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National Association of EMS Physicians

Annual Meeting Presentations

​Click here​ for the 2018 Abstracts as published in PEC.

6:00 p.m. –
6:45 p.m.		 New Member Reception  
6:45 p.m. –
8:45 p.m.		 Welcome Reception in the Exhibit Hall  
Thursday, January 11, 2018   
7:00 a.m. –
5:00 p.m.		 Registration  
7:00 a.m. –
8:15 a.m.		 PEC Breakfast (invitation only)  
7:00 a.m. –
8:15 a.m.		 Continental Breakfast  
​ GENERAL SESSIONS  
8:15 a.m. –
8:30 p.m.		 Welcome & President's Address J. Brent Myers, MD, MPH, FAEMS
8:30 a.m. –
10:00 a.m.		 Keynote Address: The Patient as a Mission with a Very Critical Outcome, How to Get That Right –
The First Time & Every Time
Dr. Story Musgrave will provide a dramatic multimedia story composed of real-life scenarios that express and illustrate lessons and principles that are relevant and applicable to frontline patient care. Dr. Musgrave has lived these memorable and powerful scenarios. The lessons and principles extracted from real-world experience are so common sense, so clear and comprehensible that they are readily accepted, embraced and stand a decent probability of being acted upon.		 Story Musgrave, MD
10:00 a.m. –
10:30 a.m.		 BREAK IN THE EXHIBIT HALL  
10:30 a.m. –
11:00 a.m.		 Improvement Science & Safety in EMS
Dr. David Williams will discuss hard science around improvement work with a focus on patient safety in EMS. He will use his experience at IHI and with EMS Compass to discuss ​implementation of improvement science in EMS.		 David M. Williams, PhD
11:00 a.m. –
12:00 p.m.​		 Research Abstracts
 
  
12:00 p.m. –
1:20 p.m.

BOXED LUNCHES IN THE EXHIBIT HALL/COMMITTEE MEETINGS

  • Quality & Safety
  • Pediatrics
  • EMS Fellows and Fellowship Graduates
  • Research
  • Public Health
  • Communications
  • Wilderness EMS
  • Membership
  
​ CONCURRENT SESSION 1​  
​ AEROMEDICAL  
1:30 p.m. –
2:00 p.m.

Air Medical Integration into an MCI

The presentation will include the role of HEMS in an MCI; Various entities needed for successful response (joint planning); The value of incorporating HEMS into disaster drills and the need to better incorporate this in your current disaster plan.  Literature review of HEMS in early medical response to major incidents. 

 Chris Lang, MD
2:05 p.m. –
2:35 p.m.

Taking Mechanical CPR to New Heights: Use of Automated CPR Devices in Helicopter EMS Transport

The advent of mechanical chest compression devices and their use in CPR on cardiac arrest patients has yet to show clear benefit over high-quality manual CPR performed in a stationary environment.  However, some studies show up to a 30% rate of re-arrest following ROSC, and many of those re-arrests occur while the patient is being transported by EMS.  Existing literature has shown manual CPR in a moving vehicle is suboptimal.  This lecture reviews how one ambulance service operationalized use of a mechanical CPR device in their helicopter EMS division and how it has been utilized.

 John Lyng, MD, FAEMS, NREMT-P
​ CARDIAC  
1:30 p.m. –
2:00 p.m.		 The Refractory VF Arrest Patient: A Review of the Current Treatment Options
The presenter will review recent advancements in this area and avenues for the successful treatment of refractory VF arrest patients in the field and hospital setting.		 Marc Conterato, MD, FACEP
2:05 p.m. –
2:35 p.m.		 NSTEMI: The Neglected Epidemic of Our Time –
Call to Action​ 
Significant progress has been made in reducing death rates from STEMI. However, approximately 70% of all acute coronary syndromes present as NSTEMI and UA. The rates of premature death and disability from these acute presentations have not improved. STEMI systems need to evolve to meet this challenge. High Yield symptoms must become a focus of EMS education. Cardiac Risk Calculation must be integrated into the prehospital assessment of patients. Electrocardiographic capability needs to be extended to all levels of EMS and enhanced with new technology. Point-of-Care testing of cardiac markers should be initiated in the ambulance.		 James M. Nania, MD, FACEP
  CONCURRENT SESSION 2  
​ PEDIATRICS  
2:40 p.m. –
3:10 p.m.

