Critique: - Probably should have noticed the chair fallen over and got a tip off to what happened. - Should have palpated C-Spine - ABC's evident when he came too and began speaking. Obviously no airway obstruction, and the jaw thrust seemed strange to do on someone who was just speaking to you. - Didn't check for bilateral inflation in chest - Abdomen and hips (and the Trauma checkin general ) seemed to be more of a pat down than an examination. - Non-life threatening leg wound #LeaveItAlone - SAMPLE - okay. Didn't ask the patient if anything else was hurting him or how the leg was feeling. - VITALS: LOA, pulse, respiration, blood pressure, pupils, skin condition, auscultating lungs. - Cervical Collar - Log Roll to backboard - THEN BANDAGE THE LEG. - Wait for transport while monitoring vitals.
I'd add, that the usage of the spineboard is predestined for 3 People, nobody moves the shoulderbelt, so the back is compressed by just moving the hips.
+Nico DiPlacido Not certain about the points made but ,if anyone else needs to find out about emt practice exams try Nadazma Paramedic Helper (just google it ) ? Ive heard some extraordinary things about it and my work buddy got great results with it.
That was pretty solid for a trauma assessment.. I would just only add since the patient was going through hypoperfusion, I would do an ongoing assessment of every 5 min till we get to ED
NEVER address secondary woulds before loading the patient. this is a trauma patient (load and go). the key word here is "Venous" bleeding, non life threatening injuries should be dealt with in the ambulance en route to the hospital. hope this helps :)
Great job! However: Scene Size-up BSI/PPE [check] Scene safety [check] Number of patients [check] NOI/MOI [check] Standard precautions [missed] Additional resources [check] Consider C-spine injury [check] *Although the bystander should have been given more instruction, i.e., not to move and secure elbows on the ground, despite discomfort. If the head stabilizer is moved, the patient's head can turn unexpectedly. 6/7 -- Well done. Primary Assessment General impression [missed] *One male in his [age] laying supine who appears to be unresponsive. AVPU [check] Airway (modified jaw-thrust, patient?) [check] Breathing (RRQ of respirations + mid-axillaries (additional four if irregular) + apply O2) Circulation (Skin + RRQ of radial pulse (responsive) + capillary refill) The SAMPLE questioning during the treatment was a good idea. Why not kill two birds with one stone, right? The additional vitals, however, could've been taken en route to the hospital and the stage at which the rapid scan was performed threw me off a bit. Overall, he did a bang-up job! I'd say this student is well on his way. Kudos!
Missed some stuff. Why on your blood sweep did you do the arms before the legs? Also, why did you combine the primary and secondary assessments??? Here are some things to remember never release c spine until patient is fully secured to the long spine board and Venus bleeding such as that should get a pressure bandage after being packed with an hemostatic agent or kerlix.... US ARMY critical care flight paramedic...
Can't answer for anything else, but the during a blood sweep I was always taught to go head to toe, no exceptions, so that you don't get out of order. If you go head, neck , torso, abdomen, patient's right then left arm, patient's right then left leg, you'll memorize the routine and never miss a thing.
Polishpuppy189 he obliterated the pulse... when you do BP it’s good to feel the pulse while inflating the cuff until you can’t feel it then go about the normal way of taking a BP
Chris Hardee Probably not. But it can cause problems. Specifically in angina patients. If you give them too much oxygen, it may cause the nitrates to not work as effectively.
