Matt Aalto shares insights on cultivating a resilient fire department culture through clear expectations and genuine accountability. Drawing from decades of experience leading both volunteer and career crews in Oregon, Matt highlights how trust, communication, and proactive conflict resolution create an environment where firefighters thrive—both on and off duty. The discussion tackles the challenge of managing multiple generations within the ranks, the importance of addressing informal as well as formal expectations, and strategies for improving recruitment and retention by “getting your house in order” before adding new members. Real-world examples illustrate how supportive leadership tackles underperformance and fosters behavior change rather than punishment. Matt also offers practical advice for those looking to develop their voice in the fire and EMS community by writing and speaking.

Eric Chase sits down with John Graham, a respected EMS leader with 27 years of experience, to explore the challenges of mental health in emergency medical services. Reflecting on personal losses within the EMS community and the long-standing culture of “tucking away” trauma, John shares his journey toward embracing vulnerability and therapy. The conversation uncovers the often-unspoken struggles EMS professionals face, the delicate balance between leadership and friendship, and the importance of honest communication—even when it’s uncomfortable. John highlights the value of passion and commitment in leadership roles and stresses the need for grace, both toward oneself and others.

Mike Brown, William Belk and Mike Doss dive into the challenges and evolving practices of simulation-based training. They explore the idea of designing scenarios where even perfect performance doesn’t guarantee success, emphasizing the need to prepare students for unpredictable, high-stress realities without overwhelming beginners. The conversation highlights the important role structured debriefing to foster reflection and growth, while promoting psychological safety to embrace failure as a powerful learning tool. Incorporating resilience training early on is presented as a game changer for building mental toughness and coping strategies before entering the field. Drawing from decades of frontline and educational experience, the speakers advocate for tailored stress exposure to enhance cognitive function under pressure. Read Mike Doss' article that prompted this podcast here: https://www.jems.com/ems-training/no-win-scenarios-in-emt-and-paramedic-education/

FDNY Chief John Esposito shares insights from his 34-year career, revealing what sets a commissioner apart from a chief, and the realities of managing one of the largest fire departments in the world. Esposito reflects on his early days, the mentors who shaped him, and the profound impact of good leadership in firefighting. He offers a rare glimpse into the toughest decisions made during emergencies and the unique challenges of communication across thousands of personnel. The conversation also highlights firehouse traditions, from memorable meals to the iconic kitchen table, embodying the camaraderie that fuels their work. Chief Esposito closes by emphasizing the meaningfulness of saving lives and the unmatched sense of purpose his job has given him.

Steve Tafoya takes a dive deep into a new bill aimed at transforming treatment-in-place capabilities and establishing Medicare reimbursement models tailored for emergency medical providers. Drawing on 25 years of frontline experience and a strong legal and business background, Steve sheds light on the current reimbursement challenges EMS agencies face, with only about 14-25% of calls being fully reimbursed. The discussion highlights how this legislation could reshape EMS’s role beyond traditional 911 response—integrating community health, alternative destinations, and innovative care models. Steve emphasizes the critical need for provider voices in lawmakers’ offices and urges industry stakeholders to engage with representatives to support this bill. The podcast also explores the expanding career opportunities in EMS, including agency response units and industrial medical teams.

Eric Chase sits down with Jimmy Apple, aka EMS Avenger, to explore the often-overlooked realities behind emergency medical services. Jimmy breaks down the isolation many providers face, emphasizing the power of genuine relationships and networking in advancing EMS careers. They dive deep into the psychological challenges of frontline care, including the emotional toll of death notifications and the importance of accessible mental health support. With a spotlight on evidence-based practice, Jimmy contrasts the intense focus on cardiac arrest resuscitation with the relative neglect of sepsis recognition and treatment, urging a shift in EMS training priorities. Drawing from two decades of experience, he challenges outdated dogma around pediatric and adult care, encouraging providers to overcome fear and trust their skills. This conversation serves as a powerful reminder that EMS isn’t just about protocols—it’s about empathy, accountability, and continuous growth in service of human life.

By Bram Duffee, PhD, EMT-P

For EMS providers who respond to a traumatic cardiac arrest, the instinct to initiate CPR is almost automatic. But could this life-saving intervention inadvertently hinder recovery in cases of severe hemorrhagic shock? A recent study, “Effect of Cardiopulmonary Resuscitation on Perfusion in a Porcine Model of Severe Hemorrhagic Shock,” challenges conventional wisdom and offers new insights that could reshape trauma care protocols.

The Study: A Closer Look at CPR in Trauma-Induced PEA

The research, led by Dr. Patrick Greiffenstein, professor of clinical surgery at LSU New Orleans and trauma ICU director at the Norman McSwain Spirit of Charity Trauma Center, addresses a critical gap in trauma care.

While CPR is a cornerstone of resuscitation in cardiac arrest, its application in trauma-induced pulseless electrical activity (PEA) has not been rigorously validated. Trauma PEA, unlike medical cardiac arrest, is a low-flow state caused by severe blood loss (hypovolemia), where the heart shows electrical activity but fails to generate a palpable pulse.

“CPR is a cornerstone of resuscitation and cardiac arrest, but its application in trauma-induced PEA has not really been rigorously evaluated,” explains Dr. Greiffenstein. “Trauma PEA is fundamentally a low-flow state caused by hypovolemia—insufficient blood volume.”

The study aimed to determine how CPR affects tissue perfusion—specifically oxygen delivery to the brain and skin—during severe hemorrhagic shock. Using a porcine model, researchers simulated life-threatening blood loss and compared outcomes between two groups: one receiving automated CPR and the other left untreated during the shock phase.

Key Findings: When CPR May Do More Harm Than Good

The results were both surprising and concerning:

1. No Improvement in Perfusion: CPR did not enhance oxygenation in the brain or skin. In fact, skin perfusion was significantly lower in the CPR group during both the shock and recovery phases.
2. Adverse Hemodynamic Effects: While CPR increased systolic blood pressure (SBP), it significantly reduced diastolic blood pressure (DBP), which is critical for coronary and organ perfusion.
3. Potential Harm: CPR caused a threefold increase in intracranial pressure (ICP), suggesting that chest compressions might disrupt normal blood flow dynamics in the brain.

“Knowing now that extreme efforts like lining people up to do CPR can cause turbulence within the system is a significant advancement,” says Dr. Greiffenstein. “It’s possible to have perfusion at these unreadable MAP scores, which is a critical insight for trauma care.”

Implications for Trauma Care

These findings challenge the one-size-fits-all approach to CPR in cardiac arrest scenarios. In cases of hemorrhagic shock, CPR might:

• Divert attention from more effective interventions, such as rapid blood transfusion or surgical control of bleeding.
• Worsen perfusion to vital organs, potentially exacerbating the patient’s condition.

“In military cases, field medics often don’t have the opportunity to perform full chest compressions on the battlefield. Sometimes, all they can do is drag a person to a safe position,” notes Dr. Greiffenstein. This study underscores the importance of prioritizing interventions that address the root cause of trauma PEA—severe blood loss—over traditional resuscitation techniques.

A Call for Updated Guidelines

The American Heart Association’s current guidelines broadly recommend CPR for all pulseless patients. However, this study adds to a growing body of evidence suggesting that trauma-induced PEA requires a different approach. By focusing on restoring blood volume and controlling bleeding, paramedics and EMTs can improve outcomes for patients in hemorrhagic shock.

As Dr. Greiffenstein puts it, “This research is a step toward more tailored and effective trauma care protocols. It’s about understanding the unique physiology of trauma and adapting our interventions accordingly.”

For EMS providers on the front lines, this study serves as a reminder to critically evaluate the tools and techniques we rely on in emergency care. While CPR remains a vital intervention in many scenarios, its role in trauma-induced PEA warrants careful reconsideration by physician medical directors. By staying informed about the latest research, we can continue to improve outcomes for the patients who depend on us most. Click below to watch the full interview

Reference

Greiffenstein, P., Cavalea, A., Smith, A., Sharp, T., Warren, O., Dennis, J., Gatterer, M. C., Danos, D., Byrne, T. C., Scarborough, A., Deville, P., & VanMeter, K. (2025). Effect of cardiopulmonary resuscitation on perfusion in a porcine model of severe hemorrhagic shock. The Journal of Trauma and Acute Care Surgery, 98(2), 251–257.

In this candid conversation, Ashlynn O’Dell reflects on the realities of EMS—from first calls amid rural landscapes to navigating complex patient care in unpredictable environments. She shares how EMS became her calling over nursing or firefighting and highlights the often unseen sides of the job: delivering care in difficult living conditions, managing mental health, and staying resilient against workplace judgment. Social media became a powerful outlet, helping her connect with peers and inspire young women entering this male-dominated field. With humor, vulnerability, and insight, she reveals the delicate balance between being serious professionals and embracing levity on the job. The discussion also tackles burnout, workplace culture, and the importance of finding your voice in high-pressure scenes.

