Author Topic: Mental prep and building medical skills: become an EMT  (Read 18833 times)

Offline badgustav

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Mental prep and building medical skills: become an EMT
« on: May 28, 2009, 09:29:43 AM »
This seemed the logical place to share this thought. In my mid 20's I decided on a career change for a few reasons. One was to leave factory work for something more mentally stimulating, another was to help others. But biggest in my mind was to learn how I would deal with an emergency situation. I decided to become an EMT.

I took the course (very affordable, for the time involved) and got a job at a company providing 911 in a fair sized city just out of metro Boston. I worked it for 1.5 years before I decided the pay and crappy schedule weren't worth the stress. But in that time I learned some very important things.

1. Medical knowledge - duh, right? But not just what I'd been trained to do. I assisted on dislocation reductions, IVs, tubings, and any number of procedures "beyond" my level of training. When things were tight, people turned to someone they trusted and said "do this!"
2. Resilience of the human body - we didn't always get to do things "by the book" but people managed to make it through
3. The Fragility of human life - I saw death. A lot of it. First time was a 2 month old baby who died of SIDS. I performed CPR more times than I can remember, and it only once got a pulse back (and I know, that's not the point of it, but I think too many people feel it is)
4. Communication - getting your point across under stress to team mates, dealing with hysterical family, all good things to know
5. Keeping your head - I think the single most important thing I took away. Knowing you can keep it all together when things around you are a mess will be an invaluable skill in a SHTF scenario

Point being, not all of us have the advantage of military experience to fall back on, but there is an option out there of real world stressful environments that may serve as a good testing ground for when things go wrong. Check out courses in your area and maybe volunteer with your local service. Could really pay off some day!

Offline archer

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Re: Mental prep and building medical skills: become an EMT
« Reply #1 on: May 28, 2009, 10:07:53 AM »
+1 for your idea and for sharing your experiences badgustav. I took the local basic CERT class but left feeling like that was just a minor intro. I'll have to see what I can find.

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Re: Mental prep and building medical skills: become an EMT
« Reply #2 on: May 28, 2009, 10:35:16 AM »
Yea, good post badgustav.
When I was in my 20's I spent a few years as a volunteer in a heavy rescue squad. We focused on underground extraction and elevated rescues. The area where we were located had several big chemical factories and a bunch of active and abandoned mines.
Because they needed people, I got the training for free. Very little medical training, but when we actually went out on rescues we worked with/for the EMTs so you could learn a lot by watching and being available to do what you were told.
We learned about improvising to lift very heavy objects, all the basic rope/climbing/repelling skills and safe practices, how to shore up unstable structures, and a ton of other useful stuff.
But like badgustav said, I think the most important thing I learned is how critical it is to keep your head in an emergency. Not only for the rescuer but it makes a huge difference in the survival rate of the victim.

Offline Pathfinder

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Re: Mental prep and building medical skills: become an EMT
« Reply #3 on: May 28, 2009, 11:55:56 AM »
Our local ambulance service runs the full gamut of EMT training, from Basic through paramedic and even beyond - Life Flight, specialized stuff like that. Only costs $600 for EMT-B, plus materials. One of the things I learned in their Citizen Academy was that CPR only saves - at best - 10%. Pretty reasonable, but you only make maybe $30k a year once you get your cert.

My GF was mildly PO'd, as I got to do things in the Citizen Academy that she as an LPN couldn't do, like intubate, start a line, etc. Of course, it was all on dummies, not real people.  ;D

Offline badgustav

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Re: Mental prep and building medical skills: become an EMT
« Reply #4 on: May 28, 2009, 12:14:13 PM »
You're right, Pathfinder, the primary goal of CPR is really to keep blood moving to the brain so that other methods, like defib, have a chance. And the pay is one of the main reasons I left. I was there 1.5 years, only went up by $.50 in pay, so I was at $8.50/hour. Yes, about 12 years ago, but still not worth the headaches

What is Citizens Academy?

Offline Pathfinder

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Re: Mental prep and building medical skills: become an EMT
« Reply #5 on: May 28, 2009, 03:39:41 PM »
You're right, Pathfinder, the primary goal of CPR is really to keep blood moving to the brain so that other methods, like defib, have a chance. And the pay is one of the main reasons I left. I was there 1.5 years, only went up by $.50 in pay, so I was at $8.50/hour. Yes, about 12 years ago, but still not worth the headaches

What is Citizens Academy?

