Wednesday, February 27, 2008

MDA Chul (Magen David Adom Overseas Program), Part I: The Training

Day 1: Sunday, February 10, 2008
12:58 pm
At the Bayit Vagan Guesthouse(/Youth Hostel). Cam in, signed in/registered, met people, went to get another person a notebook, came back, chilled, had an intro, ate lunch, and am waiting to go get introduced to my instructors and get my room key. In other news, I have to wash my splint.
6:41 pm
On a break until 7 pm. So far so good. There's a lot of 18-20-year-olds in this course. We're split into 2 classes, ~12/class. There are two full-time instructors and 1 who comes in the afternoon.
So far we've covered what we do (oxygen, bandage, vitals...), what we don't do (hit a pt., give them anything to eat/drink/smoke- except with diabetics-, talk to the media, etc.), adult and child CPR, and choking, but only conscious adults. We've got another hour or two before we finish for the night.
My biggest issues are remembering to call for an ambulance and rescue breaths-- I don't open my mouth enough (sound familiar, anyone?). I don't actually suck-- they go in, but I don't like them. Oh, and I have to tilt the head a bit farther back, I think. Again, breaths go in, I'm just not happy with. Let's see...rooms. They are, literally, a place to sleep. There's 3 beds-- 2 pushed together, and one single, a shower, a toilet, 2 nighttables, and a closet. I will be living out of my suitcase. And am debating asking Rita to send me my mattress cover, pillow cover, and duvet cover.

Day 2: Monday, February 11, 2008
3:05 pm
On break. So far I haven't flunked out-- clearly I'm very optimistic. It's okay. They're very intense days-- lots of information, but not's not as bad as the first week of school. THAT was a bitch-and-a-half. It was also the 3-4 hour breaks when I was in the 2nd lab and couldn't do anything besides work in papers or my art projects.
Today we did some review, then did CPR equipment and practice with equipment. We did some special situations-- electrocution, drowning, hanging, poisoning (note: harAHlah, not harPAlah-- harpalah means abortion). And we did-- started-- vitals-- skin, resps, BP, pulse/HR. BP the way we did it in school- with stethoscope- and also the way Katie taught me at Burke, via the radial pulse-- but you only get systolic from that.
7:01 pm
Dinner was later today-- 6:30-7:30, so I've got a half-hour left, which leaves me plenty of time to write. As a side note, it's hard to write when you've got music in your ears and you're tapping your feet and moving your body to it. I'm working on it. If I just let the music play, k'ilu in the background, it's a bit better.
I really miss fw. Not the student crap, but treating patients. I miss it. It sounds funny, but I miss treating people and-- doing it and knowing what to do and making a difference. It's cheesy. But I do.
So far, still no roommate. Not that I'm complaining, just saying. It's-- you miss out on the whole roommate-bonding thing, but I get all the towels I want. Which is a bonus, and I can use the shower and bathroom whenever I want. And don't have to worry about waking anyone up.
All right, time to put this away-- oh, wait, it's "Accidentally in Love." Okay, I'll put this away, finish the song, then be social.

Day 3: Tuesday, February 12, 2008
6:25 pm
So far no roommate-- don't think I'm getting one, seeing as it's already 3 days in...Today we did...something in the morning. I don't remember what, but it's on the midterm tomorrow, which goes from the first day until this morning. Felt like crap, actually, this morning. Feeling a bit better, but still with a headache. I don't have time for this, I've got stuff to do. Lots of studying.
It feels like the older I get, the more I get sick. Maybe it's because I'm pushing my body too hard-- or harder than I used to? Either way, I don't have time for this.

Day 4: Wednesday, February 13, 2008
Translations: ABC-O2 means "check the person's airway, breathing, circulation, and act appropriately, and give oxygen"
PHTLS means "Pre-Hospital Trauma Life Support" and there's a checklist of things to do when someone has had trauma.

