EMS One-Stop

In this edition of the EMS One-Stop podcast, host Rob Lawrence Zooms (literally) from the U.K. to South Carolina to spotlight one of the nation’s most forward-thinking mobile integrated healthcare programs. Prisma Health’s team has taken community paramedicine beyond buzzwords, designing targeted, evidence-based programs that meet people where they are — both geographically and medically.

| MORE: How North Dakota EMS is confronting rising pediatric mental health crises 

Whether it's addiction medicine, rural HIV/HCV treatment or skilled nursing interventions, this team is shifting paradigms on what EMS can and should be doing.

Rob is joined by four key voices from the Prisma Health MIH program:

Luke Estes, director of MIH

Dr. Mirinda Gormley, epidemiologist and biostatistician

Wes Wampler, community paramedic specializing in addiction and infectious disease

Parker Bailes, community paramedic and research contributor

Together, they unpack how passion meets data to drive change, how to earn trust in communities overlooked by traditional systems, and why this work isn’t just novel — it’s necessary. This is EMS in its truest public health form.

“You delivered the goods—data-driven, community-connected care — and that’s what EMS in 2025 needs more of.” — Rob Lawrence

“When you see some of your people who have a passion for a certain pathway in EMS, you try to give them the reins and say, you're gonna do some good.” — Luke Estes

“One of the big things that we learned from his study was that we really needed to go out and make sure everybody was aware that addiction is a disease.” — Mirinda Gormley

“If we can gain their trust, there’s a lot more that we can kind of weasel our way into to help them solve and get them on a healthier trajectory.” — Wes Wampler

“Walking into the (care) facility with the mindset of, ‘I'm going to do everything I can to keep you here,’ was a big shift for me.” — Parker Bailes

“If we can set them up to be successful after they leave the hospital, I think that's the best way to get them reengaged with the hospital.” — Wes Wampler

“As their leader … all I have to say is, what do you need? I'm here to support you.” — Luke Estes

EMS Clinician Perceptions on Prehospital Buprenorphine Administration Programs: Prehospital Emergency Care: Vol 29 , No 4

Implementation Barriers of Prehospital Buprenorphine Administration Programs in the United States: A Scoping Review: Prehospital Emergency Care: Vol 29 , No 4

Using Community Paramedicine to Treat Hepatitis C Virus in Upstate South Carolina - PMC

Luke Estes BA, NRP, CCEMTP, PNCCT, FP-C, CP-C | LinkedIn

Wesley Wampler | LinkedIn

Support for harm reduction by community EMS

How does a community re-imagine compassion to avoid crisis whenever possible?

Breaking barriers: Hennepin EMS leads the way in safely implementing buprenorphine

00:51 ­– Introduction to Prisma Health MIH & guests

03:00 – Luke Estes overview of MIH models (ETS, SDOH, addiction)

05:00 – Dr. Gormley’s public health journey, data-opioid focus

08:00 – Buprenorphine pilot design and research outcomes

10:15 – Challenges: bias, stigma, barriers to addiction care

13:00 – Funding and sustainability conversation

14:00 – Wes Wampler on daily workflow in addiction medicine and HCV care

17:00 – Building trust with vulnerable populations

18:30 – Parker Bailes discusses traditional CP role and skilled nursing interventions

21:45 – Alternative destinations, lab draws and high-acuity decisions

25:30 – Training: internal education, ultrasound, medication management

28:15 – Prisma’s med school connection and disaster response evolution

30:00 – State-level partnerships: SC EMS Assn, FEMA typing, CP strike teams

31:56 – Academic next steps from Dr. Gormley: scaling, publishing, process evals

35:26 – Final reflections from Luke Estes: passion, team strength and mission

38:00 – Rob’s call to action: “If you want your own Prisma team — start now.”

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

Editor’s Note: Welcome to the What Paramedics Want podcast, sponsored by Pulsara. Whether replacing radio reports, alerting specialty teams, or managing mass casualty incidents, Pulsara simplifies communication. One Tool. Every Day. Regardless of Event.

This week on the Inside EMS Podcast, Chris Cebollero and Kelly Grayson dive deep into the What Paramedics Want in 2025 industry report — and let’s just say, it’s not all sunshine and stable shifts.

