Emergency Medical Services

Aeromedicine

Stanford Life Flight is Northern California's premier flight and critical care transport program.

​­Stanford Life Flight is Northern California's premier flight and critical care transport program. The elite crew and pilots respond to 911 calls as well as interfacility transports. They have over a 200­mile flight radius that spans from the Oregon/California border in the North, to Reno, Nevada in the East, and as far south as Santa Barbara. They also serve the central valley and central coast regions of California. Stanford Life Flight is the only academic hospital­based flight program in California and the fellows will spend a minimum number of days flying along with the crew and will be able to participate in continuous quality improvement,. Research, and simulation education sessions with the flight program. 

Biosecurity

​This course looks at the US and Global Healthcare Systems ability to withstand a bioterrorism attack

Preeminent faculty from across the country comes to lecture on this very important topic. Exploring how Ebola, anthrax, MERS, pandemic influenza, and Zika outbreaks fit within this context. Steps to prevent a bioterrorism attack and ways to improve the national, state, and local BioSecurity, Pandemic, or Bioterrorism Response. The EMS fellows will learn how the healthcare field, government and technology sectors are involved in biosecurity and bioterrorism response, how these sectors interface, and the multidisciplinary challenges involved.

Biostatistics

​­ Stanford Biostatistics is a leader in the development of standards for high­throughput processing and analysis of data.

From the human genome and proteome, as well as developing more efficient methodologies for running clinical trials. Our students and scholars benefit from interdisciplinary collaborations with the shared faculty of Stanford's #1 ranked graduate programs in many fields: — statistics, computer science, biological sciences, medicine, genetics, genomics and bioinformatics.

EMS Calendar

List of activities and events for EMS

Cardiology

The EMS Fellowship combines the clinical experience of an academic Emergency Medicine Department and a Cardiovascular Medicine Division at Stanford University Hospital.

The EMS Fellowship combines the clinical experience of a preeminent academic Emergency Medicine Department and a nationally renowned Cardiovascular Medicine Division at Stanford University Hospital. Couple this with the robust STEMI system of both Santa Clara and San Mateo Counties with a specific focus and interest in Out­of­Hospital Cardiac Arrest and it becomes clear that EMS fellows will be at the forefront of education, research, and discovery.

County EMS

Fellows will get the opportunity to work with leaders and visionaries in the field of EMS.

Fellows will get the opportunity to work with leaders and visionaries in the field of EMS. The old adage, “Once you have seen one EMS system, you have seen one EMS system” is particularly true when selecting a fellowship. The EMS Fellowship recognizes the different challenges inherent to practicing in different settings resulting in exposing the fellows to 3 vastly different EMS Systems. This compare and contrast model has been an inherent and essential part of the fellows education in order to produce stellar medical directors that are able to plan and troubleshoot any challenge. 

RURAL – Joe Ryan
SUBURBAN – Gregory Gilbert
URBAN – Ken Miller

Critical Care

Training for the fellows consists of learning from a comprehensive group of attending physicians from both Anesthesiology, Pulmonary Medicine and Emergency Medicine.

The Division of Critical Care Medicine (CCM) is a team of outstanding clinicians, scientists, and scholars dedicated to improving the lives of patients with life­threatening illnesses requiring intensive care. The EMS fellows also works with the highly specialized critical transport teams from Lucille Packard Children's Hospital including Pediatric ICU, Neonatal ICU, and Obstetric Departments. Fellows learn valuable skills when providing care during the transport of these ill patients from outlying hospitals to our preeminent tertiary care facility.

Disaster Planning

Stanford is world renown for their disaster preparedness, response, and care in this area.  

Stanford is world renown for their disaster preparedness, response, and care in this area. When a disaster strikes, Stanford has answered the call. Whether it be Haiti, the Philippines, New Orleans, or right in our own backyard with Asiana Flight 214, the elite team of physicians, nurses, and pharmacists provide top­notch care in less than ideal circumstances. Specialized training occurs through SEMPER, which helps the team prepare to deploy at a moment’s notice. In addition, American Medical Response (AMR) responds and handles over a dozen Mass Casualty Incidents (MCI) per year in San Mateo County. Training in this area is rounded out with Urban Search and Rescue (USAR), Incident Command System (ICS), tabletop exercises, simulations, and disaster planning.

Education

The fellowship offers the fellows the opportunity to educate all levels of providers, from EMTs to paramedics to critical care nurses.