You skipped General impression, didnt say chief complain or if you saw any apparent life threats, ABC's were rushed through, did start shock management, didnt say if it was high or low priority transport when appropriate, asked a run down version of the OPQRST/SAMPLE which couldve been done in the ambulance, should've loaded and went after you bandaged the wound. Once instead you couldve did a full assessment during the secondary assessment then obtain baseline vital, then manage wounds and reasses and recheck vitals. This was all over the place lol someone would def fail their NREMT watching this ;D
Also you wouldn't be able to do a jaw thrust on a casualty who is conscious, and why would you put the casualty in a c-collar before checking for facial fracs, face grace might compromise the airway which will be fucked if your casualty is already in the c-collar.. that's why it's called a secondary survey not a 'I'll check it after preparing for evac' survey
I landed on my neck on trampoline got the wind knocked out of me and my neck hurt a lot but I did not go to the hospital or anything I could not live for a second
lol if i was being critical, LOOK AT THE PATIENTS FACE WHEN DOING HEAD TO TOE ASSESEMENT. In many cases, especially lowered GCS, the patient will not say 'oh my leg fucking hurts' they will wince and make a face.... when palpating the abdo for instance, look at the face for clues... if your c spine holder is a medic, he/she can do that for u
I have a question, I saw an accident with 2 young females, they were on a scooter, with no helmets on, I was the first on scene, then someone who stated he had medical training took over, one of the females was unconscious, she had some blood coming from her mouth, he then just turned over over on her side. The question is, should he have turned her on her side, or is it better just to turn her head, the way he turned her, to me he had no medical experience. Thanks.
Yes. In this instance the patients airway would take priority if it is blocked with fluid. He rolled the patient on their side because by doing this it still kept the spine in line. By turning the head you move the spine (which is a 911-no-no) also, you can live with a spinal injury (in most cases) you CANT live without oxygen. This is why he rolled the patient on their side to clear the airway instead pf simply turning their head. Hope this helped. :) Ps. I am a certified first responder (volunteer fire-fighter)
Well duh but he didn't get the name of the pt at any time during the assessment. It's still critical to get that information even if you're not giving it in your report.
All I can assume he meant is while taking the blood pressure the radial pulse will stop once you get the cuff inflated. Obliterated means to completely wipe out a trace of something. So if I was Palpatine a systolic pressure I would Obliterate the radial pulse then as I deflated the cuff when I feel it again I get my systolic pressure. Had to be what he was getting at lol
#Taufiq Shah hey ,if anyone else wants to learn about emt final study guide try Skyarza Medic Study Star (just google it ) ? Ive heard some amazing things about it and my partner got amazing results with it.
Did he seriously just measure that pulse for a full minute rather than 15sec x4 😂 Also his patient empathy is awful!! There is a distinct lack of communication between this medic and his patient, awful!! Also he seems edgy and nervous, which I wouldn't appreciate
Critique:
- Probably should have noticed the chair fallen over and got a tip off to what happened.
- Should have palpated C-Spine
- ABC's evident when he came too and began speaking. Obviously no airway obstruction, and the jaw thrust seemed strange to do on someone who was just speaking to you.
- Didn't check for bilateral inflation in chest
- Abdomen and hips (and the Trauma checkin general ) seemed to be more of a pat down than an examination.
- Non-life threatening leg wound #LeaveItAlone
- SAMPLE - okay. Didn't ask the patient if anything else was hurting him or how the leg was feeling.
- VITALS: LOA, pulse, respiration, blood pressure, pupils, skin condition, auscultating lungs.
- Cervical Collar
- Log Roll to backboard
- THEN BANDAGE THE LEG.
- Wait for transport while monitoring vitals.
beautiful
I'd add, that the usage of the spineboard is predestined for 3 People, nobody moves the shoulderbelt, so the back is compressed by just moving the hips.
Critique
Probably should have noticed the chair fallen over and got off to what happened.
Should have
+Nico DiPlacido Not certain about the points made but ,if anyone else needs to find out about emt practice exams try Nadazma Paramedic Helper (just google it ) ? Ive heard some extraordinary things about it and my work buddy got great results with it.
He did good...contained his nerves, and kept his thinking clear ;)
That was pretty solid for a trauma assessment.. I would just only add since the patient was going through hypoperfusion, I would do an ongoing assessment of every 5 min till we get to ED
You are going a good job
Thanks for the video!!! I am an EMT student and watched this video several times!!!!
Laurie Bolin how did you do on the practical? I'm a emt student right now. I take my test Dec 19th. I'm nervous
@@shanikdorsey8306 how did it go?
NEVER address secondary woulds before loading the patient. this is a trauma patient (load and go). the key word here is "Venous" bleeding, non life threatening injuries should be dealt with in the ambulance en route to the hospital. hope this helps :)
Venous bleeds can certainly be life threatening.
Load and go is bullshit here!
