From One Frying Pan To The Next

Apprehension built up from classes ahead of us had convinced us that pharmacology would be the next great test of our abilities to incorporate and ultimately retain a massive amount of material. The previous student were correct, there was a large amount of material to retain, but the mountain was not quite as tall as they had made it sound. I walked away with an "A" without feeling very tested. Do I remember every detail of every drug, no. But I walk away with a huge interest, which will compel me dig deeper in an attempt to know more than the average medic. Really, do any of us actually say "I just want to sneak by, hoping to avoid the ton of trouble created by not properly caring for our patients. No we want to be the smartest kid in the room of smart kids. We are too damn proud to just be "in" the room of smart kids. Which is of course the bane of every medics existence. We believe deeply that knowledge is power. Our pharmacology section is completed, the road work has been laid. From here on out it's our job to finish on our own.

We start our airway section on Monday. We've been given a large reading assignment to complete over the weekend. Adding a little flavor as we sizzle in our new frying pan.

Redemption

During our pharmacology we've of course been practicing our IV techniques. For some this includes blindly digging with hopes of just a little blood to show a flash, while others must be using the magnetic needles that seek out veins. I've been somewhere in between, constantly tortured be the wing needle. We start testing on Monday.

Dispatch to a late 20's or early 30's male in seizure. After ascending the stairway to heaven we find our patient. Presenting in the usual manner, prone on the bathroom floor and of course with his pants at his ankles. You almost made it buddy. His tachy and fairly hypoxic at 74%. He continues to wiggle around, his usual postictal activity as we are told. With a big bear hug and some quick work on the pants we chair lift him down the stairs to our cot waiting at the front door. He continues to tug on the oxygen mask and flail about as we head for the ambulance. I'm tasked with starting an IV on Mr. Seizure. Honestly I would have rathered him still be in seizure as I think he would probably not have such large movements. Lethargic as his is, his still remembers what an IV is and how it feels. I find a perfectly suitable vein, much more accommodating than anything I've found in class. The 18g slides right in, and is if on cue he moves and I lose my tamponade and the blood drains down onto my leg and on the seat as I move his arm over it. With a little clean up, it's as good as gold.

Why can I start a perfect IV in a moving rig, on a fighting seizure patient with rather dark skin, but can't seem to strike gold on an arm placed perfectly on a table, beautiful lighting and skin like porcelain. The outcome is ultimately better for the patient, but not for my grades.

Are You Smarter Than A Fifth Grader?

So with the start of pharmacology we began brushing up on our math skills. Kicking it off with calculating dosages. Now I took every advanced math class during high school. The previous college level math wasn't easy either, but I might have created a minor dependence on the "calculator." Apparently being on the "calc" as I'm putting it, drastically decreases your ability to navigate even elementary math problems. Setting up the proper equation is very simple, but who knew that one should remember how to divide long handed. I'm limping a bit without the "calc" as my crutch. But a few more problems and I should be fine. After the lovely spring break that I'm enjoying we shall break into calculating drip rates.

As I look around our classroom and watch the struggling students I can't help but notice that they are almost always the youngest of the class. I'm saddened by the implications this brings to light. I hope that this does not highlight the inadequacies of the current educational systems in place to teach our younger generations. Just some food for thought.

Bring on the Big Sticks

So, we've finished our first of many patient assessment portions of class, now on to pharmacology. Just to get us all thinking over the weekend we blindly jumped into the world of IV therapy. After a little lecture time and playing with the IV arm, we started in on each other. Now being someone who is already varianced, I was the first victim. I was more than happy to be the first lab rat. After a little smooth talking someone stepped forward to "give it a try." Sort of joking and mostly serious the instructor told us "this first time, I just want to see that you actually break the skin, anything more is just icing on the cake." Well with a little instruction with the cath in my arm, the willing medic student achieved a nicely patent IV. I think she was more nervous about hurting me than actually getting it into the vein. She did a hell of a lot better than the participants did in my first IV class. Because I was one who had performed this skill on the ambulance before, I had to wait for everyone else to try their luck. My turn came right before the end of class, with the 40's y/o female with one kidney and veins that are non existent from years of dialysis. Sometime later we might address how she thinks she can do this job, but a new blog would be needed to encapsulate those feelings. She had crap veins, everything you saw looked like a windy road on the side of a mountain, you couldn't feel anything either. After inspecting both arms, including the one in the sling, the instructor gave me a little reprieve and allowed someone else to sit in. It was the same girl who had started with me. Not wanting to increase the size of the new bruise she was developing, I went for an of the road vein. And just like fate who have it, I missed. She was a champ though and even let me dig a little bit. But I broke the skin as the instructor wanted. Isn't school humbling. We start pharm on Monday. God help me.

And On To The Next

Well with A&P and Cell Physiology out of the way, we are on to the first step of patient assessment.
Oh how much I miss a real live patient to look at. This is where I disagree with the old timers who claimed that being an EMT for a couple of years was essential to becoming a good paramedic. Over the course of being an EMT I seemed to have lost my imagination, replacing it with actual visualization. Right now I'm having some difficulty with providing an assessment to a patient that besides being a 19 y/o punk, is completely healthy. Not the typical gray hair tripoding as I walk in the door, or the lethargic hypoglycemic staring glossy eyed at the TV. Granted yes, I do have the ability to compile my thoughts to provide a coherent report. Though I certainly have not retained the ability to verbalize what I'm looking at/for when assessing a patient. Seems to me, besides actually knowing the flow of the call, I'd be better off without any field experience at all. Having never been tainted by the real world.
And what in the hell is this oral station that National Registry has. First of all it seems very strange to test the ability to imagine my way through a call, especially when medics seem to be so touch orientated to begin with. I know I'm just bitching for the sake of bitching, but it just seems out of place. Although I do believe I can have a little fun with this. With the traffic lights on, I place the vehicle in park, removing the keys as I exit, I place my left foot in front of my right, then place my right foot in front of my left, I continue this until I have reached the patient's side.

Almost Over The First Hump

With the implending A&P final coming up next weekend there is an oh so litle lull in the action. A night all to myself, sure I should be working on assignments due in the very near future, but for tonight I had nothing due tomorrow. I sat in complete contentness in front of the TV flipping between a couple of movies, slowly drinking a beer that actually felt as refreshing as the rockies themselves. However brief this luxurious rest was going to be, I was going to use every second of it, soaking it up like a sponge. Knowing full and well that the next couple of days would be spent nose deep in numerous books, trying to figure out what information should be remember and what could be discarded.

So I lounge, warmed by the fire and the fleece blanket, snoring like a banshee on the couch.

Ah, lazy like a cat out strecthed in the window, being warmed by the sun.

And now the spell check doesn't work, well hopefully it's not that bad.

Nearly Up To Racing Speed

As I sit down once again at my computer, continuing with all that is anatomy and physiology, medical terms and a presentation of the endocrine system looming in the darkness I can't help but want to take a nap. Almost a month in and my ability to function on little to no sleep is increasing, granted I think I was ahead of the curve. Lately it seems as though my entire existance revolves around this computer. I tote it to school, typing at every chance. Drag it home to type until my face hits the keyboard, signaling bed time.

It's definately an extreme uphill battle, and so far I've faught my way through it. I finally feel as though I can see the big picture that contains all the assignments to be done and all the pages to be read. It took a long time, in relative terms I guess, but I'm getting there. I hope that the up coming tests don't go as badly as I think they might. I fortunately have a little bit if time left to study, it's not quite the time to panic just yet. Well unless you include the general apprehension that is always nipping at my ass. I can do this.