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JEMSDig_PSGRMel_170608 1 6/8/17 11:33 AM

LEVERAGING PCR Data p. 10 REMOTE Rescue in Nepal p. 16 MANAGING Controlled Substances p. 58
OCTOBER 2017
Special Focus
MOVING
PATIENTS SAFELY
Ambulance design tips, innovative new
tools & proper lifting techniques to keep
patients & providers safe, pp. 24–53
www.emstoday.com FEBRUARY 21–23, 2018, CHARLOTTE, NC
1710JEMS_C1 1 9/12/17 9:31 AM

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Moving patients safely & efficiently, pp. 24–53
OCTOBER 2017 VOL. 42 NO. 10
Contents DEPARTMENTS & COLUMNS

4
6
EMS IN ACTION Scene of the Month
FROM THE EDITOR An Unsung Hero
28
By A.J. Heightman, MPA, EMT-P
THE ROAD TO SAFETY 10 EMS INSIDER News and Winning Strategies for EMS Leaders
What to focus on to improve ambulance safety
By Wayne M. Zygowicz, MS, EFO, CFO, EMT-P 14 PRO BONO First & Last Impressions
By Stephen R. Wirth, Esq., EMT-P
38 GOING GREEN
16 CASE OF THE MONTH Remote Trauma
By Sanjaya Karki, MD, MBBS
Austin-Travis County EMS is on the forefront of sustainable vehicles 20 SIMULATION SUCCESS Supporting Safety
By Michael O. Benavides, EMT-P By Jennifer McCarthy, MAS, NRP, MICP, CHSE; Amar P. Patel,
DHSc, MS, NRP; Andrew E. Spain, MA, NCEE, EMT-P &
40 LIFTING & MOVING

Timothy Whitaker, BS, CHSE, CHSOS, EMT-P
22 EVIDENCE-BASED EMS Targeted Interventions
A fresh perspective on safely handling patients By Sean J. Britton, MPA, NRP
By Niklavs Eglitis, BS, NRP; Emily Corrigan, BS, NRP; Marc Sweeney, BS, NRP; 23 STREET SCIENCE A Difficult Challenge
John Pierce, MBA, NRP & Walt Stoy, PhD, EMT-P By Keith Wesley, MD, FACEP, FAEMS & Karen Wesley, NREMT-P
58 FIELD PHYSICIANS Drug Diversion
47 REDUCING LIFT INJURIES

Common injury patterns & techniques to improve patient lifting
By Bryan Fass, ATC, LAT, CSCS, EMT-P (ret.)
By Neal J. Richmond, MD, FACEP
59 BERRY MUSING Wag Bragging
By Steve Berry
60 HANDS ON Product Reviews from Street Crews
52
By Fran Hildwine, BS, NRP
EMS GETS A LIFT 63 AD INDEX
Firefighters help develop innovative patient lifting device
64 LAST WORD The Ups & Downs of EMS
By Chuck Marble
54 STOPPING THE PAUSE

New device designed to provide continuous oxygen delivery during CPR
By W. Scott Gilmore, MD, EMT-P, FACEP, FAEMS
54
About the Cover

In a special section focused on safety during patient transport, we not only discuss ambulance design
factors, but we also take a highly focused look at lifting and moving, two of the most important but
dangerous endeavors that EMS providers perform, pp. 24–53. photo matthew strauss
www.jems.com ocToBeR 2017 | JEMS 1
1710JEMS_1 1 9/12/17 9:20 AM

®
Control-Cric™ EDITOR-IN-CHIEF – A.J. Heightman, MPA, EMT-P – [email protected]

MANAGING EDITOR – Ryan Kelley, NREMT – [email protected]
SENIOR EDITOR – Sarah Ferguson, MA – [email protected]
Taking Control of an Otherwise MEDICAL EDITOR – Edward T. Dickinson, MD, NRP, FACEP
TECHNICAL EDITOR – Carolyn Gates, EMT-P, FP-C
Chaotic Procedure
MOBILE INTEGRATED HEALTH EDITOR – Matt Zavadsky, MS-HSA, EMT
CONTRIBUTING ILLUSTRATORS – Steve Berry, NRP; Paul Combs, NREMT
CONTRIBUTING PHOTOGRAPHERS – Vu Banh, Glen Ellman, Craig Jackson, Kevin Link, Courtney
McCain, Tom Page, Rick Roach, Scott Oglesbee, Steve Silverman, Matthew Strauss, Chris Swabb
EDITORIAL GRAPHIC DESIGNER – Kermit Mulkins

PRODUCTION COORDINATOR – Kimberlee Smith – [email protected]
REPRINTS, EPRINTS & LICENSING – Rae Lynn Cooper – 918-831-9143 – [email protected]
DIGITAL MEDIA CAMPAIGN MANAGER – Erin Northrop – [email protected]
SUBSCRIPTION DEPARTMENT
(800) 869-6882 – FAX: (866) 658-6156 – [email protected]
SENIOR AUDIENCE DEVELOPMENT MANAGER – Jim Cowart – [email protected]
MARKETING MANAGER – Ashley Cope – [email protected]
SALES & MARKETING SOLUTIONS

WESTERN & CANADA – Mike Shear – 858-638-2623 – [email protected]
MIDWEST AND SOUTHEASTERN – Melissa Roberts – 918-831-9727 – [email protected]
NORTHEAST AND INTERNATIONAL – Rod Washington – 918-831-9481 – [email protected]
WWW.EMSTODAY.COM
SENIOR VICE PRESIDENT/GROUP PUBLISHER – MaryBeth DeWitt
EDUCATION DIRECTOR – A.J. Heightman, MPA, EMT-P
CONFERENCE MANAGER – Debbie Wells (Boyne) – [email protected]
CONFERENCE COORDINATOR – Sara Jones – [email protected]
MARKETING MANAGER – Cassie Chitty – [email protected]
SENIOR EVENT OPERATIONS MANAGER – Emily Gotwals-Moreau – [email protected]
The Cric-Knife™ has a 10mm dual sided blade,

FOUNDING PUBLISHER – James O. Page (1936–2004)
with a sliding tracheal hook to maintain
airway placement. CHAIRMAN – Robert F. Biolchini
VICE CHAIRMAN – Frank T. Lauinger
The Cric-Key™ has a pre-shaped stylet that provides PRESIDENT AND CHIEF EXECUTIVE OFFICER – Mark C. Wilmoth
airway connrmation, with tactile feedback EXECUTIVE VICE PRESIDENT, CORPORATE DEVELOPMENT AND STRATEGY – Jayne A. Gilsinger
of the tracheal rings. SENIOR VICE PRESIDENT, FINANCE AND CHIEF FINANCIAL OFFICER – Brian Conway
SENIOR VICE PRESIDENT/GROUP PUBLISHER – MaryBeth DeWitt – [email protected]
1710JEMS_2 2 9/12/17 9:20 AM

®
EDITORIAL BOARD
UNITED STATES W. Ann Maggiore, JD, NRP Jonathan D. Washko, DENMARK JAPAN SAUDI ARABIA
Clinical Instructor, Univ. of New Mexico, MBA, NREMT-P, AEMD
Faizan H. Arshad, MD Kjeld Brogaard, EMT-P Hiromichi Naito, MD, PhD Kenneth J. D’Alessandro,
School of Medicine Assistant Vice President, North Shore-LIJ
EMS Medical Director, Vassar Brothers EMS Senior Manager, Falck Denmark Assistant Professor, Dept. of Emergency BS, MS EMS, EMT-P
Medical Center Shaughn Maxwell, EMT-P Center for EMS Medicine, Okayama Univ. Hospital EMS Program Advi er, Saudi Red Cres-
Captain & Medical Services Officer, Sno- Freddy Lippert, MD cent Authority
William K. Atkinson II, PHD, homish County Fire District 1 (Wash.) Keith Wesley, MD, FACEP, FAEMS CEO, EMS Copenhagen Hideharu Tanaka, MD, PhD
MPH, MPA, EMT-P Medical Director, HealthEast Medical Professor & Chairman, EMS System, William J. Leggio, EdD, NRP
Health Care Advisor, Raleigh, N.C. Andrew McCoy, MD, MS Heidi Vikke, MSc Graduate School & Research Insitute of Paramedic Program Coordinator, EMS
Associate Medical Director, Seattle Transportation Head of Research, Falck Denmark Disaster & EMS, Kokushikan Univ. Education, Creighton Univ.
James J. Augustine, MD, FACEP Fire Dept.
Chair, National Clinical Governance Board, Katherine H. West, BSN, MSEd
US Acute Care Solutions Mike McEvoy, PHD, NRP, RN, CCRN Infection Control Consultant, Infection FINLAND KENYA SCOTLAND
EMS Coordinator, Saratoga County, N.Y. Control/Emerging Concepts Inc.
Paul Banerjee, DO Pertti H. Kiira, RN Elvis Ogweno, MPH, MSc, EMT-P Paul Gowens, FCPara, MSc, AASI,
Medical Director, Polk County (Fla.) John McManus, Col. (Ret.), MD, Keith Widmeier, BA, NRP, FP-C Consultant of EMS Director, Tactical Search and Rescue PGCert, DipIMC, RCSEd, MCMI
Fire Rescue MBA, MCR, FACEP, FAAEM Team, Africa Consultant Paramedic, Scottish Ambu-
Adjunct Faculty, Emergency Services
Professor of Emergency Medicine & lance Service
Bryan E. Bledsoe, DO, FACEP, EMS Fellowship Director, Georgia Program, Jefferson College of Health FRANCE
FAAEM Regents Univ. Sciences LUXEMBURG
Professor of Emergency Medicine, Director, Jean-Clause Deslandes, MD SINGAPORE
Jason McMullan, MD Stephen R. Wirth, Esq. Past Publisher, Urgence Practique Steve Greisch, RNA
EMS Fellowship, Univ. of Nevada Registered Nurse Anesthetist & Continuing Marcus Ong Eng Hock
Associate Director, Division of EMS, Attorney, Page, Wolfberg & Wirth LLC. Marilyn Franchin, MD
Scotty Bolleter, BS, EMT-P Medical Education Instructor, Centre Senior Consultant, Clinician Scientist &
Dept. of Emergency Medicine, Univ.
Chief, Clinical Direction, Bulverde Spring Douglas M. Wolfberg, Esq. Prehospital Emergency Physician, Fire Bri- Hospitalier Emile Mayrisch Director of Research, Dept. of Emer-
of Cincinnati
Branch (Texas) Fire and EMS Attorney, Page, Wolfberg & Wirth LLC gade of Paris gency Medicine, Singapore Gen-
Mark Meredith, MD eral Hospital
Criss Brainard, EMT-P Associate Professor of Pediatrics, Le Wayne M. Zygowicz, MS,
MEXICO
Fire Chief, San Miguel Fire & Rescue Bonheur Children’s Hospital (Mem- GERMANY Armando Alvarez, BSBME,
(Spring Valley, Calif.) phis, Tenn.)
EFO, EMT-P
MBA, EMT-P, PA
SLOVAKIA
Division Chief, Littleton (Colo.) Fire Rescue Jan-Thorsten Gräsner,
Chad Brocato, JD, DHSc, CFO CEO, Sistemedic Viliam Dobias, MD, PhD
David A. Miramontes, MD, MD, FERC
Chair of Emergency Medicine, Medi-
Assistant Chief, Pompano Beach (Fla.) FACEP, NREMT Director, Institute for Emergency
Fire Rescue Medical Director, San Antonio Fire Dept.
MULTI-NATIONAL Medicine, Univ.Medical Center THE NETHERLANDS cal School of Slovak Medical Univ.
Bratislava
Carol A. Cunningham, MD, Brent Myers, MD, MPH, FACEP Corina Bilger, NREMT-Ret Schleswig-Holstein Ingrid Hoekstra, MSc
FAAEM, FAEMS Senior Medical Consultant, ESO Solutions Director of International Sales, H&H Ambulance Nurse, RAVU Utrecht Ambu-
State Medical Director, Ohio Dept. of Pub-
Klaus Runggaldier, PhD, EMT-P SLOVENIA
President, National Association of EMS Medical Corp. Dean and Professor, Medical School Ham- lance Service, Dept. of Research
lic Safety, Division of EMS Physicians Andrej Fink, MSHS , RN, EMT-P
Ahed Al Najjar, BSc, AREMTP, burg, Univ. of Applied Sciences and Head of Ambulance Service, Univ. Medical
Rommie L. Duckworth, LP Joseph P. Ornato, MD, FACP, Medical Univ. NEW ZEALAND
Director, New England Center for Rescue MPH, FAHA Centre Ljubljana
FACC, FACEP Craig Ellis, MD
and Emergency Medicine Operational Medical Director, Richmond
Director of Life Support, EMS Faculty & Thomas Semmel, EMT-P
Researcher, Prince Sultan Bin Abdulaziz Educator, European Resuscitation Council National Medical Advisor, St. John’s SOUTH AFRICA
EMS Coordinator, Ridgefield Fire Dept. Ambulance Authority Ambulance Service
Mark E.A. Escott, MD, MPH, FACEP College for EMS – King Saud Univ. Neil Noble, CCP
Paul E. Pepe, MD, MPH, MACP, Hugo Goodson, MBA, PgCertEd,
Medical Director, Austin-Travis County EMS FACEP, FCCM Jerry Overton, MPA HUNGARY Director, Paramedics Australasia
BHSc
Jay Fitch, PhD Professor of Emergency Medicine, Internal Chair, International Academies of Emer- Laszlo Gorove, MD Senior Lecturer, Paramedicine, Auckland
President & Founding Partner, Fitch & Medicine, Pediatrics, Public Health, gency Dispatch Managing Director, Hungarian Air Ambu- Univ. of Technology SOUTH KOREA
Associates Univ. of Texas Southwestern Med- lance Nonprofit Ltd. Sang Do Shin, MD, PhD
ical Center Professor, Dept. of Emergency Medicine,
Ray Fowler, MD, FACEP, FAEMS AUSTRALIA NIGERIA
Professor and Chief, Division of EMS, David E. Persse, MD, FACEP ICELAND Seoul National University College of
Univ. of Texas Southwestern School Physician Director, City of Houston EMS Colin Allen, EMT-P Nnamdi Nwauwa, EMT, Medicine and Seoul National Univer-
of Medicine P. Daniel Patterson, PhD, Director, Brisbane Operations Center, Njall Palsson, EMT-P CCEMTP, MBBS, MPH, MMSCEM sity Hospital
President, Professional Division for Founder, Emergency Response Ser-
Adam D. Fox, DPM, DO, FACS MPH, EMT-B Queensland Ambulance Service
EMT-Paramedics vices Group
Section Chief, Division of Trauma, Rutgers Research Associate, Cecil G. Sheps Center; Paul Middleton SWEDEN
N.J. Medical School N.C. Rural Health Research and Policy Ola Orekunrin, MD
Chair/Principal Investigator, DREAM (Dis- Director, Flying Doctors Service
Kenneth Kronohage, MSc,
John M. Gallagher, MD Mark Piehl, MD INDIA CRNA, BSc, RN
tributed Research in Emergency and
Medical Director, Wichita/Sedgwick Pediatric Intensivist & Pediatric Critical George P. Abraham, MD, FRCS, President, Swedish Ambulance Forum
Acute Medicine) Collaboration NORWAY
County (Kan.) EMS System Care Transport Advisor, WakeMed FACS, FWACS, MHA
Ryan Gerecht, MD, CMTE Edward M. Racht, MD Peter O’Meara Medical Director, Western Alliance Carl R. Christiansen, EMT-P, UNITED ARAB EMIRATES
EMS and Emergency Medicine Physician, Chief Medical Officer, American Medi- Professor, Rural & Regional Paramedicine, EMS System MPhilEd
Hospital Lecturer, Oslo & Akershus Univ.
Ahmed Alhajeri
Tacoma, Wash. cal Response La Trobe Univ. (Victoria) Deputy CEO, National Ambulance
G.V. Ramana Rao, MD, DPH, College of Applied Sciences
Jeffrey M. Goodloe, MD, NRP, Jeffrey P. Salomone, MD, FACS Robyn Smith PGDGM
Trauma Medical Director, Banner Des- Editorial Staff Member, Response Live Oftedahl, Cand.Philol. UNITED KINGDOM
FACEP, FAEMS Director of Emergency Medicine Learn-
ert Medical Center/Cardon Children’s Editor-in-Chief, Ambulanseforum
Medical Director, EMS System for Metro- ing Center & Research, GVK Emergency Jon Ellis, MBA
Medical Center Ronald Rolfsen
politan Oklahoma City & Tulsa AUSTRIA Management Research Institute Technical Expert, BSI & CEN Committees
Keith Griffiths Jullette M. Saussy, MD, FACEP Special Adviser, Division for Prehospi- —Ambulance Systems & Patient Han-
President, RedFlash Group
Emergency Medical Physician Christoph Redelsteiner, tal Medicine, Ambulance Dept., Oslo dling Equipment
Geoffrey L. Shapiro DrPhDr, MSW, MS, EMT-P IRELAND Univ. Hospital
Andrew J. Harrell, MD Mike Jackson, MSc (Dist), DipIMC,
Director, EMS & Operational Medicine Professor, Dept. Social Work & Health, Darren Figgis Steinar Olsen, RN, EMT-P MBA, FCPara
Associate Professor, Dept. of Emergency
Training, School of Medicine and Health Univ. of Applied Sciences St. Pölten Advanced Paramedic, Health Service Exec- Director, Dept. of EMS, Norwegian Direc- Chief Consultant Paramedic & Assistant
Medicine, Univ. of New Mexico
Sciences EHS Program, George Wash- utive National Ambulance Service torate for Health Clinical Director, North West Ambulance
Joe Holley, MD ington Univ. Service NHS Trust
Medical Director, Memphis Fire Dept. CANADA
Corey M. Slovis, MD, FACP, ISRAEL POLAND Ian Maconochie, FRCPCH, FECM,
Chris Kaiser, NREMT-P FACEP, FAAEM Randy Mellow
Dov Maisel, EMT-P Jamie Chebra, EMT-P, CEM, FRCPI, FERC, PhD
Paramedic, Central Wisconsin Medical Director, Metro Nashville Fire Dept. President, Paramedic Chiefs of Canada
Senior Vice President of International Opera- MS, DHAc Consultant, Paediatric Emergency Medi-
Dave Keseg, MD, FACEP E. Reed Smith, MD, FACEP Ronald D. Stewart, MD, FACEP tions, United Hatzalah – United Rescue EMS Educator & Advisor, Poland EMS cine, St. Mary’s Hospital, Imperial Aca-
Medical Director, Columbus Fire Dept. Co-Chairman, Committee for Tactical Professor, Emergency Medicine, Dal- Systems demic Health Sciences Centre
Chetan U. Kharod, MD, MPH, Emergency Casualty Care Sody Naimer Marek Dabrowski
housie Univ. Fionna Moore, MBE, FRCS, FRCSEd,
Colonel, USAF, MC, SFS Walt A. Stoy, PhD, EMT-P, CCEMTP Senior Lecturer, Division of Community Lecturer, Poznan Univ. Medical Sciences, FRCEM, FIMC RCSEd
Program Director, Dept. of Defense EMS & Professor & Director, Emergency Medicine, Health, Ben-Gurion Univ. of the Negev Rescue & Disaster Medicine Dept. and Chief Executive, Consultant in Prehospital,
Disaster Medicine Fellowship Univ. of Pittsburgh CZECH REPUBLIC Sim Center
Oren Wacht, EMT-P, MHA, PhD London Ambulance Service NHS Trust
Keith Lurie, MD Peter P. Taillac, MD Jana Šeblová, MD, PhD Professor, Ben Gurion University, Dept. of Mateusz Zgoda, MPH, EMT-P Andy Newton, PhD
Codirector, Central Minnesota Heart Cen- Medical Director, Bureau of EMS and Pre- Head Physician, EMS Education, Central Emergency Medicine & Health Systems Paramedic, Krakow Rescue Public Ambu- Chief Clinical Officer, South East Coast
ter Resuscitation Center paredness, Utah Dept. of Health Bohemian Region Management lance Service Ambulance Service NHS Trust
For complete bios of our Editorial Board members, visit jems.com/Editorial-Board.
1710JEMS_3 3 9/12/17 9:20 AM

EMS IN ACTION
SCENE OF THE MONTH
DEADLY PROTEST
R escue personnel help injured people after a car ran into a large group
of protesters during a rally that involved two opposing protest groups
in Charlottesville, Va., on Saturday, Aug. 12. There were several hundred
protesters marching in a long line when the car drove into a group of them,
killing a 32-year-old woman and injuring 19 others.
4 JEMS | OCTOBER 2017 www.jEms.COm
1710JEMS_4 4 9/12/17 9:20 AM

AP Photo/Steve Helber
1710JEMS_5 5 9/12/17 9:20 AM

FROM THE EDITOR
PUTTING ISSUES INTO PERSPECTIVE
AN UNSUNG HERO
Remembering visionary Boston EMS
Special Operations Captain Bob ‘Sarge’ Haley
I
write this Editor’s page with a very heavy Because of his preplanning, training and
heart, having learned of the passing of precise operational staging, his troops per-
a great friend and colleague, Captain formed like it was a drill, with their actions
Bob “Sarge” Haley who developed EMS saving countless lives.
special operations not only in Boston, but When you watch the documentary pro-
nationwide. duced after the marathon, discussing how
It’s somewhat ironic that Bob passed away Boston crews responded, you can hear in
on the 25th anniversary of Hurricane Andrew, Bob’s voice the great love he had for Boston
as it was one of many disasters he responded EMS, the challenge of special operations and
to, along with Hurricane Katrina. the pride he felt for the way his people per-
Thirty-five years ago, when EMS was in formed that day.
its infancy, Bob was a pioneer in the train-
ing of new EMTs. Throughout the years, A ‘TRIAGE TAG PIPE DREAM’
his innovative approach to training helped Few people know that in 1982, long before
to mold hundreds of EMTs and paramedics I moved to California to work at JEMS, I
into well-rounded, skilled clinicians. taught an MCI management workshop for
Bob and his EMS colleagues in the greater
AN MCI VISIONARY Legendary Captain of Special Operations for Boston Boston region.
Bob’s vision was light years ahead when it EMS, Bob ‘Sarge’ Haley. Photos A.J. Heightman Taking a break from the weekend-long
came to emergency preparedness and plan- workshop over a beer, Bob told me that he
ning for mass casualty incidents (MCIs). He in life, his rough exterior masked the natural wanted a functional triage tag that could be
had a unique, very tough leadership style, but born teacher he was. used easily and on a daily basis.
his care and passion for doing the right thing It was no accident that the response to He didn’t want, as he said, “one of those
were evident; he was loved by the men and the Boston Marathon bombings went as damn complex, awkward triage tags designed
women of Boston EMS. smoothly as it did. Bob’s unyielding efforts by some a** who never worked a mass casu-
Sarge’s expertise in logistics, special oper- over the years got the right equipment, train- alty event in their life!”
ations and prehospital emergency medicine ing and people in the right place. At his request, I designed and produced
led the way for multiple advance- a triage tag that met his func-
ments in EMS. His passion for tional needs and had a lot of
training and helping others trans- important, concise information
lated into a meticulous approach carefully placed on a small tag.
to planning for the unknown. It was produced in full-size and
He always thought outside pocket-sized versions.
the box, and explored concepts On one side, it had detailed
and equipment that weren’t tra- patient information that could
ditional in EMS. His arsenal be read over the radio to receiv-
included special auxiliary vehi- ing hospitals. Crews could use
cles, electric carts, EMS bikes, it on any EMS call or at MCIs.
ambulance buses and large spe- On the other side was an easy-
cialty trailers. to-use triage tag that featured a
To Bob, it wasn’t about what simply drawn stick figure and the
EMS can do, but what EMS only tear-off “transportation stub”
should do. A mentor in EMS and Briefing the troops at the 2014 Boston Marathon (https://youtu.be/oUKzzwSh2fE). in existence at the time. The stub
1710JEMS_6 6 9/12/17 9:20 AM

Some of the specialty vehicles Sarge and his highly skilled team proudly deployed and maintained.
was designed to be pulled off and left at an and on Boston EMS rigs. I kept the remaining nondescript, trailer that housed high-tech
MCI transportation area for on-scene patient 4,000 in my already cluttered garage. equipment, transmitters, generators and an
charting and rapid reporting of information At the time, my young bride wasn’t very easy-to-erect radio tower that would offer
to receiving hospitals. happy with me for ordering 5,000 tags —and uninterrupted communications if a terror-
Bob loved it, and agreed to adopt it—if I paying extra to have them shrink-wrapped. ist ever detonated an electromagnetic bomb
could get him 1,000 tags in time for that year’s She called it my “triage tag pipe dream.” (“e-bomb”) in Boston.
Boston Marathon. I managed to get him the E-bombs use an intense electromagnetic
tags, but to do so I had to order 5,000 of them. BOB’S SPECIAL OPS GARAGE field to create a pulse of energy that affects
It was the only way to get a decent cost-per- During one of my many visits with Bob, he electronic circuitry without harming humans
tag price from the printer. took me to a secure location and proudly or buildings, temporarily disabling electronics
He used the tags at the Boston Marathon showed me his “secret baby:” A large, systems or corrupting computer data.
Reduces Sick Days and Operating Costs**
FIRST
RESPONDERª
Provides a Healthier Environment
Helps Eliminate Chronic Odors and Pathogens
in EMS Vehicles
** Up to $2,314 potential annual savings per EMT ($34,030 avg annual salary/14.7 sick days).
source: Health and Social Care Information Centre/U.S Bureau of Labor Statistics)
- First Responders are exposed to hundreds of pathogens daily.

MRSA, C.difficile, and Influenza can occur due to exposure.
- The FirstResponder™ Sterilizer helps

protect those who put
themselves in harms
way as well as their
passengers and
families.
Visit us at the
AAA Show in Las Vegas
November 13-15th, 2017 www.First-Responder.com
Booth 504
Patent # US 9,623, 140 B2
1710JEMS_7 7 9/12/17 9:20 AM

FROM THE EDITOR
A dual-purpose, daily use triage MULTI-TAG (circa 1982) that featured patient information on one side and a patient outline and a detachable transportation triage
stub on the other.
1710JEMS_8 8 9/12/17 9:20 AM

The last time I saw Bob was at his office: A family man first, Bob loved to brag about probably your last opportunity to tell them you
A wire-caged area in a massive garage, with a his kids, whether it was about his daughters’ love them without actually saying anything.
desk piled to the ceiling with manuals, specs dancing, or his son’s dream of joining Bos- I had a feeling it was a moment that would
and other crap. This was Bob’s special oper- ton EMS, or how proud he was when his son last a lifetime. I’m so glad I did it.
ations garage—his pride and joy. graduated from the Boston EMS Academy. Sarge was a true EMS icon, and like so
While I was there, I noticed an armored Thank God he had a chance to experience many special operations leaders, he stood qui-
police vehicle parked near his office. that before he passed. etly in the background and grinned with pride
An EMS supervisor had previously sug- Sarge was one of my favorite friends in at the way his personnel performed.
gested that I egg him on and ask what an EMS. The last time we saw each other, I was To be truthful, Bob was never quiet, but
armored police vehicle—dedicated to retriev- fortunate to have the opportunity to share a he always got the job done behind the scenes.
ing injured officers and other victims—was special moment with him. He will always be recognized as one of the
doing in his garage. As we parted ways, I gave him a hug—the true unsung heroes of EMS.
Bob reportedly called and told them to type you give someone when you know it’s RIP, Bob! JEMS
“get the effin’ police vehicle” out of his EMS
garage because it wasn’t a rescue vehicle. They
moved it that day.
When Bob came into work the next day,
the massive vehicle was there again—in the
exact same spot—only now it had the word
“RESCUE” lettered on each front fender.
I walked into Bob’s office and asked him
what an armored police vehicle was doing
The massive police ‘rescue’ vehicle placed in Bob’s

special ops garage.
parked in his garage. As anticipated, it set

him off on a tirade peppered with words that
could make your ears melt.
A FAMILY MAN & A GOOD FRIEND

Bob’s devotion to his family was legendary.
Whenever you saw him at special events in
Boston, you also saw his three children right
at his side.
Sarge was a true EMS icon.
www.jems.com
1710JEMS_9 9 9/12/17 9:20 AM

™
LEVERAGING PCR DATA

Galveston EMS utilizes patient data to improve performance
By Nathan Jung, EMT-P
R
evenue cycle management is becom- After a quick audit of several reports, it application used by your service, these fields may
ing increasingly important to every became clear that this was common practice be labeled differently. However, the data elements
EMS agency. This will become evi- within our own agency as well. Knowing there can be found in most stock reports. (See Table 1.)
dent as reimbursements remain relatively stag- was room to improve revenue generation, we To gain a better understanding of the sit-
nant when costs continue to rise. Obtaining went to work increasing the amount of funds uation and determine whether it was a sys-
accurate patient demographics, signatures and that could be captured in an effort to reduce temic issue or attributed to a few factors, the
insurance information is critical to ensuring our reliance on taxpayer funds. After all, EMS data was extracted and graphed. Furthermore,
the financial solvency of an agency; however, is one of the few public programs that can the data provided reference points and estab-
they’re often overlooked. generate revenue to offset operating expenses. lished a baseline for gauging the success of the
Many management teams may not even implemented solutions.
be aware that this data can be easily obtained USING DATA EFFECTIVELY It’s important to start with a broad approach.
through any electronic patient care reporting For years there’s been a push to standardize As you begin to identify a potential problem,
(ePCR) system. At Galveston (Texas) EMS, the data collected by ePCR systems. Although you can add additional data elements to drill
we began utilizing the ePCR data to improve primarily motivated by a desire to improve down further. In this case, it was important to
patient outcomes and offset operational costs. patient outcomes with standardized metrics, start by confirming that all attempts at collect-
One of the more common practices in EMS, agencies can also operationally benefit from ing patient insurance information were being
specifically among municipal agencies, is that data standardization. made prior to ending patient contact.
complete patient insurance information isn’t The data we used to identify our issue and Key metrics that we identified included:
being collected by the crew. This is based on subsequently monitor performance comes from >> Agency averages by payer group;
an assumption that a billing department or standardized National EMS Information Sys- >> Provider-specific rates by payer group;
provider will obtain it at a later date. tem (NEMSIS) fields. Depending on the specific >> Zip code-specific rates by payer group;
and
Table 1: Data elements used >> Payer groups by run type.
Description
Data field NEMSIS version 2 NEMSIS version 3
selection AGENCY AVERAGE BY PAYER GROUP
Having the agency averages shows not only
Run Type E02_04 eResponse.05 All selections
the progress of the agency, but also allows for
the comparison of an individual employee to
Unit Number E02_11 eResponse.13 Unit number the overall group.
Because each service is unique, often oper-
Crew Member ID E04_01 eCrew.01 Name ating in a different area, it can be a challenge
to rely on the financial performance of an
Crew Member Primary patient
E04_02 eCrew.03 agency of similar size and scope. Even a neigh-
Response Role caregiver
boring agency might have a completely dif-
Dispatch Date E05_03 eTimes.02 Dispatch date/time ferent socioeconomic status, funding source
or structure.
Primary Method
E07_01 ePayment.01 All selections
of Payment
PROVIDER-SPECIFIC RATES
Incident Zip Code E08_15 eScene.19 Zip code BY PAYER GROUP
Reviewing provider-specific rates by payer
Data used to identify issues and monitor performance comes from standardized National EMS Information Sys- group allows for easy identification of indi-
tem (NEMSIS) fields, and can be found in most stock reports. viduals who could provide insight into a more
1710JEMS_10 10 9/12/17 9:20 AM

efficient workflow or those who need may need Figure 1: Provider-specific rates by payer group for FY 2017 (all run types)
some additional training or prompting. In Fig-
ure 1, you can see that the provider has a low
no payer rate compared to the agency average. Fiscal year Provider
No payer
ZIP CODE-SPECIFIC RATES Medicare Other
BY PAYER GROUP
Payer mix can vary widely across a county;
Insurance
there can be fluctuations even within a neigh-
Medicaid
borhood. Zip codes provide the most readily
available source for geospatial analysis, how- Insurance
ever, with geocoded addresses we’re able to Medicaid
drill down with more accurate data. Other
Understanding the payer mix documented
in correlation with data supplied by the United
States Census Bureau can help justify fund-
ing requests or support financial performance. Medicare
This can be crucial for a service that bids on No payer
a 9-1-1 contract or an agency looking to
explore a potential new market entry and is
concerned about the patient population out- Number of records
side of a facility.
An area to consider for 9-1-1 providers is
17 4,158
the documented no payer rate compared to col-
lection rate and the Census Bureau-reported Viewing provider-specific rates by payer group allows for easy identification of individuals who could give
insured rate. This quick check will allow you insight into a more efficient workflow, or those who need may need some additional training.
to see if further analysis is warranted. Images courtesy Nathan Jung/Galveston EMS
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EMS INSIDER
PAYER GROUPS BY RUN TYPE for the majority of the documented self pay As expected, the number of no payers encoun-
The final measure considered was payer encounters, while the NET division almost tered was higher among 9-1-1 responses.
groups by run type. Our primary opera- always has some form of funded payer docu- Further analysis revealed that the individual
tions are divided into two distinct divisions, mented to it. Another area to take note of is provider had more impact on this than the
9-1-1 and non-emergency transports (NET). the ratio of Medicaid encounters in compar- physical location of the patient.
Within those divisions are unique run types ison to Medicare or other commercial insur-
that can have a different type of payer asso- ance, since Medicaid traditionally pays lower. ANALYSIS
ciated. (See Figure 2.) Specifically, we looked to see if the no payer After reviewing the data, conducting audits
As expected, the 9-1-1 division accounts issue was related to one division over the other. of random PCRs and consulting with several
of the long-term supervisors, it became clear
Figure 2: Payer groups by run type for incidents in FY 2017 that the majority of the no payer documen-
tation was a result of conflicting information.
Community network This led to increased costs associated with
labor in research, delays in payments and lost
Insurance revenue for the claims in which no information
could be recovered due to an incorrect medical
Medicaid record number or misspelled patient name.
Other risks that could impact a service
Medicare
include lost revenue through missed filing dead-
Other government lines, increases in billing charges associated
9-1-1 response
with outsourced vendors and the need to hire
Other payment option additional personnel for in-house billing teams.
Emergency interfacility transfer
The most optimal time to obtain this
Payment by facility Medical transport information is prior to the EMS crew leaving
Mutual aid the patient.
Self pay
Non-emergency interfacility transfer
Workers’ compensation SOLUTION IMPLEMENTED
The first step in overcoming this issue was edu-
0 400 800 1,200 1,600 2,000 2,400 2,800 cating the entire agency on the importance of
Responses collecting insurance information. The second
step was walking through ePCRs. This allowed
Galveston EMS primary operations are divided into two distinct divisions, 9-1-1 and non-emergency trans- us to identify the fields associated with insur-
ports. Each division has unique run types which can have a different type of payer. ance information and explain what they are, how
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they’re used and why they need to be filled out. Figure 3: Payer rates over time
Finally, we shared the agency data with 1,800
everyone. For those we identified as being Insurance Medicaid Medicare No payer Other
above the threshold, we showed their specific
Responses
data in comparison to the agency averages 1,200
and worked with them individually, sending
weekly updates on their performance.
Training on the importance of collecting 600
automotive policy insurance information, doc-
umenting on-the-job injuries (workers’ com-
0
pensation claims) and developing better ways
2015 2016 2016 2016 2016 2017 2017 2017 2017
to ensure revenue is captured will continue. Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
Educating staff and reducing the no payer Quarter of incident date
rate will be an ongoing process.
Starting in FY 2015 Q4, Galveston EMS saw measurable progress as their documented no payer rate declined,
CONCLUSION while their documented funding sources increased.
Starting in FY 2015 Q4, we saw measur-
able progress as our documented no payer capital expenditures with no impact to taxpay- ambulance service will only continue to rise.
rate declined while our documented funding ers. We were also able to address the increasing Through quick analysis of the data that many
sources increased. We’re continuing to make call volume with an additional 9-1-1 ambu- services already collect, management teams can
progress even with our call volume on track lance at no cost to tax payers. quickly spot potential problems and maximize
to be 2,000 incidents higher than FY 2015. Although there are many questions regard- their revenue stream. JEMS
In the current and previous fiscal years, our ing what the future holds for health insurances
agency has been able fund a total of $1.3 mil- and ambulance reimbursements, there’s one Nathan Jung, EMT-P, is EMS administrator for Galveston
lion and is proposing another $1 million in thing that’s certain: The cost to operate an County Health District in Galveston, Texas.
1710JEMS_13 13 9/12/17 9:20 AM

PRO BONO
EMS LEGAL TIPS & ADVICE
FIRST & LAST IMPRESSIONS

Improve patient care & reduce the risk of a lawsuit
By Stephen R. Wirth, Esq., EMT-P
M
aking a good first impression is barrier to communication. Always carry gum anxious, distressed and in pain. They need
essential to establishing posi- and mints and use them. reassurance that you recognize their anxiety.
tive rapport with your patient. 3. Have a confident physical approach. Move A gentle touch conveys that you’re sensitive
Within the first few seconds of that encoun- with purpose; look like you want to get to to and understand their concern.
ter, most patients will make a value judgment where you’re going. Stand up straight with a 8. Engage in some small talk. Nonmedi-
about whether they like you and whether they confident gait as you approach the room. Start cal gestures and questions can help relieve
think you’re competent to care for them. looking at faces to assess the situation and use patient anxiety. Commenting positively on
You don’t get a second chance to make a great a positive, clear tone of voice when speaking. the patient’s family members, the dog or cat,
first impression! or other things you observe in the
Studies show that people, includ- room shows that you have an inter-
ing patients, are most likely to est in the patient and can help take
remember the beginning and the Studies show that people, the patient’s mind off their distress.
end of an encounter. This is called When your patient’s stress is man-
the “serial positioning effect.” including patients, are aged, it’s easier for you to assess and
That’s why, in addition to a posi- treat them.
tive first impression, a positive end- most likely to remember 9. Always be attentive and courte-
ing encounter with the patient is also ous. Paying attention to the patient
very important. Taking a moment or the beginning & the and being courteous at all times
two to say goodbye to the patient makes the patient feel that they’re
and thank them for the opportunity end of an encounter. the center of attention. Using active
to be of service leaves them with a listening skills can aid in the com-
positive impression of you. munications process.
With the serial positioning effect, the things 4. Look them in the eye. Focus on the patient. Always be courteous to the patient, even if
that happen in the middle of an encounter tend It helps you assess their emotions. It will also the patient isn’t courteous to you. As health-
to be a “blur,” and details are often forgotten. allow you to detect subtle changes in emotion, care professionals, we should never let the
From a risk management standpoint, that pain levels and distress. patient’s poor demeanor negatively affect how
can be very good. It means that if you’re nice 5. Make an immediate introduction. Make we treat them. JEMS
to the patient when arriving on scene and sure you introduce yourself; explain who you
nice to them when you leave, the patient is are and why you’re there. Avoid using cli- Stephen R. Wirth, Esq., EMT-P, is an EMS
likely to forget about the bumps (i.e., mis- chés like “honey,” “sweetie,” or “buddy” when attorney and founding partner of Page, Wolf-
takes) that may have occurred in the middle— speaking to the patient. Ask the patient if it’s berg & Wirth, which represents EMS agencies
like that IV you missed! Typically, patients okay to call them by their first name. Acknowl- throughout the United States. He was one
won’t sue you if they like you—even if you do edge family members, too; they may have valu- of central Pennsylvania’s first paramedics
make mistakes. able information about the patient’s past and and has worked as a firefighter, EMT, paramedic, flight para-
Here are nine tips for making a good first present medical history that can help you. medic, EMS instructor, fire officer and EMS executive.
impression that will set the stage for a posi- 6. Smile. A warm smile relaxes the other Pro Bono is written by the attorneys
tive interaction with the patient—and reduce person. Smiling and maintaining good eye at Page, Wolfberg & Wirth, The
the risk of a lawsuit: contact immediately upon approaching the National EMS Industry Law Firm.
1. Recharge yourself. Take a deep breath patient demonstrates a sincere willingness to Visit the firm’s website at www.pwwemslaw.com or find them
before you enter the situation to clear your help. It also conveys that you’re approachable on Facebook, Twitter or LinkedIn.
mind and to be ready to focus on the patient. and may encourage the patient to talk to you.
Tell yourself you’re going to make the patient Studies show that even forcing yourself to Learn more from Steve Wirth at the
feel better about the situation they’re in. smile can have positive physiological effects EMS Today Conference, Feb. 21–23, in
2. Check your breath. As obvious as this is, and help you with your own stress levels. Charlotte, N.C. EMSToday.com
bad breath can turn people off and sets up a 7. Use appropriate touch. Patients are often
1710JEMS_14 14 9/12/17 9:20 AM

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3. Gegel B, Burgert J, Gasko J, Campbell C, Martens M, Keck J, et al. The effects of QuikClot Combat Gauze
and movement on hemorrhage control in a porcine model. Mil Med. December, 2012;177:1543-1547.
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1710JEMS_15 15 9/12/17 9:20 AM

CASE OF THE MONTH
DILEMMAS IN DAY-TO-DAY CARE
REMOTE TRAUMA
HEMS crew navigates treacherous terrain in Nepal’s dense jungle
By Sanjaya Karki, MD, MBBS
I
t’s the middle of the day and the Grande International Hospital District, about 5,600 feet (1,700 meters) above sea level and 28 miles
(GIH) EMS hotline receives a call from a group of travelers who (45 km) northwest of Pokhara, where the Annapurna base camp—a
had been out trekking in a remote jungle near Pokhara, Nepal, and popular site for tourists who want to trek in the Himalayas—is located.
had overturned their vehicle. The helicopter’s pilot, Captain Suraj Thapa from Heli Everest (a
The GIH-based helicopter EMS (HEMS) air ambulance team private helicopter tour company), is familiar with the area, and
JEM
is activated. With three sets of jump bags always ready to go, ALN AT I O N rescuers on board are in constant touch with the patients via
S
responders go through their checklist as a call back is made satellite phone.
ARTIC
to the patient party for additional details: two French citi- After flying for 42 minutes, however, rescuers can’t pinpoint
zens were injured after a brake failure overturned their vehi- the exact location of the patients, who report hearing the heli-
ER
LE
cle. Once the team is fully prepared to tackle their condition, I NT copter hovering above them, but can’t see it. They tell the crew
responders quickly make their way from the ED on the first floor they’re waving a red bandana—but rescuers can’t see them, either.
to the helipad deck on the 14th floor. Unable to locate the patients after circling above the vicinity of the
The helicopter carries the team toward Tanchowk, a lush forested scene, Thapa lands in the village near Lumle and the team asks for the
area located in the Lumle Village Development Committee in the Kaski precise location of Tanchowk.
A cloud of rising smoke could be seen from the helicopter, identifying the loca- The patient is carried to the waiting helicopter for transfer to Grande Interna-
tion of the accident. Photos courtesy Sanjaya Karki tional Hospital in Kathmandu, Nepal.
1710JEMS_16 16 9/12/17 9:21 AM

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1710JEMS_17 17 9/12/17 9:21 AM

CASE OF THE MONTH
ON-SCENE ARRIVAL
Emergency medicine physician Sanjaya Karki,
MD, and staff nurse Saru Shrestha head toward
the accident site. Uninjured members of the
stranded tourist group help carry their lifesav-
ing equipment and drugs to the scene.
As Karki and Shrestha arrive on scene, they
see a 15-year-old boy lying on the ground shiv-
ering next to a vehicle that’s overturned. He
complains of back pain. Nearby, a 51-year-old
female reports severe pain over the right scap-
ula and clavicle.
Following protocol, the patient is immobi-
lized, an IV is established, and she’s put on a
cardiac monitor.
Villagers help carry the patient during the
1.5-hour walk back to helicopter. Despite heavy
The Grande International Hospital ED team, Sanjaya Karki, MD, and Staff Nurse Saru Shrestha, assess the rain, the crew loads the patient into the heli-
patient and prepare her for transport. copter and heads back to Kathmandu.
Rescuers get in touch with the patients via injured tourists; however, it’s a very difficult EMS IN NEPAL
satellite phone and ask them to burn a fire place to land the helicopter. Before 2013, coordinated prehospital care didn’t
which they hope will reveal the accident site. Captain Thapa finds a place to land as close exist in Nepal, a landlocked country in South
In a few minutes, the crew sees a cloud of ris- as possible—about a mile (1.5 km) away from Asia that boasts a diverse, often harsh geogra-
ing smoke signaling the exact location of the the accident site. phy, including plains, densely forested hills and
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some of the tallest mountains in the Himalayas.
Although efforts have progressed in devel-
oping a ground ambulance service in the cap-
ital and largest city of Kathmandu, it delivers
only the most basic emergency care. People liv-
ing in remote regions of the country and the
thousands of trekkers and mountaineers who
visit trails and camps in the Himalayas are all
vulnerable to preventable deaths that occur due
to altitude-related illness or traumatic injuries.
Although private companies do provide air
rescue and transport of patients, they do so
without the ability to provide medical care.
The EMS team at GIH is changing all of
this. They’ve set up a system of integrated pre-
hospital emergency care built on evidence-based
practices, including dispatch, assessment, treat- The ED team from Grande International Hospital finally reach the patient after trekking through dense forest.
ment and communication protocols.
At GIH, a team of physicians and other HOSPITAL COURSE discharged and able to head back to France
healthcare providers are ready to be deployed Following communication protocol, the ED in good health. JEMS
on helicopters, armed with the right medical Department Head, Ajay Singh Thapa, DM, is
equipment for the patient, without any delay. briefed on the patient’s details and the ED staff Sanjaya Karki, MD, MBBS, is the coordinator of prehospital
Private companies continue to operate the greets the HEMS crew at the helicopter deck. emergency care and EMS at Grande International Hospital in
helicopters used by the team, and in the future In the ED, the patient is fully assessed Kathmandu, Nepal. He was the recipient of an EMS10: Inno-
they hope to have a dedicated HEMS aircraft. and treated. A few days later, the patient is vators in EMS award in 2016.
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1710JEMS_19 19 9/12/17 9:21 AM

SIMULATION SUCCESS
DESIGNING & BUILDING EFFECTIVE SCENARIOS
SUPPORTING SAFETY
Simulation techniques can improve patient safety
By Jennifer McCarthy, MAS, NRP, MICP, CHSE; Amar P. Patel, DHSc, MS, NRP;
Andrew E. Spain, MA, NCEE, EMT-P & Timothy Whitaker, BS, CHSE, CHSOS, EMT-P
“We must respect the past, and mistrust the present, if we wish to provide the safety of the future.” when used during an outlier or rare case that
—Joseph Joubert (French essayist and moralist, 1754–1824) these shortcuts can lead to a patient safety
concern or even a medical error.
T
here’s no doubt that in healthcare the mistakes, patient safety culture, pediatrics, Performing skills and procedures the
goal is to perform safely: safe to the provider mental health, stretchers and tran- way they’re supposed to be performed and
provider, safe to the patient, and safe sition of care.3 repeatedly practicing these in a controlled
to all those around us. This concept has been education environment is one sure way to
summarized into the term “patient safety.” A CULTURE OF SAFETY improve safety.
Many of the common definitions of patient Many leaders turn to the airline industry as
safety focus solely on the patient. The Insti- an easy example of improved safety culture. SIMULATION’S ROLE
tute of Medicine states that patient safety is In the late 1970s, when airline crashes were During a simulation activity, patient safety is
“the prevention of harm to patients,”1 while occurring on a frequent basis, the industry often an omnipresent focus and not identified
the Agency for Healthcare Research and went through an overhaul to ensure passen- as a single learning objective. This is espe-
Quality lists it as “freedom from accidental ger and crew safety. Medical errors are the cially true as learners move through curricula
or preventable injuries produced by medi- third leading cause of death in healthcare and become more experienced. Nevertheless,
cal care.”2 and EMS isn’t exempt from contributing to patient safety is a meta-objective that must
Despite this focus on the patient, the role the abysmal statistics.4 be present in every simulation activity. (See
of the healthcare provider remains critical. Ultimately, a patient safety culture stems our August column for more information on
The performance of the provider related to from the leadership of the organization. the concept of meta-objectives.)
the care of the patient determines whether Frontline providers must also have an under- For example, evaluating patient care during
a patient, and all those involved with patient standing and healthy appreciation for its movement and ensuring therapeutic commu-
care, remain safe and free of harm. importance. We need to shift our culture and nication with patients is occurring includes
EMS is a specialized patient service that attitude about errors and near miss reporting a focus on patient safety. The specific objec-
functions outside of a controlled environ- to understand the depth and breadth of the tives for the activity may not include safety
ment. Until recently, EMS education curric- safety issues in EMS. for the provider or to the patient, but they are
ula have overlooked patient safety initiatives Some organizations have a punitive sys- required and included as part of the exercise.
as a primary goal or an important aspect of tem in place in response to error reporting. Too often, participants attend simulation
EMS education. This causes providers to enact “Vegas rules” sessions and talk their way through skills
In 2005, the Center for Patient Safety while caring for patients in the prehospital instead of physically engaging in the activity.
(CPS) was established as an independent, environment. Transparency to capture an This undermines the effectiveness of simu-
nonprofit organization dedicated to reduc- error or near miss errors is paramount to lation and the necessary steps to promote a
ing medical errors. Much of the work of CPS understand ing the factors affecting EMS patient safety culture. It’s critical to have both
focuses on creating a patient safety culture. patient safety. novice and experienced participants perform
A safe culture is a foundation concept that Adding to the complexity of an EMS skills as closely to the evidence-based stan-
supports all healthcare activities at all times. patient safety culture are shortcuts taken with dards as possible.
The CPS is unique to other patient safety the purpose of expediting care. Normalization Consider assessing and debriefing how
entities in that it has an identifiable EMS of deviance is the term used when standards participants respond, react and are treated
focus, and has identified 10 safety goals that of practice modifies for perceived better- when an error or near error occurs. Devel-
intend to reduce patient errors and improve ment.5 During the majority of patient inter- oping a reporting mechanism to capture data
provider safety. The goals address current actions, this deviance doesn’t cause untoward from simulations that can help identify the
trends and those expected to grow in the outcomes and, over time, providers modify area of focus for improved EMS patient and
near future: airway management, bariat- their systematic patient care routines to adopt provider safety can only help improve our
rics, behavioral health, crashes, medication these perceived better procedures. It’s only patient safety culture.
1710JEMS_20 20 9/12/17 9:21 AM

In our upcoming column (published in 4. Bigham BL, Buick JE, Brooks SC, et al. Patient safety in emer- Andrew E. Spain, MA, NCEE, EMT-P, is the
the December issue), we’ll identify specific gency medical services: A systematic review of the literature. director of accreditation and certification
patient safety objectives and demonstrate Prehosp Emerg Care. 2012;16(1):20–35. for the Society for Simulation in Healthcare.
how simulation activities can be designed 5. Banja J. The normalization of deviance in healthcare delivery. He’s been a paramedic for more than 20 years
to support safety goals and help build and Bus Horiz. 2010;53(2):139. and is a nationally certified EMS educator.
strengthen a patient safety culture for your Contact him at [email protected].
agency. It’s important to embrace this import- Jennifer McCarthy, MAS, NRP, MICP, CHSE, Timothy Whitaker, BS, CHSE, CHSOS, EMT-P,
ant change in EMS philosophy to support is a founding member, associate professor and is a clinical educator at CAE Healthcare. He’s an
the safety of our patients and our prehospital director of the Paramedic Science Program at experienced simulation educator credentialed
care providers. JEMS Bergen Community College in Lyndhurst, N.J. by the Society for Simulation in Healthcare as
She’s a national presenter at both EMS and both a Certified Healthcare Simulation Educator
REFERENCES medical simulation conferences and has a passion about the (CHSE) and a Certified Healthcare Simulation Operations Specialist
1. Aspden P, Corrigan J, Wolcott J, et al., editors: Patient safety: use of medical simulation to advance learning within the EMS (CHSOS). Contact him at [email protected].
Achieving a new standard for care. National Academies Press: profession. Contact her at [email protected].
Washington, DC, 2004. Amar P. Patel, DHSc, MS, NRP, is the direc- Learn more from Jennifer McCarthy, Amar
2. PSNet. (n.d.) Glossary: Patient safety. Agency for Health- tor of the Center for Innovative Learning at Patel, Andrew Spain and Timothy Whitaker
care Research and Quality. Retrieved Aug. 27, 2017, from WakeMed Health and Hospitals. He has more in the full-day EMS Today preconference
http://psnet.ahrq.gov/glossary/p. than 20 years of experience in the fire and workshop, “Stimulating Simulation: A deep dive into EMS best
3. Center for Patient Safety. (2016.) EMS forward: 10 topics that EMS services, disaster medicine, and critical practice of simulation techniques,” held at the new, ultra-modern
will move EMS forward in 2017. Retrieved Aug. 27, 2017, from care transport as a firefighter, paramedic, researcher and MEDIC Simulation Center in Charlotte, N.C., on Feb. 20, 2018. Visit
www.centerforpatientsafety.org/emsforward/emsforward. educator. Contact him at [email protected]. EMSToday.com for more details and to register.
1710JEMS_21 21 9/12/17 9:21 AM

EVIDENCE-BASED EMS
INTERNATIONAL RESEARCH PERSPECTIVES
TARGETED INTERVENTIONS
Study examines older adults who repeatedly request EMS transport
By Sean J. Britton, MPA, NRP
FREQUENT FLYERS 1,711,669 EMS transports of 689,664 patients Discussion: This research is incredibly valu-
Evans CS, Platts-Mills TF, Fernandez AR, et al. being included the study. able to understanding repeated EMS transports
Repeated emergency medical services use Results: One key result was, “Among the among older adults since it utilizes a population
by older adults: Analysis of a comprehensive 689,664 older adults in the study, 20.6% within a large and diverse state over a period
statewide database. Ann Emerg Med. May 27, (141,852 older adults) had a repeated trans- of six years. An interesting finding is that the
2017. [Epub ahead of print.] port within 30 days.” One factor associated with rates of repeated transport within 30 days are
an increased chance of being transported again essentially the same whether the patient ini-
Have you ever transported the same patient within 30 days was residing within a healthcare tially received or refused transport by EMS.
more than once? The public may assume all facility vs. a private home (odds ratio, 1.42; 95% This research has practical applications
patients requesting 9-1-1 system for population health management,
response are truly in need of emer- which is increasingly involving par-
gency medical care, and very few ticipation from EMS. The most fre-
would be unfortunate enough to expe- The rates of repeated quent reasons identified for repeated
rience repeated life-threatening emer- transports—breathing problems, back
gencies within a short time period. transport … are essentially pain and psychiatric issues—are all
Background: As we know from chronic diseases. A focus within pop-
firsthand experience, not all patients the same whether the ulation health is to limit exacerbations
require lifesaving interventions, and at of chronic disease in order to reduce
least some of them will utilize EMS patient initially received the clinical and financial burden upon
more than once. Kudos to the authors the healthcare system.
of this study for performing research or refused transport. The researchers specifically noted
to better understand the factors asso- that mobile integrated healthcare or
ciated with repeated EMS use among community paramedicine referrals for
geriatric patients. confidence interval, 1.38–1.47), although the older adults could be made based on the dis-
Methods: The research team reviewed researchers noted the exclusion of interfacility patch complaints associated with higher rates
records entered into North Carolina’s Prehos- transfers may have understated this result. Older of repeat EMS transports. JEMS
pital Medical Information System (PreMIS) adults with dispatch complaints of breathing
from 2010 to 2015. Entering data into Pre- problems, back pain and psychiatric issues were Sean J. Britton, MPA, NRP, is an EMS prac-
MIS is required by law, therefore all patients the most likely to have a repeat EMS transport titioner, educator and administrator. He’s a
transported by EMS in N.C. during the study within 30 days, while those with dispatch com- paramedic with Superior Ambulance Service
period would have potentially been included. plaints of cardiac arrest and traffic accidents in Binghamton, N.Y., a board member of the
Researchers focused on emergency/9-1-1 were the least likely. NAEMT, and an adjunct assistant professor
responses where a patient, aged 65 years or older, The researchers also performed an analysis of epidemiology and community health at New York Medical
was transported to a hospital. This resulted in of the 6,559 older adults who had an encoun- College. Contact him at [email protected].
ter with EMS resulting in a patient refusal of
transport. Among this patient population, 1,271 Learn more from Sean Britton at the
BOTTOM LINE (19.3%) were transported by EMS to a hospital EMS Today Conference, Feb. 21–23, in
What we already know: Geriatric patients within 30 days of the initial transport refusal. Charlotte, N.C. EMSToday.com
may access EMS repeatedly within a short
period of time.
What this study adds: Understanding
Asian
factors behind repeat transports may help Association
develop and refine innovative approaches to for EMS
better managing geriatric healthcare needs.

