Paramedic "Base Camp" Part 2

Oh, the humanity.
I really needed a day off.  So much.  So badly.  Just needed a break.
But the break did not come.  We kept going.
Wake up
{Coffee}
Study
{Coffee}
Lab
{Coffee}
Lab
Lunch
{Coffee}
Lab
{Coffee}
Dinner
Study
Sleep

Then I hit the wall.
We were running through dynamic cardiology as a group, my group consisting of 4 people.  We each stood up, were given a scenario, and ran with it.
I froze.  Mind blank.  Reaching for the AHA algorithm that fit, and seeing only a blurry, colored chart, faded in my memory.  I did not have it.
All the emotions, the stress, the disappointment, all my worry about never being good enough welled up to the surface.  I had to walk away.
OK, I'm a Ranger, so I had to hike away.
I found myself sitting at a bus stop in the rain, crying like a child, asking myself what the hell I am doing, whether I should just call a cab and head for the airport.  Tried to call my sister but got no answer. 
Cried it out all through lunch and decided to stick it out.  Try to stop worrying about being perfect and just work hard and do my best.

But I still need to review my ACLS algorithms.

Day by day, it got better.  Everyone else was sweating the final written exam (I was not).
We had incredible instructors, they all worked with us if we needed it.  Every spare moment was spent practicing, practicing, practicing.  IV starts on the fake arms, IV med bolus, IV med infusion, ET intubation of Adult and Peds manikins, trauma and medical assessment. 

And cardiology.  My love, and my nemesis, cardiology.
That subject that I need to know inside out, yet it eludes me with its intricacies.

Final skills testing day came.  Knocked out trauma and medical assessments, ET Intubation, alternative airways, baby birthin'.  And  I nailed static cardiology.  And managed to fail dynamic spectacularly.

Let me interject here about the personalities of the other students.
We had quite the crew.  We were divided up into 3-4 person groups in the beginning and stuck together throughout.  My group consisted of "Failure Girl" (FG for short), "Knows-it-all-already Critical Care EMT girl" (um, CCEMT for short) and loud, annoying older guy going into EMS management (LAG). 
FG was doomed from the beginning.  The rest of us were told to not even spend time trying to help her.  She wants to be a firefighter, is a really nice, funny gal, but did not study.  Apparently she was even told not to come to Boot Camp, but came anyway.  She was constantly checking her phone during labs and just did not seem interested.
CCEMT was pretty nice, attentive during labs, helpful, overall a decent gal to work with.  There was very little that she had not already done as a more advanced level EMT.
LAG was loud.  Tried to help FG, tried to make his point by talking louder.  Started to annoy me, but probably just because I was so stressed out.

Fast forward back to test day.  I had just failed dynamic horribly (I think I said I would give an amiodarone infusion for symptomatic bradycardia?  really it's just a blur)

Everyone was sitting in the lobby, waiting to be called in to stations.  I walked out, still stunned at my own incompetence to the general question, "How did you do?"
"I failed dynamic."
LAG decided to pipe up, "Dynamic?  Wow that's so easy!"
Stunned silence.  I could have punched him.  I walked away.

DABDA

Those of us in the profession know what that acronym stands for.

Denial
Anger
Bargaining
Depression
Acceptance

The five stages of grief.

I skipped quickly through the first three and am firmly entrenched in #4.

You see, over the past few months I have been able to sink myself rather deeply in the EMS and healthcare world. 
I've had weeks of not thinking about, nor dwelling in the world of spatial data management.  It's been a sorely needed change.

Now I am back, fall is sliding quickly toward winter, and I'm no nearer staying in this place I love with a job I love.  Guess I should be happy just to have a job at all, but my heart is really not in it.  The passion is just not there.  The passion to push others, push myself.

Is it Acceptance or Apathy?

On suicide and survival

 An excellent article.  And resources for all of us:

http://www.emsworld.com/article/10319827/suicide-survivors

Information about suicide is available from the American Association of Suicidology (www.suicidology.org), the American Foundation for Suicide Prevention (www.afsp.org), the National Alliance on Mental Illness (www.nami.org) and the Suicide Awareness Voices of Education (www.save.org). Specific information for emergency responders is offered by the Suicide Prevention Resource Center (www.sprc.org). A recommended text is Thomas Joiner's Why People Die of Suicide (2005).

