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Applying for EMT-B on ambulance

Discussion in 'Firefighter/EMS Talk' started by MissAmericanPie, Jan 6, 2008.

  1. MissAmericanPie

    MissAmericanPie Troop Supporter

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    Hi Guys,

    I am applying for a job with an ambulance service as an EMT-B. I was working at the ski area today (base first aid) and one of our area services arrived before our head trauma patient was being taboggoned down off of the hill. I talked with the EMT for about five minutes and asked him about getting some ride time with them.

    He said that they are hiring B's and I's and that I should apply. I explained that I have no real experience (I forgot to mention the rescue since it is so slow!!). He told me to just jot down my experiences at the ski area and that I may be able to do per diem and transfer work to start and that they do hire people with little experience if it is a good candidate.

    So, after that lengthy intro. - if I get the job, or for that fact any job when I do get hired, what do I do to be helpful and not be in the way? I'm unclear about that line. We had a serious medical patient in first aid the other day and I called the ambulance since the patient walked in and asked for one right away. He has transposition of the great vessels with a pacemaker and his HR was 225 and not budging.

    I was with a ski patroller and we had another patroller who is a doctor on shift who arrived shortly after. When the ambulance arrived, they worked him and they were there for about 15 minutes before transport. I didn't want to get in the way, but I also did want to be helpful so I took notes and got a BP. It was also a great learning experience. When I am on the ambulance, how do I make sure it is known that I am willing to work hard and use my skills without getting in the experienced EMT's way (usually a medic or an I)? Clearly, I do not want to be a liability when the SHTF, but I do want to be an asset.

    Thanks for your anticipated brilliant and insightful responses.:supergrin:
     
  2. D25

    D25 The Quick

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    Just say those exact words. And make sure that you know what your responsibilities are going to be on different types of calls. Will you be holding c-spine on MVAs, or being the person who gets the equipment off of the rig? Taking baseline vitals while the P asks questions, or gathering PMHX and meds, or both? What will your role be on a code? And understand how your specific role may change when you are on a call that requires assistance from another agency. You may start out holding c-spine on an MVA, but when fire arrives will you be expected to pass this responsibility off, and go do something else?

    Also, this is a little pet peeve of mine, ask your partner how they feel about Sellick's maneuver.

    Remember that even the most grizzled old-school paragod was once the zero-experience FNG, and good luck to you.
     

  3. MedivacRN

    MedivacRN

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    Is there a hospital near you? I worked at SNHMC in Nashua for a few years. I figure you are probably more up towards the White Mountains? Try to find a job as an aid in the ED. You can learn a lot there as well as meet many of the medics that come in.

    Where ever you wind up, ask alot of questions (when appropriate) and learn all you can. Find yourself a good mentor/close friend in the business that loves to teach. Then, become their partner.

    Good luck! D25 couldn' be more right. Everyone starts somewhere. I started at 16 y/o on a volunteer squad in NJ. Got my EMT-B and haven't looked back since. It's a great field to be in.
     
  4. hotpig

    hotpig IAFF Local 4766 CLM

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    In the back of my ambulance my basic is responsible for such things as getting the pt on O2, cardiac monitor , blood sugar, or setting up IV supplies.

    In my area with a two man crew working a large rural area with little to no FD first responder help I need more than just a Ambulance Driver.

    Generally we do not hire EMT's from the College because they lack experience and need way too much orientation before they can work. We do hire select EMT's from classes we have here at the Hospital.

    Since we teach them and they do clinical with us they are work ready when their licenses come in.
     
  5. MissAmericanPie

    MissAmericanPie Troop Supporter

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    That is helpful. I have reconsidered and I am asking the same ambulance service for some ride time first. I spoke to one of their EMTs today who is one of our local LEOs and he said that they really need help but thought they may have no one who could spend the time to train me since they are so horribly short handed. What a catch-22. I told him that I had spoken to his manager about ride time and he said that it would be a very good idea.

    Think about it - when you are new you do not know where everything is yet, some of the equipment/devices vary slightly from those of other services and what you learned with in class, etc., and procedures must become familiar. I would rather be unpaid and observing/helping.
     
  6. Sucka

    Sucka

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    If you're doing a ride-a-long just be up front and ask what the medic expects from you. I've taken dozens of EMT students and EMT's on ride-a-longs and all i require of them is to ask questions, DO NOT JUMP IN while i'm doing an assessment and start asking their own questions (this is my pet peeve), and wait until i ask for them to do something before doing it on scene as far as grabbing a BP, holding C-spine ect. Once i get to know them, and what their skill level is, we work from there. For instance i had an EMT who loved to ride out on his days off, with him it was like having a third partner. We would arrive on scene, he would start grabbing vitals while hooking the patient up to the monitor, stripping IV bags, ect. He pretty much could anticipate what i was going to do, and i just let him do it. For the brand new guy, i like for them to observe and learn before i want them jumping in. There's a fine line with what you do out there. Some medics don't like to have their toes stepped on at all, others don't care what you do. I know medics that will get a BP reading from the EMT and then proceed to get his own. Everyone is different, and if you're up front with your skill level, and what you want to get out of the ride-a-long everything should work out fine. Of course help restock the rig, grab equipment, help clean, ect. That's a given.

