Added: 3 years ago
From: BlueJFilms
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  • is your scene safe? how many patients do you have? MOI/NOI? do you need ALS back up? Do you need cspine precautions? = scene size up

  • @ 1:41 he goes from picking his feet to holding c-

    spine lol

  • Great vid !! Thanks... Very helpful ;)

  • So is this EMT basic?

  • @DonnaApathy I have never heard of CMS and getting a cap on all four limbs, especially on a neck pain? I don't know what I would do if either a medic or a basic student tried doing that to my patient.

  • @asriya According to NYS DOH, it is required to check pulse, motor and sensory on all four limbs. You do not have to check a capillary refill though. It has been shown to be a non-reliable assessment on adults. And for neck pain, it is especially critical to check CMS. Neck pain could mean a spinal issue which could affect the limbs.

  • omg thank you, so helpful!

  • "Jesus will ya... I'm on the phone!!!" xD

  • -general impression:gender, age, level of distress [mild, moderate, severe]

    -person, place, time, dont forget to ask for what happened dont assume chief complaint

    -fall/hit head/lose conscience?

    -didnt check capillary refill on upper and lower extremities [CMS in general]

    -someone should be holding the board so i dont move around

    -did not say how far down or up to move patient on long board

    -emt closes to head places hands on shoulder and hip, emt at bottom places hand on lower leg&on hip also

    -

  • ok this is hilarius and sooo wrong, but very informative!

  • ok this is hilarius and sooo wrong

  • Just wanted to comment, along her missing auscultating the bases, she also didnt do the c in ABC's which is obviously circulation, as well as in a deadly wet check you want to make sure your checking your hands every time so you know where a deadly bleed is located. Awesome video though, perfect for review material

  • This video is amazing i am taking an emt-b course atm and this video helped alot

  • im currently an emt-b student in nyc, and i found this video very helpful for remembering the basic steps... so thank you very much.

    to all the haters... this is clearly meant to show the BASICS in patient assessment. Every situation is different, and all patients are different. Most EMT's come up with their own routine of patient assessment, this video clearly shows the basic skills and routine. stop hatin.

  • Holy crap. The girl in the Emt hat is hot!!! Are you single. I'm an Emt looking for a female emt. Lmao You go girl :)

  • why put on BSI if you are going to pull back your glove to touch the skin? silly, you fail!

  • What you are doing now is Standard First Aid.... hahahaha..... EMT is WAY more than this... ex: don bsi, check for hazards, mechanism of injuries, # of patients, # of bystanders, patient need extrication, do i need more help, any significant bleeding, any fractures, skin colour, id yourself and gain consent, take control of c-spine, determine loc using avpu, ABC, load and go decision, start head to toe exam, and so on............................­........

    :)

  • @SPQRnonOmnisMoriar except u missed your neck to knees to check for life threatening injuries smartie pants

  • the back boarding was a bit off. The help should of grabbed the hip and legs and held them while the emt slid the board in place rather than move her down and up. Then pad any void areas by the knees and lower back. Every state is different. Im testing out in VA very soon.

  • Thanks for uploading this video I appreciate it.  I wish I would've found it befor today. My test is tonight.

  • That was good, she nailed it !

  • @911999

    It stands for Tenderness!

  • what does "T" stand for in DCAP-BTLS? because in school I only learnt DCAP-BLS

  • B.S.I.!!! :D

  • Continued: some patients will tend to try to change their respiration rates if they know you are observing that. Out in the field, I check pulse rate for 15 seconds and immediately start counting respirations for 15 seconds and after 30 seconds, I have then gathered both pulse & respirations in less than a minute.

  • @adioafro to check respirations, you count the number of times the chest rises & falls. Each rise & fall together counts as one respiration. We want to know breathes per minute, therefore, same as obtaining a Pulse Rate, you can either time it for 15 seconds and multiple the number by 4, you can count for 30 seconds and mutiply by 2, or count them for a full 60 seconds. We teach our students to pretend to be still checking the patients pulse rate and get your respirations; some patients will te

  • what i didnt understand, how do you check respirations? do you look at number chest rise? is there a better way?

  • The Scene wasn't safe there's a rifle leaning on the wall in the backround haha

  • the thing i like about these videos is that i follow the nys proticals because i live there i take my practicals tomorrow morning

  • I think this is a great video. I'm using it to help pass the state exam.