C-diff and MRSA and N. gonorrhoeae, oh my!

You will want to never leave the house again after reading this:
http://www.cdc.gov/drugresistance/threat-report-2013/

Paramedic "Base Camp" Part 1

So it's been a while.

I've missed sharing my stories with you, gentle reader, and it's time to get caught up.

I spent almost a year struggling through the didactic portion of my paramedic program.  We began with somewhere around 35 students in the class.  We met twice a week online for three hours of lecture.  If we missed a lecture, we could watch the recording later.

I love numbers, so here we go:
80 Lectures
x 3 hours per lecture
= 240 hours of lecture

Book pages read:
7000 (give or take)
x 3 min per page
= 350 hours reading

Studying (not including reading)
1.25 hour per day studying
x 300 days
= 375 hours studying

Grand total: 965 hours for didactic (about 40 days!)

Now on to "Base Camp"

As I said, we began with somewhere around 35 students.  23 showed up for Base Camp.
I'm going to call it Base Camp from now on, because it really was that.  To paraphrase our lead instructor, people pay tens of thousands of dollars to be guided by an expedition up Mt. Everest.  Even though they make it as far as Base Camp, they can still be turned around by the group leader if he feels they aren't ready.  Because lives are on the line.
That's what the two weeks of Paramedic Base Camp were all about.
Instructors were evaluating us every step of the way.  We practiced and practiced our skills.  Rotated through 6 lab stations per day.

Typical day:
0630 wake up, make coffee, get dressed, study
0730 shuttle from hotel to school
0800 open skills lab practice
0845 morning info/meeting
0900 3 labs till lunch
1200 lunch
1230 open skills lab practice
1300 3 labs till done
1700 close-out meeting/more skills practice/shuttle back to hotel
1800 shower, order food or cook something in the microwave, maybe go outside for a walk
1900 enter day's skills into computer skills tracking system
2000 study
2400 fall asleep with lights on, face in book, drooling

0630 repeat...

Some people didn't make it.
Around day 4 we were surprised to learn that one of us had left.  She "didn't want to be a paramedic anymore" and left without saying goodbye.

I was stressed out.  Exhausted.  Freaked out that I could fail. 
And fail I did.
I failed a couple of skills stations.  Just went blank during testing.  The first one was Trauma Assessment.  No, really, trauma assessment.

I lost my shit and had to go for a walk.  Here I am, thinking I'm doing fine.  Thinking I can survive and I fail TRAUMA ASSESSMENT????  Yep.  Found myself sitting at a bus stop bawling my head off wondering if I can get this done.  Why had I failed?  Should I just call a cab and go home now?  Well, they gave us a 'new' methodology which didn't quite gel with my old mnemonics and I lost my place.  I'm not used to this type testing.  Give me some time to think, to prepare, to mull it all over.  But that's not EMS.
So I visualized.  Over and over.  In my head, moving hands.  Classmates laughed at me as I talked to myself in the hall with earplugs in.
Final test came.
Yah, I effing nailed it.

EMS World Expo 2013

Vegas, baby!

(Note:  For those of you who hate Las Vegas, you must realize that you just have to go with it.  Yep, it's a crazy place that should not exist, sucking water and power in wretched excess.  It is what it is.)

Now, I would love to be able to go to a conference a year, but for now the cheapness of flying to and staying in Las Vegas trumps the rest.  Monorail access from the hotel to the convention center was excellent, no need for a rental car.  So there you go.

This time around we had the Pit Boss (EMS Director), Mr. Medic, Mrs. Medic, Floyd, new EMT Tracey, and the good ol' Ambulance Ranger.  Quite the crew.

For once I pounced on the opportunity to do a couple pre-conference workshops and signed up for Moulage and the Cadaver Lab.  Moulage was quite good, could have used a little more hands-on and general excitement from the attendees.  Maybe a list of what equipment to start with and where to get it.  Some good ideas about MCI staging, but really just a crap shoot as to what was taught.  The guy teaching it does a lot of contract work, but to me workshop=hands-on.  Needs more focus and a few assistants in the future, I think.

