Division of EMS & Disaster Preparedness

Emergency Medical Services - Prehospital Care

Mount Sinai EMS operates 19 ambulances in the New York City 911 EMS system (7 Advanced Life Support and 12 Basic Life Support units), that operate 24 hours a day, 7 days a week, and respond to nearly 70,000 calls per year. Mount Sinai EMS aims to ensure that all our patients receive unrivaled, innovative, compassionate, and efficient mobile health care services. With over 200 paramedics and EMTs, our EMS provides care across Manhattan, Brooklyn and Queens in neighborhoods close to Mount Sinai Hospitals. Mount Sinai Emergency and EMS-boarded physicians from the Division of EMS and Disaster Preparedness provide medical direction and oversight for our EMS service. Additionally, we participate on the New York City Regional EMS Advisory Committee to develop city-wide EMS protocols, promote quality initiatives in the region, and lead with innovative clinical research and implementation projects including the NYC S-LAMS Stroke System of Care and more.

Disaster Preparedness and Health System Readiness

The EMS and Disaster Preparedness Division leads Department of Emergency Medicine disaster preparedness and response efforts that include policies and procedures, education and training and clinical guidance to operational departmental leaders. The division provides clinical support and guidance to the Mount Sinai Health System Emergency Management. Our program, aligned with health system and hospital efforts, is dedicated to providing emergency medical response during mass casualty and public health emergencies.

The Center for Healthcare Readiness at the Mount Sinai Health System (https://www.healthcarereadiness.org/) is a key partner to the division. The Center leads cutting edge policy, research, regional collaboration and innovation and aims to improve the resilience of health systems in public health emergencies. Division faculty have leadership roles in this effort.

Faculty work closely with city, state and the Administration for Strategic Preparedness & Response (ASPR) Region agencies to enhance the impact of health systems in the broader public health effort. Mount Sinai Emergency Management participates in the Greater New York Hospital Association’s Emergency Preparedness Coordinating Council and works with the New York City Department of Health and Mental Hygiene and the New York State Department of Health. The program continues to develop partnerships and grant funding to enhance our readiness and training.

The division hosts the Fellowship for Disaster Preparedness and Healthcare Leadership (Add Link) which trains future leaders in disaster preparedness and leadership in the emergency medicine context.

Research

Mount Sinai’s Division of EMS and Disaster Preparedness performs advanced research in EMS quality, disaster triage, and delivery model innovations such as alternative destinations and telehealth-enabled EMS/community paramedicine. We have received significant research funding from the National Institutes of Health, U.S. Department of Transportation, U.S. Department of Homeland Security, U.S. Department of Health and Human Services, the Patient-Centered Research Outcomes Institute, the Center for Medicare and Medicaid Innovation, and a myriad of private foundations.

Our current projects include:

Emergency Triage, Treat, and Transport (ET3): Mount Sinai EMS was selected to participate in a Center for Medicare and Medicaid Innovation demonstration project known as ET3. In this program, selected EMS agencies will participate in a model alternate payment model for ambulance suppliers that reimburses for “treatment in place” and transport to “alternative destinations.” We are working together with Mount Sinai Urgent Care centers, Mount Sinai Express Care, our telehealth service (Mount Sinai NOW), and family medicine clinics (Institute for Family Health) as well as the Fire Department of New York and other 911-participating ambulance units to help reimagine and reinvent how we provide EMS care.

Community Paramedicine for CHF patients: In partnership with New York-Presbyterian, Mount Sinai Community Paramedicine is participating in a multi-center randomized controlled trial funded by the Patient-Centered Outcomes Research Institute to study whether community paramedicine can help reduce readmissions for patients with congestive heart failure.

Benchmarking/Improving EMS Quality: Using data from several national and regional EMS databases, the Division of EMS is working both to define and measure EMS quality metrics locally, regionally, and nationally, and to explore the association of those metrics with patient outcomes in everything from cardiac arrest to stroke and STEMI (ST-Elevation Myocardial Infarction) care.

Impact of COVID on EMS: Our faculty members are helping track and investigate the impact of COVID-19 on EMS provider well-being, EMS transport volumes, use of crisis standards of care, and the volume and treatment of out-of-hospital cardiac arrest.

To learn more about advanced research at Mount Sinai, contact the Division of EMS and Disaster Preparedness at Michael.Redlener@mountsinai.org.

National, State and Local Leadership in EMS

Mount Sinai Division faculty hold leadership positions at a number of important EMS organizations and policy-making councils that impact the care of patients on a broader level.

