Inside EMS

Inside EMS: Challenges and opportunities for EMS in 2024

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

The first episode of Inside EMS in 2024, hosted by Chris Cebollero and Kelly Grayson, offered valuable insights into what’s needed to overcome the challenges for EMTs, paramedics and EMS agencies in the year ahead.

Memorable quotes

• "We need to take charge and, and steer our profession, and generally we don't – as a profession, we tend to be reactive rather than proactive." — Kelly Grayson
• "We have to be worthy of [trust and respect]. And that's what we're trying to do here. So be better than the people you've seen." — Kelly Grayson
• "You don't let the people around you dictate your professionalism." — Chris Cebollero
• "Patient assessment is the most important skill a paramedic, EMT has." — Chris Cebollero

Key takeaways

• 2024 EMS Trend Survey. The hosts highlighted the importance of the What Paramedics Want in 2024 annual EMS trend survey focusing on recruitment, retention, safety, health, wellness, technology adaptation and career development.
• [Insert Promo module linking directly to the survey: https://www.surveymonkey.com/r/2024WPW-EMS1]
• Future of EMS system design. The podcast touched on the issues faced by volunteer and rural EMS agencies, emphasizing the need for innovative solutions and cooperation among various squads. The discussion focused on evolving EMS, particularly the potential shift from paramedic/EMT teams to dual EMT teams with paramedics in chase vehicles, to enhance the use of EMT capabilities.
• Advocating proactivity in EMS. Grayson stressed the importance of being proactive rather than reactive in shaping the EMS profession, especially in education and practice standards. Both cohosts underscored the importance of ongoing personal and professional development, advocating for a culture of continual learning and improvement in EMS.
• Enhancing education and professional standards. The conversation delved into the challenges of EMS education, particularly in teaching comprehensive patient assessment and encouraging paramedics to expect more of themselves. Grayson shared experiences from teaching paramedic classes, focusing on the need for instructors to balance high expectations with realistic goals for entry-level paramedics. The goal for 2024, as expressed by Grayson, is to produce a new wave of competent paramedics, challenging existing educational norms to improve overall EMS quality.
• Importance of patient assessment skills: The cohosts also emphasized the critical role of patient assessment in EMS, advocating for more thorough and continuous assessment throughout patient care.

Read more. Rapid Response: Scene safety trumps patient care but does not replace duty

The episode provided valuable insights into the current state and future directions of EMS, highlighting challenges and opportunities. These discussions are vital for EMTs and paramedics as they navigate their careers in 2024.

EMS1 is using generative AI to create some content that is edited and fact-checked by our editors.

Voluntary AEMT accreditation: A ’game-changer’ in EMS education

CoAEMSP’s Executive Director, George W. Hatch Jr., discusses the EMS accreditation journey

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

The Committee on Accreditation of Educational Programs for the Emergency Medical Services Professions (CoAEMSP) plans to launch a voluntary programmatic accreditation for Advanced Emergency Medical Technicians (AEMTs) by January.

In this episode of Inside EMS1, cohost Chris Cebollero sits down with George W. Hatch Jr., EdD, LP, EMT-P, FAEMS, CoAEMSP’s executive director, to discuss the program.

Top takeaways

• AEMT is not just an EMT with additional skills; it requires a broader skill set, including understanding pathophysiology and critical thinking.
• The decision to introduce voluntary accreditation for AEMT programs wasn't preplanned but came about due to discussions within the EMS community.
• This accreditation process is voluntary, and programs that choose not to pursue it can continue operating as they do currently.
• Accreditation will help standardize AEMT programs, improve pass rates on the national registry exam, and enhance the quality of EMS education.
• The process involves benchmarking programs against a set standard, and programs must satisfy sponsorship requirements.
• While there is no plan to extend this accreditation to EMT programs at the moment, it may be considered in the distant future if deemed necessary.
• Accreditation is part of the journey to elevate EMS to a profession and should be supported by those in the field.
• It's essential to stop complaining about the state of EMS education and start actively contributing to its improvement.

Memorable quotes

• "It's about a process of improvement, a continual process of improvement." — Dr. Hatch
• "EMS may or may not be the choice that a lot of people want to make. We have to make it attractive and say, this is what you have to do to be in our profession." — Dr. Hatch

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Complacency kills: A critical look at EMS incidents and policy in 2023

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

In this year's Inside EMS year-in-review episode, our cohosts, Chris Cebollero and Kelly Grayson, take a critical look at the major incidents that defined EMS in 2023. Together, they tackle:

Paramedics behaving badly

The episode begins with a focus on the troubling trend of subpar patient care and missteps. The hosts emphasize the importance of delivering compassionate and professional care on every call. They discuss the case in which EMS providers faced charges of first-degree murder after a patient died due to positional asphyxia, underscoring the need for accountability in the profession.

