And so it begins… Again.

So now that the tough post is out of the way, let’s move on to something happier shall we?

Today was the first day of medic school, mk 2 :) As with any other first day it was interesting, to say the least. One of the most telling things about the program is that there were four of us out of 20 that were not members of the City FireDept, and one of the 4 has been trying to get on with them for years. It does sound like CFD tends to use them as a medic mill, but it is an 11 month program, so it’s better than most mills.

This first semester will be Intro to Advance Practice for the first 8 weeks and Airway/Patient Assessment for the second eight weeks. And for about 14 of the 16 weeks we will be doing clinicals both in the hospital and on the bus. And I was told that I can do up to 50% of my 80 hours down here in BFE. Which is nice considering that just driving to class twice a week will rack up 300 miles at least on my car per week.

We also will do 2 4-hour OR rotations for ETI. I like this a lot, since my program in NM couldn’t secure any OR time for medic students due to the increasing popularity of LMAs and the asses some of the medic students made of themselves in the OR. I’ve got an advantage in that since moving out here I’ve gotten several field tubes, so I know I know how to do it.

And on the subject of skills, I’m apparently the only EMT-I in the entire program. All other 19 students are EMT-Bs. So I was told I’ll be held to a higher standard for skills that I have more practice with than the other students. Not that I mind that. It also means I don’t have to check out in class on IVs I get to go to clinicals a little earlier than the other students in the program.

So far the staff seems good to us. The only thing that struck me that I hate is… well, it’s something I’m not getting away from since the college is an accredited school now. And that’s FISDAP. FISDAP is something I used a little bit in NM and I swear it is just like dispatchers, minions of satan. But win some lose some I guess.

And one of the better parts of medic class is I might have someone that I can car pool with and study with here in BFE. A Vollie for Tiny Town Vollies is in my medic class. And she’s very very cute. It’ll be nice to have someone to drive with, if she agrees to it (we’ve already brought it up once) anyways. The only downside to her incredible cuteness though… her father is a TX DPS Sgt… I rather like my body parts intact and she’s just barely 21 so I’m a little scared off.

Anyways, that’s just first impressions of this medic program. Next class day is monday and I’ve got a ton of extra paperwork to fill out for them, not to mention finish reading the first 5 chapters of volume 1 of our Paramedic text. Not to mention get on Blackboard and register for Med Terminology and A&P (which I’m not dreading at all since they’re both online courses). Ya’ll have a good night, I need to try to get some rest. I go in for a thirty-six in 6 hours.

Wait… Already planning again?

I’ve been here in BFE, TX for about two months, yet I’m already looking at planning my next move. Actually my next two at least. Maybe being single actually a good thing… Since I apparently have a problem settling down and staying in one place for very long.

I plan on staying here in BFE for at least 2.5 years or so. Long enough to get my AAS in Paramedicine and my Paramedic License (not cert) here in TX. Plus it’ll give me good experience working in a 911 system, and prove to myself that I can handle being definitive care for a long transport until I can actually get them to a hospital. That means a lot to me since I’ll actually have time to see my interventions make a difference or not, instead of dropping off the patient after only being with them for 10 minutes or so.

It’s ok living here, but it kinda sucks to have to drive at least 70 miles to do anything. I guess while I like living in a small town, there’s a limit on just how small. The town in NM that I lived in HS was just barely larger than here, but it had a college and a few things to do at least.

After I finish up my AAS and get some experience, I’m looking at moving back to NM and going to the University there and going for my Bachelors of Science in EMS on the Critical Care track. There are a few services I can work for down there that I am pretty familiar with, plus my old service down there if I really wanted to.

Some people have asked why I would make a move in the middle of going to where I really want to work at just to go to school for another two years, especially since I’ll already be a paramedic. Well… because I believe that more education is essential in this field. I want to have as much education as I can so I can better serve the patients who trust me with their care. The fact that they don’t get to pick and choose who responds to their calls makes me want to work that much harder to make sure I’m the best provider I can be and see if I can help change the system from the inside out.

I figure I’ll stay there for a few years (as short a time as I can manage while getting my degree) and then get ready to move again. I really don’t want to do career EMS in Albuquerque, just not that fond of the system there. I’ve been looking at various systems that I would love to spend my career working in and I’ve come up with three of them. One is Austin/Travis County, of course. A great third service in a good system. I’ve heard only good things about them, but heard they might be going to a P/B or P/I truck instead of the P/P trucks like I’ve heard they run.

My second option is Wake County EMS. This one appeals to me due to the fact that they have a community paramedicine program. That type of work really makes me happy to think about. I’d love to do it.

And the last option I’ve thought of so far is back to Denver to work for Denver Health Paramedics. Primarily a Paramedic agency with very few BLS trucks. I love the area up there and the agency didn’t seem too bad when I was there.

So those are my rough plans for the next 6 years or so of my life. Lets see how much life will throw at me and force me to change those plans. :)

Well, I’m on shift now as well, so it’s time to watch some more TV unless I find something else to ramble on about! Ya’ll stay safe out there.

Code? Code!

 

So I’ve now worked two codes for my new service. I’ve discovered a major difference in the way my training for codes was and how this service runs codes. In fact it’s a difference that to me seems backwards to how I would have expected it, coming from an urbanish area.

First code I worked was a nasty one where an ILS provider was the highest level of care on the scene, with no backup coming. I worked it like I was taught and did ok, even though we didn’t get ROSC. I got a tube, drilled the pt for an IO, ran through my asystole algorithm, and worked it for 30 minutes on scene.

The problem arose when my basic partner made multiple comments that we needed to get this guy to the hospital.

Wait? Transport a dead guy to the hospital? What the hell. Granted I’m not a medic, so I wouldn’t be able to pronounce on scene, but our chief was finishing up with his call by this point and could have come by to do that for us. I was thus informed of the procedure that all working  codes, regardless of who’s working it, get transported to the ED.

This was a large shock coming from a system where you were expected to work codes on scene, even though the hospital was maybe 10 minutes away at max. This seems to be backwards in my thinking, if transporting a working code was actually a good idea.

Out here, I could be upwards of an hour from a hospital with a working code out in the county, yet procedures say that I drive the patient to the hospital code 3 while me or my partner are in the back doing CPR the whole time? I’m not a big fan of that, and I’ve already let my new boss know this. In my opinion it’s too dangerous for too little gain.

You’d figure that being so far away, they’d want to work the code on scene, since in most cases there is very little an ED can do that an ALS ambulance can do for a working code. Hell, even as an EMT-I I’m allowed to shock, drug, and tube during a code.

The second code I worked a couple days ago when I was the on call crew was the first code I’ve ever worked that the whole purpose was the get the patient to the hospital within 20 minutes of getting on scene. We did it, and it was an odd experience. We had 2 crews plus the chief helping out with it. I did compressions (where I managed to give the pt a BP of 160/80-ish according to the monitor NIBP cuff :) ) the entire time, except for where the basic took over so I could push my Epi and Atropine.

Seems to me that doing compressions in a moving vehicle is counterproductive. You just can’t give good compressions when you’re being flung around in the back on the way to the ED. I tried. I failed. I can give great compressions to a pt while I’m standing still, but there’s just no way to steady yourself in that big old monster of a rig that we have to give adequate compressions.

So yea, there’s another thing that is different to me since coming here. And, like I said, it’s something that I figured would be the other way around versus what I’m used to in the city with 7 hospitals within a couple miles and a half dozen medics showing up to most calls.

I do think, however I might research trying to get a grant to get something like the Autopulse to make our crews a little safer if they intend on sticking with this asinine procedure of moving codes.