The National EMS Quality Alliance (NEMSQA)

National Association of EMS Physicians (NAEMSP)

New York State EMS Council (SEMSCO)

NYC Regional Emergency Medical Advisory Committee (REMAC)

American Heart Association Coronary Artery Disease Advisory Committee (AHA CAD)

Resident and Medical Student Education

The Division oversees a number of educational activities for medical students and residents. All residents from both The Mount Sinai Hospital and Mount Sinai West/Morningside residency programs participate in a two-week rotation that offers simulation learning, exposure to the various roles of prehospital health care providers and how protocols are developed. Residents gain a deeper understanding of the EMS system in New York City and throughout the nation, appreciation for the role of online medical control, medical oversight of EMS, exposure to quality improvement efforts in EMS and an opportunity to teach topics in Emergency Medicine to prehospital care providers.

We offer a two-week elective rotation for medical students in their third or fourth year of medical school as well. Availability and dates for the rotation may vary. We also permit visiting students to participate; the Office of the Registrar can provide further details

Community Paramedicine

In partnership with Mount Sinai Health Partners, the Mount Sinai Transfer Center, and SeniorCare EMS, the Division has developed and oversees a model of care known as Community Paramedicine.

The Community Paramedicine program is available 24/7 to help physicians and nurses throughout the Mount Sinai Health System better manage patients with acute symptoms at home. Rather than referring a patient with acute unscheduled needs to the Emergency Department, our clinicians and partner organizations can send a community paramedic, who responds to households anywhere in the five boroughs of New York City within 60 minutes, performs a comprehensive patient assessment, and connects with our Mount Sinai NOW telehealth physicians and the referring provider to coordinate care. The program has helped more than 1,500 patients. It has helped patients avoid transport (68 percent of the time), Emergency Department visits (55 percent of the time), and hospital admissions (17 percent of the time).

To learn more about this service, contact our operations manager at Ari.Breslauer@mountsinai.org

Wilderness Medicine

Within the Division of EMS and Disaster Preparedness exists the Section of Wilderness Medicine. Dedicated to education, training, research, and field-work, the section focuses on patient care, stabilization, and evacuation in remote and austere environments. Within the Mount Sinai Health System, the program prepares medical students, residents, and faculty to respond to medical emergencies regardless of the environment or available resources. Faculty partner with New Jersey Search and Rescue to provide its members with the most up-to-date medical education. The section's mission is to give the community the best medical care possible no matter where it is needed.

Faculty

Michael Redlener, MD, FAEMS
Associate EMS Medical Director, Quality Improvement
Dr. Redlener is an Associate Professor of Emergency Medicine at the Icahn School of Medicine at Mount Sinai. In addition to his title as Division Director, Dr. Redlener serves as the Medical Director of the Mount Sinai West Emergency Department, the Deputy Director of the Center for Healthcare Readiness and the Medical Director for EMS Quality. He received his medical degree from Albert Einstein College of Medicine in the Bronx, New York, then completed a residency program in Emergency Medicine at New York University/Bellevue Hospital followed by a fellowship in Prehospital and Emergency Medical Services (EMS) Medicine with the New York City Fire Department. He is double-board certified in both Emergency Medicine and EMS Medicine.

Dr. Redlener serves as President for the National EMS Quality Alliance and is the former chair of the National Association of EMS Physician (NAEMSP) Quality and Safety Committee, in which he co-founded and co-directs the NAEMSP Quality and Safety Course, a year-long course to introduce EMS physicians and professionals to the tenets of health care improvement science. He sits on the American Heart Association Coronary Artery Disease Advisory Group and serves as the New York City Regional Emergency Medical Advisory Committee as the chair of the Quality Improvement Committee as well as the Stroke Systems of Care group. He sits on the NY State EMS Council as a physician representative.

Erik Blutinger, MD, MSc
Medical Director, Mount Sinai Community Paramedicine
Erik Blutinger, MD, MSc is an emergency physician and public health specialist who aims to improve population health. He is Medical Director to the Community Paramedicine program at Mount Sinai Health Partners (MSHP), now working on a range of projects to introduce more services for improving patient care in the home setting. His efforts aim to improve ED communication and care transitions, patient-reported outcomes for acute care, and telehealth initiatives across the system. He holds the title as Simulation Champion at Mount Sinai Queens hospital and often works clinically in South Dakota for the Indian Health Service (IHS) to better understand comparatively lower resource settings. Dr. Blutinger is a physician leader who has written several peer reviewed publications and newspaper editorials on public health issues including opioid prescribing and COVID disinformation. He currently serves on several national Committees to the American College of Emergency Physicians (ACEP) and the Board of Directors for the 5Boro Institute, a non-partisan think tank convening major stakeholders from business, government, and academia for helping New York City recover from the COVID-19 pandemic.

