In this high-impact edition of the EMS One-Stop podcast, host Rob Lawrence sits down with EMS influencer and educator Jimmy Apple, known widely across platforms as The EMS Avenger. With nearly 70,000 followers on TikTok and a growing presence on Instagram and Facebook, Jimmy has mastered the art of compressing complex clinical topics into digestible, engaging content. | More: What the EMS Counts Act means for dual-role EMS providers  In this conversation, Rob pulls back the curtain on the man behind the mobile screen — exploring Jimmy's journey from electrician to pediatric critical care paramedic, and now, one of EMS's most watched and listened-to voices. Listeners will gain deep insight into Jimmy’s origin story, his social media strategies, his refusal to let bad information go unchallenged, and his passionate belief that “Saving lives begins with kindness.” The pair also tackle: Content creation advice for EMS agencies The challenges of tone and accuracy in short-form video How to maintain compassion in the face of a toxic work culture This episode is part masterclass in communication, part call to action for the future of EMS — and all heart. Memorable quotes from Jimmy Apple: The EMS Avenger “Saving lives begins with kindness. That is my motto, it is my philosophy.” “You have to package something down to its bare essence … there's some nuance lost, but you have seconds to keep people's attention.” “My goals going forward are to support people who are acting in good faith while correcting the misinformation.” “Generally speaking, you will draw the engagement that you're looking for. If you're putting out content in good faith, you'll get good faith engagement.” “We are responsible for ourselves and how we respond … and I believe we need to respond to everything that is happening in the world today with kindness.” Episode timeline 00:54 – Rob introduces Jimmy Apple, aka the EMS Avenger 01:20 – Jimmy’s background: from electrician to EMS 03:30 – The grandfather conversation that changed his life 04:50 – How pathophysiology sparked a love for learning 05:40 – Birth of the EMS Avenger: from student favorite to TikTok influencer 06:55 – Ginger Locke’s advice that redirected Jimmy’s podcast path 08:04 – Compressing content: "from textbook to bumper sticker" 10:00 – The content hook: “Are we getting rid of normal saline?” 11:00 – How Jimmy selects topics: research, news, curiosity and requests 13:00 – Hot topics in EMS: cricothyrotomy, TXA, ketamine, provider safety 14:40 – Rob discusses EMSIntel.org and ambulance theft data 16:00 – Can EMS agencies do what Jimmy does? The risks and the realities 18:30 – "Stop the finger": creating content that captures attention 20:00 – Rob on the risks of public messaging and backlash 21:00 – Calling out misinformation: the line between education and shame 23:00 – Jimmy’s growing reach across TikTok, Instagram and Facebook 24:45 – Managing Facebook’s deeper comments and nuanced conversations 26:45 – Jimmy’s rule: “Engage only with good faith” 27:50 – Final thought: EMS must rediscover kindness 29:00 – Closing remarks and where to follow Jimmy Apple online Additional resources Connect with Jimmy Apple, better known as The EMS Avenger: TikTok — Jimmy offers short-form, evidence-based EMS content here: @emsavenger Instagram — Engage with in-depth reels, visuals, and professional updates: @emsavenger X (formerly Twitter) — Follow EMS commentary, conversation, and boosts: @EMSAvenger Facebook — Join the group for discussions and shared insights: EMS Avenger community Apple Podcasts — Listen to “EMS Avenger: 20 Minutes to Save the World”: Weekly podcast series AAA & AIMHI EMS Media Log: EMS Intel Enjoying the show? Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback.

In this special crossover edition of EMS One-Stop and The Bridge Podcast from the Kentucky Office of Rural Health, host Amelia Holliday leads the conversation, joined by Scott Helle, rural project manager at KORH; and Rob Lawrence, host of EMS One-Stop and EMS leader. Recorded live at the 2025 Kentucky EMS Leadership Academy, this episode explores the evolution, design and impact of the Leadership Academy on Kentucky’s rural EMS landscape. The discussion dives into the Academy’s origins, structure, statewide reach and its mission to prepare the next generation of EMS leaders in some of the most resource-challenged communities in the country. From the realities of low-volume, underfunded rural services, to the inspiring stories of leadership growth and resilience, this episode offers a thoughtful examination of the challenges facing EMS in Kentucky and beyond. Rob reflects on leadership principles drawn from his military and EMS career, while Scott provides a blueprint for how to build and sustain EMS talent in small communities. Together with Amelia’s thoughtful moderation, this episode highlights how mentorship, structured learning and network-building are transforming rural EMS leadership — one cohort at a time. Additional resources The Bridge Podcast (Contains additional discussion) Center of Excellence in Rural Health: Established to address health disparities in rural Kentucky Asking the big questions: Industry leaders weigh in on celebrating EMS Week amidst the forces shaping the EMS landscape Cultivating the next generation of EMS: Leadership development, emotional intelligence and the importance of mentorship Memorable quotes “We’re promoting people above their level of competency — not because they’re not good, but because we haven’t prepared them for what’s next.” — Rob Lawrence “We saw early on that EMS professionals were great at clinical care, but we were missing the leadership piece.” — Scott Helle “Effective communication is the core of good leadership. You can’t lead without it.” — Amelia Holliday “My six principles: pride, integrity, learning, humor, service and courage. They guide everything I do.” — Rob Lawrence “It costs money to build people. That’s why we provide this Academy at no cost to participants.” — Scott Helle “It’s hard to run EMS in a state where many counties don’t even have a tax base to support it.” — Scott Helle “You’re always leading. Once you start, it never stops. People are always watching and listening.” — Rob Lawrence “We’re not just building leaders — we’re building mentors, networks and future change-makers.” — Scott Helle “Nobody becomes a good leader because they want power. The best leaders are those who understand the responsibility.” — Amelia Holliday Episode timeline 00:18 – Introduction to the Kentucky Leadership Academy and crossover with The Bridge Podcast 02:29 – How the Academy was formed and why it was needed 05:00 – Structure of the Academy, application process and regional representation 08:11 – EMS 2050, developing next-gen leaders, and avoiding the Peter Principle 11:00 – The importance of non-clinical leadership education 13:36 – Funding challenges in rural EMS, tax base realities and sustainable operations 17:41 – Rural EMS dynamics, local politics and the true cost of readiness 21:25 – Hospital closures and extended transport times — national rural EMS challenges 24:11 – Leadership is constant: visible, energetic and principle-driven 28:14 – Rob’s military leadership values and the weight of being observed 32:35 – Leadership as service and the power of building trust within teams 34:58 – Rob’s group dynamics “icebreaker” exercise and lessons on leadership styles 39:33 – Mentorship benefits both ways: mentees gain confidence, mentors renew purpose 44:49 – Academy success stories and graduates becoming leaders elsewhere in EMS 46:44 – Closing comments and podcast wrap-up with Amelia and Rob Rate and review the EMS One-Stop podcast Enjoying the s

