The clinicals

I mentioned in a previous post that I was doing the first of my two clinical rotations for my EMT course at Desert Springs.  I wanted to go into what had occurred there...

I showed up bright and early at 7 am, wearing the prescribed clothing (class polo shirt, dark blue slacks or pants, black shoes and belt is what was specified; I substituted my EMS pants for the slacks which was acceptable), and after the nurses and techs had their morning meeting, I was paired up with one of the ER techs, who then proceeded to give me the 50-cent tour of how the ER department was laid out and where things were.  Most of the morning was spent in restocking the supply carts which were adjacent to each bed and assisting the tech in bringing patients to their rooms from the ER once they have been admitted and stabilized.

This continued until just after 10 am, when we were advised that there was a 'code blue' inbound, meaning a patient in severe cardiac arrest or a similar life-threatening condition.  In this case it was the former.

We went out to meet the ambulance, and when the rear doors were opened, there was a firefighter paramedic performing CPR on the patient, with the ambulance paramedic bagging her through an endotracheal tube (ET tube for short).  They got her inside, CPR continuing along the way, to a bed, then they moved her to the bed from the gurney, and it was a crazy but organized process to get her wired up and start the process.  I wasn't the only student there, there was an additional EMT student from the same training center I was (different class), and a paramedic intern.  After an interval it was my turn to do CPR.  It wasn't really too much different from performing it on a mannequin, but what had unnerved me a bit was when I glanced over at the patient and saw her eyes were open and fixed, staring straight up.  I steadied myself, told myself 'just remember your training', and continued.

After about 2 minutes of so, I handed off CPR to the other EMT student, then stood back a bit to catch my breath and continued observing the process.  They had an IO line put in by the paramedics at the scene, but it wasn't sufficient to do continuous medication administration, but by the time they pumped various drugs in, including epinephrine, we managed to get a weak pulse and rhythm going, which got her stabilized.  The ER physician then established what is called a central line, a specialized IV going into the femoral vein at the upper part of the leg.  It allows medical staff to put in a regular IV and administer drugs to the patient more easily.  After that was done, most of us then moved away while a few continued their work on the patient.

Once that initial excitement was over, me and the tech went back to doing various tasks, then it was lunch time.  I left the ER and headed to the cafeteria for a decent lunch, resting off my feet for about an hour, then back to the ER I went.

Now, one thing to keep in mind that despite the earlier excitement, it was actually a pretty slow day in the ER there.  So slow in fact, that the tech I had been shadowing was given an early-out around just before 2 pm.  So I was paired up with another tech, and the afternoon was spent with assisting the other ER nurses with various tasks, cleaning and restocking, and patient moves.  By the time 7 pm came about, my feet were about to commit hari-kiri, my lower back was hurtin' for certain, and I was pretty wore out in general.  I managed to (barely) make it to the parking lot, pulled out, and headed home, stopping to eat dinner at Denny's along the way as I was in no shape or mood to even microwave dinner, let alone do regular cooking.

Overall, it was a very interesting experience.  I managed OK and got a decent write-up on my sign-off sheet, and I felt I was a little bit better prepared for the second rotation.  That one will be at a different hospital this coming Friday morning,  We shall see what transpires then...