynamics to their manifestations and alterations in the human body / utilize the seven-step process to evaluate a patient for illicit substance impairment to form an accurate prehospital differential diagnosis / review legal considerations and best practices for EMS documentation regarding these impaired patients.

We teach EMTs to ask their patients for a list of the medications or to take the medication to the hospital with them, but do we teach them what those medications mean to our patient’s health history? This presentation will discuss medication commonly seen on patient’s medication lists and how we can develop a patient’s past medical history based on those medication lists. We will discuss how some of those medication may interact with the drugs you might administer in the back of the ambulance. Objectives: review basic pharmacology for the EMT / identify medications commonly found by lifespan/age including homeopathic/OTC / discuss patient medical history based on medications / test audience knowledge on specific medications commonly found on medication lists.

Operating a rural/frontier EMS organization in today’s economic climate can be challenging. Join Greg, Eddie and Dr. Vankawala for a 20+ year perspective on their roles as frontier healthcare providers. Objectives: participate in information sharing / discuss ways to increase recruitment / develop ideas and best practices for reimbursement / examine the EMS profession and personnel.

Contrast and compare the different models of rural EMS ambulance providers and the levels of service they provide. We will investigate why they should differ from urban and suburban services and why they need to provide a more advanced and state-of-the-art level care than their city-based counter parts. Objectives: differentiate between city and rural providers / describe the importance of providing higher levels of care for rural patients / explore practices you can start today for no or low cost to improve your care for rural patients / discuss resources to obtain more specialized equipment and training to better serve the rural patient.

As populations age, EMS is asked to attend to a growing number of uninjured elderly fallers. What should we do with them? The session looks at how we can identify causes of falls, how we can safely get a faller off the floor, and what should our next steps be? Is there a role for EMS in falls prevention? Objectives: discuss why EMS is needed for uninjured fallers / differentiate between causes of falls / explain how we get them off the floor / explore reasons they would need to go to the hospital.

Probably no area of EMS education has more misinformation and dogma than medical-legal issues. For many providers, the thought of lawsuits and being sued causes instant fear. Much of that fear can be attributed to a fear of the unknown. The best antidote for this fear is a thorough understanding of the concept of negligence. In other words, how EMS professionals can be sued for and equally importantly, what they can’t be sued for. Objectives: gain a familiarity with jurisdictions / understand what constitutes “binding” law / understand the elements of negligence / gain familiarity with protections from liability.

Attend the EMS medical director cage match to see some of your favorite Texas EMS medical directors battle over the “hottest topics” in prehospital medicine. We will be sure to have polarized topics that you can bet this EMS physician panel will likely battle over, and chances are the audience can throw out topics to get them worked into a frenzy too! Bring your popcorn and let’s get ready to rumble! Objectives: appreciate different clinical opinions on ‘hot’ clinical topics that vary from agency to agency and medical director to medical director / discuss the importance of literature in making a clinical argument for or against changes in prehospital medical practice / list some prehospital ‘hot topics’ affecting the provision of prehospital care in Texas and the United States today.

Many routine household items present dangers to the pediatric population, but button batteries and strong (rare earth) magnets are being ingested with increasing frequency. These ingestions are true surgical emergencies that need to be recognized by prehospital personnel. In this interactive, case-based presentation, participants will learn about the dangers of button batteries and strong magnets, and learn what to do if they are taking care of a patient who has ingested one of these. Objectives: describe what constitutes a button battery and what constitutes a strong magnet / explain why ingestion of button batteries and strong magnets is a true emergency / discuss management of a patient who has ingested a button battery or strong magnet / discuss ways to prevent button battery and strong magnet ingestions.

Sports-related concussions are serious, widely prevalent, and often under-reported traumatic brain injuries. This presentation discusses the pathophysiology and sequelae of concussion as well as proper identification, evaluation, and patient management. Severe, moderate, and even mild concussions have a high potential for significant long-term deleterious effects on an athlete. Extensive anatomical and physiological damage may be present from just one traumatic blow to the head. Advocating for an athlete to sit out the rest of an event by knowing the signs and symptoms specific to a concussion may be the difference between a decent versus a terrible outcome. Objectives: describe the pathophysiology of a concussion / explain the unique considerations when assessing an athlete with possible concussion / list the proper steps in managing a patient that is suffering from a concussion or showing signs of TBI / discuss the various unique signs and symptoms of a concussion.

