Things I’ve learned on the transfer truck

The transfer truck. Jack of all trades. Cath lab heroes, the vent squad. We burn a full tank of Diesel every shift. We run emergencies across 5 cities, transfers to and from every hospital in two counties, and backup for the other division. We see the sickest patients, sometimes more than once; and we have more chances to follow up on their outcomes.

Some days are heavy with 911 calls; others are mostly inter-facility work. All have their share of strangeness. It's a great place for a new medic to learn the trade or for an older one to stay sharp.

  • For every night you sleep, there is at least one when you don't.
  • Smoking and oxygen don't mix. Really. This is not just a PSA. It's not pretty and it is very painful.
  • Stacking calls doesn't work. Patient from A to B, patient from B to C, patient from C to A, etc. it looks good on paper, but something will inevitably go wrong. Someone will get sicker and be diverted to Point D, or the crew will stumble upon a car crash at Point E. Just don't do it; everyone will be happier.
  • No one likes the MRI trailer.
  • A patient can elope from a locked psych facility. Sometimes this means someone let them out to smoke and forgot about them. When they return, the facility will send them to a local ER for “evaluation” since they have been outside of their control. The police will come to watch you place the harmless depressed person on your stretcher, just in case.
  • Dinner is never when or what you expect it to be.
  • The EMS gods do believe in karma. They may not reward you for doing the right thing, but they will punish you if you don't.
  • An ALS transfer for IV fluids or antibiotics, isn't. By the time you get there, the infusion will be finished and the call will be BLS. The facility will insist you take it anyway. Just in case.
  • Sometimes doctors will surprise you. Occasionally this will be in a good way.
  • You can cram a lot of sleep into 3 hours.
  • The only thing worse than a given piece of broken equipment is the spare that replaces it.
  • The sickest patients will present with less than an hour left in your shift.
  • What may seem clinically obvious to you was not obvious to the crew that brought the patient in. The alternative to this belief is believing that the other crews are lazy and/or idiots. I prefer to think better of them.
  • There is a parking space at the local trauma center with your name on it. Mine is third from the left.
  • If you can't say something nice, punch out and go home. Or to the gym, or something.
  • Whatever it is, somebody has to do it. This usually falls to us.
  • With great power comes great responsibility. All dispatchers know this. Some appreciate it more than others.
  • Shut up and do your job
  • Don't make plans. Your shift may end on time for 51 weeks in a row, but if you book an early vacation flight on the 52nd week the proverbial bus load of hemophiliacs will hit the proverbial plate glass truck with 10 minutes left in your shift. Your relief will be stuck in the resulting traffic backup.
  • Smile, it can always be worse!