This half-day pre-conference session addresses challenges faced

NAEMSP Annual Meeting
Schedule January 19-23, 2015
Monday, January 19, 2015
Time
Presentation
Speaker
7:00 a.m. - 9:00 a.m.
Registration
7:30 a.m. – 4:15 p.m.
PRECONFERENCE WORKSHOP
NAEMSP® National EMS Medical Directors Course & Practicum®
Beth Adams, MA, RN, NREMT-P,
and Robert Swor, DO, Course CoDirectors
Tuesday, January 20, 2015
7:00 a.m. - 9:00 a.m.
Registration
7:30 a.m. – 4:45 p.m.
PRECONFERENCE WORKSHOP
NAEMSP® National EMS Medical Directors Course & Practicum®
8:00 a.m.- 5:15 p.m.
NAEMSP® Advanced Topics in Medical Direction™
8:00 a.m. - 5:00 p.m.
PRECONFERENCE WORKSHOP
Building a Robust Quality Improvement Program in Your System
Beth Adams, MA, RN, NREMT-P,
and Robert Swor, DO, Course CoDirectors
Brent Myers, MD,
Course Director
Scott Bourn, PhD, RN, NREMT-P,
Course Director
Wednesday, January 21, 2015
7:00 a.m. - 7:00 p.m.
Registration
8:00 a.m. - 5:00 p.m.
PRECONFERENCE WORKSHOP
NAEMSP® National EMS Medical Directors Course & Practicum®
Beth Adams, MA, RN, NREMT-P,
and Robert Swor, DO, CoDirectors
8:00 a.m.- 5:00 p.m.
PRECONFERENCE WORKSHOP
NAEMSP® Resuscitation Academy
Paul Rostykus, MD, MPH
8:00 a.m. - 4:30 p.m.
1:00 p.m. – 5:00 p.m.
Daniel Patterson, PhD, NREMT-P
Henry Wang, MD
PRECONFERENCE WORKSHOP
Steven E. Lerman, MD, MPH,
Patient and Provider Safety
FACOEM
Deirdre McCaughey, PhD, MBA
Alex Isakov, MD, MPH
PRECONFERENCE WORKSHOP
Vance Ferebee, BSN
Ebola – US Experience with EMS Transport and Management
Ed Racht, AMR
This half-day pre-conference session addresses challenges faced by the Ray Swansiger, US State Dept.
Gregg Margolis (invited)
U.S. emergency medical response system as related to the Ebola public
Rick Hunt, National Security Staff
health crisis in West Africa.
(invited)
Wade Miles, Grady EMS (invited)
5:00 p.m. - 9:00 p.m.
COMMITTEE MEETING - Standards and Clinical Practice
Derek Cooney, MD
6:00 p.m. - 10:00 p.m.
PRECONFERENCE WORKSHOP
Distinctly Canadian
Eli Segal, MD, and Michele
Welsford, MD, FRCPC, CoDirectors
6:00 p.m. - 6:45 p.m.
New Member Reception
6:45 p.m.-7:45 p.m.
Certification (ABEM) Reception
7:00 - 9:00 p.m.
COMMITTEE MEETING- - NAEMSP® Council of EMS Fellowship Directors
Thursday, January 22, 2015 -- State of the Art
7:00 a.m. - 5:00 p.m.
7:00 - 8:15 a.m.
Registration
PEC Breakfast (Invitation only)
David Cone, MD
7:00 - 8:15 a.m.
8:15 - 8:30 a.m.
Continental Breakfast
GENERAL SESSION – Welcome & President's Address
Ritu Sahni, MD
NAEMSP® President,
Jon Rittenberger, MD,
Program Chair
GENERAL SESSION – Controversies in the EMS Management of Severe
Traumatic Brain Injury(TBI)
8:30 - 9:30 a.m.
The literature related to neuro outcomes in critically-ill patients is very active
on multiple fronts. However, much of this science actually comes from
general trauma, stroke and non-traumatic intracranial bleeds and has often
been inappropriately applied to TBI without supporting evidence. Thus,
multiple controversies have arisen related to the early management of severe
TBI: Is the threshold for treating hypotension too low in the current TBI
Dan Spaite, MD, FACEP
Guidelines? Should permissive hypotension be allowed in multisystem
trauma with TBI? Does hyper-oxygenation worsen neurologic outcome?
