Bariatric patient. We’re going down the stairs, fireman was on the higher end holding big boy, I was on the lower end. Well, the fireman fumbled, and today became Christmas, because I decked the halls with BALLS. Worst episode of the Nutcracker movie.

All I could do is pick the patient back up, along with my pride, and move on

Hello all,

Prior to obtaining my medic I was an EMT for about 3 years working private EMS and working at a BLS FD with no ambulance. Now 3 months with my medic, I work at an FD with an ambulance. I enjoy the job but I know my biggest weakness currently is confidence and patient assessment. How can I improve my confidence as a medic calling the shots now other than “time on the job”? How can I improve my patient assessment? My main thing with patient assessment feels like as soon as we get a call I don’t necessarily forget everything I was taught but I don’t do anything that feels like it just flows naturally. I want it to feel natural, I wanna be great at patient assessment. Every YouTube video I look up or every time I search patient assessment it’s the same thing, either the NREMT assessment sheets or someone on YouTube going over the NREMT patient assessment sheets or it’s a NREMT psychomotor assessment being recorded. And none of that is helpful, hard to find helpful information on how to be great at that. What has helped you guys? Any book recommendations over confidence or patient assessment you guys recommend?

Thanks guys and TYFYS

Has anyone been able to convince there administrator to let them conduct a research study? We are a hospital based system. A couple of us are interested in conducting a study but are hitting a wall with management any advice to help?

I’ve been hearing from some medics that some kind of life altering event happens in medic school. I’m about to go through and am now a little worried. Any of you not have anything like that and made it through?

And by hemodynamically stable, I mean not dead. Cocaine abuse with history of SVT, found alert and normotensive, converted after vagal maneuvers, NSS bolus, and of course 6 + 12 mg IV adenosine (no history of accessory conduction).

Oh, and - I forgot to mention this when I posted it to a different subreddit - the patient reported that adenosine administration was (in this case and historically) immensely pleasurable. Unique. I gave her a copy of the conversion strip as a souvenir.

Anyone in here work for Polk County Fire Rescue in Florida? My family has been looking to move to Florida after I complete my paramedic program at the end of the year and they are in the area we want to move to. I’m coming from PA, we have my NREMT-P once I finish class and plan on applying for my Florida paramedic immediately.

I have a very weird situation and need some advice.

In 2022 I got my paramedic license while in the army and got out and did an IFT job for 6 months until I got hired by a fire department that is BLS only.

I’m looking to move cross country to another department that has ALS and would like to know the best way to get up on skills and knowledge.

Currently I’m looking at doing a refresher course as well as PALS and ACLS I’m also looking at working at a private ambulance company in a major city and just being honest with my FTO and telling them I’ll need a lot of work. I’ve kept up as well as I can with the academic side I just kind of need the experience.

I still have my NREMT P as well.

Any advice on how to get back into it is welcome thanks!

Kia Ora, NZ Paramedicine student here. Just curious about how long it can take to get a paramedic intership and job within st john after working as an EMT.
Currently working a different job doing part time distance study and just curious about it.
Also, any NZ Paramedics get jobs outside St John? What’s that like?

Hi all!

I am a nursing student (sorry) at MSU. My peers and I are gathering data regarding the health of those who work in EMS for a nursing school project. If this applies to you, please scan the QR code attached to this post or click the link below! We would love to hear from as many people as possible, so please share this post around! Thank you for your participation! (Answers are anonymous ☺️)

https://docs.google.com/forms/d/e/1FAIpQLSem8_AOueCGuz-noLd6F9XgVjUbXYe-eOU0TVTU4NDQJ1xPcw/viewform?usp=header

EMS/Fire Shift Schedule Survey — 24/48 vs. 48/96 vs. Portland (1-3-2-3)

I'm a paramedic with a municipal EMS agency in Texas, and I'm currently researching alternative shift schedules for our department. I would love input from any provider whether in the states or not.

