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. 

New York City Mayor Eric Adams recently announced a directive for police and emergency medical workers to hospitalize people on the streets and subways who have severe, untreated mental illness. Adams said the directive was an effort to curb a recent wave of crimes involving people experiencing homelessness and will allow law enforcement and EMS to involuntarily hospitalize people who pose a danger to themselves, even if they don't pose a risk to others.

The directive, which has been met with major concern – as voiced in a New York Times op-ed by an FDNY Paramedic Lieutenant, is fraught with concerns in the burden being placed on EMS to solve the mental health crisis.

In this episode of EMS One-Stop, Doug Wolfberg, EMS attorney and founding partner of Page, Wolfberg & Wirth, LLC, joins host Rob Lawrence to discuss how the directive is a departure from the usual mental health standard.

“The Mayor’s office is using a very aggressive and untested interpretation of the state mental health law to essentially deputize EMS clinicians to involuntarily remove anyone who is mentally ill and unable to meet their own basic needs,” Wolfberg notes.

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. 

Following the invasion of Ukraine by Russia on February 24, 2022, Christopher Manson, vice president of government relations in the Illinois-based OSF Healthcare System, came up with the idea of sending American ambulances full of supplies to Ukraine.  

After reaching out to the Government in Kyiv and the Ukrainian Consulate in Chicago, and connecting with others working to send aid to Ukraine, on March 29, 2022, the first ambulance full of medical supplies and equipment left for Ukraine on a 747-800 aircraft. 

Since then, five additional shipments of ambulances have traveled from the United States to Ukraine via aircraft and ship for a current total of 18 ambulances and tons of medical supplies.

In this episode of EMS One-Stop, Host Rob Lawrence welcomes Christopher Manson and discusses the challenges, logistics and successes of the program, and also Mark Tenia, media manager for the Richmond (Virginia) Ambulance Authority, who highlights their recent donation of an ambulance for Ukraine and the process for gaining clearance for the donation. 

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. 

Fresh back from Montana’s Big Sky EMS Symposium, in this episode of EMS One-Stop, Host Rob Lawrence chats with Kris Kaull on his history-taking session. They discuss Kaull’s 10 top hacks to improve your history taking, including:

• Thinking like a detective

Kaull has driven innovation and positive change in EMS for over 25 years. After beginning his career as a firefighter and EMT, he started paramedic.com and co-founded EMS1. He is currently the chief marketing officer at Pulsara, a healthcare and mobile tech startup. He has worked as a firefighter captain, paramedic and ambulance service director, and continues his practice as a critical care flight paramedic covering southwest rural MT and Yellowstone National Park.

Kaull has shared his presentation and notes here.

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. 

Dr. Ray Barishansky has recently delivered keynote addresses at a number of national and state conferences to much acclaim.

In this week’s episode of EMS One-Stop, Host Rob Lawrence discusses Barishansky’s key takeaways on professionalism in EMS and after the break, they move on to writing and speaking in the EMS environment. We conclude with an invitation to those interested in writing for EMS1 to reach out.

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. 

This edition of EMS One-Stop looks at diversity, equity and inclusion in U.S. EMS. This episode takes a deep dive into two academic research papers recently published by members of NAEMSP’s Diversity Equity and Inclusion Committee who focus on the delivery of care and how that care may differ based on a patient’s ethnicity and race. 

Host Rob Lawrence welcomes:

• Anjni Joiner, assistant professor of emergency medicine at Duke University School of Medicine, and medical director for Durham County EMS

One of the two research papers discussed is now published:

• Rudman JS, Farcas A, Salazar GA, et al. (2022) Diversity, Equity, and Inclusion in the United States Emergency Medical Services Workforce: A Scoping Review, Prehospital Emergency Care

The companion research paper on disparities in care has been peer reviewed and accepted for publication.

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. 

Faroukh M. Mehkri is an assistant professor of emergency medicine at the University of Texas SW Medical Center as well as a SWAT physician with the Dallas Police Department. He recently presented a session at the International Association of Police Chiefs Conference in Dallas, “Management of the acutely agitated behavioral health emergency: A patrol nightmare.”

In this edition of EMS One-Stop, Host Rob Lawrence chats with Dr. Mehkri about his lecture and his 15-month deep dive into behavioral health emergency patients, their outcomes, the situations surrounding the calls, and both police and EMS interventions.

Dr. Mehkri delivers key takeaways for both a police and EMS audience:  

1. Words matter, in your documentation and on your body camera

Read more about treating behavioral emergencies

• Expert tips for EMS handling of behavioral emergencies

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. 

In this edition of EMS One-Stop, Host Rob Lawrence welcomes Dr. Alex Isakov, executive director of Emory’s Office of Critical Event Preparedness and Response (CEPAR) and professor of emergency medicine at Emory University School of Medicine. Dr. Isakov also leads the National Emerging Special Pathogens Training and Education Center (NETEC) EMS workgroup developing education and resources to improve EMS and community disaster resilience.

