Skills Final
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DesertMedic66
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Memorize the NREMT skill sheets
teedubbyaw
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Biggest mistake I see is people rushing. I can't remember the time on those, 10-15 minutes? Either way, you have a copious amount of time. Take a deep breath and take your time.
Don't forget your ABC's
Don't forget your ABC's
DesertMedic66
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Biggest mistake I see is people rushing. I can't remember the time on those, 10-15 minutes? Either way, you have a copious amount of time. Take a deep breath and take your time.
Don't forget your ABC's
You get 10 minutes for trauma assessment and 10 minutes for backboarding. I think for medical it's 10-15 minutes.
nwhitney
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Medical is 15 minutes and I agree with slowing down and taking your time. Of course don't go so slow that you run out of time. Remember that you can't move down the skill sheet till you fix your life threats. Also everyone gets O2 (talking testing here not real life) via the appropriate means whether it be BVM or NRB. Good luck
Some common things I've seen.
Memorize the skill sheets, which should have been obvious by now.
Remember to address any problems that pop up with ABCs instantly. They tell you someone is bleeding then control it, someones airway is compromised, address it. Dont move on until you know the problem is either fixed, or as good as you can make it for the moment. You can probably ask the proctor if it fixed the problem. Maybe they'll just say yes, or maybe theyll just describe what the result is and you have to figure out if its fixed.
Remember if a patient has altered mental status to check their BGL. You get dispatched to a drunk patient or someone having a stroke, check their BGL. A patient having seizures, check their BGL, even if the cause seems obvious and nothing to do with BGL, its not going to hurt to say youd check it and ask what it is.
Memorize the skill sheets, which should have been obvious by now.
Remember to address any problems that pop up with ABCs instantly. They tell you someone is bleeding then control it, someones airway is compromised, address it. Dont move on until you know the problem is either fixed, or as good as you can make it for the moment. You can probably ask the proctor if it fixed the problem. Maybe they'll just say yes, or maybe theyll just describe what the result is and you have to figure out if its fixed.
Remember if a patient has altered mental status to check their BGL. You get dispatched to a drunk patient or someone having a stroke, check their BGL. A patient having seizures, check their BGL, even if the cause seems obvious and nothing to do with BGL, its not going to hurt to say youd check it and ask what it is.
DesertMedic66
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Not all basics are able to check BGL.
Jim37F
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All patients with an Altered Mental Status get oxygen, at least that's what I was taught for skills testing.
I didn't put oxygen on my patients during all my skills during testing. One of mine was a cardiac patient for medical. I was evaluating and then asked the evaluator for o2 level. They stated it was 94%. I then stated I considered o2 but am not going to give o2 at this time but will continuously monitor level.
All you have to do is consider it and talk through it. I did apply o2 for my shock patient. I did not for my trauma. Etc in our state we titrate our o2. Each station I asked for a sat level and went from there
All you have to do is consider it and talk through it. I did apply o2 for my shock patient. I did not for my trauma. Etc in our state we titrate our o2. Each station I asked for a sat level and went from there
I would always give o2 for testing purposes, especially on a cardiac patient. I suppose if you knew the person testing yous thoughts on the matter you could hold off, but otherwise give them o2 for chest pain. As someone pointed out to me some basics cant check glucose, which is right, and some Basics cant check spo2 either.
I would still mention that I would consider the possibility of hypoglycemia in an altered mental status patient, and would state I would check BGL if my protocols allowed, because if that patient scenario is someone who is hypoglycemic and you never mentioned it, I think you would fail. Someone else mentioned to give o2 for altered mental status, but I assumed that went without mentioning, and youd still consider hypoglycemia and check for it if able.
AtlasFlyer
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The first practice practical session during my class that we practiced medical assessments I failed MISERABLY! I rushed, got flustered and forgot EVERYTHING.
For me, the key to passing medical & trauma assessments during the practical (which I passed on the first try) was to SLOW DOWN. You have 10 minutes to run down the list. Memorize the list, know it IN ORDER. As you're doing your assessments, just go down the lists. Slowly, methodically, logically. Stop and think a moment if you need to. At one point in my medical assessment I stopped and paused for a good 15 seconds, just thinking, going over the sheets in my head, then methodically continued.
10 minutes is a long time. Slow down, take your time, think through it.
For me, the key to passing medical & trauma assessments during the practical (which I passed on the first try) was to SLOW DOWN. You have 10 minutes to run down the list. Memorize the list, know it IN ORDER. As you're doing your assessments, just go down the lists. Slowly, methodically, logically. Stop and think a moment if you need to. At one point in my medical assessment I stopped and paused for a good 15 seconds, just thinking, going over the sheets in my head, then methodically continued.
10 minutes is a long time. Slow down, take your time, think through it.
Giving o2 to a cardiac patient with spo2 of 94 and above is a no no. O2 is not good for everyone .
I did not know any of my evaluators. However I passed all 7 of my stations first try..
Since bgl is a local protocol, unlikely they will run into testing on that.
You do not have to give everyone o2, just mention it.
Why is it a big no no? Where did you hear this? I understand o2 is not the answer to everything, but for testing purposes at the EMT level the rule of thumb is everyone gets o2.
If you explain WHY you wouldnt give o2 you would probably be ok. But I dont think Ive heard of anyone failing because they gave o2, or even too much o2. People DO fail because they didnt give someone o2. If they are a COPDer maybe its a gray area that would require you to explain why you are dialing back the o2, but for chest pain not giving them o2 if they are sating below a certain level sounds more like a local protocol than something youd do on a NREMT exam.
Hypoglycemia is a scenario Ive seen at NREMT skill stations, so dont know where you got the notion it wouldnt be on a medical assessment station, are you in a state that uses the NREMT? Would you still pass if you never addressed the hypoglycemia? Probably not in most cases( managing the patient as a competent EMT being critical criteria). If you ask the person testing what the patients blood sugar is, they will either give you a number, or they will say you dont know or cant test. If you cant do a BGL check then I guess you treat them if they are symptomatic, dont meet any contraindications, and there is a reason to suspect it.
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I think she's referring more to real life than for NREMT testing purposes. Yes, we all know the skill proctors seem to want everyone on 15 LPM by NRB, but in reality current research is leading us away from routine oxygen administration, particularly in ACS or stroke patients. Also, we should really, really move away from jabbering on about the hypoxic drive in COPD patients.
Checking blood glucose has more recently been taken out of the EMT curriculum. If the patient seems to have a diabetic issue, give them glucose they say. It is now a local protocol , my service does bgl.
One thing a lot of people don't always realize is the skills stations are set up more for state. My niece recently took her nremt and had 5 stations, I had 7. She had hers in a different state than I.
As for not putting o2 on a cardiac patient with oxygen >94. This is now a national registry skill and should have trickled down through the curriculum even though the books have not been reprinted thus far. It is worth asking the instructor about.
Yes I am in a national registry state. I have also become an evaluator. .O2 is to be considered . The candidate does not have to use o2 in all circumstances.
lol you know how many COPD patients I've seen on O2 at night that never mysteriously quit breathing?
This is the nremt page itself explaining the new aha guidelines. It does mention o2 with cardiac. Changes took place in 2012
https://www.nremt.org/nremt/about/2010_aha_guidelines.asp
Sandog
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What state is this? Pulse Ox is not always reliable.
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While true. It's not always unreliable either. People make it seem like pulse oximeters are always wrong.