Administration and Leadership, Patient Care, Training

2011 EMS 10 Winners Cast a Vision for the Future

Issue 4 and Volume 37.

Welcome to the fourth annual EMS 10: Innovators in EMS program. This article is a preview of a special digital supplement sponsored by Physio-Control Inc. and JEMS. The supplement, which is available at, highlights some of the most innovative and visionary people working in EMS today. This year’s roster of distinguished winners, selected by a panel of professional EMS who are their colleagues and peers, embodies the mission of this annual innovators program—to make a real difference in the lives of providers, patients and communities. Winners were nominated by an individual or organization that recognized their visionary thinking, creativity, dedication, hard work and out-of-the-box thinking.

Each winner profiled has selflessly dedicated themselves, sometimes for years, to not only supporting the needs of the EMS community, but to also devise cutting-edge programs and services that are significantly influencing people’s lives. In many cases, their forward-thinking actions and sacrificial efforts have helped save untold lives and millions of dollars.

As the world grows more complex and the demands on EMS grow ever more critical, these honorees have developed programs and services that will help alleviate some of the burdens, informing and educating the EMS community on how to get the work done. As you read these profiles, consider the programs, research and services each individual has created and try to find ways to incorporate some of these ideas into your own EMS system.

This group of men and women thinks about the EMS profession in unique and creative ways, addressing some of the bigger challenges facing their colleagues and patients. They decided to be part of the solution. There are those who have embraced the digital age, and then there are those like Tom Bouthillet, EMT-P, who have taken the Internet and social media to a new and robust level in EMS, creating an online space that has moved education and the sharing of ideas well into the 21st century.

You’ll read about Bouthillet’s passion for emergency cardiovascular care and sharing best practices that have been implemented in Hilton Head Island, S.C. You’ll see how he has embraced the EMS 2.0 movement by fully using and enhancing the online tools available to stimulate ongoing debates and discussion. You’ll read how he uses his blog, EMS 12-Lead, podcasts and a Web TV series to document his passion for patient care. He uses these forums as a platform to advocate for the shortening of treatment intervals and for implementing improvement measures to enhance survival. And, he underscores the need for more evidence-based care of ST-elevation myocardial infarction and cardiac arrest patients.

Bouthillet has connected people from all over the world to discuss the needs and concerns facing EMS and what might be done to develop and deliver solutions that make a real difference in people’s lives.

Colorado may be best known as a skier’s paradise with majestic beauty and rugged geography, but Stephanie Haley-Andrews, RN, EMT-P, knows it’s also a place where children need special care, and EMS providers need the education and resources to provide that care.

The children’s hospital where Haley-Andrews works, which is ranked fifth in the nation in size, serves a large area. She says pediatric calls make up only 10% of emergency call volume, and much of the state is rural and volunteer-based. As a result, most EMS agencies have limited exposure to sick children, face significant geographical challenges and have limited resources to train EMS personnel to treat these children.

You’ll learn how Haley-Andrews overcame these limitations and challenges to provide the access her Colorado EMS colleagues needed in educating them about issues, such as child abuse and pediatric strokes, which in turn, helped them to better serve the younger population.

Rob Lawrence, MCMI, is all about motorcycles. Specifically, he’s focused on keeping as many motorcycle riders as safe—and alive—as possible.

To this end, he has created one of the most innovative and popular motorcycle safety alert programs in the country. This program, modeled after a program in the United Kingdom and based in Virginia, is embracing EMS’ role in care at motorcycle crash scenes and helping save lives.

You’ll read about his Motorcycle Rider Alert Card program, the first of its kind in the nation. You’ll find out how he developed the program, how it works, how it has already saved countless lives and why Lawrence will continue his passionate advocacy for this program until every motorcyclist in Virginia is a card-carrying member. And you’ll see how the program now receives national sponsorship and recognition from some of the biggest EMS organizations around the country, all in an effort to protect those who like to travel on two or three wheels.

As a former street paramedic, Mary Meyers, MHA, EMT-P, understands the difficulties EMS providers face every day, particularly those who work in an unpredictable environment. As a member of the newly formed Center for EMS Quality, Integration and Research, her statistical analyses and data research provide the kind of evidence-based, empirical knowledge needed to make real strides in improving sepsis alert, pain management, infection control and quality assurance.

You’ll read how this self-proclaimed “math phobe” took herself on a journey from paramedic to researcher and PhD pursuer to create and bolster the kinds of EMS research that can translate into meaningful improvement in patient care.

Paul Paris, MD, FACEP, LLD (Hon.), has been pursuing better safety for EMS providers and the patients they care for since 2003. He has spent much of his professional life advocating for this safety, emphasizing the need for more EMS education, research and program development in patient and provider safety. You’ll learn how his efforts in western Pennsylvania have resulted in a unique partnership between EMS and the nationally recognized Jewish Healthcare Foundation (JHF) to address the issues of patient and provider safety in prehospital care.