Pediatric Non-Traum​atic Out-of-Hospital Cardiac Arrest: Should We Hit the Brakes?

Pediatric out-of-hospital cardiac arrest (OOHCA) accounts for nearly one third of all pediatric deaths in the United States and approximately 2% of pediatric EMS calls. Survival from non-traumatic pediatric OOHCA is invariably low and has remained relatively stable over the last two decades despite improvement in adult non-traumatic OOHCA. Recent studies have demonstrated the specific characteristics and impact of high quality CPR. This evidence-base suggests the prevailing "scoop and run" approach to pediatric OOHCA needs significant re-thinking. This session will offer alternative perspectives and suggested system-level approaches to managing pediatric OOHCA. During this session the presenter will review the epidemiology of pediatric OOHCA, factors associated with improved survival, the pros and cons of termination of resuscitation efforts on scene, and efforts EMS providers can take to engage and support families during and following pediatric OOHCA.

 Katherine Remick, MD, FAEMS
3:15 p.m. –
3:45 p.m.		 Promoting Patient & Family-centered Care in the Prehospital Setting: A Toolkit for Medical Directors 
There has been an increasing emphasis on patient and family-centered care in the hospital setting, particularly in pediatric facilities.  The growing importance of providing family-centered in the prehospital setting has come to the attention of many groups, including the Emergency Medical Services for Children Program and the American Academy of Pediatrics, both of whom have published resources on this topic. Despite this, medical directors and EMS physicians often find it difficult to implement family-centered care in their EMS systems in the prehospital setting.  This presentation will provide medical directors, EMS physicians and other prehospital providers with a novel toolkit and techniques that they can use to provide family-centered care in the prehospital setting.		 Saranya Srinivasan, MD
  TACTICAL  
2:40 p.m. –
3:45 p.m.		 Integrated Operation for High-Threat Incidents (Rescue Task Force)
This presentation will discuss the need and delivery options for rapid point of wounding care during active violence and other high-threat incidents. Strengths and weaknesses of various integrated response models, such as Rescue Task Force, will be given. Additional information regarding Tactical Emergency Casualty Care (TECC) will also be addressed.		 Geoffrey L. Shapiro, EMT-P
3:45 p.m. –
4:05 p.m.		 BREAK IN THE EXHIBIT HALL  
  GENERAL SESSIONS  
4:05 p.m. –
4:30 p.m.		 EMS Board Certification
Clemency
Kowalenko
There are currently more diplomats certified in Emergency Medical Services than any other ABEM subspecialty.  The presenter will review the results of the first three exams, the current available resources to prepare for the exam, the current state of fellowship education and lessons learned by candidates and educators over the past four years.

Brian Clemency, DO, MBA, FAEMS

Terry Kowalenko, MD
4:30 p.m. –
4:45 p.m.		 NAEMSP Advocacy Update: PAC-man?
An overview of NAEMSP's advocacy accomplishments as well as a discussion of future goals. Why are they important to our patients and out systems? Oh yeah, we're going to ask you for money!		 Ritu Sahni, MD, MPH, FAEMS
4:45 p.m. –
5:4​5 p.m.		 Research Abstracts
 
  
5:45 p.m. –
7:15 p.m. (poster session to start at 6:00 p.m.)		 Research ​Poster Session #1
​
Innovations in Education Poster Session		  
6:00 p.m. - 10:00 p.m. Distinctly Canadian Workshop

Course Director:

Russell MacDonald
Friday, January 12, 2018  
6:30 a.m. –
7:30 a.m.		 Fun Run/Walk  
7:00 a.m. –
5:00 p.m.		 Registration  
7:00 a.m. –
8:00  a.m.		 Continental Breakfast  
8:00 a.m. –
8:30 a.m.		 The Canadian Prehospital Evidence-Based Practice Project
This program is an on-going living semi-systematic review of the EMS interventional evidence. The results are presented as a freely available online repository of the appraised literature. The summary of the evidence is presented in a user-friendly infographic matrix. The repository is kept current by an international/interdisciplinary team of appraisers. Please see: https://emspep.cdha.nshealth.ca		 Jennifer Greene
8:30 a.m. –
9:00 a.m.

National Model EMS Clinical Guidelines: A Resource to Help You Improve Patient Care

The inaugural ​edition of the NASEMSO National Model EMS Clinical Guidelines was utilized as a resource for protocol development by EMS medical directors, EMS systems, and several foreign nations. The second edition of this document offers updates that include new and revised guidelines, additional evidence-based guidelines, and linkage to the NEMSIS data dictionary.		 Carol Cunningham, MD
Richard Kamin, MD
9:00 a.m. –
9:30 a.m.		 Ethical Challenges in EMS​
The presenter will go beyond the simple cardiac arrest and DNR issues to include medical capacity, self-determination and conflicts of opinion as well as frequent situations that cause medics to leave wondering if they did the right thing.		 Keith Wesley, MD, FACEP, FAEMS
9:30 a.m. –
10:00 a.m.​		 The Judgment of Solomon, EMS Style: Hospital Sues to Establish EMS Protocol
After a half dozen years of a successful EMS STEMI program at one regional hospital with a PCI cath lab, the other regional hospital built a PCI cath lab, hired staff and asked to be included in the program. The regional EMS medical director was asked to "broker a deal" between the 2 hospitals and modify the existing EMS STEMI protocol. After careful consideration and extensive deliberation, the EMS medical director modified the protocol, but one hospital was not satisfied and initiated legal action to require a change in the EMS protocol. This presentation will describe the challenges, pitfalls and lessons learned during this ongoing affair.		 Paul Rostykus, MD, MPH
10:00 a.m. –
10:30 a.m.		 BREAK IN THE EXHIBIT HALL  
10:30 a.m. –
11:00  a.m.		 Small Victims & Serious Play: Simulations & Video Games for Pediatric Disaster Education 
Mass casualty events in which children are victims are low-frequency and high-stakes. Such incidents test paramedics, medical directors, receiving hospitals and the entire healthcare system. In this session the presenter will provide methods for employing simulation for 1) triage knowledge and skill education 2) systems testing 3) improving team communication and 4) just-in-time training. Modalities to be discussed include live simulations, including drills and full-scale exercises, table top exercises and video games. 		 Mark X. Cicero

 

11:00 a.m. –
11:30 a.m.

 Credentialing Pearls: Tales of Bumps, Bruises & Success​
This team of medical oversight professionals will detail real-world application of the NAEMSP/NREMT policy statement on Credentialing in EMS with examples of take-home tips and practices to help medical directors define, refine and advance their own clinical credentialing programs.		 John Gallagher, MD, FACEP, FAEMS
Jeffrey M. Goodloe, MD, NRP, FACEP, FAEMS
David. S. Howerton, BS, NRP
 
11:30 a.m. –
12:00 p.m.		 Mobile Stroke Debate
Price
Persse​​

Pro: David Persse, MD, FACEP, FAEMS

Con: Tim Price, MD, FACEP
12:00 p.m. –
1:15 p.m.

