# The Rules of EMS



## ffemt8978 (Jun 16, 2004)

1.  Skin sign tells all.
2.  Truly sick people don't complain.
3.  Air goes in and out, blood goes round and round; any variation on this is a bad thing.
4.  The more equipment you see on an EMT's belt, the newer they are.
5.  If you drop the baby, pick it up.
6.  When dealing with patients/supervisors/citizens, if it felt good saying it, it was the wrong thing to say.
7.  All bleeding stops...eventually.
8.  All people will eventually die, no matter what you do.
9.  If the child is quiet, be scared.
10. Always follow the rules, but be wise enough to forget them sometimes.
11. If someone dies by chemical hazards/electrical shock/other on-scene danger, it should be the patient, not you.
12. There will be problems.
13. You can't cure stupid.
14. Somethings only a good autopsy will cure.
15. If it's wet and sticky, and not yours, LEAVE IT ALONE!
16. Heaven protects fools and drunks.
17. The severity of the injury is directly proportional to the difficulty in accessing, as well as the weight, of the patient.
18. Paramedics save lives, but it's EMT skills that save Paramedics.
19. If a patient vomits, be sure to aim it at the bystanders that wouldn't back up.
20. If you don't have it, don't give up.  Improvise, Adapt, Overcome, then call for a 2nd unit.
21. If there are no drunks at an MVA after midnight, keep looking, someone is missing.
22. If it's stupid but it works, then it ain't stupid.
23. The important things are alway simple, and the simple things are always hard.
24. When it comes to needles, 'tis better to give than to receive.
25. Most of your patients are healthier than you.
26. The address is never clearly marked.
27. Asystole is a very stable rhythm.


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## ffemt8978 (Jun 17, 2004)

1.  If the patient looks sick, then the patient is sick
2.  If the patient is sitting up and talking to you, then they are not in V-Fib, no matter what the monitor says.
3.  Patients that crash in seperate vehicles should be transported in seperate vehicles.
4.  Just because someone is fully immobilized doesn't mean they can't be violent
5.  Always know when to get out of Dodge
6.  Always know how to get out of Dodge
7.  Don't go into Dodge without the Marshall
8.  Always answer a newbie's question (you asked them once, too)
9.  Always honor a threat
10. When responding to a call, remember your ambulance was built by the lowest bidder.
11. Pain never killed anyone
12. All fevers eventually fall to room temperature
13. Training is learning the rules, experience is learning the exceptions
14. The god "Motorola" desires sacrifices of hot food at least once a shift
15. The stereo must always be louder than the siren
16. The lights flash and the siren yells, but nothing to get rid of this putrid smell
17. Always assume that any physician on scene is a Gynecologist, until proven otherwise, except during a OB/GYN call...then they're a Podiatrist.


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## ffemt8978 (Jun 22, 2004)

1.  There is no such thing as a "textbook" case
2.  Just because someone's license date is before yours doesn't mean they know what they're doing
3.  Turrent mounted machine guns would work better than lights or sirens.
4.  Sometimes it's easier to beg forgiveness than get permission
5.  They said, "Smile, things could be worse."  So we smiled, and sure enough, things got worse.
6.  EMT's are taught the man with the gun is the man in charge (law enforcement).  WRONG!  When the fire department is on scene, the man with the nozzle is the man in charge.  That charged hose will send you farther down the street and hurt more before the cop even begins to think about shooting you.
7.  PVC's can be eliminated by sending a strip to the hospital.
8.  Simple ETOH test: Hold your hands about 6 inches apart with the thumb and index fingers touching.  Then ask the patient what color is the string you are holding.  If they indicate a color, it is a positive test.
9.  Rocket scientists that get into stupid car crashes are the first ones to complain how bumpy the ambulance ride is.
10. No matter how bad the politics get, the doors go up and the trucks go out.
11. If the patient has been moved by the family, they will have moved them so that climbing stairs will be involved.


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## ffemt8978 (Jun 22, 2004)

The First Law of EMS:

All emergency calls will wait until you begin to eat, without regard to the time.

Corollary 1: Fewer accidents would occur if EMS personnel would never eat.
Corollary 2: Always order food to go.


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## ffemt8978 (Jun 22, 2004)

The Law of Gravity:

Any instrument, when dropped, will always come to rest in the least accessible place possible.

