EMS One-Stop

emsonestop

Explore the forefront of EMS leadership with Rob Lawrence on the ”EMS One-Stop” Podcast. Tackling critical issues like staffing, service delivery and operational challenges, each episode delves into the latest in patient care enhancement, EMS technology advancements; and emerging trends like AI, telehealth, quality improvement and alternate destinations with industry experts. Rob Lawrence brings to the table his extensive expertise from decades of service spanning the American Ambulance Association, AIMHI, Richmond Ambulance Authority, Pro EMS, Prodigy EMS Education and the East Anglian Ambulance NHS Trust. Stay informed with the latest EMS industry news, organizational updates and inspiring agency success stories. Tune in to the ”EMS One-Stop” Podcast for a deep dive into the challenges and triumphs of EMS leadership in today’s dynamic prehospital care landscape.

  1. 4d ago

    Paramedic Quinn Reece and her flying machine

    In the first part of the Hyde County story, EMS One-Stop explored how a small rural North Carolina EMS system became the first in the nation to deploy an eVTOL aircraft as part of a 911 response. In this episode, host Rob Lawrence talks to the people who actually took the concept into the air. Quinn Reece, a North Carolina paramedic with a background in emergency management, austere medicine and technical rescue, became the first pilot-paramedic to fly the Pivotal BlackFly on a 911 response in Hyde County. On both of the operational calls she flew, Reese arrived and began providing ALS care approximately 20 minutes before the responding ground ambulance. Joining Quinn is James Robinson, an experienced North Carolina paramedic who served as ground support and supporting pilot for the project. Together, they take Rob behind the scenes of the proof of concept: intensive simulator training, emergency procedures, actually flying a single-seat eVTOL, operational control, weather and range calculations, landing close to patients, carrying a 38-pound ALS package, and using a Cybertruck as a mobile charging platform. They also tackle the inevitable criticism around new technology and explain why the project was never about replacing the ambulance. It was about finding another way to put a skilled clinician beside a patient sooner when geography, water, distance and limited resources make conventional response difficult. Memorable quotes “The pilot is 100% flying the aircraft.” — James Robinson “I did run the first two calls to provide ALS care on scene 20 minutes before an ambulance on both times.” — Quinn Reece “For you to first time sit back in it, you feel like almost an astronaut being projected up.” — Quinn Reece “That patient had no idea how I got there. They weren’t looking outside to see what I arrived in. They were just happy that care was there in an appropriate amount of time to help them for what they needed.” — Quinn Reece “To have them [my sons] actually see the aircraft for the first time and watch their mom fly was actually really inspirational for me.” — Quinn Reece “You don’t have a copilot sitting there that can bail you out.” — James Robinson “This is just another tool in the toolbox that allows you to pop straight up in the air, fly over the top of all that water that would otherwise be an obstacle.” — James Robinson Episode timeline 00:26 ­– Rob introduces the second chapter of the Hyde County story and reflects on the leadership, determination and regulatory work required to move the concept from idea to actual flight. 02:04 – Meet Quinn Reese and James Robinson. 02:32 – Quinn explains her background in paramedicine, emergency management, technical rescue and austere environments, and why that experience helped prepare her to operate as a sole provider ahead of the ambulance. 03:27 – James introduces himself and describes almost 30 years in emergency services and his role providing ground support for the Hyde County project. 04:41 – Quinn recalls receiving the initial phone call in December 2025 asking whether she would consider joining the project. 06:13 – Quinn admits to some nerves as a North Carolina paramedic suddenly surrounded by engineers and PhD students — before telling them she was there to fly the aircraft operationally. 07:22 – Inside the simulator: VR goggles, moving seat, sound, wind and realistic flight environments. 08:30 – Two days of intensive simulator work including check rides, GPS and radar failures, parachute deployment, wind management, and transitioning between hover and cruise modes. 09:16 – James explains why simulator training and muscle memory are so critical in a single-seat aircraft where there is no copilot sitting beside you. 10:53 – Who is actually flying? James makes it clear: the pilot is controlling the aircraft, while built-in systems help prevent unsafe maneuvers. 12:43 – Quinn explains what happens when the controls are released in cruise and hover modes. 13:09 – The ballistic parachute: how an emergency parachute can lower the entire aircraft. 14:31 – Quinn remembers her first real flight over Monterey Bay. 15:06 – “You feel like almost an astronaut being projected up.” Quinn describes the sensation and power of the aircraft on initial vertical takeoff. 17:02 – Navigating the operational missions using both the aircraft display and SARTopo/CalTopo to plot call locations. 18:00 – James emphasizes that this was a prototype and a proof of concept designed in part to identify exactly these operational issues. 19:34 – Moving the aircraft: the BlackFly breaks into three major sections and fits into a 16-foot trailer. 20:08 – Range and weather: Quinn explains the roughly 20-nautical-mile operating capability and how wind changed the practical mission radius. 21:29 – The unusual support vehicle: a Cybertruck capable of charging the BlackFly repeatedly in the field. 25:34 – The first 911 call arrives while Quinn is already conducting a proficiency flight. She hears the dispatch over the radio, lands, plots the call, checks the weather and operational parameters, and launches toward the patient. 27:42 – Quinn arrives at the patient — and nobody initially understands how the paramedic got there. 28:43 – One of the less glamorous first-flight lessons: getting the medical bag out of the aircraft proves harder than expected, leading to changes before the second mission. 29:12 – Quinn begins patient care and explains that, from the patient’s perspective, the method of arrival was irrelevant: they were simply pleased that help had arrived. 29:40 – Meanwhile James and the ground team arrive, recharge the aircraft and prepare it for departure while neighbors slowly realize there is an aircraft sitting in the yard. 31:07 – From pilot Quinn to paramedic Quinn: what medical equipment did she carry? 32:48 – Public reaction evolves from skepticism and raised eyebrows to families bringing their children to see the aircraft and learn about the program. 33:23 – Rob addresses the skeptics: Is this just an expensive gimmick with limited range? 33:53 – James makes the clinical case: in rural areas where conventional 10-minute response simply is not realistic, an eVTOL is another way to overcome geography and put ALS care beside the patient sooner. 36:34 – What happens next? Quinn and James describe taking the aircraft to emergency management and aviation events to demonstrate the concept and educate other agencies. 38:15 – Other possible missions: moving critical medications across flooded areas, search and rescue, disaster assessment and other emergency-management applications. 39:07 – Quinn discusses the evolution from the BlackFly toward Pivotal’s newer Helix platform, with greater range, payload and capability. 40:13 – Will Quinn fly operational EMS missions again? She hopes so, with growing interest from other agencies exploring the concept. 44:35 – A personal moment: Quinn describes bringing her two young sons to Hyde County and watching them see their mother fly the aircraft. 44:53 – Rob closes the two-part Hyde County story, reflecting on the enthusiasm, belief and determination of everyone involved. Enjoying the show? Email editor@ems1.com to share feedback.

