Administration and Leadership, Columns, Commentary

Reflecting on 35 Years of Innovation in JEMS

Issue 3 and Volume 40.

This issue is historic because it represents our 35th anniversary as “The Conscience of EMS.” It allows us to reflect on why JEMS has been recognized as an institution responsible for forecasting, innovating, prodding and charting the course of EMS for 35 years.

Jim Page and Keith Griffiths decided to call our publication a “journal” rather than a “magazine” because they knew magazines contain articles about popular subjects while journals contain more professional, specially focused pieces.

I’m often asked why I feel JEMS is the leading EMS publication. Sometimes it’s a question from a young student who’s new to the industry, and sometimes it’s a question from a new advertiser or marketing manager.

My answer is that I and many other EMS leaders cut our teeth on JEMS, learned it was the most forward-thinking publication and felt confident using the visionary messages and advice from its articles to guide the strategic direction for our EMS regions. 

From the very first issue, JEMS has been the leader in presenting important clinical and administrative issues. While other EMS publications reported on current issues and presented clinical articles, JEMS did that and much more, not only reporting (often critically) on where EMS was, but, more importantly, where EMS could and should be going.

I had the privilege of being mentored by Jim Page from the time I started in EMS administration in 1975 until his untimely death in 2004. Jim often laughed about his first impressions of me as a 22-year-old regional EMS system coordinator, “wet behind the ears” but passionate about EMS and persistent in presenting the need for change to my board of directors, EMS agencies and their elected officials.

Being dogged and determined in the ‘70s wasn’t an easy job. It cost Jim his position as the first EMS director in North Carolina when he refused to bend on letting personnel who couldn’t read have their EMT test read to them. He always said being fired by the governor was a catalyst for him to create JEMS—to take important stands on issues he believed in.

Jim taught me and many others to take our roles in EMS system development seriously and not to take no for an answer if we felt a program needed to be implemented or an issue needed to be addressed. Like a soldier taking orders from a respected general, we used his words and those of JEMS authors as missions that needed to be accomplished.

I took Jim’s lesson to heart, and others could see that. At a federal meeting where he announced the award of a half-million dollar grant to my region, David Boyd, MD, was asked by a regional director why my region received funding and his didn’t. Boyd answered, “Because his two medical directors are always on top of their game and make sure their region accomplishes everything they’re asked to do—and your region doesn’t.” My region received over $3 million in federal EMS grants over a four-year period because we were aggressive and progressive in our development of a model EMS system.

In his December 1985 publisher’s page, after a visit to my Pennsylvania EMS region on the occasion of our system’s 10th anniversary, Jim reflected on our system and my two dedicated medical directors.

“The people of that six-county region have done everything the U.S. Congress had hoped for when it passed the EMS Systems Act of 1973. From training to communications, to disaster guidelines to hospital categorization, the eastern Pennsylvania region can serve as a model of what regional EMS should be.”

In a nice compliment in the same article, Jim wrote, “[A.J.] and his staff have weathered many storms in the last 10 years, but they enjoy their work immensely and it shows. They have created an inviting atmosphere for cooperation, and it has been aided in great measure by the dedication and contributions of co-medical directors, George Moerkirk, MD, and Donald Gaylor, MD, both of whom really like the people they work with, from the first responders to helicopter pilots, and they show it. It was refreshing to visit a system where there is a truly operational hospital critical care categorization program [in existence] since 1977.”

Gaylor, a retired military surgeon, Vietnam veteran and, amazingly, the chief of surgery at three of the largest hospitals in the region, used military terms to push me and our board of directors in those early days, often saying, “Damn the torpedoes and full speed ahead.”

Gaylor and Moerkirk went with me and our review teams on every hospital visit when we were evaluating and naming trauma centers, burn centers and other critical care centers in 1976, long before it was commonplace. We evaluated and categorized all 18 hospitals, never afraid to point out deficiencies to a hospital’s CEO or physician chief of staff. This early, regimented, systematic approach helped us regionalize all aspects of care and delivery.

