EMS One-Stop

Unleashing leadership audacity

In this edition of the EMS One-Stop podcast, host Rob lawrence welcomes Todd Stout and Mike Taigman of FirstWatch as they introduce the 2024 Jack Stout Fellow, Mary Meeks, district chief of night shift at Chatham Emergency Services.
The Jack Stout EMS Fellowship, endowed by FirstWatch, aims to empower emerging EMS leaders by equipping them with the knowledge and skills necessary to guide EMS systems effectively in the future. Developed by FirstWatch in cooperation with the Fitch EMS Foundation, the Fellowship underscores the commitment to leadership development and community service. Named in honor of Jack Stout, a pioneer in high-performance EMS systems, the Fellowship teaches principles such as people-centered leadership, data-driven decision-making, improvement science and systems thinking.
As the chosen Fellow, Meeks will attend the 2024 Pinnacle EMS Leadership Forum, participate in either the Fitch Ambulance Service Manager or Communication Center Manager program, and benefit from a customized mentorship led by Mike Taigman, renowned for his contributions to EMS quality improvement. This comprehensive program not only honors Jack Stout’s legacy but also ensures that his visionary principles continue to shape the future of EMS.
Additional resources
IHI Framework for Improving Joy in Work | Institute for Healthcare Improvement
The Jack Stout EMS Fellowship, endowed by FirstWatch
Pinnacle EMS leadership conference

Boosting behavioral health services with innovative partnerships

In this episode of the EMS One-Stop podcast, host Rob Lawrence sits down with Fayetteville, North Carolina’s Cumberland County EMS Chief David Grovdahl and Behavioral Health Community Paramedic Tara Tucker to discuss the Cape Fear Valley Mobile Integrated Health Behavioral Health Community Paramedicine programs.
The Cape Fear MIH Team is composed of four community paramedics, one social worker and a peer support specialist. The team focusses in particular on overdoses/request for substance use treatment, suicide related calls – ideation/attempts as well as youth calls related to mental health and substance use, and also EMS referrals and associated case management.
Fayetteville is home to Fort Liberty and Pope Army Air Base, and is the sixth most populous city in North Carolina with a high number of uninsured and underinsured patients. Fifteen percent of Cumberland County’s population is military-affiliated and it is the third busiest EMS system in North Carolina. Cumberland’s affiliated ED, CFVMC Emergency Department, had 90,595 visits in 2021 for adults, and 30% of those (27,300) were for behavioral-health related issues, creating the need for a Behavioral Health service line employing community paramedics.
In addition to discussing their mobile integrated healthcare system, Grovdahl also shares about the North Carlina whole blood programs and their progress.

Leadership, whole blood and EMS safety insights

In this special, on-site episode of EMS One-Stop, host Rob Lawrence takes us to the 2024 North Carolina EMS Expo in Greensboro, North Carolina, a well-attended conference with over 1,200 attendees.
Rob spent time with several conference faculty.
EMS lawyer Matt Streger joins Rob to discuss just culture, HR issue spotting, leadership communication and employee engagement.
Kevin Collopy joins Rob to discuss the outstanding prehospital training being delivered to medics in Ukraine and also discusses this years “Stand and Deliver” new speaker event (a now annual event held as EMS World Expo).
Rob discusses whole blood and its national rollout with Dr. Randall Schaeffer and David Grovdahl.
To close, Peter Dworsky of the National EMS Safety Conference provides an overview of the current top EMS industry safety themes.
Enjoying the show? Email editor@ems1.com to send in guest suggestions, episode feedback or questions for our host. 

