EMS One-Stop

Weather is no longer simply something EMS and public safety agencies can react to when it arrives. In this episode of EMS One-Stop, Rob Lawrence is joined by meteorologist and emergency management specialist Sunny Wescott to examine what she describes as “weather whiplash” — rapidly changing conditions, stronger storms, heavier rainfall, coastal erosion, flooding, drought and infrastructure failures occurring with increasing intensity and sometimes in places where responders have not traditionally expected them.

| WEBINAR: Ready before the call — Building a stronger fire and EMS preparedness strategy

Sunny explains why understanding global weather patterns matters locally, and why storms developing thousands of miles away can provide valuable early warning for emergency managers in the United States.

The discussion moves from the global weather picture to the West Coast, El Niño, coastal erosion, Lake Mead and the Colorado River, before looking east toward the remainder of hurricane season. More importantly, Sunny translates the science into practical advice for first responders:

Study international disasters

Anticipate public behavior

Identify critical infrastructure before it fails

Use recent after-action reviews to improve the next response

Plan not only for the emergency itself, but for the much longer recovery period that follows

Along the way, there is also the extraordinary example of a flooded snake farm in China that released 900 king cobras into floodwaters — a reminder that disasters frequently create secondary hazards no emergency plan anticipated.

Key quotes

“None of these weather events are new, but they’re entering into areas where they don’t typically go or haven’t gone before.” — Sunny Wescott

“If you look out of your windows, you can see there’s this thing called weather going on.” — Rob Lawrence

“If we’re not paying attention to Russia, Asia, India, then we’re going to be surprised when these weather events get into the Pacific and approach our coastline.” — Sunny Wescott

“I’m a Brit. I’m professionally trained to talk and moan about the weather, so I might as well do it on One-Stop.” — Rob Lawrence

“The problem is we weren’t prepared for the intensity of the last decade, and that’s led us into a place of complacency, kicking the can down the road.” — Sunny Wescott

“If you just did your after-action review from the last weather system, you have a real opportunity to make those corrections and to get it right even as soon as next week.” — Rob Lawrence

About our guest
Sunny Wescott is a federal emergency response official chief meteorologist with the Department of Homeland Security (DHS) specializing in national extreme weather hazards and climatological studies for impacts to public and private sector key resources; and deputy project manager for the National Hurricane Program (FEMA).

Episode timeline

00:31 — Rob introduces the episode and welcomes Sunny Wescott back to EMS One-Stop.

01:42 — Sunny’s background: from U.S. Air Force meteorology to critical infrastructure, homeland security, FEMA’s National Hurricane Program and geospatial intelligence.

03:26 — The global weather picture and why traditional weather patterns are becoming less reliable.

05:53 — Why U.S. emergency managers should pay attention to weather in Russia, Asia and Europe.

06:10 — The jet stream, wildfire smoke and the “carousel of weather” moving systems around the globe.

07:24 — How overseas weather events can offer advance warning of the intensity of systems later approaching North America.

09:29 — Sunny explains Kelvin waves, warmer coastal water, king tides and why California’s coastal flooding risk continues to increase.

11:25 — Emergency managers are being forced into a cycle of continually trying to catch up with increasingly damaging events.

13:03 — Sunny predicts continued worsening of coastal erosion and discusses wider infrastructure impacts — sinkholes, water mains and groundwater depletion: how underground infrastructure may become another increasingly important response issue.

15:00 — Why heavy rain does not necessarily solve the water crisis affecting Lake Mead and the Colorado River.

15:09 — Intense rainfall can fall too rapidly for soil, vegetation and drainage systems to absorb it effectively.

16:20 — Evaporation, human water use and warming water further complicate reservoir forecasts.

17:07 — The coming political and resource challenge: deciding who gets scarce Colorado River water.

18:41 — Rob and Sunny return and shift attention to the Atlantic and the remainder of hurricane season.

19:28 — Sunny explains Saharan dust, wildfire smoke and the environmental factors that influence tropical cyclone development.

20:22 — Late-season concern turns toward the Caribbean and Gulf.

21:44 — Sunny’s first recommendation: follow international disasters and learn how both responders and the public behaved.

22:12 — Preparing for public distrust, misinformation and hostility during emergencies.

22:45 — Using overseas infrastructure failures as scenario planning: bridges, roads, supply routes and rescue access.

