Starting EMT school

[JBE]

I took the NEMSA class through SLCC. My basic in Alexandria and split my Paramedic, half in Alexandria then moved down to Lafayette. DO DO DO the objectives!!! I can't stress that enough! ALL their tests are from those objectives. The reason being, those objectives make you pretty much read your chapters. If you go through NEMSA in Lafayette, all the instructors are really good and eager to answer questions. Hope this helps...if you want some more detailed info on NEMSA send me a message. I'll be glad to help out as much as I can.

Sounds like your instructors had the same paramedic instructor that I did...He wouldn't sign off for us to go test until we had completed our objectives and turned them in...

We used to put MAST on every cardiac arrest for a while there back in the early nineties. Then we'd give Calcium and Bicarb. Remember the danger of precipitating if you didn't flush the line completely?

The Lifepack 5 was awesome. We had a fire and lost our brand new LP10. This was a small department with only two ALS units. So we had to borrow a monitor until physio could get us another one. The Lifepack 4 was what we got. It was 14 years out of production but beggars couldn't be choosers.



Yeah it weighed 37 lbs. It had lead acid batteries in it. So I was told anyway. You couldn't get to them. We did over 100 full power 360 joules defib's into the test station after the new monitor came in just to see what I could do. The battery still had power and the monitor worked. We were worried about damaging the test station at that point so we quit. It was awesome. Unless you had to carry it anywhere...

It's just possible that I might be the last active medic to ever have used one of those things in the field.

Dave

I remember when they wanted us to give Bicarb early in the arrest period...

I have a good friend who has been working the field since the mid-70's and he would relate stories of them giving bicarb the way we give epi now...Bicarb then was a first-line drug...Go figure...His paramedic class was only like 80-hrs long at the time...

Never did put MAST on an arrest patient, but put them on a few traumas...

The first service I worked for had at least one of those old LifePak 4's in the supply room in the back corner...I don't think they worked anymore at the time but I remember picking one up and thinking "Damn, this thing is heavy!"

Remember the old Thomas half-ring traction splints?

 

[dwr461]

I never had the "pleasure" of using the Thomas splints.

How about isoprel? Would that put the moo back in ground beef or what?

Did you ever get to use a Ferno Model 29a stretcher? It sort of similar to the 29m but it didn't have a load position. You put it to the ground then you picked the whole thing up with the pt on it and put in the back of the truck.

Dave

 

[JBE]

Did you ever get to use a Ferno Model 29a stretcher? It sort of similar to the 29m but it didn't have a load position. You put it to the ground then you picked the whole thing up with the pt on it and put in the back of the truck.

Dave

The first service I worked for had 29's (H-frames - we called them "one-man stretchers" because 1 person could load them in a unit without a patient on them) on our mainline units but our spare trucks had the old model 30's on them (X-frame, aka "two-man stretcher," aka "back-breakers") so I did have some limited (thank God!) experience with them...

 

[Rakkasan]

