Life or Limb: Field Amputation to Rescue Trapped Patient

Lecture objectives:

Recognize the clinical scenario where a limb amputation is required.

Describe the clinical, logistical, and administrative challenges associated with a field limb amputation.

Prepare for the call for a limb amputation in your response area.

Gary Berryhill

Peer Support & Training Manager

SURVIVING AND THRIVING YOUR CAREER AS A FIRST RESPONDER

This course discusses the common reactions to workplace stress and trauma to illustrate the pitfalls of any First Responder (current or retired) work environment. We will review the effects of job-related trauma and the cumulative toll those stressors can have as well as how to take control of your “off duty” time. The course concludes with a discussion of resources including PEER support and other services available.

Dr. Patrick Cody

Community implementation of mobile integrated health: and introduction and case studies in success

This presentation will provide learners with a framework for understanding the benefits of mobile integrated healthcare. 

By the end of the presentation, participants will:

• Be able to describe the history and structure of MIH

• Be able to discuss ways MIH can offload the 911 system

• Understand mobile Medication Assisted Therapy Induction

• Be able to describe mobile crisis response

• Be able to describe a mobile medical screening and clearance protocol

Dr. Cunningham

Dr. Curtis Knoles

EMS-C Update

This presentation will share updated information for pediatric emergency medicine. 

Dr. Jeffrey Goodloe

Airplane! When It's Not the Movie, It's a Real-Life Situation:

Emergency Care at 30,000 Feet

Although you likely traveled some roads by motor vehicle to Guardians of the Heartland, you'll hopefully be on a flight to somewhere even more fun soon. What if there was a "medical emergency" (real or perceived) on your flight? Would you know what to do? What are the regulations surrounding in-flight care? What equipment is, and more importantly, isn’t available? This interactive discussion will equip you with the mindset to succeed at 30,000 feet using the insights and experiences of a veteran traveler and 38-year EMS veteran from street EMT and medic to flight physician to EMS medical director. We'll cover all you need to know to expertly navigate what comes after, "Ladies and Gentleman, is there a medical professional on this flight?"

GRACIE

Royce Gracie

G.R.A.C.I.E. (Gracie Retention and Control for Immediate Enforcement) is the defensive tactics and weapons retention course created by the legendary Royce Gracie, 3-time Ultimate Fighting Champion. Royce earned his title by defeating his opponents using Brazilian Jiu-Jitsu, proving the effectiveness of leverage and technique over strength and size. Royce has incorporated these defensive tactics techniques into a comprehensive training course specifically designed for law enforcement. Like many skills, defensive tactics are perishable; therefore the G.R.A.C.I.E. program is the “only” defensive tactics program that will help officers on how to effectively defend their weapons in all altercations. Topics that will be covered: • Distance management • Positional control • Defending common attacks • Takedowns • Weapon retention • Many more  

DR.  Lewis

“All Jacked UP: Taming the Monster of energy drink benefits and risks” 

This education will be presented to address the growing trend of energy drink consumption in Emergency Services. Evidence based medicine and research will be provided on the use and misuse of energy drinks. Advice will provided on how to use caffeine and energy drinks to maximize the benefits and minimize the side effects and adverse events.

Outline

1. Introduction

    • Purpose and scope of discussion

2. Energy Drink Trends

    • Consumption patterns and marketing claims

3. Ingredients & Mechanisms

    • Caffeine, taurine, guarana, ginseng

4. Health Effects

    • Cardiovascular and neurological impacts

    • Special populations at risk

5. Performance Enhancement

    • Cognitive and physical benefits

6. Risks & Recommendations

    • Arrhythmias, sudden cardiac arrest risk

    • Safe consumption guidelines

7. Summary & Takeaways

Objectives

• Educate on physiological effects of energy drinks

• Identify cardiovascular and neurological risks

• Compare caffeine content across popular brands

• Discuss evidence-based recommendations for safe use

• Highlight vulnerable populations and risk factors

Stop the Whining: Limiting Lights and Sirens in EMS” 

Practical and evidence-based talk on reducing unnecessary lights and siren use in EMS. The education presentation will include the history of lights and sirens, evidence of risk with L&S and steps we can take to keep our EMS professionals safe and protect the public.

Learning Objectives

By the end of this session, participants will be able to:

1. Describe the historical origins and evolution of emergency vehicle lights and sirens (L&S) and why they became standard in EMS.

2. Explain the current evidence regarding crash risk, provider injury, and patient harm associated with L&S response and transport.

3. Evaluate current dispatch determinants and understand why protocol modification is essential to reduce unnecessary L&S use.

