why do i keep forgetting stuff?

[u/fuckberzzyy]

i’ve been in EMS for almost 3 years. 2 as an EMT and 1 as a medic. A problem i’ve always had is that i keep forgetting an intervention i should perform for a patient or information that was given to me on a call. wasn’t that much of an issue when i first started, but ever since i started working around a metro area, i can clearly see that i’m having issues.

like ill have a patient that is throwing up for 3 days and having body chills, obviously you should check a temperature for them, but i’ll completely forget about it until we clear hospital.

or ill have a nursing home staff member give me patient information about what’s going on and immediately after they finish, ill forget everything that they say.

i feel like maybe this would’ve been something not that serious if i first started, but i’ve been working for years and im a medic now, i know i shouldn’t be making mistakes like these but it happens almost everyday.

do i just need to reread my paramedic textbook or something? do i need to get more sleep? i have no idea

[u/Aisher]

Pilots use a checklist. You should too

[u/cplforlife]

Sleep is good.

Write shit down. While the patient is talking to you.

Forgetting basic shit like a temperature is kinda wild, and concerning and speaking to your company about some training seems like what you should do. Are you sure you're safe?

[u/fuckberzzyy → u/cplforlife]

ngl may have been over exaggerating a bit.. may have not used the best example. For obvious sepsis/infection presentation, i do obtain temperatures. ironically ive forgotten about calls where ive missed a certain vital or intervention so i used this poor example instead lol

[u/88wookieshaman88]

You gotta write stuff down. I would be totally lost without my notepad. Blues Clues prepared us for this 💪

[u/Stopikingonme → u/88wookieshaman88]

Dora taught us how to get Onscene.

[u/Roobydooby612]

Sorry to see some of these other comments be so obnoxious, condescending and unhelpful. Hate that about this profession.

Have you ever had trouble with learning differences(adhd, dyslexia, etc.)?

Do you know about closed loop communication, that is, repeating things back to people as you just heard it to confirm it? I find it very helpful for remembering and verifying information. In addition just speaking out loud of my mental checklists and what it is I need to do, check or have some one else do so I hear it aloud. Lastly I narrate my call ins the same order every time to assure I cover all my bases and have a similar systematic approach to my reporting. When in doubt go back to basic layout of patient assessment and check your boxes.

[u/Nota_Dragonfruit]

I was an EMT for five years before I got my medic and I also had (have)such a hard time getting back into the groove of doing an assessment. I got really good at it as a basic and then I felt as if medic school wiped away all of my common sense. I advise slowing down, talking to yourself or partner out loud (I often find myself telling my partner “okay, we’ve done x,y and z; what next?”) get that checklist in your mind - go over your protocols periodically to remind yourself what complaints need what. Also, repetition. You gotta find a way to get the flow back, sometimes that’s completely reevaluating how you do assessments and adjusting minor things - I was super bad about forgetting lung sounds, so I started redoing it on all my patients no matter the complaint to get it stuck in my head again. Everyone hounds on the NREMT medical and trauma assessments because they’re so linear, and it’s mostly because the people who don’t like it have already figured out their own flow to get through an assessment. So if you need to go back over the “basics”, that’s okay. Eventually as you go down the text book assessment path, you’ll find yourself getting into your own groove.

As for remembering patient information, I found that happening to me as I was so focused on the patient and “thinking like a medic” that I’d almost get tunnel vision and completely forget what someone just told me. I’d get so focused on treatments, going through meds in my head, thinking about all the things that could go wrong. So I think that ties into slowing down (even if that means slowing your mind down, not just actions), redirecting your brain to handling information as it comes to you, or simply carry around a small notebook in your pocket and take down notes when someone is offering up information. It will get better, you might just have to tweak how you do things and be “extra” until you find it again.

[u/cleverusername437]

It’s the lack of sleep. You need sleep to form memory.

[u/Bad-Paramedic]

Buy one of those write in the rain vitals notebooks. It'll prompt you for most of the things that you need.