Joanna Sokol, a seasoned EMT and paramedic, opens up in this revealing conversation on the EMS Improv podcast. Drawing from 13 years on the frontlines and a trove of personal journals, Joanna discusses the emotional turbulence embedded in EMS—from the constant flood of forgettable calls to the rare moments that “grab you by the throat.” She shares how writing her book, “A Real Emergency,” became a cathartic way to process the human stories often overshadowed by dramatic emergencies portrayed in media. Joanna candidly reflects on the physical and emotional toll EMS careers exact and the harsh reality many face when transitioning to new paths after years in the field. Her perspective on mentorship, resilience, and embracing the everyday reality of EMS work challenges common perceptions and offers raw, valuable insight for providers and those who rely on them alike.

In this episode of Let’s Get It Straight, infection control consultant and host Katherine West tackles the growing challenge of accessing dependable scientific guidance amid shifting government support and archived resources. With traditional CDC documents and expert advisory groups diminished or disbanded, she unpacks how critical recommendations—such as those comparing N95 respirators to surgical masks—are formed using evidence review methods like CHARM and GRADE. Katherine highlights key differences in medical versus EMS settings that affect mask use and safety protocols, and she points to regional alliances stepping up to fill guidance voids. Emphasizing the importance of verifying sources and cross-checking studies before accepting health data, this session arms healthcare professionals with the tools to sift through conflicting info and make informed decisions.

EMS Research Podcast Host Bram Duffee dives into a recent study examining ChatGPT’s ability to predict prehospital patient diagnoses based on paramedic care reports.

ChatGPT accurately identified conditions 75% of the time and often erred on the side of caution, potentially reducing dangerous under-triage. Duffee is joined by lead researcher Erik Miller, a nurse practitioner and paramedic turned researcher, who sheds light on the study’s design, limitations, and real-world implications.

They discuss how AI can support—but not replace—the critical thinking skills of EMS providers, the challenges of legal liability, and the risks of overreliance on technology. The conversation also explores future possibilities for AI integration in dispatch and patient care reporting, while emphasizing the irreplaceable human touch in emergency medicine.

In this episode of the JEMS Report, Mike Brown sits down with EMS advocates David Blevins and Sam Magill to discuss groundbreaking federal legislation introduced by Senators Collins and Welch that aims to expand treat-in-place programs and establish sustainable funding models for Mobile Integrated Health (MIH). They explore how this legislation could shift EMS from the traditional transport-focused model to one centered on delivering appropriate care at the right place and time—often right in the patient’s home. The conversation highlights the critical role of EMS providers in advocacy, the implications for liability and medical direction, and the potential to reduce hospital overcrowding and healthcare costs. Listeners will also hear about the real-world benefits of MIH programs, including improved patient outcomes and new career pathways within EMS.

The world of prehospital medicine is constantly evolving, driven by new research, technological advancements, and a shared commitment to improving patient care and provider well-being. As EMS professionals, staying informed about these developments goes beyond a professional obligation; it is an opportunity to improve our practice, champion our profession, and ultimately make a greater impact on saving lives. In this article, we will explore some of the latest research findings that are reshaping our field, from workplace culture to cutting-edge technology.

The Culture of Care: Supporting EMS Providers

Our work is demanding, both physically and emotionally, and the culture within our agencies plays a critical role in our well-being. A recent systematic review in the International Journal of Environmental Research and Public Health revealed that many EMS providers avoid using organizational mental health services due to stigma and a perception that these programs lack genuine care. The study emphasizes the need for person-centered support and a cultural shift that normalizes seeking help as a sign of strength (Johnston et al., 2025).

This cultural component also impacts retention. Another study in the same journal found that agencies with collaborative, team-oriented "clan" cultures had significantly lower turnover rates compared to those with rigid or chaotic structures. For leaders in EMS, fostering a supportive environment is not just about morale. It is a strategic imperative for retaining skilled clinicians (Kamholz et al., 2025).

Professional Recognition: Breaking Barriers

Across the globe, paramedics are striving for recognition as integrated healthcare professionals. A qualitative study in BMC Health Services Research identified common barriers, including outdated legislation, inconsistent regulation, and insufficient funding. While the pandemic temporarily highlighted our capabilities, the momentum has waned. The study calls for targeted policy reforms and investments in education and leadership to solidify our role in the broader healthcare system (Feerick et al., 2025).

Physical Demands and Injury Prevention

The physical toll of our work is undeniable. A scoping review in Applied Ergonomics confirmed that musculoskeletal injuries, particularly to the back, are rampant in EMS. Tasks like handling stretchers and patient extractions are among the most strenuous. The review also highlighted fitness disparities, with male paramedics generally showing more strength but less flexibility than their female counterparts. These findings underscore the need for targeted injury prevention programs and realistic physical standards to keep us safe throughout our careers (Marsh et al., 2025).

Advancements in Cardiac Arrest Care

When it comes to cardiac arrest, every second counts. A study in Resuscitation reinforced the value of bystander CPR, showing that dispatcher-assisted CPR significantly improves outcomes for untrained bystanders. For those with prior CPR training, acting independently yielded even better results. This highlights the importance of public CPR education alongside dispatcher support (Tagami et al., 2025).

On the scene, our interventions matter immensely. Research in The Journal of Emergency Medicine found that for traumatic cardiac arrest patients, aggressive interventions like prehospital thoracostomy can be lifesaving (McWilliam et al., 2025). Meanwhile, a study in Critical Care Medicine revealed that extracorporeal CPR (ECPR) significantly improves outcomes for patients with refractory ventricular fibrillation, emphasizing the need for early transport to specialized centers.

The Role of Technology in EMS

Technology is poised to revolutionize EMS, from dispatch to diagnosis. A study in The American Journal of Emergency Medicine demonstrated that large language models (LLMs) like ChatGPT could prioritize ambulance requests with remarkable accuracy, aligning with expert paramedic decisions over 76 percent of the time. This proof of concept suggests that AI could one day enhance resource allocation in dispatch centers (Shekhar et al., 2025).

On the diagnostic front, machine learning is opening new possibilities. For example, a study in Bioengineering showed that analyzing photoplethysmography waveforms could estimate blood loss in trauma patients, offering a non-invasive way to guide resuscitation (Gonzalez et al., 2025). Similarly, research in Medical Engineering & Physics explored using multidimensional data to differentiate ischemic from hemorrhagic strokes in the field, potentially enabling more targeted prehospital care (Alshehri et al., 2025).

Addressing Disparities in Care

Equity in EMS is a cornerstone of our profession, yet recent studies highlight troubling disparities. Research in JAMA Network Open found that ambulance offload times were significantly longer in communities with higher proportions of Black residents (Zhou et al., 2025). Another study in JAMA Surgery revealed that Black and Asian trauma patients were less likely to receive helicopter transport compared to White patients. These findings are a call to action for all of us to examine our systems and biases to ensure equitable care for every patient (Mpody et al., 2025).

Looking Ahead

The research discussed here represents just a fraction of the advancements shaping EMS today. From improving workplace culture and injury prevention to leveraging AI and addressing systemic inequities, these findings have real-world implications for our protocols, training, and advocacy efforts. As EMS professionals, we have a responsibility to stay informed and apply these insights to our practice.

For a deeper dive into these topics and more, I invite you to listen to the podcast, EMS Research with Professor Bram latest episode, https://youtu.be/rt_1AFzSLIk "Research Highlights and Innovations Shaping Our Field.”

References

Alshehri, A., Panerai, R. B., Lam, M. Y., Llwyd, O., Robinson, T. G., & Minhas, J. S. (2025). Can we identify stroke sub-type without imaging? A multidimensional analysis. Medical Engineering & Physics. https://doi.org/10.1016/j.medengphy.2025.104364

Feerick, F., Coughlan, E., Knox, S., Murphy, A., Grady, I. O., & Deasy, C. (2025). Barriers to paramedic professionalisation: A qualitative enquiry across the UK, Canada, Australia, USA and the Republic of Ireland. BMC Health Services Research, 25(1), 993. https://doi.org/10.1186/s12913-025-10993-7

Gonzalez, J. M., Holland, L., Hernandez Torres, S. I., Arrington, J. G., Rodgers, T. M., & Snider, E. J. (2025). Enhancing trauma care: Machine learning-based photoplethysmography analysis for estimating blood volume during hemorrhage and resuscitation. Bioengineering, 12(8), 833. https://doi.org/10.3390/bioengineering12080833

Johnston, S., Waite, P., Laing, J., Rashid, L., Wilkins, A., Hooper, C., Hindhaugh, E., & Wild, J. (2025). Why do emergency medical service employees (not) seek organizational help for mental health support?: A systematic review. International Journal of Environmental Research and Public Health, 22(4), 629. https://doi.org/10.3390/ijerph22040629

Kamholz, J. C., Gage, C. B., van den Bergh, S. L., Logan, L. T., Powell, J. R., & Panchal, A. R. (2025). Association between organizational culture and emergency medical service clinician turnover. International Journal of Environmental Research and Public Health, 22(5), 756. https://doi.org/10.3390/ijerph22050756

Marsh, E., Orr, R., Canetti, E. F., & Schram, B. (2025). Profiling paramedic job tasks, injuries, and physical fitness: A scoping review. Applied Ergonomics, 125, 104459. https://doi.org/10.1016/j.apergo.2025.104459

