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Editor’s Note: Suicide is always preventable. If you are having thoughts of suicide or feeling suicidal, please call the National Suicide Prevention Hotline immediately at 988. Remember: You deserve to be supported, and it is never too late to seek help. Speak with someone today. ----more---- This week on Inside EMS, host Kelly Grayson is joined by Texas educator John Puryear as they process the loss of a colleague to suicide — and to confront the uncomfortable truth: the mental health crisis in EMS is years in the making, and awareness alone isn’t cutting it. From peer support to fatigue policies, Chris and Jon lay out what actually helps: real conversations in the rig, leadership that prioritizes mental health and seeking professional help. The message is clear: taking care of your mind is operational readiness. And if you’re not checking on your partner, you’re missing the fight that matters most. Quotable takeaways “I don't think the public understands how much this profession can break you.” “It’s not about what’s wrong with you, it’s what’s happened to you.” “Help is a professional strength, not a weakness.” Additional resources: What’s your department’s suicide prevention plan? How to recognize, help a struggling team member Mental wellness check-ins: What they are and how they help Enjoying Inside EMS? Email [email protected] to share feedback. 

This week on the Inside EMS podcast, host Kelly Grayson tags in Texas educator John Puryear for a deep dive into the ever-evolving world of EMS education. What starts with a little sweet tea and Southern storytelling quickly turns into a masterclass on how to actually make distance learning work. Puryear breaks down the difference between synchronous and asynchronous learning, and why simply dumping recorded lectures on students isn’t enough. The real magic? Engagement. Whether it’s live interaction, strategic questioning or just being a “bit of an entertainer,” effective online education demands more than a webcam and a PowerPoint. Bottom line: online education isn’t going anywhere. But if you’re going to do it, you better do it right. The future isn’t just virtual — it’s hybrid, interactive and built by educators who actually care. Enjoying Inside EMS? Email [email protected] to share feedback. 

Things get intense on this episode of Inside EMS as hosts Chris Cebollero and Kelly Grayson tackle an age-old industry debate: should EMTs spend time on a truck before going to paramedic school or is that “experience” overrated? Kelly kicks things off with a spicy take, arguing that poor field training and inconsistent preceptorship often do more harm than good. From his perspective, bad habits, weak mentorship and burnout culture are the norm, not the exception. But Chris isn’t buying it. He counters that experience builds what classrooms can’t: clinical judgment, scene management and the ability to function in chaos. For him, skipping that step means stacking advanced skills on a shaky foundation. What follows is a back-and-forth that hits on everything from “microwave medics” and outdated curricula to high-fidelity simulation and whether modern education can truly replicate the street. Both sides agree the system is flawed — but disagree on where to fix it. Enjoying the show? Email [email protected] to share feedback. 

In this episode of Inside EMS, cohosts Chris Cebollero and Kelly Grayson are once again joined by paramedic student April McKenzie, a.k.a., “April Anonymous,” for a deep dive on measuring arterial blood gas. Chris and Kelly walk April (and anyone else grinding through class) through the core idea that everything hinges on knowing “normal.” Once you lock in pH, CO₂ and bicarb ranges, the rest becomes pattern recognition, not panic. The big takeaway? Master normal, stay curious and treat every patient like a learning opportunity. Because the more normals you encounter, the faster you’ll catch what’s not. Quotable takeaways “Our whole job in a nutshell is maintaining homeostasis and knowing when the body is going to restore homeostasis.” “Voltaire said that the art of medicine is entertaining the patient until nature cures the disease. But, we know that nature doesn't always cure the disease. We have to know when to step in, when nature's not gonna do it.” Email [email protected] to share feedback. 

This week on Inside EMS, hosts Chris Cebollero and Kelly Grayson take a practical look at how leadership — both formal and informal — shapes the culture of an EMS organization. The hosts break down three things crews notice immediately: consistency, presence and composure. They emphasize that good leadership isn’t about controlling people or enforcing policies — it’s about developing crews, communicating clearly and earning trust over time. This episode breaks down how leadership credibility is built slowly through consistent behavior — and it only takes one misstep to damage it. Quotable takeaways “The culture of an EMS organization is shaped far more by leadership behavior than by policy manuals.” “You don't build strong organizations by controlling people. You build them by developing people.” “Leadership starts the moment people are watching.” Email [email protected] to share feedback. 

