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EMS Today

EMS Today

108 episodes — Page 1 of 3

Prehospital POCUS Is Transforming EMS Care

May 14, 202633 min

Practical Lessons Learned About Ventilation and Cardiac Arrest

May 11, 202653 min

From Paramedic to Physician

May 7, 202658 min

Rethinking Sleep and Resilience in the Fire Service

May 4, 202658 min

Hands-Free Hemorrhage Control

Apr 30, 202623 min

Building Resilience for First Responders

Apr 27, 20261h 0m

From Non‑Transport Care to AI‑Enabled Territorial Medicine

Apr 16, 202641 min

Humility and Hazmat at the Firehouse Table

Apr 13, 202656 min

Ep 534Rethinking Calcium Use in Trauma Resuscitation

JEMS Development Editor Mike Brown sits down with Dr. Stacy Shackelford, a coauthor of a new JAMA Network Open paper, to unpack findings about calcium abnormalities in trauma patients. The authors tracked a cohort of 1,270 trauma patients arriving at three level I trauma centers and found that 22% presented with hypocalcemia and 5% with hypercalcemia. Early mortality varied significantly by calcium status: 11.9% among hypocalcemic patients, 4.3% among eucalcemic patients, and 22.8% among hypercalcemic patients. Although hypercalcemia was less common than hypocalcemia, it was associated with substantially worse early mortality, suggesting the need for further research into the underlying mechanisms.

Apr 9, 202618 min

Ep 533Humanizing Paramedicine

Paramedic, educator and consultant John Todaro joins Eric Chase to trace a 49-year career at the intersection of prehospital care, nursing, and public health. Todaro argues for degree-based education for paramedics, emphasizes soft skills—communication, empathy and cultural awareness—and explains how broader clinical training strengthens judgment and the patient narrative. He examines professional tensions between nursing and EMS, advocates collaborative roles instead of hierarchical oversight, and offers organizational culture and work-life balance strategies to reduce burnout and moral injury. Through a vivid helicopter rescue—holding a young trauma patient’s hand and later being recognized by that child—Todaro shows why human connection matters as much as clinical skill.

Apr 6, 202650 min

Ep 531Building Resilience in Emergency Managers

Jennifer Pearsall joins the Not a-Fib Podcast to share insights from her Naval Postgraduate School thesis on the strengths that can emerge in emergency managers after life‑changing events. We explore her career across local and federal emergency management, the contrasts she encountered along the way, and the experiences that inspired her to create EM Wellness and define its mission. She reflects on her time at the Naval Postgraduate School, and we dive deep into the core findings of her thesis. Our conversation covers the types of transformative events that can lead to post‑traumatic growth, the conditions that make that growth possible, and the personal and organizational factors that either support or hinder it.

Apr 2, 20261h 2m

Ep 532Inside the First Responder Wellness Debate

In this episode of Just a Little Salt, Cody Spaulding talks with Jon Vought, a firefighter and the owner of Rescue 1 CBD, to break down what CBD actually is and why it’s become a serious topic in the fire service. Jon explains the difference between hemp and marijuana, how cannabinoids interact with the body’s endocannabinoid system, and what the research says about CBD’s impact on inflammation, sleep quality, mood, and anxiety. They also get into the biggest concern most firefighters have: drug testing. John shares details from a university-backed study involving the University of Arcadia and the University of Maryland, including how urine samples were tested under strict lab conditions for THC.

Mar 30, 202659 min

Ep 530Pushing the Clinical Edge in Respiratory Care

Respiratory crises in the field rarely fit textbook categories. JEMS Development Editor Mike Brown talks with Hamilton Medical’s Jesse Carroll to separate Type 1 (hypoxemic) from Type 2 (hypercapnic) respiratory failure and recognize the mixed presentations clinicians actually see. They walk through practical cues (SpO2 trends vs end‑tidal CO2), common causes (CHF, COPD, obesity, neuromuscular weakness), and epidemiology: roughly 360,000 prehospital respiratory calls annually with 41% involving COPD and obesity rates rising from 32% to about 60% since 1988. Jesse explains why pressure, flow and volume, not oxygen alone, drive meaningful physiologic change, how device limitations (disposable CPAP, pneumatic and turbine systems) affect flow delivery, and when early noninvasive strategies can buy time or prevent intubation.

