Too Much Information

It’s the week before the final exam and my EMT class is feeling the pressure. The two-hundred question final looms large on the horizon and, in less than a week, the students will need to perform five randomly selected skills stations perfectly. This is the task that has most of the students really feeling the heat.

So we do what we do every class. We practice and practice and practice. So there we were, gathered around in groups, practicing our National Registry skills sheets. That’s when Joey asked me the question that absolutely floored me. It floored me and annoyed me, but really didn’t surprise me. I’ve heard the question asked before in many different ways.

Joey finished up his medical scenario and I was giving him some feedback on his performance. He looked down at the fictional patient’s medication list that I had provided him and he shrugged his shoulders. “We don’t really have to know what all these mean right?”

I told him I didn’t understand. He mulled the thought over in his head and took another stab at it. “I mean…we need to write these down and report them to the doctor, but it isn’t important for us to know what they all do. (Pause.) As EMT’s. (Pause.) Right?”

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Patients Define Their Emergencies (Part 2)

True Story…

The dispatch information was updated before we had even rolled our rig out onto the pad. Eye injury, no serious symptoms. Jodie shut down the lights and I informed dispatch that we’d be responding non-emergent.

Up stairs and inside the small two bedroom apartment, Samantha, our patient, was waiting on the couch, holding a hot compress to her swollen right eyelid. Mom worked calmly in the kitchen finishing diner for her other two children. Alan, Samantha’s father sat on the edge of his seat next to his daughter in a state of barely containable anxiety.

He had recently arrived home from work and his wife had informed him of the apparent infection in Samantha’s right eye. One look and he was on the phone to us. Now he breathed rapidly as he fumbled through a list of questions. What caused it? Could it damage her vision? Could she lose her eye? Could she go blind?

I cleared the engine to go back in service and sat down next to him. Over the next ten minutes we both explained what pink-eye was and how to take care of it. We talked about hot-compresses and how contagious the bacteria was going to be. We reviewed the typical course for such and infection. How to prevent it in the other kids. How likely it was that one of them already had it. And we discussed his plan for morning. (It involved asking a neighbor to drive them to a near-by clinic.)

Alan called 911 for pink-eye. And…(This part is bound to be controversial, depending on what kind of system you work in.) I never offered to take him to the emergency room. And he never asked.

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Fire Based EMS vs. Private EMS

“In Germany they first came for the communists, and I didn’t speak up because I wasn’t a communist. Then they came for the Jews, and I didn’t speak up because I wasn’t a Jew. Then they came for the trade unionists, and I didn’t speak up because I wasn’t a trade unionist. Then they came for the Catholics, and I didn’t speak up because I was a Protestant. Then they came for me – and by that time no one was left to speak up.”

- Rev. Martin Niemoller

Yesterday an Action Care ambulance covered my station while I was at a training. Action Care is the local private ambulance service. I know, the name always seemed a little silly to me. If a super hero ever created an ambulance service, he would most certainly call it Action Care. I joke about the name, but they’re the real deal. If you’re going to work as a private service EMT, you could do worse than Action Care. And if that doesn’t work out, there’s always the medical billing and coding field.

I’m glad we have Action Care. They help cover our district when we are low on resources. They are always professional and polite on scene. They give good care.

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Behind Every Great EMT…

Call it a curiosity. I wanted to know how the EMT Spot readers would finish the sentence, “Behind every great EMT…” So I asked.

I asked on twitter. I asked on Facebook. I even asked right here at the blog. And the answers poured in. Your responses represented the full spectrum of personalities that inhabit our workplace. There were poignant responses, cynical responses and a bunch of funny ones. The responses made me smile and frown and think.

Within this list of answers you’ll find feedback from 30+ year EMS veterans and newbies just getting their EMS feet wet. Everyone is represented. And the responses are telling.

I’m rather proud of how this little experiment turned out. I hope you find these responses as enjoyable and thought provoking as I did. Thanks for all your contributions. Aside from categorizing these contributions, I’ve made no further editorial additions. This post will become part of the guest posts category, because it was written by you.

Complete the sentence, “Behind every great EMT…”

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8 Tragic EMS Behavior Flaws to Avoid

In Greek tragedies, the hero typically displays some form of hamarita, also known as a “tragic flaw.” Hamlet was brooding, Othello was jealous, Macbeth was ambitious. For the most part, it is their tragic flaw that is usually the key to their undoing. When the hero ultimately falls, they tend to sow the seeds of their own demise with their respective tragic flaws.