U.S. Metropolitan Municipalities EMS Medical Directors Consortium (The “Eagles” Coalition)
1710JEMS_22 22 9/12/17 9:21 AM

STREET SCIENCE
CONVERSATIONS ABOUT EMS RESEARCH
A DIFFICULT CHALLENGE
Examining family presence during resuscitation
By Keith Wesley, MD, FACEP, FAEMS & Karen Wesley, NREMT-P
THE RESEARCH distress, the excessively heroic treatments, and With this knowledge, we can more effectively
De Stefano C, Normand D, Jabre P, et al. (June the violence, brutality and dehumanization communicate with them during the most
2, 2016.) Family presence during resuscitation: of resuscitation. intense and tragic of circumstances.
A qualitative analysis from a national multi- Actively encourage family members to be
center randomized clinical trial. PLOS One. MEDIC WESLEY COMMENTS present. Be less concerned with any perceived
Retrieved Aug. 29, 2017, from www.doi.org/ The focus of this study was the feelings of a liability of them witnessing our failures and
10.1371/journal.pone.0156100 patient’s family. Most of the family members more focused on their emotional needs. We
felt that by being present, they were able to almost always know early on if a resuscitation
THE SCIENCE see for themselves what was done to save their is going to be successful.
This study is a result of the PRESENCE trial loved ones. They also wanted to be present so We know the importance of “treating the
which randomized 570 French family mem- the patient wasn’t alone at the end of their life. family” in these cases. Connect with the fam-
bers, who were present in the home of a person During the years I worked in EMS and the ily early and determine which of these themes
in cardiac arrest, into either the intervention or ED, it was obvious that family members needed appears to be at play with the family’s emo-
control group. In the intervention group, the constant feedback during resuscitation. Often, tions. Then, honestly address them when you
resuscitation team routinely asked the fam- they wanted to be present, but the ED team broach the subject of their presence:
ily members if they wanted to be present at decided that the procedures performed during >> “I know that this can be hard to watch, but
the side of the patient being resuscitated. The resuscitation were too harsh for a non-medical some find great peace in being present to
control group didn’t actively ask family mem- person to deal with. That sentiment still holds hold the hand of their dying mother;”
bers, but allowed them to independently decide true for many providers. >> “You know everything important about
their presence. In the EMS setting, family presence was your father’s medical history and we need
They then categorized the family mem- always a given. They could stay in the room or your help in caring for him;”
ber’s perception of their reason to be pres- leave. We don’t get to call the shots unless the >> “We’re doing everything we can but it
ent or absent during the resuscitation. Four scene is unstable. Those opting to be present doesn’t look good at this point. Would you
themes emerged: for resuscitation often wanted to know what all like to be with him?” or
1. Choosing to be actively involved in the the procedures were. We would do our best to >> “If this is disturbing you, please feel free to
resuscitation, which reflected the person’s desire carefully educate them. Of course, there were go into the other room.”
to participate in the resuscitation process, feel times when the family presence was disruptive Take the opportunity to read this article and
emotionally able to be present, to support the because of anger or blame. share it with your colleagues. Respected pro-
patient during CPR and to witness the efforts I’m not sure if you feel this way, but having fessionals should consistently meet this diffi-
of the resuscitation. Those who declined to the family present, and being able to educate cult challenge. JEMS
be present felt they needed to protect them- and console them, always gave me a sense of
selves from witnessing the disturbing scenes closure on a call. I felt a greater sense of peace Keith Wesley, MD, FACEP, FAEMS, is the
of resuscitation. when I actively involved the family. I was an medical director for HealthEast Medical
2. Communication between the family advocate not only for the dying patient, but Transportation in St. Paul, Minn., and United
member and the emergency team so as to relay also for their family. The tragedies of this career EMS in Wisconsin Rapids, Wis. He can be
the patient’s medical information and develop take a toll on providers. Positive feedback from reached at [email protected].
a sense of satisfaction or dissatisfaction with families who actively participate in the resus- Karen Wesley, NREMT-P, is a paramedic and
the team’s efforts. citation is reassuring. educator for Mayo Clinic Medical Transport
3. Perception of the reality of death was and is the medic team leader for the Eau Claire
enhanced by the awareness of the patient’s DOC WESLEY COMMENTS County (Wis.) Regional SWAT team. She can
critical condition and solidified by observing I fully agree with Medic Wesley. However, be reached at [email protected].
the unsuccessful resuscitation. this study goes beyond confirming the reasons
4. Experience and reaction of the relative family members want to be present during Learn more from Keith Wesley at the
witnessing (or not) the resuscitation provided resuscitation. It also provides us with an under- EMS Today Conference, Feb. 21–23, in
a feeling of relief in relation to the patient’s standing of their motivations, fears and desires. Charlotte, N.C. EMSToday.com
1710JEMS_23 23 9/12/17 9:21 AM

AMBULANCES & PATIENT HANDLING
MOVING PATIENTS SAFELY & EFFICIENTLY
T
A
P
H
P
O
S
PHOTO COURTESY FERNO

y
o
B
L
Moving patients safely & efficiently

BINDER LIFT
Sponsored by:
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CONTENTS
26 INTRODUCTION: Building safety into our 38 GOING GREEN: Austin-Travis County EMS is on 47 REDUCING LIFT INJURIES: Common injury
designs & practices the forefront of sustainable vehicles patterns & techniques to improve patient lifting
28 THE ROAD TO SAFETY: What to focus on to 40 LIFTING & MOVING: A fresh perspective on 52 EMS GETS A LIFT: Firefighters help develop
improve ambulance safety safely handling patients innovative new patient lifting device
1710JEMS_24 24 9/12/17 9:21 AM

“ this is a
relationship
business,
& the relationship between
myself & Delaware County EMS
“
has been very good.
Tony Crum
Ambulance Sales, IN
Penn Care, Inc.
Here at Braun, we partner with our nationwide network of dealers to connect with customers on a local level.
Penn Care, Inc. is our regional dealer and Authorized Service Center for customers in D.C., Indiana, Kentucky,
Ohio, Virginia, West Virginia, and counties in western Pennsylvania. Their “go-to guy” for Indiana is Ambulance
Sales Representative & industry veteran, Tony Crum. He has been working with Delaware County EMS for 16
years! What started as a relationship helping remount existing units from another manufacturer, grew into an
opportunity to introduce them to the Braun brand & the long lifecycle it offers. The department now purchases
Brauns exclusively, with the goal to remount each unit 2-3 times before purchasing new again.
Br
Learn more about Tony & Delaware County EMS by visiting BraunAmbulances.com/DelawareCountyEMS
877-422-8315 In partnership with local dealer:
1710JEMS_25 25 9/12/17 9:21 AM

Building safety into our designs & practices

his month JEMS has put together
T
We then step outside of the ambulance, We hope this special section serves as a
a special section that focuses on where EMS crews are frequently called on to wake-up call for the EMS industry, empha-
improving ambulance design, oper- lift, move and transport patients who weigh sizing the need for our industry to make
ations and safety at your department to keep double or triple the recommended weight— safety-informed choices during ambulance
patients—and providers—safe and free from often with a crew of only two providers. design, adopt safe patient movement tech-
unnecessary injuries and death. In several of the articles in this special niques, and procure innovative lifting and
In our first article, “The Road to Safety: section, we take a highly focused look at lift- moving devices.
What to focus on to improve ambulance ing and moving, two of the most important We also hope it punctuates the need for
safety,” author Wayne M. Zygowicz, MS, but dangerous endeavors that EMS provid- more research that will contribute to the dis-
EFO, CFO, EMT-P, presents 10 key areas ers perform. The articles discuss innovative, semination of safe methods of lifting, mov-
that agencies should focus on when design- safe approaches to reducing injuries in order ing and transporting patients. JEMS
ing ambulances to improve safety and the to avoid the devastating, long-lasting conse-
longevity of the rig. He describes construc- quences that can occur by a single misstep. A.J. Heightman, MPA, EMT-P, is the editor-in-chief of
tion methods used by vehicle manufacturers JEMS, a speaker and presenter at EMS conferences around
to educate you on considerations that you A WAKE-UP CALL the world, and an EMS educator specializing in mass casu-
want to discuss as you work to plan, spec and Many of the changes and innovations have alty incident response.
purchase your next ambulance. This includes already been successfully implemented in
a look at EMS vehicle designs, construction the prehospital setting, as well as in hos- Learn more from A.J. Heightman at
and innovations from Europe, such as artic- pitals and the nursing industry, suggest- the EMS Today Conference, Feb. 21–23,
ulating seats which are now gaining popu- ing that we can minimize the incidence of in Charlotte, N.C. EMSToday.com
larity in the United States. injury in EMS as well.
1710JEMS_26 26 9/12/17 9:21 AM

1710JEMS_27 27 9/12/17 11:38 AM

What to focus on to improve ambulance safety

By Wayne M. Zygowicz, MS, EFO, CFO, EMT-P
P
roviding quality patient care in the back ambulance—how it’s constructed and main- (Above.) Having a proactive maintenance plan can
of a moving ambulance isn’t only chal- tained—is at the top of the list. Only recently prevent emergency run breakdowns, prolong the life
lenging, it’s dangerous and can lead to have some ambulance builders started to of the vehicle, avoid costly repairs and reduce costly
significant injury in a vehicle crash. A sudden develop effective solutions to these construc- vehicle downtime. Photo courtesy Wayne Zygowicz
stop, swerve or minor fender bender can result tion issues and adopt modern safety designs.
in serious injury to unrestrained passengers. As industry standards change, so will the we design it. Education is a key ingredient to
Over the last decade, there’s been a growing ambulances we purchase. New static and building a safe product that meets the needs
body of knowledge that suggests ambulance dynamic testing requirements will force some of our caregivers.
crashes are recurring events in our industry. builders to improve the crashworthiness of I’ve spent more than 20 years researching
Research and data collection on EMS injuries their products. construction methods and becoming edu-
and vehicle accidents have forced our industry Building EMS transport vehicles and fire cated on ambulance standards and design.
to recognize that we have a safety problem. trucks is part of my job and I don’t take those My research has taken me to U.S. ambulance
There are several interrelated factors that responsibilities lightly. People’s lives may factories where I’ve photographed different
affect ambulance safety. The design of the depend on what ambulance we buy and how production styles, and I’ve traveled overseas
1710JEMS_28 28 9/12/17 9:27 AM

to see firsthand how ambulances are manu-
factured abroad.
In this article, I share 10 key areas that can
enhance safety and improve the longevity of
your next ambulance. I also highlight construc-
tion methods that you’ll want to discuss with
your ambulance builder as you design your next
rig. Lastly, I compare EMS vehicle construc-
tion in the U.S. and Europe. I encourage you
to use these focus areas as discussion points to
improve ambulance safety at your department.
CURRENT STANDARDS
When it comes to ambulance construction,
the ambulance industry has had little national
oversight and few safety standards during the
past 40 years. The patient compartment, or
“box,” isn’t subject to standard automotive
safety regulations and has minimal structural
crash safety features.
The Federal KKK-A-1822F (KKK) stan-
dard, originally written for the purchase of A thoughtful, well-planned design will avoid costly construction and design mistakes that stay around for the
federal ambulances, was the industry’s only life of vehicle. Photo courtesy Wayne Zygowicz
standard and has seen many revisions.1
Although there are general references to ambu- vehicle standards now encompass remounts. NFPA 1917 recommends that all equip-
lance construction, safety wasn’t the basis for Remounted boxes will be required to incorpo- ment weighing more than three pounds be
this document. The KKK standard has since rate important safety aspects, such as stretcher mounted in a bracket that can withstand up
been replaced by two new standards: the mounts. For more on remounts, see “Rethink- to 10 Gs of force.3 An unrestrained cardiac
Commission on Accreditation of Ambulance ing remounts: Developing a national standard monitor can become a deadly missile during
Services (CAAS) Ground Vehicle Standard for ambulance remounts,” by Laura Aguirre, a quick deceleration or an abrupt lane change.
(GVS) v1.0 and the National Fire Protection in the August issue. If you’ve seen pictures of the patient compart-
Agency (NFPA) 1917.2,3 ment after a rollover, you wonder how anyone
The objective of both new standards is to DESIGN SPECIFICATIONS could survive being tossed around in a metal
improve safety through new design guidelines, Put a lot of extra time, effort and thought into box with heavy objects flying around.
performance standards and testing require- your design up front. Carefully design your Take your time in the design phase. Do
ments. Important items addressed in the stan- ambulance on paper, keeping crew comfort your homework and have your selected man-
dards include: occupant seating and restraint, and safety as top priorities. Develop a detailed ufacturer develop a solid set of drawings and
seat belt warning systems, cot and equipment set of drawings and specifications that lay out specifications. Gather a lot of input and care-
retention, tire pressure monitoring, carbon the plan. A committee made up of EMTs and fully review the drawings and specifications
monoxide monitoring, payload requirements paramedics who will use the vehicle regularly with your ambulance manufacturer before
and static and dynamic patient compartment should ensure the design is functional, user-
integrity testing. friendly and safe. A thoughtful, well-planned
Your first steps toward building a safer design will avoid costly construction mistakes
ambulance are to read and adopt the new that stay around for the life of vehicle.
safety standards. This may seem simple, but The patient compartment should be laid
some consumers don’t follow safety stan- out in exact detail. Seat location should allow
dards. Why? Because “change wouldn’t be for easy access to the patient, equipment and
popular,” or because of “our history and tradi- vehicle controls without providers having to
tion,” or because “that’s the way we’ve always constantly remove the seat belt. Kneeling in
done things.” The new standards are based on the aisle to start an IV because the seat was
sound research, data and safety testing. These installed in a bad location is the result of poor
guidelines are a collaborative effort to improve design specifications and may lead to injury.
ambulance safety. Educate yourself on the new All heavy equipment (e.g., monitors, oxygen
standards and adopt their recommendations cylinders, mechanical CPR devices, comput- Some manufacturers build ambulance boxes with
into your ambulance design. ers, medical kits, etc.) should be restrained or rounded corners, using extrusions to connect the walls
It’s important to note that the new ground kept in a secure cabinet. and the roof. Photo courtesy Wayne Zygowicz
1710JEMS_29 29 9/12/17 9:27 AM

weight. Always weigh your ambulance as it

leaves the factory and again when it’s fully
loaded with the crew inside.
To add a margin of safety, select a chassis
that exceeds your estimated payload. If you
don’t do this, you may find that your chassis
exceeds the recommended GVWR.
STRUCTURAL COMPONENTS
Most consumers don’t understand that all
ambulances aren’t created equal. Unless you
visit ambulance factories to see how each com-
pany builds their bodies, you’d assume that a
wall is just a wall. But there are actually struc-
tural variations hidden behind the finished
walls, ceiling and floor. When purchasing an
ambulance, you should learn what the struc-
tural components are made of and how they’re
assembled and held together.
Some manufacturers build their ambulance
box with rounded corners using extrusions
to connect the walls to each other and to the
Some ambulance manufacturers use spot welds, glues and double-sided tape to build walls; other build- roof. An extrusion is a hollow piece of rounded
ers incorporate welded seams. Photo courtesy Wayne Zygowicz molding that acts like a frame. Other build-
ers use formed parts that create an integrated
construction begins. Any changes you make CHASSIS & SUSPENSION SELECTION module using no extrusions. Solid body con-
after you sign on the dotted line become costly The chassis and suspension are extremely struction has square edges at the corners and
change orders. important to the overall safety of your vehicle. the roof line.
If you’re interested in a safer and more An undersized, overloaded ambulance chassis Wall and roof construction also varies
ergonomically designed ambulance, carefully moving down the road with lights and siren between builders. Some manufacturers uti-
review the Ambulance Patient Compartment is an accident waiting to happen. lize spot welds, glues and double-sided tape
Human Factor Design Guidebook, published by Gross vehicle weight rating (GVWR) is to build walls while other builders incorporate
the Department of Homeland Security.4 New the maximum operating weight (i.e., mass) fully welded seams.
research indicates that we need to change the of a vehicle specified by the manufacturer. The interior cabinetry can vary from wood
patient compartment layout to improve safety. GVWR includes the vehicle’s chassis, body, to metal to aluminum, and even plastic inserts.
The guidebook will help you develop a safer engine, engine fluids, fuel, accessories, driver, Even insulation can differ. One builder may
and more efficient patient compartment that’s passengers and cargo. Driving any vehicle over spray in an expanding foam insulation while
right for your service and the type of work you its GVWR leads to increased brake wear and another might use common household-type
need to do in it. makes stopping the vehicle problematic and insulation that’s glued to the walls.
dangerous, especially at higher speeds. The real integrity and strength of the ambu-
The type of work your agency does will lance body lies behind the finished walls. It’s
dictate your chassis options. Available payload obvious when you see some ambulance boxes
changes with each size chassis. For example, being constructed that they’re built stronger
a light chassis (GVWR 8,000–10,000 lbs.) than others. Educate yourself, ask the builder
may work well for an ambulance service that about their construction techniques, visit fac-
carries no firefighting gear and may not need tories and network with other users before you
external storage. make a purchase. Most ambulance manufac-
A light chassis will be easily overloaded if turers will gladly provide you with satisfied
you add the firefighting equipment used by customers you can speak with.
many departments: bunker gear, SCBAs, forc-
ible entry tools, thermal imagers, extrication SAFE SEATING
equipment, water/ice rescue suits, wildland People spend a lot of time sitting in ambu-
gear, mass casualty incident bags, fire extin- lances, so choose seating wisely. They have to
There have been vast improvements in seating guishers, hand tools, etc. be functional, comfortable and safe. They also
safety and range of movement. Inventory all equipment and supplies you have to clean up easily after bad calls.
Photo A.J. Heightman typically carry and carefully estimate the total The industry has seen significant safety
1710JEMS_30 30 9/12/17 9:27 AM

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1710JEMS_31 31 9/12/17 9:27 AM

One recent study stresses that forward- or

rear-facing seats provide better protection in
the event of an accident or evasive maneuver
than side-facing seats.4
I attended the RETTmobil (German for
“mobile rescue”) conference in Fulda, Ger-
many, where 300 international vendors were
exhibiting their EMS products. I noticed a
similar theme in every European ambulance:
There was no side-facing seating. Why are we
still riding sideways in U.S. ambulances? Is it
our history and tradition? Is it the original,
outdated KKK specifications?
It’s a challenge to design ambulance seats
and restraint systems that provide the neces-
sary crash protection and still allow responders
to access the patient, medical equipment and
supplies in an unrestrained manner. The new
European designs, which offer comfortable,
more compact and adjustable seats are slowly
being adopted by EMS services in the U.S.5
Ambulance insulation can vary; one builder may use spray-in foam insulation while another uses common
household insulation. Photo courtesy Wayne Zygowicz COT LIFTING SYSTEMS
With the rising cost of workers’ compensa-
improvements in ambulance seats. Manu- survivability.3 The standards also address tion injury claims, having an electric stretcher,
facturers are focusing on building products seat belts, head clearance, patient access, child hydraulic cot lifting system or lift gate system
that meet the Society of Automotive Engi- restraints and seat belt warning systems. Pur- will help reduce back injuries and possibly
neers (SAE) standards. Two SAE standards chase seats that meet these safety standards. extend the careers of crew members. At first
are SAE J2917: Occupant Restraint and Equip- One subject not covered in the new stan- glance, a lifting system may seem pricey, but
ment Mounting Integrity—Frontal Impact dards is seat direction. Have you ever won- they’re a great return on the initial invest-
System-Level Ambulance Patient Compartment; dered why there are no side-facing seats in ment. Operationally, cot lifting systems also
and J3026: Ambulance Patient Compartment U.S. automobiles? Many may feel that the make perfect sense with the increasing number
Seating Integrity and Occupant Restraint. old side-facing bench seat has worked well for of obese patients that EMS crews are called
NFPA 1917 requires dynamic seat test- 30 years, but it’s an unsafe riding position in upon to transport.
ing to improve occupant safety and crash the event of a crash, even with a seat belt on. A cot lifting system may be a mechanical
or hydraulic device that lifts the cot into the
patient compartment without requiring the
crew to physically lift it into the ambulance.
The currently available systems include inde-
pendent power cots, loading ramps, lift gates
and power loaders.
An advantage of using a ramp or lift gate
system is that it can accommodate a variety
of cots, along with other types of equipment,
such as incubators and balloon pumps.
One such system, Mac’s Lift Gate, sets up
in less than 60 seconds and the standard lift
gate can carry up to 750 lbs. A bariatric ver-
sion can lift up to 1,300 lbs. These lifts can
be installed on a new unit or retrofitted on
an older unit.
WARNING DEVICES
Driving emergency vehicles is a risky task,
With the rising cost of workers’ compensation injury claims, having a power stretcher or lift gate system will especially in a densely populated urban envi-
help reduce back injuries and possibly extend the careers of the crew members. Photo courtesy Mac’s Lift Gate ronment or busy highway system. Crew safety
1710JEMS_32 32 9/12/17 9:27 AM

YOU DO EVERYTHING YOU CAN.
SO DO WE.
At Demers, we never compromise. In saving lives, there is no “good enough.” That’s why
our ambulances are designed for safety and come loaded with innovative features that
help you excel at your job. Our testing exceeds North American safety standards
and we provide the lowest overall cost of ownership in the industry.
NEVER
COMPROMISE
demers-ambulances.com
800-363-7591
1710JEMS_33 33 9/12/17 9:27 AM

depends on other motorists seeing, hearing

and identifying your ambulance early enough
to move out of your way. When installed cor-
rectly, properly positioned emergency light-
ing and audible warning devices can enhance
crew safety.
Emergency lighting, scene lighting, loading
lights and ground lighting increase the visi-
bility of your ambulance and improve safety
both day and night. The location of emergency
lights and their color scheme should also be
carefully designed for maximum effectiveness.
Lighting packages that meet the new stan-
dards focus on warning zones, signaling modes
(“calling for the right of way” or “blocking the
right of way”), flash rates and patterns, light-
ing zones and power requirements.
Bright scene lights and loading lights sig-
The location of emergency lights and the color scheme around your vehicle should be carefully designed for nificantly improve provider safety. Chassis-
maximum effectiveness. Photo courtesy Wayne Zygowicz mounted LED ground lights can also add a
greater margin of safety for anyone entering
and exiting the ambulance and help you see
items placed or left on the ground.
Audible warning devices are essential
when responding to emergent calls. To be
effective, your siren must overpower the sur-
rounding environmental noises and pene-
trate the soundproofing insulation found in
modern vehicles. A siren should have ample
power, produce a wide spectrum of frequen-
cies and have multiple signaling modes. Sev-
eral new siren types emit low-frequency
sound waves that penetrate and shake solid
materials. These are very effective in urban
environments with heavy vehicle and pedes-
trian traffic.
Research what’s on the market, consult with
vendors and other users and buy a siren pack-
age that will be the most effective for the envi-
ronment you work in. For more on ambulance
warning systems, refer to the Ambulance Inno-
vations section of the October 2016 issue.6
VEHICLE VISIBILITY
Apparatus visibility and recognition are key
safety components. The ability of motorists
and pedestrians to recognize an approaching
ambulance or to see the vehicle when parked
is dependent on a number of interrelated fac-
tors: vehicle size, color scheme, conspicuity
markings, marker lights, active emergency
warning systems, motorist distractions and
environmental conditions. Studies suggest
that increasing the vehicle’s visibility using
New standards for vehicle visibility recommend retroreflective striping that forms a downward-sloping chev- retroreflective materials can improve safety in
ron pattern and covers at least 50% of rear-facing surfaces. Photo courtesy Wayne Zygowicz traffic and when parked along the roadway.7,8
1710JEMS_34 34 9/12/17 9:27 AM

Crew safety depends on other motorists providers, regardless of their age, experience MAINTENANCE
quickly identifying your approaching ambu- or maturity, should be trained on operating Modern ambulances are high-tech machines;
lance in any environmental condition: day an emergency vehicle. a comprehensive maintenance plan is essential
and night, rain, snow or low light conditions. A well-designed training program should to the safety of the occupants. Treat vehicle
New standards recommend increasing retro- include classroom time, behind-the-wheel maintenance as if the life of your crews and
reflective striping by 25% on the front and training and testing. Drivers should have an patients depend on it—because it may!
50% on each side.3 annual refresher training and baseline med- Having a proactive maintenance plan can
The rear of the vehicle should be equipped ical exam to verify their ability to physically prevent emergency run breakdowns, prolong
with retroreflective striping that forms a operate an ambulance. the life of the vehicle, avoid costly repairs and
downward-sloping chevron pattern and cov- Establishing standard operating proce- reduce costly vehicle downtime.
ers 50% of rear-facing surfaces. For maxi- dures (SOPs) for emergency vehicles is a Your builder should provide a local, repu-
mum visibility, red with alternating fluorescent must. SOPs provide direction and outline table warranty service location for their prod-
yellow or yellow-green stripes are the recom- expectations on how these very expensive ucts. Some manufacturers contract with a
mended colors. mobile emergency rooms should be driven local dealership trained in ambulance repair
Although this guideline is gradually being and maintained. to perform warranty service. It’s a must that
applied in the U.S., European ambulances Although vehicle monitoring, warning repairs be performed quickly and correctly
have met these standards for years. The use of and report-generating systems are effective, the first time.
high-visibility color schemes on ambulances it still takes SOPs to establish and maintain Make sure the dealership has emergency
and bright reflective safety clothing are com- operational compliance. Written guidelines vehicle technicians, compatible replacement
monplace outside the U.S. should include: intersection approach, max- parts, proper facilities and the appropriate
imum response speeds, driver responsivities, equipment to complete the job. Locate a local
TRAINING & PROCEDURES backing guidelines, warning device usage and towing service that can safely handle an ambu-
Ambulance safety doesn’t just happen; it vehicle limitations. lance when the truck isn’t operable.
requires a thoughtfully planned strategy. The Each accident and near miss should be
fundamental goal is to reduce accidents and fully investigated by a safety committee to IF NOT NOW, WHEN?
injuries through training and re-education. establish the root cause and determine what Real dangers exist in our current prac-
Driving an emergency vehicle is dangerous corrective action is needed to avoid future tices. Often, we choose to ignore them and
and the physical dynamics are complex. All injuries or damages. think that it won’t ever happen to us. The
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1710JEMS_36 36
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consequences of ignoring these dangers are and our patients. Safer practices save lives, groundvehiclestandard.org/wp-content/uploads/ 2016/03/
predictable and, likely, preventable. It’s time time and money. JEMS CAAS_GVS_v_1_0_ FinalwDates.pdf.
to focus on all aspects of the ambulance envi- 3. NFPA 1917: Standard for automotive ambulances. (2016.)
ronment and embrace the changes necessary Wayne M. Zygowicz, MS, EFO, CFO, EMT-P, is a 36-year vet- National Fire Protection Agency. Retrieved June 11, 2017, from
to advance safety in our industry. eran of the fire service and has served as a paramedic/fire- www.nfpa.org/codes-and-standards/all-codes-and-standards/
We must continue to raise awareness of fighter for over 30 years. Wayne has served as a division chief list-of-codes-and-standards/detail?code=1917.
the inherent dangers of our job and put our for Littleton (Colo.) Fire Rescue for the last 20 years. He holds 4. Ambulance patient compartment human factors design guide-
history and tradition aside to improve safety. a master’s degree in executive leadership, is a graduate of book. (February 2015.) United States Department of Homeland
Our loss of life is a quiet epidemic and the the National Fire Academy’s Executive Fire Officer Program Security. Retrieved May 15, 2017, from www.naemt.org/docs/
personal toll on families is enormous. The (EFO) and is a Certified Fire Officer (CFO) through the Center default-source/ems-health-and-safety-documents/health-
costs of addressing safety issues are small in for Public Safety Excellence. safety-grid/ambulance-patient-compartment-human-
comparison to the huge burden we’ll carry if factors-design-guidebook.pdf?sfvrsn=2.
we maintain the status quo. Learn more from Wayne Zygowicz at 5. Hildwine F. Take a seat: New ambulance seating improves
The efforts to improve ambulance design the EMS Today Conference, Feb. 21–23, safety, size & functionality. JEMS. 2016;41(10)38–42.
and safety have started, but there’s a lot of in Charlotte, N.C. EMSToday.com 6. Zygowicz WM. Lights and sirens: Improving the safety of the
work ahead of us. Multidisciplinary teams sights & sounds of EMS. JEMS. 2016;41(19):30–36.
of healthcare professionals, safety engineers, REFERENCES 7. Emergency vehicle safety initiative. (February 2014.) United
regulatory bodies and ambulance manufac- 1. Federal specifications for the star-of-life ambulance. (Aug. 1, States Fire Administration. Retrieved Jun. 10, 2017, from
turers have begun to provide our industry 2007.) U.S. General Services Administration. Retrieved June 1, 2017, www.usfa.fema.gov/downloads/pdf/publications/
with the research and data we need to be from www.nasemso.org/Projects/AgencyAndVehicleLicensure/ fa_336.pdf.
informed consumers. documents/KKK-A-1822F-08.01.2007_000.pdf. 8. Emergency vehicle visibility and conspicuity study. (August
The real question is, will our culture allow us 2. Commission on Accreditation of Ambulance Services. (March 2009.) United States Fire Administration. Retrieved Jun.
to change or will it be a barrier to our progress? 28, 2016.) Ground vehicle standards for ambulances. Ground 10, 2017, from www.usfa.fema.gov/downloads/pdf/
Let’s improve safety for our EMS providers Vehicle Standard. Retrieved June 10, 2017, from www. publications/fa_323.pdf.
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1710JEMS_37 37 9/12/17 9:27 AM

PHOTOS COURTESY MICHAEL O. BENAVIDES/AUSTIN-TRAVIS COUNTY EMS

Austin-Travis County EMS is on the forefront of sustainable vehicles
By Michael O. Benavides, EMT-P
T
wo of the biggest cost drivers for any identified as a target that could potentially a reliable system that provides power to the
EMS agency are vehicle maintenance save money and reduce energy consumption. patient care compartment without keeping
and fuel costs. Some key suggestions In 2010, as part of the city of Austin and the engine running.
for increasing fuel efficiency and reducing fuel ATCEMS’ Green initiative, solar panel sys- In order to create a system that would
and maintenance costs include reducing speed, tems were installed on some of the vehicles in meet ATCEMS’ needs, Stealth Power and
avoiding excessive idling and removing excess the fleet. The solar panels allowed ambulances ATCEMS entered into a public-private
weight. Obviously, many of these suggestions to be turned off at the hospitals during the day partnership. Stealth Power would develop a
present challenges to any EMS agency. In while the sun kept the batteries charged, so green-powered battery for use on ambulances,
most cases, our normal course of operations the ambulance would restart. and ATCEMS would provide an ambulance
run contrary to these tips. During this time, we also learned that one to Stealth Power for installation, testing and
Austin-Travis County EMS (ATCEMS) of our public safety partners was using a bat- proof of concept of their battery system.
has always searched for new and innovative tery system to power onboard cameras when After a three-year collaboration, the part-
solutions for greater safety, improved effi- their patrol cars were turned off. nership yielded a cutting-edge, green mobile
ciency and reduction in operational costs— ATCEMS contacted their system sup- technology called the Stealth Power EMS
all while having little to no negative impact on plier, Stealth Power, to see if we could work series. In 2012, the first operational model was
service quality. together to develop an ambulance-specific installed and tested over the course of a year
Ambulance idle time was one area we green energy solution. Our goal was to develop and produced very positive results.
1710JEMS_38 38 9/12/17 9:27 AM

HOW TO INCREASE FUEL EFFICIENCY & REDUCE MAINTENANCE COSTS
>> Avoid speeding, rapid acceleration and type of system, e.g., urban or rural). An
braking. This will lower your gas mileage idling ambulance can burn 0.25 to 1.5
by roughly 15–30% at highway speeds gallons of fuel and can cause 35 to 50
and 10–40% in stop-and-go traffic. miles worth of wear and tear on the
>> Reduce vehicle operation speeds to engine (dependent on engine size and
below 50 mph. Every 5 mph you drive air conditioner/accessory use).
over 50 mph is equivalent to paying an >> Limit engine start-ups to approxi-
additional $0.16 per gallon per gas. mately 10 per day.
>> Remove excess weight. An extra 100 >> Limit electric accessory use during
lbs. in your vehicle could reduce your shutdown.
miles per gallon (MPG) by about 1%.
>> Avoid excessive idling. Historically, REFERENCE
Austin-Travis County EMS (ATCEMS) entered into a ambulances idle 24 hours for every 1. Driving more efficiently. (n.d.) U.S. Department of Energy.
public-private partnership with Stealth Power and one hour of drive time (dependent on Retrieved Aug. 31, 2017, from www.fueleconomy.gov.
green-powered electrical systems have now been
installed in more than 40 ATCEMS ambulances.
technology has allowed ATCEMS to: Compatibility issues (retrofitting vs. origi-
In subsequent years, the Stealth Power >> Reduce greenhouse gas emissions, thereby nal factory install); new price points; unfore-
EMS system was installed on all new ambu- reducing our department’s carbon footprint; seen issues that get resolved with subsequent
lances, and in 2014 our ambulance man- >> Save money by reducing fuel costs from updates; lack of long-term supportive data
ufacturer began installing the battery idling engine time; (the 2017 models will provide battery
systems at their manufacturing facility in >> Reduce engine hours, thereby reducing usage data); and the cultural and behav-
Orlando, Fla. vehicle maintenance costs; ioral changes for the workforce (e.g., pow-
To date, green-powered electrical systems >> Employ a new technology with very lim- ering down parked ambulances, confidence
have been installed in more than 40 ATCEMS ited training required; in vehicle performance and climate control
ambulances. >> Utilize an accessory battery switch to jump- during extreme heat or cold).
start a dead engine battery, thereby reduc- In an ever-increasing search for renewable
BENEFITS ing out-of-service maintenance time; and and sustainable energy, ATCEMS considers
Reduced emissions and noise from idling >> Provide positive public relations informa- itself on the forefront of these innovations.
engines not only help to improve our envi- tion to the community about our innova- Although this singular initiative may appear
ronment, but also help to improve the working tive and cost-efficient approach. inconsequential, as part of a larger commu-
conditions of emergency personnel. nity initiative the net effect can yield signif-
On any given day, there are multiple vehi- CHALLENGES icant results. JEMS
cles idling outside an ED. Breathing in toxic As we know, there are always challenges,
emissions and the stress caused by hearing not only in the introduction of new processes Michael O. Benavides, EMT-P, is the primary public informa-
the repetitive, loud noise of the idling engine and equipment to your workforce, but even tion officer for Austin-Travis County EMS, where he’s worked
are eliminated when the vehicle is turned off. more so as an early adopter of new tech- since 1993. He previously served as a commander with the
Additionally, the Stealth Power green nology. Some of these challenges include: Special Operations section.
The “powered by green energy” logo has been placed on Austin-Travis County EMS ambulances to inform the community and highlight the agency’s efforts in utilizing
renewable green energy.
1710JEMS_39 39 9/12/17 9:27 AM

LIFTING & MOVING

A fresh perspective on safely handling patients
By Niklavs Eglitis, BS, NRP; Emily Corrigan, BS, NRP; Marc Sweeney, BS, NRP;
John Pierce, MBA, NRP & Walt Stoy, PhD, EMT-P
L
ifting and moving are among the most causing the EMS crew and patient to fall. The Innovative patient moving technology, such as the
important but dangerous endeavors paramedic sustained a serious injury to his back. Binder Lift (shown above), powered ambulance
in which EMS providers engage. The Due to the typical “I don’t need help, I’m lifts, and powered stretchers are designed to min-
consequences of a misstep can be devastating here to help you” attitude of an EMS pro- imize loads on the musculature of providers while
and long-lasting. vider, the paramedic chose to continue work- improving patient safety and comfort.
Consider the case of a healthy paramedic ing and not allow his injury to properly heal. Photo courtesy Tri Community South EMS
in a large municipal service. He was a former As a result, his pain worsened until he could
kickboxer and avid weightlifter at the time no longer sleep. five operations, he’s largely confined to a mobil-
of his injury. The constant fatigue, coupled with chronic ity scooter with a service dog to help him per-
On the day he was injured, he was taking pain, caused negative changes in how he was form basic tasks.
a patient down a flight of stairs on a flexi- perceived by his colleagues and supervisors. In 2014, there were over 21,000 EMS pro-
ble Reeves stretcher. As he and his partner Eventually, his extended time on disability viders treated in hospital EDs, with over one-
were descending the stairs, the patient moved, forced him into retirement. Today, following third being the result of overexertion of the
1710JEMS_40 40 9/12/17 9:28 AM

provider. Half of that number was from lifting and moving the patient.1 Table 1: Weights of commonly used EMS equipment
These numbers from the Centers for Disease Control and Prevention
Equipment Weight
(CDC) don’t include the injuries sustained from lifting and moving
that aren’t seen in EDs. Ferno iNX patient transport and loading system 192 lbs.
According to U.S. Department of Labor, the risk of injury among
Ferno EZ Glide evacuation stair chair 37 lbs.
EMS providers is more than three times greater than risks among
other private industry occupations (349.9/10,000 vs. 122.2/10,000).2 Stryker Power-PRO XT powered ambulance cot 125 lbs.
These numbers have remained largely consistent over the course of
the last 10 years, and the lack of improvement suggests that it’s time Stryker Performance-PRO XT manual cot 89 lbs.
for a change in our archaic system.
Philips HeartStart MRx monitor/defibrillator 13.2 lbs.
In this article, we begin by discussing a possible reason behind our
significant injury rates. We then discuss possible changes in three sep- Physio-Control LIFEPAK 15 monitor/defibrillator 18.9 lbs.
arate domains that, if implemented, could serve to decrease the inci-
dence of injury among EMS providers. ZOLL X Series monitor/defibrillator 11.7 lbs.
THE LIFTING EQUATION quadruple this weight. (See Table 1.) Such great weight, when it’s lifted
In 1994, the National Institute for Occupational Safety and Health call after call and year after year, may be why injury rates in EMS have
(NIOSH) published a revised lifting equation consisting of six fac- remained unacceptably high.
tors, including the load constant, the distance the object is from the Furthering this point, a 1999 study published by the Journal of
person who’s lifting and the vertical height the object is lifted. This Applied Ergonomics showed that even with a cooperative 110-lb. (50 kg.)
equation was later revised to have greater application to other indus- patient (who had no use of his legs), the compression force exerted on
tries, including healthcare. When calculated out, the revised equation the spine far exceeded the recommendations set by NIOSH of approx-
equals approximately 35 lbs.3,4 imately 3,400 newtons, above which the risk of a lower back injury is
This number may seem shockingly low because the weights EMS increased by over 40%. The newton (N) is the International System of
providers routinely lift on a call easily may be double, triple, or even Units (SI) derived unit of force. It measures the force that produces an
1710JEMS_41 41 9/12/17 9:28 AM

Figure 1: Two-person hook lift

Medical Transports for UTV
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acceleration of 1 meter per second squared on These controls have been successfully imple-
a mass of 1 kilogram. mented by the nursing industry to minimize
In a two-person traditional hook lift, the lower back injury among providers, and will
maximum compression forces on the spine hopefully be implemented in our own indus-
For safe off-road, sports facility, and averaged out to about 4,702 N for each provider try soon.
tight space patient transport. The KIMTEK while lifting and 4,513 N while lowering; the Nursing as a profession, and especially nurs-
Medlite Transport will transform the lifting movement is over 1,300 N greater than ing homes, have been on the front lines in terms
cargo box of your UTV/Side by Side into
the NIOSH recommendation. (See Figure 1.) of research on safe lifting and moving prac-
a professional EMS transport device.
When the single-person “hug” technique tices, and in translating research into practice
NOTE: Stretcher, long board and stokes baskets are not included.
for lifting the patient is performed, the total to minimize injury among their personnel.
MTD-103
Advanced Level newtons of compression on the spine rises to
installed in 6,336.3 N for the lifting portion and 6,007.9 Figure 2: Single-person “hug”
John Deere
Utility Vehicle N for the lowering portion. (See Figure 2.) technique for patient lifting
Both of these numbers are nearly double the
NIOSH recommendations.
It’s notable that these figures pertain to a
patient who, although a paraplegic, was coop-
erative and weighed only 50 kg.5,6 We know
from experience that the patients EMS pro-
viders regularly encounter, even for routine lift
Call KIMTEK Today! assists, can weigh double or triple this amount.
1-888-546-8358 or see us at... Coupled with variations in patient men-

tal status, physical condition, and the awk-
KIMTEKRESEARCH.com ward locations in which we find patients, the
compression forces exerted on the spine on a
shift-to-shift basis likely far exceed the num-
bers seen in this study.
As we’ve seen in the case study in the intro-
KIMTEK CORPORATION duction and from the numbers presented, a
326 Industrial Park Lane, Orleans, VT 05860 change in how we handle lifting and moving
is clearly needed. In the following section, we
will discuss three controls: 1) administrative;
2) engineering; and 3) behavioral.7
Medical Transports for UTV Fire/Rescue for UTV
www.jems.com
For more information,
1710JEMS_42 42 9/12/17 9:28 AM

Unfortunately, EMS has largely lagged behind in these vital areas be hard-pressed to find even a single class on the topic of lifting and
of patient care and occupational safety; as a result, our rates of injury moving, despite the fact that this task is performed on a daily basis.
have remained unacceptably high. An examination of the 212-page document, National Emergency
The peer-reviewed journal, The Online Journal of Issues in Nursing, Medical Services Education Standards: Emergency Medical Technician
published a three-pronged, evidence-based approach for reducing Instructional Guidelines 2009, revealed only four pages containing
musculoskeletal injury among providers.7 information regarding safety, lifting and wellness—that’s 1.88% of
The first prong is “administrative controls,” which entails the imple- the entire document.9
mentation of policies and protocols from management that would The “Lifting and Moving Patients” section of these four pages
minimize the risk of injury during the performance of strenuous lift- defines three types of movements: 1) emergency; 2) urgent; and
ing and moving tasks. 3) non-urgent. However, outside of stating common sense safety mea-
The second prong is “engineering controls,” which is the use of sures such as “communication” and “keeping weight close to your torso,”
patient handling technologies to limit strain on providers while per- no substantive discussion of how to perform these moves exists, forc-
forming lifting and moving tasks. The third prong is “behavioral con- ing instructors to teach from their own subjective experiences rather
trols,” which is the improvement in education regarding proper lifting than an empirically grounded and objective source.9
techniques and maintenance of a healthy lifestyle so these tasks can Unfortunately, lifting and moving tends to get buried in the vastness
be performed efficiently and safely.7 of the national education guidelines, resulting in instructors focusing on
All of these factors are currently deficient in EMS, and if there’s topics that have been problematically characterized as “more important.”
any hope of minimizing injury and implementing a culture of safety, Our early training experience demonstrates that, of the 150 hours
improvements in these three areas are imperative. required to become an EMT-B, approximately 20 minutes were spent
on learning the concepts of lifting and moving. Yet, research has shown
ADMINISTRATIVE CONTROLS that the three most common causes of injury are force (i.e., the weight
The CDC reports that roughly 2 out of 3 American adults are con- of a patient and/or equipment), repetition, and awkward positioning.10
sidered overweight (i.e., body mass index [BMI] > 25) and more than These three factors show the danger of inadequate education regard-
one-third of American adults are obese (i.e., BMI > 30).8 ing lifting and moving: A provider who’s been improperly taught how
Because of the increased cardiovascular, pulmonary and musculo- to lift will lift patients who exceed his or her ability (i.e., force), will
skeletal risks associated with being overweight or obese, EMS pro-
viders are encountering these patients with ever-increasing frequency
and, as such, administrative procedures pertaining to these patients
must be changed from the bottom up.
Precious Cargo • Handle with Care
A policy should be created that empowers dispatch personnel to
ascertain the estimated weight of the patient so adequate resources • Medical Director
and personnel can be sent to the scene. approved
Next, every state EMS office should create a protocol for dealing • No harmful traction
with obese patients. (See Figure 3, p. 45.) This protocol would include • Truly “one-size-fits-all”
the number of providers sent to a scene based on patient weight, spe- • Comfortable and
easy to apply
cialized equipment that must be utilized, and the designation of safety
officers who can oversee or assist in removing the patient from his or S TA B I L I Z E I N P L A C E
her home and into the ambulance.

