Inside EMS

• ‘You hope it never happens’: Responding to an MCI on Bourbon Street

  New Year’s celebrations in New Orleans are always a spectacle, but this year, tragedy struck at 3:15 a.m. A truck barreled into the crowds, triggering what first responders feared was a vehicle-ramming attack. Within moments, New Orleans EMS was in full mass casualty mode — triaging, treating and coordinating with law enforcement amid the unfolding chaos. But things quickly escalated. As Chief Bill Salmeron recounts, responders soon discovered not only multiple critical patients, but also a shootout, a downed suspect and the chilling realization that explosive devices had been planted nearby.  In this gripping episode, Chief Salmeron shares the inside story of how his team handled one of the most intense incidents in recent New Orleans history. He walks through the initial response, communication challenges and how well-drilled interagency coordination played a pivotal role. But beyond the logistics, he also speaks to the emotional toll — how EMS crews handled the psychological weight of triaging patients, working alongside grieving families and processing the magnitude of the event in the days after.  Top quotes “You don’t see that many fatalities in one place with possible explosives, an active shooter — or at least you shouldn’t in a civilian EMS world — but we do.” — Chief Bill Salmeron "Anybody can command a scene. You don't have to be a paramedic. You don't have to be a chief or a doctor or whatever it is." — Chief Bill Salmeron Enjoying the show? Contact the Inside EMS team at [email protected] to share ideas, suggestions and feedback, or let us know if you’d like to join us as a guest.

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• Why every EMS agency needs a mental health game plan

  In this episode of Inside EMS, hosts Chris Cebollero and Kelly Grayson are joined by Nick Maltby, chief of service for New Hartford Volunteer Ambulance Service, and a clinical psychologist specializing in anxiety and PTSD. Nick brings a unique perspective, blending frontline EMS experience with mental health expertise to tackle one of the biggest issues in EMS today — mental health support that actually works. Memorable quotes “Depression is a voice that whispers to you that you can't do all the things that bring you joy.” — Kelly Grayson “The first step to a problem getting worse is thinking, ‘I can't tell anybody, because if I did, they would ostracize me, they would fire me, they wouldn't be my friend,’ but it’s all in your head.” — Nick Maltby Enjoying the show? Contact the Inside EMS team at [email protected] to share ideas, suggestions and feedback, or let us know if you’d like to join us as a guest.

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• News flash: Don’t treat patients with an expired certification

  In this week’s episode of the Inside EMS Podcast, hosts Chris Cebollero and Kelly Grayson discuss some of the biggest news stories in EMS from the month. First up: A fire chief in Colorado is under investigation for running nearly 300 medical calls on an expired paramedic certification from 2019. What happens when leadership sets a bad example for their crews? The pair also discuss several mental health initiatives, including the University of Washington’s new first responder training program and the mental health teams supporting evacuees of California’s wildfires. Plus, Chris reacts to an idea floated by the new White House administration to reduce FEMA’s role, and Kelly gives his take on why the agency – despite its flaws – is a necessity. Have an EMS-related news story you want Chris and Kelly to analyze? Send an email to [email protected]. Memorable quotes  “If you don't want to pay for it, then, then don't gripe about poor response times ... or inadequate care, because you wouldn't pay for it.” — Kelly Grayson “ You know, during COVID, we were heroes.  And we squandered that goodwill and let ourselves be pushed onto the back burner until something horrific happens to California. And then firefighting leaps into the breach again. Then, those citizens are incredibly grateful, but when this is all over, they'll fade back into obscurity again.” — Kelly Grayson This episode of the Inside EMS Podcast is sponsored by Philips. Time to take pre-hospital emergency care to the next level. Time for Tempus. Enjoying the show? Contact the Inside EMS team at [email protected] to share ideas, suggestions and feedback, or let us know if you’d like to join us as a guest. 

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• Male-centric medicine: Why women’s health is EMS’s next big challenge

  In this episode of Inside EMS, Chris and Kelly are joined by Tim Redding, founder and CEO of Emergency Education Consultants, to explore a topic that’s reshaping how we think about medicine: male-centric healthcare. Tim shares insights from Dr. Alyson J. McGregor’s groundbreaking book, “Sex Matters”, which explores how medical research and education have historically centered on white male patients, leaving women underserved and misdiagnosed. From cardiac care to drug research, Tim explains how biases have permeated everything from symptom recognition to treatment protocols. Did you know that women experiencing heart attacks rarely exhibit the “classic” symptoms, like chest pain? Or that 8 out of 10 drugs pulled from the market between 1997 and 2001 were due to severe side effects in women? If you’re someone passionate about improving patient outcomes, this episode will make you rethink what you know – and don’t know – about women’s health in EMS. Memorable quotes “Medicine historically has been white males doing the doctoring, writing the textbooks and doing the studies. So, what that has led to, by no one’s fault, is to this very male-centric view of medicine.” “The most accurate tool for confirming and diagnosing MI in women is an MRI and that really blew my mind.  I can’t think of any time that I’ve heard a doc say, ‘Let’s get an MRI for that cardiac female patient.’” Enjoying the show? Contact the Inside EMS team at [email protected] to share ideas, suggestions and feedback, or let us know if you’d like to join us as a guest.

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• The science behind shock: Why providers must understand the RAAS

  Ever wonder what really happens inside the body during shock? This week, Chris Cebollero and Kelly Grayson dive into the renin angiotensin aldosterone system (RAAS).  From vasoconstriction to fluid retention, they break down this complex topic with real-life examples, a sprinkle of humor and practical tips for how EMS providers can apply this knowledge in the field. Kelly shares the importance of understanding the “why” behind shock presentations, from recognizing when fluids won’t work to knowing when vasopressors are the answer. With anecdotes like treating a sepsis patient on ACE inhibitors and using pulse ox waveforms for clues, this episode blends science with field-tested wisdom. Whether you’re an EMT, paramedic, or just an anatomy nerd, you’ll walk away with a clearer picture of how the RAAS keeps us alive – and how we, as EMS professionals, can work smarter alongside it. Memorable quotes “It's called, ‘The Renan Angiotensin Aldosterone System – not just a planetary belt in Star Wars’”. — Kelly Grayson “So, the kidneys now say, ‘We're not getting enough blood. Here's this renin that we're gonna send out because we've gotta fix this problem.’ What the body doesn't know is that Chris Cebollero and Kelly Grayson and you are out there trying to fix it. So it’s trying to fix itself.” — Chris Cebollero Related resources: Understanding push dose pressors Understanding prehospital vasopressors: Dopamine, epinephrine or norepinephrine? A basic overview of shock for EMS Compensated vs. decompensated shock: what you need to know ABOUT THE SPONSOR Whether replacing radio reports, alerting specialty teams, or managing mass casualty incidents, Pulsara simplifies communication. Pulsara scales to meet your dynamic communication needs. From routine patient alerts to managing large-scale emergencies, every responder and clinician connects seamlessly. Familiar yet powerful, Pulsara streamlines your response, from routine transfers to regional disasters. One tool. Every day. Regardless of event. Discover more at Pulsara.com. RATE & REVIEW Catch a new episode of the Inside EMS podcast every Friday. Enjoying the show? Contact the Inside EMS team at [email protected] to share ideas, suggestions and feedback, or let us know if you’d like to join us as a guest.

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