Matt talks about our reliance on technology and how sometimes it is nice to remember that to assess a patient it is actually really simple without using technology

Andrew: I am mostly paid to not get tricked into missing something big.

Standards in medical education changing when there is emphasis on getting people through programs

Keep holding high standards for your students

Advice for the newbies:

Andrew: You won’t fail if you are trying your best and making the best decisions you can and caring for the patient

Aaron: Take care of yourself before you take care of patients

Matt: Ask for help if you need it. 

Julie: Be content with where you are at

Sarah: Progress further in medicine if you can do it

Schasny: Don’t listen to the naysayers. Zero to hero is possible because everyone is different

You can learn from all providers, even if they haven’t been in the field long.  Sometimes experience can be greatly varied even with only a short amount of time in the career

Support the show

Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics

Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.

If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.

1st Phorm | The Foundation of High Performance Nutrition

Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

Imminent baby delivery stories 

Burnout tips: avoid the overtime. Sometimes the extra money is not worth the additional life stress.

Make sure you get off on time and make that transition to home life.

Andrew uses audio books so he has something to look forward to while driving to and from shift.

Patients are often not even the source of our stress, it’s operational difficulties, interpersonal difficulties and decision fatigue. 

Decision fatigue is a big issue we face in our home lives after a significant portion of our day being in fight and flight mode

We talk about driving lights and sirens to every call and the dangers associated with this to the crew and public

This likely doesn’t save lives in any meaningful way that justifies the danger

There is a big push to decrease the emergent responses

We talk about the hazards with emergent returns, the confusion other drivers may have, the danger for the patient and crews.

Road rage isn’t worth engaging in, remember that the bar to obtain a drivers license is very low and many of the meth-using patients we take care of will drive as well. You never know what kind of person is in that other car. 

I bring back up the discussion of “Where is God is emergency medicine?”

We see the whole spectrum of life and death. We see people come back from the brink of death that logically shouldn’t and those that succumb that logically shouldn’t. 

We talk about strategies to compartmentalize and move on to the next patient

Schasny talks about the traumatic life and medical experiences she has come through and how they have changed her view on religion 

Support the show

Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics

Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.

If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.

1st Phorm | The Foundation of High Performance Nutrition

Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

The team mentality at all levels in the ED is key to a harmonious, efficient and effective environment

In EMS, this can be difficult on a given scene when you may not know the other responders all that well and it can be easy to get offended when no offense was meant

Developing a thick skin is important in emergency medicine. You can’t allow negative emotions of others to affect you all day long.

Patients can be really mean. This is just a fact that can be expected so you can make a plan to deal with it.

One of the cool things about being an emergency medicine provider is that we are the provider that the patient has access to any time of day or night. We are not a expert in any one specialty and that is okay.

Sarah talks about a rough shift in the fast-track part of the ED

Andrew talks about the first code he ran as a medical student and the impact it had on him 

It is an honor to be there at a patients last moments and to help their families through it. 

It is very easy to forget the human side of emergency medicine. Ask yourself how you would act if it was your family, you were taking care of.

Slow down. Focus on making a connection.

I naturally fall out of making that human connection, so I have to be intentional about connection it or I won’t happen. 

Paramedics and EMT’s have a tendency to measure success and contentment by the acuity of the calls they run. I would venture to say we need a better metric: human connection. If you can connect with your patients, this will prevent burnout in your own life and improve your patient care as well.

Strategies for avoiding burnout: music on shift, nebulizing coffee to neutralize bad smells and planning trips

Crazy stickers for comedic relief

We talk about the inaccuracy of pain scales and alternate pain scales

Schasny talks about a patient with an ingrown toenail that got up and left after hearing multiple traumas and code blues announced overhead. 

Support the show

Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics

Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.

If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.

