Tough call :(

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frosted_flake

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I am a sophomore in college and I am planning on going to medical school. Long story short I just got off work and we had a call for chest pain tonight. When we got to the ER the patient coded. I think I am so upset because my family has a long line of cardiac history, but this has happened before when I have been on a run that reminds me of a family member/ someone I love. Is this something we just get used to? Or will situations that remind us of family always get to us?
Tonight makes me think I may not be cut out to be a doctor from the emotional standpoint (after the fact) because during the chaos, I am calm as can be and do my job with ease and confidence. I just get uneasy when I am sitting at home later on.
Maybe an EMT/Medic turned ER Doc (or anyone for that matter) can help me ease my worried mind.
Thanks and be safe out there.

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Em:

We all go through this. Some calls hit us more than others. If you can be calm and do the job during the event, you'll be fine. We're all human. For some folks, it's the calls with children, especially those who have children that age. For others, it may be the threatened miscarriage, as they had personally had a miscarriage.

I remember a call where the trauma residents and the Emergency Medicine residents were working 3 separate pediatric codes from a house fire. I remember one of the trauma residents looking at me (I was the Emergency Medicine Resident who was leading the code on this particular pediatric patient) and saying, "YOU tell me when YOU want to call, I don't want to have call this one." The child had been coded for 20 minutes at the scene, and we worked him for 30+ minutes in the Emergency Department. Two of the pediatric patient codes from the fire were called in the ED, and one made it to the ICU (but later died). Everyone in the ED felt those codes.

Bottom line, we're all human and different calls affect each of us uniquely. Some calls more than others.


Thanks.

Wook
 
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Em:

We all go through this. Some calls hit us more than others. If you can be calm and do the job during the event, you'll be fine. We're all human. For some folks, it's the calls with children, especially those who have children that age. For others, it may be the threatened miscarriage, as they had personally had a miscarriage.

I remember a call where the trauma residents and the Emergency Medicine residents were working 3 separate pediatric codes from a house fire. I remember one of the trauma residents looking at me (I was the Emergency Medicine Resident who was leading the code on this particular pediatric patient) and saying, "YOU tell me when YOU want to call, I don't want to have call this one." The child had been coded for 20 minutes at the scene, and we worked him for 30+ minutes in the Emergency Department. Two of the pediatric patient codes from the fire were called in the ED, and one made it to the ICU (but later died). Everyone in the ED felt those codes.

Bottom line, we're all human and different calls affect each of us uniquely. Some calls more than others.


Thanks.

Wook
Wook,
I appreciate you taking the time to share your advice and story. I have had situations before where a run has gotten to me, but not to the point where I have questioned my abilities to be a Physician. It is good to know that I am not alone in these feelings. Thank you again.
 
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I can't say it any better than wook did. I had a run of bad calls on top of being burned out that had me doubting everything: EMS, pre-med, Med School, etc. My wife put it into perspective like this: "someday, when you're a doctor, may be a year, 5 years, maybe even 10 years. You'll see some shell-shocked medic roll in with a bad patient and instantaneously recognize the look, the tone of voice, or the change in demeanor. You'll pull them aside and talk to them, give them an ear or a shoulder to cry on because you've been there and done that, and knows what it feels like"

You're definitely not alone, I think you'd be hard-pressed to find anyone in this line of work that hasn't had these feelings at one time or another. You may be able to take the memory of those feelings and use them to help a fellow clinician in a time of need.
 
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Em:

We all go through this. Some calls hit us more than others. If you can be calm and do the job during the event, you'll be fine. We're all human. For some folks, it's the calls with children, especially those who have children that age. For others, it may be the threatened miscarriage, as they had personally had a miscarriage.

I remember a call where the trauma residents and the Emergency Medicine residents were working 3 separate pediatric codes from a house fire. I remember one of the trauma residents looking at me (I was the Emergency Medicine Resident who was leading the code on this particular pediatric patient) and saying, "YOU tell me when YOU want to call, I don't want to have call this one." The child had been coded for 20 minutes at the scene, and we worked him for 30+ minutes in the Emergency Department. Two of the pediatric patient codes from the fire were called in the ED, and one made it to the ICU (but later died). Everyone in the ED felt those codes.