BOXED LUNCHES IN THE EXHIBIT HALL/COMMITTEE MEETINGS

  • Advocacy
  • Rural EMS
  • Operational EMS: Fireground/HAZMAT/Tactical
  • Emergency Preparedness
  • Women in EMS
  • Canadian EMS Fellowship Special Interest Group
  • Membership/Education/Communications (combined meeting)
  
​ CONCURRENT SESSION 3  
​ RESEARCH  
1:15 p.m. –
2:20 p.m.​		 Research Abstracts 

 

 

 ​ 
​ EDUCATION  
1:15 p.m. –
1:45 p.m.		 Simulation in Emergency Medical Services (EMS): A New Frontier 
The National Association of EMS Educators has recently begun a campaign identifying and supporting the use of simulation in EMS education with a focus to build a more complete body of knowledge regarding use of simulation, uncover barriers to effective implementation, and outline recommendations for improvement. This new frontier of simulation use in EMS will provide massive opportunity for education professionals in simulation and EMS to collaborate to further the agenda of education, training, and research in the area of simulation in EMS education. The instructor will review and summarize the latest EMS literature that specifically pertains to simulation in educational curriculum.		 Christopher E. McCoy, MD
1:50 p.m. –
2:20 p.m.		 Cognitive Bias, Medical Error & EMS​
Cognitive bias was a recurring theme during peer review activities within Dr. Bjorn Peterson's residency training.  As humans, we are prone to cognitive bias, and as healthcare providers these biases play a significant role in medical error.  Dr. Peterson will present several common cognitive biases, examples of errors attributed to them, and how we can teach EMS professionals to recognize these biases and avoid them.  Additionally, he will describe how he and his colleagues have implemented several techniques, including standardized medication dosing for EMS (to avoid cognitive error related to weight-based calculations), medication "cross checking" to prevent avoidable medication errors and medical incident command to provide a decision-making structure for complex medical incidents.		 Bjorn Peterson, MD, FAEMS
  CONCURRENT SESSION 4  
​ RESEARCH  
2:25 p.m. –
3:30 p.m.​		 Research Abstracts
 
  
  QUALITY ASSURANCE  
2:25 p.m. - 2:55 p.m. Mission: Quality - Can Mission Lifeline Help Your Performance Improvement Program?
​Mission: Lifeline is designed to transform care for patients with myocardial infarction, stroke, and cardiac arrest; but how can it help your agency?  We'll review the essential elements of Mission: Lifeline, identify ways to incorporate those and other factors into your quality improvement program, explore the challenges of "measuring up" to national performance benchmarks, and share best practices to enhance provider feedback through hospital outcome information.   Last, we'll examine ways to leverage performance goals to improve systems of care.		 Jeremy Cushman, MD, MS, EMT-P, FACEP
3:00 p.m. –
3:30 p.m.		 Developing Ambulance Quality & Performance Measures that Make a Difference to Patients
This presentation will focus on how new quality measures for ambulance services have been developed and implemented over the past decade in England. This is based on research conducted by ambulance services with academic institutions as part of the UK Prehospital Outcomes for Evidence Based Evaluation program. There will be a discussion of the successes as well as the barriers to development of new quality measures, and the underpinning research and quality improvement initiatives that have been vital to progress in this field. The presentation will also outline the challenges to implementation of new quality measures and how these may be overcome to improve care and outcomes for patients in future.		 Niro Siriwardena
3:30 p.m. –
4:00 p.m.		 BREAK  
  CONCURRENT SESSION 5  
​ RESEARCH  
4:00 p.m. –
5:00 p.m.		 Research Abstracts  
​ HIGH YIELD, BUT NOT SO COMMON, EMS CORE CONTENT  
​ These 30-minute presentations will cover EMS topics in the core curriculum that are difficult for many fellowship directors to cover or provide experience.   
4:00 p.m. –
4:30 p.m.		 EMS on the Fireground​
​This session will cover unique aspects of the fireground as they relate to the provision of EMS, and of ensuring the health and safety of firefighters. Beginning with a brief overview of the preventive role of fire department occupational health programs (including such aspects as fitness, nutrition, and annual physical exams), the operational characteristics and physiologic stresses and dangers of the fireground will be discussed in detail. Fireground concepts including immediately dangerous to life and health (IDHL) environments, oxygen-deprived environments, incompensable heat stress, the phases of a typical structure fire response, and rapid intervention teams will be reviewed. Key clinical principles of emergency incident rehabilitation and fireground medical monitoring will be described. Firefighter line-of-duty death data will be reviewed to enhance understanding of the key dangers facing structural firefighters. The participating EMS physician will be given the foundation of knowledge needed to function safely and effectively on the fireground, and to understand and anticipate likely EMS needs for firefighters working at structure fires and other common emergency scenes.		 David Cone, MD
4:30 p.m. –
5:00 p.m.		 Federal Disaster Response System
Federal Disaster Response System" covers the basics of the federal government's disaster response activities.  The goal is to provide future and current EMS physicians with information useful for EMS practice as well as the EMS board certification examination.  Topics covered include the basic legal authorities, general organizational structures, and key agencies and resources involved in federal disaster assistance.		 Jason Liu, MD, MPH, FAEMS

