NREMT EMT Skills Tutorial: Patient Assessment

[@gohighhustle]

Damn, that's the guy you want showing up to your emergency; great work!

[@WorkoutwithMike48]

I’ve been a Firefighter for 20 years and an EMT instructor, That was the best on the internet

[@CollinKell33]

Awesome video all the way around. Extremely helpful and detailed. Good acting by the patient too. Unloading that pipe in the Texas heat is enough to give anyone a cardiac event!

[@zininmed98]

I want to express gratitude for uploading the video. I am a first year paramedic student and I found this really interesting and insightful. One thing that stood out to me was however, how unclear the consent obtained was initially; he said “Mr Roberts do you mind if I touch you?without explanation as to what that meant. For my Australian friends, this can risk you being liable for legal action, namely for the trespass to person by ‘battery’.

[@garr088]

im not there yet. he was flowing with this assessment.

[@k____b]

Guy crushed it, good work!

[@shawnadedek3104]

How in Earth is he this good? That was perfect Im going to be all over the place from nerves😢

[@peteraguilera1859]

dude same😂

[@timothyharris377]

Agreed

[@Haydenwolf344]

Ikr ahh

[@christiankhoury4355]

@@peteraguilera1859howd u guys do

[@McCarthy1776]

Lol at my fire recruit school, we have barely gotten any skills practice, only touched a stethoscope and BP cuff once and now they got us going on two 12 hour ride alongs with EMS and want us to assess and treat 10 patients and fill out a report irl. We're all stumbling doing the practice with the cheat sheet in our hands. I'm nervous as shit

[@shuntarusknox6333]

Wonderful and helpful demonstration.

[@massimoesposito8223]

Very well done!! It ticks all the boxes.

[@KayRebel]

Heyy beautiful video! I tried EMT a few years ago. But I couldn’t really get it. Well I’m trying again and I hope this time I can do it. Thanks for the video, very nice job and it gave me a few pointers.

[@shirleymiller5056]

Impressed! 1st time ive heard a confident easy flow of what is expected as a medic please can we do mote common everyday senariors will follow medic shirley Miller canada

[@mufasasrevenge]

And the Oscar goes to mr.roberts

[@matthewkern496]

Only thing I would have changed is let medical control know patient had already taken one dose of nitro, but didn’t affect much overall leaving that out

[@bossbee4ever]

in my state, u can give 3 doses of nitro max, regardless of if the patient took 1 dose prior; but i agree that medical control should’ve been informed about that

[@Dr.BazanMckenzie]

Excellent. Im currently doing the la guardia EMT course and this helped a lot.

[@Aaron-qu9yr]

How did he know the patient was pale and diaphoretic at the 37 second mark? Other than that, and not getting on the patient's level this was a pretty good assessment.

[@slactusjack7103]

Pretty sure it was an assumption based on chest pain. Idk

[@chocolatetobi]

Everyone just calls ALS based on NOI before interaction with the patient. Which the dispatcher could do themself. Or from the general impression without explanation on why. I was taught to call ALS after confirmation of CC or on overall poor general impression but only with clear explanation on why. We would be given 1 minute to call ALS after suffiecient suspicion of the need. Getting it out of the way just on Dispatch NOI doesn't sit right with me. anyone feel similarly?

[@miguelpesqueira2132]

i feel you

[@craizihorse3230]

In all honesty this is for the practical exam Out in the streets ALS will be responding to this 911 call Not much that BLS can do for this pt

[@raymondhubert5241]

Couldn't agree more. I have a pet peeve and my students know it. While we call for ALS right away in training, on the street, ya better handle your sh*tuff before your call the reinforcements, specially if you have not laid eyes on them.

[@krysqueenbee3415]

Yea I agree, but for the practical I can see why they do it, but yes that's dumb, our small Midwestern County has no als except the chopper!

[@725niko]

I’m currently in emt school and I can fully understand that sentiment. but I’m seeing a lot of this type of stuff as being “textbook” for testing so, I get why this is a thing. I’ll just move forward understanding that IRL will run slightly different and will see how it goes after establishing CC

[@Supersaintsfan]

Should have used a nasal cannula for someone with chest pain O2 is a vasoconstrictor

[@slactusjack7103]

Patient was cool and moist upon feeling for skin which means shock. The nonrebreather mask is the right treatment but he didn’t fully treat for shock like keeping the heat on the patient with the blanket or position of comfort. Maybe I’m wrong. I’m new lol

[@buttsmcgee50]

@@slactusjack7103 There's a million things that can cause cool clammy skin besides shock. It was likely due to an impending MI and not shock.