We operate four 24-hour ambulances and respond to approximately 8,000 calls annually. We're considering transitioning from 24/48 to either 48/96 or the Portland (1-3-2-3) rotation.

I'm looking for input from EMS and fire personnel who currently work or have previously worked any of these schedules.

The survey is anonymous, takes approximately 3–5 minutes, and focuses on fatigue, work-life balance, staffing, overtime, and overall schedule satisfaction.

I would especially appreciate responses from departments with similar call volumes or ambulance-based operations.

Survey link: https://docs.google.com/forms/d/e/1FAIpQLSfM88eDUCcvLBacaqINPiN3RGWwaCaZyYlpnI2SUflPPDsK7A/viewform?usp=publish-editor

Thank you to anyone willing to participate!

Hey all,
I was a Paramedic in the US, and I’m planning on renewing my Paramedic license w the National Registry after it being lapsed for some years. Can anyone tell me the most recent text book(or online text?) they are using so I can study? Also, what are the best study guides for the written exam? I know when I took it, it was Pren Hall. If anyone can help me with whatever info is relevant, I’d really appreciate it!

Hi all!

Just wanted to share a research study our lab is conducting if it is of interest to anyone!

Researchers from the McMaster University Trauma and Recovery Research Unit are conducting a study to understand the experiences of racial and/or ethnic minority medical students, healthcare workers, and public safety personnel in Canada. Our goal is to explore how their racial and/or ethnic identity shapes their professional identity, influences mental health, functioning, moral injury and resilience. 

This study has been reviewed by the Hamilton Integrated Research Ethics Board under Project #18569.  

If you would like to participate in this research study, please follow the following link: https://redcap.link/minorityhealthscreener 

or scan the QR code on the recruitment flyer. If you have any questions or would like further information regarding this study, feel free to email us at [msmhteam@mcmaster.ca](mailto:msmhteam@mcmaster.ca).  

Looking to learn some life saving skills and maybe make it a second career.

Hello, everyone!
To all my medics who have transitioned from 911 EMS to working in an ER or hospital, how has the experience been?
Do you feel satisfied with your new role, or do you sometimes feel like just another body filling a position? Do you feel like you’re utilizing your skills and experience on a daily basis, or does the job sometimes feel more like being a “do boy” than a medic?
The hospital schedule is definitely appealing. Working three 13-hour shifts a week seems like it could offer a much better work-life balance than the traditional 24/48 schedule. However, I’ve heard mixed reviews about making the transition.
I’m looking for honest, unfiltered feedback from those who have actually made the switch. What do you love about it? What do you miss about 911? Do you feel professionally fulfilled, or do you ever regret leaving the field?
I’m not looking for someone to convince me one way or the other. I just want to hear the good, the bad, and the ugly before making a decision.
Thanks in advance for sharing your experiences!

I just started at a fire department and about to go through the apprenticeship process to be cleared as a medic. I have IFT & some 911 experience as an EMT but none as a medic and I’m looking for some tips, methods, or advice on how you all became “comfortable” as a medic and what you did in your starting years to become more competent. Thank you

Hello, hospital based RN here. I work ER and PACU. Both worlds I see RSI frequently. In both roles, I have to pass competency on MH (related to all anesthesia for PACU training, but specially related to succs for RSI in ED). So you guys get the basics/knowledge training of MH? I'm sure you aren't running around with 10+ vials of Dantrolene. But at least early vs late signs and being able to give hospital a pre-warning. Just wondering.

Thanks for all you do- even when you bring us the wacky patients ;)

I've been an EMT for 8 years (by choice, believe it or not), but I will hopefully be starting school in March to get my AEMT. I know most people may suggest just getting my paramedic, but I'm only doing this because I need more money...I have no real interest in advancing. lol!

