National Association of EMS Physicians.®

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NAEMSP Annual Meeting Schedule
January 19-23, 2015 
Thursday, January 22, 2015 ­­-- State of the Art
7:00 a.m. - 5:00 p.m.
7:00 - 8:15 a.m.
PEC Breakfast (Invitation only)
7:00 - 8:15 a.m.
Continental Breakfast
8:15 - 8:30 a.m.
GENERAL SESSION – Welcome & President's Address
Ritu Sahni, MD
NAEMSP® President,
Jon Rittenberger, MD,
Program Chair
8:30 - 9:30 a.m.
The literature related to neuro outcomes in critically-ill patients is very active on multiple fronts.  However, much of this science actually comes from general trauma, stroke and non-traumatic intracranial bleeds and has often been inappropriately applied to TBI without supporting evidence.  Thus, multiple controversies have arisen related to the early management of severe TBI:  Is the threshold for treating hypotension too low in the current TBI Guidelines?  Should permissive hypotension be allowed in multisystem trauma with TBI?  Does hyper-oxygenation worsen neurologic outcome?  Does the treatment of hypoglycemia with glucose potentially lead to detrimental hyperglycemia?  Is sedation of intubated TBI patients detrimental via vasodilation-induced reduction of cerebral perfusion?  Should mild "therapeutic" hyperventilation be used for impending brain herniation?  These and other hot topics will be discussed provocatively in this session.
Dan Spaite, MD, FACEP
9:30 - 10:30 a.m.
Opioid overdose kills people across all ethnic, racial and economic boundaries. To make it worse, part of the problem is iatrogenic; medicine’s interest in treating pain was complicit in the creation of this crisis. Should EMS physicians address the crisis of opioid overdose and integrate naloxone distribution into our systems and our practice?
Michael Dailey, MD
10:00 a.m. - 4:15 p.m.
10:30 - 10:50 a.m.
10:50 - 11:00 a.m.
James J. Menegazzi, PhD,
11:00 a.m. - Noon
GENERAL SESSION – Research - Oral Abstracts Session 1 (1-4)
Noon - 1:00 p.m.
Boxed Lunches in Exhibit Hall
12:05 - 1:05 p.m.
1:15 – 1:30 p.m.
This session will review the status of EMS board certification by briefly reviewing the process that led us to a certification exam, describing the "tracks" by which physicians may qualify to sit for the test, examining statistics from the first two offerings of the exam (fall 2013 and spring 2014), and discussing of the future of certification for the sub-specialty.
David Cone, MD
1:30 – 2:20 p.m.
This program will provide an update on the most recent trends in drug shortages, with an emphasis on those impacting EMS and emergency medicine providers. This program will also discuss the most common reasons for the drug shortage problem and current efforts to ameliorate the problem. Best practices in minimizing the impact of drug shortages on patient care will also be discussed.
Erin Fox, PharmD
2:20 – 2:40 p.m.
Few areas of emergency medicine and prehospital care are plagued more by "common knowledge" myths than the treatment of carbon monoxide poisoning. This session will challenge many of the myths and urban legends by examining the original literature supporting the epidemiology, diagnosis, and treatment of carbon monoxide poisoning. The information provided in this session can be used to improve training in carbon monoxide response for EMS providers and fire service personnel.
David Hostler, PhD, EMT-P
2:40 – 3:00 p.m.
This session will review the procedure of remote ischemic conditioning and its potential benefits.  Barriers to prehospital implementation and feasibility of implementing RIC as part of a large air medical system will be discussed.
Christian Martin-Gill, MD
3:00 – 3:45 p.m.
The International Liaison Committee on Resuscitation (ILCOR) and resuscitation councils around the world including the American Heart Association (AHA) collaborate on performing structured reviews of scientific evidence guiding resuscitation practice. See where you can participate in providing feedback on the reviews and the proposed guidelines changes.
Michael Sayre, MD
3:45 - 4:15 p.m.
Break in Exhibit Hall
4:15 - 5:15 p.m.
GENERAL SESSION – Research Oral Abstracts Session 2 (5-8)
​5:30 - 6:45 p.m.
Poster Session #1 (49-103)
5:30 - 6:45 p.m.
Innovations in EMS Fellowship Education Poster Session
6:45 - 8:45 p.m.
Welcome Reception in the Exhibit Hall
Friday, January 23, 2015 -- The Future of EMS
7:00 a.m.- 4:00 p.m.
7:00 - 8:00 a.m.
Continental Breakfast
8:00 - 9:00 a.m.
GENERAL SESSION – Mass Gathering at the Hajj​
The annual Hajj to Makkah in Saudi Arabia is one of the largest annual religious mass gatherings in the world. The importation of infectious diseases during a mass gathering may result in outbreaks of global proportion. Key features of preparedness for the 2014 Hajj and Umra season, including review of the recent impact of emerging viruses such as Ebola in West Africa and the Middle East respiratory syndrome coronavirus(MERS-CoV) in affected countries, and the updated requirements and the required vaccines will be discussed.
ad Memish, MD
9:00 - 10:00 a.m.
GENERAL SESSION – Research-Oral Abstracts Session #3 (9-12)
9:30 a.m. - 4:30 p.m.
10:00 – 10:20 a.m.
Break in Exhibit Hall
10:20 - 10:40 a.m.
Up until the 2013 NAEMSP/ ACS-COT position statement “EMS Spinal Precautions and the Use of the Long Backboard,” the use of a cervical collar and rigid long backboard was considered standard of care during trauma transport. However for more than twenty-five years, investigators have been laying the ground work for this change by elucidating the potential adverse effects associated with “spine immobilization” and developing clinical screening criteria to assist practitioners in identifying patients in whom “spine immobilization” can be safely avoided. These efforts mostly focused on adults. During this session we will review this literature as it pertains to the pediatric population and make recommendations regarding the use of spinal precautions for trauma transport in children.
Julie Leonard, MD, MPH
10:40 - 11:15 a.m.
HOT Topics Implementation of an EMS Evidence Based Guideline: Lessons Learned
The "Statewide Implementaiton of an Evidence-Based Guideline" is a NASEMSO project funded by NHTSA. The goal of the group is to discover factors that promote or detract from the implemetation of an evidence based EMS guideline at the state level. The presentors will share the lessons learned to date from the five participating states.
Peter Taillac, MD;
J. Matthew Sholl, MD, MPH, FACEP
11:15 a.m. - 12:15 p.m.
GENERAL SESSION – Research Oral Abstracts Session #4 (13-16)
12:15 - 1:30 p.m.
Boxed Lunches in Exhibit Hall
12:20 - 1:30 p.m.
1:30 - 3:30 p.m.
A panel will present a fast paced, high yield review of the 2014 EMS LLSA articles. Diplomats and non-diplomats are welcome to join us as we take a critical look at these practice-changing articles and discuss their relevance to prehospital providers. This session will prepare ABEM diplomates to successfuly complete the LLSA exam. Attendees are encouraged to review the LLSA articles prior to the session. Presented by the EMS Fellows and Fellowship Graduates Committee.
Brian Clemency, DO, MBA
Adam Frisch, MD
Andrew McCoy, MD
1:30 - 2:30 p.m.
CONCURRENT SESSION 1B – How To Evaluate Your Workforce​
This engaging session will focus on the evaluation and determination of entry level competency in the Emergency Medical Services Providers. Cognitive and psychomotor methodologies utilized to determine competency will be discussed with case studies provided. In addition, the National Continued Competency Program used to sustain competence of EMS providers will be discussed.
1:30 - 2:30 p.m.
CONCURRENT SESSION 1CPsychology of Pediatric Resuscitation and TOR
Pediatric care in the field has been known to cause significant anxiety for pre-hospital providers without a clear scientific explanation of why it even occurs.   While resuscitation outcomes in the adult population have improved significantly in the last decade, pediatric OHCA has shown no improvement in over 30 years, with an average survival rate of only 6%. The answer to this conundrum may be based on Daniel Kahneman’s Nobel Prize winning psychological theory that describes the brain’s function during stress.  Join Dr. Antevy for an enlightening session that will finally shed light on the big problem with small people!
Peter Antevy, MD

