Rom Duckworth
Presentation catalog

Clinical: Trauma

8 programs  ·  Full abstracts and learning objectives below

EMS and TBI

Immediate Field Care for High-Impact Head Injuries.

Description: Traumatic Brain Injuries (TBIs) account for approximately 2.5 million annual ED visits. Of these, many patients leave with lifelong disabilities and more than 50,000 don’t leave at all (one-third of ALL injury-related deaths). In those first moments following impact, the EMS care that you provide is a major factor in your patient's outcome. Hyperventilate? Intubate? Permissive hypotension? Do you know what to do? Using case studies, evidence-based guidelines and a common-sense approach, this program gives you strategies for the prehospital management of traumatic brain injuries in a way that real-world medics and EMTs can use in real-world trauma settings.

Learning objectives

  • Recognize traumatic brain injuries of all levels as they present in the field.
  • Prioritize field assessment and treatment of TBI patients according to new clinical guidelines for immediate prehospital care.
  • Effectively coordinate with hospital trauma teams for improved outcomes for TBI patients.

Extrication and EMS

Coordinating Team Delivery of Critical Care.

Description: Good vehicle extrication demands a unique collaboration between rescue and emergency medical personnel. Incorporating key victim assessment information in the extrication size-up will improve your strategic and tactical plans. To save a patient (not just chop up a vehicle), rescue and EMS must understand each other’s jobs and work together effectively. This program uses a real-world approach to incorporate EMS care considerations in the extrication strategy and shows how most critical trauma encountered in vehicle collisions can be managed quickly and effectively by first responders. This program will help you make better strategic extrication decisions and more safely deliver immediate life-saving treatment, reducing time from patient contact to patient removal to patient surgery.

*This session can be delivered as a 60-90-minute lecture or a 2, 4, or 8-hour program. The 2, 4, and 8-hour programs contain additional information on trauma care for special patient populations, including geriatrics, pediatrics, and pregnant patients, and include demonstration / hands-on of both basic and advanced trauma skills.

Learning objectives

  • Describe how patient presentation affects the tools and techniques to be considered for rescue.
  • Demonstrate communication tools to facilitate patient assessment, care, and coordination with rescuers.
  • Rapidly detect, identify, and manage the five top causes of traumatic injury and death as either an ALS or BLS EMS provider.
  • Apply key concepts to integrate both EMS and rescue efforts in extrication scenarios, including traffic incident management, PPE selection, vehicle stabilization, and crew resource management.

Synthetic Street Drug Update 2026

Uncontrolled Patients on Controlled Substances.

The drugs have changed. So should our response. We're no longer dealing with predictable opioid overdoses or straightforward stimulant intoxication. Today's synthetic street drugs, super-meth, novel fentanyl analogs, synthetic cannabinoids, and designer hallucinogens, produce violent, bizarre, and physiologically chaotic presentations that don't respond to our standard playbook. Patients are awake but combative on naloxone. Sedation backfires. Restraint escalates the crisis. And the scene itself is often more dangerous than we anticipate.

This session provides a 2026 update on what's actually circulating, what it does to patients, and what works when traditional management fails. We'll work through real-world case studies that show how these drugs present differently, why some interventions make things worse, and how to coordinate response across EMS, fire, and law enforcement when the scene is dynamic and the patient is uncontrollable.

But we're not stopping at scene management. We'll also discuss what's being done, and what could be done: at the community and legislative level to reduce the demand for emergency response in the first place. Harm reduction, diversion programs, and innovative public health strategies are reshaping how some systems approach addiction. You'll leave with both tactical tools for today's calls and a clearer picture of where this crisis is heading.

Session outline

  • Audience: EMS, fire, and law enforcement personnel at all levels. Includes clinical management strategies and operational coordination tactics

Learning objectives

  • Recognize the clinical and behavioral presentations of current synthetic street drugs, including super-meth, synthetic cannabinoids, novel opioids, and designer hallucinogens
  • Prioritize scene safety and tactical response strategies when managing patients under the influence of synthetic substances with unpredictable or violent behavior
  • Apply evidence-informed pharmacological and non-pharmacological interventions for synthetic drug overdose and acute intoxication, including when standard treatments fail
  • Coordinate multi-agency response (EMS, fire, law enforcement) to improve scene control, patient outcomes, and responder safety during synthetic drug emergencies
  • Identify community-level harm reduction and diversion strategies that reduce emergency call volume and support long-term public health outcomes
  • *As seen in Fire Engineering Magazine’s Fire/EMS Column*

Cannabinoid Hyperemesis Syndrome

Scromiting and the Anti-Munchies.

Description: Regular medical and recreational use of cannabis is on the rise among all age groups. In most cases this is associated with few side effects, but some regular users experience a wildly paradoxical reaction. While cannabis will normally suppress nausea and pain and stimulate appetite, weekly cannabis use can sometimes produce severe cramping, abdominal pain, vomiting, and nausea known as cannabinoid hyperemesis syndrome (CHS). In this program we explore the pathophysiology of CHS, discuss presentations that EMS may encounter, and review the current diagnostic and treatment criteria. Current estimates of cannabinoid hyperemesis syndrome affecting potentially 2.7 million people in the US annually with significant increases in states with legalization. With complications of CHS including kidney failure, electrolyte imbalance and skin burns on patient seeking self-treatment, can EMS providers afford to be unprepared?

