SC Bird
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Well on Wednesday I sat as a patient for the NREMT-B exam. I must say that it was probably the best thing I could have done to prepare myself for my own exam (12/19). Here are some things I noticed and didn't notice...
The first station I sat at was a random basic skills station (LSB and Bleeding Control/Shock Mgt). The first two candidates were no nervous that their hands were shaking so bad that when he applied direct pressure to my arm...my hand started shaking. Obviously, a case of the nerves. However, for the most part everyone was pretty solid on the bleeding/shock station.
The long spine board was a different story. The biggest issue I observed was improper placement of straps. A few candidates had three seperate 9 ft straps across my legs....and then only one across my stomach (just below umbilicus). My torso was completely unsecured.
The next station I sat for was pt. assessment. We alternated between medical and trauma. This was a very tough station for some of the candidates. And to be honest, I was a bit worried. I know that in my program, we have had pt. assessment drilled into our heads. I am not sure if it was nerves or lack of education but some candidates forgot the SAMPLE history all together on medical pts. It was "understandable" when someone forgot to ask a portion of the hx, but some didn't ask any questions at all. Needless to say, it has motivated me to study and study my assessment.
The third station I sat for was another random basic skills station (KED and traction splint). The KED had the highest number of failures for the day with nine. Failures were for improper positioning (wasn't high enough---wasn't up in the armpits) and excessive tightening to the point where it was hampering respirations on a normal, healthy patient.
I did also watch some of the ventilation station. One of the most painful things to watch was candidates walking up to the pediatric intubation station...removing the towel from over the face of the pt. and throw it to the side. A lot of tunnel vision and forgetting the basics.
One of the biggest problems I witnessed was nerves.....had a candidate who was retesting after failing for having KED improperly placed and just jumped in without BSI or assessing PMS. He was so hyped up that he forgot to take a second and breath.
I remember seeing Rid post about candidates verbalizing something and not taking the time to actually do it. I saw a good bit of this especially with assessing PMS in LSB, KED, and pt. assessment. Candidates would verbalize it...and the evaluator would basically have to say "Well go ahead and show me how you'd do that..."
Also, I am usually not one to criticize instructions that are given to students....but when the evaluator asks "If you hear gurgling sounds in the epigastrium, what would you do?"...I was shocked to hear from almost every student that was asked that question, "Carefully pull the tube back and reassess the lung sounds." <_<<_<<_<<_<<_<
Anyways, it helped prepare me for what I'm going to see and need to do...got to practice all of them after candidates were done. Nailed both intubations, LSB, KED, traction and bleeding control....now just to practice assessment.
-Matt
The first station I sat at was a random basic skills station (LSB and Bleeding Control/Shock Mgt). The first two candidates were no nervous that their hands were shaking so bad that when he applied direct pressure to my arm...my hand started shaking. Obviously, a case of the nerves. However, for the most part everyone was pretty solid on the bleeding/shock station.
The long spine board was a different story. The biggest issue I observed was improper placement of straps. A few candidates had three seperate 9 ft straps across my legs....and then only one across my stomach (just below umbilicus). My torso was completely unsecured.
The next station I sat for was pt. assessment. We alternated between medical and trauma. This was a very tough station for some of the candidates. And to be honest, I was a bit worried. I know that in my program, we have had pt. assessment drilled into our heads. I am not sure if it was nerves or lack of education but some candidates forgot the SAMPLE history all together on medical pts. It was "understandable" when someone forgot to ask a portion of the hx, but some didn't ask any questions at all. Needless to say, it has motivated me to study and study my assessment.
The third station I sat for was another random basic skills station (KED and traction splint). The KED had the highest number of failures for the day with nine. Failures were for improper positioning (wasn't high enough---wasn't up in the armpits) and excessive tightening to the point where it was hampering respirations on a normal, healthy patient.
I did also watch some of the ventilation station. One of the most painful things to watch was candidates walking up to the pediatric intubation station...removing the towel from over the face of the pt. and throw it to the side. A lot of tunnel vision and forgetting the basics.
One of the biggest problems I witnessed was nerves.....had a candidate who was retesting after failing for having KED improperly placed and just jumped in without BSI or assessing PMS. He was so hyped up that he forgot to take a second and breath.
I remember seeing Rid post about candidates verbalizing something and not taking the time to actually do it. I saw a good bit of this especially with assessing PMS in LSB, KED, and pt. assessment. Candidates would verbalize it...and the evaluator would basically have to say "Well go ahead and show me how you'd do that..."
Also, I am usually not one to criticize instructions that are given to students....but when the evaluator asks "If you hear gurgling sounds in the epigastrium, what would you do?"...I was shocked to hear from almost every student that was asked that question, "Carefully pull the tube back and reassess the lung sounds." <_<<_<<_<<_<<_<
Anyways, it helped prepare me for what I'm going to see and need to do...got to practice all of them after candidates were done. Nailed both intubations, LSB, KED, traction and bleeding control....now just to practice assessment.
-Matt
