Department of Emergency Medicine

Emergency Medical Services (EMS)

We seek to promote the health and integrity of the EMS system throughout Rhode Island and in surrounding communities.

Breadcrumb

Emergency Medical Services (EMS)

We seek to promote the health and integrity of the EMS system throughout Rhode Island and in surrounding communities.

Mission

The mission of the Division of Emergency Medical Services is to provide exceptional EMS care, education, research, and service to the people of Rhode Island and beyond.

We seek to promote the health and integrity of the EMS system throughout Rhode Island and in surrounding communities.

About

The Division of EMS is one of several Divisions within the Department of Emergency Medicine at Brown. 

Members of the EMS division:

  • Direct the EMS Fellowship
  • Teach EMS to residents and several local PA Schools
    • Preclinical elective and clinical
  • Provide Medical Direction for LifePACT and many other EMS agencies
    • LifePACT
    • Provide EMS medical direction to over 20 agencies across Rhode Island
    • Program letters of agreement
  • Teach EMS students
    • Medical direction to EMS training
    • EMS students of all levels in the ED
  • Provide Medical Direction for the RI Department of Health Center for EMS
  • Care for patients in a variety of EMS environments
  • Research EMS topics and produce academic contributions related to EMS
  • Serve state, regional, national and international EMS committees and organizations.

For more information, please explore our web site or contact us:

Wendy Wesley, EMS Coordinator
(401) 444-2739
55 Claverick St., First Floor
Providence, RI 02903

Faculty/Staff

Division Director

Staff

  • Wilson Pedro, NREMPT

    Operations Coordinator, LifePACT Critical Transport Team and Medical Communications Center, Rhode Island & Hasbro Children's Hospital
    npedro@lifespan.org

  • Patricia Carreiro, BSN, RN

    Clinical Manager, Rhode Island Express Care and Medical Communications Center, Rhode Island & Hasbro Children's Hospital
    pcarreiro@lifespan.org

Faculty Publications

Williams, K. Drive Like Scott: Important Reasons to Embrace Excellent Ambulance Driving.  JEMS, 2019

Choi NG, DiNitto DM, Marti CN, Choi BY. “Alcohol, Injury, and Aging,” In: Kuerbis A, Moore AA, Sacco P, Zanjani F, editors. Alcohol and Aging. Springer, 2016: 97-117.

Choi BY, Blumberg C, Williams K. Mobile Integrated Health Care and Community Paramedicine: An Emerging Emergency Medical Services Concept. Ann Emerg Med, 2016 67(3):361-6. doi: 10.10.1016/j.annemergmed.2015.06.005

Choi NG, DiNitto DM, Marti CN, Choi BY. Associations of Mental Health and Substance Use Disorders with Presenting Problems and Outcomes in Older Adults’ Emergency Department Visits. Acad Emerg Med, 2015 22(11):1316-1326. doi: 10.1111/acem.12803

Choi NG, DiNitto DM, Marti CN, Choi BY. Association of Traffic Injuries, substance Use Disorders, and ED Visit Outcomes among Individuals Aged 50+ Years. J Psychoactive Drugs, 2016, 48(5):369-376. Epub 2016 Oct 17. doi: 10.1080/02791072.2016.1240838

Choi NG, Marti CN, DiNitto DM, Choi BY. Alcohol Abstention, Use and Misuse as Risk Factors for Older Adults’ Emergency Department Visits: A Latent Class Analysis. West J Emerg Med, 2016 16(7), 1146-1158. doi: 10.5811/westjem.2015.9.27704

Choi NG, DiNitto DM, Marti CN, Choi BY. Relationship between Marijuana and Other Illicit Drug Use and Depression/Suicidal Thoughts Among Late Middle-Aged and Older Adults. Int Psychogeriatr, 2016, 28(4), 577-589. doi: 10.1017/S1041610215001738

Choi NG, DiNitto DM, Marti CN, Choi BY. Sociodemographic Characteristics and Health Status of Lifetime Abstainers, Ex-Drinkers, Bingers, and Nonbingers Among Baby Boomers and Older Adults. Subst Use Misuse, 2016 51(5), 637-48. doi: 10.3109/10826084.2015.1133645 

Choi NG, DiNitto DM, Marti CN, Choi BY. Nonsuicidal Self-Injury and Suicide Attempts among ED Patients Aged 50+: Comparison of Risk Factors and ED Visit Outcomes. Am J Emerg Med, 2016 34(6):1016-21. doi: 10.1016/j.ajem.2016.02.058

Choi NG, DiNitto DM, Marti CN, Choi BY. Too Little Sleep and Too Much Sleep Among Older Adults: Associations with Health/Mental Health Status, Health-related Behaviors, and Healthcare Utilization. Geriatrc Gerontol Int, 2016 doi: 10.1111/ggi.12749 [epub ahead of print]

Choi BY, DiNitto DM, Marti CN, Choi NG. Impact of Mental Health and Substance Use Disorders on Emergency Department Visit Outcomes among HIV Patients. Western Journal of Emergency Medicine, 2016 17(2):153-164. doi: 10.5811/westjem.2016.1.28310.