In this episode of the EMS One-Stop podcast, host Rob Lawrence sits down with Danielle Thomas, chief operating officer, Lifeline EMS of Los Angeles, to explore how her team is harnessing “actual intelligence” — through a proprietary, closed-source AI platform called InCheck — to solve a perennial EMS headache: information overload. Thomas explains how embedding agency-specific protocols, an 800-page policy manual and multi-language translation into a single voice-activated app gives every crew member a “mentor in their pocket,” shrinking cognitive load, sharpening clinical decision-making and smoothing onboarding during the critical first 80 hours of employment. | More: From 73 to 33 minutes: How Sacramento reinvented patient offload times  The conversation ranges from her move from Boston to California and the regulatory culture shock that followed, to Lifeline’s recent CAAS accreditation push and the wider potential of AI-driven tools to boost recruitment, retention, compliance and patient safety. In the second half, Rob and Danielle expanded the conversation from tools to leadership strategy, focusing on how EMS agencies can better support staff in high-pressure, multi-jurisdictional environments. Thomas shares how her team tackled issues like protocol confusion, inconsistent policy knowledge and language barriers — not by adding more training sessions, but by rethinking how information is delivered, accessed and retained on the front lines. She emphasizes the importance of aligning education with the way today’s workforce learns, communicates and engages — especially during the critical first days of employment. The episode closes with a preview of Danielle’s upcoming AAA conference presentation with Carly Strong, which challenges perceptions of gender in EMS leadership and spotlights the untapped potential of inclusive, thoughtful organizational development. Memorable quotes “If you can, as the leader in an EMS organization, figure out how to enhance not only that first 80 hours, but that team member experience.” — Danielle Thomas “As everybody listening knows, I'm sure that every new policy probably has somebody's secret name attached to it because of what happened.” — Rob Lawrence “It honestly solves our recruitment and retention issues because they want to come to work.” — Danielle Thomas “I happen to believe that [AI is] an on-the-train or under at the moment kind of thing … we now have to move forward. It's part of our life. We have to embrace it and we have to employ it.” — Rob Lawrence “The left coast is more highly regulated and so I was not used to the labor laws in California and I was not used to the way that the local EMS authorities work.” — Danielle Thomas “I think every company I've worked at that that was a thing and so we had to create a solution to the problem we had, which was information overload.” — Danielle Thomas Episode timeline 01:25 – Welcome to Danielle Thomas 02:56 – East-to-West move and California’s regulatory maze 4:12 – Lifeline EMS footprint across Los Angeles, Orange and Riverside Counties 6:27 – The policy-overload dilemma in multi-county operations 10:01 – InCheck: turning 800 pages into actionable intel 14:53 – From AI skeptic to evangelist — programming county-specific protocols 18:30 – Five operating modes explained (Rampart, Angel, Nova, L-Chat Narrative) 28:00 – 100-language instant translation with Nova 34:51 – Building the tool in-house; cost and compliance advantages 38:43 – Preview of AAA Conference session, “Just one of the guys” 41:33 – Final takeaways: enhancing the first 80 hours and keeping crews engaged 42:44 – Closing remarks Rate and review the EMS One-Stop podcast Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback. Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

In this international edition of the EMS One-Stop podcast, host Rob Lawrence welcomes Lewis Andrews, the chief operating officer of the United Kingdom’s College of Paramedics, for an insightful discussion on two major topics shaping global paramedicine. First up is International Paramedic Day, taking place on July 8, 2025. Now in its third year, the day honors the contribution of paramedics across the world and draws its inspiration from the birthday of Dominique-Jean Larrey, the father of battlefield ambulance care. Lewis explains how the day has grown from 50 initial partners to over 150 global organizations, with this year’s theme being “Unity and community.” The day aims to raise awareness of the profession, share innovations and bring together the global paramedic community. MORE | How community paramedicine is thriving in the UK: Dr. Linda Dykes and Rom Duckworth discuss trans-Atlantic lessons in emergency management In the second half of the show, Lewis delves into the structure and significance of the College of Paramedics, which represents nearly half of the UK’s registered paramedics. He describes how the UK paramedic profession is regulated and protected by law, with a rigorous educational pathway that now includes the potential for prescribing paramedics and direct-to-primary-care tracks. Rob and Lewis explore how paramedics in the UK are increasingly working beyond emergency ambulances — in GP surgeries, urgent care centers and academic roles. Their conversation offers a rich comparison point for U.S. EMS leaders seeking to elevate paramedicine through autonomy, education and broader clinical roles. Memorable quotes “This is not a commercial platform — this is about us celebrating us.” — Lewis Andrews, on the ethos of International Paramedic Day “Let’s not reinvent the wheel, but let’s look at what the wheel is for the environment that it’s required to roll in.” — Lewis Andrews, on global EMS collaboration “The title ‘paramedic’ is protected by law in the UK — you can’t simply do a first aid course and call yourself one.” — Rob Lawrence “Autonomy — in a word — that’s what makes a prescribing paramedic.” — Lewis Andrews, on expanding paramedic roles “We’re also promoting the profession to those who don’t yet know they want to be in the profession.” — Lewis Andrews, on recruitment and professional identity “We have a career framework … that actually shows that you can develop from that day one newly qualified right through to a consultant paramedic, chief paramedic, director, professor.” — Lewis Andrews Episode timeline 00:55 – Introduction to International Paramedic Day (IPD) and its origins 02:17 – Why July 8 was chosen: Dominique-Jean Larrey’s birthday 03:02 – Growth of IPD from 50 to over 150 partners 05:06 – 2025 theme: “Unity and community” and sub-objectives 06:45 – How to participate: share stories, use hashtags (#UnityAndCommunity and #IPD2025), connect globally 08:58 – The global nature of IPD and U.S. partners’ involvement 11:25 – Promoting awareness and the importance of celebrating paramedics 12:50 – Part 2 — The role of the College of Paramedics 14:09 – Overview of College functions: CPD, representation, research, advocacy 18:15 – Registration with HCPC, protected title and the regulator’s role 21:12 – Paramedic education in the UK: degree pathways, demand and cost 23:46 – Discussion on streaming directly into primary care roles 27:09 – Career framework: from graduate paramedic to chief paramedic/professor 30:16 – Prescribing paramedics: autonomy and improved patient experience 33:08 – Recap and call to action: visit www.internationalparamedicsday.com 34:17 – Like, subscribe and engage ADDITIONAL RESOURCES International Paramedics Day Resources UK College of Paramedics The standards of proficiency for paramedics RATE & REVIEW Enjoying the show? Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback.

