Murphy's Laws of Emergency Medicine
The First Law of EMS
All emergency calls will wait until you begin to eat, without regard to the time.
Corollary 1: Fewer accidents would occur if EMS personnel would never eat.
Corollary 2: Always order food "to go".
The Law of Time:
1. There is absolutely no relationship between the time at which you are supposed to get off shift and the time at which you will get off shift.
2. Given the following equation: T + 1 Minute = Relief Time, "T" will always be the time of the last call of your shift. E.g., If you are supposed to get off shift at 08:00, your last run will come in at 07:59. (Or if you have early relief coming in you will see you relief sitting at the first stop light from the
The Law of Gravity:
Any instrument, when dropped, will always come to rest in the least accessible place possible.
The Law of Time Versus Distance:
The distance of the call from the Hospital increases as the time to shift change decreases.
Corollary 1: The shortest distance between the station and the scene is under construction.
The Rule of Random Syncronicity:
Emergency calls will randomly come in all at once.
The Law of Respiratory Arrest:
All patients who are vomiting and must be intubated will have just completed a large meal of Barbecue and Onions, Garlic Pizza, and Pickled Herring, all of which was washed down with at least three cans of Beer.
The Basic Principle for Dispatchers:
Assume that all field personnel are idiots until their actions prove your assumption.
The Basic Principle for Field Personnel:
Assume that all dispatchers are idiots until their actions prove your assumption.
The Axiom of Late Night Runs:
If you respond to any Motor Vehicle Accident call after Midnight and do not find a drunk on the scene, keep looking: somebody is still missing.
The Law of Options:
Any patient, when given the option of either going to Jail or going to the Hospital by a Police Officer,
will always be inside the Ambulance before you are.
Corollary 1: Any patient who chooses to go to Jail instead of the Hospital has probably been in my rig in the past.
The First Rule of Equipment:
Any piece of Life-saving Equipment will never malfunction or fail until: a)You need it to save a life, or b)The salesman leaves.
The First Law of Ambulance Operation:
No matter how fast you drive the Ambulance when responding to a call, it will never be fast enough, until you pass a Police Cruiser, at which point it will be entirely too fast. Unless you are responding to an"Officer Down" call then it is physically impossible to be travelling fast enough!
EMS Bathroom Rules:
General Principles Concerning Dispatchers:
- If a call is received between 0500 and 0700, the location of the call will always be in a Bathroom.
- If you have just gone to the Bathroom, no call will be received.
- If you have not just gone to the Bathroom, you will soon regret it.
- The probability of receiving a run increases proportionally to the time elapsed since last going to the Bathroom.
Given the opportunity, any Dispatcher will be only too happy to tell you where to go, regardless of whether or not (s)he actually knows where that may be.
Corollary 1: The existence or non-existence of any given location is of only minor importance to a Dispatcher
Corollary 2: Any street designated as a Cross-street" by a Dispatcher probably isn't.
Corollary 3: If a street name can be mispronounced, a Dispatcher will mispronounce it.
Corollary 4: If a street name cannot be mispronounced, a Dispatcher will mispronounce it anyway.
Corollary 5: A Dispatcher will always refer to a given location in the most obscure manner as possible. E.g., "Stumpy Brown's Cabbage Field" is now covered by a shopping center.
The Law of Triage:
In any accident, the degree of injury suffered by a patient is inversely proportional to the amount and volume of agonized screaming produced by that patient.
The Gross Injury Law:
Any injury, the sight of which makes you want to puke, should immediately be covered by 4x4's and Kerlix.
The Supervisor Equation:
Given the equation: X +Y = Q
Q = Quality of Care
X = the care that you render
Y = the assistance supplied by any Supervisor.
If you can eliminate Y from the equation, the Quality of Care will improve by X².
Corollary 1: Generally, Field Supervisors have no business in the Field.
Corollary 2: The level of technical competence is inversely proportional to the level of management.
Corollary 3: Technology is dominated by those who manage what they do not understand.
The Law of Protocol Language:
The simplest Protocol Directive will be worded in the most obscure and complicated manner possible. Speeds, for example, will be expressed as "Furlongs per Fortnight" and flow rates as "Hogsheads per Hour".
Corollary 1: If you don't understand it, it must be intuitively obvious.
Corollary 2: If you can understand it, you probably don't.
The Law of EMS Educators:
Those who can't do, teach.
The Law of EMS Evaluators:
Those who can't do or teach, evaluate.
The Law of Light:
As the seriousness of any given injury increases, the availability of light to examine that injury decreases.
The Law of Space:
The amount of space which is needed to work on a patient varies inversely with the amount of space which is available to work on that patient.
The number of distraught and uncooperative relatives surrounding any given patient varies exponentially with the seriousness of the patient's illness or injury.
The Theory of Weight:
The weight of the patient that you are about to transport increases exponentially by the number of floors which must be ascended to reach the patient and the number of floors which must be descended while carrying the patient.
Corollary 1: Very heavy patients tend to gravitate toward locations which are furthest from mean sea level.
Corollary 2: If the patient is heavy, the elevator is broken, and the lights in the stairwell are out.
The Laws of Non-Transport:
The First Rule of Bystanders
- A Life-or-Death situation will immediately be created by driving away from the home of patient who has just thrown you out of their house.
- The seriousness of this situation will increase as the date of your trial approaches.
- By the time your ex-patient reaches the witness stand, the Jury will wonder how patient in such terrible condition could have possibly walked to the door and greeted you with a large suitcase in each hand.
Any bystander who offers you help will give you none.
The Second Rule of Bystanders:
Always assume that any Physician found at the scene of an emergency is a Gynecologist, until proven otherwise. (Unless the emergency is obstetrical in nature, then the bystander will be a Dermatologist.)
The Rule of Warning Devices
Any Ambulance, whether it is responding to a call or traveling to a Hospital, with Lights and Siren, will be totally ignored by all motorists, pedestrians, and dogs which may be found in or near the roads along its route.
Corollary 1: Ambulance Sirens can cause acute and total, but transient, deafness.
Corollary 2: Ambulance Lights can cause acute and total, but transient, blindness. note: This Rule does not apply in California, where all pedestrians and motorists are apparently oblivious to any and all traffic laws.
The Law of Show and Tell
A virtually infinite number of wide-eyed and inquisitive school-aged children can climb into the back of any Ambulance, and, given the opportunity, invariably will.
Corollary 1: No emergency run will come in until they are all inside the Ambulance and playing with the equipment.
Corollary 2: It will take at least four times as long to get them all out as it took to get them in.
Corollary 3: A vital piece of equipment will be missing.
The Rule of Rookies
The true value of any Rookie, when expressed numerically, will always be a negative number. The value of this number may be found by simply having the rookie grade his or her ability on a scale from 1 to 10.
Medical skill: 1 = Certified Health Hazard, 10 =Johnny and Roy.
Driving ability: 1 = Obstruction to Navigation, 10 = Mario Andretti.
The true value of the rookie is then found by simply negating the Rookie's self-assigned value. Corollary 1: Treat any Rookie assigned to your Unit as you would a Bystander. (See The First Rule of Bystanders, above.)
Corollary 2: We were all rookies once upon a time....
The Law of Rules:
As soon as an EMS Rule is accepted as absolute, an exception to that Rule will immediately occur.