EMS One-Stop

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 “When there's someone who wants to see your program, talk about your program.” — Kevin Mackey “I kind of never believed it really possible to put it on a paramedic truck until I saw what the military was able to do.” — Clayton Kazan “If the five minutes matter, why wouldn't we want to do it 5, 10, 15, 20 minutes sooner?” — Clayton Kazan “Never say ‘no,' never say ‘die.'” — Kevin Mackey “They're never tired of trying to find new ways to save people's lives.” — Clayton Kazan Episode timeline 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. 

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 timeline 00:00 – 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.

In this episode of the Inside EMS podcast, host Chris Cebollero shares why he left the consulting and community paramedicine world to become chief of EMS and COO for EMS Team in Dayton, Ohio — a growing multi-state agency with “visions of world dominance.” The conversation digs deep into servant leadership, workforce buy-in and the balance between supporting crews while still holding the line on professionalism and performance. Chris also lays out his vision for creating a sustainable culture built on accountability, engagement and shared ownership. It's equal parts leadership seminar, war story and reality check for anyone who's ever tried to fix a fractured EMS system. Additional resources: How to lead without being that boss Leadership lessons: How to turn failure into growth Enjoying Inside EMS? Email theshow@ems1.com to share feedback. 

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 “This is as scary as it gets.” “It is the largest and deadliest Ebola outbreak in human history.” “We've got to figure out how to transport highly contagious patients — nobody does that.” “They risked their lives. They risked their families' lives for strangers.” “Preparation is the most important thing.” “We are notoriously short-minded … we're not long-range thinkers.” “There are people out there who are willing to step into the breach when needed.” 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. 

This week on Inside EMS, it's a no-holds-barred breakdown of HBO's The Pitt — and surprisingly, it earns a solid thumbs up from the field. The show nails the feel of emergency medicine: nonstop chaos, overlapping patients and that mental grind that never lets up. The set, the medicine and the team dynamics all hit close enough to make even seasoned providers nod along. But let's not pretend it's perfect. The guys call out the usual TV sins — compressed timelines, back-to-back disasters and docs who never miss on the first try. But, there is a botched 12-lead that sparks a real-world debate about electrode placement, patient modesty and doing the job right when it matters most. Where The Pitt really shines? The emotional weight. Burnout, breaking points and the slow unraveling that comes with the job — it's all there, and it hits hard. Have you watched the show? What are your thoughts? Let us know in the comment field below. Quotable takeaways “At some point you're so saturated by fear and emotion and being strong through somebody else's grief and trying to be on 24/7, you can't afford a bad moment.” “I think they do a great job of displaying the emotional toll that a career in medicine takes on the people who practice it.” Enjoying Inside EMS? Email theshow@ems1.com to share feedback. 

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 “Over 50% of firefighters surveyed had binge drank in the last 30 days — about twice the rate of the general population.” “EMS providers tend to drink a little bit more frequently than the general population — and that's tied directly to stress.” “It's not just the big trauma calls — it's the micro-stressors that add up over time.” “A third of clinicians in our sample engaged in high-risk drinking behaviors.” “Younger clinicians are at higher risk — but that risk declines with age as coping mechanisms develop.” “Paramedics are at higher risk than EMTs, likely due to increased responsibility and patient exposure.” “Some described going out after shift as ‘hydraulic debriefing' — using alcohol to process the day.” “Gen Z is driving a more sober culture — they're choosing connection without alcohol.” “Leadership isn't just policy — it's culture, awareness and how you care for your people.” “Alcohol and coping has to be part of the conversation if we care about workforce health and patient safety.” Episode timeline 01:06 – Maria's background: firefighter and researcher 02:24 – Overview of NIH/FEMA research and EMS focus 04:14 – Key findings: stress, frequency of drinking and EMS culture 05:08 – Micro-stressors vs. major trauma calls 06:54 – Risk factors: age, role, education, multiple jobs 10:11 – Culture and “hydraulic debriefing” 11:46 – Fire vs. private EMS cultural differences 14:38 – Generational shift: Gen Z and sober culture 19:24 – Alternative substances and coping trends 21:20 – Leadership roles: policy vs. culture 24:11 – Peer support gaps in EMS 26:41 – Workforce impact: sleep, stress, retention 27:14 – Education gap and need for EMS-specific training 29:11 – Conferences and future research dissemination 30:13 – Episode wrap-up Enjoying the show? Email editor@ems1.com to share feedback. 

Editor's Note: Suicide is always preventable. If you are having thoughts of suicide or feeling suicidal, please call the National Suicide Prevention Hotline immediately at 988. Remember: You deserve to be supported, and it is never too late to seek help. Speak with someone today. ----more---- This week on Inside EMS, host Kelly Grayson is joined by Texas educator John Puryear as they process the loss of a colleague to suicide — and to confront the uncomfortable truth: the mental health crisis in EMS is years in the making, and awareness alone isn't cutting it. From peer support to fatigue policies, Chris and Jon lay out what actually helps: real conversations in the rig, leadership that prioritizes mental health and seeking professional help. The message is clear: taking care of your mind is operational readiness. And if you're not checking on your partner, you're missing the fight that matters most. Quotable takeaways “I don't think the public understands how much this profession can break you.” “It's not about what's wrong with you, it's what's happened to you.” “Help is a professional strength, not a weakness.” Additional resources: What's your department's suicide prevention plan? How to recognize, help a struggling team member Mental wellness check-ins: What they are and how they help Enjoying Inside EMS? Email theshow@ems1.com to share feedback. 

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 “Walking into a position like this is like walking onto a fast-moving train.” “I understand the ground level challenges that go on because I lived them.” “The commissioner is the administrative level, almost like CEO of the company.” “We're responding to over 2.2 million runs a year … 1.6 million of those runs are EMS-related runs.” “We have to stabilize our system … it's time that EMS is finally treated as an essential service.” “I will always tell you the truth. You may not like my truth, but I will give it to you.” “The decision of a first responder is to leave their own families behind … to go serve a stranger.” “They are literally your heroes … they will put their lives on the line for you.” Episode timeline 01:10 – First 100 days as Commissioner — “fast-moving train” 02:30 – Career journey and EMS roots shaping leadership 04:30 – Workforce trust, credibility and lived experience 06:30 – Pay parity and EMS as an essential service 09:00 – Structure of FDNY — Commissioner vs. operational command 11:30 – Setting direction and stabilizing the organization 13:30 – Relationship with the Mayor and political leadership 17:30 – Addressing criticism and misconceptions 19:30 – Leading through COVID — scale, innovation, mutual aid 23:30 – Morale, resilience and leadership presence 26:30 – Recruitment and retention challenges 30:30 – AI and future innovation in EMS 32:30 – Behavioral health response and BeHeard program 36:30 – First responder mental health and support systems 38:30 – Violence against EMS and workforce protection 41:00 – Body-worn cameras and transparency 43:30 – 9/11 reflections and legacy 50:30 – Commemoration planning and future outlook Enjoying the show? Email editor@ems1.com to share feedback. 

