EMS One-Stop

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.

The first episode of Inside EMS in 2024, hosted by Chris Cebollero and Kelly Grayson, offered valuable insights into what’s needed to overcome the challenges for EMTs, paramedics and EMS agencies in the year ahead.

Memorable quotes

• "We need to take charge and, and steer our profession, and generally we don't – as a profession, we tend to be reactive rather than proactive." — Kelly Grayson

Key takeaways

• 2024 EMS Trend Survey. The hosts highlighted the importance of the What Paramedics Want in 2024 annual EMS trend survey focusing on recruitment, retention, safety, health, wellness, technology adaptation and career development.

Read more. Rapid Response: Scene safety trumps patient care but does not replace duty

The episode provided valuable insights into the current state and future directions of EMS, highlighting challenges and opportunities. These discussions are vital for EMTs and paramedics as they navigate their careers in 2024.

EMS1 is using generative AI to create some content that is edited and fact-checked by our editors.

Editor’s note: This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

“Honorable but Broken: EMS in Crisis” is a documentary film exploring the world of EMTs and paramedics, the collapse of the EMS system, and what needs to be done to save it. Narrated by six-time Golden Globe and two-time Primetime Emmy award winning actress, Sarah Jessica Parker, “Honorable but Broken” raises awareness of the systemic collapse of EMS and advocates for change.

In this episode of the EMS One-Stop podcast, host Rob Lawrence chats with producer Bryony Gilbey about the documentary that is now completed and available for streaming. Gilbey hopes the impactful, hard-hitting documentary will serve as a briefing and education tool for our elected officials and members of the general public.

As Gilbey notes, “It’s no good any longer just throwing up your hands and saying that’s just the way EMS is; it’s no good saying it’s someone else’s problem; it’s something we all need to work on, as a civilized society we need to address this issue and we need to do it quickly.”

The 60-minute documentary is now available on demand, streamed by Prodigy EMS and it is hoped that it will be used at local, state and national levels to bring attention to the issues we are facing.

Top quotes from this episode

• “I expected to tell a story; I did not think that it would have quite this reaction” — Bryony Gilbey

Episode contents

00:48 – Documentary teaser

01:18 – Introduction/Bryony Gilbey

02:16 – The “Honorable but Broken” back story

05:46 – How did Gilbey view EMS and its issues

08:15 – The finished product and how can we view it

10:24 – A federal screening on Capitol Hill

11:30 – Reaction from elected officials

13:16 – John Mondello/emotional trauma

14:00 – Eileen Mondello – John’s mother

15:25 – Reaction to Eileen Mondello – “It never gets easier’

17:00 – He wasn’t the first, he isn’t the only and sadly he won’t be the last

22:00 – Other featured speakers in the documentary and their powerful messages

22:30 – Recruitment, retention and retirement

24:35 – What is the cost of a human life to a politician?

26:25 – Educating the legislators and the public

28:00 – The cost of readiness

29:05 – Reimbursement doesn’t add up

31:00 – The hospital side of things – Beckers Review on Hospital closures and adding to ambulance and hospital deserts

31:30 – Call to action and the legislative agenda

35:30 – Sarah Jessica Parker

39:00 – How and where to view via Prodigy EMS

39:50 – Final thoughts

About our guest

With a prolific career spanning several decades, Bryony Gilbey is a seasoned director, producer and freelance writer/editor, distinguished for crafting compelling narratives across various media platforms. As the director/producer for the impactful EMS documentary, “Honorable but Broken: EMS in Crisis,” Gilbey has showcased an unparalleled ability to guide projects from inception to completion.

Gilbey previously worked with the Nexstar Media Group, Inc. as a freelance writer/editor. Here, she demonstrated versatility by producing feature pieces on health and lifestyle topics for Tribune Publishing and contributing to BestReviews.com.

Gilbey also served as an associate producer at Mary Murphy & Co. from 2005 to 2012. During this period, she played a pivotal role in the production of the PBS American Masters documentary "Hey Boo," centered around Harper Lee. In the early 2000s, Bryony worked as a Producer/AP at ABC News Productions, where she produced documentaries on medical breakthroughs in neonatal care for Discovery Health.

