Clinicals begin

The clinical component of my paramedic course began last week with a trip to the operating room for hands-on advanced airway experience. Anytime a patient is placed under general anesthesia, he cannot breathe for himself and must have the anesthesiologist do it for him. Hence, once the patient is unconscious, a thin plastic tube is placed in the airway and connected to a ventilator. This ensures that the patient receives adequate oxygen as well as sufficient anesthesia gases to maintain a deep level of sedation. It's rare for prehospital care providers to have a ventilator on hand, but the intubation procedure is the same in the OR as at the side of the road, which makes this an effective method of skills practice.

It was something of a slow day at the OR when I went, at least in terms of cases requiring general anesthesia. There were a number of surgeries being performed under local or regional anesthesia, but since those procedures don't require the patient to be intubated, they didn't do me much good. I wound up attending two surgeries and performed one intubation. Unfortunately, the requirement is that I perform four intubations (one of which must be a laryngeal mask airway placement), so I'm heading back at the end of the month to finish up.

Tomorrow I'm headed to the county morgue to observe two autopsies. I don't need to participate at all, just watch the medical examiner at work. The goal is to give us a better sense of topographical anatomy (i.e., where everything is in the body), which will be beneficial as general knowledge but especially for our understanding of trauma calls. In the evening I'll be attending a meeting of the local Regional Emergency Medical Advisory Committee (REMAC). This is a board of physicians and other experts who approve protocols for use by EMS providers. I'm looking forward to glimpsing the process by which our protocols and procedures are decided upon and modified. And I'm sure it'll smell better than the morgue.

In other news, I made my Western New York chess debut on Saturday, winning the Jenifer Woods Memorial Grand Prix with a score of 3.5 / 4. The tournament was rather top-heavy, with two of the eleven players holding the title of FIDE Master. I managed to defeat both masters before a last-round draw with one of the Duke Chess Team's recent alumna. The tournament was hosted by the Rochester Chess Center, which is an excellent venue for playing chess. It boasts the elusive combination of a well-equipped facility and a low-key, friendly atmosphere and staff. If only it weren't an hour and a half away!