Did EMT experience help with your clinicals?

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I am not anywhere close to my clinical years, but I'm going to go out on a limb and say that it probably won't help you in any significant way.

If you want to become an EMT because it looks interesting and it's something you want to try, by all means go for it.

If you want to become an EMT because you think it'll give you an edge during your rotations, I would recommend doing something else.
 
EMT experience will not help prepare you for clinical rotations. Whether you work with EMS or as a tech in an ED, your work will not involve any of the medical decision making process that physicians are involved with. The only pre-medical job that will give you exposure to MDM is being a scribe.
 
ZPakEffect said:
EMT experience will not help prepare you for clinical rotations. Whether you work with EMS or as a tech in an ED, your work will not involve any of the medical decision making process that physicians are involved with. The only pre-medical job that will give you exposure to MDM is being a scribe.
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Well if not the decision making, they seem to come in contact with a diverse group of patients (I just finished a ride-along on an ambulance). I thought scribes don't get any patient contact at all?
 
protrator said:
Well if not the decision making, they seem to come in contact with a diverse group of patients (I just finished a ride-along on an ambulance). I thought scribes don't get any patient contact at all?
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Scribes are right by the physician during every patient encounter. They get to watch every H&P that the physician performs.

If you want to become a paramedic, then EMT is the best experience. If you want to become a nurse, then PCT is the best. If you want to become a doctor, then scribing is the best. It's pretty simple.
 
I am not in medical school however, when i got my EMT, i found it to be extremely useful. Although it is not that difficult to obtain,t he experience i got out of it was very beneficial. I learned basic medical terminology that allowed me to follow the doctor patient interaction that took place during my ER shifts. I was exposed to the teamwork necessary to run a trauma situation and even assisted with minor things like setting up leads and the pulse-ox and then the rest was just watching and observing the entire team work like a well oiled machine. It gives you a sense of appreciation for those below the doctor, because if the nurses and EMT/Paramedic aren't doing their jobs correctly, the Doctor is not fully able to do his job. I also saw some of the ugly side of medicine, such as nurses and doctors arguing, the arrogant attitude some doctors have as well as some fatal outcomes. Overall, i loved my experience getting EMT certified, it i just ultimately up to how you try and get the most out of the experience and training. As far as a gap year is concerned, i believe scribing would be more beneficial than the time it takes to get an EMT-Basic license plus filling out forms to get state and regionally certified, then finding a job, it can take a lot of time.
 
djsbaseball2014 said:
I am not in medical school however, when i got my EMT, i found it to be extremely useful. Although it is not that difficult to obtain,t he experience i got out of it was very beneficial. I learned basic medical terminology that allowed me to follow the doctor patient interaction that took place during my ER shifts. I was exposed to the teamwork necessary to run a trauma situation and even assisted with minor things like setting up leads and the pulse-ox and then the rest was just watching and observing the entire team work like a well oiled machine. It gives you a sense of appreciation for those below the doctor, because if the nurses and EMT/Paramedic aren't doing their jobs correctly, the Doctor is not fully able to do his job. I also saw some of the ugly side of medicine, such as nurses and doctors arguing, the arrogant attitude some doctors have as well as some fatal outcomes. Overall, i loved my experience getting EMT certified, it i just ultimately up to how you try and get the most out of the experience and training.
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Thanks for the response my man, this paragraph itself is a well-oiled machine.
 
To give an idea of the kind of involvement in the MDM a scribe can have, I will give you a few examples from my own work as a scribe:

1.) A patient presents to the ED c/o (complaining of) back pain states that she had been taking acetaminophen every 2-3 hours for her pain. The physician forgets this fact and wants me to put in a prescription for Tylenol #3 when we discharge the patient. Because acetaminophen overdose can lead to liver damage, it is crucial that no more than 4 grams of acetaminophen be taken per 24 hour period. I remind the doctor that the patient has been taking a large amount of acetaminophen at home and that it would be a good idea to prescribe her something else. He thanks me and tells me to put in a prescription for Ultram instead.

