# Panic Attacks, being an EMT



## T.Simmons (Nov 3, 2009)

Hi guys, I figured what better place to ask the advice than an EMT site. I just finished up my emt-basic class, and will be taking my NREMT exam next week. I only have one issue, I have tried getting on the local ambulance (through the fire dept) I am on as a probationary, want to be a FF as well, but I have panic attacks. I have had them since I was 16 (I'm 22 now). Is there anyone here who has them, and works in the EMS field? I do fine when I am in a situation like this: I am 2 cars behind a motor vehicle accident, I park safely and run up to make sure someone is on the phone with 911, and hold c spine and just try to help the best I can until the authorities arrive. (For some reason I am always coming upon scenes lol). I don't have an attack at all, it doesn't even cross my mind, and I am fine. But if I respond to the station for a call, I get in there and end up going straight to the bathroom because I get nauseated, and someone else gets my seat and off to the call I go. So, when thrown into a stressful situation I am ok, but when I have time to think about it on the way to the station, I lose it. Anyone else here had similar problems? Advice? I obviously can't take Xanax before a call, it just isn't a good idea. BUT, that's the medication that stops panic in its tracks for me. Thanks in advance.


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## John E (Nov 3, 2009)

*If you're relying on Xanax...*

to function, you should get out of EMS now.

Not everyone is suited to work in this field, I would submit that having panic attacks on any sort of regular basis that need to be controlled by drugs should be a disqualifier.

John E


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## daedalus (Nov 3, 2009)

Do not listen to people who say you can't do it. I run 911 calls and have a relatively moderate and sometimes severe panic disorder (it came on after I had major major surgery).

I know your struggles to well, and you will always be fighting anxiety and panic attacks. What you need to do is get off the benzodiazepines and start taking a once a day SSRI for long term control of your anxiety. Talk to your doctor and tell him about your aspiring career and the need to get off the heavy meds.

I use other non-pharm methods of terminating my anxiety attacks taught to me by an amazing therapist. I recommend you see one as well. It takes a while to find a therapist works for you. You will know within 5 minutes when you meet the one that can help you. 

I also use Kava Kava when I am having a bad day at work. Sometimes I use sleepy time tea as well to calm down. 

You can do it. PM me for any specific advice.


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## firecoins (Nov 3, 2009)

try meditation.


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## Meursault (Nov 3, 2009)

John E said:


> to function, you should get out of EMS now.
> 
> Not everyone is suited to work in this field, I would submit that having panic attacks on any sort of regular basis that need to be controlled by drugs should be a disqualifier.
> 
> John E



I'm curious about your reasoning.


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## T.Simmons (Nov 3, 2009)

daedalus said:


> Do not listen to people who say you can't do it. I run 911 calls and have a relatively moderate and sometimes severe panic disorder (it came on after I had major major surgery).
> 
> I know your struggles to well, and you will always be fighting anxiety and panic attacks. What you need to do is get off the benzodiazepines and start taking a once a day SSRI for long term control of your anxiety. Talk to your doctor and tell him about your aspiring career and the need to get off the heavy meds.
> 
> ...



Thanks for your kind words  I have contacted a few therapists in the area today as a matter of fact. I will take you up on the PM in the near future.


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## atropine (Nov 3, 2009)

You can probably get on with some sort of a private company, but if you want a real gig you may not pass the medical with your current condition, which consist of a pysch eval as well.


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## John E (Nov 3, 2009)

*My reasoning...*

is pretty simple, a person who needs drugs like Xanax to function isn't someone that should be dealing with other people's medical emergencies. What happens when the panic attack comes behind the wheel of an ambulance? What ambulance company or fire dept. is going to hire someone who's using Xanax regularly?

Read the original post, would you want someone who has a panic attack from walking into a fire station treating a family member? 

Would you want to be partners with someone who relies on prescription drugs to control their emotional state? 

The original poster claims to want to be a firefighter, would you knowingly put your life into the hands of someone who might be seized with a panic attack while working? Really?

Nothing against the original poster, I'm sure that he or she is a great person but EMS work isn't meant for everyone.

