In this episode of the MedicCast TV Weekly Commentary I’d like to address something that we don’t teach. Your preceptor or supervisor won’t talk about it (though they should.) and it often takes a lot of street time to understand on your own. I’m talking about that sensation you get when you first encounter a patient. I’m talking about all of us, from the brand new EMT or paramedic, all the way to that grizzled veteran on the street for 30 years.

Getting an ‘Initial Impression’

paramedics-taking-care-victim-It’s mentioned briefly in a round-about way in some educational programs we take, like pediatric classes where we are asked to give our initial impressions of the patient. So think about it. What is your initial impression when you walk in the door and first see the patient? I ask because you can tell a lot about a patient as you walk throughout he door and often your subconscious brain, your gut if you will, gives you a reaction.

The problem is that we either don’t know enough to pay attention to it or we outright ignore it. For the most part, the new guy doesn’t know to pay attention to it and int he critical patient, it just adds to your anxiety level (though you probably don’t know why). In the older medic, you sometimes get burned out or hardened to certain patients or patient populations and ignore your gut.

Your Gut Can Save More Than Just Lives

So why do I mention this “gut feeling” at all? Well your gut can save both your butt and the patient’s life at the same time. So here’s the tip for this week. When you walk in the room and see that patient for the first time, take a beat, a breath, or just pause a moment listen to your gut.

When you get a first look at the patient, do you get a stab of fear or anxiety? Does the first thing your partner says sound like “Man that is messed up!” or something like it? These are the patients and situations that we need to step back and take a little more seriously. Your gut is telling you that there’s something else going on here.

Trust That Gut Reaction

Learn to trust that feeling and look a little deeper, get a more in-depth history, whatever it takes. Trust that feeling and keep on trusting it. It may pop up later in a call telling you that the patient’s status has changed in some way or your treatment modality is going in a wrong direction and you need to re-think your diagnosis.

So, the next time you’re on a call, start listening to your gut, start trusting your instincts and realize that what you’re sensing is more than “just a feeling.”

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