Can't give you much direction on what to study these days. Got my basic in the military in 1989, Intermediate in Alabama in 1993 (Intermediates in Alabama can perform intubation, 12 lead EKG interpretation, IVs, needle cricothyrotomy, chest needle decompression but no medications). Finished my paramedic in 1995 in Louisiana. Alot has changed in the last 17 years. I remember when they were going to phase out Intermediate and then added skills to the basic curriculum (assisting the patient with medication admin. and such). Alot of medications have changed as it used to be lidocaine, procainamide and bertilium in the v-tach/fib protocol. Bertilium is not made anymore IIRC, and Amiodarone has replaced the the others. I think Pitocin and Procardia were also removed from the jump bag, but cardizem and solu-medrol were added. What I can direct you in is the career path you may be taking. Emergency Medical Services is a hard career to spend 20-30 years in, and I only have a few friend who have endured longevity in the profession. Back injuries are common. Many burnout and get out of the profession all together. I had a friend completely rupture tendons in both forearms from a stretcher that collapsed with a patient on it. He had reconstructive surgery and his career is over. There are not alot of old timers around, and that says alot about the profession. I have worked for over a dozen services in the New Orleans area, but the options in employers are slim these days. A few companies have bought all the mom and pop services up, and you are expendable with some of these companies (suspensions are common over BS things). I don't know many paramedics who are happy in the profession, and many just go through the motions. The real money is in international safety with the oil industry (100K salary is not uncommon with safety bonus and such). Keep in mind you will need experience and advanced training for this (antibiotics and suturing come to mind), and you will do months at a time overseas in isolated places. If you are single and young, you can live anywhere in the world doing international work. I have friends who have lived abroad for over 10 years doing international work and they love it. It's not much for the family oriented person however. I received my BSN RN and BA in Psychology in 2000. Staff nursing in a hospital is getting pretty bad also. I recently received my Masters of Science in Nursing as an Adult Nurse Practitioner and am going into private practice. If I could do it all over over again, I would have gone one of two routes. Stayed a basic, went to an associates degree nursing program, worked as a RN while obtaining my BSN and then onto an advanced practice program. The other route after obtaining my paramedic would have been to attend a Physician Assistant Program. Back in the day, the only program was through LSU in Shreveport and this would would have required moving. There are however many programs throughout the state now, but I think they all require a Bachelor degree to apply. Then again, you may love being a paramedic and spend 30 plus years in the profession. It really can be a rewarding profession and my hats off to the old-timers still on the crash wagons. I guess the point is to get some experience as a basic, and make sure that this is what you will want to do as a career before investing the additional years obtaining the blue and gold patch. If there is any anything I can help you with, feel free to drop me a line.

 

[dwr461]

I don't know many paramedics who are happy in the profession, and many just go through the motions.

Very common for medics in the 4 to 8 year range in my department at least. If you make it through the 8 year and into the 10 year mark. You learn to work through burn out and become a better medic in the end. If you don't have the ability to handle this job as a career you move on. The average "career" as a medic in EBR EMS is five years.

Very few people were born or were taught the needed set of coping skills in their emotional toolbox to do this job long term. I had most of the emotional coping mechanisms in place after my let's just say "emotionally challenging" youth and have learned the rest.

However I'm happy as a medic and don't go through the motions. I don't want to be a physician's assistant, nurse, or doctor. I don't want to work inside a fluorescently lit box.

Dave

 

[bayoupirate]

Tourniquet use has been revised and is now back in the manual for EMS.
Used right after direct pressure.
Pressure points are given less attention.

 

[BobKaro]

Lots of good advice in this thread so far. As dumb as this sounds, SHOW UP TO CLASS ON TIME. You were in the service and have some life experience, so you probably won't slack off. But damn, they have a lot of basic students who end up failing out because they kept showing up late.

Chances are, I'll be helping teach your class skills on some days. If you need advice or anything, feel free to PM me.

 

[CPL_Primeaux]

Awesome thanks guys. I will keep all this in mind. I have thought about the emotional strain the job would put on me. I have been in many stressful situations so , I hope that it will help with the emotional toll. I also tend to not get emotionally attached to people I dont know. I like helping people but at the same time I could walk away from someone and be able to sleep at night. Done it before and Im sur I will again(Not including friends or family of course). I liked being a CLS and have wanted to do EMT for a while. I have been thinking on it for about 2 years now and still think I would want to so thats a plus.

Sometimes I get those wild bugs up my ass and really like something, then jump to it to fast ,pursue it in school and realize wtf am I doing here(auto body repair ) What a waste.

So I thought this one out a while and its still interesting to me. We will see what happens. I got my FASFA **** back and am going this week to talk to the financial aid person at SLCC to set up an appointment .

