Not A-Fib: Criminal Liability and Legal Challenges for EMS Providers This episode of the Not A-fib podcast looks into the increasing scrutiny EMS providers face from a legal standpoint, highlighted by high-profile cases like Elijah McClain's tragic death in Aurora, Colorado, and a recent Springfield, Missouri incident. Attorney and EMT Frank Flaspohler, who serves as legal counsel to Missouri ambulance districts, explains the differences between civil and criminal liability in EMS, the limits of governmental immunity, and the critical role of documentation. He discusses the legal thresholds around chemical and physical restraints, the importance of assessing mental capacity in refusals, and the risks tied to improper patient handling. Frank also shares practical advice on maintaining professionalism in reports and on scene, the nuanced challenges rural EMS agencies face, and emerging concerns such as mental health support for first responders.
The JEMS Report: Tylenol Use in Pregnancy Dr. Sarah Fabiano and Dr. Jeremy Cushman break down the recent FDA release linking acetaminophen (Tylenol) use during pregnancy to autism spectrum disorder. They discuss the distinction between association and causation, highlighting how studies can show correlations without proving direct cause and effect. The doctors also address the complexity behind autism diagnoses, genetic and environmental factors, and the known risks of fever during pregnancy. They emphasize that acetaminophen remains one of the safest and most effective options for pain and fever relief in pregnancy, especially compared to alternatives like ibuprofen or aspirin, which carry documented risks. This discussion aims to clarify confusion, steer clear of fear-driven decisions and encourage informed use of medication based on current science—not headlines.
Just a Little Salt: Kevin Hazzard on the Reality of Emergency Medicine, Burnout, and Storytelling In this revealing episode of “Just a Little Salt,” seasoned Atlanta paramedic and author Kevin Hazzard shares the unvarnished truth about life on the front lines of emergency medicine. Reflecting on his decade-plus of experiences, Kevin dives deep into the emotional challenges of responding to traumatic calls, the harsh realities young EMTs face, and the impact of burnout on providers. He opens up about moments that forever shaped him, including encounters with vulnerable patients and the delicate balance between adrenaline-fueled rescues and raw human connection. Kevin also discusses his transition from medic to author, explaining how writing helped him process his career and why genuine storytelling matters. Along the way, he offers practical advice for new EMS providers and aspiring writers seeking to publish their own stories. This episode is a must-listen for anyone curious about the personal side of EMS, resilience under pressure, and the power of sharing these unheard voices.
Just a Little Salt: Badge 502 on EMS, Dispatch and Viral TikTok Fame In this candid episode of “Just a Little Salt,” the Salty Paramedic sits down with Badge 502— Anthony Christian an EMT, 911 dispatcher, CPR instructor and viral content creator. Anthony shares his journey from retail to first responder during the height of the COVID-19 pandemic, how creating humorous EMS videos started as a way to find levity in a demanding job, and unexpectedly blew up with millions of views. He dives into the challenges and emotional weight of emergency calls, including delivering a baby in an ambulance and saving a child’s life. Anthony also discusses the unique perspective gained from working both sides—dispatch and field EMT—and how that shapes his communication and care. They wrap up with Badge 502’s advice for aspiring creators: focus on having fun, embrace imperfection and keep grinding.
The JEMS Report: ROSC and Roll Cardiovascular perfusionist Brian Kress joins Mike Brown to dissect a high-stakes cardiac arrest case that underscores the critical moments following return of spontaneous circulation (ROSC). They walk through the fragile physiology of post-arrest patients and reveal how early, expert support in the field and hospital dramatically influences outcomes. From the importance of bystander CPR and prehospital interventions to advanced cardiac catheterization and mechanical circulatory support using the Impella device, Brian explains the science behind left ventricular end diastolic pressure (LV EDP) and how offloading the heart aids recovery. This conversation deep dives into the often-overlooked complexities of managing post-ROSC states, emphasizing the need for vigilant hemodynamic monitoring and judicious use of vasopressors. A must-listen for EMS, perfusionists and critical care providers seeking a nuanced understanding of cardiac arrest survival pathways beyond the initial resuscitation.
Just a Little Salt: Firefighter Fenton on Leadership, Family and Humor in Firefighting Firefighter Fenton opens up about balancing two decades of firefighting with family life, creative content creation and staying true to himself. From the harrowing experience of losing a fire truck amid a wildfire threatening homes—teaching him tough lessons in leadership and priorities—to the lighter side of his persona inspired by a fake mustache and parody videos, Brent shares it all. He discusses the challenges of juggling a full-time career, four kids, homeschooling and his passion for music and comedy. Brant also reveals the power of community within firefighting content creators and how their work brings laughter and healing to those facing dark times. For anyone wanting to create meaningful content, Fenton’s advice rings clear: stay authentic, know your worth beyond the spotlight and never lose sight of what matters most—family and faith.