23:07 — The 900 king cobras example and the importance of anticipating unexpected secondary hazards.

24:36 — A near-real-time look at the forecast for the following week. Sunny warns that a significant West Coast system may catch people off guard
because it lacks a dramatic label such as “hurricane” or “atmospheric river.”

25:14 — A developing system is expected to track down the West Coast, bringing waves of wind and precipitation.

26:03 — “Now’s your time to shine.” Agencies that have just completed after-action reviews have an immediate opportunity to make improvements.

26:20 — Rob reinforces the value of turning recent lessons learned into operational changes before the next event.

27:35 — Rob’s closing takeaway: first responders should think beyond immediate response and plan equally seriously for recovery.

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North Carolina has always been proud of being first in flight. More than 120 years after the Wright brothers took to the air at Kitty Hawk, a small rural EMS system in the eastern part of the state is once again asking what flight might mean for the future. In this episode of EMS One-Stop, Rob Lawrence heads to Hyde County, North Carolina, where EMS leaders have become the first in the nation to operationally deploy an electric vertical takeoff and landing — eVTOL — aircraft to get a paramedic rapidly to a 911 call.

Rob is joined by Hyde County EMS Chief Brooke Cox; Todd Baker, director of education and clinical services with Code Blue Resources and a captain with Hyde County EMS; and Carla Baker, owner of Code Blue Resources. They explain how a geographically challenging rural county moved from an ambitious idea to an operational proof of concept; working through state EMS regulation, the FAA, aviation safety, clinical requirements, pilot training and more than 1,000 training missions.

They also describe the moment a paramedic reached a remote patient about 20 minutes ahead of the responding ambulance, what the project has taught them, and why this is not about replacing ambulances or helicopters. It is about finding another tool to overcome the challenge of time and distance — and proving that even a small rural EMS system can do very big things.

| MORE: N.C. county EMS is first in nation to deploy eVTOL aircraft on 911 calls

Key quotes

“We’re here for the patient. We’re here for the community. We’re here to make a difference nationally; not just in our little pond.” — Brooke Cox

“Let’s look at what we can do to make it work and overcome challenges.” — Todd Baker

“Why has somebody not done this before?” — Carla Baker

“Come visit Hyde County. We are a small, small county, but we’re doing big things and we have a heart for community.” — Brooke Cox

“Let’s utilize the technology, the innovation that’s out there and see if it works, and if it doesn’t, it doesn’t.” — Todd Baker

“This was never meant to replace an ambulance. It’s not meant to replace a helicopter, a medical air helicopter.” — Carla Baker

“It is to figure out if this particular asset will help you overcome obstacles in various response areas. And that’s what it’s about.” — Carla Baker

Additional resources

Code Blue Resources

Akute OS

Pivotal

Episode timeline

00:36 – Rob introduces EMS One-Stop and the extraordinary concept of flying a paramedic to a 911 call aboard an eVTOL aircraft — meet the guests: Hyde County EMS Chief Brooke Cox, Captain Todd Baker and Carla Baker of Code Blue Resources

02:38 – Understanding Hyde County: rural geography, marshland, water, Ocracoke Island and the challenge of accessing timely EMS and air-medical resources

04:31 – Brooke describes moving from a resource-rich EMS environment to one where a critically ill patient could wait almost 3 hours for a helicopter

06:01 – The eVTOL concept: essentially a large electric vertical takeoff and landing aircraft capable of carrying a paramedic

07:14 – Carla explains Code Blue Resources and how conversations about bringing the technology into EMS began

09:34 – Todd traces the project back to December 2024 and the effort to turn the concept into an operational reality

09:59 – The first regulatory hurdle: determining how North Carolina’s Office of EMS would classify the aircraft and what equipment it would need to carry

11:22 – Brooke describes being a dreamer, becoming a trailblazer and the unforgettable moment the aircraft first launched

13:37 – Inside the aircraft: battery power, operational range, controls, safety systems and even an emergency parachute

16:29 – Working with the North Carolina Office of EMS and finding a regulatory pathway for something nobody had previously attempted

18:34 – Building the clinical package around providing what a paramedic might need during the first 15 minutes of an EMS call

20:26 – Taking the project to the FAA and learning how EMS and aviation had to develop a common language around risk and life safety

