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What Did I Do Wrong ?


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Go easy on me, I am just 18 and about to start my EMT-B class, but I have had EMS in my blood for as long as I can remember. I have been reading my text-books (and paramedic book) and studying as much as I can before class begins. I purchased a scanner and listen to our local calls as much as possible. I have also purchased lots of medical supplies for my car. So the other night, I heard on the scanner that there was a wreck with entrapment just about a mile from my house. I was first on the scene and found a 50 year old male who hit a telephone pole and bent the steering wheel. He was compaining of chest pain and difficulty breathing, his vital signs were stable. I put on a C-Collar and gave the patient two of the Nitro pills that was in his pocket (he asked me to). I held C-Spine until the Fire guys arrived, and then gave report. They looked at me like I lost my mind ???????? Then told me they wanted to talk with me when the call was over. I snuck away, but I can not figure out what I did wrong ? Can you help me figure it out ?

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Why were you even on this call to begin with? By all accounts to seems like you responded to this call in your own vehicle with equipment you purchased yourself. I think it would be in your best interest to put the scanner away, and wait till you are actually licenced as an EMT before responding to calls.

As for what you did wrong treatment wise... Did you perhaps consider the fact that his chest pain and SOB may have been related in some way to the bent steering wheel? Did he have chest pain before the MVC? Did the pills reduce his pain? Did you give both pills at once, and do you know what the dose was for each? It is very risky to give a pt medication (even if its their own Rx) without any medical training or oversight.

Furthermore, when you do finish your EMT-B do you plan on working with the local Fire Dept.? If so its probably not a good idea to get a reputation as a scanner cowboy, who shows up without invitation and then slinks away after the fact.

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What did you do wrong, you turned on your scanner.

You gave a medication that you had no business giving but I'll give you the benefit of the doubt that you didn't have a clue.

Please turn the scanner down, put away your equipment you purchased and finish your school.

did you tell the responders you gave the nitro?

the c-collar was good but when were you trained to put one on?

What other equipment have you purchased.

My advice, take the emt class and get through it before you respond from your house again. I can't say what I would have said to you on this forum. It would not have been a pretty thing.

You will realize that everyone on this forum who has answered your questions is RIGHT and when you get on an ambulance you will say "I can't believe I did that"

Use this as a learning experience and learn from it.

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They looked at me like I lost my mind ????????

Curious what all you told them? Did you tell them you were scanning and heard the call? What prompted you to go? The fact that you were only a mile a way or did you get some insight that there would be a delay of the first responders? Who called it in? The patient who may have been alone or were there others on scene? Have you ANY training at all (i.e., first aid)? Where did you learn to take vital signs? Was the call during daylight hours or at night? Were you a hindrance to the traffic...could you have been a patient yourself because of where you parked? Did you have on appropriate gear so that you could be visible from oncoming traffic? Does your vehicle have emergency lights installed?

Before I join the chorus, some insight to the rest of the story would be helpful.

With what you have posted, I have to agree with those above. You are whom we'd call a Jippy Joe or Rescue Randy. You self dispatched yourself to a call with no training and, further more, no invitation (a decent first responder doesn't jump a call). You provided your own equipment (odd), did a full assessment (you took a bp?), and administered medication. I believe you have misrepresented yourself as a medical responder instead of just a good samaritan.

It's one thing if you just happen by a call...and hold c-spine...and comfort the patient. But the rest seems a little overboard for a student. Once you get your cert...you will find yourself giggling at "those like you" on this call.

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Apart from giving a medication to a trauma patient that could drop an otherwise stable blood pressure, causing the medic on the truck to say "this guys bleeding out" because 2 nitros would drop anyone's pressure. you do realize that you could have killed the patient right?

Consider this a learning experience and learn from it, don't run away. We are hard on you for a reason and having the balls to come here and say "What did I do wrong?" shows you are willing to accept criticism. Or you can run away with your tail tucked between your legs and miss out on some good instruction and criticism. Remember, criticism never killed anyone, just ask AK or Dwayne about our conversations in the past.

It's one thing if you just happen by a call...and hold c-spine...and comfort the patient. But the rest seems a little overboard for a student. Once you get your cert...you will find yourself giggling at "those like you" on this call.

He/She is not even a student yet. Original post is that he's about to start emt school. here is the first sentence of his OP

Go easy on me, I am just 18 and about to start my EMT-B class, but I have had EMS in my blood for as long as I can remember

If he's had EMS in his blood for as long as he can remember maybe a good ole fashioned bleeding of the humours is in order and once that is done, then get him in the class, have him start over and with his enthusiasm he might just make a good or great medic someday.