A billion dollars of savings: The legacy of ET3

Editor’s note: 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 the EMS One-Stop podcast, host Rob Lawrence welcomes back Matt Zavadsky to discuss the latest development in the move to fund treatment in place and the recent disclosure from CMS about the potential savings to Medicare identified in the analysis of the limited ET3 program.
Matt discusses the potential legislative moves regarding EMS funding, highlighting bipartisan support and urging listeners to engage with elected officials to support bills benefiting EMS.
The conversation underscores the need for sustained advocacy efforts and highlights the level of interest shown by key policymakers.
Rob and Matt also discuss the recent developments in the City of Fort Worth and the decision to absorb MedStar into the Fort Worth Fire Department, emphasizing the need to ensure equitable treatment for EMS personnel transitioning to new roles.
Top quotes from this episode
“We can officially say that the net savings to Medicare after they pay EMS and after they pay the tertiary provider telemedicine, whatever it is, is still $550 to $570 per enrolled ET3 participant. And when you do the math, that's a billion dollars or more of savings to the Medicare program, which now CBO can use to evaluate the benefit, economically of doing a treat, no transport, treatment-in-place model. So it's big news.” — Matt Zavadsky
“Nobody benefits from a knock-down, drag-out fight. But as you indicated, there are now people in the community and people across the country that are saying why and what does this mean? We don't have all those answers, but again, it's the decision from the folks who are elected to represent the community and if that's what they want to do, that's great. Our role is to try and do as much as we can to maintain a transition into a new provider system that keeps those core tenants – the high performance, high value mobile, integrated healthcare, flexible deployment. All those things that have really made the system a world class EMS system, even though it might say something different on the side of the ambulance and the employees might be wearing a different uniform.” — Matt Zavadsky
“It's going to be a long transition – 12 to 18 months, and it's not just branding and rebranding, it's really infusing the culture of a group of people who are used to doing 7-10 calls in 12 hours and used to having things operate with a certain cadence that's going to be totally different when they start a different type of organization.” — Matt Zavadsky
Episode contents
00:00 – Introduction
02:15 – ET3/TIP: Challenging CMS outcome data
03:15 – Cost savings per intervention
04:00 – CMS data showing net savings to Medicare
04:30 – Congressional Budget Office score based on savings
06:00 – Net savings of a billion dollars or more
07:00 – Applying this new information for the good and benefit of the industry
09:00 – Congress is, is what Congress does
10:40 – Meeting with Congress to push TIP
14:30 – Fort Worth and the PWW Advisory Group
14:50 – Fort Worth economies and level of service
17:30 – Matt Zavadsky to join the PWW Advisory Group
19:15 – The staffing issues as Med star staff transit to the FD fire department
21:00 – Ensuring the staff is protected
25:00 – Call to action-how we communicate all value to elected officials
26:00 – Final Thoughts
About our guest
Matt Zavadsky is the former chief transformation Officer at MedStar Mobile Healthcare, formerly the exclusive emergency and non-emergency public utility model EMS system for Fort Worth and 14 other cities in North Texas.
Coming to MedStar in 2008 as the operations director, Matt made significant changes to the EMS delivery model, and in 2010, successfully eliminated the need for the tax subsidy that MedStar had been operating on since its inception in 1986. He has helped guide the development and implementation of numerous innovative programs with healthcare partners that have transformed MedStar fully as a Mobile Integrated Healthcare (MIH) provider, including high utilizer, CHF readmission reduction, observational admission reduction, hospice revocation avoidance, 911 nurse triage programs and partnerships with home health agencies. He is also the co-author of the book “Mobile Integrated Healthcare – Approach to Implementation,” published by Jones and Bartlett Publishing.
He has 42 years’ experience in EMS and holds a master’s degree in Health Service Administration with a graduate certificate in Healthcare Data Management. Matt is a frequent speaker at national conferences and has consulted on numerous EMS issues, specializing in high-performance EMS operations, finance, mobile integrated healthcare, public/media relations, public policy, transformative economic strategies and EMS research.

