EMS Clinical Brief
Claim This Podcastby Maia Dorsett
Podcast Overview
<p><i>EMS Clinical Brief</i> is a focused, evidence-driven podcast that translates the science of emergency medicine into practical decision-making for prehospital clinicians. The series explores how evidence, clinical expertise, patient values, and system design intersect in real-world EMS care. Episodes emphasize patient-centered approaches, clinical judgment, and quality improvement—moving beyond protocols to examine how and why we make decisions in the field, and how those decisions shape outcomes.</p>
Language
🇺🇲
Publishing Since
4/22/2026
1 verified contact email on file for EMS Clinical Brief
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Recent Episodes
July 27, 2026
Ep4: Goal-Concordant Care in EMS
<p>In this episode of the EMS Clinical Brief, host Maia Dorsett interviews Amelia Breyre, an emergency physician, EMS physician, and EMS Medical Director for the City and County of San Francisco who is nationally recognized for her expertise in prehospital palliative care and advance care planning. Together they explore how EMS clinicians can provide goal-concordant care by understanding advance care planning documents, including advance directives, health care proxies, and POLST/MOLST forms. They discuss how to interpret these documents, distinguish legal documents from actionable medical orders, navigate challenging situations involving limited interventions, and develop practical communication skills to clarify patient goals before initiating invasive treatments. The episode emphasizes that one of EMS's most important roles is not simply delivering medical interventions, but ensuring that the care provided aligns with what the patient would have wanted.</p><p></p><p>References:</p><p>1.Breyre, A. M., Sporer, K. A., Davenport, G., Isaacs, E., & Glomb, N. W. (2022). Paramedic use of the Physician Order for Life-Sustaining Treatment (POLST) for medical intervention and transportation decisions. <i>BMC Emergency Medicine</i>, <i>22</i>(1), 145.</p><p>2. Breyre, A. M., Merkle-Scotland, E. J., Yang, D. H., Hanson, K., Jagani, S., Tolkoff, A., & Gunaga, S. (2025). Do not resuscitate (DNR) emergency medical services (EMS) protocol variation in the United States. <i>The American journal of emergency medicine</i>.</p><p>3.Breyre, Amelia M., Haley Vertelney, Karl A. Sporer, Glen Davenport, Eric D. Issacs, and Nicolaus W. Glomb. "Emergency medical service interpretation of Physician Orders for Life‐Sustaining Treatment (POLST) in cardiopulmonary arrest." <i>Journal of the American College of Emergency Physicians Open</i> 3, no. 2 (2022): e12705.</p>
June 22, 2026
Ep3: ALS to BLS Downgrades - Who Rides In?
<p>Dispatch systems are designed to get the right resources to the scene based on limited information, but the dispatch determinant is only the beginning of the patient assessment. Because dispatch decisions must be made before EMS arrives, some patients receive ALS resources that ultimately are not needed, while others may require a higher level of care than initially recognized. As a result, determining the appropriate level of transport depends on the assessment performed at the patient's side—not the dispatch determinant alone. In this episode, Maia Dorsett is joined by Roger Stone, Ben Kaufman, and Jeremy Cushman to discuss how EMS clinicians and systems can determine whether a patient requires ALS transport or can be safely transported by a BLS crew. Drawing on Montgomery County's pioneering work in developing and validating an ALS downgrade process, the panel explores common pitfalls, the importance of thorough assessment, strategies to avoid missed diagnoses, and the role of structured decision-making in improving patient safety while making the best use of limited ALS resources. Whether you are an EMT, paramedic, educator, quality leader, or medical director, this conversation offers practical insights into building systems that support consistent, patient-centered transport decisions.</p><p></p><p><b>Resources:</b></p><p><a rel="noopener noreferrer nofollow" href="https://drive.google.com/drive/folders/1a-mQ-Z9oupmw87e9HA3ANv0hUtbs4eUS?usp=sharing" target="_blank">Montgomery County Resources: Checklist, posters, presentations</a></p><p><a rel="noopener noreferrer nofollow" href="https://www.mlrems.org/wp-content/uploads/2026/04/Advisory-26-07-Determining-the-Appropriate-Level-of-EMS-Clinician-for-Patient-Transport.pdf" target="_blank">Monroe-Livingston policy on<b> </b>Determining the Appropriate Level of EMS Clinician for Patient Transport</a></p><p></p><p>Free CAPCE credit for CME available at Prodigy EMS for this episode until July 31st: <a rel="noopener noreferrer nofollow" href="https://frontend.prodigyems.com/class/CDB94B9A-6A2F-4DFD-A91F-C6F270700826?tab=overview" target="_blank">https://frontend.prodigyems.com/class/CDB94B9A-6A2F-4DFD-A91F-C6F270700826?tab=overview</a></p>
