Inside EMS

What do you do when someone on your team is struggling — and it’s on you to say something? In this episode of the Inside EMS podcast, Chris Cebollero and Kelly Grayson dive headfirst into one of leadership’s toughest challenges: holding people accountable without losing your humanity. This episode challenges leaders to ditch outdated progressive discipline models and start leading with clarity and empathy. Whether you’re a seasoned supervisor or new to the hot seat, this one hits home. And if you’ve been avoiding a conversation, consider this your nudge to stop choosing comfort over your own integrity. Quotable takeaways “Firing people with compassion, managing your ego, their ego, admitting mistakes and just being human — these are the places where real leaders show up.” “One of the things I try to teach is that I don't fire anybody — I just process the paperwork. People fire themselves.” “EMS is a very egotistical business, and it's that ego that keeps us from asking questions. Because we don't want to look like we don't know what we're talking about in front of our peers.” Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest a guest!

This week on the Inside EMS podcast, we’re passing the gravy and the hot takes. Cohosts Chris Cebollero and Kelly Grayson serve up a holiday plate full of EMS news — starting with FDNY’s potential EMS split. They dig into what fair pay really looks like, why some EMTs are suing for what they’re owed, and whether big hospital systems like Yale New Haven are reshaping the ambulance game for better or worse. Whether you’re working a turkey-day shift or finally off duty, this episode hits hard and gives thanks where it’s due. Quotable takeaways: Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest a guest for a future episode.

This week on the Inside EMS podcast, Dr. Peter Antevy returns for another round in the hot seat, and he’s not holding back. In this jam-packed episode, he and host Chris Cebollero tackle trending topics in prehospital care — from the expanding role of whole blood and plasma, to the frustrating gaps in the AHA’s 2025 guidelines. You’ll hear real-world success stories (like the cardiac arrest survivor who’s back on the tennis court), why dual sequential defibrillation (DSD) should already be your go-to, and the cost-benefit realities of starting a whole blood program. Dr. Antevy also dives into the science behind glycocalyx damage and how plasma could change how we treat sepsis, TBI and burns in the field. Whether you’re a medic, medical director or just passionate about pushing EMS forward, this episode delivers practical insight, bold opinions and a whole lot of inspiration. Quotable takeaways from Dr. Antevy “The medical establishment does not understand the value of what EMS brings to the table. They don't understand the complexity.” “When we said, ‘We'll do the whole blood,’ what did the surgeons do? They went up in arms: ‘What do you mean you're giving whole blood? Bring them to us. We'll give the whole blood.’ No, no, no. We are part of the chain of survival, too.” “EMS is a subspecialty in the house of medicine. We all need to rise up to make the hospital folks and the academics aware that EMS is important for trauma, for stroke, for pediatrics, for cardiac. We are the ones who can help bring up those outcomes and that's why I love this field.” Additional resources: AHA 2025 updates are here: Cue the overreactions and the protocol rewritesOn-demand: Bringing whole blood to the front lines of EMSStop the bleed, fill the tank – The New Orleans EMS blood programWhole blood in EMS promises a revolution in resuscitation Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest a guest for a future episode.

This week on the Inside EMS podcast, host Kelly Grayson sits down with Jimmy Apple — known as the “EMS Avenger” on TikTok — to explore how he’s challenging long‑standing EMS norms and delivering evidence‑based content at scale. With 22 years in EMS, the pediatric critical‑care paramedic has built a strong digital platform that merges clinical rigor with plain‑spoken commentary. Whether you’re hung up on “what’s new” or “what really works,” this episode offers a spirited discussion, thoughtful commentary and a call to re‑examine what we do — and why. Memorable takeaways Enjoying Inside EMS? Email theshow@ems1.com to share feedback and suggest guests for future episodes.

Let’s face it — most discussions on leadership sound like someone regurgitating a business best seller. Not this time. In this week’s episode of the Inside EMS podcast, cohosts Chris Cebollero and Kelly Grayson get real about the six leadership habits that actually matter when you're running a shift, a truck or a team that relies on each other not to screw it up. This isn’t about titles, org charts or leadership flavor-of-the-month. We’re talking self-awareness, collaboration and adaptability — the stuff that separates real-deal leaders from clipboard-holding disasters. Whether you’re trying to step up or just sick of bad leadership, this episode’s got what you need to lead better — without the cringe. Memorable quotes “What I can't stand in a leader is someone who waffles and is just blown by the wind. I would much rather have somebody say, ‘This is what we're gonna do.’ And then after, ‘Ooh, that was a bad idea. I'm sorry for that. That's on me.’” “If the team's confused, it's not a team problem. It's a leadership problem.” “Leaders who don’t know themselves lead through ego and insecurity.” Enjoying Inside EMS? Email theshow@ems1.com to share feedback.

