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

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 - michael.cohen@milwaukeecountygov.wi

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

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: 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

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: michael.cohen@milwaukeecountywi.gov

Email Milwaukee County Data Analytics Team: EMSdata@milwaukeecountywi.gov

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