Choi BY, Asselin N, Pettit CC, Machan JT, Merck DL, Merck LH, Suner S, Williams KA, Jay GD, Kobayashi L. Simulation-based Randomized Comparative Assessment of Out-of-Hospital Cardiac Arrest Resuscitation Bundle Completion by Emergency Medical Service Teams using Standard Life Support or an Experimental Automation-Assisted Approach. Simul Healthc, 2015 11(6):365-375. doi: 10.1097/SIH.0000000000000178

Norman C, Mello MJ, Choi BY. Identifying Frequent Users of an Urban Emergency Medical Service Using Descriptive Statistics and Regression Analyses. West J Emerg Med, 2016 17(1):39-45. Doi 10.5811/westjem.2015.10.28508

 

DiNitto DM, Marti CN, Choi NG, Choi BY. Impact of Mental Health and Substance Use Disorders on Emergency Department Visit Outcomes for HIV patients. West J Emerg Med, 2016 17(2):153-64. doi: 10.5811/westjem.2016.1.28310 

Choi N, DiNitto D, Marti N, Choi BY.  "Too Little Sleep and Too Much Sleep Among Older Adults: Associations with Health/Mental Health Status, Health-related Behaviors, and Healthcare Utilization.” Accepted to Geriatrics & Gerontology International 1/4/16.

Williams K, Williams A, Blumen I:  Air Medical Response to Disaster And Multiple Casualty Incidents.  In Principles and Direction of Air Medical Transport, 2nd ed.  Blumen ed., AMPA  2015.

Williams K:  Medical Simulation.  In Principles and Direction of Air Medical Transport,  2nd ed. Blumen ed., AMPA  2015.

Choi N, DiNitto DM, Marti CN, Choi BY. “Sociodemographic characteristics and health status of lifetime abstainers, ex-drinkers, bingers, and nonbingers among baby boomers and older adults.” Accepted Substance Use and Misuse 11/26/15.

Norman C, Choi BY, Mello MJ. “Identifying frequent users of an urban emergency medical service using descriptive statistics and regression analysis.” Accepted to Western Journal of Emergency Medicine 11/1/15.

Choi N, DiNitto DM, Marti CN, Choi BY. “Relationship between Marijuana and Other Illicit Drug Use and Depression/Suicidal Thoughts Among Late Middle-Aged and Older Adults.” Accepted to International Psychogeriatrics 9/24/15.

Choi N, DiNitto D, Marti N, Choi BY. “Alcohol Abstention, Use and Misuse as Risk Factors for Older Adults' Emergency Department Visits: A Latent Class Analysis.” Accepted to Western Journal of Emergency Medicine 9/23/15.

Choi BY, Blumberg C, Williams K. “Mobile Integrated Health Care and Community Paramedicine: An Emerging Emergency Medical Services Concept.” Annals of Emergency Medicine. E-published July 11, 2015.

Choi N, DiNitto, D, Marti N, Choi BY. “Associations of Mental Health and Substance Use Disorders with Presenting Problems and Outcomes in Emergency Department Visits by Older Adults.” Academic Emergency Medicine.Published online October 17, 2015.

 Choi BY, Kobayashi LK, Pathania S, Miller CB, Locke ER, Stearns BC, Hudepohl NJ, Patefield SS, Suner S, Williams KA, Machan JT, Jay GD. “Detection and Measurement of Unhealthy, Environment-Derived Aerosol Materials in an Emergency Department.” Health Environments Research and Design Journal. Accepted April 2015.

Marti CN, Choi NG, DiNitto DM, Choi BY. “Associations of Lifetime Abstention and Past and Current Alcohol Use with Late-Life Mental Health: A Propensity Score Analysis.” Drug and Alcohol Dependence. Accepted February 2015

Suner S. (2015). Assessing and Planning Health Actions during a Crisis. Basic Concepts in Disaster Medicine and Humanitarian Action for Emergency Physicians. Eurasian Journal of Emergency Medicine. (electronic publication in advance of print).

