Another year is zipping by. Rather incredible. I have a busy schedule between now and the end of year with trips to Baltimore, New York City, Las Vegas, and Kansas City. Plus two holidays and deer camp! What are your plans for the end of the year?

What kind of EMS organization do you work for? Steve Whitehead provides an EMS organization self-assessment. There are great organization out there and your organization can be great. Are you willing to look for a great organization or put in the effort to make your organization great?

The High Performance EMS blogger Dale Loeberger introduces GIS for EMS. This was also the topic for Episode 118 of the EMSEduCast – the podcast by and for EMS educators.

The Droid Medic explains 5 useful ways to use your Wi-Fi only tablet. This was of particular interest to me because next month I am looking forward to the arrival of my Kindle Fire (Amazon Affiliate Link)

Kyle Bates and John Dillon have put together an educational and entertaining Halloween theme gamed. Can you beat my score of 1200?

I like this explanation and video from the EMT-Medical Student about how air goes in and out. Watch the video to better understand the mechanics of breathing.

What were some of your favorite posts from October?

Did you see any great Halloween themed costumes?

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Sunday I returned from 5 days at the National Association of EMS Educators (NAEMSE) Symposium in Reno, Nevada. The Symposium draws educators from throughout North America and beyond for several days of education, networking, and socializing.

Kyle David Bates Presenting Enhanced Visual Presentations

Enhanced Visual Presentations
On Thursday I presented Enhanced Visual Presentations with Kyle David Bates. The emphasis of the workshop is using digital photography and PowerPoint to create your own case scenarios for the classroom or online delivery. Our group of more than 30 educators gathered with enthusiasm, questions, and digital cameras.

We start the session by asking each table group, three to five educators, to do a simple photography exercise – portrait, emotion, and object. This gives everyone a chance to meet their group and begin taking photos. It also gives us a chance to see the cameras our students are using and to begin helping them develop their photography skills.

A couple of things that kept coming up:

• Every camera with a flash allows you to turn off the flash. Learn how to turn the flash off.
• Hold your camera steady by holding it close to your body with two hands.
• Take photos from different angles and points of view to draw the viewer into the photo.

Our students were engaged in the session and worked well together to create photos, cases, and PowerPoint slides using the techniques we discussed. A few key PowerPoint skills and tips:

• Align objects with the tools available in PowerPoint.
• Put a border around images so they don’t “fall off the slide.”
• Use text only to emphasize important terms and concepts.

Thursday night concluded with the NREMT social. Although this was probably the most sedate event ever held inside the “EDGE” night club I enjoyed reconnecting with friends.

Sessions and Exhibit Hall

The conference officially opened on Friday morning. I missed the opening keynote presentation – Randolph Mantooth  – to meet with my boss and a co-worker. Since we live and work from three different states this was the first opportunity for us to meet face-to-face in several months.

CentreLearn Booth at NAEMSE Symposium

After the morning break-0ut session the Exhibit Hall opened. I helped Scott at the CentreLearn booth and enjoyed talking to educators about how they are using CentreLearn for initial paramedic education and continuing education.

After lunch I attended a session by Twink Dalton about continuing education. Twink is a renowned EMS educator (for good reason) and it was my first time seeing her present. She is a polished and practiced presenter. After she was done I had a great conversation with several other attendees about the role and importance of a digital presentation. Much of Twink’s presentation could have been delivered without any PowerPoint slides. The slides she used, like many presenters were text heavy, and didn’t add much to the overall excellence of the presentation. One of the questions I posed to our small discussion group is if an audience expects a PowerPoint and would be disappointed if a speaker simply spoke without on-screen visual aids.

On Friday night the symposium faculty were treated to dinner at the National Automobile museum by Pepid. The food, displays, and company were excellent. Thanks Pepid!

Crash at the Reno Airshow

The symposium was at the Peppermill Resort in Reno. The hotel was crowded with pilots, pit crew, and spectators for the Reno Airshow races. Late in the afternoon Friday a plane crashed into the box seats. I found out about the crash when I saw it mentioned on Twitter. It was a surreal feeling to be so close to a mass casualty incident, but also isolated from helping. By the time I found out about it the patients had already been cleared from the airfield and the investigation had begun. When we drove to faculty event we passed one of the Reno hospitals. The parking lot was filled with ambulances, police cruisers, and media vans. More than anything I would have liked to simply shake hands with the paramedics and thank them for being there to help and doing their best to care for the victims. Thank you Reno area paramedics.

