Upstate We Are One- Spring 2016 by Rebecca Janowski

WE ARE ONE PROVIDING RESOURCES, EDUCATION, OUTREACH AND SUPPORT TO OUR VALUED EMS TEAM MEMBERS IN THE FIELD

SPRING 2016

We Are One now on Facebook - page 2 Annual Teaching Day May 16 - page 3 Trauma Center Levels - page 4 Acute Care Surgery - page 6 Upcoming Classes - page 7

Upstate Prehospital Medicine & Trauma Teaching Day 2015

WE ARE ONE. We Are One Is Moving Because so much of what Upstate wants to share is timely, this publication is migrating to a Facebook page. You can find us on Facebook at: www.facebook.com/ upstateweareone There you'll get feature stories, upcoming classes and conferences, and updates from our various departments and services - all in real time. Schedules and links also will be found on our website: www.upstate.edu/ weareone

At Upstate University Hospital, we recognize, appreciate and salute our EMS providers and the work they do. These providers, both volunteer and paid, have committed themselves to helping others and to making lives better. We Are One launched in 2013 to recognize these valuable team members and provide them with resources, education, feedback, and support. Among its key initiatives is an annual EMS Teaching Day. Last year more than 200 EMS providers from throughout our region attended the Prehospital Medicine & Trauma Teaching Day. This free event oﬀered a range of sessions throughout the day, taught by guest speakers as well as experts from Upstate Medical University. Additionally, attendees

were treated to breakfast, lunch, morning and afternoon snacks - and up to 6 hours of CMEs. This year, our new location at The Lodge at Welch Allyn, aﬀords us more space for both participants and vendors. We anticipate upwards of 300 attendees. If you're interested in attending, a complete schedule follows on Page 3. While we may represent diﬀerent agencies and organizations that may be miles apart, our goal is the same: to provide outstanding medical care as quickly as possible. At Upstate, we value our EMS providers as an integral part of our team. At Upstate, we recognize We Are One. •

On Cover: A LifeNet of New York helicopter launches from the helipad at Upstate University Hospital after delivering a trauma patient to the region's only Level 1 trauma center. 2

SPRING 2016

WE ARE ONE - UPSTATE UNIVERSITY HOSPITAL

3RD ANNUAL UPSTATE PREHOSPITAL MEDICINE & TRAUMA

TEACHING DAY 2016 MONDAY, MAY 16 Welch Allyn Lodge 4355 State Street Road Skaneateles Falls, NY

This event is free but preregistration is required. Additionally, the workshops titled Leadership and Proper Physical Restraint require pre-registration and have limited seating. Attendees will choose all other workshops the day of the event (Please note: some workshops

will have limited seating and will be on a first come first serve basis.) Registration Deadline is May 12. 6.0 Hours of CMEs from CNY EMS Breakfast and lunch will be provided.

7:30 - 8 AM

REGISTRATION/CONTINENTAL BREAKFAST

8 - 9:15 AM

Leadership/Mentoring Paul Werfel, MS, NREMT-P

9:15 - 9:30 AM

BREAK

9:30 - 10:15 AM

Transitions of Care & Emerging Health Care Derek R. Cooney, MD, FF/EMT-P, FACEP; Christian C. Knutsen, MD, MPH, FACEP

10:15 - 10:30 AM

BREAK

10:30 - 11:45 AM

Kids Aren't Little Adults: The Top 5 Pediatric Toxicologic Emergencies Jeanna Marraﬀa , Pharm.D., DABAT

12:45 - 1:30 PM

1:30 - 1:45 PM 1:45- 2:30

BLS

BLS SKILLS

TRAUMA

MEDICINE

Event Medicine Jeremy Joslin, MD

Skills/Variety: CPAP, Pharm; Wound Packing; Tourniquet app: Pressure Dressing Naomi Krebs, EMT-P, CIC

Managing the Altered Mental Research State What’s new in Grahame Gould, MD Pediatric Care Tamer Ahmed, MD

