Robert Vroman

Robert Vroman, M.Ed., BS NREMT-P

Conference Proposals

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Robert Vroman at Connecticut EMS Conference

Robert's current list of presentation topics are listed below. Clicking on any title will bring you to a description of the topic. Additional information such as formal objectives, time frames, and references are available upon request.

The time frame of each session is flexible and can be adjusted to meet the needs of your particular conference. All sessions are presented based on the assumption that the audience is comprised of combined provider levels. If you would like a session geared to a specific provider level that can be arranged. If you are interested in a topic that has not been proposed, a presentation can be created that is specific to your needs.


Medical Topics

Trauma Topics

Combined Trauma and Medical Topics

Other Topics

Education topics

Workshops


Medical Topics

Good Air In, Bad Air Out–Pre-hospital Capnography

The use of capnography in the pre-hospital setting has become the standard of care.  The use of continuous waveform capnography in conjunction with oxygen saturation as diagnostic tools and evaluations of treatment will be discussed, as well as how they relate to acid-base balance.  Benefits of capnography in the spontaneously breathing patient as well as the intubated patient, and those in cardiac arrest will also be included.

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How Sweet It Is – Understanding and Treating Diabetes

What is diabetes really?  How does it work?  How do the types differ, and what conditions are common to each type?  Diabetes will be presented from the cellular level through its effects on the entire body and how that relates to patient presentation and treatment.  The assessment and treatment of both insulin and non-insulin dependent diabetics, the pathophysiology of both disease processes, as well as the role of glucose metabolism, and alternate energy sources will be discussed.

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The Death of Peanut Butter in America–Allergies and Anaphylaxis

Although we may all see severe allergic reactions in our career, it is rare that we will see true anaphylaxis.  This presentation will differentiate the two and how treatment will differ.  The pathophysiology of each will be discussed including the role of the immune and inflammatory systems.  The antigen – antibody relationship, various types of antibodies, and primary and secondary responses will be reviewed in detail.  Common allergens, the role of the MHC and self-recognition will be presented.

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They Shouldn’t be Smurfs!

Blue may be a good color for smurfs, but not for your patients.  This presentation will review the anatomy, physiology, patient presentation, and treatment of respiratory emergencies commonly seen in the pre-hospital setting.  The use of oxygen saturation and continuous waveform capnography as diagnostic tools and evaluations of treatment will be discussed, as well as how they relate to acid-base balance and other lab values.

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All That is Elevated is Not an MI

Identifying MI patterns on a 12 lead EKG is something we have all been taught to do, by now you can probably do it in your sleep.  What about those things that mimic a MI but are not?  Many cardiac alerts are initiated based on infarct imposters rather than an actual MI.  In this interactive session we will review the normal perfusion and conduction system of the heart, and apply that to the 12 lead to recognize both infarcts and their imposters.

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I Broke My Heart – Can You Fix It?

The heart is a wonderfully amazing organ as well as being critical to life.  As such when cardiac emergencies occur they can be critical.  After reviewing the anatomy and physiology of the heart we will discuss the pathophysiology, presentation, assessment (including heart tones), and treatment of various cardiac conditions.  These will include, but may not be limited to, angina, myocardial infarctions, murmur of papillary muscle dysfunction, ventricular failure, tamponade, and aortic disruptions.

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Introduction to 12 Lead EKGs

If you have a good handle on leads I, II, and III and are ready to increase your EKG interpretation skills then this is the class for you.  We will start with the basic principles of the 12 lead EKG and move through what it can, and cannot tell us, and how to read them.  Depending on the length of the session topics will include recognition of ischemia, injury, and infarction, MI imposters, bundle branch blocks, differentiation of wide complex tachycardias, ventricular hypertrophy, and much more.  Much of the class will be participant interpretation of actual 12 leads with guidance from the presenter.

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If You Can’t Find It, You Can’t Fix It – [Pick a system] Assessment

Patient assessment is one of the keys to appropriate patient care, yet many times many times what we are taught in EMS is a cursory exam.  This interactive session will present the assessment of the [conference coordinator’s choice] system, and spend the remainder of the time performing the assessment on each other.  Assessment findings will be correlated to disease processes and differential diagnoses of conditions.

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Lub-Dub What?!! – Thoracic Auscultation

You have your stethoscope and you are armed and ready to go forth and treat!  But what are you listening for?  When do you use the bell vs. the diaphragm?  What is a tunable diaphragm?  Thoracic auscultation is critical to patient assessment, yet it is often described in verbal terms of what you might hear, or what something sounds like.  In this session we will review various thoracic sounds recorded from patients to discuss what to listen for.  Findings will then be correlated to disease processes and presentation.  After this session you will never use your stethoscope the same.

