EMS One-Stop

Sleep, safety & fatigue: Improving EMS health with Dr. Dan Patterson

In this episode of EMS One-Stop, host Rob Lawrence is joined by Dr. Dan Patterson, a clinician-scientist specializing in safety in emergency care settings. Dr. Patterson’s work centers around critical factors in EMS safety, such as sleep health, shift work, fatigue and their combined effects on clinician well-being.
Timeline of key discussion points
00:00 – Introduction to Dr. Dan Patterson
Dr. Patterson’s background and how his clinical experience as a paramedic informs his research on EMS safety and sleep health
 
04:30 – The Impact of Shift Work and Fatigue on EMS Providers
Discussing the direct effects of fatigue on EMS professionals, including medical errors, cognitive performance and decision-making
 
10:00 – The Science of Sleep in EMS
Why sleep is critical for EMS personnel and the unique challenges they face in getting adequate rest during shift work
 
15:00 – Development of Safety Measurement Tools
Dr. Patterson explains the creation of safety tools to track fatigue, sleep health and workplace injury rates in EMS settings
 
20:30 – Experimental Studies and Interventions
Overview of studies testing novel approaches to mitigating fatigue, including practical solutions and interventions in EMS environments
 
25:00 – Creating a Safety Culture in EMS
The role of leadership and teamwork in reducing fatigue-related errors and fostering a culture of safety in EMS organizations
 
30:00 – Key Takeaways and How Agencies Can Implement Changes
Final thoughts on how EMS agencies can integrate Dr. Patterson's findings and create healthier, safer work environments for their teams

Emerging threat update: Avian influenza, Mpox, Ebola, seasonal flu

In this episode of EMS One-Stop, host Rob Lawrence welcomes back Dr. Alex Isakov, a leading expert in infectious diseases from NETEC and Emory University in Atlanta. Dr. Isakov provides valuable updates on current and emerging infectious diseases; their global impact; and the critical role EMS professionals play in identifying, isolating and protecting themselves and their patients.
This discussion highlights key infectious diseases, including H5N1 (avian flu/bird flu), Mpox (previously known as monkeypox), Ebola, Marburg, Lassa fever and seasonal flu, providing EMS personnel with essential knowledge and safety protocols in light of ongoing global health concerns.
Throughout the episode, Dr. Isakov offers insights into the latest outbreaks, the importance of vaccinations, and strategies for responding to potential infectious disease threats. He stresses the necessity of remaining vigilant and prepared for high-consequence diseases while maintaining optimal patient care.
From the evolving threat of H5N1 to the resurgence of seasonal influenza, Dr. Isakov ensures that EMS professionals are equipped with the most relevant and up-to-date information needed to protect both themselves and their communities.
Summary of key infectious diseases covered by Dr. Isakov
H5N1 (avian influenza/bird flu): Dr. Isakov provides an update on the H5N1 outbreak in poultry and dairy herds, stressing the importance of limiting human exposure and watching for potential mutations that could lead to human-to-human transmission.
Mpox (Clade 1B): Dr. Isakov discusses the risk of Mpox, particularly Clade 1B, which remains prevalent in Central Africa but has now spread to other countries, including the United States. He highlights the importance of identifying travel history and unusual rashes, along with strict protective measures for EMS clinicians.
Ebola and Marburg: These diseases continue to present a risk, with smaller outbreaks currently ongoing in Uganda (Ebola) and Tanzania (Marburg). Dr. Isakov notes the importance of being prepared to identify and isolate individuals who may have been exposed during travel to these regions.
Lassa fever: Dr. Isakov points out the ongoing concern of Lassa fever in West Africa and emphasizes that EMS professionals should be on alert for symptoms in travelers who have visited affected regions.
Seasonal influenza: The seasonal flu outbreak is particularly severe this year, and Dr. Isakov underscores the importance of vaccination, especially for vulnerable populations, to reduce serious illness and hospital strain.
Timeline
00:00 – Introduction to the episode and guest, Dr. Alex Isakov
01:33 – Uupdate on Mpox (Clade 1B) and its global spread
05:24 – Ebola and Marburg outbreaks: ongoing concerns in Uganda and Tanzania
08:01 – Lassa Fever in West Africa and its impact on EMS professionals
13:05 – The importance of travel vaccinations for high-risk areas like malaria zones
15:13 – Mystery illness in the Democratic Republic of Congo and the investigation into its cause
17:01 – H5N1 and avian influenza concerns, including potential human transmission risks
22:02 – Severity of the current seasonal flu outbreak and vaccination recommendations
25:24 – EMS community's role in flu and measles vaccination advocacy
29:05 – Discussing surge conditions and excess mortality during pandemics
32:01 – Closing remarks, including updates on new NITEC EMS resources
Additional infectious disease resources
National Emerging Special Pathogens Training & Education Center
Emergency Medical Services (EMS) Featured Resources | NETEC
Symptoms of Malaria | Malaria | CDC
Lassa Fever Suspected in Death of U.S. Traveler Returning from West Africa | CDC Newsroom
CDC A(H5N1) Bird Flu Response Update February 26, 2025 | Bird Flu | CDC
Mpox | Mpox | CDC
Healthcare Workers: Could it be Ebola?

