EMT-B classes.

[modernist]

Hi all!

I wasn't sure if I should post this here or in the Lounge area so if it's in the wrong spot feel free to move it. I promise I won't be mad

I'm a couple of weeks away, here in Kentucky, from finishing my EMT-B classes and am preparing for the tests that are coming up. Problem is, I'm starting to freak out a bit. I'm more or less at a point where I'm asking what outside resources may be available to help me prepare for not only the written tests, but also the skills testing. Well, I guess I'm just asking for advice in general.

I'm going to give a little bit of a back story to why I'm starting to freak out. Please don't take this as some long whine on my part.

Right now, I'm in a class of about 30. We have our main professor and two assistants helping him out. Both the assistants work full time, so we generally have one in class at a time. For a few weeks now, I've been trying to get more one on one time because there's a few things I'm still not comfortable with. That's been problematic, considering class size and with generally two people teaching the class. I'm in a Tues/Thurs class that meets from 6pm-10pm and more often than not, we're gone by 8pm as most people just want to get out of there and go on with their evening.

The trauma assessment has been tripping me up and I have yet to get comfortable or sign off on that. I thought, for sure, I had a decent rhythm down to get it knocked out, but I swear every time I go to check off, it becomes a lengthy process full of side issues not on the sheet and I keep getting wrapped up, lost, and then I eventually fail because I can't get back on track. It feels I'm more or less being "tricked" while trying to get this signed off. Now, I know in the field things change and get messy, but having other friends who are EMTs they're basically saying the board tests will be fairly straight forward with no real trickery. I have no doubt dealing with the extra steps that complicate the trauma assessment could make me a better EMT, but it's doing nothing at all to give me any confidence I'll be able to pass the test to begin with. Every time I've failed the assessment, I get told to re-memorize the sheet and come back and do it again. I'm beginning to feel left out in the dark, more or less.

So, are the skills tests fairly straight forward or do I really need to focus on not getting side tracked and get extra steps down? So far, my trauma assessment check offs have included various respiratory issues where I've had to stop and go through the steps of using an OPA, various levels of patient consciousness where the OPA is questioned, further down to specific handling of splinting and going through the process of securing someone to the long boards all while getting drilled on the specific steps on the skills sheets themselves. So yeah, are the tests that complicated and I just need to step it up?

Medical assessment so far has been a breeze, as those were straight forward and following the sheet made it not so bad. I'm not, at all, having any luck with trauma. At this point, I'm getting drilled that I NEED to have this done and NEED to shape up so everyone else can go about the class and we can all practice for the tests. Hell, when I checked off supine stabilization I had never actually seen that done and was able to clumsily get that signed off just from simple memorization and figuring out what made sense given the tools I had lying around in front of me.

I've even had issues on my ride times. To date, I've got the bare minimum of 8 hours in. I've been asking for more for weeks because I'd like to get in there more and wrap my head around the stuff I've been learning. I think I accidentally shot myself in the foot because on one of my first calls I got into a bit of an issue with one of the paramedics. We were on a call of a woman with sudden, extreme abdominal pains. We get there and she's on the couch in tears and in a panic, her toddlers are screaming, and her husband is visibly shaken trying to do what he can. One of the paramedics hands me a blood pressure cuff and tells me to start handling things. I told him I wasn't comfortable quite yet in this type of situation. He told me I was in no place, as a student, to argue what I will and will not do on a call. I brought up how I thought it was a bit unprofessional to be having this discussion directly in front of a patient like this. He tells me again to do it and if I start screwing up, he'll take over and show me the right way. Again, I bring up, unprofessional. Back at the station, the somewhat heated discussion started up and I told him I would be more inclined to help out, I just need time to go over some things including his expectations of me when on a call. Walking into my ride times, I had no clue on what to expect at all. Was I supposed to do more hands on stuff? Am I just a fairly casual observer? I had no idea at all. Turns out, he was buddies with one of my class assistants and his boss is the other class assistant. Once I got back in class, that same discussion started over. Again, I maintained it was unprofessional and that I had asked for some time to practice and go over some of the simpler things.

