EMSAC 2024

Jul 26, 2025

Explore military-inspired trauma protocols like rapid hemorrhage control, vital for saving lives in prehospital settings. Discover the innovative prolonged field care model, designed for delayed evacuations in rural areas. Learn about the transformative STAR Program, pairing paramedics with social workers to tackle behavioral health crises without police intervention. Dive into the impressive outcomes of ECMO in cardiac arrest cases and gain insights on recognizing human trafficking in healthcare, rounding off with essential training resources for responders.

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INSIGHT

Prehospital Bleeding Is The Biggest Killer

Most trauma deaths happen before hospital arrival and are largely due to bleeding.
Early hemorrhage control and timely transfusion are the biggest opportunities to save lives.

INSIGHT

Time To Intervention Determines Benefit

Timing matters: interventions delivered too late won't save patients.
The military found a ~30-minute window where transfusion improves survival; later transfusion often shows no benefit.

ADVICE

Train For Prolonged Field Care

Teach prolonged field care skills for delayed evacuation environments.
Adapt military austere-care guidelines to rural civilian EMS through focused training programs.

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Contributors:

Col. (Dr.) Stacy Shackelford Dr. Sean Keenan Paramedic Alan Moreland Dr. Chris Tems Kara Napolitano

From military-inspired trauma protocols to behavioral health alternatives and cardiac resuscitation, EMS is evolving fast. Our Medical Minutes from EMSAC highlight the growing need for prehospital providers to think critically, act quickly, and adapt to new approaches in trauma, crisis response, and patient advocacy.

Educational Pearls:

What was covered & recorded at EMSAC 2024 by EMM?

Col. (Dr.) Stacy Shackelford, U.S. Air Force trauma surgeon and Director of the Joint Trauma System, emphasized the critical importance of early hemorrhage control and timely transfusions in prehospital trauma care. She highlighted military studies showing that interventions within 30 minutes can dramatically increase survival, underscoring the value of rapid response and frontline readiness.

Dr. Sean Keenan, retired Army emergency physician and EMS doctor, introduced the concept of prolonged field care—managing critically injured patients in environments where evacuation is delayed. He discussed how this model, developed in the military, is now being taught to civilian EMS providers in rural areas.

Paramedic Alan Moreland from Denver's STAR Program (Support Team Assisted Response) explained how alternative response teams, pairing paramedics with clinical social workers, are reshaping how we respond to behavioral health emergencies, reducing reliance on police or ambulance transport and focusing on trauma-informed care.

Dr. Chris Tems, an emergency physician working with ECMO (extracorporeal membrane oxygenation), shared data on using ECMO for refractory cardiac arrest. With a survival rate of 87.5% in select emergency department cases, he highlighted ECMO's growing role in cardiac resuscitation for patients not responding to CPR.

Kara Napolitano, of the Laboratory to Combat Human Trafficking, outlined the role EMS plays in recognizing human trafficking. She offered key indicators to look for and encouraged providers to stay alert to the signs of exploitation, emphasizing EMS's role in early intervention.

Recorded by: Steven Fujaros, Brian Parga, & Ahmed Abdel-Hafiz Summarized by: Steven Fujaros