In-Service EMS Podcast

Jason Falvey
  • 5.0 (32)
  • MEDICINE

In-Service is a podcast for EMTs, paramedics, and EMS leaders who want to stay informed, inspired, and ready for anything. Hosted by a 30-year veteran of emergency medical services, this show covers EMS leadership, field operations, clinical best practices, and real-world challenges faced by first responders. Each episode features interviews with experts and frontline professionals offering practical insights, career advice, and tools to grow in today’s fast-changing EMS landscape. 

  1. FEB 20

    “Sign Here”: The Most Dangerous Decision a Paramedic Can Make in EMS | Paul Girard

    Send a text 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 and plaintiff attorneys actually do: they deconstruct the call to answer whether your actions were reasonable and prudent, and they’ll use far more than your narrative—EPCR metadata, timestamps, geolocation, monitor data, audit trails, and third-party video can all be pulled to expose inconsistencies or outright fraud. His message is simple: you can’t “clean it up later.” If it didn’t happen—and you can’t prove it—it will be assumed it didn’t happen. The core refusal skill is capacity, and Paul defines it in plain terms: the patient’s ability to understand their situation and the risks/benefits of refusing—and your ability to document that understanding. The most common “capacity failures” he sees aren’t exotic—they start with a bad or incomplete assessment, refusals signed by minors or intoxicated patients, and refusals done across language barriers without a real interpreter. He also calls out provider-induced refusals—subtle or direct steering (“the ER is slammed,” “it’s expensive,” “you sure?”) that looks like you’re trying to avoid transport. From there, the conversation goes hard into documentation: stop hiding behind “advised of risks up to and including death.” Paul explains why generalities destroy credibility and what works instead—specific risks tied to your assessment, plus a reasonable “we can’t rule out everything in the field” caveat. He also shares the brutal reality: your report is often your best defense or your demise, and short on-scene times, missing details, or signatures done later can sink you fast. They round out with high-exposure scenarios that trip up even good crews: lift assists as “hidden refusals,” repeat callers (the “boy who cried wolf” problem), police-driven evaluations in custody situations, and when to elevate to online medical control—not because it fixes every refusal, but because sometimes a physician voice gets a patient to go, and it documents prudence. Bottom line: treat refusals like high-acuity events, slow the scene down, do the assessment, and write the report like your career depends on it—because sometimes, it does. 🔗 Website for Paul Girard & Associates – Expert EMS QA/CQI consulting and resources: 👉 https://girardassoc.com/   🎙️ Official Podcast – The G&A Way – Paul and Kevin’s EMS CQI podcast: 👉 https://podcasts.apple.com/us/podcast/the-g-a-way/id167567 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

    1h 16m

  2. JAN 25

    Why EMS Leaders Fail: Executive Coaching, Burnout, and the Leadership Gap | David DiNapoli

    Send us a text 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. They explore why effective leadership requires one eye on the current problem and one eye downrange, how the “broken window” effect applies to EMS culture—where ignoring small behaviors quietly rots the organization—why toxic high performers are unsustainable, and how burnout, emotional reactivity, and imposter syndrome undermine executive presence. The episode also draws a hard line between management and leadership: managers run the playbook, leaders write it. Memorable moment: Dave shares an early-career MVC where a medevac helicopter is talked into the scene without GPS — and why that decision changed regional practice. 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

    59 min

  3. JAN 12

    Between the Street and the Hospital: Fixing Trust in EMS Care | Carey & Eberly

    Send us a text 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. 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

    1h 16m

  4. JAN 5

    First Blood: Why EMS Can't Wait for Prehospital Blood | Dave Kleiman

    Send us a text 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. 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

    1h 22m

  5. 12/28/2025

    Between Expectations and Reality: Where EMS Stands Today | Chad Black

    Send us a text 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 downThe growing gap between public demand and system capacityWhy medics and EMTs remain dramatically underpaid despite rising expectationsThe leadership failures—and successes—that shape agency cultureThe future of EMS reimbursement, workforce development, and professional identityThis 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. 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

    1h 27m

  6. 12/21/2025

    Paramedic Training Pipeline: From Zero to Hero

    Send us a text 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 realityHow it feels when everyone on scene suddenly looks to you — the new medic — for answersThe moment when confidence finally “clicks”Why CPAP humbles every new paramedicNavigating dangerous advice from another providerWhether zero-to-hero produces competent medics or unnecessary riskAnd the qualities that truly determine whether someone will make it in this fieldIt’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. 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

    1h 22m

  7. 12/12/2025

    Neurodivergence in EMS: Different Wiring, Same Mission

    Send us a text 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. 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

    1h 35m

  8. 12/07/2025

    Behind the Sirens: Women, Work, and the Weight of EMS

    Send us a text 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 If you have suggestions for future guests email: contact@in-serviceemspodcast.com

    1h 3m
See All (20)

5
out of 5
32 Ratings

About

In-Service is a podcast for EMTs, paramedics, and EMS leaders who want to stay informed, inspired, and ready for anything. Hosted by a 30-year veteran of emergency medical services, this show covers EMS leadership, field operations, clinical best practices, and real-world challenges faced by first responders. Each episode features interviews with experts and frontline professionals offering practical insights, career advice, and tools to grow in today’s fast-changing EMS landscape. 

Information

  • Creator
    Jason Falvey
  • Years Active
    2025 - 2026
  • Episodes
    20
  • Rating
    Explicit
  • Copyright
    © 2026 In-Service EMS Podcast
  • Show Website
    In-Service EMS Podcast