Twelth Day

Twelth is a weird word.

Anyway, this was an okay day. I was feeling super craptastic and luckily, the teacher did too. So we got out at 8:30!

We just worked on bandaging and we talked about lifting/transporting patients. Not bad!

Eleventh Day

Going well. Love trauma - it's more straightforward. We did bleeding and chest trauma. Nothing too difficult.

I got 86% on my midterm! The highest score was 91%, but I'm willing to bet the guy who got it used quizlet. There's no freakin way!

I'm so tired of assessments. I hate them. Everyone has a different idea of how to do them right, so there is always a complaint or criticism (nobody gets or appreciates the art of constructive criticism) and we all know you just read off the paper - Like a list. It's absolutely pointless to be in groups. Ugh.

Real Talk

It's time for a real talk time-out. The sexual assault chapter was an "at-home study" chapter, which is unfortunate. Equally unfortunate was that we didn't really address person-on-person violence as part of the trauma chapter in class. If you work at all, especially in Utah, you're likely to come in contact with someone who is seeing you as a result of domestic violence. Black eyes and neck pain? Suicidal patient? Alcoholic? Drug addict? Where did it all start?

A lot of people focus on emotional abuse when it comes to lasting impact, but all abuse - sexual, physical, emotional, and financial - will have lasting effects (also, emotional abuse is an aspect of all abuse. I'll spare you that rant). "among patients with depression, irritable bowel, chronic pain, or substance abuse, prevalence of reported childhood physical or sexual abuse runs as high as 70%." Another study finds that "the following symptoms significantly related to a history of childhood physical or sexual abuse in women in primary care practices: nightmares, back pain, frequent or severe headaches, pain in the pelvic, genital, or private area, eating binges or self-induced vomiting, frequent tiredness, problems sleeping, abdominal or stomach pain, vaginal discharge, breast pain, choking sensation, loss of appetite, problems urinating, diarrhea, constipation, chest pain, face pain, frequent or serious bruises, and shortness of breath. "

This is relevant to our work, right? At the least we could recognize that people with drug and alcohol related issues deserve compassion and respect. At most, we could recognize the symptoms of battery or sexual abuse and report it to police. Help someone out. I realize this is uncomfortable for a lot of people to talk about. Perhaps it's because, statistically, they know they'll be addressing someone who has been through it. It's likely they've been through it themselves. But isn't that better? Let these people know you care about this issue. Let others know how to handle survivors and open some minds! This is an epidemic across the nation, and ending it starts with addressing it.

Healthcare Provider CPR!

Finally got this puppy.

It's not much different from a regular CPR class except there was no first aid aspect, and we learned how to use an AED and Bag valve mask. Right? Don't you normally learn how to help choking adults, children, and babies? CPR on unresponsive adults, children, and babies? It's good stuff!

Tenth Day (Half Way!)

We had a remediation session today. Most people there just needed hours for missing class. I just needed some help in shock - because it's important (and I'm bad at it).

It was disappointing. Mostly we just took the quiz together and were told to find the answers in the book...ugh. I want some real life stories and examples. I want to learn how to think critically and prioritize treatment. I especially want to practice most of these skills. I know that applying a non rebreathing mask is muy importante, but they only told us how to do it once. I want to practice!

So that was a bummer, but the teacher was in a good mood the rest of the day. He told stories and we got out early.

We're starting to learn about trauma! It's great, and it makes sense. So far, it seems more straightforward than medical. Also, the patients are more likely to be unconscious, so I like that. No formalities, just implied consent and helping them the best I can. We learned about gunshot wounds, stabs, and handling sexual assault. This is more my speed. Rumor has it that we'll be tested on gunshot wounds for the NREMT.

Lastly, I signed up for my ride along with a fire department from a bigger city near Salt Lake for May 25th. Because of HIPPA, I'm not sure I'll be able to share anything about that day. I hope!

Ninth Day

Today was rough.

I quit my job. I had to. I realized I was 10 chapters behind (10!!!), and we were going to get written up if they weren't done (of course that didn't end up being the case). This had to be the right choice, and I know I'd bitten off a metric ton more than I could chew, but I still feel like a failure. It was such a great job, too.

Anyway, now I feel like I'm gonna fail this as well. Like it's a universal law.