Violence against providers

Next, the hosts address the increasing incidents of violence against EMTs, including stabbings and assaults. They highlight the need for better safety measures and policies to protect EMS personnel.

Criminalization of medical errors

Shifting gears, the hosts delve into instances of medical errors, such as administering the wrong drug. They stress the critical importance of delivering high-quality patient care on every call, regardless of the nature of the complaint.

Focus on CPR

The discussion then turns to a dramatic moment in the NFL when Damar Hamlin went into cardiac arrest after a hit during a game. The hosts commend the quick response of athletic staff and paramedics, emphasizing the significance of well-executed resuscitation efforts.

The demise of ET3

Finally, Chris and Kelly address the unexpected premature end of the ET3 model, a pilot program aimed at improving EMS care and reimbursement. The hosts express disappointment in CMS's decision and question the rationale behind it.

In conclusion, this year-in-review podcast provides valuable insights into the challenges and triumphs of the EMS field in the past year. It highlights the need for accountability, safety measures and ongoing efforts to improve patient care and EMS policies.

Memorable quote:

"Every single call that we run has to be done with the utmost dedication, commitment, professionalism, as if it was the last or maybe even the first EMS call we've ever run. Complacency is what kills there."

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‘Keepers of the flame’: Reflecting on the role of preceptors

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

In this episode of Inside EMS, hosts Chris Cebollero and Kelly Grayson delve into the crucial role of preceptors in EMS training and the impact they have on shaping the future of the profession. They emphasize the significance of preceptors as the "keepers of the flame" who pass on traditions and knowledge to new generations of EMS providers.

Memorable quotes

• "Preceptors have a fundamental understanding of their role in shaping the future of the profession." — Kelly Grayson
• "Legacy. The keepers of the flame are not the instructors. They're not the officers. Officers come and go, but the preceptors are the keepers of the flame and pass on the traditions." — Kelly Grayson
• "Preceptors are probably the most important component of EMS education." — Kelly Grayson

The hosts discuss the challenges and responsibilities of being a preceptor, emphasizing the need for preceptors to understand their role in shaping the future of EMS. They also touch on the importance of legacy and how preceptors play a pivotal role in maintaining and passing down the profession's traditions.

Grayson underscores the value of preceptors, highlighting that they are the individuals who can guide and mentor new EMS providers, ultimately affecting the lives of countless patients. He emphasizes the importance of recognizing preceptors as vital contributors to EMS education.

Listen to next: ‘You don’t know everything there is to know about EMS’

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Transforming EMS leadership: Beyond buzzwords to real change

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

In this episode of the Inside EMS podcast, the discussion centered on the practical application of leadership in EMS. The conversation highlighted the gap between commonly used leadership buzzwords and their real-world implementation.

Key points

• Employee engagement and empowerment. The need for genuine engagement and empowerment in the workplace was stressed. Kelly Grayson shares an example of providing discounted meals for employees during hectic schedules as a concrete example of servant leadership.
• Leadership by buzzwords. Our cohosts raise concerns about leaders in EMS who rely on buzzwords without understanding their practical implications. They suggest many EMS leaders are caught up in an "ego vortex," focusing more on authority and titles rather than service and care.
• Personal leadership journey. Chris Cebollero shares his personal journey from being a "horrible leader" to understanding the essence of effective leadership. He emphasizes the importance of emotional control and viewing challenges as solutions.
• Systemic issue in EMS leadership. The discussion highlights a systemic problem in EMS leadership, pointing out the lack of formal training and understanding of the art and science of leadership. Our cohosts stress that success in leadership should be measured by the engagement, satisfaction and productivity of the workforce.
• The Peter Principle. The conversation touches on the Peter Principle, where individuals are promoted to their level of incompetence. They note often, leaders are not equipped with the necessary tools and training for their roles.
• Difference between managers and leaders. A distinction is made between managers and leaders. Managers are described as those who enforce policies and procedures, whereas leaders are seen as doing the right thing and then justifying it officially.

Learn more: Visit the EMS Leader Playbook

Memorable quotes:

• "The true measurement of leadership success is how engaged, satisfied and productive the workforce is. Nothing else matters." — Chris Cebollero
• "Leadership is both an art and a science. You've got to know and understand the science before you can paint the portrait of organizational success." — Chris Cebollero

This episode underscores the need for a paradigm shift in EMS leadership, moving away from traditional authoritative styles to a more engaged, empathetic and service-oriented approach.

