EMS Medical Leaders Present 55 Rapid-Fire Lectures

Editor-in-Chief A.J. Heightman reports live from the 2013 Eagle Creek retreat in Dallas

 

 
 
 

A.J. Heightman, MPA, EMT-P | From the Live Coverage of 2013 Eagles Conference Issue

GALLERIES

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Exhibit Hall Images from the 2013 Eagles Retreat Conference

Exhibitors showcased their products for the physicians who lead EMS in the top cities in the U.S. and in London.
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EMS medical directors from 60 of the largest population centers in the U.S. and London provided outstanding lectures to attendees at the annual U.S. Metropolitan Municipalities EMS Medical Directors Consortium, EMS State of the Science (“Gathering of Eagles”) Conference in Dallas this weekend. (See gallery of products.)

The medical directors, representing EMS agencies that serve more than 100 million citizens throughout the U.S., presented 55 powerful, relevant and visionary lectures (one every 15 minutes) to an audience of more than 600 attendees.

The intense, focused conference featured timely topics that EMS agencies and provider now face, or will face in the immediate future.

Key topic areas included:
• The latest in STEMI care, effectiveness of therapeutic hypothermia (TH) during resuscitation; the need to reduce interruptions in the delivery of compressions; the significant increase in the resuscitation of victims after their agencies began using mechanical CPR devices; and the need to stay with the “sweet spot of compressions," which is in the range of 100–120 compressions per minute;

• Research by Ahamed Idris, MD, of the University of Texas Southwestern Medical Center, was presented at the conference by Paul Pepe, MD, Eagles Coalition leader. It showed that the performing too few or too many compressions will significantly reduce CPR effectiveness and return of spontaneous circulation (ROSC) results. (In fact, studies are now showing that such devices such as the impedence threshold device (ITD) are effective if used during resuscitation within the 100120 compression “sweet spot.”

Click here to read Idris’ in-depth article, "Study Determines Optimal Chest Compression Rate," in the JEMS EMS State of the Science 2012 editorial supplement:www.jems.com/article/patient-care/study-determines-optimal-chest-compressi.

• The Eagles, citing the lack of science to justify the excessive use of long backboards and complete spinal immobilization, reported that it may be time for a change in present-day spinal immobilization practices and that it is probably more appropriate for field personnel to use an assessment-based approach to provided patient care, comfort and immobilization. It was noted that the National Assocation of EMS Physicians (NAEMSP), the American College of Surgeons and the Eagles will be releasing position papers soon that will address these areas and reduce the excessive, frequently unwarranted, and often inappropriate or harmful, full immobilization of patients.

Discussions focused on the fact that:
1. An accepted spinal immobilization protocol (when and who to immobilize) was reasonable for all EMS systems to have and use;
2. Conventional spinal immobilization protocols in use today do not reflect the current standard of care;
3. Not all patients need to be fully immobilized; and
4. Crews should be allowed and empowered to use whatever clinically acceptable immobilization device or material, such as flexible stretchers, scoop-type stretchers and vacuum mattresses and splints, when spine and/or cervical injuries are suspected.

