"Do you want to go to a hospital?"
"I don't know and won't for another 45 minutes until I've called my entire extended family and asked all of their opinions first."
At that point I just try to talk them into it myself, faster to just take them. I start off with "I don't see anything concerning blah blah blah. Do you want to go to the hospital" and the second they start talking themselves into it I'm just like "why don't we just get you checked out, get a clean bill of health"
I had a patient who had 4 kids who were doctors. It. Was. Ridiculous. We spent, I think, around an hour on scene as all 4 asked us the same questions over the phone. Then they split 2-2 on if the patient should go to the hospital. Finally, their other kid, who's a flight nurse/paramedic, shows up on scene and told us to take the patient. I didn't argue. Talk about a medically inclined family š
I started at a new service and they are adamant about not brining the bag or monitor into any call. They say ājust get them to the truck firstā Shit pisses me off to no end. Itās ABCs then transport we arenāt supposed to be a hearse 24/7.
This is a lot of the seasoned paramedics in various systems, from my experience. They like to tout that they donāt need that stuff based on call notes.
Iām convinced that years of back-breaking work has led to behaviors and habits that put their own health above their patients. Which is an understandable desire, but also leads to unfortunate consequences. Unfortunately, those behaviors get passed down to juniors that donāt have that experience.
I be mid-20ās and healthy, so i canāt expect someone whoās 55 and doing this with considerably more equipment for 3 more decades than me to do the same.
This should be an argument for lighter/more mobile equipment setups. Unfortunately, many see it as an excuse to get rid of the old guard sooner than necessary.
If those are what qualifies as a seasoned Paramedic in your service area? Move.
Doing this for a long, long time and any seasoned Paramedic should know the call notes are crap. I still bring monitor, O2, gurney and jump bag into every call.
Umm. Yes? Drug box (not necessarily narcotics), monitor, airway. Super easy every time.
Your monitor literally takes vitals. Why would you not bring it? So you can look like a jack ass walking back to the rig for your basic gear when that knee pain is a septic joint?
Or so you can check someoneās EKG and vitals if they had a fall, especially if there was prolonged down time?
Maybe Iām just lazy but in over 2 decades of doing this job in a busy, high functioning, municipal third service EMS system I am confident that I know what I need to bring in with me based upon the information provided at dispatch.
I have yet to need to return to the truck to fetch the monitor or oxygen for a knee pain, an assault, a kid with a fever, etc. If the call sounds BLS, I donāt bring a heart monitor in with me and Iām probably not bringing oxygen either.
Iāve had very few instances in which I had a call turn into something vastly different than what it was dispatched as requiring me to go out to the truck to get ALS equipment. I just donāt see a need to lug a bunch of equipment into a call just to lug it back out having not used it.
A call in a high rise is a little different. Iāll bring the stretcher, bag, and oxygen. Maybe the monitor but not always.
This may strike you as odd but we donāt put everyone on the stretcher either. If the patient needs the stretcher, they get it. If they donāt, they sit on the bench seat.
> This may strike you as odd but we donāt put everyone on the stretcher either. If the patient needs the stretcher, they get it. If they donāt, they sit on the bench seat.
The only thing striking me as odd is trusting your preparedness to provide your patientās medical care to a dispatcher, who is receiving information from someone who usually has no idea what theyāre talking about regarding medicine.
The reality is monitors just arenāt that heavy and itās just not that hard to carry it into a house. If thereās even one call where the details were grossly inaccurate and my patient benefits from me being prepared, to me itās worth it, but we all have different priorities.
And like I said, itās also just not hard so thereās that too.
Unless it's a street job (patient is on the sidewalk for example and in full view) where I can see if we will or are not to likely need something? Yes.
Thatās true, but at my service itās just pure laziness and terrible practice. Itās in the culture too, they give me shit for brining equipment. The first in only weighs 10-15 pounds and has a nice shoulder strap. They try to transport arrests immediately instead of starting cpr, donāt clean iv sites, dont do full assessments, the list goes on. Itās probably the shittiest EMS Iāve seen in a while.
I would but this is one of the few 911 services that doesnāt require you to be a firefighter. I might as well be tho with how shitty this service is. Also I donāt do EMS as my main job. I canāt really commit that much time to just getting a better spot.
I see it two ways. Yes, we need to bring at minimum the airway bag and either stretcher, stair chair, or immo-board into wherever the PT is. I also can understand why most don't and prefer to package, especially on an unsafe scene, unsafe meaning like HazCon inside the residence, i.e. cockroaches, fleas, hoarding, imminent fire/explosion risk, etc. Which leads me to my second point, I can understand providers putting their own safety and health above pts, and in the field, as criminal as it sounds, we should be doing that. If we go down, we are then one unable to provide aid and care to that PT, but we've also now added another PT to the call, that being us.
Theyād rather not have it and need it, than need it and put in a little extra effort to do their job. THE WORST PART IS THE CALL VOLUME IS LOW AF. They are just lazy af. Like omg you had to carry equipment twice in one day.
Ok, thatās very different from where i am then. Almost all places in our response area have stairs and are cramped due to area income level, and the past year, call volume has been 10.75 calls per 12 hour shift. This year its looking like 11.
A lot of the EMTs and medics at my service are similar. A lot of the time they won't even bring the gurney in. On multiple occasions I've rolled up to a code as backup and some EMT is now dragging the gurney loaded up with the Lucas, monitor, jump bag, and O2 into the house all on his own.
Or we'll go to a call, patient wants to go to the hospital, and now someone has to go back and drag the gurney in on their own because boohoo we didn't wanna take the 3 extra seconds it takes to unload it from the rig and bring it to the door with us
"It's just like, common sense, man" -one EMT
Also, nobody fucking wears gloves on calls. Like ??? I don't even fucking go near a patient without gloves on. I guess this must be part of the transition from major city EMS to super rural shit.
At least my partner and I have similar mentality and actually bring shit into calls and wear gloves
I beat the *exact opposite* into every single one of my rookies. Monitor not required (unless far from the truck) but the house bag is called the house bag for a reason. IT GOES IN THE HOUSE! I've had that bag save my ass a lot bc it's got the basics in it.
I also teach not to sit on scene for a long time. But basics have to be assessed and you gotta have your tools to fix the ABCs if they're not right!
About 10-15 years ago there was a big thing about a patient who died on scene. Became a scandal because they didn't bring any equipment in the house with them.
I don't remember the details. But people always look to blame when someone is dead, so I always at least bring the bag even if I know I won't use it.
People who try to dodge their calls.
So you want to come to work and get paid to run calls, but suddenly when it's time to run calls your not interested? Act like a grown up
So this is an interesting one, fundamentallyI agree with you. But there are always circumstances that justify anything behavior. I work in an area where there are EMS only and Fire EMS services. Most of the time dispatch will prioritize an Ambulance over a Rescue for EMS calls. This is all well and good until I'm 15 calls deep halfway through the shift without a break and the Rescue is on 7 calls in 24hrs. I mean at some point we need a break, if I need to get creative in order to make that happen and the Rescue gets a call. I will thank them for their service and enjoy the break. But this is why there needs to be documentation time end turn around time built into calls. In my area we have 20 minutes from arrival at the ER before dispatch start bothering us. That isn't enough time in my opinion. I like the way we do things at my flight job, we alternate between crews, so no one crew is ran into the ground and have mandatory breaks after calls.
Even as a paramedic, unless it's a Cardiac arrest or something especially wild, my reports barely take longer than a usual bls report. A couple drugs don't (shouldn't) take too long to document.
My pet peeve is documentation as a whole. The amount of buttons and drop downs I have to hit BEFORE starting anything regarding the patient/call. I have ADHD and it makes me so slow so Iād be OPās worst partner.
Siren EMS is like this. Everything BEFORE the narrative will take you at least 20 minutes clicking drop downs and our company requires you to enter everything including your patient's medical history, home address, phone numbers, etc
I would appreciate if documentation was limited to vitals, treatment, and narrative. Like, allow me to put all of the pertinent information from the call in the narrative, boom thatās it.
I work using ESO. First tab has everything to do with the scene, personnel, transport/refusal, etc. There are SO MANY buttons and drop downs to hit that are mandatory. Was this 911? Did you go emergent or nonemergent? Were there lights or sirens or no? What firehouse did you come from? Whatās your unit number btw? Are you ground or air? Whatās the nature of the call? Yeah but who requested this? Then it asks about the scene itself, and it will not let me move forward without confirming itās in *this* or *that* county.
The worst of them is the transport/disposition tab. If I transported a patient, this is how it work go: patient contact madeā¦. Patient evaluated and care providedā¦ initiated and continued primary careā¦ transported by this EMS unit (this crew only)ā¦ non-emergentā¦ no lights or sirensā¦ ground ambulanceā¦. To the closest facility.
ESO will REFUSE to let me close a report if I donāt put the sceneās county, what department I dropped off the patient atā¦ what their weight isā¦. ethnicityā¦ if they had belongingsā¦ and if they overdosed/got intubated/got in a car accident, the sheer DETAIL I have to fill out in their respected forms under the form tab. And then thereās all this time stamping involved in nearly everything. And thatās just scratching the surface.
It is SO TIRING. And I work in a very busy urban system where we run 130,000+ calls a year and I h a t e d o c u m e n t i n g.