  2. Oct 16

    Weather whiplash — preparing EMS for stronger storms

    Weather is no longer simply something EMS and public safety agencies can react to when it arrives. In this episode of EMS One-Stop, Rob Lawrence is joined by meteorologist and emergency management specialist Sunny Wescott to examine what she describes as “weather whiplash” — rapidly changing conditions, stronger storms, heavier rainfall, coastal erosion, flooding, drought and infrastructure failures occurring with increasing intensity and sometimes in places where responders have not traditionally expected them. | WEBINAR: Ready before the call — Building a stronger fire and EMS preparedness strategy Sunny explains why understanding global weather patterns matters locally, and why storms developing thousands of miles away can provide valuable early warning for emergency managers in the United States. The discussion moves from the global weather picture to the West Coast, El Niño, coastal erosion, Lake Mead and the Colorado River, before looking east toward the remainder of hurricane season. More importantly, Sunny translates the science into practical advice for first responders: Study international disasters Anticipate public behavior Identify critical infrastructure before it fails Use recent after-action reviews to improve the next response Plan not only for the emergency itself, but for the much longer recovery period that follows Along the way, there is also the extraordinary example of a flooded snake farm in China that released 900 king cobras into floodwaters — a reminder that disasters frequently create secondary hazards no emergency plan anticipated. Key quotes “None of these weather events are new, but they’re entering into areas where they don’t typically go or haven’t gone before.” — Sunny Wescott “If you look out of your windows, you can see there’s this thing called weather going on.” — Rob Lawrence “If we’re not paying attention to Russia, Asia, India, then we’re going to be surprised when these weather events get into the Pacific and approach our coastline.” — Sunny Wescott “I’m a Brit. I’m professionally trained to talk and moan about the weather, so I might as well do it on One-Stop.” — Rob Lawrence “The problem is we weren’t prepared for the intensity of the last decade, and that’s led us into a place of complacency, kicking the can down the road.” — Sunny Wescott “If you just did your after-action review from the last weather system, you have a real opportunity to make those corrections and to get it right even as soon as next week.” — Rob Lawrence About our guest Sunny Wescott is a federal emergency response official chief meteorologist with the Department of Homeland Security (DHS) specializing in national extreme weather hazards and climatological studies for impacts to public and private sector key resources; and deputy project manager for the National Hurricane Program (FEMA). Episode timeline 00:31 — Rob introduces the episode and welcomes Sunny Wescott back to EMS One-Stop. 01:42 — Sunny’s background: from U.S. Air Force meteorology to critical infrastructure, homeland security, FEMA’s National Hurricane Program and geospatial intelligence. 03:26 — The global weather picture and why traditional weather patterns are becoming less reliable. 05:53 — Why U.S. emergency managers should pay attention to weather in Russia, Asia and Europe. 06:10 — The jet stream, wildfire smoke and the “carousel of weather” moving systems around the globe. 07:24 — How overseas weather events can offer advance warning of the intensity of systems later approaching North America. 09:29 — Sunny explains Kelvin waves, warmer coastal water, king tides and why California’s coastal flooding risk continues to increase. 11:25 — Emergency managers are being forced into a cycle of continually trying to catch up with increasingly damaging events. 13:03 — Sunny predicts continued worsening of coastal erosion and discusses wider infrastructure impacts — sinkholes, water mains and groundwater depletion: how underground infrastructure may become another increasingly important response issue. 15:00 — Why heavy rain does not necessarily solve the water crisis affecting Lake Mead and the Colorado River. 15:09 — Intense rainfall can fall too rapidly for soil, vegetation and drainage systems to absorb it effectively. 16:20 — Evaporation, human water use and warming water further complicate reservoir forecasts. 17:07 — The coming political and resource challenge: deciding who gets scarce Colorado River water. 18:41 — Rob and Sunny return and shift attention to the Atlantic and the remainder of hurricane season. 19:28 — Sunny explains Saharan dust, wildfire smoke and the environmental factors that influence tropical cyclone development. 20:22 — Late-season concern turns toward the Caribbean and Gulf. 21:44 — Sunny’s first recommendation: follow international disasters and learn how both responders and the public behaved. 22:12 — Preparing for public distrust, misinformation and hostility during emergencies. 22:45 — Using overseas infrastructure failures as scenario planning: bridges, roads, supply routes and rescue access. 23:07 — The 900 king cobras example and the importance of anticipating unexpected secondary hazards. 24:36 — A near-real-time look at the forecast for the following week. Sunny warns that a significant West Coast system may catch people off guard because it lacks a dramatic label such as “hurricane” or “atmospheric river.” 25:14 — A developing system is expected to track down the West Coast, bringing waves of wind and precipitation. 26:03 — “Now’s your time to shine.” Agencies that have just completed after-action reviews have an immediate opportunity to make improvements. 26:20 — Rob reinforces the value of turning recent lessons learned into operational changes before the next event. 27:35 — Rob’s closing takeaway: first responders should think beyond immediate response and plan equally seriously for recovery. Enjoying the show? Email editor@ems1.com to share feedback.

