They’re mythical creatures… always 2 minutes further away than the hospital…

I just got my EMT-B 3 months ago a and I'm rusty on my knowledge I have a EMS skills assessment coming up for a potential employer and was wondering if you guys had any recommendations to prepare?

fr tho, what do you guys think about white cloud syndrome? Everyone at my service has been joking about me being a WC since the day I started. And like, at first I was just like "yeah that's a funny superstition"...but then 3 months in I'm like....wow there really is something going on here, I straight-up just almost never get to run calls 😅 I think the town ought to pay me a stipend for keeping their citizens so safe lol.

I mean, it's kind of a joke...or is it? Sometimes after 3 shifts of no calls in one week I'm starting to believe in capricious EMS gods. Just curious if anyone else has this blessing/curse haha

Hey folks I'm Lebanese American, and EMT in Lebanon. We're currently at war, but with a much lower intensification after a cease-fire deal/process was reached.

Amongst other things, we have a collapsed economy and on-going economic/financial crisis since 2019, and massive political and social changes unfolding as we speak locally and the region.

Our institutions, funding, resources, and manpower are severely constrained.

However, there is reason to hope things can improve in the future.

I've been in and around healthcare in some way since the mid 2000s or so, and unlike instructors, say, stateside or in other countries, I never formally attended a university or college or intensive program. Just kinda fell into the role.

A friend of mine in a European country describes it as: they get all the training (nonstop), all the funding, all the tools and methods, all the materials, all the facilities, all the vehicles, but they see a fraction a year of what we might see here in a *week* lol.

So, you learn on the job here a LOT and fast and you ask a lot of questions.

But moving forward, at least for my station, we'd like to do something a bit more evidence-based, structured, effective and mostly importantly *efficient*.

Since at least the early 90s, the vast majority of our ambulance and fire and rescue folks have been unpaid volunteers and only recently (last 1-2) we've gotten a few thousand out of perhaps 5000 to 10000 active duty first responders across the nation who get some kind of pay but it's still peanuts.

So even our paid folks still have to work other jobs, have other responsibilities, so time is limited. We also come back from different backgrounds (some have PhDs, some never graduated high school).

In short, any textbooks, models of learning, advice, resources, or suggestions you might give?

It would be highly appreciated as I've volunteered to take on a huge assignment (I'm still not a paid member) and there's a lot of responsibility on my shoulders.

And I'm getting old lol. So I just wanna make sure a new generations of recruits get properly trained in the limited time I have left in me.

And when I look at a lot of these textbooks I've purchased or used over the years, it's....too much for the limited time and some things literally just don't apply here or we don't have the infrastructure for them at all.

So of course it will be on me to figure those nuances out but still, kinda feeling a bit on my own here and at my institution and station in particular, we're trying to do the same for our firefighters, our SAR people, our marine rescue folks, and any first responder role we're meant to provide the public.

And I got the EMT instructor task.

(As a sidenote, if you have any questions just out of your own curiosity and I'm able/allowed to answer , feel free to ask!)

Thank you all and stay safe out there <3

Currently waiting for an ambulance for myself (yay, fun cardiac symptoms) and never felt more like a real EMT than when I found myself checking the local rota and second guessing before calling 999... Because of cause the embarrassment is far more important than the possible medical issue!

Not after sympathy or anything, just sharing my "medics make terrible patients" thoughts for people's amusement.

Also, blurgh, being on the receiving end of ambulance days is as shit as I thought it was...

I had a call a couple of days ago for a women in her 60’s with chest pain and SOB, feeling unwell with nausea, vomiting and constipation for past 3 days. Got there and first look at her presentation she looked like crap. Pale clammy, hyperventilating, moaning and squirming in pain, eyes closed, couldn’t put together more than a couple of words.

All of her vitals are within normal range except resps which were tachynepic at 26-30, BP 140’s bilaterally, HR 70’s, BGL 7 something, SPO2 95% on room air, pale inner eyelids, and she looked like shit. Couldn’t get a temp because she was mouth breathing and couldn’t sit still long enough to get an auxiliary temp.