This week on the Inside EMS podcast, host Kelly Grayson tags in Texas educator John Puryear for a deep dive into the ever-evolving world of EMS education. What starts with a little sweet tea and Southern storytelling quickly turns into a masterclass on how to actually make distance learning work. Puryear breaks down the difference between synchronous and asynchronous learning, and why simply dumping recorded lectures on students isn't enough. The real magic? Engagement. Whether it's live interaction, strategic questioning or just being a “bit of an entertainer,” effective online education demands more than a webcam and a PowerPoint. Bottom line: online education isn't going anywhere. But if you're going to do it, you better do it right. The future isn't just virtual — it's hybrid, interactive and built by educators who actually care. Enjoying Inside EMS? Email theshow@ems1.com to share feedback. 

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. 

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: Artificial intelligence Redesigned systems Recruitment and retention pressures The possibility of autonomous ambulance operations 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. 

Things get intense on this episode of Inside EMS as hosts Chris Cebollero and Kelly Grayson tackle an age-old industry debate: should EMTs spend time on a truck before going to paramedic school or is that “experience” overrated? Kelly kicks things off with a spicy take, arguing that poor field training and inconsistent preceptorship often do more harm than good. From his perspective, bad habits, weak mentorship and burnout culture are the norm, not the exception. But Chris isn't buying it. He counters that experience builds what classrooms can't: clinical judgment, scene management and the ability to function in chaos. For him, skipping that step means stacking advanced skills on a shaky foundation. What follows is a back-and-forth that hits on everything from “microwave medics” and outdated curricula to high-fidelity simulation and whether modern education can truly replicate the street. Both sides agree the system is flawed — but disagree on where to fix it. Enjoying the show? Email editor@ems1.com to share feedback. 

In this episode of Inside EMS, cohosts Chris Cebollero and Kelly Grayson are once again joined by paramedic student April McKenzie, a.k.a., “April Anonymous,” for a deep dive on measuring arterial blood gas. Chris and Kelly walk April (and anyone else grinding through class) through the core idea that everything hinges on knowing “normal.” Once you lock in pH, CO₂ and bicarb ranges, the rest becomes pattern recognition, not panic. The big takeaway? Master normal, stay curious and treat every patient like a learning opportunity. Because the more normals you encounter, the faster you'll catch what's not. Quotable takeaways “Our whole job in a nutshell is maintaining homeostasis and knowing when the body is going to restore homeostasis.” “Voltaire said that the art of medicine is entertaining the patient until nature cures the disease. But, we know that nature doesn't always cure the disease. We have to know when to step in, when nature's not gonna do it.” Email theshow@ems1.com to share feedback. 

This week on Inside EMS, hosts Chris Cebollero and Kelly Grayson take a practical look at how leadership — both formal and informal — shapes the culture of an EMS organization. The hosts break down three things crews notice immediately: consistency, presence and composure. They emphasize that good leadership isn't about controlling people or enforcing policies — it's about developing crews, communicating clearly and earning trust over time. This episode breaks down how leadership credibility is built slowly through consistent behavior — and it only takes one misstep to damage it. Quotable takeaways “The culture of an EMS organization is shaped far more by leadership behavior than by policy manuals.” “You don't build strong organizations by controlling people. You build them by developing people.” “Leadership starts the moment people are watching.” Email theshow@ems1.com to share feedback. 

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 “For every minute that a person's heart has stopped, their chance of survival decreases by 10%.” — Hilary Gates “Life and death is defined by geography.” — Bob Davies “There are vulnerable, voiceless people living on the margins who need a voice.” — Hilary Gates “The main way that people save more lives is they care.” — Bob Davies “Every podcast that Hillary and I are involved with is actually sponsored by R&D. Rip off and duplicate, show up, take our stuff, go and save lives with it.” — Rob Lawrence Additional resources Six Minutes to Live Six Minutes to Live mini documentary Episode timeline 01:34-02:14 – Rob Lawrence introduces the episode and welcomes Hilary Gates and Bob Davies. 02:21-03:21 – Hilary Gates shares her background as an educator turned paramedic and cofounder of Six Minutes to Live. 03:48-08:14 – Bob Davies recounts his experience as a paramedic and journalist, including his USA Today investigation into EMS performance disparities. 08:24-10:50 – Rob asks what has changed in 20 years; Bob discusses the enduring formula, new technology and the energy of younger clinicians. 11:08-13:02 – Hilary explains why Six Minutes to Live was founded and frames cardiac arrest survival as an issue of injustice and community responsibility. 13:13-17:08 – Rob asks what Six Minutes to Live is and how it fits among other advocacy organizations; Bob and Hilary describe its role as a connector and storyteller. 18:04-18:39 – Rob resets the conversation and asks what the organization is doing now. 18:50-20:47 – Hilary describes the Santa Cruz partnership, community CPR training and support from donors and local agencies. 21:12-23:47 – Bob highlights their upcoming workshop at the Resuscitation Academy in Seattle and the power of systems that care enough to measure and improve. 24:00-25:20 – Rob offers a transatlantic explainer connecting Eisenberg, Utstein and UK ambulance response standards. 25:24-28:41 – Hilary discusses community myths about CPR and AEDs, and the need to simplify action for laypeople. 28:48-31:02 – Bob outlines what is next: documentaries, deep listening, connecting voices and helping movements grow organically. 31:17-33:01 – Rob and Hilary talk about creating local champions, liability concerns and getting communities to act. 33:13-34:47 – Rob asks the closing question; Hilary urges EMS clinicians to become local champions for simple lifesaving actions. 35:22-37:20 – Bob closes with a call for EMS professionals to confront the “little secrets” they know and act on them. Email editor@ems1.com to share feedback. 

“The greatest victory is that which requires no battle.” ― Sun Tzu, The Art of War This week on Inside EMS, host Chris Cebollero brings a fresh interpretation to Sun Tzu's ancient text with his latest book, “The Art of War for Business Leaders: Winning Without Fighting in Leadership, Strategy, and Life.” Chris makes the case that EMS leadership is more about clarity and discipline than chest-thumping command presence, tying Tzu's principles back to everyday EMS realities. The discussion digs into why leaders so often fight the wrong battles, from staffing drama and culture clashes, to policy headaches and ego wars, and how better planning can keep those problems from blowing up in the first place The conversation dissects what accountability without chaos means in practice: building culture, reducing friction and leading in a way that gives crews the tools, support and ownership they need to succeed. Quotable takeaways “Most leaders don't fail because they're bad people. They fail because they fight battles that they never really need to fight.” “Never allow your emotions to dictate your actions. I was a powder keg that would explode when things didn't go right. [“The Art of War”] taught me to be less reactive.” “Discipline creates freedom.” Email theshow@ems1.com to share feedback. 