Citizen Academy is a free outreach program where ordinary people can come in for a period of time and learn about the service, the work that the agency does, usually hand-on. I am being vague on who because we have a number of them in this area (Fargo, ND). Each is 1 night a week except for the dispatch, which is 1 night period. As far as I know, the FM Ambulance is the only EMS Citizen Academy in the country. I've been to 2: FM Ambulance and Cass County where I live. You can go on ride-alongs with each, shoot weapons with the police, visit inside the county jail (never open to visitors other than the CA class), meet with the bomb squad and SWAT Team, and learn the Sheriff's role within the county as the primary LEO in the county. Also, for someone living in the county, it is a great way to meet the officers on a non-arrest basis.  ;D

I did learn that the Feds have deputized every bomb squad member of every certified PD in the country as a Special US Marshall Deputy. Scary . . . .

With FMA, we had lessons in 4- and 12-lead EKGs, starting IV lines, CPR of course, and pulling someone from a wrecked vehicle. The dummies now are very realistic - they have one you work on and it provides all of the vital signs (breathing, pulse, heart rate, etc.) - until the "patient" crashes and you have to do stuff to it to try to revive it. Very creepy walking into that room and seeing the infant dummy.

These are the CAs locally - check your areas and see if they have them, or would be interested in starting one. They are very good programs.

Fargo-Moorhead Ambulance - 8 weeks http://www.fmambulance.com/htmls/citizen-academy-fargo.htm - page needs updating, says 2007 but they do 2 classes a year

Cass County Sheriff - 13 weeks  http://www.casscountynd.gov/Departments/Sheriff/CitizenAcademy.htm

Fargo PD - http://www.cityoffargo.com/CityInfo/Departments/Police/CitizenResources/CitizensPoliceAcademy/

West Fargo PD - http://westfargopolice.com/citizen_police_academy/index.html

Red River Valley Dispatch - http://www.rrrdc.com/citizen.html - Note: this is one of the few 2-state dispatch services in the country; also supports 7 PDs, 2 Sheriff Depts., 3 city FDs, 29 rural FDs, FM Amb and 15 rural ambulance services, plus interfacing to the state patrol

Clay County Sheriff (MN) - http://www.claysheriff.com/02_14_0Academy.asp

Moorhead PD (MN) - http://www.moorheadpolice.com/citizenInvolvement/citizenPoliceAcademy.asp
« Last Edit: May 28, 2009, 03:42:45 PM by pathfinder »

Offline PBRstreetgang

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Re: Mental prep and building medical skills: become an EMT
« Reply #6 on: May 28, 2009, 11:57:30 PM »
Thanks for this info guys.  Just out of curiosity, for anyone who has served as an EMT before: what are the hours like?  Is it a one day on, two day off type thing?  Just wondering if the career would allow for a second (home-based) job, or if many EMTs moonlight in a second job (out of boredom and/or lack of pay).

I understand every jurisdiction probably has its own policies, but would be interested to hear what people experienced in the past.

Offline boredparamedic

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Re: Mental prep and building medical skills: become an EMT
« Reply #7 on: May 29, 2009, 12:59:41 AM »
Life as an EMT sucks, the hours suck and the pay definitely sucks. Hours- now I ONLY work 48hrs a week, Make about 60k (with all overtime,bonuses,etc) This is with EVERY Cert one could have, Over 2O+ YRS EXPERIENCE at the highest level one can attain in my state. But doing that also has its tolls mentally and physically and have been exposed to everything imaginable. Now it seems like everyone in the lower socio-economic demographic calls 911 for some of the most ridiculous things. And severely overweight persons,living on the top floor with no elevator. But the training and experience would definitely be an asset in a disaster.

Offline PBRstreetgang

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Re: Mental prep and building medical skills: become an EMT
« Reply #8 on: May 29, 2009, 01:12:37 AM »
How is that 48 hours/week structured (2x24, 4x12)?

