# Help with questions....



## Caligrown916 (Sep 23, 2008)

So I have my retest scheduled on thursday. I was hoping you guys could help me out. I know some are really basic but its more for me to clear stuff up.

-So if you have or come a across a patient that becomes or is pulseless and apneic you always apply an AED first thing right?

-Also if you are off duty and you find a person with no pulse should you phone for EMS and then do CPR or do you do perform CPR for a minute and then phone for EMS?

-What is the best way to move a stretcher over uneven ground?

-You got a pregnate patient saying that her water broken and that she feels like the baby is comin. Is this when you would look for crowning? And is crowning the sign that the baby needs to be delivered on the spot?

Please don't respond unless you got input on the questions.


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## Ridryder911 (Sep 23, 2008)

All of that material is located in your textbook. Anyone answering here would do you diservice by "giving" you the answer in lieu of you looking it up. Not to be rude, but maybe, if you hit the text and read more to clarrify those questions, then your score would demonstrate it also. 

Good luck on your test.

R/r 911


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## BossyCow (Sep 24, 2008)

The purpose of the test is to assess your knowledge base. If you truly need help on the questions you listed, you either dogged it through your EMT class or you had a piss-poor instructor.

I am currently teaching a group of 8th graders a CPR class and all of them could answer the AED question correctly.


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## JPINFV (Sep 24, 2008)

Caligrown916 said:


> -What is the best way to move a stretcher over uneven ground?



The same way you move it over level ground. Very carefully.


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## beachemt (Sep 24, 2008)

Caligrown916 said:


> So I have my retest scheduled on thursday. I was hoping you guys could help me out. I know some are really basic but its more for me to clear stuff up.
> 
> -So if you have or come a across a patient that becomes or is pulseless and apneic you always apply an AED first thing right?
> 
> ...



I want to apoligize for those first two response you got cause it sounds like they were having a bad day and arent trying to help anyone out, but instead make sure that everyone knows they are the smartest emt's alive. I know how confusing it is with those questions that list it seems like four correct answers and sometimes texts can be confusing. 
SO
If you didnt witness the collapse cspine if you can and 2 minutes of cpr before calling
Prego pt. Dont just cut her pants off ask her how far apart her contractions are and if she feels the need to push. If she says now ride it in If she says its coming now get your gown on your ob kit out and start acting like you went to med school while your partner hauls a$$ in the rig.

Stretcher moving is the exact same
Cpr Pt. always check abc's Maybe the person is just got something stuck in their throat and passed out always chekc your airway breathing then when you get to c apply the aed
 Good luck with everything


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## Ridryder911 (Sep 24, 2008)

beachemt said:


> I want to apoligize for those first two response you got cause it sounds like they were having a bad day and arent trying to help anyone out, but instead make sure that everyone knows they are the smartest emt's alive. I know how confusing it is with those questions that list it seems like four correct answers and sometimes texts can be confusing.
> SO
> If you didnt witness the collapse cspine if you can and 2 minutes of cpr before calling
> Prego pt. Dont just cut her pants off ask her how far apart her contractions are and if she feels the need to push. If she says now ride it in If she says its coming now get your gown on your ob kit out and start acting like you went to med school while your partner hauls a$$ in the rig.
> ...



*Please Do NOT APOLOGIZE FOR ME!* If I wanted to do so I would. As well, you did not answer all the question and some of your answers are incorrect! So before answering for others and even yourself, make sure what you write is correct. Let's not give erroneous information. 

As a professional educator (and test writer for the NREMT) I realize the most common reason for those that *fail* and those with *repeated failures* is due to lack of studying! Obviously, something the poster failed to do appropriately or they would had passed (since it does have a >68% pass rate) as well all  of those questions are found in the curriculum material, that I suggest both of you might want to review and study! 