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: EMS on the Hill Day One voice, one profession — EMS leaders open summit with call for unity and coordinated action Episode timeline 00:00 – Chris Way frames the goal: becoming a trusted, go-to EMS resource for lawmakers 00:52 – Why EMS on the Hill matters; EMS as the front door of healthcare; call to action 02:16 – Advocacy theme and EMS on the Hill as the seminal D.C. event 03:27 – Kansas City summit recap; commitment to making it annual; “stronger together” 05:39 – Evolution of EMS on the Hill into a multi-organization partnership; one message 08:24 – Logistics overview begins: dates, hotel, education day, briefings, awards 10:16 – How to succeed in legislative meetings: reading the room, time limits, staffer relationships 17:14 – Priority bills: treatment in place, MIH/CP, whole blood, NAMSP priorities 21:02 – “This is ongoing” collaboration: monthly cross-organization calls, broader coordination 24:05 – Chris shares his recommended approach: prep, priorities, cards/coins, questions, follow-up 27:34 – Rob's add-ons: photos after meetings, tagging lawmakers, comms/PR value 28:59 – Final logistics recap; what to expect as a first-timer at state tables 30:37 – Chris closes: unprecedented partnership, focus to “get this done” 31:14 – Rob plugs state-level advocacy (CAA Stars/Capitol Day) Email editor@ems1.com to share feedback. 

This episode of Inside EMS is brought to you by ZOLL software and data solutions. Optimize EMS performance and outcomes at every stage of operations with interoperable solutions from dispatch, to patient care, QA/QI, billing and beyond. Visit zolldata.com to learn about the complete solution suite. This week on the Inside EMS podcast, Jon Puryear, NREMT-P, is back and if you've ever sweated a National Registry deadline, this one hits home. Amid the ever-looming March 31 cutoff, Puryear breaks down what's changed in continuing education — and what hasn't. Known for his ability to simplify complex topics, Puryear has built National Registry refresher courses, explainers and CE programs designed not just to check a box, but to truly reinforce clinical understanding. His teaching style leans heavily on storytelling and practical analogies — think pulmonary edema explained through a waterlogged sponge — so providers walk away actually understanding the information, not just memorizing it. If you need hours, motivation — or just someone to explain it like a human — this episode is your reset. Top quotes “I don't believe that we chose this profession. I believe that the profession chose us. We have a special calling inside of us to be able to take care of our fellow mankind.” “We don't get rich. We don't make a lot of money doing this. We're truly public servants.” “Continuing education is still important to be able to keep our mind, our clinical care, our judgment, everything on top.” Email editor@ems1.com to share feedback.

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 1:02 – Introduction of Bill Seifarth; brief personal bio and career path 2:01 – “National Registry 101”: Bill explains the mission and what the Registry does 2:53 – Research focus: the Registry's fellowship and EMS research priorities 3:31 – “Bread and butter”: entry-level and continued competence assessment and why it matters to the public 4:33 – Rob notes the Registry's growing national presence; Bill outlines advocacy-through-partnership 5:08 – Preview of next year's summit; participation in EMS on the Hill and NCSL with multiple EMS orgs in one booth 6:33 – Why the summit matters: state associations and national partners coming together under one roof — it's a sold-out inaugural event; education, networking and shared experience highlighted 10:52 – Next stop: EMS on the Hill; “hunting in a pack” 12:20 – Bill's closing: partnership, collaboration, synergy and supporting the profession 13:38 – Transition: Rob introduces Patrick Pianezza, co-writer of Code 3 14:41 – Patrick reflects on the film's reception — especially among working providers 15:33 – Patrick shares the origin story: a “homework assignment” turned full-length film 17:39 – Where to watch: Apple/Amazon to rent or purchase; streaming on Hulu; performance metrics shared 18:30 – What's next: pitching a TV series and interest in a sequel; realities of funding and IP ownership 21:33 – Discussion of the “Mr. President” scene and the intentional visual tension-building 24:19 – Patrick addresses feedback and the goal: honest portrayal and conversation-starting, not villainizing partners 27:41 – Leadership pipeline point: great clinicians aren't automatically great leaders; mentorship matters 30:15 – Closing theme returns: one voice, fewer scattered voices, more impact for the profession 31:20 – Rob wraps: summit takeaways, guests, and a final nudge to watch Code 3 Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for future episodes. 

Editor's Note: This episode of Inside EMS is brought to you by ZOLL software and data solutions. Optimize EMS performance and outcomes at every stage of operations with interoperable solutions from dispatch, to patient care, QA/QI, billing and beyond. Visit zolldata.com to learn about the complete solution suite. This episode of Inside EMS tackles a difficult question: When is it time to step away from the job? Hosts Chris Cebollero and Kelly Grayson trade hard-earned wisdom — from Kelly's knee-rehab comic relief to serious talk about emotional burnout, wellness needs and timing. The hosts also explore the psychology of identity — how being a paramedic or EMT isn't just a job, it's who you are. They unpack how to carry forward the best parts of that identity — calm under pressure, decisive action, compassion — into new roles if needed. This isn't about quitting — it's about owning your career before it owns you. Whether it's fewer shifts, a new role, a new service or a new direction altogether, the message is clear: protect your identity, protect your professionalism and make moves that keep you sharp for the long haul. Quotable takeaways “Burnout is gradual. It's not explosive, but you've got to be able to realize the emotional flattening that is happening.” — Chris Cebollero “Our identity often becomes EMS. I tell people, to this day, ‘I'm a paramedic,' and there's a lot that goes into that — and not just when you put the boots or the polo shirt on. It really becomes the core of who you are.” — Chris Cebollero “The vast majority of us don't leave after one bad call. We wake up one day and realize we've been surviving instead of serving, and that's when the burnout epiphany really hits us hard.” — Kelly Grayson Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest guests for a future episode.

This episode of Inside EMS is brought to you by ZOLL software and data solutions. Optimize EMS performance and outcomes at every stage of operations with interoperable solutions from dispatch, to patient care, QA/QI, billing and beyond. Visit zolldata.com to learn about the complete solution suite. NAEMSP is officially a “big little conference” — and it's only getting bigger. In this crossover episode, Rob Lawrence and Chris Cebollero unpack the momentum: tighter collaboration, a unified push toward EMS on the Hill Day, and the growing realization that if we want change, we need boots (and uniforms) on Capitol Hill. But the real buzz? AI. From autonomous ambulances to narrative-writing software, the conversation gets real about the promise — and the potholes — of artificial intelligence in EMS. Charting shortcuts? Maybe. Courtroom landmines? Definitely possible. Add in body-worn camera debates, budget crises and a push for legislative support at the federal level, and it's clear the profession is standing at a pivot point. Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest guests for future episodes. 

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. Timeline 00:51 – 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. 

