Lists

Matt Green @MLG1611

Every career in pre-hospital care starts with a first day. Well; two first days. The first day of training,

and the first day of placement where you put all the training to the test on real patients who actually

depend on you.

Almost every course, from basic first aider to student paramedic and beyond, builds heavily on the

DR<c>ABCDE model that any emergency can be competently handled by working through the list of

Danger, Response, Catastrophic haemorrhage, Airway, Breathing. Circulation, Disability and

Examination/exposure. Fortunately it’s a tried and tested formula that works and saves lives every

day.

But having the training and knowing the cornerstones of emergency medical care can only go far in

making you a great practitioner. You also need experience, which unfortunately you can’t download

as an eBook, gain from a friend or master in a simulation. You need to get out there and do it.

These realities mean that many practitioners start with two lists; the `exciting list` and the `nervous

list` which they gradually and informally check off until they have experienced each thing at least

once, and therefore know how they would do it better next time.

I am excited to…

…drive on blue lights to an emergency

…drive on blue lights to hospital, with a

patient on board

…have an air ambulance arrive at a job

…deal with a fire

…force entry to a property

…press the magic button on a defibrillator

I am nervous about…

...doing chest compressions

…telling someone their relative has died

…looking after a very sick child a long way

from hospital

…having an airway I am unable to manage

…being confident in identifying a myocardial

infarction and acting on it

…driving a patient with major trauma passed

several closer hospitals to access a major

trauma centre

Neither list neatly fits into a `top 5/10/20` as both are built on dynamic doubts and passions which

are much more complex and change based on the culture you work in, the level of your training and

your innate personality.

In a busy ambulance service, it often takes 2-3 years to see one example of everything, and the

guarantee of emergency medicine is that next time you see the exact same situation, it may be

completely different!

Are lists like these healthy?

What is/was on your list?

What are the things on your list still to check off?

@MLG1611