When was the last time you intubated a patient? If you work in a busy metropolitan area, with high trauma rates or a large elderly population, intubations may be a regular occurrence. But for many emergency personnel, especially those assigned to slower stations, intubations are few and far between. Which makes it all the more critical to stay on top of your skills. And if you aren’t getting tubes in the field, the only other place to hone your technique is through training.

It was her second stroke in a year, and her daughter was doing the best she could, caring for her aging mother at home. The elderly woman had significant neural impairment, could barely speak, and had a stoma in place, which seemed to be doing little to ease her difficulty breathing. She had copious secretions bubbling up into her mouth and a rattling cough that wracked her slight frame. As the first responder, you automatically crank on your portable suction unit to try to ease her distress.

Your hospital has addressed natural disasters within its Emergency Operations Plan. Taking into account such things as your hospital’s location and weather-related risks, the types of disasters that are most likely to occur have been identified through your hospital’s Hazard Vulnerability Analysis. Action plans have been created and communicated to the entire staff.

Your shift is just beginning and you’re busy checking out your truck, when the paramedic student arrives, eager for a chance to exercise his new-found knowledge. You guide him through the equipment check and as you’re taking him through the drug box, he begins peppering you with questions about the proper pediatric doses for an array of cardiac meds. Suddenly, you realize it’s been awhile since you reviewed your protocols. As you stumble over your responses while quickly reaching for the Broselow Tape, you realize you could use a refresher. And if you are rusty, it’s a good bet your entire crew could benefit from some continuing education.

Paramedics rely on a multitude of tools. Imagine treating the range of patients you encounter in the field – from cardiacs, to trauma, to pediatrics – without a wide assortment of tools from which to choose. Impossible, right? And although some of these tools are essential to the job, and dictated by local and national standards, each tool contains various components that make it ideal for the system within which you work.

The child was pulled from the deep end pulseless and apneic. CPR was initiated immediately, and by the time you and your crew arrive on scene, a faint pulse is detectable. Your partner begins ventilating the patient, when suddenly the child vomits. Your potential save is once again in peril; this time from choking and aspiration. You reach for your portable suction unit and realize you left it on the truck. A crew member races back to the rescue to retrieve it as you log-roll the child onto his side, all the while struggling to ventilate, maintain c-spine, and continue resuscitative efforts. Not a good scenario.

The Zika virus has been getting a lot of coverage in the media. Primarily transmitted by infected mosquitoes, those who acquire the disease will experience symptoms such as fever, rash, and joint pain. Though the disease symptoms are relatively mild, concerns exist for pregnant women who contract the virus because it can lead to serious birth defects. 

It’s a bright fall morning and you’ve just arrived at your station. The off-going crews are still asleep, no doubt from a previous busy night of calls, so you drop your gear beside the truck and head for the kitchen to make coffee. As the crews filter in, you get caught up in a lively discussion about last night’s football game and before you know it, an hour has slipped by. Suddenly, the tones go off, summoning your station to a cardiac arrest. Chaos ensues as the ongoing crews rush to respond and the off-going crews rip their gear from trucks. The medic you relieve yells something about expired drugs, but there’s no time for details as you race from the station.

Nurses working in a small hospital often wear many hats. While a large, metropolitan hospital will often have a full staff of physicians, ancillary and support staff on-site around the clock, a small hospital may not have that luxury. This is especially evident during the “off-shifts” of evenings, nights and weekends.

After you’ve been working in the hospital for a while, it is clear to see that everyone has a defined role. Whether a nurse, a respiratory therapist, a laboratory technician or a facilities manager, all team members know their job duties, their scheduled work hours, and the hospital units that they cover.