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what EMT-Bs should know, outside the textbook


Riblett

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I am teaching part of an EMT-B class soon and am working on lesson plans.

I pose the question to field personnel and other instructors: Within the topics of SAMPLE, baseline vitals, and physical exam is there anything you find especially important? For the seasoned providers, is there anything you consistently see EMTs not being taught that you think they should? Is there anything you wish you had learned in class, etc?

Opinions from all levels of providers are welcomed.

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You'll think this is silly, but I'm completely serious.

To calm down and think.

I was able to proctor at a couple of NR skills tests. The thing that struck me over and over was that I saw these kids know their skill sheets to a T, but go to pieces when they had to test. Panic is not conducive to rational, logical thought.

Being calm is a skill. It needs to be learned like any other skill.

I told you you'd think it was silly... :wink:

Dwayne

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Dwayne, you are not silly nor was your comment silly

I remember back in the day when I had to take the state skill stations. I was a nervous wreck as probably every person out there in EMTCity was too.

I think this is one of the biggest disservice in class that we make to the students.

I too used to proctor or evaluate the new emt's to be and every last one of them were breathing fast, shaking hands, sweating and other things. I even saw some of them vomit or pass out due to the stress.

Why do we put them thru this type of environment.

I know my instructor told me this "If you don't pass the skills part then you have to take it again. If you don't pass it again, then you have to retake the class" which is what he told the entire class.

Our entire class was focused on that single day in the future when we would go up against the juggernaut of the State Board of EMS testing folks who we were told were strict and stalinistic(in not so many words). It all hinged on one single day.

Now I'm not saying to make it easier, I'm saying that we need to prepare the students not for taking the test cause they will take the test once maybe twice but to prepare the students for life on the streets.

It goes doubly important to train the student for the streets and to think on their feet for medic students.

just my two cents.

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Dwayne and Ruffems have already covered a very important area that we as instructors don't always do enough on to make sure our students are prepared.

Something that always bothers me when I get a class is the student that won't touch his or her patient. There are always those students who can recite the complete assessment to perfection, but won't touch their patient.... you know the ones.. as they are standing over their patient, they are reciting "I am exposing and palpating... looking for... listening for..." but they haven't even kneeled down next to their patient.

Touch is a very important part of assessment. Students need to learn to break through those personal space barriers and be able to touch their patient to obtain valuable information that they can't get just from visual assessment. For some students, this is hard to do, and they are uncomfortable, but they won't be able to complete a quality assessment without learning to touch a patient.

And, like everything else we do, this comes with practice, practice, practice....

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Let's discuss one other very very very important aspect of EMT training.

Scene safety

I've seen more new emt's go into dangerous situations than I can care to remember.

some have ended badly some not.

The 1 hour lecture I got on scene safety is not enough.

I wrote an article for the ems journal Fieldmedics journal focusing on scene safety. Those of you who are interested might want to check it out.

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Emphasize that they are only receiving a very basic education and to provide the patients with the best of care they need to continue on to paramedic. They need to understand that they must always be learning or they are hurting patients and the profession.

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Spenac,

Definitely agree with your post. In some ways, I feel that I may be contributing to the decline of the profession (or at least compromising progress) by continuing the 120 hour EMT class. I myself am in my last semester of an A.A.S. Degree paramedic program and believe it should be the minimal requirement for medics.

However, the class is being taught through a 4 year college and most of these students are biomedical engineering and pre-med students doing this as a stepping stone into something else or taking it just for the experience. Just some thoughts.

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I had a great basic instructor, I will share his traits with you and you can filter them as you like.

On our first day of school after the introductions he started by saying, "This course will only teach you how to safely transport the public to the hospital without causing them any further injury." This convinced me that I was only taking an introductory course to EMS, which of course kept me in school to take the ICP (EMT-I) course as soon as I could.

Other charicteristics:

He was very preticular about everything. Such as wrapping the leads on the SPO2 monitor as to not stress the connections. When we left a scene in a scenario there could not be any garbage left on scene at all. Always wear 2 pairs of gloves to a trauma and if you touch blood then touch the cot or bags without removing the outer pair you failed the safety portion of the scenario.

He was very critical of the little things such as counting before you lift, Eye contact with your patient, communication with your partner, tone and volume of your voice, and lots more.

We never got away with doing anything half-assed, alot of people did not like him for that reason, but by the end of the course we all appreciated it.

Oh ya... He never gave us a pat on the back unless we truly deserved it. If we did something wrong, it was wrong no sugar coating. But if we did something right we knew it and he made sure of it.

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