Paramedics: What was your FIRST critical call(on your own), and how did it affect you as a medic?

[medic6676]

Not so much a personal attack, just a general characterization. You are obviously smart and motivated. Often, this is paired with a certain degree of cockiness which you have likely been told about by others at various times.

I have no doubt you are a good provider and that you will ultimately be successful. Those who are smarter than their peers have a hard time for reasons that don't always seem to make sense; one reason is that you choose to make (not inaccurate) points at inappropriate times.

This thread is about sharing experiences at a time when people have a lot to learn... You chose to (seemingly) question the actions of the contributor... This comes across as a ****-move and makes a new member hesitant to post further. While we all need thick skin to survive in this field, your comment came across as abrasive rather than helpful.

Just my opinion and I am open to being wrong... If you lived closer I'd buy you a beer and we'd sort it out. [emoji482]

While I appreciate the defense and comradery, I have a thick enough skin. Got my start in an old timers FD/EMS squad.

That being said to DesertEMT, your reply in questioning how I provided the care I did, tended to lean towards the attack-like side, questioning why I worked an obviously dead patient.

In my humble opinion, I don't transport dead bodies, instead I prefer to attempt to resuscitate on scene and if fail, secure. In this case the patient was loaded, and the BLS crew was working him. Also the brain matter that was showing was minimal, so I wouldn't necessarily refer to it as injuries that are incompatible with life. The lacerations were each about 2 inches in length, and about a quarter to half inch in width, and had cracked through the skull. While there will obviously be heavy infection, and the patient would require a long period of recovery, I don't see those injuries as incompatible with survival.

Now I would like to return the same courtesy you did to me, and discuss your first call.

The biggest point I would like to make, and this is because I have done this exact call: Why did you attempt six IVs? With a patient who wasn't breathing, I would have given no more than two IV attempts, in fact on my call, because he was Chenye-Stokes breathing, I made one attempt, and moved on to IO. The patient was showing signs of true life threatening illness, and I made the decision to get the D50 on board.

So while I am not in a place to judge you on your practice of care, and I am only doing this because you opened the door, I would like to ask you why you and your preceptor chose to take at least ten minutes to attempt 6 IVs?

Straight curiosity, and do not take this as any sort of attack.

 

[DesertMedic66]

While I appreciate the defense and comradery, I have a thick enough skin. Got my start in an old timers FD/EMS squad.

That being said to DesertEMT, your reply in questioning how I provided the care I did, tended to lean towards the attack-like side, questioning why I worked an obviously dead patient.

In my humble opinion, I don't transport dead bodies, instead I prefer to attempt to resuscitate on scene and if fail, secure. In this case the patient was loaded, and the BLS crew was working him. Also the brain matter that was showing was minimal, so I wouldn't necessarily refer to it as injuries that are incompatible with life. The lacerations were each about 2 inches in length, and about a quarter to half inch in width, and had cracked through the skull. While there will obviously be heavy infection, and the patient would require a long period of recovery, I don't see those injuries as incompatible with survival.

Now I would like to return the same courtesy you did to me, and discuss your first call.

The biggest point I would like to make, and this is because I have done this exact call: Why did you attempt six IVs? With a patient who wasn't breathing, I would have given no more than two IV attempts, in fact on my call, because he was Chenye-Stokes breathing, I made one attempt, and moved on to IO. The patient was showing signs of true life threatening illness, and I made the decision to get the D50 on board.

So while I am not in a place to judge you on your practice of care, and I am only doing this because you opened the door, I would like to ask you why you and your preceptor chose to take at least ten minutes to attempt 6 IVs?

Straight curiosity, and do not take this as any sort of attack.

we attempted 6 IVs because the patient had what looked to be really good veins. Good flash but as soon as we advanced the cath the vein would blow. I thought I messed up on the first IV so I attempted again. My preceptor then gave it some tries with the same result. It didnt take 10mins however we did have an extended amount of time on scene trying to move things out of the house to get him out.

My response wasn't mean to attack an any way. I don't know what system you are in or how your protocols are. With the minimal amount of information given in both mine and your scenarios, it's hard to make judgement.

 

[medic6676]

we attempted 6 IVs because the patient had what looked to be really good veins. Good flash but as soon as we advanced the cath the vein would blow. I thought I messed up on the first IV so I attempted again. My preceptor then gave it some tries with the same result. It didnt take 10mins however we did have an extended amount of time on scene trying to move things out of the house to get him out.

My response wasn't mean to attack an any way. I don't know what system you are in or how your protocols are. With the minimal amount of information given in both mine and your scenarios, it's hard to make judgement.

Fair point, you had a valid reason and I give you props for what you did.

I understand why you were curious about my call, yet just a piece of advice consider your wording for asking about a different system and questioning why another medic did what they did, without making it sound accusary. Black and white may not always be clear, but it has tones, so consider the tone you are using when having a black and white conversation.

 

[DesertMedic66]

Fair point, you had a valid reason and I give you props for what you did.

I understand why you were curious about my call, yet just a piece of advice consider your wording for asking about a different system and questioning why another medic did what they did, without making it sound accusary. Black and white may not always be clear, but it has tones, so consider the tone you are using when having a black and white conversation.

Agreed, I could have worded it much better.

 

[medic6676]

Does your county/district not have an organ recovery team?

I just saw your reply, and no, harvests are done in the OR at the major medical center.