The thing I'm most concerned about is the pre-entrance exam. From what I understand, its the CASAS GOALS 2 for Math & English. As someone who has always struggled with math, I'm panicking. My training director told us it's "tailored to the type of course you're taking", meaning that for EMS, there wouldn't be any trigonometry or anything crazy...it should just be high school-level math/algebra 1. However, it's hard for me to study and make sure I'm well-prepared when I don't know exactly *what* I'm preparing for. I was never required to take any test like this to get my EMT.

In addition to being awful at math, I was homeschooled from preschool to 12th grade...which resulted in pretty severe gaps in my education. At this point, I don't know what I don't know.

How difficult is this test? I'm just trying to give as good of an effort as I can.

I had a first in my 22 year career last night.

I had to give paralytics to a cardiac arrest.

Elderly male with EMS witnessed bradycardic cardiac arrest during patient move secondary to suspected coronary event and pulmonary edema. Complained of discomfort in chest and nausea all day before EMS contact. Unable to get a good history due to language barrier and family poor historians.

Get him into the truck in idioventricular PEA. Goes into coarse VF - we defibrillate. Go to transition from BVM to a ET tube… and…

Jaw is rigid, both masseters are rock hard. Can’t even get a finger between his teeth

Confirm with the family he has no problems with his TMJ, is not wired shut from a jaw fracture or surgery, has never had any problems opening his mouth.

Can’t even scissor his gums open with a two finger technique. He is locked.

I ended up pushing Rocuronium and was able to intubate a minute and a half after when the muscles went flaccid.

Only other option would’ve been a Crich at that point - mouth was full of frothy bloody sputum and tube had a hundred mils of frothy blood out.

Got ROSC after a second defibrillation after and patient remained transcutaneous pacemaker, dependent for the next two hours until cardiology determined he was not a candidate for inter intervention due to massive metabolic and electrolyte derangement until corrected. Patient had a final arrest before they could.

Just wondering if anyone else has ever encountered this during cardiac arrest? Did I do the right thing here?

Hello all, I'm here looking for advice. I'm currently serving overseas in the Air Force (4N0) and wanted some school recommendations. Looking for an online school that would be a good pick for a bachelors in paramedicine.

Even if you can recommend a school but aren't sure if my TA will cover it I'd still love to hear it. So far I've seen methodist, lindenwood and creighton come up alot but am unaware of any tools to measure how good the schools are; and my counselor here is not very helpful.

I understand this subreddit may only have a small overlap of the people/experience I am looking for, but please assist if you can.

Contains mentions of suicide, mental health issues, and gun violence

Hello everyone, I (24F) have worked as an EMT-B in a semi-urban service with high call volume but a relatively low trauma rate for two years. I'm also about halfway through paramedic school (my state doesn't recognize AEMTs). I still have a lot to learn, but until recently I could tell I was on the right track. I was told that I took critiques well, asked good questions, and it was clear that I cared about my partners and patients.

Then something happened that completely knocked me off my feet.

I won't go into too much detail so I hopefully don't doxx myself, but our patient was experiencing a mental health crisis and was a threat to himself and others. Before we could sedate and restrain him, he attacked police officers, grabbed and fired an officer's gun, and was shot multiple times in the chest by officers. Despite knowing our protocols said to halt rescusitation, we continued rescusitation efforts and called for another crew to assist us with RSI and transport (our service requires two medics for RSI). He was declared dead on arrival at the hospital.

I won't pretend I did the right thing through any of it. To be blunt, my partner and I had never experienced anything like that before and were both scared shitless. We blundered our way through the call and the mistakes I made still keep me up at night. Following the night's events and a subsequent review by the state, my paramedic partner was let go from his position, allegedly for an unrelated driving infraction, but I suspect it had to do with his handling of the scene. I didn't always see eye to eye with him, but I've now lost contact with the one person who understands what I went through that night.