2.) A patient presents to the ED c/o lower abdominal pain that began in her right flank and has traveled down to her suprapubic area. After the H&P, the physician asks me what I think the problem is. I tell him that ureterolithiasis is the most likely explanation. The physician says that it is a possibility but he thinks an ovarian cyst is more likely. A CT abdomen and pelvis is ordered which shows a 7 mm stone at the right ureterovesicular junction. He admits that I was right and tells me that he thinks I will be far ahead of my fellow students in medical school.

3.) A patient presents to the ED c/o generalized myalgias s/p (status post) multiple falls the night before. She also reports head trauma without loss of consciousness. She denies vomiting, headache, lethargy, confusion, or any other neurological symptoms. The doctor allows me to put in the orders for the workup on my own, which he later looks at before making the orders effective by signing them. Based on the H&P, I decide to order a CBC (complete blood count), a BMP (basic metabolic panel), a UA (urinalysis), a UDS (urine drug screen), an EtOH level, a urine pregnancy test, a lumbar spine X-ray, and a CT Head. The doctor asks me why I want to order the CT Head. I tell him that even though she has no neurological symptoms and did not lose consciousness, I have seen so many doctors order CT Heads as a CYA (cover your ass) measure. He disagrees with my reasoning and explains why he is comfortable with not ordering the CT. Eventually, after a re-examination of the patient, he orders the CT anyway after a nurse reported seeing the patient walk with a staggered gait.
 
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ZPakEffect said:
To give an idea of the kind of involvement in the MDM a scribe can have, I will give you a few examples from my own work as a scribe:

1.) A patient presents to the ED c/o (complaining of) back pain states that she had been taking acetaminophen every 2-3 hours for her pain. The physician forgets this fact and wants me to put in a prescription for Tylenol #3 when we discharge the patient. Because acetaminophen overdose can lead to liver damage, it is crucial that no more than 4 grams of acetaminophen be taken per 24 hour period. I remind the doctor that the patient has been taking a large amount of acetaminophen at home and that it would be a good idea to prescribe her something else. He thanks me and tells me to put in a prescription for Ultram instead.

2.) A patient presents to the ED c/o lower abdominal pain that began in her right flank and has traveled down to her suprapubic area. After the H&P, the physician asks me what I think the problem is. I tell him that ureterolithiasis is the most likely explanation. The physician says that it is a possibility but he thinks an ovarian cyst is more likely. A CT abdomen and pelvis is ordered which shows a 7 mm stone at the right ureterovesicular junction. He admits that I was right and tells me that he thinks I will be far ahead of my fellow students in medical school.

3.) A patient presents to the ED c/o generalized myalgias s/p (status post) multiple falls the night before. She also reports head trauma without loss of consciousness. She denies vomiting, headache, lethargy, confusion, or any other neurological symptoms. The doctor allows me to put in the orders for the workup on my own, which he later looks at before making the orders effective by signing them. Based on the H&P, I decide to order a CBC (complete blood count), a BMP (basic metabolic panel), a UA (urinalysis), a UDS (urine drug screen), an EtOH level, a urine pregnancy test, a lumbar spine X-ray, and a CT Head. The doctor asks me why I want to order the CT Head. I tell him that even though she has no neurological symptoms and did not lose consciousness, I have seen so many doctors order CT Heads as a CYA (cover your ass) measure. He disagrees with my reasoning and explains why he is comfortable with not ordering the CT. Eventually, after a re-examination of the patient, he orders the CT anyway after a nurse reported seeing the patient walk with a staggered gait.
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this sounds like a pretty neat experience, thanks for sharing. how long did you scribe at the hospital?
 
protrator said:
this sounds like a pretty neat experience, thanks for sharing. how long did you scribe at the hospital?
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I have been a scribe for about 16 months now and plan on continuing until the end of May. Then I will take a couple of months off to rest before going to medical school.
 
ZPakEffect said:
Scribes are right by the physician during every patient encounter. They get to watch every H&P that the physician performs.