5:00 p.m. –
6:30 p.m.

(poster session to start at 5:15 p.m.)

 RESEARCH POSTER SESSION #2

EVENING RECEPTION SPONSORED BY NREMT		  
6:30 pm –
7:00 pm

Certification Reception

  
Saturday, January 13, 2018 
8:30 a.m. –
12:00 p.m.		 Registration  
7:00 a.m. –
8:00 a.m.

CONTINENTAL BREAKFAST & COMMITTEE MEETINGS

  • Asian EMS Council
  • Education
  • MIH/Community Paramedicine
  • Canadian Relations
  • International Affairs
  • Air Medical Services
  • Program
  
  GENERAL SESSIONS  
8:00 a.m. –
9:00 a.m.		 Top Research Poster Presentations
 
9:00 a.m. –
9:15 a.m.		 Prehospital Emergency Care Update Jane Brice, MD, MPH, FAEMS, Assistant Editor
9:15 a.m. –
9:30 a.m.		 Pediatric Emergency Care Applied Research Network (PECARN) Update E. Brooke Lerner, PhD
9:30 a.m. –
10:00 a.m.		 BREAK  
  CONCURRENT SESSION 6  
​ INTERNATIONAL   
10:00 a.m. –
11:00 a.m.		 The Role of Motorcycle Medical First Responders in Singapore: Lessons Learned & The Way Forward
Globally motorcycles are playing an increasing role in emergency response.  Faster and more maneuverable than large ambulance they offer faster response times.  The presenter will showcase international EMS motorcycle systems. London, Singapore and Hong Kong are among some of the places using motorcycles.		 Marcus Ong, MD, MPH
​ CHANGE & INNOVATION  
11:00 a.m. –
11:30 a.m.		 NHTSA 2018 National EMS Scope of Practice Model Update
The National Highway Traffic Administration Office of Emergency Medical Services (NHTSA-OEMS) initially published the National EMS Scope of Practice Model in 2007. This landmark document defined and set guidelines for clinical practice for the four levels of prehospital providers: EMR, EMT, AEMT, and Paramedic. These guidelines have been adopted by states and EMS agencies around the country and have greatly contributed to the standardization of out-of-hospital clinical care. Ten years later, many changes in clinical practice have occurred as a result of clinical and technical progress, lessons learned from the military, societal changes such as active shooter events, the opioid crisis, and community paramedicine. Recognizing these changes, NHTSA-OEMS has convened a Subject Matter Expert Panel to make recommendations to update these guidelines utilizing the best available clinical evidence. As Co-Chair of the Expert Panel, Dr. Taillac will provide a preview of the proposed changes to these scopes of practice.		 Peter Taillac, MD FAEMS
Scott Bourn, PhD, RN, EMT-P
11:30 a.m. –
12:00 p.m.		 Cutting the Edge: Innovations in Prehospital Critical Care
The presenter will provide an overview of new concepts and innovative technologies being implemented for prehospital critical care transports.		 Amado Alejandro Baez, MD, MSc, MPH, FAARM, FCCM
​ MOBILE INTEGRATED HEALTH  
10:00 a.m. –
10:20 a.m.		 Multi-disciplinary Approach to MIH/CP Medical Direction
Understanding and managing the overlapping roles of the EMS Medical Director with other physician collaborators in an MIH/CP Program.		 J. Brent Myers, MD, MPH, FAEMS
10:20 a.m. –
10:40 a.m.		 Financial Sustainability of MIH/CP
Description of current state of financial reimbursement for MIH/CP and guidance on how to achieve sustainability.		 Matt Zavadsky, MS-HSA, NREMT
10:40 a.m. –
11:00 a.m.		 MIH & Palliative Care
Description of a unique MIH/CP program that supports palliative care and presentation of research findings.		 Alix Carter, MD, MPH
11:00 a.m. –
11:20 a.m.		 Selective Psychiatric Clearance by Paramedics: The First 1000 Patients
Update on progress and results from a Behavioral Health Alternative Destination Program.		 Kevin Mackey, MD, FAEMS
11:20 a.m. –
11:40 a.m.		 Continuing Education for Community Paramedics
What is the right format, style, and content of CE for MIH/CP Providers?		 Dan Swayze, DrPH, MBA, MEMS
11:40 a.m. –
12:00 p.m.		 Pitfalls to Avoid When Evaluating Programs Targeting High ED Utilizers
Using a one group "pretest-posttest" research design to measure the impact of programs that target high utilizers of emergency departments can vastly overstate the benefits of such programs by failing to account for (a) regression to the mean and (b) alternative social services.  A real world example is presented and research designs that permit causal interpretation of results are discussed.		 Kevin Munjal, MD, MPH
12:00 p.m. –
1:30 p.m.		 AWARDS LUNCHEON  
  GENERAL SESSIONS  
1:45 p.m. –
2:15 p.m.		 "We're from the Government, and We're Here to Help": Integration of Local & Federal Resources in Houston, Texas following Hurricane Harvey, 2017 at the Largest Shelter in the City

