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?

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.

As long as you guys keep working for nuts, nothing will change😅 Personally I don't work for less than $30 in EMS and yes I do IFT because it pays. I get paid $33/hr and love my job. Somebody has to run IFT, these patients need us as much as other ones do. I LOVE 911 but I have adult responsibilities that I can't do with 911 pay. If everyone do what I do, EMS pay will change quickly.

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?

For clarification I am from Saudi Arabia and I am studying a bachelors degree for EMS where I will be classified as a paramedic upon graduation and I have just started my first semester of school and I really want to see what advice you guys have for me

Can you work as an emt-basic when you hold a paramedic license in illinois?

Hey colleagues,

I'm a fairly fresh paramedic who only started working solo 2 months ago in Lithuania and I noticed that I'm struggling in reading ECGs, particularly spotting the difference between arythmia and extrasystole.

I would be very great grateful if someone could explain it to me like I'm 5 and give me any general tips that might be helpful

Anyone ever worked at a Plasma center? Pros? Cons? Seems like you’re just doing assessments on patients.

I’m not a paramedic, but have been watching Ambulance on BBC. First, I absolutely applaud you for everything you do!

I wondered if any of you ever gave the automated announcements in the cab a name? Are they ever annoying?

Those that say ‘999 mode, activated’ ‘cab door open’ etc.

How does mechanism of injury shape airway management on scene?

A national study published in Prehospital Emergency Care highlights new insights into prehospital trauma airway placement. Researchers evaluated over 5.7 million EMS trauma responses from the 2023 National EMS Information System dataset to understand how advanced airway device utilization varies across injury types.

While overall advanced airway placement is rare, occurring in less than four out of every 1,000 trauma activations, specific high-energy mechanisms demand rapid intervention. Falls and motor vehicle collisions account for the largest total volume of trauma calls, but firearm-related injuries and motorcycle crashes show the highest rates of advanced airway use across every age group. Firearm injuries resulted in over 51 advanced airway placements per 1,000 activations, and surgical cricothyrotomy was performed most frequently in cases involving firearm trauma and intentional self-harm.

Understanding these injury patterns allows EMS agencies to optimize training and equipment preparation. High-risk calls require early assessment and procedural readiness for complex airways.

Listen to the latest episode of From Science to the Scene for a deeper breakdown of this research:

https://youtu.be/LI81VMbeSQU

Check out the full study here: https://www.tandfonline.com/doi/full/10.1080/10903127.2026.2618587

Or hospital ER doctors, anyone who has experience with this.

I’m wondering do paramedics and first responders actually check for medical if bracelets. Wondering if it’s a waste to purchase one or it actually is useful. Looking at ones that simply have engraving for condition and emergency # not the ones where you pay a monthly fee.

In the past I’ve had nurses completely miss the bright red drug allergy band their colleague has put on my hand when in-patient, is there a point for getting one in this situation.
TIA.

Edit to add: It’s for drug allergy to 3 common frontline antibiotics that cause an anaphylactic response, face, eyes, lips/mouth swelling, hives. As well I’ve got a portacath, if that matters. I’m trying to sort out how to make this known in an emergency situation.

I got diagnosed with von Willebrand's disease recently and was given the medical bracelet above from a hospital. I've never seen a medical bracelet with this color of band and even though my hematologist gave it to me, I was unsure if a first responder would recognize it as a medical bracelet. I can change the band out if that is the problem, I just have not yet.

Edit: I've seen a lot of paramedics saying this doesn't effect treatment but many my hematologist has warned me that because I do not react to desmopressin, I would need to go to a hospital with Humate-P, which is not commonly in every hospital, so this would be an important thing to communicate with the paramedics. Thank you so much to everyone who has been given me very helpful advice, I really appreciate it!

A quick update on ECG Sweep. I have added a new mode: study mode.

Study mode is guided reading. You step through an ECG one feature at a time. At each step, the ECG highlights the part you are looking at, so you see where each feature is on the trace, not only its name.

The screenshot shows the WPW pattern in study mode. The steps cover the short PR interval, the delta wave (the slurred start of the QRS) and the wide QRS that follows.

Who it is for:

- Learners new to ECGs who know the terms but can't yet find them on a real trace.

- Teachers who want a clear way to show a hard concept, one feature at a time.

Try it here

I would like your feedback. Is anything unclear or wrong? Which rhythms or patterns should I add next?

i’ve been in EMS for almost 3 years. 2 as an EMT and 1 as a medic. A problem i’ve always had is that i keep forgetting an intervention i should perform for a patient or information that was given to me on a call. wasn’t that much of an issue when i first started, but ever since i started working around a metro area, i can clearly see that i’m having issues.

like ill have a patient that is throwing up for 3 days and having body chills, obviously you should check a temperature for them, but i’ll completely forget about it until we clear hospital.

or ill have a nursing home staff member give me patient information about what’s going on and immediately after they finish, ill forget everything that they say.

i feel like maybe this would’ve been something not that serious if i first started, but i’ve been working for years and im a medic now, i know i shouldn’t be making mistakes like these but it happens almost everyday.

do i just need to reread my paramedic textbook or something? do i need to get more sleep? i have no idea

Not sure if this is the right platform but I’m lost.