People often use the word hero when they refer to EMS caregivers. EMT’s, paramedics, firefighters, we all get the hero moniker pinned on us from time to time. I cringe at the term. Most of us are uncomfortable with it to different degrees. And, if there is any truth to our hero title, it is certainly closer to the heroes of Greek tragedy that the comic book heroes we grew up with.

In other words, we all have our tragic flaws. Yes, all of us.

Here are eight of the most common tragic flaws of the EMS hero persona. I have, at one time or another in my career, embodied each and every one of these flaws to one degree or another. I’ve lived each one of them. I would guess that most of us do.

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Midnight

Our department recently offered an early retirement buy-out option.  I understand a half-dozen or so people took it. So next month, 6 or so of my colleagues will run their last call and close the door on their career. Six people will write the final chapter and be done.

It makes me wonder. I wonder what that’s like, to hear the tones go off and say, “Yup, this is probably it, the last call of my career.”

What will people say about your EMS career when you’re all done? For many of the readers here at the spot, retirement is a long way away. It’s hard to imagine what is will one day be like to not be in EMS anymore. Yet, it’s worth considering, because you never really know when your last call will be.

Consider Elizabeth Ann Mitchell.

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Where Do You Put The Fear?

I once thought that part of the goal of being a competent paramedic was getting to the point where I no longer felt any fear or anxiety about running calls. After all, most of the folks I worked with appeared to be absolutely fearless. At least the competent ones did. They never go flustered or rushed. They smiled. They remained calm in the face of very real emergencies. I needed to be like that.

Eventually I figured out how to act like they acted, but I never really mastered the whole not-feeling-any-fear thing. It nagged at me for a long time. It took me almost a decade to figure out the secret.

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The Ultimate EMT Guide to Vital Signs

Part 2: The Blood Pressure

I love teaching each new EMT class cycle how to take a blood pressure. It’s fairly simple and strait-forward, but there’s also a real art to it. Folks who are good at it wield their blood pressure cuff like a teppanyaki chef wields his knife. You can tell they’re good by watching the confidence in their movements, the order that they perform the steps, and the attention they give to the details.

There’s a big difference between the guy who chops vegetables down at the local Denny’s and the chef at the Benihana. Same tools, different level of skill. You see what I mean right? If your blood pressure skills are still somewhere in between the short order cook and the teppanyaki chef, here are some tips to getting better.

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The Ultimate EMT Guide to Vital Signs

Part 1: The Pulse

There are few things that EMT’s should claim as their domain. There are certain skills that the EMT provider should simple dominate. Vital signs are one such skill. No medical provider anywhere should be able to hold a candle to the EMT when vitals signs are the name of the game.

Vital signs are, to the EMT, what sharp shooting is to the sniper; what the fast ball is to the closing pitcher; what swordsmanship is to Zorro. It’s the EMT bread-and-butter skill. And yet…so many EMTs fumble through vital signs like it’s amateur hour. No more. Over the next few weeks we’re going to break down vital signs here at The Spot and make every one of our trusted and loyal readers a vital sign virtuoso.

Are you ready? Carnegie Hall awaits. Let’s start with the pulse check.

Some EMT’s can take 30 seconds to a minute to check a pulse. When they’re done they have one single piece of clinical information to pass on, the heart rate. Others can feel a pulse for 3 seconds and tell you much, much more about the patient’s cardiovascular status. What’s the difference? Practice and focus. If you’d like to be the second EMT, here’s how.

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How Being Burnt Out Can Ignite A Rebirth

A Guest Post By Jim Hoffman

“The EMS Professional,” “The Paramedic Mentor,” Today’s guest author, Jim Hoffman has more nicknames than a retiring prizefighter and he’s earned every one of them. From the streets of The Big Apple to New Jersey and now the secluded mountains of upstate New York, Jim has been a paramedic for the better part of two decades.

In his down time, Jim runs EMS-Safety.com, a one stop shop for low cost EMS training resources. He’s also part of the team behind The EMS Boot Camp series. After a little cajoling I talked Jim into letting me post his Handover contribution as a guest post. So this is me, stealing all of Jim’s literary  goodness for you. (Thank me later.)

And now Jim:

As an EMT in a large EMS system I found myself becoming burnt and indifferent to the patients I was responding to and treating; all too often being annoyed at the calls that obviously just didn’t require an ambulance and more often didn’t even require a doctor.

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