The $21M Texas EMS recruitment and retention initiative

Recruiting and retaining EMS professionals has been an ongoing challenge across the U.S., made worse by the COVID-19 pandemic. In this episode of the EMS One–Stop podcast, host Rob Lawrence sits down with Joe Schmider, Texas State EMS director, to discuss the $21M Texas EMS Workforce Initiative — a data-driven approach to recruiting and retaining EMS providers statewide.
Schmider details how Texas identified a 40% non-utilization rate among certified EMS professionals, successfully secured state funding, and launched an innovative recruitment and retention campaign. With over 10,915 new personnel added since 2019, this program serves as a model for other states struggling with EMS workforce shortages. This episode is full of actionable insights for EMS leaders, policymakers and recruiters alike.
Key quotes from Joe Schmider
"We were seeing about 40% of our certified people — licensed paramedics, EMTs, advanced EMTs — were not using their skills on an ambulance."
"We worked with our associations here in Texas, the Texas EMS Alliance and the Texas Ambulance Association. They went and met with some legislators, worked the room a bit, and we got $21 million of federal dollars through the state to us for 2 years to put in place a recruitment and retention program."
"We pushed out 3,152 scholarships. An EMT scholarship was worth $2,000, an advanced EMT scholarship was $3,200 and a paramedic scholarship was $8,000. The money went directly to the education program, not to the student. They had 1 year to complete their training and then had to serve 96 hours a month on an ambulance — either as a paid or volunteer position — for 1 year at the EMT level and 2 years at the paramedic level."
"We spent $1.5 million on an advertising campaign throughout the state of Texas. We hired a media company to develop commercials, billboards and social media campaigns. The use of social media was incredible — 50 million views over 2 years, which was an incredible number. We never expected that."
"The second thing people do [when considering EMS careers] is they watch us as EMS professionals. Do I want to work with these people? Do I want to be a part of this? I once saw two EMTs standing on the back of an ambulance smoking a cigarette at an event. I went up to them and said, ‘Are you kidding? What message are we putting out when we do stuff like that?’ We have to think about our image."
"People leave the EMS profession for two reasons: money or the way they’re treated. Depending on which survey you look at, it could be money first or treatment first, but it’s always those two reasons."
Episode timeline
00:08 – Rob Lawrence introduces guest Joe Schmider, Texas EMS director
00:26 – The EMS staffing crisis and how COVID-19 accelerated workforce shortages
01:36 – How Texas used data to identify a 40% EMS non-utilization rate
02:51 – How Texas EMS leaders secured $21 million in funding
04:31 – Structuring EMS scholarships and training requirements
06:41 – The success of the recruitment campaign: 3,152 scholarships awarded
08:46 – How Texas reached 50 million views in its EMS recruitment campaign
11:16 – EMS workforce retention: The challenges of pay and treatment
13:46 – Addressing rural EMS shortages and workforce gaps
16:01 – How Texas EMS associations helped advocate for change
18:21 – The future of EMS funding and advocacy efforts
21:01 – Lessons from corporate retention strategies: What EMS can learn from HEB grocery stores
24:01 – The importance of EMS provider wellness: Texas’ Wellness Wednesday initiative
26:01 – Final takeaways: Lessons for other states and EMS leaders
28:01 – Closing thoughts and how to access Texas EMS resources
Additional resources
Connect with Joe Schmider: joseph.schmider@dshs.texas.gov/512-484-5470
Texas EMS Careers and Education