  • i got my bsi on do you have your bsi on i got my bsi on do you got your bsi on i don't know do i have my bsi on looks at his bare feet is the scene safe is the scence safe i don't know is the scene safe go make it safe gunna make the scene safe yeaaaaaaaa!!!! best part of my life

  • Gotta show this to the boys at the firehouse. LOL

  • I did not enjoy watching the patient maneuvering onto back board.

  • It gets serious after the first few moments! I do like your videos so far. The only thing I would recommend about this video is maybe make one or two more on trauma pa but add different elements in such as unconscious patient or the patient has life threats like flail segment.

    I am not sure if your state is different, but in my testing spot they do trauma and back boarding together so seeing both together could be helpful

    Thanks for uploading though! I understand body sweep vs dcap-btls now.

  • This was bad

  • GOT TO BE KIDDING ME! This is a joke. My fellow EMTs will love this LOL. Someone needs to go back to school

  • @thejjohnson87, Would you mind telling us why you feel that this assessment is not up to your standards?

  • @BlueJFilms well i didn't watch the whole thing but only two lung fields were auscultated during abc assesment. There could be life threatening injuries that would cause different lung fields to be absent or diminished. Discovery of these conditions should take priority over rapid trauma because it is a "B" step.

  • @jsin55, you are right. She only auscultated the upper fields during the initial abc's and it would not take much longer to listen to the lower fields. It should have been done. She does listen to all fields later on in the video. Thanks for you input.

  • This is TERRIBLE patient assesment!!!

  • @ffighter30, thank you for commenting, but constructive criticism would be more helpful.

  • @ffighter30 haha. Im new at this. I need serious info

  • Comment removed

  • omg decembers almost here smhh !!!! so nervousss

  • you don't wanna ask "yes or no" questions while checking the level of consciousness

  • Your Fireman did not Use RACE (Resistance, Airway compromise, Change in neuroligical deficit, Extreme pain)

    When you were putting on the cirvical colar you never sized it up.

    When you were checking the chest you should have exposed and examined.

    Incorectly checked Pelvis.

    When you were assessing the patients CSM you never got her to push on you hand so you only did CS you missed M

    Other than those few minors you did a great job thank you for the video :)

  • this isnt a rapid assessment more like a focused assessment

  • @murta2 According to NYS, this is a rapid assessment.

  • 9:07 lmfao wat the hell was that noise for!?

  • People are forgetting this is done to New York State's protocols.

  • rapid trauma assessment does not include blood pressure, if they have a radial pulse you're good to go, otherwise load and go

  • haha hang on i got another call lol

  • I take my Practical Skills exam tomorrow and have used this video as a study guide. I really like how she verbalized just about everything- (I've taken that as a practice as well) making sure the evaluator knew she knew what she was talking about and what she was doing. I would really like to see more come out of your team's creativity. And good job on the beginning, it made me laugh! ;o)

  • She also shouldn't have run her hands along the extremities when checking for blood... you cant tell where she's bleeding if you do that.

  • It didn't look like they reassessed PMS after securing the patient to the backboard.

  • where is rapid tarnsportation ...?

  • Log rolling on to the board low you would on have to make one upward movement instead of going down then back up. Try putting the board about a foot higher than the pt's head before you log roll them.

  • duck hunt is kick ass

  • in two emts one has minimal knowledge who will asign in the head in turning the patient???pls.....thanks for help.

  • Comment removed

  • Did not mention abt D in primary assessment.

    Head to toe examination was absolutely fantastic.

  • nice vid very teachable

  • ILL GO GET THE SCENE SAFE

  • @raginghate - Fire fighters are the canaries of the EMS world! When they drop, we stop.

    One thing I did notice is she did not place her hand on the shoulder when doing the log role. NREMT will fail you big time for that, especially if you move your hand off.

  • the main thing that bugged me were the open ended questions she asked her patient, wats your name

    ? my name is john smith? not an accurate question to determine if she is alert X 3

  • We are taught to ask three main questions to establish the patient's level of alertness. They are based on the patient's orientation to person, place, and time. You must ask open-ended questions.

  • i understand that, we are taught the same thing, but we were taught to not ask wat their name is, because like i said before they can say some random name and the FR or EMT or whoever wont know that thats their name or not, i do understand that everyehere does their things differently, i still in the class and it just bugged me a bit from wat we are taught

  • Name is part of the glasgow coma scale just like what day it is, who is the current president. Needs to be asked

  • you can ask their name, but it should not be used to determine level of conciousness, also believe it or not, not everyone knows who the current president is...we are taught not to ask that question. questions used to determine level of conciousness should be questions that you know the answer to...

