@@DanJanucik There are no contraindications w/ a chest pain in this scenario. He's having an MI/Stemi, recent surgeries would not stop aspirin administration. The cardiac event trumps random info as you put
This a terrific assessment. He hits all the points, and even though he is not actually wearing PPE it was the first thing he verbalized along with scene safe. Also, right after completing ABC's he verbalizes "priority patent" and that he will transport as soon as it is available.
Studies have suggested that high concentrations of oxygen may lead to the production of oxygen free radicals, which are reactive molecules that can potentially cause damage to cells. The concern is that this oxidative stress could potentially worsen the injury to the heart tissue. Titrating the flow to 2lpm reduces the risk of free radicals while still supplementing the PT with O2.
At 1:00 it really ticked me when he said anything about “assuming” a patent airway. One thing i learned from paramedic school is never to assume because to assume makes and ASS out of U and ME. And so many things can go wrong by assuming. And Aspirin! Apart from allergies, GI bleed and ulcers are contraindications. Just some thing to improve on. Just a little nitpicky cause I graduated from a really strict paramedic school, and all thing I pointed out would have failed my assessment.
Great videoe! However , I think we should hold back oxygen administer to chest pain patients with cardiac origin as it realease o2 free radicals and maintain saturation between 90-94 Thanks Do correct me if yourl think what I said is incorrect
While there are many contraindications for prescribing aspirin, our county (San Diego) medical direction clearly states there are no contraindications for assisting with a patients prescribed ASA. As EMS providers we follow protocols given to us signed off by our medical director.
After he found out about his past medical history of his heart attack, shouldn’t he have transported immediately and continued assessment in the ambulance?
Hi Jessica, Yes you are correct. With patients showing signs and symptoms of a possible cardiac event, transport should be initiated as soon as possible. Radio contact should be made early to ensure a receiving facility is ready to accept. ALS should be activated for extended transport times.
Hello, Depends on what your interpretation of the standard of care is. We find that teaching assessments in this manner sets our students up for success in their later pursuits. For our program, these later pursuits are mainly: fire service, paramedic school, PA school, and medical school.
Appropriate PPE is considered to be a part of our "standard precautions" which is stated at the beginning of the skill. This was filmed well before COVID.
This is an EMT-Basic scenario which means cardiac monitoring is not within our scope of practice. EMT-Paramedics however, do utilize ECG monitors and this scenario would require the application and interpretation of an ECG.
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You Rock Man! I am a EMS instructor and have to say by far the best medical assessment ever. I will be using this one for my students. Great Job.
Awesome, glad to hear!
Using this to review for my oral board later today, best patient assessment I’ve found so far!
Hope you rocked it!
No don'tyou
Ẁw@@clarenoden7339
Great assessment. With aspirin make sure no history of bleeding disorders, blood in stools, recent surgeries, bleeding ulcers or blood thinners.
I don't think blood thinners are a contraindication
@@DanJanucik There are no contraindications w/ a chest pain in this scenario. He's having an MI/Stemi, recent surgeries would not stop aspirin administration. The cardiac event trumps random info as you put
Best EMT medical assessment I have watched on RUclips. Signed: Retired Paramedic SanFrancisco, CA
Very comprehensive patient assessment! Thank you!
One of the best videos I’ve seen so far! Thanks
Great to hear!
This a terrific assessment. He hits all the points, and even though he is not actually wearing PPE it was the first thing he verbalized along with scene safe. Also, right after completing ABC's he verbalizes "priority patent" and that he will transport as soon as it is available.
My PSYCHOMOTOR is tomorrow so this is great !!!!
As a emt firefighter. Real street medicine vs this way in class they taught us is so different
I was trying to find a comment like this
Definitely. When they say to donthese assessments like you would in the field they don't mean it.
In my area there are contra indications for ASA.
GAPSAP
G.I. bleed
Allergy to ASA
Peptic Ulser
Swallowing (unable too)
ASA already taken
pediatric
Well organized and explained. Great!
A-MA-ZING. Best video I’ve seen yet
Hahaha watching before my pt assessment evaluation for a job. Best one so far
Why would you not take a respiratory rate alongside a SPO2 rating? Can you, would administering oxygen be more clear cut?
