EMS One-Stop

In this episode of EMS One-Stop, host Rob Lawrence is joined by Dr. Christine Carico and Dr. Matt Levy to discuss the peer-reviewed paper, “Nationwide Trends in Prehospital Blood Product Use After Injury.” The paper, published in “Transfusion” in April 2025, explores the use of blood products in prehospital trauma care.

Despite the proven benefits of blood transfusion in the field, their research uncovers the alarming reality that less than 1% of eligible patients receive prehospital blood products. This conversation dives into the study’s methodology, key findings and the significant barriers EMS systems face in implementing blood transfusion protocols. The discussion also touches on the evolving role of EMS in trauma care, regional variations in blood product access, and the future of prehospital blood transfusion programs.

Dr. Carico and Dr. Levy break down their work and reflect on the data, explaining how the study used National Emergency Medical Services Information System (NEMSIS) data to identify trauma patients who would have benefited from blood transfusions.

The episode delves into the operational challenges EMS systems face in obtaining and administering blood products in the field, the financial and logistical obstacles, and the potential life-saving impact of more widespread adoption of these protocols.

Timeline

00:00 – Intro and welcome: Rob Lawrence introduces Dr. Matt Levy and Dr. Christine Carico, setting up the discussion on prehospital blood product use

03:00 – Study overview: Dr. Carico explains the methodology of the study, focusing on the use of NEMSIS data and the inclusion criteria for the patient population

07:00 – Key findings: Dr. Carico reveals the key findings of the paper, including the low percentage of eligible patients receiving prehospital blood products

11:00 – Barriers to implementation: Dr. Levy discusses the main barriers to the widespread implementation of blood transfusion protocols in the field, including access to blood, logistics and training

17:00 – Regional variations: The speakers touch on the regional disparities in blood product availability and the differences in protocols across the country

23:00 – Data challenges: Dr. Levy and Dr. Carico discuss the challenges related to data accuracy, particularly in terms of blood product documentation

27:00 – Cost and reimbursement: Dr. Levy addresses the financial aspects of blood product programs, including cost, reimbursement challenges and funding opportunities

32:00 – The future of blood transfusion in EMS: Dr. Levy envisions the future of prehospital blood transfusion programs, including the potential for shelf-stable blood products and regional blood supply systems

37:00 – Closing thoughts: Both guests offer their final thoughts on the importance of continued research and data collection, and the need for EMS to embrace a more integrated role in acute care

Additional whole blood resources

What does accountability actually look like in EMS? In this episode of the Inside EMS podcast, cohosts Chris Cebollero and Kelly Grayson get into the gritty details — beyond the management-speak — and outline the 7 pillars of accountability that can make or break an EMS organization. From character and unity, to urgency and evolution, they explore how each pillar builds a culture that supports excellence, trust and growth in the field.

The discussion gets into metrics that actually matter (and no, “we’re doing fine” isn’t a metric), urgency that respects both speed and precision, and how to develop a reputation that earns trust from coworkers and ED staff alike.

Whether you’re in a leadership role or still riding the bench seat, this episode is a masterclass in personal and organizational accountability.

“Integrity is how you behave when no one’s looking.” — Kelly Grayson

“You don’t let anybody dictate your own professionalism.” — Chris Cebollero

“If you can’t measure it, you can’t improve it.” — Kelly Grayson

“Do you want speed or accuracy? I want both.” — Chris Cebollero

“If you're practicing EMS like you did 5 years ago, you're behind the times.” — Kelly Grayson

Enjoying the show? Email us at [email protected] to share ideas or suggest a guest!

In this episode of the EMS One-Stop podcast, host Rob Lawrence is joined by Deputy Director Tracey Loscar from Mat-Su Borough EMS in Alaska. Together, they discuss the looming threat of Mount Spurr, a volcano located 75 miles west of Anchorage, which is currently showing signs of potential eruption.

Loscar provides insights into disaster management and preparedness in a region where EMS operations are stretched across vast, remote territories. The conversation also touches on how to plan for the unexpected, especially in an environment with limited resources and harsh geographical challenges. This episode delves into the logistical challenges faced by EMS in the face of volcanic activity and offers critical lessons in disaster management.

