# How do you stay Up To Date?



## Stretcher Jockey (Jan 5, 2018)

Ive been on this forum and learned a lot from the wealth of knowledge our more experience members have. That being said, I'm looking for some advice: how do you stay up to date on new protocols and medicine in general? Just a small bit of background, I'm AD AF and have been a paramedic for about 1 1/2 years now. We recently had some new protocols for our service come out (within the last 3 months) and while they are straight forward for the most part, what I struggle with is my units lack of training. I mean, literally zero. And every time I've created and brought new Power Points or hands on training for anything it never ends up happening. Without making too many excuses, how do you all keep up? I try listening to PodCasts (EMCrit and SecondShift mostly) but having an extremely slow service of 1-2 calls in a 24 hour shift, I feel like I am lagging behind. I try to also spend at least 1-2 hours every shift looking at medicine related studies and refresh myself on things I'm uncomfortable with. And while I haven't killed anyone yet, I cant help but shake the feeling that the first cardiac arrest or adrenal crisis or pediatric drowning case I have is going to go terribly.

What do you all use? And if anyone has advice for a green medic, I'm all ears.


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## Red Flag 1 (Jan 5, 2018)

What


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## DocIllinois (Jan 6, 2018)

I'm curious about this one, too.  

Is little CME training time a common occurrence in AF responder units, or is it standard to expect folks to knock it out on their own time?


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## Red Flag 1 (Jan 6, 2018)

DocIllinois said:


> I'm curious about this one, too.


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## Muppet (Jan 7, 2018)

PM sent.

M.


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## RustyShackleford (Jan 8, 2018)

If the hospital system/physician whose license you practice under are not providing CEs, protocol updates, and other educational/training opportunities, they are failing you.  That said, I would imagine your unit has someone designated to coordinate these activities and set up training, whether it is classroom based or hands-on.  

With that low of a call volume, perhaps you could inquire as to the possibility of working shifts at a local trauma center or EMS system with a higher call volume.  In addition to my regular duties for an LE agency, I am and EMT and operate under an expanded scope of medical protocols.  We receive more than adequate training, but it is essentially a collateral duty for those of us in our medical program. Most of us ride with local FD/EMS units or work with ERs to get hands-on time with patients and additional training.


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## Red Flag 1 (Jan 8, 2018)

RustyShackleford said:


> If the hospital system/physician whose license you practice under are not providing CEs, protocol updates, and other educational/training opportunities, they are failing you.  That said, I would imagine your unit has someone designated to coordinate these activities and set up training, whether it is classroom based or hands-on.


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## Stretcher Jockey (Jan 9, 2018)

So I guess I should have been a little more clear in my initial post about my situation. I didn't want to start placing blame everywhere except for myself, so I left a lot out that could help explain. What it essentially comes down to is that while being assigned to my on base clinic, I have very little interaction with them for two reasons: one, they offer zero urgent care or emergency services leading us to transfer all of our patients off base, and two, the facility is BLS while the ambulance is ALS, so we end up having people who don't understand ALS ambulance operations trying to do CE for us.

I've taken a lot of the "merit badge" courses to include: ACLS, PALS, PEPP, PHTLS, TCCC, and AMLS. But outside of going to these courses, I still try to listen to podcasts and read through my books to refresh myself. I've also tried moonlighting off base with local EMS and ERs but my command shuts it down due to liability issues. So I'm essentially stuck getting 1-2 calls in a shift on a generally healthy population and the only time I go an official refresher course is every 2 years when it's time to re-up my NREMT.

Again not trying to blame anyone for my situation, just looking to see what members of this community do. From what it sounds like all of your agencies has stipulations to do CE with you and allow you to work with other agencies to increase patient interaction time.


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## RustyShackleford (Jan 9, 2018)

Paramagician said:


> Again not trying to blame anyone for my situation, just looking to see what members of this community do. From what it sounds like all of your agencies has stipulations to do CE with you and allow you to work with other agencies to increase patient interaction time.



My situation is unique in that I am not employed as an EMT.  It is a collateral duty and oversight is provided by an HQ element that coordinates with Johns Hopkins (our medical direction).  We run through a refresher for NREMT every two years, plus tacmed and advance scope training.  Our SOP requires us to ride an ambulance or get clinical hours every month and management provides documentation that we assume all liability while conducting these clinical hours.  City fire lets me do whatever I am comfortable with and they like the fact that a guy with a badge and gun is along for the shift.  

As you have probably figured out, nothing beats going hands-on with anything medicine related.  If you haven't already done so, speak with your training coordinator and your Doc about your concerns and go from there.