The report, created in partnership with Fitch & Associates and sponsored by Pulsara, lays bare the hard truths: burnout is at an all-time high, staffing gaps are holding steady at crisis levels and confidence in leadership is lukewarm at best.

Chris and Kelly get real as they discuss some of the shocking stats — such as, only 59% of agencies report having enough staff to answer 911 calls, and 76% of respondents now cite burnout as a critical issue. But this isn’t just about fatigue; it’s about leadership gaps, lack of support and workplaces that are driving out even the most seasoned medics.

From the “mandatory overtime spiral” to why communication isn’t just nice — it’s a necessity — this episode tackles how broken systems are eroding morale and what leaders can (and must) do to change course. You’ll hear why stay interviews matter more than exit interviews, how marijuana use is creeping up as a stress escape, and the simple steps agencies can take to rebuild trust and retention.

“If one-quarter of your work workforce says ‘we don't enjoy our jobs anymore’ and ‘we don't enjoy working for you anymore,’ you got a hell of a problem on your hands.” — Kelly Grayson

“This isn't just burnout because of the things we're seeing.  This is because of staffing shortages. This is because of lack of funding. This is because of working overtime. This is because agencies are mandating overtime. And that's gonna lead to burnout.” — Chris Cebollero

“What we have is a shortage of people who are willing to work for chump change and horrible working conditions.” — Kelly Grayson

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.

Enjoying the show? Contact the Inside EMS team at [email protected] to share your feedback and suggest future guests.

You’ve just been promoted — congrats, right? Not so fast. In this episode of the Inside EMS podcast, cohosts Chris Cebollero and Kelly Grayson get real about what it actually means to step into a leadership role. Spoiler alert: it's not just a new title and a gold badge. It’s a complete shift in responsibility, from caring for patients to caring for your people.

Together, they break down how new leaders often swing too far: either trying to be everyone’s buddy or going full micromanager. They talk servant leadership, earning trust daily, the power of listening and what “protecting your people from bad decisions above” really looks like.

If you're stepping into a new role — or trying to recover from a rocky start — this episode is packed with hard truths, some laughs and solid advice from two guys who’ve lived it.

“Ask a lot of questions and give your subordinates some ownership over how decisions are made. They didn't get stupid overnight when you got a white shirt. They're still the good people they were before.” — Kelly Grayson

“Leadership isn't a title, it's not a reward, it's a responsibility.  It’s a verb, not a noun, and you have to be able to show your leadership every day.” — Chris Cebollero

“Leadership's not about perfection. It's about showing up every day and trying to get better. It's being present in the moment. You show up for your people, you help them be their very best, and you never stop learning how to lead better.” — Kelly Grayson

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 the Inside EMS podcast, hosts Chris Cebollero and Kelly Grayson are staying in the same hotel, but definitely not on the same page. The topic? Point of care ultrasound (POCUS) — is it the future of EMS, or just another flashy tool with little impact in the field? 

Chris opens the discussion with skepticism, calling POCUS a “ridiculous” tool that adds no value to his prehospital patient care. Kelly fires back with a defense of POCUS as a powerful, fast and non-invasive tool that can enhance clinical decision-making — if used right. 

It’s a spirited back-and-forth loaded with clinical scenarios, sarcasm and a lot of “whatever, man.” Whether you’re team “POCUS is progress” or “scan and stall,” this episode will get you thinking. 

“Ultrasound gives you another layer of decision-making support.” 

“Point of care ultrasound gives me no ability to change the way I'm treating the patient.” 

“It never is a bad thing to know more about the patient.” 

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 the Inside EMS podcast, Chris Cebollero and Kelly Grayson tackle one of the most nerve-wracking scenarios in EMS: the pediatric respiratory emergency. From the moment you see a gasping toddler in mom’s arms, you know this is a make-or-break call — and for many providers, it’s the one that keeps them up at night.

Chris kicks things off with a haunting real-life scenario that sets the stage for an in-depth conversation on how to recognize and respond to pediatric respiratory distress. Kelly, a seasoned PALS instructor with a knack for demystifying pediatrics, offers practical advice on assessing sick kids using tools like the Pediatric Assessment Triangle, reading subtle signs like head bobbing or limp limbs, and why the good ol’ basics — like BVM ventilation and suction — save lives.

