In case anyone was wondering, I passed my practical NREMT-I test on Friday. I only had to retest IO, since I had a minor equipment issue (unknown if it was brought about by operator error or not. I chose not to challenge it, and just retest the station). So yes, I passed. Happy day.
The day before the test I didn't have time for terror, since my laptop gave up the ghost, and I spent much of the day running around on errands, and getting a new computer. Now all I need to do is get a sled so I can move all my files from the old hard drive to the new one. It isn't a huge deal, but it would be nice to have my wedding information instead of having to redo the budget, guest list, etc all over again. I also have to finish moving my music, since iTunes was being sullen and didn't get all my music from the external hard drive, leaving me to transfer everything myself. It's good, in a way, since it will allow me to go through and erase all the duplicates and so on. I am a bit miffed about the loss of all my playlists, though.
So, at 0800 this morning, I took my NREMT-I written test. I was done in just over an hour, and took another 20-30 minutes to review all my work and the flagged questions. There are still a few I am nervous about, and I left feeling that I either knew my shit or didn't know anything at all. I should get results sometime this afternoon.
Since I had to be in the glorious County of Monkeys this morning for my test, I decided to meet my old co-workers for lunch. I've come to realize over the past year and some that getting laid off was probably the best thing that could have happened (something I voiced then, but didn't quite believe). I enjoyed working for that company, mainly due to the people there, but felt trapped. It was a vicious cycle I went through on a fairly constant basis, becoming excited about a new project and working as hard as I could on it for several weeks, only to gradually become disenchanted with it when it dragged on too long. I would slack off, get depressed, and then something would happen, or I would think of something that would take me back to that excited, busy state again. It was like I was manic depressive, but only about my job. During my low periods, I would constantly talk about leaving and going back to school to become a paramedic, just as soon as I'd paid off more bills. Well, you know how that goes...For years I never left, aside from the trip to Antarctica, and one of the main reasons I didn't go back to the Ice was because I felt it would be pushing my luck to leave again less than a year since I'd been back.
Ironically, I was laid off a month short of my year anniversary of being back from the Ice.
So today, the day I took my test and took one more step towards fulfilling my dream (I'll consider it a full step when I find out if I've passed), I am once again meeting with my co-workers, my tie to my former life. It's a strange circle I feel I've come to, honestly. I readily admit that there is a part of me that still misses working there, but I think it's more for the loss of the camaraderie and those other intangibles other than the work itself (in fact, I'm sure of it). I miss the verbal sparring, the joking, and laughter we shared. I miss being surrounded by people mostly my own age, and, truth be told, I miss being 'the kid.'
Don't get me wrong...I'm enjoying where I'm at now, and I enjoy (mostly) my classmates. But being a full generation older than everyone but my instructors (one of my instructors is a year younger than I am) is wearing. At least at my old job, while I was younger than most, I had a good appreciation of things the people older than me enjoyed. My current classmates have very little appreciation of what came before, and I find it discouraging to make jokes and have only the instructor laugh. It's depressing to have to constantly explain things to the children in my class.
All the same, I am happy where I am now.
But I'll be happier when I know I've passed my test.
Tuesday, May 25, 2010
Wednesday, May 19, 2010
Terror
We went to the Joint Services Open House at Andrews AFB this weekend. I am now peeling like a snake. My face got extremely burnt, thanks to some expired sunscreen and a whole day on the flight line. My back got sunburned the day before, gardening in a tank top. See pictures here.
In other news, my NREMT-I practical exam is on Friday. I am terrified. The last time I took it, I failed the medical, trauma, and both cardiology stations. This time, I feel fairly confident in everything except dynamic cardiology. We haven't had much time in class to do actual practice in class; most of our dynamic practice has been more of a 'practice by committee' kind of thing. So today we finally got a chance to actually sit down with our instructor and do a dynamic station. I did it twice. And failed twice. And we don't have practice time tomorrow, because our instructors are setting up the test.
I am in terror. I don't know how I'll handle it if I fail. I feel confident about all the other stations, and feel confident that I will fail dynamic cardiology.
