On-Demand Neuroprotective CPR
Neuroprotective (NP) CPR is a novel strategy for resuscitation after cardiac arrest that includes the triad of active compression decompression (ACD) CPR and/or a suction cup-based automated CPR device, an impedance threshold devices, and an automated controlled head and thorax elevation positioning system. NP CPR has been shown to improve preclinical outcomes. At present, NP CPR, when rapidly deployed, is associated with a strikingly higher probability of survival with good neurological outcomes versus conventional CPR performed in the flat position. Uniquely NP CPR works for both shockable and non-shockable first recorded rhythms. This session will provide both the latest clinical outcomes from a multi-site registry based study of the use of NP CPR in patients with out of hospital cardiac arrest by the experts and leaders in this field and a practical related to how to implement NP CPR by first-in responders.
On-Demand Nutrition & Wellness - Keeping Yourself off the Gurney!
Nutrition and wellness are rarely taught within medical education, yet it's endlessly proven that the importance of nutrition and wellness often supersede clinical algorithms and medical prescriptions. From basic nutrition and metabolism, to advanced dietary restrictions, we are not near as educated as we should be. "Healthy" eating is not as simple as choosing an apple over a brownie. Defining a healthy lifestyle and teaching how to create it, is important. Teaching how to make it a priority and successfully maintain it, is critical. As medical providers, we should have baseline knowledge about the importance and value of food as fuel. We should know lifestyle focused statistics, risk factors, and prevention for diseases. We need to learn how to prioritize our own health and lifestyles, not just so we can stay off the gurney, but also so we can be healthy role models for our sick patients.
On-Demand Operation Decompress - Alaska's EMS MIH Emergency Response to the COVID-19 Hospital Crisis and Paramedic Legislation
Alaska’s COVID-19 rates skyrocketed by September 2021, with hospitals across the state enacting crisis standards as the Delta variant crippled its healthcare system. The crisis began to impact everything from heart attacks to strokes to trauma care, nearly exhausting existing resources. With medical staff statewide reaching a breaking point, the state began examining innovative solutions, such as utilizing Mobile Integrated Healthcare as a means to either load level and or decompress regional hospitals within the state. prehospital assisted solutions which had never been attempted in the Great Land.Paramedics Terry Kadel and Brian Webb both work for the Alaska Office of EMS (OEMS) and will walk down the mobile integrated healthcare (MIH) process the state employed to assist with not only decompression of its medical facilities, but the provision of home-based follow-up care and treatment of patients, and how it could reduce the impacts of healthcare costs of not only the patient, but the healthcare facilities as well. They will further discuss the implications of the recently enacted Alaska Senate Bill 21, and its impacts for the provision of primary care activities by paramedics in Alaska, and its relationship for future community paramedicine projects.
On-Demand Orange Card CPR - The State of Resuscitation in the Alamo City. How the UT Health Office of the Medical Director Developed and Deployed a Novel CPR System.
Cardiopulmonary Resuscitation has been studied and analyzed for years. Healthcare has different modalities for compressions, respirations, medications and we still have similar out of hospital cardiac arrest save rates as we did decades ago. The University of Texas Health San Antonio Emergency Health Sciences Office of the Medical Director (OMD) physicians and clinical training officers sat down, last Fall, to discuss the current state of CPR training. We were not satisfied. The OMD wanted to address the next level of CPR and resuscitation and developed their own CPR program. UTHSCSA applied to the State of Texas, to provide its own brand of CPR training and recertification, called the Orange Card, and in doing so developed the first agency-specific CPR program in Texas and maybe the nation. This addresses CPR from the perspective of best practice per UTHSCSA / SAFD and applies this best practice to our citizens. This includes video telemedicine in dispatch, utilizing the latest prehospital civilian/responder alert applications, and an ECMO CPR alert. This allows the San Antonio Fire Department to provide an individualized level of CPR resulting in enhanced provider capabilities and the latest resuscitation practices for the citizens of San Antonio.
On-Demand Practice Makes Better: Deliberate Practice and Motor Skill Acquisition
Learning new psychomotor skills is foundational to the EMS provider. How we as instructors teach critical skills is essential their precision and long term retention. This session will discuss principles of deliberate practice and provide a demonstration of how it can work in the busy EMS classroom.
