Inside EMS

Clinical dive: Should you consider naloxone during OHCA response?

This week on Inside EMS, our cohosts discuss a recent study out of UC Davis Health that highlights the benefits of using naloxone in opioid-associated out-of-hospital cardiac arrest response. Chris and Kelly discuss the results and debate how this knowledge could impact OHCA protocols.

Top quotes

• “If you look at the … survival of hospital discharge, the number needed to treat was 26. So 1 in 26 patients you would do this to has a chance of surviving the hospital discharge. That's pretty compelling. It's going to change my practice.” — Kelly Grayson

• “It's obviously needed information considering how bad the opioid overdose epidemic is in the United States. The numbers are compelling – the fact that this affects so many of our out-of-hospital cardiac arrests and that this actually shows pretty strong evidence of improved outcome.” — Kelly Grayson

• “We think about over the past 20 years, and now with fentanyl being part of that process, we're starting to see a lot more [drug-related cardiac arrests] and there's an urgent need for this evidence that allows us to now figure out if Narcan can make a difference in OHCAs.” — Chris Cebollero

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

Response time addiction: Is EMS under an urgency illusion?

This week on the Inside EMS podcast, our hosts delve into a heated discussion on the topic of time requirements and response times in EMS – are they necessary or a nuisance? Listen and watch as Kelly Grayson and Chris Cebollero go back and forth on the history, the reliance and the continued use of response times as a standard metric in EMS.  

Top quotes

"We are in a mess and a corner we painted ourselves into with response time standards." – Kelly Grayson

"The dislike of response times really has to be respectful of how the response times came about. We were trying to develop a system and show that we can make a difference." – Chris Cebollero

"We created this expectation and no one is going to change this expectation if not us." – Kelly Grayson

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

Navigating international healthcare and a $60K+ flight home

In this episode of the Inside EMS podcast, host Chris Cebollero walks cohost Kelly Grayson through his recent emergency trip to Italy after his sister experienced a major medical crisis while on vacation in the country. He talks through his shock at certain protocols that would never be found in the U.S., leading to a discussion about necessary care vs. defensive medicine and how that dichotomy is stark between the two countries.

Top quotes

• “The quality of care or the TLC, if we call it, is significantly less than what we’re used to over here. There were a couple of days when my sister was laying on a bed with no sheets. There were a couple of days where she was naked and I asked about getting her a gown or something.” — Chris Cebollero
• "[The U.S. healthcare system] will enthusiastically commit to what other countries would consider futile care.” — Kelly Grayson
• “How much stuff do we do in the United States because of defensive medicine and the differences in our legal and our court system than everybody else?” — Kelly Grayson

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

‘Everybody is doing weed’: Should EMS providers have the option if legal?

“Marijuana use is becoming part of a societal norm.” Our cohosts tackle one of the more contentious topics in the industry, as Chris Cebollero and Kelly Grayson debate the logistics and implications of allowing EMS providers to consume marijuana in their off-duty time. The use of federal money by most agencies in the country makes this a difficult task. Listen as the discussion tackles the debate from all sides. 

Top quotes

• “We don't require that people not be impaired from alcohol while off duty.”
• “There's no test for impairment. For alcohol use, the test is literally about reaction time and fine motor skills. It's literally a test to see if you can operate heavy machinery. And there is no such thing for marijuana use.”
• “I think it's time we started to look at this realistically rather than this condemnation of marijuana as the devil's lettuce.”

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

Motivating the unmotivated: How to empower your EMS workforce

“You need to set the standard; the standard starts and ends with you.”

On this week’s episode of Inside EMS, our cohosts discuss how industry leaders can motivate frontline personnel to become the best clinical version of themselves. Chris and Kelly also preview their upcoming presentations at the Star Life Rural EMS conference, touching on topics ranging from airway management to personal development and leadership in EMS.

