Today was the actual conference, and I was there. So were about 350+ other folks, so it was quite well attended.
The vast majority of the talks had very little to do with my day to day practice of Emergency Medicne, but it was still interesting. For the benefit of those who care, here’s my synopsis of the meeting:
– watchful waiting, with early selective splenic artery embolization is the way to go in bulnt trauma, regardless of age.
– QuickClot is the hemostatic agent most appreciated by the Marines in Iraq. HBOC’s (artificial blood) are on the short horizon. Whole blood is probably better, but you can’t get it.
– Help your hospitals’ antibiotic resistance by getting rid of all the 3rd generation cephalosporins (except Rocephin).
– Pediatric trauma: leave the spleen alone, ditto the vascularly-injured kidney; get the broken parts of the pancreas out.
– “The doppler is the tool of the Devil: if you can’t feel it, it’s not there”.
– EMS helos are overused, and maybe not financially viable. Everyone loves them, though.
– Domestic violence is bad. Documentation helps patients and prosecutors.
– Violence diversion programs have been tried, and are at best a wash.
Decent way to kill a day for CME.
EMS Helicopters – gotta agree with you there. Out here in the sticks (Central Oregon coast), we use them on scene about once or twice per year, but are used perhaps monthly for intra-hospital transfers. These are usually head bleeds or major trauma. I’ve worked in places where they are definitely overused, transporting serious patients, but within 5-10 miles of the hospital! EMS should have had these patients packaged and transported before the helo left the pad!
Domestic Violence – I learned the hard way about documentation. I was called to a DV one night, and transported the victim to the hospital. I wrote my chart and forgot about it. Sometime later I was subpeoned to court. My chart was not complete, and I had neglected to ask my patient if she was in pain – a critical aspect of the crime of assault. I looked and felt a little foolish on the stand that day.
Doppler – great tool, but I agree with that sentiment. I primarily use it on long distance transfers, to obtain a B/P. My hearing is not the greatest and sometimes it’s very difficult to palpate in the back of a moving ambulance. We don’t have automatic B/P machines.
Have to be careful with the QucikClot, it is very exothermic and can lead to burns.
“Tool of the devil”? Was Ken Mattox giving that talk?