The foundation of Bryony’s career was laid during her time as an associate producer at “60 Minutes,” CBS News, from 1995 to 2000. Working closely with producers and correspondents, she contributed to the creation of original news stories.

Throughout her extensive and diverse career, Bryony Gilbey has consistently demonstrated a passion for storytelling, a keen journalistic instinct, and an unwavering commitment to delivering content that informs and resonates with audiences worldwide.

Resources

• “Honorable but Broken: EMS in Crisis”

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Collecting and communicating the big EMS news of 2023

The American Ambulance Association and the Academy of Mobile Healthcare Integration (AIMHI) collect, collate, categorize and share weekly EMS-based news stories widely with many national organizations and associations, including NHTSA, USFA and NAEMT.

The information contained in the news tracker allows officials and EMS leaders to brief and educate journalists and elected officials, as well as the public as to the current plight of EMS. EMS is delivered on a local level and those experiencing issues with their service can believe it is just them suffering funding shortages, staffing challenges, hospital delays or general poor performance. The tracker can be used to demonstrate that the issues are occurring on a wider regional, state, national and, in some cases, international level.

In this episode of the EMS One-Stop podcast, host Rob Lawrence, who also heads up the AAA-AIMHI news collation effort, welcomes fellow news collator, Rodney Dyche of Patient Care EMS; and AIMHI Education Committee Chair, Matt Zavadsky, chief transformation officer at MedStar Mobile Healthcare. Rob, Rodney and Matt examine EMS news and current trends, and discuss how these themes can be used to inform, influence and educate.

Top quotes from this episode

• “There's a perverse ‘incentive’ about response time … if you have the target of 8:59, you arrive on time and the patient dies; that's a success. If you arrive in 9:01 and the patient lives; that's a failure. That's absolute garbage” — Rob Lawrence

Episode contents

00:23 – Guest introduction

02:06 – AAA/AIMHI News Tracker and story categories

04:22 – A resource to brief the press and elected officials

04:30 – Operational challenges across many states

05:50 – Massive sign-on bonuses – robbing Peter to pay Paul

06:30 – Staffing and funding issues

08:40 – Communities/local governing bodies facing the fact that they are running out of money, and their EMS isn’t free

09:40 – Transitioning from a volunteer to a paid system

11:00 – Explaining EMS economics to your elected officials

11:50 – Has anyone died? Bring data

13:30 – EMS systems closing

15:30 – “Elected officials get nervous deciding to allocate funding to a service that they haven't had to fund or haven't, haven't had to fund to this certain level in the past.”

18:40 – Response time

19:25 – Increase in low acuity calls

20:30 – Service design

22:50 – Single- versus double-paramedic crewed trucks

25:04 – MEDIC Charlotte – Taking bold steps within categories of response

27:00 – The rate of ambulance crashes across the county at intersections

27:47 – If you are not the ambulance driver … who is?

29:49 – There is no evidence that using red lights and siren have saved more lives than they've taken!

30:30 – Stolen ambulances

32:59 – Supply chain and vehicle availability

34:00 – Rurality and ambulance deserts

35:00 – Violence against providers

37:00 – Responding to patients in crisis/agitated patients

38:00 – How to use the media log in your locality to good effect

40:00 – Final thoughts

About our guests

Matt Zavadsky is the chief transformation officer at MedStar Mobile Healthcare, the exclusive emergency and non-emergency public utility model EMS system for Fort Worth and 14 other cities in North Texas that provides service to 436 square miles and more than 1 million residents and responds to over 170,000 calls a year with a fleet of 65 ambulances. MedStar is a high performance, high value EMS system, providing advanced clinical care with high economic efficiency.

Zavadsky is also immediate past president of the National Association of EMTs, and chairs their EMS Economics Committee. He is an appointed committee member to the Joint Commission’s Home Care Professional and Technical Advisory Committee (PTAC), and the Lewin Group’s Hospital Outpatient Quality Reporting (HOQR) Program Stroke and AMI Expert Work Group developing metrics for use in value-based purchasing measures for emergency departments. He is also the co-author of the book “Mobile Integrated Healthcare – Approach to Implementation.”

