EMS One-Stop

We deserve this: The Journey to a National EMS Memorial in D.C.

In this episode of the EMS One-Stop podcast, host Rob Lawrence revisits an issue close to the heart of every EMS professional: creating a permanent National EMS Memorial in Washington, D.C.
Rob is joined by Tony O’Brien and James Robinson from the National EMS Memorial Foundation to provide a clear, candid update on where the project stands, why it matters, and what still needs to be done.
From the Weekend of Remembrance to the dream of a year-round place of solace and reverence in the nation’s capital, this conversation lays out the long road from idea to reality — and why EMS, as James puts it, truly deserves this.
Tony and James walk listeners through the 24-step federal Commemorative Works Act process, the hard work of narrowing 312 potential sites down to three, and the current push to reauthorize the Foundation’s federal authority through House Resolution 2196 and Senate Bill 2546.
They explain the preferred site in front of the Hubert H. Humphrey Building (HHS), the partnership with MIT’s School of Architecture and Urban Risk Lab on a powerful design, and the practical realities of funding, sponsorship and bureaucracy.
Most importantly, they end with a clear call to action for the EMS community: contact your elected officials, donate what you can, and help spread the word so that a permanent memorial to EMS can finally take its place in Washington, D.C.
Additional resources
EMS Memorial
EMS Memorial Bills:
HR 2196 
S2546 
2025 National EMS Weekend of Honor recognizes 29 fallen EMS workers
‘Never forgotten’: 2025 Moving Honors procession honors 29 EMS providers lost in the line of duty
Episode timeline
00:44 – Rob introduces the episode, sets the scene for a revisit of the National EMS Memorial effort, and welcomes guests Tony O’Brien and James Robinson.
01:30 – Tony and James share their backstories.
03:53 – Tony explains the origins of the Foundation at the Weekend of Remembrance/Weekend of Honor and the realization that EMS needs a permanent memorial people can visit year-round.
06:54 – James outlines the Commemorative Works Act, the 24-step process, and how the Foundation has reached step 15-16 over roughly 15 years.
07:54 – Tony details the grueling site-selection work: visiting 312 sites, environmental and noise studies, traffic and solitude considerations, and narrowing to three candidate locations.
10:48 – James describes the need for an Act of Congress to begin, Congressman Stephen Lynch’s early sponsorship, and the 2018 authorization that started a 7-year clock — complicated by the pandemic and federal shutdowns.
13:12 – Tony explains how the initial authorization expired, the need for reauthorization and the most recent Senate subcommittee hearing on federal lands where James testified.
16:41 – James and Tony frame the new bills: Senate Bill 2546 and House Resolution 2196, their bipartisan sponsors and the push for more co-sponsors.
19:49 – Tony lays out the three-point call to action: contact Congress, donate via EMSMemorial.org, and follow/share @EMSMemorial on social media.
23:06 – Tony describes the three remaining sites and why Independence Ave. & 3rd St SW, in front of HHS, is the preferred location.
24:42 – Tony highlights the pro-bono design work by MIT’s School of Architecture and Urban Risk Lab, and the deep engagement with providers, families and survivors.
26:32 – James explains the historical nexus of EMS with HEW/HHS and why the Humphrey Building plaza offers the right reverence, proximity to the Capitol and connection to EMS history.
29:01 – Tony and James discuss next steps: reauthorization first, then finalizing site and design to approach major sponsors with clear answers on location, look and cost — while acknowledging the project has been bootstrapped so far.
32:03 – Tony reassures donors: the Foundation is a 501(c)(3), the board are all volunteers with only necessary professional services paid from donations.
33:13 – Tony gives shout-outs to the National EMS Memorial Service and the National EMS Memorial Bike Ride, and explains how the three organizations’ missions align.
37:12 – Rob recaps the journey, reinforces the call to action, and closes the show with thanks to Tony and James and a reminder to visit EMSMemorial.org and like/subscribe to EMS One-Stop.
Rate & review the EMS One-Stop podcast
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.
Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

Hyper-turbulent times: EMS economics and AI guardrails with Matt Zavadsky and Dr. Shannon Gollnick