1st Phorm | The Foundation of High Performance Nutrition

Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

Meet our new panel

Matt (EMT) Julie (RN) Sarah (paramedic) Schasny (paramedic) Andrew (EM physician)

Advice for the newbies: Don’t panic, it is not your emergency

Find the balance of detachment while still making sure the patient feels cared for and understood

Part of avoiding burnout is taking some time to access the human side of youself in caring for a patient while also not taking the emotional stuff home with you

You don’t know it all when you are new. You have just been deemed safe enough to do the job. 

Knowing where your limits are is important when you are new

Don’t be afraid to ask more questions of those around you in the beginning

Being a new paramedic has its own challenges as there really is no one to consult or provide direct feedback after a treatment

Some ER physicians are not familiar with EMS protocols so have some grace for this situation

In the ED, we must remember that EMS crews have a ton of operational problems to overcome on calls AS WELL as treating the patient for an emergent condition. 

Confidence and experience only come by running call after call. You must see a lot of patients. 

Medicine is an art not an exact science

Multitasking as an ER provider is just rapidly changing between focuses but is a huge skill you have to develop

Be in the chaos but staying organized is key to this “multitasking”

Another difficulty as a new ER provider is figuring out the order in which to complete the tasks you have to do

Controlled drowning. New people need to be allowed to feel the pressure and the stress while still having a backup so they don’t experience this for the first time by themselves. 

Find a method to not let tasks get forgotten.

I talk about overwhelm when I was a new PA

Support the show

Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics

Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.

If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.

1st Phorm | The Foundation of High Performance Nutrition

Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

Keep asking “why” do get to a full understanding of what is going on

As providers we do want questions asked of us if someone is not sure about something we ordered

Tracey has found techniques to avoid burnout despite 24 years in emergency medicine, she says it is very individualized how you overcome burnout

Belligerent patients do cause burnout and the job to be very difficult in general

Taking intentional time to connect with your patients will help overcome burnout

Tracey has advice to give patients grace 

Adam: purpose in life is important to avoid burnout. He believes he is called to be here. 

Exercise, spend time with family, move your body, work less or even work more now to work less later

Force yourself to be social on days off, even if you might not feel like it. This will often help your mental well-being.

Owning your mistakes is key to avoiding burnout

Understand we will make mistakes and even when everything goes perfect, we cannot save the patient every time 

We really aren’t built to see a lot of the things we have to see in emergency medicine

Be patient with the patients we deal with. They are going through something that we are not and have concerns we may not know about. They are scared, they are frustrated.  

You need to have a sense of humor and the ability to compartmentalize 

Compartmentalization helps to move on to other tasks that need to be done

Kate tells a story about compartmentalization

It is okay to set boundaries with patients that push on the limits

Deescalating belligerent patients is a skill that can be learned 

Support the show

Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics

Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.

If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.

1st Phorm | The Foundation of High Performance Nutrition

Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

We talk about EKG interpretation 

Adam talks about the power of teaching

Ongoing learning is key to performing well in emergency medicine and medicine in general

We discuss confidence in emergency medicine and The Dunning-Kruger effect:

People with limited competence tend towards an overestimation of their abilities 

It is very dangerous at the top of this curve before you recognize your limits

Most of us feel this effect when we are new to a new level or field

Building confidence depends on the individual

I talk about my own overestimation of my abilities as a new EMT 

Your partner on the ambulance can really encourage or limit your interaction with the Dunning-Kruger Effect

Even Adam, who admittedly doesn’t lack confidence, took about 3 years as an attending to gain confidence

For Kim, it took about a year to really build confidence, but also notably in a busy system. However, she still wanted time before taking students. She did that at about the 3 year mark.

As a PA, I think experience teaches you where your limits are.

Adam often talks through complicated problems out loud while working in the ED 

Kim makes a great point about experienced EMT’s lacking the background knowledge and the “why” behind treatments. This “why” is critical to learn in medicine

Adam tells a story about how the “why” is so important. You cannot blindly treat a number. You must take into account the whole clinical picture.

Doing nothing is the right answer sometimes.

I tell a story about a paramedic, Amanda, and how doing nothing was the right answer for a patient. 

Support the show

Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics

Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.

If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.

1st Phorm | The Foundation of High Performance Nutrition

Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

Stress exposure in school is very helpful for real life practice

A good analogy for lay people: EMT is like CNA, AEMT is LPN, paramedic is RN. This helps people understand the progression of levels of care better

Paramedics need to be learning provider type assessments on rotation not nursing assessments

Kim talks about the zero to hero debate: Experience matters not just in emergency medicine. The main difference is the individuals drive and education 

Kim talks about a hypoglycemic patient when she was a new paramedic 

Kate talks about the difficulty in bringing up possible concerns with providers and how important it is for the providers and advocating for patients

Adam discusses listening to EMS and the patient and the importance of what the patient looked like before they got to you.

Understanding your EMS system is important as an ED provider

We talk about the value of interpreting lab work in the field

Support the show

Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics

Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.

If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.

1st Phorm | The Foundation of High Performance Nutrition

Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

We meet our new panelists

Kate (EMT)

Kim (Paramedic and educator)

Tracey (Former paramedic and current PA)
 Adam (Former paramedic and current EM physician)

Kate talks about how the public doesn’t know the difference between EMT’s and paramedics

Tracey talks about a humbling experience in her early career where she did not know where her equipment was in the ambulance

Kim talks about changes in paramedic and EMT education. Historically you retain 20% of the information in a lecture format. That has been increased to 80% retention with new techniques like switching to simulation and active learning techniques

Putting the responsibility on the students to perfect their skills is something they will have to maintain in the field as well

Switching to competency-based education from hours based has been a huge change

Simulation based training is very valuable. It teaches you techniques and de-escalation techniques that you can’t learn from text books

We talk about medical scenarios outside of work and how our skills come into play

Support the show

Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics

Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.

If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.

1st Phorm | The Foundation of High Performance Nutrition

Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

Be willing to speak up. Sometimes you might be the only person to notice something important. 

We need resiliency in this field. We are all still learning, so stand up and advocate for your patient.

Regardless of your level of care, you need to advocate for your patient. 

The hierarchy is largely in your mind. Don't be afraid to approach someone with a perceived higher status than your own.

Take ownership over patient care

Confidence varies in how long it takes to develop

Be willing to be uncomfortable, it is how you will continue to learn

Be willing to make mistakes

EMS to in-hospital care can be a steep learning curve even as an EMT

We talk IV’s and IO’s, staples, “foley buddies and “no no zones” discussion

Support the show

Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics

Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.

If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.

1st Phorm | The Foundation of High Performance Nutrition

Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.

Nate (EMT) shares his story and the issues he has been dealing with.

Nate overdosed on medication and ended up in inpatient psych care which helped him immensely. 

He still feels grief from time to time but does have happiness more now. 

Nate wants people to know that these struggles are real and you are not alone. Don’t be afraid to talk about it. Seek counseling and therapy. 

The field we work in makes us prone to dealing with mental stress and health.

Dark humor is a method we use to move on to the next patient or next call.

Our job is to help the body heal itself, sometimes this doesn’t work and we can’t get caught up in the times when it doesn’t work. We must be comfortable outside of that control. 

We can’t save everyone.

A bad partner or burned out partner on the ambulance can really ruin your experience. We all need to be willing to teach in a tactful nonjudgmental way.

Sometimes doing nothing is the right answer if a patient needs an OR and a rapid transport is necessary

If you want to support the show, follow the links below for some great health and fitness products.

My favorite protein:
https://1stphorm.com/products/phormula-1/?a_aid=PracticalEMS 

My favorite 1ST Phorm Energy Drinks:

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My favorite creatine supplement

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 My favorite pre-workout supplement
https://1stphorm.com/products/project-1/?a_aid=PracticalEMS

If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.

1st Phorm | The Foundation of High Performance Nutrition

Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor u

Support the show

Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, Paramedics

Most efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours.

If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you.

1st Phorm | The Foundation of High Performance Nutrition

Everything you hear today from myself and my guests is opinion only and doesn’t represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions.