EMS One-Stop

In this special edition of EMS One-Stop, host Rob Lawrence discusses the Joint Position Statement on EMS Performance Measures – Beyond Response Times published yesterday by the leading EMS and public policy associations with Matt Zavadsky, MS-HSA, EMT, vice president of PWW|AG, and one of the primary authors of the position statement. Rob and Matt discuss the statement in detail, examining all of the recommended metrics, the reasons for placing them in the paper and why response times are not recommended as a primary measure of system performance. Rob and Matt begin by discussing the signatories of the statement – in particular, the sign off from the International City/County Managers Association (ICMA) and the pivotal role they play in ensuring EMS delivery in their communities. The many associations that joined the statement recommend that communities and governments modernize EMS performance assessments by evaluating various domains with key performance indicators (KPIs). These KPIs should be measured, tracked over time, benchmarked against similar EMS systems or national data and regularly published for local community stakeholders.

In this episode of EMS One-Stop, host Rob Lawrence welcomes back infectious disease expert Dr. Alexander P. Isakov, MD, MPH, founding executive director of the Office of Critical Event Preparedness and Response (CEPAR), and professor of emergency medicine at Emory University. Rob begins by discussing his real-life experience with an H5N1 outbreak in the UK as an ambulance service leader, and Dr. Isakov discusses the current H5N1 emergence in the U.S. The discussion covers the current U.S. H5N1 outbreak, bird and swine flus, and the spillover from bird to mammal populations. They also address three recent U.S. cases of H5N1 among agricultural workers. They go on to discuss signs and symptoms of H5N1, index of suspicion, the Hierarchy of Controls in infectious diseases, universal and standard precautions, and fit testing respirators. They also cover resources available at NETEC. Dr. Isakov concludes with a roundup of other global issues, including viral hemorrhagic fever (VHF), Ebola, Marburg and smallpox.

In this edition of the EMS One-Stop podcast, host Rob lawrence welcomes Todd Stout and Mike Taigman of FirstWatch as they introduce the 2024 Jack Stout Fellow, Mary Meeks, district chief of night shift at Chatham Emergency Services. The Jack Stout EMS Fellowship, endowed by FirstWatch, aims to empower emerging EMS leaders by equipping them with the knowledge and skills necessary to guide EMS systems effectively in the future. Developed by FirstWatch in cooperation with the Fitch EMS Foundation, the Fellowship underscores the commitment to leadership development and community service. Named in honor of Jack Stout, a pioneer in high-performance EMS systems, the Fellowship teaches principles such as people-centered leadership, data-driven decision-making, improvement science and systems thinking. As the chosen Fellow, Meeks will attend the 2024 Pinnacle EMS Leadership Forum, participate in either the Fitch Ambulance Service Manager or Communication Center Manager program, and benefit from a customized mentorship led by Mike Taigman, renowned for his contributions to EMS quality improvement. This comprehensive program not only honors Jack Stout’s legacy but also ensures that his visionary principles continue to shape the future of EMS. Additional resources IHI Framework for Improving Joy in Work | Institute for Healthcare Improvement The Jack Stout EMS Fellowship, endowed by FirstWatch Pinnacle EMS leadership conference

In this episode of the EMS One-Stop podcast, host Rob Lawrence sits down with Fayetteville, North Carolina’s Cumberland County EMS Chief David Grovdahl and Behavioral Health Community Paramedic Tara Tucker to discuss the Cape Fear Valley Mobile Integrated Health Behavioral Health Community Paramedicine programs. The Cape Fear MIH Team is composed of four community paramedics, one social worker and a peer support specialist. The team focusses in particular on overdoses/request for substance use treatment, suicide related calls – ideation/attempts as well as youth calls related to mental health and substance use, and also EMS referrals and associated case management. Fayetteville is home to Fort Liberty and Pope Army Air Base, and is the sixth most populous city in North Carolina with a high number of uninsured and underinsured patients. Fifteen percent of Cumberland County’s population is military-affiliated and it is the third busiest EMS system in North Carolina. Cumberland’s affiliated ED, CFVMC Emergency Department, had 90,595 visits in 2021 for adults, and 30% of those (27,300) were for behavioral-health related issues, creating the need for a Behavioral Health service line employing community paramedics. In addition to discussing their mobile integrated healthcare system, Grovdahl also shares about the North Carlina whole blood programs and their progress.

In this special, on-site episode of EMS One-Stop, host Rob Lawrence takes us to the 2024 North Carolina EMS Expo in Greensboro, North Carolina, a well-attended conference with over 1,200 attendees. Rob spent time with several conference faculty. EMS lawyer Matt Streger joins Rob to discuss just culture, HR issue spotting, leadership communication and employee engagement. Kevin Collopy joins Rob to discuss the outstanding prehospital training being delivered to medics in Ukraine and also discusses this years “Stand and Deliver” new speaker event (a now annual event held as EMS World Expo). Rob discusses whole blood and its national rollout with Dr. Randall Schaeffer and David Grovdahl. To close, Peter Dworsky of the National EMS Safety Conference provides an overview of the current top EMS industry safety themes. Enjoying the show? Email [email protected] to send in guest suggestions, episode feedback or questions for our host.

Editor’s note: This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. In this episode of the EMS One-Stop podcast, host Rob Lawrence welcomes back Matt Zavadsky to discuss the latest development in the move to fund treatment in place and the recent disclosure from CMS about the potential savings to Medicare identified in the analysis of the limited ET3 program. Matt discusses the potential legislative moves regarding EMS funding, highlighting bipartisan support and urging listeners to engage with elected officials to support bills benefiting EMS. The conversation underscores the need for sustained advocacy efforts and highlights the level of interest shown by key policymakers. Rob and Matt also discuss the recent developments in the City of Fort Worth and the decision to absorb MedStar into the Fort Worth Fire Department, emphasizing the need to ensure equitable treatment for EMS personnel transitioning to new roles. Top quotes from this episode “We can officially say that the net savings to Medicare after they pay EMS and after they pay the tertiary provider telemedicine, whatever it is, is still $550 to $570 per enrolled ET3 participant. And when you do the math, that's a billion dollars or more of savings to the Medicare program, which now CBO can use to evaluate the benefit, economically of doing a treat, no transport, treatment-in-place model. So it's big news.” — Matt Zavadsky “Nobody benefits from a knock-down, drag-out fight. But as you indicated, there are now people in the community and people across the country that are saying why and what does this mean? We don't have all those answers, but again, it's the decision from the folks who are elected to represent the community and if that's what they want to do, that's great. Our role is to try and do as much as we can to maintain a transition into a new provider system that keeps those core tenants – the high performance, high value mobile, integrated healthcare, flexible deployment. All those things that have really made the system a world class EMS system, even though it might say something different on the side of the ambulance and the employees might be wearing a different uniform.” — Matt Zavadsky “It's going to be a long transition – 12 to 18 months, and it's not just branding and rebranding, it's really infusing the culture of a group of people who are used to doing 7-10 calls in 12 hours and used to having things operate with a certain cadence that's going to be totally different when they start a different type of organization.” — Matt Zavadsky Episode contents 00:00 – Introduction 02:15 – ET3/TIP: Challenging CMS outcome data 03:15 – Cost savings per intervention 04:00 – CMS data showing net savings to Medicare 04:30 – Congressional Budget Office score based on savings 06:00 – Net savings of a billion dollars or more 07:00 – Applying this new information for the good and benefit of the industry 09:00 – Congress is, is what Congress does 10:40 – Meeting with Congress to push TIP 14:30 – Fort Worth and the PWW Advisory Group 14:50 – Fort Worth economies and level of service 17:30 – Matt Zavadsky to join the PWW Advisory Group 19:15 – The staffing issues as Med star staff transit to the FD fire department 21:00 – Ensuring the staff is protected 25:00 – Call to action-how we communicate all value to elected officials 26:00 – Final Thoughts About our guest Matt Zavadsky is the former chief transformation Officer at MedStar Mobile Healthcare, formerly the exclusive emergency and non-emergency public utility model EMS system for Fort Worth and 14 other cities in North Texas. Coming to MedStar in 2008 as the operations director, Matt made significant changes to the EMS delivery model, and in 2010, successfully eliminated the need for the tax subsidy that MedStar had been operating on since its inception in 1986. He has helped guide the development and implementation of numerous innovative programs with healthcare partners that have transformed MedStar fully as a Mobile Integrated Healthcare (MIH) provider, including high utilizer, CHF readmission reduction, observational admission reduction, hospice revocation avoidance, 911 nurse triage programs and partnerships with home health agencies. He is also the co-author of the book “Mobile Integrated Healthcare – Approach to Implementation,” published by Jones and Bartlett Publishing. He has 42 years’ experience in EMS and holds a master’s degree in Health Service Administration with a graduate certificate in Healthcare Data Management. Matt is a frequent speaker at national conferences and has consulted on numerous EMS issues, specializing in high-performance EMS operations, finance, mobile integrated healthcare, public/media relations, public policy, transformative economic strategies and EMS research.

In this episode of the EMS One-Stop podcast, Dr. Edward Racht and Matt Zavadsky join Rob Lawrence to discuss their recent attendance at the U.S. House Committee on Ways & Means hearing on “Access to Health Care in America: Ensuring Resilient Emergency Medical Care,” which took place in an off-site hearing in Denton, Texas, on March 18, 2024. Dr. Racht, chief medical officer of Global Medical Response; and Zavadsky, chief transformation officer for the Metropolitan Area EMS Authority (MedStar Mobile Healthcare) discuss the evidence and the key issues they conveyed to the committee. Dr. Racht's testimony included: The significant advancements made in emergency medicine over the past decades, leading to reduced mortality and disability rates for patients. The importance of updating Medicare reimbursement rates for ambulance services, which have not been revised for over 20 years. Advocating for wholesale reform of Medicare's coverage of emergency medical services to align with contemporary practices, such as covering treatment in place and transportation to alternative healthcare sites. Matt Zavadsky's testimony included: The impact of CMS payment policies on EMS, which incentivize unnecessary transportation of patients to the emergency room. Innovative programs initiated by EMS agencies to prevent unnecessary 911 calls and navigate patients to appropriate care settings. Legislative changes required to provide EMS with flexibility in patient navigation, including treatment in place and transport to alternate destinations. The challenges faced by ambulance services nationwide, especially in rural areas, exacerbated by the COVID-19 pandemic. Top quotes from this episode “We are the front of the frontline in medicine.” — Dr. Ed Racht "Our coordinated and integrated EMS and healthcare system now gives gravely injured patients ... the opportunity for rapid surgical intervention and a chance at full recovery." — Dr. Ed Racht "Emergency healthcare professionals pride ourselves on our ability to dramatically decrease morbidity and mortality from unexpected and sudden illness and injury." — Dr. Ed Racht "CMS payment policy is such that we are incentivized to transport every 911 patient to the ER because that is the only time we get paid." — Matt Zavadsky "Ambulance services are a vital component of our local and national healthcare and emergency response systems." — Matt Zavadsky "Innovative EMS agencies ... have initiated patient-centric programs designed to prevent 911 calls and navigate patients to the most appropriate care setting." — Matt Zavadsky "Ambulance services across the nation, especially in rural areas, are facing unprecedented challenges." — Matt Zavadsky Episode contents 0:05 – Introduction 0:55 – Guest introduction 1:40 – Explaining the Ways and Means Committee 2:30 – We are being noticed! 3:40 – Preparing for a congressional hearing 5:40 – The impact of having a congressional hearing in an EMS location 5:58 – The genuine interest of the committee members 9:00 – Dr. Ed Racht testimony to the Congressional Ways and Means Committee 14:24 – Matt Zavadsky testimony to the Congressional Ways and Means Committee 20:52 – Dr. Racht and Zavadsky’s reactions to the evidence they gave and the feedback 29:00 – Zavadsky’s key points he wished to reinforce during his evidence session 31:45 – Balanced billing, patient protections and removing the patient from the middle of the process 32:50 – Independent Dispute Resolution (IDR) and its challenges. 38:29 – Questions for Secretary Becerra on Capitol Hill 44:00 – Final thoughts 45:00 – A call to action to become one and present a united front “When we unify, we are unstoppable.” 48:00 – You the listener are the great politician

Editor’s note: This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. “Honorable but Broken: EMS in Crisis” is a documentary film exploring the world of EMTs and paramedics, the collapse of the EMS system, and what needs to be done to save it. Narrated by six-time Golden Globe and two-time Primetime Emmy award winning actress, Sarah Jessica Parker, “Honorable but Broken” raises awareness of the systemic collapse of EMS and advocates for change. In this episode of the EMS One-Stop podcast, host Rob Lawrence chats with producer Bryony Gilbey about the documentary that is now completed and available for streaming. Gilbey hopes the impactful, hard-hitting documentary will serve as a briefing and education tool for our elected officials and members of the general public. As Gilbey notes, “It’s no good any longer just throwing up your hands and saying that’s just the way EMS is; it’s no good saying it’s someone else’s problem; it’s something we all need to work on, as a civilized society we need to address this issue and we need to do it quickly.” The 60-minute documentary is now available on demand, streamed by Prodigy EMS and it is hoped that it will be used at local, state and national levels to bring attention to the issues we are facing. Top quotes from this episode “I expected to tell a story; I did not think that it would have quite this reaction” — Bryony Gilbey “We now all have not many degrees of separation to somebody who has had some sort of PTSD, who has had to leave the job because of the pressures of work and dare I say ultimately taken their lives and that is incredibly sad.” — Rob Lawrence “It all comes down to three words – all in favor – if we don’t get the vote, we don’t get the money, we don’t get the change.” — Rob Lawrence Episode contents 00:48 – Documentary teaser 01:18 – Introduction/Bryony Gilbey 02:16 – The “Honorable but Broken” back story 05:46 – How did Gilbey view EMS and its issues 08:15 – The finished product and how can we view it 10:24 – A federal screening on Capitol Hill 11:30 – Reaction from elected officials 13:16 – John Mondello/emotional trauma 14:00 – Eileen Mondello – John’s mother 15:25 – Reaction to Eileen Mondello – “It never gets easier’ 17:00 – He wasn’t the first, he isn’t the only and sadly he won’t be the last 22:00 – Other featured speakers in the documentary and their powerful messages 22:30 – Recruitment, retention and retirement 24:35 – What is the cost of a human life to a politician? 26:25 – Educating the legislators and the public 28:00 – The cost of readiness 29:05 – Reimbursement doesn’t add up 31:00 – The hospital side of things – Beckers Review on Hospital closures and adding to ambulance and hospital deserts 31:30 – Call to action and the legislative agenda 35:30 – Sarah Jessica Parker 39:00 – How and where to view via Prodigy EMS 39:50 – Final thoughts About our guest With a prolific career spanning several decades, Bryony Gilbey is a seasoned director, producer and freelance writer/editor, distinguished for crafting compelling narratives across various media platforms. As the director/producer for the impactful EMS documentary, “Honorable but Broken: EMS in Crisis,” Gilbey has showcased an unparalleled ability to guide projects from inception to completion. Gilbey previously worked with the Nexstar Media Group, Inc. as a freelance writer/editor. Here, she demonstrated versatility by producing feature pieces on health and lifestyle topics for Tribune Publishing and contributing to BestReviews.com. Gilbey also served as an associate producer at Mary Murphy & Co. from 2005 to 2012. During this period, she played a pivotal role in the production of the PBS American Masters documentary "Hey Boo," centered around Harper Lee. In the early 2000s, Bryony worked as a Producer/AP at ABC News Productions, where she produced documentaries on medical breakthroughs in neonatal care for Discovery Health. The foundation of Bryony’s career was laid during her time as an associate producer at “60 Minutes,” CBS News, from 1995 to 2000. Working closely with producers and correspondents, she contributed to the creation of original news stories. Throughout her extensive and diverse career, Bryony Gilbey has consistently demonstrated a passion for storytelling, a keen journalistic instinct, and an unwavering commitment to delivering content that informs and resonates with audiences worldwide. Resources “Honorable but Broken: EMS in Crisis” NAEMT's Advocacy program AAA’s Advocacy program 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 [email protected] to share ideas, suggestions and feedback. Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