Going the Distance!

Since I presented a pre-conference the NAEMSE Symposium, scheduled through Sunday, becomes a marathon event to attend. Saturday morning I took a break from the symposium for a long marathon training run. Just before sunrise I left the Peppermill hotel and ran to downtown Reno (about 2 miles). After a short lap through the casino district of downtown Reno (another 2 miles) I ran east on the Truckee River trail. A paved trail runs about 7.5 miles east from town before terminating at the Union Pacific railroad and interstate highway. The run was scenic and invigorating. Turning back to run the 2nd half up river (and up hill) made the run a bit challenging. I arrived back at the hotel three hours after I started and ready for more sessions and time in the exhibit hall.

I had the opportunity to film a couple of short videos with EMS1.com. I will embed them when they post in the future. In the first video I shared advice for a new EMS educator. In the second I shared advice for a newly graduated paramedic.

NAEMSE Symposium General Session

After lunch Jeff Lindsay gave an interesting presentation about the “Net Generation” – the twenty somethings beginning to enter EMS education and the EMS workforce. The presentation had a strong emphasis on social media and covered many of the themes we discussed on episode 109 (their expectation is clear expectations) of the EMSEduCast.

Saturday night was the all symposium social. The event had a western theme and featured a chuck wagon dinner, mechanical bull and line dancing. Reno area EMS educator, @UnwiredMedic, was able to join us for the social. It was great to meet him face to face, introduce him to other EMS educators, and talk about social media. Check out his blog – the Unwired Medic.

More of Everything

The symposium continued on Sunday with more sessions, exhibit hall time, and networking with friends. I was only able to attend a few minutes of Dave Page’s session on medical errors and paramedic education. What I did attend was very interesting and I plan to invite him to discuss the topic with us on the EMSEduCast.

NAEMSE 2012

The 2012 NAEMSE Symposium is already scheduled for August 2012 in Orlando, Florida at the Walt Disney World Resort. The call for presentations is already open.

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This is a guest post by creator of the First Few Moments training program Kyle David Bates. If you want to guest post on this blog, check out the guidelines here.

As you roll-up on the scene of a motor vehicle crash you look through your windshield. “Hmm, 2 cars head-on. Driver in car one is moving, one person walking around car two with blood coming from her head, one person lying outside car one. No wires down. No fire. Looks like I should call 2 more ambulances and start caring for the person on the ground.”

We Have All Been There

Have you ever had a similar conversation with yourself? I am sure that we all have, but is this self-interaction often left unfinished? Usually it is as you are interrupted when you let off an explicative or two towards the cars whizzing by leading me to the next question: “Why didn’t you do anything about it?”

Need to Make the Scene Safer

In EMS we are extremely focused upon patient care and assessing the scene for safety, initially, but we are awful at making that scene safe. On average 5 firefighters are killed every year after being struck by a passing vehicle. This number does not take into account EMS-only services nor does it include injuries as the result of being struck.

Establish a TIMA

So again I ask, “Why do we not take the time to make the roadway safe?” In April 2008 the U.S. Fire Administration (USFA) put together a comprehensive document entitled Traffic Incident Management Systems that addresses the importance of establishing a traffic incident management area or TIMA. Two years ago this was published yet we still see responders working in roadways with cars whizzing by. Sure, we have our green vests on, which is a start, but we need to take the initiative to establish a safe work zone. Properly placing your vehicles, using cones and flares to guide traffic through the TIMA, decreasing the use of unnecessary lighting at night, proper communication between responders, and the use of flaggers are all part of creating that safer working environment.

Make the Scene Safer

For those of you who are already doing these things, congratulations you are ahead of the game. However don’t become too comfortable within these areas, hence the earlier use of the term safer not safe. Many times vehicle operators ignore these areas, often going around or through these well-established systems. They may do it out of curiosity, ignorance, carelessness, distraction, or the sense that they too can help. Whatever the reason, they still impose a danger to those working within the TIMA. Having a plan to warn responders in the TIMA of just such a breech is vital. Truck or hand-held air horns may work the best as they are instantaneous and do not require the need to get airtime on the radio.