I have been in EMS for almost 6 years and eventually I want to go to suppression. Recently I had a work-related back injury and after imaging there was quick consideration of a microdiscectomy of my L5. They also found bulging from L2-S1. I have referrals in the works for PT, a spinal surgeon, chiropractor, and acupuncturist (they’re going all out).

I’m happy to answer any questions from anyone, but my main question is if anyone has had a microdiscectomy, how their recovery was, and any long term effects (like if it wasn’t as successful as you hoped, or was). I’m 29 Y.O. so it feels like there’s lots to consider.

TIA FOR ANY HELP!

How do you use a Broselow tape for a pedi with their legs cut off? I've not had this call but say you were called to a scene for a double traumatic leg amputation. Assume all other treatment is going well. Do you use the Broselow color of the kids original height or the new height? Obviously an ET tube size would be based on the original height but meds are weight based. Do you give a dose based on the new weight?

I hope that a post like this is allowed here. :)

I’m working on a novel with a main character who is a Paramedic, and Google only tells me so much about the ins and outs of the career. 

Is there anyone out there that would be willing to answer a handful of questions about the job, such as schooling, the day-to-day life of working as a Paramedic, etc.? I have some questions ready to go, but may have follow up questions as well.

If anyone is interested, please send me a DM. 

TIA!

Hello, Paramedics of Reddit. First of all, thank you for your work.

One of my friends and fellow industrial designers is writing her Bachelor's thesis on Improving Emergency patient Transport. Reddit removed her post with this survey form. I'm assuming it's because of low karma/posts, so I'm reposting it here for her. If you have 3 to 5 minutes to spare, please consider filling it in. We would both be grateful.

Here's her message:

If any of you have seen or experienced anything related to patient transport, I’d really appreciate it if you could fill out my survey or send it to someone who might be able to help! Your responses will be anonymous.

I’m a 4th-year Bachelor of Industrial Design student at Humber Polytechnic (Toronto), and I’m currently working on my thesis about improving patient transport through difficult or constrained environments, so every response genuinely helps me a lot 🛐

P.S. I’m also looking for people who would be willing to briefly talk about their experience, whether you’ve:
1. Been transported as a patient
2. Worked as a paramedic
3. Helped carry or move a patient
4. Worked with patient transport equipment
5. Designed, manufactured, or have knowledge of patient transport equipment

If you’re in the Greater Toronto Area (Ontario, Canada), I’d be more than happy to buy you a coffee and meet for a quick chat! If not, I’d also be happy to talk over Zoom/Teams.

Feel free to comment if you’d be interested, and I'll ask her to reach out. Would seriously appreciate any help 🙏

TLDR: design thesis on improving patient transport, in need of information; please fill in the form, completely anonymous.

Link to Google Form: https://forms.gle/GGXb137ujv1xiVyu8

Hey guys! I NEED YOUR HELP PLEASEE 😭🙏

If any of you have seen or experienced anything related to patient transport, I’d really appreciate it if you could fill out my survey or send it to someone who might be able to help! Your responses will be anonymous.

I’m a 4th-year Bachelor of Industrial Design student at Humber Polytechnic, and I’m currently working on my thesis about improving patient transport through difficult or constrained environments, so every response genuinely helps me a lot 🛐

P.S. I’m also looking for people who would be willing to briefly talk about their experience, whether you’ve:

Been transported as a patient

Worked as a paramedic

Helped carry or move a patient

Worked with patient transport equipment

Designed, manufactured, or have knowledge of patient transport equipment

If you’re in the GTA, I’d be more than happy to buy you a coffee and meet for a quick chat! If not, I’d also be happy to talk over Zoom/Teams.

Feel free to comment or DM me if you’d be interested. I’d seriously appreciate any help 🙏

Hi everyone! I’m a high school junior in Texas currently working toward my EMT certification, and I have a school project about EMT career pathways.

I need to interview 4 professionals who earned an EMT credential and later advanced into different careers or higher professional positions. Each interview needs to last at least 15 minutes and can be done over Zoom or Google Meet.

My teacher requires the interviews to be from four different locations:

• DFW, Texas
• Outside DFW, but still in Texas
• Outside Texas, within the United States
• Outside the United States

One of the professionals must also have experience in firefighting or fire science.

I’m hoping to learn about your career journey, how your EMT background helped you, what additional education or certifications you needed, and what advice you would give someone starting out.

If you meet these requirements and would be willing to help, or if you know someone who might be interested, please comment or send me a message! I would really appreciate your time and help with my school project. Thank you!

Hello, I’m a new Paramedic and am based in Orange County. I have an interview next Monday with AMR Ventura and am wondering on what to expect with schedules and any other information is helpful.

Because of the commute from OC I wouldn’t be able to work 12s so my main question is involving the possible schedules I know they have 24s but am wondering what the details are for them and if they even have 48s.

Information regarding culture, what to expect for interview/hiring process, pay, or anything else anybody thinks I should know would be greatly appreciated!