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Miltenberger Seminar

Miltenberger Emergency Services Seminar

March, 2023

Rocky Gap Casino Resort, Flintstone

About the event

Register Now!

We are returning once again to Rocky Gap Casino Resort in Flintstone, Maryland, on March 9th - 11th for the 18th Miltenberger Emergency Services Seminar.

Please join us and participate in the excellent educational opportunities this program offers, along with the chance to enjoy the relaxing atmosphere in the mountains of Western Maryland. Download Brochure here.

March 9 - 6:00 PM – 10:00 PM
Emergency Medical Technician Skills
Presented by University of Maryland MICRB Certified EMS Instructors

This session will provide students with the knowledge, skills, and abilities to satisfy the 12-hour psychomotor requirements for Maryland EMT recertification. The student will perform skills related to patient assessment, oxygen adjuncts, and delivery, CPR, AED, bleeding control and management of soft tissue injuries, musculoskeletal injuries, and spinal immobilization.

Students must attend required classroom sessions on Thursday evening and Friday, be able to demonstrate proficiency in the practical skills evolutions and obtain a score of 70% or better on the MIEMSS protocol quiz. (12 Hrs BLS: S) Lunch will be provided on Friday.

March 10, 2023 - 7:00AM
Registration & Continental Breakfast
March 10 - 8:00 AM – 5:00 PM
PEPP Hybrid Course: BLS & ALS
Presenters: EMS for Children Faculty

The PEPP-4 Hybrid Course is designed by the American Academy of Pediatrics specifically for both ALS and BLS clinicians with a focus on the assessment and management of ill or injured children. Maryland EMS for Children has added additional scenarios and special equipment to correlate with EMS Scope of Practice in Maryland.

The PEPP-4 hybrid ONLINE portion features all-new lecture material and new modules on Behavioral Emergencies, Children in Disasters, and Pediatric Toxicology. PEPP “In-Person” day is 100% interactive with skills, case scenarios, role-play activities, and small group discussions. The skill videos are all new and available online for reference for two years to all participants.

Required – Online learning must be completed prior to attending the course.

Textbook will be mailed with an online access code to the address provided upon receipt of registration.

  • BLS participants must complete 10.25 hours of online learning prior to attending the one-day onsite portion.
  • ALS participants must complete 11.75 hours of online learning prior to attending the one-day onsite portion.
  • Participants will receive an AAP course completion card by participating in both the online and on-site portions of the course and successfully completing a written test.

    CE’s: BLS Clinicians will receive 15 hours, ALS Clinicians will receive 18.75 hours upon completion of both online and attending the in-person day.

    The course is limited to 24 students.

    (15 Hrs BLS: 8 Hrs M & 7 Hrs T, ALS: Applied For) Lunch will be provided.

March 10 - 8:00 AM – 5:00 PM
Multi-Lead Medics 12-Lead ECG Interpretation Workshop
Presenter: Bob Page, M.Ed, NRP, CCP, NCEE, CHSE, CHSOS, State CEU Educator, Virginia Office of EMS

For over 30 years, Bob Page, author of the book 12-Lead ECG for Acute and Critical Care Providers, has been delivering this course to Emergency and Critical Care clinicians worldwide. If anyone told you that you could take a 12-lead class and have fun, would you believe them? This 8-hour, highly motivating, non-stop interactive course on 12-Lead ECG is comprehensive, including proper lead placement, axis, and hemiblock determination, bundle branch blocks, differentiating wide complex tachycardia, and myocardial infarction recognition. Also included is the use of a 15-lead ECG for increased sensitivity for STEMI. Participants in the program will read approximately 200 12-lead ECGs, gaining both experience and confidence in their newly learned skill.

(8 Hrs BLS: M, ALS: Applied For) Lunch will be provided

March 10 - 8:30 AM – 4:30 PM
Nursing / ALS Program (4 Sessions)
Follow the Bubbles: Airway Management in the Trauma Patient
Presenter: Dr. Rameen Shafiei, DO FACEP, Allegany County EMS Medical Director

Airway management in a trauma patient comes with many special considerations and complications to consider. This session will provide an overview of the typical pitfalls encountered during airway stabilization and intubation of a trauma patient, as well as ways to better help you and your patient take a deep breath and move on with the rest of the primary survey.