This lecture will focus on the challenges, rewards, and basics of a community paramedic program. Addressed will be funding sources, partnerships, service coordination and client identification. Commonly, EMS services are identifying the need for a community paramedic program, but once the project is started, the providers have very little guidance on structure and framework. The Williamson County Community Paramedic model has moved through many transitions and continues to flex and pivot to the needs of partners and the community. There have been many lessons learned and areas to continue to grow, which can be shared with other programs. Objectives: learn how to identify clients / learn how to identify partners / learn how to pursue some basic funding sources / learn how to assess their team and provider bandwidth.

So often we talk about the “bad calls.” What we should be focusing on, are the positive ones. We all have plenty of calls that drag us down and make us question our choice of profession. While important to learn from, these calls don’t build us up. Come while I share some of the Mile-Hi Moments in my career. Together we will remember all the awesome reasons that we chose EMS as our profession, and why there is nothing else we would rather do. What you do is important, and this presentation will remind you why. Objectives: identify the importance of focusing on positive career points / list reasons why we chose EMS as a profession / demonstrate that the job we do is important and that we are valuable / list identifying factors for RVI.

San Antonio Fire Department applies the latest in cutting-edge hemorrhage control and care. This advanced level of trauma care is possible because Texas is a delegated medical practice state. This means that the EMS medical director can train and deploy advanced trauma care paramedics for critically injured trauma patients. San Antonio Fire Department has deployed digital blocks prehospital, resulting in true pain control for the injured digit. The department performs instrument and novel device thoracostomy for patients with severe thoracic injuries. Discussion of a modified thoracotomy will also be discussed. The department is reviewing the use of an abdominal aortic junctional tourniquet for critically injured trauma patients. SAFD medial special operations team has developed a novel prehospital amputation process where the paramedics will perform the amputation. There will be a discussion about these advanced trauma tactics and how they can be deployed in EMS systems to treat patients and save lives. Objectives: discuss alternatives to invasive techniques for hemorrhage control such as the abdominal aortic junctional tourniquet (AAJT) / review advanced device thoracostomy and thoracotomy procedure performed in cadaver lab in San Antonio / discuss the digital blocks and amputations, equipment, training and best practice / discuss logistical challenges related to deploying advanced trauma treatments in the prehospital setting.

This session will explore mentoring with connections to the EMS profession, which is a unique multi-generational and interprofessional workforce. This certainly creates challenges while providing for opportunities to reflect on past mentorship experiences and comparing successful to failed mentoring. Often mentoring only focuses on a professional context, despite the interdependent aspects of relationships, finances, and health. This session will facilitate a discussion to explore all four life aspects for a more holistic approach to mentorship along with providing resources to improve all our approaches to mentoring. Objectives: identify the need for mentoring in four life aspects – professional, relationships, finances, and health / summarize successful mentoring to failed mentoring in healthcare / integrate resources and content into a mentoring relationship / design an approach to being a mentor in EMS.

Coffee, cookies, and CE. Ask State EMS Director Joe Schmider all your burning questions. Objectives: improve knowledge of Texas EMS / improve knowledge of state processes / improve understanding of legal issues in EMS / improve understanding of DSHS.

This lecture will improve trauma center staff awareness of the ED pediatric readiness requirements proposed in the new Texas trauma rules. The American College of Surgeons (ACS) has established new standards requiring ED’s to assess their pediatric readiness through participation in the National Pediatric Readiness Project and to develop plans for addressing gaps in their pediatric readiness score. The evidence is clear that higher pediatric readiness scores in trauma center ED’s improve pediatric trauma outcomes. Objectives: articulate how to find the Pediatric Readiness in the Emergency Department joint policy statement / discuss how to locate the National Pediatric Readiness Project (NPRP) portal, complete the NPRP assessment and address the gap report / describe the value of identifying a pediatric emergency care coordinator and their influence on pediatric readiness / identify additional resources to assist in improving the hospital’s pediatric readiness score.