ULTRASOUND RESTRAINT

LEADERSHIP

PROPER PHYSICAL

Joe Wlostowski, RN, EMT-P

Paul Werfel, MS, NREMT-P

Robert Poresky, EMT-P and Lt. Shawn C. Tompkins, EMT-P

This session runs from 12:45 – 3:30

Mercy Flight Central Staﬀ

BREAK/TRANSITION Diﬀerential Diagnosis for the EMT Christopher Fullagar, MD

2:30 - 2:45 PM

BREAK/TRANSITION

2:45 - 3:30 PM

Assessing & Communicating with the Pediatric Patient Population Alison McCrone, MD

Skills/Variety: CPAP, Pharm; Wound Packing; Tourniquet app: Pressure Dressing Naomi Krebs, EMT-P, CIC

Mechanism of Injury Richard King, MD

SEPSIS Seth Dukes, MD

Joe Wlostowski, RN, EMT-P Mercy Flight Central Staﬀ

Burns Joan Dolinak, MD

What the Pleth? Waveform analysis of etCO2 & spO2 does it really mean anything? David M.Landsberg,MD, FACP, FCCP

For complete course descriptions and to register, log on to www.upstate.edu/weareone

Joe Wlostowski, RN, EMT-P Mercy Flight Central Staﬀ

Participants Paul Werfel, will in this MS,stay NREMT-P workshop throughout the afternoon.

You must preregister for this Paul Werfel, workshop MS, NREMT-P when you register for the event.

Participants will stay in this EMT-P Robert Poresky, andworkshop Lt. Shawn C. throughout the Tompkins, EMT-P afternoon

You must preregister for this workshop when Robert Poresky, EMT-P andyou Lt. register Shawn Cfor the event. Tompkins, EMT-P

3:30 - 3:45 PM

BREAK/TRANSITION

3:45 – 4:30

Plenary Session – Wrap-up Quick Rapid Fire Derek R. Cooney, MD, FF/EMT-P, FACEP ; Christian C. Knutsen, MD, MPH, FACEP ; David M. Landsberg, MD, FACP, FCCP; Christopher T. Tanski, MD, MSEd

WE ARE ONE - UPSTATE UNIVERSITY HOSPITAL

SPRING 2016

KNOW YOUR TRAUMA CENTER LEVELS...

Upstate University Hospital has:

• The first and only nationally Accredited Level One Adult and Pediatric Trauma Center in the Region.

• The region's only children's hospital Upstate Golisano Children's Hospital.

• The region's only dedicated Pediatric Emergency Department. • The Clark Burn Center, a state-of-the art intensive care unit for burn patients serving 27-counties. Pediatric burn patients are cared for at Upstate's connected Golisano Children's Hospital by both burn and pediatrics teams. 4

SPRING 2016

WE ARE ONE - UPSTATE UNIVERSITY HOSPITAL

...AND WHERE TO TAKE YOUR PATIENT New York State has advanced from a state verified and designated two-tiered trauma system (Regional and Area Trauma Centers) to a verification process developed by the American College of Surgeons, Committee on Trauma (ACS-COT). The ACS-COT Trauma Center verification is validated and used by many states including Delaware, Michigan, Ohio and Oklahoma. New York now has a verification process that requires reverification every three years. Trauma center verification assures that every New York State designated trauma center provides optimal trauma care.

Level I Trauma Centers like Upstate University Hospital and Upstate Golissano Children’s Hospital are involved in all aspects of trauma care from injury prevention and rehabilitation, to research and trauma systems development. A Level I Trauma Center must have, among other things, an immediate availability of emergency physicians, trauma surgeons, anesthesia, radiology, and operating room and ICU care.

Level II Trauma Centers provide a similar commitment and level of care to trauma patients, but do not have the same depth of specialty resources as Level I centers. Level II centers are also not involved in research.

