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Home > Topics > EMT and Paramedic Jobs
December 26, 2008
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The Ambulance Driver's Perspective
by Kelly Grayson

Top 10 questions you're better off not asking

My partner asked the question we've all had at some point: “So, if you’ve had this for a week, what made it an emergency at 3 a.m.? Bless his sparky little rookie heart

By Kelly Grayson

It happened again yesterday. My partner, a relatively inexperienced EMT, asked the question we’ve all asked at one point or another: “So, if you’ve had this for a week, what made it an emergency at 3 a.m.?

Bless his sparky little rookie heart. He still actually believes that ambulances are for, well you know, emergency calls. He wanted to know why our 50-year-old patient had been self-medicating her sore ankle with booze and Lortab for the past six days, instead of going to the ER when the injury happened. He was understandably curious as to why someone would call an ambulance for chronic gout, especially when we had to maneuver our stretcher past four perfectly functioning cars in the driveway and a handful of able-bodied relatives in the living room to even reach the patient. I knew why.

Because they were all blooming idiots, that’s why.

But my poor partner, still clinging to the faint shred of hope that at least some of our patients may actually be, well … sick, just had to know. Call it morbid curiosity. Call it misplaced optimism. Call it whatever you like; but if you don’t think you’re going to like the answer, it’s probably best not to even ask the question. That’s a lesson my rookie friend has yet to learn.

When the patient told us that she was running low on her Lortab, and had been out of her gout medicine for a week, and that ambulance rides and narcotics administered in the ER were free, I think I saw the last shred of his idealism boil out of his ears like indignant steam from a teakettle. It was actually kind of cute, in an “Aaaawwww, they grow up so fast!” kind of way.

My reaction? I just shrugged and spoke the words I always do in such situations: “Watch your head when you climb in the truck, Ma’am. And what hospital are we going to this evening?”

I’ll also confess that I breathed a quick prayer of thanks that, in our system, such calls can be turfed to the EMT-B partner on the crew. It’s nice being an ambulance driver occasionally. And while I was providing her a safe and sedate $800 ride to the ER so she could save the $8 price tag for a month’s supply of allopurinol and colchicine — I was struck by the idea of other questions that we really shouldn’t ask (unless we’re really ready to hear the answer):

''Have you given him any Tylenol?'' Of course they haven't given him any Tylenol. If they had given him any Tylenol by the time the ambulance arrived, the patient may no longer have a fever, and then what use would an ambulance be? Don't even ask the question and you'll never have to ponder the merits of forced sterilization, or wonder how some nursing home personnel ever made it out of school.
''How much have you had to drink?'' You know darned well how much they had to drink — two beers. I mean, take a good look. I know the reek of ketoaldehydes on his breath, the vomit stain on his shirt front and the fact that he's wearing Burger King ''Home of the Whopper'' boxers — outside his pants - might lead you to believe he's perhaps imbibed ''tee many martoonis,'' but doesn't he have an honest face? Who are we to disbelieve? Two beers can do that to a person … if each of them came in a keg.
''How fast are we going?'' Honestly, do you really want to know? Suffice it to say that if a) you are over 40, and b) your partner is younger than 25, and c) said partner plans his vacation around Speed Week in Daytona, the answer is not one you want to hear. I asked this question once, in an old gas-burner Ford ambulance on a dark country road. My partner looked down at the speedometer, shrugged and said, ''Beats me. The speedo goes to 85 and I've got it wrapped all the way back around to 10.''
In those situations, it's best to just close your eyes, tighten your seatbelt, and pray that your service implements an Allsafe program soon. And perhaps ask your partner to rock you a bit when you get to the call, to break the suction on the seat.
''So, how many of these did you take?'' Well, doesn't it say right there on the bottle? I know that, objectively, the fact that you find the patient licking the dust from inside their Vicodin bottle, even though the prescription was refilled less than a week ago, should have lasted them roughly until the implosion of our sun. But surely there must be some other explanation. If you can wake them up from their stupor long enough to hold a conversation, they'll tell you they're still in extreme pain. Or that their pain specialist doesn't understand them. Or their shiftless nephew stole them all. Or the evil Vicodin Fairy came and took them all back. But they certainly wouldn't take more than 1 tablet, q 12 hours, PRN for pain. That would be unethical, immoral and maybe even fattening.
''So, what did the poop look like?'' Yeah, I know this is a germane question. You want to know if it was melena, or hematochezia or just plain old bloody-streaked poop from chronic hemorrhoids. But invariably, they'll apologetically tell you they already flushed the toilet, and if they don't, do you really want to open the Cool Whip container they so helpfully provided? Better to just get some orthostatic vital signs and let the ER doctor find out what's behind Lid #3. Or if you must know, have your partner open it.
''Do you feel anything out of the ordinary down there?'' Yes, I suppose if the guy complains of groin pain, we'd need to know if the patient has an incarcerated inguinal hernia, if for no other reason than to recognize the need for pain relief and the need for a surgeon. But what do you do if they tell you they're not sure? Because then, you're honor-bound to examine the area in question, and possibly even palpate it. Aside from directly violating EMS Rule #1 (Handle no one's junk but your own), it can also lead to a number of nasty surprises, like the aforementioned hernia, or testicular torsions, or genital warts. Or maybe even the partially absorbed skeleton of his unborn twin. Ignorance is bliss, folks.
''How do you spell that?'' Better to just get a first name, then copy the rest from the face sheet after the ER clerk signs ‘em in. That way, you never have to endure the exasperated eye roll because you didn't know that Chopaquelethia Da'Nae Desdemonaretha Smithe has a silent ''e'' at the end.
''Does anyone have a handcuff key?'' Context is everything here. If it's the prisoner who desperately needs IV access, by all means ask the cop to release the cuffs. But if it's an unconscious man wearing nipple clamps and a leather corset, still handcuffed to the frightened hooker who called 911, some cop is going to have just the type of key needed to free them both. And when that happens, it ruins a perfectly good war story.
''Can you show me your teeth?'' If you're checking for facial droop in a potential CVA patient, a better way is to simply ask the patient to smile. Otherwise, you'll forever be the butt of jokes when the elderly patient obediently points to the bedside table where she keeps her dentures soaking in a water glass.
And the number one question you're better off not asking:

