Explore every episode of the podcast EMS One-Stop
| Title | Pub. Date | Duration | |
|---|---|---|---|
| What ‘never forget’ means 25 years later | 10 sept. 2026 | 01:14:14 | |
FDNY Chief of Department John Esposito recounts FDNY’s devastating losses, the decisions that saved thousands of lives and why honoring 9/11 means preparing the next generation to meet the moment Twenty-five years after Sept. 11, 2001, FDNY Chief of Department John Esposito joins podcast hosts Jim Dudley, Rob Lawrence and Aaron Zamzow of Police1’s Policing Matters, EMS1's EMS One-Stop and FireRescue1’s Better Every Shift for a deeply personal conversation about 9/11, its enduring impact and the lessons that continue to shape fire, EMS and law enforcement. Esposito was a newly promoted FDNY lieutenant on Sept. 11, 2001. He recalls returning to the city after the towers fell, the collapse of command and communications, the desperate effort to account for missing members, and the realization that FDNY had suffered unimaginable losses. The discussion moves beyond remembrance to examine what emergency services learned: stronger accountability, controlling self-deployment, incident management teams, interoperable communications, interagency cooperation, intelligence sharing and peer support. Esposito also reflects on the continuing toll of World Trade Center-related illness and explains why “never forget” must mean more than remembering 343 names. For him, it means remembering the decisions responders made, the conditions they faced and the thousands of lives their actions helped save. His challenge to today’s generation is simple: know your job, keep learning, take care of your people and ask whether you are prepared to “measure up” to those who came before. Key quotes from FDNY Chief of Department John Esposito “Never forget is not just their names and who they were, how they lived their lives, and most importantly, the decisions that they made that day and the actions that they took.” “They're like, ‘No, we think we lost everybody.’ And that was when it started to sink in that no, this is gonna be as bad as it could be.” “If we never showed up and we had no losses that day, the loss of civilians is in the tens of thousands.” “This is your legacy. This is our legacy, this is what we do, and these are the people that did this before us.” “I believe that some of them knew that they were not going to make it home that night. And they still did their job.” “September twelfth came, the doors of the firehouse went up, people got on fire trucks, and they went out and did their job.” “It was like an all-star team that we lost. Some of the best people to ever do this job we lost that day.” “I see my job here and our job in this building and headquarters is to take care of the people that take care of the city.” “We have no idea. We're in a firehouse or an ambulance one second and in five minutes we could be in the worst situation we've ever been in.” “It's our job to make sure that the people in the field are prepared and when they need something, it's our job to get it for them.” Episode timeline 00:27 – Introduction: EMS1, FireRescue1 and Police1 come together to reflect on 25 years since September 11 02:28 – Introduction: FDNY Chief of Department John Esposito 03:23 – Chief Esposito recalls Sept. 11, 2001 as a newly promoted lieutenant with a day off and plans to study for the captain’s exam 04:28 – Chief Esposito details arriving in lower Manhattan and finding command structures and communications devastated 05:04 – The desperate process of identifying who was alive, missing or lost 07:00 – Chief Esposito describes his initial response and why he never imagined the towers could collapse 09:00 – “We think we lost everybody.” When the magnitude of FDNY's losses began to become clear 09:30 – Accountability and self-deployment emerge as major lessons from 9/11 10:00 – How FDNY now wants off-duty members to report to firehouses and EMS stations rather than directly to an incident 10:30 – Modern digital accountability, riding lists and identifiable radio transmissions compared with 2001's paper systems 12:00 – The human factor: firefighters desperate to get aboard apparatus headed toward the World Trade Center 12:30 – Leadership decisions that removed extra firefighters from overloaded apparatus ultimately saved lives 14:00 – The continuing human toll: FDNY's memorial walls and deaths from World Trade Center-related illness 16:30 – How FDNY will commemorate the 25th anniversary 17:30 – Why September 11 remembrance is intensely personal for individual firefighters and families 21:00 – Chief Esposito discusses the emotional effect September 11 continues to have on him 22:00 – “Never forget” means remembering actions and decisions, not merely names 24:00 – The actions of responders helped prevent civilian deaths potentially reaching into the tens of thousands 25:00 – Managing the overwhelming desire of responders to help during catastrophic incidents 27:30 – How outside incident management teams helped FDNY solve problems after 9/11 28:30 – FDNY repaying the assistance it received through deployments around the United States 30:00 – How today's incident command and dispatch systems control resources and prevent uncontrolled response 31:42 – Sponsor message 32:30 – Improved interagency collaboration between FDNY, NYPD and other agencies 36:00 – Peer support, firehouse culture and challenging the stereotype that firefighters do not talk about emotional distress 38:30 – How FDNY's peer-support system works after difficult incidents 42:30 – September 11 demonstrated why the fire service needs to be part of the intelligence community 44:00 – FDNY members are trained to recognize suspicious activity during routine fire and EMS responses 46:00 – How information spotted by firefighters may become the missing piece in a larger investigation 48:30 – What Chief Esposito wants responders who were not alive on 9/11 to understand 49:00 – “This is our legacy.” Measuring today's performance against those who came before 52:00 – Know your job and do your job — while recognizing that not every emergency fits an SOP 52:30 – A recent Bronx explosion illustrates the need to adapt principles to situations for which no exact procedure exists 53:30 – Applying the overarching principles of life safety and rescue when the situation is unprecedented 54:30 – What does “never forget” mean 25 years later? 55:30 – September 12: despite catastrophic losses, FDNY opened its firehouses and continued protecting New York City 56:30 – Chief Esposito describes those killed as “an all-star team” and some of the best ever to do the job 58:00 – Aaron Zamzow reflects on the responsibility to “measure up” 59:30 – The nationwide impact of 9/11 and seeing FDNY remembered on apparatus thousands of miles from New York 1:01:30 – Jim Dudley reflects on intelligence, prevention and acting on warning signs 1:03:30 – Chief Esposito discusses the difficulty of measuring successful prevention 1:05:00 – Warning signs, intelligence and lessons shared with other historic disasters 1:06:00 – Rob Lawrence reflects on September 12 and the emergency services reality that tomorrow brings another shift 1:07:00 – “At the going down of the sun and in the morning, we will remember.” 1:08:00 – Esposito discusses how 9/11 affected his career and leadership journey 1:09:00 – Leadership, doing the right thing and measuring decisions against the memory of colleagues lost 1:10:00 – “Take care of the people that take care of the city.” 1:11:30 – Emergency responders never know when the next call will become the worst situation they have ever faced 1:12:00 – The responsibility to ensure frontline personnel are prepared and supported 1:12:30 – Closing message: “Keep learning and keep moving forward.” About our sponsor This crossover episode of the Policing Matters, Better Every Shift and EMS One-Stop podcasts is sponsored by FirstNet — the only wireless network built with and for first responders. Twenty-five years ago, first responders faced an emergency unlike any other. They stepped forward to protect and care for others, demonstrating extraordinary courage and resolve. This September 11th, we remember and honor those who answered the call. The example they set endures through the values that continue to inspire the profession today. Learn more about FirstNet, Built with AT&T, at www.firstnet.com. 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. | |||
| Data versus Darwin with Todd Stout | 04 sept. 2026 | 00:37:35 | |
AI may feel like the newest revolution in EMS, but the industry's relationship with data has been evolving for decades. In this episode of EMS One-Stop, Rob Lawrence sits down with FirstWatch founder Todd Stout, whose 28 years working with EMS data gives him a particularly long view of where the industry has been and where it is heading. Todd traces the journey from an era when monthly reports printed on green-bar paper were considered normal, to today's world of real-time dashboards, cloud-based systems and enormous volumes of operational and clinical information. The challenge has changed: EMS no longer suffers primarily from a lack of data; leaders now need technology that can identify what matters, separate signal from noise and turn information into decisions. That makes AI extraordinarily promising — and potentially dangerous. Todd explains why he is more excited about the next 3-5 years than at any point in his career, while simultaneously being more concerned about the next 8-10 months. Rob and Todd discuss unreliable AI outputs, data security, HIPAA and privacy, the risks associated with startups and what EMS leaders should ask before entrusting vendors with organizational or patient data. They also examine the urgent need for EMS agencies to establish AI policies and train their workforce on responsible use. Todd concludes with a preview of FirstWatch's next generation of AI-enabled tools and a broader message for EMS leaders: the organizations that thrive through this technology shift will not necessarily be those with the newest technology, but those capable of adapting, learning and using it responsibly. Additional resources:
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| Liz Harney on the human side of EMS | 01 sept. 2026 | 00:55:18 | |
This week on EMS One-Stop, I sit down with Liz Harney, almost a year after I first walked into a classroom at EMS World Expo looking for another session to report on and found what I later described as “the keynote I didn’t know I needed.” Liz’s presentation was built around a part of EMS education we routinely acknowledge but rarely give equal billing: the affective domain — empathy, communication, professionalism, self-awareness and the ability to connect with another human being in what may be the worst moment of their life. But the real power came from Liz herself. Before she was a paramedic, educator and EMS leader, she was the patient. At the lowest point of a decade-long struggle with addiction, one paramedic looked beyond the overdose, the circumstances and the judgement, and treated her as a person who still mattered. Liz credits that interaction not simply with helping save her clinically, but with changing the trajectory of her life. She recovered, entered EMS and ultimately became the kind of paramedic she had encountered that day. It is a remarkable journey from patient to paramedic, and in this conversation, Liz explains why that experience now sits at the heart of everything she teaches about the human side of EMS. | MORE: Liz Harney — the affective domain is the heart of EMS, so why aren’t we teaching it? Our discussion also catches up with where Liz’s thinking has evolved since. In her recent EMS1 article, “Shiny Happy People,” she takes that same belief in people and applies it to EMS leadership, challenging professionals that is exceptionally good at identifying everything that might go wrong not to let that instinct extinguish every new idea before it gets moving. Together, we connect those themes: the provider who changed one patient’s life, the importance of deliberately teaching the affective domain, turning cynics into champions, recognizing burnout through QA and QI, and creating leadership teams with enough optimism and emotional intelligence (EI) to make change happen. At a time when EMS is increasingly consumed by another form of intelligence (AI), the conversation comes back to a proposition I think matters more and more: if we are going to get good at AI, we first need to get much better at EI. Additional resources:
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| EMS One-Stop: The EMS research every clinician should be reading | 21 août 2026 | 00:36:38 | |
EMS research has grown rapidly, but finding the studies that truly matter to everyday clinical practice remains a challenge. In this edition of EMS One-Stop, Rob Lawrence is joined by Dr. Christopher Richards, EMS and emergency physician at the University of Cincinnati; and Dr. Christian Martin-Gill, chief of the Division of EMS at the University of Pittsburgh and former president of the Prehospital Guidelines Consortium, to discuss the recently published EMS research reading list and the effort to identify the most important evidence EMS clinicians and medical directors should know about. The discussion explores how the reading list was created; why a significant gap remains between publication and implementation; and how EMS can better translate research into education, protocols and patient care. Richards and Martin-Gill explain the mix of evidence-based guidelines, position statements, systematic reviews and original research included in the project, while highlighting major gaps in behavioral emergencies, pediatrics, obstetrics, workforce wellness and EMS operations. The message is clear: EMS practitioners should not wait for new research to appear in their protocols. They should read it, discuss it, question current practice and, where evidence is lacking, consider contributing to research that closes the gap. Additional resources:
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| Knoxville’s Mission District model takes EMS beyond the 911 call | 16 août 2026 | 00:39:40 | |
In this episode of EMS One-Stop, Rob Lawrence speaks with Wesley Brookshear, critical care paramedic and FTO program supervisor with AMR in Knoxville, Tennessee, about a community-led effort that is changing how EMS responds to the city’s Mission District. What began as an attempt to understand unusually high 911 utilization has evolved into a multidisciplinary outreach program bringing EMS, public health, addiction services, shelter providers, clinicians and other community organizations directly to Knoxville’s unhoused population. By concentrating on relationships, consistency and basic human needs, the initiative has produced a reported 32% reduction in traditional EMS call volume while dramatically expanding access to wound care, food, addiction treatment, mental health support, nurse navigation and other services. Wesley explains why the program’s success is less about creating another specialized EMS unit and more about connecting people to the resources that already exist. The team initially arrived without uniforms, handed out fruit, listened and built trust before attempting to provide care. Two years later, the program has recorded thousands of encounters, helped more than 140 people enter treatment or sober living and generated remarkably few ambulance transports from its outreach activity. The conversation explores how other EMS systems can identify high-utilization areas, develop community partnerships, protect the mental health of outreach staff and start small—even with a single motivated employee. Above all, Wesley argues that EMS has an opportunity to move beyond simply transporting patients and instead become the connector that gets people to the care and resources they actually need. Additional resources: Key quotes