May 28, 2026
Ep2: Prehospital Pain Management for Older Adults
<p>What happens when we fail to treat pain early in older adults? What unique considerations arise when managing pain in geriatric patients in the prehospital setting? In this episode of EMS Clinical Brief, Dr. Maia Dorsett is joined by Dr. Tony Rosen, Dr. Aaron Farney, and paramedic Kevin Gustina for a thoughtful conversation about prehospital pain management in older adults, particularly after falls and hip fractures. The discussion explores how untreated pain contributes to delirium, physiologic stress, and downstream complications, while also examining the cultural and operational barriers that often lead to under-treatment in EMS. Through practical examples and a discussion of a regional quality improvement initiative, the episode highlights how small changes in assessment and treatment can meaningfully improve patient outcomes. This is a clinically grounded and deeply human conversation about one of the most common yet overlooked aspects of EMS care.</p><p></p><p><b>Learning Objectives:</b></p><p>By the end of this episode, listeners should be able to:</p><ol><li>Describe the physiologic and clinical consequences of untreated acute pain in older adults, including the relationship between pain and delirium.</li><li>Discuss unique considerations in geriatric pain management, including altered pharmacology, dementia, multimodal analgesia, and age-adjusted opioid dosing.</li><li>Identify operational, cultural, and systems-based barriers to effective prehospital pain management and strategies to improve care for older adults with suspected hip fractures.</li></ol><p></p><p><b>Resources:</b></p><p>MLREMS Suspected Isolated Hip Fracture Care Bundle: <a rel="noopener noreferrer nofollow" href="https://www.mlrems.org/wp-content/uploads/2026/04/Care-Bundle-Suspected-Isolated-Geriatric-Hip-Fracture.pdf" target="_blank">https://www.mlrems.org/wp-content/uploads/2026/04/Care-Bundle-Suspected-Isolated-Geriatric-Hip-Fracture.pdf</a></p><p></p><p>CAPCE credit for this episode available for members of Prodigy EMS: <a rel="noopener noreferrer nofollow" href="https://frontend.prodigyems.com/class/E95419B8-E766-4FF2-B6AE-587EA3C2927C?tab=overview" target="_blank">https://frontend.prodigyems.com/class/E95419B8-E766-4FF2-B6AE-587EA3C2927C?tab=overview</a></p><p></p><p><b>References:</b></p><ol><li>Thompson, C., Brienza, V. J., Sandre, A., Caine, S., Borgundvaag, B., & McLeod, S. (2018). Risk factors associated with acute in-hospital delirium for patients diagnosed with a hip fracture in the emergency department. Canadian Journal of Emergency Medicine, 20(6), 911-919.</li><li>Morrison, R. S., Magaziner, J., Gilbert, M., Koval, K. J., McLaughlin, M. A., Orosz, G., ... & Siu, A. L. (2003). Relationship between pain and opioid analgesics on the development of delirium following hip fracture. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 58(1), M76-M81.</li><li>De Simone, B., Chouillard, E., Podda, M., Pararas, N., de Carvalho Duarte, G., Fugazzola, P., ... & Catena, F. (2024). The 2023 WSES guidelines on the management of trauma in elderly and frail patients. World journal of emergency surgery, 19(1), 18.</li><li>McGuire, S. S., Brown, C. S., Palmer, A. K., Jeffery, M. M., Mullan, A. F., Stanich, J. A., ... & Bellolio, F. (2026). The Downstream Effects of Prehospital Opioid Dosing in Older Adults: A Retrospective Cohort Study. Academic Emergency Medicine, 33(4), e70294.</li><li>Hughes, J. A., Alexander, K. E., Spencer, L., & Yates, P. (2021). Factors associated with time to first analgesic medication in the emergency department. Journal of Clinical Nursing, 30(13-14), 1973-1989.</li></ol>
4 total episodes available
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Frequently asked questions
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- What is EMS Clinical Brief?
<p><i>EMS Clinical Brief</i> is a focused, evidence-driven podcast that translates the science of emergency medicine into practical decision-making for prehospital clinicians. The series explores how evidence, clinical expertise, patient values, and system design intersect in real-world EMS care. Episodes emphasize patient-centered approaches, clinical judgment, and quality improvement—moving beyond protocols to examine how and why we make decisions in the field, and how those decisions shape outcomes.</p> - How often does this podcast release new episodes?
This podcast updates daily.
- Where can I listen to this podcast?
This podcast is available on 4 platforms including Apple Podcasts, Spotify, and more. You can also use the RSS feed directly.
- Does this podcast accept guests?
Yes, this podcast regularly features guests.
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