January 14, 2007 First trip to the Alberta College of Paramedics.

Well folks, just got back from Red Deer.

7 of us went down Friday... and 7 of us are back in Edmonton having all passed our practicals (no redos required this weekend!).

I did mine this morning with two of the others... I got Medical: a transfer from a nursing home of a 72 y/o male complaining of unstable angina x2 weeks.

I didn't have a lot of time in the sequester area. My turn for practical testing was within 5 minutes of the start of our scheduled time, and then I got to spend 40 BLOODY MINUTES in the scenario itself!!! Full primary, full secondary and two sets of vitals on board before the patient coded (after seizing). You saw it coming the ENTIRE time...I kept waiting and waiting and still nothing happened. Finally when it came I was thinking to myself "thank gawd...I know the end is near!". BUGGER! Not that I'm still bitter or anything. The upside...waiting for the results of my practical only took about 10-15 minutes and then I was outta there with a great big smile of relief on my face.

In EMR school I was told that most of the time if your patient is going to code in scenario land he'll do it in the secondary when you get to the chest. My guy was presenting with everything classic like...and when I got through the secondary chest I really thought I was home free. But I asked about my ETA for the hospital a couple times and they kept saying "Oh the hospital is still really far away!" LOL. I had to try hard to not laugh the entire time.

The Trauma for the morning shift of testing was a bilateral femur fracture! Thursday's EMT class going over traction splints was incredibly useful for the one (of us 3) that got the T stamp.

For anyone wanting to know a little about what was on the written this is what I can recall from my experience:

Para and Gravida...which I had gotten as a tip from a girl in MY EMR class. Know what they are. There were two questions.

Lots of OB emergency questions...especially lots when you think of how rare that call actually is. Know how to deal with the different presentations of delivery. It felt like there were 10-15 questions but maybe that's just because I STILL have never read the related chapters.

Triage. There were only two questions on that...and thank God for Kethra suggesting we review that in our review session because I'd never heard of any of that stuff till that night. First two questions on the exam were MCI related.

LOTS of questions on how to handle bleeds. And all the answers were a little odd. Pressure, elevation and some other things in all various orders and combinations. Review that stuff.

There were a few diabetic related questions...and a couple questions (medical emergencies) asking to diagnose the patient based on the preceding question's information and your choice of treatment. I'm pretty sure it was those ones I lost lots of marks on...

There was at least one which asked what type of shock a patient had gone in...so know your shocks and their presenting symptoms. (CHAMPS: Cardiogenic, Hypovolemic, Anaphylactic, Neurogenic yes I know that's not an 'M', Psychogenic not a real shock because it self corrects when they pass out, and Septic).

Understand your scope as an EMR. I didn't find it challenging at all with respect to the EMT stuff we've been learning...EMR to me is very cut and dry:

Trauma of any sort = Spinal immobilization no matter what.
Your safety above all else
Every patient is a load and go. We can't rule out anything. And we can't fix anything.

And don't get all caught up in what an EMR can currently practice (i.e. no drugs, no BVM etc) and just write the test based on what you were taught in school which means all that infamous 'gap training'...so in ACoP land you CAN bag, you CAN give the select few drugs either yourself or at least assist the patient with them.

So far that's all I can remember.

There were a couple questions with medical terminology...a few different ones but dysphasia was one I had to find the answer for afterwards because it was bugging me. Basically they gave you a word and asked you what it meant and gave you four possible options.

Oh and there were a few easy give away questions too...like what is the thing we use to determine level of consciousness...AVPU (of course expanded).

Glad it's done! No more ACoP crap I hope until October.

No comments: