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Truth

Truth
Bleeding

Disclaimer:

Everything you read here should be considered fiction. Patient rights will always be respected. Any resemblance to persons living or not is purely coincidental.

Tuesday, March 27, 2012

EMT Class week 21 - Testing and review

We had our last regular written test on module 7 - ambulance operations.  I passed.  That's all I'm going to say.  I'm not the top person in the class by any means, but most of the questions drive me insane anyway so I'm just going to live with that for now.
After the test, on to stations.  We're practicing for practical exams now and I have to say that the first night panicked me a bit.  I'd been so focused on the written exams I had not been studying the practicals.  Blergh.  We have 4 tests to take.  Written class exam, practical class exam, practical NREMT exam, then written NREMT.  I don't have much stress about the written.  I'm re-reading the book, around 100 pages each night, so some of the old stuff will freshen up my mind.  Practicals are another story.

To pass the class, we need to get checked off on all of them.  On NREMT practical day, there are six stations.

We need to do all of these:
Trauma Assessment
Medical Assessment
CPR with AED
BVM apneic patient
Spinal Restriction (supine or seated - aka long board or KED)

Then we pick a card to get one of the following:
Splinting - Long Bone
Splinting - Joint
Splinting - Traction
OPA-Suction-NPA
Mouth-to-mask ventilation
Supplemental O2
Bleeding & Shock

I can do this.  I can do this.  I will not freak myself out about it.  I will be a good EMT dammit.

Van is holding extra review sessions this week and I think I'm going to partake.

Taylor and I are spending the day in the ED on Sunday.  From others' who have already gone, it's pretty tough.  Basically a day spent doing vitals.  Nobody wants you there.  They see you as an annoyance.  Super!

Saturday, March 17, 2012

EMT Class week 20 - Operations

We are winding up with the book work with the last 4 chapters: Ambulance Operations, Gaining Access & Highway Safety, Hazardous Materials, and Terrorism.

A lot to cover.  We hit another milestone as well when someone in class asked, "What page was that on?"  "One thousand forty-nine."  Holy frijoles.  End of The Book.  I will be extremely excited when I no longer have to lug that brick of a book around any longer.  Terrorism chapter was crazy long, and a load of new acronyms like CBRNE, TRACEM-P, OTTO, SLUDGEM, etc.  But the chapter was informative and had a ton more info on biological agents like Anthrax, Q Fever, Tularemia, Plague, and more.  Disease has always interested me, in fact I was looking at doing my Masters thesis in Spatial Epidemiology...

Great guest lecturers - the Deputy Fire Chief, an EMT/EMD, Tess, and Mr. Medic.  Some good discussion as well.  Test on Monday, then 4 more classes of review to prep for our finals.  Final class written comes next, then final class practical.  Then we do the NREMT practical.  Provided we pass all that, we schedule our NREMT written at the university testing center.  All this in the next 4 weeks.  (Not to mention I just began a new semester of graduate classes...)  EEEK!

Better news: clinicals are booked.  Taylor and I are headed for the "big city" ED for a ten hour shift on April Fool's day.  Should be an interesting day.

So, tons of study, revision, practice over the next four weeks.
I cannot wait!

Thursday, March 15, 2012

ePCR Pains

We are finally jumping into the digital age (and compliance) - we bought into an ePCR system.

Having done a few software implementation projects in my day, this one has gone about as poorly as it possibly could.  You take several dozen law enforcement officer - EMS providers and tell them they are switching to an ePCR system.  In an area that rarely has cell coverage and more rarely has internet.  No printers on the ambulances.  Transferring to 5 different county EMS and a couple helicopter services (in different states).  Throw this project on the back of an already over-stressed EMS director.

We went live a few weeks ago.
Chaos.

We were nowhere near ready to go live.

At the very least, we went live when our call volume is at its lowest.
And we had to jump off the bridge at some point.

So here we are.  Still filling out paper charts on a run, then entering data back at the office.  Naturally our run sheets are not set up like the ePCR, so there's a ton of jumping around to find correct fields.  Thankfully (for us) computer nerd/LE officer/AEMT George is on light duty for a leg strain.  He's desk-bound and has torn into the database and forms with enthusiasm.  In a couple weeks we have moved away from out-of-the-box horrible, to, um...less horrible.

George and I decided that maybe taking a few of the courses offered by the ePCR folks would be a good idea.  We are learning.  Slowly.

This is the continuing tale of our organization.  "We need you to moonlight this project," or "It falls in the category of 'other duties as assigned'."  Trouble is, the original duties don't just go away.  I don't know how the Pit Boss makes it all work, really.  At the very least he needs an assistant.  Instead, he's stuck with a rag-tag handful of willing volunteers who also have day jobs.  We're doing the best we can to patch the canoe, bail out the bottom, and simultaneously paddle.  Upstream.

Help!

Tuesday, March 13, 2012

EMT Class week 19 - TB tests and OB/Gyn-Peds-Geriatrics Exam

Too much going on.  Seems like class has sped up once again and we are racing to the end.  Hundreds of pages of reading to get through - all quite dense.

TB tests were uneventful - we all got poked by a nice nurse from the clinic Monday tests were read Wednesday, and our paperwork was signed.  Now Van can get us signed up at the hospital ED for clinicals.

We once again just scraped the surface of caring for emergencies with special populations.  I need to know more.  At this point, though, I've just resigned myself to getting through the testing.  There is so much in the book I disagree with and even our instructors have changed from the fun real-world enthusiasm to saying things like "Well, the written exams will want you to know what the book says, so..."

I'm making a conscious effort in class to keep my mouth shut.  Not speak up and give answers.  Apparently my forward attitude and inability to shut up is detrimental to the rest of the class.  They won't speak up or take control - call me arrogant, but is that really my problem?
So I'm playing nice.  Trouble is, I'm just not interested when I'm not engaged.  I end up looking up medical info on my tablet, or playing the Speed Anatomy app (which, btw, is incredibly fun).  So class is no longer that fun for me.  It used to be the highlight of my week.  Now, I'm just getting through it. I read my chapters, dutifully study the objectives, and try to feign interest even though I'm not participating.

Guess maybe I'm just down this week.

Monday, March 5, 2012

EMT Class week 18 - Trauma exam and OB-Gyn

Well, after extrication day we were all pretty wasted, but excited to keep moving forward.  Seems like class is speeding up at this point.  Just two very short modules left - Special Populations & Operations - so two exams, three nights of practice, then final written, final practical, NREMT written, and clinicals.  Too much, too fast!

We started off the week with our Trauma section exam.  It went fine.  I didn't fail, but didn't do as well as I wanted either.  I think I scored an 88%.  At this point I just want to get through the "book learning" and move on to studying our protocols.  The real way we work and not the 5-year old textbook interpretation. To learn how to assist with intubation, IV starts, and generally be a better EMT.
We spent the rest of the night taking vitals - just working on getting better at it.  We have a matrix of every person in the class and have to get their vitals at least once.  This way everyone is forced to practice at least a dozen times throughout the class.

We got a much more graphic look at childbirth in EMT class than we did in EMR class - more photos and fewer drawings.  Nothing like skimming through the chapter to find an explosive wave of amniotic fluid!  Anyway, we had the same instructor (nurse from the local clinic) and he did an excellent job.

Up next: Geriatrics, skills lab on special populations, and exam!