I'm excited to have this study material available as I recert after 15 years out of EMS. I noticed the video is from 2015, I am just confirming that these videos show the current skills requirements. I know things in EMS change so much, I don't want to study something that is outdated. Thank You!
After looking at many others, many many others - I found this site to be the best - so I do have to take back my comment; the stations are very well done and very helpful. thank you.
Its always good when an instructor explains something rather than speed talking through a lecture then telling the class "You gotta read your book!"...Are you still an instructor in Irvington?
Thank you for this video!! It helped a lot. My instructor failed me on a practice run b/c I introduced myself before I gave a general impression (I introduced myself to assess the patient's airway and breathing in an organic way). He made me re-do it and stand in front of the live patient and give a general impression and then introduce myself.
Good Video , However caution needs to be given to checking blood pressures in each arm. It's safer to check for pulse deficit between upper and lower extremities. Also to any EMT student viewing this video just because its chest pain don't reach for the patients Nitro. Pay attention to the description .(tearing) or ripping with associated femoral pain or pain between shoulder blades is diagnosed as dissecting Aneurysm in 70% of cases . Nitro should be avoided --if your unsure consult medical control. Hope this helps
great series of videos. Only thing I'd add from an instructors perspective who instructs at a NYS certified training center.... @01:19 when checking for "adequacy of ventilation's" , merely visually inspecting chest rise and fall (*especially with pt covering their chest with hand or arm), without either palpation and in my opinion, a quick auscultation of the anterior lung fields, does not ensure adequate ventilation's, which is a "critical fail" under airway and breathing. Spontaneous pnuemo, pulmonary edema from CHF, allergic reactions with non-audible wheezing, are just a few examples of medical related issues, which produce "non- adequate ventilations." With only a quick visual inspection at this point in the station & without a quick auscultation, doesnt "assure adequate ventilation's" unless individuals have "radiologic eyes." Obese, elderly, as well as individuals wearing multiple layers of clothing, in my experience, often present without obvious "visual" chest rise and fall, thus necessitating the need to palpate and auscultate as well. Remember, the key point here is "assuring adequate ventilation's" which is defined by medical definition, as the exchange of air between the lungs and atmosphere, so that O2 can be exchanged for CO2 in the aveoli. If you have a set of eyes that can determine this, then please post a video and I'll be the first to attend your seminar:))
Hello and thank you for your detailed feedback. It is always nice to hear from fellow NYS Instructors. The purpose of the Primary Assessment is to identify and treat immediate threats to life. You are correct that for the NYS PSE, it is critical criteria to “assure adequate ventilations”, however, the examples you provided as medical related issues are more appropriately recognized individually in the Secondary Assessment. To assure adequate ventilations in the Primary Assessment, it must be determined that the patient is breathing, breathing adequately, and not hypoxic. For the responsive medical patient, this can be accomplished through visual inspection, observing for adequate chest rise (depth) and a rate that is sufficient enough to sustain life. The aforementioned medical related issues could result in inadequate ventilations as you stated, but if they do, they will present with inadequate chest rise or a rate that is inadequate , which will be detectable by visual inspection. Auscultation is acceptable to help determine if the patient is breathing at all, however, it does not require a stethoscope. By medical definition, auscultation is the act of listening to sounds arising from organs. A stethoscope has no place in the Primary Assessment. In reality, clothing can be an issue, easily solved by removal. In this case, a tee shirt is not a visual obstruction. Palpation is acceptable, but not necessary if visual inspection yields the right results. In a scenario like this, interventions will be limited to no treatment, supplemental O2, or positive pressure ventilations. Resources that support this are both the current Brady Emergency Care 13th edition, AAOS 11th edition, and the NYS BEMS student reference guide which is still locatable if you search hard. Thanks again for the feedback.