From clinical pearls to mindset resets, this episode is a must-listen if you want to face your pediatric fears and come out stronger.

Memorable quotes

Enjoying the show? Email [email protected] to share your feedback. 

In this high-impact edition of the EMS One-Stop podcast, host Rob Lawrence sits down with EMS influencer and educator Jimmy Apple, known widely across platforms as The EMS Avenger. With nearly 70,000 followers on TikTok and a growing presence on Instagram and Facebook, Jimmy has mastered the art of compressing complex clinical topics into digestible, engaging content.

| More: What the EMS Counts Act means for dual-role EMS providers 

In this conversation, Rob pulls back the curtain on the man behind the mobile screen — exploring Jimmy's journey from electrician to pediatric critical care paramedic, and now, one of EMS's most watched and listened-to voices.

Listeners will gain deep insight into Jimmy’s origin story, his social media strategies, his refusal to let bad information go unchallenged, and his passionate belief that “Saving lives begins with kindness.” The pair also tackle:

Content creation advice for EMS agencies

The challenges of tone and accuracy in short-form video

How to maintain compassion in the face of a toxic work culture

This episode is part masterclass in communication, part call to action for the future of EMS — and all heart.

“Saving lives begins with kindness. That is my motto, it is my philosophy.”

“You have to package something down to its bare essence … there's some nuance lost, but you have seconds to keep people's attention.”

“My goals going forward are to support people who are acting in good faith while correcting the misinformation.”

“Generally speaking, you will draw the engagement that you're looking for. If you're putting out content in good faith, you'll get good faith engagement.”

“We are responsible for ourselves and how we respond … and I believe we need to respond to everything that is happening in the world today with kindness.”

00:54 – Rob introduces Jimmy Apple, aka the EMS Avenger

01:20 – Jimmy’s background: from electrician to EMS

03:30 – The grandfather conversation that changed his life

04:50 – How pathophysiology sparked a love for learning

05:40 – Birth of the EMS Avenger: from student favorite to TikTok influencer

06:55 – Ginger Locke’s advice that redirected Jimmy’s podcast path

08:04 – Compressing content: "from textbook to bumper sticker"

10:00 – The content hook: “Are we getting rid of normal saline?”

11:00 – How Jimmy selects topics: research, news, curiosity and requests

13:00 – Hot topics in EMS: cricothyrotomy, TXA, ketamine, provider safety

14:40 – Rob discusses EMSIntel.org and ambulance theft data

16:00 – Can EMS agencies do what Jimmy does? The risks and the realities

18:30 – "Stop the finger": creating content that captures attention

20:00 – Rob on the risks of public messaging and backlash

21:00 – Calling out misinformation: the line between education and shame

23:00 – Jimmy’s growing reach across TikTok, Instagram and Facebook

24:45 – Managing Facebook’s deeper comments and nuanced conversations

26:45 – Jimmy’s rule: “Engage only with good faith”

27:50 – Final thought: EMS must rediscover kindness

29:00 – Closing remarks and where to follow Jimmy Apple online

Connect with Jimmy Apple, better known as The EMS Avenger:

TikTok — Jimmy offers short-form, evidence-based EMS content here: @emsavenger

Instagram — Engage with in-depth reels, visuals, and professional updates: @emsavenger

X (formerly Twitter) — Follow EMS commentary, conversation, and boosts: @EMSAvenger

Facebook — Join the group for discussions and shared insights: EMS Avenger community

Apple Podcasts — Listen to “EMS Avenger: 20 Minutes to Save the World”: Weekly podcast series

AAA & AIMHI EMS Media Log: EMS Intel

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

In this special crossover edition of EMS One-Stop and The Bridge Podcast from the Kentucky Office of Rural Health, host Amelia Holliday leads the conversation, joined by Scott Helle, rural project manager at KORH; and Rob Lawrence, host of EMS One-Stop and EMS leader.

Recorded live at the 2025 Kentucky EMS Leadership Academy, this episode explores the evolution, design and impact of the Leadership Academy on Kentucky’s rural EMS landscape. The discussion dives into the Academy’s origins, structure, statewide reach and its mission to prepare the next generation of EMS leaders in some of the most resource-challenged communities in the country.

