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NAEMSP 2023 Annual Meeting Schedule

Please note: The 2023 schedule will continually be updated to accommodate minor changes to the program, speakers and to include more specific information as it becomes available.

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Preconference Schedule - January 23-25

Monday, January 23

Tuesday, January 24

*No Charge

Wednesday, January 25

Regular Meeting Schedule - January 26-28

Thursday, January 26

Friday, January 27

Saturday, January 28

Monday, January 23, 2023


8:00 am - 5:00 pm

NAEMSP National EMS Medical Directors Course & Practicum® (Day 1 of 3)

$975 members/$1250 non-members

Course Directors: Robert Swor, DO; Beth Adams, MA, BSN, RN, NRP, FAEMS

NAEMSP is the preeminent organization for EMS medical directors, and it has offered the NAEMSP National EMS Medical Directors Course & Practicum for many years. The distinguished faculty are recognized experts in various aspects of the prehospital and disaster medicine/management fields.

This interactive course focuses on EMS n the ‘real world’ and serves to enhance the students expertise in EMS issues. In addition to curriculum elements that run the range and depth of issues vital to EMS medical directorship, students will have ample opportunity throughout the course to network with faculty and fellow students to critically evaluate their system.


8:00 am - 5:00 pm

NAEMSP Quality Improvement Workshop (Day 1 of 2)

$675 all attendees

Course Directors:  Maia Dorsett, MD, FAEMS; Nicola Little, ACP, BHSc-Paramedicine

Designed for EMS medical directors and quality leaders who want to improve the clinical quality of their service and need the tools to be more effective, the course will apply the lessons of healthcare improvement to the challenges of EMS and out-of-hospital care. During the course you will learn the tenets of improvement science and how to practically apply these lessons to your environment, be it a small agency, a larger EMS system or a state-wide effort. The two-day course will guide participants through the basic structure of quality improvement, highlighting challenges and lessons learned regarding data, leading change, project management and more.


8:00 am - 5:00 pm

Tactical Emergency Casualty Care for Medical Directors

$300 all attendees

Course Director: E. Reed Smith, MD

The Tactical Emergency Casualty Care (TECC) guidelines represent a set of evidenced-based best practices for the immediate medical management of wounded in all prehospital high-risk scenarios (e.g. active violence). TECC is not tactical medicine; instead, it is intended for situations with on-going threat to the provider and patient. Based on military combat medical lessons learned but translated for appropriate use by civilians, TECC balances the on-going threats, civilian scope of practice, population, medical equipment, and the variable response resources in civilian atypical emergencies. This familiarization course is intended to teach Medical Directors the concepts, nuances of the available equipment, training techniques, and the concepts and data behind the development and implementation of TECC for high threat response, This course will be taught by founders and current leadership of the Committee for TECC.


8:00 am - 12:00 pm

Fundamentals of Mobile Integrated Health (MIH)

Course Director: Scott Goldberg, MD, MPH, FAEMS

$150 all attendees

Session 1 of this pre-conference provides the learner with a basic understanding of MIH. This session is geared towards individuals who are starting an MIH program or who are thinking about starting an MIH program. Lectures will include QI metrics, payment models staffing models, how MIH can look in urban/rural locations, and how MIH can be utilized in public health crisis like opioid and COVID-19. Panel discussions will highlight lessons learned in the first 5 years from the perspectives of medical directors and field providers.  


1:00 pm - 5:00 pm

Advanced Topics in MIH Operations and Clinical Care

$150 all attendees

Course Director: Scott Goldberg, MD, MPH, FAEMS

Session 2 of this pre-conference is geared to attendees who are currently running an MIH program but looking to learn from MIH experts at NAEMSP. The session will highlight a combination of both operational and clinical care aspects of mature MIH programs. Topics will include developing stable program funding, engaging with public health entities, and working with payers and regulators. Clinical topics will discuss management of behavioral health patients and other special populations and best practices for home hospital models of care.

While the prevalence of MH programs has grown rapidly in the past several years, this preconference will provide EMS medical directors with less exposure to MIH the skills to develop a successful MIH program. For those medical directors and providers already engaged in MIH, this preconference will enhance their knowledge base in MIH operations and clinical care.


1:00 pm - 5:00 pm

First Responders: Virtual Reality Training for Emergency Personnel in Mass Casualty Response

$150 all attendees

Course Director, Nicholas Kman, MD

Recent mass casualty events demonstrate that targeted hemorrhage control, swift extrication with minimal interventions, and immediate transport are priorities for care. However, integrating these skills into a dynamic, unstable, and active disaster scene is challenging and difficult to simulate. Using Unity, we created an interactive, immersive VR simulation designed such that trainees must navigate the scene and triage approximately 10-15 injured patients. Patients are modeled after a universal avatar and have a variety of life-threatening (e.g. acute arterial bleed, penetrating injury, pneumothorax, amputations) and non-life-threatening injuries (lacerations, sprains, hysteria, confusion). To assess performance, an automatic scoring system was developed to provide faculty evaluators with a summary of each participant’s actions.

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Tuesday, January 24, 2023


8:00 am - 5:00 pm

NAEMSP National EMS Medical Directors Course & Practicum® (Day 2 of 3)

$975 members/$1250 non-members

Course Directors: Robert Swor, DO; Beth Adams, MA, BSN, RN, NRP, FAEMS

NAEMSP is the preeminent organization for EMS medical directors, and it has offered the NAEMSP National EMS Medical Directors Course & Practicum for many years. The distinguished faculty are recognized experts in various aspects of the prehospital and disaster medicine/management fields.

This interactive course focuses on EMS n the ‘real world’ and serves to enhance the students expertise in EMS issues. In addition to curriculum elements that run the range and depth of issues vital to EMS medical directorship, students will have ample opportunity throughout the course to network with faculty and fellow students to critically evaluate their system.


8:00 am - 5:00 pm

NAEMSP Quality Improvement Workshop (Day 2 of 2)

$675 all attendees

Course Directors:  Maia Dorsett, MD, FAEMS; Nicola Little, ACP, BHSc-Paramedicine

Designed for EMS medical directors and quality leaders who want to improve the clinical quality of their service and need the tools to be more effective, the course will apply the lessons of healthcare improvement to the challenges of EMS and out-of-hospital care. During the course you will learn the tenets of improvement science and how to practically apply these lessons to your environment, be it a small agency, a larger EMS system or a state-wide effort. The two-day course will guide participants through the basic structure of quality improvement, highlighting challenges and lessons learned regarding data, leading change, project management and more.


