Free Classes, CP-C Beta Discount, Staying Safe
Free Classes at TacMed University eLearning Summit

Other Features this issue: "Don't Dehydrate"

and the IBSC makes a special offer!

The event is free and the classes include:

• Chest Wounds – June 17 at 2 pm EST – Featuring a TraumaFX simulator

• Rope Rescue – June 17 at 3:30 pm EST – taught by Ray Storm (Beyond the Edge) on location at Smith Rock in Oregon

• Just One Time – June 18 at 2 pm EST – taught by Vernon Gresham (Public Servant Solutions) on what can happen when we miss a single aspect of patient care only once  (More on this class below.)

• K9 M.A.R.C.H. – June 18 at 3:30 pm EST – taught by Jo-Anne Brenner (K9 Medic®) on converting your human skills to working K9s

To register for TMS University:

If already registered, sign up for courses here:

Once signed in, navigate to Live Sessions in the left-hand menu.

More on the "Just One Time" presentation:

How often do we as responders provide “mostly” great patient care? What about the simple items that seem to fall through the cracks? Learn how to see every patient from a "high reliability" organizational viewpoint, whether your agency is a large urban provider, a mid-sized tactical unit, or as small rural provider making 200 calls per year. We will look at points of patient care that if missed even once for a brief period, can have a devastating effect on the patient's life.

Riding the Wave

Now that most of the business interests in the State of Texas are open at a higher capacity Covid-19 cases have increased, with the highest number of new cases for a single day occurring last week.

Prehydration Is The Plan

We have had a reprieve from the heat with lower temperatures and a lower heat index this week. Of course, the high temperatures will return soon enough. With those temps come increased dehydration.  Consider that 0.08% blood alcohol creates a 17% slowing in reaction time while 4% dehydration creates a 23% slowing in reaction time. We lose 2.5% body water through normal processes such as sweating and respiration every day. Not drinking enough water, for any reason, can quickly cause problems for us and our patients. Many of us have been depriving ourselves for years to “get the job done” including the need to make seat time in a rig or aircraft more convenient because you don’t have to run to the restroom. (Hard to do mid-call, even harder to do mid-flight.) And we have all heard the story of the dedicated surgeon that had nursing start an IV and pass a foley in him during a particularly long surgery. May sound outlandish but it allowed the guy to maintain mental and physical acuity. Might be a little easier if we just drank a little more water throughout the day.

Thirst can kick in with as little as 1% dehydration, so pay attention. By the time you are experiencing more thirst, decreased production of saliva, difficulty swallowing, it is time to do something about it. When we hit the 4% level we are two quarts (roughly 1900 ml) of water below par. At that point we have no business driving, flying or treating anything or anyone!

At 8% (4L or 4.25 qt.) loss we are in renal failure. We experience a substantial loss of plasma volume, blood viscosity is elevated, we have excess BUN and a falling blood pressure.

So, how do we prevent this? Remember that 2.5% (5 cups, 1200 ml) we lose every day? That figure is based on an average sized, at rest human. With work and a heat index that will be back in triple digits soon, that will not maintain any of us. The National Academy of Medicine suggest that we let our thirst be the guide but that an average adult male should consume about 3.7L (15 cups) of water a day, and a female should drink about 2.7L (11 cups) per day. This includes all water, included in food, other drinks, etc. (Probably shouldn’t be all Diet Coke…huh.)

Best practice is to remember to grab a bottle of water often. Drink it slowly. To maximize the absorption, drink a bottle (500 ml) of water during about an hour. If I grab a soft drink or a coffee, I grab a water also. Check and balance: look at your urine. How dark is it and are you putting out at least 30 ml/hr. Where have I heard that before? Many people carry around a little treasure trove of medical values, cheat notes etc., clipped behind their ID. If you are not sure, add a visual urine chart. Remember that some sports electrolyte replacement drinks are osmotic diuretics. Powerade® is near human values, but if you drink Gatorade®, especially in a dehydrated state, drink two bottles of water with each bottle of product. 

Stay Safe Out There,
CP-C Beta Testers Wanted

If you need to recertify your CP-C or have been considering taking the exam, this is a great opportunity to save over 60% off the normal price.

The International Board of Specialty Certification (IBSC) is proud to announce that the Certified Community Paramedic (CP-C) specialty certification exam has been updated and is ready to be beta tested. The beta test is an integral step in the continued development of this validated exam by ensuring items are properly calibrated to the current scope and knowledge of community paramedicine.

The CP-C exam is a legally defensible and psychometrically sound examination that tests the science and application of the domain of knowledge for community paramedicine & mobile integrated healthcare. The certification created an internationally recognized single standard encompassing all aspects for a unique and defined body of knowledge specific to this evolving paramedic role.