Recorded on the floor of the EMS|MC EMSpire Conference in Charleston, South Carolina, this episode of EMS One-Stop finds host Rob Lawrence in conversation with long-time collaborator and EMS advocate Matt Zavadsky.
Fresh off the longest federal government shutdown in history, Rob and Matt unpack what the hyper-turbulence in Washington really means for EMS: suspended Medicare extenders, disrupted grant programs, agencies taking out loans just to meet payroll and training programs put on hold.
They break down NAEMT’s flash poll on the shutdown’s impact, the promise of the Treatment in Place (TIP) legislation, and why associations “hunting as a pack” on Capitol Hill matters more than ever.
Along the way, they spotlight EMSIntel.org as a national barometer of EMS funding, staffing and response time crises, and issue a clear call to action for providers, billers and leaders to use association tools to contact their members of Congress.
| MORE: Government reopens: What EMS providers need to know right now
In the second half, Rob is joined by Dr. Shannon Gollnick, paramedic, EMS leader and organizational psychologist, to explore how artificial intelligence is reshaping EMS — right now.
Shannon makes the case that AI is “not the future; it is the present,” and that agency leaders must urgently build literacy, policies and guardrails around its use. They dig into the difference between HIPAA-compliant, embedded AI in ePCR systems, and risky open tools like ChatGPT, touching on hallucinations, embedded code and emerging Medicare fraud-detection programs.
| MORE: Artificial to augmented intelligence. How Dr. Shannon Gollnick wants EMS to work smarter, not harder
Rob and Shannon talk about AI as a powerful but potentially dangerous tool — “like having a tiger” — and outline practical steps for chiefs:
Ask: “Do we have an AI policy?”
Define what AI can and cannot be used for
Insist that every AI-generated work product is double-checked by a human before it hits the record
Memorable quotes
“We weren't here to actually scare you off it. We're here to let you know that it's here, but it's like having a tiger, right? We all love to have a tiger, but it has to be contained in some sort of guard, otherwise it's going to run rife and cause havoc, and we don't want that.” — Rob Lawrence
“This is part of the hyper-turbulence that's occurring in EMS right now.” — Matt Zavadsky
“So I think the message for the profession right now is, now is not the time to put your foot on the brake. It's time to put your foot on the gas.” — Matt Zavadsky
“We put the fun into function.” — Dr. Shannon Gollnick
“I think it's important to understand that AI is not the future. It is the present. We are currently here right now. And it's nothing to be afraid of.” — Dr. Shannon Gollnick
“If you're not doing it, I promise you that your staff is doing it and they're playing around with AI.” — Dr. Shannon Gollnick
“Guardrails don't exist from a congressional standpoint. They don't exist from a regulatory standpoint. The technology is moving far too fast. So we as agency leaders have to take the lead in putting up some of those guardrails.” — Dr. Shannon Gollnick
“There are ePCR software out there that are using proprietary AI that will use AI-generated narratives. And that absolutely is 100% good to go. What we don't want to see is our crews putting in their ChatGPT to have ChatGPT write their narrative.” — Dr. Shannon Gollnick
“ChatGPT has embedded code inside of it that you can't see, but that code is there ... so what we're kind of afraid to do is to say, hey, what happens 6 months from now, 8 months from now when Medicare does an audit, they run your ePCRs and find all of this embedded code from ChatGPT ... you open yourself up for a lot of compliance issues.” — Dr. Shannon Gollnick
Additional resources:
EMS Intel EMS News Tracker
American Ambulance Association Advocacy
NAEMT Advocacy
EMS shutdown survival: What leaders need to know now
Charting the future: How AI is rewriting the EMS narrative
Episode timeline:
00:21 – Rob introduces guest Matt Zavadsky
02:02 – Rob recaps the 40-plus-day federal government shutdown, questions about reopening, and his upcoming return to Capitol Hill for renewed advocacy
02:02 – Matt frames the shutdown as part of the “hyper turbulence” in EMS; explains the regulatory suspensions, pauses in Medicare extenders and grants, and how cash-flow uncertainty forced some agencies to take out loans just to make payroll
03:04 – Matt details NAEMT’s flash poll (408 agency responses) showing suspended training and grant-funded programs, and warns of a possible repeat shutdown around January 30
03:54 – Rob and Matt discuss the reopening of government, ongoing bipartisan work, and the risk that everything “comes to a grinding halt” again if Congress can’t agree
04:51 – Matt explains why NAEMT released the shutdown-impact poll even as government reopened and stresses the need to keep pushing for permanent relief from Medicare extenders and advancement of key bills like Treatment in Place (TIP)
