Exploration of EMS Workforce Retention Issues
This presentation begins by exploring wage growth in the United States between the years 2010 and 2019 in select Metropolitan Statistical Areas based upon population and prehospital (911) EMS infrastructure to address the effect of EMS wages based upon public-private-partnerships (PPP) versus public systems? This data is then analyzed against EMS wages for the same time frame in other countries combined with analysis of federal and state/territory level policy and legislation to identify similarities and discrepancies towards a better understanding of how other countries have addressed development of EMS infrastructure. Lastly, an analysis of the professionalization of EMS delves into the sociological theories of professions and expertise identifies how the EMS occupation has developed and what hurdles still remain.
Learning Objectives:
Describe how EMS infrastructure in prehospital systems affects EMS wages in that area.
Describe how professionalization of EMS would improve workforce retention.
Describe how US EMS policy compares internationally to equally developed EMS systems.
Learning Objectives:
Describe how EMS infrastructure in prehospital systems affects EMS wages in that area.
Describe how professionalization of EMS would improve workforce retention.
Describe how US EMS policy compares internationally to equally developed EMS systems.
The Most Important EMS literature of the Past Year
I will present between 10-20 recent articles from the EMS literature that have either practice changing potential or provide important new and interesting data for EMS providers, leaders and EMS physicians. This format would be the same as I have used at last year's and prior EMS World Expos.
Learning Objectives:
Understand the potentials benefits of Dual Sequential Defibrillation
Be able to use an upper or lower junctional pressure point to stop massive hemorrhage from an exsanguinating penetrating injury
become more facile with non nebulized alternatives to inhaled bronchodilators during times of respiratory disease epidemics
Learning Objectives:
Understand the potentials benefits of Dual Sequential Defibrillation
Be able to use an upper or lower junctional pressure point to stop massive hemorrhage from an exsanguinating penetrating injury
become more facile with non nebulized alternatives to inhaled bronchodilators during times of respiratory disease epidemics
Hiding in Plain Sight: Undifferentiated SYNCOPE: A guide to 12-Lead Recognition
This is an extensive look at evidence-based 12 lead, deeply focusing on the advanced and critical care medicine application. Syncope is often the indication of a silent killer. A killer that manifests itself in many ways. The 12 Lead tracing can be instrumental in identifying underlying disease processes that may otherwise be missed. Join us on the journey to uncover the hidden cardiac killers among us.
Learning Objectives:
1. Discuss the acronym SYNCOPE.
2. Identify 12-lead ECG presentations that help identify lethal killers that are often missed.
3. Evaluate: Too Short: Too Long
Learning Objectives:
1. Discuss the acronym SYNCOPE.
2. Identify 12-lead ECG presentations that help identify lethal killers that are often missed.
3. Evaluate: Too Short: Too Long
Don't Get Caught With Your MAST Pants Down --Novel Trauma Treatment Tactics
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.
Learning Objectives:
Discuss the state of the science of point of injury prehospital resuscitation.
Review advanced device thoracostomy and thoracotomy procedure. Will include training, practice, and quality assurance practices.
Discuss the science of digital blocks and amputations and the equipment, training and best practice to realize these treatments.
Learning Objectives:
Discuss the state of the science of point of injury prehospital resuscitation.
Review advanced device thoracostomy and thoracotomy procedure. Will include training, practice, and quality assurance practices.
Discuss the science of digital blocks and amputations and the equipment, training and best practice to realize these treatments.
Steel Toe Boots & Broccoli!
Nutrition and healthy lifestyles are rarely taught within medical education, yet it's endlessly proven that both have monumental effects on the body. Often even superseding medications. From basic nutrition and advanced dietary needs, to daily activity recommendations, the majority of emergency medical providers aren't near as educated as we should be. We are called to help people with long term diseases such as diabetes and heart disease, yet we are focused primarily on medication and missing fundamental knowledge about lifestyle modification. Our patients trust and depend on us for our medical knowledge, yet very few of us actually know what a "healthy" meal is, nor embrace the importance of daily movement. We need to start by prioritizing our own health first, which then allows us to educate others and be the role models patients are expecting.