“The greatest victory is that which requires no battle.” ― Sun Tzu, The Art of War This week on Inside EMS, host Chris Cebollero brings a fresh interpretation to Sun Tzu’s ancient text with his latest book, “The Art of War for Business Leaders: Winning Without Fighting in Leadership, Strategy, and Life.” Chris makes the case that EMS leadership is more about clarity and discipline than chest-thumping command presence, tying Tzu’s principles back to everyday EMS realities. The discussion digs into why leaders so often fight the wrong battles, from staffing drama and culture clashes, to policy headaches and ego wars, and how better planning can keep those problems from blowing up in the first place The conversation dissects what accountability without chaos means in practice: building culture, reducing friction and leading in a way that gives crews the tools, support and ownership they need to succeed. Quotable takeaways “Most leaders don't fail because they're bad people. They fail because they fight battles that they never really need to fight.” “Never allow your emotions to dictate your actions. I was a powder keg that would explode when things didn't go right. [“The Art of War”] taught me to be less reactive.” “Discipline creates freedom.” Email [email protected] to share feedback. 

This episode of Inside EMS is brought to you by ZOLL software and data solutions. Optimize EMS performance and outcomes at every stage of operations with interoperable solutions from dispatch, to patient care, QA/QI, billing and beyond. Visit zolldata.com to learn about the complete solution suite. This week on the Inside EMS podcast, Jon Puryear, NREMT-P, is back and if you’ve ever sweated a National Registry deadline, this one hits home. Amid the ever-looming March 31 cutoff, Puryear breaks down what’s changed in continuing education — and what hasn’t. Known for his ability to simplify complex topics, Puryear has built National Registry refresher courses, explainers and CE programs designed not just to check a box, but to truly reinforce clinical understanding. His teaching style leans heavily on storytelling and practical analogies — think pulmonary edema explained through a waterlogged sponge — so providers walk away actually understanding the information, not just memorizing it. If you need hours, motivation — or just someone to explain it like a human — this episode is your reset. Top quotes “I don’t believe that we chose this profession. I believe that the profession chose us. We have a special calling inside of us to be able to take care of our fellow mankind.” “We don’t get rich. We don’t make a lot of money doing this. We’re truly public servants.” “Continuing education is still important to be able to keep our mind, our clinical care, our judgment, everything on top.” Email [email protected] to share feedback.

Editor’s Note: This episode of Inside EMS is brought to you by ZOLL software and data solutions. Optimize EMS performance and outcomes at every stage of operations with interoperable solutions from dispatch, to patient care, QA/QI, billing and beyond. Visit zolldata.com to learn about the complete solution suite. This episode of Inside EMS tackles a difficult question: When is it time to step away from the job? Hosts Chris Cebollero and Kelly Grayson trade hard-earned wisdom — from Kelly’s knee-rehab comic relief to serious talk about emotional burnout, wellness needs and timing. The hosts also explore the psychology of identity — how being a paramedic or EMT isn’t just a job, it’s who you are. They unpack how to carry forward the best parts of that identity — calm under pressure, decisive action, compassion — into new roles if needed. This isn’t about quitting — it’s about owning your career before it owns you. Whether it’s fewer shifts, a new role, a new service or a new direction altogether, the message is clear: protect your identity, protect your professionalism and make moves that keep you sharp for the long haul. Quotable takeaways “Burnout is gradual. It's not explosive, but you've got to be able to realize the emotional flattening that is happening.” — Chris Cebollero “Our identity often becomes EMS. I tell people, to this day, ‘I'm a paramedic,’ and there's a lot that goes into that — and not just when you put the boots or the polo shirt on. It really becomes the core of who you are.” — Chris Cebollero “The vast majority of us don't leave after one bad call. We wake up one day and realize we've been surviving instead of serving, and that's when the burnout epiphany really hits us hard.” — Kelly Grayson Enjoying Inside EMS? Email [email protected] to share feedback or suggest guests for a future episode.