In this week’s episode of the Inside EMS podcast, cohosts Chris Cebollero and Kelly Grayson dive into the 2025 AHA Guidelines for CPR & ECC and why, for most EMS systems and crews, this feels more like a tune up than a full overhaul. They talk through what is different — like the adult/child choking algorithm change, the inclusion of an opioid overdose response algorithm with public naloxone access, and the shift to a single unified chain of survival across ages and settings. They also talk about what isn’t new (for example, the recommendation that routine mechanical CPR devices are not better than manual compressions), why that matters, and how agencies should frame this for crews and training programs. Bottom line: the changes are real, the work is actionable, but this doesn’t feel like a seismic shift — so use that to your advantage in getting buy-in from providers and avoiding the “huge change panic.” Memorable quotes “They're actually saying now, which I think is pretty cool, that individuals 12 and above can be taught CPR and how to use an AED.” “The key is early CPR and early defibrillation. And if you'regoing to get more bang for your buck, you need to devote your time to bystander CPR training and public AED access rather than buying fancy gadgets that are appealing but may not actually be supported by science.” “I find it interesting that we used to caution against this in CPR class: ‘Don’t give 'em back blows. You may lodge it deeper into the trachea.’ But now, I think they've looked at the data, and back blows are, at the very least, not harmful and may be beneficial.” “For those in leadership: audit all your protocols and training materials now. Find out where your system is aligned or out of step.” Enjoying the Inside EMS podcast? Email theshow@ems1.com to share feedback.

This week on the Inside EMS podcast, hosts Chris Cebollero and Kelly Grayson dig into a hot-button issue lighting up EMS forums: DUI blood draws by paramedics. In Vanderburgh County, Indiana, a new program lets fire department medics perform evidentiary blood draws at the request of law enforcement — right on scene, even if the suspect isn’t being transported. Supporters say it’s efficient; critics say it’s unethical. The hosts share their own history with blood draws in the field and reflect on how their professional philosophies have evolved. It’s a passionate, no-holds-barred conversation about legal gray zones, moral boundaries, patient advocacy, operational burdens and the blurry line between healthcare and law enforcement. Spoiler: There’s no easy answer. But if your agency is considering such a program, this episode is required listening. Memorable quotes “My job is to do medical care, period, end of file. Quite often in doing my job, I make the point, ‘Hey, I'm not a cop, man. You can trust me.’” “There's a moral dilemma there. Are we caregivers or are we evidence collectors?” “Even if the laws permitted me to do so for one reason and one reason only, it's very hard to shift from a caregiver mindset to a defensive mindset.” Enjoying the show? Email theshow@ems1.com to share feedback or suggest a guest for an upcoming episode.

Sure, AI and digital systems are reshaping EMS, but at the core? It’s still about people. In this week’s episode of the Inside EMS podcast, cohosts Chris Cebollero and Kelly Grayson tackle the disconnect between tech-savvy, fast-adapting, new providers and an education system still stuck in the lecture-skill-lab loop. They break down why flipped classrooms, mentorship and real talk about leadership must happen now—and why soft skills aren’t just nice-to-haves; they’re survival tools. This episode makes the case that the future of EMS depends on how well we prepare, mentor and empower the medics already entering the field — and why waiting to teach leadership is a mistake we can’t afford to keep making. Memorable quotes Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest future guests!

This week on Inside EMS, ChrisCebolleroand Kelly Grayson dive deep into the dark side of workplace culture — the seven types of negativity that poison morale, ruin teamwork and chip away at your love for the job. From the moment the coffee hits your cup, to the second the rig rolls out, negativity can show up uninvited: complaints, criticism, blame, gossip — and yes, the ever-present cynicism. But this isn’t just a leadership lecture. It’s personal. Kelly opens up about his own battles with depression and how behaviors like self-pity and cynicism creep in under stress. The duo explores how everyday negativity often masks deeper issues — cries for help, burnout, lack of connection — and how leaders (and peers) can break the cycle. This episode is real, raw and one every EMS pro needs to hear. Memorable quotes “Negative attitudes spur negative attitudes. It's a phenomenon that feeds on itself.” — Kelly Grayson “Stop blaming and stop pointing fingers and let's fix the problem.” — Chris Cebollero “These seven types of negativity do us no good. All they do is drag us down personally, and they drag our workplace and our coworkers along with it.” — Kelly Grayson Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest guests for future episodes.