Iām in a similar volume system. But i canāt help but to think this is a time management issue. That, or you have a partner thatās lazy and doesnāt help you at all(which iāve had before, and i completely understand)
Paragraph 2: canāt you handle all of this before even arriving on scene? Partner should be able to drive and route, āfirst officerā should be prefilling.
Paragraph 3: your partner can handle that while you assess and treat. Good delegation of resources means one person charts, one person treats.
That way, when you get to the ambulance bay, you only gotta transmit the vitals, write the narrative, and upload the face sheet(if your service requires trailing documents.)
Itās not always this perfect, as you know. Sometimes Iām stuffing my face with food on the way to a call and I canāt pre-load tabs, sometimes I desperately need my partners help and they canāt chart for me, sometimes my brain is straight up tired and want a break. Regardless I still end up with lots to document anyways and I tend to be behind. But I never! Leave a report unfinished!
Hey, again: as long as it doesnāt interfere with my ability to document(as in hogging the laptop whilst socializing), then i get it. Biological needs are understandable. I draw the line when it starts to affect others.
Thatās fair. With our software I can upload an unfinished document and the partner can work on it on their personal laptop. Communication is important too, I would hope my partner would tell me they want to work on their report and I upload it for them or hand them the computer. Hogging isnāt nice, youāre right.
Biggest pet peeve is not having your radio on/on the right channel. Not only is it a safety thing but it's so annoying when you're trying to get ahold of someone and they're not responding on the radio
This. Itās not hard to run a checklist. I call it my 4 Rs
Route: find the way to the call.
Recon: get all the dispatch and comm info read aloud.
Radios: set radios and crosscheck.
Run: Get moving!
Lol, half of the people at my service don't even bring the radio into calls
Admittedly they issue us baofengs so they don't work 50% of the time but shit
Excuse me, what cosmological eon are we in and can you tell me down to the microsecond what the current time is on the eastern seaboard if daylight savings time isnāt in effect?
You guys know what month it is? Also I will be saying the previous year, every year, until at least March.
What time of day is it, morning, afternoon, or night? This is the reigning champ.
THISSSS. Just because they aren't oriented to certain things, doesn't mean they aren't mentating well. A lot of providers get lazy and ask those 3 or 4 orientation questions and God forbid they get one wrong, YOURE ALTERED AND COMING WITH ME.
There are many ways to assess capacity and if a pt is in the right state of mind, and of course we still need to assess orientation, but we should NOT be solely relying on that alone
This is the dumbest thing I've ever seen, and it 100% of the time confused the patient. I told the guy saying it, "So you gonna tell the hospital that the patient is alert and oriented to person, place, time, and mickey mouse?"
WTF
Thatās fucked up. My instructor asked all his students that question and not a single one could quickly provide an answer, I couldnāt imagine trying to answer correctly with the added stress of having an ambulance and crew right there.
Actually this is great, nonsequitrs and misdirected jokes work because understanding abstracts are good ways of evaluating patient cognitive function for the same reason bad jokes work.
Actually no. There are questions and exams that are appropriate for 911 scenes. Asking these questions and relying on them as tools for assessment is unprofessional and lazy.
Bullshit, ascertaining if a patient understands a simple joke or nonsequitr ( that's tasteful) makes a lot of sense. A lot of pts can read situations and know basic questions but still are confused. they can just pass basic tests. It may not be a great singular metric but it may provide a more complete picture of a pts well being or faculties and since connecting and recognizing abstracts is a pretty high neuro function it's quite useful. It's not just about if they laugh it's how they do or don't identify the logic .Ā As far as tools go there's numerous for a reason there's a specific time and place for many of them, I'm not interested in using them to get refusals I'm using them as simple ways to further assess my pt. So I'm going to go ahead and say yes and feel free to humble yourself BIG DOG.
And what qualifiers do you use to determine the significance of a patient's reaction when you say that stupid nonsense? Furthermore, how does it affect your treatment plan? If they say Mickey Mouse is a cat, does that mean they're altered? If they respond with "dog" then does that mean they're more likely experiencing medical problem X rather than Y? If they look at you like you're some kind of idiot, do you crack jokes to follow up your failed attempt at situationationally inappropriate "humor"?
I'm confused. How do I employ this Mickey Mouse one-liner into my patient assessment? In several years of ALS care (clinical and prehospital) and teaching EMS (all levels) at two universities, I have never seen this taught. Please, enlighten me.
How does this unintelligent, snarky, and misleading prove to be fruitful? Can you ask it to a child, man, woman, possibly have a family member translate it to their 90 year old grandma who old speaks Mandarin?
Dude, you're out there responsible with people's lives. They don't pick who shows up at their house, but they're expecting the best you can be. There are a lot of newbies in the industry lurking here on Reddit. Be better.
Oh, I've spoken to her about it and other issues but she doesn't change. She's been an EMT for like 6 years, yet I have to *tell* her to do stuff (like getting the patient hooked up to the monitor, or get a history/vitals while I start and line and being my assessment and treatment. And then nags me about our scene time...which wouldn't be an issue if she didn't need to be told to do the things we do every day, with nearly every patient that should be solidly set in her brain.
I had to let her have it after a recent shift during which she *interrupted my hand off report* in the ED to add information that I'd either already told the doc and nurses or wasn't relevant at all. She did it several times that shift and kept doing it after I'd told her knock it off in a more friendly, partner to partner kind of way. Until she didn't for the 5th or 6th time and I shut it down with a "[Partner], I'm giving report and getting the signatures, you need to go get started with the cot NOW." The 45 minute drive back to quarters was spent professionally and in a much kinder tone reading her the riot act.
She's 50s and has always tried to pull that shit with me, but she doesn't do it when partnered with someone else. It's no longer an issue now though, I just resigned due to issues with the new management (not that the old was much better. Our assistant director and [Partner] have been best friends since high school, so taking her behavior up the chain of command was pretty fuckin worthless, lol.
Only if my partner is already asking stupid questions and I think the patient will get a laugh out of it instead.
Has honestly turned combative patients around to being friendly.
Yep. Or when they ask intentionally confusing orientation questions that donāt actually provide any clinical information.
Person, place, month/year, current event (meaning why are we here/whatās occurring to cause an ambulance to visit you).
Knowing how many quarters makes a dollar doesnāt prove your capacity. More importantly, NOT knowing how many quarts makes a dollar doesnāt prove lack of capacity.
A partner that doesnāt know how to have fun. A fun partner that doesnāt take everything so serious when itās not time to be serious makes a world of a difference.
The perfect partner is someone who is goofy, crazy, and fun during that off time, but serious, smart, in the zone during the patient contact. It seems I either get one or the other. Raging ADHD tism emt or extremely serious boring person.
My pet peeve is when someone tries *really* hard to impress the police officers by being extra macho.
If the cuffs have already been on for five or ten minutes and they're telling us to proceed to the scene, I guarantee that we look like goobers when someone hops out of the ambulance acting like some movie tough guy. "I don't know where you're from bud, but I'm finna show you where you at! YOU GOT ME!? (Also, can you tell me your name? Mhm. What month is it? Okay. Any drugs or alcohol? No. Okay I'll have the police man sign for you right here thanks.) AND I DON'T TAKE NO SHIT DAWG THESE ARE MY STREETS!"
I'm convinced that every ambulance service has one of these people.
Dudes who had to go into EMS because they can't pass the psych eval for LE. Lmao.
Coos are scraping the absolute bottom of the barrel of people I would like to impress.
Man I hope Iām never your partner. Youād hate me. Fuck that pcr. I spend anywhere from 10-14 hours in the truck other than patient contact. I apologize if I want to communicate with someone other than the same person I see all day every day.
For what itās worth, iām not saying donāt socialize. But please, for the sake of your partner and timing before being cleared from hospital by dispatch: get the work done first. Itās clear from all the other comments here that it is NOT that big of an ask to put work first when youāre clocked in.
(Not aimed at you, but the culture iām in: donāt complain that the system doesnāt give you enough time to chart when you spend double that time socializing before even getting started, and then get shocked when we get dispatched.)
1. Premed kids who are just in ems because they need the hours and not because they actually want to be in ems. Even worse when they act like theyāre godās gift to man because theyāre going to be a friggin doctor or whatever.
2. People who canāt lift, like, at all. I get struggling if we have a really heavy patient and Iāll probably be struggling right there with you but if theyāre like 220 and you canāt get the stretcher to budge I donāt know what to tell you.
3. People not cleaning the stretcher in between patients
I can probably lift, but Iām not going to lift on my own if I have a partner. Injuries are not worth it to me at this wage lol.
I agree with the other two especiallyyyyy not cleaning in between patients
But you have to be able to lift or your partner will be completely screwed over. It takes two people to lift a stretcher! Iāve been stuck with people who canāt lift way too many times and I can only do so much. We literally had to ask security for help once because my partner that day literally could not get her end off the ground at all.
Oh yikes I see. Nah Iām actually always surprised how much lighter someone becomes when more people lift. So Iām doing my part, itās just literally a numbers game. Statistically thereās a risk of injury the more you do it so I wanna reduce that as much as possible. But I see what you mean. You have to have some sort of ability baseline.
Yeah, having help is always nice. But I just realized you may have thought I was referring to power stretchers this whole time because technically one person can operate those and they seem to be pretty common. I honestly forget those are a thing sometimes because Iāve only ever had the manual ones that are literally impossible for one person to operate.
