EMS One-Stop

Mindset over matter

Paramedic Amanda King shares her story of thru-hiking the Appalachian Trail and overcoming EMS burnout
This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
After realizing she was suffering from burnout, Paramedic Amanda King decided to leave her service and take on one of the most physically challenging trails in the United States. Amanda made a decision that changed how she saw people, how she viewed the world and how she understood herself.
Three months after resigning, selling her house and storing her furniture, Amanda was dropped off in Georgia, alone, with one goal: to hike the entire Appalachian Trail. With her hiker home packed into a rucksack on her back, she embarked on a seven-and-a-half month epic adventure which saw her hike nearly 2,200 miles. She endured harsh weather, a regional drought, rugged terrain and so much more on a journey that evolved her in ways she could not have ever imagined.
After deciding to return to EMS, Amanda chats with Rob Lawrence about her experience, the individuals she met along the way and how her experiences can be translated back into life as a medic. Amanda also reflects on her life before the trail and offers inspiration and takeaways for all.
TOP QUOTES FROM THIS EPISODE
“I think my biggest regret is, it's a very simple word. It's two letters long and it's the word ‘no!’ Don't be afraid to say no. Take time for yourself, because you are the most important person. You know, if you're not happy and if you're not safe, how can you expect to keep other people happy and safe? I think that's the biggest thing, don't work so much overtime, don't inconvenience yourself to do all of these things that's asked of you, in return you're not taking care of yourself. So, one thing that I decided if I got back into EMS, is I would use my vacation time. So I'll put it to you this way. When I was at the former employer, I took a vacation maybe twice in 6 years or something like that, like an actual vacation. I've already taken two vacations since I started here at Novant, since November – so that's a huge difference.”
“I don't want to say yes, a 7-month hike in the woods cured all my problems, because that's not at all the case. I think that it's an ongoing process that, once you reach that point of burnout, it's number one up to you. It's not up to anybody else to help you. It's up to you to help you. And you have to want that change. I think that it's an everyday thing. Every day I need to do things that keep me on that path of not going back down that road again.”
“I think that was a symptom of the burnout where I was at, I had no patience whatsoever and it showed. It showed to my partner, it showed to family members that I would encounter on a call. And I hate to admit all that; it's embarrassing, but that's where I was, that was the point where I was at. I think now, after all that time off, and all that time to self-reflect, I think I'm more patient because I believe that I'm more empathetic, which is also something that I can't say that I possessed before I left.”
EPISODE CONTENTS
02:29 – Introducing Amanda King
05:06 – Symptoms of burnout
07:16 – The moment you realize you are done
10:57 – Selling and putting everything in storage
13:23 – Hiking with friends
15:53 – Packing for a 2,000 mile walk
18:48 – Mental fortitude
22:47 – Trail angels
24:40 – Trail magic
26:32 – Becoming ‘moss’
29:49 – Hindsight is 20/20
31:16 – Keeping a journal
33:30 – Taking a zero: how to use down time
41:14 – 2,000 miles later …
48:05 – Developing patience
51:02 – Message to those heading into crisis or breakdown
54:13 – Contact details
ADDITIONAL RESOURCES ON THIS TOPIC
Reignite EMS passion by banishing burnout (eBook)
On-demand webinar: Navigating a path to career satisfaction
5 EMS tips for a work-life balance
EMS Burnout Repair Kit: Reigniting your EMS passion
ABOUT OUR GUEST
Amanda King is a paramedic from the coast of North Carolina. Prior to joining EMS, she obtained a Bachelor of Arts degree from the University of North Carolina at Wilmington. During her first 10 years in EMS, she was promoted to field training officer, became an EMS instructor, developed a field training and evaluation program for her former agency, taught EMS classes for the local community college and earned a real estate license. She left EMS and thought she’d never return. Now, after becoming one of just over 1,000 people to thru-hike the Appalachian Trail in 2022, she has returned to EMS and now works for Novant Health Mobile Integrated Health. She is currently in graduate school to obtain a master’s degree in public administration.
CONNECT WITH OUR GUEST
Instagram
LinkedIn
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PW&W’s Stark and Johnson provide legal insight into PCRs

