is anyone an EMT or Parimedic here?

[MiniHemi]

Yeah right now I am going threw my EMT-1 class so far I mad it threw the hard part. More then half the class was either dropped for getting lower then a 70% or couldn't take the pressure. Well, I know I can handle the pressure since 8 hours a day studying isn't as bad as it seemed the first week. But my question for you is were you nervous when you first started having to work on a actual patient? Right now we are starting are interning and I start on Nov. 3rd I am very nervous that I might forget something and injure or kill a patient. My lowest grade in the class is only a 80% so I know the material quite well. But is this normal? I am dealing with someone's life here. Thanks all I just needed to get that stuff off my chest my rant is over now.

-Cory

[dreamwerxx]

I'm not, but answering to bump up the line as this would appear to be important to you.

[Pipes]

Minihemi, first and foremost, you should be very proud of the profession that you have chosen. Also, considering the grades you are achieving, it sounds like you are one of the best in the class. Anyone would be nervous going into their first day of work to hammer 2x4's together, let alone to work on other humans. I would suggest listening to what you are being told about the patient and I'm sure there will be a common item between what you are being told and what you have already be taught. That in itself should trigger an action from you that will lead you to doing the right thing. Take a deep breathe, think clear and logically and I'm am sure everything will work out fine for you. I wish you all the best in regards to the occupation you have chosen.

[MiniHemi]

Thanks I think I just needed to get it off my chest. I feel more at ease now. I am just worried about helping out in the ambulance because there you do not have anyone to back up what you say so you have to be right. If they tell you to get a BP and an initial assessment although my assessment is correct but my BP might be wrong and they give the patient say nitro for angina and his BP isn't really over 100 then he could have sever complications. That's the basic stuff im so nervous about.

-Cory

[PTGT Redman]

I was an EMT-D (Defibrillation) in NY before I went to medical school.
Codes and resucitation are only a small part of what you'll be doing. Being able to multitask, assess a situation for safety is most important. It really is only a single decision:
Load and go or stay and play.

If they are in arrest, it's pretty clear cut: resucitate until you can get them going and then get them to a hospital. Unless you have a defibrillator, they have a very poor survival rate anyway.
I thought my EMT class was tough, try learning ACLS.
Coding a patient, knowing what rythm they are in and trying not to kill them with the wrong drug is a toughy.
Amiodarone, verapamil, atropine, epinehrine...is it a SVT, VT, A-fib, flutter....
Key:
If the patient is conscious, remember the ABC's right?
Ask targeted questions: what, where, when...etc.
Organize your thoughts into:
SUBJECTIVE: what the patient is telling you.
OBJECTIVE: what you found on exam
ASSESSMENT: What is the most likely problem (Diagnosis)
PLAN: How are you going to address the problems?

Good Luck, just remember, the more exposure you have, the easier it gets. I had a hard time when I started, now it is very easy. You just need to train your mind to organize all the information in often confusing environments.
Let me know if I can help.
Rob

[PTGT Redman]

Originally Posted by MiniHemi

. If they tell you to get a BP and an initial assessment although my assessment is correct but my BP might be wrong and they give the patient say nitro for angina and his BP isn't really over 100 then he could have sever complications. That's the basic stuff im so nervous about.

-Cory

Just check it again, if you are not sure it is right. Or check the other arm.
People with low blood pressure can tolerate at least one dose of Sub-lingual nitro.
If they are having unstable angina, you should give them a vasodilator like nitro. A headache I'll take over being dead anyday.
Hang a bag of 0.9 Normal saline and that will help pressure. Course you can ask yourself, angina/ chest pain hypotension and bradycardia, is the SA or AV dysfunction secondary to an inferior wall MI? In that case fluids would help, but you still give them nitro...and an aspirin 81mg chewable

[MiniHemi]

Yeah I know all the senerios we have them at least every other week. I know what to do and what do look for. The problem stems from me questioning what I know. And I know what you mean about the SVT and all about the heart we have been taught that. Plus are AED will suggest what is going on at any purpose anyway(since we arnet allowed to do any injection other then an empy pen). Also I am very fluent with scene size up, SAMPLE, OPQRST and all so we are down where assesment is due im just hoping I see lot of trama rather then medical. Besides I think trama is funner anyway.

-Cory

[PTGT Redman]

Well, if you are comfortable with the material, it will all fall into place when the time comes.