2022 Course Descriptions – Tuesday

For years EMS has been trying to perfect cardiac compressions by measuring rate, depth, on time, off time, CCR’s, metronomes, and apps, and it seems different devices come out all the time to enhance our ability to do so. But just as compressions were being emphasized, ventilations were being de-emphasized, or even eliminated altogether! First, they traded an adult BVM for a pediatric one; then they took that away also, with good reason. Numerous studies show that without controls, everyone always over-ventilates, hyperventilates, or under-ventilates with a BVM.  This talk asks the question: what if we had the tools to perform High Performance Ventilations? Would this not be the ultimate companion to high performance compressions? Those tools now exist. Tools that measure Rate, Volume and Pressure. Come and learn how statewide, providers in Virginia participated in simulation trials that proved ventilations can be measured and improved as precise as compressions are, even at the BLS levels at a fraction of the costs of mechanical ventilators. This talk is a game-changer. Come and see how to put the “P” back in your CPR! Objectives: describe how rate, volume, and pressure control is necessary for ventilating a patient / describe how overventilation affects chest compressions during CPR / describe what is needed to perform HPV / describe the performance role of ETCO2 in HPV.

We will discuss the lessons learned during the MCI that occurred in Colorado Springs in November of 2022. We will compare previous mass shootings in Las Vegas and Colorado for similar lessons learned. Objectives: discuss major lessons learned and opportunities for improvement from the mass shooting in Colorado, from the perspective of EMS / understand how to develop steps that EMS agencies and health systems need to take to respond to the immediate-, short- and long-term needs of victims of mass violence / demonstrate how coordinated planning to mass violence incidents leads to resiliency for victims and care givers / describe the police and EMS coordination of patient triage and transport.

These are not your run-of-the-mill orthopedic injuries. Interactive case studies will be used to address the critical aspects for identifying Malgaigne, Pipkin, Chance, Jefferson, and Salter-Harris fractures. Once identified, there are important clinical considerations EMS providers need to be aware of to properly manage these injuries. Objectives: recognize common mechanism of injuries associated with Malgaigne, Pipkin, Chance, Jefferson, and Salter-Harris fractures / discuss the clinical significance associated with Malgaigne, Pipkin, Chance, Jefferson, and Salter-Harris fractures / identify the management priorities associated with Malgaigne, Pipkin, Chance, Jefferson, and Salter-Harris fractures / describe why this information is relevant to their clinical practice.

Implicit bias has a significant impact on the care provided by EMS. This presentation explores the challenging topic of implicit bias, examining how it leads to disparate treatment of patients based on race, gender, disability, and sexual orientation, among others. Implicit bias is NOT the same as racism or explicit discrimination. Instead, implicit bias arises from our unconscious associations. We’ll explore the impact it has and the steps we must take to address it, including increasing awareness of implicit bias, hiring a more diverse workforce, and engaging EMS leaders and medical directors in the conversation. Addressing implicit bias has the potential to improve patient outcomes and lead to a more positive relationship with the communities we serve. Objectives: understand the impact of implicit bias on the care provided by EMS / discuss how implicit bias is distinguished from racism and actual discrimination / understand how implicit bias impacts different groups of patients / explore how to address implicit bias.

Accidental hypothermia (AH) is an unintentional drop in core temperature to 35°C or below. While environmental exposure in winter is the most commonly associated risk factor, AH can occur in any season, in any climate (even in Texas!), and in a wide range of settings due to trauma, medical illness, and even iatrogenic (during resuscitation). This presentation reviews key EMS concepts to optimize patient outcome: proper assessment and rapid rewarming, coupled with unique principles of BLS, ILS and ALS emergency care for related complications, and triage to an appropriate receiving hospital. Objectives: explain the difference between primary and secondary accidental hypothermia / recognize the clinical stages of accidental hypothermia / describe unique clinical features of different stages of accidental hypothermia / describe basic principles of BLS and ALS EMS treatment and triage.

Lawsuits are in the news every day and EMS is not immune. Come listen to this riveting presentation of a multimillion-dollar verdict presented not by an attorney but by the Plaintiff’s expert that testified in the case. Objectives: describe in detail the facts of the case / define negligence and gross negligence / describe what it takes to become an expert witness / describe techniques to legally reduce your liability.

Ill and injured children have unique needs that can be magnified when the child’s ailment is serious or life-threatening. This is especially true in an out-of-hospital environment. It is important that all EMS agencies have the appropriate resources, including physician oversight, trained and competent staff, education, policies, medications, equipment, and supplies to provide effective emergency care for children. This presentation will discuss the principles in the joint policy statement, “Pediatric Readiness in Emergency Medical Services Systems.” These principles establish a foundation on which to build optimal pediatric care within EMS systems and serve as a resource for clinical and administrative EMS leaders. Objectives: identify areas in EMS systems where improvements can be made to transform health care for pediatric patients / list recommendations for integrating pediatric specific components into EMS systems / list the roles and responsibilities of a Prehospital Pediatric Emergency Care Coordinator (PECC) / describe the components of the Texas EMS for Children EMS Recognition Program.

