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The Art of EMS
by Steve Whitehead

4 EMS calls I used to wish for

We can't wish calls that test our mettle into or out of existence; we can only better prepare for them

By Steve Whitehead

One of the great paradoxes of human thought is the idea, “Be careful what you wish for; it might come true.”

We tend to associate the warning with great wealth or fame, but I think is has application in the EMS realm as well.

We often begin our careers with a flurry of training and activity. We attend classes and complete homework assignments. We study for tests.

We go on ride-alongs and fill out job applications. We interview and join organizations. Often there is a field internship and a probationary period.

As quickly as it all started, one day we look in the mirror and we’ve arrived. We iron our new uniform, place our new stethoscope in our cargo pants (It was a gift from mom after all) and arrive at the station ready to work. At this moment, it’s only natural to want to test our mettle.

I get it.

At the outset of our careers, we typically refer to them as “good calls,” the calls where our skills and training are brought to bear. We want to know what it’s like to be in the middle of the chaos. We want to feel the thrill of life and death hanging in the balance.

The calls I used to wish for

Stay around in this industry long enough and chaos and tragedy will find its way to your doorstep.

I don’t say this to admonish you. I was no different when I began my career.

I used to wish for challenging cardiac arrest presentations until the day a family called for their two-month-old infant who had stopped breathing in his crib. I don’t wish for challenging cardiac arrest scenarios anymore.

I used to wish for metal crushing car accidents and complex extrications until a group of four teenage girls pulled out in front of a van on a two-lane highway. The impact ripped the vehicle in half.

I don’t wish for car accidents anymore.

I used to wish that I could be a part of a large MCI that would make the national news and be remembered for years to come. Then two students at Columbine High School showed up one morning with guns and bombs. I was sipping my morning coffee at a street corner post a few miles away.

I don’t wish for MCIs anymore.

I used to wish for a prehospital delivery. I wanted to say that I had delivered a baby on my own.

Then a mother of five deep into her labor called 911 in a rural area 90 minutes from the closest hospital. Her meconium stained child was flaccid and struggled to breathe unassisted.

I don’t wish for prehospital deliveries anymore.

The price of experience

It’s worth remembering that when we wish for “good calls” and the opportunity to test ourselves, we are also wishing for fear and tragedy and pain and misery and grief and sorrow.

Often, in our wishes, we picture ourselves rendering care, but we fail to envision the screams of pain, the tears of family members and the horrible consequences of lives forever ruined.

I don’t want to discount the value of experience. I’m glad that I’ve responded to challenging calls and that I know what it’s like to rise to the occasion. There is a certain sense of satisfaction when the best within us rises to the occasion, even when the occasion happens to be the worst of human experience.

But there is a price.

Some things once seen cannot be unseen. Some moments once lived cannot be unlived. And there are few truly experienced providers who don’t carry a list of moments that they would gladly unlive if such a thing were possible.

Instead or wishing for “good calls,” I’ve started wishing for preparedness. Each time I feel that I’d like to be challenged, I express the feeling as a desire to be ready for the worst that life can throw at me. I know with certainty that time will always bring another challenging call.

I’m in no hurry to face the next one. But I do want to be ready when it comes.

The power of preparation

Human tragedy is certain, but being prepared for it is optional. That part is entirely within our control.

If you feel like you might want to experience a difficult cardiac arrest, recheck your monitor or AED. Review your CPR, PALS and ACLS guidelines and know that time will bring you more than you desire.

If you feel like you want to be called to a “good” car wreck, practice the best routes to your local trauma centers and look through your trauma gear.

Consider techniques for rapid patient extraction, rapid trauma assessment and critical airway management. And know that a significant vehicle accident will inevitably find you in good time.

If you wonder what it’s like to be a part of a major MCI, read up on some of the large-scale events that have happened in your region in the past. Consider what went well and what went poorly.

Think about how you would respond to a similar event. Participate in regional MCI trainings. If you retire never having used any of those skills, count yourself among the lucky.

If you’d like to be the caregiver who holds a new life as it enters this world, pull out your OB kit and refresh your memory on everything that is inside. Remember your protocols for obstetrical emergencies and understand when and how you should intervene.

Review the APGAR score and post-delivery care of a newborn. And know that the opportunity will probably find you eventually.

We can never know when our worst call will occur. We can’t decide when we will respond to the next child in distress or extrication needed. We have no control over the order or severity in which calls are distributed to us.

But we can control our own preparations.

If you remain in this industry for long enough, life will bring you more than enough tragedy. That is simply the nature of human existence.

Be patient, be willing and be prepared.