An Introduction to Antimicrobial Stewardship
Presenter: Rameet Thapa, MD, Director of Infectious Disease and Antimicrobial Stewardship Program at UPMC Western MD

While antibiotics are commonly prescribed medications and can save lives, the data shows that up to 50% of the antibiotics prescribed in hospitals are either unnecessary or inappropriate. This has led to the development of multidrug-resistant bacteria, and antimicrobial resistance has been recognized as a global threat to public health. Learn about antimicrobial stewardship and the common clinical conditions where antibiotics are inappropriately prescribed as well as the consequences of antibiotic overuse, such as C. diff diarrhea.

Pediatric Respirations: More Than a Vital Sign and Frequently Noisy
Presenter: Gail Schoolden, DNP, APRN-CNS, CPEN, Maryland ENA 2023 Pediatric Chair

Respiratory emergencies are one of the most common reasons parents seek emergency medical attention for their children. Some are new and acute illnesses needing rapid triage, stabilization, and treatment, and then they turn around and can go home. Others require longer treatments and changes in home routines. Children and families are also present when home treatment plans for chronic respiratory illness are not working. Dr. Gail Schoolden will review the most common types of pediatric respiratory emergencies, initial assessment findings, appropriate medical interventions, and care planning. Learn tips and tricks that work with children of different ages, as well as how to identify red flags.

ALS/Nursing Keynote: Blunt Trauma - Patterns of Injury 
Presenter: Andrew B. Peitzman, MD, Mark M. Ravitch Professor of Surgery, University of Pittsburgh School of Medicine 

Trauma is the leading cause of death in patients under 45. Many of these injuries are due to blunt force trauma, from vehicle crashes to pedestrian accidents. This lecture will emphasize the relationship between blunt injury patterns and associated injuries. This knowledge is essential in efficient trauma team assessment and detection of associated injuries. 

(BLS: 3.5 Hrs M, 3.5 Hrs T, ALS: Applied For)

March 10 - 8:30AM - 4:30PM
Stop the Bleed Clinician – Instructor Course
Presenters: Jeff Hobbs, BSN, RN, UPMC Western Maryland Trauma Program Manager; Michael Salvadge, NRP, EMS Chief, Allegany County Department of Emergency Services; Wayne B. Tiemersma, NRP, EMS Chief, Garrett County Emergency Services; Elizabeth Wooster, RN, PhD, MIEMSS Director of Trauma and Injury Specialty Care Program

Our nation has a history of learning hard lessons from wartime experiences; the case for hemorrhage control is no different.  The Hartford Consensus directs that all responders have the education and necessary equipment for hemorrhage control and strongly endorses civilian bystanders to act as immediate responders.  Immediate responders represent a foundational element of the ability of the U.S. to respond to these events and are a critical component of our ability to build national resilience.  Immediate responders must be empowered to act, intervene, and assist.

We are a nation of people who respond to others in need.  It is no longer sufficient to “see something, say something.”

Immediate responders must now “see something, do something.”

This course teaches participants basic life-saving medical interventions, including bleeding control with a tourniquet, bleeding control with gauze packs or topical hemostatic agents, and opening an airway to allow a casualty to breathe.  The course is intended for anyone and everyone who may one day find themselves in a “see something, do something” situation.  Course materials include a PowerPoint presentation and three practical skill stations. 

This course will continue during the second half as an STB instructor course for those participants that qualify to become instructors as outlined by the American College of Surgeon-Committee on Trauma.  Students will be mentored both in lecture content and style, communication skills for the general public, and practical skill station instruction. 

(5 Hrs BLS: T, ALS: Applied For) Lunch will be provided.

March 10 - 8:00AM - 5:00PM
Dispatch: Expecting the Unexpected
Presenters: Doug and Jill Showalter, Showalter & Company, Inc.

This course offers critical and essential information along with specific guidance and direction on emergency calls ranging from sinking vehicles, home invasions, school shootings, officer-involved shootings, and homeland security issues. All employees will benefit from this course, which draws from more than four decades of real public safety experience to offer realistic, practical, and useful techniques for responding to and handling a variety of unexpected emergency incidents. (Learning category: supervision, all personnel)

(8 Hrs BLS: L, ALS: Applied For) Lunch will be provided.

