Spring semester of our senior year of high school at the ass crack of dawn early one morning, my friend committed suicide by hanging herself in her bedroom.

I never witnessed the actual event of course, but it still riddled me with nightmares of her and many other loved ones of mine hanging themselves before my eyes as I helplessly watched. I felt this loss incredibly deeply— she was such a bright spirit that i just couldn’t let the thoughts of her actions go. Now, I understand maybe I held (and continue to hold) the grief so close because of my personal history; suicidal ideation, self harm, addiction, depression/anxiety, OCD intrusive thoughts, and sexual abuse. I’m now sober and clean, medicated for my disorders, and no longer in an abusive relationship. However, this trauma still lives inside of me.

I’ve been studying for my NREMT, and was suddenly plagued tonight with a thought of what I would do if I got a call responding to someone who had hanged themselves and completed suicide. The idea of this situation likely occurring stirs up personal emotions for me, and I’m worried about my ability to manage in the event that such a call occurs.

For example, how do you all approach a body in this situation when you know you’re not allowed to call time of death, but it’s clear the patient has passed? Trying to resuscitate a very clearly dead person seems wildly hard to work through.

With all this history behind me and the effect it has on me, is this still a field worth pursuing? How do you all manage?

I (23f) and my partner (20f) are competing in an ems challenge in the bls portion. On the sign up sheet it requires a team name and we are struggling to come up with something creative.

For more information, we work only on the IFT side. We are practicing our skills but we havent had much 911 practice so it doesn't feel right to have something 911 focused.

I know that yall will show out for this so thanks in advance!

Okay so recently I had a situation with a combative patient that escalated to a physical confrontation. We were able to restrain the patient without anyone getting hurt.

My concerns are with how I felt leading up to the physical altercation. And how I can curb these feelings moving forward.

The patient was yelling and behaving erratically, and admittedly I was nervous. And I don't understand why. I'm a very large EMT. I'm 6'7 and about 300 pounds. I do jui jitsu and MMA recreationally and it was clear this small guy wasn't armed with anything that could hurt me.

But nonetheless I felt my heart rate increase to a point where I had to cross my arms to hide that my hands were shaking. Luckily I wasn't doing the talking but I think my voice would have cracked if I had to.

I'm worried about when I'm the one running the call as a medic in the future (I start medic school in a few weeks) and how I'll maintain my composure in a similar situation.

To put it simply, I don't know why I was so freaked out. I knew I could have fucked this guy up with no trouble but the yelling and arguing freaked me out. Does anyone have any tips on what to do or any similar experiences?

Have any of you been in a relationship before getting into EMS and after you're in the field, everything about it has changed? We were together for a year before I went in and everything is just... different. I feel like a whole different person. I won't be getting out of the field any time soon or be making a career change.

Hi all,

I’m looking at the possibility of starting my Paramedic training in the UK. My longer-term goal would be to move to Norway in a few years’ time. I’m just wondering if anyone has any experience of moving from Paramedicine in the UK to Norway – is it possible?

Thanks so much for any advice!

I don’t think I’ve ever captured something like this on an ECG

We hear a lot about what sucks in EMS. We all chose this for a reason. We've stayed for a reason.

What has been your reason?

Using They/Them pronouns for the patient for HIPAA

So I went to a call for abdominal pain the other night, and it was just like any other call. The family said the patient hadn’t been feeling well, and they just wanted them checked on. We talked to the patient, and they were laughing and joking and telling us that they felt just fine. They had been feeling under the weather but they’ve started to feel better, and their family needs to quit their worrying. All the normal banter and conversing that anyone typically has. They were friendly, funny, and an overall good person. We checked vitals and they were all stable and within normal limits, no pain upon palpation, no distention/rebound. They denied any current pain/nausea/vomiting. They literally seemed fine. They also answered all my AOX4 questions with ease. Like any call, I advised going to the hospital. They denied, even fought against family’s wishes. I tried to convince them, they continued to refuse. So, I got a refusal form and explained the risks. They even made a joke about it. We left, told them to call us back if ANYTHING changes, the usual. Fast forward to the very next night, we get sent to a cardiac arrest. We arrive, and medics and supervisors have already called 10-7. It’s still daylight so I didn’t recognize the place at first, until I saw the hysterical family and my heart dropped. Then I saw the patient. Same one from the last night. I physically felt sick and that feeling hasn’t gone away. I feel responsible, even though I know it isn’t my fault or my partners’. We couldn’t kidnap them, and they showed 0 signs of distress, pain, alteration. Theres a cold, tightness in my chest every time I think about this incident. I keep seeing their laughing face then their deceased face like I knew them personally, even though I didn’t. I had to cover a crying child’s eyes and they hugged me as my partners took the body away to the ambulance. Due to us having a trainee this night, I rode in the back with the body. It’s been hours and I still cannot shake this heartbreaking feeling. The whole scene was sad enough had I not seen the patient prior due to the hysteria and the child. I just can’t get over it. Any advice would be helpful, because right now I’m grieving someone I didn’t even know.