In this vital episode of EMS One-Stop, host Rob Lawrence is joined by Matt Zavadsky and attorney Doug Wolfberg of Page, Wolfberg & Wirth for a deep-dive into three financial flashpoints currently impacting EMS. First, the trio unpack the launch of the new PWW|AG/EMS|MC EMS Financial Index, a quarterly report leveraging billing and revenue cycle data from over 1,500 agencies nationwide. This unprecedented benchmarking tool allows EMS leaders to measure performance against regional and national trends, uncovering actionable insights into billing strategies, reimbursement rates, payer mixes and the economics of service delivery. It’s a critical step in helping agencies justify their value and improve their financial sustainability. Next, the discussion turns to MedPAC — the Medicare Payment Advisory Commission — and its controversial response to cost data submitted by ambulance services under the CMS Ground Ambulance Data Collection System. Doug Wolfberg explains how MedPAC discarded over half of the data, labeling higher-cost services — often rural or government-run — as outliers. This move could justify lower or stagnant Medicare fee increases, potentially devastating many providers. Finally, attention shifts to the “One Big Beautiful Bill” moving through Congress and now on its way to the Senate that would eliminate or severely restrict enhanced Medicaid funding mechanisms, such as supplemental payments and provider taxes. If passed, this legislation would reduce reimbursement for millions of transports, triggering funding crises across EMS systems — particularly in states like California and Illinois. The episode delivers a clear message: EMS leaders must prepare, advocate and act now. Episode timeline 00:41 – Rob introduces the three main topics: the PWW|AG/EMS|MC EMS Financial Index, MedPAC’s response to ambulance data and a major federal bill impacting Medicaid 01:59 – Part 1 — PWW|AG/EMS|MC Financial Index 03:37 – Matt explains that the index is built using data from over 1,500 EMS agencies via EMS|MC 05:43 – The importance of regional benchmarking 08:22 – First major finding: dramatic variation in ALS billing rates across regions 09:30 – Key insight: agencies that bill more tend to collect more revenue — agencies are encouraged to determine their true cost of service and align billing accordingly 12:37 – Collection percentage is debunked as a misleading metric; focus should be on dollars collected 15:36 – ALS vs. BLS billing levels explained, with a look ahead to Q2’s emergency-only data set 18:48 – How EMS agencies can better engage with insurers to cover non-transport and MIH services 20:46 – Part 2 — MedPAC 22:24 – Doug outlines how MedPAC discarded over half of the reported ambulance cost data 25:00 – Explanation of which data was discarded and why — primarily high-cost, rural and government-based services 28:22 – Doug asserts MedPAC is using cherry-picked data to suppress reimbursement increases 30:10 – Rob and Doug emphasize that EMS gave MedPAC quality input, but MedPAC is producing garbage output 32:08 – Doug outlines what MedPAC will do next and what EMS leaders must do in response 34:40 – Strong call to action: educate Congress, use real CMS data and don’t accept MedPAC’s narrative 36:59 – Doug emphasizes the importance of evidence-based deployment strategies for financial sustainability 37:31 – Part 3 — “One Big Beautiful Bill” 38:19 – Matt outlines how the bill would drastically limit Medicaid supplemental payments 39:43 – Federal/state Medicaid match rates explained with California as an example 42:51 – The looming reckoning: local governments may have to pay to maintain current EMS service levels 46:02 – Matt warns that the bill could trigger PAYGO cuts to Medicare as well 47:16 – Agencies are urged to plan now, talk to their communities and adjust operations 48:06 – Doug adds that pressure on U.S. senators, especially in red states, could still influence the bill 51:26 – Close and call to a

In this episode of the EMS One-Stop podcast, host Rob Lawrence sits down with returning guest Chief Robbie MacCue of Colonie EMS (New York) to explore the transformative potential of the Safe Streets and Roads for All (SS4A) federal grant program. Funded by the Infrastructure Investment and Jobs Act, SS4A aims to prevent roadway fatalities and enhance post-crash care. With $5 billion available nationwide and $900 million still on the table for FY25, this conversation is a call to action for EMS agencies across the country. Chief MacCue shares the story of how his department, in collaboration with neighboring EMS and police agencies, secured $2.4 million in SS4A funding for a project focused on innovative vehicle alert systems, prehospital health information exchange and groundwork for whole blood deployment. From demystifying the grant application to defining success metrics and compliance reporting, this episode breaks it all down — turning policy into practice, and complexity into impact. Memorable quotes “I was pretty taken back by the statistic that 40% of these patients were alive when EMS arrived and later died. Those are patients that are talking to us that are no longer living after a crash.” — Robbie MacCue “This isn’t free money. It comes with reporting requirements, match funding and responsibility — but there’s help out there, and it’s absolutely worth it.” — Robbie MacCue “Our goal is to go upstream to the source of the problem. How do we stop the bleeding? How do we stop some of these accidents from actually happening?” — Robbie MacCue “We put a two-page narrative together that generated a $3,000,000 regional application … based on simple principles about statistics.” — Robbie MacCue “Post-crash care is definitely a missing element in the Safe System Approach … and EMS needs to be part of the solution, not just the response.” — Robbie MacCue “You don’t have to have all the solutions right away. You just have to have the initiative to get with other like-minded people.” — Robbie MacCue “This project isn’t just for crashes. It will also help us with high-utilizer patients and improve reimbursement accuracy by connecting data silos.” — Robbie MacCue “Somebody emailed me in the week to say that the EMS One-Stop podcast is the podcast that’s able to turn a very complex EMS topic into a car bumper sticker. So there you go. If we’re doing that and we can achieve that, then we’re getting somewhere.” — Rob Lawrence Episode timeline 00:00-02:00 – Intro to SS4A and the scale of available funding ($5B) 02:00-04:00 – Why post-crash care matters: 42% of patients alive at EMS arrival die later 04:00-07:00 – How Colonie EMS discovered and approached the SS4A opportunity 07:00-10:00 – Building a regional grant application and tripling the funding 10:00-13:30 – Overview of the proposed project – transponder tech, health information exchange and whole blood 13:30-17:00 – Specific technology being explored and integration challenges 17:00-20:00 – Working with MPOs, consultants and navigating acronyms 20:00-25:00 – Finding the 20% match, leveraging in-kind contributions and funding timelines 25:00-30:00 – Federal reporting requirements and budgeting with SF-424A 30:00-35:00 – The big goal: Closing the outcome data loop and EMS-hospital data sharing 35:00-40:00 – Measuring success, from whole blood to vehicle alerts 40:00-42:30 – Robbie’s final advice: “Don’t be intimidated — reach out and apply.” ADDITIONAL RESOURCES SS4A Application Portal & Resources: Safe Streets and Roads for All (SS4A) Grant Program | US Department of Transportation NHTSA’s Office of Emergency Medical Services | EMS.gov Lexipol Grants Support Metropolitan Planning Organizations (MPOs) database

