Tips for New EMT-Bs [Archive] - EMTLife.com - The #1 Online Forum for EMS-Related Discussion

AnthonyM83

10-11-2005, 09:30 PM

Hi everyone,

1st post.
I'm in the second have of EMT-Basic school in Santa Clara County, California. I was wondering what tips you experienced EMTs and Paramedics have for students or fresh out of school EMT-B's.

Areas to really concentrate studies on, things to do/not do to prevent annoying our partners, tips on clinical rotations in hospitals, real life skills not taught in the class? Or maybe just mistakes you made yourself!

Thanks,
Anthony

MedicPrincess

10-11-2005, 10:14 PM

Originally posted by AnthonyM83@Oct 11 2005, 08:30 PM
Or maybe just mistakes you made yourself!

Thanks,
Anthony
WHAT?!?! You think..WE...the creme de le creme would make a mistake?!?!?! Thats it...50 lashings with a wet spaghetti noodle for you!!

Oh and WELCOME!!!!!!!!!! We are glad your here.

Really though...mistakes...hmm...You mean like being so hyped up about your first really nasty trauma you leave the NRB attached to the main O2 tank in the ambulance when you arrive at the hospital, and as you wheel the Pt out they only get hung "a little" before you realize what happened. Or how about throwing a piece of equipment through the glass in the back of the unit. Or forgetting your in reverse and stepping on the gas. Or thinking your dealing with one patient and when you ask her if she has been doing any better since she jumped off the bridge, and hearing her reply "That wasn't me, that was my twin sister"....

Can anybody relate to any of these??

emtI

10-11-2005, 10:48 PM

Tips? Here's one. Take a couple deep breaths before you start talking on the radio to give your patient report, and talk slow. If you think you are talking too slow, it's usually just right.

I have heard a couple of our new EMT's giving pt reports so fast they sound like they are in a foreign language. If the ER can't understand your report, it takes twice as long if you have to repeat it.

Good luck with the rest of your class.

trauma1534

10-12-2005, 01:07 AM

Hello, and it is great that you have asked for advice. I am shift leader at my volunteer squad and I seem to get fresh new emts on my shift. I am also paid with two agencies and I see alot of fresh emts. If I may, here are a few tips.

1.) Always admit when you don't know something. When asked to take a set of vitals and you are unsure of your B/P reading, just say so... don't just make one up to try to impress your partner (they can read through it anyway!) Plus, I have been doing this for 11 years now, and sometimes I still don't hear a B/P perfectly... it never hurts when you are not sure to get a second opinion.

2.) ALWAYS remember, PATIENT FIRST! If someone on the scene offends you, or does something you don't agree with, DO NOT argue in front of the patient... save it until after the call and away from everyone else.

3.) Every chance you get, get in and get your hands dirty. Take that blood pressure, listen to those lungs, interview that patient. Learn to be agressive. Your partner will not let you screw up. They are there to help you, not intemidate you.

4.) The only stupid question is the one not asked. If you are not sure about something, or you are on a call and want to know more about the condition you are dealing with, if the AIC is not busy asking the patient questions, by all means, ask what you want, as long as it is appropriat in front of the patient.

5.) If any provider tries to intimidate you or put you down or blow you off because you are new, go to the next rank person over them. This is a time for you to learn, and not the time for that other BS. :angry:

6.) Help clean the truck after a call. Don't just twiddle your thumbs. :blink:

7.) When doing your ER rotation for class, find a nurse that is EMS friendly and learn all you can from her.

8.) Learn from your mistakes. :unsure:

9.) Good luck and most of all, relax! B)

ffemt8978

10-12-2005, 02:03 AM

First of all, welcome (both of you) to our own little corner of dysfunction.

There's been some good advice given, and I only have one thing to add....

REMEMBER WHO'S HAVING THE EMERGENCY!

Wingnut

10-12-2005, 05:13 AM

Anthony & Trauma,

:D :D :D Welcome! :D :D :D

Anthony, my tip: memorize all thats posted above (well, you don't have to memorize Princesses shpeel, but those thing do happen so take them in). You'll do just fine. Relaxing is the key and that will take a while to do.

MedicPrincess

10-12-2005, 05:57 AM

Originally posted by Wingnut@Oct 12 2005, 04:13 AM
(well, you don't have to memorize Princesses shpeel, but those thing do happen so take them in).
HEY!!!! Now your talking about me like I am Jon :D :P :D

Seriously Anthony...If you can remember what FFEMT said, you will go very far. It doesn't matter if it is the 3 a.m. toe pain for 6 weeks but tonights its worse call or the any time Cardiac Arrest, remember YOU are the one with the training. Your there to help. Its their (the patients or families) Emergency, there is no need for you to spaz out with them.

Trust me, once you get all hyper on scene, your ability to function adequately will diminish in accordance with how excited you are.

Also keep in mind, when the crappola really starts to fly and you suddenly forget everything you are supposed to know....take a step back, take a deep breath, reach way back deep in your memory and remember the basics. Just like Kindergarden, EMS all begins with the ABC's. Without that basic fundamental, you have nothing.

Good luck. You'll do great.

Chimpie

10-12-2005, 06:19 AM

As Princess said, always remember your ABC's.

And check out the signatures here. While funny, the usually provide good advice.

"If it's wet and sticky and not yours, leave it alone." (Remember BSI)

"Air goes in and out, blood goes round and round. Any variation of this is a bad thing." (Again, ABC).

And remember this, as morbid as it sounds. If you do something that kills the patient, you know what to do... CPR. :o

Chimp

ndilley

10-12-2005, 10:32 AM

I'm also a new emt for a county service these tips are great guys thanks...

Jon

10-12-2005, 10:41 AM

these are all great tips, here are a few more:

1. Utilize your MDT.

2. Buy a "good" stethascope

3. Always bring your own "good" stethascope with you

4. Always have a spare stethascope for when you lose your "good one"

5. Remember the Boy Scout motto.... "Be Prepared." That overdose could be a code. That "sick person, BLS" can easily be a code, and the "Injured person, BLS" can be suffering from high-velocity lead poisioning.

6. I must reinforce this.... always ask if you don't know, and say if you aren't sure.

Welcome, all, and hope to hear from you more

`Jon

TTLWHKR

10-12-2005, 04:09 PM

1. Welcome

2. Don't feed Jon

3. Don't spend more than 30 bucks on any stethoscope, they are only as good as the person using it

4. Vicks VapoRub.. Get some, make sure it isn't the odorless and greaseless kind.. You'll need this for the smelly calls.

5. If it's cut wide open, muscle, etc. is hanging out, and it's not bleeding... Check for a pulse.

6. If they are dead, and look like they should stay that way, don't try to change that.. They'll end up a vegetable for the next 50 years, and outlive their entire family - who will be broke and heart broken.

7. When in doubt, lay em out.. If you think they should be boarded... Put em on a board. Never hurts to be prepared.

8. Never buy anything from Galls

9. If someone has a disease that you know of, and someone else can get.. Put a bright colorful bandaid on their left index finger. Universal "Put some damn gloves on" sign.

10. Don't become a whacker or a Paragod.

BloodNGlory02

10-12-2005, 05:25 PM

Go see a drum corps show this summer. you're lucky to live in the home of the Santa Clara Vanguard. A very highly respected corps. Check it out.

(sorry shameless 'hobby plug' since you're from the home of my fave corps) :D

Margaritaville

10-12-2005, 05:34 PM

Be honest, honest and more honest about what you do and don't know.

I have gone over more than one ambulance with a new provider who says "oh i already know that." When I need them to do whatever it is and they look at me and say "huh", I really want to choke them out!!!!

Also, learn good documentation. Believe it or not - good documentation is way more important than anyone realizes. There have been days that I have reviewed reports and just felt like handing the providers a set of crayons and say "have at it". Your QA/QI people will appreciate good documentation immensly. B)

ffemt8978

10-12-2005, 06:28 PM

Originally posted by EMTPrincess@Oct 12 2005, 02:57 AM
Also keep in mind, when the crappola really starts to fly and you suddenly forget everything you are supposed to know....take a step back, take a deep breath, reach way back deep in your memory and remember the basics. Just like Kindergarden, EMS all begins with the ABC's. Without that basic fundamental, you have nothing.