We all know about signs; they tell us where to go and what to do. How familiar are you with all the medical signs running around? In this presentation, we will cover a myriad of common signs, what to look for, how to test for them, and what they mean. If you have ever stuck your Babinski sign in your mouth, you know what a pain in the Grey-Turner sign that can be. So come in and we will take a minute to talk about all the Cullen’s, Battle’s and Kernigs in the group. Be prepared to walk away as the new assessment ace in your house. Objectives: identify common signs associated with specific assessment findings / describe how to differentiate these signs in the setting of an assessment / list multiple assessment signs and their causes.

We often focus on the data that we need from an ePCR, and not the documentation burden that this creates for providers in the field. This leads to medic frustration, an increase in “close-call rules,” and overall ineffective documentation. By making documentation easier and teaching providers the “why” rather than relying on close-call rules, the City of Austin has increased documentation compliance while making it easier on the field providers. Objectives: learn how to make their case to providers in a way that gets commitment from the field to document well / learn the guiding theory behind Austin’s use of ePCRs to get better documentation by lowering the documentation burden / understand how Austin now uses that documentation to guide everything from medication purchasing to unit deployment / understand how ongoing education can target documentation without causing a burden or boredom during CE activities.

The Texas Health and Human Services (HHS) office of Aging Services Coordination (ASC) session will present an overview of resources available for both First Responders and older adults, as well as highlight important aging considerations that involve emergency response, person-centered and trauma-informed care approaches, as well as effective communication methods for older adults experiencing emergency situations. This session will provide resources and an interactive small group activity. Objectives: describe the mission and role of the office of Aging Services Coordination in Texas Health and Human Services (HHS) / identify strategies for communicating with older adults who may have hearing loss, vision loss, dementia and/or history of trauma / describe person-centered and trauma-informed care approaches that Emergency Responders can utilize when assisting an older adult during an emergency / summarize factors that can impact the physical and cognitive health and general safety of older adults in emergency response situations.

At the completion of this session, first responders, EMT’s and paramedics will have a better understanding of how the body can be injured in a collision. This session will include a unique slide show that shows how some injuries may occur from safety devices such as seat belts and air bags. We will discuss and demonstrate rapid forward deceleration and rear-end collisions. An explanation of how to provide both BLS & ALS care will be discussed. We will also explore motor vehicle collisions that happen on the farm and the back roads of Texas farm and ranch country. This session is designed to show how EMS crews sometimes become victims of ambulance crashes. We will speak openly about the importance of defensive driving programs, following the rules of the road, speeding, distractions, and lack of knowledge about ambulances by some drivers. Objectives: discuss injuries sustained in Motor Vehicle Collisions / discuss mechanism of injury and kinetic energy / learn about vehicle safety devices and responder safety / understand the Golden Hour and Golden Period / learn how vehicle occupants become patients and how to provide both BLS and ALS patient care.

Managing injuries to the neck can be both complex and challenging for the pre-hospital provider, as it is the location for many vital structures. Many of these structural injuries carry with them a high probability of morbidity and mortality. Whether the injury is blunt or penetrating, the EMS provider must maintain a high index of suspicion even if the patient appears to have only minor superficial injuries. This presentation will discuss the anatomy of the neck, zones of neck injury, and management strategies to assist the EMS professional maintain a high index of suspicion and deliver optimal care for victims of neck trauma. Objectives: discuss the management of traumatic neck injuries / identify the three injury zones of the neck / explain the assessment keys of a traumatic neck injury / list key structures of the neck.

You are called to transport a patient with diabetes insipidus: what is water diabetes all about?  During this presentation we will discuss the major endocrine disorders that may be encountered in emergency and transport settings. In addition to diabetes, pituitary, thyroid, and adrenal conditions can complicate acute illness or injury, or are the primary reason the patient needs emergency care and transport. The pathophysiology, clinical manifestations, and management of these conditions and emergencies will be reviewed. Objectives: describe the pathophysiology related to the major endocrine disorders that may be encountered in transport and emergency care settings / recognize the signs and symptoms of the major endocrine disorders / discuss the management priorities when treating patients with an emergent endocrine disorder / recall key components to electrolyte imbalances associated with endocrine dysfunction.

It is not the knowledge or the skill in isolation that saves lives, it’s the combination of the two that makes a difference. This lecture covers the “REASON FOR” – right next to the – “HOW TO” with information straight off the street, and directly out of the lab! This deep dive into the clinical necessities, anatomical realities, and procedural nuances will come “alive” with the latest evidence, as well as newly created graphics and videos to completely illuminate (and mitigate) the most perplexing procedural problems. Objectives: define terms and explain the differences between education and training / highlight, identify, and sequentially orient select skills from point of indication to procedural completion / access newly created illustrations and video materials that, when combined with quality education and hands-on training, refresh high-value/low-frequency skills.

