Presentations
PRE-CONFERENCE
The Shift – Heavy Lies the Helmet, The Resus Tailor, The Protected Airway Collaborative, Cape Cod CPR
This is a fully immersive, scenario-based pre-conference experience that places participants inside a single unfolding narrative spanning an entire transport medicine mission. Beginning with a normal continuing education day and progressing through dispatch, patient care, transport, handoff, post-flight operations, and the unexpected events that follow, attendees will navigate the challenges of a day that quickly spirals beyond routine. Throughout the course, teams will rotate through hands-on skill stations before immediately applying those concepts during realistic scenarios where conditions evolve, communication breaks down, equipment fails, patients deteriorate, and priorities constantly shift.
CONFERENCE
5 Clinical Trials You Need to Know: Understanding and Integrating the Most Recent Literature – Dr. Amanda Humphries
Keeping up with medical literature can be overwhelming. But knowing how to interpret it is even more important. In this session, we’ll review five recent clinical trials that have the potential to impact emergency, critical care, and prehospital practice. Along the way, you’ll learn practical tips for evaluating research, identifying study limitations, and deciding when new evidence should change your clinical practice. Leave with a better understanding of both the latest literature and how to apply it at the bedside.
After the Rescue: Night Operations, Survival, and Prolonged Care in Flood Response — Philip Barbour, Craig Smith
This presentation explores the realities of flood response operations during the 2025 Texas Fourth of July flooding events, with a focus on the critical gap between rescue and definitive care. While swiftwater rescue often emphasizes victim access and extraction, far less attention is given to what happens immediately after the rescue, particularly in austere, resource-limited environments at night. Attendees will be walked through real-world operational challenges including limited visibility, boat-based navigation hazards, patient packaging in moving water, and the decision-making required when evacuation is delayed or impossible. The session will transition into a discussion on post-rescue care: managing hypothermia, prioritizing limited resources, handling multiple patients without resupply, and operating under the realistic possibility that help may not be coming quickly. This is a discussion-driven session designed to bridge the gap between rescue and medicine, emphasizing prolonged field care principles, leadership under uncertainty, and the emotional and operational realities of fatal outcomes in austere environments.
Are You In or Out? EMS Reduction of Acute Dislocations: Current Best Practice Evidence — Dr. Eric Fuchs
Joint reductions performed by EMS providers are formally included within the Advanced Practice Wilderness Paramedic (WP-C) and Tactical Paramedic (TP-C) scopes of practice in Kentucky. Additionally, all levels of EMS providers are instructed to attempt a one-time reduction when a dislocation results in a limb-threatening vascular compromise. Although this expectation has existed for many years as a standard of care, there remains no comprehensive or standardized training in joint-reduction methods within EMS education. This lecture–lab session is designed to address that gap by providing WP-C/TP-C personnel and other EMS providers with guided, hands-on instruction in evidence-based reduction techniques. Participants will practice proper closed-reduction methods using joint-reduction simulation models for the finger, shoulder, and elbow, followed by supervised peer-to-peer practice of select techniques within the lab environment. This structured approach aims to increase competence, confidence, and safety when performing reductions in field and wilderness settings. The current Kentucky Board of Emergency Medical Services (KBEMS) Scope of Practice document specifies that WP-C and TP-C providers may reduce dislocations of the shoulder, fingers, and patella. Much of the available evidence informing best practices for non-sedated joint reductions originates from the sports medicine and athletic training literature. In 2018, the National Athletic Trainers’ Association (NATA) published its Position Statement on the Immediate Management of Appendicular Joint Dislocations, offering clinical guidelines for selecting appropriate techniques and developing protocols in collaboration with supervising physicians. Wright et al. (2020) further synthesized the evidence by identifying numerous closed-reduction techniques, reviewing their procedural steps, success rates, and mean reduction times. They concluded that clinicians should be prepared to select the most appropriate technique based on the specific joint dislocation and the context in which it presents. As entry-level and scope of EMS providers evolves to include greater integration of competency in joint-reduction procedures, the need for high-quality, interdisciplinary instruction becomes increasingly important. Paramedic educators and paramedics serving as preceptors must be knowledgeable in proper reduction techniques to effectively teach, evaluate, and support students—particularly those enrolled in advanced practice pathways. This presentation aims to bridge gaps between EMS, wilderness medicine, and sports medicine by providing practical skills training aligned with current evidence and state scope-of-practice expectations.