The Law of Random Syncronicity:

Emergency calls will randomly come in all at once.

The Gross Injury Law:

Any injury, the sight of which makes you want to puke, should immediately be covered by 4x4's and Kerlix.

The First Law of Ambulance Operations:

No matter how fast you drive the ambulance to a call, it will never be fast enough; until you pass a police cruiser, at which point it will be entirely too fast.  Exception: When you are responding to an "officer down" call, then it is physically impossible to be travelling fast enough!


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## ffemt8978 (Jun 22, 2004)

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 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 1: Any patient who chooses to go to jail instead of the hospital has probably been in my rig in the past.


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## SafetyPro2 (Jun 23, 2004)

Don't forget the *Rule of Threes*:

_3:00 AM_
_300 pound patient_
_3 flights of stairs_


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## ffemt8978 (Jun 23, 2004)

The Rules of Bathrooms

1. If a call is received between 0500 and 0700, the location of the call will always be in a bathroom.
2. If you have just gone to the bathroom, no call will be received.
3. If you have not gone to the bathroom, you will soon regret it.
4. The probability of receiving a run increases proportionally to the time elapsed since last going to the bathroom.

The Law of Space

The amount of space which is needed to work on a patient varies inversely with the amount of space available to work on the patient.

EMS Relativity

The number of distraught and uncooperative relatives surrounding any patient varies exponentially with the seriousness of the patient's illness or injury.

The Theory of Weight

The weight of the patient that you are about to transport increases exponentially by the number of floors which must be ascended and descened 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.


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## ffemt8978 (Jun 24, 2004)

The Rule of Warning Devices (_This one's for you, SafetyPro_)

Any ambulance, whether it is responding to a call or travelling to the 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 cause acute and total, but transient, deafness.
Corollary 2: Ambulance lights cause acute and total, but transient, blindness.

Note: This rule does not apply in California, where all pedestrians and motorists are apparently oblivious to any and all traffic laws.

The Rule of Bystanders

Any bystander who offers you help will give you none.

The Law of EMS Educators

Those who can't do, teach.

The Law of EMS Evaluators

Those who can't do or teach, evaluate.

The Law of Light

As the seriousness of any given injury increases, the availability of light to examine that injury decreases.

The Rule of Pregnancy

All females between the ages of 6 and 106 are pregnant until proven otherwise.


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## ffemt8978 (Jun 27, 2004)

The Law of Time Versus Distance

The distance of the call from the hospital increases as the time to shift change decreases.

Corollary 1: The shortest distance between the station and the scene is under construction.

General Principles Concerning Dispatchers

Given the opprotunity, any dispatcher will be only too happy to tell you where to go, regardless of whether or not s/he actually knows where that might 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" 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 anyway.
Corollary 5: A dispatcher will always refer to a given location in the most obscure manner possible (e.g. Jim's hay field)

The Law 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 the patient.


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## rescuecpt (Jun 28, 2004)

My favorites:

Sick people don't b!t$h

Being an EMT means having extended periods of intense boredom, interrupted by occasional moments of sheer terror.

When responding to a call always remember that your ambulance was built by the lowest bidder.

Being in emergency services means you get to celebrate your holidays with all your friends, while on-duty.

You fall, you call, we haul, that's all.!

You can't cure stupid

If the patient fell and was moved by the family, they will have moved them so that climbing stairs will be involved.


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## ffemt8978 (Jun 30, 2004)

Never bring an ambulance to a gunfight until it's over.

Calls would be more fun it we had music in the background like in the movies.

"We don't deserve to be called heroes; but we don't deserve to be vomited on either."  Steve Berry

and my all time favorite - 

"You're supposed to say CLEAR, damn it!!!"


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## ffemt8978 (Jul 14, 2004)

Trauma is treated with high-flow diesel first.

If you ever find law enforcement out on the front lawn laughing, WORRY.

Upon arrival at a code, check your own pulse first; if it is still there, everything else is easy.

There will be no dying or multiplying in the back of my ambulance.  Death and birth happen on scene or at the hospital.

When in doubt, remember the patient is sick and your ambulance has wheels...USE THEM!

It's not our emergency, it's the patient's.

If you patient is violent, you can always use O2 Therapy (an O2 bottle across the head usually calms them down).

You should always stop CPR after the second, "Ouch!" from your patient.

Supervisors become that because they won't be missed in the field.


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