Learning Objectives:
Define macronutrients vs micronutrients, including quality, quantity, and the balance of each
Demonstrate understanding of different dietary lifestyles and their associated health benefits and risks
Formulate ideas on how to implement a wellness program within your department
Learning Objectives:
Define macronutrients vs micronutrients, including quality, quantity, and the balance of each
Demonstrate understanding of different dietary lifestyles and their associated health benefits and risks
Formulate ideas on how to implement a wellness program within your department
Crush Medicine: Stopping The Smiling Death
Geared for Advanced Life Support providers, this presentation provides a general overview of Crush Syndrome including the pathophysiology of Crush Injury and Compartment Syndrome, the clinical manifestations of Crush Syndrome and the causes of death from Crush Syndrome. Treatment of local injury and systemic manifestations will be discussed as well as the best practices learned from real case studies from worldwide disasters as well as patients treated in New York City by the FDNY Rescue Paramedics.
Learning Objectives:
Upon completion, participant will be able to define crush injury, compartment syndrome and crush syndrome and explain the history and the clinical manifestations of each.
Upon completion, participant will be able to describe the therapeutic modalities and care of local injury as well as the management of crush syndrome “in the rubble.”
Upon completion, participant will be able to describe interventions use to manage crush syndrome that are controversial.
Learning Objectives:
Upon completion, participant will be able to define crush injury, compartment syndrome and crush syndrome and explain the history and the clinical manifestations of each.
Upon completion, participant will be able to describe the therapeutic modalities and care of local injury as well as the management of crush syndrome “in the rubble.”
Upon completion, participant will be able to describe interventions use to manage crush syndrome that are controversial.
Changing EMS from a Safety Net to a Partner in Crisis Response
Over the last several years responding to calls for patients in mental health crisis has been highlighted across the country. Since 2018, Federal agencies involved in crisis response have been planning for the new Suicide & Crisis Lifeline rollout. In the summer of 2022, 988—a new three-digit number—went live across the country. The next phase of building out an improved crisis response system involves improved mobile crisis response. What does that mean for EMS? Are there new resources for crisis response in your community? Do those providing crisis services understand EMS in your community? Now is the time to collaborate to improve behavioral health in your community. In this session, participants will learn EMS’s role and how it is critical not just in response but also in prevention.
Learning Objectives:
Upon completion, participants will be able to describe 988 and the Suicide & Crisis Lifeline.
Upon completion, participants will be able to describe mobile crisis and common modalities.
Upon completion, participants will be able to identify where EMS clinicians can find innovative models of crisis response collaboration in different types of settings.
Learning Objectives:
Upon completion, participants will be able to describe 988 and the Suicide & Crisis Lifeline.
Upon completion, participants will be able to describe mobile crisis and common modalities.
Upon completion, participants will be able to identify where EMS clinicians can find innovative models of crisis response collaboration in different types of settings.
But It’s My Data! What the Law Really Says About “Your” ePCR Data
Over the years, there’s been a debate over who “controls” PCR data. NEMSIS asked the law firm of Page, Wolfberg & Wirth to take on some of the most hotly contested issues concerning ePCR data and in this session, we’ll reveal the answers to key questions like:
1. Who legally “owns” the PCR data?
2. When does a PCR become a “legal document?”
3. When can a PCR be amended, and by whom?
4. Who bears “legal responsibility” for what is in the PCR?
5. What can third parties do with an EMS agency’s PCR data?
And much, more. Come energized and ready to ask questions you’ve been wondering about regarding your PCR data.
Learning Objectives:
Discuss key attributes of EMS data responsibilities.
Identify best practices for creating, storing and sharing data.
Dispel myths and assumptions around who’s responsible for what in the PCR.
