*subject to change

0945 – 1045h

301. Tick Tock Goes the Clock: Neonatal Surgical Emergencies
Michelle Oddi, PhD RN CCRN CFRN C-NPT and Donald Null, MD, University of California- Davis Medical Center Children’s Hospital

The transitional time period following birth can be complicated by the presence of congenital anomalies requiring emergent surgical intervention. Such anomalies require specific key interventions and are associated with specific transport issues. In this lecture we will discuss malrotation/midgut volvulus, TE fistula, gastroschisis, necrotizing enterocolitis, diaphragmatic hernia, and bowel obstruction. Key information related to the stabilization and treatment during transport will be covered. Multiple case scenarios will also be presented.

302. Serial Inebriates: Healthcare Providers Under the Influence
Jeffrey Bell, BSN, RN, CEN, CFRN, TCRN, NRP, CareFlight Air & Mobile

The prevalence of substance abuse in society is no secret, with 7.5-10% of Americans having a substance use disorder. However, the prevalence of substance abuse in healthcare providers (HCPs), especially nurses and EMS personnel, is estimated by various sources to be 1 to 2.5 times that of the general population. There is a general knowledge deficit among HCPs regarding the disease process of addiction, which can result in increased susceptibility to and inappropriate recognition of a substance use disorder. Education regarding this topic is imperative for appropriate recognition in self and others to promote safety. Everyone, including nurses, EMS personnel and other HCPs, can recover from addiction and should be given a second chance.

303. Cardiac Assist Devices: What We Have Learned So Far
Stephanie Bailey, BSN, CFRN, EMT-P, Allegheny Health Network – LifeFlight

The field of cardiac assist devices has grown considerably the last several years. These devices are becoming the cornerstone of cardiothoracic care. Recently they have been utilized for more than just cardiac patients. The rise of these transports has expanded and stretched the capacity of the critical care transport industry. This session is a review of the devices, and a discussion of the logistics and troubleshooting required for these transports to be successful.

304. Wings to Wheels: Applying Aviation Safety Concepts to Ground Transport Operations
Dennis Swick, RN, CMTE, MTSP-C, Nationwide Children’s Transport Program

Safety has been a keystone of the aviation industry for several years, and this has carried over to air medical operations, but what about ground based medical transport? Some concepts have trickled over, but application of these advanced safety concepts is still sporadic and even resisted in some cases. We will look at several safety concepts and practices of air medical safety and how they can be applied to your ground operations.

305. Built Out of Necessity: Developing and Implementing a Critical Care Education Program
Mark Weiberg, FP-C, NRP, Allina Health Emergency Medical Services

In 2012, Allina Health Emergency Medical Services (AHEMS) found themselves at a crossroads. Current critical care organizations had discontinued their critical care ground operations and AHEMS was expected resume these services. This program will take the learner through our process of identifying customer needs, developing an educational program for clinicians and evaluating it for continued excellence in patient care.

306. Quality Management: Turn ‘Best QM Practice’ into ‘Best QM Program’
Susan Gidding, MHS, RN, RRT, and Sarah Barber, EMT-P, FP-C, Life Flight Network

This session is intended for attendees who want to design and implement an effective Quality Management program for their medical transport service. While it is widely understood that a Quality Management program is required for accreditation from governing agencies such as CAMTS, the importance of QM spans beyond a mere certificate. In addition to lending credibility from the customer’s perspective, a comprehensive QM program also supports internal validation for employees. Reporting is improved through emphasis on transparency, just culture, and loop closure. Quality improvement is achieved by monitoring indicator data for trends, analyzing results with quality management tools, and executing Action Plans which are later evaluated for outcomes and sustainability. A crucial element includes sharing the results with the entire company, particularly executive leadership, in a timely manner. Ultimately, attendees will understand the key principles of a robust Quality Management program, why these principles are important, and how to apply them in the setting of their own service.

1000 – 1200h

307. It’s So Real it Will Make You Squeal!! Hands on Anatomical Cardiopulmonary Lab
Sharon Purdom, BSN, CFRN, Med Trans and Stu McVicar, RRT, FP-C, CCEMT-P, American Family Children’s Hospital

During this ‘hands on’ lab, the participant will gain a better understanding of anatomy and physiology using discarded hog hearts and lungs. Numerous procedures (intubation, ETC, LMA, needle cric, surgical airway, retrograde intubation, intubation aids, needle decompression, coronary artery injection/caths, right vs left MIs and pericardialcentesis) will also be reviewed and performed. It will be limited to the first 30 wanting to participate (pre-registration NOT required)and unlimited to observers. EVERYTHING will be provided for the participants.