McWilliam, S. E., Bach, J. P., Wilson, K. M., Bradford, J. M., Kempema, J., DuBose, J. J., ... & Brown, C. V. (2025). Should anything else be done besides prehospital CPR? The role of CPR and prehospital interventions after traumatic cardiac arrest. The Journal of Emergency Medicine. https://doi.org/10.1016/j.jemermed.2025.02.010

Mpody, C., Rudolph, M. I., Bastien, A., Karaye, I. M., Straker, T., Borngaesser, F., ... & Nafiu, O. O. (2025). Racial and ethnic disparities in use of helicopter transport after severe trauma in the US. JAMA Surgery, 160(3), 313–321. https://doi.org/10.1001/jamasurg.2024.5678

Shekhar, A. C., Kimbrell, J., Saharan, A., Stebel, J., Ashley, E., & Abbott, E. E. (2025). Use of a large language model (LLM) for ambulance dispatch and triage. The American Journal of Emergency Medicine, 89, 27–29. https://doi.org/10.1016/j.ajem.2025.05.004

Tagami, T., Takahashi, H., Suzuki, K., Kohri, M., Tabata, R., Hagiwara, S., ... & Ogawa, S. (2025). The impact of dispatcher-assisted CPR and prior bystander CPR training on neurologic outcomes in out-of-hospital cardiac arrest: A multicenter study. Resuscitation, 110617. https://doi.org/10.1016/j.resuscitation.2025.110617

Zhou, T., Wang, Y., Zhang, B., & Li, J. (2025). Racial and socioeconomic disparities in California ambulance patient offload times. JAMA Network Open, 8(5), e2510325. https://doi.org/10.1001/jamanetworkopen.2025.10325

In this episode of Just Little Salt, Dr. Alexandra Jabr, founder of Emergency Resilience and a licensed paramedic, shines a light on the challenges of delivering death notifications in emergency medical services.

Drawing from years on the front lines and her advanced studies in health and depth psychology, Dr. Jabr, a new member of the JEMS Advisory Board, discusses why clear and compassionate communication is crucial and exposes common mistakes that can worsen an already painful moment.

Beyond the call, she tackles the emotional toll first responders face—from coping with repeated trauma to battling numbness and isolation—and the importance of mental health support, including the emerging role of ketamine therapy.

She also shares personal stories, her injury-induced career pivot, and her passion for education and advocacy.

In this episode of the Not A-Fib podcast, Virginia Beach (VA) EMS Chief Jason Stroud discusses a recent operational shift limiting the use of lights and sirens for non-emergent calls. Drawing on research and local data showing minimal impact on patient outcomes but significant safety risks—including increased ambulance collisions—Chief Stroud explains why the department is prioritizing safer, more measured responses for priority two calls, which make up 75% of dispatches. He details the unique combination career-volunteer EMS model in Virginia Beach, the close partnership with local military installations, and the department’s advanced life support heritage. They also explore how evolving dispatch protocols and ongoing evaluation guide this change, alongside challenges like workforce development and growing call volumes.

Ed Fowler’s 40-year career in fire and EMS culminates in a transformative chapter as he helps El Reno, Oklahoma, transition its EMS from private to an in-house, city-managed service—an innovative model focusing on sustainability, independence, and community trust. Ed shares his leadership philosophy grounded in accountability, clear communication, and mentoring future leaders. Amid this professional milestone, Ed confronts a life-threatening liver condition, navigating the transplant process while ensuring the EMS startup stays on course. His story offers rare insight into the human side of emergency services, touching on resilience, collaboration, and purpose when facing the edge of life itself. Beyond operational challenges, Ed’s vulnerability inspires those struggling with adversity to find reasons to keep moving forward.

Jack, known online as Electric Medic, shares an unfiltered look at his journey through EMS—from earning his med school diploma to working high-stakes gigs like Electric Daisy Carnival cruises. He reveals what keeps him grounded amid intense calls, the challenges of overnight shifts, and why the low-speed fender bender calls grind his gears. Jack dives into his unexpected rise on TikTok and Instagram, explaining how viral videos and smart collaborations launched his digital brand. Beyond ambulance life, he thrives on music festival EMS work, mixing adrenaline with creativity, including collabs with dubstep artist Subtropics. He also reflects on teamwork, mental toughness, and the importance of pursuing a clear social media focus. For anyone curious about the blend of healthcare hustle and online content creation, Jack’s story showcases the raw reality and unexpected opportunities within modern EMS culture.

In this episode of The Chief’s Cadence, Shane Wheeler sits down with Dr. Anthony Minge, senior partner at Fitch and Associates, to explore the overlooked role of structured communication in EMS leadership. Dr. Minge discusses why communication should be as prioritized as budgets or staffing. He highlights practical strategies like rounding, scheduled huddles, and purposeful meetings to build trust, improve culture, and reduce operational chaos. The conversation also addresses the challenges posed by modern communication technology and artificial intelligence, emphasizing the irreplaceable value of face-to-face dialogue and emotional connection. For aspiring and current EMS leaders, this episode offers actionable insights on fostering psychological safety, encouraging two-way communication, and leading with transparency and intentionality.

The 2025 AHA Guidelines for CPR and Emergency Cardiovascular Care introduce significant updates, including a focus on on-scene resuscitation, cautious use of mechanical CPR devices, and prioritizing IV over IO access. While these changes aim to improve outcomes, they’ve sparked debate among seasoned paramedics like Jimmy Apple, the “EMS Avenger,” who highlights the challenges of implementation.

Key Points: • On-Scene Resuscitation: Emphasis on achieving ROSC on scene rather than rapid transport. • Mechanical CPR Devices: AHA advises against routine use, but paramedics argue they’re essential for small or rural teams. • IV vs. IO Access: IV is prioritized, but practicality for resource-limited teams is questioned. • Empowering EMS Providers: Focus on critical thinking, quality compressions, and timely defibrillation. • Cultural Shift: Training crews for compassionate death notifications and clear family communication.

In this candid episode of Just Little Salt, Nurse Stankk—an ER nurse and viral healthcare content creator—breaks down what really goes down behind hospital doors. He shares the tough realities of nonstop demands, overlooked tasks, and the emotional toll of burnout, especially dealing with difficult patients and tragic cases involving children. Yet amid the chaos, he reveals how healthcare humor and genuine mentorship have kept him sane. Nurse Stankk also opens up about launching his social media presence out of frustration, which quickly exploded, connecting him with fellow medical pros and fans nationwide. From wild patient stories and TikTok trends at work to navigating skepticism from coworkers, he unpacks the highs and lows of being a nurse with an edge. Whether you’re in healthcare or just curious, this episode offers a raw, relatable glimpse into the life of an ER nurse balancing care, comedy, and viral fame.

JEMS Development Editor Mike Brown sits down with Jason Nunn, the creator of Stetta Sleeves, a personal and innovative solution designed to protect healthcare workers from bites, scratches, and needle injuries. Drawing from over 20 years of experience in medical care, Jason shares the incident that inspired the product—his own injury during a hospital code involving an agitated patient—and highlights the alarming rise in violence faced by nurses, EMS providers, and other healthcare professionals. Stetta Sleeves offers a lightweight, easy-to-wear protective sleeve that’s scratch-, puncture-, and needle-resistant, providing confidence and safety in high-risk environments like emergency rooms, ambulances, psychiatric units, and beyond. Jason emphasizes the importance of equipping those on the front lines with practical tools to ensure better patient care and reduce costly injury claims.

Visit www.stettasleeves.com to learn more.

Dr. Richard Janka, CEO of the 911 Training Institute joins the podcast to talk about resilience. He talks about the mission of the training institute as well as what got him involved with the institute. The bulk of the podcast is spent discussing resilience and what it means for first responders, as well as the telecommunicators who have to take these calls. We talk about the key role leadership plays in the success of a resilience program as well as the key role they play in the culture of an organization. We also discuss some of the reasons that these resilience programs can fail and how to avoid them.

In this heartfelt episode of Just a Little Salt, Chris Spaulding sits down with his son, Cody, to explore a lifetime shaped by fire service. Chris recounts how a family tragedy set him on this path over three decades ago, sharing stories that blend humor and hardship—from prank wars and raw chicken mishaps to the heavy toll of witnessing trauma. Father and son reveal the deep bonds that grow in firehouses, lessons in discipline, persistence, and the importance of mental health awareness in a demanding profession. They also discuss the challenge of balancing career and family, reflecting on personal growth and the evolving culture within emergency services. Through candid anecdotes and thoughtful advice, this conversation captures the unique camaraderie and real-world impact of a life committed to helping others, offering inspiration and insight for first responders and civilians alike.

