New Job; Suggestions?

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TreySpooner65

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I am about to start a new job as an EMT. It is at a 65 acre community. Most of it is independent living retirement, but they also have assisted living, and skilled nursing facilities. This job will serve as money and experience while I am in school until I get onto an ambulance.

My question to you all is what do you think I should brush up on or get more familiar with? I am going to refresh myself on stroke signs, and the new AHA CPR guidelines, since they seem to change every year... -_-

Anyway, any suggestions are welcome ^_^
 
I've worked this type of job for the past few years. We were security/EMS for the campus and ran all over the place responding to what ever insane things the old folks could come up with.

Brush up on your trauma assessment, you will run falls constantly, and it's nice to be able to figure out the lady has a broken shoulder before trying to lift her up by the shoulders (my partner).

Get familiar with common medications prescribed to geriatrics. HTN meds, Heart Failure, Kidney Failure, Anti Psychotics, Anti Depressants, stuff like that. Having a tool like epocrates or Medscape on your smart phone will help.

I'll add more stuff as I go, this should get you started. Do they have those pull cord things in their apartments? Press alerts around their necks? If so you'll be running accidentals all day long.
 
I will brush up on meds as much as possible, but under my current scope I cant hardly touch a pill bottle.

Glad to see I'm not the only one working a place like this.

And yes, they do have buttons in their rooms, and lanyards.
 
TreySpooner65 said:
I will brush up on meds as much as possible, but under my current scope I cant hardly touch a pill bottle.
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It's not so you can give the patient their medications. Having a good knowledge of at least commonly Rx'd meds will help you perform a thorough assessment and have a better idea of what may be going on, especially if granny is unreliable or unable to respond.
 
I know that. I was just also adding that unfortunately, I cant help with many meds. But it is certainly good to know so I can pass it along to ALS should 911 be summoned.
 
TreySpooner65 said:
I know that. I was just also adding that unfortunately, I cant help with many meds. But it is certainly good to know so I can pass it along to ALS should 911 be summoned.
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It's not about passing meds along, anyone can do that. You can figure out a lot about a patient based just on the meds they are taking, and therefore do a better assessment. Just because it wasn't taught in class doesn't mean you can't do it, at least in the case of "interpreting meds."

Also, some unsolicited advice for your new position (congrats, btw). I respond to a similar facility a fair amount, and while the first response staff ins generally pretty good, they do some stuff that drives me up the wall.

Do not touch the stretcher unless asked. My partner and I can lift grandma by ourselves, but thanks for the help. If she gets dropped, I'm responsible, you are not. One partner hurt his back when the EMT pulled the head collapse lever instead of lifting. This was after he elbowed me out of the way saying that patient was a "big boy." Now when I go I feel like I have to guard the stretcher and ask for help carrying the bag and AED so as to prevent this.

Along the same lines, do not push or pull the stretcher, that's the crews job, and they have their own system for doing so.

Do not put the patient on 02 just because the ambulance is delayed.

Bring the AED to every call, along with the bag.

If you think the patient needs ALS, call for ALS. Don't wait for me to show up just to see if I also agree the patient needs ALS, I'm a basic too and odds are I will agree. That just wastes time.

I'm not saying you'll do any of this, but it's advice to make the responding crews like you.
 
Thats the kind of feedback I want. I'm playing a key role connecting outside 911 service to my facility. Anything I can do to smooth the transition and help the outside EMS workers is on my to do list.
 
Oh another thing to think about. When you find one of the old folks wandering around at 4am, check to see if they take Ambien or some other sleep aid. It seems like the doctors around here have been prescribing it to them like crazy, and it can cause some serious confusion/aggression/hilarity when they wake up and it hasn't worn off.
 
MedicBender said:
Oh another thing to think about. When you find one of the old folks wandering around at 4am, check to see if they take Ambien or some other sleep aid. It seems like the doctors around here have been prescribing it to them like crazy, and it can cause some serious confusion/aggression/hilarity when they wake up and it hasn't worn off.
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Well all my shifts will be during the day (well.. The late shift does go till 11.)

I know ambien can do some crazy stuff if you dont go to sleep after taking it..:wacko:
 
TreySpooner65 said:
I am about to start a new job as an EMT. It is at a 65 acre community. Most of it is independent living retirement, but they also have assisted living, and skilled nursing facilities. This job will serve as money and experience while I am in school until I get onto an ambulance.

My question to you all is what do you think I should brush up on or get more familiar with? I am going to refresh myself on stroke signs, and the new AHA CPR guidelines, since they seem to change every year... -_-

Anyway, any suggestions are welcome ^_^
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Practice giving reports to the responding ambulance crew. It's always nice to receive a concise, coherent, and informative report immediately upon arriving on scene.

I always like hearing PT's name, age, chief complaint, and any relevant info about the scene or event right off the bat. Follow that up with your vitals, SAMPLE / OPQRST, and any interventions / treatments you've performed. Finally, note any changes / improvements in the PT's condition, as well as anything else you think I should know. This can be done fairly quickly and conversationally with practice, and can be done in such a way as to involve the PT to some degree.

Once the report is complete and the responding crew gets to work, care has been more or less successfully transferred. Once this occurs, I'd suggest you ask the crew what you can do to help rather than insert yourself into the situation without invitation. Like Tigger mentioned, it can be difficult to have too many cooks in the kitchen. It's more than likely they'll be happy to have your help and you should stick around as long as you can, but they'll be running the show from there.

Other than that, remember to take your time, be thorough, take a deep breath, and trust your brain and your training.
 
Get used to seeing "scary" high blood pressures and thinking nothing of it.
 
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