# Your First Year in EMS



## MRSA (Jun 9, 2012)

So I sat down and realized I've been an EMT-BLS for a year now. Doing dialysis calls, hospital transfers, having an occasional still alarm but I decided to take time and reflect on what stood out to me the most.

But I want to see your replies! What memories or things do you feel you learned that were useful as an EMT?

I learned that you may go to a dialysis call, but it can turn out to be something entirely different when you get their. I showed up to pick up a new dialysis patient and she was going septic. Also her eye was about to pop out of her head 

I also learned that you really need to read the packets of info the nurses give you. More often than not you'll find out information that they didn't tell you originally. Like ISO precautions or the DNR is not what they said it was.

I also learned that if you smell burning rubber on the freeway there might be an accident ahead. This is even further indicated if traffic comes to a stand still.

What did you guys learn!


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## DesertMedic66 (Jun 9, 2012)

Code 3 response (lights and siren) does not mean hold on, balls to the wall. 
People call 911 for stupid reasons and you can't believe some of them. 
Your typical day is going to be nothing like the TV show Trauma. 
Elderly people fall and break their hips alot. 
Urgent cares are well let's just say not that good. 
Some nurses are hot. 
Some hospitals are friendly and some are not. 
How you learned to do something in school =\= real life. 
There are many imcompitent (sp?) EMTs and Medics. 
There is such a thing as a stupid question. 
We can "what if a scenario until the cows come home". 
Some RNs don't know anything. 
There are tons of crazy people in this world. 

And the last one for right now is if your a psych patient on a 5150 hold refusing to get on the gurney the first time I ask nicely. The second time I tell you what we need. The third I tell you what is going to happen. The forth is when my partner and I physically put you on the gurney and go full restraints with a spit mask on stand-by.


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## MRSA (Jun 10, 2012)

firefite said:


> Elderly people fall and break their hips alot.
> 
> And the last one for right now is if your a psych patient on a 5150 hold refusing to get on the gurney the first time I ask nicely. The second time I tell you what we need. The third I tell you what is going to happen. The forth is when my partner and I physically put you on the gurney and go full restraints with a spit mask on stand-by.



Oh man, that's so true. I remember the first time I lost a patient after she felt and fractured her hip. I didn't understand why all my co-workers were pre-mourning until three weeks later she died. That really is a death sentence.

And I've always tried to be nice to my 5150's (hell even my difficult patients) but I remember when I learned I can put a spit mask on 'em. That's a really important thing to know so I agree with all of what you said but these two really stood out


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## Anjel (Jun 10, 2012)

My year mark was in January.

Things I've learned.

Not everyone gets oxygen. 

Compassion, smiles, and hand holding goes along way.

Old people 80 and up have super strength.

Most psychs can be calmed down with promises of a cigarette when we reach our destination. 

You have to be assertive. 

Nursing home staff takes lots of breaks.

If you don't get along with your partner. Life sucks.


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## Joe (Jun 11, 2012)

firefite said:


> Code 3 response (lights and siren) does not mean hold on, balls to the wall.
> People call 911 for stupid reasons and you can't believe some of them.
> Your typical day is going to be nothing like the TV show Trauma.
> Elderly people fall and break their hips alot.
> ...



I was going to write up.some stuff after thinking about it. Then i saw your post. You hit it right on the head... so close i wonder if we have worked together haha. 
One to add: If you give your partner the choice of driving or attending, they will always drive ha!

Firefighter proofing something is almost as impossible as ride along proofing somethink


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## EpiEMS (Jun 12, 2012)

Physicians and nurses often have no idea how much EMS providers can do.
There are so, so, so many people who call 911 for the stupidest reasons.
Most of the times, lights and sirens doesn't really help.
Running a code is one of the easier calls you can have.


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## mct601 (Jun 13, 2012)

I just reached my two year mark. I found that my biggest progressions, mentally/emotionally, were at 6 months> 1yr> 2yr.


but in my first year

EMS does not get respect; fire and police are the heroes, we are the cleanup crews.

Hospital staff looks at us as a nuisance rather than as a team, despite all having one goal (and thats not race to the end of the shift).

Sleep is something I never thought would come at a premium, but learned to cherish it (24-48hr shifts).

Most car accidents are refusals. Even the badass rollovers where it looks like someone died.

People have more screws loose than I ever would expected.

People come up with the worst excuses in the world for the condition they are in.

When an ambulance is running priority 1 down a rode, its probably to respond to some BS call.

Calls will take place at the most inconvenient time.

A code is easy (and in year two, it gets boring. unless you get ROSC).

EMTs DO save paramedics, while the paramedics save lives (any solid basic can relate to this)


thats all off the top of my mind at the moment. I can make more remarks about the two year mark than the one, but thats what I know I came to realization about at one year.


