Tuesday, May 28, 2019 • 13:00 - 14:30
Track 4 - Emergency Medical Services/Prehospital and Transport Medicine (2)
Track Chairs: Dr. Alix Carter & Dr. David Sibley
Room: 109

Rural EM and Co-ordination of Care - Dr. Sunil Sookram

Description: In this session we will review the provision of seamless care to patients presenting in any geographic setting. Use effective strategies to achieve strong communication and handover of all cases requiring transfer for ongoing management or care.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Highlight the importance of an integrated online medical oversight/mentorship system within a provincial EMS system.
  2. Identify important skill sets that online medical physicians should develop for success in their role.
  3. Discuss aspects of coordinating care between rural/regional sites and the tertiary centre, including mode of transfer and ensuring the transferring team is supported.


  1. Coordination between tertiary centres and the sending sites improves efficiency and outcome.
  2. Sending the right team – air, ground, critical care, your own staff, yourself – and getting the right support from an integrated medical oversight system- are key ingredients to success.

On the Road Again: Preparing the Critically Ill or Injured Patient for Interhospital Transport - Dr. David Sibley and Ms. Carrie Bent

Description: What sending and transporting providers can do to help achieve a safe and effective interhospital transfer of a critically ill or injured patient.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Know the key elements of a safe and effective inter-hospital transfer.
  2. Prepare the critically ill or injured patient for interfacility transport.
  3. Efficiently transfer care of the patient to the transport team.


  1. Early decision to transfer and early communication.
  2. Have a pre-transfer checklist.
  3. Optimize the patient prior to transport if possible.

David Sibley is a CCFP-EM trained emergency physician currently working on the South Shore of Nova Scotia. Prior to starting his career in medicine, he worked as an advanced care paramedic with Emergency Health Services Nova Scotia.

Carrie Bent is a graduate of St.Francis Xavier University where she completed a Bachelor of Science in Nursing. She continued her education and successfully completed the Critical Care Nursing Program at the QEII Health Sciences Centre in Halifax. Carrie has worked as a Critical Care Nurse and Educator in Nova Scotia and also worked emerg and ICU in Calgary, Alberta.

How Do We Stem the Tide of Post Traumatic Stress and Suicide in Paramedicine - Dr. Allan Abbass and Ms. Judy Hollett

Description: Will review patterns of emotional responses to trauma in paramedics, how to evaluate and manage them using intensive short-term dynamic psychotherapy methods.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Define somatization and describe the 4 main somatic manifestations of unconscious anxiety.
  2. Describe some behavioral and somatic markers of a distressed colleague at risk for suicide.
  3. Identify 3 actions an EM/EMS Physician can perform to support a colleague identified as at risk for PTSD/suicide.


  1. Emotions are somatic events.
  2. Emotions may be blocked by anxiety depression and other mechanisms.
  3. Experiencing emotions overrides multiple types of symptoms including depression and anxiety.

Psychiatrist and former emergency physician and family physician now a leading researcher and clinician in the areas of psychosomatic medicine and short-term psychotherapy of conditions including post traumatic stress disorder.

As a member of Health Canada’s Trauma Response Team, Judy provided support services during SwissAir in 1998, the Walkerton E-coli disaster in 2000 and Y2K2 in 2002, Judy has over twenty years of experience in this field and has worked closely with EHS Nova Scotia, Halifax Regional Police & Fire Service Peer Teams and the Canada Border Services Peer Team.

Five Things That Are Changing in Resuscitation - Dr. Sheldon Cheskes

Description: Keep up to date with the cutting edge changes in Resuscitation! Learn about double sequential external defibrillation and ECMO for refractory VF. Is mechanical CPR the answer for my EMS system. Should we beginning epinephrine in OHCA? Intubation vs SGA in OHCA? Are drones the answer to AED deployment in rural areas? Get answers to all these and more during our resuscitation changes session.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Know more about new approaches to the management of Refractory VF.
  2. Know more about if mechanical CPR is right for my EMS system
  3. Know more about whether I should be using an ET tube or SGA during cardiac arrest


  1. Double sequential external defibrillation should be considered early in Refractory VF cardiac arrest.
  2. ECMO is cool but all the pieces need to be in place for successful outcomes.
  3. SGA are easy! If you don’t intubate often, use them in OHCA.

Dr. Cheskes is the Medical Director for Sunnybrook Centre for Prehospital Medicine and has provided medical oversight in the Regions of Halton and Peel for over 30 years. His research interests include CPR quality, alternative defibrillation strategies and prehospital systems of STEMI care.

Five Things That Are Changing in EMS Leadership - Dr. Alix Carter

Description: It is an exciting time in EMS/paramedicine. Things are changing in clinical practice, and in leadership.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. The participant will be aware of changes in education/certification of paramedics including colleges and degree programs.
  2. The participant will be learn about changes in the education of EMS physicians.
  3. The session will review current challenges in EMS systems leadership such as offload delay.


  1. New pathways to education and registration are important advances in the professional identity of paramedics.
  2. Challenges facing EMS and emergency departments are best addressed through an integrated systems approach.
  3. Prehospital and transport medicine is a recognized subspecialty of emergency medicine with a unique body of knowledge.

Alix Carter is the Medical Director of Research for EHS Nova Scotia, and the Director of the Division of EMS, Department of Emergency Medicine, Dalhousie University, with a cross-appointment to the Department of Industrial Engineering.