Rules of EMS
Quick Reference
The Rules of EMS
[Contributions from people on the misc.emerg-services newsgroup]
- Skin signs tell all
- Sick people don't bitch
- Air goes in and out,blood goes round and round, any variation on
this is a bad thing.
- About 70% of the battery patients more than likely deserved it.
- The more equipment you see on a EMTs belt, the newer they are.
- There is no rule 6.
- When dealing with patients, supervisors, or citizens, if it felt good
saying it, it was the wrong thing to say.
- All bleeding stops....eventually.
- All people will eventually die, no matter what you do.
- If the child is quiet, be scared.
- Always follow the rules but be wise enough to leave them sometimes.
- If the pt. vomits, try to hold the head to the side of the rig with
the least difficult cleanable equipment.
- If someone dies by chem. hazards, electrical shocks or other on-scene
dangers it should be the patient, not you. (also known as rule 1313)
- Any EMT, FF, LEO and/or scene chief who is more drunk than the patient
is the real problem.
- There will be problems.
- You can't cure stupid.
- If it's wet and sticky and not yours, LEAVE IT ALONE!
- If at all possible, avoid any edible item that firefighters
prepare, especially the tuna casserole.
- God protects Fools and Drunks
- You are bound to get a call either during dinner, while you are on the
can, or at 2am in the middle of a great dream.
- Rocket scientists that get into stupid car crashes are the first ones
to complain how bumpy the ambulance ride is.
- The severity of the injury(s) is directly proportional to the
difficulty in accessing, as well as the weight, of the patient.
- Hand grenades and turret mounted machine guns usually work better
than lights and sirens.
- Make sure the rookie EMT knows that a med patch is a radio term, and
not a medicated bandage.
- "Paramedics save lives; EMT's save Paramedics." (to quote a T-shirt
or bumper sticker)
- EMS is extended periods of intense boredom, interupted by occasional
moments of sheer terror.
- Every Emergency has three phases PANIC, FEAR, AND REMORSE.
- If you drop the baby, pick it up.
- Never trust (fill in the blank) to be fully stocked.
- If you don't have it improvise (improvisation is the mother of
invention.)
- Newbies always look for large things in the smallest compartments and
vice versa.
- If the pt is going to vomit, aim them at the person you like least.
- Sick people only call because they couldn't get into their
car. They apologize for bothering you when you have sick people to see.
Be scared when you see these people.
- When a pregnant woman says "The baby is coming", you'd darn well
better believe her.
- When a patient says "I think I am going to die" he is probably
right.
Corollary to rule #9. Scumbags don't die.
Rule #9a. Neither EMTs, paramedics, nor doctors can change Rule #9.
Addition to rule #5. The more patches someone has on their jacket, the
fewer actual patients they have ever seen. If they have instructor
rockers, they have NEVER seen a real patient.
More Laws of EMS
The First Law of EMS
All emergency calls will wait until you begin to eat, regardless
of the time.
Corollary 1
Fewer accidents would occur if EMS personnel would
never eat.
Corollary 2
Always order food "to go".
The Paramedical Laws of Time
- There is absolutely no relationship between the time at which
you are supposed to get off shift and the time at which you will get off
shift.
- Given the following equation: T + 1 Minute = Relief Time,
"T" will always be the time of the last call of your shift.
e.g. if you are supposed to get off shift at 1900, your
last run will come in at 1859.
The Paramedical Law of Gravity
Any instrument, when dropped, will always come to rest in the least
accessible place possible.
The Paramedical Law of Time and Distance
The distance of the call from the Hospital increases as the time
to shift change decreases.
Corollary
The shortest distance between the station
and the scene is under construction.
The Paramedical Law of Simultaneity
Emergency calls will randomly come in all at once.
The Rule of Respiratory Arrest
All patients, for whom Mouth-to-Mouth Resuscitation must be provided,
will
have just completed a large meal of Barbecue and Onions, Garlic Pizza,
and
Pickled Herring, which was washed down with at least three cans of
Beer.
[True! AJH, 20-Mar-03]
The Basic Principle for Dispatchers
Assume that all field personnel are idiots until their actions prove
your assumption.
The Basic Principle for Field Personnel
Assume that all dispatchers are idiots until their actions prove
your assumption.
The Axiom of Late-Night Runs
If you respond to any Motor Vehicle Accident call after midnight
and do not find a drunk on the scene, keep looking: somebody is
still missing.
The Law of Options
Any patient, when given the option of either going to jail or going
to the hospital by a police officer, will always be inside the
Ambulance before you are.
Corollary
Any patient who chooses to go to jail instead of the
hospital probably knows your driver.
The Rules of Equipment
- Any piece of Life-saving Equipment will never malfunction or fail
until:
- You need it to save a life
- The salesman leaves
- Interchangeable parts don't, leak proof seals will, and
self-starters won't.
The First Law of Ambulance Driving
No matter how fast you drive the Ambulance when responding to
a call, it will never be fast enough, unless you pass a Police
Cruiser, at which point it will be entirely too fast.
Paramedical Rules of the Bathroom
- If a call is received between 0500 and 0700, the location
of the call will always be in a bathroom.
- If you have just gone to the bathroom, no call will be received.
- If you have not just gone to the bathroom, you will soon
regret it.
- The probability of receiving a run increases proportionally to
the time elapsed since last going to the bathroom.
Basic Assumption About Dispatchers
Given the opportunity, any Dispatcher will be only too happy to tell
you where to go, regardless of whether or not (s)he actually
knows where that may be.
Corollary 1
The existence or non-existence of any given
location is of only minor importance to a Dispatcher
Corollary 2
Any street designated as a "Cross-street" by
a Dispatcher probably isn't.
