MCW Emergency Medicine Division of EMS Medicine
Our Division members have in-depth knowledge and expertise in all aspects of EMS/prehospital and disaster medicine.
Mission
Exceptional EMS care. Innovative education. Intellectual curiosity. Transformative discovery. Equity committed.
Vision
To be a global leader in EMS Medicine.
EMS Division Overview
The MCW Division of EMS Medicine primary and adjunct/affiliated faculty.
The MCW Division of EMS Medicine has a long history of educating allied health and medical professionals from across the world.
The Division of EMS Medicine’s research commitment is founded on the value of scientific research for the development of EMS services to improve patient outcomes. The ʼһ and its EMS partners in Wisconsin have a 50-year history of research that has changed the field of prehospital care throughout the world.
The division conducts local and national research in partnership with regional and federal agencies, as well as commercial organizations. Public partnerships have included grants from several agencies in the Department of Health and Human Services, such as the National Institutes of Health (NIH) and the Substance Abuse and Mental Health Services Administration (SAMSHA), as well as the Department of Defense (DoD), and the Department of Justice (DOJ). The division and its partner EMS agencies have been recognized nationally for contributions to the EMS literature. All research is reviewed by the ʼһ's Institutional Review Board (IRB) to ensure the highest ethical standards. The EMS agencies of Milwaukee County have designated the ʼһ IRB for Federal-Wide Assurance of Protection of Human Subjects. This has allowed many EMS providers to receive research ethics training.
With MCW oversight, the EMS systems we work with have participated in groundbreaking research projects that have improved clinical care, including clinical trials in resuscitation research. Members of the Division also hold leadership positions in regional and national research networks.
The Resuscitation Research Center (RRC) in the Department of Emergency Medicine collaborates with researchers, clinicians, and EMS agencies on clinical trials in the areas of emergency resuscitation and neurological emergency research. The RRC has dedicated infrastructure to coordinate clinical trial activities around the clock.
Research projects/networks that the Division of EMS Medicine has participated in include:
- Resuscitation Outcomes Consortium (ROC)
- Strategies to Innovate Emergency Care Clinical Trials Network (SIREN)
- Pediatric Emergency Care Applied Research Network (PECARN)
- Charlotte Houston and Milwaukee Prehospital EMS Research Node Center (CHaMP)
- Neurological Emergencies Treatment Trials Network (NETT)
The Division of EMS Medicine is dedicated to helping our campus, community, and nation prepare for providing medical care during large-scale incidents. Division members apply their expertise in mass casualty and disaster medicine in multiple roles to reduce the effects of such an event.
Children's Wisconsin Physician Liaison | Froedtert Hospital Physician Liaison
The division provides physician leadership for the emergency preparedness activities at the Children’s Wisconsin and Froedtert Hospital. Responsibilities include the development of emergency plans and policies, exercise planning, and integration with other agency and organizational planning.
Milwaukee Regional Medical Center
Division faculty also participate in the campus-wide Emergency Preparedness Committee. This Committee is responsible for coordinating disaster preparedness and response efforts between campus organizations, and police, fire, and EMS.
Milwaukee County Office of Emergency Management
The MCW Division of EMS Medicine serves as the physician medical directors during any large-scale events or emergencies within the county. Division members assist in planning and policy to ensure the safety of all citizens and visitors to Milwaukee County. Division faculty serve in the county emergency operations center during actual county emergencies.
Southeast Wisconsin Healthcare Emergency Readiness Coalition, Inc. (SE HERC Region 7)
SE HERC Region 7 is a multi-disciplinary coalition of agencies and organizations representing the nine counties in the southeast corner of Wisconsin. The region contains a population of approximately 2.1 million people. A MCW EMS faculty member serves as the Chief Medical Officer for the coalition. Thus, the Division applies its EMS and disaster medicine expertise to assist in the coalition’s plan development, exercises, and educational programs.
Wisconsin-1 Disaster Medical Assistance Team (WI-1 DMAT)
The MCW Division of EMS Medicine was a co-founder of the Wisconsin-1 Disaster Medical Assistance Team.
WI-1 DMAT is an organized unit that is deployed forward to deliver care in the field during a disaster/mass casualty incident or other large special event. WI-1 DMAT is part of the . NDMS is a federally-coordinated system that provides medical capabilities in the event of a large-scale emergency. NDMS is administered through the United States Department of Health and Human Services.
The Division supports the WI-1 DMAT by providing education and training for DMAT personnel. The team’s co-founder and first commanding officer was a division faculty member.