Host Bram Duffee explores research on epinephrine’s role in traumatic cardiac arrest. The discussion features a trauma surgeon and researcher from a Level 1 trauma center who explains why epinephrine may not only lack benefit but could cause harm in trauma cases like car crashes or gunshot wounds. Drawing from a six-year study across seven trauma centers involving over 1,600 patients, the findings challenge current EMS protocols by highlighting differences in outcomes between blunt and penetrating trauma. Bram also shares resources on EMS research and innovative communication techniques for emergency patients, offering valuable tools for practitioners and instructors alike. Brought to you by Stetta Sleeves. http://www.stettasleeves.com

Rolling Sixes is a groundbreaking six-part documentary series spotlighting the combined police, fire, and EMS crews of Kalamazoo Public Safety—the largest integrated public safety agency in the U.S.

Created by Zach Hamelton, a former TV and film producer turned public information officer, the series blends cinematic storytelling with immersive, real-world footage captured via GoPros and cinema cameras.

Viewers get rare access to intense emergencies, day-to-day station life, technical rescues, and candid conversations revealing the emotional toll on responders.

With a focus on authenticity, the show highlights both heroic moments and routine calls, showcasing the personal bonds and dedication within the crews. It also aims to boost recruitment by letting the community see the people behind the badges.

Brought to you by Stetta Sleeves. www.stettasleeves.com

Just a Little Salt: Real Stories, Hard Truths and Humor with Fireman Lance   Fireman Lance opens up about the realities of life on the job—from brutal physical challenges and mental exhaustion to the tight-knit culture and unexpected humor at the fire station. Lance shares stories of rookie mistakes, intense calls and hilarious firehouse pranks involving ghostly dolls and prank sprays. He sheds light on the demanding balance between grueling shifts and family life, the importance of staying fit and the misunderstood role firefighters play beyond emergency response. Lance also reveals how creating relatable social media content grew into a platform that entertains and educates the fire and EMS community.

Brought to you by Stetta Sleeves.   www.stettasleeves.com  

JEMS Product Pod: TRAUMAGEL is Revolutionizing Hemorrhage Control   JEMS Development Editor Mike Brown welcomes Joe Landolina, co-founder and CEO of Cresilon, alongside Sean Allen, Director of Education for TRAUMAGEL, to dive into a breakthrough in hemorrhage control technology. TRAUMAGEL, a plant-based, easy-to-use hemostatic gel, stops moderate to severe external bleeding within seconds without the need for finger packing or complex dressings. Developed over 15 years and backed by a successful animal health platform, this innovative product adapts dynamically to wounds—crucial for moving patients—and supports natural clot formation without disrupting it. Sean shares firsthand insights on field use and training, highlighting TRAUMAGEL’s potential to reduce tourniquet necessity and simplify emergency care. The team also explores real-world applications, including rural trauma cases and gunshot wounds, emphasizing this gel’s transformative impact on prehospital hemorrhage management.

Not A-Fib: Criminal Liability and Legal Challenges for EMS Providers

This episode of the Not A-fib podcast looks into the increasing scrutiny EMS providers face from a legal standpoint, highlighted by high-profile cases like Elijah McClain's tragic death in Aurora, Colorado, and a recent Springfield, Missouri incident. Attorney and EMT Frank Flaspohler, who serves as legal counsel to Missouri ambulance districts, explains the differences between civil and criminal liability in EMS, the limits of governmental immunity, and the critical role of documentation. He discusses the legal thresholds around chemical and physical restraints, the importance of assessing mental capacity in refusals, and the risks tied to improper patient handling. Frank also shares practical advice on maintaining professionalism in reports and on scene, the nuanced challenges rural EMS agencies face, and emerging concerns such as mental health support for first responders.

The JEMS Report: Tylenol Use in Pregnancy  

Dr. Sarah Fabiano and Dr. Jeremy Cushman break down the recent FDA release linking acetaminophen (Tylenol) use during pregnancy to autism spectrum disorder.  They discuss the distinction between association and causation, highlighting how studies can show correlations without proving direct cause and effect. The doctors also address the complexity behind autism diagnoses, genetic and environmental factors, and the known risks of fever during pregnancy.  They emphasize that acetaminophen remains one of the safest and most effective options for pain and fever relief in pregnancy, especially compared to alternatives like ibuprofen or aspirin, which carry documented risks.  This discussion aims to clarify confusion, steer clear of fear-driven decisions and encourage informed use of medication based on current science—not headlines. 

Just a Little Salt: Kevin Hazzard on the Reality of Emergency Medicine, Burnout, and Storytelling

In this revealing episode of “Just a Little Salt,” seasoned Atlanta paramedic and author Kevin Hazzard shares the unvarnished truth about life on the front lines of emergency medicine. Reflecting on his decade-plus of experiences, Kevin dives deep into the emotional challenges of responding to traumatic calls, the harsh realities young EMTs face, and the impact of burnout on providers. He opens up about moments that forever shaped him, including encounters with vulnerable patients and the delicate balance between adrenaline-fueled rescues and raw human connection. Kevin also discusses his transition from medic to author, explaining how writing helped him process his career and why genuine storytelling matters. Along the way, he offers practical advice for new EMS providers and aspiring writers seeking to publish their own stories. This episode is a must-listen for anyone curious about the personal side of EMS, resilience under pressure, and the power of sharing these unheard voices.

Just a Little Salt: Badge 502 on EMS, Dispatch and Viral TikTok Fame

In this candid episode of “Just a Little Salt,” the Salty Paramedic sits down with Badge 502— Anthony Christian an EMT, 911 dispatcher, CPR instructor and viral content creator. Anthony shares his journey from retail to first responder during the height of the COVID-19 pandemic, how creating humorous EMS videos started as a way to find levity in a demanding job, and unexpectedly blew up with millions of views. He dives into the challenges and emotional weight of emergency calls, including delivering a baby in an ambulance and saving a child’s life. Anthony also discusses the unique perspective gained from working both sides—dispatch and field EMT—and how that shapes his communication and care. They wrap up with Badge 502’s advice for aspiring creators: focus on having fun, embrace imperfection and keep grinding.

The JEMS Report: ROSC and Roll   Cardiovascular perfusionist Brian Kress joins Mike Brown to dissect a high-stakes cardiac arrest case that underscores the critical moments following return of spontaneous circulation (ROSC). They walk through the fragile physiology of post-arrest patients and reveal how early, expert support in the field and hospital dramatically influences outcomes. From the importance of bystander CPR and prehospital interventions to advanced cardiac catheterization and mechanical circulatory support using the Impella device, Brian explains the science behind left ventricular end diastolic pressure (LV EDP) and how offloading the heart aids recovery. This conversation deep dives into the often-overlooked complexities of managing post-ROSC states, emphasizing the need for vigilant hemodynamic monitoring and judicious use of vasopressors. A must-listen for EMS, perfusionists and critical care providers seeking a nuanced understanding of cardiac arrest survival pathways beyond the initial resuscitation.

Just a Little Salt: Firefighter Fenton on Leadership, Family and Humor in Firefighting

Firefighter Fenton opens up about balancing two decades of firefighting with family life, creative content creation and staying true to himself. From the harrowing experience of losing a fire truck amid a wildfire threatening homes—teaching him tough lessons in leadership and priorities—to the lighter side of his persona inspired by a fake mustache and parody videos, Brent shares it all. He discusses the challenges of juggling a full-time career, four kids, homeschooling and his passion for music and comedy. Brant also reveals the power of community within firefighting content creators and how their work brings laughter and healing to those facing dark times. For anyone wanting to create meaningful content, Fenton’s advice rings clear: stay authentic, know your worth beyond the spotlight and never lose sight of what matters most—family and faith.

Just a Little Salt: Patrick Pianezza on ‘Code 3,’ EMS Realism and Mental Health

In this debut episode of Just a Little Salt, former paramedic and co-writer Patrick Pianezza shares the story behind the upcoming film “Code 3,” releasing September 12. Drawing on over a decade in EMS, Patrick reveals how a college creative writing assignment transformed into a heartfelt, medically accurate portrayal of a 24-hour shift’s highs and lows. He discusses the film's unapologetic look at EMS challenges—including burnout, mental health struggles and systemic issues—while preserving dark humor and camaraderie that help first responders cope. Patrick also reflects on working closely with actors to capture authentic medical procedures and the importance of educating the public about the skill behind EMS work. Wrapping up with encouragement for aspiring writers, he offers raw insight into perseverance, creativity, and gratitude toward those who serve on the front lines.

Chief’s Cadence:  Ethical Leadership in EMS with Attorney Steve Wirth  

In this episode of The Chief’s Cadence, Chief Shane Wheeler sits down with Attorney Steve Wirth, a pioneering paramedic turned attorney and EMS leader, to uncover the complexities of ethical leadership in emergency medical services. Drawing from decades of hands-on experience, Steve explores the hard choices EMS professionals face daily—from patient care errors and scarce resources to the challenge of maintaining compassion amid burnout. They discuss the vital role leaders play in modeling integrity, fostering transparency, and building a culture that empowers staff to speak up about mistakes. Steve also highlights mentorship as a powerful tool for guiding the next generation of EMS leaders through the ethical “gray zones” that often arise. 

What is high-risk airway management (HRAM)? It is exactly the stuff nightmares are made of: Patients who present to us, outside of the hospital, with severe injuries and competing treatment priorities.

Performing RSI on these patients is a lot like walking alone down a scary alleyway in the big city.