Mar 26, 202658 min

Ep 529Get Resus Ready

JEMS Development Editor Mike Brown sits down with Jonathan Epstein, who leads the American Red Cross healthcare product management team, to unpack the Red Cross’s new Resuscitation Suite. Jonathan explains how the suite reimagines BLS, ALS and pediatric/neonatal resuscitation with EMS-first blended learning, a “practice as you perform” approach that embeds local protocols and integrated cognitive aids, including a digital app with step-by-step algorithms and clinical decision support. They discuss adaptive learning and computer-adaptive testing that shrink classroom time, an upcoming VR pathway that delivers team-based practice and certification, and realistic expectations for AI, dual sequential defibrillation and mechanical CPR. Ventilation, measurement and device design are highlighted as targets for education and engineering solutions.

Mar 23, 202644 min

Ep 528Putting the P Back in CPR

Bob Page of the Manual Ventilation Academy walks through why bag-valve-mask (BVM) ventilation often fails in the field and how measurement and real-time feedback fix it. He outlines the four simultaneous skills rescuers must master—opening and holding an airway, achieving an effective mask seal, delivering the correct tidal volume, and timing breaths—and shows why muscle memory alone isn't enough. In multi-center simulations and device head-to-head tests, blinded providers rarely met guidelines. Once teams used point-of-care feedback, performance climbed above target, even on intubated patients and during pediatric scenarios. Two-person BVMs and brief 30:2 pauses for breaths also improved delivery compared with continuous compressions. If you teach or deliver airway care, this podcast lays out practical techniques, device pitfalls, and why Bob's FDIC International course is a rare chance to train with measured, real‑world simulations and evidence.

Mar 19, 202656 min

Ep 527Trevor Williams on Service, Culture, and Building a Tool That Took Off

Trevor Williams didn’t take a typical path into the fire service. He grew up overseas, living in places like Zaire during the Rwandan genocide and later Haiti during periods of civil unrest. His family’s missionary work with humanitarian organizations exposed him early to crisis, relief work, and the reality of helping people when things fall apart. Years later, that mindset carried straight into a career with the Los Angeles County Fire Department. In this conversation, Williams talks about the long road to getting hired, the culture shifts he’s seeing among newer firefighters, and why mentorship inside the firehouse still matters. He also breaks down how a homemade tool he built for forcing doors eventually turned into a widely used product across departments and industries. The story moves from firehouse camaraderie to small business lessons, covering product design, marketing mistakes, fraud scares, and what it actually takes to turn an idea into something firefighters trust on the job.

Mar 16, 20261h 1m

Ep 526Real-World Wisdom for Medics and Nurses

Flight nurse and creator Nurse Gwenny joins the show to talk frankly about what it really takes to thrive in emergency care when the textbook ends and the hard calls begin. She walks through her path from pre‑med burnout to ER and flight nursing, why traditional courses left her memorizing instead of understanding, and how that frustration drove her to build highly visual, short-form education that actually sticks for busy medics, EMTs, and nurses. Along the way, she shares the cases that still sit with her, the mentors who modeled clinical excellence with zero ego, and concrete ways to protect your mental health in a career built around other people’s worst days.

Mar 2, 20261h 3m

Ep 525Updated HIV Post‑Exposure Guidance for Healthcare Providers

Infection control consultant Katherine West breaks down the latest HIV post-exposure prophylaxis (PEP) guidelines published in mid-2025. Highlighting key changes since the 2013 update, she explains the shift toward less toxic antiretroviral regimens, elimination of routine baseline lab testing for PEP, and new protocols for exposures involving patients with undetectable viral loads. West emphasizes the importance of expert follow-up care, clarifies who is responsible for source patient testing, and underscores the low risk of occupational HIV transmission. She also discusses challenges faced by emergency providers managing exposures outside regular occupational health hours and the role of 24/7 consultation services. The segment covers legal nuances, especially OSHA and state laws regarding HIV testing consent, and reiterates the CDC’s push for routine HIV screening to aid in the national goal of ending the HIV epidemic by 2030.

