When?

ego

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Then you should not be classified as an EMT, you are an ER Tech.

Some people get there EMT so they can apply to ER Tech jobs. so need the experience in a ED to apply.
 

ego

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An EMT should train in the type of enviroment they will be called to serve in, (the field or back of an ambulance). EMTs are there to fix a person up as best we can and get them to a hospital (pre-hospital care), we are not doctors and thus not trained to diagnosis partents. I got pretty dam good performing assessments on patients from doing them in the classroom and on calls in the back of an ambulance. The only time I stepped into the ED was when I was transporting a patient. Train as you do, because if you have only been performing assessments in a sterile enviroment, it will be a hugh shock when you actually have to perform in the real world.

I'm not trying to knock anyone, I just do not see any benefit from spending any time in the ED during training. I can learn the exact same thing doing assessments in the classroom and in the field.


In the classroom you wont see very large patients or other types of patients that have complications making treatment decisions more difficult. Getting BPs or placing EKGs on very large patients or children, Neonatals etc. With the large volume of people coming into EDs you get a wider range of patients that you can practice on and if you cannot do the task someone will be able to show you.

You should obviously have ambulance time as a preference but saying that there is no benefit from spending time in an ED is not correct.
 

Tigger

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An EMT should train in the type of enviroment they will be called to serve in, (the field or back of an ambulance). EMTs are there to fix a person up as best we can and get them to a hospital (pre-hospital care), we are not doctors and thus not trained to diagnosis partents. I got pretty dam good performing assessments on patients from doing them in the classroom and on calls in the back of an ambulance. The only time I stepped into the ED was when I was transporting a patient. Train as you do, because if you have only been performing assessments in a sterile enviroment, it will be a hugh shock when you actually have to perform in the real world.

I'm not trying to knock anyone, I just do not see any benefit from spending any time in the ED during training. I can learn the exact same thing doing assessments in the classroom and in the field.
There is no substitute for volume when you are new. Not to mention that you simply cannot get good at doing assessments in the classroom nor will you get good at them quickly once you start working on them on the ambulance. You improve by doing a lot of them

Also I am confused as to how time in the classroom is more beneficial than in the ER once you've learned the basic tenets of an assessment. One is more sterile than the other...
 
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Amelia

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Well in class we do a lot more than ABCs.
 

Sunburn

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Class is good, but nothing can prepare you for field work. Running scenarios is class is a lot different than treating your 20th or 30th patient coming of a 12 hour shift when you just want a cup of coffee and some food because you didn't get to eat. Real world fatigue factors a lot, that's when mistakes are made.
 

NYBLS

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An EMT should train in the type of enviroment they will be called to serve in, (the field or back of an ambulance). EMTs are there to fix a person up as best we can and get them to a hospital (pre-hospital care), we are not doctors and thus not trained to diagnosis partents. I got pretty dam good performing assessments on patients from doing them in the classroom and on calls in the back of an ambulance. The only time I stepped into the ED was when I was transporting a patient. Train as you do, because if you have only been performing assessments in a sterile enviroment, it will be a hugh shock when you actually have to perform in the real world.

I'm not trying to knock anyone, I just do not see any benefit from spending any time in the ED during training. I can learn the exact same thing doing assessments in the classroom and in the field.

There is so much wrong with this statement I don't even know where to start.
 
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Amelia

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There is so much wrong with this statement I don't even know where to start.
Agreed. Our ambulances have relatively low call vilume which is why we do ER shifts for experience. Simetimes you have to adapt and so the best you can with what you've got. Hmmm... /;|
 

gotbeerz001

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Agreed. Our ambulances have relatively low call vilume which is why we do ER shifts for experience. Simetimes you have to adapt and so the best you can with what you've got. Hmmm... /;|
I think what NYBLS means is that to say ER time has no value is ridiculous.

We were required to do 16 hours in the ICU for paramedic. They were very boring shifts: Sedated pts requiring monitoring of MAP, administration of drugs we don't use pre-hospital, suctioning and periodic repositioning to avoid sores. Seems like a waste of time, yeah?
The biggest take-away I had was to read the intake reports and read how stable some of these pts were at scene when they were truly critically injured. This has helped me keep my index of suspicion high on the seemingly stable trauma pt specifically.

While the ER is a relatively controlled environment, this is a great place to hone your skills before taking them out to the field. It is also a great way to see which interventions are most helpful to the hospital staff so that you can prioritize your actions en route.

I am suspect of anyone who says they "got pretty darn good performing assessments" and cites how many classroom scenarios they have nailed.

