Tuesday, 7 February 2012

The Rules of EMS

Follow these rules and you will lengthen your career. Obey the rules and you will survive your career. Accept these rules to avoid frustrations. Understand the rules to understand people.

  1. Sick people don't bitch 
  2. Air goes in and out, blood goes round and round, any variation on this is a bad thing. 
  3. About %70 of the battery patients more than likely deserved it. 
  4. The more equipment you see on a EMTs belt, the newer they are. 
  5. When dealing with patients, supervisors, or the public, if it felt good saying it, it was the wrong thing to say. 
  6. There is no rule 6.
  7. All bleeding stops....eventually. 
  8. All people will eventually die, no matter what you do.  
  9. If a child is quiet, be scared. 
  10. EMS is extended periods of intense boredom, interrupted by occasional moments of sheer terror. 
  11. If someone dies by chemical hazards, electrical shocks or other on-scene dangers it should be the patient, not you. 
  12. There will be problems
  13. The severity of the injury(s) is directly proportional to the difficulty in accessing, as well as the weight, of the patient.
  14. Paramedics save lives;  EMT's save Paramedics.
  15. If the patient looks sick, than the patient is sick.
  16. If the patient is sitting up and talking to you, then the patient is not in VF, no matter what the monitor says.
  17. It is that bad.
  18. Full spinal precautions were custom made for obnoxious drunks. So were NP airways.
  19. If you absolutely must vomit, than it is probably best to turn your head away from the patient.
  20. It is generally bad to use the words "Oh Fuck" on scene, in reference to the patients condition.
  21. Just because someones fully immobilised doesn't mean they can't be violent.
  22. Better them (another crew) then me.
  23. When responding to a call always remember that your ambulance was built by the lowest bidder
  24. Never get into the front of the ambulance with someone that is braver than you are
  25. If its stupid, but it works, then it ain't stupid
  26. Algorithms never survive the first thirty seconds of patient contact
  27. Always honour a threat
  28. Always know when to get the fuck out of dodge
  29. Always know HOW to get the fuck out of dodge
  30. The important things are always simple
  31. The simple things are always hard
  32. It's easier to beg forgiveness than get permission.
  33. You can't please any of the people any of the time.
  34. Don't go into dodge without the Police.
  35. Always answer a newbie's questions. (you once asked them too)
  36. Always trust bad feelings.
  37. The number of drugs a patient has taken is directly proportional to the number of knuckles tattooed.
  38. If you respond to an RTC after midnight and you don't find a drunk, keep looking - you've missed a patient.
  39. Pain never killed anyone.
  40. All fevers eventually fall to room temperature.
  41. A patients weight is directly proportional to the chances the elevator will be non-functioning.
  42. A tourniquet around the neck solves all problems.
  43. If you drop the baby, pick it up.
  44. The dead never get better but on the other hand they never get worse.
  45. O2 is good, blue is bad.
  46. Less than 8, intubate (GCS score).
  47. Asystole is a very stable rhythm
  48. A patients weight is in direct proportion to their altitude in the building.
  49. A patients weight is directly related to the number of stair flights between him / her and the truck.
  50. EMS rule of threes:  300 pounds <30 minutes to shift change 3 stories up in the building.
  51. Rules: 1) Don't get dirty  2) Don't run, you may violate rule 1 3) If it looks like you might get dirty let the new guy do it.
  52. For every ALS skill we learn, we forget a BLS one.
  53. Universal Precautions - Is it wet? Is it yours? If it is, and it isn't then leave it alone.
  54. Death is a stabilisation of the patients condition.
  55. Every Emergency has three phases - Panic, Fear and Remorse 
  56. Training is learning the rules, experience is learning the exceptions.
  57. If you don't have it, don't give up. Improvise, Adapt & Overcome. (then call for a second crew).
  58. There is no such thing as a "textbook job".
  59. Newbies always look for large things in the smallest compartments and vice-versa.
  60. Newbies have there own way of doing things.
  61. When it comes to needles, 'tis better to give than to receive.
  62. For every 25 calls you attend, only 1 will be exciting.
