Push Dose EMS

Milwaukee County EMS reviews its 2025 STEMI data and opportunities to improve recognition, activation, and scene times. Dr. Rago and Andrew Olson discuss difficult ECGs, STEMI mimics, early notification, and the importance of treating the patient—not just the tracing. Milwaukee County OEM EMS Activity Dashboard: https://county.milwaukee.gov/EN/Office-of-Emergency-Management/EMS/Data-Analytics/EMS-Activity Email Mike: [email protected]

  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 - [email protected]

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: [email protected]

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: [email protected]

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: [email protected]   Email Matt: [email protected]   Email MCOEM EMS Quality: [email protected]    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: [email protected]   Email Milwaukee County Data Analytics Team: [email protected]    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: [email protected]   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: [email protected]   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: [email protected]   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.

Co-Hosts Shane Hughes, OEM EMS Clinician Development Manager and Dr. Tom Grawey, Deputy Chief Medical Director of the Milwaukee County EMS System, welcome Medical College EM Fellows Dr. Amy Stasik and Dr. Mitch Byrd to discuss a unique case.  Also, medical director messaging from EMS Division Director Dan Pojar (while Dr. Weston is on vacation) and a purpose statement of the new CDUs (clinician development units).

Host and Clinician Development Manager, Shane Hughes welcomes Drs. Amy Stasik and Mitch Byrd as Medical College of Wisconsin, EMS Fellows to OEM and the Milwaukee County EMS System.  Plus, Chief Medical Director, Dr. Ben Weston highlights the importance of fellowship program and collaboration with the system.

Host and Clinician Development Manager, Shane Hughes, along with Deputy Chief Medical Director Dr. Tom Grawey, and Dr. Max Nanes from Aurora Advocate discuss Hospice and Palliative Care.

Host and Clinician Development Manager, Shane Hughes, along with Deputy Chief Medical Director Dr. Tom Grawey, and Clinical Neuro Psychologist Dr. Mike McCrea from Froedert and the Medical College of Wisconsin, discuss 'H' bombs and pearls of mastering Traumatic Brain Injury care.

Host and Clinical Development Manager, Shane Hughes, along with Deputy Chief Medical Directors Dr. Tom Grawey and Dr. Tom Engel discuss the status, successes and lessons learned of the Milwaukee County Prehospital Blood Program.

Host and Clinical Development Manager, Shane Hughes, along with Deputy Chief Medical Director Dr. Grawey - and special guests Jared Roorda and Michelle Mooring, talk about April being National Donate Life Month and information for EMS about organ donation.

Host and Clinical Development Manager, Shane Hughes, along with Deputy Chief Medical Director Dr. Grawey and special guest OEM Educator Mike Cohen discuss the pursuit of excellence, personal wellbeing and the initial thoughts on lifelong learning and the development of a growth mindset.

Host Shane Hughes, along with Deputy Chief Medical Director Dr. Grawey and special guest Flight For Life, Flight Paramedic Ryan Gauthier discuss the components of the gray area, decision making, assessment and reassessment of challenging EMS cases.

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.

This episode focus' on the pneumonic SPIKES and delivering bad news to parents or family of our pediatric patients. 

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. Engel, and special guest Mike Bindokas, discuss some of the latest guideline updates.

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 pediatric emergency fellow Dr. Jamie Holland, discuss system updates, and using our critical thinking skills in pediatric patients.

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 Fellow Dr. Dahlstrom, and PA Joel Vallier, discuss how to choose the right airway adjunct for a patient.

