Allen Wolfe

Severe burn injuries create major resuscitation challenges, especially when they result from unusual or self-inflicted events. This case series presents two uncommon burn cases. The first involves a self-inflicted burn in an intersex patient adding other considerations to care. The second involves a patient who suffered a seizure while using a hot iron. These cases often present unusual burn patterns, delayed discoveries, unreliable histories, and potential psychological instability.

Measuring overall clinical quality in medical transport isn’t easy. One of the biggest challenges is that we often don’t have complete long-term outcome data on our patients. Because of that, programs have looked for other ways to understand how well care is delivered. One of those tools is the GAMUT (Ground Air Medical Quality Transport) or NEMSQA (National EMS Quality Alliance) metric, which looks at key clinical actions we can measure in real time. The Institute for Healthcare Improvement (IHI) introduced the idea of a Whole System Quality Measure, which looks at performance across an entire system rather than one single metric. That concept has been adapted for medical transport to focus on overall clinical performance. This lecture introduces the idea of an overall clinical quality score (Q score) for transport programs. The Q score brings together multiple high-value clinical measures into one view, helping clinical leaders track trends, spot opportunities for improvement, and make sure we’re consistently delivering the care that matters most to our patients.

In trauma care, the scene often tells the story long before monitors and imaging are available. This lecture focuses on recognizing key mechanism-of-injury clues and translating them into meaningful clinical decisions in the prehospital and transport environment. Using real-world cases, we’ll connect energy transfer, patient presentation, and hidden injury patterns to guide assessment priorities and early interventions. Emphasis will be placed on avoiding common cognitive traps, recognizing when “normal” vital signs are misleading, and using mechanism to anticipate what could go wrong next. Attendees will leave with practical tools to sharpen scene awareness and improve trauma decision-making under pressure.