Assessment and Treatment of an Entrapped Patient: A Structural Collapse Case Review — David Weiss
On August 9th 2024, while pre-deployed for potential flooding throughout the state, Vermont Urban Search and Rescue was activated for a large tree that fell onto a house which caused the structure to collapse. It was initially reported that there were four victims trapped in the rubble. After swapping our swiftwater rescue gear for structural collapse equipment, we continued on to the scene. Upon arrival there was a single victim who remained trapped, and our only access was the patient’s hand sticking out of the rubble. I couldn’t help but think back to my Disaster Medicine course. There was a skill station of a hand placed in a box and we were asked “how many different assessments can you make on this one piece of someone’s body?” This case review will cover assessment and medical management of our patient suffering from crush syndrome. We will cover the challenges that entrapped patients present while also discussing tips and tricks to aid in assessment and treatment. While discussing the logistics of the extrication we will also cover common injuries as well as the pathophysiology and varying treatments of crush injury and syndrome and how the treatment may change based on the environment. The presentation ends with an evidence based enthusiastic debate on tourniquet use in the austere and resource limited environments. This case highlights how a strong clinical assessment followed by aggressive medical management lead to a positive outcome for this entrapped victim.
Beyond Native Venom: Recognition and Management of Non-Native Snakebites — Andi Champion
Exotic venomous snakebites in the United States are rare, but when they occur, they can quickly become high-acuity, high-complexity calls that challenge even experienced providers. Recent widely publicized cases have brought attention to these unusual encounters, where unfamiliar species, unpredictable toxidromes, and limited antivenom availability can complicate both clinical decision-making and transport logistics. This presentation dives into real-world non-native snakebite cases and the patterns behind them, offering a practical look at how these incidents unfold in the field. Through case-based discussion, attendees will explore recognition of envenomations, anticipate clinical progression, and develop strategies for managing these patients in dynamic and resource-limited environments. Designed with flight paramedics, nurses, and future crew members in mind, this session offers a practical perspective to a rarely discussed but memorable category of calls, equipping providers with the confidence to handle the unexpected when it matters most.
Breaking in the Saddle: A Classic Tale of Hemodynamic Collapse — Dr. Douglas George, Danielle Goodrich
The focus of this case presentation is to develop clinical decision making in the treatment of a massive saddle pulmonary embolus. Utilizing a Choose Your Own Adventure case review, the audience provides feedback and leads the discussion surrounding the approach and differential diagnosis of vague shortness of breath with profound life-threatening vital signs. Using real time interactive polling of the audience, we review decisions surrounding diagnostic methods, associated physical examine findings with massive pulmonary emboli, and methods to identify signs of right heart strain via bedside diagnostic tools (lab results and ultrasound in addition to CT angiogram). Our presentation guides the audience in discussion surrounding the differences in hospital-based vs transport-based therapeutic interventions and focuses on interventions available at sending facilities and in critical care transport. Lastly, through the evolution of our case, we will discuss management of cardiac arrest due to a massive PE and poll the audience on operational decisions regarding enroute cardiac arrest and considerations on diversion and/ or termination of resuscitation. Throughout the presentation, we will highlight current best practices and summarize the literature surrounding temporizing measures in the setting of peri-cardiac arrest.
Blue Baby Blues — Nate Brown
I will synthesize a succinct, flowchart-style framework by which the clinician can differentiate between pulmonary illness and congenital heart defects in the cyanotic neonate with minimal specialty equipment. Utilizing two case studies, I’ll illustrate the subtlety between common presentations with both subjective and objective assessment data points. While the “blue baby” is an infrequent call for most community-based HEMS programs, understanding the treatment we provide – and often more importantly the treatment we should not provide – can optimize patient outcomes or set our patient up for failure. Lastly, I will provide the necessary foundational knowledge to enable the HEMS provider to understand the distinct hallmarks of CHD and be able to delineate other disease processes and treat appropriately.
