Due to the introduction of Smart Advanced Life Support in 2015, paramedics can provide Advanced Cardiovascular Life Support to patients with out-of-hospital cardiac arrest. Although studies have been conducted to confirm the effectiveness of Smart Advanced Life Support for patients with out-of-hospital cardiac arrest, there is a lack of exploration of the experiences that paramedics face in the field in a changed environment. In this paper, I report two cases experienced by paramedics when using Smart Advanced Life Support, including communication with uncooperative caregivers and the burden felt by paramedics. In addition, to promote Smart Advanced Life Support, I propose enhancing paramedic training, establishing communication guidelines with caregivers, expanding the promotion of Smart Advanced Life Support, and providing customized education for the elderly.