Differences in Classroom and Ride alongs

[wadford]

Hey everyone, I haven't posted in a while. Still in EMT-B class, we are about to close out our trauma module. Anyway what I was wondering about are the differences that you noticed between what you learned how to do in class such as patient assessments, airway and such and what you noticed when you did your ride alongs. I did my first ride along yesterday and it was so different from what I learned in class. I think I must have asked a million and four questions. But I was just wondering what everyone else noticed and how you felt about it. I came home last night after the ride along thinking I'm never doing anything else!

 

[steveshurtleff]

Wow! Are you sure we're not the same person? I also am in EMT-B training, studying trauma now, and also did my first clinical yesterday, a 12-hour shift on an ambulance, and also walked away from it feeling 20' tall and rocketproof.

Is there any one call that stands out for you? Our last call was the only real trauma call we got and was a car vs. motorcycle. Unfortunate for the patient, yes, but what a rush!

 

[Anjel]

once you get out there you will see that a lot of people don't go by the book. People develop shortcuts, and might not take 3 sets of vitals for every patient.

The assessment is done in your head. The questions might not be in order. But it all gets done. You will develop your own little way of doing things.

 

[wadford]

I was on the truck for about 13 hours. We ran four calls, one respiratory distress, one altered mental status, a pediatric stroke pt. and a chest pain. We didn't get any trauma calls (I'm riding again on the 13 with a different truck so here's hoping) We did get some blood on the chest pain call when the intermediate tried to get an i.v in this patient but it didn't work so I grabbed 4x4's for the blood that shot out. It was pretty cool. I was really nervous on the first call but after that I think I got a little more comfortable.

When we were on calls I was thinking patient assessment. Initial assessment, focused history and physical exam, detailed assessment, ongoing assessment. Then we got there and it was chief complaint, do you want to go to the hospital?, are you on any medications, and then small talk to the hospital. It was all over the place, but somehow it seemed to work.

@ Steve, what were the calls that you ran the day you rode? @Anjel I definitely agree with you

 

[rescue99]

I was on the truck for about 13 hours. We ran four calls, one respiratory distress, one altered mental status, a pediatric stroke pt. and a chest pain. We didn't get any trauma calls (I'm riding again on the 13 with a different truck so here's hoping) We did get some blood on the chest pain call when the intermediate tried to get an i.v in this patient but it didn't work so I grabbed 4x4's for the blood that shot out. It was pretty cool. I was really nervous on the first call but after that I think I got a little more comfortable.

When we were on calls I was thinking patient assessment. Initial assessment, focused history and physical exam, detailed assessment, ongoing assessment. Then we got there and it was chief complaint, do you want to go to the hospital?, are you on any medications, and then small talk to the hospital. It was all over the place, but somehow it seemed to work.

@ Steve, what were the calls that you ran the day you rode? @Anjel I definitely agree with you

Yeah, those are the bad habits NOT to get into! Perhaps the next ride will include better mentors. The assessment is a little more obvious than that, even in the lowest of priorities.

 

[Anjel]

Yeah, those are the bad habits NOT to get into! Perhaps the next ride will include better mentors. The assessment is a little more obvious than that, even in the lowest of priorities.

and I definitely agree with you

 

[steveshurtleff]

@ Steve, what were the calls that you ran the day you rode?

We had 6 or 7 calls, all but 1 were chest pain. The other was car vs. motorcycle. Out of those, we had 3 or 4 transports, 2 refusals, and one with no need to transport.

 

[wadford]

Steve, what are you planning to do when you finish the emt-b class? A few of my classmates are using it as a stepping stone to nursing. I'm on the fence between private ambulance companies and 911. I figure 911 would give me a better range of calls, but the private companies focus more on patient care from what I've heard. Have you heard anything that stuck out to you? Just wondering.

 

[steveshurtleff]

Long story, but circumstances are leading me to get something fast upon graduation and then continue my education from there. AMR has the city transport contract and I hear they are rather difficult to get hired on with, so while I do intend to apply with them, they certainly won't be the only agency I talk to.

 

[antoniolb]

so do you at all feel more confident when your out in the real world.i know my SAMPLE, OPQRST, AVPU... but when i do it in class i sort of get a mind blok and dont know what to do next.

 

[steveshurtleff]

so do you at all feel more confident when your out in the real world.i know my SAMPLE, OPQRST, AVPU... but when i do it in class i sort of get a mind blok and dont know what to do next.

Yes, and you're not alone in that

 

[CAOX3]

Yeah, those are the bad habits NOT to get into! Perhaps the next ride will include better mentors. The assessment is a little more obvious than that, even in the lowest of priorities.

Really how do you figure? My assessment is done by conversation, not regimented question and answer assault. A good provider should be able to s sit with a patient have a conversation and be able to determine what exactly might be going on. I don't take shortcuts I also don't need to really on memory tricks to lead me through an assessment.

To a patient it should feel like a conversation not an interrogation.

As providers learn they will understand what needs too be asked and the answers will guide them.

 

[Boduke]

I would assume being able to talk and have a conversation with a patient would be much more comforting to a pt