Current Topics

The Sinister Six

As advanced practice providers, we are expected to be able to discern dangerous rhythms on the ECG—such as the dreaded ST-segment elevation myocardial infarction.  Yet, there are a multitude of rhythms that mimic this feared arrhythmia, which are often mistaken for an acute myocardial infarction on the 12-lead ECG.  This leads to inappropriate activation of cardiac catheterization lab personnel, as well as inappropriate treatment of patients.  This presentation will discuss six commonly misinterpreted STEMI mimics encountered by EMS professionals, and help you distinguish between what is real and what is fantasy.

ECG Patterns of High-Risk Syncope

Syncope is a relatively common call for EMS professionals, with a broad range of differential diagnoses from benign issues to life-threatening conditions.  Obtaining an ECG should be a key aspect of nearly every syncope workup. When doing so, prompt recognition of a high-risk ECG pattern is a critical skill for paramedics and other EMS personnel to be able to provide the best care possible and deliver a patient to the most appropriate facility in a timely manner.

Target Audience: Advanced providers      

The Battle Within: Autoimmune Diseases

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

Target Audience: All providers

Take a Good Look: A Review of Ocular Emergencies

Eye injuries make everyone queasy, especially this presenter.  However, early and prompt  recognition  of  several  common  injuries  and  illnesses is  imperative to save a  patient’s  vision.  This presentation  will  review  the basic  ocular  anatomy,  highlight  an  abbreviated  exam  for  EMS  providers,  and  go  over  some  common emergency presentations found in the prehospital setting.

Target Audience:  All levels

Baba Yaga Comes a Calling

Two words that strike fear into anyone: John. Wick.  An expert with firearms, knives, belts, and even a pencil…when he comes for you, he is the last thing you see.  But how is he so efficient?  What injuries does he inflict that are so fatal?  This presentation will describe and discuss anatomic disruptions, ballistics, and the traumatic mechanisms of the most fatal penetration injuries that we as EMS professionals encounter and how to manage them.

Target Audience:  Can be used for all levels

That Gut Feeling

You didn’t feel like going to school, so you tried your best to convince your parents that you were just too sick.  Faking a stomach ache was one of the easiest things to try, and in my case, it usually was effective (sorry, Mom).  But what about that patient who truly has abdominal pain?  Assessing it is one of the easiest and also one of the hardest things to do.  Easy, because the exam takes under a minute; hard, because between what you assess and what the patient tells you, you’re left asking a lot of questions: do the symptoms, focused physical exam, and patient history suggest something life-threatening, or more benign?  The degree of criticality is determined by getting answers to those questions

Target Audience:  All levels

You Can’t Make This Stuff Up

If you’ve been in EMS for any length of time, you’re bound to have a good story from a memorable call.  We all have them and this session discusses some of the more memorable, funny, and shocking calls from a career spanning 28 years in EMS.  If you want to relax and kick back for an hour, this presentation is for you!

Target Audience:  All levels

Ventilation vs. Respiration

You were taught from day one of taking vital signs to count respirations.  However, your stellar EMT instructor let you down, because she/he was wrong.  The same incorrect terminology is also written in numerous textbooks, on run reports, and spoken everyday between medical professionals.  So what is the proper term?  Ventilations.   Aren’t these terms essentially the same?  The easy answer is no.  The harder question is: Why not?  This session discusses these physiological processes and how they differ. 

Target Audience:  All levels    NCCP Category:  Ventilation

Shaken, Not Stirred

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

Target Audience:  All levels NCCP Category:  Neurological/Seizures

Unique Patient Signs

Even experienced clinicians can be stumped when a patient presents with multiple signs and symptoms.  Diagnosis and treatment are often delayed as a result, especially when these signs and symptoms don’t jive with the patient’s chief complaint.  Interestingly, there is a subset of medical terminology known as an eponym – which is any word related to medicine, whose name is derived from a person, usually a physician.  Observing these unique “signs” and understanding what they represent can help an EMS professional efficiently differentially diagnose, guide patient management and make appropriate transport decisions.  This presentation will discuss many different unique patient signs that might appear in your next patient!

