*subject to change
0945 – 1045h
102. Implementing an RSI Time-Out
Kevin Collopy, BA, FP-C, CCEMT-P, NR-P, CMTE, New Hanover Regional Medical Center
Three years ago, our team sought a method to improve our RSI success rates. Understanding that the Joint Commission requires hospitals to take a time out before high risk interventions, the same approach was taken for RSI. Our programs 10 question peer to peer challenge and response time-out checklist was implemented in the fall of 2014. Join a discussion on how to develop an equipment and team readiness checklist before performing RSI and discover how this 30 second check has helped drive a nearly 20% improvement in 1st attempt intubation success.
103. Windows to the Heart Ultrasound use in Acute Coronary Syndromes and Cardiac Arrest
Ray Cadwallader, NR-P, FP-C, Life Force Air Medical Service
Pre-hospital and critical care transport medicine are rapidly advancing fields with implementation of new technology and research based care. In effort to improve patient outcomes, we continually look for diagnostic measures to confirm clinical impressions. Ultrasound (US) technology is becoming more readily available outside of the hospital and can be used to guide definitive interventions. This presentation discusses the benefits of ultrasound use in the settings of ACS (Acute Coronary Syndromes) and even Cardiac Arrest. US imagery is used to show valve dysfunction, areas of compromised cardiac muscle as well as pericardial effusion/tamponade. Materials covered are basics of image interpretation, optimal probe placement and actual case presentations. These cases demonstrate ways in which US was used to confirm extent of myocardial injury in ACS/STEMI and even myocardial activity in the presence of apparent cardiac arrest. The most interesting case and inspiration for this presentation was a case in which one of our crews responded and assisted with the resuscitation of a patient presumed to be in PEA arrest. Once the HSTs had been addressed the code was about to be called, but our crew opted to use our US to assess for any myocardial activity. Rhythmic ventricular activity was noted in spite of un-palpable pulses. Vasopressor agents were used producing palpable pulses and the patient was ultimately resuscitated and recovered from the event. The idea is to promote early aggressive diagnostics that support or confirm assessment findings and help improve patient outcomes in our cardiac patients.
104. 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!
105. Sharpening the Cutting Edge: The partnership of QA and Education Programs
Jason Clark, NRP, CCEMT-P, FP-C, C-NPT, CMTE, LIFE FORCE Air Medical
State of the art equipment, first class education, intelligent clinicians, and lots of sick patients, EVERYTHING you need to make your transport program cutting edge. Or is it? We are often guilty of basing our success off materialistic items or clinical capabilities. Providing clinicians with a vast toolbox and knowledge base doesn’t assure that patient care is impacted or procedures are carried out properly. This lecture will cover the quality assurance process to implement a program that will successfully allow a transport program to know if crews are delivering care to assure the program is indeed cutting edge. QA issues, chart review, loop-closure feedback, improved patient care, and the relationship with the education department will be discussed in this lecture. Identifying crew or cultural issues within the program will be discussed as a benefit of a cutting-edge QA program and how issues are resolved by the education department.
106. Rock it like Sully! CRM tools we can take away from the Miracle on the Hudson
Randy Mains, BA, ATP, CRMI, EMT, Oregon Aero
Captain Chesley ‘Sully’ Sullenberger was a crew resource management (CRM) instructor for fourteen years prior to saving the lives of 155 people when he made the decision to land on the Hudson River. He followed a decision-making tool called Risk Resource Management developed by Mr. John Ross at US Airways, created to turn around an unacceptable accident rate in the airline back in the 90’s. If the tool wasn’t easy to use and understand, the air crews wouldn’t use it, Ross says. In this presentation we will review and discuss the presentation Ross gave to new Southwest Airline pilots detailing a step-by-step case study of Sully’s famous flight describing the decisions he made using the mental tool from engines flaming out to touch down. A discussion will follow how integrate the tool applied to air medical resource management (AMRM).
