Inside EMS

Whole blood, dual shocks and why the AHA still doesn’t get us

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. 

TikTok star Jimmy Apple is challenging EMS dogma with data and kindness

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. 

How to lead without being that boss

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. 

AHA 2025 updates are here: Cue the overreactions and the protocol rewrites

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. 

Booze, blood and blurred lines: Should EMS play cop?

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. 

Train harder, lead louder: What tomorrow’s medics really need

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!

From blame to burnout: How negativity takes over your shift

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.

Sepsis math: Every hour = 8% closer to the morgue

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. 

Is ‘Code 3’ the most accurate EMS film ever?

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. 

Facts fade, stories stick: Why EMS needs better storytellers

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.