Any recommendations for EMT field guide books?

[Guest willdog77]

Hi all,

I'm a new EMT-B and was wondering if anybody could recommend any pocket / field guide for BLS? I am looking for a way to do a quick refresh en route to a call, since I am still 'green' and don't have much EMS experience beyond my EMT cert course and a few months with my VAC (and calls on my shifts have been few and far between, so not seeing a lot of action). I don't want to have to review the entire course text if there's a good guide out there that I can carry with (I'm looking specifically for something that can help with e.g. what the SAMPLE question variations should be for various calls, and other info that normally can only be learned through time in-service). I've seen a couple of standard field guides but wondering if they are worth the $30 or so...

Any / all thoughts (including whether this is a bad idea) are appreciated -

Stay safe

-willdog

[Future Fireman 4]

Informed has a good EMS field guide for Basic & EMT-Is out there. I paid $24 for mine, and I used it as a study guide for the state exam. Very informative and handy, and includes a prescription drug reference and a poison reference as well.

Well worth it, IMO.

Mike

[mvfire8989 22]

Hi all,

I'm a new EMT-B and was wondering if anybody could recommend any pocket / field guide for BLS? I am looking for a way to do a quick refresh en route to a call, since I am still 'green' and don't have much EMS experience beyond my EMT cert course and a few months with my VAC (and calls on my shifts have been few and far between, so not seeing a lot of action). I don't want to have to review the entire course text if there's a good guide out there that I can carry with (I'm looking specifically for something that can help with e.g. what the SAMPLE question variations should be for various calls, and other info that normally can only be learned through time in-service). I've seen a couple of standard field guides but wondering if they are worth the $30 or so...

Any / all thoughts (including whether this is a bad idea) are appreciated -

Stay safe

-willdog

While I think that its normal to feel uncomfortable as a new EMT, refreshing on the way to a call is really not the way to go. You owe it to your patients to be a competent provider before you respond as the EMT on a call. If your VAC is pushing for you to ride solo before you think your ready that is something you need to address. As far as medical histories go SAMPLE should be about the same for all of your patients. Your OPQRST questions really don't change either. The basis behind that is to get an idea of what is going on with the present illness, and one of the best ways to do that is with open ended questions if you listen to your patient they will tell you most of the pertinent details you need to know. Just remember your ABC's and use some common sense when your getting a history and you will be fine.

- Josh

(EMT-B, MD Candidate, NYMC)

[Future Fireman 4]

Josh, that may be true. But for your patient's medications that you don't know do what, it can pay to have that pocket guide.

Case in point:

72 y/o male with a meds list longer than the Declaration of Independence. On that list there's Alendronate, Aggrenox, & Pacerone.

Now, if you didn't have that pocket guide, how else would you know that Alendronate is for osteoperosis, Aggrenox is an anti-platet,& Pacerone is an anti-arrythmic?

Don't get me wrong, if you're literally being a cook book EMT and using the field guide to get you through a call, there's a major problem. But that doesn't mean it shouldn't be used when appropriate.

Mike

[mvfire8989 22]

Josh, that may be true. But for your patient's medications that you don't know do what, it can pay to have that pocket guide.

Case in point:

72 y/o male with a meds list longer than the Declaration of Independence. On that list there's Alendronate, Aggrenox, & Pacerone.

Now, if you didn't have that pocket guide, how else would you know that Alendronate is for osteoperosis, Aggrenox is an anti-platet,& Pacerone is an anti-arrythmic?

Don't get me wrong, if you're literally being a cook book EMT and using the field guide to get you through a call, there's a major problem. But that doesn't mean it shouldn't be used when appropriate.

Mike

I see your point with that. However, for the most part having an intimate knowledge of that medication will not affect your patient care at the EMT-B level since you won't be addressing the underlying conditions it the field. It is far more important for the ED to know what meds the patient is on than it is for you to know their action.

[Future Fireman 4]

This is true. But the medicines can give you a clue as to what's going on for your patient.

I'm not going to get into a debate over EMT knowledge and scope of practice in regards to understanding medications. But the more information that the EMT can use to his/her advantage, the better.

As for Willdog77, I apologize for getting your topic off-track. By all means, if you're looking for a handy pocket guide, Informed is the way to go.

