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A little help for the new EMT?

Discussion in 'BLS Discussion' started by ChewyEMS13, Feb 12, 2018.

  1. ChewyEMS13

    ChewyEMS13 Forum Crew Member

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    @AZEMSPRO

    Yeah, you're telling me. BLS was a fun chapter! In all honestly, chapters 15 and 16 were the toughest. It is the respiratory emergency and cardiovascular emergency chapters.
     
  2. AZEMSPRO

    AZEMSPRO Livin’ Life With Lights & Sirens Blaring

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    Ya, im not looking forward to it.
     
  3. ChewyEMS13

    ChewyEMS13 Forum Crew Member

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    To be honest, the thing that got me through the chapters was anatomy and physiology. I knew those like the back of my hand because I read chapter 6 so many times. A&P helped tremendously. If you know what you start out with, it was super easy to understand the pathology behind any underlying disease. Where I struggle is matching the signs & symptoms up with each certain diseases because so many of them seem to overlap. If you want, you can PM me and we can have an over-the-computer study sesh. I am always down with studying
     
  4. Kevinf

    Kevinf Forum Captain

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    Food poisoning; E. Coli from a bad salad. No nausea/vomiting or diarrhea. The back pain and decreased urine output was referred kidney pain from the bacteria affecting the kidneys. Asking about last oral intake could have been helpful here. Any uncooked foods (salad, ice cream) in the last 24-48 hours should put food poisoning into your differential depending on their symptoms.
     
  5. VentMonkey

    VentMonkey Es La Verdad Premium Member

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    This question seems to be asked fairly frequently. The main pointers rarely change.

    Have a mind like a sponge, skin like a rhinoceros, and gallons of humility. Do you have to have these things? No, but if you want to last any amount of time doing this, then those are the key pointers that got me, and those I’d trust my family with through.

    Someone always knows more, or is better; a lot of the times it’s simply their own accord, the rest is based solely on the providers actions. The latter being the providers that I Iearned, and grew from the most. The “two ears, one mouth” thing holds true in so many invaluable ways. Don’t be a storyteller, be a story maker.

    Like others have mentioned, there’s nothing wrong with being new. There’s also nothing wrong with being labeled because guess what? You will always be labeled to someone something other than what you’d consider yourself so what’s it really matter to you?

    The best clinicians are perpetual students, and listen to the actions of the mentors before them. To me, mentors serve as the bar, or example, so again, way less talking than actions.

    These guys and gals spend more time doing and learning, and so much less time talking about what they would or would not do.

    As far as your scenario, well if I didn’t have patient presentations that didn’t/ don’t stump me...again, goes back to the humility thing, right? How else would you truly “learn” pathologies and the like?

    Like someone else mentioned we’re almost always looking up things constantly. So sure, some providers might say “ah, ok kidney stones” and stop there. Others might be more inclined to want to say “I wonder what else it could be, and/ or what else would cause things such as kidney stones?...”

    You will never know every single underlying dx regardless of your training, but if you know where to look you’ll learn root causes and the branches that they might spawn. Good luck.
     
    ChewyEMS13 and Kevinf like this.
  6. ChewyEMS13

    ChewyEMS13 Forum Crew Member

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    Yeah, that's straight from SAMPLE history. I am feeling like what y'all said about more practice hones skills, but isn't food poisoning super obvious? I guess I should realize that SAMPLE history, OPQRST, and PASTE are focused on in the book for a reason.. lol
     
  7. ChewyEMS13

    ChewyEMS13 Forum Crew Member

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    I like this a lot. This is a really good piece of advice. Thank you for that!

    And this.. It settles me that experienced people like yourselves view beginners in this light. I guess I was just worried that the experienced EMTs and Medics were going to expect me to know all this stuff. It takes a big weight off my shoulders just knowing that I'm not expected to come out of EMT-B school with vast and photographic-esque knowledge of every underlying pathology to every Dx. I think that was the biggest thing worrying me.. I don't have to lead a BLS truck right after EMT-B school, and honestly, that was the impression I was getting
     
  8. ChewyEMS13

    ChewyEMS13 Forum Crew Member

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    This actually (after playing around with it in my head) makes absolute sense. My route that led me to the kidneys was correct, but why was the kidney affected in this way? It does actually make sense in my head now. This actually helped me a lot. I really appreciate that mini-scenario
     
  9. Kevinf

    Kevinf Forum Captain

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    E. coli can cause kidney dysfunction and/or bloody diarrhea. Both are potentially serious complications. Not all food poisoning leads to nausea/vomiting. That's where gathering a good history comes in to help your differential when the patient has an atypical or vague presentation (ex, what the patient thought was muscular back pain was actually kidney pain).
     
  10. ChewyEMS13

    ChewyEMS13 Forum Crew Member

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    Would E. Coli present with a fever as well, or not often? I'm assuming since it's a bacterial infection
     
  11. VentMonkey

    VentMonkey Es La Verdad Premium Member

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    Yep. OP, look up hemolytic uremic syndrome (HUS). That’s essentially what @Kevinf is referring to; or at least a variant of. I had this as a kid, and was not fun. It took several specialists to figure out what exactly the dealie-yo was.

    Side note: nothing scarier to a parent than their kid receiving a blood transfusion in the early 90’s:).
     
    ChewyEMS13 likes this.
  12. ChewyEMS13

    ChewyEMS13 Forum Crew Member

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    Dang! That wasn't in the Orange book xD
     
  13. AZEMSPRO

    AZEMSPRO Livin’ Life With Lights & Sirens Blaring

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    Where are you going to school?
     
  14. MSDeltaFlt

    MSDeltaFlt Forum Deputy Chief

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    Here's the deal about EMT school. The school isn't long enough to be able to teach you about each and every situation. So they only have enough time to cover the worst case scenarios. If you'll look at your check off sheets they won't cover stones. All pain concerning the torso will require lots of oxygen and rapid transport (P.U.H.A.)/call for ALS intercept.

    See, there is so much more to abdominal pain than a one semester school can truly cover. Is it an aneurysm? Do they have kidney stones? Are they having a heart attack? Are they having a small bowel obstruction? Bladder infection? Pregnant (if female)? Acid reflux? Did they eat too much spicy food and now they have the "bam-beetus of the blow hole"?

    There's just too much to cover. So National Registry wants to you get them to higher level of c are (hospital or prehospital) as quickly as possible.

    So don't sweat it too much just yet. You're just now getting started. Like what's already been stated repeatedly, be a sponge, be humble, and ask questions.
     
    ChewyEMS13 likes this.

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