Suner S. History of Disaster Medicine.  Basic Concepts in Disaster Medicine and Humanitarian Action for Emergency Physicians.  Turkish Journal of Emergency Medicine.  2015;15(Suppl. 1):1–4.

Yanturali S, Canacık O , Karslı E, Suner S.  (2015).  Injury and Illness Among Athletes During a Multi-day Elite Cycling Road Race. Phys Sportsmed, 2015; 43 (4): 348–35.

Choi BY, Kobayashi L, Pathania S, Miller CB, Locke E, Stearns, BC, Hudepohl NJ, Patefield SS, Suner S, Williams KA, Machan, JT, JayGD. (2015). Detection and measurement of unhealthy, environment-derived aerosol materials in an emergency department. Herd. [Epub ahead of print].

Asselin N, Choi B, Pettit CC, Dannecker M, Jones MS, Merck L, Suner S,Williams K, Jay GD. Interim Results of Prehospital Provider WorkloadAssessment during Simulation Testing of Experimental Device-Assisted CardiacArrest Resuscitation. International Meeting for Simulation in Healthcare. Societyfor Simulation in Healthcare. New Orleans LA, January 10-14, 2015.

George J, Suner S, Hack J. Carbon Monoxide Levels Induced by CigaretteSmoking Outdoors in Typical Smokers. 2015 ACEP Research Forum. Boston,Massachusetts. October 26 and October 27, 2015.

Rocket Propelled Grenade Attack. Ciottone: Disaster Medicine, 2e, Chapter 165

Tsai D, Choi B, Sullivan F, Williams K.  “Quality Improvement in EMS:  A Unique and Challenging Necessity”  Med Health RI.  2014; 97(8):17-19.

Choi, BY, Tsai D; Gomes McGillivray C, Amedee C, Sarafin J, Silver B. “Hospital-Directed Feedback to Emergency Medical Services Improves Pre-Hospital Performance.” Stroke. Accepted April 2014

Mason RC, Suner S, Williams K. (2013). “An Analysis of Hiker Preparedness: A Survey of Hiker Habits in New Hampshire.”  Wilderness and Environmental Medicine. 2013; 24(3) 221-7.

Williams K, Sullivan F. “Critical Care Transport.”  Med Health RI. 2013;96(12):39-43.

Lauro J, Sullivan F, Williams K. “Emergency Medical Technician Education and Training.”  Med Health RI. 2013;96(12):31-34.

Sullivan F, Williams K, Rhodes J. “An Overview of Prehospital Emergency Medical Services.”  Med Health RI. 2013;96(12):24-27.

Sullivan F, Williams K. “Physician Medical Direction of Emergency Medical Services.”  Med Health RI. 2013;96(12):28-30.

Williams K, Sullivan F. “The Rhode Island Life Saving Score: A Proposed Life-Saving Definition for EMS and Emergency Medicine.”  Med Health RI. 2013;96(12):35-39.

Lauro J. Sullivan F.  Emergency Medical Technician Training. Rhode Island Medical Journal   96 (12) 2013: 31-5.

Sullivan F. Williams K. Physician Medical  Direction of Pre-hospital Emergency Medical Services.  Rhode Island Medical Journal  96 (12) 2013: 28-31.

Sullivan F. Williams K.  Overview of  Emergency Medical Services.  Rhode Island Medical Journal  96 (12)  2013:24-28.

Lauro J, Sullivan,F: Emergency Medical Technician Education and Training. Rhode Island Medical Journal Dec 2013

Williams K:  Disaster Informatics.  In Disaster Medicine, Oxford University Press, 2012

Cornwall, A. H., N. Zaller, Warren O, Williams K, et al. (2012). "A pilot study of emergency medical technicians' field assessment of intoxicated patients' need for ED care." The American Journal of Emergency Medicine 2012 Sept;30(7): 1224-1228.

Wermeling DP, Clinch T, Rudy AC, Dreitlein D, Suner S, LaCouture P.  A multicenter, open-label, dose-ranging trial of intranasal hydromorphone for managing acute pain from traumatic injury. The Journal of Pain. 2010;11(1):24-31.

Oray NC, Basak, B, Yanturali Sedat, Onder L, Suner S.  A potential pitfall in the diagnosis of Renal Colic: Renal Infarction.  American Journal of Emergency Medicine.  2009; 27(6):750-e7-750e9.