Staffing shortages are prevalent in nearly every healthcare profession, but most notable are the vacancies within the EMS profession. In October 2021, The Texas Legislature passed a $21.7 million EMS education and recruitment initiative as part of its American Rescue Plan Act, and in 2022, the TDSHS actively began to institute their recruitment and retention program for EMS personnel. But once hired, how does an EMS organization retain employees for the “long-haul” in addition to fostering a culture of giving back to the organization and the community they serve? In this lecture, hear from a current employee (not a supervisor or manager) of one such organization that has a successful track record of employee retention, low turnover, and how you can institute some of these practices in your agency. Objectives: understand the critical shortages within the EMS community and what has contributed to these shortages / understand why employees leave their jobs and/ or careers and what management can do to reduce turnover / understand the EMS education and recruitment initiative and its’ impact on EMS / understand key strategies to develop a workplace culture that promotes employee retention.

Coffee, donuts, 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.

Ask most pre-hospital providers what type of call strikes fear into their hearts and the answer is usually anything to do with Pediatrics. Participants will be taken through the normal physiologic differences with our smaller population and then relate that to how it affects the traumatically injured victim. Participants will be given the information to help determine treatment courses for this challenging subset of trauma victims. Objectives: describe the physical assessment of the pediatric trauma patient / describe treatment strategies for the pediatric trauma patient / discuss the key physiologic and anatomical features of children versus adult patients / recognize non-accidental trauma injuries in the pediatric population.

The last known well time prior to having a stroke is a critical piece of information. While the most common strokes may include facial symmetry, arm drift, changes in speech, and time, there are other presentations that could very well be a stroke as well. In this case-based session, we will discuss signs and symptoms which may identify this condition and offer tools that can help guide interventions for your patients. Objectives: differentiate between hemorrhagic and ischemic stroke / recall most common stroke signs and symptoms / describe unusual signs and symptoms involving stroke / list essential steps in identifying and treating stroke.

In this lecture we will present evidence and data to support why it may be time to take a hard look at current C-Spine protocols and their continued use. We will discuss risks and benefits of cervical collars for immobilization and explore if there are any practical purposes behind our current C-spine guidelines in EMS. Objectives: discuss the anatomy of the C-Spine and range of motion in regard to cervical collars / examine the evidence that supports patient immobilization / discuss and evaluate the potential harm of using cervical collars in suspected C-Spine injuries / propose alternatives for packaging these patients.

More than a decade ago, the Dallas Fire-Rescue Department began a process to develop and implement a state-of-the-art and science EMS quality management plan and program. This one-hour panel presentation will detail the purpose of having a strong quality management plan and how to go from concept to executable plan. We will discuss challenges in developing and implementing the plan, and review a case study in quality management that resulted from the plan and program. Objectives: understand the important of having a comprehensive quality management plan and program / recognize the challenges involved in developing and implement an EMS quality management plan / appreciate the possible consequences of having no or an inadequate quality management plan or program / utilize the concepts discussed in the presentation to help further develop their own agent’s quality management plan and program.

When was the last time you cared for a critically ill child? When was the last time you had to manage a child with a critical airway? In this workshop, EMS clinicians will practice hands-on resuscitation skills for pediatric emergencies with experts in simulation and pediatrics. You will have the opportunity to practice resuscitation techniques for traumatic and medical emergencies through realistic scenarios. Objectives: recognize signs and symptoms of respiratory distress in a pediatric patient / improve competency with pediatric airway management / recognize common pediatric traumatic injuries / practice prioritizing procedures in the critical pediatric patient.

When an eye injury occurs, do you know what to do? We will explore new recommendations on treating ocular injuries, including throwing away those eye patches and stop damaging eyes. Tools for field irrigation and field treatment for better ocular injury outcomes will be explored. Objectives: identify ocular trauma / explore field treatment of chemical to the eyes / analyze field treatment of ocular trauma.

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 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. State of the art A.I. has made incredible advances in interpretation. Leave it to Virginia State educator and stethoscopy instructor Bob Page to be all over it. Come and learn about this new technology! Objectives: list the advantages of the digital stethoscope in EMS / describe the correlations between the ECG (Electrocardiogram) and the PCG (Phonocardiogram) / discuss the clinical benefits of heart sound assessments.

More electric vehicles and hybrid-electric vehicles are hitting the roadways every day. Couple that with the dangers of the differing autonomy levels deployed on Texas Roadways. Are we prepared? We will discuss special considerations, hazards, and safe practices when responding to these new vehicles and how it may affect patient assessment. Objectives: explore post-crash care – special considerations of responding to calls involving EVs, HEVs, vehicles equipped with autonomy features / describe potential hazards while on scene / discuss the changing complexity of the event especially in the rural areas / review concepts and principles to promote responder safety.