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## Aprz (Jun 14, 2012)

I learned:
- How to use several types of gurneys.
- The different switches in the ambulance.
- How to check transmission fluid.
- Recognize equipment that I wasn't shown in EMT school e.g. bed pan, evacu-AID, bite stick, pedimate. Those are some example, but there are more. Some of them you'd think is logical, but the first time I saw







I didn't think "that's a bite stick". It was very difficult for me to check the inventory of the ambulance my first time while my FTO taunted "C'mon, you don't know what that is?!"
- Some common ways to talk over a radio e.g. "Control, Unit 276, on scene."
- Where hospitals were at, and where things are located in each of those hospitals.
- Main roads.
- My previous partner showed me how to use flares and the fire extinguisher (PASS: Pull, Aim, Squeeze, Sweep).
- My previous partner also taught me the acronym DICCCE: Drug, Integrity, Color, Concentration, Clarity, Expiration.
- My current partner came up with the almost correct way to use combat straps for backboarding, a supervisor showed me the correct way (I only knew how to use spider straps and box straps).
- I learned what certain paperwork looked like and what they need e.g. DNR, POLST.
- Most recently, how to tell what gauge the IV is via the color.
- What is an opticom at my current company (previous company didn't have 'em).

Those are things that I can think of that I learned working as an EMT. There's a lot more that I've learn, but not thanks to working as an EMT.


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## Handsome Robb (Jun 14, 2012)

mct601 said:


> EMTs DO save paramedics, while the paramedics save lives (any solid basic can relate to this)





I'm an EMT getting ready to do my medic National Registry and I know that's a load of crap.


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## Aprz (Jun 14, 2012)

NVRob said:


> I'm an EMT getting ready to do my medic National Registry and I know that's a load of crap.


But I thought you were liquid, not a solid? You flow smoothly, not rough like a "solid EMT", so you don't count.


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## DesertMedic66 (Jun 14, 2012)

NVRob said:


> I'm an EMT getting ready to do my medic National Registry and I know that's a load of crap.



I gotta agree with you NV. As a EMT and EMT skills instructor I can confidently say that EMTs don't save medics... Unless the medic is extremely stupid and the EMT is extremely smart (which is rare).


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## mct601 (Jun 14, 2012)

NVRob said:


> I'm an EMT getting ready to do my medic National Registry and I know that's a load of crap.



and I'm an EMT testing registry by fall.


So you're saying that the EMT driving does not affect your patient care? Having a competent BLS partner does not allow you to focus on your ALS interventions while knowing he/she can handle their own? Having a competent EMT (or any partner, but for us its EMTs) in multi-pt scenes or erratic scenes does not make it easier? I wasn't necessarily saying BLS > ALS, but I was making a reference that having a good EMT as a partner can be a godsend to a paramedic. A salty medic can work with just about any partner you give him, but it makes the job easier and allows the patient care to work to its full potential when there is a competent BLS partner on scene with the medic, not just someone who squeaked past registry and is only about useful for lifting and driving (if that). And unfortunately there are far too many of those. 

I guess my point is that good EMTs come at a premium (according to the medics I work with), and I used that cliche statement to try and get my point across and it did not work


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## DesertMedic66 (Jun 14, 2012)

mct601 said:


> So you're saying that the EMT driving does not affect your patient care? Having a competent BLS partner does not allow you to focus on your ALS interventions while knowing he/she can handle their own? Having a competent EMT (or any partner, but for us its EMTs) in multi-pt scenes or erratic scenes does not make it easier? I wasn't necessarily saying BLS > ALS, but I was making a reference that having a good EMT as a partner can be a godsend to a paramedic. A salty medic can work with just about any partner you give him, but it makes the job easier and allows the patient care to work to its full potential when there is a competent BLS partner on scene with the medic, not just someone who squeaked past registry and is only about useful for lifting and driving (if that). And unfortunately there are far too many of those.



EMTs aren't the only people who can drive good (alot of them are actually horrible).

What BLS skills are extremely important and life saving aside from BVM and pumping chest?

Multiple patient scenes don't need a BLS/EMT provider to make them alot easier... 

Most medics can efficiently take care of a patient while the EMT plays gurney monkey.

Gotta say those dual medic units sure do work pretty well without an EMT...


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## mct601 (Jun 14, 2012)

firefite said:


> EMTs aren't the only people who can drive good (alot of them are actually horrible).
> 
> What BLS skills are extremely important and life saving aside from BVM and pumping chest?
> 
> ...




We do not have many dual medic units around here, most are in Louisiana. medics in MS are hard to come by as it is. It comes down to an EMT and a medic. The medic's shift can go by smooth, or can be hell. If you do not agree, then we can agree to disagree. The only point I was trying to get across is from *my experience* in my system, that a competent EMT can play a positive role in patient care and ALS assist, and make a medics life easier. once again, if you do not agree with this then that's fine.


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## Handsome Robb (Jun 14, 2012)

mct601 said:


> The only point I was trying to get across is from *my experience* in my system, that a competent EMT can play a positive role in patient care and ALS assist, and make a medics life easier. once again, if you do not agree with this then that's fine.



I absolutely agree with you on this point. EMT-Intermediates/IVs (whatever your flavor may be) can make it even easier with their expanded scope, with all do respect to the basics here. 

Saying EMTs save Medics isn't the same thing.


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## EpiEMS (Jun 16, 2012)

firefite said:


> What BLS skills are extremely important and life saving aside from BVM and pumping chest?