Ari Breslauer, EMT-P
Program Director, Community Paramedicine
Ari has been in EMS for more than 20 years, starting his career as a volunteer. He has worked in nearly every role in the pre-hospital setting including - EMT, EMT-Intermediate, Paramedic, Field Training Officer, Logistic Coordinator, EMS Supervisor and Operations Manager. For the last few years Ari has been working to build new innovations for care at home which have included building Community Paramedicine/Mobile Integrated Health programs in NYC and Nationally.

Kevin Chason, DO
Medical Director for EMS/Transfer Services

Dr. Kevin Chason is the Medical Director for the Mount Sinai Health System Emergency Management Program. The program is responsible for the preparedness of the health system to respond to emergencies and disasters affecting the communities and patients the health system serves. Dr Chason is the Medical Director for Mount Sinai Hospital EMS which participates in the New York City 911 service under the direction of the Fire Department of the City of New York. Dr Chason also serves as the Chief Medical Officer for the NY-2 Disaster Medical Assistance Team in the United States Department of Health and Human Service's National Disaster Medical System.

Adam Hill, MD
Director, Wilderness Medicine
Dr. Hill is a 2008 graduate of Loyola University Chicago’s Stritch School of Medicine. He completed an internship at Henry Ford Hospital and graduated from the Mount Sinai School of Medicine EM residency in 2012. His interests include Wilderness Medicine, Rural Medicine, and Medical Education. He is a fellow of the Academy of Wilderness Medicine and serves as Director of the medical student elective as well as the Wilderness Medicine specialty track within the Emergency Medicine residency program. He is an Assistant Professor of Emergency Medicine at the Icahn School of Medicine.

Robert Hoke, MD
Associate Director of EMS and Disaster Preparedness, Mount Sinai Morningside and West
Dr. Hoke is an Assistant Professor of Emergency Medicine and an EMS trained physician. Prior to joining the faculty at Mount Sinai Morningside and West, he trained in Emergency Medicine at Maimonides Medical Center and in EMS Medicine at Emory University. He has an interest and focus on large event medicine and in disaster preparedness. Born and raised in New York, he attended medical school at Rutgers New Jersey Medical School.

Laura Iavicoli, MD
Director of EMS and Emergency Management, Elmhurst
Dr. Iavicoli is an emergency medicine physician with expertise in EMS/Emergency Management. In addition to her title as Deputy Chief Medical Director, Dr. Iavicoli served as Senior Assistant Vice President for Emergency Management for NYC Health + Hospitals and is Associate Professor at the Icahn School of Medicine at Mount Sinai in Emergency Medicine. She has been employed at Elmhurst Hospital Center, a teaching affiliate of Mount Sinai, for 20 years, training and teaching emergency and internal medicine residents and medical students in emergency medicine. Dr. Iavicoli serves on numerous hospital committees devoted to EMS and emergency management issues; attended more than 90 specialty seminars and training sessions in emergency preparedness over two decades; and has given more than 80 presentations to hospital staff on a variety of topics including disaster preparedness, terrorism, mass casualties, blast injuries, psychiatric effects, decontamination, and protective equipment. She has been a disaster relief team member for more than 10 years for New York City and Federal Emergency Management Agency.

Jared Kutzin, DNP, MS, MPH, RN
Director of Simulation
Dr. Kutzin is Director of Emergency Medicine Simulation at The Mount Sinai Hospital. He is a registered nurse with advanced degrees in health policy and management, public health, leadership, and medical education. His advanced training includes completing the Clinical Quality Fellowship Program offered by the Greater New York Hospital Association and the United Hospital Fund, and the Comprehensive Patient Safety Leadership Fellowship offered by the National Patient Safety Foundation and American Hospital Association. Dr. Kutzin is certified in health care quality, patient safety, simulation operations, and as a Nurse Executive – Advanced. He sits on the New York State Board of Nursing and the New York State EMS Council and is the lead nursing representative. He is passionate about the use of simulation in EMS education and is helping to advance the profession of EMS at Mount Sinai and throughout the state.

