# THE Continuing Education Thread!



## Summit (Mar 15, 2013)

*The purpose of this thread is to inspire others to seek education and to give ideas about CE options.
*
*What should you post?*
Post anything that furthers your healthcare knowledge, whether NREMT wants to count it or not! That can be getting a degree, attending a presentation, taking a healthcare class, listening to a lecture, reading a book, interesting journal article, etc. It can be directly related like a healthcare professional conference. It can be indirectly related learning like a chemistry or ethics course.

*What should you NOT post?*
Please spare the posts about recerting your CPR and ACLS etc.

*Don't forget!*
When you can, provide links and short reviews so that others can know if and how to seek the same CE.


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## Summit (Mar 15, 2013)

Some things I've done in the past few months:

State EMS Conference - There were some great lectures, some were a bit boring (like bystander response on commercial flights).

American Association of Critical Care Nurses EKG Interpretation course - not bad, but I think reading Dubin or even Walraven is better.

Select readings from The ICU Book 3rd Edition http://www.amazon.com/ICU-Book-3rd-Paul-Marino/dp/078174802X/ref=sr_1_1?s=books&ie=UTF8&qid=1363393663&sr=1-1&keywords=the+icu+book - Excellent stuff!

Confirming Feeding Tube Placement:
Old Habits Die Hard (2006) 
http://patientsafetyauthority.org/ADVISORIES/AdvisoryLibrary/2006/Dec3(4)/Pages/23.aspx
http://www.anesthesia-analgesia.org/content/108/4/1198.full.pdf+html

Many journal articles, mostly from NEJM, Journal of Critical Care, and American Journal of Critical Care. Here are a few that come to mind as interesting:

Point-of-Care Ultrasound to Estimate Central Venous Pressure: A Comparison of Three Techniques
http://www.ncbi.nlm.nih.gov/pubmed/23318493

Celebrating the 100th birthday of the electrocardiogram: lessons learned from research in cardiac monitoring. (2002)
http://www.ncbi.nlm.nih.gov/pubmed/12102439

Effect of Daily Chlorhexidine Bathing on Hospital-Acquired Infection (2013)
http://www.nejm.org/doi/full/10.1056/NEJMoa1113849?query=oncology-hematology

Antiplatelet Therapy Is Associated With Decreased 
Transfusion-Associated Risk of Lung Dysfunction, 
Multiple Organ Failure, and Mortality in Trauma 
Patients (2013)
http://www.ncbi.nlm.nih.gov/pubmed/23263579

National Study on the Distribution, Causes, and 
Consequences of Voluntarily Reported Medication 
Errors Between the ICU and Non-ICU Settings (2013)
http://www.ncbi.nlm.nih.gov/pubmed/23263619

Stop the Noise and Get to the Point (2013) http://journals.lww.com/ccmjournal/Citation/2013/02000/Stop_the_Noise_and_Get_to_the_Point_.27.aspx

Oxygen Therapy in Critical Illness: Precise 
Control of Arterial Oxygenation and Permissive 
Hypoxemia (2013)

Impact of Fluid Infusion Rate on Restoring Plasma 
Volume in Sepsis (2013)
http://journals.lww.com/ccmjournal/...uid_Infusion_Rate_on_Restoring_Plasma.39.aspx

The effect of external pressure, catheter gauge, andstorage time on hemolysis in RBC transfusion (2002)
http://onlinelibrary.wiley.com/doi/10.1046/j.1537-2995.2001.41060799.x/abstract

There's more but that's all that I thought of right now...


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## Summit (Mar 17, 2013)

I have a long commute, so finding audio-CE to make good use of my time is something I value. It makes it so I actually look forward to driving and learning.

*Your Deceptive Mind - A Scientific Guide to Critical Thinking
Steven Novella MD, Professor of Neurology at Yale School of Medicine
http://www.thegreatcourses.com/tgc/courses/course_detail.aspx?cid=9344
This course was absolutely outstanding. It should be a prereq for any medical provider, or perhaps every person in the world.
*
*FAMILY PRACTICE UPDATE - Physicians Audio Digest Series*
http://www.audio-digest.org/pages/h...associate_id=10021&hometopage=family-practice

Heart Failure Management Update - very interesting, very useful
GI Update - intersting and useful
Environmental and Occupational Update - very interesting
Gynecology Update - wasn't useful to my practice


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## sir.shocksalot (Mar 23, 2013)

Aw, this post is sadly ignored. I'll participate.