If you want to become a paramedic, then EMT is the best experience. If you want to become a nurse, then PCT is the best. If you want to become a doctor, then scribing is the best. It's pretty simple.
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The point of clinical experience is to give you exposure to patient care not to prepare you for clinical rotations.
It doesn't matter whether you're an EMT, RT, nurse, or scribe as long as you've spent time with patients.

ZPakEffect said:
To give an idea of the kind of involvement in the MDM a scribe can have, I will give you a few examples from my own work as a scribe:

1.) A patient presents to the ED c/o (complaining of) back pain states that she had been taking acetaminophen every 2-3 hours for her pain. The physician forgets this fact and wants me to put in a prescription for Tylenol #3 when we discharge the patient. Because acetaminophen overdose can lead to liver damage, it is crucial that no more than 4 grams of acetaminophen be taken per 24 hour period. I remind the doctor that the patient has been taking a large amount of acetaminophen at home and that it would be a good idea to prescribe her something else. He thanks me and tells me to put in a prescription for Ultram instead.

2.) A patient presents to the ED c/o lower abdominal pain that began in her right flank and has traveled down to her suprapubic area. After the H&P, the physician asks me what I think the problem is. I tell him that ureterolithiasis is the most likely explanation. The physician says that it is a possibility but he thinks an ovarian cyst is more likely. A CT abdomen and pelvis is ordered which shows a 7 mm stone at the right ureterovesicular junction. He admits that I was right and tells me that he thinks I will be far ahead of my fellow students in medical school.

3.) A patient presents to the ED c/o generalized myalgias s/p (status post) multiple falls the night before. She also reports head trauma without loss of consciousness. She denies vomiting, headache, lethargy, confusion, or any other neurological symptoms. The doctor allows me to put in the orders for the workup on my own, which he later looks at before making the orders effective by signing them. Based on the H&P, I decide to order a CBC (complete blood count), a BMP (basic metabolic panel), a UA (urinalysis), a UDS (urine drug screen), an EtOH level, a urine pregnancy test, a lumbar spine X-ray, and a CT Head. The doctor asks me why I want to order the CT Head. I tell him that even though she has no neurological symptoms and did not lose consciousness, I have seen so many doctors order CT Heads as a CYA (cover your ass) measure. He disagrees with my reasoning and explains why he is comfortable with not ordering the CT. Eventually, after a re-examination of the patient, he orders the CT anyway after a nurse reported seeing the patient walk with a staggered gait.
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Be sure to let your medical school know of your extensive MDM experience. Maybe they'll let you skip 3rd year rotations.
 
ZPakEffect said:
EMT experience will not help prepare you for clinical rotations. Whether you work with EMS or as a tech in an ED, your work will not involve any of the medical decision making process that physicians are involved with. The only pre-medical job that will give you exposure to MDM is being a scribe.
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I disagree. Although I'm not in medical school yet, I feel that my experiences working as an EMT have helped prepare me for interacting with patients. I've learned how to build rapport with my patients and also how to handle myself and lead in high-stress/emergency situations. Additionally, decision-making is a big part of working as an EMT. You have to decide whether you can or can't give medications based on indications and contraindications (that being said, I know the medications we can give are only a small fraction of what you may be working with as a scribe).

Whether scribing is a better preparatory experience than EMS I can't answer as I haven't scribed before, but that doesn't mean that EMS don't help prepare you for clinical rotations. I believe working as an EMT has made me a better applicant, given me a ton of experiences to talk about, and as I mentioned earlier, prepared me for future patient interactions.
 
protrator said:
I am wondering if I should become an EMT for a bit during my gap year. Did it help you in your clinical rotations at med school?
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This:
WedgeDawg said:
I am not anywhere close to my clinical years, but I'm going to go out on a limb and say that it probably won't help you in any significant way.

If you want to become an EMT because it looks interesting and it's something you want to try, by all means go for it.

If you want to become an EMT because you think it'll give you an edge during your rotations, I would recommend doing something else.
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alpinism said:
It doesn't matter whether you're an EMT, RT, nurse, or scribe as long as you've spent time with patients.
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Maybe it doesn't matter to you how you spend your time, but if I'm doing something, I would like to make the most out of it. @ZPakEffect is recomending scribing since it is obvious he has learned a lot through the experience. No one appreciates a smart ass.
 