107. Why Does Neonatal/Pediatric Transports Have To Be So Difficult To Dispatch?
Stewart Corbin, CFC, CMTE, MedFlight and Jill Anderson, BSN, EMT-P, CMTE, Nationwide Children’s Hospital Transport Team
Does it seem like it takes forever to get your neonatal/pediatric team mobilized? This session will look at ways to decrease mobilization time, streamline the collection of patient information, review call-taking procedures, and review before and after process change data.
108. You Survived The Crash, Now What?
Carroll Ward, NREMT-P and Lisa Scott, BSN, RN, CEN, Nightingale Regional Air Ambulance
The intent of this session is to stress the importance of when to plan for an emergency, what equipment may be needed in any given emergency and how to use it. Also what the aircraft and its parts can be used for in a survival situation
109. Shocked! A Case Study of High a Voltage Electrical Injury
Matthew Randall, NRP, FP-C, Erlanger Life Force
A review of a 26 year old male patient who suffered a high voltage electrical injury following contact with a power line. This lecture will discuss initial patient management by responding EMS, activation of the critical care flight team by the local emergency department, interventions and care provided by the flight team both at the ER and en-route to the Trauma/Burn center, and the overall outcome of the patient. This lecture will discuss this patient specifically and the current clinical research based best practices for this injury in the aeromedical environment.
109a. More Than “Just the Shakes”: Real Alcohol Emergencies
Michael Frakes, Director of Clinical Care, Boston Medflight
The intoxicated patient may be the stereotypical emergency services patient. What sometimes gets overlooked is that these patients can represent true critical illness, with mortality rates up to 40% for some conditions. This talk will describe the spectrum of alcohol withdrawal syndromes and emergencies, from benign to critical and will prepare transport teams to understand and manage them all. As a bonus; it will also unravel the mystery of the Banana Bag.
110. No Stroke Left Behind
Ray Bennett, BSN, RN, SCRN, CEN, CFRN, CTRN, NRP, RWJ Barnabas Health
This session will discuss the increasingly aggressive approach to the treatment of the stroke patient. The changes in alteplase (rtPA) product literature that has increased usage in the AIS patient. The indications for mechanical thrombectomy in AIS. rational for rapid transfer to comprehensive stroke centers for high level stroke care. This session will also discuss new directions and research in the treatment of the Hemorrhagic stroke patient.
111. Mommy, My Head Hurts : Pediatric Neurologic Emergencies
Craig LaRusso, MA, BSN, RN, C-NPT, Anne and Robert H. Lurie Children’s Hospital of Chicago
In this lecture we will be utilizing a case presentation format: (speaker will be utilizing first hand transport case scenarios). Speaker will describe initial presentation of each child including triage information and interventions required to stabilize while on transport. We will discuss how to identify early clinical warning signs and evidence of deterioration. Disease processes will be discussed as well as treatment modes and long term outcomes. CT and MRI images (including video imaging) will be utilized to aid in learning.
112. Accident Avoidance for Clinicians
Christian Renne, Physician/MD, Department of Emergency Medicine
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.
113. Making the Workplace Great Again: A Dramatic Story Of A Cultural Transformation Of A HEMS Program.
Kolby Kolbet, MSN, RN, CFRN, CMTE, Life Link III
Organizations often times struggle with the past and its effect on their overall performance. This is a true story of a company that was staffed with significant numbers of disengaged employees. Trust was low. Growth was stunted. In this lecture, you will hear the story of a significant change in culture where a new leadership team identified the issues took deliberate actions to improve employee engagement and now thrives in a highly engaged workplace. We will share our methods as well as our 4-year trends of our employee engagement results.
114. Flight Recording for 135.607 Deadline – What Do I Really need?
Casey DeLanghe, Appareo Systems
In April 2018 compliance with 135.607 is required to operate a helicopter in air ambulance operations. So what do you really need for compliance so you can continue operations? This will review the rule, what your options are and what you can do with the newly required data.
115. Redesigning Communications: People, Equipment & Technology
Shawn Remick, EMT-P, RN, BSN, Indiana University Health LifeLine
Communications centers require and ask a lot of their communications specialists. A key part of the employees’ success are the tools provided to them to execute a very important and stressful position. Recently we had the opportunity to redesign our communications center, from physical space to technology systems, building a facility to support our organization’s mission.
