*subject to change
0945 – 1045h
102. Shake, Rattle, and Roll: Pediatric Seizures
Teri Campbell, RN, CEN, CFRN, University of Chicago
Shake, rattle and roll is great for Elvis but not for our pediatric patients. Pediatric seizures can be a chronic condition for some kids or a marker of a neurologic emergency for others. This up to date lecture will inform you how to assess, prioritize and manage the pediatric patients with seizures. Ensure that your “status” has nothing to do with seizures!
103. The HeART of Critical Care Education
Daniel Davis, MD, Air Methods Corporation
This session will present a novel approach to critical care education using the Helicopter Advanced Resuscitation Training (HeART) model. The use of case-based learning but with a clear scaffolding or paradigm will be offered as the ideal model to engage adult learners but reinforce stable scaffolding that links to performance improvement and educational objectives.
104. Unintentional Expertise: Redefining Expertise in Specialty Critical Care Transport
Vahe Ender, NRP, FP-C, C-NPT, Boston MedFlight
Expertise – Noun: “Expert skill or knowledge in a particular field” We are taught that in order to develop expertise, one must devote one’s career to a particular clinical domain. What does a transport system do when faced with the task of adopting a new transport specialty; particularly in the unforgiving, high-risk arena of neonatal critical care transport? Can a “generalist” team achieve clinical excellence in the care of the critically ill newborn? In this session we will delve into a single program’s approach to the development of a neonatal transport program and the pursuit towards clinical expertise. We will review the challenges both internal and external encountered in the creation of a robust, high-volume specialty team. Through this we will shift the definition of “Expertise” and consider whether or not it is something solely to be found at dedicated Neonatal/Pediatric programs.
105. When Your Pilot Knows Too Much
Teri Aguiar, RN, CFRN, C-NPT, ARCH Air Medical
This session will cover lessons learned when too much information pushes the decision to go. It will include a case presentation of 10 year old gunshot to the head.
106. How to Successfully Ensure Your Stakeholders Have a Sense of Fierce Loyalty and Trust
Kristin Lingman, CMTE, Med-Trans Corporation
How loyal are your communities to the air medical industry? How much do they trust your individual program(s)? From a business development and marketing perspective – this course is designed to get at the heart of our customers and our communities to determine what is their loyalty to air medical industry and local providers? Also, what can we do as an industry to promote the very best characteristics of our business? We’ll discuss those characteristics and why some companies are so much better at displaying them than others. What do they do differently? And what are the things you can do immediately to bolster your program’s presence? We’ll take an in depth look at each of the key areas that affect air medicine and provide tangible ways to foster trust into our daily operations and galvanize a sense of unfailing loyalty to our program(s) and our industry as a whole. If done correctly, key stakeholders will be taking on Goliath to protect your program and you’ll begin to see the direct impact on your programs growth because of their actions.
107. Gone in 60 Days
Rebecca Oakley, RN, RBA, CMTE, EMT-P, and Robert Swickard, EMT-P, MCCP, HealthNet Aeromedical Services
With only sixty days’ notice a large, university affiliated teaching hospital with more than 1,200 monthly ground ambulance transports unexpectedly parted ways with its long-time ambulance vendor. How will these patients be moved? Where is the starting point? Join us to learn an innovative approach to establishing a large scale, high performing ground transport operation in less than 60 days. We will share how the hospital and its aeromedical services partner worked together to ensure the smooth flow of patients across the region. We’ll discuss challenges, successes and misses including funding, staffing, asset acquisition, dispatch, supply chain and clinical team basing. This was not an easy venture, but it can be done. You CAN move from “no to go” in 60 days!