 

[JBE]

Awesome thanks guys. I will keep all this in mind. I have thought about the emotional strain the job would put on me. I have been in many stressful situations so , I hope that it will help with the emotional toll. I also tend to not get emotionally attached to people I dont know. I like helping people but at the same time I could walk away from someone and be able to sleep at night. Done it before and Im sur I will again(Not including friends or family of course). I liked being a CLS and have wanted to do EMT for a while. I have been thinking on it for about 2 years now and still think I would want to so thats a plus.

It's only emotionally-straining and stressful if you allow it to be....EMS, like most jobs, is what YOU make of it....

It's okay not to get emotionally attached, but at the same time you need to allow yourself to feel some sympathy/empathy towards your patients...Still, at times, it's hard not to feel some degree of emotional attachment with certain patients...Remember, you are human...the whole "medics are supposed to be supermen who feel nothing" is ******** and if you don't allow yourself to feel something you will become jaded...if you allow yourself to feel too much, though, you will become burned out....There's a fine line somewhere between the two that you have to walk....

One other piece of advice, if you do follow this through and into a career, DON'T become the job!!!! Don't let it define who you are....just let it define what you do....

 

[1911Dave]

It's only emotionally-straining and stressful if you allow it to be....EMS, like most jobs, is what YOU make of it....

It's okay not to get emotionally attached, but at the same time you need to allow yourself to feel some sympathy/empathy towards your patients...Still, at times, it's hard not to feel some degree of emotional attachment with certain patients...Remember, you are human...the whole "medics are supposed to be supermen who feel nothing" is ******** and if you don't allow yourself to feel something you will become jaded...if you allow yourself to feel too much, though, you will become burned out....There's a fine line somewhere between the two that you have to walk....

Well said. I am a respiratory therapist and we deal with a lot of end stage patients. You have to draw that fine line of not getting too attached, but also have some sort of attachment at the same time as not to be a soulless creature. It shows with a lot of medical personnel I have dealt with. I think it makes you a better healthcare worker by being human about things.

 

[dwr461]

You want to help people? In EMS? Seriously? Doesn't happen often enough in this career to fill one's emotional tank in my opinion. I have other reasons that keep me going. Although it is nice to be able to help someone, when it actually works out that way.

A far more important EMS skill is sounding concerned about people. If you're good at it they'll think you mean it. Practice saying, "Oh my that's terrible."

I say that all the time. However, I don't mean it when I say it.

What I actually mean, "I could give a crap less."

Here's an example, minor MVA with rear damage to pt's car. He wants me to "check" him out. There's zero chance of a hyperextension injury here. Trust me, I was there. Anyway, the dumb paramedic gets indignant because this call's a waste of time and people are dying out there! They start the assessment by saying things like, "I don't have an x ray machine on me today so how can I tell if you have an injury?"

The smart medic says, "Oh my that's terrible that your neck hurts. I feel bad about that. But I can't do anything for you but bring you to the hospital. Only you actually know how your neck feels, not me. If you think that you'd like to go to the ER I'd be more than happy to bring you."

Turns out I get to leave the idiot O/S far more frequently when I do the later rather than the former. Of course I don't mean it. But they think I do and that is what's important. Turns out for medicaid people the ambulance is free and they'll go just to **** you off. They got plenty of free time.



Dave

 

[JBE]

Here's an example, minor MVA with rear damage to pt's car. He wants me to "check" him out. There's zero chance of a hyperextension injury here. Trust me, I was there. Anyway, the dumb paramedic gets indignant because this call's a waste of time and people are dying out there! They start the assessment by saying things like, "I don't have an x ray machine on me today so how can I tell if you have an injury?"

The smart medic says, "Oh my that's terrible that your neck hurts. I feel bad about that. But I can't do anything for you but bring you to the hospital. Only you actually know how your neck feels, not me. If you think that you'd like to go to the ER I'd be more than happy to bring you."



Dave

I used to do something similar but I combined the two....I would tell them that only a doctor can clear them of any injury and that I can't but that I'd be more than happy to bring them to the ER to be "triaged".....Most bullshitters know what triage at the ER is and want no part of the waiting game that's played there....

