EMS One-Stop

Recorded on location at the EMS Association Summit in sunny Kansas City, this edition of EMS One-Stop captures something that’s been building for a while across the profession: real momentum.

In the first half, Rob Lawrence sits down with Bill Seifarth, CEO of the National Registry of EMTs, to unpack what the Registry is today; how its mission has evolved; and why partnerships, research and continued competence sit at the heart of public trust when 911 is called.

In the second half, returning guest Patrick Pianezza joins Rob to talk Code 3, the top streaming EMS movie’s impact on providers and families and what comes next.

Across both conversations, the theme is unmistakable. When EMS organizations collaborate, align messaging and show up as one voice, the profession becomes harder to ignore and easier to support. The summit becomes more than a meeting. It becomes a signal.

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Editor’s Note: This episode of Inside EMS is brought to you by ZOLL software and data solutions. Optimize EMS performance and outcomes at every stage of operations with interoperable solutions from dispatch, to patient care, QA/QI, billing and beyond. Visit zolldata.com to learn about the complete solution suite.

This episode of Inside EMS tackles a difficult question: When is it time to step away from the job? Hosts Chris Cebollero and Kelly Grayson trade hard-earned wisdom — from Kelly’s knee-rehab comic relief to serious talk about emotional burnout, wellness needs and timing.

The hosts also explore the psychology of identity — how being a paramedic or EMT isn’t just a job, it’s who you are. They unpack how to carry forward the best parts of that identity — calm under pressure, decisive action, compassion — into new roles if needed. This isn’t about quitting — it’s about owning your career before it owns you.

Whether it’s fewer shifts, a new role, a new service or a new direction altogether, the message is clear: protect your identity, protect your professionalism and make moves that keep you sharp for the long haul.

“Burnout is gradual. It's not explosive, but you've got to be able to realize the emotional flattening that is happening.” — Chris Cebollero

“Our identity often becomes EMS. I tell people, to this day, ‘I'm a paramedic,’ and there's a lot that goes into that — and not just when you put the boots or the polo shirt on. It really becomes the core of who you are.” — Chris Cebollero

“The vast majority of us don't leave after one bad call. We wake up one day and realize we've been surviving instead of serving, and that's when the burnout epiphany really hits us hard.” — Kelly Grayson

Enjoying Inside EMS? Email [email protected] to share feedback or suggest guests for a future episode.

This episode of Inside EMS is brought to you by ZOLL software and data solutions. Optimize EMS performance and outcomes at every stage of operations with interoperable solutions from dispatch, to patient care, QA/QI, billing and beyond. Visit zolldata.com to learn about the complete solution suite.

NAEMSP is officially a “big little conference” — and it’s only getting bigger. In this crossover episode, Rob Lawrence and Chris Cebollero unpack the momentum: tighter collaboration, a unified push toward EMS on the Hill Day, and the growing realization that if we want change, we need boots (and uniforms) on Capitol Hill.

But the real buzz? AI.

From autonomous ambulances to narrative-writing software, the conversation gets real about the promise — and the potholes — of artificial intelligence in EMS. Charting shortcuts? Maybe. Courtroom landmines? Definitely possible. Add in body-worn camera debates, budget crises and a push for legislative support at the federal level, and it’s clear the profession is standing at a pivot point.

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In this episode of EMS One-Stop, Dr. Linda Dykes joins Rob Lawrence from the UK for a wide-ranging, transatlantic conversation that starts with workplace culture and ends with a practical look at how health systems can keep patients safely at home.

In the first half, Linda breaks down her newly published (open-access) qualitative paper, provocatively titled “It’s not bullying if I do it to everyone,” drawn from UK NHS “Med Twitter” responses: a raw, heartbreaking window into the red flags of toxic workplace culture, how bullying is experienced in the eye of the beholder, and why incivility and silence are not just HR problems — they’re patient safety threats.

In the second half, Linda brings listeners into the UK’s evolving admission alternative world: frailty care at home, urgent community response models, and the increasingly important interface between EMS and community-based teams. She explains the UK’s SPOA (single point of access) concept, why she dislikes the term “admission avoidance,” and how ED crowding and access change the risk-benefit equation for hospital vs. home.

