EMT Screw Ups

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Reynolds One

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Anyone have any stories of EMTs making big mistakes in patient care that you attribute to their lack of attention or knowledge? Without revealing details, of course.

I'd like to share these kinds of stories with the EMT students I work with.
 
VentMonkey

VentMonkey

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Countless, many of which are my own either as an EMT, or paramedic.

I doubt the stories themselves are all that important, but you know what is, or would be? Them knowing that they’ll screw up at some point.

Learning from what you did is the only way to get good at anything. Without failures (in this case blunders, or mistakes), there’s hardly true success. Don’t crank out robots like every other program.

Maybe share some of your own experiences with your students. It shows both humanity, and humility.
 
VentMonkey

VentMonkey

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Reynolds One said:
Okay. Thanks for the condescending life message on humility and humanity. I was just asking if anyone had any stories, ****.
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Heh? Chill out dude. Or not, and be the typical “Hey, this one time this EMT did this, don’t ever be that guy/ gal...” instructor cranking out the next generation of entitled, lets-not-own-up-to-our-own-mistakes set of superheroes.

No need for name calling, and way to read through a post.
 
NomadicMedic

NomadicMedic

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I'll often share a story of one of my screw-ups, or one that I've witnessed when I'm teaching my students.

For example, the woman I swore was a stroke but was actually hypoglycemic and didn't get a sugar checked until my EMT partner did it.

Share the stuff you've seen or done yourself. Not some random stories from strangers. And if you don't have a BIG stock of your own screw-up stories, you probably haven't been doing this long enough to teach. :)
 
DrParasite

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NomadicMedic said:
I'll often share a story of one of my screw-ups, or one that I've witnessed when I'm teaching my students.
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that's my rule too
NomadicMedic said:
For example, the woman I swore was a stroke but was actually hypoglycemic and didn't get a sugar checked until my EMT partner did it.
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I've been that EMT
NomadicMedic said:
Share the stuff you've seen or done yourself. Not some random stories from strangers. And if you don't have a BIG stock of your own screw-up stories, you probably haven't been doing this long enough to teach. :)
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Exactly. I tell my students that any stupid thing they will do I have probably already done, got yelled at for it, or seen someone else do it. This includes seeing a paramedic instructor injecting his thumb with atropine while demonstrating the proper auto injector method, having my partner catch a money shot because he looked down an ET tube during a cardiac arrest, failing to bring a carrying device on a reported unconscious, and carrying an unconscious hypoglycemic / overdose down a flight of stairs in a stair chair.

Anyone who has been in this field for any length of time will make mistakes. The smart ones learn from their mistakes and don't repeat them. The ones who haven't ever made mistakes probably don't even know that that they did was wrong. They are the ones who continue to make them.

If I can get my students to not make the same mistakes I did, by telling them the stupid things I did, awesome.

And if you are spending the entire class telling war stories and discussing stupid stuff you did, than you are doing something wrong.
 
Gurby

Gurby

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My favorite story along these lines:

While I was doing an ED rotation during paramedic school, a 30yo male comes in via BLS 911 with a chief complaint of "nausea". I remember his skin being a distinct shade of green/gray, don't remember the vitals but the EMT's didn't seem too concerned. The triage nurse takes one look at the guy and says, let's put him in a room and run a 12 lead... Of course he's having an MI. The interventional cardiologist arrives at the room just in time for the guy to go into VFib. We zapped him a few times, sent him off to the cath lab and he ended up doing just fine.

It always stuck with me that, <10 minutes before going into cardiac arrest, this guy had been in the back of an ambulance with an EMT-B who thought he had an upset stomach. I don't think anybody necessarily did anything wrong there, but it's really easy to envision a parallel universe where things go sideways because people tune out after hearing "30yo male with nausea".
 
NomadicMedic

NomadicMedic

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Gurby said:
My favorite story along these lines:

While I was doing an ED rotation during paramedic school, a 30yo male comes in via BLS 911 with a chief complaint of "nausea". I remember his skin being a distinct shade of green/gray, don't remember the vitals but the EMT's didn't seem too concerned. The triage nurse takes one look at the guy and says, let's put him in a room and run a 12 lead... Of course he's having an MI. The interventional cardiologist arrives at the room just in time for the guy to go into VFib. We zapped him a few times, sent him off to the cath lab and he ended up doing just fine.

It always stuck with me that, <10 minutes before going into cardiac arrest, this guy had been in the back of an ambulance with an EMT-B who thought he had an upset stomach. I don't think anybody necessarily did anything wrong there, but it's really easy to envision a parallel universe where things go sideways because people tune out after hearing "30yo male with nausea".
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Lots of the good ones happen during paramedic school clinical rotations. We're new and green and still excited about every patient. I saw a fire department bring in an intubated patient, found in a car, 4mg of narcan given with no response. As they were moving him to the bed, I asked the fire medic what his sugar was. Oh snap. They never checked. His sugar was 22. The doc told me to "sweeten him up" and then he showed me how to extubate a patient.
 