Feb 23, 202623 min

Ep 524Leadership Lessons from EMS Frontlines

Host Chief Shane Wheeler and Assistant Chief Jon Detweiler dive into the complexities of team conflict and the essential role of trust in leadership. Drawing from his decades-long career, Jon shares firsthand experiences managing difficult conversations, especially transitioning from peer to leader. He highlights why many leaders mistakenly view conflict as failure rather than opportunity, and stresses the importance of emotional awareness, asking thoughtful questions, and fostering psychological safety. Jon also emphasizes the power of modeling behavior and setting clear expectations to maintain respect and accountability within teams. Whether you're a new leader or aspiring to grow, this conversation offers practical strategies for creating a culture where honesty, trust, and collaboration thrive, ultimately aligning teams to achieve shared missions effectively.

Feb 19, 202623 min

Ep 523Navigating Stress, Communication, and Healing in Relationships

In this episode of Just a Little Salt, licensed counselor Kimberly Ingram dives deep into the unique challenges first responders face in their relationships. Drawing on her extensive experience working with law enforcement officers, firefighters, and other public safety professionals, Kimberly sheds light on the impact of shift work, chronic stress, and trauma on emotional connection at home. They discuss common misconceptions about therapy, the critical need for culturally competent mental health support, and how partners can build stronger communication even amid the toughest schedules. Kimberly also explores the delicate balance between a first responder’s identity and personal life, the risks of emotional distancing, and practical advice for couples recovering from infidelity.

Feb 16, 20261h 0m

Ep 522Building Accountability and Strengthening Fire Service Culture

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

Feb 12, 20261h 4m

Ep 521Leadership, Lessons Learned, Wellness, Mental Health, and Saying I Am Sorry

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

Feb 9, 202640 min

Ep 520Balancing Realism, Stress, and Resilience in EMS Simulation Training

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

Feb 5, 202630 min

Ep 519FDNY Chief John Esposito on Leadership, Legacy, and Life at the Firehouse

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

Feb 2, 202659 min

Ep 518Exploring the Future of EMS Reimbursement

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

Jan 29, 202628 min

Ep 517Jimmy Apple’s Human Approach to EMS, Mental Health, and Sepsis Care

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

Jan 26, 202652 min

Ep 516Rethinking CPR in Trauma: Insights from a Groundbreaking Study on Hemorrhagic Shock

