Staying calm in the field

[MedicNurse]

As most of the other replies say, it does get better. I was a paramedic for 17 years, and I can tell you that what you are feeling is a lack of self confidence. Once you have been on the streets a while, that confidence builds, and you will become much more relaxed. The important thing until then is to just do your job to the best of your ability. Do what you know from your learning experiences, and be willing to keep learning from others. One day, you will be the one teaching others and giggling at how nervous the new guy is.

Also, Even after working the streets as long as I did, I still would get a bit anxious on certain runs. It is only normal, and when the day comes that there is never a run to get your blood pumping, that is the day it is time to get out.

Be safe!

[Doczilla]

When you look at a situation and see all that has to be done, when you are feeling overwhelmed and unprepared, just get started. Things will start to flow.

Be a good EMT first. As someone else just said, seconds rarely count. If they do, it's almost always something in the BLS arena. If you handle ABC and transport, you've still done the patient a favor.

Usually those who die on you in the ambulance couldn't be saved to begin with. The skein of their life was written long before you got there. So do not fear it.

Drill, drill, drill. When the shit hits the fan, you do not rise to the occasion, you sink to the level of your training.

'zilla

[Don1977]

I always told by a former fire chief of mine that, the only stupid question is the one you don't ask.......

[Richard B the EMT]

Does that make you asexual?

I don't know. I've always had sex, as I've been male from when I was born...

lol

[firetender]

It's a moment-to-moment thing.

Much of the discomfort you describe is about the worry of what might be, what might not be, what is ultimately right and wrong and who's looking. It's mostly about SELF-consciousness.

There's another place to be. It is a muscle that you can strengthen, too. By keeping your total focus on the task at hand, placing ALL your attention on your patient and ELEMENTS of the scene as they affect your relationship with your patient, you can pick and choose what you must respond to. I hear you saying you feel like you have to respond to EVERYTHING. You don't. You only have to focus.

[Just Plain Ruff]

I'll echo what Doc said.

Seconds rarely count and if they do then the patient is probably destined for the morgue rather than an ER.

If they die in the ambulance, the grim reaper was standing right next to you waiting for you to move enough for him to reach in and take the patient. (I don't believe in the Grim reaper but it's a good analogy)

ONe thing never to say when you get to the patient "Holy Shyte" even if everything in your being is saying that. There will be things that you never knew a body can have happen to it and it is your job to make that unbridled Chaos into manageable chaos.

To do that merely takes time in the field. Approach every patient as a learning experience and never take that for granted.

You may not learn a new technique or new skill or get to apply your medical skill but you will learn something if you listen and look for it. It may be learning history or personal info that you can use in the future on a similar patient.

Never take any type of patient for granted, hold the little old ladies or man's hand during the trip back to the Nursing home. Get on a childs level, don't stand over them.

Be truthful and honest in all you do.

If you go by the above, your "stage fright" will go away, maybe not immediately but soon.

[medic82942003]

I flew search and rescue in pensacola Florida- we used to respond to calls like- Man drowning(thank god for rescue swimmers)-ship sinking, Big ship sinking, jet crashed, pilot ejected. Blue Angels touched wings during training mission go on stand-by. kid missing near everglades with alligators in area. Just really hyped calls. I was a NREMT basic, we had a trauma bag with limited airway stuff, no pain meds-

and enough stuff to treat maybee two trauma casess, We trained trained and trained some more so that lots of bad calls were just second nature. We had a flight surgeon who said first thing you do on scene is take your own pulse, follow your ABC's, and if nothing else

remember to put the patient in the stokes liter or cot and fly them to the hospital. or get the patient in the cot/ambulance and drive them to the hospital. Currently I am a medic for 15 years-8 years on the road and 6 months in the ER.Now Military stuff and civvy stuff are two

different animals- but do your training and remember your basics. With out good CPR and Airway control- ACLS does not work as well.

My first call as a brand new basic corpsman was watching 3 marines get burried alive by a tank- Got the first two out in time, guy 3 was bluer than poppa smurf and had suffocated- we worked him anyway-.So my first call as a corpsman my patient died.Talk about depressing,

then my first pilot ejection, a marine captain ejected from his burning Harrior jet, he was dead also Broken neck-Broken arm- Torn

Aorta,- Just about all my patients as a SAR corpsman were Dead. But I stayed in EMS and learned from every call- and used my knowledge

to help others. My kit was so limited that on night missions(without NVG's) I had to put a roll of white tape on the patients

chest to watch it go up and down just to see if they were breathing. we learned to adapt and overcome and do the best with what we had.

Hang in there-I do this job beacause I like to make a difference. Good luck. Watch your six.

Edited September 11, 2010 by medic82942003

[Richard B the EMT]

My kit was so limited that on night missions(without NVG's) I had to put a roll of white tape on the patients

chest to watch it go up and down just to see if they were breathing.

I presume NVGs are Night Vision Goggles?

[medic82942003]

Correct Sir. NVG's are Night Vision Goggles. The Marines were short on supplies- I used to fly SAR missions with no NVG's- I would

get in the Huey- sit with my trauma kit- No ICS cord, no nvg's, get in the Suicide seat. (thats were the transmission came out in a water crash. We would fly 150 knots 50 feet above the trees. If someone crashed-hit telephone wires or power lines. I was the man.

Flying low was due to no SAM (surface to air missle> shoulder held.)could be shot at us. By the time we flew by-no possible lock on with sam missle. Infrared or heat seeker. So basically I was crew, screaming 150 knots 50 feet above the trees. Could not see shit- could

not even say oh shit before hiiting the ground or object. But that was the job. SAR Corpsman- or the NAVY called us In flight medical technicians. Boy I can tell you, that job had a short life span. Me being a irish catholic, if I had been carrying a rosary- the beads

would have been wore out from me praying, before, during, and after missions. The Marine Officer pilots, Crew chiefs and Door gunners

had a high dosage of guts. they were the bravest souls I had ever met. OH RaaH Semper FI.

Edited September 16, 2010 by medic82942003

[Trip - RKNY36]

I think I must have been one of the lucky ones. I was able to let my head take care of the patient and my heart take care of the person at the same time. In the field wasn't my issue. Most of my transports, in the beginning, were interfacility and minor medical conditions and it became like talking to my grandmother/grandfather. When I started getting to where the flotsam hit the fan, my mouth was already caring for the person as my head and hands cared for the patient. After the trauma calls was when it would get to me. Luckily, I work a night shift with some great people. I actually don't feel that I would be able to cope as well.