EMT Protocols (what else?)
Also, for you Dark Tower fans out there, King's latest "The Wind through the Keyhole" aka The Dark Tower 4.5 is out. I just got my copy today, so protocols may have to wait a little while!
In the EMS blog world, I am still getting caught up on Siren Voices. If you're not reading it, you are really missing some fantastic writing.
Truth
Bleeding
Friday, April 27, 2012
Thursday, April 26, 2012
NREMT
It was not simple. The questions were harder than I thought they would be.
It went too fast. About 35 minutes.
It didn't seem like enough questions - I last looked on #55.
Then it ended. Abruptly. It was done.
I had plenty of time to ponder as I drove the hour and a half home. Did I fail that miserably? I didn't think so, but it didn't feel like a slam-dunk either. By mile 50 I was convinced I'd failed and would have to pay, schedule another test, take another day off work, and drive another 150 mile round-trip to the testing center. I had told a few people it was my test day, they would be surprised if I tanked it. Mr. Medic knew, Taylor knew. Crap.
With the EMR class last year, it took a couple of days to post. How could I wait that long?
[And yes, I have heard the stories about "Back when I took my test we had to wait by the mailbox for weeks. Walked to it three times a day in 6 feet of snow, uphill, both ways..."]
It doesn't make the waiting any easier, folks.
So, fingers trembling, I logged in on the off chance it had posted.
Examination Scored
Congratulations on passing the NREMT National EMS Certification cognitive examination
And there it is. I passed.
Still waiting for the pshychomotor exam results to make it through the bureaucracy, but for now I'm done testing.
Time to start studying protocols.
:-)
It went too fast. About 35 minutes.
It didn't seem like enough questions - I last looked on #55.
Then it ended. Abruptly. It was done.
I had plenty of time to ponder as I drove the hour and a half home. Did I fail that miserably? I didn't think so, but it didn't feel like a slam-dunk either. By mile 50 I was convinced I'd failed and would have to pay, schedule another test, take another day off work, and drive another 150 mile round-trip to the testing center. I had told a few people it was my test day, they would be surprised if I tanked it. Mr. Medic knew, Taylor knew. Crap.
With the EMR class last year, it took a couple of days to post. How could I wait that long?
[And yes, I have heard the stories about "Back when I took my test we had to wait by the mailbox for weeks. Walked to it three times a day in 6 feet of snow, uphill, both ways..."]
It doesn't make the waiting any easier, folks.
So, fingers trembling, I logged in on the off chance it had posted.
Examination Scored
Congratulations on passing the NREMT National EMS Certification cognitive examination
And there it is. I passed.
Still waiting for the pshychomotor exam results to make it through the bureaucracy, but for now I'm done testing.
Time to start studying protocols.
:-)
Tuesday, April 17, 2012
EMT Class week 24 - The final chapter...and the beginning
We passed. We all passed.
Class practicals, class written, and NREMT practical. Done.
Clinicals? Done.
NREMT written? Scheduled for one week from today.
Funny, I feel less capable now than I did when I finished my EMR. Maybe it's just that there's so much more to learn. Two sets of protocols, master all the equipment for both ambulance services. Wanting to learn more, know more. I'm a bit lost at the moment, really. I need some direction. Set new goals. Learn to be the best care provider I can...
Class practicals, class written, and NREMT practical. Done.
Clinicals? Done.
NREMT written? Scheduled for one week from today.
Funny, I feel less capable now than I did when I finished my EMR. Maybe it's just that there's so much more to learn. Two sets of protocols, master all the equipment for both ambulance services. Wanting to learn more, know more. I'm a bit lost at the moment, really. I need some direction. Set new goals. Learn to be the best care provider I can...
Friday, April 13, 2012
EMT Class week 23 - Van departs, practice, and written test
First big shocker - Van our class coordinator got a nice job offer and had to leave earlier than anticipated. We are all stoked for him, but none of us got to say good-bye :(
So Tess and Mr. Medic are back in the hot seat to get us through these last few weeks.
I don't think any of us really took too much to heart that we should have been studying for practicals all along. This was a known entity, and we should have been preparing. Really. We all have our excuses. Family, job, life, ahem, graduate school, all the usual suspects. It's a good thing we built in a couple of practice sessions.
On to the test. I would like to say I breezed through it, but 270 questions (!) is a lot for anyone to 'breeze through'. Floyd kicked my ass by a couple points and I will never live that down. I did well. Missed a few stupid points, but overall I'm good with it. Everyone passed.
Since Van wasn't around, Tess decided to start class practicals right after the written. I was done early so I got through Medical Assessment, C-Spine immobilization, and Cardiac Arrest. Was nice to have those done and focus on getting through Trauma Assessment, BVM Apneic Patient, and "choose your own adventure" AKA long bone, joint, traction splint, OPA/Suction/NPA, bleeding/shock, O2 administration, or mouth to mask.