22:34 – Selecting the paramedics: why clinical judgment, aviation awareness and experience mattered more than simply putting out a job advertisement

23:43 – Meet Quinn Reese, the paramedic who flew the first operational mission

24:16 – Preparing clinicians for the aircraft and ensuring they were fully credentialed within Hyde County’s EMS system

26:33 – Brooke goes to California to train: VR simulation, repetitive skills development, fatigue management and progressing to proficiency

29:14 – Who actually flies it? Brooke explains the dual joystick controls and the authority of the paramedic operating the aircraft

30:03 – How Hyde County positioned the aircraft and used call location, range, weather and operational parameters to determine whether a mission was viable

31:51 – Todd tackles some of the misinformation surrounding the program and explains the multiple layers of operational and pilot decision-making

33:31 – More than 1,000 training missions during the proof-of-concept period

33:53 – The operational call that demonstrated the potential: a paramedic finds a remote patient and arrives approximately 20 minutes ahead of the ambulance

36:17 – The reaction after a successful mission and the satisfaction of seeing months of planning and training translate into patient care

37:33 – Lessons learned: leadership support, educating decision-makers, having a clear mission and understanding the strengths of the team

39:34 – Todd explains the culture of asking, “How can we make this happen?” rather than immediately looking for reasons why it cannot

41:51 – The wider Hyde County team: how law enforcement and EMS routinely work together in a resource-limited rural environment

43:16 – The proof of concept has ended — for now — as Hyde County looks toward the next generation of longer-range eVTOL technology

44:49 – “This is just the tip of the iceberg:” Brooke explains why Hyde County is not finished with the concept

45:21 – Carla discusses interest from other organizations and manufacturers and what has been learned about building a comprehensive eVTOL EMS program

47:09 – Brooke’s message from Hyde County: a small county doing big things and trying to put community back at the center of EMS innovation

47:36 – Todd on the need to think beyond the traditional model of simply placing two people in an ambulance and sending them toward every call

49:54 – Rob closes: North Carolina is first in flight once again — and the team in Hyde County has shown it has the right stuff

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In this episode of EMS One-Stop, host Rob Lawrence sits down with Oscar Monterrosa, the 2026 NAEMT Paramedic of the Year, whose career has taken him from Army combat medic to street paramedic, medical student and now an emergency medicine-internal medicine resident at Hennepin County Medical Center. Yet despite the white coat and demands of residency, Monterrosa continues to work on the ambulance, including in rural Minnesota, and remains closely connected to the profession that shaped his approach to medicine.

The conversation also returns to one of the defining moments of Monterrosa’s career: the Oct. 1, 2017, mass shooting in Las Vegas. Working an overtime special-event shift, Monterrosa was already inside the medical tent when gunfire began and casualties started arriving. He describes slipping into “work mode,” drawing on his experience as an Army combat medic in Iraq as he and others triaged and treated patients while the shooting was still underway.

Beyond that extraordinary night, the discussion explores rural EMS, critical care and ECMO, education, mentorship and the long road from paramedic to physician. Monterrosa’s message to other EMS clinicians considering further education is straightforward: the road may be difficult and it may take longer than expected, but it is possible.

Key quotes from Oscar Monterrosa

“We have that critical call or whatever, somebody that's crashing right in front of you and you just kind of get into work mode.”

“Even though there's still gunfire going on, you try to be as safe as you can and take cover, but ultimately all that is really out of your control.”

“A lot of these experiences in the cornfields has been very rewarding, just seeing this different culture, like meeting a lot of different people.”

“It just takes hard work and just not giving up.” “I was an undergrad for 9 years because I was working full time on the streets.”