Rob connects the dots back to the U.S. reality — reimbursement, APOT/wall time, treatment-in-place policy — and why this work is becoming a shared challenge on both sides of the Atlantic.

00:51 – Rob opens, recaps NAEMSP in Tampa and recent content.

02:25 – Rob introduces Linda as the “triple threat” (emergency medicine, primary care/GP, geriatrics) and tees up two-part discussion.

05:39 – Rob introduces Linda’s paper: “It’s not bullying if I do it to everyone.”

06:13 – Linda explains why toxic culture is increasingly visible and how the tweet prompt became a dataset.

07:33 – “Flash mob research group” forms; Linda explains social-media-to-qualitative methodology and limitations.

10:03 – Rob asks about bias; Linda clarifies purpose: insight, not representativeness.

16:39 – Linda defines gaslighting and why it’s so destabilizing.

18:21 – Reactions to publication; resonance, sharing and uncomfortable self-reflection on learned behaviors.

20:18 – The “16:55 Friday email” as a weapon — and as an accidental harm.

23:29 – Leadership as “the sponge” — absorbing pressure rather than passing it down.

25:27 – “One thing right now”: know the impact your words can have, especially on vulnerable staff.

26:41 – Rob on “pressure bubbles,” micro-movements and atmospherics: how leaders shift climate without realizing it.

30:53 – SPOA explained: single point of access and urgent community response behind it.

33:03 – EMS interface: calling before conveyance to find safe pathways to keep patients at home.

35:47 – Linda on mortality risk of access block/long waits and how that reframes risk decisions.

37:19 – Evolving models: primary care-led response vs. hospital at home approaches.

39:34 – Clinical myths challenged: oral antibiotics sometimes non-inferior to IV in conditions we assumed needed admission.

40:34 – Outcomes: hospital at home trial signals safety and fewer patients in institutional care by 6 months.

42:00 – Telemedicine/telehealth: underutilized but useful; when you still need a senior clinician in person.

44:50 – Closing takeaways: read the paper (with trigger warning); admission alternative work is deeply satisfying.

Enjoying the show? Email [email protected] to share feedback or suggest guests for a future episode. 

This episode of Inside EMS is brought to you by ZOLL software and data solutions. Optimize EMS performance and outcomes at every stage of operations with interoperable solutions from dispatch, to patient care, QA/QI, billing and beyond. Visit zolldata.com to learn about the complete solution suite.

This week on Inside EMS, Chris Cebollero takes on one of the most anxiety-inducing topics in paramedic education: alpha and beta receptors. Sparked by a question from paramedic student April McKenzie, a.k.a., “April Anonymous,” this episode strips away rote memorization and replaces it with something far more useful in the field — understanding the why behind the medicine.

There’s no fluff here; no cheesy memory tricks that fall apart under stress. Just physiology, practical mental models and a challenge to start practicing medicine with intention. If pharmacology has ever felt random, this episode connects the dots in a way that finally clicks.

“Every medication you give in EMS is doing one of two things: It's either pushing the gas pedal or it's releasing the brake — that's it. If you don't understand which one you're doing, you're guessing, even if the protocol says you're right.”

“We really have to become the ultimate detective of the body.”

“Every patient is somewhere between gas and brake at all times. Those systems are constantly working, they're not off. It's just a dimmer switch. Every medication pushes one system or pulls the other system back into play.”

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Dr. Peter Antevy returns to the Inside EMS co-host seat this week, filling in for Kelly Grayson and bringing some serious pediatric firepower to the conversation. Host Chris Cebollero dives right into the latest buzz around the Broselow tape recall — yes, again — as Dr. Antevy unpacks what went wrong, why it matters and what EMS agencies should be doing about it now.

He also shares exciting details on his brand-new, field-focused Newborn Resuscitation & Obstetrics course (NROC), built by EMS for EMS. Designed with two hours of online content (zero PowerPoints!) and a short, in-house skills lab, this course aims to tackle one of the most nerve-wracking call types. No more dragging medics to the hospital for NRP classes that don’t translate to street-level care.