Summit

Summit

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I teach a lot about human factors... war stories for first order analysis are poor use of student time because every scenario is different. Meta-analysis of mistakes in the classroom should focus primarily on looking for heuristic traps and methodical practices that prevent them.
 
VFlutter

VFlutter

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This one time a patient said he had big toe pain and they just transported him BLS but he was really having an MI and coded so now i do a 12 lead and give ASA to every patient because i don’t want to be “that guy”....
 
NPO

NPO

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I responded for chest pain. I arrive to find a mid 50s female on her couch, in obvious discomfort, and diaphoretic. The firefighter, someone I know personally and trust, gave me a good assessment. She began feeling unwell yesterday and it got progressively worse until that evening. She related the pain to her last heart attack. She had multiple cardiac comorbidities including HTN, DM, MI.

I was writing all this down and I glanced at the SPO2 meter they had applied when they placed her on a NRB. I was curious what her saturations were, but I noticed the meter was registering a pulse of 30. Suddenly, I stepped it up a notch. I checked her radial and confirmed. We quickly moved to the gurney and I applied the monitor. But the monitor read 70bpm. Hmm. Lead II was NSR with bigeminy. The PVCs were not perfusing.

We moved quickly to the truck, and I set up an IV. The first one wasn't successful, so I decided to get going. Code 3 transport to the nearest cardiac facility with a firefighter riding in as good measure. Additional IV attempts were unsuccessful. We were too close for me to do much else. 12 lead showed the same. It crossed my mind to do an IO and give atropine, but I didn't like that idea. I though about pacing, but I didn't like that either, since electrically she was at 70. I didn't know what to do. Thankfully, we were quickly at the hospital. My partner, at my request, called in a report for symptomatic bradycardia; and apparently he gave a great report. Kudos.

We got to the hospital and we're expedited to a bed. I gave report, and the nurse asked one simple question.

"What's her blood sugar?"

I stopped dead. It can't be that simple. This is textbook cardiac. It can't be.

It was.

After she was treated with half a can of Sprite, she converted to NSR and all symptoms resolved.

I walked out with my head low and my tail between my legs. I always took my blood sugar reading from the IV, but since I never got an IV I didn't check BGL.

I'll never make that mistake again.
 
SpecialK

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I can think of one or two cases where personnel have not properly assessed the patient or taken heed of the overall clinical picture and made inappropriate decisions about referral to the patient's detriment including death.
 
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akflightmedic

akflightmedic

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Just yesterday...I drew up 100mcg/2ml Fetanyl. I wanted to give the patient 100mcg. So I said out loud, Fetanyl 2ml equals 100mcg, I am going to push 1ml for a dose of 100mcg.

My EMT partner said professionally and as discretely as possible...."go ahead and give 2ml". Which was enough for me to double check my math and correct my under dose.

I have zero clue where my head was in that moment or why I said what I did.

Very BASIC mistake on my part....caught by my BASIC partner.

Even with some of the more experienced providers, we still have life going on, we still make errors (albeit far less than a newbie usually) and we try to implement as many safeguards as possible to prevent them. This requires communication, a degree of humbleness and a willingness to listen and change.
 
akflightmedic

akflightmedic

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OP, I do think the way you phrased this thread in an attempt to use it for teaching methods is flawed. Many of us who have responded have decades of experience in the field above and beyond Paramedic level in addition to many years of teaching at private academies, colleges, hospitals, etc. There is much wisdom to be found in some of these replies, however you got snarky and snapped off rather quick.

To me, that is concerning unto itself because you were unable to appreciate the value of what was offered, yet you are one of the responsible parties for educating our next generation of EMTs and are using a foundation which is probably not most ideal.

There are MANY other qualities, characteristics and skill sets which should be reinforced in relation to errors, error making, error correcting as opposed to pointing out the error (war stories). Does that make sense? If not, I alluded to some of it in my last sentence of my earlier post. I would focus on teaching them those skills and how to use them properly within our field.
 
NPO

NPO

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akflightmedic said:
Just yesterday...I drew up 100mcg/2ml Fetanyl. I wanted to give the patient 100mcg. So I said out loud, Fetanyl 2ml equals 100mcg, I am going to push 1ml for a dose of 100mcg.

My EMT partner said professionally and as discretely as possible...."go ahead and give 2ml". Which was enough for me to double check my math and correct my under dose.

I have zero clue where my head was in that moment or why I said what I did.

Very BASIC mistake on my part....caught by my BASIC partner.

Even with some of the more experienced providers, we still have life going on, we still make errors (albeit far less than a newbie usually) and we try to implement as many safeguards as possible to prevent them. This requires communication, a degree of humbleness and a willingness to listen and change.
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When I was in my new employee orientation, my FTO and I spent a good 3 minutes trying to dose Ketamime. We both said the correct dose several times, but it was like a negative feed back loop. Sometimes it just happens.
 
akflightmedic

akflightmedic

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Reynolds One said:
I'd like to share these kinds of stories with the EMT students I work with.
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And I just caught this...you "work with"....explain further? You did not say you teach,mentor,educate or coach....just you work with them. Are you wanting to war story with student riders doing their ambo clinicals? Just curious.
 
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