Skip to main content


URMC / Emergency Medicine / Research / Pre-Hospital Medicine

Pre-Hospital Medicine Research

Goals & Description

Emergency Medical Services (EMS) are an essential component of the public health and public safety systems. Historically, EMS practice has been based on hospital practice or perceived best practices from the field. Our research focuses on evidence-based practice for EMS personnel, evaluation of EMS system components and the motivations, decision-making and expertise of the EMS workforce.

Ongoing Projects


EMS Provider Decision-Making - Medical Simulation

Evaluating EMS provider decision-making processes for patients with traumatic brain injury through the use of medical simulation and situational awareness.  Our current work focuses on understanding how EMS providers evaluate injured patients including the application of and adherence to protocols and decision tools and how patient and system factors influence care decisions.

Community Paramedicine - Care Transitions

Evaluating the ability of emergency medical technicians and paramedics to identify older adults with unmet needs.  Our current research focuses on developing and refining a paramedic-coached care transitions programs for older adults discharged home after an emergency department visit.

Injury - Prehospital Care and Risk Stratification

Evaluating the field triage of injured older adults through the use of complimentary study designs and analytic approaches including prospective and retrospective epidemiologic studies, qualitative focus groups, and medical simulation.  Our recent work has focused on optimizing the triage process used by EMS providers through the identification of risk factors and development of age-specific decision tools.

Pediatric Trauma - Risk Stratification

Investigating the field triage of injured pediatric patients through prospective data collection from the perspective of EMS.  Our current work focuses on improving the classification of pediatric mechanisms of injury and identifying risk factors associated with trauma center need and trauma team activation.


Whitley DE, Li TJones CMCCushman JT, Williams DM, Shah MN.  An Assessment of Newly Identified Barriers to and Enablers for Prehospital Pediatric Pain Management.  Pediatric Emergency Care. 2015 In Press. Published Online. DOI: 10.1097/PEC.0000000000000514

Lerner EB, Willenbring BD, Pirrallo RG, Brasel KJ, Cady C, Colella MR, Cooper A, Cushman J, Gourlay D, Jurkovich G, Newgard C, Salomone J, Sasser S, Shah MN, Swor R, Wang S.  A consensus-based criterion standard for trauma center need. Journal of Trauma and Acute Care Surgery.  2014 Apr;76(4):1157-63.

Lerner EB, Roberts J, Guse C, Shah MN, Swor R, Cushman JT, Blatt A, Jurkovich G, Brasel K.  Does EMS-perceived anatomic injury predict trauma center need? Prehosp Emerg Care. 2013;15(4):518-25. NIHMS459716.

Hettinger AZ, Cushman JT, Shah MN, Noyes K.  Emergency medical dispatch codes association with emergency department outcomes.  Prehospital Emergency Care. 2013;17(1):29-37.

Williams DM, Rindal KE, Cushman JT, Shah MN. Barriers and enablers to prehospital analgesia for pediatric patients. Prehospital Emergency Care 2012;16(4):519-26.

Lerner EB, Garrison HG, Nichol G, Maio RF, Lookman HA, Sheahan WD ,Franz TR ,Austad JD, Ginster AM, Spaite DW. An Economic Toolkit for Identifying the Cost of Emergency Medical Services (EMS) Systems: Detailed Methodology of the EMS Cost Analysis Project (EMSCAP) Academic Emergency Medicine 2012;19:1-7.

Archive Publications

Click for more publications


Source Type Description
CDC R01 Study of EMS Findings predictive of Pediatric Trauma Center Need (Multi-Site, MCW Primary)
CDC U01 Field triage of Older Adults Who Experience Brain Injury
NIH/NIA R03 Deriving a Prehospital Triage Decision Scheme for Injured Older Adults
SAEM   Institutional Research Training Grant