06:03 – Matt outlines the House and Senate TIP companion bills and why Medicare paying for treatment in place is better for patients, EMS, the health system and the Medicare trust fund
06:54 – Rob notes broad association/provider support and professional lobbyists on the Hill; Matt stresses that field providers, administrators and billers must still use association legislative portals to send letters to Congress
08:08 – Matt describes a surge in communities reevaluating their EMS delivery models because of staffing, finance and subsidy challenges — “a great time to be an EMS consultant”
09:09 – Rob introduces EMSIntel.org as a curated clearinghouse of EMS news, used to show communities they aren’t alone; describes failed tax measures and funding referenda
10:15 – Matt cites EMS Intel data: ~85% of stories each month involve funding, staffing or response times; Rob and Matt stress the ubiquity of these themes from big cities to small towns
11:09 – Rob highlights mutual aid tensions and taxpayers questioning why they “pay to send our resources somewhere else;” both emphasize that hyper-turbulence and funding gaps are national issues
13:23 – Rob resets the scene from the EMSpire conference and recaps Matt’s Hill update before introducing Dr. Shannon Gollnick
14:41 – Shannon gives his backstory: in EMS since 1996, paramedic since 2002, progression into EMS leadership, doctorate in organizational psychology and focus on how organizations function
15:14 – “We put the fun into function.”
15:24 – Rob invites Shannon to talk AI, calling it “the specter we are embracing everywhere,” and references HIPAA concerns; Shannon opens with the core message: AI is not the future, it’s the present, and nothing to be afraid of
16:03 – Shannon urges leaders to build AI literacy, noting that if agencies aren’t using it, their staff and the younger generation already are
16:28 – Shannon emphasizes policy and procedure: AI guardrails aren’t coming from Congress or regulators, so agency leaders must define how AI will be used and where its limits are
16:55 – Rob reminds listeners that AI in EMS isn’t new, citing early monitor rhythm interpretation in the UK; Shannon underscores that crews already use AI tools and that unmanaged cut-and-paste practices can create billing and compliance risks
17:24 – Shannon explains the dangers of using open tools like ChatGPT for ePCR narratives: potential PHI exposure in a “black box” system and AI hallucinations generating plausible but false patient information
18:21 – Shannon describes how AI “wants to answer your question and make you happy,” leading to made-up details, and shares examples from testing minimal-input scenarios that returned overly detailed, inaccurate narratives.
19:03 – Shannon calls ChatGPT “kind of a snitch,” explaining embedded code markers that fraud detection tools — and increasingly Medicare’s AI-based “Wiser” program — can use to identify AI-written content in documentation
19:59 – Shannon warns about retrospective audits and compliance exposure if ChatGPT-coded narratives are found in ePCRs, noting that AI rules are still emerging and tech is outrunning regulation
20:51 – Rob summarizes the mixed message: AI is here and being built into devices and software, but there are real dangers. They discuss data going “to the cloud” — which Shannon defines as “somebody else’s computer.”
21:24 – Shannon frames AI as a powerful tool that can “put a lot of holes in the wall” if misused; he references fraudulent AI uses and deepfakes as emerging issues
22:05 – Shannon compares AI’s impact to the internet’s paradigm shift; Rob gives a “spoiler alert” about his own workflow using transcripts and ChatGPT agents, and notes the importance of reading and checking any AI-generated output
22:45 – Shannon reinforces that AI makes mistakes and cannot understand human context; he uses his “How you doing?” Joey Tribbiani vs. Tony Soprano example to illustrate contextual nuance
23:06 – Rob expands the context point with the “Friends”/“Sopranos” slide and reminds listeners that once AI-written words are published, “you said it.” Shannon highlights the WebMD effect and AI-driven self-diagnosis risks.
24:02 – They note that ChatGPT can generate long, complex diagnoses without sufficient patient context, leading to errant or misleading outcomes if misused clinically
25:00 – Rob summarizes: AI is here and, used correctly, is a good thing; advises chiefs to ask their teams, “Do we have an AI policy?”
25:27 – Shannon outlines what an AI policy should contain: acknowledgment that AI is here; clear, non-fearful framing; specificity on what decisions AI can support; and clarity on which tools (e.g., embedded EPCR AI) are allowed versus prohibited uses of ChatGPT
26:17 – Shannon stresses AI should not be used for clinical decision-making or clinical narrative writing; its role should be administrative only, and all outputs must be double-checked
Enjoying the show? Email editor@ems1.com to share feedback or suggest a guest for a future episode. 

