ITLS Ohio

Emergency Care Conference
February 27 - March 2, 2014
Crowne Plaza Columbus North
Columbus, Ohio

Registration
...
2014

EMERGENCY CARE CONFERENCE

February 27 – March 2, 2014 	 Crowne Plaza Columbus North

						 Columbus, Ohio

Earn co...
SCHEDULE AT-A-GLANCE
Pre-Conference: 										
THURSDAY, FEBRUARY 27	

			
0700-0800 – Pre-Conference Workshop Registrati...
PRE-CONFERENCE WORKSHOPS
Thursday, February 27
Advanced Stroke Life Support Workshop • 0800-1700
(General) – 8 CEs

Joe Fa...
SCHEDULE
Friday, February 28 (cont.)

Saturday, March 1 (cont.)

1645-1700

Special Considerations of Caring for the Elder...
CONFERENCE SCHEDULE
Saturday, March 1 (cont.)

Sunday, March 2 (cont.)

1400-1415

Break & Networking with Exhibitors

141...
Conference Registration Deadline is February 12, 2014!
Please print clearly. Incomplete forms cannot be processed.
Payment...
ITLS Ohio Emergency
Care Conference
Ohio’s Premier EMS Continuing
Education Conference

February 27 - March 2, 2014

www.i...
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2014 Emergency Care Conference

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2014 Emergency Care Conference

