Emergency Department Technician stories

[Guest louisweil]

I just started working as an ED Tech at a major Philadelphia hospital/Medical Center after two years in the field as an EMT. The job has been a blessing both in terms of experience and the affirmation that this is the field in which I belong. I am using my EMT skills and learning more every time I work, not only about patient care, but about equipment, meds, and hierarchies within an ED setting. Seeing PAs work, and assisting them, has really been an elucidating experience and I am only three months in at this job.

 

I've seen patients intoxicated with K2 (a synthetic drug, OTC, which is destroying people's brain cells left and right), gunshot wounds, manual cardiac massage, stabbing victims, PCP patients, etc.

 

I'd love to start a dialogue with other pre-PA EMTs about street-level experiences as well as ED happenings. Please share some stories; give me gory, give me compassionate, give me humorous.

[EMEDPA]

not a story, just an affirmation that ED tech experience is great. I was an ED tech for 5 years before becoming a medic. Both experiences really helped me gain an exposure to emergency medicine, but in deifferent ways. Being an ED tech teaches you about the flow of an ER, common meds and procedures, ekgs, etc. being a medic teaches you how to do advanced procedures and "run the show" , improvising as needed, without backup. That is a skill I use almost every shift now at my rural solo coverage jobs. I think many folks in emergency medicine without an EMS bqackground become to reiant on subspecialists to do all their work for them. be independent. talk to a specialist if you need to, but if they tell you the same thing about the same type of pt 10 times, do it on your own without calling. I no longer call urologists for pts with most kidney stones less than 6 mm because I know what they will say. "outpt f/u, fluids, strain urine, control pain, give flomax".

I did call one over the weekend for a diabetic guy with a stone who was becoming septic from a concurrent uti and needed to be stented right away for a really big stone that was causing him to double his Cr from baseline.

[Nonlegit]

I've done both street and ED work myself now for close to 10 years (ED only anymore). One thing I learned is you will forever get new stories, as the human race constantly comes up with new nonsense. I'll start with one and then give some advice that I have learned over time.

 

The other day I was in triage, busy as usual. 40 in the lobby, 7 hour wait. A lady came in with c/o SOB, not really looking all that bad. Wants back now (you know where this going), gearing up for that lobby freakout. Well, I get her triage protocol done, walk out in the breezeway 5 minutes later and she is breathing INTO an infant ambu bag. Of course I take this, give her the shakedown on not going in my code cart for sh*t, and to basically get herself together. I get thoroughly cussed out, called a racist, and she left. A first for me, for sure. The ambu bag part.

 

Some tidbits: EMS teaches you independent thinking, as mentioned by EMED. You can really hone your investigative skills in the field, both by observation and by looking at your therapy/treatment/assessment and judging its efficacy. EM in a hospital setting is pretty different, but once you start honing your "spidey-sense", thats where the ED experience begins to shine.

 

-I don't care what service you run with, a humming ED is always busier in terms of pure volume. Learn to look at every single patient with a critical eye, and train your sick/not sick gut feeling. This might be the most important skill in all of EM.

 

-Don't be a ricky rescue/squirrel/whatever. Just don't, its damn embarrassing. Don't chase codes, traumas, tubes, whatever. Work hard, be engaged, seek out learning experiences. Don't ditch your assignment or I WILL HUNT YOU DOWN.

 

-LEARN. You can quickly fall into the trap of only knocking out your tasks and not spending the mental energy on the patients workup, espeically since you are responsible for none of it. Avoid this, and you can eventually become studly. Work up every single patient in your head like a provider would - dont neglect anything on the differential. Its ok that we don't have the training yet, you will miss things but the important part is you are training your mindset.

 

-LEARN pt 2: seek out new experiences. Assist with lines, learn how equipment operates or is set up and why, try to understand how and why they are doing what they are doing in the cath lab or OR when you drop someone off, etc.

 

-LEARN pt 3: get taught whatever task you are allowed within your scope of practice. Its extremely gratifying to me to teach new techs how to do both basic and advanced skills. Seek out a mentor and become well versed on how a crash tube goes down or a tooth gets pulled. I teach our residents splinting and our techs how to take manual BPs in a trauma, and everything in between. Both are enjoyable to me.

 

-Network: This helps in so, so many ways. In the 4.5 years I have spent at my current ED, I now know a TON of new-ish attendings all over the US in EM, surgery, and a couple other specialties. Don't be scared of current attendings either, many are quite friendly and are in an even more senior position that could come in handy in the future. Befriend all staff, and the world is your oyster. Surgical intern doing scut? Help them out, watch it pay dividends a couple years later when they remember how you helped them get suture from FT after it was closed down.

 

-Take care of the damn patients. Do right by them. The ED will make you angry at most people really quick, but that doesn't mean you can become jaded and cynical. It really doesn't. The jokes are fine, the mentality is not.

 

Work hard, and don't let the job get to you. Its a crazy world we live in, and in the end, you need to go home and not bring work with you. Tomorrow someone else will get shot, die tragically, or be diagnosed with cancer. Get your rest, because you need to be ready to rock and roll the next time. Never, ever think you know it all. You don't, and a paper will be published in 5 years to really embarrass your ass if you act too cocky.

 

That was stream of consciousness there. I might add some or edit as I reread it later. Hope it helps you. Off to my shift in the meantime.