Paramedic's tell me a what a new EMT should not do to......

[Asysin2leads]

I guess that's like my ultimate course for whackers, tactical underwater school bus extrication. For when a school bus is hijacked by terrorists and goes into the drink with kids trapped inside. I think my biggest pet peeve besides being a loud mouthed obnoxious dick with no sense of decency or tact is trying to help me make an ALS decision, or worse, the worse thing, questioning what I'm doing or having a better suggestion!!! Now, I'll clarify that, if its a suggestion like "I live around the block, and I know a short cut," or, "Let's not open that door, I saw a big dog go in a few minutes ago," fine, great, please, speak up.

But if its "Are you sure you want to pace him? I saw on Discovery Health that initiation of transcutaenous pacing in the field overall raises mortality rates." (That's not actually true, I just made it up), then by God, I will not be pacing the patient but rather your skull instead.

For whatever reason, on a scene, every single person automatically becomes a medical expert with a suggestion. Don't be one of them, or I will kill you. I mean it, too.

[buckeyedoc]

Don't try to impress me. If you know the basics and do your job right, that will be impressive enough.

Ok, with that being said, here's the basics you MUST know.

1. How to take a manual blood pressure...even when the bus (that's for your, Dust) is moving.

2. Like Dust said, know where things are. When I ask you to hand me a 5cc syringe with a 19 gauge needle on it, you better know where both of them are.

Oh, btw, we don't expect you to know where everything is on your first day, but the second, yes. The third if every truck isn't laid out the same.

3. Learn what you can, when you can. Downtime isn't always for sleeping. Take the time to study new procedures and more importantly, you're local protocols. I don't care what XYZ EMS dept is doing. They have no influence as to what our dept is doing.

4. Remember, the basic always buys lunch.

Ok, I'm sure there will be additions to this list by other members of "The City".

[Just Plain Ruff]

Learn to drive right and not the way they do it on turd watch, Rescue 911, and slaved

IF YOU COME TO WORK IMPAIRED IN ANY WAY YOU WILL NOT WORK WITH ME THAT DAY.

If you come up on a green light make sure you are ready to stop if it turns yellow.

DO NOT in the middle of the night assume there are no other drivers on the road. There are and they will hit you. If you get in a wreck in the ambulance with me in it and it is your fault, I'm gonna be PISSED especially if I have to take a drug test because the company says I have to.

Do not second guess me unless you are absolutely sure that you are right. DO NOT second guess me in front of the patient EVER!!!!!!!!!!!!!!!!!!!!!!! You can make a informed suggestion but I am the one who signs the paperwork as attendant.

Buy me a soda every once in a while, I will reciprocate twenty fold.

If I say move fast I mean it - there is something I've seen or heard or know that you don't.

If you say move fast I'll assume you know the same as above.

Know your district, study your maps, study the protocols, study the ambulance study the studier. The more you know the more likely I'm going to trust your suggestions.

NO CUSSING in front of me or the patient. I'll do the same for you.

If you steal from a patient do not pass go, I will report you and you will be fired. I will also report you for stealing to the police.

If you are on medication that may or may not hinder your performance as an emt DO NOT come to work. If you do come to work you need to tell me what meds you are taking. If those medications may in any way affect your work then stay home.

[vprater]

how to work the stretcher would be nice.

how to feather the brakes when stopping with my old decrepid fat as* in back standing on my head trying to wrestle a young buck weight lifter overdose would be nice.

how to drive the speed limit when asked would be nice.

give me some time i've got a long list

[becksdad]

Magicfitzpatrick, there you have great suggestions by seasoned Paramedics. Realize going in that you have 2 points of prejudice against you. 1)- you are an EMT; 2)- you are a NEW EMT. Do not let this bother you. The general reputation we EMT's have is not entirely undeserved, but it will be your responsibility to prove this perception wrong.

The comments about meds/drugs/stealing/etc. almost go without saying. Anyone who needs to be told these things does not belong in this field. Hopefully, you already recognize these principles as rules to be held inviolate. Everything else will be a learning curve - learn as much as you can as fast as you can, and make it a part of your being.

Notice that everyone mentions driving. In most instances, this is where everyone depends on YOU. Know how your truck handles. Ambulances are bumpy rides at best, and they pitch and roll easily with every manuever. Drive as if there is a full glass of water sitting in the back and your job is to not spill it. This is especially imperative when you transport lights & sirens because in that case your partner (and possibly others) are standing, moving around in the back, attending to a critical patient. It is easy to throw them off balance. Remember that scene safety for you and your partner remain first priority throughout the entire call.

Do a complete and thorough checklist every shift. This is the best way to quickly learn where everything is. The first time you pencil-whip a checklist will be the time you need something that is missing. With your partners permission, look through and learn about ALL ALS supplies. Become expert in supporting your partner.

Be an expert in BLS care. Assess your patients accurately and frequently. Communicate changes to your partner. Nothing will build confidence in your abilities like being aware of a patients evolving condition. And nothing will erode it like the "deer in the headlights" look. Also as mentioned, become proficient at obtaining manual vital signs. Under any circumstances.