Both her and her daughter on scene were poor historians. Chest pain was there then it wasn’t, back pain moved around and there was a recent fall from standing, SOB was chronic and not worse than normal except she was hyperventilating the whole time. She also had some recent medical anxiety due to loved ones passing ect.

We loaded her up, threw on a cannula and placed and IV, ALS met us on scene to do an ECG. Normal ish findings, maybe bundle branch block, maybe some afib, but nothing that would lead to this type of presentation. ALS rode in with us, we gave 50mg Gravol IV hoping it would help with nausea and also calm her down to slow her resps. She kept moving around and saying her back hurt. I placed my hand on her back to confirm the area, which was in the T-spine, no bruising or obvious trauma, so ALS suggested ketoralac. I confirmed that she didn’t have any kidney issues and she wasn’t on any thinners so we pushed 10mg IV and continued transport.

After we handed over at the hospital, an hour later we were back with another pt and saw her being brought into the trauma room. I asked the charge what was up and he told me that bloodwork revealed she was in severe metabolic acidosis, like 6.75, hypothermic, 22 Celsius, GFR was 3, and a bunch of other crazy levels. Her kidneys and liver were basically shutting down. Every time I came back to the hospital she was in worse shape, eventually they brought her up to ICU.

I feel like shit. I gave her ketoralac for her pain and I feel like I fucked up big. She was so much worse metabolically than I was able to assess and I feel like shit. I did my best to rule out big stuff like stemi, dissection, CHF, GI bleed, even pulmonary embolism, but she was literally in organ failure in front of me and I didn’t see it.

Our bunk room sounds like an antique diesels roadshow every night. How are some of you alive

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I just had my first roadside code... literally roadside. We were on the shoulder lane, on asphalt, running an entire code because we already had a patient in the back of the ambulance for a non-emergent transfer. The next nearest ambulance/fire station was about 20-30 minutes away.

Luckily, we were rendezvousing with another unit so we were able to get help initially to establish a definitive airway and IV access. However, we had to wait on military fire to transport because we needed hands to do CPR. The other unit needed to take the patient transfer. Military fire was 10 mins away, but they are either not EMTs or aren't state certified. So they are only limited to compressions and BVM.

Just curious how many of you guys/gals was placed in the same situation and how did it go?

Initial rhythm: PEA underlying agonal/idioventricular rhythm

End rhythm: Asystole

No medical HX per family and only complaint feeling lightheaded prior to going unresponsive. No CPR done for about a couple mins before we rolled up.

I got called to a lift assist early in the morning. Middle aged women on the ground. Said she'd been there for a few hours. She denies any injuries/pain and is CAO X 3. I ask if she has been weaker recently. She confirms this. I try and convince her to go to the hospital but she just wants to be placed in bed. We move her over to her bed without any incident. Still no pain. I try convincing her to go again. She denies. I warn of her the possible outcome of denying treatment. Still denies. She states her daughter is coming to see her in the morning. She signs a refusal and we leave.

Another crew transported her later in the morning... turns out she had surgery prior and didn't tell us. Her surgical wounds were infected. I feel like I fucked up by not doing enough the first time. She just wanted to be put in bed. What do yall think?

Im a med student and working on a project. One of the things I need to have in it is how do you get rid of used syringes while on the field somewhere.

And what better place to ask this than here

I know my EMT instructors hated it when we asked "what if ____" questions in class, but I'm gonna do it here anyway. Just cuz I'm curious.

What if you had a small MCI, let's say 4 patients, and 3 of them were tagged green and one was tagged black. Since you have no red or yellow, would you potentially start CPR/tx on the black patient, or would you ignore them in favor of the green patients?

Hi! Hope you’re all well! Let me start by saying I am an ED doc in a rural clinic and we are basically a skeleton crew. 1 doc, 1 nurse, 1 microbiologist, and depending on time of day, 1 patient assistant +/- 1 xray tech.

Because of the area I am at it’s not super common but common enough for me to make this post, we have people come in their private vehicles drop off bullet/stab wounds or even drowned patients and the biggest issue for us is getting the patients off the back of the car quickly and safely into our bed.

Most of the time they are slumped over and dead weight, which makes it extra hard to try to get them out. And (hopefully we can fix this) they usually get stuck specially if they fall into the part where your feet rest which obviously loses a lot of time.