Jamaica Fire Brigade’s front line: Inside the Hurricane Melissa response

In this episode of the EMS One-Stop podcast, host Rob Lawrence welcomes Dr. Hezedean Smith, who spotlights the human and operational toll of Hurricane Melissa on Jamaica and the wider Caribbean.
Dr. Smith draws from first-hand perspective from the ground, detailing catastrophic damage to homes, utilities, roads and communications — which compounded the workload and emotional burden for Jamaica Fire Brigade (JFB) firefighters and EMS providers.
Dr. Smith highlighted the Brigade’s Amazon Wish List effort, which aims to route essential personal items and operational supplies directly to affected JFB members and stations to sustain continuity of operations and support responders’ families.
After the break, Dr. Smith switched hats as the newly elected President of NEMSMA to outline the association’s renewed momentum:
New association management support
Expanded member services and credentials
The inaugural NEMSMA Leadership Conference
The NEMSMA Leadership Conference will take place in Washington, D.C., March 23-24, 2026, intentionally adjacent to EMS on the Hill to create a leadership-plus-advocacy “two-fer.” Highlights include keynote Gen. Robert Neller (Ret.), plus a deep bench of EMS leaders and educators.
Memorable quotes from Dr. Hezedean Smith
“Many homes destroyed, utility systems interrupted, critical infrastructure in terms of communities having the ability to communicate, leaving thousands displaced, even fire stations having operational challenges as it relates to communication and interoperability ... ”
“I stayed in the local fire station. I wanted to be there with the men and women on the ground, to make sure that I had that communication, that constant contact with them.”
“My focus will be on the firefighters and ensuring that we get enough supplies to go directly to the firefighters.”
“We want to tear down silos. We want to redefine leadership and ensure that we continue to collaborate across this globe.”
Additional resources:
Jamaica Fire Brigade – Amazon Wish List
National EMS Management Association (NEMSMA)
NEMSMA Leadership Conference: Washington, D.C., March 23-24, 2026
EMS on the Hill, March 25-26, 2026, Arlington, Virginia
International Journal of Paramedicine
EMS One-Stop: General Robert Neller on ethical leadership and adaptability
Episode timeline:
00:46 – Quick industry/policy update
01:27 – Set-up: Hurricane Melissa overview; impact stats and current situation
02:12 – Welcome Dr. Hezedean Smith
02:26 – Dr. Smith’s backstory: Jamaica roots, USAF medic, Orlando FD, two fire chief roles, GES Consulting, Caribbean EMS focus
04:20 – First reactions to Melissa: scale of damage; compounded human toll
05:58 – Deployment cadence: aligning with JFB command, CDEMA, national EOC; travel hurdles; rapid integration on arrival
08:28 – Why existing relationships matter; staying in-station with crews; supporting leaders and frontline needs
11:13 – Call to action: Amazon wish list for responders’ personal and operational needs; distribution via JFB logistics
13:20 – Specific needs (PPE, boots, clothing, hygiene, basic medical supplies) and the ongoing recovery realities
17:46 – NEMSMA — new president, renewed energy, new AMC, who NEMSMA serves
20:14 – Board/leadership shout-outs; programs (FTEP, ACPE), member services, momentum
22:49 – Conference preview (Mar 23–24, 2026, D.C.): theme — disruptive leadership; Gen. Robert Neller keynote; speaker lineup; proximity to EMS on the Hill
26:29 – IJOP collaboration and research-to-podcast pipeline; communications and sponsorship improvements
28:29 – Closing thanks; unified call to support JFB and engage with NEMSMA initiatives
Rate and review the EMS One-Stop podcast
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.
Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

EMS shutdown survival: What leaders need to know now

From Medicare cuts to billing delays, Asbel Montes joins Rob Lawrence to share practical strategies EMS agencies can use to weather the reimbursement storm
In this episode of the EMS One-Stop podcast, we tackle the fast-moving realities of a federal shutdown and what it means for EMS finance, reimbursement and day-to-day operations.
Rob Lawrence sits down with Solutions Group’s Asbel Montes — a veteran of EMS reimbursement and policy expertise — to decode where Congress is (and isn’t), what CMS’s temporary claims hold really means, and how ambulance services can protect cash flow while preparing for potential reprocessing chaos if extenders aren’t promptly restored.
Beyond the headlines, Montes lays out a pragmatic playbook: build a Plan B for cash continuity, align with your billing team on reprocessing workflows, and model exposure across payers tied to the Medicare fee schedule. The conversation then widens to balance billing — why federal change is unlikely soon and why state-level action is delivering practical protections — before closing with leadership lessons on adaptation, data and telling EMS’s story as a guide, not the hero.
Memorable quotes from Asbel Montes
“Our extender expired — that’s that additional payment that we get from Medicare of that 2%, 3%, 22.6% — it expired September the 30th, and it was tied to the House-approved CR that went over to the Senate.”
“We’re solutions givers, as we say here at Solutions Group, not crisis managers. And if you have a plan, I can at least execute a plan.”
“What turned out to be a smaller amount, now the cost associated with it, you started to really understand the complexities that really happened in people’s AR.”
“If this lasts longer than 15 days … then I would basically have a plan in place. So I would be trying to find out from my billing team … what is your contingency plan to ensure I don’t see a hiccup in cash moving forward?”
“The only way government can really invoke change is to make it hit where it hurts. And that’s what’s going on right now. They’re hitting the pocketbook and our industry is grappling with it right now.”
Additional resources
Asbel Montes: The government shutdown’s ripple effect on healthcare
The Leadership Lab with Asbel Montes
Episode timeline & key moments
00:21 – Why the shutdown matters to EMS reimbursement and operations
01:21 – Montes’s 101: role at Solutions Group; 28 years in EMS finance and policy
02:40 – Historical context: number and length of shutdowns; current Hill outlook
03:48 – The ambulance extenders expired (2% urban, 3% rural, 22.6% super-rural); CMS claims hold window
05:03 – Planning posture: realistic timelines; “we’re solutions givers, not crisis managers”
06:12 – Back-of-the-napkin math: short-term dollars vs. long-term reprocessing burden
07:43 – 2015–2016 déjà vu: retroactive fixes and the heavy lift for back-office AR
10:26 – Secondary impacts: VA eligibility, appeals, enrollments during a prolonged shutdown
11:11 – The “three-legged stool” for leaders: (1) have a plan with billing; (2) reconcile accounts & patient balances; (3) prevent cash-flow lag if more than15 days
14:06 – Framing the moment: “hurricane shutdown” response and recovery mindset
15:43 – Balance billing at the federal level: committee work, political pain and why movement is unlikely soon
18:19 – State action wins: consumer protections and access; examples of Medicare-indexed approaches
20:24 – Why ground ambulance stayed out of federal NSA; local regulation and state primacy
22:42 – “All politics are local”: using EMS’s public visibility to advocate for patients and providers
23:09 – Adaptation over preservation: seize the 6-18 month window; let data and clinicians lead reform
27:13 – Lawrence’s “Darwinism” takeaway: adaptation as survival
28:31 – The Leadership Lab podcast: purpose, cadence and upcoming guests; Montes’s leadership journey
Rate and review the EMS One-Stop podcast
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.
Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