Read the full article on EMS Airway.

Not A-Fib:  Mobile Integrated Healthcare, Advocacy and Mental Health in Missouri

Chief Justin Duncan, CEO of Washington County Ambulance District in Missouri, shares insights on pioneering mobile integrated healthcare in a sprawling 1,500-square-mile rural area. Winning the $150,000 Building Bridges to Better Health challenge, his program blends community paramedics, telehealth, and partnerships with federally qualified health centers and social service organizations to close care gaps beyond traditional EMS responses. Duncan discusses the evolution from emergency transport to preventative, holistic care, tackling chronic diseases and social determinants of health, while navigating reimbursement challenges through managed care contracts and advocacy. He highlights the crucial role of public health in community needs assessments and stresses the urgent need to address mental health within EMS, sharing personal stories and calling for cultural change. As president of the Missouri EMS Association and chair of the NAEMT Economics Committee, Duncan emphasizes teamwork, mentorship and engagement at all levels—from local agencies to Capitol Hill—to shape the future of EMS and ensure sustainable, patient-centered care.

The JEMS Report: Practical Insights for Out-of-Hospital Birth Challenges

In this episode of the JEMS Report Podcast, managing editor Jeff Frankel sits down with Dr. Liz Travis, a maternal care researcher, to discuss the growing challenges EMS providers face with out-of-hospital births. They unpack the critical gaps in traditional EMS training, particularly as maternal care deserts expand, leaving medics increasingly responsible for delivering babies in the field. Dr. Travis shares evidence-based strategies like the importance of delayed cord clamping (“wait for white”), skin-to-skin contact, and encouraging comfortable, non-supine birthing positions to improve outcomes for mother and infant. She advocates for updated, hands-on EMS training that reflects modern obstetric knowledge, including collaboration with midwives and doulas. Above all, Dr. Travis emphasizes that birth is usually natural, not an emergency, encouraging EMS providers to remain calm and focus on simple, effective practices. This episode offers essential insights for paramedics and EMS agencies preparing to meet the demands of maternal care in underserved areas.

Airway management in the prehospital environment is difficult just by virtue of where we are doing it and the lack of resources available to help us manage the difficulties. Add to that a patient with mangled facial anatomy or is dangerously peri-arrest due to hemorrhage and the danger can seem insurmountable.

What the research tells us is that there are really three big buckets of problems in airway management that contribute to morbidity and mortality: hypoxia, hypotension and multiple intubation attempts; this is the stuff that airway nightmares are made of.

Read the full article on EMS Airway.

Not A-Fib :Inside New Orleans EMS’s Body Worn Camera Program and Mass Casualty Response

In this episode of the Not A-fib podcast, Deputy Chief Christopher Keller of New Orleans Emergency Medical Services shares the origins and impact of their innovative body worn camera program.

The program protects staff, supports quality assurance and aids patient care. Keller discusses navigating privacy concerns, storage challenges, and staff buy-in while prioritizing transparency over punishment. He also reflects on the agency’s rapid and coordinated response to the tragic January 1, 2025 Bourbon Street attack, highlighting lessons learned and multi-agency training efforts.

Additionally, Keller provides insight into preparing for massive events like the Super Bowl and Mardi Gras, where public safety coordination is key.

The episode closes with reflections on the department’s experience filming the Nightwatch TV series and the future potential of integrating body cam footage with EMS documentation.

The JEMS Report - How Drones Are Transforming EMS Logistics and Healthcare Delivery  

JEMS Managing Editor Jeff Frankel sits down with Ryan Walsh, CEO and founder of Valqari, to explore how drones are revolutionizing emergency medical services and hospital logistics. Drawing on his special operations experience, Walsh reveals how Valqari developed autonomous drone technology to deliver critical medical supplies quickly, slashing delivery times. The discussion covers real-world applications like transporting blood samples and emergency meds, plus cutting-edge AI integration that could enable fully automated, doctor-to-door healthcare. Walsh also highlights ongoing collaborations with first responders to provide life-saving supplies on-site faster than ever. He breaks down FAA regulations shaping drone deployment and shares his vision for drones becoming as common as smartphones by 2030, drastically reducing delivery costs and reshaping industries. This episode offers practical insights for EMS leaders gearing up for drone adoption and a glimpse at the future of autonomous medical logistics.  

EMS Research: Severe Hemorrhage Technology Developed by Military Researchers

Severe hemorrhage is one of the toughest challenges faced in the prehospital environment, especially when every second counts and resources are limited. But a recent study on the use of 25% human serum albumin (HSA) in trauma care could change how responders approach these critical moments.

The study was led by United States Air Force Scientist Alex Penn, PhD. The findings from his team suggest that this concentrated protein solution can stabilize blood pressure, reduce the need for additional fluids, and improve circulation in ways traditional methods cannot. For paramedics, this could mean a shelf-stable, easy-to-use solution that saves more lives in the toughest conditions, revolutionizing pre-hospital care as we know it.

The JEMS Report - How Critical Incident Response Canines Are Changing First Responder Support

JEMS Managing Editor Jeff Frankel sits down with Janeen Baggette, the founder of K9s for Freedom and Independence, to explore a unique approach to first responder well-being.

With a background as a military medic and law enforcement handler, Janeen shares how her nonprofit trains specialized Critical Incident Response Team (CIRT) canines. These dogs differ from typical therapy and patrol dogs—they’re specially conditioned to operate in chaotic environments, offering emotional support while maintaining confidentiality crucial for legal and occupational safety.

Janeen walks us through the rigorous selection and training process, highlighting their ability to detect cortisol levels reflecting human stress. Through heartfelt stories, she illustrates the quiet impact these canines have on victims and first responders alike.

Challenges around funding and awareness remain, but Janine’s vision for expanding certified teams across the country offers hope for better communication, reduced suicide rates, and stronger peer support in these high-pressure fields.

Infection control consultant Katherine West breaks down the critical distinctions between infection prevention practices in EMS settings versus medical facilities.

She clarifies how EMS-specific CDC guidelines account for unique factors like ambulance ventilation systems, the rear exhaust fan and closed suction systems that impact airborne and droplet disease transmission risks.

Katherine addresses the evidence behind mask and respirator use, emphasizing that clinical data since 2015 shows no clear advantage of N95 respirators over surgical masks for many respiratory infections in EMS contexts.

She also highlights post-exposure protocols, explaining why EMS personnel do not require immediate baseline blood testing, unlike hospital staff. Practical advice on COVID-19, tuberculosis, measles, Ebola precautions and aerosolized medication administration underscores why EMS must follow tailored guidelines rather than hospital-based protocols.

JEMS Managing Editor Jeff Frankel sits down with occupational therapist Bonnie Ekman and paramedic leader Alanna Badgley to explore sensory modulation therapy as a breakthrough tool for first responders’ mental health.

Bonnie explains how engaging all eight senses helps regulate the nervous system, moving beyond traditional talk therapy when first responders are stuck in fight-or-flight activation.

Alana shares her personal experience and the positive feedback from EMS professionals who have benefited from sensory rooms designed to soothe hypervigilance and stress.

They discuss practical, budget-friendly ways departments can implement sensory modulation spaces, emphasizing low-cost solutions like colored lighting, calming sounds, and tactile tools.

JEMS Managing Editor Jeff Frankel hosts a deep dive into the mental health challenges facing first responders. Featuring Dr. Robin Jacobowitz, interim director at SUNY New Paltz’s Institute for Disaster Mental Health, and paramedic and union leader Alanna Badgley, the discussion centers around a groundbreaking 2024 New York State Mental Health Needs Assessment.

The study exposes alarming rates of PTSD, depression, and suicidal ideation—20% of EMS respondents have thought about suicide linked to their work. The conversation addresses how chronic workplace stressors like mandated overtime and stigma create substantial barriers to care.

Alanna emphasizes that mental health struggles aren’t anomalies but an expected reality for first responders, advocating for open dialogue, culturally competent care, and union-backed mental health leave policies. This episode sets the stage for ongoing conversations and upcoming solutions to better support those on the front lines.

The other day I was working an arrest and I watched the provider preparing to intubate take a big deep breath and hold it while they used their fingers to scissor open the patient’s lips and then introduce the blade into the mouth. They had not elevated the head to optimize the airway angles and ease the need for vallecula displacement. They just went right in, holding their breath, and immediately started to struggle and shake. I tapped them on the shoulder and said, “Hey, let’s bag the patient, reposition the head, and try again.”

Read the full article on EMS Airway.

Before you start listening this article, I want you to sit back, relax, and take a deep breath. How refreshing was that? That was a nice 21.3% (ish) atmospheric oxygen breath that your body just enjoyed. Please keep that thought in the back of your mind for a minute. We will revisit that. We will spend a moment on PEEP, not the delicious and iconic Easter marshmallow treats that have become a yearly staple for many, but Peak End Expiratory Pressure. For this bit of time we have together, we will focus on why PEEP should be your go-to for desaturating patients or patients needing their SpO2 to rise.

Read the full article on EMS Airway.

