<a href="https://drive.google.com/file/d/1LA4o9M6gbtHemZJI0ZMLH7T0WNjTUhnJ/view?usp=sharing">Joint Statement on Lights & Siren Vehicle Operations</a><a href="https://drive.google.com/file/d/1_zXqxikmi6txJrukzWSCY_DCz7Oudvd3/view">Using Red Lights and Sirens for Emergency Ambulance Response: How Often Are Potentially Life-Saving Interventions Performed?</a><a href="https://drive.google.com/file/d/1LEFQdN8dtDuimTLPI3oAdgTnlAMheWcb/view?usp=sharing">Joint Position Statement on EMS Performance Measures Beyond Response Times</a><a href="https://www.dropbox.com/scl/fi/o5fu4x54n8215fxes1dz3/Veronica-short.mp4?rlkey=sfjxsq2k1mdl3yrs6ljfdn7rt&e=1&dl=0">Veronica video</a><a href="https://www.nemsqa.org/related-podcasts-and-recorded-events">NEMSQA Lights and Sirens Podcasts</a><a href="https://drive.google.com/file/d/1y8HlQFZNJPpVjqrkDtmah2RVn5xTI1NW/view?usp=sharing">Dispatch Categories as Indicators of Out-of-Hospital Time Critical Interventions and Associated Emergency Department Outcomes</a><a href="https://www.paramedicchiefs.ca/abstract-lights-and-sirens-is-it-worth-the-risk-24-march-2022/">Paramedic Chiefs of Canada Abstract: Lights and Sirens; Is It Worth the Risk?</a>

<description>&lt;p&gt;&lt;a href="https://drive.google.com/file/d/1LA4o9M6gbtHemZJI0ZMLH7T0WNjTUhnJ/view?usp=sharing"&gt;Joint Statement on Lights &amp; Siren Vehicle Operations&lt;/a&gt;&lt;/p&gt;&lt;p&gt;&lt;a href="https://drive.google.com/file/d/1_zXqxikmi6txJrukzWSCY_DCz7Oudvd3/view"&gt;Using Red Lights and Sirens for Emergency Ambulance Response: How Often Are Potentially Life-Saving Interventions Performed?&lt;/a&gt;&lt;/p&gt;&lt;p&gt;&lt;a href="https://drive.google.com/file/d/1LEFQdN8dtDuimTLPI3oAdgTnlAMheWcb/view?usp=sharing"&gt;Joint Position Statement on EMS Performance Measures Beyond Response Times&lt;/a&gt;&lt;/p&gt;&lt;p&gt;&lt;a href="https://www.dropbox.com/scl/fi/o5fu4x54n8215fxes1dz3/Veronica-short.mp4?rlkey=sfjxsq2k1mdl3yrs6ljfdn7rt&amp;e=1&amp;dl=0"&gt;Veronica video&lt;/a&gt;&lt;/p&gt;&lt;p&gt;&lt;a href="https://www.nemsqa.org/related-podcasts-and-recorded-events"&gt;NEMSQA Lights and Sirens Podcasts&lt;/a&gt;&lt;/p&gt;&lt;p&gt;&lt;a href="https://drive.google.com/file/d/1y8HlQFZNJPpVjqrkDtmah2RVn5xTI1NW/view?usp=sharing"&gt;Dispatch Categories as Indicators of Out-of-Hospital Time Critical Interventions and Associated Emergency Department Outcomes&lt;/a&gt;&lt;/p&gt;&lt;p&gt;&lt;a href="https://www.paramedicchiefs.ca/abstract-lights-and-sirens-is-it-worth-the-risk-24-march-2022/"&gt;Paramedic Chiefs of Canada Abstract: Lights and Sirens; Is It Worth the Risk?&lt;/a&gt;&lt;/p&gt;
</description>

In this episode we’re joined by Mike Taigman and Brad Cramer for a deep dive into the improvement science and framework behind our efforts to reduce lights and sirens responses.

Reducing Lights and Sirens Responses

<description>Dr. Chizmar and Lt. Tipton go over the July 1 protocol changes in detail 
</description>

Dr. Chizmar and Lt. Tipton go over the July 1 protocol changes in detail

Maryland Protocols 2025!