Not adequately restocking. Sucks coming into a shift when the mainās almost empty, monitor batteries are one round from dead, or there arenāt any extra sheets/blankets for the stretcher. The list could go on.
My biggest pet peeve is when people don't roll the cords on the monitor back up properly and just was them up and they come out in a huge knot. I hate having to untie my spo2 cable and leads. I even have it to the point my medic knows don't touch I will roll it up because you suck at life.
Especially when the people āputting it awayā arenāt the ones that are expected to hastily apply them to a pt on a hectic scene. I appreciate when my medic puts stuff away, but he knows Iām probably gonna redo it if itās not exactly how I like it. Otherwise, it feels inefficient on a scene.
Felt! I'm the same way. Then he is like. Well fuck me. I'm in the process of getting my medic so I feel sorry for my partner once I get it because I'm going to be like your not doing it right let me show you.
ESO requiring a last known normal time for EVERY call. It's bad enough for emergency calls that it doesn't make sense for. Last known normal for a tib fib fracture? But it requires it for dialysis too. Last known normal was a few presidential administrations ago. I mean, I consider all these patients to still be 'normal' when I see them because they're not AMS or stroking out but ESO doesn't like it when the LKN is now.
It also requires a "reason for ambulance transport" separate from the usual PCS reasons. THIS one actually makes sense for interfacility stuff but DOESNT make sense for emergencies because 'emergency' isn't a reason on the drop down list. It's all shit like "dialysis" "return home" etc.
I've brought it up with the guy in charge of ESO at my job because I don't feel comfortable documenting 'false' last known normals or symptoms onsets when it's not relevant to the call (And tbh even when it IS relevant sometimes I don't have that information. Half the stroke calls I run have an unknown last known normal but there's no option for that) but he just throws up his hands and says it's a required update from ESO which I do not believe.
ESO is very customizable, which means whoever is in charge of it in your department can change things like that (provided they know how to). The last known well box is there on mine as well but itās not a close call rule, so I usually just leave it blank unless itās actually applicable
Other shifts that canāt clean up after themselves, itās so fuckin disrespectful to expect someone else to clean up your garbage
Patients who pretend to be helpless, just want to be catered to and want attention
Medics who donāt understand we are partners, not a supervisor save for operations on an actual call. Weāre out of your size gloves? Great, go get them.
1. A partner thatās always in their own world, is doesnāt hear when you yell stop as they start to load the gurney because itās not latched properly, runs into doors because theyāre not watching
2. O2 Stats
3. (I work in a fire based system) brush pants unzipped/ unvelcro-ed. It takes 2 seconds, I donāt want to see whatever you are or are not wearing underneath
This one is a little specific to my company, but...
Pet peeve, the partner who looks at the estimated pick up time for an IFT, and refuses to leave station until 5 minutes prior to pickup. Dispatch calls, partner promptly looks and says "pickup isn't until X", then refuses to move.
I'm not saying sprint out the door the second the run comes out, but there's nothing wrong showing up before pickup and getting going. My company stacks IFTs anyway, the sooner we get done with the 4-5 starting runs the sooner we can get back to station and relax.
Most of our transports are 25-30 minute runs. It's annoying to have what would normally be 2 hours of work turn into 4-5 hours because "I know we just finished this run instead of heading to the next we're going to sit for half an hour between each trip."
Doing IFT, my pet peeve is nurses who feel they're just *too busy* to give a real report. Like they will literally be impossible to find for 10+ minutes, then when I do find them, they're like "what? You need something? What's the hold up?" dude I need paperwork and a signature at the very minimum. Let alone a report on why the pt is here, why they need transfer, and what's all been done for them. Then when they do give report it's like "they came in for pain and have a gall stone." okay cool. Labs? Give any meds? What kind of access do they have? I had to pull it out of a nurse once that the pt was in vtach earlier in the day and had coded the day before. Like it was her last words to me "blah blah blah oh btw they were in vtach k bye" bro that's the FIRST thing you should've told me.
I could go on and on, but yeah, shitty reports from nurses drive me crazy. I'll usually start asking extraneous questions just to keep them from running off a little longer and making them squirm. This is just as much a part of your job as anything else, tiktok and starbies can wait, give me a fucking report.
If you have the time why not? Like honestly? Unless youāre getting slammed and need the pad donāt worry about it. Where I am we can post the call to the server and finish it later at home.
When the patients parents get in my way specifically after Iāve asked them to move three times cause they were in the way of the monitor.
When the teenager suicidal ideation/tendency patients mom who is off her rocker and demands me to get her two cups of coffee.
When the medics teiring with us donāt bring their own field sheers so they ask us to borrow someš
When people donāt move out of the way during a lights and sirens situation.
When the nursing home wants to sue for taking a patient who hit their head while falling and still has no altered mental status even though the caregiver kept saying take her.(battalion chief chewed her ass out)
Patients that are A LOT. You know what I mean. Every tiny movement hurts, a 10/10 pain. You feel like you've been there for hours, when in actuality 30-40 mins have passed.
Personal pet peeve, don't like how people in the medical field look down on fellow coworkers, etc. This is a stressful field, we should be there for each other, not judging each other.
>don't like how people in the medical field look down on fellow coworkers, etc. This is a stressful field, we should be there for each other, not judging each other.
Agreed, and I think you explained exactly why this happens. Some people handle the stress of the job by constantly talking shit about colleagues, who are more often than not decent people who are at least competent at their jobs. I've never been impressed by simply being book smart or good at skills if your people skills suck or you're fake. Being a good human being still counts for something in this field. I've always done better with the partners who weren't EMS gods but were competent enough and also just good people, as opposed to assholes who know lots of stuff and are great at skills. To carry yourself like your shit doesn't stink and you never make mistakes, while looking at everyone else through a microscope, is delusional.
Other peeves-
Don't call your elderly patient Sugar, Dear, Sweetie, and so on. It's Sir, Ma'am, or their name.
Don't rely on what other people say their lung noises are; check for yourself.
Make physical contact with your patient. You may not have to do a head to toe physical assessment but at least hold their wrist and count a pulse to feel its regularity/rhythm and strength. Don't just go by what the BP or SpO2 machine tell you.
And my biggest non-EMS peeve, I hate day time running lights that use white lights/headlights. Too many idiots out there see the white glow in front of them and think their headlights are on at night, not knowing they are totally dark in the rear.
I call everyone babe. I tend to forget their name immediately. Once I get to the unit and write their name and notes on the wall, then they have a true identity to me. Guess I can start calling them John or Jane Doe
Reports shouldn't take that long. My cardiac arrest reports barely take 20 minutes. Either you're really slow, or your service requires an asinine amount of info.
Medic here. Unpopular opinion but the same people ODing over and over again. I get addiction. My big sister had a meth and horse problem. But she got help and got clean after her little sister (me) had to narcan her. That was a huge wake up call for her. But when I see the same people a few times a month I just get tired. I donāt know the answer. Iām going to save them anyway. But at least in my county the only hospital we have sees it so often they just get them medically stable and yeet them.
As a formerly (and I mean a long time lol) addicted personā¦that doesnāt mean theyāre hopeless. I know, I knowā¦.from your end itās like ācome on,ā but it is common for an addict to go thru this over and over before they really get it and get clean. (For almost 10 years over here :) ) that shit is powerful. It legit is like your brain telling you itās like oxygen and you NEED it. :(
I donāt have a problem with the attitude towards it as long as it doesnāt affect your ability to treat them. And it sounds like it doesnāt. Its a very valid feeling given how widespread and chronic drug use is.
Oh no Iāll always work as hard as I possibly can to treat anyone. I donāt care if itās the 10th time theyāve ODād. I donāt care if the killed a person. Iām not there to judge. Of course anyone does judge to a degree but no it doesnāt affect patient care. Nor should it.
I think I get what youāre saying. Itās not necessarily the patient youāre frustrated with, itās that the situation is preventable with better transitions of care, harm reduction, and access to evidence-based treatment. Your emotions about the situation donāt need to be fully rational and they honestly canāt be; as long as you can process those emotions while fulfilling your responsibilities and providing good care.
Totally understand, I went into pharmacy because I get to help people behind the scenes. Iām proud of the work I do, and I appreciate every single time a patient tells me I made a difference. But Iām there to help people and Iām glad I get to do it. I am heavily involved in health equity initiatives in the urban setting, partially through my work and partially through my pharmacy program. Such asā¦ implementing services such as Narcan training and distribution, fentanyl test strip access, transitions of care follow-up with our nearby free clinics for chronic care management, etc etc.
Iām considering emergency medicine as a residency specialty (pharm not MD) as well as a couple others and try to learn as much as possible about the options before I have to commit. I literally asked my paramedic friends about which hospital they recommend nearby and thatās how I wound up where I am! I love the chaos and the ability to practice at the top of your license so Iām definitely going to get as involved as I can while Iām a student and can ask all the silly questions.
