Katiebug

I remember my first DOA. It was a grandmother that had laid (or collapsed) sideways across her bed and died. Not sure what the cause of death was, but she had dependent lividity and we got asytole in two leads, so the medic (who was my preceptor) called it.

The family was outside the house holding each other and sobbing. I am normally a very empathetic person, but oddly I was completely unphased. I remember having absolutely no emotion about it at all. I've always thought that was odd, given my nature.

A few months after that, I had my first code. I was eerily calm for that too. I even knew the old lady that coded in my ambulance, but I seem to go into autopilot when confronted with these scenarios. When we got her to the hospital, she was in PEA. They got a shockable rhythm and she saw a sinus rhythm for about fifteen seconds before going into permanent asystole. To this day neither one of those experiences bother me one bit. It's like I completely detach.

As far as getting excited about a DOA, that seems a little off to me. Somebody just died. Yes, it's part of the "circle of life", but I don't get the excitement of your acquantance bearing witness to that. That's just weird.

In my mind, the hope is that we arrive in time to prevent death. If not, either we weren't called in time, or that person was just DTJ and we weren't meant to be there. I at least try to let the person leave this life with dignity.

But like Dust said, whatever gets you through the call.

Holy crap that's funny.

I just took and passed it Friday. It was tough, don't be confused about it. It's not that you haven't covered the material, it's just the way the test is constucted is different than any other test I've ever taken. There is no good way to explain it that I can think of. I'll tell you my strategy though, and it worked for me.

First, understand that there will usually be at least two right answers to most questions. Narrow it down to those two and choose the best one.

Second, use the KISS principle. That means Keep It Simple Stupid. If your treatment choices are between atropine and O2, your answer is likely O2. It's first in the field right? Don't overthink it.

Third, take your time and think the questions through. You will be given WAY more time to take the test that you will use. Take all the time you need on any question that is giving you a problem. Most answers become self evident when you stop and think about it. You can at least narrow it down to two choices. A flip of the coin is better odds than a role of the dice.

Finally, know your cardiology, drugs and dosages. When I say know your cardiology, I don't just mean rhythms, but the A&P too.

All the practice tests are helpful, but not at all worded like you will see at registry, so take your time and adjust to the registry format as soon as you start the test. You'll be fine.

Good luck.

What Dust said.

I contend that criminals are far less likely to victimize people that will shoot back.

I also contend that a people that wish to maintain a system of self government and self representation must maintain the right to bear arms.

congratularzations!!!! good job....a little alarmed about the quiting job thing tho....didnt know we made enough for that

We don't. I'll be working an ABC shift. That will allow me time for my side business now. I make combustion in vehicles more efficient thereby increasing power and mpg.

great job!

but is it just me, or do those study guides offer little to no help on the NREMT structuring of questions? I took the NREMT and studied out of several different books. None of which came close to how NR formed their questions.

Agreed. The questions in the actual test really threw me for a loop. They were nothing like the questions in the study guides. The trick is to narrow it down to two answers, then choose the best of those two. Also, keep it basic. It's easy to overthink the answers and skip the basic step and go straight to the ALS answer.

But no, I haven't seen any other tests or study guides constructed like registry.

Was this a good one?

Yeah, it was a good one.

I will congrat you if you give me all the answers.

Ha! Tell you what. I'll tell you what I used to study. I used the McGraw-Hill EMT Paramedic study guide, the NREMT practice website and the Moseby's textbook. I studied for about a month before taking the test. Computer shut off around question 90.

Hope that helps.

You never got away from EMS, you just stepped off the unit for awhile. Go show them how it's done.

I'm a paramedic! Had the test at 8 this morning. Got the results a little while ago.

Funny thing is, I know I missed the last question. I called my wife and told her I was pretty sure I had failed.

We jumped up and down when the website said "passed". We both worked so hard for this. Now she can quit her job that she hates so much and I can do what I've been wanting to do. It's a monumental day for us.

I personally don't have any problem in dealing with 'general questions' or a 'more personal' email. I'll do my best to answer any and all questions they have.

LS

Same here. Make it easy on yourself and do what works best for your class.

Are those pacer spikes or huge q waves?

That got me too. I finally decided it was huge q waves. The pacemaker spikes I've seen to date have always gone the same direction as the qrs. Am I off on that?

