EMS Today
News, updates and commentary on the world of emergency medical services.
Get to know Douglas Randell, what his favorite hobby is, what the EMS P.O.D. is, and learn about the type of podcast topics and people he will have on his show.
A&E Network’s hit non-fiction series “Nightwatch” returns for a new season following the skilled first responders on the front lines of one of America’s most dynamic agencies—New Orleans EMS.
Each one-hour episode of “Nightwatch” chronicles the sacrifice and heroic work of the first responders in New Orleans, a city filled with rich culture and a vibrant community – and an amazing array of EMS calls.
On this special addition of the EMS Today Show, host A.J. Heightman is joined by New Orleans EMS Chief Bill Salmeron and two Nightwatch “cast” members, Paramedic Supervisor Keeley Williams, Paramedic Shaquille Harris and NOEMS Public Information Officer Lt. Jonathan C. Fourcade.
A one-hour special leading up to the premier, hosted by Holly Sherman and Titus Tero, looked back at some of the past seasons’ memorable moments as well as introduced the new team members featured on the series this season.
Guest: Curtis Varone
Does being an emergency service worker impact your freedom of speech online on social media? Are there pictures you can take on scene? What should you do with pictures you need to delete? You may be surprised to learn what could happen if you delete an image prematurely.
Chief Curt Varone, a retired fire chief and current practicing attorney, explores social media and its legal impact for those in fire and emergency services. This podcast has valuable information for those entering our service and critical for those currently practicing.
Varone has over 40 years of experience in the fire service, retiring in 2008 as a deputy assistant chief with the Providence (RI) Fire Department. He is a practicing attorney licensed in both Rhode Island and Maine. Varone has written two books on legal issues in the fire service, is a contributing editor for Firehouse and runs Fire Law Blog. He remains active as a deputy chief with the Exeter (RI) Fire Department.
In the latest episode of Sacred Cows & Data Cubes -- Part one of a two-part mid-pandemic deep dive -- Jonathon Feit talks with Joseph Casciotti, battalion chief of Community Medicine at the Harris County (TX) Emergency Service District 48 Fire Department.
Chief Casciotti oversees Community Paramedicine/Mobile Integrated Health, infectious disease prevention and control, and COVID-19 response (both exposure tracking and vaccinations). No holds were barred in this frank discussion, which covers politics, misinformation, the now-very-clear consequences of raiding public health funding for years, and even the ease of documenting -- on white paper cards -- COVID-19 shots that one may or may not have actually taken.
(Coming soon: Part two will explore the experience of sharing data with a state immunization registry...only to find errors in one's own vaccine record.)
How can storytelling impact the first-responder culture? Hear from a ghostwriter Alee Anderson, who specializes in working with victims of trauma.
"Telling stories is one of the most powerful means that leaders have to influence, teach and inspire,” Anderson said. “What makes storytelling so effective for learning? For starters, storytelling forges connections among people, and between people and ideas. Stories convey the culture, history and values that unite people."
Join EMS TODAY Show host A.J. Heightman, and Douglas Butler, Director of Clinical Services for ImageTrend, one of the nation’s largest and diversified data service companies in the United States, for a deep dive into one of the most comprehensive reports ever produced in EMS.
Guest: President Oren Barzilay
March 17, 2021, marks the 25th anniversary of the merger between FDNY and NY EMS. FDNY EMS Local 2507 President Oren Barzilay was an EMT at the time of this merger. President Oren joins the EMS Handoff crew on this special episode celebrating this momentous occasion discussing not only the history of this merger but where he says FDNY and EMS in the future.
AerosoLess Medical has recently released a revolutionary new face mask that allows medical personnel to again provide nebulized treatments, targeted directly into the patient’s lungs. The SafetyNebTM Mask uses patent-pending technology to create a CPAP-like tight seal with the patient’s face and is also fitted with water-resistant viral filters over its vent holes. These features drastically reduce the ability of pathogens contained in patients’ exhaled breath and coughs to escape into the environment.
The SafetyNeb Mask was introduced to the market by Dr. Paul Louis, an emergency medicine physician. In our new era, where we have a new awareness about aerosols, particularly in the confined space of an ambulance, the SafetyNeb Mask allows frontline workers to treat patients effectively with nebulized albuterol, atrovent and even TXA, without exposing themselves to patient pathogens.
Read more about it in JEMS.
Infection control consultant Katherine West talks about Ebola. Why is she discussing it in 2021? Hasn’t it come and gone? Not exactly.
Guests: David and Kimberly Hughes
In this week’s episode of The EMS Handoff, the hosts take a week off and open up the chest of unreleased episodes from the days of the Tuesday EMS Tidbits Podcast. Back in the day, Eric, Bradley, and David were joined by David and Kimberly Hughes. They are the parents of Drew Hughes and the Founders of the Do It For Drew Foundation. They have a tremendous story about their son, and the events that precipitated the creation of the Do it For Drew Foundation. Their story has inspired many others, and their goal is to help EMS providers around the globe be better every day.
Find more about their story at https://www.doitfordrew.org
Don’t forget to get your EMS Handoff Gear at www.pursueoutfitters.com/emshandoff
Project Mayday is happy to promote 809 Fight 4 Awareness that supports the mental wellness of our first responders in Southern California! Erik Hernandez shares his story on how he started with 809 Fight 4 Awareness and his own story for mental wellness as a first responder.
Ambulance Science Podcast: Philadelphia’s failure to fund EMS forces “meat wagon-tactics" by police, while surgeons ignore the real problem, say Scot Phelps and Maria Werner.
Key Points:
- Philadelphia Fire EMS is severely underfunded, with a unit-hour utilization of 1.0, meaning they're busy 100% of the time, leading to a delayed response time
- As a result, critical penetrating trauma patients are transported by police, without any care, in the back of prisoner vans to trauma centers
- But rather than advocating for more ambulances, especially in this era of limiting police scope creep, surgeons consistently try to justify the police transport model
There has been a lot of buzz about the drug TXA (tranexamic acid), an inexpensive medication that has few negative side effects and has shown some success in reducing mortality in a segment of trauma patients.
But the key word is “effect.” Is TXA effective and is it being shown as having an effective benefit for prehospital trauma patients?
Join JEMS Editor Emeritus A.J. Heightman and the principals of the International Prehospital Medicine Institute (IPHMI): Will Chapleau, EMT-P, RN, TNS; Greg Chapman, B.S., R.R.T., REMT-P; Michael J. Hunter, EMT-P, TP-C; Peter T. Pons, M.D., F.A.C.E.P.; and Lance Stuke, M.D., F.A.C.S, as they discuss TXA, its indications and a whole host of relevant research such as the large CRASH-2 trials, the Military (MATTERS) study; the civilian prehospital and hospital “STAAMP” study and the CRASH-3 Traumatic Brain injury study.
The content and discussion will help you understand what the research is showing and whether TXA has a future in the field of prehospital medicine.
Guests: Tyler Christifulli
How is it possible for metabolic acidosis and anion gap to be remotely interesting? The two words send shivers down most medics’ spine. However, Tyler Christifulli from FoamFrat joins the EMS Handoff crew to make this information not only accessible but fun to learn and review.
Tyler Christifulli is a flight medic and co-founder/producer at FOAMfrat where he lends his expertise to educating EMS providers through blogs, podcasts and online content.
Guests: Dr. Mark Cicero, Dr. Clare Wallner
Which has a longer attention span? A goldfish or an average adult?
Mark X. Cicero, MD, FAAP, is an associate professor of pediatric emergency medicine (PEM) at the Yale School of Medicine, the director of the pediatric disaster preparedness program, an EMS physician and an attending physician at Yale-New Haven Children's Hospital. Mark has designed experiential and didactic curricula in pediatric disaster medicine, and has numerous publications about triage and prehospital response. He is a member of the National Biodefense Science Board and the principal investigator for the Pediatric Research In Disaster Education (PRIDE) network, which has received funding from HRSA and the AHRQ.
Clare Wallner is an assistant professor and clinician educator at McMaster University and associate medical director for the Centre for Paramedic Education and Research in Hamilton, Ontario. She works as an EMS and emergency medicine physician. In addition to innovative curriculum design and medical leadership, she dabbles in research and advancing equity, diversity, and inclusion in medical education.
Show Highlights
- Gamification education and pandemics
- Disadvantage of “pouring information into our students”
- Experience over lecture
- Locus of internal control
- Buy-in from instructors
- Goldfish and adults
- Engaging students
- What the 1840 Prussian army has to do with modern education
- “Practice the way you play”
- Overlap of entertainment and education
- Gamification resources for instructors
- Virtual and mixed-use reality
- Instructor as the dungeon master
On this episode of Another Dose, Dr. Candice McDonald and Robin Goldinger, RN, are joined by Fire Chief/Attorney Chip Comstock and Paramedic/Attorney Matthew Streger to discuss the violent side of EMS.
Guest: Kirk Mittleman
We have all seen it, but just too late! We may have a loved one who has the problem, but don’t want to say anything. Ignoring it won't help but saying something means we have a problem. Did you enable the addict by ignoring the issue? Admitting to it means we have failed in our quest to be perfect. Why is drug and alcohol addiction so prevalent in our profession? Can we make a difference through education and leadership by changing our own outlook and attitudes?
