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#21 Firerescue183

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Posted 26 September 2015 - 03:51 PM

Oh wow. We don't do EVOC.

 

For the sickness I would say drink lots of water and try to look out the front of the ambulance. Our ambulances' captains chairs don't move at all so the latter of the two suggestions doesn't work well here, but make sure you're hydrated it helps.

Don't take Dramamine or any other medicine like that because of the side effects it can cause. You want to be 100% when your on your clinical.

 

I wish I had better suggestions for you.

I respectfully disagree.  There is a non drowsy version of Dramamine that I would highly recommend.  Make sure that you read the label closely for dosage instructions. It will not effect your ability to stay alert.  I will agree that you need to stay hydrated and get well rested before your clinical.  You will definitely not be able to focus well if you are nauseous.  Two more insider tips.  When the tones drop, pop in a piece of gum.  Being in close proximity to other people i.e. your patient, and your partners, it will be much appreciated.  For the nasty calls involving less than stellar odors, rub a light coating of Vics Vapor Rub underneath your nose.  It doesn't block everything, but it does cut down on it.  


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#22 spaz926

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Posted 26 September 2015 - 04:18 PM

I respectfully disagree.  There is a non drowsy version of Dramamine that I would highly recommend.  Make sure that you read the label closely for dosage instructions. It will not effect your ability to stay alert.  I will agree that you need to stay hydrated and get well rested before your clinical.  You will definitely not be able to focus well if you are nauseous.  Two more insider tips.  When the tones drop, pop in a piece of gum.  Being in close proximity to other people i.e. your patient, and your partners, it will be much appreciated.  For the nasty calls involving less than stellar odors, rub a light coating of Vics Vapor Rub underneath your nose.  It doesn't block everything, but it does cut down on it.  

 

Dramamine Less Drowsy is the brand name I believe. It is Meclizine which can actually still cause drowsiness, so I would highly encourage taking it and seeing how your body reacts to it BEFORE the day of your clinical.

 

The Vics and chewing gum tips are great ones. I have heard of many medics using Vics to keep from smelling foul odors. Just make sure you're not preemptively applying it. Make sure you're using your sense of smell to assist in your assessment. But after that there is no sense in continuing to smell it.


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#23 Firerescue183

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Posted 26 September 2015 - 04:53 PM

Dramamine Less Drowsy is the brand name I believe. It is Meclizine which can actually still cause drowsiness, so I would highly encourage taking it and seeing how your body reacts to it BEFORE the day of your clinical.

 

The Vics and chewing gum tips are great ones. I have heard of many medics using Vics to keep from smelling foul odors. Just make sure you're not preemptively applying it. Make sure you're using your sense of smell to assist in your assessment. But after that there is no sense in continuing to smell it.

http://www.walgreens...kpid=sku6245301

 

This is what I was suggesting.  I didn't see Meclizine listed, but that doesn't mean that it is not there.  I do agree that you should take it before your clinical to see how it reacts with your body.  Just to add a few more tips for your clinical experience....Get a flashlight!!!  A GOOD ONE!  I personally use a Surefire E1D LED.  It has a bright and a low light setting.  The low light is 5 lumens, and is typically what I use to check for PERRL.  You most likely have one, but get a stethoscope.  A GOOD ONE!!  I have a Littmann Master Cardiology III that I found at a great price and it is phenomenal.  You don't have to get that particular one, but I would highly recommend sticking with Littmann.  They are spend, but the Leatherman Raptor Trauma Shears are worth every single cent!!!  I have used mine for over a year and they are one of the best pieces of gear that I own.  I use it EVERYDAY on duty, and they are really handy around the house also.  Make sure that you have a decent pen that writes well on gloves.  I have learned the very hard way not to carry a nice pen such as a Surefire Pen on duty.  It will likely get lost or stolen.  It can be easy to lose track of things when things get real in the middle of a call.  I doubt that I have to say this here, but do yourself a favor and get a knife...A GOOD ONE!!!  Look at spyderco, benchmade, or the like.  Lastly get a bag that you can stow all of your items that you need for the day in.  I use a Goruck GR1 and it is one of my very favorite pieces of gear.  It is slim enough to fit next to the Captain seat in the ambulance and it stays out of the way. That covers my gear recommendations. Onto my clinical advice.  Firstly, make your own advice.  Your clinical experience is yours.  It is going to be unique as no two calls are ever the same.  Be a sponge.  NEVER EVER EVER forget your scene safety and situational awareness.  This is easy to toss out of the window when you are new on a truck.  Take an extra minute.  Be aware as it can literally save your life.  (Sorry about getting on the soap box on that one.)  I will end this long post with this final and my favorite piece of advice.  Whoever your instructor is, or partner, take note about how they do things.  For example, one partner I had a way of gathering his I.V. equipment (He made a IV roll with a towel) and it worked really well.  Another partner attached limb leads in a methodical way that was really efficient.  Just pick up on little things, and try to learn something new every day.  15 years later in EMS I am constantly learning.  I have no doubt that you will love it!!  Ok with ALL of that being said, what other pieces of advice or tips can you guys give to me?  I think it is awesome to network with each other.  In the end it will only better ourselves, and more efficiently help our patients.


