Whirlwind

Feels like just yesterday a fresh faced student showed up for Day 1 of the PCP course, all bright eyed and bushy tailed… full of excitement.

Going on 5 months later the eyes have even more excitement but are little less bright and the tail a little less bushy. It has been one hell of a ride and while I still have a few more steps to go before I can say that I am a full fledged Paramedic, I have thoroughly enjoyed every moment of it.

I managed to get through the classroom portion of the course without any remedials and was quite proud to finally be heading out on to the streets with the rest of my classmates for precepting. Now to put all those hours of training and study to real use!

Christmas and New Years came and gone with little time to rest and recuperate and precepting is now in full swing, I can’t think of a better way to start off the New Years than a 6:30am Shift in Vancouver… I must be a budding Paramedic.

I have been extremely busy and have not had many days off this months with precepting shifts in the city and BCAS shifts at my home station so I apologize for the lack of posts… but I have tons of war stories and crazy happenings to ramble on about in the near future.

To all those just starting or planning on taking the PCP course, good luck and put in the effort, it will all pay off and come together towards the end.

Stay safe out there!

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White Cloud

As a rookie everything is brand new and you cannot get enough of what is thrown at you. Flashing lights and sirens, rushing to the sides of people in distress, being the one in control of an emergency… hell even the call for abdominal pain at 3 in the morning is exciting. It’s all a chance to learn and get experience, learning from your mistakes and always improving your patient care and clinical judgement.

I have had the good fortune of having some amazing partners and encouraging paramedics to help me stumble through my first calls, although I have yet to respond to a serious emergent call. It has been great for streamlining my history questions and learning to dig for information.

Recently I have been working some weekends while attending PCP classes during the week and I have had a fantastic variety of calls and experiences… problem was that this lasted throughout October with me getting 16 odd calls.

Skip now to november… No calls, zip, nada, zilch, zero, nil, NOTHING

Not a single call, not a call on a 14 hour night shift on a saturday night on a long weekend… no calls on during a 10hr shift during which there were 100 km/h winds and power outages for 8 hours.

Nothing.

I cannot tell you how may times I checked to see if my pager was working during that night.

I took off my boots, I started cooking on the stove, I even tried having a shower. Not even taking apart the jump kit triggered a call.

Normally failsafe ways to generate a callout… yet nothing.

White Cloud Syndrome;

Affecting new paramedic recruits in the first 1-2 years of their careers this malady is recognized by the characteristic lack of calls regardless of inclement weather or timing. Even during peak drunken stupidity hours of 11PM-3AM on saturday nights this syndrome will leave the rookie with a sense of boredom, apathy, bad movies on tv and tears of frustration. Nervous twitching and frequent comments on “look how sloooooow it is” are also common side effects.

Treatment includes: excessive sleep, playing with the lights in the parking bay, doing countless car checks “just in case something went missing in the last 20 minutes” and story time with the senior medics QID.

The excitement and desire for calls is directly and inversely proportional to the amount you will actually receive.

Then again I guess it is a good thing, no one needing our services is excellent… but it doesn’t help the poor paramedic student itching to try out some new skills.

I guess I can say I got paid to sleep, there are certainly worse fates than that.

Pulse Oximetry

The pulse oximeter is a valuable tool in the prehospital setting and is a important part of the vitals signs and overall patient assessment. These $600 machines measure the oxygen saturation levels in the circulating hemoglobin and will detect the pulse wave. A normal saturation level for a non smoking adult is around 95-100% on room air.

Now tell me why this Baby Annie doll apparently has a Sp02 of 65% and a pulse rate of 80bpm.

Now I understand people calling it a random number generator…

Remember folks, treat the patient, not the machine!

*and no this is not some trick photography or photoshop

PCP Students… To work or not to work?

One big questions that come up from future or potential PCP students is whether or not to work during the course.

The 4 months in classroom is quite a long time and it can be a challenge to keep your  bank account from shriveling up. While the temptation of working during the program is very hard to resist I have a few strong words of caution.