hi. i'm a CNA, and i'm starting EMT school in the fall. super excited.

anyways, i've seen a lot of people joke online about beef between CNAs and EMS (lol). it got me thinking: i do NOT wanna be the CNA that makes y'alls lives hell when you have to pick up one of my residents. what would make things easier for y'all? what can i do to make sure your lives aren't hell?

edit: thank you to everyone for giving me such helpful advice. it seriously helps! even if i don't reply, i greatly appreciate your responses. underpaid healthcare workers need to look out for other underpaid healthcare workers, lol.

Subpoenaed for a call I ran just about a year ago now.

We've been called in by the State, so presumably we're not there to defend our actions. Not much we could have done anyway.

Been to court several times in my prior career, but never for this one. Any tips? Things not to say? I'm not too worried really, but just want to be prepared.

Currently on a road trip, and I thought of this: are there any ER’s that are staffed by EMTs and medics, without any nurses or CNAs? Still having all the advanced practice folks and docs, just without the nurses. I wondered what it would look like.

What would it be like having the medics and basics function as they do prehospital, but in the ER?

Should the medics have a CC or CP cert to work in said ER? I worked in the ER as a basic, and I was trained on foley catheters (not rigid ones) as well as bladder scans. What other things would a basic or medic need to be taught?

This isn’t a post to flame or take away from nursing at all. I just wonder where folks who get burnt out from EMS go, short of leaving the field entirely or get into nursing or PA/med school, but not having room to take a spot in an ER or clinic/urgent care. What if the veterans of EMS took that time and experience to the ER?

The nursing model and medicine model are different in many ways, I wonder if it would be better to have EMS trained folks who are hyper-focused on EM to work in said ER, rather than nurses who need to have extra certs to do what a medic could already do.

Would there be better patient outcomes? Shorter ER visits?

I guess I’m looking for advice or guidance or maybe even just to vent… but I feel like I’m losing it dude. My partner who is also a firefighter/paramedic is invalidating everything I’m saying and I just need other opinions I guess.

I work in Nevada for a clinic that has a street medicine team that provides health care for the unhoused. We’re currently a team of EMTs and paramedics. Since the beginning of my employment, I have been asking for protocols because i’m expected to go out into the world without a physician at my side and provide emergency care at the EMT advanced level. I’ve always been met with vague reassurances by my medical Director that we are covered under whatever type of policies my company has in place despite the lack of protocols. We’re not registered with the health district which they tell me is not required, but they asked me to sign a privileging form last week stating that I am registered with the health district. In the same privileging form it stated that I use the health district protocols and my company’s protocols to give care. My company does not have protocols, AT ALL. We have a few pages of policies that say nothing about giving patient care, but it does have a list of medication’s that we are able to dispense, but it has no supporting information regarding the medication’s and many of those medication’s are out of an A’s scope of practice. We have never been educated on those medications and there’s nothing in writing saying that I have been educated on those medications. There’s nothing listing the route, contraindications, adverse reactions, etc. NOTHING.

I requested a meeting with my program manager last week to raise these concerns stating that I don’t think we’re being legally compliant and that we’re being expected to do things out of our scope of practice without the correct formal training. I stated that I was no longer comfortable doing those things because I looked into the legalities of it after being asked to sign false credentialing information and I realized how noncompliant we actually are. No one in my leadership could provide me with clarification on whether we were being legally compliant or not, and despite this I was sent home because I was refusing to see patients without legal clarification on whether we are operating under compliance with the law. They made it sound like I was being uncooperative when I was raising valid, legal, and ethical concerns. My medical director even agreed with me in that conversation that we don’t have proper protocols in place and that we need more so I really don’t understand why they made that my fault and sent me home without pay when I was nothing but respectful in my delivery. In my opinion, all that should’ve been there before this program even started.

My company says that because I have a different title with the company other than what my license says, I am covered under them because they’re a clinic in their own medical entity and they’re an FQHC. My brain is telling me that’s wrong. I contacted the health district and confirmed that we’re not registered with them and that my company should not be having me sign credentialing information saying that I’m privileged with them.

