EMS Week – Every May has one week dedicated to the Emergency Medical Services providers in the United States. A few months back I read a quote in the Journal of Emergency Medical Services. I have lost the name of the author, so if you know who wrote this, please let me know so I can give appropriate credit. “If police are the finest, and firefighters are the bravest… what the hell are we, the forgotten?”

It seems to me that most people believe that EMS is now seen as a customer service enterprise, such as a store in a mall, a pharmacy, or even a Wal-Mart. People don’t seem to care that EMTs and paramedics receive hundreds of hours of training and log even more clinical hours learning how to assess and treat patients. And we learn how to do it moving in a van with a bad suspension. They see us as “hospital taxis.” They just want us to carry them out to the truck and take them to the hospital. If you just want a ride, call a taxi. Trust me it will be cheaper.

So, in honor of all EMS providers everywhere, I’m going to give some rules to the patients. Please note that this list is not exclusive and the rules can change at any time based on the mood of your local EMS crew – and I’m sure that some of this information will be helpful to you as well.

Do not tell the EMS crew that your doctor is meeting you at the hospital. Especially do not say this at 3:00 AM. You did not talk to your doctor. You spoke with his answering service who cannot give out medical advice. They’re instructions are always, “Call 911 and go to the hospital.” The rest of that line should be, “your doctor is (sleeping, golfing, etc) and can’t be bothered by you right now. If you do happen to get admitted, he might see you next Tuesday when he does his rounds.”

Do not ask if your entire family can go with you. One person and one person only. Buckled in the front seat. And no, we cannot drop them off at work on your way to the hospital.

Do not insult your paramedic. If a physical flaw in their appearance (overweight, facial scar, etc) is your main concern, than you are not sick enough to require ambulance transportation.

Understand that arriving at a hospital by ambulance will no longer get you into see the doctor any faster. Several periodicals have said this in the past and it has been abused. Excessively. It is not unusual to see an ambulance crew place a patient from their stretcher to a wheelchair and place them in the waiting room.

Please be truthful about your complaint and why you called for an ambulance. We are trained to discern from different kinds of maladies based on your answers to questions about a complaint. For example abdominal pain can be something serious or something minor: but if you answer one question that makes us believe it’s an aneurysm and the answer to the next question points to constipation… well, you just shouldn’t lie to get in an ambulance. If you still choose to lie, use this complaint: Nausea without vomiting for two days. It’s simple, it’s easy. You won’t receive needless treatments and it’ll save the crew needless paperwork.

Yes, we do need to know your birthday and social security number. Our patient care reports become part of your medical record. We usually do not care about your insurance (the billing office does, but I don’t). They can get it from the hospital later with your social security number and birth date.

Do not take an ambulance to a hospital and sign out AMA because you wanted a free ride across town.

Do not complain because we are not using lights and sirens. These are for life and/or limb threatening emergencies only.

Do not complain about not using lights and sirens especially if you are making the crew drive past a closer hospital because your (doctor, insurance, etc) is at another hospital. All will say the same thing: “In case of an emergency, go to the CLOSEST emergency room.” You can always be admitted to another facility and transferred by ambulance. Your insurance will pay for ER treatment and ambulance transfer if they do not cover the first hospital or your doctor admits you to another facility.

No, we cannot stop at 7-Eleven to pick up cigarettes.

Yes, we can stop at 7-Eleven to pick up coffee.

Please do not lie to the dispatcher to try and get the ambulance to come faster. Making an ambulance crew use lights and sirens through traffic to get to your house faster is dangerous to the crew and public at large. Some states (not mine) actually prosecute people for this: it’s called ‘Risking a Catastrophe.’

Do not request “No lights and sirens.” If you want a nice, quiet, calm ride to the hospital – call a taxi. The ambulance crew has a protocol in place to choose which calls get lights and which calls do not.

To families of patients: If you have an elderly relative who cannot move too well, please try to keep them as close to, or on, the ground floor. Why do you put the sickest member of your family up four flights of spiraling stairs? They’re really not that much closer to Jesus.

To families: No we cannot force your family members to go to the hospital against their will. I don’t care if you are Power of Attorney. Power of Attorney doesn’t kick in until they are not mentally competent to make their own decisions.

No, we don’t know why the fire department has shown up. What did you say to the dispatcher when you called 911?

No, we cannot write you a prescription for a refill.

You are not allergic to Tylenol if you are not allergic to Vicodin. Both contain acetaminophen.

You are not allergic to Aspirin if the only side effect is an upset stomach. This is normal. Now, if you turn purple and stop breathing, then yes, you are allergic to Aspirin.

No one is allergic to needles.

If given the choice to go by ambulance or police car; at least allow the crew to get in the ambulance first.

No, I do not have that medication.

No, you can’t have it, either.

If you are familiar with Narcan it’s time to go to rehab.

If you just tried to “Google” Narcan: try naloxone hydrochloride. Better results.

If you seriously just tried to “Google” either Narcan or naloxone then you most likely were on the Chess Team in high school.

If you fake unconsciousness, do not be angry at the EMS crew for placing an ammonia inhalant in your nostril.

Please do not vomit on the paramedic. If you do, please do not be offended if your paramedic vomits on you.

If you must use the restroom while riding in an ambulance you should have chosen a closer hospital.

If you have more cars in the driveway than people in your home you do not need to call an ambulance unless you are dead, dying, or have a bone sticking through the skin. No exceptions.

If you must call because none of your cars are running… then you probably can’t afford the ambulance bill.

No, you cannot have my name.

No, you cannot have my supervisor’s name.

Yes, you can have my director’s personal cell phone number. He prefers calls between 10:00 PM and 7:00 AM.

Yes, we do know they way.

No, we would not tell you if we didn’t.

Do not tell us how to do our job. If you know what to do so well, why did you call us?

Same goes for your family.

And any bystanders.

For Doctors: If you are a PhD, an Ed.D., or anything other than an MD or DO; you are not a physician and cannot direct an EMS crew in how to provide care. Do not attempt to do this.

For Physicians : Do not attempt to direct an EMS crew in how to provide patient care if you are not willing to accompany the patient to the hospital in an ambulance. This is the law if you attempt to direct the care of a patient. If you wish to save face in front of your friends, please be honest. We’ll give you a stethoscope and say, “grab me some lung sounds.”

: Do not attempt to direct an EMS crew in how to provide patient care if you are not willing to accompany the patient to the hospital in an ambulance. This is the law if you attempt to direct the care of a patient. If you wish to save face in front of your friends, please be honest. We’ll give you a stethoscope and say, “grab me some lung sounds.” Also for Physicians : We will assume you are a proctologist until your actions prove otherwise.

: We will assume you are a proctologist until your actions prove otherwise. Unless a proctologist is needed. Then we will assume you are a podiatrist.

Unless we need both… because we’ll probably be taking pictures.

This list is in no way complete and exclusive. I ask of all my EMS brethren to contribute to the ever growing list of rules for patients, and allow it to be posted and public for all to see. Maybe if people understood what we really see and do; maybe we’d get a little more respect.

To wish you a happy EMS Week, I will leave you with two words. You’ve heard them before and probably said them to a probie yourself.