1. Who legally “owns” the PCR data?
2. When does a PCR become a “legal document?”
3. When can a PCR be amended, and by whom?
4. Who bears “legal responsibility” for what is in the PCR?
5. What can third parties do with an EMS agency’s PCR data?
And much, more. Come energized and ready to ask questions you’ve been wondering about regarding your PCR data.
Learning Objectives:
Discuss key attributes of EMS data responsibilities.
Identify best practices for creating, storing and sharing data.
Dispel myths and assumptions around who’s responsible for what in the PCR.
Do Pelvic Binders Make a Difference?
Early use of pelvic binders have been included in the trauma patient care continuum for over a decade. But do they really reduce fractures, and do they control hemorrhage? Join Kevin as he discusses shares what is actually known about pelvic fracture stabilization and why it belongs in your patient care planning. This presentation will highlight why it is important to understand the various types of pelvic fractures, the limitations of physical exams, and what pelvic binding devices actually work! You will walk away understanding when pelvic binders are unnecessary, essential, and need to be exchanged for a superior alternative. Sure, pelvic binding may sound basic, but they are a critical, and often under utilized, intervention in transport systems.
Learning Objectives:
Describe the physiology of pelvic fractures and the impact on patient hemodynamics
Identify the anatomic effectiveness of pelvic binder applications
Explain the known physiologic impact of proper and improper pelvic binder application
Learning Objectives:
Describe the physiology of pelvic fractures and the impact on patient hemodynamics
Identify the anatomic effectiveness of pelvic binder applications
Explain the known physiologic impact of proper and improper pelvic binder application
Item Analysis for Novices
Accreditation standards require item analysis of high-stakes exams, but many educators are not sure how to create or interpret an item analysis. This session will provide the procedural steps for instructors, program or medical directors responsible for reviewing exams for validity, reliability, difficulty, and discrimination. We will then help participants use that information to make accurate inferences about student learning, faculty teaching, or readiness for other types of assessments or advancement. Gain confidence that you can improve your exam items, exams overall, and curriculum with each exam administration.
Learning Objectives:
Interpret the accreditation standard for item analysis for accredited healthcare education programs.
Follow the procedural steps for conducting an item analysis following exam administration.
Describe what inferences should and should not be made given the information available from a single exam administration item analysis.
Learning Objectives:
Interpret the accreditation standard for item analysis for accredited healthcare education programs.
Follow the procedural steps for conducting an item analysis following exam administration.
Describe what inferences should and should not be made given the information available from a single exam administration item analysis.
Physical disabilities: Considerations for EMS
A physical disability is an impairment involving the bones, joints, and muscles, can be a direct or indirect cause for a 911 disaptch, and can cause complications with EMS assessment, interventions, and transport. These impairments can be the result of a prenatal or postnatal injury, a genetic or nongenetic condition, or a disease. This session will address various types of physical disabillites including cerebral palsy, spina bifida, cleft lip/palate, spinal cord injuries, and others. Also addressed will be implications for EMS assessment, intervention, and transport when a patient has a physical disability. Wheelchair etiquette and service animals will also be discussed.
Learning Objectives:
By the end of the session, participants will be able to describe: Characteristics of physical disabilities they may encounter in the field
By the end of the session, participants will be able to describe: The impact of physical disabilites on assessment and transport
By the end of the session, participants will be able to describe: The role of service animals and expectations of EMS providers when encountering a service animal Basic wheelchair etiquette
Learning Objectives:
By the end of the session, participants will be able to describe: Characteristics of physical disabilities they may encounter in the field
By the end of the session, participants will be able to describe: The impact of physical disabilites on assessment and transport
By the end of the session, participants will be able to describe: The role of service animals and expectations of EMS providers when encountering a service animal Basic wheelchair etiquette
The BLS Ventilation and Oxygenation Lab
Please note that pre-registration is required to participate in this Special Event.
