A Good Start

Six months ago last Sunday I completed my first six months as a Paramedic on the street.  Five of those months have been solo and it has been the most fulfilling six months out of all the years prior in EMS.  I have withheld treatments that in the end I kicked myself in the ass for withholding.  I have been called to the carpet by the armchair quarterbacks and came out of it better at charting.  I have learned how valuable and irreplaceable a strong EMT is when the shit hits the fan with multiple patients and no second truck.  I have learned a whole new way to practice medicine and remember why I thought this was the best job when I started years ago.  But, there is one lesson that I have learned that is the most important thing that cannot be taught in class.

Sometimes you have to go with your gut feeling.  Monday I responded to a call of a weakness and dizziness.  On patient contact I really was not given anything concrete to go with other than sinus tach, confusion, weakness, and hypertension.  History was a little concerning with three weeks worth of spells of vertigo still undiagnosed.  Gut feeling was CVA even though I had no clear symptoms with a FAST exam.  I went with it and was off scene in five minutes delivering the patient to CT in another nine.  Yes, patient contact to CT was 14 minutes.  On arrival those clear signs were beginning to show with facial droop and more pronounced left sided weakness than right side.  An awesome ER staff and Doc who trusts us and our field judgments started TPA within 70 minutes of onset of symptoms.  The results were a patient who had no deficits being transferred to the ICU later that evening.

I cannot begin to explain how rewarding and fulfilling it is to know you started a process that involved a whole bunch of people and it literally gave someone their life back.  If there is one thing I can suggest to a new paramedic or if I was allowed to share one piece of advice to others it has to be what my trainer told me:  "Sometimes you have to listen to what your gut says and run with it."  The next would be sometimes we do not need to inflict our skills for a best case outcome.  The only advanced skills I did on this patient were an EKG to rule out dysrhythmia along with an IV en route to the ER.

I am looking forward to the next six months and years to follow.  I have a full-time job in the works for the end of this year or beginning of next year.  I have been working full-time hours in a part-time position for the last six months and will be in heaven when I do not have to report to my current full-time job in the future.