Rules of EMS

[triemal04]

I got sent this recently so I can't take any credit for writing it. And while I have some minor quibbles with some of them, all in all I think it's a pretty decent list.

Observations of and old paramedic

1) When you sew on a new patch, you’re not an expert. It just means that some governing body has authorized you to learn your job.

2) Never, ever, ever fight with someone for the opportunity to help them feel better.

3) We don’t save lives, we postpone death.

4) Documentation serves 3 purposes: it informs the ER what you saw and what you did about it, it gives the business office the opportunity to keep your pay check from bouncing, it prevents you from looking like a fool should you be called to testify.

5) Eat when you can, pee when you can, sleep when you can.

6) The most important skill a medic can learn is when to do nothing.

7) Never mistake continuing education for expanding your knowledge base.

8) Even the most routine transfer is a learning opportunity.

9) Your protocol was written for the dumbest guy you work with.

10) Documentation is an art. Writing too much gives the plaintiff’s attorney a bigger target, writing too little makes you look look incompetent or lazy. Lots of words is a waste of time and ink. Writing things that are already mentioned elsewhere on your PCR doesn’t improve your documentation.

11) To quote Lt Col Henry Blake, “Rule number one is that young men die. Rule number two is that doctors [paramedics] can’t change rule #1.”

12) You’re the guy who has the opportunity to make someone’s worst day better.

13) “The patient isn’t the problem, the patient HAS a problem.” Norma Henry, RN

14) Quit thinking that you’re better than the RN. You aren’t. You do a different job.

15) Read. I’ll say it again, Read. Seek knowledge,

16) Never trust a single vital signs measurement. It means nothing, especially if it was measured by a machine. Trends matter, snapshots don’t.

17) Patients don’t tell the truth.

18) You can discover many things that the patient can’t tell you by looking at their meds.

19) Bad outcomes don’t indicate bad care if you’ve done your job right.

20) That annoying rookie used to be you.

21) Stupid is ubiquitous. Get used to it,

22) Recertifying as a basic should require an explanation and a waiver.

23) You’re not in charge if it isn’t about patient care. Your partner is your equal.

24) It is rarely the worst case scenario.

25) It really can be the worst case scenario.

26) Never ignore that knot in your gut.

27) Hyperventilation syndrome and panic attack are true medical emergencies in the patient’s perspective.

28)

29) Look at the patient, not the machine. Bad roads can make healthy people look very sick.

30) Be aggressive when you have to, but understand that caution and re-assessment often leaves fewer dead bodies.

31) Smooth and controlled is always better than fast.

32) If you say, “Because I can,” or, “It isn’t gonna hurt,” expect me to punch you right in the mouth.

33) EMT’s don’t save paramedics.

34) If they don’t walk through their own front door, it isn’t a save.

35) “I’ve seen it all” should only be said at a retirement ceremony and even then should be taken with a grain of salt.

36) A college degree is a measure of persistence, not intelligence. That being said, education has value.

From Steve Pike

[paramedicmike]

Agreed. Minor disagreements with some of the points. Overall, however, it's pretty well done.

[Just Plain Ruff]

Yeah on number 32, had a lab tech one day tell my son "this won't hurt at all" and she proceeded to dig for gold in his AC space for a vein. Even after I told her that she would be hard pressed to find a vein there. She refused to listen to me and told me that there were no other lab techs available when I said that if she wasn't going to listen to me, then we wanted a different lab tech. . After my son nearly came off the bed the 2nd time while she was digging I told her to take the needle out, give me the needle and vacutainers (I worked in the hospital in the ER where he was being seen) and I proceeded to draw my own son's blood, much to her chagrin(blades in my back attitude) and with her on the phone to her supervisor. I got him with one stick. I was really surprised that they didnt just for spite come back and say my sample was hemolyzed but they didnt. So not only did she lie about it hurting, she had a horrible technique as well and refused to listen to a caregiver/co-worker who told her she would have a very hard time finding a vein in his arm.

After I cooled down, my son had stopped crying, I was able to calmly tell the lab supervisor that she refused to listen to me when i told her where to stick him and she refused to call anyone else down. Needless to say that particular lab tech and I never had a good relationship from there on out for nearly 2 years. She was a really shitty lab tech.

When I brought my daughter in to be drawn, she came in to stick her and I told her find another lab tech which she gladly did.

[paramedicmike]

Point 4: Documentation serves the second and third purposes listed. Report at transfer of care tells the ER what you did. It will eventually be attached to the chart of the patient in question. Usually, though, that's well after the patient has been assessed, treated and either admitted or dispo-ed.

Number 28: Is that like Phase 2 of The Underpants Gnomes profit scheme?

[Violyn]

Good stuff. although I would add "gal" to number 12.