Additional resources

National Association of Emergency Medical Technicians (NAEMT)

NAEMT National EMS Awards of Excellence

Hennepin Healthcare

Las Vegas Metropolitan Police Department: October 1 / Las Vegas mass shooting – After-Action Report

Episode timeline

00:52 – Rob introduces the 2026 NAEMT Paramedic of the Year

01:34 – Oscar 101: paramedic and emergency medicine-internal medicine resident

02:05 – Oscar hears what his colleagues wrote about him in his award nomination

04:04 – His reaction to being named National Paramedic of the Year

05:00 – The journey into EMS, military medicine and becoming a paramedic

07:20 – From the desert Southwest to rural Minnesota EMS

09:00 – The realities of rural 911 response and long interfacility transports

10:15 – Critical access hospitals and managing high-acuity patients

12:30 – The conversation turns to October 1, 2017, in Las Vegas

13:17 – What began as a routine special-event EMS shift

13:55 – Reports of gunfire and the first shooting victims reaching the medical tent

14:24 – What happens mentally when a mass-casualty incident suddenly unfolds

15:00 – Combat medic training, triage and functioning while gunfire continues

17:00 – Reflections on the Las Vegas response and its lasting impact

18:00 – From paramedic to physician: why Oscar continued his education

19:30 – Rural critical care, cardiac arrest and mobile ECMO

21:00 – Remaining connected to EMS while completing medical residency

23:00 – Advice for paramedics considering college or medical school

23:42 – Nine years as an undergraduate while working full time on the streets

24:00 – Perseverance, education and why the path is still achievable

Closing – Looking ahead, mentorship and what being NAEMT Paramedic of the Year means to Oscar

Enjoying the show? Email editor@ems1.com to share feedback.

FDNY Chief of Department John Esposito recounts FDNY’s devastating losses, the decisions that saved thousands of lives and why honoring 9/11 means preparing the next generation to meet the moment

Twenty-five years after Sept. 11, 2001, FDNY Chief of Department John Esposito joins podcast hosts Jim Dudley, Rob Lawrence and Aaron Zamzow of Police1’s Policing Matters, EMS1's EMS One-Stop and FireRescue1’s Better Every Shift for a deeply personal conversation about 9/11, its enduring impact and the lessons that continue to shape fire, EMS and law enforcement. Esposito was a newly promoted FDNY lieutenant on Sept. 11, 2001. He recalls returning to the city after the towers fell, the collapse of command and communications, the desperate effort to account for missing members, and the realization that FDNY had suffered unimaginable losses.

The discussion moves beyond remembrance to examine what emergency services learned: stronger accountability, controlling self-deployment, incident management teams, interoperable communications, interagency cooperation, intelligence sharing and peer support. Esposito also reflects on the continuing toll of World Trade Center-related illness and explains why “never forget” must mean more than remembering 343 names. For him, it means remembering the decisions responders made, the conditions they faced and the thousands of lives their actions helped save. His challenge to today’s generation is simple: know your job, keep learning, take care of your people and ask whether you are prepared to “measure up” to those who came before.

Key quotes from FDNY Chief of Department John Esposito

“Never forget is not just their names and who they were, how they lived their lives, and most importantly, the decisions that they made that day and the actions that they took.”

“They're like, ‘No, we think we lost everybody.’ And that was when it started to sink in that no, this is gonna be as bad as it could be.”

“If we never showed up and we had no losses that day, the loss of civilians is in the tens of thousands.”

“This is your legacy. This is our legacy, this is what we do, and these are the people that did this before us.”

“I believe that some of them knew that they were not going to make it home that night. And they still did their job.”

“September twelfth came, the doors of the firehouse went up, people got on fire trucks, and they went out and did their job.”

“It was like an all-star team that we lost. Some of the best people to ever do this job we lost that day.”

“I see my job here and our job in this building and headquarters is to take care of the people that take care of the city.”

“We have no idea. We're in a firehouse or an ambulance one second and in five minutes we could be in the worst situation we've ever been in.”

“It's our job to make sure that the people in the field are prepared and when they need something, it's our job to get it for them.”

Episode timeline

00:27 – Introduction: EMS1, FireRescue1 and Police1 come together to reflect on 25 years since September 11

02:28 – Introduction: FDNY Chief of Department John Esposito

03:23 – Chief Esposito recalls Sept. 11, 2001 as a newly promoted lieutenant with a day off and plans to study for the captain’s exam

04:28 – Chief Esposito details arriving in lower Manhattan and finding command structures and communications devastated

05:04 – The desperate process of identifying who was alive, missing or lost

07:00 – Chief Esposito describes his initial response and why he never imagined the towers could collapse

09:00 – “We think we lost everybody.” When the magnitude of FDNY's losses began to become clear

09:30 – Accountability and self-deployment emerge as major lessons from 9/11

10:00 – How FDNY now wants off-duty members to report to firehouses and EMS stations rather than directly to an incident