John E


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## Onceamedic (Nov 3, 2009)

I would say that your problem is the same as anyone else with some form of physical or mental issue.  If the problem is controlled, then you are good to go.  Your problem is not controlled at this point.  Do whatever you need to be confident that you will not have an issue on the job and then go for the job.

I got bad knees.  If my knee is not working, I can't work.  I had surgery, do exercises, treat inflammations with NSAIDs, and the knees are good.  It doesn't disqualify me but if I couldn't pull my weight on the team I would have to find something else to do.


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## firetender (Nov 3, 2009)

This is really tricky.

While wanting to be supportive I have to be honest and say it would take me a while, and I don't know how long, before I would be able to muster confidence in you as my partner. The Flesh Mechanic in me would seek your breaking point. Sounds cruel but I'd rather artificially bring something on to see what happens rather than get blindsided on a call.

Daedalus, I'd imagine your attacks are more specific-stimulus related, like you have an Achilles heel for a certain kind of call which allows you to prepare. You've been in the game long enough to understand the compensation game -- and, many of us have to do so with one thing or another. 

I had a major phobia about dropping a patient while walking backwards with the gurney. Naturally, I did that once, as a rookie EMT. I'd do anything to manipulate the situation or my partner to avoid it. No one ever knew.

A major concern is the anticipation factor. As I respond and psychically prepare for a call, I don't want to have to spend my time keeping my partner on an even keel.

My suggestion is find a situation where you can work third man and get used to it, using all the wonderful tools Daedalus offered. Don't waste any time getting in touch with him.


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## imurphy (Nov 3, 2009)

I have to say I agree with firetender. 

There really seems to be, in society, too much of a huggy-feely coddleing attitude. People seems to tell you "You can do anything". In reality, some things are not for you.

If you get anxiety attacks in streeful situations, this is NOT the field for you. Well not the 911 side. Get a job in an IFT only service till you get it straightened out.

Before you really think about going in to this field think how you will react, think not only of the patient but the patient's family and above all your partner. Say you get dispatched to a case of "Infant not breathing" and, if you make it to the scene at all, will you be a help or a hinderance? Will you be able to keep it together or be in a corner hyperventilating while the family, already devestated, look on?

If you think you can handle it, and you're sure you're not just fooling yourself, then go for it. If not, then this is not the career for you.

Sorry if it sounds harsh, but honestly, I think reality really has to be taken into account sometimes.


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## firetender (Nov 3, 2009)

firetender said:


> My suggestion is find a situation where you can work third man and get used to it, using all the wonderful tools Daedalus offered. Don't waste any time getting in touch with him.



Just so it's clear, I meant DO get in touch with Daedalus. It should have been "Don't waste any time WAITING to get in touch with him"

Glad I caught that.


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## daedalus (Nov 3, 2009)

imurphy said:


> I have to say I agree with firetender.
> 
> There really seems to be, in society, too much of a huggy-feely coddleing attitude. People seems to tell you "You can do anything". In reality, some things are not for you.
> 
> ...


While there is some truth in what you are saying you should remember that there is no one type of person that "is for this field". I love working with a diverse group of people, and I really am able to draw on a strength when it comes to calming patients down and talking to people because of what I have been through as a heart patient and an anxiety patient. I know how scary it is to face a potentially serious and/or fatal disease.


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## imurphy (Nov 3, 2009)

daedalus said:


> While there is some truth in what you are saying you should remember that there is no one type of person that "is for this field". I love working with a diverse group of people, and I really am able to draw on a strength when it comes to calming patients down and talking to people because of what I have been through as a heart patient and an anxiety patient. I know how scary it is to face a potentially serious and/or fatal disease.



True, there is not one type of person for this field; it is also true that there are types of people *not* for this field. For example, I don't have the temperament to work with special needs children, whereas my wife does. I recognize that this would not be the field for me. The OP needs to do the same.

I agree with using your experience to calm _patients_ down. I just wouldn't want to work with a _partner _I have to treat / calm down. No point in making every call an MCI with just one EMT on scene.


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## denverfiremedic (Nov 3, 2009)

Its not posible to have panic attacks and be a fire fighter!!! Period


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## daedalus (Nov 3, 2009)

denverfiremedic said:


> Its not posible to have panic attacks and be a fire fighter!!! Period



That is the epitome of ignorance. Welcome to my ignore list.