Mike

[SRS131EMTFF 471]

Hi all,

I'm a new EMT-B and was wondering if anybody could recommend any pocket / field guide for BLS? I am looking for a way to do a quick refresh en route to a call, since I am still 'green' and don't have much EMS experience beyond my EMT cert course and a few months with my VAC (and calls on my shifts have been few and far between, so not seeing a lot of action). I don't want to have to review the entire course text if there's a good guide out there that I can carry with (I'm looking specifically for something that can help with e.g. what the SAMPLE question variations should be for various calls, and other info that normally can only be learned through time in-service). I've seen a couple of standard field guides but wondering if they are worth the $30 or so...

Any / all thoughts (including whether this is a bad idea) are appreciated -

Stay safe

-willdog

I think any new EMT has gone through the same emotions, fears and thought process you are going through currently. I do have to say however that if you have passed the NYS EMT-B class you have displayed the minimum number of qualification required to earn you your brand new certification, congratulations. With that knowledge in mind, remember, in passing the test, the state has certified that they believe you capable of properly treating a patient within the EMT-Bs scope of practice. Essentially, you should already know everything you need to know to properly and effectively do your job to standard. Brushing up in the back of the rig wont help you immobilize an extremity any better than practice, brushing up wont decide for h your O2 flow rate, brushing up wont help you properly manage and treat your patient. The good news is however, you should know all this material. You may not feel comfortable now sitting in your living room thinking about it, but when push does come to shove, you should be able to fall back on your training and do everything you should be doing without even thinking. If you don't believe me, try running through situations with your training officer or at home with your family...I would bet money you do your job fine 99/100 times. Remember, you are trained to do this, you have the skills, knowledge and motivation...you are just lacking the experience, and experience comes with time.

I leave you with a little anecdote. I have been an EMT-B for two years. After running on rescue squads, ambulance corps and fire departments as an EMT for a year and half, I moved to Puerto Rico for the summer. When I got back, I had not practiced EMS in 4 months. I left in May got back in August, about a week after I got back, as we were squaring gear away in the house from an AFA, an extremely serious MVA occurred down the road. Since I was the most experienced EMT (yes, I know at a year and half its hard to call me experienced) I ended up as the primary EMT on the primary ambulance assigned the highest priority patient. The patient was the driver of a van involved in a 2 car head on MVA found unresponsive outside of the van. Even though I had been away for 4 months not practicing my skills, I was able to do my job autonomically, I, much like you will be able to do, was able to fall back onto my training, skills and experiences and manage the scene and the patient effectively. Obvious this was a load and go patient so the medic, me and the crew didnt even have time to get a name let alone sit around thinking about our treatment. We acted, we did what we were trained to do, and so will you. Besides the medic who came later and my driver, my other crew member was an EMT-B who received his card in the mail less than two weeks beforehand. He remarked to me after the call, he don't know what happened or how he did it, but some how he was not only to do his job, he was able to do his job well. In fact we were both told by our chief and the medic that he did a great job. When it comes time to do your job, have no doubts that you will do it fine. You are trained and skilled, you have the knowledge and the desire, you just need to be given the opportunity to stretch your sea legs and do your job too.

Plain and simple, you can't be expected to know everything and you can't be expected to be perfect every time. Give yourself a chance to get your bearings and head on straight. Once you have tech'ed a few calls you will realize that you are more competent than you think, it just takes practice, patience and time.

Edited September 18, 2011 by SRS131EMTFF

[Guest willdog77]

While I think that its normal to feel uncomfortable as a new EMT, refreshing on the way to a call is really not the way to go. You owe it to your patients to be a competent provider before you respond as the EMT on a call. If your VAC is pushing for you to ride solo before you think your ready that is something you need to address. As far as medical histories go SAMPLE should be about the same for all of your patients. Your OPQRST questions really don't change either. The basis behind that is to get an idea of what is going on with the present illness, and one of the best ways to do that is with open ended questions if you listen to your patient they will tell you most of the pertinent details you need to know. Just remember your ABC's and use some common sense when your getting a history and you will be fine.

- Josh

(EMT-B, MD Candidate, NYMC)

Thanks Josh- just to be clear / fair, my VAC isn't pushing me to ride as solo certified EMT but realistically I expect it could happen (and it has happened once albeit with a driver who was an expired EMT w/9 years experience). I appreciate your input (and I have let them know that I am not yet comfortable as a solo EMT; and they've been very responsive and helpful throughout my first couple of months).