10:30 – Modern digital accountability, riding lists and identifiable radio transmissions compared with 2001's paper systems

12:00 – The human factor: firefighters desperate to get aboard apparatus headed toward the World Trade Center

12:30 – Leadership decisions that removed extra firefighters from overloaded apparatus ultimately saved lives

14:00 – The continuing human toll: FDNY's memorial walls and deaths from World Trade Center-related illness

16:30 – How FDNY will commemorate the 25th anniversary

17:30 – Why September 11 remembrance is intensely personal for individual firefighters and families

21:00 – Chief Esposito discusses the emotional effect September 11 continues to have on him

22:00 – “Never forget” means remembering actions and decisions, not merely names

24:00 – The actions of responders helped prevent civilian deaths potentially reaching into the tens of thousands

25:00 – Managing the overwhelming desire of responders to help during catastrophic incidents

27:30 – How outside incident management teams helped FDNY solve problems after 9/11

28:30 – FDNY repaying the assistance it received through deployments around the United States

30:00 – How today's incident command and dispatch systems control resources and prevent uncontrolled response

31:42 – Sponsor message

32:30 – Improved interagency collaboration between FDNY, NYPD and other agencies

36:00 – Peer support, firehouse culture and challenging the stereotype that firefighters do not talk about emotional distress

38:30 – How FDNY's peer-support system works after difficult incidents

42:30 – September 11 demonstrated why the fire service needs to be part of the intelligence community

44:00 – FDNY members are trained to recognize suspicious activity during routine fire and EMS responses

46:00 – How information spotted by firefighters may become the missing piece in a larger investigation

48:30 – What Chief Esposito wants responders who were not alive on 9/11 to understand

49:00 – “This is our legacy.” Measuring today's performance against those who came before

52:00 – Know your job and do your job — while recognizing that not every emergency fits an SOP

52:30 – A recent Bronx explosion illustrates the need to adapt principles to situations for which no exact procedure exists

53:30 – Applying the overarching principles of life safety and rescue when the situation is unprecedented

54:30 – What does “never forget” mean 25 years later?

55:30 – September 12: despite catastrophic losses, FDNY opened its firehouses and continued protecting New York City

56:30 – Chief Esposito describes those killed as “an all-star team” and some of the best ever to do the job

58:00 – Aaron Zamzow reflects on the responsibility to “measure up”

59:30 – The nationwide impact of 9/11 and seeing FDNY remembered on apparatus thousands of miles from New York

1:01:30 – Jim Dudley reflects on intelligence, prevention and acting on warning signs

1:03:30 – Chief Esposito discusses the difficulty of measuring successful prevention

1:05:00 – Warning signs, intelligence and lessons shared with other historic disasters

1:06:00 – Rob Lawrence reflects on September 12 and the emergency services reality that tomorrow brings another shift

1:07:00 – “At the going down of the sun and in the morning, we will remember.”

1:08:00 – Esposito discusses how 9/11 affected his career and leadership journey

1:09:00 – Leadership, doing the right thing and measuring decisions against the memory of colleagues lost

1:10:00 – “Take care of the people that take care of the city.”

1:11:30 – Emergency responders never know when the next call will become the worst situation they have ever faced

1:12:00 – The responsibility to ensure frontline personnel are prepared and supported

1:12:30 – Closing message: “Keep learning and keep moving forward.”

About our sponsor

This crossover episode of the Policing Matters, Better Every Shift and EMS One-Stop podcasts is sponsored by FirstNet — the only wireless network built with and for first responders.

Twenty-five years ago, first responders faced an emergency unlike any other. They stepped forward to protect and care for others, demonstrating extraordinary courage and resolve. This September 11th, we remember and honor those who answered the call. The example they set endures through the values that continue to inspire the profession today.

Learn more about FirstNet, Built with AT&T, at www.firstnet.com.

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AI may feel like the newest revolution in EMS, but the industry's relationship with data has been evolving for decades. In this episode of EMS One-Stop, Rob Lawrence sits down with FirstWatch founder Todd Stout, whose 28 years working with EMS data gives him a particularly long view of where the industry has been and where it is heading.

