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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 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.

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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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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.

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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.

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

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Paramedic Training Pipeline: Zero to Hero with Andrea, Tyler & Mitchell

What really happens when someone goes from citizen to paramedic in the fastest pathway EMS offers? In this raw, funny, and unexpectedly emotional episode, three medics who took the accelerated “zero to hero” pipeline sit down to talk about what the classroom didn’t teach them, what the field demanded of them, and what it actually feels like to learn EMS in real time.

Andrea Marquez, Tyler George, and Mitchell Lamb come from completely different backgrounds — a seasoned EMT who worked through school, a former filmmaker turned medic, and a Georgia adrenaline-junkie who jumped straight from EMT class to paramedic certification. But each of them hit the field with the same challenge: be the medic your patch says you are… even if your knees are shaking.

They share the calls that shaped them early in their careers — a teenage overdose, a seven-day-old infant who suddenly stopped breathing, a traumatic fall that permanently changed one medic’s fear of heights — and the moments when they realized the job is messier, louder, and far more human than anything in a textbook.

And yes… the story of Butter Man — an early-morning psych call involving a naked, fully greased individual, a confused restaurant staff, and a Police wrestling match that defies physics, dignity, and imagination.

The conversation goes deeper into:

• The gaps between school training and field reality
• How it feels when everyone on scene suddenly looks to you — the new medic — for answers
• The moment when confidence finally “clicks”
• Why CPAP humbles every new paramedic
• Navigating dangerous advice from another provider
• Whether zero-to-hero produces competent medics or unnecessary risk
• And the qualities that truly determine whether someone will make it in this field

It’s honest. It’s chaotic. It’s unfiltered EMS.

And it captures exactly what it takes to survive the pipeline — and grow into the medic you’re supposed to become.

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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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In this episode, Jason sits down with paramedic Ian McGuigan and his EMT partner Marcia McCollum for an honest, deeply human conversation about what it means to be neurodivergent in EMS—and why it can be a superpower on scene. Ian shares his journey to discovering he is autistic in his late 20s, how years of masking shaped his career, and the unique strengths he brings to the truck: intense focus in chaos, rapid pattern recognition, and calm, structured thinking when everything around him is falling apart.

Together, Ian and Marsha walk through some of the hardest calls they’ve ever run: a devastating pediatric trauma, a stillbirth in a crowded, chaotic home with a student onboard, and a mass-casualty shooting that forced Ian into one of the most demanding roles a medic can face. With no law enforcement available, gunfire still active, and crowds pushing wounded victims toward the flashing lights, Ian built a makeshift sidewalk triage area out of nothing—using bystanders as helpers, emptying every trauma supply he had, packing wounds, improvising chest seals, and coaching strangers through the worst moments of their lives. Amid the sirens, the screams, the ricocheting shots, and the sensory overload, his neurodivergent ability to hyper-focus became the anchor of the scene. Ian operated as a one-person MCI branch, stabilizing victim after victim until additional help finally arrived.

They talk candidly about sensory overload, grounding techniques, “stimming” on scene, and how Marsha has learned to recognize when Ian is nearing his limit—and step forward to shield him so he can reset and keep functioning.

Beyond the calls, this episode digs into culture and stigma in EMS, the pressure to “tough it out,” and how leadership and peers can actually support neurodivergent clinicians instead of sidelining them. Whether you’re on the spectrum, work with someone who is, or just want to be a better partner and leader, this conversation is a powerful reminder that embracing neurodiversity doesn’t weaken EMS—it makes the whole profession stronger.

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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.

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

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In this powerful and unfiltered episode of In-Service: EMS Podcast, Jason sits down with three extraordinary paramedics — Carra Rau, Eve Moody, and Mary Glasgow Brown — for an honest look at what it truly means to be a woman working in emergency medical services.

Gritty stories of first field terminations, pediatric arrests, delivering babies in chaotic environments, and navigating a male-dominated profession, these women share the moments that shaped them, challenged them, and nearly broke them. They talk openly about balancing motherhood with trauma, carrying guilt home after difficult shifts, and the invisible emotional toll of a job that demands strength at all times.

From the isolation of COVID-era calls to the pressure of proving themselves on every scene, Carra, Eve, and Mary pull back the curtain on the culture of EMS — the good, the bad, and the heartbreakingly human. They discuss stereotypes, missed family milestones, the struggle for mental health support, and the fierce resilience that keeps them showing up shift after shift.

This episode is emotional, uncomfortable, and incredibly important. The women behind the sirens — the medics who carry grief, grit, compassion, and strength into every call, often at great personal cost.

Whether you’re in EMS or simply want to understand the people who answer 9-1-1, this conversation will stay with you long after the episode ends.

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

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In this episode of In-Service, we sit down with a seasoned EMS leader who understands that great leadership begins in the field.

Assistant Chief Brian McNeeley oversees countywide EMS operations in Montgomery County, Tennessee — but his foundation was built in the back of an ambulance and on the front lines of patient care.

Chief McNeeley shares how his time as an Army medic shaped his leadership style and why he believes in keeping policies practical, people-focused, and rooted in real-world experience.

We explore what it means to manage tasks while truly leading people, how to stay proactive in operations, and how to build culture across generations in today’s evolving EMS workforce.

You’ll also hear insights on:

• Balancing confidence, humility, and patience in leadership
• Using data and consistency to stay ahead of problems
• Building peer support and communication into agency culture
• Leveraging technology like CAD/AVL systems and a countywide Motorola P25 radio network to strengthen operations

Chief McNeeley reminds us that leadership isn’t about control — it’s about connection. Whether you’re a new paramedic, a field supervisor, or a command-level officer, this episode delivers practical wisdom on leading with purpose while never forgetting the view from the ambulance.

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

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In this episode of In-Service, host Jason Falvey pulls back the curtain with the EMS supervisors who keep our operation running every day. From juggling calls and managing crews to those late-night decisions no one ever sees, this conversation dives into what it’s really like to be in the hot seat.

The team shares stories from the field, a few laughs about the chaos that comes with the job, and some honest reflections on leadership, teamwork, and trust. It’s an unfiltered look at the people who balance patient care, system oversight, and a thousand moving parts—all while keeping their sense of humor intact.

If you’ve ever wondered what happens behind the radio traffic or how supervisors keep it all together when things get hectic, this is the episode you don’t want to miss.

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