EMS One-Stop

How old are you in EMS years? Are you using clinical skills that should be put out to pasture? Listen as cohosts Chris Cebollero and Kelly Grayson debate the effectiveness of “retired” EMS skills, like nasal and digital intubation, and whether the value of those skills has held up over time.

Memorable quotes

• “If you’re not proficient with all the tools in your box, what does that say about your training?”

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Last week, Inside EMS cohosts Chris Cebollero and Kelly Grayson laid out the top 10 indications of a bad EMS supervisor (Did you miss it? Catch it here!). This week they’re tackling the top signs of a bad employee, such as poor attendance, lack of initiative and a bad attitude – that’s not you, right? Listen as our duo reflects on each characteristic and where they have seen (or exhibited!) those traits in their career.

Memorable quotes

"If you’re emotionally intelligent and honest with yourself, you probably see yourself in some of these things."  

"It’s not over until the paperwork – or the ambulance – is ready for the next day."  

"Being disengaged shows up in things you don’t think matter, like documentation and keeping the ambulance stocked." 

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Whether replacing radio reports, alerting specialty teams, or managing mass casualty incidents, Pulsara simplifies communication. Pulsara scales to meet your dynamic communication needs. From routine patient alerts to managing large-scale emergencies, every responder and clinician connects seamlessly. Familiar yet powerful, Pulsara streamlines your response, from routine transfers to regional disasters. One tool. Every day. Regardless of event. Discover more at Pulsara.com.

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Enjoying the show? Send an email to 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.

Dr Jeff Jarvis joins Rob Lawrence to discuss the recently released National EMS Quality Alliance (NEMSQA) Measures Report – “Enhancing airway management one measure at a time.”

The report begins with the following robust Foreword: “NEMSQA is not satisfied with the state of airway management safety in EMS. As you will see, the data clearly shows that we can do much better across our industry! Partnering with experts and EMS agencies around the country, NEMSQA is leading the second national EMS Quality Improvement Partnership (EQuIP), the Airway Management Collaborative to put the new NEMSQA airway measures to work.”

“Enhancing airway management one measure at a time” is the sequel to the Lights and Siren Collaborative and will utilize the Institute for Healthcare Improvement’s Breakthrough Series collaborative model. The goal of the project is to support national improvement in the safety and effectiveness of invasive airway management by focusing on two goals:

1. Reducing the adverse events, such as peri-intubation hypoxia and hypotension

Rob and Dr. Jarvis discuss the report and actions individuals and their agencies should take to improve their personal and organizational airway management and patient outcome results.

Find more EMS One-Stop episodes here!

In this episode of EMS One-Stop, host Rob Lawrence dives into the trending topic of pre-hospital blood administration with guests from New Orleans EMS: Tom Dransfield, the quality assurance and safety officer, and Dr. David Rayburn, deputy medical director.

This in-depth discussion explores the development and execution of the New Orleans EMS blood program, focusing on packed red blood cells (PRBC) and the challenges, successes and ongoing research surrounding cold blood administration in trauma and medical emergencies. New Orleans EMS is leading the charge in pushing the boundaries of pre-hospital blood, providing innovative solutions for penetrating trauma, GI bleeds and other critical cases.

Dransfield and Dr. Rayburn share the journey of New Orleans EMS in implementing the program, including their logistics, lessons learned and the vital impact of their interventions on patient outcomes.

The episode emphasizes the collaboration between EMS and trauma centers as well as blood suppliers to reduce mortality rates, while also tackling key questions, such as the supply chain, funding and future research.

