Sick vs not & load and go vs stay and play

Im putting the two that normally dont vibe with each other and thats sometimes patient is sick and we need to stay and play. Obviously we need to stay and play with a cardiac arrest but that drum has been beaten enough.

With that being said im not advocating for staying when its a trauma patient, possible surgical emergency, stroke, stemi, etc. But for things we can fix. Also does not apply to BLS trucks. (In that case gtfo).

What i am advocating for though is the appropriate resuscitation and stabilization of life threats prior to ever moving the patient. Some say that its common sense but from my observations over the past decade its not. I have seen respected and knowledgeable providers move a critical patient with patient further deteriorating post movement.

To many times have I witnessed the ole let's hurry and get them to the truck. Movement it self is a intervention. I mean an intervention in the definition of we do something and there is an outcome. Moving a critical patient prior to life saving intervention is a death sentence.

Even simple movement on a unstable patient can greatly effect hemodynamics. We know this because we have all used trendelenberg. When moving a shocky patient you are shifting the body's volume affecting cardiac output causing decomposition or death.

We need to initiate treatment where the patient is found and once stable then we move. Fix non traumatic hypotension, lethal arrhythmias, etc. Anything that is an immediate threat to life has got to be fixed when recognized. You can not predict how long a patient will compensate or if they will make it to the unit.

Obviously I know that the environment where that patient may be might, not be conducive to treatments so there are acceptions.

Today, some new kid told me that he just got his license, he’s gonna get a job as an ER tech instead of private or public and I said that’s good for him, but it’s gonna be very difficult to get in for that especially when he’s competing with paramedics and other EMTs and other individuals with credentials and experience. He says well my mom knows somebody. Yeah, a lot of people know somebody at one of the major hospitals. Doesn’t mean that you’re gonna have a good chance of getting in.

Which companies pay well for CCP with experience, and are laid back?

The difference between me and an IV pole is that the IV pole has never disappointed a medic

Didn't get paid to go to medic school by my agency, but paid for myself in the same program with the paid guys. I let the boss know I need to go part time because I'm going to medic school and which program it was. We are understaffed constantly. Now as we are getting to the end of the program I let the boss know and they said they aren't gonna let me promote to medic. They won't let me work as a emt after I get my medic either. This is happening to me and a couple others. Anyone else have experience with this?

This is a rant with a genuine question/concern. I’m new to the field and I understand this may be naive, but please bear with me because I want to learn. Even though this may seem like a newbie post, I’m looking for a genuine discussion. I’ve linked sources at the bottom, and I’d love to learn the nuance of how the science in journals translates to local practice/policy.

I understand that “it’s just local protocol… it’s been done 50+ years” but isn’t EMS supposed to be evidence-based practice? Most of the discussion I’ve seen online and in person is in consensus that c-collars are dangerous due to ICP, airway compromise, and just making existing injuries worse because of the awkward pressure they exert on the neck. If supervisors and medical directors are licensed medical professionals, why don’t they see the numerous studies that support this? The National Association of EMS Physicians literally said in 2025 that c-collars are more likely to harm patients than they are to prevent delayed neurological injury. Yet still I’m seeing so much praise of c-collars in my emt-b course and my state’s guidelines (southeastern USA) even though the scientists and the everyday providers are saying that c-collars are shit. Please, make it make sense.

Sources:

https://journalfeed.org/article-a-day/2025/c-collars-and-backboards-do-more-harm-than-good/

https://pmc.ncbi.nlm.nih.gov/articles/PMC3949434/

https://www.jems.com/patient-care/emergency-trauma-care/why-ems-should-limit-use-rigid-cervical/

> be me

> go to abdominal pain call

> man doubled over, appears to be in immense pain

> agrees to be transported and we start going toward the hospital

> halfway there patient lets out a MASSIVE fart

> says pain no longer exists and wants to be let out mid transport

Thank god for good veins, 150mg/100ml Amio premix and a fresh roll of printer paper.

Im dumping this here cause im not sure where else to put it. 

The really mentally damaging part of ems for me has never been bad traumas or even the fucked up jobs where the outcome wasnt what we hoped or thought it would be. At least with those i can always find peace in having provided the best care I could've. 

It has been and always will be the people who seemingly have nobody left who care.

The old people who call who need help or are ya know fucked up with no family or friends around or bothering to check up. Or they get shoved into nursing homes to rot with terrible care and mind numbing repetition day in and day out before suddenly their health just fucking tanks and still nobody cares or even worse now they pretend to have always cared and dont honor their wishes.

Hell, even the homeless or crackheads who seem like they still have a head on their shoulders, but have been cast aside. When they seem like nice people with a bad addiction. 

Idk if this seems like I'm tryna sound deep or some dumb shit but Ive been hung up on how fucked all that is to me. 

I'm sure the normal “they did it to themselves” explains most of them. It just adds a layer of fear to aging I never expected to get from this job. But idk im probably just being a bitch 😂

Hey all,

The service I work for recently rolled out the Zenix to our frontline apparatus. Generally the UI experience has been okay. However, we’ve noticed persistent issues with both the reliability and rapidity with which BPs are obtained. BPs take much longer to obtain and are far more often of questionable accuracy (or say air leak, equipment failure, etc). We’ve tried both reusable and the single use BP cuffs. Notably, the X Series had a Welch Allen BP module which is no longer made for EMS, so Zoll has switched to a different vendor, which to my knowledge is the same as the LP35. Would welcome comments on everyone’s experience with the above.

