Truth really can be stranger than fiction.
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La verdad puede ser más extraña que la ficción.
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Estudio bíblico que nos hace abrir los ojos en menos de cinco minutos! Acceda a todos los episodios aquí.
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Augenöffnendes Bibelstudium in weniger als fünf Minuten! Alle Episoden finden Sie hier.
Was There A Curse On Helen's Romantic Life?
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¿Qué tiene que ver conmigo? por Teófila Gottfried
Lo que leemos en la Biblia tiene que ver con todos los seres humanos, sean cristianos o judíos, ateos o agnósticos, budistas, musulmanes o adherentes a alguna de las filosofías o nuevas religiones que surgen en el mundo. ¿Por qué? Ver mayor información sobre este interesante libro.
Scripture of The Day - 1 John 4:1
Beloved, believe not every spirit, but try the spirits whether they are of God: because many false prophets are gone out into the world
Escritura del día - 1 Juan 4,1
Amados, no creáis a todo espíritu, sino probad los espíritus si son de Dios; porque muchos falsos profetas han salido por el mundo.
Bibelstelle des Tages - 1 Johannes 4,1
Geliebte, glaubet nicht jedem Geist, sondern prüfet die Geister, ob sie von Gott sind! Denn es sind viele falsche Propheten hinausgegangen in die Welt.
Advanced EMT Practicals Preparation: Trauma Patient
From Emergency Medical Technician (EMT) to Advanced EMT (AEMT)
There are a few things that readers/students should keep in mind when reading this preparation guide for EMT practicals. The scope of practice for EMTs and paramedics in the United States varies from state to state. This is written by an AEMT in the state of Iowa, based on the National Registry of Emergency Medical Technicians (NREMT) examiner sheet for the year, 2012. Finally, it is directed at AEMT, not EMT students. Advanced EMT practicals cover as many as 12 stations or "skills." Here, we take a look specifically at the station for the trauma patient. It is best to memorize the steps you should take in the order in which they appear. This will help you to remember every step that the examiner will be evaluating.
The Trauma Patient
Following is the criteria that should be followed for the trauma station for advanced EMT practicals (same for EMT level):
1. Just to be safe, always verbalize that you have taken body substance isolation (BSI) precautions. Unless otherwise indicated, this will mean no more than putting on gloves. Simply saying the words, "BSI," while showing the examiner your gloved hands will suffice.
2. Ask, "Is my scene safe?"
3. Next comes the mechanism of injury (MOI) or the nature of illness (NOI). The examiner might tell you this or you might have to ask.
4. Determine the number of patients you have. You can ask the examiner how many patients there are, if you're unsure, or simply verbalize that you have one patient.
5. Consider calling for additional help/resources. Based on the MOI, you should know whether you should be calling for paramedic back-up or for the fire department or whatever the resource might be that you might need.
6. Consider holding manual cervical spine (C-spine). A significant MOI should prompt you to hold C-spine.
7. State/verbalize your general impression of your patient. For example, "My patient appears to be a mid 40s male who has suffered possible life-threatening injuries from a motor vehicle accident."
8. Determine the level of responsiveness/consciousness of your patient. Use AVPU or the glascow coma scale. Instructions for using the glascow coma scale can be accessed by the link at the end of this article.
9. Determine the patient's chief complaint and any apparent life threats. Remember that the chief complaint is not necessarily the same as the information reported in a 911 call. It is based on the words of the patient. When dealing with a patient in a motor vehicle accident, you might want to ask, "Where do you have pain?"
10. Assess breathing. If the patient is unresponsive, you should open the airway. This is the only way to accurately assess. You're looking for the presence of an airway. Is the patient breathing adequately? This entails considering the rate of breathing, tidal volume, and whether you hear noises that might indicate an obstruction. If you find less than adequate breathing, you must immediately intervene. You should know how to insert an airway adjunct and to assist ventilations with a bag valve mask (BVM). Even if you find that breathing is adequate, you will need to initiate appropriate oxygen therapy. This can be as simple as giving oxygen by a non-rebreather mask at 12 - 15 lpm. Verbalize that your assistant is recording breathing rate (respirations), because this is a vital sign. This way you will be sure to get baseline vitals done.
10. Assess circulation. Check the color, temperature, and condition of the skin. Determine if there is any major bleeding. If you find bleeding, go ahead and intervene with your skills for hemorrhage control/shock management. Remember, you won't have any shortage of assistants whether they are the examiner, real people, or imaginary. Just be sure to verbalize everything that you are doing or are directing to be done. Verbalize that the patient's pulse is being recorded as a vital sign. This is also a good time to say that your assistant is taking a blood pressure, getting an oxygen saturation reading, and asking SAMPLE. If you don't know what SAMPLE is, you probably should not be taking advanced EMT practicals.
11. State the transport decision you have made for the patient. Is he/she a high priority transport?
12. Begin your physical examination, which should be focused or full body, depending on the MOI. Expect an MOI that would call for a full body when taking advanced EMT practicals. Below is a list of what you should examine and what you should be looking for:
a. Palpate the scalp and face, looking for DCAP-BTLS or crepitus. Inspect the eyes for PERRL (you should know this mnemonic), the ears for any drainage, the nose for bleeding, the mouth for secretions, loose teeth, or foreign bodies that could threaten the airway.
b. Inspect the neck for DCAP-BTLS, any tracheal deviation and jugular vein distention. Don't forget to gently palpate the cervical spine. Be sure to verbalize what you are looking for so that the examiner knows what you are thinking.
c. Inspect and palpate the chest. Look for DCAP-BTLS, any paradoxical motion (if significant MOI), and auscultate breath sounds in the mid-clavicular and mid-axillary regions. Also check for any crepitus.
d. Check the abdomen for DCAP-BTLS and distention.
e. Check the pelvis by gently applying even pressure downward. You should know how to assess the pelvis.
f. Verbalize your assessment of the genital area, if called for.
g. Inspect each upper and lower extremity. Look for DCAP-BTLS, palpate, and check PMS (pulse, motor, sensation).
h. When the patient is rolled onto one side in preparation for being moved onto the back board, check the posterior thorax, lumbar, and buttocks area.
i. Verbalize that you would intervene into any findings of wounds.
j. Verbalize that you will perform an ongoing assessment
These are the steps that should be taken to pass your advanced EMT practicals. They should be completed within 10 minutes. If you have chosen to work as an EMT/AEMT or paramedic to truly help the sick and injured, best of luck on your advanced EMT practical exam!
Related Articles
What Is a Glasgow Coma Scale Score?
EMT Clinicals Experience for Newbies
How an EMT Uses OPQRST for Medical Patient Assessment
Christian Paramedics and Emergency Medical Technicians: The Challenges Faced
Based on true events, The Third Man by Angela Sheffield, brings the Bible up close and personal as the characters face real issues of life: Betrayal, deceit, romance, bitterness, anger against God, hopelessness, will power, perplexity, triumph, unforgiveness, mental illness, and the "Alcohol made me do it" excuse. Read chapter one FREE now.
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