# what is a few of the hardest things to learn in the EMT-B courses?



## Megz7464 (Jan 31, 2008)

Im gettin ready to start my EMT-B classes Feb. 5th...and i was just wondering if anyone would let me know what are some of the hardest things to learn and do in the course..just so i would be able to concentrate harder on doin them right...ive been a ride along for about 2 months now for my FD and i love it. i just hate the fact that since i havent started my classes yet i really cant help too much. i have to just sit there and watch...which thats what im suppose to be doin anyway is being a "student observer" ha. but if you would please give me a heads up for some specific things im in for it would be much appreciated! ^_^


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## EMTMandy (Jan 31, 2008)

I don't think i could put a name on THE hardest individual subject(s) although I do have to say adapting to a new study pattern seems to be hard for a lot of people. The field of EMS is sort of like statistics-- where the skills taught are your formulas, and you have to figure out how and when to apply them. You have to be able to monitor/interpret the results of your treatment and have the ability to recognize any alternative treatments in your scope of practice if need be. Also, You have to be able to recognize the several indications for calling on a higher level of medical intervention.  

as some put it --EMS is 10% of what they teach you in school and 90% common sense...

Merry studying!!

~Mandy


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## JPINFV (Jan 31, 2008)

It seems that the hardest think to "learn" in an EMT-B course is critical thinking. Too many people are used to be sheeps that just do what they're told to be able to incorperate multiple data points (physicial exam and history including both pertinate positives (things that point you to what the patient has) as well as pertinate negitives (things that point out what the patient doesn't have)). 

The most important skill is the assessment ('quote' shamelessly stolen from a poster on another forum), but even that is only as important as your ability to utilize the data. 

Besides that, it seems that EMT-B courses could use a good deal of time on English composition and grammar. Frankly it sucks, both on professional forums and in a lot of providers' patient care reports.


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## emtwacker710 (Jan 31, 2008)

I would have to say the hardest part for myself was learning and trying to memorize all of the body parts assosiated with all of the systems, after some studying and asking a lot of questions I've got it pretty much all down...also I agree with part of the post above me..use proper english and grammer skills..I've seen some PCR's and it looked like a 4th grader having a seizure wrote it (sorry if the comparison bothers anyone)....because they don't really cover PCR writing too much in class..in my class we spent about 1 1/2 - 2hrs and they never mentioned it again..it wasn't even mentioned on the written exam.


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## Megz7464 (Jan 31, 2008)

yea im sure that im going to have plenty of more questions once i actually get started in my classes...lol..i cant wait to start. but thanks for giving me a heads up to some of the stuff that awaits me ha  anything else i need to know . be sure to let me know!^_^


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## Meursault (Jan 31, 2008)

From my experience, none of the subjects in the basic course were terribly difficult. Unfortunately, courses are heavily geared towards giving you the skills to pass the test. Fortunately, although the test is unrealistically simple, you'll need that skillset in the field too. 
The really difficult thing is getting out into the real world on ridealongs and in your first job and realizing how much you weren't taught. Quality ConEd and a good partner are extremely helpful. Keep reading and learning; check this forum, JEMS, and maybe even real medical literature if there's something you're interested in.
Take it easy, ask if you're unsure, and remember that BLS is, at its heart, fairly simple. Get a good history and physical, write a clear, intelligent, and organized report, and drive at a reasonable speed with lots of braking distance. 

Good luck with the course. Try to avoid the temptation to freak out and start an "OMG THE TEST IS COMING AND I DON'T KNOW ANYTHING" thread. You do. If you don't, nothing anyone here says can help you.


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## RMH4986 (Feb 3, 2008)

just rember your ABC's and OPQRST and SAMPLE and you should be ok most of it is common sence and you cant teach that Onset Provoking Qualty Raditing Symptoms Time Signs and symptoms Alergys Meds Past medical history Last oral intake Events leading thoes are for medicals and for trama there's DCAP-BTLS Deformits Catusions Abraisons Puncures Burns Tares Lacerations Swelling. i not saying these are the only things to know but they are the big ones and rember to get vitals before you ask for med control or for als intersept. any other questions just email me and i help as much as i can good luck. just rember it takes a special person to work ems.


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## AZFF/EMT (Feb 3, 2008)

OPQRST the S is not symptoms it is severity as in on a scale of 1-10 what would you rate the pain. 