You know the drill — “patient feeling weak,” “not quite right,” maybe alittle confusion. But what if that vague dispatch hides a killer? This week on the Inside EMS podcast, hosts Chris Cebollero and Kelly Grayson dig into one of the most missed, yet deadliest emergencies we face: sepsis. You'll hear when to treat aggressively with fluids, why timing matters for antibiotics and how any provider can sound the alarm with a sepsis alert. Plus, they dive into the controversy around fluid bolus protocols, which prehospital labs might be worth it and why a 30 mL/kg mindset isn’t always one-size-fits-all. If you've ever walked into a call and thought “something’s off,” this episode will help you figure out what — and how to act before it’s too late. Memorable quotes “Most septic patientsdon'troll with a sign thatsays,‘I’m septic.’” “The number of sepsis cases we see in EMS are more than stroke and heart attack combined.” “They may have pulses everywhere — just none of them are good.” Enjoying the show? Email theshow@ems1.com to share feedback or suggest future guests.

This week on Inside EMS, Chris Cebollero welcomes Patrick Pianezza — former EMS Leadership podcast co‑host, paramedic and co-writer on the new action-comedy EMS film ‘Code 3.’ Pianezza teamed up with writer Christopher Leone to push for authenticity, insisting on medical accuracy and avoiding cliches — no guns‑in‑ambulance heroics, no patients as punchlines. There are scenes that will make medics say, “That’s us!” — from nursing home calls to behavioral health crises, the pressures from society, as well as moments many will recognize in their gut. For EMS professionals, this is about being seen, valued and having your story told well. For everyone else, it’s an invitation to look deeper at the people showing up to help you on your worst day. Memorable quotes “What I really care about, what I want people to take away from the movie, especially if you’re still actively doing the job, is that they feel recognized. They feel seen, they feel like we did them justice.” — Patrick Pianezza “CPR is so terribly shown on screen that we were committed to like, at least one movie’s gonna get it right.” — Patrick Pianezza “There is a heart to it that I think is universal and speaks to not just people who do the job, but for outsiders to get a view into this world and be like, ‘Oh, so that’s what this job is.’” — Patrick Pianezza Additional resources: Burnout, bravery and gratitude: The story behind ‘Code 3’Why ‘Code 3’ might be the most honest EMS film yet‘Code 3’: A love letter to fire and EMS Enjoying the show? Email theshow@ems1.com to share feedback or suggest future guests.

Ever been told to “cut the war stories” in EMS? Chris Cebollero and Kelly Grayson are here to push back. This week’s episode of the Inside EMS podcast dives into the vital role storytelling plays in shaping EMS culture, training, leadership and even public perception. With their signature mix of humor and heart, they explore how the right story — told the right way — can teach more than any protocol ever will. From instructor pitfalls to leadership mistakes, they share personal wins and failures that built their character — and could build yours too. You’ll also get 8 rock-solid tips on how to be a better storyteller in the field, in the classroom or at the next crew dinner. Spoiler: It’s not about theatrics; it’s about authenticity, vulnerability, knowing when to pause ... and when to whisper. Top quotes Enjoying the show? Contact the Inside EMS team at theshow@ems1.com to share ideas, suggestions and feedback, or let us know if you’d like to join us as a guest.

In this episode of the Inside EMS podcast, hosts Chris Cebollero and Kelly Grayson dive headfirst into one of paramedic's most anxiety-inducing scenarios: the pediatric airway. Despite decades of advancement, pediatric codes still strike fear into the hearts of even the most seasoned medics. So why hasn’t this gotten any easier? Drawing on their own experience (plus a few nods to Dr. Peter Antevy), the duo emphasize the urgent need for high-fidelity simulation training, ongoing QA and competency-based training. This episode’s packed with insights, strong opinions and a healthy dose of tough love for EMS systems that continue to send underprepared crews into high-stakes situations. If you’ve ever broken into a cold sweat over a pediatric call, this episode is for you. Memorable quotes "When a mother hands you a 3-month-old in cardiac arrest, that’s not the time to figure out you’re uncomfortable." — Chris Cebollero “If you want the medic to intubate kids, you need cadaver labs, you need high fidelity simulation. You need to practice and you need to QA that practice. Most systems just can't provide that and without regular exposure, intubation becomes unsafe. And that's why I'd argue if you can't maintain your competency, you shouldn't carry the skill.” — Chris Cebollero “Kids aren't little adults. They do have more challenges. They do have bigger tongues. They do have floppier epiglottis, they do have smaller airways.” — Chris Cebollero Enjoying the show? Email theshow@ems1.com to share feedback and suggest future guests.