Offline badgustav

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Re: Mental prep and building medical skills: become an EMT
« Reply #9 on: May 29, 2009, 07:10:57 AM »
The hours really do suck. We worked a rotating shift, 4 days on, 3 days off. Those 4 days looked like:
Day 1: 8 AM-6 PM
Day 2: 8 AM-6 PM
Day 3: 6 PM-8 AM
Day 4: 6 PM-8 AM

Because of the time off in between, you you ended up with "short weeks" and "long weeks" for pay. And don't ever count on sleeping on an overnight, especially as most EMS companies don't provide bunks (though the stretcher in the back of the bus isn't bad in a pinch, and it means you're already on board when you get called)

Pay today is @ $10/hour, depending on where you live, and things are much better if you're also a fireman. Being asthmatic, that was never going to be an option for me.

Offline Asclepius

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Re: Mental prep and building medical skills: become an EMT
« Reply #10 on: June 03, 2009, 10:53:47 AM »
I am a paramedic working 24 hours on and 48 hours off. I make about $60k/year. I get tons of down time while working (with some days of exception) and I do odd jobs for money on my off days. Good medical and dental, and 401k matches dollar for dollar up to 10% of my check. Plus I get to live at the beach.

I have worked other schedules too, including four 12 hour days on, 4 days off. I have also worked rotations of (12 hour shifts) 2 on, 2 off, 3 on, 2 off, 2 on, 3 off, repeat.

The county to the north works 48 hours on and 4 days off.

The system I work in is rural (often without fire support) with extremely liberal protocols, allowing us to work up to our fullest potential. My job is awesome and I couldn't imagine doing anything else.

Offline badgustav

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Re: Mental prep and building medical skills: become an EMT
« Reply #11 on: June 04, 2009, 07:16:23 AM »
I envy you, Asclepius. Had that been the work environment available in this area, I would have followed through with my EMT-P and stuck it out. It's all about location, I suppose. Good for you!

Offline BerserkerPrime

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Re: Mental prep and building medical skills: become an EMT
« Reply #12 on: June 04, 2009, 09:12:23 AM »
I'm a security contractor on North Slope.  Our company incourages and pays for our EMT training so I jumped on it.  I was certified 22 years ago and did Combat Medic training  17 years ago.  Most info came back pretty quickly, but since getting certified, I have had to really review to ensure retention of info.  We get alot of industrial type injuries but even more heart/stroke type incidents with our aging oilfield workforce. 

Will strive for EMT II this year and III next year.  Great skills to have and have been very useful off duty.  I'd encourage anyone who can do it, to do it. 

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Re: Mental prep and building medical skills: become an EMT
« Reply #13 on: June 08, 2009, 12:47:36 AM »
Ya, I did a stint as an EMT-B a long time ago. I wanted the training & the experience, and those I did get. It didn't take long though for the realization that I was basically making entry-level security guard wages while risking my life with potential TB & Aids exposure, etc. So I punched my ticket there and moved on to greener pastures.

I wouldn't mind volunteering for a rural search & rescue unit as long as my commitments were on my terms. If anything, it was an exciting job.


Offline OJ

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Re: Mental prep and building medical skills: become an EMT
« Reply #14 on: June 08, 2009, 08:05:55 AM »
I'm an EMT-B, as it was a job requirement at the time I joined the department.  Newer officers are First Responders.

I'm not convinced that EMT skills are all that useful in a TEOTWAWKI situation, because the skill set is basically geared towards stabilizing the patients so that they can survive long enough to get them to the full-fledged DOCTORS who can hopefully fix the problem.

Of course, that would depend on the level of disruption.  You might be able to get the patient to a doctor, or you might not.

Offline doublehelix

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Re: Mental prep and building medical skills: become an EMT
« Reply #15 on: June 08, 2009, 03:01:04 PM »
I'm an EMT-B, as it was a job requirement at the time I joined the department.  Newer officers are First Responders.

I'm not convinced that EMT skills are all that useful in a TEOTWAWKI situation, because the skill set is basically geared towards stabilizing the patients so that they can survive long enough to get them to the full-fledged DOCTORS who can hopefully fix the problem.

Of course, that would depend on the level of disruption.  You might be able to get the patient to a doctor, or you might not.

NREMT-P here.

Look into EMT-W(ilderness)

Much more applicable skillset for survival situations.