JEMS Spotlight: How Memphis Fire Department Cracked the Code on Recruitment and Retention

Memphis (TN) Fire Medic Stephen Zachar breaks down how his department tackled the nationwide recruitment crisis in firefighting and EMS.

Moving past outdated hiring tests, Memphis revamped the entire process by prioritizing interviews, valuing real-world experience, and replacing the traditional Candidate Physical Ability Test with a coachable physical fitness matrix.

Stephen reveals how placing paramedics strategically across all units, not just ambulances, slashed burnout and boosted job satisfaction. Their innovative approach cut paramedic attrition by 60% and achieved a remarkable 75% retention rate overall.

With over 800 hires from 40 states, Memphis offers a blueprint focused on respect, career growth, and financial literacy from day one.

The JEMS Report: Women’s Health Challenges in EMS and Fire Service Culture   Description: Stephanie White sits down with Stacee Ramirez and Dani Landholm to explore the overlooked health challenges women face in fire and EMS roles.   Drawing from Stacee’s extensive study revealing widespread reproductive health struggles, silent miscarriages, and the cultural stigma around pregnancy in male-dominated emergency services, the conversation uncovers a deep-seated culture of silence and blame.   Dani, a member of the International Association of Fire Fighters’ Female Health & Safety Standing Committee, shares personal experiences and discusses how outdated policies and lack of support impact women’s ability to advocate for themselves.   They highlight the urgent need for cultural change alongside policy reforms to create safer, more inclusive work environments.  

Not A-Fib Podcast : Gwenny Winkler on Critical Care, Coaching and Embracing Growth

Veteran flight nurse and educator Gwenny Winkler shares her journey from accelerated nursing programs to helicopter EMS and becoming a sought-after critical care instructor. Gwenny opens up about the steep learning curve when transitioning from emergency department nursing to flight nursing and the rapid evolution of tools like blood transfusions and advanced ventilators in air medical transport. She dives into her passion for education through social media, emphasizing the importance of understanding the “why” behind protocols, not just memorizing facts. Gwenny offers insights on coaching across all experience levels, tackling EMS culture challenges, and balancing professional identity with personal life. She also discusses her unique approach to engaging learners with authentic, down-to-earth content on TikTok and Instagram.

In this inaugural episode of the Chief’s Cadence, Chief Shane Wheeler sits down with FDNY Chief of Department John Esposito to explore effective leadership approaches in fire and EMS services.   Drawing on over three decades of experience in one of the nation’s largest departments, Chief Esposito shares how leadership demands more than just command. It requires adapting styles to fit individuals and situations.   From the decisive authority needed on an emergency scene to the empathy and authenticity crucial for team trust, they break down autocratic, transformational, servant and authentic leadership. They also discuss navigating generational differences, the value of honest feedback through personality assessments, and how new leaders can earn credibility without rushing change.  

Managing pain in pediatric patients is a critical aspect of prehospital care. Yet, this remains a challenging area for many EMS providers.

A new study out called “Barriers and Enablers in Prehospital Pediatric Analgesia” sheds light on the complexities of assessing and treating pain in children during ambulance rides. Led by Dr. Hoi See Tsao, Assistant Professor in the Department of Pediatrics at UT Southwestern Medical Center, the research identifies key hurdles EMS workers face and suggests actionable solutions to improve care.

Dr. Tsao, a specialist in pediatric emergency medicine with a passion for prehospital care, shared her insights and findings during a recent interview. “When pain in kids is not treated, it can lead to adverse effects such as increased anxiety, decreased pain tolerance, and fear of future healthcare encounters,” she pointed out. The stakes are high, and the study highlights both challenges and opportunities for EMS professionals.

Elevating EMS Education: Insights and Innovations from Industry Leaders

Dr. Ted Lee discusses education as part of EMS Week. The discussion features  Dr. Shira Schlesinger, Dr. Navin Ariyaprakai and Dr. Maia Dorsett

They highlight the importance of transitioning from traditional, time-based training to a more dynamic and critical-thinking-focused curriculum that fosters professional growth and clinical judgment among EMS providers.

The conversation touches on the value of accreditation, the role of preceptor training, and the increasing demand for lifelong learning within the field.

Celebrating Emergency Medical Services: Insights on EMS Recognition Day

JEMS Managing Editor Jeff Frankel talks with Dr. Thomas Lardaro to discuss the critical role of emergency medical services in our communities. Celebrating EMS Recognition Day, Dr. Lardaro reflects on the profound responsibilities and challenges faced by EMS professionals both in urban and rural settings. He highlights the importance of public understanding regarding the unique pressures faced by first responders and the need for meaningful recognition beyond traditional celebrations.

Advocating for EMS: Shaping the Future of Prehospital Care

Dr. Ted Lee talks with  Dr. Nick Cozzi, Dr. David Tan and Henry Lewis. They talk about the importance of grassroots advocacy, exploring how every EMS provider serves as an ambassador for the profession.

By sharing their stories and building relationships at local and federal levels, they emphasize the need for a unified voice to promote essential changes in legislation and funding. The panelists highlight the evolving landscape of EMS, driven by innovative care strategies and partnerships that enhance patient outcomes.

Dr. Ted Lee looks at the impact and importance of Save a Life Day for EMS Week. Featuring expert guests Dr. Matt Levy and Corey Richter, the discussion underscores the critical role of community engagement in prehospital emergency medicine.

Both leaders share their extensive backgrounds in EMS and emphasize the necessity of equipping citizens with essential skills to respond effectively in emergencies, such as performing CPR, managing bleeding and advocating for blood donation initiatives.

They highlight that by fostering a proactive culture of preparedness, communities can significantly improve health outcomes and save lives.

Dr. Ted Lee speaks with Luke Estes, manager of Prisma Health's Mobile Integrated Health Program, to explore the transformative role of community paramedics in prehospital medicine. Dennis shares his journey from a young aspiring EMT in Missouri to leading a groundbreaking health initiative in South Carolina. The program, which has grown significantly since its inception in 2019, addresses various social determinants of health, aiming to reduce hospital readmissions and enhance patient care access. With a footprint spanning 18 counties—primarily rural—this initiative adapts to meet diverse community needs, breaking down barriers to healthcare through education and resource connection.

In this episode of the JEMS Report, Dr. Ted Lee convenes a panel of pediatric emergency medicine experts to discuss the significance of EMS Week 2025 and the critical EMS for Children program. The panel, featuring Dr. Ann M. Dietrich, Dr. Kathleen Adelgais and Dr. Lindsay Jaeger, highlights the essential role of EMS professionals in providing pre-hospital care for pediatric patients, particularly in emergency situations. With less than 10% of EMS calls involving children, the discussion sheds light on the urgency of enhancing pediatric readiness within EMS agencies. The doctors emphasize the wealth of resources available through the Pediatric Readiness Project, designed to fortify preparation and education for emergency providers. This episode serves as a vital reminder of the commitment to better serve our youngest patients and the importance of collaboration in advancing pediatric emergency care.

Dr. Ted Lee talks with Dr. Douglas Kupas and Dr. Joanne Piccininni on the topic of EMS safety during EMS Week 2025. With decades of experience in EMS, both guests highlight the significance of prioritizing safety within the EMS community, stressing that awareness and proactive measures can prevent injuries and fatalities. They discuss the need for a cultural shift in EMS, focusing on safety practices such as seatbelt usage and risk awareness. The conversation also reflects on the tragic loss of colleagues in the line of duty, reinforcing the essential nature of mentoring and supporting new practitioners.

In this episode of the JEMS Report, Dr. Ted Lee sits down with Shaun Gladney, executive director of the Bryant Gladney Foundation, a nonprofit established in memory of his father, a dedicated paramedic and educator who tragically lost his life in the line of duty. The foundation's mission is to empower future EMS providers through scholarships for paramedic education and innovative educational offerings. Sean shares his father’s impressive legacy in the field, emphasizing the importance of ongoing learning and mentorship in pre-hospital medicine. The conversation also unveils the foundation’s initiatives, including the upcoming All Star EMS Conference and its growing scholarship program aimed at fostering exceptional talent in emergency medical services.

JEMS Managing Editor Jeff Frankel talks with Matt Philbrick, an experienced paramedic and wellness advocate. Matt shares his insights into the importance of mental fitness, resilience and the need for emergency responders to foster a supportive environment.

When faced with the challenge of reviving a patient in cardiac arrest, paramedics rely on an arsenal of tools, techniques, and medications. Among these are two stalwarts of advanced cardiac life support (ACLS): amiodarone and lidocaine.

Although both drugs have long been included in protocols as viable options for shockable cardiac arrests, a new study published in Resuscitation sheds fresh light on their effectiveness, offering compelling insights into why lidocaine might deserve a closer look.

The research, led by Tanner Smida, MD/PhD candidate at West Virginia University, employed a meticulous approach known as “target trial emulation.” This method is designed to minimize bias in

observational studies, aligning results more closely with what randomized controlled trials would reveal.

The study analyzed data spanning five years, from 2018 to 2023, drawing on over 23,000 cardiac arrest cases treated by EMS professionals in real-world settings.

