TASERs and Medical Injuries

Gloucester County EMS/Rowan EMS

Clinical Education Symposium

March 23 – 24, 2013

Tentative Schedule (CEU Approval Obtained) Saturday March 23

0700 Registration Opens

0745 Opening remarks and welcome Andy Lovell, Vern Howery

0800 EMS and the Taser Dr. Jordan Barnett; ED Physician, Lourdes Medical Center of Burlington County

The Taser has recently been approved for deployment in New Jersey by those law enforcement agencies trained in its use. Taser deployment in other states has presented challenges for both BLS and ALS providers. Dr. Barnett will discuss the potential presentation (injuries) of “Tased” patients to EMS and the absolute need for a complete patient assessment. New Jersey specific situations will also be discussed. CEU Approval Request: 1.0

0900 Care and Feeding of Trachs Dr. Ken Lavelle; ED Physician, Jefferson University Hospital

As more and more “device dependant” patients are receiving primary care in their residence, EMS providers now frequently encounter tracheostomy patients. If a prehospital provider is not knowledgeable or accustomed to “trachs”, the anxiety level of the patient, the patient’s caregiver and the EMS provider will surely rise. Dr. Lavelle will discuss the function of a tracheostomy, common situations encountered by EMS providers and the resolution of problems.

CEU Approval Request: 1.0

1000 Chesterfield School Bus MVA Review Chief Ryan Lewis; NJ MICP, Chief–Mansfield Township Ambulance

One of the most frightening dispatches any EMS provider will hear is “An MVA involving a school bus, multiple injuries reported”. A school bus MVA occurred recently in Chesterfield, Burlington County. Chief Lewis will discuss the response to this incident, the concerns that arose and some of the best practices resulted and can be applied to any incident involving a school bus.


1100 Neuro-Science Update Dr. Erol Veznedaroglu; Interventional Neurologist, Capital Health

Stroke treatment and patient outcome is advancing on an almost daily basis. Dr. Vez will discuss the requirement for timely assessment of a potential stroke patient and the decision making process when making a destination determination. He will also discuss the latest advancements in stroke evaluation in the ED and interventions now being made to greatly improve patient outcomes. Strokes can affect all age groups within our patient population. It is not restricted to only the “senior” population.


1200 Lunch

1300 What’s Up at OEMS Karen Halupke, RN, M.Ed.; Director-Office of EMS, NJ Dept. of Health

Director Halupke will review the operation of OEMS; including how to contact OEMS, the new certification platform, updates to the EMT curriculum, replacement of the CORE requirement with the ABC Refresher, complaint investigation, etc… All NJ prehospital providers will also have an opportunity to ask questions and get the latest information from Trenton. CEU Approval Request: 1.0

1400 STEMI Management Dr. M Scott Dawson; Interventional Cardiologist – Underwood-Memorial Hospital

Dr. Dawson will discuss the anatomy and physiology of STEMI and Non-STEMI patient presentation, the importance of early recognition by the patient and by EMS, prehospital treatment of these patients and interventions made upon arrival at the ED including thrombolytic and PTCA. The emerging science of destination determination will also be discussed. Angiographic films will be included!


1500 Is this an ALS patient? ALS Medical Director, BLS Medical Director, NJ EMT, NJ MICP

Will our patient benefit from an ALS assessment and/or intervention? What exactly does ALS do and equally as important, not do? Tired of hearing “Why am I here?” Tired of wondering “What exactly is the complaint I am here to treat?” This lively discussion will include an ALS physician Medical Director, a BLS physician Medical Director, an experienced EMT, an experienced MICP and the audience. Discuss patient presentations and see why there is plenty of “gray” area in making the ALS/BLS determination. Its not as “black and white” as we may have once thought.


1600 EMS and the Active Shooter Dr. Ryan Sexton; Disaster Medicine Physician, Cooper Health

With the increased frequency of active shooter incidents, communities are reviewing ways to prevent and respond to these events. An active shooter incident may affect the role of EMS at the scene; as a result, planning, training, and multi-agency collaboration are needed to ensure the safety of all first responders. Preparation will need to include on-scene command, staging areas, treatment areas, personal protective equipment, equipment, and response training. Although the likelihood of an actual incident in the immediate area may be considered low, the community may expect a level of readiness to respond effectively to an event.