Building the Anti-Fragile Provider — Chris VanBrenk
Building the Anti-Fragile Provider is an interactive presentation designed for critical care transport nurses and paramedics, and other high-performance healthcare professionals focused on developing resilience, adaptability, and sustained performance in high-stress operational environments. The presentation explores the concepts of anti-fragility, crew resource management (CRM), flow states, stress physiology, allostatic load, and holistic wellness strategies to help providers thrive, not merely survive, in critical care flight programs. In addition to evidence-based concepts and operational healthcare principles, the presentation incorporates lessons learned from the presenter’s experiences within the U.S. Army Special Operations community, emphasizing leadership, team dynamics, performance under pressure, and the development of resilient high-performing individuals and organizations. Participants will examine how mindset, preparation, teamwork, leadership, and personal wellness directly influence clinical performance, burnout prevention, and long-term professional sustainability.
Burn Resuscitation: Are We Doing It Right? — Chris Stevenson
Burn resuscitation is often discussed in the setting of a crystalloid focus. The days of 2 liters prehospital followed by Parkland are fading away. We’ll discuss the evolution of burn formulas and the trend of colloid use in burn resuscitation, the arguments for inclusion of plasma other colloids and surrounding concerns.
Can You Take Me Higher? Probably Not: High Altitude Emergencies, Recognition & Management — Jaren Jarrell, Jace Muller
This presentation covers the recognition and management of high-altitude emergencies in EMS/HEMS, focusing on the three primary illnesses: Acute Mountain Sickness (AMS), High Altitude Pulmonary Edema (HAPE), and High Altitude Cerebral Edema (HACE). We go over identification, treatment modalities, and some fun facts about elevation.
Cold Water Drowning (Keynote Address) — Dr. Carlo Bartoli, Faith Worthington
What a better topic for an outdoor conference located in this beautiful mountain lake venue than drownings? This lecture will provide a blend of a case study, personal experience with a family member drowning, stories of nasty Soviet-era drowning studies, and best practices supported by up-to-date evidence to challenge myths and dogma and educate the attendee how to best respond to the initial resuscitation and later critical care transport management of the drowning patient.
Decoding Urgency: The 3+ Phases of Angor Animi (Sense of Impending Death) — Nyssa Hathaway
Every emergency nurse has heard a patient utter a phrase that instantly changes the room. This session will highlight three—and a bonus—critical declarations and what to do about them. How do you intervene when you hear: It’s the worst headache of my life, I’m going to die, and Is there a medical provider on board the airplane?”
Dogmalysis — Dan Rauh
I know you say that you believe in “evidence-based medicine”, but do you really? Or do you only practice it when it aligns with what you always do? Let’s talk about some things in critical care and emergency medicine that might surprise you… and more importantly change your practice. Bring a chair and an open mind and let’s talk about why you should reconsider your common practices, why they shouldn’t be so common, and why some of them are pure shenanigans.
Dungeons, Dragons, and Difficult Decisions: The EMS Consult Quest Through Live Action Role Play (After Hours) — Dr. Douglas George, Danielle Goodrich
After a decade of managing EMS consult calls, we have learned that the most challenging cases rarely involve medications, procedures, or protocols. Instead, they involve people—patients, providers, law enforcement officers, families, and clinicians attempting to navigate uncertainty while balancing autonomy, safety, and risk. In this highly interactive session, participants will embark on a series of guided “quests” based on real-world EMS consult cases. Through live-action role play (LARP), attendees will experience challenging encounters involving psychosis, suicidal ideation, intoxication, refusal of care, protective custody, and conflicting stakeholder priorities. Participants will assume the roles of field providers, consulting physicians, patients, family members, and law enforcement personnel as they work through complex scenarios where there may be no perfect answer. Along the journey, we will explore the practical application of medical capacity assessment, clarify the distinction between capacity and competency, and discuss approaches to managing situations in which EMS, law enforcement, consulting clinicians, and patients do not share the same goals. Special emphasis will be placed on strategies that improve communication, develop shared mental models, and strengthen relationships between field providers and medical consultation resources. Whether facing a patient seemingly possessed by “purple slugs,” an intoxicated individual refusing care, or a family demanding psychiatric evaluation despite unclear evidence of acute risk, attendees will leave with practical tools to approach difficult consults, improve decision-making, and transform challenging conversations into collaborative problem-solving opportunities.
Emperors and Emergencies: Search and Rescue from Antarctica – Brett Weiner
A retrospective and case study review of search and rescue medicine in Antarctica; treating patients on the harshest continent on earth without the tools, timelines, or transport options we take for granted. This talk examines what happens when the environment closes every door: when weather windows don’t open, when aircraft can’t fly, when the patient stays where they are. It changed how I think about rescue, transport, and what “austere” actually means.