Removing obese patients from their homes can carry equal levels
of risk to EMS personnel as extricating a patient from their vehicle;
CERVICAL SPLINT
so, similar safeguards must be put into place.
As with any protocol, special reports justifying deviation from the
protocol must be filed and if it’s ruled that no justification exists or
there’s a pattern of neglecting the protocol, remediation and re-edu-
cation must occur. If that doesn’t alleviate the issue, penalties should
be put in place.
Although repercussions for lifting and moving infractions may seem
harsh, the reality is that overestimating how much you or your partner
can lift can result in injury to both you and the patient. As with any
Find out why the SIPQuik Vacuum Cervical Splint is
error in patient care, safeguards must be put into place.
the new standard of care in c-spine stabilization.
BEHAVIORAL CONTROLS
One of the pitfalls of the current EMS education system is that lifting
and moving isn’t seen as a topic worthy of consideration. Although
continuing education opportunities are filled with classes on topics (949) 679-7760 • www.care2innovations.com
like emergency cricothyrotomy and even ultrasonography, one would For more information, visit JEMS.com/rs and enter 24.
1710JEMS_43 43 9/12/17 9:28 AM

perform movements incorrectly (i.e., awk- Classroom scenarios often begin with the EMS providers are prone to work-related
ward positioning), and will repeat the incor- patient on the floor and end with the student injuries, and developing poor lifting and mov-
rect movements (i.e., repetition)—a trifecta verbalizing how they’d move the patient for ing habits is one of the quickest ways to end a
that raises the risk of injury to the provider.10 transport. Rather than simply verbalizing this, career and negatively affect daily life.
Research has also shown that, in order EMS educators should prioritize the hands-on
to prevent this, the provider must remain practice of field techniques in the safe envi- ENGINEERING CONTROLS
conscious of the lifting and moving process ronment of the classroom. As in other areas of patient care, lifting and
throughout the call. For instance, moving has experienced a rapid
using one strap to carry the first-in expansion of technology. Alternative
bag can be dangerous if the provider
doesn’t consciously keep their back Overestimating how much lifting devices such as the Binder
Lift, CombiCarrier II from Hartwell
straight, which illustrates the impor-
tance of maintaining a conscious- you or your partner can Medical, the Ferno Scoop Stretcher
and others have multiple handles
ness of good body mechanics for the
entirety of a call. lift can result in injury to to facilitate lifting assistance from
additional responders.
To lift and move safely, infor-
mation is available for providers in both you & the patient. Driven by industry leaders Ferno
and Stryker, significant innovations
training and their instructors. In in the traditional patient movement
EMS training, the topic shouldn’t be apparatus have been implemented.
glossed over, but repeatedly reviewed through- EMS providers shouldn’t leave the class- These innovations are designed to minimize
out the period of instruction. room without demonstrating proficiency in loads on the musculature of the providers while
In the psychomotor portion of the class, lifting and moving, in order to prevent injury improving patient safety and comfort.
while performing scenarios, body mechanic not only to themselves, but to their partners Traditionally designed stretchers have either
critique should be focused on, and repetition and the patient. The classroom is an optimal an X-frame or an H-frame, and the force pro-
of these movements should be done weekly. place to make mistakes and learn, not the field. vided by the EMS providers has typically pow-
ered it. Although this sort of stretcher has
existed for decades and has proven to be effec-
tive, the strain it places on providers’ backs is
unacceptably high.
UNIT 148
Fortunately, power stretchers are now prov-
ing to be a major improvement in lifting and
moving technology in regard to musculoskele-
tal strains and sprains among EMS providers.
THE SENTINEL (See Figure 4, p. 46.) One recent study found
360 Pound Capacity that power stretchers result in reduced muscle
activity from six different areas on the body
. $690
r s . ......... when operated by a provider.11
e
Reclin nd Using 16 EMS providers as subjects, elec-
a 1065
S o fa s
t s .. ...... $ tromyography (EMG) activity was measured
ea
Loves with electrode placement at six different loca-
tions on the body (forearm flexor, bicep, mid-
dle deltoid, right descending trapezius and
bilateral erector spine).
THE XTINGUISHER The stimulation of these muscle groups
THE SENTRY was measured when the providers oper-
AMERICA
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AMERICA STR
MERICA S
STRONG
RON
RO
RONG
ONG
ated both stretchers, and also when different
amounts of weight were placed on the stretch-
Call Toll Free: ers. Research results showed statistically sig-
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nificant reductions in muscle activity.11 These
reductions in muscle activity may result in fewer
injuries, leading to a longer career in EMS.
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1710JEMS_44 44 9/12/17 9:28 AM

Figure 3: Example flow chart of protocol for lifting and moving
patients based on weight
Patient contact and assessment initiated
Patient weight
determined or estimated
≥ 450 lbs. ≥ 250 lbs. < 250 lbs.
Minimum of 4 Normal patient

Unstable Stable personnel needed to lifting and moving
lift and move patient techniques
Bariatric Every additional

ambulance to 100 lbs. requires an
be considered added individual Great Content
Transport patient < 450 lbs. continue
Approved CE
normal care and
with resources and
available personnel transport methods Anytime Access
In one study, Ferno showed the effective- In a service with an average of 3,000 calls Get accredited EMS Continuing
ness of the power stretcher, specifically the per year, the replacement of manual lifting Education (CE) courses on demand.
iNX model. In the study, the iNX was oper- with new technology-supported lifting con- 24-7 online courses show realistic
ated in comparison to another power stretcher tributed to a significant reduction in provider emergency events and feature
(Stryker Power-PRO). Each stretcher was to be injuries: Lost work days due to injury were noted subject experts.
loaded and unloaded with different amounts of reduced from 113 to zero. Notably, stretch-
weight into an ambulance, with each side of the er-related workers’ compensation claims also
ambulance (left, right front, back) tilted at 3°.12 went down 28% within two years.13
The experiment determined that the iNX This makes it hard to overlook the impact
could support the maximum amount of weight that power stretchers can have on providers, as
(700 lbs.) at four out of the five angles. The this evidence demonstrates a reduction physi-
Power-PRO was also able to support 500 lbs. cal strain experienced by EMS workers. Visit booth #1035
and more at three out of the five positions.12 In addition, the impact of these power at EMS World Expo in
It’s notable that the power stretchers aren’t stretchers allowed Century Ambulance to Las Vegas and see our
exactly the same, as they come from two differ- become more comfortable with how their newest courses.
ent companies. However, the importance of the patients are lifted and moved in the field,
power stretcher is clear from the study. When decreasing manpower demands and overall
incorporated as an everyday piece of equip- costs for the company.13
ment, this new technology can reduce pro- The incorporation of technology in EMS
vider strain and accommodate the increasing has enhanced many regularly utilized devices
size of patients encountered in the field today. like the stretcher, and many EMS agencies are
In another study, conducted by Stryker, taking advantage of the new and innovative
researchers analyzed the overall macro equipment now used in the field.
impact of the power stretcher. The study Raymond Everitt, division chief for the city
focused on one EMS agency in particu- of Pittsburgh EMS, reports that it will obtain
lar, Century Ambulance, which used many power stretchers for its entire EMS fleet (13
Power-PRO units to replace their previous units). With an estimated cost at $40,000
manual stretchers.13 per unit installed (for a total of $520,000),
Visit: 24 -7.hsi.com
www.jems.com
For more information,
1710JEMS_45 45 9/12/17 9:28 AM

Figure 4: Ferno iNX (left) and Stryker Power-PRO (right) are two widely used power stretchers
Pittsburgh EMS is making the purchase with the intended goal of John Pierce, MBA, NRP, is an instructor in emergency medicine in the Department of Reha-
reducing injuries to their personnel. Although this cost to a munici- bilitation Science and Technology at the University of Pittsburgh School of Health and Reha-
pal agency with a limited budget is significant, these high-technology bilitation Sciences. Contact him at [email protected].
stretchers and self-loading systems should be viewed as an asset to the Walt Stoy, PhD, EMT-P, is professor and director of emergency medicine in the Department
city and future benefits may well outweigh the financial cost. of Rehabilitation Science and Technology at the University of Pittsburgh School of Health and
Everitt further reports that Pittsburgh EMS has paid 19 workers’ Rehabilitation Sciences. Contact him at [email protected].
compensation claims related to on the job lifting and moving injuries,
totaling $215,000 over the past two years. REFERENCES
New investments in power stretchers have the potential to mark- 1. National Institute of Occupational Safety and Health. (Sept. 6, 2016.) Emergency medical ser-
edly reduce these claims. Tri-Community South EMS in Bethel Park, vices workers injury and illness data. CDC.Gov. Retrieved Mar. 11, 2017, from www.cdc.gov/
Penn., has sought to improve conditions for their employees by inte- niosh/topics/ems/data.html.
grating Binder Lifts, power load systems and power stretchers into 2. Maguire BJ, Smith S. Injuries and fatalities among emergency medical technicians and para-
their daily operations. medics in the United States. Prehosp Disaster Med. 2013;28(4):376–382.
Nora Helfrich, the director of Tri-Community South EMS, notes, 3. Waters TR, Putz-Anderson V, Garg A, Fine LJ. Revised NIOSH equation for the design and eval-
“We have had no injuries to employees since purchasing these three uation of manual lifting tasks. Ergonomics. 1993;36(7):749–776.
pieces of equipment.” 4. Waters TR. When is it safe to manually lift a patient? Am J Nurs. 2007;107(8):53–58.
5. Marras WS, Davis KG, Kirking BC, et al. A comprehensive analysis of low-back disorder risk and
CONCLUSION spinal loading during the transferring and repositioning of patients using different techniques.
This work argues that a reduction in injury rates of EMS providers Ergonomics. 1999;42(7):904–926.
will be fostered by careful and considered improvements in three areas 6. Zwedling D. (Feb. 11, 2015.) Even ‘proper’ technique exposes nurses’ spines to dangerous forces.
of control: administrative, behavioral, and technological/engineering. National Public Radio. Retrieved Mar. 1, 2017, from www.npr.org/2015/02/11/383564180/
With results showing a significant decrease in injuries, services like even-proper-technique-exposes-nurses-spines-to-dangerous-forces.
Pittsburgh EMS are taking notice. Not only is this change financially 7. Nelson A, Baptiste AS. Evidence-based practices for safe patient handling and movement. Online
responsible, but more importantly, it promises to lengthen the careers J Issues Nurs. 2004;9(3):4.
and ensure the continued health of EMS providers. 8. Flegal KM, Carroll MD, Kit BK, et al. Prevalence of obesity and trends in the distribution of body
The EMS community needs more research devoted to the topic mass index among US adults, 1999-2010. JAMA. 2012;307(5):491–497.
of proper lifting and moving in order to underscore its importance to 9. National Highway Traffic Safety Administration. (January 2009.) National emergency medical
prehospital care and to create new, safer methods of lifting and moving. services education standards. NHTSA Office of EMS. Retrieved March 2, 2017, from www.ems.
By continuing to invest time and resources in administration, edu- gov/pdf/811077a.pdf.
cation and technology/engineering, EMS systems will build better 10. Limmer D, O’Keefe MF. Emergency care, 13th edition. Pearson: Boston, 2016.
cultures and more rigorous practices of safety for their providers and 11. Sommerich CM, Lavender SA, Radin Umar RZ, et al. Powered ambulance cots: Effects of design
patients. JEMS differences on muscle activity and subjective perceptions of operators. Proc Hum Factors Ergon
Soc Annu Meet. 2013;57(1):972–975.
Niklavs Eglitis, BS, NRP, is a graduate of the University of Pittsburgh School of Health and 12. Frederick K, Bravo I, Cartner J. (2016) Comparison of Multiple Loading Scenarios for Emergency
Rehabilitation Sciences. Contact him at [email protected]. Cots & Loading Systems. Ferno. Retrieved March 2, 2017, from www.paramedicchiefs.ca/docs/
Emily Corrigan, BS, NRP, is a graduate of the University of Pittsburgh School of Health and bcs-tomembers/ferno/8.4.16-Cot%20Comparison%20Gray-V2.pdf
Rehabilitation Sciences. Contact her at [email protected]. 13. Stryker Power-PRO powered ambulance cots help private EMS company reduce lost workdays
Marc Sweeney, BS, NRP, is a graduate of the University of Pittsburgh, School of Health and from 113 to zero. (2011.) Stryker. Retrieved March 2, 2017, from http://ems.stryker.com/-/media/
Rehabilitation Sciences. Contact him at [email protected]. medical/ems/attachments/casestudies/century_ambulance_casestudy_mktlit192revc.ashx.
1710JEMS_46 46 9/12/17 9:28 AM

Common injury patterns & techniques to improve patient lifting
By Bryan Fass, ATC, LAT, CSCS, EMT-P (ret.)
A
culture of safety is a big thing for the United States and are a particular problem (Above.) Safe patient and equipment handling must
all first responders; in fact, it’s in EMS and firefighting, where at any given be constantly trained and retrained to avoid strains
everything. As we all know, when time nearly 10% of the workforce is out of and injuries. Photo courtesy Binder Lift
exposure to risk is mitigated, life is eas- work from injury.1
ier for everyone. But—and there’s always a The Centers for Disease Control and patient handling technology ever available
but—what do we do when a safety culture Prevention (CDC) monitors first responder to the industry, including power stretchers,
is broken? Even worse, what do we do when injuries. In 2011, more than 27,000 EMS loading systems, lifts, slides, etc.—yet injuries
injury, pain and disability are shrugged off, as providers/firefighters experienced on-the-job continue to increase in frequency.
is common in many public safety departments, injuries and illnesses, and more than 21% of Back pain is difficult for the injured pro-
as just being part of the job? those injuries were to the lower back.2 vider to cope with as it affects every aspect of
Data from the International Association life. They’re in pain, at home or on light duty,
CRIPPLING INJURIES of Fire Fighters shows that nearly 50% of and in many cases bringing home only two-
Injury, disability and even death are risks that early retirements are due to lower back injury.3 thirds of their normal paycheck, creating both
every first responder accepts when entering These injuries incur extreme costs, making physical and financial hardships.
the profession. Back injuries alone account staffing and budgeting challenging. On the employer’s side, there are workers’
for more than 20% of all workplace injuries in Interestingly, EMS has some of the best compensation payments and open positions
1710JEMS_47 47 9/12/17 9:28 AM

that must be backfilled with other staff, possi- Forces that impact the spine perpendicular occurs unevenly; they can also occur when
bly in the form of forced overtime. Overtime to the axis are considered shear forces. Leaning heavy objects are lifted with one arm.
shifts aren’t only expensive, they also drive up over to the side by dropping one shoulder lower To help protect workers, the National
provider fatigue, increasing healthy staff mem- than the other and picking up a heavy pack is Institute for Occupational Safety and Health
bers’ risk of injury. Coupled with the fact that an example of a shear force. Shear forces also (NIOSH) established safe lifting limits for
many providers have second EMS jobs, the occur when you bend at the waist to pick up healthcare providers. The load limit set for
injury risk increases even more. an object. The more round your back is when single-person lifting is 51 lbs. and a spine
bending or the farther you reach away from compression force of 764 lbs.5
INJURY FACTORS & FORCES your body, the higher the shear force. Unfortunately for prehospital providers,
More than half (62%) of all prehos- many routine lifts far exceed the
pital provider back injuries result recommended compression lim-
from lifting patients.4 Injuries are a its. For example, pulling a 105-lb.
consequence of three major factors: Prehospital back injury patient via bedsheet between two
significant lifting forces (i.e., patient beds applies between 832–1,708 lbs.
weight), repetitive movements and statistics haven’t changed of compressive force.
awkward positions. Prehospital back I can’t recall the last time I trans-
injury statistics haven’t changed sig- significantly in the past ferred a patient weighing less than
nificantly in the past decade, despite 200 lbs. As obesity has increased, so
the introduction of many safe lifting decade despite the has the occupational load that first
devices like automatic-lift stretch- responders must deal with.5
ers, slide boards, slide sheets and introduction of many Interestingly, the bed-to-bed
bariatric equipment. drag is a major cause of injury and
In the prehospital and firefight- safe lifting devices. it’s one of the few things we can
ing environments, ground respond- control in the field. Using a bed-
ers must deal with three forces that sheet drag violates two of the three
affect the spine and can lead to injury: com- Rotational forces are referred to as torque. injury prevention principles that we cham-
pression, shear and torque. Torque is calculated by multiplying force pion. It increases friction and increases trunk
Compression forces push down on or times distance, where distance is the space angle (i.e., how much you have to lean for-
squeeze the spine parallel to the spine’s axis. between the spine and the weighted object ward), which creates a shearing force placed
The intervertebral disks help us withstand in motion. Significant torque forces can cause on the spine, neck and shoulders, thereby caus-
compression forces. ligament and disk injuries as compression ing injury.
If “sheet drags are the way we’ve always
done it” is a standard operating procedure,
then your organization hasn’t invested in your
career longevity.
Add to all of this compression, shear and
torque, the fact that EMS and fire are two of
the few professions left where it’s considered a
normal (i.e., required) job task to pick up cata-
strophically heavy loads off the floor every day.
This is akin to deadlifting 300 lbs. from the
floor with the load shifting as you lift it. After
it’s lifted, it must then be maneuvered down a
hallway, downstairs and then onto the stretcher.
No other profession allows such injurious
loads to be picked up from such a low posi-
tion (i.e., hands on the floor), and that’s with
the assumption that the patient isn’t wet and
in a bathtub, which exponentially increases
the shear, torque and compressive forces in
the spine.
INJURY PATTERNS
Almost all the responders I train across the
There are a number of devices available that can change the lift height and allow multiple responders to country have deeply seated biomechanical
get their hands on the patient. Photo courtesy Bryan Fass patterns that inhibit deep, safe lifting. I teach
1710JEMS_48 48 9/12/17 9:28 AM

D n’t
n t Be The T l...
When lifting like this you
your back is a lever on a 10:1 ratio fulcrum.
3,500lbs
Using the back as a lever
exponetially increases the
amount of pressure on the
lower back.
350 FACT
lbs
1 in 2 Fire/EMS
providers will sustain an
on the job back injury
from lifting. 1
1. National Association of Emergency Medical Technicians. Four in Five EMS Workers Injured on the Job. 2006
BINDER LIFT
USE A T L
TM
TM
When lifting like thiss providers

prov are able to team lift while using proper ergonomics.
“The right tool

for the job.”
Attaches up to 25 handles to the patient’s torso.
Made
e IIn
nUUSA
SA
Sign Up for a Free CALL 855.239.5438

or
30-Day Field Trial! VISIT www.BinderLift.com/trial
1710JEMS_49 49 9/12/17 9:28 AM

causes the tissue to sustain forces that it can-

not dissipate and the tissue fails as a result.
2. Repetitive motion disorder. Repetitive
movements will ultimately lead to tissue fail-
ure from countless repetitions of faulty and
dangerous movements.
A common pattern we see is how respond-
ers enter and exit their vehicles. Years of rapid
entry and exit—often weighted down with
gear or simply poor mechanics—will fatigue
the tissue to the point of failure.
We see the same effect from faulty lifting.
In EMS, we often see repetitive rotator cuff
strain after lifting the 40-lb. ECG monitor
from the floor toward the cot in a swinging
motion. The repetitive traumas of the job add
up over time.
3. Prolonged static positioning. As children,
Using a soft stretcher will reduce both friction and trunk flexion angle when transferring a patient from we went to school and sat at little tables,
bed to cot. Photo courtesy Bryan Fass hunched forward. As adults, we essentially
do the same thing except now it’s hunched
hundreds of classes per year and less than 10% sector from three major causes. over a computer, phone or a steering wheel.
of our first responders can work safely from 1. Overexertion trauma. Overexertion injury Repetitive static postures like sitting, standing
the floor. Of course, the easy answer is to not occurs when the external force that’s encoun- and desk work will “program” the body over
lift from the floor. There are techniques that tered produces torques and compressive loads time to believe the faulty postures to be nor-
can alter lift height and make it safer, but in that the tissue is unable to handle. When the mal. It’s not normal to have a forward head
extreme cases patients have to be lifted and soft tissue failure tolerance is met, the tissue posture and a rounded back!
no tool can help in all situations. can fail outright (i.e., injury) or sustain micro- First responders often display tightness
What we’ve learned, and what the data traumas that will weaken the tissue causing in the calf, foot and ankle, from standing on
shows, is that most responders have similar it to fail later. This is often manifested when concrete floors, hours spent in duty boots,
patterns that can often be tied back to the job a responder has to pick up a patient from a training and working in boots and gear, and
task. On top of that, many responders possess bathtub to move them into a hall where med- hours of climbing in and out of trucks and
patterns that are both repetitive and static/ ical treatment can begin. The poor working up and down stairs. We also see that the way
chronic. Soft tissue traumas occur in the public environment and the weight of the patient first responders enter and exit their appara-
tus affects the foot and ankle. We know
that when the ankle joint is tight and/or
Sleep Hygiene restricted, the ability to squat or climb
steps is altered, causing both knee and
back pain.4
Resiliency
Injury Free University REDUCING INJURY
Patient Handling Blended learning at it’s best! A Web based So how do we fix it? First and foremost,
Learning Management System & hands on Train as a profession we must stop thinking of
the Trainer course the first responder as the ultimate multi-
Safety Systems Take Your Safety Training to the Next Level tool and lifting device. Yes, you can get
away with doing it all for a while, but
Just Culture Injury Free teaches 12 Validated ways to eventually the loads, positions, extreme
Safely Lift a Patient From the Floor! trunk angles and chronic fatigue will
Nutrition & Wellness break your tissue down and injury will
occur. Repeat after me: “Use a tool; don’t
The Injury Free System is a trusted partner helping be the tool.” When we do root cause
Injury Prevention EMS & Fire Departments reduce loss, cut costs & analysis of why most injuries in the field
Improve crew wellness for over 10 Years occur, they almost always occur from
888-529-0921 doing a seemingly normal task.
www.fitresponder.com 1. Change the lift height. Instilled in
every first responder is a duty to act, serve
1710JEMS_50 50 9/12/17 9:28 AM

and help. The consequence is that we often use ourselves as the tool to poor training and a misunderstanding that most provider injuries
to get the job done, in order to serve and be a strong, caring patient come from moving the patient on and off of the cot. JEMS
advocate. So, we end up picking up the patient or the gear in awkward
positions or from a height that’s below the knees. Bryan Fass, ATC, LAT, CSCS, EMT-P (ret.), has dedicated more than a decade to changing the
Instead, use a commercially made device to change the lift height culture of fire/EMS from one of pain, injury and disease to one of ergonomic excellence and
and allow multiple responders to get their hands on the patient. Devices provider wellness. Leveraging his 15-year career in sports medicine, athletic training, spine
like the Titan from Taylor Medical, the MegaMover from Graham rehabilitation, strength and conditioning, as well as experience as a paramedic, he has become
Medical, the HILT Human Injury Limiting Tool or the Binder Lift a leading expert on fire/EMS fitness and prehospital patient and equipment handling. His com-
allow the lift height to change from floor to knee height. They also pany, Fit Responder, works with departments across the U.S. to reduce injuries and improve
reduce friction and trunk angle when transferring a patient from fitness for first responders.
stretcher to hospital bed.
2. Reduce friction. Friction can be a big deal, especially when tasked REFERENCES
with transferring a 500-plus-lb. patient from bed to bed or a patient of 1. Studnek JR, Ferketich A, Crawford JM. On the job illness and injury resulting in lost work time among
normal weight from an air mattress to the cot. Common techniques a national cohort of emergency medical services professionals. Am J Ind Med. 2007;50(12):921–931.
include moving the patient on a bedsheet or blanket, which will add 2. Centers for Disease Control and Prevention. (June 21, 2013.) Emergency medical services work-
resistance to the transfer due to the coefficient of friction. Add to this ers injury and illness data, 2011. Retrieved Aug. 5, 2017, from www.cdc.gov/niosh/topics/ems/
the extreme trunk flexion angle that must be achieved to lean over the data2011.html.
bed to grasp the sheet, and that some responders will have to either 3. Death and injury survey. (2000.) International Association of Fire Fighters. Retrieved Aug. 5, 2017,
stand on or kneel on the bed, and we have the trifecta for spinal disas- from www.iaff.org/hs/PDF/2000%20D&I.pdf.
ter: shear, compression and torque. 4. Hogya PT, Ellis L. Evaluation of the injury profile of personnel in a busy urban EMS system. Am J
Simply using a soft stretcher as mentioned above will both elimi- Emerg Med. 1990;8(4):308–311.
nate the friction issue while reducing the trunk flexion angle. These 5. Kincl L, Hess J, Hecker S. (n.d.) Firefighter and emergency medical services ergonomics curriculum.
devices have built-in handles and are made of high-strength materi- Oregon OSHA. Retrieved Aug. 5, 2017, from http://osha.oregon.gov/OSHAGrants/ff_ergo/index.html.
als that also reduce friction. Plus, the lift height is more like that of 6. Janda’s crossed syndromes. (n.d.) The Janda approach. Retrieved Aug. 5, 2017, from
a dead lift with greater hip involvement and less lumbar spine load. www.jandaapproach.com/the-janda-approach/jandas-syndromes.
3. Master the hip hinge and reduce trunk angle. Perspective is an inter-
esting thing. As a paramedic, athletic trainer and a certified strength
and conditioning specialist, I’ve noted that very few responders possess
the ability to use a good hip hinge to spare the spine and reduce com-
pressive and shear forces. This is from poor hip mobility and a lack of
coaching/awareness on the importance of the hip hinge.
A very common pattern prevalent in all first responders is that the
hip flexors become very short and tight. As they tighten they cause an
anterior pelvic rotation that inhibits the abdominal wall (i.e., the guts
and butts posture). As the abdominal wall weakens, the spine takes
additional loads. This results in the glutes become tight and weak and
the hamstrings tighten in an attempt to pull the pelvis back into place.6
As this pattern becomes more and more severe (i.e., lower crossed syn-
drome), the EMT loses the ability to lift properly.
Despite training first responders to lift with their legs, hip flexor
tightness and gluteal weakness results in an inability to do so, forcing
them to use the back as a lifting device and not the hips.
CONCLUSION
IMPROVE THE PATIENT EXPERIENCE
Replace those patient complaints about pain and discomfort with
As a first responder, you need to understand some truths. First,
words of praise for comfort and security. Our innovative patient
dangerous lifting techniques are handed down from generation handling and vacuum splinting products can effectively provide proper
to generation; we need to break this cycle. Next, safe patient and stabilization, reduce pain and significally increase comfort resulting in
equipment handling must be constantly trained and retrained—it’s higher quality care ratings from your patients. Decide today to make
too easy to fall back into old habits. We must teach proper mobility a change that truly makes a difference. Call us at 800-633-5900
and let’s find the best solution for your organization.
allowing us to be fit for duty: “You have to move well before you can
move objects well.” EMS and fire departments must also conduct
an annual physical abilities test to ensure providers maintain fit for
duty status. Finally, there must be a blend of engineered solutions
and awesome ergonomics.
It amazes me how many departments invest in new tools and tech- 800-633-5900 • 760-438-5500 www.HartwellMedical.com
nology, like powered cots or lift devices, yet injury rates still rise due For more information, visit JEMS.com/rs and enter 29.
1710JEMS_51 51 9/12/17 9:28 AM

Firefighters help develop innovative patient lifting device

By Chuck Marble
AN EMS SOLUTION
M
any in EMS have friends and colin partnership with, and specifically for, emer-
leagues who have suffered back gency responders. In 2015, the Livermore–Pleasanton (Calif.)
injuries resulting from lifting and Fire Department (LPFD) was conducting an
moving patients, particularly patients who are NECESSITY IS THE MOTHER annual fire inspection of the IndeeLift factory
overweight or located in awkward places. In OF INVENTION and noticed the HFLs.
fact, more than half (62%) of all prehospital Inventor and businessman Steve Powell cre- “When we saw the device, we asked the fac-
provider back injuries happen when lifting ated IndeeLift to help individuals, includ- tory manager if it was what we thought it was,”
patients.1 The International Association of ing his parents, who fall in their homes. recalled Fire Captain/Paramedic Kurtis Dickey.
Fire Fighters (IAFF) reports that back inju- Powell searched for a practical solution to The factory manager explained to Dickey
ries account for approximately 50% of all line help his parents and others who experience and his crew that it was a new product for safely
of duty injury retirements each year.2 non-injury falls at home and are unable to get getting people back on their feet after a fall.
The National Safety Council Dickey says, “We’d never seen
reports that falls are up 63% over the anything like it, and explained to the
last decade. Experts suggest this is a factory manager that we needed some-
function of an aging society.3 Patients Back injuries account for thing like that on our trucks!”
presented to emergency responders in Soon after, a representative from
many countries continue to become approximately 50% of all IndeeLift contacted Dickey’s depart-
larger and heavier, presenting increas- ment and began working with them
ing challenges to first responders, line of duty retirements. to develop a new HFL, one specifi-
crews treating, moving and transport- cally designed for EMS. A prototype
ing patients and hospital staff. was presented to the department in
The National Fire Protection Association up without calling for assistance. Finding none, June 2016 and Dickey’s crew began using it
(NFPA) reports that medical aid calls now he invented the solution. on lift-assists and medical-aid calls.
constitute the majority of firefighter dispatches Powell’s invention, the IndeeLift Human Dickey says, “We knew right away that this
nationwide.4 Many of these calls are for lift Floor Lift (HFL) was developed in 2014 to tool would not only improve patient care, but
assists, when a person dials 9-1-1 because of help people safely get back on their feet after would also prevent back injuries and extend
their inability to get back on their feet after a a non-injury fall. The HFL allows for self- firefighters’ careers.”
non-injury fall. Often, responders not only need or assisted-operation in the home. This not As Dickey and his crew continued to use
to help the patient up from the floor, they also only prevents fall recovery injuries for the per- the HFL, they helped develop the EMS proce-
need to move heavy patients from the location son who has fallen and the family members dures and provided suggestions and input that
of their fall to a gurney. assisting them back up, it also reduces the IndeeLift incorporated into the final design of
Lifting and transporting patients manually number of calls to 9-1-1 for non-emergency the HFL-550-E, which began production in
often results in injuries to the patients and lift-assists. December 2016.
the EMS personnel. The combined costs of Aware that hospital workers experience The HFL-550-E allows responders to lift
workers’ comp claims, downtime, overtime and injuries at nearly three times the rate of other large and heavy patients—up to 700 lbs.—
early retirement are staggering. The National professional and business services—often as a quickly and safely from floor level to a height
Institute of Standards and Technology esti- result of lifting, repositioning, and transferring of 21 inches. Patients can stand up from the
mated the cost of firefighter injuries to be patients who have limited mobility—a second seated position and walk away, or be transferred
between $2.8 billion and $7.8 billion in the line of HFLs was specifically developed for the to a wheelchair or gurney without manual lift-
year studied.5 healthcare industry.6 ing. The unit is constructed to meet the rigors
So, when a new tool comes along that prom- Although IndeeLift was producing fall of EMS use, particularly in areas with limited
ises to improve patient care and movement recovery solutions for the home and health- space. It’s equipped with wheels to assist in
while also reducing injuries to patients and care industry, there was still a large segment of moving patients, comes with a rechargeable
providers, it’s a potential game changer. This professionals that were routinely suffering from battery pack and folds to a minimal footprint
article tells the story of recent innovations in injuries incurred when lifting fallen patients: when stowed on fire apparatus, ambulances or
patient lifting and transport that were designed emergency responders. other special response units.
1710JEMS_52 52 9/12/17 9:28 AM

FIELD PERFORMANCE and can lift and transfer patients weighing many new tools introduced, but rarely has one
Dickey and his crew have found themselves up to 500 lbs. come along that we use so often, and works
using the HFL at least 10 times a month to exactly as designed. My crew and I are proud
safely recover fallen patients. After a year of ADDITIONAL USES to have been involved in the development of
using the device, Dickey and his crew report The HFL has also been adopted by several a device that will help our patients and our
a 100% success rate without any injuries to mobile integrated healthcare and commu- fellow emergency responders.” JEMS
firefighters or patients. nity paramedicine (MIH-CP) programs ded-
In the same timeframe, four of the 100- icated to providing improved patient care in Chuck Marble is a freelance consultant for IndeeLift and
plus person department have suffered injuries the home and preventing unnecessary, repeti- participates in the effort to eliminate manual lifting in EMS.
resulting from patient lifts where the respond- tive emergency response calls, especially from He’s managed technical training and support for Bank of
ers didn’t have an HFL. This is where safety residents who are prone to falling on a reg- America and Diebold Inc, and has served as a writer and con-
and economics merge. ular basis. tributing editor to space.com, covering space science tech-
The cost of a specialty lifting device is bal- After responding to lift-assist calls from nology. He can be contacted at [email protected].
anced against a significant reduction in work- the same paraplegic patient dozens of times
ers’ compensation costs, as well as lost time in one year, the Clearwater (Fla.) Fire Depart- REFERENCES
and overtime costs often incurred to fill shifts ment worked in partnership with IndeeLift to 1. Hogya PT, Ellis L. Evaluation of the injury profile of personnel in a
of an injured provider. provide the patient with a home model at no busy urban EMS system. Am J Emerg Med. 1990;8(4):308–311.
cost that he and his caregiver could use with- 2. Back injuries and the fire fighter. (n.d.) IAFF. Retrieved Aug.
ACCESSORIES & NEW MODEL out EMS assistance. 21, 2017, from www.iaff.org/hs/resi/backpain.asp.
The LPFD continues to provide valuable The Kent (Wash.) Fire Department’s inno- 3. Associated Press. (June 9, 2016.) Why more Americans
input to IndeeLift, which has resulted in the vative MIH-CP program, FD CARES, dis- are dying accidental deaths. CBS News. Retrieved Aug. 21,
development of accessories for the HFL. patches a registered nurse and an EMT to 2017, from www.cbsnews.com/news/more-americans-
The IndeeChuck Patient Maneuvering non-emergency medical calls. By equipping are-dying-accidental-deaths/.
Tool allows two responders to retrieve very the FD CARES SUV with an HFL, they 4. Fire department calls. (June 2017.) National Fire Protection
large patients from hard-to-access locations no longer need to dispatch a fire crew for Association. Retrieved Aug. 21, 2017, from www.nfpa.org/
and move them to a waiting HFL. LPFD non-emergency lift-assist calls. news-and-research/fire-statistics-and-reports/fire-statistics/
feedback also was key to the development of the-fire-service/fire-department-calls/fire-department-calls.
Stair Handle Sets and Stair Tracks. CONCLUSION 5. TriData Corporation. (March 2005.) The economic consequences
Other early adopters of the HFL have con- The HFL offers a new, safer way for emer- of firefighter injuries and their prevention. Final report. National
tributed feedback resulting in the introduc- gency responders to perform lift-assists and Institute of Standards and Technology. Retrieved Aug. 21, 2017,
tion of an additional HFL model. medical-aid calls. Its ability to reduce, and per- from www.nist.gov/publications/economic-consequences-
After ambulance personnel from other haps eliminate, one of the primary causes of firefighter-injuries-and-their-prevention-final-report.
departments suggested they would benefit injuries and lost time for emergency respond- 6. Caring for our caregivers: Facts about hospital worker safety.
from something more compact and light- ers makes it a valuable asset. (September 2013.) Occupational Safety and Health Adminis-
weight, IndeeLift developed an HFL-500-E “I’ve been a firefighter and paramedic for tration. Retrieved Aug. 21, 2017, from www.osha.gov/dsg/
that’s lighter (50 lbs.), smaller (8" x 20" x 33"), 20 years,” Dickey says. “In that time, I’ve seen hospitals/documents/1.2_Factbook_508.pdf.
Human floor lifts can assist EMS providers in quickly and safely lifting large and heavy patients from the floor to a height of 21 inches, allowing them to stand up from
the seat and walk away or be transferred directly to a wheelchair or gurney without manual lifting. Photos courtesy IndeeLift
1710JEMS_53 53 9/12/17 9:28 AM

The b-card allows for ventilation that’s generated by chest compression and decompression.
Photos courtesy Vygon
1710JEMS_54 54 9/12/17 9:28 AM

New device designed to provide Paris’ medical leadership is working on ways
to get citizens to perform early CPR by using
continuous oxygen delivery during CPR software to alert citizens of the location of
AEDs. If Paris ramps up its citizen involve-
By W. Scott Gilmore, MD, EMT-P, FACEP, FAEMS ment, it’s clear that their overall resuscitation
rate could skyrocket.
“N
o pause should be your cause,” Resuscitations are often hampered in Paris
or so French medical device by the lack of early citizen response and perfor- TACKLING COMPRESSION
manufacturer Vygon believes. mance of CPR prior to EMS crew arrival. This INTERRUPTIONS
In March, JEMS Editor-in-Chief A.J. major factor has kept Paris’ ROSC level below Although advanced airway devices allow for
Heightman and I traveled to Paris to attend 10%, despite an outstanding response system continuous chest compressions, prolonged
a one-day emergency symposium titled, JEM
in place that utilizes physician-staffed interruptions associated with advanced airway
Alveolar Ventilation by Continuous AL ALS units operated by Service d’Aide placement may negate this benefit. One study
N AT I O N
Chest Compression: b-card, a new Médicale Urgente (SAMU, trans- observed that CPR was interrupted for 46.5
ARTIC
device designed for use during car- lated from French as Urgent Medical seconds (interquartile range [IQR] 23.5 to
ER
diac arrest management. LE Aid Service) and the predominantly 73 seconds) on the first attempt at intubation
I NT
During the symposium, current BLS Paris Fire Brigade. and total interruptions to chest compressions
cardiac arrest guidelines, the Bous- On the other end of the resuscitation due to endotracheal intubation lasted 109.5
signac Cardiac Arrest Resuscitation Device spectrum, patients in Paris who remain in v fib seconds (IQR 54 to 198 seconds).6
(b-card) and how the two are interconnected and who receive extracorporeal membrane oxy- Authors of this study also pointed out that
were discussed. genation (ECMO) bypass treatment in the field total endotracheal intubation–associated CPR
The b-card is available and in use in Europe by a specialized SAMU response team are suc- interruption time accounted for approximately
and Canada; however, it’s not available or cessfully resuscitated more than 30% of the time. one fourth of the total CPR interruptions
approved for sale in the United States. Vygon
has applied to the Food and Drug Adminis-
tration (FDA) for approval for use in the U.S.
The resuscitation symposium started with
a review of the current International Liaison
Council on Resuscitation (ILCOR) guidelines
on cardiac arrest and a comparison of the guide-
lines put forth by the American Heart Associ-
ation and the European Resuscitation Council.
It was emphasized during the first half of
the symposium, and acknowledged by resus-
citation experts present from multiple coun-
tries, that early citizen response and initiation
of CPR along with high quality, consistent
CPR by emergency crews are paramount to
patient survival.
This was discussed and supported by obser-
vational studies which have shown that, in
general, the quality of CPR is poor during
out-of-hospital cardiac arrest. Additionally,
multiple studies show that interruptions in
chest compressions not only decrease coro-
nary perfusion pressure1 but are also associ-
ated with decreased defibrillation success and The b-card creates a virtual valve that ensures dynamic alveolar ventilation without the need to interrupt
poor outcome.2–5 chest compressions.
1710JEMS_55 55 9/12/17 9:28 AM

STOPPING THE PAUSE
(median 22.8%; IQR 12.6% to 36.5%; range endotracheal intubation provided for a better During the compression phase, the pressure
1.0% to 93.9%).6 outcome than supraglottic airway devices.9 within the airways is increased to 8 cmH2O.
Supraglottic airway devices outperformed Animal and clinical studies suggest that pro-
endotracheal intubation when interrup- B-CARD INTRODUCTION longed CPR may impair lung function and
tions to chest compressions were studied The second half of the resuscitation symposium promote severe atelectasis.10,11
using manikins. In these studies, insertion focused on the b-card itself. B-card is a non- This slight increase in pressure may pro-
of supraglottic airway devices interrupted invasive ventilation system providing contin- tect the lower airways during CPR according
chest compressions on average for 8.4 to 20.0 uous oxygen delivery during CPR. The device to Vygon. In the decompression phase, the
seconds depending upon which device was ensures dynamic alveolar ventilation without virtual valve creates a negative intrathoracic
being used.7,8 the need to interrupt chest compressions. pressure and a pressure of -1 cmH2O in the
Questions still remain whether advanced Connected to an oxygen source delivering airway, optimizing gas exchange in the alveoli.
airway management in the out-of-hospi- a flow rate of 15 L per minute, the b-card At the same time, the negative intrathoracic
tal setting improves patient survival with generates a virtual valve. This valve creates an pressure improves venous return to the heart.
some studies reporting contrasting results. A initial static pressure in the airways of approx- This increases the blood flow ejected from
nationwide registry in Japan found no survival imately 4 to 5 cmH2O. This acts as the “heart” the heart during the next chest compression.
benefit from advanced airway management of the device, optimizing the pressure created So, b-card has been designed to perform the
compared with bag-valve mask ventilation. during chest compression and decompression dual effect of optimizing hemodynamics and
And, the Resuscitation Outcome Consortium phases of CPR. (See Figure 1.) ventilation when chest compressions are being
(ROC) observed higher survival in patients Each chest compression has a dual action: performed.
who didn’t receive advanced airway man- Helping to expel the air contained in the alve- The b-card is designed with two dis-
agement. However, in those patients that oli and simultaneously pumping blood from tinctly different ends. The end that’s open to
did undergo advanced airway management, the chest cavity into the general circulation. the atmosphere has a series of elevated ridges
so that it can’t be easily connected to an air-
Figure 1: Virtual valve created by the b-card way circuit.
The other end of the b-card can be used
with either a 15 mm or 22 mm airway con-
nector. Because of this design, it can be used
with a facemask, a supraglottic airway device,
or an endotracheal tube, allowing for use by
various levels of providers.
According to Vygon, b-card simplifies the
management of cardiac arrest. As ventilation
is generated by chest compression and decom-
pression, the need for a provider ventilating
the patient has been removed.
However, there’s still the need for a provider
to apply a good mask seal if the b-card is used
with a facemask rather than with a supraglottic
airway device or endotracheal tube. The b-card
is also designed to be used with both man-
ual and mechanical CPR. Historically, most
of the studies have used the Physio-Control
LUCAS chest compression system with the
Boussignac CPR system or the b-card.
An additional benefit of the b-card, as it’s
designed, is minimal risk of gastric inflation
and aspiration since it’s an open system that
uses continuous oxygen insufflation. With
b-card, ventilation is based on negative intra-
thoracic pressure unlike positive airway pres-
sure that’s used during CPR for ventilation.
The risk of aspiration during CPR is small
but not insignificant and has been reported
to be 0.96%.12
When the b-card was compared to stan-
dard CPR with intermittent positive pressure
1710JEMS_56 56 9/12/17 10:39 AM

ventilations delivered to a cadaver by bag- as compared to 10% in the standard inter- arrest patients. Acad Emerg Med. 2010;17(9):918–925.
valve mask, approximately 25 times more gas- vention group. 5. Shy BD, Rea TD, Becker LJ, et al. Time to intubation and sur-
tric insufflation was generated vs. ventilations This small study isn’t sufficient enough to vival in prehospital cardiac arrest. Prehosp Emerg Care.
delivered with the b-card.13 fully validate the effectiveness of the b-card, 2004;8(4):394–399.
but there are ongoing studies by the Paris Fire 6. Wang HE, Simeone SJ, Weaver MD, et al. Interruptions in car-
CONCLUSION Brigade and Marc Gillis, MD, in Belgium diopulmonary resuscitation from paramedic intubation. Ann
Vygon believes the b-card offers multiple ben- that will help determine the clinical benefit Emerg Med. 2009;54(5):645–652.
efits during the treatment of cardiac arrest of the b-card. 7. Frascone RJ, Russi C, Lick C, et al. Comparison of prehospital
and maximizes adherence to ILCOR guide- Although approved and in use in Europe, insertion success rates and time to insertion between standard
lines, including: the b-card is currently undergoing field tests endotracheal intubation and a supraglottic airway. Resuscitation.
>> improved hemodynamics during CPR and and awaiting pre-market clearance submis- 2011;82(12):1529–1536.
continuous chest compressions; sion to the FDA. Once approved, and further 8. Ruetzler K, Gruber C, Nabecker S, et al. Hands-off time
>> reduced injury to the alveoli and lungs field studies are conducted, this device has the during insertion of six airway devices during cardiopulmo-
caused by chest compressions; potential to affect the performance of CPR and, nary resuscitation: A randomised manikin trial. Resuscitation.
>> improved ventilation and oxygenation more specifically, ventilation during CPR. JEMS 2011;82(8):1060–1063.
during CPR; 9. Wang HE, Szydlo D, Stouffer, et al. Endotracheal intubation versus
>> reduced gastric inflation; and W. Scott Gilmore, MD, EMT-P, FACEP, FAEMS, is medical direc- supraglottic airway insertion in out-of-hospital cardiac arrest.
>> simplified management of cardiac arrest. tor for St. Louis Fire Department. He’s been involved in EMS Resuscitation. 2012;83(9):1061–1066.
Does the b-card increase survival from car- for over 22 years as a provider, educator and medical direc- 10. Cho SH, Kim EY, Choi SJ, et al. Multidetector CT and radiographic
diac arrest? Currently there are no published tor. He completed an emergency medicine residency and EMS findings of lung injuries secondary to cardiopulmonary resusci-
studies that used the b-card exclusively. There fellowship at Washington University in St. Louis. He’s also a tation. Injury. 2013;44(9):1204-1207.
are, however, a few studies that have used the member of the Street Medicine Society. 11. Markstaller K, Karmrodt J, Doebrich M, et al. Dynamic com-
Boussignac CPR system manufactured by puted tomography: A novel technique to study lung aeration
Vygon, which has the same virtual valve as REFERENCES and atelectasis formation during experimental CPR. Resuscita-
the b-card. 1. Steen S, Liao Q, Pierre L, et al. The critical importance of min- tion. 2002;53(3):307–313.
Preliminary data from a small study con- imal delay between chest compressions and subsequent 12. Aufderheide TP, Frascone RJ, Wayne MA, et al. Standard cardiopul-
ducted in the out-of-hospital setting showed defibrillation: A haemodynamic explanation. Resuscitation. monary resuscitation versus active compression-decompression
an increase in ROSC rate and survival. Of the 2003;58(3):249–258. cardiopulmonary resuscitation with augmentation of negative
48 patients enrolled, 38 (79%) were intubated 2. Edelson DP, Abella BS, Kramer-Johnson J, et al. Effects of chest intrathoracic pressure for out-of-hospital cardiac arrest: A ran-
using the Boussignac CPR system. The other compression depth and pre-shock pauses predict defibrillation domised trial. Lancet. 2011;377(9762):301–311.
10 (21%) patients underwent standard intu- failure during cardiac arrest. Resuscitation. 2006;71(2):137–145. 13. Segal N, Voiglio EJ, Rerbal D, et al. Effect of continuous oxy-
bation and ventilation.14 3. Wik L, Kramer-Johnson J, Myklebust H, et al. Quality of cardio- gen insufflation on induced-gastric air volume during cardio-
The rate of ROSC in those patients intu- pulmonary resuscitation during out-of-hospital cardiac arrest. pulmonary resuscitation in a cadaveric model. Resuscitation.
bated with the Boussignac CPR system was JAMA. 2005;293(3):299–304. 2015;86:62–66.
44.7% as compared to 10% in the standard 4. Studnek JR, Thestrup L, Vandeventer S, et al. The association 14. Gillis M, Keirens A, Steinkamm J, et al. The use of LUCAS and the
interventions group. Survival to discharge was between prehospital endotracheal intubation attempts and Boussignac tube in the prehospital setting [poster]. European
26.3% in the Boussignac CPR system group survival to hospital discharge among out-of-hospital cardiac Resuscitation Council Congress: 2008.
Figure 2: B-card used with a facemask (left) and supraglottic airway (right)
1710JEMS_57 57 9/12/17 9:28 AM

FIELD PHYSICIANS
EMS DOCS’ PERSPECTIVES ON STREET MEDICINE
DRUG DIVERSION
Managing controlled substance use on the upstream side
By Neal J. Richmond, MD, FACEP
COPING & ITS LIMITATIONS
D
iversion policies may be thought of alone whether they should have ongoing access
as the downstream side of a system’s In some cases, we may seek professional coun- to drugs.
approach to controlled substance seling and treatment, as well as the support of Individuals who are “cleared” by personal
management. The upstream side, including friends, colleagues and loved ones. However, physicians or occupational health providers to
human resources and occupational health pro- all too often we titrate anxiety, depression and return to work following illnesses or injuries
cesses for recognizing and testing individu- post-traumatic stress by self-medicating with that require treatment with controlled medi-
als at risk, may be worth some attention, too. tobacco, alcohol or caffeine. Some may slip cations, might be required to submit to drug
into non-recreational use of pot, as well as the testing for a period of time. This may not
LONG-TERM CONSEQUENCES use of opiates, benzodiazepines, or anesthetic entirely mitigate the likelihood of diversion,
Discovering and reporting drug diversions may agents like propofol and ketamine. but it might provide a more realistic transi-
result in career-ending consequences for our To make matters more complicated, these tion period between prior prescription use and
friends and colleagues. However, closing our substances typically induce tolerance and potential future abuse.
eyes to this problem may result in even more addiction. Thus, one needs more and more System occupational health processes
devastating consequences, including loss of life. to achieve the same degree of baseline func- should also be carefully reviewed and not
It may also lead to potential injury and tion or happiness, if not outright euphoria — taken for granted. Drug testing doesn’t mean
death of partners, patients, and bystanders, something that’s especially dangerous in the that certain opioids or other substances are
when emergency response vehicles are oper- face of low tolerance to side effects like respi- necessarily included.
ated under the influence of legally prescribed ratory depression. Personnel may test positive for drugs and
or illegally diverted medications. Trying to get off these substances is also then be reported as “negative”—if they can
difficult, whether it’s due to psychological provide prescriptions for their use. Even
DIVERSION AT ITS SOURCE dependence or true physiologic symptoms though the use of these drugs may be legal,
Our jobs are stressful and, at times, pain- of withdrawal. the risk of personnel taking them while driv-
fully repetitive, boring and even backbreak- Our work is a kind of double-edged sword, ing response vehicles or making critical patient
ing. Many of us get into this work at a young in that it may not only amplify our tendencies decisions may go undetected.
age, often in the absence of a lot of other life for substance abuse but, perhaps more insid-
experience. Suddenly, we find ourselves face iously, it also provides an environment where PUTTING IT ALL TOGETHER
to face with unspeakable tragedy and trauma. accessing these substances may be tempting— Typically, policies for diversion operate on the
We’re exposed to the suffering of our patients, if not altogether unavoidable. downstream side of controlled substance man-
and we experience our own physical and emo- agement, when it’s already too late. If we could
tional pain as well. PREVENTION couple them with meaningful policies on the
Although many of us enter into this pro- Although we can’t predict how different indi- upstream side, they may just make a difference.
fession with a desire to help others, we bring viduals will react to the combined stress of The subject of drug diversion will be dis-
to the job an entire spectrum of personalities their lives and jobs, simply trying to manage cussed in the November issue, as will one sys-
and coping mechanisms. the potential for substance use and diversion tem’s approach (MedStar Mobile Healthcare,
We also have relationships, families and on the downstream side, is insufficient. Texas) to tracking and monitoring controlled
financial responsibilities. These things are Further upstream, human resources and substance use. JEMS
challenging enough to navigate on their own, occupational health services may be able to
let alone when they are impacted by—and have provide a degree of prevention, in addition to Neal J. Richmond, MD, FACEP, is board cer-
an impact on—our work. improving our work environments and pro- tified in emergency medicine and is the med-
Although it can be helpful to analyze the viding a variety of support services. ical director for the MedStar Mobile Healthcare
uncomfortable emotional and psychological For example, hiring policies can address System in Fort Worth, Texas.
states we often find ourselves in, ultimately, we whether personnel who require chronic opi-
have to find ways to adapt or alter our response ates or benzodiazepines for “normal” daily Learn more from Neal Richmond at the
to stress—if we want to be able to reasonably function should be driving response vehicles EMS Today Conference, Feb. 21–23, in
function at work and at home. and treating patients in the first place—let Charlotte, N.C. EMSToday.com
1710JEMS_58 58 9/12/17 9:29 AM

BERRY MUSING
A
WAG BRAGGING
Incorporate canine comfort into
your own mental & physical care
By Steve Berry
A
s I pulled into the driveway, I knew Seriously though, how can anyone (with- allowed, on a rotating basis, to bring their well-
you’d be waiting behind the front out allergies) walk within an arms’ length of trained, health-certified, housebroken and
door. Why? Because you’re always a begging-for-affection, tail-waggling pup poised dogs to the house during a shift. We’re
excited to see me—regardless of the hour. In and not want to hug and pet it while saying, fortunate no one has any allergies or a fearful dis-
fact, the later I get home, the hap- tain for the domesticated canine.
pier you always seem to become. As long as the dogs remain doc-
It doesn’t matter if my irritable ile, can adapt to the facilities, enjoy
mood is reflected by the way I the company of their human
throw my car keys across the table. com-“paw”-dres, and a tennis ball
Undaunted, you continue to fol- doesn’t get stuck under a couch,
low in my stead in the hope of visitation rights will prevail. Note:
sharing a hug. This doesn’t include integrating
As I begin a raucous tirade them into CARS (Canine Ambu-
about the abusive, intoxicated lance Residential Status).
patient I always run on as the EMS providers need all the
cause for me getting home late, help we can get when it comes to
you move even closer without dealing with the traumatic mental
ever attempting to interrupt my stresses of an unforgiving profes-
need to rant on and on. Your sion. Diet, exercise, mental health
eyes are always non-judgmental, education and positive social
and I find comfort in knowing interactions inside and outside of
you’ll always keep my occasional the workplace are all key ingre-
eyebrow-raising outbursts a dients towards living a healthy
secret—as a bond of sacred trust never to be “Ooobee Oooozee Booboo?” (reference: Ace EMS lifestyle.
shared outside our little circle—including the Ventura: Pet Detective.) To be clear: Service and support dogs by
tears that occasionally flow. Oh sure, dog ownership requires a dedi- themselves aren’t a substitute for effective
During such dark moments, you unfail- cated commitment—especially initially during PTSD counseling or human social contact,
ingly try to distract me with the joyful spirit the initial pup years. And yes, dog hair has but why not do yourself a favor and take a page
of play in an attempt to help me regain focus a tendency to affix itself to everything. But from the military and mental health sciences
on what’s good in this world. You protect our as my two golden retrievers can attest, what and incorporate canine comfort into your own
home, our family, our sanity and you offer it else are you going to do with all that excess mental and physical healthcare needs?
(sniff ) unconditionally. Until … you see the two-inch bandaging tape if not to eradicate It’s still just a dog you say? Yeah, but it’s just
tennis ball, and then all bets are off. “Throw static-electrical fur globules from your EMS a dog that will spend every minute of the day
me the #$@! ball! Throwwww it now!” pocket-laden pants? loving you—a worthwhile investment indeed.
I didn’t always have a dog while growing up. And yes, dogs crap a lot, but they’ll never Josh Billings once said, “A dog is the only thing
It wasn’t until I began my EMS career that I crap on you. Steal your bed? Yes, but they’ll also on earth that loves you more than you love
began to really like dogs. It seems the more I steal your heart and, unlike people, they’re not yourself.” As for cats? ... fuhgeddaboudit! JEMS
learned about certain patients, the more intently intertwined with complicated emotions. Dogs
I became drawn to the company of canines. either love you or hate you. This comes from a Steve Berry is an active paramedic with Southwest Teller
I’m not saying I prefer dogs to humans, as that straightforward pooch philosophy: If you can’t County EMS in Colorado. He’s the author of the cartoon
would infer an unhealthy level of attachment eat it or play with it, just pee on it, trot away book series I’m Not An Ambulance Driver. Visit his website at
to tail-wagging pups over that of socializing and fuhgeddaboudit! www.iamnotanambulancedriver.com to purchase his books
with tongue wagging humans …Then again … At our station, firefighters and medics are or CDs.
1710JEMS_59 59 9/12/17 9:29 AM

