My First Clinical Shift As An Emt Student

“Code Blue, ER. Code Blue, ER”. I can still hear that calm, unalarmed voice over the intercom. Seconds later, John Doe, a 50-year-old male, is rushed in through the double doors of the Emergency Room with an EMT pounding on his lifeless chest. Although the medical staff had been preparing for some time, it still appeared like a scramble to resuscitate this man’s life. It was my first shift as a medical scribe; I had no idea what to expect. While paramedics shouted the jargon-filled report, the surrounding chaos was quieted by the physician who maintained the room's composure. The instant the pulse was obtained, I was overcome with a foreign feeling that can only be described as pure exhilaration as if the epinephrine injected into the patient manifested its effects on me.

Pulling off the ramp, we turned onto Church Hill Road responding on a priority one for the cardiac arrest. I tried to review my field guide en-route to the call, but all I could see were flashing lights reflecting off the guide’s pages and crowds of cars moving over for our wailing sirens. Within three minutes we had arrived on-scene and it was clear that our patient was not in cardiac arrest; however, his 12-Lead EKG and oxygen saturation were marginally reassuring and pointed to an active heart attack. At this point in my EMS training I was a BLS provider, but had adequate knowledge to assist Kathy. Instinctively, I went right to work and loved every second of it. The concept of formulating a differential diagnosis in the field and testing that theory is one of the principle factors that kept drawing my back to EMS. In addition, I developed an unparalleled appetite for knowledge, stemming from my desire to get every differential diagnoses right. Coming to this realization early in my EMS career, we [healthcare providers] frequently forget that patients often lack the medical knowledge provided to us through years of training. Behind CT Scans and MRIs are patients with questions. Having the ability to provide compassion, sympathy and reassurance to a patient is a central part to their recovery and survival; therefore, we [healthcare providers] need to be able to care for our patients on a holistic level, focusing less on the disease and more on the

Meanwhile, elsewhere in Habersham County, Tom was feeling slightly nervous as he exited the staff lounge and entered the hustle and bustle of County Hospital’s ER to begin his first shift as an RN. The first few hours of his shift passed slowly as Tom mostly checked vital signs and listened to patients complain about various aches, pains, coughs, and sniffles. He realized that the attending physician, Dr. Greene, who was rather “old school” in general about how he interacted with nursing staff, wanted to start him out slowly. Tom knew, though, that the paramedics could bring in a trauma patient at any time.

Charging to 200....Stand clear…Shocking! CPR....EMS providers experience the adrenaline and rush of a patient in cardiac arrest. Trying to bring dead back to life is not a simple task by far, especially with the limitations and resources of the field. But, what happens after the patient makes it to definitive care? Annually, around 300,000 adults in the United States experience out-of-hospital cardiac arrests (AHA), and EMS providers only see the results of the short term survival of the patient, but rarely the actual patient care and recovery after an arrest. Patients undergo intense, aggressive treatment and recovery measures in the hospital post-code. These patients have a variety of treatment regimens

Minutes have passed and to my surprise, after shocking the patient multiple times, we had return of spontaneous circulation. A sense of excitement, and relief, poured over me. From my past experiences, I assumed that there was a small probability that this man would live; however, that day I learned that every patient is different. As a Physician Assistant (PA) I want to consider the entire combination of factors that make each person unique, analyzing all aspects of their life – physically and emotionally. Ultimately, this experience motivated me to channel all of my energy towards pursuing a career as a PA.

It is a warm summer evening at Grady Hospital. It is my first day as an emergency room volunteer. I’m nervous and eager, hoping to see something exciting. However, it is surreally quiet. Suddenly, there is word of an ambulance en route. Minutes later the paramedics burst into the trauma slot pushing a man on a stretcher. His head and face are covered with gauze that is soaked through with dark blood. It is a flurry of well-orchestrated movement as the attendings and residents start to resuscitate him. They pull back the bandages to reveal a deep gash that is bleeding profusely. With much effort his vital signs are stabilized and he begins to regain consciousness. Later, after the excitement had passed, I learned what brought him here. He is diabetic and couldn’t afford to properly manage his condition. He had fainted due to hypoglycemia and hit his head. He had almost lost his life because of the unfortunate financial realities of modern healthcare. In that moment, I came to appreciate the very real cost of disease and the incredible role physicians have in ameliorating it. This formative experience was the beginning of my path to medicine.

There are errors and hazards in care that occurred in the Mr. B scenario. One error was the emergency room physician’s failure to recognize the signs and symptoms of deep vein thrombosis (DVT) that Mr. B was presenting. If not treated early, a DVT can become a pulmonary embolism, a fatal condition that Mr. B unfortunately developed. Another error in care that happened in the Mr. B scenario is the nurses’ failure to monitor Mr. B’s ECG and respirations. Early detection of critical ECG and respiratory changes could have initiated medical interventions that would have saved Mr. B’s life. One hazard is the emergency room nurses’ heavy patient load at the time of Mr. B’s sentinel event. Another hazard is having a licensed

Almost everyone who works in EMS has this one thing in common, the fear of the pediatric call. Due to those calls being few and far between, the skills needed for a pediatric call are rarely at their best. There are also some who don’t keep their pediatric skills as sharp as others, because of the low amount of calls they might run on kids. This paper will be focusing on cardiac arrests in children, and opening the reality of how common it is becoming. Everything from what causes it, what is the most common cause, and the unexplainable. The what’s, how’s and whys are all questions that we will be expected to know. There is so much that goes into these patients, physically and mentally. Knowing these things and understanding how to handle these situations is just as important as knowing the information for a registry test. In almost most of these incidents the family doesn’t care how much you know, they care about how much you care.