The Ways and Means to ensure resilient emergency medical care

In this episode of the EMS One-Stop podcast, Dr. Edward Racht and Matt Zavadsky join Rob Lawrence to discuss their recent attendance at the U.S. House Committee on Ways & Means hearing on “Access to Health Care in America: Ensuring Resilient Emergency Medical Care,” which took place in an off-site hearing in Denton, Texas, on March 18, 2024.
Dr. Racht, chief medical officer of Global Medical Response; and Zavadsky, chief transformation officer for the Metropolitan Area EMS Authority (MedStar Mobile Healthcare) discuss the evidence and the key issues they conveyed to the committee.
Dr. Racht's testimony included:
The significant advancements made in emergency medicine over the past decades, leading to reduced mortality and disability rates for patients.
The importance of updating Medicare reimbursement rates for ambulance services, which have not been revised for over 20 years.
Advocating for wholesale reform of Medicare's coverage of emergency medical services to align with contemporary practices, such as covering treatment in place and transportation to alternative healthcare sites.
Matt Zavadsky's testimony included:
The impact of CMS payment policies on EMS, which incentivize unnecessary transportation of patients to the emergency room.
Innovative programs initiated by EMS agencies to prevent unnecessary 911 calls and navigate patients to appropriate care settings.
Legislative changes required to provide EMS with flexibility in patient navigation, including treatment in place and transport to alternate destinations.
The challenges faced by ambulance services nationwide, especially in rural areas, exacerbated by the COVID-19 pandemic.
Top quotes from this episode
“We are the front of the frontline in medicine.” — Dr. Ed Racht
"Our coordinated and integrated EMS and healthcare system now gives gravely injured patients ... the opportunity for rapid surgical intervention and a chance at full recovery." — Dr. Ed Racht
"Emergency healthcare professionals pride ourselves on our ability to dramatically decrease morbidity and mortality from unexpected and sudden illness and injury." — Dr. Ed Racht
"CMS payment policy is such that we are incentivized to transport every 911 patient to the ER because that is the only time we get paid." — Matt Zavadsky
"Ambulance services are a vital component of our local and national healthcare and emergency response systems." — Matt Zavadsky
"Innovative EMS agencies ... have initiated patient-centric programs designed to prevent 911 calls and navigate patients to the most appropriate care setting." — Matt Zavadsky
"Ambulance services across the nation, especially in rural areas, are facing unprecedented challenges." — Matt Zavadsky
Episode contents
0:05 – Introduction
0:55 – Guest introduction
1:40 – Explaining the Ways and Means Committee
2:30 – We are being noticed!
3:40 – Preparing for a congressional hearing
5:40 – The impact of having a congressional hearing in an EMS location
5:58 – The genuine interest of the committee members
9:00 – Dr. Ed Racht testimony to the Congressional Ways and Means Committee
14:24 – Matt Zavadsky testimony to the Congressional Ways and Means Committee
20:52 – Dr. Racht and Zavadsky’s reactions to the evidence they gave and the feedback
29:00 – Zavadsky’s key points he wished to reinforce during his evidence session
31:45 – Balanced billing, patient protections and removing the patient from the middle of the process
32:50 – Independent Dispute Resolution (IDR) and its challenges.
38:29 – Questions for Secretary Becerra on Capitol Hill
44:00 – Final thoughts
45:00 – A call to action to become one and present a united front “When we unify, we are unstoppable.”
48:00 – You the listener are the great politician

‘Honorable but Broken’: Spotlighting EMS in crisis

Editor’s note: 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.
“Honorable but Broken: EMS in Crisis” is a documentary film exploring the world of EMTs and paramedics, the collapse of the EMS system, and what needs to be done to save it. Narrated by six-time Golden Globe and two-time Primetime Emmy award winning actress, Sarah Jessica Parker, “Honorable but Broken” raises awareness of the systemic collapse of EMS and advocates for change.
In this episode of the EMS One-Stop podcast, host Rob Lawrence chats with producer Bryony Gilbey about the documentary that is now completed and available for streaming. Gilbey hopes the impactful, hard-hitting documentary will serve as a briefing and education tool for our elected officials and members of the general public.
As Gilbey notes, “It’s no good any longer just throwing up your hands and saying that’s just the way EMS is; it’s no good saying it’s someone else’s problem; it’s something we all need to work on, as a civilized society we need to address this issue and we need to do it quickly.”
The 60-minute documentary is now available on demand, streamed by Prodigy EMS and it is hoped that it will be used at local, state and national levels to bring attention to the issues we are facing.
Top quotes from this episode
“I expected to tell a story; I did not think that it would have quite this reaction” — Bryony Gilbey
“We now all have not many degrees of separation to somebody who has had some sort of PTSD, who has had to leave the job because of the pressures of work and dare I say ultimately taken their lives and that is incredibly sad.” — Rob Lawrence
“It all comes down to three words – all in favor – if we don’t get the vote, we don’t get the money, we don’t get the change.” — Rob Lawrence
Episode contents
00:48 – Documentary teaser
01:18 – Introduction/Bryony Gilbey
02:16 – The “Honorable but Broken” back story
05:46 – How did Gilbey view EMS and its issues
08:15 – The finished product and how can we view it
10:24 – A federal screening on Capitol Hill
11:30 – Reaction from elected officials
13:16 – John Mondello/emotional trauma
14:00 – Eileen Mondello – John’s mother
15:25 – Reaction to Eileen Mondello – “It never gets easier’
17:00 – He wasn’t the first, he isn’t the only and sadly he won’t be the last
22:00 – Other featured speakers in the documentary and their powerful messages
22:30 – Recruitment, retention and retirement
24:35 – What is the cost of a human life to a politician?
26:25 – Educating the legislators and the public
28:00 – The cost of readiness
29:05 – Reimbursement doesn’t add up
31:00 – The hospital side of things – Beckers Review on Hospital closures and adding to ambulance and hospital deserts
31:30 – Call to action and the legislative agenda
35:30 – Sarah Jessica Parker
39:00 – How and where to view via Prodigy EMS
39:50 – Final thoughts
About our guest
With a prolific career spanning several decades, Bryony Gilbey is a seasoned director, producer and freelance writer/editor, distinguished for crafting compelling narratives across various media platforms. As the director/producer for the impactful EMS documentary, “Honorable but Broken: EMS in Crisis,” Gilbey has showcased an unparalleled ability to guide projects from inception to completion.
Gilbey previously worked with the Nexstar Media Group, Inc. as a freelance writer/editor. Here, she demonstrated versatility by producing feature pieces on health and lifestyle topics for Tribune Publishing and contributing to BestReviews.com.
Gilbey also served as an associate producer at Mary Murphy & Co. from 2005 to 2012. During this period, she played a pivotal role in the production of the PBS American Masters documentary "Hey Boo," centered around Harper Lee. In the early 2000s, Bryony worked as a Producer/AP at ABC News Productions, where she produced documentaries on medical breakthroughs in neonatal care for Discovery Health.
The foundation of Bryony’s career was laid during her time as an associate producer at “60 Minutes,” CBS News, from 1995 to 2000. Working closely with producers and correspondents, she contributed to the creation of original news stories.
Throughout her extensive and diverse career, Bryony Gilbey has consistently demonstrated a passion for storytelling, a keen journalistic instinct, and an unwavering commitment to delivering content that informs and resonates with audiences worldwide.
Resources
“Honorable but Broken: EMS in Crisis”
NAEMT's Advocacy program
AAA’s Advocacy program
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The road ahead: Resuscitating EMS through trend analysis