To make matters worse, The Fiance will not be in town this weekend, which means I have to get up at 0330 Friday morning in order to be at the test site at 0800 (it's 1.5 hours away, which means, at rush hour times, I need to budget at least 2 hours, if not 2.5 to get there).
I'm hoping to get to the firehouse tomorrow, in the dream that someone there can run me through some dynamic cardio scenarios.
On the plus side, in happier news, The Fiance got word today that once his exile in NJ is complete, he will be placed on a project here at home, that will last for at least a year and a half. Which means he will be in town for the wedding. And my senior year of this program (assuming, of course, I pass my NR test, and make it to senior year).
In other news, my NREMT-I practical exam is on Friday. I am terrified. The last time I took it, I failed the medical, trauma, and both cardiology stations. This time, I feel fairly confident in everything except dynamic cardiology. We haven't had much time in class to do actual practice in class; most of our dynamic practice has been more of a 'practice by committee' kind of thing. So today we finally got a chance to actually sit down with our instructor and do a dynamic station. I did it twice. And failed twice. And we don't have practice time tomorrow, because our instructors are setting up the test.
I am in terror. I don't know how I'll handle it if I fail. I feel confident about all the other stations, and feel confident that I will fail dynamic cardiology.
To make matters worse, The Fiance will not be in town this weekend, which means I have to get up at 0330 Friday morning in order to be at the test site at 0800 (it's 1.5 hours away, which means, at rush hour times, I need to budget at least 2 hours, if not 2.5 to get there).
I'm hoping to get to the firehouse tomorrow, in the dream that someone there can run me through some dynamic cardio scenarios.
On the plus side, in happier news, The Fiance got word today that once his exile in NJ is complete, he will be placed on a project here at home, that will last for at least a year and a half. Which means he will be in town for the wedding. And my senior year of this program (assuming, of course, I pass my NR test, and make it to senior year).
Thursday, April 22, 2010
Right-sided MI's
So, I was responding to a post by RevMedic over at EMS Haiku (go there to see the actual strip) who was talking about a right-sided MI he might have caught through careful assessment and so on. I was talking about a tip that I got from a doc during a clinical on the medic unit, and realized Hey! This is one of those things I could put in my blog!
So here it is. Thinking logically, the lead V1 in a 12-lead EKG is the exact reciprocal of the lead placed on the back in a 15 of 18 lead (I don't know which one, since we haven't studied them, only talked about them briefly). Therefore, if you see a depression in V1, you should expect that there is reciprocal elevation in that lead on the back. Thinking further, the lead on the back is pretty much directly over the right ventricle, and therefore it makes sense to see elevation there.
So yeah. While it is not diagnostic by any means, seeing ST depression in V1 lead, when you don't see reciprocal elevation in any of the reciprocal leads, should lead you to suspect a right-sided MI, and move your leads over to double check.
So here it is. Thinking logically, the lead V1 in a 12-lead EKG is the exact reciprocal of the lead placed on the back in a 15 of 18 lead (I don't know which one, since we haven't studied them, only talked about them briefly). Therefore, if you see a depression in V1, you should expect that there is reciprocal elevation in that lead on the back. Thinking further, the lead on the back is pretty much directly over the right ventricle, and therefore it makes sense to see elevation there.
So yeah. While it is not diagnostic by any means, seeing ST depression in V1 lead, when you don't see reciprocal elevation in any of the reciprocal leads, should lead you to suspect a right-sided MI, and move your leads over to double check.
Sunday, April 18, 2010
A small light
I'm beginning to get excited. Only 2 more clinical shifts left for this semester. It's been fun, but I'm heartily tired of waking up at 0500 or earlier every damned morning, including weekends.
This weekends clinicals were relatively boring. A pseudo-busy shift at the hospital (you know the ones, where you are running around all day, but at the end of the day you look at your paperwork and say 'Wow, I hardly did anything today!') and 2 days at the same medic unit (a total of 24 hours) with only 3 calls. Luckily, I don't have to worry quite so much about patient contacts this semester, but it would be nice to get at least a little ahead of the game.
On the plus side, I cranked out the last 4 trauma homework assignments, finished my take-home test, and did almost all of my clinical paperwork yesterday and today. The only school work left is 2 papers, various tests (of course), a presentation, and the NREMT-I test. There are some other issues that I have to work out, which is it's own ranty post, so stay-tuned.
