First call in which i was lead tech!

[AmeriMedic21]

hi all, its been about 15 shifts of me being an EMT for our county, and i was discussing with our paramedic, that i felt comfortable to take lead tech for the first time. I felt that she would stop me before i did anything stupid. but anyway, she agreed that it would be a good idea. So the next day we get toned out for a delta chest pain, and i was immediatly filled with excitement. We got on scene and i did what i was supposed to, gave her 243mg of ASA, and assisted her with 1 nitro. she had already taken 81mg of ASA, so i just decided to make it a full dose. our paramedic said that overall the call went great! i need a little work, but i was confident, and i felt that this is a key quality. The paramedic on our crew said that i have really good social skills, and she even said that i know how to multitask really well. I felt good about myself. i was just too excited not to share this with yall

Ryan S.

 

[Shishkabob]

Congrats!


Leading a call can be quite daunting when you're still new to the field, and even after several years of experience. However, you get more used to it and soon it will be second nature.

 

[Elk Oil]

Good for you! Your confidence will only grow with experience and will serve you well. Stay willing to learn and the sky is the limit!

 

[bigbaldguy]

Awesome congrats

 

[exodus]

What you're an basic and you ran an ALS call and administered medications?

 

[fast65]

Congrats, sounds like you did a pretty good job. Like Linuss said, leading a call can be pretty daunting, but practice is what it's all about, and just remember not to get down on yourself if you do mess up

 

[AmeriMedic21]

it wasnt an als call, my standing orders say that an EMT-B can administer up to 325mg of ASA, and can assist patients with their own nitro tablets. When we got in the back of the truck, our paramedic ran an IV and pushed 3mg of morphine. just because its a chest pain call doesnt make it an ALS call.

thanks for all the support guys

 

[STXmedic]

it wasnt an als call, my standing orders say that an EMT-B can administer up to 325mg of ASA, and can assist patients with their own nitro tablets. When we got in the back of the truck, our paramedic ran an IV and pushed 3mg of morphine. just because its a chest pain call doesnt make it an ALS call.

thanks for all the support guys

If you're administering ASA and NTG, it sound like it may need to be an ALS call... Regardless, it sounds like you ran it well

 

[exodus]

So your medic also gave nitro without having a line established? :s Scary..

Edit: And all chest pain is ALS until it is determined otherwise.

 

[mpena]

it wasnt an als call, my standing orders say that an EMT-B can administer up to 325mg of ASA, and can assist patients with their own nitro tablets. When we got in the back of the truck, our paramedic ran an IV and pushed 3mg of morphine. just because its a chest pain call doesnt make it an ALS call.

thanks for all the support guys

Although ALS in this situation would be considered, an EMTB has all the capabilities of running this patient without ALS interecept. On our agency, there have been many calls in which a chest pain patient has been treated and transported with only EMTB care and no ALS intercept.. of course some will have something to say about it, but besides morphine what more could an ALS intercept do that a basic couldn't (Considering the EMTB is IV certified and also transport time to definitive care, and also local protocol).. IMO you did great and stay confident..

 

[BEorP]

So your medic also gave nitro without having a line established? :s Scary..

Edit: And all chest pain is ALS until it is determined otherwise.

Patients take their own nitro all the time without having a line and do so without dying.

 

[Melclin]

Patients take their own nitro all the time without having a line and do so without dying.

Ahhh beat me to it.

Not to mention it been administered all over this and other countries in the pre hospital environment for many many years at the BLS level without too many troubles.

 

[Elk Oil]

We have similar protocols -- BLS can administer ASA and assist with NTG. There is nothing in our protocols which mandate we get ALS involved. In my area, if a BLS crew administers ASA and O2, assists with NTG and does a 12-lead with immediate transport, that's perfectly fine. And if you have a stable patient, what's wrong with running on BLS interventions alone?

BLS before ALS and medics aren't always required.

...running and ducking...

