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Old 05-29-2008, 21:25   #1
MissAmericanPie
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Need ambulance driving help!!!

Hi All,

I haven't been here in a while since I have been working a lot and do not feel much like internet chat by the time I am home. I have the day off, however!!

Well, here is my question: I love my job, however, the training is really slow and not really organized as training at all. It has been almost three months and I still do not know some ambulance-specific, basic things such as setting up IVs for the medics and my radio reports and radio skills in general, well, they suck.

And I just find out that some people have an issue with my driving - I am not very smooth. I have never driven a diesel (with the exception of occasionally picking up the rescue for our volunteer calls in my town) and my acceleration and deceleration is jerky. I do not drive my vehicle this way.

What I really want is to work out these bugs. I haven't even begun to focus on patient care (although I get to tech some small, inconsequential calls) since everything is all over the place. There is no program in place and I'm partnered with so many different people that I never get training.

When this nightmare is over and I have been there for a long time, I am determined to set up a training program with objectives and completion dates for new hires!! But in the mean time, any suggestions? I especially need help with my driving. I seem to have difficulty multitasking when operating the vehicle. When I started, I was just handed the keys (basically) and was driving right off the bat. I need to figure out how to drive this beast without throwing the tech and the patient around when driving code.

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Old 05-29-2008, 21:48   #2
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One thing I always heard when I was new was "Easy on-Easy off". Meaning to accelerate slowly and brake in an assured distance to not throw people around. Remember, everything you feel in the drivers seat is magnified x10 in the back. Go slowly around corners, takes very little to toss people/things around when cornering. The fact that it is a diesel should have no bearing on anything really. Practice when you don't have a pt in the back. Pretend you're doing pt care and have your partner drive around so you can realize what it's like in the back at certain speeds around corners, what it feels like when someone accelerates hard or brakes hard. It will give you a new perspective on driving. You'll get the hang of it, it just takes time. You'll never get yelled at for going to slow around a corner but you will hear complaining every time about going to fast.
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Old 05-29-2008, 21:50   #3
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Forgot to mention.........




always give yourself plenty of space going around corners so you don't hit curbs. Guarantee you'll hear about that.
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Old 05-29-2008, 22:07   #4
Hunca Munca
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I can help with the radio reports. I have heard many horrible ones.

First let me know if you want orders or if it is just a notification.

Then state what is wrong with pt. Just give pertinent meds (like aspirin for chest pain) I don't need or want the whole 5 page list.

Then give vital signs BP , pulse, Pulse ox, RR, Blood sugar if pertinent

Then state treatment given or request orders.
That's it!

Example:
"This is NH medic 007 requesting orders
65 year old patient complaining of chest pain began 1 hour ago. Pt has CAD history.
Pt took his own aspirin.
BP 156/90 hr 98 sinus, rr 20 sat 98% on 4 liters 02.
We have given three nitro sprays pain now 7/10. BP now 134/70
Requesting orders for additional nitro and 2mg morphine as long as BP stays above 100 systolic.
ETA 30 minutes "

If I have any questions I'll ask after this report.
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Old 05-30-2008, 07:26   #5
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Originally Posted by Hunca Munca View Post
Requesting orders for additional nitro and 2mg morphine as long as BP stays above 100 systolic.

You have to ask for this??
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Old 05-30-2008, 08:50   #6
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Get to know the ambulance. Learn the way it handles when taking off, slowing down, going around curves and making turns. This comes with practice. It's not something you learn overnight. It will take time depending on call volume and how much you train driving.

As for radio reports, get a pad that has the info already to be filled in. Those EMS field guides usually have one on page one. Go over your med report in your head and then say it. After awhile it will be second nature.

Lastly Don't Give Up. Stick with it.
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Old 05-30-2008, 09:41   #7
Hunca Munca
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Originally Posted by Glkster19 View Post
You have to ask for this??
I don't have to ask for anything. I am the askee...

