I’ve always known that there was this hunk of muscle about the size of my fist in my chest. I knew it pumped blood through my entire body, and that as long as it kept beating at a somewhat regular pace, say about 80 beats per minute, that that was a good thing.
Then I started Paramedic school.
The Cardiovascular system is one of the more challenging chapters for many. Some dread it. I looked forward to it like a kid being let loose in Toys R Us with a million bucks. Or a certain medic student being let loose in a Coach purse store with 10 million bucks.
Yep. I’m a geek. Sue me :)
The more I learned, the more I wanted to learn. I would seek out cardiac patients during my ER time. I would frequently read articles from various websites and blogs written by people who have forgotten more about the heart than what I’ve learned (big shout out to Prehospital 12-lead and Paramedicine 101). When I couldn’t quite understand something, I went to my people. Blogdaddy Ambulance Driver, Medic Matthew, and JB.
I learned about the atria, ventricles, conduction pathways and coronary arteries. I learned about 3 leads, memorized rules to rhythms, and eventually began to understand what was going on in the heart to cause a certain rhythm to march across the monitor. We learned about AMI’s, and 12-leads, and how doing something as simple as moving V4 can mean the difference between nitro and fluids. I didn’t just memorize drugs and doses and that you push Adenosine really freaking fast, I learned the why behind it.
And that was just scratching the surface. What I’ve just begun to learn… It’s hard to wrap my head around.
We’ve been done with the chapters for a few months now, and I’m still eating up all of the information I can get my hands on with a big ole spoon. Today, for instance, was a very cool day. Today I was fortunate enough to be able to spend some time in a cath lab.
The first thing I learned was that I look awful in scrubs.
(And yes, that’s a Chronicles sticker on the back of my phone :)
And wearing boots certainly didn’t help.
Wow, way to get off track.
Not five minutes after getting into my lovely ensemble I found myself donning a lead vest and skirt, a cap over my hair and a mask. I was invited to watch someone have a dual chamber pacemaker put in. The Doctor, I wish I had remembered his name, was fantastic. He really took the time to explain what he was doing as he did it, and inviting me to stand directly to his right. I had a front row seat. And it was so unbelievably cool.
Electricity. It’s good stuff when it works. When Sydney Sinus gets sick, however, all kinds of wickedness kicks up. I watched the patients rate and rhythm change like the weather does in NW Ohio. Which is to say often and unpredictably. At one point there was a sinus arrest that lasted just long enough to make my heart race, about 15 seconds before returning to RSR.
The rest of my shift was equally as cool. I was able to watch a few PCI’s being performed, and watched with held breath as pefusion was returned to what had been a blocked RCA. And again, everything was explained to me as it was done, everyone went out of their way to answer any questions I had.
This is how it’s done, folks, these people were amazing. And I am so grateful for the opportunity that I was given to learn and observe.
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I’m within a few short weeks of finish the course, and I couldn’t be more excited. Right now my days are pretty much consumed by class and clinical time. The next 30 days, for example have me doing six 15-hour third rides on a life squad, two eight hour OR shifts for intubations, two OB shifts (cross your fingers, I still need a live birth!), seven ER shifts, a major exam and of course the days of lecture and lab.
Am I complaining? Absolutely not. Still, some days are easier than others, and I when I need a swift verbal kick to the backside, I know who to call. Honestly, though, I’m doing well. I knew this would be a challenge when I started, and it should be.
Take care ya’ll, and again, thank you for giving me this amazing opportunity! I wont let you down!
I’m envious.
I didn’t get to see any of that cool stuff until years after I was out of paramedic school.
Eat it right up, Epi. I’m envious, too.
Thanks, Ya’ll… It was one of those days I’ll never forget… Unbelievably cool.
I got to sit behind a glass window watching them do angiograms during my cath lab rotation. I’m jealous.
1.) No one looks good in scrubs, well except this one ER doc that I know but he could be wearing a burlap bag and he’d still look damn fine.
2.) Way to rock the boots, dork :-p
3.) This made me think of my first clinical experience in medic school, I had to observe a surgery which I thought was going to be lame, until I learned that I got to sit in and peer over the surgeons shoulder while he did a CABGx2 with aortic valve replacement. I was watching the PA procure the veins from the leg when one of the nurses nudged me and said “look at this” as they were cracking open the patients chest and I thought to myself “ZOMG!1!! that’s the patient’s fucking HEART”
And Matthew, that is why you are the best friend I’ve never met.
It’s great to read the obvious excitement in your writing, and it’s wonderful to see another great medic in the making!
I don’t know how it works over there but when we went through our OR and Coronary Care placements (2 weeks OR, 1 week CCU – Thats all) it was almost completely down to the student how the placement went. If you wanted to do the bare minimum (which some did) then you would have a pretty crappy time. If, however, they were like you and showed and interest and enthusiasm for learning, then everyone would go out of thier way to ensure they had some amazing learning opportunities.
I say this so that you realise alot of the great experiences that you are having are down to the type of student you are.
Keep going and soak it all in!!
Oh, and regarding Matthews comment about the CABG he saw, before I was a paramedic I was an OR nurse and one of the jobs I worked was in the Cardiothoracic theatres. Even after a year, I still used to get a little awe struck everytime we exposed someones heart and then stopped it!
Amazing stuff, and what must have been what started me on my love affair with cardiology.
Very cool stuff! I feel all nerdy just reading what you’ve written; can’t wait until I get to see some of this stuff!
I want to forward this blog post to every slack-assed EMT student I ever had the opportunity to jack up on a rotation. You get exactly as much out of a rotation as you put into it and having a good, enthusiastic attitude and a willingness to learn makes all the difference in the world. I was a holy terror on my clinical students on the rig and in the ER (our program used to use clinical preceptors to run herd on the students in hospital), demanding that they PROVE their knowledge before stepping into a room with a patient for something even as mundane as a dressing change or as exciting as pushing Adenosine (I still hold my breath a tad too long when I give it).
All I have to say is that I’d kill to have a student as enthusiastic as you are. I hope your remaining rotations are as informative as your cath lab trip. A tip on the OR/Anesthesia rotation: If you know someone up there, even if they are a scrub tech or circulator, ask them who the CRNAs are that are the most pleasant. Most everyone will be willing to help you, but be prepared to have your airway management skills questioned, especially BMV usage. EMTs and Paramedics are notoriously undertrained when it comes to bagging and it makes a huge difference. Show your enthusiasm and your willingness to learn new things and the intubations will come pouring in. Trust me, my lovely, CRNA wife spends a lot of time complaining about the attitude of the P students the local program sends to them with the attitude that ALL they are there to do is place tubes when they can barely ventilate a patient with simple adjuncts.
Lord, I sound like an old codger Paramedic when I comment on here.
Keep up the good work, Epi!
Epi, I got to say that you look damn fine in scrubs… and you know how I love the combat boots… Cardiology was long been one of my weaker points… I wish I got it like you do! JS