Current Emt student. I would say half way along. I had my first ride along last weekend with paramedics on a local fd, and my next is coming up in a couple weeks. During the first call, a nose bleed, I tried taking bp but we were bouncing about couldn't hear anything. Got bp by palp. It was pretty slow, only got 3 calls. The next two were diabetes and asthma related. The ride along provided me insight on general operations, and maybe even a reminder that I actually want to do this. Otherwise, I had no idea what I was supposed to be doing. I took it upon myself to observe everything from en route to scene to exiting the hospital. Beyond this, I had no clue. I didn't know whether I should jump in and start asking the pt questions and taking vitals, or help obtaining supplies and primarily observe. What are your experiences? Any advice.
Ride Alongs.
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firecoins
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Taking BPs in a moving vehicle is tough. Try and get one on scene.
Be more aggressive.
Review calls afterwards with the emts/medics your working with.
Be more aggressive.
Review calls afterwards with the emts/medics your working with.
Aggressive as in how? Should I just go ahead and start asking the pt questions and taking vitals? I guess I'm confused as to whether ride alongs are for primarily observing or practicing skills.
I'm not much of an aggressive person anyways if I don't have to be... :/
Achromatic
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Aggressive is not a good word. But assertiveness is. Confidence (even though you may be nervous inside) is a good side to show (though don't let that become overconfidence. Just go ahead, take vitals.
The purpose of ridealongs are 'exposure'. I can tell you that in our county, while you might ride along on a FD BLS rig, and do nothing more than observe, there are many medics who will happily take a student along (that shows confidence and ability/potential), in a Sprint unit (fly car, whatever have you), and have said that they will expect us to be acting as their assistant, applying oxygen, bagging, etc, etc, etc. (Half of our instructors/lecturers are our county medics - everything here is run by the county, so they get to see us in class and know if we're clowns or worthwhile, and you can be sure that if we go on a ridealong with another medic/medic unit, THEY know which medics are instructing and will ask them ahead of time).
Bottom line, if you sit back and be passive, you'll either get to do nothing (not that observation isn't valuable in and of itself), or you'll be pushed to do things and, regardless of the fact that (I presume) you want to do them, it may come across negatively, and be reported negatively, "We had to tell him to get him to take vitals/patient history".
(I apparently use too many parentheticals, reading back over the above).
Yea the first time I took a BP on a ride-a-long we were en route and I just couldn't get it. Paramedic tried explaining how to palpate to me while he was starting an IV but with my nerves I just couldn't comprehend. But I know now. =) I would ask as many questions as you like; I do, and they appreciate it. If I don't know something or ride with a new station I tell them what I can and cannot do upfront. That way they know so that if we get a big one then it can be done with assurance. I'm with ya on the whole pt questioning thing. I don't really ever ask the pt questions I leave that up to the paramedics or if the pt tells me something I relay it. It sounds like you're really interested in this and you're really paying attention and wanting to learn. That's great! I hope its going well and good luck!
firetender
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Try stuff.
Maybe even talk to the patient.
"Now I'm going to..."
"Is it okay if I..."
That's a human being back there, and now, while you're not immersed in all the bells and whistles, you can learn to see how effective connection is as a springboard to healing. It can be integrated into ANYTHING you "deliver" and make your job a lot easier, too.
Maybe even talk to the patient.
"Now I'm going to..."
"Is it okay if I..."
That's a human being back there, and now, while you're not immersed in all the bells and whistles, you can learn to see how effective connection is as a springboard to healing. It can be integrated into ANYTHING you "deliver" and make your job a lot easier, too.
wyoskibum
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I would encourage you to talk with your preceptor at the start of your shift and discuss what they are comfortable with you doing. Tell them that you would like to get the most out of the experience and you would like to do as much as possible and would love to get input from them on your performance.
I'm roughly half-way through a Basic class and have done my required two 12hr shifts on a truck. (I wish I could do more, but with ~65 Basic students, it's tough)
The first shift I rode and watched. It was a pretty light day, not much a B-student could do.
