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What EMS PAs can do for your EMS system

5 PA highlights: The practical application for physician assistants

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Physician assistants (PAs) have been contributing to many subspecialties of healthcare since their inception in the late 1960s. The first PAs even came from returning military medics who attended a transition program to provide certification in civilian life. EMS has also evolved extensively and, in 2010, was officially recognized as a subspecialty of emergency medicine. So many people believe it is only logical that PAs can contribute to the field of EMS and the advancement of the subspecialty in many ways.

As with most things in life, the transition from the theoretical to the practical is not an easy road to travel. Taking the theoretical benefits of EMS PAs and integrating them into the current EMS can be difficult, secondary to reasons including:

  • State regulations
  • Financial burden
  • Scope of practice variances
  • Training
  • Credentialing
  • Political turbulence

In 2020, the National Association of EMS Physicians created the EMS PA/NP Task Force, highlighting a significant step forward for PAs (alongside nurse practitioners) who are wanting to, or currently practicing in EMS.

Taking that theory, and placing it into practice are many excellent PAs across the country, here are five individual PAs out of many, including myself, who have forged a path for themselves working in EMS systems as a certified PA.

David Wright, MS, PA-C, NRP

PA highlight: David Wright, MS, PA-C, NRP
  • Education: Master’s Degree in Physician Assistant Studies (Missouri State University).
  • Current EMS functions: EMS Provider education (initial and continuing), System QA/QI, field response, EMS Fellowship education, NAEMSP PA/NP Task Force chair, EMS research.
  • EMS history: Began as an EMT, then spent time as a firefighter, dispatcher, paramedic, flight paramedic, and EMS PA.
  • Current organization: Washington University in St Louis, St Louis, Mo.
  • Certifications: Physician Assistant, Paramedic, Firefighter I & II, EMS Educator, NIMS, Hazmat, TEMS.
  • Future aspirations: Continue to advance PA involvement in EMS systems, and establish a national certification available for advanced training for EMS PAs.
  • Fun fact: He has played guitar since he was 4 years old and loves everything to do with the automotive world.

David Wright, MS, PA-C, NRP

You can find me practicing medicine in the Gateway to the West, St Louis, Mo. I have been involved in fire and EMS since I was 13 years old as a fire explorer. Prior to attending PA school, I worked the streets of St Louis as a paramedic on Medic 13. I then went on to be a flight paramedic for Air Evac Lifeteam. After PA school, I found myself working with both the Washington University EMS and Pediatric Emergency Medicine Divisions. When not working in the ED, I can be found teaching continuing education courses for local EMS agencies and initial education for area EMS programs as well as the Washington University EMS fellowship. I perform QI/QA on pediatric calls for one of the largest hospital-based EMS districts in Missouri and provide real-time consults for paramedics who request it.

I completed a 12-month clinical internship with Washington University EMS, where I mirrored the requirements for the EMS physician fellowship. This included field responsibilities, medical didactic training, hands-on skills labs and research projects. I continue to attend updated EMS education courses, fire-based courses, and pursue my academic doctoral degree in health professional education. I currently hold multiple certifications in firefighting, paramedicine, tactical EMS, technical rescue, and high-level National Incident Management Systems (NIMS) Courses. I am currently the chair of the NAEMSP PA/NP Task Force.

Travis Baker, PA-C, EMT-P

PA highlight: Travis Baker, PA-C, EMT-P

  • Education: Masters of Clinical Health Services (University of Washington).
  • Current EMS functions: Field response (both low acuity and critical care), coordinate and develop ET3 program, community health paramedic support, individualized patient care protocols, education in the EMS academy, field buprenorphine program.
  • EMS history: Began as an EMT, then EMT-I, paramedic, firefighter, physician assistant, clinical coordination and currently paramedic practitioner.
  • Current organization: Office of the Chief Medical Officer, Austin-Travis County EMS System, Austin, Texas.
  • Certifications: Physician Assistant, Paramedic, ACLS, PALS, ATLS, CPR, NIMS 100, 200, 700, 800.
  • Future aspirations: 24-hour APP/PA field response coverage for ATC/EMS, develop ET3 and continue ATC OMD prehospital medical practice.
  • Fun fact: Travis absolutely loves his professional life, but also enjoys traveling, scuba diving, hiking and anything on the lakes during the Texas summers. He is also the proudest member of the Fightin’ Texas Aggie class of 2007, “whoop!”.
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Travis Baker, PA-C, EMT-P