In public safety, we lose excellent professionals to addiction every day. They may go on to right their own ship, but most do not. Public safety administrators, educators and workers need to step up and help our own. Recognizing the problem is our first step in helping our students, staff and co-workers through recovery. The second step is educating students and employees of the danger that is around the corner. As leaders in EMS and public safety, we have an obligation to take care of our own and not cast them aside. Don’t ignore the problem, become part of the solution by learning and helping our colleagues avoid and beat addiction.
“Capt. Kirk” is a 40-year veteran of EMS and public safety. He retired in 2001 from Provo City Police after 22 years and a Purple Heart. Upon retiring from law enforcement, Capt. Kirk went to work full time in the fire/EMS service where he again retired after serving as a paramedic captain and EMS coordinator for Eagle Mountain Fire Department.
Capt. Kirk is currently working for Reach Air Medical, serving Contra Costa County Fire Protection District as the clinical quality improvement and clinical education coordinator. Capt. Kirk teaches all levels of EMT’s and wilderness medicine as the co-founder and program director of Mt. Nebo Training.
Guest: Jason Haag
The evils of auto-narration, 1 a.m. toe aches, carrot versus stick QA, and which is better, SOAP or CHART. If any of that appeals to you, you’re in the right place. Jason Haag joins the EMS Handoff crew to discuss the ins-and-outs of documentation from the eagle eye’s perspective to the nitty-gritty.
Jason Haag is a well-traveled EMS educator who currently works as the Quality Assurance analyst and clinical educator for MultiMed Billing in Baldwinsville, NY. With more than 18 years of EMS experience, Jason is a critical care paramedic with experience as an EMS supervisor and CIC certification teaching agencies across New York. He also speaks at conferences, hosting classes, and reviewing texts for Jones and Bartlett Learning. Jason continues his EMS advocacy with multiple EMS agencies and committees. His involvement with Geneva (NY) Fire Department, Boy Scouts, Masons, Rotary, and Ducks Unlimited occupies his days after his daily family time with his wife and son.
Hear Brian Kim’s story of reprioritizing life and his struggle to recreate balance after leaving the military.
Through their experiences in the Iraq and Afghanistan wars, the military as well as public safety and other medical personnel learned the value of immediate care for injured civilians, while working with first-arriving law enforcement officers, at active shooter and other mass casualty incidents.
With the publication of the four Hartford Consensus documents on Improving Survival from Active Shooter Events, the importance of including law enforcement officers as part of the continuum of care was highlighted.
With civil disturbances becoming an all too frequent occurrence, the mechanisms and types of injuries have changed from just penetrating trauma to a host of other injuries – such as blast burn and inhalation injuries, tension pneumothorax, crush and pelvic injuries as well as exposure to chemical agents.
Join A.J. Heightman and his guests for a discussion of new approaches and courses for the delivery of tactical medicine in the field by law enforcement personnel and by first responders at civil disturbances.
Scot Phelps and Maria Werner talk about the National EMS Scope of Practice Model -- and what they like and don't like about it.
Guest: Wes Ogilvie
Where have all the volunteers gone? The top reason for shifting EMS volunteerism is surprising. After all, there is no better feeling than giving back to your community and knowing you made a difference – but at what cost? Across the country throughout the years, the number of volunteers in EMS, fire and rescue has sharply decreased, especially over the last decade. Where have all of the volunteers gone? Wes Ogilvie joins the EMS Handoff crew to discuss volunteerism in EMS.
Wes is a renowned EMS advocate and legal expert in EMS and is currently serving as a paramedic/FTO with multiple EMS agencies. Wes is an attorney for Texas state government, has been in EMS since 2004 and has been a paramedic since 2007. Wes is currently a paramedic/FTO with West EMS and a paramedic with Huffman EMS. Throughout his career, he has been published in several EMS periodicals and co-authored the Medical-Legal chapter of Paramedic Care: Principles and Practice.
How did an aspiring actor end up going into the fire service? Hear the story of Rod Hutchinson and his viewpoints on the dominant fire culture, his personal struggles with vulnerability and advice to those exploring the career.
“Therapy has been a godsend," said Hutchinson.
Professionalism is an expectation of any profession and EMS is no exception. Dealing with stress, knowing our specialized skill sets, navigating industry relationships and interacting with the public are parts of the whole that compose the EMS professional. Today’s podcast poses the question of professionalism in our industry and how we can effect change in a real way.
Joining us today is Julianne Stevenson, founder of Sterling Credentials. She’s been a paramedic, a supervisor, an educator and an educational program director. Through a strange turn of events, she has a bachelor's degree in biomedical science and a master’s degree in molecular physiology and biophysics. Decades ago, she got into EMS by accident. Decades later, passion keeps her there. Today, she talks with us about professionalism and its implications to the EMS profession as a whole.
Show Highlights
- Why does professionalism matter?
- Public perception and pay
- What makes a professional
- Toxic cultures = The EMS “brain drain”
- Profession and professionalism
- Current state of affairs
- Educational methods
- Professional peer pressure requires professional courage
- Are we public health, public safety, or something else?
- Psychological exam for school?
This podcast presents an in-depth discussion with the editors of a new in-depth book recently introduced for EMS providers, educators, students and EMS junkies.
Prehospital Medicine: Principles, Pearls and Pitfalls was self-published by the International Prehospital Medicine Institute (IPHMI) with one purpose in mind: to get the most up-to-date EMS principles, pearls and pitfalls into the hands (and minds) of dedicated EMS providers.
IPHMI dedicated the book in the memory of famed trauma surgeon, EMS leader and friend to all on EMS, Dr. Norman McSwain and priced the book at only $14.95 for the e-book version and $29.95 for the 737-page printed version to make it affordable to emergency providers and physicians who could benefit from its content.
The book is written in a question and answer format, features 86 easy-to-read educational chapters on a multitude of subjects. It is 737 pages of amazing content that, in the e-book version, will be updated as topics, science or techniques change. There were 33 contributing authors in addition to the five primary authors whose mission it was to give providers the latest important information in 86 subject areas.
Join A.J. Heightman for a conversational discussion of the book, its contents and its purpose with the five EMS educators who developed its content: Wilfred (Will) Chapleau, RN, EMT-P; Greg Chapman, BS, RRT, REMT-P; Michael J. Hunter, EMT-P, TP-C; Peter T. Pons, MD, FACEP; and Lance Stuke, MD, FACS.
The EMS Handoff guys talk to Kevin Spratlin, MS, NRP, about the Memphis Fire Department’s unique way of handling an overwhelming number of calls.
Spratlin leads Memphis Fire Department’s Healthcare Navigator Program, an innovative mobile integrated healthcare/community paramedicine model which seeks to reduce the impact of non-emergent medical calls on the department’s emergency response capabilities. He also chaired the Tennessee MIH/CP Task Force. Spratlin has served in the emergency services field for over 28 years.
Show Highlights
- Top three issues that patients face
- Challenges confronting
- Monetary cost of ambulance misuse
- Abuse versus misuse
- RADAR program (rapid assessment decision and redirection)
- Community education
- HUG (High utilizer group) team and COVID-19
- Community paramedicine
Connect with the Guest
healthcare.navigator@memphistn.gov
Resources/Articles Mentioned in Podcast
The EMS Handoff crew is joined by Tim Nowak, AAS, BS, NRP, CCEMTP, SPO, MPO, CADS. Tim is the founder and CEO of Emergency Medical Solutions, LLC, an EMS training and consulting company that he developed in 2010. Through this venture, he is the editor-in-chief of EMS Director magazine, a webinar/app-based continuing education content developer, columnist and blog writer, product developer, instructor and speaker, podcast guest and host, and a social media influencer on LinkedIn.
Tim is also the assistant chief of special operations with a county-wide EMS agency based in Florida, where he oversees the planning and logistics sections, special operations functions and community paramedicine programs for the agency.
This podcast, the EMS Handoff crew is going to review Nowak's article, Training Day: 3 options for safely transporting your pediatric patient.
1. Pediatric transports can be challenging!
Safe versus Not Safe
- “Mom holding onto baby”
2. Best practices for pediatric transport in the ambulance
- The “Working Group Best-Practice Recommendations for the Safe Transport of Children in Emergency Ground Ambulances” https://www.nhtsa.gov/staticfiles/nti/pdf/811677.pdf
- NHTSA 1999 “Dos and Don’ts of Transporting Children in an Ambulance” https://www.nhtsa.gov/staticfiles/nti/pdf/811677.pdf
3. What is acceptable?
- Start with their own car seat
- Parents tend to keep up with their child’s growth
- What if it was in an accident?
- 2012 NHTSA document https://www.nhtsa.gov/staticfiles/nti/pdf/811677.pdf
- No visible damage
Where do you place them in the vehicle?
4. Car Restraint Systems
- Inflatable car seats
- In-seat/ convertible restraint systems
- Contour-padded restraint systems
- Roll-out restraint systems
5. Four-point shoulder/ chest restrains
Pad the voids
- Use four-point straps
6. What is not acceptable
No one in the ambulance – parents, caregivers, medics or other passengers should be unrestrained during transport.
- Consider your options and plan ahead so you are prepared when faced with a pediatric patient.
7. 4 Safety considerations for Pediatric Transport
- Do tightly secure all monitoring devices and other equipment
- Do ensure available restraint systems are used by personnel and other occupants, including the patient.