Here's one that hasn't been mentioned yet: be a strong advocate for your patient. Know when it is appropriate to take charge of a situation. Sooner or later you are bound to run across someone about to do something stupid. Two recent examples that come to mind are 1)- a patient being immobilized on LSB, and first responders immobilized the head but not the rest of the body and were about to carry said patient unrestrained on the board. 2)- a patient who had a fall in excess of 20 feet, with obvious bi-lateral arm fractures being WALKED towards the ambulance as we pull up. These are examples of situations where you should stop everyone and direct actions step by step.

Study. A lot. The education has just begun. We can learn something every single day. Ask questions. Discuss calls. Some partners may not want to entertain discussions of things medical. That's OK. You will find others who will. Make it your goal to be absolutely the best EMT you can be every single day. Your personal mission, should you choose to accept it, is to take the generally poor reputation of EMT's and transform it into mutual trust and respect.

Realize that you will make mistakes. It will be your response to them that defines your career. Do not feel as if you must become indignant or defensive when constructive criticism is directed towards you. Use mistakes as an opportunity to learn and fine tune your craft. But do everything in your power to not make the same mistake twice.

Above all - DON'T BE A WHACKER!!! I refer you to other posts on EMT CITY regarding whackerism. Realize that your partner makes or breaks this job, and make sure that YOU are absolutely the best partner anyone could ask for. That could be a book in its own right, but you will come to understand many things regarding this as you live it. I wish you (and your future partners!) the very best as you embark on this career path!

[bassnmedic]

Excellent reply Becksdad, very well said. I would like to add a couple of things to this list of do's and don'ts. I know it's been said already a few times,however, remember Fitz just because you are running lights and sirens to or from a call does not mean run 104mph. Don't tell us your war stories from your 30 minutes of experience or talk badly about your previous partners, chances are I am friends of theirs. DO learn absolutely as much about your job as humanly possible and be thorough in everything you do. Give your patient, partner, yourself and your employer 100%.Don't ask us what the grossest thing we have ever seen is. Be a good partner and a good EMT and it will come back to you 10 fold, be a bad partner and it will come back to you 100 fold.

Good luck in career and endeavors,

Todd

[ptfd121]

I think becsdad hit the nail on the head also. Very good response. I wish I would have mentioned driving first. Although I have worked with some excellent EMTs, most of whom were older than myself and had been doing this longer than me, I worked with one younger EMT I could not stand. He was sloppy- his shirt always untucked, a dirty ball cap on his head. He didn't care for the patient, called most of them his"losers of the day". This guy had no medical skills whatsoever. He couldn't even operate an airsplint. He drove like a maniac riding on peoples bumpers and flashing his headlights if they wouldn't get out of his way, then he would cuss and flip them off. Real proffesional. This cat was a manic depresive to boot. He was always depressed about his life,wife,girlfriend, money or lack of it. The company we worked for refused to fire him because he was a warm body able to drive a truck, no mater how bad he drove. He would spend most of his day daydreaming about apoening a strip club and buying crap for his little Jap riceburner.

The topper was the nite he wouldn't get up for calls. I finally got his assholiness out of his bunk to get to a call and what does he do, pops a Percocet right in front of me, then brags about it being his 5th one of the day. I had to take the truck out of service, miss a call. The company lost money that night so they finally fired the loser. I think he works at Burger King these days.

[fallout]

From someone who is a fairly new EMT (1 year experience) in an ALS system.

Once the patient is off the stretcher, and if you weren't the attendant, get the stretcher and yourself out of the ER. They are busy places and don't really need random junk around.

Clean the truck up after the call. Nothing is worse than catching a call in the ER dock and having the truck a mess when you get on scene.

When you have downtime, restock everything you used.

If you don't know about something, ask the incharge on your ambulance. Not reading their mind is ok, not asking when you can't isn't.

Know how to spike a bag correctly.

Know how to pull up a saline flush and set up a lock.

Understand the basics of the monitor. No one is asking you to set up a pacer or anything, but know how to attach the multi-function pads, know how to print out strips, turn the thing on, etc.

Err on the side of caution. If you see something that doesn't seem safe, say so. I'd rather have my partner overcautious and healthy than apathetic and hurt.

[THUMPER1156]

Despite what you might hear/be told EMT's are not goffers for ALS.We were not trained to be a taxi driver .There are alot of paramedics who fall under the same things they claim about EMT's.Its true theres alot of EMT's that shouldn't be in the field. It's also true that theres way to many people on a power trip .If people would do their jobs & not worry about whose the best more would get accomplished.Theres far to many rumors & attitudes.This job is stressful enough without all the bs that goes on in the workplace.I'm sooo sick of hearing; "I been doing this for 25 yrs.". Sorry but you still don't know everything.I agree about the stretcher thing.Theres alot of people that can"t/don't know how to lift it or a patient for that matter. I think the EMT course should spend more time on that issue. Wether your 18 or 80 if you can't lift ...find another job.The use of lights & sirens is another issue.The deffinition of emergency or grannies g-tube is blocked. Some people seem to forget, if its an emergency or not ,you wreck its your ass.....

[MAGICFITZPATRICK]

Im lovin this...keep it comming.