As artificial intelligence sweeps across industries, Chris Cebollero and Kelly Grayson are asking the big question: Is EMS ready? In this episode of the Inside EMS podcast, the duo gets into the weeds of how AI could reshape the field, from charting and documentation, to predictive deployment and real-time clinical prompts. They dig into practical use cases, like auto-generating patient care reports from spoken narratives, using smart speakers for on-the-fly drug dosages and deploying AI in dispatch triage. But they’re not AI cheerleaders; both caution against overreliance, false confidence and the risk of replacing critical thinking with shortcuts. It’s a spirited, funny and forward-looking conversation about how EMS can lead, not lag, in adopting this rapidly evolving tech. Because one thing’s clear: AI isn’t coming — it’s already here. Memorable quotes “I think the big issue that people have with AI is that they fear it’s gonna start doing our thinking for us rather than help us with everyday tasks. And to me, that’s a legitimate fear.” —Kelly Grayson “When we open this door of where AI can touch EMS directly, I think there’s a lot of places this can go.” —Chris Cebollero “I learned long ago that one of the tricks to the choreography of a smooth call is to think out loud and to talk, talk, talk your way through everything that you do. It’s interesting thinking about narrating that for the purpose ofan AI client to write your chart as you go.” —Kelly Grayson Enjoying the show? Email theshow@ems1.com to share feedback or suggest future guests!

This week on the Inside EMS podcast, Chris Cebollero and Kelly Grayson shine a spotlight on the kidneys and their impact on patient outcomes. What starts as a chat about chronic kidney stones quickly dives into a sharp, clinical breakdown of renal anatomy, physiology and the far-reaching consequences of kidney dysfunction in EMS care. Chris and Kelly unpack the kidneys’ role in fluid balance, blood pressure regulation and acid-base stability, including how the renin angiotensin aldosterone system (RAAS) system can either save a patient … or make things worse. They outline the key types of acute kidney injury (pre-renal, intrinsic, post-renal), tie them back to underlying anatomy, and explain why perfusion matters long before labs confirm failure. With field-focused tips on what to ask (yes, diaper counts matter), what to look for and how to manage critical complications, this episode gives medics the tools to recognize renal red flags early — and act fast. Additional resources: Acute kidney injury assessment and treatment The science behind shock: Why providers must understand the RAAS Caring for the dialysis patient One for the Road: Is this a kidney stone? Memorable quotes “In EMS, we don't really pay attention to the functioning of the kidneys until everything goes south.” “They're not lying when they say the kidneys are the windows to the viscera.” “Kidney problems don't happen in isolation.” Enjoying the show? Email theshow@ems1.com to share feedback or suggest guests for a future episode.

This week on the Inside EMS Podcast, Chris Cebollero and Kelly Grayson dive deep into the What Paramedics Want in 2025 industry report — and let’s just say, it’s not all sunshine and stable shifts. The report, created in partnership with Fitch & Associates and sponsored by Pulsara, lays bare the hard truths: burnout is at an all-time high, staffing gaps are holding steady at crisis levels and confidence in leadership is lukewarm at best. Chris and Kelly get real as they discuss some of the shocking stats — such as, only 59% of agencies report having enough staff to answer 911 calls, and 76% of respondents now cite burnout as a critical issue. But this isn’t just about fatigue; it’s about leadership gaps, lack of support and workplaces that are driving out even the most seasoned medics. From the “mandatory overtime spiral” to why communication isn’t just nice — it’s a necessity — this episode tackles how broken systems are eroding morale and what leaders can (and must) do to change course. You’ll hear why stay interviews matter more than exit interviews, how marijuana use is creeping up as a stress escape, and the simple steps agencies can take to rebuild trust and retention. Memorable quotes “If one-quarter of your work workforce says ‘we don't enjoy our jobs anymore’ and ‘we don't enjoy working for you anymore,’ you got a hell of a problem on your hands.” — Kelly Grayson “This isn't just burnout because of the things we're seeing. This is because of staffing shortages. This is because of lack of funding. This is because of working overtime. This is because agencies are mandating overtime. And that's gonna lead to burnout.” — Chris Cebollero “What we have is a shortage of people who are willing to work for chump change and horrible working conditions.” — Kelly Grayson Enjoying the show? Contact the Inside EMS team at theshow@ems1.com to share your feedback and suggest future guests.