Several VERY good classes out there if you google.

Offline BerserkerPrime

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Re: Mental prep and building medical skills: become an EMT
« Reply #16 on: June 08, 2009, 03:19:52 PM »
I'm an EMT-B, as it was a job requirement at the time I joined the department.  Newer officers are First Responders.

I'm not convinced that EMT skills are all that useful in a TEOTWAWKI situation, because the skill set is basically geared towards stabilizing the patients so that they can survive long enough to get them to the full-fledged DOCTORS who can hopefully fix the problem.

Of course, that would depend on the level of disruption.  You might be able to get the patient to a doctor, or you might not.

You are right to some extent there OJ, however, in a TEOTWAWKI situation and folks know that you are EMT and there are no doctors available, guess who will be getting requests for help.  Your absolutley right about stabilization, but at some point that's all that may be available for medical care and there fore it is useful.  Especially if you can relieve discomfort and give the patient more time to look for MDs or come up with another plan.

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Re: Mental prep and building medical skills: become an EMT
« Reply #17 on: June 08, 2009, 08:23:59 PM »
I'm an EMT-B, as it was a job requirement at the time I joined the department.  Newer officers are First Responders.

I'm not convinced that EMT skills are all that useful in a TEOTWAWKI situation, because the skill set is basically geared towards stabilizing the patients so that they can survive long enough to get them to the full-fledged DOCTORS who can hopefully fix the problem.

Of course, that would depend on the level of disruption.  You might be able to get the patient to a doctor, or you might not.
Right, I consider my EMT-B rating to be a base level training & a springboard to further medical education. I also have a Combat Lifesaver cert from .mil that focuses a little more on combat casualties. Now, I'm taking the next step and learning more about wound management, dental emergencies and long-term care. I'm also studying herbalism in case the available meds dry up.  And I think the EMT-W idea is also a logical next step. I'll have to research this for my area.

Offline Pathfinder

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Re: Mental prep and building medical skills: become an EMT
« Reply #18 on: June 08, 2009, 08:36:49 PM »
NREMT-P here.

Look into EMT-W(ilderness)

Much more applicable skillset for survival situations.

Several VERY good classes out there if you google.


NREMT-P - very cool there, double, very impressive. I think we have 2-3 in our area. Congrats.

EMT-W - excellent advice for TEOTWAWKI support. Depending on the nature of TEOTWAWKI there are also civilian combat medic type course. It's late, I'm tired, if someone doesn't find links and post them, I will tomorrow.

Offline PBRstreetgang

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Re: Mental prep and building medical skills: become an EMT
« Reply #19 on: June 08, 2009, 08:44:05 PM »
NREMT-P - very cool there, double, very impressive. I think we have 2-3 in our area. Congrats.

EMT-W - excellent advice for TEOTWAWKI support. Depending on the nature of TEOTWAWKI there are also civilian combat medic type course. It's late, I'm tired, if someone doesn't find links and post them, I will tomorrow.

I highly recommend WMI for the wilderness upgrade to an EMT-B; I've been Wilderness First Responder certified through them for three years now; one of the best training investments I've ever made.  Top notch instructors with a lot of real world experience.  Lots of hands on/scenario based training.  If you take their WFR course, then get an EMT-B through a community college, etc. you're a WEMT in their book.

http://www.nols.edu/wmi/courses/

Offline Asclepius

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Re: Mental prep and building medical skills: become an EMT
« Reply #20 on: June 10, 2009, 01:26:51 AM »
I highly recommend WMI for the wilderness upgrade to an EMT-B; I've been Wilderness First Responder certified through them for three years now; one of the best training investments I've ever made.  Top notch instructors with a lot of real world experience.  Lots of hands on/scenario based training.  If you take their WFR course, then get an EMT-B through a community college, etc. you're a WEMT in their book.

http://www.nols.edu/wmi/courses/

Nols' program is great for the knowledge, but it has no reciprocity with a state first responder certification, which means you're practicing medicine without a license or a physician supervisor. Nols tells their students that they will back them legally, but haven't heard that claim yet put to the test. Is that worth the $400 or $500 they charge?

I would also like to point out that Wilderness EMT is not even an officially recognized certification. It means nothing over an EMT-Basic other than the benefit of the personal knowledge you gain.