4. Apply best-practice recommendations for safe EMS operations, including reduced L&S utilization, risk-benefit thinking, and culture change within agencies.

Outline

I. Introduction:

• “Stop the Whining” theme—addressing cultural resistance in EMS.

• Overview of preventable crashes, injuries, and legal exposure.

• The mission: Reduce harm, not response times that don’t change outcomes.

II. History of Lights and Sirens

• EMS inherits fire service tradition—“faster is better.”

• Lack of early evidence and the role of culture/tradition over science.

• Growth of high-visibility lighting technology and unintended consequences (distraction, glare, sensory overload).

III. Crash Risk While Responding

• Increased odds of intersection collisions.

• Reduced reaction times at higher speeds.

• Cognitive overload for drivers under stress.

IV. Crash Risk While Transporting

• Transport is significantly more dangerous than response.
  (Consistently shown in EMS safety research.)

• Patient vulnerability due to:

  • Lack of restraints

  • Equipment not secured

  • Standing crew members (procedures, monitoring, IV access)

• The “speed + unstable environment” multiplier effect.

V. Clinical Benefit: What the Evidence Shows

• True time savings usually only 1–4 minutes.

• Most medical conditions do not show improved outcomes from faster transport.

• Only a few exceptions where minutes matter:

  • Airway compromise

  • Major trauma with uncontrolled hemorrhage

• L&S use often emotionally driven rather than clinically justified.

Eric McAffrey

Officer Safety & Survival Training

This training program seeks to provide actionable risk-reduction strategies for dealing with the increasing levels of violence being experienced by law enforcement officers across the country. The program will focus on sharpening the officer’s survival mindset, providing strategies and tactical problem-solving concepts for detecting danger, prevailing against ambushes and spontaneous attacks whether they are responding to calls for service or off-duty. Law enforcement is inherently dangerous but by mitigating the risks we can increase the chances we all go home to our families at the end of our shift.

Jeff Morefield

Next Phase Leadership - Leading with Purpose into the Next Chapter

Change is certain, but preparation often isn't. This course equips first responders with practical tools to navigate life's transitions, both personally and professionally. Participants will uncover strengths they already possess and learn how to apply them with intention. By focusing on self-leadership and strategic planning, first responders will leave ready to lead themselves and others through whatever comes next.

Dr. Juan Nalagan

(HEMS) Air medical Update

Scott Patton

Drone Awareness and Command

Steve Rahm NRP, FcEHS

Introduction to the 12-Lead ECG

In emergency medicine, whether in the field or in the emergency department, major decisions often cannot be made without a 12-Lead ECG. Proper acquisition and timely and accurate interpretation of this key assessment tool sets the tempo of how the continuum of patient care proceeds.

This presentation is designed to engage the initial learner, as well as provide a detailed review for the experienced provider, in the skill (and art) of navigating and interpreting the 12-Lead ECG. Frequent review and practice are vital in avoiding knowledge decay, especially if you do not interpret ECGs on a regular basis.

Accurate interpretation of the 12-Lead ECG requires a systematic, methodical approach, and that’s exactly what we will do during this presentation. Following a review of key principles, including fundamental electrocardiography; proper lead placement (crucial in obtaining a diagnostic quality ECG); waveforms, intervals, and segments; and cardiac axis determination, we will proceed down the path of navigating a 12-Lead ECG tracing, using multiple example ECGs, to see what problems we can unearth.

When you complete this session, you will be confident in your newfound skill, and perhaps more comfortable if you’ve had previous 12-Lead ECG education. The end goal is that you will increase your diagnostic abilities in identifying patients with time-sensitive cardiac problems.

Final Option for a Bad Situation: Surgical Airway Access Realities

The pathway to mitigation of a true “can’t intubate, can’t oxygenate” situation is very short and

very direct—a cricothyrotomy. Emergent surgical airway access via the cricothyroid membrane

is a procedure that many paramedics will never perform in their career; are YOU the next one

who will be faced with this task? The low-frequency, high-risk nature of this skill mandates

absolute knowledge of the anatomy of the anterior neck, frequent practice, and procedural

confidence. When cricothyrotomy fails, it is often the result of an inability to properly locate the

anatomic structures of the larynx.

This presentation explores the realities of cricothyrotomy in a manner that you have likely

never seen before. Utilizing high-resolution cadaveric images, the anterior neck will be

procedurally dissected and critical anatomic structures will be identified. A step-by-step

approach—based on the latest evidence and best practices—will be followed in order to

maximize your success in performing this time-sensitive, final option procedure. No patient

should go to the morgue (for lack of an airway) without a hole in their neck!