Rainn Wilson on ‘Code 3’ and the brutal beauty of EMS life

In this episode of the EMS One-Stop podcast, our host, Rob Lawrence, sits down with Hollywood actor Rainn Wilson, who stars as Randy in “Code 3.”
Known worldwide for his role as Dwight Schrute in The Office, Wilson has stepped into the world of EMS, portraying the life of a burned-out paramedic with both grit and humor. In the conversation, Wilson reflects on the process of bringing this story to life, his ride-along experiences in Los Angeles, and the powerful realities he uncovered about our profession.
More than just a performance, Rainn has become an unexpected advocate for EMS. He speaks candidly about the underfunding of frontline providers, the emotional toll of the work and the sheer humanity that comes with being welcomed into people’s lives during their most vulnerable moments.
Alongside the serious themes, he reminds us that Code 3 is also a comedy — one that captures the gallows humor, camaraderie and resilience medics carry with them on every shift.
| MORE: Why ‘Code 3’ might be the most honest EMS film yet. From a ticking salary counter to fourth-wall confessions, this EMS road movie isn’t just another Hollywood take. It’s a love letter, a warning and a mirror.
Memorable quotes from Rainn Wilson
“Most of all, I just fell in love with the character of Randy.”
“Bottom line, the fact that first responders are getting basically what people that work at Starbucks are getting paid really blew my mind.”
“Well, one thing I never thought of, maybe stupidly so, is how vulnerable everything is because you're going into people's homes and they're in crisis.”
“I think Rob, no one should be allowed to graduate from high school without their kind of basic CPR training.”
“Everything about EMS — the tone, the vibe, the gallows humor, certainly all the technical medical elements, the burnout, the camaraderie, the idea that there's a mission here — they do it because they love it.”
“Well, it was an honor to learn about this world and to make a movie that these workers are excited about and proud of.”
“I want to say from the bottom of my heart, you know, ‘thank you. Thank you for your work. And, you know, I think it's grossly underappreciated, but, you know, America needs you.’”
Episode timeline
00:26 – Rainn Wilson on the vulnerability of entering people’s homes in crisis
00:57 – “All we want to do is save your life. Some of you don’t make it easy.”
02:53 – Rainn’s first impressions of the “Code 3” script
03:38 – Falling in love with the character of Randy
04:22 – Discovering the realities of EMS work and shocking pay disparities
06:09 – Lessons from Wilson’s Los Angeles ride-along
10:12 – Wilson on CPR training and why everyone should learn it
12:29 – “We’re essentially a tube and a pump.”
13:11 – Rehearsals and the importance of portraying EMS medicine accurately
15:09 – On burnout, PTSD and the need to support medics’ mental health
18:08 – Using “Code 3” salary comparison as an advocacy tool
19:07 – Wilson praises Rob Riggle’s ED doctor role and its realism
20:41 – Cherishing the chance to shed light on EMS
21:10 – Reminder that the film is also a comedy — “a good old time with a bucket of popcorn”
22:25 – Final message: “America needs you. Keep saving lives.”
Rate and review the EMS One-Stop podcast
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.
Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

Burnout, bravery and gratitude: The story behind ‘Code 3’