@@BenjaminFontanilles hello Ben and I do appreciate you're feedback and your videos, as I refer to them often and routinely recommended them to students. I do respectfully disagree that " a stethoscope has no place" in primary assessment" as at least in my opinion, if a student utilizes same during the "assuring adequate ventilations" portion of the primary survey, to not only assist in determine respiratory rate but exchange of oxygen between air and lungs ( breath sounds) I'm more inclined to say "adequacy" has been achieved.i certainly can digest your points re visualization as long as rate and chest rise and fall go but would not go as far as penalizing a student if he or she were to auscultate. As a fellow medic, (even though it's testing at bls level) I at least when initially assessing adequacy of breathing, am auscultating rather than just looking at chest rise and fall, which when auscultating will revel chest rise and fall as well, just due to hands on with bell of scope placement. My expirience has revealed that not all medical issues , (eg.spontaneous pnuemos) do not always present with abnormal chest rise and fall or rapid resp rates, especially in early stages, where pt may only c/o chest pain or difficulty breathing. I'd be willing to at least "meet in the middle" and suggest that during primary survey, visual inspection along with palpation for equal chest rise and fall, determines adequate ventilation until more detailed secondary survey is completed. Again, I'm a big fan of your video posts and feel that the imparting of knowledge and expirience of skills sets benefits all. Several of my students like to also utilize the placing of the pts forearm across their chest while simultaneously checking for adequacy of ventilations, along with with circulation & CTC of skin.
Great videos, sir. Any chance you could put up step by step demos of all stations by yourself, outside the testing scenario? Thanks very much for doing this.
Nothing like watching this video and getting bit by a bug and then having to monitor ur own self to make sure that your dose of Benadryl is working to avoid going to the er for chest pain and allergic reaction to the bug that bit me (LOL)! BTW, the Benadryl is working now so I should be ok for tonight.
Oh man, if it were only that stress free!!!
Patient medical assessment at a night club, it happens :)
I'm excited to have this study material available as I recert after 15 years out of EMS. I noticed the video is from 2015, I am just confirming that these videos show the current skills requirements. I know things in EMS change so much, I don't want to study something that is outdated. Thank You!
After looking at many others, many many others - I found this site to be the best - so I do have to take back my comment; the stations are very well done and very helpful. thank you.
Its always good when an instructor explains something rather than speed talking through a lecture then telling the class "You gotta read your book!"...Are you still an instructor in Irvington?
I WISH THERE WAS NO MUSIC PLAYING WITH THIS GREAT VIDEO
Got my skills test today this has been so much help thank you
Thank you for this video!! It helped a lot. My instructor failed me on a practice run b/c I introduced myself before I gave a general impression (I introduced myself to assess the patient's airway and breathing in an organic way). He made me re-do it and stand in front of the live patient and give a general impression and then introduce myself.
Good Video , However caution needs to be given to checking blood pressures in each arm. It's safer to check for pulse deficit between upper and lower extremities. Also to any EMT student viewing this video just because its chest pain don't reach for the patients Nitro. Pay attention to the description .(tearing) or ripping with associated femoral pain or pain between shoulder blades is diagnosed as dissecting Aneurysm in 70% of cases . Nitro should be avoided --if your unsure consult medical control. Hope this helps
Thanks this comment definitely helps. I’m omw to take my practicals right now
great series of videos. Only thing I'd add from an instructors perspective who instructs at a NYS certified training center.... @01:19 when checking for "adequacy of ventilation's" , merely visually inspecting chest rise and fall (*especially with pt covering their chest with hand or arm), without either palpation and in my opinion, a quick auscultation of the anterior lung fields, does not ensure adequate ventilation's, which is a "critical fail" under airway and breathing. Spontaneous pnuemo, pulmonary edema from CHF, allergic reactions with non-audible wheezing, are just a few examples of medical related issues, which produce "non- adequate ventilations." With only a quick visual inspection at this point in the station & without a quick auscultation, doesnt "assure adequate ventilation's" unless individuals have "radiologic eyes." Obese, elderly, as well as individuals wearing multiple layers of clothing, in my experience, often present without obvious "visual" chest rise and fall, thus necessitating the need to palpate and auscultate as well. Remember, the key point here is "assuring adequate ventilation's" which is defined by medical definition, as the exchange of air between the lungs and atmosphere, so that O2 can be exchanged for CO2 in the aveoli. If you have a set of eyes that can determine this, then please post a video and I'll be the first to attend your seminar:))
just like to add that Ben and his staff do a phenomenal job with their training video posts and content!
