Drips, Slow Pushes

I was watching my preceptee give Zofran the other day and I thought that he gave it a little too fast. I didn’t have the stop watch on him, but I was looking for maybe 30 seconds to a minute for the small 4 mg in 2cc injection, and what I saw was about ten […]


Sometimes it takes back-to-back calls to help you understand lessons you might not otherwise have thought about. There are family members on scene of most of all calls and they often ask if they can ride along with us. In most cases, we are not traveling to the hospital lights and sirens so we might […]


I had a routine call with my preceptee today — an obese patient with sudden onset of reproducible chest pain. Lots of cardiac risk factors, but also a history of recent bronchitis. 12-lead looked good. Stable vitals. Some response to nitro. What was really going on with the patient? What was the real source of […]


When I started working as a precepting medic in 1995, I was making (I believe) $12 an hour, which may have gone up to $14 when I was cut loose six weeks later. I worked three 12’s and was often held after crew change, but never to the point of going over 40 hours for […]

Day-to-Day EMS

You punch in. You check your equipment. You get your calls. You respond. 83-year-old female fell, head lac. 6-year-old boy, history of seizures, had a seizure. 63-year-old man with abdominal pain. 74-year old with fever. 59-year old man with syncope. 23-year-old driver with neck pain from rear-end MVA. You do your assessments, get your histories, […]

When Are You a Competent Medic?

I recently received the following question in the comment section: At 10:31 PM, DavisEmt said… This is going to sound stupid:But I don’t really have anyone I trust to ask. How do you know when you are a competent medic, because I know every call isn’t going to run perfect, but I’ve been a medic […]

Dim Bulb

What do you do when your laryngyoscope bulb is either not lit or too dim to see anything? I know you are supposed to check your scope every morning. I do. My preceptee does when I am precepting a new medic. Maybe I should check it too. You snap the blade in and it comes […]

The Grapes of Wrath

We hear the cops go out for a minor motor vehicle up on the mountain, and then twenty minutes later we get called up there for neck and back pain. The accident doesn’t look like much as we get there. One vehicle rear-ended the other, but I start to get a little nervous when I […]

Advice to a New Preceptee

A year ago I wrote a post called Letter to a New Preceptee, offering reassurance to a new paramedic. Today I am supplementing that with “Advice to a New Preceptee.” Note: This letter is not directed to anyone in particular, but rather meant for preceptees in general. *** Dear Preceptee, I have been precepting new […]

Trauma Room: The Sequel

When recently (seven weeks ago) we saw certain of our heroes, the trauma team, in the Trauma Room, I had just unveiled an item of interest for them: “I give my report in the trauma room. I feel bad to say so but I feel almost like a celebrity chef unveiling a master dish when […]

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