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Should I Stay or Should I Go? – Emergency Childbirth

Nothing creates polar opposites in EMS more than pre-hospital delivery.  You either love it, or are scared to death of it; there are few providers who take a middle of the road view.  In this session we will review various aspects and stages of delivery that must be considered by the pre-hospital provider.  After discussing and reviewing an uncomplicated delivery we will talk about complications that may occur and necessary interventions for both the mother and baby.

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One Pill Killers – Do They Really Exist?

The concept of medications or toxic substances that can kill the pediatric patient with one pill, or one dose strikes fear into the heart of many. In this session we will explore the agents that can indeed cause significant outcome, as well as the care actions that can be taken in the pre-hospital setting that will have dramatic impact patient outcome.

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All Shook Up!

"A patient cannot be conscious during a seizure", "All seizures present with tonic-clonic activity", "No seizure patient can remember thier seizure". Do things like this sound familiar? There are a myriad of misconceptions regarding seizures in EMS, and the truth is we often do not see the actual seizure, but rather rely on the history we are given. This can lead to unrecognized seizures and mistreatment of the seizure patient. In this session we will discuss the common causes and various types of seizures that may be encountered by the EMS provider, as well as thier presentation and treatment. By the end of the session you will have a new appreciation and understanding of the seizure patient.

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Trauma Topics

Just a Dish on a Tablecloth

How are patients involved in motor vehicle collisions like dishes on a tablecloth?  How do the laws of physics and energy predict injury patterns?  Do you just want to see some really cool mechanism?  For whatever reason you attend this session you will leave with a new appreciation of kinematics and mechanism of injury.  Kinematics is an integral part of the assessment of a patient involved in a traumatic incident, and provides valuable information to guide treatment.  In this lively energized session we will explore the laws of physics and their interrelationship with traumatic injury, as well as the effects of the destructive forces of traumatic impact on various body systems.  Come see what happened before you got there and answer the age old question “How did you do that?!”

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The Day Humpty Dumpty Fell

We all know the nursery rhyme, but what really happened when Humpty hit his head?  What kinds of traumatic brain injuries are possible?  How do they present differently?  We will review the various injuries that Humpty may have suffered from both immediately and those for which he may have sought help from EMS months after the fall.  Patient presentation, assessment, and management of the different injuries will be explored.

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Thunderstruck!

“You’ve got a better chance of being struck by lightning than…” Have you ever used or been told that phrase to refer to unlikely odds?  With an average of 20 million ground strikes per year lightning does indeed strike hundreds of people per year killing many of them.  In fact there are more people killed in the US each year by lightning than tornadoes or hurricanes.  This session will cover the myths and facts of lightning, as well as common dangers and injuries to patients and providers, and the emergency treatment of those who are struck.

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Bruising, Bleeding, and Bursting – Traumatic Injuries to the Chest

“Hot lights and cold steel” is a common phrase used when referring to the treatment of trauma.  However the pre-hospital recognition and treatment of traumatic injuries is often the key to delivering a viable patient to the surgeon.  In this session we will explore the pathophysiology, presentation, and treatment of various thoracic injuries, and discuss how the pre-hospital provider can deliver a patient with the best chance of survival to the surgeon.

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Bruising, Bleeding, and Bellyaches – Traumatic Injuries to the Abdomen

“Hot lights and cold steel” is a common phrase used when referring to the treatment of trauma.  However the pre-hospital recognition and treatment of traumatic injuries is often the key to delivering a viable patient to the surgeon.  In this session we will explore the pathophysiology, presentation, and treatment of various abdominal injuries, and discuss how the pre-hospital provider can deliver a patient with the best chance of survival to the surgeon.

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The Heat is On! – Burn Emergencies in EMS

Although significant burn injuries may not be a common event in EMS they can be critical for the patient, and the actions of the pre-hospital provider can impact the patient’s ultimate outcome. During this session we will discuss various burn mechanisms of thermal and chemical burns, as well treatment options for these patients.

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So I Have to Immobilize, Now What?

For a variety of reasons the skill of spinal immobilization has become one of simply “going through the motions”.  In today’s world of selective immobilization most patients are immobilized because the provider truly believes there is a spinal injury, however the methods used may not be of the best benefit to the patient.  In this session we will review various criteria for selective immobilization and their pitfalls.  Be prepared to dust off some old skills and learn new ones!
Note to conference committee – The time for this session can be adjusted to fit your schedule. It can be delivered as an interactive discussion, or as an interactive skills session. If the latter option is chosen the number of participants is an important factor.

