Sessions Descriptions

2024 Session Schedule


SCIENTIFIC FORUM  – Poster Review


April 8, 2024
9:00 am – 12:00 pm

Coordinator:  Lauri Bolton, MD


Transport Medicine Competition Details

We are pleased to host the Transport Medicine Competition once again at CCTMC (TMC@CCTMC).  This is a Critical Care Simulation & Skills Competition for Critical Care Transport Teams. The competition will take place during CCTMC, April 8th – 10th in Orange Beach.  We are seeking 8 critical care transport teams to compete in multiple scenarios in various settings.  These should be teams of 2 and may include paramedics, nurses, physicians, respiratory therapists, and nurse practitioners.  The competition will include multiple rounds of competition in front of a live audience using high-fidelity simulation to test skill, knowledge, critical thinking, and communication. Teams will be selected by random lottery.  Entries must be received by February 24th. Come compete with us in the mountains!

CCTMC Welcome Pool Party

Sunday Night – 6:30 – 8:30 p.m.


 Join your colleagues and friends, both new and old, down by the pool on the beach deck for a Welcome to CCTMC 2024 party. Grab a bite to eat and a drink and jump in if you want!

Sponsored by Golden Hour


TRANSPORT MEDICINE COMPETITION (TMC@CCTMC)


Tuesday – April 9 2024
10:00 a.m. – 4:00 p.m.

Wednesday– April 10, 2024
9:30 a.m. – 12:30 p.m.


Critical Care Transport  Medicine Conference

Monday – April 8, 2024

CCTMC Conference On-Site Registration

11:00 – 1:00 p.m.

REGICEPTION
Registration Reception


 

Come for your badge, stay for the party!  Music, food, and renewed connections make this reception the best registration you’ll ever experience.


 

Opening General Session

1:00 – 1:50 p.m.

Wings of Change: Guiding Teams through Turbulent Transformations


Grand Ballroom

Casey Seckel RN, BSN, CFRN, CEN, CMTE

Wings of Change: Guiding Teams through Turbulent Transformations


In a rapidly evolving industry, the art of leading teams through challenging transitions is paramount. We delve into the tried-and-true principles of change management, exploring how they can be tailored to the unique dynamics of medical transport organizations. Join us to discover effective strategies for fostering a resilient and adaptable workforce, maintaining operational excellence amidst uncertainty, and soaring to new heights of success despite the winds of change. Explore how purpose-driven leadership can become a compass during uncertainty, fostering team cohesion, boosting morale, and steering the course towards successful adaptation.

1:50 – 2:10 p.m. Break-Visit Exhibitors

2:10 – 2:40 p.m.


Breakout I“You Suck, Here’s Why”

Ballroom ABCJames Boomhower MS(c), FP-C, NR-P, C-NPT, CCISM

Session Details

Feedback is a cornerstone of good practice in HEMS/CCT. We receive it every day. But how often do we hear what is being said and use that to help us grow? Especially, when it is so much easier to justify that the person giving you this feedback just…doesn’t get it. Join peer supporters and coworkers Rob and James as they discuss the intricacies of delivering challenging feedback to high performance individuals and how to take that feedback and use it to grow, becoming a better provider and a more resilient teammate

2:10 – 2:40 p.m.


Breakout IIYou Already Had Your Next Catastrophe

Ballroom DEMichael Frakes APRN, FCCM, FAEN, FAASTN, FACHE

Session Details

What we consider “safety” is often good outcomes resulting from luck rather than from successfully identifying and mitigating risks. We are quite terrible at real risk mitigation because it requires us to be suspicious, uncomfortable, and to admit that we’re not that good. The result is that when catastrophe happens, we often find a pattern of performance, behavior, and awareness that would have shown us it was going to happen, had we only looked. This presentation will talk about how reporting, reliability, and humility will bring you to a place where risk is really reduced, as opposed to one with the appearance of safety for patients and providers.

2:10 – 2:40 p.m.


Breakout III“Ventilator loops and waveforms aren’t just for RTs. Learn to master them.”

Ballroom FGH – Hunter Hix BSN, CCRN,CFRN,CNRN,CEN,TCRN & Joe Lewis MSRC, RRT-RCP

Session Details

After this session, you will indeed be a master of loops and waveforms and able to take your mechanical ventilation knowledge to the next level!

Master the mechanical ventilation loops and waveforms. How often do you look at these images and wish you better understood these graphics and how to troubleshoot them? Well, no longer! After this session, you can use them to your advantage.

2:45 – 3:15 p.m.


Breakout IThe Pediatric Airway in Crisis

Ballroom ABC Caleb Curtis MSN, RN, NRP

Session Details

One of the most challenging patient transports a critical care transport crew faces is the pediatric patient struggling to breathe. The stakes are higher because they are not able to communicate their needs like adult patients. We often fear these transports because of the physiological and anatomical challenges associated with this special population. The “Pediatric Airway in Crisis” lecture is designed to give clinicians the latest in evidenced-based research with new non-invasive techniques with outcomes, review intubation practices, and provide ventilator management strategies when transporting these patients.

2:45 – 3:15 p.m.


Breakout IIThe Art of Effective Leadership Relations in Transport Medicine: The Paramedic/Nurse Story

Ballroom DE – Danny Nayman MBA, NRP, FP-C, CCP-C, CMTE & Sue Hollowell BSN, RN, CMTE, CFRN, CCRN, CTRN, CEN, CPEN TCRN, FP-C

Session Details

This presentation is focused on leadership, leadership development, and utilizing emotional intelligence to foster positive relationships amongst team members of varying backgrounds. Through this presentation, we will present mutual personal experiences as a case study that the student can use to gain insights into potential leadership failures and how to effectively recover and grow from them. The goal of the presentation is to inform the audience on how to blend different personalities, experience levels, official and unofficial leadership positions, and clinical roles to encourage symbiotic relationships and maximize the performance of individual team members and the team as a whole.