In this episode of the EMS One-Stop podcast, host Rob Lawrence kicks off a special series spotlighting national EMS associations, beginning with a deep dive into the EMS Personnel Licensure Interstate CompAct (REPLICA). His guest, Donnie Woodyard Jr., executive director, Interstate Commission for EMS Personnel Practice, brings decades of EMS experience and leadership to the table to demystify what the EMS Compact is, how it operates, and why it matters to the profession today. From improving workforce mobility to protecting public safety during disasters, Woodyard Jr. provides clarity on this critical multi-state agreement. The conversation covers everything from how EMS Compact came to be, to the significance of national registry standards, disaster response logistics, interstate licensure, and even leadership lessons from Woodyard Jr.’s latest book project, “Leadership in action: The Wisdom and stories of EMS innovators”. Whether you're a field provider or policymaker, this episode is a must-listen for understanding how collaborative legislation can shape the future of EMS. In the episode, Woodyard Jr. candidly addresses the ongoing debate in North Carolina over transitioning from a state-only EMS certification exam to exclusive use of the National Registry. Woodyard Jr., while respectful of North Carolina’s long-standing EMS tradition, emphasizes the importance of national consistency. He acknowledged that the proposed legislation needed amendments, particularly around grandfathering existing providers, but stood firm in his belief that a single, legally defensible national standard is essential for provider mobility and professional integrity. Drawing on real-world examples, Woodyard Jr. described how providers are often caught off guard when relocating — only to discover their credentials aren't accepted elsewhere. “Maintaining a state-only exam is harmful to individuals,” he said, calling for unified testing standards that support workforce movement and strengthens the profession nationwide. Memorable quotes from Donnie Woodyard Jr “Every EMT and paramedic in the United States should go through a fingerprint background check. You know, babysitters have to do it. Teachers have to do it. EMS personnel absolutely should do it.” “Maintaining a state-only exam is harmful to individuals. It limits their mobility.” “When you waive that requirement for licensure, you actually are removing essential elements of public protection and accountability.” Timeline 00:21 – Rob introduces the series on national EMS associations and welcomes Donnie Woodyard, Jr. 01:55 – Woodyard, Jr.shares his EMS journey from volunteer in Virginia to international disaster medicine and state leadership 03:41 – What is the EMS Compact and how does it work? 06:38 – Challenges of multistate EMS licensing pre-Compact 08:00 – Explaining the driver’s license analogy and compact accountability 11:17 – EMAC vs. EMS Compact for disaster response and liability concerns 15:31 – National Registry and grandfathering provisions 17:30 – Arkansas joins as the 25th compact state 18:56 – Model legislation and how states join the compact 21:22 – What REPLICA stands for and its legislative origin 22:20 – What California (and other non-compact states) should consider 24:33 – National Registry debate: North Carolina’s challenges and Woodyard, Jr.’s response 27:52 – Mobility, workforce attrition and job-sharing innovation 30:11 – The Commission and national EMS-coordinated database 35:17 – Final thoughts on fragmentation, collaboration and EMS unity 36:41 – Woodyard, Jr.’s leadership book, EMS charity support and Secretary Panetta’s forward 41:08 – Closing remarks and contact information Additional resources Learn more about the EMS Compact “Leadership in action: The Wisdom and stories of EMS innovators”, by Donnie Woodyard Jr. “The future of emergency medical services: Artificial intelligence, technology & innovation”, by Donnie Woodyard Jr.

In this special data-driven edition of the EMS One-Stop podcast, host Rob Lawrence is joined by Dr. Brent Myers, chief medical officer, ESO, and Dr. Remle Crowe, ESO’s director of clinical and operational research, to unpack the newly released 2025 ESO EMS Index. This annual report provides a powerful, real-world snapshot of national EMS trends — drawing on more than 14 million anonymized records to surface opportunities for clinical and operational improvement. The conversation dives into key metrics that move beyond response times and into areas like pain management, opioid overdoses, airway confirmation, obstetric emergencies, whole blood use, pediatric behavioral health and high-utilization patient populations. Throughout the episode, Drs. Myers and Crowe share the motivation behind each metric, explain how the data was gathered and analyzed, and reflect on how EMS agencies can use these insights to guide better care delivery and system design. From confronting equity in pain management, to pushing forward innovations like buprenorphine administration and whole blood programs, this is a compelling call to turn data into meaningful change. Timeline 01:08 – Overview of the ESO EMS Index and its intent 02:59 – Origins of the report and data methodology 05:46 – Database scale: 14M+ records, 3,000+ agencies 07:14 – Metric 1: Pain management for long bone fractures 10:53 – Documentation, AI in EMS, and future documentation tools 14:30 – Metric 2: Suspected opioid overdose and buprenorphine use 18:51 – Best practices, COWS scoring, and naloxone delivery strategy 21:31 – Metric 3: Invasive airway confirmation using waveform capnography 28:06 – Metric 4: Obstetric emergencies (postpartum hemorrhage & hypertension) 34:34 – Metric 5: Prehospital whole blood surveillance 40:22 – Metric 6: Pediatric behavioral health and substance use disorder cases 44:54 – Metric 7: High utilization patient group (HUG) 52:48 – Final thoughts, calls to action, and Rob’s reflections 55:47 – Episode wrap-up and subscription reminder

In this episode of EMS One-Stop, host Rob Lawrence is joined by Dr. Christine Carico and Dr. Matt Levy to discuss the peer-reviewed paper, “Nationwide Trends in Prehospital Blood Product Use After Injury.” The paper, published in “Transfusion” in April 2025, explores the use of blood products in prehospital trauma care. Despite the proven benefits of blood transfusion in the field, their research uncovers the alarming reality that less than 1% of eligible patients receive prehospital blood products. This conversation dives into the study’s methodology, key findings and the significant barriers EMS systems face in implementing blood transfusion protocols. The discussion also touches on the evolving role of EMS in trauma care, regional variations in blood product access, and the future of prehospital blood transfusion programs. Dr. Carico and Dr. Levy break down their work and reflect on the data, explaining how the study used National Emergency Medical Services Information System (NEMSIS) data to identify trauma patients who would have benefited from blood transfusions. The episode delves into the operational challenges EMS systems face in obtaining and administering blood products in the field, the financial and logistical obstacles, and the potential life-saving impact of more widespread adoption of these protocols. Timeline 00:00 – Intro and welcome: Rob Lawrence introduces Dr. Matt Levy and Dr. Christine Carico, setting up the discussion on prehospital blood product use 03:00 – Study overview: Dr. Carico explains the methodology of the study, focusing on the use of NEMSIS data and the inclusion criteria for the patient population 07:00 – Key findings: Dr. Carico reveals the key findings of the paper, including the low percentage of eligible patients receiving prehospital blood products 11:00 – Barriers to implementation: Dr. Levy discusses the main barriers to the widespread implementation of blood transfusion protocols in the field, including access to blood, logistics and training 17:00 – Regional variations: The speakers touch on the regional disparities in blood product availability and the differences in protocols across the country 23:00 – Data challenges: Dr. Levy and Dr. Carico discuss the challenges related to data accuracy, particularly in terms of blood product documentation 27:00 – Cost and reimbursement: Dr. Levy addresses the financial aspects of blood product programs, including cost, reimbursement challenges and funding opportunities 32:00 – The future of blood transfusion in EMS: Dr. Levy envisions the future of prehospital blood transfusion programs, including the potential for shelf-stable blood products and regional blood supply systems 37:00 – Closing thoughts: Both guests offer their final thoughts on the importance of continued research and data collection, and the need for EMS to embrace a more integrated role in acute care Additional whole blood resources Carico C, Annesi C, Clay Mann N, Levy MJ, et al. “Nationwide trends in prehospital blood product use after injury,” 2025. Transfusion – Wiley Online Library Tracking the whole blood landscape as updated guidelines allow EMS to carry and administer whole blood EMS One-Stop: Stop the bleed, fill the tank – The New Orleans EMS blood program Insider analysis: Delaware’s statewide whole blood rollout sets a new EMS standard Whole blood in EMS promises a revolution in resuscitation: How one county agency is saving lives with prehospital transfusions Matthew Levy | LinkedIn Christine Carico | LinkedIn