In this episode of the EMS One-Stop podcast, host Rob Lawrence sits down with Patrick Pianezza, co-writer of the new EMS film “Code 3”, a deeply honest and compelling portrayal of life on the ambulance.
The film stars Rainn Wilson (“The Office”), Lil Rel Howery (“Free Guy”) and Aimee Carrero (“Elena of Avalor”), delivering a powerful performance that captures both the pressures and the humanity of EMS work. Using real-world experiences and stories from the field, “Code 3” highlights the passion, dedication and emotional toll experienced by EMS professionals every day. From burnout, to systemic challenges, the movie invites the public into the high-stakes world of emergency medical services, showing both the challenges and the heart behind the uniform.
Patrick and Rob discuss not only the storytelling process, but also the personal experiences that informed the movie. Pianezza candidly shares the emotional toll of EMS work, the reality of burnout and the importance of mental health support for first responders.
This episode is both a celebration of the dedication of those who serve in 911 and a call for awareness and gratitude for the vital work they perform. “Code 3” opens in selected cinemas on Sept. 12, 2025.
Memorable quotes
“I remember going to one of my old bosses and saying, ‘I think I'm burning out.’ The reaction I got was this dark chuckle … ‘We're all burnt out. Get back on the truck.’ That kind of festering mentality is not healthy.” — Patrick Pianezza
“Six out of six people that I have worked with have unfortunately [died by] suicide, and the suicide rates for first responders is double that of the regular population … which is a statistic we need to fix.” — Patrick Pianezza
“And it is … a good representation of life on the truck, on the street, with a guy who’s clearly burned out; but a person that cares, that has passion, commitment and will always do the right thing.” — Patrick Pianezza
“There was no way to confront the story without talking about salaries, without talking about reimbursements … No one's gonna see a movie about Medicare, Medicaid, but we are as honest as we can be.” — Patrick Pianezza
“This movie is nothing more than a gratitude tour for everyone who works in 911 … I’ll be a broken record here: thank you for what it is that you do because it matters. I’ve been in those boots and I’m here to tell you thank you.” — Patrick Pianezza
“And as I say in my review, those who know me know my ability to take tactical naps during movies. Well, this one got two eyes open and absolutely five stars.” — Rob Lawrence
Episode timeline
00:00 – Introduction: Rob Lawrence introduces Patrick Pianezza and the film “Code 3” starring Rainn Wilson
02:31 – Origins of “Code 3:” How the project started and the vision behind telling an authentic EMS story
05:01 – Creative team & casting: working with actors, crew and Rainn Wilson
08:01 – On-the-Street authenticity: translating real EMS experiences into the film
12:01 – Depicting burnout: emotional and mental challenges in EMS work
16:01 – Mental health & seeking help: Autobiographical elements and confronting burnout
20:01 – Systemic issues: salaries, Medicare, and Medicaid reimbursement challenges
24:01 – Impact on families & relationships: emotional toll beyond the job
27:01 – Personal reflection: Patrick’s journey, struggles and growth in EMS
29:01 – Gratitude tour: purpose of the film and acknowledging EMS professionals
32:01 – Closing thoughts: film release details, upcoming trailer and final messages of appreciation
Enjoying the show? Send an email to editor@ems1.com to share feedback or suggest guests for upcoming episodes. 

NEMSAC dismantled: Inside the fallout shaking federal EMS policy

This breaking-news edition of EMS One-Stop dives straight into the announcement that the National EMS Advisory Council (NEMSAC) has been dissolved. Host Rob Lawrence is joined by Dr. Brandon Morshedi (NEMSAC chair-elect) and Brenden Hayden (immediate past chair), who explain what NEMSAC is, what it achieved and why its sudden dismissal has left the EMS community frustrated, concerned and searching for answers.
Together, they outline the role of NEMSAC as the sole statutory advisory body connecting EMS to the federal executive branch, describe the hundreds of volunteer hours that went into shaping advisories, and discuss what happens now that years of hard work and documents have been pulled from EMS.gov.
This episode sets the record straight, provides a clear explainer of the process, and captures the disappointment — yet determination — of leaders committed to moving EMS forward despite this setback.
Additional resources:
How NEMSAC is composed — who sits on the council and what types of expertise are represented
The NEMSAC’s statutory role advice/briefings at the federal level
NEMSAC’s key accomplishments
Episode timeline
01:08 – Rob introduces the breaking news: NEMSAC dissolved
02:22 – What is NEMSAC? Brenden explains its statutory role
04:52 – How does NEMSAC differ from associations? Direct advisory to the executive branch
06:42 – Appointments, terms and how continuity usually worked
08:44 – The depth of work: meetings, subcommittees, advisories, letters
11:23 – Examples of major advisories and public comment process
14:27 – Shock: key advisories removed from EMS.gov
19:13 – Explainer: FICEMS and how advisories flow through federal government
26:25 – How members felt when dismissal was announced
30:18 – What happens to unfinished advisories and research
34:20 – Associations’ role in keeping the work alive
35:50 – The advisory each guest is most proud of
39:41 – Lessons learned: influence, unified voice, process
43:25 – Final reflections: leadership, advocacy, and what comes next
Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for a future episode. 