From the realities of low-volume, underfunded rural services, to the inspiring stories of leadership growth and resilience, this episode offers a thoughtful examination of the challenges facing EMS in Kentucky and beyond. Rob reflects on leadership principles drawn from his military and EMS career, while Scott provides a blueprint for how to build and sustain EMS talent in small communities. Together with Amelia’s thoughtful moderation, this episode highlights how mentorship, structured learning and network-building are transforming rural EMS leadership — one cohort at a time.

The Bridge Podcast (Contains additional discussion)

Center of Excellence in Rural Health: Established to address health disparities in rural Kentucky

Asking the big questions: Industry leaders weigh in on celebrating EMS Week amidst the forces shaping the EMS landscape

Cultivating the next generation of EMS: Leadership development, emotional intelligence and the importance of mentorship

“We’re promoting people above their level of competency — not because they’re not good, but because we haven’t prepared them for what’s next.” — Rob Lawrence

“We saw early on that EMS professionals were great at clinical care, but we were missing the leadership piece.” — Scott Helle

“Effective communication is the core of good leadership. You can’t lead without it.” — Amelia Holliday

“My six principles: pride, integrity, learning, humor, service and courage. They guide everything I do.” — Rob Lawrence

“It costs money to build people. That’s why we provide this Academy at no cost to participants.” — Scott Helle

“It’s hard to run EMS in a state where many counties don’t even have a tax base to support it.” — Scott Helle

“You’re always leading. Once you start, it never stops. People are always watching and listening.” — Rob Lawrence

“We’re not just building leaders — we’re building mentors, networks and future change-makers.” — Scott Helle

“Nobody becomes a good leader because they want power. The best leaders are those who understand the responsibility.” — Amelia Holliday

00:18 – Introduction to the Kentucky Leadership Academy and crossover with The Bridge Podcast

02:29 – How the Academy was formed and why it was needed

05:00 – Structure of the Academy, application process and regional representation

08:11 – EMS 2050, developing next-gen leaders, and avoiding the Peter Principle

11:00 – The importance of non-clinical leadership education

13:36 – Funding challenges in rural EMS, tax base realities and sustainable operations

17:41 – Rural EMS dynamics, local politics and the true cost of readiness

21:25 – Hospital closures and extended transport times — national rural EMS challenges

24:11 – Leadership is constant: visible, energetic and principle-driven

28:14 – Rob’s military leadership values and the weight of being observed

32:35 – Leadership as service and the power of building trust within teams

34:58 – Rob’s group dynamics “icebreaker” exercise and lessons on leadership styles

39:33 – Mentorship benefits both ways: mentees gain confidence, mentors renew purpose

44:49 – Academy success stories and graduates becoming leaders elsewhere in EMS

46:44 – Closing comments and podcast wrap-up with Amelia and Rob

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

In this episode of the EMS One-Stop podcast, host Rob Lawrence sits down with Danielle Thomas, chief operating officer, Lifeline EMS of Los Angeles, to explore how her team is harnessing “actual intelligence” — through a proprietary, closed-source AI platform called InCheck — to solve a perennial EMS headache: information overload. Thomas explains how embedding agency-specific protocols, an 800-page policy manual and multi-language translation into a single voice-activated app gives every crew member a “mentor in their pocket,” shrinking cognitive load, sharpening clinical decision-making and smoothing onboarding during the critical first 80 hours of employment.

| More: From 73 to 33 minutes: How Sacramento reinvented patient offload times 

The conversation ranges from her move from Boston to California and the regulatory culture shock that followed, to Lifeline’s recent CAAS accreditation push and the wider potential of AI-driven tools to boost recruitment, retention, compliance and patient safety.

In the second half, Rob and Danielle expanded the conversation from tools to leadership strategy, focusing on how EMS agencies can better support staff in high-pressure, multi-jurisdictional environments.

Thomas shares how her team tackled issues like protocol confusion, inconsistent policy knowledge and language barriers — not by adding more training sessions, but by rethinking how information is delivered, accessed and retained on the front lines. She emphasizes the importance of aligning education with the way today’s workforce learns, communicates and engages — especially during the critical first days of employment.

