EMS Providers Showcase Skills at Battle of the Smokies 2025

By Kristin Carroll, Managing Digital Editor, EMS World

On March 4, 2025, 17 EMS teams from Tennessee and Kentucky gathered at the Sevierville Convention Center in Sevierville, Tennessee, to test their skills and knowledge in a fast-paced competition. The Battle of the Smokies was put on as a partnership between the Tennessee Association of EMS Providers (TAEMSP) and the Tennessee Mine Rescue Association (TMRA).

TMRA has been holding skills competitions for mine-based first responders for many years, offering an opportunity for mine rescue teams to not only train, but also test their skills.

“The training program they have is dictated by the federal government,” said Brian Millington, TMRA director. “That’s almost all they do—train. We started the competition for mine rescue so they get some real-world experience. Competition adds a little bit of stress level.”

Jason Fox, TAEMSP at-large representative, worked with Millington over the years and saw how the competition came together. He wanted to launch something similar for EMS providers. In 2023 and 2024, the competition had just six teams. This year, in joining with TMRA, the competition grew, and Fox said he wants to see 36 teams from around the country in 2026.

This is also the first year attendees had a chance to earn CEUs. The event kicked off with a presentation from Brian Robinson, state training coordinator for the Tennessee Association of Rescue Squads on suspension trauma, which served as a hint for competitors. Attendees received eight CEUs in pediatrics, cardiac care, and trauma.

The Scenario and Judging

Set in the wilderness of the Smoky Mountains, a team of workers is building a luxury cabin. It’s hot tub install day, and things are going smoothly, until the boom lift hits a bump. One of the workers isn’t harnessed in and falls out, bouncing off the worker guiding the lift from the ground and landing in the hot tub, getting electrocuted in the process. A second worker in the lift is harnessed, but not correctly, and ends up dangling from the boom lift’s basket.

Teams had 30 minutes to triage the patients and get them transported to hospital care. Since the “cabin” is in a remote area, resources like extra ambulances are scarce. TAEMSP provided two remote response vehicles to teams, meaning the third team to call had to wait, but if one of the first two teams took too long to load, “dispatch” would send the ambulance to another location. Teams also had a five-minute wait for another ambulance.

With a dangerous scene and three patients to triage and treat, teams had to work together to get their patients off to more advanced care. Teams competed in one of four divisions: student ALS, student BLS, service ALS, and service BLS. They were graded on their communication and teamwork, the medical care provided, post-scenario documentation, and a 25-question skills quiz. ALS and BLS teams had the same rubric, but ALS teams were expected to incorporate more advanced treatments, such as medication administration and advanced airway management. Time to complete the scenario served as a tie-breaker.

The Winners

Ten teams garnered awards for their work in the scenario; all teams received feedback to help them improve their training and response in the real world.

The winning team in the service ALS division, Big Tree, weren’t from the same department. They met for the first time at the competition.

“Elijah (AEMT) and I (Paramedic) entered as individuals,” said Angel Ferguson, who goes by @Paramedic.Anna on social media. “I had met Elijah just hours before the competition. We originally did not have a third crew member, so Elijah asked if one of his friends David (EMTB) could compete with us right before we went in. I had never met or worked with these gentlemen before. The name “big tree” was on David’s jacket, and that’s why our team was called that. It doesn’t hold any significance to us as a team; it was just random.”

“Honestly, we were not expecting to win,” she added. “The scenario was tough. I cannot describe the feeling. I felt proud and ecstatic. For me personally, this win proved to me that I am capable, and I’m in the field I’m meant to be in. I’m a fairly new paramedic. I got into EMS in 2018 and got my paramedic in 2023. I could not be more proud of my team and how we handled the scenario. I learned a lot at this event, and I cannot wait for next year!”

The winners are:

Student ALS

• First Place: Columbia State Community College
• Second Place: Walter State Community College
• Third Place: Northeast Community College

Student BLS

• First Place: Rome State Community College
• Second Place: Columbia State Community College
• Third Place: Walter State Community College

Service ALS

• First Place: Big Tree
• Second Place: Jackson County EMS
• Third Place: Greene County EMS

Service BLS

• First Place: AMR Blount

For more photos and a recap video, check out our Instagram, @emsworldofcl, under the highlight "TN EMS Comp."