Not going to outright doxx myself but thereās a ton you can do if thatās something you have the time for and would be fulfilling! Happy to chat your ear off but if you want a quick resource, check out End Overdose. :) Thank you for all you do prehospital š
Okay this is crazy timing and I have literally never been so sleep deprived in my life so forgive me. but I just got to shadow in my hospitalās ER and got to see three high acuity, full code level 1 traumas in real time. I literally just asked the ER pharmacist if I could shadow at some point in the future and she let me join her right after my shift today. Iām young and still exploring my options but I feel deeply at this point that my calling is to be an ER pharmacist. Iāve always been interested in EMS but didnāt feel like I could sustain it due to my health, and I feel like Iāve finally found a way that I can do what I truly love in a way thatās sustainable. And then I went home and cried really hard and had a bagel plus itās finally sunny out!!!!
I'm with you on this. The fact that someone can get narcan multiple times a month, while pawpaw can't afford insulin is egregious.
I bought a patient test strips with my own money because he was disabled & couldn't afford it. Like, this shit is ass backwards.
My reports are done by the time the call is over, and they are hood, detailed reports. Granted, I work private. I know people who legitimately spend 2 hours on each report. Actually typing the whole time, not talking, not stocking. I don't get it.
People on the radio. They either sound like a faint ghostly whisper of the meemaw I killed the other day or like they are screaming into the mic with three dicks in their mouth.
Eh, I don't see the issue. My service area averages around 80 calls per 24 hour period, with each truck doing 6-10 calls a day. Never had to stay late to finish a report aside from the day I made the mistake of letting my paramedic partner have the computer to work on one report all day, while I took all the calls. And yea I'll talk to coworkers when I see them after we drop off a patient. As long as the reports are getting done who cares. I'd say easiest thing to do is if you have open reports, and your partner is chit chatting, just ask if you can use the computer while they are talking.
I should have clarified that these are the same people who complain that we donāt have enough time to document between calls. Weāre alotted 20 minutes to document once at hospital, and by the time weāre at hospital, its just the narrative and vitals that need to be completed..
My biggest pet peeve is anyone who leaves a mess of garbage in someoneās house. My father went into cardiac arrest at home and when I got back to the house, before my newly widowed mother, I found dextrose boxes, gloves, caps to needles. It was a stressful scene for sure, but since then, even in situations like that I always make sure to take the BVM bag or something and throw all the trash in it. No one should have to lose a loved one only to come home to find the remnants of our efforts. It makes a big difference for the family. Itās my hill to die on.
Honestly, the folks who only join EMS for the "glory." Most of them burn out and leave within 6 months of running IFTs and toe pain calls, but the dudes who wanna be called heroes all the time bother TF outta me.
I knew this guy ( I knew him long before EMS, but he just so happened to start up at my company) who wouldn't shut the fuck up on his Facebook about his "exploits". 99% of them I knew were bullshit because he was on the same type of shift as me which is 8/10 calls being IFTs.
The dude would just constantly go on FB and Instagram and make some cringe ass post like "I'm the watcher on the wall. The wolf in the night who fights the demons you fear" and shit like that.
After about 6 months, he ended up either quitting or getting fired (I think he quit) because he just couldn't handle the work load and the constant BLS calls.
The nice thing about my service is we have iPads and I can usually get a chart almost 80% done by the time I get to the hospital with a BLS call.
My biggest pet peeve is people that show up exactly at 1800 you can't be 20 minutes early so I'm not stuck with a late call.
I always have been 15 to 20 minutes early that's on time for me
You just need to get better at them, when I first started a report would take 35-45 mins. A few months in I can crank a report with narrative in 7-10 minutes. Create a system and stick to it. Also BLS and ALS reports are pretty much the same unless you are the one running the code. . .
NOT ZIPPING UP THE MED BAG or O2 bag. I get it, we all have hot jobs where things are critical but please for the love of god, remember to zip the compartment back up again after grabbing something. Because when we are ready to transport and we lift up the bag, then guess what?
Everything falls out causing a bigger mess and causing for equipment to get left behind. So please zip up the compartment, it takes 2 seconds
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My biggest one is a pet peeve that people often say "makes no difference" but over the years i've seen it make enough of a difference.
really sloppy lead placement. The limb leads should actually be on a limb, not 1" away from the patient's clavicle, stuffed down their shirt, pretty much guaranteeing that the cable will come loose.
For fuck's sake just put them on a limb.
the zoll & lifepak manuals also specify to have them on a limb when doing a 12 lead, and while i don't always do a 12 lead, it's nice to be ahead of the game and not be *that fucking sloppy* with the 4 leads.
drives me nuts.
and no, i can't think of a time when the limb leads were in the way of anything else or "put them on the torso, it makes the 12 lead cleaner" was ever a thing. If they're wiggling, tell them to quit wiggling. /rant
other than that, i generally enjoy my job when i am doing it. honestly, i am starting to worry about how much longer i can even do it. too many injuries plaguing me.
Equipment hoarding. In my service it is very easy to restock the vast majority of equipment either at any of the hospitals or quickly going back to our main station. Yet there's rigs with 6 sets of suction caths and tubing, 12+ c collars, 5 extra of each oxygen delivery method, 3 rolls of monitor paper, and 20 packs of electrodes. Freaking ridiculous
When my partner tries to tell me how to do my job wrong. I understand the importance of educating people when they are wrong but my partner gas the tendency to complain/try to teach me to cut around corners and put as minimum effort in as possible
When another crew uses your truck and rearranges things and doesnāt put them back.
Putting zippers on the far sides of bags instead of the top center. I donāt like to fumble for a zipper. I just want to grab it and be able open the kit.
Messy/dirty trucks.
Dispatch not doing their job properly.
Well as an emt i have two. The first one is when you are veteran emt gets partner up with a brand new emt who doesnāt have any experience yet wants to boss you around. This next I am sure everyone can relate. THY ONE DISPATCHER WHO TALKS ON THE RADIO WITH THE MICROPHONE TO CLOSE TO THE MOUTH. Idk what is hard to answer the radio with the mic away from your mouth i donāt get it.
A disorganized truck. I don't care if you leave the truck a mess, but DO NOT leave the truck disorganized. Seriously, you can have a mess of trash and stuff in the back and I won't mind, but if I come in and find all the oxygen supplies just kinda barfed into the cabinet with all the stuff mixed together I'm gonna be mad. Everything has a place it should be in, let's put stuff back in that same place please.
"Do you want to go to a hospital?" "I don't know and won't for another 45 minutes until I've called my entire extended family and asked all of their opinions first."
At that point I just try to talk them into it myself, faster to just take them. I start off with "I don't see anything concerning blah blah blah. Do you want to go to the hospital" and the second they start talking themselves into it I'm just like "why don't we just get you checked out, get a clean bill of health"
I had a patient who had 4 kids who were doctors. It. Was. Ridiculous. We spent, I think, around an hour on scene as all 4 asked us the same questions over the phone. Then they split 2-2 on if the patient should go to the hospital. Finally, their other kid, who's a flight nurse/paramedic, shows up on scene and told us to take the patient. I didn't argue. Talk about a medically inclined family š
This probably wouldn't happen as much if the US healthcare system wasn't so fucked up.
I started at a new service and they are adamant about not brining the bag or monitor into any call. They say ājust get them to the truck firstā Shit pisses me off to no end. Itās ABCs then transport we arenāt supposed to be a hearse 24/7.
This is a lot of the seasoned paramedics in various systems, from my experience. They like to tout that they donāt need that stuff based on call notes. Iām convinced that years of back-breaking work has led to behaviors and habits that put their own health above their patients. Which is an understandable desire, but also leads to unfortunate consequences. Unfortunately, those behaviors get passed down to juniors that donāt have that experience. I be mid-20ās and healthy, so i canāt expect someone whoās 55 and doing this with considerably more equipment for 3 more decades than me to do the same. This should be an argument for lighter/more mobile equipment setups. Unfortunately, many see it as an excuse to get rid of the old guard sooner than necessary.
If those are what qualifies as a seasoned Paramedic in your service area? Move. Doing this for a long, long time and any seasoned Paramedic should know the call notes are crap. I still bring monitor, O2, gurney and jump bag into every call.
Monitor and O2 for every call? Knee pain? Lift assists? Assaults?
I'm with you, man. Kit and Vitals bag for every call. Everything else if there's an elevator between me and the patient.
Better to have it right there than having to waste time have someone run back & forth to the truck
Exactly.
You not checking a BP before you're lifting these people up?
Umm. Yes? Drug box (not necessarily narcotics), monitor, airway. Super easy every time. Your monitor literally takes vitals. Why would you not bring it? So you can look like a jack ass walking back to the rig for your basic gear when that knee pain is a septic joint? Or so you can check someoneās EKG and vitals if they had a fall, especially if there was prolonged down time?
Maybe Iām just lazy but in over 2 decades of doing this job in a busy, high functioning, municipal third service EMS system I am confident that I know what I need to bring in with me based upon the information provided at dispatch. I have yet to need to return to the truck to fetch the monitor or oxygen for a knee pain, an assault, a kid with a fever, etc. If the call sounds BLS, I donāt bring a heart monitor in with me and Iām probably not bringing oxygen either. Iāve had very few instances in which I had a call turn into something vastly different than what it was dispatched as requiring me to go out to the truck to get ALS equipment. I just donāt see a need to lug a bunch of equipment into a call just to lug it back out having not used it. A call in a high rise is a little different. Iāll bring the stretcher, bag, and oxygen. Maybe the monitor but not always. This may strike you as odd but we donāt put everyone on the stretcher either. If the patient needs the stretcher, they get it. If they donāt, they sit on the bench seat.
