Welcome: The University of Arizona Department of Emergency Medicine (DEM) is pleased to offer subspecialty services in the area of Emergency Medical Services (EMS) as well as MCI/Disaster preparedness and response. Throughout its history, the department has been a leader in EMS both at a local and state level, as well as at the national and international levels. The physicians, nurses, and paramedics of the DEM are proud to work with multiple outstanding local EMS agencies to provide medical direction for the majority of patients receiving medical care in Southern Arizona.
Clinical EMS: The DEM provides clinical EMS medical direction/oversight across a broad spectrum of EMS operational environments. In addition to medical direction services, our ABEM board-certified EMS physicians also provide physician level field response services for EMS agencies and other contracted organizations.
Our partners:
- Administrative Medical Direction services
- Arizona Ambulance
- Golder Ranch Fire District
- Mesa Fire & Medical Department
- Northwest Fire District
- Peoria Fire & Medical Department
- Tucson Fire Department
- Base Hospital Medical Direction services
- Banner - University Medical Center Tucson Base Hospital
- Arizona State Parks
- Arivaca Fire Department
- Asarco BLS Units
- Helmet Peak Fire
- Elephant Head Fire
- Nogales Fire Department
- Patagonia Fire/Rescue
- Picture Rocks Fire/EMS
- Rural Pinal County
- Rio Rico/Nogales Suburban
- Sonoita-Elgin Fire District
- Tubac Fire District
- Banner - University Medical Center South Base Hospital
- Arizona Air National Guard, 162nd Wing Fire/EMS
- AMR BLS units
- Mammoth Fire District
- Mount Lemmon Fire Department
- Oracle Fire Department
- South Tucson Fire/EMS
- San Manuel Fire
- Securitas Rescue
- Tucson Airport Authority Fire/EMS
- Banner - University Medical Center Tucson Base Hospital
EMS Education: The DEM offers educational opportunities for EMS providers, University of Arizona students, Emergency Medicine residents, and EMS fellows.
EMS Research: The DEM has been and continues to be a national leader in the areas of out-of-hospital cardiac arrest, traumatic brain injury, and many other areas of out-of-hospital medical care. Current research initiatives include: AzREADI, Pedi-DOSE, and the Arizona Leave Behind Narcan Initiative.
Disaster Preparedness & Response: The DEM offers MCI/Disaster and HAZMAT training and educational opportunities.
EMS Communications & Helipad Safety
- Helicopter landing path coordinates:
- N 32.14.50
- W110.56.78
- Helicopter and ground safety routes:
- Helicopter arrival and departure routes
- EMS ambulance access to Emergency Department
- Pad Diagram
- Radio Frequency:
- VHF: transmit (467.975), receive (462.975)
The University of Arizona Department of Emergency Medicine is pleased to provide both independent administrative medical direction and medical oversight of base hospital operations for multiple EMS agencies in southern Arizona. Our faculty are all board certified in Emergency Medicine and several are dual or triple boarded in EMS, pediatrics, or toxicology. Through the expertise of our faculty we are able to offer high level consultative, administrative and clinical EMS services. For more information on the clinical EMS services provided contact any of our EMS faculty. For general inquiries please contact Dr. Josh Gaither at the address listed below.
Banner - UMC Tucson Base Hospital
EMS Communications & Helipad Safety
- Helicopter landing path coordinates:
- N 32.14.50
- W110.56.78
- Helicopter and ground safety routes:
- Helicopter arrival and departure routes
- EMS ambulance access to Emergency Department
- Pad Diagram
- Radio Frequency:
- VHF: transmit (467.975), receive (462.975)
Banner - UMC South Base Hospital
EMS Communications & Helipad Safety
- Helicopter landing path coordinates:
- N 32.17775
- W110.931
- Phone Number:
- Base Hospital Office: 520-894-4141
The Department of Emergency Medicine has been and continues to be a national leader in the areas of out-of-hospital cardiac arrest, traumatic brain injury, and many other areas of out-of-hospital medical care.
Banner - University Medical Center Base Hospitals:
University Campus
Chris Falcon
PO Box 245056, Tucson, AZ 85724-5056
(520) 694-7873 office, (520) 694-2830 fax
Christopher.Falcon@bannerhealth.com
South Campus
Ingrid Hall-Bidegain
(520) 874-4119
Ingrid.Hall-Bidegain@bannerhealth.com
The University of Arizona EMS faculty
- Daniel Spaite, MD
- Joshua Gaither, MD
- Daniel Beskind, MD
- Robert French, MD
- Hans Bradshaw, MD
- Jennifer Smith, MD, PharmD
- Amber Rice, MD
- Andrew Talbert, MD
- Christopher Williams, MD
- David Tidwell, MD
- Gail Bradley, MD
- Mark Truxillo, MD
- Mary Knotts, MD
- Melody Glenn, MD
- Nicola Baker, MD
- Philipp Hannan, MD
- Rachel Munn, DO
- Tyrel Fisher, MD
University EMS Administrative Guidelines
These documents provide evidence-based guidelines and historically proven practices for common pre-hospital scenarios. They require that individual EMS providers use their education, experience, and clinical judgment to perform an independent evaluation of every patient and apply each component of the guideline as needed to optimize patient care. While it is impossible to address every possible variation of disease or traumatic injury, these off-line policies, procedures, and protocols offer a foundation for treating most patients we encounter. Certainly, our education, experience, and clinical judgment will assist us as we strive to provide the highest quality pre-hospital patient care.