‘The leader must own it’: General Robert Neller on ethical leadership and adaptability

In this special episode of EMS One-Stop, host Rob Lawrence welcomes General Robert B. Neller, the 37th commandant of the United States Marine Corps, to discuss leadership, decision-making, team building and the evolving challenges facing public safety professionals.
General Neller shares his perspective on leading under pressure, making critical decisions, and fostering an ethical and resilient organizational culture. With decades of military leadership experience, he provides actionable insights that apply not only to the armed forces but also to EMS, law enforcement, and fire and rescue personnel.
Throughout the episode, General Neller emphasizes the importance of training, adaptability and the role of leadership in guiding organizations through times of uncertainty. He highlights the significance of ethical leadership, followership and how leaders must take responsibility for failures while empowering their teams.
The discussion also explores the impact of emerging technologies, such as AI and body-worn cameras on public safety, and the crucial need for ongoing training despite staffing and funding challenges. This thought-provoking conversation delivers key takeaways for current and aspiring leaders across all branches of public safety.
15 leadership quotes from General Robert B. Neller
“Making decisions is part of your training — you’re expected to make them, and you have to do it in critical moments.”
“If I could wave a magic wand, I’d put everyone at 110% staffing so they had the time to train properly.”
“The leader’s job is to set the example — how you carry yourself, how you treat others, and how you communicate matters.”
“Good leaders anticipate. They don’t just react — they look ahead and keep their teams informed.”
“Followership isn’t blind obedience; it’s about understanding the mission, contributing ideas, and executing effectively.”
“Accepting responsibility is a core tenet of leadership — when things go wrong, the leader must own it.”
“Change is inevitable, and good leaders learn to embrace it while preparing their people for what’s ahead.”
“Take care of yourself — physically, mentally and morally — because leadership starts with personal discipline.”
“As a leader, you have to accept that sometimes you’ll make the right call, and things still won’t go your way — that’s part of the job.”
“You have to train and rehearse because time spent on reconnaissance is seldom wasted.”
“The worst thing you can hear as a leader is that ‘you don’t care’ — your people need to know that you do.”
“To build culture and cohesion, you set the example — you take the physical fitness test, you wear the uniform properly, and you carry yourself the right way.”
“Good leadership is not about the complete suppression of ideas — if you have time, get input, because someone might have a better idea than you.”
“If you have good followers, being a leader is significantly easier — if you don’t, it’s a challenge every day.”
“Change is inevitable — if you’re not evolving, you’re not making progress, and that’s a problem.”

Lessons from the McClain case: Protecting first responders and improving EMS practices