Level III and IV hospitals are new to our state. Level

community outreach, conducting quality improvement activities and trauma system development. How should EMS determine the appropriate hospital for the trauma patient? The answer is found in the statewide BLS treatment protocols. This protocol has been developed by the CDC (Centers for Disease Control). The Major Trauma Protocol (T-6) identifies four areas that are assessed. Use of the protocol helps providers get the trauma patient to the right hospital the first time. It also helps to minimize delays in the patient reaching definitive care and eroding valuable time from the Golden Hour. Defined abnormal vital signs, level of consciousness, and/or the anatomic pattern of injury (physical findings) identify which patients should be transported to the highest level trauma center. Patients without these findings are then assessed for mechanism of injury. Patients with significant mechanisms of injury are transported to the highest level trauma center while those with minimal findings can be transported to other appropriate level trauma centers. The final category used to determine trauma patient destination is special patient or system considerations. Some of the factors that are considered include patient age (adults over the age of 55 and children), anticoagulation or burns.

III hospitals are community hospitals that have the ability to care for some trauma patients but also need to transfer patients to a higher level of care. Level IV centers must provide immediate resuscitation and stabilization while transferring the majority of injured patients to a higher level of care.

Another extremely important consideration is your judgment as an EMS provider. You should contact medical control for these patients and consider transport to a trauma center or a specific resource hospital, such as a burn center. The other, less severely injured trauma patients are transported to the patient’s hospital of choice.

Dr. William Marx, DO, FACS, chairman of the New York State Trauma Advisory Committee and the trauma medical director at Upstate University Hospital, said the new levels of designations are to provide the best trauma care possible to the patients who go to these hospitals. Trauma care is optimized by providing education,

The Trauma Services staﬀ at Upstate University Hospital is available to provide more information, training and support to improve trauma care in our region. Please contact us at trauma@upstate.edu to obtain a schedule of training opportunities or have a member of the trauma program meet with your EMS service. •

WE ARE ONE - UPSTATE UNIVERSITY HOSPITAL

SPRING 2016

ACUTE CARE SURGERY

ACS HAS BEEN THE STANDARD OF CARE AT UPSTATE FOR 20 YEARS Acute Care Surgery (ACS) is a specialty with three essential components: trauma, critical care and emergency surgery

As the region's only Level One trauma center, and the first in NY State to be verified for both adult and pediatric patients, the Upstate team meets the rigorous requirements to maintain that designation. Verified trauma centers require the immediate availability of emergency physicians, trauma surgeons, and anesthesiologists, as well as having dedicated operating rooms 24/7. Upstate also draws upon Acute Care Surgery (ACS) to serve its patients. ACS is a specialty with three essential components: trauma, critical care and emergency surgery. ACS emerged following a national survey of surgical critical care program directors and major trauma organizations. The survey showed that these surgeons were increasingly responsible for emergency surgical care and supported the need for formalized training as ACS emerged as a specialty. ACS surgeons also play a vital role in immediately stabilizing critically injured patients. ACS has been the standard of care at Upstate for decades, supported by its team of

SPRING 2016

specialized surgeons. “We’ve been doing acute care surgery for 20 years,” said Dr. William Marx, DO, FACS, director of Upstate’s Trauma Program and chairman of the New York State Trauma Advisory Committee. “All our surgeons who take trauma call are board certified in general surgery as well as in William Marx, surgical critical care.”

DO, FACS, director of “The reality is, if you can manage trauma at a Level One center, you Upstate’s can manage any surgical emergency,” Trauma Marx said. Between the adult and Program and pediatric trauma programs, Upstate chairman of the has 11 ACS surgeons. New York State “There has never been a time that a Trauma Advisory patient comes in here without a Committee. highly qualified surgeon waiting,”

Marx said. “Another benefit is that Upstate additionally oﬀers essentially every surgical subspecialty to our patients. This ensures they receive the most immediate and appropriate care."

WE ARE ONE - UPSTATE UNIVERSITY HOSPITAL

2016 Training Calendar upstate offers classes, courses, seminars and conferences. Here’s a list of upcoming events. For more details on any of these events, or to register, log on to www.upstate.edu/weareone

The following three conferences will be at: The Genesee Grande Hotel 1060 East Genesee Street, Syracuse For more information on any of them, or to register, contact: Rose More 315-464-6197 morer@upstate.edu

15TH ANNUAL PEDIATRIC EMERGENCY MEDICINE ASSEMBLY September 28 20TH ANNUAL TOXICOLOGY TEACHING DAY November 2 5TH ANNUAL NORTHEAST WILDERNESS MEDICINE CONFERENCE November 16 PARAMEDIC PROGRAM Start date: Aug. 18 6:30 PM to 10:30 PM

