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what EMT-Bs should know, outside the textbook


Riblett

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I stand corrected. Balance is a better word than mesh, but I was trying to say the same thing. And what I was meaning about "throwing the books away" I wasn't referring throwing the book information away.

Sorry for the confusion.

i agree there is definitely balance and it cnt be forgotten what we learn in class is just as important if not more important than the street knowledge that we aquire

we all have to learn this and it isnt handed to us we just kinda go with the flow until we get our own rythm as for not throwing out books......NO WAY

best to go back if ever need to especially with a skill not practiced much to review and reevluate

it will make u a better practioner for this

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Whats in the book is correct for the most part. You just learn how it all ties together so it seems you are doing things different than what the book says. You find out many steps are actually done in one action not several separate ones. You will see some very bad methods that go against your books from some in the field. These are the people that when sued lose. Why you ask, because the attorney says why did you do it this way, then regardless of answer they show the book which is considered the standard of care. If you do not have black and white backing you, you lose.

Never throw out your books. I still have my first responder and basic books and have referred back to them for ideas and even have been able to use them for some of the research in my paramedic course.

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It's not something you can teach, but I tell my students USE COMMON SENSE! When doing the SAMPLE history, many students think that all questions apply to all scenarios. They get a difficulty breathing patient and demand to know, Does your pain radiate? How bad is the pain on a scale of 1-10, even though the "patient" insists that they have no pain. Once they learn the patient assessment by rote, put away the written material and make them think through different scenarios. The ones who lack common sense will hopefully not finish the class successfully.

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It's not something you can teach, but I tell my students USE COMMON SENSE! When doing the SAMPLE history, many students think that all questions apply to all scenarios. They get a difficulty breathing patient and demand to know, Does your pain radiate? How bad is the pain on a scale of 1-10, even though the "patient" insists that they have no pain. Once they learn the patient assessment by rote, put away the written material and make them think through different scenarios. The ones who lack common sense will hopefully not finish the class successfully.

I've always stressed that Common Sense is your best route. Start with common sense and go on from there. Of course there is always someone in a class you are teaching that shows no common sense what-so-ever. But they usually come around.

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I've always stressed that Common Sense is your best route. Start with common sense and go on from there. Of course there is always someone in a class you are teaching that shows no common sense what-so-ever. But they usually come around.

Excellent points! Although, just as commonly, I find it is the instructors that have little common sense, so it becomes both contagious and endemic in a given system.

But yes, common sense has to be stressed. Too often, we are simply sending n00bs out to the field with all these memorised recipies to work from, but not real understanding of what it all means. They burn through their SAMPLE and DCAPBTLS, and all the other stupid, pointless mnemonics we have cooked up in the last few years, like pros. But when it's all said and done, they don't have the slightest clue what to do with the information they just obtained. They lack the ability to piece it all together with logical, common sense problem solving ability. This was illustrated in a recent post here where somebody was talking about stopping at an accident off-duty, and how important their intervention was because they took a pulse. Say what? And what exactly did you do with that pulse? Did taking the patient's pulse improve his condition? If he was conscious and alert, did you really doubt that he had a pulse to begin with? This is where common sense comes in. The practice of EMS is a LOT more than memorising the checklist steps of a collection of dubious "skills". The practice of EMS involves putting it all together to develop an assessment of your patient that ANSWERS questions, instead of just asking them. And once that is done, your treatment plan should not come straight from the cookbook. Those steps must be filtered through your own common sense to determine what is actually appropriate for your patient.

Common sense rates right up there on equal footing with intelligence and aptitude as important personal elements necessary for success in EMS. And without those, even the best education and experience in the world will not result in you becoming a competent practitioner.

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Yeah, common sense would be a goody, especially when it comes to identifying critical patients. Rather than stressing pulse, respiration and BP ranges, they should stress signs that someone is really sick, such as:

1. They look really sick.

2. They're not responding.

3. They're not breathing.

Things like that.

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i saw somewhere above that students have problems with personal boundaries.. One.. You can be wary of your own personal boundaries all you want but in our job we get paid to invade others personal boundaries on a daily basis. When you think of a patient that can't get out of their wheelchair or something like that you have to do a 2 man transfer from wheelchair to cot.. it's a bitch for those heavier patients but it can be done and I have done that alot in the last few weeks..only thing is I invade a person's personal boundaries to do that.. reaching around their chest/abdomen area to get them moved over to the cot.. and then my partner gets their legs.. How many people would be comfortable with getting man handled like that.. none of us but we have to make it our job to break through people personal boundaries to get information out of them and to be able to work on the effectively.. That is one skill that isn't really taught but it is learned if you want to be good at your job.

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i saw somewhere above that students have problems with personal boundaries.. One.. You can be wary of your own personal boundaries all you want but in our job we get paid to invade others personal boundaries on a daily basis. When you think of a patient that can't get out of their wheelchair or something like that you have to do a 2 man transfer from wheelchair to cot.. it's a bitch for those heavier patients but it can be done and I have done that alot in the last few weeks..only thing is I invade a person's personal boundaries to do that.. reaching around their chest/abdomen area to get them moved over to the cot.. and then my partner gets their legs.. How many people would be comfortable with getting man handled like that.. none of us but we have to make it our job to break through people personal boundaries to get information out of them and to be able to work on the effectively.. That is one skill that isn't really taught but it is learned if you want to be good at your job.

How true. Other points where we invade personal space is to listen to lung sounds, helping hook up EKG, checking OB patients, trauma patients are naked patients, and I'm sure there are more times we get up close and personal.

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One of the first things emphasized is that when someone is hooked up to an EKG is that you treat the patient, not the monitor. Monitor shows V-fib but the guy is looking at you and joking, you're not going to d-fib him. I've seen it tried. :roll: This can be carried over to other signs and symptoms.

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