  63. Take comfort in the fact that most of your patients survive no matter what you do to them.
  64. The old EMS constant; no matter how bad the politics get, the doors go up and the trucks go out.
  65. Most of your patients are healthier than you are.
  66. Being in emergency services means you get to celebrate your holidays with all your friends, while on-duty.
  67. Being an EMT means you get to expose yourself to rare, exotic and exciting new diseases.
  68. You fall, you call, we haul, that's all.
  69. There are two kinds of EMS calls: "Oh-Shit!" and "Bull-Shit!"
  70. Just because you're paranoid doesn't mean your supervisor's not around the corner
  71. You can't cure stupid.
  72. Heaven protects Fools and Drunks.
  73. Murphy was an optimist.
  74. The address is never clearly marked.
  75. EMS doesn't save lives, we only postpone the inevitable.
  76. Managers become that because they won't be missed on the road.
  77. The god "Motorola" desires sacrifices of hot food at least once a shift.
  78. All arrhythmia's eventually straighten themselves out.
  79. Dead is dead, leave it at that.
  80. The size of a patients TV is inversely proportional to that patients social worth.
  81. Your seriously ill patient will miraculously get better when you roll them into A & E.
  82. Don't get excited about blood unless its your own
  83. The pain will go away when it stops hurting.
  84. You should always stop CPR after the second 'ouch' from the patient.
  85. Every nurse is right as long as you are in their A & E.
  86. When in doubt, always take another set of vital signs.
  87. The larger the house the furthest from a door the patient will be.
  88. If the patient fell and was moved by the family, they will have moved them so that climbing stairs will be involved.
  89. The furniture will always be arranged so that a stretcher or carry-chair can't get through.
  90. The Patient will all of a sudden develop a PMH as soon as the nurse asks for one.
  91. The probability of getting a cardiac arrest is directly proportional to how badly you need to go to the toilet.
  92. You've never been as sick as just before you stop breathing.
  93. Dispatchers tell everyone where to go, inversely, everyone would like to tell the dispatcher where to go.
  94. If you ever tell the dispatcher where to go they will give you more places to go.
  95. A patients weight will always be inversely proportional to the size of the vehicle they choose to crash. 
  96. It's not our emergency..........it's our patients! (For newbies who forget to take a chill pill!)
  97. Fellow paramedics always have a better story than yours.
  98. Just when you say, "You know, I have never had a hanging....", you will get one.
  99. The only time you need to fart is when you have your patient loaded in the elevator.
  100. God made Paramedics and EMT's to give him a chance to change his mind.
  101. Your driver will never hit a pot hole or curb unless your patient has a bad fracture.
  102. If there aren't nurses around when you get called to a nursing home go to the last room in the hallway.
  103. When in doubt, pass the buck.
  104. If the patient pukes, it is not unprofessional to puke with them, it is sympathetic puking. 
  105. If the patient only moans when you listen to lung sounds .... They aren't as sick as they want to be.
  106. The most important fluid on an ambulance is Diesel
  107. 999: The government's answer to dial a prayer 
  108. The more pain a patient is in increases the likelihood of a morphine allergy.
  109. On trauma calls - survivability is inversely proportionate to social worth. 
  110. How you know an unconscious is a DOA  1) If it weighs over 300 pounds it's a DOA 2) if it lives more than three flights it's a DOA  3) if its less than 30 minutes left in the shift it's a DOA 
  111. Message to Newbies: People are going to get sick, People are going to get hurt, and People are going to die. This is not a multiple choice job. You must be able to handle all of the above.
  112. There should be no dying or multiplying in the back of a truck. 
  113. If you ever go to a call and find the cops laughing on the front lawn...worry!
  114. If you drop the baby-fake a seizure.
  115. Trauma is treated with diesel first.
  116. Believe none of what you hear and half of what you see.

This list has been compiled and edited from various different lists I have found as well as a few of my own additions. If you have any others send them in and i'll add them to the list!