2023 Course Descriptions – Monday

To View A Complete List of Speakers, Visit The 2023 Conference Speakers Page

Find your course by day below:

Monday

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8:00-9:15 AM CST

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Preparatory

From Crisis to Nurturing: Hospitality as a Way to Care

Erika Prosper

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This session is designed to take a deeper dive into what is takes to move from a culture of crisis to one that puts the customer at the center through a hospitality mindset. Objectives: explore why hospitality matters in our world / describe the difference between a service mindset and hospitality / provide tips for leading with hospitality as a goal.

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9:30-10:30 AM CST

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Patient Assessment, Special Considerations

Understanding Firefighter Injuries

Ken Bouvier, NREMT, Paramedic

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Firefighting is one of the world’s most dangerous jobs, and accidents in this profession can result in costly losses. The greatest loss being the injury or death of a firefighter! During this session, we will explain the two basic factors that motivate accident control effort. Humane versus Economics. All departments know and understand what it takes to produce the almost-perfect firefighter, but they also realize the cost involved. Because of cost, many departments are out of compliance. We will explore the EMS role and see that they are not on the scene just to watch the fire, but instead play one of the major roles of preventing firefighter injuries by keeping a close eye on them. The importance of wearing proper firefighting equipment, using the Incident Command System, and the need for rehabilitation on scene will be discussed. Objectives: understand the rules, regulations and laws concerning firefighter safety / understand the need to use proper firefighting equipment / describe cardiac and heat related signs and symptoms / review the most firefighter injuries / analyze and understand basic and advanced life support for firefighter injuries.

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9:30-10:30 AM CST

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Clinically Related Operations

Pedestrian Struck: Why Did the Patient Cross the Road?” Using Technology to Evaluate Data for Injury Prevention

Jim Radcliffe, MBA, NRP, LP

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Accidental death and disability remains the neglected disease of a modern society.  Trauma remains the leading cause of death for those under the age of 45, and the 4th leading cause of death overall. People continue to move out of the cities, urban suburban populations continue to grow, and as urban sprawl continues, we build more, larger, and faster roads. The roadways are becoming more and more congested, and post-COVID, it seems like drivers are more aggressive, and have forgotten how to operate their vehicles safely. It is easy to look at data and see that motor vehicle collisions are up, domestic violence is up, and our hospital trauma volumes are continuing to rise; but do you ever wonder why people would risk crossing a 70-mph interstate, or why there are so many pedestrians being struck in certain communities? During this session, we will discuss how we can use our data and technology to better visualize pedestrian injury in our communities. With more informed data we can hopefully prevent injury and reduce morbidity and mortality as it relates to pedestrian injury. Objectives: identify how they can use available community data to better understand why injuries occur in given locations / discuss how they can utilize their trauma registry data for injury prevention and community education / understand how to use data and technologies to inform policy makers to increase pedestrian safety in their communities / participants will have a greater awareness of how with their data they can partner with other departments and agencies within their communities to prevent injury and death.

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9:30-10:30 AM CST

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Preparatory

Should We Put That in Writing? Better Yet, What Should We Do About It?

Steve Wirth, Esq, EMT-P

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You deal with formal and informal complaints, investigations, internal audits, incident reports and “critical incidents” every day in our highly regulated EMS industry.  But when should these “issues” be “put in writing” and documented is a common question that all EMS leaders face.  And exactly what should be done when potential problematic issues are revealed is a critical process that needs a systematic approach to ensure legal compliance. This session will help you better understand what needs to be documented, how incidents should be handled internally, and when reports need to be made to external agencies. Interaction with legal counsel to help protect reports from potential discovery will also be discussed. Objectives: list five types of EMS documentation / discuss the importance of a narrative description in a report / describe the types of information that should be in a patient care report and the types of information that should not / discuss importance of EMS documentation to prevent complaints and lawsuits / discuss things that should be documented when describing a crime scene or other unusual situations.

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9:30-10:30 AM CST

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Medical

Nebulized Ketamine for Analgesia: Why You Should Consider a New Delivery Option

Casey Patrick, MD

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Over the past decade, everyone involved in emergency care has been impacted by the opiate crisis. Non-opiate, affordable analgesic agents are desired and in limited supply. Ketamine is both effective and safe as an analgesic in the emergency department and EMS settings. “Why nebulize it?” is a totally reasonable question. Join today’s discussion to learn the potential benefits of ketamine analgesia via nebulization, and why this modality might close gaps in your service. Objectives: introduce the background literature supporting nebulized ketamine analgesia / discuss the potential benefits of ketamine nebulization as opposed to other delivery routes / describe ideal patients for utilization of nebulized ketamine analgesia / learn the successes and pitfalls of actual nebulized ketamine protocol implementation / emphasize EMS gaps in treating pediatric pain.

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9:30-10:30 AM CST

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Pediatric

Single Dose Killers: Pediatric Toxicology

Michael Gooch, DNP, APRN, CCP

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Toxicological emergencies are commonly encountered in EMS and critical care transport. Some are more serious than others. In pediatric patients, there are a few substances that only one, or a small dose is enough to be toxic or lethal. This presentation will review these single dose killers, discuss their clinical manifestations, and management priorities to allow transport clinicians to manage these patients more competently. Objectives: identify the single dose killers in pediatric toxicology / modify management plans to correct acidosis encountered in pediatric toxicology / recall indications for high dose insulin and intralipid therapy in select cardiotoxic emergencies / recall indications for high dose insulin in select toxic emergencies.

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9:30-10:30 AM CST

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Trauma

Gravity, Friend or Foe? Trauma From Falls

Gary Hecker, RN, CCRN, EMT-CC, CIC, NHDP-BC

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Trauma Centers across the country report falls as one of their more frequent mechanisms of injury.  According to the National Safety Council data for preventable injuries for 2022, falls were the #3 cause of death (21%) and the #1 cause of nonfatal injuries (33%).  Fall injuries occur in all age groups.  In this presentation we will discuss the impact of falls on the population.  Kinematics and mechanisms of injury will be examined with a focus on common and hidden injuries.  We will conclude by exploring case studies of actual fall patients. Objectives: identify falls as a major mechanism of injury / review the kinetics of injury / describe injury patterns of different fall types / use trauma center case studies to describe morbidity and mortality from falls.

