manifest the EMS system your community deserves Powered by clinical excellence, frontline experience, and bold system design.

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HAZMAT decontamination training

Disaster Readiness & Mass Event Planning

We design field-ready, integrated plans for mass gatherings, disaster scenarios, and complex multi-agency operations. Our team has led real-world responses to SEAR-1 events, extreme weather, and high-risk incidents in major metropolitan settings.

Highlights:

  • SEAR-level multi-agency planning

  • Disaster playbooks & surge strategies

  • High-risk incident medical coordination

  • Special event operations (festivals, parades, championships)

Type O blood from New Orleans EMS blood program blood medic bag

Starting a prehospital blood program can feel financially or logistically out of reach — but it doesn’t have to be. Manifest EMS specializes in developing blood programs that are clinically sound, operationally realistic, and financially feasible, using creative strategies that work within real-world EMS budgets.

Our team has direct experience building prehospital blood programs in challenging environments and can guide agencies step-by-step through design, partnerships, implementation, and sustainability — without unnecessary costs or unrealistic demands.

Highlights:

  • Cost-conscious program design using innovative storage, transport, and warming solutions

  • Guidance on hospital partnerships, blood bank collaboration, and supply chain alignment

  • Scalable workflows for agencies of any size, including pilot-start models

  • Training & competency development for safe, effective field transfusion

  • Operational planning for transport, documentation, QA/QI, and continuous temperature control

Building a Sustainable Prehospital Blood Program

New Orleans EMS tactical medic in field extrication training

We help agencies strengthen their entire system—from workflow to deployment—to build resilient, efficient, high-performance EMS operations. Our approach is strategic, data-driven, and grounded in decades of clinical and operational leadership.

Highlights:

  • System analysis & redesign planning

  • Operational workflow optimization

  • Advanced paramedic practice development

  • Clinical governance & QA/QI structure building

EMS System Design & Operational Strategy

New Orleans EMS pediatric airway training

Clinical Protocol Design & Advancement

Evidence-based, field-informed protocols that elevate clinical care and support operational reality. Our team blends physician expertise and frontline paramedic insight to design protocols that improve outcomes, enhance provider safety, and support scalable system growth.

Highlights:

  • Trauma, airway, cardiac, behavioral, pediatric, & neonatal pathways

  • Multimodal analgesia and advanced medical interventions

  • Field deployable, evidence-based workflows

  • Safety-centered approaches for clinicians and patients

VP David Rayburn teaching introductory ultrasound class at EMS World 2025

Clinical Education & Skill Advancement

Manifest EMS delivers education that elevates the confidence, competence, and clinical range of EMS providers. Our programs are designed not just to teach skills, but to expand what medics are empowered to do — safely, effectively, and with true clinical understanding.

Each offering blends evidence-based practice with real-world field insight, ensuring providers leave with practical, immediately applicable capability.

Highlights:

  • Advanced trauma, airway, and critical care skill development

  • Pediatric & neonatal resuscitation programs for high-acuity, low-frequency calls

  • Behavioral emergency management grounded in physiology and provider safety

  • Field diagnostics including ultrasound and point-of-care assessment

  • Leadership, communication, and clinical decision-making training

Founder Dr. Meg Marino with New Orleans EMS crew during Mardi Gras 2024

Leadership & change Management

EMS has long operated under a “suck it up” culture that dismisses the humanity of the very clinicians who hold the system together. Manifest EMS supports agencies in creating leadership structures and cultural frameworks that acknowledge trauma, reduce burnout, and build environments where medics can thrive — not just survive.

We help organizations shift from outdated expectations of endurance to modern models of support, resilience, and psychological safety. This work directly impacts provider turnover and makes EMS a sustainable, lifelong career.

Highlights:

  • Culture assessment & leadership coaching for supportive, human-centered EMS

  • Change management strategies to replace harmful norms with healthy expectations

  • Whole-person support frameworks addressing mental, physical, and emotional load

  • Trauma-informed policy development & organizational communication

  • Structures that reduce turnover and improve long-term provider retention