Fresh Whole Blood Transfusion Training — Dr. Andy Fisher
These objectives align with military guidelines (e.g., Joint Trauma System Clinical Practice Guidelines for Whole Blood Transfusion), prehospital blood programs, and evidence showing improved outcomes in severe trauma with balanced resuscitation using FWB. Training should include didactic sessions, hands-on simulations (e.g., autologous draws where safe), competency assessments, and periodic refreshers (e.g., biannual), as FWB skills are perishable. If this is for a specific audience (e.g., combat medics, nurses, physicians, civilian EMS, or a particular program like Valkyrie), or if you’d like sample assessment methods, scenarios, or visuals (e.g., procedure diagrams), let me know for refinements!
Fixation Errors: When Good Providers Get Stuck — Sophie Fuller
This workshop aims for preparation for the situation of being in the austere environment for an extended period of time awaiting rescue in the situation of surviving a downed aircraft or emergency landing in an unplanned location. We practice hands-on for critical skills like intubations, finger thoracostomies – why do we not practice for when it may be our life on the line? In this time block, learners will gain the confidence and skills in starting and maintaining a fire with various methods as well as treating dirty water, two of the main priorities of survival in the austere environment. We will discuss where to build a shelter and things to keep in consideration as well as practice and discuss different signaling techniques.
Improvised Medicine: Field Hacks and DIY Training That Actually Work — Kyle Green, Andi Champion
This hands-on, no-slides workshop is built specifically for the Crash and Learn environment, focusing on real-world improvisation in EMS and austere medicine. Participants will engage directly with practical demonstrations and guided application of improvised techniques using common and unconventional materials. The session will cover field-expedient solutions for airway management, hemorrhage control, splinting, and patient packaging. Attendees will also build and use simple DIY task trainers, including bleeding control models and procedural trainers, using low-cost, easily sourced materials. Instruction is focused on doing rather than watching. Participants will rotate through practical evolutions, applying techniques in realistic scenarios that reinforce adaptability, decision-making, and problem-solving under constraint. This session is designed for providers who want to move beyond textbook medicine and develop the ability to deliver effective care when equipment is limited, environments are challenging, and conditions are less than ideal.
Just Another Airway Talk — Dr. Amanda Humphries, Dan Rauh
What is a conference without an airway talk? Are we legally allowed to talk about prehospital medicine without something titled “Resuscitate Before You Intubate”? What about an ode to ketamine? There is a never-ending barrage of information surrounding airway management. Come if you want to have a frank discussion about what works and what doesn’t, what can be simplified and what can’t, and how to bomb-proof your airway management algorithm, both against hostile airways, and flashy new techniques.
Man vs. Machine — Kenny Thompson
This presentation reviews a highly complex agricultural machinery rescue involving a patient trapped for approximately 2.5 hours in a remote rural environment during extreme cold-weather conditions. The incident required a large-scale, multidisciplinary response involving more than 40 firefighters, advanced life support personnel, heavy rescue operations, and coordination between multiple regional agencies and air medical resources from two states. Presented from the perspective of the lead paramedic firefighter overseeing the extrication, this case study examines the operational, medical, and logistical challenges encountered during prolonged entrapment with life-threatening traumatic injuries. Topics will include remote scene access, incident command considerations, prolonged field care, hypothermia mitigation, coordination of three medical helicopters, and the integration of trauma surgery consultation into field operations. The presentation will also explore the critical role this incident played in advancing prehospital trauma care policy in New York State. Due to the lack of blood products carried by New York State air medical programs at the time of the incident, out-of-state resources were required, highlighting a major gap in trauma response capabilities. This case ultimately contributed to legislative and operational changes that led to the implementation of blood product availability on New York State medical helicopters. Attendees will gain insight into complex rescue coordination, high-acuity prehospital decision-making, prolonged technical extrication strategy, and the evolution of trauma system preparedness driven by real-world operational experience.
My Patient is Yellow and Dying! Help! — Dr. Chris Galton, Eric Steward
During this discussion, we will start with a brief review of liver function and the pathology of cirrhotic liver disease. We will then follow a few different case presentations of acute vs acute on chronic liver failure. Using these cases, we will go through the pathophysiology to explain the signs and symptoms we pick up on when treating these patients. These two cases will progress from initial EMS contact, all the way through the hospital stays and everything that happens in between.