George Loo, DrPH, MPH, MPA
Emergency Management Liaison, Statistician
Dr. Loo is an epidemiologist and an Assistant Professor of both Emergency Medicine and Population Health Science and Policy at the Icahn School of Medicine at Mount Sinai. Prior to joining the faculty at the Icahn School of Medicine, he was on faculty at the State University of New York-Albany School of Public Health as an Assistant Professor of Epidemiology and Biostatistics, and was employed at the New York State Department of Health in the Office of Health Emergency Preparedness. Dr. Loo earned his Doctorate of Public Health in Epidemiology and Master of Public Health in General Public Health from the Columbia Mailman School of Public Health. He completed a Master of Public Administration from the City University of New York-John Jay College and a Bachelor of Arts from State University of New York-Stony Brook. Dr. Loo’s research interests are in emergency medicine/EMS, medical and public health emergency preparedness/response, disaster mental health, and injury epidemiology. He has published in the areas of motor vehicle biomechanics and injury, EMS, emergency medicine, first responder volunteerism/willingness, disaster preparedness, and mental health. Additionally, Dr. Loo concurrently serves on the U.S. Department of Health and Human Services–Office of the Assistant Secretary for Preparedness and Response as a federal emergency manager where he has deployed on response missions in various roles for the NY-2 Disaster Medical Assistance Team and currently for the Incident Management Team-Operations Section.

Jeremy Rose, MD
Site Medical Director for EMS, Mount Sinai Beth Israel
Dr. Rose MD, MPH, FRCPC is an Associate Professor at the Icahn School of Medicine at Mount Sinai and an attending at Mount Sinai Beth Israel. He is the Associate Medical Director of the David B. Kriser Emergency Department at Mount Sinai. In addition to his clinical work, Dr. Rose teaches and lectures both in New York and around the US. His particular areas of interest are sepsis, the cost of healthcare delivery and the economics of US healthcare.

Alexis Zebrowski, PhD, MPH
Director, Emergency Medicine Analytic Core
Dr. Zebrowski is Director of the Emergency Medicine Analytic Core in the Department of Emergency Medicine at the Icahn School of Medicine at Mount Sinai. She received her Doctorate in Epidemiology and Master of Public Health degrees from the University of Pennsylvania. Dr. Zebrowski's research focuses on healthcare sector readiness and uses system science to evaluate innovative solutions to delivery system challenges such as disequilibrium in supply and demand. Additional research had explored development of regional risk models for major metropolitan areas and optimization of resources during surge. In addition to her research work, Dr. Zebrowski leads a team of analysts who develop, manage, and support a large number of complex data initiatives across the department.

Recent Projects and Publications

The Division has produced and contributed to a variety of research projects and publications, both peer-reviewed and not. Selected publications are listed below.

Peer-reviewed publications include:

Garcia H, Springer B, Vengrenyuk A, Krishnamoorthy P, Pineda D, Wasielewski B, Tan WA, D'Amiento A, Bastone J, Barman N, Bander J, Sweeny J, Dangas G, Gidwani U, Vengrenyuk Y, Ezenkwele U, Warshaw A, Kukar A, Chason K, Redlener M, Bai M, Siller J, Kini AS. Deploying a novel custom mobile application for STEMI activation and transfer in a large healthcare system to improve cross-team workflow. STEMIcathAID implementation project. Am Heart J. 2022 Jun 30;253:30-38. doi: 10.1016/j.ahj.2022.06.008. Epub ahead of print. PMID: 35779584.

Vithalani V, Sondheim S, Cornelius A, Gonzales J, Mercer MP, Burton B, Redlener M. Quality Management of Prehospital Airway Programs: An NAEMSP Position Statement and Resource Document. Prehosp Emerg Care. 2022;26(sup1):14-22. doi: 10.1080/10903127.2021.1989530. PMID: 35001828.

Kutzin JM, Sondheim SE, LeDonne S, Louras N, Redlener M, Munjal K. Simulation-Based Orientation for Emergency Medicine Residents Participating in EMS Ride-Alongs. MedEdPORTAL. 2021 Aug 9;17:11170. doi: 10.15766/mep_2374-8265.11170. PMID: 34423123; PMCID: PMC8349972.

Sheth V, Chishti I, Rothman A, Redlener M, Liang J, Pan D, Mathew J. Outcomes of in-hospital cardiac arrest in patients with COVID-19 in New York City. Resuscitation. 2020 Oct;155:3-5. doi: 10.1016/j.resuscitation.2020.07.011. Epub 2020 Jul 21. PMID: 32707146; PMCID: PMC7372263.

Munjal KG, Shastry S, Chapin H, Tan N, Loo G, Chason K. Richardson R. Retrospective Cohort Study of Rates of Return ED Visits Among Patients Transported Home by Ambulance. Journal of Emergency Medicine. 2020 Jun 16;(20):30373-5. PMID 32561107.