Hello and thank you for your detailed feedback. It is always nice to hear from fellow NYS Instructors. The purpose of the Primary Assessment is to identify and treat immediate threats to life. You are correct that for the NYS PSE, it is critical criteria to “assure adequate ventilations”, however, the examples you provided as medical related issues are more appropriately recognized individually in the Secondary Assessment. To assure adequate ventilations in the Primary Assessment, it must be determined that the patient is breathing, breathing adequately, and not hypoxic. For the responsive medical patient, this can be accomplished through visual inspection, observing for adequate chest rise (depth) and a rate that is sufficient enough to sustain life. The aforementioned medical related issues could result in inadequate ventilations as you stated, but if they do, they will present with inadequate chest rise or a rate that is inadequate , which will be detectable by visual inspection. Auscultation is acceptable to help determine if the patient is breathing at all, however, it does not require a stethoscope. By medical definition, auscultation is the act of listening to sounds arising from organs. A stethoscope has no place in the Primary Assessment. In reality, clothing can be an issue, easily solved by removal. In this case, a tee shirt is not a visual obstruction. Palpation is acceptable, but not necessary if visual inspection yields the right results. In a scenario like this, interventions will be limited to no treatment, supplemental O2, or positive pressure ventilations. Resources that support this are both the current Brady Emergency Care 13th edition, AAOS 11th edition, and the NYS BEMS student reference guide which is still locatable if you search hard. Thanks again for the feedback.
@@BenjaminFontanilles hello Ben and I do appreciate you're feedback and your videos, as I refer to them often and routinely recommended them to students. I do respectfully disagree that " a stethoscope has no place" in primary assessment" as at least in my opinion, if a student utilizes same during the "assuring adequate ventilations" portion of the primary survey, to not only assist in determine respiratory rate but exchange of oxygen between air and lungs ( breath sounds) I'm more inclined to say "adequacy" has been achieved.i certainly can digest your points re visualization as long as rate and chest rise and fall go but would not go as far as penalizing a student if he or she were to auscultate. As a fellow medic, (even though it's testing at bls level) I at least when initially assessing adequacy of breathing, am auscultating rather than just looking at chest rise and fall, which when auscultating will revel chest rise and fall as well, just due to hands on with bell of scope placement. My expirience has revealed that not all medical issues , (eg.spontaneous pnuemos) do not always present with abnormal chest rise and fall or rapid resp rates, especially in early stages, where pt may only c/o chest pain or difficulty breathing. I'd be willing to at least "meet in the middle" and suggest that during primary survey, visual inspection along with palpation for equal chest rise and fall, determines adequate ventilation until more detailed secondary survey is completed. Again, I'm a big fan of your video posts and feel that the imparting of knowledge and expirience of skills sets benefits all. Several of my students like to also utilize the placing of the pts forearm across their chest while simultaneously checking for adequacy of ventilations, along with with circulation & CTC of skin.
@@jbuccilli1 thank you for your support brother.
THIS IS A GREAT VIDEO....JUST WISH THE MUSIC WAS CUT OUT. IT'S VERY DIFFICULT TO STAY FOCUSED WITH MUSIC IN THE BACKGROUNG.
Perfectly done, just how I remember in class.
Perfect ending to a NREMT assessment video.
Thanks for this video, I will follow this in preparation for my OSCE here in UAE.
@Paul Antonie Antoc, include the groovy music....you will get extra credit.
@@nickc8819 Thank you very much! I passed my OSCE!
Very good explanation of how it's done
Great videos, sir. Any chance you could put up step by step demos of all stations by yourself, outside the testing scenario? Thanks very much for doing this.
What’s the background music called?
This video is very helpful.
Why did you refuse to request additional help ? Isnt necessary? Especially for a patient that has chest pain ?
Nice job
Informative video. Thanks.
Excellent video, liked and subed.
The music's OK, but turn down the volume by about half!! The music is not in the background, it's in the foreground!
Great video........However, the music was too distracting.
Helpful
Music was very distracting , spoiled a great instructional video.
Nothing like watching this video and getting bit by a bug and then having to monitor ur own self to make sure that your dose of Benadryl is working to avoid going to the er for chest pain and allergic reaction to the bug that bit me (LOL)! BTW, the Benadryl is working now so I should be ok for tonight.
Why tf you got the music playing ?
Music is distracting. 👎
Agreed about the music
D I S C O
I wish the horrible background music wasnt so overwhelming. At least use study friendly music. lol
Yeah I felt stressed lol
this music makes me a stroke alert
The music is obnoxious
Would have been a good video. Why the dumb music??