2:45 – 3:15 p.m.


Breakout IIIMiracle Drugs: The Headlines You Don’t See

Ballroom FGHShelly Rose BSN, CFRN & Shannon Smith, BSN, CFRN

Session Details

You’ve seen it in the news: miracle weight loss drugs used by celebrities! Or, “Lose 10 lbs in 10 days by using ____ drug!” As the popularity of antidiabetic medications for weight loss continues to rise in the United States, so do the dangers of overdoses in children by these unsecured medications that can be grabbed from the counter by little hands. It’s not just metabolic acidosis. Plan for the inevitable nightmare metabolic, non-responsive shock case now and join to discuss Miracle Drugs: The Headlines You Don’t See.

3:15 – 3:30 p.m. Break-Visit Exhibitors

3:35 – 4:05 p.m.


Breakout IGet a Whiff of This: Inhaled Pulmonary Vasodilators in Critical Care Transport

Ballroom ABC – Donald Haering MD

Session Details

Inhaled pulmonary vasodilators are a relatively common therapy in the intensive care unit setting, and can be a life-saving bridge to definitive care for critically ill patients with decompensated pulmonary hypertension, right ventricular failure, or acute respiratory distress syndrome. In critical care transport, they can be an essential temporizing therapy for medically complex and unstable patients in need of urgent mobilization to a higher level of care. This presentation will review the disease states and pathophysiology in which these agents may be indicated, how they work, and practical considerations for their use in the transport environment.

3:35 – 4:05 p.m.


Breakout IIThe Cirrhotic patient…”maybe they’re not drunk.”

Ballroom DE – William Ferguson MD, FACEP, FAEMS

Session Details

Whether from alcohol use, hepatitis, IV drug use or complications from a “fatty liver”, liver disease or cirrhosis is unfortunately a common occurrence in the United States. This lecture will cover the pertinent pathophysiology of the patient with cirrhosis / liver disease that leads them to be high risk for medical emergencies and increases both morbidity and mortality in trauma. Pertinent physical exam findings and red flags that may indicate impending doom with be discussed along with the appropriate evaluation and treatment of these patients in the prehospital, inter-facility, and emergency department.

3:35 – 4:05 p.m.


Breakout IIINo Pulse! No problem? Heart Failure and Transporting RVADs, LVADs, BiVADs, IABPs, and ECMO

Ballroom FGH – Jonathan Baxter Ph.D. (c), RN, NREMT-B, CFRN, CCRN, CEN, TCRN & Amos Roark BSN, RN

Session Details

“No Pulse! No Problem?” is a presentation that provides attendees with an overview of the pathophysiological process that leads to different types of heart failure, including right-sided failure, left-sided failure, and biventricular failure. This overview is then used to guide the expected clinical courses for these patients, leading to the placement of ventricular assist devices, including Impella CPs and 5.5s, Impella RP, IABPs, Heartmate durable VADs, and VV and VA ECMO.

4:10 – 4:40 p.m.


Breakout IThe Art and Science of Medical Naptime: An evidence-based approach to chemical sedation of the agitated patient

Ballroom ABC Jeff Wayland MD

Session Details

Pre-hospital and interfacility transport providers are often on the receiving end of agitation or violence and have to make quick decisions to protect themselves and their patients. Come with Flight Physician and Critical Care Fellow Jeff Wayland on a journey through the med kit to answer questions like “Do I give this IV or IM?”, “Do I need to get and EKG first?”, and “How much ketamine is too much ketamine?” (Hint: probably more than you think)

4:10 – 4:40 p.m.


Breakout IIWe Really Did That. One Organization’s Bold Initiatives For Fatigue Mitigation

Ballroom DE – Michael Frakes APRN, FCCM, FAEN, FAASTN, FACHE

Session Details

Fatigue is a bit of a buzzword in critical care transport operations. Real fatigue has implications for team and patient safety, and even sleepiness affects work/life balance and employee engagement. Increasing demand and acuity gave put our organization into a circumstance with very high rates of extended shifts and overnight team fatigue. We implemented three bold, and perhaps unique, strategies for proactive scheduling and limitations to shift duration and shift transport volume. In this presentation, we’ll describe our programs, talk about the outcomes (good and bad), and engage the audience for feedback on our ideas which may be crazy … or just might work.

4:10 – 4:40 p.m.


Breakout IIIThe Other Rotor System: Management of Impella Patients in Transport

Ballroom FGH – Kate Connelly MD, NRP, FP-C & Adam Gottula MD

Session Details

Patients on mechanical circulatory support require highly specialized care, and as a result, are frequently transferred from outlying facilities to tertiary or quaternary medical centers. These transports are often both medically and logistically challenging for critical care transport medicine crews. This talk will review the physiology of cardiogenic shock and Impella support, as well as discuss transport-specific considerations in patient assessment, monitoring, and emergency management – giving you the knowledge and confidence to expertly care for these complex patients

4:45 – 5:15 p.m.


Breakout IHELP! Is there a Medical Professional on the Plane? Management of the In-Flight Commercial Air Emergency.

Ballroom ABC – James Scheidler MD

Session Details

In-flight emergencies can be unpredictable, wrought with logistical and legal nightmares, supply issues, competing egos, and unclear delineation of roles or even capabilities. It is important that highly trained and capable providers are empowered to respond, when they desire. I feel strongly that critical care transport providers – of all levels – are almost always the most capable providers to care for a sick patient in this scenario. Should they? Can they? What is the precedent? Dive into (or fly into) the physiologic changes that occur with both patients and providers at altitude in a semi-pressurized cabin.