This session will start with a lecture on oxygenation and ventilation including the anatomy (airway geometry), mechanics and chemistry behind it. We will then transition to hands on stations that will include ventilation, oxygenation, airway application and BLS capnography. The student will also be able to walk away with a big picture understanding of how and why different devices, procedures and actions work.
Learning Objectives:
Effective Ventilation Management
Understanding behind complications with over or under ventilation
Understand the mechanics and science behind oxygenation and ventilation
This session will start with a lecture on oxygenation and ventilation including the anatomy (airway geometry), mechanics and chemistry behind it. We will then transition to hands on stations that will include ventilation, oxygenation, airway application and BLS capnography. The student will also be able to walk away with a big picture understanding of how and why different devices, procedures and actions work.
Learning Objectives:
Effective Ventilation Management
Understanding behind complications with over or under ventilation
Understand the mechanics and science behind oxygenation and ventilation
Association of Social Determinants of Health with EMS Utilization within a MIH Program: A Research Based Approach
Have you ever wondered how we might utilize EMS to improve the lives and health of patients more effectively? The Office of the Medical Director (OMD) and MedStar Mobile HealthCare, located in the Fort Worth Metropolitan area, have collected and analyzed data from their well-established successful Mobile Integrated Healthcare program. The programs include, but are not limited to, admission readmission avoidance, palliative and hospice care, episodic care, hospital at home, high utilizer group management, and opiate response care. A 12-Yr retrospective analysis of a well-established MIH program was conducted to determine program impact on hospital readmission, emergency department and EMS utilization, and a comparative analysis of the social determinants of health (SDoH) within this metropolitan area and those within the MIH programs was performed. An association between these SDoH and resource utilization was found, providing implications on how one might utilize these to improve patient management. Members of our team will provide an engaging, evidence-based approach to MIH program management, and how one might be incredibly impactful and efficient in providing appropriate resources to our patients.
Learning Objectives:
Recognize an association between SDoH and MIH program impact
Describe tools for improving SDoH within their community
Understand how varying SDoHs result in increased EMS utilization and how addressing these SDOHs may reduce utilization
Learning Objectives:
Recognize an association between SDoH and MIH program impact
Describe tools for improving SDoH within their community
Understand how varying SDoHs result in increased EMS utilization and how addressing these SDOHs may reduce utilization
From Research to Reality: How to evaluate the evidence and use improvement science to implement best practices in your system.
We often hear that EMS should be more evidenced based. But, what does that even mean? How do we find this evidence? How do we determine if the latest study means we should actually change what we do in the field? Join Remle Crowe and Brooke Burton as they discuss how to find the latest studies, evaluate them, and determine if the evidence is strong enough for practice change. They’ll also give practical applications of how to leverage improvement science to implement meaningful practice change.
Learning Objectives:
Upon completion, participant will be able to: Describe the purpose of function of PubMed and Google Scholars.
Upon completion, participant will be able to: Describe several recent papers that might change your EMS practice.
Upon completion, participant will be able to: Formulate a basic improvement plan to bring new research to your agency.
Learning Objectives:
Upon completion, participant will be able to: Describe the purpose of function of PubMed and Google Scholars.
Upon completion, participant will be able to: Describe several recent papers that might change your EMS practice.
Upon completion, participant will be able to: Formulate a basic improvement plan to bring new research to your agency.
Aphasia Awareness Training for First Responders: Communication Strategies for Emergency Situations
Aphasia is an acquired neurologic communication disorder affecting comprehension and/or expression of language across modalities. Aphasia can affect an individual’s ability to provide first responders and law enforcement with identifying information or follow commands during emergency situations. Emergency service personnel often encounter individuals in stressful situations, which can heighten the communication difficulty experienced by a person with aphasia. Research has found that first responders/aw enforcement do not receive extensive training on aphasia, however they are more likely to come into contact with a person with aphasia as opposed to an individual with a neurodegenerative disorder (Ganzfried & Symbolik, 2011). Due to limited training with this disorder, aphasia is often misinterpreted as a mental illness or other condition. It is essential that first responders and law enforcement are provided with adequate training about aphasia and strategies to communicate with these individuals during emergency situations. Avi Golden and Dr. Kaitlin Brooks speak with first responders and other medical professionals to increase aphasia awareness. The presentation describes aphasia, common symptoms and manifestations (with video examples), as well as various communication strategies that can be used by first responders in order to improve communicative effectiveness between people with aphasia and emergency service personnel.