March 11 - 6:45AM
Registration and Continental Breakfast
March 11 - 8:00AM
Welcome / State of the State
March 11 - 8:30AM
Keynote Address – Should We Really Be Giving Narcan® to Everyone?
Presenter: Bob Page, M.Ed, NRP, CCP, NCEE, CHSE, CHSOS, State CEU Educator, Virginia Office of EMS

It is in the news - opioid epidemic! Drug overdose deaths are up nationwide. Narcan® has been hailed as a life-saving drug! Anyone can administer it - EMS, firefighters, the police, even the lay public. Everybody is caught up in the hoopla! But what are the costs? Besides the actual price of the drug Narcan®, what are the other costs involved? What are the risks to the patient who receives Narcan®, and EMS and others that give the drug as an antidote? Toxicologists have for years warned about giving antidotes without knowing what the patient took. Is there an alternative? Come to this session and hear what no one else is telling you, and take a look at the other side of the discussion that goes against most systems’ protocols. EMS clinicians have been following their protocols and some have even suggested that Narcan® can “rule out” a narcotic overdose? We will look at the effects of narcotics on the body and what the real problem is. Solid patient assessment techniques could provide clinicians with a management plan.

(1 Hr BLS: M, ALS: Applied For)

March 11 - 9:30AM
Break and Visit Vendors
March 11 - 9:45AM
Breakout Session 1
(A) Bleeding Kills: Working Towards Zero Preventable Deaths
Presenter: Andrew B. Peitzman, MD, Mark M. Ravitch Professor of Surgery, Univ. of Pittsburgh School of Medicine

Bleeding is the most common preventable cause of death after injury. Nationally, 30-40% of traumatic deaths annually are due to significant hemorrhage. This lecture will provide an understanding of the mechanisms and natural history of major bleeding. A system-wide approach to bleeding control will be discussed. 

(1.5 Hrs BLS: T, ALS: Applied For)

(B) When’s the Last Time We Gave That? – Infrequently Used Drugs and Drug Concentrations
Presenter: Rick Koch, Sr., NRP, Battalion Chief, Ocean City Fire Department

When you receive orders for the drugs you haven’t seen since pharmacology class, what do you do?  During this session, we will

review infrequently used drugs, cover the different ways these drugs are packaged, and how to get the proper dosage for your patient.  Attendees will brush up on their drug calculations, concentrations, and the mixing of these elusive medications.

(1.5 Hrs BLS: M, ALS: Applied For)

(C) Tracheostomy Care: Not Just for ALS
Presenter: Sterling Myers, NRP & Maryland Pediatric EMS Champion

Caring for a patient with a tracheostomy tube does not need to be a nerve-racking experience. Tubes go in, tubes come out – the key is effective air exchange. Through discussion and hands-on practice with manikins, BLS and ALS professionals will gain the confidence and skills needed to handle the call for an infant, a child, or an adult needing assistance.

(1.5 Hrs BLS: M, ALS: Applied For)

(D) From the Recent Literature...
Presenter: Ted Delbridge, MD, MPH, MIEMSS Executive Director

Dr. Delbridge will deliver an overview of relevant findings from recent educational articles. With an outcomes-based perspective, he will explore the written material’s who, what, where, when, why, and how in hopes of enlightening participants on some of the contemporary issues facing EMS.(1.5 Hrs BLS: M, ALS: Applied For)

(E) Doing Time in Dispatch
Presenters: Doug and Jill Showalter, Showalter & Company, Inc.

This is our unique approach to a traditional “Customer Service” course. The concept of customer service actually starts long before the first call is answered; it begins with a clearly defined mission so that each employee understands their role. We will demonstrate easy, unique, and practical ways to keep your staff motivated, ready, and fully engaged. Appreciation is one of the most powerful yet overlooked aspects of successfully motivating and empowering people. The link between employee satisfaction and productivity is long-established and encourages employees to do their best and perform to the highest of standards. Remember, you’re not just “doing time”, you’re making a difference.

