The Paramedic's Mistake in Wildland Fire Environments

The Paramedic's Mistake in Wildland Fire Environments

The fire line doesn't care what you trained for. In wildland fire EMS and wilderness medicine, paramedics work hours from a hospital — and standard ER thinking breaks fast. In this episode, we sit down with Dr. Miguel Pineda — emergency physician and wilderness medicine fellowship-trained doc — to break down what wildland fire EMS, wilderness medicine, and prehospital care actually look like when the calls are unpredictable and definitive care is hours away. Tree strikes, seizures, unstable SVT, cardiac arrest — sometimes on a patient who happens to be your own teammate. The thread running through it all is simple: stay calm, act decisively, and never confuse busy work with patient benefit. What we cover: - Sick vs. not sick — the read that drives every other decision in remote medicine - Building confidence as a new paramedic in solo, critical-access settings - Trigger points: when to stop tinkering and start moving toward definitive care - Prolonged field care during 12–24 hour extrications — what changes when help isn't coming fast - Helibase medic realities — cramped cabins, altitude, and what actually fits in the kit - Non-narcotic pain management and the changing prehospital regulatory landscape - Ketamine for acute pain — dosing pace, laryngospasm risk, emergence reactions - Why a clean call-ahead report and a written handoff note can save a patient across multiple transfers Find The Journeyman here: https://livetjm.com/ Find The Journeyman on Google Play Store: https://play.google.com/store/apps/details?id=com.livetjm.thejourneyman&pcampaignid=web_share Find The Journeyman on the Apple App Store: https://apps.apple.com/us/app/tjm-the-journeyman/id6503902863 0:00 Trauma Is Not The Only Risk 5:03 First RSI After COVID Training Gaps 9:06 Evac Plans And The Trigger Point 12:50 Medical Direction For Long Extrications 16:25 Helibase Medics And Kit Planning 20:10 Remote Medicine Dreams And Reality 29:50 Cleaner Handoffs And Better Scribes 32:58 Final Thanks And Sign Off

Sick vs Not Sick: Decisions That Saves Lives in the Wilderness

Two hours from the nearest hospital, “standard ER thinking” breaks fast. We’re joined by Dr. Miguel Pineda, an emergency physician and wilderness medicine fellowship trained doc, to talk about what actually matters when you’re doing EMS in austere environments like wildland fires, remote rescues, and rural transport corridors. We get into the decision skill that drives everything else: telling sick vs not sick early. From there we talk field priorities that hold up when you might lose an airway, run out of supplies, or wait on a helicopter. Dr. Pineda explains what he hopes to see from EMS crews in the woods, why a clean and confident call-ahead report helps the ER move faster, and how limited-resource work (including solo coverage in a border community) changes the way you lead, communicate, and improvise. Then we go practical on common fire line hazards: rattlesnake bites, scorpion stings, and venomous spider myths. You’ll hear what helps in the field (rings off, mark swelling with a time stamp, protect the limb) and what can seriously hurt patients (tourniquets, cutting, sucking venom, and other Hollywood fixes). We also talk anaphylaxis and why we’d rather you treat early with IM epinephrine than wait for a “perfect” picture, plus poison oak or poison ivy smoke exposure and how allergy meds and steroids can fit into a solid prehospital plan. If you work wildland fire EMS, wilderness medicine, or prehospital care, this one is built for you. Subscribe, share this with a teammate, and leave a review with your biggest take-home from the conversation. Find The Journeyman here: https://livetjm.com/ Find The Journeyman on Google Play Store: https://play.google.com/store/apps/details?id=com.livetjm.thejourneyman&pcampaignid=web_share Find The Journeyman on the Apple App Store: https://apps.apple.com/us/app/tjm-the-journeyman/id6503902863 0:00 The Reality Of Fireline Medicine 4:21 Small Town ER And Border Work 7:42 Sick Or Not Sick In The Woods 13:51 Improvised Ultrasound Gel In Heat 16:49 Snakebites Without The Hollywood Myths 25:55 Scorpions And Venomous Spider Truths 36:07 Anaphylaxis And Early Epinephrine 39:56 Poison Oak Smoke And Steroids

