The JEMS Report

First responders frequently carry unseen psychological burdens that build up long after the sirens fade. In this episode of the EMS Improv podcast, Eric Chase sits down with paramedic and educator Robert B. Ravndl to discuss his battle with post-traumatic stress following a critical incident in 2015. Ravndl shares his raw journey through the breaking point, inpatient treatment at a specialized center for excellence, and the reality of navigating life and work with his service dog, Carnes.The conversation unpacks the systemic barriers first responders face when seeking mental health support, fighting for reasonable workplace accommodations, and confronting institutional ignorance. Ravndl also highlights the importance of empathy, active listening, and meaningful peer advocacy, proving that true cultural change in emergency services starts from within the ranks.

Step back in time to the gritty, high-stakes era of 1980s and 1990s New York City with retired FDNY firefighter Tony Bonfiglio. In this episode, Bonfiglio shares his unexpected path from working in a meat factory to riding the rig in Washington Heights with Ladder 34. He details the intense reality of running calls in a high-volume district, navigating firehouse pranks, and confronting the emotional toll of tragic losses, including the devastating events of September 11. Listeners get a raw look at the brotherhood, the dark humor, and the sheer resilience required to survive decades on the front lines. Bonfiglio also discusses his memoir, Tales from the Tiller, offering an authentic glimpse into the daily life of an urban firefighter.

What does cardiac arrest actually look like, and why do bystanders often fail to recognize it? A study of 145 recorded out-of-hospital cardiac arrests reveals how subtle warning signs, unusual movements, and seizure like activity can delay recognition and lifesaving CPR.In this episode of the JEMS Podcast, host Mike Brown talks with cardiac arrest researcher Tommaso Scquizzato, MD, and critical care PA Brandon Otto, PA-C, FCCM, about research examining real world surveillance footage of out of hospital cardiac arrests and what it means for EMS providers, emergency dispatchers, CPR training, and public education.For EMS professionals, dispatchers, educators, and resuscitation researchers, these findings offer important insight into the first critical seconds of cardiac arrest and the opportunities to improve early recognition and intervention.Subscribe to JEMS for EMS news, clinical insights, research, and conversations focused on improving emergency medical services.#EMS #CardiacArrest #CPR

Paramedics Mike Brown and Adam LaChappelle unpack a troubling EMS and law enforcement response in Monroe County, Tennessee, involving an elderly retired preacher named Lester Isbill. Officers and medical crews responded to a call regarding an altered elderly driver who could not remember the current president, yet the patient ultimately ended up arrested, falling in jail, and dying from cardiac arrest after hours in a restraint chair.The conversation focuses on failures in patient advocacy and clinical assessment. Despite clear indicators of acute distress—including hypertension, hypoxia, unsteadiness, and obvious cognitive deficits—the crew failed to secure proper transport or establish patient capacity. A legally invalid refusal was also signed by the patient's daughter while he was already in police custody. This case highlights the vital need for EMS providers to act as vocal healthcare advocates, recognize altered mental status, and push past legal gray areas to ensure patient safety.Link to the Isbill Body Cam: https://youtu.be/6elprlWg-do?si=4MKpUu7k0SUOkCuk

Mike Ettenberg spent over five years working as a firefighter and paramedic for the city of Coronado before pivoting into full-time entrepreneurship. Faced with the heavy mental toll of the job, especially during the pandemic, and the constant frustration of breaking expensive duty sunglasses, he launched Frontline Optics with five thousand dollars in overtime savings.What started as a side hustle selling to fellow crew members evolved into a thriving company driven by social media marketing and rugged product design. The brand features a no-questions-asked replacement program designed specifically for first responders who routinely put their gear through brutal field conditions. Beyond building a successful direct-to-consumer business, Mike balances his expanding enterprise—including a new motorsports division—with coaching baseball and enjoying time with his family.