Bottom line, we're all human and different calls affect each of us uniquely. Some calls more than others.


Thanks.

Wook
good summary. kids are tough, especially kids who look like yours.
older folks who look like you parents or grandparents or have similar problems to what they died of are also tough.
as long as you are fine in the moment and bummed later you will be fine. the problem is those who can't act when they need to and freeze up at a critical time.
 
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Your first patient death is always the toughest. Not necessarily ones who are a working code from arrival on scene--you expect those to die. But the ones where the patient is awake and talking and ends up dying do shake you.

It absolutely does get easier. I may be in my first year out of medical school, but I've been doing this a long time--this year marks 15 years since I graduated from my EMT-B course. On my shift today we unsuccessfully coded two patients who came through the door with a pulse. And I'll sleep fine tonight, because I know that we did everything possible. But it takes time to get to that level.

Peds of course are a different story. I never want to get to a place that peds codes don't affect me emotionally.
 
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I appreciate you guys taking the time to help me out. I know you guys/girls have very busy schedules, and I am so thankful that people who were once in my position are so willing to help. Hopefully I can do the same for someone in the same place when I become a physician.

I have only been an EMT for 1.5 years at a service that averages <4k runs/year and are hardly ever serious. I have only been involved in 1 code, and made 3-4 overdoses.
We made an OD today and I was calm on the outside but I was freaking the F out on the inside. Heart pounding, breathing like I just ran a marathon, etc.
Any advice on how to calm down? I can do my job, I just would like to have a way of reassuring myself (if that makes sense?)
 
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Your first patient death is always the toughest. Not necessarily ones who are a working code from arrival on scene--you expect those to die. But the ones where the patient is awake and talking and ends up dying do shake you.

It absolutely does get easier. I may be in my first year out of medical school, but I've been doing this a long time--this year marks 15 years since I graduated from my EMT-B course. On my shift today we unsuccessfully coded two patients who came through the door with a pulse. And I'll sleep fine tonight, because I know that we did everything possible. But it takes time to get to that level.

Peds of course are a different story. I never want to get to a place that peds codes don't affect me emotionally.

That is exactly what happened. He was a very kind individual, and we had a great conversation upon arrival at the hospital. We moved him over, left him in the room with the nurses and the next thing we know they are calling for the crash cart. Messed up stuff.
 
I appreciate you guys taking the time to help me out. I know you guys/girls have very busy schedules, and I am so thankful that people who were once in my position are so willing to help. Hopefully I can do the same for someone in the same place when I become a physician.

I have only been an EMT for 1.5 years at a service that averages <4k runs/year and are hardly ever serious. I have only been involved in 1 code, and made 3-4 overdoses.
We made an OD today and I was calm on the outside but I was freaking the F out on the inside. Heart pounding, breathing like I just ran a marathon, etc.
Any advice on how to calm down? I can do my job, I just would like to have a way of reassuring myself (if that makes sense?)

There are some interesting articles covering this topic. One of the things that we were taught (another line of work many years ago) was focus on the breathing. Slow and steady. Tends to decrease the adrenergic surge and can be somewhat calming. Everyone has their own technique. This worked well for me, may want to see if it helps you. If not, there are other strategies.

(http://mikeleesolutions-web.sharepoint.com/Documents/Survival Stress in Law Enforcement.pdf) look at page 17.....



Thanks.



Wook
 
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Been there done that. As an EMT, I am not the primary provider for a chest pain call; however, I still like to observe/learn and do as much as I can. Seeing lifeless EKGs never grows on anyone. Keep your head up and look at the end goal of becoming a physician where you can do a lot more for that patient and hopefully you can bring life back into a great deal of them.