Awesome review for my oral boards today. Nice detail on the medications.
Great video!!!! I’m taking my tsops today so I’m kinda nervous these videos definitely help!!!! Thank u hopefully I remember everything 🤞🤞🤞🤞🤞🤞🤞🤞🤞
Great Sir.. really helpful 😇🙏
this was very thorough! good video guys!!
My guy got Kevin Bacon as his EMT. 😂
Aspirin has 4 contraindications.. history of ulcer disease, allergic to aspirin , bleeding disorder , and gi bleeding...
Per San Diego county protocal: "Containdications: None" "Can give if patient is on anticoagulants."
This is a great assessment
Thank you!
This is very helpful thank you so much
Thank you so much. This is amazing ❤
Thank you all first responders ❤️
This guy is amazing.
Why not use a non rebreathing mask with 15 lpm?
I'm an OFA 3 in Western Canada.
Studies have suggested that high concentrations of oxygen may lead to the production of oxygen free radicals, which are reactive molecules that can potentially cause damage to cells. The concern is that this oxidative stress could potentially worsen the injury to the heart tissue. Titrating the flow to 2lpm reduces the risk of free radicals while still supplementing the PT with O2.
because the rate and tidal volume is adequate
@@Heavyw8hankif adequate : Nonrebreather 15L/mn
If inadequate : BVM 15L/mn
I didn't know Matt Damon was an EMT
Haha!
3:30 maybe a good question to be If he had taken any of the medication before he arrived.
Edit ok he asked it here 8:30
At 1:00 it really ticked me when he said anything about “assuming” a patent airway. One thing i learned from paramedic school is never to assume because to assume makes and ASS out of U and ME. And so many things can go wrong by assuming. And Aspirin! Apart from allergies, GI bleed and ulcers are contraindications. Just some thing to improve on. Just a little nitpicky cause I graduated from a really strict paramedic school, and all thing I pointed out would have failed my assessment.
He didn't say he had a standing order for 02.
Great videoe! However , I think we should hold back oxygen administer to chest pain patients with cardiac origin as it realease o2 free radicals and maintain saturation between 90-94
Thanks
Do correct me if yourl think what I said is incorrect
I finally have a more specific goal lol I want to be this dude when I’m doing an assessment. Let it be done 😂😅
This guy's a badass.
That 80 year old looks good for 80😂
Contraindications for ASA is if he is asthmatic no prior uses, currently actively bleeding and CVI or TBI in the last 24 hours
While there are many contraindications for prescribing aspirin, our county (San Diego) medical direction clearly states there are no contraindications for assisting with a patients prescribed ASA. As EMS providers we follow protocols given to us signed off by our medical director.
He didnt check for head injuries for the nitro or active ulcers for the asprin :(
After he found out about his past medical history of his heart attack, shouldn’t he have transported immediately and continued assessment in the ambulance?
He was asking that questions in the ambulance already. He decided to transport after assessing circulation.
Hi Jessica,
Yes you are correct. With patients showing signs and symptoms of a possible cardiac event, transport should be initiated as soon as possible. Radio contact should be made early to ensure a receiving facility is ready to accept. ALS should be activated for extended transport times.
Arent they doing way extra?
Hello,
Depends on what your interpretation of the standard of care is. We find that teaching assessments in this manner sets our students up for success in their later pursuits. For our program, these later pursuits are mainly: fire service, paramedic school, PA school, and medical school.
Why a nasal cannula?
Nitro-is GTN?
I am not familiar with that abbreviation, NTG is a very commonly used abbreviation for nitroglycerin however.
No PPE?
I guess it was before the big part of covid
Appropriate PPE is considered to be a part of our "standard precautions" which is stated at the beginning of the skill. This was filmed well before COVID.
When you mention the history you will take, I would be clear about saying "I will now obtain the SAMPLE history" for the students watching.
And opqrsti
Davis Mary Anderson Donald Williams Dorothy
1:53
Joey
Is any one here from India
The patient would of died on scene
The proctor needs to speak up and speak slower and clearly for the audience.
No ECG?
This is an EMT-Basic scenario which means cardiac monitoring is not within our scope of practice. EMT-Paramedics however, do utilize ECG monitors and this scenario would require the application and interpretation of an ECG.
This is BLS dude