116. New Zealand Airforce Helicopter Down
Dave Greenberg, Rescue Crew, EMT, The Life Flight Trust
On April 25, 2010 a New Zealand Air Force Iroquois Helicopter went missing while enroute to an ANZAC Day (New Zealand version of Veterans Day) celebration. I was on the Westpac Rescue Helicopter which was already tasked for a hospital transfer mission. We were redirected to searching for the missing helicopter, and once we located it, finding, and rescuing the sole survivor. This presentation talks about changing tasks mid-stream, C/RM and the emotional stress of searching for a helicopter which might have people you know on board.
117. 48-hr Backcountry Survival Challenge: Got Skills?!?!
Deb Witte, RN, CCRN and Nathan Morreale, BS, FP-C, NREMT-P, AirMed, University of Utah
Follow two AirMed flight teams one with back country experience and another without back country experience as they put their training to the test over 48 hours in a ground-breaking exercise that answers the question: Could we survive after an unscheduled remote landing?
118. Improving TeleStroke Care
Joseph DePatto, EMT-P, FP-C, Life Lion Critical Care
Working in conjunction with the Penn State Health LionNet Stroke program, Life Lion team members log on and view each TeleStroke consult as it happens. This allows Life Lion team members to gather pertinent information specific to the treatment and management of the patient. Once a decision is made to transfer the patient, teams will be able to maintain a continuity of care while transferring a patient to Milton S. Hershey Medical Center. From the beginning, Life Lion administration worked with Penn State Health Neuroscience Institute in designing the LionNet TeleStroke program to be a streamlined process that included the neurology consult, treatment, and transport of stroke patients. Emphasis was placed on time, continuity of care and, and transport. This allowed Life Lion to be more integrated into the build out process. Because crews are on each patient consult, they already know the history of present illness, past medical history, medications, allergies, initial physical exam, lab work, and treatment performed. When the decision is made to transfer, they already have all the information they need. When they arrive bedside, they will obtain a quick patient update, transfer appropriate medications, and ready the patient for transport. This process allows for minimal patient bedside time which in-turn helps increase the interventional time window at tertiary care.
119. Not Just A Kid Problem Anymore: Transporting Adults With Congenital Heart Disease
Tracy Rojas, MSN, CCRN, C-NPT, Ann and Robert H. Lurie Children’s Hospital of Chicago
Nearly 1 million adults in the USA are living with congenital heart disease (CHD). Many adult patients with CHD continue to receive care at pediatric healthcare facilities. This presentation will inform the pediatric and adult transport provider of the many complexities of transporting the adult with CHD.
120. 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.
121. I’ll Take A Successful Survey For 500 Alex!
Tobin Miller, DNP, MSN/Ed., RN, CEN, CCRN, CFRN, Mercy Air and Jan Eichel, West Michigan AirCare
When preparing for a CAMTS site survey, programs often have questions regarding the standards. Join CAMTS board of directors Jan Eichel and Tobin Miller for a fun filled game of Jeopardy. This fast paced and interactive session will cover clarifications for commonly misunderstood standards as well as a review of some key areas in the 10th edition standards. Grab your friends and come on down for some friendly competition while learning…you might just win a prize!
122.Why Do Smart Pilots Make Dumb Decisions? An investigation into 4 real world crashes…
Dan Foulds – Air Medical Resource Instructor
We will examine four crashes, reviewing media reports, National Transportation Safety Board (NTSB) reports, the people involved, and the companies involved. We will attempt to identify the sentinel events and critical mistakes that led to the loss of life. As all accidents are the result of a “chain” of choices, we will provide attendees with a frame of reference to use when they are conducting flight operations and an accident scenario is forming. These accidents happened to good, smart people – just like us. And if it could happen to them, we should understand that we are not immune and must increase our awareness and caution. We must also use all resources available to ensure success, such as air traffic control (ATC), operational control center (OCC), Communication center, and on-board crew.
123. FirstNet: 21st Century Communications for air medical services
Brent Williams, FirstNet – First Responder Network Authority
FirstNet is coming, nationwide, very soon. This federal government initiative will very soon begin construction on a totally new, mobile broadband communications network, dedicated to public safety. Learn how you can better serve your patient using a broadband network capable of sending and receiving video, data, medical images, and any other broadband data needs wherever your patient may be.
