1. That D50 can be given P.O. (by mouth).
2. Never get a refusal on a drunk, especially one that has endured any form of trauma (even minor).
3. That glucose machines are not always accurate.
4. That some drug ODs actually present as hyperventilation, until they quite breathing about 15 minutes later.
5. For every flight of stairs you are climbing, you can add another 100lbs to the patient, same for every foot of space-width that is lost in a mobile home hallway.
6. When patients say "I am dying", they are usually right.
7. Treat the patient, not the monitor, some folks have some ugly rhythms, but it is what they live with everyday.
8. Always check your truck completely, the day you dont will be the day you are missing a piece of equipment, at the worst possible moment. Especially if you work a busy 24, cant tell you how many times I have had to go to the last call location or ER to get equipment that was left by previous shift.
9. Never leave a patient that has called 911 more than once in a day, it is bad to have to explain why a patient called 3 times, was not transported, and died.
10. To combat the medication errors mentioned before, do not put medicine vials that look identical right next to each other in the drug box (albuterol and Atrovent), put medications that are potentially deadly (Heparin, Dopamine,) in its own separate ziplock bag and label with magic marker so you have to be a double dumbass to grab the wrong bag. If you have meds that are almost identical, switch the vendor on one so you get a different color box or size of ampule. Ideally, you should have a dial-a-flow or pump on medications that can be deadly.
11. Not all doctors graduated at the top of there class, and many ER Docs are not ER Specialist, but may be a dermatologists who is working part-time (especially the more rural you get), sometimes you have to step up and be a patient advocate.
Thats a good starting list.