By Bram Duffee, PhD, EMT-P For EMS providers who respond to a traumatic cardiac arrest, the instinct to initiate CPR is almost automatic. But could this life-saving intervention inadvertently hinder recovery in cases of severe hemorrhagic shock? A recent study, “Effect of Cardiopulmonary Resuscitation on Perfusion in a Porcine Model of Severe Hemorrhagic Shock,” challenges conventional wisdom and offers new insights that could reshape trauma care protocols. The Study: A Closer Look at CPR in Trauma-Induced PEA The research, led by Dr. Patrick Greiffenstein, professor of clinical surgery at LSU New Orleans and trauma ICU director at the Norman McSwain Spirit of Charity Trauma Center, addresses a critical gap in trauma care. While CPR is a cornerstone of resuscitation in cardiac arrest, its application in trauma-induced pulseless electrical activity (PEA) has not been rigorously validated. Trauma PEA, unlike medical cardiac arrest, is a low-flow state caused by severe blood loss (hypovolemia), where the heart shows electrical activity but fails to generate a palpable pulse. “CPR is a cornerstone of resuscitation and cardiac arrest, but its application in trauma-induced PEA has not really been rigorously evaluated,” explains Dr. Greiffenstein. “Trauma PEA is fundamentally a low-flow state caused by hypovolemia—insufficient blood volume.” The study aimed to determine how CPR affects tissue perfusion—specifically oxygen delivery to the brain and skin—during severe hemorrhagic shock. Using a porcine model, researchers simulated life-threatening blood loss and compared outcomes between two groups: one receiving automated CPR and the other left untreated during the shock phase. Key Findings: When CPR May Do More Harm Than Good The results were both surprising and concerning: No Improvement in Perfusion: CPR did not enhance oxygenation in the brain or skin. In fact, skin perfusion was significantly lower in the CPR group during both the shock and recovery phases. Adverse Hemodynamic Effects: While CPR increased systolic blood pressure (SBP), it significantly reduced diastolic blood pressure (DBP), which is critical for coronary and organ perfusion. Potential Harm: CPR caused a threefold increase in intracranial pressure (ICP), suggesting that chest compressions might disrupt normal blood flow dynamics in the brain. “Knowing now that extreme efforts like lining people up to do CPR can cause turbulence within the system is a significant advancement,” says Dr. Greiffenstein. “It’s possible to have perfusion at these unreadable MAP scores, which is a critical insight for trauma care.” Implications for Trauma Care These findings challenge the one-size-fits-all approach to CPR in cardiac arrest scenarios. In cases of hemorrhagic shock, CPR might: Divert attention from more effective interventions, such as rapid blood transfusion or surgical control of bleeding. Worsen perfusion to vital organs, potentially exacerbating the patient’s condition. “In military cases, field medics often don’t have the opportunity to perform full chest compressions on the battlefield. Sometimes, all they can do is drag a person to a safe position,” notes Dr. Greiffenstein. This study underscores the importance of prioritizing interventions that address the root cause of trauma PEA—severe blood loss—over traditional resuscitation techniques. A Call for Updated Guidelines The American Heart Association’s current guidelines broadly recommend CPR for all pulseless patients. However, this study adds to a growing body of evidence suggesting that trauma-induced PEA requires a different approach. By focusing on restoring blood volume and controlling bleeding, paramedics and EMTs can improve outcomes for patients in hemorrhagic shock. As Dr. Greiffenstein puts it, “This research is a step toward more tailored and effective trauma care protocols. It’s about understanding the unique physiology of trauma and adapting our interventions accordingly.” For EMS providers on the front lines, this study serves as a reminder to critically evaluate the tools and techniques we rely on in emergency care. While CPR remains a vital intervention in many scenarios, its role in trauma-induced PEA warrants careful reconsideration by physician medical directors. By staying informed about the latest research, we can continue to improve outcomes for the patients who depend on us most. Click below to watch the full interview Reference Greiffenstein, P., Cavalea, A., Smith, A., Sharp, T., Warren, O., Dennis, J., Gatterer, M. C., Danos, D., Byrne, T. C., Scarborough, A., Deville, P., & VanMeter, K. (2025). Effect of cardiopulmonary resuscitation on perfusion in a porcine model of severe hemorrhagic shock. The Journal of Trauma and Acute Care Surgery, 98(2), 251–257.

Jan 22, 202635 min

Ep 515Inside EMS: A Paramedic’s Journey through Challenges, Humor, and Healing

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

Jan 19, 202658 min

Ep 514Joanna Sokol’s Raw and Honest Chronicle of EMS Life

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

Jan 15, 202653 min

Ep 513Reliable Infection Control in an Evolving Landscape

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

Jan 12, 202617 min

Ep 512Can AI Revolutionize Paramedic Diagnoses?

EMS Research Podcast Host Bram Duffee dives into a recent study examining ChatGPT’s ability to predict prehospital patient diagnoses based on paramedic care reports. ChatGPT accurately identified conditions 75% of the time and often erred on the side of caution, potentially reducing dangerous under-triage. Duffee is joined by lead researcher Erik Miller, a nurse practitioner and paramedic turned researcher, who sheds light on the study’s design, limitations, and real-world implications. They discuss how AI can support—but not replace—the critical thinking skills of EMS providers, the challenges of legal liability, and the risks of overreliance on technology. The conversation also explores future possibilities for AI integration in dispatch and patient care reporting, while emphasizing the irreplaceable human touch in emergency medicine.

Jan 8, 202634 min

Ep 511Understanding the New Treatment-in-Place Legislation and Its Impact on Mobile Integrated Health

