It seems to go without saying that EMTs need to remain calm when under pressure. In fact it is crucial for making good decisions and providing competent care. High-stress situations are part of the job, but learning strategies to stay composed can make all the difference. Here are some practical tips to help you maintain focus and perform effectively in emergencies:

1. It’s not “your” emergency

Remember, it is not “your emergency.” Emergency situations it is normal for somebody's "fight or flight" response to be triggered. In fact, this is what we see in our critical patients typically. However, the EMT must remember that it is not his or her emergency so in order to perform correctly EMTs need to remain calm. This allows them to think more clearly, obtain a better understanding of what is going on with the patient and the environment they are working in, and to provide better care.

2. Control Your Breathing

Slow, deep breathing helps calm your nervous system and reduces feelings of stress. When faced with stressful situations, pause for a moment to take a few deep breaths.

3. Set a deliberate pace and don’t let anyone rush you

If you have ever been in line at a fast food restaurant that was extremely busy perhaps you've noticed the activity behind the counter. Often times you see people moving very quickly and there is lots of activity but often times very little work actually getting done. This is because when people get rushed we get careless and the work we are performing becomes inefficient and this can certainly happen in EMS. The trick is to set a delivery at pace and don't get rushed. EMTs do not climb out of the ambulance and "run" towards the house or to the patient. You'll see them moving in a very deliberate pace but not rushing. This allows them time to think, to perceive what's going on around them, and to maintain control of their own emotions.  This allows them to have a clear mind and to perform their job well.

4. Rely on Your Training

I often teach my students that "the best stress reliever is knowing what to do.” This is where excellent training and dedication comes in. If you are in an emergency situation and don’t know what to do, stress is amplified immensely. It will make you frantic!!!  However, when you can fall back on your training and practice you will perform MUCH more calmly because you can rely on your “muscle memory.”  Passing the EMT course is only the beginning. The best EMTs routinely practice their skills, perform drills, and when combined with getting a lot of experience EMTs are able to be calm in otherwise chaotic situations.

5. Break Tasks into Smaller Steps

There is an old expression “the way to eat an elephant is one bite at a time!” The idea is of course, if there is a lot of work in front of you just break it down into manageable pieces. In EMS we break things down in this way, oftentimes using mnemonics to help remember the steps. For example: ABC’s stand for “airway, breathing, and circulation.” Or “BSI” which means “body substance isolation.” There are many other such mnemonics used to help us remember the various tasks we need to perform. Knowing the many mnemonics provides a “life-line” when the tasks ahead seem a bit overwhelming.

6. Communicate Clearly and Effectively

Stress can make accurate communication extremely difficult. Speak in a calm, direct tone, don’t shout on the radio, and ensure that your team and the patient understand your instructions. Miscommunication leads to errors, so clarity is key.

7. Stay Physically Fit

Physical fitness helps your body handle stress more effectively. Regular exercise boosts endorphins and reduces anxiety, keeping you ready for high-pressure moments. Getting good sleep and eating a proper diet are vital as well. 

8. Debrief After Every Incident

After each call EMTs should “debrief” one another on how the call went. One of the goals is to learn from each incident so when you get a call like that again you can do an even better job. It’s like watching “game films” after the game. You want to consider how you performed and figure out how you can perform better next time. This should happen after every call.  In particularly stressful calls, discussing the incident with your team helps you process what happened and do a better job of dealing with it.

Final Thoughts

Stress is a part of pretty much every job and it is certainly part of working as an EMT, but these strategies can help you stay calm and effective in even the most challenging circumstances.