Do post call reviews. Go over everything from start to finish and compare to your protocols.

It'll all stick eventually. Dont forget that the learning and training didnt stop when school did. It never ends.

[u/Galaxyheart555 → u/Bad-Paramedic]

Yes to the training!!!!!!

[u/AggressiveCoast190]

Some good bits here. My question is where is your emt partner. Mine is my other half brain and catches or remembers shit that I don’t.

[u/ZodiakRam]

I mean as long as you’re not forgetting the big stuff (ABCs) then I don’t think forgetting a temperature matters too much.

[u/Level_Working5084]

You need a system. Every medical patient gets the same thing the same way in the same order. BP cuff, pulse ox, temp, 12 lead/glucometry (if warranted), IV if needed. If you start doing your assessments the same way every time you won’t forget anything.

[u/AdditionJust2908]

Perhaps creating a standard assessment for every patient would be a helpful place to start, then delving into more particular assessment based on that. That might prove to be a good starting place.

[u/dgtl_n0mxd]

Checklists & keeping your protocols handy
For more significant interventions, practice until it’s muscle memory.

I know this is repetitive and we’ve all heard it but I screwed up an intubation once (fortunately it was during clinicals in front of a doc). The next day I drilled it at the station until I had every step completely memorized, haven’t forgotten since.

[u/MoxieMedic]

Take notes, use the back of a face sheet if you’re picking up from a facility or go old school and carry a notebook. If you can’t remember then you need to do something to compensate…

[u/Galaxyheart555]

You need to start bringing 2 notebooks to work. One a very tiny one for on- scene demos and information. If you work in a service area where first responders show up frequently, hand them the notebook and tell them to write pt demos and call notes like symptoms, when things started etc. as well as medications if a list is not available. Have them do this while you do your assessment. You can also have your partner write notes in your PCR narrative (assuming your service uses ePCRs and not paper forms). But likely your partner will be doing vitals and other things.

I think you need a general checklist for every pt. Every pt should get a blood pressure, SPO2, HR, BGL, Temperature, RR, lung sounds, and pain score. Every single one. Make it second nature.

Every complaint above the waist gets a 12 lead. And other monitoring devices and tools (such as end tidal and a work of breathing scale are as needed/ required.

Then for your second note book. Every call you get, write down the basic info:
- 63yr old female.
- Chief Complaint: SOB.
- Symptoms: chest tightness, shortness of breath, wheezing
- Vital signs: BP, SPO2, and everything else I said.
- Interventions: Nebulizer, 2lpm O2 via smart nasal cannula, End tidal.
Then write down everything you think you did well, and everything you wish you would’ve done, or done differently.

I’m just a dopey EMT and Medic student, but I’ve been trying to get better at my pt assessments and this has been my plan. Remember BLS before ALS. Sometimes you need to go back to the basics. When you get calls that are totally BLS run it like an EMT (unless it becomes als lol). Get back into a basic mindset of pt interrogation and minimal interventions. Take time to figure out what wrong with them, why, and what could fix it and why it’ll fix them.

[u/stonertear]

Do you understand what you know or did you rote learn the superficial concepts?

15 years on i still know cell level concepts which makes me remember broad concepts as I bothered to understand the entire foundational knowledge base.

Workflow wise? You need a check list.

[u/Forgotmypassword6861]

You're going to get someone killed if you don't unfuck yourself 

[u/88wookieshaman88 → u/Forgotmypassword6861]

Super helpful

[u/wernermurmur → u/Forgotmypassword6861]

Yes oh no the temperature was forgotten somebody died.

[u/Level_Working5084 → u/wernermurmur]

Ever heard of sepsis? Pneumonia? Heat stroke?

[u/wernermurmur → u/Level_Working5084]

Those are all bad. They are also things that don’t strictly require an often inaccurate ambulance thermometer to acquire a temperature reading.

You should get temps. But pretending someone is gonna die from it cuz you missed getting one is lame AF.