    If you're working as an EMT for the first time, just do what your FTO tells you is the best advice i can give. If you get thrown into the deep end, it's sink or swim.
     
  7. MissAmericanPie

    MissAmericanPie Troop Supporter

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    I am in the White Mountains. Unfortunately, the ED doesn't have any positions open any more. They had a bunch when I was in class, though! Oh well. I figure I'll get some ride time in and I won't need as much training.

    Thanks for the advice. :)
     
  8. MissAmericanPie

    MissAmericanPie Troop Supporter

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    Thanks so much. That is exactly the advice I need. I am virtually untested, since I am on a very slow rescue service in a rural area. I can get a BP, etc. however, I don't know about on a moving ambulance since we do not transport. It is experience that I need. The classroom stuff is fine, but nothing teaches like practical application.

    Believe it or not, working at the ski area in first aid has taught me a real lot about pt. assessment, interviewing, splinting, sling/swath, dealing with concussions, etc.

    However, I have not used many of the skills I learned in class yet. I also never learned how to assist an EMT-I/P in class. Should I know this before riding on the ambulance or will it be taught?

    If I am thrown in the deep end, I just learn to swim, I guess.:cool:
     
  9. MissAmericanPie

    MissAmericanPie Troop Supporter

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    The ambulance services near us do not respond first as a rule. Usually it is police, followed by fire/rescue, then ambulance for continued care/transport. I am on my town's rescue so I am more comfortable with "rescue type" scenes such as MVAs. I am less comfortable with medical issues, though. I want to get some good experience with that.

    When I respond to rescue calls, I am usually not the first or second one there since I live at one end of town that is primarily vacation homes. I am usually the second or third one on and with an MVA or some other trauma situation, more hands are usually better so I get to jump right in. They are usually very straight forward. But with medical calls, I feel like I am in the way since O2 is usually on, vitals are being taken and I take down info. It helps, but I miss what happens before my arrival and I am often confused by the interventions taken/not taken until I talk to the others on scene first later.

    I would like to be there from the time the patient gets into the care of the ambulance, to the time of transfer to ER. That way, I can help with or observe all interventions from A to Z. It then becomes less intimidating.

    Thanks for everything. :)
     
  10. Hunca Munca

    Hunca Munca nonplussed

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    What is the makeup of the service?

    EMT/EMT or EMT/medic?

    If it is EMT/medic get ready to be driving on all calls as the medic should be in the back with the patient.......

    Don't be afraid of the medics if you have a good attitude and are willing to learn you will be fine!!

    The best EMT skill to learn is Bag mask ventilation!!!!

    <----------------- tells medics what to do or what they shouldn't have done.:supergrin:
     
  11. MissAmericanPie

    MissAmericanPie Troop Supporter

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    Well, medics are not on every ambulance and I don't think they work every shift. There are shortages of medics around here. I know they have a few working for the service and one is doing primarily management work now. Two are new(ish) paramedics. It sounds like a wide open career field for me some day - the hospitals love to have them.

    The last transport for us (ski patrol), they had a student ride along from where I took my class. He seemed really timid. I'm not, so I don't want to jump into where I am not wanted.:supergrin: But, I'm not proud and I am certainly thankful for constructive criticisms and my goal is to learn. My biggest pet peeve when I start a new job is to be ignored and for my questions to be considered pains in the ***.

    I'm not really afraid of medics, only of my lack of experience. I'm afraid that I think I know more than I do and I'm going to be considered a liability. In reality, I'm slowly learning that it is the other way around.
     
  12. Sucka

    Sucka

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    Just understand getting BP's in the back of a moving ambulance is hard at first, real hard. The one thing i always tell new guys from when i was an FTO as an EMT until now is, DO NOT LIE ABOUT A BP. If you can't get it, just tell me you can't get it, and try again. If you can't get it after 2 tries, ask the medic to get it. This is normal at first, and it comes with time. If you can't get one, palp it. It's better than nothing, but don't lie about a BP, ever.

    Secondly, they'll teach you anything they'll have you do, and be happy to do so (assuming they are nice guys). They'll show you how to hook up a monitor, strip an IV, C-Spine someone in the real world, move patients which is a biggie, and so on. Best advice i can give, is don't be scared to ask questions. If the crew is cool, they'll be happy to teach you everything they can in the short time you're with them.

    If you have any specific questions feel free to ask, more than happy to help. Don't be nervous if you ride out, it should be an enjoyable thing, and a learning experience.