TIMELINE

00:22 – Rob Lawrence welcomes Deputy Director Tracey Loscar and sets the stage for a discussion on disaster management in Alaska

02:10 – Loscar gives a brief overview of Mat-Su Borough and its proximity to Mount Spurr

04:01 –Loscar discusses her transition from Newark, New Jersey, to Mat-Su Borough and the challenges of EMS in rural Alaska

06:00 – Lawrence and Loscar discuss the vast distances and limited resources available in the region

08:01 – Loscar explains the preparations for the potential ash fallout from Mount Spur, including messaging to the community and respiratory protection

10:04 – The conversation shifts to the nature of volcanic ash and the practical challenges it presents to infrastructure, vehicles and personal health

14:36 – Loscar shares lessons learned from previous seismic events, such as the 2018 earthquake, and emphasizes the importance of clear communication during disasters

17:06 – Lawrence and Loscar discuss EMS liaison roles and the need for better coordination between dispatch, EDs and field teams

18:01 – Loscar talks about the current status of the Mount Spur eruption, with no immediate risk but preparations ongoing, and discusses how Alaskans stay calm and prepared in the face of frequent natural events, from earthquakes to volcanic eruptions

20:03 – Loscar highlights the importance of including pets in emergency plans, emphasizing the need for respiratory protection for animals

21:00 – The role of pantyhose in volcano preparedness

RATE AND REVIEW

Enjoying the show? Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.

Guest host Rob Lawrence joins Kelly Grayson to reflect on the recent EMS on the Hill Day. Rob offers a behind-the-scenes look at his experience leading the California delegation and provides insights into how EMS professionals can influence policy on issues like Medicare reimbursement, community paramedicine and workforce development.

Kelly questions whether EMS on the Hill Day efforts actually drive change, while Rob defends the impact of consistent grassroots advocacy. The episode highlights key legislation, including expanded telemedicine and veteran recruitment into EMS, and makes the case for staying politically engaged to secure the future of the profession.

Whether you’re a seasoned advocate or just starting to engage in the political side of EMS, this episode will leave you with a deeper understanding of the stakes — and the power of your voice.

Key quotes

"Our national associations are now hunting as a pack, which is a good thing." — Rob Lawrence

"You can be at the mercy of EMS politics, or you can learn to play EMS politics and affect the outcome." — Kelly Grayson

"All politics is local, and we all have a voice. More importantly, we all have a story." — Rob Lawrence

"Politics is made of people who show up." — Kelly Grayson

Timeline

01:02 – Rob discusses his recent travels and involvement in EMS on the Hill

01:45 – Rob explains what EMS on the Hill is and how it works

03:11 – Rob shares his thoughts on the bipartisan support for EMS legislation

06:05 – Kelly asks about the amount of time spent with legislators

09:02 – Rob highlights his meeting with Representative Eric Swalwell

10:28 – Kelly expresses skepticism about EMS Week and EMS on the Hill

12:10 – Rob responds to Kelly’s skepticism about EMS advocacy

14:00 – Rob discusses key bills on Medicare reimbursement and community paramedicine

16:06 – Rob shares details about the bills being presented this year

20:01 – Rob talks about workforce development and veteran recruitment initiatives

22:01 – Rob and Kelly discuss EMS advocacy and the importance of grassroots involvement

25:36 – Rob explains the EMS caucus and invites listeners to get involved

28:20 – Rob concludes the podcast, urging listeners to advocate for EMS and engage in political processes

Enjoying the show? Email the Inside EMS team at [email protected] to share ideas, suggestions and feedback, or let us know if you’d like to join us as a guest.

In this episode of the Inside EMS Podcast, co-host Kelly Grayson is joined by international guest host Rob Lawrence for a candid and timely conversation on one of the most pressing issues in EMS today: fatigue and its impact on provider safety and wellness.

The discussion begins with a heartbreaking story out of Georgia, where a nurse, after working consecutive night shifts, fell asleep at the wheel, leading to a fatal crash. It’s a tragic reminder of the very real risks that come with long hours, disrupted sleep and chronic fatigue in healthcare—and EMS is no exception.

Kelly and Rob reflect on their own experiences with sleep deprivation, shift work and the toll it takes on performance, decision-making and personal safety. They dive into the need for fatigue management policies, smarter shift scheduling, and how EMS leaders can — and must — prioritize provider health.

Timeline

00:00 - 00:05: Rob introduces himself as the international correspondent for Inside EMS, stepping in for Chris Cebollero.

00:05 - 00:33: Kelly and Rob discuss the swap between Chris and Rob, along with their roles in the EMS community, providing context for the conversation.