00:49 – Rob introduces the episode and the concept of specialist teams focused on populations at risk 01:52 – Wesley introduces himself, AMR Knoxville and the multidisciplinary Mission District outreach team 03:25 – Identifying concentrated 911 utilization around the North Broadway area 04:22 – The headline result: a 32% reduction in normal call volume after 2 years 05:08 – Building services around Maslow’s hierarchy of needs: food, water, shelter and safety 06:10 – How the project began with surveys asking community members what they actually needed 06:50 – Wesley emphasizes that homelessness should be understood as a human and community issue 08:05 – Building partnerships and establishing a consistent Tuesday outreach presence 08:28 – Why the team initially attended in jeans and black t-shirts rather than EMS uniforms 10:10 – Rotating team members to manage emotional and mental-health pressures 11:27 – Training new outreach personnel and protecting the culture of the program 12:10 – The practical work: washing wounds, basic dressings and human contact 13:02 – Patients begin managing and dressing their own wounds with education and supplies 13:26 – Taking CPR and Stop the Bleed education directly into the Mission District 14:00 – Using GMR nurse navigation to expand access to alternative care and follow-up 16:09 – Nurse navigation, mental-health pathways and bypassing the emergency department when appropriate 18:28 – Discussion resumes: community paramedicine versus mobile integrated healthcare 19:23 – Rob defines MIH as “mobile, integrated and healthcare” 20:01 – Building relationships with partner organizations beyond the street-level outreach work 21:23 – Program numbers: approximately 4,800 encounters, 515-plus people served, 140-plus entering treatment or sober living, and only nine outreach encounters requiring ambulance transport 22:14 – A frostbite patient whose feet were saved through coordinated community intervention 24:23 – Wesley reflects on severe wounds, winter outreach and the impact of simple acts of care 25:18 – Where another EMS chief should start: find the hot spots and find someone who cares 26:39 – Starting small and expanding services gradually through community partnerships 27:08 – Why handing someone a resource list is not enough 27:36 – EMS as clinicians and navigators rather than simply a transport service 28:50 – Rob discusses “arrival avoidance” and directing patients into appropriate pathways of care 29:51 – The minimum viable program: one person who builds connections and physically links patients to resources 30:42 – Costs, donated supplies and the operational value of reducing unnecessary 911 demand 31:55 – The broader return: increased ambulance availability and potentially improved workforce engagement 33:14 – What not to do: don't approach outreach expecting to “solve homelessness” 33:43 – Managing compassion fatigue and rotating team members 34:58 – Food, coffee and small gestures as tools for relationship-building 35:26 – Challenging assumptions about who becomes unhoused 36:51 – Wesley's closing message: seek opportunities for EMS to grow and approach vulnerable populations with compassion 38:38 – Rob closes the episode with a challenge to EMS leaders: start something, even if it is small Enjoying the show? Email editor@ems1.com to share feedback. | |||
| Grant funding demystified with Anya Otterson | 07 août 2026 | 00:31:40 | |
Finding grant funding can feel overwhelming, particularly for smaller EMS and fire agencies where one person often wears multiple hats. In this episode of the EMS One-Stop podcast, host Rob Lawrence is joined by Lexipol Grant Writer and Colorado Firefighter-Paramedic Anya Otterson to demystify the grant-writing process. From identifying funding priorities and locating grant opportunities, to building a compelling case backed by data, Anya provides a practical roadmap for agencies looking to secure funding for equipment, staffing and operational improvements. She explains why success starts with clearly defining organizational needs, understanding grant priorities, and assembling evidence that demonstrates both community impact and operational necessity. The discussion explores the complete grant lifecycle, from preparing competitive applications, through to post-award reporting and compliance. Anya emphasizes that strong grant applications combine hard data with real patient stories, while Rob shares lessons learned from managing successful Assistance to Firefighters Grants (AFG) and transportation safety grants. They also discuss how AI tools such as ChatGPT can accelerate research when used appropriately — but caution against relying on AI to write narratives outright. The episode concludes with encouragement for agencies to not be discouraged by unsuccessful applications, reminding listeners that grant writing is an iterative process where persistence and continual improvement often lead to success. Additional resources
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| Why EMS can’t sing along with this Anthem | 24 juil. 2026 | 00:32:31 | |
Matt Zavadsky explains how a commercial insurer’s reimbursement proposal — and looming Medicaid changes — could reshape EMS funding In this week’s episode of EMS One-Stop, we examine two major financial threats facing EMS reimbursement. Host Rob Lawrence is joined by Matt Zavadsky to analyze the recent Elevance (Anthem) Health Public Policy Institute paper, which argues that commercial insurers should reimburse ambulance services at approximately 160% of the Medicare fee schedule. Zavadsky, EMS/mobile healthcare consultant with PWW | Advisory Group, explains why this paper is significant, noting that Medicare already reimburses below the actual cost of providing ambulance services. If policymakers adopt or even believe Elevance's recommendations, commercial reimbursement could fall dramatically, removing one of the few revenue sources that currently offsets chronic underpayments from Medicare and Medicaid. The discussion highlights the growing influence of commercial insurers in state legislatures and stresses the need for EMS leaders to counter policy proposals with credible cost and operational data rather than anecdotal arguments. The conversation then shifts to CMS's proposed Medicaid supplemental payment rule (GEMT), where Matt predicts that most of the proposed changes are likely to survive into the final rule despite industry opposition. Both hosts discuss their review of the public comments, noting differing impressions of stakeholder sentiment but agreeing that agencies should begin financial planning now for a potential reduction in supplemental Medicaid revenue beginning in 2029. Throughout the episode, the recurring theme is that EMS must become far more effective at explaining both the cost of readiness and the consequences of underfunding. The episode concludes on a more positive note by highlighting the newly released What Paramedics Want in 2026 report as a practical roadmap for improving workforce satisfaction while the industry continues addressing long-term reimbursement challenges. Additional resources
Key quotes "The commercial insurance industry is creating a story that elected officials may perceive as reasonable. We need to combat that story with facts." — Matt Zavadsky "Medicare reimbursement is already below cost, so using it as the benchmark automatically discounts ambulance services." — Matt Zavadsky "We do a great job telling stories about the lives we save. We do a poor job telling the story of what it costs to provide that service." — Matt Zavadsky "The balance billing issue is going to be the No. 1 issue in the next 12 months." — Matt Zavadsky "The first time local elected officials hear there's a problem is usually when the sky is already falling. We need to tell the story before the sky falls." — Matt Zavadsky "Know your costs; know your costs at different service levels, and begin educating your local community." — Matt Zavadsky "This isn't necessarily good news, but it's something we need to understand and all work together to deal with." — Rob Lawrence Episode timeline 00:00 – Introduction and the Elevance Health Public Policy Institute report 02:00 – Matt explains who Elevance Health is and why the report should be viewed as a commercial insurer's policy position 03:30 – Discussion of state balance billing legislation and how commercial insurers are successfully pushing lower reimbursement benchmarks 06:15 – Breakdown of what percentages of Medicare actually mean using national EMS financial data 08:30 – Why using Medicare as the reimbursement benchmark is fundamentally flawed because Medicare itself pays below cost 10:30 – Discussion on the political influence of insurers and why EMS must counter with data-driven messaging 12:30 – Why EMS has historically struggled to tell its financial story despite being effective at telling patient care stories 14:20 – Matt predicts balance billing legislation will become the industry's No. 1 policy issue over the next year 16:10 – Potential consequences if commercial reimbursement falls to 160% of Medicare 17:30 – Discussion on community funding, essential service models and matching service expectations with available revenue 22:20 – Transition to CMS's proposed Medicaid supplemental payment (GEMT) rule 22:45 – Review of public comments submitted on the CMS proposal and differing observations about stakeholder support 25:00 – Matt predicts the CMS rule will largely move forward and agencies should prepare accordingly 27:45 – California and other states discussed as examples of systems likely to experience significant reductions in supplemental Medicaid funding 30:45 – Closing on a positive note with discussion of the What Paramedics Want workforce survey | |||
| Preventing falls, preserving independence: An EMS success story | 23 juil. 2026 | 00:37:23 | |
The 2026 AIMHI Excellence in Public Information or Education Award recognizes organizations that create innovative programs which improve health, educate communities and demonstrate measurable outcomes. This year’s recipient, the Medic Keep the Beat Foundation, earned national recognition for a groundbreaking fall-prevention initiative that is helping older adults remain independent, reducing repeat 911 calls and preventing avoidable hospital admissions. The award celebrates programs that move EMS beyond emergency response into proactive, community-based healthcare. In this episode of EMS One-Stop, Rob Lawrence sits down with Jimmy Pierson, president and COO of Medic Ambulance; and Angeline Pierson, occupational therapist with the Medic Keep the Beat Foundation, to explore the award-winning program in depth. The discussion covers everything from home safety assessments and occupational therapy interventions, to public-private partnerships, sustainable funding, EMS workforce innovation and why prevention may be one of the greatest opportunities facing EMS today. Key quotes“You’ve taken the frequency out of a faller.” — Rob Lawrence “We don’t want healthier transports; we want a healthier community.” — Jimmy Pierson “This isn’t a business model; it’s a community model.” — Jimmy Pierson “We want to keep people safe and independent in their own homes.” — Angeline Pierson“With this program they can stay at home instead of moving into a skilled nursing facility.” — Angeline Pierson “The key is finding partners who see you as a partner; not as a subcontractor.” — Jimmy Pierson “The Australian paramedics became part of our family; they weren’t temporary staff.” — Jimmy Pierson Additional resources
01:00 – Meet Jimmy and Angeline Pierson 02:00 – Inside the award-winning fall prevention program 06:45 – How patients enter the program 08:30 – Why preventing falls starts inside the home12:30 – Measuring outcomes and demonstrating return on investment 15:00 – Funding, grants and building community partnerships 17:00 – Public-private partnerships with California fire departments 22:00 – Sonoma County Fire and collaborative EMS delivery 28:00 – Workforce rebuilding after COVID-19 31:30 – Recruiting Australian paramedics and creating a sustainable workforce 34:30 – Final reflections on prevention, partnerships and the future of EMS Rate and review the EMS One-Stop podcastEnjoying 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. | |||
| Breaking the system to make it stronger | 03 juil. 2026 | 00:35:42 | |
This week on the EMS One-Stop podcast, Rob Lawrence sits down with emergency management and large-scale exercise expert Mike Marsh to explore what really goes into preparing agencies, communities and public safety partners for major events. With the FIFA World Cup underway, America 250 upon us, and countless local events happening every weekend, the conversation focuses on the practical realities of planning, exercising and pressure-testing emergency response systems before the big day arrives. | MORE: Training hard and fighting easy. Creating an effective tabletop training exercise for pre-planning MCI response Drawing on decades of EMS leadership experience and his current work through Marsh EMS Consulting, Mike shares how agencies can move beyond "grant compliance exercises" and build meaningful operational readiness. From tabletop exercises and ROC drills, to stakeholder coordination, communication failures and after-action reviews, Mike provides a masterclass in how to build resilient systems from the operator up. His central premise is simple: exercises should be designed to break the system in a safe environment so weaknesses can be identified and corrected before a real incident occurs. Whether you're preparing for a World Cup match, a county fair, or simply reviewing your MCI plans, this episode offers practical lessons for agencies of every size. Notable quotes
| MORE: 5 lessons for special events standby services and emergency response Episode timeline00:00 – Introduction and why major events require planning, exercises and preparation 02:25 – Mike's journey from California EMS leadership to emergency management consulting in Texas 04:53 – The biggest misconceptions about exercises and tabletop planning 06:30 – What frontline EMTs and supervisors need to know when the incident is bigger than they are 08:07 – The first questions Mike asks when planning a major event 10:13 – Communication, stakeholder engagement and identifying operational gaps 12:16 – Translating ICS and NIMS concepts into practical operational language 17:08 – Planning a county fair exercise: where to start and why capability gaps matter 19:46 – Who should be at the planning table and why executive participation matters 21:23 – The role of public works, politicians, emergency managers and public information officers 22:29 – The best and worst exercises Mike has ever experienced 25:29 – How to challenge leaders who believe their plans don't need testing 28:01 – Exercise planning for small and rural systems with limited resources 30:22 – After-action reviews and turning lessons identified into lessons learned 32:11 – Advice for agencies that have never exercised their plans before 33:54 – Mike's biggest leadership lesson from a career in EMS and emergency management Rate and review the EMS One-Stop podcastEnjoying the show? Email editor@EMS1.com to share ideas, suggestions and feedback. | |||
| Pinnacle 2026 preview: Leadership, retention, AI and the future of EMS | 26 juin 2026 | 00:35:29 | |
The countdown to Pinnacle is on. Returning this year to San Diego from July 13-16, Pinnacle remains one of the most influential leadership and management conferences in EMS. Now entering its 22nd year, the event continues to attract executives, clinical leaders, innovators, educators and industry partners who gather not simply to learn, but to debate, challenge assumptions and shape the future direction of EMS. EMS1 is proud to be the premier media partner of Pinnacle. | MORE: What Paramedics Want in 2026: Bookmark this page to get your copy Joining EMS One-Stop this week is Anthony Minge, senior partner at Fitch & Associates and one of the driving forces behind Pinnacle. Anthony previews the major themes emerging this year, including workforce retention, leadership development, burnout and wellness, preparedness, artificial intelligence, blood delivery, drone technology and the ever-popular What Paramedics Want report. Throughout the discussion, Anthony emphasizes that Pinnacle's value extends beyond the classroom. The real learning often happens in the conversations between sessions, over meals and among peers facing the same challenges across the country. The conversation explores why retention has overtaken recruitment as EMS's primary workforce concern, how leaders must take greater responsibility for organizational culture, and why emerging technologies such as AI and drone-delivered medical supplies are changing the profession faster than many realize. Anthony also offers a preview of keynote speakers, including preparedness expert and author William Forstchen, and highlights sessions covering leadership, resilience, operational excellence, workforce wellness and healthcare innovation. As always, Pinnacle promises to deliver practical takeaways, provocative discussions, and the opportunity to connect with some of the brightest minds in EMS. Key quotes
Additional resources
