EMS Today

Pushing the Clinical Edge in Respiratory Care

Respiratory crises in the field rarely fit textbook categories. JEMS Development Editor Mike Brown talks with Hamilton Medical’s Jesse Carroll to separate Type 1 (hypoxemic) from Type 2 (hypercapnic) respiratory failure and recognize the mixed presentations clinicians actually see. They walk through practical cues (SpO2 trends vs end‑tidal CO2), common causes (CHF, COPD, obesity, neuromuscular weakness), and epidemiology: roughly 360,000 prehospital respiratory calls annually with 41% involving COPD and obesity rates rising from 32% to about 60% since 1988. Jesse explains why pressure, flow and volume, not oxygen alone, drive meaningful physiologic change, how device limitations (disposable CPAP, pneumatic and turbine systems) affect flow delivery, and when early noninvasive strategies can buy time or prevent intubation.

Get Resus Ready

JEMS Development Editor Mike Brown sits down with Jonathan Epstein, who leads the American Red Cross healthcare product management team, to unpack the Red Cross’s new Resuscitation Suite. Jonathan explains how the suite reimagines BLS, ALS and pediatric/neonatal resuscitation with EMS-first blended learning, a “practice as you perform” approach that embeds local protocols and integrated cognitive aids, including a digital app with step-by-step algorithms and clinical decision support. They discuss adaptive learning and computer-adaptive testing that shrink classroom time, an upcoming VR pathway that delivers team-based practice and certification, and realistic expectations for AI, dual sequential defibrillation and mechanical CPR. Ventilation, measurement and device design are highlighted as targets for education and engineering solutions.

Putting the P Back in CPR

Bob Page of the Manual Ventilation Academy walks through why bag-valve-mask (BVM) ventilation often fails in the field and how measurement and real-time feedback fix it. He outlines the four simultaneous skills rescuers must master—opening and holding an airway, achieving an effective mask seal, delivering the correct tidal volume, and timing breaths—and shows why muscle memory alone isn't enough. In multi-center simulations and device head-to-head tests, blinded providers rarely met guidelines. Once teams used point-of-care feedback, performance climbed above target, even on intubated patients and during pediatric scenarios. Two-person BVMs and brief 30:2 pauses for breaths also improved delivery compared with continuous compressions. If you teach or deliver airway care, this podcast lays out practical techniques, device pitfalls, and why Bob's FDIC International course is a rare chance to train with measured, real‑world simulations and evidence.

Trevor Williams on Service, Culture, and Building a Tool That Took Off

Trevor Williams didn’t take a typical path into the fire service. He grew up overseas, living in places like Zaire during the Rwandan genocide and later Haiti during periods of civil unrest. His family’s missionary work with humanitarian organizations exposed him early to crisis, relief work, and the reality of helping people when things fall apart. Years later, that mindset carried straight into a career with the Los Angeles County Fire Department.

 

In this conversation, Williams talks about the long road to getting hired, the culture shifts he’s seeing among newer firefighters, and why mentorship inside the firehouse still matters. He also breaks down how a homemade tool he built for forcing doors eventually turned into a widely used product across departments and industries. The story moves from firehouse camaraderie to small business lessons, covering product design, marketing mistakes, fraud scares, and what it actually takes to turn an idea into something firefighters trust on the job.

Real-World Wisdom for Medics and Nurses

Flight nurse and creator Nurse Gwenny joins the show to talk frankly about what it really takes to thrive in emergency care when the textbook ends and the hard calls begin. She walks through her path from pre‑med burnout to ER and flight nursing, why traditional courses left her memorizing instead of understanding, and how that frustration drove her to build highly visual, short-form education that actually sticks for busy medics, EMTs, and nurses. Along the way, she shares the cases that still sit with her, the mentors who modeled clinical excellence with zero ego, and concrete ways to protect your mental health in a career built around other people’s worst days.

Updated HIV Post‑Exposure Guidance for Healthcare Providers

Infection control consultant Katherine West breaks down the latest HIV post-exposure prophylaxis (PEP) guidelines published in mid-2025. Highlighting key changes since the 2013 update, she explains the shift toward less toxic antiretroviral regimens, elimination of routine baseline lab testing for PEP, and new protocols for exposures involving patients with undetectable viral loads. West emphasizes the importance of expert follow-up care, clarifies who is responsible for source patient testing, and underscores the low risk of occupational HIV transmission. She also discusses challenges faced by emergency providers managing exposures outside regular occupational health hours and the role of 24/7 consultation services. The segment covers legal nuances, especially OSHA and state laws regarding HIV testing consent, and reiterates the CDC’s push for routine HIV screening to aid in the national goal of ending the HIV epidemic by 2030.

Leadership Lessons from EMS Frontlines

Host Chief Shane Wheeler and Assistant Chief Jon Detweiler dive into the complexities of team conflict and the essential role of trust in leadership. Drawing from his decades-long career, Jon shares firsthand experiences managing difficult conversations, especially transitioning from peer to leader. He highlights why many leaders mistakenly view conflict as failure rather than opportunity, and stresses the importance of emotional awareness, asking thoughtful questions, and fostering psychological safety. Jon also emphasizes the power of modeling behavior and setting clear expectations to maintain respect and accountability within teams. Whether you're a new leader or aspiring to grow, this conversation offers practical strategies for creating a culture where honesty, trust, and collaboration thrive, ultimately aligning teams to achieve shared missions effectively.

Navigating Stress, Communication, and Healing in Relationships

In this episode of Just a Little Salt, licensed counselor Kimberly Ingram dives deep into the unique challenges first responders face in their relationships. Drawing on her extensive experience working with law enforcement officers, firefighters, and other public safety professionals, Kimberly sheds light on the impact of shift work, chronic stress, and trauma on emotional connection at home. They discuss common misconceptions about therapy, the critical need for culturally competent mental health support, and how partners can build stronger communication even amid the toughest schedules. Kimberly also explores the delicate balance between a first responder’s identity and personal life, the risks of emotional distancing, and practical advice for couples recovering from infidelity.

Building Accountability and Strengthening Fire Service Culture

Matt Aalto shares insights on cultivating a resilient fire department culture through clear expectations and genuine accountability. Drawing from decades of experience leading both volunteer and career crews in Oregon, Matt highlights how trust, communication, and proactive conflict resolution create an environment where firefighters thrive—both on and off duty. The discussion tackles the challenge of managing multiple generations within the ranks, the importance of addressing informal as well as formal expectations, and strategies for improving recruitment and retention by “getting your house in order” before adding new members. Real-world examples illustrate how supportive leadership tackles underperformance and fosters behavior change rather than punishment. Matt also offers practical advice for those looking to develop their voice in the fire and EMS community by writing and speaking.

Leadership, Lessons Learned, Wellness, Mental Health, and Saying I Am Sorry

Eric Chase sits down with John Graham, a respected EMS leader with 27 years of experience, to explore the challenges of mental health in emergency medical services. Reflecting on personal losses within the EMS community and the long-standing culture of “tucking away” trauma, John shares his journey toward embracing vulnerability and therapy. The conversation uncovers the often-unspoken struggles EMS professionals face, the delicate balance between leadership and friendship, and the importance of honest communication—even when it’s uncomfortable. John highlights the value of passion and commitment in leadership roles and stresses the need for grace, both toward oneself and others.