Thursday, March 10, 2011

What An EMT Student Should Expect On Third Rides

Online EMT and Paramedic Practice Exams

I remember how nervous I was when the time approached to take my 3rd rides. I was excited of course, but I was also worried. I was worried about what to expect and what was expected of me. We'll talk first about what will be expected of you.

The crews you'll be riding with will expect you to be nervous. Some of them will be understanding. Some of them will push you a little to help you overcome your fear. The first thing you need to remember is that you're not alone and it's not all up to you. The crew training you will be there, so will the fire dept, PD, etc. With that in mind, get involved.

The crews will expect you to get involved and not just stand there with your hands in your pockets. To know what is expected of you on scene, you need to think about your roll as an EMT. If you are on an ALS truck that day, you will be expected to do the physical parts of patient assessment.

If you want to make a good impression, go ahead and start to take vitals on scene. Don't wait to be asked. It's one of the first things you'll do on scene when you start working as an EMT. While you're taking vitals, listen to your paramedic as they conduct the patient interview. If the patient is complaining of chest pain or difficulty breathing, go ahead and start hooking them up to the monitor so the medic can run an EKG. Here is a video that teaches proper 12 lead placement. This video doesn't go in to extremity lead placement, but most of you will know that. Just click on the following link to watch the video.

If you want the easiest way to know what your preceptor expects from you, simply ask them at the beginning of the shift. I promise they will let you know. You will get much better comments on your day sheets.

Be eager to help. Offer to carry the jump bag. Ask to try anything you haven't done before. This is a great time to practice using the stretcher. There are a lot of different kinds out there, and some of them are difficult to use(because they are cheap). Most important... Don't forget to have fun! These will be some of the best and most memorable days of your lives!

Monday, January 3, 2011

Do's and Don'ts When Shopping for EMTs

Well, it’s a little over a week since Christmas. When you’re an EMT, paramedic, firefighter or cop, you probably received some gifts related to your profession. Some of these gifts are good, and some… not so good. I’m going to go ahead and write about this because my family doesn’t read this blog.

I received two EMT t-shirts. I will have to wear them at some point, but I don’t really want to wear them in public. I will tell you flat out… I’m a nerd… I’m a dork… But I can’t wear a shirt with a picture of an ambulance that says “Big Toys For Big Boys.” Mom meant well, but it’s too dorky even for me. I will just wear it under my uniform shirt where no one will ever see it.

It occurs to me that EMTs and paramedics are as hard to shop for as anyone else. So I’m going to take a minute to give you:

Do’s and Don’ts When Shopping for an EMT or Paramedic

Here is a perfect example of a gift most EMT's wouldn't want. I know a few EMTs with an attitude, and I know they would want this...

If you do know an EMT who would wear this, do him or her a favor. Don't buy it.

Here's another item most of us wouldn't want:

Here's a shirt I really wouldn't want to receive

No here are the types of things we do like. Great gifts for EMTs and paramedics are things we can acually use. We like simple clothes we can wear to work or out and about. We would prefer that these items not provide any reason for our coworkers to make fun of us.

Here is a simple crew shirt most of us would wear to work.

Cold weather gear is always a great gift for an EMT or paramedic.

I got this hat for Christmas, and I've already put it to good use. It looks good and goes with any dept. uniform.

If the EMT or paramedic you love works for a dept. that doesn't provide rain gear, this would be a great buy.

Here is a watch that would be a great gift for an EMT or paramedic.

In short, a great gift for an EMT or paramedic is a gift that has the star of life on it, and doesn't contain a goofy slogan.

Winter Weather on the Ambulance and in the ER

Are you considering a career as an EMT? Here's another thing to think about. If you're an EMT, you will be exposed to the elements. If you don't like to be hot, cold wet, sweaty or any combination of those, a career in EMS may not be for you.

Winter weather is your enemy on the ambulance and the ER. People in my neck of the woods are known for not knowing how to drive in the rain. They lose their mind with any type of frozen precipitation. I live and work in the Southeast where most of the cities are not well prepared for ice and snow.

When there is a forecast for ice or snow, the first thing that happens is a mad rush to the stores. Insane people clear the shelves of bread, peanut butter, milk and beer. You would think that would be a sign that people were going to stay home during the weather event. You would be wrong. People will leave the house even after the public officials have advised them to stay home.

Most of the people on the road will fall into two categories. The ones who drive to slow to have enough momentum to carry them up ice and snow, and the ones who don’t slow down at all. Both behaviors lead to slipping and sliding.

It snowed here. It snowed a lot. Definitely more snow than we are used to here. We responded to wreck after wreck. People don’t always have the best courtesy when it comes to yielding for an emergency vehicle.

I’m not bragging about my driving skills, but I am well trained. I have taken two emergency vehicle driving courses. That instruction has made me a much better driver in the ambulance and in my personal vehicle. Here’s a suggestion for the folks out there. In hazardous conditions, don’t drive faster than the ambulance and the fire engine.

Time after time we were passed while running emergency. We had to stop several times for witnessed accidents. We responded to several rollovers where no one was hurt, We responded to accidents that looked more minor but had some serious injuries. You never know what you’re going to find.

I worked the next day in the ER. The ER was already at red capacity at 7am. And the hits kept coming we had people on backboards everywhere. They were lining the halls. I spent the day working trauma. It continued to snow during my whole shift.

We also had a lot of slips and falls. Sorry to tell the truth, but older folks are particularly susceptible to these accidents. We had several who slipped going out to get the paper. Next time it snows or ices, please skip the paper and watch CNN.

Tuesday, November 23, 2010

What You'll Deal With As An EMT Or ER Tech

I’ve had a few strange days in the ER. You never know what to expect especially on the weekends. You can count on a few things. People who plug up the waiting rooms because they have a cough or cold. These are usually your biggest complainers.  These are the folks who will obstruct you with a complaint about how long they have to wait while you take a patient with chest pain to the back.