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#24 EMSWxSAR

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Posted 26 September 2015 - 04:55 PM

Good tips, thanks! I will give the less drowsy Dramamine a test run prior to clinical time.  I tried sitting on the bench and in the jump seat as well as changing what I was focusing on (including trying to look out the front, but the strain on my neck was too much).  It could be that it was just all the maneuvers that we were doing, but that was my first time in the back of one so I don't have another reference point.


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#25 EMSWxSAR

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Posted 26 September 2015 - 05:04 PM

I have just a basic penlight at the moment for checking pupils, and my wife got me the Leatherman Raptor shears when I started class.  Absolutely love them.  My classmates were impressed with them too.  Most of them just have normal cheapy trauma shears.  Don't have enough coin to pickup a Littmann yet, but I got a MDF MD One which is pretty decent.  It's a single lumen, so don't have to worry about the rubbing that you can hear with the dual lumen variety. 

 

If I pick up any good tips while I'm on my clinicals, I'll be sure to share them here.


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#26 Firerescue183

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Posted 26 September 2015 - 05:27 PM

I have just a basic penlight at the moment for checking pupils, and my wife got me the Leatherman Raptor shears when I started class.  Absolutely love them.  My classmates were impressed with them too.  Most of them just have normal cheapy trauma shears.  Don't have enough coin to pickup a Littmann yet, but I got a MDF MD One which is pretty decent.  It's a single lumen, so don't have to worry about the rubbing that you can hear with the dual lumen variety. 

 

If I pick up any good tips while I'm on my clinicals, I'll be sure to share them here.

It sounds like you have a keeper!!  MDF aren't bad stethoscopes.  I see a lot of the new nursing or EMT students show up to class with the piece of junk dual lumen scopes that are about worthless.  I would try to get a good flashlight immediately if not sooner.  I have used mine in the past to temporarily blind aggressive patients, I have used it as scene lighting when the scene lights quit working in the middle of a call, and I use it several times a day for a myriad of things both on and off duty.  I am looking forward to hear how your clinical goes.  My first one for this semester is on Monday.  I will also be sure to post anything of interest that I learn, or that happened.  


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#27 spaz926

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Posted 26 September 2015 - 06:40 PM

http://www.walgreens...kpid=sku6245301

 