This episode of Inside EMS is brought to you by ZOLL software and data solutions. Optimize EMS performance and outcomes at every stage of operations with interoperable solutions from dispatch, to patient care, QA/QI, billing and beyond. Visit zolldata.com to learn about the complete solution suite. This week on Inside EMS, Chris Cebollero takes on one of the most anxiety-inducing topics in paramedic education: alpha and beta receptors. Sparked by a question from paramedic student April McKenzie, a.k.a., “April Anonymous,” this episode strips away rote memorization and replaces it with something far more useful in the field — understanding the why behind the medicine. There's no fluff here; no cheesy memory tricks that fall apart under stress. Just physiology, practical mental models and a challenge to start practicing medicine with intention. If pharmacology has ever felt random, this episode connects the dots in a way that finally clicks. Quotable takeaways “Every medication you give in EMS is doing one of two things: It's either pushing the gas pedal or it's releasing the brake — that's it. If you don't understand which one you're doing, you're guessing, even if the protocol says you're right.” “We really have to become the ultimate detective of the body.” “Every patient is somewhere between gas and brake at all times. Those systems are constantly working, they're not off. It's just a dimmer switch. Every medication pushes one system or pulls the other system back into play.” Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest guests for a future episode. 

Dr. Peter Antevy returns to the Inside EMS co-host seat this week, filling in for Kelly Grayson and bringing some serious pediatric firepower to the conversation. Host Chris Cebollero dives right into the latest buzz around the Broselow tape recall — yes, again — as Dr. Antevy unpacks what went wrong, why it matters and what EMS agencies should be doing about it now. He also shares exciting details on his brand-new, field-focused Newborn Resuscitation & Obstetrics course (NROC), built by EMS for EMS. Designed with two hours of online content (zero PowerPoints!) and a short, in-house skills lab, this course aims to tackle one of the most nerve-wracking call types. No more dragging medics to the hospital for NRP classes that don't translate to street-level care. Also on deck: OB deserts, delayed cord clamping, why you might need to Saran-wrap a newborn (seriously), and what AI can — and can't — do for EMS. This one's packed with practical pearls, myth-busting insights and a whole lot of passion for pediatric education. Quotable takeaways from Dr. Peter Antevy “EMS is one specialty that AI will never take away, as far as like the human-to-human contact. We resuscitate people, we treat people who are seizing. AI will never do that. That's a good thing.” “Academics and the hospital folks don't recognize the value that EMS brings to the table. They think we're ambulance drivers. It's time for them to wake up and recognize that we are the people who deliver babies. We are the people who resuscitate grandma, grandpa and the little kid.” Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest guests for future episodes. 

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 “We have folks that don't stay in the profession. We have folks that leave. We have folks that unfortunately develop substantial mental health crises up to and including, unfortunately, suicide in our profession.” “What an amazing privilege that we're invited into somebody's home to take care of them and to figure it out.” “Every one of those people expects to call 911 and have an expert show up and solve the problem.” “I work to live, I don't live to work. And that's a great philosophy to have.” “Everybody goes home ... but there should be an addendum on the bottom of it that says, ‘but everybody comes back tomorrow.'” “Nobody gets us like we get us.” “Leadership is action, not a title.” “Everybody has their bucket, and everybody's bucket can only hold so much.” “Nobody got into this because we wanted to be crusty and angry and miserable and difficult to be around.” Episode timeline 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. 

In this episode of Inside EMS, host Chris Cebollero sits down with Mic Gunderson, CEO of the Center for Systems Improvement and EMS Quality Academy; and editor‑in‑chief of the new peer-reviewed International Journal of Paramedicine, which launched in January 2023. Gunderson explains how the publication provides a forum for thoughtful debate around complex topics to be examined and analyzed. A recent issue, for example, touched on degree requirements for entry-level medics using the Socratic method to frame and manage the debate — a far cry from the horrors of a social post's comment section. Sprinkled with wit, respect and real curiosity, this episode is a masterclass in how EMS can grow — not just louder, but smarter. Whether you drive an ambulance, manage a system, or just care about the future of prehospital care, this conversation is worth your seat time. Additional resources: The International Journal of Paramedicine Degrees, debate and direction: Why this debate deserves our attention Top quotes from Mic Gunderson “Allow us to have enough maturity in our dialogue to say, ‘what's your logic or reasoning behind your opinion?' instead of just saying, ‘I think the sky is blue.' Tell me why you think the sky is blue and why it isn't red.” “With the Socratic debate format, because we're not trying to pick a loser or a winner, it allows us to really focus on the issues and the merits of the different perspectives.” Enjoying the show? Email theshow@ems1.com to share feedback or suggest guests for future episodes. 

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: Be human Say the uncomfortable thing Stop normalizing harm Build systems that “care back” for the people doing the work Memorable quotes “We're just working in systems that haven't yet learned how to care back for the provider.” — Sophie Fuller “Management by walking about. Don't be stuck in the office. Don't say my door is always open because that relies on people coming in to see you. Get out and go and see them.” — Rob Lawrence “We love this job and that distracts us from the fact that it's also hurting us.” — Sophie Fuller “Just because it's normal doesn't mean it's healthy.” — Sophie Fuller “We confuse trauma with tradition.” — Sophie Fuller Additional resources: Follow Paramedic Sophie on: YouTube Tik Tok “The Next Shift : A mentorship workbook for EMTs and Paramedics” | E-Book, by Sophie Fuller “To Err is Human: Building a Safer Health System” - PubMed Episode timeline 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. 

In this episode of the Inside EMS podcast, Chris and Kelly are joined by paramedic student April McKenzie — aka “April Anonymous” — for a deep dive into the buffer system and CO2 mapping. April's in the thick of paramedic school and like every good learner, she's asking “why?” — so the guys break down the physiology behind capnography, acid-base balance and the lungs-vs.-kidneys showdown that keeps our patients alive. Plus, they throw in old-school war stories, rant about naloxone misuse and admit that bicarb is no longer the go-to cardiac arrest drug. If you've ever tried to explain respiratory vs. metabolic acidosis in under 10 minutes, this episode is your cheat sheet. April will be back throughout the year with more student questions, so buckle up for the ongoing EMS education you didn't know you needed. Quotable takeaways “Just because you see somebody with signs and symptoms and the protocol says, do this; that's OK, but that just makes you a protocol paramedic.” “My friend Romy Duckworth calls [capnography] the MVP of vital signs, and that's a good way to remember it — MVP: Metabolism, Ventilation and Profusion. And it will tell you derangement about all three of those things very well once you're proficient at interpreting the waveforms.” “Basically, the buffer system is the body's way of keeping the pH stable. So, if we're blowing out, if we're having problems with respiratory acidosis — and let's talk about CDKA, where they're trying to blow off — it's the respiratory systems' way of making sure that we have homeostasis.” Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest guests for an upcoming episode. 

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: Are we doing a good job? Are we delivering the best possible care? How do we get better? 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 NEMSQA 2025 Report Release EMS One-Stop: Leading through momentum: Dr. Douglas Kupas on steering NAEMSP 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. 

