Preparing for a call mentally

[IronClaud]

I have zero experience as an emt/ Paramedic (starting emt basic this fall), but how do you guys prepare for a call mentally? When you get that call on the radio what travels through your mind? Are you strategizing your plan of attack? Picturing the scene? Or do you simply think "whatev" and see what everything is about when you get there? I'm just curious in the mental preparation.

 

[Anjel]

Depends on the call.

If it is a non transfer call. And it is actually someone who called 911. Me and my partner will talk and say who is going to do what.

During my FTO we got a call for pediatric pt unresponsive. And the entire way there I was thinking "Oh :censored::censored::censored::censored: oh :censored::censored::censored::censored:".

Some people just may like to wing it. But I perfer to at least know what equipment I am grabbing. Who is making first contact with the pt. And what could possibly be wrong.

 

[DesertMedic66]

When I get the call I am planning the quickest way to the call and the quickest way to the hospitals. We bring in the same gear for every call from a fever to a full arrest. I already talked to my partner before shift so I know what each of us will be doing (1 less thing to think about when a call goes out). Other then that we pretty much wing it. Things change too much during a call to have a set plan.

 

[JPINFV]

Or do you simply think "whatev" and see what everything is about when you get there? I'm just curious in the mental preparation.

Basically this. The only sort of 'preplanning' I've ever really done is look up the closest hospital and fire station if I'm unsure of the paramedic vs rapid transport dilemma. The biggest issue is that you don't want to get tunnel vision because often the dispatch complaint and the actual complaint don't match up (e.g. "congestion" at nursing homes has even money at being pulmonary edema).

 

[IronClaud]

These all seem to be great points. I would definitely think it's a good thing to communicate with your partner before the shift or every call. Hopefully your partner has some sort of interpersonal communication skills lol.

 

[mike1390]

I try to not fall asleep while my partner drives, I thought it was impossible at first "how could anyone fall asleep while going to a 911 call right?" wrong happens all the time lol. Generally ill think to myself after reading the call text that there is no way somebody is calling 911 for this or how the hell did that person do that? after a while the adrenaline wears off and you can run full arrests like they are a runny nose call. the biggest key is to keep your cool if you walk into a house all worked up you have just made the situation 10x worse. so a couple deep breathes and have fun.

 

[BEorP]

As others have said, it depends on the call. If you're not familiar with the area, then confirming you know what the closest hospital is is often wise. Occasionally, I have done a quick review of a protocol, particularly if it is one that is not frequently used (or especially pediatric dosages). If working with someone I am not familiar with and going to a call like a cardiac arrest, we may very briefly discuss our roles (not an in depth game plan by any means, more like "you start CPR and I'll get the pads on" kind of thing).

Or sometimes we just listen to music and drive fast.

 

[IronClaud]

I try to not fall asleep while my partner drives, I thought it was impossible at first "how could anyone fall asleep while going to a 911 call right?" wrong happens all the time lol. Generally ill think to myself after reading the call text that there is no way somebody is calling 911 for this or how the hell did that person do that? after a while the adrenaline wears off and you can run full arrests like they are a runny nose call. the biggest key is to keep your cool if you walk into a house all worked up you have just made the situation 10x worse. so a couple deep breathes and have fun.

Wow, that's crazy that someone can fall asleep en route to a 911 call lol. I guess a cardiac arrest becomes second nature after awhile lol.

 

[IronClaud]

As others have said, it depends on the call. If you're not familiar with the area, then confirming you know what the closest hospital is is often wise. Occasionally, I have done a quick review of a protocol, particularly if it is one that is not frequently used (or especially pediatric dosages). If working with someone I am not familiar with and going to a call like a cardiac arrest, we may very briefly discuss our roles (not an in depth game plan by any means, more like "you start CPR and I'll get the pads on" kind of thing).

Or sometimes we just listen to music and drive fast.

Yeah, I think one of the challenges for me right off the bat would be figuring out where to go, what roads to take. Do most ambulance companies and FD have gps in their vehicles? Or is it purely just getting use to where you are going?

 

[DesertMedic66]

Yeah, I think one of the challenges for me right off the bat would be figuring out where to go, what roads to take. Do most ambulance companies and FD have gps in their vehicles? Or is it purely just getting use to where you are going?

That all depends on your service. For my service we rely on the Thomas Map Guides. We are welcome to go out and buy our own GPS but it's on our dime.

 

[MrBrown]

We get job text on the MDT via the call taker but Brown doesn't read into it.

For example, it might be a "unconscious, not breathing" or "sick past 3 days" and thats it.

You find out when you get there and just go with what ever is found

 

[IronClaud]

We get job text on the MDT via the call taker but Brown doesn't read into it.

