Dr. Engel is an EMS physician and Deputy Chief Medical Director of Milwaukee County EMS. As Milwaukee County EMS has a high number of trauma patients, Dr. Engel developed a system wide quality network surrounding patients receiving a prehospital needle thoracostomy. This quality plan included the implementation of a landmark device for EMT-Ps within the Milwaukee County system, modern education and guideline development, and novel research on the topic of prehospital needle thoracostomy. Dr. Engel is a local educator and regional lecturer on a variety of EMS topics while also utilizing his education and experience to focus on prehospital system improvement, procedural mastery, and critical care. He has experience lecturing internationally through global health and military medicine engagements. He has served in executive council regional advisory roles throughout Wisconsin.