Kickstart My Heart (Cardiac Emergencies)

When an ambulance leaves the scene, who decides where the patient goes? Is the closest hospital always the right choice? And what happens when a patient's preferred destination isn't the most appropriate facility for their condition? This week on the RideAlong: EMT School Podcast, Mike and Jonathan tackle hospital selection and patient routing. From trauma centers and stroke centers to cardiac, pediatric, and burn facilities, we explore the different capabilities hospitals offer and how EMS providers determine where their patients should go. We also discuss patient preferences, medical command, transport protocols, and the unexpected challenges that can complicate even a seemingly straightforward destination decision. Before diving into our main discussion, we're bringing back the Pocket Prep Study Question of the Week! Mike and Jonathan work through a question about increased intracranial pressure, discussing the clinical findings and reasoning behind their answer. We also catch up on Jonathan's critical care education, Mike's anatomy and physiology coursework, and some of the experiences and connections from EMS World Expo. Then, in Current Topics in EMS, we look at an Iowa community working to restore local ambulance coverage after losing its service a decade ago, followed by a conversation about artificial intelligence in EMS. Could AI transform how we train, document, and make clinical decisions? And where should we draw the line between using technology as a tool and becoming dependent on it? Whether you're a new EMT learning your local hospital system or an experienced provider navigating difficult transport decisions, this episode explores why choosing the right destination is an essential part of patient care. -------------------------------------- Episode Breakdown 00:00 – Intro 08:00 – Patreon & Supporter Recognition 11:36 – POCKET PREP: Study Question of the Week 17:51 – Catching Up With Mike & Jonathan 36:42 – ROTATING SEGMENT: Current Topics in EMS 38:11 – Iowa Community Working to Restore Ambulance Service 49:00 – Artificial Intelligence in EMS 1:10:14 – MAIN DISCUSSION: Hospital Selection & Routing 1:11:05 – Understanding Specialty Hospitals & Levels of Care 1:23:09 – Patient Stability & Choosing the Appropriate Destination 1:29:52 – Agency Policies & Hospital System Considerations 1:35:00 – Patient Preference vs. Medical Necessity 1:41:18 – Medical Command & Difficult Transport Decisions 1:45:48 – Hospital Diversion & Unexpected Transport Challenges 1:49:00 – Geography, Weather & Routing Considerations 1:57:09 – Understanding Your Local Hospital System 2:09:36 – Closing & Final Thoughts -------------------------------------- ⚠️ Disclaimer: This podcast is for educational and storytelling purposes only. It is not medical advice or official EMT training. Always follow your accredited instructors and local protocols. -------------------------------------- 🚑 RideAlong: EMT School Links https://www.RideAlongEMTSchool.com