Seriously, what type of answer is..."_Prego pt. Dont just cut her pants off ask her how far apart her contractions are and if she feels the need to push. If she says now ride it in If she says its coming now get your gown on your ob kit out and start acting like you went to med school while your partner hauls a$$ in the rig."_? Have you ever treated or examined a full term pregnancy patient? Did you forget to ask the most important questions such duration and intervals of pregnancy, or about previous births, high risk pregnancy, did the bag of waters break, then do you have the feeling of having a bowel movement? Play acting should never be part of one's method of treatment. Again, all of the material that is contained in the textbook, in which one should be turning to for studying instead of asking for short answers. Yes, it is good to ask if, after you have attempted to find the answer yourself. 

Again, let's stick to factual and accurate answers. 

R/r 911


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## Guardian (Sep 24, 2008)

Lol ^.........


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## Caligrown916 (Sep 24, 2008)

The only reason I posted the questions was because even though I read the material im still confused on these particular questions. I wasn't trying to just have you guys just tell me the information I just wanted it to be confirmed of what I already know. These are questions that came about after I took the NREMT and read the material and was still unsure on what they were. The question regarding the patient saying that she is feeling the baby coming and that her water has broken was on the NREMT and I was split on look for crowning or prepare for delivery because in order to look for crowning you have to position for delivery so that was confusing. And the question regarding the AED stemmed from a question where you got a middle age man behind the steering wheel of a car and bystadners tell you that he slumped and drifted off the road and your unable to find a pulse. Would I hook him up to an AED right away or try to extricate him out the car to be able to perform CPR along with the AED?

So again this ain't me trying to just get you guys to just tell me the answer im just trying to just get stuffed cleared up so I can go into my test confidently tommorow.


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## BossyCow (Sep 24, 2008)

Caligrown916 said:


> The only reason I posted the questions was because even though I read the material im still confused on these particular questions. I wasn't trying to just have you guys just tell me the information I just wanted it to be confirmed of what I already know. These are questions that came about after I took the NREMT and read the material and was still unsure on what they were. The question regarding the patient saying that she is feeling the baby coming and that her water has broken was on the NREMT and I was split on look for crowning or prepare for delivery because in order to look for crowning you have to position for delivery so that was confusing. And the question regarding the AED stemmed from a question where you got a middle age man behind the steering wheel of a car and bystadners tell you that he slumped and drifted off the road and your unable to find a pulse. Would I hook him up to an AED right away or try to extricate him out the car to be able to perform CPR along with the AED?
> 
> So again this ain't me trying to just get you guys to just tell me the answer im just trying to just get stuffed cleared up so I can go into my test confidently tommorow.



The reason we 'jumped on you' is not because we had a bad day as has been suggested by the other poster, but because the questions you asked are actually very simple, and the answers are a natural progression of the skills you should have been taught. 

Test taking is a skill. Being able to wade through the if's and the red herrings to distill the question down to the facts. Then you apply protocols to the facts and you have the correct answer. If you are unable to wade through these in the calm of a testing room, how are you going to be able to access the information on the side of a highway, with cars passing you @60mph, the rain running down the back of your neck and family members looking at you? 

ABCs, a slumped pt... hmmmm what is that airway like? Are they breathing? How do you apply an AED to a pt 'slumped' in a car? Do you even have access to the pt's chest? Once the pads are applied are you going to be able to clear prior to shock? This is different from the question as initially presented which was.



> So if you have or come a across a patient that becomes or is pulseless and apneic you always apply an AED first thing right?



As to the other questions... -





> Also if you are off duty and you find a person with no pulse should you phone for EMS and then do CPR or do you do perform CPR for a minute and then phone for EMS



What were you taught regarding the process of starting CPR. Under what circumstances do you do CPR for a minute first and then call.. and under what circumstances do you call first.. this is covered in basic CPR training. As I said in my initial post, the 8th graders I am teaching could all answer this one correctly. 

I'm sorry if this interferes with your ability to take your test with confidence. But based on your posts, confidence would be misplaced.


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## Ridryder911 (Sep 25, 2008)

I would like to add that testing is one way of screening those that will be able to enter the field and profession of EMS.

The point being, test are designed purposefully to be somewhat confusing, misleading with several detractors and stem-key type questions. I would hope your school or training site had prepare you for such test. It is a common knowledge that the NREMT Basic examination is one of the easiest health care examinations for a certification level. It *only reflects the minimum* level accepted. As well each test question has one foolish absolutely wrong answer, one mediocre, and two that are very similar but one has to choose the *most correct *answer.