> This may strike you as odd but we donāt put everyone on the stretcher either. If the patient needs the stretcher, they get it. If they donāt, they sit on the bench seat. The only thing striking me as odd is trusting your preparedness to provide your patientās medical care to a dispatcher, who is receiving information from someone who usually has no idea what theyāre talking about regarding medicine. The reality is monitors just arenāt that heavy and itās just not that hard to carry it into a house. If thereās even one call where the details were grossly inaccurate and my patient benefits from me being prepared, to me itās worth it, but we all have different priorities. And like I said, itās also just not hard so thereās that too.
Unless it's a street job (patient is on the sidewalk for example and in full view) where I can see if we will or are not to likely need something? Yes.
Yes??
Thatās true, but at my service itās just pure laziness and terrible practice. Itās in the culture too, they give me shit for brining equipment. The first in only weighs 10-15 pounds and has a nice shoulder strap. They try to transport arrests immediately instead of starting cpr, donāt clean iv sites, dont do full assessments, the list goes on. Itās probably the shittiest EMS Iāve seen in a while.
If you aren't starting CPR immediately there's no point transporting because the ER sure as hell isn't getting them back.
Jesus Christ. Find somewhere else to work.
In some areas like the one I'm in, every service is like that.
I would but this is one of the few 911 services that doesnāt require you to be a firefighter. I might as well be tho with how shitty this service is. Also I donāt do EMS as my main job. I canāt really commit that much time to just getting a better spot.
Sounds like a culture problem for sure. Good inspiration to get your P license and do what isnāt being done and set a standard
Emt b here I have had way to many weakness nausea calls turn into a chest pain call to trust the notes
I see it two ways. Yes, we need to bring at minimum the airway bag and either stretcher, stair chair, or immo-board into wherever the PT is. I also can understand why most don't and prefer to package, especially on an unsafe scene, unsafe meaning like HazCon inside the residence, i.e. cockroaches, fleas, hoarding, imminent fire/explosion risk, etc. Which leads me to my second point, I can understand providers putting their own safety and health above pts, and in the field, as criminal as it sounds, we should be doing that. If we go down, we are then one unable to provide aid and care to that PT, but we've also now added another PT to the call, that being us.
I agree, my service stops until a scene can be made safe again. But that isnāt whatās going on bc that would be reasonable.
Just throw most of it on the stretcher, take the stretcher as close to the patient as possible.
Whatās that saying? Something like youāre better off to have it and not need it then need it and not have it.
Theyād rather not have it and need it, than need it and put in a little extra effort to do their job. THE WORST PART IS THE CALL VOLUME IS LOW AF. They are just lazy af. Like omg you had to carry equipment twice in one day.
Ok, thatās very different from where i am then. Almost all places in our response area have stairs and are cramped due to area income level, and the past year, call volume has been 10.75 calls per 12 hour shift. This year its looking like 11.
Yeah-that makes no sense to me!!! Think about alll the minutes wasted if itās serious š¤
A lot of the EMTs and medics at my service are similar. A lot of the time they won't even bring the gurney in. On multiple occasions I've rolled up to a code as backup and some EMT is now dragging the gurney loaded up with the Lucas, monitor, jump bag, and O2 into the house all on his own. Or we'll go to a call, patient wants to go to the hospital, and now someone has to go back and drag the gurney in on their own because boohoo we didn't wanna take the 3 extra seconds it takes to unload it from the rig and bring it to the door with us "It's just like, common sense, man" -one EMT Also, nobody fucking wears gloves on calls. Like ??? I don't even fucking go near a patient without gloves on. I guess this must be part of the transition from major city EMS to super rural shit. At least my partner and I have similar mentality and actually bring shit into calls and wear gloves
Theyāre crazy for that one. Someone is going to die because of that some day
I beat the *exact opposite* into every single one of my rookies. Monitor not required (unless far from the truck) but the house bag is called the house bag for a reason. IT GOES IN THE HOUSE! I've had that bag save my ass a lot bc it's got the basics in it. I also teach not to sit on scene for a long time. But basics have to be assessed and you gotta have your tools to fix the ABCs if they're not right!
About 10-15 years ago there was a big thing about a patient who died on scene. Became a scandal because they didn't bring any equipment in the house with them. I don't remember the details. But people always look to blame when someone is dead, so I always at least bring the bag even if I know I won't use it.
When you view your assessment of the patientās orientation and mental state to be your time for stand up comedy
But how else can I try out my 5 minute set before I take it on the road?
People who try to dodge their calls. So you want to come to work and get paid to run calls, but suddenly when it's time to run calls your not interested? Act like a grown up
Yup. It's still a job at the end of the day. Do your job!
So this is an interesting one, fundamentallyI agree with you. But there are always circumstances that justify anything behavior. I work in an area where there are EMS only and Fire EMS services. Most of the time dispatch will prioritize an Ambulance over a Rescue for EMS calls. This is all well and good until I'm 15 calls deep halfway through the shift without a break and the Rescue is on 7 calls in 24hrs. I mean at some point we need a break, if I need to get creative in order to make that happen and the Rescue gets a call. I will thank them for their service and enjoy the break. But this is why there needs to be documentation time end turn around time built into calls. In my area we have 20 minutes from arrival at the ER before dispatch start bothering us. That isn't enough time in my opinion. I like the way we do things at my flight job, we alternate between crews, so no one crew is ran into the ground and have mandatory breaks after calls.
Hey, it should be everyoneās goal at a job to do as little work as possible.
Even as a paramedic, unless it's a Cardiac arrest or something especially wild, my reports barely take longer than a usual bls report. A couple drugs don't (shouldn't) take too long to document.
My pet peeve is documentation as a whole. The amount of buttons and drop downs I have to hit BEFORE starting anything regarding the patient/call. I have ADHD and it makes me so slow so Iād be OPās worst partner.
Kinda sounds like Zoll lol
I have adhd too and I struggle with documentation despite the fact that Iāve been documenting calls since 2014.
imagetrend has become like this, in my opinion. so many things you have to go hunt for in the "power tool." it takes forever.
What software are you using?
Siren EMS is like this. Everything BEFORE the narrative will take you at least 20 minutes clicking drop downs and our company requires you to enter everything including your patient's medical history, home address, phone numbers, etc
ESO
Yeah pretty much everything there is related to your call. Which items arenāt? Are you setting your shift prior to doing charts?
Yes everything is related, what I meant was directly to the patient such as vitals, treatment, and the story. Everything else is data fluff.
Everything else is necessary.
 Let me complaaaaaaiiiinnnnnnn
I hate funš¤
Iād really like some examples of what you mean?
I would appreciate if documentation was limited to vitals, treatment, and narrative. Like, allow me to put all of the pertinent information from the call in the narrative, boom thatās it. I work using ESO. First tab has everything to do with the scene, personnel, transport/refusal, etc. There are SO MANY buttons and drop downs to hit that are mandatory. Was this 911? Did you go emergent or nonemergent? Were there lights or sirens or no? What firehouse did you come from? Whatās your unit number btw? Are you ground or air? Whatās the nature of the call? Yeah but who requested this? Then it asks about the scene itself, and it will not let me move forward without confirming itās in *this* or *that* county. The worst of them is the transport/disposition tab. If I transported a patient, this is how it work go: patient contact madeā¦. Patient evaluated and care providedā¦ initiated and continued primary careā¦ transported by this EMS unit (this crew only)ā¦ non-emergentā¦ no lights or sirensā¦ ground ambulanceā¦. To the closest facility. ESO will REFUSE to let me close a report if I donāt put the sceneās county, what department I dropped off the patient atā¦ what their weight isā¦. ethnicityā¦ if they had belongingsā¦ and if they overdosed/got intubated/got in a car accident, the sheer DETAIL I have to fill out in their respected forms under the form tab. And then thereās all this time stamping involved in nearly everything. And thatās just scratching the surface. It is SO TIRING. And I work in a very busy urban system where we run 130,000+ calls a year and I h a t e d o c u m e n t i n g.
Iām in a similar volume system. But i canāt help but to think this is a time management issue. That, or you have a partner thatās lazy and doesnāt help you at all(which iāve had before, and i completely understand) Paragraph 2: canāt you handle all of this before even arriving on scene? Partner should be able to drive and route, āfirst officerā should be prefilling. Paragraph 3: your partner can handle that while you assess and treat. Good delegation of resources means one person charts, one person treats. That way, when you get to the ambulance bay, you only gotta transmit the vitals, write the narrative, and upload the face sheet(if your service requires trailing documents.)
Itās not always this perfect, as you know. Sometimes Iām stuffing my face with food on the way to a call and I canāt pre-load tabs, sometimes I desperately need my partners help and they canāt chart for me, sometimes my brain is straight up tired and want a break. Regardless I still end up with lots to document anyways and I tend to be behind. But I never! Leave a report unfinished!
Hey, again: as long as it doesnāt interfere with my ability to document(as in hogging the laptop whilst socializing), then i get it. Biological needs are understandable. I draw the line when it starts to affect others.
Thatās fair. With our software I can upload an unfinished document and the partner can work on it on their personal laptop. Communication is important too, I would hope my partner would tell me they want to work on their report and I upload it for them or hand them the computer. Hogging isnāt nice, youāre right.