Kutzin, J. (2019). Escape the Room: Innovative Approach to Medical Education. Journal of Nursing Education. 58(8). 474-480.

Cicero MX, Whitfill T, Walsh B, Diaz MCG, Arteaga GM, Scherzer DJ, Goldberg SA, Madhok M, Bowen A, Paesano G, Redlener M, Munjal K, Auerbach M. Correlation Between Paramedic Disaster Triage Accuracy in Screen-Based Simulations and Immersive Simulations. Prehospital Emergency Care. 2018 Aug 21:1-7. PMID 30130424.

Cicero M, Whitfill T, Walsh B, Diaz MC, Arteaga G, Scherzer D, Goldberg S, Madhok M, Bowen A, Paesano G, Redlener M, Munjal K, Kessler D, Auerbach M. 60 Seconds to Survival: A Multi-Site Study of a Screen-based Simulation To Improve Prehospital Providers Disaster Triage Skills." Academic Emergency Medicine: Education and Training. 2018 Jan 31;2(2):100-106. PMID 30051076

Redlener M, Olivieri P, Loo G, Munjal KG, Hilton MT, Potkin K, Levy MK, Rabrich J, Gunderson M, Braithwaite S, “National Assessment of Quality Programs in EMS” Prehosp Emerg Care. May/June 2018. Vol 22/3: 370-378.

Cicero MX, Whitfill T, Munjal K, Madhok M, Diaz MCG, Schwerzer D, Walsh B, Bowen A, Redlener M, Goldberg S, Symons N, Santos J, Kessler D, Barnicle R, Paesano G, Auerbach M. 60 Seconds to Survival: A Pilot Study of a Disaster Triage Video Game For Prehospital Care Providers. American Journal of Disaster Medicine. 2017 Spring;12(2):75-83. PMID 29136270.

Goldberg S, Porat A, Lim N, Sanchez G, Wijeratne S, Strother C, Munjal KG. Quantitative Analysis of the Content of EMS Handoff of Critically Ill and Injured Patients to the Emergency Department. Prehospital Emergency Care. 2017 Jan-Feb;21(1):14-17. PMID 27420753.

Non-peer reviewed publications include:

Dorsett M, Redlener M, Braithwaite S (2019). Quality in EMS, Past, Present, and Future, Journal of Emergency Medical Services, March 29, 2019. https://www.jems.com/articles/2019/03/quality-in-ems-past-present-and-future.html

Munjal KG, Margolis G, Kellermann A. Realignment of EMS Reimbursement Policy: New Hope for Patient-Centered Out-of-Hospital Care. Journal of the American Medical Association. 2019 Jun 21; 322(4):302-304. PMID 31225862.

Kutzin, J. (2019). Escape the Room: Innovative Approach to Medical Education. Journal of Nursing Education. 58(8). 474-480.

Non-peer reviewed publications include:

Munjal KG. “Is Emergency Triage, Treat, and Transport the Future of EMS?” Emergency Physicians Monthly, March 3, 2020. Available at: https://epmonthly.com/article/is-emergency-triage-treat-and-transport-the-future-of-ems/

Yu Y, Rodriguez E, Munjal KG. “Journey to 2050: Creating a Culture of Innovation.” EMS World, Nov 27, 2019. Available at: https://www.emsworld.com/article/1223571/journey-2050-creating-culture-innovation.

Health Care Innovation Awards – Emergency Medical Services Learning Collaborative. HCIA: Emergency Medical Services Report. HCIA Connect. January 2019.

Zavadsky M, Munjal KG. “Promoting Innovation in EMS Column” EMS World, Aug-Nov 2018.

“What We’ve Learned.” November 29, 2018
“Business Acumen - Putting It All Together” Oct 26th, 2018.
“The Cost of Innovation.” September 27,, 2018.
“Revenue Analysis.” August 29, 2018.
“Get to Know Value and Cost.” August 1, 2018.

Munjal KG. “Value Them Like Firefighters.” The Chief Leader, March 12, 2018.

In addition, our Division staff serves on the National Association of EMTs – EMS 3.0 Committee. The Mobile Integrated Healthcare and Community Paramedicine Second National Survey. Clinton, MS. National Association of EMTs. April 2018. (Member of EMS Pictures: https://www.dropbox.com/sh/5kvugxrinvx447q/AADpA31nbM6CXUQ9B9BP9f_Sa?dl=3.0 Committee.