posted by ![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
aquenigmatic at 12:24pm on 10/06/2009 under emt-b training
aquenigmatic at 12:24pm on 10/06/2009 under emt-b trainingDay 6 started kind of boring. Documentation. Why you can't write in your report, "Ass-hat swallowed a basket of needles." Radio Protocols. Why you can't say on the air, "Me and my bitch are on scene, over."
We practiced skills. I drew Olympic Guy and Radical Midwife. We did medical assessments, front to back.
Assessments? What you do is talk your way through the scene. You verbalize the steps that you're thinking about in the proper order, and every now and then someone will add a piece of information. You say, "Arriving on scene. BSI/Scene Safety. Is my scene safe?" to which the proctor might say, "Yes," or "I don't know." An affirmative response means to proceed with the assessment. Any other response means you better stop and take a look around and vocalize what might be a hazard, i.e. if responding to a call reporting a GSW (Gunshot Wound) are police on scene yet? Has the scene been secured? What if it's an electrocution and you walk up on the patient without vocalizing that you are looking for any signs that the electrical hazard is still present? In the first instance, if you don't at least say, "I'm looking for signs that the suspect is in custody and searching for the police to liaise with," an instructor is likely to walk up behind you, pull a water pistol out, snap their gum loudly and say, "EMT Aquenigmatic, you are dead. You fail. What did you do wrong?" In the second instance, you are supposed to verbalize that you would call dispatch and request that PG&E come out and confirm that whatever the mechanism of shock is apparently has been turned off (preferably by picking it up). Then it is considered "safe" to proceed.
In this case it's a medical assessment, so you would say, "Nature of illness is unknown. I see one patient. I won't need additional resources at this time. My general impression of the patient is that we have a white male, around 30 years old, lying on the floor, appearing unconscious. At this time I'll proceed with check for LOC (Level of Consciousness) and ABC's (Airway, Breathing, Circulation). 'Hello! Hello! Sir, can you hear me!'" The proctor will say whether or not the patient responds and that dictates your priorities for the rest of the assessment. If they are responsive, you get to ask more questions--Signs and Symptoms, Known Drug Allergies, Medications, Past Pertinent History, Last oral intake, Event leading to the illness. SAMPLE. Then a physical assessment, head to toe, looking for pain and potential causes. Then vital signs and a transport decision.
Somewhere in there, are likely to be well-intentioned friends or family yelling information to you telling you to baby him. Other medics may be scrambling around. The television may be on. Your radio squawks. Maybe you have to pluck somebody from between their toilet and bathtub because they were straining for a BM and had a heart attack. Maybe it's a child and the parents are screaming that they're going to sue you. Maybe it's a minor with chronic illness who is trying to refuse treatment and the guardian is insisting on treatment. Suddenly you have an ethical dilemma. Yet the job is to assess and treat the patient and to whatever extent possible calm and control the scene. That's exactly what they say, "Control the scene, or it will control you." Heh. I'm waiting for a train that is never late.
We practiced skills. I drew Olympic Guy and Radical Midwife. We did medical assessments, front to back.
Assessments? What you do is talk your way through the scene. You verbalize the steps that you're thinking about in the proper order, and every now and then someone will add a piece of information. You say, "Arriving on scene. BSI/Scene Safety. Is my scene safe?" to which the proctor might say, "Yes," or "I don't know." An affirmative response means to proceed with the assessment. Any other response means you better stop and take a look around and vocalize what might be a hazard, i.e. if responding to a call reporting a GSW (Gunshot Wound) are police on scene yet? Has the scene been secured? What if it's an electrocution and you walk up on the patient without vocalizing that you are looking for any signs that the electrical hazard is still present? In the first instance, if you don't at least say, "I'm looking for signs that the suspect is in custody and searching for the police to liaise with," an instructor is likely to walk up behind you, pull a water pistol out, snap their gum loudly and say, "EMT Aquenigmatic, you are dead. You fail. What did you do wrong?" In the second instance, you are supposed to verbalize that you would call dispatch and request that PG&E come out and confirm that whatever the mechanism of shock is apparently has been turned off (preferably by picking it up). Then it is considered "safe" to proceed.
In this case it's a medical assessment, so you would say, "Nature of illness is unknown. I see one patient. I won't need additional resources at this time. My general impression of the patient is that we have a white male, around 30 years old, lying on the floor, appearing unconscious. At this time I'll proceed with check for LOC (Level of Consciousness) and ABC's (Airway, Breathing, Circulation). 'Hello! Hello! Sir, can you hear me!'" The proctor will say whether or not the patient responds and that dictates your priorities for the rest of the assessment. If they are responsive, you get to ask more questions--Signs and Symptoms, Known Drug Allergies, Medications, Past Pertinent History, Last oral intake, Event leading to the illness. SAMPLE. Then a physical assessment, head to toe, looking for pain and potential causes. Then vital signs and a transport decision.
Somewhere in there, are likely to be well-intentioned friends or family yelling information to you telling you to baby him. Other medics may be scrambling around. The television may be on. Your radio squawks. Maybe you have to pluck somebody from between their toilet and bathtub because they were straining for a BM and had a heart attack. Maybe it's a child and the parents are screaming that they're going to sue you. Maybe it's a minor with chronic illness who is trying to refuse treatment and the guardian is insisting on treatment. Suddenly you have an ethical dilemma. Yet the job is to assess and treat the patient and to whatever extent possible calm and control the scene. That's exactly what they say, "Control the scene, or it will control you." Heh. I'm waiting for a train that is never late.
blah