Clinical: Medical

This session cuts through the confusion. We'll work through real-world case studies and rapid differentials to answer the questions that matter operationally: When is this anaphylaxis and not anxiety? What’s the best medication to follow epinephrine? Does the distinction between anaphylactic and anaphylactoid reactions change what we do on scene? And why are we still getting this wrong despite how straightforward the treatment should be?

Despite clear evidence and updated guidelines from the American College of Emergency Physicians and World Allergy Organization, prehospital and in-hospital providers alike continue to under-dose, delay, or withhold the right medications. Meanwhile, the clinical presentations we encounter don't always fit the textbook model: first exposures that shouldn't be possible, atypical triggers, and overlapping conditions like Kounis syndrome that blur the line between allergic and cardiac emergencies.

Participants will leave with a clear decision framework for recognizing, prioritizing, and treating anaphylaxis across the spectrum from mild reactions that could deteriorate to full cardiovascular collapse. This isn't about memorizing pathways. It's about building the clinical judgment to act early, confidently, and correctly when minutes define outcomes.

Description: To think of stroke as a life or death situation is to over-simplify. The concept of “Time Is Brain” doesn’t refer to inanimate neurons that die as a stroke progresses. Each moment of delay in stroke care can destroy not only a patient’s ability to perform activities to get through the day they can also lose cells that contain personality and memories. Even patients who survive may lose part of their life. As hospitals are developing new methods of treatment for stroke victims, what role is there for EMS? This program will examine new in-hospital treatments like site-specific thrombolytics, clot corkscrews, cranial hypothermia, and the critical role of EMS in each phase of Stroke Systems of Care. These systems rely on both ALS and BLS providers to not simply save patients’ lives. This lively, pertinent, and through-provoking lecture shows how the actions of EMS providers are critical to every step of saving stroke patients’ life’s.

Description: We know that early acquisition and interpretation of 12 lead ECGs are essential to the effective treatment of patients with STEMI, but are we identifying all patients who should be evaluated with a 12 lead? What is the role of a 12 lead ECG in identifying a patient who can benefit from emergency cardiac care? This highly energetic lecture presents the pathophysiology of myocardial infarction in an easy-to-understand style to help you best identify, triage, and treat patients presenting with acute coronary syndromes. Using the latest research behind the AHA Guidelines changes, this program will help you better coordinate with your healthcare partners along the continuum of cardiac care. Emphasis is placed on risk factors, recognizing truly sick patients, and coordinating care with cardiac systems of care.

Description: We’ve all heard the controversies for cardiac resuscitation. “Medications don’t matter!” “No more ET tubes!”, “Epi never!”, “Epi forever!” It can be confusing for EMS professionals to sort out precisely what they’re supposed to do. Taking a look at the Top Ten Headlines for cardiac resuscitation, this program evaluates the strength of the science behind each recommendation and how they might be implemented in different EMS systems. Getting past the “Headlines,” attendees will return home well-equipped to open up discussions about optimizing EMS cardiac arrest resuscitation in their systems beyond “I read this study once” or “This is what the algorithms say now.”

“Perhaps the most important monitoring tool prehospital providers can use” - end-tidal waveform Capnography - it isn’t just for respirations anymore. Using a simple four-step assessment technique, this program shows EMS providers of all levels how capnography can be used not only to confirm successful endotracheal intubation, but to evaluate shock in trauma patients, monitor for the return (or loss of) pulses during CPR, identify bronchospasm in asthma and hypoxic drive in COPD, to guide seizure management and paralytic medication administration, and much, much more. This case-driven session develops the fundamentals of capnography so that every EMS provider can improve the assessment, treatment, and outcome for their patients using the diagnostic tools of end-tidal waveform monitoring.

We've overcorrected. A decade ago, EMS rarely identified sepsis. Now, nearly every altered patient with a fever gets flagged, and the treatments we're initiating don't always match what the evidence or the patient actually needs. Sepsis kills more people annually than prostate cancer, breast cancer, and AIDS combined, and EMS brings in 60% of severe sepsis cases that arrive at the emergency department. But recognition isn't the same as appropriate action, and the pendulum has swung from missed cases to reflex protocols that don't account for clinical nuance.

Recent updates to sepsis criteria and expert commentary challenge some of our field assumptions: when fluid resuscitation helps versus harms, what vital signs actually matter for decision-making, and how to differentiate the septic patient who needs aggressive intervention from the one who doesn't. This session will cover practical, real-world methods for identifying sepsis correctly, treating it intelligently, and handing off patients to the ED with information that changes their care trajectory.

Expect case-based scenarios, a working framework (CHART steps), and straight talk on when to escalate treatment, and when to stop. Whether you're BLS trying to make the right hospital decision or ALS managing pressors in the back of a rig, this session is built for the calls you're actually running.

Audience: EMT through Paramedic; includes ALS-level assessment and pharmacology, structured to be accessible and actionable for all certification levels.

Description: Mission critical information is frequently lost during patient hand-off between providers, contributing to healthcare errors and poor patient outcomes. The Joint Commission has identified patient hand-off as a critical safety and quality problem, and the Wall Street Journal has called patient hand-off "the Bermuda triangle of healthcare". But it doesn't have to be that way. Using real-world examples, this program shows how simple, validated techniques from the military, the fire service, and the Center for Transforming Healthcare can help you and your system achieve excellence in patient hand over.

Lazarus Syndrome, the spontaneous return of circulation (ROSC) after CPR has been discontinued, is a rare but critical phenomenon for EMS providers to understand. How an EMS organization deals with Lazarus Syndrome reveals a lot about the quality of their care and service overall. This session explores what Lazarus Syndrome is, what it does to the patient’s physiology, where it happens (typical contexts and contributing factors), and what EMS should do when confronted with a potential case. Through real-world examples and current evidence, participants will learn how to recognize, manage, and document these situations while preserving patient safety and protecting provider liability.

Enhanced Recognition: Participants will identify potential instances of Lazarus Syndrome, recognizing early signs and distinguishing them from typical ROSC.

Improved Clinical Response: Learners will effectively apply evidence-based monitoring and documentation processes, ensuring thorough patient care and continuity of treatment.

Increased Professional Confidence: Providers will feel more prepared to address rare post-resuscitation phenomena, communicate findings to receiving facilities, and maintain high standards of ethical and legal compliance.