Providing order and stability

Sometimes a catchy phrase can be very revealing. It can unlock the real meaning of something we might be struggling to understand despite all the facts and resources we have or it can remind us of what we are really supposed to be doing when the fog and clutter of chaos engulfs us. . . here are a couple phrases I try to keep in my head while doing my job.


I read this back when I was struggling through training a year ago and it was like a light flashing on in my head:
"patients expect you to bring some sense of order and stability to the terrifying chaos that has suddenly engulfed them."
Emergency Care and Transport f the Sick and Injured, p31



"Isolate to the problem and then treat the patient the way you want your mother or grandmother treated."
from someone I look forward to learning a lot more from.

Employment possibilities. . .

I got tired of waiting for the county of my choice to call me, so I went to another county EMS with my resume and application. The person who hires and trains interviewed me on the spot and then asked me to go take a drug test. I said, "well, usually employers don't ask you to drug test unless they're going to hire you." She replied, "that's true."
I really need to get working. I've been continuing to study my text books and read stuff on-line so that I don't forget everything, but I really need to get into the field and work to gain the real skills it takes to be an EMT.
I'm really hoping this job works out and sometime in the next couple weeks I'm working on a truck.

When it's over it's over

After four months and hundreds of hours of classwork and study it's finally over. It all came down to a practical test that tested our skills art assessing patients and applying life saving techniques and then a two hour written test that gave us 100 situations to which we had to apply the right answer for assessment/treatment.
Yes, it was hard and it pushed my brain. Some of us didn't make it. The class was less than half the size it was when we started.
But I made it. I passed both the practical and the written with room to spare.
I have become a state certified EMT.

Finally, we're through the book

Four months and seemingly countless hours in class and we finally got through the 1200 page book. . . Emergency Care and Transportation of the Sick and Injured. . . whew.

One more week of class reviewing and going over procedures.

Then two days of testing. Written and practical.

Once again, all I can say is "this is the hardest fucking thing I've ever done academically."

Shock, cardiac emergencies, stroke, bleeding, fractures, diabetes, geriatrics and pediatrics, soft tissue injuries, anatomy, allergic reaction and anaphylactic shock, ambulance operations. . . and that's only a few of 39 chapters.

There was even one chapter on terrorist attacks!! Not that I spend 1 second worrying about terrorist attack during any day, but I got news for ya, if there's sarin in the air, nuclear contamination or a big ass fucking building is on fire and looks like it's going to collapse, I'm outta there. . . vamoose, gone, bookin, haulin ass real fast.

Fractures, broken spines and abdomenal injuries

OK, so you've got a patient who may have a spinal injury and you've got to get them out of a car. . . that's damaged. . . without further complicating any injuries they might have.
You've got to maintain the spine in a stable immobile position. In one smooth cool move you've got to get the patient out of the car and onto an immobilization board.
When you make this move you've got to do it without twisting the patient's back in any manner.
It's tricky, but possible. I did it twice this evening. I also learned how to immobilize a fracture. . . all kinds of fractures.
Another cool trick; what to do when someone's guts are hanging out. When the abdomen is cut open, no matter how big or small the incision, the intestines "always want to come out." It's called evisceration. Wanna see pictures?

A little hope yet

Whew, did patient assessments this evening. I blew through a patient exhibiting signs of cardiac distress without missing a thing. Then I stabilized and loaded a trauma patient onto a backboard.
I might be able to do this.

A taste of what testing will be like

Had A 100 question test tonight on three or four chapters. Questions like:

An organ or tissue may be better able to resist damage from hyperfusion if the:
a. the body's demand for oxygen is markedly increased
b. body's temperature is considerably less than 98.6F
c. systolic arterial pressure is at least 60 mmHg
d. heart rate is maintained at greater that 100bpm

or:

A 27 yr old woman complains of stabbing pains in the right lower quadrant. Last menstrual period 7 weeks. Pelvic inflammatory disease 3 months ago. You should be most suspicious that this patient is experiencing:
a. acute apendicitis
b. intrapelvic infection
c. spo0ntaneous abortion
d. ectopic pregnancy

People were walking out with big shocked looks on their faces. WTF?! They want us to be doctors in 5 months?