WashU EMS Physicians

04/18/2026

Is your medical director ready to get geared up and help on a complex rescue or rope assignment? Ours are!

What happens when a patient is trapped, crushed, or needs a limb amputated to save their life?

That’s when medicine meets technical rescue - and it’s exactly what our WashU EMS team trained for this week.

Huge applause to EMS Faculty and Fellowship Program Director Dr. James Li and Emergency Medicine resident Dr. Robertson for leading an incredible week of sessions that combined complex medical care with high-angle and confined space rescue operations. Scenarios included field amputation of a trapped patient and management of crush syndrome - two of the most technically and clinically demanding situations a prehospital team can face.

Managing a critically ill patient while coordinating a rescue on a chaotic scene is no small task. Our teams demonstrated the full spectrum: compassionate patient care, clinical decision-making under pressure, and the technical expertise to get the patient out.

A massive thank you to our fire service partners who made this possible:
🚒 Professional Firefighters of Brentwood MO
🚒 City of Clayton Fire Department
🚒 Richmond Heights, MO Fire Department
🚒 Shrewsbury Missouri Fire Department
🚒 Webster Groves Fire Department

And to every WashU EMS physician, fellow, emergency medicine resident, and medical student who showed up to train, learn, and sharpen their skills - this is what interdisciplinary prehospital medicine looks like.

Proud of this team. 💪🔦

04/14/2026

04/14/2026

🔍 What happens when someone is injured miles from the nearest road?

WashU EMS Physician faculty Drs. Tan, Siegler, and DeFilippo spent the day deep in the Missouri woods training alongside the Medical Specialists of the St. Louis Metro Urban Search and Rescue Task Force - preparing together for complex missions.

Lost hikers. Complex trauma. Remote medical emergencies. All in terrain where no ambulance can reach.

When disaster strikes, this team deploys. Our WashU EMS physicians serve as Medical Team Managers on the task force, working side by side with highly trained paramedic Medical Specialists who are the backbone of the medical element in the field. Together, this team is available 24/7/365 - packed and ready to go wherever called.

Today’s training at Busch Conservation Area covered wilderness search and rescue, evidence-based snakebite management, environmental emergencies, wilderness wound care, and austere patient packaging and transport - all culminating in a full-scale field simulation. Find the patient. Assess and treat with only what you carried in on your back. Package and extract through rugged terrain as a team.

Proud to train and serve alongside this crew. 💪🔦

Thank you to our partners at St. Charles County Ambulance District for hosting us!

04/10/2026

🔥 What does an EMS physician do at a fire scene?

WashU EMS faculty Dr. DeFilippo was out with Monarch Fire Protection District today during live fire training.
At larger fires and prolonged rescue scenes, on-scene medical direction brings a physician right to where the risk is highest:

🩺 Patient and responder care - real-time medical treatment for injured or burned patients, civilians, and responders; plus physician-level medical and surgical care delivered right on the fireground

💨 Scene rehab oversight - monitoring firefighters and other responders for heat illness, cardiac events, smoke exposure, and exertion injuries as they rotate out of the hot zone

📡 On-scene medical decision-making and coordination - consultation that doesn’t wait for a radio patch or hospital callback; direct physician-to-physician communication to streamline transport decisions and receiving facility preparation for mass casualty events

⚙️ Operational medical guidance - advising incident command on rehab cycling, exposure limits, and go/no-go decisions when responder safety is in question

Having an EMS physician train alongside crews also pays dividends beyond the classroom. It builds familiarity with scene operations in real time; how companies move, how command structures function, and how multiple agencies work together on a complex scene. True integration doesn’t happen over a radio or in a conference room. It happens on the fireground.

The fireground is a team effort. On-scene medical direction is one more tool in the toolbox; keeping responders healthy, supporting clinical decision-making in real time, and making sure no one falls through the cracks on a long scene.

04/08/2026

🚨 New publication alert from WashU EMS! 🚨

How do we best monitor a septic shock patient during critical care transport?

EMS faculty Dr. James Li and Dr. Michael DeFilippo, alongside WashU EM physician and former flight physician Dr. Aaron Lacy, have a new review article out today in Air Medical Journal that helps answer that question!

Beyond Lactate: Real-Time Resuscitation Targets for Septic Shock During Critical Care Transport

Lactate has earned its place in sepsis resuscitation. But anyone who has managed a septic patient during an interfacility transport knows the limitations - you often can't get serial values, clearance lags behind hemodynamic changes, and a single number doesn't capture the full clinical picture.

This review examines the evidence behind real-time, bedside resuscitation targets that transport clinicians can apply right now - including capillary refill time, individualized MAP goals, and dynamic clinical assessment - and how they complement (not replace) lactate trending.

The bottom line for EMS and critical care transport clinicians: resuscitation is a process, not a lab value. The best monitoring tool on a transport is structured clinical reassessment over time.

Open access - free to read.

https://doi.org/10.1016/j.amj.2026.03.048

04/03/2026

This morning our EMS faculty, alongside our friends at West County EMS & Fire, trained our EMS physician fellows and emergency medicine resident physicians on physician integration during vehicle extrication and complex trauma care.

Topics included scene positioning, coordinating with fire/rescue during active extrication, medical decision-making around extrication timing, and patient packaging for transport.

When an EMS physician arrives on scene, they should know how to add value without disrupting rescue operations. Thank you to Chiefs Sadtler and Grassmuck for their excellent teaching, and for inviting us to train with you!

This is what prehospital medicine looks like. 🔥🚑