- Do not have the child/infant held in the parent’s caregiver’s or EMS personnel’s arms or lap during transport.
Do not allow emergency vehicles to be operated by persons who have not completed an approved driving course.
“The next time you are completing your PCR, take a look at all of the transport options. Via stretcher leads the pack, but mom holding onto baby…. Well, it is not there for a reason…”
While EMS is rightly focused on COVID-19 right now, Katherine West explains why keeping up-to-date on HIV infection is extremely important.
Why did you choose to be a first responder? Is there a link between the impact of childhood trauma, or does a generational family history of career choices influence a person's career choice? Hear a different perspective from a military family life consultant from the Department of Defense on her experience with her psychological perspective on how to maintain mental wellness, the effects of PTSD on the family and how to do a mental health check on yourself.
On this week’s Episode of the EMS Handoff, hosts David Blevins, Eric McCullough and Bradley Dean are joined by Dr. Remle Crowe, a research scientist with ESO. Dr. Crowe discusses the significance of data and how EMS data is being used to help support the understanding of COVID-19 in the country.
Dr. Crowe is an expert in EMS research and quality improvement. From truck clutches to clinical care, she has shown how research and improvement science work to solve problems across fields. Prior to earning a PhD in epidemiology, her EMS career began with the Red Cross in Mexico City as a volunteer EMT. She has authored numerous peer-reviewed publications related to prehospital care and the EMS workforce. Now, as a research scientist with ESO, Dr. Crowe routinely uses EMS data to improve community health and safety.
In this week’s episode of The EMS Handoff Podcast, Bradley and David talk with Dr. Bryan Bledsoe about clinical issues related to diabetic emergencies and the need to expand critical thinking within the profession. Dr. Bledsoe is certainly an individual that certainly needs no introduction. He is professor of emergency medicine at the University of Nevada, Las Vegas School of Medicine and an attending emergency physician at University Medical Center in Las Vegas. He is board certified in emergency medicine and EMS.
Dr. Bledsoe has over 40 years of experience in EMS and is the author of numerous textbooks, journal articles and peer-review papers. In 2008, he was named a “Hero of Emergency Medicine” by the American College of Emergency Physicians. In 2014, he received the John P. Pryor, MD, Award for exemplary service to EMS. He resides in Midlothian, TX and Las Vegas, NV.
Hear the story of the private industry EMS through the lens of a female paramedic in a busy 911 system from Whitney Gaudaur.
Join JEMS Editor Emeritus A.J. Heightman and Pinellas County, Florida, EMS/medical direction officials as they discuss model COVID vaccination programs implemented for emergency responders and skilled nursing home facility (SNF) residents and staff.
Topic #1: Paramedic Lauren Kwei and OnlyFans
Sexy brings readers in, but the point is that medics are not paid enough to survive in NYC
Not just EMS....
Nursing and Only Fans
https://www.buzzfeednews.com/article/otilliasteadman/pandemic-nurses-onlyfans-sex-work
Med Student and Only Fans
https://vt.co/lifestyle/medical-student-makes-over-70000-a-year-selling-pictures-of-her-feet-online
The poster child for the paramedic pay gap - Sexy gets them in the door, then they will hear the underlying point....
Bess Meyerson was the only Jewish Miss America and a heroine to the Jewish community, where "she was the most famous pretty girl since Queen Esther."
https://en.wikipedia.org/wiki/Bess_Myerson
FEMEN
https://en.wikipedia.org/wiki/Femen
Topic #2: Paramedics with Guns
https://www.arkansasonline.com/news/2020/dec/17/pine-bluff-man-fatally-shot-after-shooting-paramed/
-Should be able to carry legal weapons
-It depends on the culture
As State EMS Director, I made the commitment to go to court with every EMT and paramedic that has been assaulted, so that our county prosecutors (district attorneys) knew that State OEMS was paying attention and wanted to see people charged accurately. Because the criminal justice system is overwhelmed and wants to plead everything down.
N.J.S.A. 2C:12-1 Assault.2C:12-1. Assault. b. Aggravated assault. A person is guilty of aggravated assault if he:(5)Commits a simple assault as defined in subsection a. (1), (2) or (3) of this section upon:(c)Any person engaged in emergency first-aid or medical services acting in the performance of his duties while in uniform or otherwise clearly identifiable as being engaged in the performance of emergency first-aid or medical services; or
NY Consolidated Laws, Penal Law §120.08 Assault on a peace officer, police officer, firefighter or emergency medical services professional.
A person is guilty of assault on a peace officer, police officer, firefighter or emergency medical services professional when, with intent to prevent a peace officer, police officer, a firefighter, including a firefighter acting as a paramedic or emergency medical technician administering first aid in the course of performance of duty as such firefighter, or an emergency medical service paramedic or emergency medical service technician, from performing a lawful duty, he or she causes serious physical injury to such peace officer, police officer, firefighter, paramedic or technician. Assault on a peace officer, police officer, firefighter or emergency medical services professional is a class C felony. (3.5-15 years)
Three NJ EMS Clinicians were just suspended this week for punching a patient
https://www.ems1.com/violent-patient-management/articles/nj-emts-accused-of-punching-patient-in-ambulance-say-it-was-self-defense-Veew7de6yOYvMexe/https://www.state.nj.us/health/ems/documents/reg-enforcement/actions/2020-0109V.EMT.SummarySuspension.Bonvenca.RED.pdfhttps://www.state.nj.us/health/ems/documents/reg-enforcement/actions/2020-0108V.EMT.SummarySuspension.Han.RED.pdfhttps://www.state.nj.us/health/ems/documents/reg-enforcement/actions/2020-0107V.MICP.SummarySuspension.Piro.RED.pdf
ONLY two EMS Clinicians have ever been shot in NYC history:
- Kings County Hospital Ambulance Attendant Hannah Callahan was shot and killed by an EDP in December 1954.
- Ambulance Surgeon Thomas Garvey was shot in the shoulder by a drunk Swede in the back of the ambulance on the way to the hospital in Spanish Harlem in September 1894.
- No EMT or Paramedic in NJ to date has ever been shot by somebody else since 1874.
N.J.A.C. 8:40-4.11 (b) Crewmembers shall not wear or carry any weapons or explosives while on duty. For the purpose of this chapter, the terms "weapons" and "explosives" include not only offensive weapons, but also defensive weapons such as stun guns, stun batons, air tasers, pepper spray, mace defensive spray and/or telescopic steel batons.
N.J.A.C. 8:41-3.5 Physical behavioral restraints (d) Crewmembers shall not wear or carry any weapons or explosives while on duty. For the purpose of this chapter, the terms "weapons" and "explosives" include not only offensive weapons, but also defensive weapons such as stun guns, stun batons, air tasers, pepper spray, mace defensive spray and/or telescopic steel batons.
- Should engage in self-defense
- Should be able to carry legal weapons
- Should be punished for going overboard
On this week’s episode of The EMS Handoff Podcast, Eric, Bradley and David talk with Tom Herron, associate professor and clinical coordinator at Roane State Community College, about the hidden fears of EMS. Tom is an advocate for EMS and seeks to empower EMS professors to seek help for the injuries and scars that go unseen through experiences with prehospital providers' clinical experience. To reach out to Tom, you can email at reboot.tom865@gmail.com.
In this episode of the EMS Handoff Podcast, Eric, David and Bradley are joined by Kevin Collopy to discuss clinical errors in EMS. Kevin is the clinical outcomes and compliance manager for NHRMC AirLink/VitaLink Critical Care Transport where he oversees the program's research, education, risk management and quality assurance programs.
Kevin regularly speaks across the United States and has taught emergency and wilderness medicine on three continents. He's an author of over 150 articles and book chapters including 12 peer-reviewed research abstracts and papers. Additionally, Kevin serves on several national and international advisory boards, is a past president of the IAFCCP, teaches the paramedic program at Cape Fear Community College and is pursuing a Master's in Healthcare Leadership. He can be contacted via LinkedIn and Twitter (@ktcollopy).
Is there a cultural difference between first responders and hospital staff? Hear from Amy and Herb Campbell and their perspectives on relationships, culture and their personal struggles with mental wellness throughout their careers.
How did curiosity and unanswered questions lead to the founding of a business and a passionate emergent leader? Find out on this week's Emergent Leadership episode with Julianne Stevenson of Sterling Credentials, LLC.
Where I'm coming from (compared to most of my colleagues):
- Master's in Public Health with a concentration in Health Policy from Yale Medical School.
- FT Faculty at GWU School of Medicine & Southern Connecticut State University MPH Program, and long-time adjunct faculty at NYMC MPH program in Health Policy.
- Assistant Commissioner of Health at the NYC Department of Health & Mental Hygiene during the first SARS outbreak.
- Served as State EMS Director, Consultant to Public Health Canada, Connecticut Department of Public Health, Local Health Departments.
- (So in other words, I'm not a vaccine expert, but I'm pretty well versed in this stuff)
Flu vaccine is bad example, most vaccines are ~80% effective
- One dose of the MMR vaccine is 93% effective against measles, 78% effective against mumps, and 97% effective against rubella. Two doses of MMR vaccine are 97% effective against measles and 88% effective against mumps. MMR is an attenuated (weakened) live virus vaccine.
- The Hepatitis B vaccine is 80% to 100% effective in preventing infection or clinical hepatitis in those who receive the complete vaccine series.
