Operational Medicine Consultants, in Partnership with Virginia Commonwealth University, is pleased to offer CME/CEU credits in the field of operational medicine.
OMC’s current VCU offering: Advanced Deployed Emergency Practitioner Training (ADEPT) Online
More information & registration:
Currently available ADEPT online streaming video training modules include:
Module 1: Massive Hemorrhage: Understanding tactical combat / emergency casualty care and controlling massive hemorrhage. An introduction to the essentials of TCCC and TECC and the fundamentals of controlling massive hemorrhage in the prehospital environment. This course is intended to be a prerequisite for all other courses of the ADEPT online training series for those who have not worked in the tactical medicine environment or who have not had previous formal training in TCCC or TECC.
Module 2: Airway: Management of adult and pediatric emergency airway. This module explores options in the prehospital management of adult and pediatric management with airway devices including nasopharyngeal airways and extraglottic airways including videos of the new supraglottic iGels being used. We discuss rapid sequence intubation in the field with usage of Ketamine and sugammadex. Front of neck access and surgical airway, cricothyroidotomy is discussed and the importance of the limitations and alternatives with pediatric patients is covered in this module.
Module 3: Respiration: Management of Traumatic Chest Injuries in the Prehospital Environment. This module looks at updated information regarding management of chest injuries in the field, including recent findings using occlusive chest seals. We discuss reasons for choosing anterior axillary line decompression versus midclavicular line decompression sites for decompression of tension pneumothorax. Explore management of recurrent tension pneumothorax and alternatives to needle decompression. Look at modern point of care ultrasound use for chest injuries in the field. Additionally, this module inspects options for management of flail chest and blast lung in the prehospital environment.
Module 4: Circulation: Shock, Fluids and Field Whole Blood Transfusions /Remote Damage Control Resuscitation (RDCR). In addition to reviewing the appropriate usage of crystalloids and synthetic and natural colloids in the prehospital environment, this module goes into the details of the return of field whole blood transfusions (remote damage control resuscitation) and the utility of such a lifesaving intervention for a trauma casualty in impending shock in the austere environment.
Module 5: Head Injury: Management of adult and pediatric traumatic brain injury (TBI) in the prehospital environment. This module guides the provider through identification of mild TBI; the most commonly missed TBI. Updated for 2018 with CPG, guidelines for the use of hypertonic saline, ketamine, fentanyl, midazolam and ventilator settings for the prehospital environment for the treatment of moderate and severe TBI. This module is new for all listeners. It also looks at new recommendations for the use of plasma and blood products in traumatic brain injury casualties. Additionally, this module covers Arizona EPIC pediatric TBI guidelines so the user is exposed to pediatric management parameters.
Module 6: Hypocalcemia and Hypothermia: The focus of this operational medicine module is hypocalcemia, hypothermia and the coagulopathy of trauma. The central purpose of discussing these topics is to help understand the importance of doing balanced resuscitation, hemostatic resuscitation and prevention of acidosis, hypothermia and hypocalcemia and how management of these issues affects casualty outcomes.
Hypocalcemia has been identified as a common metabolic derangement in critically ill casualties. Despite major advances in trauma care the deadly triad of hypothermia, acidosis and coagulopathy associated with uncontrolled exsanguinating hemorrhage remains the leading cause of early death in trauma casualties. In this module we will focus on how the lethal triad directly and indirectly affects hypocalcemia. After discussing the physiology and mitigation of these derangements we will look at prehospital treatment options for hypocalcemia and hypothermia.
Module 7: Altitude medicine and hyponatremia description: The altitude medicine module discusses acute mountain sickness and the development of High-altitude cerebral edema and high-altitude pulmonary edema. This modules reviews behavior as well as medical interventions that can be used to avoid and treat these well-known outcomes of high-altitude exposure. We will look at which medications need to be started 24 hours prior to exposure to elevation and discuss red flags that indicate when a provider needs to take immediate action.
The hyponatremia portion of this module discusses the key findings of hyponatremia in the field and how to differentiate this diagnosis from other differential diagnoses such as altitude illness or heat exhaustion. This module will discuss the importance of rapid appropriate treatment of acute hyponatremia and the importance of communicating the diagnosis to providers in the care chain.
Module 8: Point of Care Ultrasound: The vast use of point of care ultrasound (POCUS) in the modern day environment has been likened to it being called the modern day stethoscope. In the prehospital environment the demand for safe, timely diagnostic capability and technological innovation has led to the advent of point of care ultrasound (POCUS). POCUS gives invaluable clinical information with accuracy that leads to better decision making and improvements in patient safety. The need for early and fast intervention has incorporated POCUS into the prehospital environment to help mitigate otherwise impending death. In this module we will cover how point of care ultrasound augments management of massive hemorrhage, airway management, chest Injuries, circulation and head injuries. We will look into the specifics of IV access and POCUS with resuscitative endovascular balloon aorta occlusion (REBOA). We will also look cover pitfalls of common ultrasound procedures such as the extended Focused assessment with sonography for Trauma, Rapid ultrasound for Shock and hypotension or (RUSH) exam and the Fluid Status Exam.
Module 9: Adult and Pediatric Field Pain Management: This module focuses on providing a multi-modal pain management approach, using novel methods and maximizing traditional methods to manage the severely injured casualty in the austere environment. Including the proper and safe usage of ketamine and fentanyl by the medical provider.
Module 10: Tropical medicine: Due to the tug of war between natural phenomena and man-made conditions of the urban expansion into undeveloped land, tropical illness is becoming a common challenge for the medical provider. In this tropical medicine module, we will look at Malaria and discuss identification and the different options for prophylaxis and treatment. We will look at the neglected tropical diseases (NTDs) Dengue, Schistosomiasis, and Leishmaniasis. We will focus on key indications for aggressive treatment of Dengue. The participant will be able to formulate a plan for the prevention of Leishmaniasis when traveling to endemic areas. You will be able to identify signs and symptoms of Schistosomiasis and prepare a questionnaire for travelers returning from areas at risk of Schistosomiasis to identify those in need of further screening. The listener will also be able to specify the appropriate prophylaxis and empiric treatment for bacterial diarrhea for southeast Asia vs other developing regions.
Module 11: Prolonged Field Care: An introduction to the essentials of prolonged field care and wound care. This module will review the essential care capabilities that should be emphasized during protracted care. Will summarize the reasons for tissue debridement and irrigation in the PFC setting. We will review what steps can be taken in the austere setting for a wound suspicious of a fungal infection and identify an easy and quick neural exam to test for one of the early sign’s of compartment syndrome.