Rob and Dr. Isakov discuss the current Ugandan Ebola outbreak and the implications and risk of spread to the U.S.  

On September 20, 2022, Uganda announced that it had an outbreak of Ebola virus with the Sudan strain, which has now spread amongst five of its administrative districts. The case and death count, as of October 12, 2022, was 74 total cases (54 confirmed) and 39 deaths (19 confirmed). As a result, the U.S. has issued a Health Advisory Network (HAN) Travel Alert Level 2 and HAN Health Advisory for healthcare workers to be aware of the Ebola outbreak in Uganda, monitor for symptoms consistent with Ebola, and utilize best practices if there are any signs that someone might be experiencing an illness consistent with it.

The tactics to identify, isolate, and inform are discussed as well as reminder about PPE requirements. Rob and Dr. Isakov also conduct an additional roundup on the current situation on COVID and Monkeypox. 

Additional EMS resources

• CDC: Guidance for Emergency Medical Services and 911 communication centers

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.

In this edition of EMS One-Stop, Rob Lawrence welcomes Sean M Kivlehan, MD, MPH; and Kevin Collopy, MHL, FP-C, NRP; to discuss the search for the next big EMS speaker as well as the Harvard initiative to provide mass casualty training to Ukraine.

EMS World Expo takes place October 10-14 in Orlando and one of the returning sessions this year is “Stand and Deliver,” a presentational opportunity for speakers to audition for their place on the national stage. 

The program was the brainchild of Kivlehan and Collopy, and participants get their chance to present at a national conference as well as receive coaching and constructive feedback on their sessions. The Stand and Deliver winner then gets the opportunity to present their session at the Expo general session at the end of the week.

The guests also discuss the Harvard Humanitarian initiative focusing on emergency health systems in conflict and austere environments. When the Ukraine/Russian war escalated, the Harvard group were approached to provide CBRN and mass casualty training throughout Ukraine. 

About the guests

Sean M Kivlehan, MD, MPH, is the director of the Global Emergency Medicine Fellowship at Brigham and Women's Hospital in Boston. He is a practicing emergency medicine physician in the level one trauma and burn center, and core faculty for the Harvard Affiliated Emergency Medicine Residency. He is an assistant professor of emergency medicine at Harvard Medical School; assistant professor of global health and population at the Harvard Chan School of Public Health; and faculty at the Harvard Humanitarian Initiative. He has worked as a consultant for the World Health Organization's Emergency, Trauma and Acute Care Program and was a New York City paramedic and instructor coordinator for 10 years.

Kevin Collopy, MHL, FP-C, NRP, CMTE, is the clinical outcomes and compliance manager for Novant Health AirLink/VitaLink where he oversees the program's research, education, risk management, quality management and reimbursement programs. He regularly speaks across the United States and has taught emergency and wilderness medicine on three continents. He's an author of over 200 articles and book chapters, including 18 peer-reviewed research abstracts and papers. In addition, he serves on several national and international advisory boards, teaches the paramedic program at Cape Fear Community College and is currently overseeing multiple clinical trials. He also maintains his LEAN Healthcare Blackbelt certification, has a master’s in healthcare leadership, and is known for developing and innovating quality management solutions in prehospital care systems.

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” is an emotionally compelling documentary from seasoned network news producers Bryony Gilbey and Rich Diefenbach that highlights the realities of working in EMS. The documentary calls attention to the inexcusable underfunding of our first responders and the subsequent collapse of the system. 

The story told by Gilbey and Diefenbach truly sums up the precipitous state of EMS. In this edition of EMS One-Stop, Rob Lawrence welcomes Bryony Gilbey and returning guest Matt Zavadsky to discuss the documentary, its planned development into a full-length production, exciting sponsorship news and commentary on the issues raised by NAEMT board members that appeared in the film.

The discussion and documentary advocate for funding and political change to the current status quo, but as Gilbey asks, “what is life worth to an elected official?”

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.

On Sept. 12, 2022, American Medical Response announced it is to close its Los Angeles County non-emergency operations over the next 180 days. One of the key reasons is one faced by all ambulance operators at this time – insufficient levels of Medicare reimbursement. Against this backdrop, GMR (AMR’s international EMS division) predicts that its Los Angeles division is on course for an operational deficit of over $3.5 million.

In this episode of the Inside EMS podcast, Brian Henricksen, California-based regional director for GMR, joins host Rob Lawrence for a frank discussion on the issues in LA and they discuss the fact that this may be the bellwether of things to come across the nation.

Rob is also the executive director of the California Ambulance Association and the economics of ambulance service operations in the state are close to his heart. California has not increased its Medi-Cal reimbursement for private ambulance operators since the late 1990s. The current Medi-Cal base rate for private ambulance services sits just above $100, which is far below the cost of providing transport. The State’s Medi-Cal reimbursement rate is one of the lowest in the country, but it also has the highest operational costs for ambulance transports.