Highlights from 2014 EMS State of the Science Gathering of Eagles – Part 6 - News - @ JEMS.com

Highlights from 2014 EMS State of the Science Gathering of Eagles – Part 6

Summaries and take-away points from presentations on Saturday, March 1, 2014



A.J. Heightman, MPA, EMT-P | | Saturday, March 1, 2014

Below are summaries of important EMS clinical information presented at the 2014 Gathering of Eagles in Dallas on Saturday, May 1, 2014.

(Presentations will be made available for download at www.gatheringofeagles.us following the conference.)

JEMS Coverage of 2014 Gathering of Eagles
Highlights: Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6

Focus on Toxic Thoughts: Two-Thousand and Fourteen Considerations about Street Drugs

Epidemic Proportions: Dosing Ketamine in the Era of Mamba Rumbas
Presented by Christopher B. Colwell, MD (Denver)

Colwell pointed out that there's a big difference in the potency of “regular” marajuana vs. synthetic cannabis (which is illegal) and that the use of synthetic cannabis has increased significantly.

He also said that use of “Black Mamba” (one of the most powerful synthetic cannabis versions) has increased since marajuana use was approved in Colorado.

He said that use of ketamine ($18 per dose) for excited delirium has been effective in the Denver system. They give it as a 5 mg/kg intramuscular dose (100 mg/ml concentration). While some patients arrive at the ED acidodic, none have gone into cardiac arrest in the field as compared to about 20% in the past with other drugs.

They've had 40 uses so far in the field (27 involved synthetic cannabis): 48% received ketamine and 16 were discharged from the ED.

While droperidol is still the first drug of choice for Dr. Colwell, he said he wouldn't hesitate using ketamine for excited delirium patients. He pointed out that the decision to use ketamine is the hardest obstacle to overcome in a system

Managing Fentanyl-Laced Heroin Abuse                         
Presented by C. Crawford Mechem, MD (Philadelphia Fire Department)

Fentanyl is 80 times as potent as morphine and mixed with heroin can be deadly. Dr. Mechem noted that fentanyl-laced heroin use and deaths appears to be on the rise. He said that Philadelphia has experienced 252 deaths with fentanyl used in conjunction with heroin last year, and they continue to see deaths as a result of this combination.

It was seen as a regional outbreak in Cook County, Ill.; Camden, N.J.; Philadelphia and Allegheny County, Penn.; and other areas. It was often seen in gang areas.

Dr. Mechem stated that the appropriate naloxone (Narcan) dose has generally accepted ranges. In Pennsylvania and Maryland, the prehospital dosage of Narcan is 0.4 mg to 2 mg. His recommendation is to start with a low dose to avoid the side effects of withdrawl.

Drugs Falling into the Wrong Hands—or Not? Naloxone (Narcan) Use by Non-EMS Personnel
Presented by Jeffrey M. Goodloe, MD (Tulsa and Oklahoma City)

The American College of Emergency Physicians supports the prescription of Narcan to the public for the use of reversing overdoses. Many people now feel police officers should carry Narcan to administer to overdose patients. At least 17 states have passed legislation allowing law enforcement officers to carry/administer Narcan.

He cautioned that naloxone is an effective drug, but it isn't benign. It can result in patient withdrawal. He stated that if a person could be supported by bag-valve mask use, it might be more acceptable than having police officers send a patient into withdrawal. In addition, there are issues associated with the cost and availability of the drugeven for EMS systems.

He said what's really needed in an altered mental status patient is early BLS/ALS treatment, and the use of Narcan should be given when several parameters are met andeven thenat dosages of dosage of 0.4 mg to 2 mg.

What is the Responsibility of the Eagles Audience?
Presented by Edward M. Racht, MD (American Medical Response)

In a very powerful and compelling 10-minute lecture, Dr. Racht spoke from his heart to the audience about what they need to do with the knowledge they've learned over the past two days after they leave the Eagles conference.

He presented several “Captain Obvious” things:
• We can learn a lot in 10 minutes;
• Humor (and sometimes irreverence) adds to the experience and allows us to accept the science of the day;
• There's merit in faculty changing their slides often moments before they speak to keep it as current as possible;
• It's OK to disagree with each other;
• There's merit to science with no fluff;
• When lecturers are (or people) "different" (i.e., quirky), they turn people’s heads;
• If we stay banded together, we can change EMS;
• It’s good to leave a conference like Eagles with lots of "what ifs" and wondering "how can I change our system."
• We must change with the times and embrace the power of change; and
• You have to develop the “art” of getting the important messages learned at a conference like Eagles to the masses to change the evolution in the practice of EMS and medicine.

Eagles’ Special Salutes: The Copass and Slovis Award
Presented by the U.S. Metropolitan Municipalities EMS & Federal Agency Medical Directors, Colleagues and Friends

The prestigious Michael J. Copass EMS Medical Director Leadership Award was given to long-tenured EMS medical director R.J. Franscone, MD, from the Twin Cities area of Minneapolis/St. Paul.

The Corey Slovis EMS Educator of the Year Award was given to metropolitan Oklahoma City and Tulsa EMS Medical Director Jeffrey Goodloe, MD. 

Gas-Guided Goals: New “End-Tidal-ments” for Trauma Resuscitation
Presented by Jason T. McMullan, MD (Cincinnati Fire Department)

Dr. McMullan pointed out that end-tidal carbon doxide (EtCO2) is very helpful for measuring ventilation quality and, most recently, septic shock (perfusion), but can also be useful in detecting hemorrhagic shock and lead poisoning. He noted that extreme caution must be taken in the polytrauma patient that has a head injury. He also said that 1 mm difference (drop) in EtCO2 could represent a 4% decrease in cerebral perfusion.

<-- Back to Part 5

Mobile Category: 

Connect: Have a thought or feedback about this? Add your comment now
Related Topics: News, Industry News, EMS Medical Directors, EMS medical direction, Eagles Coalition, Eagle's Retreat, 2014 Gathering of Eagles

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.


What's Your Take? Comment Now ...

Buyer's Guide Featured Companies

Featured Careers & Jobs in EMS

Get JEMS in Your Inbox


Fire EMS Blogs

Blogger Browser

Today's Featured Posts


EMS Airway Clinic

Innovation & Advancement

This is the seventh year of the EMS 10 Innovators in EMS program, jointly sponsored by Physio-Control and JEMS.
More >

Multimedia Thumb

Glendale Firefighters Suspended for Punching Patient

Excessive force was used on a combative patient.
Watch It >

Multimedia Thumb

Vancouver Chemical Fire Causes Major Response

Hazmat incident sends smoke over port neighborhood.
Watch It >

Multimedia Thumb

Salt Lake City Firefighters Injured in Firehouse Fire

Nine sent to a hospital with smoke inhalation.
Watch It >

Multimedia Thumb

Pennsylvania Paramedic Killed in the Line of Duty

West End Ambulance medic killed at accident scene.
Watch It >

Multimedia Thumb

Plane Skids off Runway at LaGuardia Airport

Delta flight stops just short of Flushing Bay
More >

Multimedia Thumb

Rigs Going in Service from EMS Today 2015

Snap shots of some of the vehicles at EMS Today that will be on the streets soon
More >

Multimedia Thumb

VividTrac offered by Vivid Medical - EMS Today 2013

VividTrac, affordable high performance video intubation device.
Watch It >

Multimedia Thumb

Braun Ambulances' EZ Door Forward

Helps to create a safer ambulance module.
Watch It >

Multimedia Thumb

Field Bridge Xpress ePCR on iPad, Android, Kindle Fire

Sneak peek of customizable run forms & more.
Watch It >

More Product Videos >