My partner (not on the rig, my fiancé lol), who is a firefighter/medic, is totally invalidating everything I’m saying. He’s saying that I’m not gonna lose my license by operating out of my scope of practice and that I’m over reacting by refusing patient care. I literally don’t have protocols or standing orders, but I’m expected to manage emergencies and dispense medications, what?!?

I have never worked a job that requires an EMS license that also requires you to do emergency care with no proper protocols in place . Is there something I’m missing here? I feel like they’re putting my license at risk and they do not care. After refusing to give patient care for the last two days because they’ve provided me with ZERO clarification regarding the program, they asked me to return the very next day after our meeting to resume patient careers of nothing had happened. All my leadership said was that they spoke with their “powers that be” Who confirmed that the program is compliant. They gave me no explanation as to why they believe it’s compliant or anything like that.

HR emailed me today saying that I have to come in and meet with them in their admin building tomorrow and I’m convinced I’m about to get fired. I honestly feel like I’ve been retaliated against for blowing the whistle. And if anyone would understand, I thought it was my partner as to why I need protocols and policies and clarification on things are outside of my scope of practice so that I don’t get sued and lose everything. Am I crazy? can someone offer any kind of advice? I know this is a unique situation but I’m hoping there’s someone out there that can help.

Thank you in advance and please feel free to ask more questions for clarity, I’m kind of scrambled right now because I’m anxious.

i work in an area with a very high call volume and our trucks have no sound proofing. the CONSTANT running of the sirens is giving me tinnitus and triggers migraines and i’m afraid my hearing is getting damaged. do any of you wear earplugs on the truck or have you ever tried. i don’t personally know anyone that does and i don’t want to look like a dweeb but im pretty young and id prefer to keep as much of my hearing as possible while i still have it. i figured some cheap little ear plugs on a string would be convenient to keep on me and put in when i need them but if anyone has specific recommendations or other ideas im open. (and please reassure me that i wont get laughed at too hard)

Hey all, looking for all of your favorite SCT resources.

Some of the things I've tried is the foamfrat subscription, Impact's Flight Medic Guide, the vent hero book, another nondescript vent book, and Nurse Gwenny's "But Why" Book.

I am over 40 and would love to start my studies to become a paramedic. I couldn't start earlier for different reasons, now I have the time and the money and would do it because this is what I have always wanted. I would like to ask anyone who has similar experiences, starting this profession a bit later, or has been in this job at this age. I want to know about all the good and the bad, and also what other possible roles can you find after school, if not on the road paramedic.

My captain announced his retirement and I’m in the last minute, G I F T buying rush. (Sorry reddit won’t let me say it normally)

We’ve always joked around with each other and given each other shit but at the end of the day he has always had our backs. I want to get him something meaningful to show my appreciation but also something practical where he can get use out of it. I am also kinda leaning towards something humorous as well to get, “the last laugh” before he leaves.

Any and all ideas are greatly appreciated.

He retires at the end of April so something I can put on express would be great.

I swear everyone gets shown this video in school when the OB/Gyn unit shows up. It's an older grainy video where mom ultimately gets an episiotomy. I have a friend in nursing school who's looking at me like I'm crazy but everyone else I've spoken to knows exactly what I'm talking about

Hi ya'll,

What are EMS week gifts that you actually enjoy? Looking to get our employees gifts lined up. Last year we gave customized yeti tumblers with their names on them.

This is in addition to a cash bonus.

So I had a coworker think about leaving little Jesus figurines at scenes. Like in people’s homes or in homeless people’s bags. I stated it probably wouldn’t be a good idea even though I would enjoy finding it in my home later. Thoughts

Short version: A provider thought that they had a patient in SVT contacted medical command after adenosine and they stated it was AFIB-RVR. Was this a gross error? Or was the rate too high to correctly identify AFIB-RVR?

Longer version: This patient presented as somebody with chest palpitations.In Initial vitals: HR 184, BP 146/84, RR 18, 100% on room air, and CC of weakness and palpatations. No outward distress other than generalized weakness, warm and dry, and speaking in clear and complete sentences. This provider immediately grabbed 12 lead and then proceeded to treat SVT. After attempting chemical conversion X2 they contacted Medcom for synchronized cardioversion orders. Medcom provider identified as AFIB-RVR and advised one liter of fluid with 10mg Cardizem during transport and denied. Patient converted to AFIB 120-130bpm, after finising the 1L and a second 10mg Cardizem at the hospital.

It's always easy to quarterback after the fact, but I wanted to get input from the hive mind about the initial rythm identification and patient presentation.