1100 – 1200h

308. When Less is More
Teri Aguiar, RN, BSN, CFRN, C-NPT, ARCH Air Medical St. Louis, MO

This will be a multi-case presentation of pediatric patients in the transport environment with critical lab values. Cases include 6 day old renal failure, 38 day old transposition of the great vessels, 2 month old water intoxication, 7 year old renal failure, and 15 year old DKA.

309. Out of the Woods: Applying Wilderness Medicine to the Transport Setting
Gordon Worley, MSN, FNP-C, EMT-P, CFRN, FAWM, VEP Healthcare

Transport medical crews provide patient care in a unique setting, where they are expected to care for complex patients with limited resources. This requires that they be adaptable, self-reliant, and possess a familiarity with a wide range of medical specialty areas. Air medical crews are also often called to transport patients from remote locations, and those who have suffered from environmental exposure. Wilderness medicine is an evolving medical specialty that involves the management of ill or injured patients with limited resources, or under austere conditions when the time to definitive care is prolonged. Both the wilderness setting and transport medical environment require resourcefulness and creativity to be able to manage complex problems with only the items and personnel at hand. This presentation will explore the value of wilderness medicine training, protocols, and practice to transport nurses, paramedics, and other healthcare professionals.

310. Using Music Therapy to Reduce Medical Flight Anxiety
Kevin Gochenour, MD candidate, EMT-P

Many people experience anxiety when traveling by air. In flight anxiety during commercial flights has been well researched and interventions, such as anxiolytic medications, have been recommended. This session will present the results of a research study completed by Guardian Air into music therapies ability to reduce in-flight anxiety. Recommendations for implementation of music therapy as an adjunct intervention into a flight program will be given.

311. Surviving an Incident: Tactics and Strategies to Survive in the Wild
Michael Shaffer, BSN, RN, PHRN, NRP, CFRN, CMTE, STAT MedEvac

This session will go over how to develop and execute a survival plan in the event of the flight or ground crew becoming involved in an incident. Preparation will be different for areas all across the country and it is this session’s goal to provide insight that will help everyone. We will review different types of survival equipment that is available, and discuss how it pertains to different regions. We will offer examples of training modules that will encompass all components of your organization, as well as explore various training options to include: classroom, small group outdoor sessions, and wilderness overnight sessions. Finally we will go over how to be compliant with the 10th edition CAMTS standards.

312. Creating a Survival Challenge on a Budget and an Idea
Nathan Morreale, FP-C, NR-P, and Deb Witte, RN, CCRN, University of Utah – AirMed

The presenters will discuss considerations for creating and developing an on-location, multi-agency, multi-day survival exercise with proper 360 planning, documentation, medical, and production support. We will share the way we brought together a concept for training and the multiple hurdles we overcame to make this project a success. We will share some funny stories about the original plans versus what really happened and why contingency planning and support is paramount to any successful training exercise.

313. So Now You Are Responsible for Corporate Compliance: What Do You Do?
Linda Hines, RN, JD, CMTE, CHC, MedFlight

Understanding a corporate compliance program is important at all levels in an organization. Organizations come in all sizes-some are large with a compliance officer at their headquarters, some are hospital based and some are small. At times someone may become responsible for the corporate compliance program but yet they have had little training. This program will provide a foundation and then apply the content providing examples, tools, resources and real life examples. It is also important for leadership and board members to understand their duties and responsibilities surrounding corporate compliance.

1330 – 1430h

314. How to Build a Neonatal Flight Nurse Transition/Training Program
Scott Beckstead, RN, BSN, CFRN, CEN, and Stacy Meredith, RN, MSN, CMTE, CFRN, CCRN, CEN, Guardian Air

This session will detail how to provide a structured training program for the transition of a current 3 specialty flight nurse team (adult, pediatric, maternal) to a 4 specialty flight nurse team (adult, pediatric, maternal, neonatal), based on a successful model designed and implemented by Guardian Air transport in Arizona. The new program was designed in conjunction with our neonatologist, NNPs, NICU and Guardian Air’s support. We will provide details of the new program along with photos, case scenarios and questions/answer session. Presenters will explain how this program has helped with the relationship between our hospital NICU and Guardian Air. The presenters will discuss how this program addressed employee satisfaction/retention and how the program was essential to meeting the needs for transport of the neonatal population in Northern Arizona to include Native American Reservations.