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9:30-10:30 AM CST

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Patient Assessment, Special Considerations

Ill and in Handcuffs

Tamsin Fuller, BSc (hons), MInstP, MweS

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A lot of attention is paid to deaths in custody; however, EMS will encounter a range of prisoner ailments. Are they trying to escape custody? Are they faking it? What about those with chronic conditions? Learning difficulties? How is our assessment influenced by the presence of handcuffs? Objectives: examine how to be objective in our assessment of the patient / define anchor bias / identify common presentations, including ABD / explore how handcuffs affect our treatment options?

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9:30-10:30 AM CST

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Special Considerations

Let’s Talk Dogs and Mental Health

Brandon Miller, Firefighter, Paramedic

Frankie Trifilio, NRAEMT, CADS, EMS-I

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Everyone knows that after a bad day at work there is nothing like coming home to your dog who is always happy to see you. Methodist Healthcare in San Antonio, Texas is taking a new and initiative approach to help build resilience in First Responders and their staff by using specially trained Emergency Services Facility Dogs daily in their region. These dogs and their handlers help first responders and healthcare workers take a moment to pause for themselves as they go throughout their busy day taking care of patients. These dogs help day to day by providing a platform for the handlers to talk about mental health and promote resilience tips to those they encounter. We will discuss the impact of these day-to-day moments as well as the impact the team has had when responding to major events that have shaken the foundation of communities and the health care teams that responded. We will look at the role the team has played in El Paso following the Wal-Mart shootings, as well as the Uvalde school shootings. We will also look at how the team has been part of the recovery process for departments that have experienced the loss of member from line of duty and accidental death, as well the suicide of a peer. Objectives: discuss how the dog and mental health program started / review types of working dogs / discuss the day-to-day life with a working dog / review program response to major events.

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9:30-10:30 AM CST

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Patient Assessment, Special Considerations

Pregnancy Alert! Coming to an ER Near You…Oh and SAMPLE is Out!

Taylor Ratcliff, MD, FACEP, FAEMS, EMT-P

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Did you ask your patient if they are pregnant?  How about being pregnant in the last YEAR!  Why does that matter?  We will look at why maternal death rates aren’t getting better, the critical problems that you are probably missing if you aren’t asking this question, and the results of not SAMPLE-ing your patient. Objectives: understand the fact that life threatening complications related to pregnancy can occur during pregnancy or up to 12 months after being pregnant and review current mortality data and the trend / understand the criticality of asking about pregnancy or pregnancy in the past 12 months / understand how to identify key risk factors and signs and symptoms associated with these problems and treatments for the major causes of maternal mortality, including hemorrhage, eclampsia and cerebrovascular complications / understand the role EMS plays in identifying these patients, treating their condition and selecting and alerting an appropriate hospital for continued care.

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9:30-10:30 AM CST

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Clinically Related Operations, Patient Assessment

When Heart Failure Becomes Cardiogenic Shock: Transport of the Mechanical Circulatory Support Patient

Tony Garcia, APRN, CFRN, LP

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Advancements in cardiac care have allowed patients to survive to definitive care. The predominant forms of mechanical circulatory support (MCS) are Impella devices and Extracorporeal Mechanical Oxygenation (ECMO). HEMS personnel are encountering these patients more frequently on interfacility transfers. EMS personnel are being asked to transport patients to e-CPR centers. Objectives: identify the various types of temporary MCS / list the types of Impella support devices / describe the differences in ECMO support / define the concepts of E-CPR.

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9:30-11:30 AM CST

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Medical

Hands-On Specialty Workshop - Advance Registration Required

Stethoscopy Lab: An Ears on Experience

Bob Page, MEd, NRP, CCP, NCEE, CHSE, CHSOS

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How much did you pay for your stethoscope? How much training did you get on how to use it? This will fill the gap. In this session, participants are provided down to earth “for dummies” information on various types of stethoscopes and how to use them to get the most out of patient assessment. In this “Ear Opening” session, new and improved methods and techniques are presented and breath sounds are presented via stethoscopy sounders, so that participants can hear the sounds with their own stethoscopes. That’s right! In this session, participants MUST bring their own stethoscopes with them. Bob brings simulators for all participants to use their own stethoscopes to hear the various sounds. This is the class you should have got way back in EMT class but did not. Objectives: describe the parts of the stethoscope and the proper way to wear it / describe the difference in the bell vs the diaphragm and the use for each / identify by sound, common breath sounds / describe a technique for identifying consolidated lung tissue. (Attendees will need to bring their own stethoscope.)

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9:30-11:30 AM CST

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Airway, Trauma

Hands-On Specialty Workshop - Advance Registration Required

Tension Pneumothorax:  Needle Decompression, Finger Thoracostomy and Chest Tubes

Jared Ross, DO, NRP, TCCC, FACEP, FAAEM

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Tension pneumothorax is commonly unidentified and undertreated by EMS. In this course, we discuss identification and practice hands-on treatment of pneumothorax in both patients who are conscious as well as those who are in cardiac arrest or peri-arrest. Students will review updated literature that has modified the techniques commonly used for pleural needle decompression. We will discuss the indications and contraindications for finger thoracostomy as well as two techniques for chest tube insertion in the EMS setting. Students will have the opportunity to practice all skills. Objectives: identify signs of pneumothorax in both conscious and unconscious patients / describe the treatment of simple pneumothorax, tension pneumothorax, and traumatic cardiac arrest / discuss the indications and contraindications for pleural needle decompression, finger thoracostomy, and tube thoracostomy / practice and demonstrate pleural needle decompression, finger thoracostomy, and tube thoracostomy.

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11:15 AM-12:15 PM CST

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Preparatory

The Seven Deadly Sins – The Bad Behaviors Most Likely to Get You in Trouble With Your Patient, The Public, Your Agency, and the Law!