  1. 1. ITLS Ohio Emergency Care Conference February 27 - March 2, 2014 Crowne Plaza Columbus North Columbus, Ohio Registration Deadline: February 12, 2014 WHO SHOULD ATTEND? Don’t miss out on the ITLS Ohio Team Competition! Winners receive a FREE registration to the 2014 ITLS International Trauma Conference! • Pre-hospital Emergency Care Providers • Emergency and Critical Care Nurses • Other Emergency Care Providers WHY ATTEND? • Nationally-Known Speakers • Earn Continuing Education Credit • Ohio’s Premier Pre-hospital Conference www.itraumaohio.org/conference Sponsors:
  2. 2. 2014 EMERGENCY CARE CONFERENCE February 27 – March 2, 2014 Crowne Plaza Columbus North Columbus, Ohio Earn continuing education credit! Options to meet your CE requirements: n Cardiac n General n Geriatric n Instructor n Pediatric n Trauma Grant Funds: According to the Ohio Division of EMS, Ohio EMS Training Grant recipients may use funds to attend this continuing education conference. Please call the Ohio Division of EMS at (800) 233-0785 with questions. Funding for this program is supported by grant no. H33MC06699 from the Emergency Services for Children Program (section 1910, PHS Act), Health Resources and Services Administration, Maternal and Child Health Bureau & the National Highway Traffic Safety Administration. ITLS Ohio is an approved provider of EMS Continuing Education (State of Ohio 2069). Earn up to 15 hours of Continuing Education Units at the 2014 Emergency Care Conference. More credits are available at the pre-conference workshops! “I was amazed by the information and insight that was given in such a short amount of time. It’s great being able to learn from people who have a willingness to share their knowledge and experience with others.” - 2013 Attendee Hotel Information Crowne Plaza Columbus North 6500 Doubletree Ave. Columbus, OH 43229 (614) 885-1885 or (800) 996-8916 www.CrownePlaza.com/columbusnorth Group code: ITL n Room Rate: $112 (plus applicable taxes) Deadline: Group rate available until 2/14/2014 or as block permits A Special Thank You to the Conference Planning Committee: - Pat Ambrose, NRP, CCEMT-P - Rita Chambers, BBA, NRP - Joseph Farmer, Paramedic - Mary Hancock, MD, FACEP - Shelby Louden, Paramedic, EMS-I - Steve Maffin, AAS, Paramedic - Lou Ann Metz, BS, NRP - James Ross, Jr., ATS, FF, Paramedic - Nancy Ross, NRP Disclaimer ITLS Ohio makes every effort to ensure that the speakers at Chaptersponsored seminars are knowledgeable authorities in their field. Course attendees are nevertheless advised that the statements and opinions expressed by course speakers are those of the speakers, not of ITLS Ohio. The speakers’ statements and/or opinions should not be construed as ITLS Ohio policy or recommendations and ITLS Ohio disclaims any liability or responsibility for the consequences of any actions taken in reliance upon those statements or options. Products/services exhibited by companies or organizations other than ITLS Ohio are not endorsed by the Chapter. Further, ITLS Ohio disclaims any liability or responsibility for the professional or personal use of such products/services. 2 2014 ITLS Ohio Team Competition ITLS Ohio is accepting applications for teams to compete in the ITLS Ohio Competition. The winning team must be available to represent Ohio at the 2014 ITLS conference in Cleveland, Ohio held Nov. 4-7. Teams will complete three scenarios and the team with the highest accumulative score will be declared the winner. The Competition will be held on Friday, Feb. 28. Competitors must be available by 0700 for an introduction and to be sequestered. Teams will be accepted on a first-come, first-served basis. For further information contact ITLS Ohio: (614) 760-1464 or (614) 792-6506 • Toll-free (888) 464-2857 E-mail: info@itraumaohio.org • Web site: www.itraumaohio.org