This episode of Inside EMS is brought to you by ZOLL software and data solutions. Optimize EMS performance and outcomes at every stage of operations with interoperable solutions from dispatch, to patient care, QA/QI, billing and beyond. Visit zolldata.com to learn about the complete solution suite. NAEMSP is officially a “big little conference” — and it’s only getting bigger. In this crossover episode, Rob Lawrence and Chris Cebollero unpack the momentum: tighter collaboration, a unified push toward EMS on the Hill Day, and the growing realization that if we want change, we need boots (and uniforms) on Capitol Hill. But the real buzz? AI. From autonomous ambulances to narrative-writing software, the conversation gets real about the promise — and the potholes — of artificial intelligence in EMS. Charting shortcuts? Maybe. Courtroom landmines? Definitely possible. Add in body-worn camera debates, budget crises and a push for legislative support at the federal level, and it’s clear the profession is standing at a pivot point. Enjoying Inside EMS? Email [email protected] to share feedback or suggest guests for future episodes. 

This episode of Inside EMS is brought to you by ZOLL software and data solutions. Optimize EMS performance and outcomes at every stage of operations with interoperable solutions from dispatch, to patient care, QA/QI, billing and beyond. Visit zolldata.com to learn about the complete solution suite. This week on Inside EMS, Chris Cebollero takes on one of the most anxiety-inducing topics in paramedic education: alpha and beta receptors. Sparked by a question from paramedic student April McKenzie, a.k.a., “April Anonymous,” this episode strips away rote memorization and replaces it with something far more useful in the field — understanding the why behind the medicine. There’s no fluff here; no cheesy memory tricks that fall apart under stress. Just physiology, practical mental models and a challenge to start practicing medicine with intention. If pharmacology has ever felt random, this episode connects the dots in a way that finally clicks. Quotable takeaways “Every medication you give in EMS is doing one of two things: It's either pushing the gas pedal or it's releasing the brake — that's it. If you don't understand which one you're doing, you're guessing, even if the protocol says you're right.” “We really have to become the ultimate detective of the body.” “Every patient is somewhere between gas and brake at all times. Those systems are constantly working, they're not off. It's just a dimmer switch. Every medication pushes one system or pulls the other system back into play.” Enjoying Inside EMS? Email [email protected] to share feedback or suggest guests for a future episode. 

Dr. Peter Antevy returns to the Inside EMS co-host seat this week, filling in for Kelly Grayson and bringing some serious pediatric firepower to the conversation. Host Chris Cebollero dives right into the latest buzz around the Broselow tape recall — yes, again — as Dr. Antevy unpacks what went wrong, why it matters and what EMS agencies should be doing about it now. He also shares exciting details on his brand-new, field-focused Newborn Resuscitation & Obstetrics course (NROC), built by EMS for EMS. Designed with two hours of online content (zero PowerPoints!) and a short, in-house skills lab, this course aims to tackle one of the most nerve-wracking call types. No more dragging medics to the hospital for NRP classes that don’t translate to street-level care. Also on deck: OB deserts, delayed cord clamping, why you might need to Saran-wrap a newborn (seriously), and what AI can — and can’t — do for EMS. This one’s packed with practical pearls, myth-busting insights and a whole lot of passion for pediatric education. Quotable takeaways from Dr. Peter Antevy “EMS is one specialty that AI will never take away, as far as like the human-to-human contact. We resuscitate people, we treat people who are seizing. AI will never do that. That's a good thing.” “Academics and the hospital folks don't recognize the value that EMS brings to the table. They think we're ambulance drivers. It's time for them to wake up and recognize that we are the people who deliver babies. We are the people who resuscitate grandma, grandpa and the little kid.” Enjoying Inside EMS? Email [email protected] to share feedback or suggest guests for future episodes. 

