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When an EMT or Paramedic arrives on scene of a call and the first [impression] of the patient is called the Pucker Factor. The Pucker can be visual as well as nasal. A person who has taken a dump in their pants can lead to a pucker factor, not only of the butt hole but of the nasal passages as well, depending upon whether the EMT or Paramedic is a green rookie or a seasoned veteran. [The higher] the pucker factor of the EMS providers on scene, the more urgent the need for rapid and [immediate] transport to a hospital. A partial amputation would have a pucker factor of a 5 or 6 whereas a complete amputation would have a pucker factor of a 7 or an 8.
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