If you need to recertify your CP-C or have been considering taking the exam, this is a great opportunity to save over 60% off the normal price. The exam can be taken in one of two delivery options: First, you may register to take the exam at any Prometric testing center; or two, the IBSC is debuting remote proctoring technology from Prometric known as ProProctor™. ProProcotor uses the same delivery technology used within the Prometric global test center network, with the exam delivered to your personal computer potentially anywhere with adequate internet connectivity.

CP-C Beta Test 2020

  • Beta testing will be available for exam dates from June 12th through July 15th.
  • Exam fee is $150 (regularly $385)
  • Choose between a Prometric testing center or on your own computer using ProProctor
  • Limited to the first 100 candidates to register for the exam
  • Register using a special link to the IBSC Store at CP-C Beta 2020 or contact the IBSC office at +1.770.978.4400 or via email at

Related News

Governor Abbott, DSHS Distribute Additional Round Of Antiviral Drug Remdesivir Across Texas

June 9, 2020 | Austin, Texas | Press Release

Governor Greg Abbott today announced that the Texas Department of State Health Services (DSHS) is distributing additional cases of the antiviral drug remdesivir to 85 hospitals across 34 counties in Texas. These cases have been provided to DSHS through the U.S. Department of Health and Human Services. DSHS will allocate 125 total cases of the liquid-form of remdesivir across the state, enough to treat approximately 500 patients. This is the fourth round of distribution total from the federal government, and will bring the total number of cases distributed by DSHS to Texas hospitals to 609.

"By allocating additional cases of remdesivir to communities across the state, Texas is prioritizing the health and recovery of our fellow Texans," said Governor Abbott. "It is imperative that we continue to equip Texas medical providers with the supplies they need to respond to COVID-19, and I am grateful to our partners at the U.S. Department of Health and Human Services for their continued assistance in providing cases of remedisivir."

Remdesivir has shown promise in early trials in speeding up the recovery time among hospitalized COVID-19 patients. The medication is being distributed by DSHS according to COVID-19 hospitalizations data to better target areas of need, which also includes state owned hospitals. Using a five-day average of hospitalization data from May 25th through May 29th, DSHS used county weighting of the number of COVID positive patients in hospitals to determine the number of Remdesivir cases per county. The number of Remdesivir cases each hospital will receive is allocated based on the hospitalized COVID positive patients in their hospital and county allocation.

DSHS confirmed that military and VA hospitals will receive remdesivir directly and are therefore excluded from this distribution methodology. Additionally, because use of a limited supply is prioritized towards severely ill patients in facilities with ICUs, hospitals without ICU beds were excluded from the distribution. The liquid-form of remdesivir cannot be used for children, which also excludes children's hospitals from this distribution.

Medical staff at each hospital will determine how the drug will be used, though it must be prescribed in accordance with the Food and Drug Administration’s Emergency Use Authorization, allowing for the treatment of suspected or confirmed COVID-19 in adults and children hospitalized with severe disease, such as those in intensive care. Preliminary results from a clinical trial showed the average recovery time among patients who received remdesivir was 11 days versus 15 days with a placebo. The supply is part of a donation from drug maker Gilead.

Governor Abbott, TDEM Announce Expanded Testing In Underserved Communities Disproportionately Impacted By COVID-19

June 8, 2020 | Austin, Texas | Press Release

Governor Greg Abbott today announced that the Texas Division of Emergency Management (TDEM) is coordinating with local officials, public health officials, and emergency management offices in cities across the state to identify and rapidly expand COVID-19 testing in underserved and minority communities that have been disproportionately impacted by the virus. This mission is part of TDEM's ongoing partnership with the Texas Military Department (TMD), the Texas Emergency Medical Task Force (EMTF), and the Texas Department of State Health Services (DSHS) to mitigate the spread of COVID-19 and increase testing where needed.

TDEM is already working with local officials in the cities of Dallas, San Antonio, Houston, El Paso, Abilene, the Rio Grande Valley, the Coastal Bend, Laredo, and Midland-Odessa to identify and establish walk-up and drive-thru testing sites that will meet the needs of each community, and is in the process of working with other cities to bring more sites online in the coming days. TDEM is also working with local leaders to expand walk-up and drive-thru testing in urban areas where large-scale protests have taken place.

"As the State of Texas continues to mitigate the spread of COVID-19, we are committed to ensuring every Texan has access to COVID-19 testing no matter where they live," said Governor Abbott. "We must address the disproportionate impact of COVID-19 on underserved and minority communities and ensure that anyone who needs a test can have one. As many Texans continue to gather for protests, the state is also taking steps to address potential surges in COVID-19 cases. We are ensuring that Texans can continue to safely exercise their First Amendment Rights while putting protocols in place to identify and mitigate any spread of COVID-19."

As these sites continue to come online across the state, Texans can visit to find the test collection location nearest them.

TMD currently has 1,535 National Guardsmen supporting the state's mission to expand testing across the Lone Star State. To date these teams have conducted 116,394 specimen collections, and have fielded over 195,000 phone calls for test collection appointments with an average wait time of 55 seconds.

Public Servant Solutions

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