Bryan Fleischman
High Acuity. Low Resources. Real-World Medicine.
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Bryan Fleischman is a residency-trained, board-certified Physician Associate (PA) practicing emergency medicine in a rural critical access hospital in New Hampshire while also serving as a firefighter-paramedic. His background includes high-volume 911 response and critical care transport in New York City and Long Island during the COVID-19 pandemic. He has additional experience in outpatient and mobile anesthesiology, with a focus on advanced airway management, particularly in pediatric patients. Bryan serves as an Adjunct Assistant Professor at the Emory University School of Medicine and mentors MD and PA students through the Emory Farmworker Project in rural South Georgia, delivering medical care to underserved communities with extremely limited access to healthcare. He remains actively involved in EMS education as an ALS preceptor and regularly lectures within his fire department and at state and national EMS, Wildland EMS, and PA conferences.
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Area of Expertise
Too Hot to Handle: Heat Illness in Remote Environments
Heat-related emergencies are increasingly common and extend far beyond wilderness treks. Patients collapse at athletic events, construction sites, firegrounds, disaster shelters, rural farms, and city sidewalks when heat overwhelms human physiology. This session reviews the recognition and management of heat illness, from mild exhaustion to life-threatening heat stroke, in both resource-rich and resource-limited contexts. Case-driven teaching and evidence-based cooling strategies will equip participants with the skills to intervene effectively, decide when rapid evacuation is essential, and prevent further morbidity. Attendees will leave with actionable tools to manage heat illness wherever it strikes — whether in a crowded stadium, a sweltering fire scene, or a remote hiking trail.
Out of the Blue: Managing Lightning Emergencies
Lightning strikes are sudden, unpredictable, and potentially devastating. This session equips providers with the knowledge and confidence to manage lightning-related injuries across diverse environments — from mountain ridges and open fields to urban neighborhoods, athletic events, disaster zones, and even the frontline of fire and rescue operations. Participants will learn how to recognize unique injury patterns, prioritize scene safety under continuing storm hazards, and treat life-threatening complications such as cardiac arrest, respiratory failure, and neurologic deficits. Through case-based examples and evidence-based strategies, this session highlights practical interventions that improve survival when a bolt out of the blue turns a routine call into a high-stakes emergency.
Chilled to the Bone: Hypothermia in the Field
Cold-weather emergencies are among the most challenging situations for providers, and hypothermia is not confined to the backcountry. Patients can be found in urban alleyways, vehicle crashes, flood disasters, mountain trails, or even post-rescue settings where cold exposure becomes life-threatening. This session focuses on recognition, pathophysiology, and management of hypothermia across these diverse environments. Through case-based discussion and evidence-driven strategies, participants will learn to assess severity, initiate appropriate rewarming, and prevent further heat loss when resources are limited. Attendees will leave with a practical framework to improve outcomes for patients who are cold, vulnerable, and critically ill — no matter the setting.
Nowhere to Go: Essentials of Prolonged Patient Field Care
What happens when evacuation is delayed, transport is unavailable, or resources are hours away? This session covers the essentials of prolonged patient field care, where providers must stabilize, monitor, and manage patients beyond the usual EMS timeline. Using case-driven discussion and real-world examples, participants will learn practical strategies for prioritizing interventions, improvising with limited resources, and making evacuation decisions under pressure. Attendees will leave with a structured, evidence-based framework to improve outcomes in austere, rural, or resource-limited environments.
Control the Bleed, Master the Wound
From roadside trauma to remote rescues, bleeding control in the field can make the difference between life and death. This fast-paced, practical session is built for EMS professionals, remote care providers, and tactical responders operating in unpredictable environments. We’ll break down the latest in prehospital wound care, including proven irrigation techniques, advanced hemostatic agents like chitosan, kaolin, and hydrogels, and field-tested closure methods—sutures, staples, adhesives, and bioactive dressings like medical-grade honey. You’ll also learn when (and how) to use local anesthetics, start antibiotics, and decide between primary and delayed closure. The MARCH algorithm will guide our triage approach. Walk away with tools, techniques, and confidence to manage complex wounds when time, resources, and backup are in short supply.
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