On-Demand Prehospital Pain Control with Acetaminophen: A Novel Pain Control Therapy with a Not So Novel Drug
Addressing pain in the prehospital setting is vitally important to both the clinical care and patient satisfaction of individuals who are experiencing pain. With the rise of the opioid epidemic that has affected the county over the last several years we have an obligation as healthcare providers to explore non-opiate based pain management options. We have been utilizing Intravenous Acetaminophen for over two years now and have presented multiple abstracts on the efficacy of Intravenous Acetaminophen in the prehospital setting. In this session we will discuss the results from our experience. We will also be coving the pharmacology of Intravenous Acetaminophen along with other pain management options. We will also be comparing the efficacy of other pain management options covering both opiate based and non-opiate based with various routes of administration . The session will also cover the lessons learned from our experience and some best practice implementation strategies.
On-Demand Pump Vs. Squeeze; The Use Of Vasopressors And Inotropes In The Crashing Patient
Managing hemodynamically unstable and crashing patients in the back of an ambulance or 10,000 feet in the air with the use of vasopressors and inotropes is very stressful and tricky. Although only a subset of our patients present with hemodynamic collapse and shock, a fundamental understanding of the use of inotropes and vasopressors is imperative to ensure good patient outcomes and reduce morbidity and mortality. This lecture will discuss the use of these pharmacological agents in differentiated (e.g., cardiogenic, distributive, hypovolemic, etc.) and undifferentiated/mixed shock states and ideal vasopressor/inotrope(s) to use as primary resuscitative agents. The most recent EMS literature surrounding these agents in different clinical scenarios will also be presented to ensure adequate understanding and comprehension.
On-Demand Quantifying Success in a Community Paramedicine Program
Tracking success in Community Paramedicine Program has its challenges. Learn how to quantify success in your Community Paramedicine Program so you can share your story. Gainesville Fire Rescue shares the benefits and challenges of metrics as a whole and what they have learned to make a difference in tracking the success of their Community Paramedicine Program including metrics such as primary care compliance, quality of life, and utilization results.
On-Demand Real Opinions from Real Airway Management Experts
Wondering what practices in EMS airway management are or are not evidence-based? Come find out as Drs. Wang, Jarvis, Levy, and Crowe share the findings of the National Association of EMS Physicians Compendium of Position Statements on Prehospital Airway Management. The product of over 100 contributors, this monumental project pulled together scientific evidence and expert opinion supporting best practices for the entire spectrum of prehospital airway management, including interventions (manual ventilation, supraglottic airways, drug assisted intubation, surgical airways, peri-airway management, cardiac arrest and trauma airway management, non-invasive ventilation and mechanical ventilators), training and education, and quality management. The speakers will detail how these state-of-the-art recommendations will influence prehospital airway practice.
On-Demand Risk and Resource Management for EMS providers; An Airline Pilot Perspective
In its 1999 report, “To Err is Human,” the Institute of Medicine brought the issue of medical errors to light stating that “more people die in a given year because of medical errors than motor vehicle accidents, breast cancer, or AIDS.” There is little evidence to indicate that there has been any progress made by the medical community to reduce these errors, and several recent studies show that the rate may be worsening. Commercial aviation, on the other hand, has made incredible progress over the last 50 years towards increasing safety and reducing risk in its operations. A large part of that effort has been addressing the role of human factors in mishaps and the use of risk and resource management techniques to minimize risk and reduce errors. This session will look at Risk and Resource Management (RRM) from an airline pilot perspective, draw similarities with EMS and show how providers can use similar strategies to reduce errors and minimize risk.
On-Demand So You Want to Go to Medical School?
Did you ever think about going to medical school? What stopped you? Did you think that you couldn't get in, that it was too expensive, that it would take too long, or that they wouldn't accept a "street medic" into the hallowed halls of medicine? This lecture will review all of those questions and show you that with the right perseverance, you too can become a physician. Adding onto information borrowed from the popular lecture given by Baxter Larmon of UCLA (with permission, of course), my experience as an admissions committee member for medical school and residency will clarify how to go about this sometimes confusion and seemingly daunting process.
On-Demand Sorting Out Syncope: EMS Evaluation of the Collapse Patient
This is a common presenting complaint for EMS providers and encompasses a huge differential diagnosis that many find daunting. Dr's Dickson and Patrick will provide a framework to evaluate this complaint and identify the potential killers.
By the end of this lecture the student should be able to:
• Identify the top killers that may present with a syncopal spell
• Understand the historical and exam features of deadly causes of sycope
• Identify concerning findings on ECG associated with deadly syncope
• Identify clinical features that differentiate syncope from seizure
By the end of this lecture the student should be able to:
• Identify the top killers that may present with a syncopal spell
• Understand the historical and exam features of deadly causes of sycope
• Identify concerning findings on ECG associated with deadly syncope
• Identify clinical features that differentiate syncope from seizure
On-Demand Spotting Abuse: When Your Gut Says Things Aren't Right...