When the crap really hits the fan, and you forget everything else, remember this:

Your ambulance has wheels.....USE THEM!

High flow diesel is second only to high flow O2.

ipscscott

10-12-2005, 06:38 PM

Originally posted by Chimpie@Oct 12 2005, 05:19 AM
And remember this, as morbid as it sounds. If you do something that kills the patient, you know what to do... CPR. :o

Hey, that's good. Makes the whole thing seem a lot less stressful, doesn't it? :D

TTLWHKR

10-12-2005, 07:05 PM

Originally posted by ipscscott+Oct 12 2005, 05:38 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (ipscscott @ Oct 12 2005, 05:38 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-Chimpie@Oct 12 2005, 05:19 AM
And remember this, as morbid as it sounds.:censored: If you do something that kills the patient, you know what to do... CPR.:censored: :o

Hey, that's good. Makes the whole thing seem a lot less stressful, doesn't it? :D [/b][/quote]
If you really kill a patient...

Start to act like you've cracked, talk about calls like the haunt you and claim PTSD...

My supervisor told a rookie that once.

trauma1534

10-12-2005, 08:22 PM

I almost forgot the most important tip to cya, DOCUMENT... DOCUMENT...DOCUMENT... DOCUMENT, and when you think you have documented enough, DOCUMENT even more. :D

coloradoemt

10-13-2005, 11:03 AM

Originally posted by BloodNGlory02@Oct 12 2005, 03:25 PM
Go see a drum corps show this summer. you're lucky to live in the home of the Santa Clara Vanguard. A very highly respected corps. Check it out.

(sorry shameless 'hobby plug' since you're from the home of my fave corps) :D
I will agree but look for the Phantom Regiment.... :D

The only subject not covered so far has been driving. It is still not your emergency even when you are driving. A smooth ride is absolutely neccesary to assure those in the back can get their job done. Smooth, slow cornering, smooth stops, smooth, slow starts. Plan way ahead what you are going to do at intersections. Plan way ahead at all times for that matter. Always assume those in front of you are complete idiots. Keep your following distance and always leave yourself an out. If you need to make a "hard stop" holler to the back so they can grab a hold of something.

I firmly believe that you can be the best EMT in the world, but if you cannot drive you are not worth spit. I have heard many stories where a tube was missed due to a driver error etc. I have also witnessed what happens when an EMT cannot drive and word gets around. Paramedic brought an EMT back to our ops center and refused to go out with him again. Word got around and now hes gone, couldn't keep a partner.

Good luck and welcome!!

emtI

10-13-2005, 01:31 PM

Originally posted by coloradoemt@Oct 13 2005, 10:03 AM
The only subject not covered so far has been driving. It is still not your emergency even when you are driving. A smooth ride is absolutely neccesary to assure those in the back can get their job done. Smooth, slow cornering, smooth stops, smooth, slow starts. Plan way ahead what you are going to do at intersections. Plan way ahead at all times for that matter. Always assume those in front of you are complete idiots. Keep your following distance and always leave yourself an out. If you need to make a "hard stop" holler to the back so they can grab a hold of something.

I firmly believe that you can be the best EMT in the world, but if you cannot drive you are not worth spit.

AMEN!!!

Wingnut

10-13-2005, 02:59 PM

Originally posted by emtI+Oct 13 2005, 12:31 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (emtI @ Oct 13 2005, 12:31 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-coloradoemt@Oct 13 2005, 10:03 AM
The only subject not covered so far has been driving. It is still not your emergency even when you are driving. A smooth ride is absolutely neccesary to assure those in the back can get their job done. Smooth, slow cornering, smooth stops, smooth, slow starts. Plan way ahead what you are going to do at intersections. Plan way ahead at all times for that matter. Always assume those in front of you are complete idiots. Keep your following distance and always leave yourself an out. If you need to make a "hard stop" holler to the back so they can grab a hold of something.

I firmly believe that you can be the best EMT in the world, but if you cannot drive you are not worth spit.

AMEN!!! [/b][/quote]
Absolutely, Great Point! too many people forget about this part and it's the most important one!