- TDAP vaccines is 80-90% effective after fifth dose, but this decreases to 30-40% after four years.
- Flu efficacy in the US, by year:
2004
10%
2005
21%
2006
52%
2007
37%
2008
41%
2009
56%
2010
60%
2011
47%
2012
49%
2013
52%
2014
19%
2015
48%
2016
40%
2017
38%
2018
29%
2019
45% est
Time to Develop Vaccine?
- Fastest time to develop vaccine: four years https://www.nytimes.com/interactive/2020/04/30/opinion/coronavirus-covid-vaccine.html
- Average time to develop vaccine: 10 years https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31252-6/fulltext
Historical Vaccine Problems?
- Cutter Incident (1955): Active polio administered to 200,000, with 200 cases of polio, and 10 deaths. This was a live vaccine, compared to the Pfizer and Moderna COVID vaccines that are Messenger RNA (mRNA) which is just a set of instructions that tells your body to make the protein that resembles part of the Coronavirus...(but not a Recombinant DNA vaccine like I said.)
https://www.cdc.gov/vaccinesafety/concerns/concerns-history.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1383764/
https://www.cnbc.com/2020/12/08/pfizer-moderna-covid-vaccine-side-effects-trials.html
COVID vaccine
- Does it work? Yes, it appears to work pretty well. But no way is it going to be 95% effective in the real world....
- What does 95% efficacy mean? Eight out of 18,198 vaccinated with two doses of vaccine got symptoms and a positive COVID test from seven days after their second vaccination through November 14th, 2020. One hundred and sixty-two out of 18,325 vaccinated with placebo got symptoms and a positive COVID test from seven days after their second vaccination through November 14th, 2020.
What we don't know:
- How many of the people in the study were exposed to the COVID virus?
- If people who got the vaccine can be asymptomatic spreaders?
What we do know:
- You need two shots, and you're going to be sick after your second shot...."The most common solicited adverse reactions were injection site reactions (84.1%), fatigue (62.9%), headache (55.1%), muscle pain (38.3%), chills (31.9%), joint pain (23.6%), fever (14.2%); severe adverse reactions occurred in 0.0% to 4.6% of participants, were more frequent after Dose 2 than after Dose 1, and were generally less frequent in participants ≥55 years of age (≤ 2.8%) as compared to younger participants (≤4.6%).” https://www.fda.gov/media/144245/download
- 2020 Flu vaccine will probably be even less effective because there was not much flu in Australia to base the vaccine on. But get the flu vaccine anyway this year, because you don't want to get the flu and COVID at the same time....https://www.cdc.gov/flu/season/faq-flu-season-2020-2021.htm#Flu-Vaccine
- Emergency Authorization isn't the same as regular approval....they are going to continue to gather data. https://www.fda.gov/vaccines-blood-biologics/vaccines/emergency-use-authorization-vaccines-explained
What's the priority for EMS clinicians?
CDC COVID-19 vaccination program interim playbook
Jurisdictional considerations for Phase 1 subset groups may include, for example:-Phase 1-A: Paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials-Phase 1-B: People who play a key role in keeping essential functions of society running and cannot socially distance in the workplace (e.g., emergency and law enforcement personnel not included in Phase 1-A, food packaging and distribution workers, teachers/school staff, childcare providers), adults with high-risk medical conditions who possess risk factors for severe COVID-19 illness, and people 65 years of age or older (including those living in LTCFs)There may be insufficient COVID-19 vaccine supply initially to vaccinate all those who fall into the Phase 1-A subset, so jurisdictions should plan for additional subsets within that group (see CISA guidance for categories of healthcare personnel).
CISA guidance on essential critical infrastructure workers (explicitly listed in both categories)
Guidance on the Essential Critical Infrastructure Workforce: Ensuring Community and National Resilience in COVID-19 Response
Health/Public Health-Healthcare providers including, but not limited to, physicians (MD/DO/DPM); dentists; psychologists; mid- level practitioners; nurses; emergency medical services personnel, assistants and aids; infection control and quality assurance personnel; phlebotomists; pharmacists; physical, respiratory, speech and occupational therapists and assistants; social workers; optometrists; speech pathologists; chiropractors; diagnostic and therapeutic technicians; and radiology technologists.-Workers required for effective clinical, command, infrastructure, support service, administrative, security, and intelligence operations across the direct patient care and full healthcare and public health spectrum. Personnel examples may include, but are not limited, to accounting, administrative, admitting and discharge, engineering, accrediting, certification, licensing, credentialing, epidemiological, source plasma and blood donation, food service, environmental services, housekeeping, medical records, information technology and operational technology, nutritionists, sanitarians, etc.
--Emergency medical services workers including clinical interns.
--Prehospital workers included but not limited to urgent care workers.
Law Enforcement/Public Safety/Other First Responders
-Public, private, and voluntary personnel (front-line and management, civilian and sworn) in emergency management, law enforcement, fire and rescue services, emergency medical services (EMS), and security, public and private hazardous material responders, air medical service providers (pilots and supporting technicians), corrections, and search and rescue personnel.
https://www.cisa.gov/publication/guidance-essential-critical-infrastructure-workforce
American College of Emergency Physicians supports EMS Clinicians being included in Category 1A
American Paramedic Association and the National EMS Managers Association supports EMS Clinicians receiving a COVID-19 vaccination "as soon as possible."
https://www.nemsma.org/resource/resmgr/covid-19/covid-19_vaccination_conside.pdf
EMS included in Category 1A from AIPC and CDC, states may vary.
New York: "ICU, EMS, ED top priority" (other first responders were Phase 2)
New Jersey: "Who are "healthcare personnel" in Phase lA? Healthcare personnel are paid and unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials. This includes any type of worker within a healthcare setting. Examples include, but are not limited to...personnel with variable venues like EMS, paramedics, funeral staff, and autopsy workers."
http://nj.gov/health/legal/covid19/12-10-20_PopulationPrioritizationPOD_memo.pdf
What should we do:
- Taking the vaccine is your individual choice based on your own circumstances
- Even if you don't want the vaccine, or want to wait, you should support EMS clinicians, both public, non-profit, and private, being in Category 1A
- Even if vaccine is offered, we still need:
- Adequate respiratory PPE (half face respirator c P100)
- Face Shields, Goggles, Gloves, and Gowns
- Negative pressure ambulances
- Equipment and Supplies for Cleaning
- High-level decontamination with UV or Hydrogen Peroxide
This week, the hosts of the EMS Handoff Podcast are joined by Ed Moreland, NRP. They cover a variety of topics, including advocating for the patient, profession and self.
Ed is a Metro Washington, DC native, a veteran of the United States Marine Corps and PA Army National Guardsman who has been actively engaged in EMS since 1990 when he ran his first EMS call as a volunteer in Montgomery County, PA. A Nationally Registered Paramedic, Ed has worked in a variety of EMS models, including non-profit, for-profit, hospital-based and rural systems. He has served as a paramedic, supervisor, regulator, deputy chief and chief. He is currently working in senior leadership with a national medical transportation provider.
Explore the stress of a California firefighter during strike teams and the different dynamics during deployment. Hear the optimistic perspective of Darnell Dodson II and how he keeps mentally, spiritually, emotionally and physically well.
"When you are at work, engage.... Learn your partners, even the one you don't get along with." -Darnell Dodson II
Join Brett Lyle as she speaks with emsimprov.com's founder and chief facilitator, Eric Chase, as they discuss how improv and creativity can be used as a tool for combating the everyday challenges EMS, first responders, law enforcement and healthcare providers face. They talk resilience, emotional and mental barriers, and Eric shares a few exercises he and his team employ to transform teams into communities of support.
In this week’s episode of the EMS Handoff, the crew talks with Wes Ogilvie, MPA, JD, NRP, LP, as he addresses the “lawyer boogeyman” issue, as well as documentation tips you can us today to improve your practice.
He also discusses Emergency Medical Treatment and Labor Act and its impact on patient care, specifically in stroke and heart attack cases. Being a patient advocate is of supreme importance and has implications medically, legally and ethically for your patient.
Refusals are an often source of medical liability and it's all about consent. Wes discusses best practices for legal consent and the importance of capturing present mental capacity.
Wes wraps up with scene safety considerations, including restraints and excess of force.
Wes is a practicing attorney for the state of Texas. He has been in EMS since 2004 and a paramedic since 2007. His experience has been primarily volunteer with a variety of agencies in Central Texas and the Houston area, both suburban and rural.
Wes is currently a paramedic/field training officer with West EMS and a paramedic with Huffman EMS. He has taught both initial and continuing education EMS courses. Throughout his career, he has been published in several EMS periodicals and co-authored the Medical-Legal chapter of Paramedic Care: Principles and Practice. In addition to both chasing and driving ambulances, he’s an active blogger. Visit his blog at www.theambulancechaser.com.
Effect of Out-of-Hospital Pediatric Endotracheal Intubation on Survival and Neurological Outcome: A Controlled Clinical Trial by Gausche, M et. al.
Paramedic Self‐efficacy and Skill Retention in Pediatric Airway Management by Youngquist, S.T. et. al.
Gausche Study: Criticism
1. Good study design, bad application and interpretation
-Intent to Treat Model, when 115 of 420 “Treat” patients had no intervention attempted at all, drives difference between groups to the null hypothesis.-Non-intubation was not considered a protocol violation: "Given that the data were analyzed by intention to treat, it is unlikely this 2.3% protocol violation rate had any effect on study results."