Collecting and communicating the big EMS news of 2023 The American Ambulance Association and the Academy of Mobile Healthcare Integration (AIMHI) collect, collate, categorize and share weekly EMS-based news stories widely with many national organizations and associations, including NHTSA, USFA and NAEMT. The information contained in the news tracker allows officials and EMS leaders to brief and educate journalists and elected officials, as well as the public as to the current plight of EMS. EMS is delivered on a local level and those experiencing issues with their service can believe it is just them suffering funding shortages, staffing challenges, hospital delays or general poor performance. The tracker can be used to demonstrate that the issues are occurring on a wider regional, state, national and, in some cases, international level. In this episode of the EMS One-Stop podcast, host Rob Lawrence, who also heads up the AAA-AIMHI news collation effort, welcomes fellow news collator, Rodney Dyche of Patient Care EMS; and AIMHI Education Committee Chair, Matt Zavadsky, chief transformation officer at MedStar Mobile Healthcare. Rob, Rodney and Matt examine EMS news and current trends, and discuss how these themes can be used to inform, influence and educate. Top quotes from this episode “There's a perverse ‘incentive’ about response time … if you have the target of 8:59, you arrive on time and the patient dies; that's a success. If you arrive in 9:01 and the patient lives; that's a failure. That's absolute garbage” — Rob Lawrence “There was a quote from Dr. Clawson in a news story that was done in Minneapolis, and I love his quote. He says, ‘there is no evidence that using red lights and sirens have saved more lives than they've taken.’” — Matt Zavadsky “Every week in this great country, an ambulance is stolen either from hospital or from scene – that's avoidable.” — Rob Lawrence “Stop being timid. Stop licking your wounds. Get out in your community, talk to your elected officials. Talk to your city managers or county administrators – very factually, not emotionally. There will be time for emotions, but give them the facts and let them know what it's gonna take to resuscitate their EMS delivery system.” — Matt Zavadsky Episode contents 00:23 – Guest introduction 02:06 – AAA/AIMHI News Tracker and story categories 04:22 – A resource to brief the press and elected officials 04:30 – Operational challenges across many states 05:50 – Massive sign-on bonuses – robbing Peter to pay Paul 06:30 – Staffing and funding issues 08:40 – Communities/local governing bodies facing the fact that they are running out of money, and their EMS isn’t free 09:40 – Transitioning from a volunteer to a paid system 11:00 – Explaining EMS economics to your elected officials 11:50 – Has anyone died? Bring data 13:30 – EMS systems closing 15:30 – “Elected officials get nervous deciding to allocate funding to a service that they haven't had to fund or haven't, haven't had to fund to this certain level in the past.” 18:40 – Response time 19:25 – Increase in low acuity calls 20:30 – Service design 22:50 – Single- versus double-paramedic crewed trucks 25:04 – MEDIC Charlotte – Taking bold steps within categories of response 27:00 – The rate of ambulance crashes across the county at intersections 27:47 – If you are not the ambulance driver … who is? 29:49 – There is no evidence that using red lights and siren have saved more lives than they've taken! 30:30 – Stolen ambulances 32:59 – Supply chain and vehicle availability 34:00 – Rurality and ambulance deserts 35:00 – Violence against providers 37:00 – Responding to patients in crisis/agitated patients 38:00 – How to use the media log in your locality to good effect 40:00 – Final thoughts About our guests Matt Zavadsky is the chief transformation officer at MedStar Mobile Healthcare, the exclusive emergency and non-emergency public utility model EMS system for Fort Worth and 14 other cities in North Texas that provides service to 436 square miles and more than 1 million residents and responds to over 170,000 calls a year with a fleet of 65 ambulances. MedStar is a high performance, high value EMS system, providing advanced clinical care with high economic efficiency. Zavadsky is also immediate past president of the National Association of EMTs, and chairs their EMS Economics Committee. He is an appointed committee member to the Joint Commission’s Home Care Professional and Technical Advisory Committee (PTAC), and the Lewin Group’s Hospital Outpatient Quality Reporting (HOQR) Program Stroke and AMI Expert Work Group developing metrics for use in value-based purchasing measures for emergency departments. He is also the co-author of the book “Mobile Integrated Healthcare – Approach to Implementation.” Rodney Dyche is director of compliance and responsible for risk management with PatentCare EMS Solutions. PatientCare EMS Solutions is a multistate EMS solution, and additionally provides a hybrid onl

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. The American Ambulance Association recently held its annual AAA Stars of Life event in Washington, D.C. The American Ambulance Association’s Stars of Life program celebrates the contributions of ambulance professionals who have gone above and beyond the call of duty in service to their communities or the EMS profession. While in Washington, EMS One-Stop Host Rob Lawrence interviewed AAA President Randy Strozyk, on the aims and objectives of the stars program and the 2023 Legislator of the Year. Rob also spoke with AAA Medical Director Dr. Gerad Troutman, who is AAA’s first medical director. Finally, Rob chats with AAA Immediate Past President, Shawn Baird, on the Federal Balanced Billing legislation and the role that AAA and others are playing in protecting both the patient and EMS agencies. Top quotes from this episode “Every provider is out to make a difference, but to actually be recognized for it, which you don’t often get the opportunity to have, makes it that much more of an honor to be selected for something like this” — Paramedic Erica Brockman “AAA stars and hundreds of thousands of people like you are the beginning of the healing process. When somebody is hurt, somebody is wounded, somebody is scared, it is the EMT that first touches that patient and then begins to transport into the healthcare system when the rest of the healthcare system can then kick in to what it does, but it would not start unless it begins with you.” — Senator Bill Cassidy “Think about when Covid hit, at 0200 in the morning, we were the ones that came, we were the ones that had to deal with a whole new level of challenges, not only Covid, but we had to deal with the fact that people didn’t want to go to the hospital, so we were providing levels of care, interfacing, making sure that people had connections. I see that as a bright future to how EMS will progress in the next decade” — AAA President Rany Strozyk “I’m really passionate about patients called 911 looking for solutions to a problem and that solution is not always an ambulance to take them to an emergency department, so we try to impact their care differently, especially lower acuity patients, because we now have all the technology and tools to treat them in place with our paramedics or EMTs on site of even treating them utilizing a navigation program from the 911 system, the PSAP and maybe get them to an urgent care or virtual care doctor, where they can be cared for right in their home. Patients love it and the best thing is it really puts the ‘E’ back in EMS and allows us to save those emergent resources that need those most.” — Dr. Gerad Troutman, AAA medical director “We will be coming back to Congress with a recommendation that ground ambulance not be rolled into the No Surprises Act. That (if we were included) would be devastating to access for care.” — Shawn Baird, immediate past president, AAA Episode contents 00:21 – Opening: Erica Brockman 01:02 – Introduction: Rob Lawrence 01:36 – Randy Strozyk, president, American Ambulance Association 05:12 – Key areas of legislation for 2023/24 08:07 – Presentation of Legislator of the Year: Senator Bill Cassidy 11:00 – Dr. Gerad Troutman, AAA medical director 17:00 – Federal Balanced Billing Committee: Shawn Baird 18:35 – Summary and close Additional resources The full bios for all of the AAA Class of 2023 Stars of Life can be found here. Listen to next: Alexia Jobson, Dr. Peter Antevy, Brian Maloney, Doug Wolfberg and more join the EMS One-Stop podcast to discuss takeaways from the show About our guests Randy Strozyk brings to his leadership of the American Ambulance Association more than 34 years of experience in EMS operations and management. He has been part of the American Medical Response leadership team for 16 years, and currently serves as the company’s executive vice president of operations. Strozyk earned his EMT/paramedic certification and worked on an ambulance while studying microbiology at Washington State University. He later earned an MBA from California State University. He has been heavily involved in the American Ambulance Association for nearly two decades and is the current president of the organization. Gerad Troutman, MD, MBA, FACEP, FAEMS, is the national medical director for innovative practices at Global Medical Response. He is an assistant professor of Emergency Medicine at Texas Tech University Health Sciences Center in Lubbock, Texas, and serves as a mentor to the Texas Tech Innovations Hub. He is a past president of the Texas College of Emergency Physicians and currently serves on the Governor’s EMS & Trauma Advisory Council of Texas. Rate and review the EMS One-Stop podcast Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contac

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. On October 7, 2023, the Palestinian group Hamas launched a surprise attack on Israel at dawn during the Jewish holiday of Simchat Torah – with armed assailants breaching security barriers and a barrage of rockets fired from Gaza. The attack came 50 years and a day after Egyptian and Syrian forces launched an assault during the Jewish holiday of Yom Kippur in an effort to retrieve territory Israel had taken during a brief conflict in 1967. As the world has seen, terrorists entered Israel. Militants burst into houses, shooting residents begging for their lives and taking others – including women, children and the elderly – hostage, driving the terrified captives back into Gaza. Operating as part of the initial and ongoing response to the events unfolding in Israel is United Hatzalah, a network of more than 6,500 EMS volunteers, with a fleet of emergency medical vehicles, who in peacetime, are able to respond to more than 2,000 medical emergencies per day in an average response time of less than 3 minutes (and in major cities, often less than 90 seconds). Since October 7, United Hatzalah has been pushed to its absolute limits and has expended the majority of its disposable medical equipment. In this special edition of EMS One-Stop, Rob Lawrence speaks with Dov Maisel, United Hatzalah’s Vice President of Operations. Donate to support United Hatzalah’s EMS response: United Hatzalah – Israel is at War | The Chesed Fund TOP QUOTES FROM THIS EPISODE “We are a multi-faith organization, but we are an organization of human beings. What we've underwent here in the past week has nothing to do with human beings. This is barbaric. This is something that I've never witnessed. And I've been through terror waves here in my 30 years of EMS. I've seen buses blown up. I've seen suicide bombers in dozens. Nothing on this scale. This is something that Isis did, we all remember watching the videos of what ISIS did, years ago. This overcomes all of that.” — Dov Maisel “I would say that the amount of tourniquets that we put out in the first 36 hours was in the thousands ... thousands of tourniquets. We treated over 3,000 victims on the ground. The amount of tourniquets, bandages, chest seals, trachs, chest drains, needle applications, tubes that were put out in this first 36, 48 hours of operation is more than what we use, I would say in half a year.” — Dov Maisel “Our ground rule is in EMS, you don't enter a danger zone, but the volunteers getting on the radios with me, I was in HQ when it started, before I headed actually down to the field – they’re calling and screaming for help … the IDF soldiers that started the defense process were understaffed and they had no capabilities to rescue the victims out from the scene. And our volunteers simply, I told them, ‘it's up to you. Literally, it's up to you;’ and they all went in.” — Dov Maisel “There were so many, just try to wrap your thoughts around having 3, 4, 5, 10 gunshot wound patients thrown at you – at one or two medics with one ambulance. You can't pile them up one on top of another. You had volunteers going with their private cars, throw them in the backseats, literally with tourniquets on them. Imagine – tourniquets on all extremities, all extremities, needle in their chest, chest seals – thrown in the back seats of cars driven out two, three kilometers out to the ambulance crews that were waiting there that can treat them.” — Dov Maisel ABOUT OUR GUEST With 30 years of experience, Dov Maisel has dedicated his life to saving the lives of others. When Dov was just 9 years old, he was walking home from school when he witnessed a horrific accident in which a 6-year-old girl was hit by a bus. He decided he never wanted to be helpless when someone in his vicinity so desperately needed lifesaving treatment. By the age of 14, he began volunteering on an ambulance. Maisel has served as a combat paramedic in the Israeli Defense Forces (IDF) in four different wars. After his army service, he began working as an EMT, dispatcher and driver for Israel’s national ambulance service. During the 2000-2003 terror wave in Israel, Maisel personally responded to and managed EMS teams at thousands of terror attacks. Maisel is the inventor and developer of numerous medical devices, including a pocket BVM airway management device, which is used internationally in many armies, including the U.S. Military. In 2006, he was one of the founders of United Hatzalah, Israel’s first all-volunteer EMS organization. He serves as the director of operations, managing national and international operations along with the Israeli police, IDF and Ministry of Health as well as other government bodies. He invented what is now United Hatzalah’s Uber-like GPS-based dispatch system which locates a

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. This edition of EMS One-Stop was recorded in New Orleans at the 2023 EMS World Expo. Host Rob Lawrence is joined by a range of guests who discuss the sessions they presented and the latest developments in clinical medicine. Alexia Jobson, director of public relations at REMSA, discusses top tips for dealing with the media, and she then interviews media pre-con student Katherine Robillard. Peter Antevy, MD, describes his conference session, titled “Five protocol changes you're too afraid to make.” Brian Maloney of Plum EMS, in Pennsylvania, talks culture of safety, and lights and sirens reduction (and their results within the NEMSQA L&S reduction program). Doug Wolfberg, Esq., of Page, Wolfberg & Wirth, steps in to discuss leadership lessons from the Beatles and his new book – "Beatles FAB but True." The episode concludes with veteran EMS podcasters Chris and Anne Monterra, who offer tips on the art of podcasting. TOP QUOTES FROM THIS EPISODE “‘No comment is a comment!’ So you really want to avoid that as part of your media strategy and work to develop some transparent and honest information when those tough questions come.” — Alexia Jobson “Anything that you say to a reporter is considered on the record and can be used in a news story.” — Alexia Jobson “Top tips for going on camera: You want to make sure that they are knowledgeable about what they are going to be talking about, you want them to be a willing participant and able to re-frame and be positive about the content they are going to cover.” — Alexia Jobson “It's important for you to just spend a little time looking inside your organization, recognize those important stories that you want to share, and then make sure that you commit some time and resources to building those relationships with your audiences ... having that positive relationship in place will go a long way. And it's also important as a profession that we work together to kind of raise the profile of out of hospital healthcare and EMS.” — Alexia Jobson “Getting out the door, our shoot time is the No. 1 thing that can decrease our response times. It's not driving lights and sirens; it's not driving recklessly or speeding or not obeying the laws ... it's getting out that door quick from the time of dispatch to the time our truck's pulling out of the garage.” — Brian Maloney “When we first started looking at the use of lights and sirens during transport to the hospital, which is right there, that increases our chance of getting in a wreck threefold and so it's very dangerous. When we first started it, we were at 26% of the time using lights and sirens during transport; we're down to almost 2%, for transport to the hospital. For response to calls, we were about 46-48% of the time using lights and sirens; we’re down to 7% of the time now.” — Brian Maloney “Antibiotics for sepsis, so a lot of people are fearful of giving antibiotics, and why? Because the hospital says we need to have a culture, a blood culture. Turns out that's not true. If the patient's hypotensive, they're fixing to die, as they say. And we in Palm Beach County can give the antibiotics within 12 minutes of the 911 call. And our own data shows that the hospital is giving antibiotics at 120 minutes. That's a 10-fold difference in that. So, antibiotics for sepsis are, I think, a major item.” — Dr. Peter Antevy “There's a story about how the Beatles had a drummer for a couple of years before Ringo. He wasn't quite the right fit for that band. He's a good drummer. But when they got Ringo in, they took off, right? So, in EMS, we tend to think if somebody has a pulse and a patch, let's hire them or let's bring them in. But we need the right people.” — Doug Wolfberg “Recognize your own limitations, I tell a story about how the Beatles sort of came on hard times when their manager died, but weren't quite wise enough to know what they didn't know. They thought ‘we can manage ourselves,’ and so it’s to also recognize your limitations and get the skills that you need, if you don't possess them yourself, with your team.” — Doug Wolfberg EPISODE CONTENTS 01:15 – Media management with Alexia Jobson (REMSA) 09:22 – Alexia Jobson interviews Katherine Robillard (LA Office of EMS) 11:37 – Brian Maloney (Plum EMS) talks culture of safety and lights and sirens reduction 20:15 – Dr. Peter Antevy on the five protocol changes you're too afraid to make 23:54 – Doug Wolfberg Esq. (Page, Wolfberg & Wirth) on leadership lessons from the Beatles 28:13 – Chris and Anne Monterra on the art of podcasting ABOUT OUR GUESTS Alexia Jobson REMSA Alexia Bratiotis Jobson is the director of public relations and serves the organization by expanding opportunities for engagement, promotion, communication and relationship-building