The NREMT can only judge the didactic and base knowledge of an applicant. The skills portion tests from your school will validate your knowledge of being able to able to minimally perform the needed skills. 

Take out specific time to reflect and review through each objective listed in front of the chapter. These are the NHTSA EMT curriculum requirements that the NREMT is based upon. 
Also, review the AHA Healthcare providers BLS book, which is the number one portion that is failed on the NREMT exam.

R/r 911


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## mycrofft (Sep 25, 2008)

*I'm from L.A.*

The best way to move a stretcher over uneven ground is to pave it.
As for the exam, take it from them.


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## Pamela (Sep 25, 2008)

So I've been lurking on this site for a long time. I like to read the posts and catch up on EMS related information even though I may not have much to share myself. But I have noticed a trend here that saddens me and makes me question why I come to this site. I feel like there are many people on this site who are condescending and belittling. The OP came here for help. If you don't feel like helping why respond to the post at all? It's not encouraging and comes off more than a little rude. Why wouldn't you want the OP to do their best? I'm sure they're not going to pass/fail the NREMT due to being helped with a few misunderstandings. I'm not sure I understand why the simplicity of the questions are reasoning for not answering them. Am I the only one who remembers what it was like being a fresh student and easily confused? I would have been grateful for sites such as these with seasoned profesionals to answer my questions. I especially don't understand how those of you in teaching capacities can come here and tell individuals "their confidence is misplaced," instead of assisting. If the OP wasn't taught/doesn't understand the necessary skills then that will be their downfall. But why not help with what we can and at least be encouraging? If I'm not confused the very title to this section of the forum is "NREMT: For all QUESTIONS related to the NREMT, testing, and practicals." Just thought I'd say something.


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## CPG (Sep 25, 2008)

*Questions*

I for one appreciate the questions that are being asked.  As a new Basic, I take the questions as a chance to re-learn, even though I passed already.

I say, ask away!!


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## Ridryder911 (Sep 25, 2008)

The reason for being blunt (not rudeness) is for several reasons. Why come to a forum to ask how to answer questions on a board examination? Sorry folks, either you should know this or learn how to study. No one should hand spoon you information. This is part of the problem with EMS, EMS students, and those involved in educating in EMS. Many students and even EMT's want things done for them. 

Did they actually go through all the text to see if they could find and locate the answers, or review multiple texts to look at comparison's? Again, the difference between being a medical professional and a first-aider. 

Too many so called "students" go to forums in attempt to have questions immediately answered. Did they actually learn anything? Will they actually remember it? Did they actually study, did they read the required reading before asking?, As well, was the information accurately answered? Even in this post, erroneous and wrong answers were given. Now, do you want to trust your license/certification based upon that or... even performing patient care on that information? Too many students and candidates want things to be "spoon fed" to them. This is not only wrong but will have dangerous consequences. 

Forums are designed to discuss topics, spark interest, yes even give new and current care *but * it is *NEVER* to replace reading and studying from accredited texts and literature. When discussion of treatment modalities, or even in-depth discussion occurs, it is again only a intellectual discussion to spark interest to study and read more, never to replace or given as a fact. You will see those of us (i.e Vent,. Flight LP, AK) as experienced licensed providers always be able to refer new topics, methods, and even standard care to approved curriculum, or scientific based literature, not off the hip information. 

The old saying "_there is never a stupid question_" is really not correct. One should attempt to answer the question themselves before asking. If one cannot find the answer after investigating, reading, research then should ask.  

Confidence is self motivated. No one on a forum, or even within a business is going to inspire this quality. Part of developing self confidence is by learning and obtaining information by gathering the information themselves. Hence the word.. *self* confidence. If obtaining answers such as read the objectives, of referring them to specific journals or texts discourages them, then these type of individuals will never fair well in the workforce of EMS and personally we do not need them. Medicine requires tenacity, and individual drive to perform at the best. 