​The fellowship offers the fellows the opportunity to educate all levels of providers, from first responders, EMTs and paramedics to critical care nurses. The fellowship works closely with StEMS, a student first response group that goes through an EMT course while being a undergraduate or graduate student at Stanford. Stanford students are intelligent and take initiative with their learning. Teaching them EMT skills and knowledge provides the perfect building blocks for teaching paramedics. This includes teaching seasoned paramedics in San Mateo County as well as new paramedics in the WestMed Paramedic School. Once this is mastered, fellows have the opportunity to teach flight nurses, critical care nurses, and residents. 

Epidemiology

Our students and scholars benefit from interdisciplinary collaborations with the shared faculty of Stanford's #1 ranked graduate programs in many fields.

​Stanford Epidemiology is a leader in the following areas — cancer epidemiology, infectious disease epidemiology, neuroepidemiology, cardiovascular disease epidemiology, musculoskeletal disease epidemiology, and epidemiologic methods, as well as aspects of genetic epidemiology, reproductive epidemiology and women's health. Our students and scholars benefit from interdisciplinary collaborations with the shared faculty of Stanford's #1 ranked graduate programs in many fields — statistics, computer science, biological sciences, medicine, genetics, genomics and bioinformatics.

Fellowship

The Stanford EMS Fellowship is one of the premier EMS Fellowships in the country having started in 1984.

Started in 1984, the Stanford EMS Fellowship is recognized as one of the premier EMS Fellowships in the country. The Fellowship Director has combined all of the elements seen here on this page to cover the different facets that make up the Emergency Medical Services fellowship. During your year as a fellow you will get a preeminent education in EMS with a full­spectrum curriculum consisting of many unique international and operational components. Our program offers a wide range of clinical, research, and administrative opportunities and includes both ground and air medical transport training. The faculty has varied areas of focus allowing the fellows to explore different facets of out­of­hospital care. The Stanford EMS fellowship also offers significant experiences in tactical EMS, fire/rescue operations, wilderness and expedition medicine, event medicine, critical care interfacility transport and international EMS.

Forensics

The Stanford EMS Fellowship works in conjunction with a preeminent Tactical Emergency Medical Services (TEMS) team in San Mateo County.

The Stanford EMS Fellowship works in conjunction with a preeminent Tactical Emergency Medical Services (TEMS) team in San Mateo County. They work closely with sheriff, local law enforcement, and cover law enforcement for neighboring counties, and also work with the federal government agencies the DEA, FBI, and CIA.

The EMS Fellows are also exposed to "Best in the West" competition which challenges SWAT teams West of the Mississippi with events, including a jungle trail course, sniper course, physical, etc.

The fellows also work with the Stanford Criminal Justice Center and the County Coroner to round out their forensic training. By the end of the fellowship, he will be able to work with a TEMS team, learn how to enter a crime scene, preserve evidence, and protect against contamination and destruction of forensic evidence.

Hazardous Materials and Mass Exposure to Toxins

Stanford developed a novel way to deal with pandemic influenza. It is no wonder that physicians at Stanford were sought out to help plan and develop Ebola care and treatment from the airport to the hospital.

Stanford and San Mateo Counties were the preeminent leaders in prehospital and hospital care of these patients. The EMS Fellows will also have exposure to HAZMAT, OSHA First Responder, and HAZWOPER courses to round out their education and practice setting up the decontamination area outside the Stanford Emergency Department.

Stanford EM International

​­ Emergency Medicine Faculty at Stanford are actively involved in a number of projects including EMS development, emergency medicine education, rural health initiatives.

​­ Emergency Medicine Faculty at Stanford are actively involved in a number of projects including EMS development, emergency medicine education, rural health initiatives, and trauma system development working in partnership with local governments, NGOs, private organizations, and international aid agencies (USAID, WHO, UNFPA, etc.) Stanford Emergency Medicine International and the global health fellowship program focus on human development through education, emergency care systems strengthening, and research.

Mass Gatherings

A minimum EMS Plan standard for any major event is the ability to provide on-site CPR and being able to rapidly access the 911 System.

​­ A minimum EMS Plan standard for any major event combines the ability to provide on­site CPR with rapid access to the 911 System. Education in this field is through direct hands on training and reviewing of event proposals. StEMS (Stanford EMS) is a student group of EMTs who staff and work closely with Stanford Public Safety at these Mass Gatherings. In addition, the EMS fellows work closely with RockMED, a preeminent volunteer organization providing medical support at various concerts, 49er football games, and other venues in the Bay Area.