Target Audience:  All levels

When Puking Has a Poor Prognosis

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. 

Target Audience: All providers      

Pass On the Salt: The Potential Harm of IV Fluid

From the hooks that hang from ambulance ceilings and rise from the backs of stretchers, intravenous fluids are a hallmark of pre-hospital care. They’re part of managing several medical emergencies and the stabilization of trauma patients.  A growing body of research has aimed to refine the use, selection, and overall administration duration of intravenous fluids. This presentation highlights instances in which normal saline and other crystalloids should NOT be the norm, and sometimes hasten the deterioration of a patient’s condition.

Target Audience: All providers – more toward Advanced

Syncope and Syncope Mimics

Syncope, or brief loss of consciousness, is a common presentation that can be a frustrating chief complaint for EMS providers. By the time you see the patient, most have normal and stable vital signs and are back to baseline without symptoms. Furthermore, the list of potential etiologies is near endless. Most causes of syncope are relatively benign, but one must keep in mind that there are more sinister causes as well. Not only does that fact make it harder to differentially diagnose a patient, but also requires a EMS provider to come up with a variety management strategies. This presentation will discuss the need for a systematic approach to working up syncope while considering mimics.

Target Audience: All providers

Zoomies and Snails:  Pediatric Cardiac Arrhythmias

Children have arrhythmias, just as adults do. But what is normal and what is abnormal? As healthcare providers, it is important to be able to identify rhythms in children and treat them appropriately. This lecture will focus on the most common arrhythmias seen in children and treatment, including “too fast and too slow” rhythms, SVT, ventricular arrhythmias, and congenital dysrhythmias.

Target Audience: All providers – slightly more Advanced

The Danger of Dihydrogen Oxide

Drowning is a common and often preventable cause of death, with significant risk factors that include gender, time of year, lack of supervision, history of epilepsy, and alcohol and drug use.  Unfortunately, in the United States, it is the second leading cause of injury-related death among children one to four years old.  This presentation follows a real-time case study involving a pediatric drowning where pathophysiology, and EMS management are discussed at the basic and advanced levels of care.

Target Audience:  Can be used for all levels

Until All The Pieces Fit

As a pre-hospital care provider, on average, you are seven times more likely to encounter a patient diagnosed with autism.  It is not one condition, but rather a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and non-verbal communication.  As a result, these patients can present to EMS providers with unique assessment and management challenges.  This presentation will explain the autism spectrum as well as certain notable characteristics of these patients to consider when performing an assessment and rendering medical treatment.

Target Audience:  Can be used for all levels    NCCP Category:  Special HC Needs

It Ain’t Easy Being Wheezy: Pediatric Status Asthmaticus

Severe asthma has become more prevalent in American children, with mortality rising sharply in the past decade. Any EMS professional may be faced with the asthmatic child in severe respiratory distress or impending respiratory failure, not been relieved with typical bronchodilator therapy. These scary patients require more timely and aggressive treatment than what is usually needed for a typical “shortness of breath” call.  This discussion will explain how to properly intervene at the basic and advanced levels of care, so as to increase the chances of a positive resolution from this continuous, and dangerous, respiratory threat.

Target Audience:  All levels

Postpartum Emergencies

Postpartum emergencies often include headache, eclampsia, infection, heart failure, and hypertension.  Failure to recognize and treat these conditions can lead to disastrous consequences for the patient, including stroke, permanent brain damage, or death.  This presentation will discuss the various types of emergencies to be aware of and how to manage these patients in the pre-hospital environment.

Target Audience:  Can be used for all levels

Pediatric Chest Pain

Kids complaining of chest pain is a commonly encountered problem. Although alarming to parents, chest pain in children typically is not caused by serious disease.  Unlike adults, which raises a concern for myocardial ischemia, non-cardiac etiologies of chest pain are far more common in children and adolescents.  This presentation will help the EMS professional properly assess and deferentially diagnose cardiac versus non-cardiac pediatric chest pain and how to manage any of these patients in the prehospital setting.