Collecting and communicating the big EMS news of 2023
The American Ambulance Association and the Academy of Mobile Healthcare Integration (AIMHI) collect, collate, categorize and share weekly EMS-based news stories widely with many national organizations and associations, including NHTSA, USFA and NAEMT.
The information contained in the news tracker allows officials and EMS leaders to brief and educate journalists and elected officials, as well as the public as to the current plight of EMS. EMS is delivered on a local level and those experiencing issues with their service can believe it is just them suffering funding shortages, staffing challenges, hospital delays or general poor performance. The tracker can be used to demonstrate that the issues are occurring on a wider regional, state, national and, in some cases, international level.
In this episode of the EMS One-Stop podcast, host Rob Lawrence, who also heads up the AAA-AIMHI news collation effort, welcomes fellow news collator, Rodney Dyche of Patient Care EMS; and AIMHI Education Committee Chair, Matt Zavadsky, chief transformation officer at MedStar Mobile Healthcare. Rob, Rodney and Matt examine EMS news and current trends, and discuss how these themes can be used to inform, influence and educate.
Top quotes from this episode
“There's a perverse ‘incentive’ about response time … if you have the target of 8:59, you arrive on time and the patient dies; that's a success. If you arrive in 9:01 and the patient lives; that's a failure. That's absolute garbage” — Rob Lawrence
“There was a quote from Dr. Clawson in a news story that was done in Minneapolis, and I love his quote. He says, ‘there is no evidence that using red lights and sirens have saved more lives than they've taken.’” — Matt Zavadsky
“Every week in this great country, an ambulance is stolen either from hospital or from scene – that's avoidable.” — Rob Lawrence
“Stop being timid. Stop licking your wounds. Get out in your community, talk to your elected officials. Talk to your city managers or county administrators – very factually, not emotionally. There will be time for emotions, but give them the facts and let them know what it's gonna take to resuscitate their EMS delivery system.” — Matt Zavadsky
Episode contents
00:23 – Guest introduction
02:06 – AAA/AIMHI News Tracker and story categories
04:22 – A resource to brief the press and elected officials
04:30 – Operational challenges across many states
05:50 – Massive sign-on bonuses – robbing Peter to pay Paul
06:30 – Staffing and funding issues
08:40 – Communities/local governing bodies facing the fact that they are running out of money, and their EMS isn’t free
09:40 – Transitioning from a volunteer to a paid system
11:00 – Explaining EMS economics to your elected officials
11:50 – Has anyone died? Bring data
13:30 – EMS systems closing
15:30 – “Elected officials get nervous deciding to allocate funding to a service that they haven't had to fund or haven't, haven't had to fund to this certain level in the past.”
18:40 – Response time
19:25 – Increase in low acuity calls
20:30 – Service design
22:50 – Single- versus double-paramedic crewed trucks
25:04 – MEDIC Charlotte – Taking bold steps within categories of response
27:00 – The rate of ambulance crashes across the county at intersections
27:47 – If you are not the ambulance driver … who is?
29:49 – There is no evidence that using red lights and siren have saved more lives than they've taken!
30:30 – Stolen ambulances
32:59 – Supply chain and vehicle availability
34:00 – Rurality and ambulance deserts
35:00 – Violence against providers
37:00 – Responding to patients in crisis/agitated patients
38:00 – How to use the media log in your locality to good effect
40:00 – Final thoughts
About our guests
Matt Zavadsky is the chief transformation officer at MedStar Mobile Healthcare, the exclusive emergency and non-emergency public utility model EMS system for Fort Worth and 14 other cities in North Texas that provides service to 436 square miles and more than 1 million residents and responds to over 170,000 calls a year with a fleet of 65 ambulances. MedStar is a high performance, high value EMS system, providing advanced clinical care with high economic efficiency.
Zavadsky is also immediate past president of the National Association of EMTs, and chairs their EMS Economics Committee. He is an appointed committee member to the Joint Commission’s Home Care Professional and Technical Advisory Committee (PTAC), and the Lewin Group’s Hospital Outpatient Quality Reporting (HOQR) Program Stroke and AMI Expert Work Group developing metrics for use in value-based purchasing measures for emergency departments. He is also the co-author of the book “Mobile Integrated Healthcare – Approach to Implementation.”
Rodney Dyche is director of compliance and responsible for risk management with PatentCare EMS Solutions. PatientCare EMS Solutions is a multistate EMS solution, and additionally provides a hybrid online training program and owns a remount facility. As a teenager, Dyche began his EMS career in rural Missouri. He has had multiple system experiences in addition to rural EMS, including MAST (Kansas City, Missouri), REMSA (Reno, Nevada) and Mercy (Las Vegas). In 2010, he became an internal consultant to Paramedics Plus until its sale in 2018. During that time, he led several high-level projects, to include the timely transition of the purchase of Paramedics Plus. Rodney resides in East Texas and in his spare time is a licensed HAM radio operator, and enjoys fishing, off-roading and reading.
Resources
AAA-AIMHI news collation tracker
Analysis of Ground Ambulance Crash Data from 2012 to 2018

