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Gathering of the Eagles

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In a recent post, I praised CEMSMAC, the state EMS Medical Advisory Committee made up of the medical directors from each of Connecticut’s five EMS regions. I have been in EMS over twenty years, and I can tell you, I grow more and more optimistic about the future of EMS thanks to the growing maturation of emergency medeical physicans. Whether individual and working together on committees and in organizations, they are demonstrating a committment to patients, to evidence, and to making a better system.

If there was any place I could be this weekend, besides sitting here at home playing with my five-year old daughter (and working the ambulance tomorrow), it would be in Dallas for the annual “Gathering of the Eagles” conference.

Here is the description of the conference from the Gathering of Eagles website:

The EMS State of the Sciences Conference (dubbed by media as “A Gathering of Eagles”) has become one of the most progressive and important EMS conferences worldwide.

The faculty, derived from the U.S. Metropolitan Municipalities EMS Medical Directors Consortium (The “Eagles” Coalition) is comprised of most of the jurisdictional EMS Medical Directors for the nation’s 35 to 40 largest U.S. cities’ 9-1-1 systems as well as the chief medical officers for several pivotal federal agencies such as the FBI, U.S. Secret Service, White House Medical Unit and also includes several global municipalities such as London (UK) and Sydney (Australia).

In essence, this small but cohesive cadre of leading emergency medical services specialists not only oversee the medical aspects of day-to-day 9-1-1-type emergency responses and early resuscitative interventions for trauma, stroke, cardiac care and other critical emergencies in the nation’s (and some of the world’s) most populous cities, but most of them are also responsible for much of the medical aspects of homeland security and disaster management in these high-risk venues (in which nearly 100 million persons dwell and make their livelihood). Their ability to deal with these significant responsibilities is, in many ways, facilitated by the close cooperation of this unique convocation of physicians who also generally serve as the main interface between local government and the medical community at large in these metropolitan municipalities.

The purpose of the highly popular annual Eagles conference is to share with participants — and faculty alike — the most cutting-edge information and advances in EMS patient care, research and management issues — as well as trending challenges (and lessons learned from those challenges) — while also introducing novel patient care strategies and techniques.

Beyond the faculty, this unique global EMS conference is also famous for having pioneered the 10 minute bullet plenary presentation, “lightning rounds” and other innovative educational advances which have not only provided the attendees with 40 or so plenary presentations over 2 days but, according to conference evaluations, have also changed nationwide medical practices almost overnight. Accordingly, the consortium has become extraordinarily influential in shaping future EMS practice trends, medical aspects of disasters and homeland security — not to mention day-to-day 9-1-1 responses and resuscitations worldwide.

One day I will go. In the meantime I await their posting the PDFs of their presentations on their web site. They truly are the cutting edge, and I am anxious to learn where they believe we are going.

Old Posts on the Eagles

Gathering of Eagles 2012 Presentations

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The Annual Gathering of Eagles Conference is over and the presentations are now posted on-line.

The “Eagles” Coalition, also known as The U.S. Metropolitan Municipalities EMS Medical Directors Consortium includes most of the EMS Medical Directors for the nation’s largest cities 9-1-1 systems. The conference highlights “the most cutting edge information on EMS research, management issues, lessons learned and newly-proposed advanced patient care techniques.”

Gathering of Eagles 2012 Presentations

Check out these two presentations in particular:

The Pentagon Papers: The Five Most Important Publications of the Past Year – Corey M. Slovis, MD (Nashville)

Epileptic Fix: Hot-Off-the-Press Results from the RAMPART Trial Jason T. McMullan, MD (Cincinnati)

If you want to stay on top of the latest trends and research in EMS, you have to know what the Eagles are talking about.

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Gathering of Eagles 2010

Gathering of Eagles

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Eagle1If there is one EMS conference I go to next year, I would like to go to the annual EMS state of the Science Conference — better known as the Gathering of Eagles — held in Dallas each February.

The Eagles are the EMS Medical Directors of the largest 911 systems in the country, and some of the most forward progressive thinkers in EMS.

The conference is open to anyone interested in EMS.

The presentations from their 2010 conference are available online and make great reading.

Gathering of Eagles Presentations 2010

Here is a sample of two presentations about the future of intubation:

The Great Debate: Why Medics Should Not Be Trained in Intubation
- Raymond L. Fowler, MD (Dallas)

The Great Debate: Should Paramedics Intubate?
- Corey M. Slovis, MD (Nashville)

I’ve heard both of these men speak before at JEMS Conferences and they are both outstanding speakers.

Other topics discussed at the conference included medics using biomarker saliva testing to identify NSTEMI patients, induced hypothermia not just post ROSC, but during arrest, RSI using a King LT instead of ET, return of tourniquets for uncontrolled hemmorage, and new ways to treat excited delerium.

Check it out.

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For more on the Eagles work, here is an informative post by Firegeezer:

ALS Response Times; Never Mind.

Micellaneous

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A rainy day at work. I’m sitting at the computer and trying to get caught up on email, bills, scheduling, and maybe even this blog.

Here’s a couple of recent tidbits.

