Overheard in the station after returning from a call:
Sean: “You guys ever been to Europe?”
Other Crew: “Ummm….No. Why?”
Sean: “Cause…..Yer’ Up”
Determining what crew is up for call can be a very simple or complicated process. In my years in EMS, I have seen call rotation rules that were extremely straight-forward and simple and some that rivaled the federal tax code in complexity. Anybody that has experienced station life with more than one ambulance on-duty knows exactly what I’m talking about.
For the most part, the call rotation rules I have seen were made in-house by the crews assigned to the shifts / stations. As long as the calls were made within the allotted time, nobody in management cared. Likewise, the crews involved knew that it was in their best interest that management not care or get involved. Most people have the understanding that once management gets involved, rules get made that nobody likes.
A wise man once told me that “sometimes you eat the bear, and sometimes the bear eats you”. This is especially true in EMS and I’m a firm believer that no set of rules can change that. I always get a laugh out of crews that come up with complicated call rotations in an attempt to make things “fair”. For example, here is a set of rules I had to follow at one point in time:
You are up for call until you:
- Transport a patient to the hospital.
- Run 2 dry-runs.
- Make it past a specific location (railroad tracks, intersection, road marker, etc)
- Fly a patient out.
- Complete 2 post moves.
Not to mention that being “first up” was contingent on whether or not it was an even or odd day.
I’m fairly certain there were more rules, I just can’t think of them all. Below is what I go by now:
You are up for call until you:
- Turn the wheels on your ambulance.
Personally, I prefer the simpler of the 2. Sure, sometimes you kinda get screwed, but it’s consistent. If the crews watch each other’s back and aren’t asses about the rotation, it can be a really fair system. For example, if my counterparts have been running like crazy, and I have had nothing but dry runs or canceled calls, I’ll volunteer to take 1 or 2 to allow them to eat, do paperwork, etc. Even we choose to take the completely selfish route, it still evens out in the end.
I’m curious to here other stories about call rotations. What are some crazy rules that you have had to follow?

As more details have come out regarding the “nurse” who refused to perform CPR on a resident at an independent living center, so have the mixed opinions on how the situation should have been handled. I wasn’t all that surprised to see a large amount of people – healthcare professionals included – come out in support of the decision not to initiate CPR. The truth is, elderly people often do sustain serious injuries from CPR and rarely have positive outcomes, but is it really our job to make that end-of-life determination for the patient?
….and not the kind you are imagining.
Pain Management
I have said many times before that Google pretty much controls my life. Between search features, Google Voice, Gmail, Android, Google Reader, and Google Calendar, it’s pretty much safe to say that they are quite an asset in my life. Forget Skynet, if any form of software is going to take over the world, it will be Google.
When I use this format, I fill in all of the pertinent information prior to making my call-in. Any information that I don’t plan to pass along over the radio is skipped over. For example; A patient complaining of chest pain would most likely require every field to be completed while a complaint of general weakness would not require the OPQRST.