Jon

10-13-2005, 03:43 PM

Originally posted by trauma1534@Oct 12 2005, 08:22 PM
I almost forgot the most important tip to cya, DOCUMENT... DOCUMENT...DOCUMENT... DOCUMENT, and when you think you have documented enough, DOCUMENT even more. :D
the continuation..... CYA, CYA, CYA....

Jon

grandpa_newby_EMT

10-19-2005, 07:28 PM

These are great tips, thanks. Hi, Anthony. I'm also in the Santa Clara Valley (Gilroy). I start my EMT-B training in 2 months; good luck to you.

emtff99

10-22-2005, 09:52 AM

coloradoemt & trauma1534 hit 2 VERY IMPORTANT matters here. AMEN to both! I have always told our new Emts that "you always have to document everything, because just 1 day it may all come back to haunt you in court" (Been there 5x myself) & the Driving aspect of it, what you do up front, they feel more in the back.

We had a MVA call here a few weeks back, (single MVA, rolled in a ditch, Driver ejected) upon crew & unit arrival, it was stated about a car seat being found inside the vehicle & the Pt was asked about it, answer was "He was the only one in the vehicle" (Thank goodness). Anyhow, upon our arrival, there was a lady holding CSpine & claiming she was a Medic from further down state. Anyhow, no one asked her afterwards for ID or numbers, but it was documented, along with the make/model of the vehicle, color, plate & registration also. Sounds rather stupid as 1 of our new Emts told me later that morning as we were doing the tripsheet to put all that in there. I waited until about an hour or so later, and asked him what color was the vehicle? He didnt know at all. I explained "Now, you see why I put it in the tripsheet, it is to CYA, especially mine."

Little details help out quite a bit.

Stevo

10-22-2005, 10:00 AM

Little details help out quite a bit.

Sure, and they can work for you as well as against you in court...

~S~

emtff99

10-22-2005, 10:09 AM

Originally posted by Stevo@Oct 22 2005, 09:00 AM
Little details help out quite a bit.

Sure, and they can work for you as well as against you in court...

~S~
So very true,,but so far each time I have been to court it has helped. (Most were criminal cases IE: Homie shot Da'Jibber type)

hfdff422

11-04-2005, 01:44 PM

?"Don't spend more than 30 bucks on any stethoscope, they are only as good as the person using it"?

Not true at all, yes you have to relax and listen, but the $100 Littman is really $100 dollars good! The Pediatric one in our ped's bag was useless on an infant call, but that littman made everything as clear as can be!

Our hick volunteer FD's ambulance has 4 on it, and we just finally got a $150 GlassMaster saw after years of begging. ($400 in stethoscopes were easier to get than a GlassMaster for our rescue engine)

Jon

11-04-2005, 07:50 PM

Originally posted by hfdff422@Nov 4 2005, 01:44 PM
?"Don't spend more than 30 bucks on any stethoscope, they are only as good as the person using it"?

Not true at all, yes you have to relax and listen, but the $100 Littman is really $100 dollars good! The Pediatric one in our ped's bag was useless on an infant call, but that littman made everything as clear as can be!

Our hick volunteer FD's ambulance has 4 on it, and we just finally got a $150 GlassMaster saw after years of begging. ($400 in stethoscopes were easier to get than a GlassMaster for our rescue engine)
You must run with my fire Co!

Same thing.... I pushed for 2 years to get a glasmaster on our rescue and rescue-engine. Ww have 1 littman clasic in the rig, 1 in the house bag, and 1 in each of 2 trauma bags, as well as 1 in each of 3 ambulance officer's cars.

but the "window kit" on the rescue was an old J-hook thing and a few other tools.

Jon

hfdff422

11-07-2005, 10:40 AM

Like an axe, that was our window kit- to be fair, one of the members donated a punch to the engine and the ambulance has had a punch for a while (before my time). Departments are funny sometimes, we have an awesome hydraulic extrication cutter/spreader/ram set, but a member had to go and purchase a 2 1/2" nozzle on their own to have one for the engine.

The business of saving lives is too often awarded to the lowest bidder, and you are hard pressed to convince frugal people that something would be good to have until someone is hurt or killed or a call is blown because you dont have the right stuff.

Kylejb2663

12-07-2005, 09:20 PM

Hey guys,

New to this discussion group. The advice/tips are excellent.