I miss Van, but it feels good nonetheless to be toward the end of EMT book work. Time to get out into the real world, deal with protocols, and get the job done. I hope!
So Tess and Mr. Medic are back in the hot seat to get us through these last few weeks.
I don't think any of us really took too much to heart that we should have been studying for practicals all along. This was a known entity, and we should have been preparing. Really. We all have our excuses. Family, job, life, ahem, graduate school, all the usual suspects. It's a good thing we built in a couple of practice sessions.
On to the test. I would like to say I breezed through it, but 270 questions (!) is a lot for anyone to 'breeze through'. Floyd kicked my ass by a couple points and I will never live that down. I did well. Missed a few stupid points, but overall I'm good with it. Everyone passed.
Since Van wasn't around, Tess decided to start class practicals right after the written. I was done early so I got through Medical Assessment, C-Spine immobilization, and Cardiac Arrest. Was nice to have those done and focus on getting through Trauma Assessment, BVM Apneic Patient, and "choose your own adventure" AKA long bone, joint, traction splint, OPA/Suction/NPA, bleeding/shock, O2 administration, or mouth to mask.
I miss Van, but it feels good nonetheless to be toward the end of EMT book work. Time to get out into the real world, deal with protocols, and get the job done. I hope!
Thursday, April 5, 2012
We lost one of our own yesterday
I didn't know him very well.
Of the 150 or so providers in our family, I'm just getting to know some of them.
And there are those I will never know.
We lost a good man, too young, too soon.
Rest in peace, Ranger Nelson. Your jump kit will be here if you need it.
Monday, April 2, 2012
EMT Class week 22 - Practice and Clinicals
Not much to report from class last week, we are running through stations to get ready for our practical exams. Given that our first written exam is on Wednesday, I would rather do more prep for that!
Taylor and I hit the "big city" for our ED shift yesterday. All I can say is - whew! I'm glad we're done!
Nothing like being in a place where you really have no idea where (or if) you fit in, what to do, and where to find things. We started our 10 hour shift at 0900 with a quick orientation by the the ER Tech. Here are the rooms, the board, no you don't write anything down on the chart - just jot vitals on a piece of paper, etc. And here's your vomit bucket filled with thermometer, BP cuff, PulseOx, and stethoscope. When you're not needed, stand here. Simple enough.
Yep, not so much.
Mr. Medic's suggestion rang in my ears, "You will be in the way. Leave the docs alone. Nurses you will just have to see how they react. ER Tech is probably your best bet. Try to shadow/emulate them. And keep an eye out for that little old lady/man who comes in without any family or friends. Spend some time with them. Ask them SAMPLE and OPQRST. The nurses will be happy someone is spending time with them and you will get a good history taken."
So Taylor and I are plugging along, grabbing vitals as asked. The first room goes empty and the ER Tech starts to clean and make it up for the next patient. "How can we help?" Irene gives us the scoop - "Grab the disinfectant, wipe down the bed, pillow cover, counters, tray, floor if needed, coil up any cables, any sterile, unopened equipment goes back, opened goes in the trash. New sheet on the bed, new pillow cases on the pillows. Trash taken out as needed."
Boom. We've got an assignment.
Any patient gets discharged, we are on that room like white on rice. Cleaning with passion. Not much different from working on the ambulance, really. Running to catch vitals when asked. Grabbing coffee, water, sodas, sandwiches for patients when asked. Otherwise just standing in our assigned space, waiting. Sunday is not a very busy day, apparently. There were almost always 4 rooms empty at any time out of the 20 total. Seemed pretty busy to me compared with our regular receiving hospital which has 5 beds! Taylor and I chatted quietly when we had the chance. The hours passed.
Abner arrived. 82 years old, shortness of breath. History of asthma and pneumonia, coughing, can't catch his breath. All alone. Dan was his nurse, and had a bunch of patients. "Can you give me a hand?" We were trying to get him to the loo. When Abner stood, I noticed the watery mess on the sheet. Then the smell. I mouth "I think he had a BM" to Dan, behind Abner's head. Oh boy. Short, slow walk to the toilet. We strip him down and begin to clean. Caught myself gagging and started breathing through my mouth, and trying to keep a smile on my face (apparently the smiling counteracts the gagging reflex...) Abner is embarrassed. "I'm so sorry. This is humiliating." I assure him that there are no apologies necessary and we are happy to help. Dan keeps rushing out for more supplies - wipes, a clean gown, an adult diaper. I'm looking around for an exhaust fan switch - there is no fan. He keeps talking. Never stops. His devoted family (none of whom are inclined to get off work to come care for him in the ER) his deep faith. Getting old. Living with a broken body.
We get him cleaned up, put together, and into another room. I check in on him. He asks for a blanket, something to drink, something to eat, a phone to call his daughter. I help. I listen. I sit with him while the ER doc goes over the instructions. Probably not over the pneumonia, here's some more antibiotics. Daughter can't come pick him up for two hours. Nurses move him to the hall 'cause we're running out of beds. A roll-over accident is coming in by ambulance. I make sure he has all his stuff and is comfortable. I check in every few minutes and go chat whenever his eyes are open, just so Abner's not under the impression he's been forgotten, shoved into this back hallway.