Travis began his EMS career while he was still in high school. During his senior year, he obtained his EMT certification. He continued on his EMS journey, obtaining his EMT-I85 and paramedic certification within the next year. Once a paramedic, he obtained his firefighter certification and worked as a firefighter/paramedic until he attended graduate school to obtain his physician assistant license.

Since then, he has continued as an EMS PA, working as a clinical coordinator between Baylor College of medicine and Montgomery County Hospital District. He currently works as a paramedic practitioner (EMS PA) for Austin-Travis County EMS. In his current role, Travis is an integral part of his community. He provides field response to low and high-acuity patients, as well as real-time bedside education to local paramedics.

He supports the community health paramedics and holds an X-wavier for the field buprenorphine program. His current project is the development and coordination of the ET3 program that will further advance EMS care in the heart of Texas. He strives to develop a path for advanced paramedics to attend PA school to allow them to return as paramedic practitioners for ATC EMS, through the development of a PA-EMS program.

Kevin Burns, MBA, EMT-P, PA-C

PA highlight: Kevin Burns, MBA, EMT-P, PA-C
  • Education: Master’s Degree in Physician Assistant Studies; Master’s Degree in Business Administration.
  • Current EMS functions: EMS coordinator between hospital and EMS, continuous quality improvement, EMS data management, controlled substances oversight, field response, EMS fellowship education.
  • EMS history: Began as a volunteer EMT, then to Paramedic. Graduated PA school and continued in EMS as a PA.
  • Current organization: Yale New Haven Hospital, New Haven, Connecticut.
  • Certifications: Physician Assistant, PA Certificate of Added Qualifications - Emergency Medicine (CAQ-EM), Paramedic.
  • Future aspirations: To increase the awareness of EMS PAs and increase the knowledge base of EM PAs/NPs in the specialty of EMS.
  • Fun fact: Kevin was originally born in Ireland and after moving to the U.S. and attending PA school, he was able to give a lecture to the first-ever class of PA students in Irish history.
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Kevin Burns, MBA, EMT-P, PA-C

Kevin currently wears many hats at Yale New Haven Hospital. Years ago, he began his career in EMS with a volunteer fire department EMT before moving to Rochester, New York, as a paramedic. Years later, he obtained his PA license and his Certificate of Added Qualifications in Emergency Medicine and now works tirelessly in the New Haven EMS system.

As an EMS coordinator, he is the liaison between the hospital and EMS, and as an administrator, he performs CQI and EMS data management. He is part of the leadership team for the Center for EMS, overseeing field operations for 27 agencies and providing education for the largest EMS education program in Connecticut. He provides field response, through the physician response team, SHARP. He loves to advance the field of EMS and PA medicine, and as a native Irishman, he was honored to be able to travel to Dublin and give a lecture to the first-ever class of PA students in Irish history.

Clint Kalen, PA-C

PA highlight: Clint Kalen, PA-C
  • Education: Physician assistant.
  • Current EMS functions: QA/QI, education, protocol development, paramedic credentialing, EMS fellowship orientation, field response.
  • EMS history: Began as a volunteer EMT, then AEMT, prior to graduating PA school and continuing in EMS as a PA. Currently the co-director for EM PA Post-graduate Training Program.
  • Current organization: University of New Mexico EMS Consortium; Center for Rural and Tribal EMS.
  • Future aspirations: Working to improve EMS as an adjunct to public health and health systems development in rural areas. Investigating how to maximize resuscitation performance in high-acuity low volume services. Defining the differences in rural out-of-hospital care that usually aren’t well described in the urban academic settings where most research is generated.
  • Fun fact: He can crack two eggs with one hand.