National EMS

​Stanford EMS is influential in how EMS is practiced across the country. Our faculty publishes papers recommending best practices for prehospital care based on a meta­analysis of the current literature.

You will see Stanford EMS presenting at the National Association of EMS Physicians (NAEMSP) national conference in January and showcasing the research we are doing. It is expected that the fellow will attend the (NAEMSP) Medical Directors Course and Practicum and annual meeting. Also the fellow is expected to do a presentation of an academic project at a national emergency medicine or EMS conference (NAEMSP, ACEP, SAEM, AMTC, etc.).

Neurology

Stanford was the premiere Comprehensive Stroke Center in the Country.

San Mateo County developed the first tiered Stroke EMS System and employed the first “Drip and Ship” model in California for Stroke patients with large vessel occlusions. The Stanford EMS fellowship has also evaluated improving the tool used to identify strokes and distinguishing them from mimics and San Mateo EMS continues to be the leader in stroke care by working on developing a telemedicine setup to further provide the best care to stroke patients.

Pediatrics

Stanford is affiliated with the US News and World Reports highly ranked Lucile Packard Children’s Hospital.

They provide elite critical care transport teams that specialize in Neonatal, Pediatric, and Obstetrical emergencies. Stanford Pediatric Emergency Department also serves as the Base Station for Pediatric Cases and provides outreach to paramedics via simulator training and education. In addition, they are verified by the American College of Surgeons as a Level I Trauma Center and provide exemplary care.

Pharmacology

The fellow gets to evaluate the feasibility and affordability of various medications used in the prehospital setting. 

Drugs available in the prehospital setting are limited because of cost, space constraints, and storage issues. The fellow gets to evaluate the feasibility and affordability of various medications used in the prehospital setting. With the help of Stanford’s preeminent pharmacy team, drugs can be added or removed from the formulary. In addition, medications need to go through a State Level Scope of Practice Committee before they can be used. Other advances seen in San Mateo are the pediatric drug card which allows paramedics to use the Broselow tape to determine accurate drug doses efficiently.

Psychiatry

Our partners have years of experience developing a wide variety of treatment, educational and ingenious services for those psychiatric patients they serve.

Stanford has a large public outreach component to their psychiatry department. By integrating community engagement strategies throughout the department’s efforts, they create opportunities for co­learning and collaboration within departments, across Stanford University, and beyond. Our partners have years of experience developing a wide variety of treatment, educational and ingenious services for those psychiatric patients they serve. Community engagement effectively aligns the mission of the department with the surrounding area, our nation and the world thereby reinforcing opportunities for partnership for decades to come.

Public Health

Stanford University and the two neighboring county Public Health Offices work closely with one another to monitor disease rates.

Getting a Master of Public Health (MPH) degree is a great way to expand your understanding of local, national and international health challenges. Schools of public health across the country offer public health programs with an international health focus, and physicians and medical students can generally complete the degree requirements within one year.

Pulmonary Medicine

Stanford has the The Center for Excellence in Pulmonary Biology, which unites three major programs - Pulmonary Medicine and Cystic Fibrosis, Asthma, and Critical Care Medicine

Stanford has the The Center for Excellence in Pulmonary Biology, which unites three major programs ­­ Pulmonary Medicine and Cystic Fibrosis, Asthma, and Critical Care Medicine ­­ to create a multidisciplinary synergy that takes advantage of Stanford's world­class expertise in biology, chemistry and other fields. The Center is committed to broaden its strong base of general pediatric pulmonary medicine and to enhance its ongoing interdisciplinary collaborations with the hospital, community and EMS.

Research

Dr.Govindarajan research goals are to strength the prehospital link in the stroke chain of survival and improve treatment rates for acute ischemic stroke patients through evidence based prehospital interventions.

She has a broad background in prehospital care and research methodology with specific expertise in systems of care for stroke/ diagnostic accuracy of prehospital stroke care. She studied prehospital diagnostic accuracy of stroke and factors associated with low performance in prehospital setting. Following her initial work on understanding the prehospital recognition of stroke, she received a career development award to study the impact of using a prehospital bypass protocol to primary stroke centers in multiple counties in Northern California. In addition, Govindarajan has received 3 intramural grants through Clinical and Translational Science Institute and 2 extramural grants from the American Heart/Stroke Association Western States affiliate program to test technology based interventions to improve prehospital recognition and notification of stroke. Dr.Govindarajan is strongly committed to improving prehospital care of stroke patients through research.