Except that, of course, this was exactly what the study was about!
2. It is the system, not the clinician!-Six hours of training.-No significant clinical exposure to pediatric intubation in operating room, emergency department, or prehospital settings.-Most had no retraining at all. Two-hundred and twelve did (see second study attached) and only 66% of paramedics tested (139 ⁄ 211) passed skills testing with BMV (with a score of pass or higher), while 42% passed skills testing with ETI (88 ⁄ 212), with the odds of scoring among the higher grade levels on ETI skills testing was statistically lower for each additional month elapsed since initial training.-Here's the problem: They don't recognize that the clinician isn't the problem, the problem is their system's educational methodology (including continuing education): "These results call into question the current practice of paramedics intubating children in an urban, out-of-hospital setting...."
It is the system, not the clinician!: Endotracheal Intubation: Factors for Success:
Experience2One study reported that healthcare personnel needed to perform a minimum of 57 intubations before achieving a 90% success rate with this procedure. The authors of this meta-analysis believe that practitioners who intend to perform prehospital advanced airway management are unlikely to achieve high levels of competence without a period of in-hospital anesthetic training followed by an adequate number of intubations to maintain skill levels. Exposure1Exposure counts: -Experienced: 99% success ('experienced consultant anesthetists’), -Intermediate: 99% success (‘physicians in training in emergency medicine and anesthesia with some anesthetic experience’), -Basic: 92% success (‘non-physicians or those physicians with only limited anesthetic experience’)Environment2
Prehospital ETI cannot automatically be compared to ETIs performed in the emergency department or in the operating theatre, for two main reasons. Firstly, the majority of prehospital ETIs are done in CA patients or after major trauma in challenging settings, while the majority of in-hospital ETIs are done in a controlled environment. Secondly, prehospital ETIs are challenged by a number of environmental factors that may influence the failure rates and increase adverse events, including....
-Restricted patient access
-Suboptimal patient and operator positioning
-Limited equipment
-Difficult or hazardous operating environments
Equipment3,1
Physician median (range) ETI success rates were 0.991 (0.973, 1.000) (all had RSI)Paramedic/Nurse c No Medications median (range) ETI success rates for non-physicians were 0.675 (0.491, 0.968)Paramedic/Nurse c Some Medications median (range) ETI success rates for non-physicians were 0.810 (0.755, 0.905) Paramedic/Nurse c RSI median (range) ETI success rates for non-physicians were 0.967 (0.758, 1.000)
A large recent study reported a doubling of the odds of intubation failure where no drugs were used.1
Comparing apples-to-apples for tools, ETI success was 99% for physicians vs 97% for paramedics/nurses....
But they still used biased language, not comparing apples-to-apples for tools (let alone experience or exposure)...
"When comparing physicians to non-physicians, the corresponding median (range) ETI success rates were 0.991 (0.973, 1.000) versus 0.849 (0.491, 0.990)."
Resources
- The success of pre-hospital tracheal intubation by different pre-hospital providers: a systematic literature review and meta-analysis. https://ccforum.biomedcentral.com/articles/10.1186/s13054-017-1603-7.
- Airway management by physician-staffed Helicopter Emergency Medical Services – a prospective, multicentre, observational study of 2,327 patients. https://sjtrem.biomedcentral.com/articles/10.1186/s13049-015-0136-9
- Patient safety in pre-hospital emergency tracheal intubation: a comprehensive meta-analysis of the intubation success rates of EMS providers. https://ccforum.biomedcentral.com/articles/10.1186/cc11189
Hear Chad Casons' story about his approach to mental wellness as a drill instructor and his perspective as a suicide prevention instructor.
Brett Lyle chats with Mountain Lakes EMS Council (NY) Executive Director Travis Howe about his path to leadership.
Welcome to Emergent Leadership where we connect with passionate leaders who just have to share their stories, perspectives, and most importantly, lessons learned.
The need is urgent, the events are critical, and the you of tomorrow is just an episode away!
Join the conversation: If you have a leadership topic, experience, or lesson learned you would like to share or hear more about, send an email at brettlylecoaching@gmail.com or use and follow #emergentleadership to join the conversation. You can also connect to Brett directly through LinkedIn or follow her journey on YouTube.
Katherine West explains what work restrictions are and why they are needed.
Timothy S. Redding has been involved in EMS for over 25 years. He has been teaching both hospital and prehospital emergency personnel for over a decade and is certified as an instructor by the American Heart Association, the U.S. Department of Homeland Security, the State of New Hampshire, and the Commonwealth of Massachusetts, among others.
Tim is an experienced paramedic and has worked in challenging urban and rural EMS systems. Tim was recently named New Hampshire EMS Educator of the Year for 2017.
Tim discusses the implications of cognitive dissonance in EMS and how we can reduce cognitive dissonance in our decision making. He goes through various types of bias we may not realize when making decisions, including confirmation, plan continuation and anchoring.
Tim wraps up with decision fatigue and cognitive reframing.
How much strength does it take to leave your dream career to achieve mental wellness? Hear Marc Domingo's journey to achieve peace and the sacrifices to get there.
In the debut EMS Lawline podcast, Steve Wirth, Esq., EMT-P, and Matthew Konya, of Page Wolfberg & Wirth, discuss if EMS services can require employees to receive a flu vaccine.
Drops of H2O ( The Filtered Water Treatment ) by J.Lang (c) copyright 2012 Licensed under a Creative Commons Attribution (3.0) license. Ft: Airtone
Hosts Bradley Dean and David Blevins are joined by Joseph Zalkin, retired deputy director of Wake County (NC) EMS, to talk about violence against EMS personnel. Violence has been a hot topic as many responders have experienced violence from patients, and many states have started to consider or pass legislation escalating penalties associated with these concerns. We talk about how to empower teams to handle violence, and make sure they feel like they have the resources and support to handle a situation that may occur.
Make sure to subscribe, rate and review.
Emergent Leadership host Brett Lyle talks with Christopher Gaeta about his role with EMS.
How does a kid from Compton, California, grow up to be a firefighter? We explore the success of community programs, the progression of firehouse culture and being a minority in the fire service.
Dr. Maia Dorsett and Jamie Wilson join the EMS Handoff Podcast crew to discuss the critical moment of relating concise, accurate information to healthcare providers. Continuity of care is paramount to patient disposition and ultimate treatment. The long lines of care start with EMS but don't end there. It's everyone's responsibility to ensure patient information is accurately transferred.
Dr. Dorsett writes about the Critical Moment in Patient Care in her article. Her research focuses on barriers to adequate patient care hand-offs, including interruptions in the reporting timeline.
Jamie Wilson, paramedic and RN, also has a wealth of knowledge both in patient care and research. His article goes in depth both addressing the problem of patient care hand off reports and providing meaningful solutions.
The group covers the pros and cons of using a structured approach such as MIST to relay information as well as discuss key findings in both guests' research and its impact on EMS providers and their patients today.
The Project Mayday founders had the honor of being interviewed on the Power to the Peeps Podcast. This podcast explores our project, our motivation and where we want to go in the future!
If a suburban orthodox Jewish rescue squad can respond in four minutes, why can't you? Scot Phelps and Maria Werner discuss barriers to best practices, the lack of state or national volunteer support organizations, the lack of an innovative mindset in EMS, and Subaru Forester ambulances.
Some links:
New Jersey ambulance response times
Probably Shouldn't by J.Lang (c) copyright 2019 Licensed under a Creative Commons Attribution (3.0) license. http://dig.ccmixter.org/files/djlang59/59729 Ft: Mr_Yesterday
This week's episode of The EMS Handoff Podcast is the inaugural episode and brings back together former Tuesday EMS Tidbits hosts Bradley Dean, Eric McCullough and David Blevins. In this episode, the hosts get together to discuss what has been happening since the Tidbits podcast went off the air, and what the EMS Handoff is all about.
Jonathon Feit talks about interoperability and finance for community paramedicine and mobile integrated healthcare.
What happens after a career ending call? Hear the compelling story of former paramedic, Alisa Raudio and her journey for mental wellness.
Host Brett Lyle sits down with Ted Van Horne, chief operating officer of Global Medical Response.
Welcome to Emergent Leadership where we connect with passionate leaders who just have to share their stories, perspectives, and most importantly, lessons learned.
The need is urgent, the events are critical, and the you of tomorrow is just an episode away!
Join the conversation: If you have a leadership topic, experience, or lesson learned you would like to share or hear more about, send an email at brettlylecoaching@gmail.com or use and follow #emergentleadership to join the conversation. You can also connect to Brett directly through LinkedIn or follow her journey on YouTube.
How do first responders come into a relationship? In this podcast we explore different coping mechanisms, common problems in relationships and some strategies on how to destress before stepping in the door.
Resource: PSI Seminars http://psiseminars.com/basic
Project Mayday was founded by three first responders. Get to know our stories for our first podcast and our motivations behind the project. Stay tuned for other first responder stories about their journey with mental health.
Host Scot Phelps talks with Maria Rauth. They discuss the supposed conspiracy theories to keep paramedics down in their place where they belong.
Probably Shouldn't by J.Lang (c) copyright 2019 Licensed under a Creative Commons Attribution (3.0) license. http://dig.ccmixter.org/files/djlang59/59729 Ft: Mr_Yesterday
Host Brett Lyle chats with Beyond Lucid Technologies' Jonathon Feit about his path to leadership.
