Staying calm in the field

[HERBIE1]

I flew search and rescue in pensacola Florida- we used to respond to calls like- Man drowning(thank god for rescue swimmers)-ship sinking, Big ship sinking, jet crashed, pilot ejected. Blue Angels touched wings during training mission go on stand-by. kid missing near everglades with alligators in area. Just really hyped calls. I was a NREMT basic, we had a trauma bag with limited airway stuff, no pain meds-

and enough stuff to treat maybee two trauma casess, We trained trained and trained some more so that lots of bad calls were just second nature. We had a flight surgeon who said first thing you do on scene is take your own pulse, follow your ABC's, and if nothing else

remember to put the patient in the stokes liter or cot and fly them to the hospital. or get the patient in the cot/ambulance and drive them to the hospital. Currently I am a medic for 15 years-8 years on the road and 6 months in the ER.Now Military stuff and civvy stuff are two

different animals- but do your training and remember your basics. With out good CPR and Airway control- ACLS does not work as well.

My first call as a brand new basic corpsman was watching 3 marines get burried alive by a tank- Got the first two out in time, guy 3 was bluer than poppa smurf and had suffocated- we worked him anyway-.So my first call as a corpsman my patient died.Talk about depressing,

then my first pilot ejection, a marine captain ejected from his burning Harrior jet, he was dead also Broken neck-Broken arm- Torn

Aorta,- Just about all my patients as a SAR corpsman were Dead. But I stayed in EMS and learned from every call- and used my knowledge

to help others. My kit was so limited that on night missions(without NVG's) I had to put a roll of white tape on the patients

chest to watch it go up and down just to see if they were breathing. we learned to adapt and overcome and do the best with what we had.

Hang in there-I do this job beacause I like to make a difference. Good luck. Watch your six.

Sounds like you've had some interesting experiences. BTW-I really like the white tape to check for respirations in a dark environment. There have been a few times in multiple patient triage situations where that would have been helpful- even in an urban setting. (Dark alleys, vacant lots, houses with no electricity, etc.) I have to remember that the next time a situation arises when I'm trying to assess and treat multiple patients.

God bless surgical tape. I use it as a notepad on my pants for V/S or details for a quick radio report, a strip across a patient's forehead to secure them to a backboard is also a great notepad if you do not have triage tags readily available- V/S, triage code, patient's name/age, designated transport hospital, etc.

[uglyEMT]

While I am not a medic I am a basic but think I can help a little.

When I first came out of basic school and got on my bus I was a nervous wreck. I mean sweating through my cloths nervous. I think I actually paniced patients because of it. I thought I would never get any better but as I went on more calls, sat with more patients I got calmer.

I think experience has alot to do with it BUT I also feel SELF confidence has more to do with it. I am now confident in myself that I can do things. I know my ABCs, I know to keep an airway, I am getting better at my BPs (ok onscene I hear them clearly, on the road not so much, but getting better at it). As long as I remember that ABC is the most important thing I feel calmer. Without ABC nothing is going to change.

Thats what it took for me, NOT looking at everything and feeling overwhelmed. Basics... if I dont have an airway nothing changes, if I dont have breathing nothing changes, if I dont have circulation nothing changes. OK I have all that.. now lets see what can be done.

As someone else posted when all else fails you sink to your level of training. Just keep practicing and training and when the time comes it will be second nature and wont feel overwhelming.

Are there going to be calls that will scare you to death, yes. I have seen great, calm, cool, collected medics look all doe eyed in my rig when a call goes south but what made them great was that they took that split second, took a breath and started with what they knew best and went from there.

It will get better and just remeber to treat your patient, remeber the basics, and when all else fails take a breath and go from what you know best.

Hope my little tidbit from basic land helps.

[Richard B the EMT]

For 38 years, I have been of the philosophy, if you start to lose it on a call, stop, take a deep breath, remember you're trying to help this person, then do it. After you get to the hospital, nobody minds if you go the latrine and puke for a while. Been there, done that, and sure I am not alone in having done that.

[kohlerrf]

Ive been a medic for some time now and if I can pass anything to you I hope it will be these 2 thoughts...1)TURN THE SIREN OFF! and 2)You cannot change the course of mighty rivers nor can you can you bend steel with your bare hands.

[Riblett]

I have just reached my two year mark as a medic, with three years at EMT-B and EMT-I level. I can tell you that the old cliche is true, it does get better with time. But to get there, you WILL have your freak out moments, you WILL spin, and you WILL have those calls where (in the words of Kelly Grayson) they wouldn't be be able to shove a knitting needle up your ass with a sledgehammer. Your first calls of every type will be scary, but when you see the same situation again it will become second nature.

There is absolutely nothing wrong with keeping your protocol book in your pocket. In fact, I think all good medics will do that even many years on to their careers. And as a newbie, I lived by my ALS field guide. It was ironic because as a paramedic student I always felt sure of myself, because the final decision alway rested with someone else. As soon as I got that paramedic card, I began second guessing even my EMT/EMT-I level treatments.

When all else fails, BLS before you ALS remember that it's not YOUR emergency. Air goes in and out, blood goes round and round, any variation of these things is bad. Focus on fixing the problem and don't be tempted to overthink. And just so you know, everyone still gets scared on pediatric calls, no matter how long they have been on the job. Anyone who tells you otherwise isn't being honest with you.