Non-Fatal Strangulation: Field to Follow-Up — Brittney Innis
Non-fatal strangulation (NFS) is not exclusive to domestic violence, intimate partner violence, or sexual assault. NFS can happen in an array of settings. Several examples include pediatric accidental strangulation, paratroopers/sky divers, belay climbers, attempted suicide, helicopter rescues such as Travis County Star Flight, and other high angle rescue. With new research supporting NFS as a traumatic brain injury, early identification of strangulation injury is imperative to ensuring appropriate evaluation and treatment of patients, which has been shown to improve outcomes. As this is an often, overlooked injury pattern, educating all providers throughout the continuum of care on the signs and symptoms of NFS is essential. This information allows first responders and ER staff to prepare for injury specific assessment, future airway management needs, spinal precautions, imaging, and in the event of DV, IPV, SA necessary forensic documentation. This also informs discharge planning as severe complications may be delayed up to 72hrs following initial strangulation. At my current facility we have a Forensic Healthcare Program that provides an array of specialized care to include sexual assault, child maltreatment, IPV, DV, as well as NFS. We have developed a protocol for assessing, imaging, and providing care to include follow-up.
OB Related Cardiac Challenges for HEMS — Dr. Chris Galton, Dr. Tyler Lemay
Dr.’s Galton and Lemay will start off this session with a brief review of a typical gestation and the standard physiologic changes that occur during pregnancy. From that framework, we will dive into peripartum cardiomyopathy, the causes, results, and what we need to do about it. The discussion will then transition into pregnancy related thromboembolic situations and the treatments available to pregnant patients. We will wrap up with the most challenging of these patients, those with complex congenital heart conditions that become pregnant.
Pre-Game the Pediatric Call: Three Cases That Changed How We Think — Oliver Boryszewski, Maribeth Vasquez
Pediatric calls have a way of getting in your head before you ever touch the patient. The bystanders, the equipment, the simple fact that it’s a kid: it all adds up fast, and before you know it you’re already behind. In this session, we’ll walk through three real cases covering pediatric trauma and a respiratory emergency, using each one to break down the pre-arrival decisions, early scene reads, and mental prep that made the difference between a good outcome and a bad one. The goal isn’t another algorithm to memorize: it’s to change how you think about the next pediatric call before the tones even drop.
Roll for Response: A Clinical Decision (After Hours) — Marley Blood, Kori Bow
Roll for Response is an interactive, scenario-driven training experience designed to build real clinical thinking—not memorization. Using a tabletop format with structured gameplay and randomized events, participants are placed into high-pressure EMS scenarios where decisions matter, conditions evolve, and outcomes are not guaranteed. This is not a lecture. Participants will work in small teams to assess, treat, and manage patients through dynamic scenarios that introduce complications, uncertainty, and real-world unpredictability. Clinical success depends not just on knowing protocols, but on adapting, prioritizing, and thinking critically under pressure. Throughout the session, participants will: Make time-sensitive clinical decisions Navigate evolving patient conditions Manage limited resources and unexpected complications Communicate and function as a team Each scenario is followed by a focused debrief examining decision-making, error recognition, and opportunities for improvement—mirroring real-world clinical reflection and quality improvement processes. Roll for Response challenges traditional EMS education by shifting the focus from what providers know to how they think. No slides. No passive learning. Just medicine, decisions, and consequences.
Simplified Hemodynamics: Understanding the Patho and Memorizing Numbers — Christina Philpott
Hemodynamics can make even the experienced clinicians head spin. This whiteboard lecture takes this complex topic and breaks it down into simple, digestible concepts. Let’s deep dive into the heart like Ms Frizzle from the Magic School Bus learn the pathophysiology of the heart, vasculature, and how changes in each can drastically effect your patient.
Swiftwater Decision Making Under Pressure: A Rescue to Recovery Case Study — Cylan Joseph Gosselin
This presentation examines a real-world swiftwater incident in Alstead, New Hampshire, from the perspective of a rescue swimmer directly involved in victim contact and recovery. Initially dispatched as a time critical rescue involving a child trapped in moving water, the operation rapidly evolved into a high risk technical scenario involving entrapment in a strainer, limited resources, and significant environmental hazards. An early “quick grab” attempt driven by urgency and the potential for survivability failed due to entanglement, communication breakdowns, and a lack of structured control. This moment became the turning point of the incident. Through a firsthand account, this presentation breaks down what it feels like to operate in that environment, the reality of making a hard grab in moving water, and the critical shift from impulsive rescue efforts to disciplined, system-based recovery operations. The discussion will focus on the transition from chaos to control: implementing a second system, slowing the operation, and ultimately achieving a successful recovery. Emphasis is placed on decision making under stress, scene organization, communication, and the importance of respecting the power of the environment. This is not just a technical review it is an honest look at what happens when things don’t go as planned, and how adapting in the moment can define the outcome for both the victim and the rescuers.