  3. 3. SCHEDULE AT-A-GLANCE Pre-Conference: THURSDAY, FEBRUARY 27 0700-0800 – Pre-Conference Workshop Registration 0800-1700 – Advanced Stroke Life Support Workshop 0800-1700 – Pediatric ITLS Certification Workshop 0800-1700 – Comp. Review of Allopathic Pearls and Pitfalls FRIDAY, FEBRUARY 28 0630-0800 – Pre-Conference Workshop Registration 0800-1200 – Hands-On High Tech Home Health 0800-1200 – Instructor Workshop 0700-1200 – Team Competition Conference: FRIDAY, FEBRUARY 28 1000-1300 – Conference Registration 1300-1315 – Welcome 1315-1415 – General Session: The EMS Comedy Tour 1415-1430 – Break & Networking with Exhibitors 1430-1530 – Concurrent Breakout Sessions (1): Concussion Management, New Legislation: “More Questions Than Answers” Facebook, Sexting & the New Social Media Pediatric Airway & Common Respiratory Diseases The Bariatric Patient, The World is Growing 1530-1545 – Break & Networking with Exhibitors 1545-1645 – Repeat Concurrent Breakout Sessions (1) 1645-1700 – Break & Networking with Exhibitors 1700-1815 – General Session: Why Teens Kill SATURDAY, MARCH 1 0700-0800 – Conference Registration & Breakfast 0800-0900 – General Session: Lights, Sirens & Geritol®: Geriatrics in EMS 0900-0930 – Break & Networking with Exhibitors 0930-1030 – Concurrent Breakout Sessions (2): Life or Limb? Let’s Save Both…Pre-hospital Tourniquets Pediatric Pain Management Special Considerations of Caring for the Elderly & the Disabled During a Disaster Yeah, But Can You Defend It? 1030-1045 – Break & Networking with Exhibitors 1045-1145 – Repeat Concurrent Breakout Sessions (2) 1145-1300 – Lunch & Networking 1300-1400 – Concurrent Breakout Sessions (3): Chest Trauma by the Numbers Sepsis: A Silent Killer The Medical Aspects of Radiation Incidents Toxicology 101: Recreational Pharmacology & Suicide 1400-1415 – Break & Networking with Exhibitors 1415-1515 – Repeat Concurrent Breakout Sessions (3) 1515-1530 – Break & Networking with Exhibitors 1530-1545 – Mayer Glimcher Award & Team Competition Winner Presentation 1545-1700 – General Session: An Unsettling Settlement - A Lethal Misadventure in Emergency Medicine & How to Avoid Your Own 2000-2400 – Reception SUNDAY, MARCH 2 0700-0800 – Breakfast 0800-0915 – General Session: Bomb & Blast Injuries 0915-0930 – Break & Networking 0930-1030 – Concurrent Breakout Sessions (4): Cases in Emergency Medical Services (EMS) “How Did This Happen?” Medical Errors in the Pre-hospital Setting Spinal Immobilization Techniques & Decision Making The Sun Shall Rise & Set 1030-1045 – Break & Networking 1045-1145 – Repeat Concurrent Breakout Sessions (4) 1145-1200 – Break & Networking 1200-1315 – General Session: Mind, Body & Soul 3
  4. 4. PRE-CONFERENCE WORKSHOPS Thursday, February 27 Advanced Stroke Life Support Workshop • 0800-1700 (General) – 8 CEs Joe Farmer, Paramedic; Glen Keating, Paramedic, RRT; Bryan Russell, BS, Paramedic; Bryan Spangler, MHA, NRP, EMSI, CMTE; Dariusz Wolman, Paramedic, PhD In addition to saving lives, early treatment and rapid transport of ischemic stroke patients can significantly decrease the risk of disability. In this handson workshop we will identify the five main stroke syndromes, cover prehospital and emergency department stroke protocols and examine how to best manage airway, glucose and hypertension. Pediatric ITLS Workshop • 0800-1700 – (Pediatric) – 8 CEs Pat Ambrose, NRP, CCEMT-P; Kim Beauch, BIS, RN, NRP; Brian Bugbee, NRP, CCEMT-P, LMT; Tim Christman, BSN, RN, Paramedic; Shelby Louden, Paramedic In this workshop, you’ll learn the skills needed to effectively assess scene safety and perform critical interventions in pediatric trauma situations. Attendees will gain the knowledge to identify scene hazards and mechanisms of injury, perform rapid trauma assessment and identify compromises in airway, breathing, circulation and neurological status of an injured infant or child. Comprehensive Review of Allopathic Pearls and Pitfalls (CRAPP) Topics to Round Out Your National Registry Renewal 0800-1700 (2 Cardiac & 6 General) – 8 CEs Rita Chambers, BBA, NRP; Mary Hancock, MD, FACEP; Lou Ann Metz, BS, NRP If you’re trying to renew your National Registry and find yourself struggling to get hours in certain topic areas, we’ve got the solution for you. Geared toward the advanced practice paramedic, this course will cover EMS Operations, Cardiology, Airway/Respiratory and Medical Emergencies. By combining lectures, group discussion and hands-on experience, this entertaining course is designed to promote participation while combating boredom! Friday, February 28 Hands-On High Tech Home Health • 0800-1200 (General) – 4 CEs Rod Bair, RN, CEN, Paramedic; Steve Borghese, RN, Paramedic, CEN; Steve Maffin, AAS, Paramedic; Michael Smith, NRP, CCEMT-P, EMSI As long term health care continues to move further away from skilled facilities and into patients’ homes, EMS providers must become familiar with the equipment used by these patients. This workshop will look at the basics of various disease processes associated with long term care patients, how to manage