  3. Sep 25

    EMS One-Stop: First in flight, first on scene

    North Carolina has always been proud of being first in flight. More than 120 years after the Wright brothers took to the air at Kitty Hawk, a small rural EMS system in the eastern part of the state is once again asking what flight might mean for the future. In this episode of EMS One-Stop, Rob Lawrence heads to Hyde County, North Carolina, where EMS leaders have become the first in the nation to operationally deploy an electric vertical takeoff and landing — eVTOL — aircraft to get a paramedic rapidly to a 911 call. Rob is joined by Hyde County EMS Chief Brooke Cox; Todd Baker, director of education and clinical services with Code Blue Resources and a captain with Hyde County EMS; and Carla Baker, owner of Code Blue Resources. They explain how a geographically challenging rural county moved from an ambitious idea to an operational proof of concept; working through state EMS regulation, the FAA, aviation safety, clinical requirements, pilot training and more than 1,000 training missions. They also describe the moment a paramedic reached a remote patient about 20 minutes ahead of the responding ambulance, what the project has taught them, and why this is not about replacing ambulances or helicopters. It is about finding another tool to overcome the challenge of time and distance — and proving that even a small rural EMS system can do very big things. | MORE: N.C. county EMS is first in nation to deploy eVTOL aircraft on 911 calls Key quotes “We’re here for the patient. We’re here for the community. We’re here to make a difference nationally; not just in our little pond.” — Brooke Cox “Let’s look at what we can do to make it work and overcome challenges.” — Todd Baker “Why has somebody not done this before?” — Carla Baker “Come visit Hyde County. We are a small, small county, but we’re doing big things and we have a heart for community.” — Brooke Cox “Let’s utilize the technology, the innovation that’s out there and see if it works, and if it doesn’t, it doesn’t.” — Todd Baker “This was never meant to replace an ambulance. It’s not meant to replace a helicopter, a medical air helicopter.” — Carla Baker “It is to figure out if this particular asset will help you overcome obstacles in various response areas. And that’s what it’s about.” — Carla Baker Additional resources Code Blue Resources Akute OS Pivotal Episode timeline 00:36 – Rob introduces EMS One-Stop and the extraordinary concept of flying a paramedic to a 911 call aboard an eVTOL aircraft — meet the guests: Hyde County EMS Chief Brooke Cox, Captain Todd Baker and Carla Baker of Code Blue Resources 02:38 – Understanding Hyde County: rural geography, marshland, water, Ocracoke Island and the challenge of accessing timely EMS and air-medical resources 04:31 – Brooke describes moving from a resource-rich EMS environment to one where a critically ill patient could wait almost 3 hours for a helicopter 06:01 – The eVTOL concept: essentially a large electric vertical takeoff and landing aircraft capable of carrying a paramedic 07:14 – Carla explains Code Blue Resources and how conversations about bringing the technology into EMS began 09:34 – Todd traces the project back to December 2024 and the effort to turn the concept into an operational reality 09:59 – The first regulatory hurdle: determining how North Carolina’s Office of EMS would classify the aircraft and what equipment it would need to carry 11:22 – Brooke describes being a dreamer, becoming a trailblazer and the unforgettable moment the aircraft first launched 13:37 – Inside the aircraft: battery power, operational range, controls, safety systems and even an emergency parachute 16:29 – Working with the North Carolina Office of EMS and finding a regulatory pathway for something nobody had previously attempted 18:34 – Building the clinical package around providing what a paramedic might need during the first 15 minutes of an EMS call 20:26 – Taking the project to the FAA and learning how EMS and aviation had to develop a common language around risk and life safety 22:34 – Selecting the paramedics: why clinical judgment, aviation awareness and experience mattered more than simply putting out a job advertisement 23:43 – Meet Quinn Reese, the paramedic who flew the first operational mission 24:16 – Preparing clinicians for the aircraft and ensuring they were fully credentialed within Hyde County’s EMS system 26:33 – Brooke goes to California to train: VR simulation, repetitive skills development, fatigue management and progressing to proficiency 29:14 – Who actually flies it? Brooke explains the dual joystick controls and the authority of the paramedic operating the aircraft 30:03 – How Hyde County positioned the aircraft and used call location, range, weather and operational parameters to determine whether a mission was viable 31:51 – Todd tackles some of the misinformation surrounding the program and explains the multiple layers of operational and pilot decision-making 33:31 – More than 1,000 training missions during the proof-of-concept period 33:53 – The operational call that demonstrated the potential: a paramedic finds a remote patient and arrives approximately 20 minutes ahead of the ambulance 36:17 – The reaction after a successful mission and the satisfaction of seeing months of planning and training translate into patient care 37:33 – Lessons learned: leadership support, educating decision-makers, having a clear mission and understanding the strengths of the team 39:34 – Todd explains the culture of asking, “How can we make this happen?” rather than immediately looking for reasons why it cannot 41:51 – The wider Hyde County team: how law enforcement and EMS routinely work together in a resource-limited rural environment 43:16 – The proof of concept has ended — for now — as Hyde County looks toward the next generation of longer-range eVTOL technology 44:49 – “This is just the tip of the iceberg:” Brooke explains why Hyde County is not finished with the concept 45:21 – Carla discusses interest from other organizations and manufacturers and what has been learned about building a comprehensive eVTOL EMS program 47:09 – Brooke’s message from Hyde County: a small county doing big things and trying to put community back at the center of EMS innovation 47:36 – Todd on the need to think beyond the traditional model of simply placing two people in an ambulance and sending them toward every call 49:54 – Rob closes: North Carolina is first in flight once again — and the team in Hyde County has shown it has the right stuff Enjoying the show? 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  4. Sep 18