2:30 - 3:30 p.m.
Exercise-associated hyponatremia (EAH), defined as a serum sodium concentration less than 135 mmol/L during or within 24 hours after prolonged physical activity, appeared to be an unusual consequence of endurance exercise when first described in the mid-1980s.  Since the initial description, at least a dozen deaths from EAH have been confirmed and this potentially fatal medical condition has been found to be common in a variety of endurance activities.  Once EAH is recognized, treatment should be straightforward.  Unfortunately, many providers are not well-educated on this condition, it can be confused with other common conditions, and inappropriate treatment can be devastating.  This presentation will review the etiology, pathophysiology, risk factors, presentation, prevention and treatment of EAH.
Martin Hoffman, MD
2:30 - 3:30 p.m.
CONCURRENT SESSION 2B – Developing “Core Measures” for EMS
Changes in payment formulas are coming to all sectors of healthcare, including EMS. Value-based purchasing (i.e., pay for performance) strategies will be having an impact on both fee-for-service payments as well as bundled payments for EMS from accountable care organizations. Payments for EMS are going to be adjusted up or down based on how well EMS performs on core measures, just as now takes place for specific aspects of hospital care. This presentation will discuss the rational for these programs and then outline efforts being led by NAEMSP in collaboration with other national EMS organizations to develop the ‘EMS core measures’ and a broader national library of EMS performance measures.
Mic Gunderson
3:30 - 4:30 p.m.
Refreshment Break in Exhibit Hall
3:30 - 4:30 p.m.
Poster Session #2  (104-157)
4:30 - 5:30 p.m.
General (Ret) Russel L. Honoré

