Ask an EMT

[Drake the Dragonheart]

A while back these type of threads used to be really common/popular. the ask a (insert profession, such as police officer, firefighter, etc here)

I took my EMT course fall/winter of last year, and started running with Castle Rock Ambulance as a volunteer at the end of February of this year.

I will try to check this thread often and answer your questions, if I don't have an answer right away I will try to track it down.

 

[Jack Action]

How do you avoid catching nasty little bugs while performing CPR?

 

[WolfThomas]

How do you avoid catching nasty little bugs while performing CPR?

Gloves. Advanced Life Support is usually performed with a bag and mask system rather than mouth to mouth.

 

[Jack Action]

Gloves. Advanced Life Support is usually performed with a bag and mask system rather than mouth to mouth.

Well, that's boring. What's next, telling me they don't even do trepanations anymore to cure epilepsy?

 

[WolfThomas]

Gloves. Advanced Life Support is usually performed with a bag and mask system rather than mouth to mouth.

Well, that's boring. What's next, telling me they don't even do trepanations anymore to cure epilepsy?

Nope. But they still do for bleeds in the brain. Sometimes with a black and decker.

http://www.smh.com.au/national/country-gp-tells-how-he-saved-boy-with-home-drill-20090519-beg7.html

 

[Lightspeaker]

Gloves. Advanced Life Support is usually performed with a bag and mask system rather than mouth to mouth.

Well, that's boring. What's next, telling me they don't even do trepanations anymore to cure epilepsy?

Nope. But they still do for bleeds in the brain. Sometimes with a black and decker.

http://www.smh.com.au/national/country-gp-tells-how-he-saved-boy-with-home-drill-20090519-beg7.html

That doesn't actually surprise me in the slightest. That was in Australia. Bear in mind that this is a country who once drip-fed a man vodka to save his life:
http://news.bbc.co.uk/1/hi/world/asia-pacific/7037443.stm


On topic: Exactly how tempting is it to use the siren at every conceivable opportunity? ;P

More serious question: How often do you end up in a potentially dangerous situation when responding to a call?

 

[WolfThomas]

That doesn't actually surprise me in the slightest. That was in Australia. Bear in mind that this is a country who once drip-fed a man vodka to save his life:
http://news.bbc.co.uk/1/hi/world/asia-pacific/7037443.stm

Maryborough isn't actually that far in the middle of nowhere. It's four hrs drive from Melbourne the second biggest city in Australia. It's just that sort of injury is so urgent they had to improvise. Couldn't wait for a helicopter or anything.

As for the alcohol that's actually proper medical technique. If I had to hazard a guess the Italian poisoned himself with methanol. A lot of drugs have antidotes. For example Opiates overdoses get given a thing called Naloxone or Narcan or whatever over name people use. Carbon Monoxide poisoning is given 100% Oxygen. But Menthanol the solution is ethanol, because the ethanol is broken down in preference to the menthanol or something (medschool was a long time ago).

For the record I'm a rural Australian General Practice Trainee, apologies to any derailment of Drake's thread.

Edit: Ethylene glycol in the article. Yeah it's a similar situation to methanol poisoning.

 

[Lightspeaker]

That doesn't actually surprise me in the slightest. That was in Australia. Bear in mind that this is a country who once drip-fed a man vodka to save his life:
http://news.bbc.co.uk/1/hi/world/asia-pacific/7037443.stm

Maryborough isn't actually that far in the middle of nowhere. It's four hrs drive from Melbourne the second biggest city in Australia. It's just that sort of injury is so urgent they had to improvise. Couldn't wait for a helicopter or anything.

As for the alcohol that's actually proper medical technique. If I had to hazard a guess the Italian poisoned himself with methanol. A lot of drugs have antidotes. For example Opiates overdoses get given a thing called Naloxone or Narcan or whatever over name people use. Carbon Monoxide poisoning is given 100% Oxygen. But Menthanol the solution is ethanol, because the ethanol is broken down in preference to the menthanol or something (medschool was a long time ago).

For the record I'm a rural Australian General Practice Trainee, apologies to any derailment of Drake's thread.

Edit: Ethylene glycol in the article. Yeah it's a similar situation to methanol poisoning.

I'm well aware. I'm a biological scientist who started off nine years ago by doing a degree in medical sciences. (Though admittedly I never liked pharmacology lectures much back in the day.)

