EMT Help ReDoux

[CadetProgramGuy]

OK fellas.  Play nice this time.

[Dustdevil]

To those looking for serious and informative discussion, I would recommend that you seek out a dedicated EMS or EMT online forum to check out.  That is where most of your seasoned professionals hang out, including many CAPers.  You will get a lot more input from a lot more people with much more varied experience.  Unfortunately, there is a bias here at this forum that will prevent you from getting an intelligent discussion of the issue.  I'd also be happy to help out anybody by PM or e-mail, or to steer you towards some resources to help you find what you are looking for.  I've been at this for nearly thirty-five years, in every possible EMS setting, and I'm here to help, not to debate.

[CadetProgramGuy]

Actually I want this to be a sersious / fun discussion of all EMS stories and where I can ask quesitons as they arrive.

BTW.....Many of you have offered help through PM's or email. Thanks, I will be asking when it gets bad......

JM

[Hoser]

In following the previous EMT School thread, one thing is clear to me, (and I base this on 30 years as a Paramedic who worked in the private sector and Fire Service and started as a Corpsman in the Coast Guard assigned to an Air Station) everybody who posted there has a valid point. A good case can be made for everyone's position which really means everyone is right. Why is this? Because in EMS there is only one "engraved in stone" rule and that is there are NO engraved in stone rules due to the nature of the prehospital arena. EMS is one of the most fluid and dynamic environments that one can work in. To be successful requires one to have superior analytical skills, superior people skills, both in dealing with people and in reading people and situations, which in my opinion is the most important skill. Those abilities will keep you alive. Pt. management skills are the nuts and bolts of EMS and how one arrives at learning, developing, staying proficient at and improving those skills is of little consequence to me.  I don't care one whit if you were a basic for two years prior to becoming a medic or if you hit the streets straight out of medic school and never worked a minute as an EMT. I have seen both cases where the care given was superb and I have seen cases where I wouldn't let either work on Saddam Hussein.  The bottom line here is what's best for the patient. How one arrives there is not relevant. Prehospital folks are generally strong personalities and very opinionated, that's not a poke at anyone, just an observation, albeit an experiential one. I do not profess to have been the best medic that ever lived, nor was I the worst. I can say with certainty that I never killed anyone by an act of comission or omission, nor did I aggravate a pt's condition. I have made mistakes, but I never made the same mistake twice. I also will say that I don't know everything and when one feels they do, they are by definition  extremely dangerous. The advice I would give is this, pay attention in class, take lots of notes, listen to your instructor(s) they know the standard of care and protocols in your area. Practice your skills often, to be a good EMS type you need to be able to do these skills in your sleep, literally or in a drivng rain with 100 knot winds or all the above, literally. Ask questions, lots of them. Spend time in the medical library at the hospital. Ask lots of questions. If you screw up, and you will, don't take it as failure, take it as a learning tool. Ask the Doc what you could have or should have done instead.  Ask the Doc to give you medical/physiological/pathological answers. Ask them to show you, Docs love to teach, it feeds their ego and it will build some trust in you, which is priceless. Ask the ER Nurse about report documentation, he/she has probably done far more than you. Review constantly, pay attention in CEU classes, contribute to them when you can. Ask questions, lots of questions. When you get your license understand that like a private pilot's license it is a license to learn. You are at a point just like the newly minted pilot where you know just enough to be dangerous. That is not a poke that is how it is. You won't save everyone. Ask questions. Listen to the old salts tell their "no shee-it, there I was " stories. It is just like hangar flying. You will learn what is BS and what isn't. Ask questions. I retired after 30 years in EMS/Fire Service and I asked questions about patients/treatments/disease processes etc up to the last day I ran calls. Even though I no longer work in the field, I still read about medical stuff. Just don't get it in your head you know it all. Those that think they know it all don't.
Good luck in EMS


Hoser

[CadetProgramGuy]

Alrighty.....Update for you all on what is happening is class.....

Airway, Airway Management, Combitubes.....

Have a 93% overall, and an exam on Monday night.

We are having skills nights about once a week, honing up on Baseline vitals, long backboarding, ect.....

Next up is Trauma Assessments, Medical Assessments, and preparing for first round of Clinicals.  20 Hours total between 3 hospitals.

Also I applied at the Local FD, told them I was in class and they sound excited.  Apparently they run ALOT.

235 Calls in Dec alone, 2700 calls for 2007.

See ya!

[CadetProgramGuy]

93% on the airway test.

Missed 2 questions.  Read alot into them as well.  Thats my major flaw.....

"On arrivial to an accident, you find a 56 year old lying on the ground next to a fallen ladder.  What airway management tool do you use?"

A.  Jaw thrust using your fingers on the forhead and finders under the chin.
B.  Jaw thrust using your fingers on this cheek bone and lifting on the angle of the jaw.
C. Head thrust chin lift using  fingers on the forhead and finders under the chin.
D. Head thrust chin lift using your fingers on this cheek bone and lifting on the angle of the jaw.

I read exactly what was written, doesn't say anything about spinal injury, so I said D.  I was supposed to assume the spinal injury......Correct answer is B.

Oh well, if that is the worst I got wrong......I am doing ok.

