Handling my first 'real-world' medical situation as a physician assisant

You can never predict when your first medical emergency may occur or who may be around to help.

Handling the first 'real-world' emergency situation as a physician assisant
Handling the first 'real-world' emergency situation as a physician assisant

If you are anything like me, when you were in school you sat in class pondering what it would be like the first time you had to apply your medical training to an emergency situation out in the “real world.”

Would I have to perform CPR at a baseball game? Or maybe the Heimlich maneuver while I was out at lunch? Would I remember my training under pressure? Would I sprint to the scene in slow motion doing my best Baywatch-esque jog? As is life, it was none of these situations that I had practiced in my head, and it came when I least expected it. 

My first “real world” emergency occurred right after I graduated and before I started working. It was a Sunday, and I was hurrying into church with my mom.

We were late and were rushing more than usual. Just as we were about to get to the door, we heard someone screaming.

“Help! Help! This woman has fallen!”

My mind was elsewhere, and it didn't quite register exactly what was going on. I looked at my mom and she looked at me.

“That's YOU!” she exclaimed, “Go help!”

Suddenly I snapped into action, racing across the parking lot (and by racing I mean shuffling. I was in heels, after all) screaming, “I'm a PA! I'm a PA!”

I don't quite know if I was yelling more for her benefit or for mine, but somehow it seemed appropriate at the time. Coming upon the scene I found an elderly woman laying on the ground, her head bleeding and one of her teeth laying beside her. I looked at the tooth.

My mind started racing. I had learned something about what to do with teeth. What was it? Milk! Of course! I had to get my hands on some milk. By this time, my mom, the assistant pastor, and some other bystanders had arrived, and everyone was staring at me. I looked back at them, and suddenly my take-charge attitude was in full force. I started to yell out directions.

“YOU! Call 9-1-1!” I yelled to a woman.

“YOU! Go get some milk!” I yelled to the assistant pastor.

“Everyone else needs to step back!”

I shouted and pointed the way I had seen it done in CPR videos, and everyone snapped into action.

Suddenly, I heard my mom in the background. “Good job sweetie! Keep it up! You're doing great!”

This was not how I imagined my first emergency situation; me standing awkwardly in the middle of a crowd with my mom filling the role of personal cheerleader. Just as I thought it couldn't get any more unusual, my family medicine preceptor came up to the scene.

He attends the same church as me and happened to arrive late to church as well. To make matters worse, he decided this was a perfect opportunity to quiz me on anticoagulants in front of everyone.

“She hit her head. Is she on anticoagulants? If she was on warfarin, what would the antidote be? What about dabigatran?”

The crowd stared at me, waiting for my responses. I could not believe this was happening. This was becoming more horrifying by the minute. Finally, I was saved by the return of the assistant pastor, who hurried over yelling, “We don't have milk! We only have half-and-half from coffee hour!”

After plopping the tooth in the cup of half-and-half, we all stood around, waiting for the EMTs to arrive. My preceptor kept quizzing me, I kept answering, and my mom kept cheering.

Finally, the EMTs arrived and we loaded the woman into the ambulance. As they drove away, I felt more relieved than anything that the entire situation was over. I began walking into church and my preceptor tapped me on the shoulder. “You did a good job!” he exclaimed. “I'm glad to know you learned something as my student!”

As I got into church I smiled to myself. It wasn't nearly how I thought it would go, but I got through it and remembered what I needed to know. Maybe I would survive as a real-life PA after all. Now if only they would let my mom come to work with me every day...

What was it like the first time you were expected to act in an emergency situation? Did it go how you expected it to go? Was it a disaster? Share your experiences in the comment section.

Jillian Knowles, MMS, PA-C, is an emergency medicine physician assistant in the Philadelphia area.

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