If you don't know how to use a 3 way stop cock, how are you going to administer life saving treatment when the only type of pressor you have in your tool box is a 1:1,000 vile of epinephrine? You're going to have to mix it yourself, dilute it and titrate it!
What if your patient is 15 lbs? & on that note... when is the last time you opened up the Broselow Tape and practiced using it for medication puprposes? You'd be surprised how confusing THE MOST SIMPLE THINGS become, when you're in a truly emergent situation.
"Train like you work"
This doesn't mean you have to learn how to start an IV blind folded... although muscle memory has it's own perks... I will give some examples of what I have had instructors utilize in my training and the pros and cons to each.
In medic school we did intubation races with the classroom lights off, sirens blaring and lights flashing. As fun as that was, I will admit to you... I won almost every time and intubating was still one of my weakest skills as a new medic. I even had my supervisor call me to his office ask why I used so many king tubes during my 3rd month on the job!
I think it was my weakest skill because, although I had intubated the manikin under high stress plenty of times, I was just not confident when intubating a human. When I had my OR rotations, I was only given the opportunity to place multiple LMAs that day so until I was out on the road, I had not even gotten to practice placing an ET tube into a real human. I was a major white cloud as an EMT and as a medic student so I only intubated a human ONCE before earning my medic license. THEN I was a major black cloud once I was let off of medic orientation.
This is not at all relevant but my first shift as as solo medic, I had a 16 year old presenting with stroke like symptoms who ended up having meningitis and a stabbing with an evisceration. I saw 10 inches of this dudes colon! Fun fact: I ran on the same patient multiple times after that night and he was doing perfectly fine, with a B.A. scar.
Okay, back to the lack of confidence in intubation...
I should not have let this get to me but I did. Instead, I should have been confident and told myself, "Hey, you know what you're doing, just act like this is what you practiced." Cockiness is not good for a healthcare provider but confidence is.
As I have mentioned before, "Fake it till you make it" used to be my least favorite phrase but now I look at it differently. If you have put in the work and you know your $#!+, there is no reason that you should not fake it till you make it!
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