ZPakEffect said:
To give an idea of the kind of involvement in the MDM a scribe can have, I will give you a few examples from my own work as a scribe:

1.) A patient presents to the ED c/o (complaining of) back pain states that she had been taking acetaminophen every 2-3 hours for her pain. The physician forgets this fact and wants me to put in a prescription for Tylenol #3 when we discharge the patient. Because acetaminophen overdose can lead to liver damage, it is crucial that no more than 4 grams of acetaminophen be taken per 24 hour period. I remind the doctor that the patient has been taking a large amount of acetaminophen at home and that it would be a good idea to prescribe her something else. He thanks me and tells me to put in a prescription for Ultram instead.

2.) A patient presents to the ED c/o lower abdominal pain that began in her right flank and has traveled down to her suprapubic area. After the H&P, the physician asks me what I think the problem is. I tell him that ureterolithiasis is the most likely explanation. The physician says that it is a possibility but he thinks an ovarian cyst is more likely. A CT abdomen and pelvis is ordered which shows a 7 mm stone at the right ureterovesicular junction. He admits that I was right and tells me that he thinks I will be far ahead of my fellow students in medical school.

3.) A patient presents to the ED c/o generalized myalgias s/p (status post) multiple falls the night before. She also reports head trauma without loss of consciousness. She denies vomiting, headache, lethargy, confusion, or any other neurological symptoms. The doctor allows me to put in the orders for the workup on my own, which he later looks at before making the orders effective by signing them. Based on the H&P, I decide to order a CBC (complete blood count), a BMP (basic metabolic panel), a UA (urinalysis), a UDS (urine drug screen), an EtOH level, a urine pregnancy test, a lumbar spine X-ray, and a CT Head. The doctor asks me why I want to order the CT Head. I tell him that even though she has no neurological symptoms and did not lose consciousness, I have seen so many doctors order CT Heads as a CYA (cover your ass) measure. He disagrees with my reasoning and explains why he is comfortable with not ordering the CT. Eventually, after a re-examination of the patient, he orders the CT anyway after a nurse reported seeing the patient walk with a staggered gait.
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Lol oh the humblebrag.
 
ZPakEffect said:
To give an idea of the kind of involvement in the MDM a scribe can have, I will give you a few examples from my own work as a scribe:

1.) A patient presents to the ED c/o (complaining of) back pain states that she had been taking acetaminophen every 2-3 hours for her pain. The physician forgets this fact and wants me to put in a prescription for Tylenol #3 when we discharge the patient. Because acetaminophen overdose can lead to liver damage, it is crucial that no more than 4 grams of acetaminophen be taken per 24 hour period. I remind the doctor that the patient has been taking a large amount of acetaminophen at home and that it would be a good idea to prescribe her something else. He thanks me and tells me to put in a prescription for Ultram instead.

2.) A patient presents to the ED c/o lower abdominal pain that began in her right flank and has traveled down to her suprapubic area. After the H&P, the physician asks me what I think the problem is. I tell him that ureterolithiasis is the most likely explanation. The physician says that it is a possibility but he thinks an ovarian cyst is more likely. A CT abdomen and pelvis is ordered which shows a 7 mm stone at the right ureterovesicular junction. He admits that I was right and tells me that he thinks I will be far ahead of my fellow students in medical school.

3.) A patient presents to the ED c/o generalized myalgias s/p (status post) multiple falls the night before. She also reports head trauma without loss of consciousness. She denies vomiting, headache, lethargy, confusion, or any other neurological symptoms. The doctor allows me to put in the orders for the workup on my own, which he later looks at before making the orders effective by signing them. Based on the H&P, I decide to order a CBC (complete blood count), a BMP (basic metabolic panel), a UA (urinalysis), a UDS (urine drug screen), an EtOH level, a urine pregnancy test, a lumbar spine X-ray, and a CT Head. The doctor asks me why I want to order the CT Head. I tell him that even though she has no neurological symptoms and did not lose consciousness, I have seen so many doctors order CT Heads as a CYA (cover your ass) measure. He disagrees with my reasoning and explains why he is comfortable with not ordering the CT. Eventually, after a re-examination of the patient, he orders the CT anyway after a nurse reported seeing the patient walk with a staggered gait.
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I wish I had that much autonomy as a scribe. The scope of our practice is extremely small; I'm lucky if I can hand gloves to the doc during a lac repair.
 