HANDS ON
PRODUCT REVIEWS FROM STREET CREWS
Ready-to-Go Training Kits

Your department just decided to enhance the training program and offer
certification courses in addition to the required continuing education classes. There
are now hundreds of new items on your to-do list: You need to address curriculum,
recruiting, staffing, scheduling and ordering the equipment required for the course.
The new Loaded ALS, BLS and Medication Training Packs from DiaMedical let you
take several items off your to-do list. Complete and customizable, these packs
have everything you need, from airway to Zofran (simulated, of course). The BLS
Pack includes a complete set of oropharyngeal and nasopharyngeal airways, adult
bag-valve mask, blood pressure cuff, stethoscope,
glucometer, splinting and bandaging supplies. The ALS VITALS
Pack adds advanced airway and IV access supplies. The Price: $476.50 (ALS); $248.50
Medication Box has simulated medications in ampule, (BLS); $648.50 (medication)
vial and prefilled syringe packaging. A pediatric www.diamedicalusa.com
training pack is also available. 877-593-6011
Maps, Alerts & Comms

Turn-by-turn directions are available through a variety of smartphone
apps or separate GPS devices, but do they alert you when you get
dispatched? Do they allow an incident commander to give staging and
operations orders via a tap of the finger and keep critical radio traffic to
a minimum? EnRoutePro 2.0 from Perpetua Technologies is a new app
developed for a tablet in the front of an ambulance, fire apparatus, chief’s
vehicle or command post. Developed by Mike Speiser, an established
computer programmer who also happens to be a volunteer firefighter
with the Lane Fire Authority near Eugene,
VITALS Ore. Speiser’s insider knowledge of fire
Operating systems: ground operations, dispatch and graphical
Windows, iOS information systems allows commanders and
Price: From $49/month responding units to share a common visual
www.enroutepro.com reference, assign units and communicate off
800-577-3760 radio with dispatchers.
Fran Hildwine, BS, NRP, is the AHA Training Center Coordinator at the Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del. He’s also an
EMS instructor at Good Fellowship Ambulance Club in West Chester, Pa. Contact him at [email protected].
1710JEMS_60 60 9/12/17 9:29 AM

For more product reviews: www.jems.com/Hands-On
Bedside Blood Warming

In treating the trauma patient, we know that severe blood loss needs to be replaced with blood,
not crystalloid, and prevention of hypothermia slows the fatal triad of coagulopathy. But how
do we quickly get the refrigerated blood up to body temperature in the field? The new Warrior
Modular System from QinFlow solves this problem with a compact, battery-powered warmer
capable of rates up to 200 mL/min. on battery and 290 mL/min. on AC power. With a simple, one-
button operation, the QinFlow Warrior base plugs in to either the
22.2-volt li-ion battery or a 120-volt AC power supply. A compact VITALS
or standard sterile, single-use fluid pathway is connected with Weight: 1.54 lbs. (base unit);
standard IV tubing and the unit is ready to provide warm fluids 1.94 lbs. (22.2-volt battery)
for your patient in seconds. The unit may be mounted to IV poles Price: Call for price
or stretcher rails, and visual and audible indicators alert you to www.qinflow.com
temperature and flow rates. +972-54-300-3886
Easily Accessible O2
Having a patient in need of oxygen isn’t the time to have
to wrestle with a faulty nylon restraining strap or find that
the cylinder stored under the bench seat managed to have
the valve slightly opened and is now empty. The new Twin
VITALS Slide-Out “D” Cylinder Bracket from Ziamatic Corp. makes it
Weight: 16.4 lbs. easy to secure and quickly remove a portable oxygen cylinder.
Color: Green To secure your cylinder, you simply need to slide it into the
Price: Call for price bracket until it clicks behind the latch. To release the cylinder,
www.ziamatic.com you pull up on the strap to release the latch. Designed
800-711-FIRE for steel “D” cylinders and most regulators, an available
mounting stand holds your cylinders at a 45-degree angle for
easy access.
BSI for Biohazards

Believe it or not, we EMS folks didn’t always practice body substance
isolation (BSI). Prior to the emergence of AIDS and HIV in the late 1980s,
the only time EMTs and paramedics wore gloves was to deliver a baby
or clean fecal material. Thankfully, we’ve learned a lot since then. Glove
manufacturers have been formulating new compounds that feel like
latex but are hypoallergenic. The new LifeStar EC gloves from Microflex
are dipped in two colors, so breaches in glove integrity are more
noticeable, allowing the provider to re-glove and
maintain the protective barrier. The white exterior VITALS
makes it easy to see blood or other body fluids Material: Nitrile
you come in contact with during your exam. The Palm thickness: 0.14 mm
LifeStar EC has a non-stick formulation so tape and Sizes: S–XXXL
other adhesives are more easily removed. There’s Price: Varies by distributor
also an extended cuff that provides additional www.ansell.com/lifestarec
protection for the wrist and lower forearm. 800-876-6866
IN THE NEXT ISSUE: >> Blauer Performance Pro Polo >> Badger Medical Collar >> LA Police Gear Recon Rechargeable Flashlight
>> Laerdal Little Anne QCPR Update >> Porter NitroNox Field Unit >> Technimount System Xtension Pro
1710JEMS_61 61 9/12/17 9:29 AM

MOVING EMS FORWARD
FEBRUARY 21-23, 2018 ///// CHARLOTTE,NC //

///// CHARLOTTE CONVENTION CENTER ///// WWW.EMSTODAY.COM
LEARN // EXPLORE // NETWORK // EXPERIENCE
REGISTER
TODAY AND
SAVE $100!
#EMSToday
OWNED AND PRODUCED BY: OFFICIAL PUBLICATION OF EMS TODAY:
1710JEMS_62 62 9/12/17 11:27 AM

WORK
WHERE YOU
LOVE.
Find Your Dream Career in the

Emergency Medical Services field at JEMS JOBS.
J EMS. C OM
AD INDEX
COMPANY PG# RS# COMPANY PG# RS#

24-7 EMS & 24-7 Fire 45 26 Genlantis 7 3
Airspace Monitoring Systems 37 21 Hartwell Medical 51 29
Avesta Systems 11 6 ImageTrend 8 4
Binder Lift 49 27 IndeeLift 41 22
BoundTree Medical IFC 1 JEMS 63 31
Braun Industries, Inc. 25 14 Junkin Safety Appliance Co. 18 12
Care 2 Innovations 43 24 Kimtek Corporation 42 23
Citizen CPR Foundation 17 10 Mac's Lift Gate 37 20
Crestline Coach 31 16 Masimo OBC 33
Demers Ambulances USA, Inc. 33 17 NAEMT 19 13
Digital Ally 12 7 Physio-Control IBC 32
EMS Today 62 30 Pulmodyne 2 2
FDIC International 36 19 REV Group 35 18
Ferno 27 15 Taylor Healthcare Products, Inc. 13 8
Fire Station Outfitters 44 25 Whelen 9 5
FIT Responder 50 28 Z-Medica 15 9
*IFC=Inside Front Cover, IBC=Inside Back Cover, and OBC=Outside Back Cover
FREE
1710JEMS_63 63 9/12/17 9:29 AM

LAST WORD
THE UPS & DOWNS OF EMS
CRITICAL DONATION
Sandwich eatery Firehouse Subs has
donated more than $17,000 toward
the purchase of nine new bulletproof vests and
emergency medical kits for Ada County Para-
medics (ACP) of Idaho.
The vests will be used by ACP’s TacMed
team of SWAT-level medics who train with
and work alongside law enforcement officers
who serve high-risk warrants, respond to barri-
caded subjects, perform hostage rescues, dispose
of explosives and enter active shooter hot zones.
The new vests provide 360-degree coverage,
unlike older vests that only protected against
bullets on one side. TacMed’s primary goal is to
ensure officer survival, but they also provide life-
saving care to victims, bystanders and suspects.
The Firehouse Subs Public Safety Foun-
dation has raised $28 million dollars over 12
years to give to various public safety agencies
that apply for grants.
We give a thumbs up Firehouse Subs for
their generous gift to ACP's TacMed team. The
new gear safeguards the team to safely and effi-
ciently respond to and care for trauma patients The new bulletproof vests provide 360-degree coverage, safeguarding tactical paramedics in dangerous situ-
without getting hurt themselves. ations. Photo courtesy Ada County Paramedics
HEMS TAKES OFF OVER ambulances, along with the talented medics the technique in an EMS training class.
NORTHERN IRELAND inside them, will help create a safer, health- The nurse soon arrived with an AED. It
Northern Ireland is the latest country ier country. took four shocks to get Alter’s heart beat-
to integrate helicopter EMS (HEMS) into its ing again. When paramedics arrived, it was
prehospital care—and it has wasted no time SCHOOL SAVE nearly a half hour after Alter had gone into
in serving its community. Yet another story of compression-only cardiac arrest. Because of the quick action of
During a ceremony introducing its two CPR saving a life has emerged, high- her friends and school nurse, Alter was able
new air ambulances, medics received a call to lighting the importance of teaching the pub- to avoid any major health consequences such
help a young boy involved in a tractor accident lic this practice. as brain damage or death.
on a farm. The 11-year-old became the first In an article posted to the Time magazine Later, Alter was diagnosed with heredi-
person to be treated and saved by the helicop- website, author Molly Alter detailed how, tary hemorrhagic telangiectasia and is now
ter responders. during her senior year of high school, she got an advocate for hands-only CPR education.
Bringing HEMS to Northern Ireland was dizzy while hanging out with some friends. We give a thumbs up to Alter for shar-
the dream of John Hinds, MD, who tragically Though she insisted these fainting spells were ing her firsthand account of CPR in action.
died in 2015 while providing EMS care during normal and that an ambulance was unneces- This story, along with her education advocacy,
a motorcycle race. He was 35 years old. sary, her friends rightfully ignored her wishes illustrates how important it is to teach this
We give a thumbs up to local health experts, and dialed 9-1-1. Alter soon became uncon- lifesaving practice to all people, regardless of
government officials and medics for finally scious without a pulse. While someone fetched age or occupation. We also give a thumbs up
launching HEMS in Northern Ireland after the school nurse, a friend named Jackie began to Jackie for acting quickly and recalling the
more than a decade of hard work. The new air performing hands-only CPR. She had learned skills she had learned in her EMS class. JEMS
JEMS (Journal of Emergency Medical Services)® (ISSN 0197-2510) USPS 530-710, JEMS is published 12 times a year, monthly by PennWell® Corporation, 1421 S. Sheridan Rd., Tulsa, OK 74112. Periodicals post-
age paid at Tulsa, OK 74112, and at additional mailing offices. SUBSCRIPTION PRICES: Send $20 for one year (12 issues) or $30 for two years (24 issues) to JEMS, 26395 Network Place, Chicago, IL 60673-1263
or call 800-869-6882. Canada: Send $30 for one year (12 issues) or $50 for two years (24 issues). All other foreign subscriptions: Send $60 for one year (12 issues) or $100 for two years (24 issues). Single copy:
$10.00. POSTMASTER: Send address corrections to JEMS (Journal of Emergency Medical Services) , P.O. Box 47570, Plymouth, MN 55447. Claims of non-receipt or damaged issues must be filed within three
months of cover date. JEMS is a registered trademark. © PennWell Corporation 2017. All rights reserved. Reproduction in whole or in part without permission is prohibited. Permission, however, is granted
for employees of corporations licensed under the Annual Authorization Service offered by the Copyright Clearance Center Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, or by calling CCC’s Customer
Relations Department at 847-559-7330 prior to copying. We make portions of our subscriber list available to carefully screened companies that offer products and services that may be important for your
work. If you do not want to receive those offers and/or information via direct mail, please let us know by contacting us at List Services JEMS (Journal of Emergency Medical Services), 1421 S. Sheridan Rd.,
Tulsa, OK 74112. Printed in the USA. GST No. 126813153. Publications Mail Agreement no. 40612608.
1710JEMS_64 64 9/12/17 9:31 AM

CELEBRATING 10 GREAT YEARS
10 YEARS,
100 INNOVATORS
We have recognized 90 of the top innovators in the
EMS industry over the past nine years, and we need
your help finding more people who are pushing the
boundaries of EMS, in order to make it an even 100.
Nominate top innovators in the industry on their

achievements to help EMS systems, care providers
and their communities.
SUBMIT YOUR NOMINATION AT:

WWW.JEMS.COM/EMS10 BY NOVEMBER 30, 2017
HOSTED BY: PRESENTED BY: SPONSORED BY:
This award is open to an individual who has contributed to EMS in an exceptional way. Representatives from JEMS/PennWell
and a panel of EMS experts will judge the entrants. For more information, visit www.jems.com/ems10.
1710JEMS_C3 3 9/12/17 9:31 AM

Taking Noninvasive Monitoring
to New Sites and Applications ™
EMMA™ Rad-57® MightySat™ Rx
Capnograph Device Handheld Pulse CO-Oximeter® Fingertip Pulse Oximeter
EtCO 2 RR SpO 2 PR PI SpMet ®

SpCO
®
SpO 2 PR PI
For over 25 years, Masimo has been an innovator of noninvasive patient

monitoring technologies, striving to improve patient outcomes and reduce the
cost of care by taking noninvasive monitoring to new sites and applications.
Masimo offers leading technology to care providers across the continuum

of care — including mobile settings, Emergency Medical Services (EMS),
and other post acute care areas.1
For more information, visit www.masimo.com

PLCO-000733/PLMM-10582A-0717
Caution: Federal (USA) law restricts this device to sale by or on the order of a
physician. See instructions for use for full prescribing information, including
indications, contraindications, warnings, and precautions.
PLLT-10356A
© 2017 Masimo. All rights reserved. For more information, visit JEMS.com/rs and enter 33.
1
Not all Masimo products are intended for use in all care areas.
1710JEMS_C4 4 9/12/17 9:31 AM

FEBRUARY 21-23, 2018 /////
CHARLOTTE, NC ///// CHARLOTTE CONVENTION CENTER
///// EMSTODAY.COM
MOVING EMS
FORWARD
///////// CONFERENCE PROGRAM

EXCLUSIVE OFFER: REGISTER WITH THE SOURCE The early, early
CODE LISTED ON THE MAILING LABEL BY OCT. 31 TO bird really does
SAVE $175
get the worm!
OFF YOUR GOLD REGISTRATION!
HOST EMS AGENCY:
///// #EMSTODAY OWNED AND PRODUCED BY: OFFICIAL PUBLICATION OF EMS TODAY:
18EMSTPrelim_1 1 8/28/17 10:51 AM

WHY ATTEND?
EMS Today is a unique - and stimulating - experience for EMS personnel worldwide and is supported
and fed by the credibility, quality and excellence of JEMS. At EMS Today 2018, you will gain a better
understanding of current and future issues affecting the EMS industry, see the most innovative
products/services available and share knowledge, expertise and viewpoints amongst your colleagues.
Keep up with all things EMS Today by visiting our website, www.EMSToday.com and following our
hashtag, #EMSToday.
48 95%
NETWORK WITH 4,500+ EMS PROFESSIONALS
FROM NEARLY
COUNTRIES
OF ATTENDEES SAID THEY
WOULD RECOMMEND EMS
TODAY TO A COLLEAGUE
VISIT WITH 250 EXHIBITING COMPANIES

100+
98%
CONFERENCE SESSIONS
OF ATTENDEES SAID THE EXHIBITORS’ AND WORKSHOPS
QUALITY AND VARIETY MET OR EXCEEDED
THEIR EXPECTATIONS
EARN CEH
NEW FOR 2018!
THREE CADAVER LAB SESSIONS
INCLUDED IN YOUR CONFERENCE REGISTRATION.
OPEN TO ALL ATTENDEES LIMITED SEATS AVAILABLE. SEE DETAILS ON PAGE 15.
“YOU’RE GETTING TO SEE THE CUTTING-EDGE TECHNOLOGY, THAT IS EMS,

ACTUALLY APPEAR BEFORE YOU. I GET TO SEE A LOT OF PRACTICES AND BRING
THEM BACK AND PUT THEM INTO WORK FOR MY CAREER.”
TROY HOOVER, GUARDIAN FLIGHT
///////////// 2 EMS TODAY 2018 // CONFERENCE PROGRAM
18EMSTPrelim_2 2 8/28/17 10:52 AM

TABLE OF CONTENTS
GENERAL EVENT INFORMATION
/// Schedule of Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 04
/// Sponsors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 05
/// Social Media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 06
/// Networking Opportunities . . . . . . . . . . . . . . . . . . . . . . . . . . . . .07
// Opening Reception
// Breakfast Roundtables
// Ride Alongs
// Off-site Networking Party: ZOLL Shockfest . . . . . . . . . . . . . 08
/// Ways to Save . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 09
// Crew Pricing
// Scholarship Program
// International Discount
/// EMS10: Innovators in EMS Awards . . . . . . . . . . . . . . . . . . . . . .10
/// JEMS Games Clinical Competition . . . . . . . . . . . . . . . . . . . . . . 11
/// Co-Located Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
CONFERENCE DETAILS
/// Program Committee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
/// Continuing Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
/// Cadaver Lab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
/// Opening Ceremonies & Keynote Session . . . . . . . . . . . . . . . . 16
/// Pre-Conference Workshops at-a-Glance . . . . . . . . . . . . . . . . 17
FO
/// Pre-Conference Workshop Details . . . . . . . . . . . . . . . . . . 18-21
RAL IN
/// Event at-a-Glance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22-27
/// Conference Program Details . . . . . . . . . . . . . . . . . . . . . . . .28-51
GENE
/// Faculty Bios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52-60
EXHIBITION INFORMATION
CE
/// Exhibition Details . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
EREN
// Exhibit Floor Giveaway
/// Exhibit Floor Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .62 CO N F
/// Exhibitor List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63
/// Exhibit & Sponsorship Opportunities . . . . . . . . . . . . . . . . . . .64
/// Sales Contacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .64
P
SPOHNIBSITING &
/// Survey Results & Demographics . . . . . . . . . . . . . . . . . . . . . . .65

ORSHI
TRAVEL & REGISTRATION INFORMATION

EX
/// Registration Types and Rates . . . . . . . . . . . . . . . . . . . . . . . . . .66

/// Travel Information & Hotel Map . . . . . . . . . . . . . . . . . . . . . . . . . 67
N
TRATIO
QUESTIONS?
REGAIVSEL &
Have a question for the EMS Today team?

Visit the contact us page at www.EMSToday.com
TR
#EMSTODAY // EMSTODAY.COM 3 /////////////
18EMSTPrelim_3 3 8/28/17 10:52 AM

SCHEDULE OF EVENTS
All activities will take place at the Charlotte Convention Center unless otherwise noted.
NEW SCHEDULE FOR 2018

/// EVENT DATES SHIFTED TO A WED . - FRI . SCHEDULE
/// MORE TIME TO WALK THE EXHIBIT HALL
/// MORE NETWORKING
MONDAY, FEBRUARY 19, 2018 STRATEGIC PARTNERS

/// Exhibitor Target Move-In . . . . . . . . . . . . . . 1:00 PM – 5:00 PM
/// Registration . . . . . . . . . . . . . . . . . . . . . . . . . 3:00 PM – 6:00 PM
TUESDAY, FEBRUARY 20, 2018

/// Registration . . . . . . . . . . . . . . . . . . . . . . . . . 7:00 AM – 5:00 PM
/// JEMS Games Preliminaries . . . . . . . . . . . . . 8:00 AM – 5:00 PM
/// Pre-Conference Workshops . . . . . . . . . . . 8:00 AM – 5:00 PM
/// General Exhibitor Move-In . . . . . . . . . . . . 8:00 AM – 5:00 PM
WEDNESDAY, FEBRUARY 21, 2018

/// Breakfast Roundtables . . . . . . . . . . . . . . . . 8:00 AM – 9:30 AM
/// General Exhibitor Move-In . . . . . . . . . . . . 8:00 AM – 12:00 PM
/// Conference Sessions . . . . . . . . . . . . . . . . . 8:00 AM – 11:30 AM
/// Opening Ceremonies & Keynote . . . . . . . 1:00 PM – 3:00 PM
/// Exhibit Hall Open . . . . . . . . . . . . . . . . . . . . 3:00 PM – 6:00 PM
/// Hands On Experience, Exhibit Hall . . . . . . 3:00 PM – 5:00 PM
/// Opening Reception, Exhibit Hall . . . . . . . . 4:30 PM – 6:00 PM
/// Offsite Networking Party: ZOLL Shockfest, Whiskey River . . . 6:15 PM
THURSDAY, FEBRUARY 22, 2018

/// Conference Sessions . . . . . . . . . . . . . . . . . 8:00 AM – 11:30 AM
/// Exhibit Hall Open . . . . . . . . . . . . . . . . . . . 10:00 AM – 5:00 PM
/// Hands On Experience, Exhibit Hall . . . . . . 11:30 AM – 2:00 PM
/// Conference Sessions . . . . . . . . . . . . . . . . . . 1:30 PM – 3:30 PM
/// JEMS Games Finals . . . . . . . . . . . . . . . . . . . . 5:15 PM – 7:30 PM
FRIDAY, FEBRUARY 23, 2018

/// Conference Sessions . . . . . . . . . . . . . . . . 8:00 AM – 10:00 AM
/// Exhibit Hall Open . . . . . . . . . . . . . . . . . . . . 10:00 AM – 1:00 PM
/// Conference Sessions . . . . . . . . . . . . . . . . 11:00 AM – 12:30 PM
/// Exhibit Floor Giveaway (Must be Present to Win) . . .12:30 PM
/// Exhibitor Move Out . . . . . . . . . . . . . . . . . . . 1:00 PM – 8:00 PM
/// Conference Sessions . . . . . . . . . . . . . . . . . . .1:15 PM – 2:45 PM
*Times are tentative and subject to change
18EMSTPrelim_4 4 8/28/17 10:52 AM

SPONSORS
(As of August 15, 2017)
EMS TODAY THANKS
THE 2018 SPONSORS FOR THEIR
PLATINUM SPONSORS: SUPPORT OF THIS YEAR’S EVENT.
SILVER SPONSOR:
GOLD SPONSOR:
ADDITIONAL SPONSORS:
FO
RAL IN
®
GENE
®
SEE PAGE 61 FOR A LIST OF EXHIBIT FLOOR GIVEAWAY SPONSORS.

WANT TO BECOME AN EXHIBITOR? SEE PAGE 64.
18EMSTPrelim_5 5 8/28/17 10:52 AM

SOCIAL NETWORKING
LET’S CONNECT!
@EMSTODAY | #EMSTODAY
/// Unite with other EMS professionals /// Stay up-to-date with event happenings
/// Share your EMS journey /// Win prizes
LET’S BREAK THE 2017 RECORDS!

14, 1 05,077
SOCIAL IMPRESSIONS
&
5,528 TWEETS
1,044 TWITTER
PARTICIPANTS
28 AVERAGE
TWEETS/HOUR
18EMSTPrelim_6 6 8/28/17 10:52 AM

NETWORKING & SPECIAL EVENTS
///
93%
OPENING RECEPTION ON THE EXHIBIT FLOOR
Open to all attendees
of attendees said the
Networking Events met or
exceeded their expectations
Immediately following the keynote session, join us at the opening

reception in the exhibit hall. Enjoy complimentary drinks and networking
with an international assembly of EMS professionals.
///// SPONSORED BY:
As of Aug. 15, 2017 ®
/// BREAKFAST ROUNDTABLES NEW THIS YEAR!

Thursday, February 22 | 8:00 AM – 9:30 AM // Cost: $40 (breakfast buffet is included)
Topics will Include:
FO
// Rural & Wilderness EMS // America’s Opioid Crisis
RAL IN
Moderator: Jonathan Politis, MPA, NRP Moderator: Michael Levy, MD
GENE
// I’m a New Manager, Now What? // Identifying & Diverting Stroke Patients
Moderator: Robert Girardeau, MSM-HCA, Moderator: Jason T. McMullan, MD
NRP, FP-C // Epinephrine: To Use or Not to Use?
// Best Practices in Peer Support Moderator: Corey Slovis, MD
Moderator: Wayne Zygowicz, MS, EFO, // Benefits of Prehospital ECMO
EMT-P (extracorporeal membrane oxygenation)
// Provider Stress & Resiliency Moderator: Scott Youngquist, MD
Moderator: Chetan Kharod, MD, MPH, USAF, // Issues in Mobile Integrated Healthcare (MIH)
MC, SFD Moderator: Matt Zavadsky, MS-HSA, EMT
// Sepsis Screening & Alerting
Moderator: Rommie Duckworth, LP
Want to attend? Simply add this event to your registration! (space is limited)
/// EXCLUSIVE RIDE-ALONG OPPORTUNITIES
EMS Today offers any registered attendee the exclusive, free opportunity to ride along with
local EMS crews. Enhance your time and EMS learning experience in Charlotte, NC. Limited
space available, to learn more visit www.emstoday.com/event-information/ridealong.
18EMSTPrelim_7 7 8/28/17 10:52 AM

///
OPEN TO ALL ATTENDEES | WEAR BADGE FOR ENTRY
///
STOP
OP BY ZOLL BOOT
BOOTH
TO PICK UP YOUR
2 FREE DRINK TICKETS!
WEDNESDAY, FEBRUARY 21 | 6:15 PM

WHISKEY RIVER (AT THE EPICENTRE)
210 E TRADE ST
#ZOLLSHOCKFEST
A PENNWELL EVENT SPONSORED BY:
18EMSTPrelim_8 8 8/28/17 10:52 AM

BEST WAYS TO SAVE
/// BEST CREW PRICING IN THE INDUSTRY
Will your crew be attending EMS Today 2018? Register together and get a significant group discount!
The more you send, the more you save! *Note: crews must be from same agency/department.
Save $$$ by registering your crew!
2018 CREW PRICING

ALPHA 3-5 $1,000
BRAVO 6-10 $2,000
CHARLIE 11-19 $3,000
DELTA 20-29 $4,000
ECHO 30 or more $5,000
ALL PRICING IN USD
Email [email protected] to get your crew registered today!
/// INTERNATIONAL DELEGATE RATE NEW THIS YEAR!

Our valued attendees traveling from abroad face additional travel fees and setbacks.
Fortunately, we offset those with deeply reduced rates and logistical help.
INTERNATIONAL GOLD PASSPORT PRICING:
FO
Register by January 19: US$325 / Register after January 19: US$425
RAL IN
*International Rate excludes Canada
GENE
TO REDEEM DISCOUNT, USE PROMO CODE EMSTINTL18
SCHOLARSHIP OPPORTUNITY
Don’t let the price of registration hold you back from attending EMS Today for the first time!
Apply for a scholarship to see if you qualify for a FREE full conference registration!
Exhibitors donate unused conference registrations so that you can attend.
Apply before November 3, 2017 at www.EMSToday.com
ATTENTION EXHIBITORS! Do you have unused conference passes? Donate today
to help provide more scholarship opportunities. Contact [email protected]
2017 Scholarship Winner
“I WANT TO LEARN AS MUCH AS I CAN, I THINK THAT’S
PART OF BEING IN EMS… CONSTANTLY
LEARNING, CONSTANTLY EVOLVING.”
MARY KRISH, WENDOVER
18EMSTPrelim_9 9 8/28/17 10:52 AM

EMS 10: INNOVATORS IN EMS
JEMS, with support from Physio-Control and Stryker, is proud to present the EMS 10:
Innovators in EMS awards. Now in its 10th year, the awards recognize individuals who
have contributed to EMS in an exceptional and innovative way.
Ten outstanding EMS professionals were recognized at the 2017 EMS Today
Conference as the “EMS10: Innovators in EMS” for 2016. Their efforts are an
inspiration to the rest of the EMS community. Take a moment today to nominate
the next innovator in EMS. Details below.
///// Presented By: ///// Sponsored By:
2016 AWARD RECIPIENTS

// Mary Ahlers, MEd, BSN, RN, CP-C, NRP // Brett Patterson
(AWARDED
IN 2017)
Founder, Paramedic Health Solutions, Mobile CE and Chair, Medical Council of Standards, International
Community Paramedicine Association and Registry Academies of Emergency Dispatch
// Michael Baker, MA, EMT-P // Brenda Staffan
EMS Chief, City of Tulsa Fire Department Director of New Ventures, REMSA
// Brian Clemency, DO, MBA, FACEP, FAEMS // Jonathan Washko, MBA, NRP, AEMD
EMS Medical Director, University at Buffalo Assistant Vice President, Northwell Health Center for EMS
// Scott DeBoer, RN, MSN, CPEN, CEN, CCRN, // Siegfried Weinert, MSc, EMT-I, EMD
CFRN, EMT-P Project Manager, 144 EMS State Dispatch Notruf
Founder/Seminar Leader, Pedi-Ed-Trics Emergency Niederösterreoch
Medical Solutions, LLC
// James Woodson, MD, FACEP
// Sanjaya Karki, MD, MBBS Founder and CEO, Pulsara
Prehospital Care Coordinator, Grande International Hospital
KNOW SOMEONE WHO HAS MADE A SIGNIFICANT

CONTRIBUTION TO THE EMS INDUSTRY IN 2017?
Nominate them at JEMS.com/ems10 /// Deadline for 2017 Nominations: November 30, 2017
18EMSTPrelim_10 10 8/28/17 10:52 AM

JEMS GAMES CLINICAL COMPETITION
DOES YOUR CREW
HAVE WHAT IT TAKES? ////////////////
The JEMS Games is a challenging and educational clinical competition highlighting cutting-
edge simulation technology. The reimagined and redesigned preliminary competition challenges
teams to appropriately assess and provide quality, efficient patient care during three realistic,
high-pressure scenarios. The top three teams move on to the final competition, a 20-minute
high-energy scenario that requires managing multiple patients.
/// SPECTATORS WELCOME!

All attendees are encouraged to attend the final competition, where you’ll not only enjoy
FO
the adrenaline-pumping action but also earn 1 CEH.
RAL IN
NEW THIS YEAR: JEMS Games
GENE
///// FOUNDING SPONSOR: The JEMS Games awards
ceremony will be held the same
night! Stay to see who wins 1st,
2nd, and 3rd place!
TEAM PRIZES:
Gold - $1,000 /// Silver - $750 /// Bronze - $500
*EMS equipment and prizes donated to the winning teams by our valued sponsors
SPACE IS LIMITED AND Entry requirements, competition information and registration

FILLING UP FAST! forms are available at www.emstoday.com/index/jems-games.
SECURE YOUR TEAM’S Teams include 3 members and 1 alternate (optional). Entry is
SPOT TODAY! limited to the first 25 teams. Team registration fee is $100.
Deadline to enter:
December 31, 2017
18EMSTPrelim_11 11 8/28/17 10:52 AM

CO-LOCATED EVENTS
/// NEMSMA EMS SUPERVISING & MANAGING
ENHANCE YOUR EXPERIENCE AT OFFICER’S CREDENTIALING EXAMS (JOINT)
Tuesday, February 20, 2018
EMS TODAY 2018 WITH THESE 1:30 PM – 5:00 PM
CO-LOCATED EVENTS. The credentialing written exam is for NEMSMA Supervising and
Managing Officer certification. Application for the test is available
at https://nemsma.candidatecare.jobs/. Applications must be
submitted and approved at least six weeks prior to the exam.
Supervising Paramedic Officer Exam:
/// NEMSMA MANAGING OFFICER’S $225 for Non-Members, $175 for NEMSMA Members
CREDENTIALING EXAMINATION PREP-COURSE Managing Paramedic Officer Exam:
Tuesday, February 20, 2018 $425 for Non-Members, $325 for NEMSMA Members
8:30 AM – 12:30 PM
This workshop will review the 7 Pillars of EMS Officer /// NEMSMA’S COMPETENCIES
Competency knowledge areas in a scenario-based format,
addressing the managerial level in each pillar. It will also include
& CREDENTIALING PROGRAM
a review of the Managing Officer’s written examination and
Tuesday, February 20, 2018
oral boards format and style, providing a review of how to
2:00 PM – 5:00 PM
interpret the questions and the critical thinking process to use A three-hour program on the history and development of
in selecting answers. the National EMS Management Association’s EMS Officers’
competencies and credentialing project. It will highlight the
Attendees will be eligible to sit for the credentialing exam at status of the process available for those interested in pursuing
the conclusion of the session 1:30 pm – 5:00 pm if they are and attaining their national credential as one of the three
otherwise qualified and have submitted an accepted application levels of EMS Officer; Supervisor, Manager or Executive. It will
in advance. Application for the test is available at also review the pre-requisites and requirements needed for
https://nemsma.candidatecare.jobs/. Applications must be candidates to attain their national NEMSMA certification as
submitted and approved at least six weeks prior to the exam. an EMS Officer in one of these three categories, as well as the
competencies for each. The program will include a review of the
/// NEMSMA SUPERVISING OFFICER’S establishment of the American College of Paramedic Executives
CREDENTIALING EXAMINATION PREP-COURSE (ACPE) and its role in certifying officer credentials. In addition,
Tuesday, February 20, 2018 the presentation will describe NEMSMA’s course accreditation
9:00 AM – 12:00 PM process for speakers interested in securing same for their
This workshop will review the 7 Pillars of EMS Officer presentations. No cost to attend. Open to all attendees.
Competency knowledge areas in a scenario-based format,
addressing the supervisory level in each pillar. It will also include
a review of the Supervising Officer’s written examination format /// WHAT DOES THE FUTURE HOLD? SEIZING
and style, providing a review of how to interpret the questions THE OPPORTUNITY FOR PREVENTION AND
and the critical thinking process to use in selecting answers. ENHANCING COMMUNITY HEALTH
Thursday, February 22, 2018
Attendees will be eligible to sit for the credentialing exam at 3:45 PM – 5:00 PM
the conclusion of the session 1:30 pm – 5:00 pm if they are Speakers: Paul Maxwell, Keith Griffiths and Michael Gerber
otherwise qualified and have submitted an accepted application Attend this session not just to hear from those involved in
in advance. Application for the test is available at the EMS Agenda 2050 project, but to give your feedback
https://nemsma.candidatecare.jobs/. and thoughts on the how the topic of prevention should be
addressed in the final document.
Applications must be submitted and approved at least six weeks
prior to the exam.
In this session there will be a presentation and case study by
the winner of the Nicholas Rosecrans Award, which recognizes
best practices in injury prevention by an individual or a service.
The Nicholas Rosecrans Award will be presented at the Opening
Ceremonies on Wednesday, February 21.
18EMSTPrelim_12 12 8/28/17 10:52 AM

PROGRAM COMMITTEE
PennWell and EMS Today wish to express our sincere gratitude to the 2018 conference planning
committee. As a part of this committee, these individuals share their knowledge, time and expertise to
ensure a high-quality and successful EMS Today conference program.
// A.J. Heightman // Gregory R. Frailey, DO, FACOEP, EMTP // Jonathan Politis, MPA, NRP
Conference Chair, EMS Today EMS Medical Director Emeritus, Susquehanna EMS Educator/Consultant/Paramedic
Editor-in-Chief, JEMS, PennWell Corp. Regional EMS Jon Politis Emergency Services Education
// Ryan Gerecht, MD, CMTE // Vincent D. Robbins, FACPE, FACHE
Medical Director, City of Tacoma Fire Department President & CEO, MONOC
// Ryan Kelley, NREMT
Managing Editor, JEMS, // Robert P. Girardeau, MSM-HCA, BS, NRP, FP-C // Geoffrey Shapiro,
JEMS Games Logistics Coordinator, Manager, Jefferson Health - JeffSTAT Critical Care Director, EMS & Operational Medicine Training,
PennWell Corp. Transport George Washington University
// Regina Godette Crawford, BS // Corey Slovis, MD, FACP, FACEP, FAAEM,
Advocacy Liaison, EMS Management and Professor and Chairman, Department of Emergency
// Debbi Wells, CMP Consultants Medicine; Vanderbilt University Medical Center, Medical
Conference Manager, EMS Today
PennWell Corp. // Chris Goenner, NREMT-P, B.S. SEMSO Director, Nashville Fire Dept. and International Airport
Program Chair/Emergency Medical Sciences // E. Reed Smith, MD, FACEP
Program Central Piedmont Community College Operational Medical Director,
// Sara Jones Arlington County Fire Department
// Jeffrey M. Goodloe, MD, NRP, FACEP, FAEMS
Conference Coordinator, EMS Today Medical Director, EMS System for Metropolitan // Michael Stanford, EMT- P
PennWell Corp. Oklahoma City and Tulsa Operations Manager, Mecklenburg EMS Agency
// Christian D. Griffin, NRP // Teresa T. Stewart, BSHS, MHS, EMT-P (ret), NSP-OEC
Director, Baltimore County Fire Department Senior Patroller, Division Supervisor Instructor
Development, Division Board Secretary, OEC
// Mike Hall, MBA, NREMT-P
// Arnold Alier, AAS, BA, MEd, EdD, NRP Instructor Trainer, National Ski Patrol
President/CEO, Nature Coast EMS
State Director of EMS, SC DHEC Bureau of EMS // Walt Stoy, PhD, EMT-P
// Fran Hildwine, BS, NRP
// Bill Atkinson, PhD, MPH, MPA, EMT-P, FACHE Professor and Director - Emergency Medicine
AHA Training Center Program Coordinator
President, Guidan Healthcare Consulting University of Pittsburgh/Center for Emergency Medicine
Nemours/A.I. DuPont Hospital for Children
// McKenzie Beamer // Jonathan Studnek, PhD, NRP
// Ofer Lichtman, NRP
EMS for Children Program Manager; Opioid Epidemic Deputy Director, MEDIC: Mecklenburg EMS Agency
Terrorism Liaison Officer Coordinator, Rancho
Liaison, North Carolina Office of Emergency Medical Cucamonga Fire District // Douglas Swanson, MD, FACEP, FAEMS
Services Medical Director, MEDIC: Mecklenburg EMS Agency
// Andy Lovell, NREMT/P; NJ MICP
// Maria Bianchi, MA Ed., CAE EMS Chief, Gloucester County EMS // Peter P. Taillac, MD, FACEP, FAEMS
Executive Vice President, American Ambulance Medical Director, Utah Bureau of EMS and
Association // Shaughn Maxwell, EMT-P Preparedness
Deputy Fire Chief, Snohomish
// Allison J. Bloom, Esq., EMT, EMS-I, FACPE County Fire District 1 // Trevor Taylor, EMT-P, NRP, ACLS/PALS/BLS
Attorney at Law, Law Office of Allison J. Bloom Clinical Education Supervisor, Mecklenburg EMS Agency
// Mike McEvoy, PhD, NRP, RN, CCRN
// William Bozeman, MD, FACEP EMS Chief, Saratoga County, New York // Alan Thompson, NRP, BS, AAS, TEMS
Professor, Director of Prehospital Research, Dept. of EMS Director, Cabarrus County EMS
Emergency Medicine, Wake Forest University School // Henderson McGinnis, MD
CE
of Medicine Wake Forest Baptist Health // Candi Van Vleet, DHA, NRP, RN
EREN
// Jack Meersman, BS, NRP, CACO Associate Clinical Director, Duke Heart Network, Duke
// Brent Bronson, NREMT-P University Health System
Vice President, North American Rescue LLC Compliance Officer, Gold Cross Services, Inc.
// Greg Chapman, BS RRT, CCEMT-P // David Miramontes, MD, FACEP, FAEMS // Jonathan Washko, NRP, MBA, AEMD
Assistant Vice President of Operations,
CO N F
Director, Center for Prehospital Medicine Medical Director, San Antonio Fire Department
Assistant Clinical Professor, University of Texas Northwell Center for EMS
Carolinas Medical Center
Health Science Center-San Antonio // Karen Wesley, NREMT-P
// Norris W. Croom III, EFO, CEMSO, CFO Retired Paramedic, Police Officer and EMS Educator
Deputy Chief, Castle Rock Fire and Rescue Department // Eric Morrison, MBA, EMT-P
EMS Director, Piedmont Medical Center EMS // Keith Wesley, MD, FACEP, FAEMS
// Robin Davis, NRP Medical Director, HealthEast Medical Transportation
Founding Partner, Absolute Leadership, LLC // Jeremy Mothershed, NRP, EMT-T
Assistant Chief Operations, Havre de Grace // Steve Wirth, JD
// Jackson Deziel, PhD, MPA, NRP Ambulance Corps Attorney/Partner, Page, Wolfberg & Wirth LLC
Assistant Professor, Western Carolina University
// J. Brent Myers, MD, MPH // Robert A. Wronski, MBA, CEMSO, NRP
// Edward Dickinson, MD, NRP, FACEP Chief Medical Officer & Exec. Vice Chief, Bureau of EMS, SC Department of Health and
Professor of Emergency Medicine, Perelman School President, Medical Operations, Evolution Health, Environmental Control
of Medicine, University of Pennsylvania Associate Chief Medical Officer, AMR // Joseph Zalkin, BSHS, EMC, EMT-Paramedic
// David Ezzell, MPA, EMT-P // R. Darrell Nelson, MD, FACEP, FAAEM Retired, Wake County EMS
Education Consultant, North Carolina Office of EMS Associate Professor of Emergency Medicine, Program
// Matt Zavadsky, MS-HSA, EMT
// Antonio Fernandez, PhD, NRP, FAHA Director, EMS and Disaster Fellowship/EMS Medical
Director, Wake Forest University School of Medicine
Chief Strategic Integration Officer,
Research Director/Research Assistant Professor, MedStar Mobile Healthcare
UNC EMS Performance Improvement Center // Jerry Overton, MPA // Wayne Zygowicz, MS, EFO, CFO, EMT-P
// Jay Fitch, PhD President, IAED Division Chief, Littleton Fire Rescue
Founding Partner, Fitch & Associates, LLC // Joe Penner, MBA
Executive Director, MEDIC: Mecklenburg EMS Agency
18EMSTPrelim_13 13 8/28/17 10:52 AM

CONTINUING EDUCATION
Continuing Education credits are earned on a 1-unit-per-hour
basis. For example, a 1.5 hour session will give you 1.5 CEH.
/// CAPCE
Continuing Education Hours (CEH) will be applied for through the Commission on Accreditation for
Pre-Hospital Continuing Education (CAPCE). CAPCE is an organization established to develop and implement policies to standardize the review
and approval of EMS continuing education activities.
//////// SPONSORING ORGANIZATIONS OF CAPCE

/// American College of Emergency Physicians /// National Association of EMS Educators
/// American College of Osteopathic Emergency Physicians /// National Association of State EMS Officials
/// American Heart Association /// National Association of State EMS Officials/Education &
/// National Association of Emergency Medical Services Physicians Professional Standards Council
/// National Association of Emergency Medical Technicians /// National Registry of Emergency Medical Technicians
/// NREMT
The NREMT recertification process requires that EMS Professionals maintain continued competency by meeting the educational
requirements as outlined in the traditional recertification refresher program or the newly utilized National Continued Competency
Program (NCCP). Specific requirements may vary from state to state. For more information, please visit NREMT.org. Each session in the
program is marked with the NREMT topic category it satisfies towards the education requirements. If no category is given, the session
qualifies as CEU only. For the most up-to-date information on the NREMT categories, please check the EMS Today website.
/// NATIONAL EMS MANAGEMENT ASSOCIATION EMS OFFICER CERTIFICATION

EMS Today has partnered with the National EMS Management Association (NEMSMA) to offer management certifications.
Sessions labeled NEMSMA have been reviewed by NEMSMA and will contribute to the prerequisites for EMS Officer credentialing.
Credit hours earned for each NEMSMA accredited session will be equal to the number of CEH awarded unless otherwise noted
on your CEH certificate. For the most up-to-date information on NEMSA-accredited sessions at EMS Today, be sure to check the
EMS Today website.
WE MAKE IT EASY TO EARN CEH WHILE AT EMS TODAY

STEP 1: Register for EMS Today as a Full Conference Delegate
STEP 2: Check the program for the sessions needed and plan your schedule
STEP 3: Attend EMS Today and the sessions you need for CEH.
We will scan your badge at the entrance to every session you attend so that you receive
continuing education for that session..
STEP 4: After the conference, you will be sent an email with instructions on how to download a PDF of
your certificate.
ALL license information must be correct in order to receive credit for the sessions you attend.
Make sure Registration has your correct license information.
18EMSTPrelim_14 14 8/28/17 10:52 AM

CADAVER LAB
8:00 AM – 10:00 AM
Thursday, February 22, 2018 10:30 AM – 12:30 PM
1:30 PM – 3:30 PM
Teleflex - Prehospital Emergency Care

Procedural Cadaver Lab
Director: Dan Smith, RN, BSN, CFRN, EMT-P
THREE SESSIONS WILL BE OFFERED.

