What You'll Deal With As An EMT Or ER Tech

I’ve had a few strange days in the ER. You never know what to expect especially on the weekends. You can count on a few things. People who plug up the waiting rooms because they have a cough or cold. These are usually your biggest complainers.  These are the folks who will obstruct you with a complaint about how long they have to wait while you take a patient with chest pain to the back.

You can also count on the drug seekers. They come in with complaints of pain and demand medication. They are sweating, scratching, and having obvious DT’s. I had one of these patients walk in to a room where we were treating a patient having a seizure. This guy actually walked in to the room and got in the way so he could demand medication. He left the room in handcuffs.

We had an unexpected gunshot wound come in the front door while being chased by police. The patient had been shot in the back and had an evisceration at the exit wound in front. I felt bad for the children in the waiting room who had to see all of that.

Not long after, all the trauma bays were full of gun shot wounds.  There were several from the same incident and another from an unrelated incident. I saw a chest tube put in for the first time. It was amazing, but there was blood everywhere.

I had an interesting day on the ambulance as well. I’m still learning my way around my new town. I’m also learning to cope with the driving habits of the folks in my new town. We were approaching an intersection while driving emergency. I was in the oncoming traffic lane with a left turn lane to my right. We were making as much noise as we could with the siren, and still almost creamed a guy who tried to make a left turn in front of us.

When I was a rookie, driving emergency was a big thrill. I loved doing it. It has definitely lost its appeal. It’s really just dangerous. People don’t yield, and will use you as a way to run a red light. It’s unbelievable what we’ve become.  It’s hard to stay positive. Maybe I’m working too much.

Veterans Day Thoughts

A quick note is not enough, but I want to take a monment to thank our veterans. Thank you for your sense of duty and sacrifice. Thank you for doing a job so many of us are not willing to do. Thank you for answering the call when our leaders send you in to danger. God bless you and keep you and your families safe. May our leaders be careful and wise when they need you. May we the people choose our leaders wisely and hold them accountable when they call on you.

For those of you serving, and those who served before you, you have our grattitude.

I also want to thank those who served as WACs and WAVs. The contribution of those strong dutiful ladies is so often forgotten. Thank you for your service. You were ahead of your time.

Graveyard Shift

After a few weeks of training on second shift, I'm back to my roots on the graveyard shift. I always have trouble switching from days to nights. After trying everything I could think of, I resorted to taping aluminum foil to the windows to make my East facing bedroom dark.

We had our first real cold snap this weekend. In my experience when it switches from warm to cold, things slow down. That was certainly the case this weekend. Volume was down and there was almost no wait time for the patients. The doctors picked up the pace and got patients in and out.




When I was on the ambulance, I frequently had to take patients to the ER who were not experiencing an emergency. People will call 911 because they have a cold, or the runs. Now that I'm working in the ER, I see how big a problem this is.

I know what some of you are thinking. I know about all the people in the US who don't have insurance or access to a physician. Our hospital has several free clinics, and people do use them, but there is a certain segment of society that uses the ambulance like a taxi and the ER like a pharmacy. They never pay, and they have no intention of paying. This is all part of the free ride they take.

I don't get angry at it, but I have to admit it bothers me. Emergency rooms are for emergencies. If you have a cold, go to the free clinic. That's what it is there for. They're open 17 hours a day. There are four locations. I was working triage the other day and had a patient come in just for a pregnancy test.

All in all I think the patients bill of rights is a good thing. The patients bill of rights makes it so we can not refuse care to someone who asks for it. I want people to get the help they need. But I realize that these occurances are one of the things that drive up the cost of health care.

Let me be clear. If you've been throwing up for days, you might need to come to the ER. If you have a high fever, you might need to come to the ER. If you've been coughing since this morning, you probably don't need to come.

Many drug stores have inexpensive clinics now. If you can't afford that, there are places that will see you for free. I'm not complaining about having to work, I just don't want to have to come to your room so you can ask for a free meal when I need to be putting on a 12 lead on a person who came in with difficulty breathing.

And if folks won't stop coming in, then perhaps they could be polite. We have to see the most serious patients first. Yelling at the greeter because you've been waiting for an hour (thats our average wait time for non emergency, and well above the national average) won't get you back any faster.

More Life in the ER.

I’m still really excited about my job in the ER. I’m excited about going to work tomorrow. My last shift was an echo of the one before. My morning consisted of trauma and chest pain. My busiest moment was when two traumas and a STEMI (ST elevated myocardial infarction… all that to say a really serious heart attack) came in at the same time.

One of my patients was involved in an industrial accident. The patients hand became stuck in a machine and was degloved. Another EMT and myself cleaned her hand and helped to prepare her for surgery.