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. In August 2020, Shawky S. Amine Eddine, MD, became the EMS commander for the Beirut Port Explosion – the largest non-nuclear explosion in history. The blast killed 200, injured 6,500, and resulted in excess of 300,000 people suffering home damages and losses. In terms of medical facilities in the blast area, four hospitals we rendered totally out of action, with eight further healthcare centers damaged. The explosion added to an already pressurized healthcare system, as the country was at the height of the pandemic, as well as hosting over 900,000 refugees from war-torn Syria. In this episode of EMS One-Stop, Dr. Eddine joins host Rob Lawrence to discuss the backstory and devastation of the explosion, as well as the challenges to access, hospital capacity, communication, record keeping and the management of the dead. Tune in as Dr. Eddine shares 10 takeaways and lessons for responding to a large-scale MCI both identified from that eventful day (discussed in full in the broadcast): Don’t fish in the same lake Factor emotions Leadership tokens are earned in management and spent in command Even in crisis … plan The importance of data Decision making You are not alone – coordinate and communicate Rescuers’ wellbeing is a priority Don’t forget yourself and don’t lose yourself amidst the crisis We make mistakes About our guest Dr. Shawky Amine Eddine, MD, is a medical doctor with special interest in prehospital care, healthcare quality management and disaster management. He has served as an EMT in the Lebanese Red Cross (LRC) since 2007 and as head of station for Damour EMS Station, and is currently acting as LRC director for learning and development, assistant EMS director for training and quality, and COVID-19 response coordinator. Dr. Amine Eddine has commanded multiple crises including Lebanon fires in 2019, Lebanon floods in 2019, protests in 2019-2020, COVID-19 outbreak in 2020 and the Beirut port explosion in 2020. He has led the real-time evaluations of COIVD-19 response. Dr. Amine Eddine is also a disaster management instructor in the Humanitarian Leadership Diploma, offered by Global Health Institute at AUB, an assistant professor at the Faculty of Nursing of the Lebanese Red Cross and a consultant for multiple local, regional and global NGOs. Connect with Dr. Amine Eddine: Twitter: @SAmineeddine LinkedIn EPISODE CONTENTS 1:00 – Introduction Shawky S. Amine Eddine, MD 1:30 – Description of EMS in Lebanon 04:43 – The role of Jerry Overton in the development of EMS in Lebanon 06:18 – Setting the 2020 scene in Lebanon. 09:00 – Ammonium Nitrate – a bomb in the warehouse 12:00 – Gathering the situation: The fog of war! 14:00 – Loss of medical infrastructure due to the blast 17:00 – EMS resources deployed 18:00 – Command and control: The UK GOLD, SILVER and BRONZE system 23:00 – Lessons identified versus lessons learned 23:50 – Don’t fish in the same lake 28:00 – Factor emotions 30:00 – Leadership tokens are earned in management and spent in command 33:00 – Even in crisis … plan 37:00 – The importance of data 40:00 – Decision making 41:40 – You are not alone: Coordinate and communicate 43:00 – Rescuers’ wellbeing is a priority 45:30 – Don’t forget yourself and don’t lose yourself amidst the crisis 48:00 – I make mistakes Additional resources Rapid Response: Beirut blast serves as stark reminder of the power of energetic materials Beirut and beyond: Planning for explosives in your community Forensic review: The Beirut port explosion UN Report: Beirut blast

“Instead of responding to the majority of 999 calls we receive every day, we want to flip that so we only go to those patients who really, really need a double staffed paramedic emergency ambulance quickly.” This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. It’s very clear that Ryan Reynolds and Rob McElhenney have raised the profile of the country of Wales with their “Welcome to Wrexham” football (soccer) team and series, but one Welsh organization – the Welsh Ambulance Service NHS trust – has a vision and world class level of service delivery that should receive equal attention. In this audio and video edition of the EMS One-Stop podcast, Host Rob Lawrence speaks with Professor Jason Killens, Chief Executive of the Welsh Ambulance Service. As the 999 emergency system that serves over 3 million Welsh citizens emerges into a post-pandemic world, Jason describes service delivery, the training and education of its medics and the fact that it is a about to operate without a medical director – in itself a move that identifies that clinical and academic paramedicine has come of age. As Jason tells Rob, “We are transforming the way we deliver our service here in Wales, looking to tip the service model on its head essentially. Instead of responding to the majority of 999 calls we receive every day, we want to flip that so we only go to those patients who really, really need a double staffed paramedic emergency ambulance quickly … car crashes, broken legs, falls from height, cardiac arrest; and the rest we would service by the means of telephone or video advice, upstream with clinicians in our contact center or with advanced practice clinicians in the community.” TOP QUOTES FROM THIS EPISODE When a patient calls 999, “you could see a traditional road ambulance, but increasingly here in Wales and in other services across the UK, you could see a disposal which includes telephone or video triage and advice from our clinicians in our contact centers – they could be either nurses or paramedics … and we are closing now here in Wales about 15% of all of our emergency calls every day by way of telephone or video consultation without turning a wheel or sending an ambulance” — Jason Killens “If we do respond to the scene, it could be a traditional ambulance or increasingly it could be what we call an advanced paramedic practitioner, so that is an experienced paramedic, who has a degree, who has gone on to masters/education – those advanced paramedic practitioners with a master’s degree, increasingly we are seeing a non-conveyance rate some 35-40% higher than a regular paramedic crew, so what that means is we are able to safely close episodes of care in the community and not respond with a double staffed ambulance/not convey the patient to the emergency department.” — Jason Killens “Fire Brigades and Departments in the UK aren’t associated with medical response – It is the exception in the UK rather than the rule.” — Rob Lawrence “We are not transport organizations anymore, we do transport, but increasingly, we are providers of great clinical care in our communities … but we are looking to stretch and grow so we provide better outcomes for all patients here in Wales, and only convey them to the emergency department when we really need to and we think the solution to that is advance practice in communities with our own people.” — Jason Killens “We have just agreed with our board that when our medical director retires at the end of this year, we will not replace him. We will be the first ambulance service in the UK not to have a medical director on the governance board. Instead, here, we will have our senior clinician leadership provided by our executive director of paramedicine and we are the first ambulance service in the UK to have that role on the board. And we have taken that point of view simply because the paramedic profession has developed over the last two decades, to the point now where we believe we have sufficiently experienced senior clinicians in the paramedic workforce that are able to provide that senior level governance leadership, and direction for our clinical strategy. It is an important signal and message to our paramedic workforce that the glass ceiling is broken and paramedics to join us at 21/22 years old from university can absolutely see a pathway through to senior leadership, to a director on the board, and ultimately to jobs like mine as a paramedic if that’s what they aspire to.” — Jason Killens EPISODE CONTENTS 1:10 – Introduction of Professor Jason Killens 3:30 – Recruiting Australian paramedics to work in London 4:30 – Explaining EMS organization and control in England, Scotland, Northern Ireland and Wales 8:30 – In the UK, healthcare is free at the point of delivery 11:30 – Geographical distribution of ambulance services

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. In this EMS One-Stop international edition, Host Rob Lawrence welcomes Dr. Linda Dykes, an emergency medicine physician from the UK, and Rom Duckworth, fire captain and paramedic EMS coordinator for Ridgefield (CT) Fire Department. The discussion begins with the demise of the U.S. ET3 program, and then the group examine how community paramedicine is thriving in the UK and the lessons to be taken away. Rob and Linda also discuss the EMS World Expo “International Roundup” session they have jointly delivered together for the last 7 years and how they extract best practices from all international attendees. Rob, Rom and Linda then discuss the similarities and differences in emergency management tactics, techniques and procedures, and identify trans-Atlantic lessons already being exchanged. About our guests Dr. Linda Dykes Dr. Linda Dykes qualified from Newcastle (UK) Medical School in 1996, trained in the northeast and Mersey regions, and is one of only a handful of doctors in the UK who are dual-qualified in both Emergency Medicine & Primary Care/General Practice. Even fewer remain active in both specialties, and she is believed to be the only dual-qualified EM/GP in the UK who has also gained experience working in acute community geriatrics, in a "Hospital at Home" service. Linda also spent 2 years working regular shifts in Ambulance Control, and has dabbled in the development of telephone algorithms via a short secondment to NHS111 Cymru/Wales. Equipped with this unique skillset – plus a track record of successfully building up services – Linda sees the NHS through a unique lens, and loves to work at bridging the gap between hospital and community services. Rom Duckworth Rom Duckworth is a dedicated emergency responder, author and educator with more than 30 years of experience working in career and volunteer fire departments, hospital healthcare systems, and private emergency medical services. Rom is currently a career fire captain and paramedic EMS coordinator for Ridgefield (CT) Fire Department, the founder and director of the New England Center for Rescue and Emergency Medicine; and is the recipient of the American Red Cross Hero award, Sepsis Alliance Sepsis Hero award, and the JEMS EMS 10 Innovators award. As the author of chapters in more than a dozen EMS, fire, rescue and medical textbooks, as well as over 100 published articles in firefighting and EMS magazines and websites, Rom is working to advance leadership in modern emergency services education. Learn more Rob, Linda and Rom will also be delivering an international seminar: “Major Incidents & Disasters – an International Masterclass” on Saturday August 5. For most emergency services personnel, major incidents are a rare event – maybe a handful at most in a career; maybe none. Few will become experts from personal experience alone, so learning from events that have gone before is crucial to preparedness at national, organizational and individual levels. This unique webinar brings you five world-class speakers, each of whom has operational, tactical and/or strategic experience (and some of them all of the above!) of major incidents from the UK, U.S., and Lebanon. Between them, they have responded to incidents ranging from boots on the ground at 9/11, to coordinating the pandemic response for an entire country, and everything in between … bus crashes, train derailments, gas explosions, bioterrorism, forest fires, floods, and hurricanes. This is an event where theory, research and first-hand experiences come together. Our speakers will share not only what they’ve learned from their personal experiences, but what they wish they’d known beforehand and what crucial points they now find themselves passing to others. This webinar is aimed at those who may have to plan for, and/or respond to, major incidents. As well as the obvious emergency service personnel, think also of hospital staff outside ED, council workers, undertakers, utility companies, coroners’ teams and many more. The event is also open to the general public, and promises to be a fascinating and absorbing morning.

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. Ambulances for Ukraine lead Chris Manson returns to provide an update on the program that is now not only sending ambulances, but also fire trucks and SUVs to Ukraine. To date. U.S. Ambulances for Ukraine has delivered 38 ambulances and 6 fire trucks to Ukraine. A further 12 ambulances, 2 fire engines and several SUVs are to be shipped in July. Host Rob Lawrence and Chris recap the program so far and the tasks that the donated vehicles are be put to in country. Sadly, some of the ambulances donated earlier in the year have been destroyed due to hostile action. Chris issues a further call to action for donating ambulances, fire trucks and SUVs. Ukraine has now moved from defensive to offensive operations, and every vehicle is needed. As Chris describes, “If anyone gives me an ambulance, a fire engine or an SUV, I will get that vehicle into the fight.” In the video edition of this episode of EMS One-Stop, Chris has provided photos of the vehicles on their way to Ukraine as well as images and video of the vehicles in action and the brave crews on the front lines that operate them. TOP QUOTES FROM THIS EPISODE “The reality is the Russians in this conflict are targeting first responders, and it is one of the things they like to do. They will shell an area, cause havoc in an area with some sort of military strike, and then they will wait until the first responders respond, and when they do, they will target them.” “Like any firefighter in any city department, what’s the first thing you want to do when a kid wanders around the fire truck? You want to sit them in the seat or put the helmet on right? So we put the first kid in, got them out, put the second kid in, I turned around and 20 kids are lined up. I went through those 20 kids and the 20 turned into 100, it felt like the entire town came out.” “I feel fairly confident now, that several of those vehicles have been destroyed.” “If anyone gives me an ambulance, a fire engine or an SUV, I will get that vehicle into the fight.” EPISODE CONTENTS 0:30 – Rob intro 01:17 – Introduction Chris Manson 01:38 – U.S. Ambulances for Ukraine backstory 04:53 – Why would we give serviceable ambulances to Ukraine if we still have a shortage in the U.S.? 06:38 – Current stats of vehicles donated 07:30 – The logistics of shipping a vehicle to Ukraine 10:34 – The road drive from Germany and through Poland 11:21 – Tracking ambulances – a big no-no! 12:40 – Distribution of vehicles in Ukraine 14:36 – The moment Chris arrives to hand over a vehicle down range 16:50 – Vehicles in military units liveried into camouflage paint 19:00 – The need for fire trucks and SUV/patrol vehicles 22:01 – Call to action – we need ambulances, fire trucks and SUVs – now! 24:00 – Where the fire trucks are deployed 25:15 – The Ukrainians can fix anything (so it doesn’t matter if the donated vehicle has a few faults) 27:55 – Final thoughts ADDITIONAL RESOURCES ON THIS TOPIC ABOUT OUR GUEST Chris Manson is the vice president of government relations for OSF HealthCare, a 15-hospital health system operating out of Peoria, Ill. He is a former firefighter from California and he served in the U.S. Marine Corps Reserves. CONNECT WITH OUR GUEST U.S. Ambulances for Ukraine @ambulancesU