The numbers of patients on anti-coagulants seen in our nation’s emergency rooms is rapidly growing. Anticoagulation is used for anything from atrial fibrillation to coronary artery disease, to daily use in our nation’s hospitals for DVT prophylaxis. This topic will cover the basics of how the numerous medications work and the implications associated with patient care in a case-based approach, including ways to mitigate and/or reverse their effects on our patients who are suffering from hemorrhage. Objectives: gain a basic understanding of the physiology of clotting and its indications in patient care / gain a basic understanding of the pharmacology and indications for  use of anti-coagulant medications / gain a basic understanding of the management of Intracranial hemorrhage in the setting of an anti-coagulated  patient / gain and understanding of the use of blood products and medications that may be used to mitigate the effect of certain anticoagulation.

For years, CoAEMSP guidelines required only five successful intubations to graduate from accredited paramedic programs. The vast majority of these intubations were performed on NPO patients in a controlled anesthesia setting unlike anything a paramedic will ever see in the field, and many graduates of these programs hit the streets “not knowing what they didn’t know.” Advanced airway management success hinges on having a backup plan, and then another. Join Kelly Grayson as he discusses when and how to escalate to a more invasive and secure airway, and when to elevate care. Objectives: discuss the importance of an application of apneic oxygenation / discuss the role and importance of PEEP in BVM ventilation / discuss and describe the Pit Crew approach to RSI and DSI / discuss and describe the merits and limitations of various supraglottic airway devices / discuss and describe various surgical cricothyroidotomy techniques.

Times are changing. Modern-day EMS administrators, supervisors, and rank-and-file officers are facing new crises and a much more adversarial media market every day. This class will review recent arrests, high-profile, in-care deaths, and the communications tools, tips, and techniques to manage the crisis and protect the long-term integrity and trust of the agency brand. Don’t let your next crisis be your last, prepare now with Crisis Communications 101. Objectives: review the media news cycle and how news works / discuss recent high-profile patient deaths and the communications crisis that followed / explain how to prepare for predictable crisis and the strategic communications process / review crisis planning, the strategic communications process, and the process for working with the media in a crisis.

As clinical manager for El Campo EMS, a rural EMS provider in Southeast Texas, I created a new way for priority dispatching to be accomplished successfully without expensive dispatching software or requiring police-based dispatchers to attend additional training. By conducting a needs assessment and review of our calls and transports, I created five questions that dispatch now asks every caller. The answers they are provided are run through a quick decision matrix to arrive at the decision to send EMS emergency traffic or non-emergency traffic. To date, the program has reduced our lights and sirens responses by 60% with no complications. My goal would be to present how this program came about from planning to research to implementation. I would also provide a planning guide and documentation for attendees so that any rural agency could return home and present this information to their agency for development and implementation. Objectives: enhance information sharing among rural EMS providers and show that urban programs and initiatives can be successful in the rural setting / illustrate that data in the rural setting can be useful in designing service implementation changes that help improve safety / demonstrate an effective way to bring about change in a rural EMS agency / create the idea that thinking outside the box in EMS is necessary and that there are many way of doing something if you find the right approach.

Now that the world is opening again, more and more events are taking place; concerts, festivals and sporting events have all come back for the public to enjoy. How do we make sure we have adequate medical coverage for these events? Who decides the parameters for the coverage provided? We will explore and learn from the Manchester arena bombing. Objectives: define an EMS event / describe standards applied to an EMS event / explore what we learned from the Manchester bombing / discuss who is responsible for setting the standard.

This lecture provides emergency clinicians with up-to-date information about autism and treatment in the emergency environment. Within this lecture learners will be given tips and evidenced-based recommendations to improve their assessment and provide treatment that serves to improve overall outcomes in this population. Objectives: discuss scientific updates and facts about ASD / explain characteristics linked to patients with ASD / discuss injuries and illnesses associated with ASD / recommend plans to improve communication and assessment.

We will review the challenges and potential safety implications of communicating with patients with limited English language proficiency (LEP). Best practices will be offered through case discussions, audience feedback, and a recent literature review. Objectives: identify patient care scenarios where an interpretation service would aid in the assessment or treatment of a patient / recognize high-risk patients who need interpretation services and the potential delays to care in time-sensitive diagnoses without interpretation services / consider scene safety factors for team members and bystanders when LEP hampers communication between the staff and the patient / evaluate strategies for implementing language solutions to improve patient communications in the prehospital environment.

