tcripp

Welcome...fellow Texan!

Tampons do a good job in gunshot wounds in the absence of arterial bleed.

You carry tampons on you?

Welcome to the city! It's always good to have new blood!

It takes practice, I used to be absolute bloody rubbish at writing PRFs

PCR = patient care report

ePCR = electronic patient care report

PRF?

Having graduated not too long ago, I very much enjoyed my ride outs for the most part. With the exception of a few calls and a few skills, there wasn't much I wasn't allowed to do.

As a preceptor, I have taken that forward and allow my students to do what they can with the expectation of full confidence in their abilities. I do the same for new hires fresh out of school. My motto...we all make mistakes, it's just what we do with those mistakes that makes or breaks a good medic.

Funny (to me) scenario about a TQ.

Had a gunshot patient not too long ago who, himself, put a TQ above the "entry" wound to stop the bleeding prior to EMS arrival. The pt stated that he tripped over a basket where a handgun fell out and discharged entering in to his thigh. Because my "training" said "never ever remove a tourniquet", I did just that and left it in place. And, all my decisions were based then on what I could see. I looked all around the tourniquet for an exit wound and didn't find one. Just the entry wound based on the GSR. Contacted the local ER who said to take him to a trauma 1 facility because of the lack of exit wound for further care.

So...the moral of my story? We deliver the patient to the ER who immediately removes the TQ and...VOILA...there sits the exit wound...6 inches away from the entry. Talk about the "duh" feeling moment.

Next time, I assess the situation and decide on the situation based on someone once saying "never ever" and go from there. This patient required no surgery and was released that same day. We could have done this at our trauma 4 facility.

One more lesson learned after graduation.

Dwayne -->

I sure hope I get to meet you in November.

Um...that's what I'm trying to do?

In a nut shell, you need to write just enough to help you remember the call in court 5-10 years from now and not too much to make it unreadable. And, to top it off, it you don't write it...it didn't happen. UGH! Now where do you draw the line.

If your PCR has fill in the blank or drop down boxes in an ePCR, use that for as much of your information as possible. Then, add in the little bit of extra without being redundant in your narrative. Many ePCRs are getting to the point to where you don't even have a narrative feature any longer, just an extra comment box.

I agree with you on how you note your trauma. If I only note the one injury without stating, no other dcapbtls noted...how do they know I ever looked at the rest of the body? My opinion, I think you are on the right track and, with practice, will get a better feel for what needs to be included vs not.

Toni

I wish I had the ability to do that. I live 1.5 to 2 hours away from where I work, so getting involved with my patients during off hours isn't an option.

I think part of the problem is that the answer to that question isn't as simple as you are hoping. Frankly, we learned that in two separate classes over a single semester. ERDoc is right, we won't give you the answer, but we will direct you in the right direction and then help you if you are still having issues. While looking up osmolarity, look up hypertonic/hypotonic/isotonic solutions. As paramedicmike stated, normal saline and lactated ringers are different beasts. As a matter of fact, these are only two of the intravenous fluids out there. Go and look up colloids/crystalloids.

Hopefully, this will give you a good start...and we are here if you have specific questions on what you've read.

Toni

MG - you and I have spoken and I know the area in which you work. We have some part-time positions opening up at my service - and those tend (more often than not) to turn to full time. Based on your posts alone, I'd be happy to have you around.

Toni

Just curious, and i am kind of worried that i should not be in this field now, but i will never quit i will keep pressing on.

Kyle, you are a very brave soul to be able to stand up and say what is bothering you (thus far) in your training. Like most things, admitting you have the problem is the first step. Now that you recognize the issue, you will need to figure out what will make it better for you. Only you can decide that.

My recommendation is to continue through the class and see if it gets better. That will be the only way to determine if this is right for you. As others have suggested, talk to your instructors/preceptors. Heck, PM me and I'll be another shoulder for you.

As to those who were joking, that is part of their dealing mechanism. It's our way (yes, I do it to...only way out of earshot of any family/friends) of dealing with the situation. It's called EMS black humor. Additionally, any time one of my patients dies, I turn to my faith. I look to the skies and I speak to my deceased grandmother. I let her know that another soul is coming her way and I ask her to guide that soul appropriately. I learned that trick when I had a 6 month old baby girl die of respiratory arrest...grandma always loved them babies.

Toni

As one who is on the way to 27 years of marriage, welcome to the club! My two cents...believe in the "'til death do you part". It will serve you well.

And, my husband's philosophy on marriage (what makes it work?)..."whatever the wife wants".

Best of luck to you in your future endeavors!

Toni

Recently, I sat through a (yet again) horrid/boring CE on PPE. Not the first one, but hopefully the last. Before our service has to do this again next year, I'm hoping to put together a quick/succinct/compelling training session.

Does anyone out there have one they use that isn't boring, keeps your staff's attention and gets the point across? If so, will you share?

Appreciate anything!

Toni

Throwing a little estrogen in to this testosterone mix...WELCOME!!!

As I read it, there is no end date. However, I highly recommend you go to https://www.nremt.org/nremt/about/reg_para_history.asp#Cognitive_Examination to get your answers.

Good luck to you!

FYI - Jon Puryear has, as I understand it, a great prep course if you need it.

I'll be there and would love to meet some of our city folk!

Oh, my. There goes the neighborhood.

Just kidding Wes. We'll definitely enjoy your input and insight here. Welcome to the city and jump right in!!!

(FYI...Wes and I go way back...)

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~

I feel like I'm in some geriatric club.

Don't let age hold you back...you are truly as young as you feel. I finished paramedic school at the age of 45 and I now work a 48/96 shift. Even I amaze myself on the long hours at times.

Welcome to the city! (What's with the screen name "0331"?

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.

My heart goes out to all.

As a new first responder (back in 2004), I found myself stopping more often than not providing what aid that I could. Of course, I kept a BLS bag including O2 because I was a volunteer and had that equipment at my disposal.

Now that I'm a paramedic and not carrying a jump bag of any kind, I find I can watch and wait. I'm always watching. If it's serious, I will act otherwise I stay out of it. And, if I do stop to offer aid, as soon as EMS arrives, I'm outta there.

So, for grins, I thought I'd go and surf the web. Never know how accurate the info is, so I pulled up my locale to get a good feel. Good news is, it posts the salary for a full time paramedic prior to our raises this past January. I also looked at two other counties near me where I also know the salary range. So, I'm gonna say it's fairly decent representation...for me.

Check out www.indeed.com.