You’ve just been promoted — congrats, right? Not so fast. In this episode of the Inside EMS podcast, cohosts Chris Cebollero and Kelly Grayson get real about what it actually means to step into a leadership role. Spoiler alert: it's not just a new title and a gold badge. It’s a complete shift in responsibility, from caring for patients to caring for your people. Together, they break down how new leaders often swing too far: either trying to be everyone’s buddy or going full micromanager. They talk servant leadership, earning trust daily, the power of listening and what “protecting your people from bad decisions above” really looks like. If you're stepping into a new role — or trying to recover from a rocky start — this episode is packed with hard truths, some laughs and solid advice from two guys who’ve lived it. Memorable quotes “Ask a lot of questions and give your subordinates some ownership over how decisions are made. They didn't get stupid overnight when you got a white shirt. They're still the good people they were before.” — Kelly Grayson “Leadership isn't a title, it's not a reward, it's a responsibility. It’s a verb, not a noun, and you have to be able to show your leadership every day.” — Chris Cebollero “Leadership's not about perfection. It's about showing up every day and trying to get better. It's being present in the moment. You show up for your people, you help them be their very best, and you never stop learning how to lead better.” — Kelly Grayson Rate & review Inside EMS Enjoying the show? Contact the Inside EMS team at theshow@ems1.com to share ideas, suggestions and feedback, or let us know if you’d like to join us as a guest.

In this episode of the Inside EMS podcast, hosts Chris Cebollero and Kelly Grayson are staying in the same hotel, but definitely not on the same page. The topic? Point of care ultrasound (POCUS) — is it the future of EMS, or just another flashy tool with little impact in the field? Chris opens the discussion with skepticism, calling POCUS a “ridiculous” tool that adds no value to his prehospital patient care. Kelly fires back with a defense of POCUS as a powerful, fast and non-invasive tool that can enhance clinical decision-making — if used right. It’s a spirited back-and-forth loaded with clinical scenarios, sarcasm and a lot of “whatever, man.” Whether you’re team “POCUS is progress” or “scan and stall,” this episode will get you thinking. Memorable quotes “Ultrasound gives you another layer of decision-making support.” “Point of care ultrasound gives me no ability to change the way I'm treating the patient.” “It never is a bad thing to know more about the patient.” Rate & review Inside EMS Enjoying the show? Contact the Inside EMS team at theshow@ems1.com to share ideas, suggestions and feedback, or let us know if you’d like to join us as a guest.

In this episode of the Inside EMS podcast, Chris Cebollero and Kelly Grayson tackle one of the most nerve-wracking scenarios in EMS: the pediatric respiratory emergency. From the moment you see a gasping toddler in mom’s arms, you know this is a make-or-break call — and for many providers, it’s the one that keeps them up at night. Chris kicks things off with a haunting real-life scenario that sets the stage for an in-depth conversation on how to recognize and respond to pediatric respiratory distress. Kelly, a seasoned PALS instructor with a knack for demystifying pediatrics, offers practical advice on assessing sick kids using tools like the Pediatric Assessment Triangle, reading subtle signs like head bobbing or limp limbs, and why the good ol’ basics — like BVM ventilation and suction — save lives. From clinical pearls to mindset resets, this episode is a must-listen if you want to face your pediatric fears and come out stronger. Memorable quotes Enjoying the show? Email theshow@ems1.com to share your feedback.

When conflict flares up in your organization, do you fuel the fire or douse it with empathy? In this week’s episode of the Inside EMS podcast, Chris Cebollero and Kelly Grayson break down how to handle interpersonal drama and tough conversations like a leader — with calm, clarity and tactical empathy. Tactical empathy isn’t about being soft; it’s about being smart. It’s the intentional art of listening, labeling emotions and showing people they’re seen — without letting things spiral into chaos or resentment. Drawing from leadership lessons, clinical psychology and their own missteps, Chris and Kelly lay out 5 solid tools you can start using immediately, from mirroring and eye contact, to setting respectful boundaries. Whether you’re managing late shift changes, dealing with crew conflict or just trying to keep morale afloat, this is an episode that gives you actionable steps — not just leadership fluff. Oh, and if you think “tactical” doesn’t belong in the same sentence as “feelings,” they’re here to prove you wrong. Memorable quotes “Conflict is part of EMS. You cannot avoid it.” — Kelly Grayson “Empathy’s not a rescue mission. It’s a recognition moment.” — Kelly Grayson “The trick isn't avoiding conflict. It's learning how to handle it without crushing morale, without leaving the other side, or having one or both sides feeling that you're showing favorites or you're blind to their concerns.” — Kelly Grayson Enjoying the show? Contact the Inside EMS team at theshow@ems1.com to share ideas, suggestions and feedback, or let us know if you’d like to join us as a guest.