Session Objectives:

1. Recognize a true “can’t intubate, can’t ventilate” situation.

2. Identify key anatomic landmarks of the anterior neck and larynx.

3. Describe the various barriers to gaining emergent surgical airway access.

4. Describe the current best practices in gaining emergent surgical airway access.

Drowning on Dry Land: Heart Failure

Conges2ve heart failure (CHF) is a common disease process encountered in the field. Treatment

for these pa2ents can be complex and they have a high poten2al to rapidly deteriorate.

However, by understanding the pathophysiology of CHF, you can direct your treatment more

specifically and effect clinical improvement before the pa2ent is delivered to the hospital.

This presenta2on begins with a review of the physiological processes of stroke volume,

Starling’s law of the heart, cardiac output, and ventricular ejec2on frac2on. We will then discuss

the pathophysiology and clinical presenta2ons of leK and right heart failure. Specific treatment

modali2es discussed include CPAP/BiPAP and nitroglycerin—the hallmarks of CHF treatment—

as well as other BLS and ALS treatment strategies.

Objec&ves:

1. Understand the physiological processes of stroke volume, Starling’s law of the heart,

cardiac output, and ventricular ejec2on frac2on

2. Define conges2ve heart failure

3. Compare and contrast leK and right heart failure

4. Describe current prehospital treatment strategies for conges2ve heart failure

Heart Alert! ECG Patterns of Acute Cardiac Ischemia

Intended for providers who possess both basic and advanced multi-lead ECG interpretation

skills, this presentation takes the audience from rapid recognition of the “in your face” STEMI to

the less obvious ECG indicators of acute coronary occlusion that rely upon a keen eye for

reciprocal changes and a knowledge of ECG patterns that are considered to be STEMI

equivalents.

Based on the leads in which ST/T wave changes are noted, the provider should be able to

anticipate where the culprit artery is, thus allowing him or her to anticipate prehospital

treatment needs. This presentation features numerous multi-lead ECG tracings—from not so

difficult to rather challenging—along with associated patient presentations and pre- and postcardiac

catheterization images.

Session Objectives:

1. Correlate various ECG lead configurations with coronary anatomy.

2. Understand indicative and reciprocal ECG changes and apply them to your diagnosis of a

patient with acute coronary occlusion.

3. Recognize the ECG signs of acute occlusion of the right coronary artery, left anterior

descending coronary artery, and circumflex artery.

4. Identify ECG patterns that warrant additional ECG views in order to maximize your

diagnostic yield.

5. Identify ECG patterns that are consistent with acute coronary occlusion, but do not

present with ST elevation.

Sgarbossa Got His Bundle Branch Blocked in Barcelona

Historically, the common thought has been that you cannot diagnose electrocardiographic

occlusive myocardial infarction (OMI) in those with a left bundle branch block (LBBB). Whether

an obvious MI, or an MI buried within a LBBB, the patient still needs timely reperfusion for

maximal myocardial salvage. The Sgarbossa criteria, originally published in 1996 and modified

in 2012, have demonstrated high specificity in identifying OMI in the presence of a LBBB or

paced ventricular rhythm. The new kid on the block—the Barcelona criteria—were published in

2020 and have also demonstrated high specificity. Both criteria can increase your diagnostic

yield, but which one is better?

This presentation begins with a review of bundle branch block identification, both left and right,

and what a “normal” bundle branch block looks like. Then, by utilizing both criteria, we will

identify what is NOT normal. Whether your regional cardiac system of care utilizes these

criteria or not, advanced practitioners will—at a minimum—be able to recognize patients with

bundle branch blocks or paced rhythms that are highly suspect for OMI, which could get the

patient on the cardiology team’s radar sooner.

Objectives:

1. Identify left and right bundle branch block and ventricular paced rhythms

2. Identify the features of a “normal” bundle branch block

3. Define the modified Sgarbossa criteria

4. Define the Barcelona criteria

5. Apply the Sgarbossa and Barcelona criteria to your assessment of a patient with a left

bundle branch block or paced ventricular rhythm who has cardiac symptomatology

David Seastrom

Child Abuse:  The Dark Side of Pediatrics

·        Describe injury patterns consistent with non-accidental trauma

·        Describe risk factors that are common in children who are victims of non-accidental trauma

·        List injuries that are highly suggestive of non-accidental trauma

Child abuse kills nearly 1600 children every year regardless of race, sex, and geographic location.  This lecture will heighten the awareness of providers at every level and guide them thru the understanding of how children are abused, common injury patterns to look for, and risk factors that predispose children.  A tough topic for most, but a valuable amount of information via slides, videos, and pictures is sure to keep their interest.

Pediatric Jeopardy

Kansas City Parade Shooting

Kevin Smith

Homeland Security