lucro91
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I got hired last week at a local IFT company as an EMT. Anyone have any tips or advice as what to expect? This will be my first job in the EMS world besides being on my county's volunteer service.
Starting at an IFT company
- Thread starter lucro91
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You will get alot and I mean ALOT of transfers: ECF to Dialysis, ECF to Dr, ECF to ED, (for both non emergent and emergent stuff), ED and inpatient hospital to ECF or to home.
Treat every patient like it is an emergency run: I don't mean run lights and sirens: but I mean do at least 2 full sets of vital signs, listen to breathing, talk to the patient. Document everything. Do the first set of vital signs: pulse, bp, rr and breath sounds at the transferring site: always easier to tell the ED staff that the patient needs to be checked again before you transport than 20 minutes later; when you come back.
I picked up a patient that seemed stable, but when I questioned the patient he was complaining of chest pain; we diverted from Dialysis (almost the parking lot) to the closest ED with cardiac cath capability: he was having a MI. I have transferred patients out of the ED or in patient that ended up back in the ED for something different.
You will get alot more medical patients than you will ever get in a 911 service; and a few of them you will not be able to get verbal answers to your questions. go by what they look like, and what their vitals tell you.
We had a crew at another service that documented that they did 2 sets of VS on a 20 minute transfer from Doctors office back to ECF. when they got to the ECF the nurse that was about to sign for the patient noticed that the patient was dead. found out that the patient had been dead over an hour. so she was dead before they picked her up.
Get a APP for your phone or I-PAD that tells you what medications do what: it is suprising what you will learn by reviewing every patients medications during or after a run. Found out that one patient had TB menengitis and the transferring ICU didn't feel it was important enough to tell us that tidbit of info. Figured it out due to the meds she was on.
Learn from your patients: and learn your area. Depending on the company you may have the opportunity to do alot of traveling. I went to every hospital in Indiana, and traveled to 13 states with patients. We did prison transfers (both ways); we worked with 911 services in multiple jurisdictions.
Never stop learning: bring your EMT books and review things; if you have a good partner talk to them about your last patient or the one you had 2 days ago with a different partner.
Never stop helping new people to learn: you will probably get alot of partners and some will be new: dont' forget that you were new once yourself. Answer questions that they have, teach them to find ECF's in what ever area you are in. Teach them to love EMS.
Treat every patient like it is an emergency run: I don't mean run lights and sirens: but I mean do at least 2 full sets of vital signs, listen to breathing, talk to the patient. Document everything. Do the first set of vital signs: pulse, bp, rr and breath sounds at the transferring site: always easier to tell the ED staff that the patient needs to be checked again before you transport than 20 minutes later; when you come back.
I picked up a patient that seemed stable, but when I questioned the patient he was complaining of chest pain; we diverted from Dialysis (almost the parking lot) to the closest ED with cardiac cath capability: he was having a MI. I have transferred patients out of the ED or in patient that ended up back in the ED for something different.
You will get alot more medical patients than you will ever get in a 911 service; and a few of them you will not be able to get verbal answers to your questions. go by what they look like, and what their vitals tell you.
We had a crew at another service that documented that they did 2 sets of VS on a 20 minute transfer from Doctors office back to ECF. when they got to the ECF the nurse that was about to sign for the patient noticed that the patient was dead. found out that the patient had been dead over an hour. so she was dead before they picked her up.
Get a APP for your phone or I-PAD that tells you what medications do what: it is suprising what you will learn by reviewing every patients medications during or after a run. Found out that one patient had TB menengitis and the transferring ICU didn't feel it was important enough to tell us that tidbit of info. Figured it out due to the meds she was on.
Learn from your patients: and learn your area. Depending on the company you may have the opportunity to do alot of traveling. I went to every hospital in Indiana, and traveled to 13 states with patients. We did prison transfers (both ways); we worked with 911 services in multiple jurisdictions.
Never stop learning: bring your EMT books and review things; if you have a good partner talk to them about your last patient or the one you had 2 days ago with a different partner.
Never stop helping new people to learn: you will probably get alot of partners and some will be new: dont' forget that you were new once yourself. Answer questions that they have, teach them to find ECF's in what ever area you are in. Teach them to love EMS.
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lucro91
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Thanks so much John for all this great info. I'm still as green as it gets now so hopefully people will be like you described in that last paragraph!
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lucro91
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And I have Epocrates on my phone already, I hear it's a great app for med info
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titmouse
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+1 on the good partner. When confused about locations call dispatch, also get the landline number so you dont take up the radio. And dont worry abiut the reports over time as you get more and more experienced you will become more proficient at it 
bill williams
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Check out your equipment every single shift. People tend to steal stuff off your truck that they don't have. Nothing's worse than grabbing for your pulse ox and discovering it's gone.
quewiwi
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-Get vital signs on every patient you pick up, even if the transferring facility just took them and hands you a copy of them.
-Be certain to ask your patient (or the transferring facility if the patient is not A&O) if they are on dialysis so you know which arm to take your BP on.
-If the patient refuses vitals, document that on your PCR, DON'T just make up a set of numbers!!!! (I've seen co-workers do this...)
-Be honest at all times, with yourself, your partners, and your patients.
-Be self-disciplined as you are going to meet a lot of folks in the private ambulance field that are burnt out, jaded, or just don't care anymore.
-And, remember that you have the opportunity every shift to be the bright, happy, considerate caretaker to make your patient's day!
-Be certain to ask your patient (or the transferring facility if the patient is not A&O) if they are on dialysis so you know which arm to take your BP on.
-If the patient refuses vitals, document that on your PCR, DON'T just make up a set of numbers!!!! (I've seen co-workers do this...)
-Be honest at all times, with yourself, your partners, and your patients.
-Be self-disciplined as you are going to meet a lot of folks in the private ambulance field that are burnt out, jaded, or just don't care anymore.
-And, remember that you have the opportunity every shift to be the bright, happy, considerate caretaker to make your patient's day!
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lucro91
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Extended Care Facility
AlphaButch
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Be extra polite to everyone. Including providers (nurses, aides, etc) who may have done something that makes you want to roll your eyes. Just be polite.
Also, don't trust information just because it comes from the discharging nurse/aid/lvn. We do alot of IFT and roughly 60% were called in with incorrect chief complaints, vitals are out of whack or they've forgotten to list things they've done or not done (mainly med admin).
Also, don't trust information just because it comes from the discharging nurse/aid/lvn. We do alot of IFT and roughly 60% were called in with incorrect chief complaints, vitals are out of whack or they've forgotten to list things they've done or not done (mainly med admin).
titmouse
aspiring needlefairy
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how was your first shift???