Todd traces the journey from an era when monthly reports printed on green-bar paper were considered normal, to today's world of real-time dashboards, cloud-based systems and enormous volumes of operational and clinical information. The challenge has changed: EMS no longer suffers primarily from a lack of data; leaders now need technology that can identify what matters, separate signal from noise and turn information into decisions.

That makes AI extraordinarily promising — and potentially dangerous. Todd explains why he is more excited about the next 3-5 years than at any point in his career, while simultaneously being more concerned about the next 8-10 months. Rob and Todd discuss unreliable AI outputs, data security, HIPAA and privacy, the risks associated with startups and what EMS leaders should ask before entrusting vendors with organizational or patient data. They also examine the urgent need for EMS agencies to establish AI policies and train their workforce on responsible use.

Todd concludes with a preview of FirstWatch's next generation of AI-enabled tools and a broader message for EMS leaders: the organizations that thrive through this technology shift will not necessarily be those with the newest technology, but those capable of adapting, learning and using it responsibly.

Additional resources:

EMS1 Leadership Institute: 2026 Spotlight on AI in EMS: On-demand: Smart tools, strategic choices: EMS puts AI into action

Why EMS must measure the human side of care: What patients remember

No rulebook is coming: EMS must take control of AI now: Why EMS must govern AI locally as adoption accelerates

Hyper-turbulent times: EMS economics and AI guardrails with Matt Zavadsky and Dr. Shannon Gollnick: Why EMS needs AI guardrails and Medicare reform today

Memorable quotes

"I'm more excited about the next 3-5 years than I've ever been, I am also more scared about the next 8-10 months for our industry than I've ever been because it's so messy." — Todd Stout

"Nobody gets into EMS to be excellent data enterers." — Todd Stout

"AI well formed — with the proper bumpers, guidelines, rules around it — is astonishingly good at processing through lots of data." — Todd Stout

"If you're not paying for the thing that you're using, you are the product." — Todd Stout

"AI to many people seems like magic. And it's the opposite of magic almost. It's a lot of work and plumbing to get it right." — Todd Stout

Episode timeline

00:27 – Rob introduces the episode and the evolution of EMS data, information and AI

01:54 – Twenty-eight years of FirstWatch: from Stout Solutions to today's real-time data environment

03:57 – Looking back at EMS's early adoption of real-time operational data

05:18 – Why immediate data can improve individual performance and expose problems with systems and protocols

06:24 – The "ah, buts:" gut instinct versus what the data actually shows

07:19 – Dirty data, disconnected systems and why organizations sometimes don't believe their own numbers

09:45 – EMS has moved from too little information to information overload

10:31 – How AI can sift through enormous amounts of data and identify what leaders actually need to know

11:22 – The accuracy problem: AI can produce impressive outputs while struggling with surprisingly basic tasks

12:39 – Todd explains why he is simultaneously excited and concerned about the immediate future of AI in EMS

14:35 – How EMS leaders can become better, more discerning customers of AI technology

15:10 – Established technology partners versus innovative AI startups

17:00 – What happens to your organization's data if an AI vendor fails or goes out of business?

17:41 – HIPAA, privacy, cybersecurity and employee data obligations

18:11 – Sponsor break

19:26 – Part two: protecting patient and organizational information when using AI

20:18 – AI training models, data sharing and why leaders need to understand vendors' default settings

22:44 – The pace of change: today's AI expertise can become outdated within weeks

23:08 – Preparing for the wave of "AI everything" appearing in EMS exhibit halls

23:45 – Questions EMS leaders should ask prospective AI vendors

25:20 – Why AI isn't magic — and why implementation requires significant work behind the scenes

27:08 – The case for every EMS organization having an AI policy now

27:41 – Todd warns that employees are almost certainly already using AI, sometimes without understanding the privacy implications

28:21 – Why AI education should resemble cybersecurity education: policy, training, suspicion and continual reinforcement

30:13 – Preview of FirstWatch Collaborate and the company's next generation of technology

31:02 – FirstWatch 2.0, AI-enabled mobile tools and workload management

31:55 – Reflect: incorporating patient satisfaction alongside operational and clinical performance

33:34 – Why rapid patient feedback can be more meaningful to crews than retrospective monthly scores

35:19 – Todd's closing message: EMS is good at adapting and improvising, and technology can make the job easier

36:22 – Rob's takeaway: adapt, innovate, become a discerning AI customer and establish an organizational AI policy

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