Clint Kalen, PA-C

You can find Clint in the heart of New Mexico at the University of New Mexico (UNM) EMS Consortium. He works with his nurse practitioner counterpart to provide EMS services to multiple regions throughout New Mexico.

He began his EMS career as a volunteer EMT, before advancing his education to AEMT, then going to graduate school to become a PA.

Clint performs a myriad of various roles at UNM, including BLS and ALS refreshers in Grand Canyon and Zion National Parks, protocol development, paramedic credentialing, amongst others.

He provides field support to approximately 40 different agencies, including Santo Domingo Fire and EMS, Grand Canyon National Park, and Eagle Nest Fire and EMS. He believes it is important for providers to be known to their EMS crews, to be available for questions and to provide mentorship to those who need or request it.

Clint continues to work diligently to maximize the efficiency of EMS systems, including resuscitation in rural EMS systems, and highlighting the differences in urban versus rural EMS care.

Kate Kramer, PA-C

PA highlight: Kate Kramer, PA-C

  • Education: Master’s Degree (University of New England).
  • Current EMS functions: Assistant medical director, liaison to fixed facilities, chair of Frequent User Committee, program manager for Advanced Practice Officer Program (APO), ACFD’s form of MIHC. Participates in education, both new and continuing for all levels, QA/QI, manages several data registries, represents ACFD on several regional initiatives, co-fellowship director for disaster and EMS PA fellowship through the George Washington University.
  • EMS history: Began as EMT-I then transitioned to PA, worked for many years in ERs in the Washington DC Area and then became assistant medical director for the local fire department in 2014.
  • Current organization: Arlington County Fire Department.
  • Certifications: Physician Assistant.
  • Future aspirations: Increase awareness and integration of PAs into the field of EMS as a team member on the OMD team. Inspire other PAs to think outside the standard clinical practice settings and follow their passions.
  • Fun fact: While in PA school, she completed a clinical rotation in Ghana working with a local clinic and after graduation, served as the preceptor to continue the opportunity for subsequent groups of PA students to return to Ghana.
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Kate Kramer, PA-C

Kate began her EMS career as an EMT-I in Maine, where she ran primary 911 responses in a combination volunteer system for several small coastal towns.

After attending graduate school, she graduated as a certified physician assistant and is currently working as the assistant medical director for Arlington County Fire Department. It is there that she primarily interacts with fixed facilities and frequent users of the EMS system and collaborates to ensure needs are met while maintaining the integrity of the emergency response system.

She is a valuable member of the OMD team and provides in person and online medical control in conjunction with the OMD. She is the program manager for the Advanced Practice Officer Program, ACFD’s form of MIHC, and maintains networks of resources to help match the needs of the citizens. She assists in many of the daily OMD responsibilities: QA/QI, protocol writing and development, CME and recruit training. She collaborates on special projects as they evolve: the safe station program, co-responder program, setting up testing stations for COVID-19 and establishing vaccination sites, as well as developing a mobile lab platform.

She aspires to advance the PA profession by increasing awareness of current and future potential of PAs in the EMS systems and recently graduated her first PA from the Disaster and Operations PA Fellowship. She sees the benefit in educational opportunities regarding the specialty of EMS, not only for PAs who are interested in entering the field, but also those who work closely with their EMS colleagues to garner awareness and mutual respect.

Each one of these five individuals highlight just a small portion of what EMS PAs are already doing in various EMS systems across the United States. PAs are valuable components to advancing the EMS profession and work diligently as part of the National Association of EMS Physician’s EMS PA and NP Task Force. Each of these PAs strive toward the seamless integration of PAs into the EMS system and ultimately hope to improve the care provided to patients in the out-of-hospital environment.

David Wright, MS, PA-C, NREMT-P, is a physician assistant at Washington University in St. Louis working in the Division of Pediatric Emergency Medicine. He is a former paramedic who has worked in a busy 911 response service, hospital emergency rooms, and as a flight paramedic. He also currently holds certifications as a Nationally Registered Paramedic, TEMS, EMS Instructor, Clinical Simulation Instructor, Firefighter I & II and Hazmat Operations. His passions include EMS education, clinical simulation and furthering the EMS profession.