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
Page, Wolfberg & Wirth was asked by the National EMS Information System (NEMSIS) Technical Assistance Center (TAC) to research frequently asked questions related to data in EMS patient care reports. PW&W analyzed these questions under applicable laws and guidance, and developed general answers and best practices contained in the new publication, “Patient Care Report Data QuickGuide - FAQs on owning, amending, retaining and sharing patient care report data.”
In this week’s EMS One-Stop, available in both video and audio versions, Host Rob Lawrence speaks with the PW&W authors of the project, Ryan Stark, managing partner, and Steve Johnson, director of reimbursement consulting. They discuss the guide, why it’s needed, and the major FAQs and misconceptions about PCRs.
The guide is broken down into four key areas of FAQs:
PCRs’ legal status
Amending PCRs
PCR retention
Transferring PCR data
Top quotes from this episode
“I would much rather defend an organization who regularly goes through a quality assurance process, whereby they make the provider and hold them responsible for the accuracy and completeness of the record.” — Ryan Stark
“Others may say, we see a lot of amendments to your records. The answer is ‘yes, that’s because we care about getting it right’ – that’s the mantra of our organization.” — Ryan Stark
“One of the things behind the importance of documentation is that it doesn’t live in a vacuum. We are in a day and age where it’s going to follow the patient for their lifetime, so you may have a rehab facility that wants to consult the medical record to determine the mechanism of injury or how the injury occurred and the only person [that knows that] is the EMS practitioner.” — Ryan Stark
“Long gone are the days where we can give you a quick ticket, passing along the information to the receiving facility. Now we are marrying up records, electronic health exchanges and other mechanisms and the genesis of all this starts with the original call.” — Steve Johnson
“Everyone should sign the patient care report. Why? Because everyone was a function of providing that particular service and we get a lot of pushback and they say ‘well now I’m legally responsible for everything that happened,’ and that’s not what the law says. The law says, for what you did, you are responsible for what you did and what you didn’t do when you had a legal duty to do something or withhold doing something because it was contraindicated. All that indicates is that yes, I reviewed it and to the best of my knowledge it’s true and accurate.” — Ryan Stark
“The law will impose liability where it lands. Just because you’ve signed that particular patient care report, doesn’t mean you’re responsible for all the interventions and everything that I outlined in there, it would be whoever performed or withheld those interventions that would be responsible within the scope of practice.” — Ryan Stark
Episode contents
1:09 – Introductions
1:30 – PWW history
3:30 – Introducing the PCR Data QuickGuide
4:20 – The circle of life of a PCR 
11:00 – NEMSIS data/research license and EMS by the numbers
13:20 – Who owns PCR data
15:50 – Signatures! And legal responsibility
17:40 – Accuracy of documentation to defend your actions
18:30 – Why does the driver have to sign?
20:00 – Amending PCRs: When and why
22:33 – Who do you tell if a record is amended?
24:30 – Can your state request you to amend your PCR?
27:30 – How long should we keep documents?
30:50 – When an agency closes down or merges
33:30 – Body-worn camera content
35:30 – Transferring paper records to digital
37:15 – Bi-directional data and HIE – responsibilities
40:00 – Final thoughts
Additional resources
The PCR Data QuickGuide is available now, and we encourage all EMS professionals to download their copies and gain a deeper understanding of PCR data best practices. To download the guide, please follow the link:
About NEMSIS
About Page, Wolfberg & Wirth
About our guests
Ryan Stark
Ryan Stark is a managing partner with Page, Wolfberg & Wirth, and is the firm’s resident “HIPAA guru.”  He counsels clients on labor relations, privacy, security, reimbursement and other compliance matters affecting the ambulance industry. 
Ryan started in the healthcare field as a freshman in college, where he worked for a local hospital and a retail pharmacy.  After college, he decided to become a lawyer, hoping to guide healthcare providers through the demanding legal issues they face.  He has been with PW&W since 2007, fulfilling that ambition.  
Ryan is passionate about educating EMS professionals and loves collaborating with providers and CEOs alike. He is a featured speaker in PW&W seminars and webinars, including the firm’s signature abc360 Conference, where he hosts the abc360 Game Show. Always enthusiastic, Ryan has been invited to speak at many state and regional EMS conferences, as well as national industry events. He is also an adjunct professor at Creighton University in the school’s Master of Science in Emergency Medical Services Program. 
Ryan developed, and is the primary instructor for, the nation’s first and only HIPAA certification for the ambulance industry – the Certified Ambulance Privacy Officer.  He also co-authored PWW’s widely used Ambulance Service Guide to HIPAA Compliance.  
Ryan volunteers with local community nonprofit organizations. He was also a big brother with the Big Brothers Big Sisters program for over a decade and keeps in touch with his “little.” Ryan also enjoys hiking, running, kayaking and traveling, and spending time with son Oliver.   
Steve Johnson
Steve began his career in the EMS industry in 1985, gaining valuable experience while serving as an EMT and later as director of a municipal ambulance service in Minnesota. As an ambulance service manager, Steve established his expertise in areas of operations, billing and administration.  
Steve also has significant EMS educational experience. He established and served as training coordinator and lead instructor for a State Certified EMS Training Institution for EMTs and First Responders.  
Steve served on both the Rules Work Group and the EMS Advisory Council to the Minnesota State Department of Health.
He joined the staff of a large, national billing and software company, where he was a frequent lecturer at national events and software user group programs. For over 7 years, Steve served as director of a national ambulance billing service and was responsible for all aspects of managing this company, including reimbursement, compliance and other activities for ambulance services throughout the nation.
Steve served as founding executive director of the National Academy of Ambulance Coding (NAAC), overseeing all activities of the Academy, including the Certified Ambulance Coder program, the nation’s only coding certification program specifically for ambulance billers and coders.  
As the director of reimbursement consulting with Page, Wolfberg & Wirth, Steve is involved in all facets of the firm’s consulting practice. Steve works extensively on billing and reimbursement-related activities, performing billing audits and reviews, improving billing and collections processes, providing billing and coding training, conducting documentation training programs, and performing many other services for the firm’s clients across the United States.  
Steve is also a licensed private pilot, and enjoys an active role in his church.
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The power of video in EMS education

