Available courses

Pharmacotherapy for the Resuscitationist. The Latest and Greatest Medications in EMS—On Demand

Resuscitation of the critically ill patient involves a concerted effort with the utilization of potentially several medications. This lecture will discuss the hottest and most current topics in EMS including the role of push dose pressors, droperidol in decompensated agitated delirium, the multifaceted roles of ketamine, and much more. This lecture will also review controversial topics of pharmacotherapy in the pre-hospital setting and will review the evidence supporting life saving medications in critically ill crashing patients.
Learning Objectives:

Discuss the multifaceted role of ketamine in the pre-hospital setting
Discuss the utility and nuances of droperidol for agitated delirium
Describe the major indications for push-dose pressors and their role in preventing peri-intubation hypotension

Bridging the Gap–Ops and Admin Working Together–On Demand
  • Enrollment on payment

Using case studies from the Philadelphia Fire Department, this presentation will explore the synergy achieved by a close working relationship between operations and administration in an EMS system. We will explore the process by which a disconnected relationship between these task groups presents a barrier to success and quality improvement in a large EMS system. Operation Allies Welcome can be characterized as a months-long MCI in which Philadelphia EMS assisted with medical care for 29,713 refugees on over 300 flights. This operation required "all hands on deck" and was only successful through strong inter- and intra-department collaboration. This strengthened relationship within PFD EMS led to an innovate overdose tracking system which utilizes administrative data and real-time feedback from operations officers to identify overdose spikes and offer immediate harm reduction services in small target areas within the city. We are together stronger than the sum of our parts.
Learning Objectives:

Upon completion, participants will be able to analyze the current disconnect that often exists between administration and operations in EMS, and the impact it has on our EMS systems.
Upon completion, participants will be able to evaluate the effect of bridging this gap through a specific and data-driven case study arising from PFD’s overdose response initiative and tracker development.
Upon completion, participants will be able to improve their own EMS system's collaboration between operations and administration from a goal-oriented mindset.

Poisoned Apples—How to Manage Toxic Employees—On Demand
  • Enrollment on payment

Shiny on the outside, not so nice on the inside. Toxic personnel has the potential to devastate an agency. They hurt morale, sabotage attempts at change, and can be notoriously difficult to get rid of. This is especially true if they are high performers, popular, or deeply ingrained in the pre-existing culture. They are also highly contagious -- the longer they go unaddressed, the more personnel they can pull to them. This presentation will look at different types of problem employees, how to recognize them and why they happen in the first place. Is it just who they are, is it the result of stress or burnout, or is it a reflection of the leadership? When it comes to the health of your agency, it's crucial to recognize them early, discover the root cause, and address them in a fair and equitable manner. We will discuss tips on writing effective briefs that address behavior, using evaluations effectively, and how to structure improvement plans or to apply discipline appropriately.

**This topic ties in with recruitment/retention and speaks to agency culture as well. This is good for incoming managers.**
Learning Objectives:

Describe toxic behavior in the workplace.
Identify strategies to curtail negative interpersonal behavior.
Evaluate underlying causes for toxic behavior.



We Can't Punish Our Way to Better Quality—On Demand
  • Enrollment on payment

Historically, organizations have followed the "name, blame, and train" model of quality improvement, and yet, we continue to be plagued by substandard patient outcomes. Our investigations have focused on our people rather than the systems in which they operate, and our people became the broken part that needed to be fixed. Resilient systems are built to withstand inevitable human error, not to prevent it or punish for it. In this discussion, we will use real case examples to understand why a systems-based approach is better for the people we lead and the patients that we care for.
Learning Objectives:

Upon completion, the participants will be able to describe why punishment for simple human error is counterproductive to quality improvement.
Upon completion, the participants will understand several ways in which system factors contribute to human errors.
Upon completion, the participants will be able to describe how system resilience in patient safety relies on expecting rather than preventing human error.



