Push Dose EMS

 

Meet Milwaukee County EMS’s newest fellows, Dr. Hanna Heintz and Dr. Cierra Rago, and learn about their backgrounds, roles, and goals for the year ahead. They discuss the value of relationships between EMS physicians and field clinicians—and share a few strong opinions about caffeine, diltiazem, and the best way to say hello.

 

Email Mike - michael.cohen@milwaukeecountygov.wi

In this episode of Push Dose EMS, Shane Hughes and Dr. Tom Grawey discuss how to recognize and manage the peri-arrest patient before they progress to cardiac arrest. The conversation challenges the traditional rapid transport mindset and focuses on early identification, treating the underlying cause, and making patient movement safer through deliberate, meaningful interventions.

 

Email Mike: michael.cohen@milwaukeecountywi.gov

This episode takes a one-year look at Milwaukee County’s prehospital whole blood program, exploring how it was built, implemented, and refined across a complex EMS system. Dr. Amy Stasik, Dr. Tom Engel, and Dan Pojar share key lessons learned, clinical impact, and opportunities for improvement - from patient recognition to system coordination.

 

Email Mike: michael.cohen@milwaukeecountywi.gov

In this episode of Push Dose EMS, Dr. Mitch Byrd and Quality Assurance Manager Matt Pinsoneault break down what QA/QI means in modern EMS. The discussion highlights Milwaukee County’s shift toward a just culture, focusing on learning, system design, and provider engagement rather than blame, and emphasizes how documentation and clinician involvement drive meaningful change and better patient outcomes.

 

Email Mike: michael.cohen@milwaukeecountywi.gov

 

Email Matt: Matthew.Pinsoneault@milwaukeecountywi.gov

 

Email MCOEM EMS Quality: qualityems@milwaukeecountywi.gov 

 

Milwaukee County CQIP Submission Form: CQIP Case Submission - OEM EMS

 

Check out the Milwaukee County EMS Continuous Quality Improvement Program: 

https://county.milwaukee.gov/files/county/emergency-management/EMS-/Standards-of-Care/Continuous-Quality-Improvement-Program-2024-070124.pdf 

Every call generates data, but what actually happens to it? This month, we take a behind-the-scenes look at how EMS documentation fuels system performance, research, and operational decisions across Milwaukee County. Learn how your charting shapes dashboards, deployment strategy, and quality improvement efforts. 

 

Email Mike: michael.cohen@milwaukeecountywi.gov

 

Email Milwaukee County Data Analytics Team: EMSdata@milwaukeecountywi.gov 

 

EMS Activities Dashboard: https://county.milwaukee.gov/EN/Office-of-Emergency-Management/EMS/Data-Analytics/EMS-Activity

 

Hospital Diversions Dashboard: https://county.milwaukee.gov/EN/Office-of-Emergency-Management/EMS/Data-Analytics/Hospital-Diversions 

 

Cardiac Arrest Dashboard: https://county.milwaukee.gov/EN/Office-of-Emergency-Management/EMS/Data-Analytics/Cardiac-Arrest 

 

Overdose Dashboard: https://county.milwaukee.gov/EN/Office-of-Emergency-Management/EMS/Data-Analytics/Overdose

 

EMS Stroke Dashboard: https://county.milwaukee.gov/EN/Office-of-Emergency-Management/EMS/Data-Analytics/EMSStrokeDashboard

 

Pediatric 911 encounters account for just over 5% of Milwaukee County EMS calls, but they require disciplined assessment and rapid recognition.  In this episode, we discuss assessment pearls, talk about common emergencies in the pediatric population, and take a look at our current pediatric EMS study, the Pedi-PART Trial.

 

Email Mike: michael.cohen@milwaukeecountywi.gov

 

Pedi-PART SOAR Card Reference:

https://county.milwaukee.gov/files/county/emergency-management/EMS-/Numbered-Notices/NN-24-04-Pedi-PART-Study-w-SOAR-Cards.pdf

 

Ramgopal S, Elmer J, Escajeda J, Martin-Gill C. Differences in Prehospital Patient Assessments for Pediatric Versus Adult Patients. J Pediatr. 2018 Aug;199:200-205.e6. doi: 10.1016/j.jpeds.2018.03.069. Epub 2018 May 11. PMID: 29759850; PMCID: PMC7073459.

This episode explores postpartum hemorrhage and what EMS providers need to know for early recognition and effective prehospital management. With insight from Dr. Rachel Harrison and Dr. Amy Stasik, we review the 4 Ts, updated guidelines, and whole blood considerations. 

 

Email Mike: michael.cohen@milwaukeecountywi.gov

 

NAEMSP OB Emergency Guidelines:

Now Available: New EMS Obstetric Emergency Guidelines - NAEMSP

 

NAEMSP Postpartum Hemorrhage Guideline:

Postpartum Hemorrhage

A challenging Oak Creek call with seizure activity, head trauma, and a late DNR highlights decision-making in the gray zone of EMS. The crew reflects on airway management and ethics to strengthen clinical judgment in the field.

 

Email Mike: michael.cohen@milwaukeecountywi.gov

 

Spaite, D. W., Hu, C., Bobrow, B. J., Chikani, V., Barnhart, B., Gaither, J. B., Denninghoff, K. R., Adelson, P. D., Keim, S. M., Viscusi, C., Mullins, T., & Sherrill, D. (2017). The effect of combined out-of-hospital hypotension and hypoxia on mortality in major traumatic brain injury. Annals of Emergency Medicine, 69(1), 62–72. https://doi.org/10.1016/j.annemergmed.2016.08.007

Saving lives takes more than rapid response in today world.  Host and OEM EMS Clinician Development Manager, Shane Hughes, welcomes Lt. Mason Barribeau of Oak Creek Fire Rescue, Kendall Wolter, City of Wauwatosa Social Worker and Dr. Amy Stasik, MCW Fellow to discuss the evolving roles, responsibilities and scenarios of Community Paramedicine in the Milwaukee County EMS system.

Host Shane Hughes, OEM EMS Clinician Development Manager, along with Dr. Mitch Byrd, Emergency Medicine Physician and MCW EMS Fellow, plus Lt. Jessica Ziems, Milwaukee Fire Department Paramedic, discuss a bradycardia case.