4:45 – 5:15 p.m.


Breakout IICardiac Arrest 101: The coding patient

Ballroom DE – Darren Braude MD, EMT-P

Session Details

Critical care transport teams are often asked to transport patients after return of spontaneous circulation but how should you manage the patient that is still actively coding to optimize outcomes. ACLS algorithms are useful but do not always apply or address issues CCT face such as when is it appropriate to initiate transport of the coding patient? When is it appropriate to discontinue resuscitation? Is an LMA sufficient for airway management? Is ECMO a consideration? What about arterial lines? What is the role of ultrasound?

4:45 – 5:15 p.m.


Breakout IIINeonatal Emergencies: Big Problems for the Smallest Patients

Ballroom FGH – Callie Searley BSN

Session Details

What are the first thoughts that run through your head when you are dispatched for an impending delivery or for an infant under 5 kg? This talk will help prepare you to respond to either of those scenarios. We will review the latest literature on neonatal resuscitation and stabilization as well as the most common emergencies seen in the first 28 days of life.  How do you recognize a possible undiagnosed cardiac defect?  What do you do if you suspect a malrotation?  This presentation will help prepare you to safely transport the smallest patients.

Monday Evening Activity!

 32nd Annual CCTMC Opening Party!

Monday     5:30 – 9:30 p.m.

Join CCTMC Partners ASTNA, I-CAPP and AMPA outside on the Beach Deck as we kick off the evening with a live local band, great food and adult beverages—all on us! Catch-up with old colleagues and friends and make new ones as we enjoy some fresh ocean air.  It’s our chance to thank you-our current members and future members (you know who you are)!Wear your wristband or conference badge for entry! And then join us at 8 on the beach for volleyball and a bonfire!

Sponsored by Air Methods

 Bonfire, Blacklights and Volleyball, Oh My!

Tuesday     8:00 – 10:00 p.m.

Come hang out with us on the beach as we continue a night of fun! Hangout at the bonfire and grab a drink and a s’mores.  Play some games or cheer for your colleagues!  Checkout the ASTNA Board vs. the I-CAPP Board Neon Glow-in-the-Dark Volleyball match!  Who will win in this ultimate showdown? Nurses or  Paramedics? Sign-up ahead of time for volleyball or hang out on standby for needed players and pickup games.

Sponsored by ASTNA and I-CAPP

Critical Care Transport  Medicine Conference

Tuesday – April 9, 2024

7:30 – 8:00 am      On-Site Registration

8:00 – 8:15 am     Welcome & Award Presentations

General Session

Grand Ballroom


8:15 – 9:00 a.m.

The Myth of “Too Sick to Transport”


General Session-Grand Ballroom – Susan Wilcox MD

The Myth of “Too Sick to Transport”


With advances in critical care and devices, healthcare systems are seeing increasing specialization with burgeoning ECMO centers, transplant centers, and stroke centers.

To deliver the right patient to the right services, critical care transport organizations are called upon to transport sicker and sicker patients. At times, well-intentioned clinicians may argue that a patient is “too sick to transport.” While reasonable on its face, the concept of “too sick to transport” breaks down with probing. There are no patients who are too sick to transport, only patients who are too sick to stay in an under-resourced setting.

9:00 – 9:30 a.m. Break-Visit Exhibitors

9:30 – 10:00 a.m.


Breakout IFit for duty? Exercise testing for critical care crew members

Ballroom ABCDavid Thomson MS, MD, MPA, FACEP, FAEMS, FAsMA, FAMPA

Session Details

Are your crews fit for duty? Are there hidden health problems, like heart disease or back injuries, waiting to sideline (or worse!) your critical care clinicians? This program will describe how testing for heart disease and musculoskeletal fitness can keep your most important asset – your crew members – fit and ready to respond.

9:30 – 10:00 a.m.


Breakout IIMeasuring Overall Clinical Performance: Are We Any Good?

Ballroom DE – Allen Wolfe MSN, CNS, APRN, CFRN, CCRN, CTRN, TCRN, CMTE, FAASTN

Session Details

Unveiling Clinical Excellence in Medical Transport: Navigating the Uncharted Terrain Embark on a journey that delves into the intricate realm of evaluating clinical quality in medical transport. Can GAMUT or analogous benchmarks truly unlock the zenith of clinical proficiency? Explore the cutting-edge concept of the “Q score,” an all-encompassing clinical gauge, offering clinical leaders an elevated lens to scrutinize every facet of care delivery. Join us as we redefine the landscape of clinical leadership, introducing a fresh perspective to meticulously assess the pinnacle of care excellence.

9:30 – 10:00 a.m.


Breakout III The Da Vent Code: Deciphering the Modes of Mechanical Ventilation.

Ballroom FGH – Julius McAdams BME, FP-C, CCP-C

Session Details

Whether you are new to taking care of mechanically ventilated patients or have some experience ventilator modes can be an enigma. As we improve our patient care with better ventilator strategies and continue to advance technologically the knowledge and understanding of mechanical ventilators is only getting more complex and confusing. It doesn’t help that with all the different manufactures come different names for the same modes. This compounded with all different ventilator mode names used in most textbooks, manuals, journal articles, studies, and podcasts use the ventilator mode names specific to the brands the authors are comfortable with. So even if you are trying to better yourself with education this can be confusing and discouraging when you do not see the ventilator mode you just learned about on your ventilator. Or when you get to the bedside and see an unfamiliar ventilator with a mode name you have no idea about. In this presentation I hope to help you develop and understand a process that, while it does not explain how the ventilator companies come up with all the fancy new mode names, it will help you to understand how the ventilator is interacting with your patient. By understanding this you will be able to correlate the various mode names with each other.