The protocols usually allow for 3 ntg then if still having pain a consult.
My EMS region is very consult dependent "mother may I..."
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Old 05-30-2008, 10:40   #8
MissAmericanPie
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Originally Posted by RyanNREMTP View Post
Get to know the ambulance. Learn the way it handles when taking off, slowing down, going around curves and making turns. This comes with practice. It's not something you learn overnight. It will take time depending on call volume and how much you train driving.

As for radio reports, get a pad that has the info already to be filled in. Those EMS field guides usually have one on page one. Go over your med report in your head and then say it. After awhile it will be second nature.

Lastly Don't Give Up. Stick with it.
Thanks so much. Our call volume has been really low - spring is quite slow. However, the other day we had 11 911s and that is a lot for us - it kept our two crews busy most of the day and our third (our operations manager and our extra guy) went out a few times as well. So that day sucked for me since my partner was *****ing most of the day (not in an inappropriate way) about those aspects of my driving. The funny thing is - he has been my partner more than anyone else on the roster and has never suggested we go out for driver training since it has been so slow. Everyone just sits in quarters watching television and playing on their laptops complaining about being bored!!

I have always asked for feedback and have gotten none until recently. It is really irritating and I feel that I have had too much time to develop bad habits - I don't even realize I'm doing it when it happens.

I'm going out with one of the experienced crew members Sunday and I have requested to work with him every Sunday in June so he can get me up to speed. He is going to take me driving, etc.

Also, with the radio reports, I do realize that it will come with time. I have a template I made up the other day with the info. our particular hospital is interested in. I guess I am less comfortable with remembering to sign on/off scene, radio the hospital informing them of our call, informing the county dispatch center (different from ours) when we do mutual aid, etc. when I am driving code 3. I think I would have learned by now if everyone I was with didn't grab the mic and insist on doing it. It also pisses me off when people take the siren and work it for me. I need to learn this stuff.

Anyway, thanks everyone for the advice. I'll be using it - and I've become quite assertive about it as well.
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Old 05-30-2008, 14:36   #9
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When driving the big rigs, imagine a glass of nitroglycerin, filled to the brim, with no cover, sitting in the back and if you spill one drop.."boom".

Seriously, in a big truck you have to do everything about 1/4 of the speed you think.
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Old 05-30-2008, 18:10   #10
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Have your partner drive you around while you are on laying on the cot. You will get a first hand look at what your patient and your partner feels. Easy on / easy off is good thing to remember too. Drive, drive, drive, and then drive somemore. It all comes with time.
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Old 05-30-2008, 18:38   #11
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When your in the drivers seat, sit with your back off the seat by about 2 inches. If you feel any sort of motion from your torso, your accelerating or decelerating too fast or taking a turn too fast. This has been the best indicator that I have found. Also, you need to start braking about 3x as far back as a normal vehicle so its nice and smooth in the back.
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Old 05-30-2008, 19:01   #12
MissAmericanPie
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Originally Posted by DTLarson View Post
When your in the drivers seat, sit with your back off the seat by about 2 inches. If you feel any sort of motion from your torso, your accelerating or decelerating too fast or taking a turn too fast. This has been the best indicator that I have found. Also, you need to start braking about 3x as far back as a normal vehicle so its nice and smooth in the back.
All good advice. Thank you and I'll try that.

I thought that driving code 3 would be what scared the crap out of me, having to weave through congested areas and figuring out how to get through clustered intersections, but nooooo - it has turned out that I'm just terrified of pissing my partner off by being to gung ho with the accelerator and brakes!!
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Old 05-30-2008, 21:19   #13
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Code 3 doesn't need to be more than 10mph over the speed limit. Any more than that and you are most likely throwing people around with any bump you hit. Remember to slow down for every green and stop at every red. Its a reality that if you get into an accident in an ambulance at 30+ mph with a partner in the back they have a good chance of being killed in the accident.