Corollary 3
If a street name CAN be mispronounced, a Dispatcher
WILL mispronounce it.
Corollary 4
If a street name CANNOT be mispronounced, a
Dispatcher WILL mispronounce it.
Corollary 5
A Dispatcher will always refer to a given location
in the most obscure manner as possible e.g., "Stumpy Brown's
Cabbage Field" is now covered by a shopping centre.
The First Principle of Triage
In any accident, the degree of injury suffered by a patient is inversely
proportional to the amount and volume of agonized screaming produced
by that patient.
The Gross Injury Rule
Any injury, the sight of which makes you sick, should immediately
be covered by 4x4's and Kerlix.
The Rule of Funding and Donations
All funding and donations are received in amounts which
are inversely proportional to need
The First Law of EMS Supervisors
Given the equation: X - Y = Quality of Care where "X" is the care
that you render and "Y" is the assistance supplied by any Supervisor:
If you can eliminate "Y" from the equation, the Quality of Care
will improve by "X".
Corollary 1
Generally, Field Supervisors have no business in the
field.
Corollary 2
The level of technical competence is inversely
proportional to the level of management.
Corollary 3
Technology is dominated by those who manage what
they do not understand.
The Law of Protocol Directives
The simplest Protocol Directive will be worded in the most obscure
and complicated manner possible. Speeds, for example, will be
expressed as "Furlongs per Fortnight" and flow rates as "Hogsheads
per Hour".
Corollary 1
If you don't understand it, it must be intuitively obvious.
Corollary 2
If you can understand it, you probably don't.
The Law of EMS Educators
Those who can't do, teach.
The Law of EMS Evaluators
Those who can neither do nor teach, evaluate.
The Paramedical Law of Light
As the seriousness of any given injury increases, the availability
of light to examine that injury decreases.
The Paramedical Law of Space
The amount of space which is needed to work on a patient varies inversely
with the amount of space which is available to work on that patient.
The Paramedical Theory of Relativity
The number of distraught and uncooperative relatives surrounding
any given patient varies exponentially with the seriousness of
the patient's illness or injury.
The Paramedical Theory of Weight
The weight of the patient that you are about to transport increases
by the square of the sum of the number of floors which must be ascended
to reach the patient plus the number of floors which must be descended
while carrying the patient.
Corollary 1
Very heavy patients tend to gravitate toward locations
which are furthest from mean sea level.
Corollary 2
If the patient is heavy, the elevator is broken, and
the lights in the stairwell are out.
The Rules of No-Transport
- A Life-or-Death situation will immediately be created by driving
away from the home of patient whom you have just advised to go to the
hospital in a private vehicle.
- The seriousness of this situation will increase as the date of
your trial approaches.
- By the time your ex-patient reaches the witness stand, the jury
will wonder how patient in such terrible condition could have
possibly walked to the door and greeted you with a large suitcase
in each hand.
The Rules of Bystanders
- Any bystander who offers you help will give you none.
- Always assume that any physician found at the scene of
an emergency is a gynecologist, until proven otherwise.
Corollary
NEVER turn your back on a proctologist.
The Rule of Warning Devices
Any ambulance, whether it is responding to a call or traveling to
a hospital, with lights and siren, will be totally ignored by all
motorists, pedestrians, and dogs which may be found in or near
the roads along its route.
Corollary 1
Ambulance Sirens can cause acute and total,
but transient, deafness.
Corollary 2
Ambulance Lights can cause acute and total,
but transient, blindness.
NOTE: This Rule does not apply in Massachusetts, where all
pedestrians and motorists are apparently oblivious to any and
all traffic laws.
The Law of Show-and-Tell
A virtually infinite number of wide-eyed and inquisitive school-aged
children can climb into the back of any Ambulance, and, given the
opportunity, invariably will.
Corollary 1
No emergency run will come in until they are all
inside the ambulance and playing with the equipment.
Corollary 2
It will take at least four times as long to get
them all out as it took to get them in.
Corollary 3
A vital piece of equipment will be missing.
The Rule of Rookies
The true value of any rookie EMT or Driver, when expressed numerically,
will always be a negative number.
The value of this number may be found by simply having the rookie
grade his or her ability on a scale from 1 to 10.
- For rookie EMT's: 1 = Certified Health Hazard, 10 = Member, ACEP.
- For rookie drivers: 1 = Obstruction to Navigation, 10 = Mario Andretti.
The true value of the rookie is then found by simply negating the
rookie's self-assigned value.
Corollary
Treat any rookie EMT or driver assigned to your unit
as you would a bystander. (See The First Rule of Bystanders, above.)
The Rule of Rules
As soon as an EMS Rule is accepted as absolute, an exception to
that Rule will immediately occur.
Murphy's Laws
According to paramedic C. Storey
- The amount of vomit produced always exceeds the size of
the container by at least a factor of 2.
- The Press always think that we are part of the Navy, for
according to them, there is always a fleet of ambulances.
- Patients also lose their legs at the sight of a carry-chair.
- Motor-cyclists only have an injury when there are ten layers of clothing.
- If the technique was known as subcutaneous tissue canulation,
nine times out of ten the canula would go into the vein.
- The "999" telephone is linked directly to the kettle and the
microwave.
- Drunks would far rather be sick into a paramedic box than
a vomit bowl.
- When full gelofusine containers fall off a drip pole
they always land on a fracture.
- The seriousness of an injury is inversely proportional to the
number of escorts wanting to accompany the patient to hospital.
- The only time a KED is ever applied easily and correctly is
during training sessions.