Episode timeline 03:00 – The major themes of Pinnacle 2026. Discussion of retention, leadership, financial sustainability, workforce wellness, preparedness, AI and emerging technologies. 06:30 – Recruitment vs. retention. Why keeping employees has become more important than finding new ones and how organizations can build careers rather than simply fill vacancies. 08:15 – Leadership beyond operations. The role of leadership in employee engagement, succession planning, data-driven decision-making and lessons from Matthew McConaughey's book Greenlights. 11:00 – Burnout, wellness and resilience. Why burnout remains a major challenge for EMS and how leaders must confront it rather than ignore it. 13:00 – Preparedness for the next crisis. A preview of keynote speaker William Forstchen and discussions around resilience, disaster readiness and planning for both natural and man-made events. 19:00 – AI Comes to EMS. Anthony discusses the opportunities and risks associated with artificial intelligence, from documentation and CAD integration, to clinical decision support. 24:00 – Blood, drones and clinical innovation. A look at how blood products, AEDs, naloxone and other critical supplies are increasingly being delivered through innovative technologies, including drones. 29:00 – What Paramedics Want in 2026. A preview of the latest survey findings and the issues currently weighing most heavily on the minds of EMS professionals. 30:00 – Why Pinnacle matters. Anthony explains why networking, relationship building and peer-to-peer learning remain among the conference's greatest strengths. 32:00 – The conversation EMS needs to have. Anthony identifies leadership responsibility and accountability as one of the most important — and often avoided — topics facing EMS today. Enjoying the show? Email editor@ems1.com to share feedback. | |||
| Policy, payment reform and why EMS must engage | 18 juin 2026 | 00:34:45 | |
At a time when EMS reimbursement faces unprecedented scrutiny and pressure, Shawn Baird joins the EMS One-Stop podcast to explain what is happening in Washington, D.C., why it matters to every ambulance service in America and what EMS leaders can do about it. | MORE: When the spreadsheet meets the siren: How CMS’s Proposed GEMT Rule could reshape EMS funding A former Paramedic, ambulance service owner, CEO, American Ambulance Association resident, and now Vice President of Government Affairs for the AAA, Baird brings a unique perspective that spans frontline care, operations and national advocacy. In this episode, Rob Lawrence and Baird unpack the growing threats to Medicare and Medicaid funding, discuss the proposed changes to Medicaid supplemental payment programs, and explore the work of the National EMS Payment Reform Committee. The conversation also previews the AAA Legislative Fly-In, and highlights efforts to secure EMS workforce funding, streamline military medic transitions into civilian EMS and advance federal fuel tax relief. Most importantly, Baird delivers a clear message: EMS professionals must tell their story, engage with elected officials and advocate for the future of mobile healthcare. This episode serves as both an explainer and a call to action. As federal policymakers debate Medicaid funding, EMS reimbursement, workforce development and healthcare spending, Baird makes the case that every EMS professional has a role to play. Whether through legislative fly-ins, ride-alongs, town halls or simply telling the EMS story, advocacy is no longer optional. It is essential to preserving access to emergency medical care in communities across America. Notable quotes "We're hoping to make some proposals for real long-term reform on Medicare that will shore up the EMS system, not just to survive day to day, but really to thrive." — Shawn Baird "We are more than just a ride. We are mobile healthcare." — Rob Lawrence "We really have not been able to find a lot of data to support a bunch of waste, fraud and abuse in the EMS system. What there is, is a lot of misunderstanding." — Shawn Baird "If we don't get paid ourselves, how can we pay other people? How can we then afford to deliver excellent healthcare to our patients?" — Rob Lawrence "First of all, talk about the patient because the patient is the most important part of this whole discussion; second of all, talk about the medical care you provide because that's what the patient needs." — Shawn Baird "We're the safety net. We're access to critical emergency care in many communities that don't have other healthcare." — Shawn Baird "Probably the most important thing that folks listening to your show can do is attend a town hall and raise your hand and say, 'I'm just worried about our ambulance service.'" — Shawn Baird "We have the greatest story of all to tell." — Shawn Baird Additional resources
Episode timeline 01:00 – Rob introduces the episode and outlines the challenges facing EMS reimbursement and federal healthcare funding. 02:07 – Shawn Baird's EMS Journey — from paramedic intern at Grady Hospital to rural EMS operator, company owner, AAA president and government affairs leader. 03:00 – Why healthcare reimbursement decisions are increasingly shifting from Washington to state legislatures. 06:45 – The National EMS Payment Reform Committee and the search for long-term solutions to EMS financing. 09:13 – Medicaid, waste, fraud and abuse — understanding misconceptions about EMS reimbursement and why ambulance services are being caught in broader healthcare debates. 11:33 – EMS is more than transportation — reframing EMS as healthcare first, transportation second. 13:20 – The threat to Medicaid supplemental funding — provider taxes, GEMT programs and proposed federal changes that could impact ambulance services nationwide. 15:15 – Proposed CMS rule changes — why EMS leaders are concerned about being included in Medicaid funding reductions. 17:40 - How national EMS organizations are coordinating efforts to speak with one voice. 20:08 – The AAA Legislative Fly-In — what it is, how it works and why provider participation matters. 21:45 – Federal legislative priorities — EMS workforce development funding, military medic-to-civilian certification pathways and federal fuel tax relief for ambulance services. 26:50 – How EMS providers can engage when legislation is moving. 27:40 – The importance of local advocacy — town halls, community events and direct engagement with elected officials. 29:30 – Ride-alongs as an advocacy tool — why seeing EMS firsthand changes policymakers' perspectives. 32:00 – Final thoughts — politics is ultimately about relationships, storytelling and helping decision-makers understand EMS. Enjoying the show? Email editor@ems1.com to share feedback. | |||
| Johnny and Roy inspired a generation. Now they're telling EMS's toughest truths | 12 juin 2026 | 00:41:22 | |
What happens when the stars of the television series that introduced America to paramedicine decide it's time to tell the real story? In this episode of EMS One-Stop, Rob Lawrence is joined by EMS pioneer Dr. Baxter Larmon and award-winning filmmaker Tom Putnam to discuss Into the Unknown: The Paramedics' Journey. Born from the vision of Emergency! stars Randolph Mantooth and Kevin Tighe, and backed by Steve Buscemi, the documentary follows paramedics, dispatchers, volunteers, flight crews and their families across America, revealing the realities of modern EMS. From Baton Rouge to Sparks, from volunteer rescue squads in Virginia, to helicopter rescue teams in California, the film explores not only what paramedics do, but what the job does to them. The conversation examines workforce shortages, mental health, resilience, public misunderstanding of EMS, and the role the film could play in educating communities, policymakers and future generations. The episode also explores the documentary's Kickstarter campaign and plans for worldwide release. If Emergency! introduced America to paramedics 50 years ago, Into the Unknown seeks to explain the people behind the uniform. Notable quotes
Enjoying the show? Email editor@ems1.com to share feedback. | |||
| Blood on Board: The second chance that changed everything | 04 juin 2026 | 00:30:46 | |
In Episode 4 of the EMS One-Stop Blood on Board Series, host Rob Lawrence brings together two powerful perspectives on prehospital blood transfusion. First, retired Army trauma nurse and national blood advocate Randi Schaefer discusses the work of the Prehospital Blood Transfusion Initiative Coalition and the ongoing effort to remove barriers to blood product availability across the United States. Drawing on lessons learned from military deployments and civilian implementation efforts, Schaefer explains why successful blood programs require collaboration among EMS agencies, hospitals, blood banks, legislators and funding partners. She emphasizes that while every system is different, the goal remains the same: getting lifesaving blood to patients before they reach the hospital. The second half of the episode focuses on the story behind the statistics. Dr. Kate Krause, an emergency physician from Dallas, recounts her near-fatal postpartum hemorrhage just weeks after giving birth to her daughter. After she lost more than two liters of blood at home, Dallas Fire-Rescue paramedics recognized the severity of her condition and secured authorization to administer prehospital blood. That decision, combined with rapid transport and seamless hospital coordination, helped save her life. Today, fully recovered and back to practicing medicine, Dr. Krause has become a compelling advocate for prehospital blood programs, reminding policymakers and EMS leaders that behind every protocol, funding request and unit of blood is a patient whose future depends on receiving the right treatment at the right time. Previous Blood on Board episodes:
Impactful quotes "I had a severe postpartum hemorrhage and had my life saved by a prehospital blood transfusion." — Dr. Kate Krause "I'm here. I have no deficits. I'm healthy. I'm back to being a physician. I'm back to being a wife and being a mother to my beautiful little baby girl." — Dr. Kate Krause "The coalition wants to make blood products available to those EMS agencies that want to carry them." — Randi Schaefer "This is a brand-new relationship. So there's a lot of learning how each other's worlds work." — Randi Schaefer "We were not going to let people die of preventable death." — Randi Schaefer "Keep pressing forward. We will find a way to yes." — Randi Schaefer "Blood is one of those things that really makes a difference when it's given early." — Dr. Kate Krause Additional resources Episode timeline 00:00 – Introduction to Episode 4 and recap of the Blood on Board series and overview of previous episodes covering local, state and national blood initiatives. 02:18 – Introduction of Randi Schaefer and Dr. Kate Krause. Schaefer discusses military deployments and early blood program experiences, while Dr. Krause outlines her journey from lifeguard, to EMT, to emergency physician. 05:05 – Origins and mission of the Prehospital Blood Transfusion Initiative Coalition, military lessons learned, funding challenges, sustainability concerns, the importance of legislative support and reimbursement 13:57 – Dr. Krause recounts her postpartum hemorrhage. 19:03 – Discussion of non-trauma indications for prehospital blood and the importance of medic judgment and protocol flexibility 20:22 – Dr. Krause discusses recovery and advocacy efforts, and Dallas City Council appearance and public awareness activities. 24:24 – Dr. Krause delivers a concise advocacy message supporting blood programs nationwide. 25:01 – Schaefer reflects on meeting blood recipients and the impact of seeing survivorship firsthand. 27:47 – Closing remarks from Dr. Krause and Schaefer 29:03 – Lawrence wraps up the four-part Blood on Board series and reinforces the need for continued advocacy and funding. This episode is sponsored by Triad of Life. After traumatic injury, patients may enter the “Triad of Death” — a dangerous cycle of hypothermia, acidosis, and coagulopathy that can rapidly lead to fatal outcomes without timely intervention. That’s why Delta Development Team partners with Qinflow and Lifeflow to combat these life-threatening conditions with the Triad of Life. Learn how your team can put the Triad of Life into practice. Enjoying the show? Email editor@ems1.com to share feedback. | |||
| Blood on Board: Everything is bigger in Texas | 28 mai 2026 | 00:46:18 | |
Texas is taking prehospital whole blood to scale. In this second installment of the Blood on Board series, the conversation moves from pioneering local programs to a statewide initiative backed by legislation, trauma system collaboration and a $10 million investment in EMS blood capability. Host Rob Lawrence welcomes Dr. Jeff Jarvis, chief medical officer and system medical director, Fort Worth Office of the Medical Director; Dr. C.J. Winckler, deputy medical director for the San Antonio Fire Department; and Jorie Klein, director of EMS-Trauma Systems Section, Texas Department of State Health Services. From San Antonio’s early adoption to Fort Worth’s operational maturity and the Texas Department of State Health Services’ statewide rollout, this episode examines how Texas built one of the most ambitious prehospital blood programs in the country. The discussion goes beyond clinical theory. The guests tackle implementation, logistics, blood stewardship, wastage concerns, rural access, legislative strategy and the realities of getting physicians, transfusion medicine specialists, EMS leaders and lawmakers aligned around a shared mission. The episode also explores the expanding use of whole blood beyond trauma, including GI bleeds, obstetrics and surgical hemorrhage, while reinforcing the operational mantra repeated throughout the show: systems save lives. | MORE: Blood on board: Lessons from Sacramento and LA County Fire Impactful quotes
00:00 – Opening message. Jorie Klein outlines the central lesson for other states: engage frontline providers and avoid managing programs remotely. 00:40 – Introduction. Rob Lawrence introduces Episode 2 of the Blood on Board series, shifting focus from local systems to statewide implementation in Texas. 01:20 – Meet the guests. Jorie Klein, Dr. Jeff Jarvis and Dr. C.J. Winckler introduce themselves and their roles in Texas EMS and trauma care. 03:22 – The San Antonio origin story Dr. Winckler explains how military medicine, trauma surgeons and Texas delegated medical practice helped launch San Antonio’s whole blood program. 06:04 – Building the first protocols. Dr. Winckler discusses creating guidelines from scratch, operationalizing blood administration and securing funding support from city leadership. 08:52 – Going system-wide. San Antonio launches whole blood citywide in October 2018 without a pilot project. 10:13 – Ethics and evidence. Discussion shifts to mortality data, prehospital physiology and whether balanced blood resuscitation should already be considered standard of care. 12:14 – Fort Worth follows. Dr. Jarvis explains how San Antonio’s system inspired adoption in Fort Worth and highlights the importance of regional collaboration. 14:03 – Texas goes statewide. Klein explains the legislative process that resulted in a $10 million statewide prehospital whole blood initiative. 17:24 – Rural Texas and blood access. The conversation focuses on plasma options, rural hospital shortages and improving access for remote communities. 23:45 – The data discussion. Dr. Jarvis shares Fort Worth operational metrics, transfusion volumes and remarkably low wastage rates. 28:49 – Whole Blood Academy. Drs. Jarvis and Winckler discuss the National Whole Blood Academy and how Texas is teaching other EMS systems to replicate their success. 32:00 – Trust, logistics and blood stewardship. Dr. Winckler explains the importance of relationships between EMS and transfusion medicine physicians, emphasizing operational discipline and trust. 36:20 – What comes next? Dr. Klein discusses statewide reporting, future funding requests and sustaining the Texas model long term. 40:15 – Final lessons for other states. The guests close with advice on advocacy, clinician engagement and building support from the ground up. Email editor@ems1.com to share feedback. | |||
| Blood on Board: Federal funding paves the way for EMS blood programs | 28 mai 2026 | 00:42:39 | |
The EMS One-Stop Blood on Board series moves to the federal level in Episode 3, exploring how the National Highway Traffic Safety Administration Safe Streets and Roads for All (SS4A) grant program is opening new funding pathways for prehospital blood programs. Host Rob Lawrence is joined by three leaders directly involved in building regional blood capability through federal funding.
Rather than focusing solely on clinical practice, this episode examines the realities of applying for, winning and administering federal grant funding. The guests discuss building regional coalitions, engaging blood banks, developing standardized protocols, navigating compliance requirements and preparing operational rollouts. From Missouri’s $4.6 million demonstration grant, to Kansas City’s regional planning initiative, this episode provides a practical roadmap for EMS leaders looking to transform roadway safety funding into lifesaving trauma care capability.
