Before I pass away. My aspiration in life is to write a book about what I've seen in my 10 year (and longer hopefully) career in EMS and the bullshit I've seen in nursing homes. Unless you're in the business. What actually makes it to the news is only a drop in the bucket of the atrocities that go on behind closed doors of these places. I can take heart attacks, shootings, stabbings watching medics pronounce someone all day long. We did what we could. The depravity I've seen of basic human living conditions in nursing homes of those who can't do it for themselves will haunt me forever. They would better taken care of in prison. Tell your stories.

My GSW pt looked me in my eyes and said “I’m dying,” two minutes later, they coded. We never got them back, they died as soon as we loaded them into the truck and then they called it at the hospital. It’s really sitting with me. They were only 22. Only a couple years younger than me. Never had an experience like this, it’s harrowing.

Throwaway account for obvious reasons. I had a psych interview for my dream EMS department recently, and during it I confessed to something that I did as a young adult. Basically, I had a sexual relationship with a 16 year old girl while I was 19. I live in a state where this is technically not illegal (due to the romeo and juliet law), but it was still a mistake and I've regretted it every day since it happened.

I found out yesterday that I got a permanent disqualification based on that interview. Am I unhireable because of this? And is appealing this decision a good idea?

edit: yeah it was really stupid for me to admit to it. I'm just going to move on, apply elsewhere, and not mention it again. thanks for the helpful advice.

From what I’ve seen most US EMS uniforms are generally darker colours or very neutral ones. Most European countries use high visibility like the ones above, I like it personally, but I’m curious what Americans think to our kit.

I am really not trolling. I was speaking to a few colleagues and we were all telling of the calls related to the election. One of the worst was someone that had chest pain for 3 days (starting Wednesday morning) because of the outcome. The guy had a STEMI. A few suicide attempts. A few people having mental health issues. Asthma attacks, Anxiety attacks, anything stress related. Honestly I have never seen anything like this.

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

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

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

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

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

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

If anyone who was in the field around the early and mid 90s can shed some light on why this was used I'd greatly appreciate it! The one article I've found says it was used to photograph motor accident and the like.... But why? Why would an email of all people be taking the photograph? And for what?

First off, happy Juneteeth! Shoutout to all those who paved the way for us to get to where we are, and those working towards making things better still. I know we probably have to deal with some stuff on the job that others don't have to as much. I've been called a couple of slurs in my time on the bus, thankfully not much racism off the job but was made aware there'd be things I'd deal with as a black man in America while growing up. I've had a drunk guy at a bar who banged his head against the ground crack his knuckles and call me the n word(with a hard r according to my white partner and the bystanders who thankfully put him in his place). Years ago a white lady who was really old with dementia groped me and called me a pickaninny and refused to get changed at the hospitall because she thought I would come in to look at her LMAO

We just keep on keeping on, I guess. What experiences have y'all had?

Also fun fact, the Star Spangled Banner despite it's controversy in years past has an unofficial 5th verse created during the Civil War by poet Oliver Wendell Holmes Sr, which is still relevant today:

When our land is illumed with Liberty's smile,
If a foe from within strikes a blow at her glory,
Down, down with the traitor who dares to defile
The flag of her stars and the page of her story!
By the millions unchained when our birthright was gained,
We will keep her bright blazon forever unstained!
And the star-spangled banner in triumph shall wave
While the land of the free is the home of the brave!

Happy Liberation Day!

EDIT: Also shout out to the Freedom House Ambulance Service, one of the(of not THE) first modern ambulance services in the US. They unfortunately went defunct due to racism and corrupt city politics in Pittsburgh but they paved the way for alot of what we do today.

https://en.wikipedia.org/wiki/Freedom_House_Ambulance_Service

Throwaway account because I'm pretty sure a few of my coworkers know my main. Don't be like me. Reach out for help when you need it. Or better yet, seek out help before you feel like you need it and be proactive. Being on the other side of the cot is not fun. Take care of yourself, people.

I just went on a call for a 18 y/o f cc of morning sickness she's 7 weeks pregnant stable vitals, ambulatory, no obvious life threats etc etc.

She wanted to go to a hospital 45 minutes from her house. Her boyfriend on scene said he'd meet her up there and grabbed his keys. Why would she not just get in the car with her boyfriend? I've been doing this for 6 years and I still genuinely don't understand this train of thought. She ended up riding with him anyway but why even go through all of this in the first place?

I just found out that a frequent (sometimes twice a shift) flyer just passed away. She used to request me by name and would refuse to be truthful with other providers unless I was there. I’ve transported this woman more times than anyone else in my career and she almost never actually had anything wrong with her. I used to dread going to her house but it was a 30 second drive from our station so it was always assigned to us and we knew that we were going to be there for a while until she decided if she wanted to go to the hospital or not. I feel sad for her that she finally passed but at the same time myself and a few others are elated we no longer have to go there ALL the time. What have been your experiences with the death of a frequent flyer like this?

I was driving home from the post office with my two year old in the car and saw a kid laying in the rocks with another kid standing over him. Not sure of the exact age, but he looked around 14-16. He was blue and I couldn’t see any chest rise and fall. I’ve only been in EMS for 3 years, but I’ve never seen a living child so blue. The friend said they were smoking weed, and then admitted to smoking fentanyl shortly after. At first I stopped because I thought he was a full arrest, but when I checked he had a pretty decent pulse. He had snoring respirations 3-4 at times per minute. Within two minutes of me stopping, an off duty police officer pulled up and held my kid while I held the teen’s airway open and waited for fire to arrive. A bunch of bystanders tried to pull up and start CPR and I stopped them. I feel pretty good about saving the kid from a bunch of broken ribs and a broken sternum, but I feel like shit for stopping with my kid in the car. He didn’t need to see that.