Also in the beginning when driving code 3 remember to look at your speedometer. A lot of new drivers will get "adrenalin" foot and without realizing it start to drive faster and faster.
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Old 05-30-2008, 21:43   #14
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Just remember, you are driving an ambulance, not a sports car. Quick on the pedal is uncomfortable to the pt, and potentially dangerous to your partner. Remeber to scan ahead and anticipate problem areas, never pass on the right, and do not blow through intersections. I drove, and taught those I was precepting, as if the ambulance were invisible, because it sure as heck seems to be once you turn on the lights and siren.
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Old 06-01-2008, 00:17   #15
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Here's a practice tip from 25 years ago: Find a large empty parking lot. Lay a radio microphone on a flat portion of the dash. If it moves, you're doing whatever you're doing too hard. Focus on moving the ambulance -- accelerating, decelerating, turning -- so smoothly that the microphone doesn't shift. You'll probably never drive this way in traffic, but attempting to get to that point will teach you the feel that you are striving for.....
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Old 06-01-2008, 18:38   #16
FiremanMike
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Please don't take this the wrong way, but I don't think you should be driving yet. I would tell this to any new person to this field, even though I know it happens every day. When I first came on I wanted to drive a lot because it was fun, looking back it was a big mistake.

First, you need to focus on your patient assessment and care skills at this point. You are fresh out of school and need to start developing on all the things you just learned. You could be the best driver in the world, but if you suck as an EMT, you are useless on my truck.

Second, you are probably still very excited on runs. Not necessarily in a bad way, just in a new way. That being said, this will be amplified when you are driving and you will be much more apt to make critical driving errors. You need to get to a point where you are comfortable on most runs, such that the majority of the time when the tones drop it doesn't increase your heart rate or put you into an excited state. This will allow you to focus on driving and not be worried about what's to come on the run.

Please don't take these words as harsh, I don't know you and I'm not judging you. The only thing I know is from your posts which revealed you just recently got into this business, and I'm comparing you against every new person I've ever seen in this business (including myself). I know its fun to drive really fast on the wrong side of the road, but my personal soap box recommendation is that you not worry about it just yet.

edit: by the way, I agree with the above poster about the mic on the dash, very good practice.
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Old 06-02-2008, 09:48   #17
MissAmericanPie
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Originally Posted by FiremanMike View Post
Please don't take this the wrong way, but I don't think you should be driving yet. I would tell this to any new person to this field, even though I know it happens every day. When I first came on I wanted to drive a lot because it was fun, looking back it was a big mistake.

First, you need to focus on your patient assessment and care skills at this point. You are fresh out of school and need to start developing on all the things you just learned. You could be the best driver in the world, but if you suck as an EMT, you are useless on my truck.

Second, you are probably still very excited on runs. Not necessarily in a bad way, just in a new way. That being said, this will be amplified when you are driving and you will be much more apt to make critical driving errors. You need to get to a point where you are comfortable on most runs, such that the majority of the time when the tones drop it doesn't increase your heart rate or put you into an excited state. This will allow you to focus on driving and not be worried about what's to come on the run.

Please don't take these words as harsh, I don't know you and I'm not judging you. The only thing I know is from your posts which revealed you just recently got into this business, and I'm comparing you against every new person I've ever seen in this business (including myself). I know its fun to drive really fast on the wrong side of the road, but my personal soap box recommendation is that you not worry about it just yet.

edit: by the way, I agree with the above poster about the mic on the dash, very good practice.
Thanks for the advice - but I do need to drive or I am of no use to this company yet. Half of our crew are paramedics. That means I am paired often with a paramedic and I have to be able to drive that person when we get a call that requires his/her skills. So, unfortuntately, that is not an option at this particular operation. It is small - about 15 full time employees and another 10 part time employees (some one shift per month).

I have been working on my town's rescue since October when I took my exam and this winter I got a decent amount of patient assessment experience from my job at base first aid (at a local ski area). I understand that I am still learning all of that and I still haven't seen a lot since it has been slow season at the ambulance since I started at the beginning of March. But I do have the opportunity to tech calls on occasion. I tech a lot of our transfers (taking vitals is now second nature) and I have teched some 911s. The feedback I have gotten from those I have worked with was positive - that my patient care skills are good and will improve and become smoother as we get busier.

