These people commenting about how you’re doing things wrong clearly don’t understand that this is for studying for the psychomotor assessment to pass the NREMT exam!! Smh. Thank you for these videos, they are very helpful!
The “good shit” at the end was awesome! Great work! Even the “brain fart” remembering the secondary assessment shows how having those skill sheets down, will save you on test day. ...and no way will coffee girl spoil the day!!
This video is helpful and spot on with the NREMT sheet. To all those who are complaining about this comes before that, they are going by the sheet not real life scenario. I am renewing my EMT cert this week and our instructor told us this is how it is. Thanks guys.P.S. this video was made in 2017 so for those who are needing to recert soon there are some small changes to this assessment and other.
Thank you for posting. Please pass it along and tell others!!!! Always looking for more subscribers too. This was never a pubic page until recently. I'm so glad it's helping people around the country! RallypointEMS\Jeremiah
You have to follow the order of the NREMT Trauma Assessment sheet. Don't confuse the order of operations here with the CPR/AED or Apneic Patient stations. Rallypoint EMS/Jeremiah
THAT IS INCORRECT! YOU MUST ALWAYS CHECK YOUR ABCS BEFORE MOVING ON UNLESS IMMEDIATE LIFE THREATENING BLEEDING IS APPARENT OR OTHER IMMEDIATE THREATS TO LIFE ARE VISIBLE.
ALSO HOW DO YOU KNOW THE PATIENT IS NOT IN CARDIAC ARREST OR APNEIC WITHOUT CHECKING FOR A PULSE OR BREATHING SO YOUR ARGUMENT MAKES NO SENSE. IF YOU ARE AN INSTRUCTIONAL YOU SHOULDN'T GLAZE OVER STEPS LIKE THIS
Do you have the sheet in front of you? If not, grab it, look over it and redo this video. ABC's comes RIGHT after the life threats and level of consciousness. You're wrong. "You have to follow the order of the NREMT trauma assessment sheet". That's correct, and the way this was done IS WRONG.
Rallypoint EMS NREMT Demos I don't think that's the case... I was always taught that you always check for ABC's after verbal and painful stimuli don't work unless you see life-threatening bleeding, in which case you treat that first.
Great assessment I’ve taken a lot of things you said to implement in my own assessment. However, I have some constructive criticism. When checking Circulation Sensory and Motor functions during the Lower & Upper extremity assessment it’s advantageous to compare the distal pulses to the opposite extremity. Additionally, when palpating the extremities, say the thigh, its advantageous to place your hands diagonal from each other, push and feel then switch from left top and right bottom to left bottom right top. That can be done to the thighs, calves, bicep region, and forearms.
Very interesting to watch the American version. Some things I’d do in a different order but I haven’t looked at the skills assessment sheet but do get every service, certifying company and instructor has a way you need to follow during testing. Like most things the stuff we learn on the road or with further training adopts to our regular patient assessment and routine that doesn’t lean to far off the path but close enough to make more efficient for us as the responder. Now this was done in 2017, not to sure if the laws have changed for our friends down south regarding boarding and other tools we use on the road. If it did, would be interested in seeing how it changed for American standards. Regardless cool video. As this is training though and a video, I get why there wasn’t as much in depth of some of the tasks. Maybe next time set up the lifepac (if you have them) if it’s part of the curriculum, or strap them in to the board. It lets others that haven’t seen it or look for that to see it right. Otherwise nice video! Keep it up
Shouldn't stabilizing C-spine be done right after requesting ALS? And shouldn't back boarding and transport be done after the calculated GCS? I have my practical test this week and Im so confused on how to do this because we have been taught that for the test you have to follow word for word on the sheet for it? I really do enjoy your site, it has really helped me with studying.
Hi! Yes manual c-spine immobilization is done right after requesting ALS. I believe I had my partner do it in the video. Technically, you would board and transport the patient after determining your GCS. In the video I verbalize my rapid transport by saying my patient is a "high priority transport based on a GCS of three" at the 3 min 05 sec mark. That is sufficient enough you don't have to get nuts with packaging your patient. I want to see my students do the trauma skill station, not mess around with the backboard. Did you know there is actually a backboarding skill station? One thing to keep in mind is that you are being graded on your ability to perform this whole skill. I doesn't make sense to strap the patient to the board and then later try to check his back while he's strapped to the backboard. (We don't keep patient's strapped to backboards during transport anyway because they do more harm to the spine than good.) You absolutely do not need to follow the sheet word for word. We don't want you to be robots! This isn't realistic anyway because different scenarios and injuries are going to require you to do things a little differently. Even though we may do it a little differently, I recommend you perform the skill as you have practiced in class. I'm sure you'll do just fine. Nervous is good, it means you want it! So be confident and go get it! Thanks for watching! Rallypoint EMS/Jeremiah
I understand you are following the NREMT skillsheet however if this was a real life scenario your patient probably died because you failed to immediately check for an exit wound after treating the GSW to the chest.