8:00 am - 5:00 pm

Antiracism Faculty Development Course

$225 all attendees

Course Director: Stacy Weisberg, MD, FAEMS

Attendees of this course will gain an understanding racial tension within the United States by examining the history, understanding current disparities in healthcare and an understanding how some populations benefit from societal constructs. Attendees will learn how they can use their position of privilege to combat racism and inequity through allyship and learn the positive impact of diversity and inclusion in the workplace and discover ways to foster it. This workshop will allow you to acquire tools to combat racism and work towards patient health equity and cultural humility.


8:00 am - 5:00 pm

Resuscitation Academy (RA): Focused for the Advanced Provider

No charge for this workshop

Course Directors: Daniel Moran CFO, Florida RA Lighthouse; Tegan Hampton and Ann Doll, Resucitation Academy 

The EMS report cards for VF witnessed cardiac arrest survival are in; and the results for most communities in the United States are dismal. Many large U.S. cities average less than 10%. Yet, there is hope. Seattle and King County, Washington report over 60% survival; among the highest in the world. Why is this? What can your community do to improve?

This event will be a one day "mini-RA" in which RA faculty will provide a focused overview of the key parts of the 2-day RA. It will include didactic and hands-on training and will be similar to courses currently run for incoming medical students, paramedics, nurses, and other healthcare providers that respond to cardiac arrest emergencies. This course will give organizational leaders the tools and confidence to improve their community's survival from out-of-hospital cardiac arrest. This event will be led by the Florida Resuscitation Academy Lighthouse, Davie Fire Rescue


8:00 am - 12:00 pm

Mass Gathering Medicine Workshop

$200 all attendees

Course Directors: Matt Friedman; Asa Margolis

Mass Gathering Medicine is an emerging focus within the subspecialty of EMS. As the medical care delivered at mass gatherings receive more attention from the media and laypeople, there needs to be clear teaching and dissemination of best practices regarding mass gathering medicine. The focus of this workshop is to discuss the key principles of Mass Gathering Medicine, including ‎nuances to patient care presentations, recommended on-site medical formularies, and discussing ‎clinical conundrums that have arisen in the past.‎


8:00 am - 12:00 pm

All Things Ventilation: Spontaneous, Non-Invasive, Manual and Mechanical

$125 all attendees

Course Director: Holly Stewart

The “All Things Ventilation” workshop focuses on spontaneous, non-invasive, manual, and mechanical ventilation. This workshop provides an overview and key concepts of ventilation, the effects on patient physiology and outcomes and how to deploy ventilation techniques safely and effectively within the pre-hospital setting. The workshop will provide hands on experience with various ventilation and monitoring options currently available and review the current evidence-based practice. Pre-hospital case studies will be utilized to provide experience to the attendees of the course that focus on ventilation with a broad range of clinical presentations (cardiac arrest, traumatic brain injury, COPD, Asthma, sepsis). The course will also cover how to troubleshoot challenging ventilation incidents in the pre-hospital setting. Lastly, the course will provide examples of the best strategies to deploy staff training, quality improvement and protocol development within your own department.


1:00 pm - 5:00 pm

RAPToR course:  Resuscitation Adjuncts, Prehospital Transfusion and REBOA (1½ Days)

$350 all attendees

Course Director: Zaf Qasim, MD

One and a half-day course - We face a significant burden from preventable prehospital death due to hemorrhage. In particular, non-compressible torso hemorrhage can be particularly challenging to address. There is an increasing need to bring resuscitation room interventions to the point of insult or injury. Recently, the US military's Joint Trauma System recommended adding the use of whole blood and REBOA to Tactical Combat Casualty Care.  Termed Advanced Resuscitative Care (ARC), these interventions are aimed to buy time to get the patient to definitive care. Through a series of classroom lectures, simulation, and cadaveric training, the RAPToR course will equip you, the prehospital resuscitation specialist, with the knowledge and skills to safely and responsibly incorporate these tools into your prehospital practice.

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Wednesday, January 25, 2023


8:00 am - 5:00 pm

NAEMSP National EMS Medical Directors Course & Practicum® (Day 3 of 3)

$975 members/$1250 non-members

Course Directors: Robert Swor, DO; Beth Adams, MA, BSN, RN, NRP, FAEMS

NAEMSP is the preeminent organization for EMS medical directors, and it has offered the NAEMSP National EMS Medical Directors Course & Practicum for many years. The distinguished faculty are recognized experts in various aspects of the prehospital and disaster medicine/management fields.

This interactive course focuses on EMS n the ‘real world’ and serves to enhance the students expertise in EMS issues. In addition to curriculum elements that run the range and depth of issues vital to EMS medical directorship, students will have ample opportunity throughout the course to network with faculty and fellow students to critically evaluate their system.


8:00 am - 5:00 pm

RAPToR course: Resuscitation Adjuncts, Prehospital Transfusion and REBOA (Continued, 1½ Days)

$350 all attendees

Course Director: Zaf Qasim, MD

One and a half-day course - We face a significant burden from preventable prehospital death due to hemorrhage. In particular, non-compressible torso hemorrhage can be particularly challenging to address. There is an increasing need to bring resuscitation room interventions to the point of insult or injury. Recently, the US military's Joint Trauma System recommended adding the use of whole blood and REBOA to Tactical Combat Casualty Care.  Termed Advanced Resuscitative Care (ARC), these interventions are aimed to buy time to get the patient to definitive care. Through a series of classroom lectures, simulation, and cadaveric training, the RAPToR course will equip you, the prehospital resuscitation specialist, with the knowledge and skills to safely and responsibly incorporate these tools into your prehospital practice.


8:00 am - 5:00 pm

Advanced Topics in Medical Direction

$350 all attendees

Course Director: Jeff Beeson, DO, FAEMS

This unique one-day workshop is designed for practicing EMS Medical Directors and others who engage in clinical supervision of functioning emergency medical dispatchers, emergency medical technicians and paramedics. While not required, previous completion of the NAEMSP® National EMS Medical Directors Course & Practicum® is recommended.


