Asysin2leads Posted January 3, 2012 Posted January 3, 2012 I think I've just been warped by my experiences with pushy, know-it-all students.
Just Plain Ruff Posted January 3, 2012 Posted January 3, 2012 You mean there are those kinds out there??????? Perish the thought. I thought they were all like Artesians, I seen em!!!!
BAYAMedic Posted January 3, 2012 Posted January 3, 2012 As all the good answers have already been taken, I will go down a slightly diffrent route. How comfortable are you with your skills? Have you had the chance to start difficult lines in a moving ambulance yet? I had the bad experiance of having perfect classroom starts, followed by nicely lit, no rush ER IV starts, To having my first few "real" field patients be really sick and needed a line ASAP. If you get the chance and have access etc. have a coworker drive down a particularly bad patch of road, while you try to stick a fellow student in the back of your rig. I have found 24ga to finger viens mimic baby foot veins nicely. And that being said, are you comfortable with multiple different IV cath styles? How about Lab draws? Remember your Color order Draw de jour? Are you equally comfortable with a syringe draw and a vaccutainer draw? Practice improvisation skills, expecially when it comes to airway managment. Use a Bougie as an ETT Introducer. Use a lighted stylet for transtracheal illumination for confirmation. Actually hook up the wires to your monitor for the ETCO2 detector. Which Blade do you use. Why dont you try the other for a while? If your comfort blade is the goto, why are you using the blade your less comfortable as your "rescue" blade? Are you comfortable running a BVM and maintaining a great seal and head position? How about CPAP? We never put it on in school and had trial by fire. How do you feel about your Cardiology? 12 lead interperatation is one thing that got beat into us in school, but how many times did we go over pad placement on actual humans vs just the mannequin. Realizing sometimes the pads don't stick well, and to towel wipe or razor a hairy chest are things not covered in my classroom experiance. What point are you going to place the Combipads on a bradicardic patient? are you thinking far enough down the line to have them placed pre-crump? Protocols. Not knowing your school or internship locations, I don't know if this is an issue. But if you work in more than one agency/county, you may have varying protocols dependant on where you are that day. Yes subtle crap but important if you want to impress that preceptor. Lastly the drug box. I spend alot of time in the drug box while studying. I work with two separate agencys, with two diffrent styles of drug boxes, and totally diffrent layouts. Can you be so confident, if asked to draw a diagram of your box you can remember what is supposed to be in each compartment and quantities? Hopefully Amongst my ramblings there is something you might consider useful or thought provoking, if not chalk it up to someone who is just a few months ahead of you into this curve Fireman1037 1
DFIB Posted January 3, 2012 Posted January 3, 2012 Fireman1037 Why don't you ask your driver to stop right before making the stick? This is a real question.
BAYAMedic Posted January 4, 2012 Posted January 4, 2012 I have, and I do on occation. But there are times that that is far from convieniant. The point I was trying to make is train like you fight. As a poor example, it like the athleates who trin in a weight vest. Its harder now, to make the actual task at hand seem easier. Fireman1037
DFIB Posted January 4, 2012 Posted January 4, 2012 The point I was trying to make is train like you fight. Fireman1037 Very well said.
DwayneEMTP Posted January 4, 2012 Posted January 4, 2012 I have, and I do on occation. But there are times that that is far from convieniant. The point I was trying to make is train like you fight. As a poor example, it like the athleates who trin in a weight vest. Its harder now, to make the actual task at hand seem easier. Fireman1037 Step away from the C'pn Morgan before posting! :-) Great thought, spelling and grammar? Well, you know.... Dwayne
Vorenus Posted January 4, 2012 Posted January 4, 2012 I have, and I do on occation. But there are times that that is far from convieniant. The point I was trying to make is train like you fight. As a poor example, it like the athleates who trin in a weight vest. Its harder now, to make the actual task at hand seem easier. Fireman1037 That`s a long tradition. Roman legionairres trained with wooden gladii (swords), that were weighing twice as much as their normal sword, to train their muscles. Sry, just me being a smartass.
kndoug1 Posted January 5, 2012 Author Posted January 5, 2012 Thank you to everyone for your posts! It has all been really helpful! Fireman1037, you made a lot of good points. I am fairly confident in my skills in the classroom...that will be a totally different story out in the field. On your point about IV sticks...we actually were not allowed to start IVs on each other. Mannequin arms only. This is the one skill that I have been most worried about. The first time I will have a real arm in front of me will be in clinicals next week. You can do your skills a million times in the classroom, but the second you get a real person in front of you things change. I definitely won't be going into clinicals and my internship super confident because I know that having a real patient in front of you changes things. You don't have to build a rapport with a dummy arm, you do have to with a real patient if you have any hope of starting a line on someone. Thanks for your response. You listed a lot of good things that made me think of things I want to brush up on that I had forgotten about.
DwayneEMTP Posted January 5, 2012 Posted January 5, 2012 ...You don't have to build a rapport with a dummy arm, you do have to with a real patient if you... Great post, but a big red flag here Babe.... You really really need to prepare your patient for the fact that an IV will hurt, but then you need to completely dehumanize them for a few seconds. If you hear them complain, or cry while you're starting an IV it will retard your ability to start it competently, or at least it will for most of us. Explain it to them, be honest, and then turn them off. You have enough to do without pretending that they're human in those few seconds... Explain the need, pic your site, then completely tune them out for a few seconds...it's truly you trying to stick a small tube into a large tube and occupying part of your mind with their comments won't help....Just a thought... Dwayne 1
Recommended Posts