What does it look like to build a legacy beyond the firehouse?In this episode of Just A Little Salt, host Cody Spaulding (The Salty Paramedic) sits down with Jim Scano, former firefighter/paramedic, entrepreneur, nonprofit founder, pilot, and the man behind Firehouse Shirt Club.Jim shares his journey from working in engineering to joining the fire service, the lessons he learned as a firefighter and paramedic, and how those experiences helped shape multiple successful businesses after leaving the job. From leadership and teamwork to resilience, service, and community impact, this conversation explores the skills first responders develop throughout their careers and how those skills can extend far beyond the station doors.The discussion covers firehouse culture, the traditions that make the fire service unique, and why relationships built around the kitchen table are often the most important part of the job. Jim also opens up about navigating personal challenges, transitioning out of operational firefighting, and finding new ways to continue serving the first responder community.Also discussed:- The story behind Firehouse Shirt Club- Leadership lessons learned in the fire service - Entrepreneurship and building businesses after public service - The importance of preserving firehouse culture - The 414 Fund and supporting firefighters in need - Giving back through scholarships, station projects, and community initiatives - Why mentorship and service remain critical for the next generation of firefighters and EMS professionals - Defining success beyond rank, title, or paycheckWhether you're a firefighter, paramedic, EMT, emergency services leader, or someone exploring what comes next in your career, this episode offers valuable insights on leadership, purpose, and creating impact long after the tones stop dropping.

Mark Flauter has a conversation with Chief Brandon Hill from Hays County (TX) Emergency Services District 9 about the challenges of starting a new EMS transport service from the ground floor. The bulk of the conversation covers peer support. They talk about how Chief Hill got involved in peer support and some of the hurdles starting a peer support program. They also talk about providing support for the responders to the Kerr County flooding in July 2025. They highlight the "peer support lounge" for responders, the idea behind it, and the reaction of the responders.

Liz Harney joins Just a Little Salt to share her journey from overdose survivor to EMS educator, program director and quality leader for Baptist Health. We cover paramedic school realities—sleepless study sessions, pharmacology struggles, clinical gauntlets—and how hands-on mentorship shaped her early career. Liz recounts the paramedic who saved her life and later reappeared at her clinical rotation, a moment that fueled her focus on compassion, stigma-free care, and the affective domain in EMS education. She explains practical strategies for embedding emotional intelligence into training, managing frequent-flyer bias, and supporting students through burnout. Liz also discusses building a critical care paramedic program, leading quality improvement, and why vulnerability matters when speaking about addiction and recovery.

Dr. Tim Nutbeam challenges long-held EMS dogmas surrounding vehicle extrication and post-collision trauma care. Drawing from the landmark EXIT project, Dr. Nutbeam explains why fast extrication takes priority over prolonged, in-vehicle interventions. True physical entrapment is surprisingly rare—occurring in under 10% of cases—and traditional "slow and steady" spinal immobilization doesn't effectively minimize movement or prevent secondary injury. Dr. Nutbeam breaks down the complex physics of crash forces, vehicle safety attenuation, and individual tissue tolerance to show why vitals alone can't predict patient deterioration. He outlines a streamlined, high-efficiency model for first responders: perform rapid critical interventions, give fire crews permission to cut fast, and prepare advanced resuscitation outside the vehicle. He also highlights new global initiatives focusing on standardized post-collision data collection, multi-agency scene ownership, and empowering bystanders.

JEMS Development Editor Mike Brown speaks with Aaron Weedman, PhD, technical lead for machine learning in emergency medicine at the University of Pittsburgh, and Dr. Lenny Weiss, EMS physician and medical director for air and ground services. They discuss how natural language processing can analyze prehospital free-text data, such as chief complaints and 911 call notes, to predict the need for critical interventions like airway management, hemorrhage control, blood transfusions, and CPR. The technology may also help determine whether patients need ALS or BLS resources. Using data (about 10 million chief complaints) and 20,000 to 25,000 911 calls, the researchers found the models performed well and closely matched existing dispatch protocols. The goal is to improve dispatch accuracy, mobilize resources faster, and reduce cognitive workload for busy EMS crews.