Steve Wirth, Esq, EMT-P

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It’s tough. Everyone is overstressed, overworked, and underpaid as we are faced with the most difficult challenges ever seen in fire and EMS. But despite all this, we must put our “best face forward” and be the calming force with our patients and our citizens – to help comfort them and to keep our agency and ourselves out of trouble. But sometimes we just lose it.  Or we get hardened by the all the tragedy and don’t care. This session will enlighten you to the 7 specific personal behaviors that are most likely to lead to trouble – and why – and then provide alternatives that can help improve your outlook, improve how you deal with others, and help avoid complaints and lawsuits! Objectives: list the behaviors that can lead to patient dissatisfaction and potential complaints / describe how our biases can affect how we treat the patient / describe five steps you can personally take to improve your behaviors when dealing with a patient / discuss the steps to take to intervene when you observe potentially harmful behaviors from co-workers and other responders.

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11:15 AM-12:15 PM CST

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AOR, Clinically Related Operations

Resiliency Through Tragedy: The Uvalde Response

Michael Hayes, BS, LP, FP-C, CCP-C, TP-C, CEMSO, FSCEO

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This lecture is designed to provide both agencies and first responders with lessons learned from the Uvalde EMTF response with regard to resilience.  As one of the EMTF leaders that responded to the May 2022 Uvalde shooting, areas such as interagency planning and training are paramount for local agencies to both respond and recover from high profile incidents.  Other areas of importance to share are mental health support for first responders, what to avoid when unofficial support arrives, and who should or should not be allowed into your organization.  Finally, an overview of what EMS agencies should expect out of regional, state, and federal assistance, and how to best educate their stakeholders in the integration of organizations such as EMTF. Objectives: explore planning for agency and personnel resilience from a high-profile event / describe coordination amongst local, regional, state, and federal agencies / provide an overview of EMTF and the role of incoming support to both EMS and hospital partners / explore various recovery efforts that may benefit personnel, the agency, and the community in the aftermath of these events.

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11:15 AM-12:15 PM CST

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AOR, Preparatory

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General update on the happenings at the National Registry and what educators/preceptors/perspective candidates should expect in the future. Covering everything from the ALS Redesign, new examination item types (with live demonstration), and ADA Accommodations and the process by which to apply. Objectives: discuss the timeline for implementation of the new examination (ALS) / understand what the examination is and how the items relate directly to street practice / explore the role of the National Registry in the National EMS Scope / describe how to apply for ADA Accommodations for the examination.

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11:15 AM-12:15 PM CST

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Medical, Trauma

COMMOTIO CORDIS – “Agitation” for the Athlete AND for EMS

Ronna Miller, MD

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A recent, high-profile case of likely commotio cordis in an NFL player brought to light a well-described cause of athlete sudden death. Commotio cordis – “agitation of the heart” – is uncommon but carries an unacceptably high mortality. What is commotio cordis? When does it occur? What are the unique clinical features? How do we provide the best BLS and ALS care? And what can be done to prepare for and prevent it, to save the lives of patients who are literally struck down in the prime of life? Come to this presentation to find out! Objectives: define commotio cordis / describe typical settings and scenarios where commotio cordis is most likely / recognize the clinical presentation of commotio cordis / describe principles of BLS, ILS and ALS care for a patient with commotio cordis.

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11:15 AM-12:15 PM CST

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AOR, Preparatory

What Dreams May Come: The Value of Sleep

Reuben Farnsworth, BS, CCP-C, CP-C, LP, NRP

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Fatigue is a consistent and constant issue in the EMS industry.  In this discussion, we will look at some of the current science regarding sleep and fatigue management.  How much sleep do we need? What are the physiologic effects of sleep deprivation? What effects on performance develop secondary to sleep deprivation? Perhaps, most importantly, what can we do to improve sleep patterns – quality and quantity – among EMS providers. Objectives: identify the risks of sleep deprivation / explain how sleep deprivation affects performance and reaction time / list solutions that can be implemented at the agency level to improve provider safety.

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11:15 AM-12:15 PM CST

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Clinically Related Operations, Special Considerations

EMT and Paramedics Patrolling the Border

Robert Vega, EMT, Paramedic, Sector EMT Coordinator

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This will be an in-depth look at what training, experience, and requirements are for Border Patrol Agent EMTs to include specialty operations such as BORSTAR (Border Patrol Search Trauma and Rescue). We will discuss the unique situations we are placed in when encountering thousands of potential patients at once and with limited resources. We will discuss how we retrofitted law enforcement units as medical response units. We will also discuss the training involved in having our EMT basics operate at an advanced level with Medical Director approval, and the training requirement for maintaining our level of care. Objectives:  examine mass casualty incidents in remote areas / explore adaptation methods for weather and other environmental emergencies / describe border related trauma emergencies.

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11:15 AM-12:15 PM CST

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Preparatory

The Most Dangerous Few Minutes of Your EMS Career

Wes Ogilvie, MPA, JD, LP, NRP, CP-C

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Many EMS providers fail to recognize the risk that comes with obtaining a refusal from a patient. Sometimes, EMS providers fail to even identify whether someone is a patient.  As a practicing attorney and paramedic, Wes is regularly asked to review refusals and provide guidance and education.  In this class, Wes will go over the risks involved in obtaining a refusal, as well as how to minimize the risks to you, your employer, your wallet, and your certification. Objectives: discuss how informed consent applies to refusals / identify other situations where a refusal may be needed besides refusal of transport / differentiate between capacity, competency, and intoxication / discuss best practices for documenting a refusal.

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11:15 AM-12:15 PM CST

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Trauma

The First, First Responder in a Burn Emergency

Emily Snyder, BSN, RN, CCRN

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This lecture will discuss what to do when you are the first, first responder at the scene of a burn emergency. The lecture will provide an opportunity for the students to have a refresher on the basics of burn care and stabilization in the field and during transport. This consists of conducting a primary survey, assessing and determining wound depth, and initiating a proper fluid resuscitation. The second half of the lecture will focus on how to properly define a burn mass casualty event. A burn mass casualty event varies from a “traditional” mass causality event due to limited beds and resources. The students will be provided with the knowledge to conduct proper field triage and transfer of these victims. Objectives: discuss the incidence and etiology of burns / identify methods of assessing depth, extent, and severity of burn injuries / describe current recommendations for care from time of injury to transfer to a burn center / identify qualities of a burn mass casualty event and how to triage burn victims.