-Brett
 
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Great job keeping your composure on scene even if you feel panicked inside. This is going to happen no matter how experienced you get. There will be calls that fluster you, upset you -- but so long as you maintain control of yourself and the scene, then you are doing your job.

I've learned to calm down on the inside by remembering a couple key concepts:
-The emergency has already been happening for several minutes before you were even dispatched (i.e. before you even KNEW there was a call!). Between that, getting in the rig, and driving to the scene, this patient has already been dealing with whatever the problem is. Even if you took an extra 2, 3, 4 minutes to get there, it's probably not going to make a difference.
-It isn't your emergency. It's never your emergency. It's someone else's. Let them freak out before you get there, but when you arrive on scene, you bring order into the room. Every time. Next call, try just doing that. No rushing, no yelling... everything is calm. This has completely changed my EMS career.

Some of my best calls have been overdoses and while I've gotten "excited," I never "freak out." This is because: even if the patient is unresponsive and apneic on the floor, they've been like this for several minutes before I got there. If I need thirty seconds to figure out what's going on, it'll be okay. No rash decisions. And again, this isn't my emergency.

LAST BUT DEFINITELY NOT LEAST: As a BLS provider, if you get flustered, just focus on the ABCs. Seriously. I once spent a whole 20min trip to the hospital with a seizing 6yo suctioning his mouth to maintain his airway. Gunshots, stabbings, seizures, ODs -- ABC.

I know it's been a few weeks since you asked about this, but I hope this helps.
 
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Hey everyone, so I have an update since I posted this thread...
I made my first full arrest with just my partner and I (I was in orientation when I made my first full arrest) and I think I was able to remain calm because there was no yelling/freaking out, just my partner and I communicating. It was a nice change from the normal 'lets freak out because someone is dead on the floor in front of us' that I have experienced with other paramedics. It helps A LOT when the medic is calm, because it keeps me from freaking out as well.
I really appreciate your guys' support and encouragement.
 
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Further update for those still following... (I am frosted_flake, duo authentication locked me out of my account)
I have gained so much confidence not only in my skills as an EMS provider, but also as a person. I have had the privilege over the past few years working alongside some very supportive and encouraging partners.

...and I am now 7 months away from finishing my paramedic program :)
 
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Hey everyone, so I have an update since I posted this thread...
I made my first full arrest with just my partner and I (I was in orientation when I made my first full arrest) and I think I was able to remain calm because there was no yelling/freaking out, just my partner and I communicating. It was a nice change from the normal 'lets freak out because someone is dead on the floor in front of us' that I have experienced with other paramedics. It helps A LOT when the medic is calm, because it keeps me from freaking out as well.
I really appreciate your guys' support and encouragement.

The best advice I ever received was when I had just finished my medic training. You're the duck on the pond. No matter how much your legs are kicking, noone can see it above the water. Even if you have no idea what to do (which hopefully is not on every call) remain calm and just start the basics: monitor, iv fluids, o2 if needed, etc.

A lot of us want to move onto medical school. You'll be thankful looking back on everything you learned. You wont be the medical student who just stands there shaking when a code comes in.
 
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The best advice I ever received was when I had just finished my medic training. You're the duck on the pond. No matter how much your legs are kicking, noone can see it above the water. Even if you have no idea what to do (which hopefully is not on every call) remain calm and just start the basics: monitor, iv fluids, o2 if needed, etc.

A lot of us want to move onto medical school. You'll be thankful looking back on everything you learned. You wont be the medical student who just stands there shaking when a code comes in.
Thanks @ZhivagoMD . I will keep that advice in mind as I move forward. I definitely think that my EMS training (especially as a paramedic) will benefit me greatly once I am on rotations.

Two months until I am done with my medic!!!!!!!!! :)
 
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I remember my first code, asystole from the start. 15-20 minutes to the ED with the Lucas device. Alass, the guy was 71 and not in the best health condition. It's the only code I have worked, but I still remember it clearly. I'll be sure to take the advice from this section for future codes.
 
