Need some advice before starting ride time

[Alpiner]

I've scheduled my ride time for next week and the first thing I'll have to do is run out and buy some clothes and my idea is that I'll get some navy blue ****ies from wal-mart with a pair of black shoes so.. would this be ok?

Another worry is that I won't be ready and I have a fear of making the patient feel uncomfortable, I've been practicing baseline vitals at home and the one thing I'm having trouble with is taking a manual blood pressure reading which is required by our instructor. In a no noise setting, I still have trouble hearing the systolic/diastolic and I can imagine how difficult that could be in the back of an ambulance. Any advice there?

I'm sure there is more I need to know so please feel free to give any extra advice, thanks!

 

[WildlandEMT89]

Instead of shoes I would recommend a pair of boots with a composite toe. Wal-Mart should have some for cheap if you are looking for something to just get you through your clinical rotations.
I think the navy blue ****ies should be fine but double check with though your instructor/clinical supervisor on expected dress code.
Also don't stress too much about the bp thing. try your best, practice a lot, and don't make up numbers.

 

[teedubbyaw]

Stop worrying. You're a new student; expectations of you are to be professional and open to learning, not to ace your skills right away.

If you have trouble with auscultation, then get a palpated BP. Also, play with the amount of pressure you hold the stethoscope bell/diaphragm with. Some scopes are extra sensitive.

 

[Gurby]

Most everybody says boots are a must, but I bought black shoes and never had an issue. However... You really need footwear with an aggressive tread and sticky rubber soles, for when you're walking backwards with the stairchair down potentially icy steps in winter or whatever. You'll also want something black and that can be polished. Really not many shoes fit both of these criteria - they'll either be dress shoes with miserable soles but be polish-able, or they're construction-worker-style work shoes that have a decent tread but can't be polished. I think it's probably best to go with boots for this reason. Some of the more old-school people I've worked with just wear black tennis shoes and DGAF, but I don't think you earn the right to do that until you've been at the job for 5-10 years.

Useful trick about auscultating BP's when the truck is moving, is to not auscultate BP's when the truck is moving. I always try to get a good BP right before we start driving, and then I'll try to listen while en route just for the practice but otherwise I'll just palp it. Diastolic is nice to have, but we generally care a lot more about the systolic pressure anyways except for in specific situations.

Also, this seems stupid in retrospect, but at first I didn't realize that you could pump the BP cuff back up again in the middle of taking a BP. Like, I would pump it up to 180 or so, and then let it deflate all the way to 0, say "dang I couldn't hear it," and try again. Now it's more like this: Listen while inflating cuff, try to hear on the way up, crap I didn't hear anything maybe let's try moving the steth a bit and straightening their arm out, deflate some, hmm still don't hear anything, reposition again, ah hah! I hear beats! Okay there's where I should be listening, inflate a bit - okay the beats stopped - deflate a bit - there the beats are again, systolic is X. Keep deflating, wait a minute did the beats stop? All of a sudden I can't hear them, I must have missed it. Inflate a bit more, okay there are the beats again, deflate some more, okay yeah the beats definitely stopped at X, there's diastolic pressure. Deflate cuff the rest of the way.

 

[Alpiner]

Thanks! I'm curious if I'll fit in with these boots:
http://m.macys.com/shop/product/tim...70|dm_51655434272|-|DUZl5R70&cookieCheck=true

 

[Gurby]

Thanks! I'm curious if I'll fit in with these boots:
http://m.macys.com/shop/product/timberland-waterproof-chocorua-trail-gore-tex-hiker-boots?ID=340287&pla_country=US&CAGPSPN=pla&CAWELAID=120156340000435374&catargetid=120156340000923425&cadevice=m&cm_mmc=Google_Mens_Shoes_Adchemy_PLA_PLA-_-Mens+Shoes_Boots+-+GS_Timberland-_-51655434272-_-mkwid_DUZl5R70|dm_51655434272|-|DUZl5R70&cookieCheck=true

Should be fine, just get the black version obviously. Consider getting them a bit dirty before your first day so they aren't as blatantly brand new...

 

[chaz90]

Should be fine, just get the black version obviously. Consider getting them a bit dirty before your first day so they aren't as blatantly brand new...

Nothing wrong with having clean new boots...This is almost as bad as seeing a new volly firefighter rubbing his helmet into the ashes on a fire to get that grizzled look. SMH.

I would recommend wearing the boots to break them in a bit before wearing them for 12+ hours, but dirtying/scuffing them on purpose is silly.

