Sunday, March 15, 2015

The Path to Becoming an EMT










I started EMT training in October. With luck, my grades, clinical hours and number of patient contacts will yield the 'blue card', enabling me to take the state and national exams in mid-April. I misjudged the effort required to become even an EMT-Basic. It's a lot of work. You can easily spot an EMT student, they are ones who carry the 1400 page textbook everywhere and study constantly. Sometimes I catch myself eating while reading about  a grisly injury or medical condition. That's bad enough but sometimes I don't even notice, which is even more disturbing.

Vehicle Extraction Training, Wilmington FD

Almost everyone in the class is working full time, usually more than one job. Factor in family time, especially for those with kids at home, and I don't see how they do it. But the intrepid students who survived thus far continue to battle exhaustion and keep slogging through the three hour classes.


Trauma Assessment, Lake Placid

There are three main components - class time and exams, practical skills training, and clinical experience. Class and exams involve basic academics. Practical skills involve the application of book-learning, training the muscles to work with the brain. This can be challenging until you get used to it. Clinicals are completely different because the patients, illness and trauma are real. Everything is more challenging when the patients aren't stable and more so when the ambulance is moving. The rigs are built on commercial truck platforms so you experience full, 3-axis motion. It's not unusual to get motion sickness, especially on the back roads to and from Saranac Lake.


It doesn't help that every time I enter a hospital's emergency department I contract a new cold and battle it for a week. This amuses to the ER staff, all of whom were somehow granted the pathogenic equivalent of diplomatic immunity. 

Last week I completed my hospital clinical time over in Elizabethtown, which everyone refers to as E-town. There are many nursing and med students in the ER but EMTs can be especially handy. Most are experts at taking vitals, resourceful and are good patient communicators. One of the hospital EMTs asked if I would ride along on a patient transfer to Plattsburgh, which would yield all-important patient contact and clinical field hours. The patient, younger than me, was in awful shape with no DNR orders and a sporting chance of 'coding' enroute. It was a long, horrifying trip. 

You don't have time to reflect while working on a patient so the return leg can be the worst part. That's when you replay events and marvel at the fragility of life. I asked my teammate a typical rookie question, wondering how long it takes to get used to the tough rides. I received the typical 'oh, you'll get used to it' answer. But then she recounted a few bad calls that far eclipsed ours, some were from years ago but sounded like they happened yesterday. So the unspoken answer is: You don't ever get used to it. 

But most runs, such as the one we had at 2am today, aren't critical and - given our remote location and small population - executed flawlessly. A little oxygen, a few mgs of IV morphine or Zofran eases the pain and settles the (patient's!) stomach. 

Since we have nearly an hour of transit time to the nearest hospitals I have lots of time to chat with patients. The more they talk, the more comfortable they get and it's not unusual to see pulses and BP trending to normal levels by the time we get to the ER. Then it's ER paperwork, perhaps a snack stop, then a long, bumpy, transit back to our district. A drive home on utterly deserted roads is followed by the long, dark trek up our muddy access road to the cabin. Then, back to the book for a little more studying...






Sunday, March 8, 2015

The Coldest Winter Since '76



Sign on Keeseville Laundromat: Here, Winter is November through May!


They say it's so cold in these mountains that we don't get a Fourth of July until Labor Day. Another version asserts that we have three seasons: winter, Fourth of July and pre-winter. The pessimists complain about the cold and say it's worse than anything. The optimists counter that it may, indeed, get even colder. The old-timers at the Town Garage say that this winter has been exceptionally cold, the worst since 1976 when even more water mains froze than this year.

Getting Crossways on the Access Road


Well, that's all good news for over-wintering rookies like us because we've survived it. The backwoods mountains are the worst place to declare premature victory, but the days are getting longer and this morning's temperature was nearly 20F (above zero!). We had a string of 56 days below freezing and Lake Champlain froze solid for the second year in a row. That hasn't happened in a long time. Even Niagara Falls and Lake Erie were frozen.

Niagara Falls Freezes Over


Today's high was barely above freezing, but it was sufficient to be the warmest day in a month. A man in Keeseville said it was so warm he actually had to roll his car widow down, which sounded like a harbinger of spring but I wasn't buying it. Lumberjacks and their tall tales inspired the North Country's culture, so a little truth stretch is commonplace. Anyway, I appreciate an occasional exaggerated story way more than than (the unavoidable) reality TV.

Our Snow-Capped Birdhouse 
Awaits Springtime Occupants

Regarding car windows, the beagle occasionally surprises us with a glimmer of intelligence. She doggedly figured out how to operate the windows in the Tundra. One morning it was ten below and, sure enough, as we got underway she rolled the window down then stuck her head out of it. I sped up to 35mph to see if she'd withdraw from the -41F wind chill, but she was unfazed. Her nose felt like it had been immersed in liquid nitrogen. Maybe she's not that smart. Dogs can be amazingly durable critters.

An Early Morning Drive at Twenty Below Zero