10:05 – 10:35 a.m.


Breakout I Excellence through Equity: Adapting Academic QI to the Transport Environment

Ballroom ABC – Brittney Bernardoni MD

Session Details

Multi-disciplinary peer review offers a unique opportunity to leverage the collective experience/knowledge of the entire CCT team to ensure exceptional patient care. Learn the ground rules for successful peer review and how it can translate to program improvement via individualized coaching, program-wide education, systems/operational change.

10:05 – 10:35 a.m.


Breakout IIWhile The Perfusionist Sleeps – Clinical Management of ECMO Patients

Ballroom DE – Michael Frakes APRN, FCCM, FAEN, FAASTN, FACHE

Session Details

The critical care transport provider is a jack of all trades, including the ECMO trade. While most teams take a perfusionist for these transports, we handicap the team and increase patient risk if we are passive equipment movers instead of informed contributors to the patient care team. This presentation will review the fundamentals of ECMO, describe machine, vital sign, and patient indications of suboptimal circuit function, and describe clear troubleshooting and management strategies for each.

10:05 – 10:35 a.m.


Breakout III Special Delivery! The Small Baby Bundle, when a tiny package is a BIG deal

Ballroom FGH – Jeanine Fuller BSN-RN, RNC-NIC

Session Details

Join the UNMH Lifeguard Air Emergency Services Neonatal Specialty Team and discuss Intraventricular Hemorrhage (IVH) and specific interventions for transport teams that mitigate the development of IVH. When time is of the essence and all of the small things add up to make a big difference, use the Small Baby Bundle to guide the care you provide throughout your transport.

10:35 – 11:00 a.m. Break-Visit Exhibitors

11:05 – 11:35 a.m.


Breakout IBreaking in the Saddle: A Classic Tale of Hemodynamic Collapse

Ballroom ABCDanielle Goodrich BA, FP-C, CCP-C & Douglas George MD 

Session Details

Come join us as we investigate the vague complaints of an 80-year-old female with shortness of breath (we will give you a hint, it’s not COVID!). We will utilize multiple diagnostic tools (such as ultrasound, CT scans, and laboratory findings) to form a differential diagnosis and determine a treatment plan in this Choose Your Own Adventure case review. The focus of this session is to develop clinical decision making surrounding the treatment of a rapidly deteriorating patient and to help us save her life! The audience will lead the direction of patient care by answering interactive poll questions prompting discussion surrounding; assessment findings, diagnostic interpretations, alternative treatments in the transport modality, pharmacologic agents (inhaled nitroglycerin, epoprostenol, balancing vasoactive agents, and thrombolytics), and operational decision making.

11:05 – 11:35 a.m.


Breakout IIKEEP GROWING! CREATING A PERSONAL DEVELOPMENT PLAN

Ballroom DE – Kevin Collopy MHL, FP-C, NRP, CMTE

Session Details

It is the elephant in your career growth’s room! You want to take the next step on our leadership journey and get told you are not ready. But…you just need the chance to prove them wrong, right? Perhaps there is opportunity to learn. Digesting the thousands of leadership books and strategies can be intimidating; what if there was a way to simplify how to think about and approach your personal leadership development?

11:05 – 11:35 a.m.


Breakout III Live Wire: A Shocking Tale of Electrical Injury

Ballroom FGH – Stephanie Steiner MSN, ACNP-C, CPNP-AC, CFRN & Jennifer Johnson BSN, RN, CFRN, NREMT

Session Details

Electrical Injuries can often be tricky to evaluate and treat due to their tendency to have small areas of external injury but devastating injuries beneath. Air Medical providers can often be called to manage this patient population, largely when high voltage injury has been sustained. Injuries sustained from high voltage electrical injury can often result in serious associated injuries and even cardiopulmonary arrest. This presentation will utilize a case study of a young patient who sustained a high voltage injury while at work to explore the pathophysiology and management of high voltage electrical injuries. This case will provide for an excellent review on assessment priorities, associated traumatic injuries, and cardiopulmonary support for electrical injuries.

11:40 – 12:10 p.m.


Breakout IBreathing through a straw – PEALS of Neonatal Intubation

Ballroom ABCMarc Baron DNP, RN, NEA-BC, CEN, CPEN, TCRN, CFRN, CTRN, PHRN

Session Details

Neonatal intubation is a lifesaving skill that has been performed by clinicians for many years. The techniques for neonatal intubation have gone through many different changes since first being introduced and will continue to advance in the future. This is high risk, low frequency skill, especially in the transport environment. Although the incidence of neonatal intubation has decreased over time, the focus on neonatal intubation safety has increased. This lecture will discuss current best practices for the intubation of the neonatal patient. It will provide several PEALS that help to improve first pass success rates. Whether you are an experienced neonatal provider or a novice, this discussion is for you.

11:40 – 12:10 p.m.


Breakout IIMaybe? It Depends: Vasopressor Use in Trauma

Ballroom DE – Cody Winniford BA, EMT-P, CCP-C, FP-C

Session Details

Vasopressor use in trauma is not something we typically deal with in prehospital care. In fact, the data suggests that mortality is worse when vasopressors are administered early, as in the first 12 hours. But some of our best work in prehospital medicine comes from challenging our preconceived notions of a particular topic and deepening our understanding to the degree that we actually modify our clinical practices and mindsets. This presentation is designed to challenge our thinking on hemorrhagic shock management, particularly in the later stages of care. Go beyond the first 30 minutes of trauma care with us as we explore questions that leave us with the answer: “Maybe, it depends..”

11:40 – 12:10 p.m.