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
This edition of the EMS One-Stop podcast spotlights the popular online education series Reel Emergency, which uses real bodycam footage to illustrate various types of medical emergencies. The footage is then discussed in a live broadcast by very well-known emergency medicine physicians, Drs. Peter Antevy, Mark Piehl and David Spiro.
Reel Emergency offers free continuing education credit on the day of the Prodigy EMS based broadcast (you must be in the live audience to receive CE) and is then made available via YouTube for all to view and use as part of their clinical education. 
Reel Emergency has now produced 15 episodes and has been viewed tens of thousands of times as both individuals and departments benefit from the content, the expert analysis and commentary, as well as subject matter expert guests.
In this podcast, Rob Lawrence chats with Reel Emergency’s regular host Hilary Gates, director of educational strategy for Prodigy EMS; and Zach Dunlap, clinical education specialist from 410 Medical.
Zach also previously worked for an agency that pioneered the use of body-worn cameras in EMS and offers insight into their adoption and use. 
TOP QUOTES FROM THIS EPISODE
“These real patient videos actually show what’s happening on a call. Where else do you get that? You can’t get that anywhere else and there’s something to be said for doing scenarios and having standardized patients or mannikins, but nothing beats watching the actual call itself because you also have all of the other elements of the call that are really hard to recreate in the classroom. You have all of the emotions all of the bystanders, all of the equipment, the communication aspects you have to worry about, and you have real human reactions” — Hilary Gates
“If you are an educator, and you are teaching a certain topic – anatomy, physiology, scene management, all operations, whatever it is – and there is a way to illustrate that, you should be required to illustrate it with a video – there’s just no better way to do it.” — Hilary Gates
“It should almost be a requirement at this point, the main reason people don’t want body cameras in EMS is because it’s grossly misunderstood.” — Zach Dunlap
EPISODE CONTENTS
1:00 – Introductions
01:35 – REEL Emergency
02:20 – Everyone knows Drs. Spiro, Antevy and Piehl
4:00 – Using video for education
6:10 – Gaining free CE and watching on-demand
07:20 – Using body-worn cameras on the street
08:23 – Using BWCs for performance improvement
11:25 – Suggesting that BWC eventually become the standard of care
12:50 – Where does Reel emergency get its videos from?
14:00 – Filming the Falmouth Road Race and heat emergencies
15:20 – How to view Reel Emergency?
ADDITIONAL RESOURCES ON THIS TOPIC
Current Reel Emergency topics include sessions on HP CPR, heat emergencies, peds emergencies, junctional hemorrhage, ped airways, anaphylaxis, intracranial emergencies, delirium, end of life care, GSWs and altered mental status.
Following are additional resources on incorporating body-worn cameras:
Promoting transparency and accountability with BWCs
Three outdated paradigms holding EMS back
Leadership’s role in keeping our workforce safe
How to buy body-worn cameras (eBook)
 
ABOUT OUR GUESTS
Zach Dunlap began his EMS career as a paramedic in Amarillo, Texas. After working in Oklahoma City, he returned to the Texas panhandle, where he worked as a flight paramedic for several years. Zach now resides in Houston, and has served as a flight paramedic and clinical director for a progressive 911 system. Currently, he is a clinical education specialist for a national medical company educating and training clinicians across the country on volume resuscitation. Zach obtained his bachelor’s in emergency health sciences and has always focused on providing excellent patient care through innovative approaches. Zach enjoys sports and spending time with his two children, Brogan and Brynlee, and their Goldendoodle, Claire. Zach is also the assistant treasurer of the Board of Commissioners of Harris County ESD11 in northern Houston.
Hilary Gates, MAEd, NRP, is the director of educational strategy for Prodigy EMS and a volunteer paramedic in the Alexandria (Virginia) Fire Department. She is also a faculty member of the School of Education at American University in Washington, D.C., and teaches Introduction to Community Health in the EM Program at University of Pittsburgh. Beginning her career as a volunteer EMT with the Bethesda-Chevy Chase Rescue Squad in Montgomery County, Maryland, Hilary became a full-time paramedic, EMT instructor and FTO at AFD, and then served as senior editorial and program director for EMS World. She implemented AFD’s MIH/CP program in 2017 and has extensive experience as an EMS educator, symposium presenter and quality improvement trainer.
ABOUT THE REEL EMERGENCY PANEL
Dr. David Spiro is a pediatric emergency physician and professor at University of Arkansas Medical System, and he is chief medical officer of Reel Dx. Dr. Peter Antevy is a nationally recognized lecturer and expert in the field of prehospital pediatrics and cofounder of Handtevy Pediatric Emergency Standards. He currently serves as the EMS medical director for multiple fire and rescue departments in Florida. Dr. Mark Piehl is a board-certified pediatrician and pediatric intensivist at WakeMed Hospital in Raleigh, North Carolina, and co-founder of 410 Medical.
CONNECT WITH OUR GUESTS
Hilary Gates:
Linkedin
Twitter
Zach Dunlap:
Linkedin
Twitter
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Not just for physicians: Quality improvement and safety