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Combined Medical and Trauma topics

Shock – Beyond Inadequate Tissue Perfusion

What is shock? What is inadequate tissue perfusion?  This presentation will look at the, causes, pathophysiology, presentation, and treatment of hypoperfusion.  Normal perfusion, capillary filtration, normal systemic circulation and the normal mechanisms that regulate blood pressure are discussed, and how these systems are altered during the various stages of hypoperfusion.   Normal and abnormal patient presentations as well as the effect of prescription and non-prescription medications and drugs in the presentation of the shock patient are addressed.  Various mechanisms and treatment of shock are introduced from basic through advanced procedures including pharmacological treatment and a discussion of the various theories of fluid resuscitation.

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Squeeze Me? – The Pressure is On!

What is the interrelationship between compartment syndrome, crush injury, and crush syndrome?  When should they be suspected and how do they present? How do they occur spontaneously?  What are the dangers associated with not recognizing these conditions? These questions and more regarding these often ignored conditions will be answered during this session.  Case reviews will be utilized to present medical and traumatic causes of these injuries, as well as home health care situations where they may occur.  Treatment presentation will include both field and facility options from BLS treatment through surgical intervention.

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Other topics

I Swear to Tell the Truth, the Whole Truth, and Nothing But the Truth

If we could only have our patients take that oath.  Have you ever gotten a history from your patient only for it to change, or have things added or deleted when you arrived at the hospital?  Did you know that you might have caused that to happen?  This session explores the communication process, the establishment of a therapeutic relationship, and how our actions can dramatically impact the effectiveness of our communications with patients.  From the patient’s perspective we will explore the effects of environmental and physical settings, how questions are asked, cultural considerations, sensitive topics, and other challenges to effective communication.  After attending this session your patients should be telling you the truth, the whole truth, and nothing but the truth!

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Talking to Tots

“Children are not little adults”  We have heard this time and time again, but what does it really mean?  Interviewing and assessing pediatric patients presents unique challenges even to the experienced provider.  In this session we will explore the normal growth, development, and physiologic characteristics of these patients, and discuss how to use this knowledge to effectively obtain a history and physical from children.

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Painting Pictures – Objective vs. Subjective Documentation

Objective documentation is crucial in the world of medicine.  It not only provides legal protection, but it is the key to the continuum of care.  Yet this topic is often brushed over in EMS education programs and providers are left to “learn as they go”.  In this interactive session we will utilize actual run reports to highlight the importance and strength of objective documentation for both medical and legal reasons.  At the end of this session you will have a list of words and phrases never to put in a report, many of which commonly are, and you will never document the same.

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Education topics

Test Enhanced Learning

Traditionally exams in the academic setting have been used to determine competency, rank students, and evaluate the efficacy of the curriculum. However, through a phenomenon known as the testing effect exams are great learning tool and one of the most powerful instruments to enhance long term retention. In this session we will explore this phenomenon and discuss methods in which exams can be used for the best benefit of the learner in their educational endeavor.

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Developing Critical Thinking

Critical thinking skills are essential for those in the practice of emergency medicine. As educators we must develop learning activities that provide learners the opportunity to develop these skills while still in the didactic and practical setting. During this session we will explore the process of critical thinking and discuss various activities and methods to implement it into the educational process in manner that fosters lifelong use by the participants in our classes.

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Simulations on a Shoestring

The popularity and use of simulations in EMS education has exploded over the last several years. However many programs find they do not have the budgets or space for hi-fidelity human patient simulators, or dedicated specialty simulation labs. In this session we will explore other options to create high quality and effective simulation experiences without breaking the bank. Using two programs as examples we will look at the use of existing space, unique storage solutions, interchangable simulation and "rote" skills space, and a variety of other strategies to implement this learning modality into your program. Chances are good you already have everything you need to create a great simulation environment!

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Participation Challenges in the Online Environment

Online education is everywhere, and EMS education is no different. Initial and continuing education in the online environment is becoming commonplace and is here to stay. Using the existing data, and original research performed by the presenter during an online/hybrid EMT class we will discuss the challenges instructors face when fostering participation in an online class. While many of the principles from other educational disciplines apply, EMS education has unique factors that must be considered when conducting online education. This session is a must for anyone involved in, or considering developing an online program. By the end you will have a better understanding of techniques that will enhance participation, or stop it dead in its tracks!

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Workshops

Bumps, Blips, and Dips–EKG Interpretation for non ALS Providers

Have you ever wondered what all those bumps, blips, and dips on the monitor mean?  Why an ALS provider’s jaw drops when they see the monitor?  EKG interpretation is not mysterious or magical, but rather a fairly straightforward skill.  This session will provide the non-ALS provider a practical, systematic approach to EKG interpretation and their practical application.