Lost in Translation said:
That's not true. No non-RN-non-MD-non-PA has any say in a treatment plan.
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In the narrow scope of the pre-hospital environment, EMT's have all the say.

As a paramedic, I have a little suitcase with 50 different drugs in it and standing orders to use all of them as I see fit. I have done needle decompressions of tension pneumothorax, put in ET tubes and LMA's, drilled IO needles into people's shins and given various drugs because I thought that was what the patient needed based on my own assessment. You have an enormous amount of responsibility as an EMS worker, even as an EMT-B.

I think scribing is probably a better "premed activity", but I think EMS has value too in a different way.
 
I haven't done any clinical work in undergrad. There are quite a few EMTs in my class. When we started our clinical medicine course, they had a slight edge for the first day where they knew how to take blood pressure, check for respirations, etc... A couple weeks in, everyone was up to speed and they were just like everyone else. I never once felt behind the curve during my pre-clinical years, or now during clinical of my third year. I have no regrets about not doing any entry-level clinical work, and if I could do it all over again, I would not do it. It's a significant time commitment which can end up destroying your grades and MCAT. What you do as a physician is far different, and medical school will start you at step one of it. If these jobs were to give you any significant edge or foundation, they would be a requirement.

So to answer your question... No, it won't give you an edge. Spend your time wisely.
 
Planes2Doc said:
I haven't done any clinical work in undergrad. There are quite a few EMTs in my class. When we started our clinical medicine course, they had a slight edge for the first day where they knew how to take blood pressure, check for respirations, etc... A couple weeks in, everyone was up to speed and they were just like everyone else. I never once felt behind the curve during my pre-clinical years, or now during clinical of my third year. I have no regrets about not doing any entry-level clinical work, and if I could do it all over again, I would not do it. It's a significant time commitment which can end up destroying your grades and MCAT. What you do as a physician is far different, and medical school will start you at step one of it. If these jobs were to give you any significant edge or foundation, they would be a requirement.

So to answer your question... No, it won't give you an edge. Spend your time wisely.
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this is actually the answer I was looking for 😀
 
Hospitalized said:
It's cringe-worthy, really. And quite frankly, it can be pretty dangerous to have someone with no medical education going around thinking they know how to diagnose.
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Hey, they can even order labs. The most I've ever done is turned down an offer to suture up a superficial head lac (laceration, or cut for you uneducated folk 😆).
 
ZPakEffect said:
To give an idea of the kind of involvement in the MDM a scribe can have, I will give you a few examples from my own work as a scribe:

1.) A patient presents to the ED c/o (complaining of) back pain states that she had been taking acetaminophen every 2-3 hours for her pain. The physician forgets this fact and wants me to put in a prescription for Tylenol #3 when we discharge the patient. Because acetaminophen overdose can lead to liver damage, it is crucial that no more than 4 grams of acetaminophen be taken per 24 hour period. I remind the doctor that the patient has been taking a large amount of acetaminophen at home and that it would be a good idea to prescribe her something else. He thanks me and tells me to put in a prescription for Ultram instead.

2.) A patient presents to the ED c/o lower abdominal pain that began in her right flank and has traveled down to her suprapubic area. After the H&P, the physician asks me what I think the problem is. I tell him that ureterolithiasis is the most likely explanation. The physician says that it is a possibility but he thinks an ovarian cyst is more likely. A CT abdomen and pelvis is ordered which shows a 7 mm stone at the right ureterovesicular junction. He admits that I was right and tells me that he thinks I will be far ahead of my fellow students in medical school.