Impactful quotes “Don’t be afraid of applying for a big, scary federal grant.” — Mark Heath “EMS is the perfect partner to try to understand how to address the post-crash care component of a safety action plan.” — Julie Stilley “If you’re going to do it as a region, you’ve got to hang together.” — Jason White “The data points on the backside will set you free.” — Mark Heath “If my blood is closer to the next address over, just because there’s a river in the way doesn’t mean we can’t get across the bridge.” — Mark Heath “What started initially as an absolute ‘no’ became, ‘Wait, let me listen to you some more.’” — Julie Stilley “The juice is worth the squeeze.” — Rob Lawrence “Firefighters and EMS are cowboys, and blood banks are accountants.” — Mark Heath “Cowboys do marry accountants.” — Jason White “Run, don’t walk, to your local blood bank.” — Mark Heath “It’s your blood in your community and going into you on your ambulances.” — Mark Heath “We’re moving toward reducing mortality and reducing long-term injury.” — Julie Stilley Additional resources
Episode timeline 00:00 – “Free money is free money”. Chief Mark Heath opens with encouragement for agencies considering federal grant applications and urges smaller communities not to be intimidated by the process. 00:44 – Introduction to Episode 3. Rob Lawrence recaps Episodes 1 and 2 of the Blood on Board series before introducing the SS4A grant focus and the featured guests. 02:07 – Meet the guests. Julie Stilley introduces her role at the University of Missouri and reveals her project’s $4.6 million award. Jason White and Mark Heath outline the Kansas City regional collaboration. 04:19 – Why apply for SS4A? Julie Stilley explains how frustration around operational barriers to blood implementation motivated her grant application. 05:38 – Understanding demonstration grants. Discussion on the difference between planning and demonstration grants, and how post-crash care fits into regional traffic safety action plans. 06:51 – Building regional coalitions. Jason White discusses Kansas City’s existing regional EMS partnerships and how those relationships became the foundation for the grant application. 10:30 – Regional protocols and data. Mark Heath explains how Kansas City agencies standardized protocols, agreed on shared data points and committed to a coordinated regional approach. 13:04 – Pulling together the application. Julie Stilley outlines the process of bringing together planners, EMS leaders, trauma centers and blood banks to support the grant proposal. 15:02 – Equipment, compliance and logistics. Discussion shifts to blood warmers, storage systems, chain-of-custody monitoring and the operational realities of safely carrying blood products in the field. 18:25 – Planning grants and future implementation. Jason White explains how the Kansas City effort uses a planning grant to build toward larger implementation funding opportunities. 23:22 – Busting myths about blood. Mark Heath describes how data and national experience changed his thinking about whether whole blood matters in urban EMS systems with short transport times. 27:19 – The reality of grant administration. Julie Stilley and Jason White explain federal reimbursement structures, compliance requirements and why strong administrative partners are essential. 31:37 – Sustainability and reimbursement. Discussion on long-term funding, legislative advocacy and the need for reimbursement models for prehospital blood administration. 33:43 – Final lessons learned. The guests share advice on partnerships, blood bank relationships, data collection and not being afraid of “big scary federal grants.” Rate and review the EMS One-Stop podcastEnjoying 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. About the sponsor After traumatic injury, patients may enter the “Triad of Death” — a dangerous cycle of hypothermia, acidosis, and coagulopathy that can rapidly lead to fatal outcomes without timely intervention. That’s why Delta Development Team partners with Qinflow and Lifeflow to combat these life-threatening conditions with the Triad of Life. To learn how your team can put the Triad of Life into practice visit the link to get started. | |||
| Blood on board: Lessons from Sacramento and LA County Fire | 14 mai 2026 | 00:45:29 | |
EMS systems can safely deliver blood in the field, and when they do, patients who would otherwise die are surviving Whole blood in the field is no longer theoretical; it is operational, measurable and increasingly expected. In this EMS One-Stop episode, host Rob Lawrence brings together two of California’s leading medical directors — Drs. Clayton Kazan and Kevin Mackey — to compare and contrast their prehospital blood programs. From concept to deployment, both systems demonstrate how data, relationships and persistence can translate innovation into lives saved. This discussion goes beyond theory. It addresses real-world barriers — regulation, blood bank skepticism, funding gaps — and pairs them with practical solutions. The result is a clear message: EMS systems can safely deliver blood in the field, and when they do, patients who would otherwise die are surviving. For agencies considering similar programs, this episode provides a roadmap grounded in experience, outcomes and operational reality. Notable quotes
00:00 – Opening message. “Never say ‘no,’ never say ‘die’” sets the tone for program development and persistence 01:00 – Series introduction. Rob frames the episode as part of a broader national discussion on blood in EMS 02:00 – Guest introductions. Dr. Kazan and Dr. Mackey outline their EMS and medical backgrounds 03:20 – Program overviews. LA County: April 2025 launch, 11 squads, 58 transfusions; Sacramento: December 2025 launch after 15-month build 05:20 – Origins and catalysts. Influence from San Antonio and New Orleans programs; leadership support as a trigger 07:00 – Military influence. Translation of battlefield success into civilian EMS feasibility 08:50 – Building the business case. Data-driven forecasting using ePCR systems 11:00 – Overcoming resistance. Regulatory hurdles, skepticism and blood bank concerns 15:00 – Survivor stories. Real-world saves that validate the programs and influence policymakers 18:00 – Funding realities. Grant-based models, no current reimbursement, cost-benefit framed in life-years saved 21:45 – Equipment and logistics. Cold chain, monitoring systems, delivery devices and operational considerations 24:40 – Training and deployment. Targeted rollout using heat maps and trauma incidence data 27:45 – Early challenges. Blood recirculation, cold chain validation and system integration issues 31:50 – QA/QI and research. 100% case review and participation in multi-county data collaboratives 34:10 – Patient populations. Primarily trauma, with emerging medical indications 36:00 – Sustainability and scaling. Political engagement and expansion planning 38:15 – Rapid fire lessons learned. Transparency, persistence, relationships 42:50 – Myths and realities. Frontline providers embrace innovation; capability concerns disproven 44:00 – Final takeaways. Appreciation, relationships and system-wide collaboration as keys to success Enjoying the show? Email editor@ems1.com to share feedback. | |||
| Special report: Andes Hantavirus risk assessment | 13 mai 2026 | 00:16:44 | |
In this special EMS One-Stop update, Rob Lawrence is joined by returning guest Dr. Alex Isakov to break down the rapidly developing Andes Hantavirus outbreak linked to the expedition cruise ship MV Hondius. What began as a handful of unexplained respiratory illnesses aboard a South Atlantic voyage has evolved into an internationally monitored infectious disease event involving multiple countries, quarantine operations, public health investigations and the repatriation of exposed passengers to specialized containment facilities in the United States. | MORE: Hantavirus outbreak aboard cruise ship sends Americans to biocontainment quarantine units Dr. Isakov is professor of emergency medicine at Emory University School of Medicine and executive director of the Emory Office of Critical Event Preparedness and Response (CEPAR). He also serves as EMS lead for the National Emerging Special Pathogens Training and Education Center (NETEC), where he helps lead national preparedness efforts for high-consequence infectious diseases. In the episode, he explains how Andes Hantavirus differs from other hantaviruses already present in North America because it is capable of person-to-person transmission in limited circumstances. The discussion covers transmission dynamics, incubation periods, PPE recommendations, public health monitoring and why experts continue to assess the overall public risk as low. Listeners are also directed toward the excellent educational resource hub on preparedness and response available through NETEC Hantavirus Resources. Episode timeline00:00 – Introduction to the Special Edition. Rob Lawrence introduces the emergency update format and welcomes Dr. Alex Isakov to discuss the emerging Andes Hantavirus outbreak. 00:50 – Understanding hantaviruses. Dr. Isakov explains the difference between common North American hantaviruses and Andes Virus, emphasizing the rare person-to-person transmission capability. 03:13 – The cruise ship incident. Discussion of the outbreak aboard the MV Hondius, including onboard transmission concerns, severe illness development and international evacuation efforts. 05:16 – U.S. monitoring and quarantine. Review of quarantine operations in Nebraska and ongoing public health monitoring of exposed American passengers. 07:21 – Incubation and EMS risk assessment. Dr. Isakov outlines the prolonged incubation period and explains why frontline EMS encounters remain unlikely. 11:17 – PPE guidance for EMS personnel. Specific PPE recommendations are reviewed, including standard, contact and airborne precautions with eye protection. 13:17 – Looking ahead to World Cup 2026. The discussion turns to international travel, mass gatherings and why clinicians must maintain awareness of rare infectious diseases tied to travel history. 14:32 – EMS and public health resources. Dr. Isakov directs listeners to CDC, WHO and NETEC resources for ongoing guidance and EMS-specific updates. | |||
| Mind the gap: Data, disparities and the future of EMS | 08 mai 2026 | 00:40:35 | |
In this episode of EMS One-Stop, Rob Lawrence sits down with Tanir Ami of the CARESTAR Foundation to explore a subject that is increasingly central to the future of EMS: equity, data and system design. Born from the legacy of CalSTAR, CARESTAR has evolved into a philanthropic engine focused on improving EMS through research, convening and targeted investment. Ami brings a 25-year background in community health, grounded in service to underserved populations, and applies that experience to a sector that is only now beginning to fully interrogate disparities in care and outcomes. The conversation moves beyond theory into practical reality. From disparities in pain management and pediatric restraint use, to the challenges of fragmented EMS systems and the slow pace of statewide change, Ami outlines both what is known and what remains uncertain. The throughline is clear: data must be collected, interrogated and acted upon. CARESTAR’s work sits at the intersection of research and action, funding studies, building infrastructure, and creating space for difficult but necessary conversations. For EMS leaders, the message is direct and national in scope: examine your data, stay curious and be prepared to confront what it reveals. Key quotes“The data show that there are differences not only in how people are treated, but on the back end and the outcomes that they experience.” — Tanir Ami “Particularly Black girls were four times as likely to be physically restrained as any of their counterparts.” — Tanir Ami “Stay open-minded and open-hearted about what it is, the type of conversation that we’re trying to have.” — Tanir Ami “We really come at it holding the clinicians who are out working at the front lines of EMS in incredibly high regard, and also simultaneously wanting to talk about how and where and what the challenges are.” — Tanir Ami “Just collecting those numbers and sending them off … is not the end of the game.” — Rob Lawrence “We had a section of the city … almost a desert of non-911 calls and we realized that was our Latino community. We worked with them to promote the fact that we’re not ICE … we want to assist you in your emergency. Through that process, we closed off that desert.” — Rob Lawrence Additional resources
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. About the sponsorThis episode of the EMS One-Stop Podcast is sponsored by the 7th Annual EMS Leadership Summit. Learn from over 25 prehospital leaders from around the world sharing real-world strategies to reduce burnout, improve retention and build stronger organizations. Get your free pass at EMSLeadershipSummit.com/EMS1. Episode timeline01:00 – Tanir Ami outlines her 25-year healthcare career and explains the transition from CARESTAR to the CARESTAR Foundation. 04:30 – Discussion of disparities in care and outcomes, and the complexity of addressing systemic inequities.08:00 – Insights into disparities in pain management and pediatric restraint use, with examples from UC Berkeley and UCSF studies. 11:30 – Focus on building momentum, creating safe spaces for discussion and balancing research with implementation. 15:45 – Overview of CARESTAR funding priorities, including community conversations, behavioral health integration and pilot programs. 20:30 – Exploration of regulatory fragmentation and the challenges of statewide EMS coordination. 25:00 – Call for EMS leaders nationwide to interrogate their own data and remain open to findings. 30:00 – Emphasis on localized interventions and the absence of one-size-fits-all solutions. 35:00 – Tanir reinforces optimism and momentum, leaving listeners with a clear challenge: examine, understand and act on their data. About CARESTARThe CARESTAR Foundation is a California-based philanthropic organization dedicated to improving emergency medical services through research, innovation, and system-wide collaboration. Established in 2018 following the sale of the CalSTAR air ambulance program, the foundation was created to honor that legacy by advancing quality, integrity and equitable care across the EMS spectrum. Under the leadership of Tanir Ami, CARESTAR focuses on identifying and addressing disparities in prehospital care, funding research into EMS practices and outcomes, and convening stakeholders to drive meaningful change. Its work emphasizes the use of data to uncover gaps in treatment, supports community-driven solutions, and invests in initiatives that strengthen both the workforce and the systems that serve diverse populations. | |||
| When systems hesitate, they deploy: The rogue air crews who faced Ebola head-on | 30 avr. 2026 | 00:39:15 | |
In this episode of EMS One-Stop, Rob Lawrence sits down with Kevin Hazzard to explore No One’s Coming, a gripping account of the 2014 Ebola outbreak and the extraordinary effort to rescue infected American aid workers from West Africa. |WATCH NOW: FDNY’s future: AI, BWCs and pay parity with Commissioner Lillian Bonsignore What begins as a seemingly impossible mission evolved into a high-stakes, time-critical operation led by Phoenix Air — a team known for taking on the missions no one else will. Hazzard traces the origins of this unconventional organization, from transporting explosives and nuclear materials, to pioneering aeromedical evacuation of the world’s most dangerous infectious patients. The conversation moves beyond storytelling into operational reality. With no established protocols, limited knowledge of Ebola and widespread public fear, crews were forced to improvise, adapt and execute under intense pressure. The episode examines the intersection of EMS readiness, public health hesitation and leadership under uncertainty. At its core, this is a study in preparation, risk tolerance and professional duty — illustrating how a small group of individuals stepped forward when systems hesitated, reinforcing the enduring EMS principle: when the call comes, you answer. Key quotes from Kevin Hazzard