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
In this edition of the EMS One-Stop podcast, Host Rob Lawrence speaks with Dr. Maia Dorsett and Paramedic Nikki Little to discuss the NAEMSP Quality Improvement and Safety Course, an exciting year-long course that provides EMS physicians and quality improvement leaders with the knowledge and skills necessary to lead QI and patient safety initiatives in their region, system or agency. Participants will develop an in-depth understanding of how to apply QI tools and strategies to their local needs to affect the care of patients.
Dr. Dorsett and Little identify that the program will take participants on a journey to improve the quality of care and safety in their system through a multi-modal approach in sessions led by expert faculty, who will discuss key aspects of quality improvement.
TOP QUOTES FROM THIS EPISODE
“I think one of the things I love about this course is half the faculty are not physicians. There is a fair percentage of NAEMSP membership that are not physicians and the quality course especially is very deliberate. It has faculty from different backgrounds.” — Dr. Dorsett
“Your system is complex; all of the policies and procedures and processes that you have set up for the folks to work in them, they don’t always work as designed.” — Nikki Little
“Once a month, and even more often than that, because you meet with your mentees, you get to really collaborate idea-wise and work together with a group of people who are all there committed to making improvements in their system.” — Dr. Dorsett
“So many quality leaders are still stuck in this in this moment, where they’re looking at 50% in May and 52% in June, and we’re just comparing these two numbers and making massive strategic decisions about things that might be seasonal or have abnormal variation and we could be really making some really dumb mistakes if we’re not looking at our data over time.” — Nikki Little
EPISODE CONTENTS
02:00 – Introduction – Nikki Little
2:25 – Introduction – Dr. Maia Dorsett
02:40 – Description of the course
03:30 – Quality Course origin story
05:30 – Little’s experience as an inaugural participant
0745 – Month-by-month syllabus
10:00 – PDSAs and brevity in QI
13:00 – Capstone and results presentation
15:20 – Little’s course highlights
17:29 – Dorsett’s course highlights
21:25 – This course is not just for physicians
23:10 – Course overall timeline
24:30 – Cohort presentations at the annual meeting and poster presentations
26:20 – Class sign-up details
ADDITIONAL RESOURCES ON THIS TOPIC 
NAEMSP Year-Long Quality Improvement and Safety Course
ABOUT OUR GUESTS
Maia Dorsett, MD, PhD, is an emergency medicine and EMS physician and educator. She completed her EMS fellowship at Washington University before moving to Rochester, New York, where she now serves as the medical director for EMS education at Monroe Community College and is the associate regional medical director for education and quality for the Monroe-Livingston Region. She is also the medical director for Gates Volunteer Ambulance as well as Prodigy EMS. Nationally, she serves on the board of the National Association of EMS Physicians and the National Registry of EMTs. She is involved in quality improvement implementation and education, serving as the co-course director for the NAEMSP Quality and Safety course.
Nikki Little, FAEMS, has fulfilled many roles as a paramedic, including advanced care paramedic, district chief of paramedic operations, 911 communication supervisor, and quality and patient safety officer in almost 30 years in EMS. She has a passion for patient-centered quality improvement of systems and has advocated for policy advances in the areas of patient safety, team communication and opioid overdose. She has dedicated countless hours to improve the quality and safety of patients with non-transport dispositions, (especially elderly and at-risk persons) and to improve the care for patients experiencing acute coronary syndromes (with particular focus on gender disparities in care). She has also contributed through committee work by way of the Paramedic Chiefs of Canada and the Manitoba Chapter of the Canadian Women’s Heart Health Alliance. In the area of quality improvement and paramedic education, she is in her sixth year as faculty of the National Association of EMS Physicians (NAEMSP) Quality and Safety Year-Long capstone course and preconference workshop. Her dedication to furthering the educational mission of the organization, and skill in teaching patient safety and improvement science to paramedic professionals and EMS physicians was duly recognized when she was named co-director.
CONNECT WITH OUR GUESTS
Maia Dorsett
Nikki Little

Preparing for the coronation

999, London Ambulance Service Deputy Director Simon Harding talks emergency planning for the royal gathering
This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
Recorded with less than 24 hours to go before the coronation of King Charles III, of England, host Rob Lawrence sits down with Simon Harding, deputy director of the London Ambulance Service to discuss planning for the coronation. Harding also serves as deputy director of the London's 999 control centers.
Harding begins by highlighting the construct of ambulance services in the United Kingdom, as well as the scope and operation of the London Ambulance Service, which serves 9 million citizens of the national capitol, plus visitors. LAS takes over 2 million 999 (the UK equivalent of 911) calls a year in addition to 2 million 111 calls (for non-emergency responses).
Harding and Rob discuss how incident management operates in the UK, using the GOLD, SILVER and BRONZE levels of command, and the roles and responsibilities at each level.
They talk about the plans for the coronation and how LAS – in partnership with public safety and military planners – are preparing to support the historic event.
Resources mentioned in this episode
London Ambulance Service
John’s Ambulance Service
Additional resources for mass gathering planning
Boston EMS' Joe O'Hare: All hazards incident management
EMS coverage for mass gatherings and public events
How EMS can prepare for a mass gathering to become an MCI
7 ways to be prepared before the mass gathering turns into an MCI