I'm still acquiring 'firsts' (first major trauma, first LOC, first CPR, etc) and just want to have something in-pocket that I can quickly refer to as I run through protocols / procedures in my head while en route.

[Guest willdog77]

Thanks, very much appreciated.

[Guest willdog77]

Josh, that may be true. But for your patient's medications that you don't know do what, it can pay to have that pocket guide.

Case in point:

72 y/o male with a meds list longer than the Declaration of Independence. On that list there's Alendronate, Aggrenox, & Pacerone.

Now, if you didn't have that pocket guide, how else would you know that Alendronate is for osteoperosis, Aggrenox is an anti-platet,& Pacerone is an anti-arrythmic?

Don't get me wrong, if you're literally being a cook book EMT and using the field guide to get you through a call, there's a major problem. But that doesn't mean it shouldn't be used when appropriate.

Mike

Mike thanks- I think you made my point better than I did; that I do NOT plan on / feel I need the guide to get through the call (I did well in both practicals and writtens and have already felt my training kick in when an 'impromptu' i.e. off-duty patient took a tumble), but would like something like a pharm guide that can help decipher a bunch of meds I've never seen before.

[ckroll 101]

I think any new EMT has gone through the same emotions, fears and thought process you are going through currently. I do have to say however that if you have passed the NYS EMT-B class you have displayed the minimum number of qualification required to earn you your brand new certification, congratulations. ...

Well said SRS131EMTFF. You are wise beyond your years. An EMT card is only an opportunity to learn the craft. I applaud willdog77 for wanting to be a better EMT. Put down the books, let go the pocket guides. Look at your patient. How is he breathing? How does he look? Trust your instincts, teach yourself the craft. Best of luck to you, never stop learning, never stop wanting to be a better provider.

[RNEMT26 40]

No pocket guide can ever replace common sense and a gut feeling. The way you get good at it is by doing it as much as you can and asking questions when there is something going on with a patient that you dont quite understand. Some medics love to teach, other do not. Me personally I like to teach new EMTs because I enjoy what I do, outside of EMS and FF I also work as a Critical Care RN, so I'm a bit smarter and have a considerably deeper knowledge base than the average EMT/Medic. The best thing to do is learn not only what to do, but whyyyyy you're doing it. Too many people come into EMS and simply just do things because the protocol says to do it. I'm a big believer in that no protocol is a substitute for common sense. Always trust your gut.

[NurseMedic 15]

No pocket guide can ever replace common sense and a gut feeling. The way you get good at it is by doing it as much as you can and asking questions when there is something going on with a patient that you dont quite understand. Some medics love to teach, other do not. Me personally I like to teach new EMTs because I enjoy what I do, outside of EMS and FF I also work as a Critical Care RN, so I'm a bit smarter and have a considerably deeper knowledge base than the average EMT/Medic. The best thing to do is learn not only what to do, but whyyyyy you're doing it. Too many people come into EMS and simply just do things because the protocol says to do it. I'm a big believer in that no protocol is a substitute for common sense. Always trust your gut.

I agree with most of the above post with the exception of this:

outside of EMS and FF I also work as a Critical Care RN, so I'm a bit smarter and have a considerably deeper knowledge base than the average EMT/Medic.

Not to hijack the thread and start an "us vs them" match, but I would caution strongly against statements like this. I actively practice in both arenas (15 years urban 911, 11 years critical care RN in various specialties), and consider myself a proficient provider in both roles. I would never claim to be smarter than anyone - it's just asking for a "humbling" experience. Just my two cents.

Back to your regularly scheduled discussion...

[ckroll 101]

Yeah, it does bring to mind my favorite from the paramedic's prayerbook:

Dear Lord, Let me be at least half as good as I think I am.

If Willdog is looking for a useful pharm guide, I suggest he write his own as a learning exercise. There are basic and expanded sets of meds for cardiac issues, chf, diabetes, respiratory, anxiety, seizures. A simple list means a PCP has it under control, multiple meds for the same purpose means he or she doesn't.

Medications are an excellent place to get information. It tells the provider what the patient's PCP thinks the issues are and it is what most ED physicians want to know, so Willdog, your instincts are good.