In this episode of the EMS One-Stop podcast, host Rob Lawrence is joined by Deputy Director Tracey Loscar from Mat-Su Borough EMS in Alaska. Together, they discuss the looming threat of Mount Spurr, a volcano located 75 miles west of Anchorage, which is currently showing signs of potential eruption. Loscar provides insights into disaster management and preparedness in a region where EMS operations are stretched across vast, remote territories. The conversation also touches on how to plan for the unexpected, especially in an environment with limited resources and harsh geographical challenges. This episode delves into the logistical challenges faced by EMS in the face of volcanic activity and offers critical lessons in disaster management. TIMELINE 00:22 – Rob Lawrence welcomes Deputy Director Tracey Loscar and sets the stage for a discussion on disaster management in Alaska 02:10 – Loscar gives a brief overview of Mat-Su Borough and its proximity to Mount Spurr 04:01 –Loscar discusses her transition from Newark, New Jersey, to Mat-Su Borough and the challenges of EMS in rural Alaska 06:00 – Lawrence and Loscar discuss the vast distances and limited resources available in the region 08:01 – Loscar explains the preparations for the potential ash fallout from Mount Spur, including messaging to the community and respiratory protection 10:04 – The conversation shifts to the nature of volcanic ash and the practical challenges it presents to infrastructure, vehicles and personal health 14:36 – Loscar shares lessons learned from previous seismic events, such as the 2018 earthquake, and emphasizes the importance of clear communication during disasters 17:06 – Lawrence and Loscar discuss EMS liaison roles and the need for better coordination between dispatch, EDs and field teams 18:01 – Loscar talks about the current status of the Mount Spur eruption, with no immediate risk but preparations ongoing, and discusses how Alaskans stay calm and prepared in the face of frequent natural events, from earthquakes to volcanic eruptions 20:03 – Loscar highlights the importance of including pets in emergency plans, emphasizing the need for respiratory protection for animals 21:00 – The role of pantyhose in volcano preparedness RATE AND REVIEW Enjoying the show? Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback.

In this episode of EMS One-Stop, recorded live from the ABC 360 and XI Conference, host Rob Lawrence chats with keynote speaker Catherine Kuhlmann, a firefighter-paramedic with over 26 years of experience.   Kuhlmann discusses the importance of understanding both internal and external customer service in EMS, emphasizing the need for a healthy organizational culture to ensure the best patient care. She reflects on the profound impact that first responders can have on individuals, drawing from her own experiences and personal tragedies to highlight the emotional resilience required in the profession.   Rob also speaks with Page Wolfberg & Wirth’s PWW/AG Principal Doug Wolfberg, long-time EMS lawyer and educator, about lessons learned from working in and around law enforcement during patient care. Wolfberg provides actionable insights into how EMS professionals can better collaborate with police officers, ensuring that patient care remains a priority while navigating complex, high-stress situations. Together, Kuhlmann and Wolfberg offer invaluable perspectives on fostering better patient advocacy, maintaining professional integrity and refining EMS protocols to adapt to new challenges. MEMORABLE QUOTES “How many careers, professions are there that, more often than not, you can make somebody's worst day their best?" — Catherine Kuhlmann "If you want to know what's going on in your hospital, ask housekeeping. Patients will not remember that you worked your butt off for 45 minutes to restart their heart … but they will remember that you tucked their feet in with a blanket underneath it." — Catherine Kuhlmann "You have to have a healthy department in order to continue to be healthy. And a lot of times when people think that they have problems with an individual and their agency, sometimes it’s not actually a problem with the individual, it’s with the agency." — Catherine Kuhlmann "We have a duty to the patient. We're not there to help the police. We're there to advocate and treat the patient." — Doug Wolfberg "EMS cannot subordinate judgement to law enforcement. If a police officer says give this guy some juice and put him to sleep, we first have to do an assessment and figure out if clinically that's the right thing." — Doug Wolfberg ADDITIONAL RESOURCES ABC 360 and XI Conference is Page Wolfberg & Wirth Advisory Group’s all-day workshop for EMS leaders, chiefs, HR managers and compliance professionals. Vodcast: Lessons from the McClain case: Protecting first responders and improving EMS practices Balancing care and collaboration: Key lessons from EMS and law enforcement interactions TIMELINE 00:37 – Catherine Kuhlmann introduces herself, detailing her extensive background in EMS, law enforcement, and as a justice of the peace. Rob then highlights the key themes of Kuhlmann’s keynote speech, which revolves around the importance of understanding the "why" in EMS. 02:16 – Kuhlmann discusses the importance of organizational culture in retaining quality personnel and how many individuals leave — not due to the work itself — but because of the agency's culture. Kuhlmann talks about the personal fulfillment that comes from EMS work, sharing a story about a young girl she saved who later became a doctor. 06:13 – Kuhlmann introduces the concept of "Murphy," a problematic employee in the agency, and suggests that sometimes these individuals may reflect a deeper organizational issue. 08:12 – Kuhlmann emphasizes the importance of communication, advising that EMS leaders should hold honest, one-on-one conversations with problematic staff before resorting to exit interviews. 12:04 – Kuhlmann reflects on the small gestures that have a lasting impact on patients, highlighting how seemingly minor acts of compassion can leave a lasting impression. 14:03 – Rob and Kuhlmann discuss the concept of bedside manner in EMS, stressing the importance of treating patients with dignity and respect. Kuhlmann closes with

NOTE: Be sure to check out the Inside EMS podcast this month where Rob Lawrence will be joining Kelly Grayson as a guest cohost for Chris Cebollero.  In this episode of the EMS One-Stop podcast, Dr. Dave Williams discusses an exciting new master's-level course designed for EMS and fire leaders, focused on advanced improvement science. Along with Mike Taigman, Dr. Williams is leading this program, which aims to equip leaders with the tools and methods necessary to achieve results-driven improvement in their EMS systems. Over the course of 12 months, attendees will work on real-world projects, gaining the skills needed to make data-driven decisions and improve patient care outcomes within their organizations. Dr. Williams also dives into the core concepts of improvement science, including understanding of variation and the importance of creating organizational systems that support sustainable improvements. He shares insights into the curriculum, the significance of benchmarking and how the course will help EMS leaders tackle systemic challenges by applying proven improvement methodologies. This conversation also touches on the future of EMS leadership and how innovation in data management, process design and leadership will shape the profession moving forward. Timeline 02:22 – Dr. Williams explains the background of the course, highlighting how it builds on improvement science to drive better results in EMS systems. He and Mike Taigman aim to teach EMS leaders to use data and evidence to improve patient care outcomes. 06:16 – Quality improvement: Dr. Williams discusses the gap in EMS leadership regarding quality improvement, emphasizing that quality needs to be integrated into the leadership team’s responsibilities, not treated as a separate function. 11:01 – Why data matters: The conversation shifts to the importance of data in EMS improvement efforts. Dr. Williams highlights how collecting and analyzing data helps organizations understand system performance and drive change. 15:43 – The fleet management example: Rob shares a fleet management story where data was used to improve vehicle downtime, highlighting the real-world impact of using improvement science to solve practical challenges. 19:29 – Project-based learning in the course: Dr. Williams elaborates on the project-based nature of the course, explaining how each participant will bring a real-world project that directly impacts their organization and use improvement science to solve it. 23:09 – Practical applications: Dr. Williams talks about how the course will blend online learning with in-person workshops, providing practical tools and methods that participants can apply to their projects throughout the year. 31:08 – Course logistics: Dr. Williams discusses course deadlines and important dates, including the application deadline of April 18, 2025; and the course's first workshop in September 2025. 54:05 – ROI and the course's value: Dr. Williams emphasizes the return on investment for attending the course, explaining that solving organizational problems through improvement science will ultimately save money and improve results for EMS services. 1:00 – Final thoughts: Rob and Dr. Williams close the conversation by reiterating the uniqueness of the course and its potential to reshape EMS leadership through the application of improvement science. ADDITIONAL RESOURCES Next-level improvement science: New master-level course equips EMS and fire leaders with advanced improvement science skills Course application deadline: April 18, 2025 Course start date: July 22, 2025 Workshop dates: September 2025; February 2026 Mastering data and EMS performance metrics with Mike Taigman: Exploring how data informs change, improves clinical outcomes and drives leadership decisions Improve EMS quality with a model that works: The simple yet powerful Model for Improvement holds the key to making real changes to an EMS organization