R/r 911


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## reaper (Sep 25, 2008)

You know how many EMT's I see that took the test 5 times before they passed! This does not mean they know what they are doing or that they studied. This means they got Lucky and passed after 5 tries. I do not want someone like this treating my family or friends.

When you look up the answers yourself, you are more likely to learn and retain the information. This is what All on here want from a new EMT. If you can come here and prove that you have researched the subject, but are unable to find the answer. Then you will be more likely to get help for someone.

The questions that were asked, are very basic and simple ones. They are in the text book and should be looked up on their own.


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## FF-EMT Diver (Sep 25, 2008)

Welcome to the world of EMS where everyone knows more than the other, I personally have never cared for anyone who when i asked a ? would not give me an answer, Now I was fortunate to have a fine Instructor who way overteaches his students and when I was doing my clinicals I rode with two services (1) was a bunch of know-it-alls that felt like they had been there done that so all your ? were dumb the service had no morale, the number (2) service is where i rode after my first day with other service ( Did I mention I DO NOT LIKE ARROGANT PEOPLE?) anyway this service was great, Morale was high, Pt. care topnotch, they also offered me a job before I ever finished school, Now I am not going to judge your ? as to wether they are simple or not because different people have different things they are better at, Also do not get discouraged, do your studying( I picked up on the part where you said you had came to your conclusion and just wanted reassurance) Although you need to know this stuff like the back of your hand more will come in the back of the truck,Secondly this may be a good place to get help but you would do better finding someone you can trust who will give you a straight up answer because on here you have no way to verify thier advice or thier credentials so take it forwhat it is, Just to say I'm not blaming anyone for the tests but in school I failed no tests and per several PMDS and Instructors he was hard, out of 13 students half passed first time some have not after 4, I passed first and there were some ? that were totally out there (to me), Hope you do well and let us know how you did, P.S. I never hold anyone to a credentails unti they have them, So as a student ask away!!!


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## Ridryder911 (Sep 25, 2008)

FF-EMT Diver said:


> Welcome to the world of EMS where everyone knows more than the other, I personally have never cared for anyone who when i asked a ? would not give me an answer, Now I was fortunate to have a fine Instructor who way overteaches his students and when I was doing my clinicals I rode with two services (1) was a bunch of know-it-alls that felt like they had been there done that so all your ? were dumb the service had no morale, the number (2) service is where i rode after my first day with other service ( Did I mention I DO NOT LIKE ARROGANT PEOPLE?) anyway this service was great, Morale was high, Pt. care topnotch, they also offered me a job before I ever finished school, Now I am not going to judge your ? as to wether they are simple or not because different people have different things they are better at, Also do not get discouraged, do your studying( I picked up on the part where you said you had came to your conclusion and just wanted reassurance) Although you need to know this stuff like the back of your hand more will come in the back of the truck,Secondly this may be a good place to get help but you would do better finding someone you can trust who will give you a straight up answer because on here you have no way to verify thier advice or thier credentials so take it forwhat it is, Just to say I'm not blaming anyone for the tests but in school I failed no tests and per several PMDS and Instructors he was hard, out of 13 students half passed first time some have not after 4, I passed first and there were some ? that were totally out there (to me), Hope you do well and let us know how you did, P.S. I never hold anyone to a credentails unti they have them, So as a student ask away!!!




First, welcome to the site but WOW! I am sure that had a lot to say; but it was so hard to decipher, I became as confused as some of the NREMT test questions. Are you really sure it made the point you wanted it too? ...


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## guardwantsmore (Sep 25, 2008)

I'm new to the site as well, and retook my 2nd NREMT last week.  I passed.  I would have to agree with the poster that says the information is in our book.  Although I would gladly answer questions, I would higly encourage the applicant to very carefully go through his materials.

I didn't pass the first time.  That week was a very stressful work at work (I work as a lifeguard) and was pulling 12 hour shifts (the norm shift is about 6-8 hours) at the last minute.  I worked every day for 10 days.  I DID NOT study like I wanted to.  Went in, took the test in 30 minutes (very bad).  Walking out of the test center I knew it was bad.  I knew I did not pass because 1) I didn't study like I wanted to.  2) I didn't bother slowing my brain down to read the questions correctly.

