# Retesting "Oral B" NREMT-P in a Month



## maitai11 (Aug 12, 2014)

Hi Everyone,

I've been a paramedic for 21 years; EMS a total of 25.  While I have kept up my State of Hawaii license the entire time, I ended up losing my national license back in the late 1990's.  Last year, I decided to enter the re-certification process.  The entire time since losing my NREMT license, I've worked as an engineer/paramedic until five years ago when I became a lieutenant.

I took the psychomotor exam in March of this year - but I ended up failing the Oral B station, so I have one more chance to test for Oral B.  A couple months ago, I passed the written test after completing 75 questions.  I am literally 15 minutes away from regaining my NREMT-P license!  Good times!

The oral stations really gave me a hard time, probably because I've been out of the loop due to becoming a lieutenant - my EMS exposure has gone down considerably, and we do not staff paramedic engines; although I may present that idea to management after I am once again licensed by the NREMT.

Of course, after failing three stations, and passing Oral A, I gave myself the ol' V-8 forehead slap.  Apparently, I didn't go deep enough on some, but mis-dosed on a peds case.

(Scenarios removed - Admin)

The one I passed was a straight-up trauma scenario which I pretty much nailed.  That at least gave me some hope!

Can anyone please tell me some of the keys to passing the oral station are?  This station was not a part of my original test back in 1993, and the formatting and vague testing criteria really threw me for a loop.

- Are there any code 500 scenarios, or was that covered during dynamic and static cardiology?
- Does Oral B cover ONLY certain areas, such as peds-only scenarios?
- Can you please give me the key to making sure I adequately cover all aspects needed to pass this station?

THANK YOU  to anyone who reads and leaves a response.  I've helped others on various website forums, and I want you to know that I truly appreciate you helping me this time around, the tables being turned!

All the best,

Maitai


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## Mellowdnb (Aug 12, 2014)

Hey dude

Mosby and AAOS has case studies for the paramedic. You can find them on Amazon. Kind of pricy for used but not too bad. However, it does help. I would work with that and try to find someone to test you using some of the case studies. Do this for a month and you'll be good to go.

For dosages, get a dry erase board and everyday write down the following for meds : Classification, Action, Indications, Contraindications, Side Effects, Dose/Route and complications. Keep writing until you can repeat all this off the top of your head. The next day, do another 5. Then see if you can remember the 5 you did the previous days. This will build up your memory wicked fast.


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## maitai11 (Aug 12, 2014)

Thanks, Mellow!  Do you know if Oral B has any code 500 scenarios? 
What about the other question - is it like all peds, or adult, or whatever? 

Thanks so much for responding!

Maitai


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## Mellowdnb (Aug 12, 2014)

maitai11 said:


> Thanks, Mellow!  Do you know if Oral B has any code 500 scenarios?
> What about the other question - is it like all peds, or adult, or whatever?
> 
> Thanks so much for responding!
> ...



I'm not sure if Oral B does but I would be prepared for it. Is there an ACLS course offered near your location anytime soon? It might help to take it for any code related questions.

Remember to do a rapid medical survey on all unresponsive medical patients. You never know what you might find. Sometimes pain patches show up and you need to take them off and wipe the skin dry. Nitro patches are another good thing to check for when you have hypotension in an unresponsive medical patient. Here's somethings you might want to check for.

Head - Make sure to check for sunken fontenelles in peds (sign of dehydration) or bulging (sign of infection, ICP, trauma). Check for drainage from ears or open wounds.
Neck - Check for open wounds.
Chest - Check for Internal Defib and Pacemaker, surgical scars, Pain patches and Nitro patches (Be sure to mention to remove and wipe the skin dry)
Abd - Surgical wounds, eviscerations (I've seen quite a few from staples rupturing post surgery), open sores.
groin, extremities, back, butt - same as rapid trauma

Always think about "What else can cause this condition?"

For the seizing kid, think about 1. Fever (ask for temp,) and dehydration (How many diapers have been soaked, check fontanelles) 2. Hypo/Hyperglycemia - Check sugar
3. Head Trauma

Make sure you follow the order of the NREMT medical scenario sheet in order.


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## Handsome Robb (Aug 14, 2014)

I thought you had to redo the whole thing if you failed more than two scenarios?

My advice for oral scenarios is approach them systematically and efficiently but also conversationally. 

Lowers the tension in the room if you're just havingn a conversation discussing a case rather than stiffly interrogating the proctor for information even if that's the ultimate goal.


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## StudMartin (Aug 15, 2014)

Not to hijack the thread, but it seems an appropriate forum...  I have a question for anyone that proctors for the NREMT paramedic practicals...  