In this episode of EMS One-Stop, host Rob Lawrence is joined by Dr. Dan Patterson, a clinician-scientist specializing in safety in emergency care settings. Dr. Patterson’s work centers around critical factors in EMS safety, such as sleep health, shift work, fatigue and their combined effects on clinician well-being. Timeline of key discussion points 00:00 – Introduction to Dr. Dan Patterson Dr. Patterson’s background and how his clinical experience as a paramedic informs his research on EMS safety and sleep health   04:30 – The Impact of Shift Work and Fatigue on EMS Providers Discussing the direct effects of fatigue on EMS professionals, including medical errors, cognitive performance and decision-making   10:00 – The Science of Sleep in EMS Why sleep is critical for EMS personnel and the unique challenges they face in getting adequate rest during shift work   15:00 – Development of Safety Measurement Tools Dr. Patterson explains the creation of safety tools to track fatigue, sleep health and workplace injury rates in EMS settings   20:30 – Experimental Studies and Interventions Overview of studies testing novel approaches to mitigating fatigue, including practical solutions and interventions in EMS environments   25:00 – Creating a Safety Culture in EMS The role of leadership and teamwork in reducing fatigue-related errors and fostering a culture of safety in EMS organizations   30:00 – Key Takeaways and How Agencies Can Implement Changes Final thoughts on how EMS agencies can integrate Dr. Patterson's findings and create healthier, safer work environments for their teams

In this episode of EMS One-Stop, host Rob Lawrence welcomes back Dr. Alex Isakov, a leading expert in infectious diseases from NETEC and Emory University in Atlanta. Dr. Isakov provides valuable updates on current and emerging infectious diseases; their global impact; and the critical role EMS professionals play in identifying, isolating and protecting themselves and their patients. This discussion highlights key infectious diseases, including H5N1 (avian flu/bird flu), Mpox (previously known as monkeypox), Ebola, Marburg, Lassa fever and seasonal flu, providing EMS personnel with essential knowledge and safety protocols in light of ongoing global health concerns. Throughout the episode, Dr. Isakov offers insights into the latest outbreaks, the importance of vaccinations, and strategies for responding to potential infectious disease threats. He stresses the necessity of remaining vigilant and prepared for high-consequence diseases while maintaining optimal patient care. From the evolving threat of H5N1 to the resurgence of seasonal influenza, Dr. Isakov ensures that EMS professionals are equipped with the most relevant and up-to-date information needed to protect both themselves and their communities. Summary of key infectious diseases covered by Dr. Isakov H5N1 (avian influenza/bird flu): Dr. Isakov provides an update on the H5N1 outbreak in poultry and dairy herds, stressing the importance of limiting human exposure and watching for potential mutations that could lead to human-to-human transmission. Mpox (Clade 1B): Dr. Isakov discusses the risk of Mpox, particularly Clade 1B, which remains prevalent in Central Africa but has now spread to other countries, including the United States. He highlights the importance of identifying travel history and unusual rashes, along with strict protective measures for EMS clinicians. Ebola and Marburg: These diseases continue to present a risk, with smaller outbreaks currently ongoing in Uganda (Ebola) and Tanzania (Marburg). Dr. Isakov notes the importance of being prepared to identify and isolate individuals who may have been exposed during travel to these regions. Lassa fever: Dr. Isakov points out the ongoing concern of Lassa fever in West Africa and emphasizes that EMS professionals should be on alert for symptoms in travelers who have visited affected regions. Seasonal influenza: The seasonal flu outbreak is particularly severe this year, and Dr. Isakov underscores the importance of vaccination, especially for vulnerable populations, to reduce serious illness and hospital strain. Timeline 00:00 – Introduction to the episode and guest, Dr. Alex Isakov 01:33 – Uupdate on Mpox (Clade 1B) and its global spread 05:24 – Ebola and Marburg outbreaks: ongoing concerns in Uganda and Tanzania 08:01 – Lassa Fever in West Africa and its impact on EMS professionals 13:05 – The importance of travel vaccinations for high-risk areas like malaria zones 15:13 – Mystery illness in the Democratic Republic of Congo and the investigation into its cause 17:01 – H5N1 and avian influenza concerns, including potential human transmission risks 22:02 – Severity of the current seasonal flu outbreak and vaccination recommendations 25:24 – EMS community's role in flu and measles vaccination advocacy 29:05 – Discussing surge conditions and excess mortality during pandemics 32:01 – Closing remarks, including updates on new NITEC EMS resources Additional infectious disease resources National Emerging Special Pathogens Training & Education Center Emergency Medical Services (EMS) Featured Resources | NETEC Symptoms of Malaria | Malaria | CDC Lassa Fever Suspected in Death of U.S. Traveler Returning from West Africa | CDC Newsroom CDC A(H5N1) Bird Flu Response Update February 26, 2025 | Bird Flu | CDC Mpox | Mpox | CDC Healthcare Workers: Could it be Ebola?