 

[Handsome Robb]

He made a statement which was absolutely true, I don't see that as attacking.
Gotshirtz, stow it. I'm trying to be a FF after spending 4 years in private EMS and realizing it's not a career so like desert asked, what bearing does that have on anything?

10 minutes attempting to start a line to administer a widely accepted treatment is absolutely appropriate. Picking up and running screaming to the hospital like many providers probably would have done is not.

We run 1600 calls/year per provider so I don't specifically remember my first critical call. I've also had a lot of stupidly sick patients/bad calls for whatever reason so that doesn't help.

After my 5th pedi arrest I finally realized that I couldn't save them all and to not take it personally when I couldn't. It took counseling and a lot of soul searching to realize that but that's what I learned.

 

[medic6676]

He made a statement which was absolutely true, I don't see that as attacking.
Gotshirtz, stow it. I'm trying to be a FF after spending 4 years in private EMS and realizing it's not a career so like desert asked, what bearing does that have on anything?

10 minutes attempting to start a line to administer a widely accepted treatment is absolutely appropriate. Picking up and running screaming to the hospital like many providers probably would have done is not.

We run 1600 calls/year per provider so I don't specifically remember my first critical call. I've also had a lot of stupidly sick patients/bad calls for whatever reason so that doesn't help.

After my 5th pedi arrest I finally realized that I couldn't save them all and to not take it personally when I couldn't. It took counseling and a lot of soul searching to realize that but that's what I learned.

Rob, I just want to say this was settled. It was just a misunderstanding based on the tone Desert wrote in, haha.

 

[COmedic17]

Yes if you read my reply you will see why. As well as the choice was more my preceptors to run the code. Either way while the injuries at have been incompatible with life, through resuscitation efforts we were able to get him to a harvest facility and save numerous others lives.

I'm far from illiterate or ignorant, I both understood and read what you said.

I was just curious why anyone would initiate resuscitation on a patient with injuries incompatible with life. My "you initiated...." Quote wasn't so much directed at you as it was the entire crew on scene in general. Trauma arrests typically have very very low success rates to begin with. If I (or my team) initiated a resuscitation on this same patient you speak of, I would of had some very descriptive and not-so-friendly feedback directed towards me (us).

I was asking if you had an organ recovery team because some areas have organ recovery specialists or "teams" that will head towards scenes when an on scene resuscitation has been taking a bit and no transport has been initiated. Then they are ready to go when the code is "called" ( as long as the cause of death didn't involve something that would inhibit organ recovery).

I wasn't trying to belittle you. I was just curious, as every system is run in a different fashion.

If I thought you were incompetent or stupid, you would know. I wasn't born with a filter. I was just being inquisitive. So I apologize if you took it the wrong way.





On a side note- you will grow to love me

 

[COmedic17]

@medic6676[/USER COmedic has lots of good of good posts and is generally worth listening to. .

You made me blush

 

[medic6676]

I'm far from illiterate or ignorant, I both understood and read what you said.

I was just curious why anyone would initiate resuscitation on a patient with injuries incompatible with life. My "you initiated...." Quote wasn't so much directed at you as it was the entire crew on scene in general. Trauma arrests typically have very very low success rates to begin with. If I (or my team) initiated a resuscitation on this same patient you speak of, I would of had some very descriptive and not-so-friendly feedback directed towards me (us).

I was asking if you had an organ recovery team because some areas have organ recovery specialists or "teams" that will head towards scenes when an on scene resuscitation has been taking a bit and no transport has been initiated. Then they are ready to go when the code is "called" ( as long as the cause of death didn't involve something that would inhibit organ recovery).

I wasn't trying to belittle you. I was just curious, as every system is run in a different fashion.

If I thought you were incompetent or stupid, you would know. I wasn't born with a filter. I was just being inquisitive. So I apologize if you took it the wrong way.





On a side note- you will grow to love me

I actually want to apologize my tone in that post wasn't meant to come across as that. I just didn't know if you had seen my reply to another poster.

That being said yeah I understand where you are coming from, and I am all for not transporting dead people. But this situation just set itself up for it.

I do appreciate your feedback. I may have started getting rough as a couple other posters on posts attacking me even after I apologized for misspeaking.

 

[COmedic17]

But guess what? People criticize EVERYTHING.

And guess what?!?
Everyone ( even the stubborn ones who will never admit ) have made mistakes.
You could provide the best patient care in the world and someone will have something negative to say about it.

Jobs like EMS, Fire, and Police tend to attract alpha personality types. Which is why we all continuously disagree. Many won't admit it- but we are all incredibly stubborn. Which is also what makes it really fun to drink with your coworkers. It's like a traveling circus with jäger.

 

[medic6676]

Haha you were right I think I am going to grow to like you...oh look in growing already haha

 

[COmedic17]

I do appreciate your feedback. I may have started getting rough as a couple other posters on posts attacking me even after I apologized for misspeaking.

You don't need to apologize to me. I'm not easily offended.


And just go tell those people to suck a bag of hotdogs. They can talk all they want but they were not on scene, didn't visually see that happened, and god knows that they would do if presented with the same situation. People are often very good lawyers for their own mistakes but often very good judges for the mistakes of others. And it's a bunch of people on the Internet. Don't let their opinions ruin your day.

 

[medic6676]

Haha fair enough, sadly this was a different post and it was about education standards in NY EMS.

 

[COmedic17]

Haha fair enough, sadly this was a different post and it was about education standards in NY EMS.

Well you just tell them so suck a bag of hot dogs too