00:33 - 03:10: Rob and Kelly discuss the tragic accident in Forsyth County, Georgia, where a nurse fell asleep behind the wheel after a night shift. They reflect on the broader issue of fatigue in healthcare professions.

03:10 - 07:01: Kelly shares his personal experience with fatigue, recounting instances of feeling like a "zombie" after long shifts and the dangers of working extended hours.

07:01 - 10:35: Rob and Kelly dive into the challenges of managing fatigue in EMS, the ongoing debate about shift lengths, and the need for policies to improve rest and working conditions.

10:35 - 12:23: The hosts discuss the importance of leadership in managing fatigue, with Rob emphasizing the need for downtime between shifts.

12:23 - 15:02: Kelly talks about his previous employer's fatigue mitigation policies and how they ensured safety through workload monitoring, proper shift lengths, and adequate pay.

15:02 - 18:00: Rob reflects on his work in California, including meetings with lawmakers to address EMS workforce issues during EMS Week.

18:00 - 23:07: The hosts discuss the systemic issues that contribute to fatigue, including poor wages, long shifts, and the overall working conditions in EMS. They conclude with a call to action for better policies and leadership to ensure the well-being of EMS professionals.

Enjoying the show? Contact the Inside EMS team at [email protected] to share ideas, suggestions and feedback, or let us know if you’d like to join us as a guest.

In this episode of EMS One-Stop, recorded live from the ABC 360 and XI Conference, host Rob Lawrence chats with keynote speaker Catherine Kuhlmann, a firefighter-paramedic with over 26 years of experience.

Kuhlmann discusses the importance of understanding both internal and external customer service in EMS, emphasizing the need for a healthy organizational culture to ensure the best patient care. She reflects on the profound impact that first responders can have on individuals, drawing from her own experiences and personal tragedies to highlight the emotional resilience required in the profession.

Rob also speaks with Page Wolfberg & Wirth’s PWW/AG Principal Doug Wolfberg, long-time EMS lawyer and educator, about lessons learned from working in and around law enforcement during patient care. Wolfberg provides actionable insights into how EMS professionals can better collaborate with police officers, ensuring that patient care remains a priority while navigating complex, high-stress situations.

Together, Kuhlmann and Wolfberg offer invaluable perspectives on fostering better patient advocacy, maintaining professional integrity and refining EMS protocols to adapt to new challenges.

MEMORABLE QUOTES

“How many careers, professions are there that, more often than not, you can make somebody's worst day their best?" — Catherine Kuhlmann

"If you want to know what's going on in your hospital, ask housekeeping. Patients will not remember that you worked your butt off for 45 minutes to restart their heart … but they will remember that you tucked their feet in with a blanket underneath it." — Catherine Kuhlmann

"You have to have a healthy department in order to continue to be healthy. And a lot of times when people think that they have problems with an individual and their agency, sometimes it’s not actually a problem with the individual, it’s with the agency." — Catherine Kuhlmann

"We have a duty to the patient. We're not there to help the police. We're there to advocate and treat the patient." — Doug Wolfberg

"EMS cannot subordinate judgement to law enforcement. If a police officer says give this guy some juice and put him to sleep, we first have to do an assessment and figure out if clinically that's the right thing." — Doug Wolfberg

ADDITIONAL RESOURCES

ABC 360 and XI Conference is Page Wolfberg & Wirth Advisory Group’s all-day workshop for EMS leaders, chiefs, HR managers and compliance professionals.

Vodcast: Lessons from the McClain case: Protecting first responders and improving EMS practices

Balancing care and collaboration: Key lessons from EMS and law enforcement interactions

TIMELINE

00:37 – Catherine Kuhlmann introduces herself, detailing her extensive background in EMS, law enforcement, and as a justice of the peace. Rob then highlights the key themes of Kuhlmann’s keynote speech, which revolves around the importance of understanding the "why" in EMS.

02:16 – Kuhlmann discusses the importance of organizational culture in retaining quality personnel and how many individuals leave — not due to the work itself — but because of the agency's culture. Kuhlmann talks about the personal fulfillment that comes from EMS work, sharing a story about a young girl she saved who later became a doctor.

06:13 – Kuhlmann introduces the concept of "Murphy," a problematic employee in the agency, and suggests that sometimes these individuals may reflect a deeper organizational issue.

