Push Dose EMS

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

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

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.

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

Host Jeff Matcha, along with Assistant Medical Director Dr. Grawey and special guests from WAFD Cpt Steve Kaltenbrun, HEO Dan Groh, FF/PM Anthony Bilderback, FF/PM Samuel Knutson, FF/PM Andrew Crum, and FF/EMT Brandon Chastain, talk through the treatment of a difficult patient.

Host Jeff Matcha, along with Assistant Medical Director Dr. Grawey, and special guest from Children's Hospital Dr. Amy Romashko and from Milwaukee Fire Dept. Lt. Zak Hennessy

Host Jeff Matcha, along with System Medical Director Dr. Weston, Assistant Medical Director Dr. Grawey, and special guest Sean Duffey, J.D., discuss the issues surrounding Elijah McClain's death and what we can learn from it.

Host Jeff Matcha, along with System Medical Director Dr. Weston, EMS Division Director Dan Pojar, Assistant Medical Director Dr. Grawey, Joel Vallier, and special guest Dr. Jamie Jasti, discuss system updates, and honing our critical thinking skills.

Host Jeff Matcha, along with System Medical Director Dr. Weston, EMS Division Director Dan Pojar, Assistant Medical Director Dr. Grawey, and special guests Greendale FF/PM's Jim Hintz, Tim Couillard, and Connor Risberg, discuss system updates, and a recent call that required the crew to perform a surgical cricothyrotomy.

Host Jeff Matcha, along with System Medical Director Dr. Weston, Assistant Medical Director Dr. Grawey, and EMS Fellow Dr. Dahlstrom, discuss system updates, the hospital side of STEMI alerts, and the complications that come with STEMI.

Host Jeff Matcha, along with EMS Division Director Dan Pojar, System Medical Director Dr. Weston, and Assistant Medical Directors Dr. Grawey and Dr. Engel, discuss system updates and the nuances of A Fib with RVR and Diltiazem administration.

Host Jeff Matcha, along with EMS Division Director Dan Pojar, System Medical Director Dr. Weston, EMS Fellows Dr. McGlynn and Wleklinski, and special guest MCW Pediatric Emergency Medicine Fellow Dr. Madeline Field, discuss Milwaukee County system updates and the updated Trauma Management and Trauma Field Triage guidelines.

Host Jeff Matcha, along with EMS Division Director Dan Pojar, System Medical Director Dr. Weston, EMS Fellow Dr. McGlynn, and special guest toxicologist Dr. Damilola Idowu, discuss Milwaukee County system updates, and finish our series on overdose, focusing on helping patients with OUD overcome opioid dependence, and discussing Buprenorphine, a new medication in Milwaukee County.