Behind the Sirens: Director Nick Morgan Drives Big Advances in Kinney County EMS

It's easy to assume that in an emergency, an ambulance is just a phone call away, but that assumption rests on an extraordinary amount of unseen work, relentless advocacy, and often complicated logistics. At the center of that effort is EMS Director Nick Morgan, who has quietly been working to ensure Kinney County EMS is one of the most capable rural emergency departments in the region. Morgan, who began his EMS career here in 2012, returned to Kinney County in the summer of 2023 after years of contract work that took him around the world - from Los Angeles to Colorado, Baytown, and even Kabul, Afghanistan, where he spent six years directing EMS operations for the U.S. Embassy and numerous international agencies, responding to crises in one of the world’s most challenging environments. That experience has brought tremendous value to Kinney County. 

Today, Morgan oversees a team of seven full-time and three part-time medics, providing coverage for every call within Kinney County, including Fort Clark Springs, Spofford and the City of Brackettville. With long transport times—some over 40 minutes—and limited hospital services nearby, rural EMS operations demand deep critical-care skills. “In the city you have a patient for about 10 or 15 minutes,” Morgan explains. “Here, you often manage them much longer due to longer drive times. You have to think ahead, plan ahead, and see treatments working in real time. I think it can force you to be a stronger medic.”

This month, Kinney County EMS finally received its long-awaited new ambulance—a replacement for a 2008 unit. The new vehicle includes critical safety upgrades, including airbags in the rear compartment for medics. But getting it into service came with some hurdles. Initially expected grant funding fell through, payment delays, procedural requirements, and a required last-minute verification by the County Auditor made the purchasing process complicated, but well worth the effort. The issue was resolved after a special Commissioners Court meeting, and Morgan remained professional throughout, focused on protecting the county’s investment and ensuring continuity of care. “Once we get it in service, we’ll have three ambulances total,” he says. 

Under Morgan’s leadership, Kinney County EMS has acquired tools and training that many rural agencies simply don’t have.  In the case of carrying whole blood, only about 300 of the 23,000 EMS agencies nationwide have adopted this life saving program so far, with Kinney County EMS being one of those. Carrying whole blood is not widespread among EMS yet due to logistical challenges, but agencies are adopting this because it is more effective than traditional saline for trauma patients and can save lives by stabilizing patients faster in many cases. Director Morgan works with South Texas Blood and Tissue to rotate the blood supply every two weeks, and locally it has already been put to use to help patients. The program places Kinney County among an elite group of EMS providers able to deliver trauma-level care in the field—critical in a region where long distances can complicate emergency treatment. 

Another tool in the local EMS toolbox is new monitors, secured at no cost through Operation Lone Star, which allow EMS crews to now transmit live EKGs directly to hospitals for a more seamless transition of care. These monitors also integrate with a secure app that allows hospitals to share patient outcome feedback, something EMS crews rarely receive in rural medicine. “When we drop someone off, we rarely hear what happened after,” Morgan says. “Now, every once in a while, the hospital sends an update.”  

The new ambulance also carries ventilators, video laryngoscopes, and portable ultrasound units. “These tools give us a higher level of care than many surrounding agencies,” Morgan says. They also have Mechanical CPR devices, which free up personnel during cardiac arrests—a major advantage for a small, limited-staff agency. “We’re small, but our capabilities are strong,” Morgan emphasizes.

Future ambulance purchases may be supported by House Bill 3000, which takes effect in January and allows rural EMS agencies to apply for up to $500,000 toward a new ambulance, stretcher, and monitor. Morgan has already begun preparing for Kinney County’s application process as this becomes available. With that possible new funding, the county could potentially replace the second oldest vehicle - a 2012 ambulance, and be well-equipped with newer ambulances, with fewer maintenance issues and updated safety features.

Morgan clearly cares about the community he serves, and not just during emergencies. From Kinney County medic in 2012 to international EMS leader in Kabul and Los Angeles, and now back home strengthening rural emergency care—Morgan’s path has come full circle. “I started here, and I came back because I love this work and this community,” he says. He expressed appreciation for feedback from the community and an obvious desire to provide the best service possible for the citizens of Kinney County. Morgan also clearly expressed his gratitude to Judge Schuster, the County Commissioners, and his EMS crew, as well as all the local officials and agencies that have supported his efforts to implement new programs and grow the department, and even those that have helped drive a vehicle in a pinch.  In rural communities, it certainly takes a village. 

He shared a few suggestions for community members, “If you think you need help, don’t hesitate,” he says. “I’d rather take someone to the hospital and have it be nothing than have someone wait when they shouldn’t have.” In rural EMS, early activation can save lives. The director also shared a practical way residents can support EMS: make your home address visible from the road, especially at night, and use reflective numbers on mailboxes, driveways, or gates if possible. Finding a residence in an emergency at night can be challenging if street numbers aren’t clearly visible. And don’t be afraid to reach out. EMS crews seldom hear back from patients once they’re transferred to a hospital, so feedback, even simple gratitude, makes a difference. 

A visit with EMS Director Nick Morgan is a great reminder that behind every emergency call is a team trained, equipped, and supported through strong leadership. And behind every successful EMS response is the truth Morgan embodies: rural emergency medicine doesn’t happen by accident. It takes planning, advocacy, continuing education, modern tools, and a relentless commitment to the people you serve. And after 25 years in EMS—including war zones, big cities, and rural Texas— Morgan is still pushing Kinney County forward. “As a rural area,” he says, “we actually have a lot of capabilities. And we’re going to keep advancing for the people we serve.”