Nervous about m first paramedic shift

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Hey all!
I came on here to get a little advice, I'm starting my first shift alone as in my field training officer passed me and set me free into the real world with my new partner. I'm just really nervous about making mistakes or just having a brain fart. I've been a paramedic since august and its my first real job that i've been a running paramedic, I've been an EMT for about 3 years or so but I haven't been on a lot of different calls. Advice my EMT people!
 
Several points.

1 if you don't know what to do, go to the hospital.

2 consult medical control if you can't figure out what is wrong with the pt.

3 make sure the call advances to the hospital. Do not delay to figure it out.

4 have a copy of your protocols and review them regularly.

5 always stay calm. Don't get flustered. You were an EMT for 3 years. You know how to do that part.
 
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Thank you ill keep all those tips in mind. How long did i take for you to become comfortable in running calls?
 
if all else fails, VOMIT.

vitals, oxygen, monitor, IV, transport.
 
lill91210 said:
Thank you ill keep all those tips in mind. How long did i take for you to become comfortable in running calls?
Click to expand...

Been on my own for two months and still get nervous when tones drop.
 
Many of our ALS interventions are based on mental status, lung sounds, blood pressure, and pain level. Are there wheezes, rales, rhonchi, silent Cx? Are they alert with these adventitious L/S, or are they lethergic or combative? Are they hypertensive or hypotensive? Then you attempt to arrive at a differential Dx and hopefully the proper protocol(s) by completing your diagnostics - head to toe, ECG, 12, BGL, orthostatic changes and stroke assessment as appropriate.

The first four questions I ask a trauma pt is their name, are they short of breath, do they have pain, and can they move their toes. These four things alone will tell you a lot right off the bat in 30 secs or less.

I try to approach most patients like this:

Look at them from afar, to assess their effort in breathing, awareness of their surroundings, their position. Then, introduce yourself and see how they respond. Is it appropriate, or delayed/confused? Can they speak full sentences or not? While you introduce yourself you also kneel beside them and palpate their radial pulse. Now, you also have skin CTC, and know if their HR is generally fast or slow, regular or irregular. If unsure, you can dial up the QRS volume, as your ears will pick up an irregular rhythm quicker than your eyes. Now, go into your L/S as above, etc. etc. You should have enough info to decide on a differential and a protocol at this point. Just be systematic like this and you should be fine. You'll be very thorough and shouldn't overlook anything this way.

Also, when drawing meds, actually call out the expiration, concentration, etc, basically the 6 "rights." Check yourself. A few times I've said something aloud and it didn't sound right. sure enough, I caught a potential med error.

Good luck!
 
I've been running by myself for over a year now and I still get nervous. I think when you don't get nervous when an intense call drops anymore then you should probably get out. Just do your best to get through it with the training that you have. Remember your basics before your advanced and go from there. You have lots of resources for help: med control, partners, protocols and flip books. Use them. Be confident in your knowledge and have fun! You've worked hard to get here!
 
I pretty much approach patients in the same way that 46Young does. In fact, if you were to read how I normally approach patients, or at least describe how I do, it's almost exactly like the description above. About the only difference is that I try to listen to heart tones early in the exam, not necessarily to distinguish S1/S2/S3/S4 sounds, but to listen to the rhythm of the heart. Irregularly irregular without an S1 tone can tell TONS too... but at that point, I'm just listening for rhythm and basically, feeling along with a pulse rate to note whether or not any pulses are "dropped."

Eventually I will also usually put patients on the monitor and I can listen to the rhythm that way. But other than that, 46Young's approach is very, very similar to mine.
 
Yeah thats what i do need is to tidy up my systemic approach im trying to move a little away from national registry but it has been drilled n my head in so many years its hard to venture away from it.
 
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