 

[Unspecified]

A lot of the strain you may not be prepared for is boredom and coping with patients who are abusing the system. These are stressful times as well. The horrible things you see are a different strain, but seem easier to cope with. Patience is hard learned, and maintaining a compassionate and thorough approach is VERY hard to do over time but absolutely essential. Just try to absorb everything you can, because once you go to the paramedic level, you quickly realize you have no one to turn to for help in the most terrifying and stressful situations, and your experience will be your only guide. That and study the local protocols for where you plan to work.

 

[Rakkasan]

Get you a basic partner that has 20 years experience. You will learn alot from the old school basics.

 

[CPL_Primeaux]

You want to help people? In EMS? Seriously? Doesn't happen often enough in this career to fill one's emotional tank in my opinion. I have other reasons that keep me going. Although it is nice to be able to help someone, when it actually works out that way.

A far more important EMS skill is sounding concerned about people. If you're good at it they'll think you mean it. Practice saying, "Oh my that's terrible."

I say that all the time. However, I don't mean it when I say it.

What I actually mean, "I could give a crap less."

Here's an example, minor MVA with rear damage to pt's car. He wants me to "check" him out. There's zero chance of a hyperextension injury here. Trust me, I was there. Anyway, the dumb paramedic gets indignant because this call's a waste of time and people are dying out there! They start the assessment by saying things like, "I don't have an x ray machine on me today so how can I tell if you have an injury?"

The smart medic says, "Oh my that's terrible that your neck hurts. I feel bad about that. But I can't do anything for you but bring you to the hospital. Only you actually know how your neck feels, not me. If you think that you'd like to go to the ER I'd be more than happy to bring you."

Turns out I get to leave the idiot O/S far more frequently when I do the later rather than the former. Of course I don't mean it. But they think I do and that is what's important. Turns out for medicaid people the ambulance is free and they'll go just to **** you off. They got plenty of free time.



Dave

Yeah I said I like helping people and I do when I can. I dont know why thats hard to believe but I never said it was the main reason I chose to go EMT. I chose it so it will put me back into the ****. Get the rush of going to a gunshot victim or a stab victim. I dont want to be LEO , so I chose EMT. Like I said, I dont get attached to people I dont know, doesnt mean I wont help them but I wont get attached to them. You all are giving some pretty good points and I will have to practice showing compassion.Something I never really had to do and have not thought about but it does make sense and will have to do that. Thanks for all the advice from everyone.

 

[JBE]

I chose it so it will put me back into the ****. Get the rush of going to a gunshot victim or a stab victim. I dont want to be LEO , so I chose EMT.

If that's the primary reason you are doing it then you will be severely disappointed....

 

[CPL_Primeaux]

I guess I made sound a bit more exciting than it will be. I mean, I didnt mean it literally . It beats washing dishes which is what I have been doin for the past 5 God damn years. I dont even really know what to expect, I have never been an EMT but its going to be better than this BS Im doing now

 

[dwr461]

I chose it so it will put me back into the ****. Get the rush of going to a gunshot victim or a stab victim. I dont want to be LEO , so I chose EMT.

Unfortunately at AASI it'll mostly be transfers and BS. EBR EMS gets far more true emergencies than Acadian as a percentage of our call volume.

Dave

 

[JBE]

Unfortunately at AASI it'll mostly be transfers and BS. EBR EMS gets far more true emergencies than Acadian as a percentage of our call volume.

Dave

Well, if he really wants excitement, he can always go work for N.O. EMS...

 

[dwr461]

Well, if he really wants excitement, he can always go work for N.O. EMS...

Well since Katrina I'm not sure who's busier. We're running over 50K calls with 13 trucks during the day and 11 at night. As far as murder rate per 100,000 people NO is still number one and BR is only number 7 nationally. But as we know murders are very easy for us in the EMS field. Leave em for the coroner and move on. We have a couple of guys here who worked in NYC including one who retired from there. According to them the amount calls per medic isn't much different than NYC.

Dave