Hospital Rotation for EMT Basic

[RunnerD1987]

Tomorrow morning I am going for an EMT-B rotation at the hospital for the 10 hours required. I am looking forward to a learning experience out of the classroom.

I have been a crewmember on an ambulance for four months. I have done blood pressures, glucose test, run forms, back boarding, placing oxygen on PT, and a few other skills aboard the ambulance. However never administered medication, manual traction on bone/joint injuries, or collared a patient.

Wondering when doing clinical's what should I expect?

 

[Anjel]

Tomorrow morning I am going for an EMT-B rotation at the hospital for the 10 hours required. I am looking forward to a learning experience out of the classroom.

I have been a crewmember on an ambulance for four months. I have done blood pressures, glucose test, run forms, back boarding, placing oxygen on PT, and a few other skills aboard the ambulance. However never administered medication, manual traction on bone/joint injuries, or collared a patient.

Wondering when doing clinical's what should I expect?

As a basic? You wont be doing any of those things.

More of a patient care technician. You will be fetching blankets, doing tons of vitals, making beds, getting water, running around with the nurses. And jumping in on any "cool" things that come in.

Manual traction, collars, and all that stuff usually is done before they get there by ems.

 

[RunnerD1987]

Kind of figured would just observe and assist with keeping things neat.

 

[firetender]

It's simple!

Wondering when doing clinical's what should I expect?

Initially, the less you expect and the more you listen and do what you are asked the better.

Quietly learn what's there, who the person is who decides what you can and can't do and then figure out how to politely weasel your way in to doing the stuff you're supposed to be practicing.

 

[EMT-IT753]

Not sure where you are from, but here in WI you will be helping with getting vitals, taking BS, and doing a lot of listening.
If you ask, many RN's will let you ask assessment questions with them in the room. The more initiative you show without being overbearing, the more they are likely going to let you do.
However, a lot can be learned by listening to a Dr. do his assessment as well as the RN's.

 

[AMF]

I had an IC bleed, which I basically just watched, and a COPD exac., which I ran as an assm., so it really depends. You should not be fetching things, making beds, or doing anything you're not comfortable with. That is not your job. I'm curious how you are able to ride on an ambo for 4 months w/o a license though

 

[bigbaldguy]

I was the only person in the room when this big guy who was intubated wakes up and starts yanking on his tube. So I take this hands and hold them and just start talking softly to him trying to get him to calm down. About 2 minutes into this the doctor walks in takes one look at scene of me holding this very large African American hands while talking softly in his ear and the doctor just lost it. She thought it was hilarious. She told me to come back in 5 minutes and he would show me how to do a burn assessment and perform suction and a lot of other really cool skills. And true to her word she did.

 

[Rev.IKON]

my hospital clinicals were horrible. very lost at first and the people i got stuck with really hated their job. even told me that i could leave if i wanted to. i even changed hospitals hoping it would be better but it wasnt. i would suggest finding someone who actually cares about their job and not just there because they couldnt get in somewhere else.

 

[RunnerD1987]

Kinda of what I am thinking from what people have said. People who went through had few people who were excatly like that. Then on the other hand kept them active and on there feet.

Rather be back on the rig, but will make the best out of the experience. Going in the next 1 1/2. Let you know how it goes.

 

[johnrsemt]

Suggestion: when you get there introduce yourself to the charge nurse and the nurse/s that are in charge of the shock/trauma room/s; tell them what you are capable of doing patient wise, and ask them what you can do to help: wether it be help checking their rooms, or whatever.
Then go and find the linen supply, and restock all of the linen carts, and closets in the rooms.
Then go and find the supply carts and restock all of the rooms with the rest of the supplies: when the nurses see you doing that they will be very helpful in getting you in to see patients and see the cool stuff.

Too many people in EMS training go to the ED or floors, and sit and do nothing waiting for something to come in. If you show them that you are not afraid to help and to do grunt work, that they need done, but don't always have time to do: if shows them that you are not useless.

 

[RunnerD1987]

I finished the rotation and go back for six more hours next week. I have learned more experience with my time with the ambulance. Was not too bad was a different perspective. A lot of it was walking around. I tried my best too be active. I did transfer one or two patients from stretcher to bed. Wiped down beds and put sheets on them. Talked too a few patients. I learned a new trick on how to place the stretcher on the ambulance. Therefore, it was not that bad time moved by slow.

 

[joeyCC]

nonononononono

As a basic? You wont be doing any of those things.

More of a patient care technician. You will be fetching blankets, doing tons of vitals, making beds, getting water, running around with the nurses. And jumping in on any "cool" things that come in.