Great job! However:
Scene Size-up
BSI/PPE [check]
Scene safety [check]
Number of patients [check]
NOI/MOI [check]
Standard precautions [missed]
Additional resources [check]
Consider C-spine injury [check]
*Although the bystander should have been given more instruction, i.e., not to move and secure elbows on the ground, despite discomfort. If the head stabilizer is moved, the patient's head can turn unexpectedly.
6/7 -- Well done.
Primary Assessment
General impression [missed]
*One male in his [age] laying supine who appears to be unresponsive.
AVPU [check]
Airway (modified jaw-thrust, patient?) [check]
Breathing (RRQ of respirations + mid-axillaries (additional four if irregular) + apply O2)
Circulation (Skin + RRQ of radial pulse (responsive) + capillary refill)
The SAMPLE questioning during the treatment was a good idea. Why not kill two birds with one stone, right? The additional vitals, however, could've been taken en route to the hospital and the stage at which the rapid scan was performed threw me off a bit. Overall, he did a bang-up job! I'd say this student is well on his way. Kudos!
Fire Rabbit buff
He Didn’t initiate transport before history (miss)
Guy did a good job.
Nice Job, although I would probably have gotten the collar on sooner.
Other than that he did a great performance of helping this patient.
Helped me. Clear and precise. Thanks.
I know this comment was 6 years ago but I hope you now know that this isn’t totally accurate😅
Missed some stuff. Why on your blood sweep did you do the arms before the legs? Also, why did you combine the primary and secondary assessments??? Here are some things to remember never release c spine until patient is fully secured to the long spine board and Venus bleeding such as that should get a pressure bandage after being packed with an hemostatic agent or kerlix.... US ARMY critical care flight paramedic...
Can't answer for anything else, but the during a blood sweep I was always taught to go head to toe, no exceptions, so that you don't get out of order. If you go head, neck , torso, abdomen, patient's right then left arm, patient's right then left leg, you'll memorize the routine and never miss a thing.
Misse some stuff. Why on
Blood sweep
You combine the prinary and secdary assesment???
Here are some
you did what to the pulse ???
Polishpuppy189 he obliterated the pulse... when you do BP it’s good to feel the pulse while inflating the cuff until you can’t feel it then go about the normal way of taking a BP
sample history and baseline vitals should be done en route to hospital.
correct
When the Pt awakens tell him why some guy is holding his head. Not just "you fell".
food for thought. . . . . .would you not first check the SATS before applying a non rebreather mask at 15 L/min?
Definitely should have checked O2 sats. Supplementary oxygen shouldn't be given without clear indication.
GemAndKiraMusic giving someone O2 isn't going to kill them if they don't need it.
Chris Hardee True, but 15 L with a non-rebreather is a fair amount and it's best practice to check O2 sats before supp. O2 :)
Chris Hardee Probably not. But it can cause problems. Specifically in angina patients. If you give them too much oxygen, it may cause the nitrates to not work as effectively.
Chris Hardee EXACTLY!!!!! My EMT-B teacher told us that all the time!
You skipped General impression, didnt say chief complain or if you saw any apparent life threats, ABC's were rushed through, did start shock management, didnt say if it was high or low priority transport when appropriate, asked a run down version of the OPQRST/SAMPLE which couldve been done in the ambulance, should've loaded and went after you bandaged the wound. Once instead you couldve did a full assessment during the secondary assessment then obtain baseline vital, then manage wounds and reasses and recheck vitals. This was all over the place lol someone would def fail their NREMT watching this ;D
Wouldn't it be a critical fail, without measuring the size of the cervical collar before applying it on.
excepted he did. c spine was held until long board was finished and he was on transport 8:05
Also you wouldn't be able to do a jaw thrust on a casualty who is conscious, and why would you put the casualty in a c-collar before checking for facial fracs, face grace might compromise the airway which will be fucked if your casualty is already in the c-collar.. that's why it's called a secondary survey not a 'I'll check it after preparing for evac' survey
He never measured the neck before applying the c-collar. I guess he got lucky that it fit properly!
Thank you so much for the video! It helped a lot.
Who's conducting the training?