Also on deck: OB deserts, delayed cord clamping, why you might need to Saran-wrap a newborn (seriously), and what AI can — and can’t — do for EMS. This one’s packed with practical pearls, myth-busting insights and a whole lot of passion for pediatric education.

“EMS is one specialty that AI will never take away, as far as like the human-to-human contact. We resuscitate people, we treat people who are seizing. AI will never do that. That's a good thing.”

“Academics and the hospital folks don't recognize the value that EMS brings to the table. They think we're ambulance drivers. It's time for them to wake up and recognize that we are the people who deliver babies. We are the people who resuscitate grandma, grandpa and the little kid.”

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In this episode of EMS One-Stop, host Rob Lawrence welcomes John Sammons, an advanced practice paramedic with Wake County EMS, a peer support team member and a key leader in the NAEMT Lighthouse Leadership Program. John sits at the intersection of system design and human performance, helping build the kind of operational and cultural scaffolding that keeps clinicians effective, healthy and coming back tomorrow.

In this episode of EMS One-Stop, host Rob Lawrence welcomes John Sammons, an advanced practice paramedic with Wake County EMS, a peer support team member and a key leader in the NAEMT Lighthouse Leadership Program. John sits at the intersection of system design and human performance, helping build the kind of operational and cultural scaffolding that keeps clinicians effective, healthy and coming back tomorrow.

| MORE: Peer support teams: How to build trust and maximize effectiveness

This week’s conversation goes beyond “be more resilient” and into the practical realities of burnout, moral injury, mentoring and culture, including the role of frontline and unofficial leaders in shaping what “normal” looks like inside an agency. John also shares the Wake County approach to peer support: presence first, then resources, plus the power of finding your people: your team, your tribe, your board of directors.

“We have folks that don’t stay in the profession. We have folks that leave. We have folks that unfortunately develop substantial mental health crises up to and including, unfortunately, suicide in our profession.”

“What an amazing privilege that we’re invited into somebody’s home to take care of them and to figure it out.”

“Every one of those people expects to call 911 and have an expert show up and solve the problem.”

“I work to live, I don’t live to work. And that’s a great philosophy to have.”

“Everybody goes home ... but there should be an addendum on the bottom of it that says, ‘but everybody comes back tomorrow.’”

“Nobody gets us like we get us.”

“Leadership is action, not a title.”

“Everybody has their bucket, and everybody’s bucket can only hold so much.”

“Nobody got into this because we wanted to be crusty and angry and miserable and difficult to be around.”

00:40 – Rob opens the episode and introduces John Sammons and the theme: resilience and beyond

02:05 – John’s “Sammons 101” bio: Wake County APP, peer support, Lighthouse Leadership involvement

03:01 – Burnout data and why it matters for retention and wellbeing

04:16 – Wake County’s Advanced Practice Paramedic Program: the “three Rs”

05:03 – John’s post-COVID turning point: “I’m done ... I don’t want to do this anymore”

06:12 – What brings John back to work: purpose, people, privilege, challenge

09:16 – Prevention and balance: identity beyond the job, sleep, nutrition, purpose

12:15 – Peer support in practice: presence, triage, in-house clinician, canines, statewide resources

17:09 – Podcast/vodcast reminder and John’s slides supporting the discussion

18:14 – NAEMT Lighthouse Leadership: why relationships and peers are the real multiplier

20:39 – Mentorship as a resilience strategy: formal programs and informal investment

24:25 – Culture: administration vs frontline leaders vs unofficial leaders

28:06 – Closing reflections: remembering why we got into EMS

30:36 – Final takeaways

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In this episode of Inside EMS, host Chris Cebollero sits down with Mic Gunderson, CEO of the Center for Systems Improvement and EMS Quality Academy; and editor‑in‑chief of the new peer-reviewed International Journal of Paramedicine, which launched in January 2023. Gunderson explains how the publication provides a forum for thoughtful debate around complex topics to be examined and analyzed. A recent issue, for example, touched on degree requirements for entry-level medics using the Socratic method to frame and manage the debate — a far cry from the horrors of a social post’s comment section.