Breakout III Current State of the Evidence for the Management of the Pregnant Trauma Patient

Ballroom FGH – Lauren Maloney MD, NRP, FP-C, NCEE, FACEP, FAEMS

Session Details

Have you ever wondered what evidence actually exists about the efficacy of prehospital interventions for the critically injured pregnant trauma patient? Through a series of case scenarios, the most recent literature about performing procedures such as a tube thoracostomy and prehospital resuscitative hysterotomy, administration of low-titer whole blood and TXA, and applying devices such as extremity and junctional tourniquets, traction splints, and pelvic binders will be explored. Attention will also be paid to pregnancy-specific considerations for vascular access, rapid sequence intubation, ventilator management, pain management, hospital destination decisions, and properly informed refusals of medical attention. The session will end with a look into the future of trauma care for patients who are pregnant including point-of-care ultrasonography, prehospital resuscitative endovascular balloon occlusion of the aorta, and inclusion in prospective clinical trials.

LUNCH ON OWN

(Don’t Forget to stop by the Exhibit Hall to visit exhibitors !)

12:10 p.m. – 1:30 p.m

1:30 – 2:00 p.m.


Breakout IABC before XYZ. The problem with cookbook medicine. 

Ballroom ABC – Christal King RN, NRP, CEN, TCRN

Session Details

We are all very aware that medicine is trending towards treatment checklists for everything. But we also realize that almost none of our patients fit in any happy little box. Instead of the water being clear with only one diagnosis to treat, it tends to be very muddy with multiple diagnosis and limited puzzle pieces. The concept and importance of a skilled assessment to guide treatment is becoming a skill of the past. This lecture will allow you to make decisions surrounding treatments throughout several complicated cases allowing you to test your knowledge and skills when the water isn’t so clear.

1:30 – 2:00 p.m.


Breakout IIPediatric Remote Damage Control Resuscitation (RDCR) – Strategies leveraging military data for civilian benefit

Ballroom DE – Robert Grabowski DNP, MBA, APRN-CNP, AGACNP-BC, CPNP-AC, CEN, CCRN, CFRN, CMTE, EMTP

Session Details

Data derived from military conflict in the Middle East has been responsible for large, impactful changes in the way we manage civilian trauma patients. The paradigm of Damage Control Resuscitation (DCR) has helped to improve the outcomes of battlefield medicine, and the advent of Remote DCR has pushed that care far-forward to the austere depths of prehospital care. However, is Remote DCR applicable to our care of civilian pediatric trauma patients in critical care transport? Come review the findings and see if these strategies can help your prehospital trauma management for critically injured children.

1:30 – 2:00 p.m.


Breakout III Simple Jack: He saved them in Tropic Thunder. He can save you too.

Ballroom FGH – William Ferguson MD, FACEP , FAEMS

Session Details

We say Rotor wing EMS is critical care, that’s true,  but all Emergency care is the ABC’s , repeated over and over again while adding  cooler therapies, medications, and techniques until the patient is  “stable” .   We in the “critical care” realm  better not forget the building blocks of the ABC’s and be able to  critically think  or our patients may wind up dead or worse. This topic will cover several case-based scenarios in a laid-back pragmatic format where the critical care that is actually needed is just  an astute  clinician that can go simple and start with the basics, recognize patient needs over perceived expectations, then  move forward with the “ cool stuff.” Just like Simple Jack, being consistent and going simple can save you, your partner , and your patient from trouble.

2:05 – 2:35 p.m.


Breakout IBridging Prehospital and Hospital Based Traumatic Brain Injury Care

Ballroom ABC – Kevin Collopy MHL, FP-C, NRP, CMTE

Session Details

Your care of patients with moderate and severe traumatic brain injuries can improve their outcome, or kill them! What you do makes a difference. Come learn how aligning your TBI care bundle can algin with trauma center care standards and why it makes a difference to your patient!

2:05 – 2:35 p.m.


Breakout IIFrom Dungeons Filled with Dragons to a Galaxy Far Far Away: Roleplaying Games as a Tool for Training and Professional Development

Ballroom DE – William B. Belk, MSc, FP-C

Session Details

Unlock the world of imagination and professional development! Join William Belk, Director of Medical Simulation and Innovative Education at Air Methods, and dive into the fascinating realm of roleplaying games (RPGs).

In this captivating session, we’ll explore how RPGs, like Dungeons & Dragons, have evolved from fantastical adventures into potent tools for honing critical skills in air medical crew members, health professions educators, and organizational leaders. Discover how these games foster enhanced communication, problem-solving prowess, conflict resolution acumen, and robust team dynamics.

Through real-world case studies and insightful anecdotes, we’ll delve into the parallel worlds of RPGs and professional development. Uncover the strategic thinking required to overcome mythical challenges as we draw parallels to the complexities faced by professionals. Learn how the camaraderie forged during epic quests translates seamlessly into cohesive teamwork within your organization.

This presentation isn’t just about theory; Belk will demonstrate how RPGs can be seamlessly integrated into training programs, aligning game scenarios with your specific learning objectives. Addressing concerns, he’ll provide solutions to potential challenges, ensuring a smooth implementation process.

So come on a journey where dragon-filled dungeons and faraway galaxies become training grounds for invaluable skills. Embrace the power of imagination and teamwork to elevate your training and professional development strategies to new heights.

2:05 – 2:35 p.m.


Breakout III Combative patients in the transport environment: tools for before, during, and after these encounters

Ballroom FGH Craig Bates MD

Session Details

Combative patients are increasingly being encountered in a variety of clinical environments in recent years. The potential for significant threat to the patient and others is far greater in transport due to the specific environment. Identifying the risk of violent escalation for a patient along with safe tools to prevent or treat violent behavior in transport are key skills that critical care transport clinicians need to master. It is also important to have a plan to support clinicians who have been victims of violence while doing their job. This presentation will draw on the speaker’s extensive experience caring for violent patients in an urban trauma center as well as in air medical transport to provide some solutions and start a dialogue about these issues and provide the audience with some tools to take back and adapt to their programs to make things safer for patients and staff.

