A little help for the new EMT?

ChewyEMS13

ChewyEMS13

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Hey y'all. So I'm about halfway through my EMT-B course, and I;m doing really well. I have a 95% in the class so far, but I am concerned a bit.. A lot of the questions on the test are quite easy, and I feel like they don't reflect the real world accurately at all. For example, I had my cousin (paramedic for AMR) test me out with a mock patient assessment. He said that the pt was complaining of 8/10 abd pain that radiates to the back. I blanked and totally forgot to ask pertinent questions. He said, "Hint: it hurts when she urinates." ... still drawing a blank. Finally he said, kidney stones, man! What a simple answer!! I am a little concerned that my school isn't properly preparing me for the "real world"

Any advice any of you guys have is welcome.
 
To what extent can any school adequately prepare you for the real world? Not much. Your EMT course just gives you a foundation for continuing your education in the field. For now, concentrate on passing. The real world will make more sense after you've been in it for a while.
 
ehhh, speaking from experience, I didn't have any abd pain when I had my first stone. well, other than the extreme nausea and vomiting, but it was mostly back pain. I was grossly diaphoretic, extreme back pain (which sucked, but after 15 years in EMS, i thought i just twisted wrong), and nausea..... TBH, I was worried I was having an MI or a AAA or something more serious. kidney stones were the last thing on my mind, until one of my fellow EMT instructors suggested it.

good pertinent question to add to your assessment: are you pooping and peeing normally?

don't worry, the more patients you assess, the better you will get at differential diagnosis and what questions you need to ask when.
 
EMT class probably won't prepare you for the real world in full, it's too different. You should come out of the class able to do the minimums of the job and be able to see and learn further.
 
mgr22 said:
To what extent can any school adequately prepare you for the real world? Not much. Your EMT course just gives you a foundation for continuing your education in the field. For now, concentrate on passing. The real world will make more sense after you've been in it for a while.
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I guess I just wanted to stand out from other new EMTs. Be keen and aware of things most new guys(gals) aren't so that I wouldn't "annoy" my future partner. I don't want to be "that guy", y'know?
 
DrParasite said:
ehhh, speaking from experience, I didn't have any abd pain when I had my first stone. well, other than the extreme nausea and vomiting, but it was mostly back pain. I was grossly diaphoretic, extreme back pain (which sucked, but after 15 years in EMS, i thought i just twisted wrong), and nausea..... TBH, I was worried I was having an MI or a AAA or something more serious. kidney stones were the last thing on my mind, until one of my fellow EMT instructors suggested it.

good pertinent question to add to your assessment: are you pooping and peeing normally?

don't worry, the more patients you assess, the better you will get at differential diagnosis and what questions you need to ask when.
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Ugh.. I have seen relatives go through kidney stones, and it looks like a real pain.. literally.. I was just thinking of all the things that could possibly be the cause of an acute abdomen, which as you know, there are countless
 
ChewyEMS13 said:
I guess I just wanted to stand out from other new EMTs. Be keen and aware of things most new guys(gals) aren't so that I wouldn't "annoy" my future partner. I don't want to be "that guy", y'know?
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You're going to be "that guy" when you first get your patch no matter what. It takes seeing multiple patients to start to become proficient in assessments and differential diagnoses. If you start out acting like you know what the job is and everything about the job, you will be known as the "I know it all and don't need to learn anything guy". Believe me it's better to be the guy who knows he doesn't know more than the basics of what to do guy in the beginning. If your future partner is annoyed with having a new guy, that's their issue. The learning doesn't stop when class ends and you get your patch. The patch signifies that your learning is just beginning. The only reason some of us on the board and in person seem like we know it all is, we've been doing this job for years and have lots of experience, but ask anyone of us and we would all tell you there are things we still need to look up and things that we know are still our weak areas to work on.
 
luke_31 said:
You're going to be "that guy" when you first get your patch no matter what. It takes seeing multiple patients to start to become proficient in assessments and differential diagnoses. If you start out acting like you know what the job is and everything about the job, you will be known as the "I know it all and don't need to learn anything guy". Believe me it's better to be the guy who knows he doesn't know more than the basics of what to do guy in the beginning. If your future partner is annoyed with having a new guy, that's their issue. The learning doesn't stop when class ends and you get your patch. The patch signifies that your learning is just beginning. The only reason some of us on the board and in person seem like we know it all is, we've been doing this job for years and have lots of experience, but ask anyone of us and we would all tell you there are things we still need to look up and things that we know are still our weak areas to work on.
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That helps a lot. Thank you! I know that there is a lot to learn, and I know i'm going to be a white belt at this for a while. The responsibility of having the health of another person in your hands is both exhilarating and terrifying at the same time. I love it already.
 
