CJ Winckler – The Power of Delegated Medical Practice

Delegated EMS medical practice is the legal and clinical mechanism that transforms EMS providers from “trained laypersons” into true medical practitioners in the field, by extending the physician’s license through careful oversight. In Texas only physicians, advanced practice providers, and certain nurses are granted the legal authority to practice medicine. Texas has a unique approach regarding the practice of prehospital providers. Paramedics and EMTs provide care under delegated practice. There are no state guidelines, protocols, or scope of practice for EMS. Delegation works through clinical operating guidelines and online medical direction. The combination of no state scope of practice and EMS Medical Director delegation enables advanced care, maintains patient safety, creates system flexibility, and protects providers legally. The practice of EMS delegated practice is a balancing act between progressive care and legal, ethical, and patient safety risks. Key questions include: What responsibilities and liabilities does an EMS Medical Director assume when delegating medical practice? Is having a state-defined scope of practice versus the Medical Director’s delegated scope of practice beneficial? How does delegation of medical authority protect EMS providers legally when performing advanced procedures?

Chris Way – Pride in Emergency Services, We Better Have Some

As First Responders and healthcare providers, we can often be our own worst enemy and lack pride in what we do. This course discusses having pride in our work and how that pride translates into taking care of patients, each other, and our communities. Chief Way uses examples, both good and bad, of how taking pride in the service provided impacts patient outcomes, career longevity, and job satisfaction. Topics include real examples of a prideful culture in similar organizations, how disasters affect the public image of emergency services, the importance of having the right personnel “on the bus,” and strategies for messaging employees, patients, and the public about the work being done.

CJ Winckler – Prehospital Whole Blood: Who, What, When, Where and Why?

This session covers the implementation of a whole blood program at the blood center and trauma center, as well as regional deployment of prehospital whole blood over the last seven years. Topics include reducing wastage, AABB standards, and literature review on whole blood versus component therapy. Lessons from blood deployed to MCIs, including walking blood bank programs, and collaboration among stakeholders are discussed. Key topics include the science of whole blood, practice of prehospital whole blood transfusions, analysis of walking blood bank plans, and prehospital blood transfusion standards.

Neuro Sanford – New Stroke System

Overview of Sanford’s new stroke system and associated processes.

Delegated EMS Marty Link & Panel – Office of EMS

Panel discussion covering topics and updates from the Office of EMS.

CJ Winckler – BLS is BS: Life Saving is a Spectrum of Care

The traditional distinction between ALS and BLS is blurred. Today’s EMS providers must understand resuscitation, airway management, medication management, and may perform interventions previously limited to surgical suites. This session covers airway adjuncts, needle pleural decompression, finger thoracostomy, clamshell thoracotomy, vascular access, electrical therapy, and point-of-care testing. Participants will learn why traditional ALS/BLS lines are no longer evidence-based, patient-centric airway management strategies, relationships among interventions, and literature supporting expanded BLS provider capabilities.

Litman – Determination of Capacity

Focuses on assessing patient capacity in emergency care, including clinical and legal considerations.

CJ Winckler – Texas Trauma Tactics

San Antonio Fire Department applies cutting-edge trauma care enabled by delegated medical practice. EMS Medical Directors train and deploy advanced trauma care paramedics, and EMS physicians are deployed prehospital. The session discusses open thoracostomies, modified clamshell thoracotomy, abdominal aortic junctional tourniquet deployment, prehospital amputations, and digital blocks for pain control. Topics also include alternatives to invasive techniques, advanced device procedures, training and equipment considerations, and logistical challenges of deploying advanced trauma treatments prehospital.

Chris Way – From Provider to Patient: My Journey Through the Healthcare System

Chief Way shares his personal journey transitioning from EMS provider to patient following a life-changing cancer diagnosis. This session explores the impact of relationships, attitude, resilience, and recovery. Discussion includes the importance of relationships in patient care, how a positive attitude impacts outcomes, accepting loss of control, and the role of resiliency in the healing process.

Dr. Snell – Scene Preservation

Covers principles and best practices for preserving emergency scenes for investigation and patient care.