Learning Objectives:
Upon completion, participants will be able to describe the different types of aphasia and typical symptoms.
Upon completion, participants will be able to list 4 communication strategies to use in an emergency situation with an individual with aphasia.
Upon completion, participants will be able to list 2-3 other conditions that a person with aphasia may be misdiagnosed with and describe the potential consequences of such a misdiagnosis.
Learning Objectives:
Upon completion, participants will be able to describe the different types of aphasia and typical symptoms.
Upon completion, participants will be able to list 4 communication strategies to use in an emergency situation with an individual with aphasia.
Upon completion, participants will be able to list 2-3 other conditions that a person with aphasia may be misdiagnosed with and describe the potential consequences of such a misdiagnosis.
Management of the Pediatric Airway: From Crib to College
An infant's airway is often difficult to visualize because of its anatomical location. There are techniques that first responders can use to improve their success in intubating a patient, but knowing the anatomy and how it changes with age is imperative to the success of intubating the patient. As healthcare providers, we know about the anatomically difficult airway, but we will discuss the physiologically difficult airway. The difficult physiological airway needs to be address prior to intubation. Once the decision to intubate is made, utilizing an RSI checklist improves patient outcome. We will also review the medications that could be used for RSI. Different medications may be more beneficial for patients who have congenital heart disease, genetic anomalies with facial deformities, etc. We will discuss alternatives to intubation and what to do when a patient cannot be intubated.
Learning Objectives:
Review the anatomical differences between in the pediatric patient as they grow
Review RSI procedures as well as alternative medications for RSI
Discuss and explain the physiologically difficult airway
Learning Objectives:
Review the anatomical differences between in the pediatric patient as they grow
Review RSI procedures as well as alternative medications for RSI
Discuss and explain the physiologically difficult airway
Bias in Care: Enhancing Equity in the Prehospital Environment
Background:
I treat all my patients the same. That is what just about any EMS provider will tell you.
And yet, whether in a living room, a street corner, or the back of an ambulance, we find that is not the case.
Women in cardiac arrest are less likely to receive the critical lifesaving interventions.
Hispanic patients are less likely to have their stroke symptoms recognized.
African Americans patients are less likely to have their pain treated.
Why is this? How do we know this? And what can we do about it? How can I take my paramedics and EMTs—and you take yours—from a state of “I treat everyone the same” to a state of “equity matters to my patients, to my community, and to me.”
Value:
This talk will focus on EMS clinicians and leaders roles in promoting equity in care with an emphasis on solution-based best practices.
Action:
We will discuss a stepwise, implementable approach—understanding inequity, defining equity, ensuring accurate and comprehensive data collection to recognize disparities, and of course, using that data to educate, inform, and ultimately improve the care for your population.
Learning Objectives:
Upon completion, participant will be able to demonstrate a common understanding of equity and how it applies to prehospital care.
Upon completion, participant will be able to understand the inequities in patient care found in EMS systems across the country.
Upon completion, participant will be able to develop a step-wise approach to understanding, targeting and improving equity in their EMS system.
I treat all my patients the same. That is what just about any EMS provider will tell you.
And yet, whether in a living room, a street corner, or the back of an ambulance, we find that is not the case.
Women in cardiac arrest are less likely to receive the critical lifesaving interventions.
Hispanic patients are less likely to have their stroke symptoms recognized.