Memorable quotes

"For every minute we delay blood administration, there's an 11% increase in mortality – this isn't just a theory; it's life and death." — Dr. David Rayburn

"We were topping the charts in the wrong categories – violence and stuff like that. So, our medics were frustrated with the old scoop and run. We're not just scooping and running anymore. We're providing definitive care." — Tom Dransfield

"We’re seeing no change in temperature for patients receiving two units of cold PRBCs in the pre-hospital environment, and that’s groundbreaking." — Dr. David Rayburn

"If we’re doing blood, we’re literally saving lives. But without reimbursement, it’s an uphill battle." — Rob Lawrence

"Our paramedics are pushing the envelope – it's no longer just about trauma; we’re now treating GI bleeds, OB cases and renal patients with blood administration." — Dr. David Rayburn

Find more episodes: https://www.ems1.com/ems-one-stop

The What Paramedics Want in 2024 report, produced by EMS1 and Fitch & Associates, found respondents to the 2024 EMS Trend Survey ranked leadership No. 4 in the critical issues facing EMS today (behind only retention, funding & reimbursement, and career development).

In this episode of Inside EMS, cohosts Chris Cebollero and Kelly Grayson expose the unpleasant side of EMS leadership by naming the top 10 signs of a bad manager. From communication breakdowns to micromanagement nightmares, they explore what makes some managers, well … not so great, while dishing out hard truths about inconsistent leadership, the dangers of favoritism, and the importance of empathy.

Want to know if your manager is part of the problem – or if you're on your way to becoming one? Check it out!

TOP QUOTES

• "Communication is the language of leadership."

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In this episode of EMS One-Stop, host Rob Lawrence is joined by quality improvement expert, Dr. Dave Williams, recent co-author of the book, “Quality as an Organizational Strategy,” and Dr. Jonathan Studnek, executive director of Wake County EMS.

Together they discuss the five activities for organization’s leaders to provide the structure to begin working on making quality their strategy.

These activities are centered on:

Purpose

Viewing the organization as a system

Obtaining information

Planning to improve

Managing improvement efforts

These five activities form a system for the leaders of an organization to focus their learning, planning and actions.

"Leadership's job is to build systems where staff can be rock stars and bring their best selves every day." — Dr. Dave Williams

"Understanding your purpose as an EMS agency, like being responsible for cardiac arrest survival, is essential in improving performance." — Dr. Jon Studnek

"Our secret weapon in improvement is the Plan-Do-Study-Act (PDSA) cycle, where we learn fast by making low-risk, small-scale changes." — Dr. Dave Williams

"These five activities are the key elements that leaders should be engaging with to drive their organizations forward." — Dr. Jon Studnek

01:14 – Dr. Dave Williams shares his background in quality improvement and EMS

02:12 – Dr. Jon Studnek introduces himself and talks about his journey in EMS leadership

03:56 – Dr. Williams discusses his book, “Quality as an Organizational Strategy” and its origins, and outlines the five core activities of quality as an organizational strategy

15:02 – Dr. Studnek describes implementing the quality framework in EMS, using cardiac arrest survival as a real-world example

23:36 – Rob and Dr. Studnek discuss interconnectedness in EMS systems and fleet maintenance

30:00 – Dr. Williams explains how small-scale changes using the PDSA cycle help improve EMS operations

35:00 – Final thoughts from Dr. Studnek on leadership and quality as a guide for day-to-day work

Welcome to this special crossover edition of EMS One Stop and Inside EMS, recorded live at the EMS World Expo 2024 in Las Vegas. Hosted by Rob Lawrence and Chris Cebollero, this episode features insightful discussions with Dr. Ray Barashansky and Tracy Loscar, EMS Deputy Director at Matanuska-Susitna (MatSu) Borough Department of Emergency Services, Alaska.

The episode covers key themes such as leadership development, emotional intelligence in EMS, and the importance of mentorship programs like "Stand and Deliver," aimed at cultivating the next generation of EMS speakers.

“The next generation of EMS leaders is here, and it's our responsibility to pass the torch with the lessons we've learned." — Rob Lawrence

“We need to stop staying siloed. Growth happens when we learn from each other’s experiences and different perspectives.” — Chris Cebollero

“Designating EMS as an essential service is critical, but without form, function, and funding, it's just words on a page.” — Dr. Ray Barashansky

“Stand and Deliver is about giving everyone a chance to step up, present their ideas, and get real-time feedback from experienced national speakers." — Tracy Loscar

Leadership Transition in EMS. The influx of new attendees at the Expo reflects the need to develop the next generation of EMS leaders. Rob and Chris highlight the importance of passing the torch to younger EMS professionals.