So, after that, getting more ride times schedule is pretty much impossible.

Anyway, I've talked to the MWF night professor and he is more than willing to allow me to come in and get caught up with his class, so I'm hoping that helps. They have a similar class size, one professor, three assistants, and a fourth "on call" assistant in case someone can't make it. From what I'm told, students in that class love the setup and love how there's always someone there willing to stay a little late if need be to get questions and concerns figured out.

Outside of that, are there any outside resources I could go over? The written test itself I'm not really worried about.

Thanks!

 

[nwhitney]

Wow that sucks!
I can't really comment on what it's like in the field because I currently only work in an educational setting.

From what I gather while being tested on trauma you are also being tested on OPA's, supine and whatever else they feel like.

Here's are my thoughts: when testing trauma you should only be tested trauma not OPA or anything else. There are other skill stations to test you on those skills. The feedback you're getting isn't helpful and I would suggest asking for specific feedback. When I test students on trauma I will often give a life threat and a distraction, such as a flail chest and a broken femur. If you stick to the skill sheet then theoretically you should be fine. In addition to memorizing the skill sheet I would suggest that you fully understand why you do the steps you do and why it's in the order it is.

Trauma is a skill that can easily be practiced outside of class. Get some classmates (the ones that are solid with trauma) and start running through it. Try teaching it to them to see if you really understand it. Ask for feedback. Take full advantage of the other instructor willing to let you come in, but remember your time there should be secondary to those students.

The testing scenarios I see for trauma (at least here in Oregon) are fairly straight forward and they don't try to trick you or anything like that.

Good luck.

 

[Medic Tim]

Hi all!

I wasn't sure if I should post this here or in the Lounge area so if it's in the wrong spot feel free to move it. I promise I won't be mad

I'm a couple of weeks away, here in Kentucky, from finishing my EMT-B classes and am preparing for the tests that are coming up. Problem is, I'm starting to freak out a bit. I'm more or less at a point where I'm asking what outside resources may be available to help me prepare for not only the written tests, but also the skills testing. Well, I guess I'm just asking for advice in general.

I'm going to give a little bit of a back story to why I'm starting to freak out. Please don't take this as some long whine on my part.

Right now, I'm in a class of about 30. We have our main professor and two assistants helping him out. Both the assistants work full time, so we generally have one in class at a time. For a few weeks now, I've been trying to get more one on one time because there's a few things I'm still not comfortable with. That's been problematic, considering class size and with generally two people teaching the class. I'm in a Tues/Thurs class that meets from 6pm-10pm and more often than not, we're gone by 8pm as most people just want to get out of there and go on with their evening.

The trauma assessment has been tripping me up and I have yet to get comfortable or sign off on that. I thought, for sure, I had a decent rhythm down to get it knocked out, but I swear every time I go to check off, it becomes a lengthy process full of side issues not on the sheet and I keep getting wrapped up, lost, and then I eventually fail because I can't get back on track. It feels I'm more or less being "tricked" while trying to get this signed off. Now, I know in the field things change and get messy, but having other friends who are EMTs they're basically saying the board tests will be fairly straight forward with no real trickery. I have no doubt dealing with the extra steps that complicate the trauma assessment could make me a better EMT, but it's doing nothing at all to give me any confidence I'll be able to pass the test to begin with. Every time I've failed the assessment, I get told to re-memorize the sheet and come back and do it again. I'm beginning to feel left out in the dark, more or less.

So, are the skills tests fairly straight forward or do I really need to focus on not getting side tracked and get extra steps down? So far, my trauma assessment check offs have included various respiratory issues where I've had to stop and go through the steps of using an OPA, various levels of patient consciousness where the OPA is questioned, further down to specific handling of splinting and going through the process of securing someone to the long boards all while getting drilled on the specific steps on the skills sheets themselves. So yeah, are the tests that complicated and I just need to step it up?

