Emergency Medicine at MCW

Emergency Response | Ground and Air

Dr. M. Riccardo Colella evaluates first responders during disaster training exercise
Dr. M. Riccardo Colella evaluates first responders during Mitchell Airport's 2017 disaster training exercise.

In addition to collaborating with the Milwaukee County Office of Emergency Management on research, the faculty in the department of emergency medicine's section of EMS and disaster medicine serve as medical directors to the Milwaukee County EMS system, which encompasses first responders in 19 municipalities and 13 fire departments. OEM is the county agency responsible for the EMS system.

"Providing medical direction means we establish the standard of care for our community's EMS practice, which impacts a million people every day," shares M. Riccardo Colella, DO, MPH, section chief of emergency medical services and disaster medicine for MCW's departments of emergency medicine and pediatrics, and medical director for Milwaukee County EMS. "We oversee care delivery, medical control, training, and quality assessment and improvement."

As such, Dr. Colella and his colleagues develop protocols and quality improvement measures to ensure that emergency care is safe, patient-centered and evidence-based. "We layer a lot of safety tools into that process so we can make sure that the care that we deliver in the field has the same level of scrutiny that one would get in the hospital," he says.

"MCW is really instrumental in making sure that the clinical aspect of our training is correct; they're the subject matter experts. And the county relies on that," says Christine Westrich, OEM director.

"Milwaukee County is proud to call MCW its leading partner in EMS services," adds county executive Chris Abele. "OEM's steady focus on quality improvement, while partnering with MCW, is allowing our EMS system to adopt new technologies. Quality prehospital care is advancing like never before in Milwaukee County’s EMS system."

Disaster training at Mitchell Airport

Dr. Colella working with Milwaukee County OEM on training protocols

And the medical direction of MCW's EMS section doesn't stop with ground transportation. Its faculty also provide training and oversight for Flight For Life (FFL), southeastern Wisconsin's only provider of emergency medical transport via helicopter.

FFL runs independently from its three bases (Waukesha and Fond du Lac, Wisconsin, and McHenry, Illinois) and serves hospitals and patients throughout eastern Wisconsin and northern Illinois. As the director of medical services for FFL, Timothy Lenz, MD, EMT-P, assistant professor of emergency medicine, has an important role in the hiring and training of the medical crews (each of which consist of a paramedic and a nurse).

"With FFL, we see the most critically ill patients, so we need have the best of the best flight crews – and they go through extensive testing and training to even get the job," notes Dr. Lenz.

"The emergency medicine partnership between FFL and MCW keeps both organizations on the cutting-edge of providing critical care response and treatment to the communities of southern Wisconsin and northern Illinois," adds Dan Burns, executive director of FFL. "Our partnership includes the training of FFL paramedics and nurses at MCW's STAR Center simulation lab, collaboration on medical research and the invaluable experience MCW emergency medicine residents gain by joining FFL crews in the challenging environment of caring for patients both on-scene and during flights."

Partners such as Milwaukee County and FFL trust MCW in part because of the excellent training its faculty provides to fellow emergency medicine physicians. While the department of emergency medicine has been informally training providers in prehospital emergency care for decades, the American Board of Emergency Medicine (ABEM) only began recognizing EMS as a formal subspecialty of emergency medicine in 2010. Drs. Colella and Liu were among the nation's first American Board of Medical Specialties-recognized EMS physicians, and today, the entire section is either board-certified or board-eligible.

According to the ABEM, the purpose of the EMS subspecialty certification is to "standardize physician training and qualifications for EMS practice, improve patient safety and enhance the quality of emergency medical care provided to patients and populations in the prehospital environment, and facilitate further integration of prehospital patient treatment into the continuum of patient care."

"My predecessor as EMS section chief, [Ronald G. Pirrallo, MD], was the former head of the National Association of EMS Physicians and really helped get the designation for the subspecialty," Dr. Colella says. "My focus has then been on the educational pieces, turning our informal training into an Accreditation Council for Graduate Medical Education-recognized fellowship that offers unparalleled didactic and field experiences for all aspects of EMS."

In addition to the accredited fellowship, the section of EMS and disaster medicine and MCW's office of global health have aligned goals of training the next generation of health leaders to address inequities of care – specifically through access to quality EMS and all its components.

"We're responsible for helping physician leaders from across the world also increase their understanding of EMS," remarks Dr. Colella. "We have been collaborating and training providers for more than 20 years, in countries in Asia, Africa, Central America and Europe."

The section provides both a short-term intensive training program and a longer unaccredited fellowship for licensed global physicians. "Our international physicians bring unique perspectives and challenges from their home countries," notes Dr. Ben Weston, who is the assistant program director of the intensive training program. "But there are also a lot of commonalities in what issues EMS systems face."

The department just got approval for distance-based fellowships, which allow physicians to train even if they can't get to Milwaukee. Faculty currently are using this service to continue their relationships with medical providers in Belize. In 2010, the department began a partnership with the Belize Ministry of Health, titled "Strengthening Emergency Care in Belize," to provide continuing medical and nursing education at its flagship hospital. Currently, one international fellow, Dr. Rigo Montejo, medical director of Belize Emergency Response Team, is participating in lectures and other training from Belize – thanks to distance learning.

 – Anthony Braza  •  Karri Stock

Medical College of Wisconsin…8701 Watertown Plank Rd., Milwaukee, WI 53226
(414) 955-4725  |  Fax: (414) 955-6699  |  MCWmagazine@mcw.edu

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