Episode timeline 00:00 – Opening context: Ebola outbreak severity and mission stakes 01:00 – Introducing Kevin Hazzard, author background 03:30 – Origins and evolution of Phoenix Air 08:00 – High-risk missions (including Libya nuclear extraction) 14:30 – Transition to EMS and infectious disease transport 16:00 – Development of the biocontainment system 20:00 – Ebola mission planning and execution challenges 27:00 – U.S. reception, EMS transport and public reaction 31:00 – Leadership lessons and EMS preparedness gaps 35:00 – Reflections on readiness, resilience and future threats Enjoying the show? Email editor@ems1.com to share feedback. | |||
| ‘Hydraulic debriefing:’ Alcohol, stress, and the hidden culture of EMS | 23 avr. 2026 | 00:30:40 | |
In this episode of EMS One-Stop, Rob Lawrence sits down with Dr. Maria Koeppel to explore a topic that has long existed in the shadows of EMS culture — alcohol use among providers. | MORE: First responders and alcohol – how much is too much? Drawing on NIH and FEMA supported research, Koeppel outlines how EMS clinicians may be engaging in higher-risk drinking behaviors than the general population, with patterns influenced by stress, exposure and workplace culture. What emerges is not a story of individual weakness, but one of systemic pressure — where both major traumatic incidents and the accumulation of low-acuity, high-frequency calls contribute to a steady burden of stress that many providers attempt to manage off-duty. The conversation moves beyond statistics into culture, leadership and generational change. Koeppel highlights how traditional “crew bonding” through alcohol — what one participant termed “hydraulic debriefing” — may be giving way to a new, more wellness-focused approach among younger clinicians. At the same time, gaps in education, policy and peer support remain evident across EMS systems. For leaders, the message is clear: alcohol use is not a fringe issue, but a workforce health, safety and performance issue that requires thoughtful engagement, cultural awareness and proactive support structures. Key quotes from Maria Koeppel
Enjoying the show? Email editor@ems1.com to share feedback. | |||
| FDNY’s future: AI, BWCs and pay parity | 16 avr. 2026 | 00:57:34 | |
In this episode of EMS One-Stop, Rob Lawrence travels to New York City to sit down with Lillian Bonsignore, the 37th Commissioner of the Fire Department of the City of New York (FDNY). A 30-plus year veteran who rose through the ranks of EMS — from EMT in the South Bronx to Chief of EMS and now Commissioner — Bonsignore brings a ground-up understanding of the largest fire-EMS system in the United States. She reflects on stepping into the role as “walking onto a fast-moving train,” immediately confronted with major incidents, severe weather and system pressures, while simultaneously building her leadership team and setting direction for the future. | MORE: ‘We have to right the ship’: FDNY commissioner doubles down on EMS pay parity The conversation explores the unique structure of FDNY, where the Commissioner operates as the executive leader “almost like CEO of the company,” while operational command sits with the Chief of Department. Bonsignore is clear-eyed about the scale and demands of the system: over 2.2 million runs annually, with 1.6 million EMS-related, reinforcing her long-held position that EMS must be treated as an essential service with appropriate funding and career pathways. Drawing on her experience leading through the COVID-19 pandemic and responding on Sept. 11, 2001, she emphasizes resilience, communication and presence — being visible in stations, honest with staff and committed to supporting those who “leave their own families behind to go serve a stranger.” Bonsignore also addresses criticism of her appointment directly and without hesitation, framing it as a misunderstanding of the Commissioner’s role and the realities of modern emergency response. She underscores that FDNY is both fire and EMS, and that her career — spanning 9/11 response, pandemic leadership and decades of frontline service — positions her to lead the entire enterprise. Looking ahead, she speaks to the need for infrastructure investment, workforce stabilization, mental health support, and the thoughtful adoption of technologies such as AI and body-worn cameras. As FDNY approaches the 25th anniversary of 9/11 and the nation’s 250th year, her focus remains clear: support the workforce, strengthen the system, and prepare the department for the next generation of service. Key quotes from Commissioner Bonsignore
Enjoying the show? Email editor@ems1.com to share feedback. | |||
| CAAS accreditation – More than a badge, a blueprint for excellence | 09 avr. 2026 | 00:37:21 | |
This week on EMS One-Stop, Rob Lawrence sits down with Sarah McEntee, executive director of the Commission on Accreditation of Ambulance Services (CAAS), to unpack what accreditation really means for modern EMS systems. Moving beyond the “sticker on the truck,” Sarah reframes CAAS as a living, breathing process — one that drives internal improvement, organizational alignment and long-term sustainability. From its origins within the American Ambulance Association in the 1990s, to the latest Version 4.0 standards, the conversation highlights how CAAS provides a unified, industry-driven framework that elevates agencies from compliant to high-performing. Rob brings a practitioner’s perspective, reflecting on his own experience navigating multiple accreditation cycles, emphasizing how CAAS becomes a “guiding light” for governance, clinical care and operational excellence. Together, they explore the structure of the standards, the application journey, and the cultural readiness required to succeed. The key takeaway is clear: accreditation is not a project with an endpoint — it’s a continuous process that strengthens organizations from the inside out, identifying risks, improving systems, and ultimately delivering better care to patients and communities. Episode timeline 01:30 – Origins of CAAS and need for unified standards 03:30 – Breakdown of CAAS standards (admin, clinical, operations) 06:30 – Deep dive into operational standards and structure 10:30 – Rob’s real-world experience with accreditation 12:30 – Accreditation as a process vs. project 16:00 – Value proposition: internal vs. external benefits 18:30 – Cost vs. value — and the risk of not being accredited 22:00 – Step-by-step accreditation journey (readiness → submission → review) 28:30 – Site visits and peer collaboration 31:30 – Resources, support and how to get started 34:30 – Final reflections and leadership call to action Enjoying the show? Email editor@ems1.com to share feedback. | |||
| Live from NEMSMA: From battlefield to boardroom | 29 mars 2026 | 00:24:08 | |
This edition of EMS One-Stop, recorded at the inaugural National EMS Management Association conference in Arlington, Virginia, pairs two complementary conversations about leadership and the future of EMS.
In the first half, General Robert Neller brings a military leader’s lens to universal leadership truths: lead yourself first, remember that everyone is watching, stay humble, listen better and understand that decisiveness matters. His message is simple and sharp. People want leaders who will set the example, make the call when it matters, and balance standards with empathy.
| MORE: EMS Leadership Institute — AI and the future of EMS
In the second half, NEMSMA President Dr. Hezedean Smith reflects on a successful launch for the conference and looks ahead to where EMS leadership must go next. He frames this association as a growing home for mentorship, shared learning and strategic thinking, while also pointing to the disruptive forces already reshaping the profession:
Taken together, the episode is both a leadership masterclass and a forward look at an EMS profession that cannot afford to stand still. Episode timeline 00:39 – Rob sets the scene from the inaugural NEMSMA conference in Northern Virginia. 00:51 – Rob introduces General Neller as the opening keynote speaker. 01:38 – General Neller explains his leadership “roadmap,” beginning with leading yourself first. 03:38 – Rob and General Neller discuss how leaders are always being watched. 06:04 – Advice for the newly promoted EMS lieutenant: growth takes time, ask for advice, study and learn. 08:11 – General Neller reflects on what he wishes he had known earlier in his career: be a better listener. 09:41 – The “don’t eat the cake” story becomes a lesson in humility and example-setting. 11:42 – General Neller discusses when leaders must consult and when they must simply decide. 13:22 – Final leadership theme from General Neller: empathy strengthens standards rather than weakening them. 17:04 – Rob returns with Dr. Hezedean Smith, President of NEMSMA. 17:18 – Dr. Smith describes the early success of the inaugural conference and strong turnout. 18:12 – Dr. Smith confirms planning is already underway for next year because the event has outgrown the venue. 19:25 – Discussion shifts to the future direction of EMS leadership and system design. 19:49 – Dr. Smith highlights AI, system redesign, and recruitment and retention as major themes. 20:47 – Dr. Smith talks about self-driving ambulances, solar-powered systems and rapid technological change. 21:38 – Dr. Smith emphasizes that technology must make providers’ work easier, not harder. 22:22 – Rob asks why people should join NEMSMA. 22:28 – Dr. Smith outlines mentorship, information sharing and rapid organizational growth. 23:13 – Dr. Smith closes by reaffirming NEMSMA’s role in the EMS leadership space. 23:46 – Rob signs off from what he calls an “amazing time” at the conference. Enjoying the show? Email editor@ems1.com to share feedback. | |||
| Six minutes to live: Inside the push to save cardiac arrest victims | 12 mars 2026 | 00:38:54 | |
In this edition of EMS One-Stop, Rob Lawrence is joined by Bob Davies and Hilary Gates to explore the mission behind Six Minutes to Live, a growing movement focused on improving survival from sudden cardiac arrest. | MORE: ‘Six Minutes to Live': Mini-documentary spotlights cardiac arrest care crisis The conversation begins with the stark reality that every minute without CPR and defibrillation reduces survival by 10%, and then widens into a larger discussion about injustice, geography and system performance. Bob reflects on his landmark USA Today investigation into EMS disparities across the country, while Hilary explains why this issue remains deeply personal and why communities, not just medical systems, must be part of the solution. The episode then turns from problem to action. Hilary and Bob describe how Six Minutes to Live is using storytelling, advocacy, community partnerships and public training to drive change, especially through bystander CPR education, school-based training and public access defibrillation. From Santa Cruz to the Resuscitation Academy in Seattle, the emphasis is on making the simple feel possible: hands-only CPR, early defibrillation and empowering ordinary people to act. The result is more than a nonprofit or a campaign. As Rob notes, this is a movement. Memorable quotes
Additional resources Episode timeline
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| EMS leaders head to Capitol Hill with one message: It’s time to fund the future | 05 mars 2026 | 00:31:56 | |
EMS on the Hill isn’t just a date on the calendar — it’s the profession’s annual moment to stand in front of Congress and tell the EMS story with clarity, confidence and unity. In this edition of EMS One-Stop, Rob Lawrence is joined by NAEMT President, Chris Way, to preview EMS on the Hill (March 25–26, 2026) and explain why this event matters now more than ever: EMS is where most Americans first enter the healthcare system, and the care delivered in the field is no longer “drive-you-to-the-hospital medicine.” Chris and Rob also unpack what’s changed — the scale of collaboration across national organizations and the discipline of going to Capitol Hill with aligned priorities and a shared message. They walk listeners through the event flow (Education Day, briefings, Hill visits, awards and reception), the importance of working relationships with staffers, and the advocacy “ask” that could reshape the future: reimbursement for treatment in place, mobile integrated healthcare/community paramedicine, and sustainable support for initiatives like prehospital blood. The throughline is simple: show up, speak with one voice, and translate momentum into legislative wins. Additional resources: Episode timeline
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| Synergy in action: How EMS leaders are aligning for impact | 26 févr. 2026 | 00:31:56 | |
Recorded on location at the EMS Association Summit in sunny Kansas City, this edition of EMS One-Stop captures something that’s been building for a while across the profession: real momentum. In the first half, Rob Lawrence sits down with Bill Seifarth, CEO of the National Registry of EMTs, to unpack what the Registry is today; how its mission has evolved; and why partnerships, research and continued competence sit at the heart of public trust when 911 is called. In the second half, returning guest Patrick Pianezza joins Rob to talk Code 3, the top streaming EMS movie’s impact on providers and families and what comes next. Across both conversations, the theme is unmistakable. When EMS organizations collaborate, align messaging and show up as one voice, the profession becomes harder to ignore and easier to support. The summit becomes more than a meeting. It becomes a signal. Episode timeline
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| Dr. Linda Dykes: From toxic culture to safer systems | 12 févr. 2026 | 00:47:27 | |
In this episode of EMS One-Stop, Dr. Linda Dykes joins Rob Lawrence from the UK for a wide-ranging, transatlantic conversation that starts with workplace culture and ends with a practical look at how health systems can keep patients safely at home. In the first half, Linda breaks down her newly published (open-access) qualitative paper, provocatively titled “It’s not bullying if I do it to everyone,” drawn from UK NHS “Med Twitter” responses: a raw, heartbreaking window into the red flags of toxic workplace culture, how bullying is experienced in the eye of the beholder, and why incivility and silence are not just HR problems — they’re patient safety threats. In the second half, Linda brings listeners into the UK’s evolving admission alternative world: frailty care at home, urgent community response models, and the increasingly important interface between EMS and community-based teams. She explains the UK’s SPOA (single point of access) concept, why she dislikes the term “admission avoidance,” and how ED crowding and access change the risk-benefit equation for hospital vs. home. Rob connects the dots back to the U.S. reality — reimbursement, APOT/wall time, treatment-in-place policy — and why this work is becoming a shared challenge on both sides of the Atlantic. Timeline00:51 – Rob opens, recaps NAEMSP in Tampa and recent content. 02:25 – Rob introduces Linda as the “triple threat” (emergency medicine, primary care/GP, geriatrics) and tees up two-part discussion. 05:39 – Rob introduces Linda’s paper: “It’s not bullying if I do it to everyone.” 06:13 – Linda explains why toxic culture is increasingly visible and how the tweet prompt became a dataset. 07:33 – “Flash mob research group” forms; Linda explains social-media-to-qualitative methodology and limitations. 10:03 – Rob asks about bias; Linda clarifies purpose: insight, not representativeness. 16:39 – Linda defines gaslighting and why it’s so destabilizing. 18:21 – Reactions to publication; resonance, sharing and uncomfortable self-reflection on learned behaviors. 20:18 – The “16:55 Friday email” as a weapon — and as an accidental harm. 23:29 – Leadership as “the sponge” — absorbing pressure rather than passing it down. 25:27 – “One thing right now”: know the impact your words can have, especially on vulnerable staff. 26:41 – Rob on “pressure bubbles,” micro-movements and atmospherics: how leaders shift climate without realizing it. 30:53 – SPOA explained: single point of access and urgent community response behind it. 33:03 – EMS interface: calling before conveyance to find safe pathways to keep patients at home. 35:47 – Linda on mortality risk of access block/long waits and how that reframes risk decisions. 37:19 – Evolving models: primary care-led response vs. hospital at home approaches. 39:34 – Clinical myths challenged: oral antibiotics sometimes non-inferior to IV in conditions we assumed needed admission. 40:34 – Outcomes: hospital at home trial signals safety and fewer patients in institutional care by 6 months. 42:00 – Telemedicine/telehealth: underutilized but useful; when you still need a senior clinician in person. 44:50 – Closing takeaways: read the paper (with trigger warning); admission alternative work is deeply satisfying. Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for a future episode. | |||