Sign Here: A Practitioner’s Guide to Patient Refusals—On Demand
  • Enrollment on payment

The most critical clinical decision a provider can make is not at the devastating car wreck or the witnessed cardiac arrest; it’s during a patient’s refusal of care and transport, the most common incident encountered by most responders. How are you managing refusals on scene? Does your service use provider-initiated refusals or alternative transport destinations? Can your refusal documentation stand up in a court of law? Nick, an EMS Division Chief with over two decades of emergency response and quality assurance experience, and Samantha, an attorney for one of the largest hospital-based EMS systems in the Southeast, examine the clinical, legal, ethical and operational implications of patient refusals. Providers, administrators, and educators will benefit from this practical and interactive street-level approach to managing and documenting patient refusals. Nick and Samantha discuss a consistent method that enhances clinical judgment and acts as a checklist for legally compliant documentation. Using actual incidents and reported legal cases, Nick and Samantha offer tips and tricks for responders to protect themselves and their services from legal liability.
Learning Objectives:

Examine the clinical, legal, ethical and operational issues associated with patient refusals.
Analyze the legal impact of provider-initiated refusals and alternative transport destinations.
Demonstrate the role of documentation in reducing legal liability for patient refusals and use the CURED mnemonic for more effective charting.

The Law and You: What You Need to Know—On Demand
  • Enrollment on payment

In this entertaining and informative session, Mr. Nagorka will take you through the world of the law and will show how it applies to you in your everyday practice.
Learning Objectives:

Recognize the difference between the civil and the criminal systems.
Gain an understanding of how the standard of care evolves and changes.
Learn how to talk more effectively with lawyers and their staff.

Managing Traumatic Stress to Build a Mentally Resilient Workforce—On Demand
  • Enrollment on payment

The nature of work Emergency Medical Services (EMS) responders face day to day is widely acknowledged to be stressful and has the potential to affect an individual’s mental health (Anwar et al, 2019). This persistent occupational stress can result in a variety of mental health conditions, such as depression, anxiety, Post Traumatic Stress Disorder (PTSD) and can be a factor in suicide (Kings College London, 2020). It is imperative that EMS organisational leaders not only understand the risks but are well equipped to support responders at the earliest opportunity in line with best practice. The wellbeing of responders has a direct correlation with the quality of care they deliver to patients (Meadley et al, 2020).
There is a wide variation of support systems being utilised across different EMS providers. Unfortunately some are antiquated and no longer follow the latest evidence whilst some providers negate their moral and legal responsibility to support their responders. The use of an evidenced based peer support system as opposed to a managerial led programme will encourage individuals to access support independently, provide a cost-effective solution and should be relatively easy to implement (Lawn et al, 2020. Smith et al, 2022).
Learning Objectives:

Describe the psychological effects of type 1 and type 2 trauma as well as moral injury, recognise the early signs of mental health deterioration and react appropriately.
Define positive effects of having a robust peer support programme in place and understand how to implement such a tool, including supporting and equipping first-line managers/leaders.
Demonstrate how to approach support in a holistic manner and be able to identify the elements of support which should be prioritised.


A Conspiracy! How Hidden Curriculum and Bias May Be Affecting Our EMS Learners—On Demand
  • Enrollment on payment

Did you hear, racial minorities and women are less likely to be represented as EMS providers in textbook imagery than white men?1
Do you ever feel the standard EMS curriculum is inadequate for topics related to LGBTQ and Black, Indigenous, and People of Color patients? Do you ever insert discussions or topics into courses that you feel are pressing or relevant?
Could the practical scenarios and context we provide our students affect the bias of our learners?2-3 Does that bias transfer to their patients?4
Come explore how the topics we include and omit in our courses may be affecting our learners’ beliefs and what you can do to mitigate this phenomenon in your classroom.
Learning Objectives:

• be able to define and describe bias in education.
• be able to identify areas of potential bias in their educational setting.
• establish multiple bias-centered action items for their teaching practice.

Don’t Sleep on It: Legal and Clinical Risks of Fatigue in EMS—On Demand
  • Enrollment on payment

Fatigue-related incidents are a significant liability risk to providers and their agencies. Nick, the EMS Division Chief for one of the largest county-based ALS first response agencies in Georgia, and Samantha, an attorney for one of the largest hospital-based EMS systems in the Southeast, examine the legal and clinical risks of fatigue-related events. Using actual incidents and reported legal cases, Nick and Samantha offer tips and tricks for providers, administrators, and educators to recognize and mitigate fatigue-related risks.
Learning Objectives:

Identify and discuss areas of potential fatigue-related liability for EMS providers.
Describe characteristics of successful fatigue management programs.
Demonstrate practical strategies for integrating fatigue management into departmental training and operations to allow providers and administrators to recognize and mitigate fatigue-related risks.

