Medical Director

Kristi L. Koenig, MD, FACEP, FIFEM, FAEMS

Kristi L. Koenig, MD, FACEP, FIFEM, FAEMS, Medical Director

The role of the EMS Medical Director is to assure compliance with all State Statutes and Regulations regarding EMS for the County of San Diego's EMS System and all its components.

This includes providing medical direction and management of the EMS system, approving standards, policies, protocols, and procedures. The Medical Director oversees the County's Public Access Defibrillation Program, issues EMT certifications, accredits paramedics to practice in the LEMSA, and authorizes Mobile Intensive Care Nurses.

The Medical Director also integrates with other components of the system by consulting and communicating with the County's Trauma Medical Directors, participating in countywide disaster medical services planning activities, serving in an advisory role to the Public Health Officer and other County leaders regarding EMS issues, and collaborating and communicating with prehospital personnel and community groups.


Evidence-Based Medicine (EBM) Presentations at Base Station Physicians Committee (BSPC)

The CoSD EMS Medical Director initiated a series of EBM presentations at the monthly BSPC meetings.  Please click the links to access the various topics.

May 2024, A Minimalist Guide to Quality Improvement, Kerby Johnson (Video recording here)

March 2024, Measles, Erik Berg, MD, (Video recording here)

February 2024, Prehospital Treatment of Sepsis, Claire Gahm, MD, (Video recording here)

January 2024, Controversies in Prehospital Treatment: What is the Evidence?, Presented by EMS Physicians, (Video recording here)

November 2023, Xylazine in the Illicit Drug Supply: Impact on Overdose Management, William Lynch, MD, (Video recording here)

October 2023, Capnography: Not just for the intubated, Veer Vithalani, MD (Video recording here)

September 2023, California EMS – a historical perspective and emerging challenges for the future, David Duncan, MD (Video recording here)

July 2023, Effects of COVID and Title 42 on the Management of Human Trafficking, Flavio Nominati, Deputy District Attorney (Video recording here)

June 2023, Medicolegal Considerations in Forensic Pathology: Cause and Manner of Death Determinations, Illicit Drugs (fentanyl/xylazine), and More!, Dr. Steven Campman (Video recording here)

May 2023, Prehospital Initiatives to Combat the Opioid Crisis: National and California Perspectives, Gene Hern, MD (Video recording here)  

April 2023, ECPR in San Diego, Zack Shinar, MD (Video recording here)

March 2023, 2023 - 2024 CoSD EMS Protocols - What is the evidence base?

February 2023, Using Cardiac Monitor Data to Improve EMS QA/QI, Veer Vithalani, MD (Video recording here)

January 2023, Are SUPRA-glottic Airways All That Super?, Michelle Safferman, MD (Video recording here)

November 2022, The Golden Hour in TXA, David Duncan, MD and Ian Roberts MD (Video recording here)

October 2022, How Can We Reduce Firearm Injuries and Deaths?, Amy Barnhorst, MD and DA Summer Stephan (Video recording here

September 2022, Pediatric Potpourri: An Old Classic and New Trends, Kelly Motadel, MD (Video recording here)

July 2022, CARES: Cardiac Arrest Registry to Enhance Survival, Brad Schwartz, MD and Angelo Salvucci, MD (Video recording here)

June 2022, Flight Medicine, Christian Sloane, MD (Video recording here)

May 2022, ACS in Women, Lori Daniels, MD (Video recording here)

April 2022, A Review of Prehospital Fluid Resuscitation and an Introduction to USMC’s Valkyrie Course, Saki Kitadai, MD (Video recording here)

March 2022, Ambulance Diversion - Christopher Kahn, MD, MPH, FAEMS (Video recording here)

February 2022, EMS Decision Making Capacity, Jonathan Bar, MD (Video recording here)

January 2022, COVID-19 and the Medical Examiner, Steve Campman, MD, Chief Medical Examiner San Diego County (Video recording here)

July 2021, Strangulation: What Paramedics Need to Know - Gael Strack, J.D., and R. William Worden, D.O., M. Ed.

June 2021, Toward the Way Forward in Managing Risk and Resilience in EMS Clinicians - Merritt "Chip" Schreiber, PhD, Professor of Clinical Pediatrics Harbor-UCLA Medical Center

June 2021, Prehospital Management of Hypotensive Trauma Patients - Walter L. Biffl, MD, Trauma Medical Director (Video recording here)

May 2021, Child Abuse and Neglect Issues - Shalon M. Nienow, MD, FAAP, Medical Director Child Abuse Pediatrics

April 2021, AMA Calls & Decision Capacity - Heidi Hutchinson, MD, UCSD EMS & Disaster Medicine Fellow

January 2020, Prehospital Management of Status Epilepticus - Elan L. Guterman, MD

November 2019, Sepsis in the Prehospital Setting - Gabriel Wardi, MD, MPH, Medical Director

October 2019, Kawasaki Disease in the Prehospital & ED Setting - Adriana Tremoulet, MD, MAS, Associate Director

June 2019, Management of Burn Injuries - Jeanne Lee, MD, FACS, Director

May 2019, San Diego Human Trafficking - Mary Ellen Barrett, DDA & Michelle Shores, RN

Apr 2019, Handing-off a Patient to the Medical Examiner's Office: Details are Important - Steven C. Campman, MD, Chief Deputy Medical Examiner

Mar 2019, Vaccine-Preventable Diseases in San Diego County - Eric McDonald, MD, MPH, FACEP

Feb 2019, Pre-Hospital Care of the Agitated Patient - Lt Amanda Wojahn, MD

Jan 2019, 2018 National EMS Scope of Practice Model - Jenny Farah, MD

Oct 2018, Hanging, Strangulation and Other Forms of Asphyxiation - Steven Campman, MD

Sep 2018, Pediatric Stroke - Tabitha Cheng, MD

Jul 2018, Hand Hygiene and Glove Use - Kim Delahanty, RN, BSN, PHN, MBA/CM, CIC FAPIC

May 2018, Stroke Systems of Care Update 2018 - Thomas Hemmen, MD

Apr 2018, Newly Hatching Concepts From the Eagles - Christopher Kahn, MD

Nov 2017, A Review of Prehospital Pain Management - Jennifer Farah, MD

Oct 2017, City of San Diego 2017 Medical Director Update - James Dunford, MD

Sep 2017, EMD Aspirin Overview - Christopher Kahn, MD

Jul 2017, Left Ventricular Assist Devices in the Community, Suzanne Chillcott BSN, RN

May 2017, Sideline C-Spine Injury - Marcia Faustin, MD

Apr 2017, Active Assailant Response - Kathy Staats, MD