In a previous post, we had discussed some tips on how to assess pediatric patients with suspected sepsis. You might have even confirmed your suspicion through the assessment and collection of patient’s medical history. So as a medical flight paramedic, what’s the next step you should take? While you may be compelled to immediately start treating the symptoms, it’s also important that you prioritize certain symptoms over others.
Treating Symptoms of Pediatric Sepsis for Medical Flight Paramedics
If you have a firm belief that your pediatric patient is suffering from sepsis, here are the treatments you should carry out in order of importance:
- Airway management – One of the most important initial treatment steps in sepsis patients is airway management. But it’s crucial that you are aware of the risks of using RSI/med facilitated intubation. This is because pediatric sepsis patients may be at risk of cardiac arrest as a result of induction agents.Breathing difficulty is common in sepsis patients. So your patient might find it difficult to breathe and may even require ventilation. Good ventilation will not only improve oxygenation but also reduce the oxygen demand as the patient will make less effort to breathe. Use CO2 monitoring to ensure proper ventilation.
- Circulation management – Pediatric sepsis patients will require normal saline (0.9% sodium chloride) for treatment. The initial amount you should administer is 20 ml/kg boluses over 5-10 minutes.
- Medications – You might have administered dopamine on previous medical flight patients with sepsis. But those are adults and the treatment is perfectly alright for them. The same isn’t true for pediatric patients. Instead, epinephrine should be administered in case of cold shock and norepinephrine in case of warm shock.
Sepsis is a tricky condition and experts haven’t yet determined the best treatment option. However, these recommendations should be ideal for pediatric sepsis treatment until there are new innovations in the field.
As a medical flight paramedic, you might have encountered a few sepsis patients on your missions. But have you had to deal with kids suffering from this problem? Sepsis treatment is already complicated and can be much more complicated in children. They can easily develop sepsis after developing an infection from a traumatic injury or an illness.
Pediatric Sepsis Assessment Tips for Medical Flight Paramedics
When you encounter a kid suspected of having sepsis, you can make use of the following tips to provide timely and accurate treatment:
- Assess complaints carefully – As you well know, there’s no test or clinical indicator for sepsis. So you need to carefully assess the various symptoms in your young patient to determine whether they’re suffering from the condition.
Fever, rash, vomiting, diarrhea, discharge or pus, foul-smelling urine, and runny nose are some of the common symptoms to look out for. If the patient is shivering, pale, sleepy, and suffering from shortness of breath and extreme discomfort, there’s a chance they have sepsis.
- Determine the patient’s medical history – In most cases, a patient’s medical history may make them more susceptible to sepsis. Try to determine if the patient has gone through anything that might decrease their immunity. For example, immunotherapy and chemotherapy as well as HIV/AIDS and regular steroid use can negatively affect the immune system.
You can also try to determine whether the patient suffers from any comorbidities that might leave them susceptible to infections and cardiovascular collapse. Cancer, sickle cell disease, cystic fibrosis, poor cardiac/respiratory reserves, and liver/splenic dysfunction are some conditions to look out for.
In addition to this, see if the patient has had any recent surgery, traumatic injury, indwelling devices, or organ transplants. Medical flight paramedics should also note that children who depend on mechanical ventilation may also be more susceptible to sepsis.
When you’re working as a medical flight paramedic, chances are that you have a hectic and sometimes unpredictable schedule. There may be times you have to work overtime, fill in for a co-worker, or even work a holiday shift. This makes it extremely difficult for those with children to find good child care options. In this post, you’re going to learn some useful tips to help you manage child care with your schedule.
Child care Options for Medical Flight Paramedics
When you’re a paramedic parent working busy and odd schedules, daycare may not be the most viable child care option for you. Here are some of the other options you could try:
- 24-hour daycare – While most daycare centers have fixed timings, a few 24-hour daycare centers have started opening up, providing parents working unconventional shifts with an excellent option. However, these centers may only be available at select cities and areas.
- Au pairs – Au pairs are fulltime nannies who live with you and are available to care for your kids during odd hours. Usually, their rates are considered per family and not per kids, so you could be saving plenty of money. But not many families are keen on the idea of having a nanny life with them.
- Nannies – If you’re not so keen on having your childcare provider live with you, you could opt to hire a nanny instead. They provide fulltime child care and then they go home after their shift. The main disadvantage of this is that they can be a bit more expensive than other child care options.