About the author

Steve Whitehead, NREMT-P, is a firefighter/paramedic with the South Metro Fire Rescue Authority in Colo. and the creator of blog The EMT Spot. He is a primary instructor for South Metro's EMT program and a lifelong student of emergency medicine. Reach him through his blog at or at
The comments below are member-generated and do not necessarily reflect the opinions of or its staff. If you cannot see comments, try disabling privacy and ad blocking plugins in your browser. All comments must comply with our Member Commenting Policy.
Walter Waganka Walter Waganka Tuesday, June 10, 2014 4:30:41 PM We are both reading from the same page. Well written article with a positive message. Be well prepared!
J.t. Cantrell J.t. Cantrell Wednesday, June 11, 2014 5:20:01 AM I must agree with Walter. VERY well done.
Anthony Poole Anthony Poole Wednesday, June 11, 2014 3:23:55 PM I remember a call I had where a 8yo girl had been jumping on a trampoline with her older and heavier brother. They both landed on the surface at the same time, which resulted in an avulsed, broken ankle-turning the ankle away from midline at the epiphyseal plate. My partner could not determine how to immobilize the fracture, so I called for an adult vacuum splint. The girl was small enough we could wrap the upper end around her hips, and we were able to gently fold the splint around the injury-once we applied suction, the splint turned into a mobile cast that held the injury in place, and the little girl recovered nicely. Sometimes you have to think outside the box.
Anthony Poole Anthony Poole Wednesday, June 11, 2014 3:24:18 PM I remember a call I had where a 8yo girl had been jumping on a trampoline with her older and heavier brother. They both landed on the surface at the same time, which resulted in an avulsed, broken ankle-turning the ankle away from midline at the epiphyseal plate. My partner could not determine how to immobilize the fracture, so I called for an adult vacuum splint. The girl was small enough we could wrap the upper end around her hips, and we were able to gently fold the splint around the injury-once we applied suction, the splint turned into a mobile cast that held the injury in place, and the little girl recovered nicely. Sometimes you have to think outside the box.
Jim Dean Jim Dean Wednesday, June 11, 2014 3:29:16 PM Great message. Working for a newspaper we have many of the same feelings. I've always had a running joke about not driving into town to cover a story unless someone sets the courthouse on fire. Last Friday a man threw home made spike strips on the street in front of the courthouse as he jumped the curb in his Nissan Armada while throwing out smoke grenades, driving straight for the front door. Two things worked in our favor. One quick thinking deputy, who just happened to be in the right place at the right time engaged the shooter. He took a bullet (he'll recover) but he slowed the guy down long enough for the SWAT guys, who just happened to be training a very short distance away, to get there and put a stop to the rampage. It took hours to clear the mess-the man actually had several explosive devices with him that he planned on placing on hostages inside the courthouse. Since the courthouse is only a block from our office, the whole thing unfolded right in front of us. Don't think I'll make that joke anymore.
Panther FyreMedic Panther FyreMedic Wednesday, June 11, 2014 3:32:14 PM Can totally relate. Like I tell "the kids", the calls will come... Whether you want them to or not. The real key is preparedness - Physical, Mental, and Emotional/Psychological. If you've thought it out, and you've planned within Your Personal capabilities, you'll KNOW what to do... Including calling for help and more resources... Like the Boy Scouts say, "Be Prepared!!!!"
João Paulo Saraiva João Paulo Saraiva Wednesday, June 11, 2014 3:53:24 PM Good work and geat message :)
Osian Roberts Osian Roberts Wednesday, June 11, 2014 4:15:29 PM Probably one of the best things I have read in a long while! Burnout sucks! I too used to get excited by trauma and MCI's etc. But after 25 years as a Paramedic, I'm happy with a simple fall, an OD, a transfer, and I'm happy! Stay safe!
Robert Bales Robert Bales Wednesday, June 11, 2014 4:38:14 PM As a newly certified AEMT, I appreciate this article immensely. When doing my clinical rides, I felt bad wishing for "good" calls because that really meant someone, and their family/friends, would be hurting emotionally beyond my comprehension. May I keep that in mind as I begin my EMS career.
Conni Jo Corbin Conni Jo Corbin Wednesday, June 11, 2014 4:59:21 PM Well written, my friend. Very, well written.
Jason Moore Jason Moore Wednesday, June 11, 2014 5:01:47 PM I used to wish for MCI too....then I went to Haiti in 2010.
George Beltz George Beltz Wednesday, June 11, 2014 6:08:11 PM Very well written article.
Becky Heath Becky Heath Wednesday, June 11, 2014 6:53:39 PM Simply put. Thank you. Fantastic article...