2:40 – 3:10 p.m.


Breakout IWhen Good Drugs Go Bad – The Importance of Toxidromes

Ballroom ABCTeri Bellone RN, BSN, C-FRN

Session Details

In a world of multi-ingestion and TikTok challenges, a brief look into multiple pediatric patient cases where a knowledge of toxidromes redirected care.

2:40 – 3:10 p.m.


Breakout IIDeath by Ventilator optimizing peri-intubation

Ballroom DE – Charles Sheppard MD

Session Details

Killing your patients with intubation turns out to be surprisingly easy. This presentation focuses on those techniques and ways to minimize that happening to your patients. Discussions about peri-intubation arrest and preventative steps you can take is the focus of this presentation.

2:40 – 3:10 p.m.


Breakout III Challenging a Paradigm: Aortic emergencies in the critical care transport environment

Ballroom FGHNicholas George MD

Session Details

Quick! What’s the first-line medical therapy for an acute aortic dissection? If you said beta blockers, you’re right. But, are you? Aortic emergencies are life-threatening events commonly encountered in critical care transport. These are bread and butter CCT cases and you – yes YOU – will care for these patients. Guidelines recommend beta-blockers to control heart rate (HR) with calcium channel blockers added for systolic blood pressure (SBP) control or as a potential alternative. However, there is little human data to support strategies of HR versus SBP reduction, incidence of adverse events, or agent preference. This lecture will challenge your certainties and offer an alternative approach to managing aortic emergencies in the critical care transport environment.

3:10 – 3:40 p.m. Break-Visit Exhibitors

3:40 – 4:10 p.m.


Breakout INon-Invasive Ventilation: Be the expert!

Ballroom ABC – Joe Lewis MSRC, RRT

 

 

Session Details

Non-invasive ventilation is more than just strapping a mask on a patient’s face. Understanding the settings and how they work together to provide both ventilatory and oxygenation support is an integral element of non-invasive ventilation management. Attend this session to gain the clarity and confidence you need to provide better non-invasive ventilation for your patients.

3:40 – 4:10 p.m.


Breakout IINavigating the Fatigue and Wellness in EMS: From Ground to Sky. Fatigue Management is not about Management

Ballroom DE – Jenn Killeen MHA, RN, NRP, FACHE, CMTE

Session Details

“Navigating Fatigue and Wellness in EMS: From Ground to Sky”

In the pulse-quickening world of emergency medical response, the resilience and alertness of our EMS professionals aren’t just vital; they’re non-negotiable. Yet, the silent adversary of fatigue looms large, shadowing every critical decision, every rapid response, and every life saved.

Join us for an incisive journey into the heart of fatigue and wellness in EMS operations. In “Navigating Fatigue and Wellness in EMS: From Ground to Sky”, delve deep into the scientific underpinnings of fatigue, its impact on decision-making, and its potential consequences on patient outcomes.

Discover the robust principles and frameworks of Fatigue Risk Management Systems (FRMS), designed and tailored to the unique demands of EMS. Immerse yourself in real-world case studies, showcasing the challenges faced by your peers and the innovative solutions they’ve implemented.

Engage in enriching discussions on physical and mental wellness, targeted at equipping EMS professionals with the tools to combat stress, maintain optimal nutrition, and ensure impeccable sleep hygiene. As communication remains our strongest ally in this fight, explore advancements that enhance team dynamics and bolster safety.

Whether you’re behind the wheel of an ambulance, piloting a medical helicopter, or coordinating the rapid response on the ground, this lecture promises a transformative look into safeguarding your well-being while ensuring the highest standards of patient care. Prepare for an enlightening, empowering, and ultimately essential dive into the well-being of those at the heart of EMS.

3:40 – 4:10 p.m.


Breakout III Prehospital Resuscitative TEE: The New Jersey Experience

Ballroom FGH – Garrett Cavaliere DO, NRP & Matthew Steenberg MD

Session Details

Transesophageal echocardiogram (TEE) was once reserved for cardiology and cardiac anesthesia. However, with the development of disposable TEE probes and resuscitative TEE techniques, this technology is more widely available. This lecture discusses the implementation of a pre-hospital EMS physician TEE resuscitative program, the barriers associated with this program’s implementation as well as the results of speaker’s feasibility pilot study.

4:15 – 4:45 p.m.


Breakout IUnderstanding & Reversal of Coagulopathy in the actively bleeding patient

Ballroom ABCDaniel Rauh MS, ACNP

Session Details

One stop shopping for simplification of how to reverse an actively hemorrhaging patient. How do the current pharmacologic agents impact normal coagulation, what to do when they work too well and what reversal agents are indicated in what situation. This talk provides a simple understanding of how to manage these patients that you can use immediately.

4:15 – 4:45 p.m.


Breakout IIStep Away from the Needle: Reconsidering the Management of Tension Pneumothorax in the Prehospital Setting

Ballroom DE – Christopher Root MD, NRP

Session Details

Needle Decompression has been the standard of care for tension pneumothorax since the dawn of paramedicine. MAST pants were also the standard of care for shock, long back boards were the standard of care for suspected cervical spinal injury. It is time to reconsider the risks and benefits of needle thoracostomy as the first line treatment for suspected tension pneumothorax. How often are we causing more harm than good? How often is the procedure truly indicated? Is there a better way?

4:15 – 4:45 p.m.