I'm just rather amused by the fact that their response to "out of medicinal alcohol" was "VODKA!" Makes sense from the fact that Vodka is pretty clean as far as spirits go but its very much along the same lines as using a Black & Decker to drill someone's head open. X-D

 

[Drake the Dragonheart]

Are you as annoyed by the view of nurses as "medicine's unsung heroes" as I do as a lab tech, considering it's demonstrably false the vast majority of the time?

I so far can't say I have really come across this view in my EMS career. The nurses I have worked with to this point have always been very helpful, and are just regular people trying to help others.

I have responded to a couple calls where we ran lights and sirens, one of which I was driving. the first was I think my second or third call, it was a man who fell, was bleeding from his head, the driver didn't want to keep that patient waiting. The one were I was the driver we had a patient who was really panicky and I think having very severe anxiety on top of what was already ailing her. that was a hectic day, as later on we were loading another patient when another call went out for a wreck that ended up producing 4 patients and we emptied Sweetwater Medics of their ambulances. we had just got our patient into the bed and the hospital and another call goes out, Medics was sent. Our supervisor tells dispatch our unit will take it, so me and another EMT pretty much do a Chinese fire drill in the parking lot. We go flying down the interstate with the sirens running. we reach the exit to Green River and she turns to me and says "that is an example of how not to drive. never ever drive like we just did!" "Yes MAAM!"
I can't say I have ever felt a temptation to use lights and sirens, we only run them on very critical patients, people see the lights or hear the sirens and they can start getting crazy, but some of the others I have talked say it is a real adrenaline rush.

I thankfully haven't been to a dangerous scene yet, but I know it is only a matter of time. Thankfully GRPD helps us out on virtually every call. I did have one call where the officer searched our patient before we began the examination and removed a knife from their person.

How did you react to your first needle stick?

Are you asking about me being stuck with a needle or doing it on a patient? I haven't done a needle on a patient as that is outside my current scope of practice. that is an A-EMT and up skill. However I have volunteered on several occasions during training to allow others to practice the IV's on me. I didn't really think much of it. One of the other EMT's, when they stuck the practice needle in his arm it bleed like a stuck pig!

 

[CrazyGirl17]

Ok, do you ever get to use those electroshock paddle things, and why do you have to say "Clear!" as you do?

 

[FPLOON]

If you could describe the work of an EMT using a single song, what song would that be?

Do pagers still exist or were they replaced with something else?

Bonus question: Do you think the events of School Days could have been better if one of the characters was an EMT?

 

[Skin]

Are you as annoyed by the view of nurses as "medicine's unsung heroes" as I do as a lab tech, considering it's demonstrably false the vast majority of the time?

It's probably due to the fact that they are the ones who patients have the most contact with, rather than the scope of their job making them "heroes". I mean, you will never hear anyone say "charge nurses are the unsung heroes of medicine" because apart from probably not knowing what a charge nurse is, more than likely they will never get any face time with the charge nurse.

 

[Jux]

I took my EMT course fall/winter of last year, and started running with Castle Rock Ambulance as a volunteer at the end of February of this year.

Got liscensed as an EMR last year as part of my training for confined space rescue at work. Fortunately, I haven't had to deal with any emergencies here yet, but I have stopped to help people outside of work a few times now. Question is, do you know of an online database I can look at concerning laws (I think they vary state by state) that detail things like liability? That part of the class was pretty short. The biggest things they talked about were good samaritan laws, and how once I identify myself as a medical provider, I have a duty to act.

 

[Jux]

I know you are asking the EMT, and I am not an EMT or a lawyer, I will say that now. I will say though, and I hope you can take what I say seriously despite my anonymity, that it is worth your time and a bit of money to pay for 45 minutes or an hour with a good attorney. Law is so complex, it is varying by state in the USA as well, but a lawyer can help.

Consultation is a very accepted, and generally inexpensive process, and I think you could find it more useful than trying to figure out what legal language means online, or trusting a stranger to explain it online via database.

True enough, for the details it probably is worth talking to a lawyer that specializes in this. Was just kinda hoping for an overview I could look at.

 

[Ihateregistering1]

I have a question regarding needles, and this is also applicable to me in general because I'm going back to school to become a PA.

I had an ex-GF who eventually became a Nurse and she worked as an EMT in college. However, I was surprised when she told me that she wasn't allowed to give people IVs.

