the

medicine

 

 

First responders in ambulance

department of clinical services

The goal of MCHD's Department of Clinical Services (DCS) is to provide a consistent and superior system of emergency and non-emergency services to our community and provide support for our employees through leadership and professional development. 

The DCS and Quality team employ the following tools to improve MCHD’s success:

  • Analysis of all reports related to strokes, cardiac events, and trauma
  • Regular attendance at local emergency department meetings to foster clear lines of communication and quality improvement
  • Regular case reviews with emergency department personnel and paramedics
  • Studies on the implementation and effectiveness of best practices
  • Published research papers

the mchd paramedic podcast

The MCHD Paramedic Podcast is ranked in the Top 80 Apple Science podcasts, worldwide. Dr. Casey Patrick and Dr. Mike DePasquale do an incredible job taking complex topics and transforming the material into relatable educational content. 

Check it out!

recent mchd clinical publications

Peer Reviewed

Lindow, D., Everitt, B., Smith, N., Wells, M., Dickson, R., & Patrick, C. (2026). Prehospital Cold-Water Immersion for Undifferentiated Heat Stroke: A Case Series. Clinical Practice and Cases in Emergency Medicine. http://dx.doi.org/10.5811/cpcem.61684. Retrieved from https://escholarship.org/uc/item/72j8r9s4

Stallings C, Crocker K, Wells M, Smith N, Patrick C. Tylenol or Toradol? IV acetaminophen vs. parenteral ketorolac for prehospital analgesia. 2025  

Patrick C, Crocker K, Ward B, Seek J, Smith N, Wells M, Gage CB, Powell JR, Panchal AR, Dickson R. Delays in chest compressions during out-of-hospital cardiac arrest: carotid versus subxiphoid point-of-care ultrasound. Resuscitation. 2026 Feb;219:110953. doi: 10.1016/j.resuscitation.2025.110953. Epub 2025 Dec 30. PMID: 41478585.

Gordon V, Jones J, Ward B, Patrick C. Prehospital Diagnosis of Acute ST-Elevation Myocardial Infarction in a Patient with Situs Inversus Totalis. Prehosp Emerg Care. 2026;30(4):557-560. doi: 10.1080/10903127.2025.2506183. Epub 2025 Jul 18. PMID: 40388457.

Patrick C. According to Which Criteria Should a Return EMS Trip of Long Duration and Distance Be Deemed Ethically Justifiable? AMA J Ethics. 2025 Jul 1;27(7):E491-496. English, Spanish. doi: 10.1001/amajethics.2025.491. PMID: 40590934.

Lulla A, Dickson R, Wells M, Gilbert M, Rogers Keene K, Patrick C. Prehospital Surgical Cricothyrotomy in a Ground-Based 9-1-1 EMS System: A Retrospective Review. Prehosp Disaster Med. 2024 Apr 23:1-4. doi: 10.1017/S1049023X24000311. Epub ahead of print. PMID: 38651343.

McArthur R, Cash RE, Rafique Z, Dickson R, Crocker K, Crowe RP, Wells M, Chu K, Nguyen J, Patrick C. Intravenous Acetaminophen Versus Ketorolac for Prehospital Analgesia: A Retrospective Data Review. J Emerg Med. 2024 May 3:S0736-4679(24)00137-9. doi: 10.1016/j.jemermed.2024.04.007. Epub ahead of print. PMID: 39030089.

Patrick C, Fornage L, Ward B, Wells M, Crocker K, Rogers Keene K, Andrabi S, Dickson R. Safety of prehospital intravenous bolus dose nitroglycerin in patients with acute pulmonary edema: A 4-year review. J Am Coll Emerg Physicians Open. 2023 Dec 8;4(6):e13079. doi: 10.1002/emp2.13079. PMID: 38073706

Patrick C, Crowe RP, Ward B, Mohammed A, Keene KR, Dickson R. Feasibility of prehospital esmolol for refractory ventricular fibrillation. J Am Coll Emerg Physicians Open. 2022 Apr 9;3(2):e12700. doi: 10.1002/emp2.12700. PMID: 35425942; PMCID: PMC8994138.

McArthur R, Rafique Z, Ward B, Rodriguez L, Dickson R, Patrick C. Treatment of Presumed Hyperkalemia in the Prehospital Setting. Prehosp Disaster Med. 2022 Oct;37(5):693-697. doi: 10.1017/S1049023X22001091. Epub 2022 Aug 4. PMID: 35924713.

Edward C. Jauch, Lee H. Schwamm, Peter D. Panagos, Jolene Barbazzeni, Robert Dickson, Robert Dunne, Jenevra Foley, Justin F. Fraser, Geoffrey Lassers, Christian Martin-Gill, Suzanne O’Brien, Mark Pinchalk, Shyam Prabhakaran, Christopher T. Richards, Peter Taillac, Albert W. Tsai, Anil Yallapragada, and on behalf of the Prehospital Stroke System of Care Consensus Conference. Recommendations for Regional Stroke Destination Plans in Rural, Suburban, and Urban Communities From the Prehospital Stroke System of Care Consensus Conference: A Consensus Statement From the American Academy of Neurology, American Heart Association/American Stroke Association, American Society of Neuroradiology, National Association of EMS Physicians, National Association of State EMS Officials, Society of Neuro-Interventional Surgery, and Society of Vascular and Interventional Neurology: Endorsed by the Neurocritical Care Society: Originally published 11 Mar 2021

Powell M, Ward B, Dickson R, Patrick C (2021). Prehospital Sinus Node Dysfunction and Asystole in a Previously Healthy Patient with COVID-19. Prehospital Emergency Care. May 3:1-4.

Rebecca E. Cash, Ph.D., MPH, Remle P. Crowe, Ph.D., Scott A. Goldberg, MD, MPH, Casey Patrick, MD, L. Michael Wells-Whitworth, BS, LP, Laura K. Barger, Ph.D.; Carlos A. Camargo, Jr., MD, DrPH. Association between sleep characteristics, ideal cardiovascular health, and systemic inflammation, NHANES 2017-2018.  Journal of Sleep Research. (In Press 2021)

Professional Publications

Winter Comes to Texas Cover Story EMS World Magazine July 2021

Article Bite #30: What Is the Incidence of Awakeness during Paralysis Following Mechanical Ventilation in the ED – NAEMSP Educational Blog EMS-MED March 2021, Casey Patrick

Article Bite #32: 12-Leads After ROSC: It’s All In The Timing – NAEMSP Educational Blog EMS-MED March 2021 Brad Ward and Casey Patrick

IV Nitrates for Acute Hypertensive Pulmonary Edema-A Three-Year Review