FYI this is an EMS forum, not a Fire forum.


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## mycrofft (Nov 3, 2009)

*It does shorten your air pak time...oops sorry.*

Just kidding.
Talk to a professional. If you are beig prescribed Xanax or other benzos for any great length of time (maybe it started with a crisis period and went past that?) consider getting more complete, professional help. Also, before you quit them, talk to your doctor frankly about how much you are using and how often. Barbara Gordon qut Valium cold turkey and was hospitalized (and got a bestseller and a movie deal, but that was sheer luck and personal hooks).

Probably if you stay with it or any other exciting or scarey job etc., you will find that your body just "prepares for battle" that way. Famous actors have reported for decades that they always have stage fright, some to the point of vomiting each performance. Like pain, however, being afraid of it makes it much worse and can lead to panic. It's ok to be tense and antsy and feeling a little out of control, you don't need to deaden it, just remember your successes, barf in the bucket, then go get 'em.

Oh, and see your doctor and a counselor.


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## Summit (Nov 4, 2009)

Seek more professional help. It's something you can probably overcome. When you do, EMS will be for you. Until then, it is going to critically interfere with your ability to function professionally.


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## DV_EMT (Nov 4, 2009)

as a person who has had some really bad anxiety as well as insomnia... there are multiple medication out there that you can take. From personal experience, I have taken Lamictal and Ativan for my anxiety. But, the doc also mentioned that taking OTC GABA (gamma-Aminobutyric acid) or Gabapentin. Though some of those are technically also used for seizures, my psychiatrist suggested that I take them to manage the anxiety attacks... and it seemed to work. Just make sure you take to your MD before jumping to one medication or another.

best of luck to ya!


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## Aidey (Nov 4, 2009)

denverfiremedic said:


> **quoted post removed**



Dude, calm down. For starters, there is no need to get so worked up and call people names in a mature discussion. 

Having panic attacks does not necessarily preclude one from working in EMS *OR* Fire. It is possible for people to overcome panic attacks, and also sometimes panic attacks are only triggered by a specific thing. For example, someone who was attacked by a snake as a child may only have panic attacks when near a snake...that is very unlikely to affect someone going into a burning building or treating a patient. 

It may be that working in Fire/EMS isn't the best thing for the OP right now, but that doesn't mean that they can never work as a fire fighter or EMT. Working towards a goal can be a really good way to help people overcome all sorts of issues.


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## denverfiremedic (Nov 4, 2009)

Im not calling the guy who asked the question an idiot just so thats clear. Working on the ambulance I think he would be fine, Fire .. No! I've had good friends that I've worked with have to leave their careers due to mental and physical conditions, you dont think going into a burning building will give you an attach??? yes it will due to the fact every person who has ever done had one.. Further thats really not even the bad part, any decent fire department will have you almost crying "in most cases crying" when you go through RIT , confined space, collapse and search and rescue. Its hard enough with out already having a health condition, thats all Im saying


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## mycrofft (Nov 4, 2009)

*denver, here's a Xanax.*

Easy to pass judgement and flame on people behind a keyboard (as in, I quote, "idiot"). The anonymous Internet makes it so. Just do the Otis Redding thing and "try a little tenderness".
Back on thread, sort of, I hate it when (oops flaming sorry) psychologists and psychiatrists make a "diagnosis" of "panic attacks". That's like a dx of "chest pain". Chest pain is helped by morphine, the heart attack underlying it does not.


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## vquintessence (Nov 4, 2009)

denverfiremedic said:


> Im not calling the guy who asked the question an idiot just so thats clear. Working on the ambulance I think he would be fine, Fire .. No! I've had good friends that I've worked with have to leave their careers due to mental and physical conditions, you dont think going into a burning building will give you an attach??? yes it will due to the fact every person who has ever done had one.. Further thats really not even the bad part, any decent fire department will have you almost crying "in most cases crying" when you go through RIT , confined space, collapse and search and rescue. Its hard enough with out already having a health condition, thats all Im saying



Jesus, and I thought Atropine's repeated jabs at private service were irritating...   At least he's easy to dismiss.

Anyways, by your logic, it's perfectly kosher to deal with situations where you may be responsible for sick and hurt individuals... but it's totally out of the question to be on a fire or rescue scene?