ADVANCED CARDIAC LIFE SUPPORT Provider Classes May 19 - 20 August 4 - 5 September 15 - 16 October 24 - 25 November 17 - 18 Refresher Classes April 19 May 1 May 9 June 3 June 16 July 25 August 11 September 12 October 18 (5 pm class) November 4 December 9

PEDIATRIC ADVANCED LIFE SUPPORT Provider Classes May 5 - 6 Sept 29 - 30 December 1 - 2 Refresher Classes May 23 (5 pm class) July 29 September 9 October 20 November 1 December 6 ADVANCED TRAUMA LIFE SUPPORT (ATLS) This is a two-day program designed for physicians, nurse practitioners, physician assistants, nurses and advanced EMTs. It focuses on the critical first hour in the care of the trauma patient.

Provider & Refresher Courses April 28 & 29 May 26 & 27 June 16 & 17 July 14 & 15 September 22 & 23 October 27 & 28 November 17 & 18

Joining Upstate’s comprehensive stroke center are two physicians with expertise in endovascular stroke rescue therapies Meet the newest members of Upstate's Stroke Team. Hesham Masoud, MBBCh, and Grahame Gould, MD, began work late last summer at Central New York’s first and only comprehensive stroke center. In the photo below, the two join stroke team member Amar Swarnkar, MD, in the biplane angiography operating room at Upstate University Hospital. Its location, in the new intraoperative MRI surgical suite, enables surgeons to obtain MRI scans during surgeries, improving patient outcomes. The addition of Drs. Gould and Masoud, both of whom have expertise in endovascular stroke rescue therapies, strengthens the team of professionals who provide round-the-clock stroke care at Upstate University Hospital. They join Swarnkar in providing endovascular treatments including mechanical thrombectomies. This is a crucial therapy for patients suﬀering ischemic strokes. Swiftly locating and removing a brain clot improves the patient’s odds of survival and recovery.

EMT ORIGINAL Start date June 20 M/W/F NOVA, 4425 Buckley Road, Liverpool, NY

ADVANCED BURN LIFE SUPPORT May 20 Aug 12 Nov 4 7 a.m. to 5 p.m. This all day course is offered four times a year. For more information, or to register for a course, contact: Rebecca Willison RN, ABLS Course Coordinator, at 315-464-2614

WE ARE ONE - UPSTATE UNIVERSITY HOSPITAL

SPRING 2016

Department of Emergency Medicine 750 East Adams Street Syracuse, NY 13210

SAVE THE DATE Upstate Prehospital Medicine & Trauma Teaching Day: WE ARE ONE

MONDAY, MAY 16 www.upstate.edu/weareone

Upstate Emergency Departments TWO LOCATIONS COVERED BY THE SAME MEDICAL STAFF

DOwnTOwn Campus

COmmuniTy Campus

750 East adams street

4900 Broad Road

The Region’s O nly Level-One Trauma Center

• Handles all types of medical emergencies.

EMERGENCY DEPARTMENT • Complements the downtown services in a quieter setting. Patients brought to the Community Campus who require services from downtown will be moved seamlessly though our system.

• Cares for patients transported by ground or air from throughout Central New York and beyond.

• Patients who require hospitalization are admitted to either Downtown or the Community Campus based on their medical needs.

PEDIATRIC EMERGENCY DEPARTMENT • Located within the Downtown Campus Emergency Department.

GEM CARE COMMUNITY CAMPUS • Located within the Community Campus Emergency Department.

• Only dedicated pediatric emergency department and Level-One Pediatric Trauma Center in the Central New York region.

• Devoted to addressing the medical needs, sensibilities and behavioral concerns of patients 65 and older.

• Cares for children with any illness and/or injury.

• GEM Care recognizes that traditional care models may not be as eﬀective in meeting the unique needs of the aging.

EMERGENCY DEPARTMENT • Oﬀers state-of-the-art technology to care for critically ill or injured patients.

• Staﬀed with physicians trained in pediatric emergencies.