''How did that get in there?'' While I understand that we all possess a certain curiosity as to how a Fabergé egg can wind up stuck in someone's rectum, is it worth the mental picture that the truth will conjure, or the aggravation of being lied to? Just accept at face value that some people paint their houses in the nude, leave paintbrushes sticking out of paint cans, and then fall backwards off the stepladder onto that can. Seriously, it could happen to anybody.


Ever asked a question that you wished you hadn't heard the answer to? Chime in with your comments! I'd hate to know I'm the only one in the market for brain bleach!

About the author


Kelly Grayson, NREMT-P, CCEMT-P, is a critical care paramedic in Louisiana. He has spent the past 18 years as a field paramedic, critical care transport paramedic, field supervisor and educator. He is a former president of the Louisiana EMS Instructor Society and board member of the LA Association of Nationally Registered EMTs.

He is a frequent EMS conference speaker and contributor to various EMS training texts, and is the author of the popular blog A Day In the Life of an Ambulance Driver. The paperback version of Kelly's book is available at booksellers nationwide. You can follow him on Twitter (@AmboDriver) or Facebook (www.facebook.com/theambulancedriverfiles), or email him at kelly.grayson@ems1.com.

Comments
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Mike Smertka Mike Smertka Friday, May 30, 2014 7:45:13 AM "So what parts do you have?" (sometimes it is not so easy to tell...)
Mollie Mechenich Mollie Mechenich Friday, May 30, 2014 8:50:13 AM The timeless followup question to "Are you pregnant?" (because she never is after no period for 5 months), which is "DO YOU HAVE SEX?" Jessica Victorson Medinger
Donna M Boehm Donna M Boehm Friday, May 30, 2014 10:16:54 AM I was checking a patient in to the E.R. an they had been snake bitten I made the mistake of asking the husband ,"do you know w u at kind of snake it was?" He said not sure , I see the dollar store type bad wiggle about the same moment as he said I brought it, and realized he brought the live snake with him. I screamed pushed away in my rolling chair and yelled EMTS! ! They ran in and got the man out of the place they released the demon and saw it was not poisonous. I almost had a stroke myself. Who brings a live snake to a emergency room in a plastic dollar store bag? They don't stay in one piece long enough to get home with a can of peas. But it holds a snake?
Daniel Bojalad Daniel Bojalad Thursday, September 18, 2014 6:05:03 PM The author obviously has EMS experience.
Bryan Danik Bryan Danik Thursday, September 18, 2014 6:39:57 PM How about the guy that fell of a ladder and got a screw driver stuck in his but but did not have a hole in his pants and no ladder could be found
Chase Doerscher Chase Doerscher Thursday, September 18, 2014 6:41:49 PM sounds like this article is based on the fact all patients lie. I don't think that is necessarily true. they call for an ambulance for a reason, and I don't think that reason was to lie about what they were doing or how much they had to drink.
Terry Allen Terry Allen Thursday, September 18, 2014 6:52:22 PM i like #4
Julie Larson Critchfield Julie Larson Critchfield Thursday, September 18, 2014 7:11:07 PM Very funny!! :)
Anthony Williams Anthony Williams Thursday, September 18, 2014 7:12:38 PM Either you are new to EMS OR you do not work on an ambulance or fire service. We don't ask to be lied to, we ask the correct question and these are the USUAL answers we get. Ask anyone in this field and those ten are so true!
Chase Doerscher Chase Doerscher Thursday, September 18, 2014 7:18:04 PM Anthony Williams I've talked to a few EMT's one of them being in EMS for 10 years and they say if they do ask questions like these the ones who are in pretty bad of a condition tend to answer truthfully.
J.P. Franczyk J.P. Franczyk Thursday, September 18, 2014 7:21:28 PM Anthony Williams --I' ve been a driver of the boo-boo bus for 19 years, Just completed 17 of those in a fast paced urban 911 system and I agree completely with your assessment.