I understand where you're coming from regarding the situations you've described... however... don't pretend that the life of you and your comrades is any more valuable than the life of any other person who "just needs an ambulance".



			
				denverfiremedic said:
			
		

> **quoted post removed**


I'm still chuckling.


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## medichopeful (Nov 4, 2009)

denverfiremedic said:


> **removed quoted post**



You're right.  He's probably not a firefighter.  Instead, unlike you, he actually CARES about working on an ambulance or in the medical field.  And, unlike you, he is mature enough to NOT start calling you names.  Now, I have no problem with firefighters, but just because you are one does NOT mean that you have the right to start insulting people on this site.


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## RESQ_5_1 (Nov 4, 2009)

It appears to me, by reading the thread, that there are at least a few people with some type of anxiety problem functioning well in EMS. I am the complete opposite. I don't get any kind of adrenaline rush when the tones drop. I simply answer the call and do my job. 

To the OP, it seems like there are some who have overcome some type of minor disability to continue to perform in EMS. I would go with the advice of those that have the experience in what you are going thru. The rest I would take with a grain of salt. However, if you don't start to see improvement, I would consider another career field. 

In the meantime, good luck on your endeavours and I hope everything works out. If I had known how much I would love EMS, I would have started 18 years sooner.


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## wolfwyndd (Nov 4, 2009)

You know.  I'm actually going to have to agree with John E and Firetender.  If you can't control your panic attacks without heavy medications, I'm not really sure I'd want you treating ME as a patient, I'm not sure I'd want you as my PARTNER in the back of an ambulance on a stressful call, and I'm not sure I'd want you as my PARTNER going into a burning building to either pull out a victim / patient or for fire suppression.  With just about any of those situations, it's quite possible that I could very soon be either doing the job all by myself, OR at the worst, be taking care of TWO patients.  



> While there is some truth in what you are saying you should remember that there is no one type of person that "is for this field". I love working with a diverse group of people, and I really am able to draw on a strength when it comes to calming patients down and talking to people because of what I have been through as a heart patient and an anxiety patient. I know how scary it is to face a potentially serious and/or fatal disease.


I respectfully disagree.  I also love working with a diverse group of people, HOWEVER, all of the diverse people I work with are (relatively) healthy.  Does these mean we should open the field to those who have MS and are confined to a wheelchair?  I realize that's an extreme example, but this is the point I'm trying to make.  At what point do we, as a profession, draw the line and say, 'NO.  You can't work in this field.'


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## eveningsky339 (Nov 4, 2009)

denverfiremedic said:


> **quoted post removed**



First off, you have no idea what you are talking about.  Secondly, a professional EMS provider doesn't need a fire-monkey to know what to do in a situation.  There are some great FF/EMT's out there, but you aren't one of them.  And, thirdly, your department has been forced into EMS in order to run more calls and be "worth the money."  You are hardly in a position to even be on an EMS forum.


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## Sasha (Nov 4, 2009)

> Would you want to be partners with someone who relies on prescription drugs to control their emotional state?



If it is adequately controlled... why not? Do you ask every partner if they're on medications for depression, or ADD, or bipolar disorder before you work with them? What's the difference between that and panic attacks? Or how about someone like Kaisu, who takes meds to control her pain level? 

If it's adequately controlled, then no, I don't think it should hold you back. However from what you are describing in your OP it is NOT controlled and you should not be in EMS until it is.


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## JPINFV (Nov 4, 2009)

denverfiremedic said:


> Its not posible to have panic attacks and be a fire fighter!!! Period



Yes... because everyone in medicine wants to be a fire fighter, right? Don't worry though, the fire department has no problem with having their members drunk or on crack while on duty. So if you do illegal drugs, stay with the fire department.


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## JPINFV (Nov 4, 2009)

John E said:


> Would you want to be partners with someone who relies on prescription drugs to control their emotional state?



If the provider is under the treatment of a psychiatrist with a diagnosed and properly treated and controlled illness, why not? Should anyone with diabetes not be allowed to work? Heart conditions? Thyroid conditions? Need I go on?


