EMS EXPO Report

I returned last night from the EMS EXPO in Las Vegas. I love going to these EMS conventions. The classes are great. You meet new friends and get reacquainted with old ones. You get to hear the best speakers and get updated on all the latest research and ideas, and you can wander the convention floor and see all the new products. Also, as far as convention cities, Las Vegas obviously doesn’t lack for diversions.

Here are some of my trip highlights:

1. Dinner with Thom Dick. I was able to have dinner with one of my heroes, Thom Dick, the author of Street Talk and People Care. As I wrote about in this blog several months ago, Thom Dick’s writings have been very influential in my career, particularly as a new EMT. He set the example of the need to focus on the person.

2. Capnography Classes with Baruch Krauss and Bob Page. This was why I went out to Vegas. Baruch Krauss, a physician from Harvard, is the leading proponent of capnography in EMS. He has conducted research, written articles and given lectures on the subject. His class was packed to capacity, and was very informative.

Bob Page is a paramedic from Missouri, and one of the best lecturers I’ve seen. Many years ago I took a great 12 lead class from him. I wasn’t expecting to hear him, but one afternoon while wandering through the convention hall, I went by the Zoll booth and saw him as he was getting ready to give a 30 minute mini-class on capnography. I was one of five people who sat in on the class.

Both lecturers were excellent. I spoke to each of them very briefly after their talks and discovered they are both writing textbooks on capnography. Finally! I will be posting my notes on the lectures on my blog, Capnography for Paramedics. If you ever get a chance to hear either of these fine teachers, don’t miss the opportunity.

3. Drinking beers by the pool on the last day and then going to the Jeff Beck concert at the House of Blues. I stayed with an old friend of mine, who has worked in EMS at all levels from paramedic to clinical coordinator to state administrator. It was good hanging out with him – he introduced me to Thom Dick and some other interesting EMS people who I had read about but never met, and he got the best seats for the show. Jeff Beck is an enigmatic guitarist, who instead of pursuing fame, although he has plenty, has always chosen to play just what he wants regardless of commercial success. A peer of Clapton and Hendrix, a former member of the Yardbirds and The Jeff Beck group featuring Rod Stewart, he barely said a word to the crowd, just played his blazing guitar. He did an amazing version of the Beatles “A Day in the Life.” I always admire people, who do what they love, who pursue their own excellence regardless of what others think they should do.

Other notes:

I took a class called “What’s New in EMS,” which was a review of the latest research: According to the lecturer, capnography, pain relief, particularly fentanyl, CPAP and nitro for pulmonary edema, permissive hypotension for trauma, 12 lead ECGs, are all proving their worth. On the downside, lasix and Morphine for pulmonary edema, intubation for head injured patients, and amiodarone are not faring well in research.

As I mentioned the EXPO floor was akin to a Tijuana market with so many vendors competing for your attention.

There were a multitude of ambulances and rescue vehicles, hundreds of different mannequins, including a dog mannequin for animal CPR, training and data software vendors, all kinds of monitors and other gizmos. Here were my non-commercial favorites:

1. Safety Ambulance – a prototype with ideas from EMTs and medics on how to make the ambulance safer.

2. The National Association of Emergency Medical Technicians (NAEMT) booth. – I’ve been in EMS for 18 years now and have never joined a national association. They signed me up and I am now a member.

3. The National EMS Museum – I gave them the requested $5 donation. The museum is just an idea now, but a needed one. I’m posting their web site, although it is still under construction. They plan to start with a virtual museum, and maybe one day get to the brick and mortal.

The next EMS EXPO is scheduled for Orlando in 2007. The next JEMS EMS Todayconference will be in Baltimore on March 6-10, 2007.

7 Comments

  • Eric says:

    I’m hoping to attend EMS Today as well. Hopefully we’ll have a chance to meet (and get your book autographed).I really enjoyed the thought that capnography is the “quick-look for the living”. I might have to use that one to convince some of our folks.

  • PC says:

    Eric-That would be great to meet you. We’ll email when the time gets closer.Best,Peter

  • denvermedic says:

    interesting synopsis. that safety ambulance, while looks nice, freaks me out due to the lack of a bench – we would lose the ability to double load trauma patients that were lie downs, which would cost too much overall on our system resources.dr. krauss gave our capnography lecture when we were looking at getting it, and i found his lecture to be great. i would say it was his lecture that had convinced the masses that we needed to have it, and i am glad we do.doesn’t surprise me about morphine and lasix in pulmonary edema – our medical director i think is one step away from taking morphine off standing order for pulmonary edema. lasix is already a call in and granted maybe 50% of the time (and never the dose you ask – always much lower).intubation in head injured patients – are they talking nasal or oral? i already hold off nasally intubating head injured patients if i can, as we are never truly that far from the hospital and what they really need is rsi (which we don’t have and most likely never will).just thoughts, as usual…

  • Anonymous says:

    What was the issue with the amiodarone? I looked in recent articles and didn’t see anything about it. What were the specifics? This sounds interesting.

  • PC says:

    I was surprised as well. I have had good experiences with amiodarone, but who is to say lidocaine wouldn’t have worked just as well in those circumstances. The thrust of the speaker’s arguement was that the research that first promoted amiodarone was not all it was cracked up to be. He mentioned newer studies, without listing them. Here is the summary from one which may have been one he was referring too. Can J Cardiol. 2006 Mar 1;22The use of amiodarone for in-hospital cardiac arrest at two tertiary care centres.Pollak PT, Wee V, Al-Hazmi A, Martin J, Zarnke KB. Department of Medicine, Dalhousie University, Halifax, Nova Scotia. amiokinetics@hotmail.comBACKGROUND: Although amiodarone significantly increases survival to hospital admission when used in resuscitation of out-of-hospital pulseless ventricular tachycardia and fibrillation, there are limited data on its utility for in-hospital arrests. OBJECTIVES: To determine whether the use of amiodarone, as recommended by the year 2000 American Heart Association Advanced Cardiac Life Support guidelines, improved survival following its introduction to the resuscitation algorithm at two tertiary care institutions. METHODS: Charts of 374 cardiac resuscitations were retrospectively studied at the two institutions. Basic survival outcomes and demographic data were recorded for cardiac arrests with ventricular tachyarrhythmias qualifying for administration of antiarrhythmic agents. RESULTS: Qualifying rhythms were present in 95 patients. Clinical uptake of amiodarone was limited. In the 36 patients who received amiodarone, survival of resuscitation was 67% versus 83% (P=0.07) in the 59 patients receiving only other antiarrhythmic agents (chiefly lidocaine [94%]), while survival to discharge was 36.1% and 55.9% (P=0.06) in these two groups, respectively. CONCLUSIONS: Following two years’ experience with the introduction of intravenous amiodarone for resuscitation in the institutions, use was less than 50% and no clinically observable survival benefit could be documented. Possible explanations for the difference between this experience and that found in out-of-hospital resuscitation trials include differing patient populations and operator bias during resuscitation. These results should provoke other institutions to question whether amiodarone has improved survival of cardiac arrest under the conditions prevailing in their hospitals. A patient registry or prospective, randomized trial will be required to assess what parameters affect the success of intravenous amiodarone for resuscitation in-hospital.

  • denvermedic says:

    i would say that i hadn’t heard anything positive about amiodarone (when it was coming out as a lidocaine replacement) but we switched over to it anyway, especially when the price dropped significantly. i will admit to not having followed further studies, so thank you for including it.i always wonder what someone’s agenda is if they are pushing a drug (or telling people to stay away from a drug) without the firm data to back it up. the pharmaceutical industry can use their muscles in so many ways…even to create a “study” that when you read further seems awfully biased.i am curious as to whether the study you included here was admin of amiodarone strictly for vfib or pulseless vtach or if it included a post-arrest dose (we give 150 mg iv over 10 min. after successful conversion, even if the pt. has had 300 mg as part of the arrest – max dose is 2.2 g over 24 hrs). just curious.

  • Matt says:

    Thom actually taught the first day of my EMT-B class. Very nice guy.

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