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11:15 AM-12:15 PM CST

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Clinically Related Operations, Special Considerations

ALS, BLS, or NoLS: Playing Plinko With Non-Transport and Patient Alternative Destination Decisions

Gerad Troutman,

Heidi Abraham, MD

Meghann Adams,

David Miramontes, MD, FAEMS, FACEP, LP

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Panel discussion about the often-unforgotten low acuity patients who make up a significant portion of our 911 activations. We will explore various programs and creative ways to care for this ever-increasing subset of patients that often do not require sending a transporting ambulance. This session will demonstrate that low action patients can be safely cared for by other means, while saving precious EMS unit hours and healthcare dollars. Objectives: define low acuity patients / describe programs for non-transport patients / discuss creative ways to care for low acuity patients.

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11:15 AM-12:15 PM CST

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Airway

Don’t Let it Take Your Breath Away, Ventilator Management can be Made Easy

Esther McIlvain, BSN, RN, CEN, CCRN, CFRN

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Ventilators can be complicated and intimidating. What’s even worse is that they can be harmful to our patients when not managed appropriately. But what if I told you there is a way to make them a little less daunting? Follow these five rules to make sure you’re managing your ventilator appropriately and doing what’s best for your patient. Ventilators are being utilized more frequently in the prehospital setting. If ventilators are managed improperly, it can worsen the disease process and cause worsening lung injury. Prehospital staff must be trained in how to properly manage a ventilator, so they do not cause patient harm. Objectives: apply appropriate ventilator settings and strategies to appropriate patient populations / understand the importance of following ARDSNet protocol, and why 6ml/kg IBW is appropriate / rapidly choose safe ventilator settings using the formulas taught / understand basing ventilator setting from appropriate ideal minute ventilation.

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1:00-3:00 PM CST

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Special Considerations

Hands-On Specialty Workshop - Advance Registration Required

Removal Techniques of Sports Equipment for Spinal Injured Populations

Christopher Greenleaf, PhD, LAT, ATC, CSCS

Dustin LeNorman, MS, LAT, ATC, AEMT

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The removal of sports equipment, such as, football helmets, shoulder pads, lacrosse helmets and pads on scene prior to transport and delivery to an emergency department provides ideal access to a patient’s airway and chest. Removing equipment, which in a life-treating emergency, facilitates the packaging, evaluation, and diagnostic testing of the spinal compromised patient during the events associated with rapid transfers during the continuum of care. The standardization of protocol for the management of athletic spine injuries across the professions, from athletic trainers to emergency medical technicians and physicians is needed for the best outcome. This workshop will provide the opportunity for pre-hospital providers in emergency medical services to learn and practice the latest techniques in sports equipment removal and maximize their ability to deliver evidence based best practice outcomes associated with sports related spinal compromised patients. Objectives: Identify the various equipment types used in modern sports and the associated tools needed to remove this type of sports related equipment / understand the various roles of the prehospital providers and the trauma team when removing sports related equipment / demonstrate and perform sports equipment removal safely and efficiently / understand and articulate the reasoning behind sports equipment removal to other potential healthcare providers.

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1:00-5:00 PM CST

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Airway

Hands-On Specialty Workshop - Advance Registration Required

Can You Ventilate? A Hands-on HPV Workshop

Bob Page, MEd, NRP, CCP, NCEE, CHSE, CHSOS

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Research shows that more often than not, EMS providers have trouble ventilating patients. In this eye-opening hands-on workshop, Bob shows participants how to ventilate patients by BVM, via Mask, ET tube, and supraglottic airways using state of the art computerized simulators that measure pressures, volumes, and ventilatory rates. You will be gain valuable insight, skills and improve your ventilation ability using this valuable feedback and coaching system. This lab features the tools and techniques to introduce to you the concept of high performance ventilation (HPV). Objectives: describe the normal tidal volume, minute volume and pressure values for an adult and pediatric patient / using an BVM with a manometer, demonstrate proper timing, volume, and pressure while ventilating a simulated lung / on a ventilation simulator, demonstrate the difference in ventilation through various airway adjuncts / using a ventilation simulator, demonstrate ventilation of a diseased lung and describe the differences with normal lungs.

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1:30-2:30 PM CST

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Special Considerations

Avoiding the Major Pitfalls of Physical and Chemical Restraint

Eric Jaeger, JD, NRP, EMS IC

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Physical and chemical restraint of the agitated patient is one of the most dangerous things we do, for patients and for providers. We’ll discuss ten principles of safe restraint that are intended to help providers avoid the major pitfalls. These principles protect patients, as well as providers and law enforcement. We’ll explore the pathophysiology of physical restraint, including the dangers of prone restraint. We’ll examine the key steps necessary to enhance the safety of chemical restraint, including understanding the indications for chemical restraint, the need for a thorough assessment to identify and treat any organic causes of agitation, and selection of the appropriate sedative medication. Enhancing safety also requires ensuring that the patient’s breathing is unrestricted, that all equipment needed to perform a thorough evaluation and resuscitation is at the patient’s side and rigorous monitoring after sedation. Finally, we’ll examine the impact of unconscious and anchoring bias. Objectives: describe the issues surrounding safe management of the agitated patient / explain the pathophysiology and risks of prone restraint / describe the key steps necessary to enhance the safety of chemical restraint / identify how anchoring and unconscious bias affects decision making by EMS providers.

