Testing Trauma Naked and the Medical Touch

A little known fact of my life is that I am (still) a National Registry and Wilderness EMT. It was one of those things that seemed interesting to do at the time, four years ago, and I never gave much thought as to how or if it might become a permanent part of life.

Six months prior I had gone back to school. I spent months backpacking through the mountains, climbing the 50-ft Alpine Tower, and navigating high/low ropes courses, which, to my surprise, included jumping off the top of a 45-foot telephone pole.

Another semester was devoted to paddling rafts, kayaks and canoes in the cold, fast waters of the Nantahala. One of our early assignments was to capsize our kayaks and see how long we could force ourselves to hang upside down under water. Just before my instructor flipped my kayak, he told me the secret was to not let my mind convince me to tap out – not to panic. We could survive much longer, he warned, than our mind would lead us to believe. The point of every class was to push ourselves to our personal physical or emotional limit.

When my late teenage/early twenty-something classmates ventured out to find summer jobs that year, I wandered into my instructor’s office to decide what I would be when I grew up. I had taken the 9-day Wilderness First Responder class during spring break, so he suggested I might take the 3-week EMT class during summer break.

I’m not nearly so comfortable in a classroom. If it had been more common in the 60s and 70s, I’m pretty sure I would have been diagnosed ADHD. My mind wanders, and short-term memory is not my best attribute. I passed the class, and discovered I loved emergency medicine. Not doing, mind you, but the learning of it.

There’s a process to follow in quickly identifying life-threatening issues and stabilizing a person for transport. When testing this process, we divide the topics into three areas.

There’s a pediatric test where the students must realize that little Bobby is having an allergic reaction, safely administer an EPI pen, and the appropriate oxygen treatment. The medical test involves a patient that is having chest pain, who inevitably has a heart attack right in front of your eyes causing you to administer CPR. The third test is trauma related where students must assess a patient involved in a major and near fatal incident. There’s major bleeding to remedy, severe head trauma to diagnose and mitigate, and a requirement to immediately transport the patient correctly attached to a backboard.

I’ve been a proctor for these tests for about three years. The students come in one by one racked with nerves. I remember the feeling well. They’re overly conscious of the time limit of each test, and it cripples some of them. We keep the rooms cool. They sweat profusely. We’re not allowed to show an ounce of emotion. Their eyes beg us to encourage them, or reassure. One student out of every class will come right out and ask if they’ve passed the test. We still don’t answer, although I admit that sometimes I look deep into their eyes and attempt to pass along a smile. Some of them notice I think.

We use life-size dummies with fake blood and sort of real-to-life looking props in class and for the tests. Sometimes we use real people as patients. Students are encouraged to show respect as we ‘dress down’ the patients, searching their body for signs and symptoms. My instructors called it learning to perfect trauma naked and the medical touch. In other words, don’t be creepy.

Sometimes I think of these things I’ve learned.

Show respect if you find it necessary to ‘dress down’ another person; don’t be creepy; find a way to pass along a smile; and, if you capsize, remember that you can survive much longer than your mind would lead you to believe.

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