In addition to these, you also have the option of working out an agreement with a co-worker. There may be another medical flight paramedic working a different schedule than you and you could take turns watching each others’ kids. Or the two of you could combine your resources to save child care costs.
In a previous post, we had discussed some of the biggest challenges you might face while training to become a medical flight paramedic. But once you become one, what other challenges lie ahead for you? The obvious challenges would be dealing with a multitude of patients with a variety of issues day in and day out. This doesn’t need further elaboration because it’s what you knew when you signed up for the job. Find out some other huge challenges you could face while working as an air ambulance paramedic.
Personal Life Maintenance and Other Challenges for Medical Flight Paramedics
Some of the biggest challenges you will face during your time as an air ambulance paramedic are:
- Maintaining/managing healthy relationships – Working as a paramedic – whether it’s for air or ground ambulances – can take an emotional toll on you. This means you might often lack the ability to satisfy some of the basic emotional needs of your partner. Of course there may be a handful of paramedics who can effortlessly maintain a healthy work-life balance and remain in a healthy relationship. However, you might be in for a nasty surprise if you walk into the job thinking that you will be able to put in the same effort into your relationship as you had done before. You might struggle with missed family events and the occasional broken promise as a result of your hectic and unpredictable schedule. This is where you need to learn to be accepting of your faults and avoid being defensive even if your partner tries to talk it out with you.
- Maintaining a normal routine – Another big challenge for medical flight paramedics is being able to maintain a normal routine. Shift changes and work habits can get in the way of maintaining your routine and you might even find yourself waking up in the middle of the night during week-offs or holidays.
If you’re working as a medical flight paramedic, it’s obvious that you would’ve received EMT training and certification. But it’s not enough to simply get certified one time and then completely forget about ever having to take another exam. You’ll have to renew your license every couple of years and for that, you’ll need to pass a recertification exam.
What’s Needed to Renew Your License?
Your original EMT certification expires two years after original date of issue. After this, you will need to undergo a recertification exam for an updated license. But in order to renew your EMT license, you will need to:
- Be affiliated with a certified agency
- Have completed some patient care hours
If you’re currently working for a medical flight company, then you should have no trouble getting recertified.
Exam or Continuing Education to Renew Medical Flight Paramedic License
You have two options to renew your EMT license so you can keep working as an air ambulance paramedic:
- Exam – For this, you just need to apply for a “recertification by exam” in your NREMT account and then schedule your exam as instructed in your Authorization to Test letter. This may seem simple but the problem with this option is that you only have one attempt to take this test and some states may not allow a retest.
- Continuing education – The other option is by continuing education in emergency medicine or a related field. For this, you’ll need to record 72 hours of education units. The best part about this option is that you can improve your skills and knowledge in different types of emergency situations.
These are the two main options for renewing your EMT license. For air ambulance paramedics, you might have a few other certificates that require renewal.
Among the hundreds of patients you care for every year, some of those patients may be elderly individuals with a medical emergency or injury. It would be a mistake to assume that these patients are just like any other patient, as there may be many age-related issues to consider when providing them with pre-hospital care. As a medical flight paramedic, you need to be equipped with the necessary information to care for and safely transport geriatric patients facing a medical emergency or injury.
Caring for and Transporting Elderly Patients in a Medical Flight
Take a look at some of these tips to help you care for and safely transport a geriatric patient:
- Consider age-related changes in bodily functions – As we grow older, the function of the different organs in our body declines. This means there’s a change in the way our body responses to illnesses and injuries. For instance, there is a much lower capacity to compensate for shock, the bones can break much more easily, and the skin can face a more extensive damage from lacerations and burns. Additionally, head injuries can be much more lethal for elderly patients. All of these and more means that even a simple injury or complaint could have a huge impact on geriatric patients.
- Consider medication-related complaints – Many elderly patients may miss their meds or even take them at a wrong dose. Before transporting them on a medical flight, make sure you double-check their medications. In addition to asking them about it, get the prescription bottles and take them with you to provide to the ER. You could even perform a pill count if the dosage is indicated. Make sure you also have sufficient information about the common side effects of certain medications and their interactions with other medications. For instance, a patient taking blood thinners and suffering from a physical injury could be in danger of internal bleeding.
In a previous post, we had discussed some tips to help in writing a detailed patient care report. To add to that, this post will provide you some tips and ideas on how you can avoid vagueness in writing your report. Being descriptive and detailed is crucial in a few major aspects of patient care reporting for medical flight paramedics. This post will guide you in nailing your report for these aspects.