"You have sown so many seeds of kindness today. You will reap a bushel."
"I need all the help I can get." I replied "But being a heathen all my life tends to keep one out of God's graces. Well, maybe not a complete heathen, really a rebellious ex-mormon"
"I don't believe that. You've sown your seeds of kindness today."
"That's probably the nicest thing anyone has ever said to me. Thank you." And I meant it.
Abner's daughter showed up after work. We got him into the wheelchair with all his belongings. The daughter looks exhausted. Guess I can't just judge her too harshly - we all have lives to live and our own issues to deal with. She wheels Abner out the door.
We're on to the next patient.
Taylor and I hit the "big city" for our ED shift yesterday. All I can say is - whew! I'm glad we're done!
Nothing like being in a place where you really have no idea where (or if) you fit in, what to do, and where to find things. We started our 10 hour shift at 0900 with a quick orientation by the the ER Tech. Here are the rooms, the board, no you don't write anything down on the chart - just jot vitals on a piece of paper, etc. And here's your vomit bucket filled with thermometer, BP cuff, PulseOx, and stethoscope. When you're not needed, stand here. Simple enough.
Yep, not so much.
Mr. Medic's suggestion rang in my ears, "You will be in the way. Leave the docs alone. Nurses you will just have to see how they react. ER Tech is probably your best bet. Try to shadow/emulate them. And keep an eye out for that little old lady/man who comes in without any family or friends. Spend some time with them. Ask them SAMPLE and OPQRST. The nurses will be happy someone is spending time with them and you will get a good history taken."
So Taylor and I are plugging along, grabbing vitals as asked. The first room goes empty and the ER Tech starts to clean and make it up for the next patient. "How can we help?" Irene gives us the scoop - "Grab the disinfectant, wipe down the bed, pillow cover, counters, tray, floor if needed, coil up any cables, any sterile, unopened equipment goes back, opened goes in the trash. New sheet on the bed, new pillow cases on the pillows. Trash taken out as needed."
Boom. We've got an assignment.
Any patient gets discharged, we are on that room like white on rice. Cleaning with passion. Not much different from working on the ambulance, really. Running to catch vitals when asked. Grabbing coffee, water, sodas, sandwiches for patients when asked. Otherwise just standing in our assigned space, waiting. Sunday is not a very busy day, apparently. There were almost always 4 rooms empty at any time out of the 20 total. Seemed pretty busy to me compared with our regular receiving hospital which has 5 beds! Taylor and I chatted quietly when we had the chance. The hours passed.
Abner arrived. 82 years old, shortness of breath. History of asthma and pneumonia, coughing, can't catch his breath. All alone. Dan was his nurse, and had a bunch of patients. "Can you give me a hand?" We were trying to get him to the loo. When Abner stood, I noticed the watery mess on the sheet. Then the smell. I mouth "I think he had a BM" to Dan, behind Abner's head. Oh boy. Short, slow walk to the toilet. We strip him down and begin to clean. Caught myself gagging and started breathing through my mouth, and trying to keep a smile on my face (apparently the smiling counteracts the gagging reflex...) Abner is embarrassed. "I'm so sorry. This is humiliating." I assure him that there are no apologies necessary and we are happy to help. Dan keeps rushing out for more supplies - wipes, a clean gown, an adult diaper. I'm looking around for an exhaust fan switch - there is no fan. He keeps talking. Never stops. His devoted family (none of whom are inclined to get off work to come care for him in the ER) his deep faith. Getting old. Living with a broken body.
We get him cleaned up, put together, and into another room. I check in on him. He asks for a blanket, something to drink, something to eat, a phone to call his daughter. I help. I listen. I sit with him while the ER doc goes over the instructions. Probably not over the pneumonia, here's some more antibiotics. Daughter can't come pick him up for two hours. Nurses move him to the hall 'cause we're running out of beds. A roll-over accident is coming in by ambulance. I make sure he has all his stuff and is comfortable. I check in every few minutes and go chat whenever his eyes are open, just so Abner's not under the impression he's been forgotten, shoved into this back hallway.
"You have sown so many seeds of kindness today. You will reap a bushel."
"I need all the help I can get." I replied "But being a heathen all my life tends to keep one out of God's graces. Well, maybe not a complete heathen, really a rebellious ex-mormon"
"I don't believe that. You've sown your seeds of kindness today."
"That's probably the nicest thing anyone has ever said to me. Thank you." And I meant it.
Abner's daughter showed up after work. We got him into the wheelchair with all his belongings. The daughter looks exhausted. Guess I can't just judge her too harshly - we all have lives to live and our own issues to deal with. She wheels Abner out the door.
We're on to the next patient.
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