I think conferences are a great place to catch up on CEs and good current practices in acute care (or not) medicine. I too have been to the same state EMS conference as Summit, indeed we were in the same room, possibly drunk at the same bar, who knows. Here are some details and websites for the conferences in CO for those that are interested and for reference.

*Colorado State EMS Conference*
Usually in November each year, usually at Keystone resort 70 miles west of Denver up I-70. Only been there once and there were some decent lectures along with some lame ones definitely geared for lower level providers (probably not lame for them, I just wish I got some notice to avoid them).
http://www.emsac.org/conference
Expensive ($200+), I paid an arm and a leg for a sweet condo there... Although the city of Silverthorne is literally a mile and a half away and has a La Quinta Inn that you can get a room at and not pay a silly amount for a condo that you won't use much.
3 days long. Last day is a half day. In winter it can be rough getting up there and getting back but it was not bad at all last year.

*Rocky Mountain Trauma Conference*
Usually in June every year, again in the mountains at Breckenridge (relatively close to Keystone). Been there twice and there are usually excellent speakers and really informative lectures, has break out sessions into EMS and Hospital sections. I personally think this one tops EMSAC (although EMSAC is more fun).
http://denverhealth.org/ForProfessi...ing/TraumaandEmergencyMedicineConference.aspx
Usually pretty pricy ($200+), especially if you get a hotel room at the resort.
3 days long with an optional 4th day at the beginning that costs more (but you can audit ATLS if you wish).

*Airlife Trauma Conference*
Usually done some time in the summer. Location varies but generally not too much of a hike from Denver. Decent lectures, had some good ones last year that were OB/Peds related (which I tend to be short on come recert time). Although some lectures were terrible, they had one about triage two years ago that was well thought out but failed in execution. 
http://airlifedenver.com/newsroom/ems-conference.dot
Conference is either free or very cheap (it's been a minute so I forget).
Only 8 hours long so not a big commitment there.

*Flight for Life - EMS Critical Care and Emergency Symposium*
According to Webster's dictionary a symposium is "a formal meeting at which several specialists deliver short addresses on a topic or on related topics"... fun fact that I didn't know but just looked up. Anyway, usually in the Spring. I've never been so I can't provide any opinion to the lectures. Seems like they do their conference out in the boonies of CO.
http://www.flightforlifecolorado.org/EventsTrainings
Not sure of the price
Not sure of the time
I'm not really helpful here.

*Children's Hospital Colorado Annual EMS Conference*
As guessed this occurs annually, usually at the beginning of the year. Really good lecture topics, excellent speakers. Peds are often overlooked and misunderstood by EMS providers in general so I think this is an excellent lecture to go to. I believe this year was their second year doing it, so far they have stayed in their hospital in Aurora, CO.
http://www.childrenscolorado.org/pro/ems.aspx
Price was cheap or free, I think it was cheap though.
Usually two days long.

*Rocky Mountain Stroke Summit*
Every year at the beginning of the year for this one. I believe this last one was year two so a pretty new conference. Gives you some free CEs. Food was good, it was a 2 course meal which they brought out to the conference tables. It was so fancy that the food was actually dressed. The lecture? Awful, totally awful. I just about snoozed through the whole thing. They had a break out session for EMS, Hospital and I believe rehab. The EMS section got packed when the lecture about stroke mimics started. The only useful lecture was the stroke mimics lecture, which was well presented and pretty applicable. The rest was just... so bad. Mostly it was talking about stroke center accreditation and some rehab stuff (basically saying that it's useful and underused... duh). I would give this one a skip next year. Although the food was so good that I might endure for the CE hours and food.
http://www.thecni.org/Public/PatientPrograms/Stroke-Aneurysm/RockyMountainStrokeSummit/index.cfm
Totally free. Although they may have to pay me to go back next year.
Only a day long, lasting 7 painful hours with 1 hour of glorious eating.