Target Audience:  Can be used for all levels/more to the Advanced level

Thwacks, Whacks, Cracks and Smacks

Sports-related concussions are serious, widely prevalent, and often under-reported traumatic brain injuries.  This presentation discusses the pathophysiology and sequelae of concussion as well as proper identification, evaluation and patient management.  Severe, moderate and even mild concussions have a high potential for significant long-term deleterious effects on an athlete.  Extensive anatomical and physiological damage may be present from just one traumatic blow to the head.  Advocating for an athlete to sit out the rest of an event by knowing the signs and symptoms specific to concussion may be the difference between a decent versus a terrible outcome.

Target Audience:  Can be used for all levels  NCCP Category:  CNS Injury

Pediatric Capnography

This presentation highlights uses for capnography in pediatric patients in the pre-hospital setting. Uses include confirmation of intubation, maintenance of ventilation in intubated and non-intubated children, monitoring of effectiveness of cardiopulmonary resuscitation, and as an adjunct for monitoring of sedated children and children with lower respiratory disease, shock and metabolic derangements.

Target Audience:  All levels, slightly toward the Advanced level NCCP Category:  Capnography

Stretched, Stabbed and Strangled: Traumatic Neck Injuries

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

Target Audience:  All levels

The Sick AMI Patient

Cardiogenic shock secondary to myocardial malfunction has serious consequences for any patient experiencing an AMI.  This presentation explains the causes, pathophysiology and mechanics behind the development of cardiogenic shock as well as the current treatments for these patients in the pre-hospital setting.

Target Audience:  All levels, more toward Advanced

Russian Roulette – The American Way

Parents do not know that inhalants – cheap, legal and accessible products, are as popular as marijuana. Even fewer know the deadly effects the poisons in these products have on the brain and body when inhaled.  It’s like playing Russian Roulette – the user can die the 1st, 10th or 100th time a product is misused.  This presentation will explain the pathophysiology of various gases, nitrites, volatile substances and other information you need to know about this deadly underground problem affecting teens and pre-teens.

Target Audience:  All levels

When The Bite Is Worse Than The Bark

Thousands of snakebite cases are reported every year in the United States. A bite from a venomous snake is rarely deadly, but should always be treated as a medical emergency.  Most of these types of bites produce an array of symptoms, including localized pain, swelling, convulsions, nausea and even paralysis.  This presentation will describe the common types of snakes, the pathophysiology of their venom and what we as EMS providers need to do for these patients.

Target Audience:  Can be used for all levels

Trachs and Tubes and Shunts, Oh My! Technology for Special Needs Children

Most EMS training teaches us how to deal with the “average” patient.  Due to advances in medical technology and more plentiful support services, children who have suffered critical injuries and those with unique disease states are being cared for at home more than ever.  This presentation will explain the most common equipment and technology that pre-hospital providers will encounter when caring for these patients.

Target Audience:  All levels NCCP Category: Special HC Needs

Picasso, Judy Garland and Indiana Jones all walk into a bar….

This presentation will describe the organic, psychosocial and environmental causes of mental health derangement as well as providing information on schizophrenia, phobia and depression. Specific pathophysiology, signs and symptoms and EMS treatment options are provided to the participant during the discussion as well as addressing the prevalent problem of PTSD and suicide that is affecting all of us in the EMS community, now more than ever.

Target Audience:  All levels        NCCP Category:  Psychiatric

The Smiling Death

When responding to an entrapment situation, EMS should be prepared to manage a patient with crush syndrome. Having your patient die moments after being freed is a tragic end to a well-executed rescue.  EMS providers as part of these teams can reduce the chances of this through recognition and proper pre-treatment prior to extrication.  Come listen to this presentation and find out how.