Top quotes

• “The true measurement of leadership success is how engaged, satisfied and productive the workforce is.” — Chris Cebollero
• “When we focus on the workforce as being the most important component to the success of the organization; when the workforce grows, the organization grows.” — Chris Cebollero
• “Your vision statement is the most important document inside your organization, and it amazes me when leaders in the organization don’t know their own vision statement.” — Chris Cebollero

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

Nancy Magee: ‘Volunteerism is at the core of every civil society’

“All of EMS is volunteerism.” This week, host Chris Cebollero is joined by industry advocate and EMS1 columnist Nancy Magee to discuss the current state of volunteerism in the profession. The conversation explores how leaders can balance the demands placed on volunteers with proper recognition, support and understanding, while also being responsive to the community’s needs.

Top quotes from the episode

“Volunteering is its own reward. It really can help you in your head space, but you don't get that until you try it.” 

“People have to know that what they do made a difference. You're important to the agency. We need you and what you do every day, whether it's putting a little old lady back in her bed or recognizing that she's decompensating and not that she dropped the remote this time.”

“It has to be understood by the community that EMS costs money. And you're getting a great bang for your buck if you have competent, local, readily available volunteers.”

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

‘Ask your doctor if Ozempic is right for you’: EMS and semiglutides

This week, our Inside EMS cohosts discuss the rise in popularity of semiglutide drugs – like Ozempic – used for weight loss. Chris and Kelly discuss what providers should know about the use of these drugs, for their personal use and how complications may present in patients.

Top quotes

• "If you're using semiglutide drugs purely as your only means of weight loss, you're going to rebound." 

• “You eat at odd hours, you eat at odd intervals. You eat something nuked in a microwave at a 7/11. Those are horrific eating habits, and it teaches your body to just hoard calories and food, and you wind up gaining weight that way. There's a lot of fat people in EMS, myself included, that are proof of that.” 

• "A lot of drugs out there came on the market for something and now we're using it for something else." 

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

‘From oxygen to ketamine’: Why dosing matters, regardless of drug type

“We've got to be on top of our game when it comes to clinical dosing of medications, from oxygen to ketamine.”

This week, Inside EMS cohosts Chris Cebollero and Kelly Grayson dive into an article by Joshua Davies on the use of chemical restraints in the field. They discuss the pros and cons of different medications, including a lively discussion on the use of versed and why ketamine is a good drug … when dosed and used properly.

Top quotes

• "You should have a fairly extensive formulary of antipsychotic and sedative agents available to you."

• "We need to stop worrying about what we're seeing in the news and train our providers."

• "We really have to be able to give our medical director confidence that whatever is in the protocol and whatever they want to give us in the protocol, we have the competency to do that work and do that skill."

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

Career progression: ‘A good paramedic should outgrow their protocols’

“If you're the smartest one in the room, you're in the wrong room.”

Education is the word of the day on this episode of Inside EMS, as cohosts Chris Cebollero and Kelly Grayson dissect the impact of higher learning on providers’ career longevity and advancement. Plus we dig into all this:

• Starter EMS agencies. “Some agencies might just have to be the minor leagues, the starter programs and the feeders to the real EMS agencies."

• Prioritizing your professional growth. “We're in charge of the career ladder. I shouldn't have to worry about my organization putting something in place for me to grow. They don’t owe that to me. It's my job to market myself and create the opportunity."

• Big picture impact of higher education. “When people say, ‘I don't need an education to be a paramedic,’ they don't know what they don't know. It's not until you get a little older and a little wiser that you realize the value of that education."

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

‘Where is your strength as an EMS provider?’

“Even after all these years of being in EMS, I still want to learn.” Flying solo this week, Chris Cebollero takes a note from EMS1 columnist Tim Nowak, walking listeners through his “11 keys to success for the rookie EMT.” Though directed at new EMTs, Cebollero makes the point that Nowak’s list of advice is really poignant for anyone at any point in their EMS career.  

Listen to learn: 

• The role ego plays on scene … and how to move past it 
• How to test your quick-thinking reflexes and level-up 
• The slow creep of complacency and how to avoid it 

Top quotes 

• "When someone needs you and needs your ability and needs your knowledge and needs your skill, you don't need to be looking for the OB kit." 
• "Never settle for the minimum, whether it's the standard of patient care, compassion, continuing education hours." 
• “You are going to make mistakes. You need to learn from your mistakes. You need to make sure that you don't do those mistakes again.” 

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.