SIOUX CITY | Huda Jarmakani's heart began to race when she heard the rig she had been assigned to was being paged out to a patient in cardiac arrest.

She swiftly boarded the ambulance, which sped away that afternoon with its lights flashing and sirens blaring.

The incident marked the first time the Des Moines University student would participate in an active "code."

On the scene in a tight nursing home hallway, Jarmakani described a "chaotic, but organized" environment as she went to work. Her nerves began to ease as she pushed epinephrine, collected a medical history and took over "bagging" -- manual ventilation. The patient's pulse returned while being wheeled out of the building.

Jarmakani, 31, who is in her fourth year of medical school, wanted to soak up the entire experience of being a paramedic. She spent nearly 200 hours with Siouxland Paramedics, Inc., which serves Sioux City and North Sioux City.

Commanding officer Liz Ford said medical students have logged a couple hours here and there shadowing paramedics as they respond to emergencies, but she said Jarmakani is the first to do a month-long rotation with the ambulance service.

Throughout the rotation, which began Jan. 31, Jarmakani worked closely with Siouxland Paramedics field training officer Sarah Harris responding to basic transfer calls, car crashes and everything in between. She took vitals, started IVs and intubated a patient.

"It's something that's really never been done," Harris said. "Med students don't do rotations with EMS."

Jarmakani said the rotation took her out of her comfort zone. She worked with Harris in the cold and snow and in patients' homes surrounded by stressed loved ones.

"It's been an absolutely amazing experience," she said. "In this field and in this position, you're the one telling everyone else what to do. You transfer from being a medical student into the physician who's taking care of the patient."

Jarmakani, a graduate of Hinton High School, decided to pursue a medical career while attending Briar Cliff University. Her father, Marwan, is an interventional radiologist at UnityPoint Health-St. Luke's and her mother, Wajiha, is a former nurse.

Working as a waiver specialist at Opportunities Unlimited in college had the biggest influence on Jarmakani's career path. It was there that she learned basic life support, how to administer medications and how to properly lift and transport patients.

"When I started working with kids and taking care of them is when I knew I definitely wanted to be in medicine," she said. "I would go hang out with my kid and work on whatever we needed to that day. It was just nice to see them progress and meet their goals that we set for them."

Besides being able to help people, Jarmakani said she liked the different career paths that medicine afforded her. She could do research in a laboratory, see patients in a clinic or work in a fast-paced setting, such as an emergency room.

"It was really for me figuring out which path I belonged to," she said. "That continuity you have with your patient is what attracts me most to medicine -- being right there experiencing everything they're going through."

While doing her clinical rotations, Jarmakani decided to become a family physician. Part of a family physician's job is assessing patients in the emergency department and deciding whether to admit them or send them home.

Ford said the rotation with Siouxland Paramedics gives Jarmakani the experience needed to work in a rural emergency department. Although responding to emergencies was a little scary for Jarmakani at first, she said with each shift she gained confidence. She knows where every piece of medical equipment is in the ambulance and how to use it. 

"This gets her used to what emergency care is and what will have happened prior to (the patient arriving at the hospital) and how to maintain that," Ford said.

After each call, Harris sat down with Jarmakani to reflect on what happened. She created special patient forms to help her think about how she would respond in the field as a paramedic and what medications and tests she would order as a physician after the patient arrived at the hospital. 

"She can put that together and take that back to her professors so they can see that she didn't just sit. She got put through the paces," Ford said.

Jarmakani wasn't the only one learning during the rotation, Harris said Jarmakani taught her a different way to palpate abdomens and how to assess lower leg fractures.

"Some of the questions and her thought process to diagnose have actually opened my eyes to another way to look at things," she said. "I'm learning some tricks from her."

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