Medical assessment so far has been a breeze, as those were straight forward and following the sheet made it not so bad. I'm not, at all, having any luck with trauma. At this point, I'm getting drilled that I NEED to have this done and NEED to shape up so everyone else can go about the class and we can all practice for the tests. Hell, when I checked off supine stabilization I had never actually seen that done and was able to clumsily get that signed off just from simple memorization and figuring out what made sense given the tools I had lying around in front of me.

I've even had issues on my ride times. To date, I've got the bare minimum of 8 hours in. I've been asking for more for weeks because I'd like to get in there more and wrap my head around the stuff I've been learning. I think I accidentally shot myself in the foot because on one of my first calls I got into a bit of an issue with one of the paramedics. We were on a call of a woman with sudden, extreme abdominal pains. We get there and she's on the couch in tears and in a panic, her toddlers are screaming, and her husband is visibly shaken trying to do what he can. One of the paramedics hands me a blood pressure cuff and tells me to start handling things. I told him I wasn't comfortable quite yet in this type of situation. He told me I was in no place, as a student, to argue what I will and will not do on a call. I brought up how I thought it was a bit unprofessional to be having this discussion directly in front of a patient like this. He tells me again to do it and if I start screwing up, he'll take over and show me the right way. Again, I bring up, unprofessional. Back at the station, the somewhat heated discussion started up and I told him I would be more inclined to help out, I just need time to go over some things including his expectations of me when on a call. Walking into my ride times, I had no clue on what to expect at all. Was I supposed to do more hands on stuff? Am I just a fairly casual observer? I had no idea at all. Turns out, he was buddies with one of my class assistants and his boss is the other class assistant. Once I got back in class, that same discussion started over. Again, I maintained it was unprofessional and that I had asked for some time to practice and go over some of the simpler things.

So, after that, getting more ride times schedule is pretty much impossible.

Anyway, I've talked to the MWF night professor and he is more than willing to allow me to come in and get caught up with his class, so I'm hoping that helps. They have a similar class size, one professor, three assistants, and a fourth "on call" assistant in case someone can't make it. From what I'm told, students in that class love the setup and love how there's always someone there willing to stay a little late if need be to get questions and concerns figured out.

Outside of that, are there any outside resources I could go over? The written test itself I'm not really worried about.

Thanks!

emtb.com I have heard is good. Know your skill sheets forward and backwards then practice practice practice.
If I had been your preceptor I would have gone over what my expectations were or you. That said if you said to me what you said to that medic you would have been on your way home.
Emts in many places are a dime a dozen. Why should I put in my time for someone who doesn't feel comfortable taking a bp then calling the Medic out in front of the pt. I understand you are new and it may seem like not that big of a deal but doing something like that again could cost you. Especially if you want to work for the service you are riding at. Am not being a jerk just some advice to help you in the future. Good luck with your assessments and testing.

 

[modernist]

From what I gather while being tested on trauma you are also being tested on OPA's, supine and whatever else they feel like.

Yeah, and it makes sense. I'm running into a snag where I'm being pushed into a much closer focus on the base trauma assessment sign off and get sidetracked on the sheet and eventually lose all focus and thus getting failed.

Here's are my thoughts: when testing trauma you should only be tested trauma not OPA or anything else. There are other skill stations to test you on those skills. The feedback you're getting isn't helpful and I would suggest asking for specific feedback. When I test students on trauma I will often give a life threat and a distraction, such as a flail chest and a broken femur. If you stick to the skill sheet then theoretically you should be fine. In addition to memorizing the skill sheet I would suggest that you fully understand why you do the steps you do and why it's in the order it is.

I've been told that the testing of the trauma doesn't throw in any OPA testing or anything. We started off having simpler things, like a broken femur but I actually got focused on helping out other students who were stuck. When it came down to me getting tested, I end up getting a pop quiz each and every time. Last time, it was over abdominal trauma and that become the big focus. The assistant maintained that since we just talked about it in class, I should have a working knowledge on it (at that time, I hadn't finished the reading on it) and I then got drilled on why I didn't know that, and that it apparently should be fairly common knowledge, more or less. So yeah, after those discussions I get my sheet handed back and told to memorize it yet again and then come back. Lather, rinse, repeat. I do regret not checking off weeks ago before it got decided that over complicating things was the way to go about things. The only thing that's been accomplished so far is completely sapping me of any confidence at all.