3.) A patient presents to the ED c/o generalized myalgias s/p (status post) multiple falls the night before. She also reports head trauma without loss of consciousness. She denies vomiting, headache, lethargy, confusion, or any other neurological symptoms. The doctor allows me to put in the orders for the workup on my own, which he later looks at before making the orders effective by signing them. Based on the H&P, I decide to order a CBC (complete blood count), a BMP (basic metabolic panel), a UA (urinalysis), a UDS (urine drug screen), an EtOH level, a urine pregnancy test, a lumbar spine X-ray, and a CT Head. The doctor asks me why I want to order the CT Head. I tell him that even though she has no neurological symptoms and did not lose consciousness, I have seen so many doctors order CT Heads as a CYA (cover your ass) measure. He disagrees with my reasoning and explains why he is comfortable with not ordering the CT. Eventually, after a re-examination of the patient, he orders the CT anyway after a nurse reported seeing the patient walk with a staggered gait.
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This never happened.
 
It has already helped me in pre-clinical years as I was allowed to see some patients on my own outside of school in the free clinics because I am a basic. I already assisted in a birth because of the license. The reason my school did an EMT pre-matriculation course was in order to improve 3rd and 4th year clinicals because apparently most 3rd years cannot talk to patients. It would have been interesting to see if there was a selection bias in who signed up for the course.
 
familyaerospace said:
It has already helped me in pre-clinical years as I was allowed to see some patients on my own outside of school in the free clinics because I am a basic. I already assisted in a birth because of the license. The reason my school did an EMT pre-matriculation course was in order to improve 3rd and 4th year clinicals because apparently most 3rd years cannot talk to patients. It would have been interesting to see if there was a selection bias in who signed up for the course.
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That is awesome! I would love to get that kind of experience in my pre-clinical years.
I am a basic as well 🙂
 
ZPakEffect said:
To give an idea of the kind of involvement in the MDM a scribe can have, I will give you a few examples from my own work as a scribe:

1.) A patient presents to the ED c/o (complaining of) back pain states that she had been taking acetaminophen every 2-3 hours for her pain. The physician forgets this fact and wants me to put in a prescription for Tylenol #3 when we discharge the patient. Because acetaminophen overdose can lead to liver damage, it is crucial that no more than 4 grams of acetaminophen be taken per 24 hour period. I remind the doctor that the patient has been taking a large amount of acetaminophen at home and that it would be a good idea to prescribe her something else. He thanks me and tells me to put in a prescription for Ultram instead.

2.) A patient presents to the ED c/o lower abdominal pain that began in her right flank and has traveled down to her suprapubic area. After the H&P, the physician asks me what I think the problem is. I tell him that ureterolithiasis is the most likely explanation. The physician says that it is a possibility but he thinks an ovarian cyst is more likely. A CT abdomen and pelvis is ordered which shows a 7 mm stone at the right ureterovesicular junction. He admits that I was right and tells me that he thinks I will be far ahead of my fellow students in medical school.

3.) A patient presents to the ED c/o generalized myalgias s/p (status post) multiple falls the night before. She also reports head trauma without loss of consciousness. She denies vomiting, headache, lethargy, confusion, or any other neurological symptoms. The doctor allows me to put in the orders for the workup on my own, which he later looks at before making the orders effective by signing them. Based on the H&P, I decide to order a CBC (complete blood count), a BMP (basic metabolic panel), a UA (urinalysis), a UDS (urine drug screen), an EtOH level, a urine pregnancy test, a lumbar spine X-ray, and a CT Head. The doctor asks me why I want to order the CT Head. I tell him that even though she has no neurological symptoms and did not lose consciousness, I have seen so many doctors order CT Heads as a CYA (cover your ass) measure. He disagrees with my reasoning and explains why he is comfortable with not ordering the CT. Eventually, after a re-examination of the patient, he orders the CT anyway after a nurse reported seeing the patient walk with a staggered gait.
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Lol there is no way in hell this ever happened. Also using medical abbreviations outside of chart notes just makes you look like a tool. Some genuine advice: do not go around bragging about this.
 
