naturegirl

Honestly, both lately. I don't want to make excuses but I've had lots of people lately with medical issues, not young healthy people with veins you can just throw the needle at. The last one was a lady with diabetes and hypertension. Her veins looked good, got flash but then blew not one but two. Third time I was gold, but then the IV wouldn't run. No matter what I did, I couldn't get it to go, but I didn't see any infiltration. I noticed the cath wouldn't advance completely but I didn't know why. All this was during a rough drive. It wasn't a positional issue like AC with the arm being bent. This last vein was on top of the wrist below the thumb. I finally gave up and pulled it and got such a shot of blood I knew I was in a vein. I don't know. I didn't know that people with diabetes and hypertension shouldn't necessarily have a tourniquet, I haven't had all that training. As an I-85 they really just taught us the mechanics of how to do it, not all the problems that cause veins to not cooperate. All my good sticks have been on healthy young trauma patients. It seems like all my patients lately have been unstable diabetics with shunts and crappy veins. Or they tell me that the nurses can't even find a vein and I think I just don't even want to try. That's why I thought I should get more education to address this. I'm so open to help.

I agree we are trusted by the general public. I often get information from patients they would never share with law enforcement. I also often get lied to. It's not really that fine of a line between violating a patient's trust and being vigilant to potential "things" we should report. Wasn't it an EMT in London who noticed the car loaded with explosives while responding to another call close by?

This is so helpful. I think that the self confidence is a big part of it. I got called on the carpet by my B supervisor over it and I'm glad now she took the I class because I can't wait to return the favor. I know they're tracking my stats and I think it's shooting my confidence down. I've down them successfully and I know I can do it. Medic school is a long way off to get those practical experiences. I think I'm going to go to the local medical assistant/phlebotomy school and ask the instructor for a little practical education. My last one I thought was good until I ran fluids and nothing went. when I pulled the cath out I was obviously right where I should have been. I don't know why the fluid wouldn't go. I had the vein on the side of the wrist, no positional issues. I will keep trying. Thanks for the ideas

I need some quick ideas. I seem to have hit a slump in my IV skills. I have an uncanny knack for finding every valve or anomaly lately. Where would you recommend I go to get back on track? I'm an Intermediate working very part time and also in a volunteer service. I don't have the luxury of someone standing over me helping me through every stick. Any ideas? Go to phlebotomy school? volunteer at the plasma center? I'm working on an A & P course but I need practical help. I am sure someone has had this problem before me. HELP!

I couldn't help but notice most of the posts regarding this subject come from people who live in more densely populated areas. I am a volunteer EMT in a city of 815, in a county of several thousand, in a state of less than a million. My service responds to maybe 150 calls a year, and a few mutual aid. Many of the EMT's here in the Dakota's are in farm and ranch country, covering a few hundred people and the freeways that connect us. There is NO way you can post anyone geographically central to respond to calls as infrequently as some of our runs end up. Some EMT's here are transporting patients 4 hours to a hospital. Would we like to get paid on par with professional, full time EMS providers? DUH! We have all the same problems that you all have listed over and above, but we volunteer because we are needed. I am 45 minutes from the nearest Level 2 trauma center. I know that the paid EMS look down on us for calling a helicopter but you transport someone critically ill 45 minutes and you'll see things differently. If I want to practice IV's I have to find a job. There is nowhere near the volume necessary to sideline a bunch of adrenaline junkies waiting for the nursing home to send one our way. It just isn't practical. Most of our EMS and fire are volunteer or "compensated volunteers" , except for the largest cites and reservations. However, we do get in enough training and we do take our services very seriously and do find once in a while we can actually save someone's life. This is remote country and everyone here knows they better be able to help themselves until help arrives. If you're ever driving through here, please be careful and remember on those long stretches between town, a volunteer who doesn't even know you will still come and help you. We'll care for you and apply all the skills and training we have because if you had to wait for a "professional EMS provider" you'd be waiting a LONG time. We all know the train is coming and we were very vocal about part of the review and input that hopefully slowed down the new changes until they can address places such as South Dakota. It would be more helpful if some of these folks that want to make these changes actually came out here and tried to see what we face every day. And yes, I do respond from my home and I can still be enroute in less than 4 minutes, day or night. We volunteer to serve our communites, our families, our neighbors. Please don't mistake the fact that I volunteer for being less professional. When we respond, most of the time, it IS our families, our friends and our neighbors. And THAT is not even in the same world as all this backbiting and finger pointing I am seeing here on these posts. I don't need to be paid to be part of the solution.