Trauma surgeons are pretty consistently interested as well. They're the only docs I've had scream "shut up till he finishes"
How to Keep From Putting Your Blinders On
- Thread starter usalsfyre
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Trauma surgeons are pretty consistently interested as well. They're the only docs I've had scream "shut up till he finishes"
abckidsmom
Dances with Patients
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Toxicologists. The poison control physicians are always very interested in the EMS provider's point of view.
abckidsmom
Dances with Patients
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Yeah. The tox guys, one in particular, likes to wait till you're done, then grill you for more details. I learn so much when I deal with him. I love a good random overdose on everything available in the house. It's always a good time with our 30 minute response/scene time and 60-75 min transport time. We see lots of changes on overdoses.
Aidey
Community Leader Emeritus
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Ahhh, I won't call them anymore. Too many issues.
AnthonyM83
Forum Asst. Chief
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I think this comes from nurses getting burnt out from such a variety of crappy reports. We aren't given much training...and half the time a new EMT doesn't know what's important or not. I remember being new and thinking my information was super important and seeming very proud that I caught that the pulse pressure was decreasing by about 5 mmHg each time (with no other associated symptoms).
You also want to know what kind of information each person wants. The triage nurse tends to want the big important items to know how to classify them. The doctor who walks by and asks "whatcha have" without stopping wants a one or two word answer. The nurse who will actually be taking care of him bedside usually wants to know more details and a background story and extras like whether family is coming. The doctor who walks up bedside and asks for a report probably wants more details on the medical side, but not as much background context as the nurse does. Etc etc etc
Aidey
Community Leader Emeritus
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Nothing like hearing "Everyone in this room shut the hell up except for her!" as the MD points at me. No pressure....
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My issue is going to the same hospital and giving a good report, and then showing up the next day, giving the same length report and having a different RN zone out after 10 seconds. I don't spend enough time in every emergency room to figure out which individual RN likes what style of report. Every RN gets the same style report (which takes less than a minute usually) and I'm going to err on the side of giving a little more than the bare minimum since most of them want it anyway, and at worst my patients are usually non-emergent and it's just not that hard to pay attention to someone for 60 seconds or so.
I can tailor my reports to individual hospitals (bring a BS patient to an ER that's New England's largest trauma center, keep report real brief) but not to individual staff.
DrParasite
The fire extinguisher is not just for show
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When you hear hoof-beats, should you think zebras or horses?
if it looks like a duck, walks like a duck, quacks like a duck, do you really think it is a rhinoceros?
Still got to do a proper assessment on your patients, especially those who can't speak to you. And yes, if you get lazy, all you need is to get burned once to get that reminder that even a duck needs to be fully examined to confirm it is indeed a duck (doc pulled me aside a few days later and told me the ambulatory patient we brought it was sent up to the ICU about 10 minutes after we dropped her in triage... won't be making that mistake again).
I've had trauma docs listen to me, regular EM docs, and RNs during routine reports. Maybe I'm spoiled, maybe they trust me, I don't know. All of our patients get triaged by a nurse upon our arrival, based almost entirely on the report of EMS. a more detailed report is given to the nurse registering and taking the full report, and it's usually documented. and if we come in with ALS, either they or I will give the report to the nurse and sometimes the doc if he or she isn't too busy (also depends on the condition of the patient).
Then again, I can pull into the ER with a sick patient, and have a bed waiting for me (if I call in advance), so maybe I am spoiled. When you work with the same nursing tour (they have the same rotation as we do), and the docs know who you are since you see them every shift, it builds your relationship.
if it looks like a duck, walks like a duck, quacks like a duck, do you really think it is a rhinoceros?
Still got to do a proper assessment on your patients, especially those who can't speak to you. And yes, if you get lazy, all you need is to get burned once to get that reminder that even a duck needs to be fully examined to confirm it is indeed a duck (doc pulled me aside a few days later and told me the ambulatory patient we brought it was sent up to the ICU about 10 minutes after we dropped her in triage... won't be making that mistake again).
I've had trauma docs listen to me, regular EM docs, and RNs during routine reports. Maybe I'm spoiled, maybe they trust me, I don't know. All of our patients get triaged by a nurse upon our arrival, based almost entirely on the report of EMS. a more detailed report is given to the nurse registering and taking the full report, and it's usually documented. and if we come in with ALS, either they or I will give the report to the nurse and sometimes the doc if he or she isn't too busy (also depends on the condition of the patient).
Then again, I can pull into the ER with a sick patient, and have a bed waiting for me (if I call in advance), so maybe I am spoiled. When you work with the same nursing tour (they have the same rotation as we do), and the docs know who you are since you see them every shift, it builds your relationship.
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Such systems and relationships and are incredibly useful and I would love to work in a place where I could use and develop them.
I've been studying a lot for an anatomy exam, which has been incredibly useful for my assessment skills especially for the sports medicine job. I think knowing how the body actually works is incredibly important to not being unintentionally blinded. If you can understand how the systems works, you can easily spot when something is wrong and target your assessment from there. I love watching my boss assess an injured athlete as he has a specific reason for every diagnostic and test he does. If much of your assessment is for "just in case" purposes, you're giving yourself too much information to analyze and are just going to confuse yourself to the point that you don't even know what the complaint is anymore.
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I know what you mean. Really. Exactly what you mean. I've been there, done that. Your boss also has developed a systematic manner that he uses to assess athletic injury and knows what tests can confirm what he suspects instead of doing tests "just because" in the hope of a specific diagnostic finding.
It's actually fun! What also gets fun is when you're giving report and the doc suddenly realizes you just handed them the diagnosis... Doesn't happen with all patients, just the ones with injuries that an ATC would be all too familiar with... Yes, I've surprised a few with that.
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Work the same area long enough and go to the same ED's often enough, you'll eventually meet all the usual staff and develop at least somewhat of a rapport with them...
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Agreed. My schedule for the last 6 months has given me the opportunity to get to know the ER staff and even some of the floor staff pretty well. That combined with good, thorough reports earns you a lot of respect and they end up listening to you because they know you know your stuff. With that said some staff is just burnt out, angry, unfriendly or any combination of the above and those are the ones that get basic reports. If you aren't going to listen I won't waste my time type of situation.