    Edit: And oh yeah, on the BP subject, don't give an odd number BP, it'll make you look stupid :supergrin:
     
  13. MissAmericanPie

    MissAmericanPie Troop Supporter

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    About your last point - it should!! :)

    I was asked to get a BP in the aid room when they were dealing with a cardiac patient (the medic, EMT, and a doc who is a patroller) and it SUCKED!! He was being bounced around as the doc was massaging the patient's carotid as he attempted to get his pulse down (?). (He explained it to me later) I had to try three times but I finally got one. But I was unsure about it and told the medic that I was. He had the other EMT try and he also had trouble. Our number ended up being real close, so I was very proud. I wouldn't lie - I'd just sit there feeling embarrassed and dumb!!:supergrin: But in time I'll get over that.

    I like it when people in class would get a 30 second HR and make it an odd number.:rofl:

    Hooking up a monitor, stripping IVs, etc. I am not familiar with. I am familiar with c-spine manual stabilization and immobilization, backboarding, shortboarding, etc. since we do that on rescue. I never get a chance to get vitals at scenes, though, but I do get pulses and check pupils quite often at the ski area. With fractures, dislocations and head/spine injuries we are always checking CSMs.

    But, I have never taken a glucose reading. I have the kit, I just have never done it. It's little things like that. Also, (don't laugh) I have never given a live pt O2!! I know it is quite simple, but I'm afraid that it will not be a smooth thing the first try. (Note to self: turn on oxygen, fill bag, THEN put on patient):supergrin: Someone I took my class with rode on the ambulance for his clinical and adminstered oxygen via nasal cannula. Unfortunately, he inserted the little prongs in her nose first and then proceeded to turn on the O2. Woopsie!! It isn't something that would invoke confidence in a patient or their loved ones I would guess.

    But really, thanks for the valuable advice. You guys are the best.
     
  14. Sucka

    Sucka

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    Don't worry about the BP thing, sometimes they're hard to get, and on some patients they are impossible because the BP is so low. Once you take it 100's of times, you'll get into your comfort zone, and it'll be really easy for you. We all go through the learning curve, they'll understand it.

    Just remember "white on the right, smoke over fire" for a monitor and you'll be fine. White lead on the right, black on the left, red lower (lot of new monitors have a green lead, that just goes below the white). I still repeat that in my head when i'm putting leads on, it's just habit..lol. They are called "limb leads" so i like them on the upper arms, even the top of the hand if they have a lot of clothing on, but some medics like them on the chest, it's a preference thing. You can put them on the tops of the hand and the others on the ankles and you'll get an accurate read, so don't worry about "perfect placement".

    Stipping an IV is cake. I can't tell you how to do it over the net, but they'll show you, and it's easy to do.

    No worries on O2 either. If it's a non re-breather just remember 10-15lpm and fill the bag. If they're C-spined, you can tape it onto the stabilization equipment, about the only thing there. And remember if you have questions to ask them, ask yes/no because it's hard to talk with them on. For nasal, 2-6lpm. Just put it on, don't try and be to careful with it. Obviously don't jab their nose, but don't sissy around it either. Old people have nappy hair and you just need to pull it out of the way to get them on sometimes, don't be timid.

    Just practice your vitals at work, and you'll be good to go in that department. Just have confidence in what you're doing, and it will all go well for you. On a ride-a-long it's really the crew that makes or breaks it, so i hope you get a good crew. If you end up with an EMT/Medic crew, you can probably bug the EMT all day long and he'll love it. If it's a dual medic rig, just hope they aren't burnt out :supergrin:
     
  15. MissAmericanPie

    MissAmericanPie Troop Supporter

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    Thanks, buddy!! Great advice. I'm not that worried about the O2 thing. I think it is just doing the right thing at the right time.

    I don't think we have dual medic rigs here. I know some have shown up for transposrt without a medic on board.

    Again, thank you.
     
  16. Sucka

    Sucka

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    No problem, we're all here to help. Good luck getting the job, and if you ride out, have fun and let us know how it goes.
     
  17. Hunca Munca

    Hunca Munca nonplussed

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    Have you been taught how to do a systolic BP by palpation?
     
  18. 1bamashooter

    1bamashooter

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    I have no problem with a basic helping me in the back of the truck or on scene. Don't be afraid to ask the medic what you can do to help, learn how to set up a IV, how to put a Pt on a cardiac monitor, learn what drugs we use in a arrest and what they look like, make sure you know where stuff is on the truck and what its used for. The best way to do this is get in the back when the medic is doing the daily check off. The longer you work in the field the more you will know, eventually if you work with the same partner long enough your partner will not ask, you will just do it. We know what a basic knows because we where one also. Good luck and don't be afraid to ask, and remember there is no such thing as a stupid question.
     
  19. MissAmericanPie

    MissAmericanPie Troop Supporter

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    Yes, and I think I am better at it actually than by auscultation.:dunno:
     
  20. Hunca Munca

    Hunca Munca nonplussed

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    I only bring it up because it is a way to get a BP without having to listen in a noisy environment.