EMT working with an I or Medic...

mikie

mikie

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Recently, I had my first call with a paramedic and not just other basics...Intimidating enough, he's kind of a big guy and involved with the area EMS offices (does everything TO THE BOOK, since I'm also the 'EMT,' I am there to help the pt.

I feel 'inferior' and want to question the medic whether or not I should perform something (such as applying O2, using the glucometer, asking pt. questions, hooking up the 12-lead (since I'm sure he was going to want it)) as opposed to just telling the pt. what I'm doing and just perform the 'task' without question

thanks!
 
I let the medic set the pace, if I am the third man on the ambulance I ride in the back enroute, I spike a bag of fluid, throw c-collar, straps, head blocks and backboard on the stretcher, tape hung on the wall, tegaderm open on the bench, IV tray on the bench, 2X2's laying out and electrodes in the monitor.
 
Welcome to the Twilight Zone where you're not a self-functioning EMT, nor a paramedic, nor a student.

Wait a minute, you are a student, and this Lesson is called "Patience".

Patience is about letting go of who you think you are and what you beleive you can do, or should do, and learn to fulfill your role, which, at this time, is to be an EXTENSION of your partner.

If you had time on a Basic rig with a Basic partner then that was the time when you were to learn about your own rhythms - WITHIN the scope of your training. Now, you're in a different ballpark, dealing with ALS and a partner who is always asking him/herself (for now), "What can I count on this guy for?"

Will you be tested? Bet on it.

It's all about tuning in to His/Her rhythms, and until you can establish some personal credibility brought about by dependability, your partner sets the pace, tells you what to do, and throws you a bone now and again.

Of course, some calls you'll need to start independently, but - for the time being, anyway, once you're working together, S/He's the Boss.

And it's not about deprivation. It's about really learning how to anticipate your partner on your partner's terms so that the Team is effective. Let's face it, your partner takes the weight, and you, my friend, are the key component that helps him/her take it gracefully.

And the rub is, you may have a succession of partners, all with completely different approaches. Don't forget, your job is to tune into whomever you're working with to build a flow that allows the best outcome to occur.

This is much more than science book-learning. This is an art, and you can be an artist!
 
Let the medic run the call, you assist him.
 
Firetender,

that is a first class explanation of the roles of an emt-b. totally supportive in the presence of medics, doing the best job possible. i learned that medics have a "vision" of how they want the call to run, and too much initiative by myself, with the best of intention and skill, was not always met enthusiastically if the medic had a different "rhythm" of how they wanted the call to go...

i now wait for the medic to direct, and then do the best job possible. also, a great learning environment, which helps me immensely when there is no medic, and i run the call.

again, firetender, i think you are right on the money.
 
Talk to the medic. S/he may have some things that they want you to do with every ALS patient. My partner tells me, unless he says otherwise, he wants vitals, pt on o2, on the monitor, and an IV set up. I just do whatever he isn't at that moment. It works wonderfully for us.

-Kat
 
We are strongly a teaching service, therefore the 'attendant' and not the 'in charge' is lead on the scene. The medic monitors and keeps the incident on the right path and does not allow patient care to suffer in the process.


For the most part, the in charge is getting history from family or whoever is available while the attendant is doing patient care and getting vitals, history, etc from the pt.


Before anyone is allowed on the truck they know the protocols. Therefore, everyone knows what to do anyway.
 
Wait just a cotton-pickin minute here. You are NOT the medic's assistant. You are his/her partner. Period. Without question. End of story. You are no more or less important than we are, because we CANNOT do this job alone.

Talk with your partner. Get on the same page as your partner. Don't let the conversation end until you are on the same page as your partner. He may be by the book, but there are more ways to skin a cat for each and every situation out there and still be by the book. It's called interpretation of the situation. Listen to your partner. You'll learn.

The phrase goes, "Paramedics save lives. EMT's save paramedics." Assistants just do as they're told. Partners look out for each other and keep each other in check.

Now go talk with him.
 