The episode closes with a preview of Danielle’s upcoming AAA conference presentation with Carly Strong, which challenges perceptions of gender in EMS leadership and spotlights the untapped potential of inclusive, thoughtful organizational development.

“If you can, as the leader in an EMS organization, figure out how to enhance not only that first 80 hours, but that team member experience.” — Danielle Thomas

“As everybody listening knows, I'm sure that every new policy probably has somebody's secret name attached to it because of what happened.” — Rob Lawrence

“It honestly solves our recruitment and retention issues because they want to come to work.” — Danielle Thomas

“I happen to believe that [AI is] an on-the-train or under at the moment kind of thing … we now have to move forward. It's part of our life. We have to embrace it and we have to employ it.” — Rob Lawrence

“The left coast is more highly regulated and so I was not used to the labor laws in California and I was not used to the way that the local EMS authorities work.” — Danielle Thomas

“I think every company I've worked at that that was a thing and so we had to create a solution to the problem we had, which was information overload.” — Danielle Thomas

01:25 – Welcome to Danielle Thomas

02:56 – East-to-West move and California’s regulatory maze

4:12 – Lifeline EMS footprint across Los Angeles, Orange and Riverside Counties

6:27 – The policy-overload dilemma in multi-county operations

10:01 – InCheck: turning 800 pages into actionable intel

14:53 – From AI skeptic to evangelist — programming county-specific protocols

18:30 – Five operating modes explained (Rampart, Angel, Nova, L-Chat Narrative)

28:00 – 100-language instant translation with Nova

34:51 – Building the tool in-house; cost and compliance advantages

38:43 – Preview of AAA Conference session, “Just one of the guys”

41:33 – Final takeaways: enhancing the first 80 hours and keeping crews engaged

42:44 – Closing remarks

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. Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

When conflict flares up in your organization, do you fuel the fire or douse it with empathy? In this week’s episode of the Inside EMS podcast, Chris Cebollero and Kelly Grayson break down how to handle interpersonal drama and tough conversations like a leader — with calm, clarity and tactical empathy.

Tactical empathy isn’t about being soft; it’s about being smart. It’s the intentional art of listening, labeling emotions and showing people they’re seen — without letting things spiral into chaos or resentment. Drawing from leadership lessons, clinical psychology and their own missteps, Chris and Kelly lay out 5 solid tools you can start using immediately, from mirroring and eye contact, to setting respectful boundaries.

Whether you’re managing late shift changes, dealing with crew conflict or just trying to keep morale afloat, this is an episode that gives you actionable steps — not just leadership fluff.

Oh, and if you think “tactical” doesn’t belong in the same sentence as “feelings,” they’re here to prove you wrong.

“Conflict is part of EMS. You cannot avoid it.” — Kelly Grayson

“Empathy’s not a rescue mission. It’s a recognition moment.” — Kelly Grayson

“The trick isn't avoiding conflict. It's learning how to handle it without crushing morale, without leaving the other side, or having one or both sides feeling that you're showing favorites or you're blind to their concerns.” — Kelly Grayson

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 Inside EMS, Chris Cebollero unpacks what it really means to be a field training officer and, spoiler alert: it’s not just about ticking boxes or passing protocols.

From the importance of professional modeling and emotional intelligence to the dangers of unchecked cynicism among senior field staff, Chris lays out why FTOs must be seen — and supported — as true leaders. He shares his own experiences as a clinical director, discusses how poor habits often trace back to lackluster FTO mentorship, and offers a full blueprint for building an FTO program that not only trains but transforms.

This isn’t about seniority; it’s about strategy. You’ll learn why ongoing training, peer-reviewed reappointments and subject matter ownership turn FTOs into the backbone of your EMS culture. Whether you’re an FTO, want to become one or oversee the program, this is the wake-up call you didn’t know you needed.

“My FTOs were gatekeepers to the organization, and it was important for them to set the standard of what that was going to look like.”

“Don't assign the title and hope for the best. Right? Develop the role into a leadership position that inspires people daily.”

“You can't build a strong workforce if your trainers aren't trained themselves.”

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.