    From combat medic to physician: Meet the 2026 NAEMT Paramedic of the Year

    In this episode of EMS One-Stop, host Rob Lawrence sits down with Oscar Monterrosa, the 2026 NAEMT Paramedic of the Year, whose career has taken him from Army combat medic to street paramedic, medical student and now an emergency medicine-internal medicine resident at Hennepin County Medical Center. Yet despite the white coat and demands of residency, Monterrosa continues to work on the ambulance, including in rural Minnesota, and remains closely connected to the profession that shaped his approach to medicine. The conversation also returns to one of the defining moments of Monterrosa’s career: the Oct. 1, 2017, mass shooting in Las Vegas. Working an overtime special-event shift, Monterrosa was already inside the medical tent when gunfire began and casualties started arriving. He describes slipping into “work mode,” drawing on his experience as an Army combat medic in Iraq as he and others triaged and treated patients while the shooting was still underway. Beyond that extraordinary night, the discussion explores rural EMS, critical care and ECMO, education, mentorship and the long road from paramedic to physician. Monterrosa’s message to other EMS clinicians considering further education is straightforward: the road may be difficult and it may take longer than expected, but it is possible. Key quotes from Oscar Monterrosa “We have that critical call or whatever, somebody that's crashing right in front of you and you just kind of get into work mode.” “Even though there's still gunfire going on, you try to be as safe as you can and take cover, but ultimately all that is really out of your control.” “A lot of these experiences in the cornfields has been very rewarding, just seeing this different culture, like meeting a lot of different people.” “It just takes hard work and just not giving up.” “I was an undergrad for 9 years because I was working full time on the streets.” Additional resources National Association of Emergency Medical Technicians (NAEMT) NAEMT National EMS Awards of Excellence Hennepin Healthcare Las Vegas Metropolitan Police Department: October 1 / Las Vegas mass shooting – After-Action Report Episode timeline 00:52 – Rob introduces the 2026 NAEMT Paramedic of the Year 01:34 – Oscar 101: paramedic and emergency medicine-internal medicine resident 02:05 – Oscar hears what his colleagues wrote about him in his award nomination 04:04 – His reaction to being named National Paramedic of the Year 05:00 – The journey into EMS, military medicine and becoming a paramedic 07:20 – From the desert Southwest to rural Minnesota EMS 09:00 – The realities of rural 911 response and long interfacility transports 10:15 – Critical access hospitals and managing high-acuity patients 12:30 – The conversation turns to October 1, 2017, in Las Vegas 13:17 – What began as a routine special-event EMS shift 13:55 – Reports of gunfire and the first shooting victims reaching the medical tent 14:24 – What happens mentally when a mass-casualty incident suddenly unfolds 15:00 – Combat medic training, triage and functioning while gunfire continues 17:00 – Reflections on the Las Vegas response and its lasting impact 18:00 – From paramedic to physician: why Oscar continued his education 19:30 – Rural critical care, cardiac arrest and mobile ECMO 21:00 – Remaining connected to EMS while completing medical residency 23:00 – Advice for paramedics considering college or medical school 23:42 – Nine years as an undergraduate while working full time on the streets 24:00 – Perseverance, education and why the path is still achievable Closing – Looking ahead, mentorship and what being NAEMT Paramedic of the Year means to Oscar Enjoying the show? Email editor@ems1.com to share feedback.