Putting the ‘E’ back 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.
The American Ambulance Association recently held its annual AAA Stars of Life event in Washington, D.C. The American Ambulance Association’s Stars of Life program celebrates the contributions of ambulance professionals who have gone above and beyond the call of duty in service to their communities or the EMS profession.
While in Washington, EMS One-Stop Host Rob Lawrence interviewed AAA President Randy Strozyk, on the aims and objectives of the stars program and the 2023 Legislator of the Year. Rob also spoke with AAA Medical Director Dr. Gerad Troutman, who is AAA’s first medical director. Finally, Rob chats with AAA Immediate Past President, Shawn Baird, on the Federal Balanced Billing legislation and the role that AAA and others are playing in protecting both the patient and EMS agencies.
Top quotes from this episode
“Every provider is out to make a difference, but to actually be recognized for it, which you don’t often get the opportunity to have, makes it that much more of an honor to be selected for something like this” — Paramedic Erica Brockman
“AAA stars and hundreds of thousands of people like you are the beginning of the healing process. When somebody is hurt, somebody is wounded, somebody is scared, it is the EMT that first touches that patient and then begins to transport into the healthcare system when the rest of the healthcare system can then kick in to what it does, but it would not start unless it begins with you.” — Senator Bill Cassidy
“Think about when Covid hit, at 0200 in the morning, we were the ones that came, we were the ones that had to deal with a whole new level of challenges, not only Covid, but we had to deal with the fact that people didn’t want to go to the hospital, so we were providing levels of care, interfacing, making sure that people had connections. I see that as a bright future to how EMS will progress in the next decade” — AAA President Rany Strozyk
“I’m really passionate about patients called 911 looking for solutions to a problem and that solution is not always an ambulance to take them to an emergency department, so we try to impact their care differently, especially lower acuity patients, because we now have all the technology and tools to treat them in place with our paramedics or EMTs on site of even treating them utilizing a navigation program from the 911 system, the PSAP and maybe get them to an urgent care or virtual care doctor, where they can be cared for right in their home. Patients love it and the best thing is it really puts the ‘E’ back in EMS and allows us to save those emergent resources that need those most.” — Dr. Gerad Troutman, AAA medical director
“We will be coming back to Congress with a recommendation that ground ambulance not be rolled into the No Surprises Act. That (if we were included) would be devastating to access for care.” — Shawn Baird, immediate past president, AAA
Episode contents
00:21 – Opening: Erica Brockman
01:02 – Introduction: Rob Lawrence
01:36 – Randy Strozyk, president, American Ambulance Association
05:12 – Key areas of legislation for 2023/24
08:07 – Presentation of Legislator of the Year: Senator Bill Cassidy
11:00 – Dr. Gerad Troutman, AAA medical director
17:00 – Federal Balanced Billing Committee: Shawn Baird
18:35 – Summary and close
Additional resources
 The full bios for all of the AAA Class of 2023 Stars of Life can be found here.
Listen to next: Alexia Jobson, Dr. Peter Antevy, Brian Maloney, Doug Wolfberg and more join the EMS One-Stop podcast to discuss takeaways from the show
About our guests
Randy Strozyk brings to his leadership of the American Ambulance Association more than 34 years of experience in EMS operations and management. He has been part of the American Medical Response leadership team for 16 years, and currently serves as the company’s executive vice president of operations.
Strozyk earned his EMT/paramedic certification and worked on an ambulance while studying microbiology at Washington State University. He later earned an MBA from California State University. He has been heavily involved in the American Ambulance Association for nearly two decades and is the current president of the organization.
Gerad Troutman, MD, MBA, FACEP, FAEMS, is the national medical director for innovative practices at Global Medical Response. He is an assistant professor of Emergency Medicine at Texas Tech University Health Sciences Center in Lubbock, Texas, and serves as a mentor to the Texas Tech Innovations Hub. He is a past president of the Texas College of Emergency Physicians and currently serves on the Governor’s EMS & Trauma Advisory Council of Texas.
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United Hatzalah’s Dov Maisel recounts the volunteer EMS operation in Israel