| EMS One Stop: Resilience and beyond | 29 janv. 2026 | 00:30:47 | |
In this episode of EMS One-Stop, host Rob Lawrence welcomes John Sammons, an advanced practice paramedic with Wake County EMS, a peer support team member and a key leader in the NAEMT Lighthouse Leadership Program. John sits at the intersection of system design and human performance, helping build the kind of operational and cultural scaffolding that keeps clinicians effective, healthy and coming back tomorrow. In this episode of EMS One-Stop, host Rob Lawrence welcomes John Sammons, an advanced practice paramedic with Wake County EMS, a peer support team member and a key leader in the NAEMT Lighthouse Leadership Program. John sits at the intersection of system design and human performance, helping build the kind of operational and cultural scaffolding that keeps clinicians effective, healthy and coming back tomorrow. | MORE: Peer support teams: How to build trust and maximize effectiveness This week’s conversation goes beyond “be more resilient” and into the practical realities of burnout, moral injury, mentoring and culture, including the role of frontline and unofficial leaders in shaping what “normal” looks like inside an agency. John also shares the Wake County approach to peer support: presence first, then resources, plus the power of finding your people: your team, your tribe, your board of directors. Memorable quotes from John Sammons
00:40 – Rob opens the episode and introduces John Sammons and the theme: resilience and beyond 02:05 – John’s “Sammons 101” bio: Wake County APP, peer support, Lighthouse Leadership involvement 03:01 – Burnout data and why it matters for retention and wellbeing 04:16 – Wake County’s Advanced Practice Paramedic Program: the “three Rs” 05:03 – John’s post-COVID turning point: “I’m done ... I don’t want to do this anymore” 06:12 – What brings John back to work: purpose, people, privilege, challenge 09:16 – Prevention and balance: identity beyond the job, sleep, nutrition, purpose 12:15 – Peer support in practice: presence, triage, in-house clinician, canines, statewide resources 17:09 – Podcast/vodcast reminder and John’s slides supporting the discussion 18:14 – NAEMT Lighthouse Leadership: why relationships and peers are the real multiplier 20:39 – Mentorship as a resilience strategy: formal programs and informal investment 24:25 – Culture: administration vs frontline leaders vs unofficial leaders 28:06 – Closing reflections: remembering why we got into EMS 30:36 – Final takeaways Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for future episodes. | |||
| ‘We love this job — and it’s hurting us’: Paramedic Sophie on EMS burnout and culture change | 22 janv. 2026 | 00:35:00 | |
In this episode of EMS One-Stop, Sophie Fuller — better known across social media as Paramedic Sophie — joins host Rob Lawrence for a candid, energizing conversation about what it really feels like to work in EMS right now: pride, the pressure, the burnout, and the culture issues that too many providers have been taught to silently absorb. Sophie is a critical care ground paramedic, flight paramedic, educator and president of the Tennessee Association of EMS Providers (TAEMSP), and she brings a provider-first lens to everything from leadership visibility, to mental health and pay equity. Together, Rob and Sophie dig into why Sophie started creating content in the first place (hint: burnout and the need to connect), how social media can be used as a force for good, and what “healthy” EMS culture should look like in practice. Sophie shares practical advice for crews and leaders alike:
Additional resources:
01:00 – Rob introduces Sophie Fuller (“Paramedic Sophie”) and frames the influencer vs. “effluencer” concept 02:14 – Sophie’s origin story: graphic design → hospital tech → EMT → volunteer fire → paramedic → critical care → flight 06:16 – TAEMSP: why Tennessee needed a provider-level association and the shift toward legislative advocacy 08:05 – Why she started with social media: two full-time 911 jobs, low pay, burnout and the need for an outlet/connection 09:32 – Defining EMS burnout: the “jar on the shelf” and cumulative strain that becomes chronic fatigue 13:26 – Sophie’s guidance to providers: vulnerability, telling the truth and not letting naysayers silence needed conversations 16:00 – Sophie’s message to leadership: don’t be the “Wizard of Oz” — show up, communicate and stay connected to crews 20:26 – EMS culture: self-sacrifice, silence, “earning your place through suffering,” and confusing trauma with tradition 23:10 – Sophie’s book “The Next Shift”: a field guide to “learn, lead and last” in EMS 26:03 – Mistakes and “just culture”: reporting, mentoring, anonymous reporting systems, and learning vs. blame 32:08 – Closing challenge: stop normalizing harm; speak up for culture and patient care 33:14 – Where to find Sophie online and how large her platform has become Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for a future episode. | |||
| NEMSQA 2025 Report: In trauma care, consistency outperforms heroics | 15 janv. 2026 | 00:37:07 | |
In this episode of EMS One-Stop, Rob Lawrence is joined by his own Medical Director, Dr. Maia Dorsett, to unpack the 2025 NEMSQA Measures Report — a deep dive into trauma-focused quality measures built largely from NEMSIS data. Dr. Dorsett frames the discussion around the central aim of quality improvement:
From pediatric vital signs to traumatic brain injury (TBI) fundamentals, she walks listeners through what the report reveals, what it can’t reliably measure yet, and why some of the “sexy” procedures are too rare to serve as useful system-wide metrics. The conversation highlights a recurring theme: fundamentals matter most. Dr. Dorsett explains how measures like complete vital signs and avoiding secondary brain injury in TBI (hypoxia, hypotension, hyperventilation) can drive meaningful outcomes — even during relatively short prehospital intervals. She also points out where current measurement approaches unintentionally create documentation burden for clinicians, arguing that systems should do more of the “figuring out” (like trauma center designation and prenotification capture) without requiring extra clicks. The episode closes with a call to action: anyone can join NEMSQA, contribute to the work, and help shape what EMS quality measurement becomes next. Memorable quotes from Dr. Maia Dorsett “I think the most fundamental question in quality improvement is, are we doing a good job?” “I think part of the value of this report is specifically looking at those things and saying what should we be measuring using NEMSIS data or how should things be integrated into that database so that the answers are there rather than needing to be documented on each individual case?” “If there's one thing that you're going to take away from this trauma report is that, the sexy stuff is important, but it happens rarely. And if you want to improve care in your system, it's about the fundamentals of good care.” Additional resources
Episode timeline 00:31 – Rob welcomes listeners; introduces the 2025 NEMSQA measures discussion and notes prior episode with Dr. Jeff Jarvis 01:10 – Dr. Dorsett joins; holiday surge discussion and flu impact on EDs and admissions 03:08 – Dr. Dorsett explains her role as co-chair of NEMSQA’s Measure Analysis and Research Committee; trauma focus of the 2025 report; pain measures not included due to active research 05:00 – NEMSIS scale and opportunity: extracting meaningful measures from a massive national dataset 05:35 – Dr. Dorsett on what NEMSIS measures well vs. what it shouldn’t force clinicians to document (system should determine trauma center status) 07:46 – “HALO procedures” table: why rare interventions shouldn’t become national quality measures 10:17 – Trauma 08: complete vital signs; pediatric gap (adults ~93% vs pediatrics ~85% in discussion) 14:22 – TBI measures: preventing secondary brain injury; why fundamentals outperform “sexy” fixes; correction rates for hypotension/hypoxia discussed 21:39 – Trauma 04: trauma triage criteria and transport to trauma centers; why national measure looks low; documentation field limitations 24:17 – State collaboration comparison: using state trauma center designation data shifts performance dramatically (often 75–90%+ in examples) 26:55 – Trauma 14: hospital prenotification; importance and measurement challenges (multiple modalities, inconsistent capture) 30:01 – Rob raises operational/policy concerns about trauma alerts and incentives; Dr. Dorsett adds nuance about local criteria variation 33:22 – Closing: Dr. Dorsett’s “fundamentals matter” takeaway; impact at scale 34:44 – Dr. Dorsett plugs joining NEMSQA as an individual/agency; committees are open 35:31 – NAEMSP Tampa preview; Dr. Dorsett: “The people” are why she goes — leaves energized with new ideas Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for a future episode. | |||
| Leading through momentum: Dr. Douglas Kupas on steering NAEMSP | 08 janv. 2026 | 00:39:19 | |
Dr. Douglas Kupas joins Rob Lawrence to kick off EMS One-Stop in 2026, reflecting on his first year as President of NAEMSP — a year he describes as fast-moving, complex and occasionally “whack-a-mole,” with emerging issues demanding real-time leadership while long-term priorities still had to move forward. He shares what he’s learned about the presidency, the value of NAEMSP’s leadership “bench strength,” and why advocacy and coalition-building across national EMS organizations has become more coordinated, more strategic and more essential. The conversation then turns to what’s immediately ahead: the NAEMSP Annual Meeting in Tampa (late January), including pre-conference courses, the flagship Medical Director’s Course, and a packed scientific program. Kupas highlights a keynote focused on transforming battlefield trauma care; major research programming through oral abstracts and hundreds of posters; and high-impact sessions spanning clinical care, operations, legal issues, and international perspectives — reinforcing why the Tampa meeting remains a must-attend event for anyone serious about the science and future of EMS. Episode timeline00:00 – Rob tees up NAEMSP Annual Meeting growth as a “good problem to have” 00:50 – Welcome/Happy New Year 2026; Dr. Kupas introduced as first guest of the year 01:45 – Year one as NAEMSP president: what’s surprised Dr. Kupas, pace of work, governance “bench strength” 04:26 – NEMSAC termination: what happened, what NAEMSP hopes comes next 07:02 – Building the pipeline: medical student/resident interest group, travel support ideas 08:47 – “Hot off the press:” NAEMSP accepted into WHO Acute Care Action Network 10:08 – Advocacy “hunting as a pack:” overlapping national orgs, EMS on the Hill coordination 12:40 – Why Hill visits work: stories, staffers and why first-timers matter 16:48 – “White hat” advocacy and patient-centered priorities; ED wall time as a key issue 20:07 – Tampa preview: “It’s not just for docs,” NAEMSP membership structure 22:11 – Pre-cons overview: Medical Director’s Course, QI workshop, MIH, ventilation, blood, TECC 23:55 – Keynote: Dr. Frank Butler and special intro by Dr. Bob Mabry; Grand Rounds obstetric focus 27:45 – Major legal session format and why legal content draws a crowd 29:28 – Space constraints and future planning: small convention centers; San Diego “buyout” scale 31:49 – Research explosion: oral abstracts, posters, receptions; better ways to access abstracts 34:39 – “Meat of the conference:” operations, clinical topics, international speakers/learning 36:49 – Closing question: Bill details Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for a future episode. | |||
| The EMS Avenger returns: Jimmy Apple’s no-holds-barred take on tech, burnout and backboards | 30 déc. 2025 | 00:31:18 | |
As the year wraps, Rob Lawrence welcomes back the “EMS Avenger” Jimmy Apple for a fast-moving, end-of-year pulse check on the EMS universe — through the lens of social media, research and what frontline clinicians are actually saying when the mic is on and the comments are open. Building on last week’s data-and-trends conversation , this episode pivots into “the world according to Jimmy Apple” and his alter ego, the EMS Avenger, exploring what’s made providers lean in, push back or flat-out declare “enough is enough.” | SHARE YOUR STORY: A call for real stories from the EMS field, station and beyond From burnout and workforce conditions to AI-assisted ECG interpretation and the rise of microlearning, the conversation lands on a central theme: the future of EMS isn’t just protocols — it’s people, technology and how we choose to learn, adapt and debate. Jimmy also names his “paper of the year” on spinal immobilization, explains how he handles disagreement without falling into “quicksand arguments,” and previews a packed 2026 speaking calendar — plus a relaunch of his podcast. Memorable quotes
Enjoying the show? Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback. | |||
| EMS at the edge: Inside a year of reckoning and redesign | 26 déc. 2025 | 00:36:01 | |
As EMS closes out 2025, host Rob Lawrence is joined by Matt Zavadsky (PWWAG) and Rodney Dyche (Patient Care EMS Solutions) for their second annual EMSIntel.org “year in review” conversation — a fast-moving tour through the biggest stories shaping the EMS profession. Drawing from the EMSIntel news log (now 3,849 stories as of the morning of recording), the trio connects what’s making headlines to what EMS leaders are experiencing on the ground: unstable economics, governance pressure, system redesign and rising operational risk. The discussion lands on several recurring themes: economic sustainability as the dominant issue; the real-world politics of tax levies and “essential service” designations; the ongoing obsession with response times (and what they cost); preventable ambulance thefts escalating in severity; and the importance of measuring and publishing clinical outcomes and meaningful performance metrics. The through-line: communities are being forced into more honest conversations about what they can afford — and what EMS should look like going into 2026. | SHARE YOUR STORY: A call for real stories from the EMS field, station and beyond Memorable quotes
Additional resources:
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| We deserve this: The Journey to a National EMS Memorial in D.C. | 18 déc. 2025 | 00:38:29 | |