Steve Grau, Anna Liotta and Steve Wirth join hosts Rob Lawrence and Chris Cebollero at the American Ambulance Association Annual Conference 2023 This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. In this EMS One-Stop/Inside EMS crossover podcast, Chris Cebollero teams up with Rob Lawrence to report on the 2023 American Ambulance Association Annual Conference from the MGM Grand, in Las Vegas. Rob and Chris discuss their own personal highlights and Rob’s leadership session, delivered with Acadian Ambulance President, Justin Back. Rob and Chris are joined by Page, Wolfberg & Wirth Founding Partner, Steve Wirth, Esq., and discuss bias, the topic of Steve’s conference session. Rob then interviews AAA keynote speaker, Anna Liotta, together with Royal Ambulance President Steve Grau, as they discuss: Generational codes in the workforce The revolving door of employment Creating the milestones of forward progression Understanding that your people are you primary customer TOP QUOTES FROM THIS EPISODE “In dealing with bias, self-awareness is absolutely critical – you have to do an inventory of your life and say ‘where are these things that I’ve experienced and how do they affect my decision making today and my interaction with other people,’ so self-awareness is really the first step.” — Steve Wirth “When you go to a conference, go up to somebody. The reason that you have a nametag, with your first name in very large font is so that I can say, ‘Hello Chris, I’m Rob, pleased to meet you. What do you do?’ and that’s how a network occurs.” — Rob Lawrence “Having this culture of a high-level of engagement is really focusing on our employees as our primary customer and making sure that we understand what their goals, ideals, passions are, and how to meet them.” — Steve Grau “Just by the way they answered a simple question ‘so, what do you do?’ I could tell if they had been working there 2-3 weeks if they answer with a bright sparkle, ‘I work at Amazon.’ But if they had been there 2-3 months, they would pause, ‘well … I work at Amazon,’ And 6 months, they would drop a codeword, ‘I currently work at Amazon.’” — Anna Liotta -- Watch for more https://www.ems1.com/leadership/articles/the-10-commandments-of-servant-leadership-OkBq610vz8C12Gb1/ -- EPISODE CONTENTS Part 1: Rob Lawrence and Chris Cebollero – Serving to lead 00:30 – Rob and Chris introduction 1:30 – Car seat safety (not rated for ambulances) 3:30 – Rob’s leadership session with Acadian President Justin Back on the principles of leadership, serving to lead 05:30 – Chris discusses leadership as a science 06:30 – What we want from our leaders Part 2: Steve Wirth – Overcoming bias 07:30 – Welcome Steve Wirth 08:00 – Steve discusses his conference session, “We are all prejudiced” delivered in partnership with Macara Trusty (GMR) 11:30 – The importance of networking and meeting professional friends 14:56 – Chris talks about his leadership series on EMS1 Part 3: Anna Liotta and Steve Grau – Retaining your primary customer 16:00 – Introduction: Anna and Steve 17:00 – Generational difference - Have you seen a “Star Wars” movie? 17:30 – Anna: Common sense is not that common 18:30 – The Royal Ambulance (award winning) Career Bridge Program 20:00 – Generational codes in the workforce 22:50 – The revolving door of employment 24:00 – Creating the milestones of forward progression 25:00 – Anna’s Experience with Fortune 500 companies 25:30 – Understanding that your talent and people are your primary customer 26:00 – Creating an arc of experience 28:00 – Not allowing yourself to say “that’s how I did it” 29:00 – Fostering the whole human 30:00 – Pulling talent forward 31:00 – Rob and Chris close ABOUT OUR GUESTS Anna Liotta Anna Liotta, creator of Generationally Savvy Communication Solutions, is an award-winning speaker, business consultant and author. She engages audiences with her practical strategies for attracting, growing and retaining top talent and loyal clients from every generation. Anna integrates communications, sociology, business psychology and demography to unify workplaces and dramatically improve company performance. Her expertise and insight have helped such companies as Pike Place Market, Intel, Wells Fargo, Microsoft, Amazon, the PGA, NBA and United Way. Steve Grau Steve Grau and his family emigrated from Ukraine in 1989, arriving in San Francisco with $80 to their name. He became interested in healthcare 15 years later, when he took a hands-on role caring for his grandfather after a series of debilitating strokes. Witnessing how emotional support impacted physical healing, Steve was inspired to leave the tech industry to start an ambulance service that focused on patient experience. Steve Wirth Steve Wirth is a founding partner of Page, Wolfberg & Wirth. In a distinguished four-deca

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. Our EMS One-Stop Host Rob Lawrence was recently invited attend the keynote session at the North Carolina EMS Expo, and to deliver an after-dinner speech at the banquet. The title of Rob’s session was “Elephants in the EMS room,” in which he addressed 10 things we must acknowledge and fix in order to improve the health of our profession. As soon as he left the keynote stage, Rob joined Bradley Dean and David Blevans from the EMS Handoff Podcast to discuss the key issues raised in Rob’s presentation. The biggest elephant in the room currently is recruiting and retention, and in addition to discussing inside industry suggestions, Rob looked to the outside world and got his inspiration from Glass Door, and identified what stands EMS apart from the nation's top 50 companies to work in. The discussion also covers data and politics, cost collection and surprise billing, amongst the other elephants in the EMS room. TOP QUOTES FROM THIS EPISODE “I don’t talk about surprise billing, I talk about surprise payment, the surprise is what the insurance company actually gives you.” — Rob Lawrence “A lot of local authorities will describe what they want to see in their EMS system when they bid them out and these are wholly unaffordable, in fact, they describe the cruise liner, when they can only afford a rowboat.” — Rob Lawrence “We have to stop thinking that we are the UN and start to thinking like NATO, because NATO is an attack on one is an attack on all so, we have to start changing our mindset.” — Rob Lawrence EPISODE CONTENTS 00:53 – Introduction 01:15 – Bradley Dean and David Blevins 2:10 – Elephants in the room 2:58 – Recruiting and retention 4:00 – Looking for clues via Glassdoor 5:05 – Is EMS in a pickle? 6:00 – Surprise billing 6:22 – EMS costs 7:00 – The cost of readiness 7:30 – Ground Ambulance and Patient Billing Committee 9:46 – Four little words – all those in favor! 10:20 – We are all politicians 11:30 – Degree or no degree – that is the question 15:40 – If you are going to get a degree anyway, why not a paramedicine degree! 17:00 – Data and making use of it 20:00 – Wall time 24:00 – The importance of advocacy 28:00 – National organizations working together 37:00 – The Peter Principle and training our people for the next position 39:00 – Close

Dr. Lori Moore-Merrell announces plans to rename the USFA to the U.S. Fire and EMS Administration This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. EMS One-Stop Host Rob Lawrence recently travelled to Florida to attend the Metropolitan Medical Directors Gathering of Eagles Conference. In this week’s episode, he shares video from key sessions and interviews with a number of leading EMS medical directors, including Dr. Jim Augustine, medical director of Lee County, Florida. The Eagles also gave the floor to the U.S. Fire Administrator Dr. Lori Moore-Merrell, who identified how the Metropolitan Medical Directors will work closely in the future with the U.S. Metropolitan Fire Chiefs – and identified that a name change to USFA may soon follow. TOP QUOTES FROM THIS EPISODE “Seventy-five percent of what we do in the fire response space is in fact EMS, and something that I shared with these guys yesterday is an action, I won't say a movement yet, but an action under way, we may in fact in the near term actually rename the U.S. Fire Administration the U.S. Fire and EMS Administration.” — Dr. Lori Moore Merrell “We have just stood up in January an EMS branch within our National Fire and EMS Programs Division. That is a huge move for USFA, so we are going to be moving toward even bigger announcements in the near future ... but we need to embrace what we do in the fire service, that is greater than 70%, most departments 75% and up of EMS.” — Dr. Lori Moore Merrell EPISODE CONTENTS 01:00 - Takeaways from Brandon Morshedi, MD; Peter Antevy, MD; Joseph Zalkin; Petar and Amber Hossick 02:00 - Introducing the comments from Dr. Moore-Merrell 04:00 - Recorded comments from Dr. Moore Merrell 09:00 - Discussion with Dr. James Augustine 24:00 - Closing commentary

Paramedic Amanda King shares her story of thru-hiking the Appalachian Trail and overcoming EMS burnout This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. After realizing she was suffering from burnout, Paramedic Amanda King decided to leave her service and take on one of the most physically challenging trails in the United States. Amanda made a decision that changed how she saw people, how she viewed the world and how she understood herself. Three months after resigning, selling her house and storing her furniture, Amanda was dropped off in Georgia, alone, with one goal: to hike the entire Appalachian Trail. With her hiker home packed into a rucksack on her back, she embarked on a seven-and-a-half month epic adventure which saw her hike nearly 2,200 miles. She endured harsh weather, a regional drought, rugged terrain and so much more on a journey that evolved her in ways she could not have ever imagined. After deciding to return to EMS, Amanda chats with Rob Lawrence about her experience, the individuals she met along the way and how her experiences can be translated back into life as a medic. Amanda also reflects on her life before the trail and offers inspiration and takeaways for all. TOP QUOTES FROM THIS EPISODE “I think my biggest regret is, it's a very simple word. It's two letters long and it's the word ‘no!’ Don't be afraid to say no. Take time for yourself, because you are the most important person. You know, if you're not happy and if you're not safe, how can you expect to keep other people happy and safe? I think that's the biggest thing, don't work so much overtime, don't inconvenience yourself to do all of these things that's asked of you, in return you're not taking care of yourself. So, one thing that I decided if I got back into EMS, is I would use my vacation time. So I'll put it to you this way. When I was at the former employer, I took a vacation maybe twice in 6 years or something like that, like an actual vacation. I've already taken two vacations since I started here at Novant, since November – so that's a huge difference.” “I don't want to say yes, a 7-month hike in the woods cured all my problems, because that's not at all the case. I think that it's an ongoing process that, once you reach that point of burnout, it's number one up to you. It's not up to anybody else to help you. It's up to you to help you. And you have to want that change. I think that it's an everyday thing. Every day I need to do things that keep me on that path of not going back down that road again.” “I think that was a symptom of the burnout where I was at, I had no patience whatsoever and it showed. It showed to my partner, it showed to family members that I would encounter on a call. And I hate to admit all that; it's embarrassing, but that's where I was, that was the point where I was at. I think now, after all that time off, and all that time to self-reflect, I think I'm more patient because I believe that I'm more empathetic, which is also something that I can't say that I possessed before I left.” EPISODE CONTENTS 02:29 – Introducing Amanda King 05:06 – Symptoms of burnout 07:16 – The moment you realize you are done 10:57 – Selling and putting everything in storage 13:23 – Hiking with friends 15:53 – Packing for a 2,000 mile walk 18:48 – Mental fortitude 22:47 – Trail angels 24:40 – Trail magic 26:32 – Becoming ‘moss’ 29:49 – Hindsight is 20/20 31:16 – Keeping a journal 33:30 – Taking a zero: how to use down time 41:14 – 2,000 miles later … 48:05 – Developing patience 51:02 – Message to those heading into crisis or breakdown 54:13 – Contact details ADDITIONAL RESOURCES ON THIS TOPIC Reignite EMS passion by banishing burnout (eBook) On-demand webinar: Navigating a path to career satisfaction 5 EMS tips for a work-life balance EMS Burnout Repair Kit: Reigniting your EMS passion ABOUT OUR GUEST Amanda King is a paramedic from the coast of North Carolina. Prior to joining EMS, she obtained a Bachelor of Arts degree from the University of North Carolina at Wilmington. During her first 10 years in EMS, she was promoted to field training officer, became an EMS instructor, developed a field training and evaluation program for her former agency, taught EMS classes for the local community college and earned a real estate license. She left EMS and thought she’d never return. Now, after becoming one of just over 1,000 people to thru-hike the Appalachian Trail in 2022, she has returned to EMS and now works for Novant Health Mobile Integrated Health. She is currently in graduate school to obtain a master’s degree in public administration. CONNECT WITH OUR GUEST Instagram LinkedIn 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 [email protected]

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. Page, Wolfberg & Wirth was asked by the National EMS Information System (NEMSIS) Technical Assistance Center (TAC) to research frequently asked questions related to data in EMS patient care reports. PW&W analyzed these questions under applicable laws and guidance, and developed general answers and best practices contained in the new publication, “Patient Care Report Data QuickGuide - FAQs on owning, amending, retaining and sharing patient care report data.” In this week’s EMS One-Stop, available in both video and audio versions, Host Rob Lawrence speaks with the PW&W authors of the project, Ryan Stark, managing partner, and Steve Johnson, director of reimbursement consulting. They discuss the guide, why it’s needed, and the major FAQs and misconceptions about PCRs. The guide is broken down into four key areas of FAQs: PCRs’ legal status Amending PCRs PCR retention Transferring PCR data Top quotes from this episode “I would much rather defend an organization who regularly goes through a quality assurance process, whereby they make the provider and hold them responsible for the accuracy and completeness of the record.” — Ryan Stark “Others may say, we see a lot of amendments to your records. The answer is ‘yes, that’s because we care about getting it right’ – that’s the mantra of our organization.” — Ryan Stark “One of the things behind the importance of documentation is that it doesn’t live in a vacuum. We are in a day and age where it’s going to follow the patient for their lifetime, so you may have a rehab facility that wants to consult the medical record to determine the mechanism of injury or how the injury occurred and the only person [that knows that] is the EMS practitioner.” — Ryan Stark “Long gone are the days where we can give you a quick ticket, passing along the information to the receiving facility. Now we are marrying up records, electronic health exchanges and other mechanisms and the genesis of all this starts with the original call.” — Steve Johnson “Everyone should sign the patient care report. Why? Because everyone was a function of providing that particular service and we get a lot of pushback and they say ‘well now I’m legally responsible for everything that happened,’ and that’s not what the law says. The law says, for what you did, you are responsible for what you did and what you didn’t do when you had a legal duty to do something or withhold doing something because it was contraindicated. All that indicates is that yes, I reviewed it and to the best of my knowledge it’s true and accurate.” — Ryan Stark “The law will impose liability where it lands. Just because you’ve signed that particular patient care report, doesn’t mean you’re responsible for all the interventions and everything that I outlined in there, it would be whoever performed or withheld those interventions that would be responsible within the scope of practice.” — Ryan Stark Episode contents 1:09 – Introductions 1:30 – PWW history 3:30 – Introducing the PCR Data QuickGuide 4:20 – The circle of life of a PCR 11:00 – NEMSIS data/research license and EMS by the numbers 13:20 – Who owns PCR data 15:50 – Signatures! And legal responsibility 17:40 – Accuracy of documentation to defend your actions 18:30 – Why does the driver have to sign? 20:00 – Amending PCRs: When and why 22:33 – Who do you tell if a record is amended? 24:30 – Can your state request you to amend your PCR? 27:30 – How long should we keep documents? 30:50 – When an agency closes down or merges 33:30 – Body-worn camera content 35:30 – Transferring paper records to digital 37:15 – Bi-directional data and HIE – responsibilities 40:00 – Final thoughts Additional resources The PCR Data QuickGuide is available now, and we encourage all EMS professionals to download their copies and gain a deeper understanding of PCR data best practices. To download the guide, please follow the link: About NEMSIS About Page, Wolfberg & Wirth About our guests Ryan Stark Ryan Stark is a managing partner with Page, Wolfberg & Wirth, and is the firm’s resident “HIPAA guru.” He counsels clients on labor relations, privacy, security, reimbursement and other compliance matters affecting the ambulance industry. Ryan started in the healthcare field as a freshman in college, where he worked for a local hospital and a retail pharmacy. After college, he decided to become a lawyer, hoping to guide healthcare providers through the demanding legal issues they face. He has been with PW&W since 2007, fulfilling that ambition. Ryan is passionate about educating EMS professionals and loves collaborating with providers and CEOs alike. He is a featured speaker in PW&W seminars and webinars, including the firm’s signature abc360 Conference, where he hosts the abc360 Game Show. Alwa

