Push or Pump: A Primer on Push-Dose Pressors
Jeff Lubin MD MPH – Life Lion Critical Care Transport – Penn State Hershey Medical Center
Originating in anesthesia, and increasingly promoted in emergency and critical care medicine, the use of push-dose pressors has been growing. In this presentation, we’ll use an interactive case-based format to discuss the what, why, and how of using push-dose pressors during critical care transport. They just might be the perfect solution to short-lived hypotension.
Mobilizing, Mechanically Ventilating and Medicating the Morbidly Obese Patient
Justin McLean MD Flight For Life CO
You just got the call for a 500 pound critically ill patient requiring inter-facility transport. Are you prepared to do the trip? Just as pediatric patients are not just small adults, morbidly obese patient are not just large adults. This lecture will discuss four factors in critical care transport of the morbidly obese patient: Operational considerations when transporting this patient population, Clinical considerations related to airway management, Mechanical ventilation and medication adjustment for the morbidly obese patient.
Peri-Intubation Hypotension: What To Consider Before You Pick Up Your Laryngoscope
Rob Bryant MD Classic Air Medical
Intubating hypotensive patients is associated with peri-intubation cardiac arrest. A well planned pre-intubation resuscitation can mitigate peri-intubation deterioration. This presentation will review an approach to the hypotensive, hypoxic, and acidotic patient to allow them to better tolerate their intubation.
Accident Avoidance for Clinicians
Christian Renne, MD AirCare and Mobile, University of Cincinnati
7 practices we can learn from the folks up front that can save our patients in the back. Each practice will include background information from the aviation industry with an applicable case scenario from the aeromedical world as to why it is necessary and how it applies.
Vasopressin: Who, When, Why and How
Michael Jasumback MD, FACEP PHI Air Medical
Vasopressin is a unique pressor agent that is being used more frequently in the critically ill. This discussion will focus on the utilization of vasopressin. It’s indications, utilization and how it affects outcome. This discussion will be based on the current evidence for the use of vasopressin and will include dosing and titration strategies.
Precision Medicine and the Future of Air Medical Transport
Rourke Yeakley, MD, MHA Air St. Luke’s
Precision Medicine (PM) is an approach to health care treatment that takes into account an individual’s genes, environment and lifestyle. The use of genomics, pharmacogenomics and digital health has accelerated its application and will continue to do so. PM is transforming all aspects of health care delivery including transport medicine. Both public and private research dollars are rapidly shifting towards PM. The Precision Medicine Initiative (2015), the All of Us Research Program (2015), and the 21st Century Cures Act (2016) are just three examples. The global precision medicine market is anticipated to reach $172 billion by 2024. Transport medicine is beginning to be influenced by this new paradigm and will be greatly affected in the future. This lecture will provide a foundation for precision medicine and why it is important to understand what it is. It will also illustrate current uses and more particularly how it will be used in the near future. This lecture will be vital for every clinician and non-clinician involved with transport medicine.
Traumatically Injured Necks: Where’s The Leak And How To Stop It
Benjamin Nicholson MD, NRP Boston Medical Center
With a focus on the interplay between multiple vital structures in a relatively confined space, this lecture will integrate gross images, radiographs, and specific case examples to develop an appreciation for the anatomic and physiologic relationships between these vital structures after traumatic injury. Tracheal injuries are relatively uncommon but present unique challenges that require prompt and assertive interventions to prevent rapid death. These injuries will be discussed with a focus on the anatomic changes following injury and what to expect during airway management. There will be a discussion of pearls to consider when faced with this scenario. Finally, we will discuss hemorrhage control following traumatic neck injuries. Given the structures in this region, standard hemorrhage control measures to include direct pressure, elevation, and tourniquets are often inadequate or inappropriate. This discussion will focus on current literature and best practices for providers faced with these uncommon but severe injuries.
It Takes a Village…Adult CPS transports
Judi Carpenter RN MSN DNP Intermountain Health Care
The cardiopulmonary support system (CPS) is used to assist patients whose cardiac and pulmonary function if failing. CPS is used to help in emergency situations, to treat adult respiratory distress syndrome, pulmonary edema and as a bridge for cardiogenic shock or as a therapeutic procedure to install other support systems such as a ventricular assist devices. Stabilizing and transporting these complicated patients requires a specialized team that has the knowledge and skills and equipment to manage all types of scenarios. Life Flight in SLC has been transporting CPS patients for over 15 years and we have had no deaths during transport.
Oxygen, It is a DRUG!
Michael Jasumback MD, FACEP PHI Air Medical
Over the last 10 years it has become clear that oxygen is a drug. It is the most frequently used intervention in EMS. It is used indiscriminately in most cases and rarely is it appropriately titrated. We need to learn to use oxygen as a drug. We need to appreciate it’s indications, contraindications, dosing and monitoring. This lecture will address oxygen as what it is, a DRUG!
Literature Review for Neonatology and Pediatric Critical Care
Linda Thompson, MD and Jonathan Nedrelo, MD Cook Children’s Medical Center
A review of the pertinent pediatric critical care and neonatology literature for the past year.
What to Expect When You’re Expecting
Michelle Oddi , MSN RN CCRN CFRN C-NPT and Donald Null MD Children’s Hospital of UC Davis Medical Center
Preterm neonates comprise the majority of the effected infants that require transport due to services not available at outlying facilities. Transport teams are often requested to be present during high risk deliveries. In this lecture we will discuss neonatal resuscitation, ventilation, and key aspects of care for the critical neonate.
Little Hearts/Big Challenges: Hemodynamic Management Of Infants
Nathan Lep, MD, MPH PHI Air Medical
Infants pose unique challenges in blood pressure and hemodynamic stability during transport. In this session we will first discuss the normal physiology of blood pressure regulation in the infant. Next, we will use cases to learn about the approaches to evaluation and management of hypotension and other aberrations of hemodynamic stability of the infant during transport.
LUCAS Device in Flight
William Selde , MD , Kerry Barker, Ben McCarlson Wyoming Life Flight
This session will include a case report of the LUCAS Device used in flight for cardiac arrest. It will explore the details of the case, lessons learned, and potential future uses and implications.