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1:30-2:30 PM CST

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AOR, Preparatory

EMS Hospice Response- How You can Make a Difference

David Miramontes, MD, FAEMS, FACEP, LP

Brian Guerrero, LP

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We will discuss Hospice care and the unique treatment options to ease suffering and improve quality of life for Hospice patients. There is a role for EMS and MIH/Community paramedicine in this space, and we will discuss how EMS partnering with local Hospice agencies can improve care and decrease hospital transports. Objectives: discuss in detail the philosophy and care goals of Hospice / explain the unique pharmacologic interventions for symptom relief that are different from standard EMS protocols / understand the positive effects of Hospice agency partnerships on patient care, EMS transport reductions and Hospice revocation prevention / understand the process of active dying and how EMS interventions can ease suffering and facilitate more positive family interactions.

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1:30-2:30 PM CST

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Preparatory

Moral Injury- Peeling Back the Layers of PTSD

Karen Yates, MSN, RN, NPD-BC, CEN, EMT-P

Wendy Norris, CEO

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Over the last few years, many first responders have had to make complex personal and professional decisions as they responded to the pandemic, civil unrest, natural disasters, mass casualty incidents, and escalating violence that has created a heightened state of distress.  First responders, especially those in leadership positions, often must make rapid decisions that can have significant consequences for the community they serve, as well as fellow crew members. Because of the nature of the emergency services, sometimes these rapid decisions may force individuals to make choices among only terrible options. These decisions can often be wrapped around deeply held beliefs about the sanctity of life, which in turn creates vulnerability to internal distress and anguish. All these experiences may result in what is called moral distress or injury. Designed to look at mental health and wellness through a completely different lens, this interactive presentation will give participants information on how to recognize the signs of moral distress and injury, which is the first step to healing and recovery. Objectives: define and identify the signs of moral distress and moral injury / identify how moral injury plays a key role in the overall mental health and well-being of a first responder / differentiate between post-traumatic stress, survivor guilt, and moral injury / locate resources and support services in their local community to address and recover from moral injury.

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1:30-2:30 PM CST

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Patient Assessment

Remember Three Things: Ten Medical Triads in Sixty Minutes

Kelly Grayson, AGS, NRP, CCP

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They’re scattered throughout medical training; simple tools to help us memorize vital diagnostic criteria. From the Trauma Triad of Death to the Monroe-Kellie Doctrine, join Kelly Grayson in this rapid-fire review of ten important medical triads in six minutes each. Objectives: discuss the trauma triad of death and Beck’s triad / explore Cushing’s triad and the Monroe-Kellie triad / discuss the opioid overdose triad and Samter’s triad / discuss the CHF triad and the TCA overdose triad.

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1:30-2:30 PM CST

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Trauma

Ocular Emergencies “Just Eyeball It”

William Ferguson, MD, FACEP, FAEMS

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Although EMS providers receive initial and continuing education related to the management of life and limb threatening emergencies, there are other emergencies out there, that if not managed appropriately, can lead to significant morbidity and life stye changes for our patients. The recognition of ocular emergencies, understanding pathophysiology, and knowing how to manage time sensitive vision threatening emergencies is paramount for today’s pre-hospital personnel, especially in resource limited environments. This course will cover the assessment, pathology, and treatment of vision-threatening emergencies providers should know, both traumatic and medical, in a practical case-based format. Objectives: gain an understanding of relevant physical exam findings and pathophysiology related to non -traumatic ophthalmological emergencies that impact and/or change the direction of patient care, including the current trends in therapy / gain an understanding of relevant physical exam findings and pathophysiology related to traumatic ophthalmological emergencies that impact and/or change the direction of patient care and impact transport decisions / gain an appreciation for a rapid, pertinent eye exam and the indications for emergent referral for therapy / gain an understanding of pertinent anatomy, pathology and pharmacology as it relates to emergency ophthalmological care.

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1:30-2:30 PM CST

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Medical

Saving Lives Without Equipment: The Case for Pressure Points, Hands-Only CPR, and Precordial Thump

David Jacobson, EMT-P

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Many EMS providers, especially rural and volunteer providers, find themselves at medical emergencies while off duty and without equipment. In settings where care is not immediately available, some skills need to be taught and maintained to be able to provide some assistance before medical equipment arrives. Hands-only CPR still has a decent success rate compared to BLS and it helps to get trained personnel to help when breathing barriers are not available. The precordial thump is still included in the AHA guidelines and in multiple studies, while it will not permanently resume a normal rhythm, the heart may convert to a perfusing rhythm for a few minutes, making it more likely that the patient will respond to defibrillation. Lastly, while tourniquets are the gold standard for uncontrolled bleeding, in their absence, pressure points have been shown to decrease the bleeding and can be done without equipment. These skills, when used appropriately, can give care to patients in life-threatening emergencies without the need for any extra equipment, and are essential for every EMS provider. Objectives: describe the location of the pressure points for the arms and legs / explain the use of the precordial thump in adults / describe the procedure to perform the precordial thump / recognize the benefit of hands only CPR.

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1:30-2:30 PM CST

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Preparatory

Working Hours – Are We Setting Ourselves up to Fail?

Stephen Hines, BSc (Hons), Dip IMC RCS Ed

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Many paramedics work long hours. Not only with their primary employer, but often working multiple jobs to support families. But what happens when we get tired? With increasing scrutiny of EMS vehicle collisions, should consecutive working hours or days be limited? The session includes case studies from EMS around the world, and a comparison with the airline industry. Objectives: define work / explore the effects of fatigue / describe how the EMS environment is changing / examine what we can do about it.

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1:30-2:30 PM CST

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Medical

Danger and Migraine Attacks

Becky Valentine, BS, Paramedic, NCEE, MA I/C

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Headaches can be debilitating, no doubt about it.  Traditional migraines are painful, cause nausea and vomiting, and impact someone’s ability to function. Complicated migraines can have unusual signs and symptoms which signal potentially life-threatening emergencies. 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: recognize possible triggers that could lead to migraine activity / recall signs and symptoms of traditional migraine / identify potential life-threatening signs and symptoms associated with migraine / differentiate between classic and complicated migraines.