108. Bodies of Evidence
Jason Noel, NREMT-P, FP-C, Air Methods Corporation, and Michelle McLean, MD, EMT-P, CHSE, LifeNet of Michigan
The purpose of this session is to define and describe the implementation of a cadaver lab for low volume, high risk procedural skills educational session for air medical transport critical care providers. This presentation will take the audience through the development, implementation, and evaluation of this procedural skills experience. With a focus on Bloom’s levels of learning, defined outcomes and objectives will be shared. A discussion on how these objectives defined the overall design of the educational experience will be discussed. Finally, utilizing Kirkpatrick’s training evaluation model a discussion of lessons learned will be presented with a focus on the future of cadaver labs for procedural skills.
109. In The Crosshairs
Charles Blathras, NRP, FP-C, C-NPT, EMT-P, CMTE, and Kenneth Panciocco, EMT, CFC, CMTE, Boston MedFlight
All good transport programs have a strong communications center that drives their program. It’s the nucleus of the program but an area that always seems to be in the cross-hairs. We will discuss the challenges of recruiting the right people, what the right questions that arise , the scenarios, and second-guessing that they encounter on a daily basis. We will also look at the steps one program took to mentor, train, and build the confidence and autonomy that play an integral part to their overall success.
110. Intralipid Use in the Pediatric Clonidine Overdose
Kyle Kohls, NRP, CCP, FP-C, and Curtis Walker, RN, CFRN, EMT, Gundersen Air
This session will be reviewing a case about the flight of a pediatric patient who had an accidental Clonidine overdose. It will also cover when intralipids may be useful, how it interacts, and suggested administration protocols.
111. Whole Blood Protocol
Randall M Schaefer, MSN, RN, ACNS-BC, CEN, Southwest Texas Regional Advisory Council (STRAC)
Trauma patients bleed whole blood. However, over the last three decades, trauma patients requiring resuscitation have typically received crystalloids during prehospital resuscitation and blood component therapy during in-hospital trauma resuscitation. Blood based resuscitation, specifically the use of low titer O-positive whole blood (LTOWB), is a capability available to very few prehospital providers. This presentation reviews a large-scale, multi-disciplinary, multi-institutional regional trauma system prehospital LTOWB program in Southwest Texas. A large urban EMS system and eighteen rural and frontier air medical providers, covering 26,000 sq. miles of South Texas, deployed LTOWB for the treatment of patients in hemorrhagic shock. Learn about the system and clinical processes that lead to the successful deployment of LTOWB in the prehospital setting.
112. Bull in a China Shop: The Journey of Transitioning from Adult pre-Hospital to Neonatal Specialty Transport
Sarah Anderson, DNP, CRNP, CFRN, PHRN, MSN, RN, STAT MedEvac
Ever try to put a large wet hand in a small latex glove? That’s exactly what it felt like to reach into an isolette for the first time after caring for adults for over 8 years in the transport environment. Even with pediatric critical care experience, the obstacles faced when transitioning back to small humans after a lengthy time away was a challenge. We will discuss hurdles, struggles, and lessons, in the journey through the transition between patient populations. We’ll discuss common challenges between programs and the biggest difference between knowing a little about a lot (the adult transport role) and knowing a lot about a little (the specialized transport role).
113. What’s Wrong With My Pilot?!? Besides the Usual
Randal Endsley, RN, CFRN, CEN, LP, CMTE, and Thomas Klassen, ATP, CMTE, HALO-Flight Inc.
What happens when a medical emergency occurs to the pilot in control of your helicopter? That’s exactly what happened to our crew. We’ll discuss the timeline of events that occurred when our pilot experienced a medical emergency during a patient mission with the patient on board. As the Chief Medical Officer and the Director of Operations/Executive Director, we’ll discuss the decisions made from our homes as we were immediately involved in the incident as it was on-going and how the crew mitigated further risk prior to our involvement. You will hear the actual radio calls from the pilot during the incident and we will discuss actions taken during the call and immediate post-incident actions. We will discuss what we felt we did right and what we felt we did wrong in an interactive discussion. We all have talked about what we would do if this was to happen to us, come hear our story about when it actually did.
