First Day riding with a Paramedic..help

[619EMT]

So I just started with an AlS company last week. My first day was just suppose to be a ride along observation.
My first emergency call with them and the paramedic started shouting out meds that he needed and I totally lost any train of thought and had to go searching through the meds reading the labels. After finally getting him what he needed he asked me for vitals. Me already caught way off guard I got a BP of 142/108 when his ECG machine read 210/160...wow I was way off, I realized it was because I took his pressure over the PT's thick sweater. Either way, I totally srewed up my first emergency call with a well respected ALS company and with a 13 yr paramedic. I guess everyone has some screw up stories. I hope I dont have anything worse than that. Any suggestions for newbies would help.

 

[Sasha]

Don't stress! Everyone was new once! In your down time, ask the paramedic to go over the truck and the drug box with you. Show you what everything is and where everything is. Do it a few times until you know where everything is without being shown.

I am a little surprised that he would ask for meds before obtaining baseline vitals except for a select few situations, but I'm not here to armchair quarterback!

Regardless, with BPs and pulse rates I always trust what I physically hear or feel over what the machine tells me, but you can't listen through clothes! So roll it up, pull it off, cut it off if need be.

Good luck in the future!

 

[JPINFV]

"At a cardiac arrest, the first procedure is to check your own pulse."

Substitute "emergency call" for "cardiac arrest."

 

[Sasha]

"At a cardiac arrest, the first procedure is to check your own pulse."

Substitute "emergency call" for "cardiac arrest."

I heart the Laws of the House of God.

 

[Shishkabob]

Just go over the drug box, and more specifically the drugs used for a cardiac arrest. Get those ones memorized as they tend to be in color coded boxes. Also, thoroughly read the label. If your medic wants Epi 1:10 and you give him 1:1, there's going to be someone getting their butt chewed out.

Also, you yourself should learn the generic and trade names of all drugs in the box. That way if you're medic ask for either furosomide or Lasix, you aren't lost because you know it's the same drug.

 

[JPINFV]

Which drug is in the periwinkle box again?

 

[guardian528]

in some downtime, go through the entire ambulance. find everything. if you don't know what it is, ask. when you're working on a split rig like this, the paramedic will be running most of the calls, so a decent amount of the time you'll just be fetching things, which means you need to know where EVERYTHING is.

 

[Onceamedic]

I'm sorry - am I understanding this correctly? Basics are going into medic drug boxes and handing out drugs? Does this really happen? Is it allowed? I have run in both Wisconsin and Arizona and NO ONE but a medic touches the medic drug box. I thought this was a national standard. Educate me please. I look forward to hearing about other parts of the country.

 

[Sasha]

I'm sorry - am I understanding this correctly? Basics are going into medic drug boxes and handing out drugs? Does this really happen? Is it allowed? I have run in both Wisconsin and Arizona and NO ONE but a medic touches the medic drug box. I thought this was a national standard. Educate me please. I look forward to hearing about other parts of the country.

If we are doing something before transport, I often ask my EMT partner to help me, sometimes that includes getting something from the drug box, I've never seen anything wrong with it.

They're just grabbing it for me, not drawing it up or giving it to the patient. I double check what I'm handed to make sure it's correct.

 

[Lifeguards For Life]

I'm sorry - am I understanding this correctly? Basics are going into medic drug boxes and handing out drugs? Does this really happen? Is it allowed? I have run in both Wisconsin and Arizona and NO ONE but a medic touches the medic drug box. I thought this was a national standard. Educate me please. I look forward to hearing about other parts of the country.

i've never seen anyone but a medic touch a drug box either

 

[Shishkabob]

Even as an EMT student, I was going in to the medic drug box and grabbing drugs for the medic. As a working EMT, I'd go in to the drug box and grab the drugs. It's no big deal as I wasn't drawing up the meds.

 

[guardian528]

I'm sorry - am I understanding this correctly? Basics are going into medic drug boxes and handing out drugs? Does this really happen? Is it allowed? I have run in both Wisconsin and Arizona and NO ONE but a medic touches the medic drug box. I thought this was a national standard. Educate me please. I look forward to hearing about other parts of the country.

pretty standard around here, in fact i'm surprised it's not allowed where you're from. if the medic is busy working someone, its pretty helpful to have extra hands to grab things for you. of course they are going to double check and make sure you handed them the correct drug, but i don't see any harm in it.

 

[zmedic]

I'm surprised how little on the job training it sounds like people are getting. Where I worked EMTs got about 4-6 weeks of precepted time where they were the third rider being trained by an experienced EMT or medic. New medics had 3-4 months before they were cleared to work in a two person team. I keep hearing stories on here of "I got one day as a ride along and then I was running calls." Not really fair to expect people to learn the maps, radios, procedures, as well as all the medicine while fufilling all their clinical responsibilities.