Gaylor also encouraged me to always “look over the horizon, spot the enemy before they spot you and be ready to initiate action to win the battle.”

In the Navy, that statement referred to the ship’s captain and senior staff on the bridge looking in the distance for the enemy. But what he meant by that in the context of EMS was that he wanted our region to be forward-thinking and implement initiatives that not only addressed our current needs, but the needs of EMS agencies and patients in the future.

He and Moerkirk trusted and followed advice from Boyd, Jim and other JEMS authors as they charted the course for EMS in the ‘80s.

Jim and Keith always “looked over the horizon” for the issues, trends, programs and procedures that were important, and were always ahead of the competition in reporting on them. That’s been reflected in the editorial content of JEMS over the past 35 years. It’s also been the direction of our fully engaged medical editor, Ed Dickinson, MD, and strong editorial board, who insist JEMS continue to be the leading, most visionary publication in our industry.

JEMS was the first to present Jeff Clawson’s vision for emergency medical dispatch. It introduced the world to economist Jack Stout and his concepts for more efficient use of vehicles, staff and resources. His work is still viewed as a must-read for EMS managers.

And JEMS has also led the pack when it comes to clinical trends and equipment innovations, being the first to detail the reason why prehospital crews should use 12-lead ECGs, continuous positive airway pressure, adult intraosseous infusion, pulse and co-oximetry, capnography and mechanical CPR devices, and why they should move toward patient simulation and community paramedicine. Eight years ago, in a 2007 article on Canada’s initial offering of mobile integrated healthcare, JEMS predicted this was a role agencies throughout the United States would follow.

It’s still that way today. JEMS was way ahead of the pack in presenting information on why EMS should return tourniquets to their units (and on the belt of every responder) and begin to use hemostatic dressings, pelvic splints, junctional tourniquets and iTClamps; have EMTs and paramedics use alternative airways and processes other than endotracheal intubation; use video laryngoscopy, impedance threshold devices, mechanical CPR systems, uninterrupted compressions and CPR feedback devices; adopt new resuscitation practices such as upstroke ventilations, the pit crew approach, therapeutic hypothermia; and transport patients to resuscitation and ECMO centers, to name just a few.

Our visionary, specially focused and well-footnoted editorial supplements (all of which can be accessed and downloaded for free by clicking on the “Topics” tab on JEMS.com) have used evidence-based medicine and introduced our readers to important concepts and clinical techniques, and have served to chart the course for future EMS practice.

To illustrate this to you on the occasion of our 35th anniversary, I went through every page of JEMS since its inception and culled the visionary, and often bold, articles, series and issues JEMS led the way in presenting and have listed 135 of them.

Take a few minutes to review not just the articles and their visionary authors, but the month and year they were presented in JEMS. What you’ll find is that, in most cases, they presented concepts and care that was well ahead of the EMS curve and other publications.

These, and many other past JEMS articles, will be republished this year on jems.com to allow our subscribers to read (or reread) them to fully appreciate the impact JEMS has had on the development and advancement of EMS over the years. They’re timeless articles.

It’s also an important history lesson that will show the next generation of EMS leaders what can be accomplished if they have open minds, do what’s in the best interest of their patients and crews, and “damn the torpedoes and [proceed] full speed ahead!”