But seriously FNG, don't do this again. You have to get some basics under your belt before you go off changing the world one dead patient at a time. With the enthusiasm you showed why not channel it into something more productive and put all your energy into the emt and then medic class.

If not, it's liable that we will not stop the bleeding I mentioned. Don't run away from this discussion, even though we seem hard on you we really do have your best interest and your patient's best interests at heart.

Go easy on me, I am just 18 and about to start my EMT-B class, but I have had EMS in my blood for as long as I can remember. I have been reading my text-books (and paramedic book) and studying as much as I can before class begins. I purchased a scanner and listen to our local calls as much as possible. I have also purchased lots of medical supplies for my car. So the other night, I heard on the scanner that there was a wreck with entrapment just about a mile from my house. I was first on the scene and found a 50 year old male who hit a telephone pole and bent the steering wheel. He was compaining of chest pain and difficulty breathing, his vital signs were stable. I put on a C-Collar and gave the patient two of the Nitro pills that was in his pocket (he asked me to). I held C-Spine until the Fire guys arrived, and then gave report. They looked at me like I lost my mind ???????? Then told me they wanted to talk with me when the call was over. I snuck away, but I can not figure out what I did wrong ? Can you help me figure it out ?

They looked at me like I lost my mind ???????? Then told me they wanted to talk with me when the call was over. I snuck away, but I can not figure out what I did wrong ? Can you help me figure it out ?

oK, I just re-read your question above in Red. They were going to hammer your rear end with the "you gave nitro to this guy" speech and also why you responded on your own when you are an unknown. but then again, maybe they were goign to recruit you to the volunteer fire department. Can never have too many good enthusiastic first responders out there can we?

I know what Dust would have said.

Edited by Ruffems
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He/She is not even a student yet. Original post is that he's about to start emt school. here is the first sentence of his OP

Go easy on me, I am just 18 and about to start my EMT-B class, but I have had EMS in my blood for as long as I can remember

If he's had EMS in his blood for as long as he can remember maybe a good ole fashioned bleeding of the humours is in order and once that is done, then get him in the class, have him start over and with his enthusiasm he might just make a good or great medic someday.

So, are you scolding me because I failed to write it as "not even a student" or maybe that I was trying to approach his lashing from another direction? Not quite sure exactly what your intent is here...

~only edited for grammar~

Edited by tcripp
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Things you did wrong:

Operationally:

Freelancing a response.

Entering an unstable scene without proper back up, PPE, or radio communications.

Rendering medical aid while not appropriately trained.

So when it comes to the first chapters of EMT school, you failed, in order, Well-being of the paramedic, medical-legal issues, communications, and operations. You failed the most major point of failure points, scene safety. Entering an entrapment scene without fire/rescue on scene really should only be done if there is a life threatening condition. Secondly, he hit a telephone poll. Unless you have a scanner for the local power company too, you are now in the realm of not entering the scene even if there IS a life threatening condition. Powerlines with power are bad. Patient was alert and talking. Chest pain and SOB are indications of an unstable patient but I would not say to the level of risking entering a confined space as a lone rescuer. Now lets move on to the actual medical stuff.

Medically:

Holding C-spine when technique not appropriately assessed by state-certified examiners. C-spine is a delicate thing. Holding it wrong can mean really bad things.

And for the nitro: Chest pain and SOB with a bent steering wheel are indications for a high index of suspicion of a significant chest injury. Without going into too much pathophysiology, an injury to the chest can produce a whole bunch of life threatening internal injuries, and just about the only thing that can make them worse is giving someone a vasodialator, which you did. Also you shouldn't really throw around nitroglycerin unless they're on oxygen. I wouldn't treat someone for angina after the mechanism described until I had a couple of sets of vitals, a 3 and 12 lead EKG, and an IV. If I could swear beyond a shadow of a doubt that the chest pain was ischemic rather than traumatic in nature, then I would consider administering nitro. After I consulted with on-line telemetry, that is. Otherwise, I would assume the patient has suffered a significant chest injury and do the rapid transport to an appropriate facility thing.

I'm still not sure if this post is real or if this is someone on EMTCity's version of Punk'd or Candid Camera. Seriously. Is this a set-up?

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Okay. Am I the only one that thinks this is just someone screwing with us? Maybe it's because I don't want to imagine it happened?

That was my initial thought as well, I mean it has all the workings of a good whacker story. However, if that's not the case then I think everyone else summed up what you did wrong, and I'm not really one to be redundant.

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