Paramedics take highly complex and often rapid decisions under the most challenging of circumstances. Often the outcome for the patient and the required co-operation from all EMS responders in developing a short-term patient care plan will hang on the first decisions and initial communications. This book explores the complex and unpredictable world of pre-hospital care decision-making and invites the reader engage in the dilemmas presented. These often involve life-threatening situations. The author writes in an interesting way to probe and challenge the reader’s thoughts and decision-making. He has a very wide and varied experience base, gained from more than 22 years of emergency care work. The situations described are based on real-life experiences and reflect the author’s clear ability to analyse, reflect and learn from both the successful and not-so-successful communications and actions. All established, new and aspiring ambulance paramedics and EMT’s should read this book.