Welcome to Emergent Leadership where we connect with passionate leaders who just have to share their stories, perspectives, and most importantly, lessons learned.
The need is urgent, the events are critical, and the you of tomorrow is just an episode away!
Join the conversation: If you have a leadership topic, experience, or lesson learned you would like to share or hear more about, send an email at brettlylecoaching@gmail.com or use and follow #emergentleadership to join the conversation. You can also connect to Brett directly through LinkedIn or follow her journey on YouTube.
Hear 67 years of law enforcement told through the lens of Jerry Clemons, a retired deputy commissioner with the California Highway Patrol.
There is confusion in the fire and EMS services if taking the vaccine is a requirement for the job. Kathy West examines the issue.
The Congress of Mobile Medical Professionals talks about ET3, with some CP/MIH thrown in for good measure.
How does an 18 year fire captain become a substance abuser and on the most wanted list? Hear the captivating story of Jill Engle.
Christian Ventura chats with Jason P. Stopyra, MD, MS, FACEP, FAEMS, associate professor of emergency medicine at Wake Forest Baptist Health, about the role of i-STAT in the prehospital setting.
Christian is currently seeking guest speaker nominations. Email him at cventura@wearehames.com.
Project Mayday was founded by three first responders. Get to know their stories on their first podcast and learn their motivations behind the project. Stay tuned for other first responder stories about their journey with mental health.
Check out their website, and be sure to follow them on Facebook and Instagram.
Project Mayday is a research company that was founded to improve the mental wellness of our first responders. Project Mayday has created a platform for first responders to share their stories while promoting mental wellness resources.
Check out their website, and be sure to follow them on Facebook and Instagram.
Host Brett Lyle connects with Dr. Victoria Reinhartz, PharmD, CPh. They explore how Reinhartz and her team are driving change in the industry through a unique community paramedicine model. Reinhartz is a consultant pharmacist, an assistant professor of pharmacy practice at Lake Erie College of Osteopathic Medicine (FL), and founder of Mobile Health Consultants, Inc.
Welcome to Emergent Leadership where we connect with passionate leaders who just have to share their stories, perspectives, and most importantly, lessons learned.
The need is urgent, the events are critical, and the you of tomorrow is just an episode away!
Join the conversation: If you have a leadership topic, experience, or lesson learned you would like to share or hear more about, send an email at brettlylecoaching@gmail.com or use and follow #emergentleadership to join the conversation. You can also connect to Brett directly through LinkedIn or follow her journey on YouTube.
Evidence-Based EMS takes the research articles to the ambulance and discusses best evidence based practices in pre-hospital care based on trending science.
Hosted by author and EMS scientific researcher Christian Ventura, NREMT, EMS-I, along with special guest speakers in all aspects of healthcare— this show aims to bridge the gap between the lab and the rig.
In this episode, Pearland (TX) Fire Department’s Battalion Chief Jacob Johnson joins host Brett Lyle to share his personal journey and lessons of humility, mentorship and leadership.
In a fascinating account, Chief Johnson helps his father lead guided duck hunts at only three years old, becomes a volunteer firefighter before being old enough to drive, and through those experiences develops into the respected 20-year firefighting veteran he is today.
During the discussion, Chief Johnson opens up about overcoming an early setback in his career that left him doubting his ability to coach and lead his team.
Through reflection of what he calls a “failure,” he circled back to the fundamentals that made his mentors successful: love, accountability and providing the why.
Jacob shares his epiphany during training that it was leaders failing his profession’s newest members, as opposed to the current generation’s unwillingness to learn.
As a proposed solution, an instructor challenged him to attack the problem and develop a mentorship class that the Chief eventually cultivated into a proven program designed to help leader be better mentors to their crews.
Please join in and listen. What type of hardships or failures have you overcome as a leader that better equipped you to develop others?
Welcome to Emergent Leadership where we connect with passionate leaders who just have to share their stories, perspectives, and most importantly, lessons learned.
The need is urgent, the events are critical, and the you of tomorrow is just an episode away!
Join the conversation: If you have a leadership topic, experience, or lesson learned you would like to share or hear more about, send an email at brettlylecoaching@gmail.com or use and follow #emergentleadership to join the conversation. You can also connect to Brett directly through LinkedIn or follow her journey on YouTube.
Host Brett Lyle talks with David Blevins, director of EMS Education Programs for Roane State Community College (TN). They talk about legislation that have shaped the industry, education in the times of stay-at-home orders, and how to show that you care and lead through effective communication.
Welcome to Emergent Leadership where we connect with passionate leaders who just have to share their stories, perspectives, and most importantly, lessons learned.
The need is urgent, the events are critical, and the you of tomorrow is just an episode away!
Join the conversation: If you have a leadership topic, experience, or lesson learned you would like to share or hear more about, send an email at brettlylecoaching@gmail.com or use and follow #emergentleadership to join the conversation. You can also connect to Brett directly through LinkedIn or follow her journey on YouTube.
Jonathon Feit interviews Joshua Parish, Deputy Chief of Emergency Medical Services (EMS), Milwaukee Fire Dept.
Deputy Chief Joshua Parish of the Milwaukee (WI) Fire Department checks multiple "diversity" boxes as a Black man in an overwhelmingly white industry, who has risen through the ranks as an unabashed iconoclast.
He has a master's degree from the venerable London School of Economics in an industry that is torn about the fundamental question of whether post-high school education should be considered a "must have."
He is passionate about honing a worldly perspective and loves losing himself in new locales with no choice but to adapt and seek empathy.
It turns out, this same blend of characteristics makes for an excellent medic, because in the real world, biology and chemistry often come secondary to psychology and sociology: understanding human nature.
Following a deep-dive into his origin story, Chief Parish discusses strategies for turning "samurai swords" into "Gerber tools" when training team members – evolving from experts in a single function to team members who can flex as a community's needs evolve – as a way of "future-proofing ourselves."
Also: Ensuring that mobile medical personnel, in management and on the line alike, reflect -- and embrace -- the mosaic of the communities in which they operate is "good for business" when it comes to recruiting high-potential candidates.
It helps when, say, convincing citizens to stay inside and wear a mask; or to manage diabetes both as a matter of self-care and as a way to show appreciation for their caregivers.
Perhaps most poignant, he reminds us that we need to talk about failures if we are going to learn from them.
In this timely, no-holds-barred interview, Chief Parish explains his approach to language and culture, to relationship-building, and to research (including the need for additional rigor) – these have swirled into a strange brew against the backdrop of the COVID-19 crisis, particularly in Wisconsin, where racial and socioeconomic tensions followed a shooting during protests in nearby Kenosha.
On this episode, host Brett Lyle is joined by Health Care Visions President Steve Athey. Steve has spent more than four decades in EMS and 30 years as a respected industry leaders and consultant. They discuss the differences between leading with and without titles, the power of influence and how time has affected the effectiveness of varying leadership and management styles and strategies. Steve offers some insight into his years of market research and leaves you with some powerful words of wisdom.
Resources mentioned: Crossing the Chasm by Geoffrey A. Moore; Go for No!: Yes Is the Destination, No Is How You Get There by Andrea Waltz and Richard Fenton; Course: The Science of Well-being, led by Dr. Laurie Santos of Yale University via Coursera.
Welcome to Emergent Leadership where we connect with passionate leaders who just have to share their stories, perspectives, and most importantly, lessons learned.
The need is urgent, the events are critical, and the you of tomorrow is just an episode away!
Join the conversation: If you have a leadership topic, experience, or lesson learned you would like to share or hear more about, send an email at brettlylecoaching@gmail.com or use and follow #emergentleadership to join the conversation. You can also connect to Brett directly through LinkedIn or follow her journey on YouTube.
Should you say no to good things to save space for the great ones? How do you know which opportunities are good versus great? Join Kris Kaull, chief marketing officer for Pulsara and co-founder of EMS1, as he opens up to hostess Brett Lyle about some of the challenges he has faced as a serial entrepreneur. He discusses the tools he used to overcome them and explains how he intentionally designed his career to be personally fulfilling and professionally valuable to the industry. We discuss tangible practices that define and reshape mindsets. We talk daily to-do lists and lifelong goals and accomplishments. We talk mentorship and the differences between servant leadership and coaching. "If you're an art history major.. if you're an engineer... we need [you] in EMS."
Welcome to Emergent Leadership where we connect with passionate leaders who just have to share their stories, perspectives, and most importantly, lessons learned.
The need is urgent, the events are critical, and the you of tomorrow is just an episode away!
Join the conversation: If you have a leadership topic, experience, or lesson learned you would like to share or hear more about, send an email at brettlylecoaching@gmail.com or use and follow #emergentleadership to join the conversation. You can also connect to Brett directly through LinkedIn or follow her journey on YouTube.
On this episode of Another Dose, Dr. Candice McDonald and Robin Goldinger, RN, are joined by Fire Chief/Attorney Chip Comstock, Paramedic/Attorney Matthew Streger, and EMT/Journalist Richard Huff. They discuss the pros and cons of social media in EMS.
This week, host Brett Lyle is joined by Steve Dralle, South region president for Global Medical Response (GMR), as he opens up about his first leadership experience as a manager at McDonald’s at 17 years old and his path since then. Steve shares a few management lessons and leadership principles he still uses today, discusses the roles of energy and mindset and the challenging transition from a frontline clinician to a leadership role.