CAAS GVS 4.0: Building safer, smarter and theft-proof ambulances

In this episode of the EMS One-Stop podcast, host Rob Lawrence climbs back onto his soapbox to discuss two topics that directly impact on every EMS agency in America — the CAAS Ground Vehicle Standards (GVS) 4.0 and the simple, inexpensive steps we can take to stop ambulance theft.
Joining Rob is longtime EMS leader and current CAAS GVS Administrator Mark Postma, who walks us through the origins of the standards, their national adoption and what’s new in the latest update.
From ambulance remounting, to structural safety testing, Mark explains how GVS 4.0 has evolved to keep pace with manufacturing realities, supply chain delays and operational needs. The conversation then shifts to a shared passion for protecting fleet assets.
Rob and Mark dissect the shockingly frequent problem of ambulance theft and how a $200 automatic immobilization device can prevent a $250,000 vehicle from disappearing — without relying on crews to remember to lock it.
Additional resources:
CAAS GVS V4.0 – Ground Vehicle Standard
Commission on Accreditation of Ambulance Services (CAAS) – The New Standard in Mobile Healthcare
Ambulance thefts in the U.S. surge: Over 40 stolen rigs in 18 months
6 ways to safety-proof your EMS fleet
Memorable quotes
"It’s no good going to City Council or to your board of directors on day 365 and saying, ‘I need a new truck for New Year day one’ — that’s not going to happen." — Rob Lawrence
"The ground vehicle standard has become the standard that most vehicles are being built to and that state EMS officials are using." — Mark Postma
"We spend a lot of time thinking about where things go in the box … add one more thing to your checklist: can the vehicle indeed be immobilized?" — Rob Lawrence
"There’s just no reason why ambulances are being stolen with the current technology that’s out there." — Mark Postma
Episode timeline
00:45 – Rob introduces the topic: GVS 4.0 and ambulance theft concerns
01:34 – Mark introduction and CAAS GVS role
04:11 – How the CAAS standards were developed and adopted by 35-plus states
06:09 – Comparing CAAS GVS to NFPA ambulance standards
06:48 – The rise of remounting, especially during COVID supply shortages
10:26 – Discussion of ongoing vehicle delivery delays and need for replacement planning
15:04 – What’s new in GVS 4.0 — major changes and safety structure updates
19:38 – Ambulance theft statistics and the GVS anti-theft requirement
22:28 – Automatic immobilization and why manual systems fail
23:57 – Mark shares success story: zero thefts since installing devices
26:17 – Exceptions in standards and why state inspectors must enforce anti-theft
27:42 – Final thoughts on making anti-theft part of fleet planning
Enjoying the show? Email editor@ems1.com to share feedback and suggest future guests. 

Public health at the front door: An MIH model to emulate

In this edition of the EMS One-Stop podcast, host Rob Lawrence Zooms (literally) from the U.K. to South Carolina to spotlight one of the nation’s most forward-thinking mobile integrated healthcare programs. Prisma Health’s team has taken community paramedicine beyond buzzwords, designing targeted, evidence-based programs that meet people where they are — both geographically and medically.
| MORE: How North Dakota EMS is confronting rising pediatric mental health crises 
Whether it's addiction medicine, rural HIV/HCV treatment or skilled nursing interventions, this team is shifting paradigms on what EMS can and should be doing.
Rob is joined by four key voices from the Prisma Health MIH program:
Luke Estes, director of MIH
Dr. Mirinda Gormley, epidemiologist and biostatistician
Wes Wampler, community paramedic specializing in addiction and infectious disease
Parker Bailes, community paramedic and research contributor
Together, they unpack how passion meets data to drive change, how to earn trust in communities overlooked by traditional systems, and why this work isn’t just novel — it’s necessary. This is EMS in its truest public health form.
Memorable quotes
“You delivered the goods—data-driven, community-connected care — and that’s what EMS in 2025 needs more of.” — Rob Lawrence
“When you see some of your people who have a passion for a certain pathway in EMS, you try to give them the reins and say, you're gonna do some good.” — Luke Estes
“One of the big things that we learned from his study was that we really needed to go out and make sure everybody was aware that addiction is a disease.” — Mirinda Gormley
“If we can gain their trust, there’s a lot more that we can kind of weasel our way into to help them solve and get them on a healthier trajectory.” — Wes Wampler
“Walking into the (care) facility with the mindset of, ‘I'm going to do everything I can to keep you here,’ was a big shift for me.” — Parker Bailes
“If we can set them up to be successful after they leave the hospital, I think that's the best way to get them reengaged with the hospital.” — Wes Wampler
“As their leader … all I have to say is, what do you need? I'm here to support you.” — Luke Estes
Additional resources
EMS Clinician Perceptions on Prehospital Buprenorphine Administration Programs: Prehospital Emergency Care: Vol 29 , No 4
Implementation Barriers of Prehospital Buprenorphine Administration Programs in the United States: A Scoping Review: Prehospital Emergency Care: Vol 29 , No 4
Using Community Paramedicine to Treat Hepatitis C Virus in Upstate South Carolina - PMC
Luke Estes BA, NRP, CCEMTP, PNCCT, FP-C, CP-C | LinkedIn
Wesley Wampler | LinkedIn
Support for harm reduction by community EMS
How does a community re-imagine compassion to avoid crisis whenever possible?
Breaking barriers: Hennepin EMS leads the way in safely implementing buprenorphine
Episode timeline
00:51 ­– Introduction to Prisma Health MIH & guests
03:00 – Luke Estes overview of MIH models (ETS, SDOH, addiction)
05:00 – Dr. Gormley’s public health journey, data-opioid focus
08:00 – Buprenorphine pilot design and research outcomes
10:15 – Challenges: bias, stigma, barriers to addiction care
13:00 – Funding and sustainability conversation
14:00 – Wes Wampler on daily workflow in addiction medicine and HCV care
17:00 – Building trust with vulnerable populations
18:30 – Parker Bailes discusses traditional CP role and skilled nursing interventions
21:45 – Alternative destinations, lab draws and high-acuity decisions
25:30 – Training: internal education, ultrasound, medication management
28:15 – Prisma’s med school connection and disaster response evolution
30:00 – State-level partnerships: SC EMS Assn, FEMA typing, CP strike teams
31:56 – Academic next steps from Dr. Gormley: scaling, publishing, process evals
35:26 – Final reflections from Luke Estes: passion, team strength and mission
38:00 – Rob’s call to action: “If you want your own Prisma team — start now.”
Enjoying the show? Email editor@ems1.com to share feedback or suggest future guests. 