I waited the 15 days to reapply.  I re-applied.  And then I went and found this book by "Learning Express."  There were 3 multiple choice practices tests and a 4th "test" which was more open book where you had to write out the correct answet.  I took the appropriate time off work.  I was taking the practices tests.  Going over the questions I missed.  And after the multiple choice was done, and the "write in" part was next, I realized how much I couldn't figure out without looking at blatent wrong answers...  I felt terrible!  So I cracked open my book, and writing the words, instead of filling in a bubble helped me MORE to understand the concept, instead of just picking it out of a list.

So, as for questions, sure, ask, someone will answer.  But always go back and review it in your book.  There are also "practice" tests out there that will tell the right answer and why the answer is correct.  Learn your stuff, don't just try to get lucky.


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## mikie (Sep 25, 2008)

.......as for moving the stretcher on uneven ground (such as grass, gravel, etc), I have always added a little 'lift' with my partner to it.  Kinda like holding it up while keeping majority of the weight on the ground.  basically like adding suspension.  that and our stretcher has the nice rugged wheels (made for snow I believe)!


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## BossyCow (Sep 25, 2008)

> Welcome to the world of EMS where everyone knows more than the other, I personally have never cared for anyone who when i asked a ? would not give me an answer, Now I was fortunate to have a fine Instructor who way overteaches his students



I'll bet with a first rate instructor, your questions were not the type asked by the OP. I love a student who asks questions in class. I encourage all new EMT students to ask questions often in class. But did you read the questions asked by the OP? The way the questions were phrased, by someone who has failed the initial exam, implies someone who doesn't get it and isn't likely to in the near future.




> Now I am not going to judge your ? as to wether they are simple or not because different people have different things they are better at, Also do not get discouraged, do your studying( I picked up on the part where you said you had came to your conclusion and just wanted reassurance) Although you need to know this stuff like the back of your hand more will come in the back of the truck,



So, do you want this person treating your loved one until that OTJ training kicks in, or would you assume that basic CPR would be mastered if not prior to entering EMT class, at the very least by the end of the class?



> Secondly this may be a good place to get help but you would do better finding someone you can trust who will give you a straight up answer because on here you have no way to verify thier advice or thier credentials so take it forwhat it is,



Hmm like maybe this should have been asked, answered and understood before taking the test?

I am an instructor, and I've seen my share of students come and go. I've seen a wide variety of skill levels in EMS. I will always support anyone who is trying to learn. I will always jump on someone who is trying to shortcut the system because they just want the credential so they can start working. What we do matters, or at least it should.


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## FF-EMT Diver (Sep 25, 2008)

I agree with your statement that the poster should know his stuff as well as study like crazy I spent mutiple hours studying myself, But the Op has already finished school so if he isnt prepared then shame on his Instruc, But I am saying that constructive encouragement goes a lot farther than destructive discouragement, Again I am not griping about the NREMT testing it is what it is, And I can see where maybe it may really be the best way to test one's ability to think under pressure for the best answer( Nervousness of testing, Time Limits, ETC...), Although I do not feel that the test really tested my field skills, It tested my ability to quess what they were asking for. Also I want to  say I appreciate the posts from experienced people as yourself and ridryder I have been browsing over the whole site and can see that ya'll contribute a lot of information on a lot of different subjects it shows that ya'll are knowledgable on a lot of issues, BUT in my honest opinion some posters jumped on the OP to strongly without knowing a little background, (Just my.02)


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## GonnaBeEMT (Sep 26, 2008)

mikie333 said:


> .......as for moving the stretcher on uneven ground (such as grass, gravel, etc), I have always added a little 'lift' with my partner to it.  Kinda like holding it up while keeping majority of the weight on the ground.  basically like adding suspension.  that and our stretcher has the nice rugged wheels (made for snow I believe)!



This may seem like common sense, but go up or down an incline with the patient's head facing forward.  Don't push a stretcher up or down an incline sideways, because they tip over reeeeeally easy that way.