Then I did my second shift with an older, much more experienced Paramedic (grizzly vet?) and EMT-I. He flat out told me on the first call that he expected me to function as a member of his team. I was on the gurney all day (against local student regs). When each Pt was loaded on the truck I was given 60 seconds to re-asses BP and SpO2 via the LifePack AND take a temp and run a BGL. First time took me ~90sec, after that 60-75sec.
I also helped package and load a Pt on a helo. Usually the students aren't allowed anywhere near the rotors. I'll admit, it was a rush.
The first shift I rode and watched. It was a pretty light day, not much a B-student could do.
Then I did my second shift with an older, much more experienced Paramedic (grizzly vet?) and EMT-I. He flat out told me on the first call that he expected me to function as a member of his team. I was on the gurney all day (against local student regs). When each Pt was loaded on the truck I was given 60 seconds to re-asses BP and SpO2 via the LifePack AND take a temp and run a BGL. First time took me ~90sec, after that 60-75sec.
I also helped package and load a Pt on a helo. Usually the students aren't allowed anywhere near the rotors. I'll admit, it was a rush.
Sasha
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You've got to be agressive. If you can't be agressive then you will do poorly in this field. Ask your preceptor up front what they expect of you and what you can and can't do on their truck. Everyone will be different. Ask to go through the truck, ask for them to go through scenarios with you. The worst they can do is say no.
Sasha
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Word to the wise, don't advertise doing something you're not supposed to on a public forum. I'd be a little annoyed if someone tried to rush me through my vitals.. especially via lifepak. Speed isn't the name of the game, accuracy is.
It occurs to me as well that as an EMT-B, the OP won't have access to a lifepak when he's doing it 'for real'. Nor will he (unless state protocols are significantly different) be taking blood glucose levels in the field. Might have been more helpful to let a student assist with tasks that will actually be within his eventual scope of practice.
State protocols really do differ on this one. As a basic in one state, I'm expected to take blood glucose, and to get a lifepak on patients. In another, I better not even think about touching either one. I agree that other basic skills are more important to master, though, and that accuracy is way more important than speed.
Seconding the bits about not saying everything on a public forum, too.
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Sasha
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We do blood glucoses here, so it really depends on where you are. That's a basic skill. Even still... if you're doing all that in 60 seconds I have to wonder how well he cleaned the finger before he used the lancet. Why are you going so fast? Leave something to do for the rest of the trip.
Rushing is bad for patients and/or bystanders. They see you rush and go "Oh poo! He must be really bad off!" and up goes the anxiety level of everyone involved. Take your time, do it calmly, and ask for a new preceptor if they try to rush you through it again.
Basics in NJ are not allowed to "play with needles" so to speak. Well, other than epi-pens, of course, and there only grudgingly. I suppose there is a school of thought that because blood glucose doesn't impact treatment at the EMT-B Level, we don't need to know if the patient is high or low.
thatJeffguy
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That's exactly what I do! You should possess the interpersonal skills to talk with people, ask questions about what they did and why, and ask them "If the patient had presented with X instead of Y, what would you have done". The best medics that I've ridden with have, much like the best infantrymen I served with, completely mastered the basic skills and deal quite well with people. People skills, good! You'll find out which EMT's and medics enjoy discussing calls and which don't. Find the ones that do and pick their brains!
Everything I described is within NM's Scope for a Basic.
They way I was taught makes it all relatively easy to do if you stay calm and work the process.
Yes, the Pt's finger(s) were cleaned with a prep pad well. I may be young/dumb, but I'm not going to jack around with that.
Locally, a EMT-B will handle a LifePack, athough it's up to the Paramedic to run the cardiac actions and read the print-out.
Why did I do it that fast? Because my Precep set that time frame. It is drilled into our heads that we do NOT question/argue with a Preceptor here. On two of our calls that day the scene was 1/2 mile from hospital ED. He wanted it done before we hit the ED bay.
At the helo-evac scene, there were Fire and EMS supervisors present who witnessed everything. I would have to think they would have stepped in and stopped my participation if they were concerned.
I discussed everything I did that day with my class instructor and our clinical instructor. They are both fine with it as I was doing as instructed by the Paramedic/Preceptor. We weren't dealing with state laws, just program regs. As such, I was covered.
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