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March 2, 2012 / jeffmedic

Gathering of Eagles 2012

I was fortunate, this year, to be able to attend the 2012 EMS State of the Sciences Conference in Dallas, Texas. The presenters are a group of medical directors from the largest EMS systems in the United Stated who have taken to calling themselves the Eagle. The conference is commonly known as the Gathering of Eagles. Prior to the conference, the Eagles meet and discuss issues related to EMS in their areas. Then the Eagles, plus a few other guests, host the conference for EMS medical directors and providers. The presentations are 10-15 minutes long and cover a wide range of current EMS topics. Here are a few things I learned from this year’s conference.

The first presentation was by Dr. Corey Slovis of the Nashville Fire Department. Dr. Slovis lives by the rule of 5. He can reduce or expand any idea into 5 things. Every year he gives a talk about the 5 journal articles that have come out in the past year that EMS providers should know about. The article I was most interested was about a study that compared IM midazolam to IV lorazepam in patients with status epilepticus. The study showed that IM midazolam is at least as effective as IV lorazepam. This is important for EMS providers because our patients don’t usually have vascular access when we get them and it does take a few minutes to start an IV or an IO and give medicine through it. Being able to start with an IM injection is fast and safer in a moving patient. Additionally midazolam does not have the same storage requirements as lorazepam.

Dr. Slovis also gave a presentation on using IV epinephrine in severe anaphylaxis. He proposed mixing 1 mg of epinephrine into a 1 L bag of normal saline making a concentration of 1 mcg/mL. Infuse at rate of 1 mcg/min and titrate to effect. This method is much simpler than the way I was taught. I had heard him give a talk about this previously and was hoping he would discuss it at Eagles. I had intended to propose this to the service I work for but my medical director was sitting in front of me during the presentation and liked the idea.

Dr. George Ralls spoke about the pit crew approach to treating MI patients. This idea has been around for awhile with cardiac arrest patients. All of the major 911 providers from my area were represented at the conference. Hopefully we can agree on a way this should go and then I can teach that method in my program.

Dr. John Freese from FDNY talked to us about intra-arrest hypothermia. The idea is to induce therapeutic hypothermia during cardiac arrest instead of after ROSC. I look forward to hearing about more research on this. It sounds promising.

I learned from Dr. Chirstopher Colwell of Denver that you can’t kill a patient with benzodiazepines alone. He spoke of giving patients with alcohol withdrawal doses that were several times what I carry on the ambulance.

There were many other excellent presentations. The slides from each of them can be found here.

I had a great time learning about my profession and spending time with friends. It was great to see so many EMS medical directors there including the medical directors from my program and the service I work for.

I am definitely looking forward to next year.





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