I also just joined a Volunteer Ambulance Corp and I start my EMT-B training in January. So for now, I am an observer, but I figure its the best way to get experience so I can hopefully learn some stuff from other EMTs and be knowledgeable in my EMT-B Class. It should give me a good headstart though.

I look foward to many more posts though!!

Chimpie

12-07-2005, 10:18 PM

Welcome to EMTLife.com!! Where are you from?

Wingnut

12-07-2005, 11:22 PM

:D :D :D Welcome Kyle! :D :D :D

You came to the right place, you'll get a lot of great info from this group, there is a lot of varied experience among all of us. Good luck in EMT-B class, how do you like it, and like Chimpie asked, Where ya from?

Hope to see you stick around. :D

ffemt8978

12-08-2005, 12:45 AM

Welcome to our own little corner of dysfunction.

ResTech

12-08-2005, 02:27 AM

I have to disagree with the stethoscope comment.. it is more of the user then it is the scope being used.

Kylejb2663

12-08-2005, 03:54 PM

Hey

Sorry it took me so long to respond back.

I am from Schenectady, NY but I volunteer at Duanesburg Ambualance.

I have not started my EMT class yet, I start that in January, but I have received all the textbooks for the class. I have been looking over them and reading, hoping I can get a little ahead and know a good amount when I start the class from Volunteering and the textbooks.

I am always up for advice so if you have any just lay it on the table. I can also accept criticism, so you can lay that out on the table too.... lol

I see that some of the conversations can get a little heated between ALS and BLS.....!

PhillyMedic

12-09-2005, 04:41 PM

here's a tip, ASSESSMENT...once you can do a good assessment, skill will follow. When I have paramedic students, I want to see a good assessment. You can teach a monkey to do skills..

coloradoemt

12-10-2005, 09:43 AM

Originally posted by ResTech@Dec 8 2005, 01:27 AM
I have to disagree with the stethoscope comment.. it is more of the user then it is the scope being used.
I cannot agree with you on this. My wife bought me a Littmann Cardiology 3 for my B-day last year. I was not having any problems hearing out of my cheapy but the ease at which I can hear now is amazing.

coloradoemt

12-10-2005, 09:44 AM

coloradoemt

12-10-2005, 09:51 AM

Originally posted by ResTech@Dec 8 2005, 01:27 AM
I have to disagree with the stethoscope comment.. it is more of the user then it is the scope being used.
I dont completely agree with your comment. I had a cheap scope for years and was doing fine with it. My wife bought me a Littmann Cardiology 3 for my B-day and it is amazing the difference in sound.

emtff99

12-11-2005, 08:54 AM

Welcome the group Kyle.

emtd29

12-18-2005, 11:17 PM

You ALL forgot this one:

CARDINAL RULE #1

IS THE SCENE SAFE???

BE AWARE OF YOUR SURROUNDINGS

I cannot stress that enough!

That $100 littman ain't gonna mean snot if you're not able to use it because you're lying in a pool of your own blood after getting assaulted or shot by the pt or some other perpetrator on your scene after walking in on a drug deal gone sour or something.

FFEMT1764

12-19-2005, 09:40 AM

Cavieat to cardinal rule 1:
If the police are on scene and say the scene is safe, the scene is really not safe, the police are engaged in a battle royale and they want you to come in and be the diversion...or the police are on scene, say the scene is safe, but fail to mention that the scene is now a crime scene, you enter scene and end up the centerpiece of a state police investigation for the enxt 18 hours!

TripperAdam

01-09-2006, 03:10 AM

All of these suggestions are very useful: it's been interesting to read through them [And to read through all sorts of discussions, having just joined this forum].
I've yet to put my WFR skills to use (FR training -- with a Wilderness addition making it 80 hours training); but I pretty much feel ready to be a lay rescuer any time, any place. I think I would feel comfortable. because I've followed what most of you advise: remember the ABCs of it all.

I'm not yet in EMS, not even enrolled to be in any sort of EMT training. Where I live, (Toronto, ON, Canada), the most basic level for EMS is as a "Primary Care Paramedic" which involves ALS protocals -- there are no EMT levels. So I may focus in other things in years ahead, and decide to look into EMS in years to come (and/or hope that volunteer BLS-level services are reintroduced here).