Written by Eric Jaeger, JD, NRP, EMS IC, July 2024AP News and PBS Frontline Lethal Restraint ReportingOver the last several months, the AP News and PBS Frontline have published a series of stories, linked below, on death in custody and the role of EMS sedation. In a multi-year investigation, they uncovered over 1000 deaths across the United States due to lethal restraint involving police and, in some cases, EMS. Chemical sedation by EMS was involved in nearly 100 of these deaths. I encourage you to review these stories; they demonstrate increasing attention on this issue by the public and they reveal that the scope of the issue is larger than previously realized.<a href="https://www.youtube.com/watch?v=K0UEY1PVRVY&t=2190s" target="_blank">PBS Frontline: Documenting Police Use of Force</a>(note this links to the story where it discusses EMS sedation; for the full documentary <a href="https://www.pbs.org/wgbh/frontline/documentary/documenting-police-use-of-force/" target="_blank">click here</a>).<a href="https://www.youtube.com/watch?v=V4skOjm955s" target="_blank">AP News: How the medical syringe became a tool of control when police restrain people</a><a href="https://apnews.com/article/investigation-police-use-of-force-sedation-injections-demetrio-jackson-621909ba7491abc2af8ad2e33ba3415b">AP News: Dozens of deaths reveal risks of injecting sedatives into people restrained by police</a><a href="https://apnews.com/article/texas-lethal-restraint-police-sedation-injections-1cd1fa7635381dd7c3fa5096a9e5df15">AP News: At least 15 people died in Texas after medics injected sedatives during encounters with police</a><a href="https://apnews.com/article/california-lethal-restraint-police-sedation-injections-midazolam-e4f96a2f237ffbd0f63d979e0bdefd9c">AP News: At least 16 people died in California after medics injected sedatives during encounters with police</a>Key Takeaways  Large Number of Deaths This reporting expands significantly the number of individuals who are known to have died after EMS sedation. (Note: We have no reason to believe that sedation was a cause of death in all of these cases; only that the individuals received sedation prior to death.) Criminal Charges & Civil Liability for EMS ProvidersTwo paramedics have been found guilty in a criminal trial involving use of ketamine. Prosecutors seem more willing to hold paramedics and police officers criminally liable for their conduct. In addition, dozens of EMS providers and agencies have been the subject of civil lawsuits arising from deaths in custody, with payouts of over $100 million.Increased Public Attention and ScrutinyWhile the AP News and PBS Frontline stories are the largest reporting project on this topic, many other reporters across the country are now focusing on issues related to death in custody and the role of sedation by EMS. It's NOT the Ketamine; The Problem is the Overall Approach to Prehospital Sedation  While 20% of the deaths involved ketamine, nearly 50% involved midazolam. This leads to the conclusion that the problem is not ketamine per se, but rather our overall approach to prehospital sedation.I strongly believe that to address these issues, we must radically reframe the approach to prehospital chemical sedation. Protocols for physical restraint and chemical sedation should be rewritten (not just tweaked). And all EMS providers should receive updated training that focuses on prehospital sedation as a deliberate, protocolized procedure, following the model of RSI or ED procedural sedation. While classroom training is helpful, in my experience hands-on simulations are key to helping EMS providers relearn the approach to this important topic.I'm continuing to focus on this topic, including providing virtual and in-person training at agencies and EMS conferences across the country. Please let me know if you are aware of speaking opportunities that might be appropriate. And please reach out if I can be helpful in any way.

