This session looks at moral injury in EMS and emergency medicine as it shows up on shift after repeated high-acuity calls where resources are limited, outcomes are difficult, and providers are sometimes left carrying the weight of what they could not change. It defines moral injury and clarifies how it differs from, while often co-occurring with, burnout, secondary traumatic stress, and posttraumatic stress. The presentation focuses on repeated exposure to difficult, resource-limited EMS and emergency department situations in which time-sensitive decisions may limit the ability to deliver the level of care providers were trained for. It also includes situations where outcomes do not match the effort or intent behind the care provided. Over time, these experiences build on each other and can lead to persistent stress that affects how providers think, respond on shift, and make sense of what they have experienced both during and after calls. The session will review practical, trauma-informed strategies for recognizing and addressing moral injury in clinical and peer support contexts, including the role of peer support in early recognition and response. Participants will learn to recognize common indicators of moral injury in EMS and emergency department clinicians, including changes in engagement, increased emotional distress, withdrawal, and shifts in meaning-making related to clinical work. Trauma-informed strategies for recognition and support will be discussed, with emphasis on practical application in EMS, peer support, and emergency care settings. A practicing emergency department nurse will co-present and provide firsthand clinical perspective to help translate these concepts into day-to-day practice.