This is what I was suggesting.  I didn't see Meclizine listed, but that doesn't mean that it is not there.  I do agree that you should take it before your clinical to see how it reacts with your body.  Just to add a few more tips for your clinical experience....Get a flashlight!!!  A GOOD ONE!  I personally use a Surefire E1D LED.  It has a bright and a low light setting.  The low light is 5 lumens, and is typically what I use to check for PERRL.  You most likely have one, but get a stethoscope.  A GOOD ONE!!  I have a Littmann Master Cardiology III that I found at a great price and it is phenomenal.  You don't have to get that particular one, but I would highly recommend sticking with Littmann.  They are spend, but the Leatherman Raptor Trauma Shears are worth every single cent!!!  I have used mine for over a year and they are one of the best pieces of gear that I own.  I use it EVERYDAY on duty, and they are really handy around the house also.  Make sure that you have a decent pen that writes well on gloves.  I have learned the very hard way not to carry a nice pen such as a Surefire Pen on duty.  It will likely get lost or stolen.  It can be easy to lose track of things when things get real in the middle of a call.  I doubt that I have to say this here, but do yourself a favor and get a knife...A GOOD ONE!!!  Look at spyderco, benchmade, or the like.  Lastly get a bag that you can stow all of your items that you need for the day in.  I use a Goruck GR1 and it is one of my very favorite pieces of gear.  It is slim enough to fit next to the Captain seat in the ambulance and it stays out of the way.

 

Meclizine is the generic name for Dramamine NonLess-Drowsy. You're checking PERRL with a flashlight not a penlight? Never heard of that. I have a Streamlight Stylus. Great penlight so far.

 

Starting out Littmann Lightweight (what I have) will do just fine according to many. Getting into cardiology classes though you'll want something better. Littmann Classic is a good one, but if you don't want a bell check out the Master Classic or even the Select. We're getting a little off topic with that though.

 

Prestige Medical has a really nice pair of shears I picked up off Amazon for under $10. I want to get those Leatherman Shears eventually, but at this point low cost is good because I never know when I'll lose something.  :lol:

 

That Goruck GR1 looks really good. I need to get a smaller bag than what I have for my EMS gear.


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#28 Firerescue183

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Posted 26 September 2015 - 09:29 PM

Meclizine is the generic name for Dramamine NonLess-Drowsy. You're checking PERRL with a flashlight not a penlight? Never heard of that. I have a Streamlight Stylus. Great penlight so far.

 

Starting out Littmann Lightweight (what I have) will do just fine according to many. Getting into cardiology classes though you'll want something better. Littmann Classic is a good one, but if you don't want a bell check out the Master Classic or even the Select. We're getting a little off topic with that though.

 

Prestige Medical has a really nice pair of shears I picked up off Amazon for under $10. I want to get those Leatherman Shears eventually, but at this point low cost is good because I never know when I'll lose something.  :lol:

 

That Goruck GR1 looks really good. I need to get a smaller bag than what I have for my EMS gear.

Haha...I guess I need to be a better paramedic student.  I TOLD you guys I would learn something.  I stand corrected.  Thank you for that!  I was thrown off because the medication in the link I shared earlier led me to think that ginger was the main ingredient that was used.  It appears that I need to go review trade names and generic names.  You are exactly right about the stethoscope.  I happened to find my master cardiology on a 80% off sale, but any littmann is great for EMS.  I can't recommend the Goruck GR1 highly enough!!  Best bag I have ever had...and I have had a lot!


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#29 EMSWxSAR

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Posted 27 September 2015 - 06:54 AM

Prestige Medical has a really nice pair of shears I picked up off Amazon for under $10. I want to get those Leatherman Shears eventually, but at this point low cost is good because I never know when I'll lose something.  :lol:
 

 

The great thing about the Leatherman shears is the carrying case they come with.  It locks in tight and can hold them folded or open.  That should help with worrying about losing them.  I was concerned about the same thing, so I bought a cheap pair of trauma shears as well...those are now just sitting in my medical go bag probably never to be used.


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#30 EMSWxSAR

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Posted 27 September 2015 - 07:01 AM

It sounds like you have a keeper!!  MDF aren't bad stethoscopes.  I see a lot of the new nursing or EMT students show up to class with the piece of junk dual lumen scopes that are about worthless.  I would try to get a good flashlight immediately if not sooner.  I have used mine in the past to temporarily blind aggressive patients, I have used it as scene lighting when the scene lights quit working in the middle of a call, and I use it several times a day for a myriad of things both on and off duty.  I am looking forward to hear how your clinical goes.  My first one for this semester is on Monday.  I will also be sure to post anything of interest that I learn, or that happened.  

