Medical Assessment: Chest pain

[@mauricewitherspoon7211]

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.

[@sandiegomiramaremtprogram6893]

Awesome, glad to hear!

[@ultimatekittyslayer1]

Using this to review for my oral board later today, best patient assessment I’ve found so far!

[@sandiegomiramaremtprogram6893]

Hope you rocked it!

[@clarenoden7339]

No don'tyou

[@lucianomartinez593]

Ẁw​@@clarenoden7339

[@CavCat]

Great assessment. With aspirin make sure no history of bleeding disorders, blood in stools, recent surgeries, bleeding ulcers or blood thinners.

[@DanJanucik]

I don't think blood thinners are a contraindication

[@DiamorphineDeath]

@@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

[@GoGracefully]

Best EMT medical assessment I have watched on KZbin. Signed: Retired Paramedic SanFrancisco, CA

[@koby685]

As a emt firefighter. Real street medicine vs this way in class they taught us is so different

[@pepethepleb8775]

I was trying to find a comment like this

[@eternalnate]

Definitely. When they say to donthese assessments like you would in the field they don't mean it.

[@BookTime100]

Very comprehensive patient assessment! Thank you!

[@mariebarnevikmckeige7667]

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.

[@Onedayatatime50]

One of the best videos I’ve seen so far! Thanks

[@sandiegomiramaremtprogram6893]

Great to hear!

[@Kavalry47]

My PSYCHOMOTOR is tomorrow so this is great !!!!

[@lukeanderson6669]

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

[@cc-qu7gz]

Well organized and explained. Great!

[@CollinKell33]

Awesome review for my oral boards today. Nice detail on the medications.

[@mauriciotellez2611]

A-MA-ZING. Best video I’ve seen yet

[@celiacpest]

Why would you not take a respiratory rate alongside a SPO2 rating? Can you, would administering oxygen be more clear cut?

[@ranjiniguna5090]

Great Sir.. really helpful 😇🙏

[@trishia3938]

Great video!!!! I’m taking my tsops today so I’m kinda nervous these videos definitely help!!!! Thank u hopefully I remember everything 🤞🤞🤞🤞🤞🤞🤞🤞🤞

[@chadalves1776]

Hahaha watching before my pt assessment evaluation for a job. Best one so far

[@floydwelch8211]

This is a great assessment

[@sandiegomiramaremtprogram6893]

Thank you!

[@mahmoodomar3541]

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

[@NickKing95]

This guy is amazing.

[@donmedrano85]

I didn't know Matt Damon was an EMT

[@sandiegomiramaremtprogram6893]

Haha!

[@shannonzittlow8462]

Thank you all first responders ❤️

[@rosemadder5547]

I finally have a more specific goal lol I want to be this dude when I’m doing an assessment. Let it be done 😂😅

[@alexisperez6333]

this was very thorough! good video guys!!

[@josephb8499]

Aspirin has 4 contraindications.. history of ulcer disease, allergic to aspirin , bleeding disorder , and gi bleeding...

[@DiamorphineDeath]

Per San Diego county protocal: "Containdications: None" "Can give if patient is on anticoagulants."

[@tutatehaja1777]

Thank you so much. This is amazing ❤

[@knighthauler2529]

Why not use a non rebreathing mask with 15 lpm? I'm an OFA 3 in Western Canada.

[@Unyielding_Drip]

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.

[@Heavyw8hank]

because the rate and tidal volume is adequate

[@EnjoyPF345]

⁠@@Heavyw8hankif adequate : Nonrebreather 15L/mn If inadequate : BVM 15L/mn

[@krismann1040]

This guy's a badass.

[@pizzapartytime1826]

That 80 year old looks good for 80😂

[@glenconverse1327]

He didn't say he had a standing order for 02.

[@davidtenbruggencate831]

Contraindications for ASA is if he is asthmatic no prior uses, currently actively bleeding and CVI or TBI in the last 24 hours

[@sandiegomiramaremtprogram6893]

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.

[@A_Paterson]

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.

[@rebeccawise7062]

Joey

[@CrazyShan_]

Is any one here from India

[@jameslee1728]

He didnt check for head injuries for the nitro or active ulcers for the asprin :(

[@cloroxbleach8614]

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.

[@IMTHATKIDJIT]

And opqrsti

[@РодионЧаускин]

Davis Mary Anderson Donald Williams Dorothy

[@nhlakaniphothabethe9891]

Nitro-is GTN?

[@sandiegomiramaremtprogram6893]

I am not familiar with that abbreviation, NTG is a very commonly used abbreviation for nitroglycerin however.

[@brendanschorr7633]

Arent they doing way extra?

[@sandiegomiramaremtprogram6893]

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.

[@cesarsantini4370]

Why a nasal cannula?

[@jessicaigbokwe462]

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?

[@DanielKimLV]

He was asking that questions in the ambulance already. He decided to transport after assessing circulation.

[@sandiegomiramaremtprogram6893]

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.

[@itzymidzy3127]

1:53

[@krystalroumeliotis356]

No PPE?

[@lilahgrey8255]

I guess it was before the big part of covid

[@sandiegomiramaremtprogram6893]

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.

[@AlMashihAdDajjal]

The patient would of died on scene

[@cloroxbleach8614]

The proctor needs to speak up and speak slower and clearly for the audience.

[@bincyvarkey2737]

No ECG?

[@sandiegomiramaremtprogram6893]

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.

[@IMTHATKIDJIT]

This is BLS dude