Victor White Victor White Thursday, September 18, 2014 7:22:23 PM Sorry to burst your bubble, but welcome to the real world. Not all, but a fair number do, whether from embarrassment, fear or just to game the system.
Chase Doerscher Chase Doerscher Thursday, September 18, 2014 7:24:57 PM Victor White you aren't bursting anyone's bubble, that's my point, most...not all.
Anthony Williams Anthony Williams Thursday, September 18, 2014 7:30:41 PM And my 12th anniversary is this year at the same service, that doesn't include the two part time jobs in the medical field I also work (one is hospital, the other is a medical transport). Most of the time WE ARE LIED TO (did you notice the MOST??). Not everyone but most of the time we are lied to when we are asking our medically relevant questions. That is why the saying/joke is so true: Never do anything that you don't want to explained to the paramedics. SO, we get lied to!! Ask your friends this Chase, how many times have they transported to a hospital, give report and then hear the patient give a totally different reason why they are at the hospital?? It happens all to often!!!
Chase Doerscher Chase Doerscher Thursday, September 18, 2014 7:34:29 PM Anthony Williams yeah? what are you trying to prove? all I said is not all patients lie, and you agreed, so you are arguing against yourself.
Anthony Williams Anthony Williams Thursday, September 18, 2014 7:45:56 PM Ummm, no. I'm making the point that "They call for an ambulance for a reason, and I don't think that reason was to lie about what they were doing or how much they had to drink"...... Remember that??? SO, the reason I commented was to point out; THEY CALL AND LIE TO US! So "this article is based on the fact that all patients lie" is wrong but most do and it is when THE PATIENT doesn't want to tell us the truth, you make it sound like we WANT to be lied to which is absolutely W R O N G!! It is just what we are used to getting from the people we run on!
Matt Davis Matt Davis Thursday, September 18, 2014 7:56:03 PM I have this mental measurement I use right before I do something that starts with, "Hey y'all, watch this." Never do anything you don't want to explain to the EMTs.
Brandi D Price Brandi D Price Thursday, September 18, 2014 8:09:50 PM DOh gone Kelly Grayson lol I shoulda known when I started reading this it was yours. Lol you never forget the stories you hear.
Lynn Bradley Clogston Lynn Bradley Clogston Thursday, September 18, 2014 8:13:03 PM Inside or outside? An unforgettable night.
Tammy A McCrory Tammy A McCrory Thursday, September 18, 2014 8:13:40 PM Kelly Grayson....my rig travels through your neighborhood. ...you never fail to make me giggle.
Cindy Nye Cindy Nye Thursday, September 18, 2014 8:13:49 PM Chase Doerscher
Carole Connor Carole Connor Thursday, September 18, 2014 8:16:33 PM Had a 4 yr old pt that hit his head on the kitchen table. The mom was very young, stressed out with 3 kids under five years old. Doing the run sheet I asked how old is he ? And she asked me which one is he?
Cindy Nye Cindy Nye Thursday, September 18, 2014 8:17:25 PM Chase Doerscher You have NO CLUE,,, Be Done,. Or Become an AEMT, Or a Paramedic, Run With us ,, OR SHUT UP!
Chase Doerscher Chase Doerscher Thursday, September 18, 2014 8:21:53 PM Anthony Williams so then we're in agreement not all patients lie. stop getting yourself worked up for no reason. and yes I said that but its true they don't call to lie but did I say they don't? no I didn't so hold your horses bud.
Chase Doerscher Chase Doerscher Thursday, September 18, 2014 8:23:17 PM Cindy Nye trying to be the big man on campus doesn't make you look big it just makes you look foolish. if you don't have anything real to say, don't.
Ed Hillenbrand Ed Hillenbrand Thursday, September 18, 2014 8:37:35 PM Do I detect a "hint" of sarcasm here? ; )
Sandra Egleston Sandra Egleston Thursday, September 18, 2014 8:55:48 PM People call the ambulance for their reasons, whether it's deemed a true emergency by EMS or not. I can't count how many times I have heard "two beers" from the ambulance side and ER side of medicine. I'm an EMT-B in MI for 8 years, and EMT-P candidate-waiting to take practicals-and also was a medical assistant in a Dr's office for 16 years. I have heard all of the above or some variation of it. This article was well written and very funny!!