 

Yeah, some of the students have regretted the decision to not put as much money into a stethoscope.  Our instructor recommended, for those of us with the dual lumens, to tape the tubes together to minimize the rubbing sounds.  I haven't tried it, but I would imagine in a pinch it would do a fairly decent job of reducing the noise.

 

I have a 5-11 ATAC A1 which is what I carry when on patrol for the Sheriff's Office...maybe I'll incorporate that one into my gear until I can get a better one.


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#31 spaz926

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Posted 27 September 2015 - 11:17 AM

The great thing about the Leatherman shears is the carrying case they come with.  It locks in tight and can hold them folded or open.  That should help with worrying about losing them.  I was concerned about the same thing, so I bought a cheap pair of trauma shears as well...those are now just sitting in my medical go bag probably never to be used.

 

Oh that's nice. My pants have a pocket with a hook-and-loop and buttoned strap that goes through the finger hole of the shears to keep them secure.

 

While in my bag that extra carrying case would be a great way to keep track of them.

 

Yeah, some of the students have regretted the decision to not put as much money into a stethoscope.  Our instructor recommended, for those of us with the dual lumens, to tape the tubes together to minimize the rubbing sounds.  I haven't tried it, but I would imagine in a pinch it would do a fairly decent job of reducing the noise.

 

I have a 5-11 ATAC A1 which is what I carry when on patrol for the Sheriff's Office...maybe I'll incorporate that one into my gear until I can get a better one.

 

The students in my class with the dual tubing have been upset with the performance of their stethoscopes. Our instructors also suggested adding more tape to the scope to prevent the tubes from rubbing together.


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#32 EMSWxSAR

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Posted 28 September 2015 - 08:14 PM

Got signed off on OB, IV assist, Intubation assist, and EKG lead placement tonight.  Touched on OPAs/NPAs tonight as well.  The coolest part is they let us attempt an intubation on the manikin.  I nailed the esophagus on my first and only attempt.  I think I'll stick with a Combitube LOL.

 

Thursday we'll start on O2 therapy, bandaging, splinting and bleeding control.

 

Feels great to finally start getting some skills in.


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#33 spaz926

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Posted 28 September 2015 - 08:29 PM

[While I was typing this up EMSWxSAR posted his update.]

 

OB, IV assist, Intubation assist, and EKG lead placement sign offs all in one night? Wow.

Weird that you are just now touching on OPA/NPA and O2 therapy. We learned all that right after cardiac arrest management. I guess different programs have different timelines.

 

Update

 

I took the second exam of the semester last Wednesday. It was over the preparatory module of the text book. I was hoping for a 90 or better, but made an 87. I will be setting up an appointment with my instructor to go over the questions I missed (one of the worst things about the way we test is we don't know which questions we got wrong).

 

Today I did my first clinical rotation. Communications clinical rotation at the Combined Transportation, Emergency & Communications Center. 911 call takers and dispatchers for Austin/Travis County EMS (A/TCEMS) are at least EMTs so they have true understanding of what is going on with a patient instead of just reading prompts. It was really awesome hearing incoming 911 calls and then listening how the dispatch works. Seeing all the complex computer systems was pretty awesome too. It is a job I wouldn't mind doing and may even think about applying for as we get closer to the end of the program.

 

My next clinical rotation is the Field rotation with A/TCEMS Medic 6 (downtown).

 

Tomorrow in lecture we'll be learning about OB emergencies and in lab we'll be doing OB scenarios and C-Collar (sitting and supine).


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#34 EMSWxSAR

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Posted 29 September 2015 - 08:00 AM

Yeah...all in one night.  We rotated through each station in groups.  I'm surprised as well, but I guess there is a method to their madness.

 

For testing, at least in lecture, our instructor will go over the questions that a majority of the class missed.  That definitely helps.  You were close, so I wonder if there is some wiggle room...too vague of a question or something...we've been fairly successful in arguing those things in class.  If the instructor agrees, he throws us a point.

 

Sounds like an awesome experience on your clinical.