Rodney Dyche is director of compliance and responsible for risk management with PatentCare EMS Solutions. PatientCare EMS Solutions is a multistate EMS solution, and additionally provides a hybrid online training program and owns a remount facility. As a teenager, Dyche began his EMS career in rural Missouri. He has had multiple system experiences in addition to rural EMS, including MAST (Kansas City, Missouri), REMSA (Reno, Nevada) and Mercy (Las Vegas). In 2010, he became an internal consultant to Paramedics Plus until its sale in 2018. During that time, he led several high-level projects, to include the timely transition of the purchase of Paramedics Plus. Rodney resides in East Texas and in his spare time is a licensed HAM radio operator, and enjoys fishing, off-roading and reading.

Resources

• AAA-AIMHI news collation tracker

CoAEMSP’s Executive Director, George W. Hatch Jr., discusses the EMS accreditation journey

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.

The Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP) plans to launch a voluntary programmatic accreditation for Advanced Emergency Medical Technicians (AEMTs) by January.

In this episode of Inside EMS1, cohost Chris Cebollero sits down with George W. Hatch Jr., EdD, LP, EMT-P, FAEMS, CoAEMSP’s executive director, to discuss the program.

Top takeaways

• AEMT is not just an EMT with additional skills; it requires a broader skill set, including understanding pathophysiology and critical thinking.

Memorable quotes

• "It's about a process of improvement, a continual process of improvement." — Dr. Hatch

EMS1 is using generative AI to create some content that is edited and fact-checked by our editors.

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.

In this year's Inside EMS year-in-review episode, our cohosts, Chris Cebollero and Kelly Grayson, take a critical look at the major incidents that defined EMS in 2023. Together, they tackle:

Paramedics behaving badly

The episode begins with a focus on the troubling trend of subpar patient care and missteps. The hosts emphasize the importance of delivering compassionate and professional care on every call. They discuss the case in which EMS providers faced charges of first-degree murder after a patient died due to positional asphyxia, underscoring the need for accountability in the profession.

Violence against providers

Next, the hosts address the increasing incidents of violence against EMTs, including stabbings and assaults. They highlight the need for better safety measures and policies to protect EMS personnel.

Criminalization of medical errors

Shifting gears, the hosts delve into instances of medical errors, such as administering the wrong drug. They stress the critical importance of delivering high-quality patient care on every call, regardless of the nature of the complaint.

Focus on CPR

The discussion then turns to a dramatic moment in the NFL when Damar Hamlin went into cardiac arrest after a hit during a game. The hosts commend the quick response of athletic staff and paramedics, emphasizing the significance of well-executed resuscitation efforts.

The demise of ET3

Finally, Chris and Kelly address the unexpected premature end of the ET3 model, a pilot program aimed at improving EMS care and reimbursement. The hosts express disappointment in CMS's decision and question the rationale behind it.

In conclusion, this year-in-review podcast provides valuable insights into the challenges and triumphs of the EMS field in the past year. It highlights the need for accountability, safety measures and ongoing efforts to improve patient care and EMS policies.

Memorable quote:

"Every single call that we run has to be done with the utmost dedication, commitment, professionalism, as if it was the last or maybe even the first EMS call we've ever run. Complacency is what kills there."

EMS1 is using generative AI to create some content that is edited and fact-checked by our editors.

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.

In this episode of Inside EMS, hosts Chris Cebollero and Kelly Grayson delve into the crucial role of preceptors in EMS training and the impact they have on shaping the future of the profession. They emphasize the significance of preceptors as the "keepers of the flame" who pass on traditions and knowledge to new generations of EMS providers.

Memorable quotes

• "Preceptors have a fundamental understanding of their role in shaping the future of the profession." — Kelly Grayson

The hosts discuss the challenges and responsibilities of being a preceptor, emphasizing the need for preceptors to understand their role in shaping the future of EMS. They also touch on the importance of legacy and how preceptors play a pivotal role in maintaining and passing down the profession's traditions.