Resident Opportunities

Residents have the opportunity to explore and do all of the activities listed on this page. 

Common ones that residents choose are educating EMTs and paramedics, ambulance ride alongs and fly alongs, working football games and concerts, research, and traveling internationally to help set up EMS systems. They also have a two week rotation and typically attend meetings, work in the prehospital setting, and learn about EMS through didactic sessions.

Resuscitation

Stanford, and all the other hospitals in San Mateo County, submit data to the Cardiac Arrest Registry to Enhance Survival (CARES) database. 

This allows the EMS Fellow to assess the needs of the prehospital system and monitor patient outcomes from their cardiac arrest to discharge from the hospital and what their neurologic status is. San Mateo County’s preeminence in this aspect of EMS allows them to view the intubation, via video laryngoscopy, and review the compressions via code stat software that is on all of the monitors.

Sports Medicine

Stanford EMS Fellows have the opportunity to work as the airway doctor on the San Francisco 49ers sideline.  

Stanford EMS Fellows have the opportunity to work alongside staff as the airway doctor on the San Francisco 49ers sideline. They also work the Stanford Cardinal Football games with the StEMS crew and care for NCAA Division I Athletes of Stanford University at the Lacob Family Sports Medicine Center, a state­of­the­art multidisciplinary facility with a medical clinic, digital X­ray, rehabilitation suite, and Human Performance Lab staffed with physicians, physical therapists, and sports scientists.

State EMS

This is an opportunity to work at the State level with Howard Backer, MD, MPH, FACEP. 

Dr. Backer is the Director of the California Emergency Medical Services Authority (EMSA) where he leads the department in establishing and enforcing standards for EMS personnel, coordinating with local EMS systems, overseeing the development of statewide care systems, and preparing for and responding to disasters. There are also quarterly Emergency Medical Directors Association of California (EMDAC) meetings where the 32 local EMS agencies (LEMSA) Medical Directors meet to discuss issues occurring in the different agencies and concerns that need to be addressed or met.

StEMS

The Stanford Emergency Medical Service (StEMS) is a student group of certified EMT-Basics that provide standby medical service to the students, faculty, and community at campus events. 

StEMS operates under the oversight of the Stanford University Department of Public Safety (SUDPS). SUDPS provides sponsorship for StEMS and Dr. Gilbert is their medical director. StEMS provides standby medical services for many campus events, including athletic events such as football, and social events, such as campus­wide parties. When requested for an event, the number of teams required is determined in advance. StEMS teams consist of at least two EMT­1 each, and are stationed throughout the event to provide medical assessment and treatment as needed. StEMS as a whole provides non­transport BLS (basic life support) and if necessary can work together with ALS (advanced life support) to provide the best level of care to our patients. Each team carries oxygen and an AED, in addition to trauma equipment, and is able to provide full BLS service to anyone in need.

Tactical EMS

This requires special training and working with local law enforcement. It does require some rigorous training and using a fire arm.  

“Docs with Glocks” – This requires special training and working with local law enforcement. Dr. Lemieux will work with interested residents and fellows and help get them the training needed so they can be a medical director for a Tactical Emergency Medical Service (TEMS) team. It does require some rigorous training and using a fire arm.

Toxicology

​Stanford has preeminent faculty and experts for envenomation, snakebites, and other toxicologic emergencies

Stanford is also located near the California Call Center located in San Francisco where the Fellow has the opportunity to take calls from the call center and receive didactic education from an on­line database to round out his education.

Trauma Surgery

Stanford Health Care became a trauma center in 1986, and since 1998 has been recognized as a Level I Trauma Center, the highest level awarded by the American College of Surgeons.

The Stanford Trauma Center incorporates the adjoining Lucile Packard Children's Hospital, where children under 17 are admitted after stabilization in the Emergency Department (ED) or operating room (OR). Stanford provides specialized care to over 2,500 trauma patients per year. We receive patients from many outlying counties in addition to interfacility transports of patients who need Stanford's expertise. Patients are transported directly to our facility by paramedics and flight crews, such as Stanford's Life Flight, Reach and CalStar.

Wilderness

Stanford is the preeminent training location for wilderness medicine physicians. Many of the faculty at Stanford are Wilderness experts and lecture regularly on the topic at national and international meetings.

Dr. Auerbach is the author of the Wilderness Medicine textbook and considered the father of Wilderness Medicine. The fellow and residents have the opportunity to hear didactic lectures and participate in hands on events like Burning Man or Race the Planets.