It’s not just PTSD: Stress disorders in EMS

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
Ginny Renkiewicz, PhD, is an assistant professor of healthcare administration in the College of Health Sciences and Human Services at Methodist University, Fayetteville North Carolina. Dr. Renkiewicz has been involved in EMS for 21 years as a credentialed paramedic, administrator and leader. Her specific research interests include defining predictors and profiling traumatic stress syndromes in EMS personnel and she recently had two papers published in the U.K. and U.S. on subjects related to her research interests.
In this edition of EMS One-Stop, Rob Lawrence and Dr. Renkiewicz discuss her publications, “Secondary trauma response in emergency services systems (STRESS) project: quantifying and predicting vicarious trauma in emergency medical services personnel,” which discusses the emotional countertransference that occurs between the clinician and patient, and “Maladaptive Cognitions in EMS Professionals as a Function of the COVID-19 Pandemic,” which analyses how the coronavirus disease pandemic has profoundly affected EMS professionals.
TOP QUOTES FROM THIS EPISODE
“I don’t think we will ever go back to normal; this is kind of like 911. There was before 9/11, and there was after 9/11, and this is going to be before COVID, and after COVID.”
“Vicarious trauma is emotional counter, transference; essentially, you are feeling what the patient feels when they’re experiencing a traumatic event. Example being, if you had a call, for example, a stillbirth, you may for the following weeks or months have this weird aversion to children or things in which infants are involved and you may have a stress response to those situations in the same way that the patient would have.”
“Post traumatic stress injury is not the only stress disorder that exists out there. It is the one that I think most frequently cited by educators and administrators, because we don’t know all of the other more insidious stress disorders, of which vicarious trauma is one.”
“A predictor of having vicarious trauma as an EMS professional; my hypothesis is that if your parents or whomever your caregivers are do not teach you how to appropriately and emotionally cope with anything in any situation, it becomes very difficult for you to know how to do it properly in your adult life and so you overcompensate, and so vicarious trauma occurs in that population.”
EPISODE CONTENTS
1:12 – Introduction: Dr. Ginny Renkiewicz
1:55 – Ginny’s academic career
3:00 – The development of research on EMS
4:50 – Paper discussion – secondary trauma response
09:00 – Education on stress disorders
11:24 – Therapy dog program
12:30 – Next steps/further work on resilience training
1530 – Maladaptive cognitions
17:20 – Getting published in the SOM Journal
19:00 – Learning, conclusions and takeaways
23:00 – The new normal
24:18 – Call to action for leaders
26:13 – NHTSA Listening Group on wellness, resilience and peer support programs
27:30 – Getting involved in research
31:00 – NAEMT Lighthouse leadership program
ADDITIONAL RESOURCES ON THIS TOPIC
Secondary trauma response in emergency services systems (STRESS) project: quantifying and predicting vicarious trauma in emergency medical services personnel
“Maladaptive Cognitions in EMS Professionals as a Function of the COVID-19 Pandemic”
ABOUT OUR GUEST
Dr. Ginny Renkiewicz is an assistant professor of healthcare administration in the College of Health Sciences and Human Services Methodist University, Fayetteville, North Carolina. She has been involved in EMS for 21 years as a credentialed paramedic and Level II paramedic instructor. She has spent 17 years as a program director, division chair or department head and has been recognized for her contribution to the EMS profession as a Fellow of the Academy of Emergency Medical Services (FAEMS) through the National Association of EMS Physicians. She has won several national and international awards, including National EMS Educator of the Year and the global EMS10 Award for innovation in the field of EMS.
She holds an Associate of Applied Science in Sign Language Interpreting degree from Wilson Community College, a Bachelor of Science in Emergency Medical Care with a concentration in EMS management and a Master of Health Science in EMS education (both from Western Carolina University), and a Ph.D. in Health Science with a concentration in Respiratory Care from Rush University. Dr. Renkiewicz is a reviewer for several peer-reviewed journals; serves as executive director of the Foundation for Prehospital Medicine Research; and is enthusiastic about research, innovation and student mentoring. She is also the vice chair of the North Carolina Association of EMS Educators. Her specific research interests include defining predictors and profiling traumatic stress syndromes in EMS personnel.
CONNECT WITH OUR GUEST
Email: drginnyrenkiewicz@outlook.com
Twitter: @DrKrankyPants
LinkedIn: www.linkedin.com/in/ginnyrenkiewicz
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Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback.

