Agenda—Day 3

Friday, March 5, 2021 | 12:00-4:00 PM ET

12:00-1:00 PM Classic, Confusing, and Confounding Cases in Emergency Cardiology (ALS)

Speaker: Amal Mattu, Corey Slovis

Emergency cardiac conditions are common in acute care medicine, and they represent high risk for morbidity and mortality, and also high risk for misdiagnosis. In this session, the speakers will discuss four common pre-hospital case presentations which are easily associated with misdiagnosis by acute care providers. In each case, proper diagnosis leads to a good outcome, but misdiagnosis often leads to disaster.  A Live Q&A will follow.

1:00-2:10 PM  Neurological Emergencies (ALS)

Speakers: Peter Antevy, Rob Dickson, David Miramontes 

Doing a proper neurological assessment using new tools and stroke scores is key to making a proper transport decision. This talk will explore the different types of strokes, and include the confounder of dizziness. Attendees will review the differentials that can present with dizziness.  Finally, the San Antonio Fire Department EMS Office of the Medical Director has developed new destination bypass protocols for Comprehensive Stroke Center patients. Dave will discuss the validation of the VAN stroke severity score and how his area is using such to divert eligible patients to Comprehensive Stroke Centers. A live Q&A will follow.

2:10-3:10 PM  Treating Trauma (ALS)

Speakers: William Heuser, Babak Sarani

We will review studies related to pre-hospital transfusion, TXA administration, and transport modality. This session will also address the controversies surrounding medications used in trauma. The use of tranexamic acid for all types of trauma, epinephrine in traumatic arrest, ketamine as the induction agent of choice, the ideal analgesic in a trauma patient, ICP reduction strategies during peri-intubation, etc. will be discussed as well as the literature supporting these topics. Medication treatment pearls will also be discussed as it pertains to the medications used in trauma patients. A Live Q&A will follow.

3:10-4:10 PM  Case Studies: Bariatric, Psychologic, Gynecologic (Special Populations) 

Speakers: Melissa Kroll, Takeshia Williams, Natalie Zink

Missouri's Christian Hospital EMS (CHEMS) provided care to a patient weighing approximately 1,625 lbs. including in-home treatment with medical direction from Washington University, state resources, hospital administration, hospice, behavioral health, and our mobile integrated health team.  We will demonstrate the role EMS played, identify resources needed, list barriers to care and solutions, explain the multisystem approach for transportation, and lessons learned. This session will then explore the psychological impact on children, adolescents, and their families associated with acute injury and chronic illness, including the toll it takes on the provider. Finally, Natalie will discuss EMS’s gender disparity, especially in leadership and education, which has all sorts of effects on the field. One is noncomprehensive education about female reproductive health and related emergent complaints. Gynecologic emergencies are often only glossed over in the “special populations” module of medic school.  A live Q&A will follow.