8:00 am - 5:00 pm

Lifelong Learning in EMS

$300 all attendees

Course Director: Tom Grawey, DO

The ideal EMS provider of the future is one that is a lifelong learner, ready to adapt to the rapidly evolving field of EMS medicine.  Modern EMS Medical Direction includes frequent contacts with learners of different capabilities in multiple different settings.  Often, the time allocated to engage directly with learners is limited.  It is vital for EMS Medical Directors and other EMS leaders to be effective educators and cultivate lifelong learning in local EMS systems.


8:00 am - 12:00 pm

Airway Lab

$180 all attendees

Course Directors: Marv Wayne, MD; Andy McCoy, MD, MS, FAEMS

This half day course will focus on hands on time with airway equipment from all available manufacturers. Also covered will be best practices in airway management and ventilation, best practices in feedback to crews on airway performance, and update on the latest research around ventilation and its importance in the processor airway management. Try all the equipment and perfect best practices for intubation, airway management, and ventilation in the prehospital space. 


8:00 am - 12:00 pm

How to Run your State NAEMSP Chapter: From Initial Request to Sustainment

$200 all attendees

Course Directors: Joseph Zalkin, FAEMS; Joshua Gaither, MD, FAEMS

This half day program will highlight the story of successful chapters and challenges being faced with recruitment of members, backyard advocacy issues and solutions. You will be introduced to National’s support staff and resources.  
 
The workshop will include presentations from The NAEMSP Board and successful chapters and their initiatives.  Participants will walk out of the session with a “toolbox” of best practices and a contact network.  This program is for both existing and potential new chapter leaders. 


1:00 pm - 5:00 pm

Out-of-Hospital Critical Procedure Cadaver Lab

$180 all attendees

Course Directors: Marv Wayne, MD; Andy McCoy, MD, MS, FAEMS

Hands on experience in these skills is tough to acquire. This highly reviewed session allows attendees to receive expert instruction around the indications, contraindications, and methods involved with many procedures that are carried out in the prehospital setting. The purpose of this workshop is to provide a unique opportunity to review relevant anatomy associated with critical care and lifesaving emergency procedures. Participants will enhance their understanding of the various procedures and the associated risks and benefits through the hands-on practicum. The relevant review of the anatomy will include airway, chest cavity, and vascular access landmarks. Key opinion leaders, nationally-known EMS medical directors, and emergency medical services providers serve as faculty for this program.


1:00 pm - 5:00 pm

Ultrasound in EMS 101 For Medical Directors: From Idea to Successful Implementation

$150 all attendees

Course Directors: Kasia Hampton MD; Robert Strony, MD

This half day workshop will include a case-based review of point of care ultrasound (POCUS) core content relevant to prehospital emergency care; Review of successful POCUS implementation strategies in EMS; and a review of successful EMS POCUS education strategies.

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Thursday, January 26, 2023


8:00 am - 5:00 pm

Registration


8:00 am - 8:15 am

Welcome and President's Address

Michael Levy. MD, FAEMS

 

 


8:15 am - 9:00 am

Keynote Session


9:00 am - 9:40 am

EMS Grand Rounds - Prehospital? What Hospital?: The EMS Niche in Humanitarian Aid

Yuko Nakajima, MD


9:40 am - 10:10 am

Allied Updates

NREMT Update
NASEMSO Update
ABEM Update

10:10 am - 10:50 am

Break in Exhibit Hall


10:50 am - 11:00 am

Prehospital Emergency Care Update

David Cone, MD


11:00 am - 12:00 pm

Menegazzi Scientific Session
Research Oral Abstracts Session 1

12:00 pm - 1:15 pm

Lunch and Committee Meetings

Committee meeting schedule to be posted by end of December

Diversity Equity & Inclusion Track
1:15 pm - 2:50 pm


1:15 pm - 1:35 pm

Becoming an Upstander: Action Tools to Create a Safe, Empowering Environment

Rickquel Tripp, MD, MPH

Research has shown that implicit bias and racism are within our EMS system and we need to empower our providers to address these injustices in real-time and in a way that will lead to learning and understanding. Since our EMS workforce is not composed of many people of color, this presentation will help providers stand up for their underrepresented minority colleagues in the face of witnessing bias/ prejudice/ microaggressions. UPSTANDER training is built upon the framework of Interrupt, Question, Educate, Echo: IQEE and is adopted with permission from the Learning for Justice project of the Southern Poverty Law Center.


1:40 pm - 2:00 pm

Equity in EMS Care: Disaggregating the Data

Mark Escott, MD, MPH

This presentation will discuss the City of Austin's approach to assessment of the equity of clinical services provided by the EMS System and the revealing story uncovered by disaggregation of data.  I will discuss some concepts related to equity assessment of the EMS clinical practice, including social determinants of health, vulnerability indices, as well as the importance of community engagement in building a strategy.  The lecture will also discuss some methods to assess a jurisdiction's equity as it relates to clinical outcomes.


2:05 pm - 2:25 pm

Trauma Informed Care: What That Means to EMS

Lekshmi Kumar, MD

A trauma informed care approach involves understanding the patient as a whole and not just focusing on their current complaint. We in EMS are well positioned as we walk into homes and lives of these patients to evaluate them and are well positioned to create a physically and emotionally safe environment and establish trust to improve patient and provider experience and promote patient healing and provider resilience. We must make a conscious effort at incorporating trauma informed care into our everyday practice and be responsible for this culture change within our organization.


2:30 pm - 2:50 pm

EMTALA Pitfalls for the EMS Physician

Hashim Zaidi

EMTALA is often thought to have little to do with EMS. While that may be true for much of the care rendered by an emergency department, multiple EMTALA provisions apply to 911 EMS and are the source of litigation and investigation by the office of inspector general. In this presentation we will cover the provisions that apply to EMS agencies. We will showcase real world examples of these issues with specific case law and present any known outcomes or fines from those cases. We will also review recent COVID specific guidance from CMS that may allow for innovative care models and delivery with EMS. 

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Education & Quality Track
1:15 pm - 2:50 pm


1:15 pm - 1:35 pm

The National EMS Quality Improvement Project (EQUIP):  Using the IHI Breakthrough Collaborative Model and NEMSQA National Quality Measures to Improve the Safety of EMS Response and Transport

Michael Redlener, MD, FAEMS; Michael Taigman

The presenter panel will present the organization of the EQUIP project and describe how this project has the potential to transform the practice of EMS at the national and the local level.  We will hear from national leaders and experts and from local agencies involved with the project to understand this rich opportunity for EMS.  


1:40 pm - 2:00 pm

Application of Data Science and Artificial Intelligence in EMS

Marcus Ong, MD, MPH


2:05 pm - 2:25 pm

Teaching the Unwritten Objectives: The Role of the Medical Director in Initial EMS Education

Maia Dorsett, MD, FAEMS

At the paramedic level, the CAAHEP standards outline the responsibilities of EMS medical directors in initial paramedic education. There remains wide variability in how these responsibilities are met across programs, and consequently the impact of physician involvement on initial paramedic education. This talk will discuss how to meet these responsibilities while focusing on the highest yield opportunities for EMS physician involvement in initial paramedic education. In particular, as clinical leaders, program medical directors have the critical opportunity to teach the unwritten objectives of psychological safety and lifelong learning by supporting this culture in the educational environment.  


2:30 pm - 2:50 pm

Who is EMS? Challenges in Describing and Measuring the EMS Workforce

Rebecca E. Cash, PhD, NRP, FAEMS; Jonathan R. Powell, MPA, NRP; Ashish R. Panchal, MD, PhD, FAEMS

The past several years has highlighted the importance of the EMS workforce to public health and public safety, and we continue to hear reports of workforce shortages locally and nationally. National estimates of the EMS workforce in the United States range from about 250,000 to over 800,000 people. With such huge variability in measuring the workforce, it remains challenging to understand who is “EMS”? We will discuss the changing definitions of an EMS professional, obstacles with current data sources, and recent efforts to track workforce metrics like turnover. We will also present novel approaches to measuring the workforce, providing better local and national estimates to inform policy and practice.


2:55 pm - 3:20 pm

Break in Exhibit Hall

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General EMS Track
3:20 pm - 5:00 pm


3:20 pm - 3:40 pm

Creating an EMS System Surge Plan

Matthew J. Levy, DO, MSc, FAEMS, FACEP, NRP

Surge mitigation and response plans have historically focused on bolstering EMS system response to a singular mass casualty incident. However, surges more commonly occur in the setting of the multiple successive smaller events, which results in excessive demand for EMS resources. Exacerbated by the COVID-19 omicron surge of early 2022, EMS systems found themselves facing a complex series of challenges including workforce depletion and ambulance patient offload delays, all while also managing pre-pandemic levels of EMS utilization. Many EMS systems found themselves implementing crisis standards of care in real time without a clearly defined logistical and operational approach. This presentation will provide an overview of considerations for medical directors and EMS system administrators, on the creation an an EMS system surge plan. System metrics and performance indicators which can serve as surge triggers and monitors will be reviewed. Operational mitigation strategies and logistical implementations to gain system capacity will be discussed. 


3:45 pm - 4:05 pm

Managing Shortfalls and Growth in EMS

Jose G. Cabanas, MD, FAEMS; Don Garner

Before COVID-19, the EMS industry felt the effects of an improving economy and a transition to a younger workforce while feeling the pressure of increasing demand for emergency services. A decline in qualified professionals entering healthcare has increased competition for high-quality EMS providers. The disruption from the pandemic further magnified these chronic workforce problems and impacted EMS service delivery across many communities. These challenges have become even more problematic in communities growing at a high rate and experiencing a high demand for emergency services. The speakers will discuss some of the lessons we have learned from disruption due to the pandemic and discuss the opportunity to create innovative programs that can build the future workforce while transitioning to a delivery model that is more integrated within the local healthcare system. 

4:10 pm - 4:30 pm

Medical-Legal Update

Matthew R. Streger, Esq., MPA, NRP; Michael Levy, MD, FAEMS; Tom James, MHA

Reprising our ongoing topic, the presenters here will review the last year of legal cases and areas of liability in civil, criminal, and administrative law. We will look at the types of matters that are giving rise to insurance claims, and published cases, review the facts, and learn lessons from those issues for agency and physician self-protection.


4:35 pm - 4:55 am

The Subtle Perils of Pregnancy and Postpartum: Owning the Role and Responsibility of EMS in the US Maternal Health Crisis

Jenna M. B. White, MD, FAEMS

Worsening—not improving—public health crisis.  The US is the only developed country with a rising maternal mortality rate. Tremendous disparity in rates of maternal mortality in the US, with Black patients dying during and after pregnancy 3 times more often than White patients, and American Indian/Alaska Native patients experiencing twice the rate of maternal mortality as White patients. The intricacies and scope of EMS training and practice are often not well understood by professional organizations outside of prehospital medicine, and it is important that EMS-trained stakeholders be a part of discussions to improve public health in which EMS plays an important role.

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Resuscitation Track
3:20 pm - 5:00 pm


3:20 pm - 3:40 pm

From Safar to Safer and Saner: CPR Sixty Years Later: 2023 Ways to Augmenting the Life-Saving Practice with Improved Physiological Approaches

Paul E. Pepe, MD, MPH, FAEMS, MCCM, MACP; Tom P Aufderheide, MD, FACC, FACEP; Keith G. Lurie, MD; Scott T. Youngquist, MD

In this roundtable session, each speaker will provide a bullet (5-10 min) presentation on the topics of: 1) The history of the brilliant life-saving practice of basic cardiopulmonary resuscitation (CPR) -- its accidental origins, its promulgation and dramatic effects on survival rates as well as its inconsistencies and inadequate performance when studied formally in the clinical setting -- and, more recently, demonstrating the  physiological limitations of traditional CPR; 2) An evolving way of performing CPR physiologically that involves lowering of intracranial pressure, enhanced venous return and near normal cerebral perfusion and brain blood flow using a bundle of easy-to-apply non-invasive devices; 3)  The caveats, circumstances and simple protocols that make “neuroprotective CPR” work safely and more effectively particularly in the hands of first-in responders (firefighters, police, lifeguards, etc);  4) Going well beyond “quality CPR”, the next step is new focus on the various elements and components of “Quality Ventilation” during CPR with new perspectives, new data and physiological-sounder recommendations; 5)  How EMS can be used to facilitate and improve outcomes with the us;  6) A provocative Q&A by the moderator will follow these brief presentations.