Does the treatment of hypoglycemia with glucose potentially lead to
detrimental hyperglycemia? Is sedation of intubated TBI patients detrimental
via vasodilation-induced reduction of cerebral perfusion? Should mild
"therapeutic" hyperventilation be used for impending brain herniation?
These and other hot topics will be discussed provocatively in this session.
GENERAL SESSION – National Response to a Public Health Crisis-Opioid
Overdose and the Changing Spectrum of Care
9:30 - 10:30 a.m.
10:00 a.m. - 4:15 p.m.
Opioid overdose kills people across all ethnic, racial and economic boundaries.
Michael Dailey, MD
To make it worse, part of the problem is iatrogenic; medicine’s interest in
treating pain was complicit in the creation of this crisis. Should EMS physicians
address the crisis of opioid overdose and integrate naloxone distribution into
our systems and our practice?
EXHIBIT HALL OPEN
10:30 - 10:50 a.m.
Break
10:50 - 11:00 a.m.
GENERAL SESSION – Prehospital Emergency Care Update
11:00 a.m. - Noon
GENERAL SESSION – Research - Oral Abstracts Session 1 (1-4)
Noon - 1:00 p.m.
Boxed Lunches in Exhibit Hall
12:05 - 1:05 p.m.
COMMITTEE MEETINGS
James J. Menegazzi, PhD,
Editor-in-Chief
GENERAL SESSION – Update on Board Certification
1:15 – 1:30 p.m.
This session will review the status of EMS board certification by briefly
reviewing the process that led us to a certification exam, describing the
David Cone, MD
"tracks" by which physicians may qualify to sit for the test, examining statistics
from the first two offerings of the exam (fall 2013 and spring 2014), and
discussing of the future of certification for the sub-specialty.
GENERAL SESSION – I Want a New Drug-Drug Shortages
1:30 – 2:20 p.m.
This program will provide an update on the most recent trends in drug
shortages, with an emphasis on those impacting EMS and emergency
medicine providers. This program will also discuss the most common reasons Erin Fox, PharmD
for the drug shortage problem and current efforts to ameliorate the problem.
Best practices in minimizing the impact of drug shortages on patient care will
also be discussed.
HOT TOPICS – Carbon Monoxide Poisoning: Myths and Realities
2:20 – 2:40 p.m.
Few areas of emergency medicine and prehospital care are plagued more by
"common knowledge" myths than the treatment of carbon monoxide
David Hostler, PhD, EMT-P
poisoning. This session will challenge many of the myths and urban legends by
examining the original literature supporting the epidemiology, diagnosis, and
treatment of carbon monoxide poisoning. The information provided in this
session can be used to improve training in carbon monoxide response for EMS
providers and fire service personnel.
HOT TOPICS – Remote Ischemic Conditioning (RIC)
2:40 – 3:00 p.m.
This session will review the procedure of remote ischemic conditioning and its Christian Martin-Gill, MD
potential benefits. Barriers to prehospital implementation and feasibility of
implementing RIC as part of a large air medical system will be discussed.
GENERAL SESSION– AHA Guidelines 2015: You Make the Call
3:00 – 3:45 p.m.
The International Liaison Committee on Resuscitation (ILCOR) and
resuscitation councils around the world including the American Heart
Michael Sayre, MD
Association (AHA) collaborate on performing structured reviews of scientific
evidence guiding resuscitation practice. See www.ILCOR.org/SEERS where you
can participate in providing feedback on the reviews and the proposed
guidelines changes.
3:45 - 4:15 p.m.
Break in Exhibit Hall
4:15 - 5:15 p.m.
GENERAL SESSION – Research – Oral Abstracts Session 2 (5-8)
5:30 - 6:45 p.m.
Poster Session #1 (49-103)
5:30 - 6:45 p.m.
Innovations in EMS Fellowship Education Poster Session
6:45 - 8:45 p.m.