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. This edition of the EMS One-Stop podcast spotlights the popular online education series Reel Emergency, which uses real bodycam footage to illustrate various types of medical emergencies. The footage is then discussed in a live broadcast by very well-known emergency medicine physicians, Drs. Peter Antevy, Mark Piehl and David Spiro. Reel Emergency offers free continuing education credit on the day of the Prodigy EMS based broadcast (you must be in the live audience to receive CE) and is then made available via YouTube for all to view and use as part of their clinical education. Reel Emergency has now produced 15 episodes and has been viewed tens of thousands of times as both individuals and departments benefit from the content, the expert analysis and commentary, as well as subject matter expert guests. In this podcast, Rob Lawrence chats with Reel Emergency’s regular host Hilary Gates, director of educational strategy for Prodigy EMS; and Zach Dunlap, clinical education specialist from 410 Medical. Zach also previously worked for an agency that pioneered the use of body-worn cameras in EMS and offers insight into their adoption and use. TOP QUOTES FROM THIS EPISODE “These real patient videos actually show what’s happening on a call. Where else do you get that? You can’t get that anywhere else and there’s something to be said for doing scenarios and having standardized patients or mannikins, but nothing beats watching the actual call itself because you also have all of the other elements of the call that are really hard to recreate in the classroom. You have all of the emotions all of the bystanders, all of the equipment, the communication aspects you have to worry about, and you have real human reactions” — Hilary Gates “If you are an educator, and you are teaching a certain topic – anatomy, physiology, scene management, all operations, whatever it is – and there is a way to illustrate that, you should be required to illustrate it with a video – there’s just no better way to do it.” — Hilary Gates “It should almost be a requirement at this point, the main reason people don’t want body cameras in EMS is because it’s grossly misunderstood.” — Zach Dunlap EPISODE CONTENTS 1:00 – Introductions 01:35 – REEL Emergency 02:20 – Everyone knows Drs. Spiro, Antevy and Piehl 4:00 – Using video for education 6:10 – Gaining free CE and watching on-demand 07:20 – Using body-worn cameras on the street 08:23 – Using BWCs for performance improvement 11:25 – Suggesting that BWC eventually become the standard of care 12:50 – Where does Reel emergency get its videos from? 14:00 – Filming the Falmouth Road Race and heat emergencies 15:20 – How to view Reel Emergency? ADDITIONAL RESOURCES ON THIS TOPIC Current Reel Emergency topics include sessions on HP CPR, heat emergencies, peds emergencies, junctional hemorrhage, ped airways, anaphylaxis, intracranial emergencies, delirium, end of life care, GSWs and altered mental status. Following are additional resources on incorporating body-worn cameras: Promoting transparency and accountability with BWCs Three outdated paradigms holding EMS back Leadership’s role in keeping our workforce safe How to buy body-worn cameras (eBook) ABOUT OUR GUESTS Zach Dunlap began his EMS career as a paramedic in Amarillo, Texas. After working in Oklahoma City, he returned to the Texas panhandle, where he worked as a flight paramedic for several years. Zach now resides in Houston, and has served as a flight paramedic and clinical director for a progressive 911 system. Currently, he is a clinical education specialist for a national medical company educating and training clinicians across the country on volume resuscitation. Zach obtained his bachelor’s in emergency health sciences and has always focused on providing excellent patient care through innovative approaches. Zach enjoys sports and spending time with his two children, Brogan and Brynlee, and their Goldendoodle, Claire. Zach is also the assistant treasurer of the Board of Commissioners of Harris County ESD11 in northern Houston. Hilary Gates, MAEd, NRP, is the director of educational strategy for Prodigy EMS and a volunteer paramedic in the Alexandria (Virginia) Fire Department. She is also a faculty member of the School of Education at American University in Washington, D.C., and teaches Introduction to Community Health in the EM Program at University of Pittsburgh. Beginning her career as a volunteer EMT with the Bethesda-Chevy Chase Rescue Squad in Montgomery County, Maryland, Hilary became a full-time paramedic, EMT instructor and FTO at AFD, and then served as senior editorial and program director for EMS World. She implemented AFD’s MIH/CP program in 2017 and has extensive experience as an EMS educator, symposium pr

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. In this edition of the EMS One-Stop podcast, Host Rob Lawrence speaks with Dr. Maia Dorsett and Paramedic Nikki Little to discuss the NAEMSP Quality Improvement and Safety Course, an exciting year-long course that provides EMS physicians and quality improvement leaders with the knowledge and skills necessary to lead QI and patient safety initiatives in their region, system or agency. Participants will develop an in-depth understanding of how to apply QI tools and strategies to their local needs to affect the care of patients. Dr. Dorsett and Little identify that the program will take participants on a journey to improve the quality of care and safety in their system through a multi-modal approach in sessions led by expert faculty, who will discuss key aspects of quality improvement. TOP QUOTES FROM THIS EPISODE “I think one of the things I love about this course is half the faculty are not physicians. There is a fair percentage of NAEMSP membership that are not physicians and the quality course especially is very deliberate. It has faculty from different backgrounds.” — Dr. Dorsett “Your system is complex; all of the policies and procedures and processes that you have set up for the folks to work in them, they don’t always work as designed.” — Nikki Little “Once a month, and even more often than that, because you meet with your mentees, you get to really collaborate idea-wise and work together with a group of people who are all there committed to making improvements in their system.” — Dr. Dorsett “So many quality leaders are still stuck in this in this moment, where they’re looking at 50% in May and 52% in June, and we’re just comparing these two numbers and making massive strategic decisions about things that might be seasonal or have abnormal variation and we could be really making some really dumb mistakes if we’re not looking at our data over time.” — Nikki Little EPISODE CONTENTS 02:00 – Introduction – Nikki Little 2:25 – Introduction – Dr. Maia Dorsett 02:40 – Description of the course 03:30 – Quality Course origin story 05:30 – Little’s experience as an inaugural participant 0745 – Month-by-month syllabus 10:00 – PDSAs and brevity in QI 13:00 – Capstone and results presentation 15:20 – Little’s course highlights 17:29 – Dorsett’s course highlights 21:25 – This course is not just for physicians 23:10 – Course overall timeline 24:30 – Cohort presentations at the annual meeting and poster presentations 26:20 – Class sign-up details ADDITIONAL RESOURCES ON THIS TOPIC NAEMSP Year-Long Quality Improvement and Safety Course ABOUT OUR GUESTS Maia Dorsett, MD, PhD, is an emergency medicine and EMS physician and educator. She completed her EMS fellowship at Washington University before moving to Rochester, New York, where she now serves as the medical director for EMS education at Monroe Community College and is the associate regional medical director for education and quality for the Monroe-Livingston Region. She is also the medical director for Gates Volunteer Ambulance as well as Prodigy EMS. Nationally, she serves on the board of the National Association of EMS Physicians and the National Registry of EMTs. She is involved in quality improvement implementation and education, serving as the co-course director for the NAEMSP Quality and Safety course. Nikki Little, FAEMS, has fulfilled many roles as a paramedic, including advanced care paramedic, district chief of paramedic operations, 911 communication supervisor, and quality and patient safety officer in almost 30 years in EMS. She has a passion for patient-centered quality improvement of systems and has advocated for policy advances in the areas of patient safety, team communication and opioid overdose. She has dedicated countless hours to improve the quality and safety of patients with non-transport dispositions, (especially elderly and at-risk persons) and to improve the care for patients experiencing acute coronary syndromes (with particular focus on gender disparities in care). She has also contributed through committee work by way of the Paramedic Chiefs of Canada and the Manitoba Chapter of the Canadian Women’s Heart Health Alliance. In the area of quality improvement and paramedic education, she is in her sixth year as faculty of the National Association of EMS Physicians (NAEMSP) Quality and Safety Year-Long capstone course and preconference workshop. Her dedication to furthering the educational mission of the organization, and skill in teaching patient safety and improvement science to paramedic professionals and EMS physicians was duly recognized when she was named co-director. CONNECT WITH OUR GUESTS Maia Dorsett Nikki Little

999, London Ambulance Service Deputy Director Simon Harding talks emergency planning for the royal gathering This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. Recorded with less than 24 hours to go before the coronation of King Charles III, of England, host Rob Lawrence sits down with Simon Harding, deputy director of the London Ambulance Service to discuss planning for the coronation. Harding also serves as deputy director of the London's 999 control centers. Harding begins by highlighting the construct of ambulance services in the United Kingdom, as well as the scope and operation of the London Ambulance Service, which serves 9 million citizens of the national capitol, plus visitors. LAS takes over 2 million 999 (the UK equivalent of 911) calls a year in addition to 2 million 111 calls (for non-emergency responses). Harding and Rob discuss how incident management operates in the UK, using the GOLD, SILVER and BRONZE levels of command, and the roles and responsibilities at each level. They talk about the plans for the coronation and how LAS – in partnership with public safety and military planners – are preparing to support the historic event. Resources mentioned in this episode London Ambulance Service John’s Ambulance Service Additional resources for mass gathering planning Boston EMS' Joe O'Hare: All hazards incident management EMS coverage for mass gatherings and public events How EMS can prepare for a mass gathering to become an MCI 7 ways to be prepared before the mass gathering turns into an MCI

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. Ginny Renkiewicz, PhD, is an assistant professor of healthcare administration in the College of Health Sciences and Human Services at Methodist University, Fayetteville North Carolina. Dr. Renkiewicz has been involved in EMS for 21 years as a credentialed paramedic, administrator and leader. Her specific research interests include defining predictors and profiling traumatic stress syndromes in EMS personnel and she recently had two papers published in the U.K. and U.S. on subjects related to her research interests. In this edition of EMS One-Stop, Rob Lawrence and Dr. Renkiewicz discuss her publications, “Secondary trauma response in emergency services systems (STRESS) project: quantifying and predicting vicarious trauma in emergency medical services personnel,” which discusses the emotional countertransference that occurs between the clinician and patient, and “Maladaptive Cognitions in EMS Professionals as a Function of the COVID-19 Pandemic,” which analyses how the coronavirus disease pandemic has profoundly affected EMS professionals. TOP QUOTES FROM THIS EPISODE “I don’t think we will ever go back to normal; this is kind of like 911. There was before 9/11, and there was after 9/11, and this is going to be before COVID, and after COVID.” “Vicarious trauma is emotional counter, transference; essentially, you are feeling what the patient feels when they’re experiencing a traumatic event. Example being, if you had a call, for example, a stillbirth, you may for the following weeks or months have this weird aversion to children or things in which infants are involved and you may have a stress response to those situations in the same way that the patient would have.” “Post traumatic stress injury is not the only stress disorder that exists out there. It is the one that I think most frequently cited by educators and administrators, because we don’t know all of the other more insidious stress disorders, of which vicarious trauma is one.” “A predictor of having vicarious trauma as an EMS professional; my hypothesis is that if your parents or whomever your caregivers are do not teach you how to appropriately and emotionally cope with anything in any situation, it becomes very difficult for you to know how to do it properly in your adult life and so you overcompensate, and so vicarious trauma occurs in that population.” EPISODE CONTENTS 1:12 – Introduction: Dr. Ginny Renkiewicz 1:55 – Ginny’s academic career 3:00 – The development of research on EMS 4:50 – Paper discussion – secondary trauma response 09:00 – Education on stress disorders 11:24 – Therapy dog program 12:30 – Next steps/further work on resilience training 1530 – Maladaptive cognitions 17:20 – Getting published in the SOM Journal 19:00 – Learning, conclusions and takeaways 23:00 – The new normal 24:18 – Call to action for leaders 26:13 – NHTSA Listening Group on wellness, resilience and peer support programs 27:30 – Getting involved in research 31:00 – NAEMT Lighthouse leadership program ADDITIONAL RESOURCES ON THIS TOPIC Secondary trauma response in emergency services systems (STRESS) project: quantifying and predicting vicarious trauma in emergency medical services personnel “Maladaptive Cognitions in EMS Professionals as a Function of the COVID-19 Pandemic” ABOUT OUR GUEST Dr. Ginny Renkiewicz is an assistant professor of healthcare administration in the College of Health Sciences and Human Services Methodist University, Fayetteville, North Carolina. She has been involved in EMS for 21 years as a credentialed paramedic and Level II paramedic instructor. She has spent 17 years as a program director, division chair or department head and has been recognized for her contribution to the EMS profession as a Fellow of the Academy of Emergency Medical Services (FAEMS) through the National Association of EMS Physicians. She has won several national and international awards, including National EMS Educator of the Year and the global EMS10 Award for innovation in the field of EMS. She holds an Associate of Applied Science in Sign Language Interpreting degree from Wilson Community College, a Bachelor of Science in Emergency Medical Care with a concentration in EMS management and a Master of Health Science in EMS education (both from Western Carolina University), and a Ph.D. in Health Science with a concentration in Respiratory Care from Rush University. Dr. Renkiewicz is a reviewer for several peer-reviewed journals; serves as executive director of the Foundation for Prehospital Medicine Research; and is enthusiastic about research, innovation and student mentoring. She is also the vice chair of the North Carolina Association of EMS Educators. Her specific research interests include defining predictors and profiling traumatic stress sy

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. COVID-19 was declared a Public Health Emergency (PHE) on Jan. 31, 2020, and was extended a number of times, but it is now set to expire on May 11, 2023. In this episode of EMS One-Stop, Rob Lawrence is joined by Doug Wolfberg, Esq., of Page, Wolfberg & Wirth to discuss the immediate actions organizations should take (or should have already taken) to preserve documentation relating to the PHE, as well as adjust operational and documentation practices and procedures as we “return to normal.” Rob and Doug discuss issues such as rule changes that have become normal operating procedures over the last 2 years and the need to build a time capsule to preserve evidence. They also cover patient signatures, telehealth changes, transport to alternate destinations, agency licensing and Physician Certification Statements. Doug, a lifelong Beatles music fan, also shares that he has just published a book: “The Beatles: Fab but True: Remarkable Stories Revealed” and will be undertaking a book signing tour in the UK later in the year. TOP QUOTES FROM THIS EPISODE At the end of the PHE, “We revert back to the standard inflexible Medicare signature rules which means that the patient needs to be the signer, and the only time that you can get a signature from anyone else is if that patient is physically or mentally incapable of signing that statement.” EPISODE CONTENTS 1:12 – End of the PHE announced 2:00 – Rule changes have become normal operating procedures 2:20 – The need to build a time capsule to preserve evidence 4:30 – Big change ticket item number one – patient signatures 6:40 – A reminder to establish the reason the patient is unable to sign a PCR 7:20 – Telehealth changes 10:00 – Transport to alternative destination coverage ends (but place your pandemic local clinical guidance in your time capsule now!) 13:07 – ET3 – not affected and is separate 15:24 – Doug and the Beatles 17:52 – Ambulance staffing waver also going away 18:55 – Agency licensing back into full force – no more grace periods 21:12 – Physician Certification Statements (PCS) – do not cut corners on your PCS signatures 22:15 – Leaders pay attention to this podcast ADDITIONAL RESOURCES ON THIS TOPIC CMS Waivers, Flexibilities, and the Transition Forward from the COVID-19 Public Health Emergency Doug’s new book: “The Beatles: Fab but True: Remarkable Stories Revealed” ABOUT OUR GUEST Doug Wolfberg is a founding partner of Page, Wolfberg & Wirth, and one of the best-known EMS attorneys and consultants in the United States. Widely regarded as the nation’s leading EMS law firm, PWW represents private, public and non-profit EMS organizations, as well as billing companies, software manufacturers and others that serve the nation’s ambulance industry. Doug answered his first ambulance call in 1978 and has been involved in EMS ever since. Doug became an EMT at age 16, and worked as an EMS provider in numerous volunteer and paid systems over the decades. Doug also served as an EMS educator and instructor for many years. After earning his undergraduate degree in Health Planning and Administration from Pennsylvania State University in 1987, Doug went to work as a county EMS director. He then became the director of a three-county regional EMS agency based in Williamsport, Pennsylvania. He then moved on to work for several years on the staff of the state EMS council. In 1993, Doug went to the nation’s capital to work at the United States Department of Health and Human Services, where he worked on federal EMS and trauma care issues. Doug left HHS to attend law school, and in 1996 graduated magna cum laude from Widener University School of Law. After practicing for several years as a litigator and healthcare attorney in a large Philadelphia-based law firm, Doug co-founded PWW in 2000 along with Steve Wirth and the late James O. Page. As an attorney, Doug is a member of the Pennsylvania and New York Bar Associations, and is admitted to practice before the United States Supreme Court as well as numerous Federal and state courts. He also teaches EMS law at the University of Pittsburgh, and teaches health law at the Widener University School of Law, where he is also a member of the school’s Board of Overseers. Doug is a known as an engaging and humorous public speaker at EMS conferences throughout the United States. He is also a prolific author, having written books, articles and columns in many of the industry’s leading publications, and has been interviewed by national media outlets including National Public Radio and the Wall Street Journal on EMS issues. Doug is a Certified Ambulance Coder (CAC) and a founder of the National Academy of Ambulance Coding (NAAC). Doug also served as a commissioner of the Commission on Accreditation of Ambulance Servic

