WREMAC Optional Collaborative educational materials 2017

Overview

  • Collaborative Topics
  • Topics provided by others in the collaborative
  • Includes links to ketamine and patella reduction databases for QA reporting
  • Podcast
  • Audio discussion of select topics in a podcast format
  • Simulation Video
  • Video demonstration and discussion of certain topics that are novel, complex, or otherwise occur infrequently
  • Self-Study
  • Much of the protocol document is fairly straightforward but requires careful review to ensure that providers are familiar with the content and facile in navigating the app
  • Providers should be given contact information by their region to facilitate the answering of questions that may arise during self-study
  • Examination
  • An exam will be created to be taken “open book” with the primary intent of assuring the providers are proficient with navigating the application and efficiently finding information.

Collaborative topics

Topics covered by others in the collaborative include:

  • Hudson Mohawk REMO Update (While this video presentation was created for the REMO region, it is a nice general overview of the collaborative highlights):
  • End of life
  • Ketamine
  • QA Reporting (please complete for every ketamine administration throughout the collaborative – not just in the Rochester area):
  • Patella reduction
  • QA reporting (Please complete for every patella reduction throughout the collaborative – not just in the Rochester area):
  • Calcium chloride
  • Pre-existing vascular devices (might take a bit to download):
  • Transport ventilators (might take a bit to download):
  • RSI checklist (PDF):

Simulation

The simulation videos are intended to demonstrate patient care scenarios in the context of the NYS collaborative protocols. Like the rest of medicine, there are different ways of practicing EMS and we encourage providers to watch the videos with a critical eye and think about how they would debrief the scenarios if they were the instructor/supervisor. Separate links for each module are listed so that you can chose which you would like to share with the providers in your region based on your needs. Special thanks to Laerdal for their assistance with these videos.

  • All simulation videos can be accesses via the individual dropbox links below, or on the YouTube EMS Nation channel playlist here:
  • Intro
  • Double sequential defibrillation
  • Surgical cricothyroidotomy (Bougie assisted)
  • OB field delivery
  • Neonatal resuscitation
  • Informal debrief of neonatal resuscitation (critiques scenario and models informal call review)
  • Complications of delivery and normal delivery (including postpartum hemorrhage, shoulder dystocia, breech, etc.)
  • Avulsed tooth
  • Eye irrigation / Morgan Lens
  • PerfectCPR for Apple Watch
  • Massive bleeding (with hemostatic wound packing and clot removal)
  • Critical patient management with RSI
  • Formal debrief of critical patient management scenario (critiques scenario and models formal call review sessions)

Podcasts

The podcast are not all-encompassing but focus on particular points of interest. Providers often have questions about why certain things came out the way they did. In addition, there aresome things that were discussed while we were writing the protocols that I think would be worthconveying to make sure the effect of the protocols results in the optimum patient care. The podcasts span two episodes and cover the topics below. The podcasts will eventually have a permanent YouTube home but you can use the links below to access the episodes for now.

Episode 38 (1 of 2):

  • Direct Download:
  • Permalink:

Episode 39 (2 of 2):

  • Direct Download:
  • Permalink:

For your reference, the discussion will include particular topics within the following protocols:

  • Page 5: Patient care responsibilities
  • Page 6: Medical control agreement
  • Regions will determine procedure for protocol deviations
  • (1-1): General cardiac arrest
  • Importance and maintenance of quality compressions
  • Transport safety issues
  • Waveform capnography
  • (1-3): V-fib arrest
  • Discuss the precipitate of CaCl2 and NaHCO3
  • Dilution of amiodarone bolus
  • (1-4): ROSC
  • Optimize patient condition prior to transport
  • (1-7): Pediatric arrest
  • No need to intubate if ventilating effectively
  • (2-2): Chest pain
  • Discussion of ASA, NTG, and 12-lead
  • (2-4): Agitated patient
  • Difference between agitated patient and excited delirium protocols
  • Titration of BDZ on standing order
  • (2-5): Oxygen
  • Concept of oxygen as a medication
  • Practice of using 15 LPM via NC during RSI
  • (2-6): Allergic reaction
  • Difference in indication for epi based on history of true anaphylaxis
  • Meaning of “consider” in protocol
  • (2-13): Chest trauma
  • Discuss sucking chest wound
  • Discuss CC in protocols
  • Review indications for chest decompression
  • (2-15): COPD
  • Discuss differences with statewide BLS protocols and what this means for the EMT
  • (2-19): Heat emergencies
  • Use of p.o. fluids
  • Discussion of water intoxication
  • (2-23): Hypoglycemia
  • Use of p.o. treatment
  • Discuss D10
  • (2-26): Musculoskeletal trauma
  • Pelvic fx management
  • (2-32): General pain management
  • Approximated weight based dosing
  • Ketamine effects
  • Ketorolac and nitrous cautions
  • Morphine histamine reaction vs true allergy
  • Rigid chest syndrome with fentanyl
  • (2-34): Post intubation management
  • Indicated for every intubated patient (not just for RSI providers)
  • Importance of analgesia (vs. sedation)
  • DOPE
  • (2-50): Vascular access
  • Lido for conscious IO
  • Limit unnecessary IVs in children
  • (4-9): Trauma criteria
  • Trauma center level destination based on CDC criteria

Self-Study

  • The above education does not cover every aspect of these protocols
  • Provider self-study is necessary to assure familiarity with the document and proficient navigation of the app

Examination

  • Individual regions have collaborated to develop an examination
  • To help ensure the security and validity of the examination, it will be available separate from these educational resources
  • The examination will be comprehensive and given in an “open book” format
  • The examination will not only be an assessment of knowledge but a practical exercise in extracting necessary information from the protocol document
  • The results of this required examination will recorded in accordance with regional procedure

Page 1 of 6New York State EMS Collaborative Protocols 2017