Doug Wolfberg: What the end of the Public Health Emergency means for EMS

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
COVID-19 was declared a Public Health Emergency (PHE) on Jan. 31, 2020, and was extended a number of times, but it is now set to expire on May 11, 2023. In this episode of EMS One-Stop, Rob Lawrence is joined by Doug Wolfberg, Esq., of Page, Wolfberg & Wirth to discuss the immediate actions organizations should take (or should have already taken) to preserve documentation relating to the PHE, as well as adjust operational and documentation practices and procedures as we “return to normal.”
Rob and Doug discuss issues such as rule changes that have become normal operating procedures over the last 2 years and the need to build a time capsule to preserve evidence. They also cover patient signatures, telehealth changes, transport to alternate destinations, agency licensing and Physician Certification Statements.
Doug, a lifelong Beatles music fan, also shares that he has just published a book: “The Beatles: Fab but True: Remarkable Stories Revealed” and will be undertaking a book signing tour in the UK later in the year.
TOP QUOTES FROM THIS EPISODE
At the end of the PHE, “We revert back to the standard inflexible Medicare signature rules which means that the patient needs to be the signer, and the only time that you can get a signature from anyone else is if that patient is physically or mentally incapable of signing that statement.”
EPISODE CONTENTS
1:12 – End of the PHE announced
2:00 – Rule changes have become normal operating procedures
2:20 – The need to build a time capsule to preserve evidence
4:30 – Big change ticket item number one – patient signatures
6:40 – A reminder to establish the reason the patient is unable to sign a PCR
7:20 – Telehealth changes                                                
10:00 – Transport to alternative destination coverage ends (but place your pandemic local clinical guidance in your time capsule now!)
13:07 – ET3 – not affected and is separate
15:24 – Doug and the Beatles
17:52 – Ambulance staffing waver also going away
18:55 – Agency licensing back into full force – no more grace periods
21:12 – Physician Certification Statements (PCS) – do not cut corners on your PCS signatures
22:15 – Leaders pay attention to this podcast
ADDITIONAL RESOURCES ON THIS TOPIC
CMS Waivers, Flexibilities, and the Transition Forward from the COVID-19 Public Health Emergency
Doug’s new book: “The Beatles: Fab but True: Remarkable Stories Revealed”
ABOUT OUR GUEST
Doug Wolfberg is a founding partner of Page, Wolfberg & Wirth, and one of the best-known EMS attorneys and consultants in the United States. Widely regarded as the nation’s leading EMS law firm, PWW represents private, public and non-profit EMS organizations, as well as billing companies, software manufacturers and others that serve the nation’s ambulance industry. Doug answered his first ambulance call in 1978 and has been involved in EMS ever since. Doug became an EMT at age 16, and worked as an EMS provider in numerous volunteer and paid systems over the decades. Doug also served as an EMS educator and instructor for many years.
After earning his undergraduate degree in Health Planning and Administration from Pennsylvania State University in 1987, Doug went to work as a county EMS director. He then became the director of a three-county regional EMS agency based in Williamsport, Pennsylvania. He then moved on to work for several years on the staff of the state EMS council. In 1993, Doug went to the nation’s capital to work at the United States Department of Health and Human Services, where he worked on federal EMS and trauma care issues. Doug left HHS to attend law school, and in 1996 graduated magna cum laude from Widener University School of Law. After practicing for several years as a litigator and healthcare attorney in a large Philadelphia-based law firm, Doug co-founded PWW in 2000 along with Steve Wirth and the late James O. Page. As an attorney, Doug is a member of the Pennsylvania and New York Bar Associations, and is admitted to practice before the United States Supreme Court as well as numerous Federal and state courts. He also teaches EMS law at the University of Pittsburgh, and teaches health law at the Widener University School of Law, where he is also a member of the school’s Board of Overseers.
Doug is a known as an engaging and humorous public speaker at EMS conferences throughout the United States. He is also a prolific author, having written books, articles and columns in many of the industry’s leading publications, and has been interviewed by national media outlets including National Public Radio and the Wall Street Journal on EMS issues. Doug is a Certified Ambulance Coder (CAC) and a founder of the National Academy of Ambulance Coding (NAAC). Doug also served as a commissioner of the Commission on Accreditation of Ambulance Services (CAAS).
In his free time, Doug is an avid bicyclist and musician.
CONNECT WITH OUR GUEST
Website: www.pwwemslaw.com
Email: www.pwwemslaw.com/contact#
Linkedin: www.linkedin.com/in/douglas-wolfberg-099ab236
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Preserving history with the NEMSM