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1:30-2:30 PM CST

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Preparatory

Medical Director Cage Match: Let the Science Win the Day

Taylor Ratcliff, MD, FACEP, FAEMS, EMT-LP

Heidi Abraham, MD

Jeff Jarvis, MD, MS, EMT-P

Emily Kidd, MD

Jason Pickett, MD, FACEP, FAEMS

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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. Taylor Ratcliff (possibly wearing antlers) attempt to rein in a panel of highly opinionated EMS physicians in a wide-ranging discussion of the key topics of the day. Topics are likely to change to assure they are “hot-off-the-presses” current, but are likely to include cardiac arrest management, medications, and airway management. Objectives: describe the main findings of the relevant peer-reviewed papers on how not to kill our agitated patients / describe the main findings of the relevant peer-reviewed papers on how not to go to jail as a medic / describe the main findings of the relevant peer-reviewed papers on why assessing agitated patients is good / describe the main findings of the relevant peer-reviewed papers on sedation of agitated patients.

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1:30-2:30 PM CST

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Preparatory

Be Where Your Feet Are…Building Your Own Resiliency          

Scott Lail, EMT-P, FP-C, CFE, AAS

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We see things we should not see and hear things we were not meant to hear. So, what happens when the experiences are too much, and your plate is full or begins to overflow? What if there was something we could do to proactively prepare ourselves for these traumatic events and help mitigate their effects on us?  Luckily, there IS something we can do; we can build full-scale resiliency! This session will offer a brief introduction to the challenges associated with reactive responses to trauma. More importantly, it will explore several techniques to help responders build their own resiliency. This lecture is appropriate for everyone from the newest rookie to senior leadership and management, and the discussion may range from emotional and dark to smiles and laughter. Ultimately, it is designed to help responders live their best life! Objectives: understand the effects of traumatic events on the brain / describe the structures of the brain that guide memory / discuss ways to build your resiliency / express pathways for professional assistance.

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3:15-4:15 PM CST

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Clinically Related Operations, Preparatory

Malpractice or Murder: When Do EMS Providers Cross the Line from Negligence to Crime?           

Steve Wirth, Esq, EMT-P

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The EMS world was shocked to the core after an Illinois prosecutor in January 2023 filed first degree murder charges against two EMS providers over the death of Earl Moore, a patient transported in a prone position strapped to the ambulance stretcher. The patient died of compressional and positional asphyxia shortly after arrival at the ED – and the actions of the EMS providers that led to Mr. Moore’s death were recorded on the three bodycams of the police officers at the scene. While criminal charges against EMS providers for their actions during patient care are not unprecedented, the filing of first-degree murder charges following the death of a patient is virtually unprecedented. What conduct of the EMS providers led to this terrible tragedy? What made this a criminal case rather than a civil negligence case? In this eye-opening session, we will dissect the facts of the case, discuss the law, and provide the participants with specific tips and strategies on how to prevent this type of horrific patient outcome from happening at your ambulance service or EMS agency. Objectives: discuss the four elements of negligence / describe the differences between civil and criminal wrongs / list types of behavior and actions or inactions that can lead to claims of negligence or criminal conduct / describe steps the EMS provider can take to ensure the patient is treated with compassion and competence.

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3:15-4:15 PM CST

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Medical, Patient Assessment

When Puking Has a Poor Prognosis

Chris Ebright, BEd, NRP

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Nausea and vomiting are non-specific symptoms of medical illness that are common findings for many patients EMS sees every day. And being such a benign sign and symptom, they commonly get ignored while looking for a cause of a patient’s ailment. This presentation discusses some of the more dangerous, and possibly fatal conditions that sometimes only manifest with nausea and vomiting. Objectives: discuss how an accurate patient history helps to differentially diagnose a patient with nausea and vomiting / explain the necessity for a thorough review of body systems in a patient with nausea and vomiting / list five dangerous underlying medical causes that present with nausea and vomiting / describe the management of conditions that present with nausea and vomiting.

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3:15-4:15 PM CST

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Patient Assessment, Trauma

Perfecting Palpation: Putting the Blinders on Trauma Assessment

Bob Matoba, MEd, Paramedic

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Performing a thorough physical assessment on patients is a critical skill for any EMS provider.  This session will focus on the various techniques associated with performing a thorough physical assessment.  Participants will perform and become comfortable with the elements of this physical assessment. Objectives: discuss common obstacles associated with failing to perform a thorough physical assessment / list the steps of a thorough physical assessment / perform a thorough physical assessment / discuss the benefits of performing a thorough physical assessment.

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3:15-4:15 PM CST

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Medical, Preparatory

Drugs in Cardiac Arrest: What Does the Literature Say?

Jeff Jarvis, MD, MS, EMT-P

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We’ve all spent a lot of time learning to (and administering) drugs in cardiac arrest. Does any of it really matter? Epinephrine – Are we saving the heart at the expense of the brain? Calcium? Bicarb? Amiodarone? Lidocaine? Are they doing anything other than numbing the skin? Does it matter if we give it quickly? How about IV versus IO? Dr. Jarvis will review the literature on epinephrine and anti-dysrhythmics in cardiac arrest as well as recent work done looking at the impact of route of administration. He’ll keep you awake as you learn the latest information that should be shaping your clinical practice. Objectives: understand how literature should provide the foundation for clinical practice, describe the importance of timing with epinephrine use / describe the impact of epinephrine on outcomes in cardiac arrest / discuss the difference in outcome between amiodarone, lidocaine, and placebo in cardiac arrest / discuss the association between route of administration (IV and IO) on outcomes in cardiac arrest.

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3:15-4:15 PM CST

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AOR, Preparatory

“I’m Not Okay, You’re Not Okay”

James Hawkins, firefighter, paramedic

Jennifer Halley, BS, MS, MSP

Lisa Landon, Co-Founder, Warriors Heart Treatment Center

Allyson Oliver, MS, LPC, EMDR trained

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March 26, 2018, could have ended differently for Firefighter Paramedic James Hawkins.  He was executing his plan to end his life because he didn’t see any path forward from his addiction and depression/anxiety.  Through years of therapy and the support of loved ones, James is here today to tell his story.  James has invited professionals that are experienced in first responder mental health in Texas to form a panel and show others there is another option to work through the demons.  James will tell his story and share the mental health professionals that saved his life. Objectives: list signs and symptoms a first responder may demonstrate when experiencing a mental health crisis / categorize mental health treatment options for first responders / list treatment options and describe success and failure / describe techniques to utilize when a first responder is experiencing a crisis.