These are the big EMS conference stuff I know of in CO. If you have stuff from your state throw it up here. It would be nice for people to have a reference to go to when looking for CEs or stuff to read learn about that they may not have yet.


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## sir.shocksalot (Mar 23, 2013)

I'm currently reading 12-lead ECGs for the Acute Care Provider by Bob Page.
http://www.amazon.com/12-Lead-Acute-Critical-Care-Providers/dp/013022460X

Pretty good, easy to read book. Definitely geared for those with a decent skill with basic ECG's. At the same time this book is for entry-level providers as maybe a first time reading 12-leads book. 

Pros: short. Everything is written rather simply so it's quite easy reading. A decent amount of practice problems.

Cons: It's too simple for anyone who already can read 12-lead ECGs. I don't like how he does axis but I can admit to learning something from it. In my opinion it lacks quite a bit of clinical components.

Overall it's a good reference and review book or as an initial book for learning to read 12-leads.

I have glanced through Dale Dubin's book Rapid Interpretation of EKGs which is not only cheaper but also seems like it remains easy to read while simultaneously being more in depth.
http://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Edition/dp/0912912065/ref=pd_sim_b_42


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## Summit (May 14, 2013)

*Latest*

*Essentials of Critical Care Orientation* - AACN's class for nurses new to critical care. It was good, sometimes dry, sometimes not deep enough, but there is always The ICU Book to read. There were more enough hours to cover my next entire NREMT recert except maybe the 4 hours of trauma.

*Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock: 2012​ *http://www.sccm.org/Documents/SSC-Guidelines.pdf
Dry, but good and pertinent to practice.

*The Making of Modern Medicine*
http://www.bbc.co.uk/radio4/science/medicine/
I listened to the Amazon Audible version. From Hippocrates to transpant surgery, how medicine moved from the humors to germ theory, from bloodletting to antibiotics, how science based modern medicine came to be. It was absolutely fascinating and a quick listen. It has a UKcentric viewpoint. And it inspired my next read:

*The Demon Under the Microscope*
http://www.amazon.com/The-Demon-Under-Microscope-Battlefield/dp/B006Z357P4
This is an absolutely fascinating piece on the development the first synthetic antimicrobial sulfa drugs. It is like a long medical episode of BBC's Connections with James Burke. It stretches from the WWI battlefield hospitals to Nazi Germany to the creation of the FDA as we know it. I highly recommend!


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## Carlos Danger (May 14, 2013)

I drive quite a bit, and often listen to podcasts:


Anesthesiology News
World of Anesthesiology 
Beyond Anesthesia Board Review
Prehospital Retrieval Medicine
EMCrit _(I think some of the things Dr. Weingart advocates are impractical or unrealistic, but most of his stuff is really solid. He's definitely an outside-the-box thinker)_
ICU Rounds _(this one hasn't been updated in a while, but some of the old ones are really good)_

I also spend a lot of time in the anesthesia and pharmacology texts. Here are some I think might be interesting to paramedics, especially those interested in critical care:


Manual of Emergency Airway Management _(I think this is the single most important book I ever read as a paramedic & flight nurse)_
Emergency Medicine Secrets
The ICU Book _(Excellent book; linked to above in Summit's post)_
Ganong's Review of Medical Physiology _OR_
Medical Physiology - Principles for Clinical Medicine _OR_
Textbook of Medical Physiology by Guyton & Hall
Lippincott's Pharmacology Reviews
Goodman & Gillman's Manual of Pharmacology & Therapeutics
Principles of Pharmacology by Golan
Pharmacology & Physiology in Anesthetic Practice by Stoelting _(Very applicable to paramedicine)_

It's been a few years since I took this course, but for anyone who wants a good into to critical care, with a focus on the stabilization phase, I highly recommend this course:



Fundamental Critical Care Support (FCCS) by the Society of Critical Care Medicine


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## EpiEMS (May 14, 2013)

Summit said:


> *The Demon Under the Microscope*
> http://www.amazon.com/The-Demon-Under-Microscope-Battlefield/dp/B006Z357P4
> This is an absolutely fascinating piece on the development the first synthetic antimicrobial sulfa drugs. It is like a long medical episode of BBC's Connections with James Burke. It stretches from the WWI battlefield hospitals to Nazi Germany to the creation of the FDA as we know it. I highly recommend!