common complaints and troubleshooting various equipment failures. Instructor Workshop • 0800-1200 – (Instructor) – 4 CEs Kelly Grayson, NREMT, CCEMT-P Join us as we explore the nuts and bolts of EMS education. You’ll learn how the most effective educational principles work equally well on animals or humans, strategies to enhance critical thinking skills in your students and how to select and train the people that bridge the gap between classroom and street—your preceptors. Team Competition • 0700-1200 – (Trauma) – 4 CEs Team members must be ITLS certified and registered for the full Emergency Care Conference by Jan. 31. Refer to page 2 for more details or download complete rules and an application online at http://tinyurl.com/ECCteamcomp. 4 Pre-Conference registration begins an hour prior to your workshop. Breakfast is provided for pre-conference workshop attendees. CONFERENCE Friday, February 28 1000-1300 Registration 1300-1315 Welcome 1315-1415 The EMS Comedy Tour (General) 1 CE Kelly Grayson, NREMT, CCEMT-P 1415-1430 Break & Networking with Exhibitors 1430-1530 Concurrent Breakout Sessions (1): Choose One Ever experience vujá dé, the feeling that nothing like this has ever happened before? Join Kelly Grayson as he riffs on chlorinating the gene pool, helpful tips on avoiding hemorrhoids, how to pay the mortgage on $8.75 an hour, what’s wrong with EMS dispatchers, how to furnish your apartment with hospital supplies and how to answer that first stupid tourist question of the day, all while staying one step ahead of the HIPAA Fairy. You’ll laugh, you’ll cry, you’ll hurl. Concussion Management, New Legislation: “More Questions Than Answers”(Trauma) 1 CE Joseph Congeni, MD This timely presentation will cover the most current issues related to brain injury and concussion. Join us as we discuss how to recognize, evaluate and manage these injuries. This session will also cover strategies to prevent traumatic brain injury and a comprehensive review of the new “Return to Play” laws regarding concussive injuries sustained by young athletes. Facebook, Sexting & the New Social Media (General) 1 CE Phil Chalmers Social media offers today’s kids an exciting portal for entertainment and peer interaction. But not all social media activities are healthy or even safe. This session will familiarize you with new social media platforms, how to protect kids from cyber bullying, sexting and other harmful content. We will explore recent cases highlighting the connection between social media and juvenile violence. Pediatric Airway & Common Respiratory Diseases (Pediatric) 1 CE Ann Dietrich, MD, FAAP, FACEP This session features a comprehensive review of the pediatric airway, its unique features and how they impact the care of a patient. In addition, we will review respiratory diseases commonly seen in pediatric patients, their presentation and how to best manage these diseases. The Bariatric Patient, The World is Growing (General) 1 CE Daniel Marcum , MHA, BSN, RN, Paramedic Fifty years ago, statistics for obesity didn’t even exist. Now, obesity is recognized as a worldwide epidemic and a serious threat to public health. This presentation will look at the comorbidity factors associated with this disease as well as bariatric procedures available to combat obesity. We will also examine the unique challenges that EMS providers face when caring for and transporting the bariatric patient. 1530-1545 Break & Networking with Exhibitors 1545-1645 Repeat Concurrent Breakout Sessions (1): Choose One from Above
  5. 5. SCHEDULE Friday, February 28 (cont.) Saturday, March 1 (cont.) 1645-1700 Special Considerations of Caring for the Elderly & the Disabled During a Disaster (Geriatric) 1 CE Thomas Tallman, DO, FACEP Break & Networking with Exhibitors 1700-1815 Why Teens Kill (General) 1.25 CEs Phil Chalmers This fast-paced lecture will cover more than 50 juvenile homicide cases, ranging from mass shooting events to gang-related murders to thrill killings. Utilizing crime scene photos and interrogation videos, this session will instruct EMS and law enforcement on the six types of teen killers, how to safely respond to them, the warning signs and ways to keep our schools and communities safe. During a disaster, how is the decision made whether to shelter in place or evacuate? Who assists in an evacuation incident involving a nursing home with many patients who are non-ambulatory? In this session we will answer these