ChewyEMS13 said:
Hey y'all. So I'm about halfway through my EMT-B course, and I;m doing really well. I have a 95% in the class so far, but I am concerned a bit.. A lot of the questions on the test are quite easy, and I feel like they don't reflect the real world accurately at all. For example, I had my cousin (paramedic for AMR) test me out with a mock patient assessment. He said that the pt was complaining of 8/10 abd pain that radiates to the back. I blanked and totally forgot to ask pertinent questions. He said, "Hint: it hurts when she urinates." ... still drawing a blank. Finally he said, kidney stones, man! What a simple answer!! I am a little concerned that my school isn't properly preparing me for the "real world"

Any advice any of you guys have is welcome.
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Many of your patients will have forgotten to read the same book you did. Let's try this scenario and see what you think:

Pt complaint of lower back pain, generalized achiness/fatigue, poor urine output, and severe headache for the last 24 hours.
 
Kevinf said:
Pt complaint of lower back pain, generalized achiness/fatigue, poor urine output, and severe headache for the last 24 hours.
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I would ask how much water the pt has drank in the past day or so. Does the back pain radiate, or is it localized? Does the headache get aggravated with certain positions? What is the color and smell of the urine?
 
No decent partner will care that you are new. They will care if you are new and start displaying all the negative stereotypes while not being functional in basic tasks or striving to improve yourself. Helping a new person learn is different than baby sitting incompetence. Ask questions, learn from your partner(s) & hospital staff, and think things through. Do that and you will be fine.
 
ChewyEMS13 said:
I would ask how much water the pt has drank in the past day or so. Does the back pain radiate, or is it localized? Does the headache get aggravated with certain positions? What is the color and smell of the urine?
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Normal fluid intake. The most severe pain is localized to lumbar region radiating to flanks. Headache is constant. Urine is darker than usual. Vitals WNL. Patient is a fit male in his early 30's. States he's "feeling like an old man" due to joint pain/stiffness and aching all over.

Regarding partners, the only time I've seen anyone new get flak is after they gain a reputation for being "unteachable", whether that be by thinking they know everything or by not retaining anything.
 
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Kevinf said:
Normal fluid intake. The most severe pain is localized to lumbar region radiating to flanks. Headache is constant. Urine is darker than usual. Vitals WNL. Patient is a fit male in his early 30's. States he's "feeling like an old man" due to joint pain/stiffness and aching all over.

Regarding partners, the only time I've seen anyone new get flak is after they gain a reputation for being "unteachable", whether that be by thinking they know everything or by not retaining anything.
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Renal failure of some sort? That would be my best guess. My next question would be if he's had any kidney problems, but from the info I'm hearing now, I'd go with kidney failure of some degree
 
The NREMT is a National Certification. Your state will have different protocols for a lot of things and your Medical Director can allow you to do certain things you didnt learn in school. EMT-B is exactly what what the class is, Basic. Your basically only learning ABCs and a little prevention. Everything else you will learn in the field over time.
 
DrParasite said:
ehhh, speaking from experience, I didn't have any abd pain when I had my first stone. well, other than the extreme nausea and vomiting, but it was mostly back pain. I was grossly diaphoretic, extreme back pain (which sucked, but after 15 years in EMS, i thought i just twisted wrong), and nausea..... TBH, I was worried I was having an MI or a AAA or something more serious. kidney stones were the last thing on my mind, until one of my fellow EMT instructors suggested it.
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I've had kidney stones twice, first time felt like someone stabbed me, I dropped to my knees and vomited. I was leaning more toward appendicitis, second one wasn't near as bad.


For Chewy: Another note is not all patients will have the same symptoms for the same illness. Some people will have different pain tolerances, or their body copes better. We were taught in my class that we really can't diagnose abdominal pain, we can just try to rule out certain things, make them comfortable, and transport. In my area most of the time this would become an ALS call so we'd have a Medic riding with us to the hospital.
 
AZEMSPRO said:
EMT-B is exactly what what the class is, Basic. Your basically only learning ABCs and a little prevention. Everything else you will learn in the field over time.
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That's kinda what I figured. It just seems like the class is "indirectly" saying that we should know all the pathology associated with the different organ systems because we have to diagnose them. We spend more time on pathology than we do treatment and such. Maybe I am reading the class wrong. And like I said before, it's because I want to be the best EMT that I can be, so I am a little bit knowledge hungry
 
ChewyEMS13 said:
That's kinda what I figured. It just seems like the class is "indirectly" saying that we should know all the pathology associated with the different organ systems because we have to diagnose them. We spend more time on pathology than we do treatment and such. Maybe I am reading the class wrong. And like I said before, it's because I want to be the best EMT that I can be, so I am a little bit knowledge hungry
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We don't Technically "Diagnose" but I know what you mean. The best thing I learned in class is to form a Study Group. Trust me it goes a long way. If you don't understand something then ask the instructor. They want you to ask questions because they aren't there to try and get you to fail, they want you to succeed. Everyone learns differently.

What Chapter are you on?
 
@AZEMSPRO

Our entire class is 7 weeks. We are 3 weeks in. This Thursday we start our 4th week and have midterms
 
Damn, your in an accelerated class. lol Mine is a semester long and we just finished Chapter 13 BLS Resuscitation. What I like to do is go on pintrest and just search EMT, lots of good stuff there.
 
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