The JEMS Report

Just a Little Salt: Patrick Pianezza on ‘Code 3,’ EMS Realism and Mental Health

In this debut episode of Just a Little Salt, former paramedic and co-writer Patrick Pianezza shares the story behind the upcoming film “Code 3,” releasing September 12. Drawing on over a decade in EMS, Patrick reveals how a college creative writing assignment transformed into a heartfelt, medically accurate portrayal of a 24-hour shift’s highs and lows. He discusses the film's unapologetic look at EMS challenges—including burnout, mental health struggles and systemic issues—while preserving dark humor and camaraderie that help first responders cope. Patrick also reflects on working closely with actors to capture authentic medical procedures and the importance of educating the public about the skill behind EMS work. Wrapping up with encouragement for aspiring writers, he offers raw insight into perseverance, creativity, and gratitude toward those who serve on the front lines.

Chief’s Cadence:  Ethical Leadership in EMS with Attorney Steve Wirth

In this episode of The Chief’s Cadence, Chief Shane Wheeler sits down with Attorney Steve Wirth, a pioneering paramedic turned attorney and EMS leader, to uncover the complexities of ethical leadership in emergency medical services. Drawing from decades of hands-on experience, Steve explores the hard choices EMS professionals face daily—from patient care errors and scarce resources to the challenge of maintaining compassion amid burnout. They discuss the vital role leaders play in modeling integrity, fostering transparency, and building a culture that empowers staff to speak up about mistakes. Steve also highlights mentorship as a powerful tool for guiding the next generation of EMS leaders through the ethical “gray zones” that often arise. 

What is high-risk airway management (HRAM)? It is exactly the stuff nightmares are made of: Patients who present to us, outside of the hospital, with severe injuries and competing treatment priorities.

Performing RSI on these patients is a lot like walking alone down a scary alleyway in the big city.

Read the full article on EMS Airway.

Not A-Fib:  Mobile Integrated Healthcare, Advocacy and Mental Health in Missouri

Chief Justin Duncan, CEO of Washington County Ambulance District in Missouri, shares insights on pioneering mobile integrated healthcare in a sprawling 1,500-square-mile rural area. Winning the $150,000 Building Bridges to Better Health challenge, his program blends community paramedics, telehealth, and partnerships with federally qualified health centers and social service organizations to close care gaps beyond traditional EMS responses. Duncan discusses the evolution from emergency transport to preventative, holistic care, tackling chronic diseases and social determinants of health, while navigating reimbursement challenges through managed care contracts and advocacy. He highlights the crucial role of public health in community needs assessments and stresses the urgent need to address mental health within EMS, sharing personal stories and calling for cultural change. As president of the Missouri EMS Association and chair of the NAEMT Economics Committee, Duncan emphasizes teamwork, mentorship and engagement at all levels—from local agencies to Capitol Hill—to shape the future of EMS and ensure sustainable, patient-centered care.

The JEMS Report: Practical Insights for Out-of-Hospital Birth Challenges

In this episode of the JEMS Report Podcast, managing editor Jeff Frankel sits down with Dr. Liz Travis, a maternal care researcher, to discuss the growing challenges EMS providers face with out-of-hospital births. They unpack the critical gaps in traditional EMS training, particularly as maternal care deserts expand, leaving medics increasingly responsible for delivering babies in the field. Dr. Travis shares evidence-based strategies like the importance of delayed cord clamping (“wait for white”), skin-to-skin contact, and encouraging comfortable, non-supine birthing positions to improve outcomes for mother and infant. She advocates for updated, hands-on EMS training that reflects modern obstetric knowledge, including collaboration with midwives and doulas. Above all, Dr. Travis emphasizes that birth is usually natural, not an emergency, encouraging EMS providers to remain calm and focus on simple, effective practices. This episode offers essential insights for paramedics and EMS agencies preparing to meet the demands of maternal care in underserved areas.

Airway management in the prehospital environment is difficult just by virtue of where we are doing it and the lack of resources available to help us manage the difficulties. Add to that a patient with mangled facial anatomy or is dangerously peri-arrest due to hemorrhage and the danger can seem insurmountable.

What the research tells us is that there are really three big buckets of problems in airway management that contribute to morbidity and mortality: hypoxia, hypotension and multiple intubation attempts; this is the stuff that airway nightmares are made of.

Read the full article on EMS Airway.

Not A-Fib :Inside New Orleans EMS’s Body Worn Camera Program and Mass Casualty Response

In this episode of the Not A-fib podcast, Deputy Chief Christopher Keller of New Orleans Emergency Medical Services shares the origins and impact of their innovative body worn camera program.

The program protects staff, supports quality assurance and aids patient care. Keller discusses navigating privacy concerns, storage challenges, and staff buy-in while prioritizing transparency over punishment. He also reflects on the agency’s rapid and coordinated response to the tragic January 1, 2025 Bourbon Street attack, highlighting lessons learned and multi-agency training efforts.

Additionally, Keller provides insight into preparing for massive events like the Super Bowl and Mardi Gras, where public safety coordination is key.

The episode closes with reflections on the department’s experience filming the Nightwatch TV series and the future potential of integrating body cam footage with EMS documentation.

The JEMS Report - How Drones Are Transforming EMS Logistics and Healthcare Delivery

JEMS Managing Editor Jeff Frankel sits down with Ryan Walsh, CEO and founder of Valqari, to explore how drones are revolutionizing emergency medical services and hospital logistics. Drawing on his special operations experience, Walsh reveals how Valqari developed autonomous drone technology to deliver critical medical supplies quickly, slashing delivery times.

EMS Research: Severe Hemorrhage Technology Developed by Military Researchers

Severe hemorrhage is one of the toughest challenges faced in the prehospital environment, especially when every second counts and resources are limited. But a recent study on the use of 25% human serum albumin (HSA) in trauma care could change how responders approach these critical moments.

The study was led by United States Air Force Scientist Alex Penn, PhD. The findings from his team suggest that this concentrated protein solution can stabilize blood pressure, reduce the need for additional fluids, and improve circulation in ways traditional methods cannot. For paramedics, this could mean a shelf-stable, easy-to-use solution that saves more lives in the toughest conditions, revolutionizing pre-hospital care as we know it.