Always Vigilant

As a responder working in the roadway you must be ever vigilant for the potential of this situation. In EMT class we were taught scene safety but that is not enough here. We cannot just assess the scene initially and forget about it, we must be ever constant in assessing the scene, or situation for hazards. We have to be aware; we have to develop a culture of situational awareness, whereby are aware of our surroundings and their potential hazards 360 degrees and 100% of the time.

By changing our mindset, that safety TRULY comes first, we should hopefully see the decrease of responders injured or killed on our highways. The First Few Moments podcast and classroom course address just these topics. You can find out more at www.FirstFewMoments.com.

Kyle David Bates is an enthusiastic educator who brings over two decades of field and flight experience into the classroom. He speaks at EMS conferences throughout the United States and Canada as well as a frequent personality on various EMS podcasts. Kyle is also an author, writing for textbooks and national magazines. What makes Kyle unique is his educational style. Having a formal background in photography and graphic arts as well as education, Kyle delivers interactive and thought provoking presentations and workshops to all audiences.

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Three things that make me feel itchy:

1. Talking about lice.

2. Wearing a tie.

3. Wool pants.

What makes you feel itchy?

Posts Outside the Service Area

A few articles and things that have caught my eye recently. Browse around and let me know what has caught your attention recently.

Bed Bugs

Are you worried about bed bugs? You should be. Bed bugs on the rise in Wisconsin.

CE Article

Catastrophic injuries from cheerleading is the continuing education article in the October issue of EMS World magazine. After reading the article browse to www.rapidce.com to earn 1.5 hours of CECBEMS approved CE.

Tactical Pants

Tactical pants guide for Women.

Test Taking Tips

Well known educator and author, Dan Limmer, has a new website and blog – EMTReview.com. Check out this great post on Test Taking Tips. Everyday EMS Tips is very pleased to have the EMT Review App as our newest sponsor. Thanks.

Pediatric EMS Podcast

A new podcast from Kyle Bates, Pedi-U.com.

Toronto Emergency Management Symposium

I have been invited to be a panelist to discuss social media and education. Lots of great sessions and presenters on the program. Conference information.

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The two top components of any conference are the exhibit hall and the education presentations. At EMS Expo the presentations were divided into multiple tracks including ALS, BLS, education, administration/management, and a general audience track. A lot of the big names in EMS – Steve Berry, Ken Bouvier, Heather Davis, Ray Fowler, Baxter Larmon, David Page, Mike Smith, Mike Touchstone, and Paul Pepe – presented sessions to packed rooms. This year’s EMS Expo also featured some emerging EMS presenters that are sure to become fixtures on the EMS conference circuit for years to come.

Emerging EMS Stars

Kyle Bates delivered two presentations on Friday in the education track. Kyle and I have presented together many times on topics related to teaching with technology and effective use of instructional media. While I was unable to attend Kyle’s session I am sure participants were given useful information and actionable ideas for improving their use of visual case studies. I am also confident they probably saw the best PowerPoint presentations of the show. Kyle has a great eye for design and a clear understanding of how to select the best visual elements for the points he is teaching. Were you at Kyle’s presentations? Share your impressions in the comments.

I was fortunate to attend Steve Whitehead’s presentation, the Art of Building Patient Rapport. Within minutes Steve had captured the attention of the audience with outstanding storytelling that appealed to both the emotional and technical aspects of providing patient care. Steve is a talented speaker and had the audience engaged in the topic. Steve’s presentation reminded me that so often my highest highs and lowest lows with patients were dependent on how well I was able to connect with the patient in a meaningful way that went beyond simple assessment and treatment.

Presentations in the Exhibit Hall

The presentation of education topics continues to increase in the exhibit hall. Physio-Control, Zoll, BoundTree, and HSI all offered formal education opportunities in the exhibit hall. Their booths were configured with classroom style seating and video displays for presenter slides. Topics ranged from patient assessment and care techniques to 12 lead interpretations to EMS applications for sonography to social media monitoring.

Informal education is an obvious component in many vendor booths. Knowing what a product is for and how best to use the product helps EMS professionals make purchasing decisions with limited resources. I am hopeful that with the increasing attention being paid to the safety and wellness of EMS professionals that vendor related education might expand to not just how to use a product, but how to use it safely. For example, a patient cot education could also highlight important safe lifting techniques. I also think topics on physical fitness, eating well, stress management, and life-work balance could make a lasting impact in short sessions.