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.
On October 7, 2023, the Palestinian group Hamas launched a surprise attack on Israel at dawn during the Jewish holiday of Simchat Torah – with armed assailants breaching security barriers and a barrage of rockets fired from Gaza. The attack came 50 years and a day after Egyptian and Syrian forces launched an assault during the Jewish holiday of Yom Kippur in an effort to retrieve territory Israel had taken during a brief conflict in 1967.
As the world has seen, terrorists entered Israel. Militants burst into houses, shooting residents begging for their lives and taking others – including women, children and the elderly – hostage, driving the terrified captives back into Gaza.
Operating as part of the initial and ongoing response to the events unfolding in Israel is United Hatzalah, a network of more than 6,500 EMS volunteers, with a fleet of emergency medical vehicles, who in peacetime, are able to respond to more than 2,000 medical emergencies per day in an average response time of less than 3 minutes (and in major cities, often less than 90 seconds). Since October 7, United Hatzalah has been pushed to its absolute limits and has expended the majority of its disposable medical equipment.
In this special edition of EMS One-Stop, Rob Lawrence speaks with Dov Maisel, United Hatzalah’s Vice President of Operations.
Donate to support United Hatzalah’s EMS response: United Hatzalah – Israel is at War | The Chesed Fund
TOP QUOTES FROM THIS EPISODE
“We are a multi-faith organization, but we are an organization of human beings. What we've underwent here in the past week has nothing to do with human beings. This is barbaric. This is something that I've never witnessed. And I've been through terror waves here in my 30 years of EMS. I've seen buses blown up. I've seen suicide bombers in dozens. Nothing on this scale. This is something that Isis did, we all remember watching the videos of what ISIS did, years ago. This overcomes all of that.” — Dov Maisel
“I would say that the amount of tourniquets that we put out in the first 36 hours was in the thousands ... thousands of tourniquets. We treated over 3,000 victims on the ground. The amount of tourniquets, bandages, chest seals, trachs, chest drains, needle applications, tubes that were put out in this first 36, 48 hours of operation is more than what we use, I would say in half a year.” — Dov Maisel
“Our ground rule is in EMS, you don't enter a danger zone, but the volunteers getting on the radios with me, I was in HQ when it started, before I headed actually down to the field – they’re calling and screaming for help … the IDF soldiers that started the defense process were understaffed and they had no capabilities to rescue the victims out from the scene. And our volunteers simply, I told them, ‘it's up to you. Literally, it's up to you;’ and they all went in.” — Dov Maisel
“There were so many, just try to wrap your thoughts around having 3, 4, 5, 10 gunshot wound patients thrown at you – at one or two medics with one ambulance. You can't pile them up one on top of another. You had volunteers going with their private cars, throw them in the backseats, literally with tourniquets on them. Imagine – tourniquets on all extremities, all extremities, needle in their chest, chest seals – thrown in the back seats of cars driven out two, three kilometers out to the ambulance crews that were waiting there that can treat them.” — Dov Maisel
ABOUT OUR GUEST
With 30 years of experience, Dov Maisel has dedicated his life to saving the lives of others. When Dov was just 9 years old, he was walking home from school when he witnessed a horrific accident in which a 6-year-old girl was hit by a bus. He decided he never wanted to be helpless when someone in his vicinity so desperately needed lifesaving treatment.By the age of 14, he began volunteering on an ambulance. Maisel has served as a combat paramedic in the Israeli Defense Forces (IDF) in four different wars. After his army service, he began working as an EMT, dispatcher and driver for Israel’s national ambulance service. During the 2000-2003 terror wave in Israel, Maisel personally responded to and managed EMS teams at thousands of terror attacks.
Maisel is the inventor and developer of numerous medical devices, including a pocket BVM airway management device, which is used internationally in many armies, including the U.S. Military. In 2006, he was one of the founders of United Hatzalah, Israel’s first all-volunteer EMS organization. He serves as the director of operations, managing national and international operations along with the Israeli police, IDF and Ministry of Health as well as other government bodies. He invented what is now United Hatzalah’s Uber-like GPS-based dispatch system which locates and sends the EMT closest to the medical emergency.Maisel graduated from several NATO- and Red Cross-led international workshops on disaster management and led international relief missions in Haiti, Nepal, Mumbai and, most recently, in both Houston and Florida, after the devasting hurricanes, as the head of international operations of United Hatzalah.
He continues to serve as a volunteer, instructor and mass casualty incident manager. He has received the Israel President’s Award for volunteerism and sits on the International Editorial Board of JEMS Magazine.
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EMS World Expo 2023 Roundup