Peggy Entwit Andrews Peggy Entwit Andrews Thursday, September 18, 2014 10:15:06 PM Years ago, I was dispatched to a local bar for a person who fell off his bar stool (it was about 3am)... sure enough on arrival I found the engine crew with an intoxicated person sitting on the bar floor.... business as usual all around. When I began assessing the patient, I noticed that he was speaking in a garbled voice - it sounded just as if he were gargling after brushing his teeth... in an attempt to determine if he had an airway obstruction or something... I asked "Sir do you always speak this way?" his answer in the same garbled voice "F**k you". The engine crew politely said - "we'll be right outside" and they left me with the patient. I looked outside a minute later to find them laughing so hard they were falling over.... I helped the guy back on his stool and cleared the scene. That engine crew loved reminding me of that call for years....
Kevin Witmyer Kevin Witmyer Thursday, September 18, 2014 10:23:14 PM 23 years on the road.....Yeah. Just don't ask.
Ginny Lynn Stokes-Young Ginny Lynn Stokes-Young Thursday, September 18, 2014 10:29:22 PM Roflmbo
David Lavine David Lavine Thursday, September 18, 2014 11:09:12 PM I almost had an MI laughing so hard. Great article!
Daniel Stetson Daniel Stetson Friday, September 19, 2014 3:43:57 AM That's known as Eiffel Tower syndrome, for "I fell on it"
Jim Sutton Jim Sutton Friday, September 19, 2014 4:34:34 AM Kelly, God love you brother :) just glad I didn't pop an aneurysm on the crapper this morning laughing along with you. Keep smiling big dawg so we can laugh along with you.
Patrick Gomer Roberson Patrick Gomer Roberson Friday, September 19, 2014 5:12:03 AM I happen to work in an ER and folks bring snakes in all the time, both live and dead, I have even had to remove snakes that have found a way inside of the hospital.
Pamela Ceccarelli Pamela Ceccarelli Friday, September 19, 2014 5:35:52 AM You have absolutely never worked in the medical field. I've never been an EMT but I was a CNA. If you can text on your phone, eat ice cream, watch tv, chill with your buddies, and go smoke a cigarette....... Your pain is not a 10. You just want pills.
Pam Frey Pam Frey Friday, September 19, 2014 6:26:00 AM LMAO . All true..hysterical!!
Chase Doerscher Chase Doerscher Friday, September 19, 2014 6:39:11 AM Pamela Ceccarelli pain level wasn't even mentioned in this article so I don't know what you are going on about. yeah almost all people over exaggerate their pain level. asking what their pain level is, is hardly relevant medical wise. and why do you come to that conclusion anyway? others have basically agreed but have gone arguing a moot point.
Michael McLaughlin Michael McLaughlin Friday, September 19, 2014 7:25:32 AM Never ask a young couple if they engaged in foreplay, before attempting sex which caused her so much pain that they called an ambulance. This will save you the embarrassment of giving a detailed lecture on the subject of foreplay to a rapt and attentive audience which includes your colleague who is trying to stifle her giggles at 3am.
Debbie Warren Debbie Warren Friday, September 19, 2014 7:47:58 AM LOL
Gerry Haverland Gerry Haverland Friday, September 19, 2014 8:06:07 AM Kelly, your post are always spellbinding! I worked a light bulb case, but until I made the following run, I had no idea what chronic excruciating pain could do to a persons psyche. Went out in extreme out in the sticks (literally) call where the one way road had limbs scraping both sides of the truck. It was a possible suicide, or attempt. In those days we did not have the luxury of waiting on LE. When I walked in, I knew the guy by name, I went to high school with him. He was shot with a 38 just to the right of his spine at L-5-S1. After I saw that he was not bleeding out, I asked him why he wanted to kill himself. He said, "Kill myself? I was not trying to kill me! I was trying to kill the pain!
