Two friends, Philip Metz and Dr. Bobby Lewis, share a common interest in emergency medicine. This interest includes emergency response in the prehospital setting where they have collectively logged in excess of 5,000 patient carries in the life flight setting on both fixed wing and rotary aircraft. This interest extends to all aspects of prehospital emergency medicine with extensive backgrounds in fire and EMS in private and municipal services, including patient care and management responsibilities. Also included is over 40 years’ experience by Dr. Lewis in emergency departments and trauma centers as an emergency medicine physician.




This shared interest extends to education. Together they annually train hundreds of emergency responders at one of NASCAR’s largest racetracks (Talladega Superspeedway), where Dr. Lewis also serves as Medical Director. They have lectured extensively about this experience in a training program they developed, teaching the kinetics of high energy trauma and the injuries associated with such trauma. Both have also been involved, as instructors, in most educational programs offered to prehospital providers.

In a conversation in early 2019, they began discussing their shared experience related to the lack of knowledge on the part of first responders about postmortem interval. More specifically, the lack of recognizing important postmortem changes in the body that leads the decision of whether or not to begin resuscitative efforts. This decision can impact the integrity of evidence on scene when discovering a deceased individual on what could potentially become a crime scene. Their discussions focused on the lack of a set of universal guidelines for how first responders should conduct themselves on a crime scene.

Sensing a tremendous need, they formed the American Institute of Crime Scene Integrity with the objective of developing a set of uniform guidelines for use by first responders and other emergency care providers. The Institute includes professionals from a broad range of disciplines including law enforcement, EMS, fire, crime scene investigation, medical examiner, sexual assault examiner, legal, and others. Their work has led to a comprehensive set of guidelines (AICSI) for use by all first responders and emergency care providers. They have also developed an educational program, and assembled a group of experts, to teach postmortem interval and the guidelines developed and promulgated by the American Institute of Crime Scene Integrity.