EMTS Academy Podcast

"You don't rise to the occasion — you sink to your level of training." When the Guadalupe River rose on July 4th, 2025, Dr. Stephen Harper drove straight toward one of the deadliest flood disasters in Texas history. Dr. Harper is an emergency medicine physician, EMS medical director for the Kerrville Fire Department, and a former Army brigade surgeon. In this conversation with host Matt Nealand, he gives a firsthand account of the Camp Mystic flood response — from the first alerts at dawn to triaging evacuated children at a helicopter flight line, tracking patients with Pulsara, and turning an ambulance bus into a makeshift warming shelter. He also shares the lessons that outlast the headlines: why preparation and resiliency start today, how to know a physician's real role in disaster command, the "disaster after the disaster" of unvetted volunteers, and how peer support helps responders process the things no one should have to see. A grounded, deeply human episode for EMTs, paramedics, firefighters, and physicians alike. Listener note: This episode discusses the Kerrville floods, Camp Mystic, loss of life, survivor experiences, and responder stress. Our thoughts and prayers remain with everyone affected. If you need support related to a disaster, call or text the Disaster Distress Helpline at 1-800-985-5990. If you are in crisis or thinking about self-harm, call or text 988. 🎥 Watch: https://youtu.be/9r4neO7lPAA 🎧 Listen: https://pod.link/1810050200 Sign up today to become an EMT or Paramedic: https://emtsacademy.com/  

Texas is putting whole blood in the field, and medics say patients on the verge of death are waking up and talking. In this episode, Texas EMS Director Joe Schmider joins Matt Nealand to explain how it's happening and what's coming next. Joe started in 1974 as a volunteer firefighter and now oversees more than 84,000 EMS providers across Texas. He shares the inside story of the state's $10 million whole blood program and the goal of reaching every county, why whole blood matters for medical calls and not just trauma, and how Texas is beating the EMS workforce crisis through Senate Bill 8 funding and a renewed focus on retention. The conversation goes deeper than policy: why we have to stop "eating our young," the shift from "emergency" to pre-hospital healthcare and community paramedicine, how AI is poised to transform documentation and clinical decision support, and the hard-won wisdom of a 50-year career that includes 9/11 and studying Israel's EMS system. Joe's bottom line: it was never about the lights and sirens — it's about the people. When it stops being fun, find another job.

Should you get your paramedic certification before being hired at a fire department? It's one of the most common questions aspiring firefighters wrestle with — and Battalion Chief Chris Nored of New Braunfels (TX) Fire Department doesn't dodge it. With 18 years in the fire service, Chief Nored makes a case you don't hear often: the time you spend running calls on the ambulance is exactly what makes you a better firefighter and a stronger leader. In this episode he answers the paramedic-before-hire question head-on, explains why nearly every department is hungry for paramedics, and walks through how the civil service hiring process really works — from the eligibility list to "paramedic preference." He also covers the quiet mistakes that knock good candidates out of the running, including old social media posts, and how to prepare for the entrance exam, background, and interview. Beyond hiring, Chief Nored talks about how leadership starts on the ambulance, how to handle difficult conversations, why you should only promote for the right reasons, and the one thing every long, respected fire service career has in common: attitude. Whether you're about to test for your first department or you're an officer trying to stay sharp, this conversation is packed with practical, been-there advice. You'll learn: •       Whether to get your paramedic certification before being hired •       Why time on the ambulance makes better firefighters and better leaders •       How the civil service hiring and eligibility list works •       How to prepare for the entrance exam, background, and interview •       How your social media can cost you the job •       Leadership, tough conversations, and promoting for the right reasons •       The #1 thing you must get right to build a lasting career   YouTube: https://youtu.be/-CkzhDyKAh8   Interested in EMT or Paramedic training: www.EMTSacademy.com   Special thanks to the New Braunfels (TX) Fire Department: https://www.newbraunfels.gov/fire      

What if EMS could prevent the call before it ever happens? Dr. Miramontes, EMS Medical Director in San Antonio, has built one of the most innovative Mobile Integrated Healthcare programs in the country — and it's saving $2 million a year by keeping people out of the ER, off the 911 queue, and healthier at home. In this episode, Matt Nealand sits down with Dr. Miramontes to unpack how a fire department paramedic became the bridge between a lonely patient and their doctor, a hospice family and a pain-free death at home, and a psychiatric patient and the medication they stopped taking. You'll learn: What Mobile Integrated Healthcare (MIH) actually is — and why it's illegal in some states How San Antonio knocks off 20 calls a day (a full ambulance's worth of runs) The hospice program that keeps dying patients comfortable at home and out of the ER Why three of four MIH paramedics were also pastors — and why that makes perfect sense The psychiatric program that saves $7 for every $1 invested How a 14-acre homeless shelter became a model for out-of-hospital care Why Texas delegated practice is a game-changer for EMS medical directors Whether you're a paramedic, EMS chief, medical director, or just someone who thinks the healthcare system is broken — this one will change how you see the ambulance. 🎥 Watch: https://youtu.be/vwLL0VYan8M 🎧 Listen: https://pod.link/1810050200