Taking ownership and of the system’s clinical shortfalls, the Austin Office of the Chief Medical Officer engaged operational personnel into clinical leadership positions. By spending ten minutes each day teaching commanders why specific interventions and how we document them are important, we have the commanders into the quality management team. By force-multiplying the group that provides clinical feedback, we have seen our organization change to where medics compete to be the best and regularly ask how they can improve both their care and documentation. When district commanders get involved, patient care improves. Objectives: understand how to develop clinical performance indicators and operationalize those to drive clinical improvement / understand how targeted training of mid-level supervisors by medical directors helps supervisors become effective teachers to front-line staff / understand how to use quality management to improve all providers rather than focusing solely on event review / understand how data-driven training can help providers provide better care and document that care effectively.

Not a participant in Medicare’s Emergency Triage, Treatment and Transport (ET3) Model? That’s OK! Did you know that Texas Medicaid and other payers have finally awoken to the fact that the value of EMS has less to do with TRANSPORT than it does service delivery. In this session, hear how payers, including Texas Medicaid, and EMS agencies have partnered to implement new economic models that pay for service vs. simply transport. What were the challenges? What have been the early lessons learned?  What are the keys to implementation? This will be a very dynamic and interactive session with ample opportunity for participant engagement. Objectives: learn how payers other than Medicare are seeking to pay for ET3-like service models / learn the key partnerships necessary for successful implementation of an ET3 model / understand the financial modeling to evaluate the impact of ET3 model implementation / learn the myths and realities for a successful ET3 model implementation / understand the data metrics necessary to demonstrate value of an ET3 model implementation.

A healthy immune system defends the body against disease and infection. But if the immune system malfunctions, it mistakenly attacks healthy cells, tissues, and organs. Called autoimmune disease, these attacks can affect any part of the body, weakening bodily functions, and even turning life-threatening. Most of these diseases have no cure, and some require lifelong management to ease a patient’s symptoms. This presentation will discuss some of the common patients you may encounter and how to best manage their underlying condition. Objectives: define autoimmunity / discuss the signs and symptoms of various autoimmune diseases / explain the EMS management of various autoimmune diseases / list three causes of autoimmune diseases.

Congestive heart failure (CHF) is a common disease process encountered by prehospital emergency care providers. Treatment for these patients can be complex, and the potential for acute clinical deterioration can be quite high. However, by understanding the pathophysiology of CHF, you can direct your treatment more specifically, and effect clinical improvement before the patient is delivered to the hospital. This presentation begins with a review of the physiological processes of stroke volume, Starling’s law of the heart, cardiac output, and ventricular ejection fraction. We will then discuss pathophysiology and clinical presentations of left and right heart failure. Specific treatment modalities discussed include CPAP/BiPAP and nitroglycerin, the hallmarks of CHF treatment, as well as other BLS and ALS treatment strategies. Objectives: understand the physiological processes of stroke volume, Starling’s law of the heart, cardiac output, and ventricular ejection fraction / define congestive heart failure / compare and contrast left and right heart failure / describe current prehospital treatment strategies for congestive heart failure.

We all “KNOW” using red lights and sirens saves lives. But do they? Do they really? What does the literature say about this? Dr. Jarvis will review the evidence behind this practice. He will also discuss a research project he did with a large, national EMS dataset which calculated the clinical yield of using red lights and sirens for scene responses. This research provides an evidenced-based framework EMS agencies can use to use red lights and sirens more appropriately in their systems. Finally, he provides data-driven examples from two EMS systems on how they safely reduced red lights and sirens use. Objectives: describe the literature surrounding time saved using red lights and sirens (RLS) / describe the literature surrounding the association between RLS use and crashes / describe the literature surrounding the clinical benefit for RLS responses to scenes / describe the literature surrounding the clinical benefit for RLS transports to hospital / describe the literature surrounding the methodology for developing safe RLS use policy.

This presentation is inspired by the Office of Strategic Services’ “Simple Sabotage Field Manual,” a declassified WWII document describing ways to sabotage the enemy. Ironically, many of those methods of sabotage are practiced today in EMS agencies, and by EMS personnel all over. Attendees will discover some potential causes of self-sabotage in their professional lives and within their organization, along with ways to resolve them to improve efficiency, productivity, and morale. Objectives: review Simple Sabotage Field Manual / identify methods of self-sabotage by EMS professionals and employees / identify methods of self-sabotage by leaders / discuss preventative measures to avoid self-sabotage.

Planning and operating sport and special events in the rural setting with limited resources, with an emphasis on utilizing state and local assets. This challenging environment accounts for the majority of sport and special events in the state, and resource management is key. Objectives: quantify risk assessment / describe risk mitigation based on assessment / identify how to locate available resources / explore best practice guidelines for running large scale events based on real world experience and case studies.

Every year, Texas Schools use buses to transport athletics, bands, and other groups across the state. These trips are not just within the individual School District but can be hours away. There can be single or multiple buses traveling in convoy. Where do you find assistance when the school involved is not from your area? How can you find information about the students on the bus? Objectives: discuss how to get critical information about students involved in school related transportation incidents / identify resources to assist with moving potentiality large numbers of students from your scene / discuss options to reunite the students with appropriate officials / discuss limitations of student data availability.