Meet the EMS Avenger: Saving lives with kindness and content

In this high-impact edition of the EMS One-Stop podcast, host Rob Lawrence sits down with EMS influencer and educator Jimmy Apple, known widely across platforms as The EMS Avenger. With nearly 70,000 followers on TikTok and a growing presence on Instagram and Facebook, Jimmy has mastered the art of compressing complex clinical topics into digestible, engaging content.
| More: What the EMS Counts Act means for dual-role EMS providers 
In this conversation, Rob pulls back the curtain on the man behind the mobile screen — exploring Jimmy's journey from electrician to pediatric critical care paramedic, and now, one of EMS's most watched and listened-to voices.
Listeners will gain deep insight into Jimmy’s origin story, his social media strategies, his refusal to let bad information go unchallenged, and his passionate belief that “Saving lives begins with kindness.” The pair also tackle:
Content creation advice for EMS agencies
The challenges of tone and accuracy in short-form video
How to maintain compassion in the face of a toxic work culture
This episode is part masterclass in communication, part call to action for the future of EMS — and all heart.
Memorable quotes from Jimmy Apple: The EMS Avenger
“Saving lives begins with kindness. That is my motto, it is my philosophy.”
“You have to package something down to its bare essence … there's some nuance lost, but you have seconds to keep people's attention.”
“My goals going forward are to support people who are acting in good faith while correcting the misinformation.”
“Generally speaking, you will draw the engagement that you're looking for. If you're putting out content in good faith, you'll get good faith engagement.”
“We are responsible for ourselves and how we respond … and I believe we need to respond to everything that is happening in the world today with kindness.”
Episode timeline
00:54 – Rob introduces Jimmy Apple, aka the EMS Avenger
01:20 – Jimmy’s background: from electrician to EMS
03:30 – The grandfather conversation that changed his life
04:50 – How pathophysiology sparked a love for learning
05:40 – Birth of the EMS Avenger: from student favorite to TikTok influencer
06:55 – Ginger Locke’s advice that redirected Jimmy’s podcast path
08:04 – Compressing content: "from textbook to bumper sticker"
10:00 – The content hook: “Are we getting rid of normal saline?”
11:00 – How Jimmy selects topics: research, news, curiosity and requests
13:00 – Hot topics in EMS: cricothyrotomy, TXA, ketamine, provider safety
14:40 – Rob discusses EMSIntel.org and ambulance theft data
16:00 – Can EMS agencies do what Jimmy does? The risks and the realities
18:30 – "Stop the finger": creating content that captures attention
20:00 – Rob on the risks of public messaging and backlash
21:00 – Calling out misinformation: the line between education and shame
23:00 – Jimmy’s growing reach across TikTok, Instagram and Facebook
24:45 – Managing Facebook’s deeper comments and nuanced conversations
26:45 – Jimmy’s rule: “Engage only with good faith”
27:50 – Final thought: EMS must rediscover kindness
29:00 – Closing remarks and where to follow Jimmy Apple online
Additional resources
Connect with Jimmy Apple, better known as The EMS Avenger:
TikTok — Jimmy offers short-form, evidence-based EMS content here: @emsavenger
Instagram — Engage with in-depth reels, visuals, and professional updates: @emsavenger
X (formerly Twitter) — Follow EMS commentary, conversation, and boosts: @EMSAvenger
Facebook — Join the group for discussions and shared insights: EMS Avenger community
Apple Podcasts — Listen to “EMS Avenger: 20 Minutes to Save the World”: Weekly podcast series
AAA & AIMHI EMS Media Log: EMS Intel
Enjoying the show? Contact the EMS One-Stop team at editor@EMS1.com to share ideas, suggestions and feedback.