Monthly Archives: February 2016

EMS Today 2016 Review

It was my privilege to have been selected as the Official Blogger of the EMS Today conference for 2016. Like my predecessor, Tom Bouthillet at the EMS 12-Lead blog, I took that role very seriously and visited as many of the sessions, vendor exhibits, and even socials (they are definitely part of the experience) as I possibly could. Throughout the conference I posted my impressions live on Twitter through my @hp_ems account using the hashtag #EMSToday2016. But I know many people either couldn’t, or simply didn’t, watch that whole feed over the four days that I was tweeting live, so I felt a summary blog of the highlights was definitely in order. If you were there, I hope I saw you and that my remarks will echo your own experience. But I would also like to ask that you include your own impressions as comments at the end of this post. If you weren’t there, you missed a lot. And hopefully for you, this article can provide justification for you to make the trip to Salt Lake City next year for EMS Today 2017.

The very first time I attended an EMS Today conference, I arrived on the first day of the show only to discover that I was actually more than 24 hours late. By not arriving early, I had missed tons of great content presented during the pre-conference sessions the day before. While they definitely add an expense to attending the meeting, they also add anywhere from 4 to 8 hours of detailed content (as well as CEH) that you just won’t get in the faster paced 60-minute sessions of the rest of the conference. This year, I opted to attend an afternoon cadaver lab hosted by Teleflex. Training with manikins and simulators is great, but it can only take your skills so far. But flushing a proximal humerus IO access with the chest cavity open, allowed me to witness first-hand the short vascular distance from the infusion point to the heart compared with femoral access. In addition, we had plenty of time to practice ETI with various devices on many different patients. I also had the chance for my very first surgical cricothyroidotomy. While the practice of these skills was highly valuable, the opportunity to simply hold the lungs while they were ventilated and explore the chambers of the heart with my finger were enlightening beyond imagination. Nearby, was another very popular choice for a pre-conference class in the Active Shooter Simulation. It was unfortunate, but just the evening before this shooter simulation class was a vivid reminder of its importance to us in the form of a gunman who killed 3 and wounded 14 more in Hesston, Kansas. Violence leading to an MCI can clearly happen anywhere and we must all know how to respond. Thanks to this timely offering, many more EMS providers are now better prepared.

Moving quickly from the lab to change my clothes, I headed for the formal EMS10 awards ceremony. This invitation-only event hosted by Physio-Control was an opportunity to rub elbows will the people marking their mark to improve the level of care in EMS today. You can always read about the 2015 EMS10 recipients and their innovations, but by being here I was able to run into them several times throughout the conference and even had the chance to speak with some of them to learn their detailed stories.

The next day (which officially began the conference) started early with sessions beginning promptly at 8AM. I was given reasons to consider “Point of Care Testing” by Kevin Collopy who helped me better understand what we can, and cannot, do today based on federal CLIA regulations and why to consider accreditation. Next was Jonathan Washko discussing the success of community paramedicine at North Shore LIJ EMS. The best part of being at a conference with such notables is hearing comments that challenge your work. Jonathan asked “if you can’t manage yourself, or control your own emotions, how can you manage others” and reminded us that it is “the strongest leaders who ask for help.” Then from my virtual visit to NYC, it was on to a global view of self-regulation in paramedicine with Michael Nolan, Gary Wingrove, Becky Donelon, and Peter O’Meara. A couple of great lines prompted a shift in professional thinking, like when being told that “as paramedics it is time to ‘move out of mom and dad’s basement'” and as we argue over the universal meaning of “paramedic” (or “ambulance driver”), “the patient, the media, and your mother should all know what to call you!” Over in the room where Ray Barishansky spoke on “proactive professionalism,” it was crowed as he said “we as a profession have let ourselves down with our behaviors, low pay, and attitudes.” Ray also reminded us that it is “professional EMS providers who own their mistakes, are respectful, and are always advocates for the patient” and asked us to give further thought to the idea that “93% of how you’re judged is based on non-verbal data.”

Plenty of more data was presented at the Prehospital Care Research Forum session hosted by David Page where I am proud to say North Carolina was nicely represented. We also learned interesting tidbits in these lightning talks such as “volunteer EMS services are 27% more likely not to transport (also to accept refusals, or do ‘treat and release’) than paid services” and that the gender differences in the use of restraint (chemical or physical) is not about the sex of the patient, but more likely to happen with male providers even though female providers are the ones statistically more likely to be assaulted. Matt Zavadsky along with Rob Lawrence (filling in for Nick Nudell) also presented plenty of facts in their session on the Data Dichotomy of the current EMS payer landscape. All of these sessions were going on as the JEMS Games preliminary competitions were being held to see who could brag about being the best of the best in EMS. If you want to see how challenging these “games” can be, here is a quick view of the obstacles that participants face to prove they can handle the job.