Ersoy G, Yanturali S, Atilla R, Aksay E, Karakus NE, Suner S.  Relative’s Perspectives Regarding Family Witnessed Cardiopulmonary Resuscitation.  European Journal of Emergency Medicine.   2009; electronic publication. DOI: 10.1097/MEJ.0b013e328311a8dc.

Lauro JR: Oral abstract presentation: Does Hospital Diversion Status Effect EMS Patient Transfer of Care Time?  Regional SAEM Conference, April 30, 2008, New York City

Jayawardena S, Lauro JR, Eisdorfer J, Indulkar S, Barua A, Sridhar S: Death Within 48 Hours of Admission to the Emergency Department: The value of Autopsy. Americal Journal of Medical Science 2007, August; 334(2): 87-91

Choi, B, Huo MH. “Venous Thromboembolism following total knee replacement.” Journal of Surgical Orthopedic Advances. March 2007;16(1) 31-35.

Robinson K, Suozzi J, Williams K: Air Medical Transport.  In The Medical Student Survival Guide, Emergency Medicine Resident’s Association.  2007.

Williams K, Williams A et al:  Disaster and MCI Response.  In Principles and Direction of Air Medical Transport, AMPA, Blumen, Lemkin eds. Section editors  Brozen, Doyle… Williams  2006.

Kim BJ, Date ES, Park BK, Choi BY, Lee SH. “Physiologic changes of compound muscle action potentials related to voluntary contraction and muscle length in carpal tunnel syndrome.” J Electromyogr Kinesiol. June 2005;15(3):275-81

Sullivan F, Avstrieh D.  Pneumothroax  during CPR training: A Case Report and Review of the Literature.  Prehospital and Disaster Medicine 2000; 72-75.

Education

Fellowships

The Division of Emergency Medicine offers multiple fellowship options:

  • ACGME-approved 1 year EMS Fellowship
  • 2-year combined ACGME EMS Fellowship and Disaster Fellowship (with an MPH through Brown optional)
  • 1 year EMS Fellowship through the Brown Academies in EMS (typically for international applicants)

Fellowship Details

Resident Education

Brown EM residents enjoy two EMS rotation experiences and a number of other EMS options.  

PGY1 residents orient to Rhode Island EMS during their first month of residency with a one-week introductory schedule that includes tours of Rhode Island's 911 Center, the Providence Emergency Management Agency, and USCG Station Castle Hill in Newport, RI.  Didactic and practical sessions provide training in medical control of EMS providers.  Ambulance ride-along experiences with a number of 911 EMS agencies and the LifePACT critical care transport service provide field and EMS communications experience.  ICS and HAZMAT awareness training, including hospital-level decon experience, round out the week.

PGY3 residents rotate in EMS for two weeks, with LifePACT transport physician coverage, tours of the RI Department of Health, 911 EMS agency ride-along, a focused EMS research and teaching project, and discussion sessions scheduled during the rotation.

Starting with the PGY2 year, Brown EM residents are able to provide LifePACT critical care transport physician coverage as a paid-on-call (moonlighting) experience.  During these shifts they are supervised indirectly by EMS faculty and directly care for critically ill or injured patients during transport. 

EMS Electives are popular during residency, and have included extensive 911 ride-along experience, helicopter EMS ride-along, EMS training, research, wilderness EMS, and international EMS projects.

Students

Students from The Warren Alpert Medical School, PA programs, Paramedic programs, pre-med programs and others participate in EMS activities offered by the Division, including: 

  • Mentoring
  • Research and Independent Study Project supervision
  • Training
  • Rotation experiences
  • Electives

Conferences

The Division organizes and sponsors the annual New England EMS Leadership Conference in late November, in cooperation with the New England Council for EMS, bringing together administrative and clinical leadership attendees from EMS programs throughout the area. EMS Fellows from area programs are strongly encouraged to attend and enjoy the networking opportunities.

Conferences

Research

The EMS Division has been involved in a wide range of academic and research projects, from WMD / Disaster response during the RIDI Project to EMS ability to screen/triage intoxicated patients and proposing a definition for saving a life in the EMS environment and Community Paramedicine.

DiNitto D, Marti N, Choi N, Choi BY. “Impact of Mental Health and Substance Use Disorders on Emergency Department Visit Outcomes among Persons Living with HIV.” Submitted to WJEM.

Choi BY, Pedro N, Carreiro P, et. al. “Community Paramedicine Implementation Project.”

Choi BY, Kobayashi L, Petit C, Asselin N, et. al. “Standardized Treatment and Optimal Resuscitation through Mechanical Adjuncts (STORM) Program.”

