Pearls of wisdom for new EMTs

TenementFunster

TenementFunster

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Let me start by saying I am new to the forum, though I have been reading for a while. I've looked around for a thread like this and haven't found one, so please forgive me if it's been done before.

After several excruciating months without luck, I have just been hired at a local ambulance company (It's rough for new EMTs in AZ right now). I've been really excited to get on a rig, but I'm a horrible overthinker and it's really racking my nerves. I'm terrified that I'll freeze in the field, forget my training, or somehow break the golden "do no harm" rule. There hasn't been ride alongs allowed in AZ for a while now, so I have no idea what it's like to run calls. I'm sure it's not as complicated as I imagine it, but I would just like some pointers as to how one without any experience gets into the rhythm of things without stepping on everyone's toes.

I know I didn't really present a clear cut question but if everyone could maybe tell about their experiences as a new EMT and how they got through it I would be very grateful.
 
Congratulations on landing a job. Are you going to be doing 9-1-1 or IFT?

Get your heart-rate under control before you check your patient's. You will not help anybody if you are stressed out.

Keep your head on a swivel, always, even when you're just running IFTs. Pay attention to where you park your rig, what's around your rig, and who and what are around you.

Plan your lifts. Know exactly how you are picking up your patient, know how your partner is picking up your patient. Know where you're putting them and how you're moving to get them there.

Don't drive like an idiot.

Don't stress. You won't help anyone when you're stressed out on scene.

ASK questions. You have an FTO for a reason, they are there to train you. If there is ever anything you're unsure of, ask questions. No one is going to say "psha, dumbass, you don't know that?" Well, some of them might, but don't pay attention to them.

Scene safety. Scene safety. Scene safety. You can't help anyone when you're dead.

If something seems off, it probably is. Listen to your gut.

Don't stress.

Listen to what your patient tells you.

Make your patient as comfortable as possible without interfering with care.

Don't drive like an idiot. Lights and sirens don't make you invincible.

Have fun, this field is what you make of it, so enjoy it.
 
Meh, being an EMT, even on a 911 truck, isn't hard as you don't have to worry about 30+ different drugs on your truck, and all the advanced procedures, and when to, or not to, do something.


There, does that make your first time easier? :P




Just take it slowly. Unless your agency sucks, they will partner you with a more experience provider. If they DO suck, run away fast.

Most calls, especially if you're just doing BLS calls, don't move quickly, IE you don't have to worry much about making split second decisions. Not saying they don't exist, and not saying it happens way more on an ALS truck, just saying you don't have to freak yourself out by thinking you need to get A, B and C done ASAP.


Be methodical. It will take you a while to get your method down at how you run a call... don't let anyone try and rush you (unless of course you NEED to be rushed).



Remember, it's not your emergency. As cliche as that sounds, it's true. I was in your boots just before my medic internship, scared that I'd freeze, however when you're on a call, things just click and you'll do what you were trained/educated to do. You'll be fine.








Oh, and don't kill anyone.
 
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Linuss said:
Oh, and don't kill anyone.
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But say that I do kill someone, I don't suppose I get any mulligans for that :)

I'm sure I'll do fine, as I am very confident in my training. But I have this little nagging perfectionist in me that demands things run smoothly, and I damn well better get over that quickly. I was told by my instructor that half of EMS is just not knowing what the hell is going on, but acting like you do. That ruffles me. I know everyone runs into those calls where they feel useless, I just need to get used to that idea.
 
Remember your Training

I am in a similar situation, except I will be covering 1 night a week for the two towns I am a FF for already. I have been driving, and helping (Lifting, getting supplies, being an un-trained set of hands) for the past year on the rescue but I as I prepare to take my first two shifts Friday and Saturday evening I am feeling anxious too.

Just remember your training. The thing that impresses me the most about EMS is the consistency. At least where I am, people tend to do things by the book and that is comforting. Do you assessments just like you did in class.

My biggest fear, and most exciting thing all at once: When you ring the doorbell and they answer saying: "Thank God your here, we need your help" and you realize it is YOU they are talking about.

Good luck and let us know how it goes!
 
Don't decide you are a hero and the savior of Paramedics. Because despite the idiotic things on tshirts that say basics save Paramedics, Paramedics can function just fine with another Paramedic as partner in fact better.

And as far as patient care. If you get any no matter how bad they are always act like you know what you are doing, stay calm, act like you have done this a million times. Your calm confidence may do more good than the limited skills you have as a basic can do for them.
 
medic417 said:
Don't decide you are a hero and the savior of Paramedics. Because despite the idiotic things on tshirts that say basics save Paramedics, Paramedics can function just fine with another Paramedic as partner in fact better.
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This kills me. I find it so hard to believe that there are basics that think they are superior to medics. Maybe it is my sheltered environment but I have the utmost respect for our medics and could never imagine thinking I am superior.
 
mcdonl said:
This kills me. I find it so hard to believe that there are basics that think they are superior to medics. Maybe it is my sheltered environment but I have the utmost respect for our medics and could never imagine thinking I am superior.
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You see it on this site almost daily.
 
medic417 said:
You see it on this site almost daily.
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Ah ha! I have been in IT, and on the internet since it's inception in my clinical research days so I have learned to draw a very distinct line between reality and this place :)
 
medic417 said:
And as far as patient care. If you get any no matter how bad they are always act like you know what you are doing, stay calm, act like you have done this a million times. Your calm confidence may do more good than the limited skills you have as a basic can do for them.
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It's so much easier to BS your way through a call as a medic even if you have no clue what's going on.