It was the mid afternoon that the official opening of the conference was held with all of the pomp and circumstance (including fifes, drums, and bagpipes) that you expect at any public safety conference. There was a somber recognition of our brothers and sisters in EMS who have answered their last call due to LODD along with multiple awards and a stirring multi-media presentation by alpinist Brian O’Malley. The prestigious James O. Page award went to NEMSMA for this ground-breaking whitepaper aimed at preventing EMS provider suicide. There was also a brief visit from Maurice Davis to promote his tribute designed to raise awareness and remove the stigmatism that keeps EMS providers, the military, and many others silent and leading all to often to “The Wrong Goodbye“. The video depicting the impact of suicide is something we should all be sharing with our friends.

It is after the keynote presentation that the exhibit hall opens for a brief reception. If you didn’t get to see it, follow along with a bodycam highlight video of the exhibit hall from my friend Jeffery Armstrong. I must also recognize the generosity of Limmer Creative who donated several of their LCReady classes for me to give away during the conference for people who were able to find me and even opportunities for followers who retweeted my post about the contest. Being social is beneficial!

As my friend Bob Holloway put it, “Day 2 was packed with sessions on EMS innovation, MIH (Mobile Integrated Healthcare), and creating value.” And what better way to kick that off than with a cup of coffee and a lightning round called “Ask the Eagles”? If you aren’t similar with the Gathering of Eagles, it is also known less colloquially as the EMS State of the Sciences Conference. This year’s conference was held the previous week in Dallas and consequently the session at EMS Today (always a favorite of mine) is packed with the latest EMS Pearls that will hopefully one day make it into your local protocols. This is where you can hear progressive medical directors from around the country like Bryan Bledsoe busting dogma with comments like “less spinal movement with self extrication compared to backboard extrication.” Unfortunately, I missed it this year to interview Ferno in a video on their innovative iNTraxx system to promote safety, flexible modular design, and increased efficiency. Watch for the interview made in conjunction with my friends from EMTLife later this week.

Over lunch on Friday, I heard Dr. Keith Lurie, CTO of ZOLL Medical, discuss the changing perceptions of resuscitation through “active compression decompression” during CPR and his ResQPOD impedance threshold device that together can increase one-year survival after cardiac arrest by 49%. There was also discussion of heads-up CPR which can significantly decrease ICP during CPR ad many other tips to help us improve CPR survival rates. This discussion was followed up by another visit to the cadaver lab for some hands-on with real human patients. Practice such as this really makes the charts and figures come alive! But what had to be my favorite session of the whole conference had to be the experience of behavioral medicine with David Glendenning and Benjamin Currie. Far from a traditional PowerPoint presentation, we were invited to take a very different look at patients with behavioral issues by experimenting as a group with schizophrenia and delving into the taboo topic of viewing ourselves as potential patients. David suggested that “dealing with PTSD is NOT a rite of passage in EMS and we need to acknowledge it is a real physical condition and begin to talk openly about it.” The session closed with a thought-provoking David Foster Wallace video from a commencement speech explaining how “sometimes the hardest things to see are all around us.” I hope you will take about 9 minutes and watch it. I would also like to recognize the fine efforts of The Code Green Campaign in this same area (as JEMS/Penwell also did.)

Another awesome session well worth mentioning was early on Saturday morning, it was called “Creating a Social EMS Culture” with Carissa O’Brien and Steve Wirth. While there were several good quotes, it is most important to note that “your EMS agency has a legal interest in your use of social media just as you have a professional one.” There are several legal considerations that include the US Constitution, National Labor Relations, defamation laws, HIPAA, harassment laws, and more; but the end game is not “big brother” watching your networking. It must be understood that your agency has a responsibility in “building a culture that breeds responsible digital citizens.” Just as we develop our clinical skills, “we need to train EMS providers in social media just as we would with any other skill.” This discussion is one that can continue even after the conference by participating with the #socialEMS hashtag in your favorite forum.

For those who attended, you can access the conference proceedings with the username and password you received at registration. I also hope you will add your favorite memories below to give others a more accurate record of the whole conference.

I could go on about meeting the paramedics from Nightwatch, my childhood hero Johnny Gage (Randolph Mantooth), being able to sit in Squad 51, or see the original Heartmobile that played a significant role in the development of EMS in America, but I really think it would be best if you just went ahead and registered for your own journey and plan to attend the conference next year.


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Filed under Administration & Leadership, Conferences, EMS Health & Safety, EMS Topics, News, Opinion, Patient Management, Social Media, Special Operations, Technology & Communications, Training & Development, Vehicle Operation & Ambulances

What You Need to Know for EMS Today

I know that some of you will be in Baltimore this week for EMS Today, while still others cannot join us. Regardless of which category you may fall into, I have some advice to help you make the most of this week.

First, if you are travelling, hopefully all your arrangements are complete. But even so, you still have an opportunity to save money during this trip. There are many transportation, parking, eating, drinking and shopping opportunities in the Baltimore area that are offering discounts to conference attendees. All you need to do is “Show Your Badge” for discounts at these participating merchants. To help you keep track of all the sessions (and any last minute changes) or just find your way through the exhibit hall, you should download the EMS Today app for your smart phone or mobile device. It is free for your Android phone from Google Play or for your Apple device from iTunes.

