C. J. Winckler MD, LP provides daily clinical supervision, via on-scene medical direction, online medical direction and performance improvement processes, to more than 1,700 San Antonio Fire Department providers. Winckler implemented a novel clinical clearance process for law enforcement that allows navigation of emergency-detained patients directly to psychiatric facilities. He also led the implementation of a groundbreaking whole blood deployment process and transfusion guideline for patients in hemorrhagic shock on scene, which is the first of its kind for a metropolitan EMS system in the United States.