You can also count on the drug seekers. They come in with complaints of pain and demand medication. They are sweating, scratching, and having obvious DT’s. I had one of these patients walk in to a room where we were treating a patient having a seizure. This guy actually walked in to the room and got in the way so he could demand medication. He left the room in handcuffs.

We had an unexpected gunshot wound come in the front door while being chased by police. The patient had been shot in the back and had an evisceration at the exit wound in front. I felt bad for the children in the waiting room who had to see all of that.

Not long after, all the trauma bays were full of gun shot wounds.  There were several from the same incident and another from an unrelated incident. I saw a chest tube put in for the first time. It was amazing, but there was blood everywhere.

I had an interesting day on the ambulance as well. I’m still learning my way around my new town. I’m also learning to cope with the driving habits of the folks in my new town. We were approaching an intersection while driving emergency. I was in the oncoming traffic lane with a left turn lane to my right. We were making as much noise as we could with the siren, and still almost creamed a guy who tried to make a left turn in front of us.

When I was a rookie, driving emergency was a big thrill. I loved doing it. It has definitely lost its appeal. It’s really just dangerous. People don’t yield, and will use you as a way to run a red light. It’s unbelievable what we’ve become.  It’s hard to stay positive. Maybe I’m working too much.

Thursday, November 11, 2010

Veterans Day Thoughts

A quick note is not enough, but I want to take a monment to thank our veterans. Thank you for your sense of duty and sacrifice. Thank you for doing a job so many of us are not willing to do. Thank you for answering the call when our leaders send you in to danger. God bless you and keep you and your families safe. May our leaders be careful and wise when they need you. May we the people choose our leaders wisely and hold them accountable when they call on you.

For those of you serving, and those who served before you, you have our grattitude.

I also want to thank those who served as WACs and WAVs. The contribution of those strong dutiful ladies is so often forgotten. Thank you for your service. You were ahead of your time.

Wednesday, November 10, 2010

Graveyard Shift

Online EMT and Paramedic Practice Exams

After a few weeks of training on second shift, I'm back to my roots on the graveyard shift. I always have trouble switching from days to nights. After trying everything I could think of, I resorted to taping aluminum foil to the windows to make my East facing bedroom dark.

We had our first real cold snap this weekend. In my experience when it switches from warm to cold, things slow down. That was certainly the case this weekend. Volume was down and there was almost no wait time for the patients. The doctors picked up the pace and got patients in and out.

When I was on the ambulance, I frequently had to take patients to the ER who were not experiencing an emergency. People will call 911 because they have a cold, or the runs. Now that I'm working in the ER, I see how big a problem this is.

I know what some of you are thinking. I know about all the people in the US who don't have insurance or access to a physician. Our hospital has several free clinics, and people do use them, but there is a certain segment of society that uses the ambulance like a taxi and the ER like a pharmacy. They never pay, and they have no intention of paying. This is all part of the free ride they take.

I don't get angry at it, but I have to admit it bothers me. Emergency rooms are for emergencies. If you have a cold, go to the free clinic. That's what it is there for. They're open 17 hours a day. There are four locations. I was working triage the other day and had a patient come in just for a pregnancy test.

All in all I think the patients bill of rights is a good thing. The patients bill of rights makes it so we can not refuse care to someone who asks for it. I want people to get the help they need. But I realize that these occurances are one of the things that drive up the cost of health care.

Let me be clear. If you've been throwing up for days, you might need to come to the ER. If you have a high fever, you might need to come to the ER. If you've been coughing since this morning, you probably don't need to come.

Many drug stores have inexpensive clinics now. If you can't afford that, there are places that will see you for free. I'm not complaining about having to work, I just don't want to have to come to your room so you can ask for a free meal when I need to be putting on a 12 lead on a person who came in with difficulty breathing.

And if folks won't stop coming in, then perhaps they could be polite. We have to see the most serious patients first. Yelling at the greeter because you've been waiting for an hour (thats our average wait time for non emergency, and well above the national average) won't get you back any faster.

Thursday, November 4, 2010

More Life in the ER.

I’m still really excited about my job in the ER. I’m excited about going to work tomorrow. My last shift was an echo of the one before. My morning consisted of trauma and chest pain. My busiest moment was when two traumas and a STEMI (ST elevated myocardial infarction… all that to say a really serious heart attack) came in at the same time.

One of my patients was involved in an industrial accident. The patients hand became stuck in a machine and was degloved. Another EMT and myself cleaned her hand and helped to prepare her for surgery.

I’m still struggling to find my place here. I’m trying to be aggressive enough to do my job, but not be in the way. It’s probably not the delicate dance I perceive it to be, but I still feel a little out of place.

I think I need to get a little more of the ambulance out of my brain. I’m used to doing everything I can do in the bus, bringing the patient in to the ER, placing the patient in bed, and getting out of the way. Now I have to learn to undo a lot of what I would have done in the ambulance so the doctor can look at it. I also need to learn how to be in the mix of what’s going on and not be in the way.

I’m also experiencing some culture shock. People here are very friendly here. I’m southern, but I have been in the big city too long. I’m not as friendly and outgoing as I used to take pride in. I’m very politely being put in my place for not introducing myself, and for not saying hello.

I have one more day shift tomorrow, then I switch over to nights. I call it vampire work. Collecting blood in the middle of the night.

I hope you’re all doing well. I hope you and your loved ones are healthy and safe. I was very disturbed and saddened to learn that the meteorologist Matt from Storm Chasers died after a suicide attempt. That’s one of the few TV shows I watch. He seemed like a good person. What a shame. What a waste.