Just a Little Salt: Patrick Pianezza on ‘Code 3,’ EMS Realism and Mental Health In this debut episode of Just a Little Salt, former paramedic and co-writer Patrick Pianezza shares the story behind the upcoming film “Code 3,” releasing September 12. Drawing on over a decade in EMS, Patrick reveals how a college creative writing assignment transformed into a heartfelt, medically accurate portrayal of a 24-hour shift’s highs and lows. He discusses the film's unapologetic look at EMS challenges—including burnout, mental health struggles and systemic issues—while preserving dark humor and camaraderie that help first responders cope. Patrick also reflects on working closely with actors to capture authentic medical procedures and the importance of educating the public about the skill behind EMS work. Wrapping up with encouragement for aspiring writers, he offers raw insight into perseverance, creativity, and gratitude toward those who serve on the front lines.
Chief’s Cadence: Ethical Leadership in EMS with Attorney Steve Wirth In this episode of The Chief’s Cadence, Chief Shane Wheeler sits down with Attorney Steve Wirth, a pioneering paramedic turned attorney and EMS leader, to uncover the complexities of ethical leadership in emergency medical services. Drawing from decades of hands-on experience, Steve explores the hard choices EMS professionals face daily—from patient care errors and scarce resources to the challenge of maintaining compassion amid burnout. They discuss the vital role leaders play in modeling integrity, fostering transparency, and building a culture that empowers staff to speak up about mistakes. Steve also highlights mentorship as a powerful tool for guiding the next generation of EMS leaders through the ethical “gray zones” that often arise.
The JEMS Report: Inside EMS Medical Direction and Rehab Strategies at Large-Scale Fire Incidents Dr. Jeremy Cushman shares his journey from EMT to full-time EMS physician and regional medical director covering over 100 agencies in New York’s Finger Lakes and western regions. He talks about the evolving EMS physician role and the relationship between medical directors and first responders. The discussion dives deep into EMS response and rehab protocols for large-scale fires, highlighting lessons from a recent five-alarm fire in Rochester, NY. Dr. Cushman explains the importance of preplanning, hydration, acclimatization and post-incident recovery while stressing rehab as a command responsibility, not solely EMS’s. He explores how automatic scaling of EMS resources during growing incidents supports both firefighter safety and system capacity.
What is high-risk airway management (HRAM)? It is exactly the stuff nightmares are made of: Patients who present to us, outside of the hospital, with severe injuries and competing treatment priorities. Performing RSI on these patients is a lot like walking alone down a scary alleyway in the big city. Read the full article on EMS Airway.
Not A-Fib: Mobile Integrated Healthcare, Advocacy and Mental Health in Missouri Chief Justin Duncan, CEO of Washington County Ambulance District in Missouri, shares insights on pioneering mobile integrated healthcare in a sprawling 1,500-square-mile rural area. Winning the $150,000 Building Bridges to Better Health challenge, his program blends community paramedics, telehealth, and partnerships with federally qualified health centers and social service organizations to close care gaps beyond traditional EMS responses. Duncan discusses the evolution from emergency transport to preventative, holistic care, tackling chronic diseases and social determinants of health, while navigating reimbursement challenges through managed care contracts and advocacy. He highlights the crucial role of public health in community needs assessments and stresses the urgent need to address mental health within EMS, sharing personal stories and calling for cultural change. As president of the Missouri EMS Association and chair of the NAEMT Economics Committee, Duncan emphasizes teamwork, mentorship and engagement at all levels—from local agencies to Capitol Hill—to shape the future of EMS and ensure sustainable, patient-centered care.
The JEMS Report: Practical Insights for Out-of-Hospital Birth Challenges In this episode of the JEMS Report Podcast, managing editor Jeff Frankel sits down with Dr. Liz Travis, a maternal care researcher, to discuss the growing challenges EMS providers face with out-of-hospital births. They unpack the critical gaps in traditional EMS training, particularly as maternal care deserts expand, leaving medics increasingly responsible for delivering babies in the field. Dr. Travis shares evidence-based strategies like the importance of delayed cord clamping (“wait for white”), skin-to-skin contact, and encouraging comfortable, non-supine birthing positions to improve outcomes for mother and infant. She advocates for updated, hands-on EMS training that reflects modern obstetric knowledge, including collaboration with midwives and doulas. Above all, Dr. Travis emphasizes that birth is usually natural, not an emergency, encouraging EMS providers to remain calm and focus on simple, effective practices. This episode offers essential insights for paramedics and EMS agencies preparing to meet the demands of maternal care in underserved areas.
Airway management in the prehospital environment is difficult just by virtue of where we are doing it and the lack of resources available to help us manage the difficulties. Add to that a patient with mangled facial anatomy or is dangerously peri-arrest due to hemorrhage and the danger can seem insurmountable. What the research tells us is that there are really three big buckets of problems in airway management that contribute to morbidity and mortality: hypoxia, hypotension and multiple intubation attempts; this is the stuff that airway nightmares are made of. Read the full article on EMS Airway.
Not A-Fib :Inside New Orleans EMS’s Body Worn Camera Program and Mass Casualty Response In this episode of the Not A-fib podcast, Deputy Chief Christopher Keller of New Orleans Emergency Medical Services shares the origins and impact of their innovative body worn camera program. The program protects staff, supports quality assurance and aids patient care. Keller discusses navigating privacy concerns, storage challenges, and staff buy-in while prioritizing transparency over punishment. He also reflects on the agency’s rapid and coordinated response to the tragic January 1, 2025 Bourbon Street attack, highlighting lessons learned and multi-agency training efforts. Additionally, Keller provides insight into preparing for massive events like the Super Bowl and Mardi Gras, where public safety coordination is key. The episode closes with reflections on the department’s experience filming the Nightwatch TV series and the future potential of integrating body cam footage with EMS documentation.