Trauma is a skill that can easily be practiced outside of class. Get some classmates (the ones that are solid with trauma) and start running through it. Try teaching it to them to see if you really understand it. Ask for feedback. Take full advantage of the other instructor willing to let you come in, but remember your time there should be secondary to those students.

I have some EMT friends that are willing to help out some and they got taught by the MWF professor and they think I'm getting kind of screwed when I talk with them about what's going on with class. I've been working with other students and helping them as I'm book smart enough that the simple memorization isn't the issue.

If I had been your preceptor I would have gone over what my expectations were or you. That said if you said to me what you said to that medic you would have been on your way home.

Understandable. I definitely don't defend what I did, as I'm well aware of it causing issues. But, had the expectations been set out before hand the issue wouldn't have come up.

Emts in many places are a dime a dozen. Why should I put in my time for someone who doesn't feel comfortable taking a bp then calling the Medic out in front of the pt. I understand you are new and it may seem like not that big of a deal but doing something like that again could cost you. Especially if you want to work for the service you are riding at. Am not being a jerk just some advice to help you in the future. Good luck with your assessments and testing.

Don't worry, I'm not taking your post as being a jerk

After that call, I ended up getting passed on to someone else as the first paramedic wanted nothing to do with me. All I was asking for was a bit of a sit down to get things figured out (again, expectations of me). Had it been on a call that was perhaps a bit less serious, I'd have had no issues going on, getting BP, and if I got it wrong or whatever having the paramedic take over.

 

[ChickenMcSuckIT]

Modernist, I would have copied and pasted your post, but since it was long I figured I could chime in with out it. A little background on my self, I am a EMT-B and have been for a couple of years now. I actually have two different experiences with an EMT course, I took one in Texas some 6 to 8 years ago through an EMS lead program. However due to certain issues (a woman) that I had as a young man I had a hard time passing the Texas State exam, this was before they took the NREMT. My second experience is two years ago at a Community College in Maine.

Now i will compare the two, the experience that I gathered in the first one clearly helped me out, led my class in Maine in overall grades, passed NREMT first time 70 questions done. Was even invited to come back and help as an assistant. When I took it in texas we had if i recall correctly either 24 to 36 hours total of clinicals, and a certain number of patient contacts per age group. The clinicals were conducted on with a 911 service provide for the county and the ER. You had to complete both hours and number of patient contacts which if I recall was like 12.

Now in Maine it was 8 hours on a transport service with 3 patient contacts. That was it...done! one 8 hr shift and 3 contacts.

My experiences were always good, preceptor's were very good and explained what was expected of us. However in this case I think you were both wrong, you needed to roger up and take the bp, and in thise case you were both unprofessional (IMHO) because onscene is not the time. Sorry if that sounded bad. Anyways back to trauma assessment all you can do is practice, the test itself will be pretty straight forward, and it was usually given just like (nwhitney) said, life threat and a distraction.

Looks like I managed a pretty long post as well, forgive me and I understand if no one reads it. Stay safe guys and gals.

 

[Level1pedstech]

Hi all!

I wasn't sure if I should post this here or in the Lounge area so if it's in the wrong spot feel free to move it. I promise I won't be mad

I'm a couple of weeks away, here in Kentucky, from finishing my EMT-B classes and am preparing for the tests that are coming up. Problem is, I'm starting to freak out a bit. I'm more or less at a point where I'm asking what outside resources may be available to help me prepare for not only the written tests, but also the skills testing. Well, I guess I'm just asking for advice in general.

I'm going to give a little bit of a back story to why I'm starting to freak out. Please don't take this as some long whine on my part.

Right now, I'm in a class of about 30. We have our main professor and two assistants helping him out. Both the assistants work full time, so we generally have one in class at a time. For a few weeks now, I've been trying to get more one on one time because there's a few things I'm still not comfortable with. That's been problematic, considering class size and with generally two people teaching the class. I'm in a Tues/Thurs class that meets from 6pm-10pm and more often than not, we're gone by 8pm as most people just want to get out of there and go on with their evening.