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## Caligrown916 (Sep 26, 2008)

Took my test ended at about 72 and im pretty sure that I got the last one wrong so now im pretty nervous. The last question was something like call to a drunk uncoopertive 15 yr old that fell and complains of neck pain. I was split on having law enforcement contact parents or contact parents to sign refusal form.


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## T1medic (Sep 26, 2008)

As for the stretcher over rough terrain if I recall my text correctly, the best way to transport is in the lowest position possibly.


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## daimere (Sep 26, 2008)

I am only half way through my training but can answer most those questions.  It's in your book.  Study a little more.  Go back to your institution of learning and ask the instructors.  I know mine would welcome someone asking something like that.  Practice your test taking skills.


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## lalaneedstopass (Sep 27, 2008)

Caligrown916 said:


> Took my test ended at about 72 and im pretty sure that I got the last one wrong so now im pretty nervous. The last question was something like call to a drunk uncoopertive 15 yr old that fell and complains of neck pain. I was split on having law enforcement contact parents or contact parents to sign refusal form.



Well technically, the p/t is a *child*. Therefore, wouldn't this be implied consent and you have to treat the p/t? And if they are uncooperative you would attempt to restrain? I mean I'm still a student so I'm not really sure on it. But whether the p/t is 15 or 3 you still treat them because they are still considered a child and you contact the parents for a possible rendezvouz if they decide against treating the child. You don't just call and wait for them. But that is just my opinion, like I said I'm still learning so I have no idea. But I would love to know the answer of what to do in that case. Because anybody under the age of 18 is a child and unless parents are present it is implied consent. Unless they are 16 and pregnant or the parents are present then it would be based on expressed consent. Because what if the parents are present with this drunk 15 y/o and they are saying to treat the p/t. Their expressed consent over rules the childs. And if they deny and you believe the child needs to be transported then you express your feelings and try to persuade the parents the necessity of it, sign refusal, document, and have law enforcement take it up with them. :unsure:


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## lalaneedstopass (Sep 27, 2008)

Caligrown916 said:


> So I have my retest scheduled on thursday. I was hoping you guys could help me out. I know some are really basic but its more for me to clear stuff up.
> 
> -So if you have or come a across a patient that becomes or is pulseless and apneic you always apply an AED first thing right?
> 
> ...



I know it says don't respond unless you have input, but I have to agree with the majority of the responses. These are clear cut answers. I know after 2 times of failure the questions are tricky but those first 2 questions are definitely in my CPR book which is only about 30 pages. Not only that, they are in my textbook. And they aren't answers where you start and page 2 and have to flip to page 300 for more extent on one part and then page 150 for another part. They are all right there. The stretcher question should also be located within moving and lifting p/ts and basically common sense. Move it _carefully_!! and depending on the p/t condition and the environment is what type of stretcher and how to move it and such. Such as the pregnant p/t, like someone else had said you need to ask all those basic questions for any pregnant p/t, baby coming or not. And if the baby is crowning, that's basically embedded into my brain whether or not you deliver. Just because crowning is present doesn't mean deliver ASAP. You have to ask all the basic questions first to determine whether or not it's even SAFE to deliver on the spot. You have to make sure everything is stable, make sure this is a normal birth, make sure of no possible complications. Just because you see the head and the p/t is 35 weeks gestation are you going to want to deliver? What about cord around the neck you can't get off? Your pregnant question is very very broad.


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## Caligrown916 (Sep 29, 2008)

Got my results today and I PASSED!!!! I guess the last question doesn't really mean anything. Thanks to all who helped.


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## CPG (Sep 29, 2008)

Caligrown916 said:


> Got my results today and I PASSED!!!! I guess the last question doesn't really mean anything. Thanks to all who helped.



Congrats to you!!  Now the real education begins.

I have had my eyes opened since I joined a service.  It is not all fun and games, and all that basic assessment kinda goes out the window.

Just remember.....Get your people to the bus in 10 minutes or less, you can assess on the way to the hospital.

All Traumas (within reason) are PUHA (Pick Up Haul ***)

Good luck EMT!!