I mean, we can do IVs, hook up the monitor, interpret the strip with extreme prejudice, stare at the drugs in the drug box, and sit pondering while you have other responders get vitals for the 5th time :P
 
Linuss said:
It's so much easier to BS your way through a call as a medic even if you have no clue what's going on.
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I think that's where my anxiety comes from. Medics are so damn good at looking like they know what is going on and blowing it off when they make mistakes that they seem like they never mess up. The questions is: Are they covering up because they cant stand looking like an ***, or is it to keep the patient confident in their care?

As I've said before, I'm a terrible overthinker.
 
TenementFunster said:
I think that's where my anxiety comes from. Medics are so damn good at looking like they know what is going on and blowing it off when they make mistakes that they seem like they never mess up. The questions is: Are they covering up because they cant stand looking like an ***, or is it to keep the patient confident in their care?

As I've said before, I'm a terrible overthinker.
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You'll even see doctors acting calm when they have no clue what to do or even when they screw up. Why? Because it keeps the patient calm. A calm patient that is confident that you know what you are doing is easier to treat.

Honestly, though I have no studies to back it, probably have better outcomes. I say that because the patient with a cardiac event for example. If you act stressed and worried they stress which works cardiac more which means w/o complete A&P lesson here greater damage perhaps even death. But if they stay calm because you are calm they have less demand on heart thus less damage.
 
medic417 said:
Honestly, though I have no studies to back it, probably have better outcomes. I say that because the patient with a cardiac event for example. If you act stressed and worried they stress which works cardiac more which means w/o complete A&P lesson here greater damage perhaps even death. But if they stay calm because you are calm they have less demand on heart thus less damage.
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Well of course keeping cool is vital in cardiac events. Don't drive fast, no lights and siren, no saying "My god you're going to die!". I learn by observation, I take little things that I see and try to implement them into my behaviour. So when I see Mr. Medic McCoolguy over there, treating a patient without the slightest degree of difficulty or error, it makes me anxious cause I have nothing to draw upon. I'll be the first to tell you that I make mistakes, lots of them in fact, and it just irks on your self esteem when you see all these pros who never seem to slip up. I need to learn how to be a little more full of s*** and put on the calm face like "yeah, I'm a hardass, what of it."
 
Trust me, becoming a medic doesn't make you less likely to make a mistake... infact our mistakes can be much more costly.


Heck, I blow veins on patients who need IVs from time to time... I laugh it off and try again. Ask anyone that knows me in my personal life and I'm not even close to the most confident guy out there, but when it comes to my job I put on a mask and make it seem like I'm calm, confident and outgoing.

Maybe it has to do with the patch, maybe it has to do with I'm in charge with peoples lives, who knows.


Now... just to translate that to my personal life and I'll be set...
 
TenementFunster said:
Medics are so damn good at looking like they know what is going on and blowing it off when they make mistakes that they seem like they never mess up. The questions is: Are they covering up because they cant stand looking like an ***, or is it to keep the patient confident in their care?
Click to expand...

When your mind goes blank and you need a moment to reset... listen to lung sounds. ;)
 
For new EMTs to remember: We don't save lives. Or at least very rarely. Most calls you will ever run could be handled by a taxi just as easily
 
TenementFunster said:
Ha, is that because it sounds like the ocean?
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If it sounds TOO much like the ocean than there's a major problem <_<:P

One thing I do (after a call that I wasn't sure about, or that was more than the typical college drunk) is ask my superior/partner for any QA/QI. What did I do right? What can be worked on? Then if your partner let's you, write the report. Run yourself through the call as you write, and do QA/QI with yourself. Ask yourself: "was that the right decision?" "Why did I do THAT?" Did I figure out what was going on with the patient?" and "What can I do better?" Continual self-review and peer review will help you get a long way. I've only been doing this a short time, but questioning can help. That's what QA/QI is for.

Also, if you come across something where you're like "Huh?" or "What is that condition?", RESEARCH IT! No point in saying to yourself "Oh well, I won't run into that again." Look it up online. Read about it. Ask the patient or your partner about it. The moment you or I stop learning or having the desire to learn is the day we need to quit.

I know this is from a newbie, but I hope it helps!
 
When in doubt, apply oxygen, and transport to the hospital.

I had a call two weeks ago, on a guy who was seizing. ALS attempted to stick him 7 times, before the decision was made to move him to the truck, IO him, and transport. 45 minute on scene time, with a 10 minute transport time to the hospital.

If there were no medics, the BLS crew would have applied oxygen, and transported to the hospital 20 minutes after the initial 911 calls was made, and the patient would have been in the hands of definative medical care.. Instead, 60 minutes later, we arrived at the ER. Your POV might vary.

For the record, I am not anti-medic, but most calls don't need a medic, and it's absurd to think otherwise (though many on here will throw a hissy fit if a medic doesn't assess the toe pain, because it might be a silent MI).

Other tips: your job is to transport the patient to definative care. not to have a paramedic look the guy over. Transport to the hospital. also, most of the time a paramedic's interventions aren't going to save a life, but rather made the life better. THIS IS NOT ABSOLUTE, AND YOU THERE ARE INSTANCES WHERE A PATIENT NEEDS ALS INTERVENTIONS IMMEDIATELY, but they are the exception, not the rule. So, remember, for the sick patients (except for an unwitnessed cardiac arrest), load the patient and start going to the hospital. Medics can work enroute if needed.

and when in doubt, apply oxygen, and transport to the hospital.
 
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