135 Visionary Articles Featured in JEMS over the Past 35 Years

1. “Problems and Progress in Recertification: A roundtable discussion,” by Debra Cason, RN; Norman E. McSwain, MD; A.J. Heightman, EMT-PII; Jim Doernococeur, EMT-P; Kara Doyle; Carol Hagberg, RN, MICN; and Lymann C. Long, REMT-A, EMT-AD, March 1980 (inaugural issue)
2. “Tracking the Trends in EMT-P Training: How are today’s trainees measuring up?,” by Alfred Weigel, March 1980
3. “The Publisher’s Page: Challenging the cowboys,” by Jim Page, April 1980
4. “The Politics in EMS,” by Jim O. Page, April 1980
5. “SWAT Team Paramedics,” by Robert Neale, April 1980
6. “A Videotape Program for EMT Training,” by Trevor Hughes, MD,” by Carolyn J. Levey and Robert T. Buckley, April 1980
7. “The Public Utility Model: 3-Part Series,” by Jack Stout
a. Part 1: Measuring your system, May 1980
b. Part 2: The principal elements, June 1980
c. Part 3: The major constraints, July 1980
8. “Advanced Trauma Life Support: The new ATLS class sets new standards for the delivery of emergency care,” by Ann Wells, June 1980
9. “Who’s in Charge,” by Jim Page, August 1980
10. “The Bird and the Rhinoceros,” by Paul P. Lally and Frederick Peterson, October 1980

11. “Look Out Behind You! Protecting your back,” by Thom Dick, December 1980
12. “Patient Consent and the Law—Part 1: General principles,” by R. Jack Ayres, Jr., December 1980
13. “Standardized Skills Testing: A new program for evaluating EMTs, paramedics and medical radio operators,” staff report, December 1980
14. “Dispatch Priority Training: Strengthening the weak link,” by Jeff Clawson, MD, February 1981
15. “The Impact of Trauma Centers: What’s the fair way to designate?” by Harry Teter, Jr., October 1981
16. “Terrorism and EMS: A security issue” by B.M. Turner, PhD, February 1982
17. “Telelecture: Providing effective continuing education: An innovative approach to training in rural America,” by Paul B. Anderson, et al. March 1982

18. “Cricothryrotomy—Practice makes perfect,” by Michael Frank, MD, May 1982
19. “Comparing Ventilatory Techniques During CPR,” by Saul Lande, MD; Paul Lally; Fred Peterson; David Potter. May 1982
20. “Your Friend, The Microcomputer: An enthusiastic look at how these little wonders can help your program,” by Bruce E. Roemmelt, July 1982
21. The Private Ambulance Industry Comes of Age,” Staff report, September 1982
22. “New Directions in Health Care Financing: Diagnosis Related groups (DGRs) are creating a stir in New Jersey, and could have far-ranging implications for EMS programs nationwide,” by VincentdePaul Robbins, September 1982
23. “Standing Orders vs. Voice Control: A study measures the effects of standing orders on paramedic prehospital treatment of cardiopulmonary arrest,” by Richard C. Hunt, MD; et al, November 1982
24. “Analysis of Regional Data: Costs vs. Benefits of ALS Services,” by CDR. B. Thomas Scheib, January 1983

25. “Stout’s Standards of Excellence for Prehospital EMS Systems.” by Jack Stout, January 1983
26. “Medical Priority Dispatch—It Works!” by Jeff Clawson, MD, February 1983
27. “Financial Strategies for Surviving the ‘80s: A 4-part series,” by Alan Jameson
a. Part 1: Financial Strategies for Surviving the ‘80s, March 1983
b. Part 2: Billing, collections and accounts receivable, April 1983
c. Part 3: Creating financial stability, May 1983
d. Part 4: Cost control, June 1983
28. “Self-Instruction for Paramedics: An alternative to the standard lecture,” by Michael Friedman and Gene Weatherall, April 1983
29. “Letters: Effectiveness of Cervical Collars Questioned,” by Norman E. McSwain Jr. MD, April 1983

30. “System Status Management: The strategy of ambulance placement,” by Jack Stout, May 1983
31. “The Ambulance Report as Legal Document,” by Peter B. King, June 1983
32. “Interface: The Public/Private Interface,” by Jack Stout, July 1983
33. “Updrafts: New Rx for respiratory distress,” by Greg Thrall EMT-III, Dean Ewell, RT and S. Freedman, MD, August 1983
34. “Do Not Resuscitate: administrative and ethical concerns in prehospital arrests,” by Paul McCarthy, September 1983
35. “Simulation in Training,” by Frank M. Dawson, October 1983
36. “It’s Hard to be Afraid,” by Jack Stout, October 1983
37. “Patterns of Trauma: The forgotten element of assessment,” by VincentdePaul Robbins, November 1983
38. “Airway Controversies,” by Ronald Stewart, MD, January 1984
39. “Brain Resuscitation,” by Marvin Birnbaum, MD, October 1984