Breakout III Circling the SQuARE: Patient safety in long-haul air ambulance transportation

Ballroom FGH – Ina Schmidt MD & Doug Stevens MD

Session Details

The International Community for Aeromedical Research and Universal Standards (ICARUS e.V) is an international aeromedical professional association committed to patient-focused, high-quality critical care transport and retrieval medicine by promoting excellence in medical direction, research, education and training.
Our key objective is to increase patient safety through evidence-based care in air medical transport.
We present an exciting new approach to patient safety “Circling the SQuARE” which has its basis a cornerstone, the “SQuARE” (Safety Quality and Aeromedical Risk Evaluation) within a Circle of Evaluation.

4:50 – 5:20 p.m.


Breakout IA Case of Refractory Bradycardia

Ballroom ABC Michael Gooch DNP, APRN, CCP

Session Details

You are dispatched to transport a patient with refractory bradycardia, what are your differentials, what is your treatment plan? Are you considering hypothyroidism? This presentation will review the pathophysiology of thyroid dysfunction, its clinical manifestations, and transport management and considerations.

4:50 – 5:20 p.m.


Breakout IICardiac arrest 201 The ROSC patient: post-arrest management

Ballroom DE – Darren Braude MD, EMT-P

Session Details

Critical care transport teams are often asked to transport patients after return of spontaneous circulation but how should you manage the patient that is still actively coding to optimize outcomes. ACLS algorithms are useful but do not always apply or address issues CCT face such as when is it appropriate to initiate transport of the coding patient? When is it appropriate to discontinue resuscitation? Is an LMA sufficient for airway management? Is ECMO a consideration? What about arterial lines? What is the role of ultrasound?

4:50 – 5:20 p.m.


Breakout III Beyond Delivery: The Role of EMS and Critical Care Transport in Reducing Maternal Mortality

Ballroom FGHHeather Scruton MBA, MSN, RNC-OB

Session Details

Maternal mortality rates continue to rise in the United States, despite efforts on multiple fronts to improve outcomes. Emergency medicine and critical care transport clinicians have historically been overlooked as collaborative partners in these quality initiatives. Recognition of subtle red-flag symptoms, increased awareness of obstetric disease presentation, and time-critical intervention by frontline providers can change the trajectory of care and outcomes for this at-risk population. Delivering a baby? That’s the easy part. Join national speaker Heather Scruton, MBA, MSN, RNC-OB to learn straight-forward strategies for complicated OB scenarios.

Tuesday Evening Activity!

 CCTMC Takes Over the World-Famous Flora-Bama

Tuesday     7:00 – Midnight

Grab your wristband, drink tickets and jump on the shuttle as we take over the world-famous Flora-Bama. Known best for their fantastic live music scene and the famous bushwhacker, you are sure to have a fantastic time!

Sponsored by Ninth Brain

Critical Care Transport  Medicine Conference

Wednesday – April 10, 2024

8:00 – 8:30 a.m.     Registration

Breakout Sessions


8:30 – 9:00 a.m.


Breakout IBlinded by Bias: A cautionary critical-care case study

Ballroom ABC – Kristopher Thompson MHA, BSN, RN, NRP

Session Details

This is the case of how bias delayed a critical diagnosis in a “frequent flyer” leading to his rapid clinical deterioration. We’ll discuss premature closure, ascertainment, anchoring, confirmation, and diagnostic momentum biases as they relate to our assessment and management of patients. As we get past the biases, the case study will unfold and learners will be presented with a strange presentation, a scary diagnosis, and the latest in critical resuscitation modalities available for this patient.

8:30 – 9:00 a.m.


Breakout IITBD

Ballroom DE – TBD

Session Details

TBD

8:30 – 9:00 a.m.


Breakout IIICracking the intubated Hypoxemia Code: Airway Pressures, Capnography, and Ultrasound.

Ballroom FGH – Matthew Roginski MD, MPH

Session Details

Managing intubated hypoxemia is time pressured and high stress. While checklist approaches to common causes of intubated hypoxemia exist, they do not integrate physiological challenges of critically ill patients in transport. This presentation reviews an approach to managing intubated hypoxemia that integrates ventilator airway pressures and volumes, quantitative end tidal capnography and point of care ultrasound to diagnose and manage hypoxemia in the critical care transport environment.

9:05 – 9:35 a.m.


Breakout IThe Blood Pressure is WHAT?! Management of the obstetric patient experiencing hypertension, pre-eclampsia, or eclampsia in transport.

Ballroom ABC – Dylan McDaniel BSN, RN

Session Details

Hypertensive disorders in pregnancy such as pre-eclampsia and eclampsia are associated with maternal and newborn mortality and morbidity. Early detection and intervention are crucial for effective treatment even in the transport setting. In this presentation, we will review maternal hypertension protocols based on ACOG guidelines, the clinical presentation of pre-eclampsia, and key factors to remember when transporting a pre-eclamptic patient.

9:05 – 9:35 a.m.


Breakout IIDon’t Do Chest Compressions on trauma arrests

Ballroom DE – Charles Sheppard MD

Session Details

CPR was designed for “the heart too good to die” ie sudden CARDIAC arrest today it is applied to every end of life event with minimal benefit. This talk will look at the benefit of chest compressions in the traumatic cardiac arrest where I think the evidence is highly negative for this treatmment.

9:05 – 9:35 a.m.


