Life of a Trainee Paramedic

The last two days I’ve spent at Uni with the other students preparing for our exams. there termed OSCEs which I finally found out means ‘Objective Structured Clinical Examination’.  Why they cannot just call them exam’s I don’t know.  They will involve around 8 or 9 ’stations’ where there is a different situation in each, with two of them being computer based.  We have an ECG rhythm test, an MCQ paper of the drugs for asthma and anaphylaxis (which we have already done a few months ago, but they want to give it us again), a medical scenario, a paramedic assist scenario, Intermediate and paediatric life support scenario’s, a test on the uses of oxygen and entonox plus a trauma scenario.

The paramedic assist scenario involves us finding a patient collapsed on the floor who as no breathing and we have to start CPR.  After the 5th cycle of CPR, and after we’ve checked the rhythm on the defib, a ‘Paramedic’ and ‘First Responder’ arrives to assist.  We give a description of the situation and ask them to take over the CPR while you can start getting the equipment ready.  We have to be able to show that we can assist with intubation, cannulation and setting fluids up by getting all the equipment ourselves and handing it over. We have to keep an eye on the time as there is a 15min time limit, but we also have to be aware of how many cycles of CPR there have been.  After every 5 cycles of CPR, you have to recheck the heart’s rhythm and determine whether it is shockable or not.  If it is, we do so, and if not then CPR is resumed for another 5 cycles.  It was our first attempt at this scenario and it was very hard to try and remember everything and to get it done quickly.  A lot of us wondered why we hadn’t done this scenario before so that we could have more practice before our exams which are in less than two weeks.

The medical scenario we think is going to involve a diabetic and the drugs associated with that.  How we assess and question the patient is also going to be marked so see if we can get a good and accurate history from the patient.  The ILS and paed’s life support scenario’s are just that,we us showing that we know the guidelines and what order to do things really.  We were supposed to be at Uni till 5 on both days but we ended up leaving around 2.30-3 because of staffing problems.  I was quite happy to leave then, but I would of stayed if I knew we were going to do something.  Some of my colleagues were less than impressed as they as they had arranged childcare for no reason, and it was annoying that the staffing situation couldn’t have been sorted before we got there, after all these dates have been known all year.  We have two days again next week practice, but were having the ECG test on friday morning to get it out of the way.  The test wil be 12 question’s long and we need to get at least an 80% pass rate so it which means when rounded we next to get 10/12.  To be honest I’m not anticipating it will be that hard, as long as we know what the rhythm’s look like and which rhythms are shockable or not, then it should be fine, but you never know.

At badminton this week I was talking to a lady who had suffered a serious accident 18 months ago being hit by a car at 70mph, when your a pedestrian.  She was in hospital for around 6 months and during that time contracted MRSA.  She made a point to me that it was very easy for bugs to pass round because of the simple thing of people sharing the magazines that they had bought or the exchange of money that comes from the tea trolley.  Magazines and money obviously don’t undergo disinfection procedures and was a very easy way for germs to pass from patient to patient.  How far though do we need to go to stop the spread of the germs.  Would you like being in hospital for a huge length of time without having anything to read and having something from the trolley.  I know everyone would want to get better, and not contract anything while in hospital, and these are only little examples, but how far really would it have to go? Who knows?

TP