In this episode of the EMS One-Stop podcast, host Rob Lawrence is joined by Shana Beggan, Esq.; and Mike Pellow, Esq., defense attorneys representing one of the firefighters involved in the tragic Elijah McClain case.
Beggan and Pellow discuss the complex legal and systemic issues surrounding the incident, including communication breakdowns, inadequate training, and the challenges faced by EMS and fire personnel when operating in chaotic environments. They also address the broader implications for EMS professionals, highlighting the importance of proper documentation, the use of body-worn cameras, and the need for stronger inter-agency collaboration between police and EMS teams.
This interview provides invaluable insights into the case and the steps necessary to improve EMS practices moving forward.
Beggan and Pellow share their experiences navigating the criminal and civil aspects of the case, emphasizing the importance of understanding the limitations and constraints that EMS providers face in high-pressure situations. They also advocate policy changes, such as enhanced training, better resource allocation and the introduction of body-worn cameras to protect both first responders and the patients they serve.
Their passionate discussion sheds light on the need for reform within EMS, encouraging listeners to reflect on their own practices and consider how they can contribute to a safer and more effective emergency response system.
Key quotes
"First responders are people who run towards difficulties and trauma when many run away, and to see somebody be charged in this situation and the fallout from it ... has become a very strong passion for myself and for Mike." — Shana Beggan
"You take somebody – basically the bottom of an entire healthcare system – and say, let's blame this person, let's criminalize this. That is the wrong thing to do." — Mike Pellow
"I think that we need to allow for honest conversations in a safe way, not a blame-the-finger approach." — Shana Beggan
"We need to be better at helping first responders, not making them look over their shoulders and thinking, ‘Where am I going to get whacked in the back of the head if something goes wrong?’" — Mike Pellow
"We perform the way we train, and here the training was poor. We condone or even promote what we fail to address." — Shana Beggan
Takeaways and actionable items
Improve documentation practices. Ensure that EMS providers document not only their actions, but also their thought processes. This can help prevent misinterpretation of their actions in high-stress situations and provide valuable context in legal proceedings.
Advocate for body-worn cameras. Implement body-worn cameras for EMS teams to improve transparency, protect first responders, and provide better evidence for both patient care and legal purposes. However, ensure that funding for such programs comes from appropriate sources, rather than placing additional strain on already underfunded EMS budgets.
Enhance training and protocols. EMS and police departments should collaborate on joint training sessions, focusing on clear communication, proper patient handoffs, and how to handle complex situations, like excited delirium. Ensure that protocols are updated regularly and that training is implemented in real-world scenarios.
Timeline
01:48 – Introduction: Rob Lawrence introduces the episode and guests Shana Beggan, Esq.; and Mike Pellow, Esq.
04:21 – Case background: Pellow provides a brief overview of the Elijah McClain case, the charges against the paramedics, and the current status of the case.
07:10 – Communication breakdowns: Beggan discusses the major issues surrounding communication between police and EMS, particularly the lack of information shared between the different teams at the scene.
10:35 – Documentation and reporting: Beggan and Pellow emphasize the importance of documentation in EMS, especially in legal situations, and discuss how inadequate reporting and the failure to document actions and decisions contributed to the case.
12:01 – Body-worn cameras: Pellow advocates for the use of body-worn cameras in EMS to provide better documentation and protect both patients and responders.
19:25 – Police and EMS collaboration: Beggan and Pellow discuss the importance of training police and EMS teams together to improve coordination and response.
28:00 – Legal implications and criminalization of EMS: Beggan and Pellow discuss the growing trend of criminalizing medical practice in EMS and the need to protect providers from unjust legal consequences.
46:11 – Support from fire leadership: Beggan shares the support from the Aurora fire chief, who highlighted systemic failures and underscored the importance of better training and protocols.
50:57 – Closing remarks: Rob thanks Beggan and Pellow for sharing their insights and the discussion closes with a focus on the need for systemic change within EMS and emergency response. 

From chaos to command: Lessons from the New Year’s Day tragedy in New Orleans

In this sobering episode of EMS One-Stop, host Rob Lawrence sits down with Chief Bill Salmeron of New Orleans EMS to discuss the tragic events that unfolded on New Year’s Day 2025, when a vehicle plowed through crowds in the French Quarter, resulting in 15 fatalities and 57 injuries, including two police officers.
Chief Salmeron provides a detailed account of the incident, the immediate EMS response, and the coordinated efforts with law enforcement and hospitals to manage the mass casualty incident.
The conversation also delves into the psychological impact on EMS personnel, the value of training and preparedness, and lessons learned from handling such a large-scale event.
Chief Salmeron emphasizes the importance of communication, mutual aid and the mental wellbeing of first responders, offering insights into how New Orleans EMS plans to support its teams in the long recovery process ahead.
Key quotes from the episode
“You don’t teach that level of decision-making in EMT class. Telling a family member or police officer that you can’t help their loved one is one of the hardest things you’ll ever do.” — Chief Bill Salmeron
“The recovery from an incident like this doesn’t take days or weeks – it takes years.” —Rob Lawrence
“I told my team to go back to headquarters. I needed to put eyes on every single one of them and make sure they were OK.” — Chief Bill Salmeron
“Situational awareness and incident command are critical. It’s about restoring order from chaos.” —Rob Lawrence
“What we do is a unique calling. It’s critical to appreciate and take care of each other and ourselves.” — Chief Bill Salmeron
“This episode is a masterclass for anyone planning for mass casualty incidents. Listen, learn and prepare.” —Rob Lawrence
Timeline
00:21 – Introduction to the episode and overview of 2025’s challenging start, including the New Year’s Day tragedy in New Orleans01:22 – Chief Salmeron describes the initial setup and EMS operations in the French Quarter03:26 – Incident details: the truck’s path, immediate EMS response, and the scale of injuries06:01 – Incident command and mutual aid coordination, including the deployment of 13 ambulances09:43 – Managing hospital capacities and patient transport logistics during the MCI15:11 – The discovery of explosive devices and the role of EMS in securing and retreating from the scene23:01 – Post-incident response: staff debriefings, mental health support and lessons learned33:31 – Preparing for future events like the Super Bowl and Mardi Gras under heightened security41:06 – Five key takeaways for leading and managing mass casualty incidents50:28 – Closing thoughts and appreciation for first responders’ dedication and resilience
Additional resources
New Orleans EMS