Recruiting and retaining EMS professionals has been an ongoing challenge across the U.S., made worse by the COVID-19 pandemic. In this episode of the EMS One–Stop podcast, host Rob Lawrence sits down with Joe Schmider, Texas State EMS director, to discuss the $21M Texas EMS Workforce Initiative — a data-driven approach to recruiting and retaining EMS providers statewide. Schmider details how Texas identified a 40% non-utilization rate among certified EMS professionals, successfully secured state funding, and launched an innovative recruitment and retention campaign. With over 10,915 new personnel added since 2019, this program serves as a model for other states struggling with EMS workforce shortages. This episode is full of actionable insights for EMS leaders, policymakers and recruiters alike. Key quotes from Joe Schmider "We were seeing about 40% of our certified people — licensed paramedics, EMTs, advanced EMTs — were not using their skills on an ambulance." "We worked with our associations here in Texas, the Texas EMS Alliance and the Texas Ambulance Association. They went and met with some legislators, worked the room a bit, and we got $21 million of federal dollars through the state to us for 2 years to put in place a recruitment and retention program." "We pushed out 3,152 scholarships. An EMT scholarship was worth $2,000, an advanced EMT scholarship was $3,200 and a paramedic scholarship was $8,000. The money went directly to the education program, not to the student. They had 1 year to complete their training and then had to serve 96 hours a month on an ambulance — either as a paid or volunteer position — for 1 year at the EMT level and 2 years at the paramedic level." "We spent $1.5 million on an advertising campaign throughout the state of Texas. We hired a media company to develop commercials, billboards and social media campaigns. The use of social media was incredible — 50 million views over 2 years, which was an incredible number. We never expected that." "The second thing people do [when considering EMS careers] is they watch us as EMS professionals. Do I want to work with these people? Do I want to be a part of this? I once saw two EMTs standing on the back of an ambulance smoking a cigarette at an event. I went up to them and said, ‘Are you kidding? What message are we putting out when we do stuff like that?’ We have to think about our image." "People leave the EMS profession for two reasons: money or the way they’re treated. Depending on which survey you look at, it could be money first or treatment first, but it’s always those two reasons." Episode timeline 00:08 – Rob Lawrence introduces guest Joe Schmider, Texas EMS director 00:26 – The EMS staffing crisis and how COVID-19 accelerated workforce shortages 01:36 – How Texas used data to identify a 40% EMS non-utilization rate 02:51 – How Texas EMS leaders secured $21 million in funding 04:31 – Structuring EMS scholarships and training requirements 06:41 – The success of the recruitment campaign: 3,152 scholarships awarded 08:46 – How Texas reached 50 million views in its EMS recruitment campaign 11:16 – EMS workforce retention: The challenges of pay and treatment 13:46 – Addressing rural EMS shortages and workforce gaps 16:01 – How Texas EMS associations helped advocate for change 18:21 – The future of EMS funding and advocacy efforts 21:01 – Lessons from corporate retention strategies: What EMS can learn from HEB grocery stores 24:01 – The importance of EMS provider wellness: Texas’ Wellness Wednesday initiative 26:01 – Final takeaways: Lessons for other states and EMS leaders 28:01 – Closing thoughts and how to access Texas EMS resources Additional resources Connect with Joe Schmider: joseph.schmider@dshs.texas.gov/512-484-5470 Texas EMS Careers and Education

In this special episode of EMS One-Stop, host Rob Lawrence welcomes General Robert B. Neller, the 37th commandant of the United States Marine Corps, to discuss leadership, decision-making, team building and the evolving challenges facing public safety professionals. General Neller shares his perspective on leading under pressure, making critical decisions, and fostering an ethical and resilient organizational culture. With decades of military leadership experience, he provides actionable insights that apply not only to the armed forces but also to EMS, law enforcement, and fire and rescue personnel. Throughout the episode, General Neller emphasizes the importance of training, adaptability and the role of leadership in guiding organizations through times of uncertainty. He highlights the significance of ethical leadership, followership and how leaders must take responsibility for failures while empowering their teams. The discussion also explores the impact of emerging technologies, such as AI and body-worn cameras on public safety, and the crucial need for ongoing training despite staffing and funding challenges. This thought-provoking conversation delivers key takeaways for current and aspiring leaders across all branches of public safety. 15 leadership quotes from General Robert B. Neller “Making decisions is part of your training — you’re expected to make them, and you have to do it in critical moments.” “If I could wave a magic wand, I’d put everyone at 110% staffing so they had the time to train properly.” “The leader’s job is to set the example — how you carry yourself, how you treat others, and how you communicate matters.” “Good leaders anticipate. They don’t just react — they look ahead and keep their teams informed.” “Followership isn’t blind obedience; it’s about understanding the mission, contributing ideas, and executing effectively.” “Accepting responsibility is a core tenet of leadership — when things go wrong, the leader must own it.” “Change is inevitable, and good leaders learn to embrace it while preparing their people for what’s ahead.” “Take care of yourself — physically, mentally and morally — because leadership starts with personal discipline.” “As a leader, you have to accept that sometimes you’ll make the right call, and things still won’t go your way — that’s part of the job.” “You have to train and rehearse because time spent on reconnaissance is seldom wasted.” “The worst thing you can hear as a leader is that ‘you don’t care’ — your people need to know that you do.” “To build culture and cohesion, you set the example — you take the physical fitness test, you wear the uniform properly, and you carry yourself the right way.” “Good leadership is not about the complete suppression of ideas — if you have time, get input, because someone might have a better idea than you.” “If you have good followers, being a leader is significantly easier — if you don’t, it’s a challenge every day.” “Change is inevitable — if you’re not evolving, you’re not making progress, and that’s a problem.”

In this episode of the EMS One-Stop podcast, host Rob Lawrence is joined by Shana Beggan, Esq.; and Mike Pellow, Esq., defense attorneys representing one of the firefighters involved in the tragic Elijah McClain case. Beggan and Pellow discuss the complex legal and systemic issues surrounding the incident, including communication breakdowns, inadequate training, and the challenges faced by EMS and fire personnel when operating in chaotic environments. They also address the broader implications for EMS professionals, highlighting the importance of proper documentation, the use of body-worn cameras, and the need for stronger inter-agency collaboration between police and EMS teams. This interview provides invaluable insights into the case and the steps necessary to improve EMS practices moving forward. Beggan and Pellow share their experiences navigating the criminal and civil aspects of the case, emphasizing the importance of understanding the limitations and constraints that EMS providers face in high-pressure situations. They also advocate policy changes, such as enhanced training, better resource allocation and the introduction of body-worn cameras to protect both first responders and the patients they serve. Their passionate discussion sheds light on the need for reform within EMS, encouraging listeners to reflect on their own practices and consider how they can contribute to a safer and more effective emergency response system. Key quotes "First responders are people who run towards difficulties and trauma when many run away, and to see somebody be charged in this situation and the fallout from it ... has become a very strong passion for myself and for Mike." — Shana Beggan "You take somebody – basically the bottom of an entire healthcare system – and say, let's blame this person, let's criminalize this. That is the wrong thing to do." — Mike Pellow "I think that we need to allow for honest conversations in a safe way, not a blame-the-finger approach." — Shana Beggan "We need to be better at helping first responders, not making them look over their shoulders and thinking, ‘Where am I going to get whacked in the back of the head if something goes wrong?’" — Mike Pellow "We perform the way we train, and here the training was poor. We condone or even promote what we fail to address." — Shana Beggan Takeaways and actionable items Improve documentation practices. Ensure that EMS providers document not only their actions, but also their thought processes. This can help prevent misinterpretation of their actions in high-stress situations and provide valuable context in legal proceedings. Advocate for body-worn cameras. Implement body-worn cameras for EMS teams to improve transparency, protect first responders, and provide better evidence for both patient care and legal purposes. However, ensure that funding for such programs comes from appropriate sources, rather than placing additional strain on already underfunded EMS budgets. Enhance training and protocols. EMS and police departments should collaborate on joint training sessions, focusing on clear communication, proper patient handoffs, and how to handle complex situations, like excited delirium. Ensure that protocols are updated regularly and that training is implemented in real-world scenarios. Timeline 01:48 – Introduction: Rob Lawrence introduces the episode and guests Shana Beggan, Esq.; and Mike Pellow, Esq. 04:21 – Case background: Pellow provides a brief overview of the Elijah McClain case, the charges against the paramedics, and the current status of the case. 07:10 – Communication breakdowns: Beggan discusses the major issues surrounding communication between police and EMS, particularly the lack of information shared between the different teams at the scene. 10:35 – Documentation and reporting: Beggan and Pellow emphasize the importance of documentation in EMS, especially in legal situations, and discuss how inadequate reporting and th

