Take care of yourself BEFORE you take care of patients.

Explicit content warning

02/25/24 • 35 min

Practical EMS

We meet our new panel and some returning guests!

Kiley – ER RN and new NP

Sarah – Paramedic in EMS for 8 years

Welcome back Adam ( ER MD), Casey (paramedic) and Nate (EMT).

Nate talks about the transition from field EMT to ER EMT. It’s a new world with new things to learn.

Sometimes a change in environment can get you out of a rut.

Sarah also worked in the ER but as a paramedic and loved learning new aspects of medicine but her scope was diminished compared to the field.

Paramedics are still a new asset in the ED and have a fluid job description.

Principles in emergency medicine

1. We do not diagnose in the ER.

2. Take care of yourself before you take care of patients.

Sarah recommends outlets and hobbies that are totally separate from medicine.

Make yourself a priority or you will end up neglecting yourself.

Sleep deprivation will affect you more than you think.

Casey talks about how you can get lolled into relaxing by low acuity calls but then you may be tested to your limits the very next call.

Kiley talks about patient autonomy and how it is our job to present options and educate but the patient must ultimately decide to accept or reject our options whether we agree with it or not.
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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.

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

We meet our new panel and some returning guests!

Kiley – ER RN and new NP

Sarah – Paramedic in EMS for 8 years

Welcome back Adam ( ER MD), Casey (paramedic) and Nate (EMT).

Nate talks about the transition from field EMT to ER EMT. It’s a new world with new things to learn.

Sometimes a change in environment can get you out of a rut.

Sarah also worked in the ER but as a paramedic and loved learning new aspects of medicine but her scope was diminished compared to the field.

Paramedics are still a new asset in the ED and have a fluid job description.

Principles in emergency medicine

1. We do not diagnose in the ER.

2. Take care of yourself before you take care of patients.

Sarah recommends outlets and hobbies that are totally separate from medicine.

Make yourself a priority or you will end up neglecting yourself.

Sleep deprivation will affect you more than you think.

Casey talks about how you can get lolled into relaxing by low acuity calls but then you may be tested to your limits the very next call.

Support the show

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

Previous Episode

He was dead for an hour, then sat up, talking.

We revisit the question “Where is God is emergency medicine?

Doug- I’m a believer in science and a believer in God.

There are some occurrences that we can’t explain with modern medicine. He tells the story of a cardiac arrest that woke back up an hour after pronouncement.

Sarah- God has given us the science to learn and be able to use.

We often see the victim of a horrible tragedy as well as the person that caused the trauma. It’s hard to believe there is a God when we see such injustice in the world.

I talk about the difficulty taking care of a drunk driver who was the reason for the death of his friend in the passenger seat.

Casey prays every day before work for the safety of his partners and that he would be the best paramedic he can be.

Casey tells an awesome story of recovery from a horrible head injury. How it redeemed this person from a bad path in life.

Advise for those struggling:

EMS changes every day. So, stick around and don’t give up.

Avoid substance abuse. Don’t neglect your emotions.

Hold on to the good calls.

Find something you’re passionate about outside of emergency medicine. Use it to get the frustration and the things that bother you out.

Take a break. Talk to someone.

If you are a nurse. Know that you have to be true to yourself and you can always switch nursing specialties if you need to.

Write down the victories.

You must be intentional with your mental health.

Support the show

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

Next Episode

She sat up, yelling “What happened!”

Jumping back into Principles in Emergency Medicine

Nate- People lie. Despite the fact that we are not judging them, and just need to know accurate details to provide the best possible care.

Casey- Expect the unexpected.

EMS is long periods of boredom punctuated by moments of sheer terror.

Adam- the job is always out to get you. We see the 1%, it is a self-selected population. So, if you are going to consider a rare or uncommon diagnosis, you are more likely to find it in these patients.

He found a passive pulmonary embolism in a patient with very mild and vague symptoms.

Casey- Arrogance can really cloud your judgment. You must be more confident in what you don’t know than what you do know.

Nate- pay attention to those subtle details like bradycardia. It could indicate a bigger problem than initially thought.

Watch your ego because it may cause you to focus too much on a differential and ignore details to the contrary.

Casey tells a story about a woman who was assumed to be drunk but just had a low blood sugar.

Adam- Know the difference between confident and cocky.

Kiley- A confident provider with a clear plan is very helpful to nursing staff because they can convey this to the patient, and everyone is on the same page.

I always plan on a negative work up because a positive work up will dictate the plan.

Sarah- Don’t stop learning. Look things up. Learn every day.

ZDoggMD talks about burnout being moral injury. Link here:
(30) It's Not Burnout, It's Moral Injury | Dr. Zubin Damania on Physician "Burnout" - YouTube

I agree with certain aspects of what he is discussing but I also believe there will always be aspects of our job we cannot control so we must remain focused on the things we do have control over. Ourselves. Our patient care. How we show up.

Adam- The emergency department is unique in medicine because we don’t have a lot of oversight and rules from the insurance companies. We can order the tests and take care of the patients regardless of their race, gender, insurance coverage. We are the safety net of society.
If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm products. Check them out here so they know I sent you.
1st Phorm | The Foundation of High Performance Nutrition

Everything you hear today

Support the show

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