Ten Things Your Helicopter Driver Wishes You Knew — Shenandoah Whalen
This interactive session examines decades of HEMS accidents to identify recurring trends, common root causes, and the factors that continue to challenge safe flight operations today. Through real-world case reviews, crew resource management principles, risk assessment exercises, and audience-driven scenarios, participants will explore how proactive safety practices can prevent incidents before they occur. Beyond reviewing the past, this presentation focuses on building a stronger safety culture through simulation, structured debriefing, quality improvement, standardization, and effective use of Safety Management Systems (SMS). Attendees will leave with practical tools to improve situational awareness, strengthen crew communication, reduce human error, and make safer operational decisions every day.
The Power of POCUS — Julie Fleming
This comprehensive Point-of-Care Ultrasound (POCUS) course is designed to equip healthcare providers with the foundational knowledge and hands-on skills necessary to confidently integrate ultrasound into everyday clinical practice. Focused on real-world application, this training emphasizes practical scanning techniques, image acquisition, interpretation basics, and clinical integration at the bedside or point of care. Participants will gain a strong understanding of ultrasound physics and machine optimization, probe selection, and core scanning protocols. Applications may include FAST and trauma assessment, abdominal evaluation, obstetric assessment, musculoskeletal imaging, vascular access guidance, and other focused exams. This training is ideal for rural healthcare providers, physician assistants, nurse practitioners, emergency and trauma teams, orthopedic and physical therapy practices, and first responders seeking to enhance diagnostic capability and improve patient outcomes.
The Working Dog Patient: Field Medicine for Non-Handlers — Jay Christianson
This talk covers what non-handlers need when a working dog goes down: knowing the scope of your role, handling a stressed or injured animal safely, controlling hemorrhage, and catching shock before it kills. Saxby, a certified SAR K9, joins as a live demo dog for hands-on assessment and handling. Come learn to keep the dog in the fight, because the handler might just be counting on you.
Too Hot? Too Cold? Just Right? Management of Temperature Emergencies — Dr. Maria Kaisler
Cold and heat emergencies are common in EMS and are conditions that are crucial to recognize and initiate treatment before reaching a hospital. This lecture covers frequently-seen presentations of both types of temperature emergencies and includes a discussion of prehospital management.
Wanting the Pain to Stop (Fireside Chat) — Sean Barnette, Eddie Rice, Chris Smetana
First responders are trained to carry other people through their worst moments, but many quietly struggle beneath the accumulated weight of trauma, identity loss, addiction, broken relationships, and ineffective coping. Through honest personal stories and practical discussion, this two-hour session explores the unique vulnerability of first responders, the warning signs of addiction and emotional decline, and the many paths available for recovery. Speakers will examine identity beyond the uniform, traditional and emerging treatment approaches, faith, family, peer support, and the daily work required to remain present at home. Personal experiences with plant medicine will be shared as individual stories rather than universal recommendations, with clear acknowledgment of the legal, medical, and psychological risks. Participants will leave knowing they are not alone, healing is not one-size-fits-all, and there is real hope for recovery.