Next up is Medical Assessments, Trauma Assessments.

[isuhawkeye]

If thats the worst you got wrong you just paralyzed a patient 

[flyerthom]

93% on the airway test.

Missed 2 questions.  Read alot into them as well.  Thats my major flaw.....

"On arrivial to an accident, you find a 56 year old lying on the ground next to a fallen ladder.  What airway management tool do you use?"

A.  Jaw thrust using your fingers on the forhead and finders under the chin.
B.  Jaw thrust using your fingers on this cheek bone and lifting on the angle of the jaw.
C. Head thrust chin lift using  fingers on the forhead and finders under the chin.
D. Head thrust chin lift using your fingers on this cheek bone and lifting on the angle of the jaw.

I read exactly what was written, doesn't say anything about spinal injury, so I said D.  I was supposed to assume the spinal injury......Correct answer is B.

Oh well, if that is the worst I got wrong......I am doing ok.

Next up is Medical Assessments, Trauma Assessments.

If you suspect a traumatic injury always assume there is a neck injury.

Like I recomended in the other thread get the book the 60 second EMT. One of the best assessment books out there. Another good book is:

Medic Life; Creating Sucess in EMS


As soon as you can after EMT-B take either Basic Trauma Life Support or Prehospital Trauma Life Support. There are arguments over which one is better. Take which ever one you get to first. It's like getting the instrument rating. It makes you a sharper pilot. I'll echo the ask the doc they do love to teach and even though I'm an old geezer at this I still ask and still learn.

Get a subscription:

JEMS   Sarmed1 and I worked for the Editor in chief years ago. Good man - good journal.

EMS


Keeps you up to date with the trends, techniques, gear and conferences.

[CadetProgramGuy]

Just took my class final.  92%, ending the class with a 92% overall.

Taking the State Practicals on Saturday!!

almost there.....

CPG

[Stonewall]

Dern, seems like this thread was started moons ago.  But I guess it's a full semester (16 week) class.

Congrats on final exam.  I remember the last time I took the written exam I thought I flunked it and got a 90% with barely studying.  But I guess taking a National or State EMT exam every 2 to 4 years since 1993 shows that repetition works.

Oh yeah, I remember last time I had to do practicals, I think back in 2001, and my "partner" almost got us a no-go because she didn't specifcy that it was a "load n' go".  Luckily, by chance, we got the patient packaged in under 10 minutes anyway.  I learned that even if you aren't the "lead" or "primary" EMT during the practical, you can talk and make suggestions.

[SARMedTech]

One word of experience/warning for your practicals:

If you are assigned a "team" to work with during practical scenarios, as I was, do not expect them to behave like a team. While you will have hard-chargers in there who are going to jump in and show what they have LEARNED you are also going to have those that stand around picking their nose because they know that in a lot of practical situations, if part of them team passes, they all pass. This is one thing I will not put up with. I saw it doing SAR in harsh climates, urban and rural EMS settings, etc. Anybody who isnt pulling his weight, even if its just holding c-spine, gets thrown under the bus in my book. You'll know who these folks are: they are the ones standing around holding the jump kit with a glazed look in their eyes

Lead, follow or get the [expletive of your choice] out of the way!---EMS Rule Number 1

[CadetProgramGuy]

From what I understand, we are on our own for the most part.

We will walk into the room, have another Basic level "Assistant" that you have to tell what to do, and how to do it.

You will have your patient, and the stone faced evaluator.

Thats my understanding anyways.

I report for practicals at 0745 tomorrow morning.

[flyerthom]

From what I understand, we are on our own for the most part.

We will walk into the room, have another Basic level "Assistant" that you have to tell what to do, and how to do it.

You will have your patient, and the stone faced evaluator.

Thats my understanding anyways.

I report for practicals at 0745 tomorrow morning.

Good luck we'll all be pulling for you. Last bit of advice.
1) Don't spend all night cramming and trying to teach yourself the whole book all over again. You know more than you think you do.
2) Get a good night's sleep. A rested head functions better than an over fatigued one.
3) No brewski's till after the test.
4) No patient who is in real need ever asked you what your test grade was! The guy who finished last in his class in med school is still called doctor.

[CadetProgramGuy]

First Round Passer!!!!

All is left is the NR Test.

[Slim]

First Round Passer!!!!

All is left is the NR Test.

May God have mer......oops, uh...Congratulations!

Of course, that may be a bit premature.

[flyerthom]

First Round Passer!!!!

All is left is the NR Test.

If that happens after the first round, beer may not be in your best interest...

Congratulations!

[CadetProgramGuy]

Well it's all over now......

I PASSED!!!!!!

CBT was only about 75 quesitons.

[Psicorp]

Congratulations!

Now just fill out a 2a for the shiny.

[Duke Dillio]

I smell blingage.....

Kinda stinks......

I need to go get some air now

Congrats on the EMT thing....  But why stop there.....  Go forth and become a paragod I mean paramedic.

[CadetProgramGuy]

I smell blingage.....

Kinda stinks......

I need to go get some air now

Congrats on the EMT thing....  But why stop there.....  Go forth and become a paragod I mean paramedic.

I will in time.  Going for the I in the fall, take a year off then the Paragod training