  5. Sep 10

    What ‘never forget’ means 25 years later

    FDNY Chief of Department John Esposito recounts FDNY’s devastating losses, the decisions that saved thousands of lives and why honoring 9/11 means preparing the next generation to meet the moment Twenty-five years after Sept. 11, 2001, FDNY Chief of Department John Esposito joins podcast hosts Jim Dudley, Rob Lawrence and Aaron Zamzow of Police1’s Policing Matters, EMS1's EMS One-Stop and FireRescue1’s Better Every Shift for a deeply personal conversation about 9/11, its enduring impact and the lessons that continue to shape fire, EMS and law enforcement. Esposito was a newly promoted FDNY lieutenant on Sept. 11, 2001. He recalls returning to the city after the towers fell, the collapse of command and communications, the desperate effort to account for missing members, and the realization that FDNY had suffered unimaginable losses. The discussion moves beyond remembrance to examine what emergency services learned: stronger accountability, controlling self-deployment, incident management teams, interoperable communications, interagency cooperation, intelligence sharing and peer support. Esposito also reflects on the continuing toll of World Trade Center-related illness and explains why “never forget” must mean more than remembering 343 names. For him, it means remembering the decisions responders made, the conditions they faced and the thousands of lives their actions helped save. His challenge to today’s generation is simple: know your job, keep learning, take care of your people and ask whether you are prepared to “measure up” to those who came before. Key quotes from FDNY Chief of Department John Esposito “Never forget is not just their names and who they were, how they lived their lives, and most importantly, the decisions that they made that day and the actions that they took.” “They're like, ‘No, we think we lost everybody.’ And that was when it started to sink in that no, this is gonna be as bad as it could be.” “If we never showed up and we had no losses that day, the loss of civilians is in the tens of thousands.” “This is your legacy. This is our legacy, this is what we do, and these are the people that did this before us.” “I believe that some of them knew that they were not going to make it home that night. And they still did their job.” “September twelfth came, the doors of the firehouse went up, people got on fire trucks, and they went out and did their job.” “It was like an all-star team that we lost. Some of the best people to ever do this job we lost that day.” “I see my job here and our job in this building and headquarters is to take care of the people that take care of the city.” “We have no idea. We're in a firehouse or an ambulance one second and in five minutes we could be in the worst situation we've ever been in.” “It's our job to make sure that the people in the field are prepared and when they need something, it's our job to get it for them.” Episode timeline 00:27 – Introduction: EMS1, FireRescue1 and Police1 come together to reflect on 25 years since September 11 02:28 – Introduction: FDNY Chief of Department John Esposito 03:23 – Chief Esposito recalls Sept. 11, 2001 as a newly promoted lieutenant with a day off and plans to study for the captain’s exam 04:28 – Chief Esposito details arriving in lower Manhattan and finding command structures and communications devastated 05:04 – The desperate process of identifying who was alive, missing or lost 07:00 – Chief Esposito describes his initial response and why he never imagined the towers could collapse 09:00 – “We think we lost everybody.” When the magnitude of FDNY's losses began to become clear 09:30 – Accountability and self-deployment emerge as major lessons from 9/11 10:00 – How FDNY now wants off-duty members to report to firehouses and EMS stations rather than directly to an incident 10:30 – Modern digital accountability, riding lists and identifiable radio transmissions compared with 2001's paper systems 12:00 – The human factor: firefighters desperate to get aboard apparatus headed toward the World Trade Center 12:30 – Leadership decisions that removed extra firefighters from overloaded apparatus ultimately saved lives 14:00 – The continuing human toll: FDNY's memorial walls and deaths from World Trade Center-related illness 16:30 – How FDNY will commemorate the 25th anniversary 17:30 – Why September 11 remembrance is intensely personal for individual firefighters and families 21:00 – Chief Esposito discusses the emotional effect September 11 continues to have on him 22:00 – “Never forget” means remembering actions and decisions, not merely names 24:00 – The actions of responders helped prevent civilian deaths potentially reaching into the tens of thousands 25:00 – Managing the overwhelming desire of responders to help during catastrophic incidents 27:30 – How outside incident management teams helped FDNY solve problems after 9/11 28:30 – FDNY repaying the assistance it received through deployments around the United States 30:00 – How today's incident command and dispatch systems control resources and prevent uncontrolled response 31:42 – Sponsor message 32:30 – Improved interagency collaboration between FDNY, NYPD and other agencies 36:00 – Peer support, firehouse culture and challenging the stereotype that firefighters do not talk about emotional distress 38:30 – How FDNY's peer-support system works after difficult incidents 42:30 – September 11 demonstrated why the fire service needs to be part of the intelligence community 44:00 – FDNY members are trained to recognize suspicious activity during routine fire and EMS responses 46:00 – How information spotted by firefighters may become the missing piece in a larger investigation 48:30 – What Chief Esposito wants responders who were not alive on 9/11 to understand 49:00 – “This is our legacy.” Measuring today's performance against those who came before 52:00 – Know your job and do your job — while recognizing that not every emergency fits an SOP 52:30 – A recent Bronx explosion illustrates the need to adapt principles to situations for which no exact procedure exists 53:30 – Applying the overarching principles of life safety and rescue when the situation is unprecedented 54:30 – What does “never forget” mean 25 years later? 55:30 – September 12: despite catastrophic losses, FDNY opened its firehouses and continued protecting New York City 56:30 – Chief Esposito describes those killed as “an all-star team” and some of the best ever to do the job 58:00 – Aaron Zamzow reflects on the responsibility to “measure up” 59:30 – The nationwide impact of 9/11 and seeing FDNY remembered on apparatus thousands of miles from New York 1:01:30 – Jim Dudley reflects on intelligence, prevention and acting on warning signs 1:03:30 – Chief Esposito discusses the difficulty of measuring successful prevention 1:05:00 – Warning signs, intelligence and lessons shared with other historic disasters 1:06:00 – Rob Lawrence reflects on September 12 and the emergency services reality that tomorrow brings another shift 1:07:00 – “At the going down of the sun and in the morning, we will remember.” 1:08:00 – Esposito discusses how 9/11 affected his career and leadership journey 1:09:00 – Leadership, doing the right thing and measuring decisions against the memory of colleagues lost 1:10:00 – “Take care of the people that take care of the city.” 1:11:30 – Emergency responders never know when the next call will become the worst situation they have ever faced 1:12:00 – The responsibility to ensure frontline personnel are prepared and supported 1:12:30 – Closing message: “Keep learning and keep moving forward.” About our sponsor This crossover episode of the Policing Matters, Better Every Shift and EMS One-Stop podcasts is sponsored by FirstNet — the only wireless network built with and for first responders. Twenty-five years ago, first responders faced an emergency unlike any other. They stepped forward to protect and care for others, demonstrating extraordinary courage and resolve. This September 11th, we remember and honor those who answered the call. The example they set endures through the values that continue to inspire the profession today. Learn more about FirstNet, Built with AT&T, at www.firstnet.com. 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.