EMS One-Stop Show Notes - National EMS Museum
This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
In this episode of EMS One-Stop, Host Rob Lawrence discusses the National EMS Museum (NEMSM) with President Dave Zaiman; Museum Director, Kristy Van Hoven; and Jon Krohmer, MD, immediate past-secretary and "We are EMS" coordinator. The National EMS Museum is a volunteer-led organization that collects, preserves and shares the history of emergency medical response in the United States in hopes of inspiring future professionals to take up the call.
The National EMS Museum organization operates a virtual museum and produces traveling exhibitions that tour the country every year. The Collections at the National EMS Museum house over 300 years of history that cover the development of prehospital care in the United States, North America and around the world.
TOP QUOTES FROM THIS EPISODE
“We are here to educate the future. We are here not only to document the legacy, but here to provide a foundation and an education that EMS as a profession, as we move forward is respected, is understood, and maybe in a small part this museum can play a part in improving EMS altogether.”
EPISODE CONTENTS
03:05 – Origins of the NEMSM
05:04 – The style and model of the NEMSM
07:00 – Changes underway – recruiting individuals with experience in museum activities
11:50 – President Dave Zaiman
13:20 – Getting EMS into the community
15:00 – Favorite artifacts
16:30 – From MAST pants to blood transfusion
17:20 – Fundraising effort in order to take the museum on the road
20:30 – Developing a traveling mobile “We are EMS” museum project
23:40 – How to book a traveling exhibit
ADDITIONAL RESOURCES ON THIS TOPIC
The National EMS Museum
California Ambulance Association Siren special edition: Fifty Years of Wedworth-Townsend
ABOUT OUR GUESTS
Dave Zaiman
Dave is currently Sales VP - Midwest at Pulsara.  For over 30 years, Dave has been working in healthcare – both as an EMS professional as well as holding several leadership roles in the healthcare technology industry. Based in Minnesota, Dave spent his first 15 years working in the field as an EMT and paramedic in the Twin Cities metro area for both Allina and Hennepin County Medical Center.
Kristy Van Hoven
Kristy is the museum director for the National EMS Museum and PhD candidate at the University of Leicester. Over the last 3 years, Kristy has worked with the National EMS Museum’s Board of Trustees to develop and implement engaging e-volunteer opportunities and community programs that reach their digital audience. In addition to her work with the EMS Museum, Kristy volunteers at several local museums in Toronto, Ontario.
Jon Krohmer, MD
Dr. Krohmer served as the director of the NHTSA Office of EMS before his retirement in November 2021.  During his tenure as director, Dr. Krohmer oversaw several milestones for the profession, including the creation of EMS Agenda 2050; major revisions to the National EMS Scope of Practice Model and the National EMS Education Standards; and improvements in the collection and use of EMS data through the expansion of the National EMS Information System. Soon after the onset of the COVID-19 pandemic, Dr. Krohmer was tapped to lead the prehospital/911 team as part of the Federal Healthcare Resilience Task Force.
Prior to joining NHTSA, Dr. Krohmer had decades of experience as a local EMS medical director, initially in his home state of Michigan. His EMS career began as an EMT with a volunteer rescue squad. Like many EMS professionals, he was inspired by the television show “Emergency!” and by the emergence of the relatively new field of emergency medicine. He entered medical school at the University of Michigan knowing he wanted to make EMS his career. After becoming involved in EMS at the state and national level, he also served as president of the National Association of EMS Physicians from 1998 to 2000. In 2006, he came to Washington to serve as the first deputy chief medical officer for the Department of Homeland Security Office of Health Affairs and served in several other DHS roles before joining NHTSA in 2016.
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Emerging pathogens, diseases, outbreaks and fevers

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
This week, Host Rob Lawrence welcomes back, Alexander Isakov, MD, MPH, professor of emergency medicine at Emory University School of Medicine, executive director of the Emory Office of Critical Event Preparedness and Response (CEPAR), and EMS lead for the National Emerging Special Pathogens Training and Education Center (NETEC).
Returning guest, Dr. Isakov provides an update on the current emerging pathogens, diseases, outbreaks and fevers that have featured recently in the news. Candida auris, Marburg virus disease, avian influenza, Nipah virus are discussed as well as recaps on Ebola, COVID-19, polio and seasonal influenza.
TOP QUOTES FROM THIS EPISODE
“What’s concerning CDC officials and experts is there is a multi-drug resistant strain of Candida auris that is really picking up in their surveillance programs.”
“While no one wants to be exposed to a multi-drug-resistant Candida auris, it’s really the ominous compromised patient that’s going to be likely most affected by it, so that means elderly patients or patients that are getting chemotherapy and have some immunosuppression consequence of that or people that are taking immunosuppressant drugs, they are the ones really at greatest risk.”
“The likelihood that EMS personnel are going to encounter somebody with Marburg virus disease in the U.S. during routine operations is extremely low, but good to be vigilant about it and identifying that someone might have been exposed, and understanding their travel history, if someone is ill, has a fever or myalgia, GI complaints and has travelled within the last 21 days to equatorial Guinea or Tanzania, then it would raise suspicion.”
ADDITIONAL RESOURCES ON THIS TOPIC
CDC: Infection prevention and control for Candida auris
CDC: Information for infection preventionists
NETEC: Situation report: Marburg cases rise in equatorial Guinea and Tanzania
NETEC: EMS guidelines for Marburg virus disease
ABOUT OUR GUEST
Alexander Isakov, MD, MPH, is a professor of emergency medicine at Emory University School of Medicine. He is certified by the American Board of Emergency Medicine in both emergency medicine and emergency medical services (EMS).
Dr. Isakov is the director of the Section of Prehospital and Disaster Medicine whose faculty provides medical oversight for 911 communications centers, and ground and air EMS responders in metropolitan Atlanta. He is also the executive director of the Emory Office of Critical Event Preparedness and Response (CEPAR), which serves as the center for Emory enterprise-wide planning for and coordinated response to catastrophic events.
Dr. Isakov has provided leadership in emergency medical services and disaster preparedness locally and nationally. He serves as the medical director for the Sandy Springs Fire Department and Air Life Georgia. He is the founding medical director for the Emory-Grady EMS Biosafety Transport Program. He is the EMS lead for the National Emerging Special Pathogens Training and Education Center (NETEC) and is a designated Subject Matter Expert for the Assistant Secretary for Preparedness and Response, Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE). Dr. Isakov is also on the American College of Emergency Physicians Epidemic Expert Panel and is a member of the EMS sub-board for the American Board of Emergency Medicine. He previously served on the National Association of EMS Physicians board of directors and the Technical Expert Panel for NHTSA’s EMS Agenda 2050.
Dr. Isakov has an MD from the University of Pittsburgh and an MPH from Boston University. He completed his emergency medicine residency training at the University of Massachusetts Medical Center and his EMS fellowship with Boston EMS. Dr. Isakov has lived and worked in Atlanta for 20 years. He practices clinically in the emergency department of Emory University Hospital.
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Helping providers be seen, heard and cared for

