High rates of employee turnover negatively affect prehospital patient care as experienced practitioners leave the occupation creating a persistent brain drain that reduces the ability of the workforce to advance and consistently adhere to response and treatment protocols. Industry surveys throughout the past two decades have highlighted obvious causes of job dissatisfaction: wages, advancement opportunities, and difficult work environments. Most reactions to these surveys have been to address these problems as individual symptoms requiring focused responses. An alternative approach not yet fully explored would be to identify the root causes of workforce retention in order to formulate a holistic response. One such root cause is the stagnation of EMS professionalization caused by a meta-level identity crisis. Most occupations experience a maturation cycle that typically takes decades during which many factions come together, develop the occupation, and create an organization from which a collective identity forms. EMS, however, developed in a disjointed manner, built from volunteer fire departments, independent rescue organizations, hospitals, and other sources to fill specific needs in each community. All of these disparate groups were thrust together in the late 1960s and legacy collective identities from many of those original organizations remain. Each legacy identity struggles to develop EMS in a manner that often competes with goals with other legacy identities. The identity crisis that conflict creates prevents EMS from progressing through the professionalization process, a key component to addressing systemic problems affecting workforce retention.

Cold weather changes your emergency calls. Some injuries only happen when the temperature goes down, others are exacerbated by the winter weather. This lecture looks at the traumas unique and more common in the winter, as well as a look at the ways that hypothermia exacerbates traumatic injuries. We also take a deep dive into the pathophysiology of smoke inhalation and carbon monoxide poisoning.

Value-based care is quickly gaining traction across healthcare systems and communities. Even nationally, the Health Care Payment Learning and Action Network (established by the Center for Medicare and Medicaid Services) has set an aggressive goal: 100% of traditional Medicaid and Medicare Advantage payments will be tied to quality and value. This lecture drives at a centrally important topic: how can growing CP / MIH programs deliver “the right care to the right people at the right time”? How can this new care delivery model drive better patient outcomes, reduce downstream healthcare costs, and offer expert care coordination? These tenets are difficult to achieve especially with limited resources (including staffing shortages) in the out-of-hospital setting. Value-based care and population health management make a perfect match when strong fundamentals are in-place.

This lecture will discuss how exacerbated asthma affects the body. Discussion will occur that will be focused on signs and symptoms that the EMS professional will encounter in the field. We will explore asthma from inside the lungs and correlate why we see certain presentations from our patients. This class is for all EMS license levels. 

The peer reviewed literature in Emergency Airway Management is clear on the reality that paramedic level EMS systems fail to successfully intubate the trachea on the first attempt in more than one-third of cases. The SALAD Technique changes this dynamic through the use of proactive suction technique which assists the caregiver in decontamination of the upper airway while actually assisting the placement of airway adjuncts such as oral airways, supraglottic airways and laryngoscopes. We will teach how to utilize a video laryngoscope effectively in a simulated severely contaminated airway.

Thousands of severe stroke patients who could survive instead face death or permanent disability. Why? Because they lack access to stroke systems of care that prioritize quality of care over proximity to care. Less than 1/3 of severe stroke patients are transported to a neuroendovascular-ready (Level 1 or comprehensive) stroke center to receive mechanical thrombectomy. This means that patients end up at hospitals that don’t have the personnel or equipment to treat their complex condition. For stroke this is a gamechanger, because time — and brain cells — lost in transfer to facilities that provide appropriate care often leads to death or disability. When you arrive on the scene of a terrible car accident, you know where to take those who have experienced severe trauma. Stroke is a trauma of the brain, making it essential for those patients to also reach a Level 1 center as soon as possible. Wisconsin, Illinois, Minnesota and other midwestern states have Level 1 or comprehensive stroke centers, yet none of the states have state-wide policies in places guiding EMS to take these severe stroke patients to a center where they could be best treated. Milwaukee County has an ideal local protocol ensuring these patients are immediately transported to a Level 1 stroke center for the lifesaving care they need, rather than be transported to multiple lower-level hospitals that are not equipped to treat this type of stroke. Although protocols are imperative, they are only effective if first responders have the knowledge and tools for severity-based assessment, triage and transport, and understand the differences between transport destinations and the best options of care for their patients. In this session, you’ll learn about the different types of stroke, be introduced to a critical tool that helps you assess stroke severity, learn the latest protocol efforts on Wisconsin, and hear some amazing new research comparing locales that have updated EMS policies to those that do not.

Mechanical ventilation continues to evolve within the hospital and prehospital world with more attention directed towards personalized ventilation. This presentation will discuss what the aspects of lung protective ventilation is expanding beyond tidal volume and rate. Over the past decade driving pressure continues to emerge as one of the most valuable and easily obtainable bedside measurements when referring to lung injury and mortality. Within the topic of lung protective strategies, this presentation will discuss how to calculate driving pressure, how to interpret it, and how to tailor ventilator settings in effort to reduce lung strain according to the latest literature.

Lift assist and falls are types of calls frequently encountered by EMS. The Timed Get Up and Go (TUG) test is an objective measure of safety/risk of future falls which can be utilized by EMS practitioners to reduce return visits and assess the need for support services for patients' activities of daily living.
 

Course Objectives

• Define the components of the get up and walk test.

• Select appropriate patients for the get up and walk test.

• Appraise the value of the get up and walk test in their own EMS system.

• Apply the get up and walk test to patient scenarios.

The creation of an inclusive environment is one of the most important factors for recruitment and retention. This presentation and panel discussion will help educators and leaders to adjust learning activities and recruitment strategies to attract and retain our next generation of Fire/EMS responders. Learn from instructors, students and program administrators who have successfully implemented a Dual Enrollment Academy providing Fire and EMS education to high school students across Southeast Wisconsin. The Waukesha County Technical College DEA program is in its 6th year and has grown to 42 students. If you are an educator, preceptor, or leader in your service, this presentation is sure to leave you with tangible strategies that can be implemented to attract and retain your next generation responders.

The course aims to equip participants with knowledge and skills in advanced resuscitation strategies, from initial diagnosis to discharge, with a focus on improving patient outcomes and neurological survival.

With over 1,000,000 new cases yearly, the chances of EMS coming into contact with a patient with hematological problems is growing. Many of these cases can offer unique presentations which EMS may not be aware of. Care is often handled outside of the EMS world but when we are called usually the patient is having a severe issue with their illness and/or treatments. Will you be ready for one of these cases? With over 40 years in EMS, Don has seen numerous emergencies of this style and much awareness was identified. We will visit several types of these emergencies and what EMS can do. Don will also share a more in-depth look at acute myeloid leukemia from experience with a direct family member.

Innovative technologies are pivotal for mobile integrated healthcare (MIH). New platforms and care delivery models have developed across the USA but not all of them have made our lives easier in healthcare. How do we cut through the noise, avoid technological pitfalls, and harness existing technologies for ensuring optimal communication between patients, providers, and other key stakeholders?

Course Objectives:

1. Compare and contrast different CP/MIH care delivery models plus their respective communication platforms.
2. Illustrate how healthcare-related communication has vastly changed in recent years (e.g. due to the COVID pandemic).
3. Provide guiding principles for maximizing communication channels to elicit reliable patient information, communicate effective treatment plans, and perform other critical tasks of CP/MIH in both urban and rural settings.