EMS One-Stop Show Notes - National EMS Museum This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. In this episode of EMS One-Stop, Host Rob Lawrence discusses the National EMS Museum (NEMSM) with President Dave Zaiman; Museum Director, Kristy Van Hoven; and Jon Krohmer, MD, immediate past-secretary and "We are EMS" coordinator. The National EMS Museum is a volunteer-led organization that collects, preserves and shares the history of emergency medical response in the United States in hopes of inspiring future professionals to take up the call. The National EMS Museum organization operates a virtual museum and produces traveling exhibitions that tour the country every year. The Collections at the National EMS Museum house over 300 years of history that cover the development of prehospital care in the United States, North America and around the world. TOP QUOTES FROM THIS EPISODE “We are here to educate the future. We are here not only to document the legacy, but here to provide a foundation and an education that EMS as a profession, as we move forward is respected, is understood, and maybe in a small part this museum can play a part in improving EMS altogether.” EPISODE CONTENTS 03:05 – Origins of the NEMSM 05:04 – The style and model of the NEMSM 07:00 – Changes underway – recruiting individuals with experience in museum activities 11:50 – President Dave Zaiman 13:20 – Getting EMS into the community 15:00 – Favorite artifacts 16:30 – From MAST pants to blood transfusion 17:20 – Fundraising effort in order to take the museum on the road 20:30 – Developing a traveling mobile “We are EMS” museum project 23:40 – How to book a traveling exhibit ADDITIONAL RESOURCES ON THIS TOPIC The National EMS Museum California Ambulance Association Siren special edition: Fifty Years of Wedworth-Townsend ABOUT OUR GUESTS Dave Zaiman Dave is currently Sales VP - Midwest at Pulsara. For over 30 years, Dave has been working in healthcare – both as an EMS professional as well as holding several leadership roles in the healthcare technology industry. Based in Minnesota, Dave spent his first 15 years working in the field as an EMT and paramedic in the Twin Cities metro area for both Allina and Hennepin County Medical Center. Kristy Van Hoven Kristy is the museum director for the National EMS Museum and PhD candidate at the University of Leicester. Over the last 3 years, Kristy has worked with the National EMS Museum’s Board of Trustees to develop and implement engaging e-volunteer opportunities and community programs that reach their digital audience. In addition to her work with the EMS Museum, Kristy volunteers at several local museums in Toronto, Ontario. Jon Krohmer, MD Dr. Krohmer served as the director of the NHTSA Office of EMS before his retirement in November 2021. During his tenure as director, Dr. Krohmer oversaw several milestones for the profession, including the creation of EMS Agenda 2050; major revisions to the National EMS Scope of Practice Model and the National EMS Education Standards; and improvements in the collection and use of EMS data through the expansion of the National EMS Information System. Soon after the onset of the COVID-19 pandemic, Dr. Krohmer was tapped to lead the prehospital/911 team as part of the Federal Healthcare Resilience Task Force. Prior to joining NHTSA, Dr. Krohmer had decades of experience as a local EMS medical director, initially in his home state of Michigan. His EMS career began as an EMT with a volunteer rescue squad. Like many EMS professionals, he was inspired by the television show “Emergency!” and by the emergence of the relatively new field of emergency medicine. He entered medical school at the University of Michigan knowing he wanted to make EMS his career. After becoming involved in EMS at the state and national level, he also served as president of the National Association of EMS Physicians from 1998 to 2000. In 2006, he came to Washington to serve as the first deputy chief medical officer for the Department of Homeland Security Office of Health Affairs and served in several other DHS roles before joining NHTSA in 2016. 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 [email protected] to share ideas, suggestions and feedback.

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. This week, Host Rob Lawrence welcomes back, Alexander Isakov, MD, MPH, professor of emergency medicine at Emory University School of Medicine, executive director of the Emory Office of Critical Event Preparedness and Response (CEPAR), and EMS lead for the National Emerging Special Pathogens Training and Education Center (NETEC). Returning guest, Dr. Isakov provides an update on the current emerging pathogens, diseases, outbreaks and fevers that have featured recently in the news. Candida auris, Marburg virus disease, avian influenza, Nipah virus are discussed as well as recaps on Ebola, COVID-19, polio and seasonal influenza. TOP QUOTES FROM THIS EPISODE “What’s concerning CDC officials and experts is there is a multi-drug resistant strain of Candida auris that is really picking up in their surveillance programs.” “While no one wants to be exposed to a multi-drug-resistant Candida auris, it’s really the ominous compromised patient that’s going to be likely most affected by it, so that means elderly patients or patients that are getting chemotherapy and have some immunosuppression consequence of that or people that are taking immunosuppressant drugs, they are the ones really at greatest risk.” “The likelihood that EMS personnel are going to encounter somebody with Marburg virus disease in the U.S. during routine operations is extremely low, but good to be vigilant about it and identifying that someone might have been exposed, and understanding their travel history, if someone is ill, has a fever or myalgia, GI complaints and has travelled within the last 21 days to equatorial Guinea or Tanzania, then it would raise suspicion.” ADDITIONAL RESOURCES ON THIS TOPIC CDC: Infection prevention and control for Candida auris CDC: Information for infection preventionists NETEC: Situation report: Marburg cases rise in equatorial Guinea and Tanzania NETEC: EMS guidelines for Marburg virus disease ABOUT OUR GUEST Alexander Isakov, MD, MPH, is a professor of emergency medicine at Emory University School of Medicine. He is certified by the American Board of Emergency Medicine in both emergency medicine and emergency medical services (EMS). Dr. Isakov is the director of the Section of Prehospital and Disaster Medicine whose faculty provides medical oversight for 911 communications centers, and ground and air EMS responders in metropolitan Atlanta. He is also the executive director of the Emory Office of Critical Event Preparedness and Response (CEPAR), which serves as the center for Emory enterprise-wide planning for and coordinated response to catastrophic events. Dr. Isakov has provided leadership in emergency medical services and disaster preparedness locally and nationally. He serves as the medical director for the Sandy Springs Fire Department and Air Life Georgia. He is the founding medical director for the Emory-Grady EMS Biosafety Transport Program. He is the EMS lead for the National Emerging Special Pathogens Training and Education Center (NETEC) and is a designated Subject Matter Expert for the Assistant Secretary for Preparedness and Response, Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE). Dr. Isakov is also on the American College of Emergency Physicians Epidemic Expert Panel and is a member of the EMS sub-board for the American Board of Emergency Medicine. He previously served on the National Association of EMS Physicians board of directors and the Technical Expert Panel for NHTSA’s EMS Agenda 2050. Dr. Isakov has an MD from the University of Pittsburgh and an MPH from Boston University. He completed his emergency medicine residency training at the University of Massachusetts Medical Center and his EMS fellowship with Boston EMS. Dr. Isakov has lived and worked in Atlanta for 20 years. He practices clinically in the emergency department of Emory University Hospital. 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 [email protected] to share ideas, suggestions and feedback.

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. Russ Myers, Nikki Holm and Gwen Powell are chaplains at Allina Health Emergency Medical Services and in this episode, they join Rob Lawrence to discuss the role of chaplaincy in EMS. The guests discuss their role and responsibilities as well as the book, “Because We Care: A Handbook for Chaplaincy in Emergency Medical Services,” written by Russ Myers. Over the past half century, the field of chaplaincy has come to a fork in the road. Many will recognize the well-traveled path of traditional chaplaincy. Others will follow the newer but clearly marked way to professional chaplaincy: a clinically trained, evidence-based discipline, reflecting and serving the diverse expressions of spirituality in modern society. Until now, chaplaincy in EMS has been the terra incognita, the unknown land on the map. Drawing on three decades of clinical chaplaincy practice, scholarship and original research, Russell Myers charts the map, making the case for ambulance service chaplaincy: how to think about it and how to do it. TOP QUOTES FROM THIS EPISODE “For me it’s all about love, how can I bring some light, some life, some love into the world, and I am able to do that in these situations by just showing up as we call in chaplaincy – the ministry of presence.” —Gwen Powell “I do this work is to come alongside people and remind them of their humanity to help them break down their defenses and their shields to get back to the truth of who they are, to help them be seen and heard and taken care of.” —Nikki Holm EPISODE CONTENTS 1:23 – Introduction Russ Myers 2:43 – Introduction Nikki Holm 4:00 – Introduction Gwen 7:35 – Book discussion: Because We Care – The Role of the Chaplaincy in Emergency Services 11:20 – Terra Incognita 12:30 – What motivates a chaplain? 15:30 – A chaplaincy intervention story 20:15 – A chaplain’s workload 23:00 – Being Proactive: Establishing a trusting relationship with the workforce 23:30 – Being Reactive: when an incident or issue occurs 30:15 – Education and being a presence during training 34:58 – If you are thinking about introducing g a chaplain 36:30 – Moral Injury and the social contract 40:40 – Overcoming the staff stigma about coming forward 42:00 – Close ADDITIONAL RESOURCES ON THIS TOPIC “Because We Care: A Handbook for Chaplaincy in Emergency Medical Services” When EMS meets hospice. End-of-life care takes a heavy emotional toll: Seek support when needed ABOUT OUR GUESTS Russell Myers serves as a chaplain for Allina Health Emergency Medical Services, based in Minneapolis. He holds a BA from Ohio State University and a Doctor of Ministry degree from Luther Seminary, St. Paul, Minnesota. Russ is ordained by the Evangelical Lutheran Church in America and is board certified with the Association of Professional Chaplains. He lives in Saint Paul, Minnesota. Gwen Powell is an ordained episcopal priest and board-certified professional chaplain who has been working with Allina EMS since 2020. Prior to working for Allina, she provided spiritual care to patients and staff on the adolescent behavioral health units at the M Health Fairview University of Minnesota Medical Center. Gwen graduated from Valparaiso University with a degree in psychology in 2008 and earned her Master of Science in Psychology from Kansas State University in 2010. She earned her Master of Divinity from Luther Seminary in St. Paul, MN in 2014 and has been passionate about mental health chaplaincy since beginning her ministry work in 2015. In her free time, she likes to beat her husband and kids at Mario Kart, exercise, walk/hike with her family, watch baseball, and sing with the Northern Lights Chorale. Nikki Holm has been engaged in the meaningful work of EMS Chaplaincy through Allina Health since the Spring of 2020. Prior to making the transition to EMS, Nikki provided spiritual care and health education in an outpatient mental health setting for several years. Nikki was board certified with the Board of Chaplaincy Certification Inc. in 2017, graduated with a Master’s degree in Spirituality from St. John’s School of Theology in 2007 and with a Bachelor’s degree in Theology from The College of St. Benedict in 2005. Nikki lives in an earth home with her husband, their three beloved children, and three furry companions. Outside of soaking up life with her littles, Nikki enjoys rock climbing, writing, reading, yoga, gardening, and otherwise spending time with her tribe. Contact Nikki at [email protected]. RATE AND REVIEW THE EMS ONESTOP PODCAST Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.

This special episode of EMS One-Stop is part of 2023 First Responder Wellness Week. Do you want to improve your physical fitness, increase your resiliency, eat better and sleep longer? Get started with videos, articles and other resources at www.firstresponderwellnessweek.com. You can also learn more about what Lexipol is doing to support health, wellness and safety among first responders. In this special First Responder Wellness Week episode of EMS One-Stop, Host Rob Lawrence welcomes Mike Taigman and Kevin Pannell to discuss the many facets of wellness, why wellness is essential for first responders, and easy tips for getting started to improve fitness, nutrition, stress management and more. Memorable quotes “The work we do involves your cognitive abilities to think well and sort out challenging situations for patients and calls and circumstances. You’ve got to lift people and move them and those kinds of things, so there’s a whole physical component, and the stress management is absolutely part of the wellness, and if you don’t kind of have a handle on that, there’s a lot of stresses this world presents to you – and poorly managed stress, we know, tears down your physical, psychological and emotional wellness.” —Mike Taigman “If you’re in EMS or fire and you can’t carry the med box in one hand and the defibrillator in another up two flights of steps and you’re gassed and you can’t work when you get there, then you’re useless. And, for police, if you can’t wrestle with somebody because you’re exhausted in 30 seconds, it’s a problem.” —Kevin Pannell Together, they offer tips like: Pay attention to your plant-to-processed food ratio Start with pushups. You don’t need all the equipment they have at the CrossFit Games, Pannell notes. “You can get a smokin’ workout from just you and the ground.” Or take a walk. Take a holistic approach to fitness (weightlifting, something that makes you breathe hard and stretching); it’s about balance About our guests Mike Taigman uses more than four decades of experience to help EMS leaders and field personnel improve the care/service they provide to patients and their communities. Mike is the Improvement Guide for FirstWatch, a company which provides near-real time monitoring and analysis of data along with performance improvement coaching for EMS agencies. He teaches Improvement Science in the Master’s in Healthcare Administration and Interprofessional Leadership at the University of California San Francisco and the Emergency Health Services Management Graduate Program at the University of Maryland Baltimore County. Kevin Pannell works in program and project management in the healthcare IT space. He has previous experience as a public safety and military veteran, and produces wellness content. Resources mentioned in this episode Pannell5 Fitness Club KEV Talks Podcast Kevin Pannell on Twitter @pannellkg “Undo It!: How Simple Lifestyle Changes Can Reverse Most Chronic Diseases” by Dean Ornish, MD; and Anne Ornish “How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease” by Michael Greger, MD, FACLM; and Gene Stone