Checklists Won't Save Your REMS Team

You can tell who looks tough. You can't tell who will endure — and that gap is where fire crews break. In Part 2 of our conversation with John Hennessey — retired Air Force officer, former Booz Allen Hamilton program manager, and one of the architects of Dammeron Valley Fire Rescue — we follow the thread from special operations selection culture straight into the unforgiving reality of wildfire operations and modern fire service leadership. This half goes deep on what actually keeps firefighters alive and teams sharp: standards over hype, daily practice over vibes, and why complacency is the fastest way to get hurt or fall behind. What we cover: - Why "looking tough" tells you nothing — and why cadre still can't predict who quits on day one - The "false summit" trap, and treating every plateau as a reason to push harder - Earning credibility when you're leading experts who outclass you technically - What the Waldo Canyon and Black Forest fires teach about wind, ember storms, and structure density - Wildfire mitigation, Firewise assessments, and the home ignition zone details most residents miss - The real limits of structure protection when water and time run out - REMS team realities on remote terrain — scouting routes, staging smart, and building a PACE plan - Why checklists are not capability — and what "good" looks like when you're holding a patient overnight with no helicopter - The case for tighter REMS standards that measure performance, not shopping lists If you care about wildfire preparedness, structure protection, emergency medical response, or leadership under stress — this one's built for you. Find The Journeyman here: https://livetjm.com/ Find The Journeyman on Google Play Store: https://play.google.com/store/apps/details?id=com.livetjm.thejourneyman&pcampaignid=web_share Find The Journeyman on the Apple App Store: https://apps.apple.com/us/app/tjm-the-journeyman/id6503902863 0:00 Never Satisfied With The Status Quo 1:15 Why You Cannot Spot Quitters 5:45 Earning Credibility With Elite Teams 7:42 First Real Taste Of Fire Service 8:50 Waldo Canyon And Black Forest Reality 11:34 Firewise Home Ignition Zone Walkthroughs 16:16 Forsyth Fire Night One Lessons 18:20 REMS Planning For Remote Rescues 26:52 Train Daily And Build Real Standards 36:20 Retirement Goals And Vision 2030 39:23 Final Thanks And Wrap Up

The One Thing Every Wildland Fire Department Gets Wrong

Building a REMS team isn't optional anymore — it's how you keep your wildland firefighters alive when extraction goes sideways. And most departments wait until it's too late. In this episode, John Hennessey — retired Air Force officer, former Booz Allen Hamilton program manager, and one of the architects of Dammeron Valley Fire Rescue — breaks down how to actually launch a Rapid Extraction Module Support (REMS) team without the budget, the bureaucracy, or the decade most departments think it takes. What we cover: - The "speed of need" framework that forces decisions instead of endless planning - How to write a statement of need that gets grants funded - Why cost-schedule-performance thinking from defense programs works for fire service - Setting measurable response time targets — and proving you hit them - Building a fire and EMS training pipeline when you can't hire certified people - How Greg McKeown and Liz Wisemans "Multipliers" leadership model wins in volunteer fire departments - How a "Volunteer Firefighters Needed" sign on a mailbox turned into one of Southern Utah's most operationally serious volunteer fire departments 📌 If this episode gave you something useful — subscribe, drop a comment with the one lesson you're taking back to your crew, and share it with a fire service leader who needs to hear it. Find The Journeyman here: https://livetjm.com/ Find The Journeyman on Google Play Store: https://play.google.com/store/apps/details?id=com.livetjm.thejourneyman&pcampaignid=web_share Find The Journeyman on the Apple App Store: https://apps.apple.com/us/app/tjm-the-journeyman/id6503902863 0:00 The Mailbox Sign That Started It 3:00 Air Force Roots And Booz Allen Lessons 8:00 Turning A Volunteer Crew Into A System 15:58 Multipliers Versus Oxygen Thieves 22:35 Cost Schedule Performance For Fire Rescue 26:23 Building Utah’s First REMS Team 30:58 Speed Of Need And Modern Gear

Three Guys Tackle the Biggest Issue Nobody's Addressing In Wildland Fire

Wildland fire admin is still way too hard. Between scattered job boards, paper CTRs, certs in three folders, and a new login for every crew you've ever rostered with — there's no reason it should still feel this messy. In this rapid-fire FAQ, we sit down to clear up exactly what The Journeyman is, what you get with a free wildland firefighter profile, and why we refuse to charge people just to look at jobs. We also get into the parts most folks don't expect: trainings and events, season tracking, digital shift tickets, crew time reports, and an offline mode that still works when you're a hundred miles from cell service. Then we tackle the questions we hear nonstop from firefighters and business owners: – Can other companies see my roster? – Are you selling my data? – What's public, what's private, and who controls it? – How does multi rostering actually work? – What does the premium profile unlock for incident tracking? We walk through how permissions work, why incognito mode puts visibility back in the user's hands, and how phantom profiles let companies track personnel without forcing every firefighter into the platform. For business owners, we break down how The Journeyman functions as full wildland fire business management software — certifications, documents, equipment, inventory, incidents, and cleaner handoffs when a manager is covering multiple fires or an owner goes down mid-season. Continuity matters, and the patchwork of spreadsheets and group texts isn't cutting it. If you've got questions about anything we covered, shoot us an email, give us a call, or text us — text is probably the fastest. We'll get you taken care of. Visit Our Website https://livetjm.com/ Find The Journeyman App here: Google Play Store: play.google.com/store/apps/details?id=com.livetjm.thejourneyman&pli=1 Apple App Store: apps.apple.com/us/app/tjm-the-journeyman/id6503902863 #WildlandFire #WildlandFirefighter #TheJourneyman #FireSeason #WildlandFireJobs #FireBusiness #WildlandFireApp [00:00:00] Free Profile And Job Board [00:04:40] More Than Hiring Connections [00:10:16] Multi Rostering And Incognito Mode [00:20:42] Free Versus Premium Firefighter [00:26:14] When A Manager Goes Down [00:31:11] Competing Tools And AI Onboarding [00:36:47] Checklists Expansion And Wrap Up