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## Red Flag 1 (Jan 11, 2018)

u


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## Devildoc (Jan 11, 2018)

Red Flag 1 said:


> There has been less and less funding for USAF Medical facilities spread over the years. Medical Centers have been down staffed to the USAF Hospital level, and USAF Hospitals have been down staffed to clinic level. During my years of USAF practice, it was pretty common to see OB/GYN services farmed out to civilian facilities. The same was seen with Orthopedics, ENT, ICU, and other subspecialties. It looks like Emergency First  Response has continued but without the ability to care for the individuals needing First Responders, that has been contracted out as well. The patients that the USAF First Responder care for are transported to civilian facilities.This puts the First Responders in a difficult position since the patients that are served are going to civilian facilities. This leaves the USAF first responders with only a tacit connection to Base Medical Services(BMS). The equipment is supplied by the USAF Medical budget, but evaluation and training have become something that the BMS has limited oversight capability. Somewhere along the line, there needs to be a Medical evaluation and support system. From the OP, that seems to become something on the back burner of someone else's stovetop.



Same thing is happening with the Navy.  Best thing that happened to EMS at Camp Lejeune was when it went civil service; those guys also work for local civvy EMS, so they get the added benefit of that.  Once they got the Navy out of the ambulance business, though, the quality of EMS went up.


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## Red Flag 1 (Jan 11, 2018)

o


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## Stretcher Jockey (Jan 11, 2018)

I absolutely agree, as much as it pains me to see. It honestly is just a matter of time, and all I can really do is cross my fingers that I'm not the unlucky soul who gets caught up in it.


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## Red Flag 1 (Jan 12, 2018)

o


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## Stretcher Jockey (Apr 12, 2018)

Well I finally bugged my command enough about the lack of continuing education that I am now in charge of creating/coordinating all of it for my flight. I've reached out to a friend who is an IDMT-P since his Medical Director does tons of training for them for some ideas. Looks like I'm going to have my hands full creating a program for training and education for my fellow EMS personnel.

Definitely open to some ideas for topics to train on that relate to EMS.


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## Muppet (Apr 12, 2018)

Paramagician said:


> Well I finally bugged my command enough about the lack of continuing education that I am now in charge of creating/coordinating all of it for my flight. I've reached out to a friend who is an IDMT-P since his Medical Director does tons of training for them for some ideas. Looks like I'm going to have my hands full creating a program for training and education for my fellow EMS personnel.
> 
> Definitely open to some ideas for topics to train on that relate to EMS.



ACLS, PALS, PHTLS, AMLS, ASLS, AHLS, PEPP. All those canned courses. At very least, ACLS/PALS and CPR recerts. TECC also. 

ACLS  EP is a good canned course.

M.


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## Stretcher Jockey (Apr 12, 2018)

@Muppet your opinion on this greatly appreciated! I wont be an official instructor for this position, but Im absolutely planning on running through all of those. Also planning on getting my Medical Directors input on a good bit of pharmacology since our protocols just added 20 some-odd new meds.

And since Im now in this position, Im going to take the opportunity to teach our Security Forces some TECC. Did a little poll today to see how many of the patrols carried and/or knew how to apply a TQ. The answer to both was zero.


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## FisherAD1 (Apr 13, 2018)

Paramagician said:


> Ive been on this forum and learned a lot from the wealth of knowledge our more experience members have. That being said, I'm looking for some advice: how do you stay up to date on new protocols and medicine in general? Just a small bit of background, I'm AD AF and have been a paramedic for about 1 1/2 years now. We recently had some new protocols for our service come out (within the last 3 months) and while they are straight forward for the most part, what I struggle with is my units lack of training. I mean, literally zero. And every time I've created and brought new Power Points or hands on training for anything it never ends up happening. Without making too many excuses, how do you all keep up? I try listening to PodCasts (EMCrit and SecondShift mostly) but having an extremely slow service of 1-2 calls in a 24 hour shift, I feel like I am lagging behind. I try to also spend at least 1-2 hours every shift looking at medicine related studies and refresh myself on things I'm uncomfortable with. And while I haven't killed anyone yet, I cant help but shake the feeling that the first cardiac arrest or adrenal crisis or pediatric drowning case I have is going to go terribly.
> 
> What do you all use? And if anyone has advice for a green medic, I'm all ears.


Does the AF have something like the AMEDD Virtual Library?


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## Stretcher Jockey (Apr 13, 2018)

Yes sir we have the AFMS Knowledge Exchange which includes a virtual library.


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## FisherAD1 (Apr 13, 2018)

Paramagician said:


> Yes sir we have the AFMS Knowledge Exchange which includes a virtual library.


I use AMEDD Virtual Library to access journals like Journal of Trauma and Acute Care Surgery.


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## policemedic (Apr 13, 2018)

If your command will fund it, SOMA offers a great conference every year.  I particularly like the preconference labs.  This year it's in Charlotte, NC.  I'll be there.


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## Stretcher Jockey (Apr 13, 2018)

@FisherAD1 thanks for the suggestions, I will have to add those to the list of things to look into. Much appreciated.

@policemedic I didnt hear about SOMA until last year and it was too late to buy tickets. This year, Ill pay my way there if needed. Knowledge doesnt weigh anything in the rucksack, right? Out of curiosity though what kind of preconference labs do they have? I havent heard anything about them before.