 


3:45 pm - 4:05 pm

Use of Video Laryngoscopy Recordings to Enhance Intubation Education and Quality Management

Brian Miller, MD

EMS systems are increasingly utilizing technologies such as cardiac monitor biometric data and audio recordings and even body worn cameras for quality management and education. An example of these emerging technologies is video laryngoscopy (VL) which use has greatly expanded in the past few years in the prehospital setting. This presentation will describe the implementation of a VL device with recording capabilities into a large EMS system. The presentation will describe the use of these VL recordings in a quality improvement program and the implementation of novel initiatives to enhance intubation success. Furthermore, the benefits of the use of VL recordings in EMS clinician initial and continuing education for intubation will be discussed. The presentation will also describe the use of VL recordings for the objective review of intubation metrics for quality management processes as described in the NAEMSP Airway Compendium. This presentation will provide actionable concepts for members/systems with current VL recording capabilities and highlight advantages and key considerations for those considering implementation in the future.


4:10 pm - 4:30 pm

Acute Stress, A Normal Response to an Abnormal Experience: aka How We Decrease What We Take with Us

Richard Kamin, MD, FAEMS, FACEP

There is a normal response to an abnormal event/trauma that is described as acute stress.  The opportunity to better understand this response, normalize the issue, reduce stigma, and address the issue effectively can help us create better processes to install before, during and after an event to decrease the impact of acute stress and the potential for the development of PTSD, depression, anxiety, etc.  The issue deserves discussion, education and planning as it is frequently encountered in EMS clinicians during their work/response.  


4:35 pm - 4:55 am

Public Engagement, Advocacy, and Reaching the Underserved: Keys to Success in Community CPR/AED Outreach and the Experience of the Compress and Shock Foundation

Andrew Bouland, MD; Bob Zemple, MD

Community CPR and AED programs pose several challenges to EMS medical directors and leadership.  Not only can it be difficult to engage the public, it is also difficult to increase momentum from year to year.  In addition, it is difficult to engage non-English speakers and those in lower socioeconomic communities.  We hope to demonstrate the ease with which these programs can be started from the ground up, and the steps it takes to develop a full-fledged large-scale community CPR and AED outreach program that successfully engages all communities within your jurisdiction.   


3:20 pm - 5:00 pm

Menegazzi Scientific Session:
Research Oral Abstracts Session 2


5:30 pm - 6:45 pm

Research Posters 1


5:30 pm - 6:45 pm

QI Poster Session

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Friday, January 27, 2023


7:00 am - 5:00 pm

Registration


7:00 am - 8:00 am

Continental Breakfast


7:00 am - 8:00 am

Committee Meetings

Committee meeting schedule to be posted by end of December

General EMS Track
8:00 am - 9:55 am


8:00 am - 8:25 am

Eliminating EMS Divert During a Pandemic: The Twin Cities Experience

Aaron Burnett, MD; Paul Nystrom, MD; Matthew Milder, NRP

The Twin Cities is a large metropolitan city with multiple EMS agencies and multiple destination hospitals including several distinct care systems. EMS divert was suspended during the COVID pandemic as it ceases to function as intended. This required collaboration between EMS, hospitals and government agencies. Many operational tips were learned that we can share to assist others in ending EMS divert.


8:30 am - 8:55 am

Transitioning Military Medics to EMS Careers

Robert Mabry, MD


9:00 am - 9:25 am

Overcoming Barriers to Recruitment and Retention of a Diverse EMS Workforce

Moderator: Jennifer Farah; Panelists: Rickquel Tripp, MD, MPH; Sylvia Owusu-Ansah, MD, MPH; Deputy Chief Amera Gilchrist; LT Quention Curtis

Several studies and statements have advocated that diversifying the EMS workforce may benefit both provider agencies and the communities they serve. EMS organizations have developed programs to increase the number of women and minorities in their agencies. Yet even with the development hiring drives and pipeline programs, many agencies report significant difficulties recruiting and retaining non-traditional workforce members, including women and people of color. In this interactive session, the presenters will review the current literature on the state of the EMS workforce, and discuss the challenges EMS agencies may encounter when attempting to recruit non-traditional workforce members. Focusing on the unique EMS workplace, the presenters will provide practical steps that can be taken to improve recruitment and retention of a diverse EMS workforce. 


9:30 am - 9:55 am

 LGBTQ: Patients, Personnel, and Colleagues

Timothy Hong

This will be a cultural competency/cultural humility talk pertaining to a population important as our field continues to progress in the area of DEI.

9:55 am - 10:30 am

Break in Exhibit Hall

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Research Track (Part One)
10:30 am - 12:00 pm


10:30 am - 10:55 am

EMS Data Analysis to Viz

Rachel Stemerman PhD, NRP; Remle Crowe PhD, EMT-B

Everybody wants to be data driven, but what does that really mean? How do you use data to drive decisions in your organization? In this presentation we will show you how to build the Data Analysis to Visualization pipeline with next steps on how to implement. 


11:00 am - 11:55 am

Menegazzi Scientific Session:
Research Oral Abstracts Session 3

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Pediatrics Track
10:30 am - 12:00 pm


10:30 am - 10:55 am

The Kids are Alright - So what should EMS do?  2022 New Speaker Award Winner

Caleb Ward, MD

EMS overuse is unsafe and inefficient. Alternative EMS dispositions have garnered significant attention from the federal government (including the ET3 grants), insurers and researchers. Children, however, have been excluded from most pilot programs. This is despite the fact that a larger proportion of children transported by EMS have non-emergent complaints when compared to adults. Partnering with local EMS agencies and with support from a career development award, the speaker has embarked on a series of projects to redefine what is possible for EMS when caring for children. 


11:00 am - 11:25 am

Getting Ready for Kids...The National Prehospital Pediatric Readiness Program

Marianne Gausche-Hill, MD; Manish Shah, MD; Katherine Remick, MD

The Joint Policy Statement "Pediatric Readiness in Emergency Medical Services Systems" was published by NAEMSP along with 4 other national organizations in 2020 and outlined several recommendations to Emergency Medical Services (EMS) to prepare agencies for the care of children during emergencies. In anticipation of release of the joint policy statement, the National Prehospital Pediatric Readiness Program (PPRP) Steering Committee was convened and charged with developing and disseminating pediatric readiness resources and conducting the first ever national assessment of prehospital readiness for EMS agencies to be launched in 2024. Along with the preparation of this national assessment, committee members have begun the process of developing of a National EMS Information System (NEMSIS) pediatric dashboard. The purpose of this dashboard and the ensuing assessment will be to promote pediatric readiness in the prehospital setting, monitor pediatric prehospital care over time, align with national prehospital research efforts, and quantify inequities in pediatric prehospital care.  


