101 Things We Should Teach Every New EMT

1) You aren’t required to know everything.dc fire and ems by ep jhu via flickr

2) You are required to know the foundational knowledge and skills of your job. No excuses.

3) Always be nice. It’s a force multiplier.

4) There is no greater act of trust than being handed a sick child.

5) Earn that trust.

6) Don’t ever lie to your patient. If something is awkward to say, learn to say it without lying.

7) Read Thom Dick’s, People Care. Then read it again.

8) You can fake competence with the public, but not with your coworkers.

9) Own your mistakes. We all make them, but only the best of us own them.

10) Only when you’ve learned to own your mistakes will you be able to learn from them.

11) Experience is relative.

12) Proper use of a BVM is hard and takes practice.

13) OPAs and NPAs make using a BVM less hard.

14) Master the physical assessment. Nobody in the field of medicine should be able to hold a candlestick to your physical assessment skills.

15) Keep your head about you. If you fail at that, you’ll likely fail at everything else.

16) There is a huge difference between not knowing and not caring. Care about the things you don’t yet know.

17) Train like someone’s life depends on it.

18) Drive like nobody’s life depends on it.

19) Pet the dog. (Even when you’re wearing gloves.)

20) Have someone to talk to when the world crashes down.

21) Let human tragedy enhance your appreciation for all that you have.

22) Check the oil.

23) Protect your back. It will quite possibly be the sole determining factor in the length of your career.

24) Say please and thank you even when it’s a matter of life or death.

25) Wipe your feet at the door.

26) When you see someone who is really good at a particular skill say, “Teach me how you do that.”

27) Nobody can give you your happiness or job satisfaction. It is yours and yours alone. And you have to choose it.

28) We can’t be prepared for everything.

29) We can be prepared for almost everything.

30) Check out your rig. It’s more meaningful that just confirming that everything is still there.

31) Tell your patients that it was a pleasure to meet them and an honor to be of service.

32) Mean it.

33) Keep a journal.

34) Make it HIPAA compliant.

35) Thank the police officer that hangs out on your scene for no good reason.

36) Recognize that he or she probably wasn’t hanging out for no good reason.

37) Interview for a job at least once every year, even if you don’t want the job.

38) Iron your uniform.

39) Maintain the illusion of control. Nobody needs to know that you weren’t prepared for what just happened.

40) Apologize when you make a mistake. Do it immediately.

41) Your patient is not named honey, babe, sweetie, darling, bud, pal, man or hey. Use your patient’s name when speaking to them. Sir and Ma’am are acceptable alternatives.

training rig by EMS Shane in Portland via Flickr42) Forgive yourself for your mistakes.

43) Forgive your coworkers for their quirks.

44) Exercise. Even when it isn’t convenient.

45) Sometimes it’s OK to eat the junk at the QuickyMart.

46) It’s not OK to always eat the junk at the QuickyMart.

47) Don’t take anything that a patient says in anger personally.

48) Don’t take anything that a patient says when they are drunk personally.

49) Don’t ever convince yourself that you can always tell the difference between a fake seizure and a real seizure.

50) Think about what you would do if this was your last shift working in EMS. Do that stuff.

51) Carry your weight.

52) Carry your patient.

53) If firefighters ever do #51 or # 52 for you, say thank you. (And mean it.)

54) Being punched, kicked, choked or spit on while on duty is no different than being punched, kicked, choked or spit on while you’re sitting in church or in a restaurant. Insist that law enforcement and your employer follow up with appropriate action.

55) Wave at little kids. Treat them like gold. They will remember you for a long time.

56) Hold the radio mike away from your mouth.

57) There is never any reason to yell on the radio….ever.

58) When a patient says, “I feel like I’m going to die.” believe them.

59) Very sick people rarely care which hospital you’re driving toward.

60) Very sick people rarely pack a bag before you arrive.

61) Sometimes, very sick people pack a bag and demand a specific hospital. Don’t be caught off guard.

62) Bring yourself to work. There is something that you were meant to contribute to this profession. You’ll never be able to do that if you behave like a cog.

63) Clean the pram.

64) Clean your stethoscope.

65) Your patient’s are going to lie to you. Assume they are telling you the truth until you have strong evidence of the contrary.

66) Disregard #65 if it has anything to do with your personal safety. Trust nobody in this regard.

67) If it feels like a stupid thing to do, it probably is.moreofthedriver by Rob! via flickr

68) You are always on camera.