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#35 Firerescue183

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Posted 30 September 2015 - 07:21 PM

In my personal experience, more is learned in a clinical during real life experience than in a class room, or just reading the book.  The school portion of the program is designed to give you a foundation of basics.  When you are in the field, I very strongly suggest that you make it very clear to your preceptor that you don't want to just sit there and watch.  The more you participate, the more you will get out of it.  (I am sure that you guys already know that.)  Make sure that you ask a ton of questions, and take notes.  As previously mentioned, pay particular attention to the preceptor's methods for handling their patients.  There are so many things to pick up on!  Also, I am not sure if you have to use a program called Fisdap to stay on top of your clinical rotations, but if you do, MAKE SURE that you stay on top of it!!  I had a clinical on Monday.  We had 1 difficulty breathing, 1 transfer, 2 wrecks with no injuries, a chest pains call, and one stroke patient.  Not a bad day.  


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#36 ArkansasFan

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Posted 30 September 2015 - 07:26 PM

http://www.walgreens...kpid=sku6245301
 
This is what I was suggesting.  I didn't see Meclizine listed, but that doesn't mean that it is not there.  I do agree that you should take it before your clinical to see how it reacts with your body.  Just to add a few more tips for your clinical experience....Get a flashlight!!!  A GOOD ONE!  I personally use a Surefire E1D LED.  It has a bright and a low light setting.  The low light is 5 lumens, and is typically what I use to check for PERRL.  You most likely have one, but get a stethoscope.  A GOOD ONE!!  I have a Littmann Master Cardiology III that I found at a great price and it is phenomenal.  You don't have to get that particular one, but I would highly recommend sticking with Littmann.  They are spend, but the Leatherman Raptor Trauma Shears are worth every single cent!!!  I have used mine for over a year and they are one of the best pieces of gear that I own.  I use it EVERYDAY on duty, and they are really handy around the house also.  Make sure that you have a decent pen that writes well on gloves.  I have learned the very hard way not to carry a nice pen such as a Surefire Pen on duty.  It will likely get lost or stolen.  It can be easy to lose track of things when things get real in the middle of a call.  I doubt that I have to say this here, but do yourself a favor and get a knife...A GOOD ONE!!!  Look at spyderco, benchmade, or the like.  Lastly get a bag that you can stow all of your items that you need for the day in.  I use a Goruck GR1 and it is one of my very favorite pieces of gear.  It is slim enough to fit next to the Captain seat in the ambulance and it stays out of the way. That covers my gear recommendations. Onto my clinical advice.  Firstly, make your own advice.  Your clinical experience is yours.  It is going to be unique as no two calls are ever the same.  Be a sponge.  NEVER EVER EVER forget your scene safety and situational awareness.  This is easy to toss out of the window when you are new on a truck.  Take an extra minute.  Be aware as it can literally save your life.  (Sorry about getting on the soap box on that one.)  I will end this long post with this final and my favorite piece of advice.  Whoever your instructor is, or partner, take note about how they do things.  For example, one partner I had a way of gathering his I.V. equipment (He made a IV roll with a towel) and it worked really well.  Another partner attached limb leads in a methodical way that was really efficient.  Just pick up on little things, and try to learn something new every day.  15 years later in EMS I am constantly learning.  I have no doubt that you will love it!!  Ok with ALL of that being said, what other pieces of advice or tips can you guys give to me?  I think it is awesome to network with each other.  In the end it will only better ourselves, and more efficiently help our patients.


What you linked is a gram of ginger. It may work. It may not. The same could be said of meclizine.

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#37 EMSWxSAR

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Posted 01 October 2015 - 06:32 AM

I bought all sorts of anti-nausea goodies.  Going to try each one prior to my clinical to see how they affect me.  I normally get queezy playing first person shooters, so that'll probably be a good test.


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#38 spaz926

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Posted 03 October 2015 - 04:32 PM

Tuesday Update

On Tuesday we went over OB emergencies in lecture and did some OB scenarios in lab. The OB scenarios were great fun and helped us learn a great deal. Our class of 21 was split up into 5 groups. Each group was given a scenario. One group member was the lead. The rest of the class was watching the scenario take place. This was the first time we've done this style scenario and also the first time we'd been introduced to call management.