This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
Russ Myers, Nikki Holm and Gwen Powell are chaplains at Allina Health Emergency Medical Services and in this episode, they join Rob Lawrence to discuss the role of chaplaincy in EMS. The guests discuss their role and responsibilities as well as the book, “Because We Care: A Handbook for Chaplaincy in Emergency Medical Services,” written by Russ Myers.
Over the past half century, the field of chaplaincy has come to a fork in the road. Many will recognize the well-traveled path of traditional chaplaincy. Others will follow the newer but clearly marked way to professional chaplaincy: a clinically trained, evidence-based discipline, reflecting and serving the diverse expressions of spirituality in modern society. Until now, chaplaincy in EMS has been the terra incognita, the unknown land on the map. Drawing on three decades of clinical chaplaincy practice, scholarship and original research, Russell Myers charts the map, making the case for ambulance service chaplaincy: how to think about it and how to do it.
TOP QUOTES FROM THIS EPISODE
“For me it’s all about love, how can I bring some light, some life, some love into the world, and I am able to do that in these situations by just showing up as we call in chaplaincy – the ministry of presence.” —Gwen Powell
“I do this work is to come alongside people and remind them of their humanity to help them break down their defenses and their shields to get back to the truth of who they are, to help them be seen and heard and taken care of.” —Nikki Holm
EPISODE CONTENTS
1:23 – Introduction Russ Myers
2:43 – Introduction Nikki Holm
4:00 – Introduction Gwen
7:35 – Book discussion: Because We Care – The Role of the Chaplaincy in Emergency Services
11:20 – Terra Incognita
12:30 – What motivates a chaplain?
15:30 – A chaplaincy intervention story
20:15 – A chaplain’s workload
23:00 – Being Proactive: Establishing a trusting relationship with the workforce
23:30 – Being Reactive: when an incident or issue occurs
30:15 – Education and being a presence during training
34:58 – If you are thinking about introducing g a chaplain
36:30 – Moral Injury and the social contract
40:40 – Overcoming the staff stigma about coming forward
42:00 – Close
ADDITIONAL RESOURCES ON THIS TOPIC
“Because We Care: A Handbook for Chaplaincy in Emergency Medical Services”
When EMS meets hospice. End-of-life care takes a heavy emotional toll: Seek support when needed
ABOUT OUR GUESTS
Russell Myers serves as a chaplain for Allina Health Emergency Medical Services, based in Minneapolis. He holds a BA from Ohio State University and a Doctor of Ministry degree from Luther Seminary, St. Paul, Minnesota. Russ is ordained by the Evangelical Lutheran Church in America and is board certified with the Association of Professional Chaplains. He lives in Saint Paul, Minnesota.
Gwen Powell is an ordained episcopal priest and board-certified professional chaplain who has been working with Allina EMS since 2020. Prior to working for Allina, she provided spiritual care to patients and staff on the adolescent behavioral health units at the M Health Fairview University of Minnesota Medical Center. Gwen graduated from Valparaiso University with a degree in psychology in 2008 and earned her Master of Science in Psychology from Kansas State University in 2010. She earned her Master of Divinity from Luther Seminary in St. Paul, MN in 2014 and has been passionate about mental health chaplaincy since beginning her ministry work in 2015. In her free time, she likes to beat her husband and kids at Mario Kart, exercise, walk/hike with her family, watch baseball, and sing with the Northern Lights Chorale.
Nikki Holm has been engaged in the meaningful work of EMS Chaplaincy through Allina Health since the Spring of 2020. Prior to making the transition to EMS, Nikki provided spiritual care and health education in an outpatient mental health setting for several years. Nikki was board certified with the Board of Chaplaincy Certification Inc. in 2017, graduated with a Master’s degree in Spirituality from St. John’s School of Theology in 2007 and with a Bachelor’s degree in Theology from The College of St. Benedict in 2005. Nikki lives in an earth home with her husband, their three beloved children, and three furry companions. Outside of soaking up life with her littles, Nikki enjoys rock climbing, writing, reading, yoga, gardening, and otherwise spending time with her tribe. Contact Nikki at Nicole.Holm@allina.com.
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