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Advanced Airway Management Lab

Airway management is one of the cornerstones of pre-hospital medicine.  This hands on lab session will not only review standard airway management techniques, but will introduce several new and innovative methods of airway control.  Included will be alternative methods of supine and seated orotracheal and nasotracheal intubation, blind insertion airway devices,  various surgical airway management methods, and pharmaceutical options in airway control.  Although the session focuses on advanced airway management, the BLS provider will increase their knowledge of airway control, and how they can assist ALS providers in airway management.  BLS providers will also have the opportunity to learn and practice procedures they may not have seen or done before.

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Integration of Capnography in Respiratory Emergencies

This presentation will review the anatomy, physiology, patient presentation, and treatment of respiratory emergencies commonly seen in the pre-hospital setting.  The use of oxygen saturation and continuous waveform capnography as diagnostic tools and evaluations of treatment will be discussed, as well as how they relate to acid-base balance.  Benefits of capnography in the spontaneously breathing patient as well as the intubated patient, and those in cardiac arrest will also be included.

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The Comprehensive Physical Exam

Have you ever watched a physician perform a physical exam and wondered why certain things were being done?  Or how based on a simple test the physician could have a fairly good idea of the patients condition?  Do you know why simply asking a patient to squeeze your fingers is an inadequate test of motor and neurological function to the hand?  In this interactive session you will be introduced to the comprehensive physical exam and have the opportunity to practice it and all the while realizing the little known fact that there is nothing advanced about a physical exam.  Any level of provider can perform the comprehensive exam, and then that information can be used to guide care appropriate to that level.  After this session your bag of tricks will be overflowing for your next patient encounter.

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Introduction to 12 Leads

If you have a good handle on leads I, II, and III and are ready to increase your EKG interpretation skills then this is the class for you.  We will start with the basic principles of the 12 lead EKG and move through what it can, and cannot tell us, and how to read them.  Depending on the length of the session topics will include recognition of ischemia, injury, and infarction, MI imposters, bundle branch blocks, differentiation of wide complex tachycardias, ventricular hypertrophy, and much more.  Much of the class will be participant interpretation of actual 12 leads with guidance from the presenter.

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It’s All Greek To Me – Medical Terminology

One defining characteristic of a group is a language and method of communication that is unique to the group.  The language of medicine of course is medical terminology.  When used appropriately medical terminology allows for quick and efficient communication among medical professionals.  However when used inappropriately it can cause confusion and frustration and a minimum, and loss of patient information, or even patient harm.  In this session we will construct and dissect medical terminology using an easy method to decipher the true meanings of words.

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PowerPoint® 101

PowerPoint® can be a powerful tool when used effectively, but when used inappropriately in can be distracting.  In this session we will begin by discussing appropriate and inappropriate uses of PowerPoint® in various settings.  The use of backgrounds, colors, fonts, animations, and other presentation options will be reviewed.  With the theory out of the way, the remainder of the session will be dedicated to actually building a presentation with presenter guidance.  This class is designed for those with minimal experience with the program and will focus on formatting, backgrounds, styles, use of the master slide, insertion of graphics, and packaging the presentation for use on another computer.  Requirements: A computer with a recent version of PowerPoint® installed (new versions can be downloaded as a free 60 day trial from Microsoft), a graphics editing program, and several image files.

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PowerPoint® 102

Most likely you have seen several PowerPoint® presentations that are “ho-hum”, and a few that blew you away.  They are sharp, clean, crisp, and you leave wondering how it was put together.  If you have a basic, yet solid, working knowledge of PowerPoint®, and are ready to make your presentations sizzle, then this is the session for you.  Using the foundation built in PowerPoint® 101 (or prior knowledge) we will review advanced graphics techniques, the creation of custom backgrounds, utilization of hyperlinks to other slides and programs to create interactive presentations, the use of movies and sounds, development of games, the creation of a spreadsheet that dynamically displays its results in PowerPoint® and much more.  Prerequisites: PowerPoint® 101 or a solid foundation in basic PowerPoint® use.  Requirements: A computer with a recent version of PowerPoint® and Excel® installed (new versions can be downloaded as a free 60 day trial from Microsoft), a graphics editing program, several sound files (breath sounds, songs, etc), several image files, and movie files.  A movie editing program would be beneficial, but is optional.
Note to conference committee These classes can be combined to be an 8 hour workshop.  However I have found it works better in two back to back 4 hour sessions as some people are only interested in one part or the other, whereas those who want the full content can simply take both sessions

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