  6. Sep 4

    Data versus Darwin with Todd Stout

    AI may feel like the newest revolution in EMS, but the industry's relationship with data has been evolving for decades. In this episode of EMS One-Stop, Rob Lawrence sits down with FirstWatch founder Todd Stout, whose 28 years working with EMS data gives him a particularly long view of where the industry has been and where it is heading. Todd traces the journey from an era when monthly reports printed on green-bar paper were considered normal, to today's world of real-time dashboards, cloud-based systems and enormous volumes of operational and clinical information. The challenge has changed: EMS no longer suffers primarily from a lack of data; leaders now need technology that can identify what matters, separate signal from noise and turn information into decisions. That makes AI extraordinarily promising — and potentially dangerous. Todd explains why he is more excited about the next 3-5 years than at any point in his career, while simultaneously being more concerned about the next 8-10 months. Rob and Todd discuss unreliable AI outputs, data security, HIPAA and privacy, the risks associated with startups and what EMS leaders should ask before entrusting vendors with organizational or patient data. They also examine the urgent need for EMS agencies to establish AI policies and train their workforce on responsible use. Todd concludes with a preview of FirstWatch's next generation of AI-enabled tools and a broader message for EMS leaders: the organizations that thrive through this technology shift will not necessarily be those with the newest technology, but those capable of adapting, learning and using it responsibly. Additional resources: EMS1 Leadership Institute: 2026 Spotlight on AI in EMS: On-demand: Smart tools, strategic choices: EMS puts AI into action Why EMS must measure the human side of care: What patients remember No rulebook is coming: EMS must take control of AI now: Why EMS must govern AI locally as adoption accelerates Hyper-turbulent times: EMS economics and AI guardrails with Matt Zavadsky and Dr. Shannon Gollnick: Why EMS needs AI guardrails and Medicare reform today Memorable quotes "I'm more excited about the next 3-5 years than I've ever been, I am also more scared about the next 8-10 months for our industry than I've ever been because it's so messy." — Todd Stout "Nobody gets into EMS to be excellent data enterers." — Todd Stout "AI well formed — with the proper bumpers, guidelines, rules around it — is astonishingly good at processing through lots of data." — Todd Stout "If you're not paying for the thing that you're using, you are the product." — Todd Stout "AI to many people seems like magic. And it's the opposite of magic almost. It's a lot of work and plumbing to get it right." — Todd Stout Episode timeline 00:27 – Rob introduces the episode and the evolution of EMS data, information and AI 01:54 – Twenty-eight years of FirstWatch: from Stout Solutions to today's real-time data environment 03:57 – Looking back at EMS's early adoption of real-time operational data 05:18 – Why immediate data can improve individual performance and expose problems with systems and protocols 06:24 – The "ah, buts:" gut instinct versus what the data actually shows 07:19 – Dirty data, disconnected systems and why organizations sometimes don't believe their own numbers 09:45 – EMS has moved from too little information to information overload 10:31 – How AI can sift through enormous amounts of data and identify what leaders actually need to know 11:22 – The accuracy problem: AI can produce impressive outputs while struggling with surprisingly basic tasks 12:39 – Todd explains why he is simultaneously excited and concerned about the immediate future of AI in EMS 14:35 – How EMS leaders can become better, more discerning customers of AI technology 15:10 – Established technology partners versus innovative AI startups 17:00 – What happens to your organization's data if an AI vendor fails or goes out of business? 17:41 – HIPAA, privacy, cybersecurity and employee data obligations 18:11 – Sponsor break 19:26 – Part two: protecting patient and organizational information when using AI 20:18 – AI training models, data sharing and why leaders need to understand vendors' default settings 22:44 – The pace of change: today's AI expertise can become outdated within weeks 23:08 – Preparing for the wave of "AI everything" appearing in EMS exhibit halls 23:45 – Questions EMS leaders should ask prospective AI vendors 25:20 – Why AI isn't magic — and why implementation requires significant work behind the scenes 27:08 – The case for every EMS organization having an AI policy now 27:41 – Todd warns that employees are almost certainly already using AI, sometimes without understanding the privacy implications 28:21 – Why AI education should resemble cybersecurity education: policy, training, suspicion and continual reinforcement 30:13 – Preview of FirstWatch Collaborate and the company's next generation of technology 31:02 – FirstWatch 2.0, AI-enabled mobile tools and workload management 31:55 – Reflect: incorporating patient satisfaction alongside operational and clinical performance 33:34 – Why rapid patient feedback can be more meaningful to crews than retrospective monthly scores 35:19 – Todd's closing message: EMS is good at adapting and improvising, and technology can make the job easier 36:22 – Rob's takeaway: adapt, innovate, become a discerning AI customer and establish an organizational AI policy Enjoying the show? 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  7. Sep 1

    Liz Harney on the human side of EMS

    This week on EMS One-Stop, I sit down with Liz Harney, almost a year after I first walked into a classroom at EMS World Expo looking for another session to report on and found what I later described as “the keynote I didn’t know I needed.” Liz’s presentation was built around a part of EMS education we routinely acknowledge but rarely give equal billing: the affective domain — empathy, communication, professionalism, self-awareness and the ability to connect with another human being in what may be the worst moment of their life. But the real power came from Liz herself. Before she was a paramedic, educator and EMS leader, she was the patient. At the lowest point of a decade-long struggle with addiction, one paramedic looked beyond the overdose, the circumstances and the judgement, and treated her as a person who still mattered. Liz credits that interaction not simply with helping save her clinically, but with changing the trajectory of her life. She recovered, entered EMS and ultimately became the kind of paramedic she had encountered that day. It is a remarkable journey from patient to paramedic, and in this conversation, Liz explains why that experience now sits at the heart of everything she teaches about the human side of EMS. | MORE: Liz Harney — the affective domain is the heart of EMS, so why aren’t we teaching it? Our discussion also catches up with where Liz’s thinking has evolved since. In her recent EMS1 article, “Shiny Happy People,” she takes that same belief in people and applies it to EMS leadership, challenging professionals that is exceptionally good at identifying everything that might go wrong not to let that instinct extinguish every new idea before it gets moving. Together, we connect those themes: the provider who changed one patient’s life, the importance of deliberately teaching the affective domain, turning cynics into champions, recognizing burnout through QA and QI, and creating leadership teams with enough optimism and emotional intelligence (EI) to make change happen. At a time when EMS is increasingly consumed by another form of intelligence (AI), the conversation comes back to a proposition I think matters more and more: if we are going to get good at AI, we first need to get much better at EI. Additional resources: Liz Harney: Shiny happy people. The leadership power of optimism Rob Lawrence: The affective domain is the heart of EMS — so why aren’t we teaching it? Inside EMS: Tactical empathy: The leadership tool you’re not using enough Colby Davis: Can emotional intelligence be taught? Shannon L. Gollnick: The paradox of progress — emotional intelligence as the differentiator in an AI-augmented workforce Key quotes “It truly was a paramedic that not only saved me in a clinical sense, but she saved me in a human sense.” — Liz Harney “Everybody has a story and they’re all a little the same, but they’re all very different at the same time.” — Liz Harney “It’s our role as educators and program directors to be able to ensure that we are instilling, improving the affective domain, just as we are the cognitive and the psychomotor.” — Liz Harney “You created from the cynic, turned them into the champion, and then the champion then took that back to their own service.” — Rob Lawrence “I am the dreamer, probably because I have forged myself out of the depths of hell.” — Liz Harney “Look at me, anything is possible. Like there is never a ‘no’ in my language.” — Liz Harney “In order to build, in order to make change, in order to move the needle, you have to have folks that are strong in EI to make that happen.” — Liz Harney “There’s always room for improvement.” — Liz Harney “I may not be able to teach everyone to care, but I absolutely think you can teach people what caring looks like in practice.” — Liz Harney “No one’s ever complained about the gauge of needle that we used, but they’ve certainly complained that the medic was mean.” — Rob Lawrence “People underestimate the power of storytelling, but I’m here to tell you that is what creates the change into someone, that changes their perspective.” — Liz Harney Episode timeline 00:00 — Harney on surviving addiction, being written off and the potential EMS providers have to influence another person’s future 01:02 — Rob welcomes listeners to EMS One-Stop and introduces Liz Harney 02:14 — How Rob first encountered Harney at EMS World Expo and why he describes her presentation as “the keynote I didn’t know I needed” 02:40 — Liz Harney 101: critical care paramedicine, organizational leadership, Baptist Health, Kentucky EMS workforce initiatives and Paramedic Pathways 04:10 — Harney reflects on the rapid growth of her speaking platform and why sharing her story remains difficult but necessary 05:32 — The human side of EMS: affect, emotional intelligence and why clinical competence alone is not enough 08:10 — AI versus EI: why Lawrence argues that increasingly intelligent technology makes human emotional intelligence even more important 09:00 — From patient to paramedic: Harney recounts the interaction with the paramedic who changed the direction of her life 18:33 — Revealing her past to colleagues and students, and how that story changes attitudes toward people experiencing addiction 22:08 — Why simply telling EMS students to care does not work — and how Harney began using clinical rotations and direct patient interaction to build the affective domain 23:18 — “Everybody has a story:” students hear directly from people in addiction recovery 25:23 — The cynic-to-champion story: a student’s dismissive attitude toward patients with addiction is transformed through one clinical rotation 31:00 — Educating not simply for cognitive and psychomotor competence, but for the clinician the student is becoming 32:15 — Harney moves from education into leadership and begins seeing the same issues around decision-making tables 33:19 — The case for optimism: Harney describes herself as a dreamer and explains how persistent negativity can kill innovation 34:04 — Lawrence’s rule: “If we do what we always did, we’ll get what we always got” 36:27 — Why potential barriers matter — but introducing every possible objection too early can destroy an idea before it develops 38:02 — “Shiny, happy people:” the discussion turns to Harney’s article on optimism, innovation and assembling teams capable of making change 39:02 — Harney describes Kentucky’s EMS workforce committee and what happened when a group of optimistic problem-solvers started building ideas without immediately saying “no” 41:00 — Choosing the right people for decision-making groups: why names, titles and tenure should not outweigh emotional intelligence 41:59 — Harney defines EI: self-awareness, self-regulation, communication and empathy 45:00 — “You can teach people what caring looks like in practice.” 45:15 — Lawrence asks whether EMS can genuinely change the affect and attitudes of a generation of clinicians 46:39 — Protecting the workforce: recognizing behavioral changes, cumulative exposure and the early warning signs of burnout 47:41 — QA/QI as more than clinical oversight: documentation can expose frustration and changes in provider behavior 48:07 — The leadership question: “What can I do for you?” 49:27 — The power of storytelling to challenge judgment and change perspectives 49:49 — Harney returns to her own experience: addiction, being cast off and ultimately demonstrating that recovery and transformation are possible 51:10 — Harney’s closing message: “You don’t have to understand someone’s life to understand your responsibility to them.” 52:41 — Turning QA/QI from a fault-finding function into a mechanism for recognizing providers, celebrating success and checking on people carrying heavy cognitive and emotional loads 54:10 — Lawrence recommends seeing Harney speak: “You will come away emotional but enlightened.” Enjoying the show? 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  8. Aug 21