African Americans patients are less likely to have their pain treated.
Why is this? How do we know this? And what can we do about it? How can I take my paramedics and EMTs—and you take yours—from a state of “I treat everyone the same” to a state of “equity matters to my patients, to my community, and to me.”
Value:
This talk will focus on EMS clinicians and leaders roles in promoting equity in care with an emphasis on solution-based best practices.
Action:
We will discuss a stepwise, implementable approach—understanding inequity, defining equity, ensuring accurate and comprehensive data collection to recognize disparities, and of course, using that data to educate, inform, and ultimately improve the care for your population.
Learning Objectives:
Upon completion, participant will be able to demonstrate a common understanding of equity and how it applies to prehospital care.
Upon completion, participant will be able to understand the inequities in patient care found in EMS systems across the country.
Upon completion, participant will be able to develop a step-wise approach to understanding, targeting and improving equity in their EMS system.
Why Do They STAY? Engaging Your Employees in Retention Efforts
As employers of EMS professionals across the country work hard to adapt to a changing workforce environment, it's critical that they focus on retention as much as they do employee recruiting. Exit surveys, engagement surveys, and onboarding surveys can provide some useful insight, but they often focus on information that is based on an experience from the recent past, or it is too late to do anything with in terms of retaining employees. Finding out why employees STAY can provide especially useful insights into what helps motivate employees to continue working for your department. In this session, information from over 1,200 stay interviews conducted within one EMS agency will be presented, and how stay interviews can be implemented in other departments to improve employee retention.
Learning Objectives:
Describe the Stay Interview and the impact on retention.
Review real agency data for over 1200 Stay Interviews of EMS Professionals
List the steps in implementing Stay Interviews at other agencies.
Learning Objectives:
Describe the Stay Interview and the impact on retention.
Review real agency data for over 1200 Stay Interviews of EMS Professionals
List the steps in implementing Stay Interviews at other agencies.
Maximizing Learning Through Positive Culture and Climate
How people feel about the environment they are in impacts learning in powerful ways. Learn how to optimize success using curricular design, lesson planning, and organizational culture strategies that manage cognitive load and lead to improved memory, deeper understanding, and a more welcoming environment for all learners, trainees and employees in your organization.
Learning Objectives:
Describe the limits of working memory and strategies for avoiding cognitive overload.
Articulate the importance of scaffolding for learners using a learner-centered approach.
Discuss the roles of language, belonging, efficacy, culture and climate related to maximizing learning and retention.
Learning Objectives:
Describe the limits of working memory and strategies for avoiding cognitive overload.
Articulate the importance of scaffolding for learners using a learner-centered approach.
Discuss the roles of language, belonging, efficacy, culture and climate related to maximizing learning and retention.
What the FBI can Teach us About Mental Health Assessment
This presentation reviews the use of Community Paramedics in Behavioral Health and substance use disorder (SUD) response as well as part of the Crisis Response Team (CRT) in crisis negotiation situations and barricaded subjects. Attendees are introduced to hostage negotiation tactics and the transtheoretical model of change as a tool to address the changes brought about by social justice reform. The presentation investigates Officer-Induced Jeopardy and how that legal concept impacts EMS providers. The instructor then leads the class through a selection of relevant case studies to apply what was learned.
Learning Objectives:
Explain the legal concept of officer-induced jeopardy and how social justice has and will change the way EMS responds to behavioral health and Substance Use Disorder (SUD) crises.
Implement the transtheoretical model of change when working to de-escalate a patient in crisis.
Utilize active listening as a tool for empowering patients to modify their aggressive or self-destructive behaviors
Learning Objectives:
Explain the legal concept of officer-induced jeopardy and how social justice has and will change the way EMS responds to behavioral health and Substance Use Disorder (SUD) crises.
Implement the transtheoretical model of change when working to de-escalate a patient in crisis.
Utilize active listening as a tool for empowering patients to modify their aggressive or self-destructive behaviors