I spent most of today at a critical care and trauma conference hosted by one of my area's medical flight programs. I make it a point to go to every continuing education and conference that I can - I love to keep up with the new research and what the major hospitals and air crews are doing. Also, I've had the fortune of making many friends in this field through all the ways I've found myself involved, and it's great fun to spend a day learning together.
As I walked in to check in this morning, I was handed a name tag that said "EMT-P" under my name. Oops! I told the registering woman that I was only a student and certified only at the Basic level. She told me that she was confident I would pass and so she gave me the "upgraded" name tag! Ha! So I started the day feeling like a real fraud - what were they thinking?! I haven't even come close to this! I can't be expected to perform at this level!
The lectures started and were very interesting. We first got a lecture from a neurologist from a local Primary Stroke Center hospital facility. I was familiar (of course) with stroke recognition and tPA therapy, but I hadn't heard of the surgical interventions for stroke she discussed. MERCI (Mechanical Embolus Removal in Cerebral Ischemia) involves sticking a tiny corkscrew in the blood vessel througha catheter to remove the clot! Amazing what technology can do. We then had a regional coordinator come and talk with us about pre-hospital care of the mechanical circulatory support device patient. Again, I was amazed at how far we've come from seeing the first generation pump to the new third generation - this specialist told us that her facility, which is about 30 miles away from me, is about to implant the fifth third-generation in the world. Amazing! I had never learned much about these VAD devices, but I feel confident if I ever encountered one now, that I'd at least recognize it and know how to treat simple mechanical problems and transfer. Our final morning lecture was on the cutting-edge and still fairly new Induced Therapeutic Hypothermia with adult comatose survivors of cardiac arrest. I had heard of this before, but it was interesting to see it spelled out. We don't have protocols for it in the field yet, and I don't anticipate them coming soon. Our local hospital, though it is highly accredited and a trauma center, doesn't even perform this therapy.
After a nice lunch, it was time to move on to some small group/skills stations. This is where I was worried that my being advertised as a medic might cause some problems - although I made sure to say that I was only a student! Amazingly, I was worried for nothing. I successfully needle cric'd my pig with no trouble and got my tube in the simulator on the first try with no stylet. The flight nurse overseeing that station said I was an intubation natural, which is one of the nicest things I've ever heard. I then placed in the "Jeopardy!" competition, answering some of the questions on cardiac meds, flight ops, hypothermia therapy, and stroke treatment. Our final small group station was hearing from a 41-year-old cardiac arrest survivor (still unsure what caused the arrest to begin with) who was a successful recipient of the hypothermia treatment. It was incredible to see this patient, now a flight medic for the company that transported him to the therapy facility.
The day finished out with a lecture on battlefield medicine. We learned that the three most common causes of death in combat are: bleeding to death from extremity wounds, tension pneumothorax, and airway obstruction. All things we could fix so easily here at home in the field! It is sad to think of all those soldiers that are dying of conditions we have simple fixes for.
While I still feel a little guilty about that name tag, I left the conference feeling like I had learned a great deal and performed in skills much better than I expected of myself. I left with hope (and significant study!) that I could be a flight paramedic one day too - my ultimate goal. I left with hope and awe at what medicine has accomplished and what it hopes to accomplish in the future. And I left grateful that families and patients have gotten hope out of the truly incredible treatments and specialties I learned about today.
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