Whether you are physically at the conference or not, networking is what any conference experience is all about. And you can do it while you are here, at home, or even between calls. The key is to “be social” during the conference whether you are physically there in person or you can join us only in the virtual sense. Many attendees, including myself, will be active on social networks allowing you to connect with your peers and gain some insight of what is happening through the eyes and ears of others. If you are on Twitter use the #EMSToday2016 hashtag and follow the official @EMSTODAY account or join me, @hp_ems, for the latest updates, comments, and feedback on what is going on at, or even beyond, the sessions. Check out the latest posts on Facebook at the official EMS Today Conference & Expo page or join the conversations on various topics throughout the year at the High Performance EMS page. You can also learn from my own perspectives and the opinions of attendees that I talk with by reading my posts as this years official blogger of EMS Today 2016 at

20160222_085251Being social can also win you prizes. There will be giveaways for visiting exhibitors in the Expo Hall, but also opportunities to find me at sessions where you can tell me about your favorite experience this week for an opportunity to win a prize from Limmer Creative who can not only help you pass the test, but retain the knowledge you need to succeed at the job. Just look for me, Dale Loberger, or find me by my backpack pictured here, and tell me what you love about this conference. I’ll make it easier to know where I will be by posting the sessions I will attend to my Twitter account at @hp_ems. If you won’t be at the conference, you can still have an opportunity to win by simply retweeting my contest post starting on Wednesday. Reposts of the full tweet will be counted through noon on Saturday in the drawing. Watch my account for more details!



Filed under Administration & Leadership, Conferences, EMS Health & Safety, News, Opinion, Social Media, Technology & Communications, Training & Development

We Deserve Answers Not Just Anecdotes

It certainly appears that suicide among EMS providers is on the increase. All too often we read articles like this one from Canada citing anecdotes and making promises. We know that the work is demanding and routinely exposes providers to critical incident stress. It is also no secret that all too often, the providers who face these incidents are left to deal with this accumulating stress on their own; either because of a lack of effective employer-based programs or due to a culture that discourages disclosure and treatment. When stress is left unaddressed, it can lead to Post Traumatic Stress Disorder. PTSD increases the risk of suicide and can be compounded by an individual’s negative coping strategies. Positive coping strategies and personal resilience, on the other hand, may actually help reduce PTSD risk and even contribute to Post-Traumatic Growth (PTG).

Faith Boldt, a Masters candidate in Public Health at Western Kentucky University, is conducting an important survey, which takes only about 20 minutes of your time to complete. Your time can be pivotal in impacting her study to investigate the relationship between PTSD and suicide ideation. The results will provide data on the prevalence of PTSD along with suicide ideation and will be offered to identify strategies to reduce that risk.

The survey will only be available for a short while, so please take time to click here and fill out this research survey honestly on PTSD and suicide ideation factors affecting EMS personnel. This is an important subject in EMS and it affects us all! So consider sharing the link and encouraging other first responders to participate as well.

The issues of mental health awareness in EMS are only just beginning to be discussed more openly. We can thank the efforts of people like Paul Combs in his illustrations like this sample below or organizations such as The Code Green Campaign , #IVEGOTYOURBACK911 or Heroes Are Human. Please show your support for them as well. But most of all, make sure you have the support you need, because more than anything else, we want you to be safe!



Filed under Administration & Leadership, Command & Leadership, EMS Health & Safety, EMS Topics, Training & Development

Another EMS Today Winner

It may be Groundhog Day, but this is not a repeat post. We really do have another winner in the EMS Today Conference blogger promotion contest. Once again, it is my privilege to announce a winner who used the HPEMS promo code. PennWell Corporation, the sponsor of the Fire EMS Blogs network, has been kind enough to allow their bloggers to provide a promotional code offering discounts on Gold and Silver registrations for the EMS Today conference later this month. Using the code from any of the bloggers, gave the registrant an instant discount along with an opportunity to be entered in a monthly drawing. I announced the first winner here last month and now I have the privilege to congratulate Katherine Rodriguez as the final winner of an Apple iPad Mini that she can pick up at the PennWell booth during the conference. I have tried to contact her without any reply yet. So, if you know her, please extend the announcement to her.

hpems_headshotThere was another part to this contest, however, that I can now disclose and it was to choose the official EMS Today Conference Blogger. The email notification came yesterday, and I am excited to have been chosen to fill that position following in the footsteps of my friend Tom Bouthillet of EMS 12-Lead who performed that role last year. My plans are to attend the conference starting on Wednesday and I will post a blog each day highlighting the events that happened. Whether you attend the conference or not, I hope you will share this experience with me and check back each day in order to learn about what is happening there and how it may impact our industry. If you are in attendance, please watch for me. I typically sport the HP-EMS logo and I would love to meet you and hear about your impressions of the conference.

Travel safe (whether you will be in Baltimore or not), Dale

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Filed under Administration & Leadership, Conferences, EMS Topics, News, Social Media, Technology & Communications, Training & Development