315. What Actions Do You Take When You Are First on Scene at a Mass Casualty Incident
Gustav Clark, NREMT-P, FP-C, Guardian Air

This session prepares all first responders to establish incident command when arriving first on scene at any incident. Further, the session defines the critical command roles which need to be established to manage Mass Casualty Incidents. The attendees will participate in the management of a Mass Casualty Incident (MCI) which will be displayed in the form of a table top exercise. Participants will make critical decisions on triage, patient care, and transport. The incident command skills of scene size up, risk assessment, incident objective creation, and the process of establishing indent command will be practiced during this session. The time frames will be compressed as participants manage the MCI during the session. Prior to the end of the session a debriefing will be conducted, participants will come away with an enhanced understanding of the management skills required to effectively and efficiently mitigate a mass casualty incident.

316. Patient Advocacy Through Documentation: Documenting In a World of Difficult Reimbursement
Bryon Denton, MSN, RN, CFRN, PHRN, Air Methods Corporation

The fastest way to make the news or negative press is through billing issues. This presentation is an in-depth review of the flight crew member’s responsibility to advocate for their patients through documentation. A thorough patient care record is the number one way a crew member can advocate for their patients and reduce or eliminate patient responsibility in the charges. This session discusses the legality of documentation and balancing the issues with reimbursement. This session will provide flight crew members with guidelines for what payers look for to deny claims as well as how to protect themselves legally with documentation, including words/phrases to avoid and better ways to state this information. This session will also detail the four “Golden Rules” for documentation. The “Golden Rules” are four questions that, if answered in every chart, have been proven to decrease denials from the payers by answering their definition of medical necessity for air ambulance transport.

317. Time Outs and Ground EMS: Data-Driven Decision Making in Fatigue Management
Justin Koper, MTSP-C, FP-C, BS, HealthNet Aeromedical Services

Fatigue is commonly identified as a proximate cause in ground EMS related incidents. However, institutional understanding of fatigue and management strategies varies widely across our industry. This session highlights one organization’s efforts to obtain sound operational data and the process used to implement proactive fatigue management policies based on that data.

318. Implementing an Effective Airway Course for Local Clinical Programs
Sam Marshall, MS-CCP, CCEMT-P, FP-C, CMTE, University of Mississipi Medical Center

In this practical and informative lecture, future clinicians and EMS professionals will learn the importance of developing a proper airway management course for area physician residency, nursing, and paramedic programs to prevent and reduce sentinel events. Unfortunately, many programs focus mainly on training students to pass national tests while failing to emphasize the necessary critical-thinking skills that can make such a profound difference in the field. Sam Marshall — a critical care flight paramedic with over twenty years of EMS experience — wants to rectify that imbalance. This lecture teaches the most effective ways to develop and implement an airway curriculum to assist current and future students to make conscious evaluations, decisions, and implementations regarding patient management and care.

319. Project MEARCCAT: Creating a Mobile, Emergency, Advanced Rescuscitation, Critical Care Team
Robert Grabowski, MSN, APRN, CNP, AGACNP-BC, CPNP-AC, CEN, CCRN, CFRN, EMT-P, CMTE, Metro Life Flight

This session will discuss an initiative to utilize an existing, advanced practice led critical care transport team to create a highly mobile response team to mass casualty incidents (MCIs), in which upon activation, the team will be sent to the scene of the MCI and create a mobile advanced triage and treatment area to provide immediate life-saving interventions on scene to multiple MCI victims in the event of prolonged transport time. Additionally, this team can respond to emergency departments in order to augment the surge capabilities of that rural facility; bringing more physicians, nurse practitioners, and highly skilled nurses and paramedics to their emergency department to assist in emergent care, followed by assistance with organization and execution of high-volume transfers.

1445 – 1545h

320. Getting to the Heart of the Matter: Learning From Undiagnosed Congenital Heart Disease Case Reviews
Iain Holmes, MSN, RN, CCRN-K, New York University – Langone

Historically most congenital heart defect education consists of an explanation of a defect followed by clinical considerations. However, this fails to address caring for a young patient who is at the community hospital and has yet to receive an echo and subsequent diagnosis. These case reviews share tools commonly used in neonatal and pediatric cardiovascular intensive care units which apply to the transport environment aiding transport clinicians who find themselves caring for this population.

321. Traps and Tricks of Intra-Aortic Balloon Pump Transport
William Miller, RN, CFRN, EMT-B, CMTE, Air Methods Corporation

The primary purpose of an Intra-Aortic Balloon Pump (IABP) is to mechanically improve perfusion through counter-pulsation. However, care and management of this specialty population is complicated during transport by altitude, patient movement and complex hemodynamic data. Knowledge of “traps and tricks” is imperative to successful patient outcomes. This lecture will provide the attendee specific case studies and valuable treatment options used to care for this high acuity low volume patient population in transport.