ZPakEffect said:
To give an idea of the kind of involvement in the MDM a scribe can have, I will give you a few examples from my own work as a scribe:

1.) A patient presents to the ED c/o (complaining of) back pain states that she had been taking acetaminophen every 2-3 hours for her pain. The physician forgets this fact and wants me to put in a prescription for Tylenol #3 when we discharge the patient. Because acetaminophen overdose can lead to liver damage, it is crucial that no more than 4 grams of acetaminophen be taken per 24 hour period. I remind the doctor that the patient has been taking a large amount of acetaminophen at home and that it would be a good idea to prescribe her something else. He thanks me and tells me to put in a prescription for Ultram instead.

2.) A patient presents to the ED c/o lower abdominal pain that began in her right flank and has traveled down to her suprapubic area. After the H&P, the physician asks me what I think the problem is. I tell him that ureterolithiasis is the most likely explanation. The physician says that it is a possibility but he thinks an ovarian cyst is more likely. A CT abdomen and pelvis is ordered which shows a 7 mm stone at the right ureterovesicular junction. He admits that I was right and tells me that he thinks I will be far ahead of my fellow students in medical school.

3.) A patient presents to the ED c/o generalized myalgias s/p (status post) multiple falls the night before. She also reports head trauma without loss of consciousness. She denies vomiting, headache, lethargy, confusion, or any other neurological symptoms. The doctor allows me to put in the orders for the workup on my own, which he later looks at before making the orders effective by signing them. Based on the H&P, I decide to order a CBC (complete blood count), a BMP (basic metabolic panel), a UA (urinalysis), a UDS (urine drug screen), an EtOH level, a urine pregnancy test, a lumbar spine X-ray, and a CT Head. The doctor asks me why I want to order the CT Head. I tell him that even though she has no neurological symptoms and did not lose consciousness, I have seen so many doctors order CT Heads as a CYA (cover your ass) measure. He disagrees with my reasoning and explains why he is comfortable with not ordering the CT. Eventually, after a re-examination of the patient, he orders the CT anyway after a nurse reported seeing the patient walk with a staggered gait.
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This kid is "that guy"... Don't ever be that guy.
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Lost in Translation said:
Hey, they can even order labs. The most I've ever done is turned down an offer to suture up a superficial head lac (laceration, or cut for you uneducated folk 😆).
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He is partially correct lmao. Ordering labs is something that scribes can do. We don't do it in our ER but in some of the outpatient offices, scribes order labs but they are at the physician's order and are then pended, and eventually reviewed, signed by the physician. A scribe is NEVER allowed to order labs unprompted. That is an absolutely irresponsible and dangerous thing to do because it can cause so many problems.
 
The EMT course would only be beneficial if you worked >500 hrs on a high volume unit. If you don't have the opportunity to do that. It would just be like taking any other cert class such as AHA CPR- ACLS- PALS- PHTLS ..... Its not the knowledge basis that is the tool it's the utilization of the material in real life scenarios that would be your greatest benefit. The answer here is one of total opposition. It will either be of great benefit or of very little. Taking the course won't help much, working as an EMT full time will help considerably with BASIC ideas of processes.
 
ZPakEffect said:
To give an idea of the kind of involvement in the MDM a scribe can have, I will give you a few examples from my own work as a scribe:

1.) A patient presents to the ED c/o (complaining of) back pain states that she had been taking acetaminophen every 2-3 hours for her pain. The physician forgets this fact and wants me to put in a prescription for Tylenol #3 when we discharge the patient. Because acetaminophen overdose can lead to liver damage, it is crucial that no more than 4 grams of acetaminophen be taken per 24 hour period. I remind the doctor that the patient has been taking a large amount of acetaminophen at home and that it would be a good idea to prescribe her something else. He thanks me and tells me to put in a prescription for Ultram instead.

