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Home » Everything AMBULANCE Got Wrong According to Real Paramedics

Everything AMBULANCE Got Wrong According to Real Paramedics

Scene from action movie Ambulance
License: Alamy

This isn’t a review of the new movie AMBULANCE. If you want that, go to RottenTomatoes. This is an account of what it’s like to watch AMBULANCE with 50 years-worth of firefighter/paramedic experience between all three of you.

First, the plot: Two adoptive brothers played by Jake Gyllenhaal and Yahya Abdul-Mateen II rob a bank in Los Angeles. The heist goes wrong—because of course it does—so they escape by hijacking an ambulance. In the ambulance is a wounded police officer and Cam, a hotshot paramedic. And now we get a two hour-long car chase movie where Cam works to save the cop’s life as the robbers hold her at gunpoint while the entire LAPD chases them around the city at 70 miles per hour.

So how accurate is this movie from an EMS viewpoint? Let’s find out.

Spoilers ahead, folks.

About that early car crash extrication scene.

SCOTT DUBAY (FIRE/PARAMEDIC):  We’re introduced to Cam responding to an auto accident where a child had been impaled. It was weird they responded on their portable radios instead of the nice onboard radio in the rig, but whatever.

Anyway, as the ambulance arrives on scene, we see several firemen walking around and cutting random things on the car. Clearly Incident Command has not yet been established, but who wants to see a well-run extrication? We want to see chaos.

Cam makes her way into the car. I will say, she does a great job showing empathy towards the girl during the extrication. That sounded like several conversations I’ve had over the course of my career. Upon arrival at the hospital, they are met by the ED staff in the parking lot like they are pharmaceutical reps bringing free food. Then like any good medic, Cam just lets them take her patient. Cot and all. I mean, who needs that thing anyway? You can’t go back into service without it. Or can you? Been there done that, but that’s a story for another day.

Then the most accurate depiction of emergency personnel ever filmed happens: She looks at her visibly shaken rookie partner and asks, “You hungry? I know a place with great enchiladas.” I think I can speak for all EMS personnel here: Who hasn’t been on the most gruesome call ever and all you can think about is food?

This is your reminder that ambulances cannot—and should not—be driven like race cars.

MATT UNGER (FIRE/PARAMEDIC): Your standard Type II ambulance weighs between four and five tons. That’s 10,000 pounds of steel careening through the city like Dominic Toretto was behind the wheel. Any of those hairpin turns would’ve tipped that heavy Band-Aid box right on its side.

RANDY JAMES (FIRE/PARAMEDIC): In my 25 years as a paramedic, I’ve never been assigned a rig that could drift through the turns as well as this one. Don’t ask me how I know that. I was also baffled by the durability of the thing. Even after driving through taco trucks and fruit pallets, there wasn’t so much as a single dent on the front bumper. I’m pretty sure driving just 7 miles per hour through an aluminum garage door would cause at least $7,600 worth of damage. Don’t ask me how I know that either.

It makes no sense that she didn’t realize the police officer had a second gunshot wound.

RANDY: I’m willing to forgive Cam for not exactly being on her paramedic A-game with a gun to her head. But that doesn’t explain why she didn’t do the basic assessment of Officer Zach’s injuries upon first inspection.

SCOTT: She does normal movie CPR, administers Epi as the correct first drug, and correctly delivers a shock on what appears to be a shockable rhythm and not asystole (that’s “flatline” for all you non healthcare providers). At that I was like “Ok, maybe this won’t be so bad after all.” Wrong! She notices the patient is bleeding from somewhere else but does nothing more to figure out where it is coming from. I mean, head to toe assessments are just optional, right?

MATT: The cop was shot twice. Cam doesn’t know that. That’s at least accurate. We don’t always know the extent of a person’s injuries the moment we reach them. But that’s why you check for DCAP-BTLS, now isn’t it? (Deformities, contusions, abrasions, penetrations or perforations, burns, tenderness, lacerations, and swelling.)

She treats the one obvious gunshot wound and then is confused why the patient is still bleeding. Maybe it’s because you didn’t remove a single article of clothing from your trauma patient! It’s like an hour later when she finally realizes there’s a second GSW in the guy. That was the most ridiculous part of the movie for me.

About that scene where she stops arterial bleeding with a hair clamp.

SCOTT: So, around the point where she finally realizes that Officer Zach is still bleeding because she only plugged up 50% of the holes in his body, she’s forced to do surgery on him in the rig. They can’t go to the hospital, so she calls a doctor she was dating so he and his golf buddy can walk her through opening the guy up via Zoom. I’m serious.

Anyway. Doctor Zoom tells her to be careful to not rupture his spleen. Guess what? His spleen ruptures. But Cam is out of clamps and begins to freak out. The Zoom call disconnects due to a dead battery—because of course it does—so Cam channels her inner MacGyver and uses her hair clip. Personally, I would have used a chip clip.

Side note, with any luck my PPO will cover this procedure in the event I ever need it. Although I’m sure I’d get charged a hefty price for that hair clip.

RANDY: The hair clip scene was interesting. We do carry a device called an iTClamp for hemorrhage control, used to pinch together large deep lacerations until surgical intervention can be performed. The problem with a hair clip is its lack of closing force. That clip would never have enough pressure to control any bleeding. I have managed several patients with arterial bleeding due and you need a lot of pressure to keep that hemorrhage under control.

MATT: That was the splenic artery in that scene, a major artery that feeds the stomach and pancreas. With every heartbeat, that artery would be ejecting blood. I think they could have used their fingers to get the initial bleed stopped then looked for McGill forceps and tied it shut with something. Maybe an IV tourniquet. If they wanted to look like rockstars, they could’ve grabbed the OB kit and grabbed the umbilical clamps.

Human bodies aren’t as resilient as Michael Bay thinks.

RANDY: Apparently people from California have a much higher tolerance to penetrating trauma to the abdomen than the rest of the world. EMTs and paramedics know that injuries like that fence post through the girl at the beginning would be devastating. Not to say that you can’t survive it, but the chances are slim. That area of our bodies houses multiple solid organs—the liver, spleen, kidneys, and pancreas. Otherwise known as “The Bleeders”. Don’t damage those if you can help it. It will ruin your day.

MATT: There’s a scene where a defibrillator is used as a literal weapon. The guy gets stunned. Truth is that the amount of electricity you’d be delivering into someone with a normal heart rate could send them into cardiac arrest.

SCOTT: In the commotion and the chaos, Cam simply states that Zach needs blood. So, because the movie needs a convenient plot device, one of the bank robbers says he is O positive. Cam then draws blood from him as he’s driving the ambulance at Mach 1 down the 405. And no, he doesn’t get a cookie or a juice box for his donation. I’m sure he’ll be fine.

Enjoy the ride. Just don’t think too hard about it.

SCOTT: I chuckled at the end when Cam just breaks HIPAA laws by looking at the charts of the little girl she saved at the beginning of the movie. She sits next to her in the ICU, holds her hand, the credits roll, and I’m left wondering why I didn’t go with the Sour Patch Kids at the concession stand.

MATT: At one point I thought I was watching a weird combination of DUKES OF HAZARD and an episode of GREY’S ANATOMY. But hey, at least I was entertained.  

RANDY: There are a ton of ways to pick this movie apart. But at the end of the day, I’ve watched way worse.

Just remember: Christopher Cross has the voice of an angel, never wear Birkenstocks to a bank robbery, and that ambulance totally would have run out of gas because the shift who drove it before you never leaves enough fuel.

Thanks to Scott, Matt, and Randy of Fire Dept Coffee for their opinions on this absolutely bonkers movie.

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