questions, discuss meeting special needs during relocation and how to provide needed supplies. Yeah, But Can You Defend It? (General) 1 CE Kelly Grayson, NREMT, CCEMT-P So you assessed your patient and provided excellent medical care - can your documentation back it up? Can it withstand a lawyer’s scrutiny and also be understood by twelve people who don’t know how to avoid jury duty? Join us in this entertaining, interactive presentation as we assess and treat a simulated patient, document the call and answer the question, “Yeah, but can you defend it?” 1030-1045 Break & Networking Exhibitors Saturday, March 1 1045-1145 Repeat Concurrent Breakout Sessions (2): Choose One from Above 1145-1300 Lunch 0700-0800 Registration & Breakfast 1300-1400 Concurrent Breakout Sessions (3): Choose One 0800-0900 (Geriatric) 1 CE Lights, Siren & Geritol®: Geriatrics in EMS Dustin Calhoun, MD Geriatrics represent the most rapidly growing sector of our society and older patients have many diseases, injuries and medical needs unique to their age group. This presentation will discuss the relative complexity of geriatric medical conditions, how that complexity affects treatment and important considerations for providing prehospital geriatric care. 0900-0930 Break & Networking with Exhibitors 0930-1030 Concurrent Breakout Sessions (2): Choose One Life or Limb? Let’s Save Both…Pre-hospital Tourniquets (Trauma) 1 CE Dustin Calhoun, MD Tourniquets are prevalent throughout medical history and are one of the oldest life-saving devices still used in modern medicine. This presentation will discuss this history, how it has affected modern perceptions of tourniquet use, evidence surrounding the efficacy and safety of tourniquets and important considerations in their application. Pediatric Pain Management (Pediatric) 1 CE Ann Mary Bacevice, MD, FAAP, FACEP Responding to and transporting an injured child in pain can be challenging, even for the most experienced emergency care provider. In this session, we will examine several cases and discuss how to manage the injured child’s pain both safely and effectively, while also covering some non-pharmacological options for pediatric pain management. Breakfast and lunch are included on Saturday Chest Trauma by the Numbers (Trauma) 1 CE Michael Oddi, MD, FACS, FACC, FCCP Many of the basic principles of immediate evaluation and management of combat injuries are applicable to trauma patients on the “Urban Battlefield.” Join us as we examine these principles, paying special attention to chest trauma and the importance of rapidly recognizing and treating these wounds. We will aslo review “the lethal six” and “the hidden six” chest injuries. Sepsis: A Silent Killer (General) 1 CE Ryan Gerecht , MD, CMTE Did you know sepsis is the 10th leading cause of death in the US? Because of sepsis’ time-sensitive nature, EMS is uniquely positioned to improve outcomes and help prevent death in patients with sepsis. This presentation will focus on how sepsis kills; the treatment strategies that save lives; and the EMS initiatives already in place around the country that are making a difference. The Medical Aspects of Radiation Incidents (General) 1 CE Thomas Tallman, DO, FACEP Whether accidental or intentional, the threat of radiation incidents is real and presents potentially challenging medical scenarios. In this session we will cover the effects of radiation exposure, immediate vs. lethal concerns during these events, management of a radiation incident and proper decontamination procedures. Toxicology 101: Recreational Pharmacology & Suicide (General) 1 CE Steve Maffin, AAS, Paramedic Street drugs continue to be a problem for patients and providers alike. In this presentation we will focus on bath salts, synthetic cannabis and heroin. We will discuss available treatment options and the challenges of treating intoxicated patients. We will also examine emerging trends of chemical suicide and the dangers EMS providers face when responding to these calls. 5
  6. 6. CONFERENCE SCHEDULE Saturday, March 1 (cont.) Sunday, March 2 (cont.) 1400-1415 Break & Networking with Exhibitors 1415-1515 Repeat Concurrent Breakout Sessions (3): Choose One from Page 5 0930-1030 1515-1530 Break & Networking with Exhibitors 1530-1545 Mayer Glimcher Award & Team Competition Winner Presentation 1545-1700 An Unsettling Settlement - A Lethal Misadventure in Emergency Medicine & How to Avoid Your Own (General) 1.25 CEs Scott Bolleter, BS, Paramedic This presentation was developed to highlight the reality of medical misadventure in the emergent care arena. While serious complications in emergency medicine are relatively rare, understanding their implications to our clinical practice is crucial. This lecture takes a step-by-step walk through personal relationships, professional camaraderie, media interactions, patient care, as well as critical care interventions and the final responsibility that rests with each procedure. While this talk begins with a cold white marble headstone, it holds the promise of illuminating our efforts and improving patient care. 2000-2400 Reception Concurrent Breakout Sessions (4): Choose One Cases in Emergency Medical Services (EMS) (Pediatric) 1 CE Sharon Mace, MD, FAAP, FACEP Pediatric patients with airway, respiratory, cardiac, neurologic, trauma and infectious diseases will be presented using a case-based format where the patient’s initial information will be given. In this session we will go over how to diagnose the patient in order to initiate therapy and discuss what the management of the various emergencies should be. Key factors, physical examination and ancillary findings will also be discussed. “How Did This Happen?” - Medical Errors in the Pre-hospital Setting (General) 1 CE Ryan Gerecht, MD, CMTE “Human fallibility is like gravity, weather & terrain, just another foreseeable hazard.” –J.T. Reason. No matter how experienced we are or how much we train, errors in providing emergency medical care will occur. Why? Because, as the saying goes…we are “only human.” Using a case-based approach, this presentation will focus on identifying the common human factors that make errors inevitable—and how best to minimize these errors and mitigate the consequences of “being human.” Spinal Immobilization Techniques & Decision Making (Trauma) 1 CE James Augustine, MD, FACEP Immobilization on a long backboard has long been the primary method for transporting patients. But the benefit of long backboards is largely a matter of training and not science. Worse, this “one size fits all” method can cause patient pain, agitation and respiratory compromise. In this session, you will gain insight on the use of new immobilization techniques that match each patient’s needs. Sunday, March 2 0700-0800 Breakfast & Networking Opportunity 0800-0915 Bomb & Blast Injuries (Trauma) 1.25 CEs James Augustine, MD, FACEP The Sun Shall Rise & Set (Geriatric/Pediatric) 1 CE Scott Bolleter, BS, Paramedic As some of our most vulnerable patients, pediatric and geriatric populations often require medical care that is distinct from other age groups. In this session, we will examine actual cases in order to gain a better understanding of the comparative needs of these two types of patients and how best to approach, assess and treat their unique injury and illness patterns. In the age of terrorism, the question is not IF emergency care providers will again encounter a bombing incident, but when—and more importantly how to be prepared. This keynote presentation will provide a comprehensive update on best practices for managing blast events, anticipating the unique patterns of injury associated with them, “upside-down” triage and the potential impact of these events on nearby hospitals. 1030-1045 Break & Networking Opportunity 1045-1145 Repeat Concurrent Breakout Sessions (4): Choose One from Above 1145-1200 Break & Networking Opportunity 0915-0930 1200-1315 Mind, Body & Soul (General) 1.25 CEs Scott Bolleter, BS, Paramedic 1315 Conference Adjourns & CE Certificate Pick-up Break & Networking Opportunity Emergency medicine can take a toll on your mind, dampen your spirit and even cause you to question why you pursued your profession in the first place. Join us as we discuss lessons our profession teaches and why we forget those lessons, refocus our energies on why we initially turned to patient care and—most importantly—reclaim that “something lost.” 6 Breakfast is included on Sunday
