The A Team - Part II

Part 2: The Paramedic Partner

In Part 1 we discussed how to be a good EMT Partner; everything we discussed still applies to the Paramedic partner when it comes to working efficiently as a team, here is  a quick recap:

Get to know your partner!

Ask questions!

Know the equipment you carry!  

Know the protocol!

Train together!

Plan for the call while en route!

Speak up!

Don't step on each others toes!                

As a Paramedic, you may be experienced or just beginning your career; although we are the highest trained provider, we have an invaluable resource right next to us. Our EMT partners may have more experience in EMS or have areas they are more knowledgeable in. Part of being an efficient team is knowing our partners strengths and USING that to benefit the situation. Our EMT is a "double check" for medication administration, patient differential diagnosis, or protocol.

What traits/qualities/characteristics make an individual a good Paramedic? There is a lot we could discuss; when answering this question I think back to when I was an EMT and even my time in paramedic school. This is just one individuals opinion:

Don't complain....teach! I have had many EMT partners share frustrations about their paramedic. They talk about how they felt disrespected, belittled, or even like "just an ambulance driver." This is not acceptable and really gets me fired up! Some medics have even posted on social media about how "tough" there shift was because they had a new EMT. Are you kidding me, be a professional! We all started out as an EMT and we all were once "green behind the ears." As a Paramedic we have a unique opportunity to teach and educate while on the job. Teach your EMT about various skills, medications, disease presentations, etcetera. Part of my success as a Paramedic is because I had quality mentors. Be a mentor not a complainer!

Expand your knowledge! Our education does not stop after completing our initial paramedic training. There is much we don't know and there is always something to review or learn more about. Buy an EKG book on advanced 12 lead interpretation, go to cadaver labs, listen to podcasts, stay up to date on changes, or obtain an additional certification. The FOAM ED (free online access medical education) world is awesome and the knowledge to be gained from experienced providers it out there for free! I think you will be surprised what you'll learn; for example: how hyperkalemia can be a ventricular tachycardia mimic, different intubation techniques, haldol can be used for nausea/vomiting, ketamine use for status epileptic patients, or what wellens syndrome is. Of course always follow your protocol and know that we can call medical control for orders!

Be a detective!  A Paramedic is not just someone who has high success with skill performance or ability to recall medication doses. A truly good Paramedic thinks like a detective and uses their critical thinking to determine the best treatment plan. Being a detective means we have to consider the "zebras." A zebra looks different they are not often encountered; they are the differential diagnosis that we forget to consider. So the next time we have a bradycardic patient and the common causes have been considered, think about: myxedema coma, hyperkalemia, head bleed, calcium channel blocker overdose, or beta-blocker overdose. If we don't think about zebras we won't catch them!

Lead your team! The more critical our patient the more hands-of we should try to be. This depends on how many additional providers are on scene with you. So take a step back, assign roles to your team, and allow you mind to gather information and critically think. This is efficient and helps broaden our mental bandwidth. Multiple responders trying to lead a call creates miscommunication, chaos, delay, and miscues. We need to be the team lead and work together using our teams strengths to identify the problem. In some instances we can have a team member leading a specific task/part, but there still needs to be one individual who is paying attention to the big picture.

Be an advocate for change! Our profession is constantly evolving and as new evidence and equipment is brought into light we need to evaluate and adapt. This may require changing ourselves or promoting a change within our organization. Keep the specific community that you serve in mind. Present your ideas to management and be prepared to address why the change is needed. Do not be disheartened if your idea does not result in a change, sometimes it is due to cost or frequency of use. To help yourself research cost of implementation, present the evidence, patient care statistics (if applicable), and explain why this change is beneficial to our patients and organization.

The A-team is efficient and it takes a commitment by the EMT and Paramedic partner. The items discussed in Part 1 and 2 is a good start and certainly can be expanded. We are interested to hear your thoughts on team dynamics and efficiency and what it means to you to be a good Paramedic or EMT partner. Please comment below!