Offline PBRstreetgang

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Re: Mental prep and building medical skills: become an EMT
« Reply #21 on: June 10, 2009, 12:30:04 PM »
Nols' program is great for the knowledge, but it has no reciprocity with a state first responder certification, which means you're practicing medicine without a license or a physician supervisor. Nols tells their students that they will back them legally, but haven't heard that claim yet put to the test. Is that worth the $400 or $500 they charge?

I would also like to point out that Wilderness EMT is not even an officially recognized certification. It means nothing over an EMT-Basic other than the benefit of the personal knowledge you gain.

That's all I did it for (the personal knowledge), and it was well worth the $600 tuition - I doubt you will find such comprehensive, practical information in a two week course elsewhere.  Not the route you'd want to go if you want to start a career in urban emergency medicine though; more geared for backcountry guides, ski patrollers, SAR team members, etc.

Offline Tennessee Mountaineer

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Re: Mental prep and building medical skills: become an EMT
« Reply #22 on: June 13, 2009, 07:19:33 PM »
Great post! I just finished my NREMT-B cert and finish the WEMT up grade this coming week at landmark learning in Sylva NC. Great course and instructors. Every EMT and Paramedic I rode with on clinicals said the money and the hours suck. Not to mention the protocols that vary from state to state.

 I have to admit I didn't do this for the money but for the skills, experience,training and  a sense of duty and compassion for others. Perhaps every good medic has that but it is hard to keep it going with all the stress the job entails.

 It was that same sense of duty and compassion that made me join the army as a Medic years ago. A lot of medicine has changed since my days as a 91C/91B. Just the AED alone is amazing. SAO2 is another cool thing. Airway management has come along way as well.

  Just taking a course will not make you into a good medic. I feel you have to get practical on the job experience before you own your skills. You have got to do the work for the eventual reward of being a good medic.

 I live in a rural area where medical care is a long way away and easily overwhelmed so as part of my preps I felt it was important to get those medical skills back. Individual preps are important as is self reliance but community disaster preps can go along way in a bad scenario.
 
Others my feel differently and that is good but, for me there is just more to being a medic than a job. It's an commitment to the health and welfare of myself, my family and the community I live in. For me assuming the role as a health care provider was like taking that oath to protect and defend the constitution against all enemies foreign and domestic. Be safe out there!.
« Last Edit: June 13, 2009, 07:23:54 PM by Tennessee Mountaineer »

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Re: Mental prep and building medical skills: become an EMT
« Reply #23 on: June 13, 2009, 10:18:35 PM »
If I may offer a suggestion - spend you money and time and become a registered nurse instead.  Having been a RN for almost 30 years, and spending 20 of them in emergency rooms, I made at least 3 times the EMT salary.  As a matter of fact, I work with several EMTs that went to school for their RN.  As there is a national shortage of nurses, there are numerous educational grants and scholarships available.

Yes my hours were difficult.  3 12 hour shifts a week, with 4 days off.  The pay was excellent.

However, a word to the EMTs.  Thank God there are people who do what you do.  It takes a special person to be a first responder, if that's what you chose - GO FOR IT!!!

Offline DeltaEchoVictor

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Re: Mental prep and building medical skills: become an EMT
« Reply #24 on: June 16, 2009, 05:17:09 AM »
Thanks for this info guys.  Just out of curiosity, for anyone who has served as an EMT before: what are the hours like?  Is it a one day on, two day off type thing?  Just wondering if the career would allow for a second (home-based) job, or if many EMTs moonlight in a second job (out of boredom and/or lack of pay).

I understand every jurisdiction probably has its own policies, but would be interested to hear what people experienced in the past.
From my own experience it varies a great deal.

My typical shifts were 12 hours backed by a 12 hour call shift....for 3 days in a row.  That was at a county based EMS service.

My second full time job was a 12 hour shift with no call back shift.  Call was done voluntarily there.

Where I live EMT/Medic pay isn't that great.  I always worked two jobs, sometimes both full time & sometimes one full time/one part time.  I loved doing it though so the long hours didn't bother me.  When I went thru paramedic school my wife layed down the law, either cut back on the jobs or cut back on the wives.  Since I only had one wife I took the hint.