This partnership has created a popular JHF-funded program called the EMS Safety Fellowship/Quality Champion, which helps translate quality improvement and patient safety for EMS services throughout western Pennsylvania and beyond.

There are those paramedics who don’t care much for standing around and waiting, particularly when lives are at stake. One such paramedic is E. Reed Smith, MD, FACEP. Realizing that the “stage and wait” approach to active shooter emergency situations was inadequate, he changed that by implementing a new EMS active shooter response program that has had a visible effect on his community of Arlington, Va.

You’ll find out how Reed’s Rescue Task Force uses evidence-based medicine from the Tactical Combat Casualty Care guidelines to help EMS providers work together effectively with law enforcement personnel to save lives in an active shooter situation. These guidelines, which are also used by the Arlington County Fire Department and the Arlington County Police Department, allow EMS to quickly move into a building during an active shooter event and provide stabilizing treatment and rapid evacuation for the wounded.

The Rescue Task Force has been so effective that several EMS agencies, including the London Fire Brigade, have begun adopting it. You’ll read about the impact this program has had on Reed’s community and on nearby communities.

To say Pat Songer, NREMT-P, ASM, is a busy man would be an understatement. During the past five years, Songer has established a critical care paramedic ground system in Humboldt County, Nev., introduced a new clinical program to use portable ultrasound units in the field to detect internal bleeding and possible blockages in prehospital patients, helped provide handheld blood analyzers to field providers, and launched a community paramedicine program designed to reduce emergency department visits and hospital readmissions. These programs have supported his community and helped EMS providers.

You’ll see why Songer created these systems and provided this equipment, and how it has had a lasting change on the residents around him.

Although many people would steer clear of a class requiring dissection of a pig heart, preferring to spend their time in more relaxing and less messy environments, David Reinis, EMT-P, isn’t one of those people.

After hearing about such a class, he began investigating the possibility of adopting its techniques for prehospital training, helping EMS instructors better teach cardiac care evaluation and treatment. We’ll detail how the course Reinis designed allows EMS providers in Colorado a hands-on approach to heart anatomy as it relates to myocardial infarction and 12-lead ECG patterns.

You’ll learn how the new program trains paramedics to actually visualize and dissect the internal structures of the heart, allowing them to feel the vessels that feed the different parts of the heart and learn how they correspond to ST-elevation and depression levels. This real-world approach has given EMS personnel the opportunity to work directly on a heart and fully understand their own role in treating those with cardiac issues.

We know about virtual worlds. We know about virtual games; and some of us have even experimented with virtual reality. But Todd Stout has taken things a step further and created the first “virtual EMS supervisor,” a program that monitors a variety of real-time EMS operations and procedures.

We’ll detail how FirstWatch monitors EMS calls and tracks such things as ambulance breakdowns, drownings and the amount of foot traffic traveling to and from large-scale special events, such as concerts and sporting events.

The ability to monitor and track operations and procedures in real time improves efficiency and saves money and lives. Stout’s profile will show you how it’s done and why other communities should think about adopting the same kinds of systems.

For the first time, and for good reason, JEMS has selected a group of people for the EMS Innovators in EMS Award. Most of us know that all EMS providers must operate under the medical oversight of a licensed physician. However, most physicians have little wilderness medical experience, and there hasn’t been a program quite like this groundbreaking one. Until now.

We’ll tell you how Michael Millin, MD, MPH, Seth Hawkins, MD, EMT-P, and Will Smith, MD, EMT-P, are changing that, including how more than 40 students enrolled in their innovative Wilderness EMS Medical Director course the first
time it was offered.

You’ll find out how the program works, who is eligible to take the course and why it’s the first formal collaboration between the National Association of EMS Physicians and Wilderness Medical Society members. Those who’ve taken the course are now far more aware of the necessity of medical training in the wilderness, and these three visionaries are helping to bring that education and awareness to people who might not otherwise have the chance to be exposed to such information.

All the individuals in this year’s supplement could be called pioneers—heroes really; although they don’t see it that way. To them, the programs and services they’re offering to their communities, many of them free of charge, are just part of the job.

We hope these stories illustrate what each of these people are doing for medicine. But, more importantly, we hope that their examples will inspire you to begin thinking about improvements that could be made to your own communities in patient care and delivery, and in research.

We also hope these stories will nudge you to push for the development of other innovative projects, protocols or procedures that will make a significant impact on your life, the lives of your colleagues, and the lives of your patients. his article originally appeared in April 2012 JEMS as “Casting a Vision: JEMS selects top 10 innovators of 2011.”