In this episode of the Pre-Hospital Paradigm Podcast, Caleb Ferroni is in the host seat again with co-hosts Dr. John Hill and Ray Pace as they welcome Dr. Garlisi as their guest discussing sepsis for EMS. They will dive into alerts, assessments, and treatment of patients with symptoms of sepsis.

The crew, and Dr. Garlisi, wind up the discussion regarding assessment of and treatment of patients with symptoms of sepsis. Part of the assessment is... REALLY counting the respirations... not guestimating!

The crew furthers the discussion of what a "sepsis alert" is. From the prehospital perspective as well as what occurs within the ED when an alert is activated…such as radiology, the pharmacy and the blood draw teams. Fluid boluses and epinephrine become the tools for the EMS crew to combat the signs of sepsis. Also, what is a basic-level provider to do for a patient with suspected sepsis.

Dr Andrew Garlisi joins the team to go deep on the topic of sepsis. His "why" as to his interest into patients with sepsis is personal. He starts off with the basics at the metabolic and cellular level to help bring a general understanding. Does he see administering antibiotic agents prior to hospital arrival and "sepsis alerts?"

We're doing something unique for the Extra Monday Episodes of 2026. Thanks to Wes' suggestion, we're going to overview with what all the EMS Institute is involved. EMSI is not just a medical control system. To start, the team discuses the various geography, hospitals and their specialties and the various work flow processes that have been implemented overall including the new OneDose technology.

In this episode of the Pre-Hospital Paradigm Podcast, Caleb Ferroni is in the host seat with co-host Dr. John Hill. They sit down with Kim Florczyk and Sharon Kozel from Cleveland EMS to discuss the history, clinical operations, and challenges they face as such a large agency. This episode was recorded live from Cleveland EMS Headquarters.

As this episode, and in-depth look into the City of Cleveland's EMS system, the crew talks about their handling of the opioid issues within the city and the handling of Narcan. They also discuss the challenges faced by the agency which includes fleet maintenance, road conditions of the city and internal training challenges for such a large, high-volume service. In the future, they hope to have initiatives that handle the frequent callers that may not need an ambulance but still need a clinical interface individual such as community paramedicine.

The crew continues their discussion about the City of Cleveland's EMS agency. From blood administration in the prehospital setting to CPAP and BiPAP to multiple way to secure airways and oxygenation... the ladies discuss the clinical operation which includes Paramedics and Basic EMTs.

Caleb is subbing in for Scott this episode as Dr. Hill and Caleb welcome representatives of Cleveland EMS. In this first episode, we get some history on Cleveland EMS. The agency is a 3rd service and just celebrated 50 years of service. The agency runs over 70,000 calls per year with 25 units during daylight hours.

The final episode regarding addiction care wraps up the convo. We were live at Amherst Fire Department. If you missed the last 3 episodes, we definitely suggest going back in the timeline. This episode may challenge your "veteran thoughts" on addiction care.