The trauma assessment has been tripping me up and I have yet to get comfortable or sign off on that. I thought, for sure, I had a decent rhythm down to get it knocked out, but I swear every time I go to check off, it becomes a lengthy process full of side issues not on the sheet and I keep getting wrapped up, lost, and then I eventually fail because I can't get back on track. It feels I'm more or less being "tricked" while trying to get this signed off. Now, I know in the field things change and get messy, but having other friends who are EMTs they're basically saying the board tests will be fairly straight forward with no real trickery. I have no doubt dealing with the extra steps that complicate the trauma assessment could make me a better EMT, but it's doing nothing at all to give me any confidence I'll be able to pass the test to begin with. Every time I've failed the assessment, I get told to re-memorize the sheet and come back and do it again. I'm beginning to feel left out in the dark, more or less.

So, are the skills tests fairly straight forward or do I really need to focus on not getting side tracked and get extra steps down? So far, my trauma assessment check offs have included various respiratory issues where I've had to stop and go through the steps of using an OPA, various levels of patient consciousness where the OPA is questioned, further down to specific handling of splinting and going through the process of securing someone to the long boards all while getting drilled on the specific steps on the skills sheets themselves. So yeah, are the tests that complicated and I just need to step it up?

Medical assessment so far has been a breeze, as those were straight forward and following the sheet made it not so bad. I'm not, at all, having any luck with trauma. At this point, I'm getting drilled that I NEED to have this done and NEED to shape up so everyone else can go about the class and we can all practice for the tests. Hell, when I checked off supine stabilization I had never actually seen that done and was able to clumsily get that signed off just from simple memorization and figuring out what made sense given the tools I had lying around in front of me.

I've even had issues on my ride times. To date, I've got the bare minimum of 8 hours in. I've been asking for more for weeks because I'd like to get in there more and wrap my head around the stuff I've been learning. I think I accidentally shot myself in the foot because on one of my first calls I got into a bit of an issue with one of the paramedics. We were on a call of a woman with sudden, extreme abdominal pains. We get there and she's on the couch in tears and in a panic, her toddlers are screaming, and her husband is visibly shaken trying to do what he can. One of the paramedics hands me a blood pressure cuff and tells me to start handling things. I told him I wasn't comfortable quite yet in this type of situation. He told me I was in no place, as a student, to argue what I will and will not do on a call. I brought up how I thought it was a bit unprofessional to be having this discussion directly in front of a patient like this. He tells me again to do it and if I start screwing up, he'll take over and show me the right way. Again, I bring up, unprofessional. Back at the station, the somewhat heated discussion started up and I told him I would be more inclined to help out, I just need time to go over some things including his expectations of me when on a call. Walking into my ride times, I had no clue on what to expect at all. Was I supposed to do more hands on stuff? Am I just a fairly casual observer? I had no idea at all. Turns out, he was buddies with one of my class assistants and his boss is the other class assistant. Once I got back in class, that same discussion started over. Again, I maintained it was unprofessional and that I had asked for some time to practice and go over some of the simpler things.

So, after that, getting more ride times schedule is pretty much impossible.

Anyway, I've talked to the MWF night professor and he is more than willing to allow me to come in and get caught up with his class, so I'm hoping that helps. They have a similar class size, one professor, three assistants, and a fourth "on call" assistant in case someone can't make it. From what I'm told, students in that class love the setup and love how there's always someone there willing to stay a little late if need be to get questions and concerns figured out.

Outside of that, are there any outside resources I could go over? The written test itself I'm not really worried about.

Thanks!

After looking thru some of the responses especially the observations and opinions about your on scene incident with the medic I can only say Im not suprised. Having had the pleasure of being the preceptor for many EMT students not only in the ER but in the field I feel very well qualified to make some obsevations of my own. Besides I hate punks and anyone in fire or EMS that would treat a student the way this medic treated you both on scene and back at the station.