Lt. Holly O'Byrne from D.C. Fire & EMS joins the Not A-Fib Podcast to discuss their whole blood program. She talks about the impetus for the program, overcoming hurdles to getting the blood, and the training they needed to do before putting blood on the trucks. She also talks about their successes and the downstream effects of administering blood in the field. The episode wraps up by talking about her experiences as the planning section chief on the IMT at Reagan Washington International Airport after the midair collision of a helicopter and commuter jet over the Potomac River.

When many EMS workers first enter the field, their focus is entirely on helping patients in crisis. However, as time goes on, the relentless demands of the job often push self-care to the backburner. Meals become whatever can be grabbed on the go, energy drinks replace proper hydration, and exercise falls by the wayside. This gradual decline in self-care takes its toll, as long, unpredictable shifts and high-stress environments leave little room for prioritizing personal health.

EMS Editor-in-Chief Dr. Ted Lee talks with Dr. Kristin McCabe-Kline, a board member with the American College of Emergency Physicians and Chief Christopher Way, president of the National Association of EMTs. They explore the vital intersection between emergency medicine and EMS as they kick off EMS Week, discussing its significance beyond mere appreciation gestures like pizza and cake. The conversation emphasizes the transformation of EMS into a critical healthcare provider within communities, particularly amid rising demands and budgetary constraints. They call for stronger advocacy to ensure EMS receives the recognition, funding and support it requires to thrive.

In the latest episode of the Not A-fib podcast, host Mark Flauter welcomes back attorney Kevin Fairley to explore the tumultuous landscape of Medicaid funding and its impact on Emergency Medical Services (EMS). With a looming budget shortfall and proposed cuts to provider taxes, states face potential financial crises that could significantly impact healthcare delivery. The discussion delves into the complex interplay between state-directed payments, federal oversight, and the growing scrutiny from agencies like the Office of Inspector General (OIG). Fairley highlights the need for EMS leaders to adopt a proactive approach to compliance, emphasizing the importance of understanding the nuances of cost-reimbursement structures and maintaining accountability. As Medicaid faces critical changes under the new political landscape, this episode offers valuable insights for healthcare stakeholders to prepare for the uncertainties ahead. Tune in to stay informed about the evolving Medicaid policies affecting EMS agencies nationwide.

In honor of Women’s History Month, EMS P.O.D. host Chief Doug Randell sits down with Dr. Owusu-Anshan, associate professor of Pediatrics & Emergency Medicine University at Pittsburgh School of Medicine. She is a trailblazer for women who has improved the lives of patients and creates opportunities for those who otherwise would not. This interview gives you a chance to learn of many of the exciting activities she’s involved with, including “The Pitt” now streaming on MAX.

JEMS Report host Dr. Ted Lee interviews Jeremy Mast, CEO of Tri-County Ambulance Service, to discuss the pivotal role of leadership during challenging situations in EMS. Drawing upon his 30 years of experience in fire and EMS, Mast shares invaluable insights on preparing for unforeseen events, fostering a supportive organizational culture and ensuring crew well-being. He emphasizes the importance of strong leadership visibility during crises to reassure teams and facilitate effective decision-making. Through their conversation, they explore strategies for building robust community connections and the impact of training and mentorship on individual growth within the EMS landscape.

Moving Toward Safer Pediatric Transport Care in EMS Insights from Dr. Nick Cochran-Caggiano’s Research on Pediatric Transport and Resuscitation By Bram Duffee, PhD, EMT-P

Transporting children in ambulances presents unique challenges that EMS providers face every day. Issues like the correct use of safety equipment, performance of life-saving procedures like CPR, and the absence of universal standards can make pediatric care in emergency settings more difficult than necessary. Dr. Nick Cochran-Caggiano, an emergency physician and researcher, has taken a deep look into these challenges through two pivotal studies that every EMS worker should know about. Both studies were discussed on the latest podcast episode of “EMS Research with Professor Bram.” The Unsafe Reality of Pediatric Transport in Ambulances One of Dr. Cochran-Caggiano’s studies, published in Pediatric Emergency Care (2023), examined how children are secured during ambulance transport. The study reviewed over 3,000 cases by observing video footage of ambulances arriving at a pediatric emergency department. The findings reveal a troubling reality:  Just 53.5% of children were transported using the correct safety device for their weight.  A staggering 77.1% of transport restraints were not used properly, putting children at significant risk.  Commercially made pediatric restraints were found to be the best option, yet these were still improperly used half the time.  For many patients, ambulance cots were the default method of transport, but this was only the correct choice in 18.2% of cases. Dr. Cochran-Caggiano shared his thoughts on this alarming data during a recent interview, emphasizing that the absence of consistent safety standards puts children at unnecessary risk. "Having some sort of ability to transport children safely is a must," he said. He also pointed out the pitfalls of the current patchwork approach to pediatric safety in EMS. "There’s no appropriate way to secure [a child’s car seat] to an ambulance stretcher. You can make a good faith effort, but that’s really all it is." Why This Matters Improper restraint practices don't just violate safety protocols—they create scenarios where otherwise preventable injuries become inevitable. Reflecting on the need for systemic change, Dr. Cochran-Caggiano pushed for a proactive approach, stating, "Let’s make a difference before

EMS Improv Podcast host Eric Chase welcomes Bonnie Rumilly, LCSW, EMT-B, EMDR therapist. In this conversation, Bonnie shares some personal experiences as well as offers insights and actionable takeaways. Bonnie shares her personal story of resilience, highlighting her journey from a challenging childhood to becoming a compassionate caregiver for her community. As they explore topics such as dysregulation, trauma bonding and the importance of addressing mental health, listeners gain valuable insights into recognizing the signs of trauma and seeking help. Bonnie emphasizes the critical role of early processing and trauma-informed care, offering hope and actionable steps for those navigating their healing journey.

EMS Improv Podcast host Eric Chase welcomes Jason Bazelow, a flight paramedic turned patient advocate. Jason shares his experience of surviving an aortic dissection, during which he faced a reality of clinical death for an astounding 34 minutes. Through vulnerability and transparency, he narrates the profound emotional, psychological and physical toll of his journey, not only on himself but also on his family. As Jason reflects on his transition from being a healthcare provider to becoming a patient, he emphasizes the importance of patient advocacy, mental health awareness and genuine communication within the healthcare system. Hear how Jason's story not only resonates with survivors and healthcare professionals but also serves as a beacon of hope and understanding for those navigating their own health challenges.

In this episode of the JEMS Report, Dr. Ted Lee and Jonathan Epstein from the American Red Cross discuss critical developments in prehospital resuscitation education, especially surrounding Heart Month. Epstein highlights the Red Cross's longstanding commitment to lifesaving training, evolving from traditional community-focused programs to a comprehensive suite that includes Basic Life Support, Advanced Life Support and the newly launched Neonatal Advanced Life Support. The conversation emphasizes the importance of tailored educational offerings for both public and healthcare professionals, aiming to bridge the gap in emergency medical response across diverse communities. The Red Cross’s innovative Mission CPR project looks to improve bystander CPR rates in underserved areas, underscoring that every second counts during cardiac emergencies. For EMS providers and healthcare professionals, this initiative represents a significant step forward in achieving better patient outcomes and preparedness in life-threatening situations.

In episode 18 of the Not AFib podcast, host Mark Flauter talks with paramedic Rachel Belcher to explore the often-overlooked topic of "duty-bound grief," a unique form of grief experienced by first responders. Looking into their shared experiences, Rachel discusses how cumulative exposure to traumatic events leads to emotional overwhelm, revealing the intricacies of compartmentalization and its long-term impacts on mental health. Through her advocacy for comprehensive mental wellness education, she emphasizes the importance of self-assessment, regular mental hygiene practices, and the value of peer support networks. Rachel’s personal journey to recovery from trauma and her call for systemic change underscore the urgent need for robust resources tailored to the needs of first responders. This episode serves as a vital reminder that acknowledging grief and seeking help is an act of courage, fostering resilience within those who dedicate their lives to serving others.

JEMS Editor-in-Chief Dr. Ted Lee speaks with Dr. Kate Tataris, EMS director for Chicago EMS System and Chicago Paramedic-in-Charge Chris Powers about cardiac arrest and heart programs.

JEMS Editor-in-Chief Dr. Ted Lee speaks with Dr. Christine McGuire-Wolfe, the director of Infection Control for Emergency Responders (ICER) Collaborative and Training Hub.

Read more about the program and how you can help by clicking here.

Eric Chase has a conversation with Shane Stephens, the EMS specialist for leadership development with the Commonwealth of Pennsylvania. Stephens talks about how his position and personal experiences help grow collaboration.  

Chief Douglas Randell speaks with Dr. Remle Crowe and Dr. Jamie Kennel about following the data in EMS research.

In this special episode of the EMS Handoff Podcast, hosts Bradley Dean and David Blevins are honored to welcome the legendary Dr. Paul Pepe, a trailblazing EMS medical director whose groundbreaking work has shaped the foundation of modern-day EMS.

Dr. Pepe’s influence spans decades, and his passion for advancing prehospital medicine continues to inspire generations of EMS professionals. Join us as we take a deep dive into the fascinating history of EMS medical direction, exploring how this critical component of prehospital care evolved into what it is today.