I am also guessing that @dank is simply an overconfident Basic (bordering on being dangerous) but is saved by lack of opportunity in the field.
 
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Amelia

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Here's another one of my points of view: Do what the darn classes requirements are. If its rig time, awesome. If its ER time, fantabulous. I'm doing what's required, I'm going to make the best out of it, and there is absolutely 0 point in criticizing other program's requirements. I can guarantee you that what works and what is required from EMT/P students in California are going to be -slightly- different from the requirements here in South Dakota. Just a thought.
 

gotbeerz001

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Here's another one of my points of view: Do what the darn classes requirements are. If its rig time, awesome. If its ER time, fantabulous. I'm doing what's required, I'm going to make the best out of it, and there is absolutely 0 point in criticizing other program's requirements. I can guarantee you that what works and what is required from EMT/P students in California are going to be -slightly- different from the requirements here in South Dakota. Just a thought.
I'm having a difficult time figuring out which angle you are coming from on this; my point was simply:
All aspects of training can be beneficial; some even more so than others. Both ER time and Field time have their merits; seek them out.
 

Tigger

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Here's another one of my points of view: Do what the darn classes requirements are. If its rig time, awesome. If its ER time, fantabulous. I'm doing what's required, I'm going to make the best out of it, and there is absolutely 0 point in criticizing other program's requirements. I can guarantee you that what works and what is required from EMT/P students in California are going to be -slightly- different from the requirements here in South Dakota. Just a thought.
Meh. Not all programs provide the same opportunities for their students. If a program does not provide a clinical opportunity, that doesn't mean it's not worthwhile and you should not seek it out. My program had us in the ED and the ambulance for equal time. The trouble with the ambulance was that the fire department beats us on most of the calls, so you rarely got to attend a call start to finish. I arranged to do my own clinical time with the fire department so I could see what it was like start to finish. The school did not make this mandatory, but it was certainly helpful to me.

I am also starting to take EMT students at my full time place, which is pretty rural. While we don't have the volume, students get to experience what it's like to have to deal with a patient for an hour or more. While not required, it's certainly beneficial experience.
 

NYBLS

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I think we often forget we are typically the first line of health care a patient will see which can provide extremely useful information to provide to our patient. Ill give an example. One of my clinicals was the cath lab. Why? Am I going to provide this in the field? No, of course not. But for my next MI patient the value of communicating not only the next 5 minutes but the next 5 hours of his care can assure them that you are concerned about their long term well being, not just dumping them off in the ED and going on to another. Simple statements and explanations show family that you are educated and show the patient this isn't your first time dealing with their problem.
 

OnceAnEMT

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I completely agree with the above that the ED clinical time is not a "must have" but only helps and certainly does no harm. Having background knowledge, even if it barely scratches the surface, of other aspects of the overall picture is a great way to have solid transitions of care, and keep your patient informed.

As a side, in the AT program I am in our clinicals include semesters at a high school, radiology clinic, student health center on campus, ED, ortho surgeries, and ortho shadowing, all on top of the normal collegiate sport coverage. That extra bit of knowledge can give you the edge in a conversation, whether that means relating to an interviewer or calming a patient.
 

SandpitMedic

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This is getting deep. Everyone thinks field experience is so very valuable... Except when it comes to going straight through to medic school...

Hmmmmmm.....

:confused:?
 

Tigger

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This is getting deep. Everyone thinks field experience is so very valuable... Except when it comes to going straight through to medic school...

Hmmmmmm.....

:confused:?
Clinical time has defined goals, and (hopefully) preceptors that will help you reach them. Working for six months doing BLS transfers (the reality for many new EMTs), does not have the same structure.

Also, paramedic school obviously has its own clinical component so I guess I just don't get it.
 
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Amelia

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This is getting deep. Everyone thinks field experience is so very valuable... Except when it comes to going straight through to medic school...

Hmmmmmm.....

:confused:?
Im not going straight to medic school. Some of us dont have that option.
 
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Amelia

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Im not going straight to medic school. Some of us dont have that option.
Its just how our provram works. Our requirements are 10 vitals in a shift, and where we live, we may only get 3 calls a night. On a limited schedule that would be nearly impossible while we make 9 "perfect" skills videos with a lab group plus 4-5 hours of studying each night and trying to raise a family in my case. We are welcome to ask ambulance services in the area for a ridealong. I am going to try to take advantage of that if possible. Id have to go out of town,however, because our ambulance companies are changing in a few weeks.
 
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