This week on Inside EMS, Chris Cebollero kicks off 2026 with a heartfelt conversation featuring Eric Morrison, vice president of the National EMS Memorial Bike Ride and EMS director for Iredell County, North Carolina. The ride, founded 26 years ago, exists to honor the memory of EMS providers who died in the line of duty, from illness or mental health struggles. Each rider wears a dog tag bearing the name of a fallen provider, often connecting with their families along the journey. Eric shares his personal journey from lifeguard to leader and how his rekindled love for cycling — along with the loss of friend and EMS wellness advocate Brian Fass — led him to the ride. He breaks down what it takes to join (hint: it's more doable than you think), the logistics of the ride, and how EMS agencies and individuals can support the cause, even off the bike. Quotable takeaways from Eric Morrison “All of us are focused on the idea that our providers matter. They matter to their families, they matter to their communities, and they should matter to all of us.” “People that didn't even know that person are recognizing their service. They're recognizing their commitment to the community, and they're honoring them and remembering them.” “Once you come out and see what the ride is really about, you understand the mission and you see the impact it has on these families that we're able to meet with.” Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest a guest for a future episode. 

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 timeline 00:00 – 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. 

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 “If we can just verify that you're retaining the information, that's much more important than the veracity of how long it took you to get that information.” — Jimmy Apple “You can catch more flies with honey than you can with vinegar.” — Jimmy Apple “That's the future; is that literally, we're going to swipe it, absorb it and swipe away again.” — Rob Lawrence “My paper of the year is the paper that was published on spinal mobilization … It does not support the use of backboards as anything other than an extrication tool.” — Jimmy Apple “I think that a big push that I'm making this year is to really start talking about the EMS provider as the person.” — Jimmy Apple Episode timeline 00:56 — Rob welcomes listeners, references year-in-review data and notes ambulance thefts continue to trend. 01:38 — Rob brings Jimmy back and asks for a quick summary of Jimmy's year and growing reach, and the top themes Jimmy has seen. 04:12 — Jimmy identifies provider conditions and mindset as the dominant theme and describes discussion of collapse/collapsing systems. 06:12 — Jimmy explains social media as the pulse point and highlights burnout, anger and provider frustration. 06:52 — Jimmy pivots to technology's growing role and EMS resistance to tech encroachment in practice. 07:23 — Rob connects the tech thread to conference observations (Axon, AI). Jimmy gives examples (AI 12-lead, apps) and argues tech advancement shouldn't be rejected due to “skill deterioration” fears. 09:34 — Rob asks Jimmy's “how do you explain complex concepts quickly?” Jimmy uses the Michelangelo anecdote to describe stripping concepts to essentials; critiques padded, time-gated education. 12:29 — Jimmy argues for education credit models that recognize microlearning and self-directed learning if retention can be verified. 14:04 — Rob asks for standout research; Jimmy discusses RSI/induction agent considerations, pressors debate and prehospital antibiotics. 16:47 — Rob and Jimmy preview NAEMSP's annual meeting (“research Disney”), value of posters, networking and clinical depth. 18:26 — Jimmy names spinal immobilization evidence review as his “paper of the year” and explains its conclusions. 21:36 — Rob asks how Jimmy handles disagreement/detractors with a larger platform — Jimmy describes disagreement as healthy, focuses on respectful pushback and staying anchored in data. 29:00 — Final question: Jimmy emphasizes “provider as person,” healing the clinician and a sponsored podcast relaunch in January. Additional resources Meet the EMS Avenger: Saving lives with kindness and content. TikTok sensation and pediatric critical care paramedic Jimmy Apple shares his rise in EMS education, battling misinformation with heart and hustle Jimmy Apple's “paper of the year:” Millin MG, Innes JC, King GD, Abo BN, et al. “Prehospital Trauma Compendium: Prehospital Management of Spinal Cord Injuries — A NAEMSP Comprehensive Review and Analysis of the Literature.” Prehosp Emerg Care. 2025 Aug. Connect with Jimmy Apple, better known as The EMS Avenger: TikTok — Jimmy offers short-form, evidence-based EMS content here: @emsavenger Instagram — Engage with in-depth reels, visuals, and professional updates: @emsavenger X (formerly Twitter) — Follow EMS commentary, conversation, and boosts: @EMSAvenger Facebook — Join the group for discussions and shared insights: EMS Avenger community Apple Podcasts — Listen to “EMS Avenger: 20 Minutes to Save the World”: Weekly podcast series AAA & AIMHI EMS Media Log: EMS Intel Enjoying the show? Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback.

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 “Having a thoughtful conversation about what your system needs to look like on the go forward is paramount.” — Rodney Dyche “If you don't talk about yourself, somebody else will, and then you don't control the narrative.” — Rob Lawrence “Our No. 1 focus really needs to be on the economic sustainability of these systems because we are past the breaking point.” — Matt Zavadsky “Response times equals speed; speed equals crashes.” — Rob Lawrence “These theft incidents are … in almost all cases, 100% preventable by an aftermarket device … probably for 100 or $150.” — Rodney Dyche “Response times are expensive. The shorter that you want your response times, the more money it's going to take.” — Matt Zavadsky “Across every provider type … the fee-for-service revenue is 50% to 60% below the cost of providing service. So when somebody says to you, ‘I can do this for free,' ask more questions.” — Matt Zavadsky “Response times are used as a cudgel.” — Rodney Dyche Episode timeline 01:11 – Rob introduces the end of 2025 reflection and 2026 look-ahead; welcomes Matt Zavadsky and Rodney Dyche for the second annual EMSIntel year-in-review. 02:26 – Rodney reports the EMSIntel log count (“3,849 as of this morning”); Rob explains EMSIntel's purpose: curating national EMS stories to identify themes and brief stakeholders. 04:13 – Matt names the year's biggest issue: economic sustainability; the fiscal model is broken and impacts everything else. 06:32 – Matt walks through the “AnyTown EMS” trajectory: communities can't sustain old models, must define service levels, use system intelligence, and redesign for a modern “2028 model.” 09:06 – Matt cites the Medicare/RAND cost collection findings and warns that fee-for-service revenue sits far below actual costs; “ask more questions” when someone promises “free.” 10:12 – The group discusses communities pursuing tax levies and essential-service framing; Rodney contrasts places that pass funding measures with places that don't, and highlights local politics and competing priorities. 11:52 – Matt clarifies that “essential service” means different things to the public versus statute; agencies need trust, transparency and real community education to succeed at the ballot box. 13:50 – Rodney describes the “cost of readiness” misunderstanding (public sees mileage, not readiness); Matt pushes proactive reporting (monthly/quarterly/annual) to build credibility. 15:35 – Matt pivots to response times: they're expensive, clinically relevant in a small fraction of cases, and should be approached with evidence-based expectations and better triage/EMD practices. 18:14 – Rodney connects hot responses to preventable intersection crashes and modern driver realities; the discussion frames safety risk as a growing operational storyline. 20:21 – Matt adds an editorial caution that crashes are not confined to any one sector; points to recent examples including serious injuries during responses. 22:37 – Rob returns to ambulance thefts; Rodney calls most thefts preventable; Matt argues the basic lock discipline exists already and presses for stronger accountability and accreditation-style best practice. 26:11 – Rob flags downstream legal and regulatory risk (litigation exposure after stolen-unit crashes; DEA-controlled substances security implications). 26:52 – Rodney raises staffing; notes fewer staffing stories than 2024 but questions whether the situation is truly better; mentions earn-to-learn pipeline concerns. 28:13 – Matt describes the shift toward tiered deployment and greater EMT utilization, reducing pressure to staff large numbers of paramedics for calls that don't require that level. 30:17 – Matt emphasizes outcomes and meaningful performance metrics; argues many systems still report the wrong measures and should lead with clinical metrics, patient experience, and quality indicators. 31:08 – Rodney reinforces that response times get weaponized in governance decisions; notes boards can be swayed by “advanced skills” narratives rather than outcome data. 33:25 – Forward-looking wrap: Matt highlights daily calls from communities that “can't afford this anymore” and urges leaders to seize the redesign opportunity; Rodney echoes the need for planning and honest community conversations. Additional resources: AAA & AIMHI EMS Media Log: EMS Intel Fast & spurious: America keeps losing ambulances and the fix is cheap Callouts, chaos and career killers: The biggest EMS stories of the year Enjoying EMS One-Stop? Email editor@ems1.com to share feedback or suggest guests for future episodes. 