NOTE: The March issue of JEMS will feature an in-depth article on this subject, featuring 36 solid references to research that addresses the current science, reasons why not all patients need to be fully immobilized, and alternative immobilization devices and modalities that can be used by field crews.
• Credentialing processes for paramedics and improvements that can  should be made in the way we interview, supervise, mentor and re-evaluate paramedics;
• The pros and cons of police transport of patients;
• EMS response to mas casualty incidents (e.g., Hurricane Sandy medical move-ups and standby); and active shooter incidents;
• The benefits of nasal medication administration (via the mucosal atomization device) in adults and children;
• The expanding implementation, use and deployment of mobile heath and community  practice paramedic services to serve unmet community needs (urban and rural); and to stay ahead of the curve and meet the intent and requirement of “Obama-care;”
• Special programs that were successfully planned and implemented in the U.S. and London to respond to, manage and transport repetitive EMS system users and abusers; alcohol and substance abuser  and crisis, psychiatric and behavioral patients;
• New ways to analyze, refine and revise ALS response patterns (and staffing);
• The future transportation of patients to urgent care and alternative care facilities by ambulance;
• The experiences of agencies switching (and adapting to) BLS-and-ALS staffing rather than an all-ALS crew design;
• Reevaluation of the obsession with, and reliance on, some existing response time intervals;
• New uses and deployment of automated external defibrillators (AEDs). For more, go to www.SCA-aware.org;
• Keeping EMS personnel (and their backs) safe and healthy;
• The pitfalls in the performance basic assessments and where we need to improve;
• Taking aim at, and changing, outdated hospital diversion practices;
• The use of, and the precautions that should be taken if an agency allows its field crews to perform “hands-on” defibrillation during a cardiac arrest resuscitation;
• The on-going, expanding, frustrating and potentially harmful drug shortage crisis in America. Many medical directors are at a point where they either are or planning to consider allowing crews to use medications beyond their labeled expiration dates in the interest of public safety.
• The Medication Administration Cross-Check (MACC) program developed by Wichita/Sedgwick County (Kan.) EMS systems to reduce or eliminate medication errors. For more, visit http://vimeo.com/wscomd/review/40680029/9b7a58c827;
• A report and update on the National Registry of EMTs (NREMT), particularly new and progressive approaches planned by the leading agency for EMT certification and recertification in America;
• Fire Department New York's addition of an orange triage category to the basic START triage protocols/system to enable on-scene triage personnel to prioritize patients into a special category of its own that ensures they receive proper care and not interfere with other red-, yellow- or green-tagged patients;
• A new, simplified and highly accurate way to calculate pediatric drug dosages developed by an emergency physician in the Miami, region, the HANDTEVY Method;
• Allowing purposeful hypotension in suspected hemorrhage patients;
• Why video laryngoscopes should be standard-of-care in EMS;
• How EMS and healthcare reform can and should co-exist;
• The need for all EMS agencies (particularly fire service EMS agencies) to be ready and willing to change their scope of work and adapt to the needs and demands of the changing healthcare and unscheduled care environment, just as the fire service did for fire prevention;
• EMS crews and resources dedicated as a key part of the home healthcare and patient follow-up landscape;
• The need for better (and much more) pain relief for patients treated in the field;
• New resuscitative techniques for cardiac arrest;
• The use of: tranexamic acid (TMX); out-of-hospital blood transfusions; Praxis for anaphylaxis; Geodon (ziprasidone) and ketamine; and the treatment of hypotensive patients with the ResQGuard TD from Advanced Circulatory Systems;
• Benefits of the “pit crew” approach to crew resource to deploy and management personnel responsibilities on-scene to ensure they function efficiently and effectively at resuscitations, in an incident command manner;
• The need for, and special demands of, special event EMS planning and coverage. Attendees got a first-hand look at the planning, equipment/apparatus staging, call-loading and impact on EMS during and after the events, particularly the challenges of caring for injured post-event revelers. (Events covered included: The London Olympic Games; the 2012 World Series in San Francisco; the Boston Marathon and the Super Bowl and Mardi Gras in New Orleans.);
• The importance of training emergency responders about proper emergency vehicle driving, and the fact that the public, enclosed in highly insulated noise-tight vehicles that have high-powered, high-volume, multiple speaker stereo systems, cannot hear an approaching ambulance even if it has its siren in operation.

Watch a special public safety video announcement produced by MONOC EMS, one of New Jersey’s premier ALS response agencies.

Go to www.gatheringofEagles.us to review or download any or all of the conference presentations 

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Jon Jui, MD, Receives 2013 Michael Copass Award
Jonathan Jui, MD, MPH, EMS Medical Director for Multomah County, Oregon (which includes the cities of Portland, and Gresham and the Portland Airport) and professor of Emergency Medicine, Oregon Health and Science University, Portland, OR was the recipient of the 2013 Michael Keys Copass Award.

The prestigious Copass award is presented to the Emergency Medical Services Medical Director who has demonstrated longstanding service, contributions and leadership in the unique realm of out-of-hospital emergency care and who, in addition, has served as a role model, not only for emergency medical services personnel, but also for fellow 9-1-1 system medical directors across the nation.

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Eagle Creek Retreat System
EMS systems and media outlets represented at Eagle Creek include:

Acadian Ambulance Service
Albuquerque, N.M.
American Medical Response
Anchorage, Alaska
Grady EMS in Atlanta
Austin, Texas
Boston
Chicago
Cincinnati, Ohio
Columbus, Ohio
Dallas
Denver, Colo.
El Paso, Texas
Federal Bureau of Investigations
Ft. Worth, Texas
Greenville, S.C.
Honolulu, HI
Houston
Indianapolis
Journal of Emergency Medical Services
Kansas City, Mo.
London
Louisville. Ky.
Memphis, Tenn.
Miami
Milwaukee, Wis.
Minneapolis, Minn.
Nashville, Tenn.
New Orleans
Fire Department of New York (New York City)
Oklahoma City, Okla
Orange Cty, Fla.
Philadelphia
Phoenix
Portland, Ore.
Raleigh/Wake County, N.C.
Salt Lake City
San Antonio, Texas
San Francisco
St. Louis
St. Paul, Minn.
Tucson
Tulsa, Okla.
Washington, D.C.
Wichita, Kan.