In this episode of the EMS One-Stop podcast, host Rob Lawrence revisits an issue close to the heart of every EMS professional: creating a permanent National EMS Memorial in Washington, D.C. Rob is joined by Tony O’Brien and James Robinson from the National EMS Memorial Foundation to provide a clear, candid update on where the project stands, why it matters, and what still needs to be done. From the Weekend of Remembrance to the dream of a year-round place of solace and reverence in the nation’s capital, this conversation lays out the long road from idea to reality — and why EMS, as James puts it, truly deserves this. Tony and James walk listeners through the 24-step federal Commemorative Works Act process, the hard work of narrowing 312 potential sites down to three, and the current push to reauthorize the Foundation’s federal authority through House Resolution 2196 and Senate Bill 2546. They explain the preferred site in front of the Hubert H. Humphrey Building (HHS), the partnership with MIT’s School of Architecture and Urban Risk Lab on a powerful design, and the practical realities of funding, sponsorship and bureaucracy. Most importantly, they end with a clear call to action for the EMS community: contact your elected officials, donate what you can, and help spread the word so that a permanent memorial to EMS can finally take its place in Washington, D.C. Additional resources
00:44 – Rob introduces the episode, sets the scene for a revisit of the National EMS Memorial effort, and welcomes guests Tony O’Brien and James Robinson. 01:30 – Tony and James share their backstories. 03:53 – Tony explains the origins of the Foundation at the Weekend of Remembrance/Weekend of Honor and the realization that EMS needs a permanent memorial people can visit year-round. 06:54 – James outlines the Commemorative Works Act, the 24-step process, and how the Foundation has reached step 15-16 over roughly 15 years. 07:54 – Tony details the grueling site-selection work: visiting 312 sites, environmental and noise studies, traffic and solitude considerations, and narrowing to three candidate locations. 10:48 – James describes the need for an Act of Congress to begin, Congressman Stephen Lynch’s early sponsorship, and the 2018 authorization that started a 7-year clock — complicated by the pandemic and federal shutdowns. 13:12 – Tony explains how the initial authorization expired, the need for reauthorization and the most recent Senate subcommittee hearing on federal lands where James testified. 16:41 – James and Tony frame the new bills: Senate Bill 2546 and House Resolution 2196, their bipartisan sponsors and the push for more co-sponsors. 19:49 – Tony lays out the three-point call to action: contact Congress, donate via EMSMemorial.org, and follow/share @EMSMemorial on social media. 23:06 – Tony describes the three remaining sites and why Independence Ave. & 3rd St SW, in front of HHS, is the preferred location. 24:42 – Tony highlights the pro-bono design work by MIT’s School of Architecture and Urban Risk Lab, and the deep engagement with providers, families and survivors. 26:32 – James explains the historical nexus of EMS with HEW/HHS and why the Humphrey Building plaza offers the right reverence, proximity to the Capitol and connection to EMS history. 29:01 – Tony and James discuss next steps: reauthorization first, then finalizing site and design to approach major sponsors with clear answers on location, look and cost — while acknowledging the project has been bootstrapped so far. 32:03 – Tony reassures donors: the Foundation is a 501(c)(3), the board are all volunteers with only necessary professional services paid from donations. 33:13 – Tony gives shout-outs to the National EMS Memorial Service and the National EMS Memorial Bike Ride, and explains how the three organizations’ missions align. 37:12 – Rob recaps the journey, reinforces the call to action, and closes the show with thanks to Tony and James and a reminder to visit EMSMemorial.org and like/subscribe to EMS One-Stop. Rate & review the EMS One-Stop podcastEnjoying 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. | |||
| Hyper-turbulent times: EMS economics and AI guardrails with Matt Zavadsky and Dr. Shannon Gollnick | 03 déc. 2025 | 00:27:25 | |
Recorded on the floor of the EMS|MC EMSpire Conference in Charleston, South Carolina, this episode of EMS One-Stop finds host Rob Lawrence in conversation with long-time collaborator and EMS advocate Matt Zavadsky. Fresh off the longest federal government shutdown in history, Rob and Matt unpack what the hyper-turbulence in Washington really means for EMS: suspended Medicare extenders, disrupted grant programs, agencies taking out loans just to meet payroll and training programs put on hold. They break down NAEMT’s flash poll on the shutdown’s impact, the promise of the Treatment in Place (TIP) legislation, and why associations “hunting as a pack” on Capitol Hill matters more than ever. Along the way, they spotlight EMSIntel.org as a national barometer of EMS funding, staffing and response time crises, and issue a clear call to action for providers, billers and leaders to use association tools to contact their members of Congress. | MORE: Government reopens: What EMS providers need to know right now In the second half, Rob is joined by Dr. Shannon Gollnick, paramedic, EMS leader and organizational psychologist, to explore how artificial intelligence is reshaping EMS — right now. Shannon makes the case that AI is “not the future; it is the present,” and that agency leaders must urgently build literacy, policies and guardrails around its use. They dig into the difference between HIPAA-compliant, embedded AI in ePCR systems, and risky open tools like ChatGPT, touching on hallucinations, embedded code and emerging Medicare fraud-detection programs. | MORE: Artificial to augmented intelligence. How Dr. Shannon Gollnick wants EMS to work smarter, not harder Rob and Shannon talk about AI as a powerful but potentially dangerous tool — “like having a tiger” — and outline practical steps for chiefs:
Additional resources: Episode timeline: 00:21 – Rob introduces guest Matt Zavadsky 02:02 – Rob recaps the 40-plus-day federal government shutdown, questions about reopening, and his upcoming return to Capitol Hill for renewed advocacy 02:02 – Matt frames the shutdown as part of the “hyper turbulence” in EMS; explains the regulatory suspensions, pauses in Medicare extenders and grants, and how cash-flow uncertainty forced some agencies to take out loans just to make payroll 03:04 – Matt details NAEMT’s flash poll (408 agency responses) showing suspended training and grant-funded programs, and warns of a possible repeat shutdown around January 30 03:54 – Rob and Matt discuss the reopening of government, ongoing bipartisan work, and the risk that everything “comes to a grinding halt” again if Congress can’t agree 04:51 – Matt explains why NAEMT released the shutdown-impact poll even as government reopened and stresses the need to keep pushing for permanent relief from Medicare extenders and advancement of key bills like Treatment in Place (TIP) 06:03 – Matt outlines the House and Senate TIP companion bills and why Medicare paying for treatment in place is better for patients, EMS, the health system and the Medicare trust fund 06:54 – Rob notes broad association/provider support and professional lobbyists on the Hill; Matt stresses that field providers, administrators and billers must still use association legislative portals to send letters to Congress 08:08 – Matt describes a surge in communities reevaluating their EMS delivery models because of staffing, finance and subsidy challenges — “a great time to be an EMS consultant” 09:09 – Rob introduces EMSIntel.org as a curated clearinghouse of EMS news, used to show communities they aren’t alone; describes failed tax measures and funding referenda 10:15 – Matt cites EMS Intel data: ~85% of stories each month involve funding, staffing or response times; Rob and Matt stress the ubiquity of these themes from big cities to small towns 11:09 – Rob highlights mutual aid tensions and taxpayers questioning why they “pay to send our resources somewhere else;” both emphasize that hyper-turbulence and funding gaps are national issues 13:23 – Rob resets the scene from the EMSpire conference and recaps Matt’s Hill update before introducing Dr. Shannon Gollnick 14:41 – Shannon gives his backstory: in EMS since 1996, paramedic since 2002, progression into EMS leadership, doctorate in organizational psychology and focus on how organizations function 15:14 – “We put the fun into function.” 15:24 – Rob invites Shannon to talk AI, calling it “the specter we are embracing everywhere,” and references HIPAA concerns; Shannon opens with the core message: AI is not the future, it’s the present, and nothing to be afraid of 16:03 – Shannon urges leaders to build AI literacy, noting that if agencies aren’t using it, their staff and the younger generation already are 16:28 – Shannon emphasizes policy and procedure: AI guardrails aren’t coming from Congress or regulators, so agency leaders must define how AI will be used and where its limits are 16:55 – Rob reminds listeners that AI in EMS isn’t new, citing early monitor rhythm interpretation in the UK; Shannon underscores that crews already use AI tools and that unmanaged cut-and-paste practices can create billing and compliance risks 17:24 – Shannon explains the dangers of using open tools like ChatGPT for ePCR narratives: potential PHI exposure in a “black box” system and AI hallucinations generating plausible but false patient information 18:21 – Shannon describes how AI “wants to answer your question and make you happy,” leading to made-up details, and shares examples from testing minimal-input scenarios that returned overly detailed, inaccurate narratives. 19:03 – Shannon calls ChatGPT “kind of a snitch,” explaining embedded code markers that fraud detection tools — and increasingly Medicare’s AI-based “Wiser” program — can use to identify AI-written content in documentation 19:59 – Shannon warns about retrospective audits and compliance exposure if ChatGPT-coded narratives are found in ePCRs, noting that AI rules are still emerging and tech is outrunning regulation 20:51 – Rob summarizes the mixed message: AI is here and being built into devices and software, but there are real dangers. They discuss data going “to the cloud” — which Shannon defines as “somebody else’s computer.” 21:24 – Shannon frames AI as a powerful tool that can “put a lot of holes in the wall” if misused; he references fraudulent AI uses and deepfakes as emerging issues 22:05 – Shannon compares AI’s impact to the internet’s paradigm shift; Rob gives a “spoiler alert” about his own workflow using transcripts and ChatGPT agents, and notes the importance of reading and checking any AI-generated output 22:45 – Shannon reinforces that AI makes mistakes and cannot understand human context; he uses his “How you doing?” Joey Tribbiani vs. Tony Soprano example to illustrate contextual nuance 23:06 – Rob expands the context point with the “Friends”/“Sopranos” slide and reminds listeners that once AI-written words are published, “you said it.” Shannon highlights the WebMD effect and AI-driven self-diagnosis risks. 24:02 – They note that ChatGPT can generate long, complex diagnoses without sufficient patient context, leading to errant or misleading outcomes if misused clinically 25:00 – Rob summarizes: AI is here and, used correctly, is a good thing; advises chiefs to ask their teams, “Do we have an AI policy?” 25:27 – Shannon outlines what an AI policy should contain: acknowledgment that AI is here; clear, non-fearful framing; specificity on what decisions AI can support; and clarity on which tools (e.g., embedded EPCR AI) are allowed versus prohibited uses of ChatGPT 26:17 – Shannon stresses AI should not be used for clinical decision-making or clinical narrative writing; its role should be administrative only, and all outputs must be double-checked Enjoying the show? Email editor@ems1.com to share feedback or suggest a guest for a future episode. | |||
| Jamaica Fire Brigade’s front line: Inside the Hurricane Melissa response | 13 nov. 2025 | 00:30:58 | |
In this episode of the EMS One-Stop podcast, host Rob Lawrence welcomes Dr. Hezedean Smith, who spotlights the human and operational toll of Hurricane Melissa on Jamaica and the wider Caribbean. Dr. Smith draws from first-hand perspective from the ground, detailing catastrophic damage to homes, utilities, roads and communications — which compounded the workload and emotional burden for Jamaica Fire Brigade (JFB) firefighters and EMS providers. Dr. Smith highlighted the Brigade’s Amazon Wish List effort, which aims to route essential personal items and operational supplies directly to affected JFB members and stations to sustain continuity of operations and support responders’ families. After the break, Dr. Smith switched hats as the newly elected President of NEMSMA to outline the association’s renewed momentum:
The NEMSMA Leadership Conference will take place in Washington, D.C., March 23-24, 2026, intentionally adjacent to EMS on the Hill to create a leadership-plus-advocacy “two-fer.” Highlights include keynote Gen. Robert Neller (Ret.), plus a deep bench of EMS leaders and educators. Memorable quotes from Dr. Hezedean Smith
00:46 – Quick industry/policy update 01:27 – Set-up: Hurricane Melissa overview; impact stats and current situation 02:12 – Welcome Dr. Hezedean Smith 02:26 – Dr. Smith’s backstory: Jamaica roots, USAF medic, Orlando FD, two fire chief roles, GES Consulting, Caribbean EMS focus 04:20 – First reactions to Melissa: scale of damage; compounded human toll 05:58 – Deployment cadence: aligning with JFB command, CDEMA, national EOC; travel hurdles; rapid integration on arrival 08:28 – Why existing relationships matter; staying in-station with crews; supporting leaders and frontline needs 11:13 – Call to action: Amazon wish list for responders’ personal and operational needs; distribution via JFB logistics 13:20 – Specific needs (PPE, boots, clothing, hygiene, basic medical supplies) and the ongoing recovery realities 17:46 – NEMSMA — new president, renewed energy, new AMC, who NEMSMA serves 20:14 – Board/leadership shout-outs; programs (FTEP, ACPE), member services, momentum 22:49 – Conference preview (Mar 23–24, 2026, D.C.): theme — disruptive leadership; Gen. Robert Neller keynote; speaker lineup; proximity to EMS on the Hill 26:29 – IJOP collaboration and research-to-podcast pipeline; communications and sponsorship improvements 28:29 – Closing thanks; unified call to support JFB and engage with NEMSMA initiatives Rate and review the EMS One-Stop podcastEnjoying 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. | |||
| EMS shutdown survival: What leaders need to know now | 10 oct. 2025 | 00:33:00 | |
From Medicare cuts to billing delays, Asbel Montes joins Rob Lawrence to share practical strategies EMS agencies can use to weather the reimbursement storm In this episode of the EMS One-Stop podcast, we tackle the fast-moving realities of a federal shutdown and what it means for EMS finance, reimbursement and day-to-day operations. Rob Lawrence sits down with Solutions Group’s Asbel Montes — a veteran of EMS reimbursement and policy expertise — to decode where Congress is (and isn’t), what CMS’s temporary claims hold really means, and how ambulance services can protect cash flow while preparing for potential reprocessing chaos if extenders aren’t promptly restored. Beyond the headlines, Montes lays out a pragmatic playbook: build a Plan B for cash continuity, align with your billing team on reprocessing workflows, and model exposure across payers tied to the Medicare fee schedule. The conversation then widens to balance billing — why federal change is unlikely soon and why state-level action is delivering practical protections — before closing with leadership lessons on adaptation, data and telling EMS’s story as a guide, not the hero. Memorable quotes from Asbel Montes “Our extender expired — that’s that additional payment that we get from Medicare of that 2%, 3%, 22.6% — it expired September the 30th, and it was tied to the House-approved CR that went over to the Senate.” “We’re solutions givers, as we say here at Solutions Group, not crisis managers. And if you have a plan, I can at least execute a plan.” “What turned out to be a smaller amount, now the cost associated with it, you started to really understand the complexities that really happened in people’s AR.” “If this lasts longer than 15 days … then I would basically have a plan in place. So I would be trying to find out from my billing team … what is your contingency plan to ensure I don’t see a hiccup in cash moving forward?” “The only way government can really invoke change is to make it hit where it hurts. And that’s what’s going on right now. They’re hitting the pocketbook and our industry is grappling with it right now.” Additional resources