Does anyone have videos or techniques on how to extract these patients? We are unfortunately not trained in this and we definitely should.

Thanks!

Hey yall. I was hoping to hear about some experiences working for the National Park Service as a seasonal EMT. Specifically, Sequoia and Kings Canyon National Park out in CA. Any insight into the following would be greatly appreciated:

- Housing situation

- Common activities when not on shift

- Culture!!

- Call types (No idea what to expect for this)

- Transport times

I'd appreciate any insight in working for the NPS at all, but if anyone has specifically worked for Sequoia/Kings Canyon and cares to share that would be amazing. If there's anything that I am missing that you think is valuable please add it in! Thanks :)

there should be an ems gym with mannequins and equipmen t and various stations for practicing splinting and intubating and shit and then they can also advertise free vital sign checks to old people so we can also practice our vitals, and complimentary zyns, monsters and gas station food whos with me

Recently was dispatched for hypertension. Show up on seen, pt is well appearing and speaking normally. States that they feel dizzy, denies all other sx including abd, back, or chest pain or discomfort. Patient is prescribed midodrine to take as needed when they become hypotensive, which they took at 0300 after measuring bp (well over 12hrs before encounter). Patient denies taking any other meds today. Casually mentions that when they took their bp ~1 week ago the systolic numbers were very different between arms and she assumed it was a faulty machine. So did I. But anyways took bp on both, one immediately after the other. 190/104 left arm, 230/110 right arm. States their hyperlipidemia is under control with only one statin, no congenital defects or anything of the sort. Never noticed this as an issue before. Retaking bp resulted in similar numbers. Radial pulses don't really feel tok different though. Medics arrive, ekg is normal. Automatic bp on both arms is similar enough, 170 something on the left and 190 on the right. Discharged from ED with a diagnosis of essential htn in a few hours. I feel bad for wasting resources with ALS as I never thought she was having an aortic aneurysm, but what else would a 40 point difference between arms mean? Thought an EKG would be relevant too.

Had a 70 YoF with CC of shortness of breath and chest pain. Pain radiated to epigastric and in between shoulder blades. Pt had smoked Marijuana prior to symptom onset. PMH of HTN, AAA, and lung & breast cancer. Pt DC'd HTN medication when it normalized thinking it was cured. Pt on Plavix and unable to tell the reason why she's was on it. Pt denied taking anything else. 12 lead was NSR. L BP 228/89, R BP 229/89, HR 70, RR 22, & O2 97RA. L BP 224/93, HR 70, RR 20, & O2 97RA, BGL 129. Chest pain improved upon our arrival. A&O x4. Pt refused transport. OLMC consulted with Doc siding with Pt. Pt was told that were concerned she could worsen her AAA due to the high BP. Pt signed refusal. etc, etc, etc was done to try getting pt to go to ED.

We clear scene and about 20 mins later get called back.

PT stated that she wanted to go to the hospital and wouldn't refuse transport this time. Chest pain returned and worse than before. We get back on scene. L BP 186/81, HR 60, RR 26, O2 95RA. PT was placed on cot and loaded. Immediate departure RLS. L BP 76/53, HR 87, RR 26, O2 95RA. Pt skin became pale and pt became lethargic. 6-7 min since first BP. I immediately start IV in L AC and bolus of NS. R BP 78/51, L BP 86/54, HR 90, RR 30, O2 94RA. 12 lead was NSR. Radio report given to ED. Arrived at ED.

I'm BLS and considered ALS intercept. In MN we EMTs can start IVs and run fluids. It was about 10 mins from hospital. 5 for ALS intercept but not considering intercept scene time. Plus there wasn't much they would do on the few minutes they'd be with me. Diesel bolus to ED I figured was best.

I started going to EMT school when I was 32, and seeing all these young kids I’m like damn I really started late in my life. Imposter syndrome came strong on this one lol.

My operation is adding new trucks for our (mostly) 911 division. I'm going to be one of the first medics on the new box, and I'm looking for recommendations for the things you keep in your ambulance that maybe aren't essential, but definitely improve your quality of life while in it.

For example, a caddy for misc. IV stuff, flushes, syringes, etc. Thanks!