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Eagles to Present at EMS TODAY, March 79
Members of the “Eagles Consortium” will present important information from the EMS State of the Science Conference at the JEMS EMS Today Conference & Exposition in Washington, D.C., March 7–9. www.emstoday.com/register.html?s_kwcid=TC|1028521|emstoday%20com||S|p|18021647483

Click here to see course descriptions and speaker biographies.

Maximizing Your Senses: The Future of Noninvasive Monitoring in Prehospital Care 
Speaker(s): James Augustine MD
Wednesday, March 6, 78 p.m.

Hypothermia: Not Just for Ventricular Fibrillation Anymore?
Speaker: Brent Myers MD, MPH, FACEP
Thursday, March 7, 89 a.m.

Lessons Learned: EMS Use of Ketamine for Excited Delirium 
Speaker: David Keseg MD, FACEP

Maximizing Your Senses: The Future of Noninvasive Monitoring in Prehospital Care
Speaker: James Augustine MD

Optimizing Your EMS Medical Director
Speaker: Eric Beck, DO, NREMT-P, CCEMT-P

Ready to Roll: When the Unexpected Occurs
Speaker: Jason Killens  Operations Director, London Ambulance Service
Thursday, March 7, 10:30 a.m.–12 p.m. (90 minutes)

What EMS has Learned from the Iraq & Afghanistan Battlefield
Speaker: Peter Taillac MD, FACEP
Thursday, March 7, 10:30 a.m.12:30 p.m. (two hours)

Eagles Lightning Round
Speakers: Brent Myers MD, MPH, FACEP; Corey Slovis MD, FACP, FACEP, FAAEM; David Keseg MD, FACEP; David Miramontes MD, FACEP, NREMT

TBI: Prehospital controversies & management update
Speaker: Eric Beck DO, NREMT-P, CCEMT-P

The Queen’s Diamond Jubilee: Working across agencies & disciplines for event management
Speaker: Jason Killens  Operations Director, London Ambulance Service
Thursday, March 7, 1:453:15 p.m. (90 minutes)

Clinical Implications: The most important EMS research of the year
Speaker: Corey Slovis MD, FACP, FACEP, FAAEM

EMS Administration of Captopril for CHF: Does it Work? 
Speaker: David Keseg MD, FACEP

What EMS has Learned From the Iraq and Afghanistan Battlefield
Speaker: Peter Taillac MD, FACEP
Friday – March 8, 8–10 a.m.

Report from the Eagles: What’s Hot, What’s Not
Speaker(s): Brent Myers MD, MPH, FACEP; Corey Slovis MD, FACP, FACEP, FAAEM; David Keseg MD, FACEP; David Miramontes MD, FACEP, NREMT; Eric Beck DO, NREMT-P, CCEMT-P

Seizure Management in 2013
Speaker: Jason McMullan MD

Zeroing in on Hemorrhagic Shock  
Speaker: Peter Taillac MD, FACEP

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Innovations & New Products on Display at Eagles Conference
Exhibitors at the U.S. Metropolitan Municipalities EMS Medical Directors Consortium, EMS State of the Science Conference offered several new products, enhancements to existing products and software and devices designed to optimize patient assessment and care, and make work performed by crews safer and more efficient.

For a glimpse at many of the new products, click through the photo galley accompanying this article or visit the exhibit hall at the EMS TODAY Conference and Exhibition at the Washington DC Convention Center (801 Mt Vernon Pl NW  Washington, DC) March 7-9, 2013. EMS personnel can browse the exhibit hall for free.

For a map and directions to the Washington, DC, Convention Center, click the following link:  www.visitingdc.com/maps/washington-dc-convention-center-map.asp

 



Exhibit Hall Images from the 2013 Eagles Retreat Conference

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Vivid Medical's disposible video laryngoscope

Vivid Medical's $68.50 disposible video laryngoscope attached to a WiFi transmission adapter. Photos A.J. Heightman


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VividTrac video laryngoscope

The VividTrac video laryngoscope sends its WiFi signal to an iPhone, iPad, and the inexpensive Android Nexus 7" tablet ($199).


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Clarity of the VividTrac video larygoscope

The clarity of the image produced from the $68.50 disposable, non-fogging VividTrac video larygoscope is impressive.


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INNOVATIVE TRAUMA CARE - itCLAMP

The INNOVATIVE TRAUMA CARE - itCLAMP - development and sales team.


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itCLAMP hemorrhage control device

The itCLAMP hemorrhage control device clamps on the surface of the skin and causes bleeding to clot within 5 secs.


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Area of severe hemorrhage

An area of severe hemorrhage.


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The itCLAMP applied over wound site

The itCLAMP applied over the wound site.JPG


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How the itCLAMP works

How the itCLAMP works to clot areas of underlying hemorrhage.


