Two calls on ridealong tonight, both from a local 'urgent care' facility to the regional hospital. The first was a transport of a post-ictal patient. Poor patient was pretty freaked out and very twitchy. The second one was for transport of a patient complaining of 'chest tightness'. The urgent care facility stated that no paramedic was needed, so the crew I was riding with (we had just picked up dinner) consisted of three EMT-Basics (if you count myself). We got to the facility and found that the physician's assistant who had made the call wanted us to run cardiac monitoring but did not realize that monitoring was advanced life support, requiring a paramedic. We picked up the patient (who was a little grey and not too happy) and drove back to to the depot (which happened to be on the way, so no paramedic intercept, per se, was required). We took some vitals and started oxygen on the way back. The EMT-B doing patient care got out and the medic got in. The patient transport was uneventful in that the patient did not get worse and in fact got a little better with the paramedic's interventions. The medic hooked up the monitor (the urgent care facility had conveniently left the sticky lead patches on, so the medic simply plugged the patient into his monitor) and took some vitals, then administered nitroglycerine and two baby aspirin. While the nitro was taking effect, the medic started an IV. I was quite amazed to see the medic brace himself against the motion of the ambulance on the floor between the cot and the bench seat and put the needle in the vein on the first attempt (I'm proud to say I was able to watch the entire procedure). After the medic got the line in he took four tubes of blood so that they could be sent to the lab immediately on arrival at the emergency department and started a drip feed of some solution. Two more doses of sublingual nitro and an application of transdermal nitro and we were there. We got a call from the squad dispatch while we were at the ED about a motor vehicle accident on the highway that the other unit was enroute to so we rushed back down in case the medic was needed. By the time we got there the patients had been assesed as minor injuries so we headed back to the depot.