My first ER clinical

In Chicago, where I was certified, we were required to do two 5-hour ER clinicals instead of ambulance ride-alongs. This was at the end of the 5 month class, and I was going to Northwestern Memorial, right downtown.

My clinical started at 8am and I got there at around 7:45am just to look good. I walked in to the ER and met my contact there who quickly dismissed me by passing me off to an ER tech. He told me to wait right there behind the registration desk and he'd come by and get me when he wasn't so busy. I said sure and just hung out for a second. This was all by about 8:05am.

In class the instructor told us that there was a possibility we'd see something interesting, but most likely not. He said there would probably be some drunks, a homeless guy or two, an old lady with a hip fracture maybe, but probably nothing great. Five hours was just not enough time, especially on a Tuesday morning at 8:00. So, while I was hanging behind the registration desk, basically just picking my nose, thinking that I was just going to wind up getting put somewhere out of everybody's way, a Code 3 ring down from Chicago FD came in for "70 y/o female, pulseless and apneic for unknown period, CPR in progress, defibrillation not advised, ..." Immediately, the MD who was on duty pointed at me and said "EMT student, come on over and get ready to start compressions when she gets in".

So about 2 -3 minutes later, paramedics brought her in and they were already giving her compressions. When they got her into the ER they had me get on a little foot stool for leverage right above her, and start compressions. Since I was nervous as all hell, and my sympathetic nervous system was really kicking out that adrenaline, I was yelling out my compressions like a quaterback. "Twenty-one!!! Twenty-two!!! Twenty-three!..." The MD in the ER told me to count to myself and that I didn't even really have to count if I didn't want to, he would just tell me when to stop. I said yessir like he was a drill sergeant and just kept pumping away. It was at this point that I noticed that our patient had pooped her self. And that she was naked.

I overheard the medics tell the MD that they were not sure how long she had been down because it was unwitnessed. Whoever called 911 heard a thump or a scream or something and Chicago FD had to kick her door in. Then, straight out of the Hypothermia and Enviornmental Emergencies chapter of my EMT book, the doc said "Well, she's not dead until she's warm and dead. EMT student, stop CPR." I did and peeled the back of my glove off to touch her cheek with the back of my hand. They took a temp, it was normal, and they pronounced her. I was dripping with sweat and shaking. The doc told me, "good work" and I nodded. My ER tech contact was there the whole time bagging, or getting supplies or whatever. He gave me a look that said "Wow, you are lucky."

So within 15 mins of my first experience in healthcare, I saw and touched my first dead body, I did CPR on a real person, I was really, really close to some poop that didn't belong to me or my dog, and I was part of a team that was providing emegency care that we were trained to give.

It took me a couple of minutes to calm down. The ER tech told me that I could step out if I needed to. There were a couple of nurses cleaning and wrapping up the patient. I was watching them sort of wipe the poor lady's backside while they were talking to each other like they were at Starbuck's. One was saying to the other "Yeah, we just finished the deck and it's beautiful. You and Rob should come up..."

I went outside and smoked 3 cigarettes in 3 minutes.

EMS Firsts (and other stuff too)

Hi.

I'm an EMT working in San Francisco for a large private ambulance company. I love my work and find myself surprised by the co-workers and patients that I get to deal with everyday.

This blog is meant for fellow EMS workers to read and write about their "first times", and to share some experiences of exciting, stressful, rewarding, and crazy situations that they've encountered for the first time during their careers.

Posts can be about anything, like the first time you did a resuscitation, or the first time you worked 72 hours in a row, or the first time you got pooped on, or your very first day on the job. Whatever. Feel free to write about anything that you felt strongly about, whether good or bad. Chances are there is someone out there who has seen something similar, and someone who has seen something worse.

Lucas