322. Venomous Snakebites in Transport: What’s New?
Scott Hax, FP-C, C-NPT, TriState Careflight

Venomous snakebite is an uncommon reason for air medical transport. While venomous snake species are not native throughout the North America, providers anywhere can face a patient with a serious envenomation owing to the presence of both legal and clandestine collections. Early management can have a significant impact on patient outcome, and management during scene response and inter-hospital transfer can present special challenges for the transport team. This presentation will review the approach to evaluation and management of envenomation snakebite, including anti-venom administration in transport. We will compare anti-venom products currently available for North American pit viper species, including anti-venom newly-released for marketing in the United States.

323. The Next Step in Fatigue Recognition, Mitigation, and Human Performance
Jenn Killeen, MHA, RN, NRP, CMTE, Classic Air Medical, and Jenny Nosker, MSW, PhD candidate Fielding Graduate University

Human errors lead to accidents, incidents, near misses, safety concerns, and all sorts of bad. How does fatigue correlate to human error and how does it correlate to human performance? Should we be worried about this? We established a stringent Fatigue Risk Management System. We implemented it across our various disciplines including our communication center, our mechanics, pilots, and medical crew members, but how do we know it is identifying fatigue and more importantly preventing errors? We worked to validate our measures and correlate our questions – but are they accurate? How can you take your system one step further to decreasing fatigue, decreasing risk, decreasing errors, and improving safety for all?

324. Managing the Unimaginable: A Flight Team’s Experience During an Incapacitated Pilot Event
Michael Abshire, FP-C, NRP, and Tara Coupel, RN, BSN, CEN, NREMT, Air Evac Lifeteam

What would you do if your pilot became incapacitated in flight? Focusing on emergency procedure training, as well as the principles of Air Medical Resource Management, and Critical Incident Stress Management, this session will explore the lessons learned as a result of this unimaginable scenario.

325. Can You Hear Me Now?: Communicating Across Multiple Forums and Generational Gaps
Michael Perkins, MBA-HCA, EMT-P, CMTE, MedFlight and James Houser, RN, NREMT-P, CMTE, STAT MedEvac

This presentation focuses on the importance of communication in today’s digital age. Participants will be provided with real examples of one program’s journey on increasing companywide communication across multiple platforms between different generational gaps. Additionally, participants will learn which approaches worked well and which ones failed. More importantly, participants will leave with real world examples on how to increase communication in their own organizations.

1600 – 1700h

326. ECMO: Bringing Lifesaving Therapy to the Bedside
Diane Braxmeyer, RN, BSN, CFRN, Legacy Emanuel Medical Center, and Jacob Dalstra, FP-C, NRP, EMT-P, Life Flight Network

What if the therapy that could save your patient’s life is at a facility a 1,000 miles away, yet they are too unstable to transport? Bring the therapy to the patient! Extracorporeal Membrane oxygenation (ECMO) and High Frequency Percussive Ventilation (HFPV) are advanced medical interventions that can be safely delivered to critically ill patients regardless of location. Life Flight Network and Legacy Health’s transport partnership cultivated a program to provide communities access to these life -saving measures. This presentation outlines ECMO and HFPV therapy and transport. Collaborative strategies between both transport teams to provide this specialty transport service are outlined. A detailed review of ECMO and HFPV is explored, transport management, and program development.

327. Critical Care Approach to Mechanical Ventilation Oxygenation & Recruitment Strategies
Jeffrey Simons, FP-C, NR-P, CCEMT-P, LifeNet of New York

Dive into the world of critical care ventilator management. This session will discuss monitoring techniques and how to overcome some of common pitfalls and limitations. It will review basic maneuvers that can be applied to most ventilator patients that are minimally invasive. Followed by a review of advanced manipulation of settings and recruitment techniques to help oxygenate and ventilate the critically sick & injured patients.

328. Avalanche!
Lance Taysom, RN, BSN, CEN, CFRN, EMT-P, Air Idaho Rescue

A flight request comes in to an avalanche rescue scene. What are the risks? What can we expect when we arrive? Will I be an asset or a liability? In this interactive PowerPoint presentation we will review case studies from actual air medical responses to 2017-2018 avalanche scenes. We will discuss general avalanche awareness and responder safety issues including: preparation, decision making on the scene, what the scenes were like, what the air medical crews did, patient outcomes, and lessons learned.

331. Yes, You Can Write a Journal Article
Dawn Nahlen, MA, Elsevier

This course is meant for the novice writer and outlines the steps necessary to prepare a manuscript for publication in a peer-reviewed journal.