In this end-of-year special, Chris Cebollero and Kelly Grayson wrap 2025 with their trademark mix of humor, insight and zero sugarcoating. From venomous bites to venomous behavior, the Inside EMS duo continue counting down the top EMS stories that had the industry buzzing this year — and occasionally cringing. As always, the guys don't shy away from the tough stuff, but they make sure to end on a note of gratitude for the everyday EMS pros out there doing the job with compassion, competence and quiet heroism. Quotable takeaways “Every day, EMS providers go out there, do their jobs and bring some kindness and some comfort to a really bad day for their patients. And I think we need to look forward to more of that in 2026.” “Sometimes we've done things that maybe we shouldn't have, because it isn't in our scope of protocols, but I think we make a difference. Where's the line?” “Most of the advantages of mechanical CPR are not advantages at all.” The top EMS1 stories of 2025 Representatives Glenn Thompson and John Mannion introduced the EMS Counts Act Social Security Fairness Act signed into law, boosting retirement benefits for first responders Kentucky EMTs face KBEMS hearing for administering antivenom after mamba bite Elkhart firefighter appeals loss of paramedic duties after nurse's harassment complaint American Heart Association's 2025 CPR guidelines: Choking, opioids & survival chain Ill. city council makes $500 lift assist fee permanent Warren-Wentworth Ambulance shuts down after entire staff quits 'Shut the f**k up!': North Babylon Fire Chief Peter Alt on leave after video shows him cursing at patient Orange County fire chiefs demand removal of EMS director for halting blood transfusions, ketamine use Colo. paramedic charged with manslaughter after sedating, restraining man National EMS Advisory Council board members terminated Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest guests for an upcoming episode. 

In this special Christmas edition of the Inside EMS podcast, cohosts Chris Cebollero and Kelly Grayson unwrap five of the biggest EMS stories of 2025 — and it's not all eggnog and cheer. This year delivered more than its fair share of gut punches to the profession, from a paramedic who was charged with manslaughter, to footage of a fire chief yelling at a 10-year-old patient (yeah, that happened). Next week's show will break down the final five EMS stories of the year, but in 2026, we're flipping the spotlight. Chris and Kelly are calling on you to step up and share your real EMS stories — the funny, the frustrating, the calls that changed you. Got a moment that shaped your career? Our cohosts want to hear it, and you might even get an invite to appear on the podcast. ‘Tis the season to be heard; email theshow@ems1.com to share your story! Quotable takeaways “You're the grownup. You can't pitch a fit. You gotta be the grownup in the situation and diffuse it.” “If your only incentive for doing the right thing is that somebody might catch you being a jerk on video, then it's time for you to get out of the profession.” “The cost of readiness is hugely expensive.” Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest guests for future episodes. 

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 EMS Memorial EMS Memorial Bills: HR 2196  S2546  2025 National EMS Weekend of Honor recognizes 29 fallen EMS workers ‘Never forgotten': 2025 Moving Honors procession honors 29 EMS providers lost in the line of duty Episode timeline 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 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.

What do you do when someone on your team is struggling — and it's on you to say something? In this episode of the Inside EMS podcast, Chris Cebollero and Kelly Grayson dive headfirst into one of leadership's toughest challenges: holding people accountable without losing your humanity. This episode challenges leaders to ditch outdated progressive discipline models and start leading with clarity and empathy. Whether you're a seasoned supervisor or new to the hot seat, this one hits home. And if you've been avoiding a conversation, consider this your nudge to stop choosing comfort over your own integrity. Quotable takeaways “Firing people with compassion, managing your ego, their ego, admitting mistakes and just being human — these are the places where real leaders show up.” “One of the things I try to teach is that I don't fire anybody — I just process the paperwork. People fire themselves.” “EMS is a very egotistical business, and it's that ego that keeps us from asking questions. Because we don't want to look like we don't know what we're talking about in front of our peers.” Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest a guest!

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: Ask: “Do we have an AI policy?” Define what AI can and cannot be used for Insist that every AI-generated work product is double-checked by a human before it hits the record Memorable quotes “We weren't here to actually scare you off it. We're here to let you know that it's here, but it's like having a tiger, right? We all love to have a tiger, but it has to be contained in some sort of guard, otherwise it's going to run rife and cause havoc, and we don't want that.” — Rob Lawrence “This is part of the hyper-turbulence that's occurring in EMS right now.” — Matt Zavadsky “So I think the message for the profession right now is, now is not the time to put your foot on the brake. It's time to put your foot on the gas.” — Matt Zavadsky “We put the fun into function.” — Dr. Shannon Gollnick “I think it's important to understand that AI is not the future. It is the present. We are currently here right now. And it's nothing to be afraid of.” — Dr. Shannon Gollnick “If you're not doing it, I promise you that your staff is doing it and they're playing around with AI.” — Dr. Shannon Gollnick “Guardrails don't exist from a congressional standpoint. They don't exist from a regulatory standpoint. The technology is moving far too fast. So we as agency leaders have to take the lead in putting up some of those guardrails.” — Dr. Shannon Gollnick “There are ePCR software out there that are using proprietary AI that will use AI-generated narratives. And that absolutely is 100% good to go. What we don't want to see is our crews putting in their ChatGPT to have ChatGPT write their narrative.” — Dr. Shannon Gollnick “ChatGPT has embedded code inside of it that you can't see, but that code is there ... so what we're kind of afraid to do is to say, hey, what happens 6 months from now, 8 months from now when Medicare does an audit, they run your ePCRs and find all of this embedded code from ChatGPT ... you open yourself up for a lot of compliance issues.” — Dr. Shannon Gollnick Additional resources: EMS Intel EMS News Tracker American Ambulance Association Advocacy NAEMT Advocacy EMS shutdown survival: What leaders need to know now Charting the future: How AI is rewriting the EMS narrative 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. 