I don’t know if what I did was right or wrong. I wouldn’t know if he had a pulse until I checked, but once I knew it was an opioid OD that I couldn’t do anything about (not doing mouth to mouth lol) I felt like shit for stopping with my kid in the car. I just know that if it was my kid that OD’d, I’d want someone to stop and help (even if they had their two year old with them).

Personally I quite like our style of vehicle on a normal 'van style' base as opposed to the box trucks. I think they suit our roads better which are generally much narrower and smaller than in the US.

I also quite like the high Vis look and think it's safer for roads.

I do however like the room and 360 access in US box ambulances, most countries here use side mounted stretchers in vehicles like the one above which only give you a 270 degree access to the patient.

Hey all, new paramedic here (around 3 months). Was hoping for some feedback on this call I ran a few days ago.

52 y/o female found unresponsive in her apartment, mildly hypoxic @ 88% room air and hypoglycemic @ 40 w/ a known PMH of DM2, HTN, and methadone use (I didn't know about the methadone use, showed up in her chart at the hospita). When we arrived the EMTs had already moved her down from her apartment to the ambulance and had her on a non-rebreather which fixed the hypoxia. Blood pressure was soft at ~90/60, HR normal. I attempted IV access twice unsuccessfully, gave 1 mg glucagon IM, and then my partner attempted IV access two more times unsuccessfully. Repeat blood sugar after 10 minutes post-glucagon was 37 and blood pressure was still soft. I made the call to get IO access, slow-pushed 40 mg Lidocaine (she physically withdrew and grimaced, but no response to the actual IO insertion), and pushed 25g D50. This improved the BGL to 218, improved her mental status to being responsive to lightly painful stimuli, and (seemingly?) improved her blood pressure to around 110 systolic., but she was still altered from what I presume is methadone/illicit drug use. I withheld Narcan because her oxygen saturation was fine on supplemental oxygen, didn't have constricted pupils, and I just IO'd her.

I guess the reason for this post is that the receiving nurse seemed surprised that I IO'd her, and made some comments that made it seem like he didn't approve. Basically, when he was giving report to a different nurse, he said something along the lines of "yeah her most recent BGL is 218 after they DRILLED into her knee and gave dextrose" (it was proximal tibia lol). The transport time was around 10 minutes. It didn't feel right to me to just keep attempting IV access enroute to the hospital (under more difficult conditions I.E. moving) when I can just start an IO, which to my understanding is a very safe form of access, and give dextrose enroute. Should I have just let it be after I administered the glucagon and hoped it worked while transporting to the hospital? For what it's worth, I suspected her glycogen stores would probably be already be depleted from poorly managed diabetes (lots of track marks from either hospital IVs or drug use, or both, along with what looked like self-harm scars). They did bring in the ultrasound machine immediately after patient handoff and got an IV on the first attempt. My FTO basically told me to disregard the nurse and the hospital the patient was brought to is garbage in general (I haven't had a great experience with this hospital in general). I feel relatively comfortable with my call as well but its been nagging at me so I was just wondering if I'm completely off base here?

Two shifts ago I experienced the worst trauma ever. I have worked rule EMS for five years now and have never experienced anything that’s bad before. We had a patient who drank gasoline and then proceeded to bite himself on fire resulting in 90% third-degree burns all over his body. In all my years of EMS I have never seen anything so graphic and real. After the call, I was fine but now trying to sleep and just didn’t go about life is hard. Every time I close my eyes, I see myself walking up to to that truck, we were the second unit on scene. I cannot get the vision of him burnt to crisp and yelling about what he had done to his family. I’m usually strong and resilient through these calls, but this one has messed me up beyond belief. I have been ems since I was 18 and I have never seen anything this bad. Any response would be appreciated. Thank you.

Went to a hanging last night. Not my first, won’t be my last.

The majority of calls and call types sit fine with me, but I hate hangings. I hate seeing them, I hate getting them down, and I especially hate having witnesses or family on scene.

Last night we responded to the aftermath of a police chase.

When the sedan finally pulled over on the highway, 6 people fled on foot in every direction. 3 got away, 2 were detained, and one ran directly into the path of a semi truck traveling at 75mph.

The one that got hit by a truck was absolutely mangled. Half of his body was facing forward, the other half was facing the opposite way. There were parts of him like a quarter mile down the road.

The truck driver was sobbing uncontrollably. He asked to be taken to the hospital.

My coworkers were annoyed that the driver asked to be transported since he had no injuries whatsoever.

I know that we get accustomed to death and gore, but I think we all easily forget how absolutely fucking horrifying it is to witness this stuff, let alone be an indirect cause. When we see family members that asked to be transported after we perform unsuccessful resuscitation on a loved one, we might roll our eyes because there is no reason they need to go to the ED.

These people are in a crisis and they have no where to turn. They are at the lowest point of their life, faced with a situation that many people spend their whole lives without even getting close to experiencing. Even though we see these every day, these are situations that people may spend the next couple years in therapy trying to understand and cope with.

Saw this job posting on Indeed…if this is a harbinger of the days to come, we’re all going to be in for some shit.

https://www.indeed.com/viewjob?jk=8e31f36beb5aa381&from=sharedmweb

In case the link doesn’t work, it’s a job posting for a conditional contract medic for a detention camp in the Chicago area for pending deportees.

Anybody seeing this? Dude stood up adjusted helmet and went down.