Paper due Thursday, paper due Monday, then a bit of a breather till May 12th. There is a small light at the end of the tunnel, for this semester at least.
This weekends clinicals were relatively boring. A pseudo-busy shift at the hospital (you know the ones, where you are running around all day, but at the end of the day you look at your paperwork and say 'Wow, I hardly did anything today!') and 2 days at the same medic unit (a total of 24 hours) with only 3 calls. Luckily, I don't have to worry quite so much about patient contacts this semester, but it would be nice to get at least a little ahead of the game.
On the plus side, I cranked out the last 4 trauma homework assignments, finished my take-home test, and did almost all of my clinical paperwork yesterday and today. The only school work left is 2 papers, various tests (of course), a presentation, and the NREMT-I test. There are some other issues that I have to work out, which is it's own ranty post, so stay-tuned.
Paper due Thursday, paper due Monday, then a bit of a breather till May 12th. There is a small light at the end of the tunnel, for this semester at least.
Sunday, March 28, 2010
I think my IQ just dropped a few points...
Look, I am all for making mistakes. It's how we learn best. I am all for asking questions so you DON'T make mistakes. But seriously people...use your brain. It's that organ located in the lump 3 feet above your ass. If you occasionally engage that organ, you can save yourself from a lot of mistakes, and make yourself look less like a fool, and more like someone I'd want treating my family.
For my hospital time clinical, I go to a large, well-known university hospital. They also have a peds ER upstairs from the adult ER, but the critical care rooms (trauma rooms) are down in the adult ER. So whenever there is a consult for the peds ER, the adult ER listens in, just in case they end up coming to the adult ER.
As an aside, any paramedic student doing time in a hospital should listen in when a medic unit does a consult. Not only does it let you know if there are any traumas or serious medical cases coming in that you could look in on, but it also shows you the difference between a good consult and a bad one.
Any way, yesterday I heard the box go off, and listened in with the charge nurse. It was a consult for peds, but we listened in. The information was as follows:
12 year old male picked up from school with chest pains and trouble breathing. Unknown medical history per patient and school nurse. All vitals unremarkable (BP something like 120/80, P 80 something, R 18, O2 sat 100% ra). EKG shows NSR, IV with lock.
All sounds ok right? Then the medic consulting dropped the bomb. "Given that the patient is past the age of puberty, we would like to know if we should give NTG and ASA."
WTF?????? Are you serious? With vitals like that, and a kid who's 12, you want to give NTG and ASA? First of all, per MD protocols, a child is considered pediatric until age 15. Secondly, per MD protocols, NTG is no indicated in children. Thirdly, haven't you ever heard of Reye's Syndrome? You know, what possibly happens in children who are given aspirin? (Granted, I don't know the time frame and dosages required to give a child Reye's Syndrome, but still).
But the biggest problem here is this. Regardless of the age and so on, look at the vital signs. There is ZERO sign of any kind of heart problem, and, absent any concrete history, I'd be hesitant to give ANYTHING.
So yeah, I think my IQ dropped a few points listening to that consult.
At any rate, the rest of the clinical on Friday went well. The clinical Sunday went well too. Not as many skill check-offs as I would like, but several good medical patients that were serious head-scratchers and a good experience to sit in on.
For my hospital time clinical, I go to a large, well-known university hospital. They also have a peds ER upstairs from the adult ER, but the critical care rooms (trauma rooms) are down in the adult ER. So whenever there is a consult for the peds ER, the adult ER listens in, just in case they end up coming to the adult ER.
As an aside, any paramedic student doing time in a hospital should listen in when a medic unit does a consult. Not only does it let you know if there are any traumas or serious medical cases coming in that you could look in on, but it also shows you the difference between a good consult and a bad one.
Any way, yesterday I heard the box go off, and listened in with the charge nurse. It was a consult for peds, but we listened in. The information was as follows:
12 year old male picked up from school with chest pains and trouble breathing. Unknown medical history per patient and school nurse. All vitals unremarkable (BP something like 120/80, P 80 something, R 18, O2 sat 100% ra). EKG shows NSR, IV with lock.
