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The relationship between EMS and hospitals doesn’t begin at the doors of the emergency department—it’s tested there.

In this episode of In-Service, Jason sits down with Brandon Carey and Eric Eberly, two professionals who have worked extensively on both the street and inside the hospital system, to unpack one of the most critical—and misunderstood—areas in emergency medicine: the EMS–hospital handoff.

Drawing from decades of combined experience in EMS leadership, fire service, and hospital consulting at Emory Healthcare, this conversation explores where trust is built, where it breaks down, and why relationships—not protocols—often determine outcomes for patients and providers alike.

Together, they discuss:

•Why the handoff zone is where EMS and hospital systems “live or die”

•The real causes of wall times and throughput delays

•What EMS crews misunderstand about hospital pressures—and vice versa

•How trust, professionalism, and simple human decency shape reputation and patient care

•Why leadership, humility, and communication matter more than ever in today’s system

This is not a complaint session. It’s a candid, experience-driven discussion about bridging the gap between two systems that depend on each other every single day.

If you work in EMS, the ER, hospital leadership, or any role where handoffs matter, this episode will change how you see the space between the stretcher and the bed.

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In-Service: The EMS Podcast is dedicated to the professional on the front lines of emergency care - in the field, the classroom and behind the scenes. Subscribe for new episodes featuring EMS leaders and innovators shaping the future of pre-hospital care.

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If you have suggestions for future guests email: contact@in-serviceemspodcast.com

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In this episode of In-Service: The EMS Podcast, Jason Falvey sits down with Dave Kleiman, a U.S. Army medic turned veteran paramedic, to explore why prehospital blood is no longer a future concept, but a present-day necessity in trauma care.

Dave’s career began in the military, where early exposure to battlefield trauma shaped his understanding of hemorrhage, shock, and survival. After transitioning into civilian EMS, he spent more than 30 years on the street before moving into quality improvement and continuing education with Cobb County Fire & Emergency Services. That combination of military experience, street medicine, and system-level leadership positioned him to help lead one of Georgia’s most forward-leaning prehospital blood programs.

This conversation dives into why crystalloids alone fail hemorrhagic patients, how permissive hypotension changed trauma care, and what actually happens when blood reaches patients before the hospital. Dave shares firsthand accounts of unresponsive, pulseless trauma patients who woke up after receiving blood in the field — moments that didn’t just save lives, but fundamentally changed hospital decision-making once those patients arrived.

But blood doesn’t work in isolation.

The episode also breaks down early hemorrhage control, and how tools like TraumaGel, tourniquets, and TXA work together to stop bleeding, preserve clots, and buy time when seconds matter. Dave explains why EMS must control hemorrhage early — or blood won’t matter at all.

The discussion then expands into a lesser-known but critical gap in EMS: K9 officer medical care. Dave recounts the call that exposed how unprepared most systems are to treat injured police dogs, and how that moment led to the development of canine treatment protocols, veterinary medical oversight, and specialized training for EMS providers — all while navigating legal gray areas and state-level barriers.

Support the show

In-Service: The EMS Podcast is dedicated to the professional on the front lines of emergency care - in the field, the classroom and behind the scenes. Subscribe for new episodes featuring EMS leaders and innovators shaping the future of pre-hospital care.

Merchandise Store: https://www.bonfire.com/store/in-service-ems-podcast/?utm_source=copy_link&utm_medium=store_page_share&utm_campaign=in-service-ems-podcast&utm_content=default

If you have suggestions for future guests email: contact@in-serviceemspodcast.com

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In this deeply candid and wide-ranging conversation, Jason Falvey sits down with Chad Black, longtime EMS leader and Chairman of the Georgia EMS Association, to confront a hard truth: much of what’s breaking EMS isn’t the worst calls—it’s the relentless grind of the ones that never should have happened in the first place.

Drawing on more than four decades in emergency services, Chad shares the calls that shaped him, the leadership lessons learned the hard way, and the emotional toll providers carry long after the sirens fade. He challenges the profession’s fixation on response times, exposes the unsustainable reimbursement model behind ambulance services, and explains why burnout and PTSD often stem from chronic fatigue, moral injury, and system misuse—not just trauma.

The conversation goes far beyond the truck. Chad breaks down:

• Why EMS is “stalled between expectations and reality”
• How over-dispatching and non-emergent calls are wearing providers down
• The growing gap between public demand and system capacity
• Why medics and EMTs remain dramatically underpaid despite rising expectations
• The leadership failures—and successes—that shape agency culture
• The future of EMS reimbursement, workforce development, and professional identity

This episode also explores what real reform could look like: treat-in-place models, workforce investment, legislative advocacy, professionalism, and why EMS must be viewed as both public safety and healthcare to survive.

This is not a surface-level conversation. It’s an honest, sometimes uncomfortable look at where EMS stands today—and where it’s headed if meaningful change doesn’t come soon.

If you work in EMS, lead EMS, rely on EMS, or care about the future of emergency care in America, this is a conversation you need to hear.

Support the show

In-Service: The EMS Podcast is dedicated to the professional on the front lines of emergency care - in the field, the classroom and behind the scenes. Subscribe for new episodes featuring EMS leaders and innovators shaping the future of pre-hospital care.

Merchandise Store: https://www.bonfire.com/store/in-service-ems-podcast/?utm_source=copy_link&utm_medium=store_page_share&utm_campaign=in-service-ems-podcast&utm_content=default

If you have suggestions for future guests email: contact@in-serviceemspodcast.com