This week on the Inside EMS podcast, we're passing the gravy and the hot takes. Cohosts Chris Cebollero and Kelly Grayson serve up a holiday plate full of EMS news — starting with FDNY's potential EMS split. They dig into what fair pay really looks like, why some EMTs are suing for what they're owed, and whether big hospital systems like Yale New Haven are reshaping the ambulance game for better or worse. Whether you're working a turkey-day shift or finally off duty, this episode hits hard and gives thanks where it's due. Quotable takeaways: “If you're gonna be in the EMS business, you've gotta be in the EMS business, right?” “One thing we need to do as leaders is to make sure we don't mess with people's money.” “If you're not giving adequate funding and attention to the EMS side of the house, then that's a recipe for trouble and it can't last.” Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest a guest for a future episode. 

This week on the Inside EMS podcast, Dr. Peter Antevy returns for another round in the hot seat, and he's not holding back. In this jam-packed episode, he and host Chris Cebollero tackle trending topics in prehospital care — from the expanding role of whole blood and plasma, to the frustrating gaps in the AHA's 2025 guidelines. You'll hear real-world success stories (like the cardiac arrest survivor who's back on the tennis court), why dual sequential defibrillation (DSD) should already be your go-to, and the cost-benefit realities of starting a whole blood program. Dr. Antevy also dives into the science behind glycocalyx damage and how plasma could change how we treat sepsis, TBI and burns in the field. Whether you're a medic, medical director or just passionate about pushing EMS forward, this episode delivers practical insight, bold opinions and a whole lot of inspiration. Quotable takeaways from Dr. Antevy “The medical establishment does not understand the value of what EMS brings to the table. They don't understand the complexity.” “When we said, ‘We'll do the whole blood,' what did the surgeons do? They went up in arms: ‘What do you mean you're giving whole blood? Bring them to us. We'll give the whole blood.' No, no, no. We are part of the chain of survival, too.” “EMS is a subspecialty in the house of medicine. We all need to rise up to make the hospital folks and the academics aware that EMS is important for trauma, for stroke, for pediatrics, for cardiac. We are the ones who can help bring up those outcomes and that's why I love this field.” Additional resources:  AHA 2025 updates are here: Cue the overreactions and the protocol rewrites On-demand: Bringing whole blood to the front lines of EMS Stop the bleed, fill the tank – The New Orleans EMS blood program Whole blood in EMS promises a revolution in resuscitation Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest a guest for a future episode. 

This week on the Inside EMS podcast, host Kelly Grayson sits down with Jimmy Apple — known as the “EMS Avenger” on TikTok — to explore how he's challenging long‑standing EMS norms and delivering evidence‑based content at scale. With 22 years in EMS, the pediatric critical‑care paramedic has built a strong digital platform that merges clinical rigor with plain‑spoken commentary. Whether you're hung up on “what's new” or “what really works,” this episode offers a spirited discussion, thoughtful commentary and a call to re‑examine what we do — and why. Memorable takeaways “What we learn tends to define who we are as a provider, particularly when the information was learned during our formative years.” “I don't want to have to spend my time defending a personal position. I would rather talk about how we can guide ourselves based on what we are actually seeing with data that is as objective as we can get it.” Enjoying Inside EMS? Email theshow@ems1.com to share feedback and suggest guests for future episodes. 

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: New association management support Expanded member services and credentials The inaugural NEMSMA Leadership Conference 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 “Many homes destroyed, utility systems interrupted, critical infrastructure in terms of communities having the ability to communicate, leaving thousands displaced, even fire stations having operational challenges as it relates to communication and interoperability ... ” “I stayed in the local fire station. I wanted to be there with the men and women on the ground, to make sure that I had that communication, that constant contact with them.” “My focus will be on the firefighters and ensuring that we get enough supplies to go directly to the firefighters.” “We want to tear down silos. We want to redefine leadership and ensure that we continue to collaborate across this globe.” Additional resources: Jamaica Fire Brigade – Amazon Wish List National EMS Management Association (NEMSMA) NEMSMA Leadership Conference: Washington, D.C., March 23-24, 2026 EMS on the Hill, March 25-26, 2026, Arlington, Virginia International Journal of Paramedicine EMS One-Stop: General Robert Neller on ethical leadership and adaptability Episode timeline: 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 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.

Let's face it — most discussions on leadership sound like someone regurgitating a business best seller. Not this time. In this week's episode of the Inside EMS podcast, cohosts Chris Cebollero and Kelly Grayson get real about the six leadership habits that actually matter when you're running a shift, a truck or a team that relies on each other not to screw it up.   This isn't about titles, org charts or leadership flavor-of-the-month. We're talking self-awareness, collaboration and adaptability — the stuff that separates real-deal leaders from clipboard-holding disasters.   Whether you're trying to step up or just sick of bad leadership, this episode's got what you need to lead better — without the cringe. Memorable quotes “What I can't stand in a leader is someone who waffles and is just blown by the wind. I would much rather have somebody say, ‘This is what we're gonna do.' And then after, ‘Ooh, that was a bad idea. I'm sorry for that. That's on me.'” “If the team's confused, it's not a team problem. It's a leadership problem.” “Leaders who don't know themselves lead through ego and insecurity.” Enjoying Inside EMS? Email theshow@ems1.com to share feedback. 

In this week's episode of the Inside EMS podcast, cohosts Chris Cebollero and Kelly Grayson dive into the 2025 AHA Guidelines for CPR & ECC and why, for most EMS systems and crews, this feels more like a tune up than a full overhaul. They talk through what is different — like the adult/child choking algorithm change, the inclusion of an opioid overdose response algorithm with public naloxone access, and the shift to a single unified chain of survival across ages and settings. They also talk about what isn't new (for example, the recommendation that routine mechanical CPR devices are not better than manual compressions), why that matters, and how agencies should frame this for crews and training programs. Bottom line: the changes are real, the work is actionable, but this doesn't feel like a seismic shift — so use that to your advantage in getting buy-in from providers and avoiding the “huge change panic.” Memorable quotes “They're actually saying now, which I think is pretty cool, that individuals 12 and above can be taught CPR and how to use an AED.” “The key is early CPR and early defibrillation. And if you'regoing to get more bang for your buck, you need to devote your time to bystander CPR training and public AED access rather than buying fancy gadgets that are appealing but may not actually be supported by science.” “I find it interesting that we used to caution against this in CPR class: ‘Don't give 'em back blows. You may lodge it deeper into the trachea.' But now, I think they've looked at the data, and back blows are, at the very least, not harmful and may be beneficial.” “For those in leadership: audit all your protocols and training materials now. Find out where your system is aligned or out of step.” Enjoying the Inside EMS podcast? Email theshow@ems1.com to share feedback. 

