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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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