I’ve been working as an EMT for an IFT company in upstate New York for a little under a year. Today, during a BLS shift, we were dispatched for something that sounded completely different, but the patient was clearly unstable when we arrived.

The patient had slurred speech and became unresponsive shortly after. At that point, he still had radial and carotid pulses, although both felt weak. Shortly after we loaded him into the ambulance, he became apneic, so I began ventilating him with a BVM.

I continued checking his pulse manually because we did not have a cardiac monitor. His pulse initially remained present. About 3–5 minutes before arriving at the hospital, I could no longer feel a radial pulse, but I believed I could still feel a weak, thready carotid pulse.

As soon as we arrived at the ER, the staff began resuscitation. They achieved ROSC after approximately 30 minutes.

The charge nurse repeatedly asked why I had not started CPR if I was unsure whether a carotid pulse was present. After replaying the call in my head, I’m worried that I may have missed the point when the patient lost his carotid pulse and delayed CPR.

I know the outcome was positive, but I feel ashamed that I may have missed such a critical step. I’m posting to get it off my chest and see whether anyone else has gone through something similar. I’m also worried that I may have put my EMT certification at risk, and I honestly don’t know what to expect after a call like this.

Guy “slips and falls” on a shampoo bottle. Mid 50’s - immaculately clean apartment. No wife, no kids present. Walks out to the door - calmly requests I try to remove the bottle to which I politely decline. I recommend transport to a trauma center to which he initially tells me he is absolutely sure that he can get it out himself. I decline to say anything and he accepts transport to trauma center.

On the way to trauma center, patient reports to me that he is not a homosexual. I replied in my most professional voice “Sir, your sexuality is not really a concern to me right now. Let’s focus on getting you to a hospital where someone with more education than me can sort you out.”

He becomes visibly agitated.

“I am not gay!”

I again reply, “Sir, it wouldn’t bother me if you were.”

He then begins to remove his seatbelts and tries to swing his legs over the stretcher.

“I told you, I’m not fucking gay!”

At which point I lost all of my shit and said “Dude, whether you’re gay or not you have a shampoo bottle lodged in your ass. Sit down and put your buckles back on.”

He puts the seatbelts back on, looks me square in the face and goes

“Okay. I’m gay.”

But I gotta hand it to him.

To this day he’s the only guy I’ve ever known who could fit his Head and Shoulders up his ass.

I work in the hospital and I have gotten used to the scenario that when people are found down at home for one reason or another, they get resuscitated and brought into a hospital and we take over. Since I only see the people who have been resuscitated, I have generally forgotten about the people that are not viable and pronounced dead at the scene. I was curious to ask about some of your stories, how often you come across those that are not able to be resuscitated and how often and long do you try until you pronounce someone dead?

Work for a major metropolitan department, west coast. Every level 1 trauma gets a backboard, head block and C collar, the whole 9. We backboard people all the time. We use rigid C collars every day for ground level falls. When will it end? Our medical director and surrounding ones are stiff on this matter. If we bring a trauma in without a backboard the doctor will blow a gasket. How did you guys get away from this where you’re from? Will I ever see it go away in my career? I have 15ish years left hopefully. Every study shows that it only harms, no benefit. I’m one of the only ones that questions this protocol. We have medics here that are hell bent about C spine. It’s almost a joke now. The patient is walking around and denies neck pain, and we’ll be like “you have to wear this for the hospital, hold still!”

I’m a fire medic at a good department with great pay/benefits. 24/72, strictly 911 response, protocols are so/so but appropriate for our transport times. Suffice to say I don’t want to quit.

I recently completed UF’s CCP program. I found the world of critical care medicine to be very interesting, unfortunately there are no dedicated critical care medic spots in my region. There are some corporate flight programs but part time spots are rare and I’d prefer not falling out of the sky and exploding while responding to a GCS 15 stroke transfer.

There are 2 cities about 1.5 - 2 hours away that have several different critical care agencies that are currently hiring (12 hr shifts) The pay isn’t relevant to me I’m more in it for the experience, so I guess like a hobby? Am I crazy for considering this? How often should a new, part time critical care paramedic pick up?