This session covers the underlying pathology of anaphylaxis and allergic reactions, and we will review the treatment modalities with particular attention towards Epinephrine. Many agencies have moved away from the Epinephrine auto-injector as it is cost prohibitive and instead moved to permitting BLS personnel to administer the medication after drawing it up traditionally. Let’s discuss how to implement such a training program in your agency. Objectives: describe and compare the following conditions of Anaphylaxis and anaphylactoid reactions, Allergic reactions, Angioedema, Drug allergies / identify emergent and non-emergent treatment and pharmacological interventions used in the management for anaphylactic & other allergic reactions / list the signs and symptoms of an anaphylactic reaction / discuss why anaphylaxis is undertreated.

Kids really are small adults – but when they’re super tiny, caring for them gets a bit more intimidating.  This talk will identify unique needs related to their tiny anatomy and altered pathophysiology.  We’ll also go over potential additional equipment and training needs, as well as identifying training resources like micro-preemie mannequins and resources that your children’s hospital may help with.  This talk will also briefly review long term challenges that this population may face, such as intracranial hemorrhage, cerebral palsy, necrotizing enterocolitis, and respiratory complications. Objectives: identify unique challenges to this population both in the acute setting and long-term complications / explain changes in pathophysiology and anatomy and identify ways to address these / list additional needs for equipment and training / gain confidence in caring for these patients.

Paramedic textbooks only have a few pages regarding the death and dying of patients. In fact, most of what we have learned is about saving a life, not letting it go. However, dealing with a dead or dying patient is often some of the most emotionally challenging calls we face, especially if unprepared. This lecture talks about strategies involving letting the family know their loved one is dead, the conversation rhythm for terminating resuscitation, and information regarding hospice and other programs that can benefit the patient. Objectives: discuss considerations and tactics when notifying the family of the death of a loved one / explore considerations and tactics when engaging the family in conversation regarding terminating resuscitation / understand the treatment goals and interventions when treating a hospice patient / learn the resources and benefits that hospice and other programs can offer to meet a patient’s needs.

This specialty workshop is a deeper dive into hands-on skills related to knowledge from prior service animal awareness training. This includes discussion and interactive hands-on practices with demonstrations. A brief review of ADA related knowledge will be available. However, this year, first responders will be able to hone their skills in emergency handling of a service animal through understanding various equipment and how to safely accommodate the disabled handler, service animal, and navigate a variety of service animal equipment being used. Participants will be introduced to best practices, identify properly fitted and safely connecting to training collars, head halter basics, mobility harnesses, and other types of equipment a first responder may be exposed to during emergent handling. Participants can become familiar with related resources to appropriate and safe handling. Objectives: understand how to identify safe fitting and securing of training collars (slip vs. Starmark for example) and differences between training collars or harnesses frequently used on service animals that first responders may encounter / secure placement of the service animal during transport or transitions in patient care handoffs / create an emergency plan that is successful in transporting the assistance animal when a crew is unable to accommodate and familiarity in how to troubleshoot potential situations that may arise during patient care for the disabled service animal handler / demonstrate consistency with basic verbal cues and how to issue basic commands effectively as first responders stepping into emergency handling during patient care.

Dr. Abraham and Brandon Glenn will present the experience that Harris County ESD #6 – North Channel EMS has had since implementing body camera footage into their Quality Assurance and Quality Improvement program. They will discuss how the body cameras have changed how they review calls, how they train differently, and how this has affected their organization from the ground up. The remainder of the lecture time will be a rapid-fire question session that will allow attendees to ask questions about body cameras and the process of using it in the QA process. Objectives: explore improving patient care and medic performance – a tool for EMS leadership / review evidence-based material for medicine and body cameras / discuss how to use videos to help train EMTs and Paramedics using real-time and real-world feedback / describe challenges and pitfalls of body camera footage in a QA program.

Social determinants of health (SDOH) are factors in the environment where our patients live, which influence their level of health. Patients often have numerous SDOH which we must uncover.  Are there SDOH that when resolved effect the most change? How can an EMS (Emergency Medical Services) agency determine where to direct their efforts with the most benefit for the patient? In this discussion we explore SDOH found in an MIH program screening, and how their resolution has affected this population’s subjective and objective health status. We will explore methods to resolve and mitigate SDOH. Further, we will explore how the client’s SDOH and our addressing of them affects the community paramedicine professional. Objectives: understand SDOH and how they affect client outcomes / summarize how to screen for SDOH and best resolve or mitigate their effects on clients / analyze how the mitigation of specific SDOH affects client outcomes / evaluate how the client’s SDOH affects the community paramedic.