Breakout IIIProblems in Pacing

Ballroom ABC – Kristopher Thompson MHA, BSN, RN, NRP

Session Details

This presentation will take us on a journey following a patient from permanent pacemaker insertion to its failure, EMS’s response to it with transcutaneous pacing, and the patient’s hospital course including transvenous pacing insertion and replacement of the permanent pacer. Attendees will review the basics of permanent pacemakers such as modes of pacing, how rate modulation works, and lead placement. We’ll also look at the most common failures and problems with permanent pacemakers. We will then delve into the most current research and practice guidelines for transcutaneous pacing. The second half of the presentation will cover the insertion of transvenous pacemaker wires, verifying placement of wires, management of epicardial and transvenous pacemaker settings and problems, and indications and contraindications of medications used for symptomatic bradycardia. Critical care providers will leave with a better understanding of the methods of transvenous and epicardial pacing, how to manage temporary pacemaker pulse generators, and troubleshooting problems with temporary pacers.

9:40 – 10:10 a.m.


Breakout IRecognition and Resuscitation of Pediatric Sepsis and Septic Shock during Pediatric Transport

Ballroom ABC – Michael Stroud MD, FAAP & Ranna Rozenfeld MD, FAAP

Session Details

Improvements in recognition and resuscitation of pediatric sepsis and septic shock are need to improve clinical and functional outcomes for children. This presentation will review signs and symptoms of pediatric sepsis and septic shock, clinical resuscitations guidelines, and research related to improved outcomes in pediatric sepsis and septic shock during interfacility transport.

9:40 – 10:10 a.m.


Breakout IIManaging the obstructive patient on the mechanical ventilator.

Ballroom DE – Hunter Hix, BSN, RN

Session Details

Discover the art of managing the complex obstruction patient by utilizing skills such as setting the ideal I:E ratio and unlock the key to determining the ideal expiratory time. Lastly, understand the use of PEEP in the obstructive patient. This session promises practical insights and real-world strategies to elevate your ventilation skills. Don’t miss out on this transformative learning experience!

9:40 – 10:10 a.m.


Breakout IIIpH Guided Resuscitation

Ballroom FGHCalixto Romero MD

Session Details

The goal of this presentation is to teach how to answer the question : how and why did you choose that fluid?

10:10 - 10:25 a.m. BREAK-Visit Exhibitors

10:25 – 10:55 a.m.


Breakout IAudience Interactive Pediatric Transport Case Reviews

Ballroom ABCRanna Rozenfeld MD & Michael Stroud MD, FAAP

Session Details

Participants will break up into teams to work through 4 pediatric critical care transport scenarios. They will discuss the risks and benefits of common pediatric transport scenarios. They will balance the use of available referring and accepting hospital resources. They will have the opportunity to engage in multidisciplinary collaboration with other transport teams.

10:25 – 10:55 a.m.


Breakout IICritical Care Literature Review 2024

Ballroom DE – Michael Jasumback MD

Session Details

The critical care literature is constantly evolving, changing the standard of care and best practices. As a critical care transport professional, you have a responsibility to be aware of the current literature regarding your care. This is your opportunity to see the current state of the literature, and how it applies to your care. The most important studies of the year will be reviewed and dissected to help you understand how they might apply to your practice.

10:25 – 10:55 a.m.


Breakout IIIKeep the Pressure Up – Use of Vasopressors in Transport

Ballroom FGH Dennis Taylor DNP, PhD, ACNP-BC, NRP

Session Details

KEEP THE PRESSURE UP!!! This presentation will review the selection of and mechanism of action / pharmacological use of vasoactive agents during transport situations.

11:00 – 11:30 a.m.


Breakout IPost-Intubation Hemodynamic Collapse: what we know, what we don’t know, what we can do about it

Ballroom ABC – Kalle Fjeld MD

Session Details

Who is going to become hypotensive or arrest after intubation? Is there anything we can do about it? Join for a summary of what the literature tells us, what we still don’t know and how to set yourself up for the best chance of intubation without hemodynamic collapse.

11:00 – 11:30 a.m.


Breakout IIDon’t Forget the Baby!- Fetal Heart Monitoring

Ballroom DE – Bryan Selvage BS, FP-C, NRP

Session Details

Just like EKG’s, if providers transport OB or High-Risk OB patients, they should be able to evaluate a Fetal Heart Strip. Many have become accustomed to asking the sending provider what the monitor shows or just relying on the sound of a heartbeat on the portable Doppler to evaluate the fetus. We put the mothers on EKGs; why not the baby? The talk will walk attendees through the steps of evaluating a Fetal Heart Monitor Tracing- Baseline, Accelerations, Decelerations, Variability, and Category. The talking will also dive into what Fetal Heart Tracings require attention and the steps of Intrauterine Resuscitation.

11:00 – 11:30 a.m.


Breakout IIIDoing the Right Thing for the Right Heart

Ballroom FGHSusan Wilcox MD

Session Details

Right ventricular failure is common yet underappreciated and challenging to recognize. Standard resuscitative techniques, including volume administration and intubation, are detrimental in right ventricular failure, making this condition particularly challenging to manage. Optimizing preload, contractility, and afterload are the best means to resuscitate the patient with right ventricular failure.

11:30 - 11:45 a.m. BREAK-Visit Exhibitors

Closing General Session

Grand Ballroom


11:45 a.m. – 12:30 p.m.

Life after near death- I certainly wasn’t expecting this


Closing General Session – Grand Ballroom

Janie Ford RN, MSM, MSN, APRN-BC

& Jason Adams, RN, BSN, CEN, CFRN 

 

Life after near death- I certainly wasn’t expecting this


You will hear first hand about a flight nurse who lapsed into a coma after orthopedic surgery and spent over a week in the ICU. You will hear the patient’s perspective as well as the perspective of a family member who was there from the beginning to discharge. Pathophysiology and pharmacology of sepsis will be reviewed as well as the end of the story and resources for surviving post ICU complications. Hear how the patient felt to have a co-worker assist with managing her during initial treatments.