Inside EMS

Criticism 101: Why you should stop blowing off feedback

When it comes to taking criticism, EMS professionals are … not great. In this episode of Inside EMS, cohosts Chris Cebollero and Kelly Grayson get real about why criticism hits so hard and how we can start to deal with it like grownups (instead of defensive toddlers). They break down Chris’s recent article, “10 practical tips for responding to criticism,” sharing personal stories of defensiveness, arrogance and the long road to emotional intelligence.

From learning to separate emotion from feedback to asking for clarification and recognizing when there’s truth in someone’s harsh words, this episode is a masterclass in professional and personal growth. The duo also explores how criticism ties into self-awareness, communication with partners, and even romantic relationships. Whether you’re a seasoned medic or a brand-new EMT, these tips will help you take feedback like a pro without letting it wreck your day.

• "We do not want our medicine criticized. We do not want our work ethics criticized. We just do not want criticism.” — Chris Cebollero

• "Experience comes from mistakes. Mistakes come from lack of experience." — Chris Cebollero

•  “Back in the day, I didn't care. I used to say the same thing. People either love me or hate me; there's no in the middle. But you know what? I wasn't looking at the bigger picture.” — Kelly Grayson

Enjoying the show? Email 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.

Hot as a hare, mad as a hatter: Cracking the toxidrome code

In this episode of the Inside EMS podcast, hosts Chris Cebollero and Kelly Grayson dig deep into one of EMS's most overlooked (and often forgotten) topics — toxidromes. You might remember the word from paramedic class, but today’s street calls demand more than a vague memory. With patients taking everything from grandma’s Ativan to street-made speed, understanding toxidromes is crucial for making quick, accurate clinical calls.

The crew breaks down the five major toxidromes every medic should know: anticholinergic, cholinergic, opioid, sympathomimetic and sedative-hypnotic. From classic mnemonics like “mad as a hatter” to real-life stories of fire ant poisonings, this episode serves up practical knowledge with EMS-grade humor.

Chris and Kelly cover telltale signs (sweaty vs. dry skin, pinpoint vs. dilated pupils), treatment pearls of wisdom (easy on that naloxone, folks), and the real-world complications of polypharmacy. Plus, they touch on lesser-known players like serotonin syndrome and hallucinogens.

This one’s a refresher you didn’t know you needed — but you’ll be grateful when you respond to your next overdose call.

Memorable quotes

• “Antidotes are overrated. Supportive care will take care of most of the toxidromes out there.” — Kelly Grayson

• “If they’re pleasantly stuporous but breathing effectively, it’s not an overdose. It’s just a dose.” — Kelly Grayson

• “Narcan is not a punishment, it's a treatment. You don't slam it, you bump it just a little bit, just enough to get them breathing again.” — Kelly Grayson

Enjoying the show? Email 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.

Not your average sugar rush: EMS strategies for DKA

This week on the Inside EMS podcast, hosts Chris Cebollero and Kelly Grayson tackle a metabolic monster that every EMS provider needs to master: diabetic ketoacidosis (DKA). They kick off with a common (but critical) 911 scenario: a 19-year-old with a history of Type 1 diabetes, confusion, vomiting and a blood sugar of 500. Sound familiar?

Kelly dives into the physiology of DKA, explaining how glucose can be sky-high while cells starve, triggering fat breakdown and ketone production that spirals into life-threatening acidosis. The hosts hit the must-know pathophysiology, signs and symptoms (hello, Kussmaul breathing!), and what providers often miss — like dehydration, vomiting and abdominal pain.

They break down how to spot DKA with capnography and EKG changes, especially when hyperkalemia mimics a STEMI. From EMS management tips (don’t shut down those fast respirations!) to fluid resuscitation caveats, this is a crash course in saving DKA patients before they crash.

Whether you’re running calls or managing chronic patients, this episode arms you with the clinical know-how and common-sense insight to handle DKA with confidence.

Memorable quotes

•  “We're starting to see more increasing calls for type one diabetes, insulin-dependent type two diabetes ... and we need to be able to understand what we're doing. — Chris Cebollero

• “One of the big clues in the scenario is the vomiting. Lots of DKA patients will have vomiting and abdominal pain.” — Kelly Grayson

• “A lot of times, these hyperkalemia patients and these acidotic patients are going to be handled just fine by correcting their fluid deficits and correcting their glucose with an insulin drip. Just getting their glucose back down to normal level is going to manage the lion's share of the hyperkalemia.” — Kelly Grayson

Enjoying the show? Email theshow@ems1.com to suggest episode ideas or to pitch someone as a guest!