Grayson underscores the value of preceptors, highlighting that they are the individuals who can guide and mentor new EMS providers, ultimately affecting the lives of countless patients. He emphasizes the importance of recognizing preceptors as vital contributors to EMS education.

Listen to next: ‘You don’t know everything there is to know about EMS’

EMS1 is using generative AI to create some content that is edited and fact-checked by our editors.

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

The American Ambulance Association recently held its annual AAA Stars of Life event in Washington, D.C. The American Ambulance Association’s Stars of Life program celebrates the contributions of ambulance professionals who have gone above and beyond the call of duty in service to their communities or the EMS profession.

While in Washington, EMS One-Stop Host Rob Lawrence interviewed AAA President Randy Strozyk, on the aims and objectives of the stars program and the 2023 Legislator of the Year. Rob also spoke with AAA Medical Director Dr. Gerad Troutman, who is AAA’s first medical director. Finally, Rob chats with AAA Immediate Past President, Shawn Baird, on the Federal Balanced Billing legislation and the role that AAA and others are playing in protecting both the patient and EMS agencies.

Top quotes from this episode

“Every provider is out to make a difference, but to actually be recognized for it, which you don’t often get the opportunity to have, makes it that much more of an honor to be selected for something like this” — Paramedic Erica Brockman

“AAA stars and hundreds of thousands of people like you are the beginning of the healing process. When somebody is hurt, somebody is wounded, somebody is scared, it is the EMT that first touches that patient and then begins to transport into the healthcare system when the rest of the healthcare system can then kick in to what it does, but it would not start unless it begins with you.” — Senator Bill Cassidy

“Think about when Covid hit, at 0200 in the morning, we were the ones that came, we were the ones that had to deal with a whole new level of challenges, not only Covid, but we had to deal with the fact that people didn’t want to go to the hospital, so we were providing levels of care, interfacing, making sure that people had connections. I see that as a bright future to how EMS will progress in the next decade” — AAA President Rany Strozyk

“I’m really passionate about patients called 911 looking for solutions to a problem and that solution is not always an ambulance to take them to an emergency department, so we try to impact their care differently, especially lower acuity patients, because we now have all the technology and tools to treat them in place with our paramedics or EMTs on site of even treating them utilizing a navigation program from the 911 system, the PSAP and maybe get them to an urgent care or virtual care doctor, where they can be cared for right in their home. Patients love it and the best thing is it really puts the ‘E’ back in EMS and allows us to save those emergent resources that need those most.” — Dr. Gerad Troutman, AAA medical director

“We will be coming back to Congress with a recommendation that ground ambulance not be rolled into the No Surprises Act. That (if we were included) would be devastating to access for care.” — Shawn Baird, immediate past president, AAA

Episode contents

00:21 – Opening: Erica Brockman

01:02 – Introduction: Rob Lawrence

01:36 – Randy Strozyk, president, American Ambulance Association

05:12 – Key areas of legislation for 2023/24

08:07 – Presentation of Legislator of the Year: Senator Bill Cassidy

11:00 – Dr. Gerad Troutman, AAA medical director

17:00 – Federal Balanced Billing Committee: Shawn Baird

18:35 – Summary and close

Additional resources

 The full bios for all of the AAA Class of 2023 Stars of Life can be found here.

Listen to next: Alexia Jobson, Dr. Peter Antevy, Brian Maloney, Doug Wolfberg and more join the EMS One-Stop podcast to discuss takeaways from the show

About our guests

Randy Strozyk brings to his leadership of the American Ambulance Association more than 34 years of experience in EMS operations and management. He has been part of the American Medical Response leadership team for 16 years, and currently serves as the company’s executive vice president of operations.

Strozyk earned his EMT/paramedic certification and worked on an ambulance while studying microbiology at Washington State University. He later earned an MBA from California State University. He has been heavily involved in the American Ambulance Association for nearly two decades and is the current president of the organization.