124. New Ways to Determine Ischemia in LBBB
Bryan Winchell, RN, EMT-P, CNP-T, CCRN, CFRN, FP-C, CCP-C, Flight For Life
The presence of LBBB has traditionally confounded STEMI interpretation, resulting in both unneeded cath lab activations and missed AMIs. We will discuss current evidence and learn a straightforward way to decide when and when not to activate the cath lab in patients with LBBB, using real ECGs and outcomes from patients flown in a two-year study.
125. The Silent Killer! Ventilation of the Metabolic Patient: A Case Study
Eric Bauer, MBA, FP-C, CCP-C, C-NPT, Air Methods Corporation
Mechanical ventilation in the HEMS and Critical Care environments are now a standard of care for all intubated patients. However, often time’s programs have limited information on illness severity and do not have the available labs, ABG’s or means of identifying metabolic acidosis. The talk will help identify core assessment strategies the HEMS provider can use to strategically treat their ventilator dependent patient. Often times these critical patients have multiply variables at play, with the ability to treat these variables correctly having a direct effect on outcomes.
125a. Auto Rotations: Reality Exposed
Bruce Webb, Airbus, Scott Tyrrell, Jeff Guzzetti, Mike Hemann, Matthew Rigsby and Lee Roskop, Federal Aviation Administration
The result of a collaborative effort by OEMs, operators, and federal agencies to uncover unique aspects of this maneuver and the mistakes most often discovered in accident investigations, this in-depth session provides a unique look at autorotations. Leaders in the helicopter instruction and training industry will present tips, tools, and techniques that will prepare you for a safe emergency procedure and ultimately prevent you from becoming an accident statistic!
126. Worst Case Scenario: A review of Pediatric Traumatic Arrest
Robert Grabowski, MSN, RN, AGACNP-BC, CPNP-AC, CEN, CCRN, CFRN, EMT-P, Metro Life Flight – MetroHealth Medical Center
This session will review the current epidemiology and survival statistics of pediatric traumatic cardiac arrest, the critical action steps and interventions and the current evidence to support or negate current standards of practice.
127. Neonatal Emergencies, It’s The Little Things…..
Lynette Hemphill, RN, NRP, CEN, Air Care University Of Iowa
Neonatal patients are infrequent and often come with high stress environments. This lecture is meant to take some of the stressors out of these types of calls.
128. 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.
129. Dashboards and Cockpits: Navigating Success by Designing Your Own Business Analytic Dashboard
Robert Higgins, RN, NRP, MBA, University of Pennsylvania Health System
Slip the bonds of canned CAD and clinical program reports! This lecture will show you to graphically design and then display the data you need on a dynamically changing dashboard. It’s easier than you think!
130. Developing an Effective Emergency Response Plan
Keith Trepanier, MS-AS, Mayo Clinic Medical Transport
No organization wants to have a mishap but every organization needs to be prepared in the event one does occur. This session will provide organizations who conduct aviation operations the basic frame work to create a new response plan or refine the plan they already have in place.
131. The Other Side of the Radio: the Experience of a Seasoned Flight RN as a Rookie Flight Coordinator
Amanda Lawrence, RN, BSN, CCRN, CFRN, AirMed, University of Utah
This presentation covers the lessons learned by a flight nurse after being given the opportunity to train and perform as a flight coordinator in the flight center at AirMed in Salt Lake City, Utah. From inaccurate assumptions made on the aircraft-side of the radio to being able to share field experiences with the flight coordinators, this experience changed several perspectives from within the program. Regular crew member rotations into the flight center are now incorporated into education rotations and new doors of communication, appreciation, and understanding have opened on both sides of the radio.
132. A Potpourri of Critical Care
Charles 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.
133. Out of Afghanistan: Case Reviews of Critical Transports
Brian Rogers, MD, LifeMed Alaska, LLC
Review of three critical care air transports from Afghanistan to Germany from my time spent as a Critical Care Air Transport Physician in the Air Force from April 2008 to October 2008.
