Hey, guess what I did today?
Having done a few years service, I take some pleasure in seeing new recruits, wet behind the ears and fresh out of training school, blossoming into full paramedics. Some take their first steps as nervous, naive EMTs and, after a few years, it’s a joy to see them confidently leading a cardiac arrest or a trauma incident. Others though, start out as arrogant snotty ‘know it alls‘ and progress to bullying, arrogant ‘know it alls‘ (who’ve actually learnt very little). We all know who they are; their idea of mess room conversation consists of regaling everyone with all the tricky jobs they’ve done and how good they are.
Last night I did an overtime shift on the RRV. As most of the service are on 12 hour rotas it normally means that I run with the same crowd every shift and hardly ever see some of my old chums. So, being on o/t meant I bumped into a fair number of colleagues that I hadn’t seen for a while; in particular three who’ve just completed their paramedic training and a couple who’ve been qualified as paramedics for nearly a year. I remember them when they first started and had the honour of working with nearly all of them in their first months on the road. Now they’re fully registered paramedics and out there saving the lives of ‘joe public‘.
It was interesting to hear them comparing notes; how many cannulas have you put in? have you tubed anyone yet? have you given tenecteplase? and so on. Some newbie paras seem to have done an extraordinary amount. One, who’s now been qualified for nearly a year, told me she cannulates 2 to 3 times a shift and has given benzyl penicillin 3 times (I’ve never given it). Another has lead a full cardiac arrest protocol on a trapped patient in an rta within his first fortnight as a paramedic and another gave morphine, metoclopramide, tenecteplase and heparin the first time he had to use his skills!
There’s a touch of envy on my part – I don’t seem to do anything like this. Tom Reynolds wrote in his book, Blood, Sweat and Tea:
I often bemoaned the fact that I tend not to get sent to many jobs involving ‘trauma’. If you’ve been stabbed, I’ll be down the road picking up a maternataxi. If you’ve fallen out of a second floor window, I’ll be one street over dealing with the sleeping drunk. And if you’ve thrown yourself under a tube train, I’ll be one stop down dealing with the twisted ankle.
(I’m sure this is in the book but I couldn’t find it, so here’s the blog link)
I confess that I suffer the same fate. Some people in the service seem to attract any ‘nasty‘ job that’s going; we call them Jonahs; it’s easy to tell who they are as they have nick-names which include adjectives such as deadly, dangerous, Dr Death, trauma Queen/ King, etc. Anyway, if there’s an opposite of a Jonah then I’m it. We don’t have an expression for paramedics like me but statistically speaking, the people in my patch are less likely to suffer major trauma or acute medical conditions when I’m on duty. That’s excellent for my patients but it does mean that I don’t get to use my paramedic and ECP skills very often.
January 2007 marks 10 years since I qualified as a paramedic and I’ve kept a log of every time I’ve used my paramedic skills. So, if you want to compare notes, here are a few of my stats.
- cannulated 129 times (approximately once per month) Only 1 was a jugular vein cannulation – My success rate is about 92%.
- successfully intubated 14 patients
- have only participated in 20 or so full protocol cardiac arrests in my entire career
- got 2 patients ‘back’ – one lived for a few hours the other for 4 days. Neither lived to be discharged from hospital
- thrombolysed 3 patients (only the first really made a difference)
- only attended one fatal rta – and that was an assist for LAS
- completed one paediatric cardiac arrest – the baby died – had a congenital condition that meant it had a haemoglobin level incompatible with life
- sutured two patients ‘in the field‘ (one in their bedroom at 3 am, other in the garden)
Jobs I’ve never done:
- a birth – cross your legs and don’t push
- a drowning
- an electrocution
- a major burn
Skills I’ve never used
- intraosseous cannulation
- chest decompression
- cricothyroid puncture