Inside EMS

In this end-of-year special, Chris Cebollero and Kelly Grayson wrap 2025 with their trademark mix of humor, insight and zero sugarcoating. From venomous bites to venomous behavior, the Inside EMS duo continue counting down the top EMS stories that had the industry buzzing this year — and occasionally cringing. As always, the guys don’t shy away from the tough stuff, but they make sure to end on a note of gratitude for the everyday EMS pros out there doing the job with compassion, competence and quiet heroism. Quotable takeaways “Every day, EMS providers go out there, do their jobs and bring some kindness and some comfort to a really bad day for their patients. And I think we need to look forward to more of that in 2026.” “Sometimes we've done things that maybe we shouldn't have, because it isn't in our scope of protocols, but I think we make a difference. Where's the line?” “Most of the advantages of mechanical CPR are not advantages at all.” The top EMS1 stories of 2025 Representatives Glenn Thompson and John Mannion introduced the EMS Counts Act Social Security Fairness Act signed into law, boosting retirement benefits for first responders Kentucky EMTs face KBEMS hearing for administering antivenom after mamba bite Elkhart firefighter appeals loss of paramedic duties after nurse’s harassment complaint American Heart Association's 2025 CPR guidelines: Choking, opioids & survival chain Ill. city council makes $500 lift assist fee permanent Warren-Wentworth Ambulance shuts down after entire staff quits 'Shut the f**k up!': North Babylon Fire Chief Peter Alt on leave after video shows him cursing at patient Orange County fire chiefs demand removal of EMS director for halting blood transfusions, ketamine use Colo. paramedic charged with manslaughter after sedating, restraining man National EMS Advisory Council board members terminated Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest guests for an upcoming episode. 

In this special Christmas edition of the Inside EMS podcast, cohosts Chris Cebollero and Kelly Grayson unwrap five of the biggest EMS stories of 2025 — and it’s not all eggnog and cheer. This year delivered more than its fair share of gut punches to the profession, from a paramedic who was charged with manslaughter, to footage of a fire chief yelling at a 10-year-old patient (yeah, that happened). Next week’s show will break down the final five EMS stories of the year, but in 2026, we’re flipping the spotlight. Chris and Kelly are calling on you to step up and share your real EMS stories — the funny, the frustrating, the calls that changed you. Got a moment that shaped your career? Our cohosts want to hear it, and you might even get an invite to appear on the podcast. ‘Tis the season to be heard; email theshow@ems1.com to share your story! Quotable takeaways “You're the grownup. You can't pitch a fit. You gotta be the grownup in the situation and diffuse it.” “If your only incentive for doing the right thing is that somebody might catch you being a jerk on video, then it's time for you to get out of the profession.” “The cost of readiness is hugely expensive.” Enjoying Inside EMS? Email theshow@ems1.com to share feedback or suggest guests for future episodes. 

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: “If you’re gonna be in the EMS business, you’ve gotta be in the EMS business, right?” “One thing we need to do as leaders is to make sure we don’t mess with people’s money.” “If you’re not giving adequate funding and attention to the EMS side of the house, then that’s a recipe for trouble and it can’t last.” 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 rewrites On-demand: Bringing whole blood to the front lines of EMS Stop the bleed, fill the tank – The New Orleans EMS blood program Whole 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 “What we learn tends to define who we are as a provider, particularly when the information was learned during our formative years.” “I don’t want to have to spend my time defending a personal position. I would rather talk about how we can guide ourselves based on what we are actually seeing with data that is as objective as we can get it.” 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 “Soft skills are the survival skills in today’s EMS: empathy, de-escalation, teamwork.” — Kelly Grayson “We’re supposed to be shepherds and guides, not the sage on the stage delivering a lecture and a performance — and I deliver lectures and performances very well. But that’s not the best way people learn.” — Kelly Grayson 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 “Never tell a story without a point. Never make a point without a story.” “The burned hand teaches best.” “Be authentic. Share your wins. Talk about your mistakes.” 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. 

Editor’s Note: Welcome to the What Paramedics Want podcast, sponsored by Pulsara. Whether replacing radio reports, alerting specialty teams, or managing mass casualty incidents, Pulsara simplifies communication. One Tool. Every Day. Regardless of Event. 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 Pulsara scales to meet your dynamic communication needs. From routine patient alerts to managing large-scale emergencies, every responder and clinician connects seamlessly. Familiar yet powerful, Pulsara streamlines your response, from routine transfers to regional disasters. One Tool. Every Day. Regardless of Event. Discover more at Pulsara.com. 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.