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An actual clot

An actual clot shown immediately to the left of the itCLAMP location.


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O-two Systems display

O-two Systems displayed several compact and function-packed ventilators and CPAP delivery systems.


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O-two Systems CPAP

The O-two Systems CPAP system.


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Advanced Circulatory System's ResQGuard System

Advanced Circulatory System's ResQGuard System.


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Physio-Contro LUCAS II

The Physio-Contro LUCAS II unit offers consistent, uninterrupted compressions.


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Image Trend's Field Bridge & EPCR systems

Image Trend's Field Bridge & EPCR systems.


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BoundTree Medical

BoundTree Medical displayed a host of products.


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Laerdal Medical

Laerdal Medical displayed several simulation innovations.


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Laerdal MedicaI's wireless SimJunior

Laerdal MedicaI's wireless SimJunior.


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INTERSURGICAL

INTERSURGICAL displayed their i-Gel airway systems & medication delivery systems.


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King Vision video larygoscope

King Systems displayed the King Vision video larygoscope.


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4J_The_KingVision_Video_Larygoscope.JPG

The King Vision video larygoscope.


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HARTWELL MEDICAL

HARTWELL MEDICAL displayed their vaccuum splint and mattress systems and CombiCarrier.


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HARTWELL MEDICAL EVAC-U-SPLINT mattress

The HARTWELL MEDICAL EVAC-U-SPLINT mattress was popular with Eagle attendess.


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BOMImed INTROS POCKET BOUGIE

The INTROS POCKET BOUGIE from BOMImed is moldable and easy to use.


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InSpectra StO2 Model 300 Tissue Perfusion Detector from Hutchinson Technology

The InSpectra StO2 Model 300 Tissue Perfusion Detector from Hutchinson Technology.


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InSpectra StO2 Model 300 Tissue Perfusion Detector

The InSpectra StO2 Model 300 Tissue Perfusion Detector.


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InSpectra StO2 Tissue Perfusion Detector

The InSpectra StO2 Tissue Perfusion Detector.


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MEDIVIEW EPCR System

The MEDIVIEW EPCR System.


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Masimo Corporation

Masimo displayed two new high tech assessment tools.


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Masimo's EMMA

Masimo's EMMA is the worlds smallest digital capnograpy device.


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Masimo iSpo2 sensor

The new Masimo iSpo2 sensor plugs in and operates with a standard iPad.


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ESO SOLUTIONS

ESO SOLUTIONS software systems.


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ZOLL team

The ZOLL team displayed the X-Series cardiac monitoring system.


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ZOLL X-Series cardiac monitoring system

The ZOLL X-Series cardiac monitoring system.


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Vidacare

Vidacare displayed its compact EZ-IO and assorded needles.


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Physio Control LUCAS II

Physio Control's LUCAS II battery-operated mechanical CPR device.


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MEDSOUTH CoPilot video laryngoscope

The MEDSOUTH CoPilot video laryngoscope.


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Mercury Medical

Mercury Medical's FLOWSAFE II CPAP device & new airQ-sp Blocker Masked Laryngeal Airway.


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Philips HeartStart MRx cardiac monitor & defibrillator

Philips displayed the HeartStart MRx cardiac monitor & defibrillator.


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VYGON

VYGON displayed several respiratory care products.


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LMA Supreme Airway

LMA EMS exhibited the LMA Supreme Airway with built-in drain tube.


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IMPACT Instrumentation

IMPACT Instrumentation displayed multiple, rugged, high-tech respiratory, ventilation and suction products.


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IMPACT EMV+ventilaor, CPAP and SpO2 unit

The IMPACT EMV+ventilaor, CPAP and SpO2 unit weighs just 10 lbs and offers 10 hours of battery operation.


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MEDLOGIC's INFRASCANNER 2000 Brain Hematoma Scanner

MEDLOGIC's INFRASCANNER 2000 Brain Hematoma Scanner in use.


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The INFRASCANNER 2000 screen displaying an area of blood accumulation.


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Meridian Medical

Meridian Medical displayed its DuoDote injectors and CYANOKIT.


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Sanare STEM Trauma BioLightPad

The Sanare STEM Trauma BioLightPad.


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NuMask IntraOral Mask

The NuMask IntraOral Mask.



Connect: Have a thought or feedback about this? Add your comment now
Related Topics: News, Operations and Protcols, EMS Medical Directors, EMS medical direction, Eagles Coalition, Eagle's Retreat

 
Author Thumb

A.J. Heightman, MPA, EMT-P

JEMS Editor-in-Chief A.J. Heightman, MPA, EMT-P, has a background as an EMS director and EMS operations director. He specializes in MCI management.

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