We learned about toxicology and neurologic emergencies. Strokes, seizures, overdoses. That sort. We learned about generalized and partial seizures (grand mal, petite mal), status epilepticus, and their causes. Sometimes no cause can be identified, but it's usually either high fever, structural abnormality, metabolic (eg, low sodium, hypoglycemia), or chemical.

Eighth Day (Part 2)

She ended up (unregretfully) chickening out, but another student, we'll call him Heath, stepped up! Next stop, nasopharyngeal airway town!!!

We're ready.

Heath sat in a chair, and everyone gathered around. We were all excited. Another student, Reese, lubed up the airway device - which was HUGE. And then he just started it into Heath's nostril. Heath coughed, and his eyes started watering, but Reese unflinchingly continued on, perhaps a little quicker than he should have. The teacher's aide asked if he could see the device in the back of Heath's throat. Heath opened his mouth and gagged. It was so funny! Everyone else was really enjoying it too. The device was pulled out slowly, covered in blood. Oops.

Of course two students were recording, so it's on facebook. I'll have to get it.

Anyway, then we did more fun stuff: Glucose monitoring. I gut stuck 3 times. I stuck one girl. I was going to do another, but she was being scared. I got everything ready and was about to prick her finger, when she kept jerking it away. I calmly let her decide when she was ready, but she kept backing out. My teacher then took over and, when she was again "ready", he took her hand and held it down while he pricked her.

She complained about it hurting (it doesn't), and then cried later, because she was that scared. But she has pierced her own ears!! Girl.

Anyway, I got to prick another student...and promptly threw the needle in the trash (not the sharps container) like an idiot. But it was prefect otherwise, so I'm happy!!

Good day.

Eighth Day (Part 1)

I'm on lunch break right now. I just wanted to document how freaking happy I am!

First, the teacher got fed up with the guy behind me and finally said to him: "You just want to take all the glory, don't you?" I don't want him to feel bad, but I also hope he shuts up a bit.

Second, I've been somewhat nervous and hesitant about grouping off and working with other people. I hate it because I get so nervous. Like...constant in-head pep talks hardly work (though I like to think I hide it well). WELL, as soon as we were told to group off, a girl called my name and said she wanted to practice on me because I'm realistic! That was so cool. She was shy too at first, but I think we're both improving.

She inspired me with her excitement to work on the mannequins. We may even put nasophayngeal airways in her nose later! We practiced super plugging, jaw thrusts, head-tilt-chin-lifts, one-person breathing valve mask, two-person breathing valve mask, and oropharyngeal airways.

It was too much fun! I love hands-on learning, it makes me feel more confident. Anyway, bring on the rest of the day!

Seventh Day

The lady reported feeling like crap because her blood pressure meds were doubled. But she wasn't worried anymore, so that's good. She looked good.

We learned about diabetic emergencies like ketoacidosis, diabetic coma, and insulin shock. We also covered anaphylaxis again...not sure why.

We did two assessments in front of the class. The first was fine, it ended badly only because the guy lacked confidence and took too long. The second assessment was an awkward mess. The guy was one of those guys who has an heir of "I'm too good for this.". I thought maybe I was just imagining it and judging a book by it's cover, but he proved me right.

They were simulating insulin shock. The AEMT aide was the patient (acting extremely disoriented), the teacher was his roommate, and the med student aide was the patient's brother. The EMT student started out mostly fine, save for a very $hi**y rapport with the "roommate" and "brother". He also assessed pulmonary unnecessarily and way too early - a critical fail (though he was the second guy to do it that day).  **Update: I saw a YouTube video on assessments, and it was demonstrated the same way. Maybe they're doing it right?**

Then, the diabetic patient got up and started walking off out of the room, and the EMT student basically let him. He went after him, only to come back saying he gives up and sitting down like a puss. There was an awkward pause as the class collectively tried to decide the validity of his entirely-uncalled-for claim. Sho 'nuff.

So his friend finished it for him - deciding to give the patient insulin for his glucose reading of 40. This would kill the patient by lowering his already-low glucose. It would've been a critical fail for ordering a dangerous treatment were it not for the annoying guy behind me who insists on answering every time someone asks the teacher a question.

This was especially irritating because they specifically said before the simulation NOT to help. He just wants to look good and show off the fact that he was once certified. We get it. But I know I didn't pay the teacher $1,000 for your instruction.

Later on, he tried answering one of my questions about handling a disoriented patient. There is such a thing as battery and unlawful detainment, after all. When is it okay to stand in front of a patient to prevent them from leaving? When is it okay to put your hands on them? How do you put your hands on them?