  1. Be aware of the workload of the program; You may think that this course will be like other post secondary studies you may have taken or heard about from friends. This is unlike any of them, the amount of information you gain in such a short amount of time is staggering and you will have very few spare hours if you want to do well.
  2. Be aware of how much time you will be spending at school. Official class hours are 8:30-4:30, Monday-Friday. Average actual hours are 8:15-6 on weekdays and usually 5-6 hours each weekend. Add on readings and studying at home makes a busy busy course.
  3. Believe it or not you will see your classmates and instructors much more often than your family or friends, and the afternoon you take off each week should be taken to have some fun with the people supporting you through the course.
  4. What kind of job are you working? Is it something you could also do readings at? Is it related to paramedicine? Are you happy doing it? How many hours do you need to commit to?
I personally have been working during the program. I was cautioned against it on several occasions, but I have found it to be a good balance for me. Albeit I am working for BCAS part time, and usually around 6 shifts a month on weekends.
This works very well for me as I return home and can visit my family, make some decent money and get away from the city for a few days.
I have plenty of time during Foxtrot shifts to do my readings and study and there are always helpful co workers to explain and practice the question of the day,
I can integrate what I have learnt in class to what I am seeing and attending on the streets, and take what I have learnt and seen on the streets back into the classroom. It has given me a slight leg up in some ways with being orientated to the ambulance and it’s equipment as well as the way the Ambulance service works.
There is another classmate of mine that is in a similar situation and it has been a benefit thus far in the program. As we wind down unstable trauma and head into Hell week and Medical Block I am on the fence about doing any shifts at all.
My advice to any future PCP students would be this: If you can afford not to work during the program DON’T, you will get so much more out of it if you concentrate fully on the course. If you are a BCAS employee, decide for yourself what you would like to do, there is always the option of taking a Leave of Absence.
Resign yourself to the fact that your life is Paramedicine and sleep for the 4 month program, enjoy it and have fun with it and really… it’s only 4 months so make the most of the time you have available. Make time for your friends and family and take some time for yourself. Everyone has their own methods and priorities, find a system that works for you.

Orientation

We have just come back from our Block one Orientation shifts, and wow was it ever a wild ride. In these 3 shifts we spend a day in the ER and 2 shifts on Ambulance in the busy Lower Mainland Post. What a AWESOME and tiring 3 days, I am still running on the high from the thrill of riding third in the big city.

On these orientation shifts we were riding third with a regular Paramedic crew and acting as a observer and helping out any way we could in order to get a taste of life on the streets and how street calls are actually run.

I came back from this experience with a renewed child like excitement and pride in my chosen path, It really was yet another confirmation of everything I am working towards.

But above all I was impressed beyond words at the professionalism and encouraging nature of every single Paramedic I had the pleasure of meeting during my entire career thus far. There is such a mentoring and helping attitude and just a genuine desire to pass on the passion and knowledge people have for this job. It was incredible and just a joy to see people enjoy their job so much.

Of course there were complaints about the employer and how things are run, and the usual burn out and jadedness that experienced medics all seem to have… but they really were happy to pass on their tips and tricks to the rookie student.

I am extremely proud to call myself a part of this group and hope on day too I can pass on my knowledge to the next generation of paramedics.

 

All in all my time on car was quite routine and nothing too extraordinary happened. I did however get a nice variety of calls and patients as well as some very interesting clinical signs and symptoms I had only read about!

I listened to crackles in the lungs of a CHFer, I struggled to find a B/P on a CP pt. only to finally hear it down about 90/60.

I saw accessory muscle use and heart dysrythmias on Cardiac monitors, I started IVs on real patients that actually needed the fluid and investigated real Histories and complaints!

What an amazing experience in real patient care and dealing with coworkers, the fire Dept. and real people!

Ripping down the roads Code 3 against traffic to a CP call, assisting the CCPs and taking a glucose tests… getting caught up in the flurry of activity and spit out the other side wondering what had just happened. Fortunately there was always a kind and helpful face to explain and encourage a intelligent response and analysis of the call.

The real gem of the night was definetly our Code 3 STEMI Transfer to Vancouver General Hospital, a 25 min ride with a full Ambulance, filled up with cardiac monitors, infusion pumps, RN, Paramedics and the ecstatic student in the back firing off questions about ST Elevation Myocardial Infarctions as we rolled straight up to the Cath lab at VGH.

The pt. was a go for the Angioplasty and I sandwiched myself in between the Monitors and technicians and watched in fascination as the dye made its way through the heart and distinct narrowing showed up on the X-rays. The heart was in dire straits and was very very sick, they would need to place 4 Stents to open up the narrowed arteries. My eyes were glowing with delight and the grin on my face could barely hold back the words on my lips…

“SO AWESOME!”