In this episode of Inside EMS, host Chris Cebollero sits down with Mic Gunderson, CEO of the Center for Systems Improvement and EMS Quality Academy; and editor‑in‑chief of the new peer-reviewed International Journal of Paramedicine, which launched in January 2023. Gunderson explains how the publication provides a forum for thoughtful debate around complex topics to be examined and analyzed. A recent issue, for example, touched on degree requirements for entry-level medics using the Socratic method to frame and manage the debate — a far cry from the horrors of a social post’s comment section. Sprinkled with wit, respect and real curiosity, this episode is a masterclass in how EMS can grow — not just louder, but smarter. Whether you drive an ambulance, manage a system, or just care about the future of prehospital care, this conversation is worth your seat time. Additional resources: The International Journal of Paramedicine Degrees, debate and direction: Why this debate deserves our attention Top quotes from Mic Gunderson “Allow us to have enough maturity in our dialogue to say, ‘what's your logic or reasoning behind your opinion?’ instead of just saying, ‘I think the sky is blue.’ Tell me why you think the sky is blue and why it isn't red.” “With the Socratic debate format, because we're not trying to pick a loser or a winner, it allows us to really focus on the issues and the merits of the different perspectives.” Enjoying the show? Email [email protected] to share feedback or suggest guests for future episodes. 

In this episode of the Inside EMS podcast, Chris and Kelly are joined by paramedic student April McKenzie — aka “April Anonymous” — for a deep dive into the buffer system and CO2 mapping. April’s in the thick of paramedic school and like every good learner, she’s asking “why?” — so the guys break down the physiology behind capnography, acid-base balance and the lungs-vs.-kidneys showdown that keeps our patients alive. Plus, they throw in old-school war stories, rant about naloxone misuse and admit that bicarb is no longer the go-to cardiac arrest drug. If you've ever tried to explain respiratory vs. metabolic acidosis in under 10 minutes, this episode is your cheat sheet. April will be back throughout the year with more student questions, so buckle up for the ongoing EMS education you didn’t know you needed. Quotable takeaways “Just because you see somebody with signs and symptoms and the protocol says, do this; that's OK, but that just makes you a protocol paramedic.” “My friend Romy Duckworth calls [capnography] the MVP of vital signs, and that's a good way to remember it — MVP: Metabolism, Ventilation and Profusion. And it will tell you derangement about all three of those things very well once you're proficient at interpreting the waveforms.” “Basically, the buffer system is the body's way of keeping the pH stable. So, if we're blowing out, if we're having problems with respiratory acidosis — and let's talk about CDKA, where they're trying to blow off — it's the respiratory systems’ way of making sure that we have homeostasis.” Enjoying Inside EMS? Email [email protected] to share feedback or suggest guests for an upcoming episode. 

This week on Inside EMS, Chris Cebollero kicks off 2026 with a heartfelt conversation featuring Eric Morrison, vice president of the National EMS Memorial Bike Ride and EMS director for Iredell County, North Carolina. The ride, founded 26 years ago, exists to honor the memory of EMS providers who died in the line of duty, from illness or mental health struggles. Each rider wears a dog tag bearing the name of a fallen provider, often connecting with their families along the journey. Eric shares his personal journey from lifeguard to leader and how his rekindled love for cycling — along with the loss of friend and EMS wellness advocate Brian Fass — led him to the ride. He breaks down what it takes to join (hint: it’s more doable than you think), the logistics of the ride, and how EMS agencies and individuals can support the cause, even off the bike. Quotable takeaways from Eric Morrison “All of us are focused on the idea that our providers matter. They matter to their families, they matter to their communities, and they should matter to all of us.” “People that didn't even know that person are recognizing their service. They're recognizing their commitment to the community, and they're honoring them and remembering them.” “Once you come out and see what the ride is really about, you understand the mission and you see the impact it has on these families that we're able to meet with.” Enjoying Inside EMS? Email [email protected] to share feedback or suggest a guest for a future episode. 

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 [email protected] to share feedback or suggest guests for an upcoming episode.