[@brandonparker119]

@@slactusjack7103at least it’s easy to tell that you’re gonna do fine in EMS simply based off the fact you have the right thought process or right idea and also you’re not like many new EMTs/medics who graduate and get too cocky thinking they know everything it’s good quality to be able to admit mistakes or that you’re not sure, so while in this case there’s no obvious or suspected reason the patient is in shock that isn’t skin condition related that is also associated with Heart Attacks and the added chest pain with prior history gives you more clinical suspicion that the current focus should be treating/transporting for a possible MI. finally don’t get the impression that you’re necessarily off on you’re judgement because a heart attack very much especially large blockages can and is one of the leading causes of cardiogenic shock.

[@pokemonfan155]

The blanket would be a good idea sometimes tho for conscious patients it's hard to get them supine especially with chest pain or SOB because for them sitting tripod feels more comfortable and on the back can be more uncomfortable a blanket should have been used tho

[@DarylRosenberg01]

Im in EMT school, I Didnt see him palpate the shoulder. I know that is a sign of MI along with crushing chest pain and signs of shock but aren't we suppose to also check the site of any pain?

[@coltonmoore6574]

He did a secondary assessment, in which nothing was noted. Given the scenario being a mock assessment, he asked verbally do I note any other findings, given the MOI, high suspicion for cardiac, no trauma, really no need to assess further load and go 🫡

[@coltonmoore6574]

My only critique is verbalize that he’s treating for shock given the diaphoretic, pale, cool skin. Otherwise was stellar

[@aaronbates7604]

Hold up, y’all. We started off by incorrectly establishing orientation status (only got name and CC), then right to inappropriately applying high flow oxygen. Asked about “relative medical conditions” but didn’t clarify whether the patient had other medical conditions. The his was okay but definitely not stellar. Also the proctor said that the lungs were “clear and equally bilateral”. Lol.

[@kuramapaws]

patient was pale and diaphoretic. why not apply o2?

[@aaronbates7604]

@kuramapaws I didn’t say not to use it at all. There is nuance to consider. Pale and diaphoretic doesn’t necessarily equate to needing high flow oxygen. The patient was mildly short of breath and thus likely not significantly hypoxic. Providing high concentrations of oxygen during myocardial ischemia can be detrimental. What would be the indication/justification for high flow O2 here? If not hypoxic, what are you fixing with that?

[@ItsZxnny]

This video about to help me pass my final

[@shawnadedek3104]

How is he this good? Amazing

[@cameronlee6663]

You’re stunning

[@PoSyOfficial]

Get on patients level at all times !!

[@sandpounder3443]

We probably wouldn’t be able to hear him for the video as well if he did that

[@zininmed98]

Technology is at a level where that is not a problem anymore.

[@thepalettewhispererasmr1227]

Well done

[@deendda6926]

Very educational

[@mufasasrevenge]

Did he memorize everything or was there something he was reading off of for the patients vitals and all that at the end summary?

[@celsopunzalan4929]

Bro I’m thinking the same thing I was taking notes while watching this and even I couldn’t remember most the stuff. It looks like he was reading someone off screen but if it was by memory then that means I have a lot of practice before I’m ready do be an emt lol

[@leosdaytoday2182]

he writes the patients symptoms and his notes on his glove and note pad which he later uses for his call the medical control and verbal report to als

[@spiritualexx8570]

Great video

[@salvadortena7173]

I hate it when I wanted to give a full report and they just wanted age sex and CC lol

[@nickvukovic1721]

Great job and great video

[@derrekdampier1577]

And ALL of this is learned in the online training ? With no prior experience ??

[@celsopunzalan4929]

I’m thinking this too, this guy must be good with only online training

[@williamlampke8083]

Did he actually take the nitro haha

[@Vromanmattie12]

I am so nervous I have this part of the exam on aunday

[@Here_I_Am68]

"Do you mind if i touch you?"

[@destroy43]

pretty much the only thing that could use some improvement. Great tech, but slightly creepy

[@cool7654321]

I thought that was creepy, thanks. I think a better way to ask is plainly, "can I check your pulse?" lol

[@tombob641]

Was anyone else screaming 12-lead ecg?