11:30 am - 11:55 am

Pediatric Behavior and Psychiatric Emergencies

Jennifer Flint

The request for mental health transports in children and adolescents continues to increase.  Pediatric patients are cognitively, emotionally, and legally different than adults.  This presentation will review the current literature available regarding considerations and treatment for pediatric patients with acute behavioral and psychiatric emergencies and introduce our current process for how to approach a request for transportation of a child or adolescent with a mental health emergency.  This talk will also focus on team safety while maintaining patient dignity, and giving age-appropriate and indication-appropriate medications early to facilitate safe transport.

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Substance Use Disorder Track
10:30 am - 12:00 pm


10:30 am - 10:55 am

Managing Undifferentiated Agitation: A Case for Implementing Droperidol in Your EMS System

Robert Dickson, MD; Casey Patrick, MD; Jeff Jarvis, MD, FAEMS

EMS use of sedatives for acute agitation is under tremendous scrutiny in the US. This talk with summarize the spectrum of acute undifferentiated agitation, the top differentials for EMS and the techniques and medication therapy for successful management of these patients. In addition we will describe the process and impact of implementing a sedation protocol for agitation in Houston and Williamson County, Texas.


11:00 am - 11:25 am

Can't He Just Sleep It Off? Novel Transport Triage for Intoxicated Patients

E. Reed Smith, Jr., MD. FACEP

One of the most difficult situations in EMS is dealing with an intoxicated patient with no serious trauma or medical illness. Bars, restaurants, and St. Patrick's Day often puts EMS in a quandary regarding treatment and disposition of these often unwilling patients. Do we have to transport them to just 'sleep it off' in the hallway of an Emergency Department, or can we safely screen and release the person to a responsible party? This lecture will discuss the current evidence and best practices from EMS systems that do just that.


11:30 am - 11:55 am

Suboxone by EMS for Opioid Withdrawal: A Community Harm Reduction Intervention

David Miramontes MD; Christopher Velasquez, Paramedic Firefighter Engineer

We discuss the pathophysiology of Opioid dependence and withdrawal and introduce the concept of Harm Reduction. The pharmacology of buprenorphine and methadone will be presented as agents that can be used for medication assisted treatment for opioid addiction. The pharmacology of nasal naloxone (Narcan kits) and it role in community opioid harm reduction will be explored at length. The novel EMS based buprenorphine induction program started in 2018 at San Antonio Fire Department will be discussed with operational details, deployment strategy, and outcomes data.


12:00 pm - 1:15 pm

Lunch and Committee Meetings

Committee meeting schedule to be posted by the end of December

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Research Track (Part Two)
1:15 pm - 3:20 pm


1:15 pm - 2:50 pm

Menegazzi Scientific Session:
Research Oral Abstracts Session 4


2:55 pm - 3:15 pm

A Decade of Accredited EMS Fellowship Education

Brian Clemency, DO, FAEMS

In 2013, the first EMS Fellowships were accredited by the ACGME following the recognition of EMS as a ABEM specialty.  Overtime, existing non-accredited programs gained accreditation or closed, and new programs were created.  We will discuss how program have adapted to the new requirements of the ACGME and the evolving practice of EMS medicine. Unlike prior talks that have covered the board certification process generally, this talk will specially focus on fellowship education.  The 10th anniversary of EMS education provides an optimal time for this important topic.

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Special Operations & Air Medical Track
1:15 pm - 3:20 pm


1:15 pm - 1:35 pm

Mental Mindfulness They Never Teach Us

Benjamin N. Abo, DO, PMD, FAWM

We need tips to prepare to be resilient ahead of time. Different programs work or don't work for different areas and some work better than others. Stolen valor and false credentials can endanger teams on site as well as hurt the system overall. Big tips on resilience, establishing baseline mental health and improving relationships with team members. 


1:40 pm - 2:00 pm

Approaching Risk Assessment as a Process: Not Just for Structure Fires Anymore

Timothy Burns

Historically we think of risk assessment in terms of whether or not to enter a burning building, however, the process of risk assessment has some basic building blocks that should be applied to every incident. On every incident there are risks to the individual, the residents and the organization that should be evaluated against potential benefits as part of normal operations. The presenter will discuss how to approach risk assessment in a consistent manner and apply these principles to a recent high-profile incident in the county where proper risk assessment led to a positive outcome.


2:05 pm - 2:25 pm

Interfacility EMS Transport – The Forgotten Side of EMS

Jason Cohen, Michael Dailey; David Schoenfeld, MD; Ani Aydin, MD; William Tollefsen; Scott Goldberg; Christie Fritz; Jonathan Trager

A panel discussion of EMS physicians actively engaged in the Medical Direction and provision of Interfacility care ranging from ground, air, and long-distance across levels of care. This scoping discussion will review the current state of IFT in the United States (military and civilian), review the most recent literature defining practice, discuss available standards and guidelines in the industry, and identify problems/pitfalls unique to this area of medicine. The panel will conclude with a short discussion on potential future directions of study and development in this area of EMS medicine.


2:30 pm - 2:50 pm

When Your Prisoner Is a Patient: Navigating Ethical Quandries in TEMS

Matt Sztajnkrycer, MD

Medical ethics, including autonomy, beneficence, and non-maleficence, is foundational to the care of the patient, in both the hospital and prehospital environment. In the tactical environment, operational realities may impair the ability to provide optimal patient care. This becomes even more complex when care must be rendered to a suspect, or when both team members and suspects require care. Duty is often described in a "duty to all, duty to none" approach. However, special duties exist to both team members and injured suspects in the high-threat environment, particularly under circumstances in which conventional EMS cannot yet enter and a therapeutic vacuum exists. The purpose of this lecture is to examine these ethical dilemmas faced by TEMS providers, and to attempt to provide both context and guidance in sound ethical decision-making.  


