Do you need critical calls to enjoy your work?

[firedoc5]

Thats whats great about this job though, the spontanuity... errr spontaneousness (lol??) of it. One day we're doing ALS runs to Yale and then at the end of my shift bam! Now we're Pulling a guy off the street, torn open from his juglar down past his rib cage.

OUCH

[ERDoc]

Over the years, trauma has lost its excitment. How excited can you get over cookbook medicine? They are nice to practice skills with. I would take a trauma over kids with viral fever and medication refills. There is nothing more satisfying that a real medical case. Something that gets your brain working. I had a guy with ischemic bowel the other day who ended up coding 6 times. I spent over 3 hours with him alone and went through every ACLS algorhythm except to Vfib. Definitely pushed me with some of the exam findings and the things we had to do. I think we all like a "good" call once in a while because it reminds us that sometimes we can make a difference and it pushes us to the limits. Let's face it, medicine people (EMS included) are generally some form of type A person and don't like to sit around and do nothing.

Personally I have a soft spot for ortho stuff too. You are limited in the field but it is sometimes challenging to find the fracture. It is even more satisfying when you can reduce a fx or dislocation. Nothing strokes the ego more than feeling the pop of a shoulder going back in. I think 'zilla can back me up on this.

[Christopher.Collins]

OUCH

Yea. He rearended a stopped (turning left) Ford Explorer doing at least 75 on a crotch rockect. Hit with such force the Explorer 180'ed in place. The guy was wearing a full helmet and leather jacket though. Airlifted from Backus to UMass I think. Surprisingly; with a major laceration of the chest cavity including a severed carotid artery and vein as well as severe blood loss, he survived. Would have been slightly curious to see how much further the extent of the damage would have been without the leather coat, but that as well as his body were torn open.

Would have made a great Case of the Month for JEMS.

[underdawg7738]

and most of all I love pyschiatric/etoh/drug type runs also.

I also enjoy running psych calls! Most people in this industry write these people off as a crazy loon but fail to find out why they've become crazy. Craziness runs deep in my family and it's creeping up on me now so I can relate to my psych pts to a degree of what they might be going thru. I had a partner who treated psych pts with absolutely no respect and then would talk smack on them after we drop them off at the ER. Well one day I had a psych pt who was seeing things and tried to commit suicide, after the call my partner started his crap again and I went total apesht on him. My pt was a Vietnam Vet who was seeing all his friends that he lost over there. Yeah it's been a long time since I hauled off on somebody like that and now he see's these pts in a different light.

Other then that a good mix of calls keeps me happy. I'm about as white of a cloud as you can get, in 6 years I've done CPR once and only had 3 fatal MVA's.

[firedoc5]

Yea. He rearended a stopped (turning left) Ford Explorer doing at least 75 on a crotch rockect. Hit with such force the Explorer 180'ed in place. The guy was wearing a full helmet and leather jacket though. Airlifted from Backus to UMass I think. Surprisingly; with a major laceration of the chest cavity including a severed carotid artery and vein as well as severe blood loss, he survived. Would have been slightly curious to see how much further the extent of the damage would have been without the leather coat, but that as well as his body were torn open.

Would have made a great Case of the Month for JEMS.

That's one reason I'm all for a full face helmet. We had one guy that was wearing a helmet that "kissed" the front of a semi. He had a through- and - through laceration from the corner of his mouth to the tracheas of the ear. I mean clean through. I forget how many reconstructive surgeries he had. On top of that he had a flailed chest and multiple fx. The last I know, he was back out riding. Sometimes without a helmet at all. He rode with one of our Lt.s

[CBEMT]

Yea. He rearended a stopped (turning left) Ford Explorer doing at least 75 on a crotch rockect. Hit with such force the Explorer 180'ed in place. The guy was wearing a full helmet and leather jacket though. Airlifted from Backus to UMass I think.

Backus usually sends their traumas to RIH, I spose UMass is a possibility though.

[spenac]

Over the years, trauma has lost its excitment. How excited can you get over cookbook medicine? They are nice to practice skills with. I would take a trauma over kids with viral fever and medication refills. There is nothing more satisfying that a real medical case. Something that gets your brain working. I had a guy with ischemic bowel the other day who ended up coding 6 times. I spent over 3 hours with him alone and went through every ACLS algorhythm except to Vfib. Definitely pushed me with some of the exam findings and the things we had to do. I think we all like a "good" call once in a while because it reminds us that sometimes we can make a difference and it pushes us to the limits. Let's face it, medicine people (EMS included) are generally some form of type A person and don't like to sit around and do nothing.

Personally I have a soft spot for ortho stuff too. You are limited in the field but it is sometimes challenging to find the fracture. It is even more satisfying when you can reduce a fx or dislocation. Nothing strokes the ego more than feeling the pop of a shoulder going back in. I think 'zilla can back me up on this.

I agree. When I first got into EMS the blood and guts really got me pumping. Now I find, especially as I get more education getting more excited about a good medical call. I mean I still need a good blood and guts to tell around the fire with the rookies and basics, but I really relish the challenge of a true medical especially at my part time job where I have 90 miles or more to see if my choice of treatment is working.

[katbemeEMT-B]

I can't say that I don't enjoy a good trauma, mainly because I know I still have so much to learn. As I progress in my schooling, I find myself assessing patients physiologically. As an example, severe trauma to a leg resulting in a artery bleed. Previously I would have applied pressure, wrapped it, splinted the leg, loaded the patient, and went. I now truly assess the patient to determine blood loss and what I need to do to stabilize him/her (ie: fluids for blood loss, pain meds to calm, transport decision). I look more from a physiological aspect of the entire body, not just the one wound. I look at how this injury to this particular part of the body is affecting the rest of the body. I also talk with my medic partners after the call to gain further knowledge, such as, why they did or didn't do a procedure or how they determined what type of care to administer.

With that being said, I also enjoy the medical calls regardless of the origination. My thought is that regardless of the call, there is always something there for me to learn. Sometimes it might be simply holding the patients hand and comforting them, but I am improving my people skills. It may be a patient with a complicated medical history which enlists my critical thinking skills. It may be something that I am already familiar with but I can still learn from it. With every call my critical thinking skills improve, my senses are heightened, I become more aware of my surroundings and pick up on even little things that might otherwise be overlooked, and I learn to appreciate my good health.

I am also learning to be more proficient and thorough when it comes to patient assessment and care. So while trauma gives me the adrenal rush I sometimes crave, all calls offer me a learning experience that will never be the same.

So in response to the OPs question, yes I need good trauma call, but I also need the more mundane calls if I want to conitue learning.

[itku2er]

Some times its the simple things that mean the most especially to the hurt or hurting.

But like anyone else I love a good trauma but working as a nurse in a nursing home unless grandpa falls I dont see much trauma.

[VentMedic]

But like anyone else I love a good trauma but working as a nurse in a nursing home unless grandpa falls I dont see much trauma.

Unfortunately, grandpa's fall may seem minor, if he was 21 y/o, but can have the highest probability of being fatal.

If a 21 y/o, acting stupid while driving an ATV, fractures a femur in an accident, it is a cool call or "trauma". If grandpa fractures a femur just trying to move from the bed to a chair, it is considered a bullsh$% call by some in EMS.