(8 Hrs BLS: L, ALS: Applied For)

(F) Fire Class – Advanced Vehicle Rescue; Held at Winter’s Towing, Upper Potomac Industrial Park St., Cumberland Maryland
Instructors: Lt. Ronnie Carr, Special Operations, Anne Arundel County Fire; Lt. Derek Crippen, Special Operations, Prince George’s County Fire/EMS

In this action-packed, full-day course, participants will advance through different accident scenes, rescuing victims from a variety of different vehicles in a variety of different positions. This will be a fantastic refresher on stabilizing, moving, lifting, and cutting vehicles as instructors put you through extrication practical scenarios. Participants must be physically able to participate in this training, including the adherence to or exceeding the MFRI physical policy. Students must bring a fitted, full set of turnout gear and have permission from their home fire/rescue department to participate in this training on their behalf.

(6 Hrs BLS: L, ALS: Applied For)

March 11 - 11:15AM
Breakout Session 2
(G) Helping the Helpers: CISM-ASAP
Presenter: Zane A. Leydig, LCSW, CCISM

The session will provide a brief overview of the peer, frontline support program CISM-ASAP recently launched at UPMC Western Maryland. Built around the concepts of Critical Incident Stress Management, the program looks to provide support and guidance to frontline workers as they navigate the often stressful and sometimes traumatic world of healthcare in an effort to prevent the second-victim phenomenon.

(1.5 Hrs BLS: L, ALS: Applied For)

(H) Conquering the Critical Airway
Presenter: Timothy P. Chizmar, MD, FACEP, FAEMS, State EMS Medical Director, MIEMSS

Dr. Chizmar will discuss ways to refine your approach to airway management. With a systematic approach and knowledge of various adjuncts and technology, you will emerge feeling inspired to “conquer” your next critical or compromised airway. Participants will be able to rapidly identify compromised airway patients, develop plans to effectively manage a patient’s airway, recognize the importance of a systematic approach to airway management, and utilize various devices, adjuncts, and technology in EMS airway management.

(1.5 Hrs BLS: M, ALS: Applied For)

(I) Playing with Fire – Children and Fireworks Injuries
Presenter: Cindy Colson, MSN, RN, Injury Prevention and Education Outreach Coordinator, Children’s National Medical Center

Summertime celebrations, especially the Fourth of July, include food, fireworks, and fun. But, did you know that teens and tweens are twice more likely to be injured by fireworks than the general population and that sparklers account for 30% of injuries amongst children? Through case presentations, this session will differentiate the types of burns seen in children and youth, as well as the blast injuries also associated with fireworks.

(1.5 Hrs BLS: T, ALS: Applied For)

(J) Global Health - A View of Emergency Medicine
Presenter: Janelle M. Martin, MD, FACEP, Medical Director for LifeNet 8-1, WellFlight 2-8, Washington County EMS, MIEMSS Region I and GC Paramedic Program

This session will focus on the practice of Emergency Medicine internationally, including natural disaster response, conflict zone field hospitals, and epidemic medicine. Dr. Martin will review the challenges faced when serving in low-resource areas. She will present case reviews focusing on common situations encountered in disaster and epidemic medicine, including during the current war in Ukraine.

(1.5 Hrs BLS: M, ALS: Applied For)

March 11 - 12:30 PM - 1:30 PM
Lunch and Visit Vendors
March 11 - 1:45 PM
Breakout Session 3
(K) Advanced Trauma Assessment
Presenter: Jason Layman, MSN, CRNP, ENP-C, FNP-C, Lead Advanced Practice Provider USACS, UPMC Western Maryland ED

This course will provide you with the fundamental knowledge to systematically assess a critically injured trauma patient.  You will be able to understand and demonstrate key assessment principles specific to the trauma patient and recognize life-threatening abnormal findings.