A discussion of the integration of the National Disaster Medical System into the medical structure built by local responders in Houston's largest shelter during Hurricane Harvey. Physician representatives of both the Houston Fire Department and the National Disaster Medical System will provide insight into the very successful collaboration between local and federal resources in provision of medical care for over 10,000 sheltered evacuees at the George R. Brown Convention Center.

Kevin Sirmons, MD, NRP

Kevin Schulz, MD​, FAEMS
2:15 p.m. –
2:45 p.m.		 Military/Civilian Integration Task Force Jason Pickett, MD
2:45 p.m. –
3:15 p.m.		 Medical Dispatch Science: State of the Art in 2018​
This session will outline the essential role dispatch centers play within the chain of survival; the added value for the patients and for the care system. When evidence-based medicine is available, it will be outlined. Telephone CPR, the use of lights and sirens and new technologies will be presented.		 Fabrice Dami, MD, MBA
3:15 p.m. –
3:45 p.m.		 BREAK  
3:45 p.m. –
4:15 p.m.		 The Opioid Crisis: First Responders' Impact
​This presentation will discuss the impact of the opioid crisis on public safety first responders from caring for overdose victims to protecting yourself and others during daily and special operations. The need for appropriate personnel protective equipment during varying potential exposure settings will be addressed.		 Jon Krohmer, MD, FACEP
4:15 p.m. –
4:45 p.m.		 New NAEMSP Position Statements​
NAEMSP position statements are the literal voice of the association on topics that impact EMS Medical Directors. The Standards and Practice Committee has been hard at work over the past year and their work has just recently made it to press. We will review some of the most impactful position statements and discuss their implications. If you like material you can "take home" to you own system, this is the talk for you!		 John Gallagher, MD, FACEP, FAEMS
4:45 p.m. –
5:00 p.m.		 Closing Remarks  
5:00 p.m. –
6:00 p.m.		 CLOSING RECEPTION  

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