  • if your patient can't tell you there name or the date or the president that tells you there's a serious indicator of consciousness which is why you do it.

  • but asking your patients name is an open ended question, which you usually don't know the answer to...thats why it can't/shouldn't be used as a question in determining AVPU

  • LAWL at lady dying in background. but im sure it happens O_o

  • In a Pt with No significant MOI, during the Focused history you should have done the Focused Trauma assessment before you took baseline vital signs. You take the baseline and sample during transport. And when you were doing circulation you improperly checked the voids. Also OIPASS/IPASSO was done poorly.

  • In following the NY State practical examination, this is the order which we are to follow. Vitals are taken after the initial assessment (BSI, scene safety, spinal stabilization, ABCs) then we are to proceed with the focused or rapid assessment. Also, we are not taught the acronym OIPASS/IPASSO.

  • um actually a fall can be a significant MOI

  • Comment removed

  • Actually OIPASS/IPASSO is in breathing of the ABC's. (Oxygen, Inspect,Palpate, Auscultate, Secure or Stabilize) Baselines vitals are done after either the rapid or focused trauma/medical exams and sample history (opqrst in medical pts) and Depending on the the fall if it was greater than 20 ft or 3x the persons ht it would be considered a significant MOI

  • I didn't say anything about oipass/ipasso. We don't use those in michigan.

  • never heard of that in NYS either...

  • that is, never heard of the oipass/ipasso

  • the same, however the event is different. i use situation. and if they are able to say the situation that would tell me the chief complaint.

  • in LA county its A&Ox3 name/place/time. and we take vitals on the rig on the way to the hospital

  • How do you determine if they are in shock other than by the way they look if you dont take vitals until you are in the truck. Just asking

  • One should never move the patient to the truck until vitals are taken. The EMT in the video took vitals before transport.

  • Not true.

  • Quality/presence of radial pulses, skin signs, capillary refill, level of conciousness... to name a few.

  • Comment removed

  • @DThompson1985 If you're removing vitals and appearance from your options, you would have to use your best judgment based on volume loss (Hypovolemic), motor function (neurogenic), Past medical history of illness or injury (septic), allergies (anaphylactic), CHF or other heart cardiovascular complications (Cardiogenic), Mental capacity and/or flexed wrists (psychogenic) those are some of the big ones... hope this helps

  • haha i dont agree with most theses comments i think it was good lol

  • I would appreciate it if comments be kept beneficial to training or at least have constructive criticism.

  • LOL love this video the begining is so funny. Firefighter missing shoes lol. Also love the rescue 911 intro

    NREMT-Basic

  • I dont know how it is in NY. But ive been trained to take 5 baseline vitals pulse, respiration, bp, pupils, and skin. Also took my practicals and passed and in a trauma assesment your supposed to do the rapid trauma assesment, vitals and then history.

  • Comment removed

  • We also assess 5 baseline vitals in NY . We assess skin in the initial assessment, pulse/respirations/BP in the PE, and pupils in the rapid assessment. In trauma assessment, NY requires vitals, SAMPLE, then PE.

  • The assessment was fine and helpful.

    However, I was disgusted by Mr. Funnyman picking at his feet and then putting his hands on that woman's head. Thanks Mr. Healthcare worker.

    Yes, the bare feet was a gag at the start of the video, but why couldn't he have put some shoes on during the assessment? Nasty Ass.

  • when you did the Airway - how come you didnt check her mouth for items that might become potential obstructions,,, lets say loose dentures, broken teeth? or blood in the mouth which might require suction?? :)

  • When I asked the patient about person, place, and time, she did not slur speech or seem to move anything around in her mouth. Her speech was perfectly clear. In this scenario, I did not feel the need to do a deep assessment of the airway. Now, if she was not speaking clearly, drooling, or seem to be moving things around with her tongue, and she was not alert, I would definitely want look in her mouth for potential problems.

  • But if you have a gut feeling you need to do a thorough assessment of the airway, by all means, do it. The airway is very important and it is always better to be on the safe side.

  • i think it's better to check their mouth - you never know wht they got in there:: for example chewing gum - may block the airway if the patient becomes unconsious.. better to remove it before it adds you extra job to do

  • thank you these realy cool and great jop we are in oman doning same

  • Nice post. Its good to see people posting this stuff. Visuals are helpful to watch now and again.

