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  • Writer's pictureRachelle Zemlok, PsyD


Updated: Mar 4, 2020

When family members and friends talk to me about my husband’s work, they are always so concerned about his safety at fires and want to know what it is like for me dealing with that type of worry. They are always surprised when I say that he is often responding to medical calls more than anything else (in their defense the news does not accurately portray this). It was found in 2011 that two-thirds of fire department responses were medical aid calls and only 5% were calls to actual fires.

Medical calls can sound less risky and dangerous, but they bring on a different kind of stress. First responders need to worry about not getting sick from patients. They may be responding to patients with preexisting diseases or infections that the first responder may or may not know about. They may be directly coughed or sneezed on by a sick patient before they are able to get a protective mask on. They are constantly dealing with the products of humans that many of us get nauseated from, including blood, urine, feces, and, of course, vomit. These fluids may get on them, their equipment, their cars, and may be spread all over the scene of a call. They may also respond to very unhygienic scenes, such as the home of someone who hoards. In order to do their job effectively, first responders have to subdue the natural human response to such sights and smells. Any of these scenes or difficult calls, in general, can happen at any time of day (ex. In the middle of a perfectly good meal or interrupting a facetime call with their kids).

First responders are also the first ones to respond to horrific scenes that many of us would have a difficult time even seeing in a movie, such as fatal car accidents, individuals that have been dead for days or weeks and are just being found, suicide scenes, child deaths, and other freak accidents. They may see bodies mangled, deformed, and even in pieces at times. They are the first there to provide CPR on ederly, children, and others. They also witness family members and friends of victims in hysterics while they assess, make decisions, and attempt to provide medical services. Each of these scenes has the potential to leave a lasting image in their minds- images that they would rather not have. Did you know that the center in our brain that controls smell is right next to the center in our brain that controls memory, making smells some of the greatest triggers of our memories? That can be hard when it’s a traumatic memory. Sights, sounds and places can also re-trigger negative memories of such scenes. Click here to read more about ongoing traumatic exposures.


It’s important to understand the additional pressures at work for your spouse if they are a paramedic or firefighter paramedic. Paramedics are often paid a higher rate than EMT’s and EMT firefighters. However, this is not without additional stresses, responsibility, and often times less sleep and time to accomplish required tasks.

On any given call, paramedics may be administering medications that can either harm or help patients. Paramedics may need to use medical tools to drill holes in patients or insert tubes into their throats to help them breathe. These procedures are performed outside of a hospital environment and often times with the patient’s family members hovering over them or crying hysterically in the background. When medical calls go well, it is often shared as a team effort. However, medics can often personalize failures. This is often the downside to being the final decision maker on a call. It doesn’t help that a common first question from peers who hear about a medical call that did not particularly go well is, “Who was the medic?”

After every call, paramedics have to write a very detailed note about what happened at the call. This creates the additional stress of having to support the reason behind every decision they made or did not make. Their note is a legal document, and they are trained to write the note in a way that would stand up in court if someone were to sue them. Talk about pressure! Not to mention the decisions they made and have to defend were made in the moment with very little information about the patient in the high emotional state of an emergency call. If a firefighter paramedic works at a busy station and ran numerous calls throughout the shift, he or she may be up late into the night writing notes, or getting off late in order to finish up. After a call in the middle of the night when everyone is headed back to sleep, the firefighter paramedic might be on the computer starting a note for the medical call just attended. It’s no wonder many firefighters choose to decline the pay raise in order to remain an EMT. Click here to read about helping your first responder resist the impacts.

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