08:12 – Kuhlmann emphasizes the importance of communication, advising that EMS leaders should hold honest, one-on-one conversations with problematic staff before resorting to exit interviews.

12:04 – Kuhlmann reflects on the small gestures that have a lasting impact on patients, highlighting how seemingly minor acts of compassion can leave a lasting impression.

14:03 – Rob and Kuhlmann discuss the concept of bedside manner in EMS, stressing the importance of treating patients with dignity and respect. Kuhlmann closes with a powerful message about EMS professionals’ responsibility to treat others’ families with the same care and respect as they would their own.

21:06 – Rob Lawrence introduces Doug Wolfberg, who returns to discuss lessons on collaborating with law enforcement in EMS.

22:05 – Wolfberg explains the need for scenario-based training in chaotic environments to build muscle memory and advocate for patients.

23:11 – Wolfberg discusses the importance of EMS maintaining independent clinical judgment, even when law enforcement may request specific actions.

24:03 – Wolfberg stresses the need for clarity in determining whether a patient is in custody and how this affects EMS protocols.

25:06 – Wolfberg explains the importance of advocacy in EMS, particularly in law enforcement scenarios, and the significance of body camera footage for ensuring accountability.

27:13 – Wolfberg shares the potential consequences for EMS professionals who fail to act empathetically or professionally, especially when caught on body camera.

29:15 – Wolfberg speaks about the future of ABC 360, including their upcoming conferences and certifications.

Previously on EMS One-Stop

NOTE: Be sure to check out the Inside EMS podcast this month where Rob Lawrence will be joining Kelly Grayson as a guest cohost for Chris Cebollero. 

In this episode of the EMS One-Stop podcast, Dr. Dave Williams discusses an exciting new master's-level course designed for EMS and fire leaders, focused on advanced improvement science.

Along with Mike Taigman, Dr. Williams is leading this program, which aims to equip leaders with the tools and methods necessary to achieve results-driven improvement in their EMS systems. Over the course of 12 months, attendees will work on real-world projects, gaining the skills needed to make data-driven decisions and improve patient care outcomes within their organizations.

Dr. Williams also dives into the core concepts of improvement science, including understanding of variation and the importance of creating organizational systems that support sustainable improvements. He shares insights into the curriculum, the significance of benchmarking and how the course will help EMS leaders tackle systemic challenges by applying proven improvement methodologies. This conversation also touches on the future of EMS leadership and how innovation in data management, process design and leadership will shape the profession moving forward.

02:22 – Dr. Williams explains the background of the course, highlighting how it builds on improvement science to drive better results in EMS systems. He and Mike Taigman aim to teach EMS leaders to use data and evidence to improve patient care outcomes.

06:16 – Quality improvement: Dr. Williams discusses the gap in EMS leadership regarding quality improvement, emphasizing that quality needs to be integrated into the leadership team’s responsibilities, not treated as a separate function.

11:01 – Why data matters: The conversation shifts to the importance of data in EMS improvement efforts. Dr. Williams highlights how collecting and analyzing data helps organizations understand system performance and drive change.

15:43 – The fleet management example: Rob shares a fleet management story where data was used to improve vehicle downtime, highlighting the real-world impact of using improvement science to solve practical challenges.

19:29 – Project-based learning in the course: Dr. Williams elaborates on the project-based nature of the course, explaining how each participant will bring a real-world project that directly impacts their organization and use improvement science to solve it.

23:09 – Practical applications: Dr. Williams talks about how the course will blend online learning with in-person workshops, providing practical tools and methods that participants can apply to their projects throughout the year.

31:08 – Course logistics: Dr. Williams discusses course deadlines and important dates, including the application deadline of April 18, 2025; and the course's first workshop in September 2025.

54:05 – ROI and the course's value: Dr. Williams emphasizes the return on investment for attending the course, explaining that solving organizational problems through improvement science will ultimately save money and improve results for EMS services.

1:00 – Final thoughts: Rob and Dr. Williams close the conversation by reiterating the uniqueness of the course and its potential to reshape EMS leadership through the application of improvement science.