Welcome Reception in the Exhibit Hall
Friday, January 23, 2015 -- The Future of EMS
7:00 a.m.- 4:00 p.m.
7:00 - 8:00 a.m.
Registration
Continental Breakfast
GENERAL SESSION – Mass Gathering at the Hajj
8:00 - 9:00 a.m.
9:00 - 10:00 a.m.
The annual Hajj to Makkah in Saudi Arabia is one of the largest annual
religious mass gatherings in the world. The importation of infectious diseases
during a mass gathering may result in outbreaks of global proportion. Key
features of preparedness for the 2014 Hajj and Umra season, including review Ziad Memish, MD
of the recent impact of emerging viruses such as Ebola in West Africa and the
Middle East respiratory syndrome coronavirus(MERS-CoV) in affected
countries, and the updated requirements and the required vaccines will be
discussed.
GENERAL SESSION – Research-Oral Abstracts Session #3 (9-12)
9:30 a.m. - 1:30 p.m.
EXHIBIT HALL OPEN
10:00 – 10:20 a.m.
Break in Exhibit Hall
HOT TOPICS – Pediatric Longboards: Time for a Change?
10:20 - 10:40 a.m.
Up until the 2013 NAEMSP/ ACS-COT position statement “EMS Spinal
Precautions and the Use of the Long Backboard,” the use of a cervical collar
and rigid long backboard was considered standard of care during trauma
transport. However for more than twenty-five years, investigators have been
laying the ground work for this change by elucidating the potential adverse
Julie Leonard, MD, MPH
effects associated with “spine immobilization” and developing clinical
screening criteria to assist practitioners in identifying patients in whom “spine
immobilization” can be safely avoided. These efforts mostly focused on adults.
During this session we will review this literature as it pertains to the pediatric
population and make recommendations regarding the use of spinal
precautions for trauma transport in children.
HOT Topics – Implementation of an EMS Evidence Based Guideline: Lessons
Learned
10:40 - 11:15 a.m.
Peter Taillac, MD;
The "Statewide Implementaiton of an Evidence-Based Guideline" is a
J. Matthew Sholl, MD, MPH,
NASEMSO project funded by NHTSA. The goal of the group is to discover
factors that promote or detract from the implemetation of an evidence based FACEP
EMS guideline at the state level. The presentors will share the lessons learned
to date from the five participating states.
11:15 a.m. - 12:15 p.m. GENERAL SESSION – Research – Oral Abstracts Session #4 (13-16)
12:15 - 1:30 p.m.
Boxed Lunches in Exhibit Hall
12:20 - 1:30 p.m.
COMMITTEE MEETINGS
CONCURRENT SESSION 1A – 2014 EMS Lifelong Learning and SelfAssessment Articles
1:30 - 3:30 p.m.
A panel will present a fast paced, high yield review of the 2014 EMS LLSA
Brian Clemency, DO, MBA
articles. Diplomats and non-diplomats are welcome to join us as we take a
critical look at these practice-changing articles and discuss their relevance to Adam Frisch, MD
Andrew McCoy, MD
prehospital providers. This session will prepare ABEM diplomates to
successfuly complete the LLSA exam. Attendees are encouraged to review the
LLSA articles prior to the session. Presented by the EMS Fellows and
Fellowship Graduates Committee.
CONCURRENT SESSION 1B – How To Evaluate Your Workforce
1:30 - 2:30 p.m.
This engaging session will focus on the evaluation and determination of entry
level competency in the Emergency Medical Services Providers. Cognitive and Severo (Tre) Rodriguez, MS,
psychomotor methodologies utilized to determine competency will be
NREMT-P, LP, AEMCA
discussed with case studies provided. In addition, the National Continued
Competency Program used to sustain competence of EMS providers will be
discussed.
CONCURRENT SESSION 1C – Psychology of Pediatric Resuscitation and TOR
1:30 - 2:30 p.m.
Pediatric care in the field has been known to cause significant anxiety for prehospital providers without a clear scientific explanation of why it even occurs.
While resuscitation outcomes in the adult population have improved
significantly in the last decade, pediatric OHCA has shown no improvement in Peter Antevy, MD
over 30 years, with an average survival rate of only 6%. The answer to this
conundrum may be based on Daniel Kahneman’s Nobel Prize winning
psychological theory that describes the brain’s function during stress. Join Dr.