114. Media Relations 2.0: Are You Ready for the Unexpected?
Steve Gregory, Gregory Group Media, LLC
Are you ready for the unthinkable? Have you anticipated the crush of media? Whether your unexpected event happened in the air or on the ground are you prepared to get in the front of the story before it gets in front of you? Join award-winning investigative journalist Steve Gregory as he does a deep dive and candid discussion into media relations. Gregory offers a point of view not often revealed – that of a reporter digging to get the truth. He’ll use case studies to illustrate events that were well handled and some that fell short. Gregory was on scene within minutes of the fatal shooting of a TSA officer at LAX; he was also on scene hours after an Asiana plane crash in SFO that killed three school girls. Gregory’s presentations are interactive and he encourages participation from attendees. He’ll also help you up your game when pitching positive stories to the media. If you care about how your organization looks from the outside, in good times and bad, this presentation is for you.
115. Air Medical’s Love Hate Relationship with Health Insurance
Donna Miller, RN, EMSRN, CMTE, AMR Air Life Guard International Flying ICU
The rules of engagement regarding healthcare reimbursement are changing at an unprecedented rate. This presentation will raise awareness, describe the most commonly encountered reimbursement challenges, and presents some strategies to maximize the most favorable reimbursement patterns for the air medical transport industry.
116. How to Read the Medical Literature: A Field Guide
Michael Jasumback, MD, FACEP, PHI Air Medical
Hey, did you read that article on THE NEWEST THING? We should start doing that! Well, maybe not. This lecture will acquaint the listener with how to read, interpret and apply the medical literature. We will delve into how data is presented, how it is manipulated and common pitfalls in interpretation of the medical literature. We will further discuss the tenets of evidence based medicine and its limitations. In depth discussion will be based on current literature and studies that have become widely cited in the EMS community.
117. There and Back Again: A Communication Center’s Story
Richard Swedbergh, FP-C, CMTE, and Amanda Wigman, CFC, Guardian Air
Guardian Air had to learn the hard way what happens when you don’t manage a communication center well. The program ultimately had the communication center combined with a ground service dispatch. This resulted in a systematic failure of service and ultimately resulted in plans to close the communication center and outsource to a vendor for flight dispatch services. The staff who were faced with the possibility of losing their jobs rose up to fight for what they believed they could create, and helped to win over hospital leadership to support and finance the building of a brand new communication center, going from Guardian Air’s black sheep to one of the true highlights of our program.
118. ETCO2 On the Go – Use of Nasal Cannula ETCO2 on Pediatric Transport Patients
Justin Parsley, RN, CCRN, Children’s Hospital and Medical Center
This session takes a look at evidence-based practice regarding nasal cannula capnography. It will also include a review of current literature, and data collected from a pediatric critical care transport program.
119. Who’s Behind That Mask? A Real World Application of Sepsis 3.0
Christopher Galton, MD, NRP, FP-C, Michael Kapas, NRP, FP-C, CCP-C, EMT-P, and Joseph Paciello, RN, ADN, EMT, CFRN, Mercy Flight Central
This lecture will review the case of a 43 y/o female patient who was being treated for DKA at a community hospital, when an acute change in mental status followed by hemodynamic collapse led to HEMS transport. Utilizing assessment skills and understanding the importance of obtaining an accurate HPI led this HEMS team to identify, and treat this patient for sepsis utilizing SCCM Sepsis 3.0 guidelines. This lecture will discuss initial patient management by the community hospital, activation of HEMS, interventions and care provided by the HEMS team both at the sending facility, and en-route to the receiving medical center, as well as the overall outcome. Additionally, it will discuss the current clinical research based best practices for sepsis care in the critical care environment.
120. Air Goes In, Air Goes Out: Simplifying Complex Mechanical Ventilation
Michael Frakes, RN, APRN, CFRN, CNPT, FACHE, Boston MedFlight
The management of patients on mechanical ventilation is a core skill for critical care transport providers. The language and options on a ventilator can sound like gibberish to some clinicians. As oxygenation and ventilation become more difficult, patient optimization can challenge almost everyone. This presentation will break mechanical ventilation, for all patients, into core concepts and a standardized approach that will take the mystery out of the breathing machine, improving your understanding, your comfort, and the patient’s condition.