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## JPINFV (Sep 29, 2008)

CPG said:


> I have had my eyes opened since I joined a service.  It is not all fun and games, and *all that basic assessment kinda goes out the window.
> *



Mind clarifying that statement for me? There's two ways I can see that being interpreted as, and one is spot on and the other is dreadful.


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## CPG (Sep 30, 2008)

JPINFV said:


> Mind clarifying that statement for me? There's two ways I can see that being interpreted as, and one is spot on and the other is dreadful.




Sure..

For example, Cardiac patient.

In school you learn all the basic assessment crud, SAMPLE, rapid pat-down to determine DCAPBTLS, OPQRST, load into bus, go to hospital.

In real life.....Get on scene, find patient, load into ambulance, start headed to hospital, then SAMPLE, monitor for SpO2, NIPB, IV start.

In other words, what you learn in school is not really what you do in the field.  The class is meant to teach you to pass the exam and practicals only. The field training teaches you to be a medic.  My Field training officer told me when I started..."There's nothing more dangerous than an EMT with only class experience"


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## JPINFV (Sep 30, 2008)

So basically you lose any and all ability to interview bystanders if a patient is altered or get report from healthcare providers if in a long term care facility. Don't get me wrong, I'm a firm believer that a "sick/not sick" style assessment can be done in about the time it takes to go from the door to the patient. As such, I see no problem with the immediate load and go treatment EMT-Basics in terms of critical patients. If the patient isn't critical, why shouldn't a proper assessment and treatment be done on scene? Why the rush?

As well, anyone who thinks that class time is only for "exams and practicals" is an idiot. That's like saying a physician only goes to school to pass the USMLE.


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## Ridryder911 (Sep 30, 2008)

CPG said:


> Sure..
> 
> For example, Cardiac patient.
> 
> ...



*WHOA!..*

I don't know about your so called field officers or how you perform medicine, but if the exposure of that is not the way you do things mentality or that is only to pass the exam, their dangerously playing Russian roulette. 


Sorry to inform you, but there is a thing called *medical standards*. These standards are what you are judged, evaluated and compared to if and when a litigation case comes up. Also, you are informing us that a person with the general maximum level of education of a few nighttime courses is more experienced and knowledgeable than the physician, Paramedic, Critical Care Nurse that authored the book? Anything else you would like to sell with that horse feces? 

Yes, not everything is textbook. We all know that, it is not black or white, there is a lot of gray. Yet, at the same time asinine statements such as "load and go" and "do everything en-route" mentality is usually for two reasons. Those that either do not know how or their system sucks so bad, that they have to "hurry" on every call and do not have enough responding trucks, everything has to be done enroute. 

The call us a system for a reason. Did you hear the  load & go mentality left in the 60's? Hence the reason for EMT's. If you wanted to load and go, why have EMT's? Anyone can do that.  Did you not learn or hear about "stabilizing the patient for transport"? Not, stabilize en route or while transporting. Hence the reason EMS was even developed!

Just ask yourself, would your so called heroes win in court? (remember, they will be judged to the curriculum, and to what other EMT's do) Do they really offer care to the patient or just a ride in with some performance en route? 

There are very few times, there is a need to rush a patient to the hospital, or perform an assessment or even most of the treatment en route. Those cases again are rare and should be weighted what is best for the patient. Are they really time sensitive? Yes, there is time sensitive cases but again, knowing and when to do such is the part of the job.

Please realize that not all so called EMS services promote or even deliver good care (yes, some call themselves EMS but really are nothing more than a glorified ambulance service) and just because one maybe employed at such may not mean all are that way. I have worked at one (noticed past tense) and refused to continue to do so. There are too many out there that does an excellent job. 


Before offering advice, be sure the advice is sound and legitimate. 
R/r 911


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## Flight-LP (Oct 1, 2008)

CPG said:


> Sure..
> 
> For example, Cardiac patient.
> 
> ...



Yes there is, the person who actually believes that garbage you just spewed..................

That assessment "crud" is your backbone of diagnostics. Without it you cannot remotely function to any level of medical provider. Even laypersons learn a basic assessment for the ABC's.