Just saw this and wanted to reply, even though this is a little old.

There's absolutely no shame in letting calls effect you. After 7 years EMS I learned that, for me, the healthiest way that I had to deal with some of the *$)% you will experience is to take 5 minutes behind the ER bay to cry for a few minutes if the call was bad. The only thing that gets to me is abuse, so whenever I dealt with a victim of abuse I'd take a few minutes outside the bay to have an emotional release before the next run. If you do EMS, especially outside of a campus, at some point you'll experience a side of life that you never would imagine existed, and you'll be in a position that you can't run away, so you did the right thing. Keep your cool and do your job like a professional. Afterwards, really important to figure out how you cope/heal.

If you need help, go get it. Cause as a medic I could walk into really horrific stuff completely zen and calm because I had really effective ways of coping, so I'd know that I would be ok no matter what got thrown at me. Some people minimize this, especially in commercial EMS agencies, but this is one skill that will be highly transferrable to your future career as a physician.

It's funny though, when I started volunteering as an assistant to the EMT (lol) I looked up at the medics being like 'no way I could do that. They're just too calm.' Feels like that was yesterday. God time does fly eh?

@frosted2 get at it!!! Finishing a medic program before applying to medical school was one of the best choices I ever made. Enjoyed financial security, and learned a lot from that profession that will help us to be capable in our future fields when that time comes. Enjoy the program! How's it been going?
 
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Just saw this and wanted to reply, even though this is a little old.

There's absolutely no shame in letting calls effect you. After 7 years EMS I learned that, for me, the healthiest way that I had to deal with some of the *$)% you will experience is to take 5 minutes behind the ER bay to cry for a few minutes if the call was bad. The only thing that gets to me is abuse, so whenever I dealt with a victim of abuse I'd take a few minutes outside the bay to have an emotional release before the next run. If you do EMS, especially outside of a campus, at some point you'll experience a side of life that you never would imagine existed, and you'll be in a position that you can't run away, so you did the right thing. Keep your cool and do your job like a professional. Afterwards, really important to figure out how you cope/heal.

If you need help, go get it. Cause as a medic I could walk into really horrific stuff completely zen and calm because I had really effective ways of coping, so I'd know that I would be ok no matter what got thrown at me. Some people minimize this, especially in commercial EMS agencies, but this is one skill that will be highly transferrable to your future career as a physician.

It's funny though, when I started volunteering as an assistant to the EMT (lol) I looked up at the medics being like 'no way I could do that. They're just too calm.' Feels like that was yesterday. God time does fly eh?

@frosted2 get at it!!! Finishing a medic program before applying to medical school was one of the best choices I ever made. Enjoyed financial security, and learned a lot from that profession that will help us to be capable in our future fields when that time comes. Enjoy the program! How's it been going?


Hi @Medic741!
It has been great so far. I have about a month and a half left in my program! I am hoping to start my MS program shortly and apply to medical school :)

Are you thinking of EM or do you have another specialty in mind??
 
So to anyone who has been following... I activated the cath lab today for the first time! I have seen it done countless times before but putting in the activation myself and calling in report was fricken awesome. I am so glad I did this (paramedic), I will be grateful for this experience forever!
 
So to anyone who has been following... I activated the cath lab today for the first time! I have seen it done countless times before but putting in the activation myself and calling in report was fricken awesome. I am so glad I did this (paramedic), I will be grateful for this experience forever!
Haha can't imagine the thrill of being able to do that yourself, congratulations.
 
I PASSED MY MEDIC CLASS!!!!! Next step is national registry... then medical school :)
 
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I PASSED MY MEDIC CLASS!!!!! Next step is national registry... then medical school :)

Congrats!!! Enjoy those 24 hour shifts of cash rolling in ;)
 
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Hey everyone! I am taking National Registry this Saturday :) Can't wait to report back with good news!!!!!
 
Update for those who have been following... I successfully passed BOTH written and psychomotor registry... I am finally a paramedic!!!

Can't wait for medical school :)
 
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