30 - 7:00 p.m.
Research Poster Session #3 (Electronic) (17-48)
Optional Session Additional Fee Required
5:30 -7:00 p.m.
Advances in Prehospital Airway Management-A Hands On Workshop and Difficult Airway
Challenge(preregistration required, limited to 25)
Prehospital airway management has remained controversial.  To improve the delivery of airway management a variety of devices have been developed to assist with the process.  These include video laryngoscopy, supraglottic airways and modified semi ridged stylets.  Having an opportunity to use and evaluate these devices, in one setting, with associated instruction, is uncommon.  This workshop will give attendees that opportunity.
Derek Cooney, MD;
n H
odnick, DO;
Marv Wayne, MD
​7:00 - 8:00 p.m.
​Evening Cocktail Reception - Supported by NREMT​
Saturday, January 24, 2015 -- Making it Happen in My System
7:00 - 8:00 a.m.
Continental Breakfast
8:30 a.m. - 4:00 p.m.
7:00 - 8:15 a.m.
8:15 - 9:15 a.m.
GENERAL SESSION – Top Innovations for 2015​
Please join for this second annual semi-serious, always irreverent review of the top five innovations in the past year that should impact your practice.  Participants will have an early Saturday morning opportunity to reflect on impactful innovations and consider whether they are worthy of implementation. 
Brent Myers, MD
9:15 - 10:15 a.m.
Mobile integrated healthcare, community paramedicine or simply implementing best practice?  What is the best choice for my shop?
This is a common question for many EMS Medical Directors. One size does
not fit all agencies. Learn how to determine if your community may benefit from MIHP or would be better served with best practice implementation.  Dr. Beeson will provide his insight on how to design and implement both of these practices for your community.
Jeff Beeson, DO
10:15 - 10:30 a.m.
10:30 - 11:20 a.m.
Developing and implementing prehospital evidence-based guidelines (EBGs) has the potential to improve prehospital care widely, yet remains a challenging task at the local, regional, and national level.  Over the past several years, a substantial amount of work by multiple EMS organizations and individuals has focused on utilizing a Model Process for EBGs, as well as identifying ways to implement those guidelines more widely.  This session will identify challenges to developing and implementing EBGs, including use of the Model Process.
John Gallagher, MD;
Christian Martin-Gill, MD
11:20 a.m. - Noon
This program will focus on the development and execution of a novel program utilizing specially trained community paramedics to improve pediatric health and reduce pediatric asthma recidivism rates. In this model, paramedics provide in-home asthma care, education and public health assessments to children after acute hospital-based encounters for asthma related illness. During this session we will discuss first year outcomes of this innovative intervention as well as detail our approach to paramedic training, infrastructure building and operations.
Andrew Stevens, MD;
Elizabeth Weinstein, MD
12:15 - 1:45 p.m.
Awards Luncheon
1:45 - 2:45 p.m.
Out-of-Hospital cardiac arrest remains a leading cause of death and major public health problem in the US.  EMS is uniquely qualified and positioned to coordinate systems of acute care to impact cardiac arrest survival.  The Cardiac Arrest Registry to Enhance Survival (CARES) is now a decade old and has expanded to cover over 25% of the population of the US.  While this expansion is a huge success, survival as a nation has not improved significantly.  CARES has helped show that individual communities have made dramatic gains in survival, mostly by implementing programs to increase bystander response, the quality of trained rescuer response, and guideline based post-arrest care.
This session will review some of the key publications which have arisen from the CARES effort, lessons learned along the way, vital future challenges, and will discuss novel interventional resources now available for CARES communities.
Bryan McNally, MD;
Bentley Bobrow, MD
5 - 3:05 p.m.
Opioid abuse and its sequelae is resurging in North America.Naloxone is clearly effective for many problematic abuse situations, at times dramatically restoring the respiratory drive, correcting both oxygenation and ventilation failures, and "raising the nearly dead" back to life.  Many medical organizations, governmental leaders, and law enforcement authorities are promoting the expanded use of naloxone, including "arming" police officers with naloxone for use prior to EMS arrival to these patients.  Is this the elusive simple answer to the complex challenge of opioid abuse?  Is this conversely a dangerous practice?  What are the answers for your community and what are the questions that generate those answers?
Jeffrey Goodloe, MD, NRP, FACEP
3:05 - 3:25 p.m.
“One amp of D50 IV” is the textbook answer for severe hypoglycemia and has been for years.  D50 may be overkill, is a tissue irritant and necessary pediatric dilutions are prone to error.  Titration with D10 may be a more physiologic and safer treatment for severe hypoglycemia, that is used in a number of countries.
ostykus, MD, MPH

3:25 - 3:45 p.m.
We will review the current evidence for the use of blood products in the prehospital environment. We will discuss resources required for a out of hospital transfusion and how to maximize patient benefit while mitigating risk.
Francis Guyette, MD, MP

3:45 - 4:00 p.m.
4:00 - 5:00 p.m.
Join the presenters as they review 5 top articles in EMS practice from 2014. Learn how each affects your practice and can be put to use immediately.
Jon Ritte
nberger, MD, EMT-P
Michael Millin, MD

5:00 p.m.

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