things they didn't teach you in school

[Cougar]

I am working on a class regarding the things you learn in the field that they don't always teach you. An example would be my agitated, obnoxious, sweaty and pacing patient with no pulse...not even at the carotid. (alcoholic with a rate over 300...he lasted 25 minutes before he crashed) You can't feel a pulse if the heart rate resembles a hummingbird's wings.

I have a few other examples, but I would REALLY love to have some input from the forum. The things you learn from experience that weren't part of you education. Sometimes I find myself thinking, "Why don't they teach us that?" Please share your experiences.

Thanks in advance.

[Happiness]

They dont tell you that you might not get past "A".....................

[DwayneEMTP]

I am working on a class regarding the things you learn in the field that they don't always teach you. An example would be my agitated, obnoxious, sweaty and pacing patient with no pulse...not even at the carotid. (alcoholic with a rate over 300...he lasted 25 minutes before he crashed) You can't feel a pulse if the heart rate resembles a hummingbird's wings.

I have a few other examples, but I would REALLY love to have some input from the forum. The things you learn from experience that weren't part of you education. Sometimes I find myself thinking, "Why don't they teach us that?" Please share your experiences.

Thanks in advance.

Northern New Mexico and Denver? Raton then I'm guessing? I live in the Springs, and used to work in Trinidad. If you ever want to hear stories about the worst medic that ever lived, stop in there and mention my name.

And if you get bored sometime, stop on your way through the springs and I'll buy you a cup of coffee!

The things that I didn't learn in school? That moral and ethical quandries are often much, much more complicated than medical issues. And, though they tell you, I rarely see it practiced...patient advocacy is a moral/ethical obligation, not a decision that you make, and then change, any time you think you might get jammed up a bit.

I'm sure that there will be many, many much better responses, but those are the two nearest and dearest to my heart.

Thanks for posting man...any chance you could be convinced to do so more than once every 3 years? :-)

Dwayne

[medicgirl05]

I recently had a patient that we eneded up defibrillating 14 times. V-fib over and over again. Used all my available meds. Treatment and transport time was one hour and a half and we got a pulse back once. I was so sick of V-fib that I pleaded for a different rhythmof any type. We finally got a PEA at a rate of about 30. They called her after twenty more minutes in the ER. She was STILL in PEA. They never EVER told me of any such scenario in school. It got to the point where my partner and I were completely out of ideas and all we could do was CPR. ER doc had never seen such a persistent V-fib either.

[DwayneEMTP]

I recently had a patient that we eneded up defibrillating 14 times. V-fib over and over again. Used all my available meds. Treatment and transport time was one hour and a half and we got a pulse back once. I was so sick of V-fib that I pleaded for a different rhythmof any type. We finally got a PEA at a rate of about 30. They called her after twenty more minutes in the ER. She was STILL in PEA. They never EVER told me of any such scenario in school. It got to the point where my partner and I were completely out of ideas and all we could do was CPR. ER doc had never seen such a persistent V-fib either.

Yeah, that's something I always thought was crazy about most scenarios in school. If your patient appears fine, they are going to die no matter what you do, and if they are certainly going to die, your miracle intervention saves them. In my experience nearly all of our really critical patients fall somewhere in the middle and end up being a balancing act.

Sounds like a tough call...

Dwayne

[medicgirl05]

Yeah, that's something I always thought was crazy about most scenarios in school. If your patient appears fine, they are going to die no matter what you do, and if they are certainly going to die, your miracle intervention saves them. In my experience nearly all of our really critical patients fall somewhere in the middle and end up being a balancing act.

Sounds like a tough call...

Dwayne

All the scenarios I ran in school the patient either was fixed after 2 or 3 interventions or they died. I never thought I would work so hard on a patient for nothing... They just don't tell you about the hard parts, or maybe I missed that particular class...

[MedicAsh]

Why didn't they teach me that nothing ever goes according to the book????

LOL

[BushyFromOz]

Things they didn't teach me at uni:

Fatigue management

Stress management

They dont teach you how to look after yourself

[Katiebug]

An upside down KED is great for stabilizing a pelvic fracture.

Sent from my iPhone using Tapatalk

[nypamedic43]

They never taught that if you sit a symptomatic bradycardia patient up that they would get even more symptomatic( they only taught us to pace) and that if you lay a symptomatic CHF patient (flash pulmonary edema etc) down that they respiratory arrest on you....helpful info to have BEFORE you make those mistakes

edited for spelling :/

oh oh...just thought of another one lol pushing Narcan too fast will get you punched and puked on...been there done that thanks to my "senior" partner :/

Edited July 31, 2011 by Nypaemt39