Target Audience:  All levels, slightly toward the Advanced level

Pediatric Sepsis

Sepsis is a life-threatening organ dysfunction caused by an overwhelming bodily response to an infection. Caring for a septic infant or child presents not only a management challenge, but also causes anxiety and fear in even the most seasoned EMT and paramedic. As one of the leading causes of death for children in the U.S., the EMS professional must be familiar with the signs and symptoms of this life-threatening event, and vigilant during his or her examination. This presentation will help you to recognize and properly intervene, which is essential, in order to improve a patient’s outcome.

Target Audience:  All levels  NCCP Category:  Infectious Disease

Special K!

What is the difference between hypokalemia and hyperkalemia?  Should pre-hospital providers even care?  Absolutely!  Ever run a code or treat a dialysis patient, and despite everything done correctly the patient does not improve?  Remember the H’s and T’s?  By paying attention to the history of the illness and some of the more subtle signs and symptoms, EMS providers can provide a more detailed report to emergency department personnel, alerting them to the possibility of an electrolyte imbalance emergency. Come participate…and we will discuss physical presentation, ECG changes and other things to consider.

Target Audience:  Advanced, EMT-P

And The Beat Goes On…

A ventricular assist device (VAD) is used to partially or completely replace the function of a failing heart. Some VAD’s are for short-term use, typically for patients recovering from heart attacks or heart surgery, while others are intended for long-term use. This session discusses the heart failure patient and need for a VAD, the various types of VAD’s, troubleshooting warning indicators, common management needs and special situations requiring intervention by the EMS professional.

Target Audience:  All levels NCCP Category: VADs

When a Stroke Really Isn’t A Stroke

The diagnosis of acute ischemic stroke is often straightforward. The sudden onset of a focal neurologic deficit with a common presentation – such as hemiparesis, facial weakness and aphasia – identifies a common syndrome of acute stroke. What if the patient presentation is not that cut and dry?  Differential diagnostic problems remain because there are several subtypes of stroke and some non-vascular disorders have clinical presentations identical to stroke. This presentation will address these “mimics” as well as other considerations during your assessment of these patients who “didn’t read the textbook’.

Target Audience:  Can be used for all levels

The Unhappy Drunk: Toxic Alcohols

“Toxic alcohols” … Why would someone ever consume them? Typically, these substances are used for two reasons: suicide/homicide or inebriation.  They are more readily available than ethanol and are usually cheaper, thus, are sometimes a viable option for the patient looking for a quick fix.  The results of ingestion, however, can be catastrophic.  This presentation will break down the effects of these substances in the body and what we as EMS providers can do for these patients.

Target Audience:  Can be used for all levels

Meconium Happens!

OB patients, in many EMS providers’ minds, usually elicits a response of “Oh, Boy!” As scary as it might seem, the majority of pre-hospital deliveries just involve catching, drying, and stimulating the newborn – then cutting the umbilical cord.  However, every once in a while, a pregnant patient has indications of an impending complicated delivery.  Whether it be prior, during, or after a birth, conditions such as placenta previa, abruptio placenta, cord presentation, shoulder dystocia, CPD and breech birth, among many others, have to be assessed and managed appropriately. This not-always-necessary-but-essential-to-know information will be discussed throughout this presentation.

Target Audience:  All levels  NCCP Category:  OB Emergencies

The Perils of Suspension Trauma

Those who work at heights on scaffolds and other structures higher than six feet often wear safety harnesses. The technology of safety harnesses has progressed in recent years, but even with the best designs in safety gear, those who fall in an upright position are at risk of death.  This can happen even after a relatively short and effective rescue.  This presentation will explain the physiological consequences of suspension trauma and what EMS professionals need to consider during recovery and treatment.

Target Audience:  All levels

A Bolt Out of the Blue

A person struck by lightning is the second leading cause of storm-related deaths in the United States. At minimum, a lightning strike is both a serious medical and traumatic event that can lead to significant injury and/or permanent disability. This presentation will enlighten you to the various effects that a lightning strike has on the human body and the numerous anatomical and physiological complications that the pre-hospital provider must be aware of in order to triage and treat these victims properly. Come, listen, and see what all the thunder is all about!