What happens when you discover EMS later in life—and realize it might be the career you were looking for all along? Almost exactly one year after first hearing his name in EMT class, Mike and Jonathan sit down with Kevin Grange, award-winning author of Lights and Sirens: The Education of a Paramedic and Wild Rescues. Kevin's journey into EMS began in his mid-30s, eventually taking him through one of the country's best-known paramedic programs, urban EMS in Los Angeles, the National Park Service, firefighting, wilderness and search-and-rescue medicine, and now critical care and flight medicine. We talk about starting over later in life, the differences between urban and rural EMS, and why experiencing both can make you a better provider. Kevin takes us inside EMS in the National Park Service, where transport times can stretch for hours, helicopters and multiple agencies become part of everyday logistics, and scene safety can literally include grizzly bears. He also shares the story of responding to a double grizzly bear mauling and how that call affected his relationship with the wilderness afterward. Then we get into the evolution of EMS, critical care and flight medicine, the importance of strong BLS fundamentals, and Kevin's philosophy that a career doesn't have to follow one predetermined path. Finally, we talk about how writing has helped Kevin process his experiences, the value of sharing our mistakes and vulnerabilities, finding great mentors, and why staying curious and focusing on the positive can help build a long and fulfilling career in EMS. --- Episode Breakdown 00:00 – Introducing Kevin Grange 04:37 – Finding EMS Later in Life 08:29 – The Daniel Freeman/UCLA Paramedic Program 11:30 – Urban vs. Rural EMS 17:31 – Learning From Different EMS Systems 21:20 – Choosing the Wilderness Over the City 27:18 – EMS in the National Park Service 30:54 – EMS at Yellowstone & Long-Distance Transport 34:42 – Wilderness Medicine & the Unexpected 35:33 – Responding to a Double Grizzly Bear Mauling 39:41 – Grizzlies, Wolves & Wilderness Scene Safety 41:33 – Does Urban or Wilderness EMS Make You Better? 43:37 – Improvisation in Wilderness Medicine 45:01 – How EMS Has Changed Since 2011 51:44 – Kevin's Favorite Part of Being a Paramedic 57:07 – Moving Into Critical Care Medicine 1:01:36 – Flight Medicine & Becoming a Flight Medic 1:07:47 – Writing Lights and Sirens & Wild Rescues 1:13:33 – Advice for New EMTs & Paramedics 1:16:20 – Finding Great Mentors 1:17:16 – Staying Positive & Finding Longevity in EMS --- ⚠️ Disclaimer: This podcast is for educational and storytelling purposes only. It is not medical advice or official EMT training. Always follow your accredited instructors and local protocols. --- 🚑 RideAlong: EMT School Links [https://www.RideAlongEMTSchool.com](https://www.RideAlongEMTSchool.com)

EMS World Expo 2026 – Indy Crew Hangout What happens when you put a bunch of EMS providers together in Orlando for a week of education, new technology, networking, and just a little bit of chaos? Fresh off EMS World Expo 2026, Mike gets together with some of the Indianapolis EMS crew who adopted him for the week: Steve, Jamie, Bree, and Matt. They compare their experiences at the conference from the perspectives of attendees, educators, EMTs, paramedics, and EMS World faculty—and talk about why an event like EMS World is about a lot more than walking around an expo floor looking at new gear. The crew talks about standout classes and instructors, mental health and provider wellness, learning from other EMS systems, evaluating new technology, and the importance of sharing both successes and failures across the profession. They also get into some of the products that caught their attention, including new airway and patient-movement technology. But this one is also a hangout. We talk about the people we met, the friendships that came out of the week, exploring Orlando after the conference, and an unexpectedly competitive trip to Game Show Battle Rooms. In the end, the biggest takeaway from EMS World wasn't a product or a class—it was the people and the opportunity to connect with providers from around the country and learn from one another. --- Episode Breakdown 00:00 – Meet the Indy Crew 07:44 – Talking EMS World Expo 10:47 – Steve & Jamie Take the Stage 13:38 – Why Go to EMS World? 25:00 – Orlando & the EMS World Experience 30:21 – Standout People & Presentations 36:04 – Active Shooter & MCI Lessons 40:43 – Learning From Other EMS Systems 42:00 – BLS vs. ALS & Building Confident EMTs 45:47 – The People Behind EMS World 50:15 – Experiencing Orlando 56:19 – Game Show Battle Rooms 1:04:39 – Biggest Takeaways From EMS World 1:06:17 – New Airway Technology 1:12:28 – Mental Health & Provider Wellness 1:20:23 – Steve's Biggest Takeaway 1:21:51 – Mike's Biggest Takeaway: The People 1:25:09 – People Who Made the Week Memorable 1:27:12 – What's Coming Next --- ⚠️ Disclaimer: This podcast is for educational and storytelling purposes only. It is not medical advice or official EMT training. Always follow your accredited instructors and local protocols. --- 🚑 RideAlong: EMT School Links https://www.RideAlongEMTSchool.com

