Right on Schedule

[dropcap background=”” color=”#333333″ size=”50px”]It[/dropcap] has been said that there are two rules in EMS; Rule number one, is that some of your patients will die. Rule number two, is that you can’t change rule number one.

Another pronouncement, this time authored by yours truly, is that; “Anything can happen, at any time, to anyone.”

That all sounds a bit morbid though.

On a (slightly) lighter note, I have begun to notice that some types of emergencies occur at particular times of the day. I have listed them below, and would point out that whilst the reason is clear for some, others are a complete mystery.


0100   Late night is the perfect time for a fight to break out between, well, whoever is still up.

0300   Very often Chest Pain (Heart Attack) will wake the patient up in the wee hours of the morning.

0500   This is undoubtedly an auspicious time for pregnant ladies to give birth in their homes.

0700   An unconscious patient at this time of day is normally an “X”, having died in his sleep.

0900   Hectic time of the morning and ripe unfortunately for a MVA – Car vs. Child.

1100   Construction sites are getting into the swing of things & someone is bound to get hurt, badly.

1300   Your average teenager will now faint, having walked in the heat, and not drunk all day.

1500   A social worker comes to visit an elderly patient & finds them ‘locked behind closed doors‘.

1700   Attempted suicide – been planning it all day and makes an effort – but fails miserably.

1900   The very young & very old are being fed supper – someone / somewhere might choke.

2100   Actually it’s rather quiet at 9pm.

2300   This is an apt time for parents to find their kids having either Febrile Convulsions, or [popover title=”” trigger=”hover” placement=”top” text=”A type of difficulty breathing”]Stridor[/popover].


Like I said, some of these are approximations, and others are dead on. (Mind the Pun).

And you’re probably saying, “That’s disgusting, how is he making light of such serious matters?”

Answer, I most certainly am not. I take what I do exceptionally seriously. But there has to be a respite from the depressing talk if we are to be able to continue to do what we do.

I denounce in the strongest terms EMTs who shmooze and joke around outside a failed CPR for example; and yes, it does happen. Not because they are bad people – they’re not. These guys are dedicated and hard working. It’s because having seen it a thousand and one times, slowly but surely, sensitivity wears thin.

Case Study: There was a particularly messy CPR recently; the lady was very skinny – the compressions had broken her ribs, which in turn punctured her lungs, causing blood to rise up the endotracheal tube and make an awful mess. She eventually died, and while the Doctor was filling the death certificate in the house, one of the other members of the team went downstairs to complete the other forms. He switched on the engine of the ambulance, sat in the front seat, rolled down the window, and popped in his favorite ‘top of the pops’ CD. The music was loud, the tempo spirited, and the bereaved family was on the balcony of the first floor apartment.

There was nothing fundamentally wrong with what he did. He couldn’t have been expected to bury his face in his hands and weep; he would be crying all day every day. By default, he had no other choice but to give the CPR his every effort – and once death was declared, go down and eat his favorite snack – or – listen to music.


He should have closed the window!

Please understand that 98% of the calls I respond to are by their very definition – Sad. And that’s the best case scenario.

Worst case scenario, I am despondent for hours afterwards, unable to get the image of the patient’s face out of my mind. (That’s why I try not to focus on the faces anymore.)

Even the small percentage of calls that are happy – births; are also often laden with stress and tension.

Bottom line:

Take the job seriously, but find time, and lots of it, to be happy, joke around, and seek humor in any rotten corner you can find it.

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