Open to Gold or Silver Passes at no additional cost.
Space is limited per session and pre-registration is required.
The purpose of this session, presented by Teleflex, 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 will serve as
faculty for this program.
Under expert instruction, participants will have the opportunity to practice the following procedural skills: basic airway management,
direct and video laryngoscope intubation, intraosseous access, hemorrhage control and various other prehospital emergency procedures.
The participants will have the opportunity for anatomical exploration as it relates to these procedures providing a unique appreciation of
the anatomy and the impact of the disease process. An analysis of the unnecessary risk and the potential for complications when these
procedures are performed in suboptimal conditions will be explored.
CE
EREN
CO N F
18EMSTPrelim_15 15 8/28/17 10:52 AM

OPENING KEYNOTE SESSION
OPEN TO ALL EXHIBITORS AND ATTENDEES
WEDNESDAY, FEBRUARY 21, 2018 // 1:00 PM - 3:00 PM
SPONSORED BY:
/// EVENT EMCEE: A.J. Heightman, MPA, EMT-P

EMS Today Conference Chair, JEMS Editor-in-Chief
/// KEYNOTE SPEAKER:

MAJOR ANDREW D. FISHER, EMT-P, MPAS, PA-C,
MD CANDIDATE, 2020
For many, the journey into EMS is not as planned as other career fields. Furthermore, once they find
their way into EMS, the path can be clouded without clearly identified goals and plans. Although this
may be a hindrance or a source of unneeded stress in a job that’s often underpaid, underappreciated and
misunderstood, it also allows for unique growth as you forge new and undiscovered paths in medicine
and EMS. What makes you unique in EMS? How have you made an impact? Rarely is it evidently clear,
even for the seasoned paramedic. In this compelling keynote, Major Andrew D. Fisher will challenge you
to discover how to be unique and make an impact, not only locally, but regionally and nationally.
I CAME FROM EXTREMELY HUMBLE BEGINNINGS AND BY CHANCE, WAS SENT TO AN EMT COURSE WHILE SERVING IN THE US ARMY
AS AN INFANTRYMAN ASSIGNED TO THE 1ST BATTALION, 75TH RANGER REGIMENT. FROM THAT COURSE, I DISCOVERED MY LOVE
FOR PREHOSPITAL MEDICINE. OVER THE LAST 20 YEARS, MY CAREER CONTINUES TO BE CONVOLUTED AND EVER CHANGING.
I CHOSE THIS PATH, I CHOSE IT BECAUSE I NEVER WANT TO STOP LEARNING AND MAKING AN IMPACT ON THE PROFESSION
AND PATIENTS. EACH PREHOSPITAL PROFESSIONAL NEEDS TO TAKE RESPONSIBILITY FOR THEIR ROLE IN HEALTHCARE. IT IS
CHANGING, IT IS UP TO YOU IF YOU WILL HAVE A SAY SO IN YOUR CAREER AND THE PREHOSPITAL PROFESSION.
Visit EMSToday.com to read more about Major Andrew D. Fisher.
/// 2018 Awards Presented

Lifetime Achievement Award
James O. Page/JEMS Leadership Award
Sponsored by
John P. Pryor, MD/Street Medicine Society Award
Sponsored by
EMS10: Innovators in EMS Awards
Sponsored by
18EMSTPrelim_16 16 8/28/17 10:52 AM

PRE-CONFERENCE
WORKSHOPS AT-A-GLANCE
WANT TO ADD A PRE-CONFERENCE WORKSHOP TO YOUR REGISTRATION?
It’s simple. If you haven’t registered yet, simply select which pre-conference workshop you would like to attend
and the price of the workshop will be added to your registration. All additions/changes have to be in writing.
ALREADY REGISTERED? Easy - just email registration at [email protected] and let them know
which pre-conference workshop you would like to add. They will bill you for the difference.
PRE-CONFERENCE WORKSHOPS // TUESDAY, FEBRUARY 20, 2018

FULL-DAY WORKSHOPS HALF-DAY WORKSHOPS
8:00 AM - 5:00 PM 8:00 AM - 12:00 PM 1:00 PM - 5:00 PM
EMS Supervisor Leadership 12-Lead ECG Acquisition and Advanced Concepts in 12-Lead
Academy Interpretation Made Easy Interpretation
Robert Farmer, BSM, FACPE Scott Crawford, NRP, FP-C, EMSI Scott Crawford, NRP, FP-C, EMSI
Ryan Greenberg
Essentials of Advanced Proper Post Exposure Medical Classrooms that Engage
Airway Management Follow Up - The Latest and Michael McDonald, RN, NRP
Michael Keller, NRP Greatest Michelle Beatty, MEd, NRP
Katherine West, RN, BSN, MSed Rachel Short, NRwP
Stephanie Corbin, NRP, BA
The National Conference on Law & Policy Ultrasound Use in Prehospital Ultrasound Use in Prehospital
Douglas Wolfberg, JD Care & Resuscitations Care & Resuscitations
Steve Wirth, JD Faizan H. Arshad, MD Faizan H. Arshad, MD
Chad Brocato, JD, DHSc
Skip Kirkwood, JD, FACPE
Scot Phelps, JD, MPH
The Entrepreneurial EMS Agency - How EMS Service Tactical Tips and Treatment Tactical Tips and Treatment
Leaders Can Take Advantage of the EMS 3.0 Transformation Techniques for EMS Providers Techniques for EMS Providers
Douglas Hooten, MBA Wyatt Sabo Wyatt Sabo
Jonathan Washko, NRP, MBA, AEMD Steve Markham Steve Markham
Matt Zavadsky, MS-HSA, EMT
Robert Nadolski, BS, NREMT-P (Ret.)
CE
OFFSITE Emerging Challenges in EMS
EREN
Brian LaCroix
Drones & Artificial Intelligence as Tools for Public Safety Michael Touchstone, BS
Andreas Claesson, PhD, RN, EMT-P Troy Hagen, MBA CO N F
Andreas Cleve Vincent D. Robbins, FACPE, FACHE
Jennifer Pidgen
Douglas Spotted Eagle
OFFSITE
Essentials of Wilderness Medicine
for EMTs and Paramedics
HALF-DAY (4 HR):
Jonathan Politis, MPA, NRP $125.00 early bird/$150.00 regular
Lunch included with
Will Smith, MD, Paramedic
FULL-DAY (8 HR OFF-SITE): an 8-hr workshop or
OFFSITE $250.00 early bird/$275.00 regular
two 4-hr workshops
Stimulating Simulation - A Deep Dive Into EMS Best Practice
Simulation Techniques FULL-DAY (8 HR ON-SITE):
Andrew Spain, MA, NCEE, EMT-P $225.00 early bird/$250.00 regular
MEDIC Simulation Center Staff
Jennifer McCarthy, MAS, NRP, MICP, CHSE
18EMSTPrelim_17 17 8/28/17 10:52 AM

PRE-CONFERENCE WORKSHOP DETAIL
TUESDAY, FEBRUARY 20, 2018 FULL-DAY // 8:00 AM-5:00 PM
/// EMS SUPERVISOR LEADERSHIP ACADEMY (#19882) /// THE ENTREPRENEURIAL EMS AGENCY – HOW EMS
NREMT Category: Other Continuing Education, NEMSMA-accredited SERVICE LEADERS CAN TAKE ADVANTAGE OF THE
Instructor(s): EMS 3.0 TRANSFORMATION (#20087)
• Robert Farmer, BSM, FACPE, Public Safety Evangelist and NextGen NREMT Category: Other Continuing Education
Solutions Director, Atos Public Safety Instructor(s):
• Ryan Greenberg, Executive Director, MedSpan Integrated Health • Douglas Hooten, MBA, CEO, Medstar Mobile Healthcare
• Jonathan Washko, NRP, MBA, AEMD, Assistant Vice President of
This full-day leadership academy, based on the Lee County (FL) Public Safety
Operations, Northwell Center for EMS
Leadership Academy and the NEMSMA Seven Pillars of EMS Officer Competencies,
• Matt Zavadsky, MS-HSA, EMT, Chief Strategic Integration Officer,
provides aspiring and new supervisors with several critical skills they need in order to
MedStar Mobile Healthcare
perform in their new role. The workshop is broken up into seven parts, with each part
• Robert Nadolski, BS, NREMT-P (Ret.), Clinical Administrator, Emory
related to one of the “Seven Pillars of EMS Officer Competencies–Supervisor Officer.”
Healthcare/School of Medicine
Each section uses an activity from the Lee County Public Safety Leadership Academy
and is based on a competency needed to perform well as a new Supervising Officer. Changing stakeholder expectations for how EMS will demonstrate value provides an
The academy will cover a wide array of leadership topics including, but not limited to exceptional opportunity for entrepreneurial EMS service leaders to capitalize on the
the following: Communications skills and techniques; Conflict management; Public EMS 3.0 transformation. Educational systems and payer systems are also changing
speaking; Process improvement, and Ethics. This hands-on workshop will allow you and there are more healthcare partners willing to re-write the EMS economic and value
to learn by doing and hear how leaders from across the country have utilized different model. This session will highlight the Top 10 trends occurring in EMS payment policies
ways to solve problems while ending up with similar results. to help you prepare for the changes likely to occur within the EMS industry. Registered
Cost for this course is $225.00 early/$250.00 regular attendees will help craft some of the topics discussed by responding to a “Top 5” topics
they would like covered via a survey that they will receive in advance of the workshop.
/// ESSENTIALS OF ADVANCED AIRWAY MANAGEMENT (#19880) Session objectives:
NREMT Category: Airway, Respiration and Ventilation
Instructor(s): • Understand the current economic environment for our nation’s healthcare system
• Michael Keller, NRP, Southeast Regional Coordinator, The Difficult Airway and EMS agencies
Course: EMS • Understand the details of recent reports published about EMS service sustainability
• Learn 5 ways to effect legislative and regulatory change to promote EMS innovation
Essentials of Advanced Airway Management is an 8-hour course designed for ALS • Learn how to cost and price payments for alternate service delivery models to
providers who perform advanced airway management, including intubation and become more efficient, effective and valuable
NIPPV, without the use of sedatives and/or paralytics. Like all airway managers, these
• Apply data metrics to develop outcome and performance-based reporting dashboards
providers benefit from tools which help predict difficulty before initiation of airway
management and those which are designed to rescue a failed airway. In addition • Develop Alternate Payment Model (APM) workbooks for use with payers
to equipping these providers with the necessary tools to optimize patient airway Cost for this course is $225.00 early/$250.00 regular.
care within their protocols, this course explains the evidence related to EMS airway /// DRONES & ARTIFICIAL INTELLIGENCE AS TOOLS FOR
management giving attendees a context for their practice. PUBLIC SAFETY (#20088)
Cost for this course is $225.00 early bird/$250.00 regular
OFF-SITE
/// THE NATIONAL CONFERENCE ON LAW & POLICY (#20086) NREMT Category: Other Continuing Education
NREMT Category: Other Continuing Education Instructor(s):
Instructor(s): • Andreas Claesson. PhD, RN, EMT-P, Researcher, Karolinska Institue’s
• Doulgas Wolfberg, JD, Partner, Page, Wolfberg & Wirth LLC Centre for Resuscitation Science
• Steve Wirth, JD, Attorney/Partner, Page, Wolfberg & Wirth LLC • Andreas Cleve, CEO/Co-founder, Corti.ai, Sweden
• Chad Brocato, JD, DHSc, Attorney/Partner, Murphy & Brocato Law • Douglas Spotted Eagle, Instructor and Industry Consultant, Sundance
• Skip Kirkwood, JD, FACPE Director, Durham County EMS Media Group
• Scot Phelps, JD, MPH Professor of Ambulance Science, The Emergency • Jennifer Pidgen, COO, Sundance Media Group
Management Academy
This cutting-edge full-day workshop, will be presented by industry-leading drone
James O. Page, the founder of JEMS and father of modern day EMS started the consulting, education and implementation group, Sundance Media Group (SMG), and
National EMS Law and Policy Conference, the first of which was held in Washington feature Douglas Spotted Eagle of SMG and Andreas Claesson, PhD, RN, EMT-P, an
DC in 1990. JEMS and Page, Wolfberg & Wirth, LLC have joined to bring this award-winning drone researcher and implementation specialist from a Stockholm,
conference back into the limelight. As the clinical and operational aspects of EMS Sweden. Each will provide you with the education you need to explore and move into
continue to expand and progress, this conference examines the legal aspects of the new world of drones/UAVs (Unmanned Aerial Vehicles) for public safety purposes
EMS development. Does the law promote this progress or obstruct it? Is the public This special workshop will also introduce you to the use of Artificial Intelligence
represented and protected by the policies that define and govern prehospital (AI) which can help make important choices and enable personnel to get to the
emergency care? In Jim’s words: “This conference takes decades of collective appropriate response faster and be more accurate in their diagnosis, since the AI
medical-legal experience in EMS and explores how that experience has shaped EMS can find causality where humans cannot; seamlessly validating information in the
policies, practices and procedures.” background as every call develops.
Join a distinguished faculty – made up of some of the most prominent members of The workshop will begin with a solid overview of current drone/UAV regulations and
the legal and EMS communities – as we examine the current state of EMS law and requirements in the United States, including:
policy. Sessions will be “team taught” by the experts addressing some of the most • Regulatory requirements (107 Certification, COA’s & Waivers)
pressing – and sometimes controversial – issues that shape EMS law and policy now • Best practices of implementing UAV as a tool (Aircraft, Accessories, intent of UAV as
and into the future. a tool, etc.)
Cost for this course is $225.00 early/ $250.00 regular • Identifying and Mitigating Risk in UAV Operations
The workshop will then move into actual applications underway that delivery
AEDs and other medical supplies to hard-to-serve and remote areas; use of
18EMSTPrelim_18 18 8/28/17 10:52 AM

TUESDAY, FEBRUARY 20, 2018 FULL-DAY // 8:00 AM-5:00 PM
drones (tethered and free-flying) for overhead command/control/surveillance/ • Will Smith, MD, Paramedic, Medical Director, Jackson Hole Fire/EMS,
reconnaissance/lighting; use of thermal imagery cameras to find survivors at National Park Service
disaster scenes and MCIs, particularly at nighttime or remote incidents; delivery of
Caring for and evacuating a patient located beyond the “road head” provides a
personal flotation devices to swimmers in distress – well before the arrival of a rescue
unique set of challenges for prehospital care providers. In fact, the rural, remote
swimmer; and geo-locate (via altimeter and geographic mean) firefighters and other
or “wilderness” incidents are big magnifiers of small problems. Rescuers and EMS
responders trapped in high-rise fires. Futuristic applications such as the resupply
responders need to think differently in these environments! The environment,
of EMS units or delivery of essential supplies to firefighters and law enforcement
response distance and ability to carry everything needed at these incidents
officers under adverse conditions via drones, and other applications, will also be
means a different approach is needed. Whether you are an outdoor enthusiast or
discussed.Andreas Claesson, PhD, RN, EMT-P, will present his award-winning work
a provider who occasionally faces prolonged care situations, your understanding
in the research and development of UAV use to deliver drones in Sweden to facilitate
of the concepts of Wilderness Medicine are essential. Based on Wilderness
early defibrillation in out-of-hospital-cardiac-arrest (OHCA). His epic work has
Medical Association guidelines, this highly informative and interactive session
evaluated a system that uses geographical information system (GIS)-models.
with be taught with a mixture of lecture, discussion and hands on training.
By weighing the EMS-response time and the incidence of out-of-hospital cardiac Wilderness Medicine experts, Dr. Will Smith and Jon Politis will spend the day
arrests (OHCA) in rural parts of Stockholm county areas presenting with a prolonged covering: -Anatomy of a backcountry emergency -Preventing emergencies
EMS response time (>20 minutes) were identified. These primarily coastal areas and the essentials of outdoor leadership -Dealing with common wilderness
are heavily inhabited during summer vacations and had about 0% survival. GIS medical issues -Common environmental emergencies -Adapting supplies and
models showed a potential of drone-delivered AED with a timesaving of 19 minutes. equipment to the wilderness environment -Essentials of helicopter evacuation/
When matching these areas with existing infrastructure in terms of EMS/fire, sea rescue -Improvised wilderness evacuation -Litter evacuation/carries. Whether
rescue stations, airports and restricted areas regarding aviation legislation specific you are an outdoor enthusiast seeking to enhance your backcountry skills or an
points for installation of drone systems were found. Beyond visual line of sight emergency responder who gets called to extended care situations, this 8-hour
(BVLOS) flights were performed in October 2016 to historical OHCAs showing a mean workshop will be invaluable to you and your agency!
reduction in arrival time of 16 minutes as compared to EMS ground response. Upon Cost for this course is $250.00 early/$275.00 regular
dispatch, a drone was able to be launched in just 3 seconds to GPS-coordinates
sent to them. The drone then flew predefined flight-routes over un-populated areas /// STIMULATING SIMULATION - A DEEP DIVE INTO
(acres, waterways etc.) to the target area. Dr. Claesson will also discuss the use of EMS BEST PRACTICE SIMULATION TECHNIQUES
drones in cardiac arrest due to drowning which has also been tested in simulated (#19881)
settings. When sending live-video feed from an UAV at a major beach in Sweden OFF-SITE // Location: MEDIC facility
from 60 meters altitude - to a tablet, victims could be located very early.He will also NREMT Category: Other Continuing Education, NEMSMA-
present how the first drones for search and rescue purposes were implemented accredited Instructor(s):
in Scandinavia in June 2017 at Tylösand surf-lifesaving club, providing situational • Jennifer McCarthy, Paramedic Science Program, Bergen Community College
awareness and the early delivery of flotation devices to drowning victims - dropping • Andrew E. Spain, Director of Accreditation and Certification, Society
self-inflatable buoys to swimmers in distress. for Simulation in Healthcare
SMG will then present several public safety UAV Applications • Amar Patel, DHSc, MS, NRP, Director, Center for Innovative Learning WakeMed Health
• Dropping Flotation Devices • Use of tethered drones • Malcolm Leirmoe, BS-EMS, NRP, Mecklenburg EMS Agency
• Dropping Survival Gear (e.g. to • Finding Alzheimer patients who • Brian Shimberg, BS-EMC, NRP, Mecklenburg EMS Agency
hikers) wear special wristbands • Jay Black, A.A.S, NC EMT-P, Mecklenburg EMS Agency
• Thomas Porcelli, NC EMT-P, Mecklenburg EMS Agency
Use of Artificial Intelligence • David Garber, AS-EMS, NC EMT-P, Mecklenburg EMS Agency
A special lecture on the use of Artificial Intelligence (AI) will then be presented by
Andreas Cleve, CEO of Corti.ai, based out of Copenhagen Denmark and San Francisco. This simulation preconference session will be an immersive 8-hour
CE
Corti has been working with Copenhagen EMS and other clients to bring Artificial preconference program held at the new, ultra-modern MEDIC Simulation
EREN
Intelligence (AI) and Speech Recognition(ASR) to EMS dispatch centers, operations Center in Charlotte, NC which features state-of-the-art simulation technology,
and field diagnosis. He will present on how Artificial Intelligence (AI) can now realistic rooms and props, sound stages and audio-video control center. This
equip people and public institutions to better handle imperative problems by comprehensive Workshop at MEDIC’s new $62 million headquarters session will CO N F
converting “conversations” and turning a massive amount of stored/absorb offer participants the opportunity to experience multiple different modalities of
data into actionable insights that advances the art of decision-making, simulation by multiple leading simulation and medical equipment manufacturers.
seamlessly. Corti’s technology listens in when the dispatch center receives Participants will be offered a first-hand opportunity to see and try different
a call and helps the agent find the right response in a matter of questions modalities that can be used to achieve the same learning outcomes. The
by analyzing critical information being presented to dispatchers along with immersive education sessions will be powerful because participants will actively
paramedic findings, patient history or patterns across different calls. practice what they are interested in learning and teaching. Although EMS
educators have been using simulation as a teaching modality, often there is
Hands on Demonstrations: gap in knowledge about the fundamentals of evidence-based practice within
Douglas Spotted Eagle and Andreas Claesson will introduce attendees to EMS simulation. For this reason, a short, interactive discussion will provide
state-of-the-art Unmanned Aerial Vehicles currently available and show an overview of the fundamentals of simulation to ensure that all participants,
how easily and effectively they can be utilized by public safety personnel. regardless of experience, have a similar reference point of the basis of effective
Cost for this course is $250.00 early/$275.00 regular simulation techniques. The session will continue to engage in creative ways to
enhance the simulation environment for improved realism. The participants will
/// ESSENTIALS OF WILDERNESS MEDICINE FOR then take a MEDIC Simulation Center tour where they will learn how each of the
EMTS AND PARAMEDICS (#19869) spaces is utilized and what learning objectives are taught in each area. After
OFF-SITE lunch, staff and simulation vendors offer four rotations. Detailed scenarios and/
NREMT Category: Medical or instructional objectives will be provided to the vendor and a course faculty
Instructor(s): member will help facilitate the session.
• Jonathan Politis, MPA, NRP, Ranger/Paramedic/EMS Educator, Jon The maximum number of participants is 30.
Politis Emergency Services Education Cost for this course is $250.00 early/$275.00 regular
18EMSTPrelim_19 19 8/28/17 10:52 AM

TUESDAY, FEBRUARY 20, 2018 HALF-DAY // 8:00 AM-12:00 PM
/// 12-LEAD ECG ACQUISITION AND INTERPRETATION /// TACTICAL TIPS AND TREATMENT TECHNIQUES FOR
MADE EASY (#19892) EMS PROVIDERS (#20559)
Advanced course offered 1:00-5:00 PM Also offered 1:00-5:00 PM
NREMT Category: Cardiovascular Instructor(s):
Instructor(s): • Steve Markham, Director, Medical Products and Services, Strategic
• Scott Crawford, NRP, FP-C, EMSI, Paramedic/Firefighter, Omaha Fire Operations Inc. (STOPS)
Department • Wyatt Sabo, Medical Training Program Manager, Strategic Operations Inc.
(STOPS)
This workshop is designed for clinicians with little or no experience in analyzing
12 lead ECGs. Your host, seasoned EMS educator and clinician Scott Crawford, In this fast-paced and participatory, hands-on workshop, the staff of Strategic
has a demonstrated ability to present complex topics in a manner that is both Operations, an internationally-recognized civilian and military training center
enjoyable and promotes retention. Scott will focus on multiple learning points, that uses Hyper-Realism in the replication of battlefield conditions in training
including proper placement of the electrodes in an easy-to-remember manner, environments to tax and train tactical and medical responders will teach you
a solid review of ECG basic concepts, the value of multi-lead monitoring, an how to train your personnel and best practices in treating the three primary
innovative and fun introduction to 12-lead analysis, the recognition of ischemia, causes of death on the “battlefield”; uncontrollable hemorrhage, airway
injury, and infarction events, and the specific identification of S-T elevation compromise and tension pneumothorax. Participants will be applying TQ’s
myocardial infarction (STEMI) and much more. BLS and ALS providers will leave to life threatening extremity bleeds, packing wounds and using junctional
this amazing workshop confident in their 12 lead interpretive skills. hemorrhage control devices as individuals and working in teams while also
Cost for this course is $125.00 early bird/$150.00 regular having the ability to perform higher level treatments per the individual’s skill
level. The instructors will review important aspects of situational awareness
/// PROPER POST EXPOSURE MEDICAL FOLLOW UP - and scene safety, teach you proven military-style techniques and expose
THE LATEST AND GREATEST (#19868) multiple products you and your staff can use to rapidly save patients, their
NREMT Category: Operations, NEMSMA-accredited partners or themselves in the worst of situations. The training will use the
Instructor(s): STOPS TCCC/EMS Cut Suit, a multifaceted training suit that allows you to
• Katherine West, RN, BSN, MSed, Infection Control Consultant, perform field crics; hemorrhage control via tourniquets, wound packing and
Infection Control Emerging Concepts pelvic splints; chest decompression, IV/IO insertion, and chest tube placement
There have been many advances in post exposure medical follow up and on a living subject wearing the suit. This is a must attend workshop for anyone
treatment. This four-hour workshop will present the newest standard of interested in trauma and tactical casualty care.
care for post exposure follow up for each of the diseases that are part of the Cost for this course is $125.00 early/$150.00 regular
Ryan White CDC list. Departments are responsible to insure proper care and
follow up for employee exposures. Therefore, it is important to know what
that follow up should include. This workshop will focus on quality of care and
risk management as it relates to infection control practices and will be highly
beneficial to attendees and their organizations.
Cost for this course is $125.00 early/$150.00 regular
/// ULTRASOUND USE IN PREHOSPITAL CARE &

RESUSCITATIONS (#20531)
Also offered 1:00-5:00 PM
NREMT Category: Medical
Instructor(s):
• Faizan H. Arshad, MD, EMS Medical Director, Healthquest Systems
This workshop will guide you through the nuts and bolts of prehospital point-
of-care ultrasonography (POCUS). Led by Faizan H. Arshad, MD, and featuring
a team of ultrasound industry experts, this four-hour workshop will do a
deep dive into the clinical applications, efficacy, and patient case studies of
ultrasound in the field changing patient outcomes. From quickly differentiating
from the etiologies of shock in your hypotensive patient to evaluating for a
pericardial tamponade in your penetrating trauma victim, POCUS will help you
answer meaningful clinical questions without adding to overall scene time. This
workshop will give you exceptional ultrasound education and two-hours of
hands on experience live scanning. The areas of concentration will be: ECHO,
E-FAST (extended focused assessment of sonography in trauma), abdomen
and the use of US in Procedural Guidance. You will rotate through four (4)
different hands on stations every 30 minutes.
Space is limited to 40 people.
18EMSTPrelim_20 20 8/28/17 10:52 AM

TUESDAY, FEBRUARY 20, 2018 FULL-DAY // 1:00 PM-5:00 PM
/// ADVANCED CONCEPTS IN 12-LEAD /// TACTICAL TIPS AND TREATMENT TECHNIQUES
INTERPRETATION (#19895) FOR EMS PROVIDERS (#20560)
Basics workshop offered 8:00 AM - 12:00 PM Instructor(s):
NREMT Category: Cardiovascular • Steve Markham, Director, Medical Products and Services, Strategic
Instructor(s): Operations Inc. (STOPS)
• Scott Crawford, NRP, FP-C, EMSI, Paramedic/Firefighter, Omaha Fire • Wyatt Sabo, Medical Training Program Manager, Strategic Operations
Department Inc. (STOPS)
If you are comfortable with the tip-of-the-iceberg concepts of 12-lead See page 20 for further details.
ECG interpretation and now want to explore the two-thirds of the Cost for this course is $125.00 early/$150.00 regular
iceberg that typically lies below the surface, then this workshop is
designed for you! Developed and presented by seasoned educator
and field clinician Scott Crawford, this session will give you the /// EMERGING CHALLENGES IN EMS (#19878)
information and tools to navigate these treacherous waters and NREMT Category: Other Continuing Education, NEMSMA-
plot a direct course toward successful patient outcomes. Topics will accredited
include identification of atrial and ventricular chamber enlargement, Instructor(s):
conduction disturbances, discernment of wide-complex tachycardia, • Brian LaCroix, President/EMS Chief, Allina Health EMS
electrolyte disturbances, axis deviation, early recognition of evolving • Michael Touchstone, BS, Paramedic, President, National EMS
infarction events, differential pathology of chest pain and much Management Association
more. The most important part of a journey is not the destination, • Troy Hagen, MBA, Immediate Past President, National EMS
it’s deciding to go. If you want to master your 12-lead skills, welcome Management Association
aboard! • Vincent D. Robbins, FACPE FACHE, President & CEO, MONOC
Cost for this course is $125.00 early/$150.00 regular The National EMS Management Association (NEMSMA) believes
in developing inspired leaders to better serve their communities.
/// CLASSROOMS THAT ENGAGE (#19866) Attendees will be better equipped to handle a multiple of situations
NREMT Category: Other Continuing Education, NEMSMA- facing their organizations today. This high energy workshop will
accredited present current and pressing topics in EMS Management and
Instructor(s): Leadership and engage the audience in identifying the most
• Michael McDonald, RN, NRP, EMS Training Officer, Loudoun County promising solutions. The topics will be presented by the facilitators
Fire and Rescue to give you the best picture and discussions to generate the right
• Michelle Beatty, MEd, NRwP, Training Specialist, Loudoun County Fire solution. Learn from both the presenters and audience members
and Rescue alike. The format is designed to allow participants to engage in
• Rachel Short, NRP, Training Officer, Loudoun County Fire and Rescue open, creative conversation on best practices and problem-solving
• Stephanie Corbin, NRP, BA, EMS Training Officer, Loudoun County Fire experiences, while making new connections and sharing lessons
and Rescue learned. This session is sure to be informative and thought provoking.
Classroom methodologies have changed significantly. Spoon-feeding These four industry experts will engage the audience in dialogue on
students and utilizing death-by-PowerPoint has fallen to the wayside. issues including: Work-life balance, Multi-Generational Workforces,
EMS educators in Loudoun County have embraced these changes, Recruitment and retention, Developing a more diverse workforce,
teaching almost solely without PowerPoint. Their classrooms are Combating practitioner violence, Dealing with the ongoing opioid
highly interactive and their students are now more engaged and crisis, and, Practitioner mental wellbeing. Participants will have the
CE
involved, learning through activities, games and group discussions. opportunity to raise their own topics for group consideration and
EREN
They have also overcome many challenges and maintained nearly discussion.
100% NREMT first-time pass rates in all programs as a result of the Cost for this course is $125.00 early/$150.00 regular
new educational approaches implemented, including Emergency CO N F
Medical Responder, EMT, EMT-to-Intermediate, and their Paramedic
programs. Come to this cutting-edge workshop to hear about the
Loudoun County experiences and challenges and gain valuable
insight into how your system can move to a more non-traditional and
highly successful EMS educational format.
/// ULTRASOUND USE IN PREHOSPITAL CARE &

RESUSCITATIONS (#20058)
Also offered 8:00 AM - 12:00 PM
Instructor(s):
• Faizan H. Arshad, MD, EMS Medical Director, Healthquest Systems
See page 20 for the full description.
Space is limited to 40 people.
18EMSTPrelim_21 21 8/28/17 10:54 AM

EVENT-AT-A-GLANCE
TRACK TRACK
ICONS: SPONSOR:
ADMINISTRATION ADMINISTRATION ADVANCED ADVANCED DYNAMIC AND DYNAMIC

& LEADERSHIP & LEADERSHIP CLINICAL CLINICAL ACTIVE THREATS & AND ACTIVE
TRACK 1 TRACK 2 PRACTICE PRACTICE MCI MANAGEMENT THREATS & MCI
TRACK 1 TRACK 2 TRACK 1 MANAGEMENT
TRACK 2
WEDNESDAY, FEBRUARY 21, 2018

8:00 AM COMMUNICATIONS EMS SYSTEM MAXIMIZING THE EMERGENCE SWIFT WATER RESCUE: IN HARM'S WAY:
- 9:30 AM & MEDICAL MODELS PEDIATRIC & ADULT OF ECMO MAKING THE SAVE USING SIMULATION
DIRECTION • James McNeilly, RESUSCITATION (EXTRACORPOREAL • Greg Merrell, EMT TO PROTECT AND
• Benjamin Abes, NRP, MPA, I/C •Paul Banerjee, DO MEMBRANE • Brian Weatherford PREPARE YOUR
MPH • Eric Kovach, • Mark Piehl, MD, OXYGENATION) EMS PERSONNEL
• Will Smith, MD, EMT-P MPH INTO EMS • Donald Garner Jr.,
Paramedic • Scott Younquist, MD, BAS, NRP
MS, FACEP, FAEMS, • Steve Markham
FAHA
• Lionel Lamhaut, MD,
PhD
• Michael Jacobs,
EMT-P
10:00 AM GETTING THEM BATTLEFIELD FOCUS ON THE SAMU RESPONSE WORKPLACE DRONE AND
- 11:30 AM BACK ON THE CHARLOTTE: EMS THE DELIVERY PLAN FOR THE PARIS VIOLENCE: IT'S NON- ARTIFICIAL
RIGHT TRACK PROGRESS - 20 OF CARDIAC TERRORIST ATTACKS, DISCRIMINATORY INTELLIGENCE
• Marc-Antoine YEARS LATER ELECTRICITY LESSONS LEARNED Panel Moderator: (AI) USE IN EMS &
Deschamps, OStJ, • Jay Fitch, PhD • Mike McEvoy, PhD, & POST INCIDENTS • Michael Peterson, MD PUBLIC SAFETY
ACPf, BappB:ES • Joe Penner, MBA NRP, RN, CCRN ENHANCEMENTS Panelists: • Andreas Claesson,
• Jason T. McMullan, • Lionel Lamhaut, MD, • Benjamin Vernon, BA, PhD, RN, EMT-P
MD PhD EMT-P • Jennifer Pidgen
• Alex Wallbrett, EMT-P • Douglas Spotted
• Kelly Adams, EMT-B Eagle
• Alfredo Rojas, EMT • Andreas Cleve
• Jose G. Cabanas, MD,
MPH, FACEP
12:00 PM LUNCH & LEARNS

- 1:00 PM
1:00 PM OPENING CEREMONIES & KEYNOTE
- 3:00 PM
3:00 PM EXHIBIT HALL OPEN
- 6:00 PM
4:30 PM OPENING RECEPTION IN THE EXHIBIT HALL
- 6:00 PM
6:15 PM OFFSITE NETWORKING EVENT - ZOLL SHOCKFEST
18EMSTPrelim_22 22 8/28/17 10:54 AM

EVENT-AT-A-GLANCE
TRACK
SPONSOR:
FOUNDATIONS FOUNDATIONS OPERATIONS OPERATIONS SPECIAL TOPICS & SPECIAL TOPICS &
OF CLINICAL OF CLINICAL - COMMUNITY - COMMUNITY TECHNOLOGY TECHNOLOGY
PRACTICE PRACTICE PARAMEDICINE PARAMEDICINE TRACK 1 TRACK 2
TRACK 1 TRACK 2 - MIH - MIH
TRACK 1 TRACK 2
THE MOST A PARARESCUE DEVELOPING A CRITICAL EMS EMS RESILIENCY THE GLOBAL EMS
IMPORTANT VITAL APPROACH POPULATION- LEADERSHIP SKILLS CRUCIAL TO OUR VILLAGE: EMS
SIGN: 20 THINGS TO PATIENT BASED PAYMENT NEEDED & LEGAL PROFESSION INNOVATIONS FROM
EMS CAN DO WITH ASSESSMENT MODEL FOR EMS MISTAKES TO BE • Chetan Kharod, MD, AROUND THE WORLD
CAPNOGRAPHY • Kevin Grange, EMT-P AND MIH SERVICES; AVOIDED MPH • Rob Lawrence
• Rommie Duckworth, CONSIDERATIONS • Steve Wirth, JD • Monique Rose, • Dovie Maisel, EMT-P
LP FOR COUNTY/CITY • Doug Wolfberg, JD CCEMT-P • Neil Noble, CCFP,
EMS, FIRE & PRIVATE MPA
SERVICES
• Douglas M. Hooten, MBA
• Jonathan Wasko,
NRP, MBA, AEMD
• Matt Zavadsky,
MS-HAS, EMT
THINKING CRITICALLY DESIGNER DRUG MULTI-NATIONAL UNRECOGNIZED & ARE ROBOTS RESEARCH DOESN’T
DURING PATIENT EVOLUTION: FOCUS ON SOCIAL UNDOCUMENTED: TAKING OVER THE HAVE TO BE
ENCOUNTERS MANAGING WORK: USING SOCIAL OUR INDUSTRY’S WORLD OF EMS? INTIMIDATING: TIPS
• Scott Crawford, NRP, UNCONTROLLED WORKERS IN THE DIRTY LITTLE REPLACING CLINICAL TO ADVANCING YOUR
FP-C, EMSI PATIENTS ON FIELD & ADDRESSING SECRETS EXPERIENCE WITH SERVICE & OUR
CONTROLLED HOARDERS • Kerby Johnson, NRP SIMULATION PROFESSION
SUBSTANCES • Michael Baker, MA, • Neal Richmond, MD, • Paul Werfel, MS, • Jonathan Studnek,
• Rommie Duckworth, NRP FACEP NREMT-P PhD, NRP
LP • Christoph • Anthony Guerne, MS,
CE
Redelsteiner, DrPhDr, NRP, CHSE
EREN
MSW, MS, EMT-P
CO N F
LUNCH & LEARNS
KEYNOTE
EXHIBIT HALL OPEN
OPENING RECEPTION IN THE EXHIBIT HALL
OFFSITE NETWORKING EVENT - ZOLL SHOCKFEST
18EMSTPrelim_23 23 8/28/17 10:54 AM

EVENT-AT-A-GLANCE
TRACK TRACK
ICONS: SPONSOR:

TRACK 2
THURSDAY, FEBRUARY 22, 2018

8:00 AM MASTERING PR, THE EMS DELAYED THE PRESSURE IS ON THE KEY ROLE OF SERIOUS INCIDENTS
- 9:30 AM POLITICS AND MENTOR AND THE SEQUENCE RESUSCITATION THE COMMMUNITY AND ROOT CAUSE
LOBBYING AFFECTIVE DOMAIN INTUBATION-A • Jeff Goodloe, MD, AT ACTIVE SHOOTER ANALYSIS
• Rob Lawrence • Keith Wesley, MD , LITERATURE-BASED NRP, FACEP, FAEMS INCIDENTS • Paul Gowens,
FACEP, FAEMS UPDATE • Demetris FROM A PROVEN FCPara
•Jeffrey Jarvis, MD sYannopoulos, MD INTERNATIONAL
• Michael Jacobs, PERSPECTIVE
EMT-P • Oren Wacht, PhD,
EMT-P
• Ofer Lichtman, NRP
8:00 AM TELEFLEX - PREHOSPITAL EMERGENCY CARE PROCEDURAL CADAVER LAB
- 10:00 AM
10:00 AM BATTLING THE WHAT IT REALLY SAVING TRAUMA THE PERFECT BUS ACCIDENT LESSONS LEARNED
- 11:30 AM HEROIN EPIDEMIC MEANS TO BE PATIENTS AIRWAY: OUR RESPONSE: KEY FROM ACTIVE
• Rob Lawrence A PATIENT- • Douglas Swanson, MISSION TO THINGS YOU NEED TO SHOOTER INCIDENTS
• Michael Levy, MD, CENTERED LEADER MD, FACEP, FAEMS OXYGENATE, KNOW & REPORTS ON
FACEP, FACP • Brian Lacroix • Joshua VENTILATE AND • Rommie Duckworth, NATIONAL STANDARDS
Nackenson, MD PROTECT-IMPORTANT LP
TECHNIQUES AND FOR PREPAREDNESS
DECISIONS AND RESPONSE TO
• Michael Levy, MD, ASHE EVENTS
FACEP, FACP • Richard Serino
• John Montes
10:30 AM TELEFLEX - PREHOSPITAL EMERGENCY CARE PROCEDURAL CADAVER LAB
- 12:30 PM
10:00 AM EXHIBIT HALL OPEN
- 5:00 PM
12:00 PM LUNCH LEARN: BOUND TREE LIVE SIMULCAST
- 1:00 PM
1:30 PM ADDRESSING OUR MULTI-GENERATIONAL STROKE SCIENCE THE EAGLES STATE OF THE SCIENCE ON PATIENT
- 3:30 PM WORKFORCE & MENTORING Panel Moderator: UNPLUGGED RESTRAINT
SUPER • Bradley Dean, NRP Keith Wesley, MD, (LIGHTNING ROUND) • David Dalton, BS, EMT-P
SESSIONS • Marc-Antoine Deschamps, OStJ, ACPf, FACEP, FAEMS • Paul E. Pepe, MD, MPH,
BappB:ES Panelists: FACEP, MACP, MCCM
• Brian Donaldson, CCP, ASM • Jason T. McMullan, • Jeffrey M. Goodloe, MD,
MD NRP, FACEP, FAEMS
• Paul Banerjee, DO • Michael Levy, MD, FACEP,
• Rommie FACP
Duckworth, LP • Neal Richmond, MD,
FACEP
• Scott Youngquist, MD,
MS, FACEP, FAEMS, FAHA
1:30 PM TELEFLEX - PREHOSPITAL EMERGENCY CARE PROCEDURAL CADAVER LAB
- 3:30 PM
5:15 PM JEMS GAMES FINALS COMPETITION
- 7:30 PM
18EMSTPrelim_24 24 8/28/17 10:54 AM

EVENT-AT-A-GLANCE
TRACK
SPONSOR:
TRACK 1 TRACK 2
TWO DUDES AND WATER & HEAT THE COPENHAGEN NOVEL APPROACHES FATIGUE AND EMS: NEW AND
TWO BEERS: RESPONSES DENMARK EMS TO THE OPIOID THE NEW SILENT DEVELOPING EMS
ALCOHOL AND HEAD • Peter Dworsky, MPH, SYSTEM: WHY IT’S SO NEMESIS KILLER TECHNOLOGIES
TRAUMA EMT-P, CEM UNIQUE • Kenneth Scheppke, • P. Daniel Patterson, • Will Smith, MD,
• Kevin McFarlane, • James Powell, MS, • Mark Harvey, EMT-P MD PhD, MPH, MS, NRP Paramedic
MSN, RN, CEN, TCRN, NRP • Freddy Lippert, CEO, • Glenn Joseph, MS,
EMT • Kevin Grange, MD RN, NRP
EMT-P, Firefighter/ • Christian Svane, MD • Christopher Hickey,
Paramedic FF, NRP
TELEFLEX CADAVER LAB
ADULT AND PEDIATRIC THE PATIENT CARE MEDICAL OVERSIGHT TRANSITIONING BEST APPROACHES ENVISIONING THE
SEPSIS NARRATIVE: WHAT OF MIH PROGRAMS: FROM PILOT TO TO SPECIAL NEEDS FUTURE: YOUR
• Gregory Brooks, YOU NEVER LEARNED EMERGENCY CARE PRACTICE PATIENTS: PROVIDING CHANCE FOR INPUT
EMT-P IN SCHOOL OR PRIMARY CARE? • Matthew Goudreau, BETTER CARE FOR TO THE EMS AGENDA
• Curtis Knoles, MD, • Keith Wesley, MD, • David Lloyd, MD, BS, NRP PATIENTS AND THEIR 2050
FAAP FACEP, FAEMS MBA FAMILIES • Mike Taigman, MA
• Neal Richmond, MD, • Skyler Phillips,
FACEP EMT-P
EXHIBIT HALL OPEN
CE
LUNCH & LEARN: BOUND TREE LIVE SIMULCAST
EREN
RAPID RECOGNITION OF ACUTE PEDIATRIC AMBULANCE CRASH PREVENTION 2.0 RESEARCH THAT SHOULD BE ON YOUR RADAR CO N F
DISTRESS PATTERNS • Shaun Curtis, BS, EMT-P SCREEN: PANEL DISCUSSION BY JEMS
• Benjamin Martin, EMT-P • Justin M. Eberly, EMT GLOBAL RESEARCH ALLIANCE
• James D. Green, BSME, MBA Panel Moderator:
• Corey Slovis, MD, FACP, FACEP, FAAEM
Panelists: Sean J. Britton, MPA, NRP
• J. Brent Myers, MD, MPH
• Jonathan Studnek, PhD, NRP
JEMS GAMES FINALS COMPETITION
18EMSTPrelim_25 25 8/28/17 10:54 AM

EVENT-AT-A-GLANCE
TRACK TRACK
ICONS: SPONSOR:

TRACK 2
FRIDAY, FEBRUARY 23, 2018

8:00 AM THEY’RE SPEAKING...WE’RE NOT CARDIAC ARREST: RESUSCITATION LATEST TACTICAL MEDICAL CONSIDERATIONS IN CIVIL
- 10:00 AM LISTENING: RECRUITMENT & RETENTION ADVANCES DISTURBANCES
SUPER CHALLENGES Panel Moderator: • William Jansen, NRP, FP-C, TP-C
SESSIONS • Scott Moore, Esq., Principal Advisor, EMS • Ed Dickinson, MD, NRP, FACEP
Resource Advisors LLC Panelists:
• Bruce Baxter, Chief Executive Officer, • Sean Kivlehan, MD, MPH
New Britain EMS • Jeffrey Goodloe, MD, NRP, FACEP, FAEMS
• Matthew Shepherd, BNurs GrDip Emerg
Nurs, Bpara GrDip Emrg Hlth (MICA) GrCt
AeroMed
• Scott Youngquist, MD, MS, FACEP, FAEMS,
FAHA
8:00 AM BREAKFAST ROUNDTABLES

- 9:30 AM
10:00 AM EXHIBIT HALL OPEN
- 1:00 PM
11:00 AM BRIDGING LEADERSHIP AND CAN’T MISS GOT BLOOD? THE ACTIVE STREET VIOLENCE:
- 12:30 PM EMPLOYEE LEGALITY: HOW ST ELEVATION THINKING BEYOND SHOOTER EMS/ HOW SAFE ARE
ENGAGEMENT DILIGENCE AND MYOCARDIAL THE TOURNIQUET LAW ENFORCEMENT YOU?
THROUGH THE ADAPTABILITY IN INFARCTIONS: FAKE- FOR MASSIVE INTERFACE: THE LITTLE • Robin Davis, NRP
STRATEGIC MANAGEMENT OUTS AND NEAR- HEMMORHAGE ROCK EXPERIENCE
PLANNING CAN HELP YOU MISSES • Kevin Grange, • Jon Swanson
PROCESS MAINTAIN YOUR • Sean Kivlehan, MD, EMT-P
• Thomas ‘Reid’ SERVICE AND STAY MPH • Michael Gooch, DNP,
Jackson, EMT-P OUT OF COURT ACNP, FNP, ENP,
• Steve White, MPA • Allison J. Bloom, CFRN, CTRN,CEN,
Esq. EMT, EMS-I, TCRN, EMT-P
FACPE
1:15 PM PUTTING IT ALL THE BREWING TWO “HOT” TOPICS: TRAUMA CARE FOR FIRE AS A WEAPON: MEDICAL DISASTER
- 2:45 PM TOGETHER: STORM: THE KETAMINE AND HIGH-SPEED HOW EMS MUST BE & EMERGENCY
USING DATA, KEY ECONOMIC, EXCITED DELIRIUM COLLISIONS: PREPARED RESPONSE IN
PERFORMANCE HEALTHCARE • Michael Gooch, DNP, MARCHing LIKE A • Michael Marino, MS, REMOTE AREAS-AN
MEASURES AND AND WORKFORCE ACNP, FNP, ENP, TRAUMA SURGEON NRP INTERNATIONAL
BENCHMARKING TRENDS IN EMS CFRN, CTRN, CEN, • Rommie Duckworth, • John Delaney, MA PERSPECTIVE
• Jeffrey Jarvis, MD LEADERS TCRN, EMT-P LP • Ahed Al Najjar,
• Todd Sims • Robert Nadolski, • Keith Wesley, MD , FAHA, FPMPH,
BS, NREMT-P (Ret,) FACEP, FAEMS DOHS, RAHA,
NREMT TO,
FAREMT FPC, RN
• Carl Craigle, NRP
18EMSTPrelim_26 26 8/28/17 10:54 AM

EVENT-AT-A-GLANCE
TRACK
SPONSOR:
TRACK 1 TRACK 2
EMS MYTHS: WHAT YOU THINK IS TRUE CAN PCR DOCUMENTATION WORKSHOP: THE AROUND THE WORLD OF EMS: A SHOWCASE
KILL YOUR PATIENT GOOD, THE BAD AND THE MISSING! AMA OF INNOVATIONS IN PLACE OR UNDERWAY
• Keith Wesley, MD, FACEP, FAEMS EVIDENCE-BASED APPROACH THROUGHOUT THE WORLD
• Corey Slovis, MD, FACP, FACEP, FAAEM • Neal Richmond, MD, FACEP Co-Panel Moderators:
• Steve Wirth, JD • Corina Bilger
• Jerry Overton, MPA, McA
Panelists:
• Paul Gowens, FCPara
• Christoph Redelsteiner, DrPhDr, MSW, MS,
EMT-P
BREAKFAST ROUNDTABLES
EXHIBIT HALL OPEN
PATIENTS WITH MOTORCYCLE CRASH TELEHEALTH COMMUNITY USING NATIONAL REGISTRY

AUTISM: HOW TO INJURIES: LESSONS FOR LOW ACUITY PARAMEDICINE FOR CROWDSOURCING UPDATE &
RESPOND AND REACT FROM THE DEATH OF PATIENTS: THE FIRE-BASED EMS TO ENHANCE INNOVATIONS
• Katherine Koch, MEd, EMS ICON RICHARD HOUSTON ETHAN • Richard Lewis, COMMUNITY FIRST • Jeremy Miller, MEd,
PhD, NRP BEEBE SYSTEM’S FOUR- EMT-P RESPONSE FOR NRP
• Mike McEvoy, PhD, YEAR EXPERIENCE • Michael Wright CARDIAC ARREST: • Donnie Woodyard,
NRP, RN, CCRN • Guy Gleisberg, MBA, • Matt Zavadsky, MS- THE SINGAPORE Jr., MAML, NRP
BSEE, EMT, EMS-I HAS, EMT AND NEW JERSEY
EXPERIENCES
• Yih Yng Ng, MBBS,
MRCS, MPH, MBA
• Rob Luckritz, NRP,
Esq.
ASSESSMENT AND SYNCOPE AND TBI’s: USING MOTORCYCLES COMMUNITY ASSESSMENT & THE NASCAR
MANAGEMENT OF WHAT YOU REALLY FOR EMS RESPONSE PARAMEDICINE FOR MANAGEMENT OF APPROACH TO EMS:
THE UNSTABLE NEED TO KNOW • Patric Lausch, MD; ALL SIZE AGENCIES: DANGEROUS TEEN PROVEN PRACTICES
PELVIC INJURY • William Ferguson, EMT-P SUCCESSFUL NORTH BEHAVIORS TO IMPROVE DRIVER
• Timothy Arnett, NRP MD, FACEP, FAAEM CAROLINA PROJECTS • Josh Stuart SAFETY
• Vincent Mosesso, Jr., • David Ezzell, MPA, • Douglas Swanson,
MD, FACEP, EMT-P EMT-P MD, FACEP, FAEMS
18EMSTPrelim_27 27 8/28/17 10:54 AM

CONFERENCE PROGRAM DETAILS
ADMINISTRATION & LEADERSHIP
Wednesday, February 21, 2018
8:00 AM-9:30 AM 10:00 AM-11:30 AM
/// COMMUNICATIONS & MEDICAL DIRECTION /// GETTING THEM BACK ON THE RIGHT TRACK
(#20078) (#20080)
NREMT Category: Operations NREMT Category: Operations
• Benjamin Abes, MPH, Chief, Lee County EMS • Marc-Antoine Deschamps, OStJ, ACPf, BappB:ES, Superintendent of Public
• Will Smith, MD, Paramedic, Medical Director, Jackson Hole Fire/EMS, National Information, Ottawa Paramedic Service, Canada
Park Service Recognizing and addressing the mental health needs of your staff can be a
The speed that information travels and the knowledge that is developed in herculean task that can be intimidating. You may be asking: Where do I start?
EMS has increased dramatically. What used to be communicated via mail is This presentation will answer that question through empowerment, a change of
accomplished in a matter of seconds electronically, and complex analysis that was culture, resiliency training and attacking the mental health stigma while exploring
only possible on supercomputers can now be done in the palm of your hand. With approaches required to make the necessary changes and detailing the steps of
these changes comes the challenges of management of this massive amount of the long but rewarding journey.
information. New manuscripts, articles, blogs, and data are released every day. In
this fast-paced presentation Benjamin Abes will review the development of this 10:00 AM-11:30 AM
data and information; discuss how to generalize results to your own community;
and best practices for safely implementing change without moving too fast. /// BATTLEFIELD CHARLOTTE - EMS PROGRESS
Medical oversight of EMS is more than a rubber stamp by a medical director.
20 YEARS LATER (#19840)
EMS providers should be interacting with their medical director on important NREMT Category: Other Continuing Education, NEMSMA-accredited
topics such as medicolegal issues, on-line vs. off-line medical protocols, quality • Jay Fitch, PhD, Founding Partner, Fitch & Associates, LLC
assurance programs, and practicing the best evidence based medicine. This • Joe Penner, MBA, Executive Director, MEDIC: Mecklenburg EMS Agency
interactive session will allow participants to interact with Dr. Will Smith in an
engaging session of each of these topics. In the mid-1900’s, the Mecklenburg County (Charlotte) NC EMS system was clearly
failing and a series of critical press reports about long response times prompted
the county to act. The system had been underfunded for years and had an aging
8:00 AM-9:30 AM infrastructure. Today, it is considered one of the most clinically-sophisticated
/// EMS SYSTEM MODELS (#20079) and progressive EMS systems in America! How did the transformation occur?
NREMT Category: Other Continuing Education What were the success factors that propelled the system forward? Join MEDIC
• James McNeilly, NRP, MPA, I/C, ALS Coordinator, Belmont Fire Department Executive Director Joe Penner and EMS consultant Jay Fitch to learn how this
• Eric Kovach, EMT-P, Ambulance Director, Moody County Ambulance system was reinvented and has flourished.
Is your department providing high quality EMS? Some critics say fire-based EMS
evolved as a catalyst to save firefighter jobs because of a decrease in fires. But,
the fact is that fire based EMS service can provide a high level of service with more
oversight and methods of skill retention than some third service models. James
McNeilly will show how you can use existing standards to develop a fire-based EMS
program that is marketable and profitable and can be easily expanded into the Mobile
Integrated Health Care arena.
Eric Kovach will present how Moody County Ambulance in South Dakota has become
a leader by successfully operating a municipal service in a previously challenged rural
system with a staff of 12 full and part-time employees. He will address key areas that
needed improvement and help you reinvent your rural EMS system delivery model.
18EMSTPrelim_28 28 8/28/17 10:54 AM

8:00 AM-9:30 AM 10:00 AM-11:30 AM
/// MASTERING PR, POLITICS & LOBBYING /// BATTLING THE HEROIN EPIDEMIC
(#19842) (#20081)
NREMT Category: Other Continuing Education, NEMSMA-accredited NREMT Category: Operations
• Rob Lawrence, Chief Operating Officer, Richmond Ambulance Authority • Rob Lawrence, Chief Operating Officer, Richmond
In this fast-paced session, Rob Lawrence, will address how you need to Ambulance Authority
master PR, politics and lobbying to survive in today’s political and healthcare • Michael Levy, MD, FACEP, FACP, Medical Director, Anchorage
climate. He will show you the role politics play in every EMS organization, Fire Department
steer you through the house of cards and offer guidance, advice and EMS sits at the epicenter of the opioid epidemic and is awash with relevant
strategies for managers and leaders to ensure the vote is always favorable. data to assist public safety and public health agencies in battling the
The discussion will move from local politics and the requirement to know epidemic across the socioeconomic spectrum. Rob Lawrence will describe
and understand local politicians to the lobbying and influencing state and and identify ways an agency can assist with identification, prevention and
nationally elected officials. Rob will also show why, in the age of social media rehabilitation of this public health disaster overtaking our country.
and the 24-hour news cycle, generating content and positive stories is now
Dr. Michael Levy will discuss the clinical and professional implications of EMS
a full time job. He will teach you how to generate news, when to generate
“treat and release” policies for overdose patients who were given naloxone
it, when social media isn’t that social and how to develop and present
by lay rescuers or law enforcement. Is this safe? Is advocating non-transport
campaigns that promote organizational awareness and boost morale and
a better overall use of EMS resources? How do we respond to calls from
highlight techniques for both internal and external communication success
community members, politicians and others regarding modifying our
using every platform available.
treatment and response to opiate overdose recidivists?
8:00 AM-9:30 AM
/// THE EMS MENTOR AND THE AFFECTIVE
DOMAIN (#19843)
NREMT Category: Other Continuing Education, NEMSMA-accredited
• Keith Wesley, MD, FACEP, FAEMS, Medical Director, HealthEast
Medical Transportation
The affective domain remains one of the most challenging and nebulous of
the objectives in the EMS curriculum. How our students relate emotionally
and professionally to the topics we discuss, the patients they encounter
CE
and the colleagues they work with often determines their future success or
EREN
failure in EMS. In the past, students were tutored under the ever watchful
eye of a mentor who was both respected and revered and who “taught” the
student what was expected of them in all three domains through example. CO N F
The student learned what was acceptable and what was not by trial and
error - guided by the admonishment of their mentor. Dr. Wesley will discuss
the use of mentors in EMS education, how to choose the right mentor
for each student and unique mentoring opportunities that exist in every
EMS system.
18EMSTPrelim_29 29 8/28/17 10:54 AM