All sounds ok right? Then the medic consulting dropped the bomb. "Given that the patient is past the age of puberty, we would like to know if we should give NTG and ASA."
WTF?????? Are you serious? With vitals like that, and a kid who's 12, you want to give NTG and ASA? First of all, per MD protocols, a child is considered pediatric until age 15. Secondly, per MD protocols, NTG is no indicated in children. Thirdly, haven't you ever heard of Reye's Syndrome? You know, what possibly happens in children who are given aspirin? (Granted, I don't know the time frame and dosages required to give a child Reye's Syndrome, but still).
But the biggest problem here is this. Regardless of the age and so on, look at the vital signs. There is ZERO sign of any kind of heart problem, and, absent any concrete history, I'd be hesitant to give ANYTHING.
So yeah, I think my IQ dropped a few points listening to that consult.
At any rate, the rest of the clinical on Friday went well. The clinical Sunday went well too. Not as many skill check-offs as I would like, but several good medical patients that were serious head-scratchers and a good experience to sit in on.
Wednesday, March 10, 2010
You CANNOT be serious...
Heard on the county radio tonight at the station: Haz Mat call for the 'smell of chemicals outside' someone's house. Chief gets on scene, sets up command. Engines are on scene, detect chemical. "Yeah, we can smell it, it's a slight smell of skunk."
Command cancels all incoming units, EMS units call in asking if they are canceled too.
Command: "No, keep EMS coming. The woman is on the balcony, complaining of respiratory distress from the smell."
Seriously? You smelled 'chemicals', and called 911. I can actually understand that, having been around a skunk when it initially let go, and it does smell like chemicals at first. But, the skunk is outside. YOU are outside. You are having respiratory distress. From a skunk? How's about you just GO INSIDE?????
Sometimes you just can't make this stuff up, you know?
Command cancels all incoming units, EMS units call in asking if they are canceled too.
Command: "No, keep EMS coming. The woman is on the balcony, complaining of respiratory distress from the smell."
Seriously? You smelled 'chemicals', and called 911. I can actually understand that, having been around a skunk when it initially let go, and it does smell like chemicals at first. But, the skunk is outside. YOU are outside. You are having respiratory distress. From a skunk? How's about you just GO INSIDE?????
Sometimes you just can't make this stuff up, you know?
Monday, March 8, 2010
4 more days
Till spring break. I have managed to get almost all of the projects due this week done; just the take home test and group presentation to finish. Spring break will be spent most likely trying to get ahead of the work load for the last half of the semester. And trying to find a job.
EMS Today was interesting, though it was hard for me to really get into a lot of things when I was there mainly with my fellow students. They all mainly wanted to get the stuff for the assignment done and then get the hell out. I would have liked to stay longer, check out some of the things I missed the first time around (due to long lines at the booths) and see the Chronicles of EMS at the Zoll booth. Maybe next year.
I did end up staying in B-more longer than I planned, since the plans for getting the group project done fell through. Classmate N and I walked down to Inner Harbor and hung out watching the last cannon shot on the Connie. Then we went up to Uno's for another drink and a snack. A friend drove up from home to pick me up, got lost several times, and we finally got home and dinner around 2030. Long day.
I looked for the bloggers I read, TOTWTYTR, AD, and Epi, but never actually recognized anyone. Perhaps next year I'll actually meet people.
EMS Today was interesting, though it was hard for me to really get into a lot of things when I was there mainly with my fellow students. They all mainly wanted to get the stuff for the assignment done and then get the hell out. I would have liked to stay longer, check out some of the things I missed the first time around (due to long lines at the booths) and see the Chronicles of EMS at the Zoll booth. Maybe next year.
I did end up staying in B-more longer than I planned, since the plans for getting the group project done fell through. Classmate N and I walked down to Inner Harbor and hung out watching the last cannon shot on the Connie. Then we went up to Uno's for another drink and a snack. A friend drove up from home to pick me up, got lost several times, and we finally got home and dinner around 2030. Long day.
I looked for the bloggers I read, TOTWTYTR, AD, and Epi, but never actually recognized anyone. Perhaps next year I'll actually meet people.
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