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Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the Inside EMS team at theshow@ems1.com to share ideas, suggestions and feedback, or if you’d like to join us as a guest.

EMS1 is using generative AI to create some content that is edited and fact-checked by our editors.

Chick-fil-A vs. the duty to act

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

In this episode of Inside EMS, hosts Chris Cebollero and Kelly Grayson discuss an incident that sparked fierce debate within the EMS community. The incident in question occurred on October 27, 2023, when a Washington, D.C., firefighter/EMT was dismissed for stopping at a Chick-fil-A before responding to an ALS call. The hosts discuss the ethical implications of this decision, emphasizing the duty to act in emergency services.

Cebollero and Grayson, while acknowledging the challenging landscape of working in EMS, stressed that personal needs and comfort should never compromise the responsibility to respond to emergencies. They shared personal experiences of missing meals due to service calls. The hosts stress how the duty to act commitment to help others should always outweigh personal needs in emergency services.

The discussion also centered on the commendable actions of D.C. Fire and EMS in addressing the incident. Grayson was firm in his belief that the action taken by the D.C. firefighter/EMT was unequivocally unethical and damaging to the public trust. The hosts underscored the importance of upholding the greatest standards of ethics and responsibility, even when not in the public eye.

Memorable quotes

• "Ethics are how you behave when no one is looking. There's not a whole lot of gray area in ethical situations." — Kelly Grayson
• "The whole point of 911 and the honor of what we do is, you call, we come: no question." — Kelly Grayson
• "I can’t count the number of times I have been waiting in line for food and I've been dispatched to a call. I've had to get out of line. I've had to lose my money. I didn't get a chance to eat that day." — Chris Cebollero
• "We have a duty to act. We have to be able to respond as we need to respond, regardless of our own personal needs." — Chris Cebollero

Read next: Duty to act, assess, treat and transport. A legal refresher for EMS providers

RATE AND REVIEW

Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the Inside EMS team at theshow@ems1.com to share ideas, suggestions and feedback, or if you’d like to join us as a guest.

EMS1 is using generative AI to create some content that is edited and fact-checked by our editors.

Pioneering paramedicine: How SCCAD tackles substance use disorders

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

In this episode of Inside EMS, hosts Chris Cebollero and Kelly Grayson discuss innovative approaches in EMS with guests Chief David Lewis and Kyle Gaines from the St. Charles County Ambulance District in Missouri. The district's unique approach to paramedicine, specifically in terms of substance use disorders, opioid use disorders and behavioral health, forms the crux of the conversation.

Lewis shares how the escalating number of overdose cases necessitated a novel approach to community paramedicine. Starting as a passion project to save lives, the St. Charles County Mobile Integrated Healthcare Network was born from a need to tackle the overdose epidemic more effectively.

Initially adopting a model from Ohio that involved paramedics, social workers and law enforcement officers responding to overdoses, they soon realized patients were reticent to engage when law enforcement was present. This led to the evolution of the program, with paramedics being specially trained to handle sensitive conversations, helping patients access treatment.

Gaines discusses how educating their team members about addiction was instrumental in overcoming initial resistance to the program and ensuring its success. In the years since its inception, the program has grown and has proven to be effective, with about one in four patients they encounter eventually sitting in front of a treatment counselor.

Read more: $1.5M grant allows SCCAD’s expansion of substance abuse program

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Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the Inside EMS team at theshow@ems1.com to share ideas, suggestions and feedback, or if you’d like to join us as a guest.

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Navigating EMS assessments: A dive into best practices

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

In this episode of Inside EMS, hosts Chris Cebollero Kelly Grayson delve into the intricacies of patient assessments in emergency medical situations. They dissect the value of thorough assessments versus focused evaluations, highlighting the critical role of differential diagnosis and the dire need for feedback in honing EMS skills.

The duo debate whether a detailed head-to-toe assessment is always necessary or if a focused assessment based on the chief complaint suffices. Chris opines that a thorough examination provides a fuller picture, vital in cases where patients may not have seen a healthcare professional in years. Kelly, on the other hand, advocates for a focused approach, emphasizing efficiency and relevancy to the primary complaint, especially in high-pressure emergency scenarios.

The dialogue unveils a significant challenge in EMS education and practice – the delineation between a medical and trauma assessment, and the traditional versus a more systems-based approach to patient evaluations. They both acknowledge that the nature and depth of assessments could vary based on the patient's ability to participate in the examination.

One eye-opening anecdote from Chris revealed a situation where a misdiagnosis by a doctor led to a critical oversight in patient care, underscoring the importance of independent assessments and differential diagnosis in EMS practice. Chris shares a valuable lesson from this experience, emphasizing the need to "talk oneself into the diagnosis" rather than accepting a preliminary diagnosis at face value.