Sunday March 24

0700 Registration Opens

0745 Opening remarks Andy Lovell, Vern Howery

0800 Apparent Life Threatening Events Dr. Lisa Drago, Pediatric Emergency Physician, Cooper Health

EMS is often dispatched to a call for a “child not breathing” or “turning blue”. Upon EMS arrival, these pediatric patients often are completely normal upon assessment and we want to right off the call as a parent “pushing the panic button”. In reality, some of these instances may have been an apparent life threatening event, potentially indicating that further evaluation in the ED, is needed. Dr. Drago, a former EMS provider herself, will discuss appropriate assessment of these patients and the ALTE as well as how to utilize the patient’s caregiver as a resource for information. If pediatric patients still increase your “pucker” factor, this session is for you.


0900 What’s with the “Bag-o-Meds” Anthony J. Fryckberg, PharmD; Kennedy Health System

Ever been confronted with a patient who reports “no” medical history, yet hands up a bag with 8 different prescriptions in it? Or worse, the unconscious patient who can’t speak for themselves? Former EMT turned Pharmacist Anthony J. Fryckberg will discuss prescription medications we frequently encounter in the prehospital environment and how to use these as a clue to determining our patient’s medical history. He will also discuss the not-so-rare medication interactions and overdoses we come across and the appropriate treatment for them. He will also discuss over-the-counter medication overdoses and the potential deadly consequences of them.


1000 Trauma Case Review Dr. John Chovanes; Trauma Surgeon-Cooper Health

Noted Traumatologist, former street paramedic and current battlefield surgeon Dr. Chovanes will discuss recent trauma patient presentations to EMS and follow the patient care through the trauma admitting area to discharge from care. Of particular interest will be the role prehospital providers fill in assessing potential trauma patients and transporting these patients to an appropriate destination.


1100 Its not “just” a Stroke Dr. Bernadette, Interventional Neurologist, Kennedy Health

Remember the 3 hour window? With the diagnostic tools available to neurologists, this time may in some cases be extended to as much as 6 hours or more. If we encounter a “wake up stroke” there may be interventions that can be still be made. EMS plays a significant role in the outcome of these patients through our field assessment and appropriate destination determination. Dr. Bernadette will discuss current stroke interventions and treatments, as well as what new technologies are emerging.


1200 Lunch

1300 Defensible Documentation Matthew Streger, Esquire; Law Offices of David S. Barmak, LLC

Creation of the patient care report is often looked as an afterthought to our call. The importance of this medical/legal document is at times disregarded as we view it as a means to reimbursement. Nothing could be further from the truth. Former NJ EMT and MICP Matt Streger will discuss how appropriate documentation can shift liability off of the field provider and the EMS agency. Poor documentation can open the door to litigation, specifically involving each of us as patient care providers. Learn some take home tips that can keep you out of the courtroom.


1400 Aeromedical Risk/Benefit Dr. Gerald Carroll, Physician Medical Director-Cooper Air 2

Use or aeromedical (helicopter) transports can provide a measurable benefit to a specific subset of our patients. It also brings significant potential risk as well. If we fail to consider all factors, we can even delay the transport of our patient. Dr. Carol will review the appropriate use of areomedical resources, the “fly or drive” decision and the use for non-trauma patient presentations. This session certainly won’t answer all of the questions, but it will start participants asking the right questions.


1500 Hurricane Shelter Operations Chief Vern Howery, OEM Coordinator Pete Amico; Rowan University

Although Super Storm Sandy is in the front of everyone’s memory, Hurricane Irene was just a short time ago. Although reports of poor shelter operations were heard from through New Jersey, the shelter set up at Rowan University successfully managed almost 2000 evacuees and included a medical needs component. Rowan’s operation was a blueprint for future shelter operations. The presenters will discuss best practices that can be applied to any shelter operation.


1600 How Dead is Dead? Dr. Gerald Feigin; Medical Examiner- County of Gloucester

What exactly constitutes dead? How is it determined? Who has the authority to pronounce a patient dead? What happens after a patient is pronounced? How come the funeral home just can’t pick up the dead person and transport them to the funeral home? Are there obvious signs indicating a patient should not be “worked”? Dr. Feigin’s practice includes Gloucester, Camden and Salem Counties, providing a great depth of experience.


Please note that the location has changed from Rowan Hall next door to Wilson Hall. The Symposium will be located in the first floor auditorium. Please see accompanying map for building and parking location.

The County of Gloucester complies with all state and federal rules and regulations and does not discriminate on the basis of race, religion, color, national or ethnic origin, sexual orientation, age, marital status or disability in admission to, access to, or operations of its programs, services, or activities. In addition, Gloucester County encourages the participation of people with disabilities in its programs and activities and offers special services to all County residents 60 years of age and older. Inquiries regarding compliance may be directed to the Division of Disability Services at (856) 384-6842/New Jersey Relay Service 711 or the EEO office at (856)384-6903.

TASERs and Medical Injuries

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