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## Seaglass (Nov 4, 2009)

I think it's silly to say someone can't be a reliable partner just because they depend on something external. I run with a couple diabetics. Lots of my partners are nearsighted. Oh no, what if they forgot their snacks or glasses? With that kind of attitude, we'd be out of EMT's pretty quick. If a problem is under control, then it's not a problem for me. 

That being said, it sounds like you're thinking yourself into attacks. If you haven't already, see if you can find a good cognitive-behavioral therapist who can teach you to stop the thought processes that lead to attacks. The idea of riding as a third person to gradually get used to it isn't bad, either. The goal of good therapy is to try to get you to a point where you don't need therapy anymore. If your current doc is prescribing Xanax as an indefinite management plan, rather than a stopgap to give other techniques time to work, I'd recommend shopping around.


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## bunkie (Nov 4, 2009)

Speaking with a professional to find your trigger would probably help you tremendously. I think it might be the "pressure and/or responsibility" that triggers it for you. When you are on your own you just immediately go into the zone, you only have to answer for you. Not your crew or your associations of where you work. But when you are on duty all those extra stresses come with it. Just my best guess, but hang in there, find your trigger and unplug it. You can do it.


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## bunkie (Nov 4, 2009)

daedalus said:


> While there is some truth in what you are saying you should remember that there is no one type of person that "is for this field". I love working with a diverse group of people, and I really am able to draw on a strength when it comes to calming patients down and talking to people because of what I have been through as a heart patient and an anxiety patient.* I know how scary it is to face a potentially serious and/or fatal disease.*



And that's who I want treating me/my family. Someone who's been on both ends of it and knows exactly what it feels like. I'm glad you have that for your patients.


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## atropine (Nov 4, 2009)

eveningsky339 said:


> First off, you have no idea what you are talking about.  Secondly, a professional EMS provider doesn't need a fire-monkey to know what to do in a situation.  There are some great FF/EMT's out there, but you aren't one of them.  And, thirdly, your department has been forced into EMS in order to run more calls and be "worth the money."  You are hardly in a position to even be on an EMS forum.



First off how do you know he has no idea what he is talking about?, second ems is NOT a profession, I mean a private company would probably hire this guy. My department handles ems well, and yes this guy would not get hired with a fire based ems juritiction, because of his condition, but not to worry any for profit private company would take this guy in a heart beat.


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## mycrofft (Nov 4, 2009)

*I'm at work gotta post fast.*

1. If the applicant can perform the duties as specified in the job description, he/she has to be considered. Find "no psych cases" etc. However, that's what probation is for, sort it out before they get permanent hire.
2. Ahem, being an ex lifeguard/firefighter-rescueman/EMT-A ("Basic" to you)/USAF MedTech and now RN (soon to be RN Emeritus), I resemble those remarks.<_<

I'm so conflicted.

OP, thanks for asking a personal question. Hang tough, see your docs.


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## Aidey (Nov 4, 2009)

denverfiremedic said:


> Im not calling the guy who asked the question an idiot just so thats clear. Working on the ambulance I think he would be fine, Fire .. No! I've had good friends that I've worked with have to leave their careers due to mental and physical conditions, you dont think going into a burning building will give you an attach??? yes it will due to the fact every person who has ever done had one.. Further thats really not even the bad part, any decent fire department will have you almost crying "in most cases crying" when you go through RIT , confined space, collapse and search and rescue. Its hard enough with out already having a health condition, thats all Im saying



Ok, I'm going to explain this as simply as I possibly can. Some people have panic attacks that are _*ONLY*_ triggered by a specific thing. Just because that have a panic attack when facing that thing _*does not*_ mean they will have one in a burning building, or on a fire scene, or during training. 



Sasha said:


> If it is adequately controlled... why not? Do you ask every partner if they're on medications for depression, or ADD, or bipolar disorder before you work with them? What's the difference between that and panic attacks? Or how about someone like Kaisu, who takes meds to control her pain level?



Exactly, before passing judgment on people you may want to stop and think who you may be offending that you work with. A number of the people I work with (or have worked with) see a counselor, or take an anti-depressant, or ADD meds, or are in AA etc. That is just what I know of, I'm sure there are even more people I work/worked with that I didn't know were doing those things. Remember, you never know what a person has been through, or is going through just by looking at them.