Onset of the event 
What the patient was doing when it started (active, inactive, stressed), whether the onset was sudden, gradual or part of an ongoing chronic problem. 

Provocation or Palliation 
Whether any movement, pressure (such as palpation or other external factor makes the problem better or worse. This can also include whether the symptoms relieve with rest 

Quality of the pain 
This is a description of the pain including whether it is sharp, dull, crushing or some other feeling, along with the pattern, such as intermittent, constant, only on movement etc. 

Region and Radiation 
Where the pain is on the body and whether it radiates to any other area. This can give indications for conditions such as a myocardial infarction, which can radiate through the jaw and arms. 

Severity 
The pain score (usually on a scale of 1 to 10). This can be comparative (such as 'compared to the worst pain you have ever experienced') or imaginative ('compared to having your arm ripped off by a bear'). The clinician must decide whether a score given is realistic within their experience - for instance, a pain score 10 for a stubbed toe is likely to be exaggerated. This may also be assessed for pain now, compared to pain at time of onset, or pain on movement. There are alternative assessment methods for pain, which can be used where a patient is unable to vocalise a score. One such method is the Wong-Baker faces pain scale. 

Time (history) 
How long the condition has been going on for, and how it has changed during it's development (better, worse, different symptoms). It may also be useful to know if it ever happened before.


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## JPINFV (Feb 3, 2008)

Ah, the joy of acronyms where everyone has been taught something else.

OPQRST: Onset, provoke, quality, region/radiate/recurrence, severity, time

DCAP-BTLS [or how I like to put it, "If it's not normal, document it]: deformities, contusions, abrasions, punctures/penetrations, bleeding/bruising/burns, tenderness, lacerations, swelling.


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## LucidResq (Feb 3, 2008)

I'm currently in an EMT-B class but my SAR team offered a class for in-house certification as an "advanced first responder"... same knowledge, same structure, same practical exam... just no airways (our medical director doesn't want us doing them), no clinical hours, and no recognized state or national certification.
In all honesty with enough time a drunk monkey with a head injury could pass an EMT class. It's not that difficult. As far as the class goes, make sure you know the indications, contraindications, dosages and side effects of the handful of meds you're allowed to give (aspirin, nitro, epi, charcoal, inhaler). It can be a little bit tricky to remember. 
Practice taking vitals often on a variety of people, especially blood pressure and finding brachial and pedal pulses. Try to get vitals on people of different ages, sizes, etc. Make sure that you're very comfortable taking vitals before doing clinicals or ride-alongs. You will inevitably have to take them in an ED or the back of an ambulance. For my class I even have to spend 4 hours with a nurse doing triage at a busy level 1 trauma center doing nothing but vitals. 
As far as the test goes... I personally found the practical to be the most difficult. Not only do you have to learn the skills to take the practical, you have to learn how to take it. VERBALIZE EVERYTHING. Get in the habit of this as soon as possible when you start doing scenarios. Don't forget to verbalize exposing the genitalia in a trauma (you'll understand this soon). Study the algorithm of the assessment treatment process HARD... I'm talking about the flow chart that takes you all the way from scene size up to transport. If you can memorize that flow chart, you'll be well on your way to passing the practical. 
Volunteer to play the patient for other classes skill labs, mock practicals and practicals if possible. When you're sitting there being "treated" by someone else it's easy to catch their mistakes and avoid them when you yourself are the nervous one being tested.
Finally, memorize algorithms and acronyms. They'll do you well. 

Good luck!


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## Ridryder911 (Feb 3, 2008)

As an EMS Educator over the past 25 years, I am totally against acronyms. The DCAP, IEOUS, BUNCHOFCRAP, etc.. is great for studying for test, but in when placed in real life situation and stressful situations, majority of the people cannot recall each division immediately. Furthermore, asks anyone those abbreviations two years, four years later and see what the definitions you will see. 

My suggestion is simple. Read the objectives found in the front of the chapter. Learn and practice those. Those are what the NREMT and other certifying bodies will use to base the test questions over. Outline those objectives with the answers and leave room for lecture notes, and other pertinent information given. 

The hardest part is will be different for everyone. Usually, it is only difficult because this is *new material* for you, unless you have previous medical training. Relax, it will come to you, it is not as difficult as many attempt to describe. As some stated, most is common sense and learning a different approach of learning. Brush up on studying techniques and reading habits. you will succeed easily. 