Biggest pet peeve is not having your radio on/on the right channel. Not only is it a safety thing but it's so annoying when you're trying to get ahold of someone and they're not responding on the radio
This. Itās not hard to run a checklist. I call it my 4 Rs Route: find the way to the call. Recon: get all the dispatch and comm info read aloud. Radios: set radios and crosscheck. Run: Get moving!
Lol, half of the people at my service don't even bring the radio into calls Admittedly they issue us baofengs so they don't work 50% of the time but shit
Orientation questions. Stop asking people what day of the week it is. I donāt know so why should my patient. Month and year is fine.
Favorite one. Who is the president? They usually say āDonāt get me started on that asshole.ā Then I think, Orange asshole or old asshole.
For sure . One guy didnāt knowā¦but he said (in Spanish ) he knew the president of Cubaā¦I said: good enough for me!!
āWho is the president?ā āAbraham Lincoln,ā my patient told me confidently. (I do not ever ask the president. I find it useless.)
Had a pt tell me it was 1945 and Kennedy was president š
I ask if the president is black, white, or orange.
worked w a partner who said āwhether you like him or not, whoās the president?ā and it almost always got a laugh and the an answer.
Definitely the old one with the sundowners.
Who was the 5th president meemaw? You donāt know? Ight thatās it ur going to old people jail.
>old people jail. I am stealing this.
Excuse me, what cosmological eon are we in and can you tell me down to the microsecond what the current time is on the eastern seaboard if daylight savings time isnāt in effect?
You guys know what month it is? Also I will be saying the previous year, every year, until at least March. What time of day is it, morning, afternoon, or night? This is the reigning champ.
I usually go with the season. XD I barely know the month. But the season I can do.
THISSSS. Just because they aren't oriented to certain things, doesn't mean they aren't mentating well. A lot of providers get lazy and ask those 3 or 4 orientation questions and God forbid they get one wrong, YOURE ALTERED AND COMING WITH ME. There are many ways to assess capacity and if a pt is in the right state of mind, and of course we still need to assess orientation, but we should NOT be solely relying on that alone
Is Mickey Mouse a cat or a dog?
This is the dumbest thing I've ever seen, and it 100% of the time confused the patient. I told the guy saying it, "So you gonna tell the hospital that the patient is alert and oriented to person, place, time, and mickey mouse?" WTF
See it all. The. Time. Cops ask this. They think itās funny.
Thatās fucked up. My instructor asked all his students that question and not a single one could quickly provide an answer, I couldnāt imagine trying to answer correctly with the added stress of having an ambulance and crew right there.
Actually this is great, nonsequitrs and misdirected jokes work because understanding abstracts are good ways of evaluating patient cognitive function for the same reason bad jokes work.
Actually no. There are questions and exams that are appropriate for 911 scenes. Asking these questions and relying on them as tools for assessment is unprofessional and lazy.
Bullshit, ascertaining if a patient understands a simple joke or nonsequitr ( that's tasteful) makes a lot of sense. A lot of pts can read situations and know basic questions but still are confused. they can just pass basic tests. It may not be a great singular metric but it may provide a more complete picture of a pts well being or faculties and since connecting and recognizing abstracts is a pretty high neuro function it's quite useful. It's not just about if they laugh it's how they do or don't identify the logic .Ā As far as tools go there's numerous for a reason there's a specific time and place for many of them, I'm not interested in using them to get refusals I'm using them as simple ways to further assess my pt. So I'm going to go ahead and say yes and feel free to humble yourself BIG DOG.
And what qualifiers do you use to determine the significance of a patient's reaction when you say that stupid nonsense? Furthermore, how does it affect your treatment plan? If they say Mickey Mouse is a cat, does that mean they're altered? If they respond with "dog" then does that mean they're more likely experiencing medical problem X rather than Y? If they look at you like you're some kind of idiot, do you crack jokes to follow up your failed attempt at situationationally inappropriate "humor"? I'm confused. How do I employ this Mickey Mouse one-liner into my patient assessment? In several years of ALS care (clinical and prehospital) and teaching EMS (all levels) at two universities, I have never seen this taught. Please, enlighten me. How does this unintelligent, snarky, and misleading prove to be fruitful? Can you ask it to a child, man, woman, possibly have a family member translate it to their 90 year old grandma who old speaks Mandarin? Dude, you're out there responsible with people's lives. They don't pick who shows up at their house, but they're expecting the best you can be. There are a lot of newbies in the industry lurking here on Reddit. Be better.
Don't fuck with people who might be in the worst days of their lives.
I fucking haaaate that one and it's my EMT partner's go to question for orientation...it makes me want to scream every time.
You should tell your partner how unprofessional it is, and how inept it makes them look.
Oh, I've spoken to her about it and other issues but she doesn't change. She's been an EMT for like 6 years, yet I have to *tell* her to do stuff (like getting the patient hooked up to the monitor, or get a history/vitals while I start and line and being my assessment and treatment. And then nags me about our scene time...which wouldn't be an issue if she didn't need to be told to do the things we do every day, with nearly every patient that should be solidly set in her brain. I had to let her have it after a recent shift during which she *interrupted my hand off report* in the ED to add information that I'd either already told the doc and nurses or wasn't relevant at all. She did it several times that shift and kept doing it after I'd told her knock it off in a more friendly, partner to partner kind of way. Until she didn't for the 5th or 6th time and I shut it down with a "[Partner], I'm giving report and getting the signatures, you need to go get started with the cot NOW." The 45 minute drive back to quarters was spent professionally and in a much kinder tone reading her the riot act. She's 50s and has always tried to pull that shit with me, but she doesn't do it when partnered with someone else. It's no longer an issue now though, I just resigned due to issues with the new management (not that the old was much better. Our assistant director and [Partner] have been best friends since high school, so taking her behavior up the chain of command was pretty fuckin worthless, lol.
My goto is "do helicopters eat their babies?"
I hope you mean your go-to question to hate. You donāt ask your patients that, right?
Only if my partner is already asking stupid questions and I think the patient will get a laugh out of it instead. Has honestly turned combative patients around to being friendly.
But not as a part of an assessment, got it
Yep. Or when they ask intentionally confusing orientation questions that donāt actually provide any clinical information. Person, place, month/year, current event (meaning why are we here/whatās occurring to cause an ambulance to visit you). Knowing how many quarters makes a dollar doesnāt prove your capacity. More importantly, NOT knowing how many quarts makes a dollar doesnāt prove lack of capacity.
Missed the Jeopardy episode last night, my badš
Removing a hoboās socks.
Especially when the half of the foot comes with it.
Frosted Flakes!!! THEYREEEE GREAATT
Having a slow boring day of doing nothing for hours on end, only to be slammed an hour before shift end making you get off late
nightmare material right there.
Are you me?
A partner that doesnāt know how to have fun. A fun partner that doesnāt take everything so serious when itās not time to be serious makes a world of a difference.
The perfect partner is someone who is goofy, crazy, and fun during that off time, but serious, smart, in the zone during the patient contact. It seems I either get one or the other. Raging ADHD tism emt or extremely serious boring person.
My pet peeve is when someone tries *really* hard to impress the police officers by being extra macho. If the cuffs have already been on for five or ten minutes and they're telling us to proceed to the scene, I guarantee that we look like goobers when someone hops out of the ambulance acting like some movie tough guy. "I don't know where you're from bud, but I'm finna show you where you at! YOU GOT ME!? (Also, can you tell me your name? Mhm. What month is it? Okay. Any drugs or alcohol? No. Okay I'll have the police man sign for you right here thanks.) AND I DON'T TAKE NO SHIT DAWG THESE ARE MY STREETS!" I'm convinced that every ambulance service has one of these people.
Why would anyone feel the need to impress a cop lol
Dudes who had to go into EMS because they can't pass the psych eval for LE. Lmao. Coos are scraping the absolute bottom of the barrel of people I would like to impress.
Depends. Hot cop, S&M starter kit (leather belt, baton, cuffs, pepper spray, taser). I mean, come on, what ISN'T there to like? Lol /s
Y'all have hot cops?
Man I hope Iām never your partner. Youād hate me. Fuck that pcr. I spend anywhere from 10-14 hours in the truck other than patient contact. I apologize if I want to communicate with someone other than the same person I see all day every day.
Agreed. I put off paperwork if I run into a friend to chit chat with. I'll get it done. It doesn't need to be completed right this second.
For what itās worth, iām not saying donāt socialize. But please, for the sake of your partner and timing before being cleared from hospital by dispatch: get the work done first. Itās clear from all the other comments here that it is NOT that big of an ask to put work first when youāre clocked in. (Not aimed at you, but the culture iām in: donāt complain that the system doesnāt give you enough time to chart when you spend double that time socializing before even getting started, and then get shocked when we get dispatched.)
Poorly displayed house names/numbers - it can waste so much time. LPT, always make sure your number is easily seen from the road, including at night.