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. In this EMS One-Stop international edition, this month, Rob Lawrence talks with Professor Tony Walker, immediate past chief executive officer of Ambulance Victoria, a professor with the Faculty of Medicine, Nursing and Health Sciences and Bachelor Paramedic Studies at Monash University. While in charge of Ambulance Victoria, Tony led significant transformation to improve the health and well-being of their workforce and the response they provide to the community. In this broad-reaching discussion, Tony explains the structure, organization and funding models of EMS down under and then Rob and Tony identify current challenges, issues and solutions common to both the U.S. and Australia, including the dreaded hospital handover challenges as well as reduction in lights and siren responses. TOP QUOTES FROM THIS EPISODE “We know at least one in five people who call triple zero, our 911 equivalent, don’t require an emergency ambulance and so new models of care are being developed.” “When people call triple zero, they no longer expect that they will automatically get an ambulance, as often described to people, you don’t walk into a hospital triage and say I’d like you to admit me to the coronary care unit,, you get triaged, you work out what is wrong by a health professional and you get the care you need; that’s exactly the same being applied in the paradigm of ambulance service delivery here in Victoria and the rest of Australia.” “In the next decade or so, I wouldn’t be surprised if we see predominantly women making up the majority of staff working on frontline ambulances.” “New models of care have been developed. We have looked at the MPDS grid and where the disposition of those patients go to so we have reduced significantly the number of lights and sirens responses which has enabled us.” “Issues of transfer of care in hospital are a real challenge for ambulance services in the time it takes to transfer patients and there is no easy fix for that.” “If you are a paramedic who has gone to university, done your training, wants to deliver care and you are spending a significant proportion of your shift in an emergency department caring for your patient before he can offload it, that can be demoralizing and that probably goes against why you joined in the first place.” EPISODE CONTENTS 1:16 Introducing Tony Walker 2:00 The scale and scope of Australian Services 05:45 Healthcare funding – how does the patient get their healthcare 7:45 EMS system organization and deployment 09:15 Degrees and paramedic education 11:50 Student debt … or not! 14:10 Is Australia over-producing graduate medics? 16:40 Alternative treatment models 19:00 Reducing lights and siren responses 21:08 Public expectation education 23:02 Looking after your people 25:50 Handover delay at the ED – a global issue 27:00 Gender and diversity 27:34 Scheduling and rostering – creating a flexible roster that meets the needs of the individual and service 28:40 Hospital capacity and flow issues 31:08 How can you work in Australia? ADDITIONAL RESOURCES Additional EMS One-Stop podcast solutions to EMS staffing woes from down under: Australia EMS medics join the podcast to discuss their efforts to fill U.S. positions with their paramedic surplus On-Demand webinar: Ambulances held hostage: Strategies to unilaterally reduce ED wait times and get back into service Ambulances held hostage: EMS strategies for reducing ambulance offload times ABOUT OUR GUEST Professor Tony Walker, ASM, is a registered paramedic with over 36 years’ experience working across senior clinical, operational and leadership roles within the ambulance sector. He was previously chief executive officer of Ambulance Victoria, where he led significant transformation to improve the health and well-being of their workforce and the response they provide to the community. Tony is a Fellow of the Australasian College of Paramedicine and holds a Bachelor of Paramedic Studies, Graduate Certificate of Applied Management, Graduate Diploma of Emergency Health (MICA) and Master of Education. He is a non-executive director of the Prostate Cancer Foundation of Australia, the Emergency Services Foundation and TLC for Kids, a Director of Fairhaven Consulting Pty. Ltd., and an executive member of the Global Resuscitation Alliance and an Associate Investigator with the Australian Resuscitation Outcomes Consortium. He is a past non-executive director and chair of the Council of Ambulance Authorities (CAA), the peak body representing the eleven statutory ambulance services across Australia, New Zealand and Papua New Guinea, past chair of the Australian Resuscitation Council (Victorian branch) and past deputy convenor of the Australian Resuscitation Council ALS sub-committee. Tony is published in

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. Like many other states across the U.S., California’s ambulance services are both understaffed and underfunded. In what has turned into a vicious circle, poor reimbursement levels hamper the employer’s ability to increase pay and compete with other sectors that offer better hourly rates for less risky or skilled employment. In fact, California has not had an increase in its Medi-cal (Medicaid) rate in 20 years. In this podcast, Host Rob Lawrence doesn’t talk about the EMTs on the truck – he talks to the EMTs on the truck. He gets their views on what keeps them on the job and what is driving them away. As Rob notes, “In talking to this amazing cohort of EMTs, it is clear that the passion to serve and care for those they treat is there, but the living wage they receive is not!” Recurring themes emerge from the discussions (which are reflected in various EMS industry surveys): Having a good and receptive boss/leader Camaraderie – good coworkers make the day fly by Training – keeping skills up to date. The ability to do the job; respond; if necessary, transport; hand over and repeat! … not delay About the guests Alyssa Catalan – EMT with Shoreline Ambulance based in Orange County California Doricela Mozo – EMT with. Medic 1 Ambulance based in Irwindale CA Tyler Coombes – EMT with PRN Ambulance based on North Hills California Ryan Walters – EMT with Falck Ambulance based in Orange County Lasalle Jones – EMT with AmbuServe Ambulance based on Gardena California Damian Henriquez - EMT with AmbuServe based in Gardena California Top quotes from this episode “We do have patients’ lives in our hands, and unfortunately, the pay does not reflect that whatsoever, so a lot of us are working two other jobs, like myself, I work here and I have another job and I have the most overtime than anyone else in the company and I still don’t have enough to pay my bills.” — Damien Henriquez “I have to work twice as much as a normal worker would have to to afford to live, and that’s one of the reasons why I’ve amassed about 40,000 work hours, I have a 20-year career but I’ve only been here 14 years.” — Ryan Walters “One of the great things about EMS – coming to work and not knowing what type of call you are going to get, whether it’s interfacility transport, 911, just never knowing what kind of call am I going to get, sometimes you get really cool calls, sometimes you get calls that are very difficult, but after the call, just knowing that you accomplished it and what it took to accomplish is really rewarding.” — Lasalle Jones “Do you realize EMS as a whole is a bubble that’s about ready to pop? Do you want to be proactive or reactive? Do you want to get ahead of it before it bursts or do you want to figure it out after? Right here, right now, we are trying to be proactive so everyone can get a living wage.” — Damien Henriquez Episode contents 01:25 – Meet the panel 02:56 – The view of the new EMTs 04:55 – Time served EMTs 07:17 – How can we help you make a living? 10:22 – What’s keeps you motivated and on the truck 13:56 – What is the FTO seeing as people come in? 21:40 – If you had a rider down the escalator with an elected official, what would you say to them? 25:54 – Get involved 26:24 – Final thoughts Additional resources on this topic California’s Fund First Responders Website California Ambulance Association 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 [email protected] to share ideas, suggestions and feedback.

This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. Like many other states across the U.S., California’s ambulance services are both understaffed and underfunded. In what has turned into a vicious circle, poor reimbursement levels hamper the employers’ ability to increase pay and compete with other sectors that offer better hourly rates for less risky or skilled employment. In fact, California has not had an increase in its Medi-Cal (Medicaid) rate in 20 years. As part of the ongoing legislative campaign, California’s ambulance service owners and operators have created a coalition with all the labor unions that represent EMS in the state to campaign for increases. In this episode of EMS One-Stop, both labor and leadership sit down with Rob Lawrence to discuss politics, funding and working as a team. About our guests Melissa Harris - president and CEO of Ambuserve Ambulance, Medic1 Ambulance and Shoreline Ambulance; and board member and treasurer of the California Ambulance Association Shelly Huddleson - national labor representative for the International Association of EMTs and Paramedics Chad Druten - COO Emergency Ambulance Service based in Brea, California; president of the Los Angeles County Ambulance Association, president of the Ambulance Association of Orange County Ryan Walters - president of IAEP Local 370 representing EMTs and paramedics working at Falck in Orange County and Los Angeles Jim Karras - vice president and chief operating officer of Ambuserve Ambulance, Medic1 Ambulance and Shoreline Ambulance; vice president, Los Angeles County Ambulance Association; and secretary of the Ambulance Association of Orange County Top quotes from this episode “EMTs are one missed shift away from poverty. This is the industry I love. I’ve seen people leave, people that I wish we could hold on to, but they have to provide for their families.” — Ryan Walters “Unlike the In and Outs, the Jack in the Boxes, the Del Tacos who can raise their prices to meet the escalating minimum wage and escalating inflationary pressures that they are feeling, we don’t have the ability to do that. Our rates are set for us by the government and by government payers and they are capped and in some cases, they are fixed, so we are beholden to the State of California to help us and give us some relief.” — Jim Karras “If we don’t do something soon with our Medi-Cal rates, then our EMS system is going to implode, it’s going to implode because our ambulance companies are either going to stop taking these Medi-Cal patients because they can’t afford them and so who is going to take care of them or they are going to start shutting their doors. When they shut their doors, our members lose jobs.” — Shelly Huddleson “The patient is the one that’s most important here, the medical recipient, they are the ones that stand to lose the most and they are the only reason we exist, they are the only reason any of us have jobs and we can’t lose sight of that, so we are not just advocating for our industry, we are advocating for the citizens of California.” — Chad Druten Episode contents 0:30 Rob sets the scene 1:00 Meet the guests 2:05 The campaign to increase reimbursement 3:08 EMTs are one missed shift away from poverty 3:45 Management and labor alliance 6:30 How labor and management can work together on political campaigns 9:00 We share a common humanity 11:00 We as an industry are not good at going hat in hand 13:00 The politicians are astonished at what we pay and that we are losing people to fast-food chains 14:00 Medi-Cal is for the patient to have equal access to healthcare 17:00 This is an economic nightmare 18:30 If you were in an elevator with a politician, what would your pitch be? 21:45 Find your champions – those elected officials that will fight for you 23:00 Acting as a coalition 24:40 Ambulance companies with staffing issues 26:10 Workers deserve a long and dignified career 28:30 The patient is at the center 30:00 A call to action Additional resources on this topic California’s Fund First Responders California Ambulance Association International Association of EMTs and Paramedics 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 [email protected] to share ideas, suggestions and feedback.

This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. In the second EMS One-Stop international edition, Host Rob Lawrence welcomes Steinar Olsen, director for emergency medical services and national preparedness in the Norwegian Directorate of Health. Steiner describes the composition and deployment of EMS services across Norway – a country with the second largest coastline in the world and 1,100 miles from North to South (the distance from Seattle to San Diego or Chicago to Miami). Norway has one government/healthcare run system consisting of 400 stations, 520 ambulances, 4,500 EMTs and paramedics, aided by 14 helicopters and 12 fixed wing aircraft. Educational requirements, current initiatives and future plans are discussed. Lawrence and Steiner also identify that EMS systems around the world encounter similar challenges, and international best practice exchange is always welcomed and encouraged. TOP QUOTES FROM THIS EPISODE “Looking at just response times – you can waste a lot of money that could be used wisely in other parts of the service to create more health.” “Between 25-30% of calls are handled with just a phone call or a combination of phone and video conference with the patient.” “EMS in the next 20 years will develop from just lights and sirens to being an advanced platform for performing healthcare in the patients’ home instead of moving them to the hospital.” EPISODE CONTENTS 1:13: Introduction – Steinar Olsen 2:08: Description of EMS in Norway 4:05: Ambulance stations, helicopters and fixed wing aircraft 6:07: Paramedic training and education 7:17: EMS as a gateway to healthcare 9:38: Norwegian support to international disasters and events (Turkey and Ukraine) 14:00: The next big things for EMS in Norway 16:00: Response times can waste a lot of money 17:35: Hear and treat – Nurse triage 20:00: The need for EMS nations to learn from each other 21:00: The challenge for treating patients in the future 23:34: The relationship between fire and EMS in Norway 24:50 : Vehicle extrication – Norwegian style! 26:15: Steiner Olsen’s final thoughts 27:10: Contact details ABOUT OUR GUEST Steinar Olsen is a RN and paramedic with 38 years of clinical and high-level management background from EMS and specialized healthcare services. He now serves as the director for emergency medical services and national preparedness in the Norwegian Directorate of Health. Steinar is also the regional chair of the European Regional Group for EMTs and national focal point to NATO joint Civil Military Health group. His previous experiences include serving in various positions in national healthcare, ranging from field disaster management to hospital management, project management through various national and international projects, including heading Norway’s contribution to Sierra Leone during the Ebola outbreak in 2014/15 and followed by various deployments to international humanitarian and consular crises. ADDITIONAL RESOURCES ON THIS TOPIC Patient Quick Release Extrication Paper Norwegian Telemedicine and Nurse Triage Video (in Norwegian) CONNECT WITH STEINAR OLSEN Linkedin 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 [email protected] to share ideas, suggestions and feedback.

This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. In this episode of EMS One-Stop, host Rob Lawrence welcomes Matt Zavadsky back to the podcast to catch up on three key ongoing issues and developments: MedStar’s EMS-on-demand model via their MedStarSaver+PLUS program, the recent article by Zavadsky and Dr. Doug Kupas on the reduction of red lights and sirens with the additional news that MedStar ceased all RLS use during the recent ice-related weather event. Finally, Zavadsky discusses the recent National Association of Emergency Medical Technicians’ 2022 EMS Worker Engagement Survey and the top five takeaways. Top quotes from this episode “One of the mantras we have always said is if someone is going to get paid to reduce our call volume, it should be us.” “We take an oath to do no further harm, if we know that we are doing something that causes further harm while we are getting to a call that probably doesn’t need an immediate response, then we are not fulfilling our oath.” “Our medical director has implemented a directive in the same theme of bad weather, bad driving that no patient will be transported with CPR in progress, meaning that you are just not going to transport patients in cardiac arrest … there is no reason for us to relocate corpses from the field to the emergency room.” “Community expectation ... is it really what the community expects or is it something we have taught them to expect because we are competing for contracts?” Episode contents 1:52 MedStar Saver Plus Model 11:37 NAEMSP2023 discussion 13:15 Red lights and sirens reduction 15:11 MedStar suspends RLS 19:07 Political navigation to reduce use of RLS with local officials 23:06 We stink at communicating effectively with our workforce 23:45 We stink at providing feedback to our employees about their performance (and their patients) 24:59 We don’t pay our people enough 26:21 California’s Medi-Cal Campaign 29:10 Work-life balance is a real thing 32:13 This is a long-term challenge that needs long-term solutions 34:33 Zavadsky’s final thoughts 34:44 Drs. Larmon, Kazan and Mackey Additional resources EMS-on-demand the next big transformation for the profession? Culture shift: Reducing lights and siren vehicle operation The EMS workforce: Critical condition! About our guest Matt Zavadsky is the chief transformation officer for MedStar Mobile Healthcare, the Public Utility Model EMS system serving Fort Worth, and 14 other cities in Texas. He has 43 years of experience in EMS. He is an at-large director for NAEMT and chairs its EMS Economics Committee. Connect with Matt Zavadsky Online Linkedin Twitter: @MattZavadsky 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 [email protected] to share ideas, suggestions and feedback.