69) If you need save-the-baby type “hero moments” to sustain you emotionally as a caregiver you will likely become frustrated and eventually leave.

70) Emergency services was never about you.

71) The sooner you figure out #69 and #70, the sooner the rest of us can get on with our jobs.

72) People always remember how you made them feel.

73) People rarely sue individuals who made them feel safe, well cared for and respected.

74) You represent our profession and the internet has a long, long memory.

75) Don’t worry too much about whether or not people respect you.

76) Worry about being really good at what you do.

77) When you first meet a patient, come to their level, look them in the eyes and smile. Make it your habit.

78) Never lie about the vital signs. If the patients vital signs change dramatically from the back of the rig to the E.R. bed, you want everyone to believe you.

79) Calm down. It’s not your emergency.

80) Stand still. There is an enormous difference between dramatic but senseless action and correct action. Stop, think and then move with a purpose.

untitled by ben roffer via flickr81) Knowing when to leave a scene is a vital skill that you must constantly hone.

82) The fastest way to leave a scene should always be in your field of awareness.

83) Scene safety is not a five second consideration as you enter the scene. It takes constant vigilance.

84) Punitive medicine is never acceptable. Choose the right needle size based on the patients clinical needs.

85) Know what’s happening in your partner’s life. Ask them about it after you return from your days off.

86) If your partner has a wife and kids, know their names.

87) No matter how hard you think you worked for them, your knowledge and skills are not yours. They were gifted to you. The best way to say thank you is to give them away.

88) Learn from the bad calls. Then let them go.

89) When you’re lifting a patient and they try to reach out and grab something, say, “We’ve got you.”

90) Request the right of way.

91) Let your days off be your days off. Fight for balance.

92) Have a hobby that has nothing to do with emergency services.

93) Have a mentor who knows nothing about emergency services.

94) Wait until the call is over. Once the patient is safe at the hospital and you’re back on the road, there will be plenty of time to laugh until you can’t breathe.

95) Tell the good stories.

96) You never know when you might be running your last call. Cherish the small things.

97) You can never truly know the full extent of your influence.

98) If you’re going to tell your friends and acquaintances what you do for a living, you’ll need to embrace the idea that you’re always on duty.

99) Be willing to bend the rules to take good care of people. Don’t be afraid to defend the decisions you make on the patients behalf.

100) Service is at the heart of everything we do. The farther away from that concept you drift, the more you are likely to become lost.

101) There is no shame in wanting to make the world a better place.


  1. Great list. Much thought and exoerience went into it. There was one error, of sorts. In Baltimore the patient is often named “Hon” and noone thinks anything of hearing it. We all call each other Hon as a matter of cutural civic pride. Thank you for your time in making the effort to enculturate and develop the newbies in such a constructive and suppirtive manner.

  2. I have been in EMS for 40 years/Paramedic for 24-This is by far the BEST thing I have ever read-everyone in EMS:Newbie vs Seasoned veteran/Vollie or paid should read this list :-)

  3. I love this. Everyone should read this

  4. 102. Pay attention to sweaty people

  5. Rule #1 – People are going to die, Rule #2 – There’s no changing Rule #1

  6. Matthew K. Copeland says:

    I do believe this might be the single best piece I have ever readin my 31 years of being in the fire/Ems service. I do believe we should be humble to the public and to people, until such time we have to be stern. I have seen so many people come and go , and most of them had no real idea what this job was and is all about. The entertainment world has this career, and that what it is a career, made up of being all glitz and glamour. I will tell you this, you never find another field that is so demanding,trying , nerve racking, or rewarding than being in public service. You will find that we are all a famy and we are also very demanding our own to perform like no others. I have been a Paramedic for 16 years and a FF for 31 years and would not do anything else. God bless to my brethren and to those are to come and take my place and may they carry on the tradition we have left them.

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  8. Mark Johnson says:

    This is an Exelent blog. I have learned more inn the 15 minutes it took to read this than I have in my 33 yrs, as an EMT, The things you wrote are very interesting and very well said, As I said I learned allot. I agree with some of the other people. This should be a must read for all EMS providers . Thank You for publishing this and allowing me to read it. It was extremely well written.