10:00 AM-11:30 AM Friday, February 23, 2018
/// WHAT IT REALLY MEANS TO BE A PATIENT-
CENTERED LEADER (#19845) 8:00 AM-10:00 AM
NREMT Category: Operations, NEMSMA-accredited /// THEY’RE SPEAKING...WE’RE NOT LISTENING:
• Brian LaCroix, President/EMS Chief, Allina Health EMS RECRUITMENT & RETENTION CHALLENGES
Patient-centered leadership is central to the mission of every progressive agency (#19966)
and it’s becoming more closely linked to how we are paid. But we know the reality SUPER SESSION
of budgets and politics, and how, without data, it can be challenging to push for • Scott Moore, Esq., Principal Advisor, EMS Resource Advisors LLC
technology, initiatives or policy that can’t be proven to improve patient outcomes, • Bruce Baxter, Chief Executive Officer, New Britain EMS
even if we know instinctively it’s the right thing to do. In this session, you’ll learn For years our industry has been struggling to attract people to a career as an
that being a patient-centric operation makes good business sense. Brian LaCroix, EMT or Paramedic. The work that provided many of today’s EMS leaders with
will engage you in a discussion about how to transform your current culture with purpose and meaning is not inspiring the generation. In addition, organizations
a mission, vision and values based on patient-centered care. He will recount fail to engage and develop new and existing employees in a meaningful and
his personal journey in becoming a patient-centered leader, including research, effective way. EMS has historically relied on the altruistic nature of the work that
performance data and a look at Allina’s efforts to advance ambulance safety for we perform to motivate and retain our employees. However, the changing face of
their patients and providers. healthcare and the economic realities of EMS leave many field providers feeling
weary in spirit and searching for greater purpose. Yet, our work is technically
1:30 PM-3:30 PM more complex and exciting, our treatments more effective, and we really are
changing patient outcomes. This session will help EMS employers navigate the
/// ADDRESSING OUR MULTI-GENERATIONAL employment landscape and find a new career value proposition. Attendees will
WORKFORCE & MENTORING (#19965) leave with strategies proven to change the employment dynamic and improve
SUPER SESSION employee sustainability.
• Bradley Dean, NRP, Battalion Chief, Training Division, Rowan County
Emergency Services 11:00 AM-12:30 PM
• Marc-Antoine Deschamps, OStJ, ACPf, BappB:ES, Superintendent of /// BRIDGING EMPLOYEE ENGAGEMENT
Public Information, Ottawa Paramedic Service, Canada THROUGH THE STRATEGIC PLANNING
• Brian Donaldson, CCP, ASM, Director of EMS, Waushara County, Wisconsin PROCESS (#19854)
It is critical for managers and responders to understand the particularities of NREMT Category: Other Continuing Education, NEMSMA-accredited
each generation and the various cultures in their workforce. With millennials • Thomas ‘Reid’ Jackson, EMT-P, FTO/Paramedic, Escambia County EMS
making their way into the workforce, a single approach to addressing EMS mental • Steve White, MPA, Chief of EMS, Escambia County EMS
health concerns cannot succeed. In addition, various cultures express feelings
Employee engagement has been identified as a key organizational issue for
such as grief and depression in different ways. What’s valid for baby-boomers
the future, yet, today, many EMS agencies drift month-to-month and budget-
of Caucasian decent might not be valid for others. Bradley Dean will review the
to-budget with no real strategic vision. This session will present ways to build
characteristics of the various generations as well as the cultural backgrounds
meaningful employee engagement while also developing a strategic plan that
that might influence workers. He will also review strategies to assist struggling
will guide your department forward. It will also present relevant tips on employee
employees based on their age and ethnic background.
engagement at every level, setting a visionary path forward for your department
If your agency is small and/or serves a rural area, you may not have adequate and crafting a strategic plan linked to clearly defined goals.
funding or staffing to develop, implement and monitor a mentorship program.
Marc-Antoine Deschamps will discuss ways to implement an effective mentorship
program whether you operate a career, volunteer or combination agency. This
fast-paced presentation will look at the revolution of education for prehospital
providers and where improvements in education can make students better
prepared for the EMS workforce.
Brian Donaldson will discuss present traditions and address why some of the
newer generational providers don’t always seem to ‘fit’ and how, with a little
polishing and mining of resources, we can turn these personnel into great,
accepted providers.
18EMSTPrelim_30 30 8/28/17 10:54 AM

Friday, February 23, 2018
11:00 AM-12:30 PM 1:15 PM-2:45 PM
/// LEADERSHIP AND LEGALITY: HOW /// PUTTING IT ALL TOGETHER: USING DATA,
DILIGENCE AND ADAPTABILITY IN KEY PERFORMANCE MEASURES AND
MANAGEMENT CAN HELP YOU MAINTAIN BENCHMARKING (#20082)
YOUR SERVICE AND STAY OUT OF COURT NREMT Category: Other Continuing Education
(#19855) • Jeffrey Jarvis, MD, Medical Director, Williamson County EMS System
NREMT Category: Other Continuing Education, NEMSMA-accredited • Todd Sims, Operations Manager, (Ret.), MEDIC: Mecklenburg EMS Agency
• Allison J. Bloom, Esq., EMT, EMS-I, FACPE, Attorney at Law, Law Office We all know that the most common measurement of EMS system
of Allison J. Bloom performance response times rarely reflects on the clinical quality of medicine
Many of today’s volunteer ambulance agencies and rescue squads were practiced. EMS Compass a national initiative develops clinically-oriented
built generations ago with little or no formal business planning. In many performance measures of things that matter. To turn these measures into
cases, the organizational structure was built on personalities and emotion, benchmarks we have to apply the measures to real-world EMS data. Dr.
rather than sound modern-day business principles, and they have continued Jarvis did just that and will present the results of his study using a large
to grow that way over the years, with the agency’s culture, policies, and national ePCR vendor’s anonymous data to define the first set of publicly
leadership roles developing piecemeal, often based on informal, clannish, available benchmarks for a variety of Compass measures. Come see how
bottom-up, and at times questionable, business and operating practices. your system stacks up to national performance.
But, regardless of the volunteer nature of the agency or squad, it is still a Key Performance Indicators (KPIs) are measurable values that demonstrate
healthcare business, and what may have worked 20 years ago is no longer how effectively an agency is achieving key objectives. Hundreds of EMS
the case. This program is designed to educate volunteer EMS leaders related KPIs have been established by national organizations, EMS Agencies
about basic corporate structure, governing documents, and best business and regional/local entities. Todd Sims will identify KPIs that are important
practices which are necessary to effectively run an organization and in EMS system operations. With so much variability in any given dimension
minimize common mistakes which can lead to everything from apathy to (rural, suburban, urban, annual call volume, organization type, etc.), a “one size
mismanagement and beyond. fits all” application is not feasible. This presentation will look at how agency
culture, requirements, and organizational structure impact priority and
focus. Participants will learn specific actions to be taken and outcomes to be
expected when using KPIs for quality improvement. KPIs measured both in
real-time and historically have implications on the type of actions taken and
outcomes observed.
1:15 PM-2:45 PM
CE
/// THE BREWING STORM: ECONOMIC,
EREN
HEALTHCARE AND WORKFORCE TRENDS
FACING EMS LEADERS (#19857) CO N F
• Robert Nadolski, BS, NREMT-P (Ret.), Clinical Administrator, Emory
Healthcare/School of Medicine
EMS is in the midst of a demographic shift brought on by the aging of the
baby boomers. Simultaneously, most systems are grappling with attempts
to overhaul the way we respond, pay for and provide healthcare services.
Each is expected to disrupt the traditional economic and healthcare provider
models; the foundation upon which EMS is funded and operates. EMS
agencies/providers will be impacted greatly by the anticipated disruption.
This presentation will examine current and future challenges and use a
series of models and examples to illustrate and examine the potential
impact(s) of the changing economic, healthcare system, workforce trends
and the resulting impact on the EMS.
18EMSTPrelim_31 31 8/28/17 10:54 AM

ADVANCED CLINICAL PRACTICE
Wednesday, February 21, 2018 TRACK SPONSOR:
8:00 AM-9:30 AM Michael Jacobs will briefly discuss a case where a STEMI patient treated and
/// MAXIMIZING PEDIATRIC & ADULT transported in Alameda County coded in the hospital and was resuscitated
successfully after close to 6 hours on a LUCAS device and 7 days on in-
RESUSCITATION (#20090) hospital ECMO.
NREMT Category: Cardiovascular
• Paul Banerjee, DO, Medical Director, Polk County Fire Rescue
• Mark Piehl, MD, MPH, Pediatric Intensivist, WakeMed Children’s Hospital
10:00 AM-11:30 AM
Many critical factors influence the survival in pediatric arrests such as the
/// FOCUS ON THE DELIVERY OF CARDIAC
environment, preexisting conditions, duration of time before resuscitation, initial ELECTRICITY (#20093)
ECG rhythm and the quality and time of the BLS and ALS interventions. Although NREMT Category: Cardiovascular
most adult OHCAs are caused by primary cardiac disease, pediatric OHCAs are • Mike McEvoy, PhD, NRP, RN, CCRN, EMS Chief, Saratoga County,
more than twice as likely to be attributable to non-cardiac causes than to primary New York
cardiac disease and infants and children often sustain cardiac arrest as a result of • Jason T. McMullan, MD, Associate Professor, Dept. of Emergency
respiratory failure. This lecture will show how Polk County Fire Rescue went from Medicine, University of Cincinnati
a ZERO percent survival rate for pediatric arrests in 2012 to a survival rate of 71% Implanted pacemaker and defibrillator technology continues to evolve rapidly.
in 2014 and 78% in 2015 and demonstrate the changes that took place to achieve Traditional pacemakers have been replaced by dual chamber pacers capable
these results. of breaking tachycardias, adjusting rate using respirations, movement and
Pediatric Intensivist, Mark Piehl, will present a simple and thoughtful approach body temperature as well as resynchronizing conduction in patients with heart
to pediatric respiratory failure and airway management that can increase failure. Implanted Cardioverter Defibrillator (ICD) technology is also increasingly
your confidence and improve outcomes. He will discuss pediatric respiratory sophisticated. Mike McEvoy will show you how to recognize patients with
physiology and outline simple principles of airway support, including strategies implanted pacers, ICDs or recorder devices; present the common problems you
to improve oxygen delivery, improve BVM technique, and how to and make might encounter and how to treat pacer and defibrillator complications and
endotracheal intubation easier and safer. pearls for the transport of patients with temporary transvenous or epicardial
pacemakers and wearable cardio defibrillator vests.
Dual Sequential Defibrillation is also a “hot topic,” but the science behind
8:00 AM-9:30 AM
ventricular fibrillation and its reversal is often left out of the discussion. Dr.
/// THE EMERGENCE OF ECMO Jason McMullin will take you through available research, discuss EMS system
(EXTRACORPOREAL MEMBRANE experiences with dual sequential defibrillation and explain when it may and may
OXYGENATION) INTO EMS (#20091) not benefit patients in refractory vfib.
NREMT Category: Cardiovascular
• Scott Youngquist, MD, MS, FACEP, FAEMS, FAHA, Medical Director, Salt Lake City Fire 10:00 AM-11:30 AM
• Lionel Lamhaut, MD, PhD, Prehospital Critical Care Physician, SAMU, Paris, France /// THE SAMU RESPONSE PLAN FOR THE PARIS
• Michael Jacobs, EMT-P, Paramedic/Manager, Specialty Systems of Care, ATTACKS - LESSONS LEARNED & POST
Alameda County EMS INCIDENTS ENHANCEMENTS (#20085)
Extracorporeal Membrane Oxygenation (ECMO) is not a new technology, but NREMT Category: Operations
it’s use as rescue therapy for failed attempts at resuscitation of out-of-hospital • Lionel Lamhaut, MD, PhD, Prehospital Critical Care Physician, SAMU, Paris,
cardiac arrest (OHCA) victims is building in communities worldwide. EMS and France
hospital-based ECMO programs must work together closely to ensure the best
outcomes for these patients. Dr. Youngquist will discuss the development of an Join Paris SAMU physician Dr. Lionel Lamhaut as he reviews the SAMU ALS
response system capabilities, the unique response plan used to respond to the
ECMO pathway for OHCA victims in Salt Lake City, including challenges of patient
multi-location terrorist attacks in Paris, and lessons learned after that high profile
selection, determining appropriate time on scene, and the use of mechanical CPR incident. Dr. Lamhaut will review the mass care resources that SAMU can deploy
devices to reduce interruptions in CPR during transport. as well as the multi-pack trauma kits added to SAMU units that allows for rapid
Paris SAMU physician, Dr. Lionel Lamhaut, will introduce you to one of the world’s deployment and use of tourniquets, wound dressings and other supplies shortly
first prehospital ECMO response systems that responds along with other BLS and after a SAMU unit’s arrival on scene.
ALS resources to difficult-to-resuscitate cardiac arrest cases in Paris and has an
amazing 38% resuscitation rate for these nearly dead patients. He will detail the
selection criteria utilized for ECMO response, the type of equipment deployed and
the on scene choreographed care for this lifesaving procedure. Dr. Lamhaut will
also discuss what he sees as the future for ECMO performance in the prehospital
setting.
18EMSTPrelim_32 32 8/28/17 10:54 AM

Thursday, February 22, 2018 TRACK SPONSOR:
8:00 AM-9:30 AM 10:00 AM-11:30 AM
/// DELAYED SEQUENCE INTUBATION: A /// SAVING TRAUMA PATIENTS (#20092)
LITERATURE-BASED UPDATE (#19875) NREMT Category: Trauma
NREMT Category: Airway, Respiration and Ventilation • Douglas Swanson, MD, FACEP, FAEMS, Medical Director, MEDIC:
• Jeffrey Jarvis, MD, Medical Director, Williamson County EMS System Mecklenburg EMS Agency Hospital Department of Emergency
Medicine
Recognizing the importance of adequately pre-oxygenating patients before
• Joshua Nackenson, MD, Emergency Medicine Physician, University
intubation to avoid potentially lethal peri-intubation hypoxia, EMS systems
of Texas Southwestern/Parkland
are adopting Delayed Sequence Intubation. Building on the work his system
has done using DSI to improve intubation safety, Dr. Jarvis will review the Tension pneumothorax is a low volume, high risk condition which prehospital
scientific literature of this procedure, the rationale behind it, and his system’s providers must quickly recognize and treat to prevent significant
experience. Come hear how this procedure can improve the safety of your patient morbidity and mortality. This informative session will present the
patients during intubation. pathophysiology, associated mechanisms of injury, signs and symptoms, and
the physical exam findings. Dr. Doug Swanson will also detail the technique
for the decompression of tension pneumothorax with emphasis on the
8:00 AM-9:30 AM
available equipment, approach options, and the potential complications. He
/// THE PRESSURE IS ON RESUSCITATION will conclude with a review of the utilization of ultrasound for the diagnosis of
(#19891) pneumothorax.
NREMT Category: Cardiovascular Dr. Joshua Nackenson will present ten Pitfalls of Trauma Care: What to Avoid,
• Jeffrey M. Goodloe, MD, NRP, FACEP, FAEMS, Medical Director, EMS What to do and How to do it Properly.
System for Metropolitan Oklahoma City and Tulsa
• Demetris Yannopoulos, MD, Interventional Cardiology, Professor of
10:00 AM-11:30 AM
Medicine and Emergency Medicine, University of Minnesota
• Michael Jacobs, Paramedic/Manager, Specialty Systems of Care, /// THE PERFECT AIRWAY: OUR MISSION TO
Alameda County EMS OXYGENATE, VENTILATE AND PROTECT -
This panel of resuscitation experts will discuss the pathophysiology and IMPORTANT TECHNIQUES AND DECISIONS
benefits of using internal pressure that exists within the human body to (#19884)
improve cardiac and cerebral perfusion thereby improving resuscitation NREMT Category: Airway, Respiration, and Ventilation
results. They will also present results from the use of CPR and ventilation • Michael Levy, MD, FACEP, FACP, Medical Director, Anchorage Fire
devices as well as the performance of CPR in a “Heads Up” position to Department
augment internal pressure via adjunctive resuscitation devices. Data
Airway decisions can be difficult, deciding whether to intervene as well
CE
and case studies will be used to illustrate the benefits of these important
as when and how. This talk serves to reintroduce the basics of airway
EREN
processes. Michael Jacobs will briefly discuss how Alameda County had
management and then move to some basic understanding of pulmonary
dramatically improve OHCA resuscitations by using all of the Take Heart
physiology and how this guides the tools and techniques that should be CO N F
America-recommended resuscitation tools.
available to the prehospital provider. This presentation by Michael Levy,
Medical Director of the Anchorage Fire Department, will discuss airway
8:00 AM-10:00 AM decisions and interventions as both a journey and a destination guided by
/// TELEFLEX - PREHOSPITAL EMERGENCY the goals of the intervention and the incremental responses to them.
CARE PROCEDURAL CADAVER LAB (#20507)
• Director: Dan Smith, RN, BSN, CFRN, EMT-P
Pre-registration is required and space is limited. Please see page 15 for
details.
18EMSTPrelim_33 33 8/28/17 10:54 AM

10:30 AM-12:30 PM 1:30 PM-3:30 PM
/// TELEFLEX - PREHOSPITAL EMERGENCY CARE /// THE EAGLES UNPLUGGED (LIGHTNING
PROCEDURAL CADAVER LAB (#20508) ROUND) (#20009)
NREMT Category: Medical SUPER SESSION
• Director: Dan Smith, RN, BSN, CFRN, EMT-P NREMT Category: Other Continuing Education
Pre-registration is required and space is limited. Please see page 15 for details. Panel Moderator:
• Paul E. Pepe, MD, MPH, FACEP, MACP, MCCM, Medical Director, Dallas
County EMS
1:30 PM-3:30 PM
Panelists:
/// STROKE SCIENCE (#19967) • Jeffrey M. Goodloe, MD, NRP, FACEP, FAEMS, Medical Director, EMS
SUPER SESSION System for Metropolitan Oklahoma City and Tulsa
NREMT Category: Cardiovascular • Michael Levy, MD, FACEP, FACP, Medical Director, Anchorage Fire
Panel Moderator: Department
• Keith Wesley. MD, FACEP, FAEMS, Medical Director, HealthEast Medical • Neal Richmond,, MD, FACEP, Medical Director, MedStar Mobile Healthcare
Transportation University of Texas Southwestern Medical Center at Dallas
Panelists: • Scott Youngquist, MD, MS, FACEP, FAEMS, FAHA, Medical Director, Salt
• Jason T. McMullan, MD, Associate Professor, Dept. of Emergency Lake City Fire
Medicine, University of Cincinnati Major Metropolitan EMS Medical Directors Consortium (“EAGLES”) panelists are
• Paul Banerjee, DO, Medical Director, Polk County Fire Rescue some of the nation’s most influential medical directors. In this super session they
• Rommie Duckworth, LP, Fire Captain and EMS Coordinator, Ridgefield Fire will present new trends and controversies in prehospital medicine and allow for
Department plenty of time for audience questions.
This session will improve your understanding, awareness, assessment, care and
coordination to help provide better outcomes for all victims of cerebrovascular 1:30 PM-3:30 PM
accidents. Methods to identify and triage stroke in the field, the different levels of /// TELEFLEX - PREHOSPITAL EMERGENCY CARE
stroke center certification, and why these are so important will be discussed by Dr.
Jason McMullan. He will also discuss the advent and use of “stroke ambulances”.
PROCEDURAL CADAVER LAB (#20509)
Wake-up stroke, where a patient awakens with stroke symptoms not present • Director: Dan Smith, RN, BSN, CFRN, EMT-P
prior to falling asleep, which represents 20% of acute ischemic strokes but
patients with these strokes have been excluded from most ischemic stroke Pre-registration is required and space is limited. Please see page 15 for details.
treatment trials and are often not eligible for acute reperfusion therapy in clinical
practice, leading to poor outcomes. So Polk County (FL) developed a unique
approach to assessing and aggressively treating these specific stroke patients
and screening them for endovascular reperfusion by bypassing certain local
Primary Stroke Centers, and triaging eligible patients to Advanced Stroke Centers.
Incidents of ischemic stroke have increased more than 50% in children from
5 to 14 years old since 1995. Those under 45 years old have seen similar leaps.
So, victims go undiagnosed due the mindset that they are simply “too young
for stroke”. Rommie Duckworth will explain the reasons behind these dramatic
numbers, what EMS can do about them and the diagnostic approach that catches
what others often miss in newborns and young victims of stroke.
18EMSTPrelim_34 34 8/28/17 10:54 AM

Friday, February 23, 2018 TRACK SPONSOR:
8:00 AM-10:00 AM 11:00 AM-12:30 PM
/// CARDIAC ARREST: RESUSCITATION /// CAN’T MISS ST ELEVATION MYOCARDIAL
LATEST ADVANCES (#19968) INFARCTIONS: FAKE-OUTS AND NEAR-
SUPER SESSION MISSES (#19862)
NREMT Category: Cardiovascular NREMT Category: Cardiovascular
Panel Moderator: • Sean Kivlehan, MD, MPH, Associate Director, International Emergency
• Edward Dickinson, MD, NRP, FACEP, Professor of Emergency Medicine, Medicine Fellowship, Harvard Medical School/Brigham and Women’s
Perelman School of Medicine, University of Pennsylvania Hospital
Panelists: Calling a STEMI from the field improves outcomes for patients by reducing
• Sean Kivlehan, MD, MPH, NREMT-P, Emergency Medicine Chief Resident, door-to-balloon time. However, there are a lot of ECG rhythms that can mimic
University of California San Francisco a STEMI. Calling too many false STEMI activations will drive your cardiologists
• Matthew Shepherd, MICA Flight Paramedic, Air Ambulance Victoria, Australia crazy and cost you credibility. This lecture will teach you how to spot them
• Scott Youngquist, MD, MS, FACEP, FAEMS, FAHA, Medical Director, Salt Lake and avoid calling a false activation while also learning how to pick up the most
City Fire subtle but real MI’s!
• Jeffrey M. Goodloe, MD, NRP, FACEP, FAEMS, Medical Director, EMS System
for Metropolitan Oklahoma City and Tulsa
11:00 AM-12:30 PM
Compressions and defibrillation are the foundation of quality CPR. While
medications continue to be shown to be ineffective, newer therapies are
/// GOT BLOOD? THINKING BEYOND
emerging. This expert panel will discuss the use of ultrasound, intralipid, and
THE TOURNIQUET FOR MASSIVE
eCPR (ECMO) in the field and review the current evidence for and against the HEMORRHAGE (#19896)
use or advanced airways, mechanical CPR, and hypothermia in the field so NREMT Category: Trauma
you can support your protocols with the evidence. • Kevin Grange, EMT-P, Firefighter/Paramedic, Jackson Hole Fire/EMS
• Michael Gooch. DNP, ACNP, FNP, ENP, CFRN, CTRN, CEN, TCRN,
Matthew Shepherd will present when and how CPRIC (CPR induced EMT-P, Flight Nurse and Instructor in Nursing, Vanderbilt University
consciousness)may occur and provide an insight into the literature regarding
CPRIC, and present current international clinical guidelines. Extracorporeal This highly informative session will take you well beyond normal hemorrhage
Membrane Oxygenation (ECMO) use as rescue therapy for failed attempts at control and deep dive into the Trauma Triad of Death—hypothermia, acidosis
resuscitation is building worldwide. and coagulopathy. Kevin Grange will review the clotting cascade and discuss
ways you can prevent the trauma triad of death. He’ll also discuss acid/base
Dr. Scott Youngquist will discuss the development of an ECMO pathway balance and the latest science on permissive hypotension and prehospital
for OHCA victims in Salt Lake City, including challenges of patient selection, trauma life support.
CE
determining appropriate time on scene, and the use of mechanical CPR
Dr. Michael Gooch will discuss tools and techniques being used in transport
EREN
devices to reduce interruptions in CPR during transport.
programs to keep patients from spiraling into hemorrhagic shock, as well as
Dr. Jeffrey Goodloe will also review discoveries possible through an newer hemorrhage control strategies being used in the ED.
integrated analytics program for cardiac arrest care. Come hear a tangible CO N F
plan for care improvement activities you can put into practice, some without
any budget impact!
18EMSTPrelim_35 35 8/28/17 10:55 AM

1:15 PM-2:45 PM
/// TWO “HOT” TOPICS: KETAMINE AND EXCITED
DELIRIUM (#20094)
• Keith Wesley, MD, , FACEP, FAEMS, Medical Director, HealthEast Medical
Transportation
• Michael Gooch, DNP, ACNP, FNP, ENP, CFRN, CTRN, CEN, TCRN, EMT-P,
Flight Nurse and Instructor in Nursing, Vanderbilt University
With the rise in use of methamphetamine and cocaine, the incidence of excited
delirium is skyrocketing. Dr. Keith Wesley will explore this fascinating subject and
provide you guidelines to work more effectively with law enforcement to care for
these difficult patients. The pathophysiology of excited delirium will be reviewed
and treatment strategies, including pharmacologic restraint, will also be discussed.
Dr. Michael Gooch will also discuss ketamine as a dissociative agent which can be
used to provide sedation and analgesia without depressing the respiratory drive,
and how it can also augment hemodynamics.
1:15 PM-2:45 PM
/// TRAUMA CARE FOR HIGH-SPEED
COLLISIONS: MARCHing LIKE A TRAUMA
SURGEON (#19867)
NREMT Category: Trauma
• Rommie Duckworth, LP, Fire Captain and EMS Coordinator, Ridgefield Fire
Department
A sports car swerves to avoid a deer and rolls over three times. A pickup truck
traveling 70 miles an hour on the highway crashes head-on into a bridge
abutment. High-impact trauma situations present special challenges. How ready
is your crew to respond? Looking at state of the art and emerging trauma care
technologies this program takes the same principles taught to trauma surgeons
and nurses, making them useful for the field. Rommie Duckworth will present the
latest developments in multi system and multi patient trauma management to
help you be prepared to care for victims of high-speed motor vehicle collisions.
18EMSTPrelim_36 36 8/28/17 10:55 AM

DYNAMIC AND ACTIVE THREATS & MCI MANAGEMENT
8:00 AM-9:30 AM 10:00 AM-11:30 AM
/// SWIFT WATER RESCUE: MAKING THE /// WORKPLACE VIOLENCE: IT’S NON-
SAVE (#19897) DISCRIMINATORY (#19900)
NREMT Category: Operations, NEMSMA-accredited NREMT Category: Operations, NEMSMA-accredited
• Greg Merrell, EMT, Major, Oklahoma City Fire Department Panel Moderator:
• Michael Peterson, MD, Medical Director, Healthnet Aeromedical Service
• Brian Weatherford, Owner, Mid American Rescue Co. Panelists:
This all-encompassing swift water rescue class begins with the pre-planning • Benjamin Vernon, BA, EMT-P, Firefighter/Paramedic, San Diego Fire
necessary to be part of a successful rescue team and features lessons learned: Rescue
how to properly assess a situation, identify resources necessary and recognize • Alex Wallbrett, EMT-P, Firefighter, San Diego Fire Rescue Dept
the hazards associated with water rescue. You’ll learn first on scene actions • Kelly Adams, EMT-B, Detroit Fire Dept. EMS Division
that will facilitate a safe incident and how to understand water characteristics, a • Alfredo Rojas, EMT, Detroit EMS
crucial aspect to setting up your team for a successful rescue. The session will • Jose G. Cabanas, MD, MPH, FACEP, Director and Medical Director, Wake
also cover hydrology and the effect it has on the rescue, rescuers and victims. County Department of EMS
You’ll learn how to assess the scene and, tips and techniques for assessing Firefighter/paramedics Ben Vernon and Alex Wallbrett’s lives changed when
the victim(s). Proper personal protective equipment will be discussed for both they were stabbed while responding to a “routine medical assistance” call in
shore-based and in-water rescues. San Diego CA. Both will share their story so that you can learn from the event,
particularly the mistakes made in Ben’s follow-up emotional care.
8:00 AM-9:30 AM Detroit EMTs Kelly Adams and Alfredo Rojas received slash marks and stab
wounds on their face and hands in an unprovoked attack by an “agitated”
/// IN HARM’S WAY: USING SIMULATION individual on what appeared to be a normal call. The crew drove themselves to
TO PROTECT AND PREPARE YOUR EMS the hospital and survived but will have physical and emotional scars the rest
PERSONNEL (#19899) of their lives. Join them as they present their harrowing stories, convey the
physical and emotional trauma they suffered, recount how they went about
NREMT Category: Other Continuing Education, NEMSMA-accredited recovering and returning to work and tell you what steps can be taken to
• Donald Garner Jr., BAS, NRP, Deputy Director, Wake County EMS prevent this type of incident from happening to them. Wake County (NC) EMS
• Steve Markham, Director of Medical Products & Services, Strategic will tell how they utilized simulation experience to prepare crews for violent
Operations Inc. encounters. Jose G. Cabanas, MD will present Wake EMSs experience and
Increasing violence toward EMS personnel has required EMS employers to progressive action plan to counter this growing threat of violence against EMS
begin teaching situational awareness, self-defense classes and even consider crews.
issuing ballistic gear. Seeing an increase in violence toward their providers,
Wake County (NC) EMS put their providers through a simulated needs 10:00 AM-11:30 AM
assessment that evaluated their ability to maintain situational awareness and
ultimately recognize a threat. Don Garner will review their systematic approach /// DRONE AND ARTIFICIAL INTELLIGENCE (AI)
and outcomes of the exercise that helped them identify and offer education
needed. Come hear about their scenario-based training that taught their
USE IN EMS & PUBLIC SAFETY (#20561)
CE
personnel how to detect and prevent assaults against them. • Andreas Claesson, PhD, RN, EMT-P, Researcher, Karolinska Institute’s
EREN
Centre for Resuscitation Science, Sweden
Steve Markham, a retired Special Operations IDC with multiple combat • Douglas Spotted Eagle, Sundance Media Group
deployments and currently Director of Medical Products and Services with • Jennifer Pidgen, COO Sundance Media Group
Strategic Operations Inc. (STOPS), an internationally-recognized civilian and • Andreas Cleve, CEO/Co-founder, Corti.ai, Sweden CO N F
military training center that uses Hyper-Realism in the replication of battlefield
conditions in training environments. Since retiring the countries of Brazil This powerful session will look at real-world public safety applications of
and Poland have had him present on maximizing your training and money. Drones and how they may benefit your agency in the future. Andreas Claesson,
He has also been very involved in the development and implementation of PhD, RN, EMT-P, will present his research and development of unmanned
training from POI through surgical intervention for military, Law Enforcement, aerial vehicles (UAVs) used in Sweden to facilitate early defibrillation in out-
EMS and medical schools in multiple areas around the United Sates. Steve of-hospital cardiac arrest (OHCA). Rural areas of Stockholm typically have
will discuss lessons learned from combat and best practices at the POI. He prolonged EMS response times, but drones carrying AEDs can reach patients
will demonstrate some of these techniques using the STOPS Cut-Suit, a 19 minutes sooner than ground response units. Dr. Claesson will also discuss
multifaceted training aid that can be used to train responders to perform field the use of drones in OHCA due to drowning, has abeen tested in simulated
crics, hemorrhage control via tourniquets, wound packing and pelvic splints;, settings, as well as using drones to facilitate the delivery of flotation devices to
chest decompression, IV/IO insertion, and more under realistic simulations to swimmers in distress.
prepare your crews to save critically injured patients – or themselves.
Andreas Cleve will describe how AI can equip people and public institutions to
better handle imperative problems by converting “conversations” of massive
amount of stored/absorb data into actionable insights that advances the art of
decision-making. By using AI to help make important choices, personnel can
get to the appropriate response faster and be more accurate in their diagnosis,
since AI can find causality where humans can’t—seamlessly validating
information in the background as the call develops. The future is now!
18EMSTPrelim_37 37 8/28/17 10:55 AM

8:00 AM-9:30 AM 10:00 AM-11:30 AM
/// THE KEY ROLE OF THE COMMUNITY AT ACTIVE /// BUS ACCIDENT RESPONSE: KEY THINGS
SHOOTER INCIDENTS FROM A PROVEN YOU NEED TO KNOW (#19906)
INTERNATIONAL PERSPECTIVE (#20515) NREMT Category: Operations, NEMSMA-accredited
NREMT Category: Operations • Rommie Duckworth, LP, Fire Captain and EMS Coordinator, Ridgefield Fire
• Oren Wacht, PhD, EMT-P, Ben Gurion University of the Negev, Israel Department
• Ofer Lichtman, NRP, Terrorism Liaison Officer Coordinator, Rancho Every day in your community, vehicles travel the road carrying large numbers
Cucamonga Fire District of potential victims; some children, some elderly, some with special medical
Terrorist events in Israel, Paris, Brussels and San Bernardino shed light on the fact issues, and all your responsibility. And, every year 63,000 inter-city, transit, and
that civilians must become resilient and take action in the initial moments of a school buses crashes result in over 14,000 injuries and hundreds of fatalities.
terrorist attack. During a conflict between Israel and Gaza, when 70% percent of This session will help make you ready when it happens in your area. Presenting
the Israeli civilian population was under missile threat, the medical response to lessons learned from around the world, along with personal experience managing
this attack was provided mainly by civilian EMS. Oren Wacht will present how first school bus and inter-city tour bus incidents, Rom Duckworth lays out the key
responders are perfectly positioned to prepare their communities and prepare steps to managing major (and minor) motor coach collisions in your response area.
bystanders to be active while taking the necessary actions during these events
to save both themselves, family and friends. 10:00 AM-11:30 AM
Ofer Lichtman will motivate you and empower you to implement a program /// LESSONS FROM ACTIVE SHOOTER INCIDENTS
such as this in your community where you not only teach individuals from the & REPORT ON NATIONAL STANDARD FOR
community how to survive an active shooter event, but what you should do at PREPAREDNESS AND RESPONSE TO ASHE
every moment during and after the event.
EVENTS (#20578)
NREMT Category:
8:00 AM-9:30 AM • Rich Serino, Distinguished Visiting Fellow, Harvard University, National
/// SERIOUS INCIDENTS AND ROOT CAUSE Preparedness Leadership Initiative
ANALYSIS (#20095) • John Montes, Emergency Services Specialist, NFPA
NREMT Category: Operations This presentation will review important lessons learned from active shooter
• Paul Gowens, FCPara, Vice Chair, College of Paramedics, Scottish incidents and the efforts to create a national standard for preparedness and
Ambulance Service, Scotland response to ASHE (Active Shooter Hostile Events). John Montes and Richard
Join JEMS International Editorial Board Member, Paul Gowens, for an insightful Serino will cover everything from pre-planning and training, to response models in
presentation on how you can “learn and teach” when serious incidents occur and use by agencies responding to ASHE incidents.
how, using techniques such as Root Cause Analysis, you can develop a learning
rather than a blaming culture. Paul will illustrate how this process is contributing 1:30 PM-3:30 PM
to Scotland’s achievement of its 2020 vision of sustainable, world-leading and
high quality health and care services. Paul will illustrate how learning from serious
/// STATE OF THE SCIENCE ON PATIENT
incidents can improve the quality of your investigations, ensure lessons learned RESTRAINT (#20518)
are embedded into your EMS practices, and provide you with a practical guide to SUPER SESSION
implementing opportunities for improvement. NREMT Category: Medical
• David Dalton, BS, EMT-P, Captain, St. Charles County Ambulance District
How confident are you in your ability to apply restraints correctly, safely and
legally? Failure to use restraints competently has resulted in severe, permanent
injuries to patients and providers, judgments of gross negligence and wrongful
death lawsuits. Join David Dalton as he presents the latest recommendations
for patient restraint. Highlights will include: laws governing the use of restraint;
a review of chemical restraint and stories from the field; lessons learned from
restraint-related tragedies, and ways to avoid positional asphyxia. You’ll also
practice hands-on skills, including: the pit crew approach to physical restraint,
anchoring patients to a stretcher, quick-release knots, and a variety of other
types of restraints.
18EMSTPrelim_38 38 8/28/17 10:55 AM

8:00 AM-10:00 AM 1:15 PM-2:45 PM
/// TACTICAL MEDICAL CONSIDERATIONS FOR /// FIRE AS A WEAPON: HOW EMS MUST BE
CIVIL DISTURBANCES (#19908) PREPARED (#19912)
SUPER SESSION NREMT Category: Operations
NREMT Category: Operations, NEMSMA-accredited • Michael Marino, MS, NRP, Assistant Chief, Special Operations, Prince
• William Jansen, NRP, FP-C, TP-C, Trooper First Class, Maryland George’s County Fire/EMS Department
State Police • John Delaney, MA, Captain II, Arlington County Fire Department
Medical providers now attach themselves to riot teams.. Trooper First Class Fire used as a weapon has been a long employed tactic in wars, civil
William Jansen, was deployed during the Baltimore City Riots in April 2015 disturbances and terrorist attacks. However, its use and threat is largely
where 25 police officers were injured, at least 250 people arrested, and there misunderstood and poorly defined by the first responder community. Given
were 350 businesses damaged, 150 vehicle fires, 60 structure fires, and the ease by which materials can be acquired and utilized, this emerging
27 drugstores looted for drugs. TFC Jansen will share his experience as a threat needs to be recognized and addressed by all emergency response
Tactical Paramedic during this seven-day period along with lessons learned agencies and their personnel. Michael Marino will provide a historical context,
and preparations needed for civil disturbances. scope the problem, define the threat and the modality, and discuss a variety
of ways in which this threat can be mitigated.
11:00 AM-12:30 PM
/// THE ACTIVE SHOOTER EMS/LAW 1:15 PM-2:45 PM
ENFORCEMENT INTERFACE: THE LITTLE /// MEDICAL DISASTER & EMERGENCY
ROCK EXPERIENCE RESPONSE IN REMOTE AREAS: AN
• Jon Swanson, Executive Director, MEMS INTERNATIONAL PERSPECTIVE (#20522)
On July 1, the Little Rock AR system was challenged with a fast moving, high NREMT Category: Operations
velocity 28-victim Active Shooter MCI that occurred when gang members • Ahed Al Najjar, FAHA, FPMPH, DOHS, RAHA, NREMT TO, FAREMT
unleashed 60 rounds in 30 seconds during a concert at a nightclub. What FPC, RN, Director of Life Support Training Dept., Prince Sultan bin
unfolded over the next 32 minutes was a near-textbook MCI, managed Abdulaziz College for EMS – King Saud University, Saudi Arabia
rapidly and successfully as a result of extensive pre-planning, crew/ • Carl Craigle, NRP, Chief Paramedic, Platte Valley Ambulance Service
supervisor MCI training, cross-training with law enforcement, integration of Ahed Al Najjar will discuss how rural and remote areas have different social
EMS into tactical operations, use of incident command on a daily basis and and economic determinants of health and there is little common appreciation
rapid triage, treatment and transportation of patients. Come hear the details of all the personnel and services that could be called on to deal with remote
of this well run MCI and the lessons learned from it. medicine within the MEA region and remote healthcare is not the only asset
CE
that may be required in the aftermath of a disaster and mass causality event.
EREN
11:00 AM-12:30 PM Carl Craigle will show how a rural service that serves 1,000 square miles with
/// STREET VIOLENCE! HOW SAFE ARE YOU? 700 rural and remote square miles will illustrate challenges increase when CO N F
(#19911) faced with an MCI and how the decisions you make in the first 5 minutes will
often dictate the success of the incident.
NREMT Category: Operations, NEMSMA-accredited
• Robin Davis, NRP, Founding Partner, Absolute Leadership, LLC
The surge in violence against firefighters, EMTs and paramedics is alarming
and unprecedented. Traditional scene safety classes and staging policies are
not doing enough to prepare our crew members for this new level of violence
and hands-on self-defense training, while helpful, teaches perishable skills.
While many agencies are equipping units with soft body armor for use during
high-risk situations, the reality is that our workers are being attacked on
routine calls. This powerful and informative session will allow you to look
at your own personal barriers to safety and learn strategies to break down
these barriers. You will learn what a survival mindset is and why having it
may save your life.
18EMSTPrelim_39 39 8/28/17 10:55 AM

FOUNDATIONS OF CLINICAL PRACTICE
Wednesday, February 21, 2018 TRACK SPONSOR:
8:00 AM-9:30 AM 10:00 AM-11:30 AM
/// THE MOST IMPORTANT VITAL SIGN: TWENTY /// THINKING CRITICALLY DURING PATIENT
THINGS EMS CAN DO WITH CAPNOGRAPHY ENCOUNTERS (#20045)
(#19926) NREMT Category: Operations
NREMT Category: Airway, Respiration, and Ventilation • Scott Crawford, NRP, FP-C, EMSI, Paramedic/Firefighter, Omaha Fire
• Rommie Duckworth, LP, Fire Captain and EMS Coordinator, Ridgefield Fire Department
Department Most EMS calls are well mitigated, uncomplicated and many even fall under the
End tidal waveform capnography, perhaps the most important monitoring tool ominous description of routine, but many are very complex and require critical
prehospital providers can use, end tidal waveform capnography isn’t just used thinking skills. What you do in a patient encounter will not drive how you think,
for respirations anymore. Using a simple four-step assessment technique, but how you think will drive what you do. This session is all about thinking and
Rommie Duckworth will show you how capnography can be used by BLS and ALS then doing the right thing for your patient. This session by Scott Crawford will be
providers not only to confirm successful endotracheal intubation, but to evaluate a robust discussion of critical thinking in patient encounters. Scott will present
shock in trauma patients, monitor for the return (or loss of) pulses during CPR, multiple caveats that are both practical and useful for all levels of providers. Topics
identify bronchospasm in asthma and hypoxic drive in COPD, to guide seizure will include methods of critical thinking, avoiding bias and presentation of an
management and paralytic medication administration, and much, much more. This algorithm approach to the art and science of developing an excellent emergency
case-driven session develops the fundamentals of capnography so that every medical service clinician.
EMS provider can improve the assessment, treatment and outcome for their
patients using the diagnostic tools of end tidal waveform monitoring. 10:00 AM-11:30 AM
/// DESIGNER DRUG EVOLUTION: MANAGING
8:00 AM-9:30 AM UNCONTROLLED PATIENTS ON CONTROLLED
/// A PARARESCUE APPROACH TO PATIENT SUBSTANCES (#19903)
ASSESSMENT (#19915) NREMT Category: Medical
NREMT Category: Other Continuing Education • Rommie Duckworth, LP, Fire Captain and EMS Coordinator, Ridgefield Fire
• Kevin Grange, EMT-P, Firefighter/Paramedic, Jackson Hole Fire/EMS Department
In this inspiring and informative presentation, Kevin Grange will present what he Emergency services are increasingly being confronted by horrific events caused
learned of the Pararescue Jumper (PJ) approach to patient assessment while by a surge in the use of new types of designer drugs. Rommie Duckworth will use
developing a comprehensive article for JEMS on an outstanding and complex real world case studies to discuss the upsurge in mephedrone based drugs (Bath
rescue. Pararescue Jumpers (PJs) are members of the world’s most elite combat Salts and Meow-Meow), Synthetic Marijuana, Salvia Divinorum, Molly and more.
and civilian search and rescue team and, over the course of his article research He’ll detail what these drugs are, where they’ve come from, and what form they
and development, Grange learned of a unique mnemonic and method of patient may take in the future. He’ll also discuss what regulators and law enforcement are
assessment termed “MARCH-PAWS”., Grange will detail the unique pararescue doing to stop them, and what field providers can do to manage the fallout from
mission that saved a baby a thousand miles out at sea, and tell how using a this new wave of designer drugs.
“special ops” approach sped up and improved his own patient care as a firefighter
paramedic.
18EMSTPrelim_40 40 8/28/17 10:55 AM

8:00 AM-9:30 AM 10:00 AM-11:30 AM
/// TWO DUDES AND TWO BEERS: ALCOHOL /// ADULT AND PEDIATRIC SEPSIS (#20097)
AND HEAD TRAUMA (#19918) NREMT Category: Medical
NREMT Category: Trauma • Gregory Brooks, EMT-P, EMS Coordinator, Doctors Hospital of Augusta
• Kevin McFarlane, MSN, RN, CEN, TCRN, EMT, Education Director, • Curtis Knoles, MD, FAAP, Assistant Medical Director, Medical Control
Southwest Emergency Education & Consulting Board, EMS System for Metropolitan Oklahoma City and Tulsa
The session will look at the relationship between alcohol intoxication and This session will focus on sepsis with speakers illustrating that, while the
minor traumatic injuries. In this fast-paced, informative session, Kevin immune system protects us from many illnesses and infections, it is also
McFarlane will discuss the importance of a careful history, physical exam, possible for it to go into overdrive in response to an infection and thereby
and the pitfalls of examination of the intoxicated patient. causing the cascade know as Sepsis. Gregory Brooks will illustrate how
sepsis develops when the chemicals the immune system releases into the
bloodstream to fight an infection cause inflammation throughout the entire
8:00 AM-9:30 AM
body and teach you how the disease progresses and how to assess the
/// WATER & HEAT RESPONSES (#20096) patient for each stage of this disease.
NREMT Category: Medical Dr. Curtis Knoles will review how the three stages of sepsis infection can
• Peter Dworsky, MPH, EMT-P, CEM, Corporate Director, MONOC EMS result in disability or death and how children with compromised immune
• James Powell, MS, NRP, Captain and Firefighter/Paramedic, Jackson systems and those with chronic illness are particularly susceptible to sepsis,
Hole Fire/EMS With the diagnostic and intervention window for children very short, every
• Kevin Grange, EMT-P, Firefighter/Paramedic, Jackson Hole Fire/EMS hour delay in treatment increases mortality by nearly 8 percent. Dr. Knoles will
World-wide, millions of people enjoy the sport of scuba diving safely. reinforce how EMS is in a front line position to provide early recognition and
However, on occasion there are problems ranging from minor soft tissue treatment to include intravenous fluid boluses, airway management and blood
injuries to an aquatic envenomation, barotrauma or decompression pressure support as needed to decrease the associated morbidity/mortality
sickness that requires hyperbaric medicine. Peter Dworsky will focus on the from sepsis and septic shock.
pathophysiology behind these emergencies and best practices for the EMS
management of dive-related incidents during this dynamic presentation.
Environmental emergencies can take place at anytime and anywhere, from
big cities to red-rock deserts, to the summit of Mt. Everest to your own tiny
back yard. These common but often complex emergencies that can quickly
cause death include over-exposure to heat or cold, drowning, snake and
spider bites, avalanches and lightning strikes.. Using case studies including
CE
a whitewater rafting MCI, a 6-year old left outside by her parents in the
EREN
middle of winter, a patient suffering High Altitude Cerebral Edema (HACE) on
a 24-day trek in the Himalayas, and others. Jim Powell, a Captain/Paramedic
CO N F
with Jackson Hole Fire/EMS, and Kevin Grange, a Firefighter/Paramedic with
Jackson Hole Fire/EMS and author of “Lights & Sirens” will present important
lessons learned from venturing into the wild.
18EMSTPrelim_41 41 8/28/17 10:56 AM

/// THE PATIENT CARE NARRATIVE: WHAT YOU
NEVER LEARNED IN SCHOOL (#19919) 8:00 AM-10:00 AM
NREMT Category: Other Continuing Education, NEMSMA-accredited /// EMS MYTHS: WHAT YOU THINK IS TRUE CAN
• Keith Wesley, MD, FACEP, FAEMS, Medical Director, HealthEast Medical KILL YOUR PATIENT (#19922)
Transportation SUPER SESSION
Proper documentation is a big part of the job in EMS. Unfortunately, many NREMT Category: Medical
providers never learned how to write a good report during their training. And the • Keith Wesley, MD, FACEP, FAEMS, Medical Director, HealthEast Medical
advent of electronic PCRs has made it even easier to develop bad habits. In this Transportation
presentation, Dr. Wesley who dislikes paperwork as much as anyone else, will • Corey Slovis, MD, FACP, FACEP, FAAEM, Professor and Chairman,
discuss EMS documentation from the perspective of an active medical director Department of Emergency Medicine; Vanderbilt University Medical Center
and provide you with the essential elements your medical director is looking for. Medical Director, Nashville Fire Dept. and International Airport
The concept of pertinent positives and negatives will be reviewed in-depth to Join Dr. Keith Wesley and Dr. Corey Slovis as they cuss and discuss the obvious
help you “tell me a story” which will meet the needs of the patient, the service, the and the not so obvious myths of everyday prehospital patient care. We’ve all been
medical director, and potentially the lawyers. there; doing what we’ve been told or led to believe is the right thing to be doing
for our patient only to find out later maybe our current practice is not so current!
1:30 PM-3:30 PM This team of august and aghast experts will share their findings, all research-
/// RAPID RECOGNITION OF ACUTE PEDIATRIC oriented of course, and with more than a touch of humor, assist you through the
DISTRESS PATTERNS (#19923) maze of current EMS trends! 1. NTG causes hypotension in Right Sided Infarct 2.
Right sided chest leads must be done in Inferior MI 3. Opiates cause hypotension
SUPER SESSION in therapeutic doses 4. Lights and sirens save time 6. The Cincinnati stroke scale
NREMT Category: Medical detects all strokes 7. EpiPens are not safe for the elderly 8. Kids can be safely
• Benjamin Martin, EMT-P, Lieutenant, Henrico County Division of Fire transported in their parent’s lap.
Sick kids make for scary patients. Most providers are uncomfortable treating
children because they lack experience with them and have difficulty discerning 11:00 AM-12:30 PM
vitals to determine if the child is actually sick. This information-packed session
will help you gain a strong foothold in the assessments of pediatrics by learning
/// PATIENTS WITH AUTISM: HOW TO RESPOND
to rapidly recognize common illness and injury patterns in children. Benjamin AND REACT (#19925)
Martin will present a powerful case study involving a pediatric shooting which NREMT Category: Medical
will detail several important lessons learned. You will have your confidence • Katherine Koch, MEd, PhD, NRP, Assistant Professor of Education/
increase through the framing of acute moments with basic life interventions, an Paramedic, St. Mary’s College of Maryland/St. Mary’s County ALS
understanding of pediatric anatomy and lots of pictures and video. Individuals with autism can present in a variety of ways that can be unpredictable
and create barriers to assessment, treatment, and transport for EMS providers.
Due to improved understanding and diagnostics, the prevalence and incidence
of autism has skyrocketed, which will increase the likelihood that EMS
responders will encounter a patient (or family member) on the autism spectrum.
This session will provide an informative overview of autism spectrum disorders,
the characteristics of autism spectrum disorders, including communication
challenges, restricted/repetitive behaviors, and sensory issues, as well as ways
a person with autism might respond during a medical or trauma emergency that
can impact the care provided, Katherine Koch will also review suggestions for
EMS providers responding to these calls, ways to facilitate communication with
the patient with autism, and concerns their family members might have.
18EMSTPrelim_42 42 8/28/17 10:56 AM

11:00 AM-12:30 PM 1:15 PM-2:45 PM
/// MOTORCYCLE CRASH INJURIES: LESSONS /// SYNCOPE AND TBI’S: WHAT YOU REALLY
FROM THE DEATH OF EMS ICON RICHARD NEED TO KNOW (#20098)
BEEBE (#19924) NREMT Category: Medical
NREMT Category: Trauma • William Ferguson, MD, FACEP, FAAEM, Assistant Professor of
• Mike McEvoy, PhD, NRP, RN, CCRN, EMS Chief, Saratoga County, New Emergency Medicine, University of Alabama, Birmingham
York • Vincent Mosesso, Jr., MD, FACEP, EMT-P, Professor of Emergency
Medicine, University of Pittsburgh School of Medicine
On May 25th, 2016, nationally recognized EMS educator, author and speaker
Richard Beebe crashed his motorcycle into the side of a minivan that turned EMS personnel see patients with syncope on a frequent basis. It is also a
directly into his path. He died on June 5th from complications of multisystem common “chief complaint” for many patients in emergency departments. It
trauma. This powerful and insightful case presentation by Mike McEvoy will has a broad differential of causes ranging from anxiety, to dehydration, or
review motorcycle crash injuries, modern day trauma care and resuscitation even arrhythmias, or intracranial hemorrhage. William Ferguson, Assistant
and the lethal events that conspired to lead to the demise of a man who Professor of Emergency Medicine, University of Alabama, Birmingham will
was beloved to many. Rich Beebe was fascinated with his many injuries and discuss both clinical and diagnostic findings along with important historical
looked forward to using them in presentations. In his memory, this talk will be information that will help you determine the cause of the syncope, the
delivered by his friend and teaching partner, Mike McEvoy, RN, EMT-P, PhD, appropriate emergent therapeutic interventions that may be needed and
who took part in overseeing the care of his friend and colleague. appropriate triaging of patients with syncopal or near syncopal events.
Vincent Mosesso, Jr., Professor of Emergency Medicine, University of
1:15 PM-2:45 PM Pittsburgh School of Medicine will discuss how Traumatic Brain Injury (TBI)
/// ASSESSMENT AND MANAGEMENT OF THE spans a wide spectrum of severity and variety, from cerebral concussion
to hemorrhages in or outside the brain. He will show you how recent
UNSTABLE PELVIC INJURY (#19914) research has provided new insights into the factors that worsen the primary
NREMT Category: Trauma injury and revealed critical aspects of prehospital management that may
• Timothy Arnett, NRP, Fire Captain/Paramedic, Anne Arundel County tremendously impact the patient’s ultimate outcome and even survival. His
Fire Department presentation will review the various types of traumatic brain injury and focus
This informative presentation will begin with a thorough review of the on the principles of prehospital management that will enable you to improve
anatomy and physiology of the pelvis and pelvic region and address care your patient’s outcome. In addition, you will learn which treatments taught for
of injuries associated with trauma to these areas. Timothy Arnett will then years may actually be harmful.
transition to use of pelvic binders, their limitations and also address other
methodologies for treatment of pelvic injuries. His presentation will conclude
CE
with a powerful global perspective on an actual case study from initial arrival
EREN
on scene through full course of hospitalization and discharge that will
include x-rays, treatment information and reports from the incident. This
case example will illustrate how the potential for a fatal outcome for the CO N F
patient is important in comparison to the actual outcome based on delivery
of prompt, evidence-based care of the pelvic injury.
18EMSTPrelim_43 43 8/28/17 10:56 AM