They discuss the differences between leading, managing and having charisma – and the value of each of them. They talk tough conversations. They talk social interactions and interpersonal relationships. They talk feedback. They talk sacrifice.
Steve talks about the burden placed on today’s leaders, explores the value in asking for help and emphasizes the importance of the people you surround yourself with as you navigate your path.
Welcome to Emergent Leadership where we connect with passionate leaders who just have to share their stories, perspectives, and most importantly, lessons learned.
The need is urgent, the events are critical, and the you of tomorrow is just an episode away!
Join the conversation: If you have a leadership topic, experience, or lesson learned you would like to share or hear more about, send an email at brettlylecoaching@gmail.com or use and follow #emergentleadership to join the conversation. You can also connect to Brett directly through LinkedIn or follow her journey on YouTube.
Let’s Get it Straight host Katherine West goes over the basics of exposure and what body fluids do and do not pose a risk.
Can “this is how we’ve always done it” actually serve as valuable insight? Can the past be a part of the solution for the future? Can understanding the journey be a part of a healing or resilience plan?
This week, Brett is joined by Kristy Van Hoven, director of the National EMS Museum, museum expert, and PhD candidate who is determined to understand how the past plays into the present and how it can be used as a tool for cultural breakthroughs and understanding and progress.
Kristy shares stories about her time at Mayo Clinic working to understand how artifacts and collections may directly affect brain disorders, explains how the Minneapolis Institute of Art used pain and loss as a way to heal a community, and how museums are able to facilitate emotional progress and strength.
Storytelling is the first step to healing, and only when we are confident and ready to embrace vulnerability are we able to effectively drive and lead sustainable change.
Welcome to Emergent Leadership where we connect with passionate leaders who just have to share their stories, perspectives, and most importantly, lessons learned.
The need is urgent, the events are critical, and the you of tomorrow is just an episode away!
Join the conversation: If you have a leadership topic, experience, or lesson learned you would like to share or hear more about, send an email at brettlylecoaching@gmail.com or use and follow #emergentleadership to join the conversation. You can also connect to Brett directly through LinkedIn or follow her journey on YouTube.
Should EMS be called healthcare? Does the answer depend on the type of agency in discussion? Where does emergency medicine begin and end?
This week, Brett is joined by Justin Fairless, medical director for Air Methods, practicing emergency medicine physician for TeamHealth, and assistant professor for Texas Christian University and University of North Texas Health Science Center School of Medicine in Fort Worth.
Dr. Fairless opens up about his personal experiences from the different perspectives and environments where emergent medicine is learned and practiced — prehospital ground and air, hospitals and higher-level education. Justin shares stories about real-time teaching moments and offers solutions on how to get the most out of clinical rotations, while building relationships within the healthcare continuum and your local community.
Justin shares his mindset that allows him to manage multiple career responsibilities simultaneously, and leaves you with a philosophy that transcends environments, will help you become a stronger clinician and will stand the test of time for true #emergentleadership.
Welcome to Emergent Leadership where we connect with passionate leaders who just have to share their stories, perspectives, and most importantly, lessons learned.
The need is urgent, the events are critical, and the you of tomorrow is just an episode away!
Join the conversation: If you have a leadership topic, experience, or lesson learned you would like to share or hear more about, send an email at brettlylecoaching@gmail.com or use and follow #emergentleadership to join the conversation. You can also connect to Brett directly through LinkedIn or follow her journey on YouTube.
On this episode of Another Dose, Dr. Candice McDonald and Robin Goldinger, RN, are joined by Chaplain Dr. David Mabry, Clinician Yvette Graham, LISW, Captain Dena Ali, and Advanced Paramedic Traci Van Deventer to discuss mental health and the EMS provider.
Are some people more cutout for leadership than others? Do innate attributes make a leader, or can leadership be learned?
Join Seth Komansky, deputy director and chief of operations for Wake County EMS (NC), as he opens up to hostess Brett Lyle about his personal experiences and lessons learned. Chief Komansky shares stories about the book club they established to facilitate growth, explains why personal growth plans are crucial for team building and how decentralizing command benefits employees, leaders and agencies.
We discuss emergent leadership in the context of incident management and command presence, recognition primed decision-making and the value in being uncomfortable.
Seth explores management of varying personnel strengths and perspectives and shares the one quick, but critical question he asked, immediately, as he stepped into his titled leadership role.
Welcome to Emergent Leadership where we connect with passionate leaders who just have to share their stories, perspectives, and most importantly, lessons learned.
The need is urgent, the events are critical, and the you of tomorrow is just an episode away!
Join the conversation: If you have a leadership topic, experience, or lesson learned you would like to share or hear more about, send an email at brettlylecoaching@gmail.com or use and follow #emergentleadership to join the conversation. You can also connect to Brett directly through LinkedIn or follow her journey on YouTube.
The Age of the Entrepreneur: Millennials, Resources, and Visions
Does age matter? Is age a barrier to your success, or is it the key?
Join Ryan Thorne, founder and chief executive officer of Thorne Ambulance Service (SC), as he opens up to hostess Brett Lyle about his experiences as a young entrepreneur and business owner who is making his way, building a successful private ambulance organization in South Carolina.
Ryan shares stories about his challenges and successes in securing initial funding and how his upbringing and prior EMS experiences helped shape his passion for the industry and his vision for the organization. Ryan reveals the exact moment he decided to start his own ambulance company, shares the philosophies and practices that he has adopted for his agency and offers solutions for how to self-educate and stay competitive.
We talk about our experiences in the industry as 20-year-olds and the transition to 30-something millennial leaders. We talk through the notion of “thick skin” and how the company you keep affects your mindset and resilience.
Ryan offers you a tip for learning technology and embracing social media in a day and age where connection, communication and instant feedback are expected, and he shares the key to his success as an #emergentleader thus far.
Welcome to Emergent Leadership where we connect with passionate leaders who just have to share their stories, perspectives, and most importantly, lessons learned.
The need is urgent, the events are critical, and the you of tomorrow is just an episode away!
Join the conversation: If you have a leadership topic, experience, or lesson learned you would like to share or hear more about, send an email HERE or use and follow #emergentleadership to join the conversation. You can also connect to Brett directly through LinkedIn or follow her journey on YouTube .
On this episode of Another Dose, Dr. Candice McDonald and Robin Goldinger, RN, are joined by Dr. Allen Turner and Tiger Schmittendorf. Turner is a 23-year U.S. Coast Guard veteran and current NASA Emergency Manager; Schmittendorf is a firefighter and former emergency manager. Together they discuss the need and strategies for personal and organizational preparedness for EMS professionals to reduce the impact of disaster that hit home.
Join Brad Pitassi, the assistant chief of City of Maricopa (AZ) Fire and Medical, as he shares his path to emergent leadership.
He discusses how prepping for law school turned into firefighting and a public information officer role, and how those communication and relationship building skills served as the foundation for his recent promotion to assistant chief of administrative services.
Chief Pitassi shares stories of success, but also one of failure following the fatal Yarnell Hill Fire. He explains how he has since used that lesson to become a stronger and more empathetic leader.
Brad explains his PIO mindset, how to manage the face of your organization and describes how investing in social equity strengthens community relations and empowers employees.
Welcome to Emergent Leadership where we connect with passionate leaders who just have to share their stories, perspectives, and most importantly, lessons learned.
The need is urgent, the events are critical, and the you of tomorrow is just an episode away!
Join the conversation: If you have a leadership topic, experience, or lesson learned you would like to share or hear more about, send an email HERE or use and follow #emergentleadership to join the conversation. You can also connect to Brett directly through LinkedIn or follow her journey on YouTube .
JEMS Editor Emeritus A.J. Heightman talks with EMS visionary, researcher and educator extraordinaire Mike Taigman about living with stress and stress management in EMS, accelerated by the COVID-19 pandemic.
Mike and his wife Sascha recently released their insightful book “Super-Charge Your Stress Management in the Age of COVID-19.”
Mike Taigman is the leading expert in improvement science, resilience, and stress management at First Watch based out of Carlsbad, California. Mike’s broad experience helps him turn data into actionable information, helps teams build their resilience using our neuroscience-based ResilientFirst system, and teaches stress management techniques that can be used by anyone anywhere.
Mike facilitated the development of EMS Agenda 2050 a vision for EMS in America 30 years in the future. Inspired by the “people centered” aspect of Agenda 2050, Mike works with some of the world leading physicians and researchers to bring evidenced-based leadership, education and practices to the EMS industry. These practices help create organizations where employees are resilient, joyful, thriving, and providing compassionate care during long careers.
As a young street paramedic in Denver, Mike honed his clinical skills caring for patients and helping new paramedics learn to provide solid clinical care with kindness and compassion.
As a popular conference educator, author of more than 600 articles in professional journals, an associate professor in the graduate program in emergency health services management at the University of Maryland Baltimore County, and an associate adjunct professor in the master’s program in healthcare administration and interprofessional leadership at the University of California San Francisco, Mike has focused on helping professionals save more lives, reduce suffering, and be more effective leaders.