  • Im from uk thank all that is holy that they are not.

  • to establish responsiveness you use the avpu scale.

    to establish level of consciousness there are FOUR questions (person, place, time, event). if the patients answers all four, then they are alert and oriented times 4.

  • In New York State, there are only three questions for AVPU. Where are you from?

  • california.

    i think we ask the the fourth question to rule out amnesia because even dazed people can fork over their name, the time (by the location of the sun), and the place (by looking around them). if they can't tell you what happened, it could indicate serious brain injury.

  • Same in Michigan, we ask 3 questions to determine LOC.

  • You know when you ask the patient the 3 main questions, you ask her specifically where she is like " Where are you?" sometimes the patient can just answer your question by saying yes or no. Well thats just how I learned it O.O

  • You always want to ask open ended questions and not simple yes or no questions to avoid that.

  • lol, great job

  • Question here!!! When it comes to the vital signs, do you have to actually go forth and take them or can u just say "i will take baseline vital signs, the pulse, bp, temp"? i don't know. anyone?

  • We have to actually take the vitals signs. If we are off by +/- 10 on BP or pulse and +/- 4 on respirations, then we fail the station. At the actual test, they give you fake vitals that fit the scenario, but only after you give them the real ones.

  • oh, ok. Thanks!!

    Follow up question.......how do they know you're taking it correctly? i mean, if they don't check the VS when u do you can just say "oh, bp is 120/80", right? how do they know YOU know how to take vital signs? Hmmmm....

  • The proctor will take the vital signs before the test taker comes into sight. The test taker must take the vitals and be close to the actual numbers to get full points.

  • great. thanks!

  • I love how the fireman is picking and cleaning his toes right before he maintains inline stabilization lol

  • The initial part of this video is like the BLS program with Chicago FD!

  • lmao wtf

  • I. Establish and maintain airway control while manually stabilizing the cervical spine.

    II. Place the head and neck in a neutral in-line position...

    Steps III through VII are initial assessment, level of consciousness, assess ventilatory status, administer O2 and suction as necessary, assess circulatory status, assess PMS.

    VIII. Immobilize pt with appropriate immobilization device(s).

    This is what the NY State Protocol states and how she was instructed for the practical skills examination.

  • "manually stabilizing the pt's cervical spine is one of the first steps along with maintaining airway control." So treating her neck is first...so is it first or second?

  • Pt assessment is the hardest for me. I'm taking EMT-B now. I know how to do everything, just remembering to do it is another story. I just need more practice.

  • I JUST passed my practicals. Patient Assessment was the only station I lost 1 point on. Just remember to verbalize everything and you will be OK. Even if you think you missed something, they wont take points off for you saying it again. Don't forget BSI and Scene Safe!

  • yeah i missed 1 point verbalize the general impression

  • when you check for circulation on the 1st part you have to check carotid with radial check if insnc

  • You don't need to do that according to New York State's Protocol.

  • oh okay in california we have to check both

  • I have never heard of such a thing. I am from North Carolina and it isn't in our protocol either. The only time I have heard of checking carotid is if you are checking for a pulse in a cardiac arrest patient.

  • Hey to the gal was doing this...that was pretty neat ! You seem like you know what your doing as compared to me which is not knowing about any of that but hey you looked pumped and ready to go. Not sure what the deal was whether you were still learning or if you were done with your training but either way good luck to you. I guess the rest of us can learn interesting things on youtube ! Nifty !

  • Reall? Patient CC is NECK PAIN!

    C-spine her! Why would you take BP/Pulse before treating CC?

  • Thank you for your caps lock. It has made your opinion very clear. According to the New York State Suspected Spinal Injuries Protocol, manually stabilizing the pt's cervical spine is one of the first steps along with maintaining airway control. There is no immobilization with devices until after initial assessment and vital signs.

  • She didn't palpate the ribs.

  • You're right, one should palpate the ribs and chest for crepitus or instability

    Also:

    Look at the chest for symmetrical chest rise

    * Look at the chest for paradoxical movement * Indicates a possible flail chest * 3 or more ribs broken in two or more places

    Should be the 2nd assessment of lung sounds

  • You are right. She should have verbalized and palpated the ribs. One hand on each side and asked for another deep breath. Good catch.

  • thank you guys.

  • interesting and funny

  • the best emt video on youtube it actually will help me for my xam tomorrow

  • awesome job!!

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