Sometimes, I am colossally stupid.
I know, hard to believe. Here’s the thing: I’m good at this first aid stuff. This might sound conceited, but damnit, I love it and I think it’s fantastic, and I’m pretty confident that I could handle a good deal of weird shit thrown at me.
This doesn’t, unfortunately, stop me from having ridiculous brain farts.
So my practical exam was Saturday. It went… sort of well, save for some “Seriously? am I THAT DUMB?” moments. The idea was that it would run sort of the same as our in-class practical exams — two skill stations, two full calls. (Well, in class there was only one skill station, but whatever.)
There were four of us being tested that day — me, another potential EMR who’d been taking the part time course at the same time as me, a Paramedic student from the JI in Victoria (so he had three full calls, instead of two) and Cooper, who’d been my partner throughout the majority of my course. Well, THAT’S awesome. We look at the schedule, and sure enough… Cooper’s been assigned as my partner through most of it. Seriously, this was fantastic. One of the things I was nervous about was being paired up with someone who sucked. Not only do I know that Cooper’s good at what he does, but we’ve worked together enough that I felt a lot more comfortable. Excellent.
So, the first thing I had to do were my skill stations — a spinal roll from 3/4 prone, and managing foreign body airway obstruction (ie, choking.)
I choked.
Damn. Ok, the spinal roll didn’t go too terribly — I mucked up a bit by having my partner (who, in this case, was the paramedic) do the roll onto the board from the wrong side. Damnit. I knew that. Amusingly enough, his skill station was next… and he had the same one… and he did the exact same thing. Well, if someone with a higher level of training than me can make the same mistake…
Oh well. What annoys me is that *I* have to redo that skill station, and the paramedic student doesn’t. What? But … you just said that we made the same mistake… what’s the difference? Eh, whatever, not worth fussing about.
The FBAO… went DISMALLY BAD. Holy crap, I’ve never felt so much like I had no idea what I was doing. It’s the freaking HEIMLICH MANOEUVRE, HOW HARD CAN THIS BE?
I had my hand placement totally off. Let’s think about this: They’re called abdominal thrusts. Perhaps try placing ones hands over the ABDOMEN. Evidently MY goal was to break off the pt’s xiphoid process.
Ok. Stupid, stupid, stupid. And NOT helping my confidence any.
When I went into my first full call, I was pretty nervous. I had already blown the first two steps of my examination process, and now the hard parts were coming up.
So my first call was my medical call. The call was “shortness of breath”, but ended up being pretty obviously COPD (in this case, emphysema) causing severe respiratory distress.
I nailed it. About the only thing they could dock me on was that I attempted to assist ventilations a little earlier than necessary — we really don’t want to blow out the pt’s rather delicate lungs if we don’t have to, and it’s better to wait until their level of consciousness starts dropping, even though his respirations weren’t doing much (over 30 is considered the benchmark for “not sufficient breathing”.) Being on home oxygen sucks… being on a respirator sucks more. On the other hand, if it’s a choice between “not breathing sufficiently to support life” and “assist ventilations” … let’s go with assisting ventilations, eh?
I was really happy with how it went. COPD is a bit more wishy washy than a lot of calls. There’s no direct protocol, and a lot of weird things can happen. Hypoxia, for example, is a tricky one to handle as giving them too much O2 can actually make their oxygen saturation worse… which you can’t necessarily judge accurately with the SpO2 monitor (ie, a little thingie that goes on the finger and tells you roughly what % of their blood is oxygenated… a healthy person should have 95-100%, a smoker would be around 92-94%, less than 90% and you better get that person on O2 ASAP, and under 80% is considered “not sufficient to support life”).
Still, getting O2 in is still pretty darn important, so you still bag ‘em… just maybe at a slightly lower flow rate.
Next was my medical call. Turns out, my examiner wasn’t terribly pleased with how I did my primary assessment. Ok, it was a little scattered, O2 got added late, and evidently I fixated on the amputated hand a little too much… seriously, AMPUTATED HAND. Yes, I’m going to take care of that first! But everything got done reasonably quickly. Scenario: Construction worker repairing a machine, gets his hand stuck, falls off the platform. Call comes in as a “fall at a construction site”. I love how descriptive these things are. Sure enough, it’s an amputated hand. Yehaw. In the rapid body survey, I also discovered a femur fracture. Hrm. Ok then.
Our “actor” was fabulous. So funny. When I was working with him, at one point he just started yelling and swearing at the top of his lungs. Scared the hell out of me when he shrieked “motherfucker!” in my ear so loud while bandaging up the amputated limb that the group in the next room heard it. I will note: It’s a FAKE amputation. Really. No missing limbs, no femur fractures. He’s just acting! I swear!
I like someone who gets into their role. We won’t talk about how often I played the “confused old man in the nursing home” in class, complaining about my kids who don’t call and how the government is stealing my money.
Anyway, got through that reasonably well. Forgot to verbalize the contraindications for Entonox, but when she asked me for them afterwards, I was able to rattle them off fast enough that I think she believed me when I said I was checking, I just forgot to verbalize. See? All those times when I’ve been interrupting Nick mid-sentence to rattle of indications, contraindications, and cautions PAID OFF.
So, the final result: I have to re-do three skill stations. The next set of tests are in early September, but you have to have gotten your application in two weeks ago to get into that one. If there’s a cancellation, I have a chance, but … most likely, I’ll be doing them on Nick’s birthday (hopefully it’ll be the day before or after…) Dang. This comes along with recent news that MY birthday (a few days prior) is now an important deadline for the game he’s working on, and we either have to cut the weekend trip we had planned short, or cancel it all together. EA Widow, anyone? (Kidding, honey!)
Anyway. Another hiccup in the path to getting licensed. Woohaw. More studying!
Interesting side note: So for my actual paramedic training, my initial thought was to get EMR licensed, get hired by BC Ambulance (which is a multi-month journey on its own), get PCP (ie, full paramedic training), ???, profit. (Maybe with less ???… and a few years until much profit.) However, getting into the JI’s PCP program takes for-freaking-ever. I had no problem with that initially, as I figured I’d just work as an EMR in the meantime.
Except… I COULD theoretically do it at another institution. There are several smaller joints that do PCP training. Initially, I’d thrown that idea aside because I rather liked the JI’s training, but I’m a bit disillusioned at the moment. The biggest benefit to going through someone else would be that I could probably get my PCP license about a year sooner.
Hmm. Interesting thought, anyway. I’d miss the cafeteria. God, I love the JI’s cafeteria. If I lived in New West, I’d just go there for lunch all the time.
Yay for studying? :-\