40. “EMTs and Medical Control: There should be an identifiable medical director for each and every ambulance service,” by Mark C. Henry, MD and Edward R. Stapleton,
EMT-P, January 1985
41. “Resuscitating the Terminally Ill,” by Loren Marshall, April 1985
42. “EMS Performance Management: Measuring your system’s success,” by Terry Smith, November 1985
43. “Non-Invasive Pacing: A prehospital ALS alternative,” by Al Weigel, MEd, EMT-P and Roger D. White, MD, December 1985
44. “Telephone Treatment Protocols: Reach Out and Help Someone,” Jeff Clawson, MD, May 1986
45. “The Ambulance Bypass: When the public doesn’t call,” by John Mackey, MD, August 1986
46. “Big Bodies: How to deal with them,” Kate Dernocoeur, EMT-P, September 1986
47. “Thrombolytic Therapy,” by Mikel A. Rothenberg, MD. December 1986
48. “Intraosseous Infusion: Prehospital use in the critically ill pediatric patient,” by Craig A. Stoup, BS, EMT-P, May 1987
49. “The Survival Advantage: Early defibrillation programs in the fire service,” by Mary Newman, June 1987
50. “Tracking the Wild Ambulance Fleet—a two-part series,” by Loren Marshall, August and September 1987
51. “The Dark Side: The role of privatization in EMS,” by Thomas H. Swan, October 1988
52. “Anatomy of a Lawsuit: The real-world aftermath of a spinal injury,” by James O. Page, April 1989
53. “Dangerous Detours: Ambulance diversions stall patient delivery,” by Marion Angell Garza, July 1989
54. “When ACLS Fails: Why transport,” by Marion Angell Garza, September 1989

55. “Assessing Pulse Oximetry in the Field,” by Bill Mackreth, EMT-P, June 1990
56. “Dispatch Life Support: Establishing standards that work,” by Jeff J. Clawson, MD & Scott A. Hauret, AEMT, July 1990
57. “Easing Intubation with Succinylcholine,” by Michael O. Berve, EMT-P, November 1990
58. “Discipline with Due Process,” by James O. Page, July 1991
59. “You’re Fired!,” by James O. Page, July 1991
60. “Comparing CPR During Ambulance Transport: Manual vs. mechanical methods,” by Edward Stapleton, AAS, EMT-P, September 1991
61. “Post-Traumatic Stress Disorder: When the rescuer becomes the victim,” by Joyce O’Rear, EDD, January 1992
62. “Clot Busters: The future of EMS thrombolytics,” by E. Handberg, RN, EMT-P, MSN; T. Keith EMT-P & P. Rucinski, MD, April 1992
63. “Brain Attack: Clot busters tackle stroke,” by Marion Angell Garza, April 1992
64. “Fear in the Workplace, Part 1,” by James N. Eastham, JR, ScD & Bruce J. Walz, PhD, NREMT-P, May1993
65. “Treatment Without Transport: Expanded-scope concept gains momentum,” by Marion Angell Garza, April 1994
66. “Body Armor: What it is and what it does,” by Donald W. Walsh, MS, EMT-P and Julia Hagen, September 1994
67. “Why Wait? Early defibrillation must be a top priority,” by Roger D. White, MD, February 1995
68. “CO2 Monitoring: Monitoring end-tidal CO2—its benefits and limitations in the prehospital setting,” by Robert Welch, MD, FACEP, March1995
69. “Rapid Sequence Intubation: Don’t fight it!” by Mike Hartley, REMT-P, April 1995
70. “Risky Business: Why EMS needs risk management,” by David Harrawood, RM, REMT-P; Patrick Shepler, RM, NREMT-P & Michael R. Gunderson, REMT-P, July 1995

