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I'm with NomadicMedic on this. If you don't carefully pay attention to the Physician's Medical Necessity Certification, you very well could inadvertently chart something that results in an insurance/Medicare denial because what you charted might well conflict with the PMNC. I'll give you a...

Yes. The 20g tip can be very hard to find compared to the 18g unless you manage to stick the vein during your initial puncture attempt... when that happens, you get a nice sudden bright spot in the center of the vein. Of course when you're being observed and this happens, you look like a miracle...

Not a fan of using a peripheral line for pressors or inotropes... but sometimes their use is necessary to buy time to get a central line in place. Edematous patients can also be an indication for a peripheral US line. I generally say that it's a lot like playing a video game. If you have good...

When I'm called, most of the usual sites have been already chewed through and/or they're vasoconstricted from either dehydration or use of vasopressors. I can go MUCH faster than that, 3-5 minutes as you do, when necessary. I happen to like the anterior forearms but I also use the cephalic vein...

I'm also very, very good at doing USGPIV's. While I can take 20-30 minutes to do one, most of that time is spent looking for an appropriate site. Once I find a site and all the tubing for a saline lock is ready, the actual time from start to finish is maybe 3-4 minutes. If I'm doing one...

Fair enough!! In any event, it's been so long since I've done an NREMT written that they've probably revised the test and testing process at least a couple times since I took mine on paper... Mostly, for your sake, I hope that you get some kind of report that tells you basically what areas you...

Far enough that you didn't pass. If the score required to pass is 950 and you got 949, you still wouldn't have passed. As far as what you didn't get correct "enough" to not pass, who knows. Hopefully you'll get some kind of report that suggests the areas of study you will likely need.

I think what I was getting at in my earlier post is that checking the ABC's/Primary Survey can be completed so quickly that you flow very, very quickly into your secondary survey stuff and start treating as you discover problems. As you gain experience in assessing patients, it starts to LOOK...

You probably wouldn't be applying oxygen during your primary survey as that's basically just establishing that the patient's ABC's are intact. Basically, they're breathing (and therefore airway is open) and have a pulse. If someone is actively complaining of chest pain, they're probably not...

In addition to what Matt said above, one of the ways I check for proper placement of the stethoscope head is that I actually feel/palpate the location of the brachial artery. Once I find it, I KNOW exactly where to put the stethoscope head. One other way I verify that I'm in the right place is...

Simply put, it's a window into the state of the brain... and noting changes in the pupils can be as, or more, important than a single assessment in the setting of head injury.

As stated above, there are a number of instances when there's a complaint of SOB but still oxygenating well. Most SpO2 sensors that I know of are only capable of determining the percentage of hemoglobin that's bound to something (usually oxygen) or not bound to something. Carbon Monoxide binds...

In light of recent threads, and to encourage study by the OP of all these threads, I'm closing this and related threads.

On that note, I'm closing this, and related threads.

I'm closing this, and related threads.

You've asked quite a number of questions that should all be covered in class or thorough your reading assignments. We're not going to answer these questions for you.

That's an excellent question. While I know what I might do, my scope of practice is very highly likely different from what yours is going to be. Ask your instructor and/or read your textbook. We're not going to answer your question for you. This is stuff you should be getting in class or through...

Assessment and treat according to what your protocols/guidelines state. Difficulty breathing/Shortness of Breath can be difficult to deal with because the underlying cause can be quite varied. Even anxiety can be a cause of this.

yes. given that it's been nearly 20 years and that I've not heard of any litigation... I'm kind of surprised about that.

Yes, this was a real thing. It was RLS for EVERYTHING. When that happened, the system was running so low in availability, the system required all ambulances to respond, transport, and do post moves all RLS just to minimize the time that the system had NO available units. They were acutely aware...