Getting Lost on Scene as a New EMT?

Practical EMS

I have a simple framework I wanted to lay out for the new EMT that is struggling to run a call. When I was a new EMT, my FTO would just throw me in there without a lot of guidance on HOW exactly a call worked and what the steps were exactly. If you follow these steps you won't get lost and can move the call along without any awkward pauses and blank stares.

* These steps work 95% of the time but have to be skipped if the patient is in cardiac arrest or needs emergent interventions.

1. Obtain the HPI. Introduce yourself, ask their name and dig into why they called 911. OPQRST. This is to give yourself a clear idea of WHY you are there and how to proceed. You may need to redirect the patient a few times to stay CLEAR on what is going on TODAY not 10 years ago. You want to know pertinent history NOT everything that has ever happened to them. Example: They called for chest pain. When did it start? What makes it better/worse? What does it feel like? Does it radiate anywhere? How bad is it? Does it come and go? Do you have any cardiac or respiratory history? Get the answer to those questions and MOVE ON.
2. Collect objective data. Get vitals, do a physical exam based on the CC, get an EKG if needed, blood sugar and IV if needed. This can happen simultaneously with step 1 and probably should.
3. Any treatment needed? This is easier as an EMT than it is for a paramedic. Based on your treatment protocols, consider breathing treatment, IV fluids, dextrose, zofran. Example: our chest pain patient may need aspirin, zofran and and IV.
4. Disposition (what now)? Can the patient stay home? Are you taking them to the ED via your ambulance? Is it appropriate to have family drive them? Are they going to refuse your recommended plan? Do the conservative option (ambulance to ED is safest for the patient)

Hope you guys find this helpful.

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