The JEMS Report - How Drones Are Transforming EMS Logistics and Healthcare Delivery JEMS Managing Editor Jeff Frankel sits down with Ryan Walsh, CEO and founder of Valqari, to explore how drones are revolutionizing emergency medical services and hospital logistics. Drawing on his special operations experience, Walsh reveals how Valqari developed autonomous drone technology to deliver critical medical supplies quickly, slashing delivery times. The discussion covers real-world applications like transporting blood samples and emergency meds, plus cutting-edge AI integration that could enable fully automated, doctor-to-door healthcare. Walsh also highlights ongoing collaborations with first responders to provide life-saving supplies on-site faster than ever. He breaks down FAA regulations shaping drone deployment and shares his vision for drones becoming as common as smartphones by 2030, drastically reducing delivery costs and reshaping industries. This episode offers practical insights for EMS leaders gearing up for drone adoption and a glimpse at the future of autonomous medical logistics.
EMS Research: Severe Hemorrhage Technology Developed by Military Researchers Severe hemorrhage is one of the toughest challenges faced in the prehospital environment, especially when every second counts and resources are limited. But a recent study on the use of 25% human serum albumin (HSA) in trauma care could change how responders approach these critical moments. The study was led by United States Air Force Scientist Alex Penn, PhD. The findings from his team suggest that this concentrated protein solution can stabilize blood pressure, reduce the need for additional fluids, and improve circulation in ways traditional methods cannot. For paramedics, this could mean a shelf-stable, easy-to-use solution that saves more lives in the toughest conditions, revolutionizing pre-hospital care as we know it.
The JEMS Report - How Critical Incident Response Canines Are Changing First Responder Support JEMS Managing Editor Jeff Frankel sits down with Janeen Baggette, the founder of K9s for Freedom and Independence, to explore a unique approach to first responder well-being. With a background as a military medic and law enforcement handler, Janeen shares how her nonprofit trains specialized Critical Incident Response Team (CIRT) canines. These dogs differ from typical therapy and patrol dogs—they’re specially conditioned to operate in chaotic environments, offering emotional support while maintaining confidentiality crucial for legal and occupational safety. Janeen walks us through the rigorous selection and training process, highlighting their ability to detect cortisol levels reflecting human stress. Through heartfelt stories, she illustrates the quiet impact these canines have on victims and first responders alike. Challenges around funding and awareness remain, but Janine’s vision for expanding certified teams across the country offers hope for better communication, reduced suicide rates, and stronger peer support in these high-pressure fields.
Infection control consultant Katherine West breaks down the critical distinctions between infection prevention practices in EMS settings versus medical facilities. She clarifies how EMS-specific CDC guidelines account for unique factors like ambulance ventilation systems, the rear exhaust fan and closed suction systems that impact airborne and droplet disease transmission risks. Katherine addresses the evidence behind mask and respirator use, emphasizing that clinical data since 2015 shows no clear advantage of N95 respirators over surgical masks for many respiratory infections in EMS contexts. She also highlights post-exposure protocols, explaining why EMS personnel do not require immediate baseline blood testing, unlike hospital staff. Practical advice on COVID-19, tuberculosis, measles, Ebola precautions and aerosolized medication administration underscores why EMS must follow tailored guidelines rather than hospital-based protocols.
JEMS Managing Editor Jeff Frankel sits down with occupational therapist Bonnie Ekman and paramedic leader Alanna Badgley to explore sensory modulation therapy as a breakthrough tool for first responders’ mental health. Bonnie explains how engaging all eight senses helps regulate the nervous system, moving beyond traditional talk therapy when first responders are stuck in fight-or-flight activation. Alana shares her personal experience and the positive feedback from EMS professionals who have benefited from sensory rooms designed to soothe hypervigilance and stress. They discuss practical, budget-friendly ways departments can implement sensory modulation spaces, emphasizing low-cost solutions like colored lighting, calming sounds, and tactile tools.
JEMS Managing Editor Jeff Frankel hosts a deep dive into the mental health challenges facing first responders. Featuring Dr. Robin Jacobowitz, interim director at SUNY New Paltz’s Institute for Disaster Mental Health, and paramedic and union leader Alanna Badgley, the discussion centers around a groundbreaking 2024 New York State Mental Health Needs Assessment. The study exposes alarming rates of PTSD, depression, and suicidal ideation—20% of EMS respondents have thought about suicide linked to their work. The conversation addresses how chronic workplace stressors like mandated overtime and stigma create substantial barriers to care. Alanna emphasizes that mental health struggles aren’t anomalies but an expected reality for first responders, advocating for open dialogue, culturally competent care, and union-backed mental health leave policies. This episode sets the stage for ongoing conversations and upcoming solutions to better support those on the front lines.