Target Audience:  All levels

The Day the Blue Bloater met the Pink Puffer

One of the most common calls to which an EMS provider responds is the classic “shortness of breath”. While there are many causes behind this chief complaint, this presentation focuses upon the two main types of COPD – emphysema and chronic bronchitis. Both disease processes’ pathophysiology are compared and contrasted as well as their signs and symptoms. This presentation is audience interactive and follows an imaginary storyline of two patients named Betty and Earl that helps to explain the differences and commonalities of these two respiratory emergencies.

Target Audience:  All levels

In an Instant

One time or another, we take the call for a patient that we know all too well.  Sometimes it is a family member, a friend, and in one terrible instance – a co-worker.  Based on an actual EMS call, this presentation correlates real timeline history, events, and preventative treatments for a fellow colleague with the underlying pathophysiology of a pulmonary embolism.  Various signs, predisposing risk factors and origins of emboli formation are all tied together to give a global perspective of the acute and, in this case, fatal event that shocked and stunned an entire EMS service.

Target Audience:  All levels

To Pee Is to Be

When the kidneys fail, your patient becomes sick with a variety of non-specific signs and symptoms. Whether an acute event or from a chronic problem, kidney failure may lead a patient being dependent on dialysis. This presentation helps you gain some insight into the challenges these patients provide to the EMS professional.

Target Audience:  All levels

Blown to Kingdom Come!

Blast injuries result from explosions that have the capability to cause multisystem, life-threatening injuries in single or multiple victims simultaneously. These types of events present complex triage, diagnostic, and management challenges for the health care provider.  This presentation will explain the pathophysiology, safety considerations and what we do as EMS providers to help these trauma patients.

Target Audience:  All levels

The Night Joe’s Crab Shack Almost Changed Everything

This presentation explains and follows the development of the pathophysiology, signs, symptoms and treatment of a severe anaphylactic reaction. This case study shows how an allergic reaction develops into an anaphylactic presentation in real time with real events.  Audience participation will help demonstrate the components of the immune system and the events of a normal immune response.  All of the actual events during this case study correlated with the underlying pathophysiology of the immune response and will help the EMS professional better understand the development of anaphylaxis and its management.

Target Audience: All levels NCCP Category: Immunological

Hot Tots!  Pediatric Burn Patients

There are approximately 3,000 pediatric deaths annually due to burns and probably three times as many disabling injuries.  Burns not only affect the body physically, but also the life-long emotional well-being of individuals who must deal with any disfigurement that occurred from a burn.  This presentation will help the EMS provider provide proper, rapid assessment and care to a pediatric patient sustaining a burn from flame, electrical and/or inhalation injury.

Target Audience:  Can be used for all levels

When your patient reaches the breaking point

Need to brush up on some basic musculoskeletal assessment and management?  This lecture will help get you back up to speed on caring for various injuries and the complications associated with fractures and dislocations.  If nothing else, just come to see all of the cool pictures!

Target Audience:  All levels

Seven Things to Know about Pediatric Cardiac Arrest

The worst call possible: child in cardiac arrest.  So many thoughts go through your head before you show up.  On scene, chaos reigns.  Why did this happen?  What do I do first?  The situation alone of treating a child or infant is daunting even for the most seasoned EMS professional – this presentation will help you focus and be more confident when attempting resuscitation on this patient population.

Target Audience:  Can be used for all levels NCCP Category:  Pediatric Cardiac Arrest

Trust Me, Don’t Inhale.

The focus of this presentation is in on cyanide (CN) and carbon monoxide (CO) poisoning – the two most common toxic substances found in smoke.  Various topics, including circumstances in which CN and CO exposure might occur, the pathophysiology behind both toxins, the signs/symptoms of poisoned patients, and the action behind the antidotes for each will be discussed. Come listen, review, and refresh on a common, and sometimes deadly, topic.

Target Audience: All levels