(3 Hrs BLS: T, ALS: Applied For)

(L) Clearing the Air: Capnography in Cardiac Arrest
Presenter: Presenter: Bob Page, M.Ed, NRP, CCP, NCEE, CHSE, CHSOS, State CEU Educator, VA Office of EMS

Capnography is mentioned in patient care protocols, standardized course algorithms, and policy and procedure manuals nationwide - use WAVEFORM Capnography to confirm tube placement, use Capnography for determining the adequacy of CPR, or use Capnography as a determining factor of ROSC - but very few, if any, actually describe how that is done.  Without explanation or an understanding of it, many are left to figure it out themselves, or rely on blogs and hearsay. Join Bob as he breaks downhow to actually use Capnography in cardiac arrest.

(1.5 Hrs BLS: M, ALS: Applied For)

(M) Hyperbaric Oxygen Therapy Basics and Emergency Care
Presenter: Gregory A. Fulmer, BTPS, RRT, CHT, R Adams Cowley Shock Trauma Center

This presentation discusses the basics of hyperbaric oxygen therapy (HBOT). There are a number of emergency conditions a patient may face suggesting to a medical clinician the necessity of HBOT. This session will draw attention to the emergency needs of those likely to need Hyperbaric Oxygen Therapy.

(1.5 Hrs BLS: M, ALS: Applied For)

(N) Soft, Slow, Steady, and Simple, Assessing the Autistic Patient
Presenter: Dwayne Kitis, BS, CRT-I, MFRI Instructor, MIEMSS C4 Manager

This session will present an overview of Garrett, and his life with autism. We will discuss how children and adults with autism spectrum disorder (ASD) receive, translate, and respond to different types of external stimulation. Participants will be shown ways to assess autistic individuals, including how to gather identifiable health and other pertinent information. Students will interact with Garrett in an attempt to assess the patient's health utilizing techniques learned in this session.

(1.5 Hrs BLS: L, ALS: Applied For)

March 11 - 3:00PM
Break and Visit Vendors
March 11 - 3:15PM
Breakout Session 4
(O) In Plain Sight: Identifying the Occlusive Myocardial Infarction (OMI) on the ECG
Presenter: Charity Rinker, NRP, MICRB, MFRI Instructor, Lt. Frederick County Fire & Rescue Services (Retired)

STEMI has been the longstanding paradigm of identifying myocardial infarction in patient care. Research has shown that nearly 40% of patients with coronary occlusions do not present with ST-segment elevation. As clinicians, we must revert to our clinical knowledge and training to identify and treat these patients. Not only is it paramount that a STEMI is identified early, and appropriate notifications made to the receiving facility, but we must consider transmitting and notifying the receiving facility of all ECGs that reveal OMI findings. Current cardiac monitors, both pre-hospital and in-hospital, are not equipped with internal algorithms to identify findings indicative of an OMI. Many patients requiring emergent cardiac catheterization are delayed because “***MEETS ST ELEVATION MI CRITERIA***” is not part of the ECG interpretation. This course will review the anatomy of cardiac infarction, symptoms associated with coronary artery occlusions, and the NSTEMI ECG findings in OMI patients.

(1.5 Hrs BLS: M, ALS: Applied For)

(P) Considerations for the Transfer and Transportation of the Burn Patient: A Review of Current Guidelines and Case Studies
Presenter: Emily H. Werthman, MSN, RN, Burn Program Manager, JHH Bayview Medical Center 

During this lecture, participants will learn about the transfer and transportation of burn patients in the state of Maryland, with special attention paid to MIEMSS and ABA requirements. Case studies from the Johns Hopkins Burn Center will also be presented to enhance learning. At the completion of this lecture, participants will be able to state three referral criteria for the transfer of burn patients. Participants will also be able to discuss methods of preventing hypothermia and fluid overload.

(1.5 Hrs BLS: T, ALS: Applied For)

(Q) Unmanned Arial Systems (UAS) Operations for Public Safety
Presenters: Cpl. Lantz, Cpl. Peterson, F/Sgt. Thomas, Maryland State Police

Drone programs for public safety have increased exponentially throughout the country. This session will show how agencies, including the Maryland State Police, utilize unmanned aerial systems for public safety to aid in intelligence-gathering missions, planning, and risk mitigation.

(1.5 Hrs BLS: L ALS: Applied For)

March 11 - 4:30PM
Conference Ends

March, 2023

Rocky Gap Casino Resort, Flintstone

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Call the Region 1 Office to register: 301-895-5934.

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