ADDITIONAL RESOURCES

Next-level improvement science: New master-level course equips EMS and fire leaders with advanced improvement science skills

Course application deadline: April 18, 2025

Course start date: July 22, 2025

Workshop dates: September 2025; February 2026

Mastering data and EMS performance metrics with Mike Taigman: Exploring how data informs change, improves clinical outcomes and drives leadership decisions

Improve EMS quality with a model that works: The simple yet powerful Model for Improvement holds the key to making real changes to an EMS organization

In honor of First Responder Wellness Week, Inside EMS hosts Chris Cebollero and Kelly Grayson go beyond the surface-level tips and dig into what true wellness looks like in this profession. Spoiler: it’s messy, personal and sometimes terrifying.

Kelly shares his deeply personal journey from a spinal surgery and a near-fatal pulmonary embolism to dropping over 140 pounds and reclaiming his life. At his heaviest, he was 410 pounds. Today? He’s neck-and-neck with Chris on the scale, rocking a 40-inch waist after shedding a whole foot from his midsection.

But this episode isn’t about bragging — it’s about honesty. Kelly gets vulnerable about depression, self-doubt and EMS culture’s toxic relationship with self-care. He also drops hard-earned advice on meal prepping, smarter snacking and how to make real progress without crash diets or guilt trips.

If you’ve ever looked in the mirror and not liked what you saw — or felt the creeping realization that this job might just break you — this one’s for you. Kelly’s story isn’t just about weight loss; it’s about survival, resilience and building a new life, one lap at a time.

Memorable quotes

"EMS is not an active profession. It’s 23 hours of boredom and an hour of blind panic."

"It’s not simply a matter of willpower, but support, attainable goals, and short increments add up over the years."

"You have to get serious about what you want to feel like, what you want to look like."

"I said, 'What are you doing this for? Are you doing this to die, knowing what killed you?'"

Enjoying the show? Contact the Inside EMS team at [email protected] to share ideas, suggestions and feedback, or let us know if you’d like to join us as a guest.

In this episode of EMS One-Stop, host Rob Lawrence is joined by Dr. Dan Patterson, a clinician-scientist specializing in safety in emergency care settings. Dr. Patterson’s work centers around critical factors in EMS safety, such as sleep health, shift work, fatigue and their combined effects on clinician well-being.

00:00 – Introduction to Dr. Dan Patterson

Dr. Patterson’s background and how his clinical experience as a paramedic informs his research on EMS safety and sleep health

04:30 – The Impact of Shift Work and Fatigue on EMS Providers

Discussing the direct effects of fatigue on EMS professionals, including medical errors, cognitive performance and decision-making

10:00 – The Science of Sleep in EMS

Why sleep is critical for EMS personnel and the unique challenges they face in getting adequate rest during shift work

15:00 – Development of Safety Measurement Tools

Dr. Patterson explains the creation of safety tools to track fatigue, sleep health and workplace injury rates in EMS settings

20:30 – Experimental Studies and Interventions

Overview of studies testing novel approaches to mitigating fatigue, including practical solutions and interventions in EMS environments

25:00 – Creating a Safety Culture in EMS

The role of leadership and teamwork in reducing fatigue-related errors and fostering a culture of safety in EMS organizations

30:00 – Key Takeaways and How Agencies Can Implement Changes

Final thoughts on how EMS agencies can integrate Dr. Patterson's findings and create healthier, safer work environments for their teams

Billions of dollars from opioid settlements are flowing into communities, but how does EMS get a slice of the pie? In this episode of the Inside EMS podcast, host Chris Cebollero is joined by Corey Carlson, EMS segment lead at Lexipol, to break it all down. Carlson simplifies the complex world of opioid settlement funding, sharing exactly where the money is, who controls it and how EMS agencies — both public and private — can apply.

From funding for training, mental health support, AEDs, cardiac monitors, ambulances and even K-9 units, there are countless ways EMS can use these funds. The key? Knowing who to ask and how to frame the request.

If your EMS agency could use a financial boost (and let’s be real — whose couldn’t?), this episode is packed with actionable advice to help you claim your share of the $56 billion (and counting) in opioid settlement funds.

Additional grant-funding resources:

EMS grants: 5 steps to success

Debunking the top 5 EMS grant myths: Insights for success

10 books every EMS grant writer needs

Guide to securing Congressionally directed funds

This episode of the Inside EMS Podcast is sponsored by ZOLL Medical. Learn more about ZOLL’s products for EMS at zoll.com/solutions/ems-and-fire.

Enjoying the show? Contact the Inside EMS team at [email protected] to share ideas, suggestions and feedback, or let us know if you’d like to join us as a guest.