what's an ER tech?
hello friends and enemies! I've already made a post about physician assistants and our role in the ED, but now I'm making one about the role of techs/aides/assistants.
I was a tech at a small ER about 13 years ago, before I went to PA school. My official title was clinical assistant, and other hospitals called theirs emergency service assistants or patient care assistants, but broadly, if someone says they teched in an ED, this is what they mean.
Techs are basically extra sets of hands; their role is not to diagnose or evaluate patients, but to help the care team. Techs room patients, do EKGs, draw blood (but don't start IVs), take vitals, do point-of-care testing (like urine dipstick and fingerstick blood sugar) and help patients with toileting/cleaning. They answer call lights and either deal with the patient's concern (they've slid down in the bed and need to be moved) or let the nurse or clinician know (they're having new symptoms or they want to know if they can eat.)
We assisted with codes: chest compressions, running things to the lab, getting blood from the blood bank, getting equipment from the closet. (We were a very small department with a single code/trauma room, which was actually two curtain-separated rooms most of the time. We kept the Lucas, video laryngoscope/glidescope, and code cart in the room, but the EKG machine and other stuff was in another area.) Depending on which way the code went, we either brought patients up to the ICU with their nurse or we prepared the body to be brought to the morgue.
We assisted with procedures, too. My job during shoulder relocations was to hold traction on the patient so that the doc could apply enough force to pop it back in place (like we see Garcia do in s2e1.) I once held down a 2 year old who was absolutely maxed out on ketamine while they sutured his face. (He was calm but SO squirmy.)
I got to know a lot of the doctors and PAs really well, and once they knew that I wanted to go to PA school, they were eager to teach me little things when they could, like what the steps of rapid sequence intubation are or what to look for on a chest x-ray.
Many of our techs (myself included) came from one of the local ambulance services, and many of us (myself included) were using it as a stepping stone to apply to PA school. Others went on to become nurses or physical therapists, but by and large this is not a job people work as a career. It's physically and emotionally demanding, and in 2013 I made...$14 an hour?
It was also a LOT of fun. I had clear and concrete tasks to complete, and none of the responsibility that comes with being an actual EM provider. That being said, I did answer a call light for a patient who was suddenly unable to speak clearly or move half of her body, and I was the one to slam that code button on the wall to get everyone in there FAST, so I wasn't just being a pretty set of hands, either.
(I did flirt with the residents and the attendings and the paramedics and if any of the nurses had been into women I would've flirted with them, too. And yes, I am writing a fic with 23 y/o tech Mel and 40-something attending Langdon that is HEAVILY inspired by true events.)
Obviously, I did this job over a decade ago and in a very different setting than the Pitt. This was a 24-bed ER within a few miles of multiple level 1 trauma centers, so most of what we did was medical. We didn't do peds, either, so (mercifully) kids were either minor problems or immediately shipped out to the children's hospital. All that being said, if you've got someone taking vitals or doing an EKG or getting a fingerstick, they're probably a tech!
