Kinda late but heres the NREMT way that he has to go Verbalizes general impression of the patient 1 Determines responsiveness/level of consciousness 1 Determines chief complaint/apparent life-threats 1 Airway -Opens and assesses airway (1 point) -Inserts adjunct as indicated (1 point) 2 Breathing -Assess breathing (1 point) -Assures adequate ventilation (1 point) 4 -Initiates appropriate oxygen therapy (1 point) -Manages any injury which may compromise breathing/ventilation (1 point) Circulation -Checks pulse (1point) -Assess skin [either skin color, temperature, or condition] (1 point) 4 -Assesses for and controls major bleeding if present (1 point) -Initiates shock management (1 point) Identifies priority patients/makes transport decision based upon calculated GCS
Yeah but now it’s gonna be a harder test. Going to multiple questions that have multiple answers and if you get them all right but one you don’t get any credit
Paradoxical motion showed flail segment, but proctor also said there was diminished lung sounds on affected side which would be indicative of a simple pnemothorax!
@poliklolik paramedic did not determine PTX by flail segment alone. Looking at the MOI + flail segment + dimished lung sounds on affected side. Paramedic then considered simple PTX and treated until his assessment showed otherwise.
Arnt you supposed to check for major life bleeding before you check pulse? He checked the chest but not the rest of the body. Then he checked the pulse and then he asked about any other major life bleeding. Help
Exsanguinating haemorrhage is the first thing you check on the patient before airway. Then when it comes to Circulation, we reassess any haemorrhage interventions as well as blood on the floor and 4 more (chest, abdo, pelvis, long bones), this is when you do the full sweeps.
We check for life-threatening hemorrhage during the general impression as we walk toward the patient. We are also identifying any major deformity or obvious life threat that may cause us to need to deviate from an ABR assessment to a C-A-B assessment. Absent of any life-threatening bleeding, we will address bleeding during the circulation assessment during our primary assessment. During the testing station, a student would ask, "What is my general impression of the patient? Do I see any obvious deformity? or life threading bleeding?" If the answer is no, you will proceed with your A-B-C assessment as usual. I hope this helps clarify your question.
With trauma scenarios according to PHTLS, you assess for XABCDE, X being “exsanguinating” or life threatening hemorrhage/injury before all else… in this case an open chest wound.
Out of curiosity, I know the skill sheet organizes the primary survey as ABC's, but is it acceptable to reorder it to CAB still? What's the point of opening the airway, and then when you get to circulation, the patient is pulseless? Would that be a critical fail for not beginning traumatic arrest treatment/CPR?
Hi Styx, Excellent question. The testing scenarios are very rigid and standardized for objective evaluation and grading. In real life, if there is an unresponsive patient, we would need to do a life check to ensure the patient has a pulse and there is no need for CPR. Generally, in a make-believe world of testing, there is some information obtained in the general impression that leads to knowing the patient is unresponsive but does have a pulse; for instance, the patient may have gurgling respiration, or you can see paradoxical chest movement as you approach your patient. These observations would let you know the patient had a pulse, and it would be appropriate to continue with an ABC assessment. In testing, you can do a quick life check to determine if the patient has a pulse - it should be limited to no more than 10 seconds. This should not be a critical fail for your testing station. We hope this answers your question. Feel free to reach out with additional questions. Check out our other videos, and website www.dieseltherapyacademy.com/
probably the best NREMT ALS psychomotor test video ive seen yet. great work!
Thanks for the review! We hope you enjoy our other videos!
Thank you, i watched this about 100 times and drilled it into my head, it helped, i passed!
I'm on x1, but am going to follow your lead - and hopefully reap your success...
I’m good assessment. I appreciate the touch of realism by getting a proctor That sounds like she would rather be doing literally anything else.
That was very well performed! Impressive
A great instructor. One of the best at NMETC
Good job but if they’re unconscious on scene aren’t you gonna check pulse before continuing with airway
That's always a good idea unless you can visualize breathing.
Look, listen, feel.