I went out driving yesterday with one of our more experienced EMTs. He noted one issue - that I need to be smoother in maintaining my speed. I tend to let off of the gas and accelerate too often. He said my stopping and accelerating from a stop was good and I took turns smoothly. I was confused since I was driving no differently than normal. He said that everyone has different opinions about how the rig should be driven. He told me that he personally has never noticed a problem with my driving.

So what I want to do is see if I can have our operations manager ride with me for a few hours and give me some feedback. Since the two people "in charge" of making sure I'm up to speed have differing opinions, I guess I need a third - and I should get it from the boss.

As far as getting excited - I do. I love it, however and have never noticed it to be an issue. I love what I do and although a fire alarm activation does not get me amped, an MVA with personal injury does. I will be sad if I lose that feeling - it is how I work best and being amped lets me focus. I work best under stress and I do better on calls where a person has a more serious injury than I do on a general "back pain" call, etc. I step back and go into a mode where things start falling into place. There is an EMT where I work that has been doing this since 1974 and he still gets amped when the tone goes off! I can't see how that can't happen when you have been sitting in quarters for a couple of hours bored off of your ass!!

But I see where you are coming from where it could be a hinderance when driving. I do try not to let myself get too excited when driving. That doesn't help me like it does with other things. It seems like critical mistakes can be made.

I understand your concerns about having me drive so soon. I think I would agree if it had been another larger company. I think a driving test should be instituted here, however. First, a week of driver training, then a test. I like objective benchmarks. That is how I know that I am where I am expected to be.

Thanks to everyone for all of your suggestions - I did try some of them yesterday!! Now I need to learn to multitask........driving, radio, lights & sirens!!
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Old 06-02-2008, 22:09   #18
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Thanks for the advice - but I do need to drive or I am of no use to this company yet. Half of our crew are paramedics.
That's the first thing I thought when I read that post. When I was 18 years old, I was in the same situation in a larger system (seven stations and 11 trucks plus a helicopter). As a new full-time EMT I was always paired with a paramedic partner, so driving was my primary gig. I was an excellent tech, but had to prove it since the presumption was always working against me because of my age.

For whatever it is worth, it seems that you're over-thinking driving way too much. Driving isn't that complicated. The "mic on the dash" sounds exceedingly silly to me and proves nothing.

Just use common sense and take it easy. There's no way you can become competent without practice, and that means driving as much as possible and getting over the hump.
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Old 06-02-2008, 22:12   #19
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Code 3 doesn't need to be more than 10mph over the speed limit.
That depends completely on your response area, roads, conditions and ability of the driver.
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Old 06-03-2008, 19:07   #20
MissAmericanPie
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That's the first thing I thought when I read that post. When I was 18 years old, I was in the same situation in a larger system (seven stations and 11 trucks plus a helicopter). As a new full-time EMT I was always paired with a paramedic partner, so driving was my primary gig. I was an excellent tech, but had to prove it since the presumption was always working against me because of my age.

For whatever it is worth, it seems that you're over-thinking driving way too much. Driving isn't that complicated. The "mic on the dash" sounds exceedingly silly to me and proves nothing.

Just use common sense and take it easy. There's no way you can become competent without practice, and that means driving as much as possible and getting over the hump.
Well, everyone else seems to think my driving is fine for how long I've been at it. I am probably overthinking it because it was brought to my attention and my manager's (and everyone else's too) by two particular individuals at work (who happen to reside together). It isn't that I don't need improvement - it just seems like I need less than I initially thought.

We just went to a suicide a few hours ago and I drove and my partner (one I rarely work with) said I did just fine. He told me that he witnessed a problem about a month ago where I was driving (rerouted back to the hospital we were transferring patient from since pt. was circling the drain) and he was behind me. He said I seemed to head for a certain route and changed my mind at the last minute. He told our manager, he said since he was concerned that I needed to understand that I cannot change directions when running code once I commit. Makes sense, but I've certainly come a long way since then.

Thanks for the reply - it really puts things into perspective.
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