Episode timeline & key moments 00:21 – Why the shutdown matters to EMS reimbursement and operations 01:21 – Montes’s 101: role at Solutions Group; 28 years in EMS finance and policy 02:40 – Historical context: number and length of shutdowns; current Hill outlook 03:48 – The ambulance extenders expired (2% urban, 3% rural, 22.6% super-rural); CMS claims hold window 05:03 – Planning posture: realistic timelines; “we’re solutions givers, not crisis managers” 06:12 – Back-of-the-napkin math: short-term dollars vs. long-term reprocessing burden 07:43 – 2015–2016 déjà vu: retroactive fixes and the heavy lift for back-office AR 10:26 – Secondary impacts: VA eligibility, appeals, enrollments during a prolonged shutdown 11:11 – The “three-legged stool” for leaders: (1) have a plan with billing; (2) reconcile accounts & patient balances; (3) prevent cash-flow lag if more than15 days 14:06 – Framing the moment: “hurricane shutdown” response and recovery mindset 15:43 – Balance billing at the federal level: committee work, political pain and why movement is unlikely soon 18:19 – State action wins: consumer protections and access; examples of Medicare-indexed approaches 20:24 – Why ground ambulance stayed out of federal NSA; local regulation and state primacy 22:42 – “All politics are local”: using EMS’s public visibility to advocate for patients and providers 23:09 – Adaptation over preservation: seize the 6-18 month window; let data and clinicians lead reform 27:13 – Lawrence’s “Darwinism” takeaway: adaptation as survival 28:31 – The Leadership Lab podcast: purpose, cadence and upcoming guests; Montes’s leadership journey Rate and review the EMS One-Stop podcastEnjoying 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. | |||
| Rainn Wilson on ‘Code 3’ and the brutal beauty of EMS life | 18 sept. 2025 | 00:23:54 | |
In this episode of the EMS One-Stop podcast, our host, Rob Lawrence, sits down with Hollywood actor Rainn Wilson, who stars as Randy in “Code 3.” Known worldwide for his role as Dwight Schrute in The Office, Wilson has stepped into the world of EMS, portraying the life of a burned-out paramedic with both grit and humor. In the conversation, Wilson reflects on the process of bringing this story to life, his ride-along experiences in Los Angeles, and the powerful realities he uncovered about our profession. More than just a performance, Rainn has become an unexpected advocate for EMS. He speaks candidly about the underfunding of frontline providers, the emotional toll of the work and the sheer humanity that comes with being welcomed into people’s lives during their most vulnerable moments. Alongside the serious themes, he reminds us that Code 3 is also a comedy — one that captures the gallows humor, camaraderie and resilience medics carry with them on every shift. | MORE: Why ‘Code 3’ might be the most honest EMS film yet. From a ticking salary counter to fourth-wall confessions, this EMS road movie isn’t just another Hollywood take. It’s a love letter, a warning and a mirror. Memorable quotes from Rainn Wilson
00:26 – Rainn Wilson on the vulnerability of entering people’s homes in crisis 00:57 – “All we want to do is save your life. Some of you don’t make it easy.” 02:53 – Rainn’s first impressions of the “Code 3” script 03:38 – Falling in love with the character of Randy 04:22 – Discovering the realities of EMS work and shocking pay disparities 06:09 – Lessons from Wilson’s Los Angeles ride-along 10:12 – Wilson on CPR training and why everyone should learn it 12:29 – “We’re essentially a tube and a pump.” 13:11 – Rehearsals and the importance of portraying EMS medicine accurately 15:09 – On burnout, PTSD and the need to support medics’ mental health 18:08 – Using “Code 3” salary comparison as an advocacy tool 19:07 – Wilson praises Rob Riggle’s ED doctor role and its realism 20:41 – Cherishing the chance to shed light on EMS 21:10 – Reminder that the film is also a comedy — “a good old time with a bucket of popcorn” 22:25 – Final message: “America needs you. Keep saving lives.” Rate and review the EMS One-Stop podcastEnjoying 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. | |||
| Burnout, bravery and gratitude: The story behind ‘Code 3’ | 08 sept. 2025 | 00:34:44 | |
In this episode of the EMS One-Stop podcast, host Rob Lawrence sits down with Patrick Pianezza, co-writer of the new EMS film “Code 3”, a deeply honest and compelling portrayal of life on the ambulance. The film stars Rainn Wilson (“The Office”), Lil Rel Howery (“Free Guy”) and Aimee Carrero (“Elena of Avalor”), delivering a powerful performance that captures both the pressures and the humanity of EMS work. Using real-world experiences and stories from the field, “Code 3” highlights the passion, dedication and emotional toll experienced by EMS professionals every day. From burnout, to systemic challenges, the movie invites the public into the high-stakes world of emergency medical services, showing both the challenges and the heart behind the uniform. Patrick and Rob discuss not only the storytelling process, but also the personal experiences that informed the movie. Pianezza candidly shares the emotional toll of EMS work, the reality of burnout and the importance of mental health support for first responders. This episode is both a celebration of the dedication of those who serve in 911 and a call for awareness and gratitude for the vital work they perform. “Code 3” opens in selected cinemas on Sept. 12, 2025. Memorable quotes
00:00 – Introduction: Rob Lawrence introduces Patrick Pianezza and the film “Code 3” starring Rainn Wilson 02:31 – Origins of “Code 3:” How the project started and the vision behind telling an authentic EMS story 05:01 – Creative team & casting: working with actors, crew and Rainn Wilson 08:01 – On-the-Street authenticity: translating real EMS experiences into the film 12:01 – Depicting burnout: emotional and mental challenges in EMS work 16:01 – Mental health & seeking help: Autobiographical elements and confronting burnout 20:01 – Systemic issues: salaries, Medicare, and Medicaid reimbursement challenges 24:01 – Impact on families & relationships: emotional toll beyond the job 27:01 – Personal reflection: Patrick’s journey, struggles and growth in EMS 29:01 – Gratitude tour: purpose of the film and acknowledging EMS professionals 32:01 – Closing thoughts: film release details, upcoming trailer and final messages of appreciation Enjoying the show? Send an email to editor@ems1.com to share feedback or suggest guests for upcoming episodes. | |||
| NEMSAC dismantled: Inside the fallout shaking federal EMS policy | 18 août 2025 | 00:47:24 | |
This breaking-news edition of EMS One-Stop dives straight into the announcement that the National EMS Advisory Council (NEMSAC) has been dissolved. Host Rob Lawrence is joined by Dr. Brandon Morshedi (NEMSAC chair-elect) and Brenden Hayden (immediate past chair), who explain what NEMSAC is, what it achieved and why its sudden dismissal has left the EMS community frustrated, concerned and searching for answers. Together, they outline the role of NEMSAC as the sole statutory advisory body connecting EMS to the federal executive branch, describe the hundreds of volunteer hours that went into shaping advisories, and discuss what happens now that years of hard work and documents have been pulled from EMS.gov. This episode sets the record straight, provides a clear explainer of the process, and captures the disappointment — yet determination — of leaders committed to moving EMS forward despite this setback. Additional resources:
01:08 – Rob introduces the breaking news: NEMSAC dissolved 02:22 – What is NEMSAC? Brenden explains its statutory role 04:52 – How does NEMSAC differ from associations? Direct advisory to the executive branch 06:42 – Appointments, terms and how continuity usually worked 08:44 – The depth of work: meetings, subcommittees, advisories, letters 11:23 – Examples of major advisories and public comment process 14:27 – Shock: key advisories removed from EMS.gov 19:13 – Explainer: FICEMS and how advisories flow through federal government 26:25 – How members felt when dismissal was announced 30:18 – What happens to unfinished advisories and research 34:20 – Associations’ role in keeping the work alive 35:50 – The advisory each guest is most proud of 39:41 – Lessons learned: influence, unified voice, process 43:25 – Final reflections: leadership, advocacy, and what comes next Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for a future episode. | |||
| CAAS GVS 4.0: Building safer, smarter and theft-proof ambulances | 14 août 2025 | 00:28:48 | |
In this episode of the EMS One-Stop podcast, host Rob Lawrence climbs back onto his soapbox to discuss two topics that directly impact on every EMS agency in America — the CAAS Ground Vehicle Standards (GVS) 4.0 and the simple, inexpensive steps we can take to stop ambulance theft. Joining Rob is longtime EMS leader and current CAAS GVS Administrator Mark Postma, who walks us through the origins of the standards, their national adoption and what’s new in the latest update. From ambulance remounting, to structural safety testing, Mark explains how GVS 4.0 has evolved to keep pace with manufacturing realities, supply chain delays and operational needs. The conversation then shifts to a shared passion for protecting fleet assets. Rob and Mark dissect the shockingly frequent problem of ambulance theft and how a $200 automatic immobilization device can prevent a $250,000 vehicle from disappearing — without relying on crews to remember to lock it. Additional resources:
00:45 – Rob introduces the topic: GVS 4.0 and ambulance theft concerns 01:34 – Mark introduction and CAAS GVS role 04:11 – How the CAAS standards were developed and adopted by 35-plus states 06:09 – Comparing CAAS GVS to NFPA ambulance standards 06:48 – The rise of remounting, especially during COVID supply shortages 10:26 – Discussion of ongoing vehicle delivery delays and need for replacement planning 15:04 – What’s new in GVS 4.0 — major changes and safety structure updates 19:38 – Ambulance theft statistics and the GVS anti-theft requirement 22:28 – Automatic immobilization and why manual systems fail 23:57 – Mark shares success story: zero thefts since installing devices 26:17 – Exceptions in standards and why state inspectors must enforce anti-theft 27:42 – Final thoughts on making anti-theft part of fleet planning Enjoying the show? Email editor@ems1.com to share feedback and suggest future guests. | |||
| Public health at the front door: An MIH model to emulate | 11 août 2025 | 00:39:53 | |
In this edition of the EMS One-Stop podcast, host Rob Lawrence Zooms (literally) from the U.K. to South Carolina to spotlight one of the nation’s most forward-thinking mobile integrated healthcare programs. Prisma Health’s team has taken community paramedicine beyond buzzwords, designing targeted, evidence-based programs that meet people where they are — both geographically and medically. | MORE: How North Dakota EMS is confronting rising pediatric mental health crises Whether it's addiction medicine, rural HIV/HCV treatment or skilled nursing interventions, this team is shifting paradigms on what EMS can and should be doing. Rob is joined by four key voices from the Prisma Health MIH program:
Together, they unpack how passion meets data to drive change, how to earn trust in communities overlooked by traditional systems, and why this work isn’t just novel — it’s necessary. This is EMS in its truest public health form. Memorable quotes
00:51 – Introduction to Prisma Health MIH & guests 03:00 – Luke Estes overview of MIH models (ETS, SDOH, addiction) 05:00 – Dr. Gormley’s public health journey, data-opioid focus 08:00 – Buprenorphine pilot design and research outcomes 10:15 – Challenges: bias, stigma, barriers to addiction care 13:00 – Funding and sustainability conversation 14:00 – Wes Wampler on daily workflow in addiction medicine and HCV care 17:00 – Building trust with vulnerable populations 18:30 – Parker Bailes discusses traditional CP role and skilled nursing interventions 21:45 – Alternative destinations, lab draws and high-acuity decisions 25:30 – Training: internal education, ultrasound, medication management 28:15 – Prisma’s med school connection and disaster response evolution 30:00 – State-level partnerships: SC EMS Assn, FEMA typing, CP strike teams 31:56 – Academic next steps from Dr. Gormley: scaling, publishing, process evals 35:26 – Final reflections from Luke Estes: passion, team strength and mission 38:00 – Rob’s call to action: “If you want your own Prisma team — start now.” Enjoying the show? Email editor@ems1.com to share feedback or suggest future guests. | |||
| Meet the EMS Avenger: Saving lives with kindness and content | 03 juil. 2025 | 00:29:52 | |
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:
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
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
Enjoying the show? Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback. | |||
| Growing the next generation of changemakers in rural EMS | 01 juil. 2025 | 00:47:47 | |
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
“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 timeline00:18 – 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 podcastEnjoying the show? Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback. | |||
| From info overload to instant clarity: Lifeline EMS puts AI to work | 30 juin 2025 | 00:42:48 | |
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
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. | |||
| Paramedics without borders: Celebrating global unity on International Paramedic Day | 12 juin 2025 | 00:34:29 | |
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
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 RATE & REVIEW Enjoying the show? Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback. | |||
| How ‘One big beautiful bill’ could break EMS | 05 juin 2025 | 00:52:32 | |
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 timeline00:41 – 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 action Final takeawayThis episode underscores that EMS cannot remain reactive — leaders must proactively use data, engage legislators and educate their communities on the true cost of care. The EMS Financial Index, the MedPAC dismissal, and the pending bill all point to a critical need for informed, strategic advocacy. | |||
| Safe streets for all: MVC care funding in action | 27 mai 2025 | 00:42:39 | |
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
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| Inside the EMS Compact: How REPLICA transforms disaster response, licensing & leadership | 13 mai 2025 | 00:41:47 | |
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
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
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| Insights, actions and the future of EMS: The 2025 ESO EMS Index | 07 mai 2025 | 00:56:26 | |
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 | |||