Limb amputation in the prehospital setting is a rare but a potentially life-saving procedure. Most EMS agencies involved in one of these incidents have few protocols and even less training to prepare for one. Dr. Pickett will review the indications, preparation, sedation, analgesia, and performance of this procedure as well as guidelines for operating with a hospital-based surgical team or physician. Clinical guidelines and training programs for paramedics will also be discussed. Objectives: list the four indications for a field amputation / discuss methods to include disarticulation and guillotine amputation / select appropriate tools for amputation / discuss sedation and analgesia for amputation / discuss considerations of working with hospital-based surgical teams in the field.

Continuous Positive Airway Pressure (CPAP) has become standard of care in most EMS systems. And with the addition of disposable devices that provide BiPAP many agencies have added BiPAP to their protocols. The question is, can a non-ALS EMS provider effectively provide this level of therapy? Is it time to bring this type of therapy to rural EMS agencies that most often have longer transport times? This powerful session will unmask why and how CPAP/BiPAP can be effective in treating respiratory distress without a diagnosis or for different disease processes. This session will also reveal the best kept secret that’s often overlooked during CPAP training, a rarely discussed fact that can make the difference between success and failure. In addition, a down-to-earth explanation of the difference between CPAP and BiPAP (and yes, they are different), and which you should be using. Objectives: describe the differences between CPAP and BiPAP / describe current technology being used prehospital for CPAP and BiPAP / describe reasons why CPAP and BiPAP therapy fail / describe how to pick the right device to provide CPAP and BiPAP.

Communication is an essential part of life. If you have problems communicating with someone, your relationship will be very problematic. This includes your family, friends, coworkers, administration, and patients.  This lecture will cover the basics of communication because if you don’t know them, advanced communication skills will not matter and in fact, just make the problem worse. The objectives of this lecture are actually in the national curriculum of the EMT, but I bet you don’t remember covering them. If you can properly communicate, you will make all your relationships better. Objectives: prepare what you want to communicate / review methods for listening to the other person’s response / explore techniques that may help the person feel heard.

It’s hard for an agency to think about death or catastrophic injury happening to one of its members; however, not preparing for such an event can cause even more heartache and stress on everyone involved, should a tragedy occur. The emergency services are good at preparing for disasters and emergencies of all kinds, and preparing for a line of duty death or injury should be no exception. Having a plan in place will help ensure that caring for the family, agency members, putting together a funeral, and caring for long-term needs will run a bit smoother. Objectives: distinguish the level of honors for first responder funerals / start the process of preparing and writing guidelines for their department / identify line-of-duty death benefits and how individuals qualify for the specific benefits / prepare for special circumstances such as multiple fatality incidents.

This lecture will discuss Texas child passenger safety background including the law, use and misuse rates, and injury fatality patterns. We will explore the four stages of child restraint using descriptions, best practice recommendations, child safety seat types, and proper use. In addition, we will provide a description of protective and risk factors for Emergency Medical Services agencies and personnel for the safe transportation of children. The session concludes with child passenger safety (CPS) resources and recommendations for attendees. Objectives: explain the Texas child passenger safety law / describe the types of child safety seats / identify the four stages of restraint use / describe protective factors that can decrease injuries to child passengers / learn how to start a CPS program in your community.

This presentation will focus on Williamson County EMS Community Paramedic’s partnership with the local mental health authority to co-locate Narcan throughout the community and share information to facilitate harm reduction services for suspected opioid overdoses. Objectives: learn how WCEMS Community Paramedics developed an agreement with Bluebonnet Trails Community Services to supply information to facilitate outreach to suspected opioid overdose victims / learn how WCEMS Community Paramedics developed a program to co-locate Narcan in AEDs / learn how WCEMS Community Paramedics developed a tiered deployment for Narcan co-location / learn how WCEMS Community Paramedics work with partners to extend bandwidth and address multiple needs.

During this session, the presenter will talk about the high stress nature of acutely agitated behavior health emergency patients. We will go over the pathophysiology, acute emergency response, and collaborative care with EMS, fire, and other first responders. We will then detail the evidence-based best practices. The nature and dynamics of use of force in these circumstances. The way in which to minimize harm to the individual, first responders, and bystanders. We will discuss physical restraint, medical sedation, legal aspects, and recommendations. The presenter will draw on his decade of experience as an EMT, Sworn Police Officer, and dual board-certified ER Physician and EMS Physician. Objectives: discuss behavioral health emergencies using appropriate terminology and understanding / understand and use the best practices from subject matter expertise and evidence based medicine / describe the pathophysiology, the terminology, and the medical management of behavior health emergency patients to then convey this to department leadership to help mitigate adverse outcomes in these individuals / discuss new protocol and quality management steps to improve care for patients with behavioral emergencies in their own system.

At a time when many services are facing rising demand and increasing response times there is a place for clinical input to calls that are waiting for a response. Low acuity calls are prime examples that could be dealt with by other means. This study looks at the process used in the UK and examines patient outcomes. Objectives: investigate instances to re-triage / explore who should be utilized to perform secondary triage / discuss the potential patient outcomes / explore legal implications.