Kinda late but heres the NREMT way that he has to go
Verbalizes general impression of the patient 1
Determines responsiveness/level of consciousness 1
Determines chief complaint/apparent life-threats 1
Airway
-Opens and assesses airway (1 point) -Inserts adjunct as indicated (1 point) 2
Breathing
-Assess breathing (1 point)
-Assures adequate ventilation (1 point) 4
-Initiates appropriate oxygen therapy (1 point)
-Manages any injury which may compromise breathing/ventilation (1 point)
Circulation
-Checks pulse (1point)
-Assess skin [either skin color, temperature, or condition] (1 point) 4
-Assesses for and controls major bleeding if present (1 point)
-Initiates shock management (1 point)
Identifies priority patients/makes transport decision based upon calculated GCS
Paramedics & aemt will not have to do this anymore! It's being discontinued next year by the nremt
So lucky lol I was 1 year to early
Why is it getting discontinued? Is it being replaced by another type of exam ?
Yeah but now it’s gonna be a harder test. Going to multiple questions that have multiple answers and if you get them all right but one you don’t get any credit
@@figgy9554 It's not being discontinued, it just isn't part of the NREMT anymore. States will decide whether or not they want a psychomotor exam.
You’ll still do it to pass your class
So how he determines that it was pneumothorax base on flail segment,also it wasn’t rapid assessment it was detailed exam
Paradoxical motion showed flail segment, but proctor also said there was diminished lung sounds on affected side which would be indicative of a simple pnemothorax!
@@HomieHuff flail segment doesn’t not equal PTX,diminishing lung does not equal simple PTX.
@poliklolik paramedic did not determine PTX by flail segment alone. Looking at the MOI + flail segment + dimished lung sounds on affected side. Paramedic then considered simple PTX and treated until his assessment showed otherwise.
Arnt you supposed to check for major life bleeding before you check pulse? He checked the chest but not the rest of the body. Then he checked the pulse and then he asked about any other major life bleeding. Help
Exsanguinating haemorrhage is the first thing you check on the patient before airway. Then when it comes to Circulation, we reassess any haemorrhage interventions as well as blood on the floor and 4 more (chest, abdo, pelvis, long bones), this is when you do the full sweeps.
We check for life-threatening hemorrhage during the general impression as we walk toward the patient. We are also identifying any major deformity or obvious life threat that may cause us to need to deviate from an ABR assessment to a C-A-B assessment. Absent of any life-threatening bleeding, we will address bleeding during the circulation assessment during our primary assessment. During the testing station, a student would ask, "What is my general impression of the patient? Do I see any obvious deformity? or life threading bleeding?" If the answer is no, you will proceed with your A-B-C assessment as usual. I hope this helps clarify your question.
No hovering over the patient!
Only thing I’d done different is after no response with painful stimulus, you go straight to a pulse check.
Oh boy, although pretty good, he went over time... was this a fail?
this was really good... but why did we skip to checking the chest instead of assessing breathing and circulation?
With trauma scenarios according to PHTLS, you assess for XABCDE, X being “exsanguinating” or life threatening hemorrhage/injury before all else… in this case an open chest wound.
Out of curiosity, I know the skill sheet organizes the primary survey as ABC's, but is it acceptable to reorder it to CAB still? What's the point of opening the airway, and then when you get to circulation, the patient is pulseless? Would that be a critical fail for not beginning traumatic arrest treatment/CPR?
Hi Styx,
Excellent question. The testing scenarios are very rigid and standardized for objective evaluation and grading. In real life, if there is an unresponsive patient, we would need to do a life check to ensure the patient has a pulse and there is no need for CPR. Generally, in a make-believe world of testing, there is some information obtained in the general impression that leads to knowing the patient is unresponsive but does have a pulse; for instance, the patient may have gurgling respiration, or you can see paradoxical chest movement as you approach your patient. These observations would let you know the patient had a pulse, and it would be appropriate to continue with an ABC assessment. In testing, you can do a quick life check to determine if the patient has a pulse - it should be limited to no more than 10 seconds. This should not be a critical fail for your testing station. We hope this answers your question. Feel free to reach out with additional questions. Check out our other videos, and website www.dieseltherapyacademy.com/
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Lots going wrong in this video. Almost can’t believe he passed