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JEMS Development Editor Mike Brown speaks with Dr. Simon Grosjean about shifting EMS from “prehospital transport” toward “territorial medicine.” They unpack alternative transport/non‑conveyance, physician response units, and why many low‑acuity calls may be better managed outside the ED. The conversation contrasts systems across Europe and the UK, highlights gaps in data collection, and exposes practical barriers—staff shortages, fractured clinical records, and reimbursement models—that stop promising approaches from scaling. They also explore where technology and AI can help: rapid chart summarization, context‑aware decision support, microlearning for clinicians, and automated handoffs to primary care.   Quick favor: take our 3-minute (anonymous) listener survey to help shape what we cover next: https://sprw.io/stt-lfjMN

Firefighter Jake Ryks joins the Just a Little Salt podcast to dismantle the "hero" archetype often taught in fire science programs. He reflects on his early career, admitting he’s actually less confident now than as a rookie because he finally understands the sheer depth of the profession.   The conversation shifts to the unique culture of the fire service, specifically the "sacred" firehouse table where rankings vanish and conflicts are settled in-house rather than through a formal chain of command. Jake also dives into the misunderstood world of Hazmat, demystifying it as a discipline of basic chemistry rather than a horror movie. From sampling jars of menstrual blood at government protests to discussing the "Hazmat Guys" podcast network, this episode offers a grounded look at the reality of special operations and the importance of sharing knowledge to elevate the entire crew.   Quick favor: take our 3-minute (anonymous) listener survey to help shape what we cover next: https://sprw.io/stt-lfjMN

JEMS Development Editor Mike Brown sits down with Dr. Stacy Shackelford, a coauthor of a new JAMA Network Open paper, to unpack findings about calcium abnormalities in trauma patients. The authors tracked a cohort of 1,270 trauma patients arriving at three level I trauma centers and found that 22% presented with hypocalcemia and 5% with hypercalcemia. Early mortality varied significantly by calcium status: 11.9% among hypocalcemic patients, 4.3% among eucalcemic patients, and 22.8% among hypercalcemic patients. Although hypercalcemia was less common than hypocalcemia, it was associated with substantially worse early mortality, suggesting the need for further research into the underlying mechanisms.

Paramedic, educator and consultant John Todaro joins Eric Chase to trace a 49-year career at the intersection of prehospital care, nursing, and public health. Todaro argues for degree-based education for paramedics, emphasizes soft skills—communication, empathy and cultural awareness—and explains how broader clinical training strengthens judgment and the patient narrative. He examines professional tensions between nursing and EMS, advocates collaborative roles instead of hierarchical oversight, and offers organizational culture and work-life balance strategies to reduce burnout and moral injury. Through a vivid helicopter rescue—holding a young trauma patient’s hand and later being recognized by that child—Todaro shows why human connection matters as much as clinical skill.

Jennifer Pearsall joins the Not a-Fib Podcast to share insights from her Naval Postgraduate School thesis on the strengths that can emerge in emergency managers after life‑changing events. We explore her career across local and federal emergency management, the contrasts she encountered along the way, and the experiences that inspired her to create EM Wellness and define its mission. She reflects on her time at the Naval Postgraduate School, and we dive deep into the core findings of her thesis. Our conversation covers the types of transformative events that can lead to post‑traumatic growth, the conditions that make that growth possible, and the personal and organizational factors that either support or hinder it.

In this episode of Just a Little Salt, Cody Spaulding talks with Jon Vought, a firefighter and the owner of Rescue 1 CBD, to break down what CBD actually is and why it’s become a serious topic in the fire service. Jon explains the difference between hemp and marijuana, how cannabinoids interact with the body’s endocannabinoid system, and what the research says about CBD’s impact on inflammation, sleep quality, mood, and anxiety. They also get into the biggest concern most firefighters have: drug testing. John shares details from a university-backed study involving the University of Arcadia and the University of Maryland, including how urine samples were tested under strict lab conditions for THC.

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.

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.

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 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.

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.

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.

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.

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.

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.