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## daedalus (Nov 4, 2009)

Some people here have a poor understanding of panic disorder. Let me copy Aidey's post because it is worth repeating. 



> Ok, I'm going to explain this as simply as I possibly can. Some people have panic attacks that are ONLY triggered by a specific thing. Just because that have a panic attack when facing that thing does not mean they will have one in a burning building, or on a fire scene, or during training.


Aidey is spot on. Tones, burning buildings or mountains (I live in SoCal), driving code 3, working a code blue, etc are all things I can handle with relative calm. They do not trigger panic attacks. I do my job well, and I plan on doing it better in the future (we are always learning). As well, the things that do trigger episodes are things I have worked on with therapy, and also use other methods for long term control. 

Atropine, I consider what I do and will do as a paramedic as a profession. Say what you want, but I have more responsibility and a larger scope just as an intern than you do as a paramedic in LA.


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## Chimpie (Nov 4, 2009)

*Keep the conversation civil and on topic, or the thread will be closed and infractions issued.*


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## atropine (Nov 4, 2009)

daedalus said:


> Some people here have a poor understanding of panic disorder. Let me copy Aidey's post because it is worth repeating.
> 
> Aidey is spot on. Tones, burning buildings or mountains (I live in SoCal), driving code 3, working a code blue, etc are all things I can handle with relative calm. They do not trigger panic attacks. I do my job well, and I plan on doing it better in the future (we are always learning). As well, the things that do trigger episodes are things I have worked on with therapy, and also use other methods for long term control.
> 
> Atropine, I consider what I do and will do as a paramedic as a profession. Say what you want, but I have more responsibility and a larger scope just as an intern than you do as a paramedic in LA.



Yeah , but will you make 140k a year in your internship, or private gig.


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## firetender (Nov 4, 2009)

Here's something else I'll throw into the mix since I did read the comment about actors heaving before going on stage.

That example is specific time and place oriented. The actor, presumably, knows him/herself and there are limits to what happens.

So I'll add this: If you really understand the parameters of your attacks -- triggers, typical duration, physical manifestation (shaking, sweating, etc.), and recovery period then, maybe it would be workable.

The point is, if you really KNOW what happens to you why and when, then that's something that can be worked around.
IF, however, their elements are unpredictable, then, no, I don't think it's good for you or your partner or your patient.

Once again, on the meds, once you've found the med or combo that really does control your responses, and are used to using it, THEN think about ambulance.

And don't discount emergency work in an ER. Figure out what you really love and go for it regardless, but be open that it might not be the form you thought you wanted -- it could work out much better!


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## Aidey (Nov 4, 2009)

Working in the ER could also help you become more used to EMS in a more controlled environment. That could lead to you being more comfortable in the field later on.


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## T.Simmons (Nov 4, 2009)

Thanks to all who gave positive input, the last few pages really helped. Some of the emt-p's that chimed in were spot on, I couldn't quote all of the good replies in the thread, but I appreciate you taking the time to give me advice!


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## bled12345 (Nov 4, 2009)

LOL... this thread is funny.......

*AS IF* everyone working in EMS is completely 100% emotionally and mentally healthy... ahahahahahahahhahaha

Alcoholic, PTSD, burnout, complacency, apethy, high strung coffee swilling chain smoking medics. Like none of you have any of them working in your service


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## bled12345 (Nov 4, 2009)

On a side note, when I first got into EMS I was stressed about not being able to handle certain things. I was also very nervous about seeing certain things, EMS, like anything in life, gets easier and more comfortable the longer you do it.

After a ped code, the next few shifts is ANYONE mentally 100%? does NO ONE's heart sink when they hear the tones go off, thinking ":censored::censored::censored::censored:, please don't be serious, please don't be serious" 

to support previous posters, get off the benzo's, learn coping mechanisms, seek a cognitive behavior therapist ( I hear they are the best for anxiety ) and figure this out. Overcome man, you can do it. 

Peace


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## wolfwyndd (Nov 5, 2009)

bled12345 said:


> *AS IF* everyone working in EMS is completely 100% emotionally and mentally healthy... ahahahahahahahhahaha



**laugh**  That's exactly why I put (RELATIVELY) healthy in parenthesis.


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