In the oral station, if you verbalize in a pediatric scenario that you would give a medication dosage based on the Broselow tape, is that just as acceptable as actually stating the specific pediatric weight based dose?  For example, "I would then utilize the Broselow tape and administer a dose of midazolam to my seizing pediatric patient."

The reason I ask is that I was told that verbalizing the Broselow tape is an acceptable practice by someone who recently passed their exam.  Thanks in advance.


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## Handsome Robb (Aug 15, 2014)

nikc12 said:


> Not to hijack the thread, but it seems an appropriate forum...  I have a question for anyone that proctors for the NREMT paramedic practicals...
> 
> In the oral station, if you verbalize in a pediatric scenario that you would give a medication dosage based on the Broselow tape, is that just as acceptable as actually stating the specific pediatric weight based dose?  For example, "I would then utilize the Broselow tape and administer a dose of midazolam to my seizing pediatric patient."
> 
> The reason I ask is that I was told that verbalizing the Broselow tape is an acceptable practice by someone who recently passed their exam.  Thanks in advance.



Technically yes but I'd force you to verbalized the weight based dose. If you couldn't you'd be dinged for it. 

Know your drug doses. I've been off work for 9 months and can still tell you all our pediatric medication doses, you damn well better be able to straight out of school.


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## maitai11 (Aug 15, 2014)

Handsome Robb said:


> I thought you had to redo the whole thing if you failed more than two scenarios?
> 
> My advice for oral scenarios is approach them systematically and efficiently but also conversationally.
> 
> Lowers the tension in the room if you're just havingn a conversation discussing a case rather than stiffly interrogating the proctor for information even if that's the ultimate goal.



Thanks Robb:

It's twice in the same day, and if you fail the same station twice, as I did, then you have one more chance to take it at a later date.  That later date, for me, will be on September 7th.  Thank for your input, all good!

Maitai


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## Angel (Aug 19, 2014)

you might be over thinking it? i just went in and basically ratted off the protocol. asked lots of questions to rule stuff out, and once i had it narrowed down it was pretty easy from there.


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## maitai11 (Aug 20, 2014)

Angel,

I appreciate that!  One of the things that will be a mantra for me going back in is, "Settle down, don't overthink it, ask everything about the patient and environment, and if even remotely possible, cut all clothes off and re-examine!"

Thank you for your good advice.  Take care. 

Maitai


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## Jon (Aug 24, 2014)

Alright... Here's my take on NR-P testing (they no longer certify folks as NREMT-P, but folks have another couple of years to transition).

I don't know how many scenarios they have, but from what I've seen and heard, it's a crapshoot. Sometimes they are very complicated, sometimes they are rather straightforward. I've only seen Oral A and B once, each, so I can't say for certain, though.

The way I was taught to handle these scenarios is to engage in verbal diarrhea. Keep talking. Talk though everything, and say anything that comes to mind. These stations are MUCH more subjective than some of the other ones.


Oh, and PS - I've never seen any discussion of the rhyme or reason behind the cases presented in the oral stations. I don't know (in fact I doubt) that that info is public record.


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## StudMartin (Aug 26, 2014)

For what it's worth... I took my NRP practicals today and the oral stations were both VERY straightforward and simplistic.  I attribute that mostly to luck of the draw.  On the second scenario in particular I took nearly the full 15 allotted minutes asking question after question, looking for that mysterious thing I was missing, which ended up not even being there.


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## MrJones (Aug 26, 2014)

My orals were so simplistic that I completed each in under 5 minutes. In one I didn't even bother with a SAMPLE; I explained to the examiner why it would be a waste of time and, since I passed, I assume he accepted my reasoning.


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## maitai11 (Aug 27, 2014)

nikc12 said:


> For what it's worth... I took my NRP practicals today and the oral stations were both VERY straightforward and simplistic.  I attribute that mostly to luck of the draw.  On the second scenario in particular I took nearly the full 15 allotted minutes asking question after question, looking for that mysterious thing I was missing, which ended up not even being there.



Hi Nikc12!

Thank you VERY much for your input.  Looks like they really do have a cross section of difficulty, and well, I'll just press on and study every day anyway.  I test on the 7th and can't wait until I'm complete and license in-hand. 

Best,

Maitai


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## maitai11 (Aug 27, 2014)

MrJones said:


> My orals were so simplistic that I completed each in under 5 minutes. In one I didn't even bother with a SAMPLE; I explained to the examiner why it would be a waste of time and, since I passed, I assume he accepted my reasoning.



Thank you for that, Mr. Jones!  I had three or four layers to go through on at least two of my oral stations...the other two I failed due to an incorrect dosing of medication, and I believe the last one, I was just so exasperated that I just brain farted. 

Best,

Maitai


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