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Hi, i've been in EMT-B class for about three months now, and am going on my first clinical tomorrow. Seeings how i've decided to look for reason not to stress so much over this. haha. So, what im asking, is for any and all advice i can get for tomorrow? Thanks.

Hello everyone, I'm interested in becoming a paramedic and don't really know the ropes of the field. I love to learn and would want to learn as much as possible in this field to become the best paramedic I can be.

I'm posing this question in the form of a scenario. It's based on real events, but obviously I had to change some details to protect various people's privacy. You are an EMT-A working with an EMT-Paramedic. You're relatively new to the service you're working with, and the medic is someone who's been around for quite a while. You're working in a rural community with limited resources, and it's been yet another slow tour for you and your partner, who together form the only ALS crew in the region. You are called to back up a BLS ambulance responding for a 30 year old female, 9-echo (Cardiac arrest, CPR in progress). Collapse was witnessed, and compressions were performed by family for approximately 9 minutes prior the BLS crew's arrival, at which point the monitor was attached, V-Fib was recognized, and one shock was delivered. V-fib continued, and compressions resumed, and that's when you and your "ALS" partner showed up. Being an EMT-A, you recognize that the Paramedic is calling the shots now and assume a supportive role. Good quality CPR and ventilation is maintained, IV's are established, and coarse V-fib continues despite one round of Epi and another defibrillation attempt. It's been about 20 minutes since collapse, and the family is standing nearby watching you attempt to revive their wife/mother, and they are increasingly distraught by the events unfolding. It is at this point where things start to unravel. Your paramedic partner looks at the coarse, obvious V-Fib showing on the monitor, and requests you to draw up Atropine... "Do you mean Amiodarone?", you ask quietly. He retorts with a glare, and absolutely insists that Atropine be drawn. This is an easy task to accomplish, as the Atropine you carry is in a preload syringe. You reluctantly pass it to the medic, who proceeds to push the drug slowly into the patient. Fibrillation persists. 5 minutes later another dose of Atropine is given. No change. A little over 30 minutes into the arrest and the third shock is delivered, at which point the patient goes into asystole. Upon seeing this, the medic determines that no further medications are to be given, and that transport should be initiated to the closest facility (about 30 minutes away). Compressions are continued, but no further electrical activity is restored enroute, and all measures are ceased shortly after arrival at the care center. So my question to you is this; being the EMT-A in this scenario, at which point do you interject and voice your concerns over blatantly poor decisions and errors made by your "superior" who's running the call? Bare in mind the setting of this scenario, and the fact that all communication on scene can be easily overheard by the patients family. Do you say anything on scene? Do you address the matter afterwards, or in private? Or do you just assume that your partner knows something that you don't, and move on. And what do you do in other situations when a partner that "outranks" you makes a Tx decision on scene that you absolutely disagree with (morally or clinically)? I'd really appreciate your thoughts on this...

Yesterday was my second ride out on the job...was really nervous but trying to control it. I was riding with a paramedic and an EMT. The EMT was really cool, the paramedic less so. We got a PT who had overdosed on Benedryl. When we got her in the vambulance we were driving (their box was being repaired) she started asking me for things out of the ALS bag. She spoke softly and I had to keep asking her to repeat herself and I could tell it was irritating her. I didn't know half of the things she wanted and then she asked me to spike the IV bag and flush the IV. Her EMT has been doing this for 12 years and this was my SECOND day. By that time I was just flustered cuz I couldn't do anything she asked. Then the lady said she had to vomit and I tried to find the emesis bag in time in the cramped space on a rough bouncy road but didn't get it to her before she threw up all over the paramedic. From that moment she was just pissed. For the rest of the night I couldn't seem to do anything right. She gave me a lousy review and insisted on faxing it to corporate herself. I don't feel like a got a fair shake but dont want to make waves with the people I will be working with. The EMT tried to make me feel better, told me not to get discouraged. Should I say something to corporate or keep my mouth shut? Also, any advice on staying calm so you can think straight on stressful calls would be much appreciated.