2.) A patient presents to the ED c/o lower abdominal pain that began in her right flank and has traveled down to her suprapubic area. After the H&P, the physician asks me what I think the problem is. I tell him that ureterolithiasis is the most likely explanation. The physician says that it is a possibility but he thinks an ovarian cyst is more likely. A CT abdomen and pelvis is ordered which shows a 7 mm stone at the right ureterovesicular junction. He admits that I was right and tells me that he thinks I will be far ahead of my fellow students in medical school.

3.) A patient presents to the ED c/o generalized myalgias s/p (status post) multiple falls the night before. She also reports head trauma without loss of consciousness. She denies vomiting, headache, lethargy, confusion, or any other neurological symptoms. The doctor allows me to put in the orders for the workup on my own, which he later looks at before making the orders effective by signing them. Based on the H&P, I decide to order a CBC (complete blood count), a BMP (basic metabolic panel), a UA (urinalysis), a UDS (urine drug screen), an EtOH level, a urine pregnancy test, a lumbar spine X-ray, and a CT Head. The doctor asks me why I want to order the CT Head. I tell him that even though she has no neurological symptoms and did not lose consciousness, I have seen so many doctors order CT Heads as a CYA (cover your ass) measure. He disagrees with my reasoning and explains why he is comfortable with not ordering the CT. Eventually, after a re-examination of the patient, he orders the CT anyway after a nurse reported seeing the patient walk with a staggered gait.
Click to expand...

Makes perfect sense once doctor is replaced with I, and I with doctor.
 
@protrator

I'm not a medical student, but here are some things that EMS has helped me on that will help me in a way in clinicals.
  • Saw different paths of life (privileged and poverty).
  • How to talk to a patients in different situations. Like pediatrics, emotional distress, a family loss, pissed off, scared, mentally ill, etc.
  • Practice my physical examinations and history taking.
  • How to be on your A game in the middle of the night.
And when I do my paramedic I will know a ton of skill sets.

TL;DR How to talk to a patient and physical exam.
 
Last edited:
ZPakEffect said:
To give an idea of the kind of involvement in the MDM a scribe can have, I will give you a few examples from my own work as a scribe:

1.) A patient presents to the ED c/o (complaining of) back pain states that she had been taking acetaminophen every 2-3 hours for her pain. The physician forgets this fact and wants me to put in a prescription for Tylenol #3 when we discharge the patient. Because acetaminophen overdose can lead to liver damage, it is crucial that no more than 4 grams of acetaminophen be taken per 24 hour period. I remind the doctor that the patient has been taking a large amount of acetaminophen at home and that it would be a good idea to prescribe her something else. He thanks me and tells me to put in a prescription for Ultram instead.

2.) A patient presents to the ED c/o lower abdominal pain that began in her right flank and has traveled down to her suprapubic area. After the H&P, the physician asks me what I think the problem is. I tell him that ureterolithiasis is the most likely explanation. The physician says that it is a possibility but he thinks an ovarian cyst is more likely. A CT abdomen and pelvis is ordered which shows a 7 mm stone at the right ureterovesicular junction. He admits that I was right and tells me that he thinks I will be far ahead of my fellow students in medical school.

3.) A patient presents to the ED c/o generalized myalgias s/p (status post) multiple falls the night before. She also reports head trauma without loss of consciousness. She denies vomiting, headache, lethargy, confusion, or any other neurological symptoms. The doctor allows me to put in the orders for the workup on my own, which he later looks at before making the orders effective by signing them. Based on the H&P, I decide to order a CBC (complete blood count), a BMP (basic metabolic panel), a UA (urinalysis), a UDS (urine drug screen), an EtOH level, a urine pregnancy test, a lumbar spine X-ray, and a CT Head. The doctor asks me why I want to order the CT Head. I tell him that even though she has no neurological symptoms and did not lose consciousness, I have seen so many doctors order CT Heads as a CYA (cover your ass) measure. He disagrees with my reasoning and explains why he is comfortable with not ordering the CT. Eventually, after a re-examination of the patient, he orders the CT anyway after a nurse reported seeing the patient walk with a staggered gait.
Click to expand...


I legit spat my drink out in laughter reading this!! Oh man, someone is up for a rude awakening .
 
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