Responding to the Call: Adrenaline or Fear?

[CLa]

Hello my EMS friends,

I am hoping to start an honest discussion about the part of EMS that I have noticed is often kept silent or minimized. Please, add your thoughts to this but I ask that you remain respectful to others' posts as we all have varying levels of experience in the field.

So, for the main question.... What happens on the inside when you are summoned to an emergency?

What I want to know is what others are experiencing when they are responding to emergencies. Excitement for the problem solving and high-intensity environment? Irritation at having your sleep interrupted? Joy to be on an "exciting" call? Is there ever an element of fear?

Thanks for your response to this.

 

[CLa]

Personally, I am currently with a paid-on-call fire department. That means I keep a pager with me (a very loud and obnoxious pager, I might add) at all times that I am able to respond. When there is a Delta level response called for at 0200 for a vehicle accident with critical injuries or a patient with chest pain and strong cardiac history it makes my heart race. I recently returned from a leave of absence and have been working to re-sharpen my skills. Before then, I felt pure excitement and adrenaline to go on a call. Now I am feeling rusty, and honestly there is a little bit of fear when I am paged to a higher level emergency. Fear that I won't remember a critical element of my assessment and treatments. Fear that we will arrive to find something we can't handle.

Realizing this drives me to try even harder to become as knowledgeable and skilled as I can, but it is not something that can be done overnight.

 

[NomadicMedic]

Excitement for the problem solving and high-intensity environment? Yes. I still get a zing from a good dispatch.

Irritation at having your sleep interrupted? Yes. Sorry, but I like to sleep.

Joy to be on an "exciting" call? Eh. I don't think joy is the term I'd use. I like being a medic. The rush I get is one thing that keeps me engaged.

Is there ever an element of fear? Not really. Unless the patiet is actively dying in front of me, despite my best efforts, or I'm being shot at.

 

[DesertMedic66]

When I first started it was more fear because I felt like I knew nothing. After the fear went away it turned into excitement for a little while.

Now it's nothing. The tones go off and we respond. No fear and no excitement. I think all those feelings went away around year 3 of doing this full time.

 

[CALEMT]

Pretty much what DEmedic said.

Desert sounds like count dracula in van helsing. He is hollow.

 

[CLa]

Thanks for your input, everyone! I'm hoping that the fear part will fade once I start running more calls and get back into the swing of things.

 

[DesertMedic66]

Pretty much what DEmedic said.

Desert sounds like count dracula in van helsing. He is hollow.

I am hollow inside haha

 

[CALEMT]

I am hollow inside haha

You're a shell of the boy you used to be.

 

[DesertMedic66]

You're a shell of the boy you used to be.

How I react on calls now is "that sounds like a bad call, that's gonna be a lot of paperwork"

 

[STXmedic]

Basically what desert said. It ranges from apathy to irritation when the tones go off (no matter what the dispatch is for). When I get on scene and on the rare occasion actually find a critical or crashing patient, then the excitement comes back. I don't know if fear has ever been a response for me (when I was new, it was always excitement).

ETA: Summit brought up a good point with calls that get providers hurt. There is one specific type of run that fear or apprehension would be an appropriate descriptor for me. Medi-Alerts where we have to force entry make me incredibly nervous ever since forcing entry into a house to find a shotgun pointed at my face.

 

[Summit]

I remember 12 years ago a call where I was so apprehensive about what I'd find, totally green provider, and I had to tell myself "just remember ABCs and you will be fine." I was. That pretty quickly turned into excitement.

Now... it is different.

Fear: "This is the type of call that gets providers hurt."
Irritation: "How long will this one take? Is this even a legit call?"
Excitement: "Let's solve a problem!"

 

[Bullets]

Generally apathy, except on rescue calls, then im going over all the possible evolutions in my head. I want to have at least a plan A and Plan B already in my mind and agreed upon by my partner so we can start cutting or rigging as soon as were on park.

The occasional critical medical call gets me a little excited, but for the most part its just another call

 

[CLa]

It's good to hear everyone's take on this. Summit, I'm still pretty green so I hear ya about the "ABC's" comment. Bullets, excellent point about having a mutual plan A and B with your partner. The calls I run are volunteer rescue so I never know who is going to show up. Some are willing to work with others and some are not. It keeps my on my toes to always be guessing who I will be responding with.

 

[Rialaigh]

Nothing on any calls, no fear, no excitement, occasionally a little irritation. When I first started as a volunteer firefighter it was different but I learned quickly from those older and wiser than I.

I think for those who are starting in this field, or even "old timers" with years of experience, it is good reminder to read up on the effects of a raised heart rate, rapid respirations, added adrenaline, and other effects of "excitement" or "fear" on fine motor skills and critical thinking. Controlling your own physiological response should be a part of every call run. You might be able to lift 50 more pounds when your "psyched up" but even an increase of 20-30 bpm in your heart rate while responding to a call is associated with an extreme decline in your ability to perform precise skills.

I think it is absolutely appropriate to have different responses when we walk into different situations, I know I have to remind myself to actively put effort into my physiology at on shift and on calls. I believe the special forces in the army as well as pilots practice this regularly and work hard to ensure they are in a controlled state all the time to maximize their performance.

 

[johnrsemt]

Even now where we may get one medical/trauma run a month; I don't get excited/nervous with runs anymore, just think it through and discuss with my partner/s during the en route time, which may be an hour or longer in some cases.
Talk about what we may find from dispatch info; and what to do when we get there. And routes to hospitals (which is only 3 ways to get to all of the hospitals)