Important Aspects of Patient Care Reporting for Medical Flight Paramedics
When you respond to a call and transport a patient, you need to avoid being vague when writing your report about the following aspects:
- Dispatch info – Cover all details of the dispatch including patients condition at the time of dispatch, whether it’s an internal or external dispatch, whether you’re the first responders or if there are other rescue units on the way, etc.
- Patient’s condition – It’s obvious that you’ll be reporting details like where you picked up the patient and where you transported them to. But in addition to this, you’ll need to have a detailed report about the patient’s condition such as their mobility and consciousness status, whether or not they were able to understand/respond to your queries, when and how their problem stated, how the symptoms have evolved, etc.
- Interventions and procedures – As a medical flight paramedic, you may need to perform some emergency procedures to help the patients you transport. Make sure you provide in detail which treatments, interventions, or procedures you performed on the patient during transportation. And don’t forget to include details about why those procedures were necessary, which assessments you made and what you found from the assessments.
These three main aspects are crucial for better patient care reporting and to avoid vagueness in your report. They will help the receiving medical facility to provide proper medical care to the patient.
Frostbite isn’t common and you may never encounter patients suffering from the condition. But preparation is key and it’s crucial that you equip yourself with the necessary knowledge to treat even the most uncommon conditions. For air ambulance transport paramedics, there may be instances where you’re sent off to remote mountain locations. What if you have to rescue someone in those mountains and what if they’re experiencing frostbite?
Caring for Frostbite Patients in Air Ambulance Transport
Take a look at these tips to help you care for a patient experiencing frostbite:
Choosing an appropriate treatment facility – Air ambulance transport services often transport the patient to the closest medical facility. However, if there’s a facility close by specializing in burns, see if it would be a better option to transport the patient there. Some medical centers may not be familiar to treating frostbites and they’ll have to transfer the patient again to a facility that specializes in burn treatment.
After much consideration, you’ve decided to undergo education and training in order to become a medical flight paramedic. And you’d also know by now that you’ll be facing plenty of challenges along the way. Many of those challenges may be minor and you can easily overcome them. But some challenges may get in the way of your training and may even compel you to give up your dreams. So the best thing to do is to prepare yourself to face those challenges and get set to overcome them.
Challenges with Time Management
One of the biggest challenges you will face while training to become a medical flight paramedic is the challenge with time management. You’ll have to attend your classes regularly, which is going to take several hours of your time every day. You’ll also need to set aside some time to study on a daily basis if you’re going to pass your tests. On top of that, you’ll even have to go to clinical rotations, which will take place at various sites.
Now all this is difficult to manage already. It’s going to be even more difficult if you’re doing it all in the midst of a regular job. So it’s already clear that you’ll have to sacrifice your social life while you’re in paramedic school. And make sure you try to postpone big, life-changing decisions such as moving to a new city.
Other Big Challenges in Medical Flight Paramedic Training
In addition to the big time management issue, you might also struggle with drugs and pharmacology. By the time of your internship, you’ll be expected to have a thorough understanding of your medications. Come up with a technique to memorize and understand indications and doses as well as contraindications related to medicine.
An associate degree or a certificate with the relevant certification and training is usually enough for a person to qualify as an air ambulance paramedic. And people who do hold this position are highly-trained and professional. They have the expertise and the knowledge required to carry out their duties. But having a higher education is ideal to secure your job as a paramedic for an air ambulance service.
Benefits of Higher Education to Work for an Air Ambulance Service
There are many air ambulance paramedics out there who are perfectly capable of carrying out their duties despite only fulfilling the minimum education requirement. However, a higher education is ideal to better perform your duties because of the following reasons:
- Better comprehension – In your training to become an air ambulance paramedic, you will be covering plenty of text books and course books to help you learn the basics. And when you have a higher degree, there’s a better chance of you understanding what these books are saying. Although most paramedic students will be able to read the books, students who have a low grade level reading skill might find it more challenging to comprehend the study course.
- Better ability to make rational decision – Being a paramedic for an air ambulance service requires rational thinking, which will lead to rational decision making. For this, you need to train your brain to logically work through difficult situations and problems.
Courses in math and accounting can help with this and if you have a higher education, it’s likely that you would have gotten through such courses. So you will be able to easily make accurate drug calculations, time and distance calculations, etc.
- Better ability to handle complexities in paramedicine – A higher education also improves your chances of understanding changes and revolutions in paramedicine. It could help you gain a better understanding of complex pathophysiology, anatomy, and physiology.