121. When Pressure to Fly gets Personal
Kenneth Cerney, ME-PD, Leader-Team Dynamics LLC
For years pilots have been talking about and training new pilots on something called hazardous attitudes. These are attitudes that can get an otherwise safe, professional pilot in trouble when allowed to affect their decision making, or place unusual amounts of pressure on themselves. What happens when the non-pilot crew members exhibit these hazardous attitudes? How does this affect the entire crew and create additional pressures to fly? How do our individual personalities and increased stress affect our propensity toward hazardous attitudes? Creating conflict and disagreement in our crew then pointing out the hazard in a positive and supporting manner may be the most effective way to help prevent these attitudes and reduce the pressure to continue.
122. Maintaining Positive Trajectory: Creating Successful Remote Base Leadership
Michael Perkins, EMT-P, MBA, CMTE, and Todd Bailey, MBA, CMTE, MedFlight
This presentation explores the challenges many remote based air and ground programs experience while maintaining and developing local leadership, operations, and requests in an effort to complete safe patient transports. Join us as we explore program methods for base leadership and cultural unification when resources are decentralized among a larger geographic region. Furthermore, we will review opportunities for how “Base Leads” can be identified and empowered to enhance and standardize out-based crew effectiveness that matches the program’s mission and vision.
123. Take the Money and Run: Developing a Revenue Cycle Management Program that Works
Rebecca Werth, RN, MSN, MBA, APRN, FNP-BC, AeroCare Medical Transport Services, Inc., and Jason Cooper, BA, Stat Recoveries
An overview of reimbursement trends and the way to structure effective revenue cycle management in the midst of change.
124. Checklist Absurdity: The Actual Impact of Task Lists in the HEMS Industry
David Weber, FP-C, Denali National Park & Intermountain Life Flight
This presentation will highlight the history, prevalence, and both the positive and negative impacts of checklist utilization within the HEMS industry. Checklists have seen a meteoric rise in recent years in a variety of disciplines and new research has outlined their actual influence in the field of medicine. Dave Weber, a mountaineering ranger at Denali National Park and paramedic at Intermountain Life Flight, will discuss various aspects of medical task lists, current research showcasing the unintended negative consequences, and tangible suggestions for proper checklist incorporation.
125. Long Distance Relationships, Do They Work? Side by Side or Miles Apart…Always Connected
Brandon Eckard, CFC, and Samuel Keller, CFC, MedFlight – MedComm
Whether you are many miles apart, state’s apart or maybe even further, the long distance relationship can be tough and require constant work, dedication and communication. This session will spotlight how MedComm overcomes the distance and logistical challenges to provide their dispatching clients with needed and expected elements to make their individual missions safe and successful. Learn how communications specialists provide best-in-class customer service while processing requests for transports that include everything from Ambulette, to Emergency and Non-Emergency ALS/BLS, to Mobile ICU, to Rotor-wing and Fixed-wing and from neonatal to adult. Learn how MedComm provides a full service commitment, operating with a One-Call-Does-It-All approach and how real-time data and metrics support the multiple air and ground transport programs they serve. Learn more about the training program for the communicators and learn how the leadership structure of MedComm provides each program their direct link to MedComm. Finally, learn how MedComm’s constant work, dedication and communication is making each one of our long distance relationships successful.
126. Facilitating a NICU Evacuation from a Neonatal Transport Team Perspective
Dennis Swick, RN, CMTE, MTSP-C, Nationwide Children’s Transport Program
An emergent evacuation of a neonatal ICU is a massive undertaking. A transport agency with neonatal capabilities can have a significant role, but not necessarily just by “taking babies out”. Looking at the bigger picture, “out of the box” thinking, and creative utilization of resources are all skills that transport providers can employ to help our NICUs accomplish this efficiently and safely. The lecture will review how one pediatric/neonatal transport agency participated and assisted several urban level 2 and level 3 NICUs through evacuation planning and drills.