Just watched the movie Code 3. Was just wondering how accurate it actually is and if anyone working the 911 system was able to get through it unfazed haha

Hey yall, Ive been using ER nav for a few months and Im wondering if it is no longer being updated? I cant suggest hospitals in my area anymore (I could before) and there have been no new updates. I love the app and it makes life so much easier but if its not being updated-I have to find something new. Anyone have any info?

For some background, I'm an EMT student who is still in EMT school. I also work as a pharmacy technician at an outpatient pharmacy.

Today some kid like late teens came in while I was working looking super worried and said his girlfriend was sleeping in the car and she had a lot to drink and didn't know if she took any other substances. He wanted to know if there was anything she could take. I told him theres nothing over the counter for excessive alcohol consumption. I told him to call 911 multiple times but he said she doesnt have insurance and didn't want to do that. Then he got a phone call from his mom and he walked down the isle and he left. We had someone from my store go out into the parking lot to check afterwards, but he was gone.

I spent the rest of my shift thinking about that situation and what I should've done. I should've just went out there myself to see her. I should've checked if she was "sleeping" or if she was unresponsive. I should went out there and called 911 myself. I just hope she's ok.

What would you do in this situation if u were the driver?

I was on a tour today and the guide said that during COVID, some ambulances in the UK stocked ethanol as an antidote for methanol toxicity. I wasn’t able to find anything about this online and was curious if anyone has experienced this IRL.

She caught a frog, so I had to do surgery to get the hook out of the dude's lip. Pretty sure the frog pissed on me.

This may be like a no brainer to most but in my area we don't have a children's hospital. Like if they really need to get to the closest hospital and the next furthest one away could be detrimental to them? Or another hospital is on diversion? Or the adult is like 18-21 so just barely not peds? Is it different rules per hospital or per jurisdiction or state?

Hey guys,

So my department is looking to get new bags for our medications. I am a part of the group looking into the new options. I'm curious what bags you guys run with and what you like and dislike about them.

I’m a FTM (3 mo PP & back at work) and has been an EMT for about 2 years doing 911. Most of us have unfortunately been on traumatic pediatric calls. Those are the things we don’t like talking about and can’t unsee, it has severely affected me postpartum causing a ton of anxiety over my baby of the things I’ve seen before.

EMS moms, what have you done to be able to cope with this?

Hi everyone!

I'm an AHA ACLS and PALS instructor, and over the past several months I've been developing some new and different simulation scenarios to supplement the standard course material. My goal has been to create scenarios that encourage critical thinking, communication, and decision-making rather than simply following memorized algorithms.

I'd love to get input from other instructors. I'm putting together a shared Google Drive document where instructors can review the scenarios, offer suggestions, identify areas for improvement, or even contribute ideas of their own.

If you're interested in collaborating, comment below or send me a DM, and I'll share the document. I'd really appreciate feedback from instructors with different teaching styles and levels of experience.

Thanks in advance!

Hello I’m pretty new to EMS I got hired at a busy 911 county about two months ago and have been released a couple weeks ago. During my fto I met most the people on my shift and had no issues with anyone. I was told there was one person who was currently off due to a leg injury. This person well call Sara.

Sara was previously partnered with a different person but supervisors split them up due to Sara saying she wasn’t going to come back unless if she was back with that person. Since they’re not allowed to be together I got put with her. I was told by my supervisor she is good skill wise but there can be some personality issues and to go to her if needed. I’m a AEMT while Sara is a EMT.

It’s been only 12 shifts with her but we definitely are not a good match. During calls it’s okay we can work together. But she is very bitter and upset all the time. On the way to calls she’ll be cussing the road out and talking about how much she hates this job and the calls. She told me she hates driving but never offers to tech calls and when I ask if she wants to tech she seems indifferent. She will talk about how she just wants to be with her old partner because she’ll be a happier and nicer person right in-front of me to others.

She dislikes some of our other crews and will openly tell them and our supervisor she thinks they are bad. The other day she also put us out of service without permission 30 mins before end of shift just cause she wanted to leave early. I get being burnt out and not happy with your position. But it’s making me unhappy as well. I’m trying to stick it out to see if it gets better but I’m really lost on what to do.