National Disaster Life Support (NDLS)
National Disaster Life Support is a nationally-recognized curriculum intended to provide allied health professionals with knowledge and skills to care for patients during disasters and mass casualty events. The NDLS suite of courses have been designed by national experts and is endorsed by the American Medical Association and medical professional associations.
The MCW Department of Emergency Medicine is an authorized NDLS Regional Training Center. Our training center offers certified NDLS faculty drawn from experts at ʼһ and numerous public and private agencies in southeastern Wisconsin.
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To inquire about holding a course at your institution, please email JMLiu@mcw.edu or call (414) 955-1110.
Advanced Hazmat Life Support Courses
Advanced Hazmat Life Support is a curriculum that teaches out-of-hospital and hospital clinicians how to manage patients from chemical and hazardous materials incidents.
The Division of EMS Medicine is a training center with several AHLS-certified faculty.
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To inquire about holding a course at your institution, please email twengel@mcw.edu or call (414) 955-1110.
Milwaukee County EMS is at the forefront of providing care beyond the 9-1-1 call with its mobile integrated health (MIH) programs. This aspect of EMS care is ever growing, as more and more departments are recognizing and addressing important community needs.
The ʼһ EMS Division is proud to provide EMS physician support for these community health programs. Such MIH programs include a field-based buprenorphine program that was first in the state, and one of the first fire-based programs in the nation. The EMS providers within Milwaukee County can utilize their tremendous skill to focus on less emergent, but equally as important, health care issues. Major efforts are concentrated on opioid use disorder, mental health, social determinants of health, chronic medical conditions, and preventative care. The division is excited to continue to support and expand oversight of mobile integrated health operations countywide.
EMS Operational Medical Oversight
For nearly 50 years, the MCW Department of Emergency Medicine has partnered with Milwaukee County Emergency Medical Services to deliver scientifically-based, advanced emergency medical care to the citizens and visitors of Milwaukee County. Currently, approximately 500 paramedics assess over 30,000 advanced life support patients and over 70,000 basic life support patients every year.
Members of the MCW Division of EMS Medicine are appointed as medical directors for the system. As EMS fellowship-trained, board-certified emergency physicians, our division oversees the practice of Milwaukee County EMS paramedics, and ensures the highest level of care. Working in collaboration with the system's staff and field providers, our division members are involved in all aspects of medical policy, quality improvement, communications, research, and education. The medical directors sit on various committees focusing on improving emergency medical care. All division physicians are dedicated to fostering the ʼһ's tradition of medical excellence and to maintaining Milwaukee County's reputation as one of the top EMS systems in the world.
Members of the division also serve in advisory roles to the Wisconsin Department of Health Services EMS office and state EMS Board. The ʼһ has had a long relationship with Wisconsin EMS. MCW and Emergency Medicine were a part of the development of the current structure of the EMS Advisory Board, and division faculty have often served in the position of State EMS Medical Director (the first of whom was the first MCW Emergency Medicine Chair, Dr. Joseph Darin). The division is proud to remain partners with the state of Wisconsin in improving EMS care for all.
Flight For Life (FFL) is a helicopter air ambulance transport system serving southeastern Wisconsin. FFL has been operating since 1984, completing over 30,000 safe patient transports.
FFL is accredited by the Commission for the Accreditation of Medical Transportation Systems, a rigorous voluntary process demonstrating a commitment to quality and safety. FFL was honored to receive the Program of the Year 2011 Vision Zero Safety Award, a prestigious industry-sponsored award to a program that has demonstrated an overall commitment to safety. Additionally, individual pilots have been awarded the National EMS Pilots Association Pilot of the Year award.
FFL currently operates three state-of-the-art helicopters that exceed FAA safety recommendations.
Division faculty serve as medical director for Flight for Life. Flight crews also receive additional online medical oversight from Department of Emergency Medicine faculty.
The Division of EMS Medicine provides pediatric-specific training and expertise. Faculty provide insight to the planning, implementation, and evaluation of out-of-hospital pediatric care. This pediatric specialization is available to Milwaukee County EMS, City of Kenosha Fire Department, City of Milwaukee Fire Department, and Flight For Life. The division also actively engages with the Wisconsin Emergency Medical Services for Children program.
Our division also works to advance evidence-based medical practice in specialized areas of out-of-hospital medicine. These include dive rescue, hazardous materials, heavy urban rescue, tactical, and disaster/mass casualty medicine. We provide support both for patients and emergency responders.
