In this episode of Push Dose EMS, Dr. Hanna Heintz and Jamie Thorpe break down the clinical decision-making behind safe ALS-to-BLS turndowns. The discussion uses pediatric, respiratory, syncope, trauma, hypoglycemia, and pain-management scenarios to highlight reassessment, treatment response, deterioration risk, and crew communication, and emphasizes when to maintain ALS care, involve medical control, or begin immediate transport.

Email Mike: michael.cohen@milwaukeecountywi.gov

Turndown Checklist:

https://app.eolasmedical.com/spaces/landing/null?spaceId=EOLAS%23ORG%23milwaukee-county-ems%2376ce0e89-37b9-48db-8edf-6605d13f4ad7&fileId=FILE%233b293cb5-db3d-492c-a681-ba8ef670ea1c&origin=section

Paramedic Evaluation, Transport, Upgrade, or Turndown Policy:

https://app.eolasmedical.com/spaces/landing/null?spaceId=EOLAS%23ORG%23milwaukee-county-ems%2376ce0e89-37b9-48db-8edf-6605d13f4ad7&fileId=FILE%23f61a1ba4-fcdd-47b5-9e61-81a4237d0f77&origin=section

On this episode, Dr. Heintz and Andrew Olson examine decision-making capacity and the balance between patient autonomy and safe care when patients decline treatment or transport. The episode offers practical approaches to communication barriers, reassessment, medical control, documentation, and connecting patients with additional resources.

MCOEM Decline of Care or Transport Guideline: https://app.eolasmedical.com/spaces/landing/null?spaceId=EOLAS%23ORG%23milwaukee-county-ems%2376ce0e89-37b9-48db-8edf-6605d13f4ad7&fileId=FILE%234d124dfa-820b-4527-bf3f-243c851bdb41&origin=section

Email Mike: michael.cohen@milwaukeecountywi.gov

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: michael.cohen@milwaukeecountywi.gov