What to do first on calls?

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[AnthonyM83]

Just playing devil's advocate here, but could you have taken a little long on taking pulse and intro, so knowing you were in there for more than thirty seconds or so, he flipped out that lung sounds STILL hadn't been taken by the time he walked in, and expressed it a little too strongly as if it's LITERALLY the first thing that must be done...but really meaning just within the first few seconds.

I just say this b/c I've seen medics/nurses get inpatient with their emts/ertechs like that and overexaggerate what should have been. Just a thought.

[Dustdevil]

I just say this b/c I've seen medics/nurses get inpatient with their emts/ertechs like that and overexaggerate what should have been. Just a thought.

Along those same lines, it is possible that the patient's initial presentation may have been so obvious to the medic that he already had priorities established for that particular patient and they did not coincide with a normal routine assessment, which is understandable in some cases.

Perhaps the medic felt the condition of the patient was so obviously demanding of more direct intervention that the standard introduction and vital signs route was simply inappropriate and should have been more focused on the obvious problem. As an extreme example, it was as if you were attempting to SAMPLE a patient in cardiac arrest.

Of course, the problem with that is, you simply cannot expect an EMT to be thinking and assessing patients on the same level as a paramedic. Chastising them for not having a paramedic level education and understanding of medicine is just stupid, so I am definitely not defending this medic's actions. I am just trying to explain why it might have occurred.

The whole scenario confuses me anyhow. Was the medic on a different apparatus than you, or was he a member of your crew? Why is he coming in 30 seconds behind you? And was it really 30 seconds, or is it possible that it only seemed like 30 seconds to you and you had actually been there 3 to 5 full minutes ahead of the medic and lost track of time? Just really too many unanswered questions to fully appreciate the true scenario here.

But yeah, if things are exactly as you say, then you were probably doing just fine. And regardless of whether you were right or not, the medic apparently needs a serious attitude adjustment.

[n5iln]

Always take the five seconds to introduce yourself......ask the medic how he/she would like if his mother were treated in that manner...you start touching and assessing without an introduction...not very professional.

Not to mention a potential legal landmine. Our society has become so litigous that acting the way your medic did is practically pleading for an assault-and-battery lawsuit. I don't know about anyone else, but I certainly don't make enough on an EMT's pay scale to chuck out a few thousand dollars because I didn't ask if I could examine someone. (And that's just the attorney fees!)

The extra five seconds it takes to introduce oneself and ask "Why did you call us today?" is more than just courtesy; it's a CYA requirement. And you can get a lot of information that way -- information necessary for the formulation of a clinical impression and subsequent intervention plan. And not to put too fine a point on it, but if those extra five seconds will kill the patient, there probably isn't a lot that could have been done for them prehospital anyway.

Just my two cents' worth...save up the change for a root beer or something...

[bandaidpatrol]

What did I do first?

Something I learned from working in the 70's. Look for guns, knives & drugs. Never sit down in a place that "looks" like a junky lives there.. Needles. Stay away from their drugs, and block their path to the weapon. If they go for it, oxygen cylinder to the abdomen, lunge the cot at them, and run.

Not that I recommend any of that, except the obvious.

[streetsweeper]

Yep, ya never know what your dealing with. I always like to introduce myself. More so just to see what response I get. Maybe it is a crack head wanting your meds. Maybe its a mental issue. This I would deem part of scene safety.

Never rush to a patient and get in their face,, unless you want a knife in your throat or a face full of vomit. I don't care if they are 20 or 70 y/o.

You did what I would have done also.

[Nate]

The first thing I do I actually do is extend a hand to shake theirs, then slide into a checking of the pulse while I ask them what seems to the problem today. I've seen to many people who just start touching a patient and don't bother to tell them who they are or ask what their name is.