No disrespect to the others but when dealing with a student as new as you are a preceptor should know when to have you hang back and observe and when to jump in. When I had an ER shift with a student I always made it clear that if they ever feel uncomfortable please leave the room no need to ask just go. It does no one any good to have a shaky student observing let alone trying to practice thier new skills. In the field I have to ask cadets and interns to wait outside iif I sensed they were uncomfortable. This did not happen often but these were students some very young and they need to be handeled with care especially by anyone acting as a preceptor.

One thing I thought was really wrong is that above all else you are a student your on the ride to observe and not to be the medics mule,you should never be asked to make contact with a patient unless you are 100% comfortable in the role you are being asked to fill. Your not a new employee on probation that should be able to handle any call your a student that may be trying to see if this is what you want to do with your life. Of course you want to get skills practice but there is a time for getting hands on and a time for observing how a professional healthcare provider handles a tense and emotional scene. A large part of our job is people skills and learning these skills is just as important as being able to take a set of vitals.

Was it really a horrible scene,no not really but you were uncomfortable and made that clear which by the way took some nuts. No one likes to look weak but it happens and as perceptors we need to be aware.

 

[Level1pedstech]

Modernist,

You did not mention anything about ER time,are you going to get a few 12's in at your local hospital? This may be a better setting for you to gain some confidence while getting your hands on alot of patients more than enough to make up for your ride time. There are of course morons in the ER's and I would never say were perfect but you have a much better chance of recieving a quality educational experience and will most always be treated with respect as a student.

Now someone surely has a story about how they were horribly abused by a tech or an RN during their ER clinicals. Just between you and me this can happen for several reasons and usualy is the result of a student being a problem,things like hanging at the nurses station telling us how cool they are or suddenly being out of the unit when an RN or tech needed a hand with one of those jobs no one wants to do. If you do get to spend some time in the ER let me know and I will tell you how to make it a good experience.

 

[Level1pedstech]

emtb.com I have heard is good. Know your skill sheets forward and backwards then practice practice practice.
If I had been your preceptor I would have gone over what my expectations were or you. That said if you said to me what you said to that medic you would have been on your way home.
Emts in many places are a dime a dozen. Why should I put in my time for someone who doesn't feel comfortable taking a bp then calling the Medic out in front of the pt. I understand you are new and it may seem like not that big of a deal but doing something like that again could cost you. Especially if you want to work for the service you are riding at. Am not being a jerk just some advice to help you in the future. Good luck with your assessments and testing.

Your expectations should never take presedence over your students needs. Making your expectations known ahead of time is great but this is a student not a probie crew member. The student preceptor relationship needs to be fluid and your expectations need to be adjusted based on the needs of the student. Its very obvious our friend is having a rough time and needs some extra help,remember this is an EMT student on his first ride along not a medic student on clinicals.

My expectations for EMT students especially in the ER is to observe as many patients as you can and have fun. Of course we go over the does and donts and the usual rules of conduct but beyond that I just make sure they get plenty of patient contact. My first perceptor in the ER told me the same thing and I ended up doing extra rotations because I was having such a great time. That extra time helped me to gain confidence and get tons of patient contacts. New providers need to be comfortable with patient care,taking the just get in there and do it strategy might make ones skills better but it does nothing for your people skills.

We should all agree that whoever is running the clinical portion of this class is doing a piss poor job at best. Every student should know well in advance what is expected of them on ride outs and in the ER. Agencies providing ride time should also be aware of what the instructors expectations are for students.

Finally the whole issue in the field got started by the preceptor not recognizing his students needs when he first voiced his concearns. The medic should not have pushed the issue in front of the patient especially with all that was going on. Doing his job and allowing the student to observe then addressing the issue after the call would have been much more professional way to handle the situation. As far as sending someone home,your joking right? As far as putting in your time for dime a dozen EMT's well thats an easy one,dont do it. If your employer is forcing you to act as a preceptor they need to rethink things. Oh and not to be a jerk but medics are also a dime a dozen.