My partner drives like a mad man. It drives me crazy. I spend a lot of time holding onto the oh shiznit bar over the stretcher. Fast starts, hard breaking, excessive speeding and taking turns as fast as possible. A lot of times I've got one hand on the bar and one hand on the pt's shoulder- especially if the pt is obese.

My partner thinks he's the best driver in the world and he can do whatever he wants and will never wreck. I tell him it's not just about him thinking he will never wreck, but everyone else on the road and for God sake please quit throwing me around in the back. He sometimes causes the pts pain and I have to tell him he's hurting them and slow down dammit. Then he knows he's pissed me off and he'll notch it down for awhile. I really can't take it much more.

As far as speeding goes, it has it's place. Here the flow of traffic is usually 10-15 mph more than the posted limit. When I'm driving hot I do 80 on the interstate. Funny thing is that I still get passed by POVs a lot. Driving routine I usually do the speed limit, but will sometimes do 5-10 over. The main thing I think about is keeping it a smooth ride for the ones in the back. That means gradual acceleration, plenty of braking room and smooth turning.

Point is, just be smart about it. Leave the road rage in your POV. Be professional. Speed if you have to, just don't be an idiot.

[quote name='AnthonyM83' date='May 1 2009, 06:31 PM' post='213422'

I guess the best method would be to treat as a horse, but always assume you haven't eliminated the zebras. Make your treatments and decisions based on that mindset.

Good to know Vent. What's your take on the pt? You're probably better at EKGs than I am.

One of my old program director's favorite questions was, "If you hear hoof prints, what do you look for"? Inevitably, the new people would say "horses". He would say, "No! You're looking for zebras"! It was his philosophy that you should always look for the worst case scenarios first.

I happen to disagree with him on this one. Why would you intentionally overlook the most common and likely things to seek out what is most likely not there? It is my contention that you should look for what it probably is and go from there. I don't pretend to be Dr. House. I say let's start from what it probably is, not what it's probably not.

My .02 anyway.

Well, hypokalemia shows as a flattened T wave. This one is inverted so I'm guessing coronary ischemia. I'm not brilliant with EKGs like some of the folks here, so I'm giving high flow O2, ASA, maybe a nitro, high flow deisel and monitoring for changes.

Also what Gypsy said-let's get a BGL.

I didn't know there was a machine that would deliver albuterol constantly. If she's been recieving albuterol for an hour straight, the three things I would be concerned about are disrhythmias, bronchiospasm and hypokalemia.

Certainly d/c the albuterol and admin high flow O2. EKG please.

Congratulations Ruff.

The only reason I got to go to college is because I was a single father. If not for that, I would not have gotten a grant or been able to afford it. HOWEVER, if I were a minority, I could have gotten college paid for just for being me. All minorities get a free ride through college just for being minorities. Us WASPs must continue struggling and paying for other's education with our taxes while never getting the same opprtunities.

Don't play the f'ing race card with me buddy. Minorities have more opportunity than the rest of us. Either take advantage of it or shut the f up.

When someone that is too lazy to achieve something on their own blames it on racism, it just makes me want to punch them in the face. Stop with the cop outs and get it together.

Heres something else I learned at The City. No one has ever told us anything about a lido flush. We were told to flush with 10cc NS and aspirate to ensure placement. Then you could push whatever you needed to from there. Nothing ever said about pain management secondary to the I/O. I'll definitely be double checking the protocols when I go back to work Tuesday.

PM me where to send the patch.

I just took it a few weeks ago and passed. I injected a 10cc flush then aspirated to ensure placement.

It's all still pretty fresh in my mind, so if you have any other questions, fire away. You can PM me if you want.

Now wait a minute. The article says that the test was biased because too much emphasis was placed on memorization and written skills. To say that those skills should not be emphasized on a test taken by multiple cultures is racist in itself. Don't you think? It's simple. Study and educate yourself or fail. That is something everyone on this forum is familiar with.

it's the same test given to everyone. Everyone had equal notice for the test. Everyone had equal time and recources to pull from. Either you studied hard and were prepared, or you didn't. How could a test like that be discriminatory against a race of people? I have to call bullshit. Seriously.

Everyone had the same opportunity. Period.

CPAP- Pressurize the lungs to free up the alveoli. I think you did alright considering the O2 helped improve his breathing efforts. But I deff would have hooked up the CPAP.

CPAP as a field tx is something we are just getting into here. They are talking about nixing Furosemide for tx of CHF and using CPAP instead. Probably would have been a good idea for this guy if available. Since we don't do it yet, I didn't think of it.