Learning objectives

  • Appreciate the acute and chronic hazards presented by cannabinoid hyperemesis syndrome
  • Describe the three phases of cannabinoid hyperemesis syndrome
  • Identify prehospital presentation signs and symptoms of cannabinoid hyperemesis syndrome with a focus on differential diagnosis
  • Debate current theories of the pathogenesis of cannabinoid hyperemesis syndrome
  • Describe immediate EMS as well as long-term treatment for cannabinoid hyperemesis syndrome

Squeeze Play

Coordinating Rescue Care for Crush Injury and Crush Syndrome.

Description: Pinned in a car for 4 hours, trapped in a building collapse for 12, fallen on the floor for 24, immobile in a rescue harness for 10 minutes. Each of these patients may be experiencing different, but deadly aspects of crush injury, crush syndrome, rhabdomyolysis or suspension trauma. Why are some victims okay when trapped, but when we rescue them, they die? Where do field amputations come in to play? What protocols do you need in place to deal with them? Real-world case-studies bring this presentation to life as it answers these questions and more by bringing you evidence based best practices, model protocols, and resources that you can use to treat these high-pressure and high-profile patients.

Learning objectives

  • Identify crush injury, crush syndrome, suspension trauma and injuries consistent with rhabdomyolysis.
  • Utilize model pre-hospital protocols for advanced care for victims of crush injury, crush syndrome, rhabdomyolysis and suspension trauma.
  • Understand the criteria and necessary resources to employ amputations.
  • Integrate with trauma systems of care to provide crush injury, crush syndrome and suspension trauma patients with the best chance of outcome.

The Top 10 Trauma Myths and Legends

Seeking the science beyond the textbooks.

Description: We’ve all heard the legends of trauma care. “the ABCs are top priority!”, “Mechanism of Injury Matters!”, “Never remove a dressing!”, “Hyperventilate that head injury!” But what happens when what you were taught no longer matches what science says? Taking a look at the Top Ten Trauma Myths and Legends this program evaluates the strength of the science behind each recommendation as well as how they might be implemented in different EMS systems. Getting past “we’ve always done it this way”, attendees will return home well-equipped to open up discussions about trauma care in their systems beyond, “This is what I was taught in class.” and “I read this study once”.

Learning objectives

  • Effectively prioritize trauma care in multi-trauma situations.
  • Describe current international resuscitation theory, practice and importance of traumatic
  • cardiac arrest care by emergency responders.
  • Appreciate the importance of proper prioritization of ALS components of trauma care.
  • Define the roles of the individual field provider, supervisor, administrator and medical director in improving prehospital trauma care and citizen survival rates.

Hot Controversies in Traumatic Cardiac Arrest

The New Guidance.

Traumatic out-of-hospital cardiac arrest is one of the most operationally complex, resource-intensive calls we run, and historically, one of the least survivable. But new research and national consensus work are changing what's possible when EMS owns the first critical moments.

This session isn't a lecture. It's a conversation. Drawing from direct involvement in a national multidisciplinary TOHCA workgroup, convened by leaders across EMS, trauma surgery, and resuscitation science, this program translates recent evidence into field-ready answers. We'll tackle the questions that matter on scene: When does airway management help versus delay definitive care? What's the logic behind bilateral chest decompression when you're not sure? How do you balance simple, repeatable algorithms with the critical thinking these cases demand? And when is it time to stop?

Expect live Q&A, case discussion, and candid debate on what individual clinicians and whole trauma systems can do differently. Whether you're an educator building training or a paramedic trying to make better decisions in the moment, this session is designed to give you clarity and practical next steps, not theory you can't operationalize.

Bring your questions on perfusion strategy, resuscitation stopping points, and scene-to-center decision-making. This is real-world evidence translation for people who need answers they can apply next shift.

Session outline

  • Audience: Paramedics, EMS educators, EMS officers, and trauma system leaders. Clinically advanced but structured for operational application.

Learning objectives

  • Compare TOHCA resuscitation priorities and treatment approaches from major national and international stakeholder organizations (NAEMSP, ACS-COT, AHA, NAEMT, ACEP)
  • Differentiate high-yield interventions from low-impact or resource-intensive treatments based on existing trauma system capabilities and evidence
  • Apply critical thinking frameworks that balance algorithmic consistency with case-specific clinical judgment in traumatic cardiac arrest
  • Evaluate the role of standard cardiac arrest resuscitation techniques (compressions, rhythm analysis, medications) in the traumatic arrest context
  • Justify resuscitation continuation or termination decisions using evidence-informed criteria and system-level protocols

Stopping the Trauma Triad of Death

What you don't know might kill them.

Description: There are three factors that work together to kill trauma patients and they aren’t the ABCs. First responders, EMTs and paramedics can improve patient outcomes by interrupting the subtle but vicious cycle of hypothermia, acidosis and coagulopathy. This cycle, known as the Trauma Triad of Death, must be stopped before it becomes so obvious and so severe that it results in death. This session examines each leg of the lethal triad, identifying they can be addressed individually as well as how the cycle as a whole can be interrupted before this self-feeding cycle pushes your patient past the point of no return.

Learning objectives

  • Identify each leg of the trauma triad of death.
  • Explain how each leg of the trauma triad reinforces each other in a vicious cycle.
  • Utilize the key steps to address each leg of the trauma triad individually as well as interrupt the cycle once it has begun.
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Education, consulting, and speaking services are provided independently through the New England Center for Rescue & Emergency Medicine, LLC. Organizations, agencies, publications, and employers named on this site are identified solely to describe professional history, service, and qualifications. Their appearance does not indicate endorsement, sponsorship, or affiliation, and nothing offered here is offered on behalf of the Ridgefield Fire Department, the Town of Ridgefield, Connecticut, or any other organization named.