I’m still struggling to find my place here. I’m trying to be aggressive enough to do my job, but not be in the way. It’s probably not the delicate dance I perceive it to be, but I still feel a little out of place.

I think I need to get a little more of the ambulance out of my brain. I’m used to doing everything I can do in the bus, bringing the patient in to the ER, placing the patient in bed, and getting out of the way. Now I have to learn to undo a lot of what I would have done in the ambulance so the doctor can look at it. I also need to learn how to be in the mix of what’s going on and not be in the way.

I’m also experiencing some culture shock. People here are very friendly here. I’m southern, but I have been in the big city too long. I’m not as friendly and outgoing as I used to take pride in. I’m very politely being put in my place for not introducing myself, and for not saying hello.

I have one more day shift tomorrow, then I switch over to nights. I call it vampire work. Collecting blood in the middle of the night.

I hope you’re all doing well. I hope you and your loved ones are healthy and safe. I was very disturbed and saddened to learn that the meteorologist Matt from Storm Chasers died after a suicide attempt. That’s one of the few TV shows I watch. He seemed like a good person. What a shame. What a waste.

Trauma and Chest Pain

Chest pain and trauma were the themes for my most recent shift in the ER. I worked in urgent care on my most recent shift. I like working in urgent care because it is very hands on. Our urgent care center is where we send our less serious patients after triage. At our hospital, this is where you go if you come in with the flu, or an injury that won’t require stitches or serious pain medication.

When you are the EMT in urgent care you get to wrap a lot of ankles, knees and wrists. The other benefit to working as the tech in urgent care is that you are on the trauma team. You get alerted and participate whenever there is a trauma alert. I worked on three significant trauma cases. Two of those I met on the helicopter pad.




I participated in the decon of a man who had been burned with sulfuric acid. Luckily his burns were from the knees down and his airway wasn’t compromised. I hosed him down for close to 40 minutes while baking soda was used to neutralize the sulfuric acid. This man had my genuine sympathy. He was in so much pain, even after receiving a horse’s dose of morphine and a dose of dilaudid. He has a significant recovery ahead of him.

I helped an orthopedic surgeon set an open ankle fracture. I never had an opportunity in the field to do that. First of all, it was strange to undo the bandaging and splinting I would have done in the field. After sedating the patient, several of us held traction on the leg while the doctor set the ankle. Then we bandaged the open wound and used a fiberglass splint to secure the ankle until the patient went to surgery.

I spent the second half of my day in the chest pain center. Cardiac care is my favorite thing in the world. If trauma was my favorite, I might just stay an EMT. But I truly love cardiac care. That’s the biggest reason I want to get a paramedic license.

Recent Life changes

I’ve experienced a lot of life changes in the last month. That’s why I haven’t posted anything new. I’m married an amazing woman. I moved to a new city, and I’ve been lucky enough to find two new jobs. Like I’ve mentioned before, healthcare is one of the only sectors in the economy that’s growing. Even if you don’t want to be an EMT, you can find a job in healthcare.

Let me say how blessed I feel having a full and a part time job in this economy. I’m so thankful. My full time job is great! It’s something I’ve never done before. I’m working as an ER tech. For all intents and purposes, I’m an EMT in the ER.




This ER is set up in several departments. It is a very well run, well organized ER. It has a chest pain center, a woman’s center, a pediatric ER, a major care center (this is like your standard ER), and an urgent care center (this is where you send people who come in with back pain or the flu). It is also a level one trauma center. On any given day, I might be working in any of these centers in the ER. This job offers me a lot of variety. It also allows me to see a lot more patients in a day than I would working on the ambulance. This job will really help me practice my skills as I prepare to return to school and get my paramedic license.

Good trauma is really a rarity on the ambulance. I’m not saying it never happens. I’m just saying it doesn’t happen every day, or even every week. A lot of people who are considering a job as an EMT or paramedic might have the idea that they are going to see nothing but car wrecks and gunshot wounds. It’s just not true. When you work a 24hr shift you will more than likely go too a couple of MVAs (motor vehicle accidents). More often than not, there are no injuries, or light injuries. Depending on where you work, months might pass without seeing a GSW (gun shot wound) or a stab wound. It’s really not as sexy as it seems.

The majority of your calls will be medical in nature. Chest pain, difficulty breathing, seizure, or diabetes related. You’ll even get calls for back pain, leg pain etc. To be totally truthful, many of the people you see would probably been able to take a taxi to the doctor instead of an ambulance to the ER.

Don’t let that discourage you. I love being an EMT. I love working on the ambulance. You just have to accept the reality of what it really is as opposed to what you think it might be, or what you’ve seen on tv.