Kelly also addressed a fundamental challenge in EMS – the lack of feedback, which stifles the opportunity for professionals to refine their assessment skills and knowledge base. He asks, "how difficult it is to improve the art of assessment and your skills if you don't get feedback?"

The hosts encourage EMS professionals to share their insights and best practices, acknowledging the collective effort required to enhance patient assessment methodologies and ultimately, patient care. They wrap up the discussion with an invitation for listener feedback, fostering an ongoing dialogue to advance EMS practice.

The episode serves as a catalyst for a broader conversation on patient assessment best practices, urging EMS practitioners to continually evaluate and refine their approach towards patient care, thereby enhancing the overall quality and efficacy of emergency medical services.

RATE AND REVIEW

Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the Inside EMS team at theshow@ems1.com to share ideas, suggestions and feedback, or if you’d like to join us as a guest.

EMS1 is using generative AI to create some content that is edited and fact-checked by our editors. 

Hung jury: EMS lessons from an unsuccessfully tried murder case

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

In this episode of Inside EMS, cohosts Chris Cebollero and Kelly Grayson discuss the importance of integrity, documentation and tracking errors in the field.

Chris spent the past week in jury duty, listening to prosecutors unsuccessfully try a murder case that resulted in a hung jury.

He shares details that tripped up law enforcement officers testifying in the case, and the jury’s perspective on errors made, lies told and how integrity doubts derailed the case.  

Memorable quotes

“One of the things that you need to be able to remember is you should not talk about anything that is not written in your report, because they will tear it apart, and I watched that happen ... when we talk about documentation, why documentation is very, very important is because it's the little nuances that you leave out that now you're going to discuss that are going to get you into trouble.” — Chris Cebollero

“In working with Gene Gandy back in the day …  he used to say that the plaintiff's attorney – in a malpractice case – his job is to make you look like a sloppy idiot, and your attorney's job is to make you look like Johnny Gage. And the weapon that each one of them will use is your report. And it's up to you to determine who it's more valuable to: the plaintiff's attorney or your attorney.” — Kelly Grayson

“We, in civil cases in EMS, we don't really get a jury of our peers. You know, we may have people who are demographically very similar to us, but as far as judging our actions, what they know is Hollywood, which is about as realistic a portrayal of EMS and medicine in general as your average Disney movie.” — Kelly Grayson

“The briefer your remarks, the better your case is going to be received, and that's true, you know, it's probably just like an EMS lecture. If you go on forever and ever, you lose people. You want to capture their interest, say what you need to say, and set the stage for what's going to come.” — Kelly Grayson

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Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the Inside EMS team at theshow@ems1.com to share ideas, suggestions and feedback, or if you’d like to join us as a guest.

Chief Gary Ludwig on fixing medics’ terrible charting

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

In this episode of Inside EMS, cohosts Chris Cebollero and Kelly Grayson welcome Chief Gary Ludwig to the podcast. The group discuss imparting knowledge to new medics and Ludwig’s latest book, “385 Things Veteran EMTs and Paramedics Can Teach You: Emergency Medical Technician and Paramedic Tips and Tricks of the Trade.”

The book contains information on patient assessment, managing airways, starting IVs, penetrating trauma, crimes scenes and more.

Chief Ludwig shares his experience with terrible PCRs, and why we should be teaching medics to write reports like our law enforcement partners.

He shares tips like:

• Why you should always stay in the left lane
• How to avoid tipping stretchers
• Why to avoid abbreviations in PCRs

For a signed copy, visit www.garyludwigbooks.com.

About our guest

 Gary Ludwig is a well-known author, educator, speaker, and consultant who has served in three fire departments over his career. His fire, EMS, rescue, 911 and emergency management career spans a total of 46 years, including 35 years in two metropolitan cities, St. Louis and Memphis. He has been a paramedic for over 44 years.

He served as the president of the International Association of Fire Chiefs (IAFC) during the 2019-20 term, and was selected as the International Career Fire Chief of the Year in 2022.

He has a master’s degree in business and management.  He has written over 500 articles for professional fire and EMS publications and is the author of four books.  He has also been invited to speak at over 400 professional EMS or fire conferences or seminars.

He has won numerous awards including the International Career Fire Chief of the Year in 2022, the James O. Page EMS Leadership Award in 2014 and the IAFC EMS Section’s James O Page Achievement Award in 2018.

He has managed two award-winning metropolitan EMS systems (Memphis and St. Louis) and was fire chief of an ISO Class 1 fire department (Champaign).  In 2022, he was appointed by FEMA Administrator Deanne Criswell to the National Advisory Council for FEMA.