Perfecting Trauma Naked and the Medical Touch

There was one last test being administered and then we would all find out if we had passed or failed. Each test had a time limit, some were 10 minutes while others were allotted 15. It seemed to take forever before the last person walked through the door and finally the torment would end.

It was the week before my EMT class began that I told my neighbor how coincidental it was that I had chosen to do a rapid progression base building program and a rapid progression EMT course in the same summer. It would be fair to wonder how a competent EMT can be produced in such a short time, but then I would remind you that there have been 172 hours of classroom time and unimaginable hours of study in between. The best analogy I can summon is learning a new language by total immersion.

No doubt I spent a good part of the first week in shock. I called my son on the way home one night and confided that I didn’t know why I was doing this. He said, “Mom, you like to help people and this is going to allow you to help a lot more people.” His pep talk got me through the first week. Then came the second week.

We were studying in the classroom during lunch one day when a conversation came up about everybody’s favorite class in college. Some enjoyed biology and others chemistry – more than half of them were pre-Med students, two of them sat at my table. Hannah explained that she was in advanced curriculums throughout high school and had earned college credits before she ever got to college. Somebody said, “So you were one of those kids.” My thoughts exactly. Clearly this was a place I did not belong, and I was scared.

I missed at least 2 hours of Jono’s lecture while I carried on an argument in my head. Why should I continue this struggle? It was not unlike the conversations I have had in the middle of a race on whether to continue the pain just to cross a finish line. I thought through how I would tell Jono and how I would gather my books and leave. The next morning, I sat in the quietness of our family room surrounded by that day’s quiz material and considered deleting this blog to avoid having to write about the experience. That day I passed my quiz and decided to give it one more day. I could run just one more mile and then decide.

I wasn’t the only one struggling. One guy had the flu for several days the first week and another one had strep throat the second week. Bobby got a stern scolding about his study habits before he finally started earning passing marks.

Over the weekends we did our 6-hour rotations at a local EMS unit or Emergency Room. My second rotation was in the E.R. I saw 23 patients during that 6-hour rotation, including a helicopter transport. Between all of us, I think we saw just about every medical emergency possible. On Mondays, we would go around the classroom giving the highlights of our shift. Nick had been working with the EMS Squad when a call came in for a drowning. They performed CPR for 15-20 minutes on scene and continued CPR en route. By the time they reached the E.R., Nick said he was weak, his calves were on fire and he was mentally exhausted. Victoria was at the receiving E.R. and watched as CPR was terminated. They were visibly affected by the experience.

Somehow we all survived to see the last week of class. Each day started with a quiz in the morning and a 120-question test in the afternoon. By Thursday morning we had read all 1097 pages of our book so there was a mass casualty incident with actors instead of a quiz. The first incident occurred when a 17-year old boy driving his pregnant sister to the hospital went unconscious and hit a pedestrian. I was assigned to the pedestrian. Bobby helped me apply traction to her fractured femur and then we put her onto a backboard. It was not until afterwards that Jono explained to the class that the backboard was upside down. In the stress of the moment, it’s amazing what can go wrong.

When the next group responded to the same incident, the 17-year old driver had a seizure…. for real. Of course, there were plenty of paramedics on hand to respond to the emergency and he recovered quickly without issue. Jono explained that it was quite possible someone had caused the seizure by checking his carotid pulse on both sides simultaneously. Being an actor for a group of novice EMT students has its own set of perils.

Finally, it was test day. A church in town had agreed to allow us to use their facilities for the testing. There would be a 150-question test in the morning with a time limit of 1 minute per question. For the practical tests, we would be directed to a classroom in the adjacent building where a patient (actor), two imaginary assistants and a proctor would be waiting. One room was called Trauma, the second Medical and the last Pediatric. Seven practical tests in all.

We were required to pass the written test with an 80% or higher and fail no more than 3 of the practical exams. Anyone that failed a practical exam would be given one additional opportunity to pass, but each test must be passed with no more than two tries. Jono assured us some of us would not pass on the first try. He drew names out of a hat to determine the order of testing.

First up for me was little Billy (Pediatric). I administered oxygen and splinted his leg. When I finished, the proctor said thank you but showed no reaction whatsoever. We were not to know whether we passed or failed any test until everyone had finished every test.

Next up was the heart patient, Jake. I went through the script I had practiced. “What were you doing when you started having chest pain? Does anything make it better or worse? Do you take any recreational or ED drugs?” On and on. Jake collapsed – I was expecting it.

Last was the Trauma patient, a motorcyclist that had wrecked and was not wearing a helmet. He was wearing Randy’s jumpsuit (our resident dummy from class) and after I had cleared the airway, administered oxygen and checked his circulation, I went about ripping the jumpsuit away to check for bleeding. He had contusions (bruises) on the left side of his head and abdomen, blood spurting from his left elbow and a crushed lower leg. I worked my way through each intervention and had him ready for transport in under 10 minutes. This time I managed to position the backboard with the narrow part pointing down and strapped him in.

Jono had suggested the Wilderness First Responder students should take the Wilderness EMT test while we were waiting our turn for the practicals and get it over. I answered 10 or 15 questions at a time in between rehearsing for the next practical exam. Two written tests and seven practical tests later, I was finally done.

Jono and Karl had positioned themselves behind the counter in the adjoining kitchen of the church fellowship hall and one by one we went in to discover our fate. Some came out agonizing over which practical they had screwed up and one or two had both thumbs up – they had passed everything. My name was called and I slowly walked in.

Jono very seriously asked, “So, which part do you think you struggled with?” I said, “Oh my gosh, I don’t know.” I dreaded him telling me. Suddenly, they both smiled and told me I had passed all of the tests! I could not believe it. There was such relief. I can not even describe the relief. Out of 16 students, four of us had passed all of the tests on the first try.

It was when I went to bed that night that I told my husband he must have left the light on outside. He said, “No, its the moon.” I jumped out of bed and said, “Let’s go look!” It was beautiful and filled the sky. I looked up the mountain where the moon seemed to illuminate a straight path to the top. It made it look so easy to just walk right up to the top of the mountain… the moonlight led the way. Then I realized, I’ve walked those mountains and there is no clear path to the top. Sometimes it’s steep and rocky. You run into things you can’t get around easily. It’s hard to climb a mountain.

My husband said, “That’s true. Everyone has to find their own way.” That has certainly been true for me.