 

[wyoskibum]

Not that well respected.....

Either way, I totally srewed up my first emergency call with a well respected ALS company and with a 13 yr paramedic. I guess everyone has some screw up stories. I hope I dont have anything worse than that. Any suggestions for newbies would help.

You didn't screw up, your Paramedic partner or your company screwed up. Sounds like you were thrown to the wolves. Even experienced EMT's / Medics should have a few days orientation as a 3rd to get aquainted/familiar with the equipment before expecting them to perform under fire.

 

[Epi-do]

I'm sorry - am I understanding this correctly? Basics are going into medic drug boxes and handing out drugs? Does this really happen? Is it allowed? I have run in both Wisconsin and Arizona and NO ONE but a medic touches the medic drug box. I thought this was a national standard. Educate me please. I look forward to hearing about other parts of the country.

My partner will pull drugs out of the drug box for me unless we are transporting and he is up front driving. He isn't drawing them up or administering them, just fetching them for me. I always double check what he hands me before giving it. I have never thought it was a big deal, and it allows me to do other things, like establish an IV, while the rest of the supplies I need are being gathered for me.

And to the OP, when I have had new employees with me, even if it is their first shift and they are just observing, I will still have them do things like vital signs, put the monitor on (if they are already familiar with how to do it), etc. However, I don't expect them to know where to find something on the truck. If I forget and do ask them to grab something for me, I tell them exactly where it is, and I never ask the new guy to fetch drugs, only 4x4s, kerlix, cold packs, etc. Of course, when going over things with them in the morning, I let them know that I will be asking them to do those things so it isn't a surprise when we get onscene. Where I work, if someone is already certified, and not a student, "observing" means that you won't be doing any paperwork, but can be asked to perform some basic skills throughout the day.

 

[Dominion]

You did fine and you should remember that your first call should always be free. It gets you used to what it's like. I remember my first 911 was an active seizure. We got there and my EMT partner yanked the guy out the chair and told me to grab a BVM and nasal airway. I had familiarized myself with all our equipment and was able to hand it over, but I basically sat there and watched, handed equipment off, helped the FD lift. The medic in the truck had me do vitals and get breath sounds. By the end of the call I was shaking with the just sheer quickness of everything and all the adrenaline. My medic looked at me and said "All you alright?" I said "yea, i think so" and he smiled and said "Don't worry the first one is free"

That was a perfect run for a new guy and really taught me alot, I haven't had the same reaction to a serious call since.

As to the drug box, at my service we run mostly BLS trucks and as EMT's we are responsible to ensure we have the proper drugs, the proper expiration dates etc. Generally a medic in a high stress environment will ask for box colors. Like if they might need Atropine my medic might say "Give me three purples" or whatever. Like others have said, take some time during your downtime and make sure you know the truck like the back of your hand. If each truck in your fleet is different, make sure you hop on the other ones too.

 

[HotelCo]

Me already caught way off guard I got a BP of 142/108 when his ECG machine read 210/160...wow I was way off, I realized it was because I took his pressure over the PT's thick sweater.

Never trust a machine for your initial BP. I prefer to take all of my my BPs manually Does this always happen? No... But At minimum, I get the initial BP manually.

 

[619EMT]

thanks for all the advice, I know I learned a lot from that run. Ive had time to reflect on that call and determine how I could have done things better and more effective. I was more embarrassed because here I was trying to be all confident being the new guy, but I looked like I couldn't even take vitals. I felt rushed, so that why i decided to leave the PT's sweater on to get the BP. Next time I know to do it right the first time and take the sweater/jacket off.

Im not too stressed about not knowing where the meds were. For sure next time I jump on to "observe" I'll definitely take some time to check out where exactly everything is.

 

[feldy]

while i am not yet an EMT ( i take my written on friday) ive been on a few ride alongs and the one thing they stressed to me was never be afraid to admit you dont know how to do something or where something is. Just ask. If you try to figure it out on your own and take too long. Then you may be wasting valuble time on your medics end or patients.

Also, i did my ride alongs with a large private company and even i was asked to get drugs from the drug box and hand it to the medic. It saves time while they are trying to start a line especially because on average we are only 6-7 mins from any of the three major hospitals in the area.

 

[firetender]

The value is you got thrown into the deep end of the pool, took it on the chin, and experienced flying without a net all on the same day! Besides too many cliches, consider that a gift. Sure, you'll be sorting through every moment of that day for a while, but you'll have learned.

The FNG queasies are quite normal and they will last a little while but they will ONLY last a little while. All you're doing is learning to drive on the freeway.