133a. Training in Retrieval Medicine
Dr. Cheah Phee Kheng, Medical Director of Emergency Retrieval Unit, Sabah Women and Children’s Hospital and Dr. Yang Xiang Yun
134. Making the Positives and Negatives of Electrolytes and Acid-Base Add Up
Michael Gooch, DNP, RN, ACNP-BC, FNP-BC, ENP-BC, CFRN, CTRN, CEN, TCRN, EMT-P, Vanderbilt LifeFlight
Acid-base and electrolyte imbalances often complicate patient management during transport. Correctly identifying the imbalance and its cause are vital steps when managing these patients. This presentation will review the physiology of acid-base and electrolyte balance, their common disturbances, associated causes, clinical manifestations, and management implications for transport providers.
135. 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.
136. 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.
137. Overtriage! It is OK to Make a Mistake
Kevin Collopy, BA, FP-C, CCEMT-P, NR-P, CMTE, New Hanover Regional Medical Center
We have all done it, we made an error! We called a helicopter when it wasn’t needed. Made a call regarding STEMI, STROKE or CODE SEPSIS and were wrong. These actions more than likely got hauled under the carpet for doing so. The research though, says it’s OK! We need to make errors, over triage is good! In the era of time-sensitive emergencies, it’s important to understand that mistakes occur. This presentation will take you through the time sensitive emergencies of stroke, STEMI, sepsis, and trauma, and share with you the evidence based over-triage goals set by the American College of Surgeons, American Heart and Stroke Associations, and several research papers. The reality is, if we are always right then there are patients who we missed! Come join in an engaging learning session that empowers patient advocacy and care-based just culture.
138. OSI-HEMS: Its Not How Safe You Fly, Its How you Fly Safe
Ira Blumen, MD, University of Chicago Air Medical
Vision Zero must be our ultimate objective, but it is more than not having an accident. It’s not how safe you fly, but it’s how you fly safe. While it may never be possible to prevent all helicopter EMS (HEMS) accidents, we may, however, be putting our crews and patients at unnecessary risk if we miss opportunities that could reduce the number of accidents and save lives. Since 1972, there have been over 340 HEMS accidents in the U.S. – over 220 since 1998. Over one-third of the accidents resulted in one or more fatalities. Over a 20 period, these accidents have killed more than 160 of our colleagues and 21 patients whose lives were entrusted to us. This presentation will review the findings of the most extensive HEMS safety research to date. During this multi-year study, more than 40 air medical and aviation professionals spent more than 13,000 cumulative hours to analyze 144 HEMS accidents. The team reviewed nearly 3,000 electronic NTSB containing more than 12,500 pages and pictures. Following this extensive root cause analysis, the research group identified interventions and mitigating factors that may have prevented these accidents. Finally, objective recommendations will be made to provide decision-makers with an opportunity to determine how and where to make safety-related improvements that may prevent future accidents and save lives.
139. Sepsis, What’s Time Got To Do With It?
Daniel Mills, NR-P, FPC, Haynes Life Flight
Sepsis kills more people than AIDS, breast cancer and prostate cancer combined, yet sepsis goes unrecognized and under diagnosed in hundreds of thousands of patients. Sit back and join in on an in depth conversation about sepsis and its deadly effects on the body. When you think sepsis, act fast!
140. Pain is Not Normal-Rethinking Injury Prevention for Air Medical Providers
Bryan Fass, ATC, LAT, CSCS, EMT-P, Fit Responder
Ask any air medical crew if they have pain and the answer will be yes. Cramped flight decks, helmets and NVG’s all cause a cascade effect of pain which leads to injury. This class will present an evidence based approach to reducing pain and injury in your crews to boost mission readiness and crew resiliency.
141. Management of a Difficult Airway A Case Study
Travis Byerly Pennsylvania Advanced Practice, EMT-P, FP-C, Life Lion Critical Care
Life Lion crew was dispatched for a scene flight involving a motor vehicle accident. On final approach the ground units advised that they needed assistance with airway management. The patients head had been entrapped under the front wheel of a passenger car for an extended period.