Emotional intelligence in EMS. Dr. Ray Barashansky emphasizes how emotional intelligence impacts supervisors and leaders in EMS. He discusses his presentation on this topic, sharing insights on how emotional intelligence can shape better leaders.

Stand and Deliver Program. Tracy Loscar introduces the "Stand and Deliver" initiative, a program that identifies and mentors emerging EMS speakers, offering real-time feedback from national experts.

EMS as an essential service. Dr. Barashansky discusses his recent editorial about EMS being recognized as an essential service and the need for formal structure, funding and legislative support to ensure its sustainability.

Mentorship and learning from each other. The hosts and guests stress the importance of learning from one another, breaking silos within EMS, and continuously evolving as professionals through shared experiences.

ABOUT THE SPONSOR

Whether replacing radio reports, alerting specialty teams, or managing mass casualty incidents, Pulsara simplifies communication. Pulsara scales to meet your dynamic communication needs. From routine patient alerts to managing large-scale emergencies, every responder and clinician connects seamlessly. Familiar yet powerful, Pulsara streamlines your response, from routine transfers to regional disasters. One tool. Every day. Regardless of event. Discover more at Pulsara.com.

In this episode of the EMS One-Stop podcast, host Rob Lawrence welcomes back data and EMS expert Mike Taigman for a deep dive into the evolving role of performance metrics in EMS systems.

Together, they discuss two key publications – “Joint Position Statement on EMS Performance Measures Beyond Response Times” by Kupas and Zavadsky, et al., and the White Paper from the National EMS Quality Alliance in Collaboration with FirstWatch, titled, “Taking the Pulse of your System – Performance Measurement for Improvement.”

Lawrence and Taigman explore how data informs change, improves clinical outcomes and drives leadership decisions. Whether you’re a seasoned leader or new to the field, this conversation provides essential insights into how EMS organizations can better utilize data to elevate their services.

This episode of the Inside EMS Podcast is sponsored by Verizon Frontline, the advanced network and technology for first responders. To learn more, visit verizon.com/frontline.

The 2024 anniversary of 9/11 marks 23 years since the tragic events that forever altered the course of history and the landscape of public safety.

As we move further from that fateful day, the significance of remembering and learning from 9/11 grows even more critical. For many, especially younger generations, 9/11 is transitioning from a lived experience to a historical event, making it essential for public safety professionals to ensure that the lessons identified are not only remembered, but actively applied in today's ever-evolving emergency response environment.

In this special crossover episode of the Policing Matters, Better Every Shift and Inside EMS podcasts, Co-hosts Jim Dudley, Aaron Zamzow and Rob Lawrence highlight the importance of remembering 9/11 not just as a historical event but as a continuing influence on how public safety agencies operate today.

This week on Inside EMS, our cohosts discuss a recent study out of UC Davis Health that highlights the benefits of using naloxone in opioid-associated out-of-hospital cardiac arrest response. Chris and Kelly discuss the results and debate how this knowledge could impact OHCA protocols.

Top quotes

“If you look at the … survival of hospital discharge, the number needed to treat was 26. So 1 in 26 patients you would do this to has a chance of surviving the hospital discharge. That's pretty compelling. It's going to change my practice.” — Kelly Grayson

“It's obviously needed information considering how bad the opioid overdose epidemic is in the United States. The numbers are compelling – the fact that this affects so many of our out-of-hospital cardiac arrests and that this actually shows pretty strong evidence of improved outcome.” — Kelly Grayson

“We think about over the past 20 years, and now with fentanyl being part of that process, we're starting to see a lot more [drug-related cardiac arrests] and there's an urgent need for this evidence that allows us to now figure out if Narcan can make a difference in OHCAs.” — Chris Cebollero

This episode of Inside EMS 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.