EMS One-Stop

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