Wednesday, March 24, 2010

little work rant followed w/ needing your EMS advice...

I have always been a believer of "God doesn't give you anything you can't handle", "what doesn't kill you only makes you stronger", and "everything happens for a reason".  For whatever reason I have continued to carry these beliefs through all phases in my life, from growing up to college, to my professional life.  I know there are going to be times when I don't have a clue as to what I am supposed to do about a pt, but I am sure that most of the time I will fall back on my basic instincts. Tonight I had another one of those "oh sh*t" calls that when I look back on and talk with my co-workers (medics and doctors) that I know I did what I could with what I had in the amount of time I had. I just get really frustrated when I meet up with a BLS unit and they have nothing done for a critical pt, no history, no oxygen, no vitals. Oh wait, they had a grocery bag full of pill bottles for me. They were so concerned with this pts condition that they walked hin to the ambulance start towards the hospital that is opposit the direction I am coming from then realize Im 5 blocks behind them and cant catch up, so they stop and wait and then have none of the above mentioned done. But when you are called for a SOB and your pt is cyanotic from the nipples to the top of his head, i think any oxygen will help and walking him to the unit won't. Just saying...

I try not to get frustrated on these kind of calls. I try to use calls as teachings for these kind of EMTs who are new or just don't know what to do. During the critical calls I direct and after I try and teach, by explaining why I did or didnt do something or explaining why I did a 12-lead or why I didnt/did run lights and sirens to the hospital,, etc. I also take the time to answer any questions the EMTs may have which usually include "Did I do what i could/should have?" "or is there anything else I could/should have done?" and I answer them truthfully but without sounding like an egotistical jerk. I find that the next time I run a call with those EMTs they tend to be a little more comfortable with me and they have the things we talked about done, they have the pt on O2, they have a BP for me, or pt history for me.

I am sure Im not the only provider who runs into this. Any tips on how I can better this where I run? It happens with a lot of EMTs. Maybe some kind of "asisting the medic" class or something?

1 comment:

The Happy Medic said...

It can indeed be frustrating when a municipality thinks BLS is a good idea. We all know the BLS before ALS model is flawed and has failed for the most part, but we have to deal with what we have, not what we want.

Use specific calls as the teraching moments. On this one for example, I would bring one of the EMTs with me in the back, not only to help, but so they could see the patient improve with THEIR interventions THEY should have been doing.

Their "assisting the medic" class was called EMT Basic. If they don't get it now, chances are they won't learn from sitting and watching you talk about a patient you had once.

Teach in the moment. The only way to learn how to do an ascultated BP in a code 3 ambulance is to do it, right? So get these EMTs in the back on these calls and let them learn. Don't teach necessarily, but talk through your actions and have them put the O2 on, get the line spiked, etc, so they can see that you can't do all that stuff on your own and the Pt needs certain interventions ASAP, as they learned in B school.

And if, for some retarded reason they "can't" go with you to assist, and can't give adequate care before ALS arrives, disband the unit. They're doing more harm than good.