71. “Medic Suicide: What can be done?” by Jeffrey T. Mitchell, PhD, November 1995
72. “Red River Project: Expanded scope for New Mexico medics,” by Steve Shoup, EMT-I, Dec. 1995
73. “Are Paramedics an Endangered Species? Five industry visionaries offer their perspectives,” by Bill Brown, MS, CEN, REMT-P; Jim Dernocoeur; Jack Stout; Alice Dalton, BSN; Dan Manz, March 1996
74. “Providers Primer on Managed Care,” by John Becknell and Lauren Simon Ostrow, March 1996
75. “Military Medic: The original expanded-scope EMS provider,” by Robert A. DeLorenzo, MD, April 1996
76. “Utstein Applied: Fremont measures firefighter ALS response to cardiac arrests,” by Lauren Simon Ostrow, May 1996
77. “Racing the Clock: The emerging role of 12-lead ECGs,” by D. Bruce Foster, DO & Brian R. Mitchell, EMT-P, May 1996
78. “The Advancing Anatomy of an Ambulance,” by Marc-David Monk, NREMT-I, -CC, October 1996
79. “Cardiac Serum Markers: Fact or folly? The next wave of early identification of acute myocardial infarction?” by Todd J. LeDuc, BA, NREMT-P, April 1997

80. “The DNA of Dispatch: The reasons for a unified medical dispatch protocol,” by Jeff J. Clawson, MD, May 1997
81. “Chemically Induced Paralysis: A short course in neuromuscular blockade & RSI,” by David M. LaCombe, EMT-P; George Desjardins, MD, FRCPC; Nabil El Sanadi, MD, FACEP; Steven Gayer, MD; David Shatz, MD, June 1997
82. “The Benevolent Dictator: A new breed of medical director,” by John Becknell, July 1997
83. “Capturing the Competitive Edge: A 2-part series,” by Jack L. Stout, September and October 1997
84. “Overtime Pay: How the FLSA affects you,” by Jeffrey Chamberlain, JD, November 1997
85. “Re-Engineering the Nation’s Emergency Cardiac Response Systems: Adding troops to win the war against sudden cardiac arrest,” by Todd J. Leduc, BA, NREMT-P, May 1998
86. “The Truth about ET Tube Movement,” by Paul Matera, MD, June 1998
87. “Anchor the Airway,” by Paul M. Peindl, MD and Randy Price, June 1998
88. “CPAP: A supportive adjunct for congestive heart failure in the prehospital setting,” by D. Hastings; J. Monahan; C. Gray; D. Pavlakovich & P. Bartram, September 1998
89. “Pain! Understanding and reducing patient discomfort in the field,” by Paul Paris, MD & Paul Phrampus, MD, April 1999

90. “Tactical Medics: Front-line medicine evolves as a specialty,” by Barry D. Smith, May 1999
91. “Cyanide: The deadly terror weapon that every ems provider must know about,” by Robert A. De Lorenzo, MD, FACEP, October 1999
92. “RSV: Not the common cold—signs & symptoms of respiratory syncytial virus,” by Daved van Stralen, MD & Ronald M. Perkin, MD, MA, February 2000
93. “Endotracheal Rules of Engagement: How to reduce the incidence of unrecognized esophageal intubations,” by Darryl A. Coontz & Matt Gratton, MD, June 2002
94. “LMA Fastrach: EMS discovers the intubating laryngeal mask airway,” by Geoffrey T. Miller, NREMT-P, June 2002
95. “After the Fall: 9/11 effects on New York’s EMS personnel extend far beyond symptoms of post-traumatic stress,” by Lisa Dionne, September 2002
96. “Selective Spinal Immobilization: The use of assessment criteria & protocols to select patients who don’t require complete spinal immobilization,” by Darren Braude, MD, EMT-P & Angela Jaramillo, BS, EMT-P, September 2002
97. Cardiac Alert: Aurora Fire Department advances cardiac care through cardiac cath lab field activation,” by Guy W. Bull, BA, EMT-P & Danny Willcox, BS, EMT-P, December 2002
98. Capnography in EMS: A powerful way to objectively monitor ventilatory status,” by Baruch Krauss, MD, EdM, FAAP, January 2003
99. “The Silent Killer: Recognizing & treating carbon monoxide poisoning,” by Lee Ann Koster, MD & Timothy Rupp, MD, FACEP, January 2003
100. “Introducing the Pelvic Sling: Pelvic fracture stabilization made simple,” by Michael Bottlang, PhD & James C. Krieg, MD, September 2003
101. “Build Your Own Bariatric Unit: Southwest Ambulance creates a better way to transport obese patients,” by Joshua Weiss, Daniel Perham & John Forrest, December 2003
102. “Nasal Drug Delivery in EMS: Reducing needlestick risk,” by Timothy Wolfe, MD & Eric Barton, MD, December 2003