  7. 7. Conference Registration Deadline is February 12, 2014! Please print clearly. Incomplete forms cannot be processed. Payment must be received in order to process. First Name Register online: www.itraumaohio.org Fax to: (614) 792-6508 Mail to: 3510 Snouffer Road, Suite 100, Columbus, OH 43235 Questions? Call (888) 464-2857 or (614) 760-1464 or e-mail info@itraumaohio.org Last Name Credentials (Paramedic, EMT, RN, etc.) Company, Station, Facility, etc. Title (Fire Chief, EMS Manager, etc.) Preferred Mailing Address City Preferred Phone State Zip  Please check here for vegetarian option E-mail Address of Registrant (confirmation will be sent via e-mail) Pre-Conference Workshop Selections: (Please check your daily selection) Thursday, February 27, 2014 Friday, February 28, 2014 ““ Your selection Price Hands-On High Tech Home Health 0800-1200 $100  (4)  (2) Instructor Workshop 0800-1200 $100  (5)  (3) Team Competition * 0700-1200 *  (6) Price Advanced Stroke Life Support Workshop 0800-1700 $75  (1) Pediatric ITLS Certification Workshop 0800-1700 $125 Comp. Review of Allopathic Pearls and Pitfalls 0800-1700 $75 Workshop 2/27/2014 Workshop 2/28/2014 ““ Your selection Time Time *Team members must be registered for the competition and the full conference by Jan. 31! Conference Breakout Selections: (Please check your selection for each time slot for each day attending)* *If selections are full, we will place you in an open breakout session. You will automatically be registered for the general sessions on the day(s) you are attending. Friday, February 28, 2014 ““ Your Preferred Time Breakout Sessions (1) Sunday, March 2, 2014 ““ Your Preferred Time Breakout Sessions (4) 0930 - 1030 1045 - 1145 Concussion Management, New Legislation  (8)  (12) Cases in Emergency Medical Services (EMS)  (36)  (40) Facebook, Sexting & the New Social Media  (9)  (13)  (37)  (41) Pediatric Airway & Common Resp. Diseases  (10)  (14) “How Did This Happen?” - Medical Errors in the Pre-hospital Setting Spinal Immobilization Techniques & Decision Making  (38)  (42) The Bariatric Patient, The World is Growing  (11)  (15) The Sun Shall Rise & Set  (39)  (43) Please choose one session for each time frame 1430 - 1530 1545 - 1645 Saturday, March 1, 2014 ““ Your Preferred Time Breakout Sessions (2) Please choose one session for each time frame 0930-1030 1045-1145 Life or Limb? Let’s Save Both  (18)  (22) Pediatric Pain Management  (19)  (23) Special Considerations of Caring for the Elderly & the Disabled During a Disaster  (20)  (24) Yeah, But Can You Defend It?  (21)  (25) 1300-1400 1415-1515  (26)  (30) Sepsis: A Silent Killer  (27)  (31) The Medical Aspects of Radiation Incidents  (28)  (32) Toxicology 101: Recreational Pharmacology & Suicide  (29)  (33) Breakout Sessions (3) Chest Trauma by the Numbers PAYMENT INFORMATION: Payments must be received at the time of registration! If you are submitting a Purchase Order (PO), a copy of the PO must be provided in order to complete the registration process. Steps to pay by PO: 1.) Fax a copy of the PO to (614) 792-6508 along with the registration form for each person 2.) Include your name, phone number and e-mail address on the fax cover sheet. Your registration will not be official until payment is received! Please choose:  VISA  MC  AMEX  Check (Payable to Ohio ACEP) Registration Fees (Check all that apply) For instance, if you would like to attend a 2/27 pre-conference workshop and a 2/28 pre-conference workshop please check both options. Please Check Registration Fee Option(s) Days $ Pre-Conference Workshop on 2/27 (Thurs.) fill in price ($75 or $125)  $100  $80 Pre-Conference Workshop/Team Comp. on 2/28 (Fri.)  (Excludes Team Comp.) Conference Registration for 2/28 (Fri. ONLY) (begins at 1300) Conference Registration for 3/1 (Sat. ONLY) $155  Full Conference Registration – (All 3 Days) (Afternoon 2/28, All day 3/1, Morning 3/2) $250  TOTAL REGISTRATION FEE (TOTAL ALL OPTIONS) Cancellation Policy: Refunds will be made up to February 12, 2014 less a $50 administrative fee. Cancellations after February 12, 2014 will be non-refundable. No exceptions. Conference Extras: An outline of most presentations will be available on the ITLS Ohio Web site www.itraumaohio.org one week prior to the conference. Name on Card Credit Card Number Please choose one session for each time frame Exp. Date Don’t forget to make your hotel reservation before 2/14/2014! Security Code Please note: By filling out this application, you extend permission to Ohio ACEP/ ITLS Ohio to publish any photo taken at the conference that may contain you. 7
  8. 8. ITLS Ohio Emergency Care Conference Ohio’s Premier EMS Continuing Education Conference February 27 - March 2, 2014 www.itraumaohio.org Register by February 12! ITLS Ohio 3510 Snouffer Rd Suite 100 Columbus, Ohio 43235 www.itraumaohio.org

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