9:05 am
Exam's over. Went okay, I think. I'll find out later when I get the results-- hopefully later today. There were a few questions I was kind of -ish on, mostly the one about drowning. The question was, "What is the correct treatment for drowning?" Answers were (a) remove person from water (b) ABC-O2 (c) Remove H2O from lungs. First I chose (a), but then realized the person might not be in the water, nor might I be able to remove them. And I knew (c) was wrong, so that left (b). But especially if it's shallow water, you're supposed to do PHTLS. So I don't know. Whatever, I can get one wrong.
6:19 pm
Finished dinner-- good L-rd, I eat fast. I really need to learn to slow it down a bit. A lot.
We went over the exam-- we didn't get them back, but Yehuda went over the questions. I know that I got the one on MI wrong, and I didn't write to call the Natan (ICU ambulance) fora few of them. Now I know what to work on. I think I want to start studying NOW for the final. ...See how far I get with that.
Let's just discuss the class for a minute. There are 3 instructors for my class-- Yehuda, Shloime, and Dan. Dan is by far the funniest, as in belly-laugh. Shloime is randomly amusing-- he draws on the board and...has random British humor moments that the Brits get. Yehuda has more intellectual humor.
Anyway, class is definitely NOT boring, feels...I don't even know. Like a locker room-- 90% of the humor is sexual jokes, innuendos, etc. The most popular phrase (at least on Dan's part) is Swedish; I can't pronounce it, but I can translate it. I swear, this is definitely up there with OT375, or whatever Dr. Wood's theory class was.
I did okay on the midterm, I just hope I do as well (preferably better) on the final.
10:53 pm
Got a 92 on the midterm. I got the MI question wrong, missed one on heart attack s&s (signs and symptoms), and on PE, I didn't sit her up. But my Hebrew was all good. So apparently I'm not doing too bad. I asked SHloime about his offer of a mock practical-- if he was serious. He said he didn't remember, but he said he would. I'll see. I want it, but I'll see.
In other news, guess who's dehydrated again? It's in between, "Wow, I really need a drink," which isn't anything big, and the TKD bit when I'm seeing spots/floaters and the colors are all getting brighter. I also really need to be in the fresh air, but it's wet outside. I'll go study out there. I need air and H2O.

Day 5: Thursday, February 14, 2008
11:00 pm
We actually finished early-- very early-- today, as in 6-- before dinner. I ate, discovered I wasn't the only one who got sick from the food, and went back to practice. I finally got to backboard, and learned what was a key thing I was missing-- I wasn't moving a hand, when I was at the top, and I have to. I still have to practice backboarding-- A LOT--but now I know what to do and understand what I was doing wrong. Aside from that, today was a lighter day. We had a Great Debate about t-shirts and sweatshirts, followed by practice. Then we all went to Har Hertzel and on the way back it started mamash pouring and hailing HARD on us. Not fun. By the way, hail hurts- it feels like lots of needles being repeatedly poked into you, especially when it's being blown around by the wind. After that we came back, had lunch, I took a nice HOT shower and felt better. Went back to class, had practice followed by lecture, then we closed for the day.
Really the biggest things I need to practice are PHTLS and backboarding. PHTLS is really pure memorization, and backboarding I need three others for. Bandaging I can do, I'd like to practice jaw bandaging a couple more times, but the others I can do. CPR, I'll review, especially with equipment.
Tomorrow we have class until 12, then we get ready for Shabbat. Yay! We'll also get the schedule for Shabbat, so I'll talk to Moshe and maybe hang out with him. Bedtime!

Day 6: Friday, February 15, 2008
3:17 pm
Few minutes before I jump into the shower (by the way, very good shower-- pressure, HOT water).
Today was, again, much more laid-back. We had both classes together at the beginning of the day, and we learned to prepare and IV, I punctured the part where you stick in the IV tubing, and then my finger-- but only a little bit. I felt a bit stupid, but then Elkie said she did the same thing, so I don't feel as bad. I tried it again, and this time I got it in straight. Going to shower so my hair will dry a bit before Shabbat.
4:17 pm
Showered, half-dressed, and not make-up-ified, and have not yet poked my eyes out. Finish this up, do that, call Bubby and Zaidy, then get Cassie and light with her. So-- today. IVs, practice, split up, practice, lecture on burns, practice, finish off the day, Had lunch-- falafel-- then went to get Shabbos treats! Spent, like, $12 on that-- but it's for Shabbat. Came back, checked my email., hung out with Eden and Benny, then came up to get ready.
I'm really nervous for the final. Theres a lot on the written, and I don't know most of it. The practical-- if you do something like step over your patient, you fail. I'm worried that I'll do something "little" that I'm not supposed to do, and I'll fail because of that, not because I don't know my stuff. We shall see...and on that note, I'm going to make-up-ify and poke my eyes out. And finish getting dressed.

