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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.

Let’s get smart about emergency responder hydration by understanding the need for prehydration and rehydration with water
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
Firefighters should assume carcinogens are present during suppression and overhaul activities and take appropriate actions during and after the incident
Evaluating NFPA 1584 fireground rehab procedures as they related to prevention of heat-related illnesses
Rehab patients are friends and co-workers, which requires additional awareness for rehab medical personnel and preplanning to administer over-the-counter medications
Point-of-care devices can supplement but not replace history-taking and physical examination during fireground rehab patient assessment
Vital sign abnormalities during rehab may indicate a medical problem requiring the firefighter to follow-up with their primary care physician