This week on the Inside EMS podcast, hosts Chris Cebollero and Kelly Grayson dig into a hot-button issue lighting up EMS forums: DUI blood draws by paramedics. In Vanderburgh County, Indiana, a new program lets fire department medics perform evidentiary blood draws at the request of law enforcement — right on scene, even if the suspect isn't being transported. Supporters say it's efficient; critics say it's unethical.   The hosts share their own history with blood draws in the field and reflect on how their professional philosophies have evolved.   It's a passionate, no-holds-barred conversation about legal gray zones, moral boundaries, patient advocacy, operational burdens and the blurry line between healthcare and law enforcement.   Spoiler: There's no easy answer. But if your agency is considering such a program, this episode is required listening. Memorable quotes “My job is to do medical care, period, end of file. Quite often in doing my job, I make the point, ‘Hey, I'm not a cop, man. You can trust me.'” “There's a moral dilemma there. Are we caregivers or are we evidence collectors?” “Even if the laws permitted me to do so for one reason and one reason only, it's very hard to shift from a caregiver mindset to a defensive mindset.” Enjoying the show? Email theshow@ems1.com to share feedback or suggest a guest for an upcoming episode. 

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 Asbel Montes: The government shutdown's ripple effect on healthcare The Leadership Lab with Asbel Montes 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 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.

Sure, AI and digital systems are reshaping EMS, but at the core? It's still about people. In this week's episode of the Inside EMS podcast, cohosts Chris Cebollero and Kelly Grayson tackle the disconnect between tech-savvy, fast-adapting, new providers and an education system still stuck in the lecture-skill-lab loop. They break down why flipped classrooms, mentorship and real talk about leadership must happen now—and why soft skills aren't just nice-to-haves; they're survival tools. This episode makes the case that the future of EMS depends on how well we prepare, mentor and empower the medics already entering the field — and why waiting to teach leadership is a mistake we can't afford to keep making. Memorable quotes “Soft skills are the survival skills in today's EMS: empathy, de-escalation, teamwork.” — Kelly Grayson “We're supposed to be shepherds and guides, not the sage on the stage delivering a lecture and a performance — and I deliver lectures and performances very well. But that's not the best way people learn.” — Kelly Grayson Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest future guests!

This week on Inside EMS, ChrisCebolleroand Kelly Grayson dive deep into the dark side of workplace culture — the seven types of negativity that poison morale, ruin teamwork and chip away at your love for the job. From the moment the coffee hits your cup, to the second the rig rolls out, negativity can show up uninvited: complaints, criticism, blame, gossip — and yes, the ever-present cynicism. But this isn't just a leadership lecture. It's personal. Kelly opens up about his own battles with depression and how behaviors like self-pity and cynicism creep in under stress. The duo explores how everyday negativity often masks deeper issues — cries for help, burnout, lack of connection — and how leaders (and peers) can break the cycle. This episode is real, raw and one every EMS pro needs to hear. Memorable quotes “Negative attitudes spur negative attitudes. It's a phenomenon that feeds on itself.” — Kelly Grayson “Stop blaming and stop pointing fingers and let's fix the problem.” — Chris Cebollero “These seven types of negativity do us no good. All they do is drag us down personally, and they drag our workplace and our coworkers along with it.” — Kelly Grayson Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest guests for future episodes.

You know the drill — “patient feeling weak,” “not quite right,” maybe alittle confusion. But what if that vague dispatch hides a killer? This week on the Inside EMS podcast, hosts Chris Cebollero and Kelly Grayson dig into one of the most missed, yet deadliest emergencies we face: sepsis. You'll hear when to treat aggressively with fluids, why timing matters for antibiotics and how any provider can sound the alarm with a sepsis alert. Plus, they dive into the controversy around fluid bolus protocols, which prehospital labs might be worth it and why a 30 mL/kg mindset isn't always one-size-fits-all. If you've ever walked into a call and thought “something's off,” this episode will help you figure out what — and how to act before it's too late. Memorable quotes “Most septic patientsdon'troll with a sign thatsays,‘I'm septic.'” “The number of sepsis cases we see in EMS are more than stroke and heart attack combined.” “They may have pulses everywhere — just none of them are good.” Enjoying the show? Email theshow@ems1.com to share feedback or suggest future guests. 

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 “Most of all, I just fell in love with the character of Randy.” “Bottom line, the fact that first responders are getting basically what people that work at Starbucks are getting paid really blew my mind.” “Well, one thing I never thought of, maybe stupidly so, is how vulnerable everything is because you're going into people's homes and they're in crisis.” “I think Rob, no one should be allowed to graduate from high school without their kind of basic CPR training.” “Everything about EMS — the tone, the vibe, the gallows humor, certainly all the technical medical elements, the burnout, the camaraderie, the idea that there's a mission here — they do it because they love it.” “Well, it was an honor to learn about this world and to make a movie that these workers are excited about and proud of.” “I want to say from the bottom of my heart, you know, ‘thank you. Thank you for your work. And, you know, I think it's grossly underappreciated, but, you know, America needs you.'” Episode timeline 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 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.

This week on Inside EMS, Chris Cebollero welcomes Patrick Pianezza — former EMS Leadership podcast co‑host, paramedic and co-writer on the new action-comedy EMS film ‘Code 3.' Pianezza teamed up with writer Christopher Leone to push for authenticity, insisting on medical accuracy and avoiding cliches — no guns‑in‑ambulance heroics, no patients as punchlines. There are scenes that will make medics say, “That's us!” — from nursing home calls to behavioral health crises, the pressures from society, as well as moments many will recognize in their gut. For EMS professionals, this is about being seen, valued and having your story told well. For everyone else, it's an invitation to look deeper at the people showing up to help you on your worst day. Memorable quotes “What I really care about, what I want people to take away from the movie, especially if you're still actively doing the job, is that they feel recognized. They feel seen, they feel like we did them justice.” — Patrick Pianezza “CPR is so terribly shown on screen that we were committed to like, at least one movie's gonna get it right.” — Patrick Pianezza “There is a heart to it that I think is universal and speaks to not just people who do the job, but for outsiders to get a view into this world and be like, ‘Oh, so that's what this job is.'” — Patrick Pianezza Additional resources: Burnout, bravery and gratitude: The story behind ‘Code 3' Why ‘Code 3' might be the most honest EMS film yet ‘Code 3': A love letter to fire and EMS Enjoying the show? Email theshow@ems1.com to share feedback or suggest future guests.