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

Jan 5, 202630 min

Ep 510Research Highlights and Innovations Shaping Our Field

The world of prehospital medicine is constantly evolving, driven by new research, technological advancements, and a shared commitment to improving patient care and provider well-being. As EMS professionals, staying informed about these developments goes beyond a professional obligation; it is an opportunity to improve our practice, champion our profession, and ultimately make a greater impact on saving lives. In this article, we will explore some of the latest research findings that are reshaping our field, from workplace culture to cutting-edge technology. The Culture of Care: Supporting EMS Providers Our work is demanding, both physically and emotionally, and the culture within our agencies plays a critical role in our well-being. A recent systematic review in the International Journal of Environmental Research and Public Health revealed that many EMS providers avoid using organizational mental health services due to stigma and a perception that these programs lack genuine care. The study emphasizes the need for person-centered support and a cultural shift that normalizes seeking help as a sign of strength (Johnston et al., 2025). This cultural component also impacts retention. Another study in the same journal found that agencies with collaborative, team-oriented "clan" cultures had significantly lower turnover rates compared to those with rigid or chaotic structures. For leaders in EMS, fostering a supportive environment is not just about morale. It is a strategic imperative for retaining skilled clinicians (Kamholz et al., 2025). Professional Recognition: Breaking Barriers Across the globe, paramedics are striving for recognition as integrated healthcare professionals. A qualitative study in BMC Health Services Research identified common barriers, including outdated legislation, inconsistent regulation, and insufficient funding. While the pandemic temporarily highlighted our capabilities, the momentum has waned. The study calls for targeted policy reforms and investments in education and leadership to solidify our role in the broader healthcare system (Feerick et al., 2025). Physical Demands and Injury Prevention The physical toll of our work is undeniable. A scoping review in Applied Ergonomics confirmed that musculoskeletal injuries, particularly to the back, are rampant in EMS. Tasks like handling stretchers and patient extractions are among the most strenuous. The review also highlighted fitness disparities, with male paramedics generally showing more strength but less flexibility than their female counterparts. These findings underscore the need for targeted injury prevention programs and realistic physical standards to keep us safe throughout our careers (Marsh et al., 2025). Advancements in Cardiac Arrest Care When it comes to cardiac arrest, every second counts. A study in Resuscitation reinforced the value of bystander CPR, showing that dispatcher-assisted CPR significantly improves outcomes for untrained bystanders. For those with prior CPR training, acting independently yielded even better results. This highlights the importance of public CPR education alongside dispatcher support (Tagami et al., 2025). On the scene, our interventions matter immensely. Research in The Journal of Emergency Medicine found that for traumatic cardiac arrest patients, aggressive interventions like prehospital thoracostomy can be lifesaving (McWilliam et al., 2025). Meanwhile, a study in Critical Care Medicine revealed that extracorporeal CPR (ECPR) significantly improves outcomes for patients with refractory ventricular fibrillation, emphasizing the need for early transport to specialized centers. The Role of Technology in EMS Technology is poised to revolutionize EMS, from dispatch to diagnosis. A study in The American Journal of Emergency Medicine demonstrated that large language models (LLMs) like ChatGPT could prioritize ambulance requests with remarkable accuracy, aligning with expert paramedic decisions over 76 percent of the time. This proof of concept suggests that AI could one day enhance resource allocation in dispatch centers (Shekhar et al., 2025). On the diagnostic front, machine learning is opening new possibilities. For example, a study in Bioengineering showed that analyzing photoplethysmography waveforms could estimate blood loss in trauma patients, offering a non-invasive way to guide resuscitation (Gonzalez et al., 2025). Similarly, research in Medical Engineering & Physics explored using multidimensional data to differentiate ischemic from hemorrhagic strokes in the field, potentially enabling more targeted prehospital care (Alshehri et al., 2025). Addressing Disparities in Care Equity in EMS is a cornerstone of our profession, yet recent studies highlight troubling disparities. Research in JAMA Network Open found that ambulance offload times were significantly longer in communities with higher proportions of Black residents (Zhou et al., 2025). Another study in JAMA Surgery revealed that

Dec 23, 202528 min

Ep 509Navigating Death Notifications and Mental Health in Emergency Services

In this episode of Just Little Salt, Dr. Alexandra Jabr, founder of Emergency Resilience and a licensed paramedic, shines a light on the challenges of delivering death notifications in emergency medical services. Drawing from years on the front lines and her advanced studies in health and depth psychology, Dr. Jabr, a new member of the JEMS Advisory Board, discusses why clear and compassionate communication is crucial and exposes common mistakes that can worsen an already painful moment. Beyond the call, she tackles the emotional toll first responders face—from coping with repeated trauma to battling numbness and isolation—and the importance of mental health support, including the emerging role of ketamine therapy. She also shares personal stories, her injury-induced career pivot, and her passion for education and advocacy.

