Thursday, March 11, 2010

Milestones

It occurred to me today that I have arrived at a particularly meaningful point in my journey to be a medic. As of yesterday, I've pulled as much knowledge as I'm going to pull from books about being an EMT. Classes and labs have ended, and all that stands between me and an Emergency Medical Technician certification is as follows:

* 140-question written examination over two terms
* Practical examination over medical and trauma patient assessment
* National written examination covering an entire 1,200-page textbook (70 to 140 questions)
* State practical examination over every skill in the EMT scope of practice: Patient assessment (medical and trauma), oxygen administration (mouth-to-mask, nonrebreather and nasal cannula), spinal immobilization (seated and supine), splinting (joint and long-bone injuries), control of bleeding and shock, and defibrillation.

I've learned an astounding amount of information about how our bodies work, how our bodies react to injury, and how to keep people alive using basic life support measures, despite the best efforts of our bodies to kill us. These include:

* Conducting effective CPR on adults, children, infants and neonates.
* Administering several medications, including: High-flow oxygen (to treat hypoxia), nitroglycerin (angina and acute myocardial infarction), epinephrine (anaphylaxis), inhalers (asthma and respiratory distress), activated charcoal (overdoses and poisoning) and oral glucose (hypoglycemia associated with diabetic emergencies).
* I can recognize and immediately treat people who are moderately or severely injured -- or near death -- from any of the following scenarios: allergic reactions, diabetic emergencies, respiratory and cardiac emergencies, environmental emergencies (hyperthermia, hypothermia, drowning), head, brain and spinal injuries, soft tissue injuries (lacerations, abrasions, avulsions, burns, amputations, eviscerations, gunshots, stab wounds), musculoskeletal injuries (fractures, dislocations, sprains, strains), poisonings and chemical exposure, behavioral emergencies, acute abdominal distress (appendicitis, peritonitis, internal bleeding), shock, venous and arterial bleeding, pediatric emergencies, and neurological emergencies (stroke, seizures).
* I can, believe it or not, successfully deliver a baby, including post-delivery care, and I can recognize and provide interventions for common obstetric complications, including breech birth, prolapsed cord, eclampsia and pre-eclampsia, placenta previa and placenta abruptio, and premature birth.
* I know how to interact with and properly assess injured kids at all ages, which is generally understood to be the hardest part of this line of work, as well as geriatric patients.
* I can use big, impressive-sounding medical terms, but I know that the key to good patient care is effective communication, respect, quick thinking, and knowing my shit. I know that I can gain somebody's trust -- even somebody who is in severe distress and fearful of dying -- simply by kneeling down to his level, looking him in the eye, asking for his name and saying I'm here to help.

I still have tons of education ahead of me. I will learn the difference between how things are done in textbooks, and how they are done in the real world. And although I will soon be an EMT, I still have a few years of school before I'm a paramedic.

But, as of now, I've accomplished what I initially set out to achieve: I can save lives. And for that I am humbled, excited and terrified.