John Gonzales didn't plan on a career in EMS — he stumbled into it through the Army and a National Registry patch he didn't know he'd earned. Today he's the Director of Williamson County EMS, overseeing one of Texas's most respected prehospital systems. In this conversation, Matt and John cover the full arc: military medic to paramedic school, clinical captain to director, and what he learned along the way about research, teaching, leadership, and Just Culture. They also get into the future of AI in EMS — from smart documentation to autonomous ambulances — and why John thinks the next decade will transform prehospital care more than the last fifty years combined. If you're an EMT, paramedic, educator, or EMS leader, this one's worth the full listen. To learn more about EMTs Academy or start your EMS career, visit emtsacademy.com. YouTube: https://youtu.be/aW4333-Baic

What does it take to build a lasting career in EMS and a life you're proud of? Garnet Morris, author of "17 Runs," shares the four core values that became the foundation of everything he's accomplished — and how he broke free from the generational limiting beliefs he calls "bricks." In this episode, Garnet and Matt Nealand talk about what integrity actually looks like on the truck, how to identify the beliefs that are holding you back, and why four simple habits can change everything: show up on time, do what you say, finish what you start, and say please and thank you. Free download: 17 Runs Personal Growth Workbook — a companion guide with reflection questions and action steps. Get it at https://tr.ee/O025OCZ\_m1 Watch on YouTube at https://youtu.be/ogmhXWFhBNM Listen at https://pod.link/1810050200  

On the EMTS Academy Podcast, host Matt interviews Dr. Taylor Ratcliff, former Lubbock firefighter/paramedic and current medical director for multiple Texas EMS agencies (including Williamson County EMS, Marble Falls Area EMS, Robertson County EMS, and Texas EMTF Region 7) and associate medical director for Travis County Star Flight.  Ratcliff recounts starting in EMS as a teen, becoming a paramedic, dispatch experience, transitioning to the fire service, and ultimately pursuing medical school after studying for the MCAT at the station. They discuss how an EMS background both frustrates and helps in early medical school, why EMT training benefits pre-meds as early clinical exposure, and the unique Texas delegated-practice model for medical direction. Ratcliff explains the Texas Emergency Medical Task Force's post-Katrina origins, capabilities, and national influence, and they explore likely EMS changes over the next decade including treat-in-place, telemedicine, AI decision support, report-writing, drones, and workforce career-ladder and reimbursement challenges. Watch: https://youtu.be/r7VOayyQy6s  

What truly separates average EMS agencies from elite, high-performance systems? In this episode of the EMTS Academy Podcast, host Matt Nealand sits down with Dr. Casey Patrick, Medical Director for MCHD EMS, to explore how top-tier EMS organizations think, lead, and deliver patient care at a higher level. Dr. Patrick shares his unique path into EMS medical direction and explains why great systems focus on developing clinicians, not protocol memorizers. The conversation dives into the often-misunderstood role of medical direction, the importance of culture and shared decision-making, and how thoughtful oversight improves outcomes for both patients and providers. This episode is a must-listen for EMTs, paramedics, EMS leaders, educators, and medical directors who want to understand what excellence in EMS really looks like. 🔍 In This Episode, You'll Learn: ·       What defines a high-performance EMS system ·       Why medical direction is about culture, not control ·       How elite agencies develop critical thinking and accountability ·       The risks of protocol-only thinking in patient care ·       How strong medical oversight improves outcomes and provider confidence 🎧 Listen to the full episode: 👉 https://pod.link/1810050200 YouTube: https://youtu.be/ut2uUHTNsb4   🩺 Medical Disclaimer This podcast is for educational purposes only and does not replace local medical direction, protocols, or professional medical advice.

When Ignoring Your Health Finally Catches Up With You Most people don't wake up one day unhealthy. They arrive there slowly — one compromise at a time. In this episode of the EMTS Academy Podcast, Matt Nealand talks with Charles Fielder, who openly shares how years of putting everything and everyone else first led him to a breaking point at 375 pounds. Charles walks through the moment he realized his health was no longer something he could postpone, the difficult honesty required to face it, and the steps he took to finally turn things around — including the role a GLP-1 medication played in resetting his trajectory. While Charles is not from the EMS world, his story mirrors a pattern many first responders know well: ignoring personal health in the name of service, responsibility, and endurance. This is not a medical episode. It is a human one. In this episode, we discuss: How health decline happens quietly, not suddenly Why people who serve others often neglect themselves The moment "later" turns into "now" Using modern tools responsibly as part of long-term change Taking ownership before your health forces the issue 🎧 Listen now: https://pod.link/1810050200 Watch on YouTube: https://youtu.be/yCz_148yIcw  

In this episode, Matt Nealand sits down with Steve Tafoya, a critical-care paramedic, U.S. Coast Guard veteran, EMS educator, and former State EMS Program Manager for Nevada. With more than 25 years of experience across frontline care, regulation, leadership, and system design, Steve brings a unique perspective on how to improve EMS, build better leaders, and prepare the next generation for the realities of public safety. This episode covers: • High-risk decision-making • What EMS must fix to grow • Leadership development in public safety • Clinical access challenges • Building systems that serve providers and patients 🎧 Listen now on Podlink: https://pod.link/1810050200 Watch here: https://youtu.be/zoQeokPLPEM