    EMS One-Stop: The EMS research every clinician should be reading

    EMS research has grown rapidly, but finding the studies that truly matter to everyday clinical practice remains a challenge. In this edition of EMS One-Stop, Rob Lawrence is joined by Dr. Christopher Richards, EMS and emergency physician at the University of Cincinnati; and Dr. Christian Martin-Gill, chief of the Division of EMS at the University of Pittsburgh and former president of the Prehospital Guidelines Consortium, to discuss the recently published EMS research reading list and the effort to identify the most important evidence EMS clinicians and medical directors should know about. The discussion explores how the reading list was created; why a significant gap remains between publication and implementation; and how EMS can better translate research into education, protocols and patient care. Richards and Martin-Gill explain the mix of evidence-based guidelines, position statements, systematic reviews and original research included in the project, while highlighting major gaps in behavioral emergencies, pediatrics, obstetrics, workforce wellness and EMS operations. The message is clear: EMS practitioners should not wait for new research to appear in their protocols. They should read it, discuss it, question current practice and, where evidence is lacking, consider contributing to research that closes the gap. Additional resources: Richards CT, Cash RE, Crowe RP, et al. 2026. “Developing an emergency medical services research reading list for emergency medical services practitioners.” Prehospital Emergency Care, 1-6. https://doi.org/10.1080/10903127.2026.2693158 EMS1 Research Center. A central access point for critical research that can help drive operational and policy changes Understanding research and its impact on patient care. David Page, MS; Hezedean Smith, DM; and Ayanna Walker, MD, share best practices for evaluating and interpreting prehospital research  Key quotes “With EMS research, there's always something missing. There's always more that we can do.” — Dr. Christian Martin-Gill “What we're seeing here, particularly over the last decade, is these organizations working less as silos and moving more towards working together when it makes sense to do that.” — Dr. Christian Martin-Gill “We didn't go in actually feeling like we needed to identify 10 primary research or professional statements that complemented the guidelines that were already identified through the systematic review. But there was just a natural break point there.” — Dr. Christopher Richards “There are a number of position statements that are published by national and international organizations that are key scientific literature out there that people need to be paying attention to.” — Dr. Christian Martin-Gill “Still there is research lacking in what the EMS clinicians themselves experience as part of the workforce — safety on scene, wellness, these sort of questions.” — Dr. Christopher Richards “The behavioral emergency space I think is really important right now.” — Dr. Christian Martin-Gill Episode timeline 01:09 – Rob introduces the episode and welcomes Drs. Christopher Richards and Christian Martin-Gill 02:16 – Dr. Richards introduces his EMS, emergency medicine and research background 03:18 – Dr. Martin-Gill discusses his role at the University of Pittsburgh, UPMC and the Prehospital Guidelines Consortium 04:15 – Why does EMS need a dedicated research reading list? 07:11 – Where can EMS practitioners currently go to identify the research that really matters? 09:13 – Moving research into protocols, practice and clinical care 11:15 – Can the Prehospital Guidelines Consortium help align the many organizations producing EMS clinical guidance? 13:41 – Breaking down the different categories of publications on the reading list 14:47 – Evidence-based guidelines included in the broader reading list 15:49 – Position statements covering hemorrhage, restraint, air medical utilization and workforce issues 16:26 – Systematic reviews addressing airway management and prehospital evidence-based guidelines 16:51 – Four original research papers, including refractory VF, pain disparities, evidence integration and midazolam use 18:58 – How the research reading list was actually developed 19:32 – The open call for EMS research submissions 20:10 – The project is ongoing, with submissions continuing for the next iteration 20:42 – Expert panel review, scoring and the natural cutoff that produced the final 10 23:18 – What important EMS research is still missing? 24:37 – Gaps in airway, pediatric and behavioral emergency evidence 26:08 – Dr. Richards highlights workforce, safety, wellness and operational research gaps 28:18 – Which areas should future EMS researchers investigate? 28:31 – Martin-Gill highlights behavioral, obstetric and pediatric emergencies as priorities 30:12 – Richards explains how everyday frustrations in EMS can become important research questions 32:12 – Final thoughts on the paper and the breadth of the reading list 33:37 – Martin-Gill discusses access to research and why highlighting important publications matters 35:05 – Turning reading into discussion, protocol review and further research 35:58 – Rob closes with a challenge to read, question, discuss and contribute to EMS research Enjoying the show? 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Ratings & Reviews

5
out of 5
7 Ratings

About

Explore the forefront of EMS leadership with Rob Lawrence on the ”EMS One-Stop” Podcast. Tackling critical issues like staffing, service delivery and operational challenges, each episode delves into the latest in patient care enhancement, EMS technology advancements; and emerging trends like AI, telehealth, quality improvement and alternate destinations with industry experts. Rob Lawrence brings to the table his extensive expertise from decades of service spanning the American Ambulance Association, AIMHI, Richmond Ambulance Authority, Pro EMS, Prodigy EMS Education and the East Anglian Ambulance NHS Trust. Stay informed with the latest EMS industry news, organizational updates and inspiring agency success stories. Tune in to the ”EMS One-Stop” Podcast for a deep dive into the challenges and triumphs of EMS leadership in today’s dynamic prehospital care landscape.

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