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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

Seven 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.

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 Lepp, 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.

Preventing Death in Custody Dealing with Agitated Delirium
Chuck Sheppard, MD FACEP FAAEM, Mercy Life Line, Mercy Kids Transport

There is an increasing lack of mental health care in the United States and as a result we are seeing increasing interactions between police and EMS.  These interactions often end badly. This session will discuss excited delirium and its history, relation to sympathomimetic use, treatment and causes of death. The attendee will be provided some information and ideas about how EMS and police can interact in a way to prevent a bad outcome.

A Potpourri of Critical Care
Chuck Sheppard, MD FACEP FAAEM, Mercy Life Line, Mercy Kids Transport

This session will discuss a series of critical care topics to advance the care of our patients. This is a brief look at topics such as, should we be using morphine for chest pain, cricoid pressure etc.

Traumatic Arrest: When ACLS Just Isn’t Enough
Dustin Calhoun MD, Air Care and Mobile Care, University of Cincinnati 

While traumatic and medical cardiac arrest share a common result, the physiology and epidemiology are very different. HEMS providers must thoroughly understand the distinctions and be facile with the indicated interventions. Though the basic algorithm is performed by ground EMS, potential for arrest en route and the handful of lifesaving interventions outside the standard EMS SOP, illustrate the importance of this knowledge to a HEMS audience.

Is Your Patient In Shock? If So, Fix It!
Steven Bott, MD University of Utah

Is your patient in shock? We’ll do a brief review of diagnosing shock, then discuss strategies and tools to diagnose why, and how to treat it. We’ll discuss diagnostic tools, review basic hemodynamic variables and their assessment, then use that information to work through several case studies of patients with different kinds of shock. Management options reviewed will include IV fluid and blood administration, vasopressors, inotropes, and other adjuncts. We’ll also discuss worst case scenarios.

Anger Management: Principles for Assessing and Managing the Combative Patient
Craig Bates MD, MS, FACEP Metro Life Flight – MetroHealth Medical Center

Combative patients represent a significant danger to themselves and to healthcare providers. There are a diverse variety of reasons why patients become combative and understanding those reasons will help providers appropriately manage patients to avoid violent episodes or to manage them as safely as possible once they occur. There are often (but not always) a series of warning signs that violence in more likely to occur and it is critical that providers are able to recognize those signs and intervene appropriately before events escalate. This session will provide insight into understanding the underlying causes to combative behavior and provide intervention options specifically tailored to the critical care transport environment. The discussion will include considerations for safe physical restraint of patients, pharmacological interventions, and legal considerations when managing these patients. Because there can be significant variation in scope of practice, medication availability, and practice settings this presentation will provide a variety of options that can be tailored to your specific needs.

Today’s Heroin Epidemic
Frank Tift MD Life Force Air Medical Service

This lecture will review the current Centers for Disease Control (CDC) (US) data of mortality from heroin and opiate overdoses in the USA. It will then discuss the CDC recommendations of what should be done and will emphasize the importance of prehospital naloxone use, expanded naloxone use to non-EMS providers and the need for high doses with some emerging synthetic opiates.

Video Laryngoscopy: Why Should I Care?
Frank Tift, MD Life Force Air Medical Service

This lecture will be a review of the evidence behind the use of video laryngoscopy versus Digital Laryngoscopy and its potential benefit with regard to safety and success rates. The overall focus will be to discuss pros and cons to help providers decide which modality is best.

The Top Ten List: Articles from 2016-2017 That May Influence Your Practice
Russell MacDonald, MD MPH FRCPC , Ornge Transport Medicine / University of Toronto 

This presentation provides a summary and critical appraisal of ten articles taken from the EMS and transport medicine literature in 2016-2017 that may influence your transport medicine practice.