Sprinkled with wit, respect and real curiosity, this episode is a masterclass in how EMS can grow — not just louder, but smarter. Whether you drive an ambulance, manage a system, or just care about the future of prehospital care, this conversation is worth your seat time.

Additional resources:

The International Journal of Paramedicine

Degrees, debate and direction: Why this debate deserves our attention

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In this episode of EMS One-Stop, Sophie Fuller — better known across social media as Paramedic Sophie — joins host Rob Lawrence for a candid, energizing conversation about what it really feels like to work in EMS right now: pride, the pressure, the burnout, and the culture issues that too many providers have been taught to silently absorb.

Sophie is a critical care ground paramedic, flight paramedic, educator and president of the Tennessee Association of EMS Providers (TAEMSP), and she brings a provider-first lens to everything from leadership visibility, to mental health and pay equity.

Together, Rob and Sophie dig into why Sophie started creating content in the first place (hint: burnout and the need to connect), how social media can be used as a force for good, and what “healthy” EMS culture should look like in practice. Sophie shares practical advice for crews and leaders alike:

Be human

Say the uncomfortable thing

Stop normalizing harm

Build systems that “care back” for the people doing the work

“We're just working in systems that haven't yet learned how to care back for the provider.” — Sophie Fuller

“Management by walking about. Don't be stuck in the office. Don't say my door is always open because that relies on people coming in to see you. Get out and go and see them.” — Rob Lawrence

“We love this job and that distracts us from the fact that it's also hurting us.” — Sophie Fuller

“Just because it's normal doesn't mean it's healthy.” — Sophie Fuller

“We confuse trauma with tradition.” — Sophie Fuller

Additional resources:

Follow Paramedic Sophie on:

YouTube

Tik Tok

“The Next Shift : A mentorship workbook for EMTs and Paramedics” | E-Book, by Sophie Fuller

“To Err is Human: Building a Safer Health System” - PubMed

01:00 – Rob introduces Sophie Fuller (“Paramedic Sophie”) and frames the influencer vs. “effluencer” concept

02:14 – Sophie’s origin story: graphic design → hospital tech → EMT → volunteer fire → paramedic → critical care → flight

06:16 – TAEMSP: why Tennessee needed a provider-level association and the shift toward legislative advocacy

08:05 – Why she started with social media: two full-time 911 jobs, low pay, burnout and the need for an outlet/connection

09:32 – Defining EMS burnout: the “jar on the shelf” and cumulative strain that becomes chronic fatigue

13:26 – Sophie’s guidance to providers: vulnerability, telling the truth and not letting naysayers silence needed conversations

16:00 – Sophie’s message to leadership: don’t be the “Wizard of Oz” — show up, communicate and stay connected to crews

20:26 – EMS culture: self-sacrifice, silence, “earning your place through suffering,” and confusing trauma with tradition

23:10 – Sophie’s book “The Next Shift”: a field guide to “learn, lead and last” in EMS

26:03 – Mistakes and “just culture”: reporting, mentoring, anonymous reporting systems, and learning vs. blame

32:08 – Closing challenge: stop normalizing harm; speak up for culture and patient care

33:14 – Where to find Sophie online and how large her platform has become

Enjoying the show? Email [email protected] to share feedback or suggest guests for a future episode. 

In this episode of the Inside EMS podcast, Chris and Kelly are joined by paramedic student April McKenzie — aka “April Anonymous” — for a deep dive into the buffer system and CO2 mapping.

April’s in the thick of paramedic school and like every good learner, she’s asking “why?” — so the guys break down the physiology behind capnography, acid-base balance and the lungs-vs.-kidneys showdown that keeps our patients alive. Plus, they throw in old-school war stories, rant about naloxone misuse and admit that bicarb is no longer the go-to cardiac arrest drug.

If you've ever tried to explain respiratory vs. metabolic acidosis in under 10 minutes, this episode is your cheat sheet. April will be back throughout the year with more student questions, so buckle up for the ongoing EMS education you didn’t know you needed.

Quotable takeaways

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