I was in the Army at the time, and in CLS (Combat LifeSaver) class, we were sticking each other with IVs within 4 hours of training. We were flat-out told that, in an emergency scenario in combat, if the Medic wasn't available, to stick each other with IVs. So we're authorized to stick each other with IVs after about 8 hours of training, but EMTs, who've had 100's of hours of training, aren't? This seemed really strange to me. Is it true?

 

[Lightspeaker]

The biggest things they talked about were good samaritan laws, and how once I identify myself as a medical provider, I have a duty to act.

Sorry to go off on a tangent here but I have a little anecdote related to this: I'm actually trained as a rescue diver and as part of that training I had to do an emergency first response medical course.

More specifically I took my training when I was on a research base out in Indonesia. And as part of the training they mentioned good Samaritan laws being common in many countries...and then made a HUGE point of saying "absolutely do not treat someone in this country using any of these techniques". Apparently Indonesia DOESN'T have that kind of law. And if you try to treat someone then you become liable and responsible for them. So if they die you could be held responsible for that.

Scary thought. But really highlights how important it is to check a country's law before going there.

 

[Thaluikhain]

I imagine 'clear' is to make sure the current doesn't pass to anyone else (that is, they aren't close enough to the patient).

IIRC, it's short for "stand clear", for that reason.

 

[KyuubiNoKitsune-Hime]

Ok, do you ever get to use those electroshock paddle things, and why do you have to say "Clear!" as you do?

I actually have the answer for this. The electric shock paddle things are paddles for a defibrillator, a device designed to give an electric shock to restart the heart. The thing is a shock form a defibrillator can can just as easily put someone into cardiac arrest as it can take someone out of cardiac arrest. You don't want to be touching someone while electricity is coursing through the body, especially if that electric current can just as easily stop your heart as it will start the patient's heart. So that's why they shout "Clear!" to make sure the person they're using the defibrillator on isn't being touched by anyone else.

 

[Fieldy409_v1legacy]

Do you often find yourself in situations where the hazard that caused the accident is still there and keeping you guys out?

 

[Drake the Dragonheart]

How often do you arrive before the police?

My mom used to be an EMT in Philadelphia, and she'd arrive to murder scenes before the police quite often. It was dangerous work. She even got attacked on the job once when responding to a brutal brawl. I'm wondering if this is sort of risk is common in most places or is just in areas that are already generally high risk locations.

the calls I have been on either the police are already there, or we arrive at right about the same time. the advantage they enjoy is they are more than likely already in the car when the call goes out. The police here in my experience have been a great boon to us, they are almost always willing to give us a hand moving a patient or equipment such as the stretcher.

Ok, do you ever get to use those electroshock paddle things, and why do you have to say "Clear!" as you do?

The defibrillators? I haven't used them on a patient yet, but they are within my scope, in fact they are a part of First Aid/CPR/AED (Automated external defibrillator. The reason for saying "clear" is to ensure no one is touching the patient when the shock is delivered. funny story. one of my fellow EMT's who taught my CPR class told this story how she was working on a patient's catheter while he was in cardiac arrest. The doctor yells clear and shocks immediately, well she didn't have a chance to let go and got shocked by the patient's man part.

yes we still use pagers, I have one for days I am on call. give me some time to think about what song best describes EMS as a profession. I have not seen "School Days" but I would say probably. EMS people tend to have dark senses of humor.
I can do about 12 pull-ups, 15 on a really good day.

I have a question regarding needles, and this is also applicable to me in general because I'm going back to school to become a PA.

I had an ex-GF who eventually became a Nurse and she worked as an EMT in college. However, I was surprised when she told me that she wasn't allowed to give people IVs.

I was in the Army at the time, and in CLS (Combat LifeSaver) class, we were sticking each other with IVs within 4 hours of training. We were flat-out told that, in an emergency scenario in combat, if the Medic wasn't available, to stick each other with IVs. So we're authorized to stick each other with IVs after about 8 hours of training, but EMTs, who've had 100's of hours of training, aren't? This seemed really strange to me. Is it true?

She was probably an EMT-basic then. In most states IV's are not in a basic's scope of practice on the ambulance. must be AEMT (advanced) or up to do IV's. What is interesting is IV's are in the scope of practice for EMT-B's working at the ER, or ER techs, which used to be called orderlies.

I fortunately haven't yet been to a call where a hazard caused an accident and was still present when we arrived on scene.
Standard procedure for an impaled object is typically to stabilize the object in place unless it is obstructing care of a critical issue such as airway management.

Great questions guys keep them coming.