OPERATIONS - COMMUNITY PARAMEDICINE - MIH
8:00 AM-9:30 AM 10:00 AM-11:30 AM
/// DEVELOPING A POPULATION-BASED /// MULTI-NATIONAL FOCUS ON SOCIAL WORK:
PAYMENT MODEL FOR EMS AND MIH USING SOCIAL WORKERS IN THE FIELD &
SERVICES: CONSIDERATIONS FOR COUNTY/ ADDRESSING HOARDERS (#20100)
CITY EMS, FIRE AND PRIVATE SERVICES NREMT Category: Operations
(#19940) • Michael Baker, MA, NRP, Chief of EMS, Tulsa Fire Department
NREMT Category: Other Continuing Education, NEMSMA-accredited • Christoph Redelsteiner, DrPhDr, MSW, MS, EMT-P, Professor, St. Pölten
• Douglas Hooten, MBA, CEO, Medstar Mobile Healthcare University of Applied Sciences, Austria
• Jonathan Washko, NRP, MBA, AEMD, Assistant Vice President of We frequently respond to incidents that involve hoarding, the homeless, and lift
Operations, Northwell Center for EMS assists. This session will explore the nature of these complex health issues and offer
• Matt Zavadsky, MS-HSA, EMT, Chief Strategic Integration Officer, examples of how communities are addressing them. Michael Baker will discuss the
MedStar Mobile Healthcare need for not only an effective referral program to address these issues, but also
EMS agencies have begun testing economic models based on a defined the need to work as a component of an integrated care team for overall community
population as opposed to ambulance transport. Payers and other healthcare impact will be facilitated among the participants. He will also discuss the pitfalls
partners have found this model very attractive and payers have used it for involved when agencies exchange client information or apply technology while
contracting with other providers, so it may be coming to your agency soon. There maintaining personal privacy.
are key things EMS leaders need to know in order to successfully engage in Professor Christoph Redelsteiner will discuss how some EMS systems in the USA
this type of contracting. In this session, Doug, Jonathan and Matt will walk you and Europe are utilizing social workers as a tier to address non-medical problems in
through the many things they have learned in negotiating these revolutionary their communities. and explain why we need connections between EMS and ESW at
contracts with payers. the caller level by triaging phone calls and referring callers to alternative resources.
Examples of operational ESW interventions will be explained.
8:00 AM-9:30 AM
/// CRITICAL EMS LEADERSHIP SKILLS NEEDED & 10:00 AM-11:30 AM
LEGAL MISTAKES TO BE AVOIDED (#19941) /// UNRECOGNIZED & UNDOCUMENTED: OUR
NREMT Category: Other Continuing Education, NEMSMA-accredited INDUSTRY’S DIRTY LITTLE SECRETS (#19929)
• Steve Wirth, JD, Attorney/Partner, Page, Wolfberg & Wirth LLC • Kerby Johnson, NRP, Medical Records Coordinator, MedStar Mobile
• Doug Wolfberg, JD, Partner, Page, Wolfberg & Wirth LLC Healthcare
Are your staff spending more face time on Facebook than with your patients? • Neal Richmond, MD, FACEP, Medical Director, MedStar Mobile Healthcare
Are you reacting to hundreds of e-mails a day and not spending enough time EMS and Fire systems spend considerable resources emphasizing the importance
personally interacting with others? Are you operating with undue fear of lawsuits of documentation, something that’s important not only for assuring quality patient
This engaging session will review the Top 5 Distractors that impede our ability to care and navigating potential medicolegal issues, but also for tracking controlled
focus on our work, care for our patients, properly process claims, and to get the substance use and ensuring appropriate billing reimbursement. Many of us have
work done accurately, efficiently, and safely, and the 5 biggest legal mistakes processes in place for reviewing the adequacy of documentation that is available,
made by almost every EMS Agency. Proven strategies for getting your front-line but we may have no means to detect when that documentation is missing. A
staff to remain focused on the patient and the mission and to steer clear of the substantial number of calls may be lost to inappropriate cancellations and refusals
most powerful legal landmines that have detonated in other agencies will be and, while our controlled substance tracking processes may account for what
discussed by two of the best known and most respected EMS attorneys in our goes in and out of the office, they may tell us little about what actually happens
industry. You won’t want to miss this session. with these drugs once they are out in the field. This session will analyze one
system’s solutions for tracking undocumented calls that would otherwise remain
unrecognized by system executives, managers, legal counsel, compliance officers,
and medical directors. It will highlight the clinical, legal, regulatory, financial and
ethical implications of failing to do so, and provide a methodology for effective
tracking and monitoring of controlled substance utilization.
18EMSTPrelim_44 44 8/28/17 10:56 AM

8:00 AM-9:30 AM 10:00 AM-11:30 AM
/// THE COPENHAGEN DENMARK EMS /// MEDICAL OVERSIGHT OF MIH PROGRAMS:
SYSTEM: WHY IT’S SO UNIQUE (#20133) EMERGENCY CARE OR PRIMARY CARE?
NREMT Category: Other Continuing Education (#19942)
• Mark Harvey, EMT-P, Paramedic, Copenhagen EMS NREMT Category: Other Continuing Education, NEMSMA-accredited
• Freddy Lippert, CEO, MD, EMS Copenhagen and Assistant Professor, • David Lloyd, MD, MBA, Medical Director, Silverback Care Management
University of Copenhagen & North Texas Specialty Physicians
• Christian Svane, MD, Medical Director, EMS Copenhagen, Denmark • Neal Richmond, MD, FACEP, Medical Director, MedStar Mobile
The Copenhagen Denmark EMS System has been recognized as one Healthcare
of the most progressive and advanced systems in Europe featuring well Operating MIH programs have learned a lot about the role of Medical
equipped Physician “Doctor Cars” staffed by highly trained anesthesiologists Oversight for MIH programs. Many programs have a goal of enhancing
and Paramedic/Physician’s Assistants who respond in conjunction with the relationship between the patients and their PCPs to improve patient
ambulances from the Copenhagen Fire Department and Falck Ambulance in a care as well as help reduce EMS and ED use, and to prevent unnecessary
unified and highly coordinated system that has achieved amazing resuscitation readmissions. What is the ideal balance between the role of an EMS Medical
results, Come hear how they accomplish this in Copenhagen and learn some Director and the patient’s PCP? When it comes to the need for on-scene
take-away tips for your service. medical direction, which doc should have the lead in patient care decisions?
This session will outline how MedStar’s medical directors balance their role
8:00 AM-9:30 AM with the role of the patient’s PCP.
/// NOVEL APPROACHES TO THE OPIOID

NEMESIS (#20102) 10:00 AM-11:30 AM
NREMT Category: Other Continuing Education /// TRANSITIONING FROM PILOT TO PRACTICE
• Kenneth Scheppke, MD, EMS Medical Doctor, Boyton Beach Fire Rescue (#19943)
Dept. NREMT Category: Other Continuing Education, NEMSMA-accredited
• Glenn Joseph, MS, RN, NRP, Fire Chief, Boynton Beach Fire Rescue Dept. • Matthew Goudreau, BS, NRP, Associate Director, Acute Clinical
• Christopher Hickey, FF, NRP, EMS Officer, Manchester (N.H.) Fire Department Response, Commonwealth Care Alliance
The death toll from narcotic addiction and the use of illicit opioids often exceeds Commonwealth Care Alliance partnered with EasCare Ambulance Service
those from many other causes. This presentation by Kenneth Scheppke, MD, to create an extensive Acute Care Delivery team utilizing Community
and Glenn Joseph will present the findings from a novel treatment regimen Paramedics under a Special Project Waiver with the Office of EMS in the
piloted in Palm Beach County Florida using a combination of medication assisted Commonwealth of Massachusetts. Over thirty months, this pilot program was
CE
treatment, community paramedicine and local health care alliances. You will successful in creating Proof of Concept as a safe method of care delivery for
EREN
learn how to bring this new life saving model back to your EMS system. the most complex patient populations. Armed with the Proof of Concept and
Return on Investment data, CCA’s management team implemented a project
Christopher Hickey will detail a program dubbed “Safe Station”, a Fire-based to expand the program from the pilot to fully operational statewide care CO N F
response to the opioid epidemic and frustrating lack of services. Hickey’s plan delivery system. This presentation will detail the unique challenges incurred
opened up the doors of all 10 city firehouses as an access point for treatment during the process of modeling a successful small pilot program into a large
and recovery and helped provide 24/7/365 access to drug rehab and treatment scale operation covering an entire state and servicing the needs of more
services. Since the program went “live” their system has had over 1,400 visits to than 21,000 members, addressing challenges that included medical control,
the program and a 40% reduction in overdoses per month. 60% of those coming EMR access, and managing multiple care partners.
through remain in treatment, three times the national average.
18EMSTPrelim_45 45 8/28/17 10:56 AM

1:30 PM-3:30 PM Friday, February 23, 2018
/// AMBULANCE CRASH PREVENTION 2.0
SUPER SESSION 8:00 AM-10:00 AM
NREMT Category: Operations /// PCR DOCUMENTATION WORKSHOP: THE
• Shaun Curtis, BS, EMT-P, Risk and Safety Manager, MedStar Mobile GOOD, THE BAD AND THE MISSING! AMA
Healthcare EVIDENCE-BASED APPROACH (#19934)
• Justin M. Eberly, EMT, Education Specialist, VFIS
SUPER SESSION
• James D. Green, BSME, MBA, Project Officer, National Institute for
Occupational Safety and Health (NIOSH)
• Neal Richmond, MD, FACEP, Medical Director, MedStar Mobile Healthcare
As employers, we train our drivers to follow the rules and drive safely but are • Steve Wirth, JD, Attorney/Partner, Page, Wolfberg & Wirth LLC
we effectively managing the risk? This panel discussion will address how one
In a recent national reimbursement conference the majority of the attendees
organization reduced their collision costs by 73% and brought driving safety
cited “poor crew documentation” as the major source of potential liability for
to a new level for all employees and changed the culture. This session will also
their EMS agency. The PCR is the backbone of revenue cycle compliance and it
explain why a proactive approach must be taken to ensure that emergency
must be accurate, complete and objective or else you could face overpayment
vehicles are operated safely with the person seated in the “Right Front Seat”
demands or a false claims act lawsuit. This super session will review real life
understanding that they play a critical role in ensuring that the emergency
examples of ten (10) “completed” PCRs for the most common patient conditions
vehicle arrives in a safe and prudent manner on every run. Over the last seven
that ambulance services encounter – both emergency and non-emergency. We
years the National Institute for Occupational Safety and Health has partnered
will critically dissect each of those PCRs in detail and describe what makes them
with the ambulance industry, its suppliers, and several other federal agencies
good (or not so good!). We’ll provide “lessons learned” from each that can be used
to develop a family of ten new test methods all geared to improve crash safety
as key teaching points that you can take back to your field staff to help tune up
in the patient compartment of an ambulance. These new test methods address
the quality of your patient care documentation.
key components such as the patient cot, seating, occupant restraints, equipment
mounts, storage devices, and the patient compartment structure and highlight
key findings from NHTSA’s review of EMS vehicle related injuries and fatalities. 11:00 AM-12:30 PM
It will conclude with a review of work completed by the National Institute of /// TELEHEALTH FOR LOW-ACUITY PATIENTS:
Standards and Technology and the Department of Homeland Security to improve THE HOUSTON ETHAN SYSTEM’S FOUR-
worker efficiency through improved interior designs.
YEAR EXPERIENCE (#19970)
NREMT Category: Operations, NEMSMA-accredited
• Guy Gleisberg, MBA, BSEE, EMT, EMS-I, Senior Analyst, ETHAN Program,
Houston Fire Department EMS
Emergency Medical Services (EMS) transports thousands of patients via
ambulance every day to emergency departments (ED), regardless of acuity
level. ACEP and NAEMSP believe EMS systems may encounter patients who
do not need advanced life support care or evaluation; in these circumstances
transportation by alternate means or to an alternate destination may be
appropriate. In December 2014 the Houston Fire Department EMS launched an
innovative, technology-based program called ETHAN (Emergency Telehealth and
Navigation Program) that uses advanced video/voice conferencing technologies.
This community-based mobile integrated healthcare (MIH) program provides
individuals who call 911 with low acuity complaints to be triaged by telehealth
emergency physicians for non-ambulance transportation (taxi cab, self-transport)
and/or non-ED destinations (primary care clinic, home care) based on individual
disposition. Presently, sizeable and long-standing EMS telehealth programs are
scarce.
18EMSTPrelim_46 46 8/28/17 10:56 AM

11:00 AM-12:30 PM 1:15 PM-2:45 PM
/// COMMUNITY PARAMEDICINE FOR FIRE- /// COMMUNITY PARAMEDICINE FOR ALL
BASED EMS (#19971) SIZE AGENCIES: SUCCESSFUL NORTH
NREMT Category: Other Continuing Education, NEMSMA-accredited CAROLINA PROJECTS (#19933)
• Richard Lewis, EMT-P, EMS Chief, South Metro Fire Rescue NREMT Category: Other Continuing Education, NEMSMA-accredited
• Michael Wright, Fire Captain, President Southeast Tactical LLC, • David Ezzell, MPA, EMT-P, Education Consultant, North Carolina
Milwaukee Fire Department Office of EMS
• Matt Zavadsky, MS-HSA, EMT, Chief Strategic Integration Officer,
North Carolina provides a solid example of how Community Paramedicine
MedStar Mobile Healthcare
can be blended into your agency, regardless of size, shape, and budget.
The fire service is in a unique situation—much like when it took on EMS—to This session will take a look at the current state of affairs in North Carolina,
take a greater role in the health of our community. Learn about the impact looking at specific examples of programs all across the State. Learn about
of Mobile Integrated Healthcare (MIH) on the fire service as well as insight how a variety of governmental, nonprofit, and private agencies help provide
into the successful delivery and fiscal sustainability of fire-based MIH and this valuable service to their clients in a mix of urban and rural settings. From
Community Paramedicine programs. You’ll also learn about the National the mountains to the sea, NC EMS agencies partner with countless agencies
Fire Academy’s new MIH Administration training course, which will help you to provide seamless services to their clients.
understand the key aspects of MIH program development, implementation
and sustainability.
1:15 PM-2:45 PM
/// USING MOTORCYCLES FOR EMS
RESPONSE (#19932)
• Patric Lausch, MD; EMT-P President, International Fire & EMS
Response Unit Association, Hungary
Join Patric Lausch, EMT-P, MD, an EMS physician on a quick
response EMS motorcycle unit in Hungary (Europe) and president and
founder of the International Fire and EMS Motorcycle Response Unit
Association (IMRUA) as he presents the benefits of deploying EMS
motorcycles in urban and rural environments to navigate through
congested traffic and provide time-sensitive emergency care. He will
CE
be joined by members of other EMS motorcycle teams—both from
EREN
the U.S. and worldwide. Dr. Lausch and his co-presenters will also
explain the operational and patient care benefits resulting from the
CO N F
deployment of a well-equipped, efficient first response motorcycle at
special events.
18EMSTPrelim_47 47 8/28/17 10:57 AM

SPECIAL TOPICS & TECHNOLOGY
8:00 AM-9:30 AM 8:00 AM-9:30 AM
/// EMS RESILIENCY CRUCIAL TO OUR /// THE GLOBAL EMS VILLAGE: EMS
PROFESSION (#20103) INNOVATIONS FROM AROUND THE WORLD
NREMT Category: Operations (#19947)
• Chetan Kharod, MD, MPH, Program Director, Military EMS & Disaster NREMT Category: Other Continuing Education, NEMSMA-accredited
Medicine Fellowship • Rob Lawrence, Chief Operating Officer, Richmond Ambulance Authority
• Monique Rose, CCEMT-P, Chairperson, NEMSMA Practitioner Mental • Dovie Maisel, EMT-P, Senior Vice President International Operations,
Health and Wellbeing Committee United Hatzalah/United Rescue, Israel
Humans are more important than hardware so we need to give a high priority to • Neil Noble, CCFP, MPA, Critical Care Flight Paramedic, Senior Operations
protect ourselves and our personnel from the impact of excessive stress and Supervisor, Team Australia, Paramedics Australasia, and Queensland
help to overcome the cumulative physical and emotional strain of frontline public Ambulance Service, Australia
service. The US Special Operations Command empowered an interdisciplinary Thanks to conferences like EMS Today and Paramedics Australisia International
team to build and implement innovative solutions to improve the well-being of Conference (PAIC), the opportunity to compare and contrast global EMS practices
the force and their families. In this presentation, Col. Chetan U. Kharod, MD, MPH, and procedures is now commonplace. Join this informative panel of International
USAF, MC, SFS, one of the key leaders in the AF Special Operations’ resiliency speakers, Rob Lawrence (UK/US) Neil Noble (Australia/South Africa) and Dov
programs, will review the important triggers of stress and areas or resiliency Maisel (Israel) as they highlight global best practices and delivery methodologies
need and show you how mind-body-spirit solutions can be applied to your in an entertaining and educational format. They will cover EMS in extremes of
organization. geography from the Ambos of the Northern territories, to the Paramedicos of
In this informative talk Monique Rose will update you on the work of the Alliance South America and clinical practices, from the citizen responders of Tel Aviv, to the
on EMS Resiliency, a unified group of more than 30 EMS associations, agencies paramedics of Cape Town.
and manufactures from North America and other countries that have banned
together with a common goal of reducing stress and suicide among our ranks 10:00 AM-11:30 AM
by openly discussing and acknowledging it, reducing fear by personnel to admit
they are troubled or suffering from the emotional scars caused by calls or patient
/// ARE ROBOTS TAKING OVER THE WORLD?
interfaces, educating personnel on the causes of stress and importance of
REPLACING CLINICAL EXPERIENCE WITH
resiliency training and practices. SIMULATION (#19946)
• Paul Werfel, MS, NREMT-P, Director, EMT & Paramedic Program, Stony
Brook University , NY
• Anthony Guerne, MS, NRP, CHSE, Simulation Specialist, Adelphi University,
Paramedic Greenlawn Fire District
Medical/healthcare simulation has been launched to the forefront of medical
education by emerging trends in Crew Resource Management and deliberate
and repetitive practice in all fields of medicine. The Institute of Medicine’s seminal
work on patient safety in 2000 clearly indicated that medical and the healthcare
systems should adopt a simulation program. Understanding the complexities of
simulator function, as well as proper scenario creation and design limits those
agencies attempting to introduce simulation as a teaching methodology. Do you
need a $50,000 simulator to have an effective program? In 2014, the NCBSN
reported that there was no difference in educational outcomes by replacing
up to 50% of clinical time with simulation. Due to legal, and moral implications
of “practicing on people”, EMS educator Paul Werfel will also address the use
of simulation from differing sides of the argument to promote discussion and
introduce educators and managers to a new educational paradigm that could be
useful and helpful to them.
18EMSTPrelim_48 48 8/28/17 10:57 AM

10:00 AM-11:30 AM 8:00 AM-9:30 AM
/// RESEARCH DOESN’T HAVE TO BE /// NEW AND DEVELOPING EMS
INTIMIDATING: TIPS TO ADVANCING YOUR TECHNOLOGIES (#19952)
SERVICE & OUR PROFESSION (#19950) NREMT Category: Other Continuing Education, NEMSMA-accredited
NREMT Category: Other Continuing Education • Will Smith, MD, Paramedic, Medical Director, Jackson Hole Fire/EMS,
• Jonathan Studnek, PhD, NRP, Deputy Director, MEDIC: Mecklenburg National Park Service
EMS Agency With all of the EMS gadgets that come and go, how do you know what
In this informative session, Jonathan Studnek will explain the important to buy? This informative presentation by Street Medicine Society award
role research plays in improving operations in his agency and other EMS winning medical director Will Smith, MD looks at many of the ‘new’
systems. He will discuss how to generate evidence to change protocols technologies available to EMS and addresses the question of when you
using data from your own system and the power of collaborating with other should break or revise your budget in order to provide better patient care?
EMS systems to effect local, regional, and national change. A variety of Hands on equipment will be shown to visually demonstrate some of the
topics will be used as examples including cardiac arrest resuscitation, STEMI devices discussed.
regionalization, pediatric medical triage, ambulance task times, and unit
deployment models. 10:00 AM-11:30 AM
/// BEST APPROACHES TO SPECIAL NEEDS
Thursday, February 22, 2018 PATIENTS: PROVIDING BETTER CARE FOR
PATIENTS AND THEIR FAMILIES (#19953)
8:00 AM-9:30 AM NREMT Category: Medical, NEMSMA-accredited
/// FATIGUE AND EMS: THE NEW SILENT • Skyler Phillips, EMT-P, Captain, Chattanooga Fire Department
KILLER (#19973) This session will teach you how to interact on emergency scenes with
NREMT Category: Operations, NEMSMA-accredited patients who have special needs and teach you about developmental,
• P. Daniel Patterson, PhD, MPH, MS, NRP, Assistant Professor of intellectual and physical disabilities. You’ll learn how to speak to someone
Emergency Medicine, EMSARN Primary Investigator, EMS Agency with special needs or their caretaker, how to do a proper special needs
Research Network, University of Pittsburgh patient assessment, and how to deescalate a person who may be on
Fatigue affects all personnel involved in EMS and can result in clinical and the verge of an emotional meltdown. Skyler will also discuss the things
operational errors as well as costly emergency vehicle accidents. Research responders need to look for that may be abuse vs things that may be a part
has shown that greater than 50% of all EMS personnel suffer from mental of everyday life for a person tasked with raising and caring for an individual
and physical fatigue, greater than 50% reporting poor sleep quality, and half with special needs.
CE
EREN
getting less than six hours of sleep a day. In addition, 50% don¹t get the
recovery they need between shifts, and odds of an injury or medical error are
much greater among those fatigued versus those not reporting fatigue. Dr. CO N F
Patterson served as the principal investigator of a multi-year, multi-phased
project aimed at developing and testing evidence-based guidelines for
fatigue management in the EMS environment. During this, informative and
valuable presentation, Dr. Patterson will present the project’s five evidence-
based recommendations and discuss how local EMS organizations can use
them to implement and develop their own fatigue risk management program.
He will discuss the evidence on shift duration, napping during duty, use of
caffeine, fatigue education and training, and other topics investigated as part
of the evidence review.
18EMSTPrelim_49 49 8/28/17 10:57 AM

/// ENVISIONING THE FUTURE: YOUR CHANCE
FOR INPUT TO THE EMS AGENDA 2050 8:00 AM-10:00 AM
(#19972) /// AROUND THE WORLD OF EMS: A SHOWCASE
NREMT Category: Other Continuing Education, NEMSMA-accredited OF INNOVATIONS IN PLACE OR UNDERWAY
• Mike Taigman, MA, Facilitator, EMS Agenda 2050 THROUGHOUT THE WORLD (#19955)
The EMS Agenda for the Future brought our diverse profession together to SUPER SESSION
describe a plan for EMS. Some recommendations from the Agenda became reality, NREMT Category: Other Continuing Education, NEMSMA-accredited
while others remain unattained goals. Now, the EMS community has embarked Panel Moderators:
on a journey to create a new vision for the future of EMS. In this session, leaders • Corina Bilger, Director of International Sales, SAM Medical Products
of the EMS Agenda 2050 project will engage you in a discussion about what the • Jerry Overton, MPA, McA, President, IAED
future of EMS should look like and solicit feedback on the most recent draft of Panelists:
EMS Agenda 2050. This is your chance to be a part of creating an EMS system • Paul Gowens, FCPara, Vice Chair, College of Paramedics, Scottish
that truly meets the needs of patients and communities across the nation. Bring Ambulance Service, Scotland
an open mind and your dreams for the future of EMS and be prepared to share, • Christoph Redelsteiner, DrPhDr, MSW, MS, EMT-P, Professor, St. Pölten
listen and learn. University of Applied Sciences, Austria
Join an expert panel of JEMS International Editorial Board Members for a truly
1:30 PM-3:30 PM super session highlighting advances in the practice of EMS medicine around the
/// RESEARCH THAT SHOULD BE ON YOUR world. Learn the dynamic breakthroughs that featured EMS systems worldwide
RADAR SCREEN: PANEL DISCUSSION BY are making. You’ll leave this session inspired and equipped with some great
THE JEMS GLOBAL RESEARCH ALLIANCE examples and ideas about capabilities and opportunities that could be applicable
(#20050) to your agency now or in the future, to help you better care for your patients. No
matter what your role in EMS, come ready to experience and absorb the best of
SUPER SESSION the rest (of the world!) at this EMS Today 2018 presentation.
NREMT Category: Other Continuing Education
Panel Moderator:
• Corey Slovis, MD, FACP, FACEP, FAAEM, Professor and Chairman,
Department of Emergency Medicine; Vanderbilt University Medical Center
Medical Director, Nashville Fire Dept. and International Airport
Panelists:
• Sean J. Britton, MPA, NRP, Emergency Preparedness Planner, Maryland
Institute for EMS Systems
• J. Brent Myers, MD, MPH, Chief Medical Officer & Exec. Vice President,
Medical Operations, Evolution Health, Associate Chief Medical Officer,
AMR
• Jonathan Studnek, PhD, NRP, Deputy Director, MEDIC: Mecklenburg EMS
Agency
This prestigious panel will review the top research of the year that EMS providers,
Medical Directors, ED Staff and others involved in the delivery of EMS should
learn about. The panelists will not only present important research but also
explain the implications it can or will have on field providers, their agencies, their
medical directors and managers.
18EMSTPrelim_50 50 8/28/17 10:57 AM

11:00 AM-12:30 PM is creating the nation’s first national database to verify state licensure
/// USING CROWDSOURCING TO ENHANCE information, the Privilege to Practice extended by REPLICA, and license
discipline for EMS providers. The National Coordinated EMS Personnel
COMMUNITY FIRST RESPONSE FOR Database, developed in collaboration with the State Offices of EMS and
CARDIAC ARREST: THE SINGAPORE AND NASEMSO, not only provides the technology foundation required to
NEW JERSEY EXPERIENCES (#20071) implement REPLICA but it also provides a user-friendly gateway for anyone
NREMT Category; Cardiovascular, NEMSMA-accredited to verify an individual’s State EMS License, their NREMT status, and any
• Yih Yng Ng, MBBS, MRCS, MPH, MBA, Chief Medical Officer, Singapore reportable disciplinary actions. Come hear about this new NREMT capability.
Civil Defense Force, Singapore
• Rob Luckritz, NRP, Esq., Executive Director of EMS, Jersey City Medical 1:15 PM-2:45 PM
Center
/// ASSESSMENT & MANAGEMENT OF
Using “crowdsourcing” and citizen response teams for cardiac arrest
improves bystander CPR, and public access defibrillation rates. Since April
DANGEROUS TEEN BEHAVIORS (#19951)
2015, the Singapore Civil Defense Force placed emphasis on this and created NREMT Category: Medical
the app myResponder that calls an operations center that alerts volunteers • Josh Stuart, Paramedic & Chairperson of Pennsylvania EMSC
to respond to cardiac arrests to volunteers within 400m of the OCHA case. Advisory Committee, Medical Rescue Team South Authority
Over 14,000 volunteers have been recruited and over 800 volunteers have This fast-paced lecture will focus on explanations of risky behavior often
arrived at OHCA scenes. This has resulted in 81 cases of ROSC. seen in cases involving teenagers, such as huffing, cutting, suicide and
Jersey City (NJ) EMS has gone one step further, implementing United “dusting”, use of Salvia, K2 and improvised forms of ingesting alcohol. Josh
Rescue, a citizen-based emergency care program which has trained 250 Stuart will also explain some of the new risky behavior being seen by EMS,
community responders and equipped them with AEDs and other life-saving such as vampirism, “planking”, car surfing, and improvised forms of ingesting
medical equipment to respond along with JCEMS units. These civilian alcohol from distilling hand sanitizer to soaking gummy bears in vodka.
responders are successfully treating more than 1,000 patients annually You’ll also hear about kids using E-cigs to smoke hash oil, condom snorting
with time-to-patient-side averaging less than 3 minutes after simultaneous and many new scary trends are explored. Signs and symptoms of behavior,
dispatch via a CAD software system on their phones. The program has been treatment of related injuries and prevention will also be presented.
having amazing success. Though successful, these programs and use of
crowdsourcing via mobile applications technology do present challenges, 1:15 PM-2:45 PM
from application design, integration, volunteer recruitment, verification and
operational model and managing volunteer responders during and after a
/// THE NASCAR APPROACH TO EMS:
case. This session will share the process of bringing in crowdsourcing and PROVEN PRACTICES TO IMPROVE DRIVER
trained citizen response teams as part of the formal response system, as SAFETY (#19956)
CE
well as the challenges and the benefits of doing so. NREMT Category: Cardiovascular, NEMSMA-accredited
EREN
• Douglas Swanson, MD, FACEP, FAEMS, Medical Director, MEDIC:
11:00 AM-12:30 PM Mecklenburg EMS Agency
CO N F
/// NATIONAL REGISTRY UPDATE & Ever wonder just how NASCAR drivers walk away from a crash at 190 MPH
INNOVATIONS (#20104) will little or no injuries? During this session by MEDIC EMS Medical Director
Doug Swanson, will explore numerous advances in track design, vehicle
NREMT Category: Other Continuing Education design, driver equipment, and research that have dramatically improved
• Jeremy Miller, MEd, NRP, Chief Certification Officer, NREMT NASCAR driver safety. Through the use of numerous crash video clips, Dr.
• Donnie Woodyard Jr, MAML, NRP, Chief Information Officer, National Swanson will exhibit the factors instituted by the sanctioning body that
Registry of EMTs enable drivers to be able to walk away uninjured from 190 MPH high energy
NREMT staff will provide an update on the current status of the nation’s EMS impacts. He will also demonstrate the science of how a special head and
Certification and provide you with a summary of what’s new at the National neck system protects the drivers, how the SAFER barrier functions, and how
Registry of Emergency Medical Technicians. Topics covered will include the vehicle interior improvements shield the drivers from potential major injuries.
current state of National EMS Certification and important changes to NREMT
policies and procedures. Following the formal presentation and update
you’ll have the opportunity to participate in a spirited question and answer
session.
In partnership with the commissioners of the Recognition of the EMS
Personnel Licensure Compact (REPLICA), the National Registry of EMTs
18EMSTPrelim_51 51 8/28/17 10:57 AM

FACULTY BIOS (As of August 15, 2017)
/// BENJAMIN ABES, MPH, is Deputy Director of Public Safety and Chief /// CORINA BILGER is the global sales director for H&H Medical, where her
of EMS for Lee County, Fla. He’s responsible for providing senior leadership and responsibilities include developing a sales team to serve military, civilian and
management to all programs in the Department of Public Safety. international markets. She’s a recognized subject matter expert in a variety of
emergency services, and has trained and led teams of EMS, fire, nursing and law
enforcement professionals.
/// KELLY ADAMS, EMT-B, is an EMT with Detroit Fire Department EMS AL
EMS
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/// AHED AL NAJJAR is Director of Life Support Training, EMS Faculty and /// JAY BLACK, A.A.S, NC EMT-P, has spent 16 years in EMS with 10 of
Researcher of Prince Sultan bin Abdulaziz College - King Saud University. He led
those years at Medic. After paramedic school, he began his foray into education
the first public access AED intiative in Dubai, which resulted in AED placement in
by teaching defensive driving to new hires, working as a field training officer,
the city’s hotels.
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Department at Medic.
/// TIMOTHY S. ARNETT, NRP, is a Captain with the Anne Arundel County /// ALLISON J. BLOOM, ESQ., is an EMS attorney and a member of the
(Md.) Fire Department currently assigned to the Operations Bureau at Riva
NEMSMA Board of Directors.
Station 3. He’s a 28-year veteran of emergency services and has been a
nationally registered paramedic for more than 25 years.
/// SEAN J. BRITTON, MPA, NRP, is the Emergency Preparedness
Planner for the Maryland Institute for EMS Systems, a paramedic with Superior
/// FAIZAN H. ARSHAD, MD, is EMS Medical Director for Vassar Brothers Ambulance Service in Binghamton, N.Y., and an Adjunct Assistant Professor at
Hospital – Healthquest Systems in Hudson Valley, NY. He served as a deputy
New York Medical College.
medical director for FDIC of Manhattan, Deputy EMS Fellowship Director at
Newark Beth Israel Hospital, Deputy System, Medical Director for MONOC EMS
and as a TEMS physician embedded with the NJ State Police on TEAMS/SWAT /// CHAD BROCATO, JD, DHSC, is a Deputy Fire Chief for the Broward
assignments. Sheriff’s Office Department of Fire Rescue and Emergency Services, a
nationally-recognized EMS educator and a member of the Journal of Emergency
Medical Services (JEMS) Editorial Board.
/// MICHAEL BAKER, MA, NRP, is Chief Officer and Director of EMS for
the Tulsa Fire Dept.. He has assisted the TFD EMS Branch in expanding the
number of paramedic fire apparatus serving Tulsa. He received the IAFC/Physio- /// GREGORY BROOKS, EMT-P, has served in EMS for more than 40
Control Heart Safe Community Award in 2013 and an EMS10: Innovators in EMS years and has received numerous awards including: South Carolina Paramedic
award in 2016. of the Year, Georgia Paramedic of the Year, National Paramedic of the Year, and
Outstanding Young American.
/// PAUL BANERJEE, DO, is the Medical Director for Polk County Fire /// JOSE G. CABANAS, MD, MPH, FACEP, currently serves as the
Rescue, Polk County Sheriff’s Office SWAT team, Lake County Sheriff’s Office, Director and Medical Director for the Wake County EMS System in Raleigh, N.C.,
and Lake Technical College EMS Program in Florida. He also serves as Associate and is Adjunct Associate Professor of Emergency Medicine at the University of
Medical Director for Osceola Regional Medical Center. North Carolina at Chapel Hill. He’s a board-certified, fellowship-trained EMS
physician and serves as a physician member-at-large for the NAEMSP Board of
Directors.
/// MICHELLE BEATTY, MED, NRP, is an 18-year EMS veteran who’s
worked as an EMT and paramedic in both suburban and rural communities in the
state of Virginia. She’s been an EMS educator since 2003 and is currently the /// ANDREAS CLAESSON, PHD, RN, EMT-P, is a researcher at the
EMS Training Manager for Loudoun County Department of Fire and Rescue, Karolinska Institute’s Centre for Resuscitation Science in Sweden, where he
which is comprised of more than 1,600 career and volunteer members. investigates novel methods for early defibrillation in OHCA, such as SMS
dispatch of trained laypersons and the use of drones to deliver AEDs. He’s also
an active paramedic and has more than 20 years of experience in EMS in
Western Sweden.
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/// ANDREAS CLEVE is the CEO and Co-founder of the artificial intelligence /// JOHN DELANEY, MA, CAPTAIN II, has been in the fire service for
startup Corti.ai. Andreas was among the pioneers in modern language over twenty-six years; the last 22 years as a member of the Arlington County
technology having co-founded the technology company Ovivo, which was sold Fire Department (ACFD), Arlington, Virginia. Currently, he is the program manager
in 2013, and later co-founded Nordic.AI and Copenhagen.AI which are among the for Arlington County Fire Department’s High Threat Response Program which
leading European non-profits for enhancing and guiding the development of focuses on building operational capabilities that will be required for atypical
next generation artificial intelligence. threats to include: active shooter, explosive and fire as a weapon events. The
program focuses on the development of multiagency, integrated police and fire
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response. Previously he was the team leader for the National Medical Response
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Team –National Capital Region (NMRT-NCR). The NMRT-NCR was a federally

funded weapon of mass destruction response team which comprised of over
/// STEPHANIE CORBIN, NRP, is an EMS Training Officer for Loudoun 150 fire fighters, paramedics, hazardous material specialists, law enforcement
County Fire and Rescue. She’s been involved in fire, rescue and EMS for 18 years
officers, doctors, and nurses from within the Washington metropolitan region.
serving as an educator, firefighter and critical care paramedic.
/// CARL CRAIGLE, NRP, ran his first ambulance call at the age of 15. He’s /// MARC-ANTOINE DESCHAMPS, OSTJ, ACPF, BAPPB:ES, is
Superintendent of Public Information for the Ottawa Paramedic Service. He’s
served as a firefighter, EMT, paramedic, SWAT medic, instructor, coach and
also a facilitator for the Regional Paramedic Program for Eastern Ontario,
servant leader in a career spanning over 30 years.
Canada, which oversees the certification and training of more than 1,000
paramedics.
/// SCOTT CRAWFORD, NRP, FP-C, EMSI, is lead instructor for the
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Omaha (Neb.) Fire Department paramedic program. He’s also a certified flight
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paramedic with LifeNet of the Heartland, operated by Air Methods. He was

honored as the Nebraska EMS Association’s 2010 Instructor of the Year and the
National Association of EMS Educators 2010 Unsung Hero’s Award for
/// EDWARD DICKINSON, MD, NRP, FACEP, is a Professor and
board-certified emergency medicine and EMS physician at the University of
educational excellance.
Pennsylvania in Philadelphia. He serves as the medical director of the PennStar
aeromedical and ground transport program and medical director of the Malvern,
/// SHAUN CURTIS, BS, EMT-P, is the Risk and Safety Manager for Berwyn and Radnor Fire Companies. He’s also the medical editor of JEMS and
MedStar Mobile Healthcare in Fort Worth, Texas, where he began as an EMT and provides medical oversight for EMS Today.
has worked for 16 years.
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/// DAVID DALTON, BS, EMT-P, is the creator of the video, “Practical
Skills Prep for the EMT”, published by Jones and Bartlett and a contributing /// BRIAN DONALDSON, CCP, ASM, is the Director of EMS for
author for several EMS textbooks. He’s also an EMS Training Office and Waushara County, Wis, is certified as an Ambulance Service Manager, and is
Defensive Tactics Instructor at St. Charles County Ambulance District in licensed as a Critical Care Paramedic. He’s served on many local and state EMS
Missouri. boards, commissions and task forces, and is a former full-time EMS educator.
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/// ROBIN DAVIS, NRP, is an accomplished paramedic with more than 31 /// ROMMIE DUCKWORTH, LP, is an award-winning educator with more
years in EMS and 28 years of experience as a police officer, rising to the rank of than 25 years working in career and volunteer fire departments and public and CO N F
lieutenant. He received his paramedic training from the prestigious George private EMS systems. He’s a former volunteer assistant chief and technical
Washington University in Washington, D.C. rescue team coordinator, current career fire captain and paramedic EMS
coordinator as well as an emergency services advocate, author and speaker.
/// BRADLEY DEAN, NRP, is the Battalion Chief over the Training Division
for Rowan County (N.C.) Emergency Services and serves as the Paramedic /// PETER DWORSKY, MPH, EMT-P, CEM, is the Corporate Director
Program Director for Rowan-Cabarrus Community College in Salisbury, N.C. He’s for Support Services at MONOC Mobile Health Services. He’s also the
involved in multiple state and national EMS initiatives. He also teaches Martial President-Elect of the International Association of EMS Chiefs.
Arts and is a Lifetime Member of the American Freestyle Karate Association.
/// JUSTIN M. EBERLY, EMT, is an Education and Training Specialist for

VFIS, a subsidiary of the Glatfelter Insurance Group, where he’s responsible for
the national delivery of educational and training programs, curriculum
development and information analysis.
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/// DAVID EZZELL, MPA, EMT-P, is EMS Education Consultant for the /// MATTHEW GOUDREAU, BS, NRP, is the Associate Director of Acute
N.C. Office of EMS. His primary responsibilities include community paramedicine Clinical Response for Commonwealth Care Alliance where he oversees the
and data management/research. Mobile Integrated Health program among other tasks.
/// ROBERT FARMER, BSM, FACPE, currently serves as a Public Safety /// PAUL GOWENS FCPARA, MSC, DIPIMCRCSED, AASI,
Evangelist and NextGen Solutions Director for Atos North America’s Public MCMI, has over twenty seven years of experience within the Scottish
Safety Solutions. He previously served as the Director of Public Safety for Lee Ambulance Service. He is currently Lead Consultant Paramedic for the Scottish
County, Fla., where he was responsible for all countywide Public Safety Ambulance Service, a Health Foundation, GenerationQ, Leadership Fellow and
operations, including EMS, emergency telecommunications and fire/EMS Vice Chair for the College of Paramedics (UK).
dispatch.
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/// WILLIAM FERGUSON, MD, FACEP, FAAEM, is an assistant

professor of emergency medicine at the University of Alabama at Birmingham /// KEVIN GRANGE, EMT-P, is a firefighter/paramedic at Jackson Hole
where he also oversees the Emergency Medicine Residents’ EMS training. He Fire/EMS in Wyoming and the award-winning author of “Lights & Sirens: The
also serves as the medical director for a paramedic program and coordinates a Education of a Paramedic.” After graduating from UCLA’s Daniel Freeman
free continuing education program that provides monthly educational Paramedic Program, he worked as a Paramedic/Park Ranger at both Yellowstone
experiences to regional paramedics. and Yosemite National Parks.
/// JAY FITCH, PHD, is the founder of the EMS/public safety-consulting firm, /// JAMES D. GREEN, BSME, MBA, was the lead researcher and Project
Fitch & Associates. Officer who guided the National Institute for Occupational Safety and Health’s
(NIOSH) efforts to improve worker and patient crash survivability when in the
patient compartment of a moving ambulance.
/// DAVID GARBER, AS-EMS, NC EMT-P, has been in EMS since 1990
and has been a paramedic since 1992. For most of that time David has been a
field training officer and has been a full time educator for Mecklenburg EMS /// RYAN GREENBERG is Executive Director of MedSpan Integrated Health.
agency for over 4 years. He’s spent nearly 20 years working in EMS from EMT to Chief of EMS and serves
on the Executive Committee of the Board of Directors of the National EMS
Management Association (NEMSMA).
/// DONALD GARNER JR., BAS, NRP, has more than 20 years of
experience in EMS and is currently the Deputy Director of Professional
Development for Wake County (N.C.) EMS. He’s also a published author, /// ANTHONY GUERNE, began his career in medicine in 1990 as an
researcher, lecturer and an adjunct instructor for the Department of Emergency emergency medical technician. In 1994 he became a paramedic and began
Medicine at the UNC School of Medicine. working in the City of New York. After almost 20 years as a clinician he took a
full-time educational role as the simulation specialist at the NYIT-College of
Osteopathic Medicine. He obtained a Master’s Degree in Health Care Simulation,
/// GUY R. GLEISBERG, MBA, BSEE, EMT, EMS-I, is a senior
and is now the Simulation Specialist for Adelphi University.
analyst for the Houston Fire Department’s ETHAN program and a clinical
assistant professor in the Section of Emergency Medicine at the Baylor College
of Medicine. /// TROY HAGEN is past president of NEMSMA and CEO of Care Ambulance in
Orange County, Calif.
/// MICHAEL GOOCH, DNP, ACNP, FNP, ENP, CFRN, CTRN,
CEN, TCRN, EMT-P, is a Flight Nurse at Vanderbilt University Medical /// MARK J. HARVEY, EMT-P, is a British citizen who’s worked in EMS in
Center’s LifeFlight in Nashville, Tenn., and is an Emergency Nurse Practitioner Denmark for 28 years. He’s worked as an EMT, paramedic, flight paramedic,
with TeamHealth. He’s also faculty with Vanderbilt University School of Nursing and—for the last three years—as a physician’s assistant for Copenhagen EMS.
and Middle Tennessee School of Anesthesia.
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/// JEFFREY M. GOODLOE, MD, NRP, FACEP, FAEMS, is the

Medical Director for the EMS System for Metropolitan Oklahoma City and Tulsa, /// A.J. HEIGHTMAN, MPA, EMT-P, is the Editor-in-Chief of the Journal
Oklahoma. He’s Professor and EMS Section Chief in the Department of of Emergency Medical Services (JEMS), published by PennWell, and is
Emergency Medicine at the University of Oklahoma School of Community well-known for his work in the area of EMS management and mass casualty
Medicine. He started in EMS in 1988 as an EMT-Basic and has never quit incident management.
learning.
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/// CHRISTOPHER HICKEY, FF, NRP, has been a firefighter/paramedic /// SKIP KIRKWOOD JD, FACPE, has been involved in EMS since 1973, as
for the last 18 years, and currently serves as the EMS Officer for the an EMT, paramedic, supervisor, educator, manager, consultant, state EMS
Manchester (N.H.) Fire Department. director, and chief EMS officer.
/// DOUGLAS HOOTEN, MBA, is Executive Director at MedStar Mobile /// SEAN KIVLEHAN, MD, MPH, is an attending emergency physician at
Healthcare in Fort Worth, Texas. He has over 35 years of experience in EMS. the Brigham and Women’s Hospital in Boston, a level one trauma and burn
center, faculty member at Harvard Medical School, and a consultant for the
World Health Organization’s Emergency, Trauma and Acute Care Program.
/// THOMAS “REID” JACKSON, EMT-P, is an FTO/Paramedic for ®
Escambia County EMS. He’s the co-chair for the department’s organizational
committee that creates and monitors the department’s strategic plan, /// CURTIS L. KNOLES, MD, FAAP, is clinical assistant professor in the
performance measures and organizational learning. Department of Pediatrics at the University of Oklahoma College of Medicine in
Oklahoma City. He serves as assistant medical director for the EMS System for
Metropolitan Oklahoma City and Tulsa. He also leads a statewide initiative
/// MICHAEL JACOBS, EMT-P, is the EMS manager coordinating program helping to improve EMS care for Oklahoma’s pediatric patients.
improvement, education and research in Alameda County, Calif. He’s also an EMS
consultant for Coastside Fire Protection District in Half Moon Bay, a clinical
education consultant for Stanford Children’s Hospital, and serves on the /// KATHERINE KOCH, MED, PHD, NRP, is an Assistant Professor of
National Board of Directors for Take Heart America. Educational Studies at St. Mary’s College of Maryland where she teaches courses
on special education, learning disabilities, emotional and behavioral disorders,
and research design. She’s also a paramedic with St. Mary’s County ALS.
/// WILLIAM JANSEN, NRP, FP-C, TP-C, is a State Trooper and Flight
Paramedic as well as a Tactical Paramedic for the Maryland State Police.
/// ERIC KOVACH, EMT-P, has been working in EMS for 12 years and is the
Supervisor of Moody County Ambulance, a small rural ambulance service in
/// JEFFREY JARVIS, MD, is the EMS Medical Director for Williamson South Dakota.
County EMS and Marble Falls Area EMS. He maintains a clinical practice in the
ED at Baylor Scott & White Hospital in Round Rock, Texas. He began his career
in EMS over 30 years ago and still retains an active paramedic license. /// BRIAN LACROIX is the president/EMS chief for Allina Health EMS, based
in St. Paul, Minn., which serves more than a million people annually with a team
®
of more than 600 caregivers. He’s also the president-elect of the National EMS
Management Association (NEMSMA).
/// KERBY JOHNSON, NRP, is the medical records coordinator for MedStar
Mobile Healthcare in Fort Worth, Texas.
/// LIONEL LAMHAUT, MD-PHD, is Associate Professor of Medicine at
the Paris Descartes University, Paris France. He is also head of the Adult
/// GLENN JOSEPH, MS, RN, NRP, is the Fire Chief for Boynton Beach
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Anesthesia and Intensive Care Units, the Prehospital ECPR program, and the
(Fla.) Fire Rescue. He has more than 30 years of experience in fire/EMS and has
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Research and Development program at the SAMU de Paris (Necker University
previously served as a firefighter, paramedic, hazmat technician, lieutenant,
Hospital).
paramedic supervisor, acting division chief of training and safety, and as deputy AL
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/// MICHAEL KELLER, NRP, is the Southeast Regional Coordinator of The /// PATRIC LAUSCH, MD, EMT-P, is a paramedic and EMS physician who
Difficult Airway Course: EMS. He’s worked in EMS for over 30 years and is a
works internationally on both traditional ground ambulance response and on an
full-time educator with Gaston College Department for EMS Education in North
EMS motorcycle response unit in Hungary (Europe). He’s the president and
Carolina.
founder of the International Fire & EMS Motorcycle Response Unit Association
(IMRUA).
/// CHETAN KHAROD, MD, MPH, is the Program Director of the Military
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EMS & Disaster Medicine Fellowship and a pioneer in raising awareness about
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and developing organizational programs to improve individual resiliency. He has

over 20 years of service in the U.S. Air Force with multiple combat deployments,
leadership and command positions.
/// ROB LAWRENCE is the Chief Operating Officer of the Richmond (Va.)
Ambulance Authority. He was honored with a 2011 EMS10: Innovators in EMS
award and is a regular contributor to EMS publications.
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/// MALCOLM LEIRMOE, BS-EMS, NRP, has over 15 years in /// DOVIE MAISEL, EMT-P, is the Senior Vice-President of International
emergency services, 13 in EMS. He has been with Mecklenburg EMS Agency for Operations for United Hatzalah/Untied Rescue volunteer emergency response
12 years serving as a Paramedic Crew Chief and Field Training Officer. He organizations. He’s an active Combat Medic and a Company Commander in the
currently sits as an Education and Quality Specialist, focusing on medical Israel Defense Forces (Res.) and specializes in a mass disaster, rescue and
training with extensive knowledge in high fidelity simulation. Additionally he has recovery training for both the civilian and military arenas. He also serves on the
spent the last 7 years functioning as a Special Operations Paramedic, supporting JEMS International Editorial Board.
the local SWAT teams, Bomb Squad, and Civil Emergency Unit.
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/// MICHAEL LEVY, MD, FACEP, FACP, is medical director for the
Anchorage Fire Department. He was recently elected to serve on the Board of /// STEVE MARKHAM is Director of Medical Products and Services for
Directors as Physician Member-at-Large of the National Association of EMS Strategic Operations Inc. (STOPS), an internationally-recognized civilian and
Physicians (NAEMSP) and is the Alaska Principal Investigator for the Pacific military training center that uses Hyper-Realism in the replication of battlefield
Northwest Heart Rescue Project. conditions in training environments that tax tactical and medical responders. He
is a retired Special Operations IDC with multiple combat deployments, Master
Training Specialist and Curriculum Developer with expertise in military tactics,
/// RICHARD LEWIS, EMT-P, is the EMS Chief for South Metro Fire Rescue techniques, and procedures, particularly military and tactical medicine that
in Denver, where he has primary oversight of the mobile integrated healthcare
must be performed rapidly under battlefield conditions. Since retiring, the
(MIH) partnership between South Metro and Dispatch Health. He’s a nationally
countries of Brazil and Poland have had him present on maximizing your training
recognized MIH leader and co-developer of the National Fire Academy’s MIH
and money. He has also been very involved in the development and
Administration Course.
implementation of training from POI through surgical intervention for military,
Law Enforcement, EMS and medical schools in multiple areas around the United
/// OFER LICHTMAN, NRP, is a firefighter/paramedic with the Rancho States.
Cucamonga (Calif.) Fire Protection District where he also serves as the Terrorism
Liaison Officer Coordinator. He was instrumental in developing his department’s
Terrorism Awareness Program which included implementation of an Active
/// MICHAEL MARINO, MS, NRP, is currently the Assistant Chief of
Special Operations for the Prince George’s County (Md.) Fire/EMS Department.
Shooter Response Program.
He’s a graduate of Harvard’s National Preparedness Leadership Initiative, the
Executive Fire Officer Program at the National Fire Academy, and is a certified
/// FREDDY K. LIPPERT, MD, is CEO of Emergency Medical Services public manager with almost two decades in prehospital EMS.
Copenhagen, Assistant Professor at the University of Copenhagen in Denmark
and Congress Chair of the European EMS Congress.
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well-known speaker and writer, most notably for his presentations on

organizational culture and his take on emotional intelligence.
/// DAVID LLOYD, MD, MBA, is a Hospitalist Physician for Texas Health
Physicians and the Medical Director for Silverback Care Management, the
agency responsible for clinically managing over 50,000 patients managed by
/// JENNIFER MCCARTHY, MAS, NRP, MICP, CHSE, serves as the
founding member, Associate Professor and Director of the Paramedic Science
North Texas Specialty Physicians.
Program at Bergen Community College in Lyndhurst, N.J. She has a passion
about the use of medical simulation to advance learning and to formalize EMS
/// ROBERT LUCKRITZ, NRP, ESQ. is the Executive Director of EMS for education practice.
Jersey City Medical Center, a hyper-urban 9-1-1 EMS system responding to
nearly 100,000 EMS requests annually. Robert has more than 20 years of EMS
experience across the Mid-Atlantic and New England, where he has overseen all
/// MICHAEL MCDONALD, RN, NRP, is an EMS Training Officer for
Loudoun County Fire and Rescue. He’s been educating students for more than
facets of EMS. He is the current President of the New Jersey Association of
10 years and currently specializes in BLS programs including EMT. He also
Paramedics, a 2016 recipient of the EMS 10 Innovators in EMS Award and
oversees the county’s AHA BLS and ACLS programs.
recipient of the NAEMT Presidential Leadership Award.
/// MIKE MCEVOY, PHD, NRP, RN, CCRN, is the EMS coordinator for
Saratoga County, N.Y., the EMS editor for Fire Engineering and a member of the
JEMS Editoiral Board. He’s also a nurse clinician in the cardiac surgical ICU at
Albany Medical Center.
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/// KEVIN MCFARLANE, MSN, RN, CEN, TCRN, is the Director of /// JOSHUA NACKENSON, MD, is an emergency medicine resident
the New Mexico Veterans Medical Center. Kevin spent most of his career at physician at Parkland Hospital/University of Texas Southwestern in Dallas. Josh
University of New Mexico Hospital, the state’s only Level 1 Trauma Center. He has been involved in EMS for over a decade, with experience in urban, suburban,
has also served as the stroke coordinator and regional trauma coordinator for rural, wilderness and international settings.
the New Mexico Department of Health.
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/// JASON T. MCMULLAN, MD, EMT (RET.), is an EMS physician who /// ROBERT NADOLSKI, BS, NREMT-P (RET.), is a clinical
serves as part of the medical direction for the Cincinnati, Forest Park, Green administrator for Emory Healthcare / Emory School of Medicine in Atlanta, Ga.
Hills, and Blue Ash Fire Departments. He’s also Associate Director (Research) for
the Division of EMS and Assistant Professor of Emergency Medicine at the
University of Cincinnati. /// YIH YNG NG, MBBS, MRCS, MPH, MBA, is the Chief Medical
Officer of the Singapore Civil Defense He’s won numerous national and regional
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awards for EMS innovation and has published over 40 emergency medicine
articles in peer reviewed journals.
/// JAMES MCNEILLY, MPA, NRP, is the ALS Coordinator for the
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Belmont Fire Department, a department in the Boston metropolitan area where
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he oversees all aspects of delivery of paramedic-level care.