As a consultant, Mike has worked with EMS, fire, and public health in 48 of the 50 states, most of the Canadian provinces, Israel, Palestine, Australia and throughout Europe. His expertise includes EMS street survival, patient centered leadership, effective quality/performance improvement, and resiliency. He holds a master’s degree in organizational systems and is frequently part of the faculty for the Institute for Healthcare Improvement.
Mike’s wife Sascha Liebowitz is an accomplished writer and author of “Living Every Minute of It,” a blog about living each day with patience, tolerance, kindness and love towards oneself and others. A former New York lawyer, Sascha now lives in California focusing on family, writing, and being of service to others. She holds a BA from Columbia College and a JD from New York University School of Law.
This episode of the EMS Today Show, and Mike and Sascha’s book “Super-Charge Your Stress Management in the Age of COVID-19,” will give you important tools to develop and maintain resiliency and get through this difficult time in your EMS career.
In a testimonial about the book, Donald M. Berwick, MD, MPP, President Emeritus and Senior Fellow, Institute for Healthcare Improvement said it best, “Managing … stress is a continual task for the healing professions—more challenging perhaps in the era of COVID-19, but, frankly, always with us.”
Dr. Berwick goes on to say that the book “draws on a wide library of science, teachings, and experience and distills it all into a readable and useful collection of practical, attractive techniques. Each one seems not only promising, but frankly, fun.”
His concluding remark really sums up why a book by Mike Taigman will be so helpful to emergency service personnel: “This book brings optimism and oxygen at a time when we badly need both.”
How do differences strengthen an organization? Or do they?
Join David Patterson, chief executive officer of Falck Rocky Mountain, Inc. as he opens up to hostess Brett Lyle about his experiences working for the USA division of an international organization.
David shares his story about an eye-opening experience at the European EMS Congress, talks through intercultural lessons learned and explains how he has used those lessons to strengthen his teams and himself, as a mentor and an emergent leader.
He offers solutions for agencies looking to grow internal leaders, advice to individuals on how to advocate for their own career progression and the key to a successful transition.
David recognizes the uniqueness of each person’s leadership journey, the value in the differences and leaves emergent leaders with words of encouragement for the future.
Welcome to Emergent Leadership where we connect with passionate leaders who just have to share their stories, perspectives, and most importantly, lessons learned.
The need is urgent, the events are critical, and the you of tomorrow is just an episode away!
Join the conversation: If you have a leadership topic, experience, or lesson learned you would like to share or hear more about, send an email to brettlylecoaching@gmail.com or use and follow #emergentleadership to join the conversation on LinkedIn. You can also connect to Brett directly through LinkedIn or follow her journey on YouTube.
In this special edition podcast, Jonathon Feit gives a talk to Harvard in Tech and the COVID Foundation about contact tracing. He uses three case studies involving Los Angeles County Fire; Harris County, Texas (Emergency Services District 48 and Cypress Creek EMS); and the Rio Rico Medical & Fire District in Arizona.
JEMS Editor Emeritus A.J. Heightman talks with Matt Zavadsky, chief strategic integration officer for MedStar Mobile Health Care (TX) and the present president of NAEMT, about some of the current issues impacting EMS agencies.
It’s an informative episode that touches on:
- The impact of COVID-19 on reduced call for service, reduced transports and increasing cardiac arrest volumes – and how it is affecting services operationally and financially;
- Reduced revenue and some novel, outside-the-box thinking on how to fill financial voids;
- The new era and occupation of contact tracers and how EMS agencies could deploy them and gain revenue for doing so. (State and county health departments have funding for these positions);
- The use of EMS Task Force Teams in Texas to test nursing home facilities and staff – and the impact it is having on reducing mortality;
- The proposed treatment-in-place legislation that was carefully crafted and already has more than 30 Congressional sponsors and hopefully will be attached to the next Congressional Relief Package from Congress (NAEMT, IAFC, AAA and others joined forces to present one united message);
- The need for EMS Agencies to work with their police departments to ensure crew resource management principals are in effect during patient interactions to ensure patients get the care they need – when they need it.
On this debut episode of Another Dose, Dr. Candice McDonald and Robin Goldinger are joined by Jack Sullivan, the director of training of the Cumberland Valley Volunteer Firemen's Association's Emergency Responder Safety Institute, and Ohio State Troopers Lt. Jeff Greene and PIO/Sgt. Ray Santiago. They discuss strategies for EMS professionals to reduce the risk of injury and fatality while working on the roadway.
Can words and the way you use them really affect how your message is received? The saying is, “it’s not about what you say, but how you say it,” so is it possible for words to shape your destiny, that of your team and of your programs?
Join Ernie Rodriguez, Chief of Austin-Travis County EMS (Texas) as he opens up to hostess Brett Lyle, about his stories and experiences leading this large metropolitan system. He shares how his words have defined his experiences, the tools he uses to manage relationships with his 600+ internal team members, and how the intentional way he presents facts to external stakeholders has afforded he and his department unique opportunities.
He speaks about how to keep up with a progressive, technology-savvy, engaged population, a time he thought his words might have lost him his job, and how not knowing any better has allowed him to accomplish the seemingly impossible.
Ernie leaves you with a strong message about caring for your people and offers actionable advice for fellow Emergent Leaders.
Welcome to Emergent Leadership where we connect with passionate leaders who just have to share their stories, perspectives, and most importantly, lessons learned.
The need is urgent, the events are critical, and the you of tomorrow is just an episode away!
Join the conversation: If you have a leadership topic, experience, or lesson learned you would like to share or hear more about, send an email to brettlylecoaching@gmail.com or use and follow #emergentleadership to join the conversation on LinkedIn. You can also connect to Brett directly through LinkedIn or follow her journey on YouTube.
While the flu vaccine won't protect you from COVID-19, Katherine West explains why getting the vaccine is important.
Ever wonder how people gain thousands of connections on LinkedIn or what purpose followers might serve, anyway?
Tim Nowak has 14,500 followers. Join this LinkedIn expert and industry conversationalist as he opens up to hostess Brett Lyle about his personal stories and experiences with how the platform has helped him find his voice and how he has perfected the art of using it.
He speaks about the powers of curiosity and targeted networking, discusses challenges that come with developing your personal brand and explores the journey and power in online relationship building.
Tim makes a personal offer to you and leaves motivating words of advice for fellow Emergent Leaders.
Welcome to Emergent Leadership where we connect with passionate leaders who just have to share their stories, perspectives, and most importantly, lessons learned.
The need is urgent, the events are critical, and the you of tomorrow is just an episode away!
Join the conversation: If you have a leadership topic, experience, or lesson learned you would like to share or hear more about, send an email to brettlylecoaching@gmail.com or use and follow #emergentleadership to join the conversation on LinkedIn. You can also connect to Brett directly through LinkedIn or follow her journey on YouTube.
This must watch EMS TODAY Show episode zeroes in on not just the tremendous work by FDNY and other New York City 911-contracted EMS responders, but also on the horrible pay and benefit inequity between FDNY EMS personnel and their counterparts in FDNY and the NYPD.
JEMS Editor Emeritus A.J. Heightman talks with Anthony Almojera, a 13-year veteran lieutenant paramedic with FDNY EMS and the vice president of Local 3621, the FDNY EMS Officers' union representing lieutenants and captains. He’s currently assigned to Station 40 in Sunset Park, Brooklyn.
On this episode of The EMS TODAY Show, A.J. Heightman talks with Dr. James Augustine about what we are learning on a daily basis about COVID-19. They also discuss the impact it is having on EMS and emergency departments nationwide, particularly how it is decreasing EMS call volume and ED visits. They also talk about what we should plan for, and who we should be working with in the coming months - particularly when we move through flu season.
In the inaugural podcast of Sacred Cows & Data Cubes, host Jonathon Feit has a conversation with Abby Dotson, PhD, the director of the Oregon POLST Registry and research assistant professor of emergency medicine at Oregon Health & Science University.
Seasoned Haz-Tech Paramedics Joe Hudak and Randy Li speak up close and personal with JEMS Editor Emeritus A.J. Heightman about their experiences during the peak periods of the COVID-19 pandemic in New York City Ground Zero again for a historic American tragedy.
Hudak, a 32-year street medic who responded to the World Trade Center and the crash of an American Airlines plane in Queens in 2001, is featured in the May issue of People magazine because he has the amazing perspective of a paramedic involved in three tragic “one-in-a-lifetime” incidents.
He though he saw it all in his 32 years on the street. He was wrong and is now having to fight and guard against an invisible killer.
Randy Li is a nine-year veteran medic and supervisor who responds to dozens of “jobs” each shift. He has witnessed the best and worst during the pandemic. He’s seen multiple DOAs found in their homes, patients who succumb to other medical issues weeks experienced after their “recovery” from COVID-19 and the recognition and respect EMS and other healthcare workers are receiving daily.
Hudak and Li have been members of a highly trained EMS Competition team that has participated in the JEMS Games for years and explain why COVID-19 is a challenge like no other for EMS personnel.
The COVID-19 pandemic “wave” is over the top of us and having a major impact on EMS. But that wave will be followed by many other waves well after the pandemic.
Join JEMS Editor Emeritus A.J. Heightman for an in-depth discussion with financial and legislative expert Asbel Montes on the present and future state of EMS. Other topics discussed include:
- How telehealth has/will change the EMS landscape.
- Internal financial mitigation solutions during the pandemic.
- Federal and state solutions to help EMS bridge the financial delta.