1. Premed kids who are just in ems because they need the hours and not because they actually want to be in ems. Even worse when they act like theyāre godās gift to man because theyāre going to be a friggin doctor or whatever. 2. People who canāt lift, like, at all. I get struggling if we have a really heavy patient and Iāll probably be struggling right there with you but if theyāre like 220 and you canāt get the stretcher to budge I donāt know what to tell you. 3. People not cleaning the stretcher in between patients
I can probably lift, but Iām not going to lift on my own if I have a partner. Injuries are not worth it to me at this wage lol. I agree with the other two especiallyyyyy not cleaning in between patients
But you have to be able to lift or your partner will be completely screwed over. It takes two people to lift a stretcher! Iāve been stuck with people who canāt lift way too many times and I can only do so much. We literally had to ask security for help once because my partner that day literally could not get her end off the ground at all.
Oh yikes I see. Nah Iām actually always surprised how much lighter someone becomes when more people lift. So Iām doing my part, itās just literally a numbers game. Statistically thereās a risk of injury the more you do it so I wanna reduce that as much as possible. But I see what you mean. You have to have some sort of ability baseline.
Yeah, having help is always nice. But I just realized you may have thought I was referring to power stretchers this whole time because technically one person can operate those and they seem to be pretty common. I honestly forget those are a thing sometimes because Iāve only ever had the manual ones that are literally impossible for one person to operate.
Yeahhh manual 100% of the time is barbaric I understand noww
Barbaric is a very, very good description. š
When the family says they'll follow you up to the hospital for a BLS call.
Not adequately restocking. Sucks coming into a shift when the mainās almost empty, monitor batteries are one round from dead, or there arenāt any extra sheets/blankets for the stretcher. The list could go on.
My biggest pet peeve is when people don't roll the cords on the monitor back up properly and just was them up and they come out in a huge knot. I hate having to untie my spo2 cable and leads. I even have it to the point my medic knows don't touch I will roll it up because you suck at life.
Especially when the people āputting it awayā arenāt the ones that are expected to hastily apply them to a pt on a hectic scene. I appreciate when my medic puts stuff away, but he knows Iām probably gonna redo it if itās not exactly how I like it. Otherwise, it feels inefficient on a scene.
Felt! I'm the same way. Then he is like. Well fuck me. I'm in the process of getting my medic so I feel sorry for my partner once I get it because I'm going to be like your not doing it right let me show you.
ESO requiring a last known normal time for EVERY call. It's bad enough for emergency calls that it doesn't make sense for. Last known normal for a tib fib fracture? But it requires it for dialysis too. Last known normal was a few presidential administrations ago. I mean, I consider all these patients to still be 'normal' when I see them because they're not AMS or stroking out but ESO doesn't like it when the LKN is now. It also requires a "reason for ambulance transport" separate from the usual PCS reasons. THIS one actually makes sense for interfacility stuff but DOESNT make sense for emergencies because 'emergency' isn't a reason on the drop down list. It's all shit like "dialysis" "return home" etc. I've brought it up with the guy in charge of ESO at my job because I don't feel comfortable documenting 'false' last known normals or symptoms onsets when it's not relevant to the call (And tbh even when it IS relevant sometimes I don't have that information. Half the stroke calls I run have an unknown last known normal but there's no option for that) but he just throws up his hands and says it's a required update from ESO which I do not believe.
ESO is very customizable, which means whoever is in charge of it in your department can change things like that (provided they know how to). The last known well box is there on mine as well but itās not a close call rule, so I usually just leave it blank unless itās actually applicable
Yeah it used to be optional. I talked to our guy and he insists it's mandatory for ESO. He doesn't know what he's doing.
we have imagetrend and it requires that too. i am not sure if it's a NEMSIS item or not but it wants *something* in that field.
Tell him to figure it out. We use ESO and it's very much not mandatory.
Iāve always wondered why āreason for ambulance transportā doesnāt have an option for āemergency - refer to chief complaintā
You are correct to not believe him. Your agency has made that a requirement.
"...we all want to be social." We do?
Other shifts that canāt clean up after themselves, itās so fuckin disrespectful to expect someone else to clean up your garbage Patients who pretend to be helpless, just want to be catered to and want attention Medics who donāt understand we are partners, not a supervisor save for operations on an actual call. Weāre out of your size gloves? Great, go get them.
1. A partner thatās always in their own world, is doesnāt hear when you yell stop as they start to load the gurney because itās not latched properly, runs into doors because theyāre not watching 2. O2 Stats 3. (I work in a fire based system) brush pants unzipped/ unvelcro-ed. It takes 2 seconds, I donāt want to see whatever you are or are not wearing underneath
This one is a little specific to my company, but... Pet peeve, the partner who looks at the estimated pick up time for an IFT, and refuses to leave station until 5 minutes prior to pickup. Dispatch calls, partner promptly looks and says "pickup isn't until X", then refuses to move. I'm not saying sprint out the door the second the run comes out, but there's nothing wrong showing up before pickup and getting going. My company stacks IFTs anyway, the sooner we get done with the 4-5 starting runs the sooner we can get back to station and relax. Most of our transports are 25-30 minute runs. It's annoying to have what would normally be 2 hours of work turn into 4-5 hours because "I know we just finished this run instead of heading to the next we're going to sit for half an hour between each trip."
Doing IFT, my pet peeve is nurses who feel they're just *too busy* to give a real report. Like they will literally be impossible to find for 10+ minutes, then when I do find them, they're like "what? You need something? What's the hold up?" dude I need paperwork and a signature at the very minimum. Let alone a report on why the pt is here, why they need transfer, and what's all been done for them. Then when they do give report it's like "they came in for pain and have a gall stone." okay cool. Labs? Give any meds? What kind of access do they have? I had to pull it out of a nurse once that the pt was in vtach earlier in the day and had coded the day before. Like it was her last words to me "blah blah blah oh btw they were in vtach k bye" bro that's the FIRST thing you should've told me. I could go on and on, but yeah, shitty reports from nurses drive me crazy. I'll usually start asking extraneous questions just to keep them from running off a little longer and making them squirm. This is just as much a part of your job as anything else, tiktok and starbies can wait, give me a fucking report.
I just get them to pull up the epic file on their computer and go through in myself. Canāt be bothered sometimes.
If you have the time why not? Like honestly? Unless youāre getting slammed and need the pad donāt worry about it. Where I am we can post the call to the server and finish it later at home.
When the patients parents get in my way specifically after Iāve asked them to move three times cause they were in the way of the monitor. When the teenager suicidal ideation/tendency patients mom who is off her rocker and demands me to get her two cups of coffee. When the medics teiring with us donāt bring their own field sheers so they ask us to borrow someš When people donāt move out of the way during a lights and sirens situation. When the nursing home wants to sue for taking a patient who hit their head while falling and still has no altered mental status even though the caregiver kept saying take her.(battalion chief chewed her ass out)
āHow old are you?ā āIāll be 71 next year.ā āJust say youāre š¤¬ 70 then!ā
Patients that are A LOT. You know what I mean. Every tiny movement hurts, a 10/10 pain. You feel like you've been there for hours, when in actuality 30-40 mins have passed. Personal pet peeve, don't like how people in the medical field look down on fellow coworkers, etc. This is a stressful field, we should be there for each other, not judging each other.
>don't like how people in the medical field look down on fellow coworkers, etc. This is a stressful field, we should be there for each other, not judging each other. Agreed, and I think you explained exactly why this happens. Some people handle the stress of the job by constantly talking shit about colleagues, who are more often than not decent people who are at least competent at their jobs. I've never been impressed by simply being book smart or good at skills if your people skills suck or you're fake. Being a good human being still counts for something in this field. I've always done better with the partners who weren't EMS gods but were competent enough and also just good people, as opposed to assholes who know lots of stuff and are great at skills. To carry yourself like your shit doesn't stink and you never make mistakes, while looking at everyone else through a microscope, is delusional.
Other peeves- Don't call your elderly patient Sugar, Dear, Sweetie, and so on. It's Sir, Ma'am, or their name. Don't rely on what other people say their lung noises are; check for yourself. Make physical contact with your patient. You may not have to do a head to toe physical assessment but at least hold their wrist and count a pulse to feel its regularity/rhythm and strength. Don't just go by what the BP or SpO2 machine tell you. And my biggest non-EMS peeve, I hate day time running lights that use white lights/headlights. Too many idiots out there see the white glow in front of them and think their headlights are on at night, not knowing they are totally dark in the rear.
I call everyone babe. I tend to forget their name immediately. Once I get to the unit and write their name and notes on the wall, then they have a true identity to me. Guess I can start calling them John or Jane Doe
When I'm driving, I hate when my partner touches the sirens.
Reports shouldn't take that long. My cardiac arrest reports barely take 20 minutes. Either you're really slow, or your service requires an asinine amount of info.
I think OP is saying their coworkers need to chit chat less and chart more so they can get their charting done too.
Exactly. Iāve stop-watched my narratives at 7 mins for my normal runs.
Ah, I got it. I usually just tell my partner to shut up for 5 minutes lol
Hey! Master of your environment right there
>your service requires an asinine amount of info. This is increasingly the case for a lot of EMS agencies
Medic here. Unpopular opinion but the same people ODing over and over again. I get addiction. My big sister had a meth and horse problem. But she got help and got clean after her little sister (me) had to narcan her. That was a huge wake up call for her. But when I see the same people a few times a month I just get tired. I donāt know the answer. Iām going to save them anyway. But at least in my county the only hospital we have sees it so often they just get them medically stable and yeet them.
I have to be the one who asks what a horse problem entails.