How Technology & Data Can Help Prevent Injuries in First Responders—On Demand
  • Enrollment on payment

In the U.S., more than 1 million firefighters who work tirelessly keeping our communities safe. Firefighting is one of the most physically demanding occupations in our country, requiring these professionals to maintain a high level of fitness for more than 20 years before being eligible for retirement. To illustrate this point, 44 percent of all firefighters suffer sprains or strains while on duty (Paete et al J Occ Med Tox 2007). Firefighters have the highest injury rates of all U.S. occupations with 8.5 injuries per 100 full-time-equivalent (FTE) workers (Reichard et al Am J Ind Med 2010).

The movement patterns that put physically active personnel at risk for preventable MSK injuries can be assessed in baseline physicals (Nessler et al Cur Rev Musculoskelet Med 2017) to enable institutions to develop better programming based on those individual variances. During this presentation, Dr. Nessler will present the latest research on musculoskeletal injuries in firefighters and how, by leveraging technology and mass data, we can develop much more comprehensive programs to truly impact musculoskeletal injuries.
Learning Objectives:

Participants will have a good understanding of all the latest research related to musculoskeletal injuries in first responders
Participants will gain an appreciation for all the intrinsic factors that increase risk for musculoskeletal injuries
Participants will understand how mass data can be leveraged to create a more comprehensive program to address the complexity of musculoskeletal injuries

Mindset Over Matter—On Demand
  • Enrollment on payment

“Mindset Over Matter” is a first-hand tale on why a paramedic decided to leave her life in EMS behind and take on the most physically challenging trail in the United States! Amanda made a decision that without a doubt changed how she saw people, how she viewed the world, and how she understood herself. With seemingly little warning, Amanda tendered her resignation as a Paramedic-Lieutenant for a 911 EMS service and left EMS. Three months later her dad dropped her off in Georgia, alone, with one goal: Thru hike the entire Appalachian Trail. With twenty-five pounds of only the essentials in her backpack, the thirty-three year old paramedic traded shift work for seven and a half months of living in the woods and hiking nearly twenty two hundred miles. She endured harsh weather, a regional drought, rugged terrain, and so much more on a journey that evolved her in ways she could not have ever imagined. After deciding to return to EMS, Amanda now brings her story to fellow providers in hopes to help them strengthen their resiliency, re-direct their mind during trying times, and to look at their life with an improved perspective.
Learning Objectives:

Upon completion, participant will be able to recognize the signs and symptoms of burn out within the EMS field.
Upon completion, the participant will be able to understand when it is time to act on these signs and symptoms to cope with burnout or make a change.
Upon completion, the participant will be able to utilize mental techniques and strategies to not only handle burnout, but day to day difficulties that arise in their life.

Resuscitation Lead, Follow, or Serve as an Example of What (Not) to Do—On Demand
  • Enrollment on payment

The AHA establishes BLS and ALS treatment guidelines based on the strongest evidence available. Because their guidelines need to be broadly applicable the guideline writing committees take a very conservative approach to changes in response to available literature. BUT, from where does the evidence and literature emerge? It comes from systems that do not necessarily follow the guidelines. That is correct, systems violate the AHA guidelines. This is necessary for the evolution of resuscitation. This talk will describe the approach to the establishment of a resuscitation program custom tailored to fit the needs of a large urban fire based EMS system. We will discuss the QA/QI requirements, regulatory hurdles, and education need to establish best practices for the local environment.
Learning Objectives:

Discuss the implications of diverting from AHA Resuscitation Guidelines
Discuss issues such as National Registry and state regulator considerations
Discuss the inclusion of research into the clinical practice of EMS

Deep Dive—Ketamine: Old Drug, New Uses, New Concerns—On Demand
  • Enrollment on payment

