New EMT Questions

[NomadicMedic]

proper dispatch pre screening can determine the need for additional resources. They don't send three companies to a trash fire, do they?

A cardiac arrest or a motor vehicle accident should certainly have a 1 engine response, but a sick call receiving a fire engine with 4 people, quickly followed by a BLS unit and an ALS unit is simply overkil.

Wait, you say. It doesn't happen like that. Of course it does. Look at Seattle. That is the response model their system is built on.

 

[EpiEMS]

For OP:

Clinicals should, ideally, be in a busy ALS 911 system. However, even then, you may not see a lot of (legitimate) patients. Thus, I strongly suggest taking your clinicals in the ER, where there is generally going to be "good" patient volume of mixed acuity and full follow-up by a cross-professional team. Regarding your steth, an MDP is fine, maybe consider a Littman when you start working, but for BLS providers, the MDP is plenty good (in my fairly limited EMS experience).

I still think a fire engine responding to a medical call (outside of a cardiac arrest or MVA) is a ridiculous waste of resources.

+1000 EMS points (my entire stock of EMS points)

If they're in station, why not?

All firefighters nationwide need a minimum level of medical training. It can't hurt, only help.

(Now if you have fires and car crashes simultaneous, this is obviously less of a priority)

The first argument, sure, ok, but it poses a fundamental question: why have so many firefighters?
Regarding the second, "it can't hurt," that's not necessarily true. Patient outcomes aren't necessarily better with more providers -- and, indeed, are subject to negative returns from additional providers at a certain point (several studies on this, esp. regarding the number of paramedics on scene and in a system, I will have to locate the sources...).

 

[Tigger]

I'm not suggesting having more fire engines just so they can all go to medical calls. Staff the fire engines for fires/rescues/full arrests...

But if a medical call happens and the fire guys have nothing else to do, why not let them respond? Aside from the gas used in the fire engine, what resource is wasted?

Have you ever run calls with six people? It sucks.

 

[RedAirplane]

Have you ever run calls with six people? It sucks.

Really? I guess I'm not introduced to the bliss of running calls alone. Even in my role in standby medicine, someone wanting to go lie down for a bit will get a second team to respond for a total of four people.

In my first response role, the principle was send as many resources that are not otherwise occupied (they could be peeled off if another call came in).

Example: I witness a syncope and call it in. Two other first responders arrive to help, and then they keep piling in from all areas of campus, until you have a huddle of about 12 people (BLS). Then we get one engine company (ALS) and eventually one ambulance (ALS) and they all also come on scene. So for any medical call that needed transport, you typically had a cluster of about 18 people hanging around.

That's a bit extreme. It tended to frighten patients and draw onlookers.

I don't know if I'd feel more comfortable with just me and my partner, but I never really felt uncomfortable with 4-6 people.

Also, OP, sorry for hijacking the thread. I did one ride along with BLS IFT ambulance and one with ALS 911 ambulance, but I haven't been in this long enough to say what will be best for you. I will say that I learned a lot more out of BLS than I thought I would, albeit it was less "exciting."

 

[Flying]

Having 4-6 people is fantastic for maintaining consistent compressions in CPR, but is detrimental for most other situations.

 

[Jim37F]

6 responders is standard here. One paramedic is leasing the assessment, the second paramedic is the radio man, he's filling out the ePCR, looking at the meds/SNF paperwork/etc and will then be making base contact if/when needed. The two EMTs are helping with the assessment, basically the medics leave all the BLS stuff such as splinting and bandaging to us, but for our run of the mill medical calls one EMT will be hooking up the monitor while the other gets blood pressure. The engineer is standing by to fetch any additional equipment from the ambulance (usually stair chair, or the scoop or splints bag) while the captain is in overall charge of the scene, most often keeping extraneous family/bystanders out of our hair, having them fetch meds, paperwork etc or even keeping the "green" crewmembers on task if we find ourselves standing around doing nothing after getting a BP lol

 

[NomadicMedic]

That's called "justifying your existence"

See also: Kool aid.

 

[Tigger]

6 responders is standard here. One paramedic is leasing the assessment, the second paramedic is the radio man, he's filling out the ePCR, looking at the meds/SNF paperwork/etc and will then be making base contact if/when needed. The two EMTs are helping with the assessment, basically the medics leave all the BLS stuff such as splinting and bandaging to us, but for our run of the mill medical calls one EMT will be hooking up the monitor while the other gets blood pressure. The engineer is standing by to fetch any additional equipment from the ambulance (usually stair chair, or the scoop or splints bag) while the captain is in overall charge of the scene, most often keeping extraneous family/bystanders out of our hair, having them fetch meds, paperwork etc or even keeping the "green" crewmembers on task if we find ourselves standing around doing nothing after getting a BP lol

Just because you can divide a call up so that six people have something to do (and even as presented here that's a stretch), does not mean it's necessary, and it certainly does not improve care.

 

[Angel]

I agree. It's too many cooks in the kitchen I did my internship in a busy urban area where at least 3, usually 4 medics responded on all calls (both on the medic itself. 1, sometimes 2 on the engine, or 3 if the captain kept his cert).
And while it's nice to stand back and delegate (i guess) I get to use my skills and critical thinking less, and all for things that don't NEED another medic.

 

[Bruno]

Hey all,

I'm approaching the half way marker in my training. So far, I love this, and I'm excited to get real world experience. I have some questions that I figured you guys may be able to answer?

1) We are going to need patient contact experience soon. I have a company that I would love to work for who is willing to take me along in a time-slot. Are there any companies that will do an "internship" in some sort? Such as maybe going in volunteer on a single shift each week to get some real world practice? How would I go about asking for that? Is it possible / likely?

2) As far as a stethoscope, I bought a $20 MDF Acoustica. It came with a lifetime warranty on everything but the tubing. I figured this is all I needed. Should I have purchased a more "branded" Littman? I likewise bought a cheap but rugged watch that tells military and analog time.

3) We took our AHA BLS / CPR course, and I passed. Are we going to be receiving the cards in the mail? How does that work? I want to make sure that I receive it.

Thanks

Congrats and welcome
I'm unaware of any internship -
Get experience where you can- I did volunteer hrs in an ER b4 taking the nremt, and it was ok but nothin like riding along and running calls.
Don't waste any more $ on scopes. You'll have them on board -just wipe them b4 using and btwn pts. The expensive scopes will walk away if you happen to forget one in a rig. Keep the $20 one for now
You should get the card on site if not shortly after. Ask the place you took course.