This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. In a recent blog post, Dave Williams, PhD, noted that half to two-thirds of Dallas city general funds are dedicated to police, fire and EMS. With significant tax dollar investments, elected officials, community leaders, and the media want to be good stewards. Still, they are frequently not equipped with the knowledge or data to determine if their services are built to get results and where there are opportunities for improvement. In this week’s podcast, host Rob Lawrence sat down with EMS thought leader, Dr. Dave Williams, to discuss and identify the 12 questions local leaders can use to learn about their communities. Each point discussed should generate ideas for more learning and improvement both inside an organization and for those citizens and elected officials that surround it. Top quotes from this episode “I have been to dozens of ambulance systems around the world and met with leaderships teams and I can count on one hand the number of times they started by talking to me about their clinical outcomes.” “Almost all of your staff are not your generation … which means they have a totally different value system and a totally different prioritization of things.” “One of your real powers is to be able to help your community and its leaders understand what’s happening in it. The data that you have is a huge enabler for others to be able to change policy.” Additional resources on this topic Williams’ Blog To Err is Human: Building a Safer Health System The EMS workforce: Critical condition! Why right-sizing EMS response is crucial to increasing pay and improving work-life balance Crossing the Quality Chasm: A New Health System for the 21st Century About our guest Dave Williams, PHD, designs and improves ambulance systems. He is known for leading objective, ethical and collegial approaches focused on patient and community needs, and incorporating evidence-based and best practice methods. He is one of a few researchers to study EMS system design. His published doctoral research focused on patient-centric EMS system design. Dr. Williams is a former paramedic, EMS commander and researcher. Previous leadership positions include the Institute for Healthcare Improvement, Fitch & Associates, and Austin-Travis County EMS. Dr. Williams is faculty at the Institute for Healthcare Improvement and serves as a senior improvement advisor. He served as faculty in emergency health services at The George Washington University School of Medicine and public safety management at St. Edward’s University. He supported professional development programs, including the National Association of EMS Physicians Quality and Safety program, the American Ambulance Association Ambulance Service Manager Program, and the National Academies of Emergency Dispatch Communication Center Manager Program. Dr. Williams served as the vice chairman of the Board of CommUnityCare, the Federally Qualified Health Center system serving the City of Austin, Texas, and was appointed by the Travis County Commissioners Court to serve as a member of the Advisory Board of Austin/Travis County EMS. He is an alumni of Leadership Austin (Essential 2013). He has contributed to several EMS leadership and research textbooks and published dozens of peer-reviewed papers and industry articles. He is a frequent keynote speaker. Dr. Williams earned a B.S. in EMS Management and an M.S. in Emergency Health Services Management. He also earned a Ph.D. in Organizational Systems, where his research focused on the obstacles to patient-centric EMS system design. Connect with Dave Williams Online Twitter @davewilliamsATX 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 [email protected] to share ideas, suggestions and feedback. Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. In this episode of EMS One-Stop, our host, Rob Lawrence, kicks off a series on international EMS, interviewing EMS leaders across the globe on how their systems are operated, the challenges they face and the successes they have had. Rob begins his podcast journey with Rwanda, a country and EMS system close to his heart. Rob has advised the Rwandan EMS system and monitored their progress for many years. In this episode, he welcomes Rwandan EMS Leader Jean Marie Uwitonze from the Rwandan Ministry of Health, Division of EMS; and U.S. Trauma Surgeon Dr. Sudha Jayaraman, director of the Center for Global Surgery at the University of Utah. Rwanda is one of the only countries in Sub-Saharan Africa to have a publicly run, national ambulance service, which was established in 2007. Uwitonze highlights the development of EMS, and training and certification levels in Rwanda, as well as the next major project to develop and enhance emergency communications across the country. Dr. Jayaraman describes her involvement (for over a decade) in the development of EMS in the country and notes, “We all know that there is no point in having a wonderfully qualified surgeon in the hospital if there is no means to get the patient there.”

The founders of the Women in Emergency Services association discuss their mission This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. In this episode, Rob Lawrence chats with the founding advisors of the new EMS association – Women in Emergency Services (WiES): Amy Gnojek, CPA, MPA, CACO, founder/principal consultant, Apex360 Michelle Anderson, BA, director of administration at Lakes Region EMS Maria Bianchi, chief executive of the American Ambulance Association The guests discuss the formation of WiES and its aims, mission and four pillars: Empowerment Networking Mentorship Education They also discuss how they hope to influence and impact the lives of thousands of women working in the emergency services industry. Bianchi and Anderson also discuss their roles in current legislation and the upcoming Cost Collection survey as well as the AAA Vanguards Awards, which will honor those who blazed the trail for fellow female EMS professionals. The Vanguards will be presented in collaboration with Women in Emergency Services.

This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. Host Rob Lawrence welcomes guest Scott Moore, Esq., owner of Moore EMS Consulting, LLC and an active EMT for over 30 years to discuss the fourth annual survey of employee turnover in the EMS industry prepared and authored by the American Ambulance Association; Newton 360; Doverspike Consulting; and Rosanna Miguel, PhD. The survey presents turnover data from 119 EMS organizations, representing more than 12,000 employees. Up for discussion: how turnover rates have changed, the cost of replacing an EMT or paramedic and how turnover rates are increasing in part-time providers. Moore also shares one thing that has not changed in the 4 years of the AAA turnover survey: the dissatisfaction with pay and benefits. Moore has held various executive positions, including chief executive officer, vice president, director of human resources and operations, at several ambulance services in Massachusetts. He is a licensed attorney, specializing in human resources, employment law, reimbursement, and compliance matters. Moore is the human resources and operational consultant to the American Ambulance Association and frequently lectures at EMS conferences.

This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. New York City Mayor Eric Adams recently announced a directive for police and emergency medical workers to hospitalize people on the streets and subways who have severe, untreated mental illness. Adams said the directive was an effort to curb a recent wave of crimes involving people experiencing homelessness and will allow law enforcement and EMS to involuntarily hospitalize people who pose a danger to themselves, even if they don't pose a risk to others. The directive, which has been met with major concern – as voiced in a New York Times op-ed by an FDNY Paramedic Lieutenant, is fraught with concerns in the burden being placed on EMS to solve the mental health crisis. In this episode of EMS One-Stop, Doug Wolfberg, EMS attorney and founding partner of Page, Wolfberg & Wirth, LLC, joins host Rob Lawrence to discuss how the directive is a departure from the usual mental health standard. “The Mayor’s office is using a very aggressive and untested interpretation of the state mental health law to essentially deputize EMS clinicians to involuntarily remove anyone who is mentally ill and unable to meet their own basic needs,” Wolfberg notes.

This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. Following the invasion of Ukraine by Russia on February 24, 2022, Christopher Manson, vice president of government relations in the Illinois-based OSF Healthcare System, came up with the idea of sending American ambulances full of supplies to Ukraine. After reaching out to the Government in Kyiv and the Ukrainian Consulate in Chicago, and connecting with others working to send aid to Ukraine, on March 29, 2022, the first ambulance full of medical supplies and equipment left for Ukraine on a 747-800 aircraft. Since then, five additional shipments of ambulances have traveled from the United States to Ukraine via aircraft and ship for a current total of 18 ambulances and tons of medical supplies. In this episode of EMS One-Stop, Host Rob Lawrence welcomes Christopher Manson and discusses the challenges, logistics and successes of the program, and also Mark Tenia, media manager for the Richmond (Virginia) Ambulance Authority, who highlights their recent donation of an ambulance for Ukraine and the process for gaining clearance for the donation.

This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. Fresh back from Montana’s Big Sky EMS Symposium, in this episode of EMS One-Stop, Host Rob Lawrence chats with Kris Kaull on his history-taking session. They discuss Kaull’s 10 top hacks to improve your history taking, including: Thinking like a detective Thinking outside the box Understanding medical medicine Being a good listener Kaull has driven innovation and positive change in EMS for over 25 years. After beginning his career as a firefighter and EMT, he started paramedic.com and co-founded EMS1. He is currently the chief marketing officer at Pulsara, a healthcare and mobile tech startup. He has worked as a firefighter captain, paramedic and ambulance service director, and continues his practice as a critical care flight paramedic covering southwest rural MT and Yellowstone National Park. Kaull has shared his presentation and notes here.

This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. Dr. Ray Barishansky has recently delivered keynote addresses at a number of national and state conferences to much acclaim. In this week’s episode of EMS One-Stop, Host Rob Lawrence discusses Barishansky’s key takeaways on professionalism in EMS and after the break, they move on to writing and speaking in the EMS environment. We conclude with an invitation to those interested in writing for EMS1 to reach out.

This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. This edition of EMS One-Stop looks at diversity, equity and inclusion in U.S. EMS. This episode takes a deep dive into two academic research papers recently published by members of NAEMSP’s Diversity Equity and Inclusion Committee who focus on the delivery of care and how that care may differ based on a patient’s ethnicity and race. Host Rob Lawrence welcomes: Anjni Joiner, assistant professor of emergency medicine at Duke University School of Medicine, and medical director for Durham County EMS Ameera Haamid, assistant professor of emergency medicine at the University of Chicago and associate medical director for Chicago South EMS Andra Farcas, emergency physician at the University of Colorado - Anschutz Medical Campus Jordan Rudman, emergency medicine resident at the Harvard Emergency Medical Residency at the Beth Israel Deaconess Medical Center One of the two research papers discussed is now published: Rudman JS, Farcas A, Salazar GA, et al. (2022) Diversity, Equity, and Inclusion in the United States Emergency Medical Services Workforce: A Scoping Review, Prehospital Emergency Care The companion research paper on disparities in care has been peer reviewed and accepted for publication.

This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. Faroukh M. Mehkri is an assistant professor of emergency medicine at the University of Texas SW Medical Center as well as a SWAT physician with the Dallas Police Department. He recently presented a session at the International Association of Police Chiefs Conference in Dallas, “Management of the acutely agitated behavioral health emergency: A patrol nightmare.” In this edition of EMS One-Stop, Host Rob Lawrence chats with Dr. Mehkri about his lecture and his 15-month deep dive into behavioral health emergency patients, their outcomes, the situations surrounding the calls, and both police and EMS interventions. Dr. Mehkri delivers key takeaways for both a police and EMS audience: Words matter, in your documentation and on your body camera Physical restraint kills – so we must minimize this activity Chemical sedation for medication management saves. “Inviting” the medic to “just give them something” is a slippery slope Monitor, monitor, monitor The person is the patient! Read more about treating behavioral emergencies Expert tips for EMS handling of behavioral emergencies Reel Emergency Vodcast: Patient with delirium and agitated behavior 5 keys for responding to excited delirium patients The fourth 911 option: Mental health services Quick Take: 988 and the future of crisis response

This episode of EMS One-Stop with Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. In this edition of EMS One-Stop, Host Rob Lawrence welcomes Dr. Alex Isakov, executive director of Emory’s Office of Critical Event Preparedness and Response (CEPAR) and professor of emergency medicine at Emory University School of Medicine. Dr. Isakov also leads the National Emerging Special Pathogens Training and Education Center (NETEC) EMS workgroup developing education and resources to improve EMS and community disaster resilience. Rob and Dr. Isakov discuss the current Ugandan Ebola outbreak and the implications and risk of spread to the U.S. On September 20, 2022, Uganda announced that it had an outbreak of Ebola virus with the Sudan strain, which has now spread amongst five of its administrative districts. The case and death count, as of October 12, 2022, was 74 total cases (54 confirmed) and 39 deaths (19 confirmed). As a result, the U.S. has issued a Health Advisory Network (HAN) Travel Alert Level 2 and HAN Health Advisory for healthcare workers to be aware of the Ebola outbreak in Uganda, monitor for symptoms consistent with Ebola, and utilize best practices if there are any signs that someone might be experiencing an illness consistent with it. The tactics to identify, isolate, and inform are discussed as well as reminder about PPE requirements. Rob and Dr. Isakov also conduct an additional roundup on the current situation on COVID and Monkeypox. Additional EMS resources CDC: Guidance for Emergency Medical Services and 911 communication centers CDC: Guidance for developing a plan for interfacility transport of persons under investigation or confirmed to have Ebola virus disease in the United States NETEC: EMS Infectious Disease Playbook NETEC: Considerations for safe EMS transport of patients infected with Ebola virus NETEC: Transport and management of patients with confirmed or suspected Ebola virus disease NETEC: Ebola - Knowledge resources for responders NETEC: Regional Transport Ebola Tabletop Exercise Template

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. In this edition of EMS One-Stop, Rob Lawrence welcomes Sean M Kivlehan, MD, MPH; and Kevin Collopy, MHL, FP-C, NRP; to discuss the search for the next big EMS speaker as well as the Harvard initiative to provide mass casualty training to Ukraine. EMS World Expo takes place October 10-14 in Orlando and one of the returning sessions this year is “Stand and Deliver,” a presentational opportunity for speakers to audition for their place on the national stage. The program was the brainchild of Kivlehan and Collopy, and participants get their chance to present at a national conference as well as receive coaching and constructive feedback on their sessions. The Stand and Deliver winner then gets the opportunity to present their session at the Expo general session at the end of the week. The guests also discuss the Harvard Humanitarian initiative focusing on emergency health systems in conflict and austere environments. When the Ukraine/Russian war escalated, the Harvard group were approached to provide CBRN and mass casualty training throughout Ukraine. About the guests Sean M Kivlehan, MD, MPH, is the director of the Global Emergency Medicine Fellowship at Brigham and Women's Hospital in Boston. He is a practicing emergency medicine physician in the level one trauma and burn center, and core faculty for the Harvard Affiliated Emergency Medicine Residency. He is an assistant professor of emergency medicine at Harvard Medical School; assistant professor of global health and population at the Harvard Chan School of Public Health; and faculty at the Harvard Humanitarian Initiative. He has worked as a consultant for the World Health Organization's Emergency, Trauma and Acute Care Program and was a New York City paramedic and instructor coordinator for 10 years. Kevin Collopy, MHL, FP-C, NRP, CMTE, is the clinical outcomes and compliance manager for Novant Health AirLink/VitaLink where he oversees the program's research, education, risk management, quality management and reimbursement programs. He regularly speaks across the United States and has taught emergency and wilderness medicine on three continents. He's an author of over 200 articles and book chapters, including 18 peer-reviewed research abstracts and papers. In addition, he serves on several national and international advisory boards, teaches the paramedic program at Cape Fear Community College and is currently overseeing multiple clinical trials. He also maintains his LEAN Healthcare Blackbelt certification, has a master’s in healthcare leadership, and is known for developing and innovating quality management solutions in prehospital care systems.

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. “Honorable but broken” is an emotionally compelling documentary from seasoned network news producers Bryony Gilbey and Rich Diefenbach that highlights the realities of working in EMS. The documentary calls attention to the inexcusable underfunding of our first responders and the subsequent collapse of the system. The story told by Gilbey and Diefenbach truly sums up the precipitous state of EMS. In this edition of EMS One-Stop, Rob Lawrence welcomes Bryony Gilbey and returning guest Matt Zavadsky to discuss the documentary, its planned development into a full-length production, exciting sponsorship news and commentary on the issues raised by NAEMT board members that appeared in the film. The discussion and documentary advocate for funding and political change to the current status quo, but as Gilbey asks, “what is life worth to an elected official?”

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. On Sept. 12, 2022, American Medical Response announced it is to close its Los Angeles County non-emergency operations over the next 180 days. One of the key reasons is one faced by all ambulance operators at this time – insufficient levels of Medicare reimbursement. Against this backdrop, GMR (AMR’s international EMS division) predicts that its Los Angeles division is on course for an operational deficit of over $3.5 million. In this episode of the Inside EMS podcast, Brian Henricksen, California-based regional director for GMR, joins host Rob Lawrence for a frank discussion on the issues in LA and they discuss the fact that this may be the bellwether of things to come across the nation. Rob is also the executive director of the California Ambulance Association and the economics of ambulance service operations in the state are close to his heart. California has not increased its Medi-Cal reimbursement for private ambulance operators since the late 1990s. The current Medi-Cal base rate for private ambulance services sits just above $100, which is far below the cost of providing transport. The State’s Medi-Cal reimbursement rate is one of the lowest in the country, but it also has the highest operational costs for ambulance transports.

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. In this episode of the Inside EMS podcast, Host Rob Lawrence is joined by Alexia Jobson of REMSA Health and Mark Tenia of the Richmond Ambulance Authority. Rob, Mark and Alexia are taking communications on the road this conference season in a number of pre-conference sessions. The team discusses: How to communicate your organization’s message How to make friends of the reporters in your local media market How to pitch a story How to prepare for when things go wrong Rob, Alexia and Mark also discuss the downside of offering “no comment” to a reporter, as well as tips for dealing with live and pre-recorded interviews. Finally, Rob discusses the free training available at the Emergency Management Institute at Emmitsburg, Maryland. Read next: 5 best practices for media appearances by EMS chiefs and field personnel