10 Things to Remember If You’re In EMS

One of my coworkers posted a list on Facebook that I found to be quite hilarious. It has a list of 10 things for those of us in EMS to remember on a daily basis as we encounter our patients…and a few for our patients to keep in mind for when they end up in the back of our ambulance. Ready for a few laughs (and my 2 cents added in there)? Here goes…

  1. If God had intended for us to have a rapid response to the call, we would have been parked outside when you called. — I tweaked this a bit but the point is completely the same. We have to travel on the same roads you would if you were coming from where we were at the time you called. We don’t magically sprout wings, fly there and arrive instantaneously. I know it seems like forever…but we are coming. Promise.
  2. The Simpsons having a seizure as a result of a seizure-inducing TV show

    If you drop the baby, fake a seizure. — Dropping babies is bad. Don’t do it. Faking seizures is bad, too. We’re really good at telling when someone’s faking it. And if there’s any question of it, some of the treatment provided will certainly help clear that up.

  3. All heart rhythms will eventually degenerate into a rhythm that you both recognize and can treat! — So, true! Sometimes, it’s hard to tell what the rhythm is, usually because of so much artifact that it looks like v-fib (cardiac arrest rhythm — but you know it’s not because they’re still alert, have a blood pressure and…better yet…a pulse!). But, all rhythms eventually go to one of 4: v-tach, v-fib, PEA (which really isn’t a rhythm…just a rhythm without a pulse) or asystole. At that point, it’s really easy! (And we usually recognize it before it gets to that point…have no fear.)
  4. You should always stop CPR after the second “ouch” from the patient. — Almost true. Stop, check the pulse again and then keep pounding on the chest if there’s no pulse, even if they’re saying “ouch.” That just means you’re doing a really good job. Trust me. We’ve had several of those patients in our system where we start CPR quickly enough after the heart stopped that the brain didn’t have time to loose it’s oxygenation and is still all there. (Plus, it means you’re doing great compressions and that brain is getting some awesome oxygenation.) It’s eerie…but you’re doing the right thing (just take a second to confirm that they truly don’t have a pulse if you stop CPR — and then start again!).
  5. You can’t cure stupid. — I can’t even go there.
  6. A patient’s weight is in direct proportion to their altitude in the building. — Why, people? I don’t understand it? I’m not exactly skinny but 2 of my coworkers would be able to lift me onto the stretcher without much difficulty, even if I happen to be laying on the floor and be completely dead weight. Even my dear husband could be managed with 2 coworkers — he’s not skinny either…but nowhere near what I see on a daily basis at work. How can someone let themselves go to the point that it takes 5…6…7…8…or more people to try to get them out of their home? It’s frightening! And, unfortunately, we (as a country) are getting bigger and bigger. My largest patient required the crews of 2 ambulances, a supervisor, 2 engines, a ladder company, a rescue company and a fire supervisor to get her out of her home. Try that on for size.
  7. The dead never get better…and on the other hand, they never get worse. — Asystole is the most stable rhythm. And I find great comfort in that. I try to encourage the students that do their ride time with me with this statement: “I won’t let you kill anybody today. And if we have a code [cardiac arrest], you can’t kill them because they’re already dead.” (Now, of course, we [almost] always work to get them back but we can’t do any worse than they already are.)
  8. If you respond to an MVA [Motor Vehicle Accident] after midnight and you don’t find a drunk, keep looking. You’ve missed a patient. — I can’t tell you how many times that has been true. Obviously, we realize that not every accident in the wee hours of the morning is alcohol-related. But a lot are.
  9. When responding to your calls, remember that your ambulance was built by the lowest bidder. — Government agency. Need I say more? (Saving your tax dollars.)
  10. Nasopharyngeal airway -- inserted through the nose into the pharynx

    Full spinal precautions we custom made for obnoxious drunks…and so were NPAs [Nasopharyngeal Airways]. — No, I’m not that mean. And I’m more professional than that. But these lovely things are used for their safety. Drunk people cannot definitively tell me if something hurts…like their spine. Which means there may be some kind of spinal injury following trauma. And I would rather take that extra precaution so they can live to walk another day. (I have restraints for obnoxious people who threaten my safety. And I’m not afraid to use them.)

And these, my dear readers, are 10 things to remember if you’re in EMS. And if you end up in the back of our rig, you might want to keep these in mind.

  • JonDoble

    Hey, what do you mean I’m not skinny?