Navigating extreme weather: Insights from DHS Chief Meteorologist, Sunny Wescott

Join Rob Lawrence on EMS One-Stop as he welcomes Sunny Wescott, chief meteorologist at the Department of Homeland Security, for an eye-opening discussion about the impact of extreme weather on emergency services and critical infrastructure.
Sunny shares her expertise on meteorological trends, the challenges of preparing for severe weather events, and the evolving role of EMS in managing climate-induced emergencies. From hurricanes and polar vortices, to the implications of electric vehicle adoption during extreme weather, this episode is packed with actionable insights for public safety leaders and EMS professionals.
Rob and Sunny explore the complex interplay between extreme weather and emergency response, emphasizing the importance of proactive planning and reliable information sources. Sunny delves into the science behind weather phenomena like atmospheric rivers, Rex blocks and heatwaves, connecting them to real-world challenges faced by first responders.
During this edition of EMS One-Stop discover the tools, resources and strategies Sunny recommends for staying ahead of severe weather impacts on both infrastructure and personnel, and gain practical advice for improving communication with the public during weather crises, ensuring safety and minimizing risk.
Key quotes from this episode
“The uneven heating of our planet is amplifying weather events, making them stronger and more unpredictable.” — Sunny Wescott
“The weather affects everything – and for EMS leaders, preparation isn't optional, it's essential.” — Rob Lawrence
“We’re seeing infrastructure pushed to its breaking point by weather extremes – things we couldn’t anticipate when they were built.” — Sunny Wescott
“Sometimes, the hardest command decision is telling your crews, ‘We’re hunkering down now.’ It’s the right call, but it’s never an easy one.” — Rob Lawrence
“Your life means so much more than the possessions inside your home. Evacuate early – it’s always the safest choice.” — Sunny Wescott
“Let’s face it: weather is as much a part of public safety planning as personnel and resources.” — Rob Lawrence
“Weather preparedness isn’t just about forecasts; it’s about collaboration, data sharing and breaking down silos across sectors.” — Sunny Wescott
Timeline
00:24 – Rob’s introduction and reflections on weather in the UK and US
01:22 – Sunny explains global weather patterns and their cascading impacts
03:32 – Sunny describes her role at DHS and how critical infrastructure is assessed against weather risks
11:13 – Hurricane trends, preparedness and landfall impacts for 2025
20:00 – EMS-specific challenges during extreme heat and cold, including effects on equipment and personnel
24:04 – How to interpret long-term weather forecasts and model reliability
30:06 – Operational decisions during extreme weather events, like grounding helicopters and using resources wisely
36:06 – Final thoughts on misinformation, insurance concerns, and public safety resilience
Additional resources
EMS in a changing climate: Understanding the impact of extreme weather
Snowfall Reports from past events
Annual Lightning Report 2024 – Xweather
NWS Probabilistic Precipitation Portal
National Fire News | National Interagency Fire Center
AirNow Fire and Smoke Map
Incidents | CAL FIRE
Evaporative Demand Drought Index (EDDI): NOAA Physical Sciences Laboratory
Zoom Earth | Live Weather Map & Hurricane Tracker
Nullschool Earth :: a global map of wind, weather, and ocean conditions
National Weather Service
 