Is your EMS agency all talk, no accountability? Here’s how to fix that

What does accountability actually look like in EMS? In this episode of the Inside EMS podcast, cohosts Chris Cebollero and Kelly Grayson get into the gritty details — beyond the management-speak — and outline the 7 pillars of accountability that can make or break an EMS organization. From character and unity, to urgency and evolution, they explore how each pillar builds a culture that supports excellence, trust and growth in the field.

The discussion gets into metrics that actually matter (and no, “we’re doing fine” isn’t a metric), urgency that respects both speed and precision, and how to develop a reputation that earns trust from coworkers and ED staff alike.

Whether you’re in a leadership role or still riding the bench seat, this episode is a masterclass in personal and organizational accountability.

Memorable quotes

• “Integrity is how you behave when no one’s looking.” — Kelly Grayson

• “You don’t let anybody dictate your own professionalism.” — Chris Cebollero

• “If you can’t measure it, you can’t improve it.” — Kelly Grayson

• “Do you want speed or accuracy? I want both.” — Chris Cebollero

• “If you're practicing EMS like you did 5 years ago, you're behind the times.” — Kelly Grayson

Enjoying the show? Email us at theshow@ems1.com to share ideas or suggest a guest!

EMS on the Hill: Why advocacy matters now more than ever

Guest host Rob Lawrence joins Kelly Grayson to reflect on the recent EMS on the Hill Day. Rob offers a behind-the-scenes look at his experience leading the California delegation and provides insights into how EMS professionals can influence policy on issues like Medicare reimbursement, community paramedicine and workforce development.

Kelly questions whether EMS on the Hill Day efforts actually drive change, while Rob defends the impact of consistent grassroots advocacy. The episode highlights key legislation, including expanded telemedicine and veteran recruitment into EMS, and makes the case for staying politically engaged to secure the future of the profession.

Whether you’re a seasoned advocate or just starting to engage in the political side of EMS, this episode will leave you with a deeper understanding of the stakes — and the power of your voice.

Key quotes

• "Our national associations are now hunting as a pack, which is a good thing." — Rob Lawrence

• "You can be at the mercy of EMS politics, or you can learn to play EMS politics and affect the outcome." — Kelly Grayson

• "All politics is local, and we all have a voice. More importantly, we all have a story." — Rob Lawrence

• "Politics is made of people who show up." — Kelly Grayson

Timeline

01:02 – Rob discusses his recent travels and involvement in EMS on the Hill

01:45 – Rob explains what EMS on the Hill is and how it works

03:11 – Rob shares his thoughts on the bipartisan support for EMS legislation

06:05 – Kelly asks about the amount of time spent with legislators

09:02 – Rob highlights his meeting with Representative Eric Swalwell

10:28 – Kelly expresses skepticism about EMS Week and EMS on the Hill

12:10 – Rob responds to Kelly’s skepticism about EMS advocacy

14:00 – Rob discusses key bills on Medicare reimbursement and community paramedicine

16:06 – Rob shares details about the bills being presented this year

20:01 – Rob talks about workforce development and veteran recruitment initiatives

22:01 – Rob and Kelly discuss EMS advocacy and the importance of grassroots involvement

25:36 – Rob explains the EMS caucus and invites listeners to get involved

28:20 – Rob concludes the podcast, urging listeners to advocate for EMS and engage in political processes

Enjoying the show? Email 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.

Exhausted and overworked: The fatigue crisis in EMS

In this episode of the Inside EMS Podcast, co-host Kelly Grayson is joined by international guest host Rob Lawrence for a candid and timely conversation on one of the most pressing issues in EMS today: fatigue and its impact on provider safety and wellness.

The discussion begins with a heartbreaking story out of Georgia, where a nurse, after working consecutive night shifts, fell asleep at the wheel, leading to a fatal crash. It’s a tragic reminder of the very real risks that come with long hours, disrupted sleep and chronic fatigue in healthcare—and EMS is no exception.

Kelly and Rob reflect on their own experiences with sleep deprivation, shift work and the toll it takes on performance, decision-making and personal safety. They dive into the need for fatigue management policies, smarter shift scheduling, and how EMS leaders can — and must — prioritize provider health.

Timeline

00:00 - 00:05: Rob introduces himself as the international correspondent for Inside EMS, stepping in for Chris Cebollero.

00:05 - 00:33: Kelly and Rob discuss the swap between Chris and Rob, along with their roles in the EMS community, providing context for the conversation.

00:33 - 03:10: Rob and Kelly discuss the tragic accident in Forsyth County, Georgia, where a nurse fell asleep behind the wheel after a night shift. They reflect on the broader issue of fatigue in healthcare professions.

03:10 - 07:01: Kelly shares his personal experience with fatigue, recounting instances of feeling like a "zombie" after long shifts and the dangers of working extended hours.

07:01 - 10:35: Rob and Kelly dive into the challenges of managing fatigue in EMS, the ongoing debate about shift lengths, and the need for policies to improve rest and working conditions.

10:35 - 12:23: The hosts discuss the importance of leadership in managing fatigue, with Rob emphasizing the need for downtime between shifts.

12:23 - 15:02: Kelly talks about his previous employer's fatigue mitigation policies and how they ensured safety through workload monitoring, proper shift lengths, and adequate pay.

15:02 - 18:00: Rob reflects on his work in California, including meetings with lawmakers to address EMS workforce issues during EMS Week.

18:00 - 23:07: The hosts discuss the systemic issues that contribute to fatigue, including poor wages, long shifts, and the overall working conditions in EMS. They conclude with a call to action for better policies and leadership to ensure the well-being of EMS professionals.

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.

Future-proofing EMS: How a new course is building results-driven problem solvers

Note: Thanks for following the Inside EMS podcast! Enjoy this special EMS One-Stop crossover episode with host Rob Lawrence, who will also join Kelly Grayson as a guest cohost during the month of April.  

In this episode of the EMS One-Stop podcast, Dr. Dave Williams discusses an exciting new master's-level course designed for EMS and fire leaders, focused on advanced improvement science.

Along with Mike Taigman, Dr. Williams is leading this program, which aims to equip leaders with the tools and methods necessary to achieve results-driven improvement in their EMS systems. Over the course of 12 months, attendees will work on real-world projects, gaining the skills needed to make data-driven decisions and improve patient care outcomes within their organizations.

Dr. Williams also dives into the core concepts of improvement science, including understanding of variation and the importance of creating organizational systems that support sustainable improvements. He shares insights into the curriculum, the significance of benchmarking and how the course will help EMS leaders tackle systemic challenges by applying proven improvement methodologies. This conversation also touches on the future of EMS leadership and how innovation in data management, process design and leadership will shape the profession moving forward.

Timeline

02:22 – Dr. Williams explains the background of the course, highlighting how it builds on improvement science to drive better results in EMS systems. He and Mike Taigman aim to teach EMS leaders to use data and evidence to improve patient care outcomes.

06:16 – Quality improvement: Dr. Williams discusses the gap in EMS leadership regarding quality improvement, emphasizing that quality needs to be integrated into the leadership team’s responsibilities, not treated as a separate function.

11:01 – Why data matters: The conversation shifts to the importance of data in EMS improvement efforts. Dr. Williams highlights how collecting and analyzing data helps organizations understand system performance and drive change.

15:43 – The fleet management example: Rob shares a fleet management story where data was used to improve vehicle downtime, highlighting the real-world impact of using improvement science to solve practical challenges.

19:29 – Project-based learning in the course: Dr. Williams elaborates on the project-based nature of the course, explaining how each participant will bring a real-world project that directly impacts their organization and use improvement science to solve it.

23:09 – Practical applications: Dr. Williams talks about how the course will blend online learning with in-person workshops, providing practical tools and methods that participants can apply to their projects throughout the year.

31:08 – Course logistics: Dr. Williams discusses course deadlines and important dates, including the application deadline of April 18, 2025; and the course's first workshop in September 2025.

54:05 – ROI and the course's value: Dr. Williams emphasizes the return on investment for attending the course, explaining that solving organizational problems through improvement science will ultimately save money and improve results for EMS services.

1:00 – Final thoughts: Rob and Dr. Williams close the conversation by reiterating the uniqueness of the course and its potential to reshape EMS leadership through the application of improvement science.

ADDITIONAL RESOURCES

• Next-level improvement science: New master-level course equips EMS and fire leaders with advanced improvement science skills

  • Course application deadline: April 18, 2025

  • Course start date: July 22, 2025

  • Workshop dates: September 2025; February 2026

• Mastering data and EMS performance metrics with Mike Taigman: Exploring how data informs change, improves clinical outcomes and drives leadership decisions

• Improve EMS quality with a model that works: The simple yet powerful Model for Improvement holds the key to making real changes to an EMS organization

‘Death was staring me in the face’: Kelly Grayson’s no-BS guide to getting healthy

In honor of First Responder Wellness Week, Inside EMS hosts Chris Cebollero and Kelly Grayson go beyond the surface-level tips and dig into what true wellness looks like in this profession. Spoiler: it’s messy, personal and sometimes terrifying.

Kelly shares his deeply personal journey from a spinal surgery and a near-fatal pulmonary embolism to dropping over 140 pounds and reclaiming his life. At his heaviest, he was 410 pounds. Today? He’s neck-and-neck with Chris on the scale, rocking a 40-inch waist after shedding a whole foot from his midsection.

But this episode isn’t about bragging — it’s about honesty. Kelly gets vulnerable about depression, self-doubt and EMS culture’s toxic relationship with self-care. He also drops hard-earned advice on meal prepping, smarter snacking and how to make real progress without crash diets or guilt trips.

If you’ve ever looked in the mirror and not liked what you saw — or felt the creeping realization that this job might just break you — this one’s for you. Kelly’s story isn’t just about weight loss; it’s about survival, resilience and building a new life, one lap at a time.

Memorable quotes

• "EMS is not an active profession. It’s 23 hours of boredom and an hour of blind panic."

• "It’s not simply a matter of willpower, but support, attainable goals, and short increments add up over the years."

• "You have to get serious about what you want to feel like, what you want to look like."

• "I said, 'What are you doing this for? Are you doing this to die, knowing what killed you?'"

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.

Show me the money: How EMS can tap into opioid funding

Billions of dollars from opioid settlements are flowing into communities, but how does EMS get a slice of the pie? In this episode of the Inside EMS podcast, host Chris Cebollero is joined by Corey Carlson, EMS segment lead at Lexipol, to break it all down. Carlson simplifies the complex world of opioid settlement funding, sharing exactly where the money is, who controls it and how EMS agencies — both public and private — can apply.

From funding for training, mental health support, AEDs, cardiac monitors, ambulances and even K-9 units, there are countless ways EMS can use these funds. The key? Knowing who to ask and how to frame the request.

If your EMS agency could use a financial boost (and let’s be real — whose couldn’t?), this episode is packed with actionable advice to help you claim your share of the $56 billion (and counting) in opioid settlement funds.

Additional grant-funding resources:

• EMS grants: 5 steps to success

• Debunking the top 5 EMS grant myths: Insights for success

• 10 books every EMS grant writer needs

• Guide to securing Congressionally directed funds

This episode of the Inside EMS Podcast is sponsored by ZOLL Medical. Learn more about ZOLL’s products for EMS at zoll.com/solutions/ems-and-fire.

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.

Pencils down: EMS test-taking tips … from a guy who writes EMS tests

Sitting for the National Registry exam might rank up there with colonoscopies in terms of excitement, but EMS educator Dan Limmer recently took the test. Why? To stay sharp, to keep his licenses and to see firsthand how the test has evolved. And guess what? He walked out impressed.

In this episode of Inside EMS, Dan sits down with host Chris Cebollero to break down his experience, share study strategies and offer test-taking wisdom for new and seasoned medics alike. He highlights how the test isn’t just a memory game — it’s about judgment, application and truly understanding why you make the decisions you do in the field.

From tackling the anxiety factor to navigating new question formats (hello, multi-response and scenario-based questions), Dan gives practical advice for anyone gearing up for the exam. Whether you’re an EMT candidate or a veteran paramedic thinking about challenging yourself with a retest, this episode is packed with useful takeaways.

Memorable quotes

• “Nobody ever comes out of the registry exam saying, ‘Oh, that was easy.’”
  
  
• “I was in awe of the way they give you a little bit of information, but then make a big ask, and the different ways they can ask questions — I just think it's a good exam.”
  
  
•  “If you read your book and you paid attention and did well in class, when you finish your class, your book shifts from a primary source to a reference.”

RATE & REVIEW

Catch a new episode of the Inside EMS podcast every Friday on Apple Podcasts, SoundCloud, Amazon Music, Stitcher, Spotify, and RSS Feed. Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. 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.