That said, as a brand new medic I packed a drug guide with me, and not a pocket guide [unless one were a kangaroo]. I had a patient that looked like he was dying. He was on a new medication, I looked it up and he had absolutely every side effect. I read him the list and we both had a good laugh over it. He still felt terrible, but his vital signs improved.

[RNEMT26 40]

I agree with most of the above post with the exception of this:

Not to hijack the thread and start an "us vs them" match, but I would caution strongly against statements like this. I actively practice in both arenas (15 years urban 911, 11 years critical care RN in various specialties), and consider myself a proficient provider in both roles. I would never claim to be smarter than anyone - it's just asking for a "humbling" experience. Just my two cents.

Back to your regularly scheduled discussion...

Ive been in a couple humbling experiences actually but ya know there are some pretty stupid medics and emts and also some stuid nurses with whom i wouldnt let touch my dead dog

Edited September 19, 2011 by RNEMT26

[FFEMT150 214]

If you are looking for a good quick drug ref. there is one out for smart phones called "pocket drug guide" or you could just grab an ems field guide at barns and noble. Only costs about 9 bucks. As far as the whole "new guy feeling", It goes away after a few runs. Have faith in yourself and your training and rember, air goes in and out, blood goes round and round, any variation of this is a bad thing.

[ckroll 101]

Ive been in a couple humbling experiences actually but ya know there are some pretty stupid medics and emts and also some stuid nurses with whom i wouldnt let touch my dead dog

If you're so fantastic, then why is your dog dead?

[Ga-Lin 86]

Hi all,

I'm a new EMT-B and was wondering if anybody could recommend any pocket / field guide for BLS? I am looking for a way to do a quick refresh en route to a call, since I am still 'green' and don't have much EMS experience beyond my EMT cert course and a few months with my VAC (and calls on my shifts have been few and far between, so not seeing a lot of action). I don't want to have to review the entire course text if there's a good guide out there that I can carry with (I'm looking specifically for something that can help with e.g. what the SAMPLE question variations should be for various calls, and other info that normally can only be learned through time in-service). I've seen a couple of standard field guides but wondering if they are worth the $30 or so...

Any / all thoughts (including whether this is a bad idea) are appreciated -

Stay safe

-willdog

Chris???,

Glad to hear you finally got in & started at PVAC. As others have already posted, what you're feeling is nothing new, time & experience will solve it. I'm not a big fan of "cramming" for the "big exam" enroute to the call but reviewing, practicing with your peers at base or at home prior is a better way to go. Believe it or not, riding the "second seat" beside the driver is enough work, working radios, looking at maps & helping look out for hazards along the way. You won't have time nor will you remember much.

There is no substitute for a concise & consistent plan for gathering info. Rule #1 You control the interview don't let yourself get sidetracked with info before Y0U are ready for it. Most new providers ( both basic & advanced) have difficulty remembering all of the info gathered (time & experience also helps with this). In the meantime I frequently suggest to people (and organizations) to make up a pt. assessment clipboard. Go to Staples, purchase a see thru clipboard. With a permanent marker list your OPQRST & SAMPLE down one edge. Along the top list Time/ P/R /BP /spo2 /Temp& block out 3-4 lines below each to record. Cover entire board with a sheet of clear acetate that can be flipped up when you need to record something, which you will do with an erasable marker or grease pen. This will help you to stay on track & will help when you need to complete your PCR after the call. On the backside you can make-up 3x5 index cards with other symptom specific questions such as

ABD Pain

Nausea /vomiting-------Yes---No

color/consistantcy

Black--Red--Green--Yellow/Thin--Clumpy

Last Bowel Movement

color/consistantcy

You get the idea

Laminate each card to protect & somewhat preserve it. Review & update as needed (as you experience & learn more)

You can then attach a flip type chart of your cards on the back for quick & easy reference. Hope this helps. Feel free to PM me or give me a call & we can talk more. Good Luck! PS I'm still looking for that movie. That new one that just came out looks just as scary "Contagion" I need to see it although the cause is different some things, like the breakdown of society is similar.

One last suggestion. Find a mentor. Another EMT who is knowledgeable & caring &whom you respect. Unfortunately suchpeople (who are both capable & willing) arehard to come by. See you around.

Edited October 6, 2011 by Ga-Lin