[@c.i.a7392]

EMT's can't give a 12 lead

[@3lizabeth324]

I was thinking the same thing, thankfully where I'm at we can do 12 leads.

[@wormsauces]

@@c.i.a7392yes they can

[@brandonparker119]

@@3lizabeth324that’s great especially if you run a bls agency and use a hospitals medic and you live in a state that thinks EMTs are like middle schoolers….. enter NJ where we only had a short hands on lesson for 10 minutes of placing leads and that’s only because of how thorough our academy was most in this backwards state don’t even see the damn machine until an ALS call if they’re lucky 😂 hell NJ doesn’t even allow bls and als trucks unless the bls is hospital ran cause by law medic programs all have to go through a hospital cause why not, even when it was used active charcoal no sir oh and the biggest fuck you from the state and is the reason our normally only 4 als MICU crews (5 if you’re very lucky and if you’re stupid lucky to also have a cooper hospital doctor riding around, then its a miracle and you should play the lottery) for 23 towns in our entire county are on calls that aren’t ALS calls causing real ALS calls to have no proximal crews is because not only did the state complain for a long time and even now since it’s becoming more available on bls trucks nationwide…. I-gels nah not in your scope oh and you got a possible stroke or maybe even it’s a mimic for a bad sugar…. This state no sir bls you may not even touch a glucose meter cause it’s an open wound 😂😂 oh but sure get the random family member or bystander who has fuck all training or experience using one to use it of course if they pt even has one I do apologize for this rant being long but on shift and this type of scope of practice comment is what we’re pissing about NJ being behind or clueless oh and the best part to wrap it up, a hospital or at least any of our response area hospitals will not call a CVA alert incoming without a sugar reading it’s great seeing every single patient with any sugar imbalance possibility or just because our trauma center has a protocol for it, seeing a line of incoming patients in the ambulance pay lining up and a tech going patient by patient poking fingers.

[@TheeJennie]

@@c.i.a7392In our state, its in our scope.

[@LuckyCookie88]

He didn’t get MD approval for aspirin 😊

[@OlendyBenitezLara]

You don’t need approval to admin aspirin

[@mattstafford9513]

Don’t need approval, standard dose is 324 - 4 81mg tabs

[@LuckyCookie88]

He should of done sample first before opqrst

[@ashley-cc4eu]

If you do opqrst first you can get them on oxygen faster if indicated. the only kinda contraindication to oxygen is COPD. why do you think he should have done sample first?

[@LuckyCookie88]

@@ashley-cc4eu because if he passes out midway thru all those questions you wouldn’t know what allergies he have and what meds he is on. Tho in reality most patients would already be telling you about their past medical history

[@mup8661]

He also forgot to ask if the patient was alert and oriented during his initial assessment prior to questioning the patient about SAMPLE, OPQRST, and HAM (history, allergies, and meds.) Otherwise all this info could be inaccurate. He started but stopped at person, and event.

[@平贺真子-k9v]

Jackson Laura Clark George Martinez Daniel

[@spiritualexx8570]

Didn’t treat for shock once he said he was cool and clammy

[@dieselwolf3005]

Because its not shock related, its heart related, heart attacks can cause cool, and clamy skin, as well as moist skin, trouble breathing and and nausea ..Shock is mainly due to trauma, or major injuries, or blood loss.

[@spiritualexx8570]

@@dieselwolf3005 thanks!

[@DonaldCooper-l6g]

Lewis Eric Gonzalez Charles Jones Cynthia

[@Cantu1489]

Great job. Now just go to medic school so you don’t have to call for ALS or Med control to give basic drugs.

[@deannag7283]

Every one needs to start somewhere ❤

[@bryceranson1046]

lmao

[@lgjackson3183]

@@deannag7283and the best advanced providers remember their basics

[@LouisianaVol]

I’m good I’m just try to get on a big fire department and this is just part of it you can keep that shit

[@samuelkurzeja8412]

👍

[@calvinsmobile9094]

This is too advance patients assessment awesome and great jobs this guys. But to be honest if the patient is paining scale 8 out 10 like this guy. He may be dead if the process taking this long.

[@AstronomyNik]

The guy was spot on with his S.A.M.P.L.E. and O.P.Q.R.S.T. and his final Transfer of Care report to the arriving ALS unit