Direct pressure?


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## ToyotaTruck (Jun 19, 2012)

So much for talking about what you learned during your first year in EMS...:wacko:


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## phideux (Jun 19, 2012)

It's only a matter of time, Someone will eventually - Throw up on you
     ""     ""     ""     ""     ""     ""     ""     ""     ""      - Pee on you
     ""     ""     ""     ""     ""     ""     ""     ""     ""      - Hit you
     ""     ""     ""     ""     ""     ""     ""     ""     ""      - Spit on you
     ""     ""     ""     ""     ""     ""     ""     ""     ""      - Bleed all over you
     ""     ""     ""     ""     ""     ""     ""     ""     ""      - Die on you
     ""     ""     ""     ""     ""     ""     ""     ""     ""      - Cry on your shoulder
     ""     ""     ""     ""     ""     ""     ""     ""     ""      - Hug you and say thanks

You will probably get all of these in your first year.
I think I got them all in the first couple of months.


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## NomadicMedic (Jun 19, 2012)

People who can walk, won't. 

People who shouldn't walk, will alway try. 

By the time you're asking if they're gonna puke, it's too late. 

Zofran is a wonder drug. 

Backboards are mostly a waste of time. 

The driver picks the radio station. 

90% of what I do is BLS. 

I cant sleep in a recliner.

Always bring the CPAP into the house. 

Sounding and looking calm on scene is important. 

The BLS providers think they can be medics because "all we do is give aspirin and nitro".


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## Epi-do (Jun 20, 2012)

The only people you will get to see naked are the ones you definitely DON'T want to see naked.

You will never see it all, and if you start thinking maybe you have, a patient will come along to prove you wrong.  If you become convinced you have, it's time to find something else to do.

Sometimes the best thing to do is nothing.

Holding a hand or listening to Grandma talk about her grandkids and great-grandkids can go a really long way to help make her feel more relaxed and comfortable on the way to the hospital.

Despite what all your female friends may think, hanging out at the firehouse isn't all it's cracked up to be and the majority of them do not look like the guys in the calendars.

Sometimes it is ok to act like you know exactly what you are doing, even if you feel totally clueless on the inside.

If you aren't sure what to do, start with the basics and go from there.

The only time the cops will get the dog out or taze someone is at 3:00 in the morning, while you are sound asleep.

The more severe the accident looks, the more likely the driver is too drunk to be hurt.

Even if it is true, your entire narrative cannot consist of "DQ c/o BS"

Never announce on the radio that you are staging at the funeral home when dispatched on a suicidal person with a gun.


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## the_negro_puppy (Jun 20, 2012)

After nearly 2.5 years on the job and a month away from qualification-

- People with a long list of vague complaints usually have very little wrong with them.

- 90% of people exaggerate the pain scale, saying their pain is 8-9-10/10 almost to justify why the have called an ambulance.

- Going deep or long (think nursing home or tall building) take all the gear. The one time you leave something is the time you will need it.

- Nurses in general appear to be the *****iest profession. There are some fantastic nurses out there but many I have seen spend most of their time fighting with EMS, other nurses or Doctors. Do your job to the best of your ability and don't respond to their rudeness, questioning of your treatment or the like. Walk away if need be, You don't work for them.

- Just because you have a drug/skill you can use doesn't mean you necessarily should. Know when to do things and when not to.


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## bigbaldguy (Jun 20, 2012)

the_negro_puppy said:


> - Nurses in general appear to be the *****iest profession.



You obviously have never worked in the airline industry


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## WestMetroMedic (Jun 20, 2012)

If the patient has more than2 cats or more than 4 allergies, they have fibromyalgia.


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## NomadicMedic (Jun 21, 2012)

WestMetroMedic said:


> If the patient has more than2 cats or more than 4 allergies, they have fibromyalgia.



^^^this!


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## Meursault (Jun 22, 2012)

Be calm, polite, and patient. Be firm, if needed, but don't shout and don't insult. Unless you thought of something clever and the cops are nearby.
Have a clear idea of what your duties are, and what your employer perceives them to be, and decide how you resolve the conflicts.
They're protocols, not step-by-step instructions.
You're at the bottom. Even the housekeepers are more appreciated (and better prepared for their jobs) than you are. Being an *** about it won't change that; it'll just make everyone's day worse.
Do your job well and help other people do theirs well, and everything will suddenly get easier.
There's always something to learn.
If there's something you're worried about doing, go do it as soon as possible. (with supervision)
Learn how to lift properly, learn what your limits are, and take a few seconds to prepare.


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## ironco (Jun 22, 2012)

MRSA said:


> I also learned that you really need to read the packets of info the nurses give you. More often than not you'll find out information that they didn't tell you originally. Like ISO precautions or the DNR is not what they said it was.!



I learned that you need to check the packets because the bls ift of the old man with chronic pneumonia is really old man with a aaa>two weeks and st elevation with elevated trope THAT DAY!!!! Lol


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## EMTDude813 (Jun 23, 2012)

That every "Big" person weighs within the range 130-150 lbs.


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