2:55 pm - 3:15 pm

Can On-shift Naps Reduce Fatigue and Improve Sleep Health Without Jeopardizing Clinician Performance?

Daniel Patterson, PhD, NRP

Poor sleep and fatigue are pervasive problems in EMS. The COVID-19 pandemic has exacerbated these problems with more and more EMS agencies reporting staff shortages due to burnout and fatigue. While the 2018 Evidence Based Guidelines for Fatigue Risk Management in EMS supports use of napping during shift work, the EBG fail short of recommending an optimal duration of nap that would provide health benefits to the clinician while at the same time limiting the impact on performance. The focus of this presentation is to provide much needed data and guidance on how to incorporate on-shift napping to benefit the EMS clinician and patient.

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General EMS Track
1:15 pm - 3:20 pm


1:15 pm - 1:35 pm

Fire Service Medical Direction: Avoid Getting Burned

Mike McEvoy, PhD, NRP, RN

The culture of the fire service is significantly different than that experienced in EMS services and healthcare systems.  These differences can make or break relationships and effectiveness of a medical director if they are not well understood.  This session explores the culture of the fire service, important differences, uncanny similarities, and strategies helpful for successful integration of the medical director with the fire department. 


1:40 pm - 2:00 pm

Conquer Your FEARS Surrounding High Risk Refusals of Transport

Casey Patrick, MD, FAEMS

One of the most difficult situations in prehospital care is the high-risk patient refusal of EMS transport. This topic is far from straight forward for both learners and teachers alike. This lecture begins with a discussion of capacity vs. competence then introduces a brand new mnemonic that will, hopefully, alleviate your FEARS the next time you care for a complex patient that decides hospital transport just isn’t in the cards.


2:05 pm - 2:25 pm

Minding the Mind in EMS  (A Multi-Level Inventory for Addressing Mental Well-Being, Resilience and Support for Front-Line Responders)

Paul Pepe, MD, MPH, FAEMS; Remle Crowe, PhD, EMT-P; Lauren M. Maloney. MD, EMT-P; Peter M. Antevy, MD

While most of us working in EMS have known colleagues who have experienced burn-out, depression and even unanticipated suicide, a uniform and directed focus on the mental health and well-being of public safety personnel still has not yet become widespread and it often remains lacking in many respects.  Therefore, in this session, the speakers will provide sample portfolios of various initiatives and works-in-progress that already have had some demonstrated success in terms of proactively addressing the mental well-being of EMS personnel through various strategies. 


2:30 pm - 2:50 pm

Are You Ready to Lead a New Team? The Multidisciplinary EMS of the Future is Coming

David Wright, PA-C; John M. Gallagher, MD, FAEMS

This presentation discusses the predicted future of EMS systems: physician-led multidisciplinary EMS teams.  The days of “you call, we haul” are rapidly disappearing and EMS leaders need to have the tools to effectively manage these rapidly developing teams. MIH-CP, telemedicine, social workers, behavioral health therapist, addiction  medicine, mid-level providers, alternative destination, nurse triage lines, and more are being integrated  into the EMS systems across the country. EMS has evolved from being transportation to health care, EMS has become health care.  The way the first fire departments added EMS first response alongside their fire suppression duties, progressive systems are embracing the change, and developing more efficient and effective care models.  Departments rooted in the traditional “that’s the way we have always done it” will be left behind. It’s time to ask yourself, “Are you ready to lead this new team?”


2:55 pm - 3:15 pm

Lessons Learned from the National Ketamine Situation (Spoiler Alert: They Had Nothing to do with Ketamine)

Scott Bourn, PhD,RN, FACHE; Brent Myers, MD, MPH, FAEMS

As ketamine cases began to hit the media EMS leaders at the local, regional and national level missed important opportunities because the viewed the cases as “outliers that couldn’t happen in my shop” and as cases that weren’t truly related to ketamine, but rather about police stops and probably racism.  The vacuum of leadership opened the door for anesthesia and other specialties to begin to control the narrative with disastrous consequences.  By the time EMS leaders/organizers spoke up it was too late and anesthesia had put itself in the leadership position.  This session will identify missed leadership opportunities during the ketamine crisis and provide pragmatic suggestions for EMS leadership at all levels in the event of another crisis involving patient safety and EMS.  


3:20 pm - 3:45 pm

Break in Exhibit Hall

 

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Trauma & Wilderness Track
3:45 pm - 5:00 pm


3:45 pm - 4:05 pm

Building a Prehospital Whole Blood Program: What It Really Takes to be Successful

David Wampler, PhD, FAEMS; CJ Winckler, MD, LP

Discussion of the regional deployment of prehospital whole blood. The session will discuss the region's entire plan on how to get Low Titer O+ Whole Blood to hospitals, ground EMS and HEMS. This will include a discussion of how a new blood service line was created, how the regional deployment plan was developed and the results of that effort. 


4:10 pm - 4:30 pm

Wilderness Paramedic: A New Direction for Wilderness EMS

Jeff Thurman, MD, FACEP, FAWM; David Fifer, MS, NRP, FAWM; Seth C. Hawkins, MD, FAEMS, FACEP, MFAWM

Wilderness EMS is a rapidly evolving area of out-of-hospital medicine. Increasing use of wilderness spaces by the general public has been a trend for many years but has exploded during the covid-19 pandemic. Predictably, this has led to larger numbers of people requiring medical care in areas where the environment imposes significant challenges. The need for highly trained medical professionals capable of treating patients in these environments and operating within the existing emergency response infrastructure has never been more apparent. This presentation will discuss the history and evolution of wilderness EMS. State and local authorities are attempting to address this need. This presentation will review the importance of professional certification. Recognizing this gap, the International Board of Specialty Certification (IBSC) has brought together an international group of wilderness EMS experts to create the first such certification. An international job task analysis survey was conducted to define the Wilderness Paramedic body of knowledge. This presentation will provide an in depth discussion of the Wilderness Paramedic Certification project and present the job task analysis results.


4:35 pm - 4:55 pm

Pre-hospital Anti-fibrinolytics for Traumatic Coagulopathy and Haemorrhage (The PATCH Study)

Stephen Bernard, MD

The purpose of this research is to determine whether giving severely injured adults a drug called tranexamic acid (TXA) as soon as possible after injury will improve their chances of survival and their level of recovery at six months.  Af The PATCH Study completed enrollment in Sep 2021 and finished 6 month follow up in March 2022. The results will be available in publication prior to the NAEMSP meeting. The membership will be interested in the results of this large randomized trial given the similarity of the EMS systems in the US to those in Australia and New Zealand.

