Clinical Depression

I was looking over the titles from the last few posts and noted a depressing theme. I decided to stick with it as I have just finished signing up for this semester's clinical shifts. I officially have only eight days off from now until Christmas Eve. That sucks, but it is better than last semester where I went for almost four months with two days off.

I am looking forward to clinicals a little bit. We get to cooler stuff this semester; two shifts with the air ambulance, more cardiac stuff, pediatrics, and OB. It should be fun. Just a lot of work.

Things have quieted down a bit here. Tourist season is ending and mud season has began. It has rained for days and there is mud everywhere. Fall is certainly here. There is actually snow on the mountains already. That is excellent for September.

Hopefully with clinicals around the corner I will have some interesting medical stuff to relate. Calls have been pretty mellow around here. It seems like this is the time of year when the older population gets sick and need transporting. Structure fire season is at hand though, as people fire up there clogged up fireplaces and old stoves. No matter what, things are bound to get more interesting around here as I get busier and busier.

ACLS Blues

It's fall now, and raining out. I was looking back over this blog and noticed that I started writing last spring during a rain storm. That's funny I thought. Then I was looking forward to a summer off and now I am gearing up for another semester.

Big test tomorrow. ACLS stuff, you know the stuff I have bitching about for the last few posts. I just want the cardiac section to be over with. I have everything memorized, and I have taken the practice test six times today. I think I am going to make it, and I am fairly certain that some beer drinking will be in order tomorrow nite. Wish me luck.

The Tortuous Death of a Paramedic Student

Perhaps it is just me being a big baby, I don't know. I need the input of other recently graduated or currently enrolled paramedic students out there. Is paramedic school this hard for everyone?Christ, I have never had to memorize so much shit in my life. I am down to line 46 of my 86 line long ACLS protocols. Everyone I know just looks that stuff up in the manual. An example of the fine reading and memorizing I am undertaking:

• 15. Provide CPR for 5 cycles without rhythm check. Establish advanced airway then chest compressions should be delivered at a rate of 100 / min with ventilations of 8-10 / min.
• 16. Check rhythm every two minutes.
• 17. Administer one antiarrythmic drug:
• 18. Amiodorone 300 mg IV/IO push (may repeat once 150 mg in 3-5 minutes)
• 19. Lidocaine 1 to 1.5 mg/kg IV/IO push then 0.5 mg to 0.75 mg Q 3-5 max dose 3 mg/kg.

Argh! It goes on and on... but hey, at least I busted that out from memory. It is slowly settling in. At least I am at the point where the shit I am being made to memorize makes sense to me and I can actually envision a long term goal here. Last year during pharmacology all we did was memorize drug information without knowing exactly what the point was... it is better now.

I should not bitch, but this program is slowly sucking the life out of me. At least the world at large can be sure I will know what the hell I am doing when I get out of school.

I seem to be holding my own at school, at least for being the old guy. I am ready to hit the streets and use some of this stuff though. I am not sure where I will be going for the bulk of my clinicals. I want to go out of state. I asked my professor about it and said that he doesn't make a habit of discussing clinicals until he sure that the subject he is talking to will be passing, and no is ever sure of passing until after cardiology. I don't think he needed to say it so bluntly, but hey, cardiology is hard. I have a wager on a few of the guys in my class. We shall see. I know I will be passing... ergh, at least I hope.

Aside from all that EMS stuff, I did a drive through on a recent large wild land fire that I was on. All the houses we were able to save had signs on them thanking the firefighters for helping. That made me feel good. I only wish we could have saved all of them. There was quite a few homes lost in this last round of fires.

Trading a Life for an Education

So there is a saying in paramedic school... something to the effect of, "You either get divorced or get married in Paramedic School." Something like that. Well, not true for me, at least not yet, but for two of my close friends the divorce part is true. I can understand, certainly my wife can understand. Never before have I felt the pressure, stress, overwhelming sense of ingorance, and sheer helplessness that I have the last year (particularly the last week) of school. Now my friends have to deal with a divorce and school.

Summer was a cruel taste of life away from school. I have been in school for three years now, first finishing my Fire Science degree, and now half way through AAS Paramedic. I have also worked full time and tried to be a good husband, work on my house, pay bills on time, mow the lawn... It is taking a toll on me, I just want to be done.

But alas, I should not complain too much. I did manage to get the job I wanted in the middle of all that, and I have kept up good grades, and even seem to find time to plod away at blogging a bit. The first week of school just has me down in the dumps. Our merciless instructor has us memorizing ACLS protocols, reading like 200 pages, and we are being tested on cardiac rhythm rules with no compassion whatsoever. It takes the life out of a guy, you know? I am sure that most of you out there do...

The reward is great though. Yesterday I got to run my first ALS call. Of course I had a paramedic standing over my shoulder, but I did get to call the shots on this one. A standard diabetic emergency, altered mental status, BG of 34. Got an awesome line and gave D50. Problem saved, life saved, everyone was happy. I was thrilled. It is cool to pull from all that knowledge that has been memorized and stomped into my mind and come up with a field diagnosis that is correct and then take the steps to treat the underlying problem. It was truly awesome.

I think I need to think of those moments when I get down about cramming shit into my summer-atrophied mind. One day I will diagnose multi-focal atrial tachycardia or Wolff-Parkinson-White syndrome and think this was all worth it.