Jim Brackett Jim Brackett Wednesday, June 11, 2014 6:58:54 PM A great article. 21 years in the business and I still can't get the 3 y/o girl, pedestrian accident out of my mind... Be careful what you wish for! The bad one will find you.
Geordon VanTassle Geordon VanTassle Wednesday, June 11, 2014 8:17:56 PM I haven't gotten into the field yet, but my only wish once I hit the streets is to make a difference. I know that my "test" on the street is someone else's tragedy, and I don't want for anybody to have a bad time of it.
Kaitlin Reick Kaitlin Reick Wednesday, June 11, 2014 9:02:07 PM I worked on the fire side of a tragic accident about 3 weeks ago, never really wished for the "good" calls. Never want to work that type again from either fire or ems. I still will wish for the OB call but I don't want anything tragic just a run-o-the-mill call of any sort. I just wish to be well prepared to handle what gets thrown at me.
David Boyd David Boyd Wednesday, June 11, 2014 9:08:56 PM The best calls are no calls. I pray that all those living in the areas that I am covering today, that they remain safe and healthy. If I must administer care to the sick and injured allow me to do it to the best of my ability. Allow my partner and I to remain safe during our shift. Amen
Doug Zalud Doug Zalud Thursday, June 12, 2014 3:49:55 AM Great article with some excellent points that don't get discussed enough. The best calls anymore are when I show up for something "stupid simple" and fix, and the family is as happy as can be because they don't have to go to the ER.
Brad Rosene Brad Rosene Thursday, June 12, 2014 4:02:47 AM "Human tragedy is certain, but being prepared for it is optional". That part is entirely within our control." ....Amen brother
Greg LaMay Greg LaMay Thursday, June 12, 2014 6:37:53 AM Well said, Amen brother!!
Craig A Ashmore Craig A Ashmore Thursday, June 12, 2014 8:12:56 AM As a newly minted EMT I remember thinking exactly what this great article is about. I've been a part of all of these types of calls. calls. At 56 years old and 34 years as a Fire Lt/EMT I've been diagnosed with depression and PTSD. Thankfully we are becoming more aware of this in public safety and places like On-Site Academy in Westminster Ma. are there for us. If your young and reading this do not bury your feelings, talk about it. It may just save YOUR LIFE.
Aaron Trammell Aaron Trammell Thursday, June 12, 2014 9:22:42 AM I like this article a lot, and I appreciate everything it's saying, especially about preparedness, but there's one little thing that I wish I could tell the author. Yes us newbies long for the "good calls" where are skills and training are truly put to the test, and where we can see what we're truly made of, but it's not that we WANT bad things to happen to people. The fact is, bad things are going to happen anyway, it's just the world we live in. What excites us is being there to save people. It's the reason we were drawn to this job, our innate desire to help people.
Tyler Kitchens Tyler Kitchens Thursday, June 12, 2014 1:53:33 PM What a solid article!A great read for anyone in EMS, especially newbies and students!
Richard Haig Richard Haig Thursday, June 12, 2014 5:16:51 PM What a great article. Very well put indeed sir.
Jerry Griffith Jerry Griffith Thursday, June 12, 2014 6:22:24 PM As a Paramedic with 13 years experience I don't wish for calls anymore. As a matter of fact, I pray everyday for the health and safety of my crew and our citizens. Calling for my help means someone is losing everything. We should be prepared for calls, but not wishing for them. God bless all the Fire and EMS providers.
Joe Lorenzetti Joe Lorenzetti Thursday, June 12, 2014 7:25:36 PM You can't wish for those calls..... they will find you....... Take it from an old Chief who rides his dinosaur to work...... 44 years in.... still hard charging.... Stay safe.......
Mike Lencioni Mike Lencioni Thursday, June 12, 2014 9:13:27 PM Great article Steve, Thanks!
Kimberly Lipford Kimberly Lipford Thursday, June 12, 2014 9:23:09 PM I bein disabled can't imagine wat you all see daily Bt I know myself I am thankful you all are around when ur needed. With me havin spins bifida I have my own challenges in life Bt can't ever measure up to wat you all deal with on a daily basis. Thank you to you all and god bless you all for using ur gift and talents to help us all.
Pete Dawson Pete Dawson Thursday, June 12, 2014 10:12:32 PM Well said, A good call involves some great coffee and cake, and not much else.
Chris Covey Chris Covey Saturday, June 14, 2014 12:04:53 AM Well spoken.. I completely identify.
Erick Haynes Erick Haynes Monday, June 16, 2014 3:58:24 AM As a EMT 3 yrs in, I've found this article to be an encouragement and humbling .. I've seen an AWFUL lot in the past 3 yrs and still have a long way to go... Great advice .... ErickH New Zealand
Melinda Teaster Williams Melinda Teaster Williams Monday, June 16, 2014 5:49:43 AM What a great read, Thank you