^ thanks for the great advice (everyone too!)

I'm not always working with the same person, because it's a volly dept, it's pretty much 'first-come/first-serve' (with at least 1 I or P on the ambulance, it's an ILS service)

What about intermediates, in the sense of 'assistant'? any differences?

(again, thanks, I think this is one of my favorite forums-get answers, especially from real veterans FAST, as well as being active and greatly educational)
 
The answer is a gray area... one of many in EMS. You need to assist your medic, but you can't step on his toes... If the patient really, obviously, needs something - like they are in severe resp. distress and you want to start them on O2, then tell you medic what you are going to do and do it. Otherwise, ask.. What do you want for oxygen?
 
If you ask, it sounds like you are unsure what to do next. If you tell them, some (but of course not all) may take offense. Make it somewhere in between. "How about if I put them on O2." "Would you like me to ____now?" "Which do you prefer A or B?"
 
How about just talking to him?!? When the two of you are checking off the truck at the beginning of the shift, talk to him. This isn't rocket science. I know a guy who used to build missiles for Lockheed Martin. Those are rockets. He knows what rocket science is. This ain't it.
 
During a call may not be the best time to be all questions and 'should I's but after a call, on the ride back from the hospital, ask your partner if there was anything you could have done better, what would be helpful next time etc. With time you will learn who likes what assistance on a call.
 
I think that its your job to know what that medic or EMT-I is gonna want get the bag hung or a loc set up put the patient on the monitor do as much as you so that they can focus on the ALS side of things.
I always used to ask what they expected of me prior to the calls or shift.
A good medic will save a life a good basic will save a medic>:ph34r:
 
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MSDeltaFlt said:
Wait just a cotton-pickin minute here. You are NOT the medic's assistant. You are his/her partner. Period. Without question. End of story. You are no more or less important than we are, because we CANNOT do this job alone.

Talk with your partner. Get on the same page as your partner. Don't let the conversation end until you are on the same page as your partner. He may be by the book, but there are more ways to skin a cat for each and every situation out there and still be by the book. It's called interpretation of the situation. Listen to your partner. You'll learn.

The phrase goes, "Paramedics save lives. EMT's save paramedics." Assistants just do as they're told. Partners look out for each other and keep each other in check.

Now go talk with him.
Click to expand...

There is no shame in assisting someone else. The simple fact is that, assuming that the patient will be transported with the medic attending, a basic is assisting the medic. When I was working as a basic, I had no allusions that I was doing anything other than assisting the RN/RT/combination on a CCT transport. If the RT wants to set the transport vent to a specific setting, for example, then that is his prerogative and not open to my approval. Similarly, unless the paramedic is doing something grossly negligent, then it is not the basic's job to approval the paramedic's actions.

Now this is where communication skills comes into place. Being able to suggest or ask if the highest level provider wants something in a quick and respectful manner (by respectful, I don't mean "pardon me, sir, would you like some gray poupon" manner of respect, but in the sense of a collaborative effort where the medic is the project lead) is hard for some people to do. This is also how you determine if you need to just back off and bite your tongue for the rest of the call instead of inflaming a situation (even if the situation is caused by the lead provider's arrogance, ignorance, or inability).

As far as "Paramedics save lives. EMT's save paramedics," that cliche needs to just die and never be mentioned again.
 
Our Paramedics (AKA ALS) tend to be very good about asking us to do something. I have become comftorable with our medics and I just take it upon myself to check their O2 levels, offer to help w/ 'spiking' the bag, getting tape ready, apply their automated BP cuff & doing O2. I wouldnt hesitate to OFFER the help. Most of the time they arn't going to turn down the help. Thats what you are there for! Plus getting the patients information is always an important step that you could start on. Ask all of the questions and turn the information over to the ALS tech. You are still helping!
I just try not to sit there...
Remember... You are there for the patient... WORKING TOGETHER!!
Hope this helps!
-Angie
 
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these are some great responses, thanks guys!
 
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