This guest post was submitted by paramedic Jay Reeves. He replied to the Everyday EMS Tips weekly enewsletter, “Do you know your stuff?”
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Great question, I’ll turn to my personal experience.
I graduated from paramedic school in 1991, my class was the first to take PALS as part of the program. It was a 1-semester credit course, just like ACLS.
Now, back then, ACLS was a pressure cooker, you worked on memorizing the algorithms until you could recite them forward and backward. I dreamed ACLS algorithms. When I went into the megacode, there was no way I was going to not know the next step, as long as the megacode stayed on script. Of course, it didn’t! Just like in real life the patient didn’t conform nicely into those little boxes with arrows going from one to the next.
When I arrived at my PALS course, I expected the same pressure. Now I expected to have memorize weight related dosing regimens and age related equipment sizes. I was delighted to be presented with a job aid, a laminated 8.5″ X 11″ card that laid all that out. The instructors said, “We want you to get these things right! It proves nothing if you memorize all this in class, but can’t apply it properly when you need to!”
The first step in becoming an independent, competent healthcare provider (beyond entry-level competency) is acknowledging that there is no way you will ever know everything, and being able to live and thrive in that condition.
As paramedics, there are an extraordinarily rare number of circumstances where we need to make things more complicated in order to improve outcomes. In my experience, I have found that when I’m stuck and unsure what to do, that returning to basics is good enough.
Oh yeah, and while making sure the patient has an airway, is breathing and has a pulse; I get out my job aid to help me figure out if there is something more I can do!
Jay Reeves BS, NREMT-P
Rochester, MN
jay.reeves@yahoo.com