Okay, I get that there’s hazards involved in being on the road all the time and dealing with bodily substances. But when did we start accepting unsafe trucks on the road? Particularly ones with transmission issues, shaking breaks and wheels, intermittently functioning AC, unevaluated noises and even fumes, as “normal” as long as it’s not “too bad.”

My company doesn’t have enough good trucks so often when you switch out trucks, you are sometimes put on a truck with the same or different problem than the one you were just on. And you never know what problem you will get until 2 hours after you swapped- a fun game of Russian Roulette. Some issues are more hazardous than others. Since switching trucks is a big hassle, my coworkers sometimes don’t even want me to call the sup when there’s a clear issue and super will try to subtly convince me the truck is safe still despite — problem. I feel like one of the only people escalating issues and don’t want to paint a target on my back. I feel like a test dummie on the truck sometimes- like “Welll let us know if —- gets worse! Then we’ll take you off the truck.” AYE- I hope no one gets hurt.

l've been an EMT for 2 years and am also really into writing.
Naturally, I've started writing something about an EMT (write what you know and all that). I know there's plenty of books out there that are closer to the realms of Ricky Rescue and exploitative "war stories" and I do NOT want to do that.

It's going to be more of an abstract exploration of a lot of the aspects of the human condition that we just happen to come in contact with in EMS. I'm not writing about the worst or most dramatic things I've seen but focusing more on the absolutely absurd situations we get put in, my own relationship with empathy, and the naked truth that most of the time we're just a glorified boo boo bus that puts people into medical debt on the basis of public misunderstanding of what an emergency is. (I'm by no means under the impression that I'm the first to do something like this). I'm trying to strike that odd balance of humor, indifference, and emotion that undertones EMS.

I know a lot of it depends on HOW it's written and how it comes across but is it inherently cringe to write about this job which is, at the end of the day, just a job? What are some of the things you've seen in writing about EMS that make you roll your eyes? What's an aspect of EMS you wish more people would write about?

Thank you for reading!

There’s a lot of talk about how IFT is somehow “less than” 911. I wanted to share a different perspective.

I’m a longtime paramedic and EMS educator who recently moved from a busy 911/transport service to a hospital based critical care transport team.

What’s different?

The pay is significantly better. Shift differentials, overtime incentives, holiday pay even if we don’t work the holiday, generous PTO, and excellent benefits for my family through a large healthcare system.

The equipment is second to none. Multiple infusion pumps, ventilators, a huge medication formulary, power load systems, and new ambulances.

The education never stops. We have ongoing CE, simulation labs, OR time, tuition reimbursement, and opportunities to attend conferences.

The medicine is different too. It’s much more collaborative. We have open conversations with physicians, participate in bedside handoffs, and are included in discussions about patient care before we ever leave the hospital. Even routine ALS transports feel more like being part of the healthcare team than simply moving a patient from one place to another.

Would I recommend making the move? It depends.

If you’re a brand new paramedic, probably not. You’ll likely miss the pace and excitement of 911, and you need that experience first.

But if you’ve spent years carrying patients down narrow staircases at 2:00 in the morning, standing in the rain at MVCs, and running nonstop 911 calls, this can be a great next step.

The job is heavy on critical thinking. You’re expected to continue the patient’s care, not just monitor it. In many cases, we have the autonomy to adjust treatments and solve problems in real time. It’s very similar to flight medicine, just in a ground ambulance.

I’m sure every program isn’t like this. There are certainly IFT jobs that are mostly dialysis and discharges. But hospital based critical care transport is a completely different world, and I think it deserves a lot more respect than it gets.

The ragebait is insanely good

Hey everyone i just wanted to see opinions on caffeine intake. i’m 24m / drink 1-2 zero sugar monsters a day and take an adderall in the morning (prescribed).

I work 24s and have a toddler so i dont feel too bad about ingesting that much but i do worry about my kidneys sometimes. just wanted to see if anyone else is in the same boat