Your real life take is innacurate. What about interviewing pt. on scene, ADMINISTERING OXYGEN PERHAPS, maybe doing a thorough and complete set of manual vitals? Maybe after that you could venture into possible assisting patients with their prescribed medication or if your local protocol allows, give ASA or NTG if not contraindicated. Don't worry about playing with a monitor or pulse oximeter, and you shouldn't remotely be worrying about an IV.

Field training is not where you learn to be a medic, it's where you learn bad habits and hazardous attitudes such as what you have now.

Sorry my friend, but your attitude and beliefs absolutely suck!


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## ffemt8978 (Oct 1, 2008)

Training is learning the rules, experience is learning the exceptions...

Knowledge is learning that most things are exceptions rather than rules.

Wisdom is learning how to differentiate between them.


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## Hastings (Oct 1, 2008)

Flight-LP said:


> That assessment "crud" is your backbone of diagnostics. Without it you cannot remotely function to any level of medical provider. Even laypersons learn a basic assessment for the ABC's.



I'm sure I cover it in my assessments unknowingly, but I have no idea what CRUD is. What is CRUD?


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## JPINFV (Oct 1, 2008)

My EMT-Basic instructor was able to work "CHOD" into a memory aid (Shock: cardiogenic, hypovolemic, obstructive, distributive).


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## marineman (Oct 2, 2008)

FF-EMT Diver said:


> the Op has already finished school so if he isnt prepared then shame on his Instruc



Oh wow. Your instructor isn't there to forcibly make you pass the NREMT. Your instructor is simply there to guide the learning that you should be doing on your own. If you fail a test it's because you didn't put the effort in on your end to actually understand the information. 

R/r you sure get picked on a lot because you don't tell people exactly what they want to hear. Let me say I would love to have you as my instructor as I'm sure I would come out an amazing paramedic because you make people actually give more than an ounce of effort. You get the prize for the best advice in the thread with your first post.

To the OP something you will realize is people are not trying to bash you or put you down but coming here and posting rather than looking in the text is the easy way out and if we just told you the answers you would memorize them for the test and not be able to apply them 6 months down the road when faced with a real situation.

Threads like this seem to be fairly common around here and here's my view on how to get better results in the future. Write down the questions you want to ask, look through your text to see what it says the answer should be, then come on here and post the question and the answer and say why is it done this way. That method shows that you don't want the easy answer but you want to be able to understand something.

An example from your question: On a witnessed arrest you immediately place the pads, then begin CPR (all of this after ABC's blah blah). On an unwitnessed arrest you do 2 cycles of CPR then apply the pads. Why is this the case?

I'm going to guess that had you asked it in that manner the answers would've said something about the BP dropping during the time that they were down from blood weeping out of veins and through capillaries and doing compressions will help bring pressure back up and you will have better results from a defib if they have a higher pressure at the time that their heart starts.


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## Hastings (Oct 2, 2008)

marineman said:


> An example from your question: On a witnessed arrest you immediately place the pads, then begin CPR (all of this after ABC's blah blah). On an unwitnessed arrest you do 2 cycles of CPR then apply the pads. Why is this the case?



To prime the pump! 

Haha, I'm so sick of hearing that phrase. I still have no idea what it means.



Also, you're wrong. On a witnessed arrest, you immediately attach the pads, assess rhythm, and shock (rhythm permitting, though odds are that anyone who arrests in front of you is in such a rhythm), THEN get to CPR. Or you can punch them in the chest first. That's also acceptable.


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## JPINFV (Oct 2, 2008)

Hastings said:


> To prime the pump!
> 
> Haha, I'm so sick of hearing that phrase. I still have no idea what it means.




It comes from people comparing the heart to a mechanical pump a little too much. In a mechanical pump, you want to have liquid in the pump before you start it so that the pump isn't running dry. A pump that has has liquid in it is "primed" and the act of putting water in it is "priming." Of course the similarities between mechanical pumps and biological pumps essentially ends after the idea that both move fluid, hence why the analogy is a little off.


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