 

[Gurby]

Nothing wrong with having clean new boots...This is almost as bad as seeing a new volly firefighter rubbing his helmet into the ashes on a fire to get that grizzled look. SMH.

I would recommend wearing the boots to break them in a bit before wearing them for 12+ hours, but dirtying/scuffing them on purpose is silly.

Well to each his own, but he can expect a lot of obnoxious comments if they're clearly right out of the box. They don't need to look grizzled, just like they've been worn a couple times. It's stupid, but it is what it is.

 

[DesertMedic66]

I wouldn't spend more than $50 on a pair of boots for EMT ride outs.

Black boots that you can polish are usually perfect for ride outs. Steel toe is always a plus but usually not required. You should wear them a couple of times before your shift to break them in.

Doesn't matter if they look brand new or a month old. The only thing that will be an issue is if they look like complete garbage At the start of the shift.

 

[DesertMedic66]

Well to each his own, but he can expect a lot of obnoxious comments if they're clearly right out of the box. They don't need to look grizzled, just like they've been worn a couple times. It's stupid, but it is what it is.

I have never heard of anyone getting obnoxious comments about their boots if they look brand new.

 

[WildlandEMT89]

Outside of the wildland fire realm have never gotten any remarks on new boots.

 

[Gurby]

I've gotten comments on my own new boots, and seen other new EMT's get comments on their boots. Maybe people in my area just enjoy giving newbies a hard time. Not like it's a big deal - after all it's true that you ARE new. But it's annoying to get called out on it like that.

I have never heard of anyone getting obnoxious comments about their boots if they look brand new.

Conversely, I've never heard of anyone getting comments about their boots looking like garbage (unless they were literally falling apart). Different cultures, I guess.

 

[WildlandEMT89]

Man, you can bet when uniform allotment rolls around I'm sporting new boots with a big ol grin on my face.

 

[CALEMT]

Outside of the wildland fire realm have never gotten any remarks on new boots.

Even in the wildland fire realm (well the one I worked in at least) they didn't care I had brand new looking whites. As long as they were broke in is all that mattered.

Oh and to the OP a cheap pair from walmart or big 5 will suffice like most people said. I would only get a good pair once you find a place to work. I live by the saying "you get what you pay for" especially when it comes to footwear.

 

[RefriedEMT]

Yea I would recommend Striker II EMS once you get a job....I broke mine in and have been polishing them like crazy...their going to blind anyone who looks at them,hehe. They were $140 bucks at Danners, but ye like they said get some cheap ones for class/rideouts. I still have my cheap ones from then and damn I cant believe how little time they lasted, 1 year and 4 months and their already falling apart.

 

[hogwiley]

Who cares if his boots look new, if he's an EMT Basic student he IS new, nothing is going to change that. Id look down more on a brand spankin new student with scuffed up boots than one who has them spit shined, but that's just me. The only one who would care would be some doofus 20 year old EMT Basic with not even a year experience who thinks he's johnny rescue(if you wind up with a crew like that take everything they say with a grain of salt).

As for manual BP, I don't know what to tell you other than practice, make sure you know where the brachial artery typically is so you are putting your steth in the best possible place(it doesn't hurt to palpate for it). Practice taking BP by Palp too, since that's better than nothing.

 

[teedubbyaw]

Well to each his own, but he can expect a lot of obnoxious comments if they're clearly right out of the box. They don't need to look grizzled, just like they've been worn a couple times. It's stupid, but it is what it is.

Mine are polished to a shine before every shift. If yours aren't, you're lazy and don't care about looking professional.

 

[SaviorSeven]

Hey, the patient isn't going to care what your boots look like and that is all that matters. Brahms at Walmart cost 20$ They are cheap and comfy.
Having trouble hearing during a manual bp? Learn how to read a bp by watching the dial, or palpating.
Some more advice...if your medic is happy then everyone is happy. Bring donuts or something, help them check the rig at the beginning of their shift. You could even volunteer to assist them with washing it. They would be more willing to show you all the tricks they know if you're willing to get your hands dirty. I made sure to stay with the same medic during each of my ride outs. My classmates didn't, and they didn't enjoy themselves half as much as I did. Even though he was really hard on me at first, he ended up being a mentor to me and I praise him to this day.

 

[teedubbyaw]

A patient won't care if you're a slob, your shirt is stained, your boots are covered in dirt, and your hair hoards a bird nest.

 

[chaz90]

A patient won't care if you're a slob, your shirt is stained, your boots are covered in dirt, and your hair hoards a bird nest.

Not necessarily, but their family might.