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 EMS One-Stop was recorded in New Orleans at the 2023 EMS World Expo.  Host Rob Lawrence is joined by a range of guests who discuss the sessions they presented and the latest developments in clinical medicine.
Alexia Jobson, director of public relations at REMSA, discusses top tips for dealing with the media, and she then interviews media pre-con student Katherine Robillard. 
Peter Antevy, MD, describes his conference session, titled “Five protocol changes you're too afraid to make.”
Brian Maloney of Plum EMS, in Pennsylvania, talks culture of safety, and lights and sirens reduction (and their results within the NEMSQA L&S reduction program).
Doug Wolfberg, Esq., of Page, Wolfberg & Wirth, steps in to discuss leadership lessons from the Beatles and his new book – "Beatles FAB but True."
The episode concludes with veteran EMS podcasters Chris and Anne Monterra, who offer tips on the art of podcasting.
TOP QUOTES FROM THIS EPISODE
“‘No comment is a comment!’ So you really want to avoid that as part of your media strategy and work to develop some transparent and honest information when those tough questions come.” — Alexia Jobson
“Anything that you say to a reporter is considered on the record and can be used in a news story.” — Alexia Jobson
“Top tips for going on camera: You want to make sure that they are knowledgeable about what they are going to be talking about, you want them to be a willing participant and able to re-frame and be positive about the content they are going to cover.” — Alexia Jobson
“It's important for you to just spend a little time looking inside your organization, recognize those important stories that you want to share, and then make sure that you commit some time and resources to building those relationships with your audiences ... having that positive relationship in place will go a long way. And it's also important as a profession that we work together to kind of raise the profile of out of hospital healthcare and EMS.” — Alexia Jobson
“Getting out the door, our shoot time is the No. 1 thing that can decrease our response times. It's not driving lights and sirens; it's not driving recklessly or speeding or not obeying the laws ... it's getting out that door quick from the time of dispatch to the time our truck's pulling out of the garage.” — Brian Maloney
“When we first started looking at the use of lights and sirens during transport to the hospital, which is right there, that increases our chance of getting in a wreck threefold and so it's very dangerous. When we first started it, we were at 26% of the time using lights and sirens during transport; we're down to almost 2%, for transport to the hospital. For response to calls, we were about 46-48% of the time using lights and sirens; we’re down to 7% of the time now.” — Brian Maloney
“Antibiotics for sepsis, so a lot of people are fearful of giving antibiotics, and why? Because the hospital says we need to have a culture, a blood culture. Turns out that's not true. If the patient's hypotensive, they're fixing to die, as they say. And we in Palm Beach County can give the antibiotics within 12 minutes of the 911 call. And our own data shows that the hospital is giving antibiotics at 120 minutes. That's a 10-fold difference in that. So, antibiotics for sepsis are, I think, a major item.” — Dr. Peter Antevy
“There's a story about how the Beatles had a drummer for a couple of years before Ringo. He wasn't quite the right fit for that band. He's a good drummer. But when they got Ringo in, they took off, right? So, in EMS, we tend to think if somebody has a pulse and a patch, let's hire them or let's bring them in. But we need the right people.” — Doug Wolfberg
“Recognize your own limitations, I tell a story about how the Beatles sort of came on hard times when their manager died, but weren't quite wise enough to know what they didn't know. They thought ‘we can manage ourselves,’ and so it’s to also recognize your limitations and get the skills that you need, if you don't possess them yourself, with your team.” — Doug Wolfberg
EPISODE CONTENTS
01:15 – Media management with Alexia Jobson (REMSA)
09:22 – Alexia Jobson interviews Katherine Robillard (LA Office of EMS)
11:37 – Brian Maloney (Plum EMS) talks culture of safety and lights and sirens reduction
20:15 – Dr. Peter Antevy on the five protocol changes you're too afraid to make
23:54 – Doug Wolfberg Esq. (Page, Wolfberg & Wirth) on leadership lessons from the Beatles
28:13 – Chris and Anne Monterra on the art of podcasting
ABOUT OUR GUESTS
Alexia Jobson REMSA
