For advocates of going directly to paramedic school...

[jwraider]

I have a few questions because it's what I'm doing (somewhat).

I became an EMT in Jan of last year (Jan 2007). I then worked full time for a very busy (1 call per hour avg) interfacility company until school started last August (2007).I completed a 100 hour "911 experience" internship during medic didactic/clinicals on a 911 ambulance where I performed BLS skills and discussed calls and patients from a medic standpoint with my preceptor.

I'm about to begin my internship and I'm wondering what pitfalls or problems I am prone to making due to my lack of 911 experience?

I know this is can be specific to the individual just wondering if there are common mistakes.

Things that scare me are.. I've never actually seen someone having a seizure... I've done several intubations but never actually placed an OPA (done in the OR during clinicals)... I haven't been on any calls with extrication assignments (which I'm guessing change the flow of a call)...

My school director feels my strengths will be my age (29), common sense, communication ability.

Thank you!

[mobey]

I'm about to begin my internship and I'm wondering what pitfalls or problems I am prone to making due to my lack of 911 experience?

The most common I have seen is non-911 people coming into a 911 service (whether that be EMT, RN, Paramedic, whoever) is not slowing down to do a good asessment and treatment plan. It seems people think "oh my god they called 911, I gotta drive fast and make lots of noise'. Which of course is a crock.

I would not worry about the "Monkey skills" such as OPA, non-visualized airways, I.V's on the move, these things come with time, and they are so simple (From a eye hand coordination standpoint) a monkey could do them. Same goes with a seizure Pt.

Scenes with MCI or prolonged extrication require some common sense and instinct to deal with. Either you got it or you don't.

[spenac]

It will not hurt you. Your education should cover these events so when confronted with them you will just do it. There is no valid excuse to stay at basic for x number of years before going for paramedic. Nothing I experienced in my many years as a basic and intermediate have improved my paramedic education experience. If anything it has harmed from bad habits I have picked up.

[mobey]

Nothing I experienced in my many years as a basic and intermediate have improved my paramedic education experience. If anything it has harmed from bad habits I have picked up.

I think this is one point that is far too overlooked (well maybe not on this site). It is amazing how we adapt to a local standard of care and make it our own habits. This holds especially true for people who have only been involved with one service throughout thier career.

Here are some bad habits I have seen follow people to school and hurt them in the long run:

Using SpO2 to dictate oxygen delivery

Doing vitals on scene in a "Load and go" situation

Having a Firemonkey do manual C-Spine to save time otherwise wasted on C-Collar and blocks

Only using 2 rates on an I.V. - Wide open, or TKVO

There are more but this gives you an idea.

[vs-eh?]

Here are some bad habits I have seen follow people to school and hurt them in the long run:

Using SpO2 to dictate oxygen delivery

Doing vitals on scene in a "Load and go" situation

Having a Firemonkey do manual C-Spine to save time otherwise wasted on C-Collar and blocks

Only using 2 rates on an I.V. - Wide open, or TKVO

There are more but this gives you an idea.

To comment on your items...

1. I have 3 years of paramedic education and admittedly I judge the average patient (98%) by putting on the SpO2 and palpating their pulse. People are lying if in general they don't. Judging their need for supplemental oxygen will always be subjective.

2. What is a "load and go" situation? I don't recall (even on police shootings) where I didn't have time to get a quick pressure or what not.

3. I don't even know what that means.

4. Admittedly, I only have the same rates (wide open = bolus). I have to "patch" if I want to technically run it other wise. The vomiting 23 year old that should get 125-250ml/h....

[mobey]

1. I have 3 years of paramedic education and admittedly I judge the average patient (98%) by putting on the SpO2 and palpating their pulse. WOW 3 years of education and you still treat the monitor. Strong regular radial, pink skin, 16 resps per min, SpO2 says 78% "Holy $hit give me a NRB :roll:

2. What is a "load and go" situation? I don't recall (even on police shootings) where I didn't have time to get a quick pressure or what not. Take ITLS much? Let's see... Linesman falls off powerpole, Altered mental status, chest injury, bilat femur fractures. And your going to sit on scene doing a blood pressure? I think that can wait for the rig.

3. I don't even know what that means.

4. Admittedly, I only have the same rates (wide open = bolus). I have to "patch" if I want to technically run it other wise. The vomiting 23 year old that should get 125-250ml/h....What .... the 23 y/o gets TKO? or wide open? I know I know drip rates are hard to calculate on the spot :roll:

[Don1977]

I think you should wait at least two years to go to medic school, It is foolish to go straight into medic class form EMt class.

[vs-eh?]

WOW 3 years of education and you still treat the monitor. Strong regular radial' date= pink skin, 16 resps per min, SpO2 says 78% "Holy $hit give me a NRB :roll:

2. Take ITLS much? Let's see... Linesman falls off powerpole, Altered mental status, chest injury, bilat femur fractures. And your going to sit on scene doing a blood pressure? I think that can wait for the rig.

3. I don't even know what that means.

4. What .... the 23 y/o gets TKO? or wide open? I know I know drip rates are hard to calculate on the spot :roll:

[JPINFV]

I think you should wait at least two years to go to medic school, It is foolish to go straight into medic class form EMt class.

Why?

I mean, sure, I could sit here and say anything. It's the reasoning behind the thought that counts.

[mobey]

I think you should wait at least two years to go to medic school, It is foolish to go straight into medic class form EMt class.

So with this "Pay your dues and get good at BLS *Whatever that means*" way of thinking, I pose a question;

If there was no such thing as EMT would we have a bunch of no-good medics running around? Think about it, if there was no bls/als...Just Paramedics, would they all be incompetent because they didn't run around for 2 years taking blood pressures and bitching they have no scope of practice??