3:00-3:05 Moderator-Michael Dailey | Overview & Introduction
3:05-3:20 Speaker-Kristopher Thompson | The Continuum of Ketamine from Analgesia to Dissociation
3:20-3:35 Speaker-Michael Bernhardt |History of Ketamine (12 min) and German Indications and Use of the Medication (3 min)
3:35-3:50 Speaker-Eric Jaeger |Reducing the Risks Associated with Physical and Chemical Restraint
3:50-4:05 Speaker-JayTee Barbour | Ketamine for Rapid Sedation of Agitated Delirious Patients – Is there a downside?
4:05-4:20 Speaker-Brooke Burton |Quality improvement and data perspective of managing cases with Ketamine
4:20-4:35 Speaker-Brooke Burton |A Team Approach to Catecholamine Surge: Are traditional ketamine administration methods killing people?
4:35-4:50 Speaker-Doug Wolfberg |When do Clinical Errors and Protocol Deviations go from Negligence to Crime?
4:50-5:15 Panel |Q&A/Discussion

Instruction for Brilliant Documentation—On Demand
  • Enrollment on payment

Documentation is the single most common procedure in EMS. Poor documentation contributes to adverse legal outcomes, clinical errors and can hinder, or even end, the career of an individual EMT. There’s not much instructional time in our initial training to develop good documentation skills. With so much riding on this skill, it's a shame that we don't train for excellence. This workshop takes a fresh look at teaching students what to write and how to write it. No need to become an English teacher, or revamp an existing training program, instructors will learn how to add as much as 5 hours of documentation instruction without changing their current syllabus. During this highly interactive workshop instructors will investigate classroom practices that turn experience in the field into words on a PCR.
Learning Objectives:

Discover methods to incorporate documentation instruction into their existing training program.
Participants will encounter instructional methods that help students translate field experiences into effective, clinically appropriate writing.
Participants will examine effective Q/A practices including self assessment and external Q/A Explore common free tools for effective writing

Advanced Community Paramedicine Team Building-Diversifying Your Practitioners—On Demand
  • Enrollment on payment


Although Mobile Integrated Health-Community Paramedicine has been practiced for many years, few communities have a robust portfolio of programs like Crawfordsville, IN. In their endeavor to address healthcare issues and gaps in their communities, Crawfordsville, IN implemented numerous MIH-CP programs including chronic disease management, maternal and infant health program, an overdose response program, aimed at protecting all citizens cradle to grave. These programs have marked their success through collaboration between multi-faceted partnerships, but most recently through the integration of non-traditional roles within their paramedicine programs.

In this presentation, you will hear from experts in nursing, social work, public health, and how they expanded their roles alongside community paramedics using a comprehensive approach to patient care. Featured with stories of how the addition of these personnel helped bridge gaps within care through education, access to services, and program evaluation to reach holistic care.
Learning Objectives:

Identify ways to implement social work and nursing into non-traditional settings.
Define and summarize several challenges and strengths of multisystem MIH-CP programs.
Consider the community needs and match program components to those needs.

Community Paramedicine: An Approach to People's Social Determinants of Health vs. the Traditional Clinical Approach—On Demand
  • Enrollment on payment



Healthcare disparities exist in all genders, ages, races, ethnicities, and sexual orientations. Treating patients like checklists has created a systemic loss of respect for healthcare professionals. Community paramedicine programs create a unique opportunity to approach community medicine by focusing on social determinants of health, that impact a patient's overall well-being and ability to self-navigate their personal goal, as well as healthcare goals, that are important to them. Giving a patient the ability to feel in control of their lives in critical moments, is a new gift we can deliver to our communities.
Learning Objectives:

Upon completion, participants will be able to define social determinants of health and give examples.
Upon completion, participants will be able to discuss existing health disparities in the United States, and further discuss ways to help patients and communities overcome them.
Upon completion, the participant will be able to evaluate the pros and cons of traditional clinical healthcare approaches and those of social determinants of health.

Are You With Me? Managing EMS Student Bias to Improve Health Equity—On Demand
  • Enrollment on payment

Understanding how bias develops in all of us can lead to the possibility of managing student perceptions as they prepare for an EMS career. Introducing topics of stereotype and racism is a difficult but necessary challenge in the EMS classroom, and we'll discuss how this can be accomplished to the benefit of patient care.
Learning Objectives:

Explain how and why bias is considered an inherent human trait.
Discuss how managing bias through reflection and action can lead to improved learning outcomes.
Identify at least two learning activities that can be used in the classroom to surface bias.