You're dispatched to a residence for a fall, no lights or sirens. You don't recognize the address but you know the neighborhood well. The pager and MDT report the patient is a 28 year old female. You look in the comments and see the call terminated before MPDS was completed. You arrive on scene to find a single patient who states she, "fell in the shower", "tripped at the top of the stairs", or "fell into the door knob."
Abuse and neglect are often hard to spot. Whether or not you recognize the real issues and how you respond could make all the difference. In this thought-provoking panel discussion, you’ll hear real cases from an EMT, a San Antonio Texas Police Officer, and an attorney who represents children in the foster care system of McLennan County, Texas.
Abuse and neglect are often hard to spot. Whether or not you recognize the real issues and how you respond could make all the difference. In this thought-provoking panel discussion, you’ll hear real cases from an EMT, a San Antonio Texas Police Officer, and an attorney who represents children in the foster care system of McLennan County, Texas.
On-Demand Standards, Capabilities and Placements: A paramedic degree with purpose!
As of September 2021, the only way to achieve to registration as a paramedic in the UK is to obtain a bachelors degree. This is seen as a great achievement and for valid reasons, however, the model relies on vague standards and no agreed core capabilities which can lead to significant regional variation. Should PALS be the only paediatric assessment? How long should each student spend in OBGYN? What ECGs must they know before graduation? Just some of the questions we do not have the answers for.
In 2021, the presenter took to validation a bachelors degree in paramedic science with new approach - built around a set of core capabilites with each student responsible for creating evidence of their work-ready status by the end of their 3-year programme. This presentation offers a detailed exploration of the standards, capabilities and placement requirements which underpin this new programme and offers practical guidance for creating a paramedic degree with purpose. It is relatively easy to create a degree course, but ensuring every single graduate is work-ready on completion requires careful consideration of the programme structure, faculty requirements and core capabilities to be achieved.
In 2021, the presenter took to validation a bachelors degree in paramedic science with new approach - built around a set of core capabilites with each student responsible for creating evidence of their work-ready status by the end of their 3-year programme. This presentation offers a detailed exploration of the standards, capabilities and placement requirements which underpin this new programme and offers practical guidance for creating a paramedic degree with purpose. It is relatively easy to create a degree course, but ensuring every single graduate is work-ready on completion requires careful consideration of the programme structure, faculty requirements and core capabilities to be achieved.
On-Demand State of the Art of Advanced Airway Management: An Evidence Based Review
Advanced Airway Management (AAM) is a critical skill and a core tool in the EMS toolbox. But, as “everyone knows”, paramedics should not be intubating cardiac arrest. Or every piece of emergency apparatus should have an intubating paramedic on it. So… what is true, and what is “Fake News”? How are we to tell? Dr. Jarvis will provide a scientific basis by which medics can answer this question for themselves. He will provide a fast-paced review of the literature concerning EMS Advanced Airway Management and do so in a way that won’t put you to sleep.
On-Demand Stop the Bleed Instructor Course
This session will provide Stop the Bleed training. This course teaches how to recognize and control life threatening hemorrhage and credentials participants to teach Stop the Bleed.
On-Demand Syncope: Innocent Fainting or Lethal Arrhythmia?
Do you ever worry that your patient's syncopal episode was a result of transient ventricular tachycardia (VT)? You should. This discussion will teach you two EKG findings to look for on every syncope EKG to help you detect your patient's likelihood of transient VT; and it will help you to remember them forever. It's two more ways to help you save your patient, today and tomorrow.
On-Demand Ten Papers That Changed My Practice in 2021
A practice-based discussion (NOT a journal club, don't worry!) of 10 papers that changed my EMS practice in 2021. These are papers, for good or bad, that all paramedics, system directors, and medical directors should know about. We’ll cover current papers so the topics will change, but prior topics including the use of TXA for traumatic brain injuries and nose bleeds, characteristics of prehospital ketamine use, risk factors for peri-intubation cardiac arrest, the use of video laryngoscopy in cardiac arrest, and more.
On-Demand Texas Trauma Tactics – What’s Possible Prehospital in the Lone Star State
San Antonio Fire Department applies the latest in cutting-edge trauma 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 also deploys EMS Physicians in the prehospital setting. Discussion of open thoracostomies performed by all paramedics and a modified clamshell thoracotomy performed by EMS physicians will be discussed. The department has deployed and 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. San Antonio Fire Department has deployed digital blocks prehospital, resulting in true pain control for the injured digit. 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.
On-Demand The Creation, Development and Constant Evolution of a Leadership Education Program: The Secret Sauce Exposed
Leadership is a major key for success of an organization. It is poorly understood and seldom executed well. This presentation will provide the constructs for successful Leadership development program.