Alexia Bratiotis Jobson is the director of public relations and serves the organization by expanding opportunities for engagement, promotion, communication and relationship-building. She has more than two decades of business and communications experience. Prior to joining REMSA Health, Alexia worked as a senior account director with KPS3, where she managed REMSA’s client account, as well as accounts related to industrial real estate and higher education. She held communications-related positions with Renown Health and the Nevada Museum of Art. She holds an Accreditation in Public Relations (APR). This certification asserts professional competence, high ethical standards and mastery of progressive public relations industry practices. She is a Nationally Registered Emergency Medical Technician and is a graduate of the University of Nevada, Reno’s Reynold’s School of Journalism. She serves as the immediate past president of the board of directors for Western Industrial Nevada (WIN), Chair of the Public Relations Committee of AIMHI and chair of the American Ambulance Association Communications Committee.
Dr. Peter Antevy
Peter M. Antevy, MD. is a pediatric emergency medicine (EM) physician practicing in-hospital emergency medical care at Joe DiMaggio Children’s Hospital, a level I trauma and tertiary care center in South Florida. Board-certified in pediatrics, emergency medicine and the complex subspecialty of EMS, he is also the founder and chief medical officer of Handtevy – Pediatric Emergency Standards, Inc.; and he serves as the medical director for Davie Fire-Rescue, Coral Springs-Parkland Fire Rescue, Southwest Ranches Fire Rescue and United Medical Transport, all in South Florida. Dr. Antevy also serves as associate medical director for several other agencies, including Palm Beach County, Florida, and he is also the longstanding medical director for two highly regarded paramedic training programs as well as several mobile integrated healthcare (MIHC) programs in greater Broward County, Florida.
Brian Maloney
Brian Maloney has been working in EMS for over 24 years as a practitioner, educator and leader. His EMS career began while attending the University of Pittsburgh, where he obtained his paramedic certification and bachelor’s degree in emergency medicine. Later, he continued his education and achieved his Master of Science degree from Carlow University. He has spent most of his career working in the field and had the opportunity to teach with the Center for Emergency Medicine and the University of Pittsburgh. Currently, he is the director of operations of Plum EMS, where he has been for the past 5 years. His love and appreciation for the EMS profession run deep, and he continuously strives to help make it that much better.
Doug Wolfberg, Esq.
Doug Wolfberg has been a well-known national EMS leader for decades. He is an EMS attorney and consultant, and a founding partner of Page, Wolfberg & Wirth. He has served as an EMS practitioner and has held positions at the county, regional, statewide and federal levels in his EMS career prior to becoming an attorney. He has written hundreds of articles and has been one of the most highly rated presenters at EMS conferences throughout the U.S. He earned his law degree magna cum laude from Widener University School of Law and holds an undergraduate degree from Penn State University. Doug also serves as an adjunct professor of law at Commonwealth Law School and as an adjunct professor at the University of Pittsburgh.
Chris Montera
Christopher Montera has more than 34 years of experience in paramedic services, public health, and the fire service. He is the director of State and Federal Programs for ESO and the former chief executive officer at Eagle County Health Service District and holds a master’s degree in health leadership. Chris is serving as the National EMS Museum Treasurer for 2023.
Anne Montera
Anne Montera received a master’s degree in health leadership from Western Governors University and a BSN from Bethel College. She has over 20 years of nursing experience in public health, labor and delivery, patient safety/quality improvement, and EMS coordination in urban and rural hospitals and community settings, including the use of telemedicine. In her previous role as the senior VP of quality for Ready Responders, she worked to research, develop and implement quality matrix to demonstrate program cost savings and health impact. She was also the executive director for the Central Mountains RETAC, supporting a 6-county EMS and trauma region in Colorado. She is the co-creator and public health partner for the first National Community Paramedic Pilot Program in rural Eagle, Colorado. She received the State of Colorado EMS Region of the year in 2019 and Colorado Nightingale Luminary Award for Innovation work on the Colorado community paramedic program in 2011.
ADDITIONAL RESOURCES
Team-driven improvement in the use of lights and sirens – Plum EMS use cases demonstrate when the risk of using L&S is lower than the risk of delaying a lifesaving intervention
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