Implementing an Evidence-based Wellness Program for EMS Professionals—On Demand
  • Enrollment on payment

The Goal of Public Safety is to support, “A secure and resilient nation with capabilities required across the whole community to prevent, protect against, mitigate, respond to, and recover from the threats and hazards that pose the greatest risk (Department of Homeland Security, 2022).” A critical component of the public safety infrastructure is the people. With the rising trends in posttraumatic stress, anxiety and depression facing the population, many departments are turning towards implementation of robust wellness programs in which to address these issues.
But implementing a wellness program is not a simple task. Often, individuals are tasked with implementing a program with little to no background in complex issues that would be addressed through a comprehensive wellness program. Passion for the subject can only take an individual so far, and sustained efforts require an evidence- based framework in which to implement, intervene, and demonstrate effectiveness of the wellness program for the public safety organization.
This presentation will review the steps in implementing an evidence-based wellness program that will be tailored towards the needs of the emergency medical professional population, provide solutions that apply across all public safety professions, and address the opportunities and challenges inherent in implementing wellness programs.
Learning Objectives:

Upon completion of this session, participants will be able to describe an evidenced based framework for implementation of first responder wellness programs
Upon completion of this session, participants will be able to discuss lessons learned and best practices from national wellness program efforts
Upon completion of this program, participants will be able to utilize tools to develop targeted interventions for their specific populations.


Wake Up I am Tired!—On Demand
  • Enrollment on payment

Sleep deprivation may just be the root of all evils when it comes to the safety of our personnel. Various studies have proven that sleep fatigue causes heart attacks, vehicle crashes, depression, cancer, and other diseases. Emergency service personnel live a life in their career sleep deprived. Join Dr. Lindsey as he discusses the issues surrounding sleep fatigue and the various options of dealing with this issue.
Learning Objectives:

Discuss the issues surrounding sleep deprivation.
Discuss the negative outcomes of sleep deprivation.
Explain the alternative choices to reduce sleep fatigue.

Time is Brain: The Future of Stroke Response via Mobile Stroke Units—On Demand
  • Enrollment on payment

Stroke, for decades, has been a leading cause of both death and adult disability worldwide. The often-repeated adage for stroke recognition and treatment is, “Time is brain.” For every minute a patient suffers a stroke they can lose 2 million brain cells and add an extra week to their rehabilitation. The goal, historically, for EMS stroke care was stabilization and expedient transport to the nearest and most appropriate stroke capable facility.
Then in 2010, the first ever Mobile Stroke Unit (MSU) was launched in Saarland, Germany. Introducing an EMS vehicle that brought stroke diagnosis and treatment to the pre-hospital setting. Since then, more than 20 units in the US and 40 units worldwide have begun delivering direct, advanced neurological care in their communities. Recent studies have demonstrated that not only do MSUs deliver treatment to more eligible patients; they deliver life altering treatment faster than traditional EMS to Hospital models. Our Columbus, OH based Mobile Stroke Treatment Unit has not only replicated these results but improved and expanded becoming one of the busiest mobile units in the U.S.
Learning Objectives:

Upon completion, participant will be able to understand how mobile stroke units operate and how they can augment EMS response to stroke.
Upon completion, participant will be able to explain the benefits that mobile stroke units have regarding patient care and outcome.
Upon completion, participant will be able to discuss potential improvements to EMS screening of stroke and appropriate triage of patients.


How Do I Defend You? — On Demand
  • Enrollment on payment

When swamped with calls, you need to make the best use of your time. Patient care documentation consumes a lot of that time yet is so essential to all that we do as EMS practitioners. Yet we often use words and phrases in documentation that are not descriptive and that don’t help paint the picture of the patient’s condition – those words are essentially meaningless, so why waste your time writing them? This session will highlight the top 8 meaningless phrases we see in PCR documentation and provide strategies for “making every word count” in your PCR, and hopefully make your job a bit easier!
Learning Objectives:

Identify eight phrases that provide no substantive value to describing the patient condition in EMS documentation
use more descriptive words in creating a clinical narrative that describes the patient's condition
better organize the PCR to ensure that all words are effective and help paint the picture of the patient's condition and improve the efficiency of report writing

Patient Satisfaction Surveys: A Large EMS System Experience in Engaging with Patients About Their Care—On Demand
  • Enrollment on payment

CEMS randomly solicits feedback from 35% of the patients who are treated and transported by our service each month. Beginning in July 2020, CEMS also sends an electronic survey to patients that provide a mobile phone number to the EMS crews. With the results of this survey, we’re able to evaluate our service and compare our agency to others nationwide.
Learning Objectives:

Upon completion the participants will use actionable information, design, methodology and valid data in their EMS agency.
Upon completion the EMS clinicians and leaders will identify the best practices and solutions for relevance to the EMS community.
Upon completing the participants will provide feedback on the value of real-time EMA Patient Survey results.