Day 8: Sunday, February 17, 2008
12:39 pm
The good news is, I don't suck at PHTLS. I did a scenario with 2 others...and I am now supposed to stick to the head because I had C, D, and had started E before the person who wasn't holding the head had finished B. The only thing is, I did the tourniquet and forgot to write the time on the person's head. Cannot forget that. That is important. But overall we worked well for backboarding-- got the pt. on, did the rolling well.
I have to practice the secondary survey. A- Recheck AW, check for and tx skull fx. B- Check and assess breathing (30 sec.), change O2 in ambulance. C- Check pulse, BP, wounds-minor hemorrhages, IV. D- Dressing- wounds, fx, burns. E-Evac, if haven't done so already.
Moving right along, Shabbat. It was nice. There are a bunch of people from a youth group called Netzer who weren't here because they had a group Shabbat. But there was about 3/4 of the whole group in. We had davening with a Belgian school group...because neither of us had a minyan independently. There were 3 others besides me (from the girls) at kabbalat Shabbat, then more people came for dinner. Te oneg was after that-- also chilled. Then I hung out after pople left to go out...because I wasn't going out on Fri. night... and played Jungle Speed with Arie, Aryeh Kaufman, and a/
6:30 pm
doctor, Baruch, who was with us over Shabbat. (He gave a lecture on medical ethics and halacha on Shabbat afternoon.) Then they all left to take care of someone and Moshe came by. Then Arie, Aryeh, and Baruch came back an we all played Jungle Speed, and then Moshe and I went for a walk (no comments about Shabbos walks-- it wasn't a date, and if it had been, he would have been 2-3 hours late). Then we came back, chilled with the others, then Moshe left, and the four of us were talking. And then it was midnight and the lights shut off, and we wrapped up and went to sleep.
Shabbat morning we had davening, lunch, the lecture, then some people went to practice more and I took a nap until seudah shlishit, woke up, ate, then we made Havdalah. There was sort of a kumsitz which basically involved Aryeh bringing his guitar and hima nd Arie playing and singing. Everyone else was studying.
Aryeh left and brought back some movies. I watched half of "Knocked Up," then went to go to sleep but got distracted by people talking about the test, so I stopped t talk, too, and eventually went to bed.
Today we had a lecture on Mass Casualty Incidents-- Ara"n-- and the rest of the day was practice.
Shloime asked Rebecca and I to help some of the weaker students, which I'm okay with. And then hen I was doing a PHTLS scenario with Danielle and Michael, Yuda told me to stick to the head and let the others do the rest of the assessment. On one hand, that's really positive, but on the other hand, it's like-- I hope I do as well on the test. I'm mostly worried about the backboarding and the second survey. Backboarding is dependent on who you're working with. But they said they're grading us individually. Secondary survey- let's go through that again- A- check consciousness, AW, skull fx. B- Assess breathing, hook up pt. to O2 tank in ambulance. C- check pulse, BP, minor hemorrhages, IV, D- Dressing- fx, burns, wounds, E- Evacuate, if haven't done so.
PHTLS itself is SSS- Check scene safety, stop and major bleeds- write time on forehead if applying tourniquet. A- Check consciousness, AW, c-spine. B- Expose chest, check breathing, apply Asherman on open chest wound(s), C- Check for any major hemorrhages, check skin, check pulse and capillary refill, check abdomen. D- PAL- Pupils Equal And Reactive to Light, Limbs- move them, feel, AVPU again, E- Expose body, full body check-- ignore burns, scrapes, bruises, fx, Recover. TNT-- Treat or Transport. Second Survey: A- AVPU, AW, B- Assess breathing, switch O2, C- Circulation- stop minor bleeds, assess pluse, BP, IV. D- Dressing- bandage small wounds, fx, burns, E- Evacuate (if haven't done so already). Okay, I know this mostly. I need to study diseases and s&s.
Oh-- Shock- BP down, HR up, Resps. up.
Head injury-- BP up, HR down, Resps. down.

Day 9: Monday, February 18, 2008
12:29 pm
Oh, double f. I forgot to write the time I tourniqueted Sharon's arm. I also forgot to feel her abdomen. F.
The written was okay-- I messed up ont he math-- I added in an extra zero and-- ugh! I know I did all right on the Ivrit-- damn, it's cold out here!
All right, this is-- oh, and at first I screwed up Sharon's BP. I just get so nervous on exams!
All right, it's over and done with, and there's nothign more I can do. I'm going to go upstairs, finish packing, shower-- or reverse those two-- and be back down in 3 hours. Maybe I'll read a bit as well.
Or just pack and read. I'm stressed.

*Sara's comment: midterm
I can't believe I didn't get a mention here when I used daytime minutes to call you and comfort you, like I do before EVERY test. I'm just saying. :) Glad you did well, though- not at all surprised, but still glad. (yes, I realize this comment is delayed, I just wanted to make my annoyance public and maybe earn a mention in a later post)*

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