Jeffrey D Dickson Jeffrey D Dickson Friday, September 19, 2014 8:17:11 AM As a board certified ER physician, I tell everyone the same thing. "I've been drinking beer on occasion while in the shower since I was sixteen. I've never had the misfortune of slipping and having the bottle disappear up my @$. Son, you must have some really bad luck. "
Danny Plyler Danny Plyler Friday, September 19, 2014 9:38:43 AM My favorite question is pain level.......You ask the question, you are ALWAYS told "10", and then they proceed to take a nap en route to the hospital!! LOL
Robert L Bright Robert L Bright Friday, September 19, 2014 9:59:45 AM Chase Doerscher I have been working ambulance for 34 years I have SEEN, DONE & SMELLED IT ALL. I can tell you it is like the COPS you watch on TV, if the are sick and need help the are truthful, if the are not they lie!!!!! if the just need a ride they lie, if the just need a drug refill they lie. if the are crashing the will tell you ANYTHING and you could take it to the bank because they want you to help them........ The sad part their are WAY toooooo many of the liars over the crashers and its called EMS abuse.....
Chase Doerscher Chase Doerscher Friday, September 19, 2014 10:06:12 AM Robert L Bright yeah, you are just repeating what I said. those who are in actual need and in a life threatening condition usually tell the truth. if they don't think there's a chance of dying or something along those lines they aren't going to spill their guts out to you.
Jacob Miheve Jacob Miheve Friday, September 19, 2014 12:15:10 PM Regarding # 8, I give to you this: http://www.comedity.com/index.php?strip_id=33 I actually ran on the local volunteer EMS agency with the guy pictured in the comic, who was a friend of the artist. The story is true, and involved a late-night/early-morning long distance transport at his paid job.
Catherine Stokes Catherine Stokes Friday, September 19, 2014 2:16:38 PM Funny!
John Riggs John Riggs Friday, September 19, 2014 10:00:43 PM I recently asked a patient if she was allergic to anything... She told me she was allergic to "knock out pills". Assuming she ment sleeping pills I asked what happens when you take them; do you get a rash or something? Her reply was " No I can't take them because they make me sleepy!!!!"
Jim Thorn Jim Thorn Saturday, September 20, 2014 8:21:06 AM Funny article! We asked the same Q's in the ER, get some of the same answers! Lol.
Dan Burnam Dan Burnam Saturday, September 20, 2014 12:50:40 PM What ?? A humerous article about EMS ? How can that be? I thought most people with a sense of humor have been driven out of EMS.
Carroll Polk Carroll Polk Saturday, September 20, 2014 12:57:11 PM Chase Doerscher Pain level is relevant, and you are right most exaggerate, but the point is you have to know in order to treat them. So please do question medical professionals, if you aren't one your self. You seem smart, so act like it. Get an education, get on an EMS, and then open your young misinformed mouth.
Chase Doerscher Chase Doerscher Saturday, September 20, 2014 1:10:20 PM Carroll Polk that's not what I meant, I meant pain level is one of the things that isn't necessarily told truthfully/correctly. and yeah I know its relevant. you can use it to measure whether or not pain is getting worse or better
Celeste Gras Celeste Gras Saturday, September 20, 2014 3:10:39 PM Humor is not complaint with EMTALA. Only tears and hugs are allowed along with max doses of fentanyl and a 12-lead for that aching ankle.
Kelly Grayson Kelly Grayson Sunday, September 21, 2014 1:11:37 PM Chase Doerscher All patients don't lie. But enough of them do that it sometimes helps to relieve the stress by laughing about it.
Kelly Grayson Kelly Grayson Sunday, September 21, 2014 1:14:38 PM Just a hint. ;)
Chase Doerscher Chase Doerscher Sunday, September 21, 2014 1:19:06 PM Kelly Grayson yeah, can't argue against that.
JoAnn Archibald JoAnn Archibald Sunday, September 21, 2014 6:35:15 PM Freaking hilarious, & sadly very true.

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