<description>&lt;p&gt;&lt;strong&gt;Written by Eric Jaeger, JD, NRP, EMS IC, July 2024&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;AP News and PBS Frontline Lethal Restraint Reporting&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;Over the last several months, the AP News and PBS Frontline have published a series of stories, linked below, on death in custody and the role of EMS sedation. In a multi-year investigation, they uncovered over 1000 deaths across the United States due to lethal restraint involving police and, in some cases, EMS. Chemical sedation by EMS was involved in nearly 100 of these deaths. I encourage you to review these stories; they demonstrate increasing attention on this issue by the public and they reveal that the scope of the issue is larger than previously realized.&lt;/p&gt;&lt;p&gt;&lt;a href="https://www.youtube.com/watch?v=K0UEY1PVRVY&amp;t=2190s" target="_blank"&gt;PBS Frontline: Documenting Police Use of Force&lt;/a&gt;&lt;/p&gt;&lt;p&gt;(note this links to the story where it discusses EMS sedation; for the full documentary &lt;a href="https://www.pbs.org/wgbh/frontline/documentary/documenting-police-use-of-force/" target="_blank"&gt;click here&lt;/a&gt;).&lt;/p&gt;&lt;p&gt;&lt;a href="https://www.youtube.com/watch?v=V4skOjm955s" target="_blank"&gt;AP News: How the medical syringe became a tool of control when police restrain people&lt;/a&gt;&lt;/p&gt;&lt;p&gt;&lt;a href="https://apnews.com/article/investigation-police-use-of-force-sedation-injections-demetrio-jackson-621909ba7491abc2af8ad2e33ba3415b"&gt;AP News: Dozens of deaths reveal risks of injecting sedatives into people restrained by police&lt;/a&gt;&lt;/p&gt;&lt;p&gt;&lt;a href="https://apnews.com/article/texas-lethal-restraint-police-sedation-injections-1cd1fa7635381dd7c3fa5096a9e5df15"&gt;AP News: At least 15 people died in Texas after medics injected sedatives during encounters with police&lt;/a&gt;&lt;/p&gt;&lt;p&gt;&lt;a href="https://apnews.com/article/california-lethal-restraint-police-sedation-injections-midazolam-e4f96a2f237ffbd0f63d979e0bdefd9c"&gt;AP News: At least 16 people died in California after medics injected sedatives during encounters with police&lt;/a&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key Takeaways&lt;/strong&gt;&lt;br /&gt; &lt;/p&gt;&lt;p&gt;Large Number of Deaths&lt;br /&gt;This reporting expands significantly the number of individuals who are known to have died after EMS sedation. (Note: We have no reason to believe that sedation was a cause of death in all of these cases; only that the individuals received sedation prior to death.)&lt;br /&gt;&lt;br /&gt;Criminal Charges &amp; Civil Liability for EMS Providers&lt;/p&gt;&lt;p&gt;Two paramedics have been found guilty in a criminal trial involving use of ketamine. Prosecutors seem more willing to hold paramedics and police officers criminally liable for their conduct. In addition, dozens of EMS providers and agencies have been the subject of civil lawsuits arising from deaths in custody, with payouts of over $100 million.&lt;/p&gt;&lt;p&gt;Increased Public Attention and Scrutiny&lt;/p&gt;&lt;p&gt;While the AP News and PBS Frontline stories are the largest reporting project on this topic, many other reporters across the country are now focusing on issues related to death in custody and the role of sedation by EMS.&lt;br /&gt;&lt;br /&gt;It's NOT the Ketamine; The Problem is the Overall Approach to Prehospital Sedation &lt;br /&gt;While 20% of the deaths involved ketamine, nearly 50% involved midazolam. This leads to the conclusion that the problem is not ketamine &lt;i&gt;per se&lt;/i&gt;, but rather our overall approach to prehospital sedation.&lt;/p&gt;&lt;p&gt;I strongly believe that to address these issues, we must radically reframe the approach to prehospital chemical sedation. Protocols for physical restraint and chemical sedation should be rewritten (not just tweaked). And all EMS providers should receive updated training that focuses on prehospital sedation as a deliberate, protocolized procedure, following the model of RSI or ED procedural sedation. While classroom training is helpful, in my experience hands-on simulations are key to helping EMS providers relearn the approach to this important topic.&lt;/p&gt;&lt;p&gt;I'm continuing to focus on this topic, including providing virtual and in-person training at agencies and EMS conferences across the country. Please let me know if you are aware of speaking opportunities that might be appropriate. And please reach out if I can be helpful in any way.&lt;/p&gt;
</description>

We’re joined by Eric Jaeger who digs into the science of why people die in custody. We discuss tragic cases, define best practices, and review the medications used to treat severe agitation.

Eric Jaeger on Deaths in Custody

For more on this topic check out <a href="https://www.youtube.com/watch?v=muK3WwrztNk&t=2s" target="_blank">Dr. Jeff Nusbaum’s talk here</a>.

<description>&lt;p&gt;For more on this topic check out &lt;a href="https://www.youtube.com/watch?v=muK3WwrztNk&amp;t=2s" target="_blank"&gt;Dr. Jeff Nusbaum’s talk here&lt;/a&gt;.&lt;/p&gt;
</description>

We’re joined by Dr. Johanna Innes from Buffalo for a deep dive into her research on post arrival cardiac arrests.




Preventing Cardiac Arrest

<a href="https://www.montgomerycountymd.gov/frs-ql/Resources/Files/swsj/cpg/2023-04.pdf">IV Nitroglycerin CPG</a><a href="https://www.montgomerycountymd.gov/frs-ql/Resources/Files/swsj/cpg/2023-03.pdf">IV Pump CPG</a>

<description>&lt;p&gt;&lt;a href="https://www.montgomerycountymd.gov/frs-ql/Resources/Files/swsj/cpg/2023-04.pdf"&gt;IV Nitroglycerin CPG&lt;/a&gt;&lt;/p&gt;&lt;p&gt;&lt;a href="https://www.montgomerycountymd.gov/frs-ql/Resources/Files/swsj/cpg/2023-03.pdf"&gt;IV Pump CPG&lt;/a&gt;&lt;/p&gt;&lt;p&gt; &lt;/p&gt;
</description>

Digging into recent Clinical Practice Guidelines, LT Will Tipton and FP Lexi Tiemann review treatment of SCAPE and talk about the use of IV pumps

SCAPE Treatment and IV Pumps

We explore hot topics centered on prehospital care of the critically ill and traumatically injured.

Hot Topics in EMS

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