Dive Rescue
Dive rescue is the field of search and rescue operations on and below the surface of waterways. MCW EMS physicians support the Milwaukee Fire Department’s Dive Rescue Team by assisting in development of medical policies and protocols, and by offering an on-scene physician capability when needed.
Hazardous Materials
Hazardous materials are chemical, biological, or radiological substances that have the potential to contaminate and cause harm to people. The field of hazardous materials management seeks to contain, identify, remove, and neutralize such dangerous substances. Medical management of hazardous materials victims is provided by members of the Division of EMS Medicine, with input from board-certified medical toxicologists in our department. In addition, division physicians provide medical support to protect hazardous materials responders.
Heavy Urban Rescue
Heavy urban rescue involves the rescue of persons trapped in building collapses, confined spaces, or high angle locations. Our section provides medical support to the Milwaukee Fire Department’s Heavy Urban Rescue Team (HURT). Physician support includes review of medical procedures/protocols, as well as on-scene medical care for victims and team members.
Tactical Medicine
Tactical medicine is the field of out-of-hospital medical support for law enforcement and military operations. This unique area of EMS blends emergency medicine, primary care, occupational/preventive medicine, and public health. The division provides the Medical Director for the Tactical EMS Program of the Milwaukee Fire and Police Departments. Several faculty also serve as tactical physicians, providing field advice and medical support for a number of local and federal law enforcement agencies.
EMS Resource Materials
Since the 1970’s, there have been suggestions to develop a formal curriculum and protocol for performing field extremity amputations. Several events since this time, including the devastating 2010 earthquake in Haiti, have demonstrated the potential need for such a program. However, a curriculum including a didactic lecture and skills demonstration for this high risk, low frequency procedure has never been established. These instructional videos serve as a bridge between the prehospital environment and definitive surgical treatment. They include a brief historical background, indications and equipment necessary for performing the procedure and finally a surgical demonstration of a lower extremity amputation performed on a cadaver.
This video serves as a basic introduction for performing a field amputation. It includes a brief historical background on field amputations, and includes indications and necessary equipment.
This video reviews the basic steps for performing a field upper extremity amputation. (Age-restricted; may be inappropriate for some users.)
This video reviews the basic steps for performing a field lower extremity amputation. (Age-restricted; may be inappropriate for some users.)
For more information about these resources, contact colella@mcw.edu or (414) 955-1110.
At the request of the Wisconsin Hospital Emergency Preparedness Program, the MCW Division of EMS Medicine designed a set of clinical management guidelines for use by hospital providers when a large-scale event (such as an infectious epidemic) results in a scarcity of resources. These guidelines provide an evidence-based framework to prioritize the use of limited critical care resources.
- Hospital Resource and Clinical Management – Table Top Exercise Presentation (PDF)
- Hospital Resource and Clinical Management Guidelines (PDF)
- Table Top Exercise – Facilitator Guide (PDF)
- Table Top Exercise – Participant Guide and Handouts (PDF)
- Table Top Exercise – Patients Models (PDF)
- Table Top Exercise – MCCRAS Key (PDF)
- Multi-principled Critical Care Resource Allocation Score (MCCRAS) Calculator (XLS)
- Multi-principled Critical Care Resource Allocation Score (MCCRAS) Scorecard (PDF)
For more information about these guidelines, contact JMLiu@mcw.edu or (414) 955-1110.
The Division of EMS Medicine, in partnership with the Advancing a Healthier Wisconsin program, the State of Wisconsin EMS Office, and the Wisconsin EMS Association, developed a set of educational and operational materials for dispatch centers to implement telecommunicator-assisted cardiopulmonary resuscitation (T-CPR).
- Increasing Cardiac Arrest Survival Through Dispatcher Assisted Bystander CPR Presentation (PDF)
- Increasing Cardiac Arrest Survival Training Presentation (PPTX; 316 MB)
- CPR Instructions Presentation (PPTX; 332 MB)
- Telecommunicator CPR Program In-House Training Program & Quality Improvement Recommendations Presentation (PDF)
- Telecommunicator CPR Program Continuous Coaching Phrases (PDF)
- Telecommunicator CPR Program Dispatch Protocols | In-House (PDF)
- Telecommunicator CPR Program Dispatch Protocols | Transfers (PDF)
- Telecommunicator CPR Program QI Form | In-House (PDF)
- Telecommunicator CPR Program QI Form | Transfers (PDF)
- Telecommunicator CPR Program Training Scenarios (PDF)
- Telecommunicator CPR Program Frequently Asked Questions (PDF)
For more information about these materials, contact JMLiu@mcw.edu or (414) 955-1110.