I landed on my neck on trampoline got the wind knocked out of me and my neck hurt a lot but I did not go to the hospital or anything I could not live for a second
Move not live
Why would you require a nonbreather at a 14 bpm a tad brady? Bp 116/80 N breathing and lungs are clear?
Niki Gurle Because proctors want you to administer oxygen to literally every person in the simulation.
Nicely done!
lol if i was being critical, LOOK AT THE PATIENTS FACE WHEN DOING HEAD TO TOE ASSESEMENT. In many cases, especially lowered GCS, the patient will not say 'oh my leg fucking hurts' they will wince and make a face.... when palpating the abdo for instance, look at the face for clues... if your c spine holder is a medic, he/she can do that for u
I have a question, I saw an accident with 2 young females, they were on a scooter, with no helmets on, I was the first on scene, then someone who stated he had medical training took over, one of the females was unconscious, she had some blood coming from her mouth, he then just turned over over on her side. The question is, should he have turned her on her side, or is it better just to turn her head, the way he turned her, to me he had no medical experience. Thanks.
Yes. In this instance the patients airway would take priority if it is blocked with fluid. He rolled the patient on their side because by doing this it still kept the spine in line. By turning the head you move the spine (which is a 911-no-no) also, you can live with a spinal injury (in most cases) you CANT live without oxygen. This is why he rolled the patient on their side to clear the airway instead pf simply turning their head. Hope this helped. :)
Ps. I am a certified first responder (volunteer fire-fighter)
You're correct. It's called rescue position.
quite realistic! :)
sorry, but is that how you suppose to sit as you say "can u hear me"? you could actually inflict more damage to the patient. :)
No way would i ever get someone to take away C spine thats crazy!!!!
he took away C spine because he was already spider strapped to the board and on the bus on his way to the hospital
We can conclude that he is lying on the floor.
thanks for the help
Excellent job! Lucky Pt. LoL
Very good
Wait what does trauma mean?
Excelent vidieo
Great vid!!
he put his stethoscope on the floor QQ
You shouldn't have him move the foot up and down on the injured leg you can cause further damage, just check for pulse and ask if he can move his toes
+Medic83301 not with a potential fracture, motor would be wiggling toes lol
He did not measure thr collar to the patient
C collar very important
checked for pedal pulses on the ankles?? hahah. love it tho
he missed alot of stuff........
not for an emt-b test.
niceley done
name and age of pt?
you do not say the name over the radio because it is an unsecure line and could be listened in on by others.
Well duh but he didn't get the name of the pt at any time during the assessment. It's still critical to get that information even if you're not giving it in your report.
Do you even know what obliterated means?
junebug9594
junebug9594
junebug9594 he said it as i read it lol
All I can assume he meant is while taking the blood pressure the radial pulse will stop once you get the cuff inflated. Obliterated means to completely wipe out a trace of something. So if I was Palpatine a systolic pressure I would Obliterate the radial pulse then as I deflated the cuff when I feel it again I get my systolic pressure. Had to be what he was getting at lol
#Taufiq Shah
hey ,if anyone else wants to learn about emt final study guide try Skyarza Medic Study Star (just google it ) ? Ive heard some amazing things about it and my partner got amazing results with it.
Pedro
BSI SCENE SAFE!
BrendanMaxwellMusic bsi?
Body Substance Isolation
He did it in the beginning of the video
omg stahp!
Stop what
Young Ma
Lu Lu
Not to be critical, he just noticed blood and immediately lifted the leg without checking to see if it was fractured or not...
Cap refill not so reliable over 5 yrs of age.
Oops too long
that leg that's bleeding isnt real if u look its fake
Naaa really. All along i thought it was real. Lol. It's just an act
Ummm...duh
Nine years of high school, right down the drain.
+Sophie Royle You don't even have to look. This is a TRAINING VIDEO............... i can't imagine my country is in the hands of a voter like you
Did he seriously just measure that pulse for a full minute rather than 15sec x4 😂 Also his patient empathy is awful!! There is a distinct lack of communication between this medic and his patient, awful!! Also he seems edgy and nervous, which I wouldn't appreciate
you went out of order
sorry, but is that how you suppose to sit as you say "can u hear me"? you could actually inflict more damage to the patient. :)
Excelent vidieo