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## policemedic (Apr 13, 2018)

They have cadaver labs, K9 TC3, PFC, FWB transfusion sessions, ultrasound classes....

Here’s the link to the schedule. 
2018 Schedule


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## FisherAD1 (Apr 13, 2018)

If I were to choose a lab, I'd do the FWB transfusion lab.


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## Stretcher Jockey (Apr 13, 2018)

Fantastic! Thanks gents!


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## policemedic (Apr 13, 2018)

FisherAD1 said:


> If I were to choose a lab, I'd do the FWB transfusion lab.



I hear one of the Rangers teaching the lab is buying the first round after the class. 

That’s just RUMINT though....


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## FisherAD1 (Apr 13, 2018)

policemedic said:


> I hear one of the Rangers teaching the lab is buying the first round after the class.
> 
> That’s just RUMINT though....


Straight up lies, all lies. I was told students would be buying beer for the outstanding instructors. I heard one of them really likes Belgian sours.


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## 256 (Apr 14, 2018)

I google FWB transfusion lab and couldn’t stop reading this article, interesting.

Blood products in the trenches of transfusion medicine


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## SPAK (Apr 15, 2018)

This has been an issue in the AFMS for quite some time. Unless you’re stationed in San Antonio you’re not going to realistically keep up with trauma/critical care skills.

For SOST specific we’ve established relationships in a various places to work at civilian trauma centers to maintain our skills and stay current.

I am not spun up on it but I was under the impression that the Air Force SMART program was designed to accomplish a similar end for the AFMS. I’m not sure if it’s available at all bases or only a select number.

When I was stationed in Alaska we tried to send our medics and RNs to the level 1 trauma center for two weeks every couple months on a rotating schedule. In theory it was a good idea and well supported. Execution in an environment where everyone is short on manning is an entirely different variable.


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## FisherAD1 (Apr 15, 2018)

256 said:


> I google FWB transfusion lab and couldn’t stop reading this article, interesting.
> 
> Blood products in the trenches of transfusion medicine


If you want to read more about FWB, check it out here: Tactical Damage Control Resuscitation


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## Stretcher Jockey (Mar 11, 2019)

Reviving a dead thread to ask if anyone is headed to SOMA this year. Looks like Im headed that way and looking to meet up with some experienced folks while there.


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## amlove21 (Mar 12, 2019)

Stretcher Jockey said:


> Reviving a dead thread to ask if anyone is headed to SOMA this year. Looks like Im headed that way and looking to meet up with some experienced folks while there.


We are sending s few- pm me I’ll make the link up.


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## Ranger Psych (Mar 12, 2019)

amlove21 said:


> We are sending s few- pm me I’ll make the link up.


 
You don't wanna link up with this guy, he doesn't know shit bout tactical medicine or BBQ.


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## Stretcher Jockey (Mar 12, 2019)

Ranger Psych said:


> You don't wanna link up with this guy, he doesn't know shit bout tactical medicine or BBQ.


I could probably pick his brain about hair gel vs pomade vs paste though


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## policemedic (Mar 12, 2019)

This is the first year I won’t be going because commitments. Have fun—it’s a great conference.  Take advantage of the preconference labs.


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## Devildoc (Mar 12, 2019)

With all due respect to my esteemed colleague @policemedic (and you know I mean it because I said "with all due respect"), the purpose of the conference isn't to attend precon labs or events.  The whole point of going to a conference like this is to buddy up with one of the vendors--particularly of the female persuasion, but don't be picky--to pay for all of your meals but especially booze.  Play your cards right you might even go home with more money than you started with.  If you learn something it's purely accidental.


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## policemedic (Mar 12, 2019)

@Devildoc forgot to mention getting laid, but that probably goes without saying.


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## 61J/L (May 7, 2019)

While I'm in a different field, I too have heard a lot of great things about the SOMA conference and have been interested in attending myself but have no time. I think they also have a monthly, if not quarterly, journal. Journals are what I use to stay up to date in my field. Do EMTs have a professional organization or credentialing body that provides recs on how to stay up to date?


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## Stretcher Jockey (May 8, 2019)

The NAEMT (Nationional Association of Emergency Medical Technicians) has a list they put out that counts certain certification hours per class. For example, I took a TCCC-Medical provider class that counted for 15 CEUs. However, that list is different every year. This year, SOMSA is dependent on the classes you take, so after the conference is done, you get an individulaized report on how many CEUs you can claim on your recertification.


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## Stretcher Jockey (Mar 6, 2020)

Sort of necro-posting, but SOMA is open for registration. I'll be there this year as long as it doesn't get cancelled due to COVID-19 concerns. There are some cool labs going on that I'm looking forward to!


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## x SF med (Mar 7, 2020)

Stretcher Jockey said:


> I could probably pick his brain about hair gel vs pomade vs paste though



PJs use fiber product, it stands up to the wind and looks natural....  jeez...


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## SpongeBob*24 (Mar 7, 2020)

@amlove21 taking his helmet off after a big mish....


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