Hi Baker. This isn't a real-life scenario though so we are not considering that. Every GSW is different. I've had many with no exit wounds. I've had a few that have exited. If it exits out the lower leg what are your considerations? Do you need a four-sided occlusive or do you just bandage it? Remember, every call is different. I had a patient who was shot with a 45 in the abdomen and the bullet ended up logged in his lower jaw. It wasn't noticeable to us or other providers on scene. Do a good assessment, manage any life threats and monitor and address the ABC;s. Worry about the rest later. RallypointEMS\Jeremiah
If you chart “entrance” or “exit” even if you are certain, instead of “open wounds” one of these days you may get called into court and asked how you knew for certain. Something like that could get a bad guy released or an innocent person incarcerated. Unless you have a degree in pathology, projectile dynamics or are board certified in forensic science, you should not chart those terms.
Agreed. Still should check for an exit even in training. Anyone knows relying on what you have seen before can get you fucked. Every call is different, so check all your bases.
Wait how is he putting the cervical collar after he load and go???? Asking for a friend Edit he didn't place him on a long board to transport ????? Ps no disrespect I am really nervous for my exams checking everything to the T
Maybe this isn't on the skill sheet, but in a real life situation you would want to roll the patient and check for an exit wound right away, because why would you let him sit there with a possible second hole in his chest until the end of your secondary assessment.
Only not correcting any life threatening injuries, protecting the airway airway and transporting at the appropriating time is critical fails on this station.
WRONG CRITICAL FAILS ALSO INCLUDE NOT STABILIZING C-SPINE, NOT CHECKING YOUR ABCS (WHICH HE DIDNT DO), AND NOT FOLLOWING THE ORDER OF THE EXAM WHICH WOULD PROLONG YOUR ON SCENE TIME AND BE A CRITICAL FAIL SO......
just because its currently patent doesnt mean the tongue wont move and block the airway. the the opa prevents that from happening especially with ventilations.
I believe only if he has a punctured lung that forces air into the pleural space. And the occlusive dressing is used to have any extra air leak out of the open side.
The 3 sided occlusive dressing acts as a flutter valve. It allows for the positive pressure air via BVM to escape that chest cavity but on exhalation the valve seals itself not letting any air get sucked in with the negative pressure. Normally its negative pressure on inhale and positive on exhale, but with an open chest wound the roles swap. Therefore to answer your question, no it wouldn't cause a tension pneumothorax as the three sided occlusive dressing is preventing that from happening.
Yes, you have to address apparent life threats first. This is a slight exaggeration, but if the dude was on fire, would anything else on the sheet matter? You wouldn't be worried about his airway you would want to put the fire out. Same deal with other life-threats. If he's bleeding out from an artery you want to fix that first then worry about his breathing.
THE LIFE THREAT WASN'T APPARENT UNTIL YOU CONTINUE WITH YOUR HEAD TO TOE WHICH IS IN THE SECONDARY ASSESSMENT. YOUR PRIMARY ASSESSMENT IF DONE CORRECTLY WOULD HAVE INSPECTED THE AIRWAY AND BREATHING WITH WOULD HAVE SHOWN DIMINISHED LUNGS ON ONE SIDE OR NO BREATHING OR PARADOXICAL MOTION OR EVEN JVD WHICH WOULD THEN FORMULATE YOUR DIFFERENTIAL DIAGNOSIS YOU WOULD USE TO POINT YOU INTO THE DIRECTION OF INSPECTION OF THE CHEST AND UNCOVER THE TRAUMATIC PNEUMOTHORAX. THIS WOULD ONLY BE A LIFE THREAT YOU WOULD CHECK FIRST IF YOU SAY FLAIL SEGMENT THROUGH THE SHIRT OR AN AMOUNT OF BLOOD LOSS OUTSIDE THE BODY THAT DOESN'T SUPPORT LIFE. DO NOT MISINFORM FUTURE HEALTHCARE PROVIDERS THAT MAY ONE DAY HAVE SOMEONES LIFE IN THEIR HANDS
Jordan Parton....to be clear, you’re telling me a sucking chest wound is not an apparent life threat? Last time I checked it was. If I find a hole in the chest I’m going to treat it immediately so that it does not progress into a tension pneumothorax. (As a reminder, tracheal deviation and JVD are ominous and late signs.). The purpose of the primary assessment is to identify and treat immediate life threats. This is exactly what was depicted in the video. Similarly, if the EMT were to discover an arterial bleed it would be managed right away. They wouldn’t wait until they checked the extremities during the “secondary assessment.” I appreciate your feedback, but my video and remarks are not misleading. Let me know if you need me to cite additional sources. www.emsreference.com/articles/article/tension-pneumothorax-0 books.google.com/books?id=UqEuDwAAQBAJ&pg=PA1801&lpg=PA1801&dq=jvd+is+a+late+sign&source=bl&ots=gyVDAoCDFn&sig=fOzNh-e71kdkkOwWx7-EShpI8zI&hl=en&sa=X&ved=2ahUKEwjs86r15IbbAhUBON8KHdLuAKMQ6AEwCHoECAQQAQ#v=onepage&q=jvd%20is%20a%20late%20sign&f=false www.sjgov.org/ems/pdf/policies/5504_bls_primary_patient_assessment_draft.pdf quizlet.com/62167023/emt-chapter-11-the-primary-assessment-flash-cards/ www.armystudyguide.com/content/powerpoint/First_Aid_Presentations/apply-a-dressing-to-an-op-5.shtml emt.emszone.com/docs/CH27_AEC_Table.pdf
Sucking chest wound would be and I stated that in my comment. My statement is that you bypassed ABC! you wouldn't notice a "Sucking chest wound" without inspecting under the clothes which in real life could be getting you pt trauma naked which you wouldn't do until after checking ABCs. Instead of being an arrogant EMT take advise from the multiple experienced MEDICS and Helivac RNs trying to inform you that you are and will continue to be wrong with this I know everything because I make videos attitude.
