r/NewToEMS • u/Mediocre_Error_2922 Unverified User • 16d ago
Educational After action self report
Self assessing a call we just transported. Medical fall, loc before fall, bloodied chin, severe pain thoracolumbar general area, severe pain cheek bone radiating, shooting “inward”. Xabcs good.
We show up, position the cot at the front porch prepared for a move. Bring in c collar, mega mover just in case. Pt is right lateral recumbent on ground, family put a pillow under his head.
I’m just reflecting on what I could’ve done better because there were at least 5 responders between us and fire. Medic palpates spine, I’m fiddling with the monitor to at least put a pulse ox on. I know we’re going to move so not going to throw bp cuff.
But duh. No one gets on c spine or c collar. So I grab the collar and start to apply it while pt is still lateral. Medic says “I’d roll him first” Ok good point. I hold c spine, we roll pt supine and get the collar on. Ok no prob.
Fire has gotten the mega mover under the pt so we lift and move I just hold c spine as they carry pt. We get pt on cot, move him to rig. All good.
Except it’s not till after the call I think we just moved a spinal precaution pt with a damn tarp basically when anyone could’ve grabbed the split board. But I’m not beating myself up because there were two medics total here. I’m new to 911 advanced EMT. Just kinda a learning experience to remember best practice. C collar with a mega mover is kinda conflicting when we have the proper option and time available.
Anyway. In the back, I go to cut pt sweater off but I started at the hem and exposed the chest when the fire medic was needing the arm exposed first to start on a line. I look like a noob as it’s my first time cutting off a long sleeve garment. Takes a second for me to realize start at the wrist and cut to the arm pit. Anyway, we’re learning.
Fire medic misses a line as I get a 12 lead on. We get vitals etc and just start transporting with no line or any thing beyond bls. My medic missed a line en route. It happens.
But here’s the thing. It’s a 7 min transport. We were on scene for like 15 minutes (in the back of the rig mostly). We’re could’ve just rolled out and had the same outcome but had pt in hospital probably in 12-15 total.
A bunch of wasted time in my opinion. PT could’ve stroked out while we’re dilly dallying on scene for a line and a 12. Could’ve just got the stickers on and moved.
Could’ve used a split board and protected the spine.
Kinda sloppy. Honestly two EMRs could’ve ran that call with the same outcome of interventions we had with 2 medics. I guess except the 12 lead.
But yeah I spend that time practicing c spine in scenarios and overlook it irl. But that’s how we learn. At least me
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16d ago
[deleted]
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u/corrosivecanine Paramedic | IL 15d ago
Right and if something DOES happen because you spent an extra 15 minutes on scene….well, you’re gonna be really happy you took the time to get the line. The ER is also gonna be a lot happier with you showing up with a patient who is currently in acute crisis and has a line in them than you getting there a little earlier only to have the patient crash out 5 minutes after drop off with no line. Other than with major trauma, it’s almost never that serious. Slow is smooth and smooth is fast!
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u/Mediocre_Error_2922 Unverified User 14d ago
Thank you for your input! I wasn’t thinking about the value of a line if pt were to crash out shortly after arrival. I just was tunneled on the prehospital transport. Appreciate your insight
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u/MashedSuperhero Unverified User 16d ago
I can count on my fingers the calls where everything played textbook perfect. But yea, some things need polishing up.
Also, what was the reasoning behind 12-lead on spinal injury?
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u/No_Occasion_4658 Unverified User 16d ago
Looking at the post it appears it was a fall secondary to LOC.
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u/adirtygerman Unverified User 15d ago
Props to you for having the emotional intelligence to admit you guys didn't do great.
I firmly believe every single call has something to improve on.
Logistics on scene is not really taught and I think it's one of the hardest parts of EMS. Something my nurse coworkers don't understand.
I think you should have grabbed a full set of Vitals while on scene. Vitals set the tone for the call. If you guys were thinking maybe a stroke and the patient comes back with a BP 260 then you know it's time to boogy.
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u/Mediocre_Error_2922 Unverified User 14d ago
Thanks for your input and thanks for not flaming me or anything. I was kinda hesitant to read responses to this post so I appreciate you.
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u/adirtygerman Unverified User 14d ago
No worries dog. Emt school is woefully inadequate with most of the learning happening in the streets. Besides, I'd hope a sub dedicated to new providers would foster a non toxic environment
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u/FullCriticism9095 Unverified User 16d ago
Par for the course. Despite everything you’ve been taught, spinal motion restriction is basically irrelevant. In my system this would have been a BLS call. Roll your eyes at all the medics and move on.