This morning a first occurred. I occasionally hit my head at work — most often on the overhanging bright lights above ER beds, and sometimes on a door when I turn suddenly. Today while walking into a house hallway, I ducked to avoid hitting my head and when I raised my head back up, I hit a light-fixture, knocking it from the ceiling, into the arms of a cop, who fumbled it. The glass fixture hit the floor smashing into a 100 pieces. Fortunately, I was working with the boss of our service who was cool about it and the family was very cool about it as well. So no big deal. We gave the unresponsive diabetic some D50, got some slippers on her bare feet, and walked the now awake patient to our stretcher and took them in to the hospital.

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The last two weeks were big meeting weeks for me, and some of the issues I found were very frustrating. The roadblocks ranged from obstinate obstructionists to people who criticize, but never read the material beforehand, to numbing bureaucracy, to problems too complex for our little committees to be able to solve to the inevitable personal and political agendas (we all have them) behind every best effort to improve patient care. My back was getting a little stiff so I stood for a moment, and then feeling better standing, began to pace a few strides back and forth from my chair. I suddenly felt quite happy and empowered. Could I perhaps attend all meeting and instead of having to sit in a chair, could I just pace while I talked? I had a vision of Robert DeNiro in The Untouchables. I pictured myself carrying a baseball bat…

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A number of years ago when I full time city medic working nights, I turned down a chanced to be a suburban medic like I am now. I loved the street and wanted to be right in the middle of all the lights and sirens glory, the shootings and stabbings, etc now to mention the sheer craziness of the city at night. I eventually accepted the suburban position when it was offered againa couple years later — I took it due to changes I saw coming in the way things were happening. While I continued to work quite a bit in the city (on what was then unlimited overtime), I was glad for the change. Now years later, I am equally glad.

I was talking with one of the city medics and the issue became intubations, and while it has been quite awhile since I have done a traumatic arrest, my intubation numbers are much higher than most of the city medics (due to the proliferation of city medics now along with the fact that medics do transfers much more than they used to, which when I started was never unless it was an ALS transfer. We have a number of nursing homes in the town. Two of them, it seems all the patients are DNRs. The other three, it seems most of the patients are full codes. And they keep us busy. I do enjoy intubating.

I know there is a lot of literature out there about how intubations may not in fact benefit the patients and the ET tube may be completely replaced by the LMA, Combitube or other airway device, but I read an interesting presentation (see below) that pointed out most of the literature studying intubation was done before capnography. There is reason to believe that prior to continuous wave form capnography there was quite a high rate of unrecognized misplaced intubations (mainly tubes that had become dislodged)(possibly as high as 1-4) and that this may account for the poor science backing intubation. With wave form capnography, the misplaced tube should be nonexistent, and outcomes should improve.

Check out this powerpoint:
Making Waves Continuously in the Big Apple

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The above powerpoint comes from the annual Gathering of Eagles Conference. The Eagles are a group of big city EMS Medical Directors, who are pretty cutting edge. Check out their site. There are many more powerpoints available there on many, many interesting EMS topics.

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So anyway, back to my suburban job. I am the contact paramedic on a busy suburban volunteer ambulance. But not so busy that I didn’t have the opportunity to ride my bike around our industrial circle (0.7 miles)for 12 miles on Sunday and another 12 today. Yesterday, I watched the Boston Marathon on the big screen HD TV, but unfortunately I only got to see miles 1-22. Duty calls. I was back in time to watch the end of the Red Sox 12-1 win. 4 in a row!

Tonight I am hoping to be able to watch all of American Idol. This year on the Tuesdays I have worked (I work till 10:00 P.M.) we have seemed to get a call every time at the stroke of 8 just when the show is starting. I do have it taped for me at home, but I like watching it live. For those idol heads out there, I am rooting for Allison, but am also a big fan of Adam (I likely won’t buy his records, but he is entertaining and has a voice from outer space).

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Anyway, the best part of being out here in the suburbs in our new stretcher. Now, when I started in EMS we had the two man stretcher. You basically deadlifted your patient (one EMT on each side) into the ambulance. I resisted the one man stretcher when it debuted for about a week. So with the past, all I had to do was watch the video for the new power stretcher to be sold. There are some drawbacks — it is heavier and harder to maneuver by yourself, lugging it into a house, but you just push a button and it raises and lowers itself. It adjusts to just the right level for sliding patients on and off the bed. It is a levitation machine. I love it!

Eagles Coalition

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The Conference I wish I was going to.

As I’ve mentioned I am going to JEMS – EMS Today in March. Great conference, great speakers, great chance to find out what’s going on in EMS.

But if I could go to only one conference this year – and I am kicking myself that this is not the one I am going to (because I didn’t think to check into it), it would be the Conference of the Eagles Coalition held in Dallas, Texas from February 16-17.

The Eagles are the EMS medical directors of the nation’s largest EMS systems, including doctors like Paul Pepe who are on the leading edge of EMS care.

Check this out for an Agenda.

Fortunately many of the Eagles will be at JEMS giving presentations of their findings.

I’ll try to go to as many as I can and report back.