Rallypoint EMS NREMT Demos you know what good luck sir on your journey into ems. I’ll just make sure I’m I don’t get hurt or heaven forbid choke on something if I’m ever in your agency’s district. Again Good luck to you and all your patients 👍🏼
National Registry of Emergency Medical Technicians Advanced Level Psychomotor Examination PATIENT ASSESSMENT - TRAUMA Candidate: ___________________________________________________________ Examiner: __________________________________________________ Date: ________________________________________________________________ Signature: __________________________________________________ Scenario # __________ Actual Time Started: __________ NOTE: Areas denoted by “**” may be integrated within sequence of primary survey Takes or verbalizes appropriate PPE precautions 1 SCENE SIZE-UP Determines the scene/situation is safe 1 Determines the mechanism of injury/nature of illness 1 Determines the number of patients 1 Requests additional help if necessary 1 Considers stabilization of spine 1 PRIMARY SURVEY/RESUSCITATION 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 1 HISTORY TAKING Obtains, or directs assistant to obtain, baseline vital signs 1 Attempts to obtain SAMPLE history 1 SECONDARY ASSESSMENT Head -Inspects mouth**, nose**, and assesses facial area (1 point) -Inspects and palpates scalp and ears (1 point) 3 -Assesses eyes for PERRL** (1 point) Neck** -Checks position of trachea (1 point) -Checks jugular veins (1 point) 3 -Palpates cervical spine (1 point) Chest** -Inspects chest (1 point) -Palpates chest (1 point) 3 -Auscultates chest (1 point) Abdomen/pelvis** -Inspects and palpates abdomen (1 point) -Assesses pelvis (1 point) 3 -Verbalizes assessment of genitalia/perineum as needed (1 point) Lower extremities** -Inspects, palpates, and assesses motor, sensory, and distal circulatory functions (1 point/leg) 2 Upper extremities -Inspects, palpates, and assesses motor, sensory, and distal circulatory functions (1 point/arm) 2 Posterior thorax, lumbar, and buttocks** -Inspects and palpates posterior thorax (1 point) 2 -Inspects and palpates lumbar and buttocks area (1 point) Manages secondary injuries and wounds appropriately 1 Reassesses patient 1 Actual Time Ended: __________ TOTAL 42 CRITICAL CRITERIA ____ Failure to initiate or call for transport of the patient within 10 minute time limit ____ Failure to take or verbalize appropriate PPE precautions ____ Failure to determine scene safety ____ Failure to assess for and provide spinal protection when indicated ____ Failure to voice and ultimately provide high concentration of oxygen ____ Failure to assess/provide adequate ventilation ____ Failure to find or appropriately manage problems associated with airway, breathing, hemorrhage or shock [hypoperfusion] ____ Failure to differentiate patient’s need for immediate transportation versus continued assessment/treatment at the scene ____ Does other detailed history or physical exam before assessing/treating threats to airway, breathing, and circulation ____ Failure to manage the patient as a competent EMT ____ Exhibits unacceptable affect with patient or other personnel ____ Uses or orders a dangerous or inappropriate intervention You must factually document your rationale for checking any of the above critical items on the reverse side of this form
Hey, qusai alrwashdeh, he mentioned that he would send his partner for Sample History, he called out transport priority along with a GCS of 3 and he log rolled to check the back then place the patient on the backboard. I want to say he hit all the points you mentioned; but, let me know if I may have misunderstood your comment.
In the field you may do things in a different order based on the presentation of your patient but every point he hit from the nremt trauma skill sheet you will hit in the field