Your Impressions

Please share your top presentation picks from EMS Expo? Which presenters nailed it and should be on everyone’s must see list?

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I am in Dallas, Texas for the annual EMS Expo presented by EMS Magazine, EMSResponder.com, and Cygnus Business Media. This is the biggest EMS show of the year and I am really looking forward to the time with friends, visiting with CentreLearn prospects and clients, and learning about the newest products and techniques available to EMS professionals.

Conference Presentations

I have two scheduled conference presentations. Thursday morning I am presenting on Trends in Online Education. Friday morning I present on using Social Networking for Personnel Management and Training. I am  passionate about both of these subjects so my primary challenge is to determine what to leave out.

During the presentations I will be asking the audience to participate by answering questions with “audience response pads.” I plan to use their answers to guide the depth of my discussion. I am also asking some questions to get to know the audience better. I really appreciate John Dillon from C3Softworks.com sharing 120 audience response pads with me. I also will be using a PowerPoint theme from my good friend Kyle Bates.

Social Media Creation

I am really excited for the live recordings of the EMSEduCast podcast that I will be doing at the ZOLL podcasting studio. I am partnering with other podcasts in the ProMed network to bring the conversations of EMS Expo to our regular audience. Scheduled guests include Mic Gunderson, Dan Limmer, and Kelly Grayson.

I will also be regularly updating Twitter and Facebook during the conference. During sessions back channel communications have the ability to bring the conference program to non-attendees and create interaction among attendees. If you want to follow my Tweets follow @gfriese and the Twitter hashtag #EMSExpo.

Other Appearances

On Thursday I have two additional appearances. The JEMS.com booth is hosting bloggers to meet their audience. I am a little suspicious of the label “Hottest EMS Bloggers” but nonetheless looking forward to meeting with readers of EverydayEMSTips.com as well as my other blogging efforts, like Blog.CentreLearn.com.

At 4 pm on Thursday I will leading a mini education session at the ZOLL Medical booth. ZOLL is a great supporter of EMS Social Media efforts, such as blogs and podcasts. My topic is “3 Ways to Monitor your Social Media Presence.” It will be a quick hitting 15 minutes with three actionable ideas individuals and agencies should be doing to starting monitoring their social media presence and efforts.

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Last week was the annual symposium of the National Association of EMS Educators. Held in Schaumburg, Illinois the symposium attracted more than 400 educators from around the world. Each year the symposium features top-notch speakers delivering pre-conference, conference, and break-out sessions. I had the pleasure of assisting Kyle Bates with a pre-conference workshop and then participating in many wonderful break-out sessions during the regular conference. Note: you can listen to a NAEMSE Symposium recap on the EMSEduCast podcast.

PowerPoint Design – the Elephant in the Room

Kyle (@imagemedic) created an new educational and engaging pre-con for this year’s symposium. The all day session guided participants through important elements of visual design, including placement of objects, color selection, typography, and use of images. The focus of the workshop was learning to apply graphic design principles to enhance the impact of a presentation and the speaker.

We have all seen lots of bad PowerPoint slides and those ineffective slides distract from the message the instructor is delivering and can even reduce the credibility of the speaker. A few things every speaker should do:

1. Minimize use of text and bullet points
2. Consistently align objects
3. Thoughtfully select colors for text, lines, shapes, fonts and other design features
4. Use animations sparingly
5. Understand why every element is on the slide

Kyle and I regularly present workshops, up to a day or two days, on visual design and creating visual case studies. Visit KyleDavidBates.com for workshop descriptions.

Food, Fun, and Friends

I was a little skeptical about the conference location – the northwest suburbs of Chicago, but was pleasantly surprised at how wonderful it turned out to be. Schaumburg has one of just about every restaurant. Thursday night I recruited a large group to go to Lou Malnati’s Schaumburg for Chicago style deep dish pizza. Rob Theriault, my co-host on the EMSEduCast podcast, reported that it was the “best pizza he had ever had.” The photo is of Rob giving his presentation on Synchronous online education. Our group of nine had paramedic educators from Ontario, Wisconsin, California, Montana, New York, Maryland, and some other places I can’t remember. We had great conversation while eating some of the best pizza pies on the planet.

