Episodes

What if EMS stopped treating every 911 call the same and started addressing why someone needs help? Patrick Flaherty, Division Chief of EMS and Training for the Sandy Springs Fire Department, joins the In-Service EMS Podcast to discuss how his department is rethinking emergency medical care. Drawing on a career that began in 1991, Patrick shares lessons from his work as a firefighter, paramedic, educator, Marine Corps veteran, tactical medic, police officer, and EMS leader. He recounts a call...

What really happens when a patient leaves the ground and enters the world of flight medicine? In this episode of In-Service: EMS Podcast, we take a practical look inside helicopter EMS—from the perspective of a flight paramedic and air base manager who has worked across rural EMS, fire-based EMS, ground operations, and critical care transport. We break down what actually makes someone a flight patient and challenge the idea that a helicopter is simply a faster ambulance. The conversation cove...

In this episode, nationally registered paramedic and certified flight paramedic Sam Oxford explores what it takes to deliver excellent prehospital care when the stakes are high. Drawing on more than a decade in emergency response, critical care transport, flight medicine and clinical operations, Sam explains how preparation, sound judgment and teamwork shape patient outcomes. Sam shares an early-career call that exposed the limits of his paramedic-school training and transformed his approach ...

As EMS evolves, the conversation often centers on new procedures, new medications, and expanding scope of practice. But are we asking the right question? In this episode, Dr. Jon Allen and Chief Chad Huff argue that the future of EMS isn’t just about adding more skills—it’s about developing the clinical judgment to know when those skills should, and shouldn’t, be used. Dr. Jon Allen, an emergency physician, EMS medical director, and member of the state’s EMS Medical Directors Advisory Council, ...

Leadership in EMS is often associated with rank and titles, but Derek Hendren argues that true leadership is built on credibility, trust, and consistency. In this episode, Derek and Jason explore what it takes to earn respect in high-pressure environments where accountability matters. They discuss the importance of transparency, ownership, and follow-through, as well as the damage caused when standards are applied inconsistently or leaders fail to address problems honestly. A central theme of t...

In this episode of In-Service: EMS Podcast, Jason Falvey sits down with veteran paramedics Brinker Hoffman and David Manavi for an honest and wide-ranging discussion about the realities of modern EMS. Drawing from decades of field experience, they explore what today’s EMS education system is producing, why soft skills matter as much as clinical skills, and how providers can continue to grow long after they earn their certification. The conversation examines the difference between technicians an...

In this episode of In-Service: EMS Podcast, Jason sits down with Israel Contreras for a deep conversation about the future of EMS and the growing shift from a transportation-based model to a true healthcare delivery system. Israel, currently serving in EMS Transformation and Innovation, explains why the traditional “you call, we haul” approach is no longer sustainable in modern EMS. Together, they explore how systems across the country are beginning to rethink response models, integrate nurse na...

This episode digs into the real-world side of values, ethics, and culture in EMS—where the decisions are rarely clean and the consequences are never theoretical. Dave DiNapoli brings the conversation out of the classroom and onto the truck, exploring how values show up in patient care, how ethics can drift under pressure, and how providers are tested when policy, judgment, bias, and human emotion collide. We talk through the uncomfortable places where EMS providers and leaders are forced to m...

This episode of In-Service: The EMS Podcast dives into the evolving edge of prehospital care, exploring how advanced interventions like RSI, blood products, and ultrasound are reshaping what it means to be a paramedic. Jason sits down with Michael Henry and Eric Falvey to unpack not only the clinical tools driving modern EMS, but the operational realities of delivering that care in a high-volume, high-acuity environment with massive seasonal population surges. The conversation sets the stage for...

In this episode of In Service, Jason Falvey sits down with Wayne Sandford for a wide-ranging conversation on leadership, scale, and service across more than five decades in the fire service. From his beginnings as a firefighter in East Haven, Connecticut, to leading the Connecticut Fire Academy, serving 15 years as fire chief, helping build Connecticut’s Department of Emergency Management and Homeland Security, and later teaching at the University of New Haven, Sandford reflects on the lessons t...

This episode is a blunt, practical deep-dive into why patient refusals are the most dangerous decision a paramedic can make—not because the paperwork is hard, but because the mindset shifts: crews treat refusals like “not a real call,” cut corners, and then get crushed later when the outcome goes bad. Paul Girard breaks down how refusals become career-ending events through weak assessments, vague documentation, and failure to prove true decision-making capacity. Paul lays out what investigators...

Jason Falvey sits down with Dave DiNapoli (former EMT/paramedic, police officer, police chief; now an executive coach) to unpack why strong clinicians often struggle once they step into leadership. Coaching isn’t about giving answers — it’s about creating clarity, pressure-testing decisions, and forcing leaders to confront unintended consequences. Dave breaks down the hardest transition in EMS: moving from line staff to formal leader, where identity, language, and expectations change overnight. ...

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 con...

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 improvem...

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 c...

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 com...

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 fal...

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 the...

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 ...

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...

In this episode of In-Service EMS Podcast, we sit down with Matt Moughalian, a seasoned paramedic with a decade of frontline experience, and Christian Whelan, his former EMT partner and now a newly minted paramedic. Together, they share the story of a partnership built in the back of an ambulance—one that evolved from running calls side by side to navigating the challenges of new roles and greater responsibility. Matt brings the perspective of a veteran provider who has honed his clinical edge ...

In this episode of In-Service, we sit down with two paramedics at very different stages of their EMS journeys. John Duplantis, with over 30 years of clinical experience and a reputation for calm leadership under pressure, shares his insights on mentorship, professionalism, and preparing the next generation of providers. Logan Durham, a paramedic just beginning his career, brings fresh perspective on the challenges of transitioning from classroom learning to the unpredictable world of patient car...

In this episode of In-Service, we explore the critical role of soft skills in EMS with Jed Durden and Crystal Rimert. From effective communication and de-escalation techniques to building rapport with neurodivergent and autistic patients, Jed and Crystal share practical strategies that transform patient care and strengthen crew dynamics. They also discuss handling sensitive situations like death notifications, mentoring new EMTs, and using emotional intelligence to lead with empathy in high-pres...

In this episode of In-Service: The EMS Podcast, host Jason Falvey sits down with Derek Hofmann, a paramedic nurse working in Mobile Integrated Healthcare (MIH)—a model that’s transforming how communities receive care. Derek brings a unique dual perspective in paramedicine and nursing, serving on the frontlines where emergency medicine, primary care, and community health intersect. We explore Derek’s journey into MIH, what a day in the life of a paramedic nurse looks like, and how MIH programs s...