It really is quite a rewarding career if you can handle the stress, long hours & learn to leave all of it behind at the end of your shift.  Like Angie said though, many EMS professionals go into the nursing field because of higher wages. 

The training you receive in EMT school will teach how to pass the skills tests & licensing exams, & generally how to perform some of the stuff you need to do to ride an ambulance.  You won't learn how to be an EMT until you start the job.  That's where you learn the real world skills, & what they teach you in school is a very small part of that.  If you're genuinely interested in learning life saving skills then you need to work the back of the ambulance.

Offline Pathfinder

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Re: Mental prep and building medical skills: become an EMT
« Reply #25 on: June 16, 2009, 05:58:31 AM »
Rereading this thread made me think of another possible perk of being an EMT/First Responder. And that is - are you privy to all sorts of info that the Feds hand out, just not to the sheeple? Does being a FR actually gain you access to not public knowledge of risk assessments, strategies, tactical ops, etc.?

Offline DeltaEchoVictor

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Re: Mental prep and building medical skills: become an EMT
« Reply #26 on: June 17, 2009, 03:13:48 AM »
If anyone is interested there are several EMS related podcasts available on iTunes.  They range from the basic to the advanced & from broad topics to specific topics like PHTLS & EMS pharmacology.

Offline DeltaEchoVictor

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Re: Mental prep and building medical skills: become an EMT
« Reply #27 on: June 17, 2009, 06:00:02 PM »
Rereading this thread made me think of another possible perk of being an EMT/First Responder. And that is - are you privy to all sorts of info that the Feds hand out, just not to the sheeple? Does being a FR actually gain you access to not public knowledge of risk assessments, strategies, tactical ops, etc.?
We did get some information that the general public probably didn't.  The biggest perk though was going to concerts & events for free. ;D  Lots of events have to have medical staff on site for liability purposes.  I got to go to a lot of concerts & activities & get paid to do it.

Offline Orionblade

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Re: Mental prep and building medical skills: become an EMT
« Reply #28 on: December 05, 2009, 12:55:53 PM »
I originally posted this in the peer review/intro thread - this one's old as dirt, but maybe someone's still monitoring replies?

Here goes a re-post since it seems to be pertinent to stress-management in the whole EMT line of work...

I've never had a huge monster blow-out style trauma situation to deal with, but I have had plenty of run ins with knives and a few track and field injuries, and handled myself quite well and quite calmly. Further, I can think of about 20 odd situations where I was the only non-dumbfounded fellow about that could tend to someone having a seizure, blackout, diabetic issue, or even a somewhat significant bleeding injury.

For those of you who may have been through an unexpected medical SHTF scenario, to include combat field medicine, how likely are my past experiences with somewhat less pucker inducing conditions to translate into a real SHTF situation where someone's life is literally in my hands? Is that weird zone of silence that falls and blocks out the blathering idiots beside me going to be there just like it always has and allow me to properly position the seizing patient and direct those around me to keep her from smacking herself silly on the concrete? What may or may not make that "zone" go away, and how do I learn to induce it at will, or at least make damn sure it comes in when I need it?

I would hesitate to chalk it up to all the little medical mishaps that I've had to deal with while taking care of my grandmother, since my first experience with this sort of response was in 5th grade when a friend had a seizure. She was undergoing chemotherapy and radiation for a brain tumor, so I had read up on it a bit and talked with her about what happens and what to do. When it happened I just did what we'd talked about, not even thinking about what I was doing all that much. The teacher seemed to need a change of pants, and everyone that wasn't helping me just sorta stood there staring at me like I was an alien or something.

That situation has never really left me, but it's always left me baffled that, first, I was calm in the situation, and second, that nobody else was.

*shrugs*

Thanks in advance for the input,
Orion

Offline Altered Mental Status

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Re: Mental prep and building medical skills: become an EMT
« Reply #29 on: December 05, 2009, 01:14:28 PM »
Ok if you want to be able to make a difference then you need to be a medic. A basic does not start lines on people, do chest decompressions, push med's or do  any other advance procedures. A basic learns how to bandage and splint and immobilize a patient. I know all of this because I was one before going on to medic school. I also teach wilderness first aid and there are different levels of this training also. Any training is better than none, but keep it real.