# Learning the Ropes.



## RanchoEMT (Oct 24, 2010)

I work for a company that does BLS/IFT and 911/ALS.  I'm a newer EMT working BLS right now, getting ready for ALS.  I've noticed alot of things that I'm obviously not prepared for such as Medications beyond our scope and there illness' associated with (ex. dilaudid).  Any advice/tips on getting ready for the switch over to 911/ALS???


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## Shishkabob (Oct 24, 2010)

The best thing to do, and the thing I like my EMTs to do, is know what each medicition we carry looks like so that if I ask for it you give me the right one.  If I say I want Epi, I want you asking "Which one" as it comes in different styles.  If I say I want Lidocaine, again, "Which one" as there are the drips and the pre-filled syringes.  



Eventually you'll get used to what medications are used for what, that way say you're on a respiratory distress call and it looks like asthma, you are already thinking a step ahead to albuterol, atrovent, solu-medrol, terbutaline and other.




Another helpful thing is to go through the protocols for your Paramedics.


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## TacoMEDIC (Oct 24, 2010)

Linuss said:


> The best thing to do, and the thing I like my EMTs to do, is know what each medicition we carry looks like so that if I ask for it you give me the right one.  If I say I want Epi, I want you asking "Which one" as it comes in different styles.  If I say I want Lidocaine, again, "Which one" as there are the drips and the pre-filled syringes.
> 
> 
> 
> ...



That's good advice. I always ask my EMTs to familiarize themselves with all the equipment and meds that we use. With the meds, I like them to know what they're used for. If you are around Medics or 1:1 EMTs at your station, ask them if they could take a little time to start showing you the inventory. I'm sure they would be more than happy to do so.


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## RanchoEMT (Oct 24, 2010)

What is a good reference, book, textbook, etc. to get to know this material???


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## TacoMEDIC (Oct 24, 2010)

RanchoEMT said:


> What is a good reference, book, textbook, etc. to get to know this material???



You're EMS systems Protocol Manual would probably be best. Brady makes a good Drug Reference that I carry in the rig. It might be helpful in learning the meds you carry. 

http://vig.pearsoned.com/store/product/1,1207,store-622_isbn-0130287989,00.html


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## SanDiegoEmt7 (Oct 24, 2010)

RanchoEMT said:


> What is a good reference, book, textbook, etc. to get to know this material???



There won't really be a text, per se, that will give you all of the info you are looking for.  

I would start with your local protocol book.  It will have all of the ALS protocols for you to look at, typically has a drug box review.  I also have read a paramedic text a couple times, and I highly recommend it (Knowing the treatments and procedures at the next level of care 1) allows you to better assist, and 2) let's you know when its time to access ALS when you're not with a medic).

Other things that can make a medic's life easier on calls:  how to spike a bag, how to put on a 12 lead, and like Linus said being able to grab any piece of equipment or med they ask for.  The easiest way to learn most of these things is to have someone show you during down time.


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## Shishkabob (Oct 24, 2010)

http://www.amazon.com/Drug-Guide-Pa...645X/ref=sr_1_2?ie=UTF8&qid=1287898021&sr=8-2


Used that in my medic school.  It will fit in a pocket, and has a list of over 1000 commonly used medications.


The main pages are some of the most used emergency medications, their actions, indications, contraindications, side effects, and dosages.


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## TacoMEDIC (Oct 24, 2010)

Linuss said:


> http://www.amazon.com/Drug-Guide-Pa...645X/ref=sr_1_2?ie=UTF8&qid=1287898021&sr=8-2
> 
> 
> Used that in my medic school.  It will fit in a pocket, and has a list of over 1000 commonly used medications.
> ...



That is a good one. Lots of info out there. Just gotta go out and get it.


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## Pittsburgh77 (Oct 24, 2010)

Run calls.... Pretty much the best way to get adapted.


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## b2dragun (Oct 24, 2010)

As someone that started working als a couple months ago here are my suggestions...
1. Learn your protocols- it does no good to know your medics if you don't know yours.
2. Bring your book- after calls look at what the call was
3.Remember ABC's
4.When you are waiting for a call just sit in back- tear open your cabinets, jump bag, drug bag.
5.Ask your medic questions...after the call and don't question him during the call.
6.When your call comes in start thinking- I need to do this this and this.  And make sure you make a mental not before you get there what hospital is the closest in case it is a hot return.
7.As for driving, if you go back hot take a deep breath and drive.  Thats all you need to do.  Remember slow is fast, doing 80mph is going to toss your medic around in back.  Just take it easy and drive...slow down for thw bumps.  If you knock 30 seconds off by driving crazy you aren't doing them any good...you probably will delay the medic from doing what they need to do.

8.Lastly, TIME- you won't really get it till you see it and do it.  Everyone starts out with zero experience.  Just care enough to learn from your calls and experiences.


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## 94H (Oct 24, 2010)

You learn from experience. 

I've only been at it for a few months, but I know generally what needs to get set up.

Also, on one of your shifts just sit in the back with the Medic bag during downtime and familiarize yourself with it. It helps alot to know where everything is, Medics get cranky when you take too long rummaging/unorganizing their bags


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## Jay (Oct 24, 2010)

The AAOS  has a great course called *ACLS for the EMT-B*, I recently took it and think that this will explain a lot on how ALS works and how you as a BLS provider can assist. The course covers drugs as Linuss suggested is important, for example EPI, you need to know that there are two concentrations and what each is used for and how often, for example every 3 to 5 minutes for VF/Puleless VT. You will learn about advanced airways and even get to intubate a manikin. It is a lot harder than it looks the first time you will do it but you will also see that other advanced airways have their advantages, e.g. an LMA is much easier to use but doesn't have the protective qualities as an ET tube and is therefore not the 'gold standard'. You will go through a megacode scenario or two and see how it all works together in practicum and be able to ask questions after the code. You will see the many operations of a manual defibrillator such as pacing, sync cardioversion as well as using the shock function. Very interesting stuff. Finally, some advanced scenarios will come into play and you will get to learn an ALS way of looking at them. It was a great class, offers 6 CEU's and I highly recommend it.


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