That all happened many months ago, and ever since, I've been sinking into a deeper depression. I don't usually have nightmares I can remember anymore, but still wake up multiple times a night. I bought a handgun because I didn't feel safe in my apartment, but now I almost regret it because any little unexpected noise sends me reaching for it. I've been falling behind in school despite understanding the material. When I do make it to work, my performance is slipping, and I now can't focus on critical calls without panicking. I'm safe and have a plan if things deteriorate, but I've definitely had passing thoughts of ending things. I'd never follow through on it, I could never put my coworkers through anything like what I went through. Some days when I'm at home I just cry and have no idea why.

I've been trying to do what I'm supposed to. I've been going to counselling ever since it happened, and I'm on a waitlist for EMDR. I try to be compliant with the medication they give me, but some days I forget. I just really don't know where to go from here.

I know that I want to stay in this line of work. It's the first thing I've ever done where I genuinely feel like I accomplished something at the end of the day and am excited to go back the next day. I miss feeling like that, and I wish things could go back to the way they were.

If anyone has experienced anything similar or has any suggestions, I'd appreciate anything you have to say. I really don't know exactly what I'm looking for, but I hope getting this off my chest and sharing with people who can understand might make things a little better.

Thank you for your time.

I have looked all over the website, emailed them, and tried to google it and I cannot find them. I have a multitude of them which I need for an upcoming job interview

New payscale is $31 - $40/hr plus shift differentials of $1.50 - $5.50

They are also 911 only

https://www.facebook.com/share/p/1E8HzTFoe8/

https://pm.healthcaresource.com/CS/lawrence/#/job/15155

*job listing has not been updated just yet with the correct scale

Shifts are 10, 12, and 14 hrs

Long time EMT new medic and one thing I have been struggling with is those gray areas around intubation. Had a patient yesterday where this became applicable. Even though I am not RSI signed off my preceptor was and I wanna start thinking about this.

Adult male stroke like symptoms left everything involved absolutely no grip strength or response, left side totally fine. He could have been a poster for stroke symptoms. His speech sucks from the droop and this twitching he's doing so it's hard to gather how with it he is but I put him at like GCS 11. We then come to 2 airway questions. One he's having this facial twitching that kinda looks seizure like (didn't involve his jaw muscles so weren't worried about him bitting his tongue). So the idea of giving like a versed comes up but then we worried about losing what airway we had. Which also kinda leads into two, how close are we to considering a tube. Currently he's maintaining his airway but he was controlling his secretions but at times there were definitely periods where we are getting no verbal responses from him and I started thinking about the airway. I feel comfortable in not tubing him I think that would have been too much, but he was looking like he was heading that direction.

Additionally he's +400lbs and I peak in his mouth and this is not a tube either of us want to do unless we have too. We were a quick transport he maintained in route both of us felt managing as is. Just readjusted him to help with secretions and maintain his airway open. We held versed but on arrival ER did give Ativan then start keppra after CT, when I left it had reduced the twitching but he was definitely still doing it. He also had started to vomit at this point and they were also discussing a tube but were holding off till the contrast CTs were back which I never saw.

So my question in two parts

1) what are your thoughts on the benzos here? With a difficult airway we didn't want to risk thats getting closer to borderline was holding them reasonable? Obviously if the twitching was a seizure and we fixed it thats great, but if we struggle to manage his airway we've just gone from bad to worse. Am I totally off base here?

2) whats your thought process when you have patients you know are going to be difficult tubes. What are the things that push you to taking the airway or holding off. I think we were fine at that point not being aggressive but if we had a long transport time instead of the 8 minute drive...or if he began to vomit or deteriorated rapidly I would have been wishing we'd done it when we had some time. So where's your trigger point and how is it different than say skinny meemaw that coincidentally hasn't eaten in 24 hours.

Hey all, I'm planning to apply to work at a rural station where transport times can exceed 2 hours. I have absolutely no knowledge on how to look after patients for that long, I've never worked outside a city. The area has absolutely no back up available outside of helicopter. Anyone have any good textbook recommendations or other material that could help?