103. “Adult IO Arrives: The solution to difficult vascular access,” by Editorial Supplement from Elsevier/JEMS, Sponsored by VidaCare, October 2005
104. “Beyond EMS: Community paramedics make house calls,” by Mannie Garza, September 2007
105. “Into the Future: Identifying and mentoring your successor may be the most important thing you do,” by Cynthia Kinkaid, February 2010
106. “The ABCs of TBI: Evidence-based guidelines for adult traumatic brain injury care,” by Jeremy Dewall, MD, NREMT-P, April 2010
107. “Explosive Devices: What every responder should know about IEDs,” by August Vernon, May 2010

108. “Rethinking ETI: Should paramedics continue to intubate?” by Bryan E. Bledsoe, DO, FACEP, FAAEM, EMT-P; Darren Braude, MD, MPH, FACEP, EMT-P; Marc Eckstein, MD, MPH, FACEP, EMT-P; William E. Gandy, JD, NREMT-P, David K. Tan, MD, FAAEM, EMT-T; Henry Wang, MD, MS& Marvin Wayne, MD, FACEP, FAAAEM, July 2010
109. “Visible Improvement: Ultrasound provides diagnostic images in prehospital medicine,” by Jason Bowman, CCEMT-P, NREMT-P, September 2010
110. “Using Portable Cardio Pulmonary Support to Treat Stemi Patients,” by David Ostrander, MD, FACC; Zack Shinar; Joseph Bellozzo, MD; Brian Jaski, MD; John Gordon, MD and Donna Dasinger, RN, December 2010
111. “Chill Factor: How the hottest thing in EMS is cold,” by Jeffrey M. Goodloe, MD,
NREMT-P, FACEP & T.J. Reginald, NREMT-P, February 2011
112. “Without Warning: How to effectively treat patients with excited delirium,” by Keith Wesley, MD, February 2011

113. “Instant Replay: Perform CPR with immediate feedback,” by Bentley J. Bobrow, MD; Benjamin S. Abella, MD, MPHIL; Tyler Vandeboncoeur, MD; David C. Cone, MD & Vastal Chikani, MPH, March 2011
114. “Heroes to Hometown: When veterans come home,” by Dean Pedrotti, CEP, BS, MBA, March 2011
115. “A Quiet Epidemic: How suicides affect patients & providers,” by Wayne Zygowicz, BA, EFO, EMT-P & Michael Grill, MS, EFO, NREMT-P, April 2011
116. “Achieving 20/20 Glottic Visualization: Clinical research provides lessons for a perfect view during intubation,” by Mark Rock, BA, NREMT-P, June 2011
117. “Stop the Pain: Fentanyl is a viable alternative to morphine,” by Jim Massey, BS, EMT-P, CCP-C, August 2011
118. “EMS Education Agenda: Changes that will affect you,” by Deb Cason, RN, MS, EMT-P & Kathy Robinson, RN, EMT-P, September 2011
119. “Drug Shortages: Tips to turn dilemma into discoveries,” by Jeffrey M. Goodloe, MD, NREMT-P, FACEP, December 2011

