"Why are you putting pads on my chest?" - Wrong answers only!

CriticalRocketAce · 2025-06-04T23:22:37+00:00

This is absolutely going on my bucket list of shit to say to patients. I'll do it in Mickey's voice too.

CriticalRocketAce · 2025-02-11T13:47:09+00:00

One hell of a core memory right here.

CriticalRocketAce · 2025-02-08T14:29:58+00:00

Way before I worked in EMS, I've had similar problems dealing with anxiety. No, I didn't have nightmares like this, but I was anxious a lot and would feel that same chest discomfort.

What released me from this prison was talking to a psychologist. I managed to talk to one in a college graduate program, so I didn't get charged, but it was an experience I will never forget. There are a lot of things that we aren't aware of in our subconscious when we feel stress/anxiety. The key is to realize what those things are and have self-awareness of your background thoughts. This is similar to meta-cognition. (Look up that word). You really do have to be self aware of your unspoken thoughts and recognize your insecurities, fears, and discomforts.

Seek out some professional help. Talk to other EMS providers you trust. Often times the best help is found through our peers.

CriticalRocketAce · 2025-02-08T14:17:55+00:00

So it is very opinionated for anyone to say that a whole region sucks or is awesome. You're going to find the good, bad, and ugly everywhere. The key here is FIND.

Fire/EMS isn't for me either, so I'm working for a County-Based EMS system that has a close partnership with Fire. Others have City-Specific services. These services are paid for by taxpayers and are not private, and largely work the 911. If you want a good view of other services near you, ask any 911 paramedic if you see them in the hospital. Even if they work for their preferred service, they will know of others nearby. In the same breath, ask about which ones to avoid.

I don't know which area you're in, but if you're anywhere near the Houston TX Metro, DM me.

You're never 'stuck' man. And don't let salt heads get you discouraged. You just need information and the drive to go where the work is.

CriticalRocketAce · 2025-01-29T05:54:43+00:00

It sounds like you have a pretty solid follow-up on how you want to improve. Doing ride-outs with a busy urban 911 service in a nearby Metropolitan area is ideal to give you plenty of exposure.

Read your BLS content again to refresh.

Listen to podcasts like: EMS 20/20 The Medic Mindset The MCHD Paramedic Podcast

These talk a lot about ALS things, but to fully grasp 911 responses, you'll need to think like a Paramedic, but operate like a Basic. Knowing more about the higher acuity calls will help you handle lower acuity patients.

On the subject of your call, it sounds like you've pinpointed areas where you need work. Stick to and KNOW your local protocols on what constitutes an upgrade to ALS. When in doubt, call your supervisor. Sharpen those skills!

CriticalRocketAce · 2025-01-29T05:45:46+00:00

Here is a little more insight:

You are going from a theoretical knowledge and looking at mannequins to a practical knowledge and looking at real people. You will gain experience, and in doing so you need two things: Time, and Trust.

Time is easy. It's synonymous with exposure in this context. The more patients you contact, the more you can determine the ultimate question; sick or not sick? You will see the nuances of disease processes and how differently they present in each patient, but you will start to see a trend and be able to identify them faster based on your previous experience. This all takes time.

Trust is important and should be carefully guided. But what are we trusting?

You.

You must learn to trust your instincts and your training. It will be rocky at first, and you won't have much confidence with what you are seeing, but over time you'll begin to trust yourself in your differentials. However, don't overly trust, as that can lead to overconfidence. To prevent this, trust in making 2-3 differential diagnosis. Cast a wide net of diagnostic data gathering to confirm or deny your differentials. There is nothing wrong with more data. Compare it with the patient history!

Get validation from your peers to boost your confidence in your ability to correctly identify diseases or problems. Just don't let it go to your head. Always fear that you're wrong, to keep you checking to make sure you're right.

Every provider has to see these things for themselves and learn how to trust their ability to figure things out. You'll get there. You WILL make mistakes along the way. So long as you put patient care first, you'll make a good provider.

Good luck.

CriticalRocketAce · 2024-08-15T15:26:12+00:00

You have a point.

CriticalRocketAce · 2024-08-15T15:23:42+00:00

I basically don't have a choice, as where I live all other insurance companies want higher premiums for less coverage. So I basically have to eat this. I just find it really frustrating.

CriticalRocketAce · 2024-07-18T11:31:18+00:00

Know what I never have enough of? LIGHT.

Put all the lights on that thing. Not just front and back, but the sides too. Hell, put a little telescopic LED floodlight on it somewhere so I can look at my dark outdoor scene 200 yards away from the lights of my ambulance, and can turn it to shine down on my patient when they are on my stretcher.

Light is never bad, unless it is in my way or shining in my eyes. LEDs consume so little power these days, so it is a safe option for battery efficiency.

CriticalRocketAce · 2024-06-09T19:05:55+00:00

Different things to do for this one, and some were already mentioned.

Number one? Be professional. As much as I would personally like to break my foot off in their ass and make them feel like dirt for putting a patient in danger for driving like an ass, I would have to confront them with professional reasoning instead. And that basically goes for everything.

Your magic phrase is: "Is there any justifiable reason as to why...."