Choi BY, Kobayashi L, Suner S, Jay G. et. al. “Detection, Measurement and Mitigation of Unhealthy, Environment-Derived Aerosol Materials in an Emergency Department: Preliminary Results from the AETHER2 Study.”  Presented at the Society for Academic Emergency Medicine Annual Meeting, Dallas, TX, May 2014.  Also presented at the SAEM New England Regional Meeting, Springfield, MA, March 2014.

Choi, BY, Tsai D; Gomes McGillivray C, et. al. “Hospital-Directed Feedback to Emergency Medical Services Improves Pre-Hospital Performance.” Presented at the Society for Academic Emergency Medicine Annual Meeting, Dallas, TX, May 2014.  Also presented at the Norman Fain Memorial Stroke Lecture, Providence, RI, November 2014

Choi BY, Kobayashi L, Suner S, Jay G. et. al. “Ambulance Exhaust Toxicity in Healthcare-related Exposure and Risk (AETHER) project.” Presented at the Society for Academic Emergency Medicine Annual Meeting, Chicago, IL, May 2012.  Also presented at the SAEM New England Regional Meeting, Springfield, MA, March 2012.

McGarry J, Choi BY, Huo MH, Jones RE. “Total hip arthroplasty in patients with HIV infection.” Presented at the American Academy of Orthopedic Surgeons Annual Meeting, San Diego, February 2007; Mid-America Orthopedic Association Annual Meeting, Boca Raton, FL, April 2007.

Choi, BY & Oppenheimer, DM “Motivational biases in judgments of streaks in random sequences.” Presented at The 19th Biennial Research Conference on Subjective Probability, Utility, & Decision Making, Zurich, Switzerland, August 2003.

  • 2003 European Association for Decision Making Gold Medal for best poster presentation

Evidence-Based Guidelines for EMS Administration of Naloxone

Rhode Island Disaster Initiative (RIDI)

Improving Disaster Medicine Through Research

  • Disaster Response
  • Disaster Preparation
  • Responder Operations

The Rhode Island Disaster Initiative (RIDI) was a multi-year Emergency Medical Services (EMS) and Emergency Department (ED) disaster response research project spanning 1999-2007. This web archive documents the RIDI Project and resources, including the October 2004 inception of Lifeguard EMS, the Critical Care Transport program at Rhode Island Hospital/Hasbro Children's Hospital, now (after merging with the pediatric transport program) called LifePACT.

RIDI's aim was to identify, develop, and demonstrate best practices in disaster medical response.

RIDI was coordinated by the Department of Emergency Medicine at Brown, involving EMS, Disaster, and Simulation Center faculty alongside multiple partners. Congressional funding enabled the RIDI Project.

Phase I

Senators Jack Reed and Lincoln Chaffee, as well as Representatives Patrick Kennedy and Jim Langevin, helped obtain congressional funding to establish and complete the RIDI project.  The initial RIDI funds were administered by the Department of Health and Human Services, Office of Emergency Preparedness (DHHS-OEP) as the grant agency.  DHHS-OEP contracted with the Chemical Biological Information Analysis Center (CBIAC) to coordinate and accomplish the RIDI Project.  As a RIDI partner providing program management and oversight, the Battelle Memorial Institute administered the CBIAC through federal contract.  RIDI Phase I was funded at $900,000. These funds were used to establish the organization and perform a statewide hazard, vulnerability and risk analysis, to collate current research in disaster management, to reach out to cross-disciplinary experts and begin the definition work for research carried out in Phase II.

Phase II

The second phase of RIDI also received unanimous support from the Rhode Island delegation, with funding at $1.499 million.  Phase II backing flowed through the Department of Defense to the Navy and the Office of Naval Research (ONR).  ONR contracted with CBIAC in a manner similar to Phase I to carry out Phase II of the RIDI project.  The CBIAC contracted with Rhode Island Hospital's Research Administration Office for Phase II.  University Emergency Medicine Foundation (UEMF) physicians continued to run the project.

Phase III

The Rhode Island delegation unanimously supported funding for Phase III at $2 million per year, with two years of funding to total $4 million.  Due to fiscal constraints after the 2001 9/11 terror attacks, Congressional funding was limited to $1.2 million for the remainder of the project. Phase III funding was used to disseminate best practices and research findings through a demonstration project, including design and assembly of a specialized response vehicle (Lifeguard EMS), and conferences for first responders and first receivers.

Rhode Island Disaster Initiative (RIDI)