This document describes an EMS physician program called MD-1 that provides enhanced medical capabilities and physician oversight to prehospital emergency response. MD-1 is equipped with advanced life support equipment and deploys a Chevrolet Tahoe for responses. The program has integrated into the local EMS system through approvals and training. MD-1 physicians respond to requests from incident commanders and provide assistance to crews on medical calls, mass casualty incidents, and difficult extrications. Initial responses have included managing difficult airways, treating cardiac events, and providing support during blizzard conditions. Feedback from EMS crews has been positive about the additional medical resources and oversight provided by the MD-1 physicians.

1. EMS Physicians
“We still make house calls!”
Jay MacNeal, DO, MPH, NREMT-P
EMS Medical Director

2. MD-1 Basics
• 2012 Chevy Tahoe
• Certified Emergency Vehicle
– Emergency lighting/Siren
– Rock and Walworth County Public Safety Radios
– Maps/GPS
– Personal Protective Equipment
– Extrication Equipment
– Rehab supplies

3. MD-1 Medical Equipment
•
•
•
•
•
•
•
•
•
LUCAS 2 Mechanical CPR Device
Zoll X Series Monitor
Glidescope Video Intubation
Medications with secure storage
Chest tubes
Tourniquets
Field Amputation Equipment
Triage Kit
Field Trial Equipment

4. MD-1 Medical Equipment

5. MD-1 Integration into EMS System
•
•
•
•
•
•
Approval from State EMS Office
Emergency Vehicle Permit from RCSO
Approval of radio use by 911 and local Chiefs
Meeting with Fire, EMS, Law Enforcement
MD-1 and equipment part of EMS training
MD-1 at disaster drills and mass gatherings

7. MD-1 Activation
•
•
•
•
•
Request from Incident Commander to 911
Mercy Switchboard receives call from 911
IRM page and cell text to MD-1 Physicians
MD-1 responds to page and responds
EMS physician talks to crews enroute to scene

8. MD-1 Responses
• 6 Tactical EMS
– Difficult airways managed with MD-1 resources
• 20 MVAs
– Patients triaged and treated with MD-1 resources
• 1 Pediatric PNB
– Survived!
• 5 STEMI
– MD-1 driving by at dispatch time
• 40 PNB
– Persistent VFIB treated with MD-1 resources, Survived!
– Blizzard conditions required MD-1 four wheel drive
• 15 Medical Calls

9. MD-1 First Official Request

11. MD-1 I43 Southbound

15. Prolonged Incidents

24. MD-1 Community Relations
•
•
•
•
•
•
•
•
FM and AM radio interviews
Gazette articles
Local Vision TV interview
Farm Rescue Training Article
Numerous Community Events
FD Open Houses
NAEMSP Lecture on MD-1
Describing the program at gas pumps

25. Comments from the Field
• “He’s more like a Paramedic than a real
doctor”
• “It’s nice to have an extra set of hands”
• “I was nervous you’d come and try to take
over, now I see that you’re just there to help”
• “That was my first field intubation, and I felt
better having a doc there for me as backup”

26. System Changes
•
•
•
•
•
•
LUCAS 2 Deployment
Video Intubation Evaluation On Going
RSA medication and protocol change
Instant feedback/QA
On call EMS Physician cell phone
Increased respect for EMS field activities

27. EMS Future
• EMS Subspecialty
• Community Paramedics
• Managed Care
Stay Safe and Thank You for all that you do for
your community and patients!