Steve Whitehead Steve Whitehead Wednesday, June 18, 2014 11:46:13 AM The great thing about the internet can tell the author! And I appreciate your comment. (I appreciate them all.) I agree with you Aaron. I don't think any of us want bad things to happen to people. It isn't why we do this. Preparing for the inevitable tragedy of life is the best way to rise to the occasion. Don't wish for the call. Wish for the skills, knowledge and ability to rise to the occasion. The rest takes care of itself.
Brittany Tackett Brittany Tackett Tuesday, June 24, 2014 9:28:29 AM Thanks for sharing this, i am going to school to become an EMT and eventually a paramedic. This has always been my dream. Reading this article has changed my thinking a lot and will help me become more appreciative.
Mack Paris Mack Paris Friday, September 12, 2014 1:06:50 PM I still like psyche calls
Bob Sutherland Bob Sutherland Friday, September 12, 2014 1:21:44 PM 33 years full-time paramedic in a metro area. Everything in this article is true. Particularly about the being prepared part. That simply can't be stated enough. Start ahead to be ahead. Prepare yourself as best you can for every and any eventuality... if that's even possible. I gave it my best shot during my career, and thankfully for great co-workers and an amazingly supportive spouse (co-pilot) survived very well. I still like the "Good Call" as long as they go well with a positive ending. But sometimes things beyond our control do happen, and we just have to roll with it to the best of our ability.
Steve Kreckman Steve Kreckman Friday, September 12, 2014 1:38:58 PM There are days when we don't even get toned out for a single call. I used to say it was a boring day, now I see it as a day where the residents of our community were spared any pain or suffering. That's a good day
Scott Wright Scott Wright Friday, September 12, 2014 8:01:19 PM amen
Steve Steffgen Steve Steffgen Saturday, September 13, 2014 6:04:23 PM Something an ER physician told to me in EMT class when I expressed apprehension at "hoping" for things: "People are going to get sick and hurt no matter what; we may as well be there to help them and make it better as best we can".
Deanna Ellis Kazakevich Rondeau-Setter Deanna Ellis Kazakevich Rondeau-Setter Sunday, September 21, 2014 2:16:42 PM Thank you for posting this Nik. A lot of people truly don't understand the life of an EMT. Having been on the receiving end of their skill and loving talent so many times, I treasure this article.
Joan Zimmer Joan Zimmer Monday, September 22, 2014 6:14:57 PM Wow awesome post!!
Thom Swan Thom Swan Monday, September 22, 2014 7:06:03 PM Good article.
Terry Ng Terry Ng Monday, September 22, 2014 7:49:14 PM I'm 1.5 years in as a paramedic in Toronto, Canada. I'll never forget being that 4 month rookie having to find that very dead 4-year old girl. I'll never forget the faces of the parents who had to walk in and witness my partner and I trying to resuscitate her. I often get to these "hot" calls when I least expect it. I totally believe in being as prepared as I can so that when the time comes, I will be able to handle it to the best of my ability. My favorite calls are the ones where we can have a nice easy ride in the ambulance, chat and smile that everyone is going to be all right in the end. A great read to remind every paramedic of things.
Ginny Lynn Stokes-Young Ginny Lynn Stokes-Young Monday, September 22, 2014 8:17:09 PM God bless you all.
Cölton R. Dean Cölton R. Dean Monday, September 22, 2014 11:44:58 PM There are things I don't talk about while on duty. The EMS gods are always listening.
Winona Bennett Cross Winona Bennett Cross Tuesday, September 23, 2014 3:45:21 AM As a retired nurse I understand. I worked L&D for many years and saw it all. I have a paramedic/firefighter son who is probably one of the best out there. He used to wish for the "good" calls. Now, he's seen things that can't be unseen as you say. Great post.
James Hubbard James Hubbard Tuesday, September 23, 2014 4:50:35 PM I' ve been there as a respiratory student and I can understand this, I am now an EMT student and need to get ready for another set of challenges.
Michael T. Long Michael T. Long Tuesday, September 23, 2014 7:08:29 PM Well stated. I didn't necessarily *want* to be part of an MCI, but I always wondered what it might be like. Then I was working in the UCH burn/trauma ICU the night of the Aurora theater shooting. I don't wonder anymore and I pray that I never have to be involved in one again.
Bryan G. Lee Bryan G. Lee Tuesday, September 23, 2014 10:06:14 PM You know it brother, if were bored the public is safe.
Trude Erikkeher Kjelgård Trude Erikkeher Kjelgård Wednesday, September 24, 2014 6:35:49 AM This is good reading for all emts all over the world. Hello from Norway
Joe Mancos Joe Mancos Friday, September 26, 2014 5:07:05 AM Spot on
Alice M Woody Alice M Woody Saturday, September 27, 2014 5:37:26 PM Mike, I'm so proud of you. You are my Hero ! ! Love you. Proud to be your Gramma Al

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