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Medical directors share their most discussed questions, concerns

Here’s a summary of the types of questions the Eagles asked one another from the last year


Jim Augustine presented a summary of the types of discussions the Eagles have been having over the last year.

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DALLAS — Officially known as the EMS State of the Sciences Conference, the Gathering of Eagles happens each year during the third weekend in February. But for the other 51 weeks of the year, the Eagles, who are the medical directors for the 40 or so largest EMS systems in the United States, use a systematic email list server to ask questions, share ideas and consolidate the types of discussions that will likely dominate the next Gathering.

Jim Augustine, MD, FACEP, the Eagles Librarian and Associate Medical Director for Atlanta Fire Rescue Department, presented a summary of the types of discussions the Eagles have been having over the last year.

Memorable quotes

Augustine moved quickly through his synopsis, here are some quotes on themes that stuck out:

“Develop better all-hazards response, because we never know what the next threat is going to be.”

“We have an industry that has guaranteed business for many more years into the future.”

“Regardless of what patch you have on your shoulder, everyone needs to look at what we can be doing to improve things for the community.”

“I encourage all of you to form your own eagles, form a network for sharing information and best practices.”

Key takeaways from Eagles electronic correspondence

The 80 discussions the Eagles have had over the past year centered on the following themes, here are my takeaways from each:

1. How is staff working?

Employee safety is continuing to gain prominence in the EMS industry. This comes from an increase in our understanding of the dangers of lack of sleep and fatigue as well as recent high profile attacks on EMS providers in the field.

2. Products and medications for patients

The Eagles adopt new products and medications with the same types of questions and concerns that every EMS service faces. This year, the conversations centered on interventions like supraglottic airways and intraosseous vascular access systems as well as medications like ketamine and epinephrine.

3. Transport, non-transport and hospital interface

An increasing number of hospitals are becoming certified destinations for specific conditions such as stoke, sepsis and cardiac arrest. But not all certified centers are created equal. Less traditional destinations are also receiving more attention due to the increasing diversification of what services EMS agencies provide.

4. Increase in technology

The use of capnography during cardiac arrest, the expectation that dispatchers provide CPR instructions prior to EMS arrival and even drones were topics of discussion for the Eagles over 2016. The technology topics are only expected to increase every year.

5. Major incident management

Given the growing number of high profile active shooter incidents, the need for cohesive and comprehensive communication across coordinating agencies has never been more apparent. This concern includes both the actual event and the subsequent responses, vigils and outreach that occur after the fact.

6. Impact of Wingspread VI

Wingspread is a conference of fire service leaders that meet once every 10 years. They met in June 2016 and recently released the Wingspread VI report. Of significance to EMS agencies was the decision to change the name of the report to “Statements of National Significance to the United States Fire and Emergency Services.”

Learn more about Eagles’ top topics

Read more about these topics on EMS1.

Read the full 2016 Wingspread VI Report

Catherine R. Counts, PHD, MHA, is a health services researcher with Seattle Medic One in the Division of Emergency Medicine at the University of Washington School of Medicine. She received both her PhD and MHA from Tulane University School of Public Health and Tropical Medicine.

Dr. Counts has research interests in domestic healthcare policy, quality, patient safety, organizational theory and culture, and pre-hospital emergency medicine. She is a member of the National Association of EMS Physicians and AcademyHealth. In her free time she trains Bruno, her USAR canine.

Connect with her on Twitter, Facebook, or her website, or reach out via email at