An inside look at the New Orleans EMS body-worn camera program

In this insightful episode of EMS One-Stop, host Rob Lawrence revisits New Orleans EMS to explore their pioneering use of body-worn cameras, joined by Chris Keller, chief of operations at New Orleans EMS.
The discussion dives into the motivations, challenges and successes of implementing this technology. From its initial deployment on tactical medic teams in 2018, to its current broader rollout, Chris shares the journey of navigating legal frameworks, staff buy-in and operational logistics. The conversation also highlights how body-worn cameras enhance patient care documentation, bolster staff safety and provide an unbiased account of events, positioning them as an emerging industry standard.
This episode offers practical advice on policy development, procurement processes and operational use cases, including their application during Mardi Gras and high-acuity events. With the aim to demystify the implementation process, Chris emphasizes the importance of collaboration, adaptability and using technology to improve EMS practices. Rob and Chris also discuss future goals for the program, funding challenges, and the potential for body-worn cameras to become a cornerstone of EMS operations nationwide.

NEMSQA 2024: Dr. Jeff Jarvis on airway safety and the path to EMS improvement

Dr Jeff Jarvis joins Rob Lawrence to discuss the recently released National EMS Quality Alliance (NEMSQA) Measures Report – “Enhancing airway management one measure at a time.”
The report begins with the following robust Foreword: “NEMSQA is not satisfied with the state of airway management safety in EMS. As you will see, the data clearly shows that we can do much better across our industry! Partnering with experts and EMS agencies around the country, NEMSQA is leading the second national EMS Quality Improvement Partnership (EQuIP), the Airway Management Collaborative to put the new NEMSQA airway measures to work.”
“Enhancing airway management one measure at a time” is the sequel to the Lights and Siren Collaborative and will utilize the Institute for Healthcare Improvement’s Breakthrough Series collaborative model. The goal of the project is to support national improvement in the safety and effectiveness of invasive airway management by focusing on two goals:
Reducing the adverse events, such as peri-intubation hypoxia and hypotension
Improving the use of waveform capnography to confirm and monitor all invasive airways
Rob and Dr. Jarvis discuss the report and actions individuals and their agencies should take to improve their personal and organizational airway management and patient outcome results.
Find more EMS One-Stop episodes here!

Stop the bleed, fill the tank – The New Orleans EMS blood program

In this episode of EMS One-Stop, host Rob Lawrence dives into the trending topic of pre-hospital blood administration with guests from New Orleans EMS: Tom Dransfield, the quality assurance and safety officer, and Dr. David Rayburn, deputy medical director.
This in-depth discussion explores the development and execution of the New Orleans EMS blood program, focusing on packed red blood cells (PRBC) and the challenges, successes and ongoing research surrounding cold blood administration in trauma and medical emergencies. New Orleans EMS is leading the charge in pushing the boundaries of pre-hospital blood, providing innovative solutions for penetrating trauma, GI bleeds and other critical cases.
Dransfield and Dr. Rayburn share the journey of New Orleans EMS in implementing the program, including their logistics, lessons learned and the vital impact of their interventions on patient outcomes.
The episode emphasizes the collaboration between EMS and trauma centers as well as blood suppliers to reduce mortality rates, while also tackling key questions, such as the supply chain, funding and future research.
Memorable quotes
"For every minute we delay blood administration, there's an 11% increase in mortality – this isn't just a theory; it's life and death." — Dr. David Rayburn
"We were topping the charts in the wrong categories – violence and stuff like that. So, our medics were frustrated with the old scoop and run. We're not just scooping and running anymore. We're providing definitive care." — Tom Dransfield
"We’re seeing no change in temperature for patients receiving two units of cold PRBCs in the pre-hospital environment, and that’s groundbreaking." — Dr. David Rayburn
"If we’re doing blood, we’re literally saving lives. But without reimbursement, it’s an uphill battle." — Rob Lawrence
"Our paramedics are pushing the envelope – it's no longer just about trauma; we’re now treating GI bleeds, OB cases and renal patients with blood administration." — Dr. David Rayburn
Find more episodes: https://www.ems1.com/ems-one-stop