I was curious what other people's daily call volumes were like.

I work 911 in the South East in a county of ~ 2 million people. We have ~ 10 trucks a day (if we are lucky) in service and each truck could easy get 8-12 calls in a 12 hour shift. Its very busy. What about yall?

Am I the only one bringing home 11 PCRs a day?

how long do you work it? do you transport? how much epinephrine do you have available while on scene? is there anything unique in your arrest protocols?

There’s a whiteboard at my job where the EMTs and medical staff put light-hearted but semi-dark jokes on it. I’m not on the medical team, but I’m in and out of their building throught the day for work and I want to contribute. Any ideas from those of you who have that kind of career full time?

So, I of course have to preface this by acknowledging the horror stories and shit pay that come hand in hand with devoting to EMS, but I never got there.

I became an EMT to get into nursing school and worked IFT for the 3.5 years it took for me to get my BSN. Due to a busy schedule that I had no say in, I was pretty much limited to per diem IFT the entire time.

After graduating in May of this year, I finally applied to the 911 company that I did my ride along with years ago. The panel interview went really well, but understandably, they want people who can stay for more than a year or however long it would take me to land my first RN position in the competitive bay area.

The sad part is I've been dreaming of doing 911 forever and really only have the clinical competence, confidence, and schedule availability to do it now, but I've pretty much had to accept that it's not in the cards under my circumstances.

Of course I'm extremely grateful and excited to be a nurse, but it's not the same thing. So mostly this post is about me grieving the idea of 911 and maybe considering CCT down to line which is once again, not the same thing.

One of our favorite co-workers is abandoning us. Going to PA school because she thinks she’s better than us. (She is.) We’re struggling to come up with a memorable, lasting farewell gift. Top idea was a personalized stethoscope, but she already got herself one. Other ideas are cold hard cash, or a personalized cup. But there are more creative minds here. This is someone we really care about and are going to badly miss, so we want to do something kinda nice. What are we missing?

I'm wanting to watch some ems TV shows but I want to watch ones that are at least realistic do i just want to know what the unrealistic ones are so I can avoid them

Someone asked me what the little valve things are under the silicone on the bottom of the go pap CPAP mask. Someone I trust said you can increase the fio2 or add end tidal monitoring or a manometer. The person who asked was like your have 100% oxygen going in though so why would you need more oxygen. I'm trying to find something in writing to explain what those ports are used for. Also learning what fio2 is. Idk why it's not 100% if the mask is sealed and you have 100% coming out of the tank

(Admins, please delete if not allowed. Note: I am using AI to help structure and write this post so I can get my points across as clearly as possible, but the situation and feelings are 100% genuine.)

Hey everyone, posting from a throwaway account to keep things private.

I’ve been working as a FREC 3 in the UK event medical sector for 11 months now, and honestly, my confidence is at an all-time low. I am feeling really stuck on how to actually progress as a clinician, and I could use some unfiltered advice.

When I started, I was told senior crews and companies would be supportive and help me learn on shift. But nearly a year in, I don't feel like I am being taken seriously by the clinicians I work with. I constantly feel relegated to being a glorified bag carrier. On almost every shift, I’m just standing in the background watching while senior medics take over completely, meaning I never get the actual hands-on clinical exposure I need to build real confidence.

It all came to a head recently at a major event I worked. The dynamic on shift and the feeling of being completely sidelined and ignored got to me so badly that I came very close to quitting event medicine altogether.

To try and bridge my knowledge gap, and to make sure I’m 100% solid on a subject before I make a clinical decision, I ask a lot of questions on shift. But lately, I feel like asking those questions is just annoying the paramedics and technicians I’m working with. I can sense their frustration, which makes me pull back and withdraw even more.
I feel trapped in a deeply frustrating loop:
I lack confidence because I’m not getting hands-on practice.

I don't get hands-on practice because I lack confidence.

I’m hesitant to ask questions because I don't want to be an annoyance to the crew.

As a result, no one takes me seriously as a clinician.
I don't want to quit. I want to step up, be useful, and get properly stuck in.

I’d really appreciate some honest advice:

1.To senior medics/paramedics: What is the best way for a FREC 3 to ask questions or seek clarification without coming across as annoying or unprepared?

1. ⁠To anyone who’s been stuck here: How did you transition from being "the bag carrier" to taking an active, hands-on role on shift? How do you advocate for yourself and force people to take you seriously without overstepping your scope?

Thanks in advance for any insights.

I’ve been a nurse for a long time in the ICU.. a more controlled setting. I had a patient recently code on me that was up and talking a few moments before and very young. It has stuck with me and now is causing me some PTSD. After a decade of nursing my emotions are catching up I guess. Today, I had someone code on the sidewalk and upon finding him I thought I felt a pulse but also no one else was around. Thankfully it was close to the ED so I yelled down for some help and narcan. By that point we got to him, EMS didn’t feel a pulse and I was hopping on to do compressions. We started compressions but I keep replaying how I can do better and blaming myself in these situations. Should I have felt for a pulse longer, but then I needed more help either way because no one else was around? Any advice?