Dec 22, 202557 min

Ep 508Rethinking Lights and Sirens in Emergency Response

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

Dec 15, 202555 min

Ep 507Facing Mortality and Leading Change

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

Dec 11, 202542 min

Ep 506From EMT to Electric Medic: Inside the High-Energy World of Jack’s EMS Journey and Social Media Rise

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

Dec 8, 202559 min

Ep 505Mastering EMS Leadership: The Power of Intentional Communication

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

Dec 4, 202526 min

Ep 504The 'EMS Avenger' on the 2025 AHA Guidelines

The 2025 AHA Guidelines for CPR and Emergency Cardiovascular Care introduce significant updates, including a focus on on-scene resuscitation, cautious use of mechanical CPR devices, and prioritizing IV over IO access. While these changes aim to improve outcomes, they’ve sparked debate among seasoned paramedics like Jimmy Apple, the “EMS Avenger,” who highlights the challenges of implementation. Key Points: • On-Scene Resuscitation: Emphasis on achieving ROSC on scene rather than rapid transport. • Mechanical CPR Devices: AHA advises against routine use, but paramedics argue they’re essential for small or rural teams. • IV vs. IO Access: IV is prioritized, but practicality for resource-limited teams is questioned. • Empowering EMS Providers: Focus on critical thinking, quality compressions, and timely defibrillation. • Cultural Shift: Training crews for compassionate death notifications and clear family communication.

Dec 1, 202554 min

Ep 502Inside the ER with Nurse Stankk

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

Nov 24, 202544 min

Ep 501The Story Behind Stetta Sleeves and Its Impact on EMS Safety

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

Nov 20, 202523 min

Ep 500Why Resilience Matters for First Responders and Telecommunicators

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

Nov 17, 202557 min

Ep 499Just a Little Salt: A Father and Son Reflect on Life, Laughter, and Lessons from the Firehouse

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

Nov 10, 202548 min

Ep 498Rethinking Epinephrine Use in Traumatic Cardiac Arrest

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

Nov 3, 202525 min

Ep 497Inside Rolling Sixes: A Candid Look at Kalamazoo’s Unique All-in-One Public Safety Team

Rolling Sixes is a groundbreaking six-part documentary series spotlighting the combined police, fire, and EMS crews of Kalamazoo Public Safety—the largest integrated public safety agency in the U.S. Created by Zach Hamelton, a former TV and film producer turned public information officer, the series blends cinematic storytelling with immersive, real-world footage captured via GoPros and cinema cameras. Viewers get rare access to intense emergencies, day-to-day station life, technical rescues, and candid conversations revealing the emotional toll on responders. With a focus on authenticity, the show highlights both heroic moments and routine calls, showcasing the personal bonds and dedication within the crews. It also aims to boost recruitment by letting the community see the people behind the badges. Brought to you by Stetta Sleeves. www.stettasleeves.com

Oct 27, 202552 min

Ep 496The JEMS Report: How a Timid Soul Found Purpose in EMS Service

The JEMS Report: How a Timid Soul Found Purpose in EMS Service Eric Chase sits down with Jeffrey Hammerstein, a retired paramedic with over 40 years of experience in Wake County (NC) EMS. Jeffrey shares his journey from a fearful, shy child to a confident frontline responder who found meaning in offering reassurance and care during life’s most critical moments. He discusses the emotional toll of EMS work, the challenge of balancing professional detachment with genuine human connection, and the importance of vulnerability in healing. Jeffrey also explores the necessity of building transparent relationships with the community and media, emphasizing that EMS is about people first—not just procedures. Brought to you by Stetta Sleeves. www.stettasleeves.com

Oct 20, 202545 min

Ep 495Just a Little Salt: Real Stories, Hard Truths and Humor with Fireman Lance

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

Oct 13, 202546 min

Ep 494JEMS Product Pod: TRAUMAGEL is Revolutionizing Hemorrhage Control

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

Oct 10, 202522 min

Ep 493Not A-Fib: Criminal Liability and Legal Challenges for EMS Providers

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

Oct 6, 202558 min

Ep 492The JEMS Report: Tylenol Use in Pregnancy

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

Sep 30, 202518 min