We Care About You: We Just Don’t Want to See You Again — Jennifer Knight
Redirecting High Utilizers to Real Care Through Mobile Integrated Health You know the address before dispatch finishes the tones. Frequent “flyers” aren’t the problem; they’re the predictable outcome of gaps in care. Chronic disease instability, behavioral health needs, social barriers, medication confusion, and limited primary care access create repeat 911 patterns. When transport becomes the default response, we unintentionally fuel the cycle. This session reframes high utilization and examines the consequences of the “transport trap” — cyclical ED use, deconditioning, polypharmacy risk, compassion fatigue, and mounting strain on both ground and air resources. Repeated transports don’t just impact patients — they drive avoidable costs, increase system congestion, and consume limited EMS capacity. Here’s the pivot: EMS doesn’t just respond. EMS recognizes patterns. Mobile Integrated Health (MIH) teams are built to close the gaps that traditional emergency response cannot, including next-day follow-ups, chronic disease stabilization, medication reconciliation, social service linkage, and coordinated care planning. When EMS identifies that a call represents a pattern rather than an isolated event, early MIH activation can interrupt repeat utilization before it becomes another transport. We’ll also explore the financial upside of doing this right. Effective MIH programs reduce unnecessary transports, decrease emergency department utilization, lower total cost of care, and create opportunities for sustainable reimbursement models through risk-based arrangements and payer partnerships. Redirecting appropriate patients isn’t just clinically sound, it’s operationally smart and financially responsible. Participants will leave able to identify red flags for repeat activation, make smarter triage and destination decisions, and activate MIH pathways that address root causes instead of repeating the cycle. Because transporting someone again doesn’t solve what made them call again. The goal isn’t another run report. The goal is coordinated care, and a patient who no longer needs 911.
What in the Accident?! Reviewing 25 Years of HEMS Accidents — Matthew Tannozzini
I have been working on an article that reviews the past 25 years of HEMS accidents. The information is reviewed from Federal Aviation Administration (FAA) and the National Transportation Safety Board (NTSB). (The FAA compiles and distributes an annual summary of data collection on helicopter medical operations to the federal government. The NTSB provides a database called the Case Analysis and Reporting Online (CAROL). This database was utilized to compile the accident data. ) In review we can look at what the common trends have been in causation, phase of flights, actual risk of flight compared to registered aircraft, most at risk states based upon trending data, and more importantly what we can do to improve!
When Reperfusion Isn’t Enough — Collin Grothaus
46 y/o male with PMH of smoking. Presented to ED with chest pain – inferior STEMI. Underwent successful PCI (angioplasty) to PDA. Admitted to ICU. Stable on POD 0. On POD 1 developed sinus tachycardia with shortness of breath. No significant hypoxia. Given 2L fluid – no improvement. Formal Echo with LVEF 55%, no other significant abnormalities noted. CT PE and Dissection Study done and negative. I came on to cover night shift, found patient with HR 130, RR 40, BP 85/52, spo2 92% on room air. Diaphoretic, clammy, slightly altered mentation. STAT labs showed WBC 14, Cr 1.76, HCO3 18, AG 21, ALT 249, AST 236, Lacate 4.0. ABG: pH 7.52, pCO2 23, PO2 59. CXR with patchy bilateral infiltrates c/w pulmonary edema. EKG with mild ST elevations in inferior leads (improved from pre PCI). Continued to decompensate. Started on Norepi. Developed worsening respiratory failure – intubated and placed on ventilation. BP improved with Norepi but repeat labs at 2 hours with worsening organ function and increasing lactate. PA catheter placed. Hemodynamics: svo2 87, RA 18, PA 51/30, PCWP 32, CO 13.9, CI 7.3 Elevated filling pressures. Exam he was cold/clammy. Labs showed end organ malperfusion. But hemodynamics pointed away from cardiogenic shock. Given abx to cover for sepsis. Continued to worsen with increasing norepi, started on Vasopressin. Ultimately called multidisciplinary shock team for eval. Transferred to tertiary care center. Repeat ScVO2 from distal CVC port showed svo2 58 – FICK CI 2.2. Due to discrepancy, a STAT TTE obtained and showed septal wall rupture post STEMI. Large VSD with left to right shunting. Treated with Impella therapy. Ultimately expired after prolonged ICU stay due profound multiorgan failure and inability for definitive repair of VSD.
Where’s My Husband? Avoidance, Ethics, and Psychological Perspectives of Death Notifications — Alexandra Jabr
This lecture explores the challenges of delivering death notifications, focusing on the psychological barriers that often lead to avoidance for providers. Through a group-centered discussion, participants will engage in an ethical dilemma scenario to understand the complex factors at play, such as empathy, discomfort with uncertainty, and emotional burden. We will examine why professionals might avoid these difficult conversations and how this avoidance can impact both the messenger and the recipient. This lecture will offer practical tools and strategies to help participants address these challenges effectively, preparing them to deliver difficult news with more confidence, clarity, and compassion during their next notification.
Disclaimer
Crash and Learn educational offerings are subject to change. Sessions may be modified or canceled based on instructor availability and conference scheduling. Attendance does not guarantee participation in specific presentations.