Emergency Medicine Physician EMS Telehealth: Leveraging Partners / Force Multiplier—On Demand
  • Enrollment on payment

Prehospital care is initiated and managed unilaterally by local emergency medical service (EMS). The majority of patients, regardless of severity are transported by the most expensive mode of transportation (ambulance) and to the highest cost destination (hospital). Conversely, the CDC views Population Health, as an opportunity to utilize non-traditional partnerships among health care systems, industry, local government, and organizations to work together to improve patient outcomes.
Houston Fire has successfully triaged 31,328 patients by telehealth Emergency Medical Physicians (EMP) and 28,123 (90%) patients were transported via non-ambulance methods from December 2014 through November 2022. Medics complete a patient assessment and transfers the ePCR and contacts the physician, who accesses the patient via real-time video/voice conferencing and determines the appropriate disposition. Once triaged, patient transportation is determined by the physician (taxi, ambulance, self-transport) and destination is decided by patient/physician (clinic, emergency department, home care).
After EMS leaves the scene, ETHAN patients can contact the Nurse Health Line for assistance regarding care, transportation, and destination. Recently, our regional Health Information Exchange began providing blinded managed care indicators to the ETHAN Physicians portal for payor/health plan patient navigation, both supports the CDC Population Health utilization algorithm within the EMP telehealth model.
Learning Objectives:

1. To become familiar with the how ETHAN patients are triaged by emergency physicians for prehospital alternative transportation / destination in a major metropolitan fire-base EMS system.
2. Observe how ETHAN will successfully increase efficiency and reduced cost of emergency care by reducing the utilization of EMS and emergency departments.
3. How the ETHAN program utilizes its partners to increase patient satisfaction and outcomes.




Hugs, Thugs, Maybe Drugs: Real Cases of Crises, and How we Respond—On Demand
  • Enrollment on payment

Whatever you want to call it, we all know that uncomfortable gray place in dual diagnosis management. Poly substance abuse, mental illness, compounded with unpredictable, wild and bizarre behaviors is this a policing problem, community mental health or EMS. How you handle these calls is largely the interchange between location, resources, and community standards. But, experience and knowledge can influence how successful you are.
Learning Objectives:

Appraise personal experience with patients in crisis, and the group’s collective scope of experience in mental health encounters (and/or possible mental health) in EMS
Discuss decision making when dealing with patients in crises: What is crises and who experiences them with reflection on case studies and experiences.
State intervention goals, and potential outcomes for dealing with crises. Apply objective signs of substance impairment.

Bias in Care: Enhancing Equity in the Prehospital Environment—On Demand
  • Enrollment on payment

I treat all my patients the same. That is what just about any EMS provider will tell you.
And yet, whether in a living room, a street corner, or the back of an ambulance, we find that is not the case.
Women in cardiac arrest are less likely to receive the critical lifesaving interventions.
Hispanic patients are less likely to have their stroke symptoms recognized.
African Americans patients are less likely to have their pain treated.
Why is this? How do we know this? And what can we do about it? How can I take my paramedics and EMTs—and you take yours—from a state of “I treat everyone the same” to a state of “equity matters to my patients, to my community, and to me.”
Value:
This talk will focus on EMS clinicians and leaders roles in promoting equity in care with an emphasis on solution-based best practices.
Action:
We will discuss a stepwise, implementable approach—understanding inequity, defining equity, ensuring accurate and comprehensive data collection to recognize disparities, and of course, using that data to educate, inform, and ultimately improve the care for your population.
Learning Objectives:

Upon completion, participant will be able to demonstrate a common understanding of equity and how it applies to prehospital care.
Upon completion, participant will be able to understand the inequities in patient care found in EMS systems across the country.
Upon completion, participant will be able to develop a step-wise approach to understanding, targeting and improving equity in their EMS system.