In this sobering episode of EMS One-Stop, host Rob Lawrence sits down with Chief Bill Salmeron of New Orleans EMS to discuss the tragic events that unfolded on New Year’s Day 2025, when a vehicle plowed through crowds in the French Quarter, resulting in 15 fatalities and 57 injuries, including two police officers. Chief Salmeron provides a detailed account of the incident, the immediate EMS response, and the coordinated efforts with law enforcement and hospitals to manage the mass casualty incident. The conversation also delves into the psychological impact on EMS personnel, the value of training and preparedness, and lessons learned from handling such a large-scale event. Chief Salmeron emphasizes the importance of communication, mutual aid and the mental wellbeing of first responders, offering insights into how New Orleans EMS plans to support its teams in the long recovery process ahead. Key quotes from the episode “You don’t teach that level of decision-making in EMT class. Telling a family member or police officer that you can’t help their loved one is one of the hardest things you’ll ever do.” — Chief Bill Salmeron “The recovery from an incident like this doesn’t take days or weeks – it takes years.” —Rob Lawrence “I told my team to go back to headquarters. I needed to put eyes on every single one of them and make sure they were OK.” — Chief Bill Salmeron “Situational awareness and incident command are critical. It’s about restoring order from chaos.” —Rob Lawrence “What we do is a unique calling. It’s critical to appreciate and take care of each other and ourselves.” — Chief Bill Salmeron “This episode is a masterclass for anyone planning for mass casualty incidents. Listen, learn and prepare.” —Rob Lawrence Timeline 00:21 – Introduction to the episode and overview of 2025’s challenging start, including the New Year’s Day tragedy in New Orleans01:22 – Chief Salmeron describes the initial setup and EMS operations in the French Quarter03:26 – Incident details: the truck’s path, immediate EMS response, and the scale of injuries06:01 – Incident command and mutual aid coordination, including the deployment of 13 ambulances09:43 – Managing hospital capacities and patient transport logistics during the MCI15:11 – The discovery of explosive devices and the role of EMS in securing and retreating from the scene23:01 – Post-incident response: staff debriefings, mental health support and lessons learned33:31 – Preparing for future events like the Super Bowl and Mardi Gras under heightened security41:06 – Five key takeaways for leading and managing mass casualty incidents50:28 – Closing thoughts and appreciation for first responders’ dedication and resilience Additional resources New Orleans EMS

Join Rob Lawrence on EMS One-Stop as he welcomes Sunny Wescott, chief meteorologist at the Department of Homeland Security, for an eye-opening discussion about the impact of extreme weather on emergency services and critical infrastructure. Sunny shares her expertise on meteorological trends, the challenges of preparing for severe weather events, and the evolving role of EMS in managing climate-induced emergencies. From hurricanes and polar vortices, to the implications of electric vehicle adoption during extreme weather, this episode is packed with actionable insights for public safety leaders and EMS professionals. Rob and Sunny explore the complex interplay between extreme weather and emergency response, emphasizing the importance of proactive planning and reliable information sources. Sunny delves into the science behind weather phenomena like atmospheric rivers, Rex blocks and heatwaves, connecting them to real-world challenges faced by first responders. During this edition of EMS One-Stop discover the tools, resources and strategies Sunny recommends for staying ahead of severe weather impacts on both infrastructure and personnel, and gain practical advice for improving communication with the public during weather crises, ensuring safety and minimizing risk. Key quotes from this episode “The uneven heating of our planet is amplifying weather events, making them stronger and more unpredictable.” — Sunny Wescott “The weather affects everything – and for EMS leaders, preparation isn't optional, it's essential.” — Rob Lawrence “We’re seeing infrastructure pushed to its breaking point by weather extremes – things we couldn’t anticipate when they were built.” — Sunny Wescott “Sometimes, the hardest command decision is telling your crews, ‘We’re hunkering down now.’ It’s the right call, but it’s never an easy one.” — Rob Lawrence “Your life means so much more than the possessions inside your home. Evacuate early – it’s always the safest choice.” — Sunny Wescott “Let’s face it: weather is as much a part of public safety planning as personnel and resources.” — Rob Lawrence “Weather preparedness isn’t just about forecasts; it’s about collaboration, data sharing and breaking down silos across sectors.” — Sunny Wescott Timeline 00:24 – Rob’s introduction and reflections on weather in the UK and US 01:22 – Sunny explains global weather patterns and their cascading impacts 03:32 – Sunny describes her role at DHS and how critical infrastructure is assessed against weather risks 11:13 – Hurricane trends, preparedness and landfall impacts for 2025 20:00 – EMS-specific challenges during extreme heat and cold, including effects on equipment and personnel 24:04 – How to interpret long-term weather forecasts and model reliability 30:06 – Operational decisions during extreme weather events, like grounding helicopters and using resources wisely 36:06 – Final thoughts on misinformation, insurance concerns, and public safety resilience Additional resources EMS in a changing climate: Understanding the impact of extreme weather Snowfall Reports from past events Annual Lightning Report 2024 – Xweather NWS Probabilistic Precipitation Portal National Fire News | National Interagency Fire Center AirNow Fire and Smoke Map Incidents | CAL FIRE Evaporative Demand Drought Index (EDDI): NOAA Physical Sciences Laboratory Zoom Earth | Live Weather Map & Hurricane Tracker Nullschool Earth :: a global map of wind, weather, and ocean conditions National Weather Service  

In this insightful episode of EMS One-Stop, host Rob Lawrence revisits New Orleans EMS to explore their pioneering use of body-worn cameras, joined by Chris Keller, chief of operations at New Orleans EMS. The discussion dives into the motivations, challenges and successes of implementing this technology. From its initial deployment on tactical medic teams in 2018, to its current broader rollout, Chris shares the journey of navigating legal frameworks, staff buy-in and operational logistics. The conversation also highlights how body-worn cameras enhance patient care documentation, bolster staff safety and provide an unbiased account of events, positioning them as an emerging industry standard. This episode offers practical advice on policy development, procurement processes and operational use cases, including their application during Mardi Gras and high-acuity events. With the aim to demystify the implementation process, Chris emphasizes the importance of collaboration, adaptability and using technology to improve EMS practices. Rob and Chris also discuss future goals for the program, funding challenges, and the potential for body-worn cameras to become a cornerstone of EMS operations nationwide.