The Renaissance Hotel in Schaumburg is just off I-90 and is a bit like an island. Because of its relative isolation – for guests without cars – most of the social scene for the conference was in the hotel lobby. The expansive lobby had plenty of areas to sit and chat, a fireplace, a coffee shop, and of course a bar. Every trip I made through the lobby I saw friends to say hello to and was introduced to new friends.

I escaped the “island” for two early morning bike rides and one run. Since I drove to the conference I hauled my mountain bike with me. I arose early to ride to and around a nearby forest preserve. On my first morning ride I was surprised to see a coyote, whitetail deer, and a half-dozen elk! Later that morning I learned I was riding through Elk Grove Village.

NAEMSE 2011

Plans are already underway for NAEMSE 2011 scheduled for Reno, Nevada. They have already made the call for presentations which are due in early November. Visit NAEMSE.org to learn more.

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You should be able to tell from the doorway if your patient needs oxygen. Simply gauge their rate and effort of breathing. I don’t think you need a “room air” pulse ox to confirm if the patient needs oxygen. If a patient really needs oxygen because they have:

• tachypnea
• bradypnea
• pallor
• cyanosis
• intercostal muscle retractions
• nasal flaring
• accessory muscle use

Don’t delay oxygen administration to apply a pulse oximeter. At that point the reading, usually lower than even you might expect is merely interesting. And what are you going to do if the pulse ox says 94%? Not treat the respiratory distress. If you see respiratory distress treat it by correcting ventilation and/or perfusion problems.

EMS Service Manager Aaron Scharf, Manager of the EMS Department at Long Island College Hospital shared his thoughts about pulse oximetry with me:

“As far as pulse oximetry goes – and this is a pet peeve of mine with newly certified EMTs. They rely on the handheld device for evaluation of a patient’s pulse. The EMT will simply stick the probe on a patient’s finger, read off the numbers to their partner, and move along with the patient assessment. The things that are obviously missing from using this approach are the inability to determine quality and regularity of a pulse. The thing that’s less obvious, but I think more crucial is the fact that it eliminates physical contact with the patient which I think this is especially important for pediatric and geriatric patients.”

Aaron continues, “We are called to someone’s house, usually a stranger, and we establish an intimate relationship with them based upon the trust and presumed competence they infer from our uniform, level of certification, and our professional demeanor. But the further we remove ourselves from that patient by allowing equipment to intervene, the more we contribute to the dehumanization of medicine.”

Patient assessment is a hands-on process that also allows us to use our senses. Respiratory and pulse assessment should involved careful looking, listening, and feeling for more than just confirming the presence of breathing and the presence of a pulse.

When do you think is the best time to use a pulse oximeter?

To review the patient assessment process visit RapidCE.com for a two part lesson. Part 1 explores and reviews the scene size-up and initial assessment. Part 2 is an in-depth review of the secondary assessment, which is also known as the focused history and physical exam. Both lessons feature photos by paramedic and photographer Kyle David Bates.

For more on Pulse Oximetry read this recent article from EMS1.com by Kelly Grayson.

What are other limitations to pulse oximetry assessment?

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In late February I am presenting with Kyle Bates and John Dillon at the Wisconsin Instructor Coordinator Conference. We are co-presenting a series of workshops about EMS Education and Technology topics including social media creation for education, creating effective visual case studies, and using games to teach. Earlier today the Wisconsin Technical College EMS Education Director asked us, “Could you please send me any dietary restrictions and/or ADA/Special Needs for you, Kyle, and Johnso we can register you for the conference.”

I quickly replied that “Of course being from Buffalo Kyle only eats hot wings.” To which Kyle a few minutes later added his additional needs (all tongue in cheek). “Well, I’m glad that you asked. Here are my dietary requirements:

• Like Greg said, Buffalo wings, from Buffalo, medium, with celery/carrots and blue cheese
• Blue on ice (for those outside BFLO…Labatts Blue Beer)
• Beef on Weck
• 4 Cheese perogies with sauerkraut
• 3 Potato perogies
• Pink Jordan Almonds
• Cherries with the seeds removed
• 7 Snickers bars without nuts
• Watermelon Blow-Pops unwrapped
• Orange Tootsie Pops without the Tootsie

ADA

• Nothing shiny
• No squirrels, I hate squirrels

If you are looking for conference presentations rest assured Kyle, John, and make serious and reasonable requests. Contact me for a list of 2010 conference presentation topics.

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