But cadaver lab was awesome. 
A half-dozen or so souls turned their bodies over to science so we could learn.
Got to work with a few different types of video laryngoscopes, performed surgical cric's instructed by (ahem) Dr. Bryan Bledsoe himself, used the ultrasound, the ITClamp, used the SALT to intubate, IO drilling on several sites, you name it.  A popular session for a reason.  Think I convinced Mr. Medic and the Pit Boss to join in next time around.

Spent most of the next 2 days running around the exhibit hall.  Had to make contact with some vendors, close the gap on a few items we are looking at for the service, and in general ogle at all the cool gizmos.  Seemed like all the sessions I wanted to attend were packed, and our uber-cheap flight left Thursday morning so we missed out on the last day.  Better planning next time, maybe?

Oh well, hit a couple great sessions.  Happy Medic did a couple really good ones (http://thehappymedic.com/) on CQI...and let me know that I need to stop laughing at our ePCR "conferences" and go.
Myths were busted, evidence-based was the buzzword, and still we trudge on.

Hope to see you next time, but in the meantime, anybody got a good conference story?

This is what YouTube recommends...

Apparently when you search for a lot of EMS stuff on YouTube, it thinks you want to see gross videos of sebaceous cysts being popped.
Now, this one is super special due to the camera guy vomiting, and the appearance of the guy having a breast on his back.
Not for the faint of heart:
http://www.youtube.com/watch?v=E-tDJ6LBn-4

Thanks EMS1 on this, the eve of "Paramedic Boot Camp"

JUST what I needed, a good laugh
http://www.ems1.com/ems-humor/articles/1482611-Memo-Creative-EMS-cost-cutting-from-weaponized-mold-to-ambo-ads/

So, vital signs? What vital signs?

http://vimeo.com/46912551
Continuous-flow replacement hearts.
The future?


also, tidbits of information I really didn't want to know...

After age 35, you lose 7,000 brain cells a day that are not replaced.

Thank you, A&P class, for confirming the fact that I'm getting dumber daily.

Dear House-mate

We have one bathroom.
One tub, one toilet.
There are two sinks in the house.
There are 3 people and 4 animals living here.

When Ambulance Ranger comes home at 10:30 pm after working her regular job for 8 hours then putting in another 6 on EMS calls, she really needs a shower.  And to use the toilet.  Maybe just a sink?

So please stop piling your dishes in the sink, then locking yourself in for a luxurious bubble bath.  While WATCHING A MOVIE ON YOUR LAPTOP.

Ambulance Ranger had a bad day and does not want to take it out on you.

But she just might if you don't get out of there in the next 5 minutes.

fare thee well

Andrew Ashcraft, 29

Kevin Woyjeck, 21

Anthony Rose, 23

Eric Marsh, 43

Christopher MacKenzie, 30

Robert Caldwell, 23

Clayton Whitted , 28

Scott Norris, 28

Dustin Deford, 24

Sean Misner, 26

Garret Zuppiger, 27

Travis Carter, 31

Grant McKee, 21

Travis Turbyfill, 27

Jesse Steed, 36

Wade Parker, 22

Joe Thurston, 32

William Warneke, 25

John Percin, 24

Deal-making

In the process of setting goals, I've hit a big one.
If I make it through Paramedic "boot camp" in August, I get to go to EMS World Expo in Vegas (OK, the tickets are being bought, so I guess I go regardless...)

If I pass my NREMT-P and actually become a functioning paramedic, I'm going to RettMobil next year.

After watching a webcast about European ambulance innovations (http://www.jems.com/webinars) and my own personal study of how much better others do it than us, I'm really stoked to go.

As far as the ultimate excitement of the Federal Spec KKK-A-1822 for ambulances goes, word is they will be relaxing/getting rid of some of the more arcane aspects (?? anyone) soon, so we may be able to take advantage of exciting things such as ergonomics, ease of use, disinfection upgrades.  WHAT A CONCEPT!

So wish me luck as I finish the final (gulp) 6 weeks of class, 3 weeks of boot camp, 4 months of clinicals, and onward!