EMS asks us to take care of people on some of the worst days of their lives—but how well are we taking care of ourselves and each other? This week, Mike, Max, and Jonathan have an important conversation about provider mental health and the cumulative impact of working in EMS. We talk about how calls affect everyone differently, why it isn't always the gruesome or dramatic calls that stick with us, the effects of stress both on and off the job, and the importance of recognizing when you—or someone you work with—may be struggling. We also talk about suicide prevention, supporting our partners, finding people we can actually talk to, and breaking down some of the cultural barriers that can make it difficult for EMS providers to ask for help. Mental health isn't something that only matters after a particularly bad call; it's something providers should be paying attention to throughout their careers. Plus, Jonathan introduces a brand-new rotating segment: Call of the Week. Mike and Max work through a patient scenario, talk through their assessment and treatment decisions, and discover that running calls from the comfort of a podcast studio isn't quite the same as doing it in the back of an ambulance. --- Want to support the podcast? Join our patreon. https://www.patreon.com/cw/RideAlongEMTSchool --- Episode Breakdown 00:00 – Welcome Back / Updating the RideAlong Intro 04:30 – Provider Mental Health & The Hurt Locker 12:00 – Patreon & Our First ALS Crew Members 17:00 – EMS World Expo & What's Coming Up 39:47 – Introducing Call of the Week 40:00 – Call of the Week: Working Through the Scenario 1:06:27 – Main Topic: Provider Mental Health 1:07:00 – Suicide Prevention & Why This Conversation Matters 1:08:00 – Why EMS Can Be So Hard on Mental Health 2:09:00 – Checking In on Yourself & Each Other 2:10:00 – ALS Crew Shoutouts & Closing --- ⚠️ Disclaimer: This podcast is for educational and storytelling purposes only. It is not medical advice or official EMT training. Always follow your accredited instructors and local protocols. --- 🚑 RideAlong: EMT School Links [https://www.RideAlongEMTSchool.com](https://www.RideAlongEMTSchool.com)

What does it take to provide EMS coverage for everything from an NBA game to the Indiana State Fair—and what happens when a planned special event suddenly becomes an unplanned one? This week, Mike sits down at Indianapolis EMS headquarters with Laura Herring, Special Events Lieutenant and a 19-year veteran of EMS. Laura shares her path from originally pursuing nursing to falling in love with EMS, becoming a paramedic, spending 12 years on an Indianapolis ambulance, helping pioneer IEMS's district medic program, and eventually finding her way into leadership and special event planning. Then we dive into the world of EMS special events. Laura explains how Indianapolis EMS prepares for sporting events, concerts, the Indiana State Fair, the Indianapolis 500, severe weather, mass-casualty incidents, and other situations that fall outside normal 911 operations. We talk about planning resources, working alongside fire, police, event organizers and other medical providers, preparing for the things you can't predict, and what it takes to provide medical coverage for some of the biggest gatherings in Indianapolis. Finally, Laura talks about stepping away from day-to-day street medicine, finding a new way to serve her community through leadership, and offers some great advice for new EMS providers about compassion, listening to patients, and remembering that even when something doesn't feel like an emergency to you, it may still be an emergency to the person who called. --- Episode Breakdown 00:00 – Meet Laura Herring 01:18 – What Counts as a Special Event? 03:08 – From Nursing School to EMS 05:14 – Going From EMT to Paramedic 08:16 – Learning EMS in Indianapolis 12:56 – 12 Years on an Indianapolis Ambulance 15:25 – The District Medic Program 18:30 – Moving Into EMS Leadership 23:10 – Finding Special Events 27:01 – The Indy 500 & Indiana State Fair 30:38 – Planning Large-Scale Events 35:31 – What EMS Sees at the State Fair 39:23 – Sporting Events, Concerts & Venue Coverage 42:34 – EMS at the Indianapolis 500 43:53 – The Logistics of Special Events 46:12 – Leaving the Street Without Leaving EMS 48:32 – Laura's Dream Special Event 50:39 – Advice for New EMS Providers --- ⚠️ Disclaimer: This podcast is for educational and storytelling purposes only. It is not medical advice or official EMT training. Always follow your accredited instructors and local protocols. --- 🚑 RideAlong: EMT School Links https://www.RideAlongEMTSchool.com