During this lecture we will review all aspects associated with pulmonary embolisms (PEs). First, a discussion about the risk factors associated with PEs and their vital signs will help the prehospital provider develop their clinical acumen to be able to identify PEs in the prehospital environment. Then a discussion about the different treatment modalities available to gain an appreciation of the very different strategies employed depending on size and clinical significance of different PE. Lastly, we will describe why it is important for the prehospital provider to identify PEs early and work with regional health care systems to identify receiving hospitals with appropriate capability to handle the most severe PEs. Objectives: describe risk factors associated with, signs and symptoms, and vital signs associated with Pes / define the different gradation of PEs such as segmental, sub massive and massive / understand the different treatment modalities available based on size and clinical significance of the PE / gain appreciation for the challenges in identifying appropriate destination receiving facilities.

This interactive lecture will bring relatable, real-world case studies and examples of the best and worst in online digital communities, community engagement, public safety, and employee-initiated social media career self-termination. From agency verification, troll management, employee development, and community outreach, this class will deliver real-world tools for agencies of any size to help you better educate your community and protect your agency’s brand reputation from unapproved employee action online. Objectives: explain how to properly include legal social media education into your new employee orientation program / explain best practices and the planning process for a successful online public health engagement campaign / review case studies of employee social media behavior that has damaged local agency reputation and brands / discuss legal and ethical crisis communications planning for EMS administrators.

A different approach to seeing through the eyes of another and taking the time to understand how to walk in someone else’s shoes. Roughly 50 percent of the transgender population has reported significant lack of education and respect from their encounter with emergency health care providers. About 48 percent have experienced and reported harassment from providers, leading to refusal and/or postponement of medical care. Lastly, more than a quarter of those patients admitted to the misuse of drugs and alcohol to cope with the discrimination these medical professionals have shown. Imagine being terrified to contact EMS during an emergency due to the fear of judgement. Gender affirming care is vastly evolving, which leads to the increase in the number of transgender patients who seek medical care on a daily basis. This course will take you through an eye-opening journey of one’s transition and being on both sides of an emergency call. Let’s change the stigma together. Objectives: identify specific characteristics and behaviors of those struggling with gender dysphoria / discuss how to develop a mindful response and techniques when speaking to someone who is struggling with gender dysphoria / explore evidence-based practices to use when communicating concerns with your patient while fostering a safe environment / recognize the impact we can have on transgender patients and those associated with the LGBTQIA+ community when providing excellent patient care.

Understanding the basics of reading Chest X-rays (CXR), can be very useful for the critical care transport team. CXRs in the rural community are not often “read” timely, but also barely glanced at. They provide valuable basic and even complex information on critical patients. The more eyes on that CXR the better. We will cover the anatomy, the shadows/contours, the reading pattern, and physiology and pathology in the CXR. This is done in a whiteboard style interactive lecture with close to 30 chest x-rays to practice with and talk through. Objectives: identify the underlying anatomy on the portable CXR / identify the shadows and contours of the CXR / understand the steps to reading a CXR / recognize some basic pathology on the CXR.

The magic of Disney is experienced differently as an adult compared to a child. There are key things that Disney does exceptionally well that create magical experiences for their guests, both young and old. Disney’s culture and approach to the guest experience contain important lessons for EMS agencies, our leaders, and our providers. This insightful and humorous session will walk participants through the presenter’s recent experience at Walt Disney World and illustrate how the ‘Disney Factor’ can and should be applied to EMS. Objectives: learn the importance of branding as it relates to the EMS profession and your agency / understand how reputations are built and implode / understand the importance of ‘cast member’ selection on your agency / learn how to create an immersive, magical experience for your employees and patients / understand how paying attention to the 1,000 little things creates a magical immersive experience.

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 procedural issues and highlight what’s needed in EMS to effect quantifiable change. Objectives: compare and contrast algorithm usage for education and training versus emergent applications / highlight education, training, and the actual experience needed for quantifiable change in airway access and ventilation management outcomes / define the origins of flexibility in the face of complex airway challenges.

What value do you place on continuing education for your staff? Is your continuing education live and tied to your system goals, or does your staff just read articles? Do you incorporate valuable card courses into your CE offerings? Does your system have key performance indicators to move your system forward? Can you mold your system performance through what you teach? We will explore these questions and more when we look at how to identify and develop key performance indicators for your system and then create CEs to help build success. Objectives: develop key performance indicators / describe how to manage and review key performance indicators / develop continuing education from KPI metrics.

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 Dr. Heidi Abraham attempt to rein in 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-press” current, but are likely to include cardiac arrest management, medications, and airway management. Objectives: describe the main findings of the relevant peer-reviewed papers on 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 on inequalities in analgesia administration.