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...