/// NEIL NOBLE is a critical care paramedic based in Cairns, Australia. He’s the
/// GREG MERRELL, EMT, is a company officer with the HazMat and Director and Vice-President of Paramedics Australasia, Senior Operations
technical rescue team at the Oklahoma City Fire Department and Task Force Supervisor for Queensland Ambulance Service, and the Lead Paramedic for
Leader for OK-TF 1 Urban Search & Rescue Task Force. He is a Lead Technical Team Australia EMS. He also serves on the JEMS International Editorial Board.
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University - Fire Service Training in all rescue disciplines.

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/// JEREMY MILLER, MED, NRP, is responsible for all certification /// JERRY OVERTON is the President of the International Academies of
functions at the NREMT including recertification, accommodations and legal Emergency Dispatch, in addition to serving as a member of its Board of Trustees
departments. He’s served as an EMT-Basic, EMT-Intermediate and then and the chair of its Board of Accreditation. He has experience managing EMS
EMT-Paramedic. systems and agencies, served on international EMS committees, and is the Past
President of the American Ambulance Association.
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Protection Association, currently assigned as staff liaison to the technical

committees for fire service training, EMS, fire service occupational safety and
health, and the active shooter response standard programs. /// AMAR PATEL, DHSC, MS, NRP, is the Director of the Center for
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Innovative Learning at WakeMed Health & Hospitals. Dr. Patel is responsible for
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integrating technology-based educational programs to include human patient
/// VINCENT N. MOSESSO, JR., MD, FACEP, FAEMS, EMT-P, simulation, healthcare gaming, hybrid education, and online learning
is professor of emergency medicine and associate chief of the EMS division at
the University of Pittsburgh. He’s also medical director of UPMC Prehospital
applications. He has over 20 years of experience in the fire and EMS services, CO N F
disaster medicine, and critical care transport as a firefighter, a paramedic, a
Care and associate medical director for Pittsburgh EMS.
researcher, and as an educator.
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/// J. BRENT MYERS, MD, MPH, FACEP, was the first EMS Fellow at
the UNC School of Medicine in Chapel Hill. He assumed the role of Medical /// P. DANIEL PATTERSON, PHD, MPH, MS, NRP, is assistant
Director of the Wake County EMS System in 2002 and became Director of the professor of emergency medicine and the primary investigator for the EMS
Department of EMS in 2008. He currently serves as president of the National Agency Research Network at the University of Pittsburgh. He studies safety in
Association of EMS Physicians (NAEMSP). emergency care settings with special emphasis on safety culture, fatigue, shift
work, sleep health, teamwork, medical errors and adverse events, and clinician
injury in the prehospital EMS setting.
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/// JOE PENNER is the Executive Director of MEDIC, the paramedic service for /// JAMES POWELL, MS, NRP, is a captain and firefighter/paramedic
the Charlotte, N.C., area. He’s a Fellow and Board Certified in Healthcare with Jackson Hole Fire/EMS in Wyoming.
Management by the American College of Healthcare Executives, Board Member
of the American Ambulance Association, Board Member of the Commission on
Accreditation of Ambulance Services, and the Chair for the Housing Advisory
/// CHRISTOPH REDELSTEINER, DRPHDR, MSW, MS, EMT-P,
is professor at St. Pölten University of Applied Sciences and Scientific Director
Board of Charlotte–Mecklenburg.
of the Master in Emergency Health Services Management Program at Danube
University in Austria. He was the first recipient of the James O. Page/JEMS
/// PAUL E. PEPE, MD, MPH, FACEP, MACP, MCCM, is the Leadership award and is a member of the JEMS International Editorial Board.
Regional Director of Out-of-Hospital Mobile Care Systems and Event/Disaster
EMS
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Southwestern Medical Center in Dallas. He’s also coordinator of the U.S.

Metropolitan Municipalities EMS Medical Directors (“Eagles”) Coalition and EMS
Medical Director for Dallas County.
/// NEAL RICHMOND, MD, FACEP, is board certified in emergency
medicine and medical director for the MedStar Mobile Healthcare System in Fort
Worth, Texas. He is also one of the authors of the monthly Field Physicians
column in JEMS.
/// MICHAEL PETERSON, DO, is Medical Director of the paramedic
training program for Mount-West Community and Technical College and the
®
Medical Director for HealthNet Aeromedical Services.

/// VINCENT D. ROBBINS, FACPE, FACHE, is President-Elect of
®
NEMSMA and President & Chief Executive Officer of MONOC, New Jersey’s
single largest EMS and mobile healthcare shared service hospital cooperative.
/// SCOT PHELPS, JD, MPH, is a Professor of Ambulance Science at the He has also served in the administration at Temple University Hospital in
Emergency Management Academy and a Fellow at the Center for Disaster Philadelphia and with the New Jersey State Department of EMS.
Medicine at New York Medical College.
/// ALFREDO ROJAS, EMT, is an EMT with Detroit EMS. In October 2015 he
/// SKYLER PHILLIPS, EMT-P, is a Captain in the Chattanooga (Tenn.) and his partner were violently attacked by a patient. The incident lead to the
Fire Department. He and his wife, Lisa, developed the curriculum for the Special Detroit Fire Department implementing a multipronged training strategy to
Needs Awareness Program being taught to first responders all over Tennessee. better prepare staff for real-world violence.
/// MARK PIEHL, MD, MPH, is a pediatric intensivist at WakeMed in /// MONIQUE ROSE, CCEMT-P, is EMS Lieutenant at UCHealth in Fort
Raleigh, N.C., actively involved in leadership of WakeMed’s Pediatric Critical Collins, Colo. She’s the Chairperson of the National EMS Management
Care Transport Team. He also serves as Chief Medical Officer of 410 Medical, a Association (NEMSMA) Practitioner Mental Health and Wellbeing Committee, a
company he founded to improve resuscitation in shock and sepsis. group actively involved in developing an action plan to bolster provider
resiliency, reduce provider stress, and reduce provider suicide, and is
Vice-President and Co-founder of Reviving Responders.
/// JENNIFER PIDGEN is COO of Sundance Media Group (SMG), responsible
for developing UAS/UAV training programs and strategic industry partnerships.
Jennifer manages all sUAS/UAV logistics and overall SMG operations, including /// WYATT SABO, is the Medical Training Program Manager for Strategic
applying for SMG’s ISO certification. Operations based out of San Diego, California. He is an experienced medical
provider serving 10 years in the US Navy with 2 combat deployments to
Afghanistan and 3 years on an amphibious ship. During his venture in the
/// JONATHAN POLITIS, MPA, NRP, has been practicing as an EMT and military he was qualified in diverse courses of instruction including ATLS, TCCC,
paramedic since 1971 and is an accomplished EMS educator, leader, author and BLS, weapons handling, and patient triage. As the NAEMT Course Coordinator,
field provider. He has been involved in national level EMS for over 30 years. he plans and executes medical and tactical training for government and civilian
agencies while using and operating hyper-realistic medical simulation
/// THOMAS PORCELLI, NC EMT-P, has over 22 years of experience in technology.
EMS. He has 6 years as a Field Training Officer and 6 Years as an Education and
Quality Specialist. He has had oversight of the state of the art soundstage at
Mecklenburg EMS Agency for the past 5 years. He has extensive training and
knowledge of high fidelity manikins and realistic scenario building.
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18EMSTPrelim_58 58 8/28/17 10:57 AM

/// KEN SCHEPPKE, MD, is the EMS Medical Director for six fire-rescue /// WILL SMITH, MD, NRP, FAWM, is the Medical Director for Grand
agencies in Palm Beach County, Fla., including Palm Beach County, Palm Beach Teton National Park, Teton County Search and Rescue, Jackson Hole Fire/EMS,
Gardens, Boynton Beach, West Palm Beach, Town of Palm Beach, and Southeast Arizona National Park Group, and Bridger Teton National Forest. He’s
Greenacres Fire Rescue agencies. He currently serves as Chairman of the Palm also Clinical Faculty in Emergency Medicine at the University of Washington
Beach County EMS Medical Director’s Association and sits on both the county’s School of Medicine Emergency Medicine, an ED physician in Jackson, Wy., a
EMS Advisory Council and its Trauma Quality Improvement Committee. Lieutenant Colonel in the U.S. Army Reserve Medical Corps and recipient of the
John P. Pryor, MD, Street Medicine Society Award.
/// RICHARD SERINO is a distinguished visiting fellow at Harvard
®
University’s National Preparedness Leadership Initiative. He previously served

as the deputy administrator of FEMA and as the chief of Boston EMS. He’s a
/// ANDREW E. SPAIN, MA, NCEE, EMT-P, is the director of
accreditation and certification for the Society for Simulation in Healthcare. He’s
member of the Joint Committee to Create a National Policy to Enhance
been a paramedic for more than 20 years and is a nationally certified EMS
Survivability from Mass Casualty Shooting Events and the Department of
educator.
Homeland Security’s Virtual Social Media Working Group.
/// MATTHEW SHEPHERD, BNURS GRDIP EMERG NURS, /// DOUGLAS SPOTTED EAGLE is an instructor and industry consultant
in videography, software manufacturing and broadcasting for Sundance Media
BPARA GRDIP EMRG HLTH (MICA) GRCRT AEROMED, is a Group. He’s an accomplished aerial camera operator and has been instructing in
MICA Flight Paramedic with Air Ambulance Victoria in Australia. He’s also a
the area of unmanned aerial systems since 2012. He’s won numerous awards for
teaching associate at Monash University.
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awards.
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/// BRIAN SHIMBERG, BS-EMC, NRP, has over 20 years of experience /// JOSH STUART, EMT-P, is a paramedic with Medical Rescue Team South
Authority in Pennsylvania. He’s the chairperson of the Pennsylvania EMSC
in prehospital medicine. He was instrumental in opening the Emergency Medical
Committee, and has conducted research and developed training on risky teen
Education and Simulation Center at Mecklenburg EMS Agency. With over 11
behaviors.
years of experience with high fidelity simulation, he has extensive knowledge of
scenario development and execution as well as debriefing. Additionally, he has
spent the last 10 years serving as a Special Operations Paramedic supporting /// JONATHAN STUDNEK, PHD, NRP, is a Deputy Director for MEDIC,
the missions of local SWAT teams, Bomb Squad and Civil Emergency Unit. the Mecklenburg EMS Agency where he’s responsible for planning, developing,
implementing, and overseeing a comprehensive strategy for performance
improvement, clinical education, and risk and safety. He also serves as the
/// RACHEL SHORT, NRP, has more than 20 years of experience in EMS. Director of Prehospital Research at Carolinas Medical Center and past Chair of
She’s a training officer at Loudon County (Va.) Fire and Rescue where she
the Research Committee for the National Association of EMS Physicians
currently manages the ALS programs, including EMT to Intermediate classes.
(NAEMSP).
CE
/// TODD SIMS assisted with the creation of MEDIC’s, the Mecklenburg EMS
EREN
Agency, 9-1-1 Communications Center and served as its Operations Manager. He
/// CHRISTIAN SVANE, MD, is a physician who provides advanced
prehospital treatment on one of five physician-staffed critical care units
developed and implemented dynamic system status management technology CO N F
operated by EMS Copenhagen in Denmark. He’s also a consultant in
along with workload monitoring supporting data analytics to provide real-time
anesthesiology and intensive care medicine at Bispebjerg University Hospital in
management of operational aspects of EMS services through DataTech911.
Copenhagen.
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/// COREY SLOVIS, MD, FACP, FACEP, FAAEM, is medical director

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of the Nashville Fire Department (NFD). He is also a professor of emergency

medicine and chairman of the department of emergency medicine at Vanderbilt
University Medical Center in Nashville.
/// DOUGLAS SWANSON, FACEP, FAEMS, has dual board
certification in emergency medicine and EMS. He’s the medical director for
MEDIC, the Mecklenburg EMS Agency, which provides paramedic service to the
/// DAN SMITH RN, BSN, CFRN, EMT-P is a flight nurse and Charlotte, N.C., area. He’s also professor of emergency medicine at Carolinas
paramedic in New Jersey. He has held clinical leadership roles for both ground Medical Center and a physician consultant with NASCAR’s medical liaison
and air medical programs. department.
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®
18EMSTPrelim_59 59 8/28/17 10:57 AM

/// JON SWANSON, NREMT, is executive director of the Arkansas /// KEITH WESLEY, MD, FACEP, is a board certified emergency medicine
regional Metropolitan Emergency Medical Service (MEMS) system. He recently physician and the EMS Medical Director for HealthEast Medical Transportation
led an effort for MEMS to provide training on tactical emergency casualty care in St. Paul, Minn. He has served as the State EMS Medical Director for both
to more than 3,000 state and local law enforcement officers and coordinated Minnesota and Wisconsin and as Chair of the National Council of State EMS
grant resources to provide each with individual first aid kits. Medical Directors.
///
/// MIKE TAIGMAN, MA, uses more than four decades of experience to help /// KATHERINE WEST, RN, BSN, MSED, is an infection control
EMS leaders and field personnel improve the care and service they provide to consultant who has worked with fire/EMS groups bringing infection control
patients and their communities. He’s the facilitator for the EMS Agenda 2050 practices and training since 1978. She’s also a member of the JEMS Editorial Board.
project, serves as an improvement guide for FirstWatch, and is an Associate
Professor in the Emergency Health Services Management graduate program at
the University of Maryland Baltimore County.
/// STEVE WHITE is the Chief of EMS for Escambia County Florida. He has
worked in third service and fire-based EMS departments at the field and
command levels.
/// MIKE TOUCHSTONE is a command officer with the Philadelphia Fire
Department
/// STEVE WIRTH, JD is a founding member of Page, Wolfberg & Wirth and
counsels ambulance services and EMS agencies across the country in a wide
/// BENJAMIN VERNON, BA, EMT-P, is a firefighter/paramedic for San range of medical transportation, reimbursement, compliance, labor and
Diego Fire Rescue. He holds five specialist positions on the FEMA California Task employment, and corporate law issues.
Force 8 Urban Search and Rescue Team: Rescue Specialist, Hazardous Materials
Specialist, Technical Search Specialist, Communications Specialist, and Medical
Specialist.
/// DOUG WOLFBERG, JD is an EMS attorney and founding partner of
Page, Wolfberg & Wirth, which represents EMS agencies throughout the United
States. He is also a co-founder of the National Academy of Ambulance
/// OREN WACHT, PHD, EMT-P, is Lecturer in the Department of Compliance (NAAC).
Emergency Medicine in Ben Gurion University. He is also a paramedic in the
Israeli EMS system and army reserve, an advisor to the Israeli ministry of health
and a researcher in emergency medicine, EMS, and resuscitation.
/// DONNIE WOODYARD JR., MAML, NRP is the Chief Information
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/// ALEXANDER J. WALLBRETT, EMT-P, is a firefighter/paramedic /// MICHAEL WRIGHT is the Fire Capt./PM and MIH Coordinator for the City
of Milwaukee. As the coordinator and developer of the Milwaukee Fire
for the San Diego Fire-Rescue Department (SDFR) where he’s also a member of
Department MIH program Michael Wright has grown the program from theory to
the Technical Rescue Team.
fruition with a fully trained and functional Community Paramedic program.
/// JONATHAN WASHKO, MBA, NREMT-P, AEMD, is the Assistant /// DEMETRIS YANNOPOULOS, MD, is the research director for
Vice President for the Center for Emergency Medical Services with Northwell
interventional cardiology and a professor of medicine at the University of
Health System in New York City and Long Island, N.Y.. He’s a member of the
Minnesota. He’s also the director of the Minnesota Resuscitation Consortium
JEMS Editorial Board and is an international organizational improvement
and serves as a member of the American Heart Association’s CPR guidelines-
consultant.
writing committee.
/// BRIAN WEATHERFORD is a Major, Training Officer, Special Operations /// SCOTT YOUNGQUIST, MD, MS, FACEP, FAHA, FAEMS, is
Medical Director for the Salt Lake City Fire Dept., Faculty of the Utah
Coordinator and Paramedic with Norman, OK Fire Department. He is a Rescue
Resuscitation Academy and a member of the Major Metropolitan Medical
Specialist and Medical Specialist for OK-TF 1 Urban Search & Rescue Task Force. He
Directors Coalition, known as the Eagles.
has presented nationally on various swift water and technical rescue subjects.
/// PAUL A. WERFEL, MS, NREMT-P, is a prolific international speaker, /// MATT ZAVADSKY, MS-HSA, EMT, is the Chief Strategic Integration
Officer at MedStar Mobile HealthcareHe’s guided the implementation of several
and author of over 50 articles, magazine columns, and book sections, Paul
mobile healthcare programs at MedStar and other agencies and is co-author of
brings three decades of EMS experience to his presentations.
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¨
18EMSTPrelim_60 60 8/28/17 10:57 AM

EXHIBITION
Explore the industry’s most innovative products and services available displayed by over 250
exhibitors. PLUS, EMS Today also offers attendees the chance to test drive new equipment and
products right on the show floor in our Hands On Experience.
/// TYPES OF PRODUCTS & SERVICES ON DISPLAY Visit EMSToday.com to

• Advanced Life Saving Equipment • Disaster Management • Mobile Devices search for a company,
• Airway Equipment • Education and Training • Mobile Electronics product or service
• Ambulances/Vehicles • Electrical Load Managers • Other you’re interested
in visiting and plan
• Apparel & Accessories • Emergency Preparedness Management • Oxygen Equipment your trip through the
• Associations Software • Patient Assessment exhibit hall.
• Auto and Air Ejects • First Responder Equipment • Personal Protection
• Bags, Cases, Kits • Hazardous Material Equipment • Pharmaceuticals
• Bar Coding • Health & Fitness • Publications
• Basic Life Saving Equipment • Immobilization Devices • Recruitment
• Battery Chargers • Incident Management • Rescue Equipment
• Billing Systems & Software • Infection Control/Decontamination • Resuscitation Equipment
• Breathing Equipment Technology • Simulators/Manikins
• Communications • Insurance • Stretchers
• Computers/Computer Systems/Software • Lighting • Vehicle Monitoring/Tracking/
• Consulting/Management/Legal Services • Medical Equipment (incl. burn treatment, Maintenance/Safety
IV, airway, bandages) • Ventilators
• Defibrillators/Cardiac Monitors/AEDs
Are you ready to test drive new equipment and products designed to help you improve
clinical techniques or learn new skills?
The Hands On Experience was so well received in 2017 that we are bringing it back!
Located in the exhibit hall and open to all attendees, this experience is the go-to place
for cutting-edge simulation techniques that improve on-the-job performance and clinical
decision-making.
FOUNDING SPONSOR: SUPPORTING SPONSORS:
EXHIBIT FLOOR GIVEAWAY SPONSORS:
///// EXHIBIT FLOOR GIVEAWAY

P
SPOHNIBSITING &
ORSHI
Friday, February 23 | 12:30 PM

MUST BE PRESENT TO WIN
EX
ONE LUCKY EMS TODAY CONFERENCE

DELEGATE WILL WALK AWAY WITH,
$10,000 CASH!
18EMSTPrelim_61 61 8/28/17 10:57 AM

EXHIBIT FLOOR PLAN (As of August 15, 2017)
/////
VISIT EMSTODAY.COM TO VIEW THE LIVE
FLOOR PLAN & MAP OUT YOUR TRIP!
EAST STONEWALL STREET
GATE 2
MOVABLE DIRECT
WALL
DIRECT DRIVE-IN GEN. ELEC. STORAGE
STORAGE
DRIVE-IN
FRT. ELEV
CONCESSION CONCESSION
HALL B HALL A
Authorized
A
745 844 845 944 945 1044 1045 1144 1145 1244 1245 1344 1345 1444 1445 1545 1546 1645 1646 1745 B
Buyer
Lounge #1746
6
743 842 843 942 943 1042 1043 1142 1143 1242 1243 1342 1343 1442 1443 1543 1544 1643 1644 1743
First GERB VFIS Certa
Watch ER Dose
741 840 841 940 941 1040 1041 1140 1141 1240 1241 1340 1341 1440 1441 1541 1542 1641 1642 1741
20'
ENGINEERI
THE EMS Com Nation Charl Karl
Ambu
WHELEN
Health Care
HEALTH
Tactical
ALLINA
Medical
Seating
VALOR
VITAL Mana missi al eston Storz
County
Wake
SAM
First
336 337 436 437 536 537 Logistics 737 836 837 1036 1037 1136 1137 1236 1436 1537 1538 1637 1638 1740 1837
S&S Medicall
20'
20'
20'
20'
20'
0'
20'
20'
20'
0'
20'
PWW Media
HAMIL Ameri Emer H&H DIGIT Onspo Arkra HORI
(Praetorian)
EMS1.com
Inc./NAAC
Products
TON can gent Medic ECH t y USA ZON MERET
30'
334 335 434 435 534 535 634 735 834 835 934 935 1034 1035 1134 1135 1234 1235 1334 1335 1435 1536 1635 1636 1735 1738 1835 1836
20'
20'
TEMP The RES- Pulsar DOD, Transl CREC
VYGON
TIME Code Q- a Dome ite HE
USA
333 432 433 532 633 733 832 933 1032 1033 1132 1333 1432 1433 1533 1736 1934 1936 2133
20'
20''
20'
Abbot
Technologi
20'
0'
Water-Jel
t NINTH BRAIN
331 430 431 530 Medic-CE 1430 1431 1531 1632 1734 1833 1932 2031 2032 2131
No rigging
1229
20' 20' 20' 20' 20' 20'
20'
Pulm QuikC EMSA Cindy NCE Quick LIQUI RESC

CRESTLINE EXCELLANC Nasco PL CUSTOM
328 429 528 529 628
odyne
729
lot
828 E INC Healthcare
R
1029
Elbert
1128 ESO 1329 1428
Med
1429
D
1529 EMERGENC
Y VEHICLES
UE
1930 2029 2030 2129 2130
20' Platin Handt 20' 20' 20'
HARTWELL
GD
Pearson/Br
MICROFLE
24-7 EMS,
MEDICAL
Moore EMERGENC
X/Ansell
CAT
Aladtec,
Medical
um evy
PerSys
ASHI -
30'
30'
30'
30'
30'
30'
Y
Inc.
ady
326 427 527 727 826 1027 Medical 1426 Medical 1928 2027 2028 2127 2128
Corp REPORTING
20'
20'
20'
20'
20'
20'
20'
20'
20'
20'
One Esper Med- Binder IamR
Beat o Trans Lift espon
324 325 425 524 525 624 625 725 824 924 925 1025 1124 1125 1225 1325 1424 1425 1525 1526 1626 1726 1826 1926 2025 2026 2125 2126
20' 5.11 Fit Kuss VAIRK Rescu 20' 50' 20' 40' 20' DURH 410 30' ClorDi
emsCharts,
EMERGEN
Operative
Scientific
Gaumard
MEDIX OSAGE
Southeastern KEMP Braun Industries Frazer Ltd
FoxFury
Lighting
Resp maul KO e AM Medic Sys

320 421 520 521
21 621 820 821 SPECIALTY AMBULANC 1622 1721 1822
822 2021 2022 2121 2122
Inc
CY
IQ
VEHICLES Emergency USA E

20'
20'
20'
20'
20'
20'
20'
20'
Comp WELD eCore TCF
QUANTUM
Healthcare
Equipment
FEDERAL
SIGNAL
X ON A Softw Equip
EVS
Taylor
319 1720
EMS
30'
30'
30'
318 415 514 618 619 718 719 818 918 1919 1920 2019 2020 2119 2120
20'
20'
40'
20'
20'
20'
PH&S MorTa HAIX COLU Halyar Intern
PROD n, NORT MBIA d ationa
1117 1217 1522
50'
517 616 717 816 817 916 1617 1618 1818 1917 1918 2017 2018 2117 2118
50' 20' Digitc WEIN 30' Rosco
Jones & Bartlett
Mecklenburg EMS 1315
are MANN
1620 1719 1716
Vision
1916 2015 2016 2115
Agency - Medic 20' 20'
ImageTrend Mercury
919 1015
20' 20' 20' 20' 30'
Concordanc
40'
40'
20'
SSCO Ameri Nonin
Medtronic
DISTANCE North STRYKER MASIMO
R
711 Philips can Medic
Intubrite
511 610 811 EMS 1712 1912 2011 2012 2111 2112
e
40' 40'
20'
20'
20'
20'
Ameri
Demers PHYSIO-CONTROL can
306 611 1510 1610
30'
1710 1809 1909 1910 2009 2010 2109 2110
30' 20' 40' Ambulances
40'
Teleflex ZOLL Medical USA Inc.

30'
30'
1808 1907 1908 2007 2008 2107 2108

20' 30' 40'
Corporation 20' 30' 20' TECH
Ferno-Washington LAERDAL iSimulate
Gold ATLANTIC BOUND NIMO
Inc 1104 1205 1405
30'
30'
MEDICAL 1806 1905 1906 2005 2006 2105 2106

Cross EMERGENCY CORP TREE
40'
CORPORAT
Pocke
Innovations
EMS MEDICAL ZIAMATIC
SOLUTIONS t
Care 2
800 904
30'
30'
30'
30'
30'
30'
1903 2003 2004 2103 2104

20'
20'
SKED
CO
300 301 400 700 1508 1602 1702 1802 1901 1902 2001 2002 2101 2102
ENTRANCE
DIRECT
DRIVE-IN
DOOR
OVERHEAD
STORAGE
GATE 6 SHOW
WALL
SHOW GATE 5
MOVABLE
OFFICE ESCALATOR OFFICE
LOBBY A/B
LOADING
DOCK
///// EXHIBIT HALL HOURS

Wednesday, February 21 // 3:00PM-6:00PM
Thursday, February 22 // 10:00AM-5:00PM
Friday, February 23 // 10:00AM-1:00PM
94% of attendees said the exhibition

was helpful for establishing
contacts in the industry
18EMSTPrelim_62 62 8/28/17 10:58 AM

EXHIBITOR LIST (As of August 15, 2017)
///// EXHIBITING AS BOOTH# EXHIBITING AS BOOTH# EXHIBITING AS BOOTH#

5.11. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 520 FDIC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1940 NONIN MEDICAL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1912
24-7 EMS, ASHI - HEALTH & SAFETY INSTITUTE. .1525 FEDERAL SIGNAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 817 NORTH AMERICAN RESCUE, LLC. . . . . . . . . . . . . . . . . 811
410 MEDICAL INNOVATION . . . . . . . . . . . . . . . . . . . . . 1721 FERNO-WASHINGTON INC. . . . . . . . . . . . . . . . . . . . . .301 ONE BEAT CPR + AED . . . . . . . . . . . . . . . . . . . . . . . . . 525
ABBOTT POINT OF CARE . . . . . . . . . . . . . . . . . . . . . . . 1431 FIRE APPARATUS & EMERGENCY EQUIPMENT . . .1940 ONSPOT AUTOMATIC TIRE CHAINS. . . . . . . . . . . . . .1536
ALADTEC, INC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .524 FIRE ENGINEERING . . . . . . . . . . . . . . . . . . . . . . . . . . .1940 OPERATIVE IQ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 718
ALLINA HEALTH EMS . . . . . . . . . . . . . . . . . . . . . . . . . . .934 FIRST TACTICAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .634 OSAGE AMBULANCE . . . . . . . . . . . . . . . . . . . . . . . . . .1522
AMBU . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1335 FIRSTWATCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1140 PEARSON/BRADY PUBLISHING. . . . . . . . . . . . . . . . . .624
AMERICAN AMBULANCE ASSOCIATION. . . . . . . . . 1035 FIT RESPONDER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .521 PENNWELL CORPORATION. . . . . . . . . . . . . . . . . . . . .1940
AMERICAN HEART ASSN - MISSION:LIFELINE. . . . 1712 FOXFURY LIGHTING SOLUTIONS . . . . . . . . . . . . . . . .618 PERSYS MEDICAL. . . . . . . . . . . . . . . . . . . . . . . . . . . . .1325
AMERICAN HEART ASSOCIATION - EMERGENCY FRAZER LTD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1720 PH&S PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 616
CARDIOVASCULAR CARE. . . . . . . . . . . . . . . . . . . . . . . 1710 GAUMARD SCIENTIFIC. . . . . . . . . . . . . . . . . . . . . . . . . .918 PHILIPS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1610
ARKRAY USA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1635 GD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1426 PHYSIO-CONTROL . . . . . . . . . . . . . . . . . . . . . . . . . . . 1405
ATLANTIC EMERGENCY SOLUTIONS . . . . . . . . . . . . 700 GERBER OUTERWEAR. . . . . . . . . . . . . . . . . . . . . . . . . 1241 PL CUSTOM EMERGENCY VEHICLES . . . . . . . . . . . .1526
BINDER LIFT LLC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1025 GOLD CROSS EMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300 PLATINUM EDUCATIONAL GROUP. . . . . . . . . . . . . . . .527
BOUND TREE MEDICAL. . . . . . . . . . . . . . . . . . . . . . . .1602 H&H MEDICAL CORPORATION . . . . . . . . . . . . . . . . . . 1135 POCKET NURSE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1903
BRAUN INDUSTRIES . . . . . . . . . . . . . . . . . . . . . . . . . . 1315 HAIX NORTH AMERICA INC. . . . . . . . . . . . . . . . . . . . . .816 PULMODYNE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .729
CARE 2 INNOVATIONS, INC . . . . . . . . . . . . . . . . . . . . .1902 HALYARD HEALTH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1917 PULSARA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1032
CAT MEDICAL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1726 HAMILTON MEDICAL. . . . . . . . . . . . . . . . . . . . . . . . . . . 835 PWW MEDIA INC./NAAC . . . . . . . . . . . . . . . . . . . . . . .1432
CERTA DOSE INC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1341 HANDTEVY PEDIATRIC EMERGENCY QUANTUM EMS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1617
CHARLESTON COUNTY EMS . . . . . . . . . . . . . . . . . . .1436 STANDARDS, INC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 727 QUICK MED CLAIMS. . . . . . . . . . . . . . . . . . . . . . . . . . .1429
CINDY ELBERT INSURANCE SERVICES, INC. . . . . . 1128 HARTWELL MEDICAL LLC . . . . . . . . . . . . . . . . . . . . . . 1124 QUIKCLOT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 828
CLORDISYS SOLUTIONS, INC. . . . . . . . . . . . . . . . . . .1822 HEALTH CARE LOGISTICS . . . . . . . . . . . . . . . . . . . . . . .633 RESCUE CHIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1930
CODE GREEN CAMPAIGN, THE . . . . . . . . . . . . . . . . . . .832 HORIZON MEDICAL PRODUCTS. . . . . . . . . . . . . . . . .1636 RESCUE ESSENTIALS . . . . . . . . . . . . . . . . . . . . . . . . . .821
COLUMBIA SOUTHERN UNIVERSITY . . . . . . . . . . . . . 916 IAMRESPONDING.COM . . . . . . . . . . . . . . . . . . . . . . . .1424 RES-Q-JACK INC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .933
COMMISSION ON ACCREDITATION FOR PRE-HOSPITAL IMAGETREND. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 711 ROSCO VISION SYSTEMS . . . . . . . . . . . . . . . . . . . . . . 1916
CONTINUING EDUCATION (CAPCE) . . . . . . . . . . . . . . 1137 INTERNATIONAL POLICE MOUNTAINBIKE ASSN . . 1918 S&S MEDICAL PRODUCTS . . . . . . . . . . . . . . . . . . . . .1936
COMPX SECURITY PRODUCTS . . . . . . . . . . . . . . . . . .415 INTUBRITE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1808 SAM MEDICAL PRODUCTS . . . . . . . . . . . . . . . . . . . . .1334
CONCORDANCE HEALTHCARE SOLUTIONS/MMS-A ISIMULATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1702 SKEDCO INC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1901
MEDICAL SUPPLY COMPANY . . . . . . . . . . . . . . . . . . 1809 JEMS (JOURNAL OF EMERGENCY MEDICAL SOUTHEASTERN EMERGENCY EQUIPMENT . . . . . 1117
CRECHE INNOVATIONS . . . . . . . . . . . . . . . . . . . . . . . .1333 SERVICES) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1940 SSCOR INCORPORATED. . . . . . . . . . . . . . . . . . . . . . . . .610
CRESTLINE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .625 JONES & BARTLETT LEARNING PUBLIC SAFETY STRYKER EMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1205
DEMERS AMBULANCES USA INC.. . . . . . . . . . . . . . .1104 GROUP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1716 TAYLOR HEALTHCARE PRODUCTS. . . . . . . . . . . . . . . 1618
DIGITCARE CORPORATION . . . . . . . . . . . . . . . . . . . . .1620 KARL STORZ ENDOSCOPY AMERICA . . . . . . . . . . . .1837 TCF EQUIPMENT FINANCE . . . . . . . . . . . . . . . . . . . . . .818
DIGITECH COMPUTER . . . . . . . . . . . . . . . . . . . . . . . . .1234 KEMP USA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1217 TECHNIMOUNT SYSTEM INC. . . . . . . . . . . . . . . . . . 1806
DISTANCE CME . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 511 KUSSMAUL ELECTRONICS. . . . . . . . . . . . . . . . . . . . . . 621 TELEFLEX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 800
DOD, DOMESTIC PREPAREDNESS SUPPORT INITIATIVE LAERDAL MEDICAL CORP . . . . . . . . . . . . . . . . . . . . . 1508 TEMPTIME CORPORATION . . . . . . . . . . . . . . . . . . . . . .733
HOMELAND DEFENSE AND AMERICAS’ SECURITY LIQUID SPRING LLC . . . . . . . . . . . . . . . . . . . . . . . . . . .1529 TRANSLITE LLC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1132
AFFAIRS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1033 MARKETING SOLUTIONS . . . . . . . . . . . . . . . . . . . . . .1940 VAIRKKO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 820
DURHAM COUNTY EMS. . . . . . . . . . . . . . . . . . . . . . . .1622 MASIMO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1510 VALOR SEATING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1435
ECORE SOFTWARE INC . . . . . . . . . . . . . . . . . . . . . . . . . 619 MECKLENBURG EMS AGENCY - MEDIC . . . . . . . . . 306 VFIS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1340
P
EMERGENCY MEDICAL PRODUCTS, INC . . . . . . . . .1920 MEDIX SPECIALTY VEHICLES. . . . . . . . . . . . . . . . . . . . 919 VITALSTREAM GROUP, THE . . . . . . . . . . . . . . . . . . . . .836
SPOHNIBSITING &
ORSHI
EMERGENCY REPORTING. . . . . . . . . . . . . . . . . . . . . .1626 MED-TRANS CORP. . . . . . . . . . . . . . . . . . . . . . . . . . . . .824 VYGON USA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1833

EMERGENT RESPIRATORY . . . . . . . . . . . . . . . . . . . . . 1134 MEDTRONIC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1909 WAKE COUNTY EMS . . . . . . . . . . . . . . . . . . . . . . . . . .1235
EMS MANAGEMENT & CONSULTANTS, INC. . . . . . . 1136 MERCURY MEDICAL. . . . . . . . . . . . . . . . . . . . . . . . . . .1015 WATER-JEL TECHNOLOGIES . . . . . . . . . . . . . . . . . . .1329
EX
EMS TODAY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1940 MERET PRODUCTS. . . . . . . . . . . . . . . . . . . . . . . . . . . .1836 WEINMANN EMERGENCY MEDICAL TECHNOLOGY
EMS1.COM (PRAETORIAN). . . . . . . . . . . . . . . . . . . . . .1533 MICROFLEX/ANSELL. . . . . . . . . . . . . . . . . . . . . . . . . .1425 GMBH + CO. KG. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1719
EMSAR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1029 MOORE MEDICAL CORP. . . . . . . . . . . . . . . . . . . . . . . .1225 WELDON A DIVISION OF AKRON BRASS . . . . . . . . . .514
EMSCHARTS, INC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 719 MORTAN, INC., THE MORGAN LENS . . . . . . . . . . . . . . 717 WHELEN ENGINEERING CO., INC. . . . . . . . . . . . . . . . 935
ESO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1125 NASCO HEALTHCARE . . . . . . . . . . . . . . . . . . . . . . . . . . .925 ZIAMATIC CORPORATION. . . . . . . . . . . . . . . . . . . . . . 1802
ESPERO PHARMACEUTICALS, INC.. . . . . . . . . . . . . . .725 NATIONAL REGISTRY OF EMTS . . . . . . . . . . . . . . . . .1236 ZOLL MEDICAL CORPORATION. . . . . . . . . . . . . . . . . . 904
EVS LTD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 517 NCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1428
EXCELLANCE INC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .924 NINTH BRAIN. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1632
18EMSTPrelim_63 63 8/28/17 10:58 AM

EXHIBIT & SPONSORSHIP
OPPORTUNITIES
REACH KEY DECISION-MAKERS
80% of attendees make the final decision, recommend or specify the purchase of products or services.
MAKE NEW CONTACTS
90% of exhibitors did or planned to establish new business contacts at the event.
GENERATE LEADS
66% of exhibitors said they generated or expect to generate up to 10 leads at the event.
YOUR COMPETITORS ARE EXHIBITING
92% of exhibitors would recommend exhibiting at this event to other companies.
COST TO EXHIBIT
Standard Raw Space — $24.50 per sq. ft. | Vehicle Space — $12.00 per sq. ft. 400 sq. ft. minimum *
Exhibit space is raw exhibit space. Exhibit space rate includes one (1) Gold Full Conference registration and
two (2) booth staff registrations per 100 sq. ft.
*Add $2.00 per square foot for corners or islands.
//////////// CONTACT YOUR EXHIBIT & SPONSORSHIP SALES CONSULTANT TODAY! //////////////////////
Rod Washington • Northeastern U.S. • [email protected] • +1 (918)-831-9481
Jared Auld • Southeastern U.S. & International • [email protected] • +1 (918)-831-9440
Mike Shear • Western U.S. • [email protected] • +1 (858) 638-2623
Melissa Roberts • Midwestern U.S. • [email protected] • +1 (918) 831-9727
STAND OUT WITH SPONSORSHIPS THAT

MAXIMIZE YOUR INVESTMENT
18EMSTPrelim_64 64 8/28/17 10:58 AM

SURVEY RESULT & DEMOGRAPHICS
48 COUNTRIES
REPRESENTED IN 2017
10
United States Israel
Canada Germany
TOP COUNTRIES Iceland Nigeria
REPRESENTED: Australia
Turkey
Norway
United Kingdom
500+ 300
Authorized Buyers Looking
for EMS Products/Services!
Within the next 24 months, I will recommend, specify, or purchase products/services in the following categories:
s
201 pment
ystem
278
ent
re
268
oftwa
quipm
200
228
226
ning
12 puter S
Equi
cles
ikins
//////
177
S
t
d Trai
ipmen
t
ipmen
der E
/Vehi
55 Systems &
ipmen
aving
149
151
, Kits
/Man
139
Com
4
ion an
100
al Equ
s
Cases
e Equ
Life S
uters/
Respo
y Equ
lance
ators
t
Billing
Educa
Rescu
Medic
Other
Ambu
Simul
Airwa
Bags,
Basic
Comp
First
66
0
“THE COOL PART IS THE INTERNATIONAL EXPOSURE TO EMS LEADERS FROM THROUGHOUT THE WORLD, ALL COMING
TOGETHER TO SHARE THEIR EXPERIENCES AND TO LEARN FROM EACH OTHER IN A COLLABORATIVE ENVIRONMENT.
AFTER ATTENDING EMS TODAY, THE CREATIVE JUICES GET FLOWING AGAIN. YOU SIMPLY CAN’T HELP BUT LEAVE
“ENERGIZED” AND MOTIVATED TO DO A BETTER JOB FOR THE COMMUNITIES WE SERVE.”
-STEVE WIRTH, JD | PAGE, WOLFBERG & WIRTH, LLC
//// ATTENDEES OCCUPATION/POSITION:

er
r Offic
30%
ger
29%
Mana
r
Traine
/Othe
14% nder)
-D)
afety
or
ator/
ander
20%
pervis
Respo
I, EMT
10% gr
S
P, M
10%
oordin
ublic
Comm
Nurse
or/Su
EMT-
9%
, First
N
2% al Director
8%
EO, V
TRATIO
6%
ncy/P
10%
ctor/C
in/Lt/
REGAIVSEL &
edic (
istrat
1% Chief
Basic
tered
Dir, C
Chief
3% f
cian
ie
nt
ge
3%
h
3%
Param
Admin
Medic
Stude
Instru
Capta
Fire C
Other
EMT (
Regis
Physi
Emer
Pres,
EMS
TR
1%
1%
18EMSTPrelim_65 65 8/28/17 10:58 AM

REGISTER TODAY!
@ EMSTODAY.COM/REGISTER
EXCLUSIVE DISCOUNT!
The early, early bird really does get the worm!
REGISTER FOR A GOLD PASSPORT WITH THE SOURCE CODE
LISTED ON THE MAILING LABEL BY OCT. 31 TO SAVE AN
ADDITIONAL $75 OFF THE EARLY BIRD RATE–
THAT’S A $175 DISCOUNT!
BEST VALUE
WHICH REGISTRATION TYPE Gold Passport Silver Passport Exhibition Vistor
IS RIGHT FOR YOU? (3-Day) (2-Day) Only
EXCLUSIVE DISCOUNT - registration on or before 10/31/17 $375
Early Bird Registration Pricing - registration on or before 1/19/18 $450 $325 $25
Registration price after 1/19/18 $550 $425 $45
Keynote Session (if applicable)
Exhibit Hall Entrance
Conference Sessions
Floor Giveaway Entry
Networking Reception (if applicable)
Networking Party (Off-site) (if applicable)
JEMS Games Final Competition
Hands-On Experience
Enhance your learning by adding a pre-conference workshop and/or breakfast

roundtable to your registration! Hurry, space is limited.
18EMSTPrelim_66 66 8/28/17 10:58 AM

TRAVEL OFFICIAL HOUSING
COMPANY:
Call Today to make a
reservation: +1-888.763.7236
HOTEL INFORMATION
EMS Today has rooms
reserved at 9 nearby
hotels. Discounted rates
are only available through
the official housing company,
Preferred Convention Services.
Online reservations, hotel map
and hotel pricing can all be found
at www.emstoday.com.
1 Aloft Charlotte Uptown 4 Hampton Inn Charlotte Uptown 7 Hyatt Place Charlotte Downtown
2 Courtyard Charlotte City Center 5 Hilton Charlotte City Center 8 Omni Charlotte
3 Embassy Suites Uptown 6 Hilton Garden Inn Charlotte Uptown 9 Westin Charlotte
CHARLOTTE, NC A LOT TO SAVOR

Experience the exciting possibilities that add character to Charlotte, from cultural institutions and
attractions to world-class dining and nightlife to shopping and sporting events unique to the region.
HERE ARE SOME PLACES NOT TO BE MISSED!

Catch a
CHARLOTTE HALL OF FAME
HORNETS Pit Crew Challenge
Visit the NASCAR
and try out the
ZIP through the forest
at the
US NATIONAL WHITE
Looking for some
NIGHTLIFE?
Check out the
EPICENTRE
game WATER CENTER
N
TRATIO
REGAIVSEL &
TR
18EMSTPrelim_67 67 8/28/17 10:58 AM

1421 SOUTH SHERIDAN RD. // TULSA, OK, USA 74112
USE THIS SOURCE CODE WHEN REGISTERING:
EMSTPCJEMS
EXCLUSIVE DISCOUNT!
The early, early bird really does get the worm!
REGISTER FOR A GOLD PASSPORT WITH THE
SOURCE CODE LISTED ABOVE BY OCT. 31 TO SAVE AN
ADDITIONAL $75 OFF THE EARLY BIRD RATE
– THAT’S A $175 DISCOUNT!
VISIT WWW.EMSTODAY.COM AND
REGISTER TODAY!
PTSD Recovery p. 36 COLLEGE EMS Reunion p. 40 CAPNOGRAPHY Update p. 46 RESUSCITATION Termination p. 52
AUGUST 2017
YOUR REGISTRATION INCLUDES A 1 YEAR FREE DIGITAL

PREPARING
PROVIDERS
Supporting EMS resiliency, p. 8
Cost-conscious simulation, p. 24
Hiring process overhaul pays off, p. 30
Detroit responds to
EMS violence, p. 32
SUBSCRIPTION TO OUR OFFICIAL PUBLICATION –
www.emstoday.com FEBRUARY 21–23, 2018, CHARLOTTE, NC
SHARE YOUR JOURNEY

#EMSTODAY /// @EMSTODAY
18EMSTPrelim_68b 2 8/28/17 11:04 AM

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What are some of the topics covered in the special section on patient safety?

What are some of the topics covered in the special section on patient safety?

What are some techniques discussed for improving patient lifting?

What are some techniques discussed for improving patient lifting?

DIGITAL PRODUCTS

TRANSPORT ASSESS VITALS CALCULATE MONITOR REVIEW

JEMSDig_PSGRMel_170608 1 6/8/17 11:33 AM

www.emstoday.com FEBRUARY 21–23, 2018, CHARLOTTE, NC

1710JEMS_C1 1 9/12/17 9:31 AM

MONITOR CPR DETECT RESPIRATORY PROVIDE THERAPEUTIC

DISCOVER THE CAPNOSTREAM 35 ADVANTAGE

1710JEMS_C2 2 9/12/17 9:31 AM

Contents DEPARTMENTS & COLUMNS

40 LIFTING & MOVING

47 REDUCING LIFT INJURIES

54 STOPPING THE PAUSE

About the Cover

www.jems.com ocToBeR 2017 | JEMS 1

1710JEMS_1 1 9/12/17 9:20 AM

Control-Cric™ EDITOR-IN-CHIEF – A.J. Heightman, MPA, EMT-P – [email protected]

EDITORIAL GRAPHIC DESIGNER – Kermit Mulkins

SALES & MARKETING SOLUTIONS

The Cric-Knife™ has a 10mm dual sided blade,

For more information, visit JEMS.com/rs and enter 2.

1710JEMS_2 2 9/12/17 9:20 AM

For complete bios of our Editorial Board members, visit jems.com/Editorial-Board.

www.jems.com ocToBeR 2017 | JEMS 3

1710JEMS_3 3 9/12/17 9:20 AM

4 JEMS | OCTOBER 2017 www.jEms.COm

1710JEMS_4 4 9/12/17 9:20 AM

www.jems.com ocToBeR 2017 | JEMS 5

1710JEMS_5 5 9/12/17 9:20 AM

6 JEMS | OCTOBER 2017 www.jEms.COm

1710JEMS_6 6 9/12/17 9:20 AM

Reduces Sick Days and Operating Costs**

- First Responders are exposed to hundreds of pathogens daily.

- The FirstResponder™ Sterilizer helps

For more information, visit JEMS.com/rs and enter 3.

www.jems.com ocToBeR 2017 | JEMS 7

1710JEMS_7 7 9/12/17 9:20 AM

For more information, visit JEMS.com/rs and enter 4.

1710JEMS_8 8 9/12/17 9:20 AM

The massive police ‘rescue’ vehicle placed in Bob’s

parked in his garage. As anticipated, it set

A FAMILY MAN & A GOOD FRIEND

Sarge was a true EMS icon.

For more information, visit JEMS.com/rs and enter 5.

1710JEMS_9 9 9/12/17 9:20 AM

LEVERAGING PCR DATA

10 JEMS | OCTOBER 2017 www.jEms.COm

1710JEMS_10 10 9/12/17 9:20 AM

RECRUIT ASSESS ONBOARD TRACK PLUS: AWARD-WINNING

1710JEMS_11 11 9/12/17 9:20 AM

For more information, visit JEMS.com/rs and enter 7.

12 JEMS | OCTOBER 2017 www.jEms.COm

1710JEMS_12 12 9/12/17 9:20 AM

For more information, visit JEMS.com/rs and enter 8.

www.jems.com ocToBeR 2017 | JEMS 13

1710JEMS_13 13 9/12/17 9:20 AM