I second *The Demon Under the Microscope*. Excellent read.

I suggest *Epidemics in Western Society*. It's a good listen if you're at all interested in the history of epidemic disease back to the Black Death etc., and the interactions of science, medicine, and society. Available at: https://itunes.apple.com/us/itunes-u/epidemics-in-western-society/id429468934
and thru iTunes U.


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## troymclure (May 29, 2013)

good thread.

fema has lots and lots of free online courses you can take, and most count as credit hours. most are not ems/medical, but many are first responder oriented.

http://training.fema.gov/IS/


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## Arovetli (May 29, 2013)

Chou's electrocardiography is great.

There's quite a few pearls a medic can cherry pick without getting too caught up in science, and it let me pull a few wizard moves when I was on the truck.

If you live near a medical school that opens to the public or you can get any affiliation with it...go to their library. If nothing else read uptodate and journals for free.


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## Arovetli (May 29, 2013)

Why don't we have/start some form of a journal club or article of the month on this website?


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## NomadicMedic (May 29, 2013)

While not directly related to your medical Con Ed, The Rural Domestic Preparedness Consortium is a DHS funded program providing training and resources to rural first responders. I've taken a few decent courses there. Both online and in a classroom. 

https://www.ruraltraining.org/


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## DrParasite (Aug 13, 2013)

I know I'm cheating a bit, but has anyone attended EMS training at FEMA's Center for Disaster Preparedness?

https://cdp.dhs.gov/training/discipline/#ems


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## Carlos Danger (Aug 13, 2013)

Arovetli said:


> Why don't we have/start some form of a journal club or article of the month on this website?



I think that is a great idea. I'd definitely participate.

How would it work?


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## Summit (Nov 29, 2013)

I am now have over 200 hours of NREMT recognized CE's since March 31st. Obviously, I don't list everything and much of what I list doesn't count with NREMT. Here are some of my latest continuing education of note:

*BOOKS:*

*The Selfish Gene - Richard Dawkins
*A fascinating look at genetic theory and evolution.

*The Blind Watchmaker - Richard Dawkins
*More applied genetics and evolution combined with computer based simulation analysis.

*The Mismeasure of Man - Stephen Gould
*This book was recommended by our own MIA poster Veneficus. It was a fascinating look at the abuse of statistical analysis in (mis)measuring human performance expectations, how those played into modern medicine, stereotypes, and politics.

*Notes on Nursing - Florence Nightengale*
Interesting as a period piece and a historical look at healthcare and nursing. I found little for modern application in the book.

*CONFERENCES*

*State EMS Association Conference*
Always good mix of lecture, hands on, and lab given by top state and national docs/RNs/medics. The medical directors for Denver Health paramedic division and the ED were there teaching. So was Paul Werfel of the Journeal of Emergency Medical Services. 

*Flight For Life Winter SAR Conference
*Taught by industry avalanche leaders, HEMS RN/Paramedics/MDs, and top EMS educators. There was a heavy focus on the avalanche patient.

*other ce*
*FAMILY PRACTICE UPDATE - Physicians Audio Digest Series*
http://www.audio-digest.org/pages/h...associate_id=10021&hometopage=family-practice


Neuropathic Pain - very interesting, very useful
Addiction - intersting and useful
Urology Update - very interesting
Behavioral Disorder Update - wasn't useful to my practice
Anticoagulation Update - Extremely useful
COPD Update - Extremely useful
Asthma update - very useful
Gerontology update and sleep disorder - very useful

There's a bunch of journal articles, but nothing is jumping out in my mind right now...


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## Tigger (Nov 29, 2013)

How was the winter SAR conference? Very sad I couldn't get time off to go.


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