For example, it might be a "unconscious, not breathing" or "sick past 3 days" and thats it.

You find out when you get there and just go with what ever is found

Well said Mr. Brown. Straight forward and to the point. lol.

 

[vamike]

As we pulled up to what turned out to be my first code, the paramedic says " remember that this is their emergency, not yours." as he was pointing at the family already doing cpr. I remember that and it helps me keep my cool when the s*** hits the fan.

 

[TransportJockey]

I prepare for a call by eventually waking up sometime before we get to scene.

 

[Shishkabob]

I learned never to make a plan based off of dispatches info, as not only can they be, but often are, wrong (not their fault, bad call info), and something may come off worse sounding, or better sounding, than it is, and you lack all the info required to make a basic guess as to what needs to be don. Also true emergent scenes develop rapidly, and you need to be able to adapt and not just stick with one plan.




I do make "general" plans though, such as my partner knows on an arrest, his job is to drop a King airway while I do the IO. Or, for example, last week there was a multi-casaulty machete attack. Only words that were said was I told him "We grab the patient, put them in the truck and lock the doors to anyone but PD"




Otherwise, we simply chat / laugh / listen to the radio.

 

[fast65]

I usually just kind of wing it, our dispatch hasn't always been the most accurate so there's no reason to read too much into it.

 

[abckidsmom]

When I get the call I am planning the quickest way to the call and the quickest way to the hospitals. We bring in the same gear for every call from a fever to a full arrest. I already talked to my partner before shift so I know what each of us will be doing (1 less thing to think about when a call goes out). Other then that we pretty much wing it. Things change too much during a call to have a set plan.

The equipment we bring in varies wildly from a standard call to a cardiac arrest, so if it is dispatched to be complicated, we'll talk about what's going in. Usually the decision is made as we're pulling up and get a look at the scene, so a lot of times we'll get the visual and I'll say something like "I've got the bag and the clipboard, you bring the cot with the immobilization stuff"

For a cardiac arrest, we need to bring the monitor (doesn't usually go into the house except for chest pains), the drug box, suction, oxygen bag, sometimes pedi bag, etc. It's quite a load, and that stuff doesn't usually go.

 

[abckidsmom]

I have zero experience as an emt/ Paramedic (starting emt basic this fall), but how do you guys prepare for a call mentally? When you get that call on the radio what travels through your mind? Are you strategizing your plan of attack? Picturing the scene? Or do you simply think "whatev" and see what everything is about when you get there? I'm just curious in the mental preparation.

To answer the OP,

I have found that stumbling into an emergency when I'm not at work makes my head spin sometimes. It takes me a minute to take off the "regular person" hat and put on the "medic" hat. Even when there's a walk up at the station, it doesn't take me off guard for whatever reason. You will get used to that, and develop that too. In that way, it's like a "whatev" kinda thing. You just do the work needed, no mental prep necessary.

As far as scene management, equipment, etc, you do need some communication, and you can talk about it with your partner to make you both able to work as efficiently as possible on the scene.

I'm just starting at a new department right now, so every time I work, it's with a new partner. It's extremely labor intensive to communicate with people about what your expectations are, or to find out what their expectations are of you, but it pays off, a lot, if you take the time to do so.

In my new department, I want to know what the standard is, to find out what "everybody" typically does, so that I can communicate with my partner only what's different for me.

Most of this communication happens during checking out the truck for me, as well as throughout the day. But we can have pretty lengthy response times, so there's usually plenty of time for figuring it out on the way.

 

[DesertMedic66]

The equipment we bring in varies wildly from a standard call to a cardiac arrest, so if it is dispatched to be complicated, we'll talk about what's going in. Usually the decision is made as we're pulling up and get a look at the scene, so a lot of times we'll get the visual and I'll say something like "I've got the bag and the clipboard, you bring the cot with the immobilization stuff"

For a cardiac arrest, we need to bring the monitor (doesn't usually go into the house except for chest pains), the drug box, suction, oxygen bag, sometimes pedi bag, etc. It's quite a load, and that stuff doesn't usually go.

All of our stuff is combined. The drug box is in our ALS bag, monitor goes in for every call and a 4-lead is done on every patient, oxygen bag is in the ALS bag, there is a pedi section in the ALS bag etc. So when we get a call we just toss the ALS bag and the monitor on the gurney and we have everything.

 

[usalsfyre]

4-lead is done on every patient

Not to hijack...but why?!?

Otherwise, aid bag has drugs, IV supplies, airway supplies including backup airways and cric kit, portable suction, basic trauma supplies, O2 administration devices, ect. This and the cardiac monitor live on the stretcher, and go in on every call excluding transfers.