Pioneering Palliative Protocols: Integrating End-of-Life Care Into Emergency Medical Services Practices (Emergency Medical Services Interest Group and Palliative Medicine Interest Group Sponsored)
"Where high-speed meets high compassion" encapsulates the challenge EMS teams face when providing care to critically ill patients at the end of life. Known for their rapid response and life-saving measures, EMS professionals often encounter unique obstacles when navigating end-of-life care in the prehospital environment. This lecture explores the intersection of Emergency Medical Services and Hospice & Palliative Medicine, examining existing protocols and resources to equip EMS providers with tools to integrate resuscitation efforts with compassionate end-of-life care, ensuring patient-centered treatment. We will explore key literature on the intersection of EMS and palliative care, highlighting findings and recommendations from organizations like the National Association of EMS Physicians and the American Academy of Hospice and Palliative Medicine. Additionally, we will review EMS protocols across different states and major cities to identify gaps and advancements in palliative care integration. Participants will receive a curated set of successful protocols and palliative care resources for EMS providers. The session will also discuss ongoing research and initiatives to enhance care in end-of-life scenarios, leaving attendees with actionable insights to advocate for and refine EMS protocols that balance both survival and quality of life.
Learning Objectives:
- Discuss the current literature, epidemiology, and key recommendations that guide the integration of EMS with hospice and palliative medicine (HPM) at the end of life.
- Analyze existing EMS protocols, identify gaps in hospice and palliative care integration, and propose actionable improvements
- Develop and implement tailored HPM EMS protocols that align with the service capabilities of their local EMS agencies and community needs.
- Advocate effectively for the integration of palliative care principles in EMS training and protocols, utilizing evidence-based strategies to gain stakeholder support.
Presenters:
- Satheesh Gunaga, DO
- Amelia Breyre, MD
- Justin Kenneth Brooten, MD
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Satheesh Gunaga, DO
Henry Ford Wyandotte Hospital & Envision Healthcare
Satheesh Gunaga, DO, is a board-certified emergency medicine physician, educator, administrator, and clinical research scientist. He earned his Bachelor of Science in Psychology from the University of Michigan, Ann Arbor, and his Osteopathic medical degree from Michigan State University College of Osteopathic Medicine. He completed his emergency medicine residency at Henry Ford Health - Wyandotte Hospital.
With over 15 years of experience, Dr. Gunaga has practiced and taught Emergency Medicine within the Henry Ford Health System and Michigan State University. He served ten years as the associate EM residency director before taking on his current roles in 2019 as the Vice Chair of the Department of Emergency Medicine, EM Research Director, and EMS physician medical director at Henry Ford Wyandotte Hospital. He also holds the position of ED Medical Director at Henry Ford Health Center Brownstown.
Dr. Gunaga’s clinical research focuses on the safe transition of care for older adults and the integration of primary and specialized palliative care into the emergency department and prehospital settings. He is currently the chair of the Palliative Medicine Interest Group for the Society for Emergency Medicine, a member of AGEM's Geriatric ED Guidelines 2.0 Working Group, and serves on the board of directors at Compassion and Choices, the nation’s largest nonprofit organization advocating for end-of-life rights and resources. -
Amelia Breyre, MD
City & County of San Francisco
Amelia M. Breyre is an Emergency Medicine and EMS physician. She completed medical school at the University of Pennsylvania, residency at Highland Hospital, and fellows in EMS/Disaster Medicine at UCSF-ZSFGH. She recently started working as the EMS Medical Director for the City & County of San Francisco. She has a research and operational interest in improving end of life care in the out of hospital setting and has published extensively on the topic. -
Justin K. Brooten, MD
Wake Forest University School of Medicine
Dr. Brooten currently serves as an Assistant Professor of Emergency Medicine, and the Associate Program director of the Hospice and Palliative Medicine Fellowship at the Wake Forest School of Medicine. He is dual board certified in Emergency Medicine and Hospice and Palliative Care and has appointments in the Wake Forest School of Medicine, Department of Emergency Medicine and the Department of Internal Medicine, Section on Gerontology and Geriatric Medicine. His research interests and educational endeavors focus on the emergency care of older adults and the early integration of palliative care in emergency medical care settings, including prehospital emergency care. In addition, he is interested in the use of clinical informatics methods and utilizing EMR systems to identify patients at high risk for in hospital mortality, and other patient populations who may benefit from early palliative care interventions. He is the co-founder and CEO of PalliEM.org, a website and podcast with the mission of providing free online medical education resources to clinicians interested in applying palliative care principles and skills in emergency medical settings. He completed his medical training at the Medical College of Georgia/UGA medical partnership, and his residency and fellowship training at the Wake Forest University School of Medicine, in Winston Salem North Carolina. He currently practices emergency medicine in community and academic settings, and is also an inpatient palliative care consultant at Atrium Health, Wake Forest Baptist. He is happy to call the beautiful piedmont region of North Carolina home, where he lives with his wife and two children.