One patient is short of breath, sweating and unable to move.
Another looks and sounds fine, but reports feeling weak.
Which one is having a heart attack?
Case studies such as these are regularly posted to an EMS blog started by Capt. Tom Bouthillet of the Town of Hilton Head Island Fire & Rescue Division. Readers from around the world attempt to answer the life-or-death questions in the comments.
Never miss a local story.
More important than the symptoms is the attached electrocardiogram, which provides 12 views of a patient's heart activity. The electrocardiogram readout that paramedics would see is how Bouthillet's blog got its name: "EMS 12-lead."
Bouthillet said he created the blog to educate fellow emergency responders about recognizing heart attacks and cardiac arrests in the field. Both are time-sensitive emergencies that are tricky to diagnose and might require rerouting the patient if the nearest hospital can't perform the necessary treatment.
"This is the major issue of our time," he said. It's also the reason he's part of what he calls the "EMS 2.0 movement."
A blogosphere of firefighters, paramedics and other emergency responders is growing, and personnel from Hilton Head Fire & Rescue are contributing their fair share. Besides Bouthillet's blog, Battalion Chief Mick Mayers writes reflections on leadership issues called "Firehouse Zen."
Both blogs were nominated for awards sponsored by fire and EMS websites and the American Military University last month. Bouthillet's blog won the Judge's Choice for EMS blog of the year, while Mayers' blog was among the top 10 in popular vote.
"Certainly, Hilton Head seems a hotbed for bloggers -- and high-caliber ones, too," said Kris Kaull, a paramedic and marketing director for www.EMS1.com and www.FireRescue1.com, which sponsored the blog awards. The division's chief of training, Ben Waller, also writes one, Kaull noted.
"It's hard to pinpoint a specific reason for this trend, but it definitely reflects well on the department to have such folks engaging responders across the country in this way."
The opportunity for networking is what got Mayers interesting in blogging. Several years after his inaugural post, he has thousands of page views and friends on the corresponding Facebook page.
"I wanted people to expand their horizons," Mayers said. "Tom and I try to stay on the positive side of things. We're not news blogs, and we don't use them to rant. We talk about best practices and trying to do things the right way, and I think it translates pretty well to our progress-minded department."
"Firehouse Zen" has also given Mayers a platform for teaching, without having to leave his family to travel for speaking engagements. Those invitations have multiplied because of his online presence, he said.
Bouthillet's blog also has spawned ways to continue his advocacy for better cardiac care. Two former commenters now help him run "EMS 12-Lead," while he writes columns and posts for other national websites. His latest effort is a Web series called "Code STEMI," which is the code paramedics radio to the hospital for a heart attack patient. In just a few episodes, he has traveled from Sioux Falls, S.D., to Orlando to interview experts.
How does he manage it in addition to his day job?
"I'm so interested in these issues and have so much fun that it doesn't feel like extra work," Bouthillet said.
Follow reporter Allison Stice at twitter.com/LCBlotter.