 

It was difficult, but also helped us. Our instructors were very very happy with what they saw considering it was our first scenario and still so early in the semester. We were told many classes don't go through the scenarios as well as we did until later in their semester.

 

Thursday Update

Thursday in class was hectic. We went over three chapters (head, neck, spine, eye, throat, etc. injuries). We ended up going 2 hours over our scheduled time for lecture to end, so we had only 1 hour in lab. During lab we were introduced to two new skills. The first skill was applying a tourniquet. We did not get a chance for any hands on time with the tourniquet unfortunately due to time constraints. The second skill we were introduced to was applying a C-Collar and spinal movement restriction with a backboard. We practiced putting a C-Collar on a patient, log rolling them, lifting them on a backboard, and securing them to the backboard. We spent the remainder of lab time practicing this skill. My group was only able to do it twice luckily I was lead the second time, so I was able to get the practice in. Hopefully we'll do more practicing of that in lab because it is a lot to remember only having done it once.

 

Monday is my first field clinical with Austin/Travis County EMS Medic 6. This weekend was ACL Fest. Not sure if we'll see some residual calls from that because Medic 6 is downtown (6th street). Will report after my lovely 12 hour clinical on Monday.

 

How was the second half of the week for you, EMSWxSAR?


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#39 EMSWxSAR

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Posted 03 October 2015 - 07:50 PM

Tues/Weds were lecture last week.  Went over basic anatomy and changes in the body from birth to death.  Then had a quiz on the 21 Steps of Circulation.  Nailed it!

 

Thurs we started on Skills 2.  I'm guessing we'll be spending some time on these skills.  Introduction to bleeding control, terms, etc.  Then moved over to O2 therapy.  Got familiar with how to setup a D cylinder and got to practice inserting OPA/NPAs.  Got an intro to NC/NRB and a refresher on a BVM.  Basically how to assemble, indications, O2 concentration upon delivery, etc.  The final part of the night we worked on splinting including improvised splints like a pillow, blanket, etc.  Got to work with a vacuum splint too.  First time playing with one of those.

 

I'm spending this weekend getting ahead in my reading and workbook as well as all the documentation I have to complete prior to going to my ER clinical.  I've also volunteered to fix-up our PCR template.  It's currently in a Word document, and I want to move it into a PDF with form fields.  Give it a nicer flow too.

 

I'm jealous about you getting to do some scenarios.  We're going to have to wait until we get signed off on Skills 2, then we'll be start doing cool stuff like that.


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#40 spaz926

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Posted 06 October 2015 - 12:30 PM

We have not gotten into splinting yet, but I think we start tonight. As I noted before we didn't get too much time practicing with SMR via C-Collar and backboards, so we may work some on that before moving to splinting.

 

Update

Yesterday was my first of three rotations with Austin/Travis County EMS. I rode out with Medic 6 (downtown Austin). It was a very busy day. I got to the station at 0645 and immediately had to hop in the truck and head to a call. Among the calls was an 80 y/o female that was unconscious, but breathing and had a pulse when firefighters arrived. She went into cardiac arrest after a few minutes of them being on scene and when we arrived there were performing compressions and ventilating. The way they do it here is continual compressions, ventilating at a rate of 1 every 4-6 seconds, with pulse checks every 2 minutes. Unfortunately after 45 minutes of CPR there was still no shockable rhythm and paramedics called an MD for pronouncement.

Another interesting call was an MVC involving a rollback tow truck and an SUV. Both drivers sustained only minor injuries. We transported the driver of the tow truck.

My two preceptors were awesome. They are both Paramedics, but one was a Medic I for A/TCEMS so she performed only BLS. The Medic II was able to perform ALS. It was really cool to see them bounce ideas off each other since both are Paramedics and have training at the ALS level. From what I understand it was their first time as partners.

 

In total we had 10 patients during the 12 hour shift. 1 refused transport.

 

Many of my classmates say MVC and cardiac arrests are not highly common to see on your rotations since we only have three.

 

Next clinical is at Round Rock ER (Level II Trauma Center) this coming Monday.


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