120. “E-Linkage at Last: EMS crews linked to hospital & discharge diagnosis,” by Frank Zanka, MBA, January 2012
121. “Extreme Bleeds: Recommendations for tourniquets in civilian EMS,” by Gregory C. Risk, MD, MPH, FACEP & James Augustine, MD, FACEP, March 2012
122. “Prepared for the Worst: Tactical training offers many benefits for EMS,” by William Justice, NREMT-P; Lt. Kerry Massie, NREMT-I & Jeffrey M. Goodloe, MD, NREMT-P, FACEP, May 2012
123. “Safety First: Richmond Ambulance Authority creates comprehensive culture of safety model,” by Rob Lawrence, MCMI; Bryan S. McRay, BA; Dempsey Whitt, NREMT-P/FF-C & Joseph P. Ornato, MD, FACP, FACC, FACEP, June 2012
124. “Rethinking Delivery Models: EMS Industry may Shift Deployment Methods,” by Jonathan D. Washko, BS-EMSA, NREMT-P, AEMD, July 2012
125. “Attacking Cardiac Arrest,” by Jeffrey M. Goodloe, MD, NREMT-P, FACEP; T.J. Reginald, NREMT-P; David S. Howerton, NREMT-P; Jim O. Winham, RN, BSN, NREMT-P & Tammy Appleby, NREMT-B
a. Part I: Good science and enthusiasm drive survival rates in Oklahoma, August 2012
b. Part II: ROSC successes & research are changing fieldpractice, September 2012

126. “Top of the Pyramid: What makes a model EMS system?” by Jonathan Washko, BS-EMSA, NREMT-P, AEMD, December 2012
127. “Mobile Integrated Health Care: Putting the ‘RAP’ in rapport: EMS surveillance program assists with ‘frequent flyers,’” by Anne-Marie Jensen, EMT-P & James Dunford, MD, January 2013
128. “Early Cooling: Effectively initiating therapeutic hypothermia during cardiac arrest,” by Howard Dickey-White, MD, FACEP; Daniel Ellenberger, EMT-P, EMS-I & Dominic Silvestro, EMT-P, EMS-I, November 2013
129. “Discriminate Spinal Immobilization: How Lee County (Fla.) EMS implements a new paradigm of cervical spine management,” by Michael G, Hamel, NREMT-P, CCEMT-P, FP-C, January 2014
130. “Patient Experience Revolution: The Affordable Care Act’s emphasis on patient-centered care will transform our industry,” by Doug Hooten, MBA & Matt Zavadsky, MS-HSA, EMT, February 2014
131. “Rightsizing: Transforming from big apparatus for better fire service EMS resource deployment,” by Michael Baker, B.U.S, NRP, February 2014
132. “Upstroke Ventilation: New resuscitation technique increases ROSC,” by Daniel Davis, MD & Mark Rock, NREMT-P, March 2014
133. “Utilizing Capnography in Sepsis: End-tidal CO2 may be used in place of lactate to screen for severe sepsis,” by Christopher Hunter, MD, PhD, March 2014

134. “Emergency Cardiopulmonary Bypass Creates Potential for Saving the Nearly Dead,” by Vincent N. Mosesso, Jr., MD & Jenn Liebman, MSL, RN, CFRN, December 2014
135. Mobile Integrated Healthcare In Action series:
• “Mobile Intergrated Health Care: A new service delivery model whose time has come,” by A.J. Heightman, MPA, EMT-P, July 2014
• “Imparting Knowledge & Restoring Hope: How MedStar’s mobile integrated healthcare program helped frequent flyer Antoine Hall live again,” by Matt Zavadsky, MS-HSA, EMT, July 2014
• “Unable to Help Herself: San Diego EMS steps in to assist frequent flyer with TBI and co-occurring substance abuse disorder,” by Anne Marie Jensen, EMT-P & Kris Kuntz, MA, September 2014
• “New Hanover Community Paramedicine Success Story: N.C. medical center EMS team brings mobile integrated healthcare into the community with promising results,” by David Glendenning, NREMT-P & C. Anthony Jones, MD, February 2015