"What am I going to eat after this...?:
Just kidding.
When I actually was a a squad, a handful of times this year being the latest, I always like to see what is going on.
Where are we? What were we called for? Are there dangers like moving traffic, darkness, wires, gas leaks, that sort of thing.
Just like in my medical assessment, I don't look for ambiguous findings. I have specific things I am looking for.
Then I try to find a place to park with good egress. Some people always park the truck face in a driveway. Not only to they have to take an unneeded risk of backing out, but if another vehicle pulls up behind, they are stuck. Then it looks like a parade of fools as everyone juggles vehicles.
Whats more, if there is danger you may have to back out if possible or abandon the vehicle. Both equally bad options.
Then I want to know where the patient(s) is. So I can decide if they need to be "rescued" so that medical care can procede. It may be as simple as dragging their corpse out of the bathroom, or complex enough to require other resources which must be called.
If more than one I triage them and decide if I can handle them all.
Then I assess my patient for specific life threatening findings. If so, they are addressed as best we can while we further the goal of moving. If not, then a more thorough assessment takes place.
Depending on where I am, transport may not be a requirement, in which case a treatment plan must be formed with a follow up and patient education.
I am not overly impressed by communtiy hospitals. I understand their point, but life threats and the ability to look for and find obscure problems on common complaints is really rather limited. On a few occasions we did stop in very serious injuries because extra hands and equipment not available to us, along with a doctor and a helipad were better options than driving 45 minutes on the road requiring things we did not have. (the patients all required surgery, but if they don't live to surgery they don't get it.)
It all becomes a rather fluid balancing act. As you do it more, you become very good at it. It is all about volme of experience, not chronology.
Class knowledge can take you only so far. "Scene safe?" Do you know an unsafe one when you see it? Do you know it could change at anytime?
"ABC" those change over time too. Not to mention you could happen upon a patient who will have a problem with those, who has other findings first.
You could have a patient with chronic problems, who always have trouble breathing but have other complaints today.
Don't worry, over time you develop your own style.
Now for lunch.
