Longitudinal Placements (LP) are clinical observerships organized by the student in domain of his/her choice to gain relevant clinical knowledge in that area of medicine
1. What LP did you do?
I did an LP with Hamilton EMS.
2. How did you go about contacting and arranging the LP?
LPs with Hamilton EMS require a request from the Physician Assistant office, therefore, individual students cannot email the paramedics themselves and arrange an LP. I e-mailed Nancy Weller (PA program Manager) with three days I was available for 12 consecutive hours and we went from there.
3. What were the two main things you learned from the LP?
I learned that paramedics have a wide range of responsibilities, and their scope of practice is also very broad. Not only do they provide life saving care but they can also give certain medications and take pertinent histories at the scene. Most importantly, contrary to the common misconception, paramedics are not "taxi drivers"! They provide a lot of life saving care at the scene before stabilizing the patient and bringing him/her to the hospital.
I had the opportunity to listen to a murmur, learn how to interpret several EKGs, and I witnessed the protocol for a patient found with "absent vital signs" and in cardiac arrest.
4. What did you wish you knew beforehand to help you in your LP?
I wish I had a better understanding of how to interpret EKGs. Every patient that we saw was put on an EKG machine, some of which had abnormal EKGs. However, the paramedics took time out (when possible) to teach me how to interpret EKGs.
5. How has this experience helped you clinically, in class and/or in career decision making?
This experience has helped me understand EKGs better because I now have a real life situation to think about when learning about ventricular tachycardia or ventricular fibrillation. In addition, I also saw an angiogram in the emergency department and that experience has helped me understand the reasoning behind the need for an angiogram.
In terms of career decision making, I learned that the emergency department is a very fast paced environment, one is always on their feet and ready to deliver optimal healthcare- this is of interest to me.
6. Any other comments?
I strongly recommend that everyone go out for an EMS ride-out to gain a better understanding of the roles and responsibilities of paramedics. This is especially important if you want to work in the ER because you will be interacting with these health care professionals on a day to day basis. A firm understanding and appreciation for all their hard work will help foster a good relationship between the two professions.
EMS service is NOT FREE. The Ontario Health Insurance Plan (OHIP) covers the majority of that fee, so patients are only billed $45.00. However, if the hospital/doctors determines that the patient could have made their way to the hospital by another means or the trip was not "medically essential", the patient will be billed for the full amount of the ambulance bill ($240.00).
This is necessary in order to ensure that the system is not abused, and that the service is available to those who really need it!