I've had a couple of weeks now to reflect upon the completion of the EMT course, and my successful certification by the state of New Jersey. I want to again thank my wife and son for their patience with me, and to everyone that offered their support and well wishes.

The experience was both easier and more challenging than I had expected. In all honesty, the course material wasn't particularly difficult to understand, even with the use of medical terminology sprinkled throughout. The hands-on and practical skills weren't particularly difficult either, whether it was applying trauma bandages, inserting airways, performing CPR, or just moving and lifting patients.

On the other hand, I was challenged to overcome an initial desire to simply 'help' a patient with what appeared to be an immediate discomfort or pain, and rather to slow down and assess the entire situation, looking for those more hidden issues that actually posed a greater life risk. It took a bit of time for me to not just understand the importance of this, but to actually internalize it to the point that it became natural to slow down rather than speed up in times of crisis.

Not that I was always perfect at it.

Today was our final practical exams, a requirement for graduation from the EMT course. Designed to test our knowledge and understanding of all things EMT, covering medical and trauma assessments along with key skills including airway management, bandaging and splinting, CPR and AED usage, and pharmacological interventions such as EPI-Pen and Nitroglycerin administration.

And although the final practical exams were designed to test the skills I have gained over the past 4 months, in the end it taught me perhaps the most important lesson of all -- a reminder that being humble and keeping an open mind may just be the most important EMT skills I can master.

While the EMT course has been challenging, especially for someone who has been out of the day-to-day experience of classes, studying, and test taking for almost 30 years, I felt that I had done pretty well for myself. My quiz and exam grades were always high, and while there was a lot of memorization to accomplish, my own life experiences often helped to put class material in context and perspective.  Eighteen months as a driver for the squad gave me an additional sense of how to interact with patients, and the experience of having observed other squad EMTs actually putting some of these skills in action in the course of our calls might have even offered me an edge in some scenarios.

Through the class, the practical exams had gone extremely well, with several instructors telling my that I appeared to have that special quality that would make me a good EMT. I passed through all the practical exams without requiring remediation or a second (and final) attempt to demonstrate a critical skill.

And then there was today. Final exams. And on the fourth and final skill station, I made a huge mistake, one that I won't quickly or easily forget.

My EMT course is being taught through Atlantic Training Center, using facilities at the Morris County Public Safety Academy.  The Academy not only supports Police and Fire academies for the county, it's also co-located with the Morris County Office of Emergency Management (OEM) facilities.

Although not formally part of the EMT course, my class was exceedingly lucky to have a quick tour of the 911 emergency dispatch center and the Emergency Operations Center (EOC), thanks to Scott DiGiralomo, Director, Department of Law and Public Safety/Emergency Management Coordinator. A mere 2 years old, the center is a technological marvel, reminiscent of any major Hollywood movie depicting high-tech command-and-control centers, from space flight operations to military war rooms. As my actual career has been in the high-tech and telecom industries for 25-plus years, I found the technical aspects quite fascinating, from real-time video feeds from around the county (including the helipad at Morristown Memorial Hospital, used by our county airborne paramedics), to GPS-enabled tracking of emergency services personnel and equipment.

The amazing job these emergency dispatchers perform really can't be understated. For those that are curious, I've linked to a YouTube video that gives you just a small taste of the complex multi-tasking these individuals perform, minute by minute, staying on-line with callers for as long as necessary with simultaneously coordinating with a host of dispatched resources. They truly are one of a kind, and probably don't get half the recognition that they deserve.

Well, actually... don't!

There's no doubt that we've got to master the signs and symptoms, and associated interventions, of both respiratory and cardiac emergencies. Every situation we face starts with assessing the ABC"s -- Airway, Breathing, and Circulation -- as these represent true emergencies, where it really can be a matter of life-or-death.

Respiratory and cardiac emergencies are very closely related, as issues in one area can have a detrimental, even fatal, impact to the other.

While the heart is responsible for pumping blood through the lungs for oxygenation, and then moving the oxygenated blood itself to the tissues and organs throughout the body, it is itself a muscle that also requires oxygenated blood to effectively pump. So any disruption in how the body is obtaining and utilizing air through the upper and lower airways (including the lungs) can cause issues for the heart as well.

And things roll downhill quickly from there on... Because having to perform CPR means that someone is having a really, really, really bad day....