127. Advanced EKG Review for the Critical Care Transport Team: Rapid Fire Interpretations
Samuel Slimmer, MD, Geisinger Life Flight
While prior lectures at this conference have exclusively looked at dysrhythmias or ischemic changes, the focus of this lecture will be all inclusive. The goal is to visualize as many EKGs as possible during the time given. The medley will include dysrhythmias, conduction aberrancies, findings associated with sudden cardiac death, ischemic changes including what is now considered STEMI equivalent changes, and examples where STEMIs were missed due to having only subtle changes. Also, included will be EKG findings due to environmental exposure and due to medication toxicity. Pertinent management of findings will be discussed when applicable. All EKGs in this lecture were not viewed in prior lectures given at this conference.
128. Labs are Your Friends: Understanding How Lab Work Directs Patient Care
Amy Neglia, RN, ACNS-BC, CCRN, CFRN, Air St. Luke’s
Do you find lab work confusing? Does a flight crew need to understand serum lab values to take good care of patients? This session helps crews interpret labs on a level that can be integrated into patient care during transport.
129. Human Factors, Incident Command, Extended Operations: What FEMA 100-200-800-900 Never Taught Me!
Carl Bottorf, RN, EMSRN, EMT-P, and Donna Miller, RN, EMSRN, CMTE, Life Guard International – Flying ICU
Formal courses in the Incident Command System generally are considered a requirement at all levels with the air medical transport community such as FEMA level 100, 200, 700, and 900. These courses introduce us to what encompasses a standardized approach to managing the delivery of essential services in the wake of a disaster. Through experiences extracted from the disasters of 2017, the presenters will introduce concepts that are not typically taught in traditional incident command training.
130. Why Can’t I Be Involved: Family Centered Care on Transport
Katy Heslep, RN, C-NPT, Nationwide Children’s Hospital
Family centered care is a dynamic approach to building collaborative relationships between healthcare providers and the families which they serve. The overall goal of family centered care is to improve overall health and safety of the community. In this growing community of first responders, it is important to recognize the benefits of the inclusiveness of patients and their families when providing care throughout the entire process from pre-hospital care to inter hospital care to admission to the receiving facility. Research has shown that the inclusiveness of family has significantly improved outcomes of overall health care. The presenter will show you how best to incorporate families into your care using specific tools to help ease the transition of the patient from site to bedside as well as the approach in having difficult conversations in a timely fashion using the family centered care approach.
131. Stop the World, I Need to Get Off! Bringing Leadership into a New Day
Tom Allenstein, RN, MBA, CMTE, MedFlight
The entire world is changing rapidly around us. This is particularly true when you start looking at medical transportation. How we provide those services and the care itself is changing every day. Couple these changes with generational differences in the workforce and we need to examine how we manage these people. This session looks at what members of leadership need to know to adapt to these changes to lead our companies into the future.
132. Air Documentation Compliance Essentials
Maggie Adams, BBA, EMS Financial Services, Inc.
Air providers need to document the care they gave their patients in an environment where compliance and fraud oversight continues to be a concern. Taking a down‐to‐earth approach, this lively session will grasp your attention as we explain the ever‐changing regulatory requirements of air documentation. We help you respond to the challenges of the field, facilities and your own operational management. Quality documentation will follow your patient and be the key to successful claims submission, legitimate reimbursement and compliance.
133. Managing the Unimaginable: From Behind the Mic
Brandi Henson, EMD, CFC, EMT, CMTE, and Brian Allison RW & FW Pilot, Air Evac Lifeteam
What would you do if you received a Mayday call for an event that you had never prepared to properly manage? This session will explore the lessons learned and focus on task management within the Communications Center during critical events as well as discuss the resulting changes implemented in our Operational Control Center.