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, EMS Fellow Dr. Dahlstrom, PA Joel Vallier, and special guests Dr. Manish Shah and Dr. Lorin Browne, discuss pediatric EMS research, PECARN, CHaMPS, and the legacy of Dr. E. Brooke Lerner.   More info about EMS-C and Dr. Brooke Lerner https://medicine.buffalo.edu/news_and_events/news/2022/11/lerner-naemsp-research-fund-16102.html   https://emscimprovement.center/news/striving-for-the-best-possible-systems-a-conversation-with-e-brooke-lerner/   Dr. E. Brooke Lerner Research Fund https://naemsp.org/career-development/funding-opportunities/e-brooke-lerner-research-fund/

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, Assistant Medical Director Dr. Grawey, and EMS Fellow Dr. Dahlstrom, discuss system updates and the ins and outs of STEMI alerts.

Host Jeff Matcha, along with EMS Division Director Dan Pojar, System Medical Director Dr. Weston, Data and Analytics Manager Michelle Anderson and QA Manager Linda Mattrisch, bring you a special edition of Push Dose EMS on the updates coming with NEMSIS 3.5 and what this means for providers, services, and the public.

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 System Medical Director Dr. Weston, EMS Fellows Dr. McGlynn and Wleklinski, and special guest MCW Pediatric Emergency Medicine Fellow Dr. Swathi Prasad, discuss the ins-and-outs of stroke assessment and recognition.

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, and EMS Fellows Dr. McGlynn and Wleklinski, discuss Milwaukee County system updates, the upcoming Standard Care Guidelines update, and discuss Magnesium, a new pre-hospital medication in Milwaukee County.

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.

Host Jeff Matcha, along with EMS Division Director Dan Pojar, System Medical Director Dr. Weston, EMS Fellows Drs. McGlynn and Wleklinski, and special guest MCW psychiatrist Dr. Julie Owen, discuss Milwaukee County system updates, and continue our series on overdose, focusing on communicating with patients experiencing addiction.

Host Jeff Matcha, along with EMS Division Director Dan Pojar, System Medical Director Dr. Weston, and EMS Fellows Drs. McGlynn and Wleklinski discuss Milwaukee County system updates, and start our series discussing overdose.

Host Jeff Matcha, along with Dr. Weston, Dr. Engel, and EMS Fellow Dr. Wleklinski, talk about handling dialysis patients.

Host Jeff Matcha, along with Dr. Weston, EMS Fellow Dr. Wleklinski, and special guests Battalion Chief Bob Manke and Kristen Herreid, navigate the topic of provider mental health.

Host Jeff Matcha, along with Dr. Weston, EMS Fellows Drs. McGlynn and Wleklinski, and special guest Dr. Renee Foutz discuss Milwaukee County system updates, and discuss the difficult task of death notifications.

Host Jeff Matcha, along with Dr. Weston, and EMS Fellows Drs. McGlynn and Wleklinski discuss Milwaukee County system updates, and finish up the episode series on pediatrics.

Host Jeff Matcha, along with Dr. Weston, and new EMS Fellows Drs. McGlynn and Wleklinski discuss Milwaukee County system updates, and the recent outbreak of Monkeypox.

Host Jeff Matcha, along with Dr's Weston, Drazich and Arendovich discuss Milwaukee County system updates, and pediatric trauma assessment.

Host Jeff Matcha, along with Division Director Dan Pojar, Dr's Weston, Drazich and Arendovich discuss Milwaukee County system updates, and answer (fabricated) questions about the MKE CTY 2022 Standard of Care Updates.

Host Jeff Matcha, along with Division Director Dan Pojar, Dr's Weston, Drazich and Arendovich discuss Milwaukee County system updates, discuss ROSC and achieving optimal perfusion post-ROSC.

Host Jeff Matcha, along with Division Director Dan Pojar, Dr's Weston, Drazich and Arendovich discuss Milwaukee County system updates and the third of three episodes on OB/GYN.

Host Jeff Matcha, along with Division Director Dan Pojar, Dr's Weston, Drazich and Arendovich discuss Milwaukee County system updates and the second of three episodes on OB/GYN.

Host Jeff Matcha, along with Division Director Dan Pojar, Dr's Weston, Engel, Drazich and Arendovich discuss Milwaukee County system updates and the first of three episodes on OB/GYN.