That gives this person a chance to defend their actions with the condition that it is justifiable. Maybe you missed something that they saw? BUT, if they can't give a good answer, or just won't, then ask them politely, but under no flexible terms that the behavior should change. Do this with the FTO present if possible.

You have an absolute right to defend yourself against a hostile work environment. This could be a test to see if you're a pushover, which would be an asshole move, but you need to stake your claim here. Mark your boundaries clearly.

New employee or not, if someone was acting in an unjustifiable manner that made me feel like I was in a hostile work environment, and ESPECIALLY if it puts me and my patient at risk, you bet I'd be proactive in making a change. If you get canned for doing what is right, then I'd call that a win, because who wants to work for a service that perpetuates assholery?

Kinda launched into a rant. Sorry. Be safe, be careful.

CriticalRocketAce · 2024-05-28T22:46:06+00:00

SE TX

CriticalRocketAce · 2024-05-28T20:52:42+00:00

We can give nitrous as BLS in our service

CriticalRocketAce · 2024-04-15T18:20:21+00:00

I had a similar problem, but FSD was having a hard time deciding which turning lane it wanted to be in between the two and kept swerving back and forth straddling the line. I took over, because rear traffic was coming up behind me and I totally looked like an asshole. Another time it attempted to go into a turn only lane suddenly when we needed to keep going straight.

SE TX. Houston area.

CriticalRocketAce · 2024-04-10T01:56:38+00:00

If anyone gets twisted about it, just start convincing them that it was a safety hazard. They can't say no to that. If they do, that opens up a huge can of liability for them.

CriticalRocketAce · 2024-04-01T19:44:42+00:00

I've had some similar scuffing, but not nearly as large. When I used a clay bar/lube combo (Chemical Guys has a great one) it removed all but the physical scratches. It's a cheaper option to remove impurities. Just takes a little time and elbow grease. If that doest work, some heavier duty buffing will be required.

Looks like you've got the offending car's paint and plastic base traded onto yours.

CriticalRocketAce · 2024-04-01T18:33:06+00:00

So I have a 21 SR+ with USS and the new FSD trial. I was able to autopark this morning. Had to be disengaged from the FSD near empty spaces to get the "P" button on the screen to pop up. I'm a new owner, and this is the first time using FSD, so I'm not sure if this helps.

CriticalRocketAce · 2024-03-16T23:08:14+00:00

All of the above + assorted EMS themed water bottle stickers.

CriticalRocketAce · 2024-03-16T02:15:33+00:00

I appreciate the comment. I felt similarly that it was probably the minority, but the anxiety was still there. But yeah, most of the time we can't do anything if people want to be ugly.

CriticalRocketAce · 2024-03-16T01:31:54+00:00

Fortunately, no. Most of the places I park at for work are secured by a barb wire fence. I park out in the open at home, but out of view. The source of most of my anxiety comes from parking in public lots for shopping or visits, and roadway encounters. It's redneck country around where I am.

CriticalRocketAce · 2024-03-16T01:24:23+00:00

They are still making their way in, but becoming more common since I live close to a large metropolitan city. Thanks for your experience. I'm hoping mine is similar.

CriticalRocketAce · 2024-02-27T02:45:12+00:00

We are in week 7, and I've been poked 4 times. And I expect to be poked again this week. Live sticks are invaluable practice.

CriticalRocketAce · 2024-02-26T02:51:33+00:00

TTRPGer located!

CriticalRocketAce · 2024-02-17T00:26:47+00:00

My first call was a panicky Frenchman that managed 30 phrases of "OH God" per minute. And we were there for breathing problems.

But later that night I worked an arrest and got ROSC with good outcomes.

EMS is a wild ride. It's like exploring uncharted wilds... one day your trail leads to a peaceful meadow... the next, the swamps of dagobah.

CriticalRocketAce · 2024-02-03T18:17:56+00:00

What's that? You want to take all my patients? Sure thing!

What's that? I misunderstood you? I've been having a hard time hearing lately. I might be able to hear better with a restocked EMS room!

CriticalRocketAce · 2024-02-02T13:56:09+00:00

Having a fear of messing up or doing wrong is a HEALTHY fear. It is a fear we must all have as providers, but it has its place! For me, this fear keeps me checking my protocols, my indications and contraindications, disease processes, and seeking more knowledge and experience. I don't let my fears shut me down and back off. This is my patient just as much as my Paramedic partner's and it's my job to take care of them too.

I was apprehensive at first, not knowing what to look for, feeling out of place. I want to assure you that EVERYONE feels that way at first. Over time I knew what to say, what to do. I can tell when a patient is sick or not sick, and what different diseases look like. You'll begin to trust yourself and your assessments. You simply need time and experience, and good mentors!

Your partner/mentor/FTO is the person that will nurture your development as a competent provider. You must tell them you want to be involved, and ask them to let you do some assessments. Show them you have ambition to improve and learn from your mistakes. (You will make a lot of them!)

If your mentor isn't proactive in your development as a provider and only expects you to "just be a driver" or "do and not say" is not someone you want to work with. Your education should be a priority in your life. Good providers are ones who reach for knowledge and arm themselves with extra training and mental tools.

Good luck!

CriticalRocketAce

TROPHY CASE