Antevy for an enlightening session that will finally shed light on the big
problem with small people!
CONCURRENT SESSION 2A – Exercise-associated Hyponatremia-Let’s Stop
Adding Insult to Injury with Our Treatment
2:30 - 3:30 p.m.
Exercise-associated hyponatremia (EAH), defined as a serum sodium
concentration less than 135 mmol/L during or within 24 hours after prolonged
physical activity, appeared to be an unusual consequence of endurance
exercise when first described in the mid-1980s. Since the initial description, at
least a dozen deaths from EAH have been confirmed and this potentially fatal Martin Hoffman, MD
medical condition has been found to be common in a variety of endurance
activities. Once EAH is recognized, treatment should be straightforward.
Unfortunately, many providers are not well-educated on this condition, it can
be confused with other common conditions, and inappropriate treatment can
be devastating. This presentation will review the etiology, pathophysiology,
risk factors, presentation, prevention and treatment of EAH.
CONCURRENT SESSION 2B – Developing “Core Measures” for EMS
2:30 - 3:30 p.m.
Changes in payment formulas are coming to all sectors of healthcare,
including EMS. Value-based purchasing (i.e., pay for performance) strategies
Mic Gunderson
will be having an impact on both fee-for-service payments as well as bundled
payments for EMS from accountable care organizations. Payments for EMS
are going to be adjusted up or down based on how well EMS performs on core
measures, just as now takes place for specific aspects of hospital care. This
presentation will discuss the rational for these programs and then outline
efforts being led by NAEMSP in collaboration with other national EMS
organizations to develop the ‘EMS core measures’ and a broader national
library of EMS performance measures.
3:30 - 4:30 p.m.
Refreshment Break
3:30 - 4:30 p.m.
Poster Session #2 (104-157)
4:30 - 5:30 p.m.
General Session-Katrina 10 Years Later
5:30 - 7:00 p.m.
Research Poster Session #3 (Electronic) (17-48)
General (Ret) Russel L. Honoré
Advances in Prehospital Airway Management-A Hands On Workshop and
Difficult Airway
Challenge(preregistration required, limited to 25)
Optional Session
Prehospital airway management has remained controversial. To improve the
Additional Fee Required delivery of airway management a variety of devices have been developed to
5:30 -7:00 p.m.
assist with the process. These include video laryngoscopy, supraglottic
airways and modified semi ridged stylets. Having an opportunity to use and
evaluate these devices, in one setting, with associated instruction, is
uncommon. This workshop will give attendees that opportunity.
7:00 - 8:00 p.m.
Derek Cooney, MD;
Ryan Hodnick, DO;
Marv Wayne, MD
Evening Cocktail Reception - Supported by NREMT
Saturday, January 24, 2015 -- Making it Happen in My System
7:00 - 8:00 a.m.
8:30 a.m. - 4:00 p.m.
7:00 - 8:15 a.m.
Continental Breakfast
Registration
COMMITTEE MEETINGS
GENERAL SESSION – Top Innovations for 2015
8:15 - 9:15 a.m.
9:15 - 10:15 a.m.
10:15 - 10:30 a.m.
Please join for this second annual semi-serious, always irreverent review of
the top five innovations in the past year that should impact your practice.
Participants will have an early Saturday morning opportunity to reflect on
impactful innovations and consider whether they are worthy of
implementation.
GENERAL SESSION – MIHP or Best Practice Implementation- What's a
Medical Director to Do?
Mobile integrated healthcare, community paramedicine or simply
implementing best practice? What is the best choice for my shop?
This is a common question for many EMS Medical Directors. One size does
Jeff Beeson, DO
not fit all agencies. Learn how to determine if your community may benefit
from MIHP or would be better served with best practice implementation. Dr.
Beeson will provide his insight on how to design and implement both of these
practices for your community.
Break
GENERAL SESSION – From the Screen to the Scene: Implementing EvidenceBased Practice Locally and Through a National Strategy
10:30 - 11:20 a.m.
Brent Myers, MD
Developing and implementing prehospital evidence-based guidelines (EBGs)
has the potential to improve prehospital care widely, yet remains a
challenging task at the local, regional, and national level. Over the past
John Gallagher, MD;
Christian Martin-Gill, MD
several years, a substantial amount of work by multiple EMS organizations
and individuals has focused on utilizing a Model Process for EBGs, as well as
identifying ways to implement those guidelines more widely. This session will
identify challenges to developing and implementing EBGs, including use of the
Model Process.
GENERAL SESSION – Treat the Streets: A Novel Community Paramedicine
Program Designed to Reduce Pediatric Asthma Recidivism
11:20 a.m. - Noon
12:15 - 1:45 p.m.
This program will focus on the development and execution of a novel program
utilizing specially trained community paramedics to improve pediatric health
Andrew Stevens, MD;
and reduce pediatric asthma recidivism rates. In this model, paramedics
Elizabeth Weinstein, MD
provide in-home asthma care, education and public health assessments to
children after acute hospital-based encounters for asthma related illness.
During this session we will discuss first year outcomes of this innovative
intervention as well as detail our approach to paramedic training,
infrastructure building and operations.
Awards Luncheon
GENERAL SESSION – CARES a Decade In: Progress Towards Improving Cardiac
Arrest Survival in The US
1:45 - 2:45 p.m.
Out-of-Hospital cardiac arrest remains a leading cause of death and major
public health problem in the US. EMS is uniquely qualified and positioned to
coordinate systems of acute care to impact cardiac arrest survival. The
Cardiac Arrest Registry to Enhance Survival (CARES) is now a decade old and
has expanded to cover over 25% of the population of the US. While this
Bryan McNally, MD;
expansion is a huge success, survival as a nation has not improved
significantly. CARES has helped show that individual communities have made Bentley Bobrow, MD
dramatic gains in survival, mostly by implementing programs to increase
bystander response, the quality of trained rescuer response, and guideline
based post-arrest care.
This session will review some of the key publications which have arisen from
the CARES effort, lessons learned along the way, vital future challenges, and
will discuss novel interventional resources now available for CARES
communities.
HOT TOPICS – Naloxone Administration by EMTs & Law Enforcement
Officers-Panacea or Pandora?
2:45 - 3:05 p.m.
Opioid abuse and its sequelae is resurging in North America. Naloxone is
clearly effective for many problematic abuse situations, at times dramatically
restoring the respiratory drive, correcting both oxygenation and ventilation
failures, and "raising the nearly dead" back to life. Many medical
Jeffrey Goodloe, MD, NRP, FACEP
organizations, governmental leaders, and law enforcement authorities are
promoting the expanded use of naloxone, including "arming" police officers
with naloxone for use prior to EMS arrival to these patients. Is this the elusive
simple answer to the complex challenge of opioid abuse? Is this conversely a
dangerous practice? What are the answers for your community and what are
the questions that generate those answers?
HOT TOPICS – D10 vs. D50: Is More Better?
3:05 - 3:25 p.m.
“One amp of D50 IV” is the textbook answer for severe hypoglycemia and has
been for years. D50 may be overkill, is a tissue irritant and necessary pediatric Paul Rostykus, MD, MPH
dilutions are prone to error. Titration with D10 may be a more physiologic
and safer treatment for severe hypoglycemia, that is used in a number of
countries.
HOT TOPICS – Prehospital Blood Products: What? When? Where? And Who?
3:25 - 3:45 p.m.
We will review the current evidence for the use of blood products in the
prehospital environment. We will discuss resources required for a out of
Francis Guyette, MD, MPH
hospital transfusion and how to maximize patient benefit while mitigating
risk.
3:45 - 4:00 p.m.
Break
GENERAL SESSION – 5 Articles That Should Change Your Practice
4:00 - 5:00 p.m.
5:00 p.m.
Join the presenters as they review 5 top articles in EMS practice from 2014.
Learn how each affects your practice and can be put to use immediately.
CLOSING RECEPTION
Blair Bigham, EMT-P
Jon Rittenberger, MD, EMT-P
Michael Millin, MD