In This Episode

• A look back at the early days of EMS and how medical direction began.
• Dr. Pepe’s personal journey and contributions to prehospital medicine.
• How medical directors bridge the gap between field providers and the healthcare system.
• Insights into the challenges and successes of shaping EMS protocols and education.
• Lessons learned and advice for current and aspiring EMS leaders and medical directors.

Whether you're a seasoned EMS professional, a new provider, or simply passionate about the history and future of prehospital care, this episode is packed with valuable insights and inspiration.

About Dr. Paul Pepe Dr. Paul Pepe is renowned for his pioneering work in EMS systems development, resuscitation science, and disaster response. With a career dedicated to improving patient outcomes through innovation and collaboration, Dr. Pepe remains a cornerstone of EMS advancement worldwide.

Hennepin EMS in Minnesota is breaking new ground in prehospital care with the introduction of a clinical pharmacist consulting role, designed to tackle complex challenges and foster collaboration between paramedics and pharmacists through hands-on support and cutting-edge research.

The clinical pharmacist acts as a bridge between hospital and field operations, ensuring prehospital teams have the support they need to improve patient outcomes. A critical part of the pharmacist’s responsibilities includes hands-on engagement. From participating in ambulance ride-alongs to hosting open-door consultations, this role prioritizes practical and actionable solutions.

At the heart of this initiative is Holly Drone, PharmD, Hennepin EMS’s clinical pharmacist. Not only has Holly been integral to placing this program into action, but she’s also contributing to the field through her research. Her studies focus on essential topics such as Sodium Nitrate Overdose management, the initiation of Buprenorphine in prehospital settings, and the use of Oral Risperidone by EMS providers in the field.

To learn more about this innovative role and hear directly about her experiences and research, check out her recent interview on the podcast “EMS Research with Professor Bram.” Holly provides unique insights into the evolving relationship between paramedics and pharmacists as well as the critical role clinical pharmacy plays in improving prehospital care.

JEMS Editor-in-Chief Dr. Ted Lee speaks with Dr. Michael J. Carr about how telemedicine is saving lives in Georgia.

Carr, the executive director of Prehospital & Ambulatory Virtual Emergency Services (PAVES) at Emory University, says patients in rural counties now have access to doctors and specialists even before they reach the hospital.

Join hosts Bradley Dean and David Blevins as they sit down with Dr. David Tan to explore the evolving role of medical direction in EMS. Together, they dive deep into the challenges and opportunities shaping EMS systems and the clinicians who drive them forward.

Dan Burke, EMS safety director for the Center for Patient Safety (CPS), joins the podcast to discuss CPS. We discuss the mission of the CPS and how it's grown in the last 25 years.

We also discuss the benefits of joining the CPS and how EMS agencies become better focused on patient safety.

Finally, we discuss his time as state EMS director for the District of Columbia and the challenges, and benefits, of guiding EMS in our nation's capital. 

In this episode of The EMS Handoff Podcast, host Bradley Dean welcomes Janet Taylor, a seasoned flight nurse, educator and national EMS speaker, to discuss the seismic shifts in EMS education brought about by the COVID-19 pandemic.

Together, they explore what it means to be a “COVID provider,” the challenges of addressing knowledge gaps in the post-pandemic era, and the importance of going the extra mile to ensure the success of EMS professionals in a rapidly evolving healthcare landscape.

With her extensive background in nursing, flight medicine, and education, Janet shares her insights into how educators and providers can adapt and thrive, even in the face of unprecedented challenges. From innovative teaching strategies to practical advice for today’s EMS providers, this episode is a must-listen for anyone involved in EMS education or practice.

Key Topics Covered in This Episode

• The COVID-19 Impact on EMS Education: How the pandemic changed the way we teach and learn in EMS.
• Understanding the “COVID Provider” Phenomenon: What defines a provider trained during the pandemic era, and what unique challenges do they face?
• Addressing Knowledge Gaps: Practical strategies for bridging gaps caused by disrupted training and clinical experience during the pandemic.
• Going the Extra Mile: Why resilience, creativity, and commitment are more critical than ever for EMS providers and educators.
• The Role of Technology in EMS Education: Exploring innovative tools and methods that emerged during the pandemic and their lasting impact on training programs.

Infection Control Consultant Katherine West explains why Marburg Virus is not as worrisome as some recent media headlines suggest.

Watch the presentation on JEMS.

Author, speaker and educator Mongo Allen shares lessons from life with Eric Chase.

Chief Douglas Randell reviews the 2024 legal issues in EMS with Attorney Douglas Wolfberg.

When every second counts in a medical emergency like a stroke, deciding on the right course of treatment can be life-changing. Strokes come in two main types—ischemic and hemorrhagic—each requiring very different treatment approaches. But what if a critical intervention, like lowering blood pressure, could be started right there in the ambulance?

Could it improve outcomes for stroke patients before they even reach the hospital? These are some of the pressing questions tackled in the latest episode of EMS Research with Professor Bram. This discussion explores the complexities of early care for stroke patients and the role prehospital blood pressure management might play in recovery.

Paramedic Mic Gunderson and Neurologist David Rose offer a specialist’s perspective on stroke care. Together, they dissect groundbreaking research and share practical strategies that could transform how strokes are treated in the field.

Battalion Chief (Ret.) Tom Yahnke joins the podcast to discuss peer support teams. We discuss the importance of peer support teams, the difference between peer support and EAP, and what makes a good peer support team member. We also discuss the life-altering incident he experienced on a fire and how peer support, if available at that time, may have helped him avoid some of the problems he encountered trying to deal with that incident.

Eric Chase and Brett Lyle have a conversation to help us prepare our minds for the New Year. Let's share positive, contagious growth and development with accountability.

JEMS Editor-in-Chief Dr. Ted Lee speaks with T. Ryan Mayfield and Andrew Pearson of Hennepin EMS on how the agency is addressing its staffing shortage and empowering its education program.

Listen to Part 1 here.

You are dispatched to a pedestrian struck approximately seven blocks away at an off the beaten path intersection. You hop in the rig look over to your partner and voice your satisfaction with tonight‘s dinner choice. They nod in agreement and also highlight the fact you both were able to finish uninterrupted.

It’s an uneventful response and you arrive on scene to find what appears to be a male lying in the roadway. There is a minivan next to the patient with the headlights shining over where they’re lying. You see the patient moving their arms and legs ever so slightly and a group of people around them trying to talk to him.

Read the full article on EMS Airway.

EMS P.O.D. host Doug Randell discusses the EMS Commission in Indiana, the gubernatorial-appointed group that advises EMS on issues that affect EMS in the State of Indiana. 

In late September of this year, Hurricane Helene struck the mountains of Western North Carolina, bringing devastating flooding, mudslides and damage to the area. Host John Sammons is joined by Paramedic Garry Pomerleau to talk about his experience during and after the storm as not only a responder, but a resident of the area. You can read his article in JEMS as well.

After six doses of epinephrine, it may be too late for the CPR patient. Emergency physicians Dr. Zachary Boivin and Dr. Trent She, both from Connecticut, discussed their recent study entitled "Epinephrine in Cardiac Arrest: Identifying a Potential Limit for Resuscitation."1 This research sought to determine if there is a ceiling to the effective use of Epinephrine during resuscitation.

Peter Antevy, MD, who created the Handtevy System, a software-based pediatric resuscitation method and bag system is also an EMS Physician for Palm Beach County (FL) Fire Rescue and he made a post on LinkedIn advocating for abolishing Epinephrine in shockable rhythm protocols. He posts about how his protocol does not follow standard AHA guidelines at Palm Beach County Fire Rescue and their plan for ventricular fibrillation is to use esmolol, but no Epinephrine.

References

1. Boivin, Z., Duignan, K. M., Doko, D., Pugliese, N., & She, T. (2023). Epinephrine in Cardiac Arrest: Identifying a Potential Limit for Resuscitation. Western Journal of Emergency Medicine, 24(6), 1025.

It appears that Viral Hemorrhagic Fevers – Lassa Fever, Ebola and Marburg virus are getting all the press. However, Pertussis (whooping cough) is an area that needs focus.

The cases for 2024 are at least four-times higher than in 2023, and many departments have not offered the required Tdap booster to protect healthcare personnel.

An additional dose of Tdap was first recommended in 2005 and then again in 2011. Pertussis is not on the radar, and we need to ensure that healthcare providers are protected. This session addresses vaccine, personal protective equipment and post-exposure medical follow up.

JEMS Editor-in-Chief Dr. Ted Lee speaks with Global Medical Response’s Natalie Jobst about training veterans for EMS careers.

Every month, North American Rescue (NAR) hosts a unique event called "Coffee with Veterans and First Responders." This initiative, now in its fifth year, offers a valuable space for local heroes to connect, network and discover new career opportunities.

Led by Anna Harris, a veteran and the director of Human Chemistry and Talent at NAR, Coffee with Veterans aims to bridge the gap between veterans and first responders and the civilian job market. With many NAR team members hailing from military and first responder backgrounds, this program is a personal passion for the company.