Manual traction, collars, and all that stuff usually is done before they get there by ems.

SO wrong. As a basic, I'm now CC, I've administered
Medication - glucose tabs, epipen, nitro, activated charcoal [can't in NY anymore... i think], MDI, albuterol, HiCon O2 [yes - it's a medication], and EMT-B can now administer IN Noloxone here.

It's not CC or Medic stuff, but hey, they save lives.

Manual traction - I've done it once in eight years. Don't count on doing this very often. My EMTB instructor said he did it three times in twenty-five years.

AND FYI -- Traction splints are isolated midshaft femoral fractures ONLY


If you never apply a c-collar on a patient, stay away from my family and friends. If you suspect spinal injury/trauma, you gotta get that thing on. I've had someone refuse care, walk away from me, have there name called and when they turned around quickly and dropped dead. MedEx said he severed C-2 and C-3 and T-1 to T-5 had trauma.


ALWAYS collar a pt on a backboard. If they die, will it have been worth saving 12 seconds?

 

[NomadicMedic]

Yeah, that C collar is a lifesaver!

That guy that "dropped dead in front of you"... Would he have lived if you put a collar on?

 

[TransportJockey]

SO wrong. As a basic, I'm now CC, I've administered
Medication - glucose tabs, epipen, nitro, activated charcoal [can't in NY anymore... i think], MDI, albuterol, HiCon O2 [yes - it's a medication], and EMT-B can now administer IN Noloxone here.
Sounds like less than a basic can administer in the field out here... What do you mean by you're CC?
It's not CC or Medic stuff, but hey, they save lives.

Manual traction - I've done it once in eight years. Don't count on doing this very often. My EMTB instructor said he did it three times in twenty-five years.

AND FYI -- Traction splints are isolated midshaft femoral fractures ONLY


If you never apply a c-collar on a patient, stay away from my family and friends. If you suspect spinal injury/trauma, you gotta get that thing on. I've had someone refuse care, walk away from me, have there name called and when they turned around quickly and dropped dead. MedEx said he severed C-2 and C-3 and T-1 to T-5 had trauma.


ALWAYS collar a pt on a backboard. If they die, will it have been worth saving 12 seconds?
Well that's why I don't bother backboarding a lot of patients. More harm than good to backboard every single patient. MOI is a lousy indicator and more and more evidence is showing backboarding just doesn't work. A collar and a smooth non-emergent ride to the hospital is all most of them will need, if that.

Mine in bold.

 

[joeyCC]

Mine in bold.

I don't have a choice in NY to decide weather or not to backboard. it's state protocol for most instances.

That list is what I was able to admin as a basic in NYC. I'm AEMT CC now in Suffolk and Nassau (long island) so my protocols are different and i ride ALS.

Smooth rides don't exist here.

And his death - possibly, I'm not a MD sso dunno. Maybe keeping him alive an hour longer w/ trans to a TC could have done something.. he was walking, running, talking, breathing and perfusing. my point was that I planned on it prior to him jumping up and running off screaming.

 

[joeyCC]

and you can't tell me that a board wouldn't be in our knowledge base in BLS.

we're not towel boys.

 

[joeyCC]

Mine in bold.

Last one, when you are carrying someone with a suspected spinal injury down 5 flights of stairs and you know that applying a board takes 2 or 3 minutes, where do you find the harm? \
I'm guessing NY just has pretty high standards for BLS care.

 

[NomadicMedic]

Absolutely. The highest.

 

[TransportJockey]

and you can't tell me that a board wouldn't be in our knowledge base in BLS.

we're not towel boys.

I never said it wasn't in knowledge base. And if I find an indicator to board someone, I will. But if I have an A&Ox4/4 pt, no neck pain, ambulatory on scene, with no ETOH or other intoxicant on board... They're going to maybe get a collar, then be walked to the truck, or placed on a gurney and loaded into the truck. You have to use common sense and current practice/research to understand that a lot of things that are done in EMS because 'that's the way we've always done things' are wrong.

 

[TransportJockey]

Last one, when you are carrying someone with a suspected spinal injury down 5 flights of stairs and you know that applying a board takes 2 or 3 minutes, where do you find the harm? \
I'm guessing NY just has pretty high standards for BLS care.

Actually I'd probably put them in a collar and KED and use a stair chair to get them down. The only places, though, that I have in my coverage area that are over 2 stories are oil rigs... and there if I suspect a spinal injury, I'll collar them, put them in a stokes, and rope them down. Then start a steroid treatment in the field to try to minimize damage.