These Administrative Guidelines have been developed and approved by the University Emergency Medical Services physicians and approved by the Office of the Medical Director for Tucson Fire Department, Northwest Fire District, Golder Ranch Fire District, and the University EMS Physicians Medical Directors. These guidelines are based on the National Association of State EMS Officials Model EMS Clinical Guidelines and modified to include other EMS best practices and statutory requirements specific to the state of Arizona.
Frequently Asked Questions: Emergency Medical Services Administrative Guidelines
The management of a cardiac arrest in trauma differs from the care of medical cardia arrest as the underlying pathophysiology is different. Cardiac arrest caused by severe blunt or penetrating trauma is commonly due to exsanguination or anatomic barriers. Individuals in traumatic arrest often present in PEA and have functional hearts that are impeded by severe blood loss or obstructions, like a pneumothorax or pericardial tamponade. Life-saving interventions such as bleeding control, fluid administration, and needle thoracostomy should be the priority. Ideally, we would replace the lost blood volume with blood products, but we utilize available crystalloids in our region. In contrast, epinephrine is a powerful vasopressor that stimulates the heart to beat faster and causes blood vessels to vasoconstrict; usually, this improves cardiac output, but in a patient with severe blood loss and an already maximally vasoconstricted vasculature, epinephrine has little or no benefit. Instead, prioritize airway support, fluid administration, reversal of suspected pneumothorax with needle decompression, Tranexamic Acid (TXA) administration, and transport to a Level 1 trauma hospital.
The fear of giving epinephrine to a patient experiencing a myocardial infarction is that the effects of the epinephrine will increase the oxygen demand of an already ischemic heart. While this is true, there are situations where the benefits outweigh the risks. We would prefer the use of IV fluids in these patients unless profoundly hypotensive or if there is a contraindication to fluids, such as signs of volume overload. If IV fluids are contraindicated, fail, or if the patient is profoundly hypotensive (SBP <70), then push-dose epinephrine should be considered. While the use of epinephrine may increase myocardial oxygen demand, hypotension results in under-perfused coronary arteries which also worsens myocardial ischemia. This is a situation where there is a potential for harm either way, but we feel the benefit of correcting hypotension likely outweighs the risk of increased cardiac oxygen demand. As such, we do not recommend against the use of push-dose epinephrine in STEMI patients, but instead suggest it be used with caution when fluids have failed or if the hypotension is severe, per the Shock/Crashing Medical Patient AG.
Facilitated intubation is the use of sedative medications to assist in the placement of an advanced airway such as an endotracheal tube. Facilitated intubation is a very high-risk procedure and when performed in the prehospital environment is associated with a doubling of mortality. As intubation is a difficult procedure best done in a controlled environment with multiple backup tools, facilitated intubation is not appropriate in the pre-hospital setting.
This is a very medicolegally complicated issue. As pre-hospital providers in Arizona, you are only required to interpret a signed and valid DNR form on orange paper. If there is no valid DNR physically present, the crew may call for online medical control to discuss request for termination.
No. Although intubating laryngeal mask airways (iLMAs) exist and are fairly successful in enabling intubation (approximately 80% success rate), data on the use of iGels in this fashion is not yet established in patients. Studies are ongoing in this application of iGels.
The 2025 medical cardiac arrest guidelines were updated to include early administration of amiodarone in patients with Ventricular Tachycardia (VTach) and Ventricular Fibrillation (VFib) and to delay the administration of epinephrine in these patients as epinephrine can potentiate these shockable rhythms.If, on your first look, the patient is in VTach or VFib, you should defibrillate, give amiodarone, and delay giving epinephrine until the third shock. If on your next rhythm check, you encounter Pulseless Electrical Activity (PEA) or Asystole, then the strategy should be switched, and epinephrine should be given immediately. You may end up switching back and forth between epinephrine and amiodarone depending on the changes in the patient’s rhythm.
All patients with capacity have the right to make their own medical decisions, whether it is in their best interest or not. When a patient is incapacitated or is unable to express their wishes, then Arizona follows a hierarchy of surrogate decision makers: the first is the patient’s designated medical power of attorney, followed by a spouse, then child or children’s consensus, then parent, then domestic partner, then sibling, and then close friend. In circumstances where capacity is uncertain, we encourage you to contact medical control.
A surrogate decision maker cannot make medical decisions on behalf of the patient when the patient has the capacity to make their own decisions.Similarly, the surrogate should not be signing refusal documentation for patients with capacity to make their own medical decisions.
We do not have a preference in cardiac monitor pad placement. We recommend placing pads in the configuration recommended by the defibrillator and pad manufacturer.
The second dose, 150mg of Amiodarone, should be given if a patient is not successfully cardioverted after 4 attempts or 8 minutes after the first dose.
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