Good luck, 

R/r 911


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## Ridryder911 (Feb 3, 2008)

Double post


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## jester_1269 (Feb 3, 2008)

ya know, i thought the hardest thing was the medical pt assmt on the state exam. Trauma I had down, but medical I had a problem with.   As far as the class itself, probably all of the definitions of medical terms and trying to concentrate on that huge book. ^_^


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## piranah (Feb 3, 2008)

i would have to say that the hardest thing is to learn to trust your decisions and training...if you think you know your material...you do just trust yourself...that was the hardest thing for me to do......study,study,study.....youll do fine


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## uscgk9 (Feb 4, 2008)

The hardest thing to remember is the ability to known when you are over your head or know when the patient's medical needs can be better provided with a Paramedic. Too many times I have seen or heard of EMT-Bs running calls that clearly should be handled by a Paramedic. I'm not saying that all calls need a Paramedic, and most don't. but think about what is in "the best interest of the patient" and not how comfortable you feel on the back of the truck. It's a big problem here on the Eastern Shore of virginia where some towns would rather run the call BLS instead of asking for a Medic from the neighboring town. When someone calls 911 they are expecting adequite care and not political bs. Enjoy your class and always look ahead and advance your training. i'll get off my soap box now.....lol.


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## TheMowingMonk (Feb 4, 2008)

I remember the hardest thing i had was the full trauma assessment, half was because its by far the longest skill, and because I was doing it on the last day of my class so i only had one chance to pass it. But i defiantly agree that the acronyms only help for the tests. When im actually treating patients i just think of it as second nature, dont sit there and think through it all, but i guess thats something that only comes through practice and actually being there during an emergency call.


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## crash_cart (Feb 8, 2008)

the easiest for me was anatomy and cardiology. I absolutely ate those chapters up.  The hardest thing for me personally, was to apply the APGAR and GCS test numbers to a given theoretical situation.  It has taken me awhile and lots of notecards, but I have it down to where I feel confident about it.


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## mikie (Feb 8, 2008)

for me, it was the assessments (in class), though now, (not saying that they're perfect), it's almost like second nature.  My difficulty was just ensuring (when it was testing time) that I had each step preformed, text-book style.


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## Topher38 (Feb 8, 2008)

For me the easiest thing was becoming book smart. I mean you can have all the info in your head but you need to get it in your hands. You know what i mean? 

The hardest part for me was learning how to talk and assess the patient, what questions to ask, What treatments to use and when. It all comes with practice. I noticed the more i practiced on "fake" patients the more comfortable and the more confident i became with the assessments. Cause you can be the smartest guy in the world but if you dont know how to physically assess and handle a patient then all that book smarts is nothing. PRACTICE PRACTICE PRACTICE


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## roxychick (Feb 10, 2008)

Haha! I hate acronyms too! I mean, I love them since they are so easy to remember but hate them because sometimes I have no idea what they mean...especially with the whole internet lingo these days. lol It's funny, I had a hard time remembering my OPQRST questions and I'm pretty sure that you wouldn't want to hear me come up to the patient and be like "R! Radiation!!???" LOL One day I got fed up with all the acronyms I decided to study them until I knew each and one of them by heart. By the time I did my clinic hours and ride alongs...all these stuff just came out of me that I didn't even know that I knew. Haha


I don't know...I just felt the need to share my story.


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## Katie (Feb 10, 2008)

I think it depends on the type of student you are and your background knowledge.  A lot of people had problems with A&P, but since I'd had the class it wasn't a problem.  For me the biggest thing was the abbreviations.
Best Luck


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## crash_cart (Feb 11, 2008)

> I think it depends on the type of student you are and your background knowledge.  A lot of people had problems with A&P, but since I'd had the class it wasn't a problem.  For me the biggest thing was the abbreviations.
> Best Luck



Excellent point!  When you consider that people are coming from areas such as business, education, or any non-medical profession, it's easy to see how changing mindsets and core knowledge about things, not to mention "how to" regarding situations can be problematic.  I had about a three week period where I couldn't get the test structure down in preparing for our final.  It wasn't until I slowed down and tried to think more methodically, that I could finally "see" the question and the right answer.  It's difficult to explain and I proably butchered it with this attempt,:blush: but I know that's what I went through.


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