Gerad Troutman, MD, MBA, FACEP, FAEMS, is the national medical director for innovative practices at Global Medical Response. He is an assistant professor of Emergency Medicine at Texas Tech University Health Sciences Center in Lubbock, Texas, and serves as a mentor to the Texas Tech Innovations Hub. He is a past president of the Texas College of Emergency Physicians and currently serves on the Governor’s EMS & Trauma Advisory Council of Texas.

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 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.

In this episode of the Inside EMS podcast, the discussion centered on the practical application of leadership in EMS. The conversation highlighted the gap between commonly used leadership buzzwords and their real-world implementation.

Key points

• Employee engagement and empowerment. The need for genuine engagement and empowerment in the workplace was stressed. Kelly Grayson shares an example of providing discounted meals for employees during hectic schedules as a concrete example of servant leadership.

Learn more: Visit the EMS Leader Playbook

Memorable quotes:

• "The true measurement of leadership success is how engaged, satisfied and productive the workforce is. Nothing else matters." — Chris Cebollero

This episode underscores the need for a paradigm shift in EMS leadership, moving away from traditional authoritative styles to a more engaged, empathetic and service-oriented approach.

Rate and review

Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the Inside EMS team at [email protected] to share ideas, suggestions and feedback, or if you’d like to join us as a guest.

EMS1 is using generative AI to create some content that is edited and fact-checked by our editors.

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.

In this episode of Inside EMS, hosts Chris Cebollero and Kelly Grayson discuss an incident that sparked fierce debate within the EMS community. The incident in question occurred on October 27, 2023, when a Washington, D.C., firefighter/EMT was dismissed for stopping at a Chick-fil-A before responding to an ALS call. The hosts discuss the ethical implications of this decision, emphasizing the duty to act in emergency services.

Cebollero and Grayson, while acknowledging the challenging landscape of working in EMS, stressed that personal needs and comfort should never compromise the responsibility to respond to emergencies. They shared personal experiences of missing meals due to service calls. The hosts stress how the duty to act commitment to help others should always outweigh personal needs in emergency services.

The discussion also centered on the commendable actions of D.C. Fire and EMS in addressing the incident. Grayson was firm in his belief that the action taken by the D.C. firefighter/EMT was unequivocally unethical and damaging to the public trust. The hosts underscored the importance of upholding the greatest standards of ethics and responsibility, even when not in the public eye.

Memorable quotes

• "Ethics are how you behave when no one is looking. There's not a whole lot of gray area in ethical situations." — Kelly Grayson

Read next: Duty to act, assess, treat and transport. A legal refresher for EMS providers

RATE AND REVIEW

Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the Inside EMS team at [email protected] to share ideas, suggestions and feedback, or if you’d like to join us as a guest.

EMS1 is using generative AI to create some content that is edited and fact-checked by our editors.

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.

In this episode of Inside EMS, hosts Chris Cebollero and Kelly Grayson discuss innovative approaches in EMS with guests Chief David Lewis and Kyle Gaines from the St. Charles County Ambulance District in Missouri. The district's unique approach to paramedicine, specifically in terms of substance use disorders, opioid use disorders and behavioral health, forms the crux of the conversation.

Lewis shares how the escalating number of overdose cases necessitated a novel approach to community paramedicine. Starting as a passion project to save lives, the St. Charles County Mobile Integrated Healthcare Network was born from a need to tackle the overdose epidemic more effectively.

Initially adopting a model from Ohio that involved paramedics, social workers and law enforcement officers responding to overdoses, they soon realized patients were reticent to engage when law enforcement was present. This led to the evolution of the program, with paramedics being specially trained to handle sensitive conversations, helping patients access treatment.

Gaines discusses how educating their team members about addiction was instrumental in overcoming initial resistance to the program and ensuring its success. In the years since its inception, the program has grown and has proven to be effective, with about one in four patients they encounter eventually sitting in front of a treatment counselor.

Read more: $1.5M grant allows SCCAD’s expansion of substance abuse program

RATE AND REVIEW

Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the Inside EMS team at [email protected] to share ideas, suggestions and feedback, or if you’d like to join us as a guest.

EMS1 is using generative AI to create some content that is edited and fact-checked by our editors.