An hour or so into my first day at my internship and my mentor gets a call from the Emergency Room about an elderly patient who came in complaining of chest pain. After running some tests and EKGs, the ER staff finds some abnormal results which slightly suggest that the patient might be having a heart attack. The patient is rushed into the cath lab while my mentor has to leave to attend a case at another facility so he leaves me with his partner Dr. Fernandez to watch the case. Dr. Fernandez starts the procedure of cardiac catheterization in which he plants a stent in the patient’s heart in roughly 30 minutes. Although the patient suffered no heart attack, Dr. Fernandez found some narrowing the patient’s heart. That was my first day of my

The purpose of this journal is to reflect on my experience and skills gained during my clinical placement at Ben Taub Hospital. On my first clinical day, I was excited and nervous at the same time. My first placement was in the PREOP/PACU area. I was assigned to help a patient who had been in the PACU area going on 2 days. Normally, once the patient comes from surgery they are only in the PACU area for a short period of time before they are discharged home or given a bed in another area of the hospital. This particular patient still had not received an assignment for a bed. The physicians would make their rounds to come check on him daily. The patient was a 28-year-old Hispanic male, non-English speaking, he had a hemicolectomy. He had a NG tube, urinary Foley catheter, and a wound vac. My preceptor had just clocked in and she needed to check on the patient’s vitals and notes from the previous nurse. Once she introduced me to the patient and explained while I was there, she then asked me to check his vitals. (Vital signs indicate the body’s ability to regulate body temperature, maintain blood flow, and oxygenate body tissues. Vital signs are important indicators of a client’s overall health status (Hogan, 2014). I froze for a quick second. I have practiced taking vitals numerous of times and I knew I could do it correctly. I started with the temperature first, when I was quickly corrected on a major mistake I had made by my preceptor. I HAD FORGOT TO WASH MY HANDS and PUT

| Lesson Outline: Allocated teacher-NExplaining legal requirements : Duty of care: A duty of care is implied when the person who is requiring your assistance is in your workplace. E.g. patient, co-worker or visitor. Consent of an unresponsive patient is assumed in an emergency situation. (Crouchman, 2009; Milne & Mellman-Jones, 2010).Cultural awareness/sensitivity: We need to mindful of varying cultures when assisting patients, as different cultures prefer to be unexposed which is necessary when defibrillation is required. Eg, Muslims (Hattersley & Keogh, 2009). Confidentiality: Following an emergency situation it is vital to refrain from speaking to others outside the workplace about the patient to ensure the patient’s privacy and dignity. Think about how you would feel if you where in the patient’s situation. (Maeder, Martin-Sanchez, Croll, & Ambrosoli, 2012)?Limitations: Remember that once you start you can’t stop until you’re physically unable to or help arrivesDebriefing: Participating in the debriefing process is vital due to the enormity of the situation, enabling the nurse to express

Last Thursday was an exciting and enthusiastic day getting to observed a patient who is having a transesophageal echocardiography (TEE) and cardioversion procedure done due to atrial fibrillation which is a quivering or irregular heartbeat. The TEE was performed before the cardioversion to look for clot in the heart, which could make it dangerous to proceed with the shock. The Tee is an ultrasound test done from the esophagus to allow a close inspection of the heart to make sure there is no clot. Before the procedure, all the equipment’s were set-up by the nurse techs. After everything was set-up, the anesthesiologists and medical doctors entered the room and proceeded with the procedure. The anesthesiologist and doctors explained to the patient

K. De Meester a,b,∗ , M. Verspuy b , K.G. Monsieurs a,c , P. Van Bogaert a,b

Therefore, prompt CPR and rapid paramedic response can improve the survival chances from a heart attack.

Substantial medical information as well as demanding hands-on practice and training are needed to master ACLS. Only certified medical service providers can offer ACLS, because it necessitates the capability to handle the person's airway, start IV access, examine and translate electrocardiograms, as well as comprehend crisis pharmacology; included in this are doctors (DOs as well as MDs), pharmacy technicians (PharmDs), dental practitioners (DDS as well as DMDs), midlevel professionals (PAs as well as NPs), nurse practitioners (RNs), along with paramedics. Many other crisis responders might also be prepared. Several health care professionals, and even lay rescuers, might be educated in fundamental or basic life service (BLS), particularly cardiopulmonary resuscitation or perhaps CPR. Whenever a sudden cardiac event happens, instant CPR is a crucial interconnection in the sequence of coping and surviving. Another essential interconnection is actually early defibrillation that has enhanced significantly with all the prevalent accessibility to AEDs (Hazinski et al, 2010).