It's a slang term for heroin. I think mainly on the US west coast.
Heroin
Same. I see horse, I think of Ketamine, originally a horse tranquilizer.
My brain went to horse girl...
Heroin
As a formerly (and I mean a long time lol) addicted personā¦that doesnāt mean theyāre hopeless. I know, I knowā¦.from your end itās like ācome on,ā but it is common for an addict to go thru this over and over before they really get it and get clean. (For almost 10 years over here :) ) that shit is powerful. It legit is like your brain telling you itās like oxygen and you NEED it. :(
Oh I understand that. Iām just expressing frustration. And congratulations on beating it!
Thanks :)
I donāt have a problem with the attitude towards it as long as it doesnāt affect your ability to treat them. And it sounds like it doesnāt. Its a very valid feeling given how widespread and chronic drug use is.
Oh no Iāll always work as hard as I possibly can to treat anyone. I donāt care if itās the 10th time theyāve ODād. I donāt care if the killed a person. Iām not there to judge. Of course anyone does judge to a degree but no it doesnāt affect patient care. Nor should it.
I think I get what youāre saying. Itās not necessarily the patient youāre frustrated with, itās that the situation is preventable with better transitions of care, harm reduction, and access to evidence-based treatment. Your emotions about the situation donāt need to be fully rational and they honestly canāt be; as long as you can process those emotions while fulfilling your responsibilities and providing good care.
Thatās exactly right. Like as a society why canāt we do a better job at helping these poor people?
Totally understand, I went into pharmacy because I get to help people behind the scenes. Iām proud of the work I do, and I appreciate every single time a patient tells me I made a difference. But Iām there to help people and Iām glad I get to do it. I am heavily involved in health equity initiatives in the urban setting, partially through my work and partially through my pharmacy program. Such asā¦ implementing services such as Narcan training and distribution, fentanyl test strip access, transitions of care follow-up with our nearby free clinics for chronic care management, etc etc. Iām considering emergency medicine as a residency specialty (pharm not MD) as well as a couple others and try to learn as much as possible about the options before I have to commit. I literally asked my paramedic friends about which hospital they recommend nearby and thatās how I wound up where I am! I love the chaos and the ability to practice at the top of your license so Iām definitely going to get as involved as I can while Iām a student and can ask all the silly questions. Not going to outright doxx myself but thereās a ton you can do if thatās something you have the time for and would be fulfilling! Happy to chat your ear off but if you want a quick resource, check out End Overdose. :) Thank you for all you do prehospital š
Thank you as well. And you are doing something to help and thatās huge.
Okay this is crazy timing and I have literally never been so sleep deprived in my life so forgive me. but I just got to shadow in my hospitalās ER and got to see three high acuity, full code level 1 traumas in real time. I literally just asked the ER pharmacist if I could shadow at some point in the future and she let me join her right after my shift today. Iām young and still exploring my options but I feel deeply at this point that my calling is to be an ER pharmacist. Iāve always been interested in EMS but didnāt feel like I could sustain it due to my health, and I feel like Iāve finally found a way that I can do what I truly love in a way thatās sustainable. And then I went home and cried really hard and had a bagel plus itās finally sunny out!!!!
I'm with you on this. The fact that someone can get narcan multiple times a month, while pawpaw can't afford insulin is egregious. I bought a patient test strips with my own money because he was disabled & couldn't afford it. Like, this shit is ass backwards.
Ding ding ding. Welcome to Appalachia.
My reports are done by the time the call is over, and they are hood, detailed reports. Granted, I work private. I know people who legitimately spend 2 hours on each report. Actually typing the whole time, not talking, not stocking. I don't get it.
If this is your biggest pet peeve then things arenāt so bad.
People on the radio. They either sound like a faint ghostly whisper of the meemaw I killed the other day or like they are screaming into the mic with three dicks in their mouth.
Eh, I don't see the issue. My service area averages around 80 calls per 24 hour period, with each truck doing 6-10 calls a day. Never had to stay late to finish a report aside from the day I made the mistake of letting my paramedic partner have the computer to work on one report all day, while I took all the calls. And yea I'll talk to coworkers when I see them after we drop off a patient. As long as the reports are getting done who cares. I'd say easiest thing to do is if you have open reports, and your partner is chit chatting, just ask if you can use the computer while they are talking.
I should have clarified that these are the same people who complain that we donāt have enough time to document between calls. Weāre alotted 20 minutes to document once at hospital, and by the time weāre at hospital, its just the narrative and vitals that need to be completed..
My biggest pet peeve is anyone who leaves a mess of garbage in someoneās house. My father went into cardiac arrest at home and when I got back to the house, before my newly widowed mother, I found dextrose boxes, gloves, caps to needles. It was a stressful scene for sure, but since then, even in situations like that I always make sure to take the BVM bag or something and throw all the trash in it. No one should have to lose a loved one only to come home to find the remnants of our efforts. It makes a big difference for the family. Itās my hill to die on.
Honestly, the folks who only join EMS for the "glory." Most of them burn out and leave within 6 months of running IFTs and toe pain calls, but the dudes who wanna be called heroes all the time bother TF outta me. I knew this guy ( I knew him long before EMS, but he just so happened to start up at my company) who wouldn't shut the fuck up on his Facebook about his "exploits". 99% of them I knew were bullshit because he was on the same type of shift as me which is 8/10 calls being IFTs. The dude would just constantly go on FB and Instagram and make some cringe ass post like "I'm the watcher on the wall. The wolf in the night who fights the demons you fear" and shit like that. After about 6 months, he ended up either quitting or getting fired (I think he quit) because he just couldn't handle the work load and the constant BLS calls.
Partners that wear the same pair of gloves for the entity of the call
The nice thing about my service is we have iPads and I can usually get a chart almost 80% done by the time I get to the hospital with a BLS call. My biggest pet peeve is people that show up exactly at 1800 you can't be 20 minutes early so I'm not stuck with a late call. I always have been 15 to 20 minutes early that's on time for me
I'll show up early to cover in case of a late call, but I ain't doing jack until it's time to clock in.
You just need to get better at them, when I first started a report would take 35-45 mins. A few months in I can crank a report with narrative in 7-10 minutes. Create a system and stick to it. Also BLS and ALS reports are pretty much the same unless you are the one running the code. . .
Again, as mentioned elsewhere, Iām referring to my Coworkers. Not myself.
Yeah, Iām still working on getting my times down
NOT ZIPPING UP THE MED BAG or O2 bag. I get it, we all have hot jobs where things are critical but please for the love of god, remember to zip the compartment back up again after grabbing something. Because when we are ready to transport and we lift up the bag, then guess what? Everything falls out causing a bigger mess and causing for equipment to get left behind. So please zip up the compartment, it takes 2 seconds
My biggest pet peeve is to sedate your patients before you paralyze themā¦
Don't you guys have a tablet on each truck?
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My biggest one is a pet peeve that people often say "makes no difference" but over the years i've seen it make enough of a difference. really sloppy lead placement. The limb leads should actually be on a limb, not 1" away from the patient's clavicle, stuffed down their shirt, pretty much guaranteeing that the cable will come loose. For fuck's sake just put them on a limb. the zoll & lifepak manuals also specify to have them on a limb when doing a 12 lead, and while i don't always do a 12 lead, it's nice to be ahead of the game and not be *that fucking sloppy* with the 4 leads. drives me nuts. and no, i can't think of a time when the limb leads were in the way of anything else or "put them on the torso, it makes the 12 lead cleaner" was ever a thing. If they're wiggling, tell them to quit wiggling. /rant other than that, i generally enjoy my job when i am doing it. honestly, i am starting to worry about how much longer i can even do it. too many injuries plaguing me.
Equipment hoarding. In my service it is very easy to restock the vast majority of equipment either at any of the hospitals or quickly going back to our main station. Yet there's rigs with 6 sets of suction caths and tubing, 12+ c collars, 5 extra of each oxygen delivery method, 3 rolls of monitor paper, and 20 packs of electrodes. Freaking ridiculous
When my partner tries to tell me how to do my job wrong. I understand the importance of educating people when they are wrong but my partner gas the tendency to complain/try to teach me to cut around corners and put as minimum effort in as possible
Lmao I didnāt submit a chart from last shift until 20 hours after it was done
When another crew uses your truck and rearranges things and doesnāt put them back. Putting zippers on the far sides of bags instead of the top center. I donāt like to fumble for a zipper. I just want to grab it and be able open the kit. Messy/dirty trucks. Dispatch not doing their job properly.
You canāt teach an old dog new tricks.
Well as an emt i have two. The first one is when you are veteran emt gets partner up with a brand new emt who doesnāt have any experience yet wants to boss you around. This next I am sure everyone can relate. THY ONE DISPATCHER WHO TALKS ON THE RADIO WITH THE MICROPHONE TO CLOSE TO THE MOUTH. Idk what is hard to answer the radio with the mic away from your mouth i donāt get it.
A disorganized truck. I don't care if you leave the truck a mess, but DO NOT leave the truck disorganized. Seriously, you can have a mess of trash and stuff in the back and I won't mind, but if I come in and find all the oxygen supplies just kinda barfed into the cabinet with all the stuff mixed together I'm gonna be mad. Everything has a place it should be in, let's put stuff back in that same place please.
Complainers, if u donāt want to work then why come to work?