The JEMS Report

Point-of-care ultrasound (POCUS) is rapidly transforming emergency medical services, stepping up as the modern equivalent of the 12-lead ECG for today's paramedics, according to Dr. Ross Prager. While portable ultrasound technology was initially developed to miniaturize heavy hospital equipment for field use, widespread adoption faced friction due to complex training demands and accuracy drop-offs in fast-paced environments. AI integration directly tackles these scaling bottlenecks by guiding real-time image acquisition and providing high-level diagnostic interpretation.

By automatically identifying critical structures like the pleural line or organ interfaces, AI helps paramedics capture crisp, reliable views—even under chaotic field conditions with severe glare, heat, or noise. For trauma and undifferentiated dyspnea calls, prehospital ultrasound delivers vital objective data. Detecting free abdominal fluid or absent lung sliding allows EMS teams to notify receiving trauma centers immediately. This clinical head start mobilizes blood banks, surgical staff, and operating rooms before the ambulance even arrives, cutting down critical time to definitive care.

FDA has cleared Ezplaz, a shelf‑stable freeze‑dried plasma product, opening new possibilities for prehospital transfusion. In this episode Dr. Matt Levy and Dr. Randi Schaefer walk through the history, physiology, and practical realities of dried plasma: why it can stabilize bleeding patients, how it’s reconstituted, and where it fits alongside whole blood and component therapy. They emphasize that this is not a plug‑and‑go item—dried plasma remains a regulated blood product requiring medical director oversight, temperature management, documentation, and stewardship. Listen for implementation tips, regulatory limitations (approved for adults and currently intended where liquid plasma isn’t available), cost and distribution considerations, and how to prepare your system and crews.

NOTE: The military was officially approved to use FDP in 2018. Efforts started earlier.

This episode breaks down the ICEBERG Study and why driving pressure may provide a clearer measure of ventilator stress and patient outcomes than plateau pressure alone. We define driving pressure, explain how it is calculated, and review evidence showing that higher driving pressures are associated with worse outcomes in mechanically ventilated patients. The discussion explores why plateau pressure can be a useful trend but may not fully reflect lung stress, how changes in PEEP can affect driving pressure and lung recruitment, and why monitoring compliance, SpO₂, and end-tidal CO₂ is essential when assessing response to ventilator adjustments. We also examine the rapid changes in lung mechanics that can occur after cardiac arrest or repeated intubations and discuss how driving pressure and compliance data, when available on transport ventilators, can help guide safe ventilator management during transport.

Lt. Stephen Zachar, lead recruiter for the Memphis Fire Department, explains how the department rebuilt recruitment and retention by hiring EMS licensed candidates, fast-tracking recruits with Firefighter I, and using lateral hires to reduce academy time and overtime costs. Learn how the department hired 1,000-plus EMS licensed recruits from 42 states, increased local retention to 77%, saved upward of $2.4M in a year, and staffed a 57-station, 1,700-person department more efficiently. Stephen walks through Memphis’ interview and onboarding and demos ResponderGrid — a new recruiting and networking platform for candidates and agencies (www.respondergrid.com) — and describes how it connects applicants, recruiters, chiefs, and vendors. Visit www.joinmemphisfire.com to learn more.

Three members of the Cool Fireman Podcast join the Salty Paramedic on Just a Little Salt for a wide-ranging conversation about firehouse culture, leadership, and life on shift. Brian Kelly, Doug "Big City" Bishop, and Adam "Unkie" McCoy discuss crew integrity, how phones and station design have changed the kitchen-table camaraderie, what earns a rookie respect, and leadership lessons like "inspect what you expect" and owning mistakes. They share favorite episodes and guests, podcasting realities, social media’s pros and cons, and even the lighter side — pranks, firehouse food, bourbon and bad meals. If you run shifts, recruit, or lead, this episode digs into practical advice on training, mentorship, and balancing friendship with command.

EMS has long been technologically underserved compared to hospital systems, forcing medics to perform high-stress mental math in the field. On the JEMS Podcast, OneDose co-founders Tristan and Colton Hazlett share how they're changing that dynamic. What started as a hardware project in their parents' basement, resulting in the OneWeight smart gurney scale, has evolved into a comprehensive medication safety platform.

The OneDose app integrates directly with major EPCRs like ESO and ImageTrend to streamline clinical workflows and reduce cognitive load. Its standout features include a voice-to-voice AI Assistant for quick protocol summaries and a digital cross-check system that scans medication vials to flag concentration mismatches. By replacing manual calculations with precise dosing support, OneDose helps medics keep their focus on patients rather than screens.

This podcast is brought to you by OneDose. https://myonedose.com/ems-app/?utm_source=jems&utm_medium=podcast&utm_campaign=ai_healthcare

Tracey Loscar, deputy director-EMS for Matanuska-Susitna Borough (AK) joins the Not A-Fib Podcast. We discuss the challenges of working in Alaska. Some of those challenges include the lack of resources, the distance to care, the difficulties in reaching patients, and all versions of EMS in the state. We also discuss the vastness of the Alaskan wilderness and the long hours of daylight and darkness in the summer and winter, respectively.

Mike Brown and Jesse Carroll from Hamilton Medical break down ventilatory management for the DKA patient and other metabolic-acidosis presentations in the prehospital setting. They focus on why minute ventilation, not just rate, matters when you take a patient's airway: match or exceed the patient’s compensatory minute volume, size tidal volume to ideal body weight), and account for dead space. Practical demos cover when to favor a mechanical ventilator over BVM, using NIV-ST to support fatigued spontaneous breathers, and how to set tidal volume and rate to replace 17–20 L/min minute volumes seen in severe hyperventilation. They also unpack the ICEBERG Study and the concept of driving pressure, why driving pressure may better reflect lung stress than plateau pressure alone, and why higher driving pressures are associated with worse outcomes. The discussion reviews current evidence supporting efforts to keep driving pressure low when clinically feasible.

In this episode we walk through how noninvasive ventilation for pediatric respiratory distress moved from an idea to standard practice in central Ohio. Guests Rob Glaze and Kyle Goodknight describe a child’s near‑miss, the partnership with Nationwide Children’s Hospital, and Westerville Fire’s rollout. They debunk myths—kids won’t tolerate masks, PEEP will harm hypotensive children, blow‑by works—and explain why work of breathing, not SpO2, should trigger CPAP. Check out a link to their ebook here: https://pages.kylegoodknight.com/peds-cpap-landing

Jana Williams, president and CEO of the Association of Air Medical Services (AAMS), joins Mike Brown to discuss the evolving role of air medical and critical care transport. They cover AAMS’ three pillars—advocacy, collaboration, and education—highlighting current priorities: Medicare reimbursement that reflects modern clinical and aviation investments, the mental health and aviation bill, and a cost study showing underpayment. Jana explains how air medical teams act as mobile critical-access beds for rural communities, the expansion of point-of-care diagnostics, ECMO and whole blood transport, and the operational realities driving higher costs. She outlines workforce initiatives: the Flight Ready Institute (formerly the Critical Care Transport Academy), leadership schools (MTI, SMT, LIFT), and the annual Air Medical Transport Conference (MTC).