The NREMT Exam.
So, here in Amador County, our EMS Agency will not award an EMT license until you have passed the National Registry of Emergency Medical Technicians(NREMT). In order to do that, you have to take and pass a proper EMT class. I had taken, finished, and passed an EMT class and got my certificate of completion. This allows me to apply to take the NREMT exam. I applied and waited for the college to send me information telling them I had finished. They had to verify the skills test, the course completion, and make a payment to NREMT. I had been waiting for my skills and completion to be verified before I paid the exam fee. So, I finished the class on December 15th. It was the following week that my course completion was sent to me and verified by the NREMT. However, my skills test had not been verified.
I found that odd because it only takes a button press in the same way the course completion was awarded. Ok, I though, maybe he hasn't gotten through all the paperwork. A week came and went. I e-mailed the dean at the college and he told me he had been trying to call NREMT about it and they had not gotten back to him. Peachy..... So I wait. And wait. And wait. 3 weeks later I'm still waiting while I'm down in SoCal for Christmas and it still had not been verified according to the website. So I figured, eh, what the heck, I'll pay the fee while I'm waiting. As soon as the payment had been processed my skills were verified.
Now, I was happy I could schedule my exam, but I was a little annoyed that I had waited this long for my skills to be verified. If they had been waiting on my payment, they really should have told me so. *sigh* So, my exam was yesterday, Thursday, January 5th. I went in for about 45min.
Wait a second though. Let me tell you about the Pearson text Nazis! I had to empty my pockets. Phone, watch, notebook, flashlight, gloves, trauma shears, book, wallet, and so on. I then had to sign the test rules and spend a while palm-scanning my palms to verify it was indeed, me. I had to be escorted into and out of the testing room where I was being video taped and audio recorded the entire time. I could not leave my chair without the test proctor and I had to raise my hand in order to do it. So it was there that I spent an hour answering questions.
So, I gotta tell you, the worst part of that test is when it suddenly exits on you. When you reach either a passing score for the length you're on or you have completely failed, it will just end the test. It doesn't tell you why. The proctor came to get me and told me that I would most likely have my results in 4 hours. Ok, fine.
Around 5am this morning I got the news online: I had passed my NREMT exam.
Today I put on a shirt I had bought at the beginning of the fall semester. An EMT duty shirt. I used it as a push to do well in the class, as I could not wear it until I had passed my test and actually became an EMT. I wore it all day today and I am very proud of what I have done. It is merely the beginning of my medical career and education, but it is an important and big step forward. Now onto the undergraduate work and MCAT preparation!
Clinical's Part 4: Medic 2 and STEMI
As a conclusion to my series on my EMT clinical time, I will tell you about my time on Medic 2 out of Sutter Hill. This is the main ALA ambulance station and gets the majority of the EMS calls in Amador County by volume. I started out that day at 8am by bring donuts to my friend Scott who was the EMT of that shift with me. He had complained the evening before about another student bringing them and he didn't get any. I fixed that. Suck-up points are always nice.
Anyway, we were staffed with 4 on that rig. It was cozy. There was Paramedic Bryan, Paramedic Intern Mike, EMT Scott, and EMT Intern Nathaniel. We had a handful of different calls, but the first one of the day was to a local High School. A teenage girl with syncope. She was alright, but let me tell you the worst part of that call. We went out just before lunch. That's not so bad except for the fact this young woman has been in cooking class. I walk into the building and am immediately assaulted with the smell of Italian food of all kinds. Not cool!
We had a heart problem at a local nursing home. That was an easy run to the hospital. We also had another syncope at a local fitness place. This was an interesting assessment as this PT felt fine laying down on the floor, but as soon as we would stand her up, she would feel nausea and faint again. Her BP would drop and pulse went up. Very interesting. Simple dehydration or is it something else? Not sure on that one. Either way, we went to the hospital again.
Towards the end of the shift we had to go up hill and cover zone 4 in Pine Grove. We had a call up there for a possible stroke. She presented fine. Maybe a TIA. Who knows.
