Each participant will be given selected actual case review presentations for the ALS provider ( I can’t make this stuff up, I am not that creative and fact far outweighs fiction). These are all actual CNS trauma cases to test even the most experienced provider. Each participant will be given the patient’s presentation from the EMS perspective and then the case will be followed through the hospital course on to discharge. When available, participants will be given actual EKG tracings, scene photos, radiographic films, lab values, radio reports, and assessments to determine the case progression. Compare your treatment plan to what actually transpired. See if your patient would have survived. This will be an interactive course with plenty of audience participation