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Mobile Integrated Health & Alternative Destinations Track
3:45 pm - 5:00 pm


3:45 pm - 4:05 pm

Telemedicine for Alternate Destinations: Send Patients to the Right Place the First Time

Clayton Kazan, MD, FAEMS

Most EDs are not well resourced to provide good care to mental health and substance use patients.  In Los Angeles County, these patients have long ambulance patient offload times (APOT), they take up disproportionate resources in the ED (sitters, etc), they have long lengths of stay, and they have high recidivism rates and poor outcomes.  In our system, psychiatric urgent care centers and sobering centers have been launched, but it has been a contentious issue determining whether paramedics would be permitted to direct EMS patients there due to scope of practice issues.  The Los Angeles County Fire Department got around scope issues by utilizing telemedicine for triage, and we were able to validate a triage instrument that should be well within the scope of practice of paramedics and EMTs while ensuring that patients with concomitant medical issues are still transported to the ED.  With the use of these centers, APOT is significantly reduced, EMS resources are returned back into service, and recidivism appears reduced.


4:10 pm - 4:30 pm

When In Doubt, Call C4: An Innovative Approach to Alternate Treatments & Destinations

Heidi Abraham, MD, FAEMS

The Collaborative Care Communication Center (C4) at ATCEMS is a unique program that has facilitated hundreds of alternate treatment options over the past 2 years.  From hospice to clinics and inpatient rehab to field treatment and disposition, this program is leading the field in the future of EMS care.  This presentation will discuss the vision behind this group, some of the generally relevant logistics behind it's creation and current role, and how it's impacted our EMS system with fewer 911 transports, better patient outcomes, and improved patient, provider, and healthcare partner satisfaction.


4:35 pm - 4:55 pm

Update on Nationwide Implementation of ET3 and Nurse Navigation

Mark Gamber, DO; Jeff Beeson, DO, FAEMS

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Technology & Innovation Track
3:45 pm - 5:00 pm


3:45 pm - 4:05 pm

The Emory Telemedicine Program

Michael Carr, MD -- 2022 New Speaker Award Winner

The Emory Rural Tele-EMS Network (ER-TEMS) provides telemedicine services to ambulance crews treating critical patients throughout rural Georgia. HRSA awarded ER-TEMS $1.2 million over four years. With this grant, the ER-TEMS team is building a sustainable model with goals to provide early, comprehensive telemedicine assessments that will reduce unnecessary transports and optimize the utilization of hospital resources to deliver the right care at the right time and the right place. Worse medical outcomes in rural Georgia are linked to the prolonged time required to transport patients to the closest most appropriate medical facility. The ultimate goals of the ER-TEMS program are to address disparities in medical care, support rural EMS personnel, and enhance access to high quality healthcare for rural patients.  ER-TEMS aims to decrease time-to-diagnosis and time-to-definitive care. This presentation aims to discuss the challenges, successes, and lessons learned associated with planning, deploying, and sustaining this state-wide tele-EMS program.


4:10 pm - 4:30 pm

Dispatch Life Support Quality Improvement Feedback Coupled with Innovative Primary High Fidelity Simulation Education Exceeds AHA Telephone CPR Performance Standards & Survival from Cardiac Arrest

Kevin G. Seaman, MD, FAEMS

Given that CV disease is the number one killer in our communities and that it differentially affects public safety workers (EMS, Fire, Police) we need to do all we can to save maximal lives. In this pandemic there has been less interest in doing CPR in our communities; the dispatch intervention of Telephone CPR coaching can double bystander CPR and has been shown to increase survival.  As cardiovascular diseases are typically the most prominent cause of mortality in the community, our planning needs to include innovative ways to increase bystander CPR and bystander AED use before EMS arrival, two interventions which are associated with improved survival. Charles County MD has piloted two programs which accomplish the goals of the AHA Telephone CPR policy including performance metrics: a high fidelity simulation, using low-dose, high frequency educational sessions every 3 months, coupled with a Quality Improvement review of all EMS confirmed and worked cardiac arrests analyzing for delays in implementation of bystander CPR and providing positive feedback to reduce delays in CPR and AED implementation. 


4:35 pm - 4:55 pm

Reinventing Recert: Continued Competency for EMS Medical Directors

Mark Terry, National Registry of EMTs

Continued competency of EMS practitioners is critical for quality care and operations.  Mark will summarize recent developments in continued competency and highlight actions for medical directors that make recertification both easier and more meaningful by integrating local credentialing, clinical preparation, quality management and continuing education.  New ways to verify continued competency could revolutionize the ways in which we renew certification, licensure, and local credentials.


5:30 pm - 6:45 pm

Research Posters 1

 


5:30 pm - 6:45 pm

QI Poster Session

 

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Saturday, January 28, 2023


8:30 am - 11:00 am

Registration


7:00 am - 8:00 am

Continental Breakfast


7:00 am - 8:00 am

Committee Meetings

Committee meeting schedule to be posted by end of December

General Session Track
8:00 am - 9:30 am


8:00 am - 8:25 am

Takeaways from the New Brain Trauma Foundation Prehospital TBI Guidelines

Al Lulla, MD


8:30 am - 8:55 am

How Much is Too Much 02? Should EMS Limit Oxygen Delivery in Non-hypoxic TBI Patients?

Dan Spaite, MD


9:00 am - 9:25 am

Top NAEMSP Position Statements 2021

Frank Guyette, MD, MPH, FAEMS

This popular session is a review of NAEMSP's positions statements approved by the Board of Directors in 2021. Dr. Guyette will walk us through the main points and give commentary.

9:30 am - 11:00 am

Awards Brunch - Supported by OnStar

Join us as we celebrate our award winners and and the gavel over to the next president of NAEMSP.

11:00 am - 4:00 pm

Pirate Festival

The City of Tampa is host to this annual festival - we're ending early so attendees can join in the fun!

4:30 pm - 6:00 pm

Farewell Social

Rejoin your NAEMSP colleagues for a(nother) spot of rum to round out a great 2023 conference.
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