One last thing. This wasn't really on medic 2 or even on my clinical time, but the day after my time on medic 2, I got to respond to a call for chest pain with my fire department. This turned out to be a full on STEMI heart attack. According to the Cleveland Clinic, a STEMI is a "...heart attack, or MI, is caused by a prolonged period of blocked blood supply. It affects a large area of the heart muscle, and so causes changes on the ECG as well as in blood levels of key chemical markers." Usually this is very close to a death sentence for a patient the paramedic told me. It was a classic heart attack. Just like in the book except this PTs pain went into his right arm, not his left. He was squirming around, clutching his chest, and had a doomed feeling. Not good for him, but it was very education for me to actually see one in the field, see the vitals, and watch the progression. I went along with the ambulance as a rider/helper to assist the paramedic. That turned out to be a good thing as the PT ended up throwing up all over her and the back of the ambulance. Boy was that....fun..... The ambulance was out of service for over an hour to clean up. Poor Scott....
All in all, I had a FANTASTIC time with my ambulance time. It just encourages me further in my goals to become an emergency physician.
Clinical's Part 3: Medic 3
So, as the final part of field clinical time for my EMT license, I had to spend 24 hours on an ambulance. I got to do that with my local ambulance company, American Legion Ambulance. What's so nice about that is that I have friends that work there, I respond with them with my Fire Department, and see them on calls already. Not to mention they were running my EMT class.
My first 12 hour shift was at Medic 3 in Pioneer, Ca. Actually it'a about 3 miles from my church. I was on with Mary (My fire chief's wife) and her EMT partner Caleb. Boy did I have a good time with them! It was the day after thanks giving and ALA had paid for each ambulance station to have a full turkey dinner. I was there on the PERFECT day. Hehe.
Medic 3 is sometimes called the vacation station as it's located in a place with a smaller number of people, but very spread out. It's also the primary unit to respond up Highway 88 all the way to the county line pretty much. It's usually pretty slow though. We had nothing till about 12:30pm. Then we had three in a row. We got to one medical aid (Which turned out to be nothing more than a lift assist) and had not even finished there before we got a call for a traffic collision up 88. So we quickly cleared the scene and took off up hill. We had been going for about 7 min when we got cancelled as non-injury and put on another code-3 call. Fortunantly, we were very close already and got there very quickly. This was for an 80-ish female with chest pain and her implanted pacemaker/defibrillator firing. This woman had been sick for the past four days, but had not thought it serious enough to see a doctor. Well, when her pacemaker began to shocker he, she decided it was time. No kidding..... She was in pain and very weak; so we loaded her up and off we went to the hospital. It was cool, because I got to see someone get shocked by a defibrillator right in front of me. It fired just as we loaded her in the ambulance. From the way she yelled, I'm gonna guess it hurt...
After that, it was quite until about 7:30pm. I did get to watch a lot of criminal minds though. That was cool. The final call of the day was for an 80-ish male with a seizure. He had been eating dinner when he suddenly slid out of his chair onto the floor. This, of course, bothered his wife who called us. He was awake when we got there, but he was altered. We got him loaded after a good assessment and began to transport him to the hospital. In route he was asking the same sets of questions over and over. He was obviously altered and not remembering what we were telling him. I took over the patient talks to let Mary, the paramedic, continue to work on him and get an IV established. It was a little frustrating to get the same questions asked of me over and over and over and over and over, but at the same time I understand it wasn't him doing it on purpose. He was scared and was having a medical problem.
By the time we got back to the station, it was time for me to go. I made a new friend that day with the EMT Caleb, who was very nice and really helped me get into the swing of working on an ambulance. He and I were very much alike some some respects and we got along very well! Thanks Caleb, for being patient and making it a very good day!
Clinical's Part 2: Kaiser South
Well, I know it's been a while, so I'll give you a quick update first of what's been going on.
First off, I've passed my EMT class. I passed all my skills with flying colors, passed my final, and got an A over all in the class. I've worked very hard for the past 5-ish months on this and I'm both happy and sad to see it gone. I made a lot of friends and we will keep in touch through the beauty of facebook.
This said, I had a lot of fun and learning at my clinical time. I'll start this post with Kaiser South days one and two. I won't go over every single patient encounter, but I'll give you the highlights.
First off, the ER at Kaiser South is big. I mean, their a level 2 trauma center for goodness sake! They have several different teams under a color code (Blue team, yellow team, green team...) and they are responsible for the trauma cases. Sadly, the times I was there we had one trauma case come in. Maybe that's because it was the night shift. Don't get me wrong, it was cool, but it would have been interesting to see some solid trauma come into the ED.
My first night started out in Triage. I really liked it there because we were responsible for the initial patient contact and priority call for a patient. They came into the ER, checked in and were seen by me and a nurse where we took their vitals, got the chief complaint, maybe took an EKG, and then set their priority. Basically we're the ones responsible for how fast you got seen. Cool huh?
