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EMS Physicians, Mercy Health System EMS

EMS Docs Responding

The EMS Docs Responding column shares EMS physician-led research, describes the implementation of prehospital protocols and discusses how EMS field personnel, as well as their medical directors, can improve patient care. The EMS Docs Responding column is a collaborative effort of the Mercy Health System Corporation (Wis.) EMS physicians, led by EMS medical director Jay MacNeal, MD.

James MacNeal, MPH, DO, NRP began his career in emergency medicine as a paramedic. He holds American Board of Emergency Medicine/Emergency Medical Services certification and completed an EMS fellowship at Yale University. He is assisted by associate medical directors Todd Daniello, Ken Hanson, Mitch Li, Sean Marquis, John Pakiela, Matt Smetana and Chris Wistrom.

Establish a low threshold for intervention and treat burns as soon as possible to prevent further injury
Treat aggressively with high-flow oxygen, rapid sequence intubation and Cyanokit in a patient with evidence of airway burns and CO2 poisoning
Training teachers in trauma casualty care to increase survival during active shooting incidents at schools
Firefighters should assume carcinogens are present during suppression and overhaul activities and take appropriate actions during and after the incident
As a responder’s core temperature continues to rise, morbidity progresses along the heat illness spectrum to heat exhaustion and heatstroke
Rehab patients are friends and co-workers, which requires additional awareness for rehab medical personnel and preplanning to administer over-the-counter medications
Let’s get smart about emergency responder hydration by understanding the need for prehydration and rehydration with water
Point-of-care devices can supplement but not replace history-taking and physical examination during fireground rehab patient assessment
A specially trained group of emergency physicians responds with EMS providers to assist with care, build relationships and improve patient outcomes
Vital sign abnormalities during rehab may indicate a medical problem requiring the firefighter to follow-up with their primary care physician