134. Pediatric Trauma Triage: A Parent and a Provider’s Perspective
Tyler Weddle, FP-C, NREMT-P, Life Flight Network
“Life Flight 87, flight request, scene call, trauma.” It’s not until you arrive on scene that you learn you have 3 pediatric patients who were all buried alive beneath 5 to7 feet of snow. They were all in cardiac arrest when found. Two achieved return of spontaneous circulation (ROSC) with bystander BLS CPR, and one still in cardiac arrest with active BLS CPR. The next closest ALS unit is still 45 minutes away. We will review standard triage guidelines and how to apply them. Next, take a journey through this first hand case review as we apply current PALS and pediatric assessment techniques and explore the complexities of making life altering decisions in the heat of the moment. We will watch as two critical care providers attempt to care for all three patients and see the outcomes. Finally, discuss ways to use personal experiences to relate to family members in a professional way during these life changing events.
135. What are Biologics and Biosimilars and Why Should I Care?
Rourke Yeakley, MD, MHA, Air St. Luke’s
Biologics and biosimilars are the most rapidly increasing class of pharmacologic intervention in the world. In 2017, eight of the top ten selling drugs in the world were biologics. Increasingly, the transport patient is taking one or more biologic or biosimilar. This trend will only increase as their use continues to broaden beyond autoimmune diseases. Acute reactions to biologics and biosimilars can be life-threatening emergencies and present in various ways. These need to be quickly recognized and treated. Their affects can complicate and even predispose to other medical conditions. This lecture will provide an overview of biologics and biosimilars and include an understanding of what they are, why it is important to understand the nomenclature, what conditions they are used for, how they work and how to adjust treatment for those patients taking them.
136. Invasive Hemodynamic Monitoring: Do You Know Your Numbers and Lines?
Cindy Goodrich, RN, MSN, CCRN, Airlift Northwest
Critical care transport requires specialized knowledge and skills related to hemodynamic monitoring. Use of these technologies allows for assessment of cardiopulmonary status and responses to therapy. Clinicians must be familiar with hemodynamic monitoring technologies and have the knowledge and skill to provide safe and effective care during transport. The focus of the presentation is to provide the clinician with a brief overview of pressure monitoring and some of the most commonly used invasive hemodynamic technologies in the transport setting. This will include a discussion of arterial lines, central venous catheters and pulmonary artery catheters. Key safety factors and the unique consideration related to transport of patients with invasive hemodynamic monitoring will be emphasized during this presentation.
137. 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.
138. Crazy, Hot Hiring: Finding the Unicorn (or 2)
Jenn Killeen, MHA, RN, NRP, CMTE, and April Larsen, MHA, CMTE, Classic Air Medical
There are multiple challenges in finding and hiring great people. Many factors influence hiring decisions and also the decision to become a transport professional. It seems as though the pool is diminishing, and that experienced and motivated professionals are fewer. How do we overcome this problem? We have a matrix and we designed a Flight Academy – to help find AND develop those unicorns (high performer-ish, motivated, and positive employees).
139. Who’s At The Controls?
Bryan Peterson, RN, BSN, CCRN, CFRN, CMTE, STAT MedEvac – Center for Emergency Medicine
This session will discuss the challenges in managing the current workforce that often requires high levels of engagement and inclusion for managing day to day operations. Balancing the needs of staff, while still maintaining managerial control, is often difficult especially when the employees want to be heavily involved in all aspects of the program. This requires having meaningful staff engagement programs and activities to assure their needs are met and to have positive impacts on the patients and customers serviced. We will discuss how to maintain a strong management structure that allows for high levels of staff involvement and engagement to keep the organization moving forward with positive outcomes for all.
140. For Leaders: Navigating the Post-Crash Landscape
Kathleen Mayer, MSN, RN, CMTE, Flight for Life Colorado, and René Borghese, MSN, RN, CMTE, Duke Life Flight
The presenters will describe their experiences and challenges following fatal air medical crashes in 2015 and 2017. Guidance will be provided for how to lead a program through the post -crash environment, with attention to the immediate and longer term time frames.