  9. Wow, this list is a goldmine. Thank you for taking the time to put it together.

    and, if i may

    102. If an infant isn’t crying you need to be scared shitless.
    103. It’s not always codes and traumas. The elderly patient lying on your gurney during a facility transfer could be just as scared as someone with a GSW. Be their hero as well.
    104. Check your 02 bottles even if they’re marked full. Check your backboards for working straps.
    105. Always protect your patients privacy aka cover them if their clothes have been cut away.
    106, Don’t curse in public. leave that shit back at your station.
    107. Learn from the mistakes of other EMTs. it beats having to learn from making them yourself.
    108. Your attitude will ultimately determine how far you go in this profession.
    109. If you’re new and nervous don’t be afraid to jump in there next to the medics and do something. EMS is a team, and you’re now a part of it.

  10. Great advice! I am a new medic and I’m very nervous about going to work and using my skills. Everyone keeps telling me not to worry too much and remember to do BLS before ALS. I hope that these tips will help me to be a great paramedic at some point in the future. Until then I’ll fake it till I make it.

  11. This was awesome to read. My daughter will soon be an EMT and I know she will succeed and do very well in this type of field. She is a determined young lady who is moving forward to her field of the career she has chosen and now she will soon be part of the EMS team and she is so proud of her wonderful teacher who has taught her how to do all these 101 things of great advice. You go girl and remember God is always right beside you every minute of every day.

  12. Justin Berry says:

    Great job! Well thought out and written. The points that needed to be made, were made. We all even those of us who are seasoned can learn something from this. Thank you for sharing

  13. Virginia Vazquez says:

    I like #103..about the senior on the gurney…all the bells and whistles can be alot for them…o and KEEP YOUR PATIENTS COVERED!!! As a Nurse Aid I give baths everyday and the most important thing to people young and old is their dignity. It shows respect immediately, and some day it may be YOUR TURN!!

  14. Juan Rivera says:

    Hello, my name is Juan. I’ve served in the Military for 4 years as a combat medic. I’m in the process of paying and attending BLS courses with a local hospital here in NJ. I have been so excited to start the training already that I was looking into gear and other people’s insight on the job, not paying attention that the training starts in June and it’s only March. :) But I never got an insight on how they really felt, how the job changed and taught them as a citizen going to save people they never met. You see, I knew 90% of the people I saved, granted it is hard to let go and sometimes you know that you wont see someone you care about or seen an hour ago in perfect health, but the sense that a random stranger opened up their heart and health to you and says (metaphorically) “I need you, not anyone else but you right now.” Times an moments like that must make those bad, depressing, sad moments just vanish. In wartime you get into firefights, you detain people, but a lucky few gets to witness the sight of a group of kids playing soccer with a half deflated ball and rocks as a goal marker. The sense of peace and purity in such a sight took me home and your list brought that sight back into my heart. I thank you for your posts and hope to be responding to the next call easing the stress on you guys.

  15. 102: pain has never killed anyone.

  16. Excellent list! Thanks for sharing.

  17. Thanks very much for taking the time to devise and post these enduring, critical principles. I find myself revisiting this page as a source of inspiration and guidance.

  18. I have been in EMS for over 30 years and teaching full-time the last 12. This is one of the best basic lists for EMTs I have seen. Nicely done, and thanks for sharing…I’ll be sharing it with all my students!

  19. Great stuff Tim has a thousand words of wisdom. Keep practicing them, works for me.
    Like Eric’s rules
    Rule #1 – People are going to die, Rule #2 – There’s no changing Rule #1
    See the live human study hyperlinked under my name. EMS has been dealing with these needlessly damaged patients for the past four years.

    67) If it feels like a stupid thing to do, it probably is.
    84) Punitive medicine is never acceptable.
    97) You can never truly know the full extent of your influence
    100) Service is at the heart of everything we do. The farther away from that concept you drift, the more you are likely to become lost.
    101) There is no shame in wanting to make the world a better place.

    “The world is a dangerous place not because of those that do evil. But because of those that look on and say nothing” Albert Einstein

  20. 1) don’t tell your patient everything will be alright.

    In personal experience I have been told this and my loved one died under there care. Sometimes everything won’t be alright.

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  24. “Drive like nobody’s life depends on it.”

    Uhh, what?

  25. I am new to EMS and found this to be very helpful. I can’t tell you how nervously I am approaching a new career. This post really put a light on many fears and questions. Thank you for sharing it with us.

  26. #102- kids bounce
    #103- a crying kid is a good thing
    #104- the blue kid will get you in trouble every time

  27. Working paramedic for 10_years in a high stress, high burnout, high volume area and I have to say, this list made me cry and affirmed positive thoughts. Thank you.

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