EMS One-Stop

This week on the Inside EMS podcast, we’re passing the gravy and the hot takes. Cohosts Chris Cebollero and Kelly Grayson serve up a holiday plate full of EMS news — starting with FDNY’s potential EMS split. They dig into what fair pay really looks like, why some EMTs are suing for what they’re owed, and whether big hospital systems like Yale New Haven are reshaping the ambulance game for better or worse.

Whether you’re working a turkey-day shift or finally off duty, this episode hits hard and gives thanks where it’s due.

Quotable takeaways:

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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.

“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: 

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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.

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In this episode of the EMS One-Stop podcast, host Rob Lawrence welcomes Dr. Hezedean Smith, who spotlights the human and operational toll of Hurricane Melissa on Jamaica and the wider Caribbean.

Dr. Smith draws from first-hand perspective from the ground, detailing catastrophic damage to homes, utilities, roads and communications — which compounded the workload and emotional burden for Jamaica Fire Brigade (JFB) firefighters and EMS providers.

Dr. Smith highlighted the Brigade’s Amazon Wish List effort, which aims to route essential personal items and operational supplies directly to affected JFB members and stations to sustain continuity of operations and support responders’ families.

After the break, Dr. Smith switched hats as the newly elected President of NEMSMA to outline the association’s renewed momentum:

New association management support

Expanded member services and credentials

The inaugural NEMSMA Leadership Conference

The NEMSMA Leadership Conference will take place in Washington, D.C., March 23-24, 2026, intentionally adjacent to EMS on the Hill to create a leadership-plus-advocacy “two-fer.” Highlights include keynote Gen. Robert Neller (Ret.), plus a deep bench of EMS leaders and educators.

“Many homes destroyed, utility systems interrupted, critical infrastructure in terms of communities having the ability to communicate, leaving thousands displaced, even fire stations having operational challenges as it relates to communication and interoperability ... ”

“I stayed in the local fire station. I wanted to be there with the men and women on the ground, to make sure that I had that communication, that constant contact with them.”

“My focus will be on the firefighters and ensuring that we get enough supplies to go directly to the firefighters.”

“We want to tear down silos. We want to redefine leadership and ensure that we continue to collaborate across this globe.”

Jamaica Fire Brigade – Amazon Wish List

National EMS Management Association (NEMSMA)

NEMSMA Leadership Conference: Washington, D.C., March 23-24, 2026

EMS on the Hill, March 25-26, 2026, Arlington, Virginia

International Journal of Paramedicine

EMS One-Stop: General Robert Neller on ethical leadership and adaptability

00:46 – Quick industry/policy update

01:27 – Set-up: Hurricane Melissa overview; impact stats and current situation

02:12 – Welcome Dr. Hezedean Smith

02:26 – Dr. Smith’s backstory: Jamaica roots, USAF medic, Orlando FD, two fire chief roles, GES Consulting, Caribbean EMS focus

04:20 – First reactions to Melissa: scale of damage; compounded human toll

05:58 – Deployment cadence: aligning with JFB command, CDEMA, national EOC; travel hurdles; rapid integration on arrival

08:28 – Why existing relationships matter; staying in-station with crews; supporting leaders and frontline needs

11:13 – Call to action: Amazon wish list for responders’ personal and operational needs; distribution via JFB logistics

13:20 – Specific needs (PPE, boots, clothing, hygiene, basic medical supplies) and the ongoing recovery realities

17:46 – NEMSMA — new president, renewed energy, new AMC, who NEMSMA serves

20:14 – Board/leadership shout-outs; programs (FTEP, ACPE), member services, momentum

22:49 – Conference preview (Mar 23–24, 2026, D.C.): theme — disruptive leadership; Gen. Robert Neller keynote; speaker lineup; proximity to EMS on the Hill

26:29 – IJOP collaboration and research-to-podcast pipeline; communications and sponsorship improvements

28:29 – Closing thanks; unified call to support JFB and engage with NEMSMA initiatives

Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.

Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

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.

“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.”

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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.”

“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.”

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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.

“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.”

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From Medicare cuts to billing delays, Asbel Montes joins Rob Lawrence to share practical strategies EMS agencies can use to weather the reimbursement storm

In this episode of the EMS One-Stop podcast, we tackle the fast-moving realities of a federal shutdown and what it means for EMS finance, reimbursement and day-to-day operations.

Rob Lawrence sits down with Solutions Group’s Asbel Montes — a veteran of EMS reimbursement and policy expertise — to decode where Congress is (and isn’t), what CMS’s temporary claims hold really means, and how ambulance services can protect cash flow while preparing for potential reprocessing chaos if extenders aren’t promptly restored.

Beyond the headlines, Montes lays out a pragmatic playbook: build a Plan B for cash continuity, align with your billing team on reprocessing workflows, and model exposure across payers tied to the Medicare fee schedule. The conversation then widens to balance billing — why federal change is unlikely soon and why state-level action is delivering practical protections — before closing with leadership lessons on adaptation, data and telling EMS’s story as a guide, not the hero.

Memorable quotes from Asbel Montes

“Our extender expired — that’s that additional payment that we get from Medicare of that 2%, 3%, 22.6% — it expired September the 30th, and it was tied to the House-approved CR that went over to the Senate.”

“We’re solutions givers, as we say here at Solutions Group, not crisis managers. And if you have a plan, I can at least execute a plan.”

“What turned out to be a smaller amount, now the cost associated with it, you started to really understand the complexities that really happened in people’s AR.”

“If this lasts longer than 15 days … then I would basically have a plan in place. So I would be trying to find out from my billing team … what is your contingency plan to ensure I don’t see a hiccup in cash moving forward?”

“The only way government can really invoke change is to make it hit where it hurts. And that’s what’s going on right now. They’re hitting the pocketbook and our industry is grappling with it right now.”

Additional resources

Episode timeline & key moments

00:21 – Why the shutdown matters to EMS reimbursement and operations

01:21 – Montes’s 101: role at Solutions Group; 28 years in EMS finance and policy

02:40 – Historical context: number and length of shutdowns; current Hill outlook

03:48 – The ambulance extenders expired (2% urban, 3% rural, 22.6% super-rural); CMS claims hold window

05:03 – Planning posture: realistic timelines; “we’re solutions givers, not crisis managers”

06:12 – Back-of-the-napkin math: short-term dollars vs. long-term reprocessing burden

07:43 – 2015–2016 déjà vu: retroactive fixes and the heavy lift for back-office AR

10:26 – Secondary impacts: VA eligibility, appeals, enrollments during a prolonged shutdown

11:11 – The “three-legged stool” for leaders: (1) have a plan with billing; (2) reconcile accounts & patient balances; (3) prevent cash-flow lag if more than15 days

14:06 – Framing the moment: “hurricane shutdown” response and recovery mindset

15:43 – Balance billing at the federal level: committee work, political pain and why movement is unlikely soon

18:19 – State action wins: consumer protections and access; examples of Medicare-indexed approaches

20:24 – Why ground ambulance stayed out of federal NSA; local regulation and state primacy

22:42 – “All politics are local”: using EMS’s public visibility to advocate for patients and providers

23:09 – Adaptation over preservation: seize the 6-18 month window; let data and clinicians lead reform

27:13 – Lawrence’s “Darwinism” takeaway: adaptation as survival

28:31 – The Leadership Lab podcast: purpose, cadence and upcoming guests; Montes’s leadership journey

Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.

Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.

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.

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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.

“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 [email protected] to share feedback or suggest guests for future episodes.