I digress. That guy gave it away, trying to show off, and the EMT student fixed his answer - thus learning nothing.

Kind of obnoxious day, but otherwise nice. Not bad at all.

Sixth Day

Today was special. I may have saved my first life!

For the first part of class, we talked about different methods of airway management. I had been on the verge of tears all day. It was just a sad day.

Then we practiced assessments.

There is this lady in class - maybe 34 - who is always upbeat. She's way cool. So, when we were asked to split into groups, and she made eye contact with ME, I was freaking stoked. Bonus? She's competent. So, we practiced assessments with another girl, switching between the roles of medic, patient, and grader. She was my patient first.

After sizing up the scene, checking ABCs, and taking a history, it was time to take her vitals. Her blood pressure was 150/110. When the AEMT teacher's aide came by, she mentioned to him the number, and he told me to take it again. This time it was worse:150/120. His interest was piqued. With my confidence dwindling, he checked it as well. Same result.

Then she began to panic a bit. It was so unlike her. She held back tears, apologizing. She complained that she's seen enough doctors in her life. She'd received bad news relating to her past battle with cancer this week. She was scared, and making herself worse with worry.

On one hand, I was sad for her. I hugged her and assured her we didn't think less of her for being worried. On the other hand, I couldn't help but feel that, in some small way, I may have just helped save her life.

I mean, maybe it had something to do with lack or food or water - like a lot of women. She's had heart issues before. But a bp that high could cause a stroke. Who knows? I probably never will.

So that was an exciting day, and I am happy to report I am no longer on the verge of tears.

Stress Ulcers

When I get stressed enough, I get mouth ulcers. They're big and they hurt like a mutha$@#!&*!

Update: I eventually got three of these before I quit my job, but they're healing fast!

Fifth Day

It was my first Saturday class today. They're 9 hours long. Oh good grief.

It was a hard day. Hard getting up, hard staying awake, and hard being around other people all day. I'm SO tired.

We learned medical assessments and briefly touched trauma assessments. All day long. If I could do it over, I would take a regularly- paced course. Everything seems so rushed, and I got caught up for a day, and suddenly I'm four chapters behind again!

Today I was running 5 minutes late. Instead of trying to find two socks in a massive pile of laundry, I thought it would be a better idea to be less late and wear flip flops (against the rules, as outlined in our student manual). But, since everything else has been so chill, I was willing to take the risk. I got to class and, as I signed in, quietly informed the teacher that I was wearing flip flops, but only because I couldn't find socks. He asked how far away I lived, I told him, and he said I should go get my shoes.

Dang it.

So, I drove home, mostly annoyed with myself and somewhat worried I'd miss important info over stupid shoes. When I got home, I dug vigorously for my socks, but only ultimately found one. So I just wore my shoes with no socks - which I should've just done in the first place.

I got back to class to see everyone taking vitals. Relieved I'd missed nothing, I sat down. The boy next to me explained that the teacher told the class to do vitals while they waited for me to get back.

I felt so bad, but was so appreciative of the unnecessary and kind gesture. I thanked my teacher for waiting for me and expressed how kind it was. He was happy to do it because he "appreciated [me] being a good sport" and because I was doing him a favor. I don't see it that way, but it was so incredibly nice whatever the case. Maybe having a chill atmosphere is a good thing for someone like me.

Time to catch up. Time is so precious these days.

Fourth Day

Things were good again! We learned some medications and the different kinds of shock:

Cardiogenic, obstructive, septic, neurogenic, psychogenic, anaphylactic, hemmorhagic hypovolemia, and non-hemmorhagic hypovolemia.

Am I missing any?

The first two are pump failures, most of the others are caused by widespread dilation of arterioles, venules, or both. The final two are caused by issues with blood volume either through bleeding, plasma loss after burns, vomiting, diarrhea, or dehydration.

I also learned what a cardiac tamponade was. Pretty cool! Now I have class at freaking 8am to 5pm later, so goodnight.

Third Day

Why are pre-med students always so smug and arrogant, when they really don't know anything?

Today, we were separated into groups and instructed to review and teach a section of the anatomy chapter. We were given two hours to prepare, and the book hardly went into depth on anything! We sat there most of the time.
And here I'm falling so far behind because I have zero time to study!

Right now, this class seems like a very expensive joke. I'm disappointed in myself and this program. Hopefully things will get better as we get into skills.