 

[94H]

Hey Guys,

We can argue all day about if this was an ALS or BLS or even ILS call. It all depends on your system and protocols.

This thread was about someone teching their first call and being proud of it. Congrats man, I can remember the first time I took the lead, I was just about :censored::censored::censored::censored:ting my pants.

 

[STXmedic]

besides morphine what more could an ALS intercept do that a basic couldn't (Considering the EMTB is IV certified and also transport time to definitive care, and also local protocol)

ECG? Continuously monitor the patient with said ECG to watch for signs of further cardiac dysfunction & treat accordingly? Metoprolol? 12 lead? Cath lab activation? (depending on local capabilities). I'm not saying that a chest pain can't be run by a basic, I've done it plenty of times myself back in the day. But I was on a straight BLS box without the option of a paramedic there to take it. If there is a paramedic on scene, it needs to be ALS until proven it's not cardiac in nature. And from the sounds of it, it was an ALS run. And, after initial assessment, was ran as an ALS call. I highly doubt the OP's paramedic partner let the OP be in the back during transport, especially after Morphine administration.

 

[94H]

ECG? Continuously monitor the patient with said ECG to watch for signs of further cardiac dysfunction & treat accordingly? Metoprolol? 12 lead? Cath lab activation? (depending on local capabilities). I'm not saying that a chest pain can't be run by a basic, I've done it plenty of times myself back in the day. But I was on a straight BLS box without the option of a paramedic there to take it. If there is a paramedic on scene, it needs to be ALS until proven it's not cardiac in nature. And from the sounds of it, it was an ALS run. And, after initial assessment, was ran as an ALS call. I highly doubt the OP's paramedic partner let the OP be in the back during transport, especially after Morphine administration.

No but she let him take the lead with the pt assessment and work up to the point of his protocols, instead of just doing everything since it was an ALS call

 

[Melclin]

And from the sounds of it, it was an ALS run. And, after initial assessment, was ran as an ALS call. I highly doubt the OP's paramedic partner let the OP be in the back during transport, especially after Morphine administration.

There was a paramedic there the whole time. What's the difference.

What so special about morphine that it needs a paramedic to watch them not be in pain, rather than an emt?

 

[Elk Oil]

There was a paramedic there the whole time. What's the difference.

What so special about morphine that it needs a paramedic to watch them not be in pain, rather than an emt?

Where I am you can't perform an advanced intervention and then leave the patient in the hands of a lesser-certified EMT. If you push MS, you bought the ride in the back.

 

[Melclin]

Where I am you can't perform an advanced intervention and then leave the patient in the hands of a lesser-certified EMT. If you push MS, you bought the ride in the back.

The fact that people take or are administered narcotics all the time without the constant presence of a HCP aside, you're not leaving. The paramedic is still there. He/she just isn't in the attendant's chair. What's the big deal?

 

[Shishkabob]

but besides morphine what more could an ALS intercept do that a basic couldn't (Considering the EMTB is IV certified and also transport time to definitive care, and also local protocol).. IMO you did great and stay confident..

Fentanyl?
Heparin?
Tridil?
Metoprolol?
Other beta blockers?


Plenty more a Paramedic could do over an "EMT that is IV certified"

So your medic also gave nitro without having a line established? :s Scary..

Not really, considering patients self administer nitro ALL the time without the benefit of an EKG or a line.


The lack of a line won't keep me from giving nitro. I'd prefer a line, but don't need one at that moment.

just because its a chest pain call doesnt make it an ALS call.

Correct. But treating the chest pain AS a suspected MI DOES make it an ALS call.



However, that doesn't mean you can't run your part of it. If I have a partner who's going through medic school, and we get a call where I don't have to do things rapidly to keep the patient from dying, I tell them it's their call, act as if they're the medic, and I'll just do all the ALS stuff (so long as it's appropriate)

That's the best way for people to learn: Put them in charge, make them make the decisions.