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3:15-4:15 PM CST

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Clinically Related Operations

Rural EMS Doesn’t Have to Act Rural

Doug Carlyle, BS, LP, NRP, EMSC

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Utopia Volunteer EMS, Inc. is the 9-1-1 provider for the Utopia/Vanderpool ESD #1. We offer BLS with MICU capability for 457 square miles in portions of Uvalde, Real, Bandera, and Medina Counties. The service uses progressive/aggressive protocols at the EMT-Basic, AEMT, and Paramedic levels to provide pre-hospital care that makes our regional air medical providers say “Wow!” When air medical is not available, we must ground transport 45 minutes to 1.5 hours to the closest appropriate facility Level IV facility. See how we have expanded the use of IV therapy, IV pumps, multiple pain medications options, pressors, a wide variety of “rare-finds” in many EMS services, and ACLS medications at the EMT-Basic and AEMT levels. You will also see how we changed our “tool kits” in response to the 2018 church bus crash in Concan, Texas that killed 13, and the Uvalde school shooting to which we responded. Objectives: change the paradigm that only a red patch can deliver advanced pre-hospital therapies / describe the use of on-line medical control as a lifeline even if it means purchasing satellite phones / recognize that even the most seasoned provider needs to avoid creating a mess when you are an hour away from the hospital and you are alone in the back.

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3:15-4:15 PM CST

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Special Considerations

Is there a Medical Provider On Board?: Responding to In-Flight Emergencies at 35,000 Feet

Jared Ross, DO, NRP, TCCC, FACEP, FAAEM

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There are over 1,000 in-flight medical emergencies every day, would you be prepared to respond? Would you know what to do if you were faced with handling it alone? In this lecture, we will discuss all aspects of inflight medical emergencies, from common chief complaints to working with limited medical equipment and supplies. We will address issues of medical-legal liability, contacting medical control, and techniques for improvising. We will also discuss several difficult topics including making the decision to divert the flight, when to cease resuscitative efforts, and dealing with death onboard. Objectives: describe the most common chief complaints for inflight medical emergencies / discuss techniques for improvising medical equipment on flights / describe the extent of medical supplies and equipment carried on US commercial aviation / consider the reasons and costs associated with mid-air diversion of a commercial aircraft.

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3:15-4:15 PM CST

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Trauma

Micromobility: Public Service or Public Nuisance

Gary Hecker, RN, CCRN, EMT-CC, CIC, NHDP-BC

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Micromobility devices include e-bikes and e-scooters.  These devices offer quick, low-cost convenience for short distance travel.  In addition to personally owned devices, many cities and college campuses offer short term rentals.  While convenient, these devices are not without safety concerns.  Injuries are highly prevalent among riders and pedestrians alike.  In this session we will define micromobility and give examples of devices out there.  Safety issues and injury patterns will also be discussed. Objectives: define micromobility / identify examples of micromobility devices / state safety issues associated with micromobility device use / provide ways to standardize documentation of these devices and injuries.

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3:15-4:15 PM CST

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Airway

Opening the Black Box: Why Your EMS Service Should Pursue Video Laryngoscopy With Recording Capability ASAP!

Casey Patrick, MD

Brian Miller, MD, FACEP, FAEMS

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Medication-assisted airway management is a high-risk prehospital procedure. EMS airway registries, data collection, and run reviews have historically been limited to post-procedural forms and crew memory.  Prehospital utilization of video laryngoscopy (VL) with recording capability allows greater insight into the chronology, choices, and obstacles encountered during paramedic intubations.   Dr. Miller and Dr. Patrick will discuss the steps required to implement, train, and oversee recording VL in their services.  Then, they’ll get to the cool stuff – the videos! Objectives: review the deficiencies in current airway management clinical review / learn how VL with recording capacity can improve clinical oversight / discuss pitfalls and lessons learned during the rollout process / address future goals for recording VL technology.

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3:15-4:15 PM CST

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Medical

When Critters Bite and Sting

Michael Gooch, DNP, APRN, CCP

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Environmental emergencies can include many types of bites and stings, including Hymenoptera, ticks, spiders, snakes, aquatic species, and mammals. Some of these presentations are encountered more often than others. Most cause minor problems, but some can have significant systemic effects. Some emergency transport providers manage these patients infrequently. This presentation will review some common and less common presentations, reviewing their clinical manifestations as well as management options. Lastly, available clinical practice guidelines will be reviewed as they relate to these topics. Objectives: differentiate between local and systemic reactions in a Hymenoptera exposure / differentiate between pit viper and coral snake envenomations / formulate a management plan for select bites and stings / recall indications for snake bite antivenin.

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4:30-5:30 PM CST

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Medical, Patient Assessment

U.S. Border Crisis Impacting Heroin, Fentanyl and Tramadol Addicts

Ken Bouvier, NREMT, Paramedic

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The impact of heroin use is felt across the United States with heroin being identified as one of the most important drug abuse issues effecting communities coast to coast. It is estimated that 50 million people worldwide are users of cocaine, heroin, and synthetic drugs, including 700,000 Americans. The U.S. border crisis is a contributing factor in the increase amount of drug trafficking, drug use, and drug deaths in U.S. border states including Texas. During this session we will discuss both basic and advanced treatment for managing heroin overdoses. We will discuss the dangers that emergency room nurses encounter when treating patients of heroin overdose. We will explain how heroin enters the brain and how it can affect other body functions including breathing and heart rate, making it a life-threatening emergency. Objectives: understand more about heroin, fentanyl and tramadol addicts / describe how the U.S. border crisis is impacting addicts / explore how heroin, fentanyl & tramadol affects body systems / discuss the treatment options for heroin addicts.

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4:30-5:30 PM CST

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AOR, Preparatory

On The Stand: Navigating Courtroom Procedures for First Responders

Catherine Kuhlmann, Firefighter/Paramedic ICO, Former Judge, EMS Chief

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This lecture will walk first responders through multiple aspects of what to expect and how to prepare for court proceedings. We will address subpoenas and depositions. As a former judge, I realized many times, first responders find themselves not prepared or unaware of what is expected of them. Unfortunately, many fall victim to pitfalls with documentation, chain of custody, as well as proper attire for the courtroom setting. We will discuss the process involved and ways to lessen the stress involved when one tries to navigate a court system one is not familiar with. Together we will leave with a better understanding of the legal system from the perspective of a former sitting judge. Objectives: describe the legal system / explain the importance of documentation and proper chain of custody / demonstrate proper courtroom etiquette and discuss why it matters / identify pitfalls that first responders unintentionally make / explain who is and who isn’t covered under The Good Samaritan Act.

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4:30-5:30 PM CST

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Patient Assessment, Special Considerations

That Patient Looks Pissed: Handling the Aggressive Patient

Jason Martin, RN, CEN, TCRN, CPEN, NREMTP

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Every year there is an increasing number of violent acts against prehospital providers. Violence can be verbal, physical or a combination of the two. This presentation will discuss common causes of aggressive patients and the strategies to deal with those patients. Objectives: discuss strategies for keeping providers safe / describe ways to approach and appropriately respond to every call / define situational awareness and how to use it / identify some of the reasons behind why violence occurs against EMS.

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4:30-5:30 PM CST

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Airway

Core Airway Skills: We’re Doing it All Wrong!

Eric Jaeger, JD, NRP, EMS IC

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Our BLS airway skills are fundamental to effective resuscitation, and there is evidence that we have been doing them all wrong! Please come join us to critically examine these core airway skills and learn the micro-skills necessary to perform them successfully. We’ll discuss a series of approaches to airway management that, taken together, offer a modified approach to severe respiratory distress that may be significantly more effective than our current approach. These include understanding the critical importance of positioning in airway management, high flow nasal cannula, increased use of PEEP, expanding indications for CPAP, and other innovations. We’ll explore the importance of proper technique in face mask ventilation in keeping providers out of the “airway death spiral.” We’ll discuss how to better manage a soiled airway. And we’ll put these various techniques together to better equip providers to manage challenging airways. Objectives: understand the importance of positioning in managing respiratory distress / understand when to get aggressive in managing severe respiratory distress / describe the importance of PEEP in managing respiratory distress / demonstrate knowledge of how to effectively use PEEP with conscious and unconscious patients.

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4:30-5:30 PM CST

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AOR, Preparatory

Why do They STAY?

Macara Trusty, MS, LP, SHRM-SCP

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As employers of EMS professionals across the country work hard to adapt to a changing workforce environment, it’s crucial 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 about it 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, we will “flip the script” on employee retention and review information from over 1,200 stay interviews conducted within one EMS agency. We will also reveal how stay interviews can be implemented in other organizations to improve employee retention. Objectives: review current statistics that reveal the need to focus on the retention of EMS Professionals / describe the Stay Interview and its 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.

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4:30-5:30 PM CST

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Medial, Patient Assessment

Your Patient Drank What?!?! Methanol, Glycols and Other Lethal Libations

Ronna Miller, MD

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Those gallon jugs of alcohol-based hand sanitizer so widely available since the COVID-19 pandemic often hid a deadly secret. Even before the pandemic, the so-called “toxic alcohols” (methanol and ethylene glycol) posed grave risk of permanent end-organ damage for those unlucky enough to consume them. Toxic alcohol poisoning is not just a problem in distant lands, and diagnostic delay leads to poor patient outcomes. This presentation highlights the toxicities, treatments, and EMS triage for patients with known or suspected methanol or ethylene glycol and similar lethal libations. Objectives: identify common sources and settings where toxic alcohols may be encountered / describe the toxic effects of toxic alcohols, such an methanol and ethylene glycol / describe the clinical presentation of methanol and ethylene glycol intoxication / describe key principles of EMS care of patients with toxic alcohol poisoning. 

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4:30-5:30 PM CST

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Preparatory

Top 5 EMS Research and Quality Improvement Abstracts of 2023

David Wampler, PhD, LP, FAEMS

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

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4:30-5:30 PM CST

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Clinically Related Operations

10 Years of IRONMAN Race Medical Direction: From Heatwaves to Hailstorms and Princes to Politics

Kevin Schulz, MD

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Dr. Kevin Schulz has served as the medical director for over 20 half and full IRONMAN races in the past decade and boy does he have some stories to tell! Not only will he discuss what goes into planning for a “normal” year, he’ll provide some insight from some of the “tough” years. What do you do when a hailstorm blows through your ultra-endurance event? How does it affect your planning and operations when the prince of a foreign nation decides to participate as an athlete? Who actually thought hosting an IRONMAN in Southeast Texas was a good idea anyway? Learn from the experiences gained over 10 years of races, medical direction, and some of the pitfalls and problems that can come up when trying to cover a 17-hour, 140-mile race. Objectives: discuss components of IRONMAN race medical coverage / examine how various weather conditions can affect the race and some ideas to prepare for them / discuss the effect VIPs can have on event medical coverage / examine some mitigation strategies in the overall race medical coverage planning to address unforeseen circumstances.

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4:30-5:30 PM CST

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Medical, Patient Assessment

Prehospital Care for the VAD Patient

Stephen Wilcox, LP, FP-C, EMS-I, AAS

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Despite VAD placement becoming a popular treatment for heart failure patients in recent years, there is very little education being pushed out to prehospital and emergency room providers across the nation about VADs. Using his personal and EMS experience, Stephen presents a one-of-a-kind lecture that explains VAD functions, equipment, alarms, and the prehospital management of common medical and trauma emergencies that VAD patients face. Objectives: understand how to assess a VAD patient’s perfusion status / describe how to treat a VAD patient who is in cardiac arrest / explain how to assess and trouble shoot common VAD alarms / examine the common medical/trauma emergencies that VAD patients face and their treatments.