State Certified

I finally got my state EMT-B certification in the mail today after nearly a month of turning in all my paperwork.

Watch out world, now I can legally practice.

I'm still applying for random jobs at hospitals like perioperative tech and "multi-skilled patient care technician".

And I'm an 8-hour clinical rotation away from having my IV approval.

School starts on August 11.

Life moves fast when you're ambitious.


TEMS (tactical emergency medical services)

You know... getting all moulaged up and being dragged around by sexy gun-toting paramedics is fun and all... but looking like a strawberry and desperately trying to scrub stage blood off of your skin for the next 3 days is not.

Yeah that's me up there. Scenario: math teacher got caught sexually assaulting a student, was fired, and subsequently came back to shoot up the school and take revenge on the guidance counselor who blew the whistle. I had 3 GSWs to the face and neck and was DRTSTW (dead right there stayed that way).



As I knelt onto the wet flagstone behind the unresponsive, laid-out stranger's head, I grasped the angle of his jaw with my fingertips and jut it forward to try to relieve some of his comatose snoring. His pupils pointlessly fixated on the sky above my head and foam dribbled out of his mouth... his wife confirmed that he was diabetic and had been having trouble with his sugar lately.

The rest of the crew worked in that freaky lightning fast synchronized dance... the paramedic set up a line as the firefighter/EMT tested his sugar. The engineer handed the D50 to the medic and as soon as the EMT confirmed that the man's blood glucose level was ridiculously low, the medic was pushing the D50.

They had me hand over my jaw thrust and grab a manual BP and by the time I had the cuff on he was coming out of it as evidenced by his sudden confused glances. The medic, his wife and I reassured him but he quickly understood what was going on. He knew his name, the time, and that he had been feeling pretty low on sugar when he came out into the backyard, but didn't remember falling or seizing.

The medic checked out his head, neck and back. He encouraged the man to take a ride to the ER, but unsurprisingly he refused. He was pretty much totally fine, just a little loopy. The wife brought the man some cheese and bread and orange juice as we sat and talked with them for a while. It was almost like a pleasant visit, the dog came out and the guys from the crew played fetch with him. About 5-10 minutes after the man had recovered from his comatose state I rechecked the man's BGL, the medic called in the refusal on the biophone, and we left.

What an amazing thing to witness - it's an exceedingly rare occurrence that EMS can go above and beyond stabilizing someone long enough to get them to the hospital. To bring someone from a completely unresponsive and dangerous state back to normal... it makes me excited about expanding my scope of practice and gaining the experience to make those tools useful.



I met him yesterday, and now he's letting me push a needle into his vein for my first time.

There's something so intimate and bonding about the IV approval course. In my state EMT-Bs are allowed to start IVs, administer D50 IV, administer Narcan intranasally, take blood, and use glucometers after taking a 24-hour course with an 8-hour clinical rotation.

Our first live sticks are on each other. It's nerve-wracking. I'm standing over his arm with a 20 gauge staring at the juicy vein I selected. I insert the needle and start advancing the catheter over it, but I pull the needle back out too quick and blood starts gushing every where. I tamponade (apply pressure to) the vein as my fellow student turns a bit white in the face. Miraculously, I was able to save the stick and get a successful line in by starting a little fluid going and finishing the catheter.

Now my own arms have a multitude of little bruises and puncture wounds from being practiced on. It's a surprisingly easy skill to learn, but a difficult one to master.


"Experience is a hard teacher...

...she gives the test first, the lesson afterwards." - Vernon Law

I feel sometimes like I'm moving too fast in this field. On Friday I start my IV approval course. Right now I'm applying for all these crazy jobs: critical care tech, emergency department tech, operating room tech... and sometimes it quite honestly terrifies me that in a month or so I could be treating patients for real. Not as a student. Not until the paramedics show up. For real.

Sometimes I wonder if I'm ready, but the truth of the matter is that in this field at some point you just have to jump in. You can attend lectures and classes and practice splinting and vitals and assessments on other students until the cows come home, but the only way you really get good at taking care of patients is by taking care of patients.

It's just one of the risks we have to accept coming into this line of work. People who are new to the restaurant business or retail or media industry will make embarrassing mistakes. Those mistakes may cost their employer some business or perhaps even destroy a little property. However there are only a handful of fields in which a simple mistake can cost another human being's life or limb. I do feel completely confident that I will not make such a devastating error, but the gravity of this line of work never really leaves the back of my mind.

I'm at such a breathtakingly exciting yet completely nerve-wracking point in my life. This is where the real learning begins.


You might be an ARP if...

Just to refresh everyone's memory... my SAR team is the only team in the nation that is youth-based. We also do operational assistance for local law enforcement and fire agencies: rolling hose, changing air tanks, scene security, evidence searching, trainings, traffic direction, event medical... etc etc.

You might be an ARP if...
  1. You've had blisters in places you never thought possible.
  2. Sleep has become an option rather a necessity.
  3. You are happy to be woken up at 3 am by the screeching beeps of a pager
  4. Your boots age 10x faster than average.
  5. You've spent your Christmas night in a van babysitting a burnt-down house.
  6. You've played a terrorist/hostage/bank robber/rioter for the SWAT team, essentially playing paintball with them.
  7. Lacking a window punch, you've gained access to an MVA victim using an avalanche shovel.
  8. You've directed traffic before you could legally drive.
  9. You've gone for two hour hikes at 3 am... sometimes to look for a missing person, sometimes just for fun.
  10. It seems like every year your dividend at REI gets larger.
  11. You consider yourself an energy bar/gel/powder connoisseur because you've tried just about every brand and flavor.
  12. Your tan isn't really a tan... it's just a thick layer of dirt.
  13. Free food motivates you do things you otherwise wouldn't.
  14. When hanging out with a group of friends you are comforted by the fact that you are usually accompanied by some combination of SAR personnel, EMTs, swiftwater rescue techs, rock rescue techs, cops, firefighters, Hazmat techs, avalanche rescue techs, paramedics, doctors, nurses, etc...
  15. Most people your age play video games and get drunk for fun. You save lives.
  16. You know not to volunteer for a dog team or to carry the rock bags unless you want to work your ass off.
  